bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of the fate of primary and re-precipitated silver nanoparticles in lake water model systems
Authors: Rao Sarayu , Gao Xiaoyu , Ghoshal Subhasis 
Published: February 2025

The increasing use of silver nanoparticles (nAg) in products and associated releases to the environment necessitates a thorough understanding of the environmental fate and transformations of these potentially toxic nanomaterials to inform environmental risk assessments. Herein, the physical and chemical transformations of nAg in natural lake water samples were investigated. Lake water systems containing filtered and unfiltered lake water (FLW and UFLW) were spiked with 80 nm polyvinylpyrrolidone-coated nAg (nAgpristine) at 6 μg/L and were maintained under quiescent or mixed conditions in the dark for up to 44 days. Aliquots withdrawn from the water column contained smaller re-precipitated nAg (r-nAg, diameter ∼26 nm) formed by precipitation of Ag+ released by oxidative dissolution of nAgpristine. The number concentrations of r-nAg and nAgpristine were comparable. In FLW, agglomerates of r-nAg and the partially dissolved nAgpristine were formed under quiescent conditions and their settling accelerated after 14 days, but no settling occurred in the mixed systems. In UFLW, heteroagglomerates of r-nAg and the partially dissolved nAgpristine with natural colloids formed and induced sedimentation in both quiescent and mixed systems. A fraction of the r-nAg formed and the larger (&gt;40 nm) or primary n-Ag (comprised of partially dissolved nAgpristine and its agglomerates with r-nAg or itself) were persistent in the water column for several weeks. Under quiescent conditions, more p-nAg remained suspended in FLW (15.7%, relative to number of nAgpristine dosed) than in UFLW (5.9%), whereas more r-nAg persisted in UFLW (2.6%) than in FLW (0.6%). Thus, the size distributions and fractions of nAg persisting in the water column can change significantly depending on water chemistry and mixing conditions.
Successful treatment with refractory myasthenia gravis that developed after allogeneic hematopoietic stem cell transplantation: two case reports
Authors: Zhang Huili , Wen Yi , Ou Yaotong , Chen Xi , Peng Yu , Lai Mingjun , Mo Wenjian , Wang Honghao 
Published: February 2025

IntroductionMyasthenia gravis (MG) is an autoimmune disorder caused by autoantibodies that target the neuromuscular junction, leading to muscle weakness and fatigability. Diagnosis is based on clinical presentation, confirmation of the presence of AChR-Ab, characteristic electromyography findings, and clinical improvement after administration of acetylcholinesterase inhibitors.MG is often associated with thymoma and other autoimmune diseases, but it is rare following allo-HSCT.Case reportwe reports two rare cases of MG after transplantation, including the first case of post-transplantation double-antibody-positive MG. Patient 1 was a 45-year-old woman diagnosed with B-cell acute lymphoblastic leukemia. She underwent haploidentical allo-HSCT from a female donor (5/10 matching human leukocyte antigens [HLAs]) and developed graft-versus-host disease (GVHD) after transplantation. At 42 months after transplantation, the patient developed episodic generalized weakness, dysarthria, dysphagia, and axial weakness. The serum anti-acetylcholine receptor antibodies (AchR-Abs) level was &gt; 20 nmol/L (normal range: &lt; 0.4 nmol/L). She was diagnosed with MG type IIb according to the Myasthenia Gravis Foundation of America classification. At 44 months post-transplantation, the patient began to experience episodic cramps, Electromyography (EMG) revealed a small number of fibrillation potentials with the right thumb extensor and the right anterior tibial muscle in a relaxed state, as well as spastic discharge, considered indicative of cramp–fasciculation syndrome (CFS). Improvement was seen following treatment with carbamazepine. Patient 2 was a 49-year-old man diagnosed with acute myeloid leukemia. He underwent haploidentical allo-HSCT from his son and did not develop GVHD. At 23 months post-transplant, the patient experienced recurrent diplopia, ptosis, axial weakness, and dyspnea. Neostigmine and repetitive nerve stimulation tests were positive, the level of anti-AChR IgG antibodies and MuSK receptor antibodies were positive, leading to a diagnosis of type IVb MG. The symptoms were mostly relieved after rituximab treatment.DiscussionThis article reports two rare cases of MG after transplantation, including the first case of post-transplantation double-antibody-positive MG, and reviews the general clinical characteristics of MG cases after allo-HSCT reported in previous literature. These cases enhance our understanding of MG following transplantation and add to the data on post-transplantation MG.
Disitamab vedotin vs. gemcitabine-cisplatin regimen with immunotherapy: a comparative analysis of efficacy and safety in muscle-invasive bladder cancer
Authors: Zhang Chuanao , Yu Yanhang , Zhou Qi , Ouyang Jun , Zhang Zhiyu 
Published: February 2025

