bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-domain Cross-task Knowledge Distillation Network for Unsupervised Domain Adaptation*
Authors: Ma Tai , Wang Chongwen , Zi Hai , Zhang Zeqing
Published: October 2023

Unsupervised domain adaptation has attracted extensive attention in recent years because it can naturally solve the problem of new domains encountered in depth model testing. Generally, unsupervised domain adaptive methods combine classification loss and adversarial loss, so that the features extracted from the model can be classified and are domain independent, thus alleviating the problems caused by cross domain models. However, it is impossible for the features extracted from the model to not contain any domain information. Therefore, we propose a new solution to make the source domain features extracted from the model fully include the style of the target domain images. Specifically, a compression network is trained by the target domain images, and the source domain features extracted by the classification network are distilled with the target domain image features extracted by the compression network to make it have the style of the target domain images. Finally, our method achieves leading or comparable results on five public data sets.
Testosterone Deficiency Promotes Arterial Stiffening Independent of Sex Chromosome Complement
Authors: Sakamuri Anil , Visniauskas Bruna , Kilanowski-Doroh Isabella , McNally Alexandra , Imulinde-Sugi Ariane , Kamau Anne , Sengottaian Divya , McLachlan John , Anguera Montserrat , Mauvais-Jarvis Franck , Lindsey Sarah , Ogola Benard Ojwang
Published: October 2023

Background Testosterone plays a vital role in men’s health. Lower testosterone level is associated with cardiovascular and cardiometabolic diseases, including inflammation, atherosclerosis, and type 2 diabetes. Testosterone replacement is beneficial or neutral to men’s cardiovascular health. Testosterone deficiency is associated with cardiovascular events. Testosterone supplementation to hypogonadal men improves libido, increases muscle strength, and enhances mood. We hypothesized that sex chromosomes (XX and XY) interaction with testosterone plays a role in arterial stiffening.Methods We used four core genotype male mice to understand the inherent contribution of sex hormones and sex chromosome complement in arterial stiffening. Age-matched mice were either gonadal intact or castrated for eight weeks, followed by an assessment of blood pressure, pulse wave velocity, echocardiography, and ex vivo passive vascular mechanics.Results Arterial stiffening but not blood pressure was more significant in castrated than testes-intact mice independent of sex chromosome complement. Castrated mice showed a leftward shift in stress-strain curves and carotid wall thinning. Sex chromosome complement (XX) in the absence of testosterone increased collagen deposition in the aorta and Kdm6a gene expression.Conclusion Testosterone deprivation increases arterial stiffening and vascular wall remodeling. Castration increases Col1α1 in male mice with XX sex chromosome complement. Our study shows decreased aortic contractile genes in castrated mice with XX than XY sex chromosomes.
Transcriptomic analysis of differentially expressed genes in the Winnie mouse model of chronic colitis
Authors: Ephraim Ramya , Fraser Sarah , Devereaux Jeannie , Sahakian Lauren , Stavely Rhian , Davidson Majid , Feehan Jack , Nurgali Kulmira , Apostolopoulos Vasso , Filippone Rhiannon
Published: October 2023

The Winnie mouse, carrying a missense mutation in the Muc2 gene, is a model for chronic colitis closely resembling the pathological changes of human IBD. Herein, transcriptomic analyses of the differentially expressed genes in the distal colon of Winnie mice with mild colitis and Winnie-Prolapse mice with severe colitis are compared to control C57BL/6 mice. Gene ontology analysis and KEGG pathway analysis demonstrated the upregulation of genes in immune and inflammation-related pathways, metabolic pathways, cancer-related pathways, and neurological processes. Further research into these pathways and individual genes may lead to the identification of new targets for the treatment of IBD. The overexpression of oncogenes, in particular, may serve as an indicator of inflammation progressing to cancer.
Effect of Green Finance in Enhancing Green Innovation Efficiency in High-Tech Industry: Evidence from China
Authors: Xiao Yi , Shi Xiongtian , Kong Li
Published: October 2023

Green finance (GF) is acknowledged as a critical policy tool in China's sustainable development sector, with the goal of lowering the financial burden associated with ecological transformation for Chinese firms. This paper investigates the impact of GF on the green innovation efficiency (GIE) of the high-tech industry (HTI) under carbon neutrality using a panel dataset covering 30 provinces, autonomous regions, and municipalities in China from 2013 to 2021 and deems that GF substantially enhances the GIE of HTI. The result remains after a series of robustness tests. Furthermore, this paper employs a threshold panel regression model to explore the threshold effect of industrial agglomeration on the relationship between GF and GIE. Furthermore, a threshold panel regression model is used in this study to investigate the threshold impact of industrial agglomeration on a connection between GF and GIE. In order to explore the threshold effect of industrial agglomeration on the link between GF and GIE, the study additionally utilizes a threshold panel regression model. It's interesting to note that the research demonstrates the existence of a threshold impact in each of the three characteristics of agglomeration: specialization, diversity, and competition. By providing enhanced financial support to enterprises, GF effectively reduces the costs associated with green transformation, thereby boosting HTI's GIE. This study not only identifies the external factors that influence GIE but also offers valuable theoretical insights and implications for the implementation of GF. As a result, it contributes to a better understanding of the role of GF in promoting sustainable development within China's high-technology industry.
Community perspectives regarding preparedness, response and prevention of Ebola Virus Disease amidst COVID-19 pandemic, an exploratory descriptive qualitative study using a community Engagement approach (CES) in Mbale city
Authors: Kagoya Enid Kawala , Nsubuga Allan G. , Ewing Helen , Atuhairwe Irene , Ijangolet Esther , Otim Eric , Ronald Kibuuka , Jesca Atugonza , Okibure Ambrose , Okello Francis , Nakattudde Prossy , Nyangoma Faith , Namara Racheal , Nakabaale Mark , Nakawuki Ashley , Kizito Prisca , Waako Paul , Wandabwa Julius , Musaba Milton , Ahaisibwe Bonaventure , Barugahare Banson
Published: October 2023

