bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced capacity of thiol-functionalized sugarcane bagasse and rice husk biochars for arsenite sorption in aqueous solutions
Authors: hasan Israr Masood ul , Niazi Nabeel Khan , bibi Irshad , Younas Fazila , Al–Misned Fahad , Shakoor Muhammad Bilal , Ali Fawad , Ilyas Shazia , Hussain Muhammad Mahroz , Qiao Jinli , Lüttge Andreas
Published: April 2024

Utilization of biowastes to produce biochars as sorbents to remove toxic elements from water represents an important pathway for aquatic ecosystem decontamination. Here we explored the significance of thiol-functionalization on sugarcane bagasse biochar (Th/SCB-BC) and rice husk biochar (Th/RH-BC) to enhance arsenite (As(III)) removal capacity from water and compared their efficiency with pristine biochars (SCB–BC and RH–BC). The maximum As(III) sorption was found on Th/SCB-BC and Th/RH-BC (2.88 and 2.51 mg g−1, respectively) compared to the SCB–BC and RH–BC (1.51 and 1.40 mg g−1). Relatively, greater percentage As(III) removal was observed with the Th/SCB–BC and Th/RH–BC (92% and 83%, respectively) at pH 7 compared to pristine SCB–BC and RH–BC (65% and 55%). Langmuir (R2 = 0.99) isotherm and pseudo–second order (R2 = 0.99) kinetic models provided the best fits to As(III) sorption data. Desorption experiments indicated that the regeneration ability of biochars was in the order of: Th/SCB–BC (88%) > Th/RH–BC (82%) > SCB–BC (77%) > RH–BC (69%) up to three sorption-desorption cycles. The FTIR spectroscopy and XPS results demonstrated that the thiol (S–H) surface functional groups were successfully grafted on the surface of biochars and enhanced As removal from water. Spectroscopic data indicated that functional groups, such as S–H, –OH, –COOH, C=O were involved in slightly enhanced As(III) sorption on thiol-engineered biochars. This study highlights that thiol-grafting on biochars, notably on SCB-BC, enhanced their ability to remove As from water, which can be used as an effective technique for the treatment of As from drinking water.
TIGIT and PD-L1 co-blockade promotes clonal expansion of multipotent, non-exhausted anti-tumor T cells by facilitating costimulation
Authors: Chiang Eugene , Nutsch Katherine , Banta Karl , Wu Thomas , Mittman Stephanie , Duong Ellen , Tran Charles , Nabet Barzin , Qu Yan , Williams Katherine , Müller Sören , Patil Namrata S. , Mellman Ira
Published: April 2024

Blockade of the immune checkpoints PD-1 and TIGIT has demonstrated activity in mouse tumor models and human cancer patients. Although these coinhibitory receptors can restrict signaling in CD8+ T cells by regulating their associated costimulatory receptors CD28 and CD226, the functional consequences of combining PD-1 and TIGIT blockade remain poorly characterized. In mouse tumor models, combination blockade elicited CD226-driven clonal expansion of tumor antigen-specific CD8+ T cells. The expanded clones emerged from a population of stem-like cells in draining lymph nodes (dLN), entering the blood as a previously unidentified single-phenotype, multi-clonal population. Upon reaching the tumor, these tumor antigen-specific transiting cells expanded further and differentiated into effector or exhausted T cells, with combination blockade restricting entry into the exhaustion pathway by favoring costimulation. Thus, PD-1 and TIGIT inhibition helps shape the repertoire of tumor-reactive CD8+ T cells in dLN and determines their immunological fate in the tumor to enhance therapeutic benefit. Analysis of clinical trial samples suggests a similar mechanism may also occur in cancer patients.
The Facebook Algorithm's Active Role in Climate Advertisement Delivery
Authors: Sankaranarayanan Aruna , Hemberg Erik , Sapiezynski Piotr , O'Reilly Una-May
Published: April 2024

Communication strongly influences attitudes toward climate change. In the advertising ecosystem, we can distinguish actors with adversarial stances: organizations with contrarian or advocacy communication goals towards climate action, who direct the advertisement delivery algorithm to launch ads in different destinations by specifying targets and campaign objectives. We present a 2 part study; part 1 is an observational study (N=275,632) and part 2 is a controlled (M=650) study. Collectively, they indicate that the advertising delivery algorithm could be actively influencing climate discourse, asserting statistically significant control over advertisement destinations, characterized by U.S. state, gender type, or age range. Further, algorithmic decision-making might be affording a cost advantage to climate contrarians. These findings have implications for climate communications and misinformation research, revealing consequential ways in which the advertising
algorithm could be skewing delivery decisions away from targeting intentions, thereby influencing audience attitudes towards climate change.
A Deep Multi-Omics Integration Approach Reveals New Molecular Features of Uterine Leiomyosarcoma
Authors: Petta Tirzah , Falcao Raul Maia , de Souza Jorge , Gonzalez-Molina Jordi , Mathieson William , Carlson Joseph
Published: April 2024

