bluuebunny/crossref_metadata_2025 huggingface dataset:
Pendekatan Penilaian Gedung Penting Yang Tidak Direncanakan Secara Patut
Authors: Kimsan Masykur
Published: February 2025

This study investigates the technical condition of the Air Traffic Control (ATC) tower at Halu Oleo Airport, Kendari, with a focus on its foundation and structure. The selection of this building is motivated by the critical need to ensure its safety and adequacy in earthquake-prone areas, particularly following the devastating Palu earthquake in 2018. This research encompasses a comprehensive scope of field testing, including visual surveys, soil testing using cone penetration tests and hand-boring, as well as non-destructive testing such as hammer tests, ultrasonic pulse velocity measurements, and rebars locators. The selection of these methods is tailored to the operational requirements of the building. Both field and laboratory analyses reveal significant shortcomings in the structure's compliance with required concrete strength standards for earthquake-resistant buildings. Additionally, deflections in the structure do not meet the necessary criteria for optimal performance during seismic events. Finite Element Method (FEM) analyses of the upper and foundation structures indicate that the foundation's load-bearing capacity is insufficient for demanded earthquake loads, while the upper structure's natural period exceeds standard requirements. For all seismic scenarios considered, the structure fails to meet criteria for deflection (serviceability) and strength, resulting in performance at the Immediate Occupancy – Life Safety level. This implies that while the structure is safe for use, it requires maintenance and repairs to achieve better performance levels. Recommendations for improvement include reinforcing the entire structure, from the foundation to the upper levels, with construction materials that meet earthquake standards, or constructing a new ATC building that adheres to current regulations. Consequently, this study offers an alternative approach for evaluating critical buildings in earthquake-prone areas.
Perceptions of the term “abstinence” among adolescents and young adults: a qualitative study on alcohol non-consumption in Switzerland
Authors: Fernandes Palhares Diana , Chok Lorraine , Suris Joan-Carles , Barrense-Dias Yara
Published: February 2025

As part of a broader qualitative study aimed at understanding the experiences and opinions of adolescents and young adults (AYA) who do not drink alcohol in Switzerland, participants were questioned about their perceptions of the term “abstinence” in the context of alcohol non-consumption. Twelve focus groups were conducted with 63 participants (36 females, 27 males), aged between 14 years and 20 years. Participants were grouped by gender, age (based on Swiss alcohol laws), and drinking status (non-drinker or drinker). The discussions were recorded and transcribed, and thematic content analysis was used to identify and categorize key themes. The terms “abstinence,” “abstainer,” and “abstention” were generally considered unsuitable when describing young people who do not consume alcohol regardless of the drinking status of the participants. The connotation carried by the terms was mostly perceived as religious, sexual, negative and stigmatizing. “Abstinence” was considered more appropriate for adults who have stopped drinking due to alcohol-related issues. When referring to youths, terms such as “non-drinking,” “non-drinkers” or “alcohol non-consumption” were preferred, especially to better integrate non-drinking youths and positively highlight their choices in preventive and educational initiatives.
Advanced biomaterials in pressure ulcer prevention and care: from basic research to clinical practice
Authors: Tian Shaoqiang , Bian Wei
Published: February 2025

Pressure ulcers are a common and serious medical condition. Conventional treatment methods often fall short in addressing the complexities of prevention and care. This paper provides a comprehensive review of recent advancements in advanced biomaterials for pressure ulcer management, emphasizing their potential to overcome these limitations. The study highlights the roles of biomaterials in enhancing wound healing, preventing infections, and accelerating recovery. Specific focus is placed on the innovation and application of multi-functional composite materials, intelligent systems, and personalized solutions. Future research should prioritize interdisciplinary collaboration to facilitate the clinical translation of these materials, providing more effective and tailored treatment approaches. These advancements aim to improve the quality of life and health outcomes for patients by offering more reliable, efficient, and patient-specific therapeutic options.
A model for preliminary cost estimation in buildings construction projects
Authors: Jassim Hassanean S. H. , Hasan Musaab F. , Altaee Mohammed J. , Gamil Yaser
Published: February 2025

Despite recent rapid developments in computer programs used to improve buildings construction sector cost estimation techniques, costing models utilizable in a building construction project’s early planning stages remain scarce due to the lack of a simplified, integrated method that can operate with the limited data available. This research aimed to help buildings construction project stakeholders in Iraq to improve the accuracy of preliminary buildings project cost estimations based on the initial information available and historical buildings project data to evaluate a future project’s feasibility. A literature review of topics related to preliminary cost estimation, particularly buildings projects and factors affecting their cost, informed development of an integrated mathematical model based on a support vector machine to facilitate preliminary cost estimation during early buildings construction project planning utilizing relevant factors from both old and new projects (i.e., total floor area of buildings, construction duration, total number of floors, average floor height, location index, project quality standards, project complexity, and facilities provision). To enhance accuracy, the final cost forecasting model was modified using an inflation rate impact scenario to account for any future economic effects on anticipated building costs. This study concluded that the dominant factors behind cost variations between similar projects over different periods, and thus the primary factors for building cost estimation, are building area, average floor height, and number of floors. Thus, this study contributes to enhancing best practice in cost estimating for building construction projects in the pre-design, early planning phase, enabling decision makers to plan alternative options to enhance decisions on feasibility within the project’s constraints. Novelty arises from the features of the input factors used for the developed model to determine the preliminary budget required in the early planning stage taking into account construction sector inflation values for the following period.
Discrete choice experiments: a primer for the communication researcher
Authors: Reynolds Reed M. , Popova Lucy , Yang Bo , Louviere Jordan , Thrasher James F.
Published: February 2025

