bluuebunny/crossref_metadata_2025 huggingface dataset:
Recurrence-free Time after Pterygium Surgery with Sutureless Conjunctival vs. Conjunctival-Limbal Autograft: Is There Still a Role for Conjunctival Graft Alone?
Authors: Lucentini Stefano , Martellucci Cecilia Acuti , Rossi Luca , Sacchi Matteo , Nucci Paolo , Luccarelli Saverio
Published: June 2024

Background/Objective:
To compare the risk of recurrence and disease-free time after conjunctival autograft (CAG) or conjunctival-limbal autograft (CLAG) with sutureless (fibrin glue) fixation for pterygium excision.
Subjects/Methods
This is a retrospective cohort study. We reviewed the charts of 312 patients who underwent CAG and CLAG sutureless techniques between 2010 and 2019. Follow-up included visits on the 1st day, at weeks 1, 4, and 3, 6, 9, and 12 months after surgery, and every two years afterwards. The primary outcomes were the overall recurrence rate and average time to recurrence. The secondary outcomes were the rates of postoperative complications and the operation duration. Multivariate logistic regression was performed to verify the potential independent predictors of the study outcomes.
Results
265 patients were included, with a mean follow-up time of 31.5 months (maximum 8 years). The pterygium recurrence rate was significantly lower in the CLAG group at 12 months (3.9% vs. 17.4%, p < 0.001) and at the end of the follow-up (4.6% vs. 18.2%, p < 0.001). Patients with CLAG also had a longer time to recurrence (8.8 vs. 4.8 months, p = 0.012). The complications rate was lower for CLAG (0.6% vs. 10.6%, p < 0.002), while no clinically relevant differences were found in the surgery duration (23.4’ for CLAG vs. 25.2’ for CAG). Multivariate analysis confirmed these bivariate results.
Conclusions
Compared with CAG, CLAG reduced the risk and time to pterygium recurrence. Owing to the comparable surgical time and better safety profile, the CLAG technique can be considered a clinically and cost-effective approach for pterygium management.
Rational Design of Phytovirucide that Inhibits the Nucleocapsid Condensates of Tomato Spotted Wilt Virus
Authors: Song Runjiang , ning Zan , Li Jiao , Yao Jiahui , Wu Shang , Li Jianzhuan , Chen Feifei , Song Bao-An
Published: June 2024

Chemical management of crop failures caused by plant viruses poses serious challenges in agricultural chemistry. Recently, phase separation has emerged as a key role in the viral lifecycle, with the discovery of corresponding small molecule inhibitors in the medical field sparking significant interest. However, the applicability of this promising antiviral tactic for plant protection remains largely unknown. Herein, we have demonstrated that the aggregation of the tomato spotted wilt virus (TSWV) nucleocapsid protein (N) is regulated by RNA-induced phase separation, and disclosed a new rationally designed inhibitor Z9. Z9 is capable of binding to TSWV N at the R94 and Y184 sites, preventing the assembly of N and RNA into aggregated ribonucleoproteins through phase separation. Mutations of the binding sites substantially diminish the colocalization between N protein and processing bodies, interfering with the normal interaction of N protein with RNA. This study provides opportunities to phase separation-based anti-plant virus strategies.
A dynamic nomogram for predicting knee osteoarthritis after sports injury based on MR imaging features, demographics and clinical sport-related factors in cold regions of northern China
Authors: Zhu Jingya , Qi Miao , Yang Benqiang , Zhang Libo , shi lin , xing dengxiang , Zhang Nan , Duan Yang
Published: June 2024

Objectives
People who regularly participate in sports activities and those who work in certain specialized occupations are susceptible to knee injuries and have a substantially increased risk of post-traumatic knee osteoarthritis (KOA). Our aim was to develop a nomogram prediction model for the risk of KOA after sports injury based on imaging features of knee structures and demographic and clinical sport-related variables.
Methods
The modeling group included a total of 1002 patients with a complete history of knee joint sports injury admitted to the General Hospital of the Northern Theater of Surgery from January to December 2023. The patients were divided into KOA and non-KOA groups. Multivariate logistic regression analysis was used to identify risk factors, and a dynamic online nomogram prediction model for the risk of KOA after knee sports injury was constructed. Receiver operating characteristic (ROC) curve analyses, Hosmer-Lemeshow tests, and calibration plots were used to test the goodness of fit and predictive effect of the models. The prediction model was verified in an external validation cohort with a total of 429 patients with knee joint sports injuries, 145 with KOA and 284 with no KOA, admitted to the 962nd Hospital of the People’s Liberation Army (PLA) from October to December 2023.
Results
Among 1002 patients with knee joint sports injuries in the modeling group, 307 (30.64%) had KOA. Multivariate logistic regression analysis identified six factors: age, usual duration of exercise, foot strike pattern, fracture and bone contusion, meniscus injury, and cruciate ligament injury, as independent predictors of KOA after knee joint sports injury (P < 0.05). An online nomogram was constructed based on the six risk factors and the risk of KOA was quantified. The area under the ROC curve (AUC) for KOA after sports injury was 0.746 (95% confidence interval [CI], 0.721–0.768), sensitivity 0.739, and specificity 0.654. The AUC for the validation group was 0.731 (95% CI, 0.712–0.751), sensitivity 0.646, specificity 0.71. For Hosmer-Lemeshow test, P = 0.539 and 0.169, indicating that the model possesses effective discrimination and fitting effects.
Conclusion
The online dynamic nomogram prediction model we established, which includes six risk factors, among them age, exercise duration, and foot strike pattern, can better predict the risk of KOA after knee joint sports injury in a susceptible population and provides a simple quantitative evaluation tool for high-risk patients. It is helpful for the early identification of individual disease risk, timely intervention, and adjustment of training methods to provide a reference for preventive care.
Biparametric MRI-based radiomics for noninvastive discrimination of benign and malignant prostate nodules: A bio-centric retrospective cohort study
Authors: Lu Yang-Bai , Yuan Run-qiang , Su Yun , Liang Zhi-Ying , Huang Hong-Xing , Leng Qu , Yang Ang , Xiao Xue-Hong , Lai Chao-Qi , Zhang Yong-Xin
Published: June 2024

