bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between low-density lipoprotein cholesterol to high- density lipoprotein cholesterol ratio and atrial fibrillation in adults with chronic kidney disease
Authors: Guan Mijie , Hu Haofei , Qi Dongli , Qin Xun , Wan Qijun
Published: January 2024

Background: Atrial fibrillation (AF) is more common in patients with chronic kidney disease (CKD). Although a reverse relationship between lipid levels and AF has been suggested, it is uncertain if this link is relevant to CKD patients. This research investigated the association between the low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and the risk of AF in individuals with CKD.
Methods: Data was collected from 21,091 non-selective, consecutive CKD patients from 2006 to December 31, 2015. We assessed the association between the LDL-C/HDL-C ratio and AF in CKD patients using binary logistic regression, along with a series of sensitivity and subgroup analyses. The dataset supporting these analyses can be accessed at:https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230189.
Results: Of the 21,091 CKD patients, 211 (1.00%) were diagnosed with AF. The cohort, predominantly male (79.93%), had a mean age of 60.89 ±10.05 years. The mean LDL-C/HDL-C ratio was 1.39±0.35. After adjusting for covariates, a significant inverse association was observed between the LDL-C/HDL-C ratio and the incidence of AF in CKD patients (OR = 0.422, 95% CI: 0.273-0.652, P = 0.00010). The robustness of these findings was confirmed through sensitivity analysis and subgroup analysis consistently showed a link between the LDL-C/HDL-C ratio and AF, suggesting that confounding factors had little effect on the LDL-C/HDL-C ratio's relationship with AF.
Conclusion: Our research demonstrates an independent inverse relationship between the LDL-C/HDL-C ratio and the risk of AF in CKD patients. It is recommended to avoid overly aggressive lowering of LDL levels in CKD patients, as this may increase the risk of developing AF.
Exploring the relationship between Clinical Supervision and Well-being in Otolaryngology Residency Board, KSA
Authors: Alessa Mohammad Ali , Eltouny Sarah , Abed Rabab
Published: January 2024

Introduction:
Surgical residency has been recognized as stressful because of the long working hours and challenging cases. In addition, family care or being a spouse or parent may be associated with a positive or negative impact on well-being. Therefore, well-being care is important for managing burnout in residents. The concept of psychological well-being refers to optimal psychological functioning and experience, while burnout is a syndrome of emotional exhaustion, feelings of depersonalization, and lack of personal accomplishment. Sideways training has recently drawn increased amounts of attention in residency training, and residents claim to have a great impact on the clinical learning environment. Clinical supervision is an important component of the clinical environment that facilitates the safe development of clinical skills and the knowledge of trainees to prepare them for independent practice. Residents during rotation are exposed to different types of supervision with different experiences and backgrounds, which influences their learning. We would like to investigate this impact in depth to determine whether there is a difference in otolaryngology residents’ well-being under different supervision conditions and to measure the degree of wellbeing from one level to another during training.
Subjects and Method:
This was a descriptive cross-sectional correlational study in which an online survey was conducted to determine the relationship between resident wellbeing and clinical supervision among Saudi otolaryngology head and neck surgery residents.
The data collection instruments used included the D-RECT (Dutch Residents Educational Climate Test) for measuring clinical supervision and the Warwick-Edinburgh Mental Well-being Scale questionnaire for measuring wellbeing.The mean and standard deviation were calculated for each item using SPSS 21.0.
Results:
The majority of residents reported higher mean (SD) scores for the following items: “I’ve been feeling useful” (3.53 [1.23]); “I’ve been feeling interested in new things” (3.28 [1.13]); and “I’ve been dealing with problems well” (3.27 [1.10]). The mean (SD) WEMWBS item scores showed no statistically significant difference between junior and senior residents; however, mental wellbeing was significantly associated with all four D-RECT score levels.
Conclusion:
Clinical supervision and mentorship have a strong impact on physicians’ mental well-being, specifically by promoting self-esteem and a sense of utility at work in the context of medical training.
Allergy and autoinflammation drive persistent systemic inflammatory response in Meniere Disease
Authors: Frejo Lidia , Cara Francisca , Flook Marisa , Robles-Bolivar Paula , Escalera-Balsera Alba , Montilla-Ibañez Maria Alharilla , Dominguez-Duran Emilio , Martinez-Martinez Marta , Perez-Carpena Patricia , Lopez-Escamez Jose Antonio
Published: January 2024

Meniere disease (MD) is an inner ear disorder associated with genetic and environmental factors. Several triggers may induce an inflammatory response that may persist over time, leading to a chronic inflammatory process. This study aims to determine if the inflammatory state observed in some MD patients is mediated by allergy or autoinflammation. A 2-year longitudinal study including 72 patients was designed to track levels of cytokines and chemokines in plasma samples. We used discriminant and trajectory analyses to define functional clusters. Furthermore, THP-1 cells were treated with MD patients’ plasma and NaCl to study their capacity to polarize to M1 or M2 macrophages, and qPCR was used to study the upstream events leading to cytokine release. We identified 4 groups of patients according to their cytokine levels. First, an autoimmune group with high TNF-α levels (19%). An allergic phenotype (24%) with elevated IgE and the capacity to polarize macrophages into M2. The third with an autoinflammatory phenotype had increased IL-1β (14%) activated through CASP1 and NLRP3. The last group had low levels of cytokines (42%). Most individuals remained in the same group according to their cytokine levels over time; interestingly, 36% of patients with an allergic profile also showed high levels of IL-1β. We characterized 2 immunophenotypes according to cytokines and IgE levels. The first may drive an allergic reaction led by IgE and classical allergy-related cytokines. A second group of patients seems to be mediated by the production of IL-1β and the inflammasome pathway.
Wheezing Episodes in Children Before and After the Onset of the COVID-19 Pandemic in Brussels
Authors: Delporte Clémentine , Bruwaene Lore Van , Bruffaerts Nicolas , Rebuffat Elisabeth , Goetghebuer Tessa
Published: January 2024

