bluuebunny/crossref_metadata_2025 huggingface dataset:
Decoupling effect and influencing factors of transportation carbon emissions in Hainan Province,China
Authors: Tang Yongping , Jiang Huiyuan
Published: April 2024

Hainan, as the pioneering province in China to declare a comprehensive ban on the sale of petrol-driven automobiles by 2030, is actively propelling the low-carbon transformation of its transportation industry. Through the integration of the Tapio model and the LMDI method, an exhaustive analysis spanning the years 2006 to 2020 was conducted to scrutinize the decoupling dynamics and influencing factors between carbon emissions in Hainan's transportation industry and the concurrent trajectory of its economic development. The research has yielded noteworthy findings: (1) Total and per capita carbon emissions from transportation exhibit an initial phase of rapid ascent followed by a gradual deceleration, with carbon emissions from oil energy sources constituting an overwhelming 99%, where kerosene stands out as the primary contributor with the highest proportional increase; (2) The decoupling index exhibits an "M" curve trajectory, signifying an overarching trend of initial deterioration succeeded by subsequent improvement, reflecting an unstable decoupling status; (3) With the introduction of urbanization effects, positively driving factors include income urbanization effect, spatial urbanization effect, transportation intensity effect, and industrial structure effect. Conversely, negatively driving factors encompass energy intensity effect, population urbanization effect, and energy structure effect. Among these, the paramount factor propelling an increase in carbon emissions is income urbanization effect, while the paramount factor inhibiting carbon emissions is energy intensity effect. Finally, proposing policy recommendations.
Blinatumomab-induced macrophage activating syndrome (MAS) in adult with B-cell acute lymphoblastic leukemia (B-ALL)
Authors: Braun Adam , Otoukesh Salman , PharmD Jose Tinajero , Marcucci Guido , Aldoss Ibrahim
Published: April 2024

Blinatumomab as a single agent has demonstrated superiority over salvage chemotherapy in patients with relapsed and refractory B-cell acute lymphoblastic leukemia (B-ALL), with manageable safety and efficacy. Though known to have anticipated drug toxicities including cytokine release syndrome (CRS) and neurotoxicity, there is only one prior report of macrophage activating syndrome (MAS) due to blinatumomab. Case Presentation: We report the first case of blinatumomab-induced MAS in an adult. The patient presented with fever, cough, and weakness on the second cycle of blinatumomab. Complete blood count was notable for severe leukopenia, with comprehensive metabolic panel notable for elevated alkaline phosphatase, AST, ALT, LDH, and hyperferritinemia consistent with MAS. The patient was already in MRD-negative remission at presentation with MAS. She responded rapidly to withholding the drug and administration of both tocilizumab and dexamethasone. She was able to restart therapy with blinatumomab dosed at 9 mcg/day with no recurrence of symptoms. Conclusion: Though MAS is not an expected association with blinatumomab, the risk for CRS is. Secondary MAS in this case likely shares a mechanism with other hyperinflammatory conditions. Management includes holding the offending agent, like blinatumomab, and administering tocilizumab and dexamethasone. Future research will be needed to predict which patients are at highest risk to develop MAS after similar T-cell therapies.
Integrated approach for estimating the alteration in the CO 2 sink capacity of an inland waterbody due to climate change - Case study: Wadi El-Rayan Lakes, Egypt
Authors: Khalil Hanady H. , Abdrabo Mohamed A. , Hassaan Mahmoud A. , Elshemy Mohamed M.
Published: April 2024

An essential regulatory ecosystem function of inland Lakes is their ability to dissolve atmospheric carbon dioxide (CO2), therefore, they serve as CO2 sinks. Wadi El-Rayan Lakes are two lakes (Upper and Lower) in Fayoum, Egypt at different levels in respect to mean sea level (MSL) and are connected through a waterfall. Their CO2 sink capacity depends on their water temperature and salinity as well as their water volume which are all highly sensitive to climate conditions. Consequently, any slight change in climate conditions would affect their CO2 sink capacities. This paper aims to quantitatively estimate the change in the CO2 sink capacity of Wadi El-Rayan Lakes under climate change scenarios. For the purpose, an integrated approach is developed assimilating CO2 solubility model, hydrodynamic simulation and geographical information systems (GIS). According to the developed approach, CO2 solubility under variable temperature and salinity is mathematically modelled and this model is further used with hydrodynamically simulated data for Wadi El-Rayan Lakes' temperature, salinity and water depth to estimate their CO2 sink capacities. CO2 sink capacity is estimated for 2014 and 2050 under two Representative Concentration Pathways (RCPs) 2.6 and 8.5. Afterwards, the alteration in CO2 sink capacities due to climate change is determined. The results revealed that by 2050, the lakes would lose about 23–25% of their capacities compared to that of 2014 according to RCP 2.6 and 8.5, respectively.
Scintillator–single-photon avalanche diode array-based energy resolving photon counting X-ray detector
Authors: Shimazoe Kenji , Kim Donghwan , Hamdan Moh , Kamada Kei , Yoshino Masao , Shoji Yasuhiro , Sakamoto Kyohei , Acerbi Fabio , Gola Alberto
Published: April 2024

