bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Health Disparities on Peripheral Vascular Access Outcomes in Hospitalized Patients: An Observational Study
Authors: Mielke Nicholas , O’Sullivan Charlotte , Xing Yuying , Bahl Amit
Published: February 2024

Background
Placement of peripheral intravenous catheters (PIVC) is a routine procedure in hospital settings. The primary objective is to explore the relationship between healthcare inequities and PIVC outcomes.
Methods
This study is a multicenter, observational analysis of adults with PIVC access established in the emergency department requiring inpatient admission between January 1st, 2021, and January 31st, 2023 in metro Detroit, Michigan, United States. Epidemiological, demographic, therapeutic, clinical, and outcomes data were collected. Health disparities are defined by the National Institute on Minority Health and Health Disparities. The primary outcome is the proportion of PIVC dwell time to hospitalization length of stay, which is expressed as the proportion of dwell time (hours) to hospital stay (hours) x 100%. Multivariable linear regression and a machine learning model were used for variable selection. Subsequently, a multivariate linear regression analysis was utilized to adjust for confounders and best estimate the true effect of each variable.
Results
Between January 1st, 2021, and January 31st, 2023, our study analyzed 144,524 ED encounters, with an average patient age of 65.7 years and 53.4% female. Racial demographics showed 67.2% White, 27.0% Black, with the remaining identifying as Asian, American Indian or Alaska Native, or other races. The median proportion of PIVC dwell time to hospital length of stay was 0.88, with individuals identifying as Asian having the highest ratio (0.94) and Black individuals the lowest (0.82). Black females had a median dwell time to stay ratio of 0.76, significantly lower than White males at 0.93 (p < 0.001). After controlling for confounder variables, a multivariable linear regression demonstrated that Black males and White males had a 10.0% and 19.6% greater proportion of dwell to stay, respectively, compared to Black females (p < 0.001).
Conclusions
Black females face the highest risk of compromised PIVC functionality, resulting in approximately one full day less of reliable PIVC access than White males. To comprehensively address and rectify these disparities, further research is imperative to improve understanding of the clinical impact of healthcare inequities on PIVC access. Moreover, it is essential to formulate effective strategies aimed at mitigating these disparities and ensuring equitable healthcare outcomes for all individuals.
LMagNet: a Lightweight Magnetic Convolutional Neural Network on Microcontrollers for Hidden Corrosion Detection in Aircraft Structures
Authors: Vu Thuy Phuong , Luong Van Su , Le Minhhuy
Published: February 2024

Detection of hidden corrosion within aircraft structures poses a significant challenge in nondestructive testing (NDT) methodologies, particularly in electromagnetic testing (ET) method. Corrosions often manifest in the recesses of rivet fastener holes, complicating their identification. In this paper, we propose an approach to enhance ET system detectability by introducing a Lightweight Magnetic Convolutional Neural Network (LMagNet) model tailored for the efficient processing of electromagnetic signals from corrosion. We aim to develop a lightweight model that could be deployed on low-resource microcontrollers ensuring its practical applicability in aircraft inspection scenarios. The proposed LMagNet model archives better performance compared to other lightweight models such as ShuffleNet, SqueezeNet, and MobileNet structures. The model archives an accuracy of 92% with only 16K parameters when being evaluated on hidden corrosion of aircraft structure, having volumes from 2.8-195.4 mm3. The model size is about 224×, 67×, 96× smaller compared to the ShuffleNet G1, SqueezeNet Complex, and MobileNet V3 model. When deploying on low-resource microcontrollers (i.e., STM32 MCUs), the LMagNet model requires only 90kB of flash and 36kB of RAM allowing to run within 40ms per prediction. In addition, we employed explainable techniques to interpret how the decision-making process of the model is made to achieve reliable results.
Enhanced slime mould algorithm with backtracking search algorithm: global optimization and feature selection
Authors: Wang Jian , Chen Yi , Zou Huilai , Lu Chenglang , Heidari Ali Asghar , Liu Lei , Chen Huiling , Liang Guoxi
Published: February 2024

The Slime Mould Algorithm (SMA), renowned for its swarm-based approach, encounters challenges, particularly in maintaining a balance between exploration and exploitation, leading to a trade-off that impacts its optimization performance. The simple structure and limited hyperparameters of SMA contribute to difficulties in effectively navigating the exploration-exploitation trade-off, with a drawback being its poor ability for exploration. To address these challenges and enhance SMA, this paper introduces BSSMA, an improved variant that incorporates the Backtracking Search Algorithm (BSA). The introduction of the \(phaseratio\) parameter aims to synergize BSA and SMA, capitalizing on the strengths of both algorithms while mitigating their individual drawbacks, including SMA's poor exploration ability. BSA facilitates a thorough exploration, dispersing search agents widely across the solution space, ensuring significant diversity. These search agents then transition to SMA to further refine the search for optimal solutions while addressing SMA's exploration limitations. Evaluating the performance of BSSMA involves comparisons with 12 other meta-heuristic algorithms (MAs) and 10 advanced MAs using the CEC2017 benchmark functions. Experimental results showcase that the enhanced BSSMA outperforms SMA in terms of convergence speed and accuracy, specifically addressing the challenges associated with balancing exploration and exploitation trade-offs, including SMA's poor exploration ability. Additionally, to demonstrate BSSMA's effectiveness in practical engineering applications, a binary version (bBSSMA) is developed for feature selection (FS) using a V-shaped transfer function. Comparative experiments with seven other binary MA variants reveal that bBSSMA selects fewer features, attains higher classification accuracy, and demands less computational time. These results affirm the effectiveness of bBSSMA for practical feature selection applications.
Optimization of deamidation of casein by protein-glutaminase and its effect on structural and functional properties
Authors: Jiang Deming , Wei Ouyang , Huang Lingling , Niu Jinjin , Zhang Zheng , Jin Congli , Gu Siyi , Liu Mengmeng , Chang Zhongyi , Niu Yanning , Zou Chunjing , Huang Jing , Jia Caifeng , Tang Lihua , Gao Hongliang
Published: February 2024

