bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical features of bonding disorders in Japanese mothers derived from the Stafford Interview
Authors: Nishikii Yumi , Suetsugu Yoshiko , Yamashita Hiroshi , Yoshida Keiko
Published: December 2023

Background
This study aimed to systematically describe the characteristics of bonding disorders and diagnostically classify them using the Japanese version of the 6th Stafford Interview. We investigated the cut-off points of the Mother-Infant Bonding Scale (MIBS-J) and Postpartum Bonding Questionnaire (PBQ) to screen for bonding disorders.
Methods
We recruited participants in their second trimester and studied 40 mother-infant dyads. At one month postpartum, we conducted the mother-infant relationship section of the Stafford Interview and classified participants into diagnostic groups. We applied the MIBS-J at four days and one month postpartum and the PBQ at one month, combined with the interview. We used the total scores to analyse the receiver operating characteristic curve at four days and one month.
Results
We diagnosed one case of emotional rejection and eleven cases of mild disorder. Additionally, three cases exhibited pathological anger with mild disorder—one with emotional rejection and one infant-focused anxiety case with normal bonding. The screening scores for bonding disorders, including mild cases, were 2 points or more for MIBS-J at four days and 3 points or more at one month. The PBQ was better at identifying severe bonding disorders, scoring 19 points or more.
Conclusions
Bonding disorders can expose mothers to serious mental and parenting conditions as early as one month postpartum. Questionnaire screening and diagnostic interviews can help with early detection and care.
Flood-induced sediment deposition drives rapid invertebrate colonization of hyporheic zone
Authors: Negishi Junjiro N.
Published: December 2023

How hyporheic invertebrates at relatively shallow depths cope with floods and sediment movements that involve vertical and horizontal distribution shifts is not well known. This study examined the responses of macroinvertebrate communities in both benthic and hyporheic zone (30–50 cm deep from the riverbed) to a flow release at a fine temporal resolution (a few hours prior to and four days after an artificially caused flood) of a gravel-covered point bar so that immediate responses to the event can be described. Hyporheic communities exhibited little change during the flood, whereas benthic communities exhibited substantial decreases in total abundance. Most strikingly, at the taxon level, numerically dominant hyporheic species at relatively shallow depths, Alloperla ishikariana, increased substantially in the hyporheic zone, and its increase was positively correlated with deposited sediment depth (up to 45 cm). This study suggests that flood-induced sediment deposition drives rapid invertebrate colonization of the hyporheic zone. This can be perceived as refuge use of the benthic zone by hyporheic species in association with sediment deposits, which is a new conceptual framework for explaining how hyporheic invertebrates can persist through flood events by adapting to dynamic sediment movements. Experiments using artificial floods provide promising opportunities for challenging hyporheic studies.
Development of scaffold-free tissue-engineered constructs derived from mesenchymal stem cells with serum-free media for cartilage repair and long-term preservation
Authors: Maeda Satoshi , Matsumoto Masaya , Segawa Kotaro , Iwamoto Kaori , nakamura norimasa
Published: December 2023

Synovial mesenchymal stem cells (sMSCs) have great potential for cartilage repair, but their therapeutic design to avoid adverse effects associated with unknown factors remains a challenge. In addition, because long-term preservation is indispensable to maintain high quality levels until implantation, it is necessary to reduce their fluctuations. This study aimed to investigate the properties and feasibility of novel scaffold-free tissue-engineered constructs using serum-free media and develop long-term preservation methods. sMSCs were cultured in serum-free media, seeded at high density in a monolayer, and finally developed as a sheet-like construct called “gMSC1.” The properties of frozen gMSC1 (Fro-gMSC1) were compared with those of refrigerated gMSC1 (Ref-gMSC1) and then examined by their profile. Chondrogenic differentiation potential was analyzed by quantitative real-time polymerase chain reaction and quantification of glycosaminoglycan content. Xenografts into the cartilage defect model in rats were evaluated by histological staining. gMSC1 showed nearly similar properties independent of the preservation conditions. The animal experiment demonstrated that the defect could be filled with cartilage-like tissue with good integration to the adjacent tissue, suggesting that gMSC1 was formed and replaced the cartilage. Furthermore, several chondrogenesis-related factors were significantly secreted inside and outside gMSC1. Morphological analysis of Fro-gMSC1 revealed comparable quality levels to those of fresh gMSC1. Thus, if cryopreserved, gMSC1, with no complicated materials or processes, could have sustained cartilage repair capacity. gMSC1 is a prominent candidate in novel clinical practice for cartilage repair, allowing for large quantities to be manufactured at one time and preserved for a long term by freezing.
Global research landscape and trends of cancer stem cells: visualization biology analysis
Authors: Chen Yuxian , Qu Baozhen , Zheng Keke , Liu Yanhao , Zhang Xiaotao , Lu Linlin
Published: December 2023

