bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction and validation of a predictive model for mortality risk in patients with Acinetobacter baumannii-induced septicaemia
Authors: Li Xiaojun , Cai Donghao , Mei Chuangchuang , Huang Xinghui , Zhou Xiaohong , Yuan Lin , Guo Jianfen , Duan Yan
Published: June 2024

Purpose To develop and validate a predictive model for the risk of death in patients with Acinetobacter baumannii (A. baumannii) sepsis for clinical decision-making and patient management.Methods Demographic and clinical data related to patients with A. baumannii sepsis admitted to the Guangdong Second Traditional Chinese Medicine Hospital for 13 consecutive years from January 2011 to December 2023 were collected. The 160 patients admitted from January 2011–December 2020 composed the training cohort, and the 46 patients admitted from January 2021–December 2023 composed the validation cohort according to the time of admission. LASSO regression analysis and multivariate Cox regression were used to determine the independent risk factors for death in patients with A. baumannii sepsis, and a nomogram was constructed based on the results of multivariate Cox regression. The predictive model was evaluated using the area under the curve (AUC) of the subject's work characteristics (ROC) curve, decision curve analysis (DCA), and standard curves for discrimination, accuracy, and calibration.Results Comorbid septic shock, an elevated neutrophil/lymphocyte ratio (NLR), low hemoglobin levels, and low platelet counts were found to be independent risk factors for death in patients with A. baumannii sepsis. With the models constructed from these four variables, the AUCs of the ROC curves of the test and validation cohorts for the prognostic scenarios at 7, 14, and 28 days were not less than 0.850, and the AUCs of the ROC curves of the risk-of-death prediction model were the highest for both groups at 7 days, at 0.907 and 0.886, respectively. The two sets of calibration curves show that the calibration curves oscillate around a 45° diagonal line at 7, 14, and 28 days, and there is a good correlation between the actual risk and the predicted risk, with a high degree of calibration. The clinical decision curve shows that the model has a strong discriminatory ability when the probability is between 10% and 70%, and the net benefit is greater.Conclusion The variables for constructing the model are convenient and easily available, and the proposed model has good predictive value for the risk of death in patients with A. baumannii sepsis and can be widely used.
A Follow-Up Study on the Thai Pharmacogenomics Database-1 (TPGxD-1): Validating CYP2D6 Allele Calls Using Contemporary Bioinformatics Tools
Authors: John Shobana , Sura Thanyachai , Dejsuphong Donniphat , Srit Piyamitr , Vathesatogkit Prin , Thongchompoo Nartthawee , Thabthimthong Wiphaporn , Teerakulkittipong Nuttinee , Chantratita Wasun , Sukasem Chonlaphat , Klumsathian Sommon , Own-eium Paravee , Eu-ahsunthornwattana Jakris , Charoenyingwattana Angkana
Published: June 2024

The accurate prediction of star alleles of the CYP2D6 gene is crucial for pharmacogenomic precision, enabling tailored drug therapy based on individual genetic profiles. This study evaluates the efficacy of various bioinformatics algorithms for calling diplotypes, structural variants (SVs), and copy number variations (CNVs) of the CYP2D6 gene using whole genome sequencing (WGS) data from a cohort of 942 Thai individuals and validating our TPGxD-1 allele calls for CYP2D6. WGS data were processed using Illumina and HiSeq X technologies, with alignment to the GRCh38 reference genome. The Burrows-Wheeler Aligner and GATK tools were employed for read alignment, duplicate marking, and base quality score recalibration. Four algorithms—SGv2.0.2, sPGxv1.2.7, Aldyv4.0, and Cyrius v1.1.1—were used for star allele analysis. The results indicated that Aldyv4.0 had the highest calling rate for diplotypes/SVs/CNVs at 99.3%, followed by SGv2.0.2, while other algorithms showed varying efficiencies. Concordance analysis revealed high similarity in diplotype/SV/CNV frequencies between SGv2.0.2 and other tools, with Cyrius v1.1.1 showing the highest concordance in diplotype frequencies (r = 0.99) and sPGxv1.2.7 in SV/CNV frequencies (r = 0.99). Phenotype prediction was conducted using SGv2.0.2 and sPGxv1.2.7, showing high concordance in predicted metabolizer statuses. However, discrepancies were observed, primarily due to differing algorithmic capabilities in handling complex genetic variations. Unique and discordant diplotypes/SVs/CNVs were identified, highlighting areas for further tool optimization. Overall, this research contributes to the refinement of CYP2D6 allele calls, providing insights into the performance of contemporary bioinformatics tools and their implications for pharmacogenomic testing.
Impact of Marmara-yegen Cutting Gastrojejunostomy on Delayed Gastric Emptying After Pancreatoduodenectomy: Initial Results
Authors: Atici Ali Emre , Ozocak Ayşegul Bahar , Kayaci Ayse Eren , Ozturk Ecem Guclu , Kararmaz Alper , Yegen Sevket Cumhur
Published: June 2024

