bluuebunny/crossref_metadata_2025 huggingface dataset:
Total Self-BAT scores associated with choice of heavy menstrual bleeding treatment
Authors: Eising Heleen P. , Punt Marieke C. , Grimberg Evelyn , Schermer Tjard R. , Leemans Jaklien C. , Bongers Marlies Y.
Published: March 2024

Background
Heavy menstrual bleeding (HMB) is frequently the indicating symptom of an underlying bleeding disorder. The self-administered bleeding assessment tool (self-BAT) provides an overview of the bleeding history and indication of a bleeding tendency. Research about the association between a bleeding tendency and choice of HMB treatment is scarce.
Methods
The self-BAT was sent to all adult patients with HMB seeking care at a gynecological clinic. Closed questions on medical and surgical HMB management were provided, as well as a free-text question to reflect on personal experiences and opinions concerning HMB management. For clinical assessment of bleeding tendency, the cut-off for an abnormal self-BAT score was ≥5 in young women (18-30 years) or ≥6 for women of 31-52 years.
Results
Overall, 36% (234/650) of eligible women completed the questionnaire. The median total self-BAT score was 6 (interquartile range: 0–17). An abnormal total self-BAT score was more prevalent in women who underwent a hysterectomy compared to those who had not for women age 31-52 years (OR 4.3; 95%CI,1.2; 15.3; p=0.02). Medical therapy (hormonal, tranexamic acid or iron) was more prescribed in women with an abnormal self-BAT score. The most frequently mentioned responses from patients were related to low awareness of the effects of HMB and the need for patient empowerment.
Conclusions
Findings imply that there is a substantial group of patients with HMB who experience a bleeding tendency. This bleeding tendency may influence the choice of HMB treatment like a hysterectomy. Structured bleeding assessment tools could guide optimal diagnostics and treatment for women with HMB.
Surgery for severe pneumocephalus caused by Gorham-Stout disease: a case report and literature review
Authors: Zhang Yiming , Zhang Dong , Qi Yinbao , Wang Lanlan , Liu Xiang , Yue Peidong , Qian Ruobing
Published: March 2024

Background
Gorham-Stout disease (GSD) is an extremely rare bone resorption disease, and there are few reports of GSD affecting the skull and cervical spine. We report a rare case of severe pneumocephalus caused by GSD in the past decade. Satisfactory results were achieved through surgical treatment.
Case presentation:
The patient had been diagnosed with GSD for 14 years, during which the patient's skull began to dissolve from the occipital bone, and the cervical spine was gradually affected. One day before admission, the patient experienced severe headache and vomiting, and a head CT scan showed severe pneumocephalus. After admission, the patient underwent fistula repair surgery. One year after surgery, the patient's condition remained stable.
Conclusion
There is currently no effective unified treatment plan for GSD. Here, we provide a case in which severe pneumocephalus caused by GSD was effectively treated through surgery, which provides treatment ideas for similar patients.
Incident of violence escalation of patients with psychiatric emergencies boarding in the emergency department in the Central Region of Thailand and its association: A prospective observational study
Authors: Khlaisuk Angsana , Seeherunwong Acharaporn , Utriyaprasit Ketsarin , Poungkaew Autchariya , Tongsai Sasima
Published: March 2024

Background
This study aimed to investigate the incidence of violence escalation in psychiatric emergency patients who were admitted to general emergency departments. The study also determined patient and service delivery system factors associated with the survival time of violence escalation in 16 emergency departments in the central region of Thailand. The research design was a prospective observational study, and the study sample includes 507 psychiatric emergency patients over the age of eighteen, selected through stratified random sampling and purposive sampling.
Methods
The study analyzes patient data consisting of demographic data, emergency services used, and clinical characteristics using descriptive statistics. The Kaplan-Meier method was used to estimate the violent escalation curve, and the log-rank test was used to compare violent escalation-free time between the levels of the violent behavior group. Additionally, univariable and multivariable Cox proportional hazard analyses were used to investigate the factors affecting violence escalation.
Results
The results of the study indicate that the incidence of violent escalation of patients with psychiatric emergency boarding in the emergency department was 7.3%, while the incidence rate of violence escalation was 3 per 100 psychiatric emergency patient visits-hours. The factors affecting violent escalation were the violence behavior score at triage (aHR = 2.004; 95% CI: 1.051–3.823) and the nurse competency score (aHR = 0.147; 95% CI: 0.032–0.680).
Conclusions
Assessing the violent behavior of psychiatric emergency patients at triage may assist emergency providers in monitoring patient behavior and providing early intervention to prevent the escalation of violent behavior. Furthermore, training emergency nurses in psychiatric emergency care is required.
Psychological distress associated with suicidal ideation and attempt of people with glaucoma at tertiary eye care clinic, gondar city, Ethiopia
Authors: Andualem Fantahun , Ali Dawed , Tinsae Techilo , Nakie Girum , Demilew Demeke , Tadesse Gebresilassie , Muluye Getachew
Published: March 2024

