bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immersive medical training: a comprehensive longitudinal study of extended reality in emergency scenarios for large student groups
Authors: Einloft Jonas , Meyer Hendrik L , Bedenbender Simon , Morgenschweis Muriel L , Ganser Andre , Russ Philipp , Hirsch Martin C , Grgic Ivica 
Published: September 2024

AbstractYoung healthcare professionals and medical graduates often fall short in the practical experience necessary for handling medical emergencies. This can not only lead to strained feelings of inadequacy and insecurity among future physicians and less experienced healthcare providers in general, but also to detrimental outcomes for patients as emergency medicine demands rapid decision-making with low tolerance for errors. New didactic modalities and approaches may be needed to effectively address this shortcoming. Immersive technologies are powerful novel educational tools with untapped potential in medical training, and may be particularly suitable for simulation trainings in the high-stakes field of emergency medicine.Herein, we systematically explored the educational potential of extended reality (XR) technology, particularly virtual reality (VR), in the management of patients presenting as medical emergencies, combining the use of the STEP-VR application with an untethered hardware setup.Importantly, we aimed at studying multiple, large cohorts of senior medical students involving a total of 529 participants and collecting data over a period of two years. We assessed students’ acceptance of the training through a modified questionnaire measuring device handling, content complexity, degree of immersion, learning success, and seminar design.Our results show high, sustained acceptance and ease of use across different student cohorts and subgroups, with most students finding XR/VR engaging and beneficial for acquiring emergency medicine skills. Importantly, the prevalence of simulation sickness was minimal. Moreover, no major effect of the head-mounted displays (HMDs) price range was noted with regard to the learning experience. The results underscore the potential of XR/VR capabilities in effectively enhancing medical education, particularly in areas of high-stakes clinical scenarios and emergency care, by providing realistic and reproducible immersive training environments.In summary, our findings suggest that XR/VR-based training approaches could significantly contribute to preparing future physicians for the complexities of emergency medical care, encouraging the integration of such technologies into medical curricula. However, careful consideration must be given to its suitability for all students and the practical challenges of its implementation, highlighting the need for further research to harness its full potential for medical education.
The polymorphism analysis and therapy vaccine target epitopes screening of HPV-35 E6 E7 among the threaten α-9 HPV in Sichuan area
Authors: He Jiaoyu , Li Tianjun , Cheng Chunlan , Li Ning , Gao Peng , Lei Dan , Liang Rong , Ding Xianping 
Published: September 2024

AbstractHigh-risk human papilloma virus (HR-HPV) persistent infection is closely associated with the development of cervical cancer and squamous intraepithelial lesion (SIL).The α-9 HPVs, which is predominantly composed of HR-HPV types, account for 75% of HR-HPV infection in Sichuan. The oncoproteins E6 and E7 of HPV play a crucial role in tumor initiation and progression. Notably, HPV-35 is the only HR-HPV type within the α-9 genus that is not included in the nine-valent HPV prophylactic vaccine. Cervical cell samples obtained from Sichuan were collected for HPV detection and genotyping. Among the 406 HPV-positive samples, 31 HPV-35 were detected, 24 HPV-35 E6 and 26 E7 were successfully amplified and sequenced, five nucleotide mutations in E6 and three in E7 were detected, T232C, T434G of E6 (W78R, I145R) and C67T, G84T of E7 (H23Y, L28F) were non-synonymy mutation. PAML 4.8 server was used to detect positive selection sites of HPV-35 E6, E7, and E6 is W78R. Phyre2 were used to predict and analyze protein structures, W78R made influences on protein structure. IEDB were used to screen epitopes vaccine target for HPV-35 affection therapy, and 5 HPV-35 E6 and 3 HPV-35 E7 most potential epitopes were obtained, the most potential peptides for therapy vaccine design were 79-91YRYSVYGETLEKQ, 45-60FACYDLCIVREGQPY, 124-135RFHNIGGRWTGR of E6; 3-19GEITTLQDYVLDLEPEA, 38-47TIDGPAGQAK, 70-88VQSTHIDIRKLEDLLMGTF of E7 and W78R mainly decreased the epitopes affinity.Conclusions Amino acid substitution in the positive selection sites of HPV-35 E6 and E7 genes have been found to influence protein structure and to decrease the overall affinity of antigen epitopes. This observation aligns with the evolutionary significance of positive selection site, which may confer advantages to the virus by making infected cells more challenging for the immune system to detect, thereby enhancing HPV’s adaptability to the host environment. The polymorphism analysis of HPV-35 E6, E7 contributes to the enrichment of α-9 HPV data in Sichuan China, which is instrumental in improving the effectiveness of clinical detection. Furthermore, these findings provide a relevant theoretical foundation for the prevention and treatment of HPV-related diseases.
Effect of cephalexin on chlorophyll and carotenoid content of Chlorella pyrenoidosa-2378 and its biodegradation in BG-11 medium
Authors: Kumar Sachin , Chanana Ishita , Utkarsh Kumar , Khan Ahmed Reza , Upadhyay Navneet Kumar , Khan Azhar , Kulshrestha Saurabh , Kumar Pradeep 
Published: September 2024

