Excellent Value Research Articles

Hematologic cancers and infections: how to detect infections in advance and determine the type?

Infection is one of the leading causes of death in patients with hematologic cancers. Hematologic cancer patients with compromised immune systems are already susceptible to infections, which come on even more rapidly and are difficult to control after they develop neutrophil deficiencies from high-dose chemotherapy. After patients have developed an infection, the determination of the type of infection becomes a priority for clinicians. In this review, we summarize the biomarkers currently used for the prediction of infections in patients with hematologic cancers; procalcitonin, CD64, cytokines, and CD14 et al. can be used to determine bacterial infections, and (1-3)-β-D-glucan and galactomannan et al. can be used as a determination of fungal infections. We have also focused on the use of metagenomic next-generation sequencing in infections in patients with hematologic cancers, which has excellent clinical value in infection prediction and can detect microorganisms that cannot be detected by conventional testing methods such as blood cultures. Of course, we also focused on infection biomarkers that are not yet used in blood cancer patients but could be used as a future research direction, e.g., human neutrophil lipocalin, serum amyloid A, and heparin-binding protein et al. Finally, clinicians need to combine multiple infection biomarkers, the patient’s clinical condition, local susceptibility to the type of infection, and many other factors to make a determination of the type of infection.

Perspectives on theological training in times of crisis

When crises arise, like in the case of the #FeesMustFall-movement (FMF) during 2015–2017, we often tend to be reactive in our actions and immediate plans are made to address the crisis. In this contribution, however, I want to look at a longer-term solution by making use of Stellenbosch University’s five core values. The values of excellence, respect, responsibility, equity, and compassion will be examined in this contribution to empower lecturers who prepare students for church ministry. The basic research question that will be investigated is: How can the five core values of Stellenbosch University help the lecturers with the preparation of students for ecclesiastical training in times of crisis? In response to this, each of the values will first be explained, after which their meaning and impact on theological training will be examined. Afterwards, some crises in the theological training will be investigated where some of the values conflict with each other. At the end, we will turn to the re-scripting of the narrative of higher education by looking at the extended curriculum program (ECP) at the Faculty of Theology at Stellenbosch University.

High sensitivity and high figure of merit graphene mid-infrared multi-band tunable metamaterial perfect absorber

In the research of this paper, we have devised a mid-infrared band metamaterial perfect absorber made of graphene material. The absorber is composed of a traditional three-layer structure of MPA. The top layer is a graphene layer with a specific structure, with SiO2 as the dielectric layer and the gold film as the substrate. In the wavelength range of 5500 – 13000 nm, the graphene layer generates seven absorption peaks and shows ultra-high absorption efficiency. The respective absorption rates are 91.17%, 99.41%, 99.01%, 95.69%, 94.16%, 96.89%, and 95.01%. By verifying the absorption spectra and the principle of effective impedance matching, analyze the electric field distribution image of the xoy plane based on the principle of surface plasmon resonance, we have proved that it conforms to the classical physical theory and expounded the reason why the absorption peaks were formed. The comparison of different graphene patterns has confirmed the superiority of this structure. By changing the relaxation time and Fermi level of graphene, the tunability of the absorber structure has been verified. Changing the incident angle has proved its insensitivity to the polarization angle (0° - 50°). Finally, by calculating and comparing the figure of merit (FOM) and the sensitivity (S), it is shown that this structure has significant sensitivity and excellent application ability and value. We firmly believe that our absorber can be well applied in high-sensitivity sensors, filters and detectors, and can contribute to fields such as photoelectric detection, optical communication and photoelectric sensing.