Background
Suicide is an act of intentionally ending one’s own life with implicit or explicit evidence. The studies done from five countries in Africa (including; Ethiopia) revealed that the pooled prevalence of suicidal ideation was 21.7% and suicidal attempt was 11.06%, whereas, suicidal ideation and attempt were higher in Ethiopia 22.7% and 16.97%, respectively. Suicidal ideation and attempt were associated with various psychological, social and medical conditions. This study aimed to assess the prevalence of suicidal ideation and attempt among adult people with glaucoma and its contributing factors in Gondar city, Ethiopia.
Methods
A cross-sectional study was conducted on 422 glaucoma patients at Tertiary Eye Care Clinic, University of Gondar Comprehensive and Specialized Hospital. The sample size was calculated by using a single population proportion formula and the sample selected by using systematic random sampling method. Suicidal ideation and attempt assessed using the suicidality module of the World Mental Health (WMH) Survey Initiative version of the World Health Organization’s Composite International Diagnostic Interview (CIDI). The data was edited, cleaned, coded and entered into Epi-info version 7 and analyzed by using Statistical Packages for Social Science (SPSS) 25 version. Binary logistic regression was conducted to identify factors associated with suicidal ideation and attempt. The p-value less than 0.05 were considered as statistically significant.
Results
The overall prevalence of suicidal ideation and attempt were 6.4% with 95% CI (4.3–9.2%) and 2.4% with 95% CI (1.1–4.3%), respectively. In multivariate analysis; severe psychological distress, moderate psychological distress, mild psychological distress, and current substance use were identified as a risk factor for suicidal ideation, whereas, lived alone, co-morbid chronic medical disease/diseases and ever substance use were identified as a risk factor for suicidal attempt.
Conclusion
Based on our finding the prevalence of suicidal ideation and attempt was not contemptible. The study also identified factors associated with suicidal ideation and attempt; psychological distress and current substance use were significantly associated with suicidal ideation, whereas living alone, co-morbid chronic disease/diseases and ever substance use were significantly associated with suicidal attempt. Our finding lead, they should be screened and managed in eye care institution.
Robotic-resisted Exercise for Health Promotion in Younger Adults
Authors: Lee Su-Hyun , Kim Eunmi , Kim Jinuk , Kim Dongwoo , Lee Dokwan , Lee Hwang-Jae , Kim Yun-Hee
Published: March 2024

Introduction
Physical inactivity and sedentary behavior both increase the risk of chronic disease and mortality. Regular participation in physical activity and reducing sedentary behavior play important roles in maintaining physical health and disease prevention. The purpose of this study was to investigate the effect of a wearable hip exoskeleton, Bot Fit, on muscle strength, muscle effort, and the kinematics of the pelvis during walking in younger adults.
Methods
We designed three parallel experimental conditions and randomly assigned participants to one of three groups: those assigned to exercise using an interval program of Bot Fit (interval group), those who used a power program of Bot Fit (power group), and a control group who exercised without Bot Fit. A total of 45 young adults participated in 18 exercise-intervention sessions over six weeks, and all participants were assessed at two time points: before and after the 18 exercise sessions. Each assessment evaluated muscle strength, muscle effort, and the kinematics of the pelvis during walking. In addition, the number of steps, distance, energy expenditure, and heart rate for 30 min during the exercise sessions were recorded.
Results
A significant increase in the maximum voluntary contraction (MVC) of the right biceps femoris (BF) was evident in the interval group while significant changes in the MVC of the bilateral BF were seen in the power group showed after Bot Fit exercise. A significant decrease of muscle effort in right BF in the interval group and right lumbar erector spinae and bilateral BF in the power group were also observed. In addition, the symmetry index of pelvic tilt significantly improved in the interval group, and greater exercise volume and intensity in both the interval and power groups compared with the control group were confirmed as measured by the number of steps, distance, energy expenditure, and heart rate.
Conclusion
Results of this study indicate a beneficial effect of the Bot Fit on muscle strength, walking efficiency, and pelvic movement symmetry in younger adults. Personalized exercise programs using different exercise protocol with the Bot Fit may therefore improve the physical health and gait symmetry of younger adults.
Oral administration of Lactobacillus delbrueckii UFV-H2b20 protects mice against Aspergillus fumigatus lung infection
Authors: Andrade Ana Clara Matoso Montuori , Oliveira Nathalia Luisa , Silva Ana Elisa Nolasco e , Vaz Leonardo Gomes , Martins Flávia Rayssa Braga , Lopes Mateus Eustáquio Moura , Torres Lícia , Junior Celso Martins Queiroz , Russo Remo Castro , Santos Liliane Martins , Vieira Leda Quercia , Soriani Frederico Marianetti
Published: March 2024

Methods
we investigated survival, respiratory mechanics, histopathology, colony forming units, cytokines in bronchoalveolar lavage, IgA in feces, efferocytosis, production of reactive oxygen species and the cell population in the mesenteric lymph nodes.
Results
L. delbrueckii induces tolerogenic dendritic cells, IL-10+macrophages and FoxP3+regulatory T cells in mesenteric lymph nodes and increased IgA levels in feces; after infection with A. fumigatus, increased survival and decreased fungal burden. There was decreased lung vascular permeability without changes in the leukocyte profile. There was enhanced neutrophilic response and increased macrophage efferocytosis. L. delbrueckii-treated mice displayed more of FoxP3+Treg cells, TGF-β and IL-10 levels in lungs, and concomitant decreased IL-1β, IL-17A, and CXCL1 production.
Conclusion
our results indicate that L. delbrueckii UFV H2b20 ingestion improves immune responses, controlling pulmonary A. fumigatus infection. L. delbrueckii seems to play a role in pathogenesis control by promoting immune regulation.
Impact of integrated treatment of hepatitis C on happiness among people who inject drugs: results from the INTRO-HCV.
Authors: Lucas Clara , Vold Jørn Henrik , Aas Christer Frode , Chalabianloo Fatemeh , Løberg Else-Marie , Johansson Kjell Arne , Fadnes Lars Thore
Published: March 2024