Experiments are widely used in communication research to help establish cause and effect, however, studies published in communication journals rarely use discrete choice experiments (DCEs). DCEs have become a mainstay in fields such as behavioral economics, medicine, and public policy, and can be used to enhance research on the effects of message attributes across a wide range of domains and modalities. DCEs are powerful for disentangling the influence of many message attributes with modest sample sizes and participant burden. The benefits of DCEs result from multiple design elements including stimulus sets that elicit direct comparisons, blocked and/or fractional factorial structures, and a wide range of analytic options. Though sophisticated, the tools necessary to implement a DCE are freely available, and this article provides resources to communication scholars and practitioners seeking to add DCEs to their own methodological repertoire.
Effects of exercise on pulse wave velocity in hypertensive and prehypertensive patients: a systematic review and meta-analysis of randomized controlled trials
Authors: Xi Haoyu , Du Liwen , Li Gen , Zhang Shiyan , Li Xiang , Lv Yuanyuan , Feng Lin , Yu Laikang
Published: February 2025

Background

This study aimed to examine the effects of exercise on pulse wave velocity (PWV) in hypertensive and prehypertensive patients.

Methods

A comprehensive search was performed in PubMed, Cochrane, Embase, Scopus, and Web of Science, covering data up to August 31, 2023. A meta-analysis was conducted to determine the weighted mean difference (WMD) and 95% confidence interval for the effects of exercise on PWV in hypertensive and prehypertensive patients.

Results

A total of 17 studies met the inclusion criteria. Exercise had a significant effect on improving PWV in hypertensive and prehypertensive patients (WMD, −0.93, P = 0.0001). Subgroup analysis showed that aerobic exercise (WMD, −1.29, P = 0.0004) significantly improved PWV in hypertensive and prehypertensive patients. Moreover, aerobic exercise, specifically moderate-intensity aerobic exercise (WMD, −1.69, P = 0.03), conducted for ≥12 weeks (WMD, −1.54, P = 0.002), ≥3 times per week (WMD, −1.44, P = 0.002), ≤60 min per session (WMD, −1.50, P = 0.02), and ≥180 min per week (WMD, −0.57, P = 0.005), was more effective in improving PWV in hypertensive and prehypertensive patients, especially in middle-aged individuals (WMD, −1.78, P < 0.0001).

Conclusion

To improve arterial stiffness, hypertensive and prehypertensive patients, particularly middle-aged individuals, are recommended to participate in a minimum of 12 weeks of moderate-intensity aerobic exercise at least 3 times per week for less than 60 min per session, with a goal of 180 min per week being achieved by increasing the frequency of exercise.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=458981, identifier: CRD42023458981.
The activation and slip of laboratory faults containing gypsum gouge under triaxial stress conditions
Authors: Liu Han , Si Hu , Yang Zili , Xu Dayang
Published: February 2025

Understanding the activation and slip characteristics of faults is essential for the safety and stability of underground engineering. The mechanical behavior of laboratory faults with gouge of specific strength remains unclear. Therefore, triaxial compression tests were performed on saw-cut sandstone specimens containing artificial gypsum gouge. Strength criteria analysis, crack pattern analysis, and fault surface roughness evaluation were conducted to investigate the effects of dip angle, confining pressure, and loading rate on the failure modes and stick-slip characteristics of the faults. The results indicate that as the fault dip increases, the fracture mode transitions from rock damage to shear failure along the saw-cut surface. Fractures within the gypsum fault gouge result in deviations between the measured and theoretical strength values. The magnitude of the normal stress controls the fault surface roughness and the variations in the stress drop during fault activation. An increase in the loading rate results in a transition from stick-slip behavior to stable slip. This study enhances the understanding of fault stability and provides valuable insights into monitoring strategies for underground engineering and earthquake prediction.
A quantitative coupling degree model for source-to-sink (S2S) system through entropy weight-coupling theory: a case study of the Chengbei Low Uplift area, offshore Bohai Bay Basin, Eastern China
Authors: Ji Xinyuan , Xu Chunqiang , Li Wenrui , Wang Qiming , Hu Hewei
Published: February 2025

Introduction

Source-to-sink (S2S) analysis plays a crucial role in sedimentological studies, serving as an effective tool for reconstructing sediment-routing processes and guiding hydrocarbon exploration. Numerous studies on S2S systems have focused on examining the correlations among subsystems by statistically analyzing and characterizing the parameters of the S2S system. However, few studies focus on quantifying the degree of interaction (i.e., the coupling degree) between multiple sub-S2S systems, leading to a biased understanding of coupling mechanisms, S2S processes, and exploration potential.