Research on the Efficiency of Major Airports in China’s Six Major Airport Cluster: Based on Common Frontier Super-Efficiency DEA and Malmquist Method

Airport clusters are of great significance to the sustainable development of the civil aviation transportation industry. The study utilises common frontier and super-efficiency DEA methods to assess the efficiency of China’s six major airport groups. It then employs the Malmquist index method to analyse changes in airport productivity. The results highlight regional disparities in airport efficiency. The East China Airport Group and the Southwest Airport Group consistently demonstrate excellent efficiency values, while the North China Airport Group and the Northeast Airport Group have significant room for improvement. Most airports within the groups operate at low and ineffective levels, with efficiency initially increasing and then decreasing. Moreover, the technology gap ratio (TGR) for each airport group somewhat shows a downward trend. The Malmquist index indicates that the overall factor productivity of each airport has generally remained stable, with efficiency growth primarily dependent on scale efficiency. On average, technical efficiency has increased by 1.5%. However, in terms of technological changes, most airports have experienced technological regression, indicating insufficient focus on technological improvement. Therefore, it is crucial to prioritise technological innovation and enhance management efficiency to achieve efficiency improvements in airport clusters. It is necessary to formulate strategies accurately based on the specific conditions of different regions, promote coordinated development, foster regional exchanges and cooperation, address regional disparities, ensure sustainable development of China’s airport clusters, and establish a world-class airport cluster.

Exploring common biomarkers of ischemic stroke and obstructive sleep apnea through bioinformatics analysis.

Clinical observations have shown that many patients with ischemic stroke (IS) have a history of obstructive sleep apnea (OSA) both before and after the stroke's onset, suggesting potential underlying connections and shared comorbid mechanisms between the two conditions. The aim of this study is to identify the genetic characteristics of OSA patients who develop IS and to establish a reliable disease diagnostic model to assess the risk of IS in OSA patients. We selected IS and OSA datasets from the Gene Expression Omnibus (GEO) database as training sets. Core genes were identified using the Limma package, Weighted Gene Co-expression Network Analysis (WGCNA), and machine learning algorithms. Gene Set Variation Analysis (GSVA) was conducted for pathway enrichment analysis, while single-sample gene set enrichment analysis (ssGSEA) was employed for immune infiltration analysis. Finally, a diagnostic model was developed using Least Absolute Shrinkage and Selection Operator (LASSO) regression, with its diagnostic efficacy validated using receiver operating characteristic (ROC) curves across two independent validation sets. The results revealed that differential analysis and machine learning identified two common genes, TM9SF2 and CCL8, shared between IS and OSA. Additionally, seven signaling pathways were found to be commonly upregulated in both conditions. Immune infiltration analysis demonstrated a significant decrease in monocyte levels, with TM9SF2 showing a negative correlation and CCL8 showing a positive correlation with monocytes. The diagnostic model we developed exhibited excellent predictive value in the validation set. In summary, two immune-related core genes, TM9SF2 and CCL8, were identified as common to both IS and OSA. The diagnostic model developed based on these genes may be used to predict the risk of IS in OSA patients.

Reliability and validity of My Jump 2® app to measure the vertical jump in visually impaired five-a-side soccer athletes.

Although My Jump 2 ® consistently presented excellent values of reliability and validity when compared to force platforms (FPs) and contact mats, to date no scientific investigation assessed the validity and reliability of My Jump 2 ® to measure jump height in visually impaired five-a-side soccer athletes. Thus, the study aimed at analyzing the validity and reliability of the My Jump 2® to measure the vertical jump of five-a-side soccer athletes. Twelve visually impaired five-a-side soccer athletes, volunteered for this study. Each player performed five countermovement jumps (CMJs) and squat jumps (SJs) on a contact platform (CP) while they were simultaneously recorded using My Jump 2 ®. There was almost perfect agreement between the My Jump 2® and the contact platform measurements of CMJ (intraclass correlation coefficient = 0.99; p < 0.001) and SJ (intraclass correlation coefficient = 0.99; p < 0.001), heights for athletes during the first and second measurement days. Bland-Altman analysis showed a bias of 0.25 ± 0.5 cm; maximum SD = 1.3; minimum SD = -0.88 for CMJ, while that Bland-Altman analysis showed bias 0.18 ± 0.5 cm; maximum SD = 1.3; minimum SD = -0.96, for SJ. We can conclude that the My Jump 2® is a valid and reliable method to measure CMJ and SJ in visually impaired five-a-side soccer athletes.

