bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of minocycline on patients with acute anterior circulation ischaemic stroke undergoing intravenous thrombectomy (MIST-A): the study protocol for a multicentre, prospective, randomised, open-label, blinded-endpoint trial
Authors: Zhang Xiao , Zhao Jingjing , Sun Zhongqing , Wei Dong , Yao Li , Li Weiwang , Zhu Hao , Liu Wen , Zhang Huiping , Yuan Xiangjun , Ma Xingshun , Meng Junpeng , Wang Bin , Jia Yi , Qin Na , Jiang Wen
Published: December 2024

Introduction

Despite the implementation of mechanical thrombectomy, acute ischaemic stroke with large vessel occlusion (AIS-LVO) remains a significant health concern, characterised by substantial morbidity and mortality. Our trial aims to evaluate the efficacy and safety of minocycline in reducing infarct volume and improving functional outcomes in patients undergoing mechanical thrombectomy for anterior circulation AIS-LVO.

Methods and analysis

The MIST-A trial is a prospective, randomised, open-label, blinded-endpoint trial to be conducted across 12 medical centres. The study will enrol 180 adult patients who have experienced an anterior circulation AIS-LVO and have undergone mechanical thrombectomy. These patients will be randomly divided into two groups: one receiving minocycline in addition to standard care and the other receiving only standard care. The primary efficacy outcome is the change in infarct volume as measured by MRI, from baseline to day 5. The secondary efficacy outcomes include the incidence of intracerebral haemorrhage occurring within 24 hours and the clinical scores between the baseline and follow-up assessments. The primary outcome will be assessed using a mixed-effects model to determine the association between treatment and outcomes.

Ethics and dissemination

The study is approved by the Ethics Committee of Xijing Hospital (XJLL-KY20222186) and is registered at ClinicalTrials.gov (NCT05487417). This trial is estimated to end in the first quarter of 2025 and study findings are expected to be published in scientific journals that undergo peer review and also to be showcased at scientific conferences.

Trial registration number

NCT05487417.
Prevalence and factors associated with burnout among healthcare providers at Kasulu district in Kigoma region, 2024: an analytical cross-sectional study in a primary healthcare setting
Authors: Mfuru Godbless Henry , Ubuguyu Omary , Yahya-Malima Khadija I
Published: December 2024

Background

Burnout among healthcare providers affects their well-being and quality of care. Despite its importance, limited data exist on burnout among primary healthcare providers in Tanzania.

Objectives

To determine the prevalence of burnout and associated factors among healthcare providers in Kasulu district, Kigoma region, 2024.

Study design

Analytical cross-sectional study conducted from January to June 2024.

Study setting

Primary health facilities at Kasulu district in Kigoma region.

Participants

Healthcare providers working in Kasulu district for more than 6 months before study.

Primary outcome

Burnout.

Results

Among 266 healthcare providers with a response rate of 99%, 59.4% were male. The median age was 32 years (IQR 27–37). Burnout prevalence was 54.5% (95% CI 48.5% to 60.4%), higher among nurses (61.3%), those living off-site (69.6%) and those considering leaving their careers (86.2%). Significant factors included age 21–30 years (adjusted prevalence ratio (aPR) 1.55, 95% CI 1.06 to 2.27), nursing profession (aPR 2.19, 95% CI 1.07 to 4.48), off-site residence (aPR 1.23, 95% CI 1.02 to 1.49), 6 months to 2 years of experience (aPR 1.44, 95% CI 1.12 to 1.86), dissatisfaction with salary (aPR 1.77, 95% CI 1.02 to 3.07), poor colleague relationships (aPR 1.25, 95% CI 1.03 to 1.51), ≥4 night shifts/week (aPR 2.54, 95% CI 1.33 to 4.86), attending ≥41 patients per day (aPR 1.52, 95% CI 1.06 to 2.19) and lack of academic growth opportunities (aPR 1.62, 95% CI 1.15 to 2.29).

Conclusion

Rural settings like Kasulu face unique challenges, including limited resources and heavy workloads, exacerbating burnout among healthcare providers. Over half of healthcare providers experienced burnout, with younger providers, nurses, those living off-site, less experienced staff, poor colleague relationships and high patient loads at higher risk. To mitigate burnout, authorities should provide career counselling, onsite housing, mental health support and increased staffing.
Enlarged airspaces in the distal lung in adolescents born very preterm as measured by aerosol
Authors: Öhrneman Hugo , Lindström Frida , Hagman Cecilia , Petersson Sjögren Madeleine , Rissler Jenny , Wollmer Per , Tufvesson Ellen , Löndahl Jakob
Published: December 2024

Rationale

Preterm infants diagnosed with bronchopulmonary dysplasia (BPD) are thought to have fewer and larger alveoli than their term peers, but it is unclear to what degree this persists later in life.

Objectives

To investigate to what degree the distal airspaces are enlarged in adolescents born preterm and to evaluate the new Airspace Dimension Assessment (AiDA) method in investigating this group.

Methods

We investigated 41 adolescents between 15 and 17 years of age, of whom 25 were born very preterm (a gestational age <31 weeks, with a mean of 26 weeks) and 16 were term-born controls. Of the preterms, 17 were diagnosed with BPD. The AiDA method was used to measure the average distal airspace radius (rAiDA) in the lungs. In addition, lung function was evaluated by spirometry, impulse oscillometry and diffusing capacity of carbon monoxide (DLCO).

