bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bidirectional, longitudinal associations between depressive symptoms and IADL/ADL disability in older adults in China: a national cohort study
Authors: Zhu Xuequan , Wang Yanshang , Luo Yanan , Ding Ruoxi , Shi Zhenyu , Ping He 
Published: April 2024

Abstract

Introduction Based on the data from the China Health and Retirement longitudinal study (CHARLS), we aimed to investigate the bidirectional relationship between depressive symptoms and functional disability.
Method Data were collected across 3 waves from 2013 to 2018. The activities of daily living (ADLs) and the instrumental activities of daily living (IADLs) scales were used to measure functional disability and the CESD-10 was used to measure depressive symptoms. Cross-lagged models were performed to examine cross effect between depressive symptoms and functional disability across three waves.
Results Data on 10092(mean [SD] age, 61.98[8.44] years; 3764 females [37.30%]) and 10180 participants (mean [SD] age, 62.01[8.46] years; 3788 females [37.21%]) in IADL sample and ADL sample were included in the analyses. For IADL disability, the cross-lagged model shows a bidirectional association across three waves; the multivariable GEE model revealed that changes in CESD-10 score across waves were associated with worse IADL disability (β ranges: 0.08-0.10) and vice versa, worsen of IADL disability ascending developing of CESD-10 score (β ranges: 0.09-0.10). For ADL disability, the cross-lagged model shows a bidirectional association across three waves; the multivariable GEE model revealed that changes of CESD-10 score across waves were associated with worse IADL disability (β ranges: 0.08-0.10) and vice versa, worsen of IADL disability ascending developing of CESD-10 score (β ranges: 0.09-0.10).
Discussion Study findings underscore a significant bidirectional between depressive symptoms and functional disability in older adults. Thus, simultaneous intervention should be taken to manage the mutual development of functional disability and depression.
ADH4—a potential prognostic marker for hepatocellular carcinoma with possible immune-related implications
Authors: 李 玲 , Huang Yong-ta , Wang Li-ting , Wang Xiao-ling , Chen Zhen-yu , Jiang Shao-lan , Zeng Qiu-ling , Huang Hui-pin , Li Xiao-long 
Published: April 2024

Abstract

Objective
This study aims to explore ADH4 in hepatocellular carcinoma (HCC), its prognosis impact, and immune correlation for novel insights into HCC prognostication and treatment.
Methods
HCC prognostic marker genes were rigorously selected using GEO database, Lasso regression, GEPIA, Kaplan-Meier and pROC analyses. The interested markers (DNASE1L3, RDH16, ADH4, LCAT, HGFAC) in HCC and adjacent tissues were assessed by Immunohistochemistry (IHC). ADH4 expression were validated by symbol rank tests and unpaired Wilcoxon rank sum tests across pan-cancer and HCC datasets. Clinical significance and associations with clinicopathological variables were determined using Kaplan-Meier, logistic regression and Cox analyses on TCGA data. The ADH4 related immune responses were explored by Spearman correlation analysis using TIMER2 data. CD68, CD4, and CD19 protein levels were confirmed by IHC in HCC and non-cancerous tissues.
Results
ADH4 showed significant downregulation in various cancers, particularly in HCC. Immunohistochemistry analysis confirmed reduced ADH4 expression in HCC tissues compared to normal liver tissues. Moreover, ADH4 expression was associated with clinicopathological variables and served as an independent prognostic marker for HCC patients. Our nomograms based on ADH4 expression, tumor status, and T stage demonstrated its clinical prognostic significance. Additionally, ADH4 exhibited immunoregulatory functions in the HCC microenvironment, correlating with immune cell infiltration patterns. Furthermore, ADH4 expression inversely correlated with several immune checkpoint markers, suggesting its potential as a therapeutic target in HCC immunotherapy.
Conclusion
This study highlights the diagnostic, prognostic and immunomodulatory roles of ADH4 in HCC. ADH4 could serve as a valuable biomarker for HCC diagnosis and prognosis, as well as a potential target for immunotherapeutic interventions.
A Deep Learning Approach to Find Optimal Path in Underwater Networks Using ns3-ai
Authors: R Shruthi K , C Kavitha 
Published: April 2024