Background: Delayed gastric emptying (DGE) is one of the most common reasons for morbidity after pancreatoduodenectomy. Technical characteristics of anastomosis which you affect may offer a relevant chance to improve postoperative DGE rates. We investigated the effect of a technical modification of gastrojejunostomy after the classical pancreaticoduodenectomy on DGE.
Materials and Methods: A total of 144 patients underwent classical pancreaticoduodenectomy (with 20-40 per cent antrectomy) due to pancreatic adenocarcinoma at the Department of General Surgery, Marmara University, School of Medicine Hospital, from February 2019 to May 2013, and those who met the inclusion criteria were enrolled. 107 patients had undergone classical end-to-side gastrojejunostomy (Classical GJ group), and 37 had undergone Marmara-Yegen cutting partially side-to-side gastrojejunostomy (M-Yc group). The postoperative DGE rates of both groups were compared according to the International Study Group of Pancreatic Surgery (ISGPS) definition of DGE. In addition, a multivariate analysis of the influencing factors for DGE development and severity has also been conducted.
Results: The total incidence of DGE was 36.4% in the Classical GJ group and 21.6% in the (M-Yc group). Although there was no significant difference between the groups regarding DGE and DGE grade rates (p=0.097), DGE was distinctly lower in the M-Yc GJ group than the Classical GJ group. In the multivariate analysis determined the presence of intra-abdominal fluids/collections, the use of the ERCP route for biliary drainage, and PTBD as independent predictors for DGE.
Conclusions: We tried to clarify the mechanism of DGE from the anatomic configuration aspect. The incidence and severity of DGE decreased in patients who underwent M-Yc GJ.
PortableNet: An Automatical Diagnosis Method for Gastrointestinal Motility Analysis
Authors: Lin Junwu , Wu Xiaofang , Chen Qun , Guo Cunhan , Ma Liyi , Luo Shaoye , Huang Jiayan
Published: June 2024

Gastrointestinal motility serves as a crucial diagnostic indicator for functional gastric disorders. However, manual analysis of swallowing cloud images in gastrointestinal motility presents numerous drawbacks, including time-intensive processes, labor-intensive procedures, and subjectivity in diagnosis. In response to these challenges, we propose a gastrointestinal motility analysis model based on deep learning techniques to facilitate preliminary diagnosis of swallowing cloud images in gastrointestinal motility, thereby augmenting diagnostic efficiency for medical practitioners. Initially, we construct a gastrointestinal motility dataset. Subsequently, we introduce a light weight model, termed PortableNet, derived from MobileNet architecture. The research findings demonstrate that the PortableNet model achieves a recognition accuracy of 93.99% with only 4.3 million parameters. Compared to the MobileNet architecture model, there is a 5.05% increase in recognition accuracy and a 58.65% reduction in size. These results collectively indicate that the PortableNet model delivers superior overall performance, offering both high accuracy and efficiency in recognizing gastrointestinal motility swallowing cloud images. Such advancements can significantly enhance diagnostic efficiency among medical professionals, thereby offering valuable insights for future research endeavors.
Terson’s syndrome: sometimes a challenge diagnosis
Authors: Castaño-Martín Beatriz , Martin-Herrero Andrea , Pastora-Salvador Natalia , Prieto-Del-Cura Mar , Irache-Varona Iciar
Published: June 2024

Background:to highlight the importance of a complete ophthalmologic examination in patients with hemianopia.
Case presentation: a 19-year-old female patient who underwent craneotomy for hematoma and brain herniation due to ruptured left temporal arteriovenous malformation was referred to ophthalmology from neurosurgery due to right hemianopia complaints.
In the examination, she showed best-corrected visual acuity of 20/25 in right eye and 20/200 left eye, in confrontation campimetry temporal hemianopsia in right eye and not assessable in left eye due to low visual acuity. Funduscopic examination showed mild papillary paleness in right eye and central fibrinoid hemovitreous in left eye that required surgical vitrectomy with good evolution. After surgery, the patient presented an improvement in visual acuity, but not in her right homonymous hemianopia.
Conclusions: Terson’s syndrome diagnosis worsens the vital prognosis and clinical outcomes of patients with intracraneal hemorrhages and could seriously compromise the vision. Although imaging test detect most intraocular hemorrhages and some previous manuscript concluded that could replace routine ophtalmologic examinations, we found the presence of a visually significant vitreous hemorrhage inadvertent in previous serial imaging test.We want to emphasize, by this case report, the importance of funduscopy examination in patients with intracraneal hemorrhages even when radiological tests do not show intraocular hemorrhages.
Impact of depth of body cavity at the upper-right portion of the abdomen on open and laparoscopic liver resection of segment 7
Authors: Gon Hidetoshi , Komatsu Shohei , Soyama Hirotoshi , Tanaka Motofumi , Kido Masahiro , Fukushima Kenji , Urade Takeshi , So Shinichi , Yoshida Toshihiko , Arai Keisuke , Tsugawa Daisuke , Yanagimoto Hiroaki , Toyama Hirochika , Fukumoto Takumi
Published: June 2024

