bluuebunny/crossref_metadata_2025 huggingface dataset:
PET/CT reading for relapse in non-small cell lung cancer after chemoradiotherapy in the PET-Plan trial cohort
Authors: Brose Alexander , Michalski Kerstin , Ruf Juri , Tosch Marco , Eschmann Susanne M. , Schreckenberger Mathias , König Jochem , Nestle Ursula , Miederer Matthias
Published: May 2023

Background

Current studies indicate that fluorine-18-fluorodeoxyglucose positron emission tomography/ computed tomography ([18F]FDG PET/CT) is the most accurate imaging modality for the detection of relapsed locally advanced non-small cell lung cancer (NSCLC) after curatively intended chemoradiotherapy. To this day, there is no objective and reproducible definition for the diagnosis of disease recurrence in PET/CT, the reading of which is relevantly influenced by post radiation inflammatory processes. The aim of this study was to evaluate and compare visual and threshold-based semi-automated evaluation criteria for the assessment of suspected tumor recurrence in a well-defined study population investigated during the randomized clinical PET-Plan trial.

Methods

This retrospective analysis comprises 114 PET/CT data sets of 82 patients from the PET-Plan multi-center study cohort who underwent [18F]FDG PET/CT imaging at different timepoints for relapse, as suspected by CT. Scans were first analyzed visually by four blinded readers using a binary scoring system for each possible localization and the associated reader certainty of the evaluation. Visual evaluations were conducted repeatedly without and with additional knowledge of the initial staging PET and radiotherapy delineation volumes. In a second step, uptake was measured quantitatively using maximum standardized uptake value (SUVmax), peak standardized uptake value corrected for lean body mass (SULpeak), and a liver threshold-based quantitative assessment model. Resulting sensitivity and specificity for relapse detection were compared to the findings in the visual assessment. The gold standard of recurrence was independently defined by prospective study routine including external reviewers using CT, PET, biopsies and clinical course of the disease.

Results

Overall interobserver agreement (IOA) of the visual assessment was moderate with a high difference between secure (ĸ = 0.66) and insecure (ĸ = 0.24) evaluations. Additional knowledge of the initial staging PET and radiotherapy delineation volumes improved the sensitivity (0.85 vs 0.92) but did not show significant impact on the specificity (0.86 vs 0.89). PET parameters SUVmax and SULpeak showed lower accuracy compared to the visual assessment, whereas threshold-based reading showed similar sensitivity (0.86) and higher specificity (0.97).

Conclusion

Visual assessment especially if associated with high reader certainty shows very high interobserver agreement and high accuracy that can be further increased by baseline PET/CT information. The implementation of a patient individual liver threshold value definition, similar to the threshold definition in PERCIST, offers a more standardized method matching the accuracy of experienced readers albeit not providing further improvement of accuracy.
Bacteriospermia and its antimicrobial resistance in relation to boar sperm quality during short-term storage with or without antibiotics in a tropical environment
Authors: Ngo CongBang , Suwimonteerabutr Junpen , Prapasarakul Nuvee , Morrell Jane M. , Tummaruk Padet
Published: May 2023

Background

In tropical environments, boar semen is prepared either from a boar on the same farm as the sow herd or collected in semen collection centers and then transported to other farms. Thus, the semen doses can be used for artificial insemination either immediately or preserved for 2–3 days. The present study investigated the bacteriospermia and its antimicrobial resistance in relation to boar sperm quality during short-term storage in semen extender with or without antibiotics in Thailand.

M&M

In total, 20 Duroc ejaculates were collected. Each ejaculate was diluted in Beltsville Thawing Solution extender either with 0.25 g of gentamicin per liter (ANTIBIOTIC) or without gentamicin (NO-ANITIBIOTIC) to create semen doses containing 3,000 × 106sperm/100 mL. These were stored at 17 °C for 4 days. Semen characteristics and total bacterial count (CFU per mL, log10) were measured after collection and during storage.

Results

Sperm viability was decreased by 6.4% for every 1.0 log10increase in total bacterial count (p = 0.026) andStaphylococcus spp.were the most frequently isolated across ejaculates. Throughout the 4 days of storage, sperm motility, viability and acrosome integrity in the ANTIBIOTIC group were higher than those in the NO-ANTIBIOTIC group (p < 0.05), while the total bacterial count was lower (1.9 ± 0.1 versus 3.9 ± 0.1 log10, respectively;p < 0.001). Without antibiotic supplementation, the total numbers of bacteria counted on days 2 and 3 of storage were higher than those determined on days 0 and 1 (p < 0.001). Differences in semen quality were detected on days 2 and 3 between the NO-ANTIBIOTIC and ANTIBIOTIC groups in high-viability semen (p < 0.05). However, no differences in sperm quality between the NO-ANTIBIOTIC and ANTIBIOTIC groups were detected in the low-viability semen on each storage day (p > 0.05). On the last day of preservation,Globicatella sanguinis (57.2%),Delftia acidovorans (18.9%)andMicrococcus spp.(5.9%) remained as the top three most abundant contaminants in the semen with antibiotic.

