bluuebunny/crossref_metadata_2025 huggingface dataset:
A Research Protocol to Study the Critical Time Window for Rehabilitation After Incomplete Spinal Cord Injury: Early vs Late Locomotor Training
Authors: Henry Molly , Coxe Ryan C. , Barry Alex , O’Donnell Amanda , Kessler Allison , Shan Guogen , Swank Chad , Rymer W. Zev , Sandhu Milap S.
Published: December 2024

Spinal cord injury (SCI) often results in severe motor and sensory deficits, leading to significant disability. Preclinical studies and retrospective studies suggest that a critical window of enhanced neuroplasticity may exist immediately after SCI, during which therapeutic interventions could yield greater functional improvements. The impact of time interval since SCI on efficacy of rehabilitation has not been directly assessed and is the focus of this clinical trial. This study will compare the efficacy of high-intensity gait training, initiated at different time intervals post-injury, on walking performance in individuals with SCI. We hypothesize that early intervention will yield the greatest improvements in walking ability and community ambulation, compared to training initiated at 3 or 6 months after SCI, or standard of care.
This randomized, multi-site clinical trial will enroll 108 participants with acute, traumatic SCI. Participants will be randomized to receive 20 hours of high-intensity gait training that will be initiated either early (<60 days post-SCI), sub-acute (3 months), chronic (6 months), or to a control group receiving standard of care. Primary outcomes include gait speed (10 Meter Walk Test) and walking endurance (6-Minute Walk Test). Secondary outcomes include daily step count via wearable sensors, lower extremity strength, and quality of life measures. Assessments will occur at baseline, pre/post-intervention, and at 3, 6, 9, and 12 months post-SCI.
This study will provide insights into the optimal timing of rehabilitation post-SCI and could have profound effects on our approach to training individuals with SCI in the healthcare setting as well as long term recovery outcomes.
Trial Registration
ClinicalTrials.gov NCT06176833 was completed on 12/11/2023.
Concave side of proximal thoracic zone vulnerable to pedicle screw perforation in adolescent idiopathic scoliosis surgery: Comparative analysis of pre- and intraoperative computed tomography navigation
Authors: Yamada Tomohiro , Yu Yamato , Hasegawa Tomohiko , Yoshida Go , Banno Tomohiro , Arima Hideyuki , Oe Shin , Ide Koichiro , Kurosu Kenta , Matsuyama Yukihiro
Published: December 2024

Purpose
To evaluate the accuracy of pedicle screw (PS) and clarify the characteristics of pre- or intraoperative perforation using computed tomography (CT) navigation in adolescent idiopathic scoliosis (AIS) surgery.
Methods
One hundred and seven patients who underwent surgery were retrospectively selected. Overall, 853 PSs were implanted in 48 patients using preoperative CT, whereas 1,059 PSs were implanted in 59 patients using intraoperative CT with a second intraoperative 3-dimensional (3D) scan. We analyzed the postoperative CT images for pedicle perforation using Rampersaud criteria.
Results
Total PS placement accuracy (grade A, B) was significantly higher in the intraoperative group than the preoperative CT group (97.2% vs 94.8%, respectively; P = 0.008). Accuracy was significantly higher among Lenke type 1 AIS cases in the intraoperative CT group (97.8% vs 95.1%, respectively; P = 0.014). Grade D perforation occurred most frequently at the concave side of proximal thoracic (PT) zone, followed by the transitional PT/main thoracic zone in both groups. The second intraoperative 3D scan allowed the re-insertion of 10 screws to prevent grade D perforation in the intraoperative CT group.
Conclusions
Both navigation systems were sufficiently accurate. However, surgeons must be careful at the concave side of the PT zone. Intraoperative CT navigation yielded higher accuracy by using the intraoperative second 3D scan than preoperative navigation.
Ion Concentrations in CSF and Serum are Differentially and Precisely Regulated
Authors: Lyckenvik Tim , Forsberg My , Johansson Kalle , Axelsson Markus , Zetterberg Henrik , Blennow Kaj , Illes Sebastian , Wasling Pontus , Hanse Eric
Published: December 2024

Background Disturbances in brain ion concentrations have been implicated in the regulation of brain states such as sleep and wakefulness, as well as in a variety of neurological conditions, including dementia, epilepsy, and migraine. Despite this, studies specifically characterizing normal cerebrospinal fluid (CSF) ion composition are generally lacking.Methods We quantify the normal human CSF ion composition in this non-interventional, cross-sectional, retrospective study using paired CSF and serum concentrations of Ca²⁺, Cl⁻, K⁺, Mg²⁺, and Na⁺ measured in healthy young to middle-aged volunteers (n = 28) and patients without neurological disease (n = 14). Relationships with variables such as albumin quotient, age, sampling time, and sex were analyzed. Group differences were assessed using the Kruskal-Wallis and Mann-Whitney U tests, while correlations were examined with Spearman's rank correlation coefficient.Results CSF ion concentrations were significantly different from serum for all ions measured (P < 0.0001). Cl− (+ 25%), Na+ (+ 5%) and Mg2+ (+ 37%) concentrations were higher, while K+ (-30%) and Ca2+ (-50%) concentrations were lower. These differences were consistent with no overlap between serum and CSF concentrations. There was a trend toward higher ion concentrations in samples collected later in the day and in men, but no significant correlation with the albumin quotient.Conclusions The distinct ion composition of CSF, compared to serum, may establish a low baseline neuronal excitability, allowing for controlled modulation by neuromodulators without leading to pathological hyperexcitability. This might offer new insights for targeting neurological diseases associated with disrupted ion homeostasis.
Long-term effect of COVID-19 social distancing measures on pertussis transmission in England; a mathematical modelling study
Authors: Choi Yoon Hong , Leeuwen Edwin , Miller Elizabeth
Published: December 2024

