bluuebunny/crossref_metadata_2025 huggingface dataset:
A Retrospective Comparative Chart Review of Hearing Recovery in Neural and Sensory Type Sudden Sensorineural Hearing Loss Patients
Authors: Xu Rebecca Z. , Wijesinghe Printha , Guo Ru C. , Joshua Temitope G. , Ayub Aysha , Lee Melissa , Nunez Desmond A.
Published: June 2023

Background
The pathogenesis of Sudden Sensorineural Hearing Loss is complex, and the prognosis for recovery is variable. While the pathological lesion is thought to be localized to the cochlea, recent microRNA findings suggest a primarily neuro-topic pathogenesis at least in some patients. This study seeks to use established hearing-loss categorization systems to distinguish neural from non-neural hearing loss patients and determine if the two groups differ in functional recovery.
Methods
The Charts of 132 Sudden Sensorineural Hearing Loss patients presenting at Vancouver General Hospital (November 2013-June 2019) were retrospectively reviewed. Patients’ characteristics, treatment modality, Pure Tone Audiometric thresholds (averaged across four frequencies: 0.5, 1, 2, and 3 kHz), and Word Recognition Scores were collected. Neural type Sudden Sensorineural Hearing Loss was defined as a presenting Word Recognition Score (<60%), with a Word Recognition Score reduction 20% greater than expected based on the averaged pure tone audiometric loss. Hearing recovery was defined as an improvement of ≥ 10 decibels in pure tone audiometric thresholds.
Results
48 patients meeting the American Academy of Otolaryngology Head and Neck Surgery 2019 diagnostic criteria and with comprehensive data were included. 12 (mean age ± standard deviation: 57.7±14.9 years) and 36 (55.3±15.2 years) patients were classified as neural and sensory Sudden Sensorineural Hearing Loss, respectively. 66.7% (8/12) and (24/36) of neural and non-neural Sudden Sensorineural hearing loss patients, respectively demonstrated hearing recovery. The affected ear’s initial Word Recognition Score (mean ± standard deviation %): 17.1±17.6 and 71.5±35.5 (p < 0.0001), and Word Recognition Score change with treatment: 46.9±29.8 and 3.2±25.8 (p < 0.0001), in neural and non-neural patients, respectively were significantly different.
Conclusion
The hearing recovery rate in neural and sensory type Sudden Sensorineural Hearing Loss patients was similar. Patients with a neural type of hearing loss demonstrated greater word recognition score recovery after treatment than those in the sensory group.
Cardioprotective effects of metformin and alpha lipoic acid against myocardial complications induced by hypothyroidism in rats
Authors: Khadawy Yasser A , Hosny Eman N , Abou-Seif Howida Sayed , Morsy Fatma A , Sawie Hussein G
Published: June 2023

The therapeutic effects of alpha lipoic acid (LA) and metformin (MET) against the myocardial complications associated with hypothyroidism were assessed in the current study. Rats were divided into three groups: control, hypothyroidism model induced by propylthiouracil (PTU), hypothyroidism model treated with LA and/or MET. At the end of the experiment, the thyroid hormones (T3, T4 and TSH) were measured in the serum. Lipid peroxidation (MDA), nitric oxide (NO), reduced glutathione (GSH), NrF2, BCL2, NF-κB, serotonin (5-HT), norepinephrine (NE) and dopamine (DA), acetylcholinesterase (AchE), monoamine oxidase (MAO) and Na+,K+,ATPase were measured in the cardiac tissue. The histopathological changes were also examined. PTU significantly decreased T3 and T4 and significantly increased TSH. A significant increase in MDA, GSH, NrF2, BCL2, NF-κB, 5-HT, NE, DA, AchE, MAO and Na+,K+,ATPase and a significant decrease in NO were observed in the cardiac tissue of hypothyroidism model. This was associated with histopathological changes. LA alone or with MET restored T3 and TSH and improved almost all the biochemical changes except the decreased NO and the increased DA in the cardiac tissue. MET restored T3, T4 and TSH and the biochemical changes induced in the cardiac tissue. MET ameliorated the histopathological changes that were still observed with LA alone or in combination with MET. The present findings indicate that MET had cardioprotective effect against hypothyroidism and its myocardial complications. This effect was less prominent with LA alone or in combination with MET. No synergistic effect was observed between LA and MET.
The Utility of Genomics and Functional Imaging to Predict Sunitinib Pharmacokinetics and Pharmacodynamics: The Predict Su Study
Authors: Michael Michael , Toner Guy C. , Ganju Vinod , Link Emma , Thompson Mick , Matera Anetta , Hicks Rodney J , Campbell Ian , Rowley S , Karapetis Christos S , Burge Matthew , Pook David W
Published: June 2023

