bluuebunny/crossref_metadata_2025 huggingface dataset:
Experts’ prediction of the actual item difficulty of multiple-choice questions in the Ethiopian Undergraduate Medicine Licensure Examination
Authors: Gedamu Shewatatek , Tadesse Tefera , Moges Belay , Schauber Stefan
Published: February 2024

Background
The ability of expert ratings to predict the difficulty level of items to identify test-taker performance is an important aspect of licensure exams. Expert judgment is used as a primary source of information for users to make prior decisions to determine the pass rate of test takers. The nature of the raters involved in predicting item difficulty is central to setting credible standards. Therefore, this study aimed to assess and compare raters' prediction and actual MCQ item difficulty of the 2022 Ethiopian undergraduate medicine licensure examination (UGMLE).
Method
200 Multiple-Choice Questions (MCQs) of the 2022 cohort of 815 UGMLE examinees were used in this study and seven physicians participated in the difficulty level ratings. Then, analysis was conducted to understand experts' rating variation in predicting the computed actual difficulty levels of examinees. Descriptive statistics to profile the rater’s assessment results and ANOVA to examine differences between the raters' estimations of the difficulty levels of the MCQs were computed. Additionally, regression analysis was used to understand the interrater variations in their predictions of difficult levels compared to actual difficult levels of MCQs.It was also used to examine the proportion of variation that each rater explained in the predictions of actual difficulty levels across the whole set of MCQs and all UGMLE fourteen domains.
Results
The study revealed statistically significant differences in the mean difficult level ratings of some raters and moderate to high positive linear relationships with some exam domains. But also, statistically nonsignificant relationships were found in some other domains. Thus, considerations have been needed on the observed variability in difficult-level rating values across raters and UGMLE domains. In the regression results, experts' ratings accounted for 33% of the variations in the actual UGMLE difficulty levels. Between the expert-rated and actual difficulty levels, the regression model showed a moderately positive linear correlation (R = 0.57) that was statistically significant at p = .05.
Conclusion
This study demonstrated the complex nature of rating the level of difficulty of MCQs on UGMLE and the benefits of employing prior expert ratings. To improve a rater's rating accuracy in UGMLE, designing strategies in line with the changing nature of assessment methods guarantees to maintain the required reliability and validity of the exam.
Comparations of efficacy and safety of rituximab, calcineurin inhibitors and cyclophosphamide in primary membranous nephropathy: a single-center retrospective analysis
Authors: Lu Luying , Zhu Huayan , Cai Shasha , Liu Guangjun , Wang Yaomin , Ren Pingping , Lan Lan , Shen Xiaoqi , Chen Liangliang , Xu Ying , Cheng Jun , Li Xiayu , Chen Jianghua , Han Fei
Published: February 2024

Background Rituximab (RTX), calcineurin inhibitor (CNI) and cyclophosphamide (CTX) plus glucocorticoids are first-line therapeutic options for primary membranous nephropathy (PMN).
Methods Totally 478 biopsy-proven PMN patients in single center were retrospectively included. After 1:1 propensity score matching (PSM), 258 patients were included in RTX, CNI or CTX group (86 patients in each group).
Results After PSM, there were no differences on serum creatinine, eGFR, serum albumin, urine protein, anti-PLA2R antibody among groups. The follow-up duration was 12 (10.5, 18) months in CNI group, 12 (12, 18) months in CTX group and 12 (12, 18) months in RTX group. Throughout entire follow-up period, 39 patients (45.3%) in CNI group, 47 patients (54.7%) in CTX group, and 59 patients (68.6%) in RTX group achieved composite response (complete remission and partial remission). The survival curve showed a higher composite response in RTX group than CNI group (p=0.018). A relapse occurred in 15 of 39 (38.5%) patients in CNI group, significantly higher than CTX group (4.3%, p<0.001) and RTX group (3.4%, p<0.001). In CNI group, 36% patients had a ≥25% decline in eGFR, and 15.1% of patients had a ≥50% decline in eGFR.
Conclusions RTX may be more effective than CNI in inducing remission in PMN and showed similar efficacy to CTX. CNI may have a high risk of proteinuria relapse and eGFR decline.
Integrated Analysis of Remote Sensing with Meteorological and Health Data for Allergic Rhinitis Forecasting in Tianjin
Authors: guo yudi , wang Yuan , Fan Wenyan , Li Gen
Published: February 2024

Long time series of vegetation monitoring can be carried out by remote sensing data, the level of urban greening is objectively described, and the spatial characteristics of plant pollen are indirectly understood. Pollen is the main allergen in patients with seasonal allergic rhinitis. Meteorological factors affect the release and diffusion of pollen. Therefore, studying of the complex relationship between meteorological factors and allergic rhinitis is essential for effective prevention and treatment of the disease. In this study, we leverage remote sensing data for a comprehensive decade-long analysis of urban greening in Tianjin, focusing on its impact on allergic rhinitis through changes in pollen distribution. Utilizing high-resolution imagery, we quantify changes in urban Fractional Vegetation Coverage (FVC) and its correlation with pollen types and allergic rhinitis cases. Our analysis reveals a significant correlation between FVC trends and pollen concentrations, highlighting the influence of urban greenery on allergenic pollen levels. We establish a robust connection between the seasonal patterns of pollen outbreaks and allergic rhinitis consultations, with a noticeable increase in consultations during high pollen seasons. our findings indicate a higher allergenic potential of herbaceous compared to woody vegetation. This nuanced understanding underscores the importance of pollen sensitivity, alongside concentration, in driving allergic rhinitis incidents. Employing a generalized linear model, we develop a predictive framework for allergic rhinitis consultations, integrating remote sensing, meteorological, and health data. The model demonstrates high predictive accuracy, particularly in summer and autumn, offering a novel approach for anticipatory healthcare in urban environments. Overall, our study pioneers the integration of remote sensing with meteorological and health data for allergic rhinitis forecasting. This integrative approach provides valuable insights for public health planning, particularly in urban settings, and lays the groundwork for advanced, location-specific allergenic pollen forecasting and mitigation strategies.
Comparison of Intradermal Irritation based on Poly(methyl methacrylate) Hydrogel
Authors: Racheal Christianah
Published: February 2024

