bluuebunny/crossref_metadata_2025 huggingface dataset:
Elin Pelin’in “Toprak” Adlı Eserinin Olay Örgüsü ve Şahıs Kadrosu Bakımından İncelenmesi
Authors: ATAKAN Müge
Published: September 2023

Yeni Bulgar Edebiyatı’nın başlıca nesir türlerinden biri olan uzun hikâye (povest) türü, karakter, olay ve hacim bakımından roman ile hikâye arasında yer alır. Yeni Bulgar Edebiyatı dönemi yazarlarından olan Elin Pelin’in uzun hikâye türünde kaleme almış olduğu “Toprak” (Zemya) adlı eser ilk kez 1922 yılında yayınlanmıştır. Eserde konu olarak kırsal alanda yaşamın zorlukları ve maruz kalınan kaçınılmaz değişimler, karakter olarak da Bulgar köylüsü seçilmiştir. Eser, dönemin yaygın konu ve karakter seçimi kapsamı dışında kalarak daha çok insan hakları, toplumun ahlaki değerleri ve olumsuz yanlarına değinmiş olması bakımından önemlidir. Eserde çok zincirli olay örgüsü kullanılmıştır. Zaman kavramı olay örgüsünün okuyucuya aktarılmasında yardımcı unsur olarak kullanılmıştır. Olay örgüsünün başladığı ve bittiği zaman açıkça belirtilmemiştir. Elin Pelin’in edebi yaratıcılığında büyük öneme sahip olan “kötü” ve “yoksul” kavramları, eserde karakterlerin iyi- kötü, doğru-yanlış arasında yaşadığı iç çatışmalar doğrultusunda, olay örgüsü içerinde farklı boyutlarda gösterilmiştir. Olay örgüsünde, karakterlerin olaylar karşısında gösterdiği değişimler bakımından farklılıklar olduğu görülmüştür.
Strategy for ERCP stenting in cholangiocarcinoma
Authors: Prijic Radovan , Ladic Agata , Markos Pave
Published: September 2023

Considering the steadily growing incidence of cholangiocarcinoma (CCA) worldwide, there is a constant need to re-evaluate and re-think its pathophysiology, diagnostic modalities, and mostly important, its treatment. No matter the histopathological appearance, endoscopic procedures - mainly Endoscopic Retrograde Cholangiopancreatography (ERCP) with stenting - are often used in the treatment of CCA complications, such as biliary obstruction when biliary drainage is indicated. Indications for preoperative biliary drainage in surgical cases are adjusted to each patient’s status. On the contrary, palliative drainage is the first option for relieving symptoms and improving the quality of life in the context of locally advanced and unresectable CCA. Further, concern about stenting techniques depends on the stricture location: Bismuth-Corlette types I and II are usually endoscopically drained with one stent placed in biliary tract, while for types III and IV, even bilateral stenting may prove inadequate. Stents used in ERCP are either plastic or self-expandable metallic stents (SEMS). Though plastic stents show some advantages over SEMS in terms of removability and possibility to adapt to a biliary tree which allows potential reinterventions, SEMS are better in terms of patency, lower complications number, and success of drainage. Besides ERCP, echo-endoscopic drainage is also an option, especially when ERCP approach has not yielded a successful drainage. The aim of this study was to show the potential of ERCP stenting in CCA treatment, its possible pitfalls, and the need to consider multiple levels of ERCP-related care.
What’s new with rootstocks?
Authors: Marguerit Elisa , Blois Louis , Goutouly Jean-Pascal , Lafargue Maria , Lagalle Loïc , Morel Marine , Tandonnet Jean Pascal , Ollat Nathalie
Published: September 2023

French research on rootstocks is based on two strategies: the creation of new rootstocks and the evaluation of existing rootstocks (GreffAdapt facility). The search for traits associated with drought tolerance has not yet been brought to a successful conclusion, but work is continuing with the emphasis on field experiments, measurement of δ13C, consideration of yield, and study of trait plasticity as a function of the scion and the water status.
Assessment of the impact of chitosan treatment on microorganisms in enology
Authors: Miot-Sertier Cécile , Paulin Margot , Dutilh Lucie , Lucas Marine , Ballestra Patricia , Albertin Warren , Masneuf-Pomarède Isabelle , Coulon Joana , Moine Virginie , Vallet-Courbin Amélie , Maupeu Julie , Dols-Lafargue Marguerite
Published: September 2023

As part of the move to reduce SO2 in wines, the empirical use of chitosan to eliminate the spoilage yeast Brettanomyces bruxellensis is becoming a frequent alternative. Chitosan treatment has an effect on a number of microbial species, at least temporarily, but there is wide variability in response within strains of each species. In addition, the effectiveness of chitosan also depends on the physical and chemical parameters of the wine. However, when chitosan treatment is effective, it appears to be long-lasting.
Mortality and vigour based indicators for an early diagnosis of vineyard decline
Authors: Merot Anne , Coulouma Guillaume , Smits Nathalie , Robelot Elsa , Gary Christian , Guerin Dubrana Lucia , Poulmarch Jouanel , Burgun Xavier , Pellegrino Anne , Fermaud Marc
Published: September 2023

Similar to the forestry industry, the winegrowing sector has experienced a grapevine decline phenomenon over the last twenty years, so that decline is now considered an increasingly widespread problem in many vineyards across the world (De la Fuente et al., 2016). In this work, the relationships between yield, mortality and vegetative vigour were investigated, in both temporal and spatial terms, to identify early diagnosis indicators of vine decline.
Assessing the Effectiveness of Radon Action Plans: Searching for a Systematic and Standardized Method
Authors: Martell Meritxell , Perko Tanja , Rovenská Kateřina Navrátilová , Fojtiková Ivana , Geysmans Robbe
Published: September 2023