Purpose
The impact of body-cavity depth on open (OLR) and laparoscopic liver resection (LLR) of segment 7 remains unclear. Therefore, we investigated the influence of body-cavity depth at the upper-right portion of the abdomen on LLR and OLR of segment 7.
Methods
In total, 101 patients who underwent segment-7 liver resection over 2010–2023 were included. Body-cavity depth was measured from the abdominal-wall surface to the deepest site on the right side of the liver. Patients were categorized into shallow (< 18.4 cm) and deep (≥ 18.4 cm) populations based on median body-cavity depth. We compared surgical outcomes between OLR and LLR in shallow and deep populations after propensity-score adjustments.
Results
In OLR and LLR groups, 27 and 22 patients in the shallow population, respectively, and 26 and 26 patients were included in the deep population, respectively, were included. The OLR group in the deep population had significantly greater blood loss than the corresponding LLR group (difference: 144 mL, 95% confidence interval (CI): [50, 238], P = 0.004). Other surgical outcomes, including operative time, were similar between groups. In the shallow population, the OLR group had significantly shorter operative time (difference: − 54 mL, 95% CI: [–101, − 6], P = 0.028) and similar blood loss than the LLR group.
Conclusions
For segment-7 liver resection, LLR is likely favorable for patients with a deep body cavity, with similar operative time and lower blood loss compared to OLR. Body-cavity depth could be a useful indicator for determining the suitable surgical approach for segment-7 liver resection.
Monitoring and evaluation framework for Primary Health Care programmes and systems: a scoping review
Authors: Endalamaw Aklilu , Khatri Resham B , Erku Daniel , Zewdie Anteneh , Wolka Eskinder , Getahun Frehiwot , Assefa Yibeltal
Published: June 2024

Background: Primary health care (PHC) is a whole-of-society approach that strengthens the national health system and brings health services closer to communities. It encompasses health service provision, community engagement, and multisectoral action. The health system’s performance regarding PHC is expected to be evaluated based on these three perspectives. However, comprehensive evidence presenting the elements to be evaluated in each aspect of PHC was lacking. Therefore, we assessed essential elements to be considered in the PHC monitoring and evaluation processes.
Methods: We searched articles from PubMed, EMBASE, Web of Science, CINAHL, and PsycInfo. A complementary search of grey literature was conducted from Google Scholar, WHO website, Primary Health Care Program Initiative interface, and Google. We synthesised findings by bringing similar concepts into a common dimension based on predetermined set of activities, including identifying review questions, selecting relevant frameworks, extracting data, identifying domains, and categorising in major themes, The main themes are structure, input, process, output, and outcome.
Results: A total of 48 monitoring and evaluation frameworks were included. When evaluating PHC performance, it’s essential to consider population characteristics and contexts, including social, economic, cultural, and political factors. Existing population-based data sources should inform these assessments. Within the broader context, global and national health systems need to address effective system structures. Key components include governance, leadership, health financing, and alignment with population health needs. Inputs such as physical infrastructure, health workforce, medicines, health information, and digital technologies play a crucial role. Processes involve models of care, quality improvement systems, and resilient health facilities and services. Outputs in service delivery encompass access, availability, and quality of care. The goal of the PHC system is to improve health outcomes (reduced morbidity and mortality) and achieve health system objectives (equity, efficiency, resilience, and responsiveness).
Conclusions: The review identified areas of overlap within the three aspects of PHC. Many monitoring and evaluation frameworks lack comprehensiveness and uniformity, show differences between data sources, and use inadequate indicators. This review may offer insights for policy measures, clinical service enhancements, and community engagement strategies. It helps identify essential indicators towards the overarching goal of achieving universal health coverage, health security, and health system outcomes.
Retrospective analysis of multiparametric MRI in Predicting Complete Pathologic Response of Neo-adjuvant Chemotherapy in Bladder Cancer
Authors: De Maeseneer Daan , De Visschere Pieter , Broecke Mats Van den , Delbare Felix , Villeirs Geert , Verbeke Sofie , Fonteyne Valérie , Praet Charles Van , Decaestecker Karel , Decruyenaere Alexander , Rottey Sylvie
Published: June 2024

Background
Muscle invasive bladder cancer (MIBC) treatment combines systemic therapy and radical cystectomy (RC) or local (chemo-)radiotherapy. Response to systemic therapy is an important outcome predictor but is difficult to assess pre-operatively.
Methods
We analyzed multiparametric MRI (mpMRI) in consecutive MIBC patients receiving cisplatin-based neo-adjuvant chemotherapy at our institution. Two readers, blinded for pathological outcome, independently scored mpMRI before and after 2 and 4 cycles using both a qualitative 3-step method and nacVI-RADS. We analyzed accuracy of mpMRI scores to predict pathologic complete response (pCR) and inter-observer agreement.
Results
We analyzed 46 patients receiving NAC, 6 patients did not undergo RC after NAC and were excluded. Eleven out of 40 (28%) patients showed a pCR. mpMRI could be assessed in over 90% of patients. Radiographic complete response (rCR) using both methods was significantly associated with pCR, with an overall specificity of 96% and sensitivity of 36% and a high inter-observer agreement. rCR as assessed by the 3-step score was significantly associated with disease free survival (DFS) benefit.
Conclusion
The use of nacVI-RADS can predict pCR after NAC with high specificity but low sensitivity and a high inter-observer agreement. A 3-step score adds value in determining local residual disease, rCR assessed by this method could correlate with DFS benefit. mpMRI scores should be prospectively assessed in future trials of multimodal management of MIBC and can be a predictive asset in routine clinical management.
A Multi-disciplinary Analysis of the Portrait of Philip the Good in Dijon
Authors: Buti David , Cartechini Laura , Fontana Raffaella , Iwanicka Magdalena , Raffaelli Marco , Targowski Piotr , Verheyen Jan
Published: June 2024