Background
Cancer stem cells (CSCs) are a subset of cells with self-renewal ability and tumor generating potential. Accumulated evidence has revealed that CSCs were shown to contribute to tumorigenesis, metastasis, recurrence and resistance to chemoradiotherapy. Therefore, CSCs were regarded as promising therapeutic targets in cancer. This study aims to reveal the development process, research hotspots, and trends of CSCs research through bibliometric methods.
Methods
All relevant publications on CSCs with more than 100 citations during 1997–2023 were extracted from the Science Citation Index Expanded of Web of Science Core Collection (WoSCC), and related information was collected and analyzed using Microsoft Excel 2019, GraphPad Prism 8, VOSviewer, Citespace and “bibliometrix” packages of the R software.
Results
A total of 2521 papers were included. Cancer Research published the largest number of papers (184 papers). The USA accounted for the most publications (1326 papers). Rich, JN was the author with the most publications (56 papers) and the highest M-index (3.111). The most contributive institution was the University of Texas System (164 papers). Before 2007, research mainly focused on the definition and recognition of CSCs. Between 2007 and 2016, with the emergence of the terms such as "sonic hedgehog", "metabolism", “oxidative phosphorylation” and “epithelial mesenchymal transition”, research began to shift toward exploring the mechanisms of CSCs. In 2016, the focus transitioned to the tumor microenvironment and the ecological niches. The analysis of papers published in major journals since 2021 showed that “transcription”, “inhibition”, and “chemoresistance” emerged as new focused issues.
Conclusion
There has been a growing number of research on CSCs. The USA has always been a leading position in this field. In general, the research focus has gradually shifted from basic biology to clinical transformation. “Tumor microenvironment” and “chemoresistance” should be given more attention in the future.
Effects of fabric structure on the ballistic impact response of 3D angle- interlock woven fabric targets
Authors: Wei Qingsong , Chen Jiaxue , Yang Dan , Pan Zhongxiang
Published: December 2023

High-performance 3D fabrics are widely used for ballistic protection. In this study, we conducted finite element analysis (FEA) to investigate the ballistic mechanisms of 3D layer-to-layer angle-interlock woven fabric (3DLAWF) and 3D through-the-thickness angle-interlock woven fabrics (3DTAWF) under impact. We constructed full-scale mesoscale fabric models for two 3D fabrics to examine the influence of 3D fabric structures on dynamic behavior and ballistic performance. Additionally, by comparing and analyzing the energy absorption patterns and failure mechanisms of the fabrics under ballistic penetration, optimization strategies for 3D fabric structures were proposed. This work reveals the impact damage evolution mechanisms, energy absorption mechanisms, and stress wave distribution patterns in these two fabrics, providing valuable guidance for the design of ballistic protection using 3D fabrics.
Ten-Year Outcomes after Purified CD34+ Cells Transplantation in Patients with Angiitis-induced Critical Limb Ischemia
Authors: Liu Hao , Jiang Xiaolang , Zou Lingwei , Fang Yuan , Fang Gang , Liu Yifan , Chen Bin , Gu Shiyang , Wei Zheng , Liu Peng , Fu Weiguo , Pan Tianyue , Dong Zhihui
Published: December 2023

Background
Angiitis-induced critical limb ischemia (AICLI), which is defined as critical limb ischemia (CLI) caused by thromboangiitis obliterans (TAO) or other arteritis-related autoimmunological diseases. In the current study, we aimed to report the 10-year outcomes of AICLI patients who underwent purified CD34+ cells (PCCs) transplantation.
Methods
AICLI patients who underwent PCCs transplantation at our center from May 2009 to September 2011 were retrospectively enrolled. The main outcome was major amputation-free survival (MAFS); other outcomes included Rutherford classification, pain-free walking time (PFWT), Wong-Baker Faces Pain Rating Scale (WBFPS), recurrence, new lesions, quality of life (QoL) and patients’ posttransplantation work conditions.
Results
Twenty-four patients were enrolled with a mean age of 41.5 ± 7.8 years. Three underwent major amputation during the follow-up, and the 10-year MAFS was 87.5%. Eight were observed to have recurrence, and 2 had new lesions; the 10-year recurrence-free rate was 66.1%. All patients were unable to work at admission, 17 (70.8%) patients were reemployed after transplantation.
Conclusion
The current study further demonstrated satisfactory long-term efficacy of PCCs transplantation, with a 10-year MAFS of 87.5%. However, the 10-year recurrence-free rate of 66.1% suggested that strict and regular long-term follow-up is necessary.
Cognitive Control in Heroin Use Disorder Patients after Prolonged Methadone Maintenance Treatment
Authors: Zhao Wei , Duan Fan , Li Xiangyu , Li Junda , Xia Lingling , Ren Zixuan , Song Li , Song Peipei , Mu Linlin , Wang Lijin , Zhang Jing , Song Xun , Wang Ze , Chen Jinxuan , Zhang Xiaochu , Jiao Dongliang
Published: December 2023

Objective
Relapse after detoxification remains a major challenge for addiction treatment worldwide. Although cognitive control impairment is common in heroin use disorder (HUD) patients and is considered a major cause of relapse, it remains unclear after long-term detoxification. The aim of the present study was to assess cognitive control and its association with relapse in HUD patients after prolonged periods of drug abstinence.
Methods
A total of 63 HUD patients (mean abstinence: 12.24 ± 2.92 years), including 41 relapsers and 22 non-relapsers, and 31 healthy volunteers participated in this study. The eye tracking tasks, prospective memory tasks, Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and Prospective and Retrospective Memory Questionnaire (PRMQ) were used to assess cognitive control.
Results
HUD patients showed worse saccade error rate but no significant impairment in prospective memory. Furthermore, compared to the non-relapsers, the relapsers performed worse in BRIEF-A scores, antisaccade amplitude and velocity. Moreover, the antisaccade amplitude and velocity were negatively correlated with the BRIEF-A subtest scores. Finally, impairment of inhibition, shift and self-monitoring mediated the association between relapse and poor antisaccade performance.
Conclusions
Even after prolonged methadone treatment, heroin relapse is associated with worse executive function and antisaccade, and antisaccade amplitude and velocity mainly reflect impairment of inhibition, shift and self-monitoring in executive function.
Change in tissue resistance after irreversible electroporation in liver tumors as an indicator of treatment success - A multi-center analysis with long term follow-up
Authors: Frühling Petter , Stillström David , Holmquist Fredrik , Nilsson Anders , Freedman Jacob
Published: December 2023