Background: Ebola virus disease (EVD) is a rare and deadly infectious hemorrhagic fever disease. Four of the 6 known Ebola virus species can cause human disease. Since 1976, EVD outbreaks have been recorded sporadically in East, Central, and West Africa. Uganda has experienced 6 documented outbreaks of EVD since 2000 that can be attributed to 3 species of Ebola viruses (Zaire, Sudan, and Bundibugyo). Despite substantial advances in clinical management, the case fatality ratio for EVD remains high, reaching more than 60% for the Zaire Ebola virus in 2018–2020.
Methods. The study followed a descriptive qualitative study design. Data were collected using an interviewer-administered questionnaire with both closed and open-ended questions. Data were analyzed using ATLAS Pro.
Results: Our results illustrate the lack of health education in the community among the different categories of people and this comes from an emic perspective (country). We identified 4 high-level themes and 19 subthemes, (1) Knowledge of Ebola Virus Disease, (2) Prevention of EVD in the community, (3) Preparedness for Ebola Virus Disease and (4) community response to Ebola Virus Disease and the final thematic area (4) which included giving first aid, using traditional medicines, and approaching a health facility among others.
Conclusions: With all the available information in relation to the previous outbreaks in Uganda, it is surprising that less effort was made this time round to take local sensibilities and culture into account among other social factors contributing to the poor practices of masses toward the Ebola Virus Disease, preparedness, prevention and response.
Diet and lifestyle intervention-induced pattern of weight loss related to reduction of low attenuation coronary plaque burden
Authors: Henzel Jan , Kruk Mariusz , Kępka Cezary , Makarewicz-Wujec Magdalena , Wardziak Łukasz , Trochimiuk Piotr , Krysztofiak Hubert , Dąbrowski Rafał , Dzielińska Zofia , Maurovich-Horvat Pál , Demkow Marcin
Published: October 2023

Objective: To determine the association between body composition dynamics and low-attenuation coronary plaque (LAP) burden.
Subjects/Methods: 89 participants (40% women, 60±7.7 years) of the Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCO-CT) study with nonobstructive atherosclerosis confirmed in computed tomography angiography (CCTA), a randomized (1:1), single-center study were included into the analysis.
Interventions/Methods: Patients were randomly assigned to either experimental arm [intensive diet and lifestyle intervention atop optimal medical therapy (OMT)] or OMT alone over 66.8±13.7 weeks. Changes (∆) in body mass (BM) and body composition parameters, including total body fat (TBF), skeletal muscle mass (SMM), and fat-to-muscle ratio (FMR) were compared with CCTA-measured ∆LAP.
Results: BM reduction was significantly higher in the experimental (∆BM=-3.6±4.9 kg) vs. control arm (∆BM=-1.4±2.9 kg; p=0.015). In the experimental arm, TBF and FMR decreased [∆TBF=-3.4±4.8%; ∆FMR=-12.9 (-21.2,-4.3)%] and SMM increased (∆SMM=1.9±2.8%). Opposite changes were observed in the control arm [∆TBF=1.1±5.5%; ∆FMR=3.1(-5.3,10.7)%; ∆SMM=-0.7±3.2%; all interarm p<0.001]. ∆LAP was positively correlated with ∆BM, ∆TBF, and ∆FMR (r=0.45, p<0.001; r=0.300, p=0.004; r=0.233, p=0.028; respectively), and negatively with ∆SMM (r=-0.285, p=0.007). Multivariate linear regression analysis revealed the association of ∆LAP with ∆TBF and ∆FMR.
Conclusions: The study intervention resulted in BM reduction characterized by fat loss and skeletal muscle gain. This weight loss pattern may lead to reduction of high-risk coronary plaque.
The DISLOH study: comparative evaluation of the results between the ProFlor and Lichtenstein techniques for open inguinal hernia repair. A randomized controlled trial
Authors: Romano Giorgio , Buono Giuseppe Di , Rodolico Vito , Romano Giorgio , Barletta Gabriele , Zanghì Guido , Calò Pietro Giorgio , Buscemi Salvatore , Agrusa Antonino
Published: October 2023

The Lichtenstein open anterior approach with static flat meshes, the most popular inguinal hernia repair technique, has raised concerns regarding mesh fixation, defect patency, and poor quality biological response. To address these issues, the 3D dynamic ProFlor scaffold promoting a fixation-free hernia defect obliteration has been developed as an alternative. The results of open inguinal hernia repair with the ProFlor approach compared with those of the Lichtenstein repair were evaluated. In a time frame of 24 months two cohorts of patients were enrolled, 95 in the ProFlor group and 93 in the Lichtenstein group. ProFlor demonstrated superior outcomes compared to the Lichtenstein technique, with shorter procedure times, decreased intraoperative complications, and lower rates of postoperative complications. Additionally, ProFlor provided enhanced postoperative pain relief, faster return to daily activities, no long-term discomfort. No chronic pain was reported in ProFlor versus 11,8% of the Lichtenstein group. The results highlight the need to reevaluate the conventional Lichtenstein approach and align it with recent scientific progress.. Further consideration of the evolving understanding of inguinal pathophysiology and groin protrusion genesis is crucial for advancing surgical techniques.
Power, measurement error, and pleiotropy robustness in twin-design extensions to Mendelian Randomization
Authors: Castro-de-Araujo Luis FS , Singh Madhurbain , Zhou Yi , Vinh Philip , Maes Hermine HM , Verhulst Brad , Dolan Conor V , Neale Michael C
Published: October 2023

