bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced Stress-Resilience Training (ESRT) for Graduate-Entry Medical Students: A Mixed-Method Investigation
Authors: Sanders Luke , Budd Georgie , Carter Lebares , Dave Umakant , Kemp Andrew H.
Published: April 2024

Background
Medical students face demanding academic requirements, fierce competition, self-doubt and financial concerns contributing to high rates of depression, anxiety, stress, sleep problems and burnout, highlighting a need for effective interventions. We explored a promising intervention known as Enhanced Stress-Resilience Training (ESRT), a modified form of mindfulness training adapted for clinicians, that was applied to medical students for the first time.
Methods
A randomised controlled trial was conducted to examine the effectiveness of ESRT for graduate-entry medical students (N = 98). Group (ESRT, active control) by time (pre-intervention, post-intervention, 6-month follow-up assessment) analyses of variance (ANOVAs) were conducted on psychological flexibility, resilience and stress reactivity. Student experience and perception of ESRT were investigated via exit evaluations (n = 25), one-on-one semi-structured interviews (n = 12), and end-of-study focus groups (n = 11) which underwent reflexive thematic analysis.
Results
ESRT users demonstrated increased psychological flexibility scores at post-intervention (p = .001, d = 0.62) and six-months follow-up (p = < .001, d = 0.96), and these findings were confirmed in intention-to-treat analysis. Those with low baseline resilience who underwent ESRT displayed increased resilience (p = < .001, d = 1.86) and decreased stress reactivity (p = < .001, d = 1.58) at the six-month follow-up. Reflexive thematic analysis revealed a strong demand for ESRT, which improved capacity for coping. Feedback from ESRT participants demonstrated overwhelmingly positive experiences and a demand for integrating ESRT into the medical curriculum.
Conclusions
ESRT is an effective intervention for enhancing psychological flexibility, while also increasing resilience and decreasing stress reactivity in the most vulnerable students. While students felt subjectively better across multiple domains, engagement in ESRT was challenged by time constraints and conflicting priorities. To overcome these barriers, we advocate for further implementation efforts which would benefit from institutional support to integrate ESRT into the formal medical curriculum.
Assessment and exploratory analysis of Indicator Based Surveillance (IBS) system in Rwanda
Authors: Nizeyimana Pacifique , Nsekuye Olivier , Ruyange Laurent , Twahirwa Solange , Manariyo Marcel , Zimulinda Alain , Kayirangwa Marie Rose , Uwamahoro Sandrine , Itanga Ines , Kabeja Adeline , Rwagasore Edson , Muvunyi Claude Mambo
Published: April 2024

Introduction: Rwanda, like other countries, is facing emerging and re-emerging infectious diseases. Since 2002, Rwanda has implemented indicator-based surveillance through the Integrated Disease Surveillance and Response (IDSR) framework. This study aimed to explore the completeness and timeliness of reporting and use of the tool in Rwanda. Method: In this study, we used a cross-sectional descriptive approach using a structured questionnaire for IDSR focal persons and data managers in 46 public hospitals accompanied by a secondary data analysis of monthly records from the national HMIS for the period 2018–2021 from 564 public health facilities (HFs) and 283 private HFs. Exploratory analysis and correlation assessments complemented dataset analysis. Results: This study reveals that public HF consistently achieves or surpasses the 80% completeness (96.7%) and timeliness (80.8%) targets. In contrast, private HF demonstrates 42.8% and 25.3%, completeness and timeliness, respectively. Eight-seven percent (87%) of interviewees reported to have received feedback from the central level, with varying frequencies. Hospitals provide feedback to HFs in their catchment area (91%), but frequencies differ. Regarding data accuracy, 95.7% possess standard case definitions, and 87% regularly refer to them. Two-thirds (67.6%) report they monitor weekly trends, but only 34.9% produce and share weekly reports promptly. Challenges identified include internet issues (30%), other competing duties (30%), and forgetting to report (26%). 84.8% of HFs used the system to detect outbreaks in their catchment areas; 71.7% of these were responded to according to national guidelines. Furthermore, 92.3% of all HFs have used the eIDSR system for planning purposes. Conclusion: The IDSR system was highly useful by providing evidence for decision-making in early detection and response to outbreaks as well as for hospital program planning. Maintaining timely reporting, enhancing data quality and timely use, and improving health workers' knowledge and practices are vital for a surveillance system user to detect outbreaks early. More focus should be put on Private Health Facilities.
Recurrence with isolated vaginal metastasis after comprehensive treatment of ulcerated moderately differentiated carcinoma of the lower rectum: A case report
Authors: Zhang LIxia , Jiang Xiaoling , Wu Maoyuan , Zhang Wenwen , Wang Guanyan , Yang Wei , Li Tingchao , He Lianli , Wang Gangcheng
Published: April 2024

Locally recurrent rectal cancer (LRRC) refers to the lesions that appear in the pelvic cavity and perineum with the same pathological type as the primary tumor after radical operation of rectal cancer, excluding other distant metastases such as liver, lung, and bone. Radical surgical resection in such patients is a central element in improving quality of life and survival. In this paper, we report the case of a patient who was admitted to our hospital with a recurrence of ulcerated moderately differentiated carcinoma of the lower rectum with vaginal involvement after comprehensive treatment. After discussion by a multidisciplinary team, surgical treatment was selected to be performed through a longitudinal incision approach in the prone position of the sacrum, with complete resection of the tumor tissues, which improved the patient's quality of life and increased her survival rate.
Endovascular electrothrombosis treatment for carotid cavernous fistula caused by ruptured primitive trigeminal artery aneurysm: a case report and literature review
Authors: Wan Yuhui , Cheng Zengjing , Lu Ziyan , Yang Dehong , Li Zhaoliang , Yang Kai , Chen Binglin , Chen Ailin , Zhu Qing
Published: April 2024