Conclusion

Our findings contribute new insights toward reducing antibiotics as well as rational antibiotic use in the boar AI industry. The growth of bacteria was significantly greater only after 2 days of preservation in the semen without antibiotic. For semen doses diluted from highly viable ejaculates, it is possible to store for 2 days without any antibiotic supplementation. Moreover, bacterial counts increased at the end of storage in the presence of gentamycin, suggesting the loss of bacteriostatic properties of gentamicin to the growth of bacteria during storage.
Severe Hypercalcemia due to Hypervitaminosis D in a Breastfed Infant
Authors: Barzilay Julie R , Kreienkamp Raymond J , Gordon Rebecca J
Published: May 2023

Vitamin D is one of the most commonly recommended dietary supplements and is often the first medication ever prescribed in infancy. However, with the variety of concentrations available, including many over-the-counter formulations, dosing errors can easily occur. We present a case of a breastfed infant with a calcium level greater than 23 mg/dL (5.75 mmol/L), whose severe hypercalcemia was due to hypervitaminosis D from accidentally overdosed vitamin D supplementation. We consider the differential diagnosis for her presentation and review the interventions required for treatment of her hypercalcemia. Notably, we reinforce the importance of carefully reviewing dosing of vitamin D supplementation with families. We also discuss the management of hypercalcemia, including the role of fluids, diuretics, and glucocorticoids, as well as the long-term sequalae of severe hypercalcemia.
From Rhetorical Theory to Spiritual Pedagogy in The Cloud of Unknowing
Authors: Field Rebecca
Published: May 2023

The fourteenth-century contemplative manual The Cloud of Unknowing and the shorter texts attributed to its author explore an extreme form of apophatic spiritual encounter. In order to guide his disciples in this kind of practice, the anonymous Cloud-author adopts a classical theory for pedagogy and adapts it to suit his specifically contemplative ends. He transforms the traditional rhetorical schoolroom triad of natura, doctrina, and usus into a new Middle English version, tailored for teaching contemplation: “disposicoun, techying, and profe.” This article examines the technical, theoretical, and theological implications of the three terms in the Cloud-author's reconceptualized triad. It argues that the nuances and subtleties of each term reveal the author to be a self-conscious and self-theorizing pedagogue who uses the triad to offer new descriptions of the contemplative's pursuit of the divine.
John Gower Illustrated: The Archer Images, Astronomical Science, and Poetic Identity
Authors: Mitchell J. Allan
Published: May 2023

Three manuscript copies of John Gower's Vox Clamantis contain large frontispiece images of a fashionable archer shooting at a suspended globe, headed by the short poem “Ad mundum mitto mea iacula, dumque sagitto.” The text-image ensemble aligns with Gower's ethical and rhetorical imperatives and was likely designed to idealize his posture as a social satirist and sum up the ambitions of his life's work. This essay adds another dimension to understanding this memorial image, reading the archer through a technical figure of mathematical astronomy. Seeing in the illustration a silhouette of an elementary chord diagram, the essay argues that Gower's archer imagery presents an allusive visual emblem, positioning himself in an elevated sphere with broader implications for the integration of medieval poetic and scientific disciplines. Representational strategies common to the arts show their dependence on conceptual models, graphical interfaces, and technical objects commensurate to the described world.
Genetics of sinoatrial node function and heart rate disorders
Authors: van der Maarel Lieve E. , Postma Alex V. , Christoffels Vincent M.
Published: May 2023

The sinoatrial node (SAN) is the primary pacemaker of the mammalian heart, initiating its electrical activation and ensuring that the heart's functional cardiac output meets physiological demand. SAN dysfunction (SND) can cause complex cardiac arrhythmias that can manifest as severe sinus bradycardia, sinus arrest, chronotropic incompetence and increased susceptibility to atrial fibrillation, among other cardiac conditions. SND has a complex aetiology, with both pre-existing disease and heritable genetic variation predisposing individuals to this pathology. In this Review, we summarize the current understanding of the genetic contributions to SND and the insights that they provide into this disorder's underlying molecular mechanisms. With an improved understanding of these molecular mechanisms, we can improve treatment options for SND patients and develop new therapeutics.
Computed tomography-based radiomics nomogram for the pre-operative prediction of BRAF mutation and clinical outcomes in patients with colorectal cancer: a double-center study
Authors: Li Manman , Xu Guodong , Zhou Hui , Chen Qiaoling , Fan Qi , Shi Jian , Duan Shaofeng , Cui Yanfen , Feng Feng
Published: May 2023

Objective:

To develop and validate a radiomics nomogram based on CT for the pre-operative prediction of BRAF mutation and clinical outcomes in patients with colorectal cancer (CRC).

Methods:

A total of 451 CRC patients (training cohort = 190; internal validation cohort = 125; external validation cohort = 136) from 2 centers were retrospectively included. Least absolute shrinkage and selection operator regression was used to select radiomics features and the radiomics score (Radscore) was calculated. Nomogram was constructed by combining Radscore and significant clinical predictors. Receiver operating characteristic curve analysis, calibration curve and decision curve analysis were used to evaluate the predictive performance of the nomogram. Kaplan‒Meier survival curves based on the radiomics nomogram were used to assess overall survival (OS) of the entire cohort.

