bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of coagulation traits on the risk of retinal vein occlusion: a mendelian randomization study
Authors: Yuan Chaoyi , He Chao , Zuo Ling , Liu Baoxing , Qi Hui
Published: August 2024

Introduction Retinal vein occlusion (RVO) is the leading cause of vision loss due to an obstruction in the retinal venous system. While RVO is often linked to thrombotic tendencies and coagulation abnormalities, the exact role of coagulation traits in its development is not fully understood. This study aims to investigate the potential causal relationship between coagulation traits and the risk of RVO by analyzing publicly available genome-wide association study (GWAS) summary statistics.
Materials and methods A two-sample Mendelian randomization (MR) analysis framework was employed to investigate the causal relationship between coagulation traits and the risk of RVO. Stringent quality control measures were applied to select appropriate instrumental variables strongly linked to exposure, such as coagulation factor III (FIII), coagulation factor V (FV), coagulation factor VIII (FVIII), coagulation factor XI (FXI), coagulation factor VII (FVII) and coagulation factor X (FX), as well as plasmin, platelet count, platelet crit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW). The study utilized the FinnGen project RVO GWAS summary statistics cohort, consisting of 372 RVO cases and 182,573 controls. The analysis focused on 11 coagulation traits.
Results The research suggests that genetically predicted plasma levels of FIII, FVII, MPV, and PCT may be potentially causative for reducing the risk of RVO, and that levels of FVIII may be potentially causative for increasing the risk of RVO.
Conclusion Our MR analysis, utilizing GWAS data from a comprehensive population-based study, revealed a causal association between plasma levels of FFIII, FVII, FVIII, MPV, and PCT with the risk of RVO.
The association of biological sex and long-term outcomes in older patients with physical restraint at the emergency department
Authors: Manfredini Laetitia , Pépin Marion , Ayar Pradeebane Vaittinada , Gay Matthieu , Certin Marie , Ayar Prabakar Vaittinada
Published: August 2024

Backgrounds: The worldwide population is ageing. Biological sex is first and foremost a genetic modifier of disease. To prevent self-arm many techniques can be used in older patients. Among them coercive measure consisting of physical restraint (PR) is one of the techniques. This study aims to assess the effects of the biological sex on the long-term survival after PR in geriatric patients during the initial emergency department (ED) visit. Methods: This retrospective study included patients between November 2019 to March 2021. All consecutive hospitalized patients after emergency department visit older than 75 years with PR were included. The population was compared according to the biological sex. One-year all-cause mortality was plotted with the Kaplan-Meier curve. Hazard ratios (HRs) for 1-year mortality were calculated using a Cox proportional hazards regression model. Mortality was monitored over a 3-year period. Results: PR was used in 149 patients representing 4.6% of 3210 hospitalized patients older than 75 years after ED visit. Women represented 52% of the study population. Compared to men, women were older [median (IQR) age 89 (85–93) vs. 85 (81–90) years, P = 0.002]. Women more often presented dementia (93 vs. 80%, P = 0.031). Both sexes presented the same limited autonomy. All-cause mortality was significantly lower for women than men after one year (25 vs. 51%, respectively, P = < 0.001). Likewise, adjusted HR of 1-year all-cause mortality was higher in men [a HR 3.1 (95% confidence interval 1.5–6.3), P < 0.001]. Conclusions: This study suggested that the use of physical restraint in older adults was a more related factor of mortality in men than women. In men PR use seemed to be a sign of global health decline. Further prospective studies are needed to assess if PR are a cause or a consequence of a global health decline.
Community structure and diversity changes for fish in a temperate tidal lagoon, as a response to changes in water temperature and depth
Authors: Odongo Victor , Asmus Harald , Boersma Maarten , Heubel Katja , Sander Lasse , Rubinetti Sara , Sidorenko Vera , Horn Sabine
Published: August 2024

Coastal marine ecosystems are characterized by high productivity and biodiversity supporting coastal fisheries for centuries. These ecosystems have undergone changes over the last few decades, experiencing shifts in seasonal patterns due to climate change. As a case study for responses of cold temperate coastal ecosystems to climate change, changes in fish diversity in the Sylt-Rømø Bight (SRB), northern Wadden Sea; 54°58’40”N, 8°29’45”E, were analyzed using data from the monthly monitoring from 2007 to 2019. Results showed that the diversity changes correlated to seasonal changes in water temperature. The spatial distribution of fish to intertidal areas for feeding and refuge was correlated to changes in water depth. Rank abundance curves (RACs) showed that a few species dominated the fish community and this changed per season and habitat type. General Additive Models (GAMs) showed higher species richness (S) at 5°C and 15°C, which are seasonal transition phases for winter/spring and summer/autumn, respectively. Evenness (J) and Shannon-Wiener Index (H) decreased with increasing water temperatures in the benthic and pelagic habitats while dominance (D) increased. Generalized linear mixed-effects models (GLMMs) showed that S decreased while J increased with water depth in benthic habitats. Similar patterns were observed in the nearshore pelagic habitats contrary to the deep tidal channels. There were no significant effects of water depth on H. The diversity changes reveal the sensitivity of fish to seasonal changes in oceanographic processes and the use of intertidal habitats. Thus, the significance of shallow coastal habitats for fish needs implementation in conservation and management measures.
Deciphering Clinical Predictors in Japanese Encephalitis: A Systematic Review and Meta-Analysis of Effective Diagnosis and Prognosis Indicators
Authors: Rabaan Ali A. , Al-Subaie Maha F. , Kaabi Nawal A. Al , Alkathlan Mohammed S. , Tombuloglu Huseyin , Abdullah Rashid Al , Khamis Faryal , Alissa Mohammed
Published: August 2024