Abstract

Undersea communication has become increasingly common due to its varied applications including a collection of oceanographic information, environment monitoring, seismic and pollution monitoring, and many more [1]. The environment undersea is highly unstable due to its intermittent and noisy characteristics [1][2]. Therefore, the routing approach that comprehends the environment is the need of the hour. The reinforcement learning method is one such approach that performs action based on environmental conditions [3]. One of the machine learning methods called Reinforcement learning allows an agent to learn from the environment and behave accordingly. In this paper, the authors have used a deep learning approach, a class of reinforcement learning which uses neural networks to train agents. Ns3-ai framework provides the abstraction between the ns3 simulator and the ai framework [4]. Here, an underwater sensor network is simulated in ns3 and a deep-learning approach is used to train the agents. The connection between ns3 and the deep learning framework is established through ns3-ai. The deep learning framework trains the agents based on the data received from the ns3 simulator. The actions performed by the agents are transferred to ns3 simulator where the actual routing of the packets happens. The results are compared with Q learning algorithm. The deep learning approach outperforms Q learning in terms of delay and delivery time.
Characteristics of eye movements and correlation to cognitive functions in relation to the location of guide signs and driving speed
Authors: Maeyama Takaya , Okada Hiroki , Sawamura Daisuke 
Published: April 2024

Abstract
This study aimed to explore the relationship between eye movements and cognitive functions when recognizing destinations in guide signs using actual on-board videos and the effects of driving speed and location of guide signs on eye movements. Twenty-four participants were recruited. Attention and processing speed, verbal memory, visual memory, planning, and useful field of view (UFOV) were assessed as cognitive functions necessary for driving. Eye movements while recognizing the destination in guide signs (duration and number of fixations and amplitude and number of saccades) were measured using four conditions in on-board videos: slow/fast speed, front/left side. The results showed that cognitive functions correlated during in-front conditions at slow and fast speeds. At left-side guide signs, cognitive functions did not correlate, but correlated with age and driving experience. The results suggest that recognizing left-side guide signs required a higher skill, which depended more on the driver’s experience than on cognitive functions. In addition, of the four conditions, visual recognition of destinations in guide signs made more difficult with fast speeds and left-side locations. The increased load from left-side guide signs and faster speeds influenced eye movements. Thus, the location of the guide sign and the speed was shown to affect the difficulty in recognizing destinations within the guide signs.
A Novel Data Credibility-based Machine Learning Approach for UAV Capability Evaluation
Authors: Zhu Jun-Yi , Yu Chenhao , Chang Leilei , Cao You , Xu Xiaobin , Hao Zhiyong 
Published: April 2024

Abstract

The Unmanned Aerial Vehicle (UAV) has become more and more important in both civil use and military operations. The overall reconnaissance capability of the UAV swarm is often affected by multiple signals. A new approach is proposed by recognizing data credibility (DC) using multiple machine learning (ML) techniques, i.e., a novel DCML approach. There are two major components (and major theoretical contributions) of the proposed approach. The first component is the initial identification of less-credible data using a single ML technique. The second component is the cross-identification of less-credible data using multiple ML techniques based on the initial identification results. A practical case is studied for validating the proposed DRML approach. Case study results show that (1) The proposed approach in this paper demonstrates a proficient ability to identify less credible data, (2) The validation with various machine learning methods proves effective, but the efficacy of the method is not necessarily proportional to the quantity of methods employed, (3) The combination of BPNN and GPR yields the most favorable outcomes.
The seroprevalence of HBV infection and associated factors among pregnant women attending antenatal clinic (ANC) at Burao General Hospital (BGH).
Authors: Jama Ahmed Adan 
Published: April 2024

