bluuebunny/crossref_metadata_2025 huggingface dataset:
Phenotypic and Genotypic Characterization of Candida parapsilosis complex isolates from a Lebanese Hospital
Authors: Hady Reine El , Fattouh Nour , Finianos Marc , Bitar Ibrahim , Husni Rola , khalaf Roy
Published: May 2024

The opportunistic fungal pathogen Candida parapsilosis is a major causative agent of candidiasis leading to death in immunocompromised individuals. Azoles are the first line of defense in treatment by inhibiting ERG11, involved in the synthesis of ergosterol, the main sterol fungal sterol. Resistance to azoles is on the increase worldwide including in Lebanon. The purpose of this study is to characterize nine hospital isolates labeled as C. parapsilosis: four resistant and five sensitive to fluconazole. Phenotypic characterization was achieved through a battery of tests that target pathogenicity attributes such as virulence, biofilm formation, stress resistance, and ergosterol content. Genotypic analysis was done through whole genome sequencing to mutations in key virulence and resistance genes. Phylogenetic comparison was performed to determine strain relatedness and clonality. Genomic data and phylogenetic analysis revealed that three of the nine C. parapsilosis isolates were misidentified; two as C. orthopsilosis and C. metapsilosis belonging to the C. parapsilosis complex, while the third was C. albicans. Moreover, several known and novel mutations in key drug resistance and virulence genes were identified such as ERG11, ERG3, ERG6, CDR1, and FAS2. Phylogenetic analysis revealed a high degree of relatedness and clonality within our C. parapsilosis isolates. Our results showed that resistant isolates had no increased ergosterol content, no statistically significant difference in virulence, but exhibited an increase in biofilm content compared to the sensitive isolates. In conclusion, our study, the first of its kind in Lebanon, suggests several mechanisms of antifungal drug resistance in C. parapsilosis hospital isolates.
Randomized crossover trial of a demand oxygen delivery system in nocturnal hypoxemia
Authors: Yatani Atsuhiko , Nagano Tatsuya , Murakami Sae , Otoshi Takehiro , Hazama Daisuke , Katsurada Naoko , Yamamoto Masatsugu , Tachihara Motoko , Nishimura Yoshihiro , Kobayashi Kazuyuki
Published: May 2024

The newly developed portable oxygen concentrator with an auto-demand oxygen delivery system (auto-DODS) automatically switches between 3 sensitivities according to the negative pressure gradient of inhalation and supplies oxygen only during inhalation. The aim of this study was to verify the effectiveness and safety of auto-demand devices compared with a continuous flow oxygen concentrator, during sleep, in a randomized crossover noninferiority trial. We alternatively used an auto-DODS or a continuous-flow oxygen concentrator, all night on separate days for HOT (Home Oxygen Therapy) patients with nocturnal hypoxemic symptoms. The primary endpoints were the mean value of oxygen saturation (SpO2) over the total sleep time. The secondary endpoints included the efficacy endpoints and the safety endpoints. Regarding the primary endpoint, the difference in SpO2 between the auto-DODS and continuous flow was 0.835%. Since the upper limit of this difference did not exceed 2.8, which was set as the noninferiority margin, it was shown that the auto-DODS did not reduce SpO2 by at least 2.8% on average compared to continuous flow. No equipment failure or exacerbation of disease was observed, confirming the safety of the auto-DODS during the night.
Molecular questioning of potential efficacy of epsilon targeted antiviral treatment option for Domestic Cat Hepadnavirus
Authors: KOÇ B. Taylan , Adiguzel Ece , Oguzoglu T. Cigdem
Published: May 2024

We aimed to elucidate the molecular and secondary structure of DCH to predict the development of antiviral drugs. We performed a series of polymerase chain reactions to obtain complete sequences of DCH. The complete sequences were processed using computational tools. The phylogenetic analysis showed that our sequences belong to one clade, but four are not part of this monophyletic clade. A recombination detection program identified four cases as potential recombination events. The secondary structure of the cis-acting RNA region (ε) was evaluated and revealed motifs similar to those found in HBV. This similarity highlights the potential for new-generation therapeutics in this region.
Empowering Health and Wellness in Rural Kenya: An Examination of Nutrition Knowledge, Dietary Practices, and Treatment Management among Adults with Hypertension and Type 2 Diabetes Mellitus
Authors: Onyango Joseph , Kiarie Ruth
Published: May 2024

Non-communicable diseases (NCDs) are the leading cause of global mortality, particularly prevalent in low to middle-income countries (LMICs). Hypertension and type 2 diabetes mellitus often coexist, contributing to long-term complications and mortality. Lifestyle interventions, including dietary modifications, are vital in preventing these complications. This study aimed to assess nutrition knowledge and dietary practices among patients with diabetes and hypertension at Kitale County Referral Hospital. This descriptive cross-sectional study focused on patients with type 2 diabetes and hypertension at Kitale County Referral Hospital. Data were collected from 283 respondents out of a target population of 973 using structured questionnaires. The Social Cognitive Theory guided the study, emphasizing the interaction of individual, behavioral, and environmental factors influencing self-care activities. Most participants demonstrated an understanding of dietary management for their conditions. Cultural influences posed challenges, yet participants reported familial and social support. Willingness to change dietary habits was evident, but barriers such as food availability and cost were noted. Despite adequate nutrition education, adherence to balanced diets remained problematic. The study highlights the importance of sustained patient education and counselling, incorporating experiential learning such as hospital kitchen use to promote locally available foods. Strategies to address food insecurity, particularly among the elderly, are recommended to enhance dietary adherence and overall health outcomes. Efforts to improve dietary practices among patients with type 2 diabetes and hypertension should prioritise culturally sensitive education, accessibility to recommended foods, and addressing socioeconomic barriers. These recommendations could significantly enhance self-care behaviours and health outcomes in similar healthcare settings.
A Comprehensive Study of Depression, Anxiety, and Stress Among USMLE Aspirants: A Cross-Sectional Survey
Authors: Khan Qaisar Ali , F.Belay Naod , Semakieh Bader , Farrukh Ameer Mustafa , Aisha Marium , Khan Fahd Zafar , Wiyarta Elvan , Khan Hamza Ali , Verma Ravina
Published: May 2024