Purpose: Sunitinib has marked pharmacokinetic (PK) & pharmacodynamic (PD) interpatient variability. This study evaluated the utility of extensive excretory/metabolic/PD pharmacogenomics (PGx) with hepatic functional imaging (HNI) to explore associations with Sunitinib PK/PD (toxicity/response) and progression-free survival (PFS).
Methods: Eligible patients (pts) suitable for Sunitinb therapy. At baseline: (i) PGx: blood analyzed by the Affymetrix-DMET™-Plus-Array (1936 variants/225 genes) and Sanger sequencing (HNF1A, FLT3, VEGFR2, VEGFR3, RET, PDGFRα, TNFα). (ii) HNI: pts given IV 800MBq 99mTc-MIBI, imaging data analysed for hepatic extraction/excretion parameters (CLHNI, T1/2-HNI, 1hRET, HEF, Td1/2). In cycles 1 and 2, bloods taken for sunitinib parent (SU), metabolite (SU12662), and Total SU (metabolite + parent) PK. Associations evaluated between (i) HNI parameters and (2) PGx, with Sunitinib PK, toxicity/response and PFS.
Results: N = 15 pts. The two most significant associations in either direction between PGx variants or HNI parameters (P <0.05) for: (i) PK included: (a) SU logAUC0-14days with HEF, ATP7B-(rs1801246), UGT8-(rs4148254), (b) SU logAUC0-28days, with Td1/2, SLC15A1-(rs8187832), SLC10A2-(rs188096), (c) SU Css, with Td1/2, SLC15A1-(rs8187832) (d) SU Ctrough with TNFα-(rs1799724), ATP7B-(rs1801246), (e) Total SU logAUC0-14days with Td1/2, TNFα-(rs1799724), (f) Total SU logAUC0-28days with Td1/2 and SLCO3A1-(rs2283458), (g) Total SU Css and Td1/2, UGT8-(rs4148254) and (h) Total SU Ctrough with SLC16A1-(rs11585690). (ii) Toxicity (a) Diarrhea Gr1+ with HEF, VEFGR3-(rs307826), AKAP9-(rs7785971) (b) ≥Grade 3 AEs with CBR1-(rs998383) (iii) Overall response rate with SULT1E1-(rs1881668), GSTA2-(rs2180314) (Iv) PFS with CYP4Z1-(rs4926802) and CYP2A6-(rs28399442).
Conclusions: Exploratory associations were observed between Sunitinib PK/PD with hepatic functional imaging with extensive pharmacogenomics. Further validation is required
Machine learning algorithms-based spam detection in social networks
Authors: Sumathi M. , Raja S. P.
Published: June 2023

Many social media platforms have emerged as a result of the online social network's (OSN) rapid expansion. They have become important in day-to-day life, and spammers have turned their attention to them. Spam detection is done in two different ways, such as machine learning (ML) and expert-based detection. The expert-based detection technique’s accuracy depends on expert knowledge, and the manual process is a time consuming task. Thus, ML-based spam detection is preferred in OSN. Spam identification on social networks is a difficult operation involving a variety of factors, and spam and ham have resulted in an imbalanced data distribution, which gives an advantage to spammers for corrupting our devices. Spam detection based on ML algorithms like Logistic Regression (LR), K-Nearest Neighbor (KNN), Decision Trees (DT), Random Forest (RF), Support Vector Machine (SVM), and XGB, Voting Classifier (VC), and many other algorithms are used to design the address balance and to attain high assessment accuracy. There is a non-balance issue. Text is vectorized by vectorizers and all the relative results are stored. The experimental result shows that, as compared to KN, NB, ETC, RF, SVC, LR, XGB, and DT, the proposed VC provides a higher classification accuracy rate of 97.96%. The proposed methods are effective in identifying balanced and imbalanced datasets, as evidenced by the validation results. The website was created to detect messages as spam or not.
Analyzing the invasive front of colorectal cancer – by punching tissue block or laser capture microdissection?
Authors: Pavlič Ana , Urh Kristian , Boštjančič Emanuela , Zidar Nina
Published: June 2023

Background
The aim of this study was to determine the advantages and limitations of two commonly used sampling techniques, i.e., punching tissue block and laser capture microdissection when investigating tumor cell-derived gene expression patterns at the invasive front of colorectal cancer (CRC).
Methods
We obtained samples from 20 surgically removed CRCs at locations crucial for tumor progression, i.e., the central part, the expansive front and the infiltrative front exhibiting tumor budding, using both sampling techniques. At each location, we separately analyzed the expressions of miR-200 family (miR-141, miR-200a, miR-200b, miR-200c and miR-429), known as reliable markers of epithelial-mesenchymal transition.
Results
We found significant downregulation of all members of miR-200 family at the infiltrative front in comparison to the central part regardless of the used sampling technique. However, when comparing miR-200 expression between the expansive and the infiltrative front, we found significant downregulation of all tested miR-200 at the infiltrative front only in samples obtained by laser capture microdissection.
Conclusions
Our results suggest that punching tissue block is an adequate technique for studying the differences in tumor gene expression between the central part and the invasive front of CRC, but is insufficient to analyze and compare morphologically distinct patterns along the invasive front including tumor budding. For this purpose, the use of laser capture microdissection is essential.
“It Just Made Me Feel Better": Qualitative Examination of the Implementation of a Novel Virtual Psychosocial Support Program for Adolescents with Cancer
Authors: Kilfoy Alicia , Panesar Prabdeep , Hashemi Elham , Masama Tatenda , Pereira Myra , Liu William , Alexander Sarah , Korenblum Chana , Jibb Lindsay
Published: June 2023