Radon, a carcinogenic radioactive gas, is a leading cause of lung cancer according to the World Health Organization. European Member States are required to develop and implement National Radon Action Plans (RAPs) to address its dangerous health effects. However, assessing the effectiveness of these RAPs presents challenges for authorities. This study aims to explore the possibility for a systematic and standardised assessment method to evaluate the effectiveness of RAPs strategies and its implementation. The method involved analysing the strategies of 27 EU Member States and the UK, conducting legal document analysis and group interviews with responsible authorities. Additionally, four regional workshops and one final European workshop were held. The research took place from March 2021 to May 2023. Findings indicate that evaluating RAP effectiveness is challenging due to limited existing common criteria or indicators. To address this, the study proposes guiding questions for each element required by the EU Directive, as well as additional questions related to education and training. This contribution benefits RAP owners and European regulatory authorities, supporting the development of effectiveness indicators for RAPs. BY improving assessment methods, we can enhance the effectiveness of strategies in mitigating the risks associated with radon exposure.
Recent advance and Prospect of Enhanced Oil Recovery Mech-anisms in Reservoir Sandstone
Authors: Sikiru Surajudeen , Soleimani Hassan , Yusuf Jemilat Yetunde , Hassan Yarima Mudassir , Hamza Mohammed Falalu , Singh Ramesh
Published: September 2023

Enhanced oil recovery (EOR) refers to the various techniques used to increase the amount of crude oil that can be extracted from an oil field. These techniques are used after the primary and secondary recovery methods have been depleted. There are three main types of EOR: thermal, gas injection, and chemical. EOR techniques can be expensive and complex, but they can help to recover additional oil that would otherwise be left in the reservoir. EOR can also extend the life of an oil field and increase the overall production from a given field. The parameters affecting oil recovery are a major concern in EOR systems, and these parameters need more consideration with the factors affecting them. In this study, the influence of permeability variations on fluid flow in a sandstone reservoir was explored, as well as an up-to-date description of three states of EOR with thorough explanations of the methods utilized and the mechanisms driving their oil recovery application. The difficulties encountered in the use of the different standard EOR Mechanisms were noted, and solutions to these difficulties were proposed. Furthermore, the contemporary trend of adding nanotechnology and its synergistic effects on the stability and efficiency of traditional chemicals for EOR were examined and analysed. Finally, laboratory findings and field initiatives were discussed. The review went into detail about the transport of nanoparticles across reservoirs, as well as the evaluation of EOR, mobility ratio, and fluid displacement efficiency. This review provides thorough information on the uses of improved oil recovery mechanisms for sustainable energy production.
Bibliometric Analysis of Islamic Banking Literature Published in Times of Covid-19 Pandemic
Authors: Gunawan Muhammad Raihan , Rusydiana Aam Slamet
Published: September 2023

This study aims to analyze articles with the subject matter of Islamic Banking published during the 2020-2021 period in times of the Covid-19 Pandemic and indexed by Scopus (https://scopus.com) on an analysis of articles, authors, journals, and keywords. The papers analyzed were as many as 681 documents using bibliometric analysis with the help of R Biblioshiny software. The numbers showed the researcher's high desire to research with the theme of Islamic Banking during the pandemic. The author who often studies this theme is Hassan MK. Most journals published on Islamic Banking during covid-19 are "Journal of Islamic Marketing" and "Journal of Islamic Accounting and Business Research." Several themes related to Islamic Banking research, namely corporate social responsibility, profitability, efficiency, financial crisis, and Islamic finance. However, the trend analysis shows that few researchers have linked Islamic Banking research to these themes. Therefore, a study with these themes needs development considering the limited research that extensively addresses the Islamic Banking theme in Islamic economics and finance research.
Effects of Traditional Chinese Acupoint Massage Combined with Tailored Tai Chi on low back pain in patients with lumbar disc herniation: a randomized controlled trial
Authors: Zhang Shuaipan , Wang Yongchao , Huang Ruixin , Yao Chongjie , Zhou Xin , Guo Guangxin , Li Jianhua , Fang Min , Zhu Qingguang
Published: September 2023

