bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on current assisted flexible mold micro-forming process based on single channel
Authors: Zhao Qingjuan , Wang Gui , Sun Jinchao , Zhang Ruoyu , Zhou Lejia , Qu Yunfei
Published: February 2025

Aiming at the problems such as poor forming accuracy and serious thickness thinning in sheet metal bulging, a method of current-assisted flexible mold forming was proposed. The single channel flexible mold forming experiment was carried out with 304 stainless steel sheet as the experimental material. Firstly, the microstructure change of the sheet under the action of current was analyzed. Then, the flexible mold bulging law of stainless steel sheet was explored from two aspects of current intensity and pressure holding time. Finally, the difference between the traditional rigid mold and the flexible mold is compared. The experimental results show that with the increase of the pretreatment current, the fibrous distribution in the thickness direction of the sheet is alleviated, the work hardening is weakened, the bulging depth of the flexible mold is gradually increased, and the wall thickness distribution is more uniform. When the current is 25A, the bulging depth of the rolled sheet increases from 841um to 903um, an increase of about 7.4%. The thinning rate of rounded corners was reduced from the initial 30.05% to 12.74%. When the pressure holding time is increased from 1.5s to 3.5s, the wall thickness thinning in each area is improved, and the thinning at the rounded corner is reduced to about 10.66%. Under the same experimental parameters, the bulging of flexible mold is better than that of rigid mold, the single channel profile is clearer, the surface roughness is lower, and the forming performance is better.
Mechanical field assisted additive manufacturing of ultrahigh strength aluminum alloy
Authors: Liu Wenjie , Shen Shengnan , Meng Jinlong , Xiao Jiafeng , Li Hui , Du Hejun , Yin Qianxing , Tan Chaolin
Published: February 2025

Additive manufacturing of aluminum (Al) alloys has attracted significant attention in the aerospace industry. However, achieving ultrahigh strength (> 500 MPa) Al alloys remains challenging due to their intrinsic poor printability. Here, we report a novel hybrid additive manufacturing (HAM) approach to process ultrahigh strength AlMgSc alloy, which combines laser powder bed fusion (LPBF) with interlayer ultrasonic shot peening (USP). The results show that the interlayer ultrasonic shot peening depth reached ~700 µm, leading to almost full density and residual stress convection from tension to compression. The HAM method promotes equiaxed grain formation and refines grain due to grain recrystallizations. Interestingly, the HAM followed by aging treatment tailors the hierarchically multi-gradient structures, inhibits Mg element intragranular segregation and promotes the multi-nanoprecipitates (e.g., Al3(Sc, Zr) and Al6Mn) precipitation. Remarkably, the HAM followed by aging treatment achieves yield strength of 609 MPa and break elongation of 7.5 %, demonstrating ultrahigh strength and good ductility compared with other Al alloys manufactured by LPBF and forging as reported in the literature. The multi-strengthening mechanisms in this AlMgSc alloy are also investigated. The high-density Al3(Sc, Zr) precipitates are the main strengthening contributor, and unique hetero-deformation induced (HDI) strengthening (originates from the heterogeneous microstructures) further enhances the strength of the material. This work highlights a new way to process complex-structured ultrahigh strength Al alloy components by hybrid additive manufacturing.
Machine Learning Enhanced Metal 3D Printing: High Throughput Optimization and Material Transfer Extensibility
Authors: Zhang Yuanjie , Lin Cheng , Tian Yuan , Gao Jianbao , Song Bo , Zhang Hao , Wang Min , Song Kechen , Deng Binghui , Xue Dezhen , Yao Yonggang , Shi Yusheng , Fu Kun Kelvin
Published: February 2025

Metal 3D printing holds great promise for future digitalized manufacturing. However, the intricate interplay between laser and metal powders poses a significant challenge for conventional trial-and-error optimization. Meanwhile, the ‘optimized’ yet fixed parameters largely limit possible extensions to new designs and materials. Herein, we report a high throughput design coupled with machine learning (ML) guidance to eliminate the notorious cracks and porosities in metal 3D printing for improved corrosion resistance and overall performance. The high throughput methodologies are mostly on obtaining the printed samples and their structural and physical properties, while ML is used for data analysis by model building for prediction (optimization), and understanding. For 316L stainless steel, we concurrently printed 54 samples with different parameters and subjected them to parallel tests to generate an extensive dataset for ML analysis. An ensemble learning model outperformed the other five single learners while Bayesian active learning recommended optimal parameters that could reduce porosity from 0.57% to below 0.1%. Accordingly, the ML-recommended samples showed higher tensile strength (609.28 MPa) and elongation (50.67%), superior anti-corrosion (Icorr = 4.17×10−8A/cm2), and stable alkaline oxygen evolution for >100 hours (at 500 mA/cm2). Remarkably, through the correlation analysis of printing parameters and targeted properties, we find that the influence of hardness on corrosion resistance is second only to porosity. We then expedited optimization in AlSi7Mg using the learned knowledge and feed hardness and relative density, thus demonstrating the method’s general extensibility and efficiency. Our strategy can significantly accelerate the optimization of metal 3D printing and facilitate adaptable design to accommodate diverse materials and requirements.
Spectral sparse random feature decomposition and its application in rotating machinery composite fault diagnosis
Authors: Liu Zhijun , Zhou Jun , Wu Xing , tao liu
Published: February 2025