Measurements and main results

We observed a mean rAiDAof 295±53 µm for the preterm group compared with 231±12 µm for the control group (p<0.0001). The adolescents diagnosed with BPD had a mean rAiDAof 313±54 µm. There was a strong negative correlation between gestational age and distal airspace radius (p<0.0001). The BPD group had a decreased FEV1(forced expiratory volume in 1 s, z-score: −1.28±1.37, p=0.012) and DLCO(z-score: −0.92±1.01, p=0.013) compared with the controls, but all other lung function variables showed normal values.

Conclusions

Our results suggest that the enlarged airspaces seen in preterm infants likely remain in adolescence. Distal airspace radius as measured by AiDA was the lung function variable that showed the most significant difference between preterm and term-born adolescents.
Professional obligations and the demandingness of acting against one’s conscience
Authors: Giubilini Alberto
Published: December 2024

Conscience is typically invoked in healthcare to defend a right to conscientious objection, that is, the refusal by healthcare professionals to perform certain activities in the name of personal moral or religious views. On this approach, freedom of conscience should be respected when the individual is operating in a professional capacity. Others would argue, however, that a conscientious professional is one who can set aside one’s own moral or religious views when they conflict with professional obligations. The debate on conscientious objection has by and large crystallised around these two positions, with compromise positions aiming at striking a balance between the two, for instance, by arguing for referral requirements by objecting healthcare professionals.

In this article, I suggest that the debate on conscientious objection in healthcare could benefit from being reframed as a problem around demandingness rather than one about freedom of conscience and moral integrity. Being a professional, and a healthcare professional specifically, typically requires taking on additional burdens compared with non-professionals. For instance, healthcare professionals are expected to take on themselves higher risks than the rest of the population. However, it is also widely agreed that there are limits to the additional risks and burdens that healthcare professionals should be expected to take on themselves. Thus, a question worth exploring is whether, among the extra burdens that healthcare professionals should be expected to take on themselves as a matter of professional obligation, there is the burden of acting against one’s own conscience.
Smartphone application-based pulmonary rehabilitation in COPD: a multicentre randomised controlled trial
Authors: Gloeckl Rainer , Spielmanns Marc , Stankeviciene Asta , Plidschun Anne , Kroll Daniela , Jarosch Inga , Schneeberger Tessa , Ulm Bernhard , Vogelmeier Claus F , Koczulla Andreas Rembert
Published: December 2024

Background

Pulmonary rehabilitation (PR) is an essential element of chronic obstructive pulmonary disease (COPD) management. However, access to conventional face-to-face PR programmes is limited.

Methods

This multicentre, randomised controlled trial recruited patients with COPD from 18 sites in Germany and Switzerland, aiming to evaluate the impact of 12 weeks of a mobile app (intervention group; IVG) on quality of life, measured by COPD Assessment Test (CAT), and exercise capacity, assessed by 1-minute-sit-to-stand-test (1MSTST), compared with a control group (CTG) receiving ’enhanced standard-of-care’.

Results

278 patients were included in the study with a median age of 65 years (IQR 60–70) and forced expiratory volume in 1 s 48% predicted (IQR 37–60). In the intention-to-treat analysis at week 12, CAT improved from baseline by median −4 points versus −3 points in the IVG versus CTG groups, respectively (difference: 0 points (95% CI: −1, 2); p=0.7); 1MSTST improved by 1 vs 2 repetitions, respectively (difference: 1 repetition (95% CI: 0, 2); p=0.12)). In a subset of the IVG, with patients grouped by application adherence (≥3 days/week for≥75% of the weeks), adherent users (40.4%) improved 1MSTST versus non-adherent users by median 2 repetitions (95% CI: 1, 3]; p=0.006. Application use did not raise any safety concerns.

Conclusions

Application-based PR improved outcomes in COPD compared with baseline, and adherent users improved exercise capacity more compared with non-adherent users. Although not statistically significant compared with enhanced standard-of-care, this study may support the use of this application for COPD management and addresses the healthcare challenge of access to PR interventions.

Trial registration number

DRKS 00024390.
LiDAR for rapid geomorphological assessment in relict periglacial landsystems
Authors: Giles David Peter
Published: December 2024

The construction of the A21 Sevenoaks Bypass in Kent is a seminal case study in engineering geology. In 1965 during the earthworks for the road, major slope failures occurred presenting a significant setback to the programme. No slope stability issues were foreseen before the groundworks commenced. Post failure forensic investigations revealed multiple shear surfaces within lobe-like landforms that dissected the original route alignment. At that time, these landforms were not recognised, and their problematic nature not fully understood. Similarly, the Maidstone district has long been described as an area of relict periglacial landforms, specifically cambering and associated gulls, and valley bulge. This paper presents key case studies, which detail the nature of the relict periglacial landsystem that gave rise to the encountered geohazards and demonstrates the advances in ground model assessment offered by airborne LiDAR (laser scanning) data sets for engineering geomorphology. High resolution digital elevation models derived from the LiDAR imagery (that became available for the first time in 2019) can be utilised to interpret and visualise the on-ground geomorphology. The available LiDAR imagery is described, and examples of their use presented from these classic case study sites.
A Novel Intelligent Video Surveillance System Using Low-Traffic Scene-Preserving Video Anonymization
Authors: Huh Jungwoo , Kang Jiwoo , Woo Jongwook , Lee Sanghoon
Published: December 2024