One of the finest portraits of the Burgundian Duke Philip the Good resides in the Musée des Beaux-Arts in Dijon. This small yet exceptionally crafted panel holds significance for both historians and art historians alike. Surprisingly, prior to this study, the context, the dating and the authorship of the piece remained obscure, and the unfounded yet widely circulated hypothesis of it being "a copy of a lost portrait by Rogier van der Weyden" does not withstand critical analysis. Therefore, this painting underwent a multidisciplinary investigation spanning both the positive and human sciences. Macro-XRF scans were conducted alongside hyperspectral reflectance scans, multispectral imaging in the visible and infrared range, and optical coherence tomography. These analyses were complemented by an art historical study. As a result, a precise delineation between authentic and retouched sections was achieved. This article does not merely present the various perspectives separately but constructs a coherent narrative based on all these foundations. This holistic multidisciplinary research methodology produced a clear account, albeit with some scope for future inquiry. The involvement of the painter Pieter Cristus was conclusively demonstrated. This painter, whether himself personally, an assistant in the workshop or a contemporary follower, is attributed to the genesis of this work, which is presumed to be not the original portrait but a contemporaneous copy, possibly commissioned by the Burgundian Duke himself. While we no longer remain in the dark and have lifted some veils, this study also paves the way for further investigation into this panel and the numerous other portraits of Philip the Good.
Acute Cholecystitis Diagnosis in the Emergency Department: An Artificial Intelligence-based Approach
Authors: Saboorifar M. D. Hossein , Rahimi Mohammad , Babaahmadi Paria , Farokhzadeh Asal , Behjat Morteza , Tarokhian Aidin
Published: June 2024

Objectives
This study aimed to assess the diagnostic performance of a support vector machine (SVM) algorithm for acute cholecystitis and evaluate its effectiveness in accurately diagnosing this condition.
Methods
Using a retrospective analysis of patient data from a single center, individuals with abdominal pain lasting one week or less were included. The SVM model was trained and optimized using standard procedures. Model performance was assessed through sensitivity, specificity, accuracy, and AUC-ROC, with probability calibration evaluated using the Brier score.
Results
Among 534 patients, 198 (37.07%) were diagnosed with acute cholecystitis. The SVM model showed balanced performance, with a sensitivity of 83.08% (95% CI: 71.73–91.24%), a specificity of 80.21% (95% CI: 70.83–87.64%), and an accuracy of 81.37% (95% CI: 74.48–87.06%). The positive predictive value (PPV) was 73.97% (95% CI: 65.18–81.18%), the negative predictive value (NPV) was 87.50% (95% CI: 80.19–92.37%), and the AUC-ROC was 0.89 (95% CI: 0.85 to 0.93). The Brier score indicated well-calibrated probability estimates.
Conclusion
The SVM algorithm demonstrated promising potential for accurately diagnosing acute cholecystitis. Further refinement and validation are needed to enhance its reliability in clinical practice.
Risk factors for Hepatic failure after Transarterial Chemoembolization in patients with Hepatocellular carcinoma: A Systematic Review and Meta-Analysis
Authors: Prasitsumrit Vitchapong , Thiravetyan Ben , Sodsri Tulaton , Thongpiya Jerapas , Charoenngam Nipith
Published: June 2024

Background
Hepatic failure is a potentially fatal complication in hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE). However, there is a lack of clear predictive factors for hepatic failure after TACE in HCC patients.
Aims
The purpose of this study was to complete a systematic review and meta-analysis of the factors associated with post-TACE hepatic failure.
Methods
Medline and Embase databases were searched for original articles reporting predictive factors for hepatic failure after TACE. Mean differences (MD) or odds ratios (OR) were derived for each predictor and pooled using random-effects meta-analyses.
Results
Of 2,680 studies screened, a total of 1,654 patients across 9 studies were included in meta-analyses. Albumin (MD = 0.34, 95%CI -0.62-(-0.06)), total bilirubin (TB) (MD = 0.65, 95%CI 0.01–1.28), platelets count (MD = -15.82, 95%CI -20.91-(-10.72)), AFP (MD = 74.05, 95%CI 64.12–83.99), Model for End-Stage Liver Disease (MELD) (MD = 3.4, 95%CI 1.33–5.48), Child-Pugh score (CTP score) (MD = 1.06, 95%CI 0.84–1.28), CTP class (OR = 4.64, 95%CI 1.2-17.96), tumor size (MD = 7.75, 95%CI 6.87–8.63), portal vein thrombosis (OR = 1.78, 95%CI 1.19–2.67), and indocyanine green retention test after 15 minutes (ICG-R15 test) (MD = 16.58, 95%CI 11.92–21.24) were associated with hepatic failure after TACE.
Conclusions
In this meta-analysis, factors associated with hepatic failure in HCC patients undergoing TACE include low albumin and platelets, high TB, AFP, MELD score, CTP score and class, tumor size, presence of portal vein thrombosis and the high values of ICG-R15 test.
Exploring the impact of flow dynamics on deep-sea corrosion with a novel high-pressure bio-electrochemostat
Authors: Ivanovich Nicolò , Marsili Enrico , Shen Xinhui , Messinese Elena , Marcos Marcos , Rajala Pauliina , Lauro Federico
Published: June 2024