Background
To investigate the potential of an MRI-based radiomic model in distinguishing malignant prostate nodules from benign ones, as well as determining the incremental value of radiomic features to clinical variables, such as prostate-specific antigen (PSA) level and Prostate Imaging Reporting and Data System (PI-RADS) score.
Methods
A restrospective analysis was performed on a total of 251 patients (training cohort, n = 119; internal validation cohort, n = 52; and external validation cohort, n = 80) with prostatic nodules who underwent biparametric MRI at two hospitals between January 2018 and December 2020. The clinical model was constructed using logistic regression analysis. Radiomic models were created by comparing seven machine learning classifiers. The useful clinical variables and radiomic signature were integrated to develop the combined model. Model performance was assessed by receiver operating characteristic curve, calibration curve, decision curve, and clinical impact curve.
Results
The ratio of free PSA to total PSA, PSA density, peripheral zone volume, and PI-RADS score were independent determinants of malignancy. The clinical model based on these factors achieved an AUC of 0.814 (95%CI: 0.763–0.865) and 0.791 (95%CI: 0.742-840) in the internal and external validation cohorts, respectively. The clinical-radiomic nomogram yielded the highest accuracy, with an AUC of 0.925 (95% CI: 0.894–0.956) and 0.872 (95%CI: 0.837–0.907) in the internal and external validation cohorts, respectively. DCA and CIC further confirmed the clinical usefulness of the nomogram.
Conclusion
Biparametric MRI-based radiomics has the potential to noninvasively discriminate between benign and malignant prostate nodules, which outperforms screening strategies based on PSA and PI-RADS.
Understanding of charge relaxation dynamics of Sr doped on Gd 2 Ti 2 O 7 pyrochlore system as Electrolyte for IT-SOFCs
Authors: Ali Arshiya A. A. , Acharya Smita , Bhongale Kuldip , Shirbhate Shraddha , Kulkarni Shilpa , Joshi Shraddha
Published: June 2024

The pyrochlore-based system is gaining significant attention as a solid electrolyte in electrochemical energy devices, particularly solid oxide fuel cells (SOFC) due to its high oxygen-ion conductivity at the Intermediate temperature range (400−650 o C). In this study, we investigate the Gd 2 − x Sr x Ti 2 O 7 , pyrochlore system doped with strontium (Sr), where, x = 0, 0.02 and 0.04, 0.06, 0.08 and 0.1 to develop an oxygen-ion conductor as an electrolyte for intermediate temperature SOFCs (IT-SOFCs). Structural information is collected using the X-ray diffraction technique and confirms the cubic pyrochlore phase with Fd−3m symmetry accompanied by superstructure peaks (111) (311) (511) and (111) planes across all compositions. The structural data are simulated using Rietveld Refinement. Microstructural features of as-calcined and sintered samples studied by Scanning Electron Microscopy; confirm non-spherical grains with high non-uniformity in particle size distribution. of as-calcined samples and highly dense sintered samples. Elemental composition is confirmed by EDAS. Raman spectroscopy reveals detailed insights into the dopant-induced local restructuring in the Gadolinium Titanate lattice. Few intense Raman modes related to Eg+F2g and Alg involve the modulation of crystal structure through the vibration of oxygen along < 100 > cubic axis. Ionic conductivity and activation energy data are extracted through AC impedance measurements. The electric modulus study reveals the ionic relaxation and ion hopping dynamics and their effect on ionic conductivity. M'' relaxation peak and its distribution in relaxation time are analyzed using the Kohlrausch-Williams-Watts (KWW) fit. The presence of dopants induced structural deformations and oxygen vacancies in the GTO host lattice. This led to the disordering of vacancies and modifications in the stretching exponent 'β' and activation energy. Cooperative hopping dynamics through ion-vacancy interactions are found to be a notable influence on ionic conductivity. The optimized dopant composition of GSTO−4 exhibits the highest conductivity peak (σ = 4.3 x 10 − 3 S/cm@650oC). This suggests that apart from vacancy concentration and energy barriers for single-ion hopping, the cooperative dynamics of oxygen ions play a crucial role in determining the ionic conductivity values. Consequently, the GSTO−4 system demonstrates the potential for application as an electrolyte in intermediate temperature-SOFCs.
Exploring the recent trends, progresses, and challenges in the application of Artificial intelligence in water quality assessment and monitoring in Nigeria: A systematic review
Authors: Omeka Michael E.
Published: June 2024

