bluuebunny/crossref_metadata_2025 huggingface dataset:
Remote screening protocol for functioning and contextual factors (e-Followkids) in Brazilian children with biological risk in the first 2 years: a longitudinal prospective study
Authors: de Abreu Raissa Wanderley Ferraz , Lima Camila Resende Gâmbaro , Santos Adriana Neves dos , Rocha Nelci Adriana Cicuto Ferreira
Published: July 2024

Background
Children with biological risk may experience developmental delays, even in the absence of brain injury. Identifying warning signs and knowledge of contextual factors are vital to favor intervention. Telehealth can aid in screening by providing access for populations that face physical and social barriers. As such, the aim of this study was to describe the e-Followkids screening protocol and how its feasibility will be assessed.
Methods
A multicentric longitudinal prospective study with 50 caregivers of children born with some form of biological risk: preterm, low birth weight or perinatal complications. Screening will be conducted remotely at 12, 18 and 24 months old, using internationally recognized instruments with valid psychometric properties. Functional skills will be measured via the Pediatric Evaluation of Disability Inventory Computer Adaptive Test and participation by Young Children's Participation and Environment Measure. Contextual factors will be analyzed using the Child’s Context questionnaire, the environment portion of each section of the YC-PEM, Social Support Scale, the physical dimension of the Affordances in the Home Environment for Motor Development scale, sociodemographic data, and the Survey of Well-being of Young Children. The data will be collected by filling out forms, telephone interviews or video calls.
Discussion
The e-Followkids protocol could contribute to identifying possible signs of limitations and guiding referrals to specialized intervention.
A clinical trial comparing the occlusal parameters and wear of artificial teeth between lingualized and anatomical occlusal complete dentures
Authors: wang zhiqiang , su yan , wang jianmin , liu yang , xing wenzhong
Published: July 2024

Object:
The purpose of this study was to compare the occlusal parameters and the wear of artificial teeth between lingualized and anatomical occlusal complete dentures.
Methods
Edentulous patients who met the inclusion criteria were divided into three groups, and each patient made a complete denture. The Excellence IPN (IPN) group and Surpass G group were lingualized occlusal complete dentures, and Endura group was anatomical occlusal complete dentures. The occlusal contact area (OCA) and occlusal contact number (OCN) of the mandibular dentures was measured by silicone rubber translucency method, and the bite force was measured with Dental Prescale II at the 2-week, 3-month, and 12-month follow-up visits. The complete dentures were scanned at the 2-week and 12-month follow-up visits, and the wear of the maxillary and mandibular posterior teeth was assessed with software (Geomagic Qualify 2013; Raindrop). The data were analyzed by SPSS software.
Results
The results of One-way ANVOA showed that the OCA of the Endura group were significantly larger than the IPN and Surpass G groups at the 2-week follow-up visits, while the OCA of the IPN group were significantly larger than the Endura and Surpass G groups at the 3-month and 12-month follow-up visits (P < 0.05). The OCN of the three groups were significantly different at the 2-week, 3-month, and 12-month follow-up visits (P < 0.05). The bite force of IPN and Surpass G group were significantly lower than that of Endura group at the 2-week, 3-month, and 12-month follow-up visits (P < 0.05). The wear of IPN and Surpass G artificial teeth was significantly greater than Endura at the 12-month follow-up visits (P < 0.05)
Conclusions
The occlusal contact area increased as the complete dentures were used for longer periods of time. Compared with anatomical occlusion, lingualized occlusion was able to reduce the bite force. Wear varied among the three types of artificial teeth. (The Chinese Clinical Trial Registry (No. ChiCTR2300073420))
Association of Physical Activity with Chronic Diseases: A Cross-sectional Study of 18500 Middle-aged and Elderly Chinese
Authors: Huang Yongyu , Lu Zuosheng
Published: July 2024

Background
Regular physical activity is beneficial for both physical and mental health. However, studies on physical activity levels among middle-aged and elderly individuals in China are relatively scarce, and the health benefits of different activity levels remain unclear.
Objective
Using cross-sectional data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), this study describes the prevalence of chronic diseases and examines their association with physical activity (PA).
Methods
Participants self-reported the presence of fifteen chronic health conditions: Hypertension, Dyslipidemia, Diabetes, Cancer or Malignant tumor, Chronic lung diseases, Liver disease, Heart attack, Stroke, Kidney disease, Stomach or other Digestive diseases, Emotional, Nervous, or Psychiatric problems, Memory-related diseases (such as dementia, brain atrophy), Parkinson’s disease, Arthritis or Rheumatism, and Asthma. Total physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Multivariate logistic regression was used to estimate the association between chronic diseases and PA.
Results
In China, more than a quarter of middle-aged and elderly individuals do not meet physical activity guidelines, with only about a third achieving high activity levels. Compared to those with low PA, individuals with moderate PA had a reduced risk of 4 chronic diseases (Stroke, Emotional and Mental problems, Memory-related diseases, Asthma), while those with high PA had a reduced risk of 10 chronic diseases (Hypertension, Dyslipidemia, Diabetes, Cancer, Heart attack, Stroke, Emotional, Nervous, or Psychiatric problems, Memory-related diseases such as dementia and brain atrophy, Parkinson’s disease, Asthma).
Conclusion
Higher physical activity levels are associated with lower risks of chronic diseases. Governments and organizations should encourage individuals to achieve higher activity levels (> 3000 MET-min/week), not merely meet physical activity guidelines (≥ 600 MET-min/week).
Targeting inhibition of prognosis-related nicotinamide metabolism genes, including poly (ADP-ribose) polymerase 9 (PARP-9) attenuates glioma progression
Authors: Zeng Wei , Jiang Hai'xiao , Sun Guan , Pei Yunlong , Wang Jun , Nie Dekang
Published: July 2024