Japanese encephalitis (JE) is a neurotropic flavivirus that causes brain inflammation and is transmitted by bites from infected mosquitoes of the Culex species. The disease can range from mild to severe, with initial symptoms such as fever, headache, vomiting, and fatigue. As the infection progresses, patients may develop more severe neurological symptoms, including seizures, confusion, and paralysis. A systematic review process using established reporting guidelines such as PRISMA was used to analyze 1477 studies, resulting in 880 unique investigations imported into Zotero for further analysis. In this review, 307 research articles were excluded due to lack of relevance. Eventually, this review synthesized findings from 38 investigations that met the criteria for inclusion. The review investigated clinical predictors for Japanese encephalitis diagnosis and prognosis, finding potential risk factors in seizures and muscle rigidity but no significant correlation at the 95% confidence level. Fever and vomiting were significant predictors, but headache was not due to heterogeneity among studies. A large dataset is needed to confirm associations, and not all infected individuals will show all symptoms.
Saturated Fat Restriction for Cardiovascular Disease Prevention: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Yamada Satoru , Shirai Tomomi , Inaba Sakiko , Inoue Gaku , Torigoe Minami , Fukuyama Naoto
Published: August 2024

The recommendation to limit dietary saturated fat intake is primarily drawn from observational studies rather than randomized controlled trials of cardiovascular disease prevention. Thus, we investigated the efficacy of saturated fat reduction in preventing mortality and cardiovascular diseases. In this systematic review and meta-analysis of randomized controlled trials, Cochrane CENTRAL, PubMed, and Ichu-shi databases were searched up to April 2023. Randomized controlled trials on saturated fat reduction to prevent cardiovascular diseases were selected. Cardiovascular and all-cause mortality and cardiovascular outcomes were evaluated. Changes in electrocardiography or coronary angiography findings were excluded because they could be evaluated arbitrarily. Two or more reviewers independently extracted and assessed the data. A random-effects meta-analysis was performed using the Grading of Recommendations Assessment, Development, and Evaluation method. Nine eligible trials with 13,532 participants were identified (two were primary and seven were secondary prevention studies). No significant differences in cardiovascular mortality (RR = 0.94, 95% CI: 0.75–1.19), all-cause mortality (RR = 1.01, 95% CI: 0.89–1.14), myocardial infarction (RR = 0.85, 95% CI: 0.71–1.02), and coronary events (RR = 0.85, 95% CI: 0.65–1.11) were observed between the intervention and control groups. However, due to limited reported cases, we were unable to evaluate the impact of stroke. At present, a reduction in saturated fats cannot be recommended to prevent cardiovascular diseases and mortality. Clinical trials are needed to evaluate the effects of saturated fat reduction under statin administration.
Relationships between Crosslinking Behaviour and Morphological Development in PLA/ENR Blends Using Maleic Anhydride as a Coupling and TPV Agent
Authors: Hadi Muhamad Al-Haqqem Abdul , Rahim Nor Azura Abdul , Hazan Roshasnorlyza , Keat Yeoh Cheow
Published: August 2024

Maleic anhydride (MA) can function as both a grafting agent and a thermoplastic vulcanizate (TPV) agent in thermoplastic elastomer (TPE) blends of polylactic acid (PLA) and epoxidized natural rubber (ENR), depending on the degree of crosslinking. To validate the claim, a set of formulations with MA ranges from 0 to 2.0 phr was added to the PLA/ENR blend at different matrix blend ratios and compounding sequences. To distinguish the types of networks responsible for altering the blend’s phase and melt flow behaviour, various tests including mechanical, rheological, viscoelasicity validation, visual imaging, thermal analysis and spectroscopy testing of X-ray diffraction analysis (XRD) and Fourier transform infrared (FTIR) were conducted. The results revealed that, without the presence of MA, the blends behave as typical thermoplastic elastomers (TPEs). Meanwhile, the addition of MA enhances the tensile properties and modifies the blend microstructure, indicating the presence of a coupling effect in the PLA/ENR blend. With further inclusion of more MA inside the blends, the rise in crosslinking degree transforms the blend into a thermoplastic vulcanizate (TPV) compound. Interestingly, in the molten state, the TPV blends exhibit dilatant flow behaviour, which is in contrast with the shear-thinning flow pattern of PLA.
Carbon Dioxide-Enhanced Angiography for Detection of Colonic Diverticular Bleeding and Clinical Outcomes
Authors: Kitamura Ryoichi , Maruhashi Takaaki , Woodhams Reiko , Suzuki Koyo , Kurihara Yutaro , Fujii Kaoru , Asari Yasushi
Published: August 2024

