bluuebunny/crossref_metadata_2025 huggingface dataset:
Catalytic Evaluation of an Optimized Heterogeneous Composite Catalyst Derived from Fusion of Tri-Biogenic Residues
Authors: Oyedele Oyelayo Ajamu , Jekayinfa Simeon Olatayo , Alade Abass O , Enweremadu Christopher Chintua
Published: October 2024

This study analyzes the elemental and oxide compositions of three selected agricultural residues—Dried Pawpaw Leaves (DPL), Kolanut Pod (KNP), and Sweet Orange Peel (SOP)—for their potential as heterogeneous catalysts. Energy Dispersive X-ray (EDX) analysis identified calcium (25%) and potassium (29%) as the primary elements in DPL and KNP, with calcium oxide (CaO) and potassium oxide (K2O) as the dominant oxides. SOP had a similar composition but lacked vanadium. Calcined residues were analyzed at temperatures ranging from 500°C to 900°C using X-ray Fluorescence (XRF), revealing stable silicon dioxide (SiO2) content and temperature-dependent variations in CaO and K2O, indicating their catalytic potential for transesterification processes. Scanning Electron Microscopy (SEM) showed non-uniform, spongy microstructures, enhancing the surface area and catalytic efficiency. Fourier Transform Infrared Spectroscopy (FTIR) identified functional groups essential for catalytic activity, such as hydroxyls, methyl, and carboxyl. X-ray Diffraction (XRD) confirmed the presence of crystalline phases like calcium carbonate and calcium oxide, crucial for catalytic performance. Experimental biodiesel production using a mixture of the calcined residues (33.33% each of KNPA, SOPA, and DPLA) resulted in the highest biodiesel yield at 65.3%. Model summary statistics, including R² (0.9824) values and standard deviations (0.0026), validated the experimental design, indicating high precision and prediction accuracy. These results suggest that the selected agricultural residues, when calcined and mixed properly, can serve as effective heterogeneous catalysts, with significant implications for biodiesel production, supporting previous research on the importance of calcium in catalytic processes.
Range and Depth Estimates of Whale Signals Recorded by Triplets of Hydrophones
Authors: Le Bras Ronan , Nielsen Peter
Published: October 2024

The hydroacoustic in-water stations of the International Monitoring System (IMS) network consist of three hydrophones placed at Sound Fixing and Ranging (SOFAR) channel depths and about 2 km away from each other. Whale signals recorded in the vicinity of a hydrophone triplet offer the opportunity to verify simple models of propagation in the immediate neighborhood of the triplet, by comparing arrival times and amplitudes between the three hydrophones. Two examples of whales passing by hydrophone triplets are presented and conclusions drawn about waveform coherency and amplitude of the signals recorded at the three hydrophones in the 0-50 Hz frequency band. On the examples recorded at the HA11 IMS hydroacoustic station, the amplitude decay law of one over the distance is verified, and analysis of hundreds of calls located almost above the hydrophone triplet lead to the possibility that the H11S3 hydrophone may be located further from H11S1 and H11S2, and the H11S1 hydrophone’s depth may be deeper than expected from the published locations.
Analysis of the Use of Satellite Data and Drones for Land Monitoring in Kazakhstan
Authors: Kudaibergenov Olzhas
Published: October 2024

The article discusses the use of satellite data and drones for land monitoring in Kazakhstan, emphasising their importance in the context of population growth and increasing agricultural demand. Satellite technologies, such as Sentinel-2 and Landsat, provide essential data for analysing land resources, including soil erosion and the condition of agricultural lands. Unmanned aerial vehicles (UAVs) complement satellite data by offering detailed low-altitude imagery, enabling the detection of local issues such as irrigation system failures and soil compaction.The study demonstrates that integrating drone and satellite data allows for more efficient land resource management. For example, 35% of agricultural land in southern Kazakhstan is affected by soil degradation, while overgrazing issues were identified in the northern regions. These innovative monitoring methods enable early detection of threats, allowing timely measures to be taken to improve land management practices.The conclusion highlights that the use of these technologies requires not only infrastructure but also skilled professionals. The integration of satellites and drones creates opportunities for more precise and timely monitoring, which is essential for sustainable land resource management in Kazakhstan.
Invertebrates Of Siberia, A Potential Source Of Animal Protein For Innovative Human Food Production. 4. Biomass Nutrient Composition Change In Worms And Crickets
Authors: Tshernyshev Sergei E. , Babenko Andrei S. , Babkina Irina B. , Baghirov Ruslan T-O. , Modyaeva Vera P. , Morozova Margarita D. , Skrebtsova Ksenia E. , Subbotina Elena Yu. , Shcherbakov Mikhail V. , Simakova Anastasia V.
Published: October 2024

Background: The possibility of nutrient composition design in biomass of invertebrates is studied. The results may be used for gaining the particular nutrient concentration in biomass used for food products or medicine purposes. Methods: Two model species of terrestrial invertebrates, such as the House cricket Acheta domesticus (Linnaeus, 1758) and the earthworm Eisenia fetida (Savigny, 1826), within the variation of feeding substrate, are studied in this paper. Results: It is stated that in crickets and earthworms similar tendencies of B-vitamin content increase occur for those vitamins where their initial level was high. A double dose of the vitamin enrichment of food substrate leads to increasing of vitamin C, fat-soluble vitamins and the major part of B-vitamins content. In a control group of crickets a level of vitamin C was 1.5 times lower than in a control group of earthworms. After the enrichment of feeding substrate, the level of vitamin C in biomass of crickets has not changed, but within the earthworms it has significantly increased. The content of a multiple range of minerals have not changed after a singular dose enrichment, but some microelements, such as Pb and Se, have significantly decreased in earthworms after a double dose enrichment of feeding substrate. The calorific value of crickets is twice higher than the earthworms one and it has not significantly changed after a double dose substrate enrichment. Conclusions: It is revealed that the content of vitamins in the biomass of model species can be controlled within the feeding substrate enrichment.
Robotics Applications In Criminal Investigations – A Novel Proposal Of Robots Potential For Assisting In Crime Suspects Interrogations and Human Questioning
Authors: Al-Batati Abdulrahman , Al-Khaldi Hamadah
Published: October 2024