Background
Nicotinamide (NAM) metabolism plays a significant role in glioma development. This study aimed to investigate the correlation between NAM metabolic genes and prognosis, immune microenvironment, and tumor progression in glioma.
Methods
We analyzed the expression and prognostic significance of NAM-metabolism-related genes in patients with glioma to develop a new NAM metabolism-related signature (NMRS) and nomograms using data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases and compared the differences in gene set enrichment analysis (GSEA), protein-protein interaction networks, competing endogenous RNA (ceRNA) regulatory network, prognosis, mutation load, and immune landscape between different groups. Additionally, we employed Western blotting, cell proliferation and apoptosis analysis, Semi-quantitative Reverse Transcription-Polymerase Chain Reaction(SqRT-PCR), and a xenograft model in nude mice to investigate the role of PARP9 in tumor progression.
Results
Our study identified eight genes, including NT5C1A, NNMT, CDKN1A, PTGS2, PNP, PARP10, PARP14, and PARP9, that exhibited a significant correlation with glioma prognosis and could act as an independent indicator. Risk stratification was conducted based on the NMRS, and the low-risk group exhibited more favorable clinical results. The GSEA revealed that the low-risk group exhibited a significant enrichment in immune-associated pathways, while the high-risk group showed significant enrichment in cancer-related pathways. The ESTIMATE and single-sample GSEA algorithms indicated that the low-risk group displayed higher antitumor immunocyte infiltration. TIDE analysis revealed that the low-risk group responded more favorably to immunotherapy. Furthermore, validation experiments revealed that PARP9 is a proto-oncogene associated with the PARP9-JAK2-STAT3 signaling pathway.
Conclusion
We developed a new NMRS for predicting prognosis and treatment efficacy in glioma. The identified gene, PARP9, is a potential therapeutic target for glioma.
Comparative efficacy of virtual reality headset and auditory distraction for reducing anxiety and pain during inferior alveolar nerve block in 7-10-year-old children: A clinical trial
Authors: Bahrololoomi Zahra , Vaez Kazem , Irannezhad Maryam , Parvizi Zahra
Published: July 2024

Objectives: Pain and anxiety are not limited to a certain age group; however, their thresholds are closely correlated with age, and they can cause irreversible mental disorders in children. This study compared the efficacy of a virtual reality (VR) headset and auditory distraction for reducing anxiety and pain in 7- to 10-year-old children during inferior alveolar nerve block (IANB) injection.
Materials and Methods: This randomized clinical trial included 45 patients who required an IANB. The children were randomly assigned to 3 groups (n=15) to use a VR headset, headphones, or no distraction (control) during the IANB. The pain experienced by the children during the injection was quantified subjectively using the Wong-Baker FACES pain rating scale (WBFPS) and objectively using the Face Leg Activity Cry Consolability (FLACC) scale. Anxiety was quantified subjectively using the Facial Image Scale (FIS) and objectively by measuring changes in heart rate (HR) and blood pressure (BP). The data were analyzed using SPSS 19 (alpha=0.05).
Results: The mean age of the patients was 8.31±1.07 years. There were no significant differences in age or sex distribution among the three groups (P>0.05). Significant differences were found in the FLACC (P=0.000), WBFPS (P=0.011), and FIS (P=0.020) scores after the injection among the three groups; the headphone group had the highest scores, and the VR group had the lowest scores.
The mean change in systolic BP was significantly different among the three groups (P=0.00), and the VR headset group experienced the smallest increase in BP. The differences in diastolic BP (P=0.291) and HR changes were not significant among the groups (P=0.062).
Conclusion: Using a VR headset significantly decreased anxiety and pain during the IANB, while using headphones had no particular advantage.
Trail Registration:
The ethics committee of the university (IR.SSU.DENTISTRY.REC.1401.072)
The Iranian Registry of Clinical Trials (IRCT20230614058486N1)
Response tests on the effects of particle size of waste glass sand and glass powder on the mechanical and durability performance of concrete
Authors: Tong Gejun , Pang Jianyong , Shen Jingzhao , Tang Bin , Jiang Ziliang , Li Bing , Huang Jinkun , Zou Jiuqun , Wang Heng
Published: July 2024