Purpose
Adolescents with cancer routinely report feelings of isolation and exclusion, including from medical decision-making. To address this problem and support adolescents, we designed and implemented the novel, virtual, weekly Teens4Teens peer support group and patient education program. We examined the views of participating adolescents, program guest speakers, and program moderators as they pertained to the need for the program, its feasibility, acceptability, and perceived impact.
Methods
We recruited all available adolescents, moderators, and guest speakers who participated in Teens4Teens to take part in audio-recorded, semi-structured interviews. Interviews were transcribed, coded, and analyzed using thematic analysis.
Results
We conducted 21 interviews across participant groups. We identified four broad themes: pathways into the Teen4Teens program, Teens4Teens implementation capacity, perspectives of the positive impact of Teens4Teens and suggestions to improve Teens4Teens. These themes described a perceived need for adolescent-centered psychosocial programing in pediatric cancer care, provided lessons on how best to build and apply such a program, and highlighted the value of the program for both adolescents and clinicians' acceptability, feasibility, and perceived utility.
Conclusion
Adolescents, guest speakers, and moderators valued Teens4Teens and made suggestions to improve capacity to routinely implement the program. Adolescent-tailored psychosocial programming such as Teens4Teens is positioned to be integrated into clinical care with relative ease and may serve to improve the cancer care experience of adolescents and their families. This study has potential to provide researchers and clinicians with valuable information about the content, design, and delivery of virtual peer support programming for adolescents with cancer.
Recycling ABS from WEEE with peroxo- modified surface of titanium dioxide particles: alteration on antistatic and degradation properties
Authors: Oliveira Iago. M. , Gimenez Jessica C. F. , Xavier Gabriela T. M. , Ferreira Marco A. B. , Silva Caio M. P. , Camargo Emerson R. , Cruz Sandra A.
Published: June 2023

The increasing concern about plastic disposal and its impact on the environment has led to the necessity to reuse these materials, completing their life cycle within the circular economy mentality: production, use, recycling, and reuse. One of the residues that has caused great concern is the so-called waste electrical and electronic equipment (WEEE). The reintroduction of a recycled material back into the market requires some type of modification since the recycling process lightly alters the general properties of those materials. In this work, we studied the recycling of ABS - one of the polymers most found in waste electrical and electronic equipment - and its modification through commercial titanium dioxide (TiO2) and modified with peroxide groups (TiO2 – OPM). The TiO2 – OPM have interesting electrical properties due to their lower band gap values, which results in them being good candidates for the modification of recycled polymers for WEEE applications. For this, different percentages of particles were incorporated into ABS from the electro-electronic industry. Aspects of degradation, rheology, and antistatic were analyzed. A good interaction between the particle and polymer is observed, especially for those modified with the peroxo group. Nevertheless, it is observed that this modification promotes a reduction in the initiation of exothermic reactions for the butadiene phase, which seems to be a positive aspect because it preserves the acrylonitrile-styrene phase. The interaction is observed rheologically, indicating the formation of a percolated network that favors antistatic characteristics, even with a reduced amount of TiO2-OPM. This work presents a framework for the development of more sustainable materials with concepts of a circular production system.
Prehospital treatment targets for patients with traumatic brain injury requiring tracheal intubation. A retrospective analysis of 308 patients
Authors: Knapp Jürgen , Doppmann Pascal , Huber Markus , Meuli Lorenz , Albrecht Roland , Sollid Stephen , Pietsch Urs
Published: June 2023

Background
Traumatic brain injury (TBI) remains one of the main causes of mortality and long-term disability worldwide. Maintaining physiology of brain tissue to the greatest extent possible through optimal management of blood pressure, airway, ventilation, and oxygenation, improves patient outcome. We studied the quality of prehospital care in TBI patients by analyzing adherence to recommended target ranges for ventilation and blood pressure, prehospital time expenditure, and their effect on mortality, as well as quality of prehospital ventilation assessed by arterial partial pressure of CO2 (paCO2) at hospital admission.
Methods
This is a retrospective cohort study of all TBI patients requiring tracheal intubation on scene who were transported to one of two major level 1 trauma centers in Switzerland between January 2014 and December 2019 by Swiss Air Rescue (Rega). We assessed systolic blood pressure (SBP), end-tidal partial pressure of CO2 (petCO2), and paCO2 at hospital admission as well as prehospital and on-scene time. Quality markers of prehospital care (petCO2, SBP, prehospital times) and prehospital ventilation (paCO2) are presented as descriptive analysis. Effect on mortality was calculated by multivariable regression analysis and a logistic general additive model.
Results
Of 557 patients after exclusions, 308 were analyzed. Adherence to blood pressure recommendations was 89%. According to petCO2 45% were normoventilated, and 29% had a SBP ≥ 90 mmHg and were normoventilated. Due to the poor correlation between paCO2 and petCO2, only 33% were normocapnic at hospital admission. Normocapnia at hospital admission was strongly associated with reduced probability of mortality. Prehospital and on-scene times had no impact on mortality.
Conclusions
paCO2 at hospital admission is strongly associated with mortality risk, but normocapnia is achieved only in a minority of patients. Therefore, the time required for placement of an arterial cannula and prehospital blood gas analysis may be warranted in TBI patients requiring on-scene tracheal intubation.
Reclassification of Adolescent Ambulatory Prehypertension and Unclassified Blood Pressures by 2022 American Heart Association Pediatric Ambulatory Blood Pressure Monitoring Guidelines
Authors: Hill-Horowitz Taylor , Merchant Kumail , Reyes Laura Castellanos , Singer Pamela , Dukkipati Haripriya , Frank Rachel , Sethna Christine B , Basalely Abby
Published: June 2023