AbstractCephalexin (CFX), a β-lactam antibiotic which is identified for the treatment of different disease infections, has been reported as a micropollutant in wastewater released from sewage, hospital, or pharmaceutical industries. Chlorella pyrenoidosa-2378, a green microalgal strain, is recognized for its degradation ability against wastewater pollutants and the potential of the biomass it produces. In this present study, the cultivation process of Chlorella pyrenoidosa-2378 strain with CFX concentration of 50 mg/L, 100 mg/L, 150 mg/L, and 200 mg/L added to its culture medium labeled as test I, test II, test III, and test IV, respectively, is the process being observed for evaluation of its degradation ability and as sustainable approach for antibiotic degradation. chlorophyll a in test IV, chlorophyll b in test III, and carotenoid content in test I were observed to be higher in amount than control by 0.775 mg/L, .069 mg/L, and 0.356 mg/L, respectively. Using the HPLC method, the total removal efficiency was observed to be 79.09%, 86.26%, 89.62%, and 88.03% against 50, 100, 150, and 200 mg/L concentrations of CFX, respectively. The observations that C. pyrenoidosa-2378 remained stable while being used as an alternative bioremediation method, provide an alibi for its novelty and potentiality to be used commercially for biomass production and at industrial scale for degradation.
Graphical Abstract
Vertebrobasilar Artery Occlusion Treatment Outcomes Within 24 hours of Estimated Occlusion Time
Authors: Xu Yingjie , Zhang Pan , Hu Miaomiao , Sun Wen , Xu Guoqiang , Dai Chunyan 
Published: September 2024

BACKGROUND AND OBJECTIVES:
The aim of this study was to investigate the efficacy and safety of endovascular treatment (EVT) in patients with acute vertebrobasilar artery occlusion (VBAO) within 24 hours of estimated occlusion time (EOT) and to evaluate the effect of early and late time window in a cohort of patients with VBAO treated with EVT.

METHODS:
Retrospective analysis was conducted on patients within 24 hours of the EOT in 65 stroke centers in China. Favorable outcome was defined as modified Rankin Scale ≤3 at 90 days. Patients were divided into the medical management (MM) group and the EVT group. Times were dichotomized into early (EOT ≤6 hours) and late (>6 hours) time windows. Multivariate logical regression models were used to evaluate the efficacy and safety of EVT and the effect of time windows on outcomes in EVT patients.

RESULTS:
Among 4124 patients, 2473 and 1651 patients were included in the early and late windows, respectively. 1702 patients received MM and 2422 were treated with EVT. EVT was associated with a higher rate of a favorable outcome at 90 days both in early (odds ratio [OR] 2.16, 95% CI 1.94-2.41) and late (OR 1.89, 95% CI 1.65-2.17) time windows. No differences were found regarding favorable outcome (OR 0.95, 95% CI 0.87-1.03) between VBAO patients treated with EVT within and beyond 6 hours.

