bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adequacy of In-Mission Training to Treat Tibial Shaft Fractures in Mars Analog Testing
Authors: Manon Julie , Saint-Guillain Michael , Pletser Vladimir , Buckland Daniel Miller , Vico Laurence , Dobney William , Baatout Sarah , Wain Cyril , Jacobs Jean , Comein Audrey , Drouet Sirga , Meert Julien , Casla Ignacio Sanchez , Chamart Cheyenne , Vanderdonckt Jean , Cartiaux Olivier , Cornu Olivier 
Published: May 2023

Abstract
Long bone fractures are a concern in long-duration exploration missions (LDEM) where crew autonomy will exceed the current Low Earth Orbit paradigm. Current crew selection assumptions require extensive complete training and competency testing prior to flight for off-nominal situations. Analog astronauts (n=6) can be quickly trained to address a single fracture pattern and then competently perform the repair procedure. An easy-to-use external fixation (EZExFix) was employed to repair artificial tibial shaft fractures during an inhabited mission at the Mars Desert Research Station (Utah, USA). Bone repair safety zones were respected (23/24), participants achieved 79.2 % repair success, and median completion time was 50.04 minutes. Just-in-time training in-mission was sufficient to become autonomous without pre-mission medical/surgical/mechanical education, regardless of learning conditions (p>0.05). Similar techniques could be used in LDEM to increase astronauts’ autonomy in traumatic injury treatment and lower skill competency requirements used in crew selection.
Identification of Stage-Specific Differentially Expressed Genes and Network Meta-Analysis Reveals Potential Molecular Signatures in Chronic Hepatitis E Virus Infection
Authors: Shafat Zoya , Farooqui Anam , Tamkeen Naaila , Islam Asimul , Chaudhary Anis Ahmad , Alawam Abdullah S. , Almuqri Eman Abdullah , Parveen Shama 
Published: May 2023

Abstract
Background
Hepatitis E virus (HEV) is the major pathogen responsible for chronic hepatitis infection (CHE) in solid organ transplant recipients. As CHE seems to be dependent on patient’s immunological status, in this context, a comprehensive assessment of gene-, pathway-, and network-level interaction was accomplished to identify key regulators in CHE. To our knowledge, this study conducted novel analysis on the NCBI-GEO obtained mRNA expression profile comprising all three HEV infection stages, i.e., mild, moderate and severe.
Methods
The patients with CHE were separated into 3 groups according to the time of HEV clearance (early, late, or no HEV clearance at the time of analysis). Gene expression analysis was applied on microarray profile dataset, consisting of control samples (kidney transplant recipients without HEV) and infected samples (kidney transplant recipients with HEV), to unveil the differentially expressed genes (DEGs). Interrelationship among DEGs was studied to identify the overlapping DEGs, which were utilized for the construction of the protein-protein interaction (PPI) network. Additionally, the significant modules were identified form the PPI network. Gene term and pathway enrichment analyses were employed on the identified DEGs. Subsequently, the identified hub gene-associated miRNAs were undertaken for enrichment analysis.
Results
Our analysis revealed a total of 69, 157, and 411 specific DEGs which included 34 upregulated and 35 downregulated genes, 138 upregulated and 19 downregulated genes, and 326 upregulated and 85 downregulated genes for mild, moderate, and severe CHE respectively. Interestingly, we found upregulated expression levels of 8 genes BATF2, OASL, IFI44L, IFIT3, RSAD2, IFIT1, RASGRP3 and IFI27, which shows their association with persistent HEV infection. Of these genes, 6 (OASL, IFI27, IFIT1, IFIT3, RSAD2 and IFI44L) made into the PPI network and were common at each stage, thus, could serve as important area of interest for further research. Enrichment analysis showed DEGs association with binding and catalytic activities, viral replication and interferon signaling pathways. Furthermore, we identified key gene associated-miRNAs (miR-129-2-3p, miR-130a-3p, miR-138-5p, miR-212-3p, miR-221-3p, miR-27b-3p and miR-29c-3p).
Conclusions
The current study might provide insights into these identified key genes and pathways which could be targeted to offer better interventions for CHE in future biological research.
Long-term outcomes of delayed clozapine initiation in treatment-resistant schizophrenia: A multicenter retrospective cohort study
Authors: Hatano Masakazu , Kamei Hiroyuki , Takeuchi Ippei , Gomi Kazuhiko , Sakakibara Takashi , Hotta Shogo , Esumi Satoru , Tsubouchi Kiyotaka , Shimizu Yoshihito , Yamada Shigeki 
Published: May 2023