X-ray photon counting computed tomography (PCCT) has garnered considerable interest owing to its low dose administration, high-quality imaging, and material decomposition characteristics. Current commercial PCCT systems employ compound semiconductor photon counting X-ray detectors, which offer good energy resolution. However, the choice of materials is limited, and cadmium telluride or cadmium zinc telluride is mostly used. Although indirect radiation detectors can be used as alternatives to compound semiconductor detectors, implementing fine-pitch segmentation in such detectors is challenging. In the present study, we designed an indirect fine-pitch X-ray photon counting detector by combining miniaturized silicon photomultiplier arrays and fast scintillation crystals, with a pixel size of 250 µm, for PCCT. Performance characterization of the fabricated detector reveals its potential to discriminate photon energies with a reasonable resolution, good spatial resolution, charge-sharing inhibition ability.
Improving the introduction of telemedicine in pre-hospital emergency medicine: Understanding users and how Acceptability, Usability and Effectiveness influence this process
Authors: O'Sullivan Seán F. , Krautwald Jennifer , Schneider Henning
Published: April 2024

Introduction: Increasing numbers of ambulance calls, vacant positions and growing workloads in Emergency Medicine (EM) are increasing the pressure to find adequate solutions. With telemedicine providing health-care services by bridging large distances, connecting remote providers and even patients while using modern communication technologies, such a technology seems beneficial. As the process of developing an optimal solution is challenging, a need to quantify involved processes could improve implementation. Existing models are based on qualitative studies although standardised questionnaires for factors such as Usability, Acceptability and Effectiveness exist.
Methods: A survey was provided to participants within a German county. It was based on telemedical-surveys, the System Usabilty Scale (SUS) and earlier works describing Usability, Acceptability and Effectiveness. Meanwhile the investigated county introduced a telemedical system. A comparison between user-groups and an exploratory factor analysis (EFA) was performed.
Results: Of n=91 included participants n=73 (80,2 %) were qualified as emergency medical staff (including paramedics (39,56 %), EMTs (30,77 %), call handlers (9,89 %)) and n=18 (19,8%) as emergency physicians. Most participants approved that telemedicine positively impacts EM and improved treatment options with an overall Usabilty Score of 68,68.
EFA provided a 3-factor solution involving Usability,Acceptability and Effectiveness.
Discussion: With our results being comparable to earlier studies but telemedicine only having being sparsely introduced, a positive attitude could still be attested.
While our model could only describe 51,28% of the underlying factors of implementation, more research is needed to identify these.
We showed that Usability is correlated with Acceptability (strong effect), Usability and Effectiveness with a medium effect, likewise Acceptability and Effectiveness.
Therefore we see a need to improve available systems. Our approach can provide as a guide for decision makers and developers, that a focus during implementation should be on improving usability and on a quantifiable data driven implementation process.
Safety Assessment of Symptomatic Intracranial Atherosclerotic Stenosis: A Comparison between Sole Balloon Angioplasty and Medical Treatment
Authors: Cao Wen-feng , Wen An , Cao Xian-min , Wu Ling-feng , Zhou Yong-liang , Xiang Zheng-bing , Rao Wei , Chu Quan-hong , Hang Wang-Wong , Liu Shi-min
Published: April 2024

Patients with symptomatic intracranial arterial stenosis (sICAS) will likely face perioperative risks with stent placement and recurrence with medication. Simple balloon angioplasty (SBA), as a less invasive and safer alternative to stent placement, may offer an effective treatment option for sICAS. This study aimed to assess the perioperative safety of SBA compared to medication for sICAS. A retrospective analysis was conducted on sICAS patients admitted to the Department of Neurology, Jiangxi Provincial People's Hospital, between January 2020 and December 2021, within 60 days of onset. Patients with severe stenosis (70% to 99% rate), confirmed by cerebral angiography, were divided into medication and SBA groups. Demographic data, medical history, NIH Stroke Scale (NIHSS) scores at onset, responsible vessels, degree of vascular stenosis, postoperative residual stenosis rate, and any stroke or death within 30 days postoperatively were assessed. The study included 91 patients, with 51 in the medication group (38 males, mean age 58.06±1.58 years) and 40 in the SBA group (24 males, mean age 60.95±1.37 years). There were no significant differences in demographics, medical history, NIHSS scores, or degree of vascular stenosis (all P > 0.05). All SBA patients underwent successful balloon angioplasty, with 8 cases (20%) requiring a stent placement due to significant post-dilation stenosis regression or dissection affecting blood flow. Within 30 days postoperatively, 2 patients (3.9%) in the medication group experienced progressive stroke, while 3 patients (7.5%) in the SBA group experienced endpoint events, including 2 cases of new-onset infarction and 1 case of subarachnoid hemorrhage. There was no statistically significant difference in endpoint event occurrence between the groups (P > 0.05), and no deaths occurred. In conclusion, SAB in sICAS patients did not significantly increase the risk of stroke within 30 days postoperatively compared to medication treatment. Long-term efficacy warrants further investigation.
Developing archetypes for key roles in a pragmatic trial: implementing human-centered design to promote advance care planning in primary care
Authors: Saylor Martha Abshire , Scerpella Danny , Chapin Margo , Jajodia Anushka , Kadali Amrutha , Colburn Jessica , Cotter Valerie , Wolff Jennifer
Published: April 2024

