bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and risk factors of overweight and obesity among children and adolescents in Hangzhou: a cross sectional study
Authors: Zhao Lijuan , Jiang Xiujun , Zhang Wenhui , Hao Li , Zhang Yuting , Wu Shangxi , Zhu Bing
Published: January 2024

Purpose To investigate the prevalence and influencing factors of overweight and obesity among primary and secondary school students in Hangzhou city, and provide ideas for the formulation of overweight and obesity prevention and control measures.Methods A total of 353,783 primary and middle school students in 13 districts of Hangzhou city were investigated with physical examination. Using a stratified cluster random sampling method, 6,148 students of primary and junior high school from 24 schools were investigated via questionnaires. Univariate and multivariate logistic regression were used to screen possible risk factors of overweight and obesity.Results The overall overweight and obesity rate was 27.20%, with the increase of the school period, the prevalence of overweight and obesity among students showing downtrend (χ2 = 14.47, P<0.01). The prevalence of overweight and obesity in girls is lower than that in boys (χ2 = 69.79, P<0.01); the prevalence of overweight and obesity in urban students is higher than that in suburban students (χ2 = 2.01, P = 0.02). High blood pressure, had menstruation or nocturnal emission, eating fresh fruit ≥ 1 time a day, daily brushing ≥ 2 times and bullying victimization are independently associated with higher prevalence of overweight and obesity. Moreover, the increased school period, girls and boarding student are protective factors for overweight and obesity.Conclusions The overweight and obesity prevalence among children and adolescents in Hangzhou is still at a relatively high level, and is affected by most factors such as high blood pressure, had menstruation or nocturnal emission, eating fresh fruit frequency, school period and gender, needing targeted intervention measures.
Shoreline evolution along Benin coast using satellite data through CASSIE Tool
Authors: BONOU Frederic , METEM Raïssa Christelle MADIESSEU , Almeida Luis Pedro , Angnuureng Donatus , Sohou Zacharie
Published: January 2024

Satellite imagery has been used to understand coastal dynamics. In order to better adapt to the impacts of climate change, it is imperative to continuously monitor coastal zones. To this end, automatic shoreline mapping and analysis tools such as Coastal Analyst System from Space Imagery Engine (CASSIE) are now in use. The aim of this study is to analyze the coastal dynamics along Benin coast, by assessing the rate of shoreline evolution generated by CASSIE tool basing on satellites images from 1984 to 2023, evaluating erosion trends over the entire Benin coastal zone, and determining the different hotspot along this coast. To assess the coastal features of the CASSIE tool, the method based on satellite data and the video camera system at Grand Popo was used, drawing on Sentinel 2 and Landsat data. It can be seen that shoreline generated by CASSIE are within the range of values read by the camera data. Cloudy images were rigorously eliminated. Nonetheless, shorelines detected by Sentinel2 moderately reproduce those in-situ and highlight the strong erosion trend evident during summer and mainly during July and August. In general, Benin's shoreline is marked by alternating, erosion, stability situation, accretion from Hilacondji to Cotonou . Zones of very strong erosion are recorded on beaches bordering protection structures (groynes) at the eastern part of Cotonou Harbor, which are classified as critical erosion with more than 15 m/year of erosion sites while significant accretion is obtained at western part of PAC over the period of 1984 to 2023.
Orthopaedic Surgeons' Attitude Toward Physical Activity for People after Total Hip or Knee replacement: Northern vs Southern European country
Authors: Zinno Raffaele , Akker-Scheek Inge , Pinelli Erika , Bragonzoni Laura , Stevens Martin , Mazzotta Alessandro , Iliescu Alina , Manunta Andrea Fabio , Marin Andreea , Dimitrova Ani , Stensdotter Ann-Katrin , Paggetti Cristiano , Dallari Dante , Tamburini Elena , Benvenuti Francesco , Pegreffi Francesco , Barone Giuseppe , Østerås Havard , Ciobanu Ileana , Dimitrov Ivo , Helbostad Jorunn Laegdheim , Yoncheva Lora , Massini Maria Scoppolini , Teodorescu Matei , Tsvetanova Maya , Berteanu Mihai , Unsgaard-Tøndel Monica , Shalamanova Natalya , Todorov Nicolay , Hals Odd Magne , Shalamanova Rumyana , Geli Simona , Cardinale Umberto , Mooiweer Yvet
Published: January 2024

