bluuebunny/crossref_metadata_2025 huggingface dataset:
Kidney Transplant in Low Resources Countries; 6 Years of Successes and Challenges at Benjamin Mkapa Hospital, Tanzania
Authors: Shija kessy charles , Makubi Abel Nkono , Chandika Alphonce B , Mwashambwa Masumbuko , Meremo Alfred , Kobayashi Shuzo , Hidaka Sumi , Tanabe Kazunari , Mohamed Awadh , Mputi Devotha , Mmbali Sabina Matulo , Misago Venance John , Sukunala Okoa , Kajerero Vitus , Rugakingira Remigius Andrew , Mkinga Reuben , Toure Ahmed , Ibrahim Hindu , Rainer Denis , Gyunda Anthony , Kagwe Nashon , Mwakilasa Christina Benny , Kilovele Andason
Published: November 2024

Background
Kidney Ttransplant (KT) is the best therapy for patients with Chronic Kidney Disease (CKD). It is advanced services involving multi discipline and highly skilled personnel, conducive infrastructure and sustainable availability of immunosuppressive drugs and consumables. Set-up of KT at Benjamin Mkapa Hospital (BMH) Tanzania in 2018 in collaboration with Shonan Kamakura General Hospital and Tokyo Women’s Medical University from Japan, was of reasonable success despite the challenges encountered. In this review, our experiences, success, challenges and project’s sustainability are discussed.
Methodology
This was a review study of the methods used to set-up a KT in Tanzania with incorporation of patient data from March, 2018 to July,2024 for 37 transplant recipients. Data was analysed using the SPSS version 27 to obtain the mean and proportions and for patient and gaft survival rate a Kaplan Meir survival curve analysis was applied.
Results
Succefully a KT was set by BMH in collaboration with Shonan Kamakura General Hospital and Tokyo Women’s Medical University from Japan and 11 medical personnel were trained. Challenges were lack of trained personnel, unreliable supply of medical supplies and immunosuppressive drugs in the local market, lack of fund and shortage of kidney donors.
A total of 37 out of 40 patients who have been transplanted were analyzed. The recipients were 73% male and 27% female and their mean age was 47.98 ± 10.81 years. Majority (84%) of kidney donors were blood related to the recipients and 16% spouses of recipients. Hypertension was the leading cause of ESRD with 45% followed by diabetes of 32.5%.
Graft survival rates at 1, 3, and 5 years were 90%, 85% and 83% respectively and patient's survival rates at 1, 3, and 5 years was 98.5%, 90% and 85.5% respectively.
Conclusion
Benjamin Mkapa Hospital has successful sustained KT program by local team after training and mentorship by Japanese experts. Outcomes at 1, 3 and 5 of recipients were good and similar to those in developed countries. The Hospital has demonstrated unique experience in establishing and sustaining KT services in the past 6 years signifying that low income countries can establish kidney transplant program.
Predicting the Molecular Subtypes of 2021 WHO Grade 4 Glioma by a Multiparametric MRI-Based Machine Learning Model
Authors: Xu Wenji , Li Yangyang , Zhang Jie , Zhang Zhiyi , Shen Pengxin , Wang Xiaochun , Yang Guoqiang , Du Jiangfeng , zhang hui , Tan Yan
Published: November 2024

Purpose: To develop and validate a machine learning (ML) model using multiparametric MRI for the preoperative differentiation of 2021 World Health Organization (WHO) grade 4 astrocytoma and glioblastoma (GBM) (Task 1), and to stratify grade 4 astrocytoma to distinguish isocitrate dehydrogenase-mutant (IDH-mut) from IDH-wild-type (IDH-wt) (Task 2). Additionally, to evaluate the model’s prognostic value.
Materials and methods: We retrospectively analyzed 320 glioma patients from three hospitals. Cases were randomly divided into training and validation sets with a 7:3 ratio. Features were extracted from tumor and edema on contrast-enhanced T1-weighted imaging (CE-T1WI) and T2 fluid-attenuated inversion recovery (T2-FLAIR). Extreme gradient boosting (XGBoost) was utilized for constructing ML, clinical, and combined models. Model performance was evaluated with receiver operating characteristic (ROC) curves, decision curves, and calibration curves. Stability was evaluated using six additional classifiers. Kaplan-Meier (KM) survival analysis and the log-rank test assessed the model’s prognostic value.
Results: In Task 1 (grade 4 vs GBM) and Task 2 (IDH-mut grade 4 vs IDH-wt grade 4), the combined model (AUC = 0.911 and 0.854, 0.902 and 0.909) and the optimal ML model (AUC = 0.902 and 0.855, 0.904 and 0.895) significantly outperformed the clinical model (AUC = 0.671 and 0.656, 0.619 and 0.605) in both the training and validation sets. Survival analysis showed the combined model performed similarly to molecular subtype in both tasks (P = 0.966 and P = 0.793).
Conclusion: The multiparametric MRI ML model effectively distinguished grade 4 astrocytoma from GBM and differentiated IDH-mut from IDH-wt grade 4 astrocytoma. Additionally, the model provides reliable survival stratification for glioma patients with various molecular subtypes.
Effect of Single-Parent versus Dual-Parent Households on Dietary Intake and Growth among Under-Five Children in Rwanda: An Analysis using Directed Acyclic Graph
Authors: Joyeuse Ukwishaka , Sekou Samadoulougou , Vincent Sezibera , Fati Kirakoya-Samadoulougou , Geneviève Lefebvre
Published: November 2024