Abstract

Introduction:-
Hepatitis B virus disease is a potentially life-threatening liver infection and a major global health problem. Hepatitis B infection is associated with the risk of death arising from cirrhosis, liver and non-liver cancers, Transmission of Hepatitis B virus (HBV) results from exposure to contaminated blood or body fluids, unprotected sexual contact with an infected person, blood transfusion, use of contaminated needles, syringes, and sharps as well as vertical transmission from mother to child, there is risk of HBV transmission to the newborn delivered by a hepatitis B surface antigen (HBsAg)-positive woman. This risk is amplified with positivity of hepatitis B envelope antigen [1 ].
Methods
- The research was an institution based cross-sectional study, which involves the systemic collection and presentation of data to give a clear picture about the topic. This research used simple random sampling. This was probability sampling which involves choosing the nearest and the available person of research as a respondent, and systematic sampling for the lab results of the hepatitis B virus infection.
Findings
: In this study, the overall sero-prevalence of HBsAg was 3.9% (15/384), as documented from the reports of laboratory investigations, the socio-demographic characteristics of the participants, where majority of the age group participated in this study were between 26–35 years old, the educational level of the majority of participants were high school among other variables examined in this section
Conclusion
- In this study, the overall sero-prevalence of HBsAg was 3.9% (15/384), as documented from the reports of laboratory investigations, the socio-demographic characteristics of the participants, where majority of the age group participated in this study were between 26–35 years old, the educational level of the majority of participants were high school among other variables examined in this section According to the specific objective three the seroprevalence of HbsAg among pregnant women attending ANC at BGH, the total sero-prevalence of HBsAg in this research was 2.48 percent. Because many people may not have symptoms or are unaware they are sick, their disease is frequently undiagnosed and hence cannot be recorded or tallied, so this data only includes those who completed the test at Burao General Hospital.
Evaluating the quality of care for suspected placenta accreta spectrum referred to a regional PAS centre in Semarang, Indonesia
Authors: Cahyanti Ratnasari D , Wiyati Putri S , Dewantiningrum Julian , Pramono Besari A , Rinawati Rinawati , Nindrea Ricvan D , Ameh Charles 
Published: April 2024

Abstract

Background
In low middle income countries (LMICs), the increase in the rate of caesarean surgery, a main risk of placenta accreta spectrum (PAS), and limited resources to manage it. In Indonesia a PAS clinical guideline was developed, and disseminated, a regional PAS Centre was set up within a functional comprehensive emergency obstetric care (CEmOC) and the quality of care provided afterwards evaluated.
Study Design:
A retrospective cohort study design that included all suspected PAS cases referred in between January 2020 to December 2022, in Semarang, Indonesia. The study compared the quality of care provided for invasive and non-invasive cases. Differences in quality of care in each outcome group was explored at different shifts and periods of the day, public holidays or weekends and weekdays. The quality of 24/7 care based on maternal outcome, timeliness of emergency care, and adherence to national PAS management guidelines was evaluated.
Results
Ninety-nine of the 154 (64.28%) referral patients with suspected PAS were in the invasion group. Of these, 81 (81.8%) were diagnosed prenatally and confirmed at surgery or histopathology. The quality of care was similar between women with and without invasion regardless of time intervention. The multidisciplinary team and blood unit availability were found to be the key performance of adherence to the standard process.. The decision to delivery interval (DDI) of ≤ 30 minutes was the most important missing element in the timeliness of emergency care, with median (IQR) 57.50 (30–120) minutes on weekdays and 43.00 (20–66) minutes on public holidays and weekends in the invasion group. Nevertheless, in emergency cases, the access to ICU and time to transfusion in invasion group was adequate. A reduction in case fatality rate (CFR) of PAS was observed from 4.0% (2020) to 3.03% (2022).
Conclusions
The findings suggest that the regional PAS centre is functioning optimally according to national PAS guidelines, with no difference in the quality of care provided to all referred suspected PAS cases irrespective of the degree of placental invasion, the time of the day or period of the week.
Evaluation of Conventional Blades Versus Diode Laser Incisions on Postoperative Sequelae and Healing After Extraction of the Mandibular Third Molar.
Authors: SAINI DEEPIKA , GUPTA D.S. , DONEPURI NANDAKISHORE , CHAUDHARY NAKUL , BIJARNIYA POOJA , JAIN AASHITA 
Published: April 2024