With the development of computer vision technology, intelligent video surveillance systems have been developed for automatic monitoring. However, the problem of personal information protection has also emerged. Existing systems attempted to solve this problem by anonymizing a video by, for example, sending only low-dimensional abstract information such as a person’s 2D pose or blurring a person’s face in the video before sending it to the central cloud server. However, these approaches failed to balance scene-preservation and traffic efficiency, because abstract information is too limited for preserving the entire scene, and video modification generates massive traffic. This article proposes a novel intelligent video surveillance system to overcome such limitations that preserves the scene information and generates minimal traffic through video anonymization. The proposed system reconstructs 3D human models and estimates segmentation masks to preserve a scene captured by a surveillance camera in its entirety. Parametric models represent 3D human models with several sets of parameters, and dictionary coding compresses the segmentation mask with a high compression ratio. The system follows the edge-cloud architecture, where the edge node extracts and transmits the scene information and the central cloud server generates the final anonymized video. We demonstrate the effectiveness of the proposed system by conducting experiments on processing time, scene preservation, and traffic efficiency. Our proposed system runs in real-time (

\(>\)

25fps) in a typical hardware setting and has a data compression ratio of more than 5,000 compared with raw data transfer while maintaining over 85% scene-preservation correlation with the original video.
A Roadmap for Software Testing in Open-Collaborative and AI-Powered Era
Authors: Wang Qing , Wang Junjie , Li Mingyang , Wang Yawen , Liu Zhe
Published: December 2024

Internet technology has given rise to an open-collaborative software development paradigm, necessitating the open-collaborative schema to software testing. It enables diverse and globally distributed contributions, but also presents significant challenges to efficient testing processes, coordination among personnel, and management of testing artifacts. At the same time, advancements in artificial intelligence (AI) have enhanced testing capabilities and enabling automation, while also introducing new testing needs and unique challenges for AI-based systems. In this context, this paper explores software testing in the open-collaborative and AI-powered era, focusing on the interrelated dimensions of process, personnel, and technology. Among them, process involves managing testing workflows and artifacts to improve efficiency, personnel emphasizes the role of individuals in ensuring testing quality through collaboration and contributions, while technology refers to AI methods that enhance testing capabilities and address challenges in AI-based systems. Furthermore, we delve into the challenges and opportunities arising from emerging technologies such as large language models (LLMs) and the AI model-centric development paradigm.
CT- and MRI-based Factors Associated with Rapid Growth in Early-Stage Hepatocellular Carcinoma
Authors: Jang Hyeon Ji , Choi Sang Hyun , Wee Sungwoo , Choi Se Jin , Byun Jae Ho , Won Hyung Jin , Shin Yong Moon , Sirlin Claude B.
Published: December 2024

Multivariable analysis revealed that among hepatocellular carcinomas, Liver Imaging Reporting and Data System category M was an independent factor for rapid growth (median doubling time = 79 days), observed in 70% of such tumors.
Advancing the teaching of equilibrium potential: five small yet transformative additions
Authors: Guerrero Felipe , Kuang Serena Y.
Published: December 2024

This novel approach to advance teaching of the equilibrium potential ( Eion) addresses and fills common educational gaps by 1) making a critical point explicit, rather than implicit; 2) introducing overlooked concepts to prevent confusion; 3) adding an effective assessment to promote mastery; and 4) emphasizing the importance of strengthening medical students’ understanding of Eion. These targeted additions facilitate a more comprehensive and transformative learning experience for medical students.
Do pulmonary ionocytes absorb chloride or secrete chloride?
Authors: Thornell Ian M. , Lei Lei , McCray Paul B. , Welsh Michael J.
Published: December 2024

Pulmonary ionocytes express high levels of cystic fibrosis transmembrane conductance regulator (CFTR) channels. When studied using the short-circuit current technique, ionocytes produce CFTR-dependent short-circuit currents consistent with Cl− secretion. However, when studied without a voltage clamp, data indicate that ionocytes absorb Cl−. In this review, we resolve these seemingly conflicting findings by considering the different transepithelial voltages and the resultant movement of Cl− during short circuit and physiological open-circuit conditions. This analysis indicates that behavior under short-circuit conditions cannot be directly extrapolated to infer behavior under physiologic conditions. Finally, we discuss the potential role of basolateral Cl− channels in controlling absorption and secretion in ionocytes.
Hydrogen sulfide-mediated inhibition of ROCK2 exerts a vasoprotective effect on ischemic brain injury
Authors: Chen Ye , Xu Fangfang , Chen Fang , Li Shuaishuai , Wu Miao , Chen Shuo , Chen Jinhua , Yang Zhaoyi , Sun Zhongwu , Chen Zhiwu
Published: December 2024

This study employs a diverse array of methods; our collective findings indicate that H2S safeguards against ischemic brain injury by inhibiting ROCK activity, thereby promoting relaxation of cerebral smooth muscle and mitigating the impairment of cerebral smooth muscle cell function caused by oxygen-glucose deprivation/reoxygenation. In addition, our data underscore the critical role of ROCK2 in mediating the cerebral protective effects of H2S, surpassing that of ROCK1.
VPS41 deletion triggers progressive loss of insulin stores and downregulation of β-cell identity
Authors: Yau Belinda , An Yousun , Germanos Mark , Schwarzkopf Patricia , van der Kraan A. Gabrielle , Larance Mark , Webster Hayley , Burns Christian , Asensio Cedric S. , Kebede Melkam A.
Published: December 2024