Abstract
Background
Clozapine is the only antipsychotic medication with proven efficacy against treatment-resistant schizophrenia. This multicenter retrospective cohort study aimed to evaluate the impact of a delay in clozapine initiation on long-term outcomes.
Methods
Patients who initiated clozapine treatment between July 2009 and December 2018 were included in this study. According to the length of time from the diagnosis of schizophrenia to the clozapine initiation, the patients were categorized into one of three groups: early (≤ 9 years), intermediate (10–19 years), and late (≥ 20 years) initiation. The endpoints were psychiatric rehospitalization, all-cause clozapine discontinuation, and treatment failure at 3 years. Hazard ratios (HR) and 95% confidence interval (CI) were estimated using the Fine and Gray method or the Cox proportional hazards model.
Results
The incidence rates of rehospitalization at 3 years according to the cumulative incidence function were 32.3% for early, 29.7% for intermediate, and 62.2% for late initiation, respectively. Late initiation had a significantly higher risk of rehospitalization than both early (HR, 2.94; 95% CI, 1.01– 8.55; P = 0.016 by the Gray's test) and intermediate initiation (HR, 3.13; 95% CI, 1.34–7.30; P = 0.0025 by the Gray's test). The incidence rate of all-cause clozapine discontinuation at 3 years using the Kaplan–Meier method were 13.0% for early, 10.6% for intermediate, and 20.1% for late initiation. The risk of all-cause clozapine discontinuation was not significantly among the groups. The late initiation group showed significantly increased risk of treatment failure only when using univariate analysis. The late initiation group had more patients discontinuing because of death due to physical diseases than the other groups.
Conclusions
The study suggests that clozapine should be initiated promptly in patients with treatment-resistant schizophrenia to prevent psychiatric rehospitalization during long-term treatment. Further studies of higher quality, with appropriate consideration of patient characteristics, and with larger sample sizes are needed.
Cdk5rap3 as a modulator of the UFMylation pathway is indispensable for survival and function of pancreatic acinar cells
Authors: Yonghong Huang , Quintero Michaela , Siyang Liu , Cong Liu , Zhu Guangxun , Yafei Cai , Dong Zheng , Bollag Roni , Sabbatini Maria Eugenia , Honglin Li 
Published: May 2023

Abstract
The acinus is the functional unit of the exocrine pancreas that produces and secretes a large amount of digestive enzymes. Damage and dysfunction of pancreatic acinar cells (PACs) may lead to malnutrition, pancreatitis and other pathological conditions. To cope with the high demand of protein synthesis and secretion, PACs possess an extensive network of rough endoplasmic reticulum (RER) where proteins are translated, modified and transported to Golgi apparatus for further modifications and packaging into zymogen granules (ZGs). The UFM1 (Ubiquitin fold modifier 1) conjugation system has been reported to clear up jammed nascent proteins on the ER membrane and maintain the ER homeostasis. Cdk5rap3 is one of the key components of the UFM1 system and its physiological function and working mechanism is currently under active investigation. We investigated its role in pancreatic homeostasis of protein synthesis using a PAC-specific knockout mouse model. We found that ablation of Cdk5rap3 in PACs led to fewer ZGs, loss of RER, acinar to ductal metaplasia (ADM) and degeneration of the acini compartment. Then, we further tested if it is involved in co-translational quality control of ER proteins. Interestingly, we found that the protein level of the ribosomal stalling reporter was much higher in Cdk5rap3 knockout cells, suggesting that Cdk5rap3 is a part of the quality control mechanism of ER proteins. Furthermore, we found that the reduced level of Cdkrap3 was correlated with human pancreatic diseases. Together, our results strongly suggest that Cdk5rap3 is essential for the survival and function of pancreatic acinar cells.
A process-based analysis of Arctic Ocean warming in response to increasing CO2
Authors: Saenko Oleg , Gregory Jonathan , Tandon Neil 
Published: May 2023