We examined the correlation between decrease in tissue resistance and time to local tumor recurrence after irreversible electroporation (IRE) in patients with hepatocellular carcinoma (HCC) and colorectal cancer liver metastases (CRCLM). This population-based retrospective cohort study included consecutive patients treated with IRE for liver tumors in Sweden betweem 2011 and 2018. In total 149 patients with 206 tumors were treated. Exclusion due to missing and inaccurate data resulted in 124 patients with 170 tumors for the analyses. In a multivariable Cox regression model, a smaller decrease in tissue resistance (HR 1.02 (1.01-1.03), p=0.002) and tumors of size 21-30 mm (HR 2.48, 95% CI 1.26-4.88, p=0.009) and >30mm (HR 2.56, 95% CI 1.17-5.71, p= 0.019) were associated with shorter time to local tumor recurrence for CRCLM. This correlation was not seen for HCC. We found an association between a decrease in tissue resistance and time to local tumor recurrence for CRCLM. Our findings suggest that a decrease in tissue resistance, instead of rise in current, may be the parameter the interventionist should use during IRE to decide if the treatment is successful.
Detection of Coronavirus in Viral Transport Media using Ultraviolet and Near-Infrared Absorbance Spectra and Pattern Recognition Model
Authors: Rumaling Muhammad Izzuddin , Chee Fuei Pien , Bade Abdullah , Chang Jackson Hian Wui , Goh Lucky Poh Wah , Juhim Floressy
Published: December 2023

SARS-CoV-2 causes individuals to become infected with respiratory disease known as COVID-19. Rapid and robust identification ensures that the infected patients can be quarantined. In this paper, the detection of SARS-CoV-2 utilizes ultraviolet (UV) and near-infrared (NIR) absorbance spectra, along with principal component analysis and linear discriminant analysis (PCA-LDA). A total of 75 negative and 75 positive swab samples are separately placed in vials of viral transport media and transferred into cuvettes. The absorbance spectra are acquired and processed before they undergo dimensionality reduction using PCA. The dataset is divided into training set and testing set to develop and evaluate the PCA-LDA model. The scree plot analysis reveals that the two principal components are optimal for both UV and IR absorbance spectra. By utilizing the first two principal components, the performance indicators demonstrate higher accuracy (97.00%), sensitivity (94.84%), and specificity (99.31%) on IR absorbance spectra. This is attributed to the overall difference in IR absorbance, as well as two peaks centred at 558.5 nm and 972 nm respectively. Utilizing IR absorbance spectra with PCA-LDA model is cost-effective while showing performance comparable to conventional methods such as polymerase chain reaction. This method provides an alternative for rapid and effective SARS-CoV-2 detection.
Field Testing of Dual-species Synbiotic Microcapsules during IMNV Disease Outbreak and Fluctuate Weather: Growth Performance and Immune Response in Vaname Shrimps
Authors: Ermawati Rikha Putri , Yuhana Munti , Widanarni Widanarni , Afiff Usamah
Published: December 2023

This study aimed to evaluate the effectiveness of synbiotic microcapsules through feed on growth performance and immune response of vaname shrimp in field testing during IMNV disease outbreak and fluctuate weather. Four groups of shrimp(4.11±0.05g) were fed with different doses of synbiotic microcapsules, SIN 0(0%), SIN 0.5(0.5%), SIN 1(1%) and SIN 1.5(1.5%) for 60 days. The synbiotic microcapsules consisted of prebiotic mannanoligosaccharide/MOS, probiotic Pseudoalteromonas piscisida (1UB) and Bacillus cereus (BR2). This study focused on growth performance (survival rate/SR, specific growth rate/SGR, feed conversion ratio/FCR), immune response (total hemocyte count/THC, differential hemocyte count/DHC, respiratory burst/RB, phenoloxidase/PO activity, phagocytic activity/PA), microbiology (total bacterial count/TBC, 1UB+BR2 TetR count, total Vibrio count/TVC) and histopathology. The results showed significant results that synbiotic microcapsules increased SR, SGR also reduced FCR with the best results in SIN 1.5 (SR: 93.50±1.30%. SGR:4.83±0.01% days-1 and FCR:1.16±0.02). Immune response of THC, RB, PO and PA in the synbiotic microcapsule treatment showed higher values with the best results in SIN 1.5 treatment while DHC had no significant difference. The values of TBC, 1UB and BR2 TetR count increased until the 60th day with the highest value in the SIN 1.5 while TVC showed the lowest value in both intestinal and hepatopancreas organs. Histopathological results showed hepatopancreas and intestinal organs experienced tissue damage in all treatments with synbiotic microcapsules showing less damage when compared to SIN 0. In conclusion, supplementation of synbiotic microcapsules through feed can improve growth performance, immune response and suppress Vibrio during outbreak with the best dose of 1.5%.
Conditional connectivities of the n dimensional godan graph
Authors: Hua Xiaohui , Lai Yonghao
Published: December 2023