Methods

To address this issue, we developed a quantitative model for coupling degree based on entropy weight-coupling theory (EW-CT), providing a novel framework for systematically evaluating the interactions within S2S systems. The Paleogene Chengbei Low Uplift (CBLU) in the Bozhong Sag, offshore Bohai Bay Basin (OBBB) in eastern China, serves as a case study to validate the model and examine the multi-hierarchy S2S coupling mechanisms as well as the exploration potential in an ancient uplift system.

Results

The main findings are: (1) the CBLU is divided into five second-level S2S systems (P/Q/R/S/T), with the study area (S) further subdivided into six third-level sub-S2S systems (S1–S6); (2) there is a positive correlation between EW-CT values and coupling degree in the S2S systems; (3) the coupling degree of the eastern braided-delta S2S systems (S4–S6) exceeds that of the northern fan-delta S2S systems (S1–S3); (4) among the braided-delta S2S systems, the S5 system shows the greatest exploration potential.

Discussion

Importantly, this study underscores the broader applicability of the EW-CT model across diverse geological settings, offering a quantitative approach to assess S2S interactions and identify high-potential areas for hydrocarbon exploration. The proposed framework has the potential to enhance sedimentological research and improve exploration strategies in various sedimentary basins worldwide, bridging the gap between theoretical studies and practical applications.
Effect of thyroid stimulating hormone on the prognosis of coronary heart disease
Authors: Ding Ning , Hua Rui , Guo Hanqing , Xu Yu , Yuan Zuyi , Wu Yue , Li Ting
Published: February 2025

Introduction

Clinical studies have shown that thyroid stimulating hormone (TSH) is associated with increased cardiovascular disease risk and mortality. Even within normal ranges, elevated TSH levels have an impact on the cardiovascular system and have been associated with cardiac dysfunction. The aim of our study was to evaluate the predictive value of admission fasting serum TSH levels in patients with coronary heart disease in relation to long-term major adverse cardiovascular events (MACE) and all-cause mortality.

Method

A total of 3515 patients with coronary heart disease who met the inclusion criteria were divided into four groups according to the quantile of TSH levels: Group 1 (TSH, 0.34-1.02 mIU/L, n=878); Group 2 (TSH, 1.03-1.71 mIU/L, n=886); Group 3 (TSH, 1.72-2.84 mIU/L, n=880); and Group 4 (TSH, 2.86-5.50 mIU/L, n=873). MACE and all-cause mortality were also compared. TSH concentrations associated with the risk of MACE, all-cause mortality were assessed using continuous scales (restricted quartic splines) and Cox proportional hazards regression models.

Results

A total of 3515 patients with coronary heart disease were eligible for analysis. At a median follow-up of 70 months, patients in group 2 had a lower incidence of MACE compared to the other three groups. All-cause mortality was lower in the 3rd group. Restricted quartic spline analysis also revealed that TSH concentrations were associated with heart failure risk.

Discussion

TSH levels have predictive value for adverse cardiovascular events and heart failure in patients with coronary heart disease.
Impact of segmental body composition on metabolic dysfunction-associated fatty liver disease in Chinese children
Authors: Hu Meng-Yuan , Sun Dan-Qin , Yang Fan , Zheng Xiao-Wei , Wu Ning-Xi , Zhang Hao-Yang , Yao Xiao-Die , Zhang Jia-Hui , Zhang Le
Published: February 2025

Purpose

This study aimed to assess the relationship between regional body composition and metabolic dysfunction-associated fatty liver disease (MAFLD) in Chinese children.

Methods

In this study, 1399 children aged 7–14 years were included. Liver steatosis was assessed using the controlled attenuation parameter (CAP) measured through Fibroscan. MAFLD is defined as the presence of liver steatosis along with either overweight/obesity, prediabetes/diabetes, or at least two metabolic index abnormalities. Regression analyses were applied to assess the relationship between regional body composition and MAFLD in children. Subgroup analyses were performed based on sex and weight.

Results

The participants had a mean age of 9 years, with 52.11% being boys. Among them, 134 (9.57%) were diagnosed with MAFLD, and 17 (1.22%) had severe fatty liver disease. We found an inverse correlation between the muscle percentage in each region and MAFLD, with the extremities demonstrating the most significant negative correlation (OR: 0.732; 95% CI: 0.634–0.844). Conversely, regional fat was positively associated with MAFLD, with the strongest correlation found in the upper limbs (OR: 3.104; 95% CI: 2.023–4.764). Subgroup analyses showed similar results.

Conclusion

The decrease in regional muscle percentage, particularly in the limbs, along with the increase in regional fat percentage, especially in the upper limbs, is associated with a higher probability of developing MAFLD in prepubertal children. Additional prospective studies are needed to strengthen and validate these findings.
Single-cell dual-omics reveals translational and transcriptional landscapes and regulations in oocytes from ovarian endometriosis patients
Authors: Diao Xiaoting , Huang Jiana , Xiang Rui , Zhuang Shaohong , Liang Qiqi , Liang Xiaoyan , Zeng Haitao
Published: February 2025

Introduction

A significant proportion of women in their reproductive years are afflicted by endometriosis. And one of the major contributing factors to infertility linked to ovarian endometriosis is thought to be oocyte quality. The precise molecular mechanisms are still unknown. Furthermore, because of transcriptional silence, translatome is better able to explain molecular behavior in oocytes than transcriptome sequencing, which has been used widely in recent years.