Introduction
: Poor childhood diet and malnutrition are global issues, particularly in low- and middle-income countries. Adequate nutrition during the early years of life is crucial for optimal child growth. Household dynamics influence children’s well-being, with single-parent households facing unique challenges that can affect dietary intake and growth. In Rwanda, stunting and being underweight are still prevalent, and the role of household structure has not been studied. This study assessed the effects of single- versus dual-parent households on children’s diet and growth and explored the mediating role of wealth in these relationships.
Methodology
: This cross-sectional study used data from the 2019/2020 Rwanda Demographics and Health Survey (DHS). The analysis included households with single and dual parents who had children under five years of age at the time of the survey, with a specific focus on children aged 6–23 months for dietary information. We performed survey-weighted multivariate logistic regressions, adjusting for confounders identified by a directed acyclic graph (DAG). The mediation analysis explored the mediating effect of wealth on the relationships among household structure, the minimum acceptable diet (MAD), and child growth.
Results
Among the 3,531 participants, 26.9% lived in single-parent households.​​​​​​ Stunting affected 34% of the children under 5 years old, 8.3% were underweight, 1% were wasted, and only 21.1% of the children aged 6–23 months met MAD standards. Single-parent households were significantly associated with stunting (OR: 1.22; 95% CI: 1.01–1.46) and wasting (OR: 2.11; 95% CI: 1.11–3.99) but were not associated with underweight or MAD. Household structure indirectly influenced MAD (indirect effect (IE) = -0.007, p = 0.02), height-for-age (IE = -0.068, p < 0.001), and weight-for-age z scores (IE = -0.029, p = 0.001) through wealth, but no mediation effect was observed for height-for-weight z scores.
Conclusion
This study highlights the influence of family structure on children’s dietary intake and growth in Rwanda. To effectively combat malnutrition in Rwanda and similar settings, targeted interventions should address household structure, particularly that of single-parent households, and wealth disparities.
Folic acid supplementation and Neural Tube Defects: Knowledge and practice among pregnant mothers in Lira, northern Uganda
Authors: Nakaziba Rebecca , Muhindo Miriam
Published: November 2024

Background and Aim: Folic Acid requirements increase during pregnancy in order to meet the metabolic needs, DNA synthesis, and rapid cell division during fetal development. Low levels of folate before and during pregnancy augment the chances of poor pregnancy outcomes, like neural tube defects. In sub-Saharan Africa, very few pregnant women take folic acid pre- and post-conception. In Uganda, 1400 children are born with spinal bifida annually yet taking 400 micrograms daily of folic acid, before and during early pregnancy reduces the risk of neural tube defects. This study intended to explore the level of knowledge and practices of pregnant mothers regarding folic acid supplementation in preventing neural tube defects in Lira, northern Uganda.Study Design: This study employed a quantitative and descriptive approach of data collection and analysis. A consecutive sampling technique was employed to recruit and interview 199 respondents. SPSS V20 was used for data entry and statistical analysis for frequencies, and percentages. Correlation and chi-square tests were used to determine the association between knowledge and practices of folic acid supplementation for prevention of neural tube defects among pregnant mothers. A p-value of ≤ 0.05 was statistically significant.Results The knowledge level regarding Folic acid was adequate. 88% ever heard of it; 73.0% knew its benefits, but only 20.1% knew that it prevents neural tube defects; 83.9% were currently taking while only 18.0% took it before conception. In addition, the practice of Folic acid supplementation was significantly associated with cues to action (p = 0.000) and perceived risk (p = 0.000) while knowledge was significantly associated with practice (p = 0.000).Conclusion Very few mothers knew the value of Folic acid in preventing neural tube defects with very low pre-conception intake. Strategies should be designed to improve the knowledge regarding the role of folic acid in averting neural tube defects among women of childbearing age. These women should be encouraged to take Folic acid pre and post-conception, especially in the first trimester.
Stature Estimation from the Thumb and Foot length of Adult Port Harcourt Residents of Nigeria using linear regression equations
Authors: Orupabo Clinton David , Dinah Eldred Ayebatari , Baribor Maakai , Amadi Hebinuchi
Published: November 2024

Background
Stature estimation is as important as other biological data like age and sex in the identification of unknown persons in a forensic case investigation. Hence for its peculiarity there is a need to develop population-specific data for every population as stature could be subject to variations.
Methods
A sample size of 266 subjects comprising 133 males and 133 females of the ages 18 to 60 years, all of Nigerian origin and residing in Port Harcourt were recruited for the study after an informed consent was given to the participants. Anthropometric parameters measured include the right and left thumb length, right and left foot length and the height. Standardized protocols and techniques in anthropometry were adopted for the measurements using a digital sliding vernier caliper and stadiometer. The data obtained was analyzed with Microsoft Excel to obtain linear regression equations for stature estimation.
Results
The mean right thumb length (RTL) for males and females is 6.26 ± 4.82 and 5.41 ± 0.52 respectively. The mean right foot length (RFL) for males and females is 26.52 ± 1.23 and 25.48 ± 1.62 respectively. Student t test shows that sexual variation in all the measured parameters was statistically significant (p ≤ 0.05) at a confidence interval of 95% with males showing greater values in all parameters studied. There was statistically significant (p ≤ 0.05) bilateral symmetry for both right and left sides of the thumb and foot length. The females showed a strong positive correlation r of thumb length against height at 0.707.
Conclusion
The study shows that stature can be estimated using the thumb and foot length but that thumb length is more reliable and accurate in females. Also, both halves of the thumb or foot can accurately estimate stature in the study population as there were no bilateral asymmetry.
Injection of Mitomycin-C in combination with a bladder neck incision in patients with a bladder neck stenosis after prostatic surgery, a retrospective cohort study
Authors: Sandel Noah J. , Tijans Aline , Ronkes Brechje , De Bruin Martijn D. , Vis Andre N. , Pigot Garry L.S.
Published: November 2024

