bluuebunny/crossref_metadata_2025 huggingface dataset:
FloPy for Optimizing the Structure of Hydraulic-driven Groundwater Circulation Wells
Authors: Fang Zhang , Liu Zhiguo , Wang Guowen
Published: August 2024

The Groundwater Circulation Wells (GCW) are in-situ remediation technology that can integrate multiple remediation techniques within a single well. An optimal well structure is crucial for the efficient use of GCW. Numerical simulations are most used for design optimization. However, this work can be time consuming because of the complexity of the development and processing. FloPy was applied in this study to describe and optimize the structure of a hydraulically driven GCW at Xi'an, Shaanxi Province, China. Based on the hydrogeological conditions, Python was used to develop a program known as the FloPy library that can construct numerical models for groundwater flow (MODFLOW), particle tracking (MODPATH), and solute transport (MT3DMS) under the hydraulic driving of the GCW. The program can automatically calculate the indicators of the effectiveness of the GCW operation, including the radius of influence (R), migration radius of pollutants (rm) and pollutant removal efficiency (η). By using the largest influence radius of the GCW for optimization, a model for optimizing the GCW structure was developed. The ideal structural blueprint for the GCW was ascertained through the automated computation of every conceivable well structure in the range. In an optimal scheme, there was a 10%, 14.10%, and 11.98% enhancement in the GCW influence radius, migration radius of pollutants, and pollutant removal efficiency, respectively, compared with the pre-optimization levels.
Thymidine phosphorylase imaging probe for differential diagnosis of nonalcoholic steatohepatitis
Authors: Higashikawa Kei , Uehara Riho , Horiguchi Sawako , Shibata Yuki , Okubo Naoto , Mizuno Yuki , Yasui Hironobu , Ohnishi Shunsuke , Takeda Hiroshi , Kuge Yuji
Published: August 2024

Purpose
Non-alcoholic fatty liver disease (NAFLD) comprises simple steatosis (SS), which has a low risk of mortality, and non-alcoholic steatohepatitis (NASH), which can progress to liver cirrhosis and hepatocellular carcinoma. Because differentiation between NASH and SS is the most important issue in the diagnosis of NAFLD, the establishment of noninvasive diagnostic methods is urgently needed. In this study, we evaluated the potential of [123I]IIMU, a thymidine phosphorylase (TYMP) targeted SPECT imaging probe, for differential diagnosis of NAFLD in a preclinical animal model.
Procedures
SS and NASH mice were prepared by feeding db/db mice with a standard diet and a methionine/choline-deficient diet, respectively. Control mice were prepared by feeding m/m mice with a standard diet. TYMP expression in the liver was evaluated by RT-PCR, western blotting, and immunohistochemistry. The biodistribution of [125I]IIMU in the three model mice was evaluated at 30 min post-injection. SPECT/CT imaging studies of the three model mice were performed 30 min after injection of [123I]IIMU.
Results
Hepatic TYMP expression level was the highest in the SS mice and the lowest in the NASH mice at both mRNA and protein levels. The immunohistochemistry experiment showed a patchy distribution of TYMP only in the liver of NASH mice. In the biodistribution study, the hepatic accumulation of [125I]IIMU was the highest in the SS mice and the lowest in the NASH mice. The SPECT/CT imaging study showed similar results to the biodistribution experiment.
Conclusion
Hepatic TYMP expression level may serve as a promising imaging biomarker for differential diagnosis of SS and NASH. SPECT imaging using [123I]IIMU potentially provides a novel noninvasive diagnostic method to differentiate NASH and SS.
Symbiotic bacteria Sodalis glossinidius, Spiroplasma sp and Wolbachia do not favour Trypanosoma grayi coexistence in wild population of tsetse flies collected in Bobo-Dioulasso, Burkina Faso
Authors: Mfopit Youssouf Mouliom , Bilgo Etienne , Boma Soudah , Somda Martin Bienvenu , Gnambani Jacques Edounou , Konkobo Maurice , Diabate Abdoulaye , Dayo Guiguigbaza-Kossigan , Mamman Mohammed , Kelm Soerge , Balogun Emmanuel Oluwadare , Shuaibu Mohammed Nasir , Kabir Junaidu
Published: August 2024