To investigate the potential skin irritation response of domestically produced medical poly(methyl methacrylate) hydrogel, the intradermal injection method was used. Healthy white rabbits were selected for intradermal injection of 0.5% sodium chloride solution as a control, 0.5% sodium chloride extract, and olive oil extract for the test samples. The rabbits were observed for erythema and edema at 24 and 72 hours, and the primary irritation index was calculated. The primary irritation index of the domestically produced poly(methyl methacrylate) hydrogel was 0, indicating no skin irritation response.
Emerging Topological Multiferroics from the 2D Rice-Mele Model
Authors: Vergara Patricio , Saez Guidobeth , Castro Mario , Allende Sebastian , Nunez Alvaro
Published: February 2024

We introduce a novel two-dimensional dimerized lattice model that reveals a remarkable feature: the emergence of a complex, nontrivial topological multiferroic phase marked by zero Berry curvature and a significant Berry connection that influences the model's bulk topology. This model extends the one-dimensional Rice-Mele Hamiltonian model to explore polarization-dependent topological properties in a 2D Su-Schrieffer-Heeger lattice, providing a detailed framework for studying the impact of symmetry-breaking and spatially varying potentials on electronic and spin properties. The findings are particularly relevant for spintronics, offering a foundation for topologically robust and electrically controlled spin-conducting edge states, with implications for developing advanced spin-dependent transport devices.
A Generalized Bouc-Wen Model for Simulating the Quasi-Static and Dynamic Shear Responses of Helical Wire Rope Isolators
Authors: Capuano Raffaele , Vaiana Nicolò , Carboni Biagio
Published: February 2024

This research investigates the mechanical behavior of a helical wire rope isolator deforming along its shear direction. In particular, we present the results of an extensive experimental campaign including both quasi-static and dynamic tests. The former provide hysteresis loops characterizing the device quasi-static behavior; the latter, performed by using an electro-mechanical shaker, furnish frequency response curves describing the dynamic behavior of a rigid block supported by the tested device. To simulate such a complex behavior, we adopt a generalized Bouc-Wen model and identify its parameters on the basis of the quasi-static test results. Subsequently, such a model is employed to reproduce the frequency response curves of the isolated rigid block. Since the results of the dynamic tests suggest the presence of rate-dependent hysteresis phenomena in the isolated system, the generalized Bouc-Wen model is enhanced by introducing a linear viscous component. Finally, to substantiate the model validation, the experimental results obtained by applying a series of white noise signals are compared with those obtained numerically to demonstrate the model capability of reproducing the device behavior in non-stationary response conditions.
PET-MR Guided, Pre-targeted delivery to HER2(+) Breast Cancer Model
Authors: Si Ge , Hapuarachchige Sudath , Lesniak Wojciech , Artemov Dmitri
Published: February 2024

Purpose: HER2(+) metastatic breast cancer (mBC) is one of the most aggressive and lethal cancer types among females. While initially effective, targeted therapeutic approaches with trastuzumab and pertuzumab antibodies and antibody-drug conjugates (ADC) lack long-term efficacy against HER2(+) mBC and can cause severe systemic toxicity due to off-target effects. Therefore, the development of novel targeted delivery platforms that minimize toxicity and increase therapeutic efficacy is critical to the treatment of HER2(+) breast cancer (BC). A pretargeting delivery platform can minimize the non-specific accumulation and off-target toxicity caused by traditional one-step delivery method by separating the single delivery step into a pre-targeting step with high-affinity biomarker binding ligand followed by the subsequent delivery step of therapeutic component with fast clearance. Each delivery component is functionalized with bioorthogonal reactive groups that quickly react in situ, forming cross-linked clusters on the cell surface, which facilitates rapid internalization and intracellular delivery of therapeutics.
Procedures: We have successfully developed a click chemistry-based pretargeting platform for HER2(+) BC enabling PET-MR image guidance for reduced radiation dose, high sensitivity, and good soft tissue contrast. Radiolabeled trastuzumab and superparamagnetic iron-oxide carriers (uSPIO) were selected as pretargeting and delivery components, respectively. HER2(+) BT-474 cell line and corresponding xenografts were used for in vitro and in vivo studies.
Results: An enhanced tumor accumulation as well as tumor- to-organ accumulation ratio was observed in pretargeted mice up to 24 h post uSPIO injection. A 40% local T1 decrease in the pretargeted mice tumor was observed within 4 h, and an overall 15% T1 drop was retained for 24 h post uSPIO injection.
Conclusions: Prolonged tumor retention and increased tumor-to-organ accumulation ratio provided a solid foundation for pretargeted image-guided delivery approach for in vivo applications.
Co-cultivation of Lipomyces starkeyi and Acinetobacter baylyi for the production of microbial lipids from lignocellulosic hydrolysates
Authors: Subramaniam Ramalingam , Chistoserdov Andrei
Published: February 2024

