bluuebunny/crossref_metadata_2025 huggingface dataset:
An improved density peaks clustering algorithm use similarity assignment strategy with K-nearest neighbors
Authors: Hu Wei , Feng Ji , Yang Degang
Published: March 2024

Some particular shaped datasets, such manifold datasets, have restrictions on Density Peak Clustering (DPC) performance. The main reason of variations in sample densities between clusters of data with uneven densities is not taken into consideration by the DPC algorithm, which could result in the wrong clustering center selection. Additionally, the use of single assignment method is leads to the effect of assignment errors. To address these problems, this paper creates a new, improved density peaks clustering method use the similarity assignment strategy with K nearest Neighbors (IDPC-SKNN). Firstly, a new method for defining local density is proposed. Local density is comprehensively consider in the proportion of the average density inside the region, which realize the precise location of low-density clusters. Then, using the samples' K-nearest neighbors information, a new similarity allocation method is proposed. Allocation strategy successfully address assignment cascading mistakes and improves algorithms robustness. Finally, based on four evaluation indicators, our algorithm outperforms all the comparative clustering algorithm, according to experiments conducted on synthetic and real world datasets.
Exclusive Breastfeeding Practice and Associated Factors among Mothers Having Infants (Aged 0-6 Months) in the Pastoral Community of Sawena District, Bale Zone Oromia, Ethiopia, 2023
Authors: Hussein Dursa , Girma Derara , Oyato Befekadu Tesfaye , Birhanu Belete , Teressa Beka , Bacha Sintayew , Geleta Rabbira Edessa , Ibrahim Seifu Mohammed , Lakew Meron Seyoum
Published: March 2024

Background: Breastfeeding is the easiest, healthiest, and most cost-effective feeding method forinfants. Despite the promotion of exclusive breastfeeding, its importance is poorly understood in pastoral communities. Little information is available on the practices and factors underlyingexclusive breastfeeding, especially in pastoral communities in the Sawena district, Bale zone, Oromia region, and Ethiopia.
Objective: This study aimed to assess the prevalence of and factors associated with exclusive breastfeeding among mothers with infant (aged 0-6 months) in pastoral communities in the Sawena district, Bale Zone, Oromia Region, SoutheastEthiopia, 2023.
Method: A community-based cross-sectional study design was employed from March 01 to April 2023. A total of 631 women were selected using simple random sampling. The data were collected through face-to-face interviews. The collected data were entered into Epi Data software version 4.6 and subsequently exported into SPSS version 26 for analysis. Variables with a P value < 0.25 in the bivariate analysis were included in the multivariable logistic regression model. The degree of association was expressed using adjusted odds ratios (AOR) with a 95% confidence interval (CI) of < 0.05.
Results: Out of 631 eligible mothers, 625 participated in this study, for a response rate of 99.0%. The prevalence of exclusive breastfeeding (EBF) practices among mothers in the study area was 53.8% (95% CI; 49.8%–57.4%). Household food security status [AOR=1.6, 95% CI (1.1-2.2)], ANC follow-up during pregnancy, [AOR = 5.3, 95% CI (2.4-11.9)], counselling about EBF during ANC visits[AOR=5; 95% CI (2.1-11.7)], number of children [AOR =1.6, 95% CI (1.1-2.3)] and attitudes toward EBF [AOR= 1.8; 95% CI (1.4-2.6)] were significantly associated with EBF.
The majority of interviewees explained that there were various reasons why exclusive breastfeeding was not practiced, including beliefs that breast milk was insufficient, giving babies water would reduce colic, and fears of food refusal.
Conclusion: The prevalence of exclusive breastfeeding practices in the study area was lower than the country-recommended level. Household food security status, ANC follow-up during pregnancy, counselling about breastfeeding during ANC, number of children and attitude toward EBF practice were significantly associated with EBF. BF counselling during ANC services can be provided to mothers to improve their BF knowledge and subsequently improve their EBF practices.
Piloting the co-culture of Gracilaria verrucosa seaweed and Penaeus monodon in extensive pond systems in Java, Indonesia
Authors: Nauta Reindert Wieger , Lansbergen Romy Alana , Ariyati Restiana Wisnoe , Widowati Lestrari Lakhsmi , Rejeki Sri , Debrot Adolphi Oscar
Published: March 2024

With an increasing need for food for the growing global human population, more food will have to be produced sustainably with a lower impact on the environment while still being economically profitable. We studied the effect of combining seaweed cultivation with extensive shrimp farming on production, gross profit and nutrient concentrations. Pond experiments were conducted using different combinations of the agaroid seaweed Gracilaria verrucosa, and the Giant tiger prawn, Penaeus monodon, without supplemental feeding. Combined cultivation showed 18% higher seaweed production during the first cycle and 27% higher production during the second. Shrimp production was 53.8% higher in combined cultivation than in single-species cultivation. Seaweed quality in terms of agar content and gel strength did not differ between treatments. Gross profit of combined cultivation was, respectively, 156% and 318% higher compared to single-species seaweed and shrimp cultivation. As no feed was used, environmental impact was reduced using this method. Seaweed culture decreases nutrient loading in the water and pond sediment when cultured either solely or in combination with shrimp and lowered bacterial counts. Co-cultivation therefore improves the income whilst reducing the environmental impact.
An Isolable Phosphinidene Oxide
Authors: Goicoechea Jose , Hu Chenyang , Rees Nicholas , Pink Maren
Published: March 2024