Background: Archetypes are representations of a group of people with shared behaviors, attitudes, and characteristics. The design and use of archetypes have potential application to increase partnership and support when embedding and scaling interventions but methodological approaches have not been developed.
Objective: To describe the methodology of designing archetypes for use in a pragmatic trial of advance care planning in the primary care context, SHARING Choices ((NCT04819191). We present resulting archetypes representing three key roles (primary care champion, advance care planning facilitator, and patient) in our pragmatic trial.
Methods: Our process for developing archetypes involved 4 steps: 1) Identify roles for archetype development, 2) Identify Shareholders and Data Sources for Archetype Development, 3) Generate unique archetypes and their distinguishing traits, and 4) Iteratively refine archetypes through exposure, scrutiny, and shareholder input. We also developed a process map to communicate our methodology.
Results: We created 6 distinct archetypes for the primary care champion role, 5 archetypes for the advance care planning facilitator role and 6 archetypes for the patient role. For each archetype we described strengths, challenges, prevailing emotions, and successful approaches to collaboration (e.g., “what works for me”). Unique opportunities for synergy between archetypes (such as with facilitator and champion) and potential challenges between archetypes (such as for facilitator and patient) suggest ways to improve training and support of key roles.
Discussion: Our process for creating archetypes for use in implementation research was iterative and informative in discussion of implementation with shareholders. We expect this methodology to be useful for anticipating and analyzing many aspects of implementation.
Study on the structure of sputum flora in silicosis patients with different stages
Authors: Liu Tao , Zuo Haojiang , Zheng Tianli , Pei Xiaofang , Cheng Lin
Published: April 2024

Silicosis is a serious respiratory disease, which causes great harm to human health. Silicosis patients due to long-term exposure to silica dust particles, may lead to the imbalance of bacterial flora in the respiratory tract, thereby increasing the risk of respiratory infection. In this study, sputum samples from inpatients with silicosis at different stages in a hospital in Chengdu were collected, the genome was extracted, the sputum sample genome was sequenced by high-throughput sequencing technology, and the microflora composition of sputum samples was obtained by using QIIME 1.8.0 for analysis, including OTUs analysis, Alpha diversity analysis, Beta diversity analysis, etc. Then, the structure of respiratory microflora in silicosis patients was analyzed, and the composition, distribution and diversity of microflora in sputum of silicosis patients with different stages were compared. The results showed that the sputum flora of silicosis patients were firmicutes, Proteobacteria, Bacteroidetes, actinobacteria and clostridium, which were consistent with those of healthy people. However, there were differences in the placement of dominant bacteria in silicosis patients with different stages. Therefore, the study of sputum flora structure of silicosis patients with different stages is helpful to further understand the pathophysiological process of silicosis, and provide a more in-depth theoretical basis for the prevention, early diagnosis and treatment of silicosis.
Ultra-deep three-dimensional optical coherence tomography in turbid media
Authors: Ding Zhihua , Yang Lu , Han Tao , Tang Yun , Chen Changyong , Ma Cui , Liu Zhiyi
Published: April 2024

Ultra-deep three-dimensional (3D) optical coherence tomography (OCT) in turbid media is reported. Parallel detection along depth combined with scanning detection across lateral field is exploited in a swept-source OCT system to obtain the depth-resolved reflection matrices. Scanning detection enables the use of a highspeed swept source and a matched detector providing the required depth range for ultra-deep imaging. Disturbances intrinsic to scanning detection are compensated with negligible intra-frame phase variations to ensure satisfactory reconstruction by the inter-frame phase insensitive algorithm. 3D OCT imaging with an ultra-deep imaging depth of 11.5 times the scattering mean-free-path and a triple extension of the imaging depth achieved by a conventional SS-OCT is realized. The measurement time for 3D imaging (125μm×125μm×4mm ) is ~5 min, a significant leap over the time-domain matrix OCT where 6 min is taken for only one specified depth.
Serum soluble CD25 levels were associated with prognosis of children with Langerhans cell histiocytosis
Authors: Zhao Zijing , Lian Hong-Yun , Li Wei-Jing , Zhang Qing , Ma Hong-Hao , Wang Dong , Zhao Yun-Ze , Zhu Ting , Li Hua-Lin , Huang Xiao-Tong , Wang Tian-You , Zhang Rui , Cui Lei , Li Zhi-Gang
Published: April 2024

Background
Langerhans cell histiocytosis (LCH) is a rare myeloid neoplasm with inflammatory characteristics. This study aims to investigate the correlation between sCD25 levels and clinical characteristics and prognosis in pediatric LCH.
Methods
Serum sCD25 levels were measured in 370 LCH patients under 18 years old using ELISA assays. The patients were divided into two cohorts based on different treatment regiments. We further assessed the predictive value for prognosis impact of sCD25 in a test cohort, which was validated in the independent validation cohort.
Results
The median serum sCD25 level at diagnosis was 3908 pg/ml (range: 231 − 44 000). sCD25 level was significantly higher in MS RO + LCH patients compared to SS LCH patients (P < 0.001). Patients with increased sCD25 were more likely have involvement of risk organs, skin, lung, lymph node, or pituitary (all P < 0.05). sCD25 level could predict LCH progression and relapse with an area under the ROC curve of 60.6%. The best cutoff value was determined at 2921 pg/ml. High-sCD25 group had a significantly worse progression-free survival than those in the low-sCD25 group (P < 0.05).
Conclusion
Elevated serum sCD25 levels at initial diagnosis was associated with high-risk clinical features and worse prognosis. sCD25 levels can predict the progression/recurrence of LCH after treatment with first-line chemotherapy.
Deep learning-based carotid plaque ultrasound image detection and classification study
Authors: Zhang Hongzhen , Zhao Feng
Published: April 2024