The formation of biofilms on metal surfaces contributes to the degradation of the metallic materials through a process known as microbially influenced corrosion (MIC). While MIC accounts for a substantial portion of the global corrosion-related costs, its study results particularly challenging when related to infrastructure deployed in extreme environments inhabited by microorganisms, such as the deep sea. Here, this limitation was addressed with a novel high-pressure bio-electrochemostat able to simulate the conditions of the deep sea more accurately than the traditional closed-batch setups. With this device, the corrosive capabilities of the piezophilic sulfate-reducing bacterium (SRB) Pseudodesulfovibrio profundus were analysed at atmospheric pressure and 30 MPa under flow and static conditions. The results highlighted the device's ability to closely replicate environmental conditions, thereby keeping bacterial communities metabolically active throughout the experiments and allowing for a more accurate assessment of the impact of MIC. Furthermore, the comparison between atmospheric and high hydrostatic pressures clearly showed that MIC represents a threat for metallic structures at the bottom of the ocean as much as at surface level.
Sensitively electrochemical determination of quercetin and folic acid with cobalt nanoparticle functionalized multi-walled carbon nanotube
Authors: Xu Yanxue , Gao Xilan , Tao Tao , Ji Lili , Liu Maoping , Zhang Xicui , Xiao Dan
Published: June 2024

A nanocomposite of cobalt nanoparticle (CoNPs) functionalized carbon nanotube (Co@CNT) was prepared to be modified on glassy carbon electrode (Co@CNT/GCE). Characterization indicates the morphology of Co@CNT is CoNPs adhering on CNTs. As the nano-interface, Co@CNT processes large surface area, highly catalytic activity and efficient electron transfer, makes Co@CNT/GCE exhibiting satisfactory electrochemical response toward quercetin (QC) and folic acid (FA). pH investigation indicates the same number of electron and proton involves in the redox process of the analytes, the optimized pH value for the detection of FA and QC is 7.0 and 3.0, respectively. The saturated absorption capacity (Γ*) and catalytic rate constant (kcat) of Co@CNT/GCE for QC and FA are calculated as 1.76×10− 9, 3.94×10− 10 mol∙cm− 2 and 3.04×102, 0.569×102 M− 1∙s− 1. The linear range for both of FA and QC is estimated to be 5.0 nM-10 µM, the LODs (3σ/s) were calculated as 2.30 nM and 2.50 nM, respectively. The contents of FA and QC in real samples determined by Co@CNT/GCE are approximate with the results determined by HPLC. The recoveries were in the range of 90.5%~114% and the total RSD was lower than 8.67%, further confirms the reliability of the proposed electrode for the practical detection.
Desmoplastic Small Round Cell Tumor: A Study of CT, MRI, PET/CT Multimodal Imaging Features and Their Correlations with Pathology
Authors: Xu Kaiwei , Chen yi , Shen Wenqi , Liu Fan , Wu Ruoyu , Ni Jiajing , Wang Linwei , chen Chunqu , Zhu Lubin , Zhou Weijian , Zhang Jian , zuo Changjing , wang jianhua
Published: June 2024

Purpose
Exploring the computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT Multimodal Imaging Characteristics of Desmoplastic Small Round Cell Tumor (DSRCT) to enhance the diagnostic proficiency of this condition.
Methods
A retrospective analysis was performed on clinical data and multimodal imaging manifestations (CT, MRI, FDG-PET/CT) of eight cases of DSRCT. These findings were systematically compared with pathological results to succinctly summarize imaging features and elucidate their associations with both clinical and pathological characteristics.
Results
All eight cases within this cohort exhibited abdominal-pelvic masses, comprising six solitary masses and two instances of multiple nodules, except for one case located in the left kidney, the remaining cases lacked a clear organ source. On plain images, seven cases exhibited patchy areas of low density within the masses, four cases showed calcification within the masses. Post-contrast imaging displayed mild-to-moderate, uneven enhancement. Larger masses displayed patchy areas without significant enhancement at the center. In the four MRI examinations, T1-weighted images exhibited uneven, low signal intensity, while T2-weighted images demonstrated uneven high signal intensity. Imaging unveiled four cases of liver metastasis, four cases of ascites, seven cases of lymph node metastasis, three cases of diffuse peritoneal thickening, and one case involving left ureter invasion with obstruction. In the FDG-PET/CT examinations of seven cases, multiple abnormal FDG accumulations were observed in the abdominal cavity, retroperitoneum, pelvis, and liver. One postoperative case revealed a new metastatic focus near the colonic hepatic region. The range of maximum standardized uptake values (SUVmax) for all lesions is 6.62–11.15.
Conclusions
DSRCT is commonly seen in young men, and the imaging results are mostly multiple lesions with no clear organ source. Other common findings include intratumoral calcification, liver metastasis, ascites, peritoneal metastasis, and retroperitoneal lymph node enlargement. The combined use of CT, MRI and FDG-PET/CT can improve the diagnostic accuracy and treatment evaluation of DSRCT. However, it is imperative to underscore that the definitive diagnosis remains contingent upon pathological examination.
A molecular gut content analysis reveals the feeding hosts of the Brown marmorated stink bug Halyomorpha halys
Authors: Fluch Maja Regina Amalie , Corretto Erika , Grella Nina , Fischnaller Stefanie , Schwembacher Stefan , Schuler Hannes
Published: June 2024