IntroductionMuscle-invasive bladder cancer (MIBC) is an aggressive bladder cancer characterized by invasion of the muscular bladder wall, often necessitating a multimodal treatment approach for optimal outcomes. This study aimed to compare the real-world efficacy and safety of disitamab vedotin (RC48), an antibody-drug conjugate (ADC), combined immunotherapy targeting programmed cell death protein-1 (PD-1), against the gemcitabine and cisplatin (GC) regimen with PD-1 immunotherapy in the treatment of MIBC.MethodsThis single-center, retrospective study was conducted at the First Affiliated Hospital of Soochow University and included 38 patients with MIBC treated with either RC48 plus immunotherapy or GC regimen plus immunotherapy, between January 2022 and December 2023. Patients were divided into two groups: the RC48 with immunotherapy (ADC + PD-1) group and the GC regimen with immunotherapy (GC + PD-1) group. Efficacy was evaluated based on their pathological complete response rates (PCRR) and pathological downstaging rates (PDR). Adverse events (AEs) were assessed to compare safety profiles.ResultsOf the 38 patients, 17 were in the ADC + PD-1 group and 21 were in the GC + PD-1 group. The PCRR was significantly higher in the ADC + PD-1 group (82.35%, 14/17) compared to the GC + PD-1 group (47.62%, 10/21; P = 0.043). The PDR was also higher in the ADC + PD-1 group (94.12%, 16/17) than in the GC + PD-1 group (80.95%, 17/21), although the difference was not statistically significant (P = 0.355). No serious allergic reactions or fatal AEs were reported in either group. No Grade 4 AEs were reported, while Grade 3 AEs occurred at a rate of 5.71% in the ADC + PD-1 group and 12.20% in the GC + PD-1 group (P = 0.260).ConclusionRC48 combined with immunotherapy demonstrated a significantly higher PCRR compared to the GC regimen with immunotherapy, while maintaining a comparable safety profile. These findings highlight the potential of RC48 combined with immunotherapy as an effective treatment option for MIBC in clinical practice.
Multi-parameter optimizations of elastic chain catenary based on response surface methodology for high-speed railway
Authors: Zhang Zongfang , Zhang Maoyou 
Published: February 2025

As train operating speeds increase, the quality of pantograph-catenary current collection deteriorates, sometimes even resulting in contact loss. To ensure stable current collection during high-speed operation, it is crucial to optimize the design parameters of the catenary system. This study employs finite element analysis and constructs a pantograph-catenary coupling model using MSC. Marc software to simulate the coupled motion between the catenary and the pantograph. During the research process, the primary technical challenge was accurately evaluating the comprehensive effects of multi-parameter variations on pantograph-catenary current collection quality. First, we independently analyzed the effects of catenary tension and linear density variations on contact pressure to clarify the mechanisms of individual parameter influences. However, recognizing that multiple parameters might change simultaneously in actual operations, we introduced the Response Surface Methodology (RSM) to deeply explore the combined effects of two parameters on current collection quality. The innovation of this study lies not only in considering the effects of individual parameters but also in systematically analyzing the impact of multi-parameter interactions using RSM. Furthermore, from the perspective of the combined effects of catenary tension and contact wire linear density, we proposed an optimized catenary design scheme for the 500 km/h high-speed train operation scenario. Specifically, by increasing the contact wire tension, reducing the messenger wire tension, and lowering the linear density of the contact wire, we can significantly improve pantograph-catenary current collection quality, thereby providing robust support for the safe and stable operation of high-speed railways. In conclusion, this study addresses key technical challenges in multi-parameter optimization and proposes a practical optimization scheme with significant application value, offering important references for the design and optimization of high-speed railway catenary systems.
Prevalence and contributing factors of depression among women with infertility in low-resource settings: a systematic review and meta-analysis
Authors: Tadesse Shimelis , Kumsa Henok , Kitil Gemeda Wakgari , Chereka Alex Ayenew , Gedefaw Getnet , Chane Fiker , Mislu Esuyawkal 
Published: February 2025