Casein is a commonly used protein in the food industry, and its related products are abundant, such as beverages, desserts, but the further application of casein is limited by its solubility and stability. This study aimed to optimize the deamidation of casein using Protein-glutaminase (PG) and investigate its impact on the structure, solubility and stability of casein. Through center composite experiments, the optimal conditions for PG deamidation were determined to be at pH 6.0, E/S 15 U/g, and a temperature 45°C. The deamidation process alters the secondary structure of casein, resulting in a decrease in α-helix structure and an increase in β-sheet structure. The modification of casein improved emulsifying activity at pH 8.0 and pH 10.0, and significantly enhanced solubility at 5.0 to 6.0. Furthermore, the deamidation of casein leads to an increase in zeta potential and a decrease in particle size, resulting in improved stability of the protein solution due to reduced particle aggregation. The 3% deamidated casein based beverage with carrageenan exhibited reduced precipitation rates compared to the control after sterilization at 121°C for 15 min. In summary, PG deamidation offers a promising method to modify casein, enhancing its functional properties, including solubility, stability and emulsifying activity, thereby expanding the use of casein in the food industry.
RETRACTED: Empirical analysis of link prediction methods based on the topological structure of the COVID-19 network
Authors: Solangi Shauban Ali , Mahesar Abdul Waheed , Dhomeja Lachhman Das , Khoumbati Khalil-ur-Rehman , Memon Bisharat Rasool
Published: February 2024

The authors have requested that this preprint be removed from Research Square.
Glacier Lake Detection Utilizing Remote Sensing Integration with Satellite Imagery and Advanced Deep Learning Methods
Authors: Sharma Anita , Prakash Chander , Thakur Divyansh
Published: February 2024

The Himalayan glaciers are extremely susceptible to global climate change, leading to substantial glacial retreat, the creation and expansion of glacial lakes, and a rise in GLOFs.These alterations have changed the patterns of river flow and moved the borders of glaciers, resulting in significant socio-economic damages. Accurately monitoring glacial lakes is essential for managing GLOF events and evaluating the effects of climate change on the cryosphere. This study utilizes a Deep Learning-based U-net technique to extract glacial lakes from Landsat-8 satellite imagery by propagating characteristics and minimizing information loss. The method improves the importance given to glacial lakes, reduces the influence of low contrast, and handles different pixel categories. We apply this methodology to the Chandra-Bhaga basin, Himachal Pradesh located in NW Indian Himalaya, and successfully extract 107 glacial lakes. The U-net model attains an accuracy of 97.32%, precision of 95.98%, recall of 95.23%, and an IoU of 97.45% during validation with high-resolution photos from Google Earth and a digital elevation model. The suggested approach could be beneficial for precise and effective monitoring of glacial lakes in different areas, assisting in the management of natural disasters and offering vital information on the effects of climate change on the cryosphere.
The incidence and severity of pediatric injuries sustained by electric bikes and powered scooters - the experience of an urban, tertiary pediatric emergency department
Authors: Moati Seraj , Tavor Oren , Capua Tali , Sukhotnik Igor , Glatstein Miguel , Rimon Ayelet , Cohen Neta
Published: February 2024

Purpose: To describe the incidence and severity of electrical bicycle- (E-bike) and power scooter (P-scooter)-related injuries and their secular trends among pediatric patients presenting to a pediatric emergency department (ED).
Methods: This retrospective cohort study of patients aged <18 years who sustained E-bike and P-scooter injuries was performed between 2018 and 2023. We explored trends of severe trauma cases, ED visits, hospitalizations, and surgical interventions. Severity of trauma was rated by either an injury severity score (ISS) >15 or the patient’s need for acute care as defined by intensive care unit (ICU) admission, direct disposition to the operating room, acute interventions performed in the trauma room, and in-hospital death.
Results: Of the 1,467 pediatric patients who presented to our pediatric ED following P-scooter and E-bike injuries, 217 (14.8%) were hospitalized, with a median age 14.0 years (interquartile range 10.5–16.0), and male predominance (69.1%). The number of ED visits increased 3.5-fold by study closure, with a parallel increase in hospitalizations, surgical interventions, and severe trauma cases. The relative percentages of severe trauma cases were not significantly different over time, but the mean length of stay in the ICU and the mean number of ventilation days increased significantly during the late period (p=0.02, and p=0.04, respectively). Among hospitalized patients, 3 patients (1.4%) died and 8 (3.7%) required rehabilitation care.
Conclusions: The incidence and severity of E-bike and P-scooter injuries and fatalities continue to increase within the pediatric population. Current personal and road safety regulations are failing to alleviate and prevent these injuries and require urgent revision and enforcement.
The importance of geographic and sociodemographic aspects in the characterization of mucopolysaccharidoses: a case series from Ceará state (Northeast Brazil)
Authors: Santos Augusto , Mariath Luiza Monteavaro , Trapp Franciele , Facchin Ana Carolina Brusius , Leistner-Segal Sandra , Kubaski Francyne , Giugliani Roberto , Schuler-Faccini Lavinia , Ribeiro Erlane Marques
Published: February 2024