In recent decades, machine learning (ML) artificial intelligence has found wide application in water quality monitoring and prediction due to the increasing complexity of water quality data. This complexity has been attributed to the global upsurge in anthropogenic activities and climatic variations. It is therefore critical to identify the most accurate and suitable ML model for water quality prediction. In this study, a systematic literature review (SLR) was carried out to explore the trend and progress in the application of ML models in water quality monitoring and prediction in Nigeria from 2003–2024. A comprehensive review of the effectiveness of advanced ML models as well as the gaps in their application in the area of water quality assessment and monitoring was also carried out using the PRISMA-P meta-analysis technique. Forty publications were used to perform bibliographic analysis and visualization using the VOS viewer software. The study found that globally, the use of hybrid ML models in water quality prediction has not been well explored; a majority of the prediction has been based on the use of artificial neural networks (ANN). Among the ANN algorithms, the adaptive neuro-fuzzy inference system (ANFIS), and Wavelet-Adaptive Neural Fuzzy Interference System (W-ANFIS) hybrid models are the most accurate in prediction; with temperature, dissolved oxygen (DO), pH, conductivity (EC), and total dissolved solids (TDS) among the most frequently predicted parameters. Nigeria is grossly lagging in the application of ML in water quality prediction. This limitation is largely attributed to inadequate data on environmental monitoring. It is critical therefore for future water quality monitoring and prediction studies in Nigeria to take advantage of the rapidly evolving field of machine learning; with more emphasis placed on the hybridized machine learning algorithms
Total Protein Determination by Recovery Fluorescence of Trinitrotoluene-Quenched protein-functionalized Gold Nanoclusters
Authors: Xia Xiaodong
Published: June 2024

Determination of total protein content is very important for clinical, pharmaceutical and food chemistry, and the selectivity and accuracy of the existing total protein assays should be improved. Here, a novel fluorescent sensor for total protein assay is described using near-infrared emitting fluorescent gold nanoclusters (Au NCs) prepared with egg white. Trinitrotoluene (TNT) serves as highly efficient quencher to quench the Au NCs fluorescence. Interestingly, the TNT-protein complex formed by premixing of TNT and protein-containing real samples can maintain the Au NCs fluorescence. These interesting findings provide a novel mechanism to design a fluorescence sensor to determine total protein levels in various real samples (commercial sera and food milk). With available and low-cost bovine serum albumin (BSA) serves as reference, the obtained standard curve for total protein determination indicates a linear range of 0.1 – 3.5 g L−1 with a detection limit of 0.06 g L−1 (3σ rule) and a correlation efﬁciency (R2) of 0.9850. The good performance and applicability of the proposed sensor are validated by comparison with which of the biuret assay. Comparison with the existing spectrophotometric methods, the proposed method is advantageous of simplicity, rapidity, cost-effectiveness and improved sensitivity and accuracy.
Comparison of Medical Students' Peer Assessment and Teaching Staff Assessment of Community Health Projects: Perceptions and Experiences
Authors: Mahmoud Mahmoud A , Almutairi Zaid Saud , Mahmoud Abdulrahman M , Alanazi Hind Bashir , Abdulrahman Sundus M
Published: June 2024

Background Public health education increasingly emphasizes experiential learning and community engagement. Peer review complements traditional staff assessment, enhancing learning outcomes and refining teaching strategies. This study aims to investigate the perceptions and experiences of medical students with peer assessment of community health projects. Staff assessment for the same projects will be used for Comparison.Methods A cross-sectional survey study involving medical students from the epidemiology and community health course at the College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU). Students assessed their peers' community health projects using a self-administered questionnaire. Staff evaluations were also compared. Data was analyzed by IBM SPSS 29.Results The study included 187 participants, primarily medical students (98.3%), who evaluated 20 community health projects. Additionally, three teaching staff members also rated the same projects. Medical students ranked effort expended (4.34), topic importance (4.26), and obvious participation (4.26) in descending order of value. The staff evaluated the relevance of the topic as the highest (4.43), but they rated the tools as lower (3.9). Medical students ranked tools sufficiency significantly higher with mean of (4.16 vs. 3.90) than staff (p < 0.05). Both groups evaluated the project's level of innovation and the clarity of its target audience in a comparable manner. The analysis of the Full Project Level indicated that there was no substantial disparity between medical students and staff, as evidenced by the p-value of 0.920.Conclusion This study validates that peer assessment of student projects is equally effective as assessment conducted by faculty members. Consequently, it is justifiable to allocate resources towards enhancing peer students' learning and assessment capabilities.
High-Intensity Interval Training and Strength Conditioning in patients with Chronic Lymphocytic Leukemia: a systematic review.
Authors: Cunha Pedro , Ribeiro Ricardo , Pizarro Andreia , Mota Jorge , Ribeiro José
Published: June 2024