BackgroundDepressive symptoms are the most common manifestations of psychiatric disorders among women with infertility. In low-resource settings, the overall prevalence and contributing factors of depressive symptoms among women with infertility remain unknown.ObjectivesTo estimate the prevalence and contributing factors of depression among women with infertility in low-resource settings.MethodsA review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The PubMed, MEDLINE, Google Scholar, and Cochrane databases were used to identify eligible studies published up to 30 November 2024. Three authors independently extracted the data. Studies that reported depression among women with infertility were included in this review. The data were analyzed with STATA version 14, and a meta-analysis was conducted using a random-effects model. Publication bias and heterogeneity were assessed via Eager’s tests and I2. Subgroup and sensitivity analyses were performed to identify the potential source/s of heterogeneity. A p-value of 0.05 was declared as statistically significant. The findings were synthesized and presented using texts, tables, and forest plots with measures of effect and 95% confidence interval (CI).ResultsSeventeen published cross-sectional studies that met the inclusion criteria with a total of 3,528 women with infertility were selected for this study. The pooled prevalence of depression among women with infertility was 48.77% (95% CI (35.86, 61.67). Good functioning family {OR 0.71 [95% CI (0.51, 0.97), I2: 0.00%]}, good husband support {OR 0.52 [95% CI (0.34, 0.79), I2: 0.00%]}, primary infertility {OR 2.55 [95% CI (1.36, 4.79), I2: 68.53%]}, history of divorce {OR 4.41 [95% CI (2.11, 9.24), I2: 0.00%]}, and duration of infertility lasting more than 10 years {OR 6.27 [95% CI (2.74, 14.34), I2: 15.26%]} were statistically significant.ConclusionDepression was high among women with infertility in low-resource settings such as Africa compared to those in high-income countries, men, and pregnant mothers. Good functioning family, good husband support, primary infertility, history of divorce, and duration of infertility lasting more than 10 years were statistically associated. Therefore, African countries and the stakeholders in collaboration with mental health experts and gynecological care providers should address these problems in order to reduce or prevent depression among women with infertility.Systematic Review RegistrationPROSPERO (ID: CRD42024516458).
Social participation patterns and associations with subsequent cognitive function in older adults with cognitive impairment: a latent class analysis
Authors: Li Xin , Feng Haishan , Chen Qingling 
Published: February 2025

BackgroundSocial participation (SP) has been associated with cognitive benefits among older adults; however, little is known about SP patterns and their relationships with cognitive function in cognitively impaired populations. This study aimed to identify SP patterns among cognitively impaired older individuals and evaluate their associations with subsequent cognitive function, specifically mental intactness and episodic memory.MethodsData were drawn from the China Health and Retirement Longitudinal Study (CHARLS), including 5,673 individuals aged 60 years and older with cognitive impairment from 2015 to 2018. Latent class analysis (LCA) was used to identify SP patterns, and hierarchical linear regression analyses were conducted to examine associations between these patterns and cognitive function.ResultsFour distinct SP patterns were identified: “Offline Social Participation Group” (Class 1), “Intellectual Social Participation Only Group” (Class 2), “Club and Volunteer Activities Group” (Class 3), and “Minimal Social Participation Group” (Class 4). The Class 4 comprised the majority (73%) and exhibited the poorest cognitive outcomes. Compared to the Class 4, Class 2 showed significant improvements in mental intactness (p &lt; 0.001) and episodic memory (p = 0.022), while Class 3 demonstrated significant improvements in mental intactness (p = 0.032) but not episodic memory. Class 1 showed significant improvements in episodic memory (p = 0.023).ConclusionThis study highlights the cognitive benefits of social participation, particularly intellectual activities, for older adults with cognitive impairment. Targeted interventions promoting SP, especially intellectual activities, are essential to mitigate cognitive decline and improve cognitive resilience in vulnerable populations.
Differences in lower limb co-contraction calculations vary clinical interpretation of aquatic treadmill walking in typically developing and children with cerebral palsy
Authors: Harrington Joseph W. , Knarr Brian A. , Dutt Vivek , Kingston David C. 
Published: February 2025