Criminal acts deprive humanity of peace and safety. Therefore, all societies, including both governments and ordinary people tries to fight and minimize crimes. And it goes without saying that societies have developed post-crime mitigation for justice insurance and criminals trials. Moreover, one of the essential post-crime procedures is suspect interrogations and witness questioning. Nevertheless, interrogations take a lot of time and effort, and it requires high qualification from the interrogators. Thus, we propose a robust solution to implement robotics in the field of interrogations and questioning where our design could be implemented in police departments, schools, airports, and anywhere that requires human interaction and questioning for security or criminal investigation.
Climate Change Risks Impacts on Public Health Correlated with Air Pollution, African Dust in South Europe
Authors: Adamopoulos Ioannis , Syrou Niki
Published: October 2024

Climate change poses a significant risk to the environment and public health, leading to extreme weather patterns, rising sea levels, and loss of biodiversity. The relationship between air pollution from African dust and climate change demonstrates its critical role in trapping heat in the atmosphere, resulting in heat-related illnesses, heart problems, and respiratory issues. This Research points to the detrimental effects of pollutants such as smog, dust, acid rain, and ozone depletion on ecosystems, highlighting the importance of using Geographically Weighted Regression modeling and MODIS-NDVI analysis to address air pollution. Particulate Matter (PM 2.5-10) and ozone levels can have negative impacts on respiratory and cardiovascular health. Proactive steps, such as implementing clean energy technologies and enforcing stricter pollution regulations, are necessary to protect public health. Acting is crucial to addressing these global challenges and creating a cleaner, healthier future for future generations, underscoring the need for climate justice commitment.
Kombinasi Pupuk Anorganik dan Pupuk Organik Meningkatkan Produksi Tanaman Tomat (Licopersicum esculentum Mill) dengan Pemangkasan Pucuk Apikal
Authors: Salli Maria Klara , Lewar Yosefina , Hamawi Mahmudah
Published: October 2024

The research aims to determine the effect of a combination of inorganic fertilizer (KNO3) and organic fertilizer (goat manure) on the yield of the Betavila variety when apical shoots are pruned. The research took place from March to October 2019 in Kupang Regency, NTT. The research used RAK with 4 repetitions. The treatments are as follows: M1 = inorganic fertilizer 5 g/l KNO3; M2 = organic fertilizer 20 tons/ha goat manure; M3 = inorganic fertilizer 5 g/l KNO3 + organic fertilizer 30 tons/ha goat manure; M4 = inorganic fertilizer 5 g/l KNO3 + organic fertilizer 15 tons/ha goat manure; M5 = Inorganic fertilizer 3.75 g/l KNO3 + organic fertilizer 15 tons/ha goat manure; M6 = Inorganic fertilizer 3.75 g/l KNO3 + organic fertilizer 30 tons/ha goat manure; M7 = inorganic fertilizer 2.5 g/l KNO3 + organic fertilizer 15 tons/ha goat manure; M8 = inorganic fertilizer 2.5 g/l KNO3 + organic fertilizer 30 tons/ha goat manure. The results of the research showed that the combination of applying inorganic fertilizer and organic fertilizer simultaneously influenced the yield of Betavila variety tomato plants whose apical shoots had been pruned, namely on the number of fruits, fruit weight, and fruit production. Fertilization dose of inorganic fertilizer 3.75 g/l KN03 + organic fertilizer 30 tons/ha goat manure gave the number of fruits per plant (59.63 fruit), fruit production per plant (2.63 kg), and fruit production per experimental plot (50.33 kg) highest.
Numerical Analysis of the Influence of Preadsorbed Water on Methane Transport in Crushed Shale
Authors: Ban Wentao , Yu Qingchun
Published: October 2024

