bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine Learning for Leprosy Suspicion Questionnaire: A Low-Cost Tool for High Quality Leprosy New Case Screening
Authors: Simões Mateus Mendonça Ramos , Lima Filipe Rocha , Lugão Helena Barbosa , de Paula Natália Aparecida , Silva Cláudia Maria Lincoln , Ramos Alexandre , Frade Marco Andrey Cipriani 
Published: May 2024

Abstract

Leprosy is a dermatoneurological disease and can cause irreversible nerve damage. In addition to being able to mimic different rheumatological, neurological and dermatological diseases, leprosy is underdiagnosed because several professionals present lack of training. The World Health Organization instituted active search for new leprosy cases as one of the four pillars of the global leprosy strategy, which aims detecting cases early before visible disabilities occur. The Leprosy Suspicion Questionnaire (LSQ) was created aiming to be a screening tool to actively detect new cases; it is composed of 14 simple yes/no questions that can be answered with the help of a health professional or by the very patient themselves. During its development, it was noticed that combination of marked questions was related to new case detections. To better perform and being able to expand its use, we developed MaLeSQs, a Machine Learning tool whose output may be LSQ Positive when the subject is indicated for being further clinically evaluated or LSQ Negative when the subject does not present any evidence that justify being further evaluated for leprosy. To achieve an efficient product, we trained four classifiers with different learning paradigms, Support Vectors Machine, Logistic Regression, Random Forest and XGBoost. We compared them based on sensitivity, specificity, positive predicted value, negative predicted value, and area under the ROC curve. After the training process, the Support Vectors Machine was the classifier with most balanced metrics, and it was chosen as the MaLeSQs. With Shapley values, we were able to evaluate variable importance and nerve symptoms were considered imported to differentiate between subject that potentially had leprosy of those who did not. The results highlight the possibility that machine learning algorithms are able to contribute improving health care coverage and strengthening leprosy control strategies.
Exploring perceptions of nursing identity construction in Pakistan: Qualitative study on self, public, and professional perspectives
Authors: Abbas Sidra , Zakar Rubeena , Fischer Florian 
Published: May 2024

Abstract

Background
Nursing identities are intricately woven with societal norms, organizational expectations, and individual self-perceptions, often entailing negative connotations and societal devaluation. This study aims to explore the intersectionality of nursing identities through the lenses of gender performativity and work identity theories. Specifically, it seeks to analyze nurses’ perceptions regarding the construction of their self, public, and professional identities, thereby shaping the nursing profession’s image in Pakistan.
Methods
Employing a qualitative exploratory research design and purposive sampling, 15 in-depth interviews were conducted with nurses from three public hospitals in Lahore, Punjab. Thematic analysis was applied to elucidate the participants’ viewpoints, corroborated by real-life narratives. Utilizing NVIVO-14 qualitative data software for coding, nine codes, three common themes, and fifteen sub-themes were generated.
Results
The findings revealed three overarching themes concerning constructed nursing identities: (i) Self-identity: Female nurses, predominantly, perceive themselves as disempowered due to fluctuating self-perceptions and conflicting identities, facing hierarchical subordination within patriarchal organizational structures. (ii) Public identity: Nursing care is often relegated to menial work, extending the notion of domestic labor into the public sphere, thus reflecting societal recognition of nursing as a poverty-induced profession. (iii) Professional identity: Nurses are predominantly viewed as clinical task performers, akin to competent robots following physicians’ directives, lacking recognition as intellectual beings within the healthcare hierarchy.
Conclusion
The study underscores the complexity of nursing identities and their impact on the broader perception of the nursing profession in Pakistan. The findings highlight the need for comprehensive strategies to address the multifaceted challenges faced by nurses in constructing and asserting their identities. Efforts should be directed towards fostering a supportive organizational culture that acknowledges and respects the diverse contributions of nurses.
Experimental Investigation on Loads of Nets with Different Types under Current
Authors: Xu Lingyun , Miao Yuji , Wu Xiaofei , Li Peng , Qin Hongde 
Published: May 2024