Geographic and sociodemographic aspects may influence the natural history and epidemiology of mucopolysaccharidoses (MPS). In this case series, we have evaluated clinical and molecular data from 76 individuals with MPS from a region in Brazilian Northeast. MPS II was the most common type, with the most affected individuals presenting missense pathogenic variants. Patients with MPS I proved to be the most severe clinical phenotype, presenting the first symptoms (mean: 7.1 months; SD = 4.5) and being diagnosed earlier (2.2 years; SD = 2.1) in comparison with the other types. In addition, we have shown that 13 individuals with MPS VI were born of consanguineous marriages in small, nearby cities, in a place where geographical isolation, consanguinity, and clusters of genetic diseases were previously reported. Ten of these individuals (at least, seven different families) presented a rare pathogenic variant in the ARSB gene, c.1143-8T > G in homozygosity, previously reported only among Iberian and South American patients. We discuss the possible evolutionary processes and biosocial dynamics that can help to explain this finding in terms of population medical genetics and public health.
Exploring the Influence of Improved Horizontal Resolution on Extreme Precipitation in Southern Africa Major River Basins: Insights from CMIP6 HighResMIP Simulations
Authors: Samuel Sydney , Tsidu Gizaw Mengistu , Dosio Alessandro , Mphale Kgakgamatso
Published: February 2024

This study examines the impact of enhanced horizontal resolution on simulating mean and precipitation extremes in the major river basins of southern Africa. Seven global climate models (GCMs) from the High-Resolution Model Intercomparison Project (HighResMIP) within the Coupled Model Intercomparison Project Phase 6 (CMIP6) are employed. The models are available at both high-resolution (HR) and low-resolution (LR) resolutions. Three datasets are used to assess the models for the period 1983-2014 during December-January-February. The distributions of daily precipitation from the HR models are nearly identical to those of their LR counterparts. However, the bias of intense daily precipitation is not uniform across the three observations. Most HR and LR models reasonably simulate mean precipitation, maximum consecutive dry days (CDD), and the number of rainy days (RR1), albeit with some biases. Improvements due to enhanced horizontal resolution are realised for mean precipitation, CDD, and RR1 as noted from high spatial correlation coefficients (SCCs), low root mean square errors, and biases. The CMIP6 HighResMIP models tend to overestimate very and extreme wet days (R95p and R99p), maximum one-day precipitation (Rx1day), and simple daily intensity (SDII) with a pronounced wet bias in HR models for R95p and R99p. Most HR models outperform their LR counterparts in simulating R95p, R99p, and SDII. Our results indicate that enhanced horizontal resolution under CMIP6 HighResMIP results in either improvements (e.g., increased SCC) or deterioration (e.g., decreased SCC), depending on precipitation extremes, river basin, and model. The findings of this study are important for both climate scientists and policymakers.
Targeting ACSS2 activity suspends the formation of chemoresistance through suppressed histone H3 acetylation in human breast cancer
Authors: Shui Xiaoxi , Tian Liying , Zhou Yuepeng , Zhao Baohua
Published: February 2024

Histone hyperacetylation is a prevalent occurrence in neoplastic cells within tumors, arising from the coordinated interplay of various biological processes. This phenomenon relies on the robust modulation of gene expression to effectively adapt to environmental adaptations in response to spatial and temporal fluctuations. Histone hyperacetylation has been closely linked to the proliferation, metastasis, and therapeutic resistance of tumor cells. In this investigation, we substantiated the overexpression of the well-documented acetyl-CoA synthetase short-chain family member 2 (ACSS2) at both protein and mRNA levels in breast cancer (BC) cells derived from tumor tissues. Subsequent examinations unveiled that the heightened acetylation of histone H3 in BC cells under environmental stress is contingent upon the accumulation of ACSS2 and enhanced acetyl-CoA synthesis. Intriguingly, the augmentation of H3K9 and H3K27 acetylation (H3K9/K27ac) induced by nutrient stress, mediated by ACSS2, was primarily governed by the histone acetyltransferases (HATs) CBP/p300, with no significant association with conventional histone deacetylases (HDACs). Supplementation with an alternative carbon source, acetate, confirmed that targeted inhibition of ACSS2 mitigated the further elevation of ATP-binding cassette (ABC) transporters, specifically ABC subfamily B member 1 (ABCB1/MDR1) and breast cancer resistance protein (BCRP/ABCG2). These transporters reportedly play crucial roles in both energy metabolic homeostasis and the modulation of intracellular drug concentrations, driven by histone H3 hyperacetylation. Mechanistically, inhibitors of ACSS2 significantly mitigated the resistance of BC cells to doxorubicin and cisplatin, predominantly by reducing H3K27ac levels through the downregulation of nuclear acetyl-CoA content and constraining its binding to the promoters of MDR1 and BCRP. The poor overall survival of BC patients associated with high ACSS2 expression and its positive correlation with MDR1 and BCRP were further confirmed in human BC tumors. Consequently, histone acetylation induced by ACSS2 emerges as a promising epigenetic target for the treatment of BC.
Uncovering the Single-cell Transcriptomic Signatures and Pathogenesis of Mucosal-associated Invariant T cells during Nonalcoholic Steatohepatitis
Authors: Zhang Leisheng , Xu Jing , You Xingjie , Huang Shixin , Xue Fenglin , Mou Tangwei , Wu Zihan , Wang Ao , Hu Yueyan , Qu Qiu , Gu Man , Fang Ting , Yin Jiajia , Mo Qiquan , He Huiping , Zeng Linran , Yang Yu , Wang Yongli , Sun Yang , Huang Hanfei , Yang Hongju
Published: February 2024

