bluuebunny/crossref_metadata_2025_split huggingface dataset:
Industrial eco-efficiency of resource-based cities in China: Spatial-temporal dynamics and associated factors
Authors: Chen Yueying , Chen Yanbin , Yin Guanwen , Liu Yujie 
Published: June 2023

Abstract

Promoting the greening of industry is the key to achieving high-quality and sustainable development of the urban economy. It is particularly important for resource-based cities (RBCs) that exploit natural resources as the leading industries. In this paper, the Windows-Bootstrap-DEA model was used to calculate the industrial eco-efficiency (IEE) of 114 RBCs in China from 2003 to 2016, and the regional differences and dynamic evolution characteristics of the IEE were analyzed. The panel Tobit model was used to explore the factors associated with IEE in RBCs. The results showed that the IEE of RBCs in China was at a low level during the study period, and the resource utilization process had not reached an optimal state. There were large regional differences in IEE, and there was a significant degree of spatial agglomeration. The results of conditional probability density estimation showed that the distribution of IEE had strong internal stability on the whole, and the distributions of IEE of RBCs in different regions, different resource types, and different development stages showed significant differences. The results of the panel Tobit model showed that per capita GDP, ownership structure, science and technology input, and industrial agglomeration had significant positive effects on IEE, while industrial structure and employment structure showed significant negative effects. The conclusions of this paper can provide a scientific decision-making basis for industrial transformation planning of RBCs.
Chiroptical detection and mutation analysis of cancer-associated extracellular vesicles in microfluidic devices with oriented chiral nanoparticles
Authors: Kotov Nicholas , Nagrath Sunitha , Kang Yoon-Tae , Kim Ji-Young , Emre Sumeyra , Jung Hee Jeong , Cha Minjeong , Kumari Abha , Palacios-Rolston Colin , Subramanian Chitra , Purcell Emma , Owen Sarah Nicole , Lim Chung-Man , Reddy Rishindra M , Ramnath Nithya 
Published: June 2023

Abstract
Cancer-cell secreted small-extracellular vesicles, also known as exosomes, represent a rapidly emerging family of nanoscale biomarkers for cancer and other diseases. While being high in information content, the current protocols for exosome profiling require complex procedures and equipment involving exosome purification, which prevents their broad utilization and timely diagnosis. Here we show that chiral gold nanoparticles with twisted disk geometry can isolate and profile cancer-associated exosome directly from blood plasma due to the marker-specific chiroptical response. The sub-100 nm pockets matching exosome dimensions, strong chiroplasmonic resonances in these pockets and horizontal orientation of the disk-shaped particles facilitate vesicle capture and analysis. Exosomes from lung cancer patients can be distinguished from those from healthy donors by strongly enhanced polarization rotation signatures of nanoscale biomarkers. Mutation/deletion analysis of epidermal growth factor receptor suggest the possibility of rapid mutation profiling due to high specificity of their chiral interactions with nanoparticles. Compared to traditional techniques, even a single channel microfluidic device with nanoparticle films improves the sensitivity and detection speed by 14 times and 10 times, respectively, enabling the low-cost microfluidics for rapid and versatile profiling of disease markers.
The impact of super-selective episiotomy on maternal short-term morbidity
Authors: Naimi Ammar Al , Radner Gazal , Jennewein Lukas , Brüggmann Dörthe , Louwen Frank 
Published: June 2023

Abstract
Purpose: Our aim is to investigate the risk of short-term maternal morbidity caused by super-selective clinical use of episiotomies (rate of below 0.02). A secondary aim is to compare our risk of severe perineal tears to the state-wide risk.
Methods: This is a retrospective cohort study investigating the effect of super-selective episiotomy on the risk of severe perineal tears and blood loss.
Results: The study included 10992 women who delivered between 2008-2018. Episiotomies were performed in 171 cases (1.56%), 3 of which (1.75%) experienced severe perineal tears compared to 156 (1.44%) in the control cohort. The adjusted odds ratio of severe perineal tears was 0.99 (0.95 CI 0.30, 3.26 p-value 0.98). Multivariate linear regression showed that episiotomies increased blood loss by 77.47 ml (0.95 CI 34.34, 120.59 p-value <0.0001). Episiotomies were performed in 23% (0.95 CI 0.228, 0.23) of vaginal deliveries in the state of Hessen with a risk of severe perineal tears of 0.0143 (0.95 CI 0.0139, 0.0147) compared to 0.0145 (0.95 CI 0.0123, 0.0168) in our entire cohort.
Conclusion: Institutionally implemented super-selective use of episiotomy does not increase the risk of higher-grade perineal tears but leads to increased blood loss. Therefore, episiotomies potentially increase maternal morbidity.
Unveiling the Dot-perspective Task: Integrating Implicit-mentalistic with Sub-mentalistic Processes
Authors: Fan Cong , Susilo Tirta , Low Jason 
Published: June 2023

