bluuebunny/crossref_metadata_2025 huggingface dataset:
Global nitrogen pollution from cropping could be cut substantially through farm size optimization amid socio-economic drivers
Authors: Liu Lei
Published: February 2024

Mitigating nitrogen pollution in regions dominated by smallholder farming is crucial for achieving Sustainable Development Goals (SDGs) while feeding the growing population. Small farms with size less than two hectares, constituting around 84% of all farms globally, support food production but suffer from low nitrogen use efficiency and nitrogen overuse. It remains poorly understood where to put forward future efforts in small farms to address both production and pollution challenges simultaneously. By linking agronomic research with air quality modelling, health impact as well as cost-benefit analysis, here we report the outcome of a global integrated analysis focused on enhancing nitrogen use efficiency and environmental performance by optimizing small farms. Our findings reveal that small farms, less than 2 hectares in size, apply nitrogen at a rate 2-3 times higher than large farms for major crops. The overall global nitrogen waste amounts to approximately 103 billion USD in 2020, with a significant portion in Asia (65%), followed by the Americas (15%), Africa (11%), Europe (8%), and Oceania (1%). Through optimizing small farms with consolidating fragmented lands in alignment with socio-economic drivers, we predict that substantial nitrogen use efficiency improvement can be achieved by 2-14%; this could potentially cut global nitrogen waste in half (13-71% across regions) and avoid over 142,000 premature deaths per year and generate an annual benefit of over 500 billion USD globally. Although significant investment is required for this shift, there would be substantial progress towards achieving SDGs, associated with food security and human health.
Safety and efficacy of ketorolac in improving the prognosis of acute type A aortic dissection patients: a protocol of a randomized, double-blinded, and placebo-controlled study
Authors: Lv Zhi-Kang , Pan Tuo , Zhang Hai-Tao , Wang Ya-Peng , Matniyaz Yusanjian , Tang Yu-Xian , Lu Li-Chong , Wang Dong-Jin
Published: February 2024

Background: Acute type A aortic dissection (aTAAD) is a critical and life-threatening condition. Previous research has demonstrated that the use of ketorolac not only reduces the progression, incidence, and severity of aortic aneurysms in animal models, but also decreases postoperative mortality and complications in patients undergoing open abdominal aortic aneurysm replacement. However, there is a lack of studies investigating the efficacy of ketorolac in treating aTAAD in humans. Therefore, we conducted a study to evaluate the safety and efficacy of ketorolac in patients with aTAAD. Our hypothesis was that ketorolac treatment for aTAAD patients would meet safety indicators and effectively improve patient prognosis.
Methods/design: This study is a single-center, randomized, double-blinded, and placebo-controlled study. A total of 120 patients with aTAAD will be recruited and will be randomised into the ketorolac group and placebo group with a ratio of 1:1.Ketorolac tromethamine 60mg per 2ml will be intramuscularly injected within 2 hours before surgery, followed by intramuscular injections of 30mg per 1ml BID. on the first and second postoperative days in the Ketorolac group, while 0.9% saline will be administered at the same dose, dosage form, and time in the placebo group. This study aims to evaluate the safety and the efficacy of ketorolac in improving the prognosis of aTAAD. The primary endpoints of the study represent changes in inflammatory indicators after drug treatment. Secondary endpoints include drug related adverse events, laboratory examination of blood, diagnostic imaging test, clinical biomarkers, etc.
Discussion: This study has been approved by Medical Ethics Committee of Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical College (approval number: 2023-197-02). This study is designed to evaluate the safety and efficacy of ketorolac in patients with aTAAD. All participating patients will sign an informed consent form, and the trial results will be published in international peer-reviewed journals.
Trial registration: The Chinese Clinical Trial Registry (http://www.chictr.org.cn) ChiCTR2300074394. Registered on 4 October 2023.
Behavioral Economic and Wellness-based Approaches for Reducing Alcohol Use and Consequences Among Diverse Non-Student Emerging Adults: Study Protocol for Project BLUE, a Randomized Controlled Trial
Authors: Murphy James G. , Dennhardt Ashley A. , Tempchin Jacob , Colgonis Hannah E. , McDevitt-Murphy Meghan , Borsari Brian , Berlin Kristoffer S.
Published: February 2024

Background: Emerging adults (EAs) who are not 4-year college students nor graduates are at elevated risk for lifetime alcohol use disorder, comorbid drug use, and mental health symptoms, compared to college graduates. There is a need for tailored brief alcohol intervention (BAI) approaches to reduce alcohol risk and to facilitate healthy development in this high-risk population. Most BAIs include a single session focused on discussing risks associated with drinking and correcting normative beliefs about drinking rates. EAs may benefit from additional elements that enhance general wellness. The Substance-Free Activity Session (SFAS) aims to clarify life goals and values and increase goal-directed activities that provide alternatives to alcohol use, and the Relaxation Training (RT) session teaches relaxation and stress reduction skills.
Methods: The present study is a randomized 3-group (BAI+SFAS vs. RT+SFAS vs. education control) trial with 525 EAs (175 per group; estimated 50% women & 50% African American) who report recent risky drinking and who are not students or graduates of 4-year colleges. Participants will have the option of completing the intervention sessions in person or via a secure video teleconference. Levels of drinking and alcohol-related problems will be evaluated at baseline and 1, 3, 6, and 12-months post-intervention. The primary hypothesis is that both BAI+SFAS and RT+SFAS participants will report significantly greater reductions in alcohol use and problems relative to education control participants, with no differences in outcomes between the two active treatment conditions.
Discussion: The results of this study will inform alcohol prevention efforts for high-risk community dwelling emerging adults.
ClinicalTrials.gov Identifier: NCT04776278
E2F-1 inhibits ferroptosis in osteosarcoma cells by activating the PSAT1/Xct/GPX4 signaling axis
Authors: Wang Po , Xiao Jun , Zeng Jin , Yang Feng , Lin Mingchao , Liang Tao , Zhan Haibo , Liu Hucheng
Published: February 2024