Purpose: To determine the ability of CO2-enhanced angiography to detect active diverticular bleeding that is not detected by iodinated contrast medium (ICM)-enhanced angiography and its impact on clinical outcomes when used to confirm embolization, particularly the risks of rebleeding and ischemic complications.
Materials and Methods: We retrospectively identified a cohort of patients with colonic diverticular bleeding who underwent catheter angiography between August 2008 and May 2023 at our institution. We divided them according to whether they underwent CO2 angiography following a negative ICM angiography study or to confirm hemostasis post-embolization (the CO2 angiography group) or ICM angiography alone in the absence of active bleeding or for confirmation of hemostasis post-embolization (the ICM angiography group). The ability to detect active colonic diverticular bleeding and clinical outcomes were compared between the two groups.
Results: There were 31 patients in the ICM angiography group and 29 in the CO2 angiography group. The rate of detection of active bleeding by CO2 angiography that was not identified by ICM angiography was 48%. The rebleeding rate was 23% in the ICM angiography group and 6.9% in the CO2 angiography group. Among the patients who underwent TAE, the ischemic complications rate was 7.1% in the ICM angiography group and 4.5% in the CO2 angiography group.
Conclusions: CO2 angiography may detect active diverticular bleeding that is not detectable by ICM angiography and appears to be associated with a lower rebleeding rate.
Level of evidence: IV
Pan-cancer analysis of Sp1 with a focus on immunological roles in gastric cancer
Authors: Zhou Yang , Luo Zhenzhen , Guo Jinfeng , Wu Lixia , Zhou Xiaoli , Huang Junjie , Huang Daijia , Li Xiao , Duan Qiuhua , Chang Jianhua , Gong Libao , Hang Junjie
Published: August 2024

Background
Sp1, a transcription factor, plays a pivotal role in tumorigenesis across diverse cancers. However, its comprehensive pan-cancer analyses and immunological roles in gastric cancer (GC) remain inadequately elucidated.
Methods
Through a comprehensive analysis utilizing bioinformatics tools and datasets from TCGA, GEO, and THPA, we examined the multifaceted role of Sp1. Expression profiles were assessed across cell lines, tissues, and tumors, alongside exploration of genetic alterations, DNA methylation, and protein phosphorylation. Its associations with immune infiltration, tumor mutational burden, and immune checkpoint signaling were investigated. Additionally, single-cell transcriptome data showed its expression in different immune cells in GC. Validation of correlations between Sp1 and immune microenvironment in GC was performed using immunohistochemistry and multiple immunofluorescence in an immunotherapy-treated patient cohort. The prognostic value of Sp1 in GC receiving immunotherapy was evaluated with Cox regression model.
Results
Elevated Sp1 levels were observed in various cancers compared to normal tissues, with notable prominence in gastric cancer. High Sp1 expression correlated with advanced stage, poor prognosis, elevated tumor mutational burden (TMB), and microsatellite instability (MSI) status, particularly in GC. Sp1 levels also correlated with CD8 + T cell and M1 phenotype of tumor-associated macrophages infiltration. Furthermore, GC patients with higher Sp1 levels exhibited improved response to immunotherapy. Moreover, Sp1 emerged as a prognostic and predictive biomarker for GC patients undergoing immunotherapy.
Conclusions
Our pan-cancer analysis sheds light on Sp1's multifaceted role in tumorigenesis and underscores its potential as a prognostic and predictive biomarker for GC patients undergoing immunotherapy.
Borderline Ovarian Tumors: Recurrence Patterns and Management
Authors: Tunç Mehmet , Akıllı Hüseyin , Günakan Emre , Haberal Nihan , Haberal Ali , Ayhan Ali
Published: August 2024

Purpose: We aimed to evaluate the factors associated with disease recurrence, recurrence patterns, and obstetric outcomes of borderline ovarian tumors. The main outcome was prognostic factors for disease recurrence. The secondary outcomes were recurrence sites and obstetric results.
Methods: This study included patients diagnosed with BOT in Başkent University. Data was obtained from patient files and hospital records. Histopathological results were re-evaluated based on the new 2020 WHO classification. Risk factors for disease recurrence were evaluated for early-stage and advanced-stage diseases. Survival was measured from the time of diagnosis.
Results: A total of 142 patients were included. The median follow-up time was 100.5 months. Recurrence occurred in 24(16.9%) patients and the 5-year RFS 86.3% and no deaths were recorded. The main recurrence site of the tumor was the same ovary (12/24, 50%). In multivariate analysis, cystectomy was found as a risk factor for recurrence in the early stage (HR:4.28; 95%CI: 1.40 – 13.08, p:0.011). One patient’s tumor showed malignant transformation (1/24, 4.17%). The pregnancy rate was 76.7% among 43 patients who attempted to conceive. There was no difference in obstetric outcomes between USO and cystectomy (p:0.223).
Conclusion: The risk of recurrence in patients with BOT was higher in patients who underwent cystectomy and obstetric outcomes were similar between cystectomy and USO. In this study, most recurrences occurred in the ovaries. Therefore, fertility-sparing appears to be an appropriate choice for young women with satisfactory obstetric outcomes even in the advanced stage.
Effects of calcium phosphate and phosphorus-dissolving bacteria on microbial structure and function during Torreya grandis branch waste composting
Authors: Yu Chenliang , Guan Yuanyuan , Wang Qi , Li Yi , Wang Lei , Yu Weiwu , Wu Jiasheng
Published: August 2024