Methane migration in shale is affected by preadsorbed water. To understand this effect, we examined several key parameters, including the effective pore diameter Le, the pore volume distribution of Le, the effective porosity ϕe, the equivalent particle diameter da, and the water film thickness h. Using these parameters, we established an equivalent relationship linking the particle packing da and the Le and the ϕe of the capillary pores within a unit-length cuboid of particles. Based on this relationship, a conceptual model was developed to simulate methane adsorption and transport in partially saturated crushed shale, incorporating parameter estimation for the tangential momentum adjustment factor δ and methane desorption rate coefficient kd, where δ characterizes the slip flow intensity and kd is related to the Langmuir adsorption constant. The finite element method was used to calculate the methane permeability ke, Knudsen diffusion coefficient Dke, surface diffusion coefficient Ds, and adsorption phase transition rate Rm, which are all affected by adsorbed water. The model’s numerical results were validated through comparison with the results from adsorption experiments. These results revealed three distinct regions in the trend of the variation in δ with Le: a rapid increase in Region I (Le < 10 nm), a slowing increase in Region II (10 ≤ Le ≤ 100 nm), and a gradual increase in Region III (Le > 100 nm). In addition, kd is positively correlated with da. kd is also correlated with water saturation S; specifically, kd decreases when S ≤ 12%, increases when S = 12% to 45.8%, and decreases again when S exceeds 45.8%. The results also reveal overall negative correlations between h and ke, Dke, Ds and Rm. Furthermore, the rates of change in ke, Dke, Ds and Rm with increasing ε (ε is the bending coefficient associated with adsorbed water) range from 7.5% to 49.4%. Similarly, ke, Dke, and Ds increase by factors of 0.73–7.19 with increasing χ (χ is the coverage rate of the adsorbed water film). Additionally, as the adsorption time t increases, Ds initially increases rapidly, followed by a gradual increase. Between t = 500 seconds and 1,500 seconds, the rate of change in Ds decreases by 20%. Rm shows a three-stage relationship with t, namely, a rapid decrease from t = 0 seconds to 500 seconds, a steady decrease from 500 seconds to 1,000 seconds, and a stabilization from 1,000 seconds to 1,500 seconds, with Rm ranging from 1.10×10-11 mol/(m3·s) to 9.45×10-11 mol/(m3·s) overall. Ds increases with the adsorption amount ratio Ed (Ed is the ratio of the adsorption amount at t to the equilibrium adsorption amount). As Ed ranges from 0.2 to 0.6, the rate of change in Ds increases by 87% to 100%. Furthermore, Rm is negatively linearly correlated with Ed.
Dust mites and mugwort allergens disrupt the nasal mucosal epithelial barrier by inhibiting mitochondrial biogenesis
Authors: Liu Yiting , Meng Cuida , Sha Jichao , Wang Fang , Zhu dongdong , Sun Qingjia
Published: October 2024

Background: Allergic rhinitis (AR) is a type I hypersensitivity reaction mediated by IgE in the nasal mucosa of susceptible individuals. The nasal mucosa's physical, chemical, and immune barriers are crucial in preventing allergens from triggering allergic reactions. Mitochondria are essential for energy production and maintaining Ca2+ homeostasis, playing a vital role in energy metabolism.
(2) Methods: Inferior turbinate tissue was collected from normal individuals and AR patients to identify the expression of proteins related to the epithelial barrier and mitochondrial biogenesis. Experimental mice were exposed to dust mite and mugwort pollen allergens, and nasal mucosal epithelial cells were stimulated with these allergens to assess barrier damage and mitochondrial biogenesis. The mitochondrial biogenic agonist SRT1720 was then administered to these cells and AR mice to evaluate improvements;
(3) Results: AR patients allergic to dust mites and mugwort pollen showed significantly lower expression of epithelial barrier and mitochondrial biogenesis-related proteins compared to normal individuals. Mice sensitized with these allergens exhibited similar reductions, significant nasal mucosal barrier disruption, and inhibited mitochondrial biogenesis. Treatment with SRT1720 increased protein expression, improved allergic inflammation, and restored epithelial barrier integrity;
(4) Conclusions: Dust mites and Artemisia argyi disrupt the nasal mucosal epithelial barrier by inhibiting mitochondrial biogenesis
A Survey to Determine the Zone of Equipoise for the Proximal FEmur Resection or Internal Fixation fOR Metastases (PERFORM) Randomized Controlled Trial
Authors: Fogel Jessa , Ng Vincent , Schubert Thomas , Forsberg Jonathan , Randall R. Lor , Becker Ricardo , Morris Carol , Ghert Michelle
Published: October 2024

Objective:
The objective of this study was to establish a zone of clinical equipoise for the Proximal FEmur Resection or Internal Fixation fOR Metastases (PERFORM) randomized controlled trial, which will compare resection and endoprosthetic reconstruction to internal fixation for skeletal metastases of the proximal femur.
Methods:
A survey was developed, piloted, and distributed to self-declared interested stakeholders in the PERFORM trial. The survey targeted orthopaedic oncologists and was designed to assess patient and bone lesion characteristics that drive surgical decision making in the treatment of skeletal metastases in the proximal femur. An Ethics Waiver was obtained at the lead academic institution and data was collected in the REDCap survey database.
Results:
Responses were complete from 76 surgeons across North America, South America, Europe, Asia and Africa. Responses indicate that a study population for which either resection and endoprosthetic reconstruction or internal fixation are acceptable options include: (1) life expectancy at least 6 months, (2) bone loss of no more than 75% and no less than 25%, and (3) minimal to moderate risk for peri-operative complications. Ninety-three percent of respondents indicated that they would be interested in participating in the PERFORM trial.
Conclusion:
A preliminary zone of equipoise for the PERFORM trial includes patients with 25–75% bone loss, low to moderate risk of operative complications, and life expectancy of at least 6 months. Further stakeholder discussions will finalize the PERFORM trial protocol prior to study initiation.
Deep learning-based prediction of HER2 status and trastuzumab treatment efficacy of gastric adenocarcinoma based on morphological features
Authors: Wu Zhida , Wang Tao , Lan Junlin , Wang Jianchao , Tong Tong , Chen Gang , Zhang Hejun
Published: October 2024

Background
First-line treatment for advanced gastric adenocarcinoma (GAC) with human epidermal growth factor receptor 2 (HER2) is trastuzumab combined with chemotherapy. In clinical practice, HER2 positivity is identified through immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH), whereas deep learning (DL) can predict HER2 status based on tumor histopathological features. However, it remains uncertain whether these deep-learning-derived features can predict the efficacy of anti-HER2 therapy.
Methods
We analyzed a cohort of 300 consecutive surgical specimen patients undergoing HER2 testing and 41 biopsy specimens receiving trastuzumab-based therapy for HER2-positive GAC.
Results
We developed a convolutional neural network (CNN) model that achieved an area under the curve (AUC) value of 0.847 in predicting HER2 amplification. Additionally, our method achieved an AUC of 0.903 in predicting HER2 status specifically in patients with HER2 2 + expression. Furthermore, our classifier was trained on 41 HER2-positive gastric biopsy specimens that had undergone trastuzumab treatment; our model demonstrated an AUC of 0.833 for the (CR + PR) / (SD + PD) subgroup.
Conclusion
This work explores an algorithm that utilize hematoxylin-eosin (H&E) staining to accurately predict HER2 status and assess the response to trastuzumab in GAC, potentially facilitating clinical decision-making.
RETRACTED: Polymorphisms rs2073618 and rs3102735 in TNFRSF11B with the Susceptibility to Gastric Cancer
Authors: Tang Xuan , Dai Zhe , Gong Dandan , Pan Huiwen , Man Changfeng , Zhang Shiqi , Gao Zhenjun , Wang Xiaoyan , Fan Yu
Published: October 2024