Purpose
Bladder neck stenosis (BNS) is a challenging complication following prostate cancer surgery or endoscopic procedures for benign prostatic hyperplasia. Bladder neck incision (BNI) is a common initial treatment, though recurrence occurs in up to 28% of patients. Mitomycin-C (MMC), an anti-fibrotic agent, has shown promise in reducing stenosis recurrence in other surgical contexts. This study retrospectively evaluates the efficacy and safety of MMC injection during BNI in reducing BNS recurrence.
Methods
We conducted a single-center, retrospective cohort study at the Amsterdam University Medical Center, including patients who underwent BNI with MMC injection. Patients were included if they had bothersome obstructive urinary symptoms and a history of at least one failed BNI. Recurrence-free rate was calculated, defined as a bladder neck not passable by a 16Fr cystoscope, requiring additional intervention. Postoperative complications and serious adverse events were recorded.
Results
Twelve patients were included in the study, with a median follow-up of 7 months (range 3–32 months) after BNI. Mean age was 69.1 (range 49–81 years). BNS etiology was robot-assisted laparoscopic prostatectomy in 41.7% of patients, while 58.3% of patients had an etiology of a transurethral resection of prostate (TURP). Recurrence-free rate was 83.3%. Two patients experienced recurrent BNS within 7 months post-procedure. No serious adverse events related to MMC were reported.
Conclusion
Our study demonstrates promising results for the use of MMC injection during BNI for recurrent BNS. Beside a relative high recurrence-free rate, the incidence of adverse events and of postprocedural complications was low.
Building and externally validating a prediction model for long COVID in severe and critical COVID-19 patients: A multicenter cohort study
Authors: Zhang Haojing , Kan Lin , Pan Dianzhu
Published: November 2024

Objective: To investigate the risk factors for corona virus disease 2019 (COVID-19) and construct a nomogram prediction model to evaluate the clinical treatment of long COVID.
Methods: Clinical data were collected from patients who were diagnosed with COVID-19 and hospitalized at the First Affiliated Hospital of Jinzhou Medical University from December 7, 2022, to February 1, 2023. The prediction model was constructed via a nomogram. External validation was carried out with clinical data from patients at Panjin Central Hospital.
Results: In the development cohort and the validation cohort of this study, 60.3% and 59.5% of the patients developed long COVID, respectively. After least absolute shrinkage and selection operator (Lasso) regression, the final variables included in the prediction model were the percentage of lymphocytes, the Charlson comorbidity index (CCI), computed tomography (CT) score, and oxygen requirement. The area under the receiver operating characteristic curve (AUROC) for external validation of the model was 0.794, and the p value of the calibration curve was 0.170. The decision curve analysis indicates that the model performs well.
Conclusion: The prediction model developed in this study is useful for assessing the likelihood of developing long COVID in hospitalized patients.
Comparison of Systemic Inflammation Indices With Post- Cardiac Surgery Mortality and Morbidity
Authors: Koyuncu Ahmet Ozan , YESILTAS Mehmet Ali , Ozsoy Sadiye Deniz , Mert Ali Murat
Published: November 2024

Background
The Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR), and Lymphocyte/Monocyte Ratio (LMR) are recognized markers linked to inflammation and have been associated with mortality and morbidity following cardiac surgery. This study aims to not only evaluate the relationships between these inflammatory indexes and specific clinical endpoints, such as in-hospital survival and one-year freedom from Major Adverse Cardiac and Cerebrovascular Events (MACCE), but also to directly compare the predictive accuracy of NLR, PLR, and LMR. By highlighting the comparative ability of these indexes, this study seeks to determine which marker offers superior predictive value for postoperative outcomes.
Method
A total of 1528 cardiac surgery patients were retrospectively analyzed, including a subset of 1205 patients who underwent coronary artery bypass grafting (CABG). The study assessed the associations between the NLR, PLR, LMR with in-hospital mortality/survival, as well as 1-month, 6-month, and 1-year mortality. In addition, postoperative complications, including MACCE, atrial fibrillation (AF), myocardial infarction (MI), low cardiac output syndrome (LCOS), acute kidney injury (AKI), cerebrovascular events (CVE), among others, were evaluated. The duration of intensive care unit (ICU) and hospital stays were also examined. The predictive accuracy of these indexes was specifically compared within the CABG subgroup. As the LMR ROC curve remained below 0.5, LMR was interpreted as "free of events." The cut-off values for the indexes were determined as NLR: 3.10, PLR: 143.9, and LMR: 3.52.
Results
NLR correlated with higher mortality and complications, whereas PLR showed no significant relation with in-hospital mortality or neurological complications. LMR was found to be related with free of events. Patients with higher NLR and PLR values experienced increased mortality and MACCE along with a higher incidence of complications such as postoperative revision, AF, LCOS, and renal issues. Conversely, higher LMR values corresponded with lower rates of such complications.
Conclusion
NLR emerges as a crucial indicator for predicting mortality and complications in cardiac surgery patients, more so than PLR and LMR. Especially NLR can be used to predict the risk of mortality and complications in cardiac surgery. This prediction can be support further with PLR and LMR.
Predicting Calorific Value through Proximate Analysis of Municipal Solid Waste Using Soft Computing System
Authors: Mondal Saptarshi , Rafizul Islam M.
Published: November 2024

