bluuebunny/crossref_metadata_2025 huggingface dataset:
Alligatorascension: climbing performance of Alligator mississippiensis
Authors: Swords Annelise , Cramberg Michael , Parker Seth , Scott Anchal , Sopko Stephanie , Taylor Ethan , Young Bruce A.
Published: December 2023

In tetrapedal locomotion, whether horizontal or during climbing, interactions between the foot and the contact surface or substrate influence the locomotor performance. Multiple previous studies of tetrapedal squamates (lizards) have reported that the animals used the same locomotor velocity, regardless of the angle of ascension. The present study was performed to determine if the American alligator (Alligator mississippiensis) would exhibit a stable climbing velocity and to determine to what degree, if any, this climbing velocity could be modified by substrate differences. Sub-adult Alligator mississippiensis, with body lengths around 170 cm, used the same stride velocity when moving at angles of 0°, 30°, and 55°. During these trials, both the sub-adult and juvenile alligators used a “low walk” gait, rather than a distinctive climbing gait. When the alligators traversed an open grate, their stride duration increased (and stride velocity decreased) presumably due to the insertion (and retraction) of their claws and digits into the grate. When climbing at 55° the juvenile and sub-adult alligators used the same stride duration; the sub-adults used a stride length that was significantly larger in absolute terms, but significantly shorter in relative terms. Despite their large size, and their more caudal center of mass, the climbing performance of Alligator mississippiensis is similar to what has been described in the previously-studied tetrapedal squamates.
Exempla in 1 Maccabees and Josephus’ Bellum Judaicum: Doing Jewish Exemplarity in the Greco-Roman World
Authors: Bay Carson , van Henten Jan Willem
Published: December 2023

The study of exempla and exemplarity in Mediterranean antiquity touches the methodological borderlines and interest areas of several distinct academic disciplines. Earlier studies focused on semantics and the development from the Greek παράδειγμα to the Roman exemplum. More recently, the field of Classics has tended to examine exemplarity as a phenomenon with a distinctively Roman edge. At the same time, scholars in adjacent disciplines like ancient Judaism and early Christianity have engaged Classics scholarship on this topic in their own work. This paper extends this arena by clarifying aspects of exemplarity within two paradigmatic texts of Hellenistic- and Roman-era Judaism. We examine 1 Maccabees 2:49–68 and Josephus’ Jewish War 6.99–110, both speeches set within “contemporary” histories written by Jewish authors. By examining these ancient Jewish passages, written within the Greco-Roman world, we help add clarity and meaning to what could be “Jewish” about exemplarity in ancient Mediterranean contexts.
Textiles in the Funerary chaîne opératoire. Perspectives from Meroitic and Postmeroitic Sudan and Nubia (c.350 BCE–550 CE)
Authors: Yvanez Elsa
Published: December 2023

This paper exploits the rich but little-studied corpus of archaeological textiles found in modern Sudan and Nubia and dated to the Meroitic and Postmeroitic periods (c.350 BCE–550 CE). It allies current approaches developed in the field of mortuary archaeology with an in-depth analysis of textile artefacts discovered in situ in the graves of the ancient Sudanese people. Going beyond the simple description of textile items and their potential place in the tomb, the concept of funerary chaîne opératoire is used to trace and interpret textile gestures around the deceased. Through many examples and the detailed case study of an ‘archer’ grave from Gebel Adda (Lower Nubia), this article aims at demonstrating the active and important role of textiles in the transformation of the dead, from an inert body to a revered ancestor.
Biblical Call and Classical Response: Intertextuality and Image-Text Relations in Henricus Engelgrave’s Sermon Books
Authors: Reddemann Lukas
Published: December 2023

This paper aims to explore the unique structure and function of the emblems in Henricus Engelgrave’s (1610–70) sermon books (Lux evangelica, Caeleste pantheon, and Caelum empyreum). The emblems serve as introductions to sermons for Sundays and feast days of the liturgical year; they include two mottos: one biblical quotation and a quotation from classical Roman poetry. Based on a selection of exemplary emblems, this paper demonstrates that the second mottos are not merely decorative additions, as has sometimes been argued. Rather, they constitute key features in Engelgrave’s emblematic conception as they provide allegorical and pictorial imageries that affect the picturae of the emblems, the expression of the moral purpose of the sermons, and the relationship between both. This article is part of the special issue of the Journal of Jesuit Studies on Jesuit emblems and emblematic edited by Walter S. Melion.
Ménestrier on Emblems in the Context of “Erudite Images” and His Wider “Philosophy of Images”
Authors: Loach Judi
Published: December 2023

This paper shows how Ménestrier’s theorizing on emblems developed from his practice as devisor of decorative schemes and festivals, as indeed did that of fellow Jesuits. It explains his concern for developing a theoretical framework (whereas fellow Jesuits usually published collections of emblems with little theory) in terms of the influence exerted by his Jesuit training in Aristotelian philosophy and Thomist theology and the example set by the (ex-)Jesuit theorist Emanuele Tesauro. It puts Ménestrier’s theory and practice of emblems within the context of his more general concern for “erudite,” or symbolic, images and how he conceived such images, in general, operate on humans. In conclusion, I suggest how this understanding of such images’ potential within the context of Catholic renewal affects how Ménestrier understands the purpose and creation of emblems. This article is part of the special issue of the Journal of Jesuit Studies on Jesuit emblems and emblematic edited by Walter S. Melion.
Interactive effects of temperature and substrates on selected life history parameters of the African palm weevil Rhynchophorus phoenicis (Fabricius) (Coleoptera: Curculionidae)
Authors: Anankware J.P. , Debrah S.K. , Asomah S. , Egonyu J.P. , Eilenberg J. , Roos N. , Obeng-Ofori D.
Published: December 2023