The authors have requested that this preprint be removed from Research Square.
The expression and clinical significance of tumor stem cell markers CD34 and CD40 in osteosarcoma tissue
Authors: Pei Fang , Wang Yuan , Yao Shengcheng , Shen Yeshuai , Zhao Rui
Published: October 2024

Objective: To investigate the expression and clinical significance of tumor stem cell markers CD34 and CD40 in osteosarcoma tissue.
Methods: A total of 106 osteosarcoma patients who underwent surgical treatment were selected as the study subjects. The expression of CD34 and CD40 in tumor and adjacent tissues was detected by immunohistochemistry. Clinical and pathological data were collected, and the impact of CD34 and CD40 expression on clinical and pathological parameters and prognosis of osteosarcoma patients was statistically analyzed.
Results: (1) RT-qPCR and Western blot assay showed that the mRNA and protein expression levels of CD34 and CD40 in osteosarcoma tissues were significantly higher than those in adjacent tissues. (2) CD34 and CD40 were mainly located on the cell membrane of tumor cells. The positive rates of CD34 in adjacent and tumor tissues were 17.9% (19/106) and 60.4% (64/106), respectively, and the positive rates of CD40 in adjacent and tumor tissues were 23.6% (25/106) and 64.1% (68/106), respectively. The positive rates of CD34 (χ2=40.095, P＜0.001) and CD40 (χ2=35.420, P＜0.001) in osteosarcoma tissues were significantly higher than those in adjacent tissues. (3) CD34 and CD40 positive expression was closely related to Histological Grading, Tumor metastasis, and TNM staging. The Kaplan-Meier survival analysis showed that the survival time of patients in CD34-positive group (χ2=29.33, P＜0.01) and CD40-positive group (χ2=8.690, P=0.003) was significantly shorter than that in corresponding negative control group.
Conclusion: The tumor stem cell markers CD34 and CD40 are highly expressed in osteosarcoma tissues and have a significant negative impact on clinical and pathological parameters and prognosis of osteosarcoma patients.
miR-200 family as new potential prognostic factor of overall survival of patients with WHO G2 and WHO G3 brain gliomas
Authors: Bilski Mateusz , Ciesielka Marzanna , Orzechowska Magdalena , Jarosz Bozena , Calka Paulina , Bilska Sylwia , Banach Agata , Czaja Gabriela , Fijuth Jacek , Kuncman Lukasz
Published: October 2024

Purpose
Gliomas are the predominant cause of cancer-related deaths among the young population. Even after incorporation of IDH1/2 mutations and 1p19q codeletion there are doubts regarding adjuvant treatment in WHO G2/G3 gliomas. miRNA molecules control about 30% of all genes, also many oncogenes, tumor suppressor genes and genes responsible for the response to ionizing radiation and systemic treatment. Patients with brain gliomas exhibit miRNA disorders. We aimed to evaluate the expression of miR-200 family members in relation to selected clinico- pathological factors and their prognostic value.
Material/Methods
We enrolled 53 patients diagnosed with WHO G2/G3 brain gliomas treated between 2012–2016. RT-qPCR based expression of miR-200 family was assessed in tumor and surrounding non-cancerous tissue. An analysis of selected clinico- pathological features was carried out. A logistic regression model was prepared for the miRNA signature. The predictive potential of the signature was assessed using the ROC curve. A stepwise backward regression model was used to select variables with a significant predictive potential related to OS.
Results
It was shown that miR-200a-3p, miR-200a-5p, miR-200c-5p, miR-141-3p and miR-429 can be independent predictors of survival. Better 2- and 5-year OS was associated with higher expression of miR-200a-3p, miR141-3p and lower expression of miR-200a-5p, miR-200c-5p, miR-429. The strongest predictors of survival were miR-200a-5p, miR-200b-3p, miR-200c-5p, miR-141-3p, miR-429, tumor volume and CTV.
Conclusion
Members of the miR-200 family exhibit prognostic value for 2- and 5-year OS. Presented predictive models of survival may be clinically useful for treatment optimization.
Resilience of Unaccompanied Refugee Children Under Foster Care: A Case Study of the Tongogara Refugee Camp, Zimbabwe
Authors: Chikoko Witness , Mhlanga Johanne , Mwapaura Kudzai
Published: October 2024

This article explores and discusses the resilience of refugee children under foster care in Zimbabwe. It advances the argument that there are resilience factors associated with unaccompanied refugee children under the foster care programme at the Tongogara Refugee Camp. Data were gathered using an exploratory qualitative research design using document analyses and 10 key informant interviews, which were conducted to gain a deeper understanding of the lives of refugee children under foster care at the Tongogara Refugee Camp. Evidence from the sources shows that there are several factors enhancing resilience among unaccompanied minors in foster care, such as religious, personal and macro support from foster parents, agencies involved in childcare, and educational support. It is recommended that the National Orphan Care Policy of 1999 be reviewed and the provisions of social protection programmes for unaccompanied refugee children under foster care be strengthened.
Subclinical hypothyroidism: a new risk factor for prediction of heart failure with improved ejection fraction
Authors: Zhou Haiqing , Wang Qi , Liu Zhiquan , Wu Guohong , Zhou Wenqing , Yang Dongmei , Chen Kangyu
Published: October 2024