Results:

The Radscore consisted of nine radiomics features which were the most relevant to BRAF mutation. The radiomics nomogram integrating Radscore and clinical independent predictors (age, tumor location and cN stage) showed good calibration and discrimination with AUCs of 0.86 (95% CI: 0.80–0.91), 0.82 (95% CI: 0.74–0.90) and 0.82 (95% CI: 0.75–0.90) in the training cohort, internal validation and external validation cohorts, respectively. Furthermore,the performance of nomogram was significantly better than that of the clinical model (p < 0.05). The radiomics nomogram-predicted BRAF mutation high-risk group had a worse OS than the low-risk group (p < 0.0001).

Conclusion:

The radiomics nomogram showed good performance in predicting BRAF mutation and OS of CRC patients, which could provide valuable information for individualized treatment.

Advances in knowledge:

The radiomics nomogram could effectively predict BRAF mutation and OS in patients with CRC. High-risk BRAF mutation group identified by the radiomics nomogram was independently associated with poor OS.
Antenatal diagnosis of hydrometrocolpos with Mullerian duplication on ultrasound and fetal MRI: case report and literature review
Authors: Bhagat Abhinav Chander , Gupta Radha Sarawagi , Malik Rajesh
Published: May 2023

Fetal abdomino-pelvic cystic lesions are uncommon and can have varied etio-pathogenesis. Most commonly they originate from the gastrointestinal or genitourinary tract. These include choledochal cyst, hydronephrosis, renal cyst, mesenteric/omental cyst, ovarian cyst, meconium pseudocyst, and hydrocolpos/hydrometrocolpos among others. Fetal hydrometrocolpos is rare with a reported incidence of 0.006% and its diagnosis requires a high index of suspicion. Antenatal ultrasound and magnetic resonance imaging (MRI) is invaluable in diagnostic evaluation. This case report describes the imaging features of antenatally detected congenital hydrometrocolpos with Mullerian duplication secondary to cloacal malformation using antenatal ultrasound and MRI. Per-operative findings and other possible differential diagnoses are discussed along with a brief review of literature.
c.151dup variant in LAMA3 in Pakistani patients affected with Shabbir Syndrome but showing mild symptoms
Authors: Ullah Asmat , Syed Fibha , Khan Shazia
Published: May 2023

Objective: To identify genetic causes of Shabbir syndrome in two patients of Pakistani origin.

Methods: In the present study, we have investigated a Pakistani family with two affected members segregating Laryngo-onycho-cutaneous (LOC) syndrome. The patients were diagnosed as suspected cases of LOC based on phenotypes including abnormal larynx, nails, and hyperpigmentation in patients’ eyes. Genetic investigation was done by performing whole exome sequencing (WES) using DNA of the patients. Sanger sequencing was performed to validate WES findings and segregation analysis in the family.

Results: Data analysis of exomes and Sanger sequencing of patients revealed a homozygous one base pair duplication (NM_000227.6; LAMA3; c.151dup; p.Val51GlyfsTer4) in LAMA3 in the patients. Parents of the patients were heterozygous for the identified variant.

Conclusion: Previously, the same variant has been found in most of the Pakistani Punjabi patients affected with LOC. Therefore, Pakistani Punjabi families affected with Shabbir Syndrome may be screened for c.151dup variant in LAMA3 using targeted sequencing. Sanger sequencing is a cost-effective and time-saving technique as compared to whole exome/genome sequencing. Hence, developing ethnicity-specific LAMA3 targeted molecular diagnostic test would be cost-effective. Further, the study would assist in carrier testing and prenatal diagnosis of the affected families.

doi: https://doi.org/10.12669/pjms.39.4.6926

How to cite this: Ullah A, Syed F, Khan S. c.151dup variant in LAMA3 in Pakistani patients affected with Shabbir Syndrome but showing mild symptoms. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.6926

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gegen Qinlian Decoction combined with Metformin for the treatment of patients with Type-2 Diabetes Mellitus: A retrospective observational study
Authors: Yingqi Chen  , Zhou Xiazhi , Jiang Zixiang , Liu Yinglian
Published: May 2023

Objectives: To investigate Gegen Qinlian Decoction (GQD) combined with metformin for treatment of patients with Type-2 Diabetes Mellitus (T2DM).

Methods: This retrospective observational study reviewed the clinical data of 89 patients diagnosed with T2DM in the Department of Acupuncture and Massage, Hainan Medical University from January 2021 to June 2022. Patients were non-randomized and divided into two groups based on the treatment received: observation group (n=41, GQD combined with metformin); control group (n=48, metformin only). Fasting blood glucose levels (FBG), traditional Chinese medicine (TCM) syndrome scores, clinical effect, blood glucose time in range and adverse reactions were compared between the two groups.

Results: There were no statistically significant differences in age, gender, BMI and duration of T2DM between the two groups (P>0.05). The FBG, 2h glucose, HbA1c levels and TCM syndrome scores of the two groups were significantly lower post-treatment (P<0.001) with a greater decrease in the observation group (P<0.001). The observation group was more clinically efficacious than the control group post-treatment (92.68% vs. 77.08%; P<0.05). Blood glucose time in range and the incidence of adverse reactions were lower in the observation group than the control group (P<0.001 and P<0.05).