Background
As an inflammatory subtype of nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH) has turned into a major trigger of liver cirrhosis and liver-associated deaths worldwide. Longitudinal studies have indicated the T lymphocyte-associated immunodysfunction in the pathogenesis of NAFLD, yet the detailed information of the subsets including Mucosal-associated Invariant T (MAIT) cells in NASH is largely obscure.
Methods
In this study, we isolated peripheral blood-derived mononuclear cells (PBMCs) from NASH patients and healthy controls (HC), and dissected the single-cell transcriptomic signatures of immune cell sub-clusters and MAIT cells by conducting multifaceted bioinformatics analyses. Meanwhile, the distribution and expression of MAIT cells and the candidate biomarkers (e.g., GADD45B, STAT1, CCL4, RPL38) in liver tissues or PBMCs was identified by immunostaining (e.g., IHC, IF), qRT-PCR and western-blotting analysis. Additionally, the STAT1-mediated network in MAIT cell-related regulatory mechanism of NASH was explored as well.
Results
Compared to the HC group, NASH patients revealed multifaceted variations in the distribution of MAIT cells and the relative immune cells in PBMCs. In detail, MAIT cells were collectively accumulated in PBMCs and liver tissues of NASH patients, which revealed a distinct distribution pattern from the HC group according to the 7 sub-clusters. Of the indicated candidate biomarkers for clinical diagnosis, STAT1-T-bet axis served as the pathogenic mechanism of NASH via mediating MAIT cell differentiation and inflammatory response.
Conclusion
Overall, our data illuminated the single-cell transcriptomic signatures of MAIT cells and the concomitant sub-clusters in NASH patients. Our findings put forward the involvement of MAIT cells in NASH, which would benefit the further dissection of the MAIT cell-related pathogenesis and clinical diagnosis of NASH.
Certain investigations of linear, fractional varying DP within the framework of f(R, T) gravity
Authors: MISHRA R.K , Sharma Rahul
Published: February 2024

This communication aims to discuss the interplay between cosmic acceleration and deceleration in the context of the f(R, T ) theory, along with different forms of deceleration parameters. The study encompasses the evolution of the universe's expansion rate concerning cosmic time, denoted as t . We have also derived solutions for the Einstein field equations (EFE) within the context of this study. The significant implications of the f(R, T ) theory concerning cosmic acceleration and deceleration have been explored. Furthermore, we have presented pictorial representations of key cosmological parameters. Additionally, we have tabulated the values of all cosmographic parameters for Model-I and Model-II. In the end, a comprehensive analysis, along with a tabulated form of all important cosmological parameters under the studied cases along with the standard ΛCDM model-have been presented.
Frequency of Endometrial Cancer Precursors Associated with Lynch Syndrome
Authors: Kennedy Kathryn , Gaertner-Otto Jennifer , Lim Eav
Published: February 2024

Objective: To identify the rate of mismatch repair deficiency in women with endometrial hyperplasia compared with the rate in endometrial cancer.
Patients and Methods: A retrospective cohort pilot study was conducted to identify the frequency of mismatch repair deficiency in endometrial hyperplasia specimens, and compare to the known rate in endometrial cancer. A keyword search of the medical record at a single institution was performed to identify 1300 endometrial tissue blocks either from biopsy, curettage, or hysterectomy. After exclusion, cohort of 91 women with endometrial hyperplasia were included for analysis. Patient characteristics for both those with normal and abnormal MMR results were analyzed using the Mann-Whitney U test and Fisher exact test. Immunohistochemical staining was performed to test for mismatch repair deficiency.
Results: Among the 91 women with known endometrial hyperplasia specimens who met inclusion criteria, 4 specimens exhibited mismatch repair deficiency. The observed rate of mismatch repair deficiency in hyperplasia (4.4%), was found to be significantly less than that of mismatch repair deficiency seen in endometrial cancer (25%, p< 0.0001).
Conclusions: Based on the data, dMMR is not identified at a similar rate in endometrial hyperplasia compared to endometrial cancer. Currently there is no rationale to recommend immunohistochemical staining for mismatch repair deficiency on hyperplasia specimens, and further investigation is recommended to advance screening guidelines for Lynch syndrome.
Magnetic anisotropy and GGG substrate stray field in YIG films down to millikelvin temperatures
Authors: Serha Rostyslav , Voronov Andrey , Schmoll David , Verba Roman , Levchenko Khrystyna , Koraltan Sabri , Davídková Kristýna , Budinska Barbora , Wang Qi , Dobrovolskiy Oleksandr , Urbánek Michal , Lindner Morris , Reimann Timmy , Dubs Carsten , Gonzalez-Ballestero Carlos , Abert Claas , Suess Dieter , Bozhko Dmytro , Knauer Sebastian , Chumak Andrii
Published: February 2024