To investigate the response of concrete's mechanical and durability properties to different particle sizes of waste glass materials, two stages of experiments were conducted. First, comprehensive tests were carried out to separately study the effects of monodisperse glass sand and glass powder on the mechanical and durability properties of concrete. Secondly, based on the results of the comprehensive tests, orthogonal tests were designed to explore the response of composite particle sizes of glass sand and glass powder to the mechanical and durability properties of concrete, and the optimal replacement quantities were obtained. Finally, the influence mechanism of composite particle-sized glass sand and glass powder on concrete properties was revealed through scanning electron microscopy (SEM). The research results show that under monodisperse glass sand/glass powder particle sizes: the incorporation of an appropriate amount of glass sand can enhance the mechanical and durability properties of concrete, but excessive replacement and larger particle sizes can have adverse effects on the properties of concrete; due to the pozzolanic effect of glass powder, the incorporation of glass powder can improve the mechanical and durability properties of concrete, but excessive replacement quantities are not conducive to the development of early strength of concrete, and it is recommended that the replacement rate be controlled within 20%. Compared to monodisperse replacement with a single particle size, under the conditions of compounding addition, the compressive, tensile, and shear strengths of concrete were increased, with improvement magnitudes of 35.56%, 21.74%, and 13.79%, respectively. In addition, the durability of concrete was significantly enhanced, with the maximum reduction in water absorption rate being 20.73%, and the maximum decrease in chloride ion permeation being 63.10%. Under the condition of a total replacement rate of 20%, the optimal relative replacement quantities determined by orthogonal test, range analysis, and response surface methodology were 2.86% of 0.6mm glass sand, 1.43% of 1.18mm glass sand, 8.57% of 50-60μm glass powder, and 7.14% of 60-70μm glass powder. The incorporation of composite particle-sized glass sand and glass powder played a role similar to gradation in the concrete matrix, improving the microstructure of concrete, thereby enhancing the mechanical and durability properties of concrete.
Effects of two posterior procedures for treatment of cervical hyperextension injury with multilevel spinal stenosis: A retrospective study
Authors: Liang Zhihao , Guo Tingxian , Xu Yue , Zhao Changqing , Zhao Jie , Cheng Xiaofei
Published: July 2024

Background Cervical hyperextension injuries (CHI), commonly resulting in central cord syndrome and spinal instability, often affect the elderly with preexisting degenerative spinal changes, leading to a need for surgical interventions that address both the compression and stability of the cervical spine. This study compares the clinical outcomes of two posterior decompression and fixation procedures for treating cervical hyperextension injury in patients with preexisting multilevel spinal canal stenosis.Methods Patients suffering from cervical hyperextension injury combined with multilevel spinal stenosis were divided into two groups. They received laminoplasty combined with selective unilateral pedicle screw fixation or laminectomy combined with bilateral lateral mass screw fixation. The clinical records including demographic data, operation time, length of hospital stay, estimated blood loss and surgical complications were collected, and clinical outcomes were evaluated using the American Spinal Injury Association (ASIA) impairment scale. Preoperative and postoperative cervical lordosis were measured.Results Postoperative AISA scores were significantly increased compared with that before surgery in both groups, there was no significant differences between groups. The intraoperative blood loss in the laminoplasty group was significantly less than that in the laminectomy group and there were no significant differences in operation time and length of hospital stay between the two groups. No significant difference was found in the incidence of overall surgical complications between the two groups. There was no significant difference in the cervical lordosis after surgery compared with that before surgery in both groups.Conclusions For patients suffering from cervical hyperextension injury combined with preexisting multilevel spinal stenosis, both cervical laminoplasty with selective unilateral pedicle screw fixation and laminectomy with bilateral lateral mass screw fixation could achieve satisfactory clinical outcomes.
The Impact of Smart City Construction on Residents' Physical Exercise Behavior: An Empirical Analysis Based on CFPS Data
Authors: Dong Fengwei , Ma Miao , Chang Yujie , Tang Lixu
Published: July 2024

Background
Smart city construction, as a new model of urban development, has become a crucial means to encourage residents' participation in physical exercise. However, there is still a lack of empirical studies on how smart city construction impacts residents' physical activity behavior.
Method
This paper examines the influence of smart city construction on residents' physical activity behaviors using data from the 2014 to 2020 China Family Tracking Survey (CFPS) and employing the double difference model (DID). Data processing involves removing missing values, trimming outliers, and incorporating control variables at the individual, household, and city levels.
Results
The study reveals that smart city construction significantly boosts residents' engagement in physical activity. Smart city policies have a notable positive impact on residents' participation in physical activity, and there are discernible differences in how various resident groups respond to physical activity behaviors. The findings on the mediating effect indicate that the built environment, information channels, and enjoyable consumption play crucial mediating roles between smart city policies and residents' physical activity participation.
Conclusion
Smart city construction directly and indirectly shapes residents' physical activity behavior by enhancing urban infrastructure, broadening information access channels, and fostering enjoyable consumption. In the future, smart city initiatives should prioritize resource distribution balance, enhance infrastructure development in rural and western regions, and further elevate the national fitness level.
Effect of Estimated Glomerular Filtration Rate on In-hospital Mortality in Patients with Acute Myocardial Infarction
Authors: SHEN LONGBIN , WANG NAN , YANG RUI , HUANG TAO , HUANG YIXUAN , ZHENG JIAXING , CHEN ZHUOMING , LYU JUN
Published: July 2024