Abstract

The drag of the net is the main component of the total hydrodynamic loads of the cage. Net drag is related to the safe use and reliability of the net cage. However, there is still a lack of tests about the influence of different parameters such as materials, mesh types, solidity ratios, and angles of attack on the hydrodynamic loads of nets. In this paper, a series of flume tests are used to investigate the drag on the nets and the relationships between the drag coefficient and the net material, net solidity ratio, mesh shape, current velocity, and current direction. The drag of six nets with different types under varying current velocities and current directions are calculated, and the curves between the drag coefficient and the current velocity or Reynolds number are further obtained. The test results show that the drag and drag coefficients of the net are not only related to the current velocity and the windward area but also to the mesh shape, net solidity ratio, material properties, etc. On this basis, the drag coefficients of these nets obtained from the prediction models and the tests are compared and analyzed, and the applicable conditions of different prediction models are further clarified. This paper can provide data support for the drag calculation of the cage.
Chiglitazar, the first pan-PPAR agonist approved globally, shows potential to treat metabolic dysfunction–associated steatohepatitis in vitro and in vivo
Authors: Deng Sijun , Li Sijia , Zhang Qian , Mao Xuhua , Pan Desi , Yang Xiaoyan , Huang Shengjian 
Published: May 2024

Abstract

Chiglitazar was approved by China's National Medical Products Administration (NMPA) in 2021 to treat patients with type 2 diabetes and potentially benefit patients with metabolic dysfunction–associated steatohepatitis (MASH). To investigate its efficacy in MASH, we performed monocyte activation and migration assays and liver and stellate cell proliferation assays in vitro, as well as conducted three different animal model studies of MASH in vivo. Our results showed that Chiglitazar significantly reduced the number of migrated cells of MCP-1 activated THP-1 cells. Furthermore, Chiglitazar-treated THP-1 cells showed reduced gene expression of TNF-α and MCP-1. Furthermore, Chiglitazar dramatically reduced the cell proliferation of TGF-β induced human skin fibroblasts and liver stellate cells, as well as reduced the gene expression of α-SMA and CTGF. In animal studies, Chiglitazar alleviated liver steatosis and inflammation in the MCD model and ameliorated liver inflammation and fibrosis in both the CCL4 and HFD+CCL4 models. In conclusion, as the first approved peroxisome proliferator-activated receptor (PPAR) agonist, Chiglitazar also shows potential to treat MASH by regulating steatosis, inflammation, and fibrosis. This potential could be translated into clinical studies in the future.
Increased biofilm-associated Carbapenem-resistant Acinetobacter- calcoaceticus-baumannii complex infections among the hospitalized patients in Kathmandu Model Hospital, Nepal
Authors: Bhandari Shova , Upreti Milan Kumar , Angbuhang Khadga Bikram , Shrestha Basudha , Shrestha Upendra Thapa 
Published: May 2024

Abstract

Background
Acinetobacter calcoaceticus-baumannii complex (ACBC) has emerged as a global burden to various clinical infections. The increasing resistance to the majority of antibiotics adds a huge problem in empirical therapy and control of ACBC infections. In addition, the ability of ACBC to produce biofilm has not only contributed to its antimicrobial resistance but also helped its persistence and survival in the environment. Most tertiary care hospitals in Nepal are facing similar ACBC infections.
Methods
Hence, this hospital-based cross-sectional study was carried out to associate the biofilm formation with carbapenem-resistant ACBC isolates detecting biofilm-forming genes Bap, csuE, and blaPER1 from February 2020 to August 2020 at Kathmandu Model Hospital, Kathmandu, Nepal. The clinical bacterial isolates were identified by standard Microbiological procedures including Gram staining, and cultural and biochemical characteristics. A modified Kirby-Bauer disk diffusion method was performed to assay the antibiotic susceptibility testing of ACBC isolates to various antibiotic classes. A quantitative adherence assay was used to determine the biofilm assay. A conventional Polymerase Chain Reaction (PCR) method was used to find the targeted biofilm-related genes using specific primers.
Results
Out of 665 different clinical samples, bacterial growth was observed in 281 (42.3%) clinical samples. Of these, 32 (11.4%) isolates were identified as ACBC. Out of 32 ACBC isolates, 29 (90.6%) of which were carbapenem-resistant. All carbapenem-resistant ACBC isolates were found to be sensitive to polymixin B and colistin. Out of 29 CR-ACBC, 17.2% of isolates were resistant to tigecycline. A total of 31 ACBC isolates were biofilm producers, out of which 2 were strong biofilm producers followed by 8 moderate, and 21 were weak biofilm producers. The occurrence of biofilm-forming genes; Bap, csuE, and blaPER1 genes were found to be 65.6%, 65.6%, and 56.3% respectively among ACBC clinical isolates. A significant association was observed between carbapenem resistance, biofilm formation, and biofilm-related genes.
Conclusion
Since ACBC isolates are ubiquitous including in the hospital environment and its infections are alarming to clinical settings, the effective sterilization of clinical equipment and hospital environment are utmost. In addition, a strong policy should be made to prescribe the proper antibiotic based on antibiogram profile to fight against an emerging threat of ACBC infections
Influence of Crab Shell Particles Reinforcement on the Mechanical Properties of Aluminium 6063
Authors: Owa Adebayo Felix , Olubambi Peter Apata 
Published: May 2024