The growth of Acinetobacter baylyi and Lipomyces starkeyi was investigated individually and in a co-culture in a minimal medium (MM) in the presence of vanillin, syringaldehyde, para-hydroxybenzaldehyde (PHB), furfural and hydroxymethylfurfural (HMF), to understand the growth and lipid accumulation capability. The MM, which was developed in our laboratory, significantly reduced the medium cost for lipid production by L. starkeyi from $12.68 per gallon lipids to $3.11 per gallon lipids with the carbon source representing the remaining major cost factor. A. baylyi failed to grow in the MM but grew in the modified Suutari medium (MSM). L. starkeyi showed a decreased growth in the presence of a mix of 0.1 g/L and 0.25g/L of furfural, HMF, PHB, vanillin, and syringaldehyde in comparison to the growth in the MM without these inhibitors and completely failed to grow when they were present at the 0.5 g/L concentrations. The co-culture of L. starkeyi and A. baylyi in the MM resulted in the maximum cell concentration and lipid production of 9.72 g/L and 5.04 g/L; 9.72 g/L and 4.90 g/L; and 9.24 g/L and 4.65 g/L for the initial inhibitor concentrations of 0.1 g/L; 0.25 g/L and 0.5 g/L, respectively. Almost complete consumption of the inhibitors was observed when they were added at 0.1 g/L and 0.25 g/L concentrations. However, at initial inhibitor concentrations of 0.5 g/L, the inhibitors were first taken up but then released back into the media when the co-culture reached the stationary phase.
Evaluation of INSAT 3DR Sounder derived Wind Index using Radiosonde Observation over India
Authors: Singh Neeti , Vinayak Munn , Lohan Nitin , Mitra A. k. , Giri Ram Kumar
Published: February 2024

Rapid advancements in the field of forecasting demand in-depth study spanning wind-derived products and other several climate fields. The wind index is one of the most valuable parameters and shows significant changeable and intermittent over a range of timescales since it is weather-dependent. Therefore, accurate wind index observation is acknowledged as a vital contribution to trustworthy large-scale Thunderstorm forecasts. This remote-sensing information is associated with errors and needs to be validated. In the current investigation, in situ, ground-based radiosonde data have been used to evaluate Infrared (IR) sounder data onboard the Indian navigation satellite (INSAT-3DR) satellite. It is discovered that the outcomes rather closely match the satellite data's unfavorable skew. There is a demand for this study that needs to be done on larger domains and data sets. All of India's different stations are considered and 2022, 2021, and 2020 data are analysed. Furthermore, this paper emphasizes the Wind Index accuracy for helicopter operation. However, wind index information is derived by satellite but always missing by Radiosonde. The proposed method is applied to the estimating Radiosonde wind index. This study mainly focuses on calculating wind index from different radiosonde parameters and then validating INSAT 3DR with Radiosonde WI.
Traceability for Strengthening Supply Chain Systems and Enhancing Real-Time Visibility: Focus of NAFDAC on Advancing Vaccines Traceability in Nigeria
Authors: Adeyeye Mojisola , Kayode John , OLASUPO Sabitu
Published: February 2024

This study explores the successful implementation of activities aimed at scaling traceability for COVID-19 and Routine Immunization (RI) vaccines to the Local Government Level (LGA) and selected Healthcare facilities in Nigeria, funded by the Bill and Melinda Gates Foundation. The study was executed by the National Agency for Food and Drug Administration and Control (NAFDAC) and sought to enhance supply chain systems by deploying advanced traceability mechanisms, underscoring product monitoring, and ensuring real-time stock visibility. The inquest discusses the accomplishments, challenges, and regulatory framework of NAFDAC, emphasizing GS1 Technology-driven Traceability, and presents the outcome of the field scanning activities conducted in July 2023. The study utilized GS1 standards to uniquely identify products, locations, and personnel in the supply chain. The approach involved a phased public sector pilot, showcasing the feasibility and challenges of tracking vaccine movement through the supply chain. The result shows the detection of 43 unique products across 1022 facilities from a total of 110,113 scans, offering valuable insights into vaccine distributions. The strategic goals of the project aligned with developing safety surveillance systems in Low- and Middle-Income Countries (LMICs) to facilitate patient access to global health products. The safety surveillance initiative complemented ongoing global efforts among WHO-HQ, PAHO, ASEAN, and MHRA, underlining safety systems across regions. Similarly, a significant improvement in traceability through automated data capture (barcode scanning) and expanded coverage for COVID-19 and selected RI vaccines in Nigeria was recorded. Summarily, information derived from this report will build confidence in patients regarding vaccine authenticity, establish a transparent and robust supply chain, and foster pharmacovigilance capability through integration with the track-and-trace systems. Thus, the study provides invaluable insights and opportunities for global health practitioners, policymakers, and researchers. Convincingly, this script will also serve as a reliable blueprint and innovative model for incorporating track-and-trace into regulatory oversight by other National regulatory authorities, most especially in Low- and Middle-Income Countries.
Antagonist of CD39 and CD73 potentiate Doxycycline repositioning to induce potent antitumor immune response
Authors: DALAI PARAMESWAR , Shah Dhruvi , Soni Kinal , Shah Jigna , Desai Chirag , Thanki Kavya , Agrawal-Rajput Reena
Published: February 2024

