bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of Aerosols and Clouds and Their Role in Earth’s Energy Budget
Authors: Yu Lan , Zhang Ming , Wang Lunche , Li Huaping , Li Junli 
Published: January 2024

Abstract
Clouds and aerosols provide the greatest uncertainty in estimating and interpreting Earth’s energy budget. This study not only focuses on surface brightening/dimming, but also explores Earth’s energy balance. The validation results of the CERES-SYN, ISCCP-FH, and GEWEX-SRB datasets with Baseline Surface Radiation Network (BSRN), Surface Radiation Budget Network (SURFRAD), and CMA observations show that CERES data have the highest accuracy and the longest temporal coverage. The role of clouds and aerosols in Earth’s energy budget was explained using CERES and MERRA-2 products. The results show that Earth’s energy increases at a rate of 0.63 W m−2 decade−1 in 2000–21. The global surface brightens at a rate of 0.57 W m−2 decade−1, with surface energy decreasing at a rate of 0.19 W m−2 decade−1. Brightening was found over Australia, central Asia, and southern Africa, mainly associated with cloud reduction, with aerosol emissions reductions contributing to the East Asian surface brightening. The surface brightening in South America and Southeast Asia is also due to the reduction of clouds. The increase of aerosols in South Asia is the main factor for its surface dimming, while we infer that the climatic effect from the increase of black carbon (BC) aerosols in South Asia is the inducing factor for the dimming in southern China. The surface darkening in West Asia is the result of the combined effect of clouds and aerosols, while in northern Africa it may be related to the increase of clouds caused by the decrease of dust aerosols. Surface energy increases only in Southeast Asia, South America, and Europe.

Significance Statement
Clouds and aerosols provide the greatest uncertainty in estimating and interpreting Earth’s changing energy budget. Moreover, the relative importance of clouds and aerosols is variable, depending on the regions and time scales of studies. This study shows that the energy inflow to the Earth system is greater than the energy outflow in 2000–21, with radiation on Earth increasing at a rate of 0.63 W m−2 decade−1 with the surface energy decreases at a rate of 0.19 W m−2 decade−1. Brightening was found over Southeast Asia, South America, Australia, and southern Africa, with the areas of surface darkening occurring mainly in Asia and northern Africa.
Characterization of Mixing at the Edge of a Kuroshio Intrusion into the South China Sea: Analysis of Thermal Variance Diffusivity Measurements
Authors: Sanchez-Rios Alejandra , Shearman R. Kipp , Lee Craig M. , Simmons Harper L. , Laurent Louis St. , Lucas Andrew J. , Ijichi Takashi , Jan Sen 
Published: January 2024

Abstract
The Kuroshio occasionally carries warm and salty North Pacific Water into fresher waters of the South China Sea, forming a front with a complex temperature–salinity (T–S) structure to the west of the Luzon Strait. In this study, we examine the T–S interleavings formed by alternating layers of North Pacific Water with South China Sea Water in a front formed during the winter monsoon season of 2014. Using observations from a glider array following a free-floating wave-powered vertical profiling float to calculate the fine-scale parameters Turner angle, Tu, and Richardson number, Ri, we identified areas favorable to double-diffusion convection and shear instability observed in a T–S interleaving. We evaluated the contribution of double-diffusion convection and shear instabilities to the thermal variance diffusivity, χ, using microstructure data and compared it with previous parameterization schemes based on fine-scale properties. We discover that turbulent mixing is not accurately parameterized when both Tu and Ri are within critical ranges (Tu > 60; Ri < ¼). In particular, χ associated with salt finger processes was an order of magnitude higher (6.7 × 10−7 K2 s−1) than in regions where only velocity shear was likely to drive mixing (8.7 × 10−8 K2 s−1).
Different Perception on the Use of Hawley and Vacuum-formed Retainers Amongst Post-orthodontic Patients. Part 1: Discomfort and Aesthetic Perception
Authors: Latief Andina Alia , Soegiharto Benny Mulyono , Jazaldi Fadli 
Published: January 2024