Osteosarcoma is a common primary malignant bone tumour that occurs mainly in children and adolescents and has a poor survival and prognosis. Currently, ferroptosis is a newly defined form of cell death, but the mechanism between it and osteosarcoma is unclear. To further investigate the relationship between osteosarcoma and ferroptosis, it is important to search for new biomolecular factors. We used bioinformatics to dig deeper into the ferroptosis gene PSAT1, which is closely associated with osteosarcoma. Although PSAT1 has been reported in other types of tumours and plays an important role in the development of many tumours, such as melanoma and breast cancer, little research has been done in the field of osteosarcoma. To explore the role of PSAT1 in osteosarcoma and its association with ferroptosis, we designed relevant experiments. Subsequently, we predicted the transcription factor E2F-1 for PSAT1 from the transcription factor frediction database and experimentally verified that E2F-1 could inhibit ferroptosis in OS cells by activating PSAT1. The results indicated that PSAT1 could promote the development of osteosarcoma and inhibit the ferroptosis process in osteosarcoma cells. This finding implies that PSAT1 may become a new target for the diagnosis and treatment of osteosarcoma in the future, bringing new breakthroughs to clinical practice.
Spatiotemporal Evolution of the Institutional Eldercare in the Yangtze River Delta Urban Agglomeration
Authors: Zhou Rong , Cui Jinghang , Crandall K. Jason
Published: February 2024

Background: The objective of this study is to examine the spatiotemporal evolution mechanism of the institutional eldercare in the Yangtze River Delta Urban Agglomeration (IE-YRDUA). It aims to analyze the developmental patterns and spatial correlations of these institutions over a twenty-year period, in order to shed light on the increasing demand for eldercare services in this economically significant region.
Methods: This study utilizes spatial analysis and factor detection methods within an economic geography framework to analyze data from 2001 to 2020. The focus of the analysis is on understanding spatial correlations and identifying factors that influence the evolution of eldercare services.
Results: The findings indicate a significant growth and distribution of eldercare institutions, with notable spatial correlations suggesting a trend towards regional agglomeration. The study also reveals imbalances in the spatial development of eldercare, with a concentration of facilities in central urban areas and a decline on the periphery. Additionally, factors such as economic level and capacity to consume have a significant impact on the spatial evolution of eldercare services.
Conclusions: This study emphasizes the dynamic nature of institutional eldercare in the Yangtze River Delta, highlighting the necessity for strategic planning and resource allocation to address spatial imbalances in eldercare provision. The insights gained from this study are crucial for policymakers and stakeholders in optimizing eldercare infrastructure and meeting the growing demands of the population.
The causal effects of genetically predicted Alcohol Consumption on Endometrial Cancer risk from a Mendelian Randomization study
Authors: Yang Jie , Qu Xiang , Zheng An-jie , Jiang Fan , Chang Hui , Zhang Jin-ru , Yan Li-juan , Ning Peng
Published: February 2024

Endometrial cancer (EC) is a common gynecological tumor in females with an increasing incidence over the past few decades. Alcohol consumption has been linked to the occurrence of various cancers; However, epidemiological studies have shown inconsistent associations between alcohol consumption and EC risk. In order to avoid the influence of potential confounding factors and reverse causality in traditional epidemiological studies, we used a method based on genetic principles-Mendelian randomization (MR) analysis to test whether there is a causal relationship between alcohol consumption and EC. MR analysis was conducted using publicly available summary-level data from genome-wide association studies (GWAS). Fifty-seven single nucleotide polymorphisms (SNPs) were extracted as instrumental variables (IVs) for alcohol exposure from the GWAS and Sequencing Consortium of Alcohol and Nicotine (GSCAN) GWAS summary data involving 941,287 participants of European ancestry. SNPs for EC were obtained from the Endometrial Cancer Association Consortium (ECAC), the Endometrial Cancer Epidemiology Consortium (E2C2), and the UK Biobank, involving 121,885 European participants. The inverse variance weighted (IVW) method was used as the primary method to estimate the causal effect, and the MR-Egger regression and weighted median method were used as supplementary methods. Sensitivity analyses were conducted using the Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO) global test, MR-Egger intercept test, and leave-one-out analysis to evaluate the impact of pleiotropy on causal estimates. An increase of 1 standard deviation (SD) of genetically predicted log-transformed alcoholic drinks per day was associated with a 43% reduction in EC risk (odds ratio (OR) = 0.57, 95% confidence interval (CI): 0.41–0.79, P<0.001). Subgroup analysis of EC revealed that alcohol consumption was a protective factor for endometrioid endometrial cancer (EEC) (OR = 0.56, 95% CI: 0.38–0.83, P = 0.004) but not for non-endometrioid endometrial cancer (NEC) (OR = 1.36, 95% CI: 0.40–4.66, P = 0.626). The MR-Egger regression and weighted median method yielded consistent causal effects with the IVW method. The consistent results of sensitivity analyses indicated the reliability of our causal estimates. Additionally, alcohol consumption was associated with decreased human chorionic gonadotropin (HCG) and insulin-like growth factor 1 (IGF1) levels. This MR study suggests that genetically predicted alcohol consumption is a protective factor for EC, particularly for EEC, and this protective effect may be mediated through the reduction of HCG and IGF1.
The Port-A-Cath Application and Care Knowledge Scale (PACKS) for nurses: Development and initial validation with Rasch analysis
Authors: Li Yueh Ping , Hu Fang Wen , Hsieh Hsiao Yen , Lin Chun Chang , Lin Chung Ying
Published: February 2024