Abstract
BACKGROUND
Postoperative morbidity heightens patients' apprehension towards the surgical extraction of the mandibular third molar. Various innovative strategies like lasers have been created to reduce these negative effects and there is limited research comparing the effectiveness and wound healing between laser and conventional methods of incision.
PURPOSE
To evaluate the conventional scalpel versus diode laser incisions on postoperative sequelae and healing after extraction of mandibular third molar surgery.
STUDY DESIGN
A prospective, randomized and comparative study was conducted in the outpatient clinic. A total no. of 36 patients, 18 in scalpel group (group A) and 18 in Laser group (group B) among individuals of a specific age range of 18 to 40 years requiring extraction of impacted mandibular third molar which were within the Pederson difficulty index range of 3 to 7 and free from any infection.
INDEPENDENT VARIABLE
Type of incision (conventional blade or diode laser); Patient demographics (gender);
MAIN OUTCOME VARIABLE
Post-operative swelling, pain, trismus and wound healing was evaluated on 1st , 3rd and 7th day.
COVARIATES
Preoperative pain level; Preoperative facial swelling, Surgical accessibility and Intraoperative precision.
ANALYSES
The intergroup comparison between the two groups was done using Independent t test with p < 0.05
RESULTS
36 outpatients (44.4% males and 55.6% females), 18 in each group, among individuals of a specific age range of 18 to 40 years were included in this study. Compared to scalpel incision, laser incision was associated with statistically lower pain scores on 3rd post operative day (p=0.001)and edema on postoperative days 3rd (p=0.023) and 7th (p=0.028). Mouth opening was statistically non - significant by postoperative. Scalpel incisions had shown better healing in 3rd and 7th postoperative days when compared with laser incisions (p = 0.001).
CONCLUSION
Our data indicate that utilizing laser incisions on impacted mandibular third molars has a beneficial impact on postoperative problems such as pain, edema, and trismus.The laser incision offered excellent accessibility and visibility to the operative site. The only disadvantage of the diode laser was delayed wound healing. The healing was faster and excellent after being incised with a conventional scalpel.
Genotypic and Phenotypic Analysis of Korean Patients with Tuberous Sclerosis
Authors: Shin Hui Jin , Lee Sangbo , Kim Se Hee , Lee Joon Soo , Oh Ji Young , Ko Ara , Kang Hoon-Chul 
Published: April 2024

Abstract

Tuberous sclerosis complex (TSC) is a rare autosomal dominant disorder caused by mutations in the TSC1 or TSC2 gene. The aim of this study was to analyze the genotypes and phenotypes of Korean patients diagnosed with TSC and expand our understanding of this disorder. This retrospective observational study included 331 patients clinically diagnosed with TSC between November 1990 and April 2023 at Severance Children’s Hospital, Seoul, South Korea. The demographic and clinical characteristics of the patients were investigated. Twenty-five novel variants were identified. Of the 331 patients, 188 underwent genetic testing, and genotype-phenotype variation was analyzed according to the type of gene mutation and functional domain. Fifty-one patients (51/188, 27%) were had TSC1 mutations, 109 (58%) had TSC2 mutations, and 28 (8.5%) had no mutation identified (NMI). Hotspots were identified in exons 15 and 18 of TSC1 and exons 34, 35, and 41 of TSC2. Patients with TSC2 mutations exhibited a significantly younger age at the time of seizure onset and had refractory epilepsy. Infantile epileptic spasms syndrome (IESS) was more common in the middle mutation domain of TSC2 than in the hamartin domain (p = 0.047). Additionally, retinal hamartoma, cardiac rhabdomyoma, and renal abnormalities were significantly associated with TSC2 compared with other gene types. This study contributes to our understanding of TSC by expanding the genotypic spectrum with novel variants and providing insights into the clinical spectrum of patients with TSC in Korea.
Evaluation of Tobacco heating system (THS) during closed lower limb fracture healing in trauma smokers’ patients
Authors: Herbst Moritz , Aspera-Werz Romina H. , Braun Benedikt , Schulz Kevin , Rollmann Mika F. , Histing Tina , Nüssler Andreas 
Published: April 2024