Purpose
Studies have reported that cellular metabolism at tumor-immune microenvironment (TiME) serve as a critical checkpoint and perturbs/supports anti-cancer immunity. Extracellular ATP (eATP) may mediate anti-cancer immune response however; its catabolism by ectonucleotidase generates immunosuppressive adenosine. Antagonist of ectonucleotidases: CD39 and CD73 have been explored as potential therapeutic. In the presented work we have tried to repurpose doxycycline for mitigating ATP metabolism with or without antagonist of ectonucleotidase.
Methods
eATP and adenosine level were quantified. The bone marrow-derived M1 and M2 polarized macrophages were maintained in tumor mimicking condition (TMC). Total or CD4+ Tcells were co-cultured with macrophages to understand the impact of doxycycline and antagonist of ectonucleotidase T cell/subset differentiation. Preclinical efficacy of doxycycline and ectonucleotidase antagonist and their synergy was scored in 4T1 breast carcinoma.
Results
Doxycycline manipulates macrophage polarization by decreasing the frequency CD206+M2 macrophages that promoted CD4+ directed CD8+ T cell mediated tumor cell lysis. Doxycycline alleviated the expression of CD39 and CD73, rescuing ATP catabolism. Doxycycline delayed tumor growth by enhancing F4/80+ CD86+ M1 macrophages and subsequently anti-tumor Tbet+ CD4+ T-cells, attenuating the frequency of FOXP3+ regulatory T cells which was cooperatively supported by ARL67156 and AMPCP (CD39 and CD73 antagonist). Doxycycline promoted CD8+T cell mediated cytotoxicity which was synergistically enhanced with ARL67156 and AMPCP ensuring a possibility of using doxycycline alone or in combination with antagonist of ectonucleotidase.
Conclusion
Presented data indicate a prospective usage of doxycycline as novel immune checkpoint blocker (ICB) against ectonucleotidase and may be modified/delivered appropriately as a sole ICB.
Heparinase III cleaved HS promotes vasculogenic mimicry in Triple Negative Breast Cancer via VEGFA signaling
Authors: Chen Xinjie , Kong Weijia , Zhang Ganlin , Sun Xu , Xie Ying , Wang Xiaomin
Published: February 2024

Anti-angiogenic therapy sometimes triggers alternative vasculogenic mimicry, which is a predictor of poor prognosis. Researches on angiogenesis and vasculogenic mimicry double-related targets and the mechanism behind them could help with this dilemma. The interaction between HS and growth factors in the extracellular matrix can affect various biological behaviors of cells, including tumor cells. Heparinase III from Flavobacterium heparin is an enzyme primarily degrading heparan sulfate (HS). Using heparinase III and HS degeneration inhibitor OGT2115 as regulators, we found that HS-cleaved triple-negative breast cancer cells were more capable of obtaining blood supply by enhanced angiogenesis and vasculogenic mimicry formation. Further studies showed that this effect was achieved by affecting the affinity between HS and VEGFA because HS functions as a co-receptor of VEGFA and induces a stronger signal response by heparinase III exposed neo-epitope. Our work shows for the first time that cleaved heparan sulfate is able to promote VM formation and comes up with a combination of heparinase inhibitors or HS mimetics with anti-angiogenic agents or VEGFR2 inhibitors will be a promising tumor treatment strategy.
From Legislation to actual Health Service: Evaluation of Health Provisions in the Disability Law of Ghana by Children with Disabilities and their Families
Authors: Gyimah Ebenezer Mensah , Dassah Ebenezer , Opoku Maxwell Peprah , Ntoaduro Afua , Ampratwum Joseph , Tutu Clement Osei , Opoku Cecilia , Zakia Issaka
Published: February 2024

Background: Despite Ghana's Persons with Disability Act, 2006 (Act 715) making provisions for access to healthcare services for Children with Disabilities and their families, corpus of literature has reported that persons with disabilities continue to face challenges in accessing the healthcare services. However, the voices of children with disabilities and their families are very scare in such discourse. This study explored the experiences of children with disabilities and their families in accessing healthcare services as per the provisions described in Ghana’s Act 715. The study attempted to connect legal provisions to experiences of families and children in accessing healthcare.
Methods: This qualitative study involved 45 participants, including 25 children with disabilities and 20 family members from a municipality in Ghana. Employing a phenomenological design, semi-structured interviews were conducted which was then analyzed thematically and interpreted using Critical Disability Theory.
Results: The study identified two major categories of barriers to healthcare access: environmental (socio-economic difficulties, poor built environment, unavailability of rehabilitation services) and systemic (cultural beliefs, poor support at healthcare facilities and inadequate healthcare legislative provisions for families of children with disabilities). Despite legal provisions for free healthcare, participants faced significant financial barriers, with specialist services often not covered by the National Health Insurance Scheme. Poor infrastructure and cultural beliefs also impeded access, while healthcare workers' indifferent attitudes and disrespect further compounded these challenges.
Conclusions: The study reinforces the principles of Critical Disability Theory, emphasizing the importance of upholding individual rights, echoing marginalized voices, appreciating diversity, and fostering independence in healthcare access. The study further calls for policy adjustments to fully cover specialist care under Ghana's National Health Insurance Scheme, establishment of district-level health assessment and resource centers, educational campaigns to change cultural perceptions, and training of healthcare workers to promote quality access to healthcare.
A systematic review of the clinical treatment of patients with fecal incontinence by artificial anal sphincter
Authors: Wang Minghui , Zhou Wei , Liu Ji , Liao Yucheng , Liu Bolin , Yu Hongliu
Published: February 2024