BACKGROUND
Heart failure (HF) with improved ejection fraction (HFimpEF) has gradually attracted widespread attention in recent years for its better clinical prognosis. In this study, we attempted to investigate the relationship between subclinical hypothyroidism (SCH) and HFimpEF.
METHODS
This study retrospectively collected clinical data on patients with HF with reduced ejection fraction (HFrEF) hospitalized at the First Affiliated Hospital of USTC from March 2015 to September 2023, and divided into two groups as euthyroidism or SCH according to the baseline thyroid function. Then patients were further categorized into HFimpEF (follow-up LVEF > 40% and absolute increase ≥ 10%) and persistent HFrEF based on their LVEF on the echocardiograms during the follow-up period. Afterwards, logistic regression was used to estimate the effect of SCH on HFimpEF.
RESULTS
A total of 916 patients with HFrEF met the inclusion and exclusion criteria, and 396 patients (43.2%) progressed to HFimpEF status during the follow-up period. Compared with HFrEF patients, the prevalence of SCH is lower in HFimpEF patients (9.3% vs. 14.4%, P = 0.020). Univariate logistic regression analysis indicates that SCH was a potential risk factor for HFimpEF (OR: 0.612 [95% CI 0.403–0.928], P = 0.021). After adjusting for multiple factors in logistic regression, the odds ratios of HFrEF patients with SCH progressing to HFimpEF decreased by 37.8% (OR: 0.622 [95%CI 0.397–0.974], P = 0.038) compared with patients with euthyroidism.
CONCLUSIONS
This study demonstrated that thyroid function affects the improvement of cardiac function in patients with HFrEF and SCH is an independent risk factor for HFimpEF.
Association Between Body Fat Variation Rate and Risk of Diabetic Nephropathy - A posthoc Analysis Based on ACCORD Database
Authors: Li Shuai , Lin Li , Chen Xiaoyue , Liu Siyu , Gao Ming , Cheng Xunjie , Li Chuanchang
Published: October 2024

Background
Weight control has consistently been regarded as a significant preventive measure against diabetic nephropathy; however, the potential impact of substantial fluctuations in body fat during this process on the risk of diabetic nephropathy remains uncertain. This study aimed to investigate the association between body fat variation rate and Diabetic Nephropathy incident in patients with type 2 diabetes.
Methods
The study used data from the Action to Control Cardiovascular Risk in diabetes(ACCORD) trial to calculate body fat variation rates over two years and divided participants into Low and High groups. The hazard ratio and 95% confidence interval were estimated using a Cox proportional hazards model, and confounding variables were addressed using propensity score matching.
Results
4609 participants with Type 2 Diabetes were studied, with 1511 cases of diabetic nephropathy observed over 5 years. High body fat variation rate was linked to a higher risk of diabetic nephropathy compared to low body fat variation rate (HR 1.13, 95% CI 1.01–1.26). Statistically significant interaction was observed between body fat variation rate and BMI (P interaction = 0.008), and high level of body fat variation rate was only associated with increased risk of DN in participants with BMI > 30 (HR 1.34 and 95% CI 1.08–1.66).
Conclusions
Among participants with Type 2 Diabetes Mellitus(T2DM), body fat variation rate was associated with increased risk of diabetic nephropathy. Furthermore, the association was modified by BMI, and positive association was demonstrated in obese but not non-obese individuals.
Trial registration
Clinical Trials. gov, no. NCT000000620(Registration Date 199909)
Establishment of two novel organoid lines from patients with combined hepatocellular cholangiocarcinoma
Authors: Gao Yun , Chen Xiaoyun , Zhu Yuerong , Zhou Suiqing , Zhang Long , Wu Qiuyue , Zhang Hui , Wang Ziyi , Chen Xuejiao , Xia Xinyi , Pu Liyong , Wang Xuehao
Published: October 2024

Combined hepatocellular cholangiocarcinoma (cHCC-CCA) is a unique subtype of primary liver cancer displaying both hepatocytic and cholangiocytic differentiation. The development of effective treatments for cHCC-CCA remains challenging because of its high heterogeneity and lack of a suitable model system. Using a three-dimensional culture system, we successfully established two novel cHCC-CCA organoid lines from patients undergoing surgical resection for primary liver cancer. cHCC-CCA organoid lines were authenticated by fingerprint analysis, and their morphology, growth kinetics, and anchorage-independent growth were also characterized. Hematoxylin and eosin staining and immunohistochemical analysis showed that the cHCC-CCA organoids preserved the growth pattern, differentiation grade, and phenotypic characteristics of their parental tumors. Whole-exome sequencing demonstrated that patient-derived cHCC-CCA organoid lines retained the genetic alterations identified in their original tumors. Subcutaneous tumors developed in immunodeficient mice after injection of cHCC-CCA organoids. Histologically, the xenografts recapitulated the features of the original cHCC-CCA tumors, harboring both HCC and intrahepatic cholangiocarcinoma components within the same tumor. The establishment of patient-derived cHCC-CCA organoid lines with high tumorigenicity provides a valuable resource for the mechanistic investigation and drug development of this disease.
Spatial Analysis of Malaria Cases and Anopheles Species in East Java Region, Indonesia
Authors: Ngadino Ngadino , Winarko Winarko , Nurmayanti Demes , Marlik Marlik , Wardoyo Slamet , Nurhayati Syarifah , Wuryaningtyas Desya
Published: October 2024