Backgrounds and Objectives The use of a retainer in the retention phase creates different perceptions amongst patients. However, the evidence regarding it is limited. This research was conducted to analyze the difference in patients’ perception of discomfort and aesthetics between Hawley and vacuum-formed retainers. Methods This study included 80 patients ( n per group = 40). Patients were invited to participate if they had completed their treatment for 6 months to 5 years and complied with the inclusion criteria. Seven questions were given to the patients using a digital-based questionnaire. Each was asked twice to address both maxillary and mandibular retainers. Responses were measured using the Visual Analogue Scale. Blinding was applied through data analysis. Results Statistically significant differences were found in the perception of the aesthetic, shape, and retainer color. Statistically significant differences were not found in the perception of comfort, pain, sharpness, pressure, presence of soft tissue cut, and confidence level with the retainer in place. No harm was observed to any patients during the study. Conclusions Vacuum-formed retainers (VFRs) were more acceptable than Hawley retainers (HRs) regarding the retainer’s aesthetic, shape, and color. There were no significant differences between HRs and VFRs regarding patient perception of discomfort and confidence when using the retainer.
Anwulignan Alleviates the Acute Liver Injury Induced by Acetaminophen in Mice
Authors: Chenghe Zhao , Yao Wang , Shu Jing , Huijiao Lin , He Li , Jianguang Chen , Wei Xia 
Published: January 2024

Background Drug-induced liver injury (DILI) is extremely common in clinical practice and needs to be focused. Anwulignan is a unique lignan monomer of Schisandra Sphenanthera Fructus and is used as the main active ingredient of Wuzhi tablet, which is used for liver protection in clinical practice. In this study, an acute liver injury mouse model induced by acetaminophen and paracetamol (APAP) was used to observe its effects. Materials and Methods An acute liver injury mouse model was established by intraperitoneally injecting APAP. Mice were divided into blank control (CON) group, APAP model (MOD) group, Anwulignan CON group, and Anwulignan MOD group. Anwulignan (6 mg/kg) or sodium carboxymethylcellulose (10 mL/kg) was intragastrically given to mice once a day, successively for 14 days. On day 14, 250 mg/kg APAP solution (10 mL/kg) or saline was injected intraperitoneally, and 12 h later, the mice were killed. alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in the serum of mice were tested. The liver index of mice was calculated, and the pathology of liver injury was evaluated by HE staining in mice. The activities of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) as well as the content of malondialdehyde (MDA) in the liver tissue were tested. The levels of kelch-like ECH-associated protein 1 (Keap-1), nuclear factor erythroid-2-related factor 2 (Nrf2), heme oxygenase 1 (HO-1), BCL2 associated X protein (Bax), B-cell lymphoma-2 (Bcl-2), caspase-3 and tumor suppressor protein (P53) mRNAs in the liver tissues of mice were detected by reverse transcription-PCR (RT-PCR), and the expression levels of Keap-1, Nrf2, HO-1, Bax, Bcl-2, caspase-3 and P53 proteins in the liver tissue of mice were detected by Western blot. Results Anwulignan can alleviate the acute liver injury of mice. The down-regulation of the cyclophosphamide (CYP2E1) expression in the liver tissue of mice to reduce the hepatotoxicity of APAP, and the regulation of Nrf2-ARE signaling pathway-related gene expressions to play an antioxidant role and apoptosis-related gene expressions to inhibit the liver cell apoptosis may be involved in the mechanism through which Anwulignan can exert its effect. Conclusion Anwulignan can alleviate the liver injury induced by APAP in mice, and this study may provide evidence for researching and developing some drugs and nutraceuticals used for preventing and treating liver injury.
Ramulus Mori (Sangzhi) Alkaloids (SZ-A) Ameliorate Myocardial Injury in Type 2 Diabetic Rats by Regulating Autophagy
Authors: Liu Ying , Ma Leilei , Xu Wenxuan , La Xiaojin , Zhang Biwei , Cui Jianmei , Tian Chunyu , Chang Hong , Li Ji-an 
Published: January 2024