Purpose: Studies have demonstrated important changes in the seasonality of pediatric respiratory illnesses since the onset of the COVID-19 pandemic. The aim of this study was to describe the epidemiology of childhood wheezing episodes before and after the start of the COVID-19 pandemic in relation to their potentially associated environmental triggers.
Methods: Files of all children treated with salbutamol for a wheezing episode in September and October 2019, 2020 and 2021 were retrospectively reviewed. Infection epidemiology, daily concentrations of air pollutants (NO2, O3, PM10 and PM2.5) and fungal spores were collected over the same time period.
Results: In 2021, 298 episodes of wheezing were observed compared to 111 in 2020 and 86 in 2019 (p<0.001). Compared to 2019, children with wheezing in 2021 were significantly older (p<0.001), less likely to have a history of recurrent wheezing (p<0.001) and required less hospitalization (p=0.034). Adenovirus and SARS-CoV-2 were more prevalent in 2021 as compared to 2019 (p<0.001). The concentration of PM10, PM2.5 and O3 was higher in 2021, as compared to both 2019 and 2020 (p<0.001) while the concentration of NO2 and airborne spores was lower in 2021 compared to 2019 (p<0.0001).
Conclusion: A threefold increase in wheezing episodes was observed in the autumn post-COVID (2021) compared to pre-COVID (2019) together with a significant increase in some viruses and most air pollutants. We hypothesize that this abnormal surge may be related to the release of restrictions with rapid spread of viruses in children who were exposed to high levels of air pollution.
Bias-stress-stable Sub-1.5 V Oxide Thin-film Transistors via Synergistic Composition of Sol-gel Quaternary High-k Oxide Dielectrics
Authors: Baek Seokhyeon , Choi Jun-Gyu , Lee Won-June , Kwak Taehyun , Jo Yong-Ryun , Park Sungjun
Published: January 2024

A rising demand in reliable, energy-efficient, and large-area electronics, particularly in the realm of sol-gel oxide thin-film transistors (TFTs), has steered research focus away from semiconductor towards dielectrics. However, achieving both bias stability and low-voltage operation remains a significant hurdle. While typical oxide TFTs employ high-dielectric-constant (high-k) dielectrics with lowered film thickness to acquire low-voltage operation, they inevitably suffer from undesired defects at both bulk and interfacial trap sites in dielectric layer. In this study, bias-stress-stable all solution-processed oxide TFTs were demonstrated with operation voltage under 1.5 V via sol-gel quaternary high-k oxide dielectric (Al-Hf-Zr-O, AHZO). In-depth understanding of their individual contributions to dielectric performance leads to the acquisition of optimized composition ratios of AHZO with amorphous feature and outstanding dielectric performance, marked by dielectric constant (k) over 11, leakage current density (Jleak) below 10− 5.5 A cm-2, and sturdy breakdown strength (EB) exceeding 5 MV cm-1. By integrating the AHZO with In-Ga-Zn-O (IGZO) layer, we achieved sub 1.5 V TFTs while maintaining excellent bias stability with threshold voltage (VTH) shift lower than 0.20 V for 3600 s. Our findings offer a detailed insight into the realm of multi-component oxide dielectrics, paving the way for miniaturization and reliability in functional devices and sensors.
Risk factors of severe acute malnutrition in children aged 12 to 23 months. A case-control study in the Kabinda Health Zone, Lomami Province, Democratic Republic of Congo (DRC)
Authors: KALALA Christian MBAMBU , Luzingu Joy Kinko , Kyloka Jean Nyandwe
Published: January 2024

Objective:
To identify the risk factors of severe acute malnutrition (SAM) in children aged 12 to 23 months in the Kabinda health zone, Democratic Republic of Congo.
Methods:
We conducted an unmatched case-control study in a hospital setting. We enrolled 180 children (60 cases and 120 controls) aged 12 to 23 months admitted to the Kabinda general referral hospital in the Kabinda health zone between May and August 2023. Data were collected by interview of mothers/caregivers using an electronic questionnaire and by measuring the children's anthropometric parameters. The nutritional status of cases and controls was determined according to the 2006 WHO growth standards.
Risk factors of severe acute malnutrition were identified using logistic regression by reporting the odds ratios and confidence intervals at the 95% threshold. A p-value < 0.05 was considered as the threshold for statistical significance. All analyzes were carried out using STATA 17 software.
Results:
In this study, the risk factors of SAM among 12 to 23 months olds were the initiation of complementary feeding before the age of 6 months (aOR = 2.93; 95% CI: [1.26 - 6.80] ; p = 0.012), household size greater than 5 members (aOR = 3.66; 95% CI: [1.61 - 8.28]; p = 0.002) and the household wealth index: very poor (aOR = 16.39; 95% CI: [3.19; 84.20]; p = 0.001), poor (aOR = 5.64; 95% CI: [1.07 - 29.56]; p = 0.041) and average households (aOR = 5.75; 95% CI: [1.09 - 30.31]; p = 0.039).
Conclusion:
The study identified household size, household wealth index and initiation of complementary feeding before 6 months of age as risk factors of SAM among children aged 12 to 23 months. A multisectoral approach is necessary for the implementation of intervention strategies aimed at improving the socioeconomic level of households, family planning and the promotion among mothers of good infant and young child feeding practices in order to have an impact more important on the SAM situation.
Amino acid-modified porous carbon foams derived from wheat powder with enhanced adsorption performance for VOCs
Authors: Huang Weiqiu , Chai Xinhan , Li Xufei , Wang Xinya , Zhou Yankang , Zhu Bing , Li Yuning , Tian Xinchen
Published: January 2024