Negative long-term prognostic value of stress echocardiography in patients with incomplete revascularization after successful primary PCI

Abstract Background The role of stress echocardiography (SECHO) in a risk stratification of patients with incomplete revascularization after primary percutaneous coronary intervention (pPCI) has not been extensively documented. The Aim The aim of our study was to assess the negative long-term prognostic value of SECHO after successful pPCI and incomplete revascularization of non-culprit lesions. Methods Our study consisted of 194 patients (mean age 59±10years, male 136; 70.1%) successfully treated with pPCI, who performed SECHO according to Bruce protocol in order to assess residual ischemia in coronary artery with non-culprit lesion other than treated vessel. Lesion severity of non-culprit coronary arteries was assessed by quantitative coronary angiography. Duke treadmill score, functional capacity (Metabolic Equivalents - METs), achieved target heart rate (THR), chronotropic incompetence, heart rate recovery (HRR), wall motion score index (WMSI) and ejection fraction were calculated in all patients. Slow HRR was defined as ≤18 beats/min. Median follow up of the patients was 96 ± 32.5 months for the occurrence of all-cause mortality and non-fatal myocardial infarction (MI). Results Out of 194 patients, 38 (19.6%) had positive SECHO test, and 7 patients (3.6%) were lost to follow up so they were excluded from further analysis. During the follow-up period 29 out of 149 patients (18.8%) had an adverse event (20 deaths and 9 non-fatal MI). Negative predictive value of SECHO test was 81.2%. Median time from MI to SECHO test was 8 months. Using the Cox regression analysis, univariate predictors of adverse events were slow HRR (HR 3.750 [95% CI 1.620-8.679], p=0.002), Duke score (HR 0.866 [95% CI 0.755-0.994], p=0.040) and chronotropic incompetence (HR 0.310 [95% CI 0.107-0.895], p=0.030). In the multivariate analysis only the slow HRR remained an independent predictor of adverse events (HR 3.329 [95% CI 1.417-7.825], p=0.006). Using the Kaplan-Meier survival curve we see that the patients with slow HRR had much shorter event-free time (slow HRR 117.2 ± 13.4 months vs normal HRR test 139.4 ± 4.2 months, Log Rank 4.988, p=0.026). (Figure 1.) Conclusion SECHO test has excellent negative long-term prognostic value in patients with incomplete revascularization of non-culprit lesions after successful pPCI while patients with slow HRR have more pronounced risk for the occurrence of adverse events.Figure 1.Kaplan-Meier survival curve

A Novel Carbon Dot-Bromothymol Blue System for Ratiometric Colorimetric-Fluorometric Sensing of Glutathione in Urine: A Smartphone-Compatible Approach.

This study presents a novel dual-modal approach for glutathione (GSH) detection using blue and yellow dual-emission carbon dots (BY-CDs) and bromothymol blue (BTB) at pH 8.0. The method employs both colorimetric and fluorometric detection modes, offering a new perspective on GSH quantification. BTB's blue coloration induces selective fluorescence quenching of the CDs' 610nm emission peak, with minimal effect on the 445nm peak. Upon GSH addition, the quinonoid structure (blue color) of BTB transforms to its benzenoid form (yellow color). This transformation triggers fluorescence restoration at 610nm and significant quenching at 445nm, enabling ratiometric fluorescence analysis (F610/F445). Concurrently, colorimetric detection is also ratiometric, based on measuring the ratio between the emerging yellow color peak (435nm) and the decreasing blue color peak (618nm) (A435/A618). The state-of-the-art aspect of this detection method lies in the strategic choice of dual-emission CDs and a dye with distinct absorption spectra that closely match the emission spectra of the CDs. This unique combination allows for dual detection with opposite responses in the two detection modes, enhancing selectivity and reliability. The probe was thoroughly characterized, and its detection mechanism was elucidated using various spectroscopic techniques. The method shows excellent linearity, a broad detection range, and low detection limits for both fluorometry (0.02 - 10.0μM, 5.88nM) and colorimetry (1.0 - 35.0μM, 301.25nM). Additionally, a smartphone-based platform was developed for colorimetric GSH determination, enhancing the method's potential for on-site analysis. The assay's practicality was validated through successful application to human urine samples, yielding excellent recovery values (97.33% to 99.13%).