Conclusions: GQD combined with metformin can significantly reduce FBG, 2h glucose and HbA1c levels, and improve TCM syndrome, with good clinical efficacy, shorter blood glucose time in range and less adverse reactions.

doi: https://doi.org/10.12669/pjms.39.4.7776

How to cite this: Chen Y, Zhou X, Jiang Z, Liu Y. Gegen Qinlian Decoction combined with Metformin for the treatment of patients with Type-2 Diabetes Mellitus: A retrospective observational study. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7776

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Fizinių asmenų bankroto procesas
Authors: Jokubauskas Remigijus
Published: May 2023

BANKRUPTCY PROCEEDINGS OF NATURAL PERSONS This book deals with the legal issues related to bankruptcy proceedings of natural persons. The problems of indebtedness of natural persons which lead to their insolvency require complex legal assessment. In Lithuania, the insolvency problems of natural persons were acknowledged on 10 May 2012 when the Law on Bankruptcy of Natural Persons (hereinafter – LBNP) was adopted which entered into force on 1 March 2013. The purpose of the LBNP was to regulate bankruptcy proceedings of a natural person, farmer, or other natural person pursuing individual activity and acting in good faith. Also, the LBNP aims to ensure that creditors’ claims are satisfied according to the procedure established by this law in order to strike a fair balance between the interests of the debtor and creditors. Until the adoption of the LBNP, the concept of the insolvency of natural persons was not established in Lithuanian insolvency law and payment of debts was carried out only using the enforcement procedures established in the Code of Civil Procedure of the Republic of Lithuania. The lack of regulation of the bankruptcy proceedings of natural persons not only caused the problem of forum shopping when a debtor would seek to commence insolvency proceedings in other countries, but also failed to secure the interests of creditors. Moreover, the adoption of the LBNP provides certain mechanisms for the social protection of debtors and their family members and requires the protection of their right to their dignity and basic needs.
The Generalized c/μ Rule for Queues with Heterogeneous Server Pools
Authors: Long Zhenghua , Zhang Hailun , Zhang Jiheng , Zhang Zhe George
Published: May 2023

Dynamic Routing of Queues with Heterogeneous Server Pools

In “The Generalized c/μ Rule for Queues with Heterogeneous Server Pools,” Long, Zhang, Zhang, and Zhang study the optimal control of queueing systems with heterogeneous server pools and a single customer class. The goal is to balance the holding cost of the queue with the operating costs of the server pools. They introduce the target-allocation policy, the Gc/μ rule, and the fixed priority policy for systems with general, convex, and concave cost functions, respectively. They also consider an extension to minimize operating costs and maintain a service-level target for customers waiting in the queue. Moreover, they show that their asymptotically optimal routing policies coincide with several classic policies in the literature in special cases.
Sequential Learning with a Similarity Selection Index
Authors: Zhou Yi , Fu Michael C. , Ryzhov Ilya O.
Published: May 2023

In large-scale simulation optimization, it is impossible to exhaustively simulate every choice. However, there are often inherent similarities between choices: for example, two similar sets of input settings to a simulation model can reasonably be expected to produce similar output. The information gained from simulating one choice can thus be used to infer the values of other similar choices, enabling learning more from a relatively small number of samples. The paper “Sequential Learning with a Similarity Selection Index,” by Zhou, Fu, and Ryzhov, develops a new similarity model to improve the final selection decision after all samples have been collected. The new “similarity indices” are complementary to all existing information collection procedures, which do not focus on the final decision. At the same time, the new model allows a tractable theoretical treatment of an optimal procedure, which can be efficiently approximated.
The Global Threat of Non-Communicable Diseases
Authors: Moffat Polly
Published: May 2023

The World Health Organization has reaffirmed its mission to provide leadership for international action on surveillance, prevention and control of non-communicable diseases across the world. Why is this issue so important for population health?
Examining sustainable practice in prescribing
Authors: Robertson Deborah
Published: May 2023

Deborah Robertson provides an overview of recently published articles that may be of interest to non-medical prescribers. Should you wish to look at any of the papers in more detail, a full reference is provided
Mask wearing and COVID-19: What does the evidence say?
Authors: Winter George
Published: May 2023

George Winter discusses the use of masks to protect against transmission of infection, and whether or not research now suggests they were effective at preventing spread during the pandemic
Prescribing anti-malarials in the UK
Authors: Gawthrop Mary
Published: May 2023

Malaria is a serious, potentially fatal parasitic infection spread by mosquitoes. It is a risk for international travellers visiting malarial regions in Africa, Asia, Central and South America and Oceania. Malaria is preventable, but every year in the UK, malaria cases and fatalities are reported in returning travellers. UK health professionals prescribing antimalarials should ensure they are familiar with the appropriate malaria guidelines and use them to access current malaria recommendations when advising travellers.
Are postoperative blood tests always required after lower limb arthroplasty?
Authors: Naathan Habillan , Ilo Kevin , Berber Reshid , Matar Hosam E. , Bloch Benjamin
Published: May 2023

Aims

It is common practice for patients to have postoperative blood tests after total joint replacement (TJR). However, there have been significant improvements in perioperative care with arthroplasty surgery, and a drive to reduce the length of stay (LOS) and move towards day-case TJR. We should reconsider whether this intervention is necessary for all patients.