Reliability and fault tolerance are two important parameters of an interconnection network. As a topology structure of interconnection networks, thegodan graph EA_n has many good properties. In this paper, we give various connectivities of EA_n: the g-component edge connectivity for $3\leq g\leq 5$, the h-extra edge connectivity for $1\leq h\leq 3$ and the (edge) neighbor connectivity.
Two Fluids in f(T) Gravity with Observational Constraints
Authors: Pawar D D , Gaikwad P S , Ghungarwar N G
Published: December 2023

In this study, we have examined the behavior of two fluids within the framework of $f(T)$ gravity, while taking into account observational constraints. Our focus was specifically on the Locally Rotationally Symmetric Bianchi-I Universe in the context of $f(T)$ theory of gravity. By investigating the evolution of the universe, we utilized various cosmological parameters, such as the deceleration parameter, equation of state parameter, density parameter, pressureand statefinder diagnostics. Additionally, we analyzed the geometric properties of the model. In the teleparallel theories, we derived the torsion scalar T from the given metric's torsion tensor.
Short-read full-length 16S rRNA amplicon sequencing for characterisation of the respiratory bacteriome of captive and free-ranging African elephants (Loxodonta africana).
Authors: Martin Lauren C. , O’Hare Michaela A. , Ghielmetti Giovanni , Twesigomwe David , Kerr Tanya J. , Gumbo Rachiel , Buss Peter E. , Hemmings Sian M.J. , Miller Michele A. , Goosen Wynand J.
Published: December 2023

Hypervariable region sequencing of the 16S rRNA gene plays a critical role in microbial ecology, offering insights into bacterial communities within specific niches. While providing valuable genuslevel information, its reliance on limited genetic data from targeted regions of this gene limits its overall utility. Advances in sequencing have enabled characterisation of the full-length 16S rRNA gene, enhancing species-level classification. Third-generation sequencing technologies can sequence genes in single reads, yet challenges in cost and accessibility persist. Although Illumina's short-read platforms are cost-effective and precise, they lack full-length 16S rRNA amplicon sequencing capability. This study aimed to evaluate the feasibility of a modified 150 bp paired-end 16S rRNA amplicon shortread sequencing technique on the Illumina iSeq 100 by utilising a mock microbial community and subsequently performing exploratory characterisation of captive (zoo) and free-ranging African elephant (Loxodonta africana) respiratory microbiota. Our findings support the viability of the sequencing technique through taxonomic assignment that is consistent with the microbial standard’s theoretical composition. Tentative bacterial signatures, potentially representative of distinct respiratory tract compartments (trunk and lower respiratory tract) were observed, necessitating further investigation with larger sample sizes to gain deeper insights into its implication for elephant physiology and health.
Optimizing Health-Oriented Websites in Iran: Prioritizing APIs using the TOPSIS Method for Enhanced User Experience
Authors: Mohammadzadeh Zahra , Raayatpanah Mohammad Ali
Published: December 2023

Objective: The objective of this study to provide website developers and administrators with a systematic and objective approach to evaluate and rank APIs based on predefined criteria, ultimately enhancing the functionality, reliability, and user experience of health-oriented websites.
Method: This study adopts a quantitative research design, employing the TOPSIS method as the analytical framework for evaluating and ranking the available APIs based on predefined criteria. Data for this study is collected through a combination of primary and secondary sources. Primary data is obtained through surveys and interviews with website developers, administrators, and healthcare professionals involved in the development and management of health-oriented websites in Iran. Secondary data is gathered from relevant literature, official documents, and online sources to understand the local context and specific requirements of the Iranian healthcare industry.
Results: A total of 150 APIs were identified and assessed based on specific criteria. The TOPSIS method was employed to determine the order of priority for these APIs. Findings from this study provide valuable insights into enhancing the user experience of health-oriented websites in Iran by effectively selecting and implementing APIs.
Conclusion: By prioritizing APIs based on the TOPSIS method, website developers and managers can optimize the functionality and usability of health-oriented websites, ultimately leading to an enhanced user experience and improved overall satisfaction. The findings from this study contribute to the field of health-oriented website optimization, providing practical recommendations for the selection and integration of APIs in the Iranian context.
The exact solutions of Schrödinger-Hirota equation based on the extended auxiliary equation method
Authors: Du Yajun , Yin Tianle , Pang Jing
Published: December 2023

The Schr\"{o}dinger-Hirota equation are studied in light transmission, optical fiber communication, and nonlinear effects in optics. The extended fourth Jacobi elliptic equation is used in this paper to seek different types of exact solutions, which include bright soliton solutions, kink solutions, periodic wave solutions, and singular traveling wave solutions via selecting appropriate parameters.The characteristics of some solutions are graphically presented using two- and three-dimensional graphs such as the real part, the imaginary part, and their modulus via providing suitable values to arbitrary parameters. Compared to other methods, the method is more direct and easier for calculations.
Analysis of a nonlinear stochastic perturbed HIV model with CD4+ T cells
Authors: Liu Lanxi , Liu Qun
Published: December 2023

Considering that the consequences of human immunodeficiency virus (HIV) infection may lead to exhaustion of $\text{CD4}^{+}$ T cells, this paper investigates a nonlinear stochastic perturbed HIV epidemic model. First, the stochastic Lyapunov function approach is used to establish the condition $\mathcal{R}_{0}^{S}>1$ of having a stationary distribution with the ergodicity property. The approximate probability density around the endemic equilibrium of the stochastic system is then derived by solving the Fokker-Planck equation. In addition, we provide the requirements for disease eradication. Finally, some numerical test results and relevant pictures are given.
PAM 4 Transmission Over OM3 Fiber Using OAM Mode Group Multiplexing
Authors: Shukla Abhishek Mani , Gupta Sumanta
Published: December 2023