The prognostic value of contrast stress echocardiography in a real-world population of symptomatic patients without known coronary artery disease

Abstract Background Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. In addition to diagnosis, non-invasive tests may also provide prognostic information useful in the risk stratification and management of CAD patients. Stress echocardiography (SE) is an accurate, non-invasive method for the detection of obstructive CAD. However, in real-world clinical practice the test performance may vary among different centres, depending on availability, local protocols, and operator expertise. Purpose To evaluate the prognostic value of contrast SE in a real-world population of symptomatic patients without known CAD. Methods This was a cohort follow-up study of patients without known CAD and symptoms of atypical chest pain, unexplained dyspnoea or palpitations who were referred to the echocardiography lab of a tertiary hospital for SE between January 2020 and December 2021. Patients with resting regional wall motion abnormalities were excluded. All patients underwent treadmill exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE) if unable to exercise. Contrast agents were used in almost all patients (99%). The study population was followed-up for at least 2 years after SE by phone and/or electronic hospital records. Cardiac outcome was defined as anatomically or functionally significant stenosis on angiography, revascularization, acute coronary syndrome (ACS), or cardiac-related death. Results The study comprised 266 patients (mean age 58±12 years, 63% male) who underwent either ESE (58%) or DSE (42%). The patients' details are reported in Table 1. The most common indication for the exam was atypical chest pain, with a prevalence of 73%. SE exams were positive for inducible ischaemia in 14 (5%) patients. Symptoms during the exam were present in 3 (21%) patients with positive SE and 4 patients (2%) with negative SE (p=0.004). No serious complications (sustained ventricular tachycardia, myocardial infarction, or death) were recorded. During the follow-up (median 30, IQR 23–38 months), 264 patients (99%) were successfully contacted. Cardiac outcome occurred in 10 patients. Among 14 patients with positive SE, 8 underwent revascularization due to significant coronary artery stenosis. Among 250 patients with negative SE, 1 underwent revascularization due to significant coronary artery stenosis and 1 presented with ACS 13 months after the test (both patients underwent DSE). Negative predictive value was 99% over a median follow-up of 30 months, corresponding to an annualized event rate of 0.32% per year. A positive SE was significantly associated with cardiac outcome (log-rank test p&amp;lt;0.0001, Figure 1). Conclusion Contrast SE carries significant prognostic implications in symptomatic patients without known CAD. A positive test is strongly associated with the need for revascularization, while a normal test result has an excellent negative predictive value regarding cardiovascular morbidity and mortality.Figure 1

Evaluation of the 2021 ESC recommendations for family screening in hereditary transthyretin cardiac amyloidosis