The African palm weevil Rhynchophorus phoenicis (Fabricius) is an alternative to conventional protein sources from livestock and poultry due to their rich nutritional content and ability to be reared on agricultural by-products. When establishing a production protocol for mass production of R. phoenicis larvae, it is imperative to understand the interaction between substrate and temperature on the development and reproductive success of the weevils. To determine the optimum temperatures for continuous production of R. phoenicis, the larvae were subjected to four temperatures (20 °C, 25 °C, 30 °C, and 35 °C) at a relative humidity of 70% on different substrates (elephant ear corm, peeled sugarcane, and palm yolk) in an incubator. The developmental duration of R. phoenicis larvae decreased with a temperature above 30 °C whilst percentage larval survival was high at 20 °C and 25 °C. The temperature with the fastest larval development and highest mortality was 35 °C. The optimal temperature from egg to the adult stage was observed at 25 °C. The oviposition and hatchability of eggs was high on elephant ear corm (EC), and palm yolk (PY) at 25 °C whilst the number of cocoons was high at 20 °C on decorticated coconut coir (DC).

Thus, it is feasible to utilise the easily accessible substrates that interact well with temperature to produce optimum condition for the production of R. phoenicis larvae.
Farmed yellow mealworm (Tenebrio molitor; Coleoptera: Tenebrionidae) welfare: species-specific recommendations for a global industry
Authors: Barrett M. , Godfrey R.K. , Schnell A. , Fischer B.
Published: December 2023

Yellow mealworms (Tenebrio molitor; Coleoptera: Tenebrionidae) are currently the most farmed holometabolous insect species in the insects as food and feed industry, with over 300 billion individual mealworms reared annually. Yellow mealworm larvae are being developed for potential uses as human protein, pet, livestock and fish feed, reclamation of mycotoxin-contaminated grains, and more. Insect welfare is of great interest to consumers, producers, and academics; yet no studies have considered the species-specific welfare concerns of farmed yellow mealworms under current industry conditions. Following a model for considering farmed insect welfare, we review yellow mealworm biology and its relationships to welfare in commercial rearing facilities, including: interspecific interactions (predators, parasites, and pathogens), abiotic conditions (temperature, hydration, atmospheric gasses, lighting), nutrition (including pollutants, plastics, and hormones), intraspecific concerns (genetics, morphological defects, cannibalism, density, mating and oviposition needs, and handling-associated stress), and slaughter and depopulation methods (including anesthesia and stunning). From this review, we identify practical recommendations for improving current welfare concerns in the industry and mitigating future concerns that may appear as the industry continues to grow. Finally, we discuss future research directions that are necessary to better understand the welfare of this species.
Third new fossil species of the genus Ephedrus Haliday, 1833 (Hymenoptera: Braconidae: Aphidiinae) from Baltic amber
Authors: DAVIDIAN ELENA M. , MANUKYAN ANDRANIK R. , BELOKOBYLSKIJ SERGEY A.
Published: December 2023

A new species of aphid parasitoid from the genus Ephedrus Haliday, E. zaikai Davidian, sp. nov. (Braconidae: Aphidiinae), is described and illustrated from Late Eocene Baltic amber. This new species was compared with described fossil taxa Ephedrus mirabilis Timon-David, 1944 (Oligocene imprint from Bassin de Marseille), Ephedrus carsteni Davidian, 2023 and E. primordialis Brues, 1933 (both from Eocene Baltic amber), and E. rasnitsyni Davidian & Kaliuzhna, 2021 (Eocene Sakhalinian amber), as well as with extant E. niger Gautier, Bonnamour & Gaumont, 1929 and E. chaitophori Gӓrdenfors, 1986.
Introduction
Authors: Hutchings William
Published: December 2023

The Introduction examines, by means of examples, the building blocks of Pope’s poetry: couplets and verse paragraphs. It then briefly surveys some significant genres of his work – satires, verse epistles, imitations – before providing a map of all his poems under the headings of genres and themes. Throughout, some of the stylistic features and syntactic structures he uses (such as chiasmus) are defined and exemplified.
3. An Essay on Criticism
Authors: Hutchings William
Published: December 2023

Chapter 3 takes seven key examples from Pope’s first unarguable masterpiece, An Essay on Criticism, with the aim of showing how the poem extends the genre of practical didacticism into a probing and imaginative inquiry into the sources of creative writing.
8. Elegy to the Memory of an Unfortunate Lady
Authors: Hutchings William
Published: December 2023