Objectives
Determining the effect of the estimated glomerular filtration rate (eGFR) on in-hospital mortality among patients with acute myocardial infarction (AMI), to provide information for clinicians to develop a diagnosis and treatment plan for patients with AMI.
Design:
Adult patients with AMI from the Medical Information Mart for Intensive Care IV database were selected. Kaplan-Meier curves were used to determine the survival differences between patients in different eGFR groups. The relationship between the eGFR group and in-hospital mortality was estimated using the Cox regression model. Sensitivity analysis was then achieved by selecting gender and age strata. The nonlinear correlation showed the relationship between the eGFR values and the outcome, and the segmentation functions further calculated the optimal cutoff point.
Results
This study included 6,480 patients with AMI in intensive care units (ICUs). The patients with AMI were divided into two groups according to the eGFR value of 60 mL/min/1.73m2 (low-eGFR group: eGFR < 60 mL/min/1.73m2; high-eGFR group: eGFR ≥ 60 mL/min/1.73m2). There was a significant difference in survival status between the two eGFR groups (P < 0.001). High-eGFR group was a protective factor for in-hospital mortality in patients with AMI in different percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (ByPass) groups (P < 0.001). High-eGFR group was a protective factor for in-hospital mortality in patients with AMI in different sex groups. The effect of the high-eGFR group on the outcome for those aged < 65 years was not statistically significant, while the high-eGFR group was a protective factor for the outcome for those aged ≥ 65 years. After excluding patients aged ≥ 65 years, eGFR values were strongly nonlinearly correlated with outcome (P = 0.006), and at this time, the best cutoff point for eGFR affecting the outcome was 31.60 mL/min/1.73m2 (95% confidence interval = 23.23–39.97 mL/min/1.73m2, P < 0.001).
Conclusions
Low-eGFR group in patients with AMI was associated with a higher in-hospital mortality risk. The optimal cutoff point of eGFR values for patients aged ≥ 65 years was 31.60 mL/min/1.73m2.
Exploring the Potential of Large Language Models: Can ChatGPT effectively assume the role of medical professionals by providing accurate and reliable responses in childhood cancer?
Authors: Cui Kongkong , Lin Jie , Hu Zaihong , Hong Peng , Gao Zhiqiang , Tian Xiaomao , Wang Yu , Liu Feng , Wei Guanghui , Shi Qinlin
Published: July 2024

Background: Childhood cancer incidence rises by 1.1% annually, with leukemia up 0.6% and soft-tissue sarcomas 1.8%. This trend challenges pediatric oncology and increases demand for accurate online medical information. This study examined ChatGPT's accuracy and reliability in answering questions about childhood tumors and its ability to provide emotional support.
Methods: This study screened 150 questions from authoritative sources to assess ChatGPT's effectiveness in providing accurate information on childhood cancer. A double-blind evaluation and a four-level scoring system by pediatric oncologists were implemented. We also evaluated ChatGPT's ability to provide emotional support by tailoring ten questions to the users' specific needs.
Result: ChatGPT demonstrated high precision, accurately answering 132 (88%) of 150 questions across various domains: basic knowledge (28%), diagnosis (26.7%), treatment (32%), and prevention (13.3%). It provided 13 (8.7%) correct but incomplete responses and 5 (3.3%) partially correct responses, with no completely incorrect answers. Reproducibility was high at 98%. When evaluated on ten questions about humanistic care and emotional support for children with cancer, ChatGPT received a "B" grade in empathy and an "A" in effective communication. For emotional support, it scored "B" on eight occasions and "C" on two.
Conclusion: Our findings suggest that ChatGPT's accuracy and repeatability could enable it to offer virtual doctor consultations. However, its emotional support capacity needs improvement. As ChatGPT evolves, it may assume roles traditionally held by physicians. Further research is necessary to assess the risks and efficacy of ChatGPT in pediatric oncology and other medical fields to enhance patient outcomes.
Challenges of implementing electronic prescribing: a case study of a developing country
Authors: Mostafavi Hakimeh , Takian Amirhossein , Mostafavi Sahar , Baktiari Ahad , Mohamadi Efat , Olyaeemanesh Alireza
Published: July 2024

Background
Electronic prescribing (E-prescribing) is one of the helpful technologies used in healthcare organizations since it provides complete patient information and helps to avoid prescription errors. We aimed to evaluate the present state of E-prescribing in Iran and identify its process and software flaws in this study.
Methods
Semi-structured interviews with several user groups, health system executives, and patients were used to conduct this qualitative study in 2022. After the interviews were conducted, the MAXQDA 11 was used to code and build the major themes and sub-themes.
Results
According to the interviews, shortcomings in the E-prescribing process include a lack of appropriate culture, poor management, a lack of support for service providers, a lack of physician cooperation, frequent system interruptions, the imposition of extra duties on pharmacies, and a failure to pay attention to underprivileged areas. Moreover, the software has a number of flaws, notably inconsistent coding, a lack of coverage for some medicines, the inability to keep up with an increase in workload, the difficulty to connect some older systems to the latest one, and a lack of user-friendliness.
Conclusions
Despite the country's E-prescribing system improving day by day, its effective implementation requires ongoing interaction with all stakeholders, listening to their ideas, and resolving any current problems or obstacles as quickly as feasible.
Enhanced resolution of optical genome mapping utilizing telomere-to-telomere reference in genetic disorders
Authors: Tallapaka Karthik , Banu Sofia , K Kanakavalli M , George Joel , MS Sreelekshmi , Patil SJ , Phadke Shubha , Sowpati Divya
Published: July 2024

Reference genomes serve as a baseline criterion for comparison of personal genomes to deduce clinical variants. The widely used reference genome, GRCh38, contains stretches of gaps and unresolved bases particularly in complex regions which could obscure variant discovery. In contrast, the gapless telomere-to-telomere CHM13 (T2T-CHM13) reference genome can be used to assess difficult regions of the genome. Optical genome mapping (OGM), an imaging technique for structural variation identification has improved resolution compared to traditional cytogenetic methods. Our study showcases the utility of the T2T-CHM13 reference genome for enhanced structural variant (SV) detection in complex regions. We illustrate this through two clinical cases, where improved alignment with T2T-CHM13 led to significantly higher confidence scores for critical SVs. We demonstrate improved clinical diagnostic outcomes with the updated T2T-CHM13 reference and advocate its adoption.
Classifying Intraspinal Tumors: A Multi-modal MRI and Machine Learning Approach
Authors: Liyun Hu , Yuan Zhang , Yuanshan Lin , Jie Ma , Xiaofan Yuan
Published: July 2024