PWID are at high risk of being unhappy. However, to which degree happiness in patients with SUD is linked to infection with HCV and its treatment is unknown. The present study investigated the effect of integrated compared to standard HCV treatment on happiness in this population. This multi-center, randomized controlled trial evaluated happiness as a secondary outcome of integrated HCV treatment. From May 2017 to June 2019, 276 participants in Bergen and Stavanger, Norway, were randomly assigned to receive integrated and standard HCV treatment. Integrated treatment was delivered in eight decentralized outpatient OAT clinics and two community care centers while standard treatment was delivered in outpatient clinics at referral hospitals, with 21% absolute difference in SVR. The level of happiness was assessed with an eleven-point Likert scale and presented as percentage (from 0% “completely unhappy” to 100% “completely happy”).We applied a LMM to evaluate the impact of integrated HCV treatment on changes in happiness scores. At baseline, the mean happiness score for participants receiving integrated treatment was 49% (SD 26) and 52% (SD 25) for those on standard treatment. Twelve weeks after completed HCV treatment, the mean happiness score for participants receiving integrated treatment was 51% (SD 20) and 52% (SD 23) for those receiving standard treatment. Compared to the standard HCV treatment, the happiness score tends to increase from baseline to end of treatment in the integrated HCV treatment groups, but not significantly. Further research is needed to improve the subjective experience in happiness in this population.Trial registrationClinicalTrials.gov.no NCT03155906, 16/05/2017.
Assessment of Drought Tolerance in Wheat genotypes for Sustainable Food Security and Breeding Programs
Authors: Shah Adnan Noor , Ghulam Hafiz , Naeem Muhammad , Ullah Aziz , Saeed Amjad , Hussain Ghulam Sabir , Hatamleh Ashraf Atef , Al-Dosary Munirah Abdullah , Lamlom Sobhi F. , Ercisli Sezai
Published: March 2024

The crop which is widely consumed and utilized because of its social benefits and economic importance worldwide is wheat. In many parts of the world, it is generally consumed as feed and food for its nutritional benefits, and its productivity is uniform under different environmental effects. In a randomized complete block design (RCBD) with three replication, an experiment was conducted to assess 50 different wheat cultivars. These cultivars were evaluated under two distinct levels; normal (non-stressed) and drought (stressed) conditions. The analysis of variance (ANOVA) under non-stressed (normal) and stressed (drought) conditions of the examined traits showed highly significant differences which indicated the variation in the studied germplasm. The Genotypes that performed very well in both the normal and water deficit conditions are G12 followed by G8, G23, G20 and G16 while genotypes that performed poorly in both conditions were G35 followed by, G37, G47, G48 and G42 considered as drought susceptible genotypes. Attribute grain yield per plant disclosed the significant and positive correlation among all the studied traits under the non-stresses condition. Results revealed from principal component analysis (PCA), only 4 PCA showed the significant value under the both normal and stressed conditions because these PCAs exhibited eigenvalue more than one considered as significant. Under the normal condition, the PC1 indicated the 78.7% for the variance, PC2 indicated 14.6%, PC3 indicated 12.2% and PC4 indicated 10.1% as mention in Fig-4.7. In the drought condition, the PC1 represented for 74.5%, PC2 represented for 16.7%, PC3 represented for 11.6% and PC4 represented for 11.1%. The findings from this study will be valuable for both researchers anf farmers, as they can utilize the data to cultivate these specific genotypes for improved yield. Morever, the results can also be employed in future breeding aim to develop drought-resistant wheat genotypes, contributing to sustainable food security efforts.
Left Atrial Mechanics in Youth with Chronic Kidney Disease and Similarly Aged Healthy-Controls
Authors: Kula Alexander J , Frisby-Zedan Jeanne , Linder Jarrett , Hauck Amanda
Published: March 2024

Introduction: In adults with chronic kidney disease (CKD), abnormal left atrial reservoir strain (LASr) is an early, yet clinically significant, indicator of myocardial dysfunction. However, left atrial mechanics are understudied in youth with CKD. The objective of this study was to assess left atrial strain function in youth with CKD and similarly aged, healthy controls.
Methods: We performed a single-center, retrospective, observational study of persons aged 12-21 years with stage 3-4 CKD and healthy controls. Exclusion criteria included a history of a kidney or other solid organ transplant, congenital heart disease, and/or dialysis requirement <3 months prior. We measured LAS (LASr, conduit, contractile), E/e’, E/A, left ventricular mass index (LVMI), and ejection fraction. Pearson correlations were performed between echocardiographic measures.
Results: This study included 37 patients with CKD and 19 controls. Mean age was similar between groups and male sex was over-represented in both groups (CKD: 62%, Healthy: 63%). Mean ± standard deviation (SD) eGFR in the CKD group was 32 ±14mL/min/1.73m2. Mean absolute LASr was significantly lower in those with CKD (43.0 ±8.5%) compared to healthy controls (47.4 ±6.1%). Patients with CKD had significantly higher LVMI, and lower E/A and E’ compared to controls. There was poor correlation between LASr with E/A, E/e’, and LVMI.
Conclusions: As observed in adults with CKD, LASr was significantly lower in youth with CKD compared to healthy controls. Moreover, LASr poorly correlated with traditional measures of diastolic dysfunction such as E/e’ and E/A.
Comparing Human Text Classification Performance and Explainability with Large Language and Machine Learning Models Using Eye-Tracking
Authors: Venkatesh Jeevithashree Divya , Jaiswal Aparajita , Nanda Gaurav
Published: March 2024