Background.
In 2024 England, in common with many other countries, experienced a pertussis resurgence the cause of which is unclear. We used a pertussis transmission model, previously developed to investigate the cause of the pertussis resurgence in England in 2012, to explore potential factors contributing to the increase in pertussis cases observed in England in 2024.
Methods
An age-stratified dynamic transmission model fitted to pertussis notification data from England between 1953 and 2013 was run until 2054 with and without changes in social mixing as estimated from Google mobility and school attendance data during the COVID-19 pandemic. The model assumes vaccination protects better against disease than pertussis infection, and that an infection results in more durable immunity than vaccination. Counterfactual scenarios were also run to explore the effect of reductions in vaccine coverage during the pandemic and of the addition in 2014 of boosters in the 2nd year of life and in adolescence.
Results
A resurgence was only generated with reduced social mixing and could not be explained by short-term reductions in vaccine coverage. Additional boosters at 18 months and 14 years from 2014 would not have prevented a resurgence though would have reduced its magnitude. Peaks of increased pertussis incidence are predicted over the next decade. The parameter sets that generated a resurgence in 2024 had the shortest duration of acellular vaccine protection, median 5 years with 90% protection against infection.
Conclusion
This modelling study implicates reduced mixing in England during the COVID-19 pandemic as the cause of the pertussis resurgence in 2024 together with the short duration of protection from acellular vaccine. Interruption of the background rate of natural boosting during the pandemic increased the pool of susceptible individuals resulting in increased transmission post-pandemic with clinical cases in those with waned vaccine–induced protection and the unvaccinated, including infants of unvaccinated mothers. In countries using acellular pertussis vaccines, infection continues to play an important role in maintaining population immunity around an endemic equilibrium. Improved pertussis vaccines that provide more complete and more durable protection against infection are needed to improve pertussis control.
Defining the Learning Outcomes and Core Curriculum for Clinical Clerkships
Authors: KEMAHLI Sabri , TAŞKIRAN Hüseyin Cahit , Mohamed Ayman M.A. , ALBAR Raed A. , AlKattan Khaled
Published: December 2024

Background: The core curriculum is defined as a curriculum that is essential and common to all students. Defining the core curriculum for clinical clerkships will help to clarify the content to which disorders and skills must be mastered by students.
Objectives: This study aimed to define the content of the clinical clerkship core curriculum based on the expectations of graduates to work at the primary healthcare level.
Methods: The core learning outcomes of clinical clerkships were defined by starting from diseases, clinical presentations, conditions, and skills listed in SaudiMeds framework and the Saudi Medical Licensing Exam content outline. Although some diseases are expected to be managed at the primary care level, only emergency management or preliminary diagnosis with referral to a more advanced level is required. Thus, the knowledge and skills to be acquired for each disease/disorder are competencies in one or more of the following areas: preliminary diagnosis, diagnosis, treatment, emergency management, prevention, and follow-up.
Results and Conclusion: A total of 404 diseases/disorders and 137 skills (66 procedural and 71 examination skills) were listed, and their levels of knowledge and performance were defined. The clerkships where each clinical skill should be practiced and acquired were also identified.
The implementation of the clinical core curriculum faces challenges due to faculty practices and the misinterpretation of some hospital policies.
This final document can be shared with other medical schools to define the core curriculum on a national basis.
Association of Sociodemographic, Clinical factors, and Self-Care with Intrinsic Capacity in Older Adults with Heart Failure
Authors: PENG Ronggang , YANG Fang , WAN Xia , XU Yanhua , ZHAO Qing
Published: December 2024

Objective
This study aimed to examine the association between sociodemographic and clinical characteristics, self-care practices, and intrinsic capacity in older adults with heart failure.
Methods
A total of 215 heart failure patients aged 60 years or older were recruited from two tertiary hospitals in Wuxi, China. The intrinsic capacity composite score was derived from scores on the Montreal Cognitive Assessment (MoCA), Short Physical Performance Battery (SPPB), Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Depression Scale-15 (GDS-15), and self-reported visual or hearing impairments. Self-care was assessed using the Self-Care Heart Failure Index (SCHFI). Sociodemographic and clinical data were collected via a self-designed questionnaire. The associations between sociodemographic and clinical characteristics, self-care, and intrinsic capacity were explored using binary analysis, Spearman’s correlation coefficient analysis, and multiple linear regression analysis.
Results
98.1% of participants experienced a decline in at least one domain of intrinsic capacity. The most affected domains were vitality (87.9%) and cognition (60.95%). Reduced intrinsic capacity composite scores were associated with older age (β = 0.138, t = 2.163, p = 0.032), higher NYHA class grade (β = 0.466, t = 8.032, p < 0.001), and poorer self-care (β = -0.133, t = -2.140, p = 0.033).
Conclusion
Intrinsic capacity in older adults with heart failure was found to be related to age, NYHA class grade, and self-care practices. Healthcare professionals should focus on these factors and implement targeted interventions to support this population.
Pathological Response to Neoadjuvant Therapy in Breast Cancer Patients and Its Relationship with Survival: A Retrospective Cohort Study
Authors: Loaiza-Osorio Sara , Caicedo Ana María , Vásquez Elsa María , Quintero Néstor Llinás , Naranjo Ana María
Published: December 2024