Quantum magnonics investigates the quantum-mechanical properties of magnons such as quantum coherence or entanglement for solid-state quantum information technologies at the nanoscale. The most promising material for quantum magnonics is the ferrimagnetic yttrium iron garnet (YIG), which hosts magnons with the longest lifetimes. YIG films of the highest quality are grown on a paramagnetic gadolinium gallium garnet (GGG) substrate. The literature has reported that ferromagnetic resonance (FMR) frequencies of YIG/GGG decrease at temperatures below 50 K despite the increase in YIG magnetization. We investigated a 97 nm-thick YIG film grown on 500 µm-thick GGG substrate through a series of experiments conducted at temperatures as low as 30 mK, and using both analytical and numerical methods. Our findings suggest that the primary factor contributing to the FMR frequency shift is the stray magnetic field created by the partially magnetized GGG substrate. This stray field is antiparallel to the applied external field and is highly inhomogeneous, reaching up to 40 mT in the center of the sample. At temperatures below 500 mK, the GGG field exhibits a saturation that cannot be described by the standard Brillouin function for a paramagnet. Including the calculated GGG field in the analysis of the FMR frequency versus temperature dependence allowed the determination of the cubic and uniaxial anisotropies. We find that the total anisotropy increases more than three times with the decrease in temperature down to 2 K. Our findings enable accurate predictions of the YIG/GGG magnetic systems behavior at low and ultra-low millikelvin temperatures, crucial for developing quantum magnonic devices.
The use of heart rate variability (HRV) biomarkers in the identification of anger in adults
Authors: Dehghanizadeh Zahra , Dolatshahee Behrouz , Nosratabadi Masoud , Sabzevar Manocher Moradi
Published: February 2024

Background
Undoubtedly, the existence of accurate measurement tools can be an important step in the direction of early diagnosis of problems related to emotions and emotional dysregulation.
Objective
I n the present study, we tried to identify the emotion of anger in people using one of the biomarkers called heart rate variability (HRV). In this way, the diagnostic accuracy of five subscales related to heart rate, i.e. HR, RR, HF, LF and LFtoHF, was investigated among subjects with high anger and low anger.
Method
The study is descriptive (exploratory) and quantitative analysis. The current research population includes all adults (age range 20–45 years selected based on research literature) living in Tehran. The statistical sample of the current research, which was selected using the available sampling method based on the entry and exit criteria, was 100 people who, after the initial review of the data obtained from their heart rate sensor and preparation for entering the analysis stage, due to insufficient recording time and Lack of accurate recording of heart rate eliminated 24 of them and the remaining sample in the present study was 76. The instrument of the current research consists of two parts: Panas positive and negative emotions scale and BVP sensor. All analyzes related to descriptive statistics, t table of two independent groups were performed by SPSS software. In addition, ROC analysis and sensitivity analysis were performed by Medcalc software.
Results
Preliminary studies on the difference in the mean scores of the two groups of people with high and low anger in five scales HR, RR, HF, LF and LFtoHF showed that the difference in the mean scores of the two groups in the HR scale (at a significant level of less than 0.05) and RR (at a significance level of less than 0.001) is statistically significant. In both scales, the average scores of people with high anger were higher than the average scores of people with low anger. Among the five HR, RR, HF, LF and LFtoHF scales, the RR scale had the highest purity index (= 0.71). This scale performed significantly better than other HR, HF, LF and LFtoHF scales.
Conclusion
The results of this study can make the use of biological indicators more prominent in identifying positive and negative emotions.
Metaverse and Industry 4.0 in Cheese Production: An Innovative Integration Example
Authors: Özkurt Cem
Published: February 2024

In the ever-evolving landscape of cheese production, a revolutionary initiative is taking center stage, boldly addressing the dynamic challenges that permeate the industry. This groundbreaking endeavor seamlessly intertwines the artisanal craft of cheese making with the avant-garde realms of digital innovation. The catalyst for this transformative leap is the ingenious integration of a digital twin—a cutting-edge methodology that transcends traditional boundaries. This digital doppelganger goes beyond a mere virtual replica; it becomes the oracle of foresight, empowering cheese machinery to not just operate but to anticipate and thwart potential failures. At its core, this visionary approach births a virtual twin that meticulously replicates real-world conditions, providing a sophisticated platform for intricate testing of milk interactions within the machinery. The ultimate goal is nothing short of amplifying the efficiency of cheese production lines through strategic design and component enhancements. These metamorphic changes are not just a nod to progress but a resolute commitment to embracing the principles of Industry 4.0, ushering in an era where cheese production machinery gracefully migrates into the boundless expanse of the virtual realm. This paradigm shift not only facilitates simulated testing of machines but also unfurls exciting possibilities for locally-produced machines to undergo a crucible of rigorous evaluation within a risk-free virtual domain.
Rhabdomyosarcoma with initial pancreatic metastasis: a case report
Authors: Luo Shuai , Li Jin , Zeng Jiafei , Li Yao , Wang Jinjing
Published: February 2024