In this study, we show that acute VPS41 deletion results in rapid degradation of insulin, whereas chronic VPS41 deletion results in downregulation of β-cell identity. In acute VPS41 depletion in vitro, the loss of insulin is associated with increased degradative pathway activity, increased Adapter Protein 3 complex colocalization with lysosomes, increased nuclear localization of transcription factor E3, and downregulation of PDX1 and INS mRNA expression. Inhibition of lysosomal degradation rescues the rapidly depleted insulin content.
BRD4 inhibition rewires cardiac macrophages toward a protective phenotype marked by low MHC class II expression
Authors: Schuetze Katherine B. , Stratton Matthew S. , Bagchi Rushita A. , Hobby Alexander R. H. , Felisbino Marina B. , Rubino Marcello , Toni Lee S. , Reges Caroline , Cavasin Maria A. , McMahan Rachel H. , Alexanian Michael , Vagnozzi Ronald J. , McKinsey Timothy A.
Published: December 2024

BRD4 inhibition blocks stress-induced recruitment of pro-inflammatory monocytes to the heart. BRD4 inhibition reprograms resident cardiac macrophages toward a reparative phenotype marked by reduced NF-κB signaling and diminished MHC-II expression. BRD4 inhibition reduces infarct size in an acute model of ischemia/reperfusion injury in mice.
A novel automated method for comprehensive renal cast quantification from rat kidney sections using QuPath
Authors: Yunker Lauren , Harwig Megan Cleland , Kriegel Alison J.
Published: December 2024

We developed a method of automated renal tubule cast quantification using a machine learning-based pixel classifier within QuPath, an open-source image analysis software. The advantages of this approach are demonstrated by rigorous comparison of quantification methods on a set of Masson’s trichrome-stained kidney sections from high- and low-salt fed salt-sensitive Dahl rats. Researchers are provided with step-by-step instructions for creating and training a pixel classifier in QuPath for application to image analysis.
Physiological, biochemical, and genome-wide expression patterns during graded normobaric hypoxia in healthy individuals
Authors: Rani Ritu , Kutum Rintu , Punera Deep Shikha , Yadav Anand Prakash , Bansal Vishal , Prasher Bhavana
Published: December 2024

Our study delves into the multifaceted response to hypoxia, integrating gene expression and hematological, biochemical, and physiological assessments. Hypoxia, crucial in both physiology and pathology, prompts varied responses, necessitating a thorough systemic understanding. Examining healthy subjects exposed to graded normobaric hypoxia, we observed significant shifts in heart rate, oxygen saturation, and heart rate variability. Moreover, genomic analysis unveiled distinct gene signatures associated with physiological parameters, offering insights into molecular perturbations and adaptations to oxygen deprivation.
Shift From Warming Slowdown to Rewarming of Winter Sea Surface Temperature in the South China Sea Before and After 2013
Authors: Wang Zhaoyun , Yao Shiqiang , Wang Yanyan , Liu Hanjin , Zhang Yimin , Dong Wenjing , Liu Xing , Han Yu , Shi Xiaoran
Published: December 2024

The winter sea surface temperature (SST) in the South China Sea (SCS) before and after 2013 experienced a shift from warming slowdown to rewarming, and the interdecadal variability in the northern SCS was more pronounced than that in the southern SCS. The heat budget results indicate that the warming slowdown of SST in the northern SCS was primarily attributed to negative oceanic advection during 1997–2012. During 2013–2019, the reduction of evaporation played a dominant role in the rewarming of SST in the northern SCS, while the increase of short‐wave radiation and positive oceanic advection played secondary roles. Further analysis suggests that the shift from warming slowdown to rewarming in the northern SCS may be related to the changes in the location and intensity of the North Pacific subtropical high. The southward shift of the eastern Pacific subtropical high (EPSH) during 1997–2012 resulted in anomalous easterly winds in the equatorial eastern Pacific Ocean and caused the weakening of Kuroshio intrusion into the SCS, which was the main mechanism leading to the warming slowdown of winter SST in the northern SCS. During 2013–2019, the enhancement of the western Pacific subtropical high (WPSH) caused the weakening of the East Asian winter monsoon (EAWM) and the reduction of cloud cover, resulting in the enhancement of the net surface heat flux into the ocean, which was the primary mechanism leading to the rewarming of winter SST in the northern SCS. Meanwhile, the northward shift of the EPSH led to the increase of Kuroshio intrusion into the SCS due to the anomalous westerly winds in the equatorial eastern Pacific Ocean, which also contributed to the rewarming of winter SST in the northern SCS.
Internal Fixation for Unstable Distal Ulnar Fractures by 2.7 mm Semitubular Hook Plate
Authors: I. Abulsoud Mohamed , Elmarghany Mohammed , Zakaria Ahmed R. , Alshal Ehab A. , Moawad Mohamed , Elzahed Ehab A. , Elhalawany Mohamed F. , Kornah Bahaa A.
Published: December 2024

Objective: The purpose of this study is to investigate the outcomes of the use of a 2.7 mm semitubular hook plate for internal fixation of unstable metaphyseal ulnar fractures.