Sparse random mode decomposition (SRMD) is a new signal decomposition method that integrates sparse random feature models with clustering methods. The method firstly represents the input signal as a series of sparse random feature points in time-frequency space, then employs clustering algorithms to cluster these sparse feature points into different modes, and finally decomposes the signal into a series of modes. Due to its excellent signal decomposition capability, SRMD has been applied in various fields, including mechanical fault diagnosis, biological signal processing, and image processing. However, the performance of SRMD is constrained by its own hyperparameters, and the results are strongly influenced by the clustering method. To overcome these shortcomings, the spectral sparse random feature decomposition (SSRFD) is proposed. In the process of representing signal as sparse random features, we design the fault characteristic frequency amplitude energy ratio (FCFAER) index and employ zebra optimization algorithm (ZOA) to select two key parameters: window length and relative error coefficient. Thus, an optimal sparse spectrum representation of the signal is obtained to alleviate the effects of SRMD hyperparameters; in the process of mode separation, the sparse random feature correlation spectrum (SRFCS) is proposed, which indicates the frequency ranges of the sparse random feature points corresponding to different modes within the sparse spectrum of the signal. Lastly, the automatic division of SRFCS is realized through parameterless scale space division, so that the sparse random features can be reasonably classified and clustered into modes respectively, and the separation of different modes in the signal can be realized without using the clustering method. Finally, the viability and usefulness of the proposed method are proved through composite fault data from the rolling bearings and the RV reducer gears in rotating machinery. The results show that the method has good composite fault characteristics separation and extraction capability.
YOLOv8-ADDA: An Enhanced Algorithm for Real-Time Traffic Sign Detection
Authors: Zheng Xiaolong , Guan Zhiwei , Chen Qiang , Lu Xiaofeng , Xia Longqing
Published: February 2025

Existing deep learning-based traffic sign recognition methods often face challenges such as low accuracy, slow detection response, and limited applicability in real-world scenarios. This paper proposes an improved model based on YOLOv8, aiming to enhance detection accuracy and reduce model complexity. To achieve this, the Adaptive Downsampling (ADown) method is integrated into the Backbone Conv module, effectively reducing input feature dimensions and minimizing redundant parameters. Additionally, the Deformable Attention Transformer (DAT) mechanism is incorporated into the C2f module, dynamically adjusting the attention range to capture more relevant visual features. Furthermore, Wise and Efficient IoU (Wise-EIoU) is employed as the loss function to improve classification performance in object detection tasks.The proposed algorithm is evaluated on the Roadsign and CCTSDB2021 datasets, achieving significant performance improvements. On the Roadsign dataset, the model achieves a precision of 94.9%, with mAP50 and mAP50:95 reaching 97.1% and 85.9%, respectively, surpassing the YOLOv8n benchmark by 2.7% and 4.2% on the same metrics. The number of model parameters is reduced to 2.79M, reflecting a 7.5% decrease compared to YOLOv8n. To verify its practical applicability, experiments are conducted on the PIX miniature intelligent vehicle platform. The proposed model achieves an inference speed of 59 FPS, representing a15.6% improvement over the baseline, demonstrating its suitability for real-time traffic sign detection tasks. These results validate the effectiveness of the YOLOv8-ADDA model in improving detection accuracy and reducing computational complexity.
Akt Maintains Cell Size and Survival by Increasing mTOR-dependent Nutrient Uptake
Authors: Edinger Aimee L. , Thompson Craig B.
Published: July 2002

In multicellular organisms, constituent cells depend on extracellular signals for growth, proliferation, and survival. When cells are withdrawn from growth factors, they undergo apoptosis. Expression of constitutively active forms of the serine/threonine kinase Akt/PKB can prevent apoptosis upon growth factor withdrawal. Akt-mediated survival depends in part on the maintenance of glucose metabolism, suggesting that reduced glucose utilization contributes to growth factor withdrawal-induced death. However, it is unclear how restricting access to extracellular glucose alone would lead to the metabolic collapse observed after growth factor withdrawal. We report herein that growth factor withdrawal results in the loss of surface transporters for not only glucose but also amino acids, low-density lipoprotein, and iron. This coordinated decline in transporters and receptors for extracellular molecules creates a catabolic state characterized by atrophy and a decline in the mitochondrial membrane potential. Activated forms of Akt maintained these transporters on the cell surface in the absence of growth factor through an mTOR-dependent mechanism. The mTOR inhibitor rapamycin diminished Akt-mediated increases in cell size, mitochondrial membrane potential, and cell survival. These results suggest that growth factors control cellular growth and survival by regulating cellular access to extracellular nutrients in part by modulating the activity of Akt and mTOR.
Mutually independent and cilia-independent assembly of IFT-A and IFT-B complexes at mother centriole
Authors: Tasaki Koshi , Satoda Yuuki , Chiba Shuhei , Shin Hye-Won , Katoh Yohei , Nakayama Kazuhisa
Published: February 2025