Abstract
Using an ensemble of atmosphere–ocean general circulation models (AOGCMs) in an idealized climate change experiment, this study evaluates the contribution of different ocean processes to Arctic Ocean warming. On the AOGCM-mean, the Arctic Ocean warming is greater than the global ocean warming in the volume mean, and at most depths within the upper 2000~m. The Arctic warming is greatest a few 100~m below the surface and is dominated by the import of extra heat which is added to the ocean at lower latitude and is conveyed to the Arctic via the large-scale barotropic ocean circulation. The change in strength of this circulation in the North Atlantic is relatively small and not correlated with the Arctic Ocean warming. The Arctic Ocean warming is opposed and substantially mitigated by the weakening of the Atlantic meridional overturning circulation (AMOC), though the magnitude of this effect has a large model spread. By reducing the northward transport of heat, the AMOC weakening causes a redistribution of heat from high latitude to low latitude. Within the Arctic Ocean, the propagation of heat anomalies is influenced by broadening of cyclonic circulation in the east and weakening of anticyclonic circulation in the west. On the model-mean, the Arctic Ocean warming is most pronounced in the Eurasian Basin, with large spread across the AOGCMs, and accompanied by subsurface cooling by diapycnal mixing and heat redistribution by mesoscale eddies.
Block-chain Abnormal Transaction Detection Method Based on Auto-encoder and Attention Mechanism
Authors: Xiong Ao , Qiao Chenbin , Tong Yuanzheng , Qi Baozhen , Jiang Chengling 
Published: May 2023

Abstract
The significant changes brought by block-chain technology have posed many challenges to financial services, ecological security, and privacy protection. Therefore, in order to achieve intelligent block-chain supervision and assess the risk of potential money laundering, terrorist financing, and other financial crimes of customers, anomaly detection of blockchain networks is required. Structurally, blockchain data is essentially represented by a graph, where nodes represent addresses and edges represent behaviors such as transactions, and the model after constructing the transaction graph can extract high-dimensional features in the graph structure relationships. Existing anomaly detection methods ignore the interaction information between network structure and node attributes and have limited ability to detect anomalies. Based on this, this paper proposes GraphAEAtt, a deep learning framework based on self-encoder and attention mechanism, which consists of a structural auto-encoder and an attribute auto-encoder to jointly learn node and attribute feature vector representations, and in addition, introduces an attention mechanism to learn the correlation between nodes and their neighboring nodes. First the structural encoder converts the observed raw node attributes into a vector representation of the low-dimensional potential space, and then the shared attention mechanism is used to aggregate the embeddings of all neighboring nodes to finally generate node embedding. The attribute encoder uses a multi-layer perceptron to map the observed attribute data into a potential attribute embedding representation. Then, a structure decoder is used to reconstruct the adjacency matrix and an attribute decoder to reconstruct the attribute matrix, and the reconstruction error of the nodes is measured from both structure and attribute perspectives as the objective function for neural network training. Then anomaly detection is implemented based on the reconstruction error of the nodes measured from both structure and attribute perspectives. Finally, a large number of experiments are conducted to verify the effectiveness of the proposed method in real datasets.
Designing an Improved Deep Learning-based Model for COVID-19 Recognition in Chest X-ray Images: A Knowledge Distillation Approach
Authors: BabaAhmadi AmirReza , Khalafi Sahar , ShariatPanahi Masoud , Ayati Moosa 
Published: May 2023