Background:
Regular physical activity (PA) is a key factor of lifestyle behavior enhancing general health and fitness, especially in people after total hip or knee replacement (THR and TKR). Orthopedic surgeons can play a primary role in advocating the benefits of an active lifestyle. Aim of the study was 1) to assess the attitude of orthopaedic surgeons towards PA for people after THR/TKR and 2) to compare the attitude between a Northern European (the Netherlands) and a Southern European (Italy) country and analyze which factors influence the attitude towards PA.
Methods:
A cross-cultural study. An (online) survey was distributed among orthopaedic surgeons in Italy and the Netherlands. Exploratory factor analysis was employed to determine the underlying factor structure of the questionnaire. Chi-square and Mann-Whitney tests were used to compare surgeons’ and clinics’ characteristics, and questionnaires’ factors score, respectively. A linear regression analysis was conducted to assess which surgeon characteristics influence attitude towards PA.
Results:
A cohort of 159 surgeons (103 Italians and 56 Dutch) were analyzed. The median score of overall orthopaedic surgeons’ attitude towards PA was 57 (out of 72). Dutch surgeons showed a more positive attitude compared to Italian surgeons (p < 0.01). Main difference was found in the “Physical activity concern” factor, where Italian surgeons showed more concern about the negative effects of PA on the survival of the prosthesis. The regression analyses showed that “Country” and “Type of clinic” were associated with the surgeons’ attitude.
Conclusions:
Overall, the orthopaedic surgeons’ attitude towards PA for people with THR and TKR was positive. However, Dutch surgeons seem to be more positive compared to the Italian. The country of residence was the item that most influenced attitude. Further investigations are needed to untangle specific factors, such as cultural, socioeconomic, or contextual differences within the variable “country” that may influence orthopaedic surgeons' attitudes towards PA. Educational pathways of orthopaedic surgeons should involve the more recent knowledge about the benefits of PA and sport, since they have the potential to promote physically active lifestyle in people after THR and TKR and as such, enhancing the health of their patients.
A Multi-step Data Assimilation framework to investigate the effect of measurement uncertainty in the reduction of water distribution network model errors
Authors: Fayaz Ibrahim Miflal , Alfonso Leonardo , Gama Mario Castro
Published: January 2024

Water distribution network (WDN) models are a common decision support tool for understanding the behavior and performance of WDNs, aiding in the planning and management of WDN systems. The increasing availability of real-time data has recently promoted the exploration of Data Assimilation (DA) techniques to improve these models. However, flow, pressure and demand data are uncertain, particularly due to sensor characteristics such as precision and noise. An open question is to what extent DA can still improve hydraulic models when the data used to this end is uncertain. This paper proposes a three-step Ensemble Kalman Filter based DA approach for WDNs (3-EnKF-WDN), building on previous approaches, and advancing in two main fronts: the use of extended period simulation, and the use of pressure-dependent demand (PDD) analysis. Different scenarios considering uncertain sensor data, with varied precision and noise, are applied to two networks of different sizes, representative of real-world WDNs. The computational demand of the 3-EnKF-WDN method is also assessed. Results show that increasing sensor's precision and decreasing the noise in state measurements reduce model error, as expected. However, we also found that model errors: 1) are reduced more effectively by using 3-EnKF-WDN than by increasing sensors' precision; 2) are not reduced if certain noise thresholds are surpassed; 3) can be reduced without assimilating demand data if the WDNs are fully monitored with head sensors in all the nodes and flow sensors in all the links.
A moderately higher time-in-range threshold improves the prognosis of type-2 diabetes patients complicated with COVID-19
Authors: Cong Riping , Zhang Jianbo , Xu Lujia , Zhang Yujian , Wang Hao , Wang Jing , Wang Wei , Diao Yingli , Liu Haijiao , Zhang Jing , Tang Kuanxiao
Published: January 2024

After fully lifting coronavirus disease 2019 (COVID-19) pandemic control measures in mainland China in 12/2022, the incidence of COVID-19 has increased markedly, making it difficult to meet the general time-in-range (TIR) requirement. We investigated a more clinically practical TIR threshold and examined its association with the prognosis of COVID-19 patients with type-2 diabetes. Sixty-three type-2 diabetes patients complicated with COVID-19 were evaluated. Patient information included epidemiological and laboratory characteristics, treatment options and outcomes. The percentages of time-above-range (TAR), time-below-range (TBR) and TIR were calculated from intermittently scanned continuous glucose monitoring. The composite end point included a >20-day length of stay, intensive care unit admission, mechanical ventilation use, or death. TIR with thresholds of 80 to 190 mg/dL was significantly associated with favorable outcomes. An increase of 1% in TIR is connected with a reduction of 3.70% in the risk of adverse outcomes. The Youden index was highest when the TIR was 54.73%, and the sensitivity and specificity were 58.30% and 77.80%, respectively. After accounting for confounding variables, our analysis revealed that threshold target ranges (TARs) ranging from 200 mg/dL to 230 mg/dL significantly augmented the likelihood of adverse outcomes.The TIR threshold of 80 to 190 mg/dL has a comparatively high predictive value of the prognosis of COVID-19. TIR >54.73% was associated with a decreased risk of adverse outcomes. These findings provide clinically critical insights into possible avenues to improve outcomes for COVID-19 patients with type-2 diabetes.
Molecular systematics and taxonomy reveal three new wood-inhabiting fungal species (Basidiomycota) from southern China
Authors: Li Qi , Luo Yunxuan , Zhao Changlin
Published: January 2024