Objective:To detect and classify carotid plaque ultrasound images based on different deep learning models of convolutional neural networks, and to compare the advantages and disadvantages of each model, with a view to providing a fast and accurate detection method for carotid atherosclerotic plaque ultrasound screening in stroke risk groups using artificial intelligence techniques.
Methods:A total of 5611 carotid ultrasound images of 3683 patients from the ultrasound departments of the Eighth People's Hospital of Shanghai, Fengxian District Central Hospital of Shanghai, the Second People's Hospital of Guangdong Province in Guangdong Province, and the People's Hospital of Huainan City in Anhui Province during the period of 17 September 2020 to 17 December 2022 were selected for the study.All carotid ultrasound image data redundant information was cropped, and two attending physicians with more than ten years of experience in cardiovascular ultrasound labelled and classified all the images for diagnosis. The total dataset was randomly split into a training set (3927 images) and a test set (1684 images) in a ratio of 7:3. Four deep learning models-YOLO V7 (ResNet 50) model, YOLO V7 (Inception V3) model, Faster RCNN (ResNet 50) model, and Faster RCNN (Inception V3) model-were used to detect and analyse the carotid artery plaque ultrasound images and to atherosclerotic plaques to identify and classify whether the carotid arteries are vulnerable plaques or stable plaques.The efficacy of the four deep learning models in classifying carotid atherosclerotic plaques was assessed using Accuracy (ACC), Sensitivity (SEN), Specificity (SPE), F1 scores, and Area under the curve of the working characteristics of the subjects (AUC), with P< 0.05 was taken as statistically significant difference.
Results:In this study, Faster RCNN model and YOLO V7 network base model were constructed using deep learning algorithms and two different feature extraction networks (ResNet 50 and Inception V3) were used to classify ultrasound images of carotid artery plaques.The Faster RCNN (ResNet 50) model in the test set had ACC, SEN, SPE, AUC were 0.88, 0.94, 0.71, and 0.91, respectively, which was the highest prediction efficacy for carotid atherosclerotic plaque classification among the four models. This study demonstrates the feasibility of deep learning for carotid plaque ultrasound image detection and classification, in which the Faster RCNN (ResNet 50) model has high accuracy and reliability.
Conclusion:In the diagnosis of carotid artery vulnerable plaque, the confidence level of the diagnosis using the deep learning Faster RCNN (ResNet 50) model is close to that of intermediate physicians, and the model can improve the diagnosis level of junior ultrasonographers, and also help clinics to formulate a more reasonable ischemic stroke prediction and early warning plan.
Contrasting microbial communities drive iron cycling across global biomes
Authors: Epihov Dimitar , Bryce Casey
Published: April 2024

The global iron (Fe) cycle governs important aspects of biosphere function by defining Fe availability thus supporting productivity of terrestrial and ocean ecosystems. However, the link between soil microbiome function to global patterns in terrestrial iron cycling remains poorly investigated. Here, we developed a novel database termed IRon cycle Annotation (IRcyc-A) targeted at discovering and annotating Fe cycle genes within omics data that we validated against known localized patterns of iron cycling. We leveraged this new tool to analyse the Fe cycle of over 220 publicly available soil metagenomes and metatranscriptomes encompassing a wide range of biomes on Earth. We show that the greatest abundance of Fe(III)-reduction and Fe(II)-oxidation genes were attributed to Acidobacteriota and were most abundant in the microbiomes of peatlands and iron sulfide soils, respectively. This is consistent with the high levels of dissolved Fe recorded in rivers draining such areas. In contrast, genes encoding the biosynthesis of siderophores deployed in iron sequestration in response to Fe deficiency peaked in agroecosystems with the majority assigned to Actinomycetota. Siderophore synthesis genes were negatively correlated with Fe(III)-reduction and Fe(II)-oxidation genes, supporting the view of divergent communities under low and high iron availability. Our findings highlight how iron availability shapes terrestrial microbial communities and how microbial processes can in turn contribute to global patterns in terrestrial Fe and C cycling.
Risk Factors and Prevention Strategies for Group B Streptococcus Colonization in Pregnant Women and Infection in Newborns
Authors: su yanlin , Wei Xin , Xu Fang , Liu Pengmin , Zhou Ting , Zhang Xuelian , Rao Lijuan , li minghua
Published: April 2024

