bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishing a Learning Health System through the implementation of a health service wide Continuous Quality Improvement program: A qualitative evaluation
Authors: Bierbaum Mia , Hillier Susan , Ellis Louise A. , Clay-Williams Robyn , Hibbert Peter
Published: July 2024

Introduction
Continuous quality improvement (CQI) initiatives are commonly used to enhance patient safety and quality of care. A novel South Australian Local Health Network (SALHN) Continuous Improvement Program (CIP009) has integrated a top-down model of executive-directed change initiatives, with a bottom-up approach of clinician designed interventions to address an organisational-wide goal of improved patient flow. This study evaluated the strengths and challenges of CIP009 implementation from the perspective of participants and deliverers.
Methods
A qualitative study was conducted to evaluate the implementation of CIP009 and 12 associated quality improvement projects. Semi-structured interviews, document review, and observations were guided by the Consolidated Framework for Implementation Research (CFIR). Interviews, focus groups and observations were conducted with key stakeholders (executives, coaches and participants). Data were analysed inductively using thematic analysis, then deductively mapped against the five CFIR domains.
Results
Thirty-one participants were interviewed, two presentation days and six team meetings were observed, and 78 documents were reviewed. Seven key themes were identified highlighting key challenges and strengths of CIP009 implementation within the SALHN setting. These included four key strengths: the CIP framework and culture (the flexible framework, common language, training, and a culture of flattened hierarchy); the benefits of support from a dedicated, internal improvement Faculty (wrap around support from coaches); the advantages of an enthusiastic participant disposition and incentives (vested interests to enhance workflow and patient outcomes); and effective teams and team composition (teams comprised of senior clinician change agents). Three key challenges included: workforce and organisation-level challenges (individual workloads, workforce capacity, and data access); team cohesion, logistics and stakeholder engagement challenges (issues in the way teams worked together); and training and support shortcomings (the training course, and the top-down nature of CIP009).
Conclusion
This evaluation identified that CIP009 was considered an effective multifaceted CQI program. The strengths of CIP009 support a learning health system (a data driven model, utilising systematic frameworks, with commitment from leadership, and a culture of continuous learning). Further integration of implementation science principles may support the program to overcome the key challenges identified.
Single-access MPCNL with flexible cystoscopy vs. multi-access MPCNL for complex renal stones: a prospective, randomized controlled study
Authors: Tang Qing-lai , Wang Qing , Ji Jun-biao , Yang Tian-xiao , Wang Du-jian , Zhou Xing-zhu , Wu Jie , Tao Rong-zhen
Published: July 2024

Objective To observe the efficacy and safety of single-access minimally invasive percutaneous nephrolithotomy (MPCNL) combined with flexible cystoscopy and multi-access MPCNL in patients with complex renal stones (CRS).
Patients and Methods A total of 195 patients with CRS were prospectively randomized into twogroups. Ninety-eight in the single-access MPCNL group and 97 cases as control in the multi-access MPCNL group. The stone-free rates (SFRs) at different times (Postoperative 2nd day and 4th week end) were considered as the primary outcome of the study. The secondary end points were operative time, hemoglobin decrease, postoperative hospital stay and operation-related complications.
Results There was no obvious difference between two groups in patients’ demographics and preoperative clinical characteristics (all P > 0.05). Postoperative data showed that mean decrease in hemoglobin level was less in single-access MPCNL group than that in multi-access MPCNL group (7.3 vs. 13.4 g/L, P < 0.001). Postoperative hospital stay in single-access MPCNL group was more shorten than that in multi-accessMPCNL group (4.2 vs. 5.1 days, P < 0.001). Moreover, the SFRs of the postoperative 2nd day and 4th week in single-access MPCNL group were both significantly higher than those in multi-access MPCNL group (88.8% vs. 74.2%, P = 0.009; 94.9% vs. 85.6%, P = 0.028, respectively). However, in terms of the rates of low back pain, perirenal hematoma and renal artery embolization, multi-accessMPCNL group were all significantly higher than single-access MPCNL group (18.5 vs. 7.1%, P = 0.017; 13.4 vs. 4.1%, P = 0.021; 4.1 vs. 0.0%, P = 0.042; respectively).
Conclusions Our study shows that single-access MPCNL and flexible cystoscopy are ideal complementary techniques in the treatment of CRS, satisfying both high SFR and minimized renal injury. This method was safe and reproducible in clinical practice.
Single nucleotide polymorphism (SNP) analysis reveals ancestry and genetic diversity of cultivated and wild grapevines in Croatia
Authors: Marinov Luka , Magris Gabriele , Gaspero Gabriele Di , Morgante Michele , Maletić Edi , Bubola Marijan , Pejić Ivan , Zdunić Goran
Published: July 2024