BACKGROUND: This study aimed to evaluate and compare the safety and efficacy of artificial anal sphincters in clinical practice.
Methods: A systematic review of articles in PubMed, MEDLINE, EMBASE, Web of Science, and the Cochrane Library was performed. The literature was reviewed three times by several independent investigators, resulting in the identification of 53 studies that met the criteria. The primary outcomes of interest included: adverse events, incontinence assessment, quality of life assessment, and anorectal manometry.
RESULTS: A total of 12 postoperative complications related to the implantation of the different artificial anal sphincters were reported. Seven different incontinence rating scales and four quality of life scales were used to assess patients' fecal incontinence and improvement in quality of life. A total of 29 studies measured changes in patients' anorectal pressure before and after surgery.
CONCLUSIONS: In terms of safety, the GK, SK, and MAS are simpler devices that cause less damage during implantation and have additional advantages over the AMS800, AN, PAS, and AAB. In terms of therapeutic efficacy, the AN, which is currently the most widely used, is technologically mature and has the best results, while the other artificial anal sphincters have also shown significant improvement in fecal incontinence.
A pediatric case of cat scratch disease complicated by meningitis diagnosed by Metagenomic Next-generation Sequencing
Authors: Jin Li , Wen Yang , Wang Yanjing , Liu Lu , Li Yiyuan
Published: February 2024

Background
While the clinical manifestations of cat scratch disease (CSD) can vary, the occurrence of meningitis in CSD patients is rare. Here we present a case of CSD complicated by meningitis associated with Bartonella henselae (B. henselae).
Case presentation:
An 11-year-old child developed prolonged fever, accompanied by a mild cough and headache. Metagenomic next-generation sequencing identified B. henselae in the blood, and meningitis was confirmed through cerebrospinal fluid analysis. The patient was diagnosed with CSD complicated by meningitis and recovered after receiving antibiotic and prednisone therapies.
Conclusion
For children with CSD presenting with neurological symptoms, the presence of CSD meningitis must not be overlooked.
A unique equivalence class of near-points of coincidence for generalized contractions in interval spaces
Authors: Sharifi Marzieh , Mosadegh Sayed Mohamad Sadegh Modarres
Published: February 2024

In this article, we discuss some theorems of near-points of coincidence for generalized contractive mappings in metric and normed interval spaces that are also weakly compatible self-mappings. In these theorems, we investigate the existence and uniqueness of common near-fixed points. We also provide examples to demonstrate the validity of our work.
Mathematics Subject Classification (2010). Primary 47H10; Secondary 54H25.
Ultrasound activity score in the carotid arteries for assessing disease activity of Takayasu arteritis
Authors: Ma Lingying , Sun Ying , Liu Yun , Huang Huijing , Chen Rongyi , Li Chaolun , Han Hong , Jiang Lindi
Published: February 2024

Objective: The role of ultrasonography for evaluating vessel wall inflammation in Takayasu arteritis (TAK) is well-recognized; however, an effective approach for the quantitative assessment of disease activity remains lacking. This study aimed to develop a novel ultrasound-based scoring system for determining TAK activity.
Methods:TAK patients with carotid artery involvement were prospectively followed-up for 6 months. Their clinical symptoms, inflammatory biomarkers, and ultrasonographic features at baseline and follow-up were recorded. Our proposed ultrasound activity score (ULTRAS) consisted of wall thickness (TS) and semi-quantitative echogenicity scores (ES). The diagnostic performance of ULTRAS for disease activity was evaluated in terms of area under the receiver operating characteristic curve (AUC). Internal validation was subsequently performed.
Results: A total of 136 patients were included. 83 (61.0%) of whom had active disease. Active TAK demonstrated significantly increased ESR and CRP levels, greater wall thickness and proportion of low echogenicity on ultrasonography, and higher TS, ES, and ULTRAS. At an optimal cut-off of 7, ULTRAS showed satisfactory diagnostic accuracy for active TAK (AUC, 0.88; 95% CI, 82–94). Improved diagnostic performance was achieved when combined with ESR (AUC, 0.91; 95% CI, 86–96). At 3-month follow-up, an improvement in wall thickness of ≥0.3 mm correlated with symptom recovery in 50% of patients.
Conclusions: Our proposed ultrasound-based scoring model carries the potential in the detection of active disease among TAK patients.
Predictive ability of longitudinal changes in Kerbs von Lungren 6 for acute exacerbation of fibrotic interstitial lung disease: Database research
Authors: Shiroshita Akihiro , Anan Keisuke , Shirakawa Chigusa , Shiba Hiroshi , Yajima Nobuyuki
Published: February 2024