Methods

We conducted single-cell transcriptome and translatome sequencing on oocytes obtained from patients with ovarian endometriosis, as well as from control subjects with infertility due to tubal or male factors.

Results

For the first time, we characterized the translational and transcriptional profiles of mRNA in GV-stage oocytes from patients with ovarian endometriosis and control subjects. Our translational analysis identified 2,480 differentially expressed genes in oocytes from ovarian endometriosis patients. Furthermore, we demonstrated that global translational activity in human oocytes is significantly altered by ovarian endometriosis. Key pathways such as "oxidative stress," "oocyte meiosis," and "spliceosome" were identified as critical factors influencing oocyte quality in ovarian endometriosis patients.

Discussion

This study elucidated the molecular characteristics and potential mechanisms underlying poor oocyte quality in patients with ovarian endometriosis. Our findings provided new insights into the pathogenesis of endometriosis-associated infertility and highlighted potential therapeutic targets for improving oocyte quality and reproductive outcomes.
Optimizing load frequency control in isolated island city microgrids: a deep graph reinforcement learning approach with data enhancement across extensive scenarios
Authors: Wu Min , Ma Dakui , Xiong Kaiqing , Yuan Linkun
Published: February 2025

This study presents a Data-Enhanced Optimum Load Frequency Control (DEO-LFC) strategy for microgrids, targeting an optimal balance between generation costs and frequency stability amidst high renewable energy integration. By replacing traditional controls with agent-based systems and reinforcement learning, the DEO-LFC employs an optimal balance between generation costs and frequency stability amidst high renewable energy integration. By replacing traditional controls with agent-based systems and reinforcement learning, the DEO-LFC employs a Soft Graph Actor Critic (SGAC) algorithm, integrating deep reinforcement learning with graph sequence neural networks for effective frequency management. Proven effective in the China Southern Grid’s island microgrid model, DEO-LFC offers a sophisticated solution to the challenges posed by the island microgrid model. Proven effective in the China Southern Grid’s island microgrid model, DEO-LFC offers a sophisticated solution to the challenges posed by the variability of modern power grids.
Role of PD-L1 in mediating the effect of lipid on ulcerative colitis: a mediation Mendelian randomization study
Authors: Li Peihong , Wang Yiwen , Hu Hongyi , Sun Boyun
Published: February 2025

Introduction

Recent evidence suggests that lipids play a crucial role in intestinal metabolic balance and are closely linked to ulcerative colitis (UC). However, the mechanisms underlying their effects remain unclear. This study employed Mendelian randomization (MR) to investigate the relationships among lipids, inflammatory factors, and UC.

Methods

We analyzed data on 179 lipids from the GeneRISK cohort (7,174 individuals), 91 inflammation-related proteins from the EBI GWAS Catalog (14,824 participants), and UC GWAS summary statistics from the FinnGen Biobank (411,317 samples). Associations were assessed using inverse variance weighted (IVW) and Bayesian-weighted MR (BWMR) methods. A mediation analysis was conducted to explore the potential role of inflammatory factors in mediating lipid effects on UC.

Results

MR analysis revealed a significant negative association between sterol ester (27:1/20:4) levels and UC (SNPs = 31; IVW: OR = 0.900 [95% CI: 0.851–0.952], p < 0.001; BWMR: OR = 0.906 [95% CI: 0.849–0.967], p = 0.003). Furthermore, sterol ester (27:1/20:4) was negatively correlated with PD-L1 (SNPs = 30; IVW: OR = 0.961 [95% CI: 0.934–0.990], p = 0.008), and PD-L1 was found to be inversely associated with UC (SNPs = 24; IVW: OR = 0.850 [95% CI: 0.724–0.999], p = 0.048). Mediation analysis suggested that sterol esters (27:1/20:4) may indirectly increase UC risk by downregulating PD-L1 expression. However, the MR analysis results suggest that sterol esters (27:1/20:4) act as a protective factor against UC, which contradicts the mediation analysis. This discrepancy highlights the dual role of PD-L1 in UC pathogenesis.

Discussion

PD-L1 may serve as a key mediator in the regulation of UC pathogenesis by sterol esters, but the underlying complex mechanisms require further investigation.
Exploration and verification of circulating diagnostic biomarkers in osteoarthritis based on machine learning
Authors: Wang Xinyu , Liu Tianyi , Sheng Yueyang , Qiu Cheng , Zhang Yanzhuo , Liu Yanqun , Wu Chengai
Published: February 2025

Background

Osteoarthritis (OA) is a prevalent chronic joint condition. This study sought to explore potential diagnostic biomarkers for OA and assess their relevance in clinical samples.

Methods

We searched the GEO database for peripheral blood leukocytes expression profiles of OA patients as a training set to conduct differentially expressed gene (DEG) analysis. Two machine learning algorithms, least absolute shrinkage and selection operator (LASSO) logistic regression and support vector machine-recursive feature elimination (SVM-RFE), were employed to identify candidate biomarkers for OA diagnosis. The performance was assessed using receiver operating characteristic (ROC) curves, and the areas under the curve (AUCs) with 95% confidence interval (CI) were calculated. Furthermore, we gathered clinical peripheral blood samples from healthy donors and OA patients (validation set) to validate our findings. Small interfering RNA and CCK8 proliferation assay were used for experimental verification.