Background and Importance: Persistent primitive trigeminal artery aneurysms are clinically rare, especially with carotid cavernous fistula caused by their rupture. At present, endovascular treatment is of choice for carotid cavernous fistula, including by detachable balloon / coil, coil combined with Onyx glue, covered stent and so on. We cured a patient harbored carotid cavernous fistula caused by a ruptured primitive trigeminal artery aneurysm by detachable coil combined with endovascular electrothrombosis with a good result.
Clinical Presentation: The patient was admitted with a history of head trauma over two months ago and had experienced right eye protrusion for the past three weeks. Physical examination revealed protrusion of the right eye, along with conjunctival congestion and swelling. Digital subtraction angiography (DSA) confirmed a diagnosis of an incomplete Cavernous Carotid Fistula (CCF) on the right side, associated with a Persistent Primitive Trigeminal Artery (PPTA) on the same side. We cured by a ruptured primitive trigeminal artery aneurysm by detachable coil combined with endovascular electrothrombosis with a good result. It effectively avoided the mass effect associated with excessive coil filling and mitigated the risk of unintended embolization.
Conclusion: The combination of mechanical detachable bare metal coil embolization and electrocoagulation presents a novel and innovative approach for addressing CCF resulting from a ruptured PPTA aneurysm. This approach brings several notable advantages, including cost-effectiveness, reduced mass effect from embolic materials, and avoidance of potential complications associated with the use of medical glue for embolization.
Inhomogeneity Enhanced Signatures of Electromagnetically Induced Transparency
Authors: Vaduganathan Ramesh Kumar , R Rajadurai , Ramaswamy Radha
Published: April 2024

We investigate the propagation of a weak probe and a strong couple(pump) beam in an inhomogenous medium exhibiting Electromagnetically Induced Trans-parency(EIT) described by the Maxwell-Bloch equation. Unlike the homogenous case, the density matrix elements vary with the direction of pulse propagation. Employing the Gauge transformation approach, we have generated bright soli-tons for the weak probe and strong pump. The collisional dynamics of bright solitons shows that the presence of inhomogeneity makes the signatures of EIT more pronounced unlike the homogeneous counterpart. In particular, the colli-sional dynamics shows that one can not only slow down the laser pulses, but also can stop them literally leading to better optical storage. In addition, one also witnesses probe pulse broadening arising by virtue of space dependent density matrix showing that the medium becomes transparent to the probe over a wide range of frequencies.
Association of Cancer Status with Persistent Opioid Use in Kentucky Medicaid Patients Undergoing Colorectal Surgery
Authors: Oyler Douglas , Delcher Chris , Shelton Brent , Bae Jungjun , Bhakta Avinash
Published: April 2024

Background: Opioid prescribing guidance primarily focuses on patients with non-cancer pain. Patients undergoing surgery for cancer may have a higher risk of persistent postoperative opioid use compared to patients undergoing similar procedures for other indications.
Methods: This was a retrospective analysis of Medicaid claims data for patients undergoing colorectal surgery between 2015-2018. Included patients were assigned to a cancer or non-cancer cohort based on International Classification of Disease 9 or 10 codes indicating cancer or other relevant disease (e.g., Crohn’s disease). Multivariable logistic regression was used to assess the rate of persistent postoperative opioid use, defined as an opioid prescription between 90 and 180 days after surgery.
Results: This analysis included 1,929 patients: 891 in the cancer cohort and 1,038 in the non-cancer cohort. Adjusting for other relevant variables, patients undergoing surgery for cancer were significantly more likely to develop persistent postoperative opioid use (OR 1.35, 95% CI 1.08 to 1.69). Other variables associated with increased likelihood of the primary endpoint were opioid use within 30 days prior to hospitalization (OR 3.00, 95% CI 2.34 to 3.85), laparoscopic proctocolectomy or open colectomy (OR 2.66, 95% CI 1.19 to 5.91 and OR 1.75, 95% CI 1.37 to 2.23 compared to laparoscopic colectomy, respectively), and hospital drive distance over 60 miles (OR 1.72, 95% CI 1.26 to 2.32).
Discussion: Persistent opioid use was more likely in patients undergoing surgery for cancer. Guidelines for opioid prescribing should be inclusive to cancer patients to prevent undesired outcomes.
Muscle-invasive bladder cancer subtyping and prognosis: a multi-omics study based on a ferroptosis and cuproptosis-related signature
Authors: Hao Sida , Yang Zitong , Wang Gang , Cai Guofeng , Qin Yong
Published: April 2024