Background
Acute exacerbation (AE) in fibrotic interstitial lung diseases (ILDs) poses a significant challenge, with limited available evidence for predicting such events. Kerbs von Lungren 6 (KL-6) is a proposed predictive marker for prospective AE; however, only its baseline value has been evaluated. To address this gap, this study investigates the association between the patient-specific evolution of serum KL-6 levels and the AE risk of fibrotic ILD.
Methods
This study used data from the Japanese Database of Health, Clinic, and Education Information Evaluation Institute and JMDC Inc. The included patients had fibrotic ILDs and antifibrotic therapy with ≥ 2 measurements of serum KL-6 from the index date to the end of follow-up. The outcome was AE of acute or chronic fibrotic ILDs defined based on the combination of its primary diagnoses, emergency admission, and pulse/high-dose steroids on the day of or after admission. We used a joint regression model for each patient’s serial serum KL-6 measurements and a proportional hazards regression model for the hazard ratio of AE.
Results
The study included 939 patients with fibrotic ILDs, and 194 (21%) experienced AE during the follow-up (event rate, 0.13/person-year; 1-year incidence, 35%). The hazard ratio of AE comparing patients differing in cumulative serum KL-6 was 1.54 (95% confidence interval: 1.20–1.98, p < 0.001).
Conclusions
A high baseline KL-6 level and its upward evolution can predict the AE of fibrotic ILD. Longitudinal KL -6 measurement should be considered, especially for patients who cannot perform pulmonary function tests well. Our study could help develop strategies for improving fibrotic ILD prognosis and treatment.
Comorbid thrombosis as an adverse prognostic factor in patients with ovarian clear cell carcinoma regardless of staging
Authors: Yamaguchi Kohei , Tsuruga Tetsushi , Taguchi Ayumi , Tanikawa Michihiro , Sone Kenbun , Mori-Uchino Mayuyo , Iriyama Takayuki , Matsumoto Yoko , Hiraike Osamu , Hirota Yasushi , Fujii Tomoyuki , Osuga Yutaka
Published: February 2024

[Objective] Patients with ovarian clear cell carcinoma (OCCC) often present with thrombosis. While cancer patients with concomitant thrombosis were generally reported to have worse prognoses than those without, the association between thrombosis and prognosis has not been elucidated in OCCC. This study aimed to determine how the co-occurrence of thrombosis affects OCCC prognoses.
[Methods] We retrospectively examined 115 patients with OCCC who were diagnosed and treated at the University of Tokyo Hospital between 2009 and 2019.
[Results] Of 115 patients with OCCC, thrombosis was present in 12.5% of 80 patients and in 42.8% of 35 patients who had OCCC stage I/II and stage III/IV, respectively. In stage I/II, the 5-year progression-free survival was 20.6% and 91.8% among patients with thrombosis and among those without, respectively, while the corresponding 5-year overall survival rates were 50.0% and 94.1%. Therefore, the outcomes were significantly poorer among patients with thrombosis (p < 0.0001 and p < 0.0001, respectively). In stage III/IV, the 5-year progression-free survival was 26.7% and 52.8% among patients with thrombosis and among those without, respectively, while the corresponding 5-year overall survival rates were 32.0% and 62.2%. Similarly, the outcomes were significantly poorer among patients with thrombosis (p = 0.0139 and p = 0.369, respectively).
[Conclusion] We determined that thrombosis is more likely to develop in advanced OCCC stages than in early stages, and its co-occurrence is associated with a poor prognosis, regardless of disease stage.
Do the perioperative intravenous fluids affect kidney graft function and electrolytes in pediatric kidney transplantation?
Authors: Aleysae Nabil Abdulrahman , Kimawi Abdullah , Bamahmoud Alaa , Alharbi Naffa , Salem May , Jaafari Abdulla , Alfaifi Malak , Alfarran Lujain , Alturkistani Bushra , Yousef Aly , Jouhar Toufik , Alhassoun Abdulkarim , Qadi Najib
Published: February 2024

Background. The type and volume of intravenous fluids administered perioperatively for kidney transplant recipients may affect the graft function and induce electrolyte disturbances in these patients. We studied whether the type of intravenous fluids given during perioperative period affect kidney graft function and electrolyte balance in paediatric kidney transplant recipients.
Methods. This retrospective study included all pediatric patients who underwent kidney transplantation at a single center between January 2014 and December 2022. We grouped patients based on the amount of normal saline (NS) they received: high NS (received >70% of their total fluids as NS) and low NS group (received <70% of their total fluids as NS). The outcome was the incidence of slow graft function, electrolyte disturbances and metabolic acidosis in the first 48 hours after surgery.
Results. Of 78 patients who included, 29.5% had slow graft function on posttransplant day 2 with no significant difference between both groups. Hyperchloremia, hypokalemia, hyponatremia, hypernatremia, and hyperkalemia were observed in 42.3%, 26.9%, 24.4%, 5.1%, and 2.6%, respectively. Hypokalemia was less in low NS group. There is no significant difference between the groups regarding the metabolic acidosis (78% vs 62%).
Conclusion. This study found that perioperative administration of normal saline at volumes greater than 70% of total fluids did not significantly affect the incidence of slow graft function, electrolyte disturbances, or metabolic acidosis in pediatric patients who underwent kidney transplantation.
Protective Effects of Antimicrobial Peptide Microcin J25 (MccJ25) Isolated from Escherichia coli against Breast Cancer Cells
Authors: Shalibeik Saman , Ghandehari Fereshte , Ahadi Ali-Mohammad , Rastegari Ali-Asghar , Ghiasian Mojgan
Published: February 2024