To understand the alignment between reasonings of humans and artificial intelligence (AI) models, this empirical study compared the human text classification performance and explainability with a traditional machine learning (ML) model and large language model (LLM). A domain-specific noisy textual dataset of injury narratives had to be classified into six cause-of-injury codes. While the ML model was trained on pre-labelled injury narratives, LLM and humans did not receive any specialized training. The explainability of different approaches was compared using the words they focused on during classification. These words were identified using eye-tracking for humans, explainable AI approach LIME for ML model, and prompts for LLM. The classification performance of ML model was relatively better than LLM and humans- overall and particularly for complicated and challenging to classify narratives. The top-3 words used by ML and LLM for classification agreed with humans to a greater extent as compared to later words.
Lacrimal duct diseases are the potential cause of corneal epitheliopathy
Authors: Minezaki Teruumi , Hattori Takaaki , Shibata Motoko , Nezu Naohiro , Kumakura Shigeto , Goto Hiroshi
Published: March 2024

Purpose: The purpose of this study was to determine the frequency of corneal epitheliopathy in patients with lacrimal duct diseases and to elucidate the clinical characteristics of patients with corneal epitheliopathy.
Methods: Among patients diagnosed with lacrimal duct diseases comprising chronic dacryocystitis and lacrimal canaliculitis at our institution between 2015 and 2022, those who had corneal epitheliopathy were studied. Severity of corneal epitheliopathy was evaluated using the National Eye Institute/Industry (NEI) corneal grading scale. Systemic diseases, ocular diseases, and types of eye drops used were extracted from medical records. Pathogens cultured from ocular secretions in lacrimal duct or revealed by pathological examination of concretions were examined. NEI scores before and after treatment for lacrimal duct diseases were compared.
Results: 161 eyes with lacrimal duct diseases consisted of 138 eyes with chronic dacryocystitis and 23 eyes with lacrimal canaliculitis. Corneal epitheliopathy was found in 13 eyes (8.1%) with lacrimal duct diseases; 11 eyes (8.0%) with chronic dacryocystitis, and 2 eyes (8.7%) with lacrimal canaliculitis. None of the patients with corneal epitheliopathy had specific systemic or ocular diseases. Six patients used antibiotic eye drops, but only one patient used corticosteroid eye drops. Pathogens were detected in the lacrimal duct in 12 of 15 eyes with corneal epitheliopathy. Corneal epitheliopathy improved in all eyes after treatment for lacrimal duct diseases.
Conclusion: Lacrimal duct diseases may potentially lead to corneal epitheliopathy. In a case of refractory corneal epitheliopathy accompanied by conjunctival congestion and ocular secretions lacrimal duct disorders should be investigated and treated appropriately.
Effect of depression on asthma: insight from the NHANES 2007-2018 and Mendelian randomization study
Authors: Ji Tanao , Lv Yue , Yang Jianan , Diao Xianping , Gu Jun
Published: March 2024

Background
Depression and asthma share several pathophysiologic risk factors, and their precise connection remains unclear. Our research seeks to assess the relationship between depression and asthma.
Methods
The association between depression and asthma was assessed through a multivariable logistic regression analysis, with data sourced from The National Health and Nutrition Examination Survey (NHANES) 2007–2018. Subsequently, a linkage disequilibrium score regression (LDSC) analysis was conducted to evaluate the genetic correlation between depression and asthma. Moreover, a two-sample Mendelian randomization (MR) analysis was conducted by employing genome-wide association study (GWAS) summary statistics by means of both univariable MR (UVMR) and multivariable MR (MVMR).
Results
This study included 22467 participants from NHANES for our observational research. In the unadjusted model, participants with depression symptoms had a significantly increased risk of asthma in comparison to participants without depression symptoms (OR = 1.924, 95%CI: 1.717–2.152, P < 0.0001). After adjusting potential confounders, the results remain significant. The LDSC result revealed a significant positive genetic correlation between depression and asthma (rg = 0.254, P < 0.0001).The UVMR results further substantiated a causal effect between depression and asthma (OR = 1.243, 95%CI: 1.141–1.354, P < 0.0001). Similar findings from MVMR were obtained for the causality investigation after adjusting smoking (OR = 1.29, 95%CI: 1.17–1.42, P < 0.0001), drinking (OR = 1.27, 95%CI: 1.16–1.38, P < 0.0001), and education attainment (OR = 1.21, 95%CI: 1.11–1.31, P < 0.001).
Conclusion
Our study showed that depression is an independent risk factor for asthma and may increase the risk of asthma.
Adult Uterine Wilm’s Tumor Miss-interpreted as "Carcinosarcoma," a case report
Authors: Izadimood Narges , Nili Fatemeh , Sarmadi Soheila , Mirzaian Elham
Published: March 2024