Methods: Between January 2015 and July 2019, 30 consecutive patients with a recent unstable distal ulnar fracture were included in this prospective case series. All patients were subjected to follow‐up with the time of union, range of motion, pain using a Visual Analog Scale (VAS), and radiological and functional outcome using the quick Disabilities of the Arm, Shoulder, and Hand (DASH) score and Mayo wrist score after 12 months.

Results: The mean age of the patients was 45.3 ± 10 years. There were 18 males (60%) and 12 females (40%), and there were 16 patients associated with distal radius fractures (53.33%). According to the AO classification of distal ulnar fractures, 3 fractures were type A2.1 (10%), 9 were type A2.2 (30%), 8 fractures were type A2.3 (26.67%), and 10 fractures were type A3 (33.33%). All fractures have been united with a mean duration of 9 ± 1.4 weeks, the mean supination was 81.4° ± 3.5°, the mean pronation was 81.3° ± 4.5°, the mean flexion was = 71.7° ± 3.6°, and the mean extension was = 81.7° ± 3.4°. The mean VAS was 1.1 ± 1 points, the mean DASH score was 9.3 ± 5.6 points, and the mean Mayo wrist score was 88.5 ± 7.2 points; 17 patients were excellent (56.67%) and 10 patients were good (33.33%) while 3 patients had satisfactory outcome (10%).

Conclusion: Using the 2.7 mm semitubular hook plate is a successful choice for internal fixation of unstable distal ulnar fractures isolated or associated with distal radius fractures with a favorable union time, functional outcome, and range of motion with minimal complications.
Worst‐Case Accident Analysis of Accident Tolerant Fuel in NuScale Using RELAP5/MOD3‐Based Code
Authors: Zuidersma Willem , du Toit Maria Hendrina , van Eldik Martin
Published: December 2024

Research in nuclear engineering focusses on improving the safety of light water reactors (LWRs), driven by accidents like Fukushima in 2011. The severity of this accident was a result of active cooling system failures and cladding material oxidation resulting in hydrogen explosions. To this end, efforts concentrate on the improvement of passive safety in LWRs and the development of accident tolerant fuel (ATF). Natural circulation small modular reactors (SMRs) are new reactor concepts designed around passive safety. One such SMR called the NuScale SMR was chosen for this study. This study aimed to evaluate the combination of one selected passively safe reactor system with two selected ATF cladding materials, namely FeCrAl alloy and a silicon‐carbide (SiC) composite, to determine if this combination would greatly increase the safety of LWRs. The use of ATF cladding materials in the NuScale for possible mitigation of a potential worst‐case scenario accident has not been evaluated. A model of the SMR was developed using ASYST 3.4 thermal–hydraulics code and validated for steady state operation and one worst‐case scenario accident transient using data taken from the NuScale final safety analysis report (FSAR) and literature. Results indicated minimal impact on steady state operation when employing ATF cladding materials. FeCrAl and SiC caused minor changes in peak cladding temperature (PCT) and peak fuel centerline temperature (PFCT). The worst‐case scenario accident transient involved the inadvertent opening of one reactor vent valve (RVV) with subsequent failure of the emergency core cooling system (ECCS) and decay heat removal system (DHRS). In the current model, this led to failure of the Zr‐alloy cladding after 6.42 h. This coping time was increased with the use of ATF cladding, with FeCrAl and SiC providing an increase of 0.5 and 4.35 h, respectively.
The Effect of Nanocurcumin Supplementation on Inflammatory and Biochemical Indicators in Hospitalized Patients With COVID‐19: A Randomized Controlled Clinical Trial
Authors: Ahmadi Sedigheh , Mohit Mohsen , Mehrabi Zeinab , Heydari Mohammad Reza , Faraji Seyed Nooreddin , Yaghoubi Shoeleh , Zare Morteza , Masoumi Seyed Jalil
Published: December 2024

Background: The prior studies showed that nanocurcumin (NC) has potential anti‐viral properties against a wide range of viral infections, making it a promising candidate for treating COVID‐19. This study aimed to investigate the effect of NC supplementation on the acute phase proteins, including interleukin‐6 (IL‐6), C‐reactive protein (CRP), albumin (ALB) and Erythrocyte Sedimentation Rate (ESR), and biochemical markers including lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine transaminase (ALT) and complete blood cells (CBC) in the hospitalized patients with Coronavirus disease 2019 (COVID‐19).

Methods and Materials: In a double‐blind placebo‐controlled clinical trial conducted at Ali‐Asghar Hospital of Shiraz University of Medical Sciences, 76 COVID‐19 patients with mild to moderate disease severity were randomly assigned to two groups. All patients received the national treatment guideline for COVID‐19. The intervention group was administered 160 mg/day of NC for a period of 2 weeks. Blood samples were obtained at the start and the end of the research, and nutritional consumption was determined using a 24 h dietary recall.

Results: The mean age of participants in the NC and placebo groups was 54.69 ± 13.44 and 53.94 ± 11.62 years, respectively. In the NC group, compared with placebo group, the levels of IL‐6 (p = 0.017) and LDH (p = 0.004) was significantly reduced. There was no significant difference in the mean changes of AST (p = 0.197), ALT (p = 0.086), ALB (p = 0.560), CRP (p = 0.197), ESR (p = 0.298), hemoglobin (Hb) (p = 0.372), white blood cells (WBC) (p = 0.995), neutrophils (p = 0.264), and lymphocyte (p = 0.418) between two groups.