Methods

This retrospective study included all patients who underwent a primary unilateral TJR at a single tertiary arthroplasty centre during a one-year period. Electronic medical records of 1,402 patients were reviewed for patient demographics, LOS, and American Society of Anesthesiologists (ASA) grade. Blood tests were examined to investigate the incidence of postoperative anaemia, electrolyte abnormalities, and incidence of acute kidney injury (AKI).

Results

For total knee arthroplasties, preoperative (R = −0.22) and postoperative haemoglobin (R = 0.2) levels were both negatively correlated with LOS (p < 0.001). For all patients who had undergone a TJR, 19 patients (0.014%) required a blood transfusion postoperatively due to symptomatic anaemia. Risk factors identified were age, preoperative anaemia, and long-term aspirin use. Significant abnormal sodium levels were found in123 patients (8.7%). However, only 36 patients (2.6%) required intervening treatment. Risk factors identified were age, preoperative abnormal sodium level, and long-term use of non-steroidal anti-inflammatory drugs, angiotensin receptor blockers, and corticosteroids. Similarly, abnormal potassium levels were evident in 53 patients (3.8%), and only 18 patients (1.3%) required intervening treatment. Risk factors identified were preoperative abnormal potassium level, and long-term use of angiotensin-converting enzyme inhibitors and diuretics. The incidence of AKI was 4.4% (61 patients). Risk factors identified were age, increased ASA grade, preoperative abnormal sodium, and creatinine level.

Conclusion

Routine blood tests after primary TJR is unnecessary for most patients. Blood tests should only be performed on those with identifiable risk factors such as preoperative anaemia and electrolyte abnormalities, haematological conditions, long-term aspirin use, and electrolyte-altering medications.

Cite this article: Bone Jt Open 2023;4(5):357–362.
Relationships, technology and the role of living arrangements during social lockdown related to COVID-19
Authors: Cascalheira Cory J. , McCormack Mark , Wignall Liam
Published: May 2023

COVID-19-related social lockdowns had profound consequences in all aspects of social life, yet technology’s role in mediating relationships during lockdown has received little attention. Drawing on a survey of 565 young adults in the UK, we used mixed methods to explore (a) differences in technology use by people in serious romantic relationships (cohabiting vs. living apart together), casual relationships or single; and (b) how COVID-19 influenced long-term, serious relationships. For participants in a serious relationship, technology was used as a strategy to facilitate ongoing communication, enabling partners to achieve ‘intimacy from afar’. Qualitative analysis revealed five reasons (more free time, navigating lockdown restrictions, greater boredom, desire for love and miscellaneous) for online dating profile usage changes. People in serious relationships perceived deeper intimate bonds, boundary issues, less physical intimacy, difficulty with lockdown separation and greater negative impact because of COVID-19. Limitations and implications are discussed.
Complete polarization modulates arbitrary dual optical vortices in free space
Authors: Li Ziyan , Guo Ji , Wang Guanxue , Gao Xiumin , Zhang Xuedian , Zhuang Songlin
Published: May 2023

Modulation of the position and shape of the double optical vortex with opposite phases is perplexing scientists due to the complex polarization of Pancharatnam–Berry. In this paper, we used an optical pen and cross-phase to solve these problems. Importantly, the topological charges of the dual optical vortex produced by this method are independent of each other, the shape of which is polygonal and the position of which can be predesigned in free space. The dual optical vortex can keep its amplitude, size, and shape in a certain propagation process. These characteristics help it to have a good application prospect in the fields of micromanipulation and optical tweezers, as well as other multidimensional operations.
Broadband, compact and reflection-less silicon polarizer and polarization beam splitter using chirped anti-symmetric multimode nanobeams
Authors: Cheng Rui , Wang Wenkang , Sun Ronglei , Li Ang , Liang Yuxin
Published: May 2023

We present chirped anti-symmetric multimode nanobeams (CAMNs) based on silicon-on-insulator platforms, and describe their applications as broadband, compact, reflection-less, and fabrication-tolerant TM-pass polarizers and polarization beam splitters (PBSs). The anti-symmetric structural perturbations of a CAMN ensure that only contradirectional coupling between symmetric and anti-symmetric modes is possible, which can be exploited to block the unwanted back reflection of the device. The new possibility of introducing a large chirp on an ultra-short nanobeam-based device to overcome the operation bandwidth limitation due to the coupling coefficient saturation effect is also shown. The simulation results show that an ultra-compact CAMN with a length of ∼4.68 um can be used to develop a TM-pass polarizer or a PBS with an ultra-broad 20 dB extinction ratio (ER) bandwidth of >300 nm and an average insertion loss of <1.3 dB. The CAMN-based polarizer and PBS were fabricated and experimentally characterized in a wavelength range from 1507 to 1575 nm. The measured ERs were >20 dB over the entire tested wavelength range and the average insertion losses were <0.5 dB for both devices. The mean reflection suppression ratio of the polarizer was ∼26.4 dB. Large fabrication tolerances of ±60 nm in the waveguide widths of the devices were also demonstrated.
Silver nanosphere array substrates fabricated by glancing angle deposition: morphology, hot spots and SERS properties
Authors: Wei Jinping , liu zhenglin , Huang Jiawei , Zhong Xiao , Zhang Qian , Sun Yuhan , Wan Yuan , Chen Yuliang , Duan Peitong , Luo Shuai , Han Caiqin
Published: May 2023