Phosphorus monoxide (PO•) was the first compound with a P–O bond to be spectroscopically detected in interstellar space. On Earth, PO•, and related functionalized molecules such as R–P = O (R = OH, CH3, OCH3, Ph), have been studied in inert gas matrices at ultralow temperatures (3–15 K). These species are believed to be key intermediates in the degradation/combustion of organic phosphorus compounds (a class of chemicals that includes chemical warfare agents and flame retardants). However, despite numerous attempts, an isolable example of R–P = O has eluded synthetic chemists to date. Here we describe the use of an extremely bulky amine ligand to isolate the first two-coordinate phosphorus(III) oxide. Reactivity studies on this and other related compounds shows that phosphorus center can be readily oxidized, and that in doing so, the P–O bond remains intact, an observation that is of interest to the proposed reactivity of phosphorus monoxide (PO•).
Non-acidotic hypercapnia limits atrophy and loss of specific force in rat diaphragm after 5 days of controlled mechanical ventilation in parallel with increased local inflammation
Authors: Cacciani Nicola , Addinsall Alex B. , Larsson Lars
Published: March 2024

Background
Controlled Mechanical Ventilation (CMV) is associated with Ventilator Induced Lung Injury (VILI) and Ventilator Induced Diaphragm Dysfunction (VIDD). VIDD delays weaning from the respirator and increases the risk of further complications and health care costs, which are disproportionately increased with increasing duration of mechanical ventilation. Hypercapnia is frequently observed and tolerated as “permissive hypercapnia” during lung protective MV strategies. The systemic effects of hypercapnia are well known and considered potentially protective for diaphragm muscle in acute and short-time experimental MV studies. However, hypercapnia is commonly associated with acidosis, affecting immunity and inflammation pathways.
Methods
This study aims to determine the potential of hypercapnia in the absence of acidosis on diaphragm muscle structure and function in a well-established clinically relevant experimental ICU model, not limited by early mortality. The effects of hypercapnia at physiological pH on diaphragm single fibers cross sectional area (CSA) and specific force (maximum force normalized to CSA) were investigated.
Results
Non-Acidotic Hypercapnia (NAH) reduced body mass loss, diaphragm muscle fiber atrophy and loss of specific force, in parallel with an increased gene expression of proinflammatory cytokines (TNF-α and IL-1β) and of the MuRF-1 atrogene. In the diaphragm, TNF-α gene expression was significantly increased in NAH rats compared with 5 days normocapnic and controls, while IL-1β showed an increasing trend. In the lung lysates, IL-1β gene expression was significantly increased in 5 days normocapnic rats compared with the controls, while gene expression of TNF-α was increased in the NAH rats compared with controls. In NAH rats the increase was not significant. The gene expression of mitochondrial factors TFAM (regulator of mitochondrial gene expression), MFN2 (involved in mitochondrial fusion, quality control and cell metabolism), PARKIN (involved in mitochondrial quality control and mitophagy), ULK-1 (activator of mitophagy) was analyzed. NAH reversed, significantly the decreased gene expression of ULK 1 observed in the 5 days normocapnic rats.
Conclusions
These results suggest that non-acidotic hypercapnia limits the development of VIDD, irrespective of amplified local muscle inflammation. Therefore, we suggest its clinical role may be complementary to the known anti-inflammatory effects of hypercapnic acidosis (HCA), which has preventive VIDD effects as well.
Individual differences in processing multisensory information predict presence in different virtual reality environments
Authors: Glenn Callum P , Coxon Matthew
Published: March 2024

One of the most notable aspects of using a head mounted display (HMD) is the feeling of being ‘within’ the digitally created virtual world. Technological advances across the fields of computer science and engineering have helped to increase this sense of presence. However, there remains wide variations between individuals, which are only just beginning to be captured at a theoretical level. One potential explanation for these individual differences may be how individuals process multisensory information. In this paper we detail two studies which explored whether performance on two different multisensory tasks (the pip and pop and a redundant signals task), predict some of these differences in self-reported presence. In study 1 (N=32), clear correlations between the multisensory task (pip and pop) and presence scores were found using an underwater simulation. This provided the first indication that individuals that were positively influenced by illusory audiovisual conjunctions were also those that had the strongest sense of presence. Study 2 (N=68) expanded upon these results, finding again that multisensory integration (within a redundant signals task) was related to self-reports of presence using a different VR experience. In addition, it was found that this relationship could be moderated by either providing a unisensory or multisensory VR experience. Together these results suggest that individual differences in the efficiency of multisensory integration may provide an additional level of explanation not currently accounted for within theoretical models of presence formation.
Multi-criteria decision-making approach for evaluating wastewater treatment plant performance using the Analytical Hierarchy Process : a case study of the Sebdou textile industry treatment plant (NW- Algeria)
Authors: Abdelmoumene Hanane , Lallam Faiza , Boumediene Maamar
Published: March 2024