Background
The 2022 American Heart Association (AHA) pediatric ambulatory blood pressure monitoring (ABPM) guidelines eliminated the prehypertension phenotype and blood pressure loads in ABPM interpretation criteria. Adolescents who were prehypertensive or unclassified according to the 2014 AHA pediatric ABPM guidelines will be reclassified as having hypertension or normotension. The epidemiology and association of reclassification phenotype with target organ damage (TOD) is not yet known.
Methods
A single center retrospective review of adolescents ages 13–21 years old between 2015–2022 was performed. Adolescents diagnosed with prehypertension or unclassified by the 2014 AHA pediatric ABPM guidelines were reclassified by the 2022 definitions. Logistic regression models adjusted for body mass index z-score evaluated the association of reclassification phenotype with left ventricular hypertrophy (LVH).
Results
Among 88 adolescents with prehypertension, 68% (N = 60) were reclassified as hypertensive. The majority (58%, N = 35) of hypertensive reclassification was based on isolated nocturnal blood pressures ≥ 110/65 mmHg. Taller males were more likely to reclassify as hypertensive. Adolescents reclassified as hypertensive had a greater-than-six-fold increased odds of LVH in adjusted models [OR 6.4 95%CI 1.2–33.0, p = 0.027]. Of 40 adolescents with unclassified blood pressures, 37.5% (N = 15) reclassified to normotension. There were no significant clinical or demographic variables associated with reclassification category nor was there an association with LVH.
Conclusions
The new ABPM guidelines effectively reclassify adolescents who were previously prehypertensive as normotensive or hypertensive based on risk of TOD. Further studies are needed to describe the long-term outcomes of ABPM phenotypes with the implementation of these guidelines.
Using Experience-based Co-design to develop mobile/tablet applications to support a person-centred and empowering stroke rehabilitation
Authors: Marwaa Mille Nabsen , Guidetti Susanne , Ytterberg Charlotte , Kristensen Hanne Kaae
Published: June 2023

Aim To investigate and describe the process of using Experience-based Co-design (EBCD) to adapt and develop mobile/tablet applications to support a person-centred and empowering stroke rehabilitation.
Setting Two cross-sectoral stroke rehabilitation settings in Denmark comprising six rehabilitation units.
Participants Stroke survivors (n=23), significant others (n=18), occupational therapists (n=12), physiotherapists (n=9), representative of a patient organization (n=1), application developers (n=3) and researchers (n=2).
Method A structured, facilitated EBCD approach comprising six stages was used to co-produce a service that aimed to address the priorities and needs of all relevant end-users. Data were collected by interviews, participant observations, notes on “flip sheets” and written feedback on the content in the apps and on the instruction pages. Data were analyzed descriptively and with a constructivist grounded theory analysis.
Results The application platforms “Mit Sygehus” and “Genoptræn.dk” were adapted and new functions were developed to support the needs identified by all end-users. Relevant evidence-based knowledge, person-centred exercises and guidelines using video recordings were the most important among the developed solutions in the applications to support person-centred and empowering stroke rehabilitation. Furthermore, easy, and seamless communication were considered important.
Conclusions EBCD facilitated the adaptation and development of applications to support a person-centred and empowering stroke rehabilitation. Participants experienced that their contribution was considered important and valued.
In vitro and in vivo assessment of the safety and applications of potential probiotics isolated from Egyptian fermented food products
Authors: Tawab Fatma I. Abdel , kadr Menna H. Abd El , Sultan Amany M. , Hamed Ehdaa O. , El-Zayat Ayatollah S. , Ahmed Marwa N.
Published: June 2023

Lactic acid bacteria are of major concern due to their health benefits. Fermented food products comprise variable lactic acid bacterial isolates demonstrating probiotic properties. In this study, we isolated and functionally characterized lactic acid bacterial strains isolated from different Egyptian fermented food sources as probiotics. Only four isolates showed probiotic attributes and are considered to be safe for their implementation as feed or dietary supplements. Additionally, they were shown to exert antimicrobial activities against pathogenic bacteria and anticancer effects against the colon cancer cell line Caco-2. The Enterococcus massiliensis IS06 strain was exclusively reported in this study as a probiotic strain with high antimicrobial, antioxidant, and anti-colon cancer activity. Hitherto, few studies have focused on elucidating the impact of probiotic supplementation in vivo. Therefore, in the current study, the safety of the four isolates was tested in vivo through the supplementation of rats with potential probiotic strains for 21 days. The results revealed that probiotic bacterial supplementation in rats did not adversely affect the general health of rats. The Lactiplantibacillus plantarum IS07 strain significantly increased the growth performance of rats. Furthermore, the four strains exhibited increased levels of antioxidants such as superoxide dismutase and glutathione in vivo. Consistently, all strains also showed high antioxidant activity of the superoxide dismutase enzyme in vitro. Overall, these findings demonstrated that these isolated potential probiotics harbor desirable characteristics and can be applied widely as feed additives for animals or as dietary supplements for humans to exert their health benefits and combat serious diseases.
Sub-Region Model for Flux-Switching Permanent Magnet Machine with Outer Rotor and Inner Rotor Distinctly to Calculate Cogging Torque, Electromagnetic Torque and Inductance (self and mutual)
Authors: Shirzad Ehsan
Published: June 2023