The intraflagellar transport (IFT) machinery, containing the IFT-A and IFT-B complexes and powered by dynein-2 and kinesin-2 motors, is crucial for bidirectional trafficking of ciliary proteins and their import/export across the transition zone (TZ). Stepwise assembly of anterograde IFT trains was proposed previously; i.e., the IFT-B complex first forms a TZ-tethered scaffold with sequential incorporation of IFT-A, dynein-2, and finally kinesin-2. However, IFT-A and IFT-B complexes also demonstrate distinct localization to the basal body/mother centriole. We show that IFT-A, IFT-B, and dynein-2 complexes are recruited to the mother centriole independently of ciliogenesis. Furthermore, mother centriole recruitment of IFT-A and IFT-B can occur in the absence of IFT-B and IFT-A, respectively, and dynein-2 recruitment is independent of IFT-A and IFT-B. Expansion microscopy revealed that the IFT-A/IFT-B pool at the basal body is distinct from that at the TZ. We conclude that IFT-A and IFT-B are recruited to the mother centriole in a mutually independent and ciliogenesis-independent manner before IFT train assembly.
MYC regulation of the miR-92-Robo1 axis in Slit-mediated commissural axon guidance
Authors: Majumder Tanushree , Khot Bhakti , Suriyaarachchi Harindi , Nathan Anagaa , Liu Guofa
Published: February 2025

In the developing spinal cord, translational repression of Robo1 expression by microRNA-92 (miR-92) in precrossing commissural axons (CAs) inhibits Slit/Robo1-mediated repulsion facilitating commissural axon projection and midline crossing; however, the regulatory mechanisms governing miR-92 expression in the developing commissural neurons (CNs) are currently lacking. Here, we propose that the transcription factor MYC regulates miR-92 expression in the developing spinal cord (of either sex) to control Robo1 levels in precrossing CAs, modulating Slit/Robo1-mediated repulsion and midline crossing. MYC, miR-92, and Robo1 are differentially expressed in the developing chicken spinal cord. MYC binds to the promoter region upstream of the gga-miR-92 gene in vitro. MYC knockdown dramatically decreases miR-92 expression and increases chicken Robo1 (cRobo1) levels. In contrast, overexpression of MYC significantly induces miR-92 expression and reduces cRobo1 levels. MYC knockdown or overexpression results in significant inhibition or induction of miR-92 activity in the developing chicken spinal cord, respectively. Disruption of the MYC-dependent regulation of the miR-92-cRobo1 axis affects Slit2-mediated CA growth cone collapse in vitro and impairs CA projection and midline crossing in vivo. These results elucidate the role of the MYC-miR-92-cRobo1 axis in Slit2/Robo1-mediated CA repulsion and midline crossing.
Hospitalized Pediatric Patients: Risk Factors Related to the Development of Immobility-Related and Medical Device-Related Pressure Injuries
Authors: Nie Ann Marie , Delmore Barbara
Published: February 2025

GENERAL PURPOSE

To review risk factors for the development of medical device-related and immobility-related pressure injuries in hospitalized pediatric patients.

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will be better able to:

1. Describe trends in pressure injuries (PIs) for hospitalized pediatric patients as summarized in current literature.

2. Identify risk factors predictive of medical device-related and immobility-related PIs in hospitalized pediatric patients.

3. Summarize the methodology used to understand risk factors for developing PIs in the hospitalized pediatric patient population.

OBJECTIVE

To determine the pressure injury (PI) risk factors associated with medical devices and immobility in varied ages of the pediatric population and determine if there is an association between medical devices, immobility, and PI development.

METHODS

A retrospective study was performed on an established PI database with medical records reviewed for accuracy. The sample consisted of 799 children who developed a PI at a pediatric hospital in the upper Midwestern US. Multivariate logistic analyses were conducted to determine PI risk factors associated with medical devices and immobility in the pediatric population by age.

RESULTS

Five risk factors were predicative of a medical device-related PI for the entire sample; additional risk factors were specific to individual ages. Conversely, only one risk factor was statistically significant for predicting immobility-related PI in the total sample: decreased sensory perception (P = .035). Immobility was not associated with the development of medical device-related PIs.

CONCLUSIONS

Medical devices and immobility remain a major concern in relation to their propensity to cause PIs in hospitalized pediatric patients. Although this vulnerable population is beginning to garner more attention in the literature, the standard is to use adult PI risk factors for the pediatric population. Adult risk factors do not always equally translate to the hospitalized pediatric patient; however, clinicians use this “measuring stick” because research extricating the differences between these populations is limited. Understanding the unique PI risk factors in the pediatric population is key to preventing PIs among these patients.
Operation and Practice of the Scott-Munro Model: Risk Assessment of Intraoperatively Acquired Pressure Injuries
Authors: Wu Yanjun , Chen Yuting , Kong Weina , He Caiqin , Li Dongxue
Published: February 2025

OBJECTIVE

To evaluate the feasibility and effectiveness of the Scott-Munro (S-M) model in the dynamic assessment of intraoperatively acquired pressure injuries (IAPIs) in adults.

METHODS

This study included 8,254 patients who underwent surgery between October 2022 and September 2023. The S-M model was applied for the dynamic risk assessment of IAPIs. The first cycle was set as the baseline from October 1, 2022, to December 31, 2022, and cycles were set every 3 months thereafter. Each cycle was compared with the first cycle and the previous cycle, in terms of IAPI incidence, actual assessment rate of IAPIs in high-risk patients, and accuracy of IAPI assessment in high-risk patients.