This study investigated the accurate prediction of the calorific value of municipal solid waste (MSW) using soft computing systems, namely artificial neural networks (ANN), adaptive neural fuzzy inference system (ANFIS), support vector machine (SVM), and multi-layer perceptron (MLP). The research focused on proximate analysis parameters obtained from the laboratory and utilized the measured calorific value to develop predictive models. All the models demonstrated a very good correlation between input and output, with consistently strong values of the coefficient of determination (R2). ANFIS showed the best correlation with an exceptional predictive power. Statistical parameters were determined to compare model accuracy, with ANFIS exhibiting the top performance, followed by ANN, and then MLP, which had the lowest values of MSE, RMSE, MAD, and MAPE at 8.704E-07, 0.00019, 0.00016, and 1.295E-05 respectively. However, SVM has the least capability to predict calorific value accurately compared to other models. Soft computing models, specifically ANFIS, displayed exceptional precision in forecasting the calorific value.
Leveraging Machine Learning models to predict contraceptive nonuse among women of reproductive age in Rwanda: A machine learning approach
Authors: Nawe Norbert , Muhoza Dieudonné N.
Published: November 2024

Background: Despite efforts and commitments put in place by the Rwandan Government and collaborating great health organizations, contraceptive prevalence rate (CPR) remains low in Rwanda (64% in 2019 for married women using any method and 58.% for only modern methods. CPR has however been increasing from 45% in 2010 and 48% in 2015. Consequently, unmet need for family planning dropped from 34% to 14% between 2010 and 2020. This study aims to leverage Machine Learning to predict contraceptive nonuse among women of reproductive age in Rwanda.
Methods: A cross-sectional analysis of secondary data was conducted on 2020 Rwanda Demographic and Health Survey. We used six Machine Learning algorithms on the sample of 14,634 women of reproductive age, which were trained and evaluated using various metrics to know the best model. Moreover, multivariable binary logistic regression was used to determine key factors of contraceptive nonuse through Python software and to identify women at higher risk of not using contraceptives, providing valuable insights for targeted interventions and policy enhancements to improve access to reproductive health and family planning services for underserved populations in Rwanda.
Results: Findings revealed that woman age, residence region, education, wealth status, marital status, urban-rural residence, total children ever born, working status, partner's occupation, and the desire for more children are key determinants of not using contraceptives. Younger women, particularly those aged 15-24, urban residents, wealthier women, and those desiring more children are at a higher risk of not using contraceptives. Furthermore, Support Vector Machine model performed better than other five classifiers in predicting nonuse of contraceptives status with an accuracy of 75%, giving a ROC-AUC score of 83%, and making it the best model to predict contraceptive behavior in Rwanda.
Conclusion The results from this study suggest the use of Machine Learning to predict contraceptive outcomes accurately. Additionally, by tailoring focused interventions for identified women at higher risk of not using contraceptive could contribute to contraceptive use uptake in Rwanda.
Medication adherence following transition to emicizumab in patients with severe hemophilia A: results of a longitudinal observational multicenter real-life study
Authors: Pagnot Laurie , Novais Teddy , Cahoreau Véronique , Lopez Isabelle , Prudent Christelle , Hamon Marie , Leroy Estelle , Gérout Anne Cécile , Toguyeni Elise , Sylvestre Ludovic , Jouglen Julien , Varin Rémi , Chamouard Valérie
Published: November 2024

Medication adherence following transition to emicizumab in patients with severe hemophilia A: results of a longitudinal observational multicenter real-life study

Background

Hemophilia A (HA) is a rare X-linked congenital bleeding disorder characterized by a deficiency in coagulation factor VIII (FVIII). Treatment traditionally involves regular intravenous injections of clotting factor concentrates. Recent advances, such as extended half-life FVIII and the subcutaneous non-factor replacement therapy emicizumab, have significantly impacted management strategies for patients with HA.

Aim

The ADHEMI study aimed at assessing the impact on medication adherence of a switch from intravenous prophylaxis (FVIII or bypassing agents [BPA]) to subcutaneous emicizumab for patients with severe HA.

Methods

A multicenter longitudinal study was conducted across eleven French Reference Centers for Hemophilia. The study included 187 patients with severe HA treated with emicizumab for at least 12 months following a minimum of 12 months with FVIII or BPA prophylaxis. Medication adherence was measured using the Medication Possession Ratio (MPR), calculated for both periods, accounting or not for the inclusion of emergency doses (ED).

Results

Medication adherence significantly increased after switching to emicizumab (mean + standard deviation MPR 0.98 ± 0.07) compared to the previous period with FVIII or BPA (MPR 0.85 ± 0.23 without ED, 0.90 ± 0.24 with ED, p < 0.001). The proportion of adherent patients (MPR ≥ 80%) rose from 62.6% (without ED) and 71.1% (with ED) to 97.9% post-switch (p < 0.001).