Background: Wilm’s tumor (WT) is a common renal malignancy in children. Adult extrarenal WT involving the uterus is extremely rare. Herein, we report a rare case of uterine WT in an old woman that was primarily diagnosed as carcinosarcoma.
Case presentation: A 63-year-old woman presented with abdominal pain and radiologic evidence of pelvic mass originating from the uterus, suggestive of sarcoma. In addition to the serum elevation of Cancer Antigen 125 (CA125), Human Epididymis Protein 4 (HE4), and Cancer Antigen 19-9 (CA19-9), Alpha Fetoprotein (AFP) was also increased. Pathologic examination of total hysterectomy, bilateral salpingo-oophrectomy, and omentectomy specimens revealed a large uterine mass with a serosal surface and an omental invasion. On microscopic examination, mixed epithelial and mesenchymal components were seen, so the initial diagnosis was carcinosarcoma. On the second opinion, triphasic components of papillary, primitive tubules and glomeruloid structures, mesenchymal, and blastemal elements were identified. The IHC study revealed positive reactions of the tumor cells for WT1, CKAE1/AE3, EMA, Glypican-3, and CD56 in all components. P53 showed normal expression. GATA3, ER, PR, and CD10 were negative. The final diagnosis was changed to WT.
Conclusion: Uterine Wilm’s tumor is an extremely rare malignancy that could be associated with elevated serum AFP. The diagnosis and treatment of these rare tumors are challenging for both pathologists and clinicians.
Shielding Characteristics of Polydimethylsiloxane Reinforced with Iron for Radiation Protection
Authors: Yazdankish Enayatolah
Published: March 2024

This study investigates the radiation shielding properties of Polydimethylsiloxane reinforced with iron in weight fractions ranging from 5–40%. The density of the composite material was calculated using a formula that considers the densities of Polydimethylsiloxane and iron. The mass attenuation coefficient, linear attenuation coefficient, half-value layer, effective atomic number, and equivalent atomic number were calculated using the WinXCom program. The results indicate that the mass attenuation coefficient and linear attenuation coefficient values are higher for low-energy photons, and the composites reinforced with higher weights of iron display higher mass attenuation and linear attenuation coefficients. The contribution of Compton scattering remained almost constant across the energy range, while the photoelectric effect dominated at low energies, and pair production became increasingly dominant at higher energies. The half-value layer decreased as the weight fraction of iron in the composite increased, making composites with a higher weight fraction of iron more efficient at attenuating radiation to a certain level. The effective atomic number and equivalent atomic number values were also higher for composites with a higher weight fraction of iron, indicating that they are more effective at attenuating radiation. Overall, Polydimethylsiloxane reinforced with iron shows promise as a material for radiation shielding applications.
Rheumatoid Arthritis and Infertility:A Mendelian Randomisation Study
Authors: XIE Yafei , ZHANG Zeling , YIN Qiaozhi
Published: March 2024

Background: Numerous observational studies have found a higher risk of infertility in patients with rheumatoid arthritis（RA）, but the causal relationship is subject to inherent confounding bias in traditional retrospective studies, and the causal relationship between the two has not been definitively established.
Methods: This paper analyzes the causal relationship between RA and infertility using two-sample MR. In this paper,we performed a bidirectional two-sample Mendelian randomization (MR) analysis to test for the causal association between RA and infertility using data from Independent single nucleotide polymorphisms(SNP) closely associated with RA were selected as instrumental variables from a genome-wide association meta-analysis including 14,361 patients with RA and 43,923 controls of European ancestry. The summary statistics of infertility were obtained from the Finnish Biobank, which included 6,481 cases and 68,969 controls in women and 680 cases and 73,479 controls in men. Inverse variance weighting was used as the main estimator, supplemented by MR-Egger, Weighted median. MR-PRESSO was used to remove biased SNPs, Cochran's Q test to and MR-Egger intercept analysis to detect heterogeneity and horizontal pleiotropy.
Results: Individuals with higher genetic liability to RA were more likely to develop female infertility ([OR,1.04; 95%CI,1.01-1.07; p<0.05]).But,RA is not causally related to male infertility.
Conclusions: We found that genetically predicted RA causes a higher risk of infertility in women, a risk that has existed since conception. However, in terms of genetic variation, there is no evidence that RA increases the risk of infertility in men. the damage to reproductive health from RA is greater in women than in men. Our findings help women of childbearing age with RA to intervene early before they are ready to conceive, with the expectation of improving conception rates and reducing the risk of infertility in women with RA.
Diversity and bioprospection of Gram-positive bacteria derived from a Mayan sinkhole
Authors: Wissner Julian L. , Parada-Fabián José Carlos , Márquez-Velázquez Norma Angélica , Escobedo-Hinojosa Wendy , Gaudêncio Susana P. , Prieto-Davó Alejandra
Published: March 2024