RESULTS

The incidences of IAPIs in the four cycles were 0.52%, 0.27%, 0.09%, and 0.13%, respectively. The third and fourth cycles both differed significantly from the first cycle (P < .05). The actual assessment rates of IAPIs in high-risk patients in the four cycles were 13.01%, 47.20%, 90.96%, and 95.67%, respectively (P < .05). Similarly, the accuracy of the assessment of IAPIs in high-risk patients was 38.04%, 67.37%, 89.93%, and 86.58%, respectively, in the four cycles (P < .05).

CONCLUSIONS

The S-M model can reduce the incidence of IAPIs, dynamically and effectively evaluate IAPIs, and provide a basis for the management and prevention of IAPIs.
The 5-HT7 receptor contributes to increased hindquarter blood flow caused by skeletal muscle contraction.
Authors: Krieger-Burke Teresa , Yoder Elise , Frisbee Jefferson C. , Garver Hannah , Fink Gregory D , Watts Stephanie W
Published: February 2025

Serotonin (5-hydroxytryptamine, 5-HT) at low plasma concentrations reduces blood pressure and dilates some skeletal muscle arterioles in the rat. We hypothesized that the 5-HT7 receptor is essential for both 5-HT-induced changes in blood pressure and skeletal muscle arteriolar function. Male 5-HT7 receptor knock out (KO) rats under isoflurane anesthesia had a higher resting hindquarter vascular resistance [HQVR; mm Hg/ml/min; KO (16.0+2.0) vs WT (10.8+0.6.0), p = 0.04]; this was not observed in females. The reduction in blood pressure and HQVR caused by intravenous infusion of 5-HT (25 μg/kg/min) was attenuated (∼56%) in male and female KO rats vs WT. Left anterior descending (LAD) coronary arterial ligation was used to create a model of impaired hindquarter perfusion and exercise intolerance. The goal was to determine whether heart failure associated skeletal muscle blood flow abnormalities were affected by loss of a functioning 5-HT7 receptor in skeletal muscle vasculature. Transdermal neuromuscular electrical stimulation (NMES) was used to mimic exercise induced contraction of skeletal muscle and increase blood flow in the hindquarters (HQ). Male (M) and female (F) 5-HT7 receptor KO rats had a profoundly reduced ability to increase HQ flow during NMES vs WT (% increase from basal; M WT = 118.0+18.0 vs KO=14.6+7.1%; F WT= 101.0+12.0 vs KO = 7.6+6.0%), observed in sham and LAD rats. In a naive cohort of 5-HT7 WT and KO rats, NMES-induced increases in HQ flow did not occur in 5-HT7 receptor KO rats. The NMES-induced increase in HQ flow was also abolished in the presence of the 5-HT7 receptor antagonist SB269970 in normal Sprague-Dawley rats. Lectin visualization of gastrocnemius muscle microvasculature indicateded that the elevated HQVR at rest in male 5-HT7 receptor KO rats was not due to a reduced microvascular density vs the WT. We conclude that 5-HT acting at least in part via the 5-HT7 receptor may have a larger role in (patho)physiological regulation of the circulation than has been heretofore appreciated.
Systemic Lymphoma Masquerading as Birdshot Chorioretinopathy
Authors: Wei Elizabeth Y. , Popovic Marko M. , Christakis Panos G.
Published: February 2025

Purpose:

To report a rare case of systemic lymphoma causing a birdshot-like chorioretinopathy (BSCR) in a histocompatibility leukocyte antigen (HLA)-A29 negative patient.

Methods:

A 58-year-old man presented with a one year history of blurry vision and intermittent floaters. He had evidence of bilateral choroidal birdshot-like lesions which appeared atrophic without any vitritis. He had a history of low-grade B-cell lymphoma and chronic myeloid leukemia, both of which were diagnosed >10 years prior to presentation and treated with chemotherapy.

Results:

The differential diagnosis of these birdshot-like lesions included autoimmune, neoplastic, and infectious etiologies. Work-up revealed a negative HLA-A29, and negative results for syphilis and tuberculosis. Magnetic resonance imaging (MRI) revealed enhancement of the trigeminal and oculomotor nerve cisternal segments but no overt evidence of malignancy. Full field electroretinogram (ffERG) and multifocal electroretinogram (mfERG) tests were within normal limits. Serial follow-up clinical examinations, retinal imaging, ffERG and mfERG demonstrated no disease progression. Two years after his initial consultation, he developed a paraspinal mass which was biopsied and found to be diffuse large B-cell lymphoma (DLBCL) and was treated with chemotherapy.

Conclusion:

Clinicians should consider BSCR masquerade syndromes in patients that present with birdshot-like choroidal lesions with negative HLA-A29, history of lymphoma, or atypical characteristics. In this case, we suspect the patient’s past low-grade B-cell lymphoma and chemotherapy resulted in the chronic choroidal findings. It is unclear whether choroidal involvement predisposes a patient to high-grade transformation to DLBCL. His ocular findings remained inactive throughout the treatment of his DLBCL.
Diagnostic Accuracy of a Nasal Rapid Staphylococcus aureus PCR Test in Intubated Children With Severe Community-Acquired Pneumonia
Authors: Watson Joshua R. , Delerme A. Anyélika , Toocheck Corey , Karsies Todd
Published: February 2025