The inefficiency of wastewater treatment plants (WWTP) for the removal of pollution has devastating effects on human health, negative impacts on the environment, and unfavorable consequences for economic activity. The activated sludge process is extensively used for wastewater treatment across the globe, especially in Algeria. While the purification performance and reliability of this process have been established, various types of biological malfunctions can occur. Our objective is to provide practical guidance in identifying these malfunction types. The evaluation of a wastewater treatment plant's (WWTP) malfunction degree is a crucial step in assessing its purification performance. This study aims to evaluate the operational performance of a textile industry WWTP situated in our region. The study focused on the wastewater treatment plant (WWTP) at the DENITEXT textile complex in Sebdou, Western of Algeria. The performance of the plant was analyzed with the help of the Analytical Hierarchy Process (AHP), a method that considers all criteria impacting that have an impact on the malfunctioning of the WWTP's malfunction and their relative importance. To evaluate the dysfunction score and the operational status of the treatment plant, a hierarchical multicriteria analysis (HMA) was used.The value of the SDG (Score Dysfunction Global), evaluates the performance of the WWTP in treating effluent, obtained 1.50, which falls within the range of [0, 2], indicates that the treatment plant is in a dysfunctional state but poses no present or future risks. The purpose of this work is to assist plant managers in effectively managing the wastewater treatment process of the plant. Currently, there are no known or potential risks.
A missense c.80G＞A mutation in the CAV3 gene in a Han Chinese family with rippling muscle disease
Authors: Lu Xiaoqing , Hu Fan , Li Lingjuan , Zhang Honglian , Fu Saifang , Zhang Hong , Li Jie , Nie Hongbing , Huang Gang , Shen Yaoyao
Published: March 2024

Background
Rippling muscle disease (RMD), one of the special clinical phenotypes of caveolinopathies, is characterized by muscle hyperexcitability causing by mutations in the CAV3 gene. Few data exist on muscle MRI in patients with RMD, frequently reported as normal.
Methods
Here, we describe a Han Chinese family with RMD. Whole exome sequencing (WES), muscle MRI, and tissue biopsy were performed in this study.
Results
The proband and his mother presented with RMD, which was initially noticed during their childhood or adolescence, accompanied with increased level of serum creatine kinase (CK). Biopsy specimen illustrated slight variation in fiber size and increased numbers of internal nuclei in the muscle fibers, without obvious atrophy. Muscle MRI of the thighs showed short-tau inversion recovery (STIR) hyperintensity without fatty replacement. WES identified a heterozygous missense mutation of c.80G>A (p.R27Q) in the CAV3 gene.
Conclusions
Our findings deepen our awareness of the muscle MRI and pathological features of hereditary RMD. Regarding muscle MRI, this study first reports STIR hyperintensity in the thighs, which may be linked with muscle oedema.
Kelvin-Helmholtz instability in 3He superfluids in zero temperature limit
Authors: Eltsov V.B. , Hosio J.J. , Krusius M.
Published: March 2024

In rotating 3He superfluids the Kelvin-Helmholtz (KH) instability of the AB interface has been found to follow the theoretical model above 0.4 Tc. A deviation from this dependence has been assumed possible at the lowest temperatures. Our NMR and thermal bolometer measurements down to 0.2 Tc show that the critical KH rotation velocity follows the extrapolation from higher temperatures. We interpret this to mean that the KH instability is a bulk phenomenon and is not compromised by interactions with the wall of the rotating container, although weak pinning of the interface to the wall is observed during slow sweeping of the magnetic field. The KH measurement provides the only so far existing determination of the interfacial AB surface tension as a function of pressure and temperature down to 0.2 Tc.
Endogeneity, Heterogeneity and Determinants of Inefficiencies in Crop-producing Farmers: Empirical Evidence from Central Highlands of Ethiopia
Authors: BERISSO Oumer
Published: March 2024

This study estimated transient and persistent inefficiencies distinguished from farm-heterogeneity and endogeneity forEthiopian grain crop-producing farmers for the period 2004 – 2015. The study used Mundlak-adjusted random effect – four error component stochastic frontier (4eCSF) model byextending earlier version of the 4eCSF model to distinguished endogeneity and farm-heterogeneity from time-invariant inefficiency and to explain inefficiencies. The Mundlak-adjusted model is then estimated using multi-step estimation. The estimated average values of persistent, transient and overall efficiencies were 79%, 73% and 58%, respectively indicating there was room for improvement using the present resource and technology. Result from inefficiency effect model reveals sex, family size, number of plots, owing oxen, land quality and rainfall influenced transient inefficiency negatively while age, education, and temperaturevariation influenced positively. Persistent inefficiency was influenced negatively by owing oxen, irrigation, land quality, farm size, population pressure, rainfall and distance to market whereas age and education affected positively. The findings exhibit a low overall technical efficiency of Ethiopian grain crop-farmers is mainly due to the transient part. On the other hand, though the level of persistent inefficiency is lower than that of transient inefficiency, it is still substantial. Hence, these findings are important to initiate government policy options to reduce inefficiency focusing on factors affecting the long-run and short-run inefficiencies distinctly. The current low level of efficiency can be addressed by increasing farmers’ access to education, modern agricultural machineries and input market accesses, improving technologies that promote land conservation (quality) and reduce weather adverse effects and support for female farmers.
JEL Classification: C23; C33; D24; O13; Q12; Q18.
Biomarkers In Prediction of Acute Mesenteric Ischaemia: a prospective multicentre study (BIPAMI study): a study protocol
Authors: Tamme Kadri , Acosta Stefan , Biloslavo Alan , Björck Martin , Casian Dumitru , Damaskos Dimitrios , Forbes Alastair , Kase Karri , Kisand Kalle , Lakbar Ines , Mihnovitš Vladislav , Murruste Marko , Mändul Merli , Padar Martin , Starkopf Joel , Visconti Diego , Blaser Annika Reintam
Published: March 2024