Three new wood-inhabiting fungal species, Lyomyces australis, L. lancangjiangensis and Mycobernardia yunnanensis are proposed based on a combination of morphological features and molecular evidence. Lyomyces australis is characterized by a smooth hymenophore, a monomitic hyphal system with the generative hyphae having clamp connections, the presence of fusoid cystidia, and ellipsoid basidiospores (4–5.3 × 2.5–3 µm); L. lancangjiangensis is characterized by a monomitic hyphal system with clamped generative hyphae, fusiform and capitate cystidia, and ellipsoid basidiospores (4.5–5.8 × 2.8–4.5 µm). Mycobernardia yunnanensis is characterized by a monomitic hyphal system with clamped generative hyphae, and allantoid basidiospores (4.5–6.3 × 2–3 µm). Sequences of ITS and nLSU rDNA markers of the studied samples were generated and phylogenetic analyses were performed with the maximum likelihood, maximum parsimony, and Bayesian inference methods. The phylogram inferred from the ITS dataset revealed that L. australis formed a monophyletic lineage and was grouped closely with L. crustosus, L. juniperi, L. niveus and L. ochraceoalbus. Additionally, L. lancangjiangensis grouped closely with L. albopulverulentus and L. bambusinus with strong supports. Sequences of the ITS + LSU rDNA markers of seven genera related to the genus Mycobernardia within the families Corticiaceae were generated and carried out the phylogenetic analyses, in which the result of the phylogenetic analysis indicated that the new species belong to the genus Mycobernardia, and the species M. yunnanensis was sister to M. incrustan.
e-Cigarette Use among Ecuadorian Students: A Comprehensive Study across Different Educational Levels
Authors: Cherrez-Ojeda Ivan , Osorio Maria F. , Robles-Velasco Karla , Calderón Juan C. , Faytong-Haro Marco , Queirolo Luis Stward , Cevallos-Levicek Denisse , Zevallos Juan C , Espinoza Fernando , Farber Harold J.
Published: January 2024

Introduction: Although the World Health Organization requires monitoring of e-cigarette use and up to 40% of youth who self-identified as Hispanic/Latino have reported the ever-use of electronic vapor products in the US, there has been limited research describing the prevalence and patterns of E-cigarette use in Latin America. For this reason, we aim to explore e-cigarette use among Ecuadorian students from various educational levels, such as primary, secondary, and university.
Methods: A cross-sectional was conducted in 2022 using the US Centers for Disease Control National Youth Tobacco Survey. Participants were students aged 10 years and older from Ecuador. They were categorized as never-, current- or former-users. The same categories were applied to combusted cigarettes. The IRB approval was HCK-CEISH-2022-003. Stata 17.0 was used to perform descriptive statistics and chi-squared tests to explore the associations between e-cigarette use and demographic variables.
Results: Of 3608 participants, 16% were current e-cigarette users, 21% former users and 63% never users. Among current users, 3.41% belonged to primary school, 25.3% to secondary and 61% to university. Age of initiation of an e-cigarette was 12 ± 4 years. More than half of current users has ever tried a combusted cigarette. 62% used disposable devices, 75% of surveyed vaped nicotine and more than 90% used flavored e-cigarettes, being fruit the most used flavor.
Conclusions: This is the first study to show the youth's e-cigarette use trends and preferences in Ecuador. Our findings point to a substantial public health risk for Ecuadorian youth.
Study on the Internal Flow State and Local Resistance of a Bend under Different Operating Conditions
Authors: Wang Jie , Song Chongfang , Pan Wuxuan , Yan Yajing , Zhao Ke
Published: January 2024

At present, to reduce the energy consumption of buildings and thereby decrease carbon emissions, the research on the internal flow mechanism of local components represented by elbows has been paid more and more attention in heating, cooling and water supply systems. In this paper, the study delves into the mechanisms behind fluid flow pattern changes in elbows, examining factors such as the causes of fluid flow pattern changes, the dynamic mechanisms of uneven pressure distribution, and mechanical properties. Comparative analyses were conducted on the changes in local resistance coefficient, center section velocity, and wall shear stress of elbows under various conditions. The results revealed that, the local resistance coefficients of bending pipes with different pipe diameters do not completely change according to the power function law at the same inlet flow velocity. Further analysis of the mechanical properties and dynamic mechanisms in elbows with these pipe diameters indicates that the observed results are attributed to various factors, including fluid velocity and wall shear stress. It is found that the result is caused by many factors such as fluid velocity and wall shear stress. With the increase of pipe diameter, the influence of the turning section on the fluid decreases, and the curvature effect of the pipe also weakens. This study offers theoretical insights for drag reduction optimization of local components in heating, cooling, and water supply pipelines.
Effect of Organic Fertilizer Solutions on the Growth and Yield of Tomato (Lycopersicon esculentum Mill.)
Authors: Rajapaksha Ishara , Vibodhani Nisansala , Harshana Maleesha , Jayathilaka Dilki , Munasinghe Udara , Bandara Shaliya , Jayamal Vishwa , Bandara Samadhi , Rathnayake Sanduni , Madusanka Harsha , Alahakoon Chamitha , Madushani Pamuditha , Kavinda Kasun , Wijesekara Nethmi , Wijesundara Imasha , Kodithuwakku Chamod , Balasooriya Chandu , Madushanka Tharindu , Rathnayaka Rathnayaka Mudiyanselage Sangeeth Maduranga Bandara
Published: January 2024