Background. Tsetse flies, the biological vectors of African trypanosomes, have established symbiotic associations with different bacteria. Their vector competence is suggested to be affected by bacterial endosymbionts. The current study provided the prevalence of three tsetse symbiotic bacteria and trypanosomes in Glossina species from Burkina Faso.
Results. A total of 430 tsetse flies were captured using biconical traps in four different collection sites around Bobo-Dioulasso (Bama, Bana, Nasso, and Peni), and their guts were removed. Two hundred tsetse were randomly selected and their guts were screened byPCR for the presence of Sodalis glossinidius, Spiroplasmasp., Wolbachia and trypanosomes. Of the 200 tsetse, 196 (98.0%) were Glossina palpalis gambienseand 4 (2.0%) Glossina tachinoides. The overall symbiont prevalence was 49.0%, 96.5%, and 45.0%, respectively for S. glossinidius, Spiroplasma and Wolbachia. Prevalence varied between sampling locations: S. glossinidius(54.7%, 38.5%, 31.6%, 70.8%); Spiroplasma (100%, 100%, 87.7%, 100%); and Wolbachia(43.4%, 38.5%, 38.6%, 70.8%),respectively in Bama, Bana, Nasso and Peni. Noteworthy, no G. tachhnoideswas infected by S. glossinidius and Wolbachia, but they were all infected by Spiroplasma sp. A total of 196 (98.0 %) harbored at least one endosymbionts. Fifty-five (27.5%) carried single endosymbiont. Trypanosomes were found only in G.p. gambiense, but not G. tachinoides. Trypanosomes were present in flies from all study locations with an overall prevalence of 29.5%. In Bama, Bana, Nasso, and Peni, the trypanosome infection rate was respectively 39.6%, 23.1%, 8.8%, and 37.5%. Remarkably, only Trypanosoma grayi was present. Of all trypanosome-infected flies, 55.9%, 98.3%, and 33.9% hosted S. glossinidius, Spiroplasma sp and Wolbachia, respectively. There was no association between Sodalis, Spiroplasma and trypanosome presence, but there was a negative association with Wolbachia presence. We reported1.9 times likelihood of trypanosome absence when Wolbachia was present.
Conclusion: This is the first survey reporting the presence of Trypanosoma grayi in tsetse from Burkina Faso. Tsetse from these localities were highly positive for symbiotic bacteria, more predominantly with Spiroplasma sp. Modifications of symbiotic interactions may pave way for disease control.
Driving Change: The Influence of Female Directors on ESG Performance in the Automotive Industry
Authors: Khan Kashif Ullah , Atlas Fouzia , Ali Wajahat
Published: August 2024

Board gender diversity has garnered significant attention in recent years as a component of internal governance. The automobile industry is a conventional sector characterized by its significant scale and the board of directors has historically been predominantly male. The share of female board members increased due to the rapid development of the new energy vehicle industry, which emerged as a combination of high-tech and traditional cars, in the last two decades. This study examines the relationship between the proportion of female directors and the environmental, social, and governance (ESG) performance of companies in the automotive sector. This study collected data on the proportion of female board members and environmental, social, and governance (ESG) ratings for 50 automotive industry businesses across 13 countries from 2002 to 2022. The findings indicate a positive relationship between the proportion of female serving as directors and the environmental, social, and governance (ESG) performance of automotive industry. Furthermore, this study demonstrates that there was no delay in the favorable correlation between the proportion of female directors and the environmental, social, and governance (ESG) performance of companies in the automotive sector.
JEL Classification G34 ∙ M14
Study of the correlation between choledochal cyst with intrahepatic and extrahepatic bile duct dilatation
Authors: Abdullahi khalid Mohamoud , Ali ahmed Faisal , Adan Mohamed Mohamoud , shu Qiang
Published: August 2024

Background
Choledochal cysts are congenital glitches categorized by dilatation of the bile ducts, which can arise in various forms distressing the intrahepatic, extrahepatic, or both parts of the biliary tree. The purpose of our study was to observe the relationship between the dilatation of intrahepatic and extrahepatic bile ducts and prognosis.
Methods
A total of 79 cases in which patients had undergone laparoscopic choledochal cyst excision surgery were conducted from August 2016 to October 2020 at a single Centre of the Children’s Hospital of Zhejiang University of School of Medicine. There was a total of 64 females and 15 males. The age ranged from 21 days to 14 years, with an average age of 2 years. Choledochal cysts were recorded retrospectively for their age, gender, clinical presentation, physical, laboratory, and histological findings, diagnostic methods, and operative procedures.
Results
Results revealed that ALT and AST (< 0.001) and PT (0.005), GGT (0.004), total bile acid (0.019) and blood Amylase (0.024) were statistically significant with the presence of intrahepatic or extrahepatic bile duct dilation with insignificant demographics features and PT (0.040), ALT (0.002), AST (0.007) and total bile acid (0.021) were considered to be statistically significant predictors. Similarly, in the presence of bile duct dilation, ALT (< 0.001) and AST (< 0.001) were statistically highly significant, whereas the rest of the indicators were found to be insignificant. In terms of Odds Ratio ALT and AST gave the lowest CI (95% of the confidence interval). In contrary, C- reactive Protein “CRP” showed the highest CI (95% of the confidence interval) which is (1.78), and PT comes after by showing (0.50) confidence interval.
Conclusions
Thus, it is statistically confirmed that PT and CRP exposure variables have the lowest risk factor of the presence of both intra and extrahepatic bile duct dilations in our 79 patients. Since the small CI indicates a higher precision of the OR, the ALT and AST exposure variables determine that it has a higher risk factor of the presence of intrahepatic and extrahepatic bile duct dilatations of the given respondents in this study Moreover, the research highlights the crucial significance of understanding the correlation between choledochal cysts, intrahepatic bile duct dilations, extrahepatic bile duct abnormalities, and their influence on prognosis. Accurate classification and early intervention are crucial for improving long-term outcomes and reducing the risk of complications.
Associations between hemoglobin A1c levels and platelet reactivity and their impact on outcomes in patients after coronary insertion of drug-eluting stents
Authors: wu Yilin , Jiang Xuan , Jiang Lijuan , Ji Hongyu , Liu Min , Li Weizhen
Published: August 2024