Mendelian Randomization (MR) has become an important tool for causal inference in the health sciences. It takes advantage of the random segregation of alleles to control for background confounding factors. In brief, the method works by using genetic variants as instrumental variables, but it depends on the assumption of exclusion restriction, i.e., that the variants affect the outcome exclusively via the exposure variable. Equivalently, the assumption states that there is no horizontal pleiotropy from the variant to the outcome. This assumption is unlikely to hold in nature, so several extensions to MR have been developed to increase its robustness against horizontal pleiotropy, though not eliminating the problem entirely (Sanderson et al. 2022). The Direction of Causation (DoC) model, which affords information from the cross-twin cross-trait correlations to estimate causal paths, was extended with polygenic scores to explicitly model horizontal pleiotropy and a causal path (MR-DoC, Minică et al 2018). MR-DoC was further extended to accommodate bidirectional causation (MR-DoC2 ; Castro-de-Araujo et al. 2023). In the present paper, we compared the power of the DoC model, MR-DoC, and MR-DoC2. We investigated the effect of phenotypic measurement error and the effect of misspecification of unshared (individual-specific) environmental factors on the parameter estimates.
Effects of arbuscular mycorrhizal fungi on root foraging and competitive ability between native and invasive plants
Authors: Yao Na-Na , Wang Xiao-Jing , Deng Hao-Hui , Fan Sheng-Qi , Zhang Hai-Jie , Peng Shao-Lin , Chen Bao-Ming
Published: October 2023

Background and Aims
Besides the direct uptake of nutrients by roots, plants can acquire nutrients through the aid of arbuscular mycorrhizal fungi (AMF). AMF play a crucial role in plant growth and competitive abilities. However, few studies have investigated the effects of AMF on root-foraging, and their interactive effects on competition between native and invasive species in response to heterogeneous nutrients.
Methods
Two invasive plants and their two co-existing native plants of the Asteraceae family were selected to create a common garden experiment involving three factors (heterogeneous vs. homogeneous phosphorus, with vs. without AMF inoculation, and monoculture vs. mixture).
Results
AMF significantly reduced the foraging scale of the invasive species, Bidens pilosa, and decreased the precision of the invasive species, Praxelis clematidea, and the native species, Emilia sonchifolia. There were significant interactive effects of AMF and phosphorus heterogeneity on plant biomass and nutrient uptake. Heterogeneity significantly decreased the tolerance ability of B. pilosa but increased that of P. clematidea. In the homogeneous treatment, AMF significantly decreased the suppression ability of B. pilosa, while in the heterogeneous treatment, AMF decreased that of P. clematidea. Heterogeneous phosphorus with AMF increased the suppression relative interaction intensity of B. pilosa but decreased that of P. clematidea.
Conclusion
The interactive effects of AMF and phosphorus heterogeneity on root foraging and competitive abilities differ between invasive and native plants and show invasive-native pair differences. These findings provide valuable insights into the interactive effects of AMF and roots on nutrient uptake and competition in different nutrient distributions.
Protocol for Prognosticating PPD Using EEG Changes during Labor Pain by Uterine Contractions: A Prospective Cohort Study in the First Stage of Labor
Authors: Wang Yan , He Wan-Ying , Zhan Chang' an A , Pan Shi-Lei , Wu Wen , Li Feng-Xian , Zhang Hong-Fei
Published: October 2023

Background
Lack of motivation and behavioural abnormalities are the hallmarks of postpartum depression (PPD). Severe uterine contractions during labour are pain triggers for psychiatric disorders, including PPD in women during the puerperium. Creating biomarkers to monitor PPD may help in its early detection and treatment. It has been suggested that uterine contraction-induced labour pain plays a role in the emergence of this syndrome. Therefore, abnormal electroencephalography (EEG) patterns during the early stage of labour may provide useful information. Here, we propose that aberrant EEG patterns caused by uterine contraction pain may be predictive markers for PPD.
Methods
This study is a single-centre prospective cohort planned for 330 parturients for vaginal delivery in the maternity ward of Zhujiang Hospital from 2021 to 2023. At baseline, online or paper-based questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS) and demographic data, will be collected at their final prenatal visit in the outpatient clinic. EEG, electrocardiography (ECG) and electrohysterography (EHG) signals will be monitored and recorded during the first stage of labour in the ward. Follow-up will be taken at the postpartum timepoints of day 3, day 42, and 3, 6 and 12 months, respectively. Power spectral density and functional connections will be quantified. The connections between PPD severity and EEG measurements as a function of time will be assessed using linear mixed-effects models. Maternal age, parity, and whether oxytocin is used during labour, all have an impact on the incidence of PPD, hence a stratified analysis will be carried out.
Discussion
We expect EEG changes caused by painful uterine contractions in the first labour may predict early PPD. The results from this study may act as a predictor for the development of PPD which may enhance long-term quality of life for the parturient and her offspring.
Trial registration:
Name of registry: EEG Changes of Uterine Contractions in the First Stage of Labor Predicting PPD. Trial registration number: NCT05217251; registration date on the ClinicalTrial.gov platform: March, 23/2022.
Long-term effectiveness and mediators of cognitive behavioural therapy among adults with attention- deficit/hyperactivity disorder: Secondary outcomes of a randomised controlled trial
Authors: Pan Mei-Rong , Dong Min , Zhang Shi-Yu , Liu Lu , li Hai-Mei , Wang Yu-Feng , Qian Qiu-Jin
Published: October 2023