Introduction:
Breast cancer is the most common cancer among women worldwide. Neoadjuvant therapy (NAC) aims to reduce tumor size before surgery and assess the tumor's biological response to treatment. Pathological complete response (pCR) is an important marker of oncological outcomes, but its evaluation in the Colombian population is limited. This study aimed to evaluate pCR and its relationship with overall survival in breast cancer patients who received NAC at a hospital in Medellín.
Methodology:
This is a retrospective cohort observational study conducted at Clínica Vida, Medellín, between 2017 and 2023, including 1,008 breast cancer patients treated with NAC. Sociodemographic, histological, and treatment variables were evaluated. Bivariate analyses and the Kaplan-Meier test were used to assess survival.
Results
A total of 36.2% of the patients achieved pCR, which was associated with better overall survival (95.1% vs. 91.1%). Factors associated with pCR included younger age, higher histological grade, elevated Ki67, negative hormone receptors, and lower lymph node involvement. The use of anthracycline-based chemotherapy, taxanes, and Trastuzumab was more common in pCR. Most patients with pCR underwent conservative surgery and sentinel lymph node biopsy.
Conclusions
Factors such as tumor biology and therapeutic regimen significantly influence the likelihood of achieving pCR and improving long-term survival. This highlights the importance of personalizing NAC in breast cancer, guided by specific biological characteristics of the tumor to optimize clinical outcomes.
Dual Epigenetic Targeting with Chidamide and Azacitidine after Allogeneic Hematopoietic Stem Cell Transplantation for High-Risk Acute Myeloid Leukemia Patients
Authors: HU Xiao-Hui , Wu Yaxue , Wan Chao-Ling , Li Zheng , Zhang Yang , Wu Depei , Chen Suning , Wang Ying , Ma Xiao , Dai Haiping , QIAN Chongsheng , Bao Haiyan , Jiang Shanshan , Zhang Hao , Zhang Yanming , Li Ling-Hao , Xue Sheng-Li
Published: December 2024

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is potentially the only curative option for high-risk acute myeloid leukemia (AML) patients. However, disease relapse remains the principal cause of treatment failure of these patients, and outcomes of salvage treatments are poor. Azacitidine (AZA), a DNA methyltransferase inhibitor, shows anti-leukemia activity in myeloid diseases. Chidamide, a selective histone deacetylase inhibitor, effectively induces apoptosis in AML cells. When combined, these agents have a synergistic inhibitory effect on AML cells. A multicenter, prospective study (ChiCTR2300067593) was conducted with 48 high-risk AML patients after allo-HSCT. Patients received chidamide 5 mg/d plus azacitidine 75 mg/m²/d for 5 days. Additionally, 28 patients who received azacitidine alone as maintenance therapy after allo-HSCT were reviewed as a control group. With a median follow-up of 448 days (range 151–918), the chidamide plus azacitidine (CHI-AZA) regimen demonstrated superior 2-year relapse-free survival (RFS) (93.3% vs 71.6%, P = 0.039) and overall survival (OS) (96.3% vs 75.3%, P = 0.011) compared to AZA alone. The difference of 2-year cumulative incidence of relapse (CIR) was not significantly (6.7% vs 22.1%, P = 0.163). In conclusion, the CHI-AZA maintenance therapy could be an effective method to improve outcomes of high-risk AML patients after allo-HSCT.
Objective Evaluation of the Prognostic Value of Common Nutritional Indicators in Patients with Different Inflammatory States after Radical Gastrectomy for Gastric Cancer: A Real-world Study Running Head：Nutritional Indicators in Inflammatory State
Authors: Zheng Hua-Long , Zheng Zhi-Wei , Wei Ling-Hua , Wang Jia-Bin , Lin Jian-Xian , Xue Zhen , Xu Bin-Bin , Shen Li-Li , Lin Jia , Zhang Ling-Kang , Huang Chang-Ming , Li Ping
Published: December 2024

Background and aim:
Few studies have investigated the prognostic significance of nutritional indicators in patients with various inflammatory states.
Methods
Patients who underwent radical gastrectomy for TNM stages I–III gastric cancer were included. Nutritional assessment was performed using commonly used indicators. The patients were categorized into two groups with high and low inflammatory status using the X-tile analysis.
Results
A total of 1327 patients were enrolled in this study, including 843 and 484 patients in the low- and high-SII groups, respectively. Compared with the SII-low group, the SII-high group exhibited significantly lower GNRI, PNI, CXI, and SMI indices and a higher proportion of patients with malnutrition based on the GLIM and CONUT criteria(all P < 0.05). Multivariate COX analysis revealed that GLIM criteria (overall survival [OS]: P = 0.002; recurrence-free survival [RFS]: P = 0.007) and CONUT (OS: P = 0.010; RFS:P = 0.001) were independent prognostic factors for OS and RFS in the SII-low group. In the SII-high group, the GLIM criteria, GNRI, and SMI were the independent prognostic factors for OS(all P < 0.05), the GLIM criteria and SMI were the independent influencing factors for RFS(all P < 0.05). The TimeROC curve and AUC demonstrated the robustness of the GLIM criteria in predicting prognosis across various inflammatory states.
Conclusions
Different nutritional indicators should be considered while evaluating the prognosis of patients with gastric cancer with varying inflammatory states. Compared with other nutritional indicators, the GLIM criteria are more suitable for patients with different inflammatory conditions.
The effectivity of Zero-Profile in treating Single-Level Traumatic Cervical Disc Herniation: A 3- year follow-up Retrospective Cohort Study
Authors: Qin Guang bing , Zhao Wen jie , Nong Zhuo , Qin zhaojie
Published: December 2024