Porous Carbon Foam (PCF), known for its high surface area and abundant functional groups, is considered to exhibit superior adsorption capacity and wide applicability for gases. Wheat, being a widely cultivated and easily accessible crop globally, contains abundant carbon elements. In this study, wheat powder served as the carbon precursor, and β-alanine, rich in amino and carboxyl groups, was introduced into the hierarchical pore structure of wheat powder. Subsequently, the material underwent secondary hydrothermal treatment with the activation agent potassium hydroxide (KOH), resulting in Hydrothermal Wheat Powder PCF (HWPCF) rich in a three-dimensional interconnected structure with layered pores as the representative feature. This structural treatment increased the specific surface area (2278 m2·g− 1) and total pore volume (1.17 cm3·g− 1) of PCF, accelerating the rapid mass transfer of gas molecules and significantly enhancing the utilization of adsorption sites in the modified PCF. HWPCF exhibited outstanding adsorption performance for acetone (608.7 mg/g) and n-hexane (517.6 mg/g). Additionally, the modified PCF showed good adsorption capacity for CO2 (4.99 mmol·g− 1). This study highlights the effective modification of expired wheat powder with β-alanine, reducing the overall carbon footprint of the production process and achieving the reuse of waste in an environmentally friendly manner.
Prescribing Patterns of SGLT2 inhibitors and GLP-1 receptor agonists in Patients with T2DM and ASCVD in South Korea
Authors: Eom Yeong Rok , Joo Hajung , Chae Seung Eun , Je Nam Kyung
Published: January 2024

Background:
Despite cardiovascular benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1RA) in patients with type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD), their utilization remains low globally. This study aimed to evaluate the utilization of SGLT2i and GLP1RA in patients with T2DM and ASCVD, as well as the factors associated with medications in South Korea.
Methods:
This retrospective study was conducted from 2015 to 2020, using National Patient Sample claims data. The study population included adult patients with confirmed T2DM and ASCVD diagnosed between March 1 and October 31 each year. Demographic and clinical characteristics, and influencing factors were investigated.
Results:
Among 57,576 study participants, SGLT2i use increased from 1.2–10.51% during the study period, whereas GLP1RA use increased slightly from 0–1.17%. Older age, comorbid chronic kidney disease, concurrent use of dipeptidyl peptidase 4 inhibitors (DPP4i), and prescriptions from specific physician specialties negatively influenced SGLT2i use. Conversely, comorbid dyslipidemia, heart failure, concurrent use of sulfonylurea (SU), and prescriptions from cardiologists positively influenced SGLT2i use. For GLP1RA, older age, concurrent DPP4i use, and specific physician specialty were negative factors, whereas female sex, dyslipidemia, insulin, and SU use were positive factors.
Conclusions:
Despite increasing utilization, 88.35% of eligible patients remained untreated with SGLT2i and GLP1RA as of 2020. This study highlights the disparities in utilization based on patient characteristics and physician specialties, emphasizing the need to remove barriers and enhance clinical benefits for high-risk patients.
A secure multi-party hybrid encryption sharing scheme with a new 2D sine-cosine chaotic system and compressed sensing
Authors: Ma Fengying , Wu Liming , Ye Yunxiao , Zhang Fangfang
Published: January 2024

To address the security and fraud issues associated with transmitting sensitive plaintext image data over public channels, a secure multi-party hybrid encryption-sharing scheme, which integrates the 2D sine-cosine (2D-SC) chaotic system and P-tensor product compressed sensing (PTP-CS), is proposed. Firstly, the 2D-SC chaotic system is presented, and its state variables and performance are thoroughly analyzed. Secondly, by combining the 2D-SC chaotic system with the Logistic chaotic system, a sensing matrix and keystream are constructed. Under the control of the keystream, sparse processing, position permutation, compressed sensing, and bidirectional diffusion are applied to the plaintext image, generating a secret image and effectively reducing the correlation between pixels. Subsequently, the secret image is embedded into a non-sensitive carrier image using image steganography, creating a cipher image that provides dual protection for both the content and visual aspects of sensitive plaintext data. Finally, the cipher image is segmented into N shadow images and transmitted to N recipients through a public channel. Only when at least r recipients (r represents the minimum number of shares required for the reconstruction of the image, r < N) decide to initiate the image recovery process, the image can be successfully restored. The experimental findings validate that the proposed encryption scheme guarantees the secure recovery of sensitive data while resisting various common attacks, and exhibits strong visual security and compression performance.
Can Chat-GPT read and understand guidelines? - An example using the S2k guideline Intrauterine Growth Restriction of the German Society for Gynecology and Obstetrics
Authors: Psilopatis Iason , Bader Simon , Krueckel Annika , Kehl Sven , Beckmann Matthias Wilhelm , Emons Julius
Published: January 2024