Background
Croatia is a geographically small country, but it has a remarkable genetic diversity of cultivated and wild grapevines. Local germplasm has been characterised by microsatellite markers, but a detailed analysis based on single nucleotide polymorphisms (SNPs) is still lacking. Here we characterize the genetic diversity of 149 accessions from three germplasm repositories and four natural sites using 516,101 SNPs to identify complete parent-offspring trios and their relations with spontaneous populations, offering a proof-of-concept for the use of reduced-representation genome sequencing in population genetics and genome-wide association studies.
Results
Principal component analysis revealed a clear discontinuity between cultivated (V. vinifera) and spontaneous grapevines, supporting the notion that the latter represent local populations of the wild progenitor (V. sylvestris). ADMIXTURE identified three ancestry components. Two vinifera components are alternatively predominant in cultivars grown either in northern Adriatic Croatia and Continental Croatia or in Dalmatia (i.e. central and southern Adriatic Croatia). A sylvestris component, which is predominant in accessions from natural sites, is a minor ancestry component in cultivated accessions. TREEMIX provided evidence of a unidirectional gene flow from the vineyards to natural sites, suggesting that the introduced domesticated germplasm has colonized local wild populations stronger than vice versa. Identity-by-descent analysis indicated an extensive kinship network, including 14 complete parent-offspring trios and involving only cultivated accessions, and 6 full-sibling relationships, and invalidated a presumed pedigree of the most intriguing ones, the one of ‘Plavac Mali’. Despite this strong population structure, significant association was found between 143 SNPs and berry skin colour and between 2 SNPs and leaf hairiness, across two known QTL regions.
Conclusions
The genetic separation between Croatian cultivars and sylvestris excluded the hypothesis that cultivars originated from independent events of local domestication. On the other hand, the evidence of a crop-to-wild gene flow, especially in but not limited to the Modro jezero population, signals the need for an urgent adoption of conservation strategies that preserve the genetic integrity of wild relatives. The SNP panel enables enhanced parentage assignment for grapevine cultivars historically grown in Croatia.
Neurocognitive Profile in Pediatric Kidney Transplant Candidates: Effects of Medical and Sociodemographic Factors
Authors: Gu Lidan , Anzalone Christopher J , Kane-Grade Finola , Glad Danielle , Evans Michael , Kizilbash Sarah
Published: July 2024

Background
We evaluated the effects of kidney failure etiology, dialysis, and sociodemographic factors on the subdomains of intellectual functioning in pediatric kidney transplant candidates.
Methods
This retrospective study included 78 pediatric kidney transplant candidates who completed a Wechsler Intelligence Scale assessment during pre-transplant neuropsychological evaluation between 1/1/2010 and 10/31/2022. Linear regression models were employed to examine the effects of kidney failure etiology, dialysis status, neighborhood area deprivation, and race on subdomains of intellectual functioning.
Results
The mean scores of various intellectual functioning domains in pediatric kidney transplant candidates were significantly lower than in the general population (ps <0.001). After adjusting for covariates, patients with congenital anomalies of the kidney and urinary tract had significantly lower processing speed (M=85; 95% CI: 79-91) compared to patients with nephrotic syndrome (M=99; 95% CI: 90-107) and other etiologies (M=84; 95% CI: 78-90) (p=0.003). Patients living in high-level deprivation neighborhoods showed lower working memory performance (M=84, 95% CI: 77-91) than patients living in median-level (M=91, 95% CI: 87-95) and low-level (M=98, 95% CI: 92-104) neighborhood area deprivation (p=0.03). Patients from marginalized racial groups demonstrated lower verbal skills (M=80, 95% CI: 74-87) than White patients (M=92, 95% CI: 88-97) (p=0.02). Additionally, patients receiving dialysis showed higher reasoning skills (M=98, 95% CI: 90-104) than patients without dialysis (M= 90, 95% CI: 86-95) (p=0.04).
Conclusions
Neurocognitive development in pediatric kidney transplant candidates is associated with medical and sociodemographic factors. Strategies to monitor, treat, and accommodate neurocognitive concerns need to be considered to optimize long-term medical and social outcomes.
Prognostic Factors for Endoscopic Third Ventriculostomy Success in Hydrocephalus with Myelomeningocele
Authors: Macedo Fernando Augusto Medeiros Carrera , Giannetti Alexandre Varella , Vandi Hudson Henrique Santos
Published: July 2024

Purpose Myelomeningocele (MMC) is a prevalent neural tube closure defect often associated with hydrocephalus, necessitating surgical intervention in a significant proportion of cases. While ventriculoperitoneal shunting (VPS) has been a standard treatment approach, endoscopic third ventriculostomy (ETV) has emerged as a promising alternative. However, factors influencing the success of ETV in MMC patients remain uncertain. This retrospective observational study aimed to identify clinical and radiological factors correlating with a higher success rate of ETV in MMC patients.Methods Medical records of MMC patients who underwent ETV at a tertiary care center between 2015 and 2021 were reviewed. Demographic, clinical, and radiological data were analyzed. ETV success was defined as the absence of further hydrocephalus treatment during follow-up.Results Of 131 MMC patients, 21 met inclusion criteria and underwent ETV. The overall success rate of ETV was 57.1%, with a six-month success rate of 61.9%. Age ≤ 6 months was significantly associated with lower ETV success (25%) compared to older patients (76.9%) (OR: 0.1; 95% CI 0.005–2.006; p = 0.019). Radiological factors, including posterior fossa dimensions and linear indices, did not exhibit statistically significant associations with ETV success.Conclusion Age emerged as a significant factor affecting ETV success in MMC patients, with younger patients exhibiting lower success rates. Radiological variables did not significantly influence ETV outcomes in this study. Identifying predictors of ETV success in MMC patients is crucial for optimizing treatment strategies and improving patient outcomes.
Peripheral Blood Mononuclear Cells Regulated Cytokines and Transcription Factors Reduce Haemonchus contortus Larval Establishment in Black Bengal Goat
Authors: Ahmed Nurnabi , Roy Babul Chandra , Biswas Amitav , Rabbi Md. , Sajib Md. , Zim Md. , Rahman Md. Khalilur , Hasan Md. Manjurul , Biswas Hiranmoy , Talukder Md. Hasanuzzaman
Published: July 2024