Objective: This study aims to compare the mid-term efficacy and safety of anterior cervical discectomy and fusion (ACDF) using the Zero-Profile device versus a cage-and-plate construct in treating single-level traumatic cervical disc herniation.
Background：While the Zero-Profile device demonstrates comparable functional and radiological outcomes to the cage-and-plate system in single- and multi-level ACDF for cervical degenerative disc diseases, and reduces complication rates, particularly dysphagia, its suitability for single-level symptomatic traumatic cervical disc herniation remains unclear.
Methods: Between August 2020 and August 2023, 50 patients with symptomatic traumatic cervical disc herniation underwent ACDF using either the Zero-Profile device (Group ZP) or the cage-and-plate system (Group CP). Clinical outcomes, including Japanese Orthopedic Association (JOA) scores, Neck Disability Index (NDI) scores, Visual Analogue Scale (VAS) scores, Hospital Anxiety and Depression Scale (HADS) scores, radiological outcomes, and complications, were evaluated and compared.
Results: All procedures were successfully completed. Both groups demonstrated significant postoperative improvements in JOA, NDI, VAS scores, and cervical lordosis, with no significant differences between groups at any follow-up interval. Fusion and cage subsidence rates were also comparable. Notably, dysphagia rates immediately postoperatively, at 1 week, and at 1 month were lower in Group ZP (14.8%, 11.1%, and 3.7%) compared to Group CP (21.7%, 17.4%, and 13.0%) (P =0.79, 0.82 and 0.49). All patients achieved solid fusion, and no cases of dysphagia were observed at the final follow-up. In terms of HADS scores, no significant differences were observed between the two groups.
Conclusions: ACDF using the Zero-Profile device provides comparable surgical outcomes to the cage-and-plate system for single-level traumatic cervical disc herniation while potentially reducing early postoperative dysphagia rates. Thus, it represents an effective and reliable treatment option for this condition.
LACC with low ERCC1 expression has better survival
Authors: Zhongxin Zhang , Wei Chen , Junwei Qin , Meiye Ge , Baopeng Li
Published: December 2024

Aims and background. To investigate the ERCCl protein in locally advanced cervical cancer tissues and its relationship with the efficacy of radiotherapy and chemotherapy.
Methods and study design. Immunohistochemistry was used to detect ERCCl protein in 74 locally advanced cervical cancer tissues treated with intensity-modulated conformal radiotherapy. According to the strength of immune response, they were divided into a high expression group of 32 cases and a low expression group of 42 cases; During radiotherapy, cisplatin 40mg/m2/week is synchronized. Analyze the relationship between ERCCl protein expression status and the clinical pathological characteristics and prognosis of patients.
Result. The total effective rate CR+PR of high expression of ERCC1 protein was 84.37% (27/32), while the CR+PR of low expression of ERCC1 was 88.10% (37/42), with no statistically significant difference (χ2=0.016, p=0.901). ERCC1 protein expression was not related to age, FIGO stage, pathological type, differentiation degree, lymph node metastasis, or A point dose (χ 2=3.094, 2.250, 0.002, 0.301, 0.360, 0.604, all p>0.05), but was related to recurrence and metastasis (χ2=4.160, 4.142, p<0.05). The 5-year survival rates of the two group were 34.38% and 78.57%, respectively, with a significant difference (χ2=3.965, p=0.046).
Conclusion. The group with high expression of ERCCl protein is more prone to local recurrence and distant metastasis than the group with low expression of ERCCl protein. The expression status of ERCCl protein may become one of the biological indicators for predicting the prognosis of cervical cancer, which has certain guiding significance for the judgment of patient prognosis.
Arginyltransferase1 drives a mitochondria-dependent program to induce cell death
Authors: Zhang Fangliang , Kumar Akhilesh , O'Shea Corin , Yadav Vikas , Kandasamy Ganapathih , Moorthy Balaji , Ambrose Evan , Mulati Aliya , Fontanesi Flavia
Published: December 2024