Malaria remains a significant public health challenge worldwide, including in Indonesia, especially in East Java. This study aims to analyze the spatial distribution of malaria cases and Anopheles species that act as vectors in the area. Using an observational design with a cross-sectional approach, malaria case data were collected from the Provincial Health Office and public health centers documented in the malaria information system during the period 2021–2023. In addition, Anopheles larvae samples were taken from locations in each region in East Java. The results of the analysis show that the distribution of malaria cases is uneven, with hotspots identified in several coastal areas, mountains and cities, such as Malang, Trenggalek, and Batu. The presence of Anopheles species, especially An. sundaicus and An. maculatus, contributes to malaria transmission, with An. sundaicus more common in coastal areas and An. maculatus in valleys and rice fields. Environmental factors, such as temperature, humidity, and rainfall, as well as socio-economic factors, such as population density, affect the distribution of malaria. This study emphasizes the importance of an ecosystem-based approach in malaria control, as well as the need to improve access to health services and community education. These findings provide important insights for the development of more effective and sustainable health policies in malaria control efforts in East Java.
A Comparative Study of Convolutional Neural Network and Recurrent Neural Network models for Analysis of Cardiac Arrest Rhythms during Cardiopulmonary Resuscitation
Authors: Lee Sijin , Lee Kwang-Sig , Park Hyunjun , Han Kap Su , Song Juhyun , Lee Sung Woo , Kim Su Jin
Published: October 2024

Background: Accurate and timely cardiac rhythm classification during cardiopulmonary resuscitation (CPR) is crucial for improving outcomes in cardiac arrest patients. This study aimed to develop and evaluate deep learning models for real-time rhythm classification during ongoing CPR.
Methods: We analyzed 508 ECG segments from 131 cardiac arrest patients, including both artifact-free and CPR-corrupted data. 1 dimensional convolutional neural network (1D-CNN) and recurrent neural network (RNN) models were developed and compared for four binary classification tasks: shockable vs. non-shockable rhythms and pulse-generating vs. non-pulse-generating rhythms, for both overall and CPR-corrupted ECG data. Model performance was evaluated using accuracy, sensitivity, specificity, and F1-score.
Results: The 1D-CNN model consistently outperformed the RNN model across all classification tasks. For shockable vs. non-shockable rhythm classification, the 1D-CNN achieved accuracies of 91.3% and 89.8% for overall and CPR-corrupted data, respectively, compared to 50.6% and 54.5% for the RNN. In detecting pulse-generating rhythms, the 1D-CNN demonstrated accuracies of 90.9% and 85.7% for overall and CPR-corrupted data, respectively, while the RNN achieved 92.2% and 84.4%. The 1D-CNN model maintained high performance even with CPR-corrupted data, showcasing its robustness in real-world resuscitation scenarios.
Conclusions: Our study demonstrates the superior performance of 1D-CNN models in real-time cardiac rhythm classification during CPR. The ability to accurately classify rhythms, including detecting return of spontaneous circulation, without interrupting chest compressions reinforces existing findings and demonstrates the feasibility of real-time rhythm analysis without interrupting CPR.
Endothelial dysfunction in COVID-19: Insights from bronchoalveolar lavage and molecular markers
Authors: Arab Zohreh , Rezaee Seyed Abdolrahim , Mohammadi Fatemeh Sadat , Asna-Ashari Amir-Hashem , Shariati Alireza , Mahmoudabady Maryam , Niazmand Saeed
Published: October 2024

Endothelium play a crucial role in immune responses and inflammatory reactions. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces an exaggerated immune response. Therefore, in this study the roles of endothelium in the manifestation of sever Coronavirus disease 2019 (COVID-19) was investigated. The direct effects of SARS-CoV-2 alpha (SCA) and SARS-CoV-2 omicron (SCO), on endothelial function were investigated in bronchoalveolar lavage (BAL), that were obtained by leftover samples of Covid-19 patients who were compared to forty control group to enrich genes and proteins expression of Intracellular Adhesion Molecule-1 (ICAM-1), Vascular cell adhesion molecules 1 (VCAM-1), Nuclear factor erythroid 2–related factor 2 (Nrf2), NADPH oxidase 2 (NOX2), von Willebrand factor (vWF) and Inducible nitric oxide synthases (iNOS). SARS-CoV-2 increased gene and protein expression of ICAM-1. SCA and SCO increase VCAM-1 gene expression. VCAM-1 protein expression in SCO increased too. vWF gene expression increased in SCO. vWF protein expressed highly too. SCO group showed a significant increase in iNOS gene expression. Although, NOX2 gene increased by SCA and SCO and its protein increased too, Nrf2 gene and protein decreased by SARS-CoV-2. Based on our findings, severe COVID-19 can cause damage to vascular endothelium, which is crucial in affecting multiple organ dysfunction. Our research indicates that endothelial dysfunction is a significant factor in the progression of severe COVID-19 in comparison to other respiratory diseases.
Clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia-derived sepsis
Authors: Li Jiayan , Pan Dongxu , Guo Yuxin , Zhang Bo , Lu Xinglin , Deng Chen , Xu Feifei , Lv Zongnan , Chen Qinhe , Zheng Yafeng , Nong Shuhao , Su Lihua , Qin Rongfa , Jiang Fufu , Gai Wei , Qin Gang
Published: October 2024