Conclusions

Switching to emicizumab significantly improves medication adherence in patients with severe HA. Emicizumab, administered subcutaneously, simplifies treatment regimens while also reducing the frequency of injections and the need for hospital pharmacy dispensation.
Prevalence of chronic kidney disease and associated risk factors among Iranian adults: analysis of data from the PERSIAN cohort
Authors: Aliakbari Fatemeh , Moosazadeh Mahmood , Alatab Sudabeh , Poustchi Hossein , Masoudi Sahar , Mohammadi Zahra , Kebar Sousan Mohammadi , Naghashi Shahnaz , Eftekhar Ebrahim , Moradpour Azad , Vakil Mohammad Kazem , Bavarsad Amir Hooshang , Mohammadkarimi Vahid , Hamzeh Behrooz , Hosseini Seyed Vahid , Shamsizadeh Ali , Rastegar Ayoob , Heydari Keyvan , Makhdoomi Khadijeh , Mehrabi Sadrolah , Mirjalili Mohammad Reza , Shahraki Elham , Sepanlou Sadaf , Ahmadi Ali
Published: November 2024

To date, no comprehensive study has been conducted to assess the prevalence of kidney diseases in Iran. With the establishment of the Prospective Epidemiological Research Studies in IrAN (the PERSIAN cohort) across various provinces, we aim to address this gap using data from the baseline phase of this cohort study. In this large-scale population-based cross-sectional study, we included 151,227 adult participants (aged 35–70 years) from 17 cohort centers in Iran. The variation in CKD prevalence was investigated using complex survey design. The multivariable logistic regression was used to identify the determinants of impairment in renal function. Almost 18.4% of participants had eGFR less than 60 mL/min/1.73m². CKD prevalence was higher in females across all age groups, peaking in the 65–70 age group. Regional CKD prevalence varied from 6.2–32.7%. Female sex (OR = 2.43, 95% CI:2.06–2.86), hypertension (OR = 1.32, 1.19–1.46), overweight (OR = 1.29, 1.20–1.39), obesity (OR = 1.26, 1.12–1.41), high cholesterol (OR = 1.19, 1.08–1.32), and high fasting blood sugar (OR = 1.14, 1.01–1.27) were risk factors for CKD. Physical activity had protective effect. Our findings serve as a crucial alert for policymakers to develop and implement strategies to manage the escalating burden of chronic kidney disease and mitigate the associated risk factors in Iran.
Low Rates of Diagnosis and Treatment of Iron Deficiency Anemia After an Acute Severe Gastrointestinal Hemorrhage
Authors: Lin Elissa S. , Dutson Usah , Jensen Dennis M.
Published: November 2024

Background: Few studies report about management of iron deficiency anemia after a severe, acute gastrointestinal bleed. Most include good risk patients with upper gastrointestinal bleeds and report only laboratory improvements but not clinical outcomes.Aims: To assess management of iron deficiency anemia and clinical outcomes of patients after a severe, acute gastrointestinal bleed from either upper or lower sources in an unselected group of patients.Methods. Retrospective analysis of adult patients hospitalized with severe gastrointestinal bleeding in two referral centers. They had endoscopic diagnoses of lesions including non-variceal upper, variceal, and lower sites (diverticulosis or other colon sources). Analyses were of rates of iron studies ordered and iron treatments up to 4 months post discharge. Composite clinical outcomes were also assessed and analyzed.Results: For 337 patients studied, iron studies were ordered in only 50%. When tested, iron deficiency was diagnosed in 75% of anemias. Intravenous iron or oral iron was prescribed in only 7.1% and 26.7% of patients respectively. By 4 months, 94% of patients treated with intravenous iron and 80% treated with oral iron achieved ≥ 2 g/dL increase in hemoglobin level. Patients with high rates of severe comorbidities and severe anemia had poorer clinical outcomes than others with severe anemia and less comorbidity.Conclusions: Despite significant anemia after a severe gastrointestinal bleed from common diagnoses, iron studies were not routinely ordered. Iron deficiency anemia was infrequently recognized or treated with iron therapies. Patients with severe co-morbidities and anemia after an acute gastrointestinal bleed had poor clinical outcomes.
AMPK activation attenuates high glucose-induced oxidative stress and apoptosis through regulation of TRPM2-mediated signaling pathway in endothelial cells
Authors: Lu Ting , Zhang Yihua , Zhou Dayan , Wang Zhe , Zhao Lu , Xu Qiang
Published: November 2024

Background
This study aimed to determine the potential role of AMP-dependent protein kinase (AMPK) in high glucose-induced oxidative stress and to explore the underlying mechanisms in endothelial cells.
Methods and Results
Human umbilical vein vascular endothelial cells (HUVECs) were pretreated with 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR) (AMPK activator), Compound C (CC) (AMPK inhibitor), or N-(p-amylcinnamoyl) Anthranilic Acid (ACA) [transient receptor potential melastatin 2 (TRPM2) inhibitor]. Subsequently, the cells in the intervention groups were exposed to high glucose. Reactive oxygen species levels, endothelial apoptosis, calcium entry, and protein expression levels in the HUVECs were detected. The AMPK activator, AICAR, exhibited a significant reduction in high glucose-stimulated ROS production and apoptosis in HUVECs, whereas the AMPK inhibitor, CC, significantly enhanced these effects. Pretreatment with the TRPM2 inhibitor, ACA, significantly abrogated high glucose-induced calcium entry, high glucose-stimulated oxidative stress, and apoptosis, indicating the role of TRPM2-mediated intracellular calcium ([Ca2+]i) influx in these cellular processes. Furthermore, the AMPK inhibitor, CC, significantly increased the levels of TRPM2-related proteins,including the primary calcium sensor calmodulin (CaM) and NADPH oxidase (NOX). Conversely, the AMPK activator exhibited opposite effects on these proteins.
Conclusions
AMPK activation could attenuate high glucose-stimulated oxidative stress and play a protective role in ECs partly through inhibiting the TRPM2-CaM-NOX pathway.
Correlation between human expert macular fluid height assessment and fluid volume quantification in neovascular age-related macular degeneration
Authors: Steiner Stefan , Gerendas Bianca S. , Deak Gabor , Leingang Oliver , Whitby Ariadne , Bogunovic Hrvoje , Reiter Gregor S. , Schmidt-Erfurth Ursula
Published: November 2024