Introduction:
Microcins are Antimicrobial peptides (AMPs) with low molecular weight, which are produced by Enterobacterales and have broad-spectrum antibacterial activity. They can selectively replace common cancer treatments in cancer cells with less side effects and higher effectiveness. Given the aforementioned context, the present study endeavors to examine the antitumor activity of microcins isolated from of the Enterobacterales.
Material and Methods
In total, 120 Enterobacterales isolates were examined after identification. Subsequently, the bacteria were subjected to an agar diffusion test to assess their antibacterial efficacy. Positive isolates were further examined for the presence of Mccj25 using PCR. The cytotoxic effects of isolates harboring the microcin gene were explored using quantitative real-time PCR (RT-qPCR) and the MTT test on breast cancer cells. Additionally, the expression levels of BCL2 and STAT3 genes were evaluated, and apoptosis was quantified using flow cytometry. The repair rate of normal cells was determined using a scratch assay.
Results
The findings obtained from the phenotypic and biochemical assays have duly verified and established the categorization of the Enterobacterales. After conducting the agar diffusion test, a total of 25 isolates of Escherichia coli and Klebsiella pneumoniae displaying inhibition zones were chosen as suitable specimens possessing AMPs. Urinary E. coli was identified as isolate 83. The analysis conducted on the expression of the Mccj25 gene within the aforementioned isolates indicated that isolate 83 exhibited significant expression of the Mccj25 gene.
Conclusion
The extract obtained from this isolate on the breast cancer cell line exhibited the most significant degree of toxicity after precisely 48 h. Furthermore, the treatment of breast cancer cells with isolate 83 showed that the rate of apoptosis was about 86%, and the expression of BCL2 and STAT3 genes decreased. Moreover, it potentiated the reparative ability of normal fibroblast cells. They resulted in growth suppression of breast cancer cells and elicited an escalated rate of cellular demise via the apoptosis pathway.
The Effects of Urtica Dioica Root and Rosa Damascena Mill Petal Extracts on Andropause symptoms and Reproductive Characteristics of Middle-age Male Rats
Authors: esfahlani Mohsen Abedini , Haghpanah Tahereh , Afarinesh Mohammad Reza , Mirzaie Vida , Nematollahi-Mahani Seyed Noureddin
Published: February 2024

Background
Andropause starts in middle-aged men and affects hormonal balance and behavioral/sexual functions. The aim of the present study was to determine the effects of two Rosa Damascena Mill. (Rosaceae, Rosa) and Urtica dioica L. (Urticaceae, Urtica); in relieving andropause symptoms due to their antioxidant and reproductive properties.
Methods
Animals were allocated into five groups including the young, control vehicle, Rosa, Urtica and Rosa + Urtica groups. Behavioral tests were performed. Sperm parameters and sex hormones were also assessed.
Results
Both extracts, especially in combined form increased preference index and muscle strength and decreased the level of depression significantly. Semen quality increased in the extract-treated groups. Testosterone level was increased significantly in the Rosa + Urtica group in middle-aged animals after 50 days of treatment. luteinizing hormone (LH), follicle-stimulating hormone (FSH), and the level of sex hormone binding globulin (SHBG) also changed in the extract-treated groups.
Conclusions
Rosa Damascena Mill and Urtica dioica can change testosterone level in the middle-aged animals and also ameliorate andropause symptoms. Mood, muscle strength and cognition would improve following administration of these herbs. The herbal nature of these extracts and their worldwide use in traditional medicine make them more appropriate for human studies and applications.
Dispersion Complex Network-Transition Entropy: A Novel Metric for Nonlinear Signal Processing
Authors: Geng Bo , Wang Haiyan , Shen Xiaohong , Zhang Hongwei , Yan Yongsheng
Published: February 2024

In signal acquisition, various forms of noise interference are inevitably present, and the resulting nonlinear signals severely limit the applicability of traditional signal processing methods. To address this challenge, this study proposes a novel complexity measurement metric called dispersion complex network-transition entropy (DCN-TE), which integrates the concepts of complex networks and information entropy. Specifically, we use the single cumulative distribution function values as nodes and employ Markov chains to represent the links, thereby transforming the signal into a complex network with directional weights. Then, we assess both the significance of nodes and the links to compute the DCN-TE value, and combine it with classifiers for signal processing tasks. Subsequent experiments comprehensively evaluate the performance of DCN-TE using simulated chaotic models and real hydroacoustic signals. The results indicate that compared with Lempel-Ziv complexity, permutation entropy, and dispersion entropy, DCN-TE can more rapidly and accurately capture dynamic changes in signals. Importantly, DCN-TE also exhibits optimal performance in distinguishing between different categories of chaotic models, ships, and modulation signals, thereby demonstrating its significant potential in signal processing.
Diagnostic ability of magnifying endoscopy compared to biopsy examination for early gastric cancer prior to endoscopic submucosal dissection
Authors: Yoshida Takuma , Dohi Osamu , Seya Mayuko , Yamauchi Katsuma , Fukui Hayato , Miyazaki Hajime , Yasuda Takeshi , Ishida Tsugitaka , Iwai Naoto , Doi Toshifumi , Hirose Ryohei , Inoue Ken , Yoshida Naohisa , Uchiyama Kazuhiko , Ishikawa Takeshi , Takagi Tomohisa , Konishi Hideyuki , Morinaga Yukiko , Kishimoto Mitsuo , Itoh Yoshito
Published: February 2024

