bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the early diagnostic value of popliteal artery wall shear stress in lower extremity arterial disease in type 2 diabetes patients using color doppler ultrasound combined with WSS quantitative analysis
Authors: Zhao Yuxin , Wang He , Gu Junyi , Sun YuQing , Zhang Bo 
Published: August 2024

Abstract

Background The global rise in type 2 diabetes mellitus (T2DM) has led to an epidemic of lower extremity arterial disease (LEAD), primarily caused by atherosclerosis and compounded by late detection and high treatment costs. Early detection is key for managing LEAD effectively. Color doppler ultrasound (DUS), a non-invasive and cost-effective technique, enhances early diagnosis through high-resolution imaging. Integrating DUS with proprietary MATLAB-based software for quantitative wall shear stress (WSS) analysis offers a non-invasive method to assess WSS. This approach targets the popliteal artery, using WSS as a reliable marker for early LEAD detection in T2DM patients.Methods This study included 202 patients clinically diagnosed with T2DM from March 2019 to November 2023 at Shanghai East Hospital, along with 69 healthy volunteers recruited during the same period. The T2DM group was further divided into three subgroups based on the intima-media thickness (IMT) of the popliteal artery: T2DM IMT normal group (IMT < 0.9 mm), T2DM IMT thickening group (1.0 ≤ IMT < 1.2 mm), and T2DM plaque formation group (IMT ≥ 1.2 mm). Using WSS quantitative analysis software, we calculated the average WSS of the popliteal artery and created two-dimensional WSS distribution maps, three-dimensional WSS spatial distribution maps, and WSS fusion images. Subsequently, we analyzed the WSS and its variation patterns among the control group, the T2DM group, and its various subgroups.Results In a study comparing T2DM patients to controls, T2DM groups showed significantly altered blood pressure, blood lipids, and blood viscosity, along with reduced WSS values, indicating advanced arterial damage. Specifically, WSS was lower in T2DM groups with normal and thickening IMT and those with plaque formation compared to controls. The optimal WSS cutoff for predicting LEAD was 1.82 dyne/cm², with a sensitivity of 68% and specificity of 83%. WSS negatively correlated with factors like age and disease duration, and positively with peak systolic velocity (PSV).Conclusions Non-invasive WSS measurement using DUS provides a valuable diagnostic tool for early LEAD detection in T2DM patients. Reduced WSS in the popliteal artery is a predictive marker of disease onset, offering potential for earlier intervention and better management of LEAD, ultimately improving patient outcomes.
National energy consumption structures modulate PAH source apportionment in Ethiopian soils
Authors: Shan Xinyue , Yuan Wang , Song Shuai , Wu Qiang , Li Fadong , Chen Gang , Yang Shengjie , Su Chao , Hirwa Hubert 
Published: August 2024

Abstract

Polycyclic aromatic hydrocarbons (PAHs), a ubiquitous substance in the environment, are closely associated with human energy consumption, which can be released to the environment from incomplete biomass combustion or emitted from petroleum. There is currently a knowledge gap on the relationships between energy consumption structures (ECSs) and PAH contamination, especially in African countries. This study investigated the distribution, sources, and risks of 16 prioritized PAH compounds (Σ16PAHs) in Ethiopia, and explored the impact of ECSs on PAH contamination. The concentrations of Σ16PAHs ranged from 12.51 to 435.67 ng/g, descending across an urban-rural gradient. Based on diagnostic ratios and positive matrix factorization (PMF) model, biomass combustion and vehicle emissions were the most important sources. By comparing the ECSs and PAH concentrations in African countries, it was found that differences in ECSs shaped the diverse patterns of sources and concentrations of PAHs in Africa. The results of incremental lifetime cancer risk assessment suggested PAHs posed a low risk to children, adolescents, and adults at some sampling sites. The Ethiopian government has been making continuous efforts to develop cleaner energy and optimize ECSs to decrease soil PAH concentrations and reduce potential risks. This study will provide support for Ethiopia to improve energy structure management.
INF2-mediated actin polymerization at ER-organelle contacts regulates organelle size
and movement
Authors: Manor Uri , Schiavon Cara , Wang Yuning , Feng Jasmine , Garrett Stephanie , Sung Tsung-Chang , Dayn Yelena , Shadel Gerald , Quintero-Carmona Omar , Wang Chunxin , Youle Richard J. 
Published: August 2024