Chapter 8 reads the Elegy to the Memory of an Unfortunate Lady as a discreet but emotionally charged poem. Using the language of pastoral and incorporating the tradition of classical elegy, it represents an often overlooked, if relatively small, area of Pope’s oeuvre.
9. Homer, The Iliad
Authors: Hutchings William
Published: December 2023

Chapter 9 proposes that Pope’s translation of Homer’s Iliad can be fruitfully read as perhaps the most significant of all contributions to a cultural history of maintaining the tradition of epic. The key principle driving this endeavour is that the authentic voice of ancient epic should be preserved and made comprehensible for a readership living in the ethos of, and accustomed to the poetic modes of, a different world. Two passages, one from book eight and one from book twelve of the Iliad , are examined alongside versions by Sir John Denham (seventeenth century), William Cowper (later eighteenth century) and Alice Oswald (twenty-first century) to show how the inner voice of the original is maintained within living language.
17. The Second Satire of the Second Book of Horace Imitated. To Mr Bethel
Authors: Hutchings William
Published: December 2023

Chapter 17. The Second Satire of the Second Book of Horace Imitated. To Mr Bethel is in two sections. The first and longer part, which Pope calls ‘Bethel’s sermon’ (from Horace’s term ‘sermo’, meaning speech or conversation) is an oration in praise of traditional virtues and moderation. The second section, in Pope’s own voice, adopts Bethel’s principles by applying them, with graceful humour, to his own humble life-style.
23. The Sixth Epistle of the First Book of Horace Imitated. To Mr Murray
Authors: Hutchings William
Published: December 2023

Chapter 23 tracks The Sixth Epistle of the First Book of Horace Imitated. To Mr Murray through its sceptical review of the misplaced pursuits of wealth, fame and power. Dominating each in turn is the key phrase that opens the poem, quoting Thomas Creech’s standard 1684 translation: ‘Not to admire, is all the art I know, / To make men happy, and to keep them so’. ‘Not to admire’ translates literally Horace’s ‘Nil admirari’. ‘Admire’ carries the connotation of foolish wonderment. The best guide to happiness is not to be taken to extremes, but to maintain a position of moderation and detachment.
A List in Three Dimensions
Authors: Wallraff Martin
Published: December 2023

Wallraff examines the canon tables of the gospels, composed by Eusebius of Caesarea in the first half of the fourth century CE, as a new form of synopsis: a list in three dimensions which uses both the extension (length and breadth) of a page in a codex, and the hypertextuality within the codex (intratextual references back and forth). In the antique culture of the book, this system raises the list to a new level of complexity. Given the extraordinary success of the device (with many hundreds of extant copies in numerous languages), the impact on viewing habits and textual practices was enormous.
Medical treatment of pleural infection: antibiotic duration and corticosteroid usefulness
Authors: Skouras Vasileios , Chatzivasiloglou Foteini , Iliopoulou Marianthi , Rimpa Theofani
Published: December 2023

The data about the optimal duration of antibiotics and the usefulness of corticosteroids in the management of parapneumonic effusion and pleural infection are scarce. Two randomised controlled trials evaluating short antibiotic courses (ODAPE and SLIM) and another trial assessing the benefit from corticosteroid use (STOPPE) in this setting were recently published. The aim of this journal club is to present these trials and discuss their significance and limitations. ODAPE compared the efficacy and safety of a short (2 weeks)versusan extended (3 weeks) course of amoxicillin–clavulanate in community-acquired complicated parapneumonic effusions, while SLIM compared the efficacy and safety of short (14–21 days)versuslonger (28–42 days) antibiotic courses in patients with community- or hospital-acquired pleural infection. STOPPE assessed the benefit from dexamethasone use in patients with community-acquired pneumonia and concomitant pleural effusion. Both ODAPE and SLIM found that shorter antibiotic courses produce less adverse events while being equally efficacious to the longer courses in a subgroup of patients, such as those with pleural infection that is stabilised with only medical treatment and does not require surgery. In contrast, STOPPE found no benefit from the use of dexamethasone in unselected patients with pneumonia and pleural effusion. Due to the significant limitations of these trials, further studies are required to confirm these findings.

Commentary on:

Hassan M,et al. The ShortversusLong Antibiotic Course for Pleural Infection Management (SLIM) randomised controlled open-label trial.ERJ Open Res2023; 9: 00635-2022.

Porcel JM,et al. Twovs. three weeks of treatment with amoxicillin–clavulanate for stabilized community-acquired complicated parapneumonic effusions. A preliminary non-inferiority, double-blind, randomized, controlled trial.Pleura Peritoneum2020; 5: 20190027.