Background
This systematic review explores the impact of physical exercise (EX) on Chronic Lymphocytic Leukemia (CLL) patients' physical fitness, immunologic, and quality of life outcomes.
Methods
Eligible cohort studies were searched in PubMed and Web of Science up to February 2024 and were included if they involved participants in adult age, with confirmed CLL diagnose, using physical activity protocols with study design helding intervention protocols, clinical trials, or quantitative data reporting.
Results
This review identifies 92 studies, with 6 meeting the inclusion criteria. These studies focus on cardiovascular training combined with resistance training, continuous cardiovascular training, and endurance resistance training, highlighting the importance of EX in CLL patients before treatment, with significant improvements in physical fitness and immunologic parameters. However, none address strength training, which is known as one of the best options to increase muscular mass in physical activity (PA) interventions.
Conclusions
There is a gap in the literature regarding exercise influence on CLL, with small samples of patients in Pilot Study experiments. It is noted that exercise plays a vital role in improving physical fitness and immunologic parameters. But to advise Exercise Professionals on prescribing different modes of exercise, improving compliance with the prescribed exercise program, and determining which intervention in the context of exercise prescription should be used to maximize the benefits resulting from regular practice of EX, more studies are needed to evaluate the impact of PA on the health-related quality of life and life span of the CLL patient.
Systematic review registration:
This review was registered in PROSPERO International prospective register of systematic reviews with ID: CRD42023464877.
The Association of Dietary Inflammation Index with Incidence of Both All-cause and Cardiovascular Mortality among US Adults with Cardiovascular Diseases
Authors: Luo Zehua , Tian Cheng , Ge Sheng
Published: June 2024

Background: Dietary Inflammation Index (DII) increases the risk of cardiovascular disease (CVD). However, few studies have revealed an association between DII with Incidence of Both All-cause and CVD Mortality among CVD populations.
Methods: The effect of DII on all-cause and CVD mortality was assessed using weighted multivariable Cox proportional hazards models. Weighted restricted cubic spline (RCS) and weighted Kaplan-Meier survival curves were used to determine the linearity between DII and mortality. Subgroup analysis was performed to explore whether the effect of DII on all-cause and CVD mortality was influenced by confounding factors.
Results: The data in this study were obtained from The National Health and Nutrition Examination Survey (NHANES) 2003-2018. During the mean follow-up time of 7.13 years, all-cause mortality and cardiovascular mortality were 38.96% and 13.51%, respectively. Furthermore, we found a linear relationship between the DII and all-cause and CVD mortality. After full adjustment for potential confounders (Model 3), the presence of the DII increased the risk of all-cause mortality by 4.3% (HR, 1.043; 95% CI, 1.006-.082; P-value =0.023) and the risk of CVD mortality by 8.3% (HR, 1.083; 95% CI, 1.020-1.150; P-value =0.009). Weighted Kaplan-Meier survival curves and weighted RCS plots revealed that All-cause and CVD mortality increased as DII increased.
Conclusion: Elevated DII levels were independently associated with an increased risk of all-cause and CVD mortality among CVD populations. However, the existence of a causal relationship between the two needs to be explored further.
Negative exokarstic units as a basis for urban management: Yucatan Peninsula, Mexico
Authors: May-Arias Elsi Margarita , Frausto-Martínez Oscar , Rodríguez-Castillo José Francisco , Arroyo-Arcos Lucinda
Published: June 2024

The morphological characterization of large-scale depressions, with high-resolution contributions and in urban contexts, has been carried out in the cities of Cozumel and Playa del Carmen. For Tulum, the inputs have been insufficient in identifying depressions at a detailed level. This research aimed to analyze and characterize the negative exokarstic relief of the city of Tulum through morphometric parameters and urban elements that contribute to the knowledge of the man-nature relationship. From the DEM ALOS PALSAR, contour lines, elevation models, slopes, and shadows were extracted, which allowed the identification of depressions, topographic profiles, and the calculation of morphometric indices; subsequently, the distribution of depressions was analyzed concerning urban elements. The identified depressions were classified into uvalas, sinkholes, and poljes. The analysis of the topographic profiles allowed us to recognize units in the shape of "V" (64%), "U" (19%), and "Hoya" (17%). The highest concentration of type V depressions is observed in the city's central area, characterized by a medium and high population density, as well as the centralization of commercial and public establishments. The detailed characterization of depressions is a planning and management tool for the territory.
Associations of fish oil with cardiovascular disease events: results from the Taiwan longitudinal study in aging
Authors: Chen Hsiu-Chuan , Tai Chi-Jung , Huang Jing-Yang , Kuo Tsu-Ann , Huang Yuan-Der , Yen Chi-Hua , Lee Meng-Chih
Published: June 2024

Background
The effectiveness of fish oil in preventing cardiovascular events is still debating. Some studies indicate a correlation between the use of fish oil supplements and reduced mortality or decreased incidence of stroke. However, other studies show no significant association between fish oil intake and stroke prevention, indicating an ongoing debate.This study aimed at exploring which subjects may benefit more from fish oil supplementation.
Methods
This study utilized the data from the Taiwan Longitudinal Study in Aging (TLSA). A total of 3,652 participants were included from the 2003 baseline data, after excluding patients with pre-existing ischemic heart disease or stroke. Participants were divided into two groups based on whether taking fish oil supplement or not. Participants were followed until 2015, estimating and comparing the all-cause mortality and cumulative incidence rate of stroke between both groups.
Results
The results of the 12-year longitudinal study showed that the cumulative incidence rate of stroke in the fish oil supplementation group was 5.7%, compared to 7.7% in the non-supplemented group (P < 0.05). Additionally, the crude hazard ratio for stroke was significantly lower in the fish oil supplementation group (HR = 0.686;95% CI 0.476–0.987). However, after adjusting potential confounders, the adjusted risk of stroke was lower only for the diabetic patients supplemented with fish oil (aHR = 0.123; 95% CI 0.016–0.930) compared to non-diabetic patients (aHR = 0.917; 95% CI 0.616–1.364).
Conclusion
This study demonstrates that fish oil supplementation can reduce the cumulative incidence rate of subsequent stroke among diabetic patients.
Short-term effects of live comedy on optimism, anxiety, and stress in a pre-post comparison study
Authors: Tomisawa Toshiko , In Naoya , Horie Kayo , Nanashima Naoki , Takamagi Shizuka , Mikami Kasumi
Published: June 2024