To investigate the association of manually measured retinal fluid by a human expert with AI-quantified retinal fluid volumes and to explore disease activity indicated by fluid volume distributions in neovascular age-related macular degeneration (nAMD) using an approved AI-based algorithm. This is a retrospective study analyzing baseline OCT data of patients with nAMD from multicenter study data. Manually measured maximum macular fluid heights vertically on B-scans in the central millimeter (CMM) for intraretinal fluid (IRF), subretinal fluid (SRF), and pigment epithelial detachment (PED) acquired from expert were associated with vertical fluid heights and three-dimensional volumes obtained by automated quantification using an AI-based tool (RetInSight Fluid Monitor Version 2). Out of 890 patients/eyes, we identified IRF in the CMM both manually and automatically in 328 eyes, SRF in 502 eyes, and PED in 705 eyes. The correlation between manual height and AI-based height was strong for IRF (r = 0.87) and PED (r = 0.91), and moderate for SRF (r = 0.67). Manual height vs. AI-based volume correlation in the CMM was strong for IRF (r = 0.76), and PED (r = 0.87) and moderate for SRF (r = 0.55). The correlation worsened when associating total fluid volumes in the central 6mm with manual CMM fluid height, indicating that CMM height does not represent total nAMD disease activity. AI-based fluid segmentation, in contrast to conventional human expert fluid measurements, provides a more comprehensive assessment, allowing for a significantly more accurate interpretation of total nAMD disease activity.
Characteristics and long-term health outcomes of the first domestic COVID-19 outbreak cases in Da Nang, Vietnam: a longitudinal cohort study
Authors: Tsuruoka Miyuki , Huynh Mai Kim , Toizumi Michiko , Hoang Thanh Tien , Nguyen Trieu Bao , Dao Anh The , Nguyen Luong Dinh , Le Huy Xuan , Le Chung Thanh , Dang Anh Quang , Do Hung Thai , Yoshida Lay Myint
Published: November 2024

Background
Vietnam experienced the first COVID-19 domestic outbreak due to the Wuhan strain (B.1.1) in Da Nang from July 2020. COVID-19 can cause acute as well as long term health problems. We aimed to characterise clinical features and risk factors related to severe illness of COVID-19 among Da Nang outbreak cases, and to describe long-term health outcomes among survivors of this outbreak.
Methods
We conducted an ambidirectional cohort study. Study subjects were all hospitalised cases with positive real-time PCR test of SARS-CoV-2, in the three major hospitals in Da Nang, from 25 July to 28 August 2020. Clinical and demographic information was collected from medical charts retrospectively. Then, the survivors were followed-up prospectively, at 6 and 16 months after acute infection, to assess their health status using standardized questionnaires, physical examination, chest X-rays and pulmonary function tests.
Results
A total of 362 cases including 20 fatal cases were enrolled into the study retrospectively. The median age of participants for the medical chart review was 46.5 years and 60.8% were female. Overall, 7.8% required respiratory support during the hospitalisations and 20 of them died. Compared to the survivors, the fatal cases were significantly older (median age of survivors 45.0 year vs fatal cases 66.5 year, P < 0.001) and more likely to have underlying conditions. The proportions of participants who had at least one long COVID symptom, within the 7 days of each follow-up at 6 and 16 months, were 72.0% (134/186) and 63.5% (47/74), respectively. We also found that females and adults reported symptoms more often in the follow-up surveys, 78.9% (90/114) [females] vs 61.1% (44/72) [males] at 6 months, P = 0.008; 68.7% (46/67) [\(\:\ge\:\)20 years] vs 14.3% (1/7) \(\:[<\)20 years] at 16 months, P= 0.004.
Conclusions
In the first domestic COVID-19 outbreak in Vietnam, mortality rate was around 6% and associated with underlying medical conditions. In the follow-up surveys, a substantial proportion of participants reported long COVID related health problems, although the prevalence declined over time. Females and adults reported symptoms more often and that might be due to the pathophysiological difference by sex and age. (344 words)
Impact of COVID-19 on Metabolic Parameters in Patients with Type 2 Diabetes Mellitus
Authors: Shabestari Motahare , Salari Forouzan , Azizi Reyhaneh , Ghadiri-Anari Akram , Namiranian Nasim
Published: November 2024