Abstract

Background
Since 1976, it's been recognized that increased cigarette consumption correlates with decreased bone density, hindering fracture healing and leading to prolonged hospitalization. Although prior research has shown the relatively less harmful effects of electronic nicotine delivery systems (ENDS) on bone cells in lab settings and animal models, clinical evidence regarding their impact on fracture healing remains scarce. This study aims to investigate whether switching to a tobacco heating system (THS) post-orthopedic surgery improves outcomes for smoking patients during tibia or femur fracture healing over a 6-month period.
Methods
The study is a prospective, open-label, non-parallel, single-center trial involving 150 patients from a Level 1 Trauma center, Germany, diagnosed and treated for closed tibia, closed femur shaft, or closed distal femur fractures (according to AO/OTA: 41A2-41C3, 42A-C, 43A-C, 32A-C, 33A2-3, 33B-C). Participants will be categorized into three groups based on smoking behavior: smokers (no intervention), THS (participants switching from cigarettes to THS), and ex-smokers (participants abstaining from cigarettes or ENDS during the study). Clinical, radiological, and laboratory data will be collected during preoperative and postoperative assessments at 6, 12, 18, and 24 weeks. The primary outcome will be the serum concentration of N-terminal propeptide procollagen type 1, a bone formation marker. Secondary outcomes include bone metabolism, healing, immunological, blood count, and clinical parameters. Approval for the study protocol and consent declarations was obtained from the ethics committee of the medical faculty of Eberhard Karls University (724/2022BO1).
Discussion
The study results will provide evidence that switching to THS previous orthopedic intervention improves clinical outcomes during closed tibia or femur fracture healing in smokers’ patients due to reduced bone resorption rate consequent to the diminished activity of cigarette smoke-activated osteoclast.
Trial registration:
The study is registered on ClinicalTrials.gov (NCT05859451).
Expression Level of Autoimmune Regulator In B Cells Correlates With Residual Islet β Cell Function In Type 1 Diabetes Mellitus
Authors: Li Weixia , Liu Yuting , Liu Shangming , Zhang Aixia , Jiang Pengjun , Fang Chen , Xie Dongmei , Wang Xin 
Published: April 2024

Abstract

Background
Autoimmune modulators (Aire) mediate immune tolerance by inducing expression of tissue-restricted antigen (TRA) in thymic medullary epithelial cells. However, the function of Aire in peripheral B cells remains unknown. We aimed to investigate whether Aire is expressed in human peripheral B cells and how its expression is regulated.
Methods
Human thymus tissues were collected and firstly, islet-specific autoantibodies and insulinogen c-peptide were determined by luciferase immunoprecipitation (LIPS). Secondly, Aire expression in peripheral blood lymphocytes was identified by flow cytometry, Western Blot and immunofluorescent staining. Then, immunofluorescent staining was performed on cells cultured in vitro and surgically resected tissues. Meanwhile, Aire promoter methylation. Finally, insulinogen expression was quantified by reverse transcription qPCR and IF staining. Data were compared by Mann-Whitney U test between groups.
Results
Aire was expressed in CD19+ B cells but not in CD3+ cells, and the expression of Aire in B cells was much lower than that in thymus. Induction of Aire expression under BCR activation in B cells. The level of Aire expression in peripheral B cells of patients with T1D and healthy subjects showed no difference in Aire expression level between the two groups.
Conclusions
Aire expression in peripheral B cells may play a role in peripheral immune tolerance and protection of islet β-cell function in T1D patients.
Angiotensin II type-1 receptor autoantibodies and effects in neonates of preeclamptic women.
Authors: PONTHIER Laure , HAMEL Chahrazed EL , MAZEAU Perrine COSTE , MARTINEZ Sophie , WEHBE Sarah , FROGET Rachel , YARDIN Catherine , GUIGONIS Vincent 
Published: April 2024

Abstract

Background
Maternal agonistic autoantibodies against the angiotensin II type 1 receptor (AT1-AAs) have been implicated in the pathophysiology of preeclampsia, but their presence in their offsprings and their possible neonatal effects have not been specifically explored. This prospective study aimed to evaluate the presence of AT1-AAs and their potential clinical effects in neonates of AT1-AAs positive mothers.
Methods
Preeclamptic women and their neonates were included. Blood samples were collected in order to search for AT1-AAs.
Results
AT1-AA determination was positive in 35 out of 64 of the studied women (54.7%). Thirty one newborns from the group of AT1-AA positive women were included and 22 (71%) were AT1-AA positive. The mothers’ and children’s AT1-AAs titers were significantly correlated. The 33 newborns from the group of AT1-AA negative women were all negative for AT1-AAs. Regarding the clinical data of newborns (birth weight, percentile of weight, gestational age, Apgar score at five minutes, mechanical or noninvasive ventilation), no significant difference was observed between the children with or without detected AT1-AAs.
Conclusion
Even though AT1-AAs are detected in newborns of positive mothers during the first days of life, no specific clinical signs seem to be associated with the presence of these antibodies.