bluuebunny/crossref_metadata_2025_split huggingface dataset:
International recommendations on epinephrine auto-injector doses often differ from standard weight-based guidance: a review and clinical proposals
Authors: Dreborg Sten , Walter Graham , Kim Harold 
Published: December 2022

AbstractBackgroundIn anaphylaxis, the dosing of injectable epinephrine in medical settings has been arbitrarily recommended to be 0.01 mg/kg of body weight. For ethical reasons, there have been no dose–response studies or double-blind studies performed on patients with active anaphylaxis. Intramuscular delivery of epinephrine has been the standard. Auto-injectors for use in the treatment of anaphylaxis are available in four strengths (0.1, 0.15, 0.3, and 0.5 mg). However, in many countries, only the 0.15 and 0.3 mg strengths are available. Consequently, many adult, heavy patients are prescribed the 0.3 mg dose, which may result in only one-fifth to one-third of the recommended weight-based dose being administered in heavy patients experiencing anaphylaxis. Underdosing may have therefore contributed to mortality in anaphylaxis.ObjectiveTo review the doses of epinephrine recommended for the treatment of anaphylaxis in the community, and assess whether recommendations should be made to increase dosing for heavy adult patients in hopes of avoiding future deaths from anaphylaxis.MethodsWe reviewed multiple national and international recommendations for the dosing of epinephrine. We also reviewed the literature on adverse drug reactions from epinephrine, lethal doses of epinephrine, and epinephrine dose-finding studies.ResultsThe majority of national and regional professional societies and authorities recommend epinephrine delivered by auto-injectors at doses far lower than the generally accepted therapeutic dose of 0.01 mg/kg body weight. Furthermore, we found that the recommendations vary even within regions themselves.ConclusionsWe suggest prescribing more appropriate doses of epinephrine auto-injectors based on weight-based recommendations. There may be some exceptions, such as for patients with heart disease. We hypothesize that these recommendations will lead to improved outcomes of anaphylaxis.
Activation of Piezo1 downregulates renin in juxtaglomerular cells and contributes to blood pressure homeostasis
Authors: Yang Xiaoqiang , Zeng Honghui , Wang Le , Luo Siweier , Zhou Yiming 
Published: December 2022

Abstract
Background
The synthesis and secretion of renin in juxtaglomerular (JG) cells are closely regulated by the blood pressure. To date, however, the molecular identity through which JG cells respond to the blood pressure remains unclear.

Results
Here we discovered that Piezo1, a mechanosensitive ion channel, was colocalized with renin in mouse kidney as well as As4.1 cells, a commonly used JG cell line. Activation of Piezo1 by its agonist Yoda1 induced an intracellular calcium increase and downregulated the expression of renin in these cells, while knockout of Piezo1 in JG cells abolished the effect of Yoda1. Meanwhile, mechanical stress using microfluidics also induced an intracellular calcium increase in wildtype but not Piezo1 knockout JG cells. Mechanistically, we demonstrated that activation of Piezo1 upregulated the Ptgs2 expression via the calcineurin-NFAT pathway and increased the production of Ptgs2 downstream molecule PGE2 in JG cells. Surprisingly, we discovered that increased PGE2 could decreased the renin expression through the PGE2 receptor EP1 and EP3, which inhibited the cAMP production in JG cells. In mice, we found that activation of Piezo1 significantly downregulated the renin expression and blood pressure in wildtype but not adeno-associated virus (AAV)-mediated kidney specific Piezo1 knockdown mice.

Conclusions
In summary, these results revealed that activation of Piezo1 could downregulate the renin expression in JG cells and mice, subsequently a reduction of blood pressure, highlighting its therapeutic potential as a drug target of the renin-angiotensin system.
Prediction of noninvasive ventilation failure using the ROX index in patients with de novo acute respiratory failure
Authors: Duan Jun , Yang Juhua , Jiang Lei , Bai Linfu , Hu Wenhui , Shu Weiwei , Wang Ke , Yang Fuxun 
Published: December 2022

Abstract
Background
The ratio of SpO2/FiO2 to respiratory rate (ROX) index is commonly used to predict the failure of high-flow nasal cannula. However, its predictive power for noninvasive ventilation (NIV) failure is unclear.