The generation and exploitation of hot spots play a crucial role in the fabrication of highly sensitive surface-enhanced Raman scattering (SERS) substrates. In this work, silver nanosphere (AgNS) array substrates with various morphologies of polystyrene (PS) core/Ag shell were fabricated by reactive ion etching and glancing angle deposition technique on PS sphere templates. The electromagnetic field distribution (hot spots) of AgNS array was calculated by the finite difference time domain method. R6G and MB were used as probe molecules to investigate the effect of structure spacing on electric field enhancement. Under 785 nm excitation, an AgNS substrate with a gap of approximately 20 nm exhibited the best SERS enhancement, and the limit of detection reached 5×10-8 M for both analytes. These results serve as a reference for the development of a new highly sensitive SERS sensors.
The Laro Kwo Project: A train the trainer model combined with mobile health technology for community health workers in Northern Uganda
Authors: Ebbs Daniel , Benson Oyoo , Jasicki Stanton , McCollum Sarah , Cappello Michael
Published: May 2023

Community Health Workers (CHWs) in low and middle income countries (LMICs) provide invaluable health resources to their community members. Best practices for developing and sustaining CHW training programs in LMICs have yet to be defined using rigorous standards and measures of effectiveness. With the expansion of digital health to LMICs, few studies have evaluated the role of participatory methodologies combined with the use of mobile health (mHealth) for CHW training program development. We completed a three-year prospective observational study aligned with the development of a community-based participatory CHW training program in Northern Uganda. Twenty-five CHWs were initially trained using a community participatory training methodology combined with mHealth and a train-the-trainer model. Medical skill competency exams were evaluated after the initial training and annually thereafter to assess retention with use of mHealth. After three years, CHWs who advanced to trainer status redeveloped all program materials using a mHealth application and trained a new cohort of 25 CHWs. Implementation of this methodology coupled with longitudinal mHealth training demonstrated an improvement in medical skills over three years among the original cohort of CHWs. Further, we found that the train-the-trainer model with mHealth was highly effective, as the new cohort of 25 CHWs trained by the original CHWs exhibited higher scores when tested on medical skill competencies. The combination of mHealth and participatory methodologies can facilitate the sustainability of CHW training programs in LMIC. Further investigations should focus on comparing specific mHealth modalities for training and clinical outcomes using similar combined methodologies.
A general framework to support cost-efficient fecal egg count methods and study design choices for large-scale STH deworming programs–monitoring of therapeutic drug efficacy as a case study
Authors: Coffeng Luc E. , Vlaminck Johnny , Cools Piet , Denwood Matthew , Albonico Marco , Ame Shaali M. , Ayana Mio , Dana Daniel , Cringoli Giuseppe , de Vlas Sake J. , Fenwick Alan , French Michael , Kazienga Adama , Keiser Jennifer , Knopp Stefanie , Leta Gemechu , Matoso Leonardo F. , Maurelli Maria P. , Montresor Antonio , Mirams Greg , Mekonnen Zeleke , Corrêa-Oliveira Rodrigo , Pinto Simone A. , Rinaldi Laura , Sayasone Somphou , Steinmann Peter , Thomas Eurion , Vercruysse Jozef , Levecke Bruno
Published: May 2023

Background

Soil-transmitted helminth (STH) control programs currently lack evidence-based recommendations for cost-efficient survey designs for monitoring and evaluation. Here, we present a framework to provide evidence-based recommendations, using a case study of therapeutic drug efficacy monitoring based on the examination of helminth eggs in stool.

Methods

We performed an in-depth analysis of the operational costs to process one stool sample for three diagnostic methods (Kato-Katz, Mini-FLOTAC and FECPAKG2). Next, we performed simulations to determine the probability of detecting a truly reduced therapeutic efficacy for different scenarios of STH species (Ascaris lumbricoides, Trichuris trichiura and hookworms), pre-treatment infection levels, survey design (screen and select (SS); screen, select and retest (SSR) and no selection (NS)) and number of subjects enrolled (100–5,000). Finally, we integrated the outcome of the cost assessment into the simulation study to estimate the total survey costs and determined the most cost-efficient survey design.

Principal findings

Kato-Katz allowed for both the highest sample throughput and the lowest cost per test, while FECPAKG2 required both the most laboratory time and was the most expensive. Counting of eggs accounted for 23% (FECPAKG2) or ≥80% (Kato-Katz and Mini-FLOTAC) of the total time-to-result. NS survey designs in combination with Kato-Katz were the most cost-efficient to assess therapeutic drug efficacy in all scenarios of STH species and endemicity.

Conclusions/significance

We confirm that Kato-Katz is the fecal egg counting method of choice for monitoring therapeutic drug efficacy, but that the survey design currently recommended by WHO (SS) should be updated. Our generic framework, which captures laboratory time and material costs, can be used to further support cost-efficient choices for other important surveys informing STH control programs. In addition, it can be used to explore the value of alternative diagnostic techniques, like automated egg counting, which may further reduce operational costs.