Black Bengal goat (BBG) is a native breed of Bangladesh and its ability in reducing the establishment of H. contortus infection through cellular and immune responses was unexplored. In vitro larval motility in response to PBMC, in vivo larval infectivity assay, differential blood cell counts, histopathology, cytokine and transcription expression have been investigated in BBG kids following H. contortus L3. In vitro motility experiment revealed that L3 exposed to PBMC from primed kids had significantly (P < 0.05) reduced speed and straight-line distance compared to L3 exposed to PBMC from naive kids. Kids with L3 exposed to PBMC in primed and naive kids, reduced H. contortus egg shed. Upon 10,000 L3 challenge, WBC count was higher in primed kids compared to naive and 35% of TC were neutrophils. Lymph nodes were increased in weight (P < 0.05) in primed kids except 1st day (D0). IL-4, IL-5, IL-13, IL-33, MCP1, CXCL1, TLR2 and GAL14 were expressed both naive and primed kids. Significant expression of IL-4, IL-5, IL-13, IL-33, MCP1 and CXCL1 at D3, D5 and D7, suggesting early TH2 differentiation in primed kids. These results suggest that BBG can much resist H. contortus infectivity. Role of transcriptome differences in other resistant breeds should be investigated.
Characteristic changes in the mRNA expression profile of plasma exosomes from patients with MPO-ANCA-associated vasculitis and its possible correlations with pathogenesis
Authors: 陈 杨凡 , 周 东清 , 钱 辛 , 格 尚庆 , 帅 宗文
Published: July 2024

Objective
To explore the expression patterns and potential roles of mRNAs in exosomes from patients with myeloperoxidase-specific anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (MPO-AAV).
Methods
Plasma exosomes were isolated from MPO-AAV patients and healthy controls (HCs) to screen for differential mRNA expression via exosomal mRNA sequencing. The differentially expressed mRNAs in exosomes from the 2 groups were comparatively explored by bioinformatics analysis. The six most differentially expressed mRNAs were selected and validated in larger groups of MPO-AAV patients and HCs by real-time quantitative polymerase chain reaction (RT‒qPCR). The relationships between these selected mRNAs and patient characteristics were statistically analyzed.
Results
Compared with HCs, a total of 1,077 mRNAs in exosomes from MPO-AAV patients were found to be significantly upregulated, including DEPDC1B and TPST1, while NSUN4 and AK4 were significantly downregulated. Statistical analysis did not reveal any correlation between the six selected mRNAs and clinical indicators, including disease activity. GO enrichment analysis revealed that these differentially expressed genes participate in various enzyme activities, protein synthesis, etc. KEGG pathway analysis revealed that metabolic pathways, cell adhesion molecules, epithelial signaling, and mitogen-activated protein kinase (MAPK) signaling pathways were significantly enriched in the exosomal mRNAs.
Conclusions
There were significant differences in the expression of exosomal mRNAs between MPO-AAV patients and HCs, which may be related to the occurrence and development of MPO-AAV. These findings provide clues for further investigations of MPO-AAV pathogenesis and the identification of new potential therapeutic targets.
Towards the development of better therapeutic agents for Mycobacterium Tuberculosis: Computational design and evaluation of pyrazinone derivatives as inhibitors of enoyl acyl carrier protein reductase
Authors: Goel Akshita , Negi Indu , Aggarwal Sanchita , Pandey Ankur Ganesh , Sharma Purshotam
Published: July 2024

The treatment of tuberculosis (TB) has become challenging due to the emergence of multidrug-resistant strains of Mycobacterium tuberculosis. Consequently, new, and efficient therapies need to be developed to combat this dreaded disease. In this study, we apply in-silico techniques to analyse the potential inhibitory role of pyrazinone derivatives for enoyl-acyl carrier protein reductase (InhA), an important component protein involved in the synthesis of mycolic acids, the major components of the mycobacterial cell wall. Specifically, we amalgamated molecular docking, molecular dynamics (MD) simulations and quantum mechanical (QM) calculations to analyse the interaction of InhA with eight distinct pyrazinone derivatives, that contain thiophenyl, phenyl, or chloro substitutions at C6, ethyl or methoxybenzyl substitutions at N4, and carboxylate group (hydrolysed form of the parent carbonitrile group) at C2 position of the pyrazinone skeleton and compared our results with isoniazid, a well-known first-line TB drug that potentially inhibits InhA. Docking suggests that despite binding within the same pocket (albeit with different residues), pyrazinone derivatives interact more strongly with InhA than isoniazid. This points towards the potentially greater efficacy of these compounds than isoniazid towards InhA inhibition. Further, although C6 substitution does not significantly affect the ligand binding, N4-methoxybenzyl derivatives exhibit higher docking scores than their N4-ethyl counterparts, thereby suggesting their promising inhibitory potential against InhA. Extended (500 ns) all-atom explicit solvent MD simulations, amounting to a total of 9 µs of the simulation time, provide a refined picture of ligand binding in the explicit-solvent environment, and suggest that the crucial interaction with Arg 194 observed in the docked structures is mostly retained. Analysis of the hydrogen bond occupancies and binding-site linear interaction energies reiterate that the binding of the pyrazinone derivatives with InhA is stronger than isoniazid. In synchrony with MMGBSA binding energy calculations and QM calculations, these analyses reveal that irrespective of the nature of C6 substitution, pyrazinone derivatives with N4-methoxybenzyl substitution exhibit stronger binding to InhA, compared to those containing N4-ethyl substitution. Overall, this study identifies promising candidate compounds that should be experimentally tested for their potential inhibitory effects towards InhA.
Impact of Non-Uniform Heat Flux on Heat Transfer in Laminar Flow Between Parallel Plates
Authors: Verma Ram Niwas
Published: July 2024