Abstract

Proper regulation of organelle dynamics and inter-organelle contacts is critical for cellular health and function.
Both the endoplasmic reticulum (ER) and actin cytoskeleton are known to regulate organelle dynamics, but
how, when, and where these two subcellular components are coordinated to control organelle dynamics
remains unclear. Here, we show that ER-associated actin consistently marks mitochondrial, endosomal, and
lysosomal fission sites. We also show that actin polymerization by the ER-anchored isoform of the formin
protein INF2 is a key regulator of the morphology and mobility of these organelles. Together, our findings
establish a mechanism by which INF2-mediated polymerization of ER-associated actin at ER-organelle
contacts regulates organelle dynamics.
Refeeding syndrome after bariatric surgery: a systematic review of the literature
Authors: Triantafyllidis Konstantinos Katsikas , Giannos Panagiotis , Geropoulos Georgios , Stathi Dimitra , Kechagias Konstantinos , McCabe Gerard , Lucocq James , Robertson Andrew G 
Published: August 2024

Abstract

Background
Refeeding syndrome (RFS) is defined as a set of metabolic and electrolyte abnormalities after nutrition initiation following prolonged starvation. Bariatric surgery and the associated rapid weight loss have been proposed as potential triggering factors for RFS.
Objective
The aim of this study was to examine the currently available literature and provide an overview of the reported cases of RFS in patients who underwent bariatric surgery.
Method
We performed a systematic screen of Embase, Medline and Scopus until June 2024. The review was conducted according to PRISMA guidelines.
Results
We identified a total of 9 patients with RFS who had a history of bariatric surgery with mean age of 37.25 years. Five participants (55.5%) were females and 2 were males (22.2%). Adjustable gastric band was the main bariatric procedure performed in almost half of the patients (44.4%, 4/9) followed by gastric bypass (22.2%, 2/9). Post-operatively all patients experienced weight loss that ranged from 29.7–78.1% of the pre-operative weight. Most common symptoms included vomiting (44.4%, 4/9) and abdominal pain (22.2%, 2/9). Most of the patients (66.6%, 6/9) received vitamin supplementation, followed by electrolyte replacement (55.5%, 5/9). Most of patients (88.8%, 8/9) improved and one patient died (11%, 1/9).
Conclusion
Refeeding syndrome is a rarely reported complication after bariatric surgery, but as the frequency of bariatric surgery increases, RFS is expected to become more common. Clinical awareness among bariatric specialists is important for the identification of high-risk individuals as well as for the early diagnosis and successful management of patients with RFS.
Reconstruction of the paleoenvironmental context of Holocene human behavior at the Fenghuangzui site in the Nanyang Basin, Middle Yangtze River, China
Authors: Guo Aipeng , Mao Longjiang , Li Chenchen , Mo Duowen 
Published: August 2024

Abstract

Prehistoric city sites, as pivotal aspects of early urban evolution, are intricately linked to regional environmental factors such as climate, geomorphology, and hydrology. However, due to the lack of reliable chronologies associated with these ancient sites, there is limited understanding of environmental factors in relation to prehistoric urban centers. This study focuses on the sedimentary records from the southern moat of the Fenghuangzui (FHZ) ancient city site, a representative site in the middle Yangtze River region, integrating a chronological framework and climate proxies such as elemental geochemistry. It reconstructs the evolution of the regional sedimentary environment and the hydrogeomorphology during the mid-late Holocene at the FHZ site, elucidating its interplay with human activities. Key findings include: (1) From 5.5 ~ 4.5 ka BP, elevated CIA, Rb/Sr, and Mn/Ti values indicate a warm and humid climate. The Qujialing culture unified the middle Yangtze River and expanded abroad, building prehistoric cities such as Shijiahe city. The FHZ city was built in the Nanyang Basin at this time to prevent the invasion of northern culture. (2) During 4.5 ~ 3.9 ka BP, decreased CIA and Rb/Sr values alongside rising Saf and Be values signify reduced weathering and a transition to cooler, drier conditions. A flood event of 4 ~ 3.9 ka BP caused the moat of the FHZ city to lose its defensive function. (3) During 3.9 ~ 2.7 ka BP, declining CIA and Rb/Sr values with slight increases in Saf and Be suggest ongoing dry and cool environmental conditions. The FHZ city was abandoned at the end of the Meishan culture. (4) Between 2.7 ~ 1.6 ka BP, rising CIA and Rb/Sr values indicate a return to warmer and more humid conditions. The FHZ site was built to expand the influence of Qujialing culture and protect the Shijiahe city. Taking into account the location of the water system and farming area, the south-facing direction was chosen. After a flood in 4.0 ~ 3.9 ka BP, the FHZ site lost their defense function and were invaded by Meishan culture. In general, our findings suggest that changes in regional hydrology in the context of climate change can trigger upheaval and even collapse of prehistoric societies.
Sociodemographic Inequities and Risk Factors for Radiation Exposure and Suboptimal Imaging in Suspected Pediatric Appendicitis
Authors: George Michael , Melvin Patrice , Grice Amanda , Ward Valerie 
Published: August 2024