Conclusion: According to the research results, it seems that adding NC supplementation to the treatment plan for COVID‐19 patients who are hospitalized and have mild to moderate illness severity might possibly reduce inflammation.

Trial Registration: ClinicalTrials.gov identifier: IRCT20211126053183N1.
Causes, Complications and Short‐Term Outcome of Acute Kidney Injury in a Resource‐Limited Setting
Authors: Herath Nalaka , De Silva Shamila , Liyanage Prasitha , Kumara Sameera , Devi Suganthika , Abeysekara Vajira , Mallawarachi Ruvini , Perera Suharshi , Karunathilaka Iresha , Samarasinghe Sameera , Weerakoon Kosala
Published: December 2024

Aims: The outcome of acute kidney injury (AKI) depends on causes, patient factors and care received. We studied the causes, complications and 90‐day outcomes of patients with AKI at a tertiary referral centre in Sri Lanka.

Methods: Patients aged 18 years or older with AKI referred to nephrology services were analysed retrospectively. AKI severity was assessed using the KDIGO classification. Information was gathered from hospital and clinic records.

Results: Of the 464 patients studied, 262 (56.5%) were males. The mean age of the study sample was 57.04 (SD 16.85) years. The majority (212–45.69%) were discharged with normal renal functions, 173 (37.28%) were discharged with impaired functions, and 79 (17.03%) died during hospital stay. There were 377 patients at 3 months follow‐up; 331 (87.8%) had normalised renal function, 40 (10.6%) had not recovered fully and 6 (1.6%) had succumbed. Progression of AKI to chronic kidney disease or death was significantly high in patients aged > 60 years (p = 0.017). More severe AKI was associated with type 2 diabetes (p = 0.0042), hypertension (p < 0.0001) and multiple comorbidities (p = 0.0014). Persons with no comorbidities had less severe AKI (p = 0.0004). Even in the early stages of AKI, there was significantly high mortality (11% in AKI stages 1 and 2) which doubled in stage 3 (22%). Mortality was low in patients with prerenal causes of AKI (OR: 0.59, 95% CI: 0.35–0.99 and p = 0.047).

Conclusions: AKI in elderly and comorbid patients has high morbidity and mortality. Identification of individuals who are at high risk of developing AKI is important for its prevention, early diagnosis and proper treatment. Limitations in infrastructure, manpower, local research, reporting and recording of AKI are key challenges in providing optimal care for AKI in Sri Lanka.
A Review on Reinforcement Learning for Motion Planning of Robotic Manipulators
Authors: Elguea-Aguinaco Íñigo , Inziarte-Hidalgo Ibai , Bøgh Simon , Arana-Arexolaleiba Nestor
Published: December 2024

Effective motion planning is an indispensable prerequisite for the optimal performance of robotic manipulators in any task. In this regard, the research and application of reinforcement learning in robotic manipulators for motion planning have gained great relevance in recent years. The ability of reinforcement learning agents to adapt to variable environments, especially those featuring dynamic obstacles, has propelled their increasing application in this domain. Notwithstanding, a clear need remains for a resource that critically examines the progress, challenges, and future directions of this machine learning control technique in motion planning. This article undertakes a comprehensive review of the landscape of reinforcement learning, offering a retrospective analysis of its application in motion planning from 2018 to the present. The exploration extends to the trends associated with reinforcement learning in the context of serial manipulators and motion planning, as well as the various technological challenges currently presented by this machine learning control technique. The overarching objective of this review is to serve as a valuable resource for the robotics community, facilitating the ongoing development of systems controlled by reinforcement learning. By delving into the primary challenges intrinsic to this technology, the review seeks to enhance the understanding of reinforcement learning’s role in motion planning and provides insights that may suggest future research directions in this domain.
Ursolic Acid as a Protective Agent against UVB-Induced Metabolic and Epigenetic Alterations in Human Skin Keratinocytes: An Omics-Based Study
Authors: Li Shanyi , Li Zixin , Kuo Hsiao-Chen Dina , Kong Ah-Ng
Published: December 2024

This study aimed to assess how ursolic acid (UA) can protect human skin keratinocytes from damage caused by UVB radiation. Utilizing an omics-based approach, we characterized the features of photodamage and investigated the potential of UA to reverse HaCaT cell subpopulation injury caused by UVB radiation. The most significant changes in metabolite levels after UA treatment were in pathways associated with phosphatidylcholine biosynthesis and arginine and proline metabolism. Treatment with UA can reverse the levels of certain metabolites, including creatinine, creatine phosphate, and succinic acid. Pathways activated by UA treatment in UVB-irradiated HaCaT cells were associated with several biological processes, including the positive regulation of protein modification process, cell division, and enzyme-linked receptor protein signaling pathway. Treatment with UA demonstrates the capability to mitigate the effects of UVB radiation on specific genes, including S100 calcium-binding protein A9 and IL6 receptor. DNA/CpG methylation indicates that UA can partially reverse some of the alterations in the UVB-induced CpG methylome. Utilizing integrated RNA sequencing and methylation sequencing data, starburst plots illustrate the correlation between mRNA expression and CpG methylation status. UA potentially influences the metabolic pathway of glycerophospholipid metabolism by modulating the expression of several key enzymes, including phospholipase A2 group IIA and lipin 2. Altogether, these results indicate that UVB radiation induces metabolic reprogramming, epigenetic changes, and transcriptomic shifts. Meanwhile, UA demonstrates the capacity to inhibit or reduce the severity of these alterations, which may underlie its potential protective role against skin damage caused by UVB exposure.