Abstract Background The 2021 European Society of Cardiology (ESC) screening recommendations for individuals carrying a pathogenic transthyretin amyloidosis (ATTR) variant (ATTRv) are based on expert opinion. We aimed to (1) determine the yield of ATTR cardiomyopathy (ATTR-CM) at baseline; (2) evaluate the performance of the 2021 ESC position statement on initiating screening for ATTRv carriers; (3) establish the value of first-line tests recommended in ATTRv carriers; and (4) examine the yield of serial evaluation. Methods We included 159 relatives (median age 55.6 [interquartile range 43.2-65.9] years, 52% male) at-risk for developing ATTR-CM from 10 centres. ATTR-CM diagnosis was defined as the presence of either 1) cardiac tracer uptake in bone scintigraphy as recommended; or 2) cardiac biopsy proven positive for ATTR. Our secondary endpoint was a composite of heart failure symptoms (NYHA class³II) and conduction disorders necessitating pacemaker implantation. An individual fulfilled screening criteria as proposed by the 2021 ESC position statement if: 1) cardiac screening was performed ~10 years prior to disease onset in the proband (or in other individuals with the same variant if disease onset in the family was unknown); or 2) had extracardiac amyloidosis as diagnosed by a Neurologist or Ophthalmologist. Results At baseline, 40/159 (25%) relatives were diagnosed with ATTR-CM. Of those 40 relatives, 20 (50%) met the secondary endpoint. Relatives diagnosed with ATTR-CM were significantly older (66.5 [61.0-75.2] vs. 49.2 [40.8-58.8] years, p&amp;lt;0.001)(Figure 1A). Figure 1B-C visualizes the yield of screening by screening indications of the 2021 ESC position statement. Both screening for age, extra-cardiac amyloidosis or both age and extra-cardiac amyloidosis as indication to screen had a 31% (n=17/54), 18% (n=2/11) and 68% (n=19/28) yield of ATTR-CM, respectively. Diagnosis of ATTR-CM in relatives without an indication to screen was rare (3%; n=2/66). As a result, indication to screen as proposed by the 2021 ESC position statement yielded an almost excellent negative predictive value (97%). Other independent pre-screening predictors were infrequently identified variants and male sex. Of note, 13% of relatives with ATTR-CM did not show any "red flags" of cardiac amyloidosis on electrocardiogram (ECG), echocardiogram, and laboratory parameters. Excluding those who meet the secondary endpoint (i.e. those who already should have been diagnosed based on symptoms), ATTR-CM diagnosis in the absence of "red flags" increased from 13% to 26%. The yield of repeat bone scintigraphy (n=41 ATTRv carriers; follow-up 3.1 [2.2-5.2] years) at 3-years’ interval was 9.4% (Figure 2). Conclusion The recommendations made by the 2021 ESC position statement are adequate. Clinicians should adhere to the 3-year repeat bone scintigraphy as progressing to ATTR-CM in the absence of "red flags" and symptoms is not uncommon.Cardiac amyloidosis at baselineATTR-CM development during follow-up

Prospective and External Validation of Machine Learning Models for Short- and Long-Term Mortality in Acutely Admitted Patients Using Blood Tests

Background: Predicting mortality in emergency departments (EDs) using machine learning models presents challenges, particularly in balancing simplicity with performance. This study aims to develop models that are both simple and effective for predicting short- and long-term mortality in ED patients. Our approach uses a minimal set of variables derived from one single blood sample obtained at admission. Methods: Data from three cohorts at two large Danish university hospitals were analyzed, including one retrospective and two prospective cohorts where prognostic models were applied to predict individual mortality risk, spanning the years 2013–2022. Routine biochemistry analyzed in blood samples collected at admission was the primary data source for the prediction models. The outcomes were mortality at 10, 30, 90, and 365 days after admission to the ED. The models were developed using Light Gradient Boosting Machines. The evaluation of mortality predictions involved metrics such as Area Under the Receiver Operating Characteristic Curve (AUC), sensitivity, specificity, negative predictive values, positive predictive values, and Matthews correlation coefficient (MCC). Results: A total of 43,648 unique patients with 65,484 admissions were analyzed. The models showed high accuracy, with very good to excellent AUC values between 0.87 and 0.93 across different time intervals. Conclusions: This study demonstrates that a single assessment of routine clinical biochemistry upon admission can serve as a powerful predictor for both short-term and long-term mortality in ED admissions.

A novel ultra-light bio-based fiberboard from mexican feather grass for thermal and acoustic insulation in green building construction applications

The use of natural fibers as raw materials for insulation fiberboard production is emerging as a strategy to replace wood fibers. This study developed an ultralightweight natural fiber insulation core fiberboard (CFB) with high mechanical strength, hygroscopic resistance, and excellent acoustic and thermal insulation properties. This study examined the production of CFB, which utilizes Mexican feather grass fibers with an epoxy resin binder across a range of densities of 0.18–0.36 g∙cm−3. Furthermore, the impact of incorporating a reinforcing skin layer of woven glass fibers on the core fiberboard's physical, mechanical, acoustic, and thermal properties was evaluated. All the fiberboard samples exhibited excellent thermal conductivity values (0.048–0.057 W/mK), which increased with increasing panel density (0.18–0.36 g∙cm−3). In addition, all of them displayed superior mechanical properties following the ASTM C208 standard. In terms of climatic resistance of the fiberboards, the results displayed excellent water resistance, exhibiting minimal humidity content (<5 %), thickness swelling (<6.5 %), and a hydrophobic surface, as indicated by the high-water contact angle (>121.96 at 30 s). Sound reduction exhibited a frequency-dependent tendency, with denser and sandwich fiberboards showing greater sound reduction of up to 27.9–36.56 dB at 3150 Hz for CFB-0.36 and SFB-0.52, respectively. Following ASTM C208, both core fiberboards and those coated with woven glass fiber skins (sandwich fiberboards, SFB) met the thermomechanical property requirements for regular and structural wall sheathing applications, respectively. These findings highlight the potential of Mexican feather grass as a bio-based alternative to wood, enabling the production of eco-friendly ultralightweight fiberboards with excellent thermomechanical properties suitable for building construction, such as regular and structural wall sheathing applications and ceiling decorations.