Background Biopsy-specimen examination is the gold standard for the preoperative histological diagnosis of early gastric cancer (EGC). However, few studies have compared the diagnostic accuracies of biopsy and magnifying endoscopy with narrow-band imaging or blue laser imaging (ME-NBI/BLI). Thus, we compared the diagnostic accuracy of biopsy specimens and ME-NBI/BLI to evaluate whether ME-NBI/BLI is a feasible preoperative diagnostic tool for EGC.
Methods This retrospective single-center study enrolled 185 patients who underwent gastric endoscopic submucosal dissection (ESD) between January and December 2018. The sensitivity and positive predictive value (PPV) of the histological diagnosis of ME-NBI/BLI and biopsy were evaluated. Logistic regression analysis was used to assess the risk factors for the misdiagnosis of biopsy specimens and ME-NBI/BLI.
Results In total, 158 patients with EGC were analyzed. Sensitivities of biopsy and ME-NBI/BLI were 1 and 0 for adenomas (P = 0.333), 0.693 and 0.971 for differentiated adenocarcinomas (P < 0.001), and 0.688 and 0.625 for undifferentiated adenocarcinomas (P > 0.999), respectively. PPVs of biopsy and ME-NBI/BLI were 0.077 and 0 for adenomas (P> 0.999), 0.960 and 0.958 for differentiated adenocarcinomas (P > 0.999), and 0.750 and 0.750 for undifferentiated adenocarcinomas (P > 0.999), respectively. The underdiagnosis rate for differentiated adenocarcinomas was significantly higher in biopsy examination than in ME-NBI/BLI (27.9% vs. 0%, respectively, P < 0.001).
Conclusion ME-NBI/BLI had a higher sensitivity than biopsy examination for the preoperative diagnosis of differentiated adenocarcinomas. Therefore, performing ME-NBI/BLI for these lesions may be preferable regardless of their diagnosis as non-cancerous lesions from biopsy specimens.
Chunk Integrated Network Slicing(CINS) with Eagle Sight View Optimization for 5G System using wireless networks
Authors: Rao Voore Subba , Gaur Manish
Published: February 2024

The use of high-speed transmission media is improved by the development of data communication systems. The network strength and data routing determine this speed. Because of this, the 5G network architecture increased bandwidth use and improved the LTE model, which improved communication system performance. Since these parameters are insufficient to obtain the maximum level of data transmission speed increase. The ideal routing system is the subject of the majority of research studies. An improved version of Seagull with Eagle Sight View Optimization (SESVO) is used in this suggested work in order to boost 5G system performance. In order to slice the network into multiple combinations, the optimization algorithm chooses the optimum network slicing strategy. This determines the best availability path to route the data with the best distance prediction and quick switching effect after ideally analysing the traffic level in a network path. The suggested method calculates the correlation coefficient between the communication nodes and weights the dynamic traffic that flows through the routing path. The optimization approach uses these estimated properties to choose the best attributes from the node arrangement's total feature set. By reusing the link pattern, the SESVO algorithm predicts relative feature qualities and develops a clustering architecture to depict high data transfer. The optimal routing path is represented by the convergence graph's best fitness value at each iteration of the optimization method. It is possible to analyse the optimal routing path and pattern availability for a node at any given time by looking at the SESVO objective function's fitness. The experimental result justifies the efficiency of proposed work comparing to other state-of-art methods for routing and link allocation system.
Optimized Transfer Learning Models for Breast Cancer image classification
Authors: Slimi Houmem , Abid Sabeur
Published: February 2024

Breast cancer (BC) is one of leading cause of cancer death among women. Early detection of this pathology allows to define, for patients, the appropriate treatment which improve the possibility of survival. Consequently, the earlier it is detected, the better the survival rate will be. In last years, big interest has been made on applying deep learning neural networks to BC analysis, detection and classification. Several interesting results have been found but they still needing more improvement and validation. In this frame is located our work which consists on developing and comparing different deep leaning approaches for earlier detection and classification of BC from mammogram images. Different new deep learning techniques are developed resulting on a considerable improvement in the rate of the classification accuracy with more robust models. Simulations are carried out on two data bases illustrating that the new proposed approaches provide significant evaluation metrics in comparison with several commonly known transfer learning architectures.
From Gaussian to Lognormal: Improving Material Property Modeling forPrecise Structural Predictions.
Authors: kumar rakesh
Published: February 2024

Accurate prediction of material properties is essential in structural engineering design to ensure re-liability and safety. Traditional approaches often rely on Gaussian distributions to model materialvariability. However, our research reveals limitations with Gaussian assumptions, particularly whencovariance parameters exceed certain thresholds, leading to physically unrealistic negative values formaterial properties.To overcome these limitations, we investigate an alternative approach using lognormal distribu-tions for material property modeling. Through Monte Carlo simulations employing Cholesky decom-position, we compare the performance of lognormal distributions with Gaussian counterparts. Ourfindings demonstrate that lognormal distributions offer a viable alternative, providing more accuraterepresentations of material variability while maintaining computational efficiency.Furthermore, we utilize finite element method (FEM) data from Monte Carlo simulations to predictbeam deflection using deep neural networks (DNNs). Leveraging inverse modeling techniques, weshowcase the ability to predict elastic modulus from beam deflection data under both normal andlognormal distribution assumptions.By integrating lognormal modeling and inverse modeling techniques into structural analysis, weenhance the realism and accuracy of predictions, thereby improving reliability in engineering design.This paper discusses the implications of our findings and emphasizes the importance of consideringalternative probability distributions for material property modeling in structural engineering applica-tions.