Background
To investigate the effects of phosphorus solubilizing microorganisms and calcium phosphate on the composting of Torreya grandis branches and leaves, as well as to explain the nutritional and metabolic markers related to the composting process.
Methods
In this study, we employed amplicon sequencing and untargeted metabolomics analysis to examine the interplay among phosphorus (P) components, microbial communities, and metabolites during T. grandis branch and leaf waste composting that underwent treatment with calcium phosphate and phosphate-solubilizing bacteria (Burkholderia).
Results
The results indicated that Burkholderia inoculation and calcium phosphate treatment affected the phosphorus composition, pH, EC, and nitrogen content. Furthermore, these treatments significantly affected the diversity and structure of bacterial and fungal communities, altering microbial and metabolite interactions. The differential metabolites associated with lipids and organic acids and derivatives treated with calcium phosphate treatment are twice as high as those treated with Burkholderia in both 21d and 42d. The results suggest that calcium phosphate treatment alters the formation of some biological macromolecules.
Conclusion
These results extend our comprehension of the coupling of matter transformation and community succession in composting with the addition of calcium phosphate and phosphate-solubilizing bacteria.
Numerical analysis of microwave and radiofrequency ablations: A novel design for electrode-based radiofrequency ablation
Authors: Hamzavi Fahimeh , Karimi Mohammad Javad , Bahadoran Mahdi
Published: August 2024

Thermal ablation is atreatment modality for liver cancer that utilizes heat to destroy cancerous tissues. The numerical analysis of thermal ablation processes in liver tissue was studied using two different methods: microwave ablation (MWA) and radiofrequency ablation (RFA). The effectiveness of both methods and the thermal characteristics of tumor ablation, including temperature distribution, temporal variation intemperature, volume of ablation, and destruction of cancerous tissue, were investigated. MWA requires less time for complete ablation than RFA and can generate larger ablation zones. Additionally, a novel electrode-based design for RFA, we call it Norfolk pine electrode (NPE), which focuses on ablating large and spherical tumors, has been proposed and analyzed. To the best of our knowledge, the conventional RFA designs, which utilize the Christmas tree electrode and umbrella electrode, are effective in ablating tumors smaller than 3 cm . However, they fail to completely eradicatespherical tumors. Interestingly, our proposed NPE claims the ability to fully ablate spherical tumors, even those larger than 3 cm . This NPE could be a promising and practical advancement in the realm of tumor treatment.
A food-borne outbreak of gastroenteritis caused by norovirus GII in a university located in Guangzhou City, China
Authors: Hui Wang , Xie Huaping , Chen Changming , LI Nengjiu , Zhen Ruonan , Lu Jianyun , Li Xiaoning
Published: August 2024

In order to determine the causative pathogen and source of infection of an acute gastroenteritis outbreak in a university located in Guangzhou City, China, and summarize the lessons learned from food safety risk management.A series of epidemiological investigations were conducted in the university, including investigations of cases, food, drinking water, and the environment. A 1:4 matched case-control study was carried out to explore the risk factors for infection. Reverse transcriptase PCR was performed on all suspected cases for norovirus detection. Phylogenetic analysis was conducted to confirm pathogen typing. A total of 431 suspected cases were identified in this outbreak, of which 216 were laboratory-confirmed cases. The main clinical symptoms observed in the cases were diarrhea (62.6%) and vomiting (60.8%). A retrospective case-control study with a ratio of 1:4 was conducted. The results of multivariate analysis showed that four factors were significantly associated with the outbreak, including contact with patients' vomit or stool, presence of cases in the same dormitory, dining at Canteen B and Canteen E respectively. The odds ratios (OR) and their corresponding 95% confidence intervals (CI) for these factors were as follows: 15.587 (2.188 ~ 111.054), 3.166 (1.595 ~ 6.281), 3.86 (1.497 ~ 9.956), and 9.456(4.785 ~ 18.686), respectively. Phylogenetic analysis indicated that all eight specimens tested positive for norovirus GII.4 strains including seven confirmed outbreak cases and one food handler.Based on the environmental investigation, case-control study and laboratory test results, it was concluded that the outbreak was caused by kitchen workers infected by norovirus through contact. The health surveillance and hygiene practice of kitchen workers still need to be strengthened in the future.
A Study On Optimizing The Organisation System With Focus On Mental Wellbeing, Substance Abuse, Counterproductive Work Behaviour, Resilience And Stress, Using Structured Equation Modeling
Authors: Deka Prateek , Singh Gurinder , Sharma Chandra Shekhar , Verma Pranay , Kapoor Shikha
Published: August 2024

Inspired by the principles of Systems Theory, this study explores the modern workplace, as a multifaceted and ever-evolving organisation system in which mental wellbeing, stress, resilience, counterproductive work behavior, and substance abuse are interrelated, impacting one another via feedback loops. Thus, our aim was to evaluate a management framework that addresses how these constructs are connected as well as how to manage them within the workplace. A survey tool with standardized questionnaires was used to collect data from 446 employees. The measurement model demonstrated construct reliability and validity, whereas the structural model examined the strength of linkages. Higher resilience reduced stress, boosting mental wellbeing which acted as a stabilizing influence against substance abuse and counterproductive work behavior. This study highlights the complicated interplay between these variables and emphasizes the critical significance of mental wellbeing in maintaining balance for organizational success.
Workplace interpersonal relationships and turnover intentions among care workers in older adult care facilities: a mediation analysis comparing direct and mediated effects via psychological distress
Authors: Takeda Shinya , Fukuzaki Toshiki
Published: August 2024