Abstract

Background and Objectives:
COVID-19 has adversely affected humans and societies in different aspects. Numerous people have perished due to inaccurate COVID-19 identification and, consequently, a lack of appropriate medical treatment. Numerous solutions based on manual and automatic feature extraction techniques have been investigated to address this issue by researchers worldwide. Typically, automatic feature extraction methods, particularly deep learning models, necessitate a powerful hardware system to perform the necessary computations. Unfortunately, many institutions and societies cannot benefit from these advancements due to the prohibitively high cost of high-quality hardware equipment. As a result, this study focused on two primary goals: first, lowering the computational costs associated with running the proposed model on embedded devices, mobile devices, and conventional computers; and second, improving the model's performance in comparison to previously published methods (at least performs on par with state of the art models) in order to ensure its performance and accuracy for the medical recognition task.
Methods
This study used two neural networks to improve feature extraction from our dataset: VGG19 and ResNet50V2. Both of these networks are capable of providing semantic features from the nominated dataset. Streaming is a fully connected classifier layer that feeds richer features, therefore feature vectors of these networks have been merged, and this action resulted in satisfactory classification results for normal and COVID-19 cases. On the other hand, these two networks have many layers and require a significant amount of computation. To this end, An alternative network was considered, namely MobileNetV2, which excels at extracting semantic features while requiring minimal computation on mobile and embedded devices. Knowledge distillation (KD) was used to transfer knowledge from the teacher network (concatenated ResNet50V2 and VGG19) to the student network (MobileNetV2) to improve MobileNetV2 performance and to achieve a robust and accurate model for the COVID-19 identification task from chest X-ray images.
Results
Pre-trained networks were used to provide a more useful starting point for the COVID-19 detection task. Additionally, a 5-fold cross-validation technique was used on both the teacher and student networks to evaluate the proposed method's performance. Finally, the proposed model achieved 98.8% accuracy in detecting infectious and normal cases.
Conclusion
The study results demonstrate the proposed method's superior performance. With the student model achieving acceptable accuracy and F1-score using cross-validation technique, it can be concluded that this network is well-suited for conventional computers, embedded systems, and clinical experts' cell phones.
The Effect of Eight Weeks of Stop-X and FIFA 11+ Kids Warm-Up on Proprioception and Balance in Football Players with Dynamic Knee Valgus
Authors: Eslami Adeleh , Sahebozamani Mansour , Bahiraei Saeid 
Published: May 2023

Abstract
Background
This study examined the effect of neuromuscular programs on proprioception and balance in athletes with dynamic knee valgus (DKV) defects.
Methods
The present investigation involved the purposive and random allocation of 45 male soccer players with dynamic knee valgus (DKV) defects into three distinct groups: a control group (n = 15, age = 11.40 ± .74, weight = 36.24 ± 5.31, height = 140.73 ± 3.34, BMI = 19.93 ± 3.74, sport experience = 2.47 ± .52), Fifa11 + kids group (n = 15, age = 11.07 ± .88, weight = 32.61 ± 3.53, height = 138.40 ± 3.38, BMI = 16.03 ± 2.18, sport experience = 2.39 ± .42), and Stop-X group (n = 15, age = 11.40 ± .74, weight = 37.00 ± 4.10, height = 141.47 ± 4.63, BMI = 17.27 ± 2.22, sport experience = 2.27 ± .46). The leg landing test (ICC = 0.87), knee proprioception (ICC = 0.801), and stork balance (ICC = 0.76) were utilized for both pre- and post-implementation of the training protocol. After identifying the variables, the participants in the training cohort underwent an eight-week intervention consisting of the Stop X and FIFA 11 + Kids programs. The training programs included three sessions per week, each lasting between 20 and 25 minutes, while the control group followed their usual warm-up routine. A Mixed Repeated Measurement analysis was conducted using SPSS 26 software at a significance level of 0.05 to assess the differences between pre-test and post-test results.
Results
The study's results indicate a significant difference among the three groups in the Mixed Repeated Measurement test (p = 0.01). The Stop-X group showed significant differences compared to the control group (p = 0.01) and the FIFA11 + Kids group (p = 0.04) in terms of AKJPS. Moreover, the knee valgus in both the Stop-X (p = 0.03) and FIFA11 + Kids (p = 0.007) groups significantly differed from the control group. Additionally, there was a significant difference in stork balance before and after the intervention between the intervention groups and the control group.
Conclusion
The study findings suggest that Stop-X exercises are more effective than FIFA 11 + exercises in improving dynamic knee valgus and balance among young football players with knee valgus abnormalities.
Atezolizumab and Bevacizumab Combination in Advanced Hepatocellular Carcinoma; A Systematic Review of Economic Evaluations
Authors: Mohammadnezhad Ghader , Esmaily Hadi , Talebi Maryam , Jafari Matin 
Published: May 2023