Abstract

Background
Inequity in health care access leads to inequities in outcome. In recent years, health outcome disparities have been documented in children with appendicitis, but inequities in accessing optimal diagnostic imaging have not been adequately assessed, particularly with respect to imaging-related ionizing radiation exposure.
Objective
The purpose of our study is to assess sociodemographic and racial/ethnic inequities in accessing optimal diagnostic imaging for children with suspected appendicitis. Our hypothesis is that sociodemographic inequities exist in accessing optimal imaging modalities and in ionizing radiation exposure.
Material and Methods
Our nation-wide retrospective cohort study examined emergency room encounters for suspected appendicitis between January 2018 and September 2023. Primary exposures included neighborhood-level sociodemographic metrics as measured by Child Opportunity Index (COI), race/ethnicity, and insurance status. Outcomes included access to diagnostic imaging, suboptimal imaging, imaging with ionizing radiation, and imaging without radiation exposure. Mixed effects multivariable logistic regression analyses assessed factors associated with suboptimal imaging. A mixed effects multivariable ordered logistic regression analysis was performed using a three-tiered hierarchal imaging variable (no imaging, imaging with ionizing radiation, imaging without radiation).
Results
105,392 patient encounters were examined (mean patient age 11.2 years +/- 3.9; 62,001 females). 85.2% were imaged. Children from lower COI neighborhoods were less frequently imaged (83.8%), and more often imaged suboptimally (aOR 1.10 [95% CI 0.95–1.14]) or with ionizing radiation (aOR 1.07 [95%CI 1.03–1.31]). Black children were less frequently imaged (80.5%) and more often imaged suboptimally (aOR 1.35 [95% CI 1.28–1.42]) or with ionizing radiation (aOR 1.16 [95% CI 1.12–1.21]). Children with public insurance were less frequently imaged (83.8%) and more often imaged suboptimally (aOR 1.25 [95% CI 1.20–1.30]) or with ionizing radiation (aOR 1.16 [95% CI 1.12–1.19]).
Conclusion
Children from lower COI neighborhoods, Black children, and children with public insurance are less often imaged in the setting of suspected appendicitis; and when they were imaged, it was more likely to be suboptimal or utilize ionizing radiation.
Immunoinformatics-Driven Design of Malaria Protein-Based Multi-Epitope Vaccine
Authors: Afolayan Funmilayo Ibitayo Deborah , Olaniyi Damilare Adebayo 
Published: August 2024

Abstract

BackgroundPlasmodium falciparumaccounts for over 90% of global malaria-related mortalities, posing a great challenge to public health. Conventional control measures, such as the use of insecticides and antimalarial drugs, have proven less effective owing to parasite resistance. Additionally, many promising malaria vaccine candidates have encountered reduced efficacy at different stages of preclinical and clinical studies. The complicated biology ofPlasmodiumparasites, including their genomic size and multiple stages of the life cycle, impedes the development of an effective malaria vaccine. Therefore, this study aimed to design a vaccine candidate capable of eliciting immune responses across multiple stages of theP. falciparumlifecycle using immunogenic regions from the Kelch Protein (KP), Erythrocyte Binding Antigen 175 (EBA-175), and Liver Stage-Specific Antigen 1 (LSA1). Methods ABCPred, CTLPred, and Immune Epitope Database (IEDB) and NetMHCII-2.3 were used to predict B-cell, cytotoxic T-cell lymphocyte (CTL), and helper T-cell lymphocyte (HTL) epitopes, respectively. The VaxiJen v.2.0 and AllergenFP v.1.0 databases were used to predict antigenicity and allergenicity, respectively. Population coverage analysis was performed using IEDB. The vaccine was constructed using immunogenic B- and T-cell epitopes, with flagellin as an adjuvant. The vaccine was modeled using the Iterative Threading ASSEmbly Refinement server, refined using GalaxyRefine, and docked with toll-like receptors (TLR5 and TLR8) using Cluspro v.2.0. The docked complexes were subjected to molecular dynamics simulation using the Desmond package in Schrodinger. The Java Codon Adaptation Tool was used for codon optimization, and SnapGene was used forin silicocloning. The C-IMMSIM server was used to simulate the immune response. Results Forty-five B-cell, thirteen CTL, and twenty-two HTL epitopes were antigenic and non-allergenic. The HTL epitope-associated human leukocyte antigen (HLA) alleles were expressed globally. The vaccine construct demonstrated good expression potential and was cloned into the pET-28a (+) expression vector. Furthermore, the docked complexes demonstrated strong binding interactions, and molecular dynamics simulation underscored the stability of the vaccine-TLR8 complex. Conclusions The immune response simulations affirmed that the vaccine can induce an effective immune reaction against malaria. Further immunological experimental validations are needed to prove the functionality of this vaccine.
In-person versus remote (mHealth) delivery for a responsive parenting intervention in rural Kenya: A cluster randomized controlled trial
Authors: Garcia Italo Lopez , Luoto Jill , Aboud Frances , Jervis Pamela , Mwoma Teresa , Alu Edith , Odhiambo Aloyce 
Published: August 2024