Results

A total of 31 DEGs were discovered, and the machine learning screening found five DEGs that were considered to be candidate biomarkers. Notably, BIRC2 had a very good discriminatory effect among the five candidate biomarkers, with an AUC of 0.814 (95% CI: 0.697-0.915). In our validation set, results showed that the levels of BIRC2 and SEH1L were remarkably higher in healthy donors than OA patients, consistent with the results of the training set. SEH1L owned the largest AUC of 0.964 (95% CI: 0.855-1.000). BIRC2 also displayed a larger AUC of 0.836 (95% CI: 0.618-1.000) in the training set. Knockdown of these two genes could significantly suppress human chondrocyte proliferation.

Conclusion

Two novel biomarkers, SEH1L and BIRC2, were indicated to have the capacity to differentiate healthy people from OA patients at the peripheral level. Experiments have shown that knockdown of these two genes could inhibit human chondrocyte proliferation, as verified by cell proliferation assays.
Artificial intelligence and science of patient input: a perspective from people with multiple sclerosis
Authors: Helme Anne , Kalra Dipak , Brichetto Giampaolo , Peryer Guy , Vermersch Patrick , Weiland Helga , White Angela , Zaratin Paola
Published: February 2025

Artificial intelligence (AI) can play a vital role in achieving a shift towards predictive, preventive, and personalized medicine, provided we are guided by the science with and of patient input. Patient-reported outcome measures (PROMs) represent a unique opportunity to capture experiential knowledge from people living with health conditions and make it scientifically relevant for all other stakeholders. Despite this, there is limited uptake of the use of standardized outcomes including PROMs within the research and healthcare system. This perspective article discusses the challenges of using PROMs at scale, with a focus on multiple sclerosis. AI approaches can enable learning health systems that improve the quality of care by examining the care health systems presently give, as well as accelerating research and innovation. However, we argue that it is crucial that advances in AI – whether relating to research, clinical practice or health systems policy – are not developed in isolation and implemented ‘to’ people, but in collaboration ‘with’ them. This implementation of science with patient input, which is at the heart of the Global PROs for Multiple Sclerosis (PROMS) Initiative, will ensure that we maximize the potential benefits of AI for people with MS, whilst avoiding unintended consequences.
Randomized clinical trial in cancer patients shows immune metabolic effects exerted by formulated bioactive phenolic diterpenes with potential clinical benefits
Authors: Gómez de Cedrón Marta , Moreno-Rubio Juan , de la O Pascual Victor , Alvarez Beatriz , Villarino Marta , Sereno María , Gómez-Raposo César , Roa Silvia , López Gómez Miriam , Merino-Salvador María , Jiménez-Gordo Ana , Falagán Sandra , Aguayo Cristina , Zambrana Francisco , Tabarés Beatriz , Garrido Beatriz , Cruz-Gil Silvia , Fernández Díaz Cristina M. , Fernández Lara P. , Molina Susana , Crespo María Carmen , Ouahid Youness , Montoya Juan José , Ramos Ruíz Ricardo , Reglero Guillermo , Ramírez de Molina Ana , Casado Enrique
Published: February 2025

Background

Nutrients, including bioactive natural compounds, have been demonstrated to affect key metabolic processes implicated in tumor growth and progression, both in preclinical and clinical trials. Although the application of precision nutrition as a complementary approach to improve cancer treatments is still incipient in clinical practice, the development of powerful “omics” techniques has opened new possibilities for delivering nutritional advice to cancer patients. Precision nutrition may contribute to improving the plasticity and function of antitumor immune responses.

Objectives

Herein, we present the results of a randomized, prospective, longitudinal, double-blind, and parallel clinical trial (NCT05080920) in cancer patients to explore the immune-metabolic effects of a bioactive formula based on diterpenic phenols from rosemary, formulated with bioactive alkylglycerols (Lipchronic© WO/2017/187000). The trial involved cancer patients, including those with lung cancer (LC), colorectal cancer (CRC), and breast cancer (BC), undergoing chemotherapy, targeted biological therapy, and/or immunotherapy. The main readouts of the study were the analysis of Lip on systemic inflammation, hemogram profile, anthropometry, lipid and glucose profiles, and tolerability. Additionally, a deep immune phenotyping of peripheral blood mononuclear cells (PBMCs) was performed to identify the functional effects of Lip on key mediators of the immune system.

Results

Lip was well tolerated. The lung cancer subgroup of patients showed a reduction in biomarkers of systemic inflammation, including the neutrophil-to-lymphocyte ratio (NLR). Furthermore, modulation of key players in the immune system associated with the experimental treatment Lip compared to the control placebo (Pla) treatment was revealed, with particularities among the distinct subgroups of patients. Our results encourage further research to apply molecular nutrition-based strategies as a complementary tool in the clinical management of cancer patients, particularly in the current era of novel immunotherapies.