Background
Despite the increasing use of metagenomic next-generation sequencing (mNGS) in sepsis, identifying clinically relevant pathogens remains challenging. This study was aimed to evaluate the clinical utility of simultaneous plasma and bronchoalveolar lavage fluid (BALF) detection using mNGS.
Methods
This retrospective study enrolled patients with pneumonia-derived sepsis (PDS) admitted to the intensive care unit (ICU) between October 2021 and January 2023. Patients were divided into two groups: the mNGS group and the non-mNGS group, based on whether simultaneous plasma and BALF mNGS were conducted. All patients underwent conventional microbiological tests (CMT), including bacterial/fungal culture of peripheral blood and BALF, as well as sputum culture, detection of 1, 3-beta-D- glucan in BALF and RT-PCR testing.
Results
The mNGS group exhibited a lower mortality rate than the non-mNGS group (35.0% vs 57.1%, P = 0.034). Simultaneous detection in dual-sample resulted in a higher proportion of microorganisms identified as definite causes of sepsis alert compared to detection in either plasma or BALF alone. Acinetobacter baumannii, Stenotrophomonas maltophilia, Candida albicans, and human mastadenovirus B were the primary strains responsible for infections in PDS patients. Patients with lower white blood cells and neutrophil indices had a greater consistency in dual-sample mNGS. Patients in the mNGS group had more antibiotic adjustments compared to the non-mNGS group. The percentage of neutrophils was a risk factor for mortality in PDS patients.
Conclusion
Dual sample mNGS has the advantage of detecting and determining the pathogenicity of more pathogens and has the potential to improve the prognosis of patients with PDS.
Intestinal obstruction caused by disseminated mycobacterium avium complex disease following solid organ transplantation: A case report
Authors: Mita Akane , Nakakubo Sho , Nishimura Yusuke , Shima Hideki , Watanabe Masaaki , Shimamura Tsuyoshi , Konno Satoshi
Published: October 2024

Background
Mycobacterium avium complex (MAC) is a common pathogen causing non-tuberculous mycobacterial infections, primarily affecting the lungs. Disseminated MAC disease occurs mainly in immunocompromised individuals, such as those with AIDS, hematological malignancies, or those positive for anti-IFN-γ antibodies. However, its occurrence in solid organ transplant recipients is rare. Herein, we report a rare case of disseminated MAC disease following liver transplantation, which led to an obstructive mass in the intestinal tract that required differentiation from a malignant tumor.
Case Presentation
A 76-year-old woman, who had undergone living-donor liver transplantation 15 years earlier for primary biliary cirrhosis, presented with persistent fever and vomiting three months before admission. She had a history of pulmonary MAC diagnosed five years earlier but remained untreated due to stable lung lesions. Abdominal CT during her current illness revealed new thickening at the jejuno-jejunal anastomosis site and enlarged mesenteric lymph nodes. PET-CT indicated increased uptake at these sites, suggesting a possible malignancy. Endoscopy revealed an elevated lesion with circumferential ulcers, leading to a suspicion of primary malignant lymphoma. However, biopsies showed CD68-positive histiocyte-like cells with numerous acid-fast bacilli, confirming disseminated MAC infection. Despite ongoing antimicrobial therapy, the patient's intestinal lesions persisted, and she required prolonged hospitalization and interventions for bile drainage and enteral nutrition.
Conclusion
This case underscores the importance of considering disseminated MAC as a potential complication in solid organ transplant recipients, even when a long period has passed since transplantation. Disseminated MAC can mimic malignancy, presenting with significant lesions causing intestinal obstruction. Awareness and thorough differential diagnosis are essential for timely and accurate management in such complex cases. The patient's outcome emphasizes the need for vigilance in managing long-term immunosuppressed patients, particularly when they present with atypical infections.
Bioequivalence Study of Eltrombopag 75 mg Film-coated Tablets under Fasting Conditions during the Covid-19 Pandemic in Healthy Caucasian Male Subjects
Authors: Inal Ahmet , Sezer Zafer , Pınarbaşlı Onur , Bulut Burcu , Reinsch Martin , Martin Wolfgang , Mazicioglu Mumtaz M. , Koru Selma Alime
Published: October 2024

This study aims to determine the bioequivalence of the reference preparation and the test preparation containing eltrombopag when both were given during the COVID-19 pandemic while fasting. Participants in the research were healthy male Caucasian subjects. One film-coated tablet of the test preparation or one film tablet of the reference preparation, equivalent to 75 mg of eltrombopag, was given to the participants in a randomized order throughout each treatment session. At pre determined blood sampling points, blood samples were taken to determine the pharmacokinetics of eltrombopag. Eltrombopag concentrations in the samples were determined using an LC-MS/MS technique verified using ESI(-). The study results were used to calculate the rate (the maximum plasma concentration, or Cmax) and extent (area under the concentration-time curve of plasma, or AUC(0−72) and AUC(0−t) of eltrombopag absorption from the test preparation and reference preparation. The 90% confidence intervals (CI) of the ln-transformed AUC(0−72), AUC(0−t), and Cmax of eltrombopag met the bioequivalence requirements of 80.00% -125.00%. Both trial preparations had a similar and very satisfactory safety profile.
Real-World Treatment Patterns and Outcomes in Hormone Receptor Positive HER2 Negative Early-Stage Breast Cancer in a Private Community Oncology Practice of Brazil
Authors: Goncalves Aline , Reinert Tomas , Cruz Heloisa , Silva Matheus , Mano Max , Resende Cristiano , Bretas Gustavo , Oliveira Leandro , Figueroa Maria Cristina , Paes Rafael , Canedo Jorge , Koyama Fernanda , Bueno Carolina , Ferreira Erica , Barrios Carlos , Dienstmann Rodrigo
Published: October 2024