Purpose: This study aimed to develop a Port-A-Cath Application and Care Knowledge Scale (PACKS) for nurses and examine its initial psychometric properties.
Method: This was a methodological study. The initial 30 items of the PACKS included two subscales with items generated from a literature review, expert validity, and face validation. A questionnaire survey was then completed by clinical nurses (n =377) from three hospitals in Taiwan. Rasch analysis was used to test whether each PACKS subscale was unidimensional and whether all items in the same subscale fit with their constructs.
Results: The application knowledge PACKS subscale demonstrated evidence of unidimensionality with acceptable item fit according to the Rasch model (infit mean square [MnSq] = 0.91-1.08; outfit MnSq = 0.66-1.15). Similarly, the care knowledge PACKS subscale demonstrated evidence of unidimensionality with acceptable item fit except (infit MnSq = 0.87-1.16; outfit MnSq = 0.77-1.28) for the fifth item (outfit MnSq = 1.77). After removing the fifth item, all the remaining items had acceptable infit and outfit MnSq. However, several items displayed differential item functioning (DIF) across gender, which could have been caused by the imbalanced gender distribution in this study.
Conclusions: The PACKS is a reliable and valid instrument which clinical staff and researchers can use to evaluate nurses’ knowledge on Port-A-Cath application and care.
Liver transplant-facilitated recovery of MAIT cell from dysregulation in HBV-related liver failure demonstrates clinical benefits
Authors: Weng Xiufang , Wang Wei , Dai Chen , Zhu Peng , Wu Mi , Zhang Haoquan , Wei Qing , Zhou Ting , Tan Xiaosheng , Jiang Ying , Cheng Xue , Liang Zhihui , Wu Xiongwen , Chen Zhishui
Published: February 2024

Mucosal-associated invariant T (MAIT) cells exert multifaceted effects such as anti-microbial activity, tissue repair, and pro-fibrotic effects across various disease settings. Nonetheless, their role in liver injury and hemostasis is a current topic of debate. Here, we presented a MAIT cell-centered profiling in chronic HBV-infected patients with varying degree of liver injury and those who underwent liver transplantation. Liver transplantation facilitated a gradual recovery of recipient-originated MAIT cells from dysregulation associated with disease severity and accumulated bile acids in liver failure. Transcriptome analysis and T cell receptor (TCR) mining indicated an upregulation in MAIT cell migration during liver injury and post liver transplantation, characterized by elevated liver egress in the former and rescued liver homing receptors in the latter. TCR activation exacerbated the pathological potency of MAIT cells from liver failure patients, but conferred a protective potential in those from transplant recipients. Compromised recovery of MAIT cells was linked to post-transplantation complications, whereas prompt recovery predicated a more favorable clinical outcome. These findings underscore the intricate interplay between MAIT cells and the hepatic environment, highlighting MAIT cells as potential therapeutic targets and sensitive predictors for clinical outcome in individuals experiencing liver failure and post liver transplantation.
Cross-cultural adaptation of PIDAQ questionnaire to evaluate the psychosocial impact of dental esthetics in Chilean adolescents with malocclusion
Authors: Oneto Humberto González , Pinto María Ignacia Torres , Abuawad Yazmín Zedan , Chaparro María Macherone , Buratovic Juan Pablo Vargas , Borroto Duniel Ortuño
Published: February 2024

Background: Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is a useful index to assess aspects of malocclusion that impact individuals' oral health-related quality of life. This study aimed to perform cross-cultural adaptation of the PIDAQ questionnaire to the language of the Chilean adolescent population.
Methods: We used the framework of the Guidelines for the Transcultural Adaptation Process of self-reports and the Manuals for a language inclusive for the transcultural adaptation of the PIDAQ. The instrument was tested on 34 Chilean adolescents with malocclusion between 11 and 17 years of age. We evaluated equivalence considering criterion, content, and construct validity according to COSMIN methodology and performed Cronbach's alpha statistical test. A total of 23 items in the questionnaire were tested according to how clear and understandable the questions were to the reader and according to a Likert scale graduated in: not at all clear, unclear, clear, or very clear. For temporal stability, we calculated intraclass correlation coefficients (ICC).
Results: We obtained a more than acceptable reliability with a Cronbach's Alpha of 0.951 for the total questionnaire. The questions grouped according to the dimensions of dental self-confidence, social impact, psychological impact, and esthetic concern obtained a Cronbach's Alpha of 0.955, 0.947, 0.946 and 0.939, respectively. The questionnaire showed high temporal stability at the test-retest with a total ICC of 0.907 (0.885-0.913).
Conclusion: The cross-cultural adaptation of the PIDAQ questionnaire achieved equivalence with the original instrument and obtained reliable criterion, content, and construct validity in Chilean adolescents.
Uncovering the Connection between Obesity and Thyroid Cancer: the Therapeutic Potential of Adiponectin receptor agonist in the AdipoR2-ULK/p-ULK1Ser555 Axis
Authors: Sun Hui , li changlin , ZHANG JIAO , dionigi gianlorenzo , guan haixia , LIANG NAN
Published: February 2024