Uterine leiomyosarcoma (uLMS) is a rare and aggressive cancer representing approximately 2-5% of all uterine malignancies. The molecular heterogeneity and pathogenesis of uLMS are not well understood and translational studies with the aim of discovering the vulnerabilities of this tumor type are of high priority. We conducted an innovative comprehensive multi-omics integration study from DNA to protein using fresh frozen tumors to unravel unprecedented molecular features of uLMS. Here we present that two tumors harbor actionable therapeutic targets, IDH1_p.Arg132Cys and KRAS_p.Gly12Cys and homologous recombination deficiency (HRD) was the most predominant genomic signature, suggesting that uLMS patients could benefit from individualised precision medicine. Additionally, 80% of the samples presented a chromothripsis signature reinforcing the aneuploidy phenotype of these tumors. Moreover, uLMS with high proliferation score and high Ki67 expression presented a worse overall survival. By applying an innovative pipeline to explore structural variants, we observed a high frequency of balanced translocation involving the gene EEF1A1 with enrichment of EGFR pathway. For the first time, uLMS proteomics analysis shows the enrichment of pathways associated with the suppression of innate immune system and extracellular matrix (ECM) organization. Finally, our comprehensive multi-omics integration analysis identified amplification of the gene CTHRC1 a gene from the matrisome with negative impact on the overall survival. Taken together, the deep functional multi-omics approach contributes to the detection of new molecular features of uLMS and suggests that patients would benefit from precision oncology in clinical practice.
Locoregional Recurrence-Free Survival in Postmastectomy Breast Cancer: A Comparative Longitudinal Study of Hypofractionated Versus Conventional Fractionated Radiation Therapy
Authors: Meloot Suma Susan , Raveendran Ciniraj , Yadev IP
Published: April 2024

Background: The primary objective of our study was to estimate the difference in locoregional recurrence-free survival (LRFS) and investigate the influence of various clinical factors on the risk of locoregional recurrence (LRR) in post-mastectomy breast cancer patients treated with two different radiation fractionation.
Methods: Data from 317 post-mastectomy patients were retrospectively analyzed. The conventional fractionation schedule was 50 Gy in 25 fractions; the hypofractionated schedule was 42.6 Gy in 16 fractions. LRFS between the two fractionations was estimated and compared.
Results: The median LRFS for hypofractionated radiation (n=194) is 52.5 months (95% CI, 23.0–60.0); for conventional fractionated radiation (n=123) is 60.0 months (95% CI, 35.5–60.0; P=0.008), significant difference at first, but not after further analysis. With univariate cause-specific risk analysis, the Hazard Ratio (HR) for recurrence with hypofractionated radiation was 1.55 (95% CI: 0.76–3.15; p = 0.2). The cause-specific HR for competing events with hypofractionated radiation was 1.04 (95% CI: 0.67–1.60; p = 0.9). With multivariable cause-specific hazard analysis, HR for recurrence with hypofractionated radiation vs. conventional is 1.27 (95% CI 0.61–2.65; p = 0.5). Nodal stage is a significant predictor of LRR. Positive margins are associated with higher LRR risk (HR 2.02;p = 0.052). Age, tumor stage, chemotherapy, histology, tumor grade, and hormone receptor status did not significantly influence LRR risk.
Conclusion: For post-mastectomy breast cancer patients, hypofractionated radiation treatment is not different from conventional fractionation in achieving locoregional control. Lymph node positivity is a crucial determinant of local recurrence.
Bibliometric analysis of a comprehensive of culture＆symbol in Character animation during (2004–2024)
Authors: Yang Chen , Jamali Siti Salmi , Husain Adzira
Published: April 2024

The analysis of academic research on animated characters in the animation industry effectively summarises the current state of scholarly research on animated characters through a variety of software tools such as CiteSpace, VOS viewer, HistCite, and Bibliometrix analysis, and visually charts and formulates this data. Through study and research, it that the United States is (278) the most prolific country, and the United States has the highest intermediary centrality, as well as the most Centre National de la Recherche Scientifique (CNRS) and PEOPLES R CHINA are the most cited organizations and Countries/Regions with the highest intermediary centrality and Countries/Regions with the highest citation explosiveness, respectively. This study also suggests possible challenges and future directions in character design for animated characters.
Thiousulfate Leaching in Carbonaceous Gold-Bearing Ores in Ethiopia
Authors: Chaka Kaleb , Rupprecht Steven
Published: April 2024

One of the main unit operations in metallurgical processing plant designs is gold leaching. The traditional cyanidation process was chosen and is currently in widespread use. However, the mining sector is looking for lixiviants other than cyanide. Cyanide's effects on the environment have made it difficult for humans and other biotic creatures to survive. There is now research to discover a substitute for this cyanide. It is currently argued that thiosulfate is a preferable substitute for cyanide. The effectiveness of thiosulfate as a leaching agent in carbonaceous gold-bearing ores in Ethiopia is discussed in this paper compared to cyanide. The study has looked into the advantages of employing thiosulfate over cyanide from a technical, environmental, and economic standpoint. The leaching effects of both lixiviants on carbonaceous gold-bearing ores extracted from MIDROC Legadembi Open Pit mine in Southern Ethiopia, Oromia region, were examined in a laboratory experiment. After 48 hours of leaching, it was discovered that thiosulfate has a better and quicker recovery of 91.54% over 61.70% of cyanide recovery. Tables and graphs are used to demonstrate thiosulfate's technical advantage over cyanide. As a result, this paper provides evidence regarding the Legadembi gold mine in Ethiopia's amenability to thiosulfate leaching on carbonaceous gold-bearing ores. A further research perspective is also sought for thiosulfate leaching in other refractory ores.
Pulmonary nocardiosis due to Nocardia otitidiscaviarum in an immunocompetent host:A case report and literature review
Authors: Wan Junjun , Feng Feifei
Published: April 2024