This paper investigates the bit error rate (BER) performance of the 10 Gbaud PAM4
transmission over conventional multimode fiber using OAM mode group multiplexing. This proof-of-concept study uses two orbital angular momentum (OAM) mode groups, with topological charges I = 0, and l = +1, without using any multiple-input-multiple-output (MIMO) processing. The study reveals that the 10 Gbaud PAM-4 transmissions are possible using OAM mode multiplexing over 1 km conventional Multimode fiber with some stability challenges. Moreover, we have found that each mode achieved the bit error rate value well below the pre-FEC 3.8 × 10−3 after 1 km of OM3 fiber. This study also reports the open-eye diagrams, which are captured over several minutes, indicating that PAM4 Transmission is possible over conventional fiber. This study also emphasizes that a proper adaptive polarization adjustment is required to achieve long-term stability in terms of reduced crosstalk.
Neutrophil to lymphocyte and platelet ratio as a prognostic marker of short-term mortality and disease severity in sepsis-associated acute kidney injury patients in the intensive care unit: a retrospective study
Authors: Zhang Jinhui , Zhao Qun , Hu Zhenkui
Published: December 2023

Background:Sepsis-associated acute kidney injury (S-AKI) is a common and life-threatening complication in critically ill patients. The neutrophil to lymphocyte and platelet (N/LP) ratio has been identified as a risk factor for the development of S-AKI. However, the relationship between the N/LP ratio and adverse outcomes in S-AKI patients remains unclear. Therefore, the aim of this study was to investigate the prognostic value of the N/LP ratio in S-AKI patients and its potential application in early identification of short-term mortality and severity of AKI.
Methods: We conducted a retrospective analysis of patients diagnosed with S-AKI at our institution between January 2015 and July 2023. Sepsis was diagnosed according to the Sepsis-3 criteria, while AKI diagnoses were made following the KDIGO guideline. The primary objective of this study was to evaluate the 30- and 60-day mortality rates among these patients. Additionally, we also aimed to assess the incidence of severe AKI as a secondary endpoint measure.
Results: In this study, a total of 483 patients with S-AKI were included, with a median age of 76.0 (67.0-84.0) years and 296 (61.3%) being male. Among these patients, 332 (68.7%) were classified as stage 1, 79 (16.4%) as stage 2, and 72 (14.9%) as stage 3 AKI. The 30-day mortality rate was 38.9%, and the 60-day mortality rate was 44.3%. Patients in the high N/LP ratio group, as determined by the median at ICU admission, had an increased risk of 30- and 60-day mortality, as well as a higher occurrence of severe AKI (stages 2 and 3). In multivariate Cox proportional hazard models, the high N/LP group exhibited a 1.728-fold increase in 30-day mortality and a 1.702-fold increase in 60-day mortality compared to the low N/LP group. Similarly, in a multivariate logistic regression model, the high N/LP group had a 1.634-fold increased risk of severe AKI occurrence. Spearman's analysis revealed a positive correlation between the N/LP ratio and APACHE II and SOFA scores. Subgroup analyses showed that the association between the N/LP ratio and 30-/60-day mortality and severe AKI occurrence did not differ significantly across strata such as age, hypertension, diabetes, and SOFA score, except for gender and smoking status. Furthermore, the ROC analysis indicated that the initial N/LP ratio at ICU admission had the highest area under the curve (AUC) of 0.652 and 0.635 for 30- and 60-day mortality prediction, respectively, compared to other biomarkers such as WBC, Neu, Lym, Hb, PLT, CRP, Alb, BUN, uric acid, and lactate. Additionally, the N/LP ratio was found to have good predictive power for severe AKI (AUC: 0.596) in S-AKI prognosis.
Conclusions: The N/LP ratio, which can be easily obtained from routine blood analysis, was independently associated with both 30-/60-day mortality and the occurrence of severe AKI in S-AKI patients.
Surgical Treatment of Duplicated Collecting System in 185 Children: A Single-Center Experience
Authors: Liu Zhiyuan , Yu Chengjun , Yang Shuhan , Zhang Jie , Luo Jin , Wen Sheng , Hua Yi , Wei Guanghui
Published: December 2023