Background: Group B Streptococcus (GBS), poses a significant threat to the health of pregnant women and newborns, often leading to life-threatening conditions such as neonatal sepsis, meningitis, pneumonia, and urinary tract infections. Hence, investigating the colonization rate of GBS in pregnant women, along with associated risk factors and their implications on adverse pregnancy and neonatal outcomes, remains imperative.
Objective: This study aims to ascertain the prevalence of GBS colonization in late-term pregnant women and newborns, and to analyze the factors influencing GBS colonization and infection.
Methods: A prospective monitoring was conducted on 7751 pregnant women who underwent GBS screening and delivered between January 2020 and December 2022. GBS diagnosis was conducted via bacterial culture.
Results: The colonization rate of GBS in pregnant women was found to be 6.08% (471/7751), with 44 newborns testing positive for GBS colonization (5.68/1000). Among these cases, 27 newborns required hospitalization due to EOGBS infection (3.48/1000). Multivariate logistic regression analysis revealed that maternal GBS colonization, premature rupture of membranes, and maternal chorioamnionitis were independent risk factors for GBS-positive colonization in newborns (P=2.19e-09,P=8.02e-06,P=0.0354). Cesarean section emerged as an independent protective factor against GBS-positive colonization in newborns (P=0.0277). Moreover, maternal GBS colonization, premature rupture of membranes, and maternal chorioamnionitis were identified as independent risk factors for EOGBS infection in newborns(P=7.41e-07,P=0.00133,P=0.01721).
Conclusion: Timely identification of GBS-positive colonization in newborns and enhancing the prognosis of infants with EOGBS infection can be achieved through GBS screening and intervention for pregnant women and newborns.
Efficacy of vitamin B1 in alleviating chemotherapy-induced nausea and vomiting
Authors: Matsushima Satoru , Sano Hirozumi , Hori Daiki , Yanagi Masato , Suzuki Daisuke , Kobayashi Ryoji
Published: April 2024

Background
The management of chemotherapy-induced nausea and vomiting (CINV) is of primary concern for both patients with cancer and medical workers. Refractory or breakthrough CINV is especially difficult to deal with and necessitates a different approach. Vitamin B1 deficiency is likely to occur during cancer chemotherapy, with early symptoms of fatigue, anorexia, nausea and vomiting. The efficacy of vitamin B1 for the treatment of delayed or refractory CINV should be confirmed.
Methods
Serum vitamin B1 level was prospectively measured in patients experiencing persistent nausea and vomiting after chemotherapy. The response to vitamin B1 therapy was evaluated for three consecutive days after vitamin B1 infusion. Moreover, serum level of vitamin B1 at diagnosis of persistent delayed CINV was compared with the level before chemotherapy.
Results
In total, 408 courses of chemotherapy in 86 patients were analyzed. The median age at hospital admission of the enrolled patients was 10.7 years (0.2–25.2). Among these, 44 (10.8%) episodes of persistent delayed CINV were identified in 26 of the enrolled patients. At day 3, the overall response rate was 79.5%; 21 (47.7%) patients achieved a complete response and 14 (31.8%) patients achieved a partial response. The median vitamin B1 level at diagnosis of CINV was significantly lower than the value before chemotherapy (22.8, range 11.9–49.2 vs. 32.7, range 11.2 − 80.1, respectively, P < 0.001).
Conclusion
Patients with a malignant disease who experience persistent nausea and vomiting after chemotherapy often exhibit vitamin B1 deficiency. Vitamin B1 infusion may be beneficial for many of these patients.
Comparison of Efficacy, safety, and cost-effectiveness of pembrolizumab versus chemotherapy for patients with advanced non-small cell lung cancer: a real-world study
Authors: Wan Ning , Yang Chen , Wang Bing , Guo Ya , He ZiJian , Lv YaJuan , Lu LiQing , Yang Ning , Xiao WeiBin , Chen YongBang , Yuan Jin , Yang DanDan , Liu Tao , Fang WenFeng , Chen ZhuoJia , Liang WeiTing
Published: April 2024

Background: While pembrolizumab has demonstrated effectiveness in clinical trials for non-small cell lung cancer (NSCLC), its real-world efficacy and cost-effectiveness, particularly considering its high cost, remain uncertain. This study aimed to compare the clinical efficacy, safety, and cost-effectiveness of pembrolizumab versus chemotherapy in treating patients with advanced NSCLC.
Methods: In this retrospective cohort study, advanced NSCLC patients treated with pembrolizumab (either as monotherapy or combined with chemotherapy) and chemotherapy alone were analyzed from April 2017 to March 2023 at a major 3A Hospital. Primary outcomes included progression-free survival (PFS), overall survival (OS), and the incremental cost-effectiveness ratio (ICER). Secondary outcomes were the objective response rate (ORR), disease control rate (DCR), and adverse events (AE).
Results: The study involved 630 patients, with 169 in the pembrolizumab group and 461 in the chemotherapy group. Post propensity score matching (PSM), the sample size was 450 (149 in pembrolizumab, 301 in chemotherapy). Pembrolizumab showed a significantly higher ORR (48.63% vs. 36.00%, p<0.05) and comparable DCR (95.21% vs. 90.00%, p>0.05) compared to chemotherapy. The median PFS was longer with pembrolizumab (15.5 months vs. 8.8 months, p<0.001), and the median OS was not reached compared to 26.2 months in chemotherapy. In second-line treatments, pembrolizumab showed superior PFS and OS. From the perspective of the Chinese healthcare system, pembrolizumab was not cost-effective compared to chemotherapy at a willingness-to-pay threshold of $36,070.2/QALY but was cost-effective at three times the per capita GDP in Guangzhou.
Conclusion: Pembrolizumab demonstrates superior clinical efficacy over chemotherapy in a real-world setting for advanced NSCLC, with manageable AEs. Its cost-effectiveness varies by regional economic conditions and payment thresholds, suggesting potential economic feasibility in economically developed areas with drug grant policies.
The Role of Environmental Health in the Prevention and Control of Environment-Related Diseases Worldwide
Authors: Ravanipour Masoumeh , Ravanipour Maryam , Hamidi Ali
Published: April 2024