Water-filled sinkholes known locally as cenotes, found on the Yucatán Peninsula, have remarkable biodiversity. The primary objective of this study was to explore the biotechnological potential of Gram-positive cultivable bacteria obtained from sediment samples collected at the coastal cenote Pol-Ac in Yucatán, Mexico. Specifically, the investigation aimed to assess production of hydrolytic enzymes and antimicrobial compounds. 16S rRNA gene sequencing led to the identification of 49 Gram-positive bacterial isolates belonging to the phyla Firmicutes (n=29) and Actinobacteria (n=20) divided into the common genera Bacillus and Streptomyces, as well as the genera Virgibacillus, Halobacillus, Metabacillus, Solibacillus, Neobacillus, Rossellomorea, Nocardiopsis and Corynebacterium. With growth at 55ºC, 21 of the 49 strains were classified as moderately thermotolerant. All strains were classified as halotolerant and 24 were dependent on marine water for growth. Screening for six extracellular hydrolytic enzymes revealed gelatinase, amylase, lipase, cellulase, protease and chitinase activities in 93.9%, 67.3%, 63.3%, 59.2%, 59.2% and 38.8%, of isolated strains, respectively. The genes for polyketide synthases type I, were detected in 24 of the strains. Of 18 strains that achieved >25% inhibition of growth in the bacterial pathogen Staphylococcus aureusATCC 6538, 4 also inhibited growth in Escherichia coli ATCC 35218. Isolates Streptomycessp. NCA_378 and Bacillus sp. NCA_374 demonstrated 50-75% growth inhibition against at least one of the two pathogens tested, along with significant enzymatic activity across all six extracellular enzymes. This is the first comprehensive report on the biotechnological potential of Gram-positive bacteria isolated from sediments in the cenotes of the Yucatán Peninsula.
Superior Survival with Allogeneic Hematopoietic Stem Cell Transplantation versus Chemotherapy for High-Risk Adult Acute Lymphoblastic Leukemia in PDT-ALL-2016 Pediatric-Inspired Cohort
Authors: Zhou Hongsheng , Chen Junjie , Cai Zihong , Huang Zicong , Lin Jieping , Wang Zhixiang , Ou Jiawang , Xu Xiuli , Tang Bingqing , Ding Chenhao , Li Jia , Lin Ren , Zhang Ting , Xuan Li , Liu Qifa
Published: March 2024

The role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for adult high-risk acute lymphoblastic leukemia (HR-ALL) remained elusive in the pediatric-inspired regimen era. We conducted a cohort study on the outcome of allo-HSCT post-consolidation versus chemotherapy for HR-ALL in the first complete remission in PDT-ALL-2016 pediatric-inspired cohort. A total of 245 patients with HR-ALL were enrolled, according to donor availability and patients’ preferences, among which 159 received allo-HSCT after consolidation therapy, and 86 received post-remission chemotherapy. With a median follow-up of 43.6 months, the 3-year overall survival (OS) in allo-HSCT cohort was 77.1% (70.6–84.2%), and 51.7% (41.7–64.1%) in chemotherapy cohort, respectively (p < .001). In multivariate analysis, allo-HSCT cohort showed superior OS (HR = 0.33, 0.21–0.54, p < .001), event-free-survival (EFS, HR = 0.36, 0.23–0.56, p < .001), cumulative incidence of relapse (CIR, HR = 0.13, 0.07–0.22, p < .001), and increased non-relapse mortality (NRM, HR = 4.06, 1.23–13.4, p = .021), compared to chemotherapy cohort. Notably, allo-HSCT improved the outcome of minimal residue disease (MRD)-positive subset (OS, HR = 0.42,0.20–0.90, p = .025), as well as MRD-negative subset (OS, HR = 0.21, 0.10–0.43, p < .001). Our study demonstrates that allo-HSCT post-consolidation, compared to chemotherapy, could further improve survival of HR-ALL in pediatric-inspired cohort, regardless of MRD status.
Prognostic value of preoperative ascending aortic diameter on postoperative acute kidney injury in adult cardiac surgery
Authors: Dou Dou , Yuan Su , Jia Yuan , Li Yinan , Wang Hongbai , Ding Jie , Wu Xie , Bie Dongyun , Liu Qiao , An Ran , Yan Haoqi , Yan Fuxia
Published: March 2024

Background The ascending aortic diameter (AAD) is common in ultrasound examinations of cardiac surgery patients, and it is important for the prognosis of cardiac patients. The ascending aortic diameter has effect on renal perfusion. However, the impact of AAD on the incidence of postoperative acute kidney injury (AKI) in cardiac surgery patients is still unknown. This study aims to explore the prognostic value of ascending aortic diameter on the incidence of postoperative AKI in cardiac adult patients.
Method This retrospective study included patients aged ≥18 years who underwent cardiac operations between April 2023 to July 2023 in Fuwai Hospital, China. Patients were divided into two groups: AKI group and non-AKI group. The values of cardiac ultrasound the day before surgery were collected. The end point was the rate of acute kidney injury. Univariable and multivariable logistic regression analyses were performed to identify the independent risk factors for postoperative AKI. The receiver operating characteristic curve was used to assess model performance. Using another model without AAD, the effect of the addition of AAD was assessed.
Result 442 patients were included in this study. Univariable and multivariable results suggested that AAD was an independent factor of postoperative AKI for both on-pump and off-pump cardiac patients (P<0.05). To avoid CPB time confounding factor, we went subgroup analysis of the area under the curve of CPB time further. The addition of AAD improved the area under the curve from 0.67 to 0.72 (P<0.05) in on-pump patients.
Conclusion AAD represents a prognostic value of postoperative AKI in adult cardiac surgery. The prognostic value of AAD was higher in on-pump patients.
Diagnosis And Treatment Trends In Pediatric Stone Disease: Preferences of Urologists In The Field
Authors: Akdogan Nebil , Deger Mutlu , Yılmaz Ismail Onder , Ates Tunahan , Arıdogan Ibrahim Atilla , Satar Nihat
Published: March 2024