Background
The United States Medical Licensure Examination (USMLE) represents a critical step for medical licensure in the United States, requiring extensive preparation that can lead to significant mental health challenges among aspirants. This study aims to explore the prevalence and contributing factors of depression, anxiety, and stress among USMLE aspirants.
Methods
This cross-sectional survey investigates the prevalence and contributing factors of depression, anxiety, and stress among USMLE aspirants. We deployed a detailed online and paper-based questionnaire targeting a diverse pool of 321 medical students and graduates globally. The survey incorporated validated scales such as the Perceived Stress Scale, Generalized Anxiety Disorder 7-item scale, and Patient Health Questionnaire-9 to evaluate mental health statuses. Data analysis was conducted using SPSS, focusing on demographic correlations and mental health outcomes.
Results
A total of 321 participant’s data were collected, out of whom 51.1% (n = 164) were male and 48.9% (n = 157) were female. 91.3% (n = 293) were International Medical Graduates (IMG), while 8.7% (n = 28) were American Medical Graduates (AMG), educational status results show undergraduates 38.6% (n = 124) and graduates 61.4% (n = 197). Participants were interviewed through a validated questionnaire, and 75.1% (n = 241) had depression, 71.96 (n = 231) had anxiety, (n = 16) had low stress, (n = 231) had moderate, and (n = 66) had severe perceived stress.
Conclusion
Our study reveals a high prevalence of depression, anxiety, and stress among USMLE aspirants, with significant variations across demographic subgroups and chosen medical specialties.
Prognostic Value of Cardiopulmonary Exercise Test in Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention
Authors: Li Zhengyan , Fan Baochao , Wu Yifan , Rui Haomiao , Hu Yongcun , Gu Yingchun , Bai Juncai , Lu Liming , Wang Dongwei
Published: May 2024

Objectives: To determine the independent risk factors of cardiopulmonary exercise test (CPET) parameters related to adverse prognostic events within 5 years in patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) and establish a prediction model for the occurrence of adverse events within 5 years to provide a reference for cardiac rehabilitation training.
Methods: From August 2015 to December 2021, patients who underwent PCI for AMI and completed CPET within 1–2 weeks after surgery before discharge from the Department of Cardiovascular Medicine of Zhengzhou Central Hospital Affiliated to Zhengzhou University, Henan Provincial Hospital of Traditional Chinese Medicine, and Anyang District Hospital were selected as participants. Univariate and multivariate analyses were used to screen for independent risk factors associated with 5-year adverse events. Feature importance was interpreted using SHapley Additive exPlanations (SHAP), and a logistic regression model was established for prediction. A receiver operating characteristic (ROC) curve was constructed to evaluate the performance of the prediction model. Calibration was assessed by the Hosmer-Lemeshow test and the calibration curve.
Results: In total, 375 patients met the inclusion criteria, including 53 in the event group and 322 in the non-event group, according to whether adverse events occurred during the 5-year follow-up period. Peak oxygen uptake (peakVO2), carbon dioxide ventilation equivalent slope (VE/VCO2slop), and peak end-tidal carbon dioxide partial pressure (PETCO2) were three independent risk factors for re-acute myocardial infarction (re-AMI), heart failure (HF), and even death after PCI for AMI (P < 0.05). The SHAP plots demonstrated that the significant contributors to model performance were related to peakVO2, VE/VCO2slop, and PETCO2. The risk of adverse events was significantly reduced when the peakVO2 was ≥ 20 ml/kg/min and the VE/VCO2slop was < 33. The ROC curves of the three models were drawn, including the no-event and event groups, re-AMI group, and HF group, which performed well, with AUC of 0.894, 0.760, and 0.883, respectively. The Hosmer-Lemeshow test showed that the three models were a good fit (P > 0.05). The calibration curve of the three models was close to the ideal diagonal lines.
Conclusions: CPET parameters can predict the prognosis of adverse events within 5 years after PCI in patients with AMI and provide a theoretical basis for cardiac rehabilitation training.
The Embryological Characteristics and Clinical Outcomes of Oocytes with Indented Zona Pellucida
Authors: Lin Jie , Fang Lu , Yao Lv , Wang Haichao , Lan Hongyan , Tong Xiaomei
Published: May 2024