Observational studies demonstrate that nasal methicillin-resistant Staphylococcus aureus (MRSA) surveillance swabs have a high negative predictive value for MRSA infections. This prospective study of 94 children intubated for severe pneumonia showed a negative predictive value of >99% for rapid MRSA nasal polymerase chain reaction swabs performed at diagnosis, suggesting they could aid initial antibiotic prescription in critically ill children with pneumonia.
Where is the pain? Spatial patterns of pain co-occurrence in a population-based study of 4833 pain drawings incorporating network analysis
Authors: Evans David William , Liew Bernard Xian Wei , Andersen Johan Hviid , Mose Søren
Published: February 2025

Spatial pain patterns are widely used as diagnostic tools, yet population-level estimates, such as the prevalence of pain in specific body regions and likelihood of their co-occurrence, are lacking. Despite this, bilateral limb pain is considered relatively uncommon. Baseline data from a population-based Danish cohort were analysed. Twenty-one pain drawing regions, coded as binary “pain”/“no-pain” variables, were entered into an Ising model. Conditional dependencies between pairs of painful regions were quantified, while accounting for the pain state of other regions. Four-week prevalence of pain was also calculated for body regions. Of 4833 analysed pain drawings, 34.7% (1676) reported bilateral (upper or lower) limb pain and 32.3% (1561) reported symmetrical (mirrored) bilateral limb pain. Strongest positive edge weights of the Ising model were between mirrored contralateral regions; the strongest being between left and right hips (mean: 3.86, 95% confidence interval: 3.84-3.87). Next strongest edge weights were between spatially adjacent ipsilateral regions; the strongest being between the right hip and right buttock (mean: 2.72, 95% confidence interval: 2.71-2.74). Negative edge weights, indicating inhibitory relationships, were consistently seen between nonmirrored contralateral regions, the strongest being between regions adjacent to their mirrored contralateral counterparts. In conclusion, bilateral limb pain, particularly in mirrored regions, is more prevalent than previously thought. Pain co-occurrence is facilitated between mirrored contralateral regions and, to a lesser degree, between adjacent ipsilateral regions. An inhibitory effect occurs between nonmirrored contralateral regions, diminishing with increasing distance from the mirrored region. Potential inhibition between mirrored contralateral regions is likely overshadowed by the more dominant facilitation.
Development and Psychometric Testing of a Tool to Measure Nursing Care Intensity for Stroke Patients
Authors: Ferrara Amalia , Iovino Paolo , Magni Valentina , Dibuono Maria Rosa , Brunelli Tiziana , Mastrorocco Rosaria , Favilla Cinzia , Giacomelli Silvia , Cerchia Pio , Rasero Laura
Published: February 2025

BACKGROUND: Nurses play a crucial role in the care of stroke patients improving health outcomes. However, stroke nursing care is complex, and an instrument available to monitor the patient dependence over time and an efficient management of care would be beneficial for the stroke care units. The purpose of this study is to develop and psychometrically test an instrument to measure nursing care intensity for patients admitted to stroke units. METHODS: A 3-step process was implemented. First, item generation was performed based on an established theory. Second, content validity was assessed on the generated pool of items, and finally, the instrument was tested on a sample of 1200 stroke patients at admission and discharge time points, to test its psychometric properties. RESULTS: Item generation was driven by the theory of Roper-Logan-Tierney, and a total of 13 items were derived. Content validity led to the elimination of 5 items. The final instrument, the Chart of Nursing Assessment in Stroke (STROKE-CNA), was made of 8 items. Confirmatory factor analysis had a supportive fit (root mean square error of approximation = 0.077, comparative fit index = 0.99), indicating structural validity. Scores of the instrument at admission were significantly lower than at discharge (P < .001, Cohen d = 1.42), indicating longitudinal validity. The changes in STROKE-CNA scores between admission and discharge were positively correlated with the corresponding changes in scores on the Scandinavia Stroke Scale (r = 0.57, P < .001), confirming adequate responsiveness. The STROKE-CNA scores were negatively correlated with age (admission: r = −0.22, P < .001; discharge: r = −0.28, P < .001), indicating convergent validity. Internal consistency was adequate at 0.93, and interrater reliability was optimal, with Cohen kappa ranging between 0.61 and 0.99. CONCLUSIONS: The STROKE-CNA has promising validity and reliability when used for assessing nursing care complexity of patients admitted to stroke units.
Causal relationship between vitamin D and stress urinary incontinence: Two-sample Mendelian randomization study
Authors: Wang Chao , Sun Shuangquan , Wang Yong , Wang Hui , Li Hui , Wen Hui
Published: February 2025