Cryptocurrency Transaction Fraud Detection Based on Imbalanced Classification With Interpretable Analysis

This study introduces an interpretable imbalanced data classification method for detecting cryptocurrency transaction fraud. We address data imbalance using SMOTE oversampling and data augmentation through contrastive learning. Next, we introduce a Transformer-based deep learning model that learns sample relevance. The model undergoes pre-training with a contrastive loss and fine-tuning through Bayesian optimization to effectively extract high-dimensional, higher-order, and fraud-related features. We employ a SHAP-based interpreter along with attention scores to elucidate the role of various transaction features in fraud detection. Comparative results demonstrate the model's remarkable recall performance in identifying cryptocurrency transaction fraud. Furthermore, it achieves an excellent F1 value, striking a balance between accuracy and recall. This research not only enriches financial fraud detection but also enhances cryptocurrency transaction security, promotes market development, and contributes to economic stability and social security.

Analysis of 15 children with type Ⅳ branchial cleft cyst treated with endoscopic transoral approach

Objective: To analyze the clinical characteristics and endoscopic surgical procedures of the second branchial cleft cyst type Ⅳ in children. Methods: A retrospective review was conducted on 15 pediatric cases with type Ⅳ second branchial cleft cysts treated at the Beijing Children's Hospital affiliated with Capital Medical University and Henan Children's Hospital from September 2019 to November 2023. All patients underwent excision via a two-person, three-hand endoscopic transoral approach. The cohort included 12 males and 3 females, with an age range of 10 months to 10 years and 5 months, and a median age of (59.20±32.05) months. The clinical data of initial symptoms, sides, imaging features, treatment methods, complications, length of hospital stay, prognosis and outcome were recorded and analyzed. SPSS 22.0 software was used for statistical analysis. Results: Of the 15 children, 13 cases presented with snoring as the primary symptom, 1 case with dysphagia, and 1 case was asymptomatic and was found unintentionally. The mean disease duration was (6.74±9.05) months (range, from 3 days-2 years). MRI revealed cystic lesions on the right side in 12 cases and on the left side in 3 cases, characterized by uniform long T2 signal, equal T1 or short T1 signal. The cysts appeared dumbbell-shaped in 10 cases with the pharyngeal constrictor muscle as the waist, the posterior outside of the mass was adjacent to the internal carotid artery. The remaining 5 cases showed an isolated cyst located inside the pharyngeal constrictor muscle. The intraoperative MRI findings were consistent. Partial cystectomy was performed in 10 cases near the internal carotid artery, leaving only the portion with a clear arterial pulse intact. Five cases with isolated cysts on the medial side of the pharyngeal constrictor muscle were totally removed. The average length of hospital stay was (4.53±0.52) days (4-5 days). All patients were followed up for 7-56 months [median (30±15.12) months] with no recurrence of symptoms observed. Conclusions: The second branchial cleft cyst type Ⅳ in children is characterized by prominent pharyngeal cystic mass, with snoring as a predominant initial symptom, MRI provides excellent diagnostic value. The two-person, third-hand endoscopic transoral approach for cyst excision is feasible, safe, and offers the benefits of minimal invasiveness and reduced hospitalization time.