BackgroundNocardia otitidiscaviarum is a relatively rare pathogen that belongs to the distinctive species within the Nocardia genus. It is typically found in soil or decaying matter and can enter the body through a break in the skin or, less commonly, through the respiratory tract. Pneumonic nocardial disease is an uncommon infection that primarily affects immunocompromised individuals.
Case presentationThis article presents a case study of a pneumonic nocardiosis infection in a 22-year-old immunocompetent female with symptoms of fever, cough, and sputum production. The patient had no prior history of diabetes, was not on steroid therapy, had no adverse lifestyle habits, and had not been diagnosed with tuberculosis previously. A chest CT scan revealed suppurative inflammation in both lungs. Bronchoscopy was conducted, and alveolar lavage fluid was collected and sent for culture and next-generation sequencing (NGS). NGS results confirmed the presence of Nocardia otitidiscaviarum within 24 hours. After 96 hours of conventional laboratory culture, positive colonies were observed. The morphological features of bacteria in these colonies were consistent with Nocardia otitidiscaviarum, as confirmed by Gram staining. The patient received precise antibiotic treatment and showed positive outcome. We conducted a review of previously documented cases involving infections caused by Nocardia otitidiscaviarum.
ConclusionsEnhanced recognition of the diverse presentations of Nocardia otitidiscaviarum could potentially elevate the survival rate of this otherwise lethal condition.
Simulation analysis of pressure relief effect of upward mining in the lower protective layer (group) of deep extra-thick coal seam
Authors: Qin Guangpeng , zhang zhenyu , Cao Jing , Ma Jinpeng , Zhang Xueyuan
Published: April 2024

In this paper, an examination of the upward mining of multi-protected layers through simulation is conducted in a mine in Dongsheng Coal Field, China, as an example. FLAC3D numerical simulation software was used to calculate the mining scheme of the lower protected layer (group) and analyze the stress changes and pressure unloading characteristics of the protected layer during the mining process. Similar simulation experiments were conducted to provide additional explanations on the characteristics of fissure development in the overburden rock layer and the expansion and deformation characteristics of the protected layer during the mining process. The test results show that the stress distribution curve of the protected layer can be divided into four parts: the original rock stress area, the stress concentration area, the stress reduction area, and the stress recovery area. The bending deformation of the coal seam is evident after the completion of mining the lower protected seam group, and the expansion deformation area undergoes three processes: increasing, decreasing, and stabilizing. Overall, the unloading rate and length of double-protected seam mining are much larger than those of single-protected seam mining, providing an engineering basis for the mining of deep extra-thick coal seam protected seam (group).
Personalized glucose prediction using in situ data only
Authors: Salathé Marcel , Toumi Marouane , Singh Rohan
Published: April 2024

The worldwide rise in blood glucose levels is a major health concern, as various metabolic diseases become increasingly common. Diet, a modifiable health behavior, is a primary target for the preventive management of glucose levels. Recent studies have shown that blood glucose responses after meals (post-prandial glucose responses, PPGR) can vary greatly among individuals, even with identical food consumption, and suggested that the gut microbiota might play an important role in these differences. While accurate glucose response prediction has been achieved using various features like microbiome data and blood parameters, the exact influence of each individual factor on the prediction is still not clear. Here, we show that a machine learning algorithm with data collected from a digital cohort with over 1,000 participants can achieve high accuracy in PPRG prediction. Interestingly, we find that the best PPGR prediction model only requires glycemic and temporally resolved diet data. The demonstrated ability to predict PPGR with high accuracy using only data collected in situ, without the need for biological lab analysis, offers a path towards highly scalable personalized nutrition and glucose management strategies.
Overexpression of Heme oxygenase 1 enhances the neuroprotective effects of exosomes in subarachnoid hemorrhage by suppressing oxidative stress and endoplasmic reticulum stress
Authors: Gao Qiongqiong , Su Zhumin , Pang Xiangxiong , Chen Jinshuo , Luo Ruixiang , Li Xiaoyang , Zhang Chi , Zhao Yun
Published: April 2024

Aims: To investigate the therapeutic effects and potential mechanism of exosomes from Heme oxygenase 1 (HO-1)-overexpressing human umbilical cord mesenchymal stem cells (ExoHO-1) on subarachnoid hemorrhage (SAH) mice.
Methods: Western blotting, particles analyzer, and transmission electron microscopy were used to identify the exosomes. Garcia scoring system, Beam balance, Rotarod test, and Morris water maze test were performed to assessed the effect of ExoHO-1 and ExoCtrl on neurological function of SAH mice. TUNEL and Nissl staining were used to examinate the neuron apoptosis. Immunofluorescence, Western blotting, DHE, Enzyme-linked immunosorbent assay, and commercial kits were used to examine the levels of oxidative stress and endoplasmic reticulum stress.
Results: HO-1-overexpressing human umbilical cord mesenchymal stem cells loaded HO-1 into their exosomes. ExoHO-1 exhibited a significantly beneficial effects on short-term and long-term neurological function protecting. By reducing activation of PERK/CHOP/Caspase12 pathway and levels of oxidative stress, ExoHO-1 more effectively inhibited neuronal apoptosis in ipsilateral temporal cortex.
Conclusion: HO-1 over-expression enhanced the therapy of exosomes on the SAH mice by against neuronal apoptosis in SAH. These therapeutic effects are likely through suppressing the oxidative stress and endoplasmic reticulum stress.
The Influence of Patient Awareness on the Incidence and Severity of Pain During Propofol Injection: A Randomized Controlled Study.
Authors: bahr mahmoud , abdelaal ahmed , abdelbadie mohamed , moaz doaa
Published: April 2024