Background:
Muscle-invasive bladder cancer (MIBC), is a common, aggressive malignancy with significant mortality. Recent advancements have identified ferroptosis and cuproptosis as potential therapeutic targets. However, their interactions and impacts on MIBC overall survival (OS) and treatment outcomes are unclear. This study uses multi-omics approaches to explore these roles and their therapeutic potential, aiming to improve MIBC understanding and management.
Methods:
Using Cox’s regression and multiple machine learning (ML) techniques, a nomogram-based model incorporating ferroptosis and cuproptosis-related signature was developed based on the data of MIBC patients from The Cancer Genome Atlas (TCGA). Two Gene Expression Omnibus (GEO) datasets (GSE13507 and GSE32894) were utilised to externally validate this signature. Biological experimental validation was also performed in human bladder cancer cell lines.
Results:
The study identified a robust ferroptosis and cuproptosis-associated gene signature that significantly stratifies MIBC patients into distinct prognostic categories. This signature was not only predictive of overall survival but also correlated with distinct molecular subtypes of MIBC. Validation in independent datasets confirmed the prognostic value of the ferroptosis and cuproptosis-related signature and nomogram-based model.
Conclusions:
The established bioinformatics model based on ferroptosis and cuproptosis markers offers a novel framework for MIBC subtyping and could potentially guide personalised therapeutic strategies.
The Relation of Nasopharyngeal Colonization by Streptococcus pneumoniae in Comorbid Adults with Pneumonia and Unfavorable Outcomes in a Low-Middle Income Country
Authors: Olivella-Gomez Juan , Lozada Julián , Méndez-Castillo Lina , Garcés André Emilio Viñán , Serrano-Mayorga Cristian C. , Bustos Ingrid G. , Acosta-González Alejandro , Ibáñez-Prada Elsa D. , Fuentes Yuli V. , Crispin Ana M. , Garcia-Garcia Erica Y , Santana Eveling , Josa Diego F. , Saenz Jorge Pulido , Rodíguez-Castaño Gina Paola , Orjuela Jorge Alberto Rodríguez , Jaimes Diego , Tettelin Hervé , Orihuela Carlos J. , Reyes Luis Felipe
Published: April 2024

Purpose: Streptococcus pneumoniae (Spn) is the primary bacterial cause of lower respiratory tract infections (LRTI) globally, particularly impacting older adults and children. While Spn colonization in children is linked to LRTI, its prevalence and consequences in adults with comorbidities remains uncertain. This study aims to provide novel data in that regard.
Methods: This is a prospective study of outpatient adults with chronic diseases. Data on demographics, vaccination, and clinical history was gathered. Nasopharyngeal aspirate samples were examined for Spn colonization using traditional cultures and PCR. Patients were followed for 18 months, with colonization prevalence calculated and factors influencing colonization and its impact on clinical outcomes analyzed through logistic regressions.
Results: 810 patients were enrolled, with 10.1% (82/810) identified as colonized. The mean (SD) age was 62 years (±15), and 48.6% (394/810) were female. Major comorbidities included hypertension (52.2% [423/810]), cardiac conditions (31.1% [252/810]), and chronic kidney disease (17.4% [141/810]). Among all, 31.6% (256/810) received the influenza vaccine in the previous year, and 10.7% (87/810) received anti-Spn vaccines. Chronic kidney disease (OR 95% CI; 2.48 [1.01-6.15], p=0.04) and chronic cardiac diseases (OR 95% CI; 1.62 [0.99-2.66], p=0.05) were independently associated with Spn colonization. However, colonization did not increase the risk of LRTI (OR 95%CI; 0.64 [0.14-2.79], p=0.55) or unfavorable outcomes (OR 95% CI;1.17 [0.14-2.79], p=0.54) during follow-up.
Conclusions: Chronic kidney and cardiac diseases are independently associated with Spn colonization, underscoring the importance of vaccination in this population. Spn colonization was not associated with LRTI/unfavorable outcomes in adult patients with chronic comorbidities.
Association between the Inflammatory Burden Index and rheumatoid arthritis and its all-cause mortality: Data from NHANES 1999-2018
Authors: Zhai Jiali , Yuan Bo , Liu Tiebing , Mo Linfei , Xie Yajie , Zhao Yi , Cao Shuai , Meng Liesu
Published: April 2024

Background and Aims: Rheumatoid arthritis (RA) is a prevalent chronic autoimmune disease characterized by chronic inflammation. The Inflammatory Burden Index (IBI) is a newly proposed comprehensive inflammation index used to assess systemic inflammation. The relationship between IBI and RA, as well as its all-cause mortality, remains unclear. The objective of this study was to examine the correlation between IBI and RA and to analyze the association between IBI and all-cause mortality in RA.
Methods: The study conducted a comprehensive analysis of adult data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 1999 to 2018.The participants' IBI was calculated using the formula IBI = CRP * neutrophils/lymphocytes. Three models were constructed to investigate the relationship between IBI and the prevalence of RA. Nonlinear relationships were determined using restricted cubic spline curves. Stratified analyses and interaction tests were used to explore the relationship between RA and IBI in different subgroups. The same data analyses were applied to investigate the association between IBI and RA all-cause mortality.
Results:The data analyses revealed a stable positive and nonlinear correlation between IBI and the risk of RA, as well as a positive, nonlinear, J-shaped association between IBI and RA all-cause mortality. The correlation and association were consistent across most subgroups, and multiple covariates had no effect on the results. No significant effect of multiple covariates on the association was found through interaction tests.
Conclusions:Our study has demonstrated a positive correlation between the prevalence of RA and all-cause mortality with the IBI index. This suggests that lower levels of inflammation in the body are associated with a reduced risk of RA prevalence and all-cause mortality. Further prospective studies are required to explore the mechanisms involved.
Automatic Detection of Liver Diseases based on Supervised Learning Algorithms
Authors: Ahmed Abdelmoty M. , Bouallegue Belgacem , Khattab Mahmoud M. , Ibrahim Hegazi , Mabrouk Ahmed G.
Published: April 2024