Cell death regulation is essential for stress adaptation and/or signal response. Past studies have shown that eukaryotic cell death is mediated by an evolutionarily conserved enzyme, arginyltransferase1 (Ate1). The downregulation of Ate1, as seen in many types of cancer, prominently increases cellular tolerance to a variety of stressing conditions. Conversely, in yeast and mammalian cells, Ate1 is elevated under acute oxidative stress conditions and this change appears to be essential for triggering cell death. However, studies of Ate1 were conventionally focused on its function in inducing protein degradation via the N-end rule pathway in the cytosol, leading to an incomplete understanding of the role of Ate1 in cell death. Our recent investigation shows that Ate1 dually exists in the cytosol and mitochondria, the latter of which has an established role in cell death initiation. Here, by using budding yeast as a model organism, we found that mitochondrial translocation of Ate1 is promoted by the presence of oxidative stressors and is essential for inducing cell death with characteristics of apoptosis. Also, we found that Ate1-induced cell death is dependent on the formation of the mitochondrial permeability pore and at least partly dependent on the action of mitochondria-contained factors including the apoptosis-inducing factor, but is not directly dependent on mitochondrial electron transport chain activity or its derived reactive oxygen species (ROS). Furthermore, our evidence suggests that, contrary to widespread assumptions, the cytosolic protein degradation pathways including ubiquitin-proteasome, autophagy, or endoplasmic reticulum (ER) stress response has little or negligible impacts on Ate1-induced cell death. We conclude that Ate1 controls the mitochondria-dependent cell death pathway.
Antibiotics for UTIs Cause Distinct Alterations in Gut Microbiome and Host Health Compared to Enteritis Treatment
Authors: Xu Zhengyi , Xu Jianshu , Jiang Peng , Wei Shichao , Gu Chaoqun , Gu Yifeng , Wei Qun , Guo Hao , Wang Shiyu , Li Zhi , Liu Fengping , Feng Ninghan , Zhao YU , Li Zhou , Zhou Xiang
Published: December 2024

Background
Fecal microbiota transplantation (FMT) has gained attention as a potential treatment for various chronic inflammatory diseases, including colitis and urinary tract infections (UTIs). However, the effects of different antibiotics, especially those used for UTIs, on the gut microbiota and host are not well-studied.
Methods
Male Sprague-Dawley rats, 8 weeks old, were subjected to antibiotic cocktails for the treatment of enteritis and UTIs, receiving daily doses of 0.5g and 1g via gavage over a 2-week period. Following this treatment, samples of feces and jejunal tissue were collected for microbiota analysis, and bacterial DNA was subsequently isolated and sequenced using 16S rRNA. The microbial composition, diversity, and abundance were thoroughly assessed. Additionally, a comprehensive evaluation included histomorphological analysis, body weight measurement, food intake monitoring, as well as assessments of liver, renal function, and urinary parameters.
Results
Fecal and tissue samples exhibited distinct microbial profiles, with fecal samples being more diverse. Antibiotics, both for enteritis and UTIs, significantly altered microbial communities in fecal samples, reducing richness and diversity. The effects were less pronounced in tissue samples. UTI antibiotics had a more detrimental impact on intestinal histomorphology compared to enteritis antibiotics. Rats on higher UTI antibiotic doses showed lower body weight and reduced food intake. Liver, renal function, and urinary parameters were affected, indicating potential systemic consequences.
Conclusions
This study underscores the differential impacts of antibiotics on gut microbiota and host health, particularly emphasizing caution in UTI antibiotic use and advocating further research for mitigation.
Citric acid water as an alternative to food restriction to motivate task performance in mice during touchscreen testing
Authors: Dzinic Leila , Ghosh-Swaby Olivia , Antolin Joel , Dumont Julie , Sheppard Paul , Bussey Timothy , Saksida Lisa
Published: December 2024

Rodent behavioural testing paradigms in touchscreen operant chambers have successfully provided insight into the neural mechanisms underlying various cognitive domains in healthy and disease models. Touchscreen testing has previously required food restriction to sufficiently motivate rodents to complete behavioural tests, limiting the use of interventions, for example diet-based interventions, that alter animals’ motivation for food in experimental design. Here, we explored the safety and efficacy of water manipulation via addition of citric acid in motivating behavioural performance in touchscreen operant chambers 1) in comparison with food restriction and 2) when mice are fed an obesogenic high-fat, high-sugar (HFHS) diet. Water manipulation and food restriction produced similar performance on the progressive ratio task in non-obesogenic, standard-fed mice. However, when water-manipulated mice were fed a HFHS diet they showed deficits in this motivation-sensitive task. Critically, all groups, regardless of restriction type or diet, showed similar learning curves during a pairwise visual discrimination task. Together, these findings demonstrate that water manipulation can safely and effectively motivate mice to perform touchscreen tasks for reward, even when fed a highly satiating HFHS diet, which opens the possibility of using interventions, especially diet-based, in conjunction with touchscreen cognitive testing batteries.
Is It Necessary To Use A Drain After Perineal Urethroplasty If We Can Avoid Complications By Pressure Dressing?
Authors: Sarıkaya Ege A. , Terzi Sümeyye , Çakmak Atahan , Özer M. Selçuk , Şen Volkan , Bozkurt Ozan
Published: December 2024

Purpose
Peri-operative management of urethroplasty is yet to be standardized. One of the major obscure issues in perioperative management is the use of perineal drainage. Some reconstructive urologists prefer to use drain as a routine while others never use one. Although the main purpose of drain placement is to prevent collection and related wound complications, no study up-to-date refers to these complications neither with nor without drain usage.
Methods
152 consecutive patients who underwent perineal urethroplasty without perineal drain were included. Strict pressure dressing was applied to all patients. Presence of any perineal fluid collection, wound related complications and need for re-operation for these complications were recorded.
Results
Despite 42.1% of patients having a smoking history and other potential risk factors for wound related complications, there were no instances of fluid collection or wound dehiscence post-operatively.
Conclusion
Given the absolute absence of drainage related complications by applying only pressure dressing, we suggest that perineal drain is not necessary after perineal urethroplasty. Applying pressure dressing is an effective method to prevent fluid collections and related morbidities.
Development of machine learning Predictive Model for Type 2 Diabetic Retinopathy Using the Triglyceride-glucose index explained by SHAP method
Authors: Liu XiaoQin , Wu ShuYing , Yang Yue , Li Yang , Zhang XinTing , Qin Ling , Li Fei
Published: December 2024