Background
Increased hemoglobin A1c levels indicate a poor cardiovascular prognosis; however, the associations between glycemic control, platelet reactivity assessed by thromboelastography (TEG), and outcomes after coronary stenting in the Chinese population are unclear. Our study aimed to determine whether HbA1c levels are related to platelet reactivity after the administration of a loading dose of clopidogrel and aspirin; therefore, there is an effort to intensify antiplatelet treatment in patients with poor glycemic control after percutaneous coronary intervention.
Methods
HbA1c levels were categorized into 3 groups: <6.5% (n = 1103, 48.12%), 6.5–8.5% (n = 341, 36.9%), and > 8.5% (n = 177, 14.9%). ROC (resistance to clopidogrel, ROC) and ROA (resistance to aspirin) were defined as the ADP (adenosine diphosphate.) inhibition rate of less than 30% and an AA (Arachidonic Acid.) inhibition rate of less than 50% by TEG, respectively. Multivariate Cox regression analysis was performed to evaluate HbA1c levels and the independent impact of the ROC curve on adverse events. Univariate logistic analysis was used to evaluate the associations between HbA1c levels and ROC. A restricted cubic spline was used to explore the nonlinear relationship between HbA1c and MACEs. Receiver operating characteristic analysis was conducted to assess the predictive value of HbA1c for MACEs.
Results
The incidence of ROC was 9.3% (151 of 1621), whereas that of ROC was 16.5% (268 of 1621). The ROC for each of the 3 groups significantly increased with increasing HbA1c levels [4.3% vs 7.1% vs 10.1%, p = 0.006]; however, the ROA did not [16.4% vs 17.7% vs 14.3%, P = 0.694]. Both HbA1c > 8.5 and 6.5 ≤ HbA1c ≤ 8.5 were significantly associated with ROC. However, after adjustment for other covariables, only the HbA1c > 8.5 subgroup remained significantly associated with ROC (3.356 [1.231, 9.234], p = 0.009). Compared with the HbA1c < 6.5 subgroup, the HbA1c˃8.5 subgroup was significantly associated with nonfatal MI (2.297 [1.275, 4.137], P = 0.006), ischemia-driven revascularization (3.845 [2.082, 7.101], p < 0.001) and MACE (3.142 [2.346, 4.206], < 0.001), but not all-cause mortality (2.371 [0.551, 10.190], 0.246), and remained associated even after fully adjusting for confounders at the 36-month follow-up. When considered a continuous variable, HbA1c had a positive correlation with MACEs, as indicated by the RCS. The AUC of HbA1c for the prediction of 36-month MACEs was 0.636 (0.612, 0.624; P < 0.001).
Conclusion
In our two-center large-scale study, HbA1c levels were positively correlated with ROC, but the adverse effect on clinical outcomes was driven by elevated HbA1c, which forecasted nonfatal MI and ischemia-driven revascularization, constituting an argument to intensify glycemic control in subjects with diabetes after intracoronary stent placement.
Bacterial pathogens associated with community-acquired pneumonia in children aged from 28 days to 10 years admitted in Dakahlia Governorate hospitals: a cross-sectional study
Authors: Elhindawy Samah A. , Mohammed Amira H. , Hassanin Eman. A. , Hussein Amira , Soliman Amir
Published: August 2024

Background
Community-acquired pneumonia (CAP) constitutes a significant public health burden, accounting for a substantial proportion of childhood hospital admissions. However, accurately diagnosing the specific bacterial etiology of CAP solely based on clinical presentation remains a substantial challenge. This study aimed to elucidate the spectrum and prevalence of bacterial pathogens responsible for CAP in a well-defined pediatric population.
Methods
A cross-sectional design was employed to investigate a cohort of 100 children diagnosed with CAP and admitted to hospitals across Dakahlia Governorate between January and August 2021. The inclusion criteria stipulated that participants be between 28 days and 10 years of age. Children younger than 28 days, exceeding 10 years of age, or with pre-existing chronic lung disease, immunodeficiency, documented hospital-acquired pneumonia, or other congenital anomalies were excluded from the study. All participants underwent comprehensive laboratory investigations, including C-reactive protein (CRP) measurement, blood culture, and either gastric lavage culture or sputum culture, as deemed clinically appropriate. Chest X-rays (CXR) were also performed for each participant.
Results
Analysis of blood culture isolates revealed Klebsiella pneumoniae (7%) as the most prevalent pathogen, followed by Staphylococcus aureus (5%) and Streptococcus pneumoniae (3%). Notably, Gram-negative bacteria exhibited a higher detection rate (52.7%) compared to Gram-positive bacteria (47.05%) within blood cultures. Klebsiella pneumoniae (13%) maintained its dominance in gastric lavage/sputum cultures, followed by Staphylococcus aureus (16%) and Streptococcus pneumoniae (3%). A significant proportion of patients (64%) exhibited no bacterial growth in these cultures.
Conclusion
This investigation identified Klebsiella pneumoniae and Staphylococcus aureus as the predominant bacterial pathogens associated with CAP in the study population. These findings contribute valuable preliminary data regarding the spectrum and frequency of bacterial etiologic agents in CAP among Egyptian children under 10 years of age. Future research endeavors with larger sample sizes and potentially incorporating molecular diagnostic techniques could provide more comprehensive insights into the evolving epidemiology of childhood CAP.
Trial registration
Our study was registered retrospectively with Clinicaltrials.gov under the identifier NCT06377163 on 19 April 2024.
Diagnosis of trigeminal neuralgia based on plain skull radiography using convolutional neural network
Authors: Han Jung Ho , Ji So Young , Kim Myung Ju , Kwon Ji Eyon , Park Jin Byung , Kang Ho , Hwang Kihwan , Kim Chae-Yong , Kim Tackeun , Jeong Han-Gil , Ahn Young Hwan , Chung Hyun-Tai
Published: August 2024