Abstract

The utilization of natural resources in material science has gained prominence due to the quest for sustainable and innovative materials. This work explores the development and characterization of an aluminum matrix composite reinforced with crab shell particles (CSPs). The CSPs were produced via the milling process for 72 hours and the CSPs were incorporated in varying percentages (0–20 wt%) into the aluminum matrix using a stir casting technique, the mechanical properties (tensile strength, compressive strength, % elongation, and impact energy) of the composites were determined using an Instron universal testing machine (UTM) and a Charpy impact testing machine, respectively. A scanning electron microscope (SEM) was used to examine the microstructure of the composite fracture surfaces and Gywddion 2.65 software was used to view the SEM images of the fracture surfaces in three dimensions (3D). The results showed that tensile strength, compressive strength, % elongation, and impact energy were enhanced by adding varying percentages of CSPs on the aluminum 6063 composites.
WITHDRAWN: A Cross-sectional Study on Pelvic Inflammatory Disease Prevalence and Dietary Phosphorus using NHANES Data from 2015-2018
Authors: Mai Hui-Min , Zheng Ya-Fang , Chen Ze-Ru , Zha Yong-Ping , Jia Pan , Yan Chen , Luo Hong-Bin , Lao Jian-Wei , Guo Xu-Guang , Lin Li-Hong 
Published: May 2024

Abstract

Background
Phosphorus, an essential constituent of the human body, not only is present in human tissues but also actively participates in numerous metabolic processes. Pelvic inflammatory disease (PID), a condition that is widely observed in women and is considered to be a common problem in the field of gynecology, involves inflammation of female pelvic reproductive organs such as the uterus, fallopian tube, and ovary, along with the surrounding connective tissue and peritoneum. The objective of this study was to examine how dietary phosphorus intake is related to the prevalence of PID.
Methods
The female participants included in our cross-sectional investigation were sourced from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2015 to 2018. Various statistical methods, such as regression equations with multiple factors, analyses within subgroups, and smooth curve fitting were utilized to analyze the relationship between dietary phosphorus intake and PID incidence.
Results
A decrease in PID incidence is associated with increased dietary phosphorus intake. Model 1, adjusted for age and ethnicity, exhibited a strong connection between dietary phosphorus consumption and PID (OR = 0.9995, 95% CI = 0.9992-0.9998, p = 0.002655), a finding further supported by Model 2, which underwent full adjustments (OR = 0.9996, 95% CI = 0.9993-0.9999, p = 0.011260). Moreover, a notable pattern toward a negative correlation between phosphorus intake and PID was observed in the tertile subgroups (OR < 1, p < 0.05), indicating a robust association. Additionally, the smoothed curves revealed a consistent link between PID and dietary phosphorus consumption.
Conclusions
The incidence of PID was found to be negatively linked to dietary phosphorus intake in this cross-sectional study. Nonetheless, additional prospective studies are required to confirm a direct link between dietary phosphorus and PID, bearing in mind the limitations of the current study.
On the present and future changes in Indian summer monsoon precipitation characteristics under different SSP scenarios from CMIP6 models
Authors: Norgate Marc , Tiwari Pushp Raj , Das Sushant , Kumar Dhirendra 
Published: May 2024