Objective
To determine the clinical efficacy of traditional Chinese acupoint massage (TCAM) combined with tailored tai chi multimodal therapy on low back pain (LBP)in patients with lumbar disc herniation (LDH).
Methods
A total of 72 patients with LBP as the main clinical symptom were randomly divided into the intervention group (IG, TCAM combined with tai chi therapy) and control group (CG, TCAM therapy). Each intervention was conducted three times a week for 4 weeks. The primary outcome was Oswestry Disability Index (ODI) score, the secondary outcomes included Visual Analog Scale (VAS) score, Short-Form Health Survey (SF-36) score, and total effective rate measurements. Changes of trunk muscle group peak torque (PT) and average power (AP) at 60°/s and 90°/s isokinetic tests were also observed in the two groups.
Results
All data were represented as mean and 95% Confidence Intervals(CI), and between-group comparison, it showed that ODI (3.88 [0.5, 7.27], P = 0.026); VAS (8.1 [1.87, 14.34], P = 0.012), and some items of the SF-36, namely, physical functioning (2.3 [0.96, 3.64], P = 0.001), bodily pain (1.11 [0.51, 1.71], P = 0.001), general health (1.0 [0.12, 1.8], P = 0.027), vitality (1.91 [1.2, 2.6], P༜0.001), and mental health (3.2 [2.4, 3.9], P༜0.001), had higher levels of improvement in the IG group than in the CG group (P < 0.001). Within-group comparison showed that both treatments significantly alleviated pain and dysfunction and improved quality of life, consistent with the total effective rate (69.44% versus 72.22%, P = 0.795). The PT and AP at angular velocities of 60°/s and 90°/s were higher in the IG group (P < 0.001), and the mechanical indexes at week 4 significantly increased compared with those at week 0 (P < 0.001).
Conclusion
Both interventions were effective in treating pain and dysfunction and improving the quality of life in patients with LBP. However, TCAM combined with tai chi had higher efficacy than single TCAM, particularly in improving physical and mental states and back muscle strength. The exploratory results showed that the multimodal physical therapy could be used as a complementary and alternative therapy for patients with LBP caused by LDH.
Trial registration
Chinese Clinical Trial Registry (ChiCTR1900023028) on 08/05/2019
URL: http://www.chictr.org.cn/showproj.aspx?proj=38496
Who Influences Cancer Conversations on Twitter in Japan? Comparison of Breast, Lung, and Colon Cancer-Related Tweets in Japanese
Authors: Kusudo Maho , MitsuoTerada Mitsuo , Kureyama Nari , Wanifuchi-Endo Yumi , Fujita Takashi , Asano Tomoko , Kato Akiko , Mori Makiko , Horisawa Nanae , Toyama Tatsuya
Published: September 2023

Various cancer-related information is spreading on social media. Our study aimed to examine the account types associated with cancer-related tweets on Twitter in Japan, specifically focusing on breast, lung, and colon cancer. Using the Twitter application programming interface, we collected tweets containing keywords of the three cancers type in August–September 2022. The accounts were categorized into seven types: Survivor, Patient’s family, Healthcare provider, Public organization, Private organization, News, and Other according to account name and texts. We analyzed the sources of the top 50 most liked and retweeted tweets. Out of 7,753 identified tweets, breast cancer represented the majority (62.8%), followed by lung cancer (20.8%) and colon cancer (16.3%). Tweets came from 4,976 accounts. Account types varied depending on the cancer type, with breast cancer topics more frequently from Survivor (16.0%) and lung cancer from Patient’s family (16.3%). Healthcare provider and Public organization had minimal representation across three cancer types. The trends in the top 50 tweets mirrored the distribution of accounts for each cancer type. Breast cancer-related tweets had the highest frequency. There were few from public organizations. These findings emphasize the need to consider the characteristics of cancer-related information sources when sharing and gathering information on social media.
Novel HPD mutation causes A new transient form of Hawkinsinuria? Case report
Authors: Liang Rujia , Liu Fang , Cui Liru
Published: September 2023

Background Hawkiniuria is a rare group of autosomal dominant tyrosine metabolic diseases, usually caused by HPD gene mutations. So far, only a few cases of Hawkiniuria have been reported due to HPD gene mutations, and clinical symptoms usually resolve spontaneously around the age of 1 year.
Case report Dizygotic twins were screened in 4 days old for inherited metabolic diseases using gas chromatography-tandem mass spectrometry (GC–MS/MS), and the elevated tyrosine in the blood and significantly elevated 4-hydroxyphenylpyruvate, 4-hydroxyphenyllactic acid and 4-hydroxyphenylacetic acid in the urine were significantly increased. At follow-up, the twins' blood tyrosine and urine levels of hawkinsin metabolites dropped significantly to normal levels at 80 days without special intervention. A new mutation in the HPD gene was found in the patient, the first time it has been found in the Chinese population.
Conclusion A new missense mutation of HPD gene has been detected in 2 cases of children diagnosed as hawkinsinuria, which is a possible pathogenic mutation and has not been reported at home and abroad. The clinical manifestations of the patients we reported are also different from previous literature reports. Our case enriches the clinical manifestations and gene mutation spectrum of hawkinsinuria, providing new insights for further research on hawkinsinuria.
SGLT-2 inhibitors in patients with heart failure and a preserved ejection fraction: a systematic review and meta-analysis of five randomized controlled trials
Authors: Sun Yue , Zhou Yiting , Ding Xu , Liu Min , Yu Zhiming
Published: September 2023

Background: The purpose of this systematic review and meta-analysis was to determine the effects of SGLT2 inhibitors on major heart failure outcomes (such as HHF and CVD) in patients with heart failure and preserved ejection fraction
Methods: We searched four English databases from inception to February 14, 2023. The primary efficacy outcome was a composite of hospitalization for HF (HHF) or cardiovascular death (CVD). Two reviewers independently screened literature and extracted data. Fixed-effects models were used to estimate pooled Hazard risks (HRs) for binary outcomes, and weighted mean differences for continuous outcomes with 95% confidence intervals.
Results: We included data from five randomized controlled trials (RCTs) comprising data for 15733 patients. The composite outcome of hospitalization for HF (HHF) or cardiovascular death (CVD) was reduced with SGLT2 inhibitor therapy compared with placebo (HR 0.80, 95%CI 0.74–0.87,P<0.00001). Similar results were observed for HHF. However, compared with placebo, there were no significant changes in CVD and all-cause mortality (P>0.05).
Conclusions: SGLT2 inhibitors can significantly reduce the hospitalization rate for heart failure and the composite endpoint of cardiovascular mortality or hospitalization for heart failure in patients with heart failure and preserved ejection fraction. Further RCTs with sufficient representation of patients in this population are warranted to corroborate our analysis.
Boosting all-weather atmospheric water vapor harvesting with a solar-driven membrane system
Authors: Jin Yong , Ghaffour Noreddine
Published: September 2023