ObjectiveThe purposes of this study were to (1) investigate muscle co-contraction during aquatic (Wet) and conventional (Dry) treadmill walking at various speeds in typically developing (TD) and children with cerebral palsy (CP) and (2) explore how the clinical interpretation of co-contraction, using co-contraction indices (CCI), may vary depending on the method employed.MethodsFifteen TD children (30 limbs, 7 M | 8F, 11.3 ± 4.1 yrs., 1.46 ± 0.18 m, 44.2 ± 16.8 kg) and 10 children with CP (20 limbs, 6 M | 4F, 13.1 ± 3.5 yrs., 1.54 ± 0.18 m, 53.2 ± 26.2 kg, 7 GMFCS I and 3 II) participated in this study. Muscle activity of the tibialis anterior (TA), rectus femoris (RF), medial gastrocnemius (MG), and semitendinosus (ST) was recorded during three 3-min walking trials on a Dry treadmill followed by a Wet treadmill. Muscle co-contraction was calculated using three common CCI calculation methods for the RF/ST and TA/MG muscle pairings. Separate linear mixed-effects models examined the influence of population (TD vs. CP), walking speed (Slow, Normal, Fast), and treadmill environment (Dry vs. Wet) on CCI for each equation and muscle pairing.ResultsCCIUnnithan and CCIRudolph demonstrated that aquatic treadmill walking reduced muscle co-contraction in TD (p &lt; 0.001) and CP (p &lt; 0.012) populations for the RF/ST muscle pairing. Additionally, CCIUnnithan and CCIRudolph showed significant differences between speeds in both environments (p &lt; 0.001) except for the Slow-Normal comparison in the aquatic treadmill (p &gt; 0.423). All methods had a significant CCI reduction in the TA/MG muscle pairing for both populations. For the RF/ST muscle pairing, CCIF&amp;W showed that only TD children had lower muscle co-contraction in the aquatic treadmill (p = 0.023). CCIF&amp;W also showed no speed effect for the muscle pairings.ConclusionThis study shows the potential of aquatic treadmill walking to reduce muscle co-contraction; however, caution is recommended as clinical implications can vary due to the computation method. Future studies should aim to report values from multiple methods to account for the variability within methods and validation of results.
The relationship between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and both MASLD and advanced liver fibrosis: evidence from NHANES 2017–2020
Authors: Li Juyi , Kou Chunjia , Chai Yuwei , Li Yuchen , Liu Xue , Zhang Li , Zhang Haiqing 
Published: February 2025

BackgroundThe non-HDL-C to HDL-C ratio (NHHR) is a dependable lipid marker linked to atherosclerotic traits. This study examines the potential relationship between NHHR and both metabolic dysfunction-associated steatotic liver disease (MASLD) and advanced liver fibrosis.MethodsThis study investigated the relationship between NHHR levels and both MASLD and advanced liver fibrosis using data from the 2017–2020 National Health and Nutrition Examination Survey (NHANES) in the United States. First, we conducted a baseline characteristics analysis of the population based on NHHR quartiles. Second, we employed multivariable weighted linear regression models to examine the associations between NHHR and MASLD, as well as advanced liver fibrosis. Third, we utilized restricted cubic splines (RCS) to assess potential non-linear relationships. Fourth, we performed subgroup analyses. Finally, ROC curve analysis was conducted to evaluate the effectiveness of NHHR.ResultsIn the main analysis, this study included a total of 9,864 participants. Following multivariable logistic regression and comprehensive adjustments, elevated NHHR levels in the Q3 and Q4 groups were significantly linked to MASLD, with odds ratios of 1.59 (95% CI: 1.20–2.11) and 1.83 (95% CI: 1.40–2.39), respectively (P for trend &lt; 0.0001). Elevated NHHR levels in the Q2 and Q3 groups remained significantly linked to a decreased risk of advanced liver fibrosis, with odds ratios of 0.61 (95% CI 0.40–0.94, P = 0.03) and 0.64 (95% CI 0.47–0.89, P = 0.01), respectively. RCS analysis revealed a U-shaped nonlinear association between NHHR and both MASLD (P = 0.000; P for nonlinear = 0.029) and advanced liver fibrosis (P = 0.0001; P for nonlinear = 0.000). In the subgroup analysis, we found that this relationship was significant only in certain subgroups. The ROC curve analysis revealed that NHHR exhibited the best predictive performance for diagnosing MASLD based on the fatty liver index (FLI). The optimal cutoff point for NHHR in predicting MASLD using FLI was determined to be 2.476, with sensitivity and specificity values of 0.589 and 0.698, respectively.ConclusionNHHR may serve as a predictive marker for MASLD and advanced liver fibrosis, highlighting its potential significance in risk assessment and prevention strategies.
Explainable AI in medical imaging: an interpretable and collaborative federated learning model for brain tumor classification
Authors: Mastoi Qurat-ul-ain , Latif Shahid , Brohi Sarfraz , Ahmad Jawad , Alqhatani Abdulmajeed , Alshehri Mohammed S. , Al Mazroa Alanoud , Ullah Rahmat 
Published: February 2025