Background: The long-term effectiveness of cognitive behavioural therapy (CBT) in medicated attention-deficit/hyperactivity disorder (ADHD) adults with residual symptoms needs to be verified across multiple dimensions, especially with respect to maladaptive cognitions and psychological quality of life (QoL). An exploration of the mechanisms underlying the additive benefits of CBT on QoL in clinical samples may be helpful for a better understanding of the CBT conceptual model and how CBT works in medicated ADHD.
Methods: We conducted a secondary analysis of a randomised controlled trial including ninety-eight medicated ADHD adults with residual symptoms who were randomly allocated to the CBT combined with medication (CBT+M) group or the medication (M)-only group. Outcomes included ADHD-core symptoms (ADHD Rating Scale), emotional symptoms, maladaptive cognitions (Automatic Thoughts Questionnaire and Dysfunctional Attitude Scale), and psychological QoL (World Health Organization Quality of Life-Brief Version-psychological domain). Mixed linear models (MLMs) were used to analyse the long-term effectiveness at the 48-week follow-up, and structural equation modeling (SEM) wasperformed to explore the potential mechanisms of CBT on psychological QoL.
Results: ADHD patients in the CBT+M group outperformed the M-only group in reduction of ADHD core symptoms (d= 0.491), depression symptoms (d = 0.570), a trend of reduction of maladaptive cognitions (d = 0.387 and 0.395, respectively), and improvement of psychological QoL (d = -0.454). The changes in the above dimensionscorrelated with each other (r = 0.201~0.636). The influence of CBT on QoL was mediated through the following four pathways: 1) changes in ADHD core symptoms; 2) changes in depressive symptoms; 3) changes in depressive symptoms and then maladaptive cognitions; and 4) changes firstly in depressive symptoms, maladaptive cognitions, and then ADHD core symptoms.
Conclusions: The long-term effectiveness of CBT in medicated ADHD adults with residual symptoms was further confirmed. The CBT conceptual model was verified in clinical samples, which would be helpful for a deeper understanding of how CBT works for a better psychological QoL outcome.
Trial registration: ChiCTR1900021705 (2019-03-05)
Investigating breast cancer metastasis through collagen remodelling and metal accumulation: an advanced X-ray imaging approach
Authors: Conceicao Andre Luiz Coelho , Müller Volkmar , Burandt Eike-Christian , Mohme Malte , Nielsen Leonard , Liebi Marianne , Haas Sylvio
Published: October 2023

Breast cancer is a significant global health burden, causing a substantial number of deaths. Systemic metastatic tumour cell dissemination is a major cause of poor outcomes. Understanding the mechanisms underlying metastasis is crucial for effective interventions. Changes in the extracellular matrix play a pivotal role in breast cancer metastasis. In this work, we present an advanced multimodal X-ray computed tomography, by combining Small-angle X-ray Scattering Tensor Tomography (SAXS-TT) and X-ray Fluorescence Computed Tomography (XRF-CT). This approach likely brings out valuable information about the breast cancer metastasis cascade. Initial results from the its application on a breast cancer specimen reveal the collective influence of key molecules in the metastatic mechanism, identifying a strong correlation between zinc accumulation (associated with matrix metalloproteinases MMPs) and highly oriented collagen. MMPs trigger collagen alignment, facilitating breast cancer cell intravasation, while iron accumulation, linked to angiogenesis and vascular endothelial growth factor VEGF, supports cell proliferation and metastasis. Therefore, these findings highlight the potential of the advanced multimodal X-ray computed tomography approach and pave the way for in-depth investigation of breast cancer metastasis, which may guide the development of novel therapeutic approaches and enable personalised treatment strategies, ultimately improving patient outcomes in breast cancer management.
Sustainable methods for the development of novel “green” roof tiles with enhanced photocatalytic performance
Authors: Stratidakis Antonios , Kouroutzi Maria , Kermenidou Marianthi , Karakitsios Spyridon , Sarigiannis Dimosthenis
Published: October 2023