Adiponectin, a unique adipose-derived factor, is significantly downregulated in obesity, making it a crucial target for tumor-related metabolic research. AdipoRon is a novel adiponectin receptor agonist with the advantages of a small molecular weight, high stability and a long half-life. By screening the cervical adipose tissue of papillary thyroid carcinoma (PTC) patients with adipokine antibody array, we found that adiponectin was a potential correlation factor between obesity and PTC progression. AdipoRon has oral activity and is easily absorbed and delivered to target tissues. The effects of AdipoRon on thyroid cancer have not been reported. In this study, we identified adiponectin receptor 1 (AdipoR1) and AdipoR2 on the surface of thyroid cancer cell lines. AdipoRon inhibited the proliferation and migration of thyroid cancer cells, limited energy metabolism in thyroid cancer cells, promoted differentiation of thyroid cancer cells, and induced autophagy and apoptosis. Mechanistic studies revealed that AdipoRon inhibited p-mTOR Ser2448 and p-p70S6K Thr389, and activated ULK1 and p-ULK1 Ser555. ULK-1 knockdown suppressed the effect of AdipoRon on LC3BII/I protein and lysosomes. AdipoR2 knockdown reduced AdipoRon-induced autophagy in thyroid cancer cells. This study is the first to demonstrate the role of AdipoRon in PTC. Our findings illustrate a previously unknown function and mechanism of the AdipoRon-AdipoR2-ULK/p-ULK1Ser555 axis in PTC and lay the foundation for clinical translation of AdipoRon to PTC. Targeting the AdipoRon-AdipoR2-ULK/p-ULK1Ser555 axis may represent a new therapeutic strategy for PTC.
Evaluation of malignant potential based on infection with high-risk human papillomaviruses16, 52, and 58 in the uterine cervix
Authors: Lee Juhun , Lee Hyun-Jung
Published: February 2024

High-risk human papillomavirus (HR-HPV) is known as the most important carcinogen in uterine cervical carcinoma. Previous studies have evaluated genotype-specific risk for carcinogenesis. However, the genotype-specific risk remains still unclear due to some limitations of those studies. This study aimed to evaluate the malignant potential of the three most prevalent HR-HPVs in Korea. Patients who underwent cervical conization were included. They had received HPV test within a year before the surgery and those exhibiting concurrent multiple infections with HR-HPVs were excluded. Of single infections with HR-HPV, the three most prevalent HR-HPVs were included to analyze. To evaluate their malignant potential, CIS+, including carcinoma in situ (CIS) and invasive carcinoma, was categorized in each HR-HPV group. The ratios of pathologic diagnoses and odds ratios for malignant potential were evaluated between the three most prevalent HR-HPVs. Totally 230 patients were found to have a single infection with HR-HPV16, HR-HPV52, or HR-HPV58. The HPV16 group did not exhibit a significantly more CIS, invasive carcinoma, and CIS + than HPV52 or HPV58. Physicians should pay attention to not only HPV16 but also HPV52 and HPV58 because these genotypes have similar malignant potential. These findings support the need for a nine-valent vaccine against HR-HPVs in Korea.
Physiological relaxation and increased working speed induced by volatile organic compounds emitted from interior walls made of Kagawa hinoki Japanese cypress (Chamaecyparis obtusa)
Authors: Kishida Fumi , Tani Kazuki , Nakashima Taisuke , Zennifa Fadilla , Isa Akiko , Fujimoto Noboru , Fujita Koki , Taki Ryuma , Yasutomi Hiroo , Yasumori Naotoshi , Shimizu Kuniyoshi
Published: February 2024

Since ancient times, Japanese cypress timber (Chamaecyparis obtusa; 'hinoki' in Japanese) has been highly valued in Japan. Because of its beautiful color and fragrance, this timber has been widely used as houses and furniture materials. Scientific evidence on the effect of the usage of hinokis' timber especially from Kagawa’s area as a building material toward human psychophysiological response has yet to be reported. The current study examined participants' psychophysiological responses to volatile organic compounds (VOCs) generated by hinoki interior walls growing in Kagawa Prefecture, Japan. This timber was reported to have a relaxing effect toward the participants, and this study discovered that inhaling air containing VOCs emitted by Kagawa hinoki interior walls increased parasympathetic nervous activity during resting periods between arithmetic tasks. When compared to a control condition, the participants' performance on a calculation test improved dramatically in the hinoki condition. These findings suggest that VOCs released by Kagawa hinoki walls influence the autonomic nervous system, emotions, and work performance. This study not only proved Kagawa hinoki fragrance's potential to boost human working speed, but it also newly confirmed the fragrance's ability to increase parasympathetic nervous system activity while at rest. This study also discovered that the enhanced working speed is caused by a part of the neurological underpinning for heightened arousal in the brain. As a result, this study concluded that the aroma of cypress can have physiological effects that change over time, hence optimizing individuals' behavior at work and at rest.
Design and characterization of geopolymer foams reinforced with Miscanthus x giganteus fibers
Authors: Walbrück Katharina , Witzleben Steffen , Stephan Dietmar
Published: February 2024