Abstract

Background
An estimated 43% of children under age 5 in low- and middle-income countries (LMICs) experience compromised development due to poverty, poor nutrition, and inadequate psychosocial stimulation. Numerous early childhood development (ECD) parenting interventions have been shown to be effective at improving ECD outcomes, at least in the short-term, but they are a) still too expensive to implement at scale in low-resource and rural settings, and b) their early impacts tend to fade over time. New approaches to deliver effective ECD parenting interventions that are low-cost, scalable, and sustainable are sorely needed.
Methods
Our study will experimentally test a traditional in-person group-based delivery model for an evidence-based ECD parenting intervention against a hybrid-delivery model that increasingly substitutes in-person meetings for a remote (mHealth) delivery via smartphones, featuring audiovisual content and WhatsApp social interactions and learning. We will assess the relative effectiveness and cost of this hybrid-delivery model against purely in-person delivery and will extend the interventions over two years to increase their ability to sustain changes in parenting behaviors and ECD outcomes longer-term. Our evaluation design is a cluster Randomized Controlled Trial (cRCT) across 90 villages and approximately 1200 households. Midline and endline surveys collected 12 and 24 months after the start of the interventions, respectively, will examine short- and sustained two-year intention-to-treat impacts on primary outcomes. We will also examine the mediating pathways using Mediation Analysis. We hypothesize that a hybrid-delivery ECD intervention will be lower cost, but remote interactions among participants may be an inferior substitute for in-person visits, leaving open the question of the most cost-effective program.
Discussion
Our goal is to determine the best model to maximize the intervention’s reach and sustained impacts to improve child outcomes. By integrating delivery into the ongoing operations of local Community Health Promoters (CHPs) within Kenya’s rural health care system, and utilizing new low-cost technology, our project has the potential to make important contributions towards discovering potentially scalable, sustainable solutions for resource-limited settings.
Trial Registration
NCT06140017 (02/08/2024) AEARCTR0012704.
First Case Report: Acute Necrotizing Encephalopathy and Acute Fulminant Myocarditis
Authors: Ma Juan , Pan Chenliang , Bai Nan , Zhang Shanshan , Mi Peiling , Wa Yongling , Lu Andong 
Published: August 2024

Abstract

Background: Acute necrotizing encephalopathy (ANE) is a rare condition characterized by multiple symmetrical brain lesions mainly involving the thalamus. Acute fulminant myocarditis is a diffuse inflammatory disease of the myocardium characterized by acute onset, rapid progression, and a high risk of death. Its pathogenesis involves excessive activation of the innate immune system and the formation of an inflammatory storm. Both conditions are thought to be caused by viral infections. We present a case of ANE with fulminant myocarditis. Reporting this case is important due to the rarity and the critical interplay of these two severe conditions occurring simultaneously.
Case presentation: A 16-year-old student presented with a 3-day history of high fever, cough, and expectoration, followed by multiple episodes of convulsive seizures. The patient was diagnosed with acute fulminant myocarditis. Despite high doses of vasoactive medications, the patient exhibited low blood pressure and elevated lactate levels. Portable echocardiography revealed diffuse decreased left ventricular motion with severe left ventricular dysfunction (ejection fraction < 30% by visual estimation). The patient remained comatosewith a Glasgow coma scale (GCS) score of 3 (E1V1M1).Brain CT and MRI revealed bilateral striatal, thalamic, and brainstem lesions, typical of ANE. Consequently, a diagnosis of ANE accompanied by fulminant myocarditis was considered. The treatment regimen included high doses of glucocorticoids, immunoglobulins, tocilizumab, and V-A ECMO (Veno-arterial extracorporeal membrane oxygenation) life support. The patient showed significant recovery of cardiac function and was discharged after approximately 24 days of rehabilitation.
Conclusion: This case report highlights the coexistence of ANE preceded by acute fulminant myocarditis. The underlying mechanisms remain unclear. Early recognition of these two conditions is crucial for prognosis, though challenging. This report underscores the need for heightened awareness and prompt, comprehensive treatment strategies to improve outcomes in such complex cases.
Nursing care of a patient with severe respiratory failure caused by Penicillium Marneffei infection after Kidney Transplantation: a case report
Authors: Qiao Wenbo , Deng Qionglin , Xiang Xinyue , Chu Junqing , Li Huijuan , Lin Yan 
Published: August 2024