The introduction of eco-friendly nanomaterials capable of addressing environmental challenges in industrial applications has gained wide attention and encouraged strong collaborations between science and the public and private sectors. WHO and many governmental health organizations have highlighted the environmental and human health effects caused by exposure to nitrogen oxides (NOx) and especially nitrogen dioxide (NO2). Vast research has highly investigated the adverse effects on human health after exposure to NO2 and has profoundly recommended its mitigation in the emissions of various sources. This study proposes the development of a novel bioclimatic product in the form of a “green”, eco-friendly tile, with photocatalytic properties, able to degrade atmospheric pollutants, for subsequent use in roof tiles. To this aim, novel “green” roof tiles were developed based on the deposition of various crystallographic types of titanium dioxide (TiO2) and the addition of two polymeric materials onto their upper surface. Experiments were conducted using nanoparticles of TiO2 anatase, rutile, and a mixture of them along with the addition of Polyethylene glycol and Pluronic F-127. All types of newly developed nanomaterials were characterized using X-Ray diffraction analysis (XRD), particle size distribution analysis, the Brunauer-Emmet-Teller (BET) method, and Scanning electron Microscopy (SEM). Commercial ceramic roof tiles underwent spray-coating techniques, using the novel nanoparticles, followed by the investigation of their photocatalytic performance. The TiO2 anatase samples with the addition of PEG exhibited the greatest specific surface area among all types of samples, thus indicating their high photocatalytic efficiency, which was also proved by subsequent photocatalytic experiments for the tiles sprayed with the same type of nanoparticles. The results reported in this study indicate that the novel cool and eco-friendly roof tiles prove to be ideal for the enhancement of environmental protection, the mitigation of air pollution and greenhouse gas emissions, and the reduction of the urban heat island phenomena.
A Cost-Effectiveness and Budget Impact Analysis of the Introduction of Heat Stable Carbetocin for Postpartum Hemorrhage Prevention in Nigeria
Authors: Amode Olatunde , Oyedele Damilola , Salele Hadiza , Adekeye Olajumoke , Igbokwe Uchenna , Ameyan Lola , Afolabi Kayode , Fasawe Olufunke , Wiwa Owens
Published: October 2023

Background
Nigeria contributes about 28.5% of the global maternal death burden and 22% of these deaths are attributable to postpartum hemorrhage (PPH). The World Health Organization recommends that the administration of a potent uterotonic agent within the first minute of birth is critical to preventing PPH. Studies reveal preponderance of low-quality oxytocin, misoprostol and other uterotonics in Nigeria due to substandard manufacturing practices, weak regulatory oversight, broken cold-chain systems, demanding climactic conditions (high heat; high humidity), inconsistent electricity and falsification of uterotonics. WHO, in its 2018 Recommendations, surmised heat-stable uterotonic agents may be more suitable options, depending on the context. This study evaluates the cost-effectiveness and budget impact of heat-stable carbetocin (HSC) compared to other uterotonic options for PPH prophylaxis.
Methods
This is a health-economic evaluation to compare the occurrence of PPH events, costs, and the cost-effectiveness of introducing heat-stable carbetocin versus oxytocin+/-misoprostol for PPH prevention among women delivering in public healthcare facilities in Nigeria. The study utilized a hierarchical decision-tree model, developed from the public healthcare system perspective, that had as inputs demographical, clinical, and economical information, and generated results related to PPH events (categorized as mild-moderate and severe), PPH-related deaths, DALYs (disability adjusted life-years) on account of PPH and PPH-related direct costs to the healthcare system.
Results
The cost-effectiveness analysis revealed that in a cohort of 2,548,136 deliveries in Nigeria, HSC can avert 111,652 PPH events, 12,873 severe PPH events, 31,442 DALYs, and 1,165 deaths when compared against oxytocin, at a 4.5% reduction in total cost to the health system. Similar favorable results are associated with heat-stable carbetocin when compared with misoprostol and oxytocin-misoprostol combination. The budget impact analysis revealed that HSC can lead to total cumulative savings of USD $325,114 (₦ 240,743,2931) if scaled up over a 5-year period to 17% market share of prophylactic uterotonics administered in the country.
Conclusions
Introduction of HSC for PPH prevention is a cost-effective public health intervention in Nigeria. Health-economic modeling projects HSC to be associated with lower costs to the health system while conferring better maternal health outcomes when compared to oxytocin, misoprostol, or oxytocin-misoprostol combination.
[1] At a CBN rate of ₦740.49 to 1 USD (accessed 01/09/2023)
A randomized feasibility trial of nutritional ketosis in Parkinson's disease
Authors: Choi Alexander , Delgado Melanie , Chen Kong Y. , Chung Stephanie T. , Courville Amber , Turner Sara , Yang Shanna , Airaghi Kayla , Dustin Irene , McGurrin Patrick , Wu Tianxia , Hallett Mark , Ehrlich Debra J.
Published: October 2023

BACKGROUND:
A ketogenic diet (KD) may benefit people with neurodegenerative disorders marked by mitochondrial depolarization/insufficiency, including Parkinson’s disease (PD).
OBJECTIVE:
Evaluate whether a KD supplemented by medium chain triglyceride (MCT-KD) oil is feasible and acceptable for PD patients. Furthermore, we explored the effects of MCT-KD on blood ketone levels, metabolic parameters, levodopa absorption, mobility, nonmotor symptoms, simple motor and cognitive tests, autonomic function, and resting-state electroencephalography (rsEEG).
METHODS:
A one-week in-hospital, double-blind, randomized, placebo-controlled diet (MCT-KD vs. standard diet (SD)), followed by an at-home two-week open-label extension. The primary outcome was KD feasibility and acceptability. The secondary outcome was the change in Timed Up & Go (TUG) on day 7 of the diet intervention. Additional exploratory outcomes included the N-Back task, Unified Parkinson’s Disease Rating Scale, Non-Motor Symptom Scale, and rsEEG connectivity.
RESULTS:
A total of 15/16 subjects completed the study. The mean acceptability was 2.3/3, indicating willingness to continue the KD. Day 7 TUG time was not significantly different between the SD and KD groups. The nonmotor symptom severity score was reduced at the week 3 visit and to a greater extent in the KD group. Blood ketosis was attained by day 4 in the KD group and to a greater extent at week 3 than in the SD group. The plasma levodopa metabolites DOPAC and dopamine both showed nonsignificant increasing trends over 3 days in the KD vs. SD groups.
CONCLUSIONS:
An MCT-supplemented KD is feasible and acceptable to PD patients but requires further study to understand its effects on symptoms and disease.
TRIAL REGISTRATION:
Trial Registration Number NCT04584346, registration dates were Oct 14, 2020 – Sept 13, 2022.
Resistivity Tomography Assessment for Structural Stability of Selected Buildings around College of Medicine, University of Ilorin
Authors: Olanrewaju Abubakar Hussain , Folorunsho Ismail Oluwaseye , Okonkwo Iheme Kenneth , Adebayo Mumeen Yusuf , Bolaji Olawumi Hakeem
Published: October 2023