Fitzgerald DB,et al. Steroid Therapy and Outcome of Parapneumonic Pleural Effusions (STOPPE): a pilot randomized clinical trial.Am J Respir Crit Care Med2022; 205: 1093–1101.
Research on Energy Efficiency Characteristics of Mining Shovel Hoisting and Slewing System Driven by Hydraulic-Electric Hybrid System
Authors: Wang Xiangyu , Ge Lei , Li Yunhua , Quan Long
Published: December 2023

Mining shovel is a crucial piece of equipment for high-efficiency production in open-pit mining and stands as one of the largest energy consumption sources in mining. However, substantial energy waste occurs during the descent of the hoisting system or the deceleration of the slewing platform. To reduce the energy loss, an innovative hydraulic-electric hybrid drive system is proposed, in which a hydraulic pump/motor connected with an accumulator is added to assist the electric motor to drive the hoisting system or slewing platform, recycling kinetic and potential energy. The utilization of the kinetic and potential energy reduces the energy loss and installed power of the mining shovel. Meanwhile, the reliability of the mining shovel pure electric drive system also can be increased. In this paper, the hydraulic-electric hybrid driving principle is introduced, a small-scale testbed is set up to verify the feasibility of the system, and a co-simulation model of the proposed system is established to clarify the system operation and energy characteristics. The test and simulation results show that, by adopting the proposed system, compared with the traditional purely electric driving system, the peak power and energy consumption of the hoisting electric motor are reduced by 36.7% and 29.7%, respectively. Similarly, the slewing electric motor experiences a significant decrease in peak power by 86.9% and a reduction in energy consumption by 59.4%. The proposed system expands the application area of the hydraulic electric hybrid drive system and provides a reference for its application in oversized and super heavy equipment.
Configuration Design and Kinematic Performance Analysis of a Novel 4-DOF Parallel Ankle Rehabilitation Mechanism with Two Virtual Motion Centers
Authors: Song Jingke , Wei Jun , Yu Bin , Liu Chenglei , Ai Cunjin , Zhang Jianjun
Published: December 2023

Aiming at the problem that the existing ankle rehabilitation robot is difficult to fully fit the complex motion of human ankle joint and has poor human-machine motion compatibility, an equivalent series mechanism model that is highly matched with the actual bone structure of the human ankle joint is proposed and mapped into a parallel rehabilitation mechanism. The parallel rehabilitation mechanism has two virtual motion centers (VMCs), which can simulate the complex motion of the ankle joint, adapt to the individual differences of various patients, and can meet the rehabilitation needs of both left and right feet of patients. Firstly, based on the motion properties and physiological structure of the human ankle joint, the mapping relationship between the rehabilitation mechanism and ankle joint is determined, and the series equivalent model of the ankle joint is established. According to the kinematic and constraint properties of the ankle equivalent model, the configuration design of the parallel ankle rehabilitation robot is carried out. Secondly, according to the intersecting motion planes theory, the full-cycle mobility of the mechanism is proved, and the continuous axis of the mechanism is judged based on the constraint power and its derivative. Then, the kinematics of the parallel ankle rehabilitation robot is analyzed. Finally, based on the OpenSim biomechanical software, a human-machine coupling rehabilitation simulation model is established to evaluate the rehabilitation effect, which lays the foundation for the formulation of a rehabilitation strategy for the later prototype.
Effects of Orthogonal Heat Treatment on Microstructure and Mechanical Properties of GN9 Ferritic/Martensitic Steel
Authors: Ma Tingwei , Hao Xianchao , Wang Ping
Published: December 2023

Microstructure and mechanical properties of GN9 Ferritic/Martensitic steel for sodium- cooled fast reactors have been investigated through orthogonal design and analysis. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), differential scanning calorimeter (DSC), tensile and impact tests were used to evaluate the heat treatment parameters on yield strength, elongation and ductile-to-brittle transition temperature (DBTT). The results indicate that the microstructures of GN9 steel after orthogonal heat treatments consist of tempered martensite, M23C6, MX carbides and MX carbonitrides. The average prior austenite grains increase and the lath width decreases with the austenitizing temperature increasing from 1000 °C to 1080 °C. Tempering temperature is the most important factor that influences the dislocation evolution, yield strength and elongation compared with austenitizing temperature and cooling methods. Austenitizing temperature, tempering temperature and cooling methods show interactive effects on DBTT. Carbide morphology and distribution, which is influenced by austenitizing and tempering temperatures, is the critical microstructural factor that influences the Charpy impact energy and DBTT. Based on the orthogonal design and microstructural analysis, the optimal heat treatment of GN9 steel is austenitizing at 1000 °C for 0.5 h followed by air cooling and tempering at 760 °C for 1.5 h.
Exploration of inorganic nanoparticles for revolutionary drug delivery applications: a critical review
Authors: Unnikrishnan Gayathri , Joy Anjumol , Megha M. , Kolanthai Elayaraja , Senthilkumar M.
Published: December 2023

The nanosystems for delivering drugs which have evolved with time, are being designed for greater drug efficiency and lesser side-effects, and are also complemented by the advancement of numerous innovative materials. In comparison to the organic nanoparticles, the inorganic nanoparticles are stable, have a wide range of physicochemical, mechanical, magnetic, and optical characteristics, and also have the capability to get modified using some ligands to enrich their attraction towards the molecules at the target site, which makes them appealing for bio-imaging and drug delivery applications. One of the strong benefits of using the inorganic nanoparticles-drug conjugate is the possibility of delivering the drugs to the affected cells locally, thus reducing the side-effects like cytotoxicity, and facilitating a higher efficacy of the therapeutic drug. This review features the direct and indirect effects of such inorganic nanoparticles like gold, silver, graphene-based, hydroxyapatite, iron oxide, ZnO, and CeO2 nanoparticles in developing effective drug carrier systems. This article has remarked the peculiarities of these nanoparticle-based systems in pulmonary, ocular, wound healing, and antibacterial drug deliveries as well as in delivering drugs across Blood–Brain-Barrier (BBB) and acting as agents for cancer theranostics. Additionally, the article sheds light on the plausible modifications that can be carried out on the inorganic nanoparticles, from a researcher’s perspective, which could open a new pathway.