Methods
This was a secondary analysis of a multicenter prospective observational study, intended to update risk scoring. Patients with de novo acute respiratory failure were enrolled, but hypercapnic patients were excluded. The ROX index was calculated before treatment and after 1–2, 12, and 24 h NIV. Differences in predictive power for NIV failure using the ROX index, PaO2/FiO2, and PaO2/FiO2/respiratory rate were tested.

Results
A total of 1286 patients with de novo acute respiratory failure were enrolled. Of these, 568 (44%) experienced NIV failure. Patients with NIV failure had a lower ROX index than those with NIV success. The rates of NIV failure were 92.3%, 70.5%, 55.3%, 41.1%, 35.1%, and 29.5% in patients with ROX index values calculated before NIV of ≤ 2, 2–4, 4–6, 6–8, 8–10, and > 10, respectively. Similar results were found when the ROX index was assessed after 1–2, 12, and 24 h NIV. The area under the receiver operating characteristics curve was 0.64 (95% CI 0.61–0.67) when the ROX index was used to predict NIV failure before NIV. It increased to 0.71 (95% CI 0.68–0.74), 0.74 (0.71–0.77), and 0.77 (0.74–0.80) after 1–2, 12, and 24 h NIV, respectively. The predictive power for NIV failure was similar for the ROX index and for the PaO2/FiO2. Likewise, no difference was found between the ROX index and the PaO2/FiO2/respiratory rate, except at the time point of 1–2 h NIV.

Conclusions
The ROX index has moderate predictive power for NIV failure in patients with de novo acute respiratory failure.
On secrecy performance analysis of multi-antenna STAR-RIS-assisted downlink NOMA systems
Authors: Xu Shu , Liu Chen , Wang Hong , Qian Mujun , Li Jin 
Published: December 2022

AbstractTo accommodate the stringent requirements of enhanced coverage quality and improved spectral efficiency, simultaneous transmitting and reflecting reconfigurable intelligent surface (STAR-RIS)-aided communication has been perceived as an interesting research topic. This paper investigates a downlink STAR-RIS-aided non-orthogonal multiple access (NOMA) system, where a STAR-RIS is deployed to enhance the transmission qualities between users and a multiple-antenna base station (BS). The considered STAR-RIS utilizes the energy splitting (ES) protocol to serve a pair of NOMA users located at both sides of STAR-RIS. Based on the ES protocol, each reconfigurable element can operate in the modes of transmission and reflection simultaneously. In an effort to characterize the secrecy performance, we first derive the closed-form expressions of secrecy outage probability (SOP) for STAR-RIS-aided NOMA system. Then, the asymptotic performance of the derived SOP is analyzed. For gleaning further insights, secrecy diversity order (SDO) is derived according to the asymptotic approximation in the high signal-to-noise ratio and main-to-eavesdropper ratio regimes. As a further advance, the system parameters are optimized to minimize the SOP of the system. Our analytical results demonstrate that the multiple-antenna BS has almost no impact on SDO for STAR-RIS-aided NOMA system. In simulations, it is demonstrated that the theoretical results match with the simulation results very well and the SOP of STAR-RIS-aided NOMA is less than that of conventional orthogonal multiple access (OMA) system obviously.
Nonlinear operators between neutrosophic normed spaces and Fréchet differentiation
Authors: Khan Vakeel A. , Khan Mohammad Daud 
Published: December 2022

AbstractThe article focuses on the introduction of neutrosophic continuity and neutrosophic boundedness, which is a fair extension of intuitionistic fuzzy continuity and intuitionistic fuzzy boundedness, respectively. The article further advances to illustrate the Fréchet derivative of nonlinear operators between neutrosophic normed spaces (NNS). Examples have been provided in compliance with the theory with the aid of some standard sequence spaces.
Deep brain stimulation of the nucleus basalis of Meynert modulates hippocampal–frontoparietal networks in patients with advanced Alzheimer’s disease
Authors: Jiang Yin , Yuan Tian-Shuo , Chen Ying-Chuan , Guo Peng , Lian Teng-Hong , Liu Yu-Ye , Liu Wei , Bai Yu-Tong , Zhang Quan , Zhang Wei , Zhang Jian-Guo 
Published: December 2022