Background
This study aimed to investigate the relationship between workplace interpersonal relationships, psychological distress, and turnover intentions among care workers working in older adult care facilities.
Methods
An anonymous online survey among 811 care workers in Tottori Prefecture, Japan, was conducted between November and December 2023. The data were collected using the Workplace Interpersonal Problems Scale for care workers (WIPS), the K6 scale, the Turnover Intention Scale and basic attributes. Responses were obtained from 254 participants with a response rate of 31.3%.
Results
The results of the mediation analysis for the WIPS subscale which was adjusted for basic attributes show that insufficient communication (direct effect, 0.319; mediated effect, 0.194), a sense of unfair workload (direct effect, β = 0.314; mediated effect, β = 0.190), and different attitudes to care work (direct effect, β = 0.278; mediated effect, β = 0.204) had stronger direct effect on turnover intention, whereas difficulty guiding subordinates/new staff (direct effect, β = 0.207; mediated effect, β = 0.219) and labeling (direct effect, β = 0.198; mediated effect, β = 0.211) had slightly stronger mediated effect on turnover intentions through psychological distress. For bullying (direct effect, β = 0.207; mediated effect, β = 0.204), the direct and mediated effects on turnover intention were nearly equal.
Conclusions
This study revealed that some workplace interpersonal problems have a stronger direct effect on turnover intentions, whereas others have a stronger mediating effect on turnover intentions through psychological distress. Workplace interpersonal problems are predictors of turnover intentions among care workers working in elderly care facilities, and different workplace interpersonal problems should be targeted for intervention to reduce turnover intentions.
The Protective Effect of Cysteine Peptides on UV-B-Induced Skin Deterioration in Healthy People: A Randomized, Placebo-controlled, Double-blind, Parallel- group Study
Authors: Sakuma Ayako , Kai Yumiko , Yamasaki Yoshimitsu , Tanaka Tomoya , Sakurai Takanobu
Published: August 2024

The oral administration of antioxidants may suppress UV-B-induced skin damage. HITHION™ YH-15, the extract of Torula yeast (Cyberlindnera jadinii), is rich in cysteine-containing peptides such as reduced and oxidized glutathione (GSH and GSSG), γ-glutamylcysteine (γ-Glu-Cys), and cysteinylglycine (Cys-Gly). These four constituents are termed cysteine peptides. In this study, we investigated the protective effects of cysteine peptides against UV-B in a randomized, placebo-controlled, double-blind, parallel-group study. A total of 90 healthy males and females aged 30–59 years were enrolled and randomized into two groups of 45 individuals each (cysteine peptides (48 mg/day) and placebo). Changes in UV-B-induced (1) erythema and (2) pigmentation were compared between groups after 5 weeks of test food intake. The minimal erythema dose (MED) significantly increased (*p = 0.019) in the cysteine peptides group compared to that in the placebo group, indicating suppression of UV-B-induced erythema. ΔL* value significantly increased (***p < 0.0001) in the cysteine peptides group compared to that in the placebo, indicating pigmentation suppression. We demonstrated that oral administration of cysteine peptides suppresses UV-B-induced erythema and pigmentation through multiple mechanisms. Thus, cysteine peptides may find use as nutricosmetics for maintaining skin health and well-being. (UMIN Clinical Trials Registry ID: UMIN 000050157)
In Vitro and In Vivo Vein Assessment of a Novel Vein Visualizing Device to Improve First-Time Peripheral Venous Access
Authors: Liddelow Michael D. , Ho Phuoc Hao , Boyce Cara A. , Redknap Matthew D. , Hansen Ellaby L. , Buckley Nicholas M. , Arenson Katherine , Carr Peter J. , Doyle Barry J. , Bappoo Nikhilesh
Published: August 2024

Inserting needles into veins is fundamental to medical care with up to 90% of inpatients requiring a peripheral intravenous catheter/cannula (PIVC) during their stay. Yet 40%-50% of PIVC insertions fail on the first attempt. Here, we present an easy-to-use novel vein visualizing ultrasound prototype device and data from in vitro and in vivo performance. Our prototype’s locational accuracy in simulated forearm veins is 0.16mm ±1.63mm (s.d.) (97.8% agreement to the ground truth, p<.001), across variations of vein diameter (3-5mm), depth (10-20mm), and velocity (10-100mm/s). Usability trials conducted with nine clinicians found that 100% of users were able to handle the prototype in a sterile manner with minimal assistance. In 80 forearm scans of 40 volunteers, sensitivity was excellent to both find veins (94%). In comparison, sensitivity of vein finding using landmark technique with torniquet (visible 46% and palpable 74%) were far inferior. The prototype is a novel ultrasound device which empowers clinicians to detect and visualize well-perfused veins at depth in the coronal view of vein pathways whilst enabling, ultra portability, accessibility and ease of use.
Evaluation of Therapeutic Outcomes for Intraoperative MCL Injury in Subjects Undergoing Total Knee Arthroplasty: a Cohort Study
Authors: Shirouei Sepehr , Karimi Mehdi , Ghorbani-Amjad Gholamreza , Majidi Morteza , Shirsalimi Niyousha , Moradi Abbas
Published: August 2024