Graphical abstract
Advancing drug–target interaction prediction: a comprehensive graph-based approach integrating knowledge graph embedding and ProtBert pretraining
Authors: Djeddi Warith Eddine , Hermi Khalil , Ben Yahia Sadok , Diallo Gayo
Published: December 2023

Background

The pharmaceutical field faces a significant challenge in validating drug target interactions (DTIs) due to the time and cost involved, leading to only a fraction being experimentally verified. To expedite drug discovery, accurate computational methods are essential for predicting potential interactions. Recently, machine learning techniques, particularly graph-based methods, have gained prominence. These methods utilize networks of drugs and targets, employing knowledge graph embedding (KGE) to represent structured information from knowledge graphs in a continuous vector space. This phenomenon highlights the growing inclination to utilize graph topologies as a means to improve the precision of predicting DTIs, hence addressing the pressing requirement for effective computational methodologies in the field of drug discovery.

Results

The present study presents a novel approach called DTIOG for the prediction of DTIs. The methodology employed in this study involves the utilization of a KGE strategy, together with the incorporation of contextual information obtained from protein sequences. More specifically, the study makes use of Protein Bidirectional Encoder Representations from Transformers (ProtBERT) for this purpose. DTIOG utilizes a two-step process to compute embedding vectors using KGE techniques. Additionally, it employs ProtBERT to determine target–target similarity. Different similarity measures, such as Cosine similarity or Euclidean distance, are utilized in the prediction procedure. In addition to the contextual embedding, the proposed unique approach incorporates local representations obtained from the Simplified Molecular Input Line Entry Specification (SMILES) of drugs and the amino acid sequences of protein targets.

Conclusions

The effectiveness of the proposed approach was assessed through extensive experimentation on datasets pertaining to Enzymes, Ion Channels, and G-protein-coupled Receptors. The remarkable efficacy of DTIOG was showcased through the utilization of diverse similarity measures in order to calculate the similarities between drugs and targets. The combination of these factors, along with the incorporation of various classifiers, enabled the model to outperform existing algorithms in its ability to predict DTIs. The consistent observation of this advantage across all datasets underlines the robustness and accuracy of DTIOG in the domain of DTIs. Additionally, our case study suggests that the DTIOG can serve as a valuable tool for discovering new DTIs.
Genome-wide analysis of SET domain genes and the function of GhSDG51 during salt stress in upland cotton (Gossypium hirsutum L.)
Authors: Jian Hongliang , Wei Fei , Chen Pengyun , Hu Tingli , Lv Xiaolan , Wang Bingqin , Wang Hantao , Guo Xiaohao , Ma Liang , Lu Jianhua , Fu Xiaokang , Wei Hengling , Yu Shuxun
Published: December 2023

Background

Cotton, being extensively cultivated, holds immense economic significance as one of the most prominent crops globally. The SET (Su(var), E, and Trithorax) domain-containing protein is of significant importance in plant development, growth, and response to abiotic stress by modifying the lysine methylation status of histone. However, the comprehensive identification of SET domain genes (SDG) have not been conducted in upland cotton (Gossypium hirsutum L.).

Results

A total of 229 SDGs were identified in four Gossypium species, including G. arboretum, G. raimondii, G. hirsutum, and G. barbadense. These genes could distinctly be divided into eight groups. The analysis of gene structure and protein motif revealed a high degree of conservation among the SDGs within the same group. Collinearity analysis suggested that the SDGs of Gossypium species and most of the other selected plants were mainly expanded by dispersed duplication events and whole genome duplication (WGD) events. The allopolyploidization event also has a significant impact on the expansion of SDGs in tetraploid Gossypium species. Furthermore, the characteristics of these genes have been relatively conserved during the evolution. Cis-element analysis revealed that GhSDGs play a role in resistance to abiotic stresses and growth development. Furthermore, the qRT-PCR results have indicated the ability of GhSDGs to respond to salt stress. Co-expression analysis revealed that GhSDG51 might co-express with genes associated with salt stress. In addition, the silencing of GhSDG51 in cotton by the virus-induced gene silencing (VIGS) method suggested a potential positive regulatory role of GhSDG51 in salt stress.

Conclusions

The results of this study comprehensively analyze the SDGs in cotton and provide a basis for understanding the biological role of SDGs in the stress resistance in upland cotton.
Sex-disparities in chest pain workup: a retrospective cohort review of a university based clinical decision pathway
Authors: Titus Benjamin R. , Ream Karen S. , Rehman Tehreem , Allen Larry A.
Published: December 2023

Background

Females have historically lower rates of cardiovascular testing when compared to males. Clinical decision pathways (CDP) that utilize standardized risk-stratification methods may balance this disparity. We sought to determine whether clinical decision pathways could minimize sex-based differences in the non-invasive workup of chest pain in the emergency department (ED). Moreover, we evaluated whether the HEART score would minimize sex-based differences in risk-stratification.