Introduction: This study aimed to develop a diabetic retinopathy (DR) Prediction model using various machine learning algorithms incorporating the novel predictor Triglyceride-glucose index (TyG). Furthermore, the model was interpreted using the SHapley Additive exPlanations (SHAP) method.
Method: Real-world data were collected from a general hospital in a major city and a county clinic, then divided into the DR Group (1392) and non-DR group (2358). Baseline data were collected, and variables were selected using Recursive Feature Elimination with Cross-Validation (RFECV). The performance of five machine learning algorithms, including Logistic Regression model (LR), Decision Tree (DT), Random Forest (RF), Support Vector Machine (SVM), and XGBoost (XGB), was assessed based on accuracy, sensitivity, specificity, and Area Under the Curve (AUC) of the Receiver Operating characteristic Curve (ROC). The optimal model was interpreted using SHAP.
Result：SVM and LR demonstrated superior performance in both the test set and training set (ROC, 0.85 and 0.82, respectively). The top five predictors identified by SHAP analysis included TyG, Insulin therapy, HbA1c, Diabetes Course, HDL. HDL was identified as a protective factor, while the remaining factors were associated with retinopathy.
Conclusion：LR and SVM demonstrated the best performance. This is the first study constructing a DR Prediction model using TyG index. Notably, TyG significantly predicted DR and may serve as a crucial indicator for guiding clinical screening of high DR Risk.
Space-Time Decoupled Metasurface Integrating Reflective Mixer and Phase Shifter Functions
Authors: Mi Tiebin , Dong Xuehui , Feng Miyu , Lai Bokai , Shao Chen , Zhang Jianan , Xiong Rujing , Wan Kai , Qiu Robert
Published: December 2024

Electromagnetic (EM) information metasurface represents a class of 2D metamaterials that can swiftly manipulate their EM characteristics to convey specific information. Past researches present various strategies for embedding information within ambient EM waves through the superposition of time-varying quantized properties for each unit. Despite their capabilities, these approaches alone are insufficient for concurrently but independently realizing the creation of information and the allocation of spatial energy. In this work, we introduce a comprehensive approach named the space-time decoupled metasurface (STD-Metasurface), facilitating the simultaneous and independent control of information modulation and passive beamforming by incorporating reflective mixer and phase shifter functionalities into each unit. As a proof of concept, we present a minimalist design of single-diode unit where the ingenious utilization of analog switch bonds the digital signal and analog signal together. By inputting baseband analogue signals in a specific level range, STD-Metasurface prototype is capable of modulating them onto the envelopes of reflected EM waves without distortion meanwhile controlling the reflected radiation patterns by digital signals, even waveform superposition and spatial multiplexing. To demonstrate the superior capabilities of the STD-Metasurface, we have developed an experimental platform to highlight its practicality and potential applications as a reconfigurable backscatter transmitter and a dynamic Doppler-spoofing reflector array.
An Optimization Approach for Blood Supply Chain Management Integrating Drone Delivery Method
Authors: N Mayuri K , M Gowsalya
Published: December 2024

This paper investigates the application of drone delivery for blood supply chainmanagement (BSCM). This paper aims to minimize the delivery lead time andmake the fastest delivery of lifesaving blood products within a specified deliveryrange. We proposed an optimization model that utilizes Mixed Integer Non-LinearProgramming (MINLP) with Dijkstra’s algorithm. This model considers thedrone capabilities such as payload capacity, travel speed, and range. This studyinvestigates the possibilities of drone delivery in blood supply chain management,with a priority on reducing delivery lead time and enabling rapid deliveries. Whileincorporating real-world scenarios with multiple locations like hospitals, clinics,and demand location. Randomly generated test instances are used. In order toevaluate the model’s effectiveness, Numerical illustration has been analysed usingPython programming as the development platform for implementing the solution.
Fibrolipoma of the Spermatic Cord: First Reported Case in Children and a Review of the Literature
Authors: Mansiroglu Agah Koray , Duman Abdullah
Published: December 2024

Background
Benign tumors of the spermatic cord constitute the majority of paratesticular tumors. While fibrolipoma is uncommon in adults, there are no recorded cases of fibrolipoma of the spermatic cord in children.
Case Presentation:
A male patient, aged 13, arrived at the emergency department complaining of right inguinoscrotal pain and nausea for the past four days. The Doppler scrotal ultrasound demonstrated a soft tissue structure measuring 48x19 mm with heterogeneity and absence of vascular activity, located along the spermatic cord in proximity to the right testicle. Right scrotal tenderness and absence of blood supply on Doppler ultrasound indicated emergency surgical intervention, considering the possibility of torsion in an accessory testicle, more frequently encountered in pediatrics. Surgical exploration of the inguinal region and mass excision were conducted. The pathology report determined a tumor exhibiting collagenized tissues surrounding fatty lobules, indicative of a fibrolipoma.
Conclusions
This case represents initial documentation of a pediatric paratesticular fibrolipoma. The mean age of the six cases reported thus far is 55.3 years. In the definitive diagnosis of paratesticular tumors, which are rarely seen and cannot be adequately evaluated through radiologic imaging, histopathologic sampling holds significant importance.
Empowering the Next Generation: The Role of Team Hierarchy in Retaining Junior Researchers
Authors: XU HUIMIN , Bu Yi , Liu Meijun , Ding Ying
Published: December 2024