The Brown marmorated stink bug Halyomorpha halys is one of the most harmful invasive species worldwide. It is highly polyphagous with the ability to feed on more than 300 different plants. So far, most studies describe the different host plants based on visual observations, which allowed to diagnose the most important host plants in the invasive range in North America and Europe. However, the exact feeding behavior of this important pest species is not known. By applying a molecular gut content analysis approach to individuals collected in the field across the seasons, we investigated the feeding plants and the composition of plants which were ingested on an individual level. In total, we detected 65 different feeding host genera belonging to 37 families, with Salix, Robinia, and Malus being the most important genera. Moreover, we newly described eight plant genera as host plants of H. halys. The number of plant genera within single individuals ranged from one up to 17, highlighting a complex feeding behavior and supporting the highly polyphagous nature of this species. Beta diversity analysis of host plants over the seasons showed significant differences and highlights different feeding hosts in winter and summer months and overall a different range of host plants across the season. Our results provide new insights into the feeding behavior of H. halys and provide important knowledge about the biology of this important pest species.
Understanding medicine access strategies for innovative medicines registered in South Africa
Authors: Jama Thulasizwe Njabulo Qiniso , Suleman Fatima
Published: June 2024

Background
South Africa is composed of two tiers, viz. A private healthcare system that is funded through medical insurance, comprised of people who can afford to make monthly payments towards their medical insurance, and a government-funded public healthcare system, which covers the majority of the population. This study explored the barriers that exist in South Africa that hinder access to innovative medicines, along with the current strategies being utilised by the pharmaceutical industry to increase access to medicines.
Objectives
The objectives of the study were to (1) quantify and classify innovative medicines registered between 2010 and 2020 by the South African Health Products Regulatory Authority (SAHPRA), (2) identify barriers to accessing innovative medicines in South Africa through interviews with market access managers from innovator companies, and (3) explore the current market access strategies used by the pharmaceutical industry.
Design
This study employed a quantitative and qualitative methodology, whereby the former involved the extraction of a list of innovator medicines from the regulator database, and the latter involved 9 semi structured interviews. Purposive sampling was conducted through pharmaceutical association member companies. The interviews included seven market access managers and two medicine managers from one of the payers in South Africa. Thematic analysis was used to interpret the data collected from the study.
Results
According to the regulator database, during the review period, 238 innovative medicines were registered. Only 14.77 % were available in the public sector in the form of tenders, whereas in the private sector (based on the products having a SEP), 76.92 % were available. From the interviews, six themes emerged: reimbursement of medicines, types of reimbursement, partnerships, technology, legislative challenges, and other factors (e.g., real-world evidence).
Conclusion
Access to innovative medicines in South Africa is a challenge, as the price of these therapies is high. Therefore, various stakeholders in the health sector must collaborate to identify and implement solutions that are locally relevant. The government needs to proactively update policies that would allow for alternative reimbursement methods to be explored.
Design And Experimental Analysis of Pervious Concrete to attain Desired Compressive Strength
Authors: Singh Preetpal , Kaur Manmeet , Sharma Vishal
Published: June 2024

The pervious concrete is produced by using conventional cementitious materials, aggregates and water. In the present work pervious concrete is studied for its mix proportioning to study its various properties, such as cube compressive strength, split tensile strength, flexural strength and water permeability. The objective of the present study is to investigate the effect size of coarse aggregate, fine aggregate content, cement content and water cement ratio on the engineering properties of pervious concrete. Compressive strength tests were carried out in accordance with standard procedures, and specimens of pervious concrete were made using mix designs that were developed from the experimental design. The parameters of variation are size of coarse aggregates i.e. 10mm and 20mm (graded), w/c ratio i.e. 0.35 to 0.4, cement content i.e. 400 to 450kg/m3, fine aggregate content i.e. 0%, 5% and 10% by total weight of aggregates and cement: coarse aggregate ratio is maintained 1:4. To determine the possible interactions between the factors and determine the importance of each one, statistical analysis, including Analysis of Variance (ANOVA), was performed on the gathered data. The results show that several elements have a considerable impact on compressive strength, which can be used to optimize mix designs and reach the necessary strength levels. This study advances our knowledge of pervious concrete technology and provides useful advice for using it in building projects when certain compressive strength standards must be met.
The causal effect of autoimmune diseases on myelodysplastic syndrome:a Mendelian randomization study
Authors: Miao Zhengyang , Zhu Wenwei , Zhou Yongming , Chen Hailin
Published: June 2024

Background
The relationship between different types of autoimmune diseases and myelodysplastic syndrome (MDS) are inconclusive. Therefore,we employed Mendelian randomization (MR) to explore the causal associations between autoimmune diseases and MDS.
Methods
Single nucleotide polymorphisms (SNPs) significantly associated with 10 autoimmune diseases were extracted from the summary statistics of European genome-wide association studies (GWAS). A two-sample MR analysis was performed using summary-level statistics sourced from GWAS datasets. Inverse-variance weighting (IVW),MR‒Egger,and weighted median (WM) were further supported by several sensitivity analyses.
Results
Four autoimmune diseases showed genetical predisposition to MDS: rheumatoid arthritis(OR = 1.186,95%CI = 1.028–1.367, P = 0.019), multiple sclerosis(OR = 1.247,95%CI = 1.013–1.534, P = 0.037), myasthenia gravis(OR = 1.326,95%CI = 1.010–1.742, P = 0.042), and hashimoto thyroiditis(OR = 1.519,95%CI = 1.008–2.290, P = 0.046).Nevertheless,no similar causal relationship was found between the remaining seven autoimmune diseases and MDS.The accuracy and robustness of these findings were confirmed by sensitivity tests.
Conclusions
We are the first to use MR analysis to explore the causal relationships between autoimmune diseases and MDS.The mechanism of this causal link needs to be further explored.
Comparison of production performance and meat quality characteristics between Guizhou Black goats and F4 generation hybrids of South African Kalaha Goats
Authors: YAO Min , CHANG LingLe , XU SuYun , ZHANG Jing , Li Ping , Tian Bing , LUO Li , Yang DanPin , Long QingMeng , Zou Xiao
Published: June 2024