Introduction
Acute mesenteric ischaemia (AMI) is a life-threatening disease where early diagnosis is critical to avoid morbidity and mortality from extensive irreversible bowel necrosis. Appropriate prediction of presence of bowel necrosis is currently not available but would help to choose the optimal method of treatment.
The study aims to identify combinations of biomarkers that can reliably identify AMI and distinguish between potentially reversible and irreversible bowel ischaemia.
Methods
This is a prospective multicentre study. Adult patients with clinical suspicion of AMI (n=250) will be included. Blood will be sampled on admission, at and after interventions, or during the first 48h of suspicion of AMI if no intervention undertaken. Samples will be collected and the following serum or plasma biomarkers measured at Tartu University Hospital laboratory: intestinal fatty acid-binding protein (I-FABP), alpha-glutathione S-transferase (Alpha- GST), interleukin 6 (IL-6), procalcitonin (PCT), ischaemia-modified albumin (IMA), D-lactate, D-dimer, signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) and lipopolysaccharide-binding protein (LBP). Additionally, more common laboratory markers will be measured in routine clinical practice at study sites.
Diagnosis of AMI will be confirmed by computed tomography angiography, surgery, endoscopy or autopsy.
Student’s t or Wilcoxon rank tests will be used for comparisons between transmural vs. suspected (but not confirmed) AMI (comparison A), confirmed AMI of any stage vs suspected AMI (comparison B) and non-transmural AMI vs transmural AMI (comparison C). Optimal cut-off values for each biomarker for each comparison will be identified based on the AUROC analysis and likelihood ratios calculated with positive likelihood ratio >10 (>5) and negative likelihood ratio <0.1 (<0.2) considered of high (moderate, respectively) diagnostic accuracy. All biomarkers with at least moderate accuracy will be entered as binary covariates (using the best cutoffs) into the multivariable stepwise regression analysis to identify the best combination of biomarkers for all comparisons separately. The best models for each comparison will be used to construct a practical score to distinguish between no AMI, non-transmural AMI and transmural AMI.
As a result of this study, we aim to propose a score including set of biomarkers that can be used for diagnosis and decision-making in patients with suspected AMI.
Trial registration number: NCT06212921
Comprehensive mapping of immune perturbations associated with aplastic anemia
Authors: Wang Huijun , Chen Yinchun , Deng Haimei , Zhang Jie , Jiang Xiaotao , Mo Wenjian , Wang Shunqing , Zhou Ruiqing , Liu Yufeng
Published: March 2024

Background
Acquired aplastic anemia (AA) is an immune-mediated syndrome resulting in bone marrow failure. Therefore, comprehending the profile and cell interactions in affected patients is crucial.
Methods
Human peripheral blood mononuclear cells (PBMCs) were collected from both healthy donors (HD) and AA patients, and analyzed using multicolor flow cytometry. Utilizing FlowSOM, we explored and visualized the immunophenotypic and metabolic characteristics of AA.
Results
Patients with AA show increased CD56+ monocytes with NK characteristics and activated cytotoxic T cells in peripheral blood compared to HD. Conversely, less functional CD56dim NK cells, regulatory T cells and myeloid-derived suppressor cells (MDSCs) decrease in AA. Additionally, MDSCs demonstrate post-treatment recovery and can serve as clinical indicators to distinguish between acquired aplastic anemia (AA) and congenital aplastic anemia (CAA). We assessed correlations among 29 immune cell types and found that a significant increase in memory B cells, eosinophils, and NK bright cells, along with a marked decrease in NK dim and non-classic monocytes, indicates a discernible interplay and correlation among these immune cell populations.
Conclusion
Our study results demonstrate significant immune dysregulation in patients with AA. Thus, CD56+ monocytes with NK characteristics, activated cytotoxic T cells, less functional CD56dim NK cells, Treg cells, and MDSCs may play crucial roles in the onset and progression of AA, serving as potential diagnostic biomarkers. These findings are expected to facilitate accurate diagnosis and timely treatment, thereby reducing the high mortality rate.
Insertion site and risk of peripheral intravenous catheter colonisation: A post hoc analysis of the CLEAN 3 study including more than 800 catheters
Authors: Drugeon Bertrand , Marjanovic Nicolas , Boisson Matthieu , Buetti Niccolò , Mimoz Olivier , Guenezan Jérémy
Published: March 2024