Abstract
Background
Deep brain stimulation (DBS) of the nucleus basalis of Meynert (NBM) has shown potential for the treatment of mild-to-moderate Alzheimer’s disease (AD). However, there is little evidence of whether NBM-DBS can improve cognitive functioning in patients with advanced AD. In addition, the mechanisms underlying the modulation of brain networks remain unclear. This study was aimed to assess the cognitive function and the resting-state connectivity following NBM-DBS in patients with advanced AD.

Methods
Eight patients with advanced AD underwent bilateral NBM-DBS and were followed up for 12 months. Clinical outcomes were assessed by neuropsychological examinations using the Mini-Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale. Resting-state functional magnetic resonance imaging and positron emission tomography data were also collected.

Results
The cognitive functioning of AD patients did not change from baseline to the 12-month follow-up. Interestingly, the MMSE score indicated clinical efficacy at 1 month of follow-up. At this time point, the connectivity between the hippocampal network and frontoparietal network tended to increase in the DBS-on state compared to the DBS-off state. Additionally, the increased functional connectivity between the parahippocampal gyrus (PHG) and the parietal cortex was associated with cognitive improvement. Further dynamic functional network analysis showed that NBM-DBS increased the proportion of the PHG-related connections, which was related to improved cognitive performance.

Conclusion
The results indicated that NBM-DBS improves short-term cognitive performance in patients with advanced AD, which may be related to the modulation of multi-network connectivity patterns, and the hippocampus plays an important role within these networks.

Trial registration

ChiCTR, ChiCTR1900022324. Registered 5 April 2019—Prospective registration. https://www.chictr.org.cn/showproj.aspx?proj=37712
Does online food shopping boost dietary diversity? Application of an endogenous switching model with a count outcome variable
Authors: Ma Wanglin , Vatsa Puneet , Zheng Hongyun , Guo Yanzhi 
Published: December 2022

AbstractIncreasingly, rural households in developing countries are shopping for food online, and the COVID-19 pandemic has accelerated this trend. In parallel, dietary guidelines worldwide recommend eating a balanced and healthy diet. With this in mind, this study explores whether online food shopping boosts dietary diversity—defined as the number of distinct food groups consumed—among rural households in China. Because people choose to shop for food online, it is important to account for the self-selection bias inherent in online food shopping. Accordingly, we estimate the treatment effects of online food shopping on dietary diversity using the endogenous switching model with a count outcome variable. The results indicate that online food shopping increases dietary diversity by 7.34%. We also find that education, asset ownership, and knowing the government’s dietary guidelines are the main factors driving rural households’ decisions to shop for food online.
Identifying resilience promoting factors in vocational education and training: a longitudinal qualitative study in Norway
Authors: Schmid Evi , Haukedal Christiane Lingås 
Published: December 2022

AbstractDrawing on the literature on resilience in education, this article explores personal characteristics, abilities and behaviours that enable vulnerable students and apprentices to succeed in education and training. Despite high dropout rates in vocational education and training (VET) in most countries, little research on resilience in vocational contexts exists, and there is no general understanding or conceptualisation of resilience in VET. The study is based on qualitative interviews with eight adolescents from lower socioeconomic backgrounds who were identified as being at risk of not completing upper secondary education. The adolescents were interviewed the first time during the school-based part of their education (year 2) and the second time during apprenticeship training (year 4). Our findings show that commitment to learning and perseverance, self-regulated learning, goal orientation, self-efficacy and help-seeking are important resilience promoting factors in a vocational context that may serve to enhance resilience among students and apprentices in VET. The study discusses the role of learning environments in school and in the workplace in resilience in VET.
Synthetic biology promotes the capture of CO2 to produce fatty acid derivatives in microbial cell factories
Authors: Liu Xiaofang , Luo Hangyu , Yu Dayong , Tan Jinyu , Yuan Junfa , Li Hu 
Published: December 2022