Background
Total knee arthroplasty (TKA) is an effective procedure for replacing damaged knee joints, recommended when conservative treatments fail. Intraoperative medial collateral ligament (MCL) injuries are a known complication of TKA, potentially impacting patient recovery and overall surgical outcomes. Effective management of these injuries is crucial to ensuring optimal function and stability of the knee postoperatively. This study aims to evaluate the therapeutic outcomes for patients who sustained intraoperative MCL injuries during TKA, focusing on recovery, stability, and the need for additional interventions.
Material and Methods
In this prospective cohort study, over 2 years, 553 patients with advanced severe knee arthritis underwent TKA, and only 13 patients had intraoperative MCL injury. After surgery, patients followed a partial weight-bearing protocol with a locked knee brace for two weeks, followed by physiotherapy to restore motion over six weeks gradually. The patients were followed up for 12 months. The International Knee Documentation Committee (IKDC) score was used to evaluate patients before and after surgery, and collected data was analyzed.
Results
None of the patients who experienced intraoperative MCL injury showed any knee instability during the 12-month follow-up period. The statistical analysis revealed no significant relationship between MCL injury and gender (P = 0.786). The mean pain score decreased from 90 preoperatively to 3.8 postoperatively, indicating a statistically significant improvement in knee pain (P < 0.001). No significant association was found between the IKDC score in intraoperative MCL injury and patient gender (P = 0.806). A comparison of the mean IKDC scores post-surgery between individuals who had intraoperative MCL injury (77.78) and received treatment and the control group without intraoperative MCL injury (80.00) revealed that MCL injury, when treated, had no significant effect on the IKDC score (P = 0.141). The mean IKDC score increased from 28.2 preoperatively to 77.8 postoperatively, indicating a statistically significant improvement in knee function (p-value < 0.001).
Conclusion
When MCL injury is treated intraoperatively, it has no significant effect on the IKDC score and significantly improves knee function. MCL injury during TKA, managed with primary repair and reinforcement with hamstring autograft or reattachment to the bone using pull-out techniques followed by six weeks of knee brace use postoperatively, is associated with favorable and treatable outcomes.
SADCL-Net: Sparse-driven Attention with Dual-Consistency Learning Network for Incomplete Multi-view Clustering
Authors: Xue Sicheng , Zhu Changming
Published: August 2024

In recent years, various deep learning-based methods have been proposed to address the problem of incomplete multi-view clustering. However, these methods still face two major challenges: firstly, due to the incompleteness of views, they are susceptible to noise and irrelevant features, leading to redundant and untargeted learned features; secondly, although these methods attempt to leverage the consistent information across different views for cross-view learning, they often overemphasize consistency, thereby neglecting inter-view differences. To address these issues, this paper proposes a novel method: Sparse-driven Attention with Dual-Consistency Learning Network for Incomplete Multi-view Clustering (SADCL-Net). Specifically, we utilize a sparsity-constrained self-attention module to effectively capture the intrinsic sparsity and local salient information of the data, thereby highlighting key features. Subsequently, we design a Dual-Consistency Learning module, which incorporates a joint entropy term into the consistency loss function to balance the consistency and difference information across views, thereby optimizing the contribution of different views to the final clustering results. Additionally, to avoid potential issues arising from imputing missing data, we integrate feature projection and alignment modules. Our proposed method has been extensively evaluated on four widely-used multi-view datasets, with results prominently demonstrating the significant advantages of SADCL-Net in terms of clustering performance.
Evaluation of the Health Literacy Curriculum at a Southeastern Medical School
Authors: Albertson Faith , Kennedy Ann Blair , Taylor Shannon , Natafgi Nabil
Published: August 2024

Background
Health literacy (HL) is crucial for making informed health decisions. Over one-third of US adults have limited HL, leading to adverse health outcomes. Despite its importance, HL education lacks standardization in medical training. This study evaluates the University of South Carolina School of Medicine Greenville’s (USC SOMG) HL curriculum to propose recommendations for HL instruction.
Methods
A convergent parallel mixed methods design was used to assess the HL curriculum through a curriculum review, student survey, and faculty interviews. The study utilized thematic analysis for qualitative data and statistical analysis for quantitative data, focusing on prior and current HL training, confidence in HL application, and perceptions of HL education.
Results
The curriculum at USC SOMG incorporates active learning strategies, emphasizing HL, and patient communication. Most participants reported high confidence in their HL knowledge and skills. The preferred teaching methods were hands-on clinical interactions, observing clinical interactions, and interactive lessons. Barriers to using HL interventions included time constraints and lack of real-world experience. Faculty recommended time prioritization and collaborative strategies to overcome these barriers.
Conclusions
USC SOMG’s HL curriculum combines didactic and active strategies longitudinally, preparing students to feel confident in their ability to engage with patients experiencing LHL. This demonstrates the curriculum’s strength and potential as a model for other schools. However, for broader implementation, standardized requirements and competency-based assessments are recommended to ensure consistent HL education across medical programs, focusing on practical application and overcoming identified barriers. This could markedly enhance patient outcomes by equipping future providers with essential HL skills.
Proximal Small Intestine Bypass Outperforms Roux-en-Y and Jejunoileal Bypass in Glucose Regulation in Streptozotocin‑Induced Diabetic Rats
Authors: Xu Chiying , Tan Cai , Luo Xin , Yang Kun , Wu Renran , Lin Lei , Liu Guanlei , Duan Jinyuan
Published: August 2024