This paper presents the effects of different amounts of fibers and foaming agent, as well as different fiber sizes, on the mechanical and thermal properties of fly ash-based geopolymer foams reinforced with Miscanthus x giganteus fibers. The mechanical properties of the geopolymer foams were measured through compressive strength, and their thermal properties were characterized by thermal conductivity and X-ray micro-computed tomography. Furthermore, design of experiment (DoE) were used to optimize the thermal conductivity and compressive strength of Miscanthus x giganteus reinforced geopolymer foams. In addition, the microstructure was studied using X-ray diffraction (XRD), Field emission scanning electron microscopy (SEM) and Fourier-Transform Infrared Spectroscopy (FTIR). Mixtures with a low thermal conductivity of 0.056 W (m K)−1 and a porosity of 79 vol% achieved a compressive strength of only 0.02 MPa. In comparison, mixtures with a thermal conductivity of 0.087 W (m K)−1 and a porosity of 58 vol% achieved a compressive strength of 0.45 MPa.
Bortezomib restrains M2 polarization and reduces CXCL16-associated CXCR6+CD4 T cell chemotaxis in bleomycin-induced pulmonary fibrosis
Authors: Zhou Ting , Lin Lan , Zhan Yawen , Zhang Ziyao , Jiang Ying , Wu Mi , Xue Dan , Chen Limin , Weng Xiufang , Huang Zhenghui
Published: February 2024

Background
The development of pulmonary fibrosis entails a cascade of events, where immune cell-mediated inflammation plays a central role. Chemotherapeutic drugs have been observed to exert dual impacts on fibrosis, with bleomycin exacerbating pulmonary fibrosis and bortezomib alleviating tissue fibrotic processing. Understanding of the complex interactions between chemotherapeutic drugs, immune responses, and pulmonary fibrosis is likely to serve as the foundation for crafting tailored therapeutic strategies.
Methods
A bleomycin-induced pulmonary fibrosis model was established, followed by bortezomib treatment. Tissue samples were collected for immune cell subset analysis and functional evaluation through flow cytometry and in vitro cell experiments. Additionally, multi-omics analysis was conducted to further elucidate the expression of chemokines and chemokine receptors and the characteristics of cell populations.
Result
Here, we noticed that CXCL16 and CXCR6 were elevated in the lung tissue of pulmonary fibrosis model. In the context of pulmonary fibrosis or in vitro TGF-β1 stimulation, macrophages exhibited M2-polarized phenotype and secreted more CXCL16 compared with control group. In addition, flow cytometry revealed that pulmonary CD4 T cells expressed higher CD69 and CXCR6 levels in fibrosis progress. Upon administration of bortezomib, bleomycin-induced pulmonary fibrosis was alleviated accompanied by decreased M2-polarized macrophages and reduced accumulation of CXCR6-expressing CD4 T cells.
Conclusions
Our findings provide insights into the key immune players in bleomycin-induced pulmonary fibrosis and offer the preclinical evidence supporting the repurposing strategy and combination approach to reduced lung fibrosis.
Risk of stress cardiomyopathy associated with selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors: A real-world pharmacovigilance analysis
Authors: Tan Boyu , Chen Li , Yan Sulan , Pan Huijie , Zhang Jingxian , hongyan wei
Published: February 2024

Objective
Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are the two commonly prescribed antidepressants, but these drugs have been reported clinically to cause stress cardiomyopathy (SC). This study aimed to evaluate the possible association between SSRI or SNRI usage and the occurrence of cardiomyopathy by mining the publicly available U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database.
Methods
The disproportionate analysis and likelihood ratio test were employed to identify risk signals associated with the use of SSRIs or SNRIs and the incidence of stress cardiomyopathy. The raw data was sourced from the FAERS database from 2012 to 2022. Descriptive statistics were further applied to present the demographic characteristics, time to onset, concomitant medications and prognostic outcomes. Statistical analysis and data visualization were conducted using the R v4.0.2.
Results
In total, 132 individual case safety reports (ICSRs) of SC associated with SSRIs or SNRIs were identified. Venlafaxine and fluoxetine were identified as the most commonly suspected antidepressant medications, accounting for 48% and 27% of the ICSRs, respectively. Approximately 80% of SC cases were reported in females, with individuals aged 45–65 identified as a high-risk population. The reporting regions were mainly in Europe and North America, with differences in antidepressant utilization preferences between geographic regions. Both venlafaxine (RSIC 2.54, 95%CI 2.06 to 3.04) and fluoxetine (RSIC 3.20, 95%CI 2.31 to 4.47) exhibited a significant disproportionality of SC, with likelihood ratio estimates of 3.55 (p = 0.02) for venlafaxine and 4.82 (p = 0.008) for fluoxetine. Propofol, lidocaine, oxycodone, gabapentin and zonisamide were the frequently co-administered with SSRIs or SNRIs. The median time to cardiomyopathy onset was 20 days. The most frequently reported outcomes were hospitalization or prolonged hospitalization in 48.33% of patients, and other serious events occurred in 12% of patients.
Conclusion
This analysis based on the FAERS database provided new insight into the main characteristics of adverse cardiomyopathic events associated with SSRIs and SNRIs in real-world. The risk of cardiomyopathy varied between SSRIs and SNRIs, and there was a significant disproportionate risk signal associated with stress cardiomyopathy, particularly in middle-aged women for venlafaxine and fluoxetine. Caution should be exercised when SSRIs or SNRIs are used with other serotonergic medications.
WITHDRAWN: Study on prevalence, risk factors and clinical phenotypic appraisals of Theileria annulata infection in Gir cattle
Authors: Parmar Vijay L. , Vagh A. A. , Patel U. D. , Bilwal A. K. , Thakre B. J. , Brahmbhatt N. N. , Patbandha Tapaskumar , Parmar J. N.
Published: February 2024