Results
(1) Reproductive and production performance: The lambing percentage (LP) reached 196%, significantly higher than GB and SK (p < 0.01), with a survival rate of 95.5%; 3-month-old daily weight gain (DWG) was 275.5 g, significantly surpassing GB (p < 0.01); adult body weight (ABW) reached 55.6 kg, with a slaughter rate (DP) of 53.5%, markedly higher than GB (p < 0.05). (2) In terms of meat quality: BKF4's overall meat quality falls between GB and SK, with two main influencing factors.The key factors affecting meat quality include pH45, intramuscular fat (IMF), nutrient index (NI), PUFAs / MUFAs, n-6 FAs, and drip loss (DL). pH45, water retention, and crude protein increased, while intramuscular fat content incresed compared to GB and ash content decreased. Amino acid composition is similar to GB, while taste is closer to SK. Nevertheless, the fatty acid composition and functionality had negative impacts. Continued improvement will be made through selective breeding and livestock management practices like feeding.
Nonlinear Memristive Computational Spectrometer
Authors: Chen Xiaoshuang , Li Xin , Wang Jie , Yu Feilong , Chen Jin , Li Guanhai , Lu Wei
Published: June 2024

In the domain of spectroscopy, miniaturization efforts frequently encounter notable challenges, particularly in achieving high spectral resolution and construction accuracy. Here, we introduce a computational spectrometer powered by a nonlinear photonic memristor featuring a WSe2 homojunction. This innovation overcomes traditional limitations, such as constrained Fermi level tunability, persistent dark current depression, and limited photoresponse dimensionality, by leveraging dynamic energy band modulation via palladium (Pd) ion migration. This approach engenders pronounced nonlinearities in the spectral response, significantly enhancing spectral resolution and measurement precision. By integrating this system with a bespoke nonlinear neural network, our spectrometer achieves unprecedented peak wavelength accuracy (0.18 nm) and spectral resolution (2 nm) over a comprehensive 400–800 nm bandwidth. This development heralds a paradigm shift towards compact, highly efficient spectroscopic instruments and establishes a versatile framework for their application across a broad spectrum of material systems.
Impact of Meloidogyne incognita Population Densities on Muskmelon Growth.
Authors: V BASAVARAJ , SHARADA M S , R SAMPATHKUMAR M , M MAHESH H
Published: June 2024

This study investigated the impact of varying initial population densities of the root-knot nematode Meloidogyne incognita on the growth of muskmelon (Cucumis melo L.). Muskmelon, an important fruit crop with increasing global recognition, faces the threat of Meloidogyne spp., particularly M. incognita, which significantly affects plant growth and yield. The experiment, conducted in a controlled glasshouse environment, involved inoculating muskmelon plants with different population densities of M. incognita ranging from 100 to 5000 J2 (infective second-stage juveniles). The study assessed growth and nematode reproduction parameters, at 15, 30, 45, 60, and 90 days after inoculation. The results revealed that M. incognita became pathogenic to muskmelon at inoculum levels of 500 J2 and above per plant. The crop exhibited significant reductions in shoot and root lengths, as well as fresh and dry weights. The study also documented changes in the nematode population in the soil, reproductive rates, and other growth parameters. These findings offer crucial insights into the relationship between nematode density and muskmelon growth, contributing to a better understanding of the dynamics of M. incognita infestation. These findings can aid in developing targeted strategies for managing nematode-induced losses in muskmelon cultivation.
Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study
Authors: Zhang Bin , Li Qing , Li Mingna , Wang Hao , Shen Jianan , Liu Qian , Deng Jia , Jiang Hongying , Zhao Zhanqi
Published: June 2024

Objective: The aim of this study was to assess the impact of speaking valve (SV) on ventilation changes, spontaneous effort and their potential effectiveness in difficult-to-decannulate patients with diverse medical conditions.
Methods:Patients with prolonged tracheostomy were included, who had been weaned from a ventilator for more than 48 hours, clinically stable and tolerance to the SV. Wearing time of the SV was extended continuously for 4 hours. Electrical impedance tomography (EIT) measurements were conducted at three time points: Tbaseline: prior to the SVs wearing; TSV ~ 3.5 hours after wearing the SVs; Tpost: 10 minutes after removal of SVs after a 4-hour SVs usage.
Results: A total of 102 patients were included for the final analysis. No adverse event was recorded in ECG. Oxygenation and respiratory rate were stable. Ventilation distribution was homogeneous in some patients but not in the other after 3.5 hours SV training. Ventilation distributed towards dorsal regions during SV (p<0.001). As spontaneous effort increased during SV, EIT-derived pendelluft increased in most of the patients as well (p<0.001). The correlations between the days to decannulation and the change of EIT-based parameters were significantly correlated (p<0.001). The highest correlations were between Days and temporal ventilation heterogeneity indices (r=0.61 and 0.57, intra-tidal gas distribution and pendelluft, respectively, p<0.001).
Conclusion: SV activated patients’ respiratory muscles by increasing the ventilation distribution portions in the dorsal regions, as well as introducing the temporal heterogeneity between ventral and dorsal regions. Such heterogeneity was associated with the day to decannulation.
Smad4 deficiency in hepatocytes
attenuates NAFLD progression via inhibition of lipogenesis and macrophage polarization
Authors: Zhang Jinhua , Yang Wei , Yan Xuanxuan , Xin Xin , Ge Shuang , Zhao Yongxiang , Yan Xinlong
Published: June 2024