Background This study aimed to compare the efficacy of modified proximal small intestine bypass (PSIB), Roux-en-Y gastric bypass (RYGB), and conventional jejunoileal bypass (JIB) in weight loss and glucose metabolism in streptozotocin (STZ)-induced diabetic rats.
Methods Rats with STZ-induced diabetes were randomly divided into PSIB, RYGB, JIB, and sham-operated (sham) groups. Body weight, food intake, fasting blood glucose (FBG) level, oral glucose tolerance test (OGTT), insulin tolerance test (ITT), liver function, and blood lipids were measured in rats in each group from 1 to 6 weeks after surgery.
Results No significant difference in the body weight of the rats in the PSIB and RYGB groups was observed postoperatively, whereas the body weight of the rats in the JIB group was significantly lower. The food intake of the rats in all three surgical groups was significantly less than that in the sham group. The PSIB group had a better glucose-lowering effect than the RYGB and JIB groups. Glucose tolerance improved significantly in all three surgical groups at 2 weeks postoperatively; with improved glucose tolerance in the PSIB group than in the RYGB and JIB groups. At postoperative week 2, insulin sensitivity improved only in the PSIB group; however, by postoperative week 6, insulin sensitivity improved significantly in both the PSIB and JIB groups.
Conclusion PSIB demonstrated excellent hypoglycemic effects and OGTT improvements in the early postoperative period, with better efficacy than that of RYGB and JIB. Compared with PSIB and RYGB, conventional JIB was more effective for weight loss.
Objective Assessment of Adherence to Dry Powder Inhalers Attached with Flow Velocity Detection Devices in Asthmatic Children: a cohort study
Authors: Li Shuxian , Song Jiayao , Qi Qi , Zhu Cihang , Yang Xin , Ren Hongxian , Wu Lei , Xie Yicheng , Wang Yingshuo
Published: August 2024

Background
Suboptimal adherence to asthma medication is one of the major causes of asthma exacerbation. Currently, there is no report on the objective and scientific evaluation of medication adherence among asthmatic children. We aimed to identify and quantify adherence and techniques of using dry powder inhalers (DPIs) among pediatric asthmatic patients with a newly developed electronic device that can monitor the use pattern of DPIs during inhalation.
Methods
A prospective, single-center, observational cohort study was conducted. On discharge from the hospital, pediatric asthmatic patients were given Diskus DPIs with attached electronic devices. The frequency, flow velocity, volume, duration and angle were analyzed to determine the adherence and technical proficiency of DPI use.
Results
Pediatric asthmatic patients (n = 128) with a mean age of 7.8 years, a mean forced expiratory volume in 1 second (FEV1) of 1.5 L, and a mean FEV1% of 93.5% were recruited. Total 4096 results were recorded. The most common error types were short duration (98.8%), low volume (94.5%), wrong angle (33.3%), missed use (27.9%), low peak inspiratory flow rate (PIFR) (24.4%), exhalation (15.8%) and multiple use (0.8%). The mean actual adherence was 0.1% (standard deviation (SD), 0.9%). The errors in Diskus DPI use were correlated with asthmatic children's age, basic lung function, and desensitization treatment status.
Conclusion
Our study is the first to objectively characterize the primary types and proportions of technique errors among asthmatic children using modified Diskus DPIs and revealed that asthmatic children’s real-world actual adherence to DPIs was unsatisfactory.
Elevated fasting serum xylitol levels are associated with a lower risk of incident type 2 diabetes among individuals with prediabetes in the Chinese population
Authors: Ma Jing , Qi Yicheng , Li Xiaoyong , Liu Yu , Wang Meng , Wu Yiming , Su Qing , Qin Li
Published: August 2024

Background
Detection of predictors of prediabetes progressing to diabetes are important for exploration the strategy of reversing diabetes. Although polyols have beneficial effects on glycometabolism in clinical intervention studies, little is known about the association between fasting serum polyols of participant with habitual diet and the risk of prediabetes progressing to type 2 diabetes.
Methods
In this nested case-control study, 180 participants with type 2 diabetes developed from prediabetes (progressors), and 180 matched controls (non-progressors) with prediabetes during a 3.5-year follow-up were enrolled. The baseline levels of serum polyols in the fasting state were quantified using time-of-flight mass spectrometry. Multivariate conditional logistic regression was performed to assess the effects of the differentially polyols levels on the risk of incident diabetes.
Results
Baseline fasting xylitol levels, but not sorbitol or erythritol levels, were higer in non-progressors than in progressors (P < 0.001). Non-progressors, compared with progressors, had significantly higer proportions within the third tertile of xylitol levels (71/180 non-progressors [39.4%] vs. 49/180 progressors [27.2%]). After adjusting for potential confounders, the odds ratio of risk for incident diabetes in the highest tertile of xylitol levels was 0.338 (95% confidence interval 0.182–0.628), compared with that in the lowest quartile. In addition, the association between xylitol levels and incident diabetes was persistent in the diabetes subtype with high fasting blood glucose and both high fasting and 2h-postprandial blood glucose, but disappeared in the isolated high 2h-postprandial blood glucose subtype.
Conclusions
Elevated baseline fasting serum xylitol levels are associated with a lower risk of prediabetes progressing to diabetes. This association was particularly evident in the high fasting blood glucose subtype. These findings suggest that fasting serum xylitol levels may serve as an important predictor and protective factor against diabetes development.
Intraoperatively measured prehepatectomy portal vein pressure as a useful predictor of postoperative liver failure
Authors: Nakajima Takayoshi , Ikuta Shinichi , Aihara Tsukasa , Ikuta Lisa , Matsuki Goshi , Fujikawa Masataka , Ichise Noriko , Okamoto Ryo , Nakamoto Yoshihiko , Yanagi Hidenori , Yamanaka Naoki
Published: August 2024