Background:Theileria annulata is responsible for tropical bovine theileriosis, which hasa significant impact on cattle health and leadsto remarkable economic losses to the dairy industry in India. In the present study, 702 Gir cattle were screened for Theileria annulata infection viatraditional microscopic and molecular techniques. The prevalence of the disease in relation to age, gender, season, tick infestations, and the frequency of acaricidal treatment in infected animals was assessed by the chi-square test, and potential risk factors were explored through multivariatelogistic regression. Additionally, a thorough clinical examination of each infected animal was performedto document clinical markers.
Results: The overall prevalence of T. annulata infection in Gir animals was37.46%. Among Gir cattle, the prevalence and risk of disease was significantly greaterin the >5 year age group (57.73%; P=0.001, OR=5.19, 95% CI = 3.504-9.996), during the summer season (49.08%; P=0.001, OR=3.19, 95% CI = 2.096-4.878), with tick infestation (58.58%; P=0.001, OR=6.5, 95% CI = 4.609-9.183) and significantly lower in animals with regular acaricidal application (6.98%; P=0.001, OR=0.04, 95% CI = 0.022-0.091). Pyrexia, lymphadenopathy, altered appetite, ocular and nasal discharge, pale mucous membrane, and tick infestations are considered important clinical appraisals.
Conclusions: The prevalence and risk of T. annulata infection were greater in addition to the variation in clinical markers in the Junagadh region, suggesting that further research is needed to explore the epidemiological status of this disease in the western region of Gujarat in Gir to develop effective preventive measures.
Classifying Students' Grounded Mental Models on Energy with Deep Neural Network
Authors: Yaz Ömer Volkan , Kurnaz Mehmet Altan , Karacı Abdulkadir
Published: February 2024

The concept of energy, a common interdisciplinary concept, is frequently used in daily life and can be associated with different subjects in terms of its scope. Additionally, it has an important place in science education, throughout primary, secondary and higher education. Thus, many grueling applications are carried out to detect learning situations. However, in recent years, opportunities have emerged to determine learning situations with deep learning networks (DNNs), which are a subunit of artificial intelligence. This study aimed to demonstrate the usability of DNNs in the classification of learning and to establish an example in this field of educational research concerning the concept of energy. To this end, a learning situation test was used to evaluate “energy types”, “transformation of energy” and “conservation of energy” to determine the “grounded mental model” (GMM). The test was used to determine the GMM of preservice teachers and to test the classification success with the least error by using a DNN. In this context, DNN models consisting of different parameters were designed for the training of deep neural networks. The models were analyzed with the most appropriate algorithm considering the number of hidden layers, the number of neurons in the hidden layers, the activation function, the optimization algorithm, the loss function, and the epoch values. Two methods were used for training and testing the ensemble classifiers and individual classifiers. The first is to divide the dataset into 70% training data and 30% test data, and the second is a 5-fold cross-validation method. The results were evaluated using the recall (R), specificity (S), accuracy (ACC), and F1 score metrics. According to the test results obtained from both methods, the ensemble classifier has the best classification performance. According to the results of the analysis with deep neural network algorithms, 95% classification accuracy was obtained. Trainers can use the designed DNN models as a validation tool in the detection of GMM.
Relationship between sexual function and marital satisfaction with quality of life-related gestational diabetes mellitus: a cross-sectional study
Authors: Nazarpour Soheila , Simbar Masoumeh , Kiani Zahra , Khalaji Neda , Khargh Mobina Khorrami
Published: February 2024

Background: Sexual dysfunction is a common problem among women with Gestational Diabetes Mellitus (GDM) that may affect the women’s quality of life (QoL). This study aimed to assess the relationship between women’s sexual function and marital satisfaction with GDM-related quality of life and its dimensions.
Method: This was a cross-sectional study of 168 women with GDM. The participants were recruited using a multi-stage sampling method from the maternal care centers affiliated with Shahid Beheshti University of Medical Sciences in Tehran-Iran. The data were collected using a socio-demographic questionnaire, the standard GDM-related quality of life questionnaire (GDMQoL-36), the Female Sexual Function Index (FSFI), and the Enrich's Marital Satisfaction questionnaire. The data were analyzed by using SPSS-23 software and statistical tests such as Pearson and Spearman correlation coefficient, t-test, ANOVA, and multiple linear regression.
Results: The average women’s age and the gestational age were 31.79±6.64 years and 30.73±6.11 weeks, respectively. The average scores for GDMQoL, FSFI, and marital satisfaction were 55.43±8.67 (ranging 0-100), 19.95±11.43, and 34.45±9.13, respectively. Female Sexual dysfunction (FSD) was observed in 62.5 percent of the participants. The total score of GDMQoL and the “Perceived constraints” dimension had a significant positive correlation with the total score of FSFI and its all domains. There were also significant positive correlations between the total score of GDMQoL with Enrich's marital satisfaction. Furthermore, there was a significant relationship between the total score of GDMQoL with age, weight, duration of marriage, adequacy of monthly income, husband's occupation, and history of GDM. Multiple linear regression revealed that sexual function and marital satisfaction are the potential predictors of GDMQoL.
Conclusion: Sexual function and marital satisfaction are related to the GDM-related quality of life of women. Therefore, improving sexual function and marital satisfaction should be considered for improving GDM-related quality of life in health care policies.
The catheter flushing method increases the diagnostic yield of brushing cytology for biliary strictures
Authors: Jang Sung Ill , Sung Min Je , Nahm Ji Hae , Jeong Seok , Lee Tae Hoon , Kwon Chang-Il , Kim Dong Uk , Lee See Young , Cho Jae Hee
Published: February 2024