Tomato, a popular Sri Lankan vegetable, faces challenges in yields due to inadequate chemical fertilizer access, impacting growers' livelihoods. Therefore, this experiment was conducted to compare the effectiveness of the use of organic fertilizer solutions compared to the prevailing fertilizing practices. For that, recommended N, P, and K fertilizers (Chemical fertilizers), organic fertilizer solutions, organic fertilizer solutions + Albert’s solution and Albert’s solution only were tested. Two organic fertilizer solutions were prepared and applied aiming at two growth stages of the plant. The first solution included cow dung, Glyricidia leaves, and dried banana leaves. It was applied throughout the vegetative phase of the plant. The second solution included cow dung, Glyricidia leaves, egg shells, and banana peels and it was applied aiming at the reproductive stage of the plant. Results indicated that compared to the chemical fertilizers, the use of organic fertilizer solutions had a higher number of leaves per plant 12 weeks after planting (10.27 ± 0.45) and a higher root length (35.53 ± 3.22 cm) at the end of the life span. Also compared to the other treatments, they showed a higher fruit fresh weight (g) and a fruit diameter (cm). There were no significant differences (p < 0.05) among treatments for the Total Soluble Solid content (Brix %) and pH. Additionally, though the total weight of fruits per plant and the total number of fruits per plant were lower, better results were given with the plants treated with the organic fertilizer solutions.
Relationship between State Anxiety, Heart Rate Variability, and Shooting Performance in Adolescent Shooters
Authors: Zhao Chaochao , Wang Kun , Li Dan , Li Yan , Wang Zhuo , Liu Yongsen , Zhang Tingran
Published: January 2024

Objective
To investigate the key factors affecting the shooting performance of young shooters, and to reveal the correlation between pre-competition state anxiety, inter-competition heart rate variability (HRV), and shooting performance, to provide a basis and reference for scientific monitoring and evaluation of the athletic state of shooters.
Methods
A total of 45 adolescent shooters were selected in Chongqing, China, and completed 40 effective shots at self-pace in real shooting scenes. The pre-competition state anxiety, inter-competition HRV, and shooting performance of the athletes were monitored and evaluated respectively.
Results
1) There was a significant difference in the pre-match state anxiety of the adolescent shooters, which showed that the cognitive state anxiety and physical state anxiety of the first-level athletes were significantly lower than those of the second-level athletes, while the state confidence was significantly higher than that of the second-level athletes. 2) There were significant differences in HRV of athletes with different sports levels during the competition, showing that the RMSSD, TP, and HFn of the first-level athletes were significantly higher than those of second-level athletes, while LFn was significantly lower than the latter. 3) The shooting performance of first-level athletes was significantly better than that of second-level athletes. 4) Among adolescent shooters of different grades, there was a significant correlation between pre-competition state anxiety, inter-competition HRV, and shooting performance. The negative dimension of state anxiety was positively correlated with sympathetic activity in HRV, negatively correlated with parasympathetic activity, and negatively correlated with shooting performance. The positive dimension of state anxiety was negatively correlated with sympathetic activity in HRV, positively correlated with parasympathetic activity, and significantly positively correlated with motor performance.
Conclusion
Adolescent shooters with higher sports levels usually have better pre-competition mental state and emotional regulation ability, and could better maintain autonomic nerve dynamic balance and focus attention resources on shooting tasks during the competition, so it was easier to achieve good shooting performance. Meanwhile, pre-competition state anxiety and HRV during competition could be used as objective indicators to monitor and evaluate the competitive state of young shooters.
The effect of temperature on the current-carrying tribological behevior of C/Cu contact pairs in high humidity environments
Authors: Ji De-Hui , Xiao Li , Hu Qiang , Chen Siyang , Li Qiuping , Shen Mingxue
Published: January 2024

The environmental temperature alters the frictional behaviour by changing the state of the current-carrying contact interface, which makes the electrical contact invalid. In this work, the effects of three different temperatures (-20 ℃, 0, 20 ℃) on the current-carrying tribological behaviour of C-Cu tribo-pairs in high humidity environment (85%) were discussed. The evolution laws of friction coefficient, wear volume, contact surface properties, and contact resistance of C-Cu contact pairs under the coupling effect of temperature and current were studied, and the current- carrying wear mechanism of C-Cu at low temperature was analyzed in depth. The friction coefficient at each temperature exhibits a similar changing rule before and after current-carrying, demonstrating that the friction coefficient increases as temperature falls. However, the average friction coefficient at each temperature is lower than that without current. Although it will hasten the material surface's oxidation, a drop in ambient temperature will effectively lessen the transfer behavior of copper to carbon surface and reduce the wear volume of carbon material. The amount of copper transferred increases as current rises. Compared with the current, the change of temperature has a greater impact on the damage of tribo-pairs. At room temperature, the contact resistance under high current is greater than that of low current, the low temperature is just the opposite. In addition, at 0℃, although the contact resistance of low current (5 A) decreases significantly in the early stage of friction, its average resistance and fluctuation amplitude are the largest. As the temperature decreases, the current-carrying wear mechanism of C-Cu contact pairs gradually changes from adhesive wear to fatigue wear.
Drawing a line from CO2 emissions to health - Evaluation of medical students’ knowledge and attitudes towards climate change and health following a novel serious game: a mixed-methods study
Authors: Stevens Merel , Israel Adriana , Nusselder Anouk , Mattijsen Juliette C. , Chen Feng , Erasmus Vicki , Beeck Ed van , Otto Suzie
Published: January 2024