Purpose
The aim of this study is to investigate the embryological characteristics and clinical outcomes of oocytes with indented zona pellucida (ZP).
Methods
A total of 109 in vitro fertilization (IVF) cycles from 56 subjects had all oocytes with an indented ZP (IZP). Another 1095 cycles of 574 subjects with oocytes retrieved on the same time were included as controls (NZP). The comparisons were conducted between two groups in embryological characteristics and clinical outcomes.
Results
The patients with IZP suffered from significantly prolonged duration of infertility and were more likely to have primary infertility. In embryonic development, oocytes with IZP demonstrated significantly lower rates of oocyte retrieved, oocyte maturity, normal fertilization, embryo cleavage and embryo utilization. Thirty-two patients with IZP participated in the fresh embryo transfer, with a clinical pregnancy rate of 43.8% and a live birth rate of 34.4%, which were significantly lower than NZP group. In addition, the clinical outcomes of frozen embryo transfer (FET) cycles showed no significant differences. Compared to the rescue- intracytoplasmic sperm injection (ICSI) group, ICSI regimen facilitated a substantially higher rates of oocyte fertilization, cleavage, and enhanced efficiency in embryo utilization.
Conclusions
Patients with IZP had unsatisfactory embryological and fresh embryo transfer outcomes, and it was a favor choice to use ICSI insemination timely. FET might potentially mitigate the impact of ZP abnormalities.
Reproductive outcomes in women with advanced endometriosis in fresh versus frozen embryo transfer cycles.
Authors: Shoukry Ahmed , Gazeirly Wael Samir El , Khattab Mohamed Abdelkader , Abdelmoneim Hesham Mahmoud Adel
Published: May 2024

Background: ART in women with endometriosis is associated with poor quality of the retrieved oocytes and lower fertilization and pregnancy rates, reflecting that endometriosis may influence fertility by altering the quality of both the oocyte and embryo quality and also by impairing the endometrial receptivity. On comparing endometriosis affected patients to healthy counterparts, many differences were demonstrated at the endometrial level. Thus, choosing the appropriate method of embryo transfer is of utmost importance, particularly for patients with advanced endometriosis. Objective: The aim of the present study was to compare the reproductive outcomes between fresh and frozen embryo transfer cycles in women with advanced endometriosis. A retrospective cohort study was conducted for patients recruited from two IVF centers, Alexandria, Egypt. Careful review of paper and electronic medical records of infertile women (primary, relative, or secondary infertility) aged 18 – 37 years who were diagnosed with advanced endometriosis by means of laparoscopy and were scheduled for ICSI followed by either fresh embryo transfer (group I) or freeze all embryos and deferred embryo transfer (group II) of day 5 embryo(s) were included in the study.
Results: Two hundred and eleven women were eligible and included in the study. Women in each study group were matched regarding baseline characteristics. Clinical pregnancy, implantation, ongoing pregnancy rates were statistically significant higher in the group of frozen embryo transfer (p<0.001). Miscarriage rate was found to be higher in the group of fresh transfer compared to FET group but without a statistical significance (20.9% vs 9.2%, p = 0.072).
Conclusion: In women with advanced endometriosis, freeze all policy is associated with better implantation, ongoing pregnancy rates and it is recommended to be adopted when appropriate in such patients.
Astragalus polysaccharides improve adjuvant chemotherapy-induced fatigue for patients with early breast cancer
Authors: Shen Wen-Chi , Chen Shin-Cheh , Wang Cheng-Hsu , Hung Chao-Ming , Peng Meng-Ting , Liu Chien-Ting , Chang Yueh-Shih , Kuo Wen-Ling , Chou Hsu-Huan , Yeh Kun-Yun , Wu Tsung-Han , Wu Chun-Feng , Chang Pei-Hung , Huang Yen-Min , Yu Chi-Chang , Lee Chun-Hui , Rau Kun-Ming
Published: May 2024

Purpose
This study aimed to evaluate the effect of Astragalus polysaccharides (PG2) on reducing chemotherapy-induced fatigue (CIF) and toxicity, thereby encouraging compliance to chemotherapy.
Methods
This was a randomized, placebo-controlled, phase 2 study. Patients with stage II/III early breast cancer planning to undergo adjuvant anthracycline-based chemotherapy were randomly assigned to receive PG2 500 mg or placebo on days 1, 3, and 8 every 21 days. The fatigue global score (FGS) was assessed using the brief fatigue inventory (BFI)-Taiwan. The Breast Cancer-Specific Module of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires-Core30 evaluated the health-related quality of life during the first four cycles of adjuvant chemotherapy.
Results
Overall, 66 eligible patients were equally randomized into the PG2 and placebo groups between March 01, 2018, and March 09, 2021. The mean change in the FGS and fatigue intensity did not significantly differ between both groups. However, the FGS and fatigue intensity were less aggravated in the first four cycles in the premenopausal-PG2 group than in the placebo group.
Conclusion
PG2 combined with adjuvant chemotherapy can reduce CIF, insomnia, the negative effect on future perspectives, and improve global health status, especially for premenopausal patients with breast cancer.
Trial registration number: NCT03314805 registered on 19/10/2017.
Causal Cortical and Thalamic Connections in the Human Brain
Authors: Parvizi Josef , Lyu Dian , Stieger James , Lusk Zoe , Buch Vivek
Published: May 2024

The brain's functional architecture is intricately shaped by causal connections between its cortical and subcortical structures. Here, we studied 27 participants with 4864 electrodes implanted across the anterior, mediodorsal, and pulvinar thalamic regions, and the cortex. Using data from electrical stimulation procedures and a data-driven approach informed by neurophysiological standards, we dissociated three unique spectral patterns generated by the perturbation of a given brain area. Among these, a novel waveform emerged, marked by delayed-onset slow oscillations in both ipsilateral and contralateral cortices following thalamic stimulations, suggesting a mechanism by which a thalamic site can influence bilateral cortical activity. Moreover, cortical stimulations evoked earlier signals in the thalamus than in other connected cortical areas suggesting that the thalamus receives a copy of signals before they are exchanged across the cortex. Our causal connectivity data can be used to inform biologically-inspired computational models of the functional architecture of the brain.
Unveiling the Impact of High-Intensity Interval Training on Adolescent Middle-Distance Running Events through Heart Rate Variability Analysis
Authors: Mingyang Liu , Peng Zhang , Bo Leng , Weishuai Guo , Songwei Wei , Gang Wang , Kim Sukwon
Published: May 2024