Background
Although there have been many studies on laughter and health, few studies have clarified the effects of laughter on optimism and pessimism, as well as anxiety. The purpose of the study was to evaluate the effects of viewing a comedy live performance on optimism, pessimism, and anxiety, sAA as a stress marker, and examine the relationship between laughter attitude and optimism, pessimism and stress marker and clarify significant factors that contribute to optimism.
Methods
In this pre–post study, we evaluated the effects on attendees of laughter elicited by a comedy live performance (CLP). The participants were 110 volunteers aged 18–64 years. Participants attended a two-hour CLP by four famous Japanese comedians (Sisonnu, Tonikaku Akarui Yasumura, Mouchugakusei, and Panther) and completed pre- and post-event questionnaires that included items from the Japanese Optimism and Pessimism Scale(JOPS), State-Trait Anxiety Inventory (STAI), the Laughter Attitude Scale(LAS) and Salivary alpha-amylase (sAA).
Results
The valid response rate was 101. Participants’ optimism was higher, and pessimism, anxiety and sAA were lower, after attending the CLP. α-amylase was significantly lower in more people before and after CLP. Factors contributing to optimism were strongly influenced by the degree to which people made them laugh, as well as pessimism, anxiety, and forced laughter.
Conclusion
The personal factors contributing most strongly to optimism were “A state that makes you laugh”, as well as pessimism, anxiety, and a low level of “Forced Laughter”. Attending a two-hour CLP increased optimism and decreased stress level, pessimism and anxiety, these effects were more pronounced in those who laughed regularly in their everyday lives
Exploring the impact of body mass index on tumor biology and cancer development
Authors: Ahrenfeldt Johanne , Carstensen Stine , Eriksen Ida Maria Hemdorff , Birkbak Nicolai Juul
Published: June 2024

Purpose
Cancer continues to be a major global health challenge, affecting millions of individuals and placing substantial burdens on healthcare systems worldwide. Recent research suggests a complex relationship between obesity and cancer, with obesity increasing the risk of various cancers while potentially improving outcomes for diagnosed patients, a phenomenon termed the "obesity paradox". In this study, we used a cohort of 1,781 patients to investigate the impact of obesity on tumor characteristics, including gene expression, pathway dysfunction, genetic alterations and immune infiltration.
Methods
Patient samples spanned 10 different cancer types, and were obtained from the Cancer Genome Atlas, with annotations for body mass index (BMI), age, sex, tumor size and tumor gene expression data.
Results
When we compared the proportion of large (T3-T4) to small tumors (T1-T2) between obese and non-obese patients, we found that obese patients tended to present with smaller, less invasive tumors and exhibited distinct gene expression profiles, particularly in metabolic and proliferative pathways. Moreover, smaller tumors in obese patients show higher immune cell infiltration and increased T cell diversity, suggesting enhanced immune activity.
Conclusion
Taken together, these findings highlight the influence of obesity on tumor biology, with implications for personalized treatment strategies that consider patient physiology alongside tumor characteristics.
Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study
Authors: Ding Xiaoyan , Yin Xue , Zheng Linlin , Zhou Lin , Hu Junke , Sun Wei , Sun Lei , Shen Yanjun , Teng Ying , Xu Yawen , Li Wendong , Liu Mei , Chen Jinglong
Published: June 2024

Background: Unresectable hepatocellular carcinoma (uHCC) patients with Child-Pugh grade B have limited treatment options and poor outcomes.
Methods: Patients with uHCC and Child-pugh B who received lenvatinib plus PD-1 inhibitors or sorafenib plus PD-1 inhibitors at one of three centers were retrospectively reviewed. These patients were divided into two subgroups: one with Child-pugh B7 (Group A, n =106) and another with Child-pugh B/9 (Group B, n = 73). Overall survival (OS) was defined as the primary endpoint. Secondary endpoints included time to progression (TTP), the objective response rate (ORR), and safety. Prognostic factors were evaluated using multivariate Cox proportional hazards models, while nomograms were constructed to predict 12-month survival.
Results: Between December 31, 2020 and March 30, 2023, a total of 179 patients were enrolled. The objective response and disease control rates of patients in the Child–pugh groups B and A were 26.0% and 76.7%, and 33.0% and 83.0%, respectively. There was no difference in median TTP (6.3 vs. 7.8 months, P = 0.28) or OS (14.0 vs. 17.8months, P = 0.20) between Group B and Group A. However, while the safety profiles were comparable between the two groups, patients with Child-pugh B8/9 had a significantly higher frequency of dose reductions and discontinuations (P = 0.04 and P < 0.001), compared to those with Child-pugh B7. According to the results of multivariate analysis，we constructed a nomogram to predict 12-month survival rates，considering tumor size, BCLC stage, tumor response , drug resistance. The nomogram-related receiver operating characteristics (ROC) curves indicated that the area under the curve (AUC) values were 0.752. Furthermore, the calibration curves revealed good agreement between real measurements and nomogram predictions.
Conclusions:
A combination of multi-kinase inhibitors (lenvatinib or sorafenib) plus PD-1 inhibitors was safe, well-tolerated, and especially it can also benefit patients with uHCC and Child-pugh B8/9.
Nonlinear dynamics of rotating functionally graded graphene platelets/titanium alloy trapezoid plates under 1:3 internal resonance
Authors: Fan Ming-Yang , Chen Jie
Published: June 2024