Early-career scientists are essential to driving scientific progress, yet nearly half leave academia after their first publication. While factors like team size, gender, mentorship, and institutional prestige are known to affect retention, the influence of team hierarchy on junior researchers’ career paths remains underexplored. This study investigates how hierarchical structures within research teams impact the retention of junior scientists, using Microsoft Academic Graph data from over 30 million teams across 19 disciplines. We define retention as a combination of paper publishing (continue publishing), academic independence (continue publishing without depending on the same senior authors), and career progression (change institution). Team hierarchy is measured through the Gini coefficient of career age for all team members. We reveal that flat team structures support the retention of junior researchers with a career age of 5 years or less, especially in social science and small teams. These findings remain robust when accounting for diverse individual- and team-based variables and are consistent across different disciplines. Our findings provide insights that can inform team composition, ultimately contributing to more sustainable academic careers for early-career scientists.
Sensitive ultra-performance liquid chromatography coupled with triple quadruple mass spectrometry (UPLC-TQ-MS) for simultaneous determination of biogenic amines in Montenegrin red wines
Authors: Raičević Danijela , Ivanova-Petropulos Violeta , Popović Tatjana , Tašev Krste , Pajović-Šćepanović Radmila
Published: December 2024

A highly sensitive ultra-performance liquid chromatography coupled with triple quadruple mass spectrometry (UPLC-TQ-MS) was applied for simultaneous determination of seven biogenic amines (cadaverine, putrescine, histamine, spermine, tyramine, phenyethylamine and tryptamine) in Montenegrin red Vranac and Kratošija (Vitis Vinifera L.) wines. The method was validated, confirmed the suitability for determination of biogenic amines in red wines and was applied to examine the changes of biogenic amines in three vinification stages: after alcoholic fermentation, malolactic fermentataion and ten months of aging of the wines. The results showed that the total amine levels were low, ranging from 1.27 to 3.26 mg/L, observing increased concentration in the wines after finished malolactic fermentation. Putrescine, which was constituted as a main amine in wines (range: 0.79 to 2.39 mg/L), was observed in a slightly higher content in Vranac wines compared to Kratošija, followed by the aliphatic cadaverine (range: 0.091 to 0.35 mg/L) and the aromatic phenylethylamine (range: 0.119–0.373 mg/L). Histamine and tyramine which are subject of toxicological interest, were present in a very low concentration in wines (on average value: 0.082 and 0.015 mg/L, respectively). Cadaverine and putrescine significantly correlated with the sum of total biogenic amines, even the reached values were below the toxicity threshold. According to the principal component analysis, wines were clearly separated in three groups according to the three vinification stages.
Development of Novel DALY-Based Indices for Assessing Productivity Loss and Resource Allocation for Liver Cancer in the MENA Region
Authors: Momahhed Shekoofeh Sadat , Banaee Arian , Haghighathoseini Atefeh , Hekmat Hamidreza
Published: December 2024

Objective This study presents new indices to evaluate productivity inefficiency and resource expenditure for liver cancer in the MENA region, aiming to bridge the gap between health outcomes and economic factors for better policy insights. Setting Population data from eight MENA countries between 2000 and 2021 was analyzed, focusing on liver cancer rates among different age and gender groups. The study assessed GDP per capita, health expenditure, employment levels, and the Socio-Demographic Index (SDI) to evaluate health and economic resilience. Design Data from the Global Burden of Disease (GBD) database and the World Bank were analyzed. A Random Forest Regressor assessed the importance of features related to Productivity Loss and Resource Allocation indices, while a sensitivity analysis confirmed their robustness. Results Liver cancer predominantly affects adults aged 20 to 49 and those 50 and older, with alcohol use as the main risk factor. Men are mostly diagnosed with hepatitis B and C, while women tend to have Non-Alcoholic Steatohepatitis (NASH). Egypt has the highest health-related productivity loss index (IHAPI), indicating significant losses, while Saudi Arabia has the lowest, suggesting better economic resilience. A Random Forest analysis showed that the Economic Vulnerability and Health Index (EVHI) explained over 71% of the variation in IHAPI, followed by the Risk Level of Cancer Loss (RLCL) at 22%. Sensitivity analysis indicated that indices like HAPLI, EVHI, RLCL, and IHAPI showed narrow variability, while the Total Productivity Loss Transition Index (TPLTI) and Socio-Demographic Health Equity Index (SD-HEI) were more volatile concerning Disability-Adjusted Life Years (DALY). Resource allocation indices (RAEI, HSRI, CBRPI) were close to 1, indicating effective resource use and a strong health system. Conclusions This study highlights liver cancer's impact on health and economies in MENA countries, aiding in case identification, resource optimization, and policy goal setting to reduce productivity losses.
HAdV-7 and HAdV-3: A Comparative Study on Tropism, Replication, and Receptor Mediated Infection in Human Cell Lines
Authors: Zhou Jing , Chen Qigao , Li Lianzhong , Yang Yihao , Lin Yongping
Published: December 2024