Purpose
To investigate the capacity of Chat-Generative Pre-Trained Transformer (Chat-GPT) to understand the S2k guideline of the German Society for Gynecology and Obstetrics on intrauterine growth restriction.
Methods
The German-language free Chat-GPT version was used to test the ability of Chat-GPT to understand the definition of small for gestational age and intrauterine growth restriction, to indicate the correct time and place of delivery and to evaluate ist ability to recommend a spontaneous delivery versus a primary caesarean section in accordance with the guideline recommendations. In order to objectively evaluate the suggestions a simple three-color ´traffic light´ evaluation system was employed.
Results
Almost all Chat-GPT´s suggestions in the context of definition of small for gestational age/intrauterine growth restriction as well as correct time of delivery were adequate, whereas more than half of the suggestions made in terms of correct delivery mode needed reformulation or even correction.
Conclusion
Chat-GPT appears to be a valuable form of artificial intelligence that could be integrated into everyday clinical practice.
A rare pediatric patient of anti-IgLON5 encephalitis with epileptic seizures as the first symptom
Authors: Xue Jiao , Song Zhenfeng , Zhao Hongshan , Yi Zhi , Li Fei , Yang Chengqing , Liu Kaixuan , Zhang Ying
Published: January 2024

Background: Anti-IgLON5 encephalitis was a rare neurological and heterogeneous disorder, which was mainly found in adults. Epileptic seizures related to anti-IgLON5 disease were rarely reported.
Methods: The autoimmune encephalitis-related antibodies in serum and cerebrospinal fluid (CSF) were tested using Cell-Based Assays (CBA) with immunofluorescence double staining. The antibodies in serum were further confirmed by Tissue-Based Assay (TBA) with rat brain and kidney tissue (1:100).
Results: We reported a pediatric case presented with epileptic seizures, cognitive impairments, and sleep disorders. The presence of anti-IgLON5 antibodies (1:100+) in the serum leaded to a confirmed diagnosis of anti-IgLON5 encephalitis. While the low titer of anti-NMDAR antibody IgG (1:10+) in serum and negative in CSF prevented it as the primaryresponsible antibody.
Conclusion: We described the second pediatric case with anti-IgLON5 encephalitis, who was also the first presented with epileptic seizures as the initial presentation, with coexisting anti-IgLON5 as well as anti-NMDAR antibodies.
Maturity Onset Diabetes of the Young of eleven Chinese Children
Authors: Ma Shifeng , Li Rui , Liu Xiaoxiao , Han Xinyi , Sheng Sihan , Li Yilin , Zheng Rongxiu
Published: January 2024

Objective
To identify characteristics of eleven children with Maturity Onset Diabetes of the Young (MODY) and reveal the correlation between phenotypes and genotypes for these patients.
Methods
We collected clinical characteristics including age at diagnosis, gender, clinical symptoms, physical examinations, development histories, laboratory data, and family histories, etc. Next-generation sequencing (NGS) panels were used to reveal the genetic variants for these patients.
Results
There were 6 male and 5 female patients in this study, age at diagnosis ranged from 5.1 to 14.5 years old, and body mass index (BMI) ranged from 18.1 kg/m2 to 31.6 kg/m2, 6 of them were overweight or obese. 13 mutations were identified from 11 patients in 8 genes: HNF4A and INSR (n = 1), GCK (n = 3), HNF1A (n = 2), PAX4 (n = 1), HNF1B (n = 2), BLK and ABCC8 (n = 1), and ABCC8 (n = 1). 2 patients obtained two mutations those could cause diabetes. Glutamate decarboxylase antibody (GADA) and islet associated antibody (IAA) were positive in the patient with PAX4-MODY. And clinical features of patients with the same MODY type were still different from each other. Insulin was used for patients with MODY 3, MODY 5, MODY 9, and 3 MODY 12 patients in this study.
Conclusion
Family history of hyperglycemia is not an exact clinical feature of every MODY, genetic sequencing should be applied for more patients with diabetes. The proportions of GCK-MODY were greater than others, and treatment for children with MODY is still challenging.
Vertical margin distance in T1 colorectal carcinoma resected by endoscopic submucosal dissection affects prognosis after additional surgery
Authors: Tanino Fumiaki , Yamashita Ken , Nagata Shinji , Kuwai Toshio , Kamigaichi Yuki , Tanaka Hidenori , Tamaru Yuzuru , Takigawa Hidehiko , Asayama Naoki , Urabe Yuji , Shimamoto Fumio , Oka Shiro
Published: January 2024

Purpose
A vertical margin (VM) distance of < 500 µm is a risk factor for recurrence in patients with T1 colorectal carcinoma (CRC) resected by endoscopy. We aimed to determine the effects of the VM distance on the recurrence and prognosis of T1 CRC
Methods
We enrolled 154 patients with T1 CRC who underwent additional surgery after endoscopic submucosal dissection (ESD) at multiple centers between 2008 and 2016. None of the patients had lymph node metastasis (pStage I) and were followed up for > 5 years. A total of 154 patients were classified into patients with VM distance of < 500 µm including positive VM (n = 62, VM distance < 500 µm group) and patients with VM distance of ≥ 500 µm (n = 92, VM distance ≥ 500 µm group). The clinicopathological features, recurrence rates, and prognoses were compared between the groups using propensity-score matching (PSM).
Results
Tumor size and the rate of budding grade 2/3 in the VM distance < 500 µm group was significantly smaller and higher, respectively, than those in the VM distance ≥ 500 µm group. Tumors recurred in six of the 154 patients with VM distance < 500 µm. The 5-year recurrence-free survival rate was significantly higher in the VM distance ≥ 500 µm group than that in VM distance < 500 µm group after PSM (100% vs. 90%, p < 0.012).
Conclusions
Complete en bloc resection of T1 CRC via ESD must include a sufficient amount of submucosa to reduce the risk of metastasis and recurrence after additional surgery.
Two-stage hybrid surgical repair for aortic arch pathology with a shaggy aorta: A case report
Authors: Morishita Atsushi , Katahira Seiichiro , Hoshino Takeshi , Hanzawa Kazuhiko , Tomioka Hideyuki
Published: January 2024