Abstract
Adults’ performances on the dot-perspective task showed a consistency effect: participants were slower to judge their own visual perspective when their own perspective and others’ perspective were different compared to when both perspectives were the same. This effect has been explained by two competing accounts. The implicit mentalising account suggests the effect arises from relatively automatic tracking of others’ visual perspectives. The submentalising account suggests the effect arises from domain-general attentional orienting. We conducted three experiments to adjudicate between accounts. Experiment 1 manipulated eye-head directional cues (gaze-averted-face versus head-averted-face) and measured its effect on implicit mentalising (in the dot-perspective task) and attentional orienting (in the Posner task). Eye-head directional cues modulated attentional orienting but not implicit mentalising, supporting the importance of visual access and the existence of implicit mentalising in the dot-perspective task. Experiment 2 compared effect of gaze-averted versus finger-pointing agents. Finger-pointing direction might induce attentional orienting effects on both tasks. Experiment 3 combined finger-pointing with manipulation of agent’s visual access (eyes-sighted versus eyes-covered) on the dot-perspective task. Visual access did not modulate the consistency effect when finger-pointing was simultaneously displayed. The findings of Experiments 2 and 3 indicated the contribution of the sub-mentalistic process to dot-perspective task. Overall, the findings suggest that implicit mentalising and submentalising may co-exist in human social perceptual processes. Visual access appears to play a dominant role in modulating implicit mentalising on the dot-perspective task, but the process may be interfered by finger-pointing cues (more salient than gaze cues) via a sub-mentalistic attentional-orienting mechanism.
Expression Profile of Glutathione-S-Transferase Gene Family in Response to Cu(OH)2 Nanopesticide in Maize
Authors: AKSAKAL Özkan 
Published: June 2023

Abstract
Glutathione-S-transferases (GSTs) are a large family of genes that play a major role in detoxifying pesticides and tolerance to abiotic stress in plants. Copper hydroxide nanopesticides [Cu(OH)2 NP] are nanostructures with two to three dimensions between 1-200 nm widely used in modern agriculture recently. There are very few studies on the eco-toxicological effects, behavior, and fate of these nanopesticides. In this study, one-week-old maize seedlings grown in a hydroponic medium were exposed to 10 mg/L Cu(OH)2 NP for 7 d, and root-shoot length, ASA and GSH content, GST enzyme activity, and expression of all GST genes were examined. Besides, maize seedlings were exposed to 100 µM CuSO4 for 7 d to evaluate the effect of copper ions. Results showed that both Cu(OH)2 NP and CuSO4 reduced root and shoot length. GST activity increased significantly after Cu(OH)2 NP exposure. Foliar application of Cu(OH)2 NP or CuSO4 led to an accumu1ation of Cu in roots and shoots, and increased contents of GSH, GSSG, and DHA, but they reduced ASA level. Exposure to Cu(OH)2 NP induced remarkable changes in the expression levels of GST genes in shoots and roots of maize seedlings; while 14 GST genes were up-regulated in shoots and 13 in roots, 7 GST genes were down-regulated in shoots and 8 in roots. The expression level of 17 genes in shoots and roots did not change. A similar trend for GST genes was also observed in CuSO4-treated seedlings. This indicated that most of the changes in GST gene expression were due to the released copper ions.
Clinical efficacy of arthroscopic-assisted anchor fixation VS hook plate for the treatment of acute acromioclavicular joint dislocation
Authors: Zhang Qing , Xiang Zhou , Xiang Ming , Chen Guo , Yang Jinsong , Dai Fei 
Published: June 2023