Background and aim
Since the onset of the Coronavirus disease 2019 (COVID-19) pandemic, individuals with Type 2 diabetes mellitus (T2DM) have been one of the most susceptible populations to contracting the virus. Also, COVID-19 and its related lockdown restrictions have affected metabolic regulatory mechanisms within the T2DM population. The present study aims to determine the impact of the viral infection and its lockdown on the physiological parameters in individuals with T2DM.
Methods:
In this retrospective cohort study, the medical records of 118 individuals with prior diagnoses of T2DM were collected. All the subjects had undergone at least one laboratory test within a maximum of three months before the onset of the COVID-19 pandemic in Iran. Fifty-nine patients with a confirmed COVID-19 infection within the first three months of the pandemic underwent a follow-up lab test six months after their initial COVID-19 diagnosis. The individuals without a history of the infection underwent a follow-up lab test six months after the onset of the pandemic. Noninfected populations were matched for age and gender with infected patients. Comparative analysis of clinical and laboratory data within each group was conducted.
Results:
The ‘COVID-19 positive’ group exhibited a significant decrease in levels of triglycerides (TG) (P = 0.001) and total cholesterol (TC) (P = 0.028), body mass index (BMI) (P = 0.034), atherogenic index of plasma (AIP) (P = 0.027), triglyceride glucose (TyG) index (P = 0.001), and triglyceride glucose -BMI (TyG-BMI) index (P < 0.001) during the first six months post-infection compared to pre-pandemic. Other variables did not show notable changes. The ‘COVID-19 negative’ group had a significant reduction in TC (P = 0.001) and low-density lipoprotein cholesterol (LDL-C) (P = 0.01).
Conclusion:
Individuals with T2DM and mild to moderate COVID-19 infection experienced an improvement in the levels of TC, TG, BMI, and insulin-related indices. Restrictions in the first lockdown were associated with a decrease in the levels of TC and LDL-C in the T2DM population who did not have a history of the viral infection.
Construction and validation of an automatic segmentation method for respiratory sound time labels
Authors: Fan Jian , Ni Haoran , Chen Xiulan , Duan Yulin , Wang Wanmin , Xu Fan , Shang Yan
Published: November 2024

Background:In the field of respiratory system diseases, the utilization of respiratory sounds in auscultation plays a crucial role in the specific disease diagnosis. However, during the process of auscultation, the personal experiences and environmental factors may affect the decision making, leading to diagnostic errors. Therefore, to accurately and effectively obtaining and analyzing respiratory sounds can be positively contribute to the diagnosis and treatment of respiratory system diseases. Objectives:Our aim was to develop an analytical method for the visualization and digitization of respiratory audio data, and to validate its capability to differentiate between various background diseases. Methods:This study collected the respiratory sounds of patients admitted to the Department of General Medicine of Shanghai Changhai Hospital from June to December 2023. After strict screening according to the inclusion and exclusion criteria, a total of 84 patients were included. The research process includes using an electronic stethoscope to collect lung sounds from patients in a quiet environment. The patients expose their chests and lie flat. Sound data is collected at six landmark positions on the chest. The collected audio files are imported into an analysis tool for segmentation and feature extraction. Specific analysis methods include distinguishing heart sounds and respiratory sounds, segmenting respiratory sounds, determining the inspiratory and expiratory phases, and using a tool developed by the team for automatic segmentation encoding. Results:We standardized the respiratory sounds of 84 patients and segmented multiple respiratory cycles. Following the localization and segmentation of the respiratory cycles based on label information, we calculated the average and standard deviations of the amplitude features for each segment of the respiratory cycle. The results indicated differences among various diseases. Conclusions:The robust algorithm platform is capable to segmenting the respiratory sounds into inhale and exhale phase accordingly, then to comparing the difference between different background disease. This method provides objective evidence for auscultation of respiratory sounds and visual display of breath sounds.
The Linkage between Decision-making and Bodily States: An Investigation Using an Emotional Startle Reflex Paradigm and the Iowa Gambling Task
Authors: Miranda Azahara , Duschek Stefan , Mata José Luis
Published: November 2024

Theories such as the somatic marker hypothesis posit that emotions and feedback from bodily states support higher cognition and decision-making. This study investigated the connection between decision-making and activity of the startle reflex, a defense reflex that is sensitive to emotional states. Decision-making was assessed using the Iowa Gambling Task (IGT), which simulates real-life decision-making with respect to complexity and uncertainty. The startle reflex was quantified, via electromyography, as the eyeblink following intense noise stimulation during the viewing of pleasant, neutral, and unpleasant emotional pictures. Forty-two healthy participants were classified according to their performance on the IGT using the median-split method. In the entire sample, the startle response amplitude progressively increased from pleasant to unpleasant picture exposure. Participants with high IGT performance exhibited smaller response amplitudes than those with low IGT performance, independent of picture valence. Furthermore, inverse linear associations were seen between IGT performance and response amplitudes. The association between decision-making and startle reflex activity may be mediated by individual differences in emotional state. According to previous studies, a positive emotional state, as opposed to a negative emotional state, relates to smaller startle amplitudes and a preference for decision-making strategies based on intuition and body-related information (i.e., somatic markers), which are beneficial in situations involving complex and uncertain decisions. Moreover, an impact of individual differences in prefrontal cortex function on decision-making and startle reflex activity is feasible. The startle paradigm may be a useful tool to investigate the interaction between bodily states and higher-order cognitive processing in future research.
Idiopathic intraconal abscess: A case report of rare condition with a diagnostic dilemma
Authors: Debela Asrat Sime , Jibriel Tewodros Adugna , Abore Kibruyisfaw Weldeab , Wirtu Roby Dessalegn , Worke Alemayehu Bedane
Published: November 2024

Background
Intraconal abscess is a rare complication of rhino-sinusitis
that could cause permanent visual loss. Orbital, especially
intraconal involvement without any inciting event is a very rare
occurrence.