Background: The surgical treatment strategy for aortic arch pathology with a shaggy aorta must be determined on a case-by-case basis because of the risk of catastrophic complications, such as brain infarction and spinal cord injury.
Case presentation: This report describes the surgical case of two saccular aneurysms of the arch and abdominal aorta associated with a shaggy aorta in a 63-year-old man who underwent total arch replacement and secondary thoracic endovascular aortic repair. Considering the risk of embolization during endovascular therapy, graft replacement for the abdominal aortic aneurysm was initially performed. On postoperative day 28, total arch replacement with the conventional elephant trunk was performed using the functional brain isolation technique, which invloves manipulating places far from the atherosclerotic burden, such as arterial inflow for cardiopulmonary bypass and unclamping of neck vessels. On postoperative day 7 after total arch replacement, thoracic endovascular aortic repair was performed across the conventional elephant trunk in the nondiseased descending aorta. No postoperative complications, such as cerebrovascular failure, paraplegia, or embolization to abdominal viscera or lower extremities, occurred. The patient remained asymptomatic.
Conclusions: The present case suggests that total arch replacement with the conventional elephant trunk and secondary thoracic endovascular aortic repair may be an effective alternative for aortic arch pathology with a shaggy aorta. The strategy for surgical treatment in patients with aortic arch pathologies with a shaggy aorta must be judged on a case-by-case basis, considering patient characteristics, comorbidities, and preoperative evaluation using transesophageal echocardiography and computed tomography angiography, to eliminate potential determinants of intraoperative stroke.
Video tracking-based Mandibular Movement Kinematic Analysis in patients with nasopharyngeal carcinoma
Authors: Yang Chen , Wei Zhenhai , Zhao Fei , Zhou Yangshiyu , Wu Linfei , Wei Xiaomei , Xie Chunqing
Published: January 2024

Objective
Patients with dysphagia due to nasopharyngeal carcinoma (NPC) after radiotherapy often have chewing difficulty. Kinematic analysis of mandibular movements may provide clinically useful information for the chewing function. However, current kinematic device costs limited clinical application, and specialized software is required for control and data processing. This study aimed to mandibular kinematics parameter recognition using a self-developed Nswallow 2D motion capture software. To investigate whether differences in kinematic data of mandibular movements during mastication can be used as an indicator of masticatory dysfunction in NPC patients, and the relationship with mastication efficiency.
Method
Thirty-three patients with early-stage NPC after radiotherapy and thirty-five healthy controls were recruited. The self-developed Nswallow 2D motion capture software was used to automatically mark and capture the facial parts of the participants. We tracked jaw kinematic during chewing, and analyzed the characteristics of kinematic data of mandibular movements during chewing tasks. Meanwhile, the masticatory efficiency using two-color chewing gum was analyzed by the Viewgum software.
Result
Significant differences were observed in the mastication time (Total Masticatory Time (NPC:12.349 ± 2.428; HC:8.742 ± 1.349) & Chewing Sequence Duration (NPC:636.573 ± 85.432; HC:543.646 ± 65.9388)), speed of mandibular motion (Maximum Speed (NPC:23.740(17.775,25.906); HC:28.800(24.643,38.800) & Average Speed (NPC:11.844(10.395,13.285); HC:18.169(15.790,21.435)), and Mandibular Motion Amplitude (NPC:7.159(5.887,7.869); HC:8.478(7.291;11.020)) between two groups (P < 0.000). Logistic regression analysis and receiver operating characteristic curve analyses were performed based on the above data as explanatory variables. Among them, the average chewing speed exhibited the highest area under the ROC curve, the odds ratio was 3.629, the cutoff value was 14.28, with a sensitivity of 90.91%, a specificity of 80.00%, and an area under the curve of 0.9255. The masticatory efficiency in the NPC group significantly decreased compared to the healthy control group (P < 0.000). Linear regression analysis showed that average chewing speed negatively affects masticatory efficiency.
Conclusion
The Nswallow 2D motion capture software represents an easy-to-use and affordable system that can be utilized to assess masticatory function in patients with NPC. In addition, the average speed of chewing is a highly sensitive kinematic indicator for evaluating mastication efficiency.
Efficacy and safety of different doses of tirzepatide in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis
Authors: Zhu Junxia , Huang Yingjie , Luo Yang , Wen Yan , Li Haiyi , Li Wei , Deng Yutong , Shao Jieying , Huang Hai , Zhu Zhangzhi
Published: January 2024