Objective (s):Develop a predictive model for benign and malignant intraspinal tumors using MRI radiomics combined with machine learning, enhancing diagnostic accuracy.
Methods: Retrospective data from 132 patients with intraspinal tumors (2020-2023) were analyzed. MRI scans were processed with 3D Slicer and Pyradiomics to extract features. Features were reduced using the LASSO algorithm and recursive elimination, followed by model construction using logistic regression, SVM, DT, RF, and XGBoost.
Results: 15 key features were identified post-screening. The XGBoost model showed the highest accuracy, with AUCs of 0.992 (training) and 0.542 (test). RF and DT models also performed well, with AUCs of 0.964/0.885 and 0.986/0.543 respectively.
Conclusion(s): Integrating MRI radiomics with machine learning, particularly XGBoost, effectively differentiates intraspinal tumors, offering a non-invasive diagnostic tool that enhances early identification and treatment planning.
The mpox healthcare seeking barriers scale : Development and validation among men who have sex with men in 6 cities of China
Authors: Liu Shangbin , Gao Ying , Xu Huifang , Wang Ying , Xu Gang , Cai Yong , Zhang Jiechen
Published: July 2024

Background
China is one of the ten countries most severely affected by the monkeypox outbreak. Over 90% of mpox cases are MSM, primarily identified through proactive healthcare visits. Mpox medical visit worries are barriers to MSM proactively seeking medical assistance. However, there are currently no tools available to measure the barriers of MSM regarding seeking medical care for mpox.
Methods
A total of 2,347 MSM were recruited for this study from six cities in China. Factor analysis was used to explore and validate the factor structure of the MMHSBS. The model's structural validity was evaluated and compared using GFI, NFI, RFI, IFI, TLI, CFI, SRMR and RMSEA. Split-half reliability, Cronbach's α, and McDonald's ω were used to assess the reliability of MMHSBS.
Results
The three-factor structure model of MMHSBS performed best. The indices were as follows: GFI = 0.937, NFI = 0.926, RFI = 0.952, IFI = 0.967, TLI = 0.959, CFI = 0.967, SRMR = 0.046, RMSEA = 0.073. Split-half reliability was 0.844, Cronbach's α was 0.949, and McDonald's ω was 0.950.
Conclusions
The three-factor structure of the MMHSBS demonstrated good reliability and validity among Chinese MSM. Chinese men who have sex with men face relatively strong barriers to seeking healthcare for mpox, with the most prominent barrier being the impact on their personal social image.
Ventilator-associated pneumonia caused by a new-found opportunistic fungal pathogen——Myceliophthora heterothallica：A case report
Authors: Wang Chengxin , Yang Chun , Wang Dan , Wang Jiayin , He Dan , Xu Jiancheng
Published: July 2024

Background
Myceliophthora heterothallica belonging to Myceliophthora is considered as an environmental fungus and has not been reported to be pathogenic or colonizing in recent literatures. The present case firstly reports an elderly ventilation-associated pneumonia caused by Myceliophthora heterothallica.
Case presentation:
A 67-years-old Asian female patient suffering from a sudden disturbance of consciousness for 3 hours was admitted to our hospital. Cardiac arrest occurred during emergency transport, and sinus rhythm was restored after cardiopulmonary resuscitation. Invasive mechanical ventilation was given to this patient for respiratory failure. After mechanical ventilation, the lung CT images showed multiple cuneiform nodules arranging subpleural accompanying with ground-glass opacity. On the 5th day of mechanical ventilation, Myceliophthora heterothallica was cultured from endotracheal aspirates. Two methods, namely automatic microbial identification system and internal transcribed spacer sequencing were employed to identify this fungus. The present case firstly uncovered the colonization ability and pathogenicity of Myceliophthora heterothallica in the respiratory tract. After 28d of treatment with piperacillin-tazobactam, this patient weaned from the ventilator and recovered consciousness with lung infection disappearance.
Conclusions
This is the first case report of ventilation-associated pneumonia in elderly patient caused by Myceliophthora heterothallica. This current case is worth for the clinical diagnosis and treatment of Myceliophthora heterothallica infection, and also enriches new pathogenic species found of Thermothelomyces species.
Combining Interferon-γ Release Assays and Metagenomic Next-generation Sequencing for Diagnosis of Pulmonary Tuberculosis: A Retrospective Study
Authors: Liu Yanyan , Fang Miaohong , Yuan Chenxi , Yang Yi , Yu Liang , Li Yasheng , Hu Lifen , Li Jiabin
Published: July 2024