Although rotating blades are designed to operate diverging from structural frequencies, internal resonance also occurs under certain rotation speeds that greatly affect the stiffness of the blades. Therefore, a detailed investigation of the resonance mechanisms of rotating blades, especially those introduced by nonlinearities, is of great importance in structural design and optimization. A dynamic model of a functionally graded graphene/titanium alloy composite trapezoid plate is established to investigate the nonlinear dynamics of a rotating blade with varying cross-sections. The ordinary differential equations of the plate are established based on the energy method and Lagrange equations. The occurrence of one to three internal resonance for the trapezoid plate is identified through the analysis of linear and nonlinear free vibrations. Then, the steady-state responses of the rotating plate in the case of 1:3 internal resonance are numerically calculated and verified by the approximation solution of the method of multiple scales. Parametric studies are conducted to investigate the effects of the rotation speed, taper ratio, excitation amplitude and excitation frequency on the amplitude‒frequency and amplitude‒force curves.
The effects of lower eyelid epiblepharon surgery on the meibomian glands
Authors: Kim Seongmi , Yoon Da Eun , Kim Namju , Jeon Hyun Sun
Published: June 2024

Background
To investigate the morphological and functional changes of meibomian glands (MG) in pediatric patients who underwent surgery for lower eyelid epiblepharon.
Methods
A total of 176 eyes of 88 patients aged 19 and under (mean age: 8.9 ± 2.8 years old) who underwent bilateral lower eyelid epiblepharon correction surgery from May 2022 to April 2023 were included. Meibograde, lipid layer thickness (LLT), total blink rate, and corneal/refractive astigmatism were compared between pre- and 2 months postoperatively.
Results
There were no statistically significant changes in meibograde and LLT after surgery. The total blink rate was significantly decreased after surgery (p = 0.02). While corneal and refractive astigmatism showed no significant changes in total eyes, corneal astigmatism in eyes of high astigmatism of 2.0D or more subgroup exhibited a significant decrease postoperatively (p < 0.001).
Conclusions
Lower eyelid epiblepharon surgery in pediatric patients does not significantly alter the structure and function of the MG. Additionally, stabilizing the ocular surface through surgical correction may have beneficial effects on blink rate and corneal astigmatism. Although the long-term evaluation would be needed, we suggest that lower eyelid epiblepharon surgery could be performed without worrying about adverse effects on the MG.
Cholecystitis and cholangiocarcinoma: a two-sample mendelian randomization study
Authors: Gao Xing , Gao Hao , Wang Song , Tang Futian , Zhao Yang , Li Yumin
Published: June 2024

Background
In recent years, the incidence of cholangiocarcinoma increases. Epidemiological studies suggest that cholecystitis elevates the risk of hepatobiliary cancer. However, an independent causal relationship remains unrevealed. Observational studies are vulnerable to residual confounders and bias, which compromises causal inference. Our study aimed to evaluate whether cholecystitis is an independent risk factor for cholangiocarcinoma.
Methods
Instrument variables were identified as independent single nucleotide polymorphisms highly associated with cholecystitis (n = 62). The entire dataset from the Integrative Epidemiology Unit (IEU) public availability genome-wide association studies was utilized to determine outcomes for cholangiocarcinoma (n = 62). In this study, five Mendelian randomization (MR) statistical techniques (Inverse Variance Weighted, MR Egger, Weighted Median, Simple Mode, and Weighted mode) were used. The MR Egger intercept test, leave-one-out analysis, and the funnel plot were all utilized in sensitivity analyses.
Results
Results of the Inverse Variance Weighted tests genetically predicted that cholecystitis was significantly associated with higher risk of cholangiocarcinoma, with an odds ratio of 1.27 (95% CI: 1.038–1.553; P = 0.02). But the Weighted Median Method, MR Egger Regression, Simple Mode, and Weighted Mode all showed no statistical significance (P > 0.05). Both funnel plots and MR Egger intercepts indicated the absence of any directional pleiotropic effects between cholecystitis and cholangiocarcinoma.
Conclusion
We found potential evidence of a causal effect between cholecystitis and cholangiocarcinoma, indicating an increased likelihood of cholangiocarcinoma in patients with cholecystitis through mendelian randomization analysis. Our results excepted enhance the management of patients with cholecystitis to decrease the risk of cholangiocarcinoma.
Exploring Spiking Neural Networks for Deep Reinforcement Learning in Robotic Tasks: A Comparative Study
Authors: Zanatta Luca , Barchi Francesco , Manoni Simone , Tolu Silvia , Bartolini Andrea , Acquaviva Andrea
Published: June 2024