Aim: Although uncommon, infections associated with peripheral intravenous catheters (PIVCs) may be responsible for severe life-threatening complications and increase healthcare costs. Few data are available on the relationship between PIVC insertion site and risk of infectious complications.
Methods: We performed a post hoc analysis of the CLEAN 3 database, a randomised 2x2 factorial study comparing two skin disinfection procedures (2% chlorhexidine-alcohol or 5% povidone iodine-alcohol) and two types of medical devices (innovative or standard) in adults patients before admission to a medical ward. PIVC insertion sites were grouped into five groups: hand, wrist, forearm, cubital fossa and upper arm. We evaluated the risk of risk of PIVC colonisation (i.e., tip culture eluate in broth showing at least one microorganism in a concentration of at least 1000 Colony Forming Units per mL) and positive PIVC tip culture (i.e., PIVC-tip culture eluate in broth showing at least one microorganism regardless of its amount) using multivariate Cox models.
Results: Overall, we included 823 PIVCs with known site of insertion that were sent to the laboratory for quantitative culture. After adjustment for confounding factors, PIVC insertion in the wrist or the cubital fossa was associated with an increased risk of positive and colonised tip culture. In other words, insertion of a PIVC into a site of the upper limb other than the wrist or the cubital fossa reduced the risk of colonised PIVC (HR 0.57 [0.35-0.92], p=0.020) and of positive PIVC tip culture (HR 0.75 [95%CI, 0.55-1.02], p=0.065).
Plasticity of mouse dorsal root ganglion neurons by innate immune activation is influenced by electrophysiological activity
Authors: Friedman Timothy N. , Lamothe Shawn M. , Maguire Aislinn D. , Hammond Thomas , Hilton Brett J. , Plemel Jason R. , Kurata Harley T. , Kerr Bradley J
Published: March 2024

Background.
The intricate interplay between inflammation, its effects on neuronal excitability, and the ensuing plasticity of dorsal root ganglion (DRG) sensory neurons remains to be fully explored. In this study, we have investigated the impact of inflammatory conditioned media on the excitability and activity of DRG neurons and how this relates to subsequent growth responses of these cells.
Findings.
We show here that an early phase of increased neuronal activity in response to inflammatory conditioned media is critical for the engagement of plastic processes, and that neuronal excitability profiles are linked through time to the structural phenotype of individual neurons. Pharmacological blockade of neuronal activity was able to abolish the growth promoting effects of inflammatory media. Our findings also demonstrate a sex specificity of these responses.
Conclusions.
Our results suggest that targeting the activity of DRG neurons may provide a novel therapeutic avenue to manipulate their growth status and potential for plasticity in response to inflammation. While further studies are needed to fully elucidate the underlying mechanisms of the relationship between neural activity and growth status, a more complete understanding of this relationship may ultimately lead to the development of new treatments for neuropathic pain in disorders associated with heightened immune responses such as rheumatoid arthritis and MS.
Seismic Vulnerability Assesment of RC Buildings in Sylhet City Using Fuzzy Logic
Authors: Lecturer Sadek Hossain
Published: March 2024

Due to tectonic setup, Bangladesh is the one of the most earthquake prone country in the world. In Bangladesh Sylhet is the riskiest city regarding to earthquake. Besides this over the last few years the unplanned development in Sylhet city has result very few resiliency to earthquakes. So now it is very important to identify the buildings which are very vulnerable. This study represents the seismic vulnerability of RC buildings in Sylhet city based on the fuzzy logic model. For analysis purpose fuzzy logic toolbox of Matlab 2016a software was used. In this study considered variables were short column, soft story, vertical geometric irregularity, plan irregularity, year of construction, construction quality, previous damage, pounding effect and number of stories. In this study 210 buildings of ward no 14 and 15 of Sylhet City Corporation were observed, where 54% buildings were slightly vulnerable, 33% buildings were moderately vulnerable and 13% buildings were highly vulnerable.
Standards of Care for Medical Management of Acromegaly in Pituitary Tumor Centers of Excellence (PTCOE)
Authors: Giustina A , Uygur M M , Frara S , Barkan A , Biermasz N R , Chanson P , Freda P , Gadelha M , Haberbosch L. , Kaiser U B , Lamberts S , Laws E , Nachtigall L B , Popovic V , Reincke M , Lely A J , Wass J A H , melmed S , Casanueva F F
Published: March 2024

Purpose: A series of consensus guidelines on medical treatment of acromegaly have been produced in the last two decades. However, little information is available on their application in clinical practice. Furthermore, international standards of acromegaly care have not been published. The aim of our study was to report current standards of care for medical therapy of acromegaly, using results collected through an audit performed to validate criteria for definition of Pituitary Tumor Centers of Excellence (PTCOE).
Methods Details of medical treatment approaches to acromegaly were voluntarily provided by nine renowned international centers who participated in this audit. For the period 2018-2020, we assessed overall number of acromegaly patients under medical treatment, distribution of patients on different treatment modalities, overall biochemical control rate with medical therapy and specific control rates for different medical treatment options.
Results: Median number of total patients and median number of new patients with acromegaly managed annually in the endocrinology units of the centers were 206 and 16.3, respectively. Median percentage of acromegaly patients on medical treatment was 48.9%. Among the patients on medical treatment, first generation somatostatin receptor ligand (SRL) monotherapy was used with a median rate of 48.7%, followed by combination therapies with a median rate of 29.3%. Cabergoline monotherapy was used in 6.9% of patients. Pegvisomant monotherapy was used in 7 centers and pasireotide monotherapy in 5 centers, with median rates of 7.9 % and 6.3%, respectively.
Conclusions: Current standards of care in PTCOE’s include use of SRLs as first medical option in about 50% of patients, as informed by consensus guidelines. However, some patients are kept on this treatment despite inadequate control suggesting that cost-effectiveness, availability, patient preference, side effects and therapeutic inertia may play a determinant role in PTCOE. Moreover, at odds with consensus guidelines, other monotherapies for acromegaly appear to have a marginal role as compared to combination therapies as extrapolated from PTCOE practice data. The results indicate that the presence of uncontrolled patients in each treatment category require further optimization of medical therapy as well as utilization of other therapeutic tools such as radiosurgery.
Outcomes of Charcot Arthropathy Limb Salvage with Patient-Specific 3D-Printed Cage and Dynamic Hindfoot Fusion Nail Combination Fixation
Authors: Kim Michael , Mann Tara , Kelly Cambre , Palmer Ryan , Abar Bijan , Zhang Hui , Cush Gerard
Published: March 2024