Environmental factors are crucial in the global health landscape and the burden of diseases. Scientometrics is a quantitative method used to better analyze research status and trends in a specific subject area. This study aims to analyse the role of environmental health in preventing and controlling diseases.
A total of 50,274 documents were retrieved. The US and Harvard University were the most prolific and influential countries and organizations. The top three journals were PLOSONE, International Journal of Environmental Research and Public Health, and Environmental Health Perspectives. The highest interest is in burden of disease and air pollution, mainly particulate matter and PM2.5. The main focus are on air pollution, cardiovascular diseases, coronavirus disease, inflammatory bowel disease, multiple sclerosis, cognitive decline, and COVID-19 lockdown.
In the early years, studies predominantly centered on exposures, but investigating the relationship between these factors and medical science and health has become a significant area of interest in recent years. Air pollutants and burden of disease are topics of interest recognized as global environmental challenges.
A modified endobutton technique for treating acromioclavicular joint dislocation
Authors: Duan Wenyu , Yijun Zhang , Beiyu Wang , Qiang Yu , zhou Zhou , Youcai Liu
Published: April 2024

Purpose:
The aim of this study is to evaluate the clinical effects of the modified Endobutton surgical technique in the treatment of acromioclavicular joint dislocation.
Methods
A total of 46 patients with Rockwood type III-V acromioclavicular joint dislocation, treated with modified ETP (Endobutton) or CHP (clavicular hook plate) from June 2018 to May 2023 in our department, were selected as research subjects. They were divided into CHP internal fixation group (control group, n = 22) and ETP fixation group (observation group, n = 24) according to the surgical treatment method.
Results
The the observation group had a shorter postoperative length of hospital stay compared to the control group (P < 0.05), and the combined incidence of postoperative shoulder pain and complications was lower in the observation group compared to the control group (P < 0.05). However, the observation group had lower VAS pain scores at 3 days and 3 months postoperatively compared to the control group (P < 0.05). The observation group had a higher Constant-Murley shoulder joint function score at 3 months postoperatively compared to the control group (P < 0.05). The observation group had a significantly higher rate of excellent and good shoulder joint function recovery compared to the control group at 12 months postoperatively (P < 0.05).
Conclusion
The modified endobutton technique for treating acromioclavicular joint dislocation has shown promising clinical outcomes.
White Matter Microstructural Lateralization and Links to Language Function in Perinatal Stroke
Authors: Geeraert Bryce L. , Brooks Brian L. , Kirton Adam , Carlson Helen L.
Published: April 2024

Perinatal strokes occur more commonly in the left hemisphere and often impact language areas, yet language disability only occurs in 20–25% of cases. Functional imaging studies investigating language processing have shown that perinatal stroke in the left hemisphere may result in contralesional shifts of activity, but none have investigated the structure of white matter connections in such altered language network conditions. Diffusion tensor imaging and neurite orientation dispersion and density imaging offer robust, microstructurally-sensitive metrics which can probe links between language-related tracts and function. In a sample of 73 participants with perinatal stroke and 32 typically-developing controls, we applied these methods to evaluate microstructure and lateralization of the arcuate fasciculus and uncinate fasciculus, two tracts classically associated with language. Furthermore, we examined associations between the microstructure of the contralesional arcuate and uncinate and language-based measures (i.e., verbal learning and verbal fluency) in children with unilateral perinatal stroke. We observed greater lateralization of white matter microstructure in the arcuate and uncinate for stroke participants than typically developing controls driven largely by differences in the ipsilesional hemisphere. Microstructure of the contralesional arcuate fasciculus was associated with both verbal learning and verbal fluency, while the contralesional uncinate fasciculus structure was associated with verbal fluency only. Overall, we demonstrate that white matter microstructure of bilateral language networks is impacted by unilateral perinatal stroke, and microstructural development of the arcuate and uncinate appear to be associated with language-based tests. Enhanced understanding of such functionally-relevant neuroplasticity may inform future rehabilitation strategies and intervention trials.
New target-HMGCR inhibitors for the treatment of primary sclerosing cholangitis: a drug Mendelian randomization study
Authors: Zhou Jie , Xu Yixin , Wang Haitao , Liu Zhilin
Published: April 2024