This paper presents a general analytical subdomain model for the computation of magnetic field distribution in any number of stator slots and rotor poles in presence of only permanent magnet (PM) and excitation (2-layer) for flux switching permanent magnet machines (FSPMMs) with outer and inner rotor. The target of this work is to elaborate an analytical general method based on subdomain model for prediction of magnetic field, cogging torque, electromagnetic torque and inductance (mutual and self) by solving Maxwell law. To evaluate subdomain model, the effect of saturation is neglected due to considering infinite permeability for cores. The presented general subdomain method is comparable to finite element method (FEM) where the mesh elements can be compared to the number of harmonic terms used in each subdomain. To validate, the proposed model results are compared with those obtained from FEM.
Identification of COVID-19 Cuproptosis-Related Gene Subtypes and Construction of Prediction Models Using Multiple Machine Learning Methods
Authors: Hu Renwang , Liu Can , Li Dan
Published: June 2023

Objective
To identify the subtypes of cuproptosis-related genes associated with COVID-19 and construct prediction models with multiple machine learning methods.
Methods
Whole-genome sequencing data of normal people and COVID-19 patients (GSE163151 dataset, GSE156063 dataset) were downloaded from GEO database, and the differentially expressed cuproptosis-related genes were screened. Consistent clustering typing was used to divide the COVID-19 patients into two types (C1, C2). The correlation between the infiltration of 22 kinds of immune cells and the expression of cuproptosis-related genes in different typing COVID-19 patients was studied. GSVA method was used to study the gene variation set of different typing COVID-19 patients. WGCNA clustering method was used to construct gene co-expression network between normal people and COVID-19 patients, and between different typing (C1, C2) COVID-19 patients respectively, and the gene modules with the largest correlation coefficient and statistical significance were selected to screen out the key genes. Multiple machine learning methods (GLM, RF, SVM, XGB) were used to construct prediction models for the key gene sets, and the models with the highest accuracy and stability were selected.
Results
Thirteen differentially expressed cuproptosis-related genes (FDX1, LIPT1, DLD, DLAT, PDHA1, PDHB, GLS, ATP7B, SLC31A1, ATP7A, DLST, DBT, GCSH) were screened. Based on these 13 genes, 138 COVID-19 patients were divided into two types (C1, C2). There were obvious differences in the infiltration of immune cells, expression of cuproptosis-related genes and gene pathway variation sets (GSVA) between different typing COVID-19 patients. Finally, 11 genes that were significantly correlated with COVID-19 patients and different typing were selected by WGCNA method. The prediction model constructed by SVM method with 5 key genes (RSAD2, AIM2, ZBP1, DDX60L, GBP1) had strong predictive ability (training group AUC = 0.956, validation group AUC = 0.931).
Conclusion
Multiple cuproptosis-related genes expressions are significantly correlated with COVID-19 subtypes (C1, C2) and the amount of immune cells infiltration; The prediction model constructed by SVM method can predict the probability of patient infection with COVID-19 well.
The impact of regular taxation on non-oil economic growth: Evidence from a PANEL-ARDEL study in the Arab Gulf Cooperation Council countries – during the period 1990-2019
Authors: ASSMA GUERFI
Published: June 2023

This study aimed to identify the contribution of fiscal ordinary to achieving economic growth outside of hydrocarbons in the GCC countries during the period 1990–2019. By using the PMG method and by taking GDP outside of hydrocarbons as a dependent variable, and fiscal regular revenues as the main independent variable, in addition to other independents variables. The study found that the decline in oil prices harmed the sample countries during the study period which made them implement many reforms to their tax structures to ensure the sustainability of public revenues outside the fiscal petroleum.
Jel Classification: E62, O47, C22.
Autoimmune Encephalitis and Other Neurological Syndromes With Rare Neuronal Surface Antibody in Children after hematopoietic stem cell transplantation
Authors: Zhang Ming-min , Wang Jing , Sun Dan , Wang Jing-xuan , Zhang Jun-hong , Xu Jia-wei
Published: June 2023

Introduction:
Neuronal surface antibody syndromes (NSAS) are an expanding group of autoimmune neurological diseases, whose most frequent clinical manifestation is autoimmune encephalitis (AE). Anti-N-methyl-D-aspartate receptor (NMDAR) autoimmunity represent the most described form, while other NSAS such as anti-metabotropic glutamate receptor-5 (mGluR5) are rarer and less well-characterized, especially in children.
Case description:
Here, we carried out a case of a 7-year-old girl with abnormal behavior after hematopoietic stem cell transplantation (HSCT). She was diagnosed as anti-mGluR5 AE and the Electroencephalogram (EEG) showed increased number of generalized slow waves in the waking-period. Intravenous injection of gamma globulin and methylprednisolone followed by oral administration of prednisone tablets. During hormone shock therapy, levetiracetam was given anti epileptic treatment. The abnormal behaviors improved significantly after treatment.
Discussion and Evaluation:
The mechanism of anti-mGluR5 AE after HSCT is unclear. Impairment of glutamatergic synaptic transmission by anti-neuronal surface GluR antibodies is increasingly recognized as a major cause of AE in humans.
Conclusions:
To our knowledge, this is the first report on rare pediatric NSAS of anti-mGluR5 AE after HSCT. An improved characterization may aid our recognition and treatment in children. Serum antibody testing in HSCT patients with negative cerebrospinal fluid autoimmune antibodies may allow the early identification and treatment of anti-mGluR5 AE.
The association between urinary lead and risk of kidney stones: A population-based study
Authors: Liu Chang , Liang Dan
Published: June 2023