Clinical trial registration

ClinicalTrials.gov, identifier NCT05080920
Intradermal delivery of SARS-CoV-2 RBD3-Fc mRNA vaccines via a needle-free injection system induces robust immune responses in rats
Authors: Wang Cenrong , Tang Xin , Jiang Chenghan , Zhang Yu , Han Bo , Sun Yi , Guo Jianfeng , Peng Hanyu , Wang Zihan , Wang Yipeng , Zhang Jialu , Zhang Yong , Jiang Chunlai
Published: February 2025

Introduction

Needle-free injection system (NFIS) is easy to operate and can decrease needle phobia. Besides, NFIS can increase the interaction of antigens in a more dispersed manner with immune cell at local injection site, which may improve the immune responses of mRNA vaccines. Although SARS-CoV-2 mRNA vaccines have great success, universal vaccines are urgently needed. Delivering universal mRNA vaccines by NFIS is preferred to combat COVID-19.

Methods

RBD3-Fc mRNA expressing BA.4, Delta, and prototype RBD, and human IgG Fc with YTE mutation was designed and synthesized. The safety and immune responses of universal RBD3-Fc naked mRNA and mRNA-LNP vaccines delivered intradermally using NFIS (named GV-01) and intramuscularly via needles were evaluated and compared in rats.

Results

The prime-boost regimen administered by two routes resulted in potent immune responses and intradermal delivery displays comparable or better performance in terms of binding antibodies, neutralizing antibodies and T cell responses. Naked mRNA vaccines were functional, but less effective than mRNA-LNP vaccines.

Discussion

The above results suggest that RBD3-Fc vaccines are safe and immunogenic and NFIS can be used as an alternative to needles/syringes for the inoculation of mRNA-LNP vaccines to elicit robust systematic immune responses.
Seroprevalence of Getah virus in pigs in Southeast China determined with a recombinant Cap protein-based indirect ELISA
Authors: Lan Jianhui , Duan Leilei , Liu Xuya , Zhou Yao , Zeng Botao , Chen Siya , Ye Yu , Huang Dongyan , Wan Gen , Zhang Fanfan , Song Deping
Published: February 2025

Getah virus (GETV) is a mosquito-borne virus with a broad host range, including mosquitoes and various animals such as pigs, horses, goats, cattle, boars, and blue foxes. In pigs, GETV can cause fever, abortion and reproductive disorders in sows, as well as fever, tremors, and diarrhea in piglets, posing a serious threat to the pig production industry. However, there are few reports on the epidemiology of GETV in China, and reliable diagnostic kits for large-scale detection of GETV antibodies are lacking. Therefore, this study aimed to establish a rapid, sensitive and suitable GETV antibody detection assay for clinical detection. We expressed the recombinant protein Cap in Escherichia coli by constructing a recombinant plasmid, pET-32a-Cap, which contained a His tag and the GETV-Cap domain. The expression of the recombinant protein was achieved in the supernatant following bacterial lysis by optimizing the culture temperature and duration for Escherichia coli. The recombinant Cap protein was successfully purified via a nickel affinity column, which was used for develop an indirect ELISA method (rCap-ELISA). Following optimization of the rCap-ELISA reaction conditions, a cutoff value of 0.45 was established with 100 swine serum samples analyzed by indirect immunofluorescence (IFA). The overall coincidence rate between rCap-ELISA and IFA was 95.83%, with a 94.03% sensitivity and 100.00% specificity. IgG antibodies against GETV were subsequently detected in 2,102 serum samples from pig farms in Jiangxi and Fujian provinces via the rCap-ELISA method, and the positive rates were 63.36% (1,102/1739) and 37.1% (137/363), respectively. The findings suggest that the indirect ELISA method (rCap-ELISA) is a reliable, accurate, and cost-effective way to detect IgG antibodies against GETV in pigs. This technique is valuable for understanding the dynamics of GETV transmission and for preventing GETV epidemics in pigs.
A predictive model for early neurological deterioration after intravenous thrombolysis in patients with ischemic stroke
Authors: He Liping , Zhang Meng , Xu Fei , Wu Zhangsong , Chen Huijuan , Li Ying , Chen Ran
Published: February 2025

Objective

Intravenous thrombolysis (IVT) is the treatment of choice for acute ischemic stroke (AIS), but some patients develop early neurological deterioration (END) within 24 h after IVT. Therefore, we aimed to identify predictors of END in AIS patients following treatment with IVT.

Methods

We retrospectively analyzed the clinical data of 621 AIS patients who received IVT with recombinant tissue-type plasminogen activator (rt-PA) at the Stroke Centre of the People’s Hospital of Lu’an City, China, from July 2018 to July 2023. Clinical data, including demographic characteristics, clinical assessment results, underlying diseases, and laboratory indices, were collected at the time of admission. The patients were divided into training and validation cohorts, after which LASSO regression was applied to select the most important predictor variables, and multivariate logistic regression was used to construct a nomogram. The discriminative power of the model was determined by calculating the area under the curve (AUC), and calibration and decision curve analyses (DCA) were performed.

Results

The platelet-to-lymphocyte ratio (PLR) (OR 1.01, 95% CI 1.01–1.01, p < 0.001), mean platelet corpuscular volume (MPV) (OR 2.12, 95% CI 1.67–2.69, p < 0.001), and admission NIHSS score (OR 1.25, 95% CI 1.16–1.36, p < 0.001) were significantly associated with the development of END. The AUC of the prediction model constructed from these three factors was 0.896 (95% CI 0.862–0.93), and the calibration curve was close to the diagonal.