This study aimed to determine whether trigeminal neuralgia can be diagnosed using convolutional neural networks (CNNs) based on plain X-ray skull images. To this end, 166 skull images of patients aged > 16 years with trigeminal neuralgia diagnoses were compiled into a labeled trigeminal neuralgia dataset and 498 skull images of patients with unruptured intracranial aneurysms were compiled into a labeled control dataset. The images were partitioned into training, validation, and test datasets in a 6:2:2 ratio using random permutation. The accuracy and area under the receiver-operating characteristic (AUROC) curve were used to evaluate the classifier performance. Gradient-weighted class activation mapping was employed to identify the focal areas of attention. External validation was performed using a dataset obtained from another institution. We observed an overall accuracy of 87.2%, sensitivity and specificity of 0.72 and 0.91, respectively, and AUROC of 0.90 on the test dataset. In most cases, trigeminal neuralgia was predicted by observing the sphenoid body and clivus. The overall accuracy on the external test dataset was 71.0%, indicating the promise of deep learning-based models in distinguishing between X-ray skull images of patients with trigeminal neuralgia and control individuals. This is expected to serve as a useful screening tool after further development.
Preventing Renal Tubulointerstitial Fibrosis: Effect of Rosuvastatin on the HOXA13- USAG-1-BMP7 Pathway
Authors: Oh Donghwan , Kim Hyo Jeong , Kim Seok-hyung , Kim Soo Hyun , Kim Tae Yeon , Choi Hoon Young , Kim Hyunwook , Kim Hyung Jong , Park Hyeong Cheon
Published: August 2024

Statins act as antifibrotic agents but their mechanism is unclear. Therefore, we aimed to evaluate the antifibrotic effects of rosuvastatin in a chronic kidney fibrosis model in vivo and transforming growth factor-β1 (TGF-β1)-stimulated Madin-Darby canine kidney (MDCK) cells in vitro. Mice with unilateral ischemic reperfusion injury and contralateral nephrectomy (uIRIx) were administered vehicle or rosuvastatin (10 mg/kg/day by oral gavage) for four weeks and kidney fibrosis markers were analyzed. Moreover, control and homeobox protein Hox-A13 (HOXA13) knocked-down MDCK cells were stimulated with TGF-β1 (5 ng/ml) and then treated with rosuvastatin. The uIRIx mice developed severe tubulointerstitial fibrosis with increased α-smooth muscle actin (α-SMA), collagen I and uterine sensitization-associated gene-1 (USAG-1) expression, but rosuvastatin therapy attenuated these expression and improved fibrosis. Rosuvastatin also reduced Smad3 phosphorylation and increased Smad1/5/9 phosphorylation, both associated with bone morphogenic protein-7 (BMP-7) signaling. TGF-β1-stimulated MDCK cells exhibited increased α-SMA, fibronectin, vimentin, and collagen 1 expression, which rosuvastatin reversed. In addition, TGF-β1-stimulated MDCK cells demonstrated increased USAG-1 expression without changes in BMP-7 expression. Gene knockdown using HOXA13 siRNA suggested rosuvastatin decreased USAG-1 expression by increasing HOXA13 expression. Our results demonstrate that rosuvastatin inhibits kidney fibrosis by activating BMP-7 signaling via upregulation of HOXA13 and downregulation of USAG-1.
Novel and Cost-Effective CNC Tool Condition Monitoring Through Image Processing Techniques
Authors: Falah Alireza , Andó Mátyás
Published: August 2024

This paper introduces a novel and effective approach for tool condition monitoring (TCM) in CNC machining through the application of image processing techniques. Utilizing a consumer-grade camera capable of recording videos at 60 frames per second, the study demonstrates a cost-effective method for detecting tool breakage and identifying edge fractures. Basic image processing techniques, including frame extraction, background subtraction, thresholding, and morphological operations, are applied to analyze the captured images and videos. This research not only offers a practical solution to enhance the efficiency and accuracy of CNC machine operations but also aligns with advancements in smart manufacturing and Industry 4.0. Moreover, it paves the way for future research in this area, suggesting potential for further refinement and broader application of such monitoring techniques.
Endodontic Treatment Need Index (ETNI): A Comprehensive Index for Assessing Endodontic Treatment Needs in Traumatized Anterior Teeth
Authors: Enabulele Joan Emien , Sede Matthew Asizide , Chukwumah Nneka Maureen , Ehizele Adebola Oluyemisi
Published: August 2024

Background: The classification of traumatized anterior teeth has undergone significant developments over the years, with various systems offering distinct benefits and limitations. Despite these advancements, a more comprehensive and endodontic-focused approach to categorizing these injuries is needed. This study aims to introduce a novel classification system, the Endodontic Treatment Need Index (ETNI), which is specifically designed to assess and categorize traumatized anterior teeth on the basis of their endodontic treatment requirements. This system provides a more accurate and practical approach to managing these injuries, ultimately enhancing patient outcomes.
Methods: A prospective study was conducted at the University of Benin Teaching Hospital's dental center, which evaluated 391 cases of traumatized anterior teeth. Three classification systems were applied to each case: Ellis' classification, Andreasen's classification, and the novel Endodontic Treatment Need Index (ETNI) classification. This comparative analysis aimed to assess the effectiveness and applicability of each classification system in managing traumatized anterior teeth.
Results: The prevalence of anterior traumatic injuries was assessed viathree different classification systems. According to the Ellisclassification, Class II injuries were the most common (24.0%), followed by Class IV injuries (20.7%). Andreasen's classification revealed that enamel‒dentinefractures were the most prevalent type of trauma (24.6%), followed by complicated crown fractures (18.4%). The Endodontic Treatment Need Index (ETNI) classification revealedthat Grade 1b injuries were the most common (18.9%), followed by Grade 6 injuries (15.3%). The results indicate notable variation in the distribution of trauma types across the three classification systems.
Conclusion: This study demonstrates the potential of the novel Endodontic Treatment Need Index (ETNI) in the management and treatment planning of traumatized anterior teeth. While existing classifications provide valuable insights, the ETNI offers a unique perspective on endodontic treatment needs. Further research is necessary to validate the clinical applicability and reliability of the ETNI in various clinical settings, ultimately aiming to establish its utility in informing treatment decisions and enhancing patient outcomes. The ETNI has the potential to become a valuable tool in the armamentarium of dental professionals, ensuring more effective and personalized care for patients with traumatized anterior teeth.
The Relationship Between Serum Phenylalanine Levels, Genotype, and Developmental Assessment Test Results in Non-Phenylketonuria Mild Hyperphenylalaninemia Patients
Authors: İlgüy Müge , Yıldırım Gonca Kılıç , Eyüboğlu Damla , Çarman Kürşat Bora , Yarar Coşkun
Published: August 2024