Background
The challenge of surgical treatment of hindfoot collapse can be exacerbated by host conditions that may limit healing potential and increase the risk of infection. Many patients with neuropathy, Charcot joint, or end-stage arthritis that undergo tibiotalocalcaneal (TTC) fusion with bulk allograft progress to nonunion and often require amputation. 3D-printed titanium implants provide benefits that may improve outcomes of limb salvage within this population, but long-term outcomes of these implants have not yet been reported, given their relatively recent development. This study reports mid-term outcomes of patients with Charcot arthropathy or end-stage arthritis who received 3D-printed titanium cage and dynamic hindfoot fusion nail combination fixation for limb salvage.
Methods
This study was a retrospective review of consecutive patients who underwent hindfoot arthrodesis with a combination of patient-specific 3D-printed titanium cage and dynamic hindfoot fusion nail by a single surgeon at a single institution. The primary outcome was to establish the safety of the 3D-printed cage in a medically complicated population. Medical records were reviewed for adverse events, including subsequent surgical intervention and implant survivorship. The secondary outcome was to evaluate the efficacy of the 3D-printed cage, as evaluated by patient-reported pre- and post-operative 11-point Numeric Rating Scale (NRS) pain score, ambulation status, and satisfaction. Deformity correction was evaluated by radiograph. Descriptive statistics were calculated, and a Kaplan-Meier curve of all-cause reoperation was produced.
Results
This study evaluated 13 cases with at least one year follow-up. Mean follow-up was 3.72 years (range 2.67–4.60 years). As of the most recent follow-up, 11 of 13 cages remain implanted, with two cages having been explanted in the setting of amputations indicated by conditions unrelated to the cage itself. Patients reported a mean pre-operative NRS pain of 6.6 ± 2.9 points. At the last follow-up, mean NRS pain was 2.0 ± 1.7 points. Pre-operatively, six of 13 patients reported the ability to ambulate independently without an assistive device. Post-operatively, 11 of 13 patients were able to ambulate independently.
Conclusion
This study reports mid-term outcomes of TTC arthrodesis with a patient-specific 3D-printed titanium cage and dynamic intramedullary nail in patients with Charcot arthropathy or non-traumatic arthritis. The results demonstrate no implant-related complications and promising outcomes in terms of fusion, deformity correction, and patient satisfaction, which are especially remarkable in the setting of Charcot arthropathy. While this data is promising as a technique for limb salvage in this patient population, further experimental studies are required to demonstrate superiority.
Level of Evidence: Level IV
Methylphenidate enhances a frontoparietal-dominant brain state improving cognitive performance
Authors: Yan Weizheng , Demiral Şükrü Barış , Tomasi Dardo , Zhang Rui , Manza Peter , Wang Gene-Jack , Volkow Nora D.
Published: March 2024

Background
Methylphenidate (MP) is a widely used stimulant medication for the treatment of attention deficit hyperactivity disorder (ADHD) that enhances brain dopamine signaling and improves attention. However, how dopamine stimulation alters brain state dynamics to support improved attention during task performance is still unclear.
Methods
We employed a multimodal neuroimaging approach combining positron emission tomography, functional magnetic resonance imaging, and behavioral tests, to discover associations between dopamine signaling, brain activity, and cognition. Multimodal images were collected from 37 healthy adults under a single-blind, counterbalanced, placebo-controlled crossover study. Dynamic functional analysis was used to compare the alterations in dynamic features of brain states before and after MP. Subsequently, we analyzed the correlation between these brain state changes and baseline striatal D1 and D2 dopamine receptor (D1R, D2R) availability. We then examined alterations in dynamic brain states and their effects on attention performances.
Results
The results showed that MP primarily affected frontoparietal-dominant activated (FPN+), somatomotor-dominant activated (SOM+), and visual-dominant suppressed (VIS-) brain states. Specifically, the dwell time and fractional occupancy exhibited significant increases within the FPN + and VIS- while an opposite trend within the SOM+. Furthermore, the increase of dwell time in FPN+, which was positively correlated with baseline striatal D1R availability, was also associated with quicker response in the 2-ball-track task, but not significant for the 3-ball-track task.
Conclusions
The findings suggest that MP’s enhancement of brain states with FPN + and VIS- while decreasing SOM+, in part through D1R signaling might underlie the MP’s improvement of attention for low cognitive effort tasks in healthy populations.
Dynamic Behavioural Analysis of Privacy-Breaching and Data Theft Ransomware
Authors: Ozturk Mehmet , Demir Ayse , Arslan Zeynep , Caliskan Omer
Published: March 2024