In practical engineering, heating and cooling are among the most common applications. Typically, during these processes, the heat flux to the heat transfer surface is not uniform. This study analyzes convection heat transfer between parallel plates subjected to non-uniform heat flux. The flow between the parallel plates is laminar, hydrodynamically developed, and thermally developing. A two-dimensional unsteady model is developed, and the momentum and energy equations are derived and solved numerically to obtain the velocity and temperature fields. An indigenous solver is created to solve the two-dimensional unsteady partial differential energy equation using the finite difference method. The algorithm for this solver is written in MATLAB and verified against analytical solutions. Temperature profiles are plotted and analyzed under various heat flux conditions to describe the rate of heat transfer. Local and average Nusselt numbers are calculated from the obtained temperature and velocity fields and presented graphically. This study is valuable for practical engineering applications, heating and cooling systems, and radiation calorimeters. Additionally, the development of this solver contributes to the research field of CFD simulations.
Maximising Organ Donor Utility System-wide (MODUS): A study protocol for using linked health services data in multi-modal modelling of kidney transplant waitlist outcomes
Authors: Rosales Brenda Maria , Shah Karan K , Mata Nicole La , Baldwin Heather , Hedley James A , Clayton Philip , Wyld Melanie , Wyburn Kate , Kelly Patrick J , Morton Rachael L , Webster Angela C
Published: July 2024

Increasing deceased organ donation is a global priority constrained by concerns of inadvertent transmission of cancer or infectious disease from deceased organ donors. Up to 60% of potential donors referred for consideration for deceased organ donation in Australia do not proceed for biovigilance concerns. However, there are opportunities to increase acceptance. We aim to describe the impact of accepting or declining potential donors forgone for biovigilance concerns on patient and transplant outcomes. We will use data for all potential donors referred for consideration for deceased organ donation and data for patients ever waitlisted for kidney transplantation in New South Wales, Australia’s most populous state, 2010–2020. We will 1) describe the patient journey on the kidney transplant waitlist, including episodes of suspension and reactivation, time waiting and whether transplanted; 2) describe the characteristics of patients on the kidney transplant waitlist who decline a deceased donor organ offer and patient outcomes after their first decline; 3) determine potential gains made through increased donor acceptance and profile potential donors forgone for medical suitability; 4) use economic modelling to investigate the benefits and costs of increasing donor acceptance. Research findings will be presented at scientific conferences, published in the scientific media, and via collaborator networks.
Assessing the relevance of sharks and rays for Mediterranean EU fisheries to support a transition from species exploitation to species conservation
Authors: Colloca Francesco , Arcioni Martina , Acampa Francesca , Valente Salvatore , Ventura Daniele , Lorenzo Manfredi Di , Milisenda Giacomo , Moro Stefano
Published: July 2024

Ten years (2013–2022) of official data on elasmobranchs landed and discarded by European fishing fleets operating in the Mediterranean Sea were analysed with the primary objective of assessing the significance of shark and ray catches for the main fleet segments across five Mediterranean regions (i.e. Western, Central and Eastern Mediterranean, Ionian Sea, Adriatic Sea). The annual elasmobranch catches ranged from 3,200 to 5,800 tons, declining consistently from 2020 to 2022. Four fishing gears (i.e. bottom trawls, longlines, trammel nets, and gillnets) contributed over 96.6% of the reported catch, with notable variations among regions. Bottom trawlers accounted for approximately 75% of catches, discarding around 40%; fixed nets and longlines had minimal discard rates (< 2.5%). The Western Mediterranean contributed the most to total catches (2,057 − 3,229 tons/year), followed by the Adriatic Sea. Generalized Additive Models revealed a significant correlation between catches and fishing effort, indicating increasing catches at high fishing effort levels. Reported landings included species absent in the Mediterranean and considered rare or extremely rare in the basin, highlighting the need for better species reporting. The average contribution of sharks and rays to the total annual landings of Mediterranean fleets was 1.66% in weight and 0.60% in value, totaling approximately 96.4 million euros over the decade, compared to the overall value of 15.8 billion euros for the whole landing. As elasmobranchs no longer represent a substantial revenue stream for Mediterranean fleets, implementing conservation measures to restore depleted shark and ray populations will likely have minimal impact on the economic sustainability of fisheries.
Sex-Specific Response to A1BG Loss Results in Female Dilated Cardiomyopathy
Authors: Emerson James I. , Shi Wei , Conlon Frank L.
Published: July 2024

Background
Cardiac disease often manifests differently in terms of frequency and pathology between men and women. However, the mechanisms underlying these differences are not fully understood. The glycoprotein A1BG is necessary for proper cardiac function in females but not males. Despite this, the role of A1BG in the female heart remains poorly studied.
Methods
To determine the sex differential function of A1BG, we generated a novel conditional A1bg allele and a novel conditional A1bg Rosa26 knockin allele. Histology, electrocardiography, transcriptional profiling (RNA-seq), transmission electron microscopy, western blot analyses, mass spectrometry, and immunohistochemistry were used to assess cardiac structure and function.
Results
The study reveals that the absence of A1BG results in significant cardiac dysfunction in female but not male mice. Gene expression underscores that A1BG plays a critical role in metabolic processes and the integrity of intercalated discs in female cardiomyocytes. This dysfunction may be related to sex-specific A1BG cardiac interactomes and manifests as structural and functional alterations in the left ventricle indicative of dilated cardiomyopathy, thus suggesting a sex-specific requirement for A1BG in cardiac health.
Conclusion
The loss of A1BG in cardiomyocytes leads to dilated cardiomyopathy in females, not males.
Measuring the health-related quality of life in HIV patients with integrase strand transfer inhibitor-based regimens in China
Authors: Tang Wei , Huang Yaxiong , Qi Hui , Chen Zhong , Zheng Fang , Zhou Guoqiang , Xiao Gang , Cao Jing
Published: July 2024