Prevention Relevance: Our research indicates that UA has the potential to mitigate or lessen the impact of UVB radiation, which is known to cause metabolic reprogramming, epigenetic alterations, and transcriptomic changes. These effects could be responsible for UA’s possible protective function against skin damage induced by UVB exposure.
Retinal Optical Coherence Tomography in Bipolar Disorder – A Scoping Review
Authors: Schönthaler Elena MD. , Aminfar Haleh , Dalkner Nina , Fellendorf Frederike T. , Georgi Johanna , Lenger Melanie , Wedrich Andreas , Reininghaus Eva Z.
Published: December 2024

Background: Bipolar disorder (BD) is a psychiatric condition with significant health implications due to its comorbidities, premature mortality, and functional impairments. Despite extensive research on treatment and rehabilitation, gaps remain in diagnosis and monitoring. Therefore, there is a need for biomarkers to identify individuals at risk for disease progression or excacerbation. Developmentally part of the central nervous system, the retina represents a possible marker for observing BD-related structural and functional alterations in the brain.
Summary: The retina's structure can be assessed through optical coherence tomography (OCT), a non-invasive and cost-effective method. Retinal alterations, particularly in the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL), have been associated with neurodegenerative and psychiatric disorders in cross-sectional OCT studies. This scoping review discusses findings on retinal changes in BD as well as their association with disease characteristics like symptom severity and illness duration, and highlights OCT as a potential diagnostic tool in BD treatment.
Key Findings: The majority of studies indicate RNFL and GCL thinning in BD patients, which was found to correlate with clinical characteristics in some studies. Although the data is currently limited, there is a possibility that retinal biomarkers could facilitate monitoring of BD, but more research needs to be conducted to observe the relationship between these parameters and BD. Moreover, other factors (e.g., treatment, metabolic and inflammatory conditions) may impact retinal changes, which highlights the need for longitudinal studies to clarify these relationships. Further research should focus on replicating current findings, understanding the role of inflammation, and differentiating between retinal regions affected by BD.
Enacting and Experiencing Martyrdom in 4 Maccabees
Authors: Castelli Silvia
Published: December 2024

Building on second-generation cognitive criticism, notably enactivism, on studies of phonetic iconicity, especially on the use of prosodic and phonological effects to convey meaning, as well as on ancient reflections on enargeia, this article investigates the narrative and linguistic strategies used by 4 Maccabees to create enargeia/immersion in the scene of Eleazar’s martyrdom—one of 4 Maccabees’ most immersive scenes and one of the peaks of the story. Through a close reading focused on verbal forms (tenses and voices), prefixes, adverbial expressions, space markers, bodily movements, phonetic mimesis, prose rhythm, and metaphoric language, it argues that in this scene enargeia is achieved by a narrative carefully constructed through enactive style and linguistic strategies close to the audience’s non-mediated way of perception, highly effective in engaging the audience into an embodied experience of martyrdom.
Does the Burnt Offering Atone?
Authors: Zuckier Shlomo
Published: December 2024

The wholly burnt offering, or olah, and its relation to expiation/atonement, poses a vexing question. Across biblical, Second Temple, and rabbinic sources, there is conflicting evidence as to whether olah atones. Among the rabbinic materials this question is especially complicated, with multiple texts stating that olah does atone (‮כ.פ.ר‬‎), and others implying or stating outright that it does not. This study analyzes these varied materials, considering rabbinic texts against parallel biblical and Second Temple materials. This question is important both for understanding this offering and for how that impacts upon understandings of sacrifice and atonement in ancient Judaism. The flexibility of the olah offering renders it a site for negotiation between differing conceptions of these categories for ancient Jews.
Social Progress and Environmental Performance as Boosters for Innovation in LAC: an Econometric Analysis
Authors: Pinto Karen E. F. , Falcini Gabriel , Juk Yohanna , Avanci Vanessa de Lima
Published: December 2024

Numerous studies have explored the role of technological innovation in the development of nations. However, these studies often focus predominantly on countries in the Global North, overlooking the interplay between government, industry and university – the Triple Helix helices, and socioenvironmental factors. Even scarcer are studies that examine specifically Latin American and Caribbean countries (LAC). In this quantitative study, we apply linear discriminant analysis and panel data analysis to the scores of the GII, EPI, and SPI indices for 127 countries since 2012. Focusing on the results for LAC, our findings highlight the cohesion in innovation among the countries in the region and indicate a positive relationship between innovation and environmental performance. However, conversely, an increase in innovation scores tends to correlate with a reduction in social progress scores. This study contributes to providing a basis for political decisions that consider the Triple Helix thinking, incorporating academia, companies, and the government to better allocate resources towards designing policies to alleviate social and environmental challenges.
Science of Learning: Journeys of Hope, Challenges and Resilience in Realizing Academic Ambitions
Authors: Muthanna Abdulghani
Published: December 2024

This self-reflective article highlights the educational journeys of the author with the purpose of inspiring undergraduate and graduate students along with postgraduate scholars toward continuing their efforts to realizing their academic ambitions. By sharing a variety of challenges related to unfair employment measures, financial constraints, and unethical research reviews and decisions, the article underscores how resilience coupled with patience and perseverance helps achieve one’s academic ambitions. While the article inspires students and scholars to face academic injustice, it also invites decision makers to reflect ethics in their words and deeds.
Two new species of the Mallomonas mangofera species complex (Synurales, Chrysophyceae) from the tropics based on morphological and molecular studies
Authors: GUSEV EVGENIY , MARTYNENKO NIKITA , TRAN HOAN , PODUNAY YULIA
Published: December 2024