Background: Propofol, a widely utilized intravenous anaesthetic agent for induction and maintenance of anaesthesia, is renowned for its rapid onset and brief duration. However, discomfort associated with its injection is reported in approximately 20% to 90% of cases, negatively impacting patient satisfaction and procedural safety.
Objectives: The primary aim of this study was to assess the influence of patient awareness regarding the potential for pain during propofol injection on both the occurrence rate and severity of the pain experienced. The assessment of pain scores associated with propofol injection served as the principal endpoint of the investigation.
Methods: This randomised, controlled trial was conducted at Beni-Suef University Hospital with approval from the anaesthesiology department, the surgical ICU, pain management, and the hospital's ethical committee. A total of 210 patients participated in the study, randomly allocated into two groups: Group A (Aware), informed about the potential for pain associated with propofol injection, and Group B (Unaware), not informed of this possibility.
Results: Statistical analysis revealed significant differences between the groups in terms of verbal categorical scoring (VCS) and the numerical rating scale (NRS) across various pain intensity levels (0, 1-3, 4-6, 7-9, and 10). However, no significant differences were observed regarding age, weight, and the American Society of Anaesthesiology (ASA) classification.
Conclusion: The findings underscore the significant impact of patient awareness on the experience of pain during propofol injection. Educating patients about the possibility of pain may influence their perception and reporting of pain intensity, suggesting a need for tailored patient communication strategies in clinical practice.
Resolving Mega-Dams Energy-Water Nexus in the Eastern Nile Basin During Prolonged Droughts
Authors: Heggy Essam , Abotalib Abotalib , You Jongeun , Hanert Emmanuel , Ramah Mohamed
Published: April 2024

Optimizing hydropower generation from mega-dams during prolonged droughts while minimizing downstream water deficits is decisive to resolving the ongoing major conflict on transboundary river management in the highly populous Eastern Nile basin. Our study provides comprehensive assessments of the efficiency of multiple drought-mitigation operation policies based on the outcomes of negotiations. In addition, we develop four novel policies that reduce potential adverse downstream impacts and maximize upstream hydropower generation during prolonged droughts. We use a multi-reservoir hydraulic-energy model with the most up-to-date entries to simulate and optimize the hydropower generation and reservoir level response of the two Nile's largest mega-dams, Grand Ethiopian Resonance Dam (GERD) and Aswan High Dam (AHD), utilizing 100 years of historical flow records. Our results show that, during wet and average flow conditions and a temporary drought, GERD can generate maximum hydropower without a noticeable downstream deficit. However, for prolonged droughts, GERD can still generate sustainable energy from more than 87% of its maximum hydropower while minimizing the dam-induced downstream water budget deficit to a manageable volume. Our up-to-date findings can reduce the negotiations' disparities on operating Nile’s hydropower mega-dams during prolonged drought and help reach a collaborative framework to mitigate the threats of rising hydroclimatic fluctuations.
The Introduction of a 42 + 4 Hour Work Week for Surgical Residents in Switzerland – a Stakeholder Analysis
Authors: Antony Pia , Kalkum Eva , MK Muller , Hager L , Probst Pascal
Published: April 2024

Background
The Swiss national union of residents and attendings (VSAO) has voiced its desire for a transition to a 42 + 4h work week, in which 42h be focued on patient care with the remaining 4h be dedicated solely to training purposes. This could potentially result in a decrease of 20% in surgical education time. The current study seeks to address the issues involved in its implementation as well as possible compensatory mechanisms.
Methods
This mixed methods study seeks to clearly underline the challenges associated with the implementation of a 42 + 4h work week. First, the major stakeholders were identified and analysed via umbrella review. Thereafter, a classic stakeholder analysis was performed. Via morphological matrix, possible models for the implementation of a 42 + 4h work week were developed and evaluated. Finally, representatives from the identified stakeholder groups were interviewed and given the opportunity to provide feedback.
Results
A total of 26 articles were identified by the literature search and were used to identify the major stakeholders and issues involved in the implementation of the desired work hour regulation. Overall, these showed conflicting results with regard to the effect decreased working hours would have on surgical training and patient outcomes. In the end, the morphological matrix produced three feasible and desirable models for the implementation of a 42 + 4h work week. Each included compensatory mechanisms like auxiliary staff, reduction in administrative tasks, and a switch to EPAs. In their interviews, the stakeholders generally supported these solutions.
Conclusion
Given the increasing emphasis on the importance of a positive work-life balance, it seems inevitable that the next few years will see the introduction of a 42 + 4h work week in Switzerland. However, it is imperative that every effort be made to preserve the quality of training and patient care for the next generations. This will require the cooperation of all stakeholders in order to find workable solutions.
Initial signs in patients with ruptured abdominal aortic aneurysms - Time for an expanded triad?
Authors: Bergmark Peter , Sadeghi Mitra , Talvitie Mareia , Hultgren Re
Published: April 2024