Background Diabetes mellitus (DM) is a persistent metabolic condition resulting from insufficient insulin or insulin resistance, which gives rise to diverse complications endangering human well-being. Ramulus Mori (Sangzhi) alkaloids ­(SZ-A) have various pharmacological effects, potentially benefiting clinical comprehensive kidney and cardiovascular protection. Nevertheless, the potential protective effect of SZ-A on myocardial injury in individuals with type 2 diabetes mellitus (T2DM) remains unexplored. Materials and Methods Sprague-Dawley (SD) rats were divided into four groups, including control, model, metformin, and SZ-A. The establishment of the type 2 diabetes model was initiated by injecting streptozotocin (STZ) along with a diet of high glucose and fat. Following a 12-week period of treatment, measurements were taken for heart mass index (HMI), fasting blood glucose (FBG), and 2-h postprandial blood glucose (2hPG). Additionally, serum glycated hemoglobin (HbA1c), indicators of myocardial injury, and oxidative stress were assessed. The expressions of mammalian target of rapamycin (mTOR), p-mTOR, beclin-1, and LC3 in myocardial tissue were detected by Western blot. Results The administration of SZ-A effectively reduced the levels of HMI, FBG, 2hPG, HbA1c, malondialdehyde (MDA), lactate dehydrogenase (LDH), and creatine kinase isoenzymes (CK-MB) in rats with type 2 diabetes while enhancing the activity of superoxide dismutase (SOD). Additionally, SZ-A could improve myocardial tissue arrangement structure and fibrosis degree. Additional analysis revealed that SZ-A suppressed the activation of p-mTOR while enhancing the levels of Beclin-1 and LC3, suggesting that the potential therapeutic impact of SZ-A on myocardial damage could be attributed to its ability to regulate autophagy, thereby mitigating oxidative stress. Conclusion In summary, the results indicate that SZ-A might possess inhibitory properties against myocardial damage in rats with type 2 diabetes, presenting a potential therapeutic approach in the clinic.
A data-driven prioritisation framework to mitigate maintenance impact on passengers during metro line operation
Authors: Consilvio Alice , Vignola Giulia , López Arévalo Paula , Gallo Federico , Borinato Marco , Crovetto Carlo 
Published: January 2024

AbstractThe application of artificial intelligence (AI) techniques may lead to significant improvements in different aspects of rail sector. Considering asset management and maintenance, AI can improve data analysis and asset status forecasting and decision-making processes, fostering predictive and prescriptive maintenance strategies. A prescriptive approach should be able to predict future scenarios as well as to suggest a course of actions. Nevertheless, the decision-making in rail asset management is often based on the classical asset-oriented approach, concentrating on the function of the asset itself as a main key performance indicator (KPI), whereas a user-oriented approach could lead to improved performance in terms of level of service. This paper is aimed at integrating the passengers’ perspective in the decision-making process for asset management to mitigate the impact that service interruptions may have on the final users. A data-driven prioritisation framework is developed to prioritise maintenance interventions taking into account asset status and criticality. In particular, a three-step approach is proposed, which focuses on the analysis of passenger data to evaluate the failure impact on the service, the analysis of alarms and anomalies to evaluate the asset status, and the suggestion of maintenance interventions. The proposed approach is applied to the maintenance of the metro line M5 in the Italian city of Milan. Results show the usefulness of the proposed approach to support infrastructure managers and maintenance operators in making decisions regarding the priority of maintenance activities, reducing the risk of critical failures and service interruptions.
Drug therapy problems among hospitalized patients with cardiovascular disease
Authors: Niriayo Yirga Legesse , Kifle Roba , Asgedom Solomon Weldegebreal , Gidey Kidu 
Published: January 2024

Abstract
Background
Optimal utilization of cardiovascular drugs is crucial in reducing morbidity and mortality associated with cardiovascular diseases. However, the effectiveness of these drugs can be compromised by drug therapy problems. Hospitalized patients with cardiovascular diseases, particularly those with multiple comorbidities, polypharmacy, and advanced age, are more susceptible to experiencing drug therapy problems. However, little is known about drug therapy problems and their contributing factors among patients with cardiovascular disease in our setting. Therefore, our study aimed to investigate drug therapy problems and their contributing factors in patients with cardiovascular diseases.

Method
A prospective observational study was conducted among hospitalized patients with cardiovascular disease at Ayder Comprehensive Specialized Hospital in the Tigray region of Northern Ethiopia from December 2020 to May 2021. We collected the data through patient interviews and review of patients’ medical records. We employed Cipolle’s method to identify and categorize drug therapy problems and sought consensus from a panel of experts through review. Data analysis was performed using the Statistical Software Package SPSS version 22. Binary logistic regression analysis was performed to determine the contributing factors of drug therapy problems in patients with cardiovascular disease. Statistical significance was set at p < 0.05.