A Study on the Reliability and Validity of the Social Media Leadership Scale in Education Organizations Sample

Purpose: In this study, it is aimed to develop a Likert-type scale that can measure the status of managers and employees working in organizations in the context of social media leadership in a sample of educational organizations. Design/Methodology/Approach: The study was conducted on teachers working in schools affiliated with the Ministry of National Education during the 2022–2023 academic year. Expert opinions were sought to ensure the construct validity of the scale. The content validity rates of the items were determined, and the content validity index of the scale was calculated as 0.88. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted to test the validity of the scale. KMO and Bartlett tests were used to determine the suitability of the obtained data for factor analysis. The EFA revealed that the scale had a 5-factor structure, which was then confirmed by the CFA. The CFA results were supported by acceptable and excellent fit values. The conformity and validity of the scale and the correlation between the factors were calculated. The internal consistency reliability coefficient was used to determine the reliability of the scale. After the aforementioned procedures, the Social Media Leadership Scale (SMLLS) was developed. The SMLLS consists of 24 items with 5 factors: guidance, innovation, ethical principles, sensitivity, and awareness. The lowest score on the scale is 24, and the highest score is 120. Findings: The SMLS is a measurement tool developed to determine the leadership levels of social media users. The findings regarding the validity and reliability of the scale indicate that it has sufficient psychometric properties to determine the leadership levels of social media users. Highlights: This scale can be used to assess the current status of teachers and administrators working at various levels within educational institutions in the context of social media leadership.

Boronate affinity metal–organic frameworks molecularly imprinted membranes with hierarchical porous channels for the selective separation of naringin

Naringin (NRG), known as an important natural flavoniod compounds, exhibits excellent phamaceutical value and clinical application prospect. However, the main obstacle to the isolation and purification of NRG is the low concentration and complexity of the extraction system. Herein, a new kind of hierarchical porous metal–organic frameworks (MOFs) based molecularly imprinted membranes (PBMMA-MIMs) for the specific separation of NRG. The prepared PBMMA-MIMs showed the fast adsorption kinetics (within 120 min). Moreover, the abundant boronic acid imprinted recognition sits and hydrophilic hierarchical porous MOFs improved the adsorption capacity (the maximum adsorption amounts 57.39 μmol/g) and exhibited selective NRG adsorption (imprinting factor 2.31) with efficiency over 91.69 % after seven adsorption–desorption cycles. In addition, the coarse NRG could be effectively extracted to a promising purity of 93.13 % via PBMMA-MIMs. This study provides new insights into the design molecularly imprinted membranes via environmentally friendly synthesis route for the preparation for enriching high-value flavoniods, achieving efficient purification rate of agricultural wastes for pollution control, and promoting the sustainable reuse in complex agricultural wastewater.

Performance of WHO mid-upper arm circumference cut-off to diagnose severe acute malnutrition in under-fives

Background Many studies indicate that the current WHO recommendation of cut-off value mid-upper arm circumference (MUAC) is not sensitive to detect severe acute malnutrition (SAM) in under-fives cases. Various new cut-off values have been proposed with better diagnostic values but have a wide interval, 12.1 cm—14.5 cm, which may be due to different races or habitus. Objective To evaluate the diagnostic value of MUAC in diagnosing SAM compared to the weight for height Z score (WFZ) index, to evaluate sensitivity, specificity, positive and negative predictive value of MUAC with 11.5 cm as standard cut-off, and to find an alternative cut-off value that may offer better diagnostic performance. Methods We collected 421 subjects consecutively in January-February 2020 in Cipto Mangunkusumo Hospital and Puskesmas Cengkareng. We performed brief conversations for demographic data and did the measurement of physical examination and anthropometric measurement by trained researchers and research assistants. Results Mid-upper arm circumference has excellent diagnostic value to assess SAM in under-fives with area under curve 0,939 (CI95% 0,903-0,974). Diagnostic values MUAC using cut off 11.5 cm were 21% sensitivity (Se) 21%, 99.7% spesificity (Sp)and Youden Index (YI) of 0.20. By using 13.3 cm as a new cut-off value, MUAC has Se 89%, Sp 87%, and YI of 0.76. Conclusion We conclude that WHO MUAC cut-off using 11.5 cm has lower performance to detect SAM cases than the proposed new cut-off value of 13.3 cm. New MUAC cut-off should be considered to detect more SAM cases among under-fives.