Purpose
This study aimed to investigate the impact of HIIT on sports performance and heart rate variability (HRV) in adolescents with prior sports experience.
Method
A randomized controlled experiment was conducted over 8 weeks, with participants engaging in either HIIT or moderate-intensity continuous training (MICT). The HIIT group consisted of 15 individuals, while the MICT group also comprised 15 participants, with an average age of (17.1 ± 0.61) years. Real-time heart rate monitoring was facilitated using Polar H10 heart rate chest straps, allowing precise tracking of subjects' heart rate dynamics and exercise intensity. HRV indicators were measured before and after the intervention, and sports performance was statistically analyzed.
Results
Post-test analysis revealed a significant improvement in performance for the HIIT group compared to the MICT group (MICT 140.93 ± 4.34 vs. HIIT 134.67 ± 4.51 s, p < 0.05). Two-factor analysis of variance revealed significant time effect (p = 0.0003) and interaction (time × group) effect (p = 0.0014), while no significant difference was observed in the group effect (p = 0.5633). Notably, HRV indicators (SDNN, LF, and LF/HF) exhibited significant improvements.
Conclusion
Evaluation based on heart rate variability indices indicates superior effectiveness of HIIT over MICT, underscoring the significance of tailored training interventions for young athletes. This research provides valuable insights for time-constrained teenagers seeking to optimize their exercise regimen.
Refuge preferences and web trap lines: the potential for competitive displacement of endemic katipō Latrodectus katipo by the invasive false katipō Steatoda capensis (Araneae: Theridiidae).
Authors: Roberts James Joseph , Wignall Anne , Brunton Dianne H.
Published: May 2024

Competitive displacement is a form of interspecific competition. Here, we explore the potential for competitive displacement in refuges of the endangered katipō spider (Latrodectus katipo) by the invasive false katipō (Steatoda capensis) (Araneae, Theridiidae). We conducted experimental assays using artificial refuges to test individual preferences for refuge shape, surface, and height. We also tested how refuge type affects the number of web trap lines used for prey capture. Both species preferred triangular refuges over rectangular refuges, with no evidence of a preference for other refuge types. For reasons which remain unclear, individuals varied in their preferences for surface and height. Katipō spiders showed site fidelity in all three assays, while false katipō spiders only showed site fidelity in the shape and surface assays. However, there was also evidence of individual variation in site fidelity in the shape assay. Spiders constructed more web trap lines beneath the triangular refuges, potentially due to their preference for triangular refuges. We suggest that overlapping refuge preferences, but not web structure, may contribute to competition and the potential for competitive displacement of the katipō by false katipō. Although not exclusively preferred by katipō, introducing artificial triangular refuges in katipō habitats should be tested as a means of supporting the persistence and expansion of katipō populations.
The value of shear wave elastography combined with red blood cell distribution width in evaluating arterial erectile dysfunction
Authors: Wang Qingyuan , Guo Yixuan , Zhang Hanqi , Qin Xiachuan , Zhang Chaoxue , zhou wang
Published: May 2024

Background
A prospective study was conducted to determine the value of shear wave elastography (SWE) and red blood cell distribution width (RDW) in the diagnosis of various forms of erectile dysfunction (ED).
Methods
With the method of Nocturnal Penile Tumescence and Rigidity (NPTR) and the screening method of Color Duplex Doppler Ultrasound (CDDU), hematological data were collected from 131 individuals, among whom 24 are with psychogenic ED, 48 are with non-arterial ED(NAED) and 59 are with arterial ED(AED) with erectile dysfunction. SWE value of penile corpus cavernosum(CCP) and cavernous arterial flow velocity were measured before (flaccid state) and after (erect state) intracavernous injection (ICI) in all patients.
Results
Among the AED patients and other types of ED patients, there were statistically significant differences in the abridged five-item International Index of Erectile Function (IIEF-5), red blood cell distribution width-coefficient of variation (RDW-CV), red blood cell distribution width-standard deviation (RDW-SD), and SWE values (all P < 0.01). In the AED patients, the IIEF-5 scores had a significant negative relationship with RDW-CV, RDW-SD, and SWE values, with SWE values having the strongest correlation. (p < 0.001, r=-0.638).
Conclusion
The combination of RDW level and SWE value demonstrated the greatest performance in diagnosing AED, according to the receiver-operator characteristic(ROC) curve analysis (AUC = 0.870, p < 0.0001, cut-off value of 0.75, sensitivity of 74.6%, specificity of 91.7%).RDW and SWE value may develop into an incredibly simple, practical tool for predicting and diagnosing AED.
Trial registration:
retrospectively registered.
Performance of heat-resisting functional polypropylene/hollow silica substrates for 6th generation wireless communication
Authors: Yang Kai-ru , Ouyang Shuang , Ma Ning , Hsu Tim , Huang Ya-qiong , Yeh Jen-Taut
Published: May 2024