The incidence of Liver disease has been steadily rising due to the excessive consumption of alcohol, exposure to harmful gases through inhalation, consumption of contaminated food, and the use of certain drugs. Dataset was used that extracted from ultrasound images for liver, and some chemical compounds (bilirubin, albumin, proteins, alkaline phosphatase) present in human body as features, to build and evaluate a classifier model, it can classify and differentiate liver diseases. This paper with the help of machine learning technique proposes diagnosing and classifies liver diseases into liver patient (abnormal) and non-liver patient (normal), then classify the liver patient into fatty liver or cirrhosis, using many supervised learning algorithms. The findings indicated that the Random Forest (RF) algorithm exhibited superior accuracy, achieving an impressive 95.12% accuracy rate. Following closely was the Decision Tree (DT) classifier, achieving a respectable accuracy of 90.24%. These results were obtained after employing a data reduction technique involving resampling. The model's performance was subsequently assessed using a 10-fold cross-validation (CV) approach, widely regarded as the optimal method for classifier evaluation. This approach leverages resampling across various folds of the dataset during multiple iterations, enhancing the classifier's ability to generalize and consequently yielding elevated accuracy when applied to unlabeled image samples.
Screening of Potential Biomarkers and Immune Analysis for Osteoarthritis Based on Machine Learning and WGCNA
Authors: Zheng Li , Heng Hongquan , Li Jian , Zhou Feng , Hu Zhenghui
Published: April 2024

The real pathogenesis of osteoarthritis (OA) remains unknown, leaving a significant burden of social and medical experiences. Thus, this study aimed to identify potential novel biomarkers in OA. The OA dataset (GSE55235) was from the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) for filtering the dataset to generate differentially expressed genes (DEGs). Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis to explore functional biology and related diseases. Subsequently, a further selection of latent biomarkers using three techniques (least absolute shrinkage and selection operator (LASSO) regression, support vector machine (SVM), and random forest (RF)). Receiver operating curve (ROC) of potential biomarkers were drawn to evaluate the diagnostic validity. The infiltration of immune cells for OA was evaluated using CIBERSORT, and the association with potential biomarkers and immune infiltrating cells was analyzed. Lastly, correlations and expression differences of potential biomarkers were investigated. In total, 803 DEGs were identified in OA and control samples. By overlapping DEGs and two module genes of WGCNA, we obtained 137 genes. LTC4S, XIST, CXCL8 and PIM1 were identified after validation by machine learning methods and ROC. Immune infiltration analysis demonstrated that T cells, and mast cells were linked to the pathogenesis of OA. The research might now help in understanding the etiology of OA.
Long-term Outcomes of CNS WHO grade 2 Oligodendroglioma in Adult Patients: A single- institution experience
Authors: Byeon Yukyeng , Lee Chaejin , Jeon Juhee , Kim Gung Ju , Chong Sangjoon , Kim Young-Hoon , Cho Young Hyun , Hong Seok Ho , Hong Chang-Ki , Kim Jeong Hoon , Song Sang Woo
Published: April 2024

Purpose
Oligodendrogliomas (ODGs) are a subtype of diffuse lower-grade gliomas with overall survival of >10 years. This study aims to analyze long-term outcomes and identify prognostic factors in patients with WHO grade 2 isocitrate dehydrogenase (IDH)-mutant, 1p19q-codeleted ODG.
Methods
We retrospectively reviewed 138 adult patients diagnosed with WHO grade 2 IDH-mutant, 1p19q-codeleted ODG who underwent surgical resection or biopsy between 1994 and 2021, analyzing clinical data, treatment details, and outcomes. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier analysis. Univariate and multivariate Cox regression analyses were utilized to identify significant prognostic factors.
Results
In the gross total resection (GTR) group, 63 (45.7%) underwent observation and 5 (3.6%) received postoperative treatment; in the subtotal resection (STR) or biopsy group, 37 (26.8%) were observed and 33 (23.9%) received postoperative treatment. The median PFS and OS were 6.8 and 18.4 years, respectively. Between adjuvant treatment and observation, there was no significant difference in PFS or OS. However, GTR exhibited significantly better PFS and OS compared to STR or biopsy (p = 0.043 and 0.014, respectively). Multivariate analysis revealed that contrast enhancement on MRI was associated with worse PFS (HR = 2.08, p = 0.004) and OS (HR = 5.89, p = 0.001). And the presence of seizures at presentation was associated with improved OS (HR = 0.21, p = 0.002).
Conclusion
This study underscores favorable long-term outcomes for patients with IDH-mutant, 1p19q-codeleted ODG WHO grade 2. Our findings indicate that GTR plays a crucial role in enhancing PFS and OS in WHO grade 2 ODG.
Frequency of serological results of antibodies related to autoimmune hepatitis in Iranian patients with non-viral hepatitis
Authors: Basir Hamid Reza Ghasemi , Khalilian Alireza , Eslami-Ghayour Anahita , Ghobakhlou Mehdi
Published: April 2024