Background
Education is urgently needed to equip medical students with knowledge, values and skills to promote planetary health. However, the current literature offers little insight into evidence-based approaches and best practices. In response to this pressing need, a novel serious game was introduced into the medical curriculum at Erasmus Medical Center in 2023. The aim of this study was to evaluate the knowledge and attitudes of medical students after they had played a serious game that addresses climate change and health.
Methods
In accordance with a mixed-methods design, quantitative data were collected using pre- and post-intervention surveys. Differences were assessed using the Wilcoxon signed rank test. Focus group discussions were held after the game to explore the underlying mechanisms that led to the changes in knowledge and attitudes as identified in the survey. The transcripts were then thematically analysed.
Results
145 students played the game, of which 59 (40.7%) students completed the pre- and post-intervention surveys. After the game, self-reported knowledge and the proportion of students who recognized the importance of climate change education, to inform patients and society about the health impacts of climate change, significantly increased. Moreover, survey results indicated a significant increase in climate worry subsequent to the game. Eleven students participated in the focus group discussions. Thematic analysis highlighted participants’ reflections on the roles and responsibilities in climate change and health, along with their recognition of climate and health co-benefits as tools for action. Another significant aspect was the importance participants placed on learning alongside peers with diverse attitudes. Additionally, participants appreciated the tangible overview of climate change and health provided by the serious game.
Conclusions
Our novel serious game positively influenced medical students’ knowledge and attitudes towards climate change and health. The accompanying climate worry needs attention through the empowerment of students’ agency to foster change.
Updated Morphological and Immunohistochemical Profile of Neuroendocrine Tumors Developed in Ovarian Teratomas: A Large Series of a Rare and Heterogeneous Disease
Authors: Leclerc Julie , Genestie Catherine , Chen Ruiqian , Hentic Olivia , Koskas Martin , Gouy Sebastien , Scoazec Jean-Yves , Couvelard Anne , Bucau Margot
Published: January 2024

Introduction Ovarian carcinoid tumors are rare, often arising within a mature teratoma of the ovary. No recent reevaluation of the immunophenotype of these tumors with the new markers available in the field of neuroendocrine neoplasms has been performed. The objectives were to describe the morphological and immunohistochemical characteristics of neuroendocrine tumors (NETs) arising from ovarian teratomas, to correlate them with the type of teratomatous epithelial components present and to evaluate their proliferative capacities using the WHO recommendations for gastroenteropancreatic NETs. Materials and Methods This is a bi-centric retrospective study using a panel of differentiation markers (chromogranin-A, Synaptophysin, CDX2, SATB2, TTF1, PAX8, Islet-1, Serotonin and Calcitonin) and Ki-67 proliferation. Results The 34 NETs studied were unilateral and presented four distinct immunophenotypic profiles: 8 NETs expressed serotonin and CDX2 (small intestine profile), 12 SATB2 (colorectal profile), one TTF1 (thoracic profile) and 4 “null” cases expressed none of the above markers. Ki-67 index ranged from 0 to 19.82% (median: 1.51%). 28 cases were of grade 1 (84.8%), 5 grade of 2 (15.2%). They were associated with squamous (n = 26), respiratory (n = 23), thyroid (n = 10) and gastrointestinal (n = 5) components. Discussion and Conclusion The main type of NET is intestinal (large or small intestine) phenotype, but rarely accompanied with the corresponding digestive tissue in the surrounding teratoma. This suggests that the cell of origin might be a neuroendocrine precursor present in the teratoma, and confirms that primary NETs arising in ovarian teratoma should not be classified or named according to the type of the surrounding teratoma tissue.
Assessing the Clinical Impact of Cardiac Intensivists in Adult Cardiac Care Units: Results from the RESCUE registry
Authors: Bae Dae-Hwan , Lee Sang Yeub , Bae Jang-Whan , Yang Jeong Hoon , Ko Young-Guk , Ahn Chul-Min , Yu Cheol Woong , Chun Woo Jung , Jang Woo Jin , Kim Hyun-Joong , Kim Bum Sung , Kwon Sung Uk , Kim Je Sang , Lee Wang Soo , Jeong Jin-Ok , Park Sang-Don , Lim Seong-Hoon , Cho Sungsoo , Gwon Hyeon-Cheol
Published: January 2024

Background: Presence of dedicated intensive care unit (ICU) physicians is associated with reduced ICU mortality. However, the information available on the role of cardiac intensivists in cardiac intensive care units (CICU) is limited. Therefore, we investigated the association of cardiac intensivist–directed care with clinical outcomes in adult patients admitted to CICU.
Methods: In this retrospective study, we extracted data from the SMART-RESCUE registry, a multicenter, retrospective, and prospective registry of patients presenting with cardiogenic shock (CS). Overall, 1,247 patients with CS were enrolled, between January 2014 and December 2018, from 12 tertiary centers in Korea. The patients were categorized into two groups based on the involvement of a cardiac intensivist in their care. The primary outcome was in-hospital mortality rate.
Results: The all-cause mortality rate was 33.6%. The in-hospital mortality rate was lower (25.4%) in the cardiac intensivist group than in the non-cardiac intensivist group (40.1%). Cardiac death rates were 20.5 and 35.4% in the cardiac intensivist and non-cardiac intensivist groups, respectively. In patients undergoing extracorporeal membrane oxygenation, the mortality rate at centers with cardiac intensivists was 38.0%, whereas that at centers without cardiac intensivists was 62.2%. The dopamine use was lower, norepinephrine use was higher, and vasoactive-inotropic score was lower in the cardiac intensivist group than in the non-cardiac intensivist group.
Conclusion: Involvement of a cardiac intensivist in CICU patient care was associated with reduction in in-hospital mortality, and administration of low dose of vasopressors and inotropes according to the cardiogenic shock guidelines.
Evaluation of the performance of a CdZnTe-based soft gamma-ray detector for CubeSat payloads
Authors: Pal Partha Sarathi , de Kuijper Kees , Diwan Rishank , Kong Andy C. T. , Parkinson Pablo M. Saz , Ritter Andreas , Parker Quentin
Published: January 2024