Resistivity tomography assessments were taken around the new College of Medicine University of Ilorin to investigate the structural stability of some selected buildings around the area. This was done to unveil the structurally weak zones and to delineate the extent of possible fractures, faults, and voids that may result in building collapse or failure. A profile of eighty-four meters (84m) was spread around the college buildings. Data was acquired by Schlumberger, Werner, Spontaneous Potentials, and Dipole-Dipole electrode configurations using LS2 ABEM Terrameter, and the profile was acquired to a maximum depth of 15 m with a maximum electrode spacing of 2 m. The data was subjected to a series of filtration processes and a reduced inverse model to ascertain the objectives. Data reductions and generation inversion model were done using the RES2DINV software and interpretation was done to delineate, and estimate the size and extent of structural failure. Results obtained reveal that interpretation of the inverse model is done in a manner of classifying the different lithology facies concerning their resistivity distribution shown as the different color code on the legend; this facie distribution is used to locate weak zones and other subsurface factors which can hinder the integrity of the soil that holds the building structure in the study site. The results of the data acquired show relatively low resistivity zones or facies typical of an incompetent clay formation. The soils around the study area are expected to exhibit medium swelling potential. It is therefore concluded that the sub-soils within which buildings are found in the study area are incompetent, also to note that facies like clay are incompetent for erecting engineering structures upon as repeated expansion and contraction of clay can make the foundation fracture and thereby fail.
Synergistic Enhancement of Woven Copper Wires with Graphene Foams for High Thermal Conductivity of Carbon Fiber Laminated Composites
Authors: Lu Ni , Sun Xinyang , Zhang Jiangang , Ma Chaoqun , Liu Chang , Wang Han , Zeng You
Published: October 2023

Enhancing thermal conductivity of carbon fiber laminated composites (CFRP) in out-of-plane directions without sacrificing mechanical properties is still challenging for fabrication of high-performance composites with structural and functional integration. In this work, a novel hybrid sandwich composite was fabricated by weaving copper wires through carbon fiber (CF) fabrics, laminating graphene foams (GrFs) onto surfaces, and infiltrating with epoxy via vacuum-assisted resin transfer molding technique. High-efficiency heat transfer pathways were constructed to greatly increase out-of-plane thermal conductivity of composites with maintaining CF continuity. Microstructure, electrical property, and thermal conduction of composites were experimentally measured and theoretically simulated. The hybrid sandwich composites exhibited much higher electrical and thermal conductivity than the CFRP, and their out-of-plane thermal conductivity was up to 1.097 W/m·K, increasing by 104% in comparison with that of CFRP. Such remarkable thermal enhancement is mainly attributed to high intrinsic conductivity of the copper wire and GrF, continuous heat transfer pathways, and synergistic effect of copper wire with GrF for rapid heat transfer and diffusion. The hybrid sandwich composites show great potential to be used as high-performance materials with structural and functional integration in the fields of aerospace and transportation.
Discussion on Technical Defects and Improvement of the Current Prediction Index System for Gas Outburst Risk Areas
Authors: Zhang Zhang Yafei , Wang Zhaofeng
Published: October 2023

The prediction of coal and gas outburst areas is the leading link of the two "four in one" comprehensive outburst prevention measures for gas prevention and control. The accurate determination of prediction indicators and critical values is of great significance for ensuring coal mine safety production and reducing the cost of outburst prevention work. The critical indicators for regional prediction specified in the "Detailed Rules for the Prevention and Control of Coal and Gas Outburst" are gas pressure of 0.74MPa and gas content of 8m3/t. However, there is no corresponding relationship between the critical values of regional prediction indicators for coal seams with different metamorphic degrees. The current gas outburst regional prediction indicator system does not provide corresponding regional prediction indicators and critical values based on different coal qualities. This article presents the critical values of gas content corresponding to the gas pressure of 0.74MPa for the regional prediction index based on the statistics of gas basic parameters of coal mines with different degrees of metamorphism and different regions, combined with the coal rank classification standards. This provides a basis for the determination of the gas content for the regional prediction index of outburst coal seams with different degrees of metamorphism.
Comparison of early patient-reported outcomes between uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small-cell lung cancer
Authors: ZHAO Yingzhi , LIU Wenwu , GAO Xin , ZHANG Kaixin , DAI Wei , WEI Xing , ZHENG Haoqian , LEI Cheng , YU Hongfan , SHI Qiuling , LI Qiang , Tianpeng Xie
Published: October 2023