Background
Autoimmune hepatitis as a chronic inflammatory disease of the liver can occur when the body's immune system is stimulated against liver cells, but its exact cause is unknown. Autoimmune hepatitis, if left untreated, leads to liver damage or cirrhosis over time, which can eventually cause liver failure.
Objective
This descriptive-analytical study was done to assess the frequency of serological results of autoimmune hepatitis-related antibodies in patients with non-viral hepatitis referring to an inpatient clinic in 2019 and provide basic information for future studies and assistance in localization of external guidelines performed to diagnose autoimmune hepatitis.
Methods
All patients were evaluated for age and sex, ANA, ASMA, and LKM antibodies, and immunoglobulin by preparing 5 cc of blood samples using laboratory techniques and electrophoresis. The collected data were recorded in the checklist created by the researcher.
Results
The total number of 209 patients with non-viral hepatitis, with a mean age of 37.98 years participated in this study. In patients with non-viral hepatitis, 50.2% of patients had polyclonal hypergammaglobulinemia, in 17.2% ANA was positive, in 16.3% ASMA was positive, and 1.9% LKM was positive.
Conclusion
hypergammaglobulinemia, ANA, and ASMA are suitable antibodies for autoimmune hepatitis. Moreover, laboratory results of ANA and ASMA in patients with autoimmune hepatitis indicate low levels of these antibodies in Iran and their deficiency in other countries. Conventional diagnostic methods can provide a definitive diagnosis. Therefore, it shows the need for further examination of laboratory instruments and wider use of other diagnostic methods, including biopsy and further assessments.
Fracture-related infection of the lower limb caused by Mucor velutinosus: amputation or salvation?
Authors: Eijkenboom Alexander , Militz Matthias , Kern Thomas , Papetti Maurizio , Krenn Veit , Hackl Simon
Published: April 2024

Purpose:
Fracture-related infections caused by mucormycosis are rare and potentially fatal. Evidence-based experience with its treatment is limited and surgical management ranges from limb salvage to amputation, with indications not always clear.
Case presentation:
A 56-year-old woman was admitted after an aircraft accident, sustaining major trauma injuries, including a Gustilo-Anderson type III open ankle joint fracture. Following initial damage control surgery with external fixation, the patient developed a fracture-related infection in the ankle caused by Mucor velutinosus. Despite its invasive growth and tenacity, surgical debridement combined with systemic and local antifungal therapy led to remission in this immunocompetent patient. The ankle arthrodesis achieved bone union with a hexapod fixator 10 months post trauma.
Conclusion:
In the treatment of invasive mucormycosis, a multidisciplinary approach is necessary. Through apt diagnosis and thorough treatment by experienced surgeons, infectiologists and pathologists successful limb salvage may be attained in patients with an intact immune system and amputation can be prevented.
A Novel Method for Establishing a Rabbit Model of Diabetic Periarthritis: The Combination of Alloxan and a Continuous Strain with Ice Compression
Authors: XIONG Zichao , PENG Sichen , CHENG Shaodan , GE Cheng , ZHANG Yang , WANG Shihui , GAO Yunwen , MA Yinghui
Published: April 2024

Background
Diabetic shoulder periarthritis is a prevalent form of shoulder periarthritis that causes significant discomfort to patients. However, the pathogenesis and treatment of this condition remain unresolved, highlighting the need for a stable and effective experimental animal model. The use of animal models is the primary experimental method for studying the pathogenesis and treatment of human shoulder periarthritis. The absence of an animal model for diabetic shoulder periarthritis is a major obstacle to the advancement of related research.
Methods
This study aimed to develop a rapid, simple, and naturally pathologically consistent model of diabetic shoulder periarthritis using a combination of alloxan and continuous strain and ice compression methods. Postinduction, pathological specimens were collected from the long head of the biceps tendon, shoulder joint synovium, and pancreas for macroscopic, histological, immunohistochemical, and biochemical assessments, as well as radiological evaluation through MRI of the shoulder joint.
Results
MRI revealed that the diabetic shoulder periarthritis model group exhibited more pronounced joint effusion and tendon structural disorders at various time points than did the control group. An increase in signal intensity within the joint cavity was observed at 14 days postinduction compared to 7 days, indicating an increase in effusion. The tendon fibers in the model group were disorganized, the synovial tissue structure was dense, with significant vascular proliferation and synovial cell hyperplasia, and the degree of fibrosis increased over time. Pancreatic islet observation revealed a significant reduction in islet number and sparse islet cells in the diabetic shoulder periarthritis model group compared with those in the control group. These results indicate that the diabetic shoulder periarthritis model group exhibited more severe pathological changes in structure and function.
Conclusion
The combination of alloxan and continuous strain and ice compression can be used to successfully and rapidly and easily induce a rabbit model of diabetic shoulder periarthritis. This study provides further options for the establishment of an animal model for diabetic shoulder periarthritis.
Long Term Impact of Child Abuse in University Students in Al Dakahlia Governorate
Authors: Soliman Amir , Hamdy Reem , Mohammed Amira. H
Published: April 2024