Spiking Neural Networks (SNNs) stand as the third generation of Artificial Neural Networks (ANNs), mirroring the functionality of the mammalian brain more closely than their predecessors. Their computational units, spiking neurons, characterized by Ordinary Differential Equations (ODEs), allow for dynamic system representation, with spikes serving as the medium for asynchronous communication among neurons. Because of their inherent capability of capturing input dynamics, SNNs are promising as deep networks in Reinforcement Learning (RL) tasks. Deep RL (DRL), and in particular Proximal Policy Optimization (PPO) has been proven to be valuable for for training robots due to the difficulty in creating comprehensive offline datasets that capture all environmental features.DRL combined with SNNs offers a compelling solution for tasks characterized by temporal complexity. In this work, we study the effectiveness of SNNs on DRL tasks leveraging a novel framework we developed for training SNNs with PPO in Isaac Gym simulator implemented using the SKRL library. Thanks to its significantly faster training speed compared to available SNN DRL tools, the framework allowed us to: i) Perform an effective exploration of SNN configurations for DRL robotic tasks; ii) Compare SNNs and ANNs for various network configurations such as the number of layers and neurons. Our work demonstrates that in DRL tasks the optimal SNN topology has a lower number of layers than ANN and highlights how in complex tasks, such as Ant, SNNs fail to leverage deeper layers. Finally, we applied the best topology identified thanks to our Isaac Gym-based framework on Ant-v4 benchmark running on MuJoCo simulator, exhibiting a performance improvement by a factor of 4.4x over the state-of-art SNN trained on the same task.
Phenomenon of room-temperature interdiffusion self-bonding between entangled glassy polymers: a statistical study
Authors: Boiko Yuri M.
Published: June 2024

A comprehensive statistical analysis of the distributions of the adhesion strength (σ) developed during a long-term contact (up to 2 months) of two identical specimens of an amorphous entangled polymer at a very low temperature (T) of 24°C with respect to the bulk glass transition temperature (Tg), below Tg by 80°C, was carried out. For this purpose, two representative glassy polymers, polystyrene [PS; three PSs differing markedly in the number-average molecular weight (Mn) from 75 to 966 kg/mol] and poly(methyl methacrylate) (PMMA; Mn = 43.5 kg/mol), were selected. Keeping in contact the two specimens of PS or PMMA at T = 24°C resulted in self-bonding at PS-PS and PMMA-PMMA interfaces. The as-self-bonded interfaces were shear fractured in tension to measure their σ values. The four σ distribution sets obtained for such a low T for the first time were examined using a number of common formal tests for normality and graphical statistical methods, including Weibull’s model. In general, the σ distributions for the PS with the highest Mn = 966 kg/mol were described more correctly than those for the other three polymers, regardless of the statistical methods applied. These results were compared with those obtained after self-bonding at a significantly higher T = Tg − 33°C for the same polymers. The statistical parameters estimated at markedly different temperatures (T = Tg − 80°C and Tg − 33°C) were compared and discussed.
tert-Butylhydroquinone alleviates postharvest endocarp browning of longan fruit by regulating antioxidant metabolism
Authors: Yu Zhiqian , Kang Wenjing , Zhang Zhengke , Yang Ziqin , Jiang Yueming , Pan Yonggui , Yang Jiali
Published: June 2024

Harvested longan fruit is prone to endocarp browning, which restricts preservation quality and shelf life. The antioxidant system defends against oxidative stress-mediated quality deterioration such as fruit browning. The study aimed to evaluate the effect of tert-Butylhydroquinone (TBHQ) on anti-browning ability of longan fruit in association with antioxidant capacity. The results indicated that application of 0.02% TBHQ significantly suppressed the progression of endocarp browning. In comparison with control, TBHQ treatment decreased the levels of hydrogen peroxide (H2O2), superoxide radical (O2−⋅), and malondialdehyde (MDA), and retained high levels of ascorbic acid (AsA), glutathione (GSH), total phenolics as well as 1,1-diphenyl-2-picrylhydrazyl (DPPH) scavenging rate. Enhanced enzymatic activities of superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), glutathione reductase (GR), monodehydroascorbate reductase (MDHAR), dehydroascorbate reductase (DHAR), but inhibited polyphenol oxidase (PPO) and peroxidase (POD) activities were also observed in TBHQ-treated fruit. Gene expression analysis suggested oxidative stress-related genes including DlSOD, DlCAT, DlGR, and DlAPX were up-regulated after TBHQ treatment. The results suggest that TBHQ is effective in alleviating endocarp browning by increasing antioxidant capacity of longan fruit.
Molecular structure and interactions of the flavonols, quercetin, fisetin, kaempferol, and myricetin, with liposomal membranes
Authors: Veiko Artem G. , Sekowski Szymon , Olchowik-Grabarek Ewa , Wilczewska Agnieszka Z. , Dobrzyńska Izabela , Roszkowska Anna , Lapshina Elena A. , Zamaraeva Maria , Zavodnik Ilya B.
Published: June 2024