Background: To explore the tropism and replication proficiency of specific human adenoviruses, namely HAdV-7 and HAdV-3, across a spectrum of human cell lines, and to elucidate the relationship between viral infection and the levels of hDSG2 and hCD46 receptor expression.
Methods: We employed a variety of human cell lines originating from diverse tissues to evaluate viral replication. Viral titers were determined using a standard plaque assay, and cell infection was evaluated by immunofluorescence staining for viral hexon protein. Flow cytometry was used to assess the surface expression of hDSG2 and hCD46. The statistical analysis was conducted with GraphPad Prism version 6 software.
Results: HAdV-7 demonstrated higher replication efficiency than HAdV-3 in most cell lines, with significant replication observed in Hep-2, Calu-3, HEK-293, and HeLa cells. The expression of hDSG2 and hCD46 correlated with viral susceptibility, indicating that these receptors are vital for viral adhesion and penetration. Notably, HAdV-7 showed a stronger association with hDSG2, which may explain its increased pathogenicity.
Conclusions: Our study provides evidence that HAdV-7 has a broader tropism and higher replication efficiency in human cell lines compared to HAdV-3, with hDSG2 being a potential target for antiviral interventions. These results deepen our comprehension of HAdV-7 pathogenesis and could inform the creation of innovative treatment approaches for adenovirus infections.
Power and efficiency of a self-field magnetoplasmadynamic thruster estimated with resistive MHD simulations
Authors: Tkachenko Yevhen , Ciardi Andrea , Khiar Benjamin
Published: December 2024

Existing numerical work on Magnetoplasmadynamic Thrusters (MPDTs) adopt injection conditions that assume the propellant to be ”hot” (T ∼ 1 eV) and fully ionized. Although such simulations are capable of recovering the experimental values of integral quantities, such as thrust and voltage, it is not clear how the plasma dynamics and thruster’s efficiency are affected by these simplified boundary conditions.
Our goal is to build upon and extend a multi-physics computational platform specifically for studying MPDTs under realistic conditions. Here, we focus on understanding the effects of different propellant injection boundary conditions on the plasma dynamics, energy budget and efficiency.
We carry out simulations of argon-fed self-field MPDTs in 2D cylindrical axisymmetric geometry.We use the single-fluid, two-temperature magnetohydrodynamic (MHD) code FLASH with tabulated equation of state calculated with the IONMIX code. A weakly ionized, ”cold” propellant (T ∼ 0.13 eV) injection boundary condition is implemented. The resistivity model is extended to take into account the effects of electron-neutral collisions, which are non-negligible in this case.
The simulation results show the importance of injecting a ”cold” propellant and its effects on the plasma dynamics, power balance, Lorentz and thrust efficiencies. Although injecting ”cold” propellant boundary results in the similar electromagnetic thrust as the ”hot” case, it leads to significant changes in the distribution of MHD parameters and, overall, a more complicated flow pattern. At the same time we are able to discard large powers associated with the pre-heated, fully ionized, and fast inlet, while achieving realistic Lorentz efficiency, consistent with the thrust efficiency. Finally, the work lays the basis for future studies of a more accurate propellant injection model.
Suitable Water Conservation Measures and its Potential Sites for Sustainable Water Management Using Geospatial Techniques and SWAT model
Authors: Balan Panchamy , Joseph Asha , Varughese Anu , K.P Rema , P.S Sheeja
Published: December 2024

A study on the Manali watershed used geospatial techniques, the SWAT model, and IMSD guidelines to identify suitable water conservation measures and their sites to combat water scarcity. SWAT model was calibrated and validated for the watershed with performance indicators R2 (0.85 − 0.61) and NSE (0.71 − 0.61) in the acceptable range. SWAT water balance estimation revealed that 78 percent of rainfall contributes to the runoff process as stream flow, which could be reduced through water conservation measures. A multi-criterion weighted overlay analysis, considering factors like land use, runoff, stream density, soil permeability, and slope, classified 15% of the area in Manali watershed as highly suitable, 84.8% as moderately suitable, and 0.2% as less suitable for water conservation. Recommendations included the construction of 32 farm ponds, seven percolation ponds, and four check dams, ultimately leading to the provision of clean water and sanitation to the people in the watershed.
Nitrene-mediated Aminative N–N–N Coupling: Facile Access to Triazene 1-Oxides
Authors: Wang Hao , Zhu Shi-Yang , Zhang Hai-Ruo , Sun Bo-Yang , Bai Zi-Qian , He Gang , Chen Gong
Published: December 2024

Significant strides have been made in the realm of nucleophile-electrophile coupling reactions over recent decades. However, the development of innovative strategies for nucleophile-nucleophile coupling is still highly sought after. Among these, aminative coupling, especially when involving two nitrogen-connected nucleophiles, is not only rare but also exceedingly challenging. In this work, we present a novel nitrene-mediated aminative N–N–N coupling reaction that employs an anomeric amide as a key reagent to connect amines with nitrosoarenes. This innovative method capitalizes on the in situ generation of an aminonitrene intermediate, which is efficiently captured by nitrosoarenes. The resultant reaction offers a direct, mild, and highly efficient pathway for synthesizing triazene 1-oxides, thereby establishing a new paradigm for aminative coupling between nucleophiles. Our mechanistic studies demonstrate that the \textit{N}-substituents of the amine have a profound impact on the reactivity of the aminonitrene intermediate. Additionally, complementary computational studies suggest that aryl nitroso and aminonitrene coupling is significantly favored due to the substantial reduction in distortion energy, outcompeting alternative nitrene dimerization pathways.