The effects of density and shape of hollow silica (functionalized silica hollow tubes (FSHT) or hollow glass microspheres (FHGM)) on dielectric constant (εr) and dielectric loss (tan δ) of hindered phenol (HP) grafted functional polypropylene (FPP)/FSHT, heat-treated FPP (HTFPP)/FSHT, FPP/FHGM or HTFPP/FHGM substrate films were systematically investigated. The dielectric or free-volume-hole characteristics of FPP/FSHT, FPP/FHGM, HTFPP/FSHT, or HTFPP/FHGM films decrease to a minimum, as FSHT or FHGM contents approach an optimal value of 4wt% or 8wt%, respectively, and their dielectric or free-volume-hole characteristics decrease or increase gradually with increasing HP molar%. The minimum εr and tan δ of FPP/FSHT or HTFPP/FSHT films decrease significantly with decreasing FSHT’s densities. By filling with 0.46 g/cm3 identical density of hollow silica fillers, the minimum εr or tan δ procured for FPP/FSHT or HTFPP/FSHT films are somewhat smaller than those of corresponding FPP/FHGM or HTFPP/FHGM films. The linear coefficient of thermal expansion (LCTE) or onset degradation temperature (DTonset) of FPP/FSHT, HTFPP/FSHT, FPP/FHGM or HTFPP/FHGM films reduce or increase visibly with increasing FSHT or FHGM contents, respectively. All DTonset values of HTFPP/hollow silica films are ~ 150℃ higher than those of conventional PP polymers. Satisfactorily low εr/tan δ (1.74/0.0019, 1.83/0.0020, 1.83/0.0024 and 1.92/0.0028 at 1 MHz), LCTE (95×10− 6/℃, 89×10− 6/℃, 80×10− 6/℃ and 74×10− 6/℃) and pleasing heat-resisting properties for 6G ultrarapid communication are acquired for properly prepared FPP/FSHT, HTFPP/FSHT FPP/FHGM or HTFPP/FHGM substrate films having 1.2 HP molar% and 0.46 g/cm3 density of FSHT and FHGM fillers. Probable reasons accounting for these reduced dielectric, LCTE and improved heat-resisting characteristics are proposed.
The Effect of Antiseizure Medication on Mortality in Spontaneous Aneurysmal Subarachnoid Hemorrhage
Authors: Kanter John Harold , Glaser Adam C. , Martinez-Camblor Pablo , Gerstl Jakob V.E. , Lebouille-Veldman Anna B , Arora Harshit , Buhl Lauren , Boone Myles Dustin , Ogilvy Christopher S
Published: May 2024

Background
Spontaneous aneurysmal subarachnoid hemorrhage (aSAH) is a major cause of morbidity and mortality in the United States. The efficacy of early antiseizure medication (ASM) is debated. Recent literature reports seizure rates ranging from 7.8% to 15.2% following spontaneous aSAH. Current guidelines recommend use of early ASM in patients with “high-risk features,” but whether early ASM use decreases the rate of death associated with aSAH remains unclear. This study assessed whether early administration of early ASM impacts mortality rates after spontaneous aSAH.
Methods
We conducted a retrospective cohort study using a publicly available dataset from the Massachusetts Institute of Technology, Medical Information Mart for Intensive Care-III (MIMIC) database of all patients over the age of 18 with spontaneous aSAH resulting in an intensive care unit (ICU) admission to a major United States trauma center from 2001 to 2012. The primary exposure was receiving early ASM and primary outcome of death within 7 days. Different regression models were created to explore the association between early ASM administration within 24 hours of admission and a composite outcome of seizure and/or death within 7 days of admission. Secondary outcomes included 30-day and one-year mortality.
Results
Of 253 patients with spontaneous aSAH, 148 received early ASM within 24 hours. Patients who did not receive early ASM were more likely to die within 7 days of admission (adjusted odd ratio, [aOR]: 0.25 95% CI 0.09 to 0.067; P=0.006) but were less likely to have a seizure (aOR: 7.65 95% CI 2.03 to 28.89).
Conclusion
Early ASM administration was associated with lower rates of seizure and/or death within 7 days of admission among patients who presented to an ICU with spontaneous aSAH. These findings suggest broader use of early ASM in patients who present with spontaneous aSAH may improve early mortality.
A Non-Linear Association of Low-density lipoprotein cholesterol with All-Cause and Cardiovascular and Mortality Among Patients with Hypertension: Results from the NHANES 1999–2018
Authors: Liang Guoliang , Ma Jiangwei , Zhang Wenhao , Gu Xinxin , Zhang Qiong , Liu Ankang , Qing Xinran
Published: May 2024

Background
Although numerous studies have examined the correlation between low-density lipoprotein cholesterol (LDL-C) and mortality, no study has explored these associations in hypertensive populations. This study aims to investigate the relationship between low-density lipoprotein cholesterol and cardiovascular and all-cause mortality in adults with hypertension.
Methods
Hypertensive participants aged ≥ 18 years old from the National Health and Nutrition Examination Survey (NHANES) 1999–2018 with blood lipid testing data and complete follow-up data until December 31, 2019 were enrolled in the analysis. Univariate and multivariate Cox regression were conducted for the calculation of hazard ratios (HR) and 95% confidence intervals (CI). To visually represent the relationship between LDL-C and mortality, a restricted cubic spline (RCS) curve was created, and stratification analysis was also carried out.
Results
We analyzed 9,635 participants (49.6% male, mean age of 59.4 years). Following a median of 98 months of follow-up, there were 2,283(23.7%) instances of all-cause fatalities, with 758(7.9%) cases attributed to cardiovascular disease. Multivariate Cox regression analysis showed lower levels of LDL-C groups had a higher risk of all-cause and cardiovascular mortality; the LDL-C group's lowest level (< 2.198 mmol/L) still showed a 19.6% increased risk of all-cause mortality (p = 0.0068) in the the model that has been completely adjusted. Both all-cause mortality and cardiovascular mortality showed a non-linear association with LDL-C concentration in restricted cubic spline regression analysis.
Conclusions
In individuals with hypertension, LDL-C was linked to cardiovascular and all-cause mortality, and we further demonstrated that this relationship was non-linear.
Ultrasonic stress detection and regulation in the whole machining process of thin-walled part
Authors: Jia Jinjie , Lu Renhua , Song Wenyuan , Huang Mingcong , Zhang Ye , Yuan Xinman , Hou Junseng , Hu Zhiqing , Wang Feng , Huang Kun , Song Ge
Published: May 2024