Background
With bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF), and dolutegravir/lamivudine (DTG/3TC) included in the national drug reimbursement list, the integrase strand transfer inhibitor (INSTI)-based regimens could be afforded and used by more patients. Majority of previous health-related quality of life (HRQoL) studies were conducted before INSTI-based regimens reimbursed and have no restriction on the regimens received. The aim of the study is to measure the HRQoL of HIV patients with INSTI-based regimens in China.
Methods
A cross-sectional survey of HIV patients conducted in the First Hospital of Changsha. Adult patients diagnosed with HIV-1 infection between January 1st, 2021-July 31st, 2022, with the prescription of BIC/FTC/3TC or DTG/3TC as the current treatment were included. Patients’ responses were collected through a digital platform and the HRQoL were measured by three questionnaires, including HIV-symptom index (HIV-SI) questionnaire, Patient Health Questionnaire‐9 (PHQ-9) and the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L). Generalized linear regression model was used to estimate the effects of covariates on each HRQoL measure.
Results
A total of 143 HIV patients with HRQoL data available were included in the study. The mean (SD) of HIV-SI total score, PHQ-9 total score and EQ-5D utility score was 26.7 (14.4), 7.4 (1.0) and 0.95 (0.12), respectively. Compared with treatment-naive patients, treatment-experienced patients reported significantly higher score/proportion of HIV-SI and PHQ-9 total score, presence of depression and problems in anxiety/depression (all p<0.05). Patients with older age, without formal work, having treatment switch due to safety reason and lower CD4 cell counts had significantly higher HIV symptom burden and worse depression status, respectively (all p<0.05).
Conclusions
HIV patients suffer from HIV symptoms and depression, which greatly deteriorate their HRQoL. Considering the aging population and lower employment rate, the needs for social support or patient-assistant program for HIV patients are highlighted. The early initiation of INSTI-based regimens is necessary to avoid the HRQoL loss due to safety reasons.
Conceptual study of a scramjet with symmetrical internal compression system
Authors: Araújo Tiago Aleixo , Bezerra Ítalo Sabino Arrais , Souza Sandi Itamar Schafer , Toro Paulo Gilberto Paula
Published: July 2024

This paper focuses on the design analysis of a planar hydrogen-powered scramjet constructed with a symmetrical internal compression system of rectangular cross-sectional area, developed to demonstrate supersonic combustion in atmospheric flight at 30 km of altitude and velocity of 2050 m/s, equivalent to Mach number 6.8. In this analysis, is proposed an analytical approach based on theories of oblique shock wave optimized by the criterion of maximum total pressure recovery, Rayleigh flow’s and the area ratio coupled to Prandtl–Meyer to dimension the compression, combustion, and expansion sections. The design of the compression system was developed to provide velocity, and temperature sufficiently adequate for spontaneous supersonic combustion of the hydrogen-air mixture. The atmospheric airflow was modeled by the hypothesis of calorically perfect gas without viscous effects. A visualization of the effects of various flow phenomena, such as shock waves, combustion, and expansion waves, on the evolution of thermodynamic properties throughout the scramjet demonstrator is discussed. The results showed by conducted compression performance analysis, a major increase in entropy in the reflected shock wave where the criterion of shock waves of equal strength was not applied. Also, the airflow thermodynamic properties and velocity from the leading edge to the trailing edge were analyzed. With heat addition, the scramjet was able to produce uninstalled thrust.
Fabrication of the reduced graphene oxide/activated carbon composite modified by PbSO 4 as ternary additive to negative plate of lead acid battery
Authors: Ri Chung-Nam , Ri Jin-Chon , Jon Min-Ung
Published: July 2024

In this paper reduced graphene oxide/Activated Carbon(rGO/AC, GAC) composite modified by PbSO4(PbSO4-rGO/AC, PGAC) as the additive to Negative Active Material(NAM) of Lead Acid Battery(LAB) was fabricated and its effect on High Rate Partial State of Charge(HRPSoC) cycle life was investigated. To fabricate PGAC, the powder of AC was added to graphene oxide suspension and reduced by glucose. GAC powder was immersed in Pb2+ solution to allow ion exchange and the final product PGAC composite was obtained. X ray Diffration (XRD) and Scanning Electron Microscopy(SEM) was used for the structural characterization of the PGAC and electrochemical measurement was carried out by using Cyclic Voltametry(CV), Linear Sweep Voltametry(LSV), Galvanostatic Charge-Discharge(GCD). The results showed that the addition of PGAC composite(PbSO4:GAC= 26:74 wt. ratio) to NAM at 2wt.% increased HRPSoC cycle life by 343% from 14768 to 65477.
Impact of Clonal Hematopoiesis on the Carcinogenic Process of Multiple Myeloma
Authors: Koh Youngil , Park Changhee , Cho Gayeon , Ryu Gangpyo , Park Jeongmin , Yoon Hyundong , Oh Yu Mi , Lee Chansub , An Hongyul , Sun Choong-Hyun , Jung Sung-Hoon , Lee Je-Jung , Kim Bum Suk , Byun Ja Min , Shin Dong-Yeop , Hong Junshik , Kim Inho , Yoon Sung-Soo , Nachun Daniel , Maurer Taylor , Choi Su-Yeon , Kim Seok Jin , Kim Chan-Hyuk , Kim Kihyun , Cho Sung-Yup , Jaiswal Siddhartha , Kim Jong
Published: July 2024