CONCLUSION:
Patients with acute VBAO who received EVT within 24 hours were associated with improved favorable outcome compared with patients who received MM. EVT beyond 6 hours is feasible and safe with no increase in symptomatic intracranial hemorrhage.
Brachialis to Anterior Interosseous Nerve Transfer: Comprehensive Anatomic Rationale
Authors: Politikou Olga , Harnoncourt Leopold , Fritsch Fabian , Maierhofer Udo , Tereshenko Vlad , Laengle Gregor , Festin Christopher , Luft Matthias , Gstoettner Clemens , Hirtler Lena , Aszmann Oskar C. 
Published: September 2024

BACKGROUND AND OBJECTIVES:
Distal nerve transfers for muscle reinnervation and restoration of function after upper and lower motor neuron lesions are a well-established surgical approach. The brachialis to anterior interosseous nerve (BrAIN) transfer is performed for prehension reanimation in lower brachial plexus and traumatic cervical spinal cord injuries. The aim of the study is to shed light on the inconsistent results observed in patients who undergo the BrAIN transfer.

METHODS:
An anatomic dissection was conducted on 30 fresh upper limb specimens to examine the intraneural topography of the median nerve (MN) in the upper arm at the level of the BrAIN transfer and the presence of intraneural fascicular interconnections distally.

RESULTS:
Fascicular interconnections between the AIN and other MN branches were consistently found in the distal third of the upper arm. The first interconnection was at 3.85 ± 1.82 cm proximal to the interepicondylar line, and the second one, after further proximal neurolysis, was at 9.45 ± 1.16 cm from the interepicondylar line. Intraneural topography of the AIN at the transfer level varied, with dorsomedial, dorsolateral, and purely dorsal locations observed.

CONCLUSION:
Consistent fascicular interconnections between the AIN and MN branches and intraneural topography variability of the MN may lead to aberrant reinnervation.
Effect of high-flow nasal oxygen therapy combined with ipratropium bromide on Th1/Th2 balance and inflammation in patients with chronic obstructive pulmonary disease and respiratory failure
Authors: Li Ting , Xu Xuefen 
Published: September 2024

Objective: To investigate the effect of a combination of high-flow nasal oxygen therapy (HFNO) and ipratropium bromide (IB) on Th1/Th2 balance and inflammation in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure (RF).
Methods: A retrospective analysis was conducted on the clinical data of patients with COPD and RF admitted to the Affiliated Nanjing Brain Hospital of Nanjing Medical University from June 2021 to March 2023. A total of 162 patients were included, with 79 patients received respiratory support using HFNO (HFNO group) and 83 patients who were treated using combined HFNO/IB (combined group). Treatment effect, lung function, levels of Th1/Th2, and inflammatory state were compared before and after the treatment.
Results: Total effeicacy of patients in the combined group was significantly higher than that of the HFNO group (P<0.05). After the treatment, pulmonary function levels of the two groups was higher than that before the treatment, and was significantly better in the combined group compared to the HFNO group (P<0.05). The treatment was associated with a significant increase in the levels of Th1/Th2 in both groups. Post-treatment levels of these indexes in the combined group were markedly higher compared to the HFNO group (P<0.05). After the treatment, the inflammatory response of the two groups decreased, and was lower in the combined group that in the HFNO group (P<0.05).
Conclusions: In COPD patients with RF, HFNO combined with IB is efficient in alleviating the inflammatory state of patients, restoring Th1/Th2 balance, and improving lung function compared to HFNO alone.
doi: https://doi.org/10.12669/pjms.40.9.10221
How to cite this: Li T, Xu X. Effect of high-flow nasal oxygen therapy combined with ipratropium bromide on Th1/Th2 balance and inflammation in patients with chronic obstructive pulmonary disease and respiratory failure. Pak J Med Sci. 2024;40(9):---------. doi: https://doi.org/10.12669/pjms.40.9.10221
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
A Retrospective Approximation Approach for Smooth Stochastic Optimization
Authors: Newton David , Bollapragada Raghu , Pasupathy Raghu , Yip Nung Kwan 
Published: September 2024