Introduction: This study aims to evaluate the effectiveness and safety of different doses of tirzepatide on hypoglycemic, weight-loss, improvement of beta-cell function and insulin resistance in patients with type 2 diabetes mellitus compared with other glucose-lowering drugs or placebo.
Research Design and Methods: Searches were conducted for PubMed, Cochrane Library, Web of Science and Embase for randomized controlled trials (RCTs) of tirzepatide from their inception to 2023. The network meta-analysis followed the PRISMA guidelines. Based on the Cochrane risk of bias tool, we analyzed the included RCTs using Stata 15.1. The standardized mean difference and surface under the cumulative ranking curve were presented for each result. An evaluation of publication bias was conducted using funnel plots.
Results: Data from 17 studies involving 10405 patients was analyzed. Tirzepatide 10 mg and 15 mg were more effective at hypoglycemic control and weight loss than basal insulin (glargine or degludec) or GLP-1RAs (dulaglutide or semaglutide). Tirzepatide 15mg plays a leading role in lowering body weight (SCURA probability: 98.3%), fasting insulin (95.4%), fasting C-Peptide (91.8%), fasting blood glucose (88.2%) and glycated hemoglobin (85.7%). As for safety, 7407 (72%) had at least one treatment-emergent adverse events and most of that were gastrointestinal adverse events.
Conclusions: Tirzepatide 15 mg, not only exhibited a favorable hypoglycemic and weight-loss efficacy, but also achieve a reduction of fasting insulin and fasting C-Peptide by comparison with insulin and GLP1-RAs. It is need of more well-designed RCTs to evaluate potential benefits on insulin resistance and pancreatic beta cell function of tirzepatide.
Low frequency of the wild-type freezing-tolerance LsCBF7 allele among lettuce population suggest a negative selection during domestication and breeding
Authors: Park Sunchung , Shi Ainong , Mou Beiquan
Published: January 2024

Lettuce is one of the most consumed vegetables globally. Typically grown in temperatures ranging from 13 to 21°C, its cultivation continues through the colder months in regions with milder winters. However, these areas often experience freezing temperatures, leading to substantial yield losses. Therefore, the development of freezing-tolerant lettuce varieties has become a long-term goal of lettuce breeding programs. Despite its significance, our understanding of freezing tolerance in lettuce remains limited. Plants evolve a coping mechanism against freezing, known as cold acclimation, whereby they can increase freezing tolerance when pre-exposed to low nonfreezing temperatures. The CBF pathway is well-known for its central role in cold acclimation. Previously, we identified 14 CBF genes in lettuce and discovered that one of them, LsCBF7, had a loss-of-function mutation. In this study, we uncovered that accessions from colder regions carried the wild-type allele of LsCBF7 and this allele contributed to increased freezing tolerance, with 14% of the lettuce population carrying this allele. Interestingly, in wild lettuce (L. serriola) that is considered a progenitor of cultivated lettuce, this wild-type allele was much more common, with a frequency of 90%. This finding suggests that this wild-type allele may have undergone negative selection during the domestication or breeding of lettuce. Our data strongly indicate that this allele could be linked to early bolting, an undesirable trait in lettuce, which may have driven the negative selection. While this wild-type allele shows promise for improving freezing tolerance in lettuce, it is crucial to decouple it from the early bolting trait to fully harness its potential in lettuce breeding.
Complete Solution of the Einstein Field Equations for a Spherical Shell of Truly Incompressible Liquid
Authors: deLyra Jorge L.
Published: January 2024

We present the solution of the Einstein field equations, in the static and spherically symmetric case, for an incompressible fluid, that has constant proper energy density at each and every point of the volume where it exists, according to a set of local observers who are stationary with respect to the fluid at each point. In the general case the fluid exists within a spherically symmetric shell with an inner vacuum-matter interface at a radial position r1 and an outer matter-vacuum interface at a radial position r2 in the Schwarzschild coordinate system. Therefore, in the general case there is an inner vacuum region with a repulsive singularity at the origin, just like in all other similar shell solutions. We present the parameter plane of the problem, and show that there are limits of solutions that approach the configuration of black holes, with the formation of an event horizon at the radial position r2.
Genome-Wide Association Studies meta-analysis uncovers NOJO and SGS3 novel genes involved in Arabidopsis thaliana primary root development and plasticity
Authors: López-Ruíz Brenda Anabel , García-Ponce Berenice , Sánchez María de la Paz , Álvarez-Buylla Elena , Urrutia Araxi O. , Garay-Arroyo Adriana
Published: January 2024

Arabidopsis thaliana primary root growth has become a model for evo-devo studies due to its simplicity and facility to record cell proliferation and differentiation. To identify new genetic components relevant to primary root growth, we used a Genome-Wide Association Studies (GWAS) meta-analysis approach using data published in the last decade. In this work, we performed intra and inter-studies analyses to discover new genetic components that could participate in primary root growth. We used 639 accessions from nine different studies and performed different GWAS tests. We found that primary root growth changes were associated with 41 genes, of which six (14.6%) have been previously described as inhibitors or promoters of primary root growth. The knockdown lines of two genes, Suppressor of Gene Silencing (SGS3), involved in tasiRNA processing, and a gene with a Sterile Alpha Motif (SAM) motif named NOJOCH MOOTS (NOJO), confirmed their role as repressors of primary root growth. As none has been shown to participate in this developmental process before, our GWAS analysis identified new genes that participate in primary root growth.
Temporalis Muscle Thickness as a Prognostic Factor for 30-day, 90-day, and Overall Mortality in Newly-Diagnosed Glioblastoma
Authors: Abouelleil Mohamed , Nabulsi Omar , Chandra Ankush , Massie Lara , Mansour Tarek , Mustaquim Momina , Macki Mohamed , Walbert Tobias , Robin Adam , Griffith Brent , Chang Victor , Kalkanis Steven N. , Lee Ian Y. , Zakaria Hesham Mostafa
Published: January 2024