Trial Registration

ClinicalTrials.gov NCT03465488
The expression of stem cells markers and its effects on the propensity for recurrence and metastasis in bladder cancer: A systematic review
Authors: Hamid Agus Rizal Ardy Hariandy , Syadza Yasmina Zahra , Yausep Oliver Emmanuel , Christanto Roberto Bagaskara Indy , Muharia Bayu Hernawan Rahmat , Mochtar Chaidir Arif
Published: May 2023

Bladder cancer is one of the most frequent cancers of the urinary tract, associated with high recurrence rates and metastasis. Cancer stem cells (CSCs) are a subpopulation of cancer cells characterized by high self-renewal and differentiation capacities, resulting in increased cancer recurrence, larger tumor size, higher rates of metastasis, higher resistance to treatment, and overall poorer prognosis. This study aimed to evaluate the role of CSCs as a prognostic tool to predict the risks of metastasis and recurrence in bladder cancer. A literature search was conducted across seven databases from January 2000 to February 2022 for clinical studies investigating the use of CSCs to determine the prognosis of bladder cancer. The following keywords were used: (“Bladder Cancer” OR “Transitional Cell Carcinoma” OR “Urothelial Carcinoma”) AND (“Stem Cell” OR “Stem Gene”) AND (“Metastasis” OR “Recurrence”). A total of 12 studies were deemed eligible for inclusion. SOX2, IGF1R, SOX4, ALDH1, CD44, Cripto-1, OCT4, ARRB1, ARRB2, p-TFCP2L1, CDK1, DCLK1, and NANOG, which were all identified as CSC markers. Several of these markers have been implicated in the recurrence and metastasis of tumor in bladder cancer, which played a role as prognostic factor of bladder cancer. Given the pluripotent and highly proliferative properties of CSCs. CSCs may play a role in the complex biological behavior of bladder cancer, including, but not limited to, its high rates of recurrence, metastasis, and resistance to treatment. The detection of cancer stem cell markers offers a promising approach in determining the prognosis of bladder cancer. Further studies in this area are thus warranted and may contribute significantly to the overall management of bladder cancer.
Construction of model animals to explore intestinal microbiome for detection of breast cancer
Authors: Ji Xia , Li Ruipeng , Hu Xiaoyu , Tian Yufang , Liu Liqiong , Zhang Chenyu , Xu Liangxiong , Chen Yongzhi , Xie Haiwei , Mao Lutian , Cai Tianshu , Li Weiwei
Published: May 2023

Breast cancer ranks first among female cancers and has become a major public health problem in the current society. More studies indicated that these cancers are related to the change in the gut microbiome that can cause metabolic and immune system disorders in the body. However, there are few studies on the changes in gut microbiome caused by the onset of breast cancer, and the relationship between breast cancer and gut microbiome needs to be further clarified. In this study, we inoculated 4T1 breast cancer cells to induce breast cancer tumorigenesis in mice and collected their feces samples at different stages during this process. These intestinal florae were analyzed using 16S rRNA gene amplicon sequencing, and the results showed that at the phylum level, the ratio of Firmicutes/Bacteroidetes decreased with the development of the tumor; at the family level, the intestinal microbiome had obvious variations of Lachnospiraceae, Bacteroidaceae, Erysipelotrichaceae, etc. The Kyoto Encyclopedia of Genes and Genomes (KEGG) and COG annotation demonstrated that decreased abundance of cancer-related signaling pathways. This study elucidated the relationship between breast cancer and intestinal microbiome, and the research results can be used as an important biomarker for the diagnosis of breast cancer.
Buffering the effects of bad news: Exposure to others’ kindness alleviates the aversive effects of viewing others’ acts of immorality
Authors: Buchanan Kathryn , Sandstrom Gillian M.
Published: May 2023

Negatively valenced news dominates the press, with stories of death and destruction gaining significant traction while also negatively impacting people’s mental health and perceptions of humanity. Given that horrific acts happen and need to be reported, we examined if news stories featuring others’ kindness could undo the aversive effects of news stories featuring others’ immorality. In Studies 1a-d we tested whether media exposure to the acts of kindness that occurred in response to a terrorist attack could alleviate the aversive effects of media exposure to the terrorist attack. In Study 2, we examined whether, more generally, the aversive effects of news stories featuring immorality (e.g., homicide, paedophilia, bullying) could be alleviated through news stories featuring acts of kindness (e.g., volunteering, philanthropy, caring for the homeless). In Studies 1 and 2, we found that participants exposed to others’ immorality and then others’ kindness suffered from less aversive changes to their mood, experienced greater levels of elevation and were more inclined to believe in the goodness of others, than participants exposed only to others’ immorality. Given this, we suggest there is merit in journalists shining a light on others’ kindness if people’s affective well-being and belief in the goodness of humanity is to remain intact.
Mechanisms and contextual factors related to key elements of a successful integrated community-based approach aimed at reducing socioeconomic health inequalities in the Netherlands: A realist evaluation perspective
Authors: Wilderink Lisa , Visscher Annemijn , Bakker Ingrid , Schuit Albertine J. , Seidell Jacob C. , Renders Carry M.
Published: May 2023

Background

Reducing health inequalities is a challenge for policymakers and civil society. A multisectoral and multilevel approach is most promising to reduce those inequalities. Previous research showed what key elements of Zwolle Healthy City, an integrated community-based approach aimed at reducing socioeconomic health inequalities, are. To fully understand approaches that are complex and context dependent, questions as ‘how does the intervention work’ and ‘in what context does it work’ are just as important as ‘what works’. The current study aimed to identify mechanisms and contextual factors associated with the key elements of Zwolle Healthy City, using a realist evaluation perspective.