Primary sclerosing cholangitis (PSC) lacks specific drugs. Statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), have shown potential for improving PSC prognosis, but their therapeutic efficacy remains controversial. We analyzed HMGCR single nucleotide polymorphisms (SNPs) from published genome-wide association studies using Mendelian randomization (MR) to assess the causal link between HMGCR and PSC risk. Effects of HMGCR were compared with proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors, common lipid-lowering drugs, using coronary heart disease risk as a positive control. The inverse-variance weighted (IVW) method was the primary analysis, complemented by the weighted median method. Heterogeneity analysis, examination of horizontal pleiotropy, and leave-one-out sensitivity analysis were conducted for result robustness. Genetically predicted HMGCR exhibited a pronounced detrimental effect on PSC in both the IVW method (OR [95%] = 2.43 [1.23 to 4.78], P = 0.010) and weighted median method (OR [95%] = 2.36 [1.02 to 5.45], P = 0.04). Conversely, PCSK9 did not reach statistical significance. Heterogeneity tests, horizontal multiple validity tests and sensitivity analyses all reflect the reliability of the results. This study establishes a causal relationship between HMGCR and PSC, providing robust evidence supporting the potential enhancement of prognosis in PSC patients through statin drugs targeting HMGCR.
The causal relationship between antidepressant use and venous thromboembolism
Authors: Peng Qiufeng , Ye Kui , Xue Hongbo , Zhao Yingjian , Cui Hongbin , Du Junji , Zhang Zengguang , Zhang Hewei , Liu Yidong
Published: April 2024

The use of antidepressants has been increasing in recent years, however, the connection between antidepressant use and the risk of venous thromboembolism has been inconsistent, with earlier research yielding contradictory findings about the impact of antidepressant use on the risk of venous thromboembolism. Mendelian randomization was used to determine if antidepressant use affects venous thromboembolism at the genetic level. Genetic tools linked to antidepressant use at a large genome-wide level (P < 5e-7) were selected from the FinnGen consortium. We acquired pooled VTE data from the European Bioinformatics Institute (EBI). Mendelian randomization analyses, both univariate and multivariate, were carried out. Genetically predicted antidepressant use did not affect venous thromboembolism [odds ratio (OR) = 1.00; 95% confidence interval (CI) 0.99-1.00; P = 0.68] under a multiplicative random-effects inverse-variance-weighted model. MR-Egger (OR = 0.99; 95% CI 0.97-1.00; P = 0.06), similar causality was found between the other different models, and multivariate Mendelian randomization (OR = 1.00; 95% CI 1.00-1.01; P = 0.08) was not significantly correlated. Individual single nucleotide polymorphisms have no effect on the overall calculations. Therefore, in the general population, there is no causal relationship between antidepressant use and venous thromboembolism.
Decreased serum IL-35 and IL-37 in COPD patients with severe emphysema
Authors: Yang Liuqing , Wei Yuying , Yan Qunfeng , Cui Luyun , Wang Qing
Published: April 2024

Background
Chronic obstructive pulmonary disease(COPD) is a heterogeneous syndrome and chronic persistent inflammation has been discovered to play critical role in the structural damage leading to the progression of emphysema. IL-35 and IL-37 are both immune-suppressing cytokines which exert inhibitory effects on a lot of inflammatory disorders. This study aimed to determine the correlation between serum levels of IL-35 and IL-37 with the severity of emphysema and clinical parameters of COPD patients.
Methods
We detected the serum levels of IL-35, IL-37 and IL-33 from 64 Chinese patients with stable COPD by using an enzyme-linked immunosorbent assay and examined the association of their concentrations with COPD patients’ clinical parameters.
Results
The serum levels of IL-35 and IL-37 were significantly decreased in the COPD patients with severe emphysema subtype compared to non-emphysema or mild-to-moderate emphysema subtype. The serum level of IL-35 was correlated with body mass index(BMI), modified Medical Research Council(mMRC) score and the concentrations of IL-33 and IL-37. The lower IL-35 group exhibited decreased BMI, lower FEV1/FVC, severe extent of emphysema and worse mMRC. Multivariable regression showed that lower FEV1/FVC, worse mMRC score and decreased serum levels of IL-35 were independently associated with severe emphysema.
Conclusions
We found that the serum IL-35 and IL-37 levels were decreased in severe emphysema subtype. The lower level of IL-35 was correlated with lower BMI and worse mMRC score. IL-35 concentrations, FEV1/FVC and mMRC score were independently associated with the extent of emphysema.
Experimental Study on the Optical Properties and Photothermal Conversion of Biomass Composite Phase Change Materials
Authors: Zhijuan CHANG , Qiangwei WANG , Jiawen HOU , Xuehong WU , Cai LV , LIU Yong
Published: April 2024

Solar energy is a renewable source of energy. The advantages of solar energy include its wide distribution, short cycle, high power, easy availability, and no pollution. As solar energy is seriously affected by changing weather, large-scale utilization of solar energy is restricted. Organic phase change materials (PCMs) are an ideal thermal energy storage medium, and the development of solar-thermal energy conversion technology requires materials to effectively capture and store solar energy. However, PCMs have some characteristics that need improvement, such as low light-to-heat conversion rates. Therefore, this article added biomass porous carbon (BPC) to improve the thermal conductivity and optical properties of PCMs. The experimentally determined thermal conductivity of 70% paraffin wax (PA)-(BPC) composite PCM (CPCM) was 3.18 times higher than that of pure PA. In addition, the average absorbance in the range of 190–2000 nm was approximately 1.3, and approximately 95% of solar radiation was absorbed by the CPCM and stored as thermal energy. The photothermal conversion efficiency of the CPCM was as high as 89.6%, thus infrared thermal image analysis was used to discover the positive effects of biomass porous materials on solar light capture and heat transfer. Therefore, composite BPC-based PCMs have broad application prospects in light-to-heat conversion and energy storage.
Spatiotemporal gait analysis of patients with spinocerebellar ataxia types 3 and 10 using Inertial Measurement Units: a comparative study
Authors: Barcellos Igor , Hasen Clint , Strobel Giovanna Klüppel , Geritz Johanna , Munhoz Renato P. , Moscovich Mariana , Maetzler Walter , Teive Hélio Afonso Ghizoni
Published: April 2024