Background: Pancreatic metastasis, particularly as the primary site of metastasis in rhabdomyosarcoma (RMS), is exceedingly rare, leading to a lack of relevant literature and research studies due to its extreme rarity. Moreover, its clinical presentation closely mimics pancreatitis, posing significant challenges in early clinical detection and diagnosis.
Case demonstration: A 44-year-old male patient with a history of RMS originating from the right paranasal sinus underwent regular postoperative chemoradiotherapy. He presented to our gastroenterology department with complaints of abdominal pain and lower back pain for one month. Subsequent auxiliary examinations, including ultrasound gastroscopy and positron emission tomography-computed tomography (PET-CT) scans, suggest the possibility of pancreatitis or tumor metastasis. Eventually, a pancreatic puncture biopsy confirmed RMS with pancreatic metastasis. Following diagnosis, the patient was transferred to the Cancer Hospital for scheduled chemoradiotherapy. During an 8-month follow-up, the patient exhibited no evidence of metastasis to organs other than the pancreas and survived.
Conclusions:Historically considered an advanced condition precluding surgical intervention, the reported instance of metastatic RMS to the pancreas demonstrates the potential for improved survival and quality of life with timely surgical and adjunctive therapies contingent upon early detection, diagnosis, and treatment. Given the clinical resemblance to pancreatitis, definitive diagnosis relies heavily on pathological biopsy. Therefore, more cases warrant collection for a comprehensive investigation into the clinical, pathological, and genetic characteristics of this rare condition.
Phototherapeutic Keratectomy Results for the Treatment of Corneal Scarring After Pterygium Excision
Authors: Uzunovalı Berrin , Mutlu Demet , Atas Mustafa
Published: February 2024

Purpose
To evaluate the post-treatment corneal changes by corneal topography in patients who underwent phototherapeutic keratectomy (PTK) to reduce anterior corneal irregularity and corneal scarring after pterygium excision. Materials and
Methods: Before and after PTK, K1 (flattest central keratometry), K2 (steepest central keratometry), Kmax (maximum keratometry), corneal astigmatism, ISV (index of surface variance), IVA (index of vertical asymmetry), IHA (index of height asymmetry) and IHD (index of height decantration) values were compared.
Results
Of the 23 patients included in the study, 16 were male (69.6%) and 7 were female (30.4%), with a mean age of 57.09 ± 11.96 years (23–81 years). After PTK surgery patients were asked to come for check-ups at 1., 3., 6. months and at 1 year.The mean time to PTK after pterygium excision was 5.93 ± 1.39 months (4–9 months) and the PTK values taken at the end of the first year were included in the study. The corrected distance visual acuity (CDVA) significantly improved from 0.55 ± 0.28 logMAR (0.10-1.00 logMAR) to 0.46 ± 0.32 logMAR (0.1-1.00 logMAR) after PTK. While the postoperative K1, K2, Kmax and corneal astigmatism values were lower than preoperative values, there was no statistically significant difference compared to preoperative values (respectively p = 0.301, p = 0.060, p = 0.075, p = 0.570). Although ISV, IHA and IHD values were higher than before surgery, the differences were not statistically significant (p > 0.05). In 17 patients, the postoperative IVA value was higher than before the operation, and the difference was statistically significant (p = 0.014).
Conclusions
PTK can reduce the corneal surface irregularity and the astigmatism in a way that can be corrected with glasses and CDVA will be better. Patients who underwent PTK had a more transparent and more regular cornea.
Prognostic significance and value of further classification of lymphovascular invasion in invasive breast cancer: a retrospective observational study
Authors: Zhang Yuyang , Wang Huali , Zhao Huahui , He Xueming , Wang Ya , Wang Hongjiang
Published: February 2024

Purpose
To investigate the prognostic significance of lymphovascular invasion in invasive breast cancer and the value of using specific vascular endothelial markers to further classify lymphovascular invasion.
Methods
We collected 2124 patients with invasive breast cancer who were hospitalized at the First Hospital of Dalian Medical University from 2012 to 2020. Statistical methods were used to investigate the relationship between lymphovascular invasion and clinicopathological characteristics of breast cancer, and the correlation between lymphovascular invasion on overall survival (OS) and disease-free survival (DFS) of various categories of breast cancers. Immunohistochemical staining of breast cancer samples containing lymphovascular invasion using specific vascular endothelial markers D2-40 and CD34 was used to classify lymphovascular invasion and to investigate the relationship between lymphovascular invasion and breast cancer progression.
Results
There was a high correlation between lymphovascular invasion and T-stage, N-stage and nerve invasion. Survival analyses showed that patients with lymphovascular invasion, especially luminal B, triple-negative, and Her-2 overexpression breast cancer patients, had poorer OS and DFS prognosis, and that lymphovascular invasion was an independent prognostic factor affecting OS and DFS in breast cancer. The immunohistochemical staining results showed that positive D2-40 staining of lymphovascular invasion was linked to the N stage and localized recurrence of breast cancer.
Conclusion
Lymphovascular invasion is associated with aggressive clinicopathological features and is an independent poor prognostic factor in invasive breast cancer. Breast cancer localized recurrence rate and lymph node metastases are influenced by lymphatic vessel invasion. Immunohistochemical techniques should be added to the routine diagnosis of lymphovascular invasion.
STOPS study: total colectomy with ileorectal anastomosis versus subtotal colectomy with cecal-rectal anastomosis for slow transit constipation: a study protocol for a multicenter randomized controlled trial
Authors: Tian Yue , Guo Man , Fu Tao , Gao Feng , Jiang Jun , Zhang Lin , Wang Yongbing , Huang Bin , Bu Fan , Liu Weicheng , Xu Dongbo , Ni Ling , Zheng Jianyong , Li Fan , Jiang Congqing , Cui Zhe , Gong Wenjing , Tong Weidong
Published: February 2024