Background
Duplicated collecting system (DCS) is a common congenital urinary tract anomaly in children. It can manifest as complete duplicated collecting system (CDS) or incomplete duplicated collecting system (IDS). While many DCS cases are asymptomatic, some children experience complications such as hydronephrosis, urinary tract infections, incontinence, and vesicoureteral reflux (VUR), which are often associated other urinary tract anomalies, mainly affecting the upper pole moiety. Surgical intervention is frequently required, and various surgeries are now available.
Patients and Methods:
This retrospective study analyzed data from 185 pediatric patients with DCS who underwent surgical treatment between 2012 and 2021. The choice of surgical approach was based on a comprehensive evaluation by experienced pediatric urologists. The study included different procedures: upper pole heminephrectomy (UHN), endoscopic ureterocele incision (EUI), upper ureteric reimplantation (UIR), and pyeloureteroplasty (PUP).
Result
Results showed that UHN led to complete resolution of hydronephrosis and incontinence in 127 cases. However, 9 (7.1%) experienced febrile urinary tract infections, 5 (3.9%) experienced ureteral stump syndrome, 3 (2.4%) experienced residual renal atrophy and 8 (6.3%) required reoperations. Comparison between laparoscopic and open UHN revealed the benefits of laparoscopic techniques, including shorter hospitalization and fewer complications. EUI provided a minimally invasive option with significantly reduced hospitalization and resulted in reduced hydronephrosis, although 6 (17.6%) cases experienced febrile urinary tract infections (fUTIs) and 4 (11.8%) needed additional surgeries. UIR was successful in relieving incontinence and hydronephrosis, but 1 (5.9%) experienced fUTIs and 1 (5.9%) required reoperation. PUP also resulted in reduced hydronephrosis without complications. No statistically significant difference existed in rates of unplanned reoperations and fUTIs between UHN and nephron-sparing surgeries.
Conclusion
Our experience underscores the effectiveness and safety of UHN, especially when utilizing laparoscopic techniques, to treat DCS, resulting in fewer complications. Procedures like UIR, EUI, and PUP, designed to preserve the duplicated moiety, have proven safe and effective, minimizing renal trauma, and preserving renal function.
Multi-omics reveal that two probiotic strains associated with the gut microbiome and host metabolome contribute to the efficacy of Lactobacillus intervention in alleviating feline chronic kidney disease
Authors: Huang Hsiao-Wen , Kuo Tzu-Chien , Lee Ya-Jane , Chen Ming-Ju
Published: December 2023

Background
Gut dysbiosis in patients with chronic kidney disease (CKD) contributes to deteriorating CKD progression. However, alterations in microbial function and their association with metabolic pathways in feline CKD pathophysiology remain unclear. Our previous findings revealed that Lactobacillus mix (Lm) intervention alleviates CKD progression by recovering dysbiotic gut microbiota and harmonizing the gut environment. Therefore, this study aimed to evaluate the efficacy of Lm intervention in feline CKD and elucidate the mechanisms underlying host-microbe interactions.
Results
We performed full-length 16S rRNA amplicon sequencing and untargeted metabolomics in a pilot study of cats with stage 2–3 CKD to characterize the intricate interactions between the gut microbiome and serum metabolome. During the eight weeks of Lm intervention, creatinine and blood urea nitrogen levels were reduced or maintained in most cats with CKD. Similarly, gut-derived uremic toxins (GDUT) were downregulated in the serum. Gut microbiome data revealed that Lm markedly improved intestinal diversity, altered the levels of specific bacterial taxa, and upregulated microbial functions, especially those involved in the GDUT and short-chain fatty acid (SCFA) biosynthesis pathways. Furthermore, the distribution of Lm strains was higher in cats who exhibited better outcomes after Lm intervention. The modulation of microbial functions involved GDUT (tyrosine, tryptophan, and phenylalanine metabolism) and SCFA (pyruvate, propanoate, and butanoate metabolism) biosynthesis pathways. Gut-derived metabolites were more explicit in high responders among cats with CKD, demonstrating the downregulation of indoxyl sulfate, p-cresyl sulfate, and phenyl sulfate. This result further demonstrated the upregulation of acetic acid, butyric acid, and propionic acid. Finally, the abundance of Lm strains was negatively or positively correlated with GDUT and SCFA levels.
Conclusions
This study demonstrates an Lm-mediated interconnection between the modulation of microbial composition, metabolic reactions, and metabolite profiles. Moreover, Lm intervention contributed to varied individualized outcomes in the levels of gut-derived metabolites and kidney function in cats with CKD. This indicates that the colonization of probiotic strains intrinsically impacts their efficacy in alleviating CKD, suggesting that identifying crucial factors influencing microbial colonization is essential for developing adaption strategies to improve outcomes.
Development of a client exit survey tool to measure person-centered contraceptive counseling as part of a quality improvement process in Kenyan hospitals
Authors: Sitrin Deborah , Laudeman Grace , Odipo Erick Onyango , Ndombi Salome
Published: December 2023

Background
Simple methods and tools that health care facilities can routinely use to measure trends in the quality of family planning (FP) counseling are necessary for applying a quality improvement process. This paper describes the development and testing of a client exit survey tool that is being used by quality improvement teams in 8 hospitals in Kenya to improve FP counseling.
Methods
A stakeholder consultation was held in Kenya to select questions from existing tools that measure client-reported quality of FP services and were validated or tested in low or middle-income countries. Ten questions were selected: 4 comprising the Person-Centered Contraceptive Counseling (PCCC) measure, 4 comprising the Method Information Index Plus (MII+), 1 comprising the Net Promoter Score, and 1 pulled from the Service Provision Assessment. We then conducted cognitive interviews with 18 women receiving FP services in Kenya to assess their understanding of questions, the face validity of the tool, and client preferences for survey logistics.
Results
There were mixed results in understanding of PCCC questions, which had not been used in Kenya previously: two were easily understood while two were frequently misunderstood. Respondents generally reported the survey was not difficult to understand and it was not hard to respond to questions. The results of asking participants to rank survey items from most to least important were that PCCC statements ranked most important followed by MII+ items. The Net Promoter Score ranked lowest. Few participants thought questions needed to be added to the tool to capture what they view as quality provider-client interactions. Most participants were unable to select questions for removal. Respondents had differing preferences for how to take the survey, with the most popular mode (8/18) being that the client reads and responds to the survey herself on paper followed by a facility staff member reading the questions aloud and the client recording her responses on paper (5/18).
Conclusions
A client exit survey tool incorporating the PCCC and MII+ scales seems reasonably understandable and to have good face validity in measuring dimensions of FP counseling important to clients in Kenya.
Brain oscillations and functional connectivity involved in single-letter processing
Authors: Takai Osamu , Herdman Anthony T.
Published: December 2023