Background: A growing body of research underscores the detrimental impact of child maltreatment on a child's development. Encompassing a wide range of actions by caregivers that significantly impede optimal development and violate societal norms, child maltreatment can manifest in various forms, including neglect of physical, cognitive, emotional, and social needs.
Objectives: To investigate the long-term psychological and social sequelae associated with different types of child abuse specifically within a university student population.
Methods: Employing a cross-sectional design, researchers conducted the study over a six-month period. Participants completed self-report questionnaires in the presence of research team members. The questionnaires were designed to assess the type of child abuse experienced, along with its long-term physical, social, and psycho-behavioral effects.
Results: The study's findings revealed a compelling association between a history of child abuse and a multitude of negative long-term psycho-behavioral consequences in university students. Specifically, participants reported experiencing symptoms of generalized anxiety, low self-esteem, feelings of inadequacy, and post-traumatic stress disorder (PTSD). Notably, gastrointestinal problems emerged as the primary physical health concern linked to child maltreatment.
Conclusion: This investigation contributes to the existing body of knowledge by demonstrating a significant association between child abuse and a range of adverse long-term outcomes in university students. These outcomes encompass a spectrum of psycho-behavioral issues, such as anxiety, low self-esteem, and PTSD, as well as physical health concerns like gastrointestinal problems. The findings underscore the critical need for further research to elucidate the specific mechanisms underlying these associations and to inform the development of effective preventive and intervention strategies to mitigate the long-term consequences of child maltreatment.
Trial registration: The study was retrospectively registered with ClinicalTrials.gov under the identifier NCT06366126 on April 10, 2024.
A negative association between the Life’s Essential 8 and overactive bladder in United States Adult
Authors: Wei Baian , Lin Pinli , Zhao Ying , Wang Shusheng , Su Qingyuan , Deng Tewei , Deng Lili , Tang Xiaona , Liang Yuyan , Gu Chiming , Tan Pingjuan
Published: April 2024

Background: Overactive bladder (OAB) significantly impacts the quality of life of affected individuals. This study aims to investigate the association between Life’s Essential 8 (LE8) and the presence of OAB among adults in the United States.
Methods: We included adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. LE8 score were categorized as low (0–49), moderate (50–79), and high (80–100). We utilized multivariable logistic models and restricted cubic spline models to assess these associations.
Results: A total of 25,859 participants were included, among whom 5,255 were determined to have OAB. After adjusting for potential confounders, higher LE8 score were significantly associated with a lower risk of OAB (OR 0.78; CI 95% 0.75-0.81). This relationship exhibited a negative linear dose–response pattern. Similar patterns were also identified in the association between health behavior and health factor scores with OAB. Subgroup analyses confirmed the robustness and reliability of the results.
Conclusions: Our study reveals a negative linear association between LE8 and its subscale scores, and the presence of OAB risk. These findings suggest that adherence to the LE8 framework might be advantageous in reducing OAB risk.
Predictive Value of Progesterone Receptor in Advanced Stage Breast Cancer Patients Treated with CDK4/6 Inhibitors
Authors: Öner İrem , İnci Bediz Kurt , Tolunay Pınar Kubilay , Karabuğa Berkan , Türkel Alper , Ateş Öztürk , Karaçin Cengiz
Published: April 2024

Purpose: Phase III studies investigating CDK4/6 inhibitors have failed to uncover significant predictive or prognostic markers aiding clinicians in therapeutic decision-making. Given the treatment complexity, identifying patient and tumor traits is crucial for CDK4/6 inhibitor use across varied treatment approaches.
In our study, we aimed to evaluate the predictive role of PgR expression levels in patients with advanced-stage ER+/HER2- breast cancer treated with CDK4/6 inhibitors.
Methods: In the study, 246 patients who received a combination of CDK4/6 inhibitors and endocrine therapy as first-line treatment were evaluated retrospectively. Those with PgR levels below 20% were called low PgR expression patients, and those with 20% and above were called high PgR expression patients. These two groups were compared regarding demographic characteristics and progression-free survival (PFS).
Results: The mPFS of low PgR expression patients was 23.85 (95% CI; 15.47-32.23) months, and that of high PgR expression patients was 34.66 (95% CI; 24.30-45.02) months, and this was statistically significant (p: 0.008). There was also a difference in mPFS between patients with de novo disease and those with recurrent disease at diagnosis (NE vs. 25 months, respectively; p: 0.021). Additionally, tumor PgR expression (low vs. high) and disease status (de novo vs. recurrent) were determined to be independent predictive factors.
Conclusions: Our study is clinically significant as it demonstrates the impact of PgR expression levels on PFS, especially given the absence of identified biomarkers predicting which patients will benefit most from CDK4/6 inhibitor treatments. However, these positive data need to be supported by further studies.
Harnessing Complexity: Integrating Remote Sensing and Fuzzy Expert System for Evaluating Land Use Land Cover Changes and Identifying Mangrove Forest Vulnerability in Bangladesh
Authors: Islam Md. Monirul , Rafi Dewan Abdullah Al , Jannat Arifa , Aruga Kentaka , Liebenehm Sabine , Hossain Radita
Published: April 2024

In this study, we analyze Landsat images to examine the alterations in land cover within the Sundarbans and its surrounding regions in Bangladesh, spanning twenty-one years from 2000 to 2021. Furthermore, we develop a vulnerability map considering the combined effect of eight socioeconomic, geophysical, and climatic factors. The results show that a significant portion of the mangrove forest has been transformed into aquaculture practices because of the expansion of high-value shrimp cultivation. A decrease in forest areas and the expansion of aquaculture zones suggest a livelihood shift among the local population over time. This transition has adversely affected human activities within the ecosystem and the biodiversity of mangrove forests. Consequently, it is imperative to implement suitable measures to enhance the state of mangrove forests and safeguard their biodiversity. The vulnerability analysis shows that the highly vulnerable, moderately vulnerable, and low vulnerable areas cover 35.66%, 26.86%, and 19.42%, respectively. The vulnerability maps generated in this research could serve as a valuable resource for coastal planners seeking to ensure the sustainable stewardship of these coastal mangrove forests. These results offer a detailed understanding of coastal mangrove LULC patterns and vulnerability status, which will be useful for policymakers and resource managers to incorporate into coastal land use and environmental management practices urgently.
Structural basis and biased signaling of proton sensation by GPCRs mediated by extracellular histidine rearrangement
Authors: Sun Jin-Peng , Guo Lulu , Zhu Kong-Kai , Zhong Ya-Ni , Gao Mingxin , Liu Junyan , Qi Zhimin , Liu Zili , Rong Naikang , Zhang Minghui , Li Dongfang , Zhang Qi-Yue , Yang Gongming , Zhang Xinxin , Zhang Mingyue , Ding Ning , Yang Zhao , Xiao Peng , Xia Ming , Yu Xiao , Gaole Alatan , Yang Fan
Published: April 2024