Conclusion

This predictive model can be used for the early identification of the risk of developing END after IVT and development of active interventions to improve the prognosis of AIS.
Case report: A case report and literature review on spontaneous bacterial peritonitis induced by intestinal barrier damage in a colorectal cancer patient with malnutrition
Authors: Xu Peng , Shi Sanbao , Yu Zhiyu , Li Da , Zhang Cheng
Published: February 2025

Background

Spontaneous bacterial peritonitis (SBP) is an infectious condition characterizing the presence of bacterial infection in the peritoneal fluid with no apparent source of infection within the abdomen. It is extremely rare for patients with malnutrition after colorectal cancer (CRC) surgery to develop SBP. This is the first ever case reported case of SBP resulting from intestinal barrier compromise in a patient with colorectal cancer with malnutrition.

Case summary

A 72-year-old woman with malnutrition was diagnosed with CRC, and following brief nutritional support, she underwent the laparoscopic-assisted radical right hemicolectomy. The patient was then diagnosed with peritonitis after the operation. An emergency laparotomy was performed, and the patient was finally diagnosed with SBP. The patient ultimately recovered following a series of appropriate postoperative supportive treatments.

Conclusion

This case highlights the poor outcomes of short preoperative nutritional therapy in CRC patients with malnutrition. Further studies should investigate the role of the intestinal barrier function in the recovery of patients with CRC after surgery.
TriSwinUNETR lobe segmentation model for computing DIR-free CT-ventilation
Authors: Nomura Gabriela Roque Oliveira , Luong Aaron T. , Prakash Ananya , Alemand Annabelle , Bhowmick Tanish , Ali Alisa , Ren Jaimie , Rehani Basil , Nair Girish , Castillo Richard , Vinogradskiy Yevgeniy , Castillo Edward
Published: February 2025

Purpose

Functional radiotherapy avoids the delivery of high-radiation dosages to high-ventilated lung areas. Methods to determine CT-ventilation imaging (CTVI) typically rely on deformable image registration (DIR) to calculate volume changes within inhale/exhale CT image pairs. Since DIR is a non-trivial task that can bias CTVI, we hypothesize that lung volume changes needed to calculate CTVI can be computed from AI-driven lobe segmentations in inhale/exhale phases, without DIR. We utilize a novel lobe segmentation pipeline (TriSwinUNETR), and the resulting inhale/exhale lobe volumes are used to calculate CTVI.

Methods

Our pipeline involves three SwinUNETR networks, each trained on 6,501 CT image pairs from the COPDGene study. An initial network provides right/left lung segmentations used to define bounding boxes for each lung. Bounding boxes are resized to focus on lung volumes and then lobes are segmented with dedicated right and left SwinUNETR networks. Fine-tuning was conducted on CTs from 11 patients treated with radiotherapy for non-small cell lung cancer. Five-fold cross-validation was then performed on 51 LUNA16 cases with manually delineated ground truth. Breathing-induced volume change was calculated for each lobe using AI-defined lobe volumes from inhale/exhale phases, without DIR. Resulting lobar CTVI values were validated with 4DCT and positron emission tomography (PET)-Galligas ventilation imaging for 19 lung cancer patients. Spatial Spearman correlation between TriSwinUNETR lobe ventilation and ground-truth PET-Galligas ventilation was calculated for each patient.

Results

TriSwinUNETR achieved a state-of-the-art mean Dice score of 93.72% (RUL: 93.49%, RML: 85.78%, RLL: 95.65%, LUL: 97.12%, LLL: 96.58%), outperforming best-reported accuracy of 92.81% for the lobe segmentation task. CTVI calculations yielded a median Spearman correlation coefficient of 0.9 across 19 cases, with 13 cases exhibiting correlations of at least 0.5, indicating strong agreement with PET-Galligas ventilation.

Conclusion

Our TriSwinUNETR pipeline demonstrated superior performance in the lobe segmentation task, while our segmentation-based CTVI exhibited strong agreement with PET-Galligas ventilation. Moreover, as our approach leverages deep-learning for segmentation, it provides interpretable ventilation results and facilitates quality assurance, thereby reducing reliance on DIR.
Risk factors and incidence of unplanned re-operation after transumbilical single-hole laparoscopic appendectomy in children
Authors: Luo Yuanyuan , Zhang Hong , Wu Qiang , Li Qianlong , Ye Zhihua , Zeng Jixiao , Xu Xiaogang
Published: February 2025

Purpose

This study aims to investigate the factors associated with unplanned re-operations (UR) following transumbilical single-hole laparoscopic appendectomy (TUSILA) in pediatric patients.

Methods

We conducted a retrospective analysis of clinical data from children diagnosed with acute appendicitis (AA) who underwent TUSILA at our center between January 2020 and January 2024. All the operations were performed under single-port laparoscopy, including two methods of appendectomy, intra-TUSILA and extra-TUSILA. Patients were categorized into the UR and control groups to compare baseline characteristics, clinical data, postoperative management, and surgical outcomes.