Purpose: Phenylalanine (PA) levels below 360 μmol/L don't require treatment, however, cognitive deficits have been observed in patients with elevated PA levels, necessitating a safe upper limit for treatment and therapeutic objectives. The main purpose of this study is to evaluate the correlation between developmental assessments (Denver Developmental Screening Test-II [DDST-II] and Ankara Developmental Screening Inventory [ADSI]) and electroencephalogram (EEG) findings with blood PA levels and genotypic data in non-phenylketonuria mild Hyperphenylalaninemia (HPA) patients, to re-evaluate their treatment status based on potential adverse outcomes.
Materials and Methods: This study encompassed 40 patients aged 1-5 years diagnosed with HPA and not on treatment, identified through initial blood PA levels, and monitored for a minimum of one year on an unrestricted diet. Data on demographics, serum PA levels during presentation and follow-up, and genetic mutations were retrieved from hospital records. Patients were categorised into two groups as well-controlled (120-240 μmol/L) and at-risk (240-360 μmol/L) based on average PA levels. Sleep-activated EEGs and developmental assessments using the DDST-II and ADSI were conducted to compare outcomes with PA levels and genetic findings.
Results: Developmental delays in the DDST-II were observed across language, gross motor, fine motor, and personal-social domains, predominantly in males. No significant difference in delays was noted between the well-controlled and at-risk groups based on PA levels. The ADSI revealed delays in similar developmental areas, with fine motor skills being particularly prominently affected in the at-risk group. Only a well-controlled patient showed abnormal EEG results deemed unrelated to HPA.
Conclusion: Our findings indicate that children with untreated PA levels above 240 µmol/L are particularly susceptible to fine motor skill impairments, suggesting a need to reassess the PA level thresholds for initiating treatment. This study highlights the potential requirement for amending current guidelines to ensure early and appropriate intervention in non-PKU mild HPA patients, thereby mitigating the risk of developmental delays.
Diagnosis and management of chronic intractable otitis media as an initial manifestation of antineutrophil cytoplasmic antibody-associated vasculitis (AAV)
Authors: Hong Ji Song , Jung Da Jung , Yoo Myung Hoon , Kwon Eun hye , Han Seung woo , Lee Kyu-Yup
Published: August 2024

Antineutrophil cytoplasmic antibody (ANCA)-mediated otitis media is rare, posing challenges for diagnosis and treatment. This study aimed to facilitate the diagnosis and understanding of the clinical features of intractable otitis media as the initial manifestation of ANCA-associated vasculitis (AAV) and provide a compelling basis for refining treatment guidelines specific to this rare condition. We retrospectively analyzed the medical records of patients exhibiting intractable chronic otitis media as their initial AAV. The most common initial symptoms were intractable chronic otitis media with effusion or otorrhea, unresponsive to standard treatments, leading to progressive hearing loss and facial palsy. Patients exhibited characteristic tympanic membrane findings, including typical vasodilated hypervascularity. Facial palsy was a common accompanying symptom, affecting 60% of the patients. Following a treatment regimen involving a combination of corticosteroids and immunosuppressants, otitis media subsided, restoring hearing. After initiating treatment with corticosteroids and immunosuppressants, all patients experienced significant improvement, with no reported relapses. Intractable chronic otitis media, as the initial presentation of AAV, originated from the middle ear before progressing to other organs, potentially causing severe otologic complications such as facial palsy and hearing loss. However, timely diagnosis of ANCA-associated otitis media and initiation of treatment should be considered to improve clinical outcomes.
EHD1 Modulation in Hypoxic Preconditioning of SHED Enhances Angiogenesis: A Preliminary Research
Authors: Zhu Ningxin , Wang Dan , Xie Fei , Qin Man , Wang Yuanyuan
Published: August 2024