Methods

We conducted a retrospective cohort review of adult ED encounters for chest pain where CDP was employed. Primary outcome was any occurrence of non-invasive imaging (coronary CTA, stress imaging), invasive testing, intervention (PCI or CABG), or death. Secondary outcomes were 30-day major adverse cardiac events (MACE). We stratified HEART scores and primary/secondary outcomes by sex.

Results

A total of 1078 charts met criteria for review. Mean age at presentation was 59 years. Females represented 47% of the population. Low, intermediate, and high-risk patients as determined by the HEART score were 17%, 65%, and 18% of the population, respectively, without any significant differences between males and females. Non-invasive testing was similar between males and females when stratified by risk. Males categorized as high risk underwent more coronary angiogram (33% vs. 16%, p = 0.01) and PCI (18% vs. 8%, p = 0.04) than high risk females, but this was not seen in patients categorized as low or intermediate risk. Males experienced more MACE than females (8% vs. 3%, p = 0.001).

Conclusions

We identified no sex-based differences in risk-stratification or non-invasive testing when the CDP was used. High risk males, however, underwent more coronary angiogram and PCI than high risk females, and consequently males experienced more overall MACE than females. This disparity may be explained by sex-based differences in the pathophysiology driving each patient’s presentation.
Loss of capture of conduction system pacemaker caused by fibrosis surrounding the lead: a case report
Authors: Hopman Luuk H.G.A. , Beunder Kyle P. , Borodzicz-Jazdzyk Sonia , Götte Marco J.W. , van Halm Vokko P.
Published: December 2023

Background

Conduction system pacing (CSP) is a novel technique that involves pacing the His-Purkinje system instead of the traditional right ventricular (RV) apex. This technique aims to avoid the adverse effects of RV apical pacing, which can lead to ventricular dyssynchrony and heart failure over time. CSP is gaining popularity but its long-term efficacy and challenges remain uncertain. This report discusses a case where CSP was initially successful but faced complications due to an increasing pacing threshold.

Case presentation

A 65-year-old female with total atrioventricular block was referred for brady-pacing. Due to the potential for chronic RV pacing, CSP was chosen. The CSP implantation involved subcutaneous device placement, with a CSP lead in the left bundle branch area (LBBA) and an RV backup lead. A year after successful implantation, the LBBA pacing threshold progressively increased. Subsequent efforts to correct it led to anodal capture and battery depletion. Cardiac magnetic resonance imaging (CMR) revealed mid-septal fibrosis at the area of LBBA lead placement and suggested cardiac sarcoidosis as a possible cause.

Conclusion

CSP is a promising technique for treating bradyarrhythmias, but this case underscores the need for vigilance in monitoring pacing thresholds. Increasing thresholds can render CSP ineffective, necessitating alternative pacing methods. The CMR findings of mid-septal fibrosis and the potential diagnosis of cardiac sarcoidosis emphasize the importance of pre-implantation assessment, as CSP may be compromised by underlying structural abnormalities. This report highlights the complexities of pacing strategy selection and the significance of comprehensive evaluation before adopting CSP.
Association between having a primary care physician and health behavioral intention in Japan: results from a nationwide survey
Authors: Sugiyama Kemmyo , Oshio Takashi , Kuwahara Susumu , Kimura Hiromi
Published: December 2023

Introduction

Introducing a primary care physician (Kakaritsuke-I: KI) system to improve the efficiency of the health care system has been controversial in Japan. This study aimed to determine the relevance of KI to an individual’s health behavioral intentions.

Methods

We used data from a nationwide, population-based internet survey (N = 5,234) to conduct a cross-sectional regression analysis. Additionally, we used a propensity score matching method to mitigate the potential endogenous biases inherent in the decision to have a KI.

Results

KI was positively associated with various behavioral intentions. For example, the probabilities of intending to eat a well-balanced diet and engaging in moderate exercise were 12.8 (95% confidence interval [CI]:9.5–16.1) percentage points and 7.2 (95% CI: 3.9–10.4) percentage points higher, respectively, among those with a KI than among those without a KI. A KI equally increased the likelihood of getting vaccinated against coronavirus (in November 2021) by 7.5 (95% CI: 5.2–9.8) percentage points.

Conclusions

Although further analysis is needed to examine the effect of KI on health, the results of this study suggest the potential benefits of policy measures to promote the KI system.
Effects of posture on heart rate variability in non-frail and prefrail individuals: a cross-sectional study
Authors: Chen Huiling , Tse Mimi Mun Yee , Chung Joanne Wai Yee , Yau Sui Yu , Wong Thomas Kwok Shing
Published: December 2023

Background

Frailty is an aging-related syndrome leading to high mortality in older adults. Without effective assessment and prevention of frailty, the incidence of frailty and relevant adverse outcomes will increase by 2050 as worldwide populations age. Although evidence suggested heart rate variability (HRV) is a potential measure of frailty, the role of HRV in frailty assessment remains unclear because of controversial findings. This study examined the effects of posture on HRV parameters in non-frail and prefrail individuals to understand the role of HRV in assessing frailty.