The interactions of flavonols with biological membranes underlie their beneficial biochemical effects. In the present work, we performed quantum chemical modeling of the molecular structure and electronic characteristics of some flavonols such as fisetin, kaempferol, and myricetin and compared our findings with those for quercetin obtained earlier. We considered the effects of the flavonols on liposomal membranes, using the methods of fluorescence probe spectroscopy, an electric-kinetical method and differential scanning calorimetry. The AC and B rings in the molecules of all the flavonols studied were located in the same plane. All the flavonols (5–25µM) increased the lipid bilayer order both in the surface zone and the hydrophobic area of the membrane. Quercetin was more effective in changing the liposomal membrane mobility and fisetin modulated markedly the thermotropic behavior of the membrane. Myricetin was located predominantly in the surface zone, whereas quercetin penetrated into the deeper zone of the bilayer. Using the fluorescent probe Laurdan we showed that all the flavonols studied increased the hydration of the lipid bilayer. The incorporation of effector molecules into the liposomal membrane bilayer resulted in an increase in the absolute value of zeta potential and induced an increase in the liposomal diameter. Destabilization and enhanced heterogeneity of liposomal membranes in the presence of all the flavonols studied were revealed.
Toward Iran's health system regionalization: a qualitative approach.
Authors: Eskandarian Mohamad , Raeisi Ahmadreza , Ferdosi Masoud , Golzari Mojtaba
Published: June 2024

Background:Regionalized health systems are expected to provide an integrated chain of services for a defined population. However, developing such systems is possible only through alignment across policy, administrative/coordinative, and operational levels. The present study aimed to identify the requirements for such alignment among various levels of Iran's health system.Methods: This qualitative study was conducted with experts in related departments of the Ministry of Health and Medical Education in Iran and selected universities over 5 months in 2023-2024. Fifteen semi-structured interviews were conducted with policymakers and academic experts to collect the study data. The data were grouped into three themes based on thematic content analysis using the MAXQDA software.Results:Three main categories of requirements for developing regionalized health systems, encompassing policy, administrative/ coordinative, and operational levels, and 23 sub-themes, were extracted. Like other hierarchical health systems, the country's health system faces fundamental challenges due to insufficient organizational infrastructure, which hinders its transition into an integrated healthcare management system.Conclusions: Given the legal obligations imposed on the Ministry of Health and Medical Education to establish an integrated regionalized health system and the failure of the relevant initiatives, it is critical to develop the essential infrastructural requirementsacross levels to achieve this goal.
Plausible Efficacy of COVID-19 Vaccination against Covid-like Symptoms in Nigeria: A Cross-sectional Study.
Authors: Osibogun Akin , Shuaib Faisal , Odusolu Yetunde , Okposen Bassey , Osibogun Opeyemi , Akanmu Sulaimon , Mohammed Abdullahi , Yahya Shuaib , Akande Tanimola , Aliyu Alhaji , Ifeadike Chigozie , Akande Aderonke , Aigbokhaode Adesuwa , Adebiyi Akin , Tobin-West Charles , Olatunya Oladele , Aguwa Emmanuel , Danjuma Garba , Dika Joseph , Nwosu Augustina , Olubodun Tope , Oladunjoye Adebimpe , Giwa Opeyemi
Published: June 2024

Background:
Vaccination strengthens the immune system by using the body’s intrinsic defense mechanisms to enhance resistance to notable or specific disease agents. A cross-sectional community-based study comparing the occurrence of Covid-like symptoms among individuals earlier vaccinated or unvaccinated against Covid-19 using all the four different vaccine types administered in Nigeria. Given that Sub-Sahara Africans were not included in the vaccine clinical trials before Emergency Use Authorization, this study could provide indirect evidence on the effectiveness or otherwise of the vaccines among Nigerians.
Methods: A cross-sectional community-based study of prevalence of covid like symptoms reported in subjects who had received any of the Covid-19 vaccine types deployed in Nigeria compared with subjects who had not received any of the vaccines in the six geo political zones of the country. A multi-stage sampling technique was used to select 24 Local government Areas from all six (6) geopolitical zones of the country.
Results: Lesser proportion of subjects who had received any of the COVID-19 vaccines reported experiencing symptoms such as headaches, muscle, joint aches, fatigue, fever, sore throat, cough, and chills in the preceding 3 months to the survey as compared to subjects who had not received any of the vaccines. These observed differences were statistically significant, (p<0.05).
Conclusion: The COVID-19 vaccines would appear protective against the symptoms of interest based on these findings. The reduction in the proportions reporting symptoms for the different types of vaccine are invariably similar therefore vaccine recipients can be encouraged to receive any brand to curb the pandemic.
Environmental Regulation and Financial Motivations: Analyzing the Impact of Firm Financialization on Green Innovation
Authors: Hao Liangfeng , Zhao Yongmeng , Deng Biyi
Published: June 2024

This study develops a unified theoretical model that integrates environmental regulations, firm financialization, and green innovation. We utilize the increased pollution discharge fees in China as a quasi-natural experiment to assess the impact of environmental regulation. Our findings indicate that higher pollution discharge fees enhance both the quantity and quality of green patents. We identify an inverted U-shaped relationship between firm financialization and the quantity of green patents, where financialization initially promotes but subsequently weakens the enhancement of green patent quality. Further analysis reveals that increased pollution fees intensify firms' financialization tendencies. We discover that risk aversion motivation, by easing financial constraints, significantly boosts the quantity and quality of green patents. In contrast, speculative motivation tends to displace physical investment, negatively affecting green patent outcomes. Additionally, our results suggest that financial technology might substitute for traditional firm financialization practices, and that robust financial regulation can curb financialization to foster green innovation. Cities employing market-controlled policy tools appear more affected by financialization investment impacts.