Abstract
Objective
To compare the clinical efficacy and imaging outcomes of hook plate fixation versus arthroscopically assisted coracoclavicular ligament reconstruction with two anchors for acute acromioclavicular joint dislocation (Rockwood III-V).
Methods
Ninety-eight patients with acute acromioclavicular joint dislocation (Rockwood III-V) who were admitted between January 2016 and June 2022 were included in the study. Patients were treated with either arthroscopically assisted coracoclavicular ligament reconstruction using two anchors or open reduction and hook plate fixation. Radiological findings were recorded at 3 months, 6 months, 1 year, and 2 years postoperatively, and shoulder function was evaluated using the ASES and Constant scores. Pain was evaluated using the VAS score, and shoulder range of motion was recorded.
Results
The study included 79 male and 19 female patients, with 37 left-side and 61 right-side dislocations. The patients' ages ranged from 21 to 60 years, with a mean age of 37.6 years. Fifty-five patients underwent arthroscopically assisted coracoclavicular ligament reconstruction using two metal anchors, and 43 patients underwent open reduction and hook plate fixation. The mean follow-up period was 25.4 months. At 3 and 6 months postoperatively, the pain scores in the anchor group were significantly lower than those in the hook plate group. There was no significant difference in pain scores between the two groups at 1 and 2 years postoperatively. At 3 and 6 months postoperatively, the ASES and Constant scores in the anchor group were significantly higher than those in the hook plate group. There was no significant difference in ASES and Constant scores between the two groups at 1 and 2 years postoperatively. At 3 and 6 months postoperatively, the anchor group showed significantly better forward flexion and external rotation than the hook plate group. There was no significant difference in flexion and external rotation between the two groups at 1 and 2 years postoperatively. At 3 months, 6 months, 1 year and 2 years after surgery, there was no statistical difference in internal rotation between the two groups.Two patients in the anchor group had complete loss of reduction at 1-month follow-up. One patient in the hook plate group had internal fixation loosening.
Conclusion
Arthroscopically assisted coracoclavicular ligament reconstruction using two metal anchors is an effective method for the treatment of acute acromioclavicular joint dislocation. This technique provides earlier restoration of shoulder function with less pain compared to hook plate fixation, and it can reduce surgical trauma and improve surgical efficiency.
Strategies for monitoring and evaluation of climate change adaptation: localizing global approaches into Andean realities
Authors: Garces Alexandra , Llambi Luis Daniel , Bustamante Macarena , Dupuits Emilie 
Published: June 2023

Abstract
While there is increasing progress made at the global scale on understanding climate change impacts and implementing adaptation solutions, there is still a major gap in documenting and assessing the effectiveness of monitoring and evaluation (M&E) systems for climate change (CC) adaptation. This is particularly challenging if we consider the diversity of local perceptions and interpretations of what CC adaptation concretely means and how to measure it. This is even more complex in developing countries, where CC adaptation and socioeconomic development go hand in hand. This paper offers a brief literature review of the approaches on M&E to CC adaptation that have been designed at the global scale. Based on this contextual analysis, we evaluate to what extent these global approaches are being localized in monitoring the effectiveness of public policies and territorial strategies for CC adaptation in the Andes. The analysis draws on four national and local case studies in Colombia, Ecuador, Peru and Bolivia. The analysis is based on a review of the status of national programs for M&E of CC adaptation and the implementation in those countries of the project “Adaptation to Climate Change Impacts in Water Resources in the Andes” (AICCA). The M&E systems in the four case studies differed widely in the way in which global M&E approaches are localized, reflecting the diversity of conceptions, goals, strategies and contexts in which adaptation is being implemented. Despite the diversity of implementation contexts and the complexity of monitoring the responses of socio-ecological systems, the M&E proposals analyzed share a focus on biophysical indicators over sociopolitical and institutional indicators. In addition, this study emphasizes the need to further implement participatory M&E systems from the community, to improve the territorial articulation of M&E proposals in the Andean region.
An online survey of UK medical students’ experiences of undergraduate medical education activities during the crisis of COVID-19; lessons to inform future inclusivity
Authors: Harrison Michael , Clarke Nicola , Ramanathan Agalya , Premadasan Yathavan , Hunt Julia Hamer , Park Sophie 
Published: June 2023