Observational studies have found an association between vitamin D and stress urinary incontinence (SUI); however, this conclusion remains controversial, and the causal relationship is unclear. This study aimed to investigate the causal relationship between vitamin D and SUI using a Mendelian randomization (MR) approach. We conducted an MR analysis utilizing publicly available summary data from genome-wide association studies on European ancestry for SUI, vitamin D levels, vitamin D supplementation, and vitamin D deficiency. Regression models such as the inverse variance-weighted (IVW) method, MR-Egger, weighted median, and weighted mode were used for analysis, along with heterogeneity tests, sensitivity analyses, and pleiotropy assessments.MR analysis indicated that vitamin D levels, vitamin D deficiency, and vitamin D supplementation were not causally associated with SUI (IVW OR: 0.999, 95% CI: 0.992–1.006, P = .786); (IVW OR: 1.000, 95% CI: 1.000–1.000, P = .646); (IVW OR: 1.000, 95% CI: 1.000–1.001, P = .064). No evidence of horizontal pleiotropy or heterogeneity was found (P > .05). Our findings do not support a causal relationship between vitamin D and SUI. The incidental effect of SUI and vitamin D may be mediated by other factors, warranting further observational studies and clinical trials.
Evaluation of healthcare professionals’ knowledge of Alzheimer’s disease in government hospitals and healthcare centers: A cross-sectional study in Jeddah, Saudi Arabia
Authors: Alzahrani Yahya A. , Harbi Maan H. , Almalki Adel G. , Althomali Rana A. , Alorabi Roaa F. , Basulyman Bashaer S. , Alansari Khawla A. , Alzahrani Jasser A. , Alzahrani Dalia A. , Asuhaimi Ibrahim A. , Alzahrani Abdullah M. , Alkatheeri Ayed A.
Published: February 2025

Knowledge of Alzheimer’s disease (AD) among healthcare staff influences important aspects of care and is associated with better patient outcomes. This study aimed to assess the knowledge of AD among healthcare professionals working in government hospitals and healthcare centers in Jeddah, Saudi Arabia. This cross-sectional study used an online questionnaire to assess Alzheimer’s disease knowledge using the Alzheimer’s Disease Knowledge Scale (ADKS). Participants also self-rated their knowledge and reported their experience in dementia care and training. The study included 231 healthcare professionals, with 61.5% males and 38.5% females. Medical professionals demonstrated significantly higher mean ADKS score = 19.84 compared to pharmacy, nursing, and allied health professionals (P < .05). Other factors, such as gender, age, workplace setting, years of experience, and formal dementia training, showed no significant impact on ADKS scores (P > .05). However, participants with additional dementia-related learning experiences, such as workshops or self-directed study, had significantly higher scores (P < .05). A notable finding was the discrepancy between self-assessed and actual knowledge. Among those who rated themselves as “very knowledgeable,” only 10% achieved a very good ADKS score, while more than half failed the test. Conversely, those who rated themselves as having poor knowledge often performed better than expected, with many achieving good or very good ADKS scores 44.3% and 13.1%, respectively. This study highlights significant disparities in Alzheimer’s disease knowledge among healthcare professionals in Jeddah, with medical staff showing higher understanding. Tailored educational programs are needed to address these gaps and improve dementia care.
A novel T-cell proliferation-related model for predicting the prognosis of head and neck squamous cell carcinoma
Authors: Huang Wenkai , Zhao Mingyu , Li Yunshan , Xiang Junwei , Yang Lin , Wang Yuanyin , Chen Ran
Published: February 2025

Head and neck squamous cell carcinoma (HNSCC) have a poor prognosis since its high rates of metastasis and recurrence. T-cell proliferation-related genes (TRGs) act a significant role in tumor pathology through regulating the function, proliferation of immune cells. We designed and validated an individualized TRGs signature for predicting prognosis in HNSCC patients with risk estimation model. We screened out differentially expressed TRGs (DETRGs) in cancer tissues as opposed to paracancerous tissue. gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were used to investigate the functional involvement of TRGs in the TGCA HNSCC cohort. We constructed a TRG signature using 7 biomarkers which screened by univariate and multivariate analysis and reclassified the HNSCC patients into high- and low-risk group according to prognostic information. After Kaplan–Meier analyzing, we found that patients in high risk was extremely lower in survival than patients in low risk. Combining univariate and multivariate regression analysis, we prove that risk scores is an independent prognostic factor. Further, we explored the immune function and tumor mutation burden (TMB) of our prognostic model. Functional enrichment analyses suggested that TRGs mainly included in the biological pathways related to T-cell and other immune cell response. Different tumor microenvironment, immune cells and TMB can be distinguished clearly according to both risk stratification and subtype clustering. In this study, our team successfully identified specific T-cell proliferation-related genetic biomarkers of HNSCC and established a new prognostic model of HNSCC based on TRGs, which has the outstanding performance in predicting the prognosis of HNSCC.
Global systematic mapping of Vibrio species pathogenicity: A PRISMA-guided cluster-based analysis
Authors: Onohuean Hope , Nwodo Uchechukwu U.
Published: February 2025

Background:

A systematic global map on toxigenesis and genomic virulence of Vibrio spp. was analyzed for research progress to identify the emerging research patterns for establishing a database for designing future interventions.

Method:

The databases (Web of Science and Scopus) were analyzed with Voxviewer software to map the global scale of Vibrio spp. or virulence toxin/genes publications and standardized using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) strategies.

Results:

The results identified 1162 (Web of Science n = 620, Scopus n = 542), while 314 studies qualified for inclusion and were significantly analyzed on virulence toxin/genes. By co-citation analysis, 4-thematic clusters were developed from 6420 citations and a total reference of 9062. Cluster #1 (pathogenesis & virulence factors) and cluster #4 (host response factors) generated the utmost publications and citations (n = 40, 643) and the least (n = 7, 85) interest by the researcher. Whereas 8-thematic clusters were developed by bibliographic coupling technique analysis, cluster#1 and cluster#8 generated the utmost (n = 78, 1684) and least (n = 7, 81) publications and citations interest by the researcher.