Methods

Forty-six participants aged ≥ 50 years were recruited between April and August 2022. Frailty was defined using Fried’s criteria. HRV was measured in standing, sitting, and lying postures, respectively, using a Polar Watch, and analyzed using Kubios HRV Standard 3.5.0 (Kubios). The five most commonly used parameters were examined, including standard deviations of all normal-to-normal intervals (SDNN), root mean square of the successive differences (RMSSD), low frequency (LF), high frequency (HF), and LF/HF. Independent t-tests and Mann–Whitney tests were used for inter-group comparisons. Friedman tests were used for intra-group comparisons across postures.

Results

The non-frail group showed significant differences in HRV parameters across postures (all p < 0.05), whereas the prefrail group did not demonstrate any difference (all p > 0.05). The differences in the non-frail group included higher RMSSD and HF in the lying posture compared to those in the standing posture (29.54 vs 21.99 p = 0.003, 210.34 vs 96.34 p = 0.001, respectively), and higher LF and LF/HF in the sitting posture compared to those in the lying posture (248.40 vs 136.29 P = 0.024, 1.26 vs 0.77 p = 0.011, respectively).

Conclusions

The effects of posture on HRV were blunted in the prefrail group, which suggests an impaired cardiac autonomic functioning. Measuring the effects of posture on HRV parameters may contribute to frailty assessment. However, further evidence from larger cohorts and including additional HRV parameters is needed.
Post-malaria neurological syndrome (PMNS): a rare case report with brain biopsy findings
Authors: Alawad Mouhammad J , Almayoof Moustafa , Al bozom Adel , Alkhidir Taha , Emam Saeed S , Farfar Khalifa
Published: December 2023

Post-malaria neurological syndrome (PMNS) is a rare, self-limiting condition that presents with a wide range of neurological manifestations after clearance of malarial infection, especially 𝘗𝘭𝘢𝘴𝘮𝘰𝘥𝘪𝘶𝘮 f𝘢𝘭𝘤𝘪𝘱𝘢𝘳𝘶𝘮, most patients recover without residual deficits. Here we present a case of a 29-year-old, male with a recent history of malaria treated successfully, who presented due to a generalized tonic-clonic seizure, without any other neurological symptoms, the examination and labs were unremarkable, he underwent a computer tomography (CT) scan and Magnetic resonant imaging (MRI) which both showed two areas of vasogenic edema involving the subcortical white matter of left frontal and right posterior parasagittal regions, all autoimmune screens, infection workup from blood and CSF were negative, he underwent a brain biopsy that showed intense perivascular inflammation with neuronal loss and gliosis, findings are nonspecific and can be seen in a variety of condition. The patient’s condition improved, and he was discharged without any complications.
Depression and self-care in diabetes; adjustment for misclassification bias: application of predictive weighting method
Authors: Kordi Zahra , Khosravi Ahmad , Fotouhi Akbar
Published: December 2023

Objective

This study aimed to investigate the association between depression and self-care in diabetic patients potentially influenced by biases in depression measurement using weighting the positive and negative predictive values.

Methods

In this cross-sectional study, 1050 patients informedly consented to participate in the study. Using a WHO-5 well-being index, the participants were examined for depressive mood as exposure. The sensitivity and specificity of this index in a systematic review study were 0.86 and 0.81, respectively. Self-care (that is outcome) was assessed using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. To correct the misclassification bias of exposure, the predictive weighting method was used in the multivariable logistic regression model adjusted for covariates. Bootstrap sample with replacement and simulation was used to deal with random error.

Results

The mean age of patients was 42.8 ± 7.5 years. In this study, 70.1% of diabetic patients (n = 720) were depressed based on the questionnaire score and only 52.7% (n = 541) of them had appropriate self-care behaviors. Our study revealed a close relationship between self-care and covariates such as gender, depression, having comorbidities, abdominal obesity, economic status and education. The odds ratio of the association between depressive mood and lack of self-care in primary multivariable logistic regression was 2.21 (95% CI: 1.62-3.00, p < 0.001) and after misclassification bias adjusting, it was equal to 3.4 (95% CI: 1.7–6.6, p < 0.001). The OR percentage of bias was − 0.55.

Conclusion

After adjusting for depression misclassification bias and random error, the observed association between depression and self-care was stronger. According to our findings, psychiatric interventions, and counseling and education along with self-care interventions are necessary for these patients. Special attention should be paid to male, low economic classes, less educated and those having a history of comorbidities along with psychological assessment when improving the care and progress of treatment in diabetic patients is expected. Future studies are needed to clarify the role of other psychological disorders on self-care of diabetics.
Online COVID-19 diagnosis prediction using complete blood count: an innovative tool for public health
Authors: Teng Xiaojing , Wang Zhiyi
Published: December 2023

Background

COVID-19, caused by SARS-CoV-2, presents distinct diagnostic challenges due to its wide range of clinical manifestations and the overlapping symptoms with other common respiratory diseases. This study focuses on addressing these difficulties by employing machine learning (ML) methodologies, particularly the XGBoost algorithm, to utilize Complete Blood Count (CBC) parameters for predictive analysis.