Background
Rapid diagnosis of pulmonary tuberculosis (PTB) is urgently needed. We aimed to improve diagnosis rates by combining tuberculosis-interferon (IFN)-γ release assays (TB-IGRA) with metagenomic next-generation sequencing (mNGS) for PTB diagnosis.
Methods
A retrospective study of 29 PTB and 32 non-TB patients from our hospital was conducted between October 2022 and June 2023. Samples were processed for TB-IGRA and mNGS tests according to the manufacturer’s protocol.
Results
The levels of IFN-γ release in PTB patients were significantly higher than those -in non-TB patients (604.15 ± 112.18 pg/mL, and 1.04 ± 0.38 pg/mL, respectively; p < 0.0001). Regarding presenting symptoms or signs, cough and thoracalgia were less common in PTB patients than in non-TB patients (p = 0.001 and p = 0.024, respectively). Total protein and albumin levels in the sera of PTB patients were significantly elevated compared to non-TB patients (p = 0.039 and p = 0.004, respectively). The area under the ROC curve (AUC) for TB-IGRA in PTB diagnosis was 0.939. With an optimal IFN-γ cut-off value of 14.3 pg/mL( Youden’s index 0.831) sensitivity was 86.2% and specificity was 96.9%. ROC curve analysis for mNGS and TB-IGRA combined with mNGS showed AUCs of 0.879 and 1, respectively.
Conclusions
TB-IGRA combined with mNGS is an effective method for diagnosing tuberculosis, and can be used in the clinical diagnosis of PTB.
Implausible, Not Impossible: Delayed Supradiaphragmatic Thoracic Migration of a Ventriculoperitoneal Shunt in a 17-Month-Old
Authors: FLORIAN Ioan-Alexandru , TOPAL Paula , FLORIAN Teodora-Larisa , FONT Dragos , FLORIAN Ioan-Stefan
Published: July 2024

Background
Intrathoracic migration of a ventriculoperitoneal shunt (VPS) is a phenomenally rare complication, with the supradiaphragmatic intercostal variant even more so. Whereas it can prove debilitating or even fatal via massive hydrothorax, the causative mechanism and proper management of this occurrence are undefined.
Case Presentation:
A 17-month-old girl who had undergone VPS insertion at one month of age was brought to our department for somnolence and dyspnea, which had a sudden onset. Despite a previous thoracostomy provided temporary symptom relief, she had relapsed. Computed tomography (CT) of the chest showed a large loop of the right-sided VPS penetrating into the thorax through the anterior wall, as well as marked right hydrothorax. She was subjected to VPS revision and thoracostomy, with the swift, complete, and lasting remission of her complaints.
Conclusion
It is possible that local reaction coupled with negative inspiratory pressure caused the catheter loop to break into the pleural cavity. Our case demonstrates an exceedingly rare event that has a favorable prognosis if diagnosed and treated quickly and appropriately.
Discrete wavelet analysis of acoustic emission precursory characteristics of confining pressure failure in Coal and rock triaxial unloading
Authors: Ma Shaojie , Zhou Yan , Ma Depeng
Published: July 2024

Acoustic emission information can describe the damage degree of rock samples in the process of failure. However, as a discrete non-stationary signal, acoustic emission information is difficult to be effectively processed by conventional methods, while wavelet analysis is an effective method for non-stationary signal processing. Therefore, acoustic emission signal is deeply studied by using wavelet analysis method. In this paper, on the basis of noise reduction of acoustic emission signal, Matlab calculation program is used to decompose the acoustic emission signal of coal sample under the confining pressure test of triaxial unloading, and the singularity detection is carried out. The results show that the time when the Lipschitz index value first appears α negative can be used as the prediction time. However, the corresponding time when the Lipschitz index value is -0.15~-0.31 should be excluded; The absolute range of the difference between the final forecast time and the actual rupture time of coal samples is [5.2s, 17.1s], and the coal samples with the absolute value of time difference within [5.2s, 10.0s] account for 63.6% of the total.
Hemolysis intraoperative monitoring by Helge V-test in patients undergoing extracorporeal circulation in cardiac surgery: a single center data
Authors: Schiavoni Lorenzo , Stifano Mariapia , Mattei Alessia , Verde Francesca La , Strumia Alessandro , Pumpo Annalaura Di , Sarubbi Domenico , Rizzo Stefano , Conti Maria Cristina , Mortini Lara , Cataldo Rita , Costa Fabio , Pascarella Giuseppe , Rita Alessandro , Casali Elena , Agrò Felice Eugenio , Carassiti Massimiliano
Published: July 2024

Purpose
Hemolysis is a complication in all surgical procedures requiring extracorporeal circulation (ECC). The aim of this study is to evaluate the effectiveness of the disposable point of care device Hemcheck Helge™ V-TEST quantifying hemolysis during cardiac surgery in ECC.
Methods
Two whole blood samples of 78 patients were simultaneously collected at different times of surgery: T0 pre ECC; T1 at the time of clamping of aorta; T2 at 20 minutes after the start of ECC; T3 at the end of ECC; T4 at the end of surgery. Both samples were analyzed by the disposable Hemcheck Helge™ V-TEST device, which offers a real-time assessment of hemolysis through a value of plasma free hemoglobin (PfHb) expressed in mg/dL.
Results
Out of all cases analyzed, no case of hemolysis (PfHb ≥ 50 mg/dL) was recorded at T0. The results recorded median PfHb values at T0 0.5 (0-7.1) mg/dL, at T1 3.75 (0-14.4) mg/dL; at T2 8.25 (0.4–19.1) mg/dL, at T3 27.5 (9.9–50) mg/dL, at T4 18.5 (2.4–41) mg/dL; for all T time p value was < 0.001. A statistically significant correlation was recorded between hemolysis values > 50 mg / dL at T3 and ECC time > 100 minutes (p < 0,05).
Conclusions
The use of Hemcheck Helge™ V-TEST allows effective identification of hemolysis directly in the operating room, reducing wasted time for laboratory analyses. This could help the anesthetist, perfusionist or cardiac surgeon approaching earlier intraoperative hemolysis and its effects on organs function and improve the post-operative course of patients undergoing cardiac surgery in ECC.
Providing excellence of care through the development and implementation of Digital Care Pathway across Northern Health, Australia: A co-designed methodological protocol
Authors: Duckham Rachel L , Webster Tracey , Gan Min , Gust Anthony , See Katharine
Published: July 2024