Objective Misdiagnosis of ruptured abdominal aortic aneurysms (rAAA) contributes to delayed treatment and potentially higher mortality. The symptomatology in patients with rAAA is complex and challenging, 25–50% presumably fulfill the criteria of the standard triad of signs (STS). The objective was to determine the initial signs registered for patients with verified rAAAs, and to investigate if an expanded diagnostic triad could increase the diagnostic accuracy.Methods A population-based study was conducted among all patients presenting with verified rAAAs in Stockholm County, Sweden, from January 2010 to October 2021. Patients were identified with ICD code 171.3 (rAAA). The STS was defined as 1) abdominal pain, 2) syncope and 3) the finding of a pulsatile abdominal mass, the prevalence of STS was investigated. An expanded triad included similar and related signs commonly registered for patients with rAAA, and was referred to as the modified abdominal aortic aneurysm rupture signs (MARS). The MARS-signs encompassed 1) the registered pain-associated symptoms or signs, 2) all hypovolemic associated signs, and 3) pulsatile abdominal mass and/or ultrasound finding, and the prevalence was similarly investigated. Finally, the STS and MARS were compared to evaluate the usefulness and performance of the MARS-score.Results A total of 216 patients were identified. The majority were men (77%) with a mean age of 77 years. The dominating symptom was abdominal pain (84%), followed by dizziness (50%). Few patients presented with three STS (13%), two STS were found in 37% and one STS in almost half of the patients (41%). By contrast, when applying MARS 35% presented with the complete expanded triad, 47% with two and 17% with one. Comparison of accuracy favored MARS (13% vs 35% with 3 signs, p < 0.001 for STS vs. MARS) (2 or 3 signs, 48% vs 82% STS vs MARS, p < 0.001).Conclusions The expanded MARS-signs could aid in easier and faster identification of rAAA patients, thus facilitating the first step with accurate diagnosis into the lifesaving rAAA care chain. Supportive diagnostic mnemonics and tools are especially important when targeting fatal diagnoses such as rAAA. Further studies are needed to investigate the implementation of the MARS-signs in various clinical settings.
Rare Serious Etiologies in Patients Admitted to Pediatric Clinics with Acquired Torticollis
Authors: SEÇİLMİŞ YILMAZ , GÜLEÇ AYTEN , DURMUŞ NİMETULLAH ALPER , GÜMÜŞ ÜMMÜGÜLSÜM ÖZGÜL , ÖZTÜRK SELCAN , CANPOLAT MEHMET , BÜLBÜL EMRE , ORAL ŞÜKRÜ , GÖKALP EMİR , PER HÜSEYİN
Published: April 2024

Purpose
Torticollis is a clinical symptom characterized by an abnormal head posture. It can be caused by simple muscle-related pathologies, space-occupying lesions, neurological diseases, genetic disorders, or even ophthalmic pathologies. In this study, we evaluated the underlying etiologies in patients admitted to pediatric emergency departments and pediatric clinics due to torticollis.
Methods
This retrospective study included 13 patients admitted with torticollis between July 1, 2018, and December 1, 2021.
Results
Four patients had cranial pathologies, including cerebellar ependymoma, choroid plexus carcinoma, pontine glioma, and diffuse astrocytoma. One patient had a demyelinating disorder: anti-myelin oligodendrocyte glycoprotein (MOG antibody)-associated disease (MOGAD). Three patients had spinal pathologies, including atlantoaxial subluxation, vertebral osteoblastoma, and spinal dural arteriovenous fistula. Two patients presented with ear, nose, and throat pathologies; specifically, laryngomalacia and reactive lymph nodes. One patient had epilepsy, one had ocular pathologies (strabismus and esotropia), and one had a rare neurodegenerative genetic disorder resulting in epileptic encephalopathy.
Conclusions
Torticollis is a symptom that may indicate serious underlying conditions. When evaluating children with torticollis, it is important to consider the possibility of a posterior fossa tumor until it is ruled out. Radiologic imaging and a comprehensive ophthalmologic examination should be performed, especially to assess intracranial and ocular pathologies, even if theneurological examination appears normal. This report presents a case of torticollis associated with MOGAD, which, to the best of our knowledge, has not been previously reported. Additionally, the report discusses a wide spectrum of torticollis presentations, including an extremely rare case involving a patient with ADPRHL2mutation who presented with paroxysmal torticollis and developed progressive neurodegeneration. These findings emphasize the importance of investigating multiple underlying etiologies of torticollis.
Sequential use of midazolam and Remimazolam besylate for sedation in critically ill, mechanically ventilated patients: a randomized controlled study
Authors: liu renhuai , Su Binxiao , Gan Guifen , Wang Guangming , Wang Chengli , Xu Ning , Feng Guangcai , Guo Hao , Yuan Qingxia , Li Aiguang , Zheng Wenping , Li Jiang , Chen Yu , Zhang Xijing
Published: April 2024