The purpose of writing this paper is: The low-energy $\gamma$-ray (0.1-30 MeV) sky has been relatively unexplored since the decommissioning of the COMPTEL instrument on the Compton Gamma-Ray Observatory (CGRO) satellite in 2000. However, the study of this part of the energy spectrum (the ''MeV gap") is crucial for addressing numerous unresolved questions in high-energy and multi-messenger astrophysics. Although several large MeV $\gamma$-ray missions like AMEGO and e-ASTROGAM are being proposed, they are predominantly in the developmental phase, with launches not anticipated until the next decade at the earliest. In recent times, there has been a surge in proposed CubeSat missions as cost-effective and rapidly implementable ''pathfinder" alternatives. A MeV CubeSat dedicated to $\gamma$-ray astronomy has the potential to serve as a demonstrator for future, larger-scale MeV payloads. This paper presents a $\gamma$-ray payload design featuring a CdZnTe crystal calorimeter module developed by IDEAS. We report the detailed results of simulations to assess the performance of this proposed payload and compare it with those of previous $\gamma$-ray instruments.
Steatosis-associated fibrosis estimator (SAFE) score in Asian patients with metabolic dysfunction-associated steatotic liver disease (MASLD)
Authors: Kim Kunhee , Lee Hye Won , Lee Jae Seung , Kim Mi Na , Kim Beom Kyung , Kim Seung Up , Kim Do Young , Ahn Sang Hoon , Park Jun Yong
Published: January 2024

Background & Aims:
Recently, steatosis-associated fibrosis estimator (SAFE) score has been developed for predicting significant fibrosis in primary car. We externally validated the SAFE score in Asian patients with MASLD.
Approach & Results:
We validated the SAFE score in 6,229 patients who underwent transient elastography (TE) between 2012 to 2022. The sensitivities, specificities, negative predictive values, and positive predictive values of SAFE scores (two cut-offs: <0 and ≥ 100) for predicting fibrosis stage ≥ 2 were calculated. Based on TE results, SAFE score had an area under the receiver operating characteristic curve of 0.753 (95% confidence interval [CI] 0.737–0.769), outperforming the fibrosis-4 index (0.672) and NAFLD fibrosis score (0.663). Non-obese and obese patients had similar sensitivities (77.0% vs. 78.4%) and specificities (61.5% vs. 51.8%) for SAFE score < 0, and similar sensitivities (50.0% vs. 50.0%) and specificities (90.1% vs. 85.4%) for SAFE score ≥ 100. Sensitivity of the SAFE score for ≥ 100 increased by age, from 16.1% (age 19–30) to 79.7% (age ≥ 61), whereas specificity for ≥ 100 showed a decreasing trend.
Conclusions
We externally validated good performance of SAFE score in Asian patients. The SAFE score has potential as an initial assessment to identify low-risk population in a primary care setting.
Recreational sport-based activity improves psycho-emotional status in community-dwelling individuals living with substance abuse disorder
Authors: Guardia Lucio Della , Salvetti Moreno , Palombi Tommaso , Alivernini Fabio , Epifano Vincenza , Mariani Carlo , Lucidi Fabio , Chirico Andrea , Codella Roberto
Published: January 2024

Physical activity is known to improve mental well-being both in the general population and among individuals affected by various health conditions. This study aims to assess the effect of recreational sport-based physical activity (SBA) on depression, anxiety, and other parameters that measure mental wellness in a cohort of community-dwelling individuals living with substance use disorder. Twenty subjects (age: 26.1±3.2 years, mean±SD) participated in an 8-week training program. These subjects were randomly assigned to two groups: a) a group practicing sport-based physical activity; and b) a non-exercising group, performing as control. Depression and anxiety levels were assessed using the Beck Depression Inventory (BDI) and the PROMIS Anxiety Short Form, respectively. Additionally, insomnia and perceived stress were evaluated using the Insomnia Severity Index (ISI) and the Perceived Stress Scale (PSS). The PROMIS score significantly improved after 8 weeks of SBA in the treated group compared to controls (group × time; F1,29 = 5.58; p = 0.025), indicating that anxiety improved significantly following the intervention. The BDI score improved in the intervention group (-24,4; CI,11.5-37.4; p<0,0018), but no interaction was detected (group × time F1,29 = 5.58; p=0.23). No significant difference at 8 week was found also in the PSS and ISI score (PSS: F1,4.= 1.21; p = 0.35. ISI: F1,4 = 1.21; p=0.21). SBA significantly improved anxiety among community-dwelling individuals living with substance use disorder. Thereby, recreational sport-based activity may represent a viable and effective approach to enhance the mental health status in this class of subjects.
Cannabidiol protects against neurotoxic reactive astrocytes-induced neuronal death in mouse models of epilepsy
Authors: Ye Haojie , Wan Yuhui , Wang Xin , Wang Suji , Zhao Xiansen , Wang Xinshi , Yu Tianfu , Yan Chao , Chen Zhang-Peng , Liu Xiangyu
Published: January 2024