Ultrasensitive detection of hazardous gas at room temperature enabled by MOF@MXene 0D-2D heterostructure

Achieving high sensitivity in detecting trace concentrations of toxic gases, particularly under room temperature (RT) conditions, remains a significant challenge. Herein, a 0D-2D heterostructure that can detect ppb-level H2S at RT is proposed by self-assembling cobalt-based metal–organic framework (Co-MOF) on Ti3C2Tx MXene. Co-MOFs with high specific surface areas can capture and concentrate target gas molecules, enhancing host-guest interactions and thereby boosting the selectivity and sensitivity. MXene nanosheets with high conductivity enable rapid electron transport at heterointerface, hence efficiently accelerating the reaction kinetics. Thereby, the as-prepared chemiresistive gas sensor based on Co-MOF@MXene 0D–2D heterostructure possessed excellent sensitivity against interfering gases and delivered an excellent response value of 11.1 to 400 ppb H2S at RT. The judicious design of MOF@MXene heterostructure may spur advanced hybrid material systems for superior sensing applications.

Pressure-induced band gap enhancement and temperature-dependent thermoelectric characterization of semiconducting Transition Metal Chalcogenides LiMS (M = Cu, Ag)

The first principles study of Transition Metal Chalcogenides LiMS (M = Cu, Ag) has been conducted utilizing the concepts of Density Functional Theory (DFT). Both the compounds possess a cubic structure with space group F-43m. The mechanical stability of LiCuS and LiAgS has been predicted based on the values of elastic tensor. These Chalcogenides possess an interesting electronic band structure which reveals their semiconducting nature with a direct band gap. The electronic structure is further subjected to high pressure and the changes in band gap are deeply observed. For these materials, the changes in band gap in response to applied pressure suggest the possibility of their use in band gap engineering. The phonon curves are investigated over the Brillouin zone's high symmetry directions which reveal the lattice dynamical stability of the presently studied compounds. Moreover, the atoms present at different positions inside a crystal lattice exhibit vibrations of different intensities and in different directions which have been studied through the Eigenvector representations. The thermoelectric properties of LiCuS and LiAgS have been characterized using Boltzmann's theory over the range of temperature between 100 K and 1600 K. The calculated thermoelectric parameters reveal the high thermoelectric efficiency of these materials with excellent values of the figure of merit. The interesting properties of ternary Chalcogenides LiMS (M = Cu, Ag) make them promising candidates for thermoelectric applications.

The Impact of Perioperative Bilirubin and Albumin Levels on Postoperative Early Complications in Adult Liver Transplantation.

Postoperative complications persist as a significant cause of graft failure in liver transplantation. Identifying circulatory markers that predict such complications holds excellent clinical value. This study aimed to investigate serological indicators that can indicate early complications in adult liver transplantation. This study included 436 patients who underwent liver transplantation at our hospital, along with corresponding monitoring protocols. The differences and interactions of circulating indicators at various time points were analyzed using repeated measures analysis of variance. Post-hoc multiple comparisons were adjusted using the Bonferroni method. Restricted cubic spline regression models assessed non-linear associations between circulating markers, complications, and mortality. This study demonstrated significant time effects for all related markers, with substantial differences in complications and mortality for direct bilirubin and albumin. The restricted cubic spline model revealed a significant positive association between direct bilirubin and complications across three postoperative phases (p postoperative phase 1 = 0.0011, p postoperative phase 2 = 0.0001, p postoperative phase 3 = 0.0020). Conversely, albumin showed a significant negative association with complications in phases 1 and 2 (p postoperative phase 1 = 0.0001, p postoperative phase 2 = 0.0009). Furthermore, direct bilirubin was significant associated with increased mortality of postoperative phase 2 and phase 3 (p postoperative phase 2 < 0.0001, p postoperative phase 3 < 0.0001), while albumin showed a significant negative association with mortality (p postoperative phase 1 = 0.0306). Direct bilirubin and albumin are potential critical factors affecting early complications after liver transplantation. Close monitoring of these markers within 24-72 postoperative hours may help predict the occurrence of complications.