Purpose
This study aims to assess the disease characteristics, practice patterns and real-world outcomes of patients (pts) with HR positive (+)/HER2 negative (-) early breast cancer (EBC) treated in Brazil's largest network of community oncology practices.
Methods
Retrospective study from the Oncoclínicas&CO real-world database from 2016 to 2021. We assessed risk profile distribution (high-risk [HR], intermediate-risk [IR] or low-risk [LR]) as per recent adjuvant trials in EBC, endocrine and chemotherapy (CT) prescriptions and 3-year invasive disease-free survival (iDFS).
Results
In total, 1,786 cases were selected for the study. Median age was 57 years, 566 (32%) were premenopausal, 1,179 (66%) were LR, 351 (20%) IR, and 256 (14%) HR. In post-menopausal pts, aromatase inhibitor (AI) was used by 74% with LR, 79% with IR and 83% with HR. In premenopausal pts, ovarian function suppression (OFS) – combined with tamoxifen or AI – was prescribed to 18% LR pts, 15% IR, and 48% HR. CT was offered to 32%, 38%, and 73% of postmenopausal pts in LR, IR, and HR groups. In premenopausal pts, 55%, 57%, and 78% received CT in LR, IR, and HR groups. The 3-year iDFS was 86% (95% CI 84%-89%) in LR population, 87% (82%-91%) in IR, and 72% (95% CI 65%-81%) in HR.
Conclusions
In this large real-world cohort of patients treated in a private setting in Brazil, most pts are diagnosed with low-risk EBC. We found that a significant proportion of premenopausal pts with high-risk EBC were not treated with OFS and did not receive CT.
Risk factors for bloodstream infection in COVID-19 patients in intensive care units: A systematic review and meta-analysis
Authors: Wang Jun , Jiang Ting
Published: October 2024

Background: Risk factors for bloodstream infection in patients with COVID-19 in the intensive care unit (icu) remain unclear. The purpose of this systematic review was to study the risk factors for BSI in patients admitted to ICUs for COVID-19.
Methods: A systematic search was performed on PubMed, EMBASE, Cochrane Library, and Web of Science up to July 2024. Data were reported as combined odds ratio (OR) for categorical variables and weighted mean difference (WMD) for continuous variables.
Results: 6914 studies were retrieved, of which 55 were included in the meta-analysis. Men (OR=1.28, 95% CI: 1.10-1.50, P=0.006), high SAPS II score (WMD=6.43, 95% CI: 0.23-12.63, P=0.042), diabetes (OR=1.34, 95% CI: 1.04-1.73, P=0.022), tracheal intubation (OR=8.68, 95% CI: 4.68-16.08, P<0.001), mechanical ventilation (OR=22.00, 95% CI: 3.77-128.328, P<0.001), ECMO (OR=2.70, 95% CI: 1.17-6.26, P=0.020), central venous cannulation (OR=9.33, 95% CI: 3.06-28.43, P<0.001), prolonged ICU stay (WMD=10.37, 95% CI: 9.29-11.44, P<0.001), methylprednisolone use (OR=2.24, 95% CI: 1.24-4.04, P=0.008), and the combination of methylprednisolone and Tocilizumab (OR=4.54, 95% CI: 1.09-18.88, P=0.037) were risk factors for ICU-BSI in COVID-19 patients.
Conclusion:We identified 10 risk factors for ICU-BSI in COVID-19 patients. In future studies, these factors can be combined to establish a more comprehensive and accurate prediction model for ICU-BSI in COVID-19 patients. Targeted measures can be taken earlier to control BSI.
Establishment and Validation of a Machine Learning Model Predicting Post-Radical Prostatectomy Gleason grading group upgrading Author’s information
Authors: Wu Jinfeng , Yuan Runqiang , Lu Yangbai , Tan Jian , Chen Zhenjie , Li Xianzhe , Leng Qu , Zhong Rui , Zhang Yongxin , Huang Hongxing
Published: October 2024

Background
Based on the 2014 International Society of Urological Pathology (ISUP) grading system, the study assesses the disparities in gleason grading group between preoperative needle biopsy pathology and post-radical prostatectomy (post-RP) specimens for prostate cancer (PCa). It investigates the risk factors for post-RP gleason grading group upgrading (GGU) and develops and validates a machine learning (ML) model for predicting post-RP GGU in PCa patients.
Methods
A retrospective analysis is conducted on demographic and clinicopathological variables of PCa patients from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2018. Five different ML algorithms, including logistic regression (LR), gradient boosting machine (GBM), neural network (NNET), random forest (RF), and XGBoost (XGB), are utilized. The patients with localized PCa who underwent radical prostatectomy (RP) at Zhongshan People's Hospital from January 2018 to December 2023 were selected as the external validation group. Model performance is evaluated using receiver operating characteristic (ROC) area under the curve (AUC), calibration curve, decision curve analysis (DCA), sensitivity (recall), and specificity. A web-based predictor is developed based on the best-performing model.
Results
This study included a total of 65,574 PCa patients from the SEER database and 98 patients from the external validation group. Among them, there were 11,931 in the training group, 5,112 in the internal validation group, and 24 in the external validation group who experienced post-RP GGU. Risk factors such as patient age, race, preoperative prostate-specific antigen (PSA) level, needle biopsy ISUP grading group, total number of biopsy cores, number of positive cores, and percentage of positive cores were significantly associated with GGU (P < 0.05). Five ML algorithms demonstrated relatively stable consistency, with their AUC values exceeding 0.7. A web-based predictor was developed using the XGB model, which showed the best predictive performance.
Conclusion
The study introduced a ML model and an online predictor designed to assess the risk of post-RP GGU in PCa patients, aiding physicians in customizing clinical decisions and treatment strategies.