Case Presentation:
A 31-year-old male Ethiopian patient presented with 5 days
history of painless protrusion of the right eye. Physical
examination showed significantly decreased visual acuity is the
right eye with very high intra-ocular pressure, significant
proptosis, absent motility and high hyperopic shift. Laboratory
investigations didn’t reveal any abnormalities, and orbital
Computer Tomography and Magnetic Resonance Imaging were suggestive
of intra-orbital abscess collection. Surgical drainage of the
abscess with lacrimal gland incisional biopsy was done and sent for
histopathology, culture and sensitivity. Histopathology results
showed mild inflammatory infiltrate of the lacrimal gland, and
culture and Sensitivity revealed Coagulase-negative staphylococcus
species sensitive for ciprofloxacin. After 3 days of intravenous
antibiotics, it was changed to oral ciprofloxacin 500 mg three
times per day and sent home. He had mild lid swelling and motility
started to return to normal on his early post-operative follow-up
with improvement on hyperopic shift. Subsequently, on follow-up,
the patient had a near-normal visual acuity with complete
resolution of hyperopia, full motility and no proptosis.

Conclusion
Idiopathic intraconal abscess collection is an extremely rare
presentation of patients with proptosis with significant diagnostic
dilemma altering the course of treatment. Preoperative imaging
followed by early surgical drainage and antibiotics is the
definitive management that yields drastic improvement to the course
of illness.
Allometrically adjusted chair stand test cutoff points to identify sarcopenia in older Brazilian adults: A cross-validation study
Authors: Bohn Lucimere , Teixeira Eduardo , Tavares Gysely Bastos , Carvalho Anderson Santos S , Flores Ariane Etyhur , Cyrino Edilson , Cordeiro Jéssica Fernanda Corrêa , Santos André Pereira dos , Sebastião Emerson , Karaçam Aydin , Machado Dalmo , Mota Jorge , Abdalla Pedro
Published: November 2024

Background: The decline in muscle strength with age is linked to impaired functional ability and increased fall risk, leading to fractures, hospitalization, and mortality. The European Working Group on Sarcopenia in Older People recommends muscle strength assessment, especially with respect to handgrip strength (HGS). The chair stand test (CST) is a practical alternative that measures quadriceps strength without additional equipment, although it is influenced by body size. The
Purpose of this study is to cross-validate allometric adjustments in the 30-second CST (30-s CST) for identifying low muscle strength in older adults, contributing to a more accurate and practical assessment of sarcopenia.
Methods: This cross-sectional study analyzed data from older Brazilian adults. Muscle strength was measured via the 30-s CST and normalized by body size through allometric adjustments. Functional limitations (< 400 m) were assessed via the six-minute walk test (6MWT).
Results: Allometric normalization effectively removed body size effects on the 30-s CST results, with an AUC > 0.70 in the ROC analysis. This validated the cutoff points proposed previously.
Conclusions: Allometric adjustments in the 30-s CST provide a robust method for identifying low muscle strength and functional limitations in older adults, irrespective of body size and variations in chair height.
Research on the Safe Burial Depth Range of Hard Rock Compressed Air Energy Storage Chambers Based on No Plastic Zone Condition
Authors: Zhao Cheng , Sun Zeyuan , Luo Qinyuan , Qian Yuan , Niu Jialun , Wei Chao , Xing Jinquan
Published: November 2024

The high internal pressure and high surrounding pressure in the surrounding rocks of the compressed air energy storage (CAES) chamber can cause plastic zones, resulting in cracks and affecting the stability of the chamber. This paper proposes a safe burial depth solution method based on elastic and elastic-plastic theories, with the condition that no plastic zone occurs. An approximate method is used to solve the boundary of the plastic zone, and by requiring the plastic zone to be contained within the boundary of the chamber, the range of safe burial depth is determined. The verification, sensitivity and limitation of the solution are finally discussed. The comparison with numerical simulation and previous experimental results proved that the error of this solution is extremely small, and it possess the following advantages: (1) The surrounding rocks remain elastic, ensuring the stability of chambers; (2) Being closed-form solutions, infinite resolution is preserved throughout; (3) Can be directly solved through the air pressure and accessible geomechanical parameters. Further studies found that the range of selectable burial depths is wider, and more suitable as a gas storage cavern site when the lateral pressure coefficient is closer to 1 and the shear strength of the surrounding rocks is higher. The research results have sizable engineering application value for site selection and design of buried depth of CAES chambers.
Artificial seed technology modified for long-term preservation of Lemna aequinoctialis
Authors: NHU PHUONG HOANG THI , Phung Truong Quy
Published: November 2024

Duckweeds, the Lemnaceae family, are employed in a wide range of industries, including agriculture, animal feed, wastewater treatment, biofuel production, and human food. Duckweeds are therefore also of interest for researchers. However, because to their rapid growth and development and ease of contamination by bacteria and algae during the storage process, duckweed samples require a great deal of time and effort to be maintained. In order to overcome the difficulties in preserving duckweed samples for scientific research, we developed an approach for duckweed storage by modification the ‘artificial seed’ procedure. We found that encapsulation of entire fronds of Lemna aequinoctialis in sodium alginate (3, 4, and 5%) and calcium chloride (150, 200, and 250 mM) were appropriate for maintaining them in a metabolically reduced state. After being stored for two months, there were no obvious variations between artificial seeds having an endosperm composition of ½ DN, DN, and water. After two months, duckweed samples kept in seeds with DN endosperm medium containing 150 mM CaCl2 and 3% sodium alginate recovered the best. Following a year of storage, a noticeable difference could be seen between the treatments with various endosperm medium compositionsThe optimal conditions were encapsulation in an aqueous medium containing 200 mM CaCl2 and 3% sodium alginate. This procedure offers an effective, cost-saving long-term preservation strategy that may be adapted in future for further duckweed species.