Background
The identification of novel prognostic biomarkers for glioblastoma (GBM) can guide clinicians and patients in treatment approaches. Frailty, as measured by sarcopenia, has been proven to predict overall survival in other oncologic processes.
Objective
We evaluated whether sarcopenia, as measured by temporalis muscle thickness, predicted survival in GBM, and we compared its accuracy to other survival markers.
Methods
A prospective GBM database identified 257 patients undergoing initial diagnostic surgery. Sarcopenia was quantified by temporalis muscle thickness and grouped into tertiles. Mortality hazard ratios were calculated using multivariate analysis.
Results
After multivariate analysis, sarcopenia at the time of initial surgery was the only factor associated with mortality at 30 days postoperatively (OR 0.10, P = 0.030). Sarcopenia at initial surgery predicted 90-day postoperative mortality; the most sarcopenic patients (1st tertile) had greater mortality than those in the 2nd (OR 0.28, P = 0.021) and 3rd tertiles (OR 0.04, P = 0.003). Sarcopenia predicted overall mortality, greater in the 1st tertile than the 2nd (OR 0.41, P < 0.001) and 3rd tertiles (OR 0.41, P < 0.001). Sarcopenia compared favorably to other predictors of mortality, including initiation of postoperative temozolomide and radiation treatment (OR 0.27, P < 0.001), gross total resection (OR 0.54, P = 0.007), and MGMT methylation status (OR 0.44, P < 0.001). Kaplan-Meier survival curves represent differences in survival (Log-Rank p < 0.001)
Conclusions
Sarcopenia predicts postoperative 30-day, 90-day, and overall survival from diagnosis in GBM. The frailty/sarcopenia paradigm is independent of patient demographic, oncologic, genetic, surgical, and therapeutic factors. Temporalis muscle thickness assessment provides a simple method to help guide treatment decisions in this population.
Urban Transport Dynamics During COVID-19: Examining Subway Ridership and Road Congestion Trends in Beijing Amidst Varied Built Environments
Authors: Cui Ziruo , Xue Gang
Published: January 2024

This study delves into the profound impact of the COVID-19 pandemic on subway ridership and road congestion in Beijing, with a specific focus on the moderating role of the built environment. Utilizing panel data regression models, our analysis encompasses the daily average subway ridership at 157 stations over 366 days, alongside corresponding average congestion indices. The study integrates a comprehensive set of variables including COVID-19 case numbers, public search trends, various emergency response levels, and control variables such as the density of work, residence, and entertainment tourism areas. Our findings reveal a significant downturn in subway ridership and a decrease in road congestion during the pandemic, with these effects being more pronounced in high-density residential and commercial areas. The study indicates that the built environment plays a crucial role in shaping travel patterns during such a public health crisis. Specifically, areas with high work and residential density experienced a substantial reduction in subway usage, while regions with elevated entertainment and tourism density witnessed an increase in private vehicle usage. The temporal analysis of the data presents further insights. The initial stages of the pandemic saw a steep decline in subway ridership, suggesting an immediate reaction to the outbreak and associated restrictions. As the pandemic progressed, there was evidence of gradual adaptation in travel behavior, with a slow recovery in subway ridership and changes in road congestion patterns. Moreover, the study highlights the varying impact of COVID-19 across different stages of the pandemic. In the early phase, stringent lockdown measures and high public fear significantly influenced mobility patterns. However, in the later stages, as the public adapted to the ‘new normal,’ there was a notable shift in travel preferences, with a gradual return to public transit and changes in congestion levels. Overall, this research provides comprehensive insights into how a global health crisis can reshape urban transportation dynamics. It underscores the necessity for adaptive urban planning and policy-making that can effectively respond to such unprecedented challenges, taking into consideration the diverse needs of different urban areas and stages of public health emergencies.
Treatment of Primary Cardiac Tumors in Children: A Single Center 18-Year Experience
Authors: Lee OK Jeong , Park Ilkun , Yang Ji-Hyuk , Kang I Seok , Huh Jun , Song Jinyoung , Jun Tae-Gook
Published: January 2024

This study aimed to compare the clinical characteristics and courses of pediatric patients with cardiac tumors in nonoperative and operative groups to help guide treatment decisions. We reviewed the medical records of patients diagnosed with primary pediatric cardiac tumors at our institution between 2003 and 2020. Demographic data, clinical characteristics, and follow-up data between the operation and nonoperation groups were compared. A total of 56 patients were included in the study. Thirteen patients underwent surgery. The median age was 1.4 months (range, 1 to 18 years). The patients in the operation group had more frequent symptoms or signs, such as desaturation, respiratory difficulty, murmur, a higher mass area /chamber area (MC) ratio, decreased ventricular contractility, and significant obstruction of the flow tract. An MC ratio of 0.568 was the cutoff value for differentiating patients with symptoms or signs of heart failure and decreased ventricular contractility. At the last follow-up, all patients had good ventricular contractility except one patient in the operative group with fibroma. Two patients in the nonoperative group died. Surgery-related mortality or tumor recurrence were not observed. Among pediatric patients with primary cardiac tumors, those with symptoms or signs of heart failure, a high MC ratio, decreased ventricular contractility, and significant flow tract obstruction or embolic risk may be candidates for surgery. In this study, patients had good outcomes with or without surgery, even when the tumor was large, or surgery was performed in early infancy.
Cloning and functional identification of anthocyanin synthesis-regulating transcription factor AaMYB4 in Aeonium arboreum ‘Halloween’
Authors: Zhao Rong , Li Su-Hua , Han Hao-Zhang , Zhang Li-Hua , Wang Fang , Zhang Nan
Published: January 2024