Background: Constipation is a common and frustrating gastrointestinal disorder with a prevalence of 10%–15% of adults in the United States and around 8.2% of the general population in China. Slow transit constipation (STC), representing 15%-42% of constipated patients, is characterized by a loss of colonic motor activity. While the patients with no response to any medicine suffering from long-term intractable symptoms and poor quality of life, the surgical approach is ultimately recommended. Currently, the main surgical procedures for STC are total colectomy with ileorectal anastomosis (TC-IRA) and subtotal colectomy with cecorectal anastomosis (SC-CRA). This study aims to compare TC-IRA with SC-CRA regarding efficacy and safety for refractory STC.
Methods and analysis: The STOPS trial is a randomized controlled trial comparing TC-IRA with SC-CRA in patients with STC. After screening for eligibility and obtaining informed consent, a total of 202 adult patients are included in the trial and randomized to the trial groups in a 1:1 ratio after assuring that none of exclusion criteria is present. The primary outcome parameter is the scores of Wexner Constipation as a measure of efficacy. The secondary outcomes include operative time, conversion rates, blood loss, short- and long-term complications, bowel movements, abdominal pain, bloating, straining, enema use, laxative, the scores of Wexner incontinence, the gastrointestinal QOL index, the 36-item short form and satisfaction. Both the primary and secondary outcome measures will be collected at pre-operation, 1, 3, 6, 12, 24 and 36 months after surgery.
Discussion: To our knowledge, the STOPS trial is the first multicenter randomized controlled trial of surgical procedure for STC. Results of this study may be helpful to choose reasonable procedure for STC and provide further evidence for developing consensus for STC treatment.
Ethics and dissemination: The STOPS trial has been reviewed and approved by the Medical Ethics Committee of Army Medical Center (reference number 2021-248).
Trial registration: current controlled trials NCT05352074 (Registered on 28 April 2022).
Secure Communication in Multi-Subnetwork by QKD Protocol with Entanglement and Decoy States
Authors: Sihare Shyam R.
Published: February 2024

This research focuses on enhancing secure quantum communication in multi-subnetwork environments, specifically focusing on vulnerabilities associated with quantum key distribution (QKD) protocols. The study uses an in-depth analysis of the decoy state strategy within the QKD protocol, quantifying security parameters and proposing dynamic recalibration strategies based on quantum channel parameters. Sensitivity analyses are used to assess the impact of variations in attenuation coefficient, detector efficiency, and the fraction of rounds with eavesdropping attempts. A dynamic adaptation mechanism is introduced to optimize the choice between entangled and decoy states over time. The research reveals modest disclosures into the vulnerabilities of quantum communication channels and offers dynamic recalibration strategies to ensure ongoing security against quantum threats. Quantitative metrics, such as the quantum key rate (QKR) and information leakage (SKR), are presented, providing a comparative analysis between entangled and decoy states. The findings highlight the efficacy of the proposed multi-subnetwork QKD protocol in mitigating external threats and adapting to evolving quantum environments. The research contributes to the field by providing a comprehensive understanding of security parameters influencing QKD protocols and paving the way for improved quantum communication protocols with applications in secure information transfer.
Folate mediates cognitive impairment of aged people with periodontitis
Authors: Liu Fei , Mei Jian-Song , Zhao Jia-Shuo , Feng Yu-Heng , Zhang Yan-Yan , Pan Qing , Shen Jie-Fei
Published: February 2024

Aims
To examine the mediation of folate on the periodontitis-promoted cognitive impairment (CI) in the elderly population.
Materials and Methods
Data for this cross-sectional population-based study was obtained from the National Health and Nutrition Examination Survey (NHANES), 2011–2014 database. Associations between periodontitis and cognitive scores, exogenous and endogenous folate levels were estimated by propensity score weighted regression models. Natural effect models were applied to estimate the mediation effect of folate for the periodontitis-cognition relationship.
Results
Out of the 1966 participants, 869 (44.2%) had periodontitis. The periodontitis group has lower cognitive scores and dietary supplement, serum total, and RBC folate levels. The mediation effect of dietary supplement folate for periodontitis-general cognition score association was significant with mediation proportions of 8.4%. The mediation effects of serum total folate and RBC folate for periodontitis-general cognition score were both significant with mediation proportions of 9.1%. Notably, periodontitis cases with dietary supplement folate or high dietary intake folate had significantly higher general cognition scores than those of periodontitis cases without dietary supplement folate or with low dietary intake folate.
Conclusions
Exogenous folate supplementation can alleviate periodontitis-related CI in the elderly population. Serum and RBC folate are key markers for alleviating periodontitis-related CI.
RETRACTED: Environment sensing architecture of quadruped robot and verification in typical scenarios
Authors: Tang Chao , wang Ning , Gao Hongbo , Wang Chengbo , Yan Chi , Wang Yue , Zhou Lin
Published: February 2024