Methods

Transcripts of semi-structured interviews with a wide range of local professionals were used (n = 29). Following realist evaluation logic in the analysis of this primary data, context-mechanism-outcome configurations were identified and thereafter discussed with experts (n = 5).

Results

How mechanisms (M) in certain contexts (C) were of influence on the key elements (O) of the Zwolle Healthy City approach are described. For example, how, in the context of the responsible aldermen embracing the approach (C), regular meetings with the aldermen (M) increased support for the approach among involved professionals (O). Or, how, in the context of available financial resources (C), assigning a program manager (M) contributed positively to coordination and communication (O). All 36 context-mechanism-outcome configurations can be found in the repository.

Conclusion

This study showed what mechanisms and contextual factors are associated with the key elements of Zwolle Healthy City. By applying realist evaluation logic in the analysis of primary qualitative data we were able to disentangle the complexity of processes of this whole system approach and show this complexity in a structured manner. Also, by describing the context in which the Zwolle Healthy City approach is implemented, we contribute to the transferability of this approach across different contexts.
Relationships of weight perceptions with weight control related behaviors among Chinese children and adolescents: A school-based study in Zhejiang Province
Authors: Yu Zhu , Dong Guanping , Wu Wei , Huang Ke , Zhou Xiao-Yan , Wang Hao , Wang Meng , Fu Junfen
Published: May 2023

Objectives

Weight perceptions have been implicated in weight control related behaviors among children and adolescents, yet studies in mainland China are scarce. We examined the associations of self-perceived weight status and weight misperception with weight control related behaviors in Chinese middle and high school students.

Methods

We used cross-sectional data from the 2017 Zhejiang Youth Risk Behavior Survey which that included 17,359 Chinese students, with 8,616 boys and 8,743 girls. Perceived weight status, as well as height, weight and weight control related behaviors information was collected via a self-reported questionnaire. Odds ratios (ORs) with 95% confidence intervals (CIs) calculated by multinomial logistic regression were used to assess the relationships between weight perceptions and weight control related behaviors.

Results

Among the 17,359 students aged 9 to 18 years, the mean (SD) age was 15.72 (1.64) years. Overall, 34.19% of children and adolescents perceived themselves as overweight and the prevalence of weight misperception was 45.44%, with 35.54% overestimation and 9.90% underestimation. Children and adolescents perceiving themselves as overweight were more likely to have weight control behaviors, with OR was 2.60 (95% CI: 2.39–2.83) for weight control attempt, 2.48 (2.28–2.70) for exercising, 2.85 (2.60–3.11) for dieting, 2.01 (1.51–2.68) for taking laxatives, 2.09 (1.67–2.02) for taking diet pills, and 2.39 (1.94–2.94) for fasting, respectively, compared to those with right weight status. Among children and adolescents with overestimating weight status, the OR was 2.40 (2.22–2.59), 2.50 (2.31–2.70), 2.85 (2.61–3.11), 1.81 (1.39–2.37), 2.20 (1.77–2.74), and 2.16 (1.77–2.63) for weight control attempt, exercising, dieting, taking laxatives, taking diet pills, and fasting, relative to those with accurate weight perception.

Conclusions

Self-perceived overweight and weight misperception are prevalent in Chinese children and adolescents, and positively associated with weight control related behaviors.
Industrial structure, high-quality development of logistics industry and the economy
Authors: Yan Borui , Yao Bo , Zhang Chenjing
Published: May 2023

The logistics industry is closely related to the high-quality economic development. At different levels of industrial structure, the relationship between high-quality development of the logistics industry and the high-quality economic development will vary, resulting in different roles and paths in promoting economic development. However, there is still a lack of research on the relationship between high-quality development of the logistics industry and high-quality economic development at different levels of industrial structure, and further empirical research is needed. It used the benchmark regression model to analyze the impact of the high-quality development of the logistics industry on high-quality economic development, and the panel threshold model was used to analyze the impact of the logistics industry on high-quality economic development at different levels of industrial structure development. The results show that the high-quality development of the logistics industry has a positive role in promoting the high-quality economic development, and in different levels of industrial structure development, the impact of high-quality development level of logistics industry on the high-quality economic development is different. Therefore, it is necessary to further optimize the industrial structure, promote the deep integration and development of logistics and related industries, and continue to promote the high-quality development of the logistics industry. And when formulating development strategies for the logistics industry, governments and enterprises need to consider factors such as changes in industrial structure, the overall goals of national economy, people’s livelihood, and social development, in order to provide solid support for achieving high-quality economic development. This paper demonstrates the importance of high-quality development of the logistics industry in high-quality economic development, and it encourages the adoption of different strategies at different stages of industrial structure development to promote high-quality development of the logistics industry, and achieve high-quality economic development.