Background: Previous research has indicated that the administration of short-acting sedatives prior to weaning from mechanical ventilation is linked to a more rapid recovery and extubation process, as well as to lower intensive care unit (ICU) treatment expenses. The present study endeavors to assess the efficacy and safety of the sequential application of remimazolam besylate compared with midazolam before weaning from mechanical ventilation.
Methods: This multicenter, randomized controlled trial was conducted across medical and surgical ICU within a tertiary, academic medical center. The study population comprised critically ill, mechanically ventilated adult patients. Candidates anticipated to be ready for weaning from the ventilator within 12 hours were subjected to a Spontaneous Breathing Trial (SBT) safety screen, only those who successfully passed this assessment were considered for inclusion in the final phase of the study for subsequent randomization.
Patients were randomized to either group M, where the sedative regimen was transitioned to midazolam, or to group R, which involved a switch to remimazolam. Sedative dosages were titrated to achieve the targeted Richmond Agitation-Sedation Scale (RASS) score range of -3 to 0. The primary endpoint of the stud was the time to extubation.
Results: A total of 435 patients underwent screening, with 306 patients being randomized, and 272 patients ultimately included in the analysis, comprising 132 patients in group M and 140 patients in group R. Patients in group R maintained a lighter level of sedation compared to those in group M. And patients in group R demonstrated a significantly earlier recovery (P<0.05) and extubation (P<0.05) at the same RASS score before the cessation of sedatives. A higher prevalence of agitation was observed in group M as opposed to group R (20.45% vs. 8.57%, P=0.005). However, there was no notable difference in the incidence of delirium between the two groups.
Conclusions: In critically ill, mechanically ventilated patients receiving remimazolam besylate exhibited a shorter time to recovery and extubation before weaning from the ventilator, coupled with a diminished incidence of agitation.
Trial registration: ChiCTR 2200065048. Registered October 22. 2022
The fitness of pelargonium cuttings affects the relationship between the photochemical activity of the photosynthetic apparatus and rooting ability
Authors: Rapacz Marcin , Szewczyk-Taranek Bożena , Bani Ipsa , Marcinkowski Paweł
Published: April 2024

Pelargoniums cultivated for ornamental purposes rely on efficient vegetative propagation. This study researched applicability of chlorophyll fluorescence for validating the physiological conditions of pelargonium cuttings. Results indicated a correlation between the chlorophyll fluorescence and rooting potential. The ET0/RC values were negatively correlated with the rooting efficiency between the varieties and the duration of cold storage. A negative correlation was observed between OJIP parameters, representing energy flow in thylakoids, and chlorophyll content in cuttings with lower nutritional status. The phenomenological energy fluxes for leaf cross-sections and the number of active PSII reaction centers in the not-excited state (RC/CS0) increase with raised chlorophyll concentration. This imply the influence of rooting ability on the demand for photoassimilates in pelargonium cuttings, which can be detected early on through chlorophyll fluorescence analysis but not chlorophyll content measurements. Chlorophyll fluorescence evaluation, along with specific OJIP test parameters such as the performance indices PIABS and PItotal, prove useful for predicting rooting efficiency in relation to the nutritional status of cuttings, suggesting the effects of cuttings cold storage and discerning varietal differences in rooting. This study establish the pragmatic application of chlorophyll fluorescence assessment for elucidating the physiological intricacies of pelargonium cuttings and factors influencing rooting efficiency.
Macrophage Migration Inhibitory Factor (MIF) Axis Drives Intracranial Aneurysms Macrophage M1 Polarization: Insights from Single-Cell and Bulk RNA Sequencing
Authors: Huang Jian-huang , Chen Yao , Kang Yuan-bao , chen Jian-ning , Song Jian-hua
Published: April 2024

Background: Intracranial aneurysms (IAs) develop and progress through pathological processes, including inflammation and abnormal changes in the vascular structure. The cytokine Macrophage Migration Inhibitory Factor (MIF) is implicated in the pathology of vascular diseases. However, the role of MIF in IAs remains to be elucidated.
Methods: This study utilized the Gene Expression Omnibus (GEO) database to analyze samples from IAs and normal arteries. Differential expression of MIF mRNA was assessed via Bulk-RNA sequencing (GSE54083 for testing, GSE75436 for validation), and methylation levels were examined with data from GSE75434. Single-cell transcriptomics (GSE193533) were analyzed using the Seurat package to profile Vascular smooth muscle cells (VSMCs) and macrophages. The CellChat package explored cell communication, particularly between secretory VSMCs and macrophages.
Results: Significant upregulation of MIF mRNA was observed in IAs, correlating strongly (r=0.783, p=0.008) with elevated M1-like macrophages, an indication of diagnostic potential. A corresponding decrease in MIF methylation levels and an increase in secretory VSMC proportions were noted. Elevated intercellular MIF signaling suggests it regulates VSMC-macrophage communication, influencing IAs development.
Conclusion: Our findings delineate the MIF axis as a pivotal factor in IAs pathogenesis by modulating the activity of secretory VSMCs and M1 macrophages. This axis could present novel therapeutic avenues for managing IAs, potentially stalling progression or serving as adjunctive post-surgical treatment.
Effect of intravenous lidocaine on catheter‑related bladder discomfort, postoperative pain and opioid requirement in complex fusion lumbar spinal surgery: a randomized, double blind, controlled trial
Authors: Chantrapannik Ekasak , Munjupong Sithapan , Limprasert Natirat , Jinawong Sarita
Published: April 2024