Conclusions:

Our findings suggest that Vibrio toxigenesis and virulence factors are a complex field requiring an interdisciplinary approach consisting of interconnected perspectives that have important consequences for academics and policymakers.
Optimizing functional brain network analysis by incorporating nonlinear factors and frequency band selection with machine learning models
Authors: Hu Kaixing , Zhong Baohua , Tian Renjie , Yao Jiaming
Published: February 2025

The accurate assessment of the brain’s functional network is seen as crucial for the understanding of complex relationships between different brain regions. Hidden information within different frequency bands, which is often overlooked by traditional linear correlation-based methods such as Pearson correlation (PC) and partial correlation, fails to be revealed, leading to the neglect of more intricate nonlinear factors. These limitations were aimed to be overcome in this study by the combination of fast continuous wavelet transform and normalized mutual information (NMI) to develop a novel approach. Original time-domain signals from resting-state functional magnetic resonance imaging were decomposed into different frequency domains using fast continuous wavelet transform, and adjacency matrices were constructed to enhance feature separation across brain regions. Both linear and nonlinear aspects between brain regions were comprehensively considered through the integration of complex correlation coefficient and NMI. The construction of functional brain networks was enabled by the adaptive selection of optimal frequency band combinations. The construction of the model was facilitated by feature extraction using tree models with extreme gradient boosting. It was demonstrated through comparative analysis that the method outperformed baseline methods such as PC and NMI, achieving an area under the curve of 0.9054. The introduction of nonlinear factors was found to increase precision by 14.25% and recall by 17.14%. Importantly, the approach optimized the original data without significantly altering the feature topology. Overall, this innovation advances the understanding of brain function, offering more accurate potential for future research and clinical applications.
Examination of factors causing postoperative pneumonia in elderly hip fracture patients: A narrative review
Authors: Ji Dongqi , Li Huanhuan , Jin Shasha , Tian Chunyan , Wu Liang
Published: February 2025

With the increasing aging problem, the number of fractures in the elderly is also increasing, of which hip fractures are more common, known as “the last fracture of life.” Postoperative pneumonia (POP) is a common complication of hip fracture, which greatly increases the mortality of patients. It is particularly important to clarify the factors of perioperative pneumonia for the prevention and treatment process. In this paper, the factors causing POP mainly include demographic factors, pre-injury comorbidities, blood index parameters, major clinical interventions and related mechanisms were reviewed, and the risk degree of the factors causing postoperative pneumonia was mainly discussed, and they were divided into independent factors and risk factors. The objective is to make the most accurate POP prevention measures for hip fracture patients according to the classification of independent factors and risk factors, and reduce the incidence of postoperative pneumonia.
Venous thrombosis related to duplicated inferior vena cava: A case report and systematic review
Authors: Chen Chun , Huang Di-Sheng , Chang Kuo-Song , Lai Yen-Chun , Su Yu-Jang
Published: February 2025

Rationale:

Swollen legs are commonly observed in clinical practice, and deep vein thrombosis (DVT) is 1 of the causes. Duplicated IVC (DIVC) is a relatively rare anomaly that results in DVT.

Patient concerns:

A 52-year-old male patient presented to the emergency department because of right leg swelling, pain, and redness for 3 days. His right leg was swollen from the sole to the thigh, with mild tenderness and local heat, without pitting edema.

Diagnoses:

Laboratory tests showed mild elevated C-reactive protein (CRP) 3.82 mg/dL (reference value: 0–0.79 mg/dL), and notably high levels of D-dimer (25,700 ng/mL; reference value: 0–653). Lower limb computed tomography angiography showed duplication of the IVC (DIVC) and was highly suspicious for venous thrombosis involving the right popliteal vein, superficial femoral vein, common femoral vein, external iliac vein, internal iliac vein, common iliac vein, and inferior vena cava (IVC).

Interventions:

Enoxaparin (80 mg) was administered subcutaneously, twice daily. After admission, catheter-directed thrombolysis and thrombectomy via the right superficial femoral and popliteal veins were performed.

Outcomes:

The congestion in the right lower leg improved, and the patient was discharged with rivaroxaban 15 mg twice daily 3 days later.

Lessons:

A systematic review using the keywords “duplication IVC,” “thrombosis” and “case report” was performed on PubMed until May 2023. Males accounted for 55.2% (16 of 29) of the cohort. The mean ± standard deviation age of the patients was 48.9 ± 17.9 years old. Pulmonary embolism was documented in 27.6% (8 29) of the cases. Regarding treatments, we found that 21 patients (72.4%) used anticoagulants, 20 patients (69.0%) received IVC filter placement, and 7 cases (24.1%) were treated by catheter-directed thrombolysis. Women had a higher proportion of popliteal vein and calf vein thrombosis, with a statistically significant difference (25% vs 61.5%, P = .047 < .05), (12.5% vs 53.8%, P = .017 < .05). The incidence of DIVC is around 0.3% to 0.7% with male predominance. A DIVC is a risk factor for DVT, especially in young people.
Current surgical management of malignant parotid tumors
Authors: Di Santo Davide , Deretti Alessandra , Vander Poorten Vincent
Published: February 2025

Purpose of review

Surgical treatment of parotid cancer presents challenges due to the rarity of the disease, the histologic heterogeneity, and the complex regional anatomy. Recently published international guidelines contain recommendations for surgical management of the primary tumor and the neck lymph nodes, but still allow both T and N to be managed in different ways. This review summarizes the remaining areas of discussion.