Abstract

Introduction Penicillium Marneffei (PM) infections often present with nonspecific clinical manifestations, and severe respiratory failure after infection is particularly uncommon. This case report elucidates the nursing care provided to a patient who developed severe respiratory failure due to PM infection post-kidney transplantation. Additionally, it delves into pertinent intervention measures and nursing strategies.
Clinical Findings A 35-year-old male, more than a decade post-kidney transplantation, was admitted to the nephrology department for "chest tightness and a two-day reduction in urine output." He exhibited dyspnea, decreased blood pressure, and a resting SpO2 of 90% while on mask oxygen inhalation, necessitating his transfer to the ICU.
Diagnosis The patient was diagnosed with PM infection, respiratory failure, and post-kidney transplant status.
Interventions In the ICU, interventions included the application and evaluation of nitric oxide combined with ECMO-prone position ventilation to alleviate hypoxia, dynamic adjustment and vigilant monitoring of the antimicrobial Voriconazole, balancing bleeding and thrombosis risks, proactive anemia correction, early enteral nutrition guided by intra-abdominal pressure and ultrasound assessment, and adaptive progression to pulmonary rehabilitation exercises.
Outcomes By the eighth day in the ICU, the patient's oxygenation had markedly improved, allowing a reduction in ECMO support and subsequent removal. The tracheal tube was extracted on the tenth day, and high-flow oxygen was administered. The patient was transferred to a general ward on the twelfth day.
Conclusion Acute respiratory failure following PM infection in solid organ transplant recipients is exceedingly rare, and nurses may lack pertinent care experience. This case is a valuable reference for critical care nurses managing patients in similar conditions.
Pediatric Endoscopic Pilonidal Sinus Treatment: Lessons Learned After 100 Consecutive Cases
Authors: Pérez-Bertólez Sonia , Casal-Beloy Isabel , Pasten Albert , Martín-Solé Oriol , Salcedo Paula , Tapia Leopoldo , Tarrado Xavier 
Published: August 2024

Abstract

Aim
Pediatric Endoscopic Pilonidal SInus Treatment (PEPSiT) has favorable short-term-outcomes, but there is a lack of reliable data on medium and long-term follow-up. The objective of our study was to evaluate the effectiveness and advantages of PEPSiT vs conventional surgery of pilonidal sinus in the pediatric population.
Methods
A quasi-experimental study was carried out in pediatric patients undergoing pilonidal sinus surgery at a single institution from 2019 to 2022. Excision and healing by secondary intention (EHSI), excision and primary closure (EPC), and PEPSiT were compared. The surgical technique chosen was surgeon-dependent.
Results
149 patients were studied – 100 undergoing PEPSiT, 28 undergoing EHSI, and 21 undergoing EPC. Median full healing process was 4 weeks (IQR: 3–8) in PEPSiT, 16 weeks in EHSI (IQR: 12-26.5) and 7 weeks (IQR: 4–10) in ECP (p < 0.01). Pain on the Visual Analogue Scale (VAS) and need for analgesics were lower in the PEPSiT group (p < 0.01). Mean time to return to normal life was shorter with PEPSiT – 177 days earlier than EHSI (CI95%: 124.7-230.2; p < 0,01) and 7.2 days earlier tan EPC (CI95%: 20.2-138.6; p < 0,009). Complications with PEPSiT were 9.3 times lower tan EHSI (OR: 9.3; CI95% 3.5–24.7) and 8.5 times lower than ECP (OR = 8.5; CI95% 2.9–24.4). EHSI had 5.3 times more probability of recurrence than PEPSiT (OR = 5.3; CI95% 1.3–22.7), and ECP 15.2 times more (OR = 15.2; CI95% 3.2–71.7).
Conclusions
Endoscopic pilonidal sinus treatment is effective in medium-term follow-up, with fewer complications than classic techniques. It allows for an early return to normal life without restrictions.