Background: Catheter-related bladder discomfort (CRBD) and pain commonly arises postoperatively among patients experiencing intra-operative urinary catheterization. The study aims to demonstrate the effectiveness of intravenous lidocaine to prevent CRBD and postoperative pain in complex lumbar spinal surgery.
Methods: Sixty male patients, aged 20-79 years, scheduled for undergoing elective fusion spine surgery at least 2 levels were randomly assigned to obtain intravenous lidocaine
(1.5 mg/kg then 2 mg/kg/h) (group L) or a parallel volume of normal saline (group C). The primary outcome was incidence of moderate to severe CRBD in a postanesthetic care unit (PACU) between group comparison. The secondary outcomes were postoperative pain and the postoperative 24-hour of opioid requirement, mild and moderate to severe CRBD at 1-, 2-, 6- and 24-hours postoperative periods, patient satisfaction the adverse effects of lidocaine and surgical complications.
Results: Group L showed a significantly lower incidence of moderate-to-severe CRBD compared with that of group C at PACU (P = 0.002) and at 1 hour (P = 0.039). Moreover, group L experienced a significantly reduced average pain score compared with that of group C in all time periods (P<0.001, P<0.001, P=0.001, P<0.001 and P<0.001 at 0, 1, 2, 6 and 24 hours, respectively and significantly lower postoperative opioid requirement compared with that of group C at 2, 6 and 24 hours postoperatively (P=0.0022, P<0.001 and P<0.001, respectively). Group L experienced significant more satisfaction regarding GPES scores than group C (P< 0.001). No adverse outcome was found in both groups.
Conclusion: Intravenous lidocaine administration exhibited significantly reduced moderate-to-severe CRBD at PACU and 1-hr post operative period. Moreover, the use of intravenous lidocaine during complex spine surgery resulted in reduction of postoperative pain, opioid requirement and improved patient satisfaction without side effects.
Fine mapping of stem rust resistance derived from soft red winter wheat cultivar AGS2000 to an NLR gene cluster on chromosome 6D
Authors: Rivera-Burgos Luis , VanGessel Carl , Guedira Mohammed , Smith Jared , Marshall David , Jin Y. , Rouse Matthew , Brown-Guedira Gina
Published: April 2024

The Puccinia graminis f. sp. tritici (Pgt) Ug99-emerging virulent races present a major challenge to global wheat production. To meet present and future needs, new sources of resistance must be found. Identification of markers that allow tracking of resistance genes is needed for deployment strategies to combat highly virulent pathogen races. Field evaluation of a DH population located a QTL for stem rust (Sr) resistance, QSr.nc-6D from the breeding line MD01W28-08-11 to the distal region of chromosome arm 6DS where Sr resistance genes Sr42, SrCad, and SrTmp have been identified. A locus for seedling resistance to Pgt race TTKSK was identified in a DH population and an RIL population derived from the cross AGS2000 x LA95135. The resistant cultivar AGS2000 is in the pedigree of MD01W28-08-11 and our results suggest that it is the source of Sr resistance in this breeding line. We exploited published markers and exome capture data to enrich marker density in a 10 Mb region flanking QSr.nc-6D. Our fine-mapping in heterozygous inbred families identified three markers co-segregating with resistance and delimited QSr.nc-6D to a 1.3 Mb region. We further exploited information from other genome assemblies and identified collinear regions of 6DS harboring clusters of NLR genes. Evaluation of KASP assays corresponding to our co-segregating SNP suggests that they can be used to track this Sr resistance in breeding programs. However, our results also underscore the challenges posed in identifying genes underlying resistance in such complex regions in the absence of genome sequence from the resistant genotypes.
Malnutrition status of children aged under-5 years in Bangladesh: evidence from BDHS 2017-2018
Authors: Rana Sohel , Rahman F. M. Arifur , M Abu Sayed Md. Al , Khan Md. Mobarak Hossain
Published: April 2024

Background Malnutrition is a major risk factor to create permanent, widespread damage to child's growth, development and well-being. This study aimed to determine the risk factors of malnutrition status of below five-years aged children in Bangladesh.
Methods Analysis was conducted using data from Bangladesh Demographic & Health Survey (BDHS, 2017-18). A total number of 8402 under five-year old children’s data from BDHS 2017-18 were included in this study. Descriptive statistics, chi-square test and binary logistic regression models were implemented to examine the prevalence of malnutrition status and its association with the different selected socio-demographic factors in this study.
Results The study found that the prevalence of stunting, wasting, underweight, and overweight of under-5 children were 31.0%, 8.8%, 22.0% and 2.4% respectively. Current age of children, division, mothers’ educational level, mothers’ height and BMI were found to be significant predictors for stunting and underweight children. Whereas, sex of child, mothers’ educational level and mothers’ BMI significantly impacted wasting. Furthermore, children’s overweight status was significantly associated with sex of child, current age of children, division, wealth index, mothers’ height and BMI.
Conclusions Several geographical and socio-demographic factors significantly impacted on malnutrition status of Bangladeshi under-five children. Therefore, government of Bangladesh and other health authorities should focus on the findings of this study to develop and implement concrete policies in the aim to reduce complications arising from under-five child malnutrition in Bangladesh.
CMIP6 Model Evaluation for Wind Speed Responses to IOD during Monsoon Season over the Indian Ocean
Authors: Prasad Ramakant , Kumar Prashant , Yadav Anshu , Singh Anurag , Sardana Divya , Hisaki Yukiharu
Published: April 2024