Recent findings

The reference treatment for parotid cancer is total parotidectomy; however, for low-grade, low-stage tumors a superficial parotidectomy may be sufficient. The cN+ neck requires a comprehensive neck dissection; for cN0 multiple valuable options remain. Frozen section analysis on level II nodes can guide the extent of neck dissection. The definition of ‘clear margins’ remains debated; close margins in low-grade tumors appear to be acceptable, positive margins always require additional treatment.

A thorough understanding of the guidelines, fine-tuned if needed based on accurate preoperative workup and intraoperative surgeon's decision-making will provide the best outcome for the patient with parotid cancer.
Coupled Plasma Filtration and Adsorption in Eliminating Inflammatory Mediators and Enhancing Sublingual Microcirculation in Severe Acute Pancreatitis
Authors: Zhou# Hongli , Ma Chunjian , Zhong ShengNian
Published: February 2025

Objective:

This study aims to assess the effectiveness of coupled plasma filtration and adsorption (CPFA) in patients with SAP through its effect on inflammatory mediators and sublingual circulating blood volume. The hypothesis put to test is that CPFA can achieve a satisfactory reduction in inflammatory mediators and enhance sublingual microcirculation in SAP with a very good clinical outcome.

Methods:

A cohort of 112 SAP patients admitted to the ICU of our institution between January 2018 and December 2022 was consecutively recruited. Participants were randomized to the CPFA or the control group (standard treatment) using a random number table for assignment. Post-treatment alterations in inflammatory mediators and sublingual microcirculation were analyzed and compared.

Results:

Following treatment, the study group showed significantly reduced levels of IL-1β, TNF-α, and IL-6 versus the control group. Additionally, the study group witnessed lower serum and urinary amylase levels and APACHE II and SOFA scores. Parameters related to sublingual microcirculation, including Total Vessel Density (TVDs), Small Vessel Perfusion Ratio (PPVs), Perfusion Small Vessel Density (PVDs), and Microvascular Flow Index (MFIs), were significantly improved in the study group. Moreover, the study group observed lower rates of Systemic Inflammatory Response Syndrome (SIRS) and 30-day mortality versus the control group.

Conclusion:

The application of CPFA in SAP patients effectively eliminates inflammatory mediators and enhances microcirculation, leading to improved clinical outcomes and reduced mortality rates.
Knowledge of breast cancer among nurses in a tertiary care center-a descriptive cross-sectional study
Authors: Shrestha Simangainda Deependra Man , Barma Aachal , Rawal Gunjana , Karn Mitesh , Bk Jeevan , Adhikari Jayaj
Published: February 2025

Objective:

This study aims to assess the knowledge and awareness of breast cancer among nurses, a critical component of the healthcare workforce. While many previous studies have focused on female participants and students, this study specifically targets nurses working in a tertiary care center, given their crucial role in patient education, early cancer detection, and facilitating timely medical intervention.

Methods:

A descriptive cross-sectional study was conducted among 235 nurses working in the various departments of a tertiary care center from August to September 2021. Data on breast cancer knowledge were collected using structured questionnaires with knowledge levels categorized as “good” or “poor” using the median score as a cut-off. The validity and reliability of the questionnaire were ensured through expert review and pilot testing. Descriptive statistics were used to present the findings.

Results:

Our study revealed overall good knowledge (64.7% correct answers) about breast cancer among the study participants. Most participants (93.2%) were aged 18–29, and 72.3% held a PCL nursing qualification. Only half of the respondents recognized obesity and smoking as risk factors, with common misconceptions including the belief that nulliparity and alcohol consumption are not risks. While over 90% identified breast lumps and enlargement as symptoms, only half recognized non-lump symptoms like nipple discharge and skin changes. Participants were highly aware of breast cancer detection tools, with nearly all recognizing clinical breast exams, mammography, and breast ultrasound. About 75.7% knew of biopsy, and 74.5% mentioned MRI. Mammography was the most commonly recognized screening tool (95.7%).

Conclusion:

While general awareness of breast cancer is high among nurses, specific gaps remain regarding certain risk factors and symptoms, including obesity, smoking, and non-lump breast cancer indicators. Targeted education through workshops or continuous medical education programs could enhance nurses’ ability to effectively educate and screen patients.
Factors Associated with Paid Service Use among Caregivers of Community-Dwelling Older Adults
Authors: Shin Ju Young , Pohlig Ryan T. , Habermann Barbara
Published: February 2025

This study aimed to describe paid service use among informal caregivers of community-dwelling older adults and to identify factors associated with paid service use using data from the Caregiving in the U.S. 2020. Home modification was the most used paid service (43.2%) followed by paid help (41%), outside transportation (22.5%), and respite care (14.5%) among 912 caregivers. Higher levels of caregiver education and household income, recipients' older age, greater numbers of recipient health conditions/problems, higher levels of care intensity, and providing medical/nursing tasks were associated with a greater number of paid service use. Home healthcare clinicians play an essential role in supporting informal caregivers in the community setting by assessing caregiving needs and the home environment during each visit and referring caregivers to appropriate state or federal caregiver support programs. Research examining the decision-making process regarding paid service use among older adults and their caregivers could provide an opportunity to deliver more patient/caregiver-centered services.