Understanding how the spectral-spatial-temporal dynamics of neural activity and information transfer among brain regions is an important goal in knowing how visual and orthographic information is processed throughout the human brain. This study aimed at understanding these dynamics for letter processing by investigating oscillatory and functional connectivity in the first-language (L1) adult brain. We used a multi-source beamforming method for EEG source modeling of the event-related potentials to single letter and pseudoletter stimuli in order to minimize findings of false connections. Time-frequency analyses were performed using wavelet analyses of the electrode and source waveforms. Event-related enhanced power within the theta band (4–8 Hz) was significantly different between letters and pseudoletters within the 0-300 ms, but removing the evoked response contributions mostly abolished this effect. More event-related depressed power was seen for letters than pseudoletters within the alpha band (9–15 Hz). Phase-locking value (PLV) network connectivity results showed significantly greater connectivity within theta band for pseudoletters than letters within a posteriorly distributed network. Alpha-band connectivity was significantly more desynchronized among posterior brain regions for letters than pseudoletters between 85–400 ms. Overall connectivity, revealed similar amounts of synchronized connectivity for letters and pseudoletters but predominantly more desynchronized connectivity for letters than pseudoletters. Overall network was more left-lateralized for both synchronized and desynchronized connections, regardless of stimulus condition (letters and pseudoletters). These results indicated that visual processing of letters and pseudoletters occur within a widely distributed left-dominant network with significant differences in oscillatory activity and network dynamics between letters and pseudoletters.
Establishment of a risk prediction model for Aromatase Inhibitor-Induced Arthralgia in breast cancer patients: a retrospective cohort study in high-altitude regions
Authors: Zhao Ju , Shen GuoShuang , Li Meng , Zhao Fuxing , Wei Yingyuan , Xiao Wenjun , Cai Yanqiu , Ren Dengfeng , Zhao Jiuda , Zhao Yi , Wang Miaozhou
Published: December 2023

Background:
Aromatase inhibitor-induced arthralgia (AIA) is a common and debilitating adverse event in breast cancer patients receiving aromatase inhibitors (AI) treatment. One of the reasons why breast cancer patients discontinue AI treatment prematurely. However, the risk factors and predictive models specific to high-altitude regions are lacking. This study aimed to develop a predictive model for AIA in breast cancer patients in high-altitude regions.
Methods:
A retrospective cohort study was conducted in a high-altitude region at Qinghai University Affiliated Hospital from June 2021 to October 2023. This study involved a total of 315 breast cancer patients undergoing AI treatment. Participants were randomly assigned to either a training set (n=220) or a validation set (n=95) in a 7:3 ratio. Variable selection was carried out using the Least Absolute Shrinkage and Selection Operator (LASSO) regression, coupled with 7-fold cross-validation. A multivariate logistic regression analysis was performed on the training set to identify independent risk factors for AIA, leading to the establishment of a nomogram based on these risk factors. The model's performance was assessed using calibration plots, Receiver Operating Characteristic (ROC) curves, and Decision Curve Analysis (DCA).
Results:
Out of the 14 variables analyzed, five predictors were selected for the development of the predictive model. These included prior chemotherapy, years since the last menstrual period (LMP), menopause mode, stage, and psychological factors. The incidence rate of AIA in the cohort was 58.41%. The multivariate logistic regression analysis identified several significant independent predictors for AIA in high-altitude regions. These included previous use of taxane chemotherapy (Odds Ratio [OR] = 10.174, 95% Confidence Interval [CI] = 2.008-62.69, P=0.008), LMP (OR = 0.175, 95% CI = 0.052-0.494, P=0.002), drug-induced menopause (OR = 3.834, 95% CI = 1.109-14.13, P=0.036), stage (OR = 10.423, 95% CI = 4.114-32.15, P < 0.001), and psychological factors (OR = 25.108, 95% CI = 8.430-87.95, P<0.001). The developed nomogram exhibited a strong predictive capacity, with an area under the Receiver Operating Characteristic (ROC) curve value of 0.971. The calibration curve demonstrated a high degree of consistency between predicted probabilities and observed values. Decision Curve Analysis (DCA) underscored the clinical utility of the nomogram.
Perceptions of Breast Reconstruction Among Native American Women: A Qualitative Analysis
Authors: Marquez Jessica L , Tausinga Telisha , Scott Kaylee , Tuncer Fatma Betul
Published: December 2023