This study presents a comprehensive analysis of privacy-breaching ransomware, emphasizing the dynamic behavioral patterns and techniques employed by these malicious entities to compromise data privacy. Employing a systematic methodology that includes the collection of diverse ransomware samples, establishment of a secure analysis environment, and execution of a dynamic behavioral analysis procedure, we have delineated the sophisticated tactics that characterize modern ransomware operations. Our findings reveal a significant shift in ransomware strategies, with an increasing focus on data theft over mere financial extortion, highlighting the evolving landscape of cyber threats. The analysis underscores the necessity for advanced cybersecurity measures that incorporate machine learning and behavioral analysis to proactively detect and mitigate these threats. Furthermore, the study identifies key areas for future research, including the development of adaptive security systems and the importance of international collaboration in cybersecurity efforts. This research contributes valuable insights into the behavior of privacy-breaching ransomware, offering a foundation for future advancements in the field of dynamic ransomware analysis and cybersecurity defense strategies.
Validation of an Analytical Methods of 3',4',5-Trihydroxy-3-Methoxy-6,7- Methylenedioxyflavone 4'-Glucuronide for Standardization of Spinacia oleracea
Authors: Son Yun Gon , Jung Juyoung , Lee Dong Kun , Park Sang Won , Kim Jeong Yoon , Kim Hyun Joon
Published: March 2024

Spinach (Spinacia oleracea) is one of the most famous vegetables worldwide, rich in essential metabolites for various health benefits. It is a valuable plant source that has the potential to be a nutraceutical. In the process of developing functional foods, it is crucial to establish a standard compound and quantitative analysis methods to ensure standardization. Thus, the analytical method validation was established using 3',4',5-trihydroxy-3-methoxy-6,7-methylenedioxyflavone 4'-glucuronide (TMG) as a marker compound. The specificity, accuracy, linearity, precision, repeatability, limit of detection (LOD), and limit of quantification (LOQ) was proved according to validation guideline. The specificity was confirmed from the BPI and UV chromatogram of the standard compound (TMG) as the predominant metabolite in the spinach sample. The calibration curve of TMG (15.625 ~ 500 µg/ml) had reasonable linearity (R2 = 0.999) considering with LOD and LOQ values, respectively. Recovery rate of TMG was 93.31-100.98% for FDS and 90.37–95.04% for SEC. The precision was less than 3 and 6% in the intra-day and inter-day. The spinach samples (FDS and SEC) were validated using TMC as a standard compound to comply with AOAC and KFDA regulations for approving functional ingredients in health functional food.
Impact of Transesophageal Echocardiographic Parameters on Procedure-Related Radiation Exposure in Percutaneous Transcatheter Patent Foramen Ovale Closure
Authors: Demirtola Ayşe İrem , Mammadli Anar , Inan Duygu , Erdoğan Aslan , Yavuz Sevil , Pamuk Özlem , Genç Duygu , Demirtaş İhsan , Şen Furkan , Kılıçgedik Alev
Published: March 2024

Background: Patent foramen ovale (PFO) is a cardiac congenital anomaly with a prevalence of 20% to 30% in the general population, associated with clinical conditions such as cryptogenic stroke, migraine, and decompression sickness. Percutaneous PFO closure has been proven superior to medical treatment alone for PFO-related stroke, exhibiting a favorable safety profile. However, the procedure's radiation exposure necessitates a deeper understanding of the influencing factors, especially the impact of PFO anatomical characteristics on radiation dose and procedural time.
Methods: This study analyzed 83 patients undergoing transcatheter PFO closure for CS. The study evaluated the relationship between the anatomical features of PFO and radiation exposure, measured by Air Kerma. Increased radiation exposure was defined as falling within the highest quintile (5th quantile) of the Air Kerma. Statistical analyses included univariate and multivariate logistic regression and Receiver Operating Characteristic (ROC) analysis.
Results: The study population had a mean age of 40.9 ± 9.0 years, with a slight male predominance (51.8%). The median fluoroscopy time was 10.9 minutes, with an interquartile range (IQR) of 7.5 to 19.9 minutes. The median Air Kerma value was 149 mGy (IQR, 83 – 311). In the multivariate regression analysis, a shorter aortic rim length was identified as an independent predictor of increased radiation exposure, with an odds ratio of 2.01 (95% confidence interval [CI], 1.3 – 3.1; P=0.002). In the ROC analysis, the aortic rim length demonstrated good predictive value for increased radiation exposure, with an area under the curve of 0.872 (95% CI, 0.791 – 0.953; P<0.001). A cutoff value of less than 4.5 mm for the aortic rim length was associated with an 88% sensitivity and 80% specificity in predicting increased radiation exposure.
Conclusion: A short aortic rim length is associated with increased radiation exposure during percutaneous closure of PFO.
Non-linear Association between Serum Sodium-To-Potassium Ratio and 14-day Mortality in AKI Patients with COPD: A Retrospective Cohort Study
Authors: Wang Yaotang , Hu Ruimin , Lam Yatsu
Published: March 2024