Background: Analysis of patient-reported outcomes (PROs) offers valuable insights into distinguishing the effects of closely related medical procedures from the patient’s perspective. In this study we compared symptom burden in patients undergoing uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small cell lung cancer (NSCLC).
Methods: The study extracted patients with peripheral NSCLC in a prospective cohort (CN-PRO-Lung 3) who underwent segmentectomy or wedge resection with tumor diameter ≤ 2 cm and consolidation tumor ratio (CTR) ≤ 0.5. PROs data were collected using the Perioperative Symptom Assessment for Lung Surgery questionnaire pre-operatively, daily post-surgery up to the fourth hospitalization day, and weekly post-discharge up to the fourth week. Propensity score matching and a generalized estimation equation model were employed to compare symptom severity and short-term clinical outcomes.
Results:In total, 286 patients (82.4%) undergoing segmentectomy and 61 patients (17.6%) undergoing wedge resection were extracted from the cohort. No statistically significant differences were found in the proportion of moderate-to-severe scores for pain, cough, shortness of breath, disturbed sleep, fatigue, drowsiness, and distress during the 4-day postoperative hospitalization or the 4-week post-discharge period before or after matching (all p > 0.05). Compared with segmentectomy, wedge resection showed better short-term clinical outcomes, including shorter operative time (p = 0.001), less intraoperative bleeding (p= 0.046), and lower total hospital costs (p= 0.002).
Conclusions: Uniportal thoracoscopic segmentectomy and wedge resection seems to exert similar early postoperative symptom burden for patients with peripheral NSCLC (tumor diameter ≤ 2 cm and CTR ≤ 0.5).
Autoimmune Thyroid Disease and Myasthenia Gravis: A study bidirectional Mendelian randomization
Authors: Wang suijian , Lin Shaoda , Chen Xiaohong , Chen Daiyun
Published: October 2023

Background
Previous studies have suggested a potential association between AITD and MG, but the evidence is limited and controversial, and the exact causal relationship remains uncertain.
Objective
Therefore, we employed a Mendelian randomization (MR) analysis to investigate the causal relationship between AITD and MG.
Methods
To explore the interplay between AITD and MG, We conducted MR studies utilizing GWAS-based summary statistics in the European ancestry.Several techniques were used to ensure the stability of the causal effect, such as random-effect inverse variance weighted, weighted median, MR-Egger regression, and MR-PRESSO. Heterogeneity was evaluated by calculating Cochran's Q value. Moreover, the presence of horizontal pleiotropy was investigated through MR-Egger regression and MR-PRESSO
Results
The IVW method indicates a causal relationship between both GD(OR 1.31,95%CI 1.08 to 1.60,P = 0.005) and autoimmune hypothyroidism (OR: 1.26, 95% CI: 1.08 to 1.47, P = 0.002) with MG. However, there is no association found between FT4(OR 0.88,95%CI 0.65 to 1.18,P = 0.406), TPOAb(OR: 1.34, 95% CI: 0.86 to 2.07, P = 0.186), TSH(OR: 0.97, 95% CI: 0.77 to 1.23, P = 0.846), and MG. The reverse MR analysis reveals a causal relationship between MG and GD(OR: 1.50, 95% CI: 1.14 to 1.98, P = 3.57e-3), with stable results. On the other hand, there is a significant association with autoimmune hypothyroidism(OR: 1.29, 95% CI: 1.04 to 1.59, P = 0.019), but it is considered unstable due to the influence of horizontal pleiotropy (MR PRESSO Distortion Test P < 0.001). MG has a higher prevalence of TPOAb(OR: 1.84, 95% CI: 1.39 to 2.42, P = 1.47e-5) positivity and may be linked to elevated TSH levels(Beta:0.08,95% CI:0.01 to 0.14,P = 0.011), while there is no correlation between MG and FT4(Beta:-9.03e-3,95% CI:-0.07 to 0.05,P = 0.796).
Conclusion
AITD patients are more susceptible to developing MG, and MG patients also have a higher incidence of GD.
Intelligent Transfer Learning for Bitewing X-Ray Dental Caries Image Classification
Authors: Divakaran Sindu , Vasanth K , Rani Sheela
Published: October 2023

Dental carriers are found in humans as the most common and oldest diseases. Dental caries result from cariogenic bacteria of tooth adherence that cause prevalent chronic infection in teeth by metabolizing sugar for the production of acid that leads to demineralization of tooth structure over time.It is considered a major health problem worldwide almost all adults have the probability of getting affected by dental caries. Bitewing X-ray offers a medical diagnosis of changes below the gum line or decay between the teeth.The main focus of the study is to evaluate the application of deep learning models that include the Naïve Bayes classifier,K-Nearest Neighbour, and transfer learning like LeNet,VGGnet,ShuffleNet, and MobileNetfor the classification of by being X ray dental carries images.AI can provide an assistive diagnosis in the automatic detection of complex images efficiently in intraoral radiography for providing effective patient care.
Which is the safe position of femoral component in coronal plane in mobile-bearing unicompartmental knee arthroplasty? a finite element-based study
Authors: Li Chao , Cheng Jingbo , Feng Mingli
Published: October 2023