Abstract
Background
The COVID-19 pandemic has caused significant disruption to clinical and non-clinical medical education. This study aims to elicit the views of UK medical students about teaching and learning activities during this time, including barriers and facilitators to participation and their status as essential workers.
Method
Following stakeholder consultation, a cross-sectional questionnaire was designed based upon five categories of participation - on-site and off-site clinical, synchronous and asynchronous remote learning and other e.g., voluntary or paid work. The survey was made accessible online to all UK medical students. Quantitative data of student participation was analysed to provide context for thematic analysis of qualitative responses in order to understand students’ perceptions and experiences.
Results
207 UK medical students from eight UK medical schools, with a range of degree durations and across different geographical areas. Students participated in a range of face-to-face and virtual teaching activities, favouring on-site clinical learning. Students valued interaction with patients, peers and tutors and timely feedback across all teaching methods. Attendance at clinical placement was facilitated by access to private transport. Remote learning was facilitated by access to broadband and devices. Access to confidential spaces improved engagement with remote clinical learning.
Most students disagreed with their status as an essential worker, with many questioning their clinical ‘value’ in comparison to other essential workers or with other paid/voluntary activities. However, some acknowledged the value of access to clinical placements, personal protective equipment (PPE) and vaccines that the status allowed.
Conclusions
Medical schools can optimise learning by increasing interactivity with patients, peers and tutors, regardless of teaching format. Engagement with all learning activity types was impacted by access to certain resources, including transport, devices and confidential space. Students from disadvantaged backgrounds are arguably less likely to have access to these resources. Medical schools need to maximise inclusive strategies to support all students.
Students’ perceived own professional value and identity as ‘essential workers’ is debatable. To ensure legitimate identity formation during their medical degrees their sense of belonging and role within clinical teams must be supported.
Effects of exercise on autonomic cardiovascular control in individuals with chronic, motor-complete spinal cord injury: an exploratory randomised clinical trial
Authors: Dorey Tristan , Nightingale Tom , Alrashidi Abdullah , Thomas Stefan , Currie Katharine , Hubli Michele , Balthazaar Shane , Krassioukov Andrei 
Published: June 2023

Abstract

Study Design:
Secondary analysis of a clinical trial.
Objective:
To assess the impact of 6 months of arm-cycle ergometer training (ACET), or body weight supported treadmill training (BWSTT), on autonomic cardiovascular responses to a laboratory sit-up test (SUT) in individuals with chronic (≥1-year post-injury) spinal cord injury (SCI).
Setting: Canada.
Methods:
Sixteen individuals with motor-complete (American Spinal Injury Association Impairment Scale A-B) SCI between the fourth cervical and sixth thoracic spinal cord segments, aged 39±11 years, were assessed. Participants were randomized to receive 72 sessions of moderate-to-vigorous intensity ACET (n=8) or passive BWSTT (n=8). Changes in mean arterial pressure (MAP; finger plethysmography), hemodynamics (Modelflow® method), and heart rate/heart rate variability (HR/HRV; electrocardiography) were measured in response to SUT before and after 6 months of exercise training. Spontaneous cardiovagal baroreflex sensitivity (cvBRS) was assessed using the sequence method.
Results:
Neither ACET nor BWSTT impacted hemodynamic responses to SUT or the incidence of orthostatic hypotension (all P>0.36). ACET led to increased HR and high frequency (HF) power HRV responses (interaction effects, both P<0.01) to SUT following 6 months of training compared to BWSTT. Consistent with this, cvBRS improved (P<0.05) following ACET but not BWSTT. At the group level, improvements in cvBRS were highly correlated with both the HR (r=0.726, P<0.0001) and HF power (R=-0.484, P<0.01) responses to SUT.
Conclusion:
Six months of exercise training had no effect on BP responses to SUT in individuals with SCI. However, ACET, but not BWSTT, improved cardiovagal baroreflex control of HR in individuals with chronic, motor-complete SCI, suggesting benefits of volitional upper-body exercise.
Clinical Trial Registration: NCT01718977
L-shaped association between ankle-brachial index and coronary heart disease in Chinese adults with hypertension
Authors: Zhou Wei , Yu Chao , Wang Tao , Zhu Lingjuan , Bao Huihui , Cheng Xiaoshu 
Published: June 2023