Proton sensing by membrane G protein-coupled receptors (GPCRs) is crucial in controlling the breathing rate, bone formation, and cardiovascular and kidney functions. However, the structural basis and mechanistic insights of proton sensing-induced GPCR activation remains unclear. Here, we report seven cryo-EM structures of GPR4 and GPR68, two well-known proton-sensing receptors, at different pH values and in complex with Gs or Gq trimers. Structural inspection, structure-based pKa calculations, and mutational and computational analyses revealed that the protonation of two conserved extracellular histidines in ECL2 and TM6, HECL2-45.47 and H7.36, induced polar network formation and other conformational changes to tether TM6 to ECL2, and these changes constitute the central common mechanisms of the proton-induced activation of both GPR4 and GPR68. Unexpectedly, proton sensation by specific extracellular histidine determined biased G protein subtype coupling of GPR4. Moreover, GPR68 has an additional pH-sensing residue, H842.67, whose protonation facilitates tighter interactions between TM2, ECL1 and ECL2, which may contribute to the more acidic optimal pH range for GPR68 activation than for GPR4 activation. The propagation path connecting proton-sensing histidines to the toggle switch and the structural basis of the Gs and Gq coupling of GPR4 and GPR68 were characterized. In summary, our study provides structural and mechanistic insights into the proton sensing, activation and downstream effector coupling mechanisms of two proton-sensing GPCRs.
AI-Enhanced Audio-Based Predictive Control for Injection Molding Machines in the Era of IoT
Authors: Huang Ming-Shyan , Chen Jian-Yu , Kanga Chih-Wei , Chou Tung-Hsiang
Published: April 2024

In the past, most of traditional master craftsmen always adopted the acoustic actions to recognition the situation of machine. Along with the development of time and technology, the mode of industry has changed with the Fourth Industrial Revolution (Industry 4.0). The long been known for the mother of industry, mold industry, has been inevitably impacted by Industry 4.0. This research stems from the structure of the six-level IoT model, through Internet connecting sensors, data collection, and the appropriate implementation of human and machine interface to intellectualize the injection molding machine. This research has collected 130 times of audio frequency, and there were 53 effective data sets, in sum there were 34,030,640 datasets. There were 5 manufacturing actions of petroleum molding machines that were successfully identified. Due to the low accuracy of one of the manufacturing actions, the training of audio frequency is based on the other four. In the end, there are 93.64% of accurate AI intelligent identifying models. Concurrently, through labeling the audio characteristics of different manufacturing parameters, the model recognizing audio characteristics from injection molding machines under different injection speed and rotation speed parameters is successfully trained. It is expected that in the future, other researchers can use this research as a reference to further strengthen the correlation between audio characteristics and injection molding machines to engage a more in-depth and diverse application of this topic.
JEL Classification: C80, C88, C90.
Study on the characteristics of acoustic-thermal precursors of destabilization damage in coal-rock combination bodies with different proportions
Authors: Hao Tianxuan , Wang Guoqing , Li Fan , Tang Yiju , Yuan Meiqi
Published: April 2024

The destabilization and damage process of the coal-rock body is accompanied by the release of acoustic and thermal signals. In order to investigate the destabilization and damage precursor signal characteristics of coal-rock combination bodies with different ratios, and to analyze the reliability and applicability of the warning signals, this paper carries out the uniaxial compression tests of 7 different ratios of coal-rock combined body specimens by using the rock mechanics loading test system and the synchronous monitoring platform of IR and AE and analyzes the destructive precursor feature laws of specimens in terms of the mechanical, acoustic-emission, infrared thermographic, and temperature characteristics, respectively. The results show that: the strength characteristics of the specimens satisfy the linear relationship with the coal-rock ratio, the smaller the coal-rock ratio is, the greater the uniaxial compressive strength of the specimens and the more obvious the tensile damage is. The AE counts of the coal-rock combined body damage precursors are positively correlated with the coal-rock ratio, and the AE peak count is negatively correlated with the coal-rock ratio, and the smaller the coal-rock ratio is, the closer the slope of AE cumulative counts curves is to 1 at the stage of the peak damage. In the elastic and yielding phases, the MIRT curve fluctuates and rises, and before the peak damage, the MIRT curve shows a "V" shape, and the smaller the coal-rock ratio is, the more obvious the "V" shape is. When the coal-rock ratio is 1:3 or less, the monitoring effect of IR is better than that of AE, and AE monitoring is more suitable for specimens with a coal-rock ratio greater than 1:3. When the coal-rock ratio is 3:1, IR monitoring is not as effective as AE monitoring. Therefore, the synergistic monitoring of AE and IR can make the early warning signal of coal-rock combination bodies damage precursor more reliable and accurate.
The Association between Systemic Immune-Inflammation Index and Cardiotoxicity Related to 5-Fluorouracil in Colorectal Cancer
Authors: Liu Xiaoqin , Wang Yan , Wang Wenling , Dong Hongming , Wang Gang , Chen Wanghua , Chen Juan , Chen Weiwei
Published: April 2024