Background The negative effects of lead exposure on human health have attracted widespread attention. Our present study focused on assessing the relationship between urinary lead levels (ULL) and the risk of kidney stones in US adults.Methods We used data from NHANES 2007–2018 for this cross-sectional study, where participants had complete data on ULL and kidney stones. The correlation between ULL and kidney stones was explored by weighted multiple logistic regression analysis. In addition, we also performed subgroup analysis and interaction tests.Results A total of 8325 subjects were included, and the prevalence of kidney stones was 9.90%. In the fully adjusted model, we observed a positive association between ULL and the risk of kidney stones (OR:1.07, 95% CI: 1.01–1.14, p = 0.03). Participants in the highest quartile of ULL had a 64% higher risk of kidney stones than those in the lowest quartile of ULL (OR:1.64, 95% CI: 1.05–2.57, p = 0.03). Subgroup analysis and interaction test indicated that the association between ULL and the risk of kidney stones was similar in different population settings.Conclusion ULL was associated with an increased likelihood of kidney stones.
Adaptive resistance to cefiderocol in carbapenem-resistant Acinetobacter baumannii (CRAB): microbiological and clinical issues
Authors: Desmoulin Anissa , Sababadichetty Loïk , Kamus Laure , Daniel Marion , Feletti Lucie , Allou Nicolas , Potron Anais , Leroy Anne-Gaëlle , Jaffar-Bandjee Marie-Christine , Belmonte Olivier , Garrigos Thomas , Miltgen Guillaume
Published: June 2023

Purpose: Determining the best available therapy for carbapenem-resistant Acinetobacter baumannii (CRAB) infections is a challenge. Cefiderocol is an attractive alternative drug effective against many resistance mechanisms in Gram-negative bacteria. However, its place in the treatment of Acinetobacter baumannii infections remains unclear and much debated, with contradictory results.
Methods: We describe here the case of a 37-year-old man with ventilator-associated bacteraemic CRAB pneumonia in an intensive care unit. He was initially treated with a combination of colistin and tigecycline, and was then switched onto colistin and cefiderocol. We then used a new accessible protocol to test 30 CRAB isolates (OXA-23/OXA-24/OXA-58/NDM-1) for adaptive resistance to cefiderocol (ARC) after exposure to this drug.
Results: After clinical failure with the initial combination, we noted a significant clinical improvement in the patient on the second combination, leading to clinical cure. No ARC was detected in the two OXA-23 case-CRAB isolates. All NDM CRAB isolates were resistant to cefiderocol in standard tests; the OXA-23, OXA‑24 and OXA‑58 CRAB isolates presented 84.2%, 50% and 0% ARC, respectively.
Conclusions: ARC is not routinely assessed for CRAB isolates despite frequently being reported in susceptible isolates (69.2%). Subpopulations displaying ARC may account for treatment failure, but this hypothesis should be treated with caution in the absence of robust clinical data. The two main findings of this work are that (i) cefiderocol monotherapy should probably not be recommended for OXA-23/24 CRAB infections and (ii) the characterisation of carbapenemases in CRAB strains may be informative for clinical decision-making.
Transforming Telecom Revenue- The impact of OTT Service
Authors: Dahal Madhu Sudan
Published: June 2023

The telecom industry's primary revenue streams used to be voice and SMS, but with the rise of Over the Top (OTT) services, this scenario is changing. This paper aims to analyze the transition from the voice and SMS era of cellular communication to a data-centric business. The study uses ten years data of voice traffic, data traffic and SMS count and their respective revenue of Telecom operators of Nepal. The research explores how user behavior is shifting from voice and SMS to data usage patterns, provides valuable insights into the changing landscape of the telecom industry and impact of OTT services on traditional revenue streams. It also highlights the need for telecom operators to adapt to these changes by embracing new technologies and providing innovative products to meet the evolving needs of their customers. Finally, the paper provides the various strategies to be implemented by telecom operators in response to revenue loss due to OTT services. It demonstrates that embracing OTTs and providing different products that resemble flat-rate pricing will be the most successful strategy for mobile operators to retain revenues. Additionally, the research reveals that the regulator should resist the push for regulating OTTs and instead facilitate the evolution to flat access pricing.
Clinical impact of timing of surgery on outcomes in preterm infants with surgical necrotizing enterocolitis
Authors: Garg Parvesh Mohan , Riddick Robin , Ansari Md Abu Yusuf , Pittman Isabella , Hillegass William
Published: June 2023