Given the high morbidity related to the progression of gait deficits in spinocerebellar ataxias (SCA), there is a growing interest in identifying biomarkers that can guide early diagnosis and rehabilitation. Spatiotemporal parameter (STP) gait analysis using inertial measurement units (IMUs) has been increasingly studied in this context. This study evaluated STP profiles in SCA types 3 and 10, compared them to controls, and correlated them with clinical scales. IMU portable sensors were used to measure STPs under four gait conditions: self-selected pace (SSP), fast pace (FP), fast pace checking-boxes (FPCB), and fast pace with serial seven subtractions (FPS7). Compared to healthy subjects, both SCA groups had higher values for step time, variability, and swing time, with lower values for gait speed, cadence, and step length. We also found a reduction in speed gain capacity in both SCA groups compared to controls and an increase in speed dual-task cost in the SCA10 group. However, there were no significant differences between the SCA groups. Swing time, mean speed, and step length were correlated with disease severity, risk of falling and functionality in both clinical groups. In the SCA3 group, fear of falling was correlated with cadence. In the SCA10 group, results of the Montreal cognitive assessment test were correlated with step time, mean speed, and step length. These results show that individuals with SCA3 and SCA10 present a highly variable, short-stepped, slow gait pattern compared to healthy subjects, and their gait quality worsened with a fast pace, mainly with dual task involvement.
Using Virtual Reality Simulations to Alleviate Fear and Anxiety in Children Awaiting MRI: A Small-Scale Randomized Controlled Trial
Authors: Saliba Thomas , Boitsios Grammatina , Presziosi Marco , Negro Giulia , De Leucio Alessandro , Simoni Paolo
Published: April 2024

Purpose:
Up to 75% of paediatric patients experience anxiety and distress before undergoing new medical procedures. Virtual reality is an interesting avenue for alleviating the stress and fear of paediatric patients due to its ability to completely immerse the child in the virtual world and thus expose them to the sights and sounds of an MRI before undergoing the exam. We aimed to explore the impact of virtual reality exposure on reducing fear and anxiety in paediatric patients scheduled to undergo an MRI.
Methods:
We conducted a prospective randomized control trial in a tertiary paediatric hospital over three weeks. Inclusion criteria comprised children aged 4 to 14 undergoing MRI without medical contraindications for VR use. Thirty patients (16 in VR, 14 in control) were included in the study. The VR group experienced a simulated MRI room with typical sounds for up to 5 minutes before their actual MRI. Fear and anxiety were measured using the FACES scale before and after MRI for the control group as well as after VR exposure for the VR group.
Results:
The VR group exhibited a significant reduction in anxiety post-VR exposure regarding the upcoming MRI (p = 0.009).
Conclusions:
VR exposure effectively reduces pre-MRI anxiety in paediatric patients who are about to undergo the exam. This research is in line with previous findings, however there is need for further investigation in this field using larger and MRI-naïve groups of patients.
TRAIP enhances progression of tongue squamous cell carcinoma through EMT and Wnt/β-catenin signaling by interacting with DDX39A
Authors: Liu Litong , Wang ping , Guo cheng , Song li , Chen lifang , Qi hongbin , Zheng Yangyang , Xing xiaoming , Wang Chengqin
Published: April 2024

Background
Tongue squamous cell carcinoma (TSCC) is one of the most common malignant tumors with high mortality and poor prognosis. Its incidence rate is increasing gradually. Tumor necrosis factor receptor-associated factor interacting protein (TRAIP), as a factor related to several tumors, reveals that its gene expression is different between normal tissue and primary tumor of head and neck squamous cell carcinoma using bioinformatics analysis.
Method
In our study, TCGA database, immunohistochemistry, proliferation assay, colony formation, wound healing assay, Transwell, cell cycle analysis and tumor xenografts model were used to determine the expression and functions of TRAIP in TSCC.
Result
We found that TRAIP may promote the proliferation, migration and invasion of TSCC. Furthermore, the results of bioinformatics analysis, mass spectrometry and co-immunoprecipitation suggested that DDX39A may be a TRAIP interacting protein. DDX39A has been proven to be an oncogene in several tumors, which may have an important effect on cell proliferation and metastasis in multiple tumors. In addition, the high expression of DDX39A implies the poor prognosis of patients. Our study demonstrated that TRAIP probably interact with DDX39A to regulate cell progression through epithelial-mesenchymal transition and Wnt/β-catenin pathway.
Conclusion
These results indicate that TRAIP is important in occurrence and development of TSCC and is expected to become the new promising therapeutic target.