Abstract

Monsoons are a vital part of the agriculture and economy of India which most of its population rely on for their livelihoods. It still is not clear how climate change will impact precipitation events over India due to the complexity of accurately modelling precipitation. Using 12 Coupled Model Inter-comparison Project 6 (CMIP6) models, we compared their performance to observed data taken from CRU as well as looking at the future changes in precipitation until the end of the 21st century for the 6 precipitation homogenous regions over India. The individual models showed varying degrees of wet and dry biases and the ensemble mean of these models showed relatively lesser bias and improved spatial correlation. Out of 12 models, NorESM and MIROC6 models outperform other models in terms of capturing the spatial variability of precipitation over the Indian region. It is also found that due to lesser moisture transport from the adjoining seas represented through vertically integrated moisture transport (VIMT) analysis, there is consistent dry bias across the models. Shared Socioeconomic Pathways (SSPs) were used for future projections and a slight increase in JJAS precipitation until the end of the century with SSP5-8.5 showing the largest increase. We found an increase in precipitation of 0.49, 0.74 and 1.4mm/day under SSP1-2.6, SSP2-4.5 and SSP5-8.5 in the far future. The northeast region was shown to receive the largest increase in precipitation (2.9 mm/day) compared to other precipitation homogenous regions and northwest will experience largest shift in precipitation. Interestingly, the number of wet days is expected to increase in the northwest region implying more VIMT towards the region. Our results indicate that monsoon precipitation extremes across all the homogenous regions will increase into the future with a higher severity under fossil-fuelled development, although the models still show large biases lowering confidence in our results.
A Correlation Study between Drug Dose and Shock Severity in Adults with Amlodipine Poisoning
Authors: Li Hui , Zhang Hua , Fu Yuanwei , Guo Zhiguo , Ma Qingbian 
Published: May 2024

Abstract

Background:Calcium channel blockers (CCBs) are increasingly implicated in cardiovascular drug poisoning. Among CCBs, amlodipine is associated with the highest rates of acute toxicity and fatalities. However, the dose-outcome relationship in amlodipine poisoning has not been extensively studied. This study aimed to investigate the correlation between the ingested dose of amlodipine and the severity of shock in affected patients by analyzing clinical data from documented cases.
Methods:This study included adult patients treated for amlodipine poisoning-induced shock at the emergency department of Peking University Third Hospital between January 2018 and December 2022. Additionally, cases reported in the literature from January 1997 to December 2022 were also included. Patients were categorized into two groups: shock and refractory shock.
Results:This study included a total of 80 patients, with 37 experiencing shock and 43 presenting with refractory shock. Significant differences were observed between the two groups in terms of sex distribution (p=0.037) and the ingested amlodipine dose (p=0.001). Through binary logistic regression analysis, the amlodipine dose was identified as an independent predictor of shock severity (p=0.005). A subgroup analysis was performed on patients who were poisoned by ingesting amlodipine alone, further confirming the significant dose difference (p=0.003) between the shock and refractory shock categories. The area under the receiver operating characteristic curve (AUC) for predicting refractory shock in patients with amlodipine poisoning was 0.723 [95% CI: 0.613, 0.833]. The optimal cutoff dose for predicting refractory shock was 347.5 mg, with a sensitivity of 0.651 and a specificity of 0.784. Sensitivity analyses, excluding cases of mixed poisoning, yielded a higher AUC of 0.795 [95% CI: 0.634, 0.956], with a slightly adjusted cutoff dose of 350 mg, a sensitivity of 0.867, and a specificity of 0.737. Dose‒response relationship plots demonstrated that the incidence of refractory shock increased as the ingested amlodipine dose increased.
Conclusion:In adult patients with amlodipine poisoning, the severity of shock was correlated with the ingested dose of the drug. When the ingested amlodipine dose exceeds 347.5 mg, it is crucial to be cautious of the development of refractory shock.
Trial registration:Retrospectively registered.
Predictors for Persistent Hypogammaglobulinemia After Rituximab Therapy in Pediatric Patients
Authors: Höppener Susanna P.C. , Veldkamp Saskia R. , Groot Mark C.H. , Haitjema Saskia , Drylewicz Julia , Boelens Jaap Jan , Lindemans Caroline A. , Montfrans Joris van , Royen-Kerkhof Annet van , Jansen Marc H.A. 
Published: May 2024