Introduction:
Many different treatment options exist for pediatric stone disease (PSD). We conducted a survey among urologists in Turkey to find out which diagnostic and therapeutic method urologists choose for stones of different localization and size in pediatric patients of varying age groups.
Materials and Methods
A survey on treatment options in various PSD was developed for urologists working in hospitals of different statuses. The survey consisted of 36 multiple-choice questions, and the average response time was 5 minutes. The measure taken to avoid repetitive responses was that the survey could only be completed once from an internet protocol.
Results
The number of respondents was 95. 91.67%, 89.47%, and 80.21% of the participants preferred ultrasonography as the diagnostic method in the 0–2, 2–6, and 6–18 age ranges, respectively. In treating staghorn kidney stones between 0–2 and 2–6 years, mini percutaneous nephrolithotomy (PCNL) was preferred most frequently, followed by standard PCNL. In all age groups, shockwave lithotripsy was the most common procedure for symptomatic pelvic stones smaller than 10 mm.
Conclusions
Urologists in Turkey act following the guidelines. However, this is not always possible due to lack of facilities. The necessary facilities for urologists need to be improved.
Disentangling the impact of soil type, geographical location, altitude, and family identity on the flower and leaf microbiome in alpine plants
Authors: Abdelfattah Ahmed , Ramakrishnan Dinesh Kumar , Jauernegger Franziska , Hoefle Daniel , Berg Christian , Berg Gabriele
Published: March 2024

Background
While substantial research has explored rhizosphere and phyllosphere microbiomes, knowledge on flower microbiome, particularly in wild plants remains limited. This study explores into the diversity, abundance, and composition of bacterial and fungal communities on leaves and flowers of wild flowering plants in their natural alpine habitat, considering the influence of environmental factors.
Methods
We investigated 50 wild flowering plants representing 22 families across seven locations in Austria. Sampling sites encompassed varied soil types (carbonate/silicate) and altitudes (450–2760 m). Amplicon sequencing to characterize bacterial and fungal communities and quantitative PCR to assess microbial abundance was applied, and the influence of biotic and abiotic factors assessed.
Results
Our study revealed distinct bacterial and fungal communities on leaves and flowers, with higher diversity and richness on leaves (228 fungal and 91 bacterial ASVs) than on flowers (163 fungal and 55 bacterial ASVs). In addition, Gammaproteobacteria on flowers and Alphaproteobacteria on leaves suggests niche specialization for plant compartments. Location significantly shaped both community composition and fungal diversity on both plant parts. Notably, soil type influenced community composition but not diversity. Altitude was associated with increased fungal species diversity on leaves and flowers. Furthermore, significant effects of plant family identity emerged within a subset of seven families, impacting bacterial and fungal abundance, fungal Shannon diversity, and bacterial species richness, particularly on flowers.
Conclusion
This study provides novel insights into the specific microbiome of wild flowering plants, highlighting adaptations to local environments and plant-microbe coevolution. The observed specificity indicates a potential role in plant health and resilience, which is crucial for predicting how microbiomes respond to changing environments, ultimately aiding in the conservation of natural ecosystems facing climate change pressures.
A novel monomer of Elephantopus mollis H.B.K., EM-6, inhibits the proliferation of Huh-7 cells by blocking autophagic flux and activating the ROS/MAPK pathway
Authors: Hou Changyan , Lou Ruoxuan , Wu Zhihui , Tang Jingjing , Zhao Na , Xu Xinwen , Zhou Junzhen , Xiong Peiqian , Li Qiang , Zhang Qing , Jiang Yue , Jiang Jianwei
Published: March 2024

Purpose
Primary liver disease is one of the major health problems in the world, and the prognosis of liver cancer is very poor. Liver cancer cells develop strong resistance to clinical chemotherapy drugs, leading to repeated liver cancer.
Materials and Methods
RNA-sequence was applied to related signal pathways that significantly altered. Flow cytometry and Western blot were performed to detect the changes of cell cycle, apoptosis and MAPK pathways. Immunofluorescence and flow cytometry were used to detect changes in cell mitochondrial membrane potential and intracellular ROS levels. Western blot, immunofluorescence, qRT-PCR and mCherry-GFP-LC3 were used to detect the effect of autophagy. Western blot and qRT-PCR were utilized to detect the effect of ER Stress.
Results
EM-6 is a novel monomer purified from Elephantopus mollis H.B.K. Mechanistically, compared with cisplatin (CDDP), EM-6 significantly inhibited the proliferation of human hepatocellular cancer cell lines and had less toxicity to human normal epithelial cells. EM-6 can induce mitochondrial membrane potential disruption, which leads to the accumulation of ROS, S-phase arrest and activation of the IRE1α-ASK1-JNK/p38 pathway to promote apoptosis in Huh-7 cells. In addition, EM-6 blocked protective autophagy by inhibiting the initiation of autophagy, and inhibiting the formation of autophagolysosomes triggered Huh-7 cell apoptosis.
Conclusion
Taken together, our findings suggest that EM-6 activates mitochondrial apoptosis through the ROS/MAPK pathway and promotes the activation of ER stress and the inhibition of autophagic flux to exacerbate apoptosis. These studies demonstrated the promising future of EM-6 in the clinical treatment of hepatocellular cancer.
Deciphering Abnormal Platelet Subpopulations in Inflammatory Diseases through Machine Learning and Single-Cell Transcriptomics
Authors: Qiu Xinru , Nair Meera G. , Jaroszewski Lukasz , Godzik Adam
Published: March 2024