Stochastic Gradient (SG) is the de facto iterative technique to solve stochastic optimization (SO) problems with a smooth (nonconvex) objective f and a stochastic first-order oracle. SG’s attractiveness is due in part to its simplicity of executing a single step along the negative subsampled gradient direction to update the incumbent iterate. In this paper, we question SG’s choice of executing a single step as opposed to multiple steps between subsample updates. Our investigation leads naturally to generalizing SG into Retrospective Approximation (RA), where, during each iteration, a “deterministic solver” executes possibly multiple steps on a subsampled deterministic problem and stops when further solving is deemed unnecessary from the standpoint of statistical efficiency. RA thus formalizes what is appealing for implementation—during each iteration, “plug in” a solver—for example, L-BFGS line search or Newton-CG—as is, and solve only to the extent necessary. We develop a complete theory using relative error of the observed gradients as the principal object, demonstrating that almost sure and L1 consistency of RA are preserved under especially weak conditions when sample sizes are increased at appropriate rates. We also characterize the iteration and oracle complexity (for linear and sublinear solvers) of RA and identify a practical termination criterion leading to optimal complexity rates. To subsume nonconvex f, we present a certain “random central limit theorem” that incorporates the effect of curvature across all first-order critical points, demonstrating that the asymptotic behavior is described by a certain mixture of normals. The message from our numerical experiments is that the ability of RA to incorporate existing second-order deterministic solvers in a strategic manner might be important from the standpoint of dispensing with hyper-parameter tuning. Funding: R. Pasupathy received financial support from the Office of Naval Research [Grants N000141712295 and 13000991]. R. Bollapragada received financial support from the Lawrence Livermore National Laboratory and the National Science Foundation [Grant NSF DMS 2324643].
The Effect of Probiotics on Obesity with Comorbid Depression: A Systematic Review and Meta-Analysis
Authors: Chen Liang , Zhou Jinhu , Xu Ting , Xu Liwei , Yu Chaoli 
Published: September 2024

Aims/Background Obesity and depression frequently co-occur, and the relationship between them is bidirectional. Being obese or overweight increases the risk of depression, and conversely, depression increases the risk of obesity or overweight. Emerging clinical research has shown that probiotics may be effective in treating obesity and associated depression. Modulating gut microbiota with probiotics may improve obesity-related depression, but current evidence is inconsistent. Methods We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library for randomized controlled trials examining probiotics for depression in obese adults. Mean difference (MD) in depression scores between probiotic and placebo groups was pooled across studies using random-effects models. Heterogeneity was assessed using I2 to explain heterogeneity in meta-regression analysis. To detect the publication bias of the included studies, a funnel plot, and Begg and Egger tests, were used. Possible heterogeneity moderators were detected by subgroup and sensitivity analyses, Galbraith plot, and graphic display of study heterogeneity (GOSH) analysis. Leave-one-out and Influence analyses were performed to assess sensitivity. Results Five trials (n = 488) were included. Overall, probiotics did not significantly improve depressive symptoms versus placebo (MD = 0.08, 95% confidence interval [CI] = −0.63 to 0.79, p = 0.82). Considerable heterogeneity among studies was observed (I2 = 63%). In subgroup analyses, probiotics significantly reduced depression as measured by the Edinburgh Postnatal Depression Scale (MD = −0.60, 95% CI = −1.17 to –0.03, p = 0.04) with no heterogeneity (I2 = 0%). Probiotics also decreased depressive symptoms after 12 weeks of supplementation (MD = −0.78, 95% CI = −1.58 to –0.01, p = 0.05) versus placebo. No publication bias was found using Begg and Egger tests. The GOSH diagnostics revealed three outliers, among the clusters identified by K-means, DBSCAN (Density-based spatial clustering of applications with noise algorithm), and GMM (Gaussian Mixture Model) analyses. Conclusion Overall, probiotics did not improve depressive symptoms in obesity. However, beneficial effects were observed with the Edinburgh Postnatal Depression Scale and short-term use of probiotic. Additional rigorous randomized controlled trials are warranted to elucidate the therapeutic potential of probiotics for obesity-related depression.
Cartographies of infrastructural imaginations: mapping ecological utopias and dystopias in the Global South
Authors: Valero Thomas Ernesto 
Published: September 2024