Abstract

Hypogammaglobulinemia (HG) is a recognized consequence of rituximab (RTX) therapy, extensively studied in adults but minimally explored in children. We conducted a retrospective cohort study at a tertiary care center to determine prevalence, predictors and clinical outcomes of HG in children after RTX therapy. Patients aged ≤ 18 years treated with RTX for various indications between 2000 and 2020 were included. Patients were classified as having HG when (1) IgG levels were <-2SD below reference for age, or (2) they received immunoglobulin replacement therapy (IGRT). HG after the last RTX dose was observed in 100/141 patients (71%). Persistent HG (>6 months) was observed in 61/95 patients (64%), of whom 10 patients remained in HG for more than 5 years. Low baseline IgG levels and HSCT treatment were significantly associated with persistent HG. Median reconstitution time for CD19+ B cells was 11 months (IQR=[7.3-18.1]). Median reconstitution time for CD19+CD27+IgG+ switched memory B cells was 1.8 years (IQR=[0.87-2.8]) and for every additional 6 months of IgG+ memory B cell depletion, chances of recovering from HG fell by 11% (HR=0.89, 95% CI=[0.81-0.98], p=0.02). Four patients developed a class-switch recombination-deficiency. Recurrent infections, of which 2 fatal, were observed in 18 patients with HG. In conclusion, over 70% of children had low IgG levels and/or required IGRT following RTX therapy. Predictors for persistent HG were low pre-RTX IgG levels and/or patients post-HSCT. Children with HG were often IGRT-dependent, may suffer from (lethal) recurrent infections and can occasionally develop secondary Ig class-switch defects.
Modifiable lifestyle factors, genetic susceptibility, and incident ankylosing spondylitis
Authors: Liu Ke , Lin Hao , Ying Jiacheng , Luo Peiyang , Wang Manli , Ye Ding , Wei James Cheng-Chung , Mao Yingying , He Zhixing 
Published: May 2024

Abstract

Background: Whether the lifestyle is associated with the risk of ankylosing spondylitis (AS) in the presence of different genetic risk levels remains unknown. We aimed to evaluate modifiable lifestyle-genetic susceptibility interaction with the risk of AS.
Methods: This study included 382,035 individuals free of AS at baseline in the UK Biobank. A lifestyle score based on a combination of body mass index, smoking status, alcohol consumption, diet, sleep duration and physical activity, and a polygenic risk score (PRS) using 24 ASassociated genetic loci were constructed for each participant, and were further classified into three lifestyle and genetic risk categories, respectively. Cox proportional hazards regression models were applied to evaluate the associations of lifestyle, PRS with AS risk. Moreover, we estimated the percentage of total association between healthy lifestyle score and AS mediated by systemic inflammation markers.
Findings: During a median follow-up of 13.6 years, 694 patients with AS were diagnosed in the UK Biobank cohort. With unfavorable lifestyle as the reference group, intermediate lifestyle (hazard ratio [HR]: 0.65, 95% confidence interval [CI]: 0.53-0.80) and favorable lifestyle (HR: 0.59, 95% CI: 0.46-0.74) were associated with a decreased risk of AS. For the combined effect of lifestyle and PRS, participants with unfavorable lifestyle and high genetic risk had the highest risk of AS (HR: 1.95, 95% CI: 1.32-2.89) compared to those with favorable lifestyle and low genetic risk. However, no evidence of addictive and multiplicative interaction were observed. Furthermore, mediation analyses revealed that the inverse association between healthy lifestyle score and AS risk was in part mediated by systemic inflammation which ranged from 0.54% for neutrophil-to-HDL-c ratio to 13.79% for C-reactive protein.
Interpretation: Our study suggested that adherence to a favorable lifestyle significantly reduced the risk of AS by attenuating the systemic inflammatory response, which was independent of genetic susceptibility to AS.