Atmospheric water vapor harvesting (AVH) is vital to supply fresh water in arid regions. Sorbent-based harvesting stands out because it can adapt to weather conditions and utilize lowgrade energy. Current harvesting research focuses on sorbent material preparation (especially solid sorbents, such as MOFs) without integrating them into advanced water production systems. Moreover, solid sorbents show poor adaptability to changing relative humidities and temperatures in real-world applications. Here, we propose a novel AVH membrane system (AVH-MS) driven by solar energy to address these challenges. Liquid hygroscopic solutions were utilized as the working fluid in the AVH-MS to avoid the solid sorbents’ limitations. The advanced design of the AVH-MS helped boost water production and adapt to all weather conditions simultaneously. The feasibility of the system was demonstrated both theoretically and experimentally. The system could produce 6.27, 2.41, and 0.82 kg freshwater/m2/day at relative humidities of 69%, 35%, and 19% at 25 °C, respectively, using solar energy. The production improved by almost 700% compared with the reported study under the same weather condition. Our system's converted water production capacity (kg/J) is also the highest under various relative humidities compared with the reported studies.
Associations of Five Blood Heavy Metals with Hepatitis B Virus Infection and Immunity in Adults: A Cross-Sectional Study
Authors: Li Xinpeng , Bi Lei , Han Lu
Published: September 2023

Background Heavy metal pollution has emerged as a significant concern for human health, prompting increased awareness of its potential adverse effects. While previous research has established a connection between heavy metals and liver function biomarkers, the specific relationship between heavy metals and HBV infection remains unexplored. This cross-sectional study aims to investigate the potential correlations between five blood heavy metals - lead, cadmium, mercury, manganese, and selenium - and the presence of HBsAg, HBsAb, and HBcAb in adults.
Methods The study utilized data from NHANES 2007-2018. Participants were classified into four groups based on their infectious status, and the association between heavy metals and HBV infection was analyzed using multiple logistic regression and stratification analysis.
Results A total of 8431 participants were included, with 5 436 classified as Susceptible, 1 765 as Vaccinated, 865 as Natural Infection, and 103 as Acute/Chronic HBV Infection. The Vaccinated group exhibited a lower mean age (34.52 ± 14.16 years) compared to the other groups. Statistically significant differences in heavy metal concentrations (except selenium) were observed among the groups (P < 0.001). After adjusting for covariates, lead was significantly associated with HBV infection (Q2: OR 2.37, 95%CI 1.04-5.39; Q3: OR 2.34, 95%CI 1.01-5.40), and positive trends were observed for high blood concentrations of mercury (Q4: OR 3.03, 95%CI 1.31-7.04) and manganese (Q4: OR 2.52, 95%CI 1.20-5.28). Furtherly, the presence of lead reduced the protection of HBsAb (Q2: OR 0.84, 95%CI 0.73-0.97; Q3: OR 0.77, 95%CI 0.66-0.90; Q4: OR 0.83, 95%CI 0.70-0.98). Subgroup analysis indicated that cadmium was associated with an increased risk of HBV infection in Asians (OR 1.36, 95%CI 1.03-1.78) and individuals with a BMI range of 25 to 30 (OR 1.60, 95%CI 1.17-2.18).
Conclusions The findings of this study suggest a correlation between elevated blood lead concentrations and an increased risk of HBV infection. Additionally, higher blood lead levels appear to potentially undermine the protective efficacy of hepatitis B surface antibodies. Consequently, emphasizing hepatitis B vaccination is crucial, particularly in regions affected by heavy metal pollution.
Directed Energy Deposition of PH 13-8 Mo Stainless Steel: Microstructure and Mechanical Properties Analysis
Authors: KAŞ Mustafa , Muslim Talha , Yilmaz Oguzhan , Karagoz Taner , Turedi Enbiya , Gumus Serap , Bayram Alperen
Published: September 2023

Laser metal deposition (LMD) is of the directed energy deposition (DED) process which is widely used for producing large scale, dense, and functional parts in the field of Additive Manufacturing (AM). This research work investigates the microstructure and mechanical properties of PH 13 − 8 Mo martensitic stainless-steel parts produced via LMD. The workshop trials were conducted using an LMD system collaborated with a robotic arm to deposit single-track thin walls and horizontal blocks. The microstructural characteristics of the additively manufactured parts were analyzed using scanning electron microscopy (SEM) and X-ray diffraction (XRD). The mechanical properties were evaluated through hardness measurements and uniaxial tensile tests. The influence of energy density and powder deposition density on the characteristic geometry of straight walls was also investigated. The microstructural analysis showed that the microstructure consisted of columnar dendrites that grew epitaxially from the substrate, with primary austenite cells containing intercellular ferrite and martensite laths that were roughly parallel with the retained austenite. When the energy density increased from 43 J/mm² to 86 J/mm² (a doubling of energy density), there was an increase in secondary dendritic arm spacing (SDAS) by approximately 250% in the first layer and approximately 90% in the top layer. The difference in SDAS change between the first and top layers can be attributed to the difference in cooling rates experienced by each layer during the additive manufacturing process. Increasing powder deposition density from 0.5 g/min to 1 g/min results in a decrease in porosity from 3% to less than 1%, and an increase in strength from 800 MPa to over 1000 MPa. The hardness of the deposits was found to range from 300 HV to 400 HV. This variation in hardness can be attributed to differences in microstructure resulting from changes in cooling rates at different heights.
Potential distribution of Batocera horsfieldi (Hope) in Sichuan based on species distribution models
Authors: Wu Sijun , Qiao Tianmin , Li Shujiang , Hu Binhong , Zhu Hanmingyue , Zhu Tianhui
Published: September 2023