Background: Healthcare costs within Australia continue to rise without commensurate improvement in health outcomes of care delivered. Across Australia there is a commitment to reform the healthcare system focusing on value-based care for patients. Within Victoria Australia, Northern Health have sought to enhance communication with patients and their families, particularly around shared decision making, quality of life and symptoms, and the impact of the patient care and treatment. This paper describes the co-design methodology utilised to: 1) Develop and implement new digital models of care, 2) capture, utilise and analysis patient reported outcome measures, and 3) evaluate the effectiveness and cost effectiveness of the transformed models of care across the health service.
Methods: A six-phase co-design methodology incorporating the Kotters change model will be piloted to develop, refine, implement and evaluate innovative multi-lingual, fully automated digital care pathways across ten clinical services. Quantitative and qualitative data will be collected from consumers and clinicians during the development and implementation of the digital care pathway to 1) understand the barriers and enablers of clinical care across specific clinical departments, 2) provide information to inform decision making, 3) understand patient outcomes and inform treatment, and 4) to evaluate each implemented digital care pathway.
Discussion: Northern Health is leading the change in Australia to implement evaluate and redesign models of care based on evidence to maximise the impact on health outcomes for patients and the community. This innovative initiative will change the way in which healthcare is delivered. At the time of publication this methodological approach has been applied with one digital care pathway implementation and 9 are currently under development.
Fusing fact and mask mechanism to promote consistency between long text summarization and fact
Authors: Wang Xianchuan , Lu Ben , Ming Wenkai , Wang Xianchao
Published: July 2024

The basic requirement of text summarization is that the facts in the summary and the original text must be consistent. At present, most of the summarization models choose to introduce fact information in the decoding stage. With the increase of the text content, the ability to process fact information becomes weak, which leads to fact consistency errors in the model. From the perspective of data fusion in input section, this paper proposes a LTSum-FTL (Long Text Summarization model with Fact Triples Labeling) to improve factual consistency, which help readers obtain more accurate information. Firstly, use fact triples to represent the factual information of the original text. Then annotate the three attributes in the triple, and vector the annotation information and fuse into the input vector. Finally, use the improved masking mechanism to mask or replace the triple attributes of the input part, to improve the model summary ability. The experimental results show that the proposed model can effectively reduce the probability of fact consistency errors,it is at least 2.4%,1.1% and 0.3 higher than that of other comparison models in the metrics of Pre1,Pre2 and FactCC-Socre.
The comparison of the risk of neurological deterioration and clinical outcomes in different atherosclerotic stroke patterns
Authors: He Yue , Zhang Tingting , Wu Wenqi , Niu Kai , Cai Zhirong , Zhao Tian , Shao YuanWei , Yang Yi , Zhu Ying , Yu Ming
Published: July 2024

This study aims to compare the incidences of ND and poor outcome (a modified Ranking scale > 2 points at discharge) among patients with different atherosclerotic stroke patterns. A total of 688 participants were categorized into 4 groups according to atherosclerotic stroke pattern: multiple small infarcts (MSI), single subcortical infarction (SSI), borderzone infarct (BZI) and large infarct groups. Among the 4 groups, MSI group had the lowest incidences of ND and poor outcome (13.5% and 16.2%, respectively). In multivariable analyses, for BZI patients, the risks of ND [odds ratio (OR) = 4.33, 95% confidence interval (CI) = 2.37–7.94, p< 0.001] and poor outcome (OR = 4.16, 95% CI = 2.04–8.50, p < 0.001) both increased approximately 3-fold than MSI, both of which were the highest among the 4 stroke patterns. The neutrophil to lymphocyte ratio in BZI and large infarct groups were higher than in MSI and SSI groups [3.35 (2.28, 5.04) and 3.36 (2.53, 4.94) vs. 2.64 (1.89, 4.06) and 2.71 (1.93, 3.91), p< 0.001]. BZI group had the highest risks of ND and poor outcome among atherosclerotic stroke patients. BZI and large infarct patients had stronger poststroke inflammation than MSI and SSI patients.
Insulin resistance, left atrium enlargement, and recurrence in patients with atrial fibrillation undergoing radiofrequency ablation
Authors: Luo Yan , Qin Shujuan , Huang Wenchao , Yang Guoshu , Luo Duan , Sun Huaxin , Tang Yan , Xu Bao , He Guijun , Yang Yongxin , Tong Lin , Cai Lin , Zhang Zhen , Liu Hanxiong , Xiong Shiqiang
Published: July 2024