Results

The study included 188 patients (110 males and 78 females), with 4 (2.1%) in the UR group. Within the UR group, three cases (75%) necessitated re-operation due to adhesive intestinal obstruction, while one case (25%) was due to an appendiceal remnant fistula. The baseline characteristics, operation duration, intraoperative blood loss, surgeon experience, and postoperative fasting times showed no significant difference between the two groups (all P > 0.05). However, the incidences of procedures beyond standard TUSILA, lateral peritoneum lysis, appendiceal perforation, complicated appendicitis as confirmed by pathology, drainage tube placement, and the length of antibiotic duration were significantly higher in the UR group compared to the control group (all P < 0.05).

Conclusion

A notable percentage of pediatric patients undergoing TUSILA experience UR, primarily due to adhesive ileus, with a substantial proportion potentially linked to surgical technical errors and postoperative management.
Comparison of the effects of perioperative fentanyl and morphine use on the short-term prognosis of patients with cardiac surgery in the ICU
Authors: Zhong Jingtao , Sui Runqian , Zi Jie , Wang Anbiao
Published: February 2025

Aim

This study aimed to analyze the effects of perioperative morphine and fentanyl use on delirium, length of ICU stay, and in-hospital mortality after cardiac surgery.

Methods

This cohort study retrieved the data of 4,596 patients admitted to ICU after cardiac surgery in MIMIC-IV database from 2008 to 2019. The primary outcome was postoperative delirium. The secondary outcomes were length of ICU stay, and in-hospital mortality. To compare the effects of perioperative fentanyl and morphine use on postoperative delirium, length of ICU stay, and in-hospital mortality, univariate, two-way stepwise, as well as multivariable Logistic regression, linear regression, and Cox proportional hazards models was respectively used. Odd ratio (OR), β coefficient, hazard ratio (HR), and respective confidence interval (CI) were calculated. Subgroup analysis was conducted in terms of age, use of extracorporeal circulation, midazolam, dexmedetomidine or surgery type.

Results

In total, the data of 4,596 patients were analyzed including 2,589 morphine user and 2007 fentanyl user. We found that the risk of postoperative delirium was reduced in patients with cardiac surgery undergoing perioperative morphine relative to perioperative fentanyl (OR = 0.62, 95%CI: 0.40–0.96). Perioperative morphine use was negatively correlated with the length of ICU stay in patients with cardiac surgery in comparison to patients with perioperative fentanyl use (β = −0.72, 95%CI: −1.06, −0.39). Relative to patients who had perioperative fentanyl, patients who had perioperative morphine were associated with reduced risk of in-hospital mortality in patients with cardiac surgery after adjusting for respective confounding factors (HR = 0.35, 95%CI: 0.13–0.91).

Conclusion

Perioperative morphine use was related to lower risk of delirium and in-hospital mortality as well as shortened length of ICU stay in these patients. The findings might offer a reference for perioperative anesthesia management in patients receiving cardiac surgery.
A limited sampling strategy for estimating busulfan exposure in pediatric hematopoietic stem cell transplantation
Authors: Jia Chenhong , Qin Yabin , Han Yu , Ding Weijing , Pei Yuntao , Zhao Yile
Published: February 2025

Background

Busulfan (Bu) is the foundation of conditioning regimens for pediatric hematopoietic stem cell transplantation (HSCT). Evidence indicates that the efficacy and side effects of Bu are intimately tied to the area under its concentration-time curve (AUC). Given its cytotoxic nature and a small therapeutic index, coupled with marked inter-individual pharmacokinetic variability, Bu requires therapeutic drug monitoring to facilitate individualized therapy. However, research investigating the relationship between Bu exposure and clinical outcomes among the Chinese population remains scarce. This study aimed to develop a limited sampling strategy (LSS) for estimating Bu exposure in pediatric HSCT recipients using multiple linear regression (MLR) analysis to predict the AUC0-360.

Methods

We enrolled 26 pediatric patients who underwent Bu-based conditioning for HSCT. Blood samples were collected at 11 time points after Bu infusion. Pharmacokinetic parameters were calculated using non-compartmental methods. MLR models were developed using 1–4 sampling points to predict the AUC0-360. Model accuracy was assessed using the Jackknife and Bootstrap methods, with consistency evaluated via intraclass correlation coefficient (ICC) and Bland–Altman (BA) analyses.

Results

The mean ± standard deviation (SD) for AUC0-t, mean residence time 0-t, clearance, and volume of distribution were 845.54 ± 111.03 μmol min/L, 181.37 ± 10.55 min, 0.23 ± 0.04 L/h/kg, and 0.73 ± 0.15 L/kg, respectively. Models with 2–4 sampling points showed improved prediction accuracy compared to single-point models. The four-point model (60, 135, 240 and 360 min) demonstrated the highest accuracy with an adjusted r2 of 0.965. Internal validation confirmed the models’ stability and accuracy, with the four-point model exhibiting the best performance. External validation using three additional cases supported the predictive accuracy of the model.

Conclusion

The LSS model developed in this study accurately predicts the Bu AUC0-360 with 2–4 sampling points, offering a practical and clinically valuable tool for therapeutic drug monitoring in pediatric HSCT recipients. The four-point model was found to be the most accurate and is recommended for clinical applications.