Background
Despite having a high incidence of breast cancer, Native American/American Indian (NA/AI) women have among the lowest rates of breast reconstruction (BR). While NA/AI women are often racially miscategorized, little is known as to why reconstruction rates remain low. This study investigates cultural factors, values, and perceptions of held by NA/AI that might impact BR rates.
Methods
Individual, semi-structured interviews utilizing open-ended questions prompting for insight into barriers to care, cultural values, body image, and reconstructive preferences were conducted. All interviews were audio-recorded and transcribed. Qualitative content analysis was performed, which allowed for inductive themes to be drawn from the raw data.
Results
Fifteen NA/AI women who underwent surgical treatment for breast cancer were interviewed. Emerging themes included acceptance, privacy, humility, wholeness, self-image, negative perceptions of plastic surgery, naturality, fear, and cultural contraindication of ADM use. All women discussed their reconstructive options with a breast surgeon, but only 3 chose to reconstruct. Most women suggested that reconstruction with autologous tissue was a more culturally congruent choice than implant-based reconstruction. Reconstructive surgery was often viewed as strictly cosmetic. All women unanimously opposed ADM use in BR due to cultural beliefs surrounding the use of tissue from deceased individuals.
Conclusions
This is the first study to investigate culture-specific perceptions of BR. Our results suggest that culture specific factors and preferences may contribute to low rates of BR. Results from this study can be used to improve cultural competency in addressing BR in NA/AI women.
Bending and Buckling Analysis of Porous 2D Functionally Graded Beams with Exponential Material Property Variation
Authors: Adıyaman Gökhan , TURAN Muhittin
Published: December 2023

The bending and buckling analysis of porous two-directional (2D) functionally graded (FG) beams was conducted using a higher-order shear deformation theory (HSDT). The introduction of exponential functions to depict changes in material properties is a novel approach in the static analysis of 2D FG beams. Three distinct porosity distribution functions were taken into account. The governing equations were formulated through the application of Lagrange’s principle. During the numerical analysis, a finite element comprising two nodes and eight degrees of freedom (DOFs) was utilized. This choice facilitated accurate and efficient solutions, even for shorter beams, without the need for a shear correction factor. Notably, the obtained shear stresses aligned with actual values, registering as zero at both the top and bottom of the beam. The obtained results of the study were validated against findings reported in the literature. A parametric study was carried out to investigate the effects of porosity, porosity distributions, gradation parameters, slenderness, and boundary conditions on the non-dimensional deflections, stresses, critical buckling loads, and buckling mode shapes. It was found that both porosity and the distribution of porosity have noticeable effects on the static analysis of the beams.
Hyper-recombination in ribosomal DNA is driven by resection-independent RAD51 loading
Authors: Gál Zita , Boukoura Stavroula , Korsholm Lea Milling , Oxe Kezia Catharina , Nieto Blanca , Dulina Ekaterina , Rasmussen Anna Vestergaard , Dahl Christina , Galanos Panagiotis , Lin Lin , Guldberg Per , Bartek Jiri , Luo Yonglun , Larsen Dorthe Helena
Published: December 2023

Ribosomal DNA (rDNA) encodes the ribosomal RNA genes and represents a genomic region that is intrinsically unstable. Despite decades-long awareness of rDNA instability, the underlying mechanisms and implications for genome integrity remain elusive. Here, we use Bloom Syndrome (BS), a rare genetic disease characterized by DNA repair defects and hyper-unstable rDNA, to investigate the mechanisms leading to rDNA instability. We find that in BLM proficient cells the homologous recombination (HR) pathway in rDNA bear resemblance to that of nuclear chromatin; initiated by resection, RPA loading and BRCA2-dependent RAD51 filament formation. However, we show that BLM deficiency compromise RPA-loading and BRCA1/2 recruitment to rDNA, but intriguingly not RAD51. RAD51 accumulation at rDNA occurs despite depletion of resection nucleases but display increased dependency on BRCA1 in BLM deficient cells. Furthermore, we show that rDNA repair intermediates result in micronuclei formation in the absence of BLM. Our findings suggest that rDNA is permissive to RAD51 loading in the absence of BLM, leading to micronucleation and potentially global genomic instability.
Access to Essential Medicines for Diabetes Care: Availability, Price, and Affordability in Central Ethiopia
Authors: Deressa Hachalu Dugasa , Abuye Habtamu , Adinew Alemayehu , Ali Mohammed K. , Kebede Tedla , Habte Bruck Messele
Published: December 2023

Background
Diabetes is a major global public health burden. Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines (EMs) which is a challenge especially in low-and-middle-income countries such as Ethiopia.
Methods
A cross-sectional study was conducted in 60 selected public and private medicine outlets in central Ethiopia from January to February 2022 using the World Health Organization/Health Action International (WHO/HAI) standard tool to assess access to EMs. We included EMs that lower glucose, blood pressure, and cholesterol as these are all critical for diabetes care. Availability was determined as the percentage of surveyed outlets per sector in which the selected lowest-priced generic (LPG) and originator brand (OB) products were found. The number of days’ wages required by the lowest paid government worker (LPGW) to purchase a one month’s supply of medicines was used to measure affordability while median price was determined to assess patient price and price markup difference between public procurement and retail prices.
Results
Across all facilities, availability of LPG and OB medicines were 34.6% and 2.5% respectively. Only two glucose-lowering (glibenclamide 5mg, metformin 500mg) and two blood pressure-lowering medications (nifedipine 20mg and hydrochlorothiazide 25mg) surpassed the WHO’s target of 80% availability. The median price based on the least measurable unit of LPG diabetes EMs was 1.6 ETB (0.033 USD) in public and 4.65 ETB (0.095 USD) in private outlets, respectively. The cost of one month’s supply of diabetes EMs was equivalent to 0.3 to 3.1 days wages in public and 1.0 to 11.0 days wages in private outlets, respectively, for a typical LPGW. Thus, 58.8% and 84.6% of LPG diabetes EMs included in the price analysis were unaffordable in private and public outlets, respectively.
Conclusion
There are big gaps in availability and affordability of EMs used for diabetes in central Ethiopia. Relevant stakeholders should work to improve access to EMs.