Methods

We performed a retrospective study involving 2114 COVID-19 patients treated between December 2022 and January 2023 at our healthcare facility. These patients were classified into fever (1057 patients) and pneumonia groups (1057 patients), based on their clinical symptoms. The CBC data were utilized to create predictive models, with model performance evaluated through metrics like Area Under the Receiver Operating Characteristics Curve (AUC), accuracy, sensitivity, specificity, and precision. We selected the top 10 predictive variables based on their significance in disease prediction. The data were then split into a training set (70% of patients) and a validation set (30% of patients) for model validation.

Results

We identified 31 indicators with significant disparities. The XGBoost model outperformed others, with an AUC of 0.920 and high precision, sensitivity, specificity, and accuracy. The top 10 features (Age, Monocyte%, Mean Platelet Volume, Lymphocyte%, SIRI, Eosinophil count, Platelet count, Hemoglobin, Platelet Distribution Width, and Neutrophil count.) were crucial in constructing a more precise predictive model. The model demonstrated strong performance on both training (AUC = 0.977) and validation (AUC = 0.912) datasets, validated by decision curve analysis and calibration curve.

Conclusion

ML models that incorporate CBC parameters offer an innovative and effective tool for data analysis in COVID-19. They potentially enhance diagnostic accuracy and the efficacy of therapeutic interventions, ultimately contributing to a reduction in the mortality rate of this infectious disease.
Computed tomography-based patient-specific cutting guides used for positioning of the femoral component of implants during unicompartmental knee arthroplasty: a cadaver study
Authors: Cai Junfeng , Ma Min , Zeng Wen , Luo Shuling , Yuan Feng , Yin Feng
Published: December 2023

Background

To investigate whether patient-specific instrumentation (PSI) improves the femoral component positioning of implants during unicompartmental knee arthroplasty (UKA) using cadaver bone models.

Methods

Fifty adult cadaveric femoral bone specimens collected from February 2016–2018, were randomized to receive medial UKA with a PSI guide (n = 25) or conventional instrumentation (CI) (n = 25). Standard anteroposterior and lateral view radiographs were obtained postoperatively to assess the coronal and sagittal positioning of the femoral prostheses, respectively. The osteotomy time was recorded to assess the convenience of PSI in guiding osteotomy.

Results

Osteotomy time significantly shortened in the PSI group (3.12 ± 0.65 versus 4.33 ± 0.73 min, p < 0.001). There was a significant difference in the postoperative coronal alignment of the femoral component between the PSI and CI groups (varus/valgus angle: 1.43 ± 0.93° vs. 2.65 ± 1.50°, p = 0.001). The prevalence of outliers in coronal alignment was lower in the PSI than the CI group (2/25, 8% vs. 9/25, 36%). Sagittal posterior slope angle of the femoral component was significantly different between the two groups (8.80 ± 0.65° and 6.29 ± 1.88° in the CI and PSI groups, respectively, p < 0.001). The malalignment rate of the femoral component in the sagittal plane was 60% in the CI group, whereas no positioning deviation was observed in the PSI group.

Conclusion

This study used a cadaver model to support the fact that CT-based PSI shows an advantage over CI in optimizing implant positioning for UKAs.
Predictive value of systematic immune-inflammation index combined with Ki-67 index on prognosis of prostate cancer patients after laparoscopic radical prostatectomy
Authors: Wu Rongxin , Hu Mingjin , Zhang Pei
Published: December 2023

Background

Prostate cancer (PCa) presents a wide spectrum. Systemic immune-inflammation index (SII) and Ki-67 index are new biomarkers that can predict prognosis in different types of cancer. We explored the predictive value of their combination on the prognosis of PCa patients after laparoscopic radical prostatectomy (LRP).

Methods

In this retrospective study, 290 patients who underwent LRP at Nanjing Lishui People’s Hospital between January 2016 and February 2021 were enrolled. They were divided into the good prognosis group (N = 235) and poor prognosis group (N = 55) based on the follow-up results. Both the baseline data and postoperative pathological results were collected. The Ki-67 index was determined using immunohistochemical kits, and the patients were allocated to the SII/Ki-67 index high/low expression groups according to the cut-off values to further analyze their relationship with clinical/pathological data of PCa patients. Logistics multivariate regression analysis was utilized to analyze the independent factors affecting post-LRP prognosis of CPa patients. ROC curve was plotted to assess the predictive value for post-LRP prognosis, and Kaplan-Meier curve/Log-rank were used for analysis.

Results

Significant differences were found in PSA/Gleason score/T stage/lymph node metastasis/seminal vesicle invasion/neutrophils/lymphocytes/platelets/preoperative SII/Ki-67 index between the good/poor prognosis groups. Preoperative SII/Ki-67 were related to PSA/lymphocytes/platelets in PCa. Seminal vesicle invasion and preoperative SII + Ki-67 index were independent factors affecting post-LRP prognosis. Preoperative SII + Ki-67 index had a better predictive value than preoperative SII or Ki-67 index alone. Patients with high preoperative SII and Ki-67 index levels had an increased risk of poor prognosis after LRP.

Conclusion

Preoperative SII + Ki-67 index had a better predictive value for poor prognosis after LRP than SII or Ki-67 index alone.