Reactive astrocytes play a critical role in the pathology of various neurological disorders, often resulting in neuronal damage and death. Accumulating evidences demonstrate that reactive astrocyte is an important component of glia scar of epileptic human brain, but the molecular subtyping and functional characterization of reactive astrocytes in the initiation and progression of epilepsy is not fully understood. In this study, we report the existence of neurotoxic reactive astrocytes, a novel defined reactive astrocyte subtype, that are pro-epileptic in the epileptic brain. In a kainic acid-induced mouse model of epilepsy, these neurotoxic reactive astrocytes are induced by microglia-secreted cytokines IL-1α, TNFα, and C1q and formed in the mouse brain as early as seven days post kainic acid stimulation. These cells exhibit a distinct molecular signature marked by elevated expression of complement 3 and adenosine 2A receptor. Transcriptomics and metabolomics analyses using brain tissues from patients with temporal lobe epilepsy and epileptic mice reveal that neurotoxic reactive astrocytes contribute to neuronal loss through lipid-related mechanisms. Moreover, our study demonstrated that the anti-epileptic drug cannabidiol and an adenosine 2A receptor antagonist can suppress the formation of neurotoxic reactive astrocytes. These compounds also exhibit pronounced effects in inhibiting gliosis and neuronal loss in mouse models of epilepsy. Electrophysiological and behavioral studies provide compelling evidences that cannabidiol attenuates seizure symptoms and enhances memory capabilities in epileptic mice. Our findings suggest that neurotoxic reactive astrocytes are formed at an early stage in the epileptic mouse brain and can lead to neuronal death through releasing toxic lipids. Importantly, cannabidiol and adenosine 2A receptor antagonist emerge as promising therapeutic candidates for epilepsy treatment. Our study provides valuable insights into the mechanism of action of cannabidiol in epilepsy and opens avenues for targeted interventions against neurotoxic reactive astrocytes in neurological disorders.
Retinal Microperimetry as a Novel Tool for Early Detection of Cognitive Dysfunction and Brain Damage in Type 1 Diabetes: A Pilot Study
Authors: Mateu-Salat Manel , Stanton-Yonge Nicole , Santaló Frederic Sampedro , Vela José Ignacio , Cascajosa Jesús Díaz , Pérez Eva Safont , Chico Ana
Published: January 2024

Context: Retinal microperimetry (MPR) is a non-invasive method that measures retinal light sensitivity and gaze fixation stability (GFS). MPR has been described as an early marker of cognitive impairment in people with type 2 diabetes. Our group described subclinical cognitive alterations, structural brain differences, and increased levels of light chain neurofilament (NfL) in people with type 1 diabetes (T1D) and impaired awareness of hypoglycemia. The utility of MPR has not been described in T1D. Objective: to measure RS and GFS using MPR in individuals with T1D and evaluate possible differences depending on hypoglycemia awareness (IAH vs NAH). Secondary objectives: to perform a secondary analysis of correlation between MPR findings with neuropsychological assessment, plasma NfL levels, structural GM, and WM changes, and CGM-derived glucometric parameters, independently of hypoglycemia awareness. Design, setting and participants: Pilot observational study, adult people with type 1 diabetes without cognitive impairment, moderate-severe retinopathy, or glaucoma. MPR was performed with MAIA3. Results: 30 subjects were studied: 40% women, age 58 ± 11 years; T1D duration 31 ± 9 years, mild retinopathy 33%. RS was 27.5 dB (26.1–28.3) and GFS 97.6% (93.5–99.5%). We found a significant correlation between RS and memory alteration tests (p = 0.016) and between GFS and a composite of attention and executive neuropsychological tests (p = 0.025); between RS and insular cortical thickness (p = 0.04); RS and the right hippocampal volume (p = 0.02); and between GFS and the fractional anisotropy of thalamic radiations (p = 0.04). An inverse correlation between GFS and time below range was found. No correlation was found with NfL. Conclusion: Our exploratory study supports the potential utility of MPR as a screening tool for neurocognitive alterations and incipient structural brain damage in people with T1D.
Unraveling Precipitation Trends and Variability under the Influence of Climate Change in the Navsari District of Gujarat
Authors: Delvadiya Jay , Garde Y. A. , Thorat V. S. , Parmar P. K. , Varshney Nitin , Shrivastava Alok
Published: January 2024

Studying the variability of rainfall holds significant importance in the dominion of agriculture. To facilitate the optimal planting of crops in the face of climate fluctuations, agro-meteorologists predominantly depend on rainfall distributions. These distributions serve as a crucial tool for understanding the rainfall patterns within a specific area. This study undertakes a thorough examination of precipitation trends in the Navsari district of Gujarat, spanning the years 1983 to 2022 under the influence of climate change. The study utilized descriptive statistics to assess the characteristics of rainfall, while the Mann-Kendall test is utilized to determine the trend in rainfall patterns. Additionally, the Standard Precipitation Index (SPI) is calculated to quantify the degree of wetness in the region. It was observed that over the four decades, Navsari witnessed an annual mean rainfall of 1662.59 mm, accompanied by a standard deviation of 475.73 mm and a Coefficient of Variation (CV) of 28.61%, indicating notable inconsistency in annual rainfall. Onset delays were observed in five years, with notable delays in 1986, 1992, and 2005. Withdrawal delays occurred in seventeen years, ranging from 7 to more than 15 days. The normal monsoon duration of 111 days was exceeded in fourteen years but curtailed in twenty-six years, with 1996 experiencing the highest and 1986 the lowest monsoon days. Additionally, in the last decade, a noticeable increase in very wet months was observed. Season-wise SPI analysis identified extreme wet conditions in post-monsoon (1983, 1999), winter (1994, 2014), and pre-monsoon seasons.
Low-dose aspirin use does not increase disease activity in pregnant patients with Inflammatory Bowel Disease
Authors: DeBolt Chelsea A. , Gottlieb Zoë S. , Rao Manasa G. , Johnson Shaelyn , Rekawek Patricia , Deshpande Richa , Meislin Rachel , Berkin Jill , Bianco Angela , Mella Maria Teresa , Dubinsky Marla C.
Published: January 2024