Abstract
Background: Atezolizumab (ATZ) plus bevacizumab (BVC) co-administration is one of the newest systemic interventions in advanced hepatocellular carcinoma (AHCC). This treatment approach is more costly and more effective than other therapeutic interventions, and significantly improved AHCC survival and health-related quality of life.
Objectives: This economic study aimed to systematically review all cost-effectiveness analyses of ATZ/BVC combination in AHCC.
Method: To find all related economic evaluations, a comprehensive search in scientific databases was performed by a highly sensitive syntax. The target population was AHCC patients. The intervention was ATZ/BVC which was compared with sorafenib, nivolumab, and other anticancer strategies. We included studies that reported quality-adjusted life-years (QALYs) and/or life-years, costs, and incremental cost-effectiveness ratio (ICER), and finally, the characteristics of included studies were categorized.
Results: Out of 315 identified records, 12 cost-effectiveness analyses were eligible for inclusion in the systematic review. Treatment costs were significantly higher with ATZ/BVC in all studies (From 61,397 to 253,687 USD compared to sorafenib and nivolumab, respectively). Incremental QALYs varied from 0.35 to 0.86 compared to sintilimab/BVC and sorafenib, respectively. Although ICERs for drugs varied widely, all were united in the lack of cost-effectiveness of the ATZ/BVC. The willingness-to-pay threshold in all studies was lower than the ICER, which indicated a reluctance to pay for this treatment strategy by the health systems.
Conclusion: It can be concluded that ATZ/BVC combination is an expensive approach in AHCC management. Significant discounts in ATZ and BVC prices are essential for this novel approach to be cost-effective and extensively used.
U-Shaped Association Between Serum 25-hydroxyvitamin D concentrations and Urinary Leakage Among Adult Females Aged 45 Years and Over in the United States: A Cross-Sectional Study
Authors: Li Zeyu , Lu Xinzhuo , Zhang Keshuai , Wu Shuangyan , Yu Wei , Chen Xiaoling , Zheng Wenzhong 
Published: May 2023

Abstract
Background
The relationship between serum vitamin D status and urinary leakage (UL) among middle-aged females remains to be further studied. In this study, we aimed to evaluate the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with UL among American females ages 45 years and over.
Methods
We used seven cycles of the National Health and Nutrition Examination Survey (NHANES) with self-report UL data. A total of 9525 women, 45 years and older, were enrolled in this study. Univariate and multivariate logistic regression models and the smooth curve fitting were used to analyze the association between clinical UL and serum 25-hydroxyvitamin D [25(OH)D] concentrations.
Results
We observed a non-linear relationship between serum 25(OH)D concentrations and clinical UL. We found that when serum 25(OH)D concentration was higher than the inflection point 63.5, there was a positive correlation between serum 25(OH)D concentrations and clinical UL ([OR]: 1.007, 95%CI: 1.005–1.009, P < 0.01). However, when serum 25(OH)D concentration was lower than the inflection point 63.5, there was a negative correlation between serum 25(OH)D concentrations and clinical UL ([OR]: 0.993, 95%CI: 0.989–0.996, P < 0.01).
Conclusions
The association between serum vitamin D and the risk of UL followed an U-shaped relation among US middle-aged females, with an inflection point at 63.5 nmol/L serum 25(OH)D concentrations.
The spatiotemporal variability in precipitation gradients based on meteorological station observations in mountainous areas of Northwest China
Authors: Zhang Xi , Xu Min , Kang Shichang , Wu Hao , Han Haidong 
Published: May 2023

Abstract
Exploration of the spatiotemporal variability in precipitation gradients (PGs) is important for understanding the spatial differences in precipitation and optimizing hydrological process simulations. Here, the spatiotemporal distribution of precipitation and PG was analyzed in the Tianshan and Qilian Mountains based on national meteorological station data from 1961–2017. The relationships between PG and relative humidity and wind speed were explored. The results show that precipitation exhibits a significant increasing trend during last decades. Precipitation in the Tianshan Mountains is greater in the north and west, the maximum precipitation height (MPH) occurs at 1942.5 m a.s.l., and the precipitation change rate is higher in the west than in the east. Precipitation in the eastern Qilian Mountains is greater, the MPH is approximately 2850 m a.s.l., and the precipitation change rate decreases from the middle to the western and eastern sections. There are noticeable differences in PG between the two mountain areas. Annually, the PG in the Tianshan and Qilian Mountains, except for the Yili Valley, has increased significantly. The PG change rate in the western Qilian Mountains is higher. Monthly, the PG increases most significantly from June-August. Precipitation is positively correlated with elevation in the Tianshan Mountains from May-September and in the western and eastern sections of the Qilian Mountains every month, while that in the middle Qilian Mountains decreases with increasing elevation from November-January. The PG in both mountain regions experienced abrupt changes around the 1970s-1980s, and most areas increased significantly after the abrupt changes, showing a clear humidification phenomenon. Except for some subregions, PG is directly proportional to relative humidity and inversely proportional to wind speed.