Abstract
Purpose
Previous studies have shown that ankle-brachial index (ABI) ≤ 0.9 is independently and positively correlated with cardiovascular events, including coronary heart disease (CHD), However, ABI, as a classified variable, has limited effect in exploring the relationship between CHD. We aimed to investigate the association of ABI level with CHD in hypertensive population.
Methods
This cross-sectional analysis based on the registration study of H-type hypertension in China included 10,900 hypertensive patients. Multivariable linear regression and multivariable binary logistic regression analyses were conducted to assess the associations between WWI and MMSE and dementia, respectively.
Results
The study participants had a mean (SD) age of 68.3 (9.25) years and 5129 (47.06%) were men. The outcome was CHD. There were 552 (5.06%) participants who had CHD in10900 hypertensive participants. Overall, there was an L-shaped association of ABI with CHD. The full adjusted OR of CHD for participant's ABI level were 0.75 (95%CI: 0.33–1.71). Association of ABI with CHD was evaluated binary logistic regression model, which figured out the turning point was 1.07. On the left of the turning point, ABI is negatively correlated with CHD (OR: 0.27; 95%CI:0.08–0.84), while the prevalence of CHD does not decrease with the increase of ABI level on the right of turning point (OR: 3.08; 95%CI:0.60–15.80).
Conclusion
The results of stratified analysis showed that ABI and CHD were L-shaped related. In this large-scale cross-sectional study, ABI has a nonlinear L-shaped association with CHD in Chinese adult with high blood pressure and its inflection point was 1.07.
Association between arterial carbon dioxide, brain biomarkers and central nervous system injury during veno-venous extracorporeal membrane oxygenation: A Prospective Cohort Study.
Authors: Thiara Sonny , Stukas Sophie , Hoiland Ryan , Wellington Cheryl , Tymko Mike , Isac George , Finlayson Gordon , Kanji Hussein , Romano Kali , Hirsch-Reinshagen Veronica , Sekhon Mypinder , Griesdale Donald 
Published: June 2023

Abstract
Background Central nervous system (CNS) injury following initiation of veno-venous extracorporeal membrane oxygenation (VV-ECMO) is common. An acute decrease in PaCO2 following VV-ECMO initiation has been suggested as an etiological factor, but the challenges of diagnosing CNS injuries has made discerning a relationship between PaCO2 and CNS injury difficult.Methods We conducted a prospective cohort study of adult patients undergoing VV-ECMO for acute respiratory failure. We collected blood biospecimens to measure brain biomarkers (neurofilament light [NF-L]; glial fibrillary acidic protein [GFAP]; and phosphorylated-tau 181 [p-tau 181]) in the first seven days following initiation of VV-ECMO. We assessed the relationship between both PaCO2 over the first 24-hours and brain biomarkers with CNS injury using mixed methods linear regression.Results In our cohort twelve of 59 (20%) patients had overt CNS injury identified on head CT. The PaCO2 decrease with VV-ECMO initiation was steeper in patients who developed a CNS injury (-0.32%, 95%CI: -0.25 to -0.39) compared to those without (-0.18%, 95%CI: -0.14 to -0.21, P-interaction < 0.001). The mean concentration of NF-L increased over time and was higher in those with a CNS injury (464 [739]) compared to those without (127 [257])(P = 0.001). GFAP was higher in those with a CNS injury (4278 [11653] pg/ml) compared to those without (116 [108] pg/ml) (P < 0.001).Conclusions Although rapid decreases in PaCO2 following initiation of VV-ECMO were slightly greater in patients that had CNS injuries vs. those without, data overlap and absence of relationships between PaCO2 and brain biomarkers suggests other pathophysiologic variables are likely at play.