Background:The clinical impact of the timing of surgery on outcomes in preterm infants with surgical necrotizing enterocolitis (NEC) is not well defined.Aim:We sought to investigate the impact of the different timing of surgery from the day of NEC diagnosis on clinical outcomes in preterm infants with surgical NEC.Study Design:Retrospective Cohort Study.Subjects:Preterm 75 infants admitted between January 2013 and December 31, 2018, with an NEC (Bell stage III) diagnosis.Outcomes:Comparison of clinical information by the timing of surgery at three different time points (less and more than 48 hours, 96 hours, and 168 hours) in preterm infants with surgical NEC.Results:75 infants were included in the analysis. Those who received surgery after 48 hours (n= 29/75) had lower median gestational age, lower birth weight, had less pneumoperitoneum, were out born less frequently, had higher acute kidney injury, were intubated and ventilated more frequently, and had higher hemorrhagic and reparative lesions on histopathology than those receiving surgery after 48 hours. Infants receiving surgery after 96 hours had similar trends expect had significantly lower hematocrit and more prolonged parenteral nutrition dependence than less than 96 hours group. The infants receiving surgery after one week had significantly lower birth weight and had higher reparative changes and cholestasis than those receiving surgery < 1 week. There was no significant impact of surgery timing on the length of bowel loss, surgical morbidity, Bronchopulmonary dysplasia, white matter injury, and mortality.Conclusion:The infants receiving surgery later were young and smaller and received parenteral nutrition longer with no significant impact on morbidities and mortality. Our data point out that there are advantages of operating early with fewer morbidities which need further confirmation and evaluation in large multicentric prospective studies or clinical trials.
A Deep Learning Based Holistic Diagnosis System for Immunohistochemistry Interpretation and Molecular Subtyping
Authors: Fan Lin , Liu Jiahe , Ju Baoyang , Tian Yushen
Published: June 2023

Purpose: Breast cancer in different molecular subtypes, which is determined by the overexpression rates of human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER), progesterone receptor (PR) and Ki67, exhibit distinct symptom characteristics and sensitivity to different treatment. Immunohistochemical method, one of the most common detecting tool for tumour markers, is heavily relied on artificial judgment and in clinical practice, with an inherent limitation in interpreting stability and operating efficiency. Here, a holistic intelligent breast tumour diagnosis system has been developed for tumour-markeromic analysis, combining the automatically interpretation and clinical suggestion.
Methods: The holistic intelligent breast tumour diagnosis system included two main modules. The interpreting modules were constructed based on convolutional neural network, for comprehensively extracting and analyzing the multi-features of immunostaining. Referring to the clinical classification criteria, the interpreting results were encoded in a low-dimensional feature representation in the subtyping module, to efficiently output a holistic detecting result of the critical tumour-markeromic with a diagnosis suggestions on molecular subtypes.
Results: The overexpression rates of HER2, ER, PR and Ki67, as well as an effective determination on molecular subtypes were successfully obtained by this diagnosis system, with an average sensitivity of 97.6% and an average specificity of 96.1%, among those, the sensitivity and specificity for interpreting HER2 were up to 99.8% and 96.9%.
Conclusion: The holistic intelligent breast tumour diagnosis system shows improved performance in the interpretation of immunohistochemical images over pathologist-level, which can be expected to overcame the limitations of conventional manual interpretation in efficiency, precision and repeatability.
The causality between CD8 + NKT cells and CD16 - CD56 on NK cells with hepatocellular carcinoma: a Mendelian randomization study
Authors: Lu Zhengmei , pan yong , chai xiaowei , li shibo
Published: June 2023

Background Hepatocellular carcinoma (HCC), which is featured with high morbidity and mortality worldwide, is a primary malignant tumor of the liver. Recently, there is a wealth of supporting evidence revealing that NK cell-related immune traits are strongly associated with the development of HCC, but the causality between them has not been proven.Methods Two-sample Mendelian randomization (MR) study was performed to probe the causal correlation between NK cell-related immune traits and HCC. Genetic variations in NK cell-related immune traits were extracted from recent genome-wide association studies (GWAS) of individuals with European blood lineage. HCC data were derived from the UK Biobank Consortium's GWAS summary count data, including a total of 372184 female and male subjects, with 168 cases and 372016 controls, all of whom are of European ancestry. Sensitivity analysis was mainly used for heterogeneity and pleiotropy testing.Results Our research indicated the causality between NK cell-related immune traits and HCC. Importantly, CD8+NKT cells had protective causal effects on HCC (OR = 0.9996;95%CI,0.9993–0.9999; P = 0.0489). CD16−CD56 caused similar effects on NK cells (OR = 0.9997;95%CI,0.9996–0.9999; P = 0.0117) as CD8+NKT cells. Intercepts from Egger showed no pleiotropy and confounding factors. Furthermore, insufficient evidence was found to support the existence of heterogeneity by Cochran's Q test.Conclusion MR analysis elucidated that low CD8+NKT cells and CD16−CD56 expression on NK cells were linked with a higher risk of HCC.
Designing for Sustainability and Safety in Urban Micro-mobility: A Novel Helmet Concept
Authors: Serra Gabriel , Sousa Guilherme Antunes e , Fernandes Fábio António Oliveira , de Sousa Ricardo José Alves , Noronha Eduardo Jorge Henriques
Published: June 2023