Background and aims: The cardiotoxicity related to 5-fluorouracil（5-FU） in cancer patients has garnered widespread attention. The systemic immune-inflammation index (SII) has recently been identified as a novel predictive marker for developing cardiovascular diseases in healthy individuals. However, it remains unclear whether the increasing SII leads to a higher risk of cardiotoxicity related to 5-FU. This study aims to address this gap by investigating the association between SII and cardiotoxicity related to 5-FU in a colorectal cancer cohort.
Methods: From January 1, 2018 to December 31, 2020, colorectal cancer patients who underwent 5-FU-based chemotherapy at affiliated cancer hospital of Guizhou Medical University were included. After adjustment for confounders and stratification by tertiles of the interactive factor, linear regression analyses, curve fitting and threshold effect analyses were performed.
Results: Of the 754 participants included ﬁnal analysis, approximately 21% (n=156) of participants ultimately experienced cardiotoxicity related to 5-FU. Monocyte (M) was identified as an interactive factor for SII on cardiotoxicity related to 5-FU. In the low tertile of M (T1: M≤0.38×109/L), increasing log SII was positively correlated with cardiotoxicity related to 5-FU (Odds Ratio [OR], 8.04; 95% confidence interval [95%CI], 1.68 to 38.56). However, a non-linear relationship between log SII and cardiotoxicity was observed in the middle tertile of M (T2: 0.381.37 (OR, 0.14; 95%CI, 0.02 to 0.88) but with a threshold effect. In the high tertile of M (T3: M>0.52 × 109/L), a trend towards a negative linear correlation between the log SII and cardiotoxicity was observed (OR, 0.85; 95%CI, 0.37 to 1.98).
Conclusion: Our findings suggest that SII may serve as a potential biomarker for predicting cardiotoxicity related to 5-FU in colorectal cancer patients. SII is an independent risk factor for cardiotoxicity related to 5-FU with low monocyte levels (T1). Conversely, in the middle monocyte levels (T2), SII is a protective factor for cardiotoxicity related to 5-FU but with a threshold effect.
Analyzing the Physical Properties of Polymer-Loaded Phenolic Resin
Authors: Afzal Amina , Khalid M Adeel , Kalsoom Umber
Published: April 2024

This research interrogates the effect of loading phenolic resin (\({C}_{8}{H}_{6}{O}_{2}\)) and graphene oxide (GO) solutions into a polyethersulphone (PES) matrix to improve the physio-mechanical properties of PES. A new class of thin-film was successfully synthesized by incorporation of phenolic resin (\({C}_{8}{H}_{6}{O}_{2}\)) and graphene oxide (GO) solutions into a 2 wt% polyethersulphone (PES) matrix and its application in pharma packaging was investigated. To alter the mechanical properties of the thin films, a mixture of phenolic resin and graphene oxide was dispersed into a prepared polyethersulphone solution at varying concentrations using a solution mixing technique. the XRD spectra for PES/GO/PR thin films to confirm the presence of GO. The sharp peak was observed at 2θ = 19.79˚. The tensile testing of the polyethersulphone composite thin films revealed an increase in the tensile strength, which rose from 3.74 to 33.91 MPa, and Young's modulus was also improved from 9.97 to 20.85 MPa. Additionally, there was a significant improvement in the percentage elongation, which rose from 1.02 to 1.66% for PC-4, indicating a strong agreement between the filler used and the composition method.
Flow Characteristics and Performances of the Electrostatic Precipitator Enhanced by Turbulence Agglomerators
Authors: Maulana Hasan Syafik , Lin Rong-Xian , Tien Wei-Hsin
Published: April 2024

The electrostatic precipitator (ESP) is an effective device for removing particulate matter (PM) in the air, especially for larger particles. However, the collection efficiency of sub-micron particles is significantly reduced. This could be a problem when PM becomes a virus carrier, as happened in 2019 when the spread of Coronavirus 2 (SARS-CoV-2). This virus can survive in aerosols for an hour and be transmitted via particulate matter attached to a surface for several days. One possible solution is to add particle agglomerators before the charging section of the ESP to coagulate particles together into a larger one to improve the particle collection efficiency. This study examined the flow characteristics of eight different turbulence agglomerator configurations using Particle image velocimetry (PIV). The effectiveness of agglomeration and collection efficiency were also compared. The impacts of the ribs' profiles, slits, and inclination angle conditions were investigated. The results of the flow visualization indicate that Z-type turbulators produce a greater and larger region of turbulent kinetic energy (TKE) than quadrilateral-type turbulators. The 135° inclined angle minimizes the turbulent kinetic energy. However, the slit in the center of the ribs can increase it. Particle sizer measurements imply that the turbulence agglomerator successfully coagulates the ultrafine particles into bigger particles, and the efficiency is correlated with the turbulent kinetic energy. Particle agglomeration increases the ESP's ability to collect ultrafine particles, but because of the weak cohesive force, coagulated particles could disintegrate back into ultrafine particles when they collide on the collecting plate.