Objectives
The primary objective of this study was to explore the effects of hypoxic preconditioning on stem cells derived from human exfoliated deciduous teeth (SHED) and to identify key molecular regulators that facilitate vascularized differentiation. The research question addressed was how hypoxic conditions influence SHEDs to induce angiogenesis and whether specific molecular targets can be manipulated to enhance this process.
Materials and Methods
SHEDs were subjected to hypoxic preconditioning, and their behavior was assessed under controlled conditions. Cellular responses were evaluated through whole exome sequencing, which led to the identification of Eps15 homology domain-containing protein 1 (EHD1) as a significantly altered gene. The role of EHD1 was investigated through a series of in vitro and in vivo experiments, including post-transcriptional modification analysis, assessment of cytoskeletal protein regulation, measurement of VEGF secretion and downstream pathway investigation.
Results
Hypoxic preconditioning induced significant changes in SHEDs, particularly in the expression of EHD1. When the expression of EHD1 was inhibited, SHEDs were able to differentiate into larger vascular structures, with upregulated expression of vimentin and increased expression of VEGF and its receptors. This secretion, in turn, affects the recruitment of endothelial cells and influences angiogenesis.
Conclusions
This study demonstrates that EHD1 is a pivotal factor in the hypoxic preconditioning of SHEDs, playing a key role in the regulation of cytoskeletal proteins and influencing cytoskeletal and membrane behavior. By controlling the paracrine secretion of VEGF, EHD1 affects the recruitment of endothelial cells and angiogenesis.
Correlation analysis between serum NETs, FIB, miR-374a-5p levels and deep vein thrombosis in the lower limb after knee arthroplasty
Authors: gui zhongshan , Ning XianZong , Wang BeiYue , Li XiaoQiang
Published: August 2024

Objective
To investigate the changes in the levels of serum neutrophil extracellular traps (NETs), fibrinogen (FIB), and micro RNA-374a-5p (miR-374a-5p) after knee arthroplasty, and to analyze their correlation with postoperative deep vein thrombosis (DVT) and their predictive efficacy.
Methods
108 patients who underwent knee arthroplasty in Nanjing Pukou People's Hospital from September 2020 to May 2023 were selected for the study, and 32 patients in the DVT group and 76 patients in the non-DVT group were categorized according to the occurrence of lower limb DVT at 7 days after surgery. The clinical data of the two groups and the levels of serum NETs, FIB and miR-374a-5p in the preoperative period, 1 day postoperative period and 3 days postoperative period were compared and analyzed. Pearson's method was used to analyze the correlation between preoperative serum NETs, FIB, miR-374a-5p levels and the venous thromboembolism risk assessment scale (Caprini) score. Multifactorial logistic regression was used to analyze the factors influencing the occurrence of lower limb DVT after surgery. The predictive value of serum NETs, FIB, and miR-374a-5p levels on the occurrence of postoperative lower limb DVT was evaluated by using receiver operating characteristic curve(ROC) and area under the curve (AUC).
Results
The levels of serum NETs, FIB, and miR-374a-5p were higher in the DVT group than in the non-DVT group at 1 day and 3 days postoperatively (P<0.05); the levels of preoperative serum NETs, FIB, and miR- 374a-5p were positively correlated with the Caprini score (P<0.05); The Caprini score and elevated levels of serum NETs,FIB,and miR-374a-5p at 3 days after surgery were independent risk factors for postoperative lower limb DVT (P<0.05);The combined prediction of serum NETs,FIB,and miR-374a-5p levels at 3 days after surgery for AUC in lower limb DVT was greater than that predicted by single indicators ( P<0.05).
Conclusion
The levels of serum NETs,FIB, and miR-374a-5p in patients with DVT after knee arthroplasty increase.Combined detection of their levels has certain predictive value for the occurrence of postoperative lower limb DVT.
Study of the RTM effect in gravity disturbances and height anomalies at future IHRF stations in Brazil using different approaches, Digital Elevation Model with forests and buildings removed and lateral topographic density model
Authors: Padilha Thiago Kerr , Rodrigues Tiago Lima
Published: August 2024

The present work aimed to evaluate the use of different approaches (rectangular prisms, polyhedrons, tesseroids and point mass) in spatial domain to provide RTM gravity disturbance and height anomaly at future IHRS stations in Brazil. The RTM gravity disturbances are calculated only at the stations as example, since they possibly contribute more to the calculation of the anomalous potential via Hotine’s integral (innermost zone). For the numerical tests, FABDEM V1-2 Digital Elevation Model (DEM) has been tested. In the case of stations in coastal regions, additional bathymetric data from the SRTM15+ DEM have been used to complement the continental data. For the density information, we have used the UNB_TopoDensT_2v01 model with 30 arc sec resolution. As results, in terms of RTM height anomaly, the values obtained by each approach separately were concordant at submillimeter level, regardless of integration radius value. For RTM gravity disturbances the differences reached mGal level. In this case, the use of combined approaches has also been tested. For accuracy analysis, the computed RTM values ​​were compared with reference values. For the case of gravity disturbance, there was no tendency for better or worse results using a given approach. In the context of density values, the divergences reached up to approximately 5 mm in RTM height anomaly and 1 mGal in gravity disturbance. The use of FABDEM V1-2 in substitution to the COPERNICUS 30 DEM proposed differences of approximately 4mgal in relation to gravity disturbances, while for height anomalies, the difference varied between 1mm and 5mm.
Evaluation of Pathology Resources for Cervical Cancer Detection Between 2018 & 2022: a Retrospective Study at Moi Teaching and Referral Hospital, Western Kenya
Authors: Anangwe Nelson , Steimgrimson Jon , Cu-Uvin Susan
Published: August 2024