Succulents are widely appreciated for indoor decoration, primarily due to their vibrant leaf colors. However, the underlying mechanisms of leaf color development in succulents remain largely unexplored. In this study, we isolated AaMYB4, an MYB transcription factor that represses anthocyanin synthesis, from an ornamental succulent, Aeonium arboreum 'Halloween'. Our study employed 'Halloween' leaves for experimental analysis, incorporating gene cloning, bioinformatics, functional validation of transgenes, and yeast two-hybrid assays to investigate AaMYB4's role. The finding revealed that the full-length Open Reading Frame (ORF) of AaMYB4 spans 825 base pairs, encoding 274 amino acids. Phylogenetic analyses suggest AaMYB4 as a transcription factor suppressing flavonoid biosynthesis. Comparative analysis of protein sequences revealed that AaMYB4 functions as an R2R3-MYB transcription factor, characterized by a typical repressive EAR motif. AaMYB4 was cloned into Arabidopsis by inflorescence infestation. The WT and stably overexpressing AaMYB4 T2-generation Arabidopsis were subsequently grown under stress conditions including nitrogen deficiency, high light exposure, 6% sucrose, and abscisic acid (ABA) treatment. The results indicated that the anthocyanin content was significantly reduced in AaMYB4 overexpressing Arabidopsis compared with the WT under the four treatments described above, and the structural genes for anthocyanin synthesis were down-regulated in the AaMYB4 transgenic Arabidopsis. Moreover, the expression levels of the positively regulated MYB and bHLH transcription factors involved in anthocyanin synthesis, specifically AtPAP1 and AtTT8, exhibited a significant downregulation in Arabidopsis. Yeast two-hybrid assays revealed no interaction between AaMYB4 and AaTT8, and the AaMYB4 protein itself can interact. This research confirms AaMYB4's role in inhibiting anthocyanin synthesis in 'Halloween' leaves, enriching our understanding of the molecular basis of leaf color formation in succulents. Additionally, it offers valuable genetic insights for developing new 'Halloween' colorful leaf varieties.
RETRACTED: Dynamic Spectrum Allocation: Unleashing the Power of DRL-RW Algorithm in UAV-Based Energy Harvesting Networks
Authors: R Abdul Sikkandhar. , A Merline.
Published: January 2024

The authors have requested that this preprint be removed from Research Square.
Developing a reliable and practical multi-domain model to facilitate the diagnosis of ADHD in older preschool children
Authors: Chen I-Chun , Chang Che-Lun , Chang Meng-Han , Ko Li-Wei
Published: January 2024

A multi-method, multi-informant approach is emphasized for the evaluations of attention-deficit/hyperactivity disorders (ADHD) in preschool children due to the complexity and challenges of diagnosis at this stage. Most artificial intelligence (AI) studies on the automated detection of ADHD used a single type of data. This study aims to create a reliable multimodal AI-detection system for facilitating the diagnosis of ADHD among older preschool children. 78 older preschool children were recruited; 43 (mean age: 68.07 ± 6.19 months) of them were diagnosed with ADHD and 35 (mean age: 67.40 ± 5.44 months) of them were with typical development (TD). Machine learning (ML) and deep learning (DL) methods were adopted to develop three individual predictive models by using electroencephalography (EEG) data recording with a wearable wireless device, scores of the computerized attention assessment via Conners’ Kiddie Continuous Performance Test (K-CPT), and ratings of the ADHD-related symptom scales; finally, one ensemble model was merged. The results suggest that teacher ratings, K-CPT reaction time, and occipital high-frequency EEG band power values are significant features in identifying older preschool children with ADHD, and the ensemble model can achieve an accuracy of 0.974. The present study can respond to the three issues in most ADHD-related AI studies: the utility of wearable technologies, databases derived from different types of ADHD diagnostic instruments, and appropriate interpretability of the models. This established multimodal system can be reliable and practical in discriminating ADHD from TD and further facilitate the clinical diagnosis of preschool ADHD.
Relationships between yield and agronomic traits among geographic groups of barley landraces grown under high yielding conditions
Authors: Hoebe P. N. , Alegria-Terrazas R. , Hoad S. P. , Topp C. F.E.
Published: January 2024

Future crop production needs to deliver sustained yield increase in important crops such as barley. Although significant progress has been made over the last century in improving yields, in the last few decades yield improvement has stagnated. Morphological traits related to yield from a wide genetic base can be explored to identify novel variation to support future plant breeding. This includes exploitation of traits and yield association for developing varieties with more consistent yield.
We investigated the strength of the association between yield (grain yield, thousand grain weight) and related agronomic traits (seed number, height, ear number, flag leaf width and length, ear length). This was done among groups of European barley landrace from different geographic origins and Harlan composite cross populations compared to modern cultivars grown under a common high yield test protocol. Relationship of agronomic traits and yield were assessed for each group across environments and years. There were significant relationships between yield and morphological traits among landrace and other groups and between 2 and 6 rowed ear habit.
Traits most strongly associated with grain yield were number of ears, plant height, flag leaf width and seeds per ear.
Grain size as thousand grain weight was correlated with number of ears, ear length, seeds per ear, flag leaf width and plant height.
We conclude that phenotypic relationships between yield and agronomic traits among barley landraces could be exploited for enhancing yield and sustainable production in future barley breeding.