The authors have requested that this preprint be removed from Research Square.
A protocol for estimating health burden posed by early life exposure to ambient fine particulate matter and its heavy metal composition: A mother-child birth (ELitE) cohort from central India
Authors: Trushna Tanwi , Yadav Vikas , Mandal Uday Kumar , Diwan Vishal , Tiwari Rajnarayan R , Ahirwar Rajesh , Raj Dharma , Rana Sindhuprava , Surve Suchitra Vishwambhar , Dey Sagnik , Sabde Yogesh Damodar
Published: February 2024

Background
Pregnant women and children are vulnerable to air pollution-related adverse health effects, especially those residing in low-resource and high-exposure settings like India. However, evidence regarding the effects of early-life exposure to air particulate matter (PM) on childhood growth/developmental trajectory is contradictory; evidence about specific constituents of PM like heavy metals is limited. Similarly, there are few Indian cohorts investigating PM exposure and the incidence of acute respiratory infection during infancy. This study protocol aims to fill these critical gaps in knowledge.
Methods
We aim to establish a mother-child birth cohort through the enrolment of 1566 pregnant women residing in two urban areas of central India. Antenatally we will collect socioeconomic, demographic, and clinical information, and details of confounding variables from these mothers, who will then be followed up till delivery to assess their exposure to air PM. Biomonitoring to assess heavy metal exposure will be limited to the top five heavy metals found in the air of their residential city. At delivery, pregnancy outcomes will be noted followed by postnatal follow-up of live-born children till the first year of life to assess their achievement of growth/development milestones and exposure to pollutants. We will also estimate the incidence of ARI during infancy.
Discussion
This manuscript describes the protocol for an Indian mother-child air pollution birth cohort study which aims to generate comprehensive evidence regarding the adverse effects of early-life exposure to air PM and its constituent heavy metals among Indian children. This study will provide an epidemiological basis for further understanding in this context. Finally, by reporting our carefully planned study methods/outcome measures, which are at par with published and ongoing birth cohorts, we aim to serve as the starting point for similar cohorts in the future which when considered together would generate enough evidence to facilitate context-specific policy-making and development of appropriate prevention and mitigation strategies.
A fault diagnosis method for railway turnout systems based on Convolution Transformer through data augmentation
Authors: Fu Yingguo , Yang Zhongqun , li linfeng , Si Guixing , Li Hao , Zhang Sizhong , Liu Jianyang
Published: February 2024

In this work, we tackle the challenge of improving fault diagnosis in railway turnout systems (RTS), a critical component of railway infrastructure. Addressing limitations in existing fault-diagnosis techniques, especially their efficacy with small training datasets, we focus on meticulous identification of RTS failure modes. The limited availability of fault samples and the issue of dataset imbalance further compound this challenge. To this end, we propose an innovative fault-diagnosis approach leveraging the Convolution Transformer (ConvTran) combined with advanced data augmentation techniques. This method is uniquely designed to ensure precise fault detection in situations characterized by restricted and skewed data. Existing augmentation techniques often inadequately capitalize on the specific features of time series data. To counteract this, our study proposes an innovative pseudo-synthetic data generation algorithm, utilizing feature combination to effectively overcome the challenges of sample imbalance and small sample sizes. The effectiveness of our model is rigorously tested and validated through comprehensive experiments using an actual dataset from a railway station monitoring system in China. The experimental outcomes decisively demonstrate that our proposed data augmentation method significantly improves the precision of turnout fault diagnosis, especially in contexts with limited sample sizes and imbalanced data. Impressively, our approach achieves a 92% accuracy rate in fault classification on small datasets, which further escalates to 99.7% following data augmentation. This exceptional performance not only outstrips that of other benchmark models but also underscores the superior efficiency and practical applicability of our proposed methodology in the field of RTS fault diagnosis.
Pre-Earthquake Rapid Visual Screening (RVS) & Earthquake Safety Assessment of RCC and Masonry buildings located in Chandigarh Area (India)
Authors: Poonam Poonam , Kumar Anil , Kumar Rajesh
Published: February 2024

The northern part of India, situated along the Himalayan fault line, faces heightened earthquake risk due to the convergent boundary between the Indian and Eurasian Plates, resulting in frequent seismic activity and potential large earthquakes. Rapid urbanization of this region called for rampant construction and a quick seismic assessment of these buildings may save human sufferings and economic losses. Rapid Visual Screening (RVS) of buildings is such a method which can be used to quickly assess the seismic vulnerability of buildings based on their visual characteristics. In the work presented here, RVS of 179 reinforced cement concrete (RCC) and 120 masonry buildings located in the Chandigarh (India) region was carried out. It is found 102 (57.3%) are deemed unusable for earthquake safety, while 40 (22.5%) are tagged as yellow, indicating that they can be made usable through temporary interventions or seismic retrofitting techniques. Additionally, 36 (20.2%) buildings have been classified as green and are deemed safe for use. Moreover, among the 120 masonry buildings, 91 (75.8%) have received a red tag or are deemed unusable, 14 (11.7%) require temporary intervention, and 15 (12.5%) are usable. These findings are pivotal for making critical decisions, such as determining whether buildings require further investigation, retrofitting, or reconstruction. This risk and vulnerability assessment holds the potential to safeguard human lives and mitigate the economic losses stemming from future earthquake events. As only a few (12 to 20%) of the assessed buildings are found usable, urgent steps are needed for seismic intervention to prevent the occurrence of cascading disasters and damage thereof.