Batocera horsfieldi (Hope) is a highly destructive pest in the forestry sector, causing significant damage to forests in Sichuan. This study aimed to assess the potential distribution of B. horsfieldi(Hope) in Sichuan under different CO2 emission scenarios (SSPs126, SSPs245, SSPs370, SSPs585) from 2021 to 2100, using field surveys and climate data. Nine key environmental variables that strongly influenced the distribution of B. horsfieldi (Hope) were identified based on their high contribution and low correlation coefficients. The most suitable model, determined by the highest AUC value, was used to predict the suitable areas for B. horsfieldi (Hope) in Sichuan. The total suitable area was calculated, and the offset angle and distance were marked. The results indicated that under the projected climatic conditions from 2021 to 2100, the nine critical environmental variables were Alt (450m-850m), Slope (40–60°), Prec06 (180mm-200mm), Prec07 (250mm-300mm), Bioc07 (25–28), Tmax01 (11–14°C), Tmax02 (12–15°C), Bioc17 (55mm-62mm), and Ve (600–800). Among the three models compared(BIOCLIM, GARP, MaxEnt), MaxEnt exhibited the highest AUC value (0.845) and the best accuracy. The potential suitable areas for B. horsfieldi (Hope) in Sichuan were classified into four categories: unsuitable area (316,731.36km2 and 65.17%), low suitable area (86,890.74km2 and 17.88%), medium suitable area (56,362km2 and 11.6%), and high suitable area. The high suitable areas were mainly concentrated in Lezhi and Yanjiang, with a general trend of north to south distribution. The SSPs126 scenario (2061–2080) had the largest area of high suitability, while the 2081-2100-SSPs585 scenario had the lowest latitudinal extent.
A genome-wide association study for survival from a multi-centre European study identified variants associated with COVID-19 risk of death
Authors: Colombo Francesca , Minnai Francesca , Biscarini Filippo , Esposito Martina , Dragani Tommaso , Bujanda Luis , Rahmouni Souad , Alarcon Marta , Bernardo David , Carnero Elena , Buti Maria , Zeberg Hugo , Asselta Rosanna , Romero-Gomez Manuel , Fernández-Cádenas Israel , Fallerini Chiara , Zguro Kristina , Furini Simone , Renieri Alessandra
Published: September 2023

The clinical manifestations of SARS-CoV-2 infection vary widely among patients, from asymptomatic to life-threatening. Host genetics is one of the factors that contributes to this variability as a previous case-control genome-wide association study by the COVID-19 Host Genetics Initiative (HGI) identified sixteen loci associated with COVID-19 severity. Herein, we investigated the genetic determinants of COVID-19 mortality, by performing a case-only genome-wide survival analysis, 60 days after infection, of 3,904 COVID-19 patients from the GEN-COVID and other European series included in the EGAS00001005304 study of the COVID-19 HGI. Patients were genotyped using Illumina Infinium Global Screening Arrays. We carried out data quality check, principal component analysis, imputed the data, and performed survival analysis using the Cox model adjusted for age, age2, sex, series, time of infection, and the first ten principal components. Results of the analyses showed a genome-wide significant (P-value < 5.0x10-8) association of the rs117011822 variant, on chromosome 11, and association, approaching the genome-wide threshold, of rs7208524 (P-value = 5.19x10-8), on chromosome 17. A total of 113 variants were associated with survival at P-value < 1.0x10-5and most of them had gene expression regulatory functions as expression quantitative trait loci, mainly involved in immune response (e.g.,CD300andKLRgenes), or in lung repair and function (e.g.,FGF19andCDH13). Overall, our results suggest that germline variants may modulate COVID-19 risk of death, possibly through the regulation of gene expression in immune response and lung function pathways.
Prevalence, Clinical Reasons and Associated Factors of Extended Treatment Duration for Drug Susceptible Tuberculosis – a Real-World Experience
Authors: Liu Chih-Yu , Chen Rou-Tsern , Shu Chin-Chung , Lin Shu-Yung
Published: September 2023

Purpose
The standard short-course treatment for drug-susceptible tuberculosis (TB) is 6 months, but in certain cases, treatment duration may need to be extended. However, limited research has been conducted on the prevalence and factors associated with extended TB treatment.
Methods
A retrospective study was conducted. Drug-susceptible patients with TB from the TB registry of a study hospital between January 2018 and December 2020 were enrolled. The prevalence, reasons, and associated factors for extended TB treatment (≥ 9 months) were analyzed and compared with those of the standard treatment course.
Results
A total of 221 patients with TB were analyzed, of whom 80 (28.7%) received extended TB treatment and 141 were in the control group. The extended treatment group had higher proportions of hepatitis B infection (12.5% vs. 5%, p = 0.043) and recent treatment for cancer (17.5% vs. 8.5%, p = 0.046). Adverse drug events were more prevalent in the extended treatment group (grade 3 or more symptoms: 26.3% vs. 11.3%, p = 0.008), and treatment interruption was more frequent (46.3% vs. 18.4%, p < 0.001). Logistic regression analysis revealed that hepatitis B infection (adjusted odds ratio [AOR] 3.10, p = 0.039), recent treatment for cancer (AOR 3.09, p = 0.013), and post-treatment abnormal aminotransferase (AOR 2.40, p = 0.014) were independent factors associated with extended treatment duration.
Conclusions
Extended anti-TB treatment is not uncommon, affecting 28.7% of the patients in this study. Factors such as host characteristics and adverse drug effects might contribute to extended TB treatment duration. Integration of these factors into treatment strategies is necessary to optimize patient care.
Associations between dietary calcium intake and lung function were modified by age and gender in the USA : A cross-sectional study of NHANES
Authors: Chen Wenwen , Liu Zitian , Zhang Xiang , Ni Jiangwei , Zheng Liangcheng , Cheng Dezhi , Chen Kun
Published: September 2023