Clonal hematopoiesis (CH), a phenomenon linked to aging, correlates with inflammation and myeloid malignancies. Here, we explore the interaction of CH, with terminally differentiated lymphoid malignancy, and multiple myeloma (MM). Analysis of CH in clinical cohorts revealed a higher prevalence among MM patients and a lower deep response to proteasome inhibitors. By utilizing the bone marrow samples from MM patients with CH, single-cell transcriptome analyses indicated frequent interaction between CH and MM cells, mediated by CCR10-CCL2, resulting in the upregulation of the MAPK pathway and angiogenesis, findings corroborated by exosome RNA analysis. Conditioned media from TET2 knockdown macrophages significantly enhanced MM cell proliferation compared to that from wild-type cells, an effect reversible by a CCR10 inhibitor. Our results underscore the pivotal role of TET2 CH in driving CCR10-high myeloma progression through paracrine oncogenic effects via exosomal interactions on CCR10, suggesting its potential as a therapeutic target.
Impacts of heat exposure on pregnant women, fetuses and newborns: a systematic review and meta-analysis
Authors: Lakhoo Darshnika , Brink Nicholas , Radebe Lebohang , Craig Marlies , Pham Minh , Haghighi Marjan , Wise Amy , Solarin Ijeoma , Luchters Stanley , Maimela Gloria , Chersich Matthew
Published: July 2024

Climate Change has wide-ranging and severe health impacts, especially for vulnerable groups. We systematically reviewed the literature (n=198 studies) on heat impacts on maternal, fetal, and neonatal health, conducted meta-analyses to quantify impacts, analysed periods of susceptibility, and graded certainty. Studies covered 66 countries and 23 outcomes. Our results showed increased odds of preterm birth of 1.04 (95%CI=1.03, 1.06) per 1°C increase in heat exposure and 1.26 (95%CI=1.08, 1.47) during heatwaves. Similar patterns were shown for stillbirths and congenital anomalies. Gestational diabetes mellitus odds increased by 28% (95%CI=1.05, 1.74) at higher exposures, whileodds of any obstetric complication increased by 25% (95%CI=1.09, 1.42) during heatwaves. Patterns in susceptibility windows vary by condition. The review demonstrated that escalating temperatures pose major threats to maternal and child health globally. Findings could inform research priorities and selection of heat-health indicators. Clearly more intensive action is needed to protect these vulnerable groups.
Enhancing Resilience in Water and Wastewater Distribution Networks: A Tehran Case Study, Iran.
Authors: Mohammadi Payam , Ourang Shiva , Hosseini Sanaz Sadat , Shaafi Farhang
Published: July 2024

Water and wastewater infrastructures are crucial assets constantly exposed to various disasters, prompting researchers to prioritize strategies for improving their resilience. Given Tehran's significance as Iran's capital and the heightened vulnerability of its water transmission pipelines to seismic events, along with the looming threat of major earthquakes, this study investigates existing research on resilience. The aim is to pinpoint essential strategies for fortifying the resilience of Tehran's water supply infrastructure against earthquakes. Through semi-structured interviews and a survey, we refined criteria and tested research hypotheses based on insights from water and wastewater construction sector experts. The consensus among experts confirms the availability of practical solutions for enhancing the resilience of water supply pipelines against earthquakes. These solutions revolve around enhancements to pipe material, thickness, fittings, and implementation strategies.
ECG-based Cardiovascular Disease Diagnosis: An Ensemble Learning Approach
Authors: Gupta Amaz , Sharadat Baru , Huddle Thomas
Published: July 2024

The classification and identification of arrhythmias using ECG signals are of substantial practical importance in the early prevention and detection of cardiac and cardiovascular disorders. We propose an ensemble learning model to leverage the power of convolutional neural networks and transfer learning techniques to analyze heartbeat data.
We transfer CNN models on 1D heartbeat signals and employ ensemble techniques to aggregate their predictions
Our results underscore the improved accuracy of our approach in classifying ECG data, demonstrating its potential for early cardiovascular disease detection. Our method addresses the limitations of traditional ECG interpretation and offers a robust, automated approach to arrhythmia detection and classification, potentially revolutionizing the field of cardiac diagnostics. This research showcases the significance of transfer learning and ensemble learning techniques in advancing healthcare applications.
Thermal testing of ophthalmic lenses to establish environmental impact: Implications for sustainable waste management practices and training for healthcare professionals
Authors: Pillay Rayishnee , Hansraj Rekha , Singaram Veena S
Published: July 2024