IntroductionA brain tumor is a collection of abnormal cells in the brain that can become life-threatening due to its ability to spread. Therefore, a prompt and meticulous classification of the brain tumor is an essential element in healthcare care. Magnetic Resonance Imaging (MRI) is the central resource for producing high-quality images of soft tissue and is considered the principal technology for diagnosing brain tumors. Recently, computer vision techniques such as deep learning (DL) have played an important role in the classification of brain tumors, most of which use traditional centralized classification models, which face significant challenges due to the insufficient availability of diverse and representative datasets and exacerbate the difficulties in obtaining a transparent model. This study proposes a collaborative federated learning model (CFLM) with explainable artificial intelligence (XAI) to mitigate existing problems using state-of-the-art methods.MethodsThe proposed method addresses four class classification problems to identify glioma, meningioma, no tumor, and pituitary tumors. We have integrated GoogLeNet with a federated learning (FL) framework to facilitate collaborative learning on multiple devices to maintain the privacy of sensitive information locally. Moreover, this study also focuses on the interpretability to make the model transparent using Gradient-weighted class activation mapping (Grad-CAM) and saliency map visualizations.ResultsIn total, 10 clients were selected for the proposed model with 50 communication rounds, each with decentralized local datasets for training. The proposed approach achieves 94% classification accuracy. Moreover, we incorporate Grad-CAM with heat maps and saliency maps to offer interpretability and meaningful graphical interpretations for healthcare specialists.ConclusionThis study outlines an efficient and interpretable model for brain tumor classification by introducing an integrated technique using FL with GoogLeNet architecture. The proposed framework has great potential to improve brain tumor classification to make them more reliable and transparent for clinical use.
Case Report: Anti-interferon-γ autoantibodies in an adolescent with disseminated Talaromyces marneffei and mycobacterial co-infections
Authors: Li Bingkun , Li Tiantian , Huang Qihua , Mo Nanfang , He Xiaojuan , Jiang Zhiwen , Li Xiuying , Huang Xiaolu , Zhang Xinyu , Cao Cunwei 
Published: February 2025

BackgroundAnti-interferon-γ autoantibodies (AIGAs) are associated with adult-onset immunodeficiency syndrome, which makes individuals susceptible to intracellular pathogen infections. However, AIGAs are rarely reported in adolescents.Case presentationWe report a 13-year-old Chinese boy who presented with fever, cough, and enlarged cervical lymph nodes. Blood cultures yielded Mycobacterium abscessus, and Talaromyces marneffei (TM) was cultured from pericardial effusion. Whole exome sequencing revealed no pathogenic variants. Notably, high levels of neutralizing AIGAs were detected in the patient's serum. After receiving treatment for Mycobacterium abscessus and antifungal therapy for TM, the patient showed significant improvement. However, at the 19-month follow-up, the patient developed a Mycobacterium asiaticum infection.ConclusionThis case highlights the importance of screening for AIGAs in pediatric patients with disseminated TM or NTM infections. Prolonged treatment and continuous follow-up remains crucial for managing pediatric patients with AIGAs.