Purpose
The present study aimed to evaluate the associations between dietary calcium intake and lung function, and whether these associations were affected by age and gender.
Methods
A total of 6476 participants aged 18 and above from the National Health and Nutrition Examination Survey (NHANES) of the 2007 to 2012 were included in the analyses. Weighted linear regression was used to estimate beta coefficients and 95% confidence intervals (CIs) for the associations between dietary calcium intake and pulmonary function test parameters, with adjustment for relevant covariates and restricted cubic spline (RCS) analysis were conducted.
Results
Calcium intake was positively associated with forced expiratory volume in one second (FEV1) (β: 0.16; 95% confidence interval (CI): 0.10–0.21; P < 0.0001) and forced vital capacity (FVC) (β: 0.25; 95% CI: 0.18–0.31; P < 0.0001), and interactions between calcium intake, age, gender, and chronic obstructive pulmonary disease (COPD) existed on lung function. RCS analysis shows that for 60–79 year-old individuals, there was the U-shape dose–response relationship between the calcium intake and FEV1 (P for nonlinearity = 0.0415), and the association between the calcium intake and FEV1 was linear (P for non-linearity = 0.076) for 20–40 years old individuals, and there is no correlation between calcium intake and FEV1 for 40–60 years old individuals (P for overall = 0.8337). In addition, RCS analysis shows that for male, there was the U-shape dose–response relationship between the calcium intake and FEV (P for nonlinearity = 0.0012), while the association between the calcium intake and FVC was linear in female (P for overall = 0.8056).
Conclusion
Findings suggested that dietary calcium intake and lung function were modified by age and gender. Increased calcium intake was recommended for participants with young and elderly people in improving lung function.
Factors to Improve Odds of Success Following Medial Opening-Wedge High Tibial Osteotomy: A Machine Learning Analysis
Authors: Yang Hong Yeol , Shin Yong Gwan , Shin Hyun Ho , Choi Ji Hoon , Seon Jong Keun
Published: September 2023

Background: Although high tibial osteotomy (HTO) is an established treatment option for medial compartment osteoarthritis, the predictive factors for HTO treatment success remain unclear. This study aimed to identify informative variables associated with HTO treatment success and to develop and internally validate machine learning algorithms to provide patient-specific predictions of which patients will achieve HTO treatment success for medial compartmental osteoarthritis.
Methods: This study retrospectively reviewed patients who underwent medial opening-wedge HTO (MOWHTO) at our center between March 2010 and December 2015. The primary outcomes were the lack of conversion to total knee arthroplasty (TKA) and achievement of the minimal clinically important difference of improvement in the Knee Injury and Osteoarthritis Outcome Score (KOOS) at a minimum of five years postoperatively. Recursive feature selection was used to identify the combination of variables from an initial pool of 25 features that optimized model performance. Five machine learning algorithms (XGBoost, multilayer perception, support vector machine, elastic-net penalized logistic regression, and random forest) were trained using five-fold cross-validation three times and applied to an independent test set of patients.The performance of the model was evaluated by the area under the receiver operating characteristic curve (AUC).
Results: A total of 231 patients were included, and 200 patients (86.6%) achieved treatment success at the mean of 9 years of follow-up. A combination of seven variables optimized algorithm performance, and specific cutoffs increased the likelihood of MOWHTO treatment success: body mass index (BMI) ≤26.8, preoperative KOOS for pain ≤46.0, preoperative KOOS for quality of life ≤33.0, preoperative International Knee Documentation Committee score ≤42.0, preoperative Short-Form 36 questionnaire (SF-36) score >42.25, three-month postoperative hip-knee-ankle angle >1.0, and three-month postoperative medial proximal tibial angle (MPTA) >91.5 and ≤94.7. The random forest model demonstrated the best performance (F1 score: 0.93; AUC: 0.81) and was transformed into an online application as an educational tool to demonstrate machine learning capabilities.
Conclusions: The random forest machine learning algorithm best predicted MOWHTO treatment success. Patients with a lower BMI, poor clinical status, slight valgus overcorrection, and postoperative MPTA <94.7, more frequently achieved a greater likelihood of treatment success.
Level of Evidence: Level III, retrospective cohort study.
ROCK inhibitor Y-27632 down-regulates Il-1β expression in mice with experimental autoimmune myocarditis
Authors: Li Yanjun , Gao Ge , Han Yiru , Xiao Bingshuai , Shen Liyuan , Yang Xiangxin , Liu Yangqing , Mu Yaqin , Zhang Nianping , Niu Chunhong , Wang Yuxing
Published: September 2023