AbstractEnvironmental problems such as greenhouse effect, the consumption of fossil energy, and the increase of human demand for energy are becoming more and more serious, which force researcher to turn their attention to the reduction of CO2 and the development of renewable energy. Unsafety, easy to lead to secondary environmental pollution, cost inefficiency, and other problems limit the development of conventional CO2 capture technology. In recent years, many microorganisms have attracted much attention to capture CO2 and synthesize valuable products directly. Fatty acid derivatives (e.g., fatty acid esters, fatty alcohols, and aliphatic hydrocarbons), which can be used as a kind of environmentally friendly and renewable biofuels, are sustainable substitutes for fossil energy. In this review, conventional CO2 capture techniques pathways, microbial CO2 concentration mechanisms and fixation pathways were introduced. Then, the metabolic pathway and progress of direct production of fatty acid derivatives from CO2 in microbial cell factories were discussed. The synthetic biology means used to design engineering microorganisms and optimize their metabolic pathways were depicted, with final discussion on the potential of optoelectronic–microbial integrated capture and production systems.
To what extent tsunami source information can be extracted from tsunami deposits? Implications from the 2011 Tohoku-oki tsunami deposits and sediment transport simulations
Authors: Masuda Hidetoshi , Sugawara Daisuke , Abe Tomoya , Goto Kazuhisa 
Published: December 2022

AbstractA quantitative understanding of paleotsunamis is a significant issue in tsunami sedimentology. Onshore tsunami deposits, which are geological records of tsunami inundation, are used to reconstruct paleotsunami events. Numerical models of tsunami hydrodynamics and tsunami-induced sediment transport are utilized in such reconstructions to connect tsunami deposit characteristics, flow conditions, and (paleo-) tsunami sources. Recent progress in tsunami numerical modeling has increased the possibility of developing a methodology to estimate paleotsunami sources from tsunami deposits. Several previous studies have estimated paleotsunami sources using tsunami sediment transport simulations. However, the accuracy of paleotsunami source estimation has not yet been explored. Thus, to bridge this research gap, in this study, we showed the potential and limitations of deposit-based tsunami source estimation based on the 2011 Tohoku-oki tsunami deposit data on the southernmost part of the Sendai Plain, northeastern Japan. The tsunamigenic megathrust along the Japan Trench was divided into ten subfaults having similar lengths and widths. The hypothetical source models with varying slips on each subfault were examined by comparing the depositional volume and sediment source of onshore tsunami deposits. Due to limited information on the depositional area of the tsunami deposits used in the modeling, slips only in some parts of the entire tsunami source region could be estimated. The fault slip was slightly overestimated but could be compared with previous well-constrained source models. Thus, these results indicated that vast high-quality datasets of tsunami deposits can improve the accuracy of paleotsunami source estimation. It is also suggested that the amplitude of the receding wave affects the erosion pattern from the shoreface to the nearshore area. Although sufficient data for paleotsunami source estimation are lacking, an effective combination of tsunami deposit data and sediment transport simulations potentially improves the accuracy of the source estimation. The results will contribute to developing a framework of deposit-based paleotsunami source modeling and assessing its accuracy.
Quantitative [99mTc]Tc-MDP SPECT/CT correlated with [18F]NaF PET/CT for bone metastases in patients with prostate cancer
Authors: Tanaka Kenichi , Norikane Takashi , Mitamura Katsuya , Yamamoto Yuka , Maeda Yukito , Fujimoto Kengo , Takami Yasukage , Ishimura Mariko , Arai-Okuda Hanae , Tohi Yoichiro , Kudomi Nobuyuki , Sugimoto Mikio , Nishiyama Yoshihiro 
Published: December 2022

Abstract
Background
The purpose of the present study was to elucidate the correlation between standardized uptake value (SUV) and volume-based parameters measured by quantitative [99mTc]Tc-methylene diphosphonate (MDP) single photon emission computed tomography (SPECT)/CT and [18F]-sodium fluoride ([18F]NaF) positron emission tomography (PET)/CT in the assessment of bone metastases in patients with prostate cancer.