This article provides the reader with a theoretical framework and a method of representing cities called cartographies of infrastructural imaginations. The study employs mapping methods from the fields of architecture, urban geography and visual cultures. The research inquires about the role of cartography in the analysis of discourses that define policies of water supply, food distribution and land-use regulation, which are three environmental challenges in cities. How can we identify and situate the urban actors that attend to such challenges in cities from the Global South?
The research is empirically grounded in Mexico City, Shanghai and Bangalore, urban settlements with a history of colonial occupation in previous centuries. Their foreign interventions still shape urban imaginaries of these cities. The method of blending photographic analysis with maps aims to offer objective precision of geographical data and subjective street-level views of local stories. The intention is to understand where the infrastructural ideas come from, and how imaginaries flow to communicate visions about the development of the city. A central task here is to frame how power structures interact and represent their interests via utopian and dystopian narratives.
SARS-CoV-2 impairs male fertility by targeting semen quality and testosterone level: A systematic review and meta-analysis
Authors: V. J. Ashonibare , P. J. Ashonibare , T. M. Akhigbe , Akhigbe R. E. 
Published: September 2024

Background
Since the discovery of COVID-19 in December 2019, the novel virus has spread globally causing significant medical and socio-economic burden. Although the pandemic has been curtailed, the virus and its attendant complication live on. A major global concern is its adverse impact on male fertility.

Aim
This study was aimed to give an up to date and robust data regarding the effect of COVID-19 on semen variables and male reproductive hormones.

Materials and methods
Literature search was performed according to the recommendations of PRISMA. Out of the 852 studies collected, only 40 were eligible for inclusion in assessing the effect SARS-CoV-2 exerts on semen quality and androgens. More so, a SWOT analysis was conducted.

Results
The present study demonstrated that SARS-CoV-2 significantly reduced ejaculate volume, sperm count, concentration, viability, normal morphology, and total and progressive motility. Furthermore, SARS-CoV-2 led to a reduction in circulating testosterone level, but a rise in oestrogen, prolactin, and luteinizing hormone levels. These findings were associated with a decline in testosterone/luteinizing hormone ratio.

Conclusions
The current study provides compelling evidence that SARS-CoV-2 may lower male fertility by reducing semen quality through a hormone-dependent mechanism; reduction in testosterone level and increase in oestrogen and prolactin levels.
All-cause and cause-specific mortality risk among men and women with hepatitis C virus infection
Authors: Wang Hung-Wei , Wang Yen-Chung , Huang Yun-Ting , Jiang Ming-Yan 
Published: September 2024

Background
Hepatitis C virus (HCV) infection affects men and women differently, yet few studies have investigated sex differences in long-term mortality risk among the HCV-infected population. We conducted a population-based study to elucidate all-cause and cause-specific mortality among men and women with HCV infection.

Methods
The study population consisted of adult participants from the 1999–2018 National Health and Nutrition Examination Survey, including 945 HCV-infected and 44,637 non-HCV-infected individuals. HCV infection was defined as either HCV seropositivity or detectable HCV RNA. Participants were followed until the date of death or December 31, 2019, to determine survival status.

Results
The HCV-infected population, both male and female, tended to be older, more likely to be Black, single, have lower income, lower BMI, higher prevalence of hypertension, and were more likely to be current smokers. During a median follow-up of 125.0 months, a total of 5,309 participants died, including 1,253 deaths from cardiovascular disease (CVD) and 1,319 deaths from cancer. The crude analysis showed that the risk of death from all causes and from cancer, but not from CVD, was higher in the HCV-infected population. After adjusting for potential confounders, we found that both HCV-infected men (HR 1.41, 95% CI 1.10–1.81) and women (HR 2.03, 95% CI 1.36–3.02) were equally at increased risk of all-cause mortality compared to their non-HCV infected counterparts (p for interaction > 0.05). The risk of cancer-related mortality was significantly increased in HCV-infected women (HR 2.14, 95% CI 1.01–4.53), but not in men, compared to non-HCV-infected counterparts. Among HCV-infected population, there was no difference in the risks of all-cause, CVD-related, or cancer-related death between men and women.

Conclusion
Both men and women with HCV infection had an increased risk of death from all causes compared to their non-HCV infected counterparts, but we did not observe a significant sex difference.