The past few years have witnessed a remarkable surge in urban mobility with the proliferation of micro-mobility sharing services. The advent of e-scooters and e-bikes has revolutionized the urban landscape across the globe. However, this transformation has also led to a worrisome increase in severe accidents associated with these new modes of transportation. The primary factors contributing to this trend are the inability of governments to swiftly adapt regulations to match evolving mobility trends and the unsuitability of traditional bicycle helmets for the spontaneous nature of micro-mobility. Moreover, in an era of resource scarcity and escalating global warming concerns, prioritizing sustainable development has become imperative for the modern economy. Unfortunately, conventional helmets significantly lack in terms of sustainability, not only due to their predominantly petroleum-derived materials but also because their manufacturing process combines the protective foam and outer shell, rendering them difficult to recycle or repurpose after disposal. This paper outlines the development of an innovative helmet concept designed for micro-mobility. The comprehensive research encompasses the design process, material selection, experimental testing, ergonomics, life cycle assessment, and design for manufacturing. The resulting helmet can be flattened to the size of a laptop, enabling convenient storage in a backpack. Additionally, it exhibits a 42% lower carbon footprint compared to standard helmets and can be fully disassembled and recycled. This novel helmet concept not only advances aesthetics and functionality but also meets three goals outlined by the UN 2030 agenda for sustainable development, making it a significant milestone for the helmet industry.
Enhanced Coalescence Backdoor Attack Against DNN Based on Pixel Gradient
Authors: Yin Jianyao , Chen Honglong
Published: June 2023

Deep learning has been widely used in many applications such as face recognition, autonomous driving, etc. However, deep learning models are vulnerable to various adversarial attacks, among which backdoor attack is emerging recently. Most of the existing backdoor attacks use the same trigger or the same trigger generation approach to generate the poisoned samples in the training and testing sets, which is also commonly adopted by many backdoor defense strategies. In this paper, we develop an enhanced backdoor attack (EBA) that aims to reveal the potential flaws of existing backdoor defense methods. We use a low-intensity trigger to embed the backdoor, while a high-intensity trigger to activate it. Furthermore, we propose an enhanced coalescence backdoor attack (ECBA) where multiple low-intensity incipient triggers are designed to train the backdoor model, and then, all incipient triggers are gathered on one sample and enhanced to launch the attack. Experiment results on three popular datasets show that our proposed attacks can achieve high attack success rates while maintaining the model classification accuracy of benign samples. Meanwhile, by hiding the incipient poisoned samples and preventing them from activating the backdoor, the proposed attack exhibits significant stealth and the ability to evade mainstream defense methods during the model training phase.
Social Excluder’s Face Reduces Gaze-Triggered Attention Orienting
Authors: Yang Jiajia , Zhou Li , Hu Zhonghua
Published: June 2023

Social ostracism, a negative affective experience in interpersonal interactions, is thought to modulate the gaze-cueing effect (GCE). However, it is unclear whether the impact of social exclusion on the GCE is related to the identity of the cueing face. Therefore, the present study employed a two-phase paradigm to address this issue. In the first phase, two groups of participants were instructed to complete a Cyberball game with two virtual avatars to establish a binding relationship between a specific face’s identity and the emotions of social exclusion or inclusion. In the second phase, these two virtual avatars (exclusion faces/inclusion faces) and two new faces (control faces) were used as cueing faces in the gaze-cueing task. The results found that, for the exclusion group, the magnitudes of the GCEs for the exclusion and exclusion-control faces were similar in the 200 ms stimulus onset asynchrony (SOA) condition, while the exclusion face’s GCE was significantly smaller than that of the exclusion-control face in the 700 ms SOA condition. In contrast, for the inclusion group, the GCEs for inclusion and inclusion-control faces in both the 200 ms SOA and 700 ms SOA conditions were no significant difference. This study reveals that the effect of social exclusion on the GCE is related to the identity of the cueing face, with individuals more reluctant to follow the gaze direction of excluder and shift their attention and provides experimental evidence that the perception of higher social relations can exert a top-down impact on the processing of social spatial cues.
Inspecting the quality of care: a comparison of CUSUM methods for inter hospital performance
Authors: Gomon Daniel , Sijmons Julie , Putter Hein , Dekker Jan Willem T , Tollenaar Rob AEM , Wouters Michel WJM , Tanis Pieter J , Fiocco Marta , Signorelli Mirko
Published: June 2023

Background During the past 14 years, a clinical audit has been used in the Netherlands to provide hospitals with data on their performance in colorectal cancer care. Continuous feedback on the quality of care provided at each hospital is essential to improve patient outcomes. It is unclear which methods should be used to generate most informative output for the identification of potential quality issues. Our aim is to compare the commonly employed funnel plot with existing cumulative sum (CUSUM) methodology for the evaluation of postoperative survival and hospital stay outcomes of patients who underwent colorectal surgery in the Netherlands.
Methods Data from the Dutch ColoRectal Audit on 25367 patients in the Netherlands who underwent surgical resection for colorectal cancer between 2019 and 2021 is used to compare four methods for the detection of deviations in the quality of care. Two methods based on binary outcomes (funnel plot, binary CUSUM) and two CUSUM charts based on survival outcomes (BK-CUSUM and CGR-CUSUM) are considered. A novel approach for determining hospital specific control limits for CUSUM charts is proposed. The ability to detect deviations as well as the time until detection are compared for the four methods. Charts were constructed for the inspection of both postoperative survival and hospital stay.
Results Methods using survival outcomes always yielded faster detection times compared to approaches employing binary outcomes. Detections between methods mostly coincided for postoperative survival. For hospital stay detections varied strongly, with methods based on survival outcomes signalling over half the hospitals. Further pros and cons as well as pitfalls of all methods under consideration are discussed.
Conclusions Methodology for the continuous inspection of the quality of care should be tailored to the specific outcome. Properly understanding how the mechanism of a control chart functions is crucial for the correct interpretation of results. This is particularly true for CUSUM charts, which require the choice of a parameter that greatly influences the results. When applying CUSUM charts, consideration of these issues is strongly recommended.