Nonalcoholic fatty liver disease (NAFLD), a major cause of chronic liver disorders, has become a serious public health issue. Although the Smad4 signaling pathway has been implicated in the progression of NAFLD, the specific role of Smad4 in hepatocytes in NAFLD pathogenesis remains unclear. Hepatocyte-specific knockout Smad4 mice (AlbSmad4-/-) were first constructed using the Cre-Loxp recombinant system to establish a high-fat diet induced NAFLD model. The role of Smad4 in the occurrence and development of NAFLD was determined by monitoring the body weight of mice, detecting triglycerides and free fatty acids in serum and liver tissue homogenates, staining the tissue sections to observe the accumulation of liver fat, and RT-qPCR detecting the expression of genes related to lipogenesis, fatty acid intake and fatty acid β oxidation. The molecular mechanism of Smad4 in hepatocytes affecting NAFLD was therefore investigated through combining in vitro and in vivo experiments. Smad4 deficiency in hepatocytes mitigated NAFLD progression and decreased inflammatory cells infiltration. Moreover, Smad4 deficiency inhibited CXCL1 secretion by suppressing the activation of the ASK1/P38/JNK signaling pathway. Furthermore, targeting CXCL1 using CXCR2 inhibitors diminished hepatocyte lipogenesis and inhibited the polarization of M1-type macrophages. Collectively, these results suggested that Smad4 plays a vital role in exacerbating NAFLD and may be a promising candidate for anti-NAFLD therapy.
Women at Work: An International Perspective on the Interconnected Forces of Human Development, Female Education, and Labour Force Participation
Authors: Silva Malsha , Jayathilaka Ruwan , Peter Suren
Published: June 2024

The purpose of this study was to investigate the effects of the Human Development Index (HDI) and Tertiary School Enrolment Rate of Female (TSEF) on Female Labour Force Participation (FLPR) globally and by continent. Secondary data on sixty countries, including nine African countries, 18 Asian countries, 27 European countries, two North American countries, and four South American countries, were examined between 2000 and 2020. The Panel regression model was used to investigate the regional impact, and the Multiple Linear regression model was used to investigate the country-specific impact. The study found that HDI and TSEF are two significant factors influencing FLPR. When country-specific results were considered, the effect of each variable on FLPR revealed mixed results, with positive and negative impacts based on the characteristics of the selected country. The findings offer an in-depth understanding of how HDI and TSEF affect FLPR, which will aid policy makers in establishing and amending strategies to accelerate women's employment and, consequently, economics growth. This study focused on the HDI and TSEF variables that were rarely used in existing literature together on FLPR.
Clinical efficacy of CRN’s three-stage approach for the treatment of infected neuropathic diabetic foot：a retrospective study
Authors: Dong Qiang , Zuo Zhicheng , Li Qing , Zhu Zhenhua , Zhou Kailong
Published: June 2024

Background
Currently, clearing infections and repairing wounds are the main treatment for diabetic foot. However, statistics indicate that most cases of diabetic foot are caused by neuropathy alone or combined with vascular disease. In such cases, follow-up Neurotherapy plays a crucial role in managing diabetic foot patients. This study aimed to investigate the efficacy of using the CRN’s (Control infection, C; Repair wound, R; Neurolysis, N) three-stage approach in treating infected neuropathic diabetic foot.
Methods
A retrospective analysis was conducted on 84 diabetic foot patients with infection, ulceration, local gangrene, and neuropathy who were admitted to the Second Affiliated Hospital of Soochow University between March 2019 and March 2022. The treatment protocol involved complete surgical debridement in the first stage, wound repair surgery in the second stage, and the performance of Dellon triple neurolysis treatment three months after complete wound healing. The rate of foot sensory relief and the change of two-point discernment were compared before and after the operation.
Results
Following the operations, out of the 84 diabetic foot patients, 3 patients were treated with amputation due to progressive aggravation of infection and necrotizing fasciitis, while 81 underwent stages 2 and 3 of the treatment. Over an 8–18 months follow-up period, 3 patients were lost to follow-up, leaving 78 patients for analysis. Among them, 70 patients experienced successful wound healing without diabetic foot recurrence after the three-stage treatment, leading to successful limb preservation. 6 patients had diabetic foot recurrence but were readmitted for further treatment, resulting in successful wound repair and limb preservation. 2 patients passed away due to complications. Post-operation, neurologic symptoms improved in 76 patients who were followed up successfully, with a 95.9% foot sensory relief rate three months after the surgery, indicating positive outcomes. Additionally, two-point discrimination significantly improved three months post-surgery compared to pre-surgery levels, with statistical significance (P < 0.01).
Conclusion
The CRN’s three-stage surgical approach proves to be an effective method for treating infected neuropathic diabetic foot. It can shorten the hospital stay, regulate the treatment course, improve the limb-saving rate, and reduce the recurrence of diabetic foot.