Background and Aim: Endobiliary brushing is usually performed in the diagnosis of indeterminate biliary strictures; however, in this setting, brush cytology is limited by a low diagnostic yield and sensitivity. Here, we evaluated whether the catheter flushing method (CFM) could improve cellularity and diagnostic performance compared with the conventional cytologic method (CCM).
Methods: Endobiliary brushings were obtained during endoscopic retrograde cholangiopancreatography (ERCP) from patients with biliary strictures enrolled at six tertiary hospitals. Additional CFM was performed after brushing. Using liquid-based cytologic preparations of samples, we assessed the diagnostic performance of the CCM using Pap staining and the CFM using methionyl-transfer RNA synthetase 1 (MARS1) immunofluorescence staining.
Results: From a total of 399 patients (malignant, 253; benign, 146), 374 CCM samples and 361 CFM samples contained adequate cells, with no significant difference in diagnostic yield (93.7% vs. 90.5%, respectively, P = 0.721). The sensitivity of the CFM (90.3%) was significantly higher than that of the CCM (75.1%; P < 0.001), with no significant difference in accuracy between methods (81.2% vs. 82.6%, respectively; P = 0.608).
Conclusions: Diagnostic yield was equivalent between CCM and CFM. Also, the high sensitivity and similar accuracy of the CFM compared with the CCM indicates that the CFM could be an additional brush cytology method for detecting malignancy in patients with indeterminant biliary strictures. Further prospective studies are needed to validate these findings.
D-mannose suppresses the angiogenesis and progression of colorectal cancer
Authors: Du Yu , Zhang Xinchao , Xu Yixin , Zhou Yuefan , Xu Yanping
Published: February 2024

Angiogenesis is an important factor influencing the development of solid tumors, and vascular endothelial growth factor receptor-2 (VEGFR2) is a central regulator of angiogenesis. Antibodies and inhibitors against VEGFR2 have been widely used in various malignancies. However, the regulatory mechanism of VEGFR2 has not been fully clarified. Here, we show that D-mannose can significantly inhibit angiogenesis and tumor growth by degrading VEGFR2. Specifically, D-mannose inactivates GSK3β by promoting the phosphorylation of GSK3β at Ser9, enhances nuclear translocation of TFE3, and promotes lysosomal biogenesis, thereby increasing lysosomal-mediated degradation of VEGFR2. Thus, D-mannose significantly suppressed proliferation, migration and capillary formation of human umbilical vein endothelial cells (HUVEC) in vitro. Oral administration of D-mannose dramatically inhibited angiogenesis and tumor growth in mice. Our findings reveal a previously unrecognized anti-tumor mechanism of D-mannose by destabilizing VEGFR2 and provide a new strategy for clinical treatment of colorectal cancer (CRC).
A case report of Implantable Collamer Lens removal with cataract extraction and TECNIS Symfony extended range of vision intraocular lens (ZXR00) implantation
Authors: Yue Peilin , Li Enjie , Wang Zhenyu , Song Xudong
Published: February 2024

Background One of the most common reasons for patients to have a second operation to remove the implantable collamer lens (ICL) is anterior subcapsular cataract (ASC), which is also one of the major problems following ICL implantation. Nonetheless, it is still unclear if patients with high myopia can benefit from contemporaneous ICL removal, cataract extraction and multifocal intraocular lens (MIOL) implantation in terms of their visual outcomes.
Case presentation A 39-year-old male highly myopic patient who underwent concurrent ICL removal, cataract extraction, and TECNIS Symfony ZXR00 IOL implantation in both eyes is reported in this case. Surgeons organize the surgery taking into account the patient's strong desire for freedom from spectacles, the needs for everyday vision, and the features of the chosen IOL. Enhanced biological measurement devices, such us Pentacam and IOL Master 700, were used to get accurate parameters. The IOL power was calculated using the Barrett True-K formula, thereby allowing a residual refraction of -0.50D to -0.75D to match patient’s demand. The surgeries were performed on the right and left eyes with a 2-week interval. A comprehensive evaluation of the patient's visual outcomes was conducted at the 3-month follow-up using manifest refraction, anterior segment OCT (Casia2), defocus curve, OPD-Scan III, and NEI-VFQ-14. The patient demonstrated excellent near and intermediate vision as well as overall visual quality, with high satisfaction.
Conclusion For patients with ASC requiring surgery after ICL implantation, and with a strong desire for spectacle independence and specific occupational demands, the use of TECNIS Symfony ZXR00 IOL, along with adjustments to the residual refractive power, may result in outstanding visual quality and patient satisfaction.
The Fractional Exhaled Nitric Oxide (FeNO)- test as add-on test in the diagnostic work-up of asthma
Authors: Kaya Tuba , Braunstahl Gert-Jan , Veen Johannes in 't , Valk Johanna van der
Published: February 2024