Background: Cervical cancer cases are increasing in sub-Saharan Africa, particularly in Kenya, exacerbated by inadequate histopathology resources, posing a significant barrier to timely diagnosis and treatment. There has been little research on the availability and evolution of histopathology resources for diagnosing cervical cancer over the years. This retrospective study evaluated this evolution at Moi Teaching and Referral Hospital in Kenya between 2018 and 2022.
Methods: We used a mixed-methods approach. An in-depth interview was conducted with one of MTRH’s pathology laboratory staff to assess the equipment, personnel, and quality control trends between 2018 and 2022. A thematic analysis was conducted in NVivo. We also retrospectively conducted a comprehensive inventory review of laboratory resources from 2018-2022 via purposive sampling. Microsoft Excel and Stata version 17 were utilized for descriptive statistical analysis. Turnaround time (TAT) was assessed against the UK’s National Health Service Cervical Screening Program guidelines.
Results: The number of histopathology laboratory personnel at MTRH increased from 2018 to 2022, during which the facility included two pathologists, one records person, and one office administrator. Patient annual visits increased from approximately 350,000 in 2018 to approximately 500,000 in 2022. However, the histopathology personnel-to-population ratio decreased from 1.5 pathologists and 2.7 histo-technicians per 100,000 in 2018 to 1.4 pathologists and 1.8 histo-technicians per 100,000 in 2022. Despite this decrease, lab equipment, automatic tissue processors and embedding machines were added, and an average 14-day turnaround time was maintained for pathology reports.
Conclusions: Despite a decreased personnel-to-patient ratio, the addition of crucial histopathology equipment mirrors the operational commitment of the Moi Teaching and Referral Hospital. The 14-day TAT is commendable, contributes to operational effectiveness and significantly contributes to timely detection. The hospital's dedication to upgrading its infrastructure underscores a proactive approach to addressing growing healthcare demands and improving patient outcomes, even with limited human resources. The decline in the personnel-to-patient ratio underscores challenges in diagnosis, emphasizing the need to address workforce and infrastructure gaps to improve patient care within similar low-resource settings.
Culture, community, and cancer: Understandings of breast cancer from a non-lived experience among women living in Soweto
Authors: Malope Seemela D. , Norris Shane A. , Joffe Maureen
Published: August 2024

Background Individual perceptions compounded with socio-cultural beliefs and health system factors are key determinants of people’s health seeking behavior and are widely cited as the causes of delayed breast cancer diagnosis among women from structurally vulnerable settings. Asking: “how do women with a non-lived experience of cancer understand the disease and, what informs their health seeking behaviors?”, we explored individual, sociocultural and health system elements from a conceptual model derived from the Socioecological, Health Belief and Cancer Stigma Frameworks, to understand perspectives of breast cancer in a South African urban community setting.Methods Using a deductive approach, we conducted a qualitative study consisting of 6 focus group discussions among 34 women from Soweto, Johannesburg (aged 35–74 years) and followed-up with 20 semi-structured in-depth interviews.Results Findings revealed some awareness of breast and other cancers, but confusion and gaps in understanding of the disease, resulting in socio-culturally influenced misperceptions of risks, causes, and outcomes following treatment of breast cancer. This fueled perceptions of profound fear and stigma against people with breast and other cancers. These findings together with participant perceptions of primary healthcare providers being unwelcoming, under-resourced, and insufficiently trained to deal with breast cancer, resulted in women reporting being reluctant to participating in screening/early detection care seeking behavior. They only accessed primary care when experiencing extreme pain or ill-health. Participants suggested as solutions for future interventions, the need for sustained community engagement, harnessing existing clinic and community stakeholders and resources to provide clear and understandable breast cancer information and encouragement for screening uptake.Conclusions Health literacy gaps surrounding breast cancer fuels socio-culturally influenced misperceptions, fear, stigma, and fatalism among community women from Soweto, South Africa. Women perceive primary care providers of having insufficient knowledge, skills, and resources to provide effective breast cancer screening services. Participants suggested the need for greater community engagement involving primary clinics and existing community stakeholders working hand in hand. Clear, understandable, and consistent information about breast cancer must be regularly disseminated and communities must be regularly encouraged to utilise breast cancer screening services.
Structural Barriers to Primary Care Among Sex Workers: Findings from a Community- Based Cohort in Vancouver, Canada (2014–2021)
Authors: Harris Miriam TH , Shannon Kate , Krüsi Andrea , Zhou Haoxuan , Goldenberg Shira M
Published: August 2024

Background: Due to structural marginalization, sex workers experience health inequities including a high prevalence of sexually transmitted and blood-borne infections, mental health disorders, trauma, and substance use, alongside a multitude of barriers to HIV and substance use services. Given limited evidence on sex workers’ broader primary healthcare access, we aimed to examine structural factors associated with primary care access among sex workers over a 7-year period.
Methods Data were derived from An Evaluation of Sex Workers Health Access (AESHA), a community-based open prospective cohort of women (cis and trans) sex workers in Metro Vancouver, from 2014 to 2021. Descriptive statistics were used to summarize the proportion of primary care use in the past six months and to assess primary care trends over time from 2014-2021. We used multivariate logistic regression with generalized estimating equations (GEE) to identify structural factors associated with primary care access (seeing a family doctor in the last six months), after adjusting for confounders.
Results: Amongst 646 participants, most (87.4%) accessed primary care at some point during the study period, and primary care use in the in the last 6 months was relatively stable (ranging from 60-78%) across each follow-up period. At first available observation, participants faced a high burden of sexually transmitted and blood-borne infections (STBBIs) (48.0%, 11.5%, and 10.4% were HCV, HIV, or STI seropositive, respectively), 56.8% were diagnosed with a mental health disorder, 8.1% had recently overdosed, and 14.7% were recently hospitalized. In multivariable GEE analysis, exposure to intimate partner violence was associated with reduced access to primary care (Adjusted odds ratios (AOR) 0.63, 95% Confidence interval (CI): 0.49 - 0.82), and limited English fluency was marginally associated (AOR 0.76 CI: 0.51 - 1.14).
Conclusions: This study characterized primary care access and its structural determinants among sex workers over 7-years. Participants faced a high burden of STBBIs and other health disparities, and a proportion faced gaps in primary care access. Scale-up of trauma-informed, culturally and linguistically tailored, sex worker-friendly primary care models are needed, alongside structural interventions to decriminalize and destigmatize sex work and substance use.
In-Person Vs Mobile App Facilitated Life Skills Education to Improve the Mental Health of Internally Displaced Persons in Nigeria: Protocol for the RESETTLE-IDPs Cluster Randomized Hybrid Type 2 Effectiveness-Implementation Trial
Authors: Eboreime Ejemai , Obi-Jeff Chisom , Orji Rita , Ojo Tunde M , Iyamu Ihoghosa , Harri Bala I , Said Jidda M , Oguntimehin Funmilayo , Ibrahim Abdulrahman , Anjorin Omolayo , Duke Andem Effiong Etim , Musami Umar Baba , Liebenberg Linda , Crider Raquel , Wagami Lydia , Dahiru Asmau MC , Uneke Jesse C. , Yaya Sanni , Agyapong Vincent IO
Published: August 2024