Clinical relevance: Healthcare professionals have a crucial role as environmental stewards, and comprehensive, accessible information is required to improve sustainable waste management practices in healthcare. Eyecare practitioners need to be cognisant of the environmental impact of their disposal practices.
Background: Polymeric spectacle and contact lenses are typically discarded after a specific period of wear. Upon waste bin disposal, they are deposited in landfill sites where their decomposition rates and consequent environmental impact is currently uncertain. This study aimed to determine the onset of decomposition temperature and the subsequent thermal responses of various spectacle and contact lenses to predict the environment consequences of lens disposal and to guide eyecare practitioners with sustainable waste management practices.
Method: Simultaneous thermogravimetric analysis and differential scanning calorimetry techniques were conducted on a sample of uncoated, coated, and tinted spectacle and contact lenses.
Results: The lowest extrapolated onset of decomposition temperature of the lens sample was ~249°C. Heat flow results indicated exothermic behaviour during the thermal analysis. Some samples exhibited release of undetermined content, potentially attributable to moisture loss or volatile compounds.
Conclusion: Spectacle and contact lenses can be considered as thermally stable as they are unlikely to encounter temperatures above 249°C upon disposal under natural landfill conditions, and therefore the study lenses are predicted to persist as solid waste. The increasing volumes of landfilled plastics pose an environmental threat due to persistence and associated methane emissions. Therefore, alternate end-of-life measures, such as lens recycling or utilisation in controlled energy recovery facilities should be considered. The findings highlight the necessity of integrating sustainable waste management into health sciences curricula and continuing education programs for healthcare practitioners. Educating healthcare professionals on the environmental impact of disposal practices and sustainable methods is essential for reducing the sector's ecological footprint and fostering environmental responsibility.
Restriktive Transfusion von Erythrozytenkonzentraten in Patienten mit akuter myeloischer Leukämie unter intensiver Induktionschemotherapie
Authors:   , Fleckenstein Philine
Published: July 2024

Dieser Arbeit lag die Fragestellung zugrunde, welchen Einfluss die jeweilige Transfusionsstrategie auf AML-Patienten unter intensiver Induktionschemotherapie hat. Dafür wurde ein am Universitätsklinikum Frankfurt zwischen 2007 und 2018 behandeltes Kollektiv von 352 Patienten untersucht. So erfolgte hier bis ins Jahr 2015 hinein die Transfusion eines EK ab einem Hb-Wert <8g/dl und nach Änderung des Transfusionstriggers ab einem Hb <7g/dl. AML-Patienten aus dem Jahr 2015 – dem Jahr der Änderung der Transfusionsregel – wurden von weiterer Untersuchung ausgeschlossen, um zwei klar abgrenzbare Kohorten erhalten zu können. Es zeigte sich, dass die weniger restriktive Transfusionskohorte unter Induktionschemotherapie einen durchschnittlich um 1g/dl höheren Hb-Wert aufwies und früher als die restriktive Kohorte transfundiert wurde. Die Anzahl an Fiebertagen, CRP-Werte, Aufenthalte auf Intensivstation sowie die Dauer des Krankenhausaufenthaltes betrachtend, zeigte sich hingegen kein signifikanter Unterscheid zwischen beiden Kohorten. Basierend auf unserer Arbeit ergeben sich keine Hinweise dafür, dass die restriktive Transfusionspraxis einer weniger restriktiven für AML-Patienten unterlegen ist. Limitierend auf die Aussagekraft der Ergebnisse wirken sich dabei die retrospektive Natur der Arbeit sowie die zeitliche Verschiebung der Behandlungszeiträume beider Kohorten aus. Ergebnisse der bislang ausstehenden randomisierten Studien, die den Einfluss unterschiedlicher Transfusionsregimes auf Patienten mit hämatologischen Krankheiten untersuchen, sind in Bälde zu erwarten. Die bereits vorliegenden Pilotstudien und Ergebnisse der TRIST-Studie decken sich mit der von uns beobachteten Nicht-Unterlegenheit der restriktiven Transfusionspraxis für ein hämatoonkologisches Patientenkollektiv, sodass es abzuwarten gilt, ob sich dies auch in weiteren größeren randomisierten und kontrollierten Studien beweisen kann.
Analysis of Cannabinoids in Medicinal Cannabis Products: A Comprehensive Review
Authors: Herrera Julieth , Rolim Larissa , Honorato Ricardo , Pimentel Maria Fernanda
Published: July 2024

Cannabis plant has been known for its medicinal use for centuries. Recent research into its pharmacology has revealed medicinal properties, promoting the use of cannabis for therapeutic purposes and consequently the growth in the production of medicinal cannabis-based products. The potency of cannabinoids in products for therapeutic purposes is essential to assess their effects on health. Medicinal cannabis products, based on extracts from the cannabis plant, however, lack standardization in both preparation and quality control. In this review, chromatographic methods and alternative strategies are described for qualitative and quantitative analysis of cannabinoids in cannabis-based products. The direct application of portable spectroscopic techniques on cannabis farms for monitoring plant growth is also reported. Finally, a special section has been dedicated to the use of chemometric tools that have been employed in the field of cannabis including methods utilizing chemometric tools such as exploratory analysis, multivariate classification, and calibration.
Development of a Cancer-associated Fibroblast Signature for
Evaluating Immunotherapy Response and Prognosis of
Hepatocellular Carcinoma
Authors: Xia Hui , Feng Pei , Wang Wei , Gong Zhao , Ran Jun , Lu Peng , Dai Bin
Published: July 2024

Background:

Alcohol abuse, non-alcoholic fatty liver disease (NAFLD), and hepatitis B and C are the main pathogenic factors of hepatocellular carcinoma (HCC). Though
the current understanding of risk factors for HCC has been improved, patients with this type
of cancer are normally diagnosed at advanced stages, posing significant challenges to effective treatment.