Autoimmune myocarditis is a limited or diffuse inflammation of the myocardium brought on by dysfunction in the normal function of cellular and humoral immunity of the body. Mouse models of experimental autoimmune myocarditis (EAM) were constructed using peptide MyHC-α614–629. After secondary immunization, the mice were given intraperitoneal injection of the Rho kinase (ROCK) inhibitor Y-27632 the next day, and the heart tissues of the EAM mice were isolated and weighed on day 21. As a result, the hearts of EAM mice were significantly enlarged and whitened; the body weight (BW) of mice in the EAM group increased slowly, and the heart weight (HW) and the ratio of HW/eventual body weight (e-BW) were raised; the inflammatory infiltration and fibrosis of the myocardial tissue were aggravated. But Y-27632 treatment improved the above-mentioned phenotypic or pathological features of EAM mice. Besides, the monocytes in the spleen of EAM mice mounted up, which showed a decline in number after Y-27632 treatment. Mechanistic analysis revealed a significant increase in the expression of Notch1, Hes1, Jag2, Dil1, Tlr2 and Il-1β in the myocardial tissue of the EAM mice. Notably, the expression of IL-1β was consistent with that of Notch1 and Tlr2. After Y-27632 treatment, the expression of key target genes (Notch1, Hes1, Dil1 and Jag2) of the NOTCH signaling pathway and Tlr2 expression were obviously decreased. The ROCK inhibitor Y-27632 exerts a protective effect in EAM mice by down-regulating Il-1β expression. This study aims to provide a reference value for the future treatment of myocarditis in clinical settings.
Reliability of an ultrasound imaging acquisition procedure for examining osteoarthritis in the first metatarsophalangeal joint
Authors: Molyneux Prue , Bowen Catherine , Ellis Richard , Rome Keith , Fitzgerald Kate , Clark Phillip , Carroll Matthew
Published: September 2023

Objective Given the ability of ultrasound imaging (USI) to depict tissue-specific morphological changes before the onset of pain and before the point of irreversible structural damage, USI could play a fundamental role in earlier detection and assessment of foot osteoarthritis. Current guidelines require further refinement of anatomical landmarks to establish a standardised imaging procedure to improve interpretability and reproducibility between studies evaluating the first metatarsophalangeal joint (MTPJ). The aims were to develop an USI acquisition procedure and grading system to examine OA features in the first MTPJ and to determine intra-examiner and inter-examiner reliability of a newly developed USI acquisition procedure.Design Thirty participants with first MTPJ osteoarthritis confirmed radiographically with the use of the La Trobe Foot Atlas were included. An experienced sonographer applied a newly developed USI procedure to examine the following features: joint effusion, synovial hypertrophy, synovitis, joint space narrowing, osteophytes, and cartilage thickness. To determine intra and inter-examiner reliability an experienced radiologist and sonographer applied the developed grading system to the images acquired from two imaging sessions. Intra-examiner and inter-examiner reliability were calculated using intraclass correlation coefficients (ICC).Results ICCs for intra-examiner between session reliability ranged from 0.58 to 0.92 for semiquantitative grading and 0.39 to 0.94 for continuous measures. Joint effusion and osteophytes achieved the highest intra-examiner reliability (ICC = 0.78–0.94). ICCs for session one inter-examiner reliability ranged from 0.61 to 1.0 for semiquantitative grading, all continuous measures had an ICC of 1. ICCs for session two inter-examiner reliability ranged from 0.55 to 1.0 for semiquantitative grading and 0.9 to 0.97 for continuous measures. Inter-examiner reliability was good for grading joint effusion (ICC = 0.55–0.62) and was excellent for all other USI features (ICC = 0.77-1.0).Conclusion The USI acquisition procedure and grading system are reliable in evaluating first MTPJ osteoarthritis features in participants with radiologically confirmed osteoarthritis. The study will inform the methodological development of an ultrasound atlas for grading the degree of osteoarthritic change in the first MTPJ.
Aerosol Influence on Cloud Macrophysical and Microphysical Properties over the Tibetan Plateau and Its Adjacent Regions
Authors: Wei Chengqiang , Zhao Pengguo , Wang Yuting , Wang Yuan , Mo Shuying , Zhou Yunjun
Published: September 2023