BACKGROUND
There is a lack of evidence about association between serum sodium-to-potassium ratio on admission and 14-day mortality in AKI patients with chronic obstructive pulmonary disease. Herein, we aimed to identify the association between serum Na/K ratio and short term mortality in AKI patients with COPD.
METHODS
A retrospective analysis of data from the Dyrad database was performed on AKI patients identified by electronic recordings. A multivariate Cox proportional hazard regression model and Kaplan-Meier survival curve analysis were used to analyse the correlation of serum sodium-to-potassium ratio between the serum sodium-potassium ratio and 14-day mortality in AKI patients with COPD. Furthermore, interaction and subgroup analyses were evaluated for the consistency of these correlations.
RESULTS
A total of 1867 AKI patients with COPD were included in this study. The 14-day mortality was 7.6% (142/1867). Multivariate analysis after adjusting for potential confounders indicated that high serum Na/K ratio(≥33) were associated with decreased risk of 14-day mortality as compared to low serum Na/K ratio (>33), (hazard ratio (HR): 0.67 [95% CI: 0.47–0.97]). Similarly, the Kaplan–Meier (K–M) survival curve also showed that patients with high serum Na/K ratio had a great survival rate. Stratiﬁed analyses further showed that depending on the variable tests, an association between higher serum Na/K ratio and 14-day mortality in different subgroups was observed.
CONCLUSIONS
Among AKI patients with COPD, high serum Na/K ratio was associated with decreased short-term mortality.
Collaborative Strategies for Adolescent Suicide Prevention: Insights from Slovakia and Kyrgyzstan
Authors: Salimova Leila , Rusnakova Marketa
Published: March 2024

Objective
The study aimed to analyze the role and effectiveness of multidisciplinary teams in preventing adolescent suicide within educational settings in Slovakia and Kyrgyzstan.
Materials and Methods
Qualitative research methods were employed, involving semi-structured interviews with 10 specialists from Slovakia and Kyrgyzstan. The study assessed the collaborative efforts of various professionals involved in suicide prevention.
Results
Despite differing levels of development and implementation of multidisciplinary team concepts, findings revealed a generally positive impact of collaborative efforts in both countries (more structured in Slovakia and less developed in Kyrgyzstan). Multidisciplinary teams in educational settings strive to create supportive environments for adolescents, contributing significantly to mitigating various issues during their formative years.
Conclusions
Prevention efforts require coordinated action among multiple social institutions with unified strategies. While progress has been made, there remains potential for further development, particularly in improving cooperation among specialists, national recognition of youth suicide as a critical issue, and institutionalizing procedures to elevate the status and education of multidisciplinary teams. Significance: This research provides innovative insights into the effectiveness of multidisciplinary teams in suicide prevention among adolescents. By suggesting comprehensive strategies for team collaboration, it offers valuable contributions to reducing youth suicide rates in both Slovakia and Kyrgyzstan.
Scientific literature on carbon dioxide removal much larger than previously suggested: insights from an AI-enhanced systematic map
Authors: Lück Sarah , Callaghan Max , Borchers Malgorzata , Cowie Annette , Fuss Sabine , Geden Oliver , Gidden Matthew , Hartmann Jens , Kammann Claudia , Keller David P. , Kraxner Florian , Lamb William , Dowell Niall Mac , Müller-Hansen Finn , Nemet Gregory , Probst Benedict , Renforth Phil , Repke Tim , Rickels Wilfried , Schulte Ingrid , Smith Pete , Smith Stephen M , Thrän Daniela , Spek Mijndert van der , Minx Jan C.
Published: March 2024

Carbon dioxide removal (CDR) is a critical component of any strategy to limit global warming to well below 2°C and rapidly gaining attention in climate research and policymaking. Despite its importance, there have been few attempts to systematically evaluate the scientific evidence on CDR. Here we use an approach rooted in artificial intelligence to produce a comprehensive systematic map of the CDR literature. In particular, we hand-label 5,339 documents to train machine learning classifiers with high levels of precision and recall to identify a total of 28,976 CDR studies across different technology domains and disciplines published in the period 1990-2022 which is at least 2-3 times more than previous studies suggested. We paint a granular picture of available CDR research in terms of the CDR methods studied, the geographical focus of research, the research method applied, and the broad area of research. The field has grown considerably faster than the climate change literature as a whole. This is driven mainly by the rapid expansion of literature on biochar, which made up about 62% of CDR publications in 2022. Beyond this stark concentration of CDR research on a few individual CDR methods, we find that most studies (86%) focus on improving the CDR methods themselves, but there is little research on their societal implications and ethical foundations. Citations patterns from the most recent IPCC report strongly differ from publication patterns on CDR in terms of its attention to CDR methods, research design and methodological context, as does attention to CDR methods in policy and practice in terms of real-world deployments, patenting activity, as well as public investments. As the importance of CDR grows for meeting the Paris climate goals, we believe that the accompanying literature database will be of additional value for the upcoming IPCC assessment, but also for science, policy and practice.