Background
Predicting posthepatectomy liver failure (PLF) may be a critical requirement for liver disease patients undergoing hepatectomy. This study retrospectively analyzed the impact of the intraoperatively measured portal vein pressure (PVP) prior to hepatectomy on the prediction of PLF in hepatectomized patients.
Methods
A total of 334 hepatectomized patients in whom the PVP was intraoperatively measured before resection at our institution were enrolled in the present study. Outcomes were assessed according to the International Study Group of Liver Surgery definition and the severity of PLF grading.
Results
Thirty-nine of the 334 patients (11.6%) developed grade B/C PLF. The following factors were significantly associated with grade B/C PLF in a univariate analysis: indocyanine green retention rate after 15 minutes, Child-Pugh score, prehepatectomy PVP, and transfusion (each P < 0.0001). A prehepatectomy PVP value of 19.5 cmH2O was the optimal cutoff value for predicting grade B/C PLF. In a multivariate analysis, prehepatectomy PVP (≥ 19.5 cmH2O) was selected as the most relevant risk factor for grade B/C PLF (P = 0.0003, hazard ratio: 5.96, 95% CI: 1.80–19.70).
Conclusions
Prehepatectomy PVP can serve as a useful predictor of the risk of PLF in patients who have undergone hepatectomy. The results emphasize the possibility of reducing the planned extent of hepatic resection when the prehepatectomy PVP value measured intraoperatively exceeds 19.5 cmH2O, and the importance of predicting the PVP before the operation.
Ionizing radiation altered the expression profiles and intracellular distribution of the circadian gene per1 in mouse brain neuronal cells
Authors: Shao Zhiang , Wang Yuan , Qu Pei , Zheng Zhouhang , Li Yixuan , Wang Wei , Zhang Yanan , Hua Junrui , He Jinpeng , Wei Wenjun , Lu Dong , Xu Dan , Wu Qingfeng , Wang Jufang , Ding Nan
Published: August 2024

Circadian rhythms are highly conserved in virtually all organisms. They regulate numerous biological functions and keep them synchronized with alterations in the external environment. Environmental factors such as light, temperature and microgravity have been shown to affect circadian rhythms, but the impact of ionizing radiation (IR) on circadian rhythm is still elusive. Here, the transcription and translation of key circadian genes, such as per, clock, cry and bmal1, were detected in mouse brain neurons after 2Gy X-ray or 2Gy carbon ion beam (CIB) irradiation and were compared with those in the unirradiated group. Moreover, the nuclear import of PER1 was detected by immunoblotting and immunofluorescence. The data showed that the expression phase of circadian genes was not significantly impacted by IR in either HT22 or BV2 cells, while the expression levels of per1 were markedly altered by both X-rays and carbon ion beams. Moreover, IR significantly promoted the nuclear import of PER1. Taken together, our findings suggest that IR, as an exogenous factor, disturbs per1 expression and promotes the nuclear import of PER1.
Coastal Vulnerability of Archeological Sites of Southeastern Crete, Greece
Authors: Novikova Anna V. , Argyriou Athanasios V. , Andriopoulou Nafsika C. , Alexandrakis George , Papadopoulos Nikos
Published: August 2024

The study assesses the coastal evolution of Southeastern Crete and the vulnerability of archeological sites of the area to coastal erosion. Shoreline dynamics for the period since the 1940s was investigated based on the interpretation of high-resolution aerial photos and satellite images. The set of climatic variables derived from the Copernicus databases, as well as data on geomorphological and geological factors obtained from fieldworks, images interpretation, archives, and open sources, were analyzed. The impact of these variables on coastal dynamics was evaluated through regression analysis, correlating their spatial distribution with rates of shoreline retreat/advance. Based on this analysis, variables for the Coastal Vulnerability Index (CVI) calculation were selected, and the weights for the weighted CVI were determined. Both approaches, the CVI and the weighted CVI, identified the most vulnerable areas as being situated in the north, east, and southeast of Koufonisi island, as well as in the north and east of the Chrisi island. The least vulnerable are the wide beaches in the closed bays in the areas of Gra Lygia, Ierapetra, and Ferma, along with the rocky capes at the east of the Ierapetra area. Two of five archeological sites of the area (Lefki Roman Town and Stomio Roman Villa) are located within the zone of high or very high coastal vulnerability. This study provides the first in-depth analysis of coastal dynamics and coastal vulnerability of the area of Southeastern Crete, which has significant cultural heritage assets but has previously remained under-researched.