Methods
The study included 26 male prostate cancer patients with confirmed or suspected bone metastases who underwent both [99mTc]Tc-MDP SPECT/CT and [18F]NaF PET/CT studies. Skeletal lesions visible on both SPECT/CT and PET/CT were classified as benign or metastases. The maximum SUV (SUVmax), peak SUV (SUVpeak), mean SUV (SUVmean), metabolic bone volume (MBV), and total bone uptake (TBU) were calculated for every lesion showing abnormal uptake.

Results
A total of 202 skeletal lesions (147 benign and 55 metastases) were detected in the 26 patients. Strong significant correlations were noted between SPECT/CT and PET/CT for the SUV- and volume-based parameters (all P < 0.001). The SUVmax, SUVpeak, SUVmean, and TBU values obtained with SPECT/CT were significantly lower than the corresponding values obtained with PET/CT (all P < 0.001). The MBV in SPECT/CT was significantly higher than that in PET/CT (P < 0.001). All SUV- and volume-based parameters obtained with both SPECT/CT and PET/CT for metastatic lesions were significantly higher than the corresponding parameters for benign lesions (P values from 0.036 to < 0.001).

Conclusions
These preliminary results demonstrate that the SUV- and volume-based parameters for bone uptake obtained with quantitative SPECT/CT and PET/CT are strongly correlated in patients with prostate cancer. The SUV parameters obtained with SPECT/CT were significantly lower than those obtained with PET/CT, whereas the uptake volume obtained with SPECT/CT was significantly higher than that obtained with PET/CT.
A case report involving suppressed nuclear receptor transcription factors 4a1 and Stevens-Johnson syndrome induced by a single dose of pembrolizumab and successfully treated with early steroid administration, resulting in complete remission of stage III lung cancer
Authors: Machida Maiko , Yamazaki Chika , Kouda Nao , Hanai Yousei , Sato Hideki , Konda Ainari , Yamagata Yuka , Itho Tatsuya , Aisaka Haruhiko 
Published: December 2022

Abstract
Background
Immunotherapy with immune checkpoint inhibitors is associated with immune-related adverse events (irAEs). A positive correlation between treatment efficacy and irAEs has been reported. Clinical indicators are required for appropriate interventions, such as steroid administration, to prevent fatal outcomes. Nuclear receptor transcription factor 4a (Nr4a), which is involved in T-cell anergy, exhaustion, and regulatory T cells, were observed not only in thymocytes but in peripheral blood mononuclear cells. We describe a case of Stevens-Johnson syndrome (SJS) that was induced by a single dose of pembrolizumab and successfully treated with steroids, leading to complete remission of lung cancer during the monitoring of immune response indices, including Nr4a1 mRNA.

Case presentation
A 68-year-old male with squamous cell lung cancer (cT2aN3M0, stage IIIb) received a single dose of pembrolizumab (200 mg). On Day 21 of treatment, SJS appeared, and the patient was treated with prednisolone 60 mg/day, which was gradually tapered off. After the disappearance of the SJS symptoms, complete remission of cancer was achieved and was maintained for more than 1 year. Acute increases in the plasma IFN-γ and IL-17 concentrations and a decrease in IL-10 concentrations were observed at the onset of SJS. Simple regression analysis showed that these changes in IL-17, IFN-γ and IL-10 were significantly influenced by the decreased expression of Nr4a1 mRNA. The pembrolizumab levels and prednisolone doses significantly influenced the suppression of Nr4a1 mRNA levels. Although Nr4a1 mRNA levels in the current case fluctuated during the observation period, they were significantly lower than those in a nonresponding progressive-disease case, as well as a pembrolizumab-responding case with non-SJS but similar background. The suppression of Nr4a1 in current case, might result in upregulation of cytotoxic T cells and a reduction in functional regulatory T cells, promoting favorable antitumor immunity.

Conclusion
The immune responses involving Nr4a1 suppression might relate to complete remission of lung cancer in this case, despite causing SJS, which may be attributed to synergistic effects from pembrolizumab treatment and intervention with steroids. The current case indicates the preliminarily clinical benefit of evaluating Nr4a expression-related indices as the possible clinical covariates and may serve as a milestone for appropriate future chemotherapy interventions.