Aims: To investigate the association between insulin resistance (IR), left atrial enlargement, and atrial fibrillation (AF) recurrence in AF patients undergoing radiofrequency catheter ablation (RFCA).
Methods: 910 AF patients were evaluated for IR using TyG-BMI and left atrial enlargement using LAD. Various analytical methods were employed to study the relationship between TyG-BMI, LAD, and AF recurrence.
Results: Over a median 12-month follow-up period, 189 (20.77%) cases of AF recurrence were observed. The likelihood of AF recurrence rose with elevated TyG-BMI and LAD levels. After adjusting for multiple factors, both TyG-BMI and LAD were significant predictors of AF recurrence. Both TyG-BMI and LAD demonstrated a positive dose-response relationship with AF recurrence. The areas under the ROC curves for TyG-BMI and LAD in predicting AF recurrence were 0.634 and 0.639, respectively. Notably, LAD partly mediated the association between TyG-BMI and AF recurrence, accounting for an 19.23% proportion.
Conclusion: Elevated baseline TyG-BMI and LAD were associated with a higher risk of AF recurrence in patients undergoing RFCA. Furthermore, the enlargement of the left atrium partially mediated the relationship between IR and AF recurrence. Ameliorating IR may serve as a potential upstream therapy for the comprehensive management of AF in clinical practice.
Characterization and Structural Basis for the Brightness of mCLIFY: A Novel Monomeric and Circularly Permuted Bright Yellow Fluorescent Protein
Authors: Goldman Yale , Shweta Him , Gupta Kushol , Zhou Yufeng , Cui Xiaonan , Li Selene , Lu Zhe , Dantzig Jody
Published: July 2024

We present mCLIFY: a monomeric, bright, yellow, and long-lived fluorescent protein (FP) created by circular permutation of YPet, the brightest yellow FP from Aequorea Victoria for use in cellular and in vitro single molecule studies. mCLIFY retains the enhanced photophysical properties of YPET as a monomer at concentrations ≤ 40 μM. In contrast, we determined that YPet has a dimerization dissociation constant (KD1-2) of 3.4 μM. Dimerization of YPet can cause homo-FRET, which underlies quantitative errors due to dimerization and homo-FRET. We determined the atomic structure of mCLIFY at 1.57 Å resolution and used its similarity with Venus for guided chromophore-targeted substitution studies to provide insights into its enhanced photophysical properties. The mutation V58L within the chromophore pocket improved quantum yield and extinction coefficient, making mCLIFY ~30% brighter than Venus. The extensive characterization of the photophysical and structural properties of YPet and mCLIFY presented here allowed us to reveal the basis of their long lifetimes and enhanced brightness and the basis of YPet’s dimerization.
Comprehensive genomic profiling of Taiwanese triple negative breast cancers with medium- and large-sized sequencing panels: a comparative study of actionable genes
Authors: Huang Chi-Cheng , Yeh Yi-Chen , Tsai Yi-Fang , Lin Yen-Shu , Chao Ta-Chung , Liu Chun-Yu , Ho Hsiang-Ling , Tseng Ling-Ming
Published: July 2024

Introduction:
Comprehensive genomic profiling (CGP) is a molecular diagnostic tool with increasing use in cancer research and treatment. There are several commercialized CGP assays with variable targeted genes, however, how large a panel should be used for breast cancer remains undetermined.
Methods
Triple negative breast cancer (TNBC) patients from the VGH-TAYLOR study were initially assayed by a medium-sized CGP panel (Oncomine Comprehensive Panel, OCP, v3), and the remaining nucleic acid specimens were re-sequenced with a large-sized CGP panel (TruSight Oncology 500, TSO500). Molecular profiling between the two sequencing panels was compared and reported.
Results
A total of 108 breast cancers were successfully assayed using both platforms and 272 variants were reported at least once by OCP or TSO500. Variants reported were among actionable genes (AKT1, BRCA1/2, PALB2, ERBB2, PIK3CA, PTEN) and TP53. Concordance rate between TSO500 and OCP was 34.6% and was enhanced to 58.9% after excluding polymorphisms, out-of-targeted region variants and those with low variant allele frequency (< 10%).
Conclusion
Only one-third of actionable mutations could be detected consistently between the medium- and the large-sized CGP panels using the default analytical pipelines, while extensive bioinformatics analyses improved variant calling consistency substantially. TSO500, the larger panel, detected more variants than OCP from the same set of actionable genes.
Preoperative anxiety and its association with resilience of surgical patients in the preoperative waiting area: A latent profile analysis
Authors: Shen Xiaowen , Wu Min , Wang Rong , Yang Silan , Wang Yuwei , Dai Suwan , Zhou Qinghe
Published: July 2024

Background
Preoperative anxiety is a specific type of anxiety that focuses on concerns and worries related to anesthesia and surgical procedures. However, there has been limited research conducted on the various aspects of this phenomenon, especially in waiting areas.
Objective
Using latent profile analysis (LPA), this study aimed to identify various preoperative anxiety profiles among surgical patients in the preoperative waiting area. Additionally, this study aimed to explore the demographic and resilience factors associated with different preoperative anxiety profiles.
Methods and Materials
A cross-sectional study was conducted at comprehensive hospitals in Jiaxing, Zhejiang Province, China. Three hundred seventy-three (373) surgical patients were included in the analyses. Surgical patients completed the demographic characteristics questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS-C), and the Connor-Davidson Resilience Scale (CD-RISC) while waiting for surgery in the waiting area.
Results
The LPA results indicated that the data were most consistent for four types of solutions: high preoperative anxiety-medium information need, high preoperative anxiety-low information need, low preoperative anxiety-medium information need, and low preoperative anxiety-low information need. One-way ANOVA revealed significant differences between the four groups with respect to resilience. Sex, education background, tumor diagnosis, sleep quality and surgical experience significantly predicted profile membership.
Conclusion
There is heterogeneity in preoperative anxiety among surgical patients in the waiting area. When supporting surgical patients in waiting areas, nurses should consider the level of psychological resilience of patients in addition to assessing demographic factors to identify high-risk subgroups to warrant intervention.