Results
The study included a total of 222 patients, of whom 117 (52.7%) experienced one or more drug-related problems. We identified 177 drug therapy problems equating to 1.4 ± 0.7 drug therapy problems per patients. The most frequently identified DTP was the need for additional drug therapy (32.4%), followed by ineffective drug therapy (14%), and unnecessary drug therapy (13.1%). The predicting factors for drug therapy problems were old age (AOR: 3.97, 95%CI: 1.68–9.36) and number of medications ≥ 5 (AOR: 2.68, 95%CI: 1.47–5.11).

Conclusion
More than half of the patients experienced drug therapy problems in our study. Old age and number of medications were the predicting factors of drug therapy problems. Therefore, greater attention and focus should be given to patients who are at risk of developing drug therapy problems.
Geriatric nutritional risk index and adverse medical outcomes among Egyptian patients admitted to a geriatric hospital: a prospective cohort study
Authors: Mohammed Hebatullah O , Hassan Azza M. , Mostafa Aya , Khater Mohamed S. , Aboelfotoh Aisha , Abd Elaziz Khaled M. 
Published: January 2024

Abstract
Background
Elderly are one of the most heterogeneous and vulnerable groups who have a higher risk of nutritional problems. Malnutrition is prevalent among hospitalized elderly but underdiagnosed and almost undistinguishable from the changes in the aging process. The Geriatric Nutritional Risk Index (GNRI) is a tool created to predict nutrition-related complications in hospitalized patients. This study aims to measure the prevalence of nutritional risk using the GNRI among hospitalized elderly Egyptian inpatients and to determine the association between the GNRI and selected adverse clinical outcomes.

Methods
A hospital-based prospective cohort study was conducted among 334 elderly patients admitted to a tertiary specialized geriatric university hospital in Cairo, Egypt from August 2021 to June 2022. Within 48 hours after hospital admission, socio-demographic characteristics, blood biomarkers, anthropometric measurements, and nutritional risk assessment by the GNRI score were obtained. Patients were divided into three groups based on their GNRI: high, low, and no nutritional risk (GNRI<92, 92-98, and >98) respectively. Patients were followed up for the occurrence of adverse outcomes during hospital stay (bed sores, Healthcare-Associated Infections (HAIs), hospital Length of Stay (LOS), and hospital mortality) and three months after discharge (non-improvement medical status, appearance of new medical conditions, hospital readmission and 90-day mortality). Multivariable regression and survival analysis were conducted.

Results
The prevalence of high-nutritional risk was 45.5% (95% CI, 40%–51%). Patients with high risk had significantly longer LOS than those with no risk. The high-nutritional risk was significantly associated with the development of bed sores (Adjusted Odds Ratio (AOR) 4.89; 95% CI, 1.37–17.45), HAIs (AOR: 3.18; 95% CI, 1.48–6.83), and hospital mortality (AOR: 4.41; 95% CI, 1.04–18.59). The overall survival rate was significantly lower among patients with high-nutritional risk compared to those with no risk.

Conclusion
GNRI is a simple and easily applicable objective nutritional screening tool with high prognostic value in this Egyptian sample of patients. The findings of this study signal the initiation of the application of this tool to all geriatric hospitals in Egypt.
The causal relationship between COVID-19 and estimated glomerular filtration rate: a bidirectional Mendelian randomization study
Authors: Li Qiuling , Lin Mengjiao , Deng Yinghui , Huang Haozhang 
Published: January 2024

Abstract
Background
Previous Mendelian studies identified a causal relationship between renal function, as assessed by estimated glomerular filtration rate (eGFR), and severe infection with coronavirus disease 2019 (COVID-19). However, much is still unknown because of the limited number of associated single nucleotide polymorphisms (SNPs) of COVID-19 and the lack of cystatin C testing. Therefore, in the present study, we aimed to determine the genetic mechanisms responsible for the association between eGFR and COVID-19 in a European population.

Methods
We performed bidirectional Mendelian randomization (MR) analysis on large-scale genome-wide association study (GWAS) data; log-eGFR was calculated from the serum levels of creatinine or cystatin C by applying the Chronic Kidney Disease Genetics (CKDGen) Meta-analysis Dataset combined with the UK Biobank (N = 1,004,040) and on COVID-19 phenotypes (122,616 COVID-19 cases and 2,475,240 controls) from COVID19-hg GWAS meta-analyses round 7. The inverse-variance weighted method was used as the main method for estimation.