This study uses aerosol optical depth (AOD) and cloud properties data to investigate the influence of aerosol on the cloud properties over the Tibetan Plateau and its adjacent regions. The study regions are divided as the western part of the Tibetan Plateau (WTP), the Indo-Gangetic Plain (IGP), and the Sichuan Basin (SCB). All three regions show significant cloud effects under low aerosol loading conditions. In WTP, under low aerosol loading conditions, the effective radius of liquid cloud particles (LREF) decreases with the increase of aerosol loading, while the effective radius of ice cloud particles (IREF) and cloud top height (CTH) increase during the cold season. Increased aerosol loading might inhibit the development of warm rain processes, transporting more cloud droplets above the freezing level and promoting ice cloud development. During the warm season, under low aerosol loading conditions, both the cloud microphysical (LREF and IREF) and macrophysical (cloud top height and cloud fraction) properties increase with the increase of aerosol loading, likely due to higher dust aerosol concentration in this region. In IGP, both LREF and IREF increase with the increase in aerosol loading during the cold season. In SCB, LREF increases with the increase in aerosol loading, while IREF decreases, possibly due to the higher hygroscopic aerosol concentration in the SCB during the cold season. Meteorological conditions also modulate the aerosol-cloud interaction. Under different convective available potential energy (CAPE) and relative humidity (RH) conditions, the influence of aerosol on clouds varies in the three regions. Under low CAPE and RH conditions, the relationship between LREF and aerosol in both the cold and warm seasons is opposite in the WTP: LREF decreases with the increase of aerosol in the cold season, while it increases in the warm season. This discrepancy may be attributed to a difference in the moisture condition between the cold and warm seasons in this region.
Efficacy of endoscopic submucosal resection with a ligation device for small rectal neuroendocrine tumor: study protocol of a multicenter open-label randomized control trial (BANDIT trial)
Authors: Takada Kazunori , Imai Kenichiro , Yamada Takanori , Ohata Ken , Kanesaka Takashi , Nagami Yasuaki , Yamasaki Yasushi , Kobara Hideki , Inokuchi Yasuhiro , Chino Akiko , Yamaguchi Shinjiro , Ikehara Hisatomo , Kawamura Takuji , Yabuuchi Yohei , Mizuguchi Yasuhiko , Ikematsu Hiroaki , Yokoi Chizu , Hattori Santa , Ohno Kazuya , Yoshizawa Yashiro , Fukuzawa Masakatsu , Tsuji Yosuke , Konishi Jun , Yamamura Takeshi , Osawa Satoshi , Oka Shiro , Hikichi Takuto , Togashi Kazutomo , Hirasawa Kingo , Uraoka Toshio , Takeuchi Yoji , Chiba Hideyuki , Komeda Yoriaki , Doyama Hisashi , Oba Mari S , Saito Yutaka
Published: September 2023

Background:Endoscopic resection is widely accepted as a local treatment for rectal neuroendocrine tumors sized ≤ 10 mm. However, there is no consensus on the best method for the endoscopic resection of rectal neuroendocrine tumors. As a simplified endoscopic procedure, endoscopic submucosal resection with a ligation device (ESMR-L) indicates a histologically complete resection rate comparable to that of endoscopic submucosal dissection (ESD). We hypothesized that ESMR-L than ESD would be preferred for rectal neuroendocrine tumors. Hence, this trial aimed to verify whether ESMR-L is non-inferior to ESD in terms of histologically complete resection rate.Methods:This is a prospective, open-label, multicenter, non-inferiority, randomized controlled trial of two parallel groups, conducted at the Shizuoka Cancer Center and 31 other institutions in Japan. Patients with a lesion endoscopically diagnosed as a rectal neuroendocrine tumor ≤ 10 mm are eligible for inclusion. A total of 266 patients will be recruited and randomized to undergo either ESD or ESMR-L. The primary endpoint is the rate of en bloc resection with histologically tumor-free margins (R0 resection). Secondary endpoints include en bloc resection rate, procedure time, adverse events, hospitalization days, total devices and agents cost, adverse event rate between groups with and without resection site closure, outcomes between expert and non-expert endoscopists, and factors associated with R0 resection failure. The sample size is determined based on the assumption that the R0 resection rate will be 95.2% in the ESD group and 95.3% in the ESMR-L group, with a non-inferiority margin of 8%. With a one-sided significance level of 0.05 and a power of 80%, 226 participants are required. Assuming a dropout rate of 15%, 266 patients will be included in this study.Discussion:This is the first multicenter randomized controlled trial comparing ESD and ESMR-L for the R0 resection of rectal neuroendocrine tumors ≤ 10 mm. This will provide valuable information for standardizing endoscopic resection methods for rectal neuroendocrine tumors.Trial registration:Japan Registry of Clinical Trials, jRCTs042210124. Registered on Jan 6, 2022.
The relationship between physical activity and academic achievement in middle school students: the chain mediating role of social support and learning engagement
Authors: Xiang Jun , Gao Jia , Gao Yun
Published: September 2023

The academic achievement of middle school students has always been a hot topic that scholars pay attention to.
Objective: To investigate the relationship between physical activity and academic achievement of middle school students, and to verify the mediating role of social support and learning engagement between them.
Methods: 3230 middle school students in Guangdong Province were investigated and tested by physical activity scale, academic achievement scale, perceptive social support scale and learning engagement scale.
Results: (1) Boys scored slightly higher than girls in physical activity and social support, but slightly lower in academic achievement and engagement. There were some differences in physical activity, academic achievement, social support and learning engagement among middle schools in Guangdong Province (P<0.05). (2) Physical activity had a significant positive correlation with academic achievement (r=0.37, p < 0.01), and physical activity had a significant direct path to academic achievement (β=-0.025, t=2.052, p < 0.01). Physical activity positively predicted social support (β=0.085, t=1.552, p < 0.01) and learning engagement (β=0.082, t=0.562, p < 0.01). Social support significantly predicted learning engagement (β=0.096, t=3.376, p < 0.01) and academic achievement (β=-0.038, t=1.568, p < 0.01). Learning engagement positively predicted academic achievement (β=0.054, t=1.558, p < 0.01). (3) Social support and learning engagement play a significant mediating role between physical activity and academic achievement, and the mediating effect accounts for 90.25% of the total effect. The mediating effect was composed of three pathways: physical activity → social support → academic achievement (13.82%), physical activity → learning engagement → academic achievement (26.02%), physical activity → social support → learning engagement → academic achievement (50.41%).
Conclusion: Physical activity can significantly positively predict middle school students' social support, learning engagement and academic achievement, that is, physical activity can not only directly predict middle school students' academic achievement, but also directly predict academic achievement through the independent mediating effect of social support and learning engagement, and indirectly predict academic achievement through the chain mediating effect of social support and learning engagement.