This research is devoted to the study of the Mallomonas mangofera species complex in a tropical region using electron microscopy and molecular methods. Based on a study of nine algal cultures belonging to the Mallomonas mangofera morphotype, two new clades were identified based on the SSU rDNA + rbcL cpDNA and ITS1-5.8S-ITS2 rDNA datasets. Two new species, Mallomonas hippocrepica and M. kornevae, were described from Vietnam based on molecular characteristics and morphological analysis of the scale and bristle ultrastructure. The distribution of these taxa was analysed using the information of strains origin and a metabarcoding approach. Mallomonas hippocrepica was found in 2 localities in 2 provinces, and M. kornevae was found in 12 localities in 7 provinces in Vietnam.
Ranunculus magniflorus sp. nov. and R. irregularifrons sp. nov., (Ranunculaceae), two new species of the R. auricomus complex in Romania
Authors: DUNKEL FRANZ G.
Published: December 2024

Two new species of the Ranunculus auricomus complex of Romania with undivided basal leaves are described and depicted: according to flow cytometry measurements, Ranunculus magniflorus Dunkel is a diploid species with large flowers and petals up to 20 mm, the lowermost cauline leaf segments are undivided (var. magniflorus) or have 2–8 short or long and patent teeth (var. dentatus). The taxon occurs at the Banat Mountains, at southern border of the Southern Carpathians and in adjacent Serbia. R. irregularifrons is a tetraploid species characterised by an irregularly und acutely serrated leaf edge of the final leaves. To present knowledge, it is restricted to the Banat Mountains.
A natural hybrid of Anoectochilus (Orchidaceae) from Xizang, China
Authors: LI CHEN XING , LIU YUE , SHI BEI BO , SUN MEI , HUANG JING , LIU ZHEN , TIAN HUAI ZHEN
Published: December 2024

Anoectochilus × buqunhuensis, a natural hybrid new to science is described from Xizang Autonomous Region, China. A detailed morphological description with dissection photographs, line drawings and molecular data of plastid DNA (matK, rbcL, trnL-F) and nuclear DNA (ITS) are provided to identify the hybrid and the parental species (A. griffithii and A. medogensis).
Henckelia arunachalensis (Gesneriaceae), a new species from Patkai Hills of Arunachal Pradesh, India
Authors: SAHANI VINAY KUMAR , PERTIN MINOM , VARIYA MAYUR H , TARAM MOMANG , MAITY ROHAN , BORAH DIPANKAR
Published: December 2024

Repeated expeditions conducted since 2018 in Arunachal Pradesh led to the collection of several taxa of Gesneriaceae, many of which are newly described. Among these, a peculiar species from the Patkai Hills of Arunachal Pradesh is described here as Henckelia arunachalensis, a species new to science. This new species is allied to Henckelia dibangensis but differs in its elliptic to obovate leaves with 9–13 pairs of lateral veins (vs ovate to ovate-elliptic with 5–8 pairs of lateral veins), erect to perpendicular cymes with 1–5 flowers (vs pendulous cymes with 1–2 flowers), broadly ovate to ovate lanceolate bracts (vs linear bracts), a leathery calyx, pale green and puberulous outside, glabrous inside (vs light green, glabrous calyx), and a purplish white corolla with white flaps (vs a pale pink corolla with no flaps). An extended taxonomic description, accompanied by photographs and ecological information, is provided.
Peliosanthes planicoronata (Asparagaceae), a new species from Southeastern Yunnan, China
Authors: WANG LI HONG , BI MING HUI , CHU HONG BO , FENG HUI ZHE
Published: December 2024

Peliosanthes planicoronata is described and illustrated as a new species from southern China. The new species is morphologically closest to P. khasiana N.Tanaka, differing in its triangular segments, smaller orifice of the corona, connate filaments and style which densely marked with purple spots and verrucose protrusions. Comparisons with other closely related species are also provided.
Forced Migration and Family Language Policy: The Ukrainian Experience of Language
Authors: Shevchuk-Kliuzheva Olha
Published: December 2024

This study investigates the impact of forced migration on family language policy among Ukrainian families, with a particular focus on women who have relocated to Poland with their children due to the war in Ukraine. Utilizing data from in-depth interviews, it explores the language situation in refugee families. The analysis concentrates on changes in language behaviour caused by shifts in emotional attitudes towards their language repertoire, due to the traumatic experience of war. It is noteworthy that there has been an increase in the use of the Ukrainian language in family communication, an intentional familiarization of children with the linguistic situation in Ukraine, and a conscious avoidance of the Russian language in public places abroad. Despite these trends, some families continue to predominantly use Russian at home as the primary language for family communication, or they frequently engage in language code-switching. The study examines patterns of changes in language behaviour resulting from the rejection of the Russian language in daily communication, highlighting politically motivated decisions to alter language use and the corresponding strategies of language behaviour. These changes in adults' speech behaviour significantly affect the speech practices of children, one manifestation of which is language attrition. Special attention is given to the phenomenon of language shame and self-shame associated with the use or non-use of the Russian language, the evolution of language attitudes, and their influence on language choice in family language practices.