Background Asthma is a common disease characterized by chronic inflammation of the lower airways, bronchial hyperactivity, and (reversible) airway obstruction. The Global Initiative of Asthma Guideline recommends a flowchart to diagnose asthma with first-step spirometry with reversibility and a bronchial challenge test (BPT) with histamine or methacholine as a second step. The BPT is considered burdensome, time-consuming for patients and staff, can cause side effects, and is expensive. In addition, this test strongly encumbers lung function capacity. Elevated Nitric Oxide (NO) is associated with airway eosinophilic inflammation in asthma patients and can be measured in exhaled air with the Fractional exhaled (Fe) NO-test. This low-burden FeNO-test could be used as an ‘add-on’ test in asthma diagnostics.
Methods and analysis This multi-center prospective study (Trial number: NCT06230458) compares the ‘standard asthma diagnostic work-up’ (spirometry with reversibility and BPT) to the ‘new asthma diagnostics work-up’ (FeNO-test as an intermediate step between the spirometry with reversibility and the BPT), intending to determine the impact of the FeNO-based strategy, in terms of the number of avoided BPTs, cost-effectiveness and reduced burden to the patient and health care. The cost reduction of incorporating the FeNO-test in the new diagnostic algorithm will be established by the number of theoretically avoided BPT. The decrease in burden will be studied by calculating differences in the Visual Analogue Scale (VAS) -score and Asthma Quality of Life Questionnaire (AQLQ) -score after the BPT and FeNO-test with an independent T-test. The accuracy of the FeNO-test will be calculated by comparing the FeNO-test outcomes to the (gold standard) BPTs outcomes in terms of sensitivity and specificity. The intention is to include 171 patients.
Ethics and dissemination The local medical ethics committee approved the proposed study and is considered a low-burden and risk-low study. The local medical ethics committee registration number: R23.005.
Learner Evaluation of an Immersive Virtual Reality Mass Casualty Incident Simulator for Triage Training
Authors: Way David P. , Panchal Ashish R. , Price Alan , Berezina-Blackburn Vita , Patterson Jeremy , McGrath Jillian , Danforth Douglas , Kman Nicholas E.
Published: February 2024

Background
To minimize loss of life, modern mass casualty response requires swift identification, efficient triage categorization, and rapid hemorrhage control. Current training methods remain suboptimal. Our objective was to train first responders to triage a mass casualty incident using Virtual Reality (VR) simulation and obtain their impressions of the training’s quality and effectiveness.
We trained subjects in a triage protocol called Sort, Assess, Lifesaving interventions, and Treatment and/or Transport (SALT) Triage then had them respond to a terrorist bombing of a subway station using a fully immersive VR simulation. We gathered learner reactions to their VR experience and post-encounter debriefing with a custom electronic survey. The survey was designed to gather information about participants’ demographics and prior experience, including roles, triage training, and VR experience. We then asked them to evaluate the training and encounter and the system’s potential for training others.
Results
Nearly 400 subjects experienced the VR encounter and completed evaluation surveys. Subjects were primarily paramedics, but also included medical learners as well as other emergency medical service (EMS) professionals. Most participants (95%) recommended the experience for other first responders and rated the simulation (95%) and virtual patients (91%) as realistic. Ninety-four percent of participants rated the VR simulator as “excellent” or “good.” We observed some differences between emergency medical service and medical professionals with regard to their prior experience with disaster response training and their opinions on how much the experience contributed to their learning. We observed no differences between subjects with extensive VR experience and those without.
Conclusions
Our VR simulator is an automated, customizable, fully immersive virtual reality system for training and assessing personnel in the proper response to a mass casualty incident. Participants perceived the simulator as an adequate alternative to traditional triage and treatment training and believed that the simulator was realistic and effective for training. Prior experience with virtual reality was not a prerequisite for the use of this system.
Impact of transducer arrays on deep-site dosimetry in radiotherapy with concurrent TTFields for glioblastoma (extreme analysis)
Authors: Zheng Jiajun , Wang Zhi , Zhu Huanfeng , Guo Wenjie , Wu Jianfeng , Sun Li , Zong Dan , He Xia
Published: February 2024

Objective To study the impact of transducer arrays on the deep-site dosimetry of radiotherapy with concurrent tumor treating fields (TTFields) for glioblastoma.
Methods Firstly, the covering style of transducer arrays to CIRS-038 phantom was designed to simulate the "extreme situation": four arrays were attached to the phantom as a style similar with that in clinical scene and, meanwhile, to assure that layer of interest of CIRS-038 was surrounded by twelve electrodes (three in each array). Then, eight patients undergone glioblastoma radiotherapy were selected, and the planed dose of each patient was delivered to the phantom with dosimetry film inside without and with transducer arrays. For the phantom with arrays, CBCT was used to check the dedicated covering style before dose delivery. Finally, Gamma-based consistency analysis was performed for two dose distributions for each plan (without/with arrays).
Results The covering style of the TTFields array met the requirements in 8 cases before dose delivery. Gamma indexes under the four criteria (2%/2 mm, 2%/3 mm, 3%/2 mm and 3%/3 mm) were (93.16±5.16)%, (96.08±3.49)%, (96.77±2.54)% and (97.96±1.61)%, respectively.
Conclusion Even in extreme situation (twelve electrodes covering the same cross-section), the perturbation of the TTFields arrays to the deep-site dose distribution of the radiotherapy for glioblastoma is weak and acceptable.