Indian Ocean Dipole (IOD) exerts a substantial influence over wind speed (WS) in the Tropical Indian Ocean (TIO), yet climate model's potential to replicate the observed IOD impact on WS has not been estimated. This study assesses 24 CMIP6 models to determine their ability to replicate the impact of the Indian Ocean Dipole (IOD) on wind speed (WS) in the Tropical Indian Ocean (TIO) during the JJA season from 1958 to 2014. The observation data for WS is obtained from fifth generation European Centre for Medium-Range Weather Forecasts Reanalysis (ERA5). In the CMIP6 models, IOD portrays a crucial role to simulate WS across the tropical Indian Ocean. The efficacy of models is computed based on three skill metric criteria such as interannual variability score (IVS), M-Score, and root mean square error (RMSE). A total rank has been evaluated based on the three-skill metrics. The top ten best performing models are CESM2, EC-Earth3, ACCESS-ESM1-5, EC-Earth3-Veg-LR, MMM, NorESM2-LM, CESM2-WACCM, EC-Earth3-Veg, MPI-ESM1-2-HR, and FIO-ESM2-0. Despite this, significant biases are found in the CMIP6 models, indicating a moderate overall ability to capture WS responses to IOD over the Indian Ocean.
Transcriptome Profiling and Gene Network Analysis Revealed Regulatory Mechanisms of Bract Development in Bougainvillea glabra
Authors: liu xiangdong , Peng Yaonan , Zeng Qinghui , Ma Yuwan , Liu Jin , Huang Yaqi , Yu Xiaoying , Luo Jun , Li Yanlin , Li Meng , Cao Fuxiang
Published: April 2024

Background: Bracts are important in ornamental plants and their developmental regulation is complex, but relatively little research has been done on them. In this study, physiological, biochemical and morphological changes in Bougainvillea glabraleaves, leaf buds and bracts during seven developmental periods were systematically investigated in B. glabra bracts. Meanwhile, transcriptome data of B. glabra bracts were obtained using PacBio and Illumina sequencing technologies, and key genes regulating their development were screened.
Results: Scanning electron microscopy revealed that the bracts develop with a process of regression of hairs, changing colour from green to white; Transcriptome sequencing yielded 79,130,973 bp of transcript sequences, totalling 45,788 transcripts; Differential gene analysis revealed 50 expression patterns across seven developmental periods, with significant variability in transcription factors such as BgAP1, BgFULL, BgCMB1, BgSPL16, BgEIL1, and BgBH305 KEGG and GO analyses of growth and development concerning chlorophyll metabolism and hormone-conducting metabolic pathways; Key genes for chlorophyll metabolism include PORA, SGR, PPH, PAO and RCCR; The growth hormone and abscisic acid signalling pathways involve 44 and 23 homologous genes, and co-expression network analyses revealed that the screened genes BgAPRR5 and BgEXLA1 are involved in the regulation of bract development.
Conclusions: These findings promote the understanding of the molecular mechanism of plant bract development, as well as provide important guidance for the molecular regulation and genetic improvement of the growth and development of ornamental plants, mainly ornamental bracts.
Vasoconstriction with Phenylephrine increases Cardiac Output in Preload Dependent Patients
Authors: Højlund Jakob , Cihoric Mirjana , Foss Nicolai Bang
Published: April 2024

Purpose: General Anaesthesia (GA) is accompanied by a marked decrease in sympathetic outflow and thus loss of vasomotor control of cardiac preload. The use of vasoconstriction during GA has mainly focused on maintaining blood pressure.
Phenylephrine (PE) is a pure α1-agonist without inotropic effects widely used to correct intraoperative hypotension. The potential of PE for augmenting cardiac stroke volume (SV) and -output (CO) by venous recruitment is controversial and no human studies have explored the effects of PE in preload dependent circulation using indicator dilution technique.
We hypothesized that PE-infusion in patients with cardiac stroke volume limited by reduced preload would restore preload and thus augment SV and CO.
Methods: 20 patients undergoing GA for gastrointestinal surgery were monitored with arterial catheter and LiDCO unity monitor. Upon stable haemodynamics after induction patients were placed in head-up tilt (HUT). All patients became preload responsive as verified by a stroke volume variation (SVV) of > 12%. PE-infusion was then started at 15-20mikrg/min and adjusted until preload was restored (SVV < 12%). Li-dilution cardiac output (CO) was initially measured after induction (baseline), again with HUT in the preload responsive phase, and finally when preload was restored with infusion of PE.
Results: At baseline SVV was 10±3% (mean±st.dev.), CI was 2,6±0,4L/min*m2, and SVI 43±7mL/m2. With HUT SVV was 19±4%, CI was 2,2±0,4L/min*m2, SVI 35±7mL/m2. During PE-infusion SVV was reduced to 6±3%, CI increased to 2,6±0,5L/min*m2, and SVI increased to 49±11mL/m2. All differences p < 0,001
Conclusion: Infusion of phenylephrine during preload dependency abolished preload dependency as evaluated by SVV and increased cardiac stroke volume and -output as measured by indicator-dilution technique. This is the first human trial to describe the physiology of this common clinical intervention isolated from other effects.
Trial registration: ClinicalTrials.gov (NCT05193097).