Background: Internally displaced persons (IDPs) in Nigeria face a high burden of mental health disorders, with limited access to evidence-based, culturally relevant interventions. Life skills education (LSE) is a promising approach to promote mental health and psychosocial well-being in humanitarian settings. This study aims to evaluate the effectiveness and implementation of a culturally adapted LSE program delivered through in-person and mobile platforms among IDPs in Northern Nigeria.
Methods: This cluster-randomized hybrid type 2 effectiveness-implementation trial will be conducted in 20 IDP camps or host communities in Maiduguri, Nigeria. Sites will be randomly assigned to receive a 12-week LSE program delivered either through in-person peer support groups or WhatsApp-facilitated mobile groups. The study will recruit 500 participants aged 13 years and older. Intervention effectiveness outcomes include the primary outcome of change in post-traumatic stress disorder (PTSD) symptoms assessed using the PCL-5 scale, and secondary outcomes of depression, anxiety, well-being, and life skills acquisition. Implementation outcomes will be assessed using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). Both sets of outcomes will be compared between the in-person and mobile delivery groups. Quantitative data will be analyzed using mixed-effects linear regression models, while qualitative data will be examined through reflexive thematic analysis. The study will be guided by the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework.
Discussion: The RESETTLE-IDPs study addresses key gaps in the evidence base on mental health interventions for conflict-affected populations. It focuses on underserved IDP populations, evaluates the comparative effectiveness of in-person and mobile-delivered LSE, and incorporates implementation science frameworks to assess contextual factors influencing adoption, fidelity, and sustainability. The study employs a community-based participatory approach to enhance cultural relevance, acceptability, and ownership. Findings will inform the development and scale-up of evidence-based, sustainable mental health interventions for IDPs in Nigeria and other humanitarian contexts.
Trial Registration: ClinicalTrials.gov, NCT06412679. Registered 15 May 2024,
https://clinicaltrials.gov/study/NCT06412679?tab=table
Spatial and Temporal Variation of Malaria Incidence in Children Under 10 Years in a Pyrethroid-Resistant Vector Area in Southern Benin
Authors: Dangbenon Edouard , Atchadé Mintodê Nicodème , Akogbéto Martin Codjo , Hounkonnou Mahouton Norbert , Assongba Landry , Akpovi Hilaire , Kulkarni Manisha A. , Protopopoff Natacha , Cook Jackie , Accrombessi Manfred
Published: August 2024

Background: Spatial and temporal identification of malaria-endemic areas is a key component of vector-borne disease control. Strategies to target the most vulnerable populations, the periods of high transmission and the most affected geographical areas, should make vector-borne disease control and prevention programmes more cost-effective. The present study focuses on the spatial and temporal dynamics of malaria cases and the exogenous factors influencing the transmission in an area with pyrethroid-resistant mosquito vector populations.
Methods: A prospective cohort study of 1,806 children under 10 years of age was conducted over 20 months to assess the risk of malaria incidence in the Cove-Zagnanado-Ouinhi (CoZO) health zone located in southern Benin. Childhood malaria data were used to identify malaria hotspots according to months of follow-up using the Kulldoff algorithm. Stability scores were calculated by season to assess incidence heterogeneity. Incidence values by month were aggregated with meteorological data; and demographic data were merged to detect cross-correlation between incidence and meteorological variables. Generalised equation estimators were used to identify the factors explaining the spatio-temporal heterogeneity of malaria incidence in the Cove-Zagnanado-Ouinhi (CoZO) health zone.
Results: We observed spatial heterogeneity in malaria transmission hotspots over the study period, with relative risks ranging from 1.59 (p-value=0.032) to 16.24 (p-value=0.002). Malaria incidence ranged from 1.41 (95% IC: 0.96-2.08) to 13.91 (95% IC: 12.22-15.84) cases per 100 child-months. We also found that there was a significant negative association (correlation coefficient =-0.56) between malaria incidence and temperature; and a slightly positive association (correlation coefficient = 0.58) between malaria incidence and rainfall.
Conclusion: Our results have shown that high-resolution satellite data can be used on a small scale to find the relationship with vector-borne diseases such as malaria.