The study focuses on understanding the transcriptional heterogeneity of activated platelets and its impact on diseases like sepsis, COVID-19, and systemic lupus erythematosus (SLE). Recognizing the limited knowledge in this area, our research aims to dissect the complex transcriptional profiles of activated platelets to aid in developing targeted therapies for abnormal and pathogenic platelet subtypes. We analyzed single-cell transcriptional profiles from 47,977 platelets derived from 413 samples of patients with these diseases, utilizing Deep Neural Network (DNN) and eXtreme Gradient Boosting (XGB) to distinguish transcriptomic signatures predictive of fatal or survival outcomes. Our approach included source data annotations and platelet markers, along with SingleR and Seurat for comprehensive profiling. Additionally, we employed Uniform Manifold Approximation and Projection (UMAP) for effective dimensionality reduction and visualization, aiding in the identification of various platelet subtypes and their relation to disease severity and patient outcomes. Our results highlighted distinct platelet subpopulations that correlate with disease severity, revealing that changes in platelet transcription patterns can intensify endotheliopathy, increasing the risk of coagulation in fatal cases. Moreover, these changes also seem to impact lymphocyte function, indicating a more extensive role for platelets in inflammatory and immune responses. This study sheds light on the crucial role of platelet heterogeneity in serious health conditions, paving the way for innovative therapeutic approaches targeting platelet activation, which could potentially improve patient outcomes in diseases characterized by altered platelet function.
PFC/M1 activation and excitability: a longitudinal cohort study on fatigue symptoms in healthcare workers post-COVID-19
Authors: Han Tao , Dai Chunqiu , Liang Ying , Lin Xiaodong , Gao Ming , Liu Xinyu , Wu Xiangbo , Lu Yuheng , Xi Xiao , Tian Fei , Zhao Chenguang , Sun Xiaolong , Yuan Hua
Published: March 2024

Background
Fatigue is one of the most common neurological symptoms reported post coronavirus disease 2019 (COVID-19) infection. In order to establish effective early intervention strategies, more emphasis should be placed on the correlation between fatigue and cortical neurophysiological changes, especially in healthcare workers, who are at a heightened risk of COVID-19 infection.
Methods
A prospective cohort study was conducted involving 29 COVID-19 medical workers and 24 healthy controls. The assessment included fatigue, sleep and health quality, psychological status, and physical capacity. Functional near-infrared spectroscopy (fNIRS) was employed to detect activation of brain regions. Bilateral primary motor cortex (M1) excitabilities were measured using single- and paired-pulse transcranial magnetic stimulation. Outcomes were assessed at 1, 3, and 6 months into the disease course.
Results
At 1-month post-COVID-19 infection, 37.9% of patients experienced severe fatigue symptoms, dropping to 10.3% at 3 months. Interestingly, the remarkable decreased activation/excitability of bilateral prefrontal lobe (PFC) and M1 were closely linked to fatigue symptoms after COVID-19. Notably, greater increase in M1 region excitability correlated with more significant fatigue improvement. Re-infected patients exhibited lower levels of brain activation and excitability compared to single-infection patients.
Conclusions
Both single infection and reinfection of COVID-19 lead to decreased activation and excitability of the PFC and M1. The degree of excitability improvement in the M1 region correlates with a greater recovery in fatigue. Based on these findings, targeted interventions to enhance and regulate the excitability of M1 may represent a novel strategy for COVID-19 early rehabilitation.
Trial registration
The Ethics Review Committee of Xijing Hospital, No. KY20232051-F-1, registered February 3, 2023. The Chinese Clinical Trial Registry, ChiCTR2300068444, registered February 20, 2023. https://www.chictr.org.cn
The Correlation Between the Movement, Legislation, Paradigm, and Existence of Cooperatives Plays a Crucial Role in Achieving Success in Providing Services.
Authors: Samad Abdul Wahab , Sandopart Dewa Putu Yohanes Agata L.
Published: March 2024

The development and expansion of cooperatives in Indonesia, which serve as a fundamental pillar of the economy, have been subject to historical fluctuations within the country. During the New Order era, there was significant progress in assisting farmers through the establishment of Village Unit Cooperatives (Koperasi Unit Desa, KUD). However, these cooperatives are today facing obstacles and setbacks. To assess the difficulties and advantages of cooperatives, it is necessary to establish a cooperative framework that encompasses the cooperative movement and the support of regulatory norms. This paradigm ensures the continued presence and provision of cooperative products in the economy. The research was conducted utilizing quantitative methodologies, specifically utilizing smart Partial Least Square (Smart PLS) analysis. A study was undertaken to investigate the scope of opportunities and challenges for the cooperative market to integrate into the Indonesian economy. The findings, from the data discovered by the academic community at the Institute of Business and Informatics in 1957, indicate that the p value is less than 0.05, indicating a significant correlation with a value over 0.7. Therefore, there is a significant potential for the development and establishment of cooperatives in Indonesia, which can serve as a fundamental pillar of the country's thriving economy in the future.
UNVEILING THE FRONTIERS: EXPLORING EMERGING FIELDS IN COMPUTER SCIENCE AND ARTIFICIAL INTELLIGENCE
Authors: Agarwal Abhinav
Published: March 2024

This research paper delves into the dynamic landscape of computer science and artificial intelligence, unraveling the emerging fields that are shaping the future of technology. Aimed at students of class 11th, this paper provides an insightful exploration of cutting-edge domains, their applications, and the potential impact on various industries.