Thin-walled aerospace parts have the characteristics of large size, thin wall thickness and complex shape, etc. In the process of machining, poor rigidity and high material removal rate are easy to cause machining deformation due to uneven distribution of residual stress, and conventional detection methods and regulation means can not meet the needs of on-site production. In order to solve these problems, an effective method of ultrasonic nondestructive in-situ stress detection and ultrasonic stress regulation is proposed in this paper. Firstly, the ultrasonic residual stress detection and ultrasonic stress regulation are analyzed theoretically, and their working principles are explained, which provides a theoretical basis for the subsequent use of the equipment. Then, according to the deformable sections of large thin-walled parts in the production site, the typical characteristics are extracted to complete the design of the experimental part, and the residual stress detection and regulation of the whole machining process are studied. Finally, through two groups of comparison experiments, the changes of residual stress values in different depth ranges of parts and the changes of the flatness of the final parts are analyzed. The results show that the ultrasonic critical refraction longitudinal wave (LCR wave) method can be used to detect the residual stress of thin-walled parts in different depth ranges, and the ultrasonic stress regulation method can reduce and homogenize the stress of thin-walled parts, and the machining deformation and conformal ability of the parts are significantly improved after the stress regulation.
Conbercept enhances the phagocytic activity of retinal Müller glia towards hard exudates in diabetic retinopathy
Authors: Zhu Yingying , Qin Shiyue , Xie Hai , Liu Yinping , Li Xiaosa , Zhang Yanchun , Zhang Chaoyang , Zhang Jingfa
Published: May 2024

Purpose
Hard exudates (HEs) are one of the main factors affecting vision in patients with diabetic retinopathy (DR) and diabetic macular edema (DME). Anti-vascular endothelial growth factor (anti-VEGF) is the main therapy for DME, but its effect on Müller glia phagocytosis remains unclear. The aim of this study was to investigate the effects of conbercept on phagocytosis of HEs by Müller glia in DR and elucidate the underlying mechanism(s).
Methods
Twenty-one eyes from 17 patients diagnosed with DR or DME underwent optical coherence tomography (OCT) imaging at baseline and one week after each consecutive intravitreal conbercept injection (ICI), administered three times with an interval of over one month between each injection, to assess changes in HEs. The rat Müller cell line (rMC-l) was cultured under high glucose conditions to mimic a diabetic environment. Cells were treated with oxidized low-density lipoprotein (Ox-LDL) alone or in combination with conbercept. Cell viability was assessed using the Cell Counting Kit-8 (CCK-8). The phagocytosis of Ox-LDL by rMC-l cells with or without conbercept was examined via immunofluorescence, flow cytometry, and Western blot. Gene expressions of several scavenger receptors and transporters involved in lipid metabolism, including RAGE, LOX-1, TLR-4, CD36, SR-AII, and ABCG-1, were analyzed using quantitative real-time polymerase chain reaction (qRT-PCR).
Results
The area of the HEs exhibited minimal changes following the initial ICI, whereas a significant decrease in area was observed after three consecutive injections. The viability of rMC-l cells was obviously reduced at higher concentrations of conbercept (> 100 µg/mL). Under high glucose conditions, rMC-l cells phagocytosed Ox-LDL, particularly locolized around the nucleus, and conbercept further enhanced this phagocytosis. Ox-LDL treatment increased the expression of the receptors and transporters involved in phagocytosis and lipid metabolism, while conbercept treatment further enhanced their expressions, except for ABCG-1 which was decreased.
Conclusion
This study confirmed that Conbercept treatment can effectively reduce the area of HEs in DR and DME. This therapeutic effect may be attributed to the enhanced phagocytic capability of Müller glia towards HEs, which is mediated by the regulation of key lipid metabolism receptors and transport proteins. These findings provide novel mechanisms underlying the facilitation of HEs clearance in DR and DME by anti-VEGF therapy, thereby establishing a theoretical basis for future therapeutic strategies.
US and MRI: which is better in the postoperative follow-up of Bone tumor?
Authors: Yu Ping , Hu Yue , Zhu Jiaan , Wang Yu
Published: May 2024

Background: Magnetic resonance imaging (MRI) is a good imaging way to detecting the local recurrence of primary malignant bone tumors, which can image the structure of local muscles, joints, blood vessels and nerves to evaluate intramedullary infiltration and extrinsic invasion area. However, imaging has been limited by the presence of metal implants which causing substantial artifacts on MRI. Therefore, the purpose of this study is to compare the diagnostic value of ultrasound (US) versus MRI in local recurrence of primary bone tumors after surgery.
Methods: We retrospectively reviewed the medical records of patients who were examined in our hospital after primary bone tumor surgery from June 2016 to June 2023. All confirmed relapsed cases both underwent US and MRI prior to pathological examination. The McNemar’s test was used for paired variables between US and MRI. P values <0.05 were considered significant.
Results: Local tumor recurrence confirmed by pathology in total 21 cases, including 14 cases of osteosarcoma, 5 cases of chondrosarcoma, 1 case of Ewing's sarcoma, and 1 case of sacrum tumor. There were 11 cases without local tumor recurrence, including 3 cases with pathological results and 8 cases by following-up. There was statistical difference in the detection rate of local recurrence after primary malignant bone tumor between US and MRI.
Conclusion: Compared with MRI, US shows better effect on postoperative follow-up of primary malignant bone tumors. US should be used as a routine post-operative monitoring method for patients in primary bone tumors.
Prevalence and Risk Factor Analysis of Hypertension in Rural Adults: A Novel 7-Category Blood Pressure System and Generalized Linear Mixed-Effects Model Approach
Authors: Ahmad Fayaz , Mehmood Tahir , Liu Xiaotian , Yuchi Xianghao , Kang Ning , Liao Wei , Wu Ruiyu , Baheti Bota , Dong Xiaokang , Hou Jian , Akhtar Sohail , Wang Chongjian
Published: May 2024