Results
Analyses showed that the genetically instrumented reduced log-eGFR, as calculated from the serum levels of creatinine, was associated with a significantly higher risk of severe COVID-19 (odds ratio [OR]: 2.73, 95% confidence interval [CI]: 1.38–5.41, P < 0.05) and significantly related to COVID-19 hospitalization (OR: 2.36, 95% CI: 1.39–4.00, P < 0.05) or infection (OR: 1.24, 95% CI: 1.01–1.53, P < 0.05). The significance of these associations remained when using log-eGFR based on the serum levels of cystatin C as genetically instrumented. However, genetically instrumented COVID-19, regardless of phenotype, was not related to log-eGFR, as calculated by either the serum levels of creatinine or cystatin C.

Conclusions
Our findings suggest that genetical predisposition to reduced kidney function may represent a risk factor for COVID-19. However, a consistent and significant effect of COVID-19 on kidney function was not identified in this study.
Impact of a one-year supervised physical activity program on long-term cancer-related fatigue and mediating effects of the gut microbiota in metastatic testicular cancer patients: protocol of the prospective multicentre, randomized controlled phase-III STARTER trial
Authors: Noh Hwayoung , Anota Amélie , Mongondry Rodolf , Meyrand Renaud , Dupuis Carmen , Schiffler Camille , Marijnen Philippe , Rinaldi Sabina , Lachuer Joel , Keski-Rahkonen Pekka , Gunter Marc J , Fléchon Aude , Fervers Béatrice , Pérol Olivia 
Published: January 2024

Abstract
Background
Testicular germ cell tumours (TGCTs) are the most common malignancy in men aged 15–40 years, with increasing incidence worldwide. About 33 ~ 50% of the patients present with metastatic disease at diagnosis. TGCT survivors experience short- and long-term sequelae, including cancer-related fatigue (CRF). Physical activity (PA) has established effects on reducing CRF and other sequelae and improving health-related quality of life (HRQoL). However, its impact on TGCT survivors has so far received little attention. The gut microbiota plays a crucial role in various physiological functions, including cognition and metabolism, and may mediate the effects of PA on CRF and other sequelae, but this has not been investigated in randomized controlled trials.

Methods
This national, multicentre, phase-III trial will evaluate the impact of a one-year supervised PA program on CRF and other short- and long-term sequelae in metastatic TGCT patients receiving cisplatin-based chemotherapy combined with etoposide+/-bleomycin. It will also investigate potential mediating effects of the gut microbiota and its metabolites involved in the gut-brain axis on the relationship between PA and CRF and other sequelae. A total of 236 men ≥ 18 years of age with metastatic TGCT (seminoma and non-seminoma) will be enrolled before starting first-line chemotherapy in several French hospitals. The primary (CRF) and secondary (cognitive/psychological/metabolic sequelae, HRQoL, etc.) outcomes and gut microbiota and relevant metabolites will be assessed at inclusion, during and at the end of the one-year intervention, and annually until 10 years since inclusion to assess long-term sequelae, more specifically CRF, cardiovascular toxicities, and second primary cancer occurrence in this population.

Discussion
This trial will provide comprehensive and novel insights into the effects of a long-term supervised PA program on CRF and other sequelae in metastatic TGCT patients receiving first-line chemotherapy. It will also contribute to understanding the potential role of the gut microbiota and its metabolites in mediating the effects of PA on these outcomes. The findings of this study will help the development of effective PA interventions to improve the health of TGCT survivors and may have implications for other cancer populations as well.

Trial registration
The study was registered on ClinicalTrials.gov (NCT05588700) on 20 Oct. 2022.
Possible unusual presentation of opioid side effect in a child: a case report
Authors: Jihane Moukhaiber , Zavi Lakissian , Marianne Majdalani 
Published: January 2024

AbstractAtypical presentations are commonly encountered in the Pediatric intensive care unit (PICU) but having a high index of suspicion is crucial to prevent or treat severe and life-threatening conditions. This case describes the clinical presentation and course of a 14-month-old girl with congenital heart disease who was admitted to the PICU after cardiac repair and remained agitated, irritable, in hysteria and delirium despite adequate sedation. Different measures to relieve her condition were attempted but to no avail. All the common causes of this atypical presentation including pain, ventilator induced agitation, low cardiac output syndrome (LCOS), opioid side effects, toxicity, opioid induced neurotoxicity (OIN) as well as withdrawal syndrome were ruled out. However, the use of naloxone as a last resort after exhausting all the other options has led to immediate and successful reversal of her symptoms.