Background: The adverse effects of nonsteroidal anti-inflammatory (NSAID) drugs on the gastrointestinal system are well recognized, but the effect of NSAID use on disease activity patients with inflammatory bowel disease (IBD) remains unresolved. Low-dose aspirin (LDA) is recommended for all pregnant patients with risk factors for developing preeclampsia, including autoimmune conditions. As recognition of risk factors for preeclampsia improves, the preventative use of LDA is likely to increase.
Aims: To investigate if LDA use for prevention of preeclampsia increases the risk of disease activity in pregnant women with IBD.
Methods: Single-center retrospective cohort study of pregnant patients with IBD who delivered from 2012-2020, comparing those with and without LDA use. Primary outcome was odds of clinical IBD activity in patients in remission at time of conception. Secondary outcomes were rate of elevated inflammatory biomarkers, defined as C-reactive protein >5 ug/mL or fecal calprotectin >250 ug/g, and rate of preeclampsia. Univariate and multivariate tested for associations.
Results: Patients taking LDA were older (p=0.003) and more likely to have chronic hypertension (p=0.002), to have undergone in vitro fertilization (p < 0.001), and to be on biologics (p=0.03). Among patients in remission at conception, there was no difference in clinical disease activity or biomarker elevation during pregnancy based on LDA use (OR 1.27, 95% CI [0.55-2.94], p=0.6). Rates of preeclampsia were similar between groups.
Conclusion: LDA use for preeclampsia prevention did not increase the incidence of IBD activity in pregnant patients with IBD.
A Hybrid NOMA/OFDM Model for Next Generation Communication Systems
Authors: Hussein Abdulmutalib A-Wahab , Bouallegue Ammar
Published: January 2024

Visible light communication (VLC) is an innovative optical wireless communication (OWC) technology that can provide both lighting and high-speed wireless data transmission. Another advantages of VLC system that allow for a wide range of applications are its fast data rate, reliable communication channels, and interference protection against electromagnetic (EM) waves. Light Emitting Diodes (LEDs) are used as transmitters while Photodetectors are utilized at the receiver side. The LED has to be supplied with a positive real valued signal. Orthogonal frequency division multiplexing (OFDM) uses multiple subcarriers with orthogonal frequencies to enhance the spectral efficiency of the system. There are two types of unipolar OFDM used to obtain real-valued and positive signal, they are DC-biased optical OFDM (DCO-OFDM) and asymmetrically clipped optical OFDM (ACO-OFDM). A hybrid design NOMA/OFDM is introduced in this paper to be able to study the performance of the VLC system. Three users are positioned in different spots throughout an interior environment. User1 is considered as the farthest user with lower channel gain while user3 is the near user that has high channel gain. The bit error rate (BER) is estimated for the three users vs. the SNR with different power allocation coefficients. The results show that NOMA/ACO-OFDM performs better than NOMA/DCO-OFDM. Also, the BER of the three users converges to each other with the increasing of the SNR for the two models.
Analyzing Evaluation Methods for Large Language Models in the Medical Field: A Scoping Review
Authors: Lee Junbok , Park Sungkyung , Shin Jaeyong , Cho Belong
Published: January 2024

Background: Owing to the rapid growth in popularity of Large Language Models (LLM), various performance evaluation studies have been conducted to confirm their applicability in the medical field. However, there is still no clear framework for an LLM evaluation.
Objective: By reviewing studies on LLM evaluations in the medical field and analyzing the research methods used in these studies, this study aims to provide a reference for future researchers designing LLM studies.
Methods & Materials: We conducted a scoping review of three databases (PubMed, Embase, and MEDLINE) to identify LLMs published between January 1, 2023, and September 30, 2023. We analyzed the method type, number of questions (queries), evaluators, repeat measurements, additional analysis methods, engineered prompts, and metrics other than accuracy.
Results: A total of 142 articles met the inclusion criteria. The LLM evaluation was primarily categorized as either providing test examinations (n=53, 37.3%) or being evaluated by a medical professional (n=80, 56.3%), with some hybrid cases (n=5, 3.5%) or a combination of the two (n=4, 2.8%). Most studies had 100 or fewer questions (n=18, 29.0%), 15 (24.2%) performed repeated measurements, 18 (29.0%) performed additional analyses, and 8 (12.9%) used prompt engineering. For medical assessment, most studies had 50 or fewer queries (n=54, 64.3%), most studies had two evaluators (n=43, 48.3%), and 14 (14.7%) used prompt engineering.
Conclusions: More research is required regarding the application of LLMs in healthcare. Although previous studies have evaluated performance, future studies will likely focus on improving performance. For these studies to be conducted systematically, a well-structured methodology must be designed.