Background
Hypertension (HTN) is a major health risk factor for heart disease. This study explored HTN prevalence, awareness, treatment, and control in rural China using the Henan Rural Cohort Study. We also aimed to identify risk factors for developing HTN.
Methods
We surveyed 39,224 adults (aged 18–79) between 2015–2017 (response rate: 93.7%) and followed up with 28,621 in 2018–2022. Surveys assessed HTN status (categorized by age and sex) using a novel 7-category blood pressure system. To identify HTN risk factors, we employed a novel generalised linear mixed-effects model (GLMM) that accounts for individual variations within the study population.
Results
Overall HTN prevalence was around 33% (first survey: 32.73%, second survey: 33.85%). Awareness (20.09–25.31%) and treatment (18.77–24.42%) improved significantly (p < 0.05) between surveys, but control remained low (6.15–12.30%). Our GLMM analysis identified several factors associated with an increased risk of HTN. These included older age (OR: 1.23, 95% CI: 1.18–1.28), female gender (OR: 1.882, 95% CI: 1.669–2.121), ever having consumed alcohol (OR: 1.519, 95% CI: 1.342–1.719), and having a waist-to-hip ratio in the "Yes" category (WHRgrpYes) (OR: 1.161, 95% CI: 1.076–1.252).
Conclusions
Despite improvements, HTN prevalence remained high. The 7-category system aided HTN diagnosis. This study's application of a novel GLMM to predict HTN risk based on various factors, including age, sex, and body mass index, can inform future research to improve HTN management in rural China.
Clinical Trial Registration: The Henan Rural Cohort Study was registered at the Chinese Clinical Trial Register (registration number: ChiCTR-OOC-15006699). Date of registration: July 06, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375
MultiEthno-Linguistic Toolkit for Stakeholder Involvement in Research
Authors: Nagraj Sumanth Kumbargere , Eachempati Prashanti , Uhm Seilin , Nasser Mona
Published: May 2024

The United Nations’ 2030 Agenda for Sustainable Development says we should not leave anyone behind, meaning everyone should have a fair chance to improve their lives without facing poverty, discrimination, or exclusion. This agenda well applies to the field of research and in research, it is important to ask questions that matter to everyone involved. However, there are challenges like cultural differences, trust issues, and power imbalances that make it tough for diverse groups to join research. That is why we need better ways to involve people from minority ethnic groups who may not speak English or have much experience with research. Even though funders say we should involve different kinds of people in health research, it is hard because of cultural, language, and political differences. Therefore, it is important to make sure everyone is on board with the research right from the start. At present, many research groups have made guidance documents or toolkits with advice on how to involve different people in clinical trials, guideline development, research priority setting, and systematic reviews. They focus on being fair and making sure everyone is included. Even though these guidance documents say patients and the public should help make healthcare rules, there is not much information about how non-English-speaking minority ethnic groups can join in. So, we suggest a toolkit to help involve people from different ethnic and language groups in research. We looked at information and what we learned from three projects where people from different ethnic groups and who spoke different languages were involved. Using this, we made a toolkit called the MultiEthno-Linguistic Toolkit (MELT) to help get stakeholders involved in the research process.
Comparative Acute Toxicity and Safety Indices of Organophosphate Insecticides on Apis mellifera
Authors: Ayoub Liyaqat , Yaqoob Munazah , Kanth Raihana H. , Wani Fehim Jeelani , Wani Fazil Fayaz , Gull Audil
Published: May 2024

European honey bee (Apis mellifera L.) plays a vital role as a pollinator, contributing significantly to global ecosystems and agricultural productivity. However, their populations are increasingly threatened, primarily due to exposure to pesticides, particularly organophosphates, commonly used in agriculture for pest control. In this study, insecticides including chlorpyriphos 20 EC, dimethoate 30 EC, and profenophos 50 EC were evaluated at various concentrations (0.005–0.09%) through topical and oral application methods. Results showed significant mortality in experimental bees across all concentrations of the insecticides, with higher mortality observed in oral exposure. Mortality increased with concentration and time, with chlorpyriphos 20 EC exhibiting mortality percentages ranging from 6.67–100%, dimethoate 30 EC from 0.00–100%, and profenophos 50 EC from 8.33–100%. Toxicity assessment revealed lowest LC50 values in chlorpyriphos 20 EC (0.008) and dimethoate 30 EC (0.007) through topical and oral methods at 24 hours after treatment (HAT), respectively. Relative toxicity, extrapolated from LD50 values, was highest in chlorpyriphos 20 EC (1.62) and dimethoate 30 EC (1.85) through topical and oral methods at 24 HAT, respectively. Profenophos 50 EC exhibited the lowest safety index (0.26) through topical application and dimethoate 30 EC (0.23) through oral application at 24 HAT. Overall, the study highlights the negative impact of insecticides on A. mellifera and underscores the urgent need for a comprehensive evaluation of the risks posed by current pest control practices to honey bees and other essential pollinators.
Online Problem Based Learning in Child and Adolescent Psychiatry in Nagoya University, Japan
Authors: Kwon Daseul , Kondo Takeshi , Takahashi Noriyuki , Takami Hideki , Nishigori Hiroshi , Aleksic Branko , Villalobos Itzel Bustos , Kasuya Hideki , Yagi Tetsuya , Skokauskas Norbert
Published: May 2024