Background
Apply finite element analysis to explore the influence of different femoral prosthesis positions on the stress of the polyethylene bearing to determine the safe position of the femoral prosthesis in mobile-bearing Unicompartmental Knee arthroplasty.
Methods
A normal knee joint model was established and verified. The femoral component were designed with intorsion13 °,intorsion6 °, 0°(neutral position),extorsion6°,extorsion13°,and were combined into 5 three⁃dimensional finite element models of medial unicompartmental knee arthroplasty. A 1000 N load was applied along the femoral mechanical axis. The von Mises cloud stress distribution was observed. Moreover, the high contact stress of femoral prosthesis, the lateral compartment load ratio, the upper surface of the polyethylene liner, and the femoral cartilage in the lateral compartment was measured. Compared with the neutral position (6°and 13°intorsion or extorsion of the femoral prosthesis) to find the appropriate position of the femoral component.
Results
The maximum contact stress of the femoral prosthesis from the neutral position to the internal and external rotation of the femur, tibia prosthesis and meniscal liner gradually increase. When the femoral prosthesis internal and external rotation at 13°,the maximum contact stress of the femoral prosthesis increased by 3.21 MPa and 1.17 MPa, respectively, the maximum contact stress of the polyethylene liner increased by 4.46 MPa and 3.22 MPa, respectively. The maximum contact stress increased with the internal and external rotation angles, which suggested that it was unsafe for the femoral prosthesis to rotate within 10°.
Conclusion
Static knee biomechanics after mobile bearing unicompartmental knee arthroplasty can be affected by femoral component alignment༎During unicompartmental knee arthroplasty surgery, femoral prosthesis rotations within 10°are cannot be considered as appropriate for placing the femoral prosthesis in mobile—bearing unicompartmental knee arthroplasty, femoral prosthesis rotations more than 6°will increasing the risk of postoperative complications and may reduce the long-term survival rate of the prosthesis.
Predicting Liver Metastasis in Pancreatic Neuroendocrine Tumor After Surgery: A Population-Based Study
Authors: Wang Yizhi , Kong Yang , Yang Qifan , Zhou Dongkai , Wang Wei-Lin
Published: October 2023

Background The occurrence of liver metastasis in pancreatic neuroendocrine tumor (pNET) after primary site surgery significantly hampers the improvement of patient’s overall survival (OS). Therefore, it is necessary for early detection of metastatic lesions. However, the relationship between clinical variables and the liver metastasis potential remains obscure. Methods Detailed information of pNET patients received primary site surgery was retrieved from the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2019. Univariate and multivariate logistic regression analysis were recruited to generate independent risk factors of liver metastasis to construct a model presented as a nomogram using training cohort of SEER database. Moreover, a testing cohort from SEER database and a cohort of 96 patients from Second Affiliated Hospital of Zhejiang University School of Medicine were further recruited for internal and external verification respectively. The receiver operating characteristic curve, calibration curve, decision curve analysis (DCA) and clinical impact curve (CIC) were used to evaluate the accuracy, reliability and clinical application value respectively. The risk subgroups were finally generated according to the score of the nomogram. Results 2458 pNET patients were included in the present study. And 1638 of them were assigned as training cohort and 820 of them were assigned as testing cohort. Tumor size, AJCC T stage, functional status and other site metastases were considered as independent risk factors of liver metastasis via multivariate logistic regression analysis (all, p < 0.05). Our nomogram showed an excellent accuracy with the area under curve (AUC) of 0.821 in training cohort, 0.766 in testing cohort and 0.817 in validation cohort, respectively. Moreover, the calibration curve, DCA and CIC indicated a better net benefit and clinical application value in training cohort, testing cohort and validation cohort compared with single variate. Finally, pNET patients could be classified into low, medium and high risk of liver metastasis. Patients with high risk of liver metastasis showed a significant poorer OS compare to other two groups. Conclusion Tumor size can be an important predictor of liver metastasis in pNET patients. The nomogram we established could predict liver metastasis of pNET patients after surgery accurately.
Safety and Effectiveness of Multimodal Opioid-Free Anesthesia for Pain and Recovery after Laparoscopic Surgery: A Systematic Review and Meta- Analysis
Authors: Cheng Lin , Liu Jiang , Qin Sifan , Geng Xinyan , Zhang Limin , Fang Shirong
Published: October 2023

Background
Multimodal Opioid-free anesthesia (OFA), a new anesthetic strategy, is always controversial for relieving postoperative pain in patients undergoing laparoscopy. The aim of this study was to investigate the safety and effectiveness of OFA compared to conventional opioid anesthesia (OA) in postoperative pain management and recovery in patients undergoing laparoscopic surgery.
Methods
This systematic review is registered on PROSPER. The databases of PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to September 2023. The study selection, data extraction, and risk of bias assessment were independently conducted by two reviewers. The primary outcomes included postoperative pain scores at 2h and 24h, postoperative analgesic consumption, Quality of recovery (QoR-40) scores, and the incidence of Postoperative Nausea and Vomiting (PONV) and other complications. The risk of bias was assessed using RoB 2.0, and meta-analysis was carried out using random effects models.
Results
Ultimately, 12 studies involving 983 patients undergoing laparoscopic surgery were included in this systematic evaluation and meta-analysis. The results of the meta-analysis showed that OFA significantly reduced early postoperative pain response in laparoscopic patients compared with conventional OA. OFA also reduced the incidence of PONV and the consumption of analgesics and antiemetics and improved the subjective quality of recovery in patients. The other variables presented no significant differences between the groups or were unable to be analyzed.
Conclusions
OFA may be more beneficial for postoperative pain management and recovery in patients undergoing laparoscopic surgery compared with conventional OA. Future studies could further extend these findings to other surgical populations.