Methods:

This study analyzed the HCC datasets from The Cancer Genome Atlas (TCGA)
and Gene Expression Omnibus (GEO) database (GSE14520 and GSE116174). Stromal and
immune cell infiltration in the tumor microenvironment (TME) was quantified by the ESTIMATE algorithm. To identify gene modules associated with cancer-associated fibroblasts
(CAFs), weighted gene co-expression network analysis (WGCNA) was performed to develop gene co-expression networks. A CAF prognosis score (CAFPS) model was established
based on the prognostic CAF genes screened by univariate and multivariate Cox regression
analyses. To determine the role of the genes in the vital module in HCC, we conducted
Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. Finally, the relationship between CAFPS and drug sensitivity was analyzed using Genomic
Data for Cancer Drug Sensitivity (GDSC)

Results:

In this study, we found significant differences in immune scores, stromal scores,
CAFs scores, and CD4/8 T-cell scores between normal samples and samples with different
TNM staging. In particular, the proportion of CAFs was higher than all other cells in normal
samples. Gene modules related to CAFs were identified by developing a gene co-expression
network using WGCNA analysis. The lightyellow and greenyellow modules showed the
highest correlation with CAF scores. Univariate COX analysis identified 12 genes related to
HCC prognosis from a total of 191 genes in the two modules. The Kaplan-Meier (KM) survival analysis revealed that a high expression of these genes was associated with a lower survival chance. Based on the 12 genes obtained by univariate COX analysis, multivariate
COX analysis was performed to construct a risk score model for the characteristics of CAFs
(CAFPS). The KM survival curves of patients in the high CAFPS and low CAFPS groups
showed that patients in the low CAFPS group had better survival.

Conclusion:

CAFs played a crucial role in the pathogenesis and treatment response of
HCC. Targeting the CAFs milieu may provide therapeutic benefits, highlighting the importance of CAFS in developing a personalized treatment for HCC patients. Further studies are
required to verify the current findings and explore their implications in clinical settings.
Bushen Zhuyun Decoction Improves Endometrial Receptivity by Inhibiting NF-κB/NLRP3 Signaling Pathway
Authors: Wang Xiaolan , Tong Yun , Zhang Haidong , Zou Yeting , Ding Yinyin , Liu Bei , Zhou Weiye , Shan Jinjun , Ji Jianjian , Su Wenren , Liu Yinyin , ZHou Huifang
Published: July 2024

Objective:

Bushen Zhuyun Decoction (BSZY), a traditional Chinese herbal prescription
has shown promising effects on gynecological infertility, but the mechanism for endometrial
receptivity is still unclear. This study aimed to investigate the regulatory effects of BSZY on endometrial
receptivity, which plays a key role in colonization of embryo, and its regulatory mechanisms
associated with NF- κB/NLRP3 pathway.

Methods:

SD rats at reproductive age with affected endometrial receptivity was established using
mifepristone (RU486), and the regulatory effects of BSZY on endometrial receptivity were
evaluated by H&E staining, and changes in sex hormones by ELISA and Western blot. Moreover,
human endometrial RL95-2 cells were treated with H2O2, and inflammatory cytokines in rats
and RL95-2 cells were analyzed by ELISA. The activation of NF-κB/NLRP3 signaling pathway
in RL95-2 cells were characterized using immunofluorescence and Western blot. Mitochondrial
morphology and function in RL95-2 cells were observed by transmission electron microscope
and cell mitochondrial stress test.

Results:

BSZY increased uterine endometrial thickness and attenuate histopathological changes
induced by RU486. BSZY can regulate endometrial estrogen receptor and progesterone receptor,
and the levels of sex hormones and inflammatory cytokines in pregnant rats. BSZY-containing
serum also showed strong anti-inflammatory and cytoprotective effects in vitro. In addition,
BSZY-containing serum inhibited the activation of NF-κB/NLRP3 signaling pathway, and improve
mitochondrial morphology and function in RL95-2 cells.

Conclusion:

BSZY can improve endometrial receptivity, potentially by improving mitochondrial
morphology and function to inhibit the activation of NF-κB/NLRP3 signaling pathway in endometrial
cells, thus regulate inflammation to improve endometrial receptivity.
Genomic Insights into Bacterial Antimicrobial Resistance Transmission
and Mitigation Strategies
Authors: Barcan Alexandru Stefan , Barcan Rares Andrei , Vamanu Emanuel
Published: July 2024

The rapid emergence and global spread of antimicrobial resistance in recent years
have raised significant concerns about the future of modern medicine. Superbugs and multidrugresistant bacteria have become endemic in many parts of the world, raising the specter of untreatable infections. The overuse and misuse of antimicrobials over the past 80 years have undoubtedly contributed to the development of antimicrobial resistance, placing immense pressure
on healthcare systems worldwide. Nonetheless, the molecular mechanisms underlying antimicrobial resistance in bacteria have existed since ancient times. Some of these mechanisms and
processes have served as the precursors of current resistance determinants, highlighting the ongoing arms race between bacteria and their antimicrobial adversaries. Moreover, the environment harbors many putative resistance genes, yet we cannot still predict which of these genes
will emerge and manifest as pathogenic resistance phenotypes. The presence of antibiotics in
natural habitats, even at sub-inhibitory concentrations, may provide selective pressures that favor the emergence of novel antimicrobial resistance apparatus and, thus, underscores the need
for a comprehensive understanding of the factors driving the persistence and spread of antimicrobial resistance. As the development of antimicrobial strategies that evade resistance is urgently needed, a clear perception of these critical factors could ultimately pave the way for the design of innovative therapeutic targets.