Purpose
Mental health care is limited worldwide, especially for children and adolescents. In the case of Japan, one in five children has a mental health problem. However, there are barriers to using mental health services for children and adolescents, including a shortage of standardized training programs and the subsequent workforce. To solve this, Japan adapted Problem Based Learning (PBL) to enhance standardized medical education about Child and Adolescent Psychiatry (CAP). This study aims to evaluate online CAP studies at Nagoya University (NU), Japan, with a focus on PBL materials.
Design and methods
A descriptive cross-sectional study was carried out at NU with a questionnaire developed under the Trondheim-Nagoya (TroNA) project by NU and the Norwegian University of Science and Technology (NTNU). The questionnaire measuring students' perceptions and understanding of the PBL curriculum and PBL in CAP consisted of 15 questions using a three-point Likert scale. To compare PBL CAP delivered online (2021) with established PBL CAP carried out in person (2019) at NU, an identical questionnaire was used both in 2019 and 2021.
Results
The majority of medical students in both in-person (82.5%) and online (91.2%) classes agreed that PBL helped them to develop clinical problem-solving skills. In addition, 53.6% of students in in-person class and 75.8% of students in online class thought PBL enhanced their understanding of CAP. In terms of specific case scenarios, the majority of students in the in-person class (59.8%) and online class (74.7%) agreed that the PBL case helped them to understand the importance of a multidisciplinary approach in CAP.
Conclusion
Most of the NU medical students were generally satisfied with CAP's online PBL curriculum. The online PBL CAP curriculum with specific case scenarios can provide medical students with suitable educational means. This study can be a cornerstone for establishing online PBL education in CAP and making plans to attract more future doctors to CAP.
An Improved Sand Cat Swarm Optimization with Lens Opposition-based Learning and Sparrow Search Algorithm
Authors: cai yanguang , guo changle , chen xiang
Published: May 2024

In order to enhance the global search ability of the sand cat swarm optimization, avoid falling into the local optimum at a later stage, and improve the performance of the algorithm, an improved algorithm is proposed - Improved sand cat swarm optimization based on lens opposition-based learning and sparrow search algorithm (LSSCSO). A dynamic spiral search is introduced in the exploitation stage to make the algorithm search for better positions in the search space and improve the convergence accuracy of the algorithm. The lens opposition-based learning and the sparrow search algorithm are introduced in the later stages of the algorithm to make the algorithm jump out of the local optimum and improve the global search capability of the algorithm. To evaluate the effectiveness of LSSCSO in solving global optimization problems, the performance of the algorithm is tested using 23 standard benchmark functions and compared with seven competitive algorithms, which show that LSSCSO has strong optimality finding ability and performs optimally in most cases. Finally, the application of LSSCSO to four engineering optimization problems also verifies the effectiveness of the algorithm in solving engineering optimization problems.
IKZF3 amplification predicts worse prognosis especially in intestinal-type gastric cancer
Authors: Cui Zhaomeng , Liang Huaiyu , Luo Rongkui , Huang Wen , Yuan Wei , Zhang Lei , Luan Lijuan , Su Jieakesu , Huang Jie , Xu Chen , Hou Yingyong
Published: May 2024

Purpose
IKAROS family zinc finger 3 (IKZF3) is an oncogene involved in different malignancies, particularly in the development and malignant progression of lymphocytes. However, IKZF3 amplification and clinical significance in gastric cancers (GCs) remain unexplored.
Methods
We examined IKZF3 amplification status in 404 GCs with HER2 amplification status using tissue microarray (TMA) and fluorescence in situ hybridization (FISH) assays.
Results
IKZF3 amplification was detected in 6.9% (28/404) of all GC patients, with higher rates in intestinal-type gastric cancer (IGC) (11.22%, 22/196) compared to other types (2.88%, 6/208). HER2 amplification was identified in 16.09% (65/404) of all GC patients, with higher rates in IGC (20.92%, 41/196) compared to other types (11.54%, 24/208). Co-amplification of IKZF3 and HER2 was detected in 8.16% (16/196) of IGC patients and in 2.40% (5/208) of other types. IKZF3 amplification showed significant correlation with IGC (P = 0.001) and HER2 amplification (P = 0.0001). IKZF3 amplification exhibited significantly worse disease-free survival (DFS) (P = 0.014) and overall survival (OS) (P = 0.018) in GC patients, particularly in IGC (DFS: P < 0.001; OS: P < 0.001), rather than other types. Cox regression analysis demonstrate IKZF3 amplification as an independent poor prognostic factor in all GCs (P = 0.006, P = 0.004 respectively) and in IGC patients, regardless of stages I-II or III-IV (P = 0.007, P = 0.004 respectively). On the other hand, HER2 amplification was significantly associated with worse DFS (P = 0.008) and OS (P = 0.01) in IGC patients, but not in all GCs and in multivariate analysis. Within the subset of patients with HER2 amplification, those also exhibiting IKZF3 amplification displayed potential poorer prognosis (P = 0.08, P = 0.11 respectively).
Conclusion
IKZF3 amplification was detected in minority of GC patients, especially in IGC, and was an independent indicator of poor prognosis. Our study, for the first time, found the prognostic value of IKZF3 was superior to HER2 for GC patients.