bluuebunny/crossref_metadata_2025 huggingface dataset:
SABR-Dual: A phase II/III trial of two-fraction versus five-fraction stereotactic radiotherapy for localized low- and favorable intermediate-risk prostate cancer
Authors: Fredman Elisha , Icht Oded , Moore Assaf , Bragilovski Dimitri , Kindler Yoni , Golan Shay , Limon Dror
Published: August 2023

Background: Dose-escalated radiotherapy is known to improve progression free survival in patients with localized prostate cancer, and recent advances have led to the standardization of ultrahypofractionated stereotactic ablative radiotherapy (SABR) delivered in just 5-fractions. Based on the known effectiveness of the accepted though invasive 2-fraction treatment method of high-dose-rate brachytherapy and given the ubiquity of prostate cancer, a further reduction in the number of treatments of external-beam SABR is possible. This study aims to evaluate the safety, efficacy, and non-inferiority of generalizable 2-fraction SABR compared to the current 5-fraction regimen.
Methods: 608 patients will be enrolled on this phase II/III randomized control trial. Eligible patients will have previously untreated low- or favorable intermediate-risk adenocarcinoma of the prostate. Patients will be randomized between standard SABR of 40 Gy in 5 fractions given every-other-day and 27 Gy in 2 fractions at least two days apart but completing within seven days. MRI-based planning, SpaceOAR VueTM insertion, and fiducial marker placement are required, and SABR will be delivered on a standard CT-guided linear accelerator. The primary endpoint will be freedom from disease progression, with additional secondary clinical, toxicity, and quality of life endpoints.
Discussion: This study will be the largest prospective randomized trial, adequately powered to demonstrate non-inferiority, comparing 2-fraction SABR to standard 5-fraction SABR for localized prostate cancer. As the protocol does not necessitate use of an MRI-LINAC or other adaptive technologies, results will be broadly generalizable to the wider community.
Trial registration: This trial was prospectively registered on Health.gov.il
Health.gov.il identifier: MOH_2022-08-30_012007
Telemedicine in pediatric and family care: physicians’ perceptions toward the quality of care, safety, and satisfaction with telephone visits in Israel
Authors: Shalom Tamar , Bashkin Osnat , Gamus Alexander , Blachar Yoram , Yaron Shlomit , Netzer Doron , Nevet Ayelet , Lavie Gil
Published: August 2023

Background Technological development of remote healthcare has accelerated since the outbreak of the COVID-19 virus. While telemedicine offers an efficient way to deliver care, it also presents considerable new challenges. In this study, we examined family physicians’ and pediatricians’ perceptions regarding three aspects of the use of telephone visits: quality of care, safety of care, and physicians’ satisfaction.Methods This mixed-methods study surveyed 342 family physicians and pediatricians in Clalit Health Services (Clalit) regarding their perceptions toward using telephone visits. Participants responded to an online survey that included demographic questions and eighteen 5-point Likert scale statements describing quality, safety, and physicians’ satisfaction with telephone visits. This was followed by in-depth interviews with 26 physicians between January to April 2023.Results Participants expressed high satisfaction (3.66 ± 0.80) with the use of telephone visits and lower assessments of safety (3.03 ± 0.76) and quality (2.27 ± 0.76) of care using the telephone modality. Eighty percent of the respondents think combining a face-to-face visit with a telephone visit is recommended and 51% noted that the inability to examine the patient closely affects and impedes the physician’s decision-making. Most interviewees indicated that telephone visits are safe only with former patients they had already seen in the clinic. Interviewees suggested improvements, such as patient education, a decision support system, and technological upgrades to the modality.Conclusions The findings shed light on the perceptions of family physicians and pediatricians regarding telephone visits. Although satisfaction with telemedicine is generally high, the differing opinions regarding the quality and safety of the telephone meeting underscores the need for careful use of telephone visits in healthcare. The findings uncover the barriers for the acceptance of this modality and our recommendations may help healthcare organizations to improve the use and increase the acceptability of this service, including proper and balanced selection of patients, implementing technological upgrades to the modality and performing patient education practices.
Postpartum uterine health, and energy metabolism of primiparous and multiparous crossbred dairy cows raised in the Amazon biome
Authors: Pfeifer Luiz , Andrade Jessica Souza , Barbosa Ingrid Pedraça , Gomes Leonardo Silva , Silva Samira Alves , Silva Renata Reis , Paes Felipe Haridassa , Noleto Gabrielly Santos
Published: August 2023

This study aimed to compare the biological activity of the uterus and the metabolism between primiparous and multiparous crossbred dairy cows. Eighteen crossbred dairy cows (B. indicus x B. taurus) were divided by parity order into primiparous (n = 8), and multiparous (n = 10) cows. These cows were evaluated from parturition to 50 days in milk (DIM) for metabolic and reproductive variables. Also, uterine tissue was collected using the cytobrush technique to assess the proportion of polymorphonuclear cells and abundance of transcripts of genes associated with inflammation and receptivity. Multiparous cows had greater milk production (P = 0.04). Primiparous cows had a higher (P ≤ 0.05) relative abundance of IL-6, PTCH2, and PGR mRNA. In contrast, Multiparous cows had a higher relative abundance of IL-10 mRNA. The proportion of primiparous cows ovulating from calving to 50 DIM tended (P = 0.08) to be greater. Overall, the findings indicated that parity does not significantly affect energy metabolism and that multiparous cows have lower uterine inflammatory response associated with lower relative expression of IL-6 and higher relative expression of IL-10. These results led us to conclude that parity has little effect on the puerperium of crossbred dairy cows. Moreover, crossbred dairy cows were considered healthy by 50 DIM; however, further field studies with larger numbers of animals should be performed to define an optimal voluntary waiting period for crossbred dairy cows raised in the Amazon Biome.
Traditional Chinese medicine paraffin therapy for functional dyspepsia： a randomized controlled trial protocol
Authors: Yang Xiaochen , Liu Lanping , Yan Wenxi , Peng Weina , Feng Ling , Yang Tao , Gao Yinqiu
Published: August 2023

Background: Traditional Chinese medicine paraffin therapy (TCMPT), a combination therapy of herbal acupoint application therapy and paraffin therapy, has demonstrated great effectiveness in treating some diseases. However, there is no relevant research in the treatment of functional dyspepsia (FD) with TCMPT.Using a randomized controlled trial, we investigate whether TCMPT is effective in improving Clinical-Assessment–FD symptoms (SCA-FD), in comparison with herbal acupoint application therapy, paraffin therapy and basic treatment. Further more, this study is also interested in changes of psychological status in patients with FD before and after TCMPT.
Methods: This trial will be conducted in the Guang’anmen Hospital of China Academy of Chinese Medical Sciences in China. 120 FD patients will be randomized to one of the four arms of the trial: (1) TCMPT group, (2) Herbal acupoint application therapygroup, (3) Paraffin therapy group, and (4) Basic treatment group. The experimental phase will last 4 weeks,followed by a 2-week and 4-week follow-up period. During the 4-week treatment period, all the patients included will be treated with basic treatment (Omeprazole Magnesium Enteric-coated Tablets of 20mg, take orally, once daily for 4 weeks). In addition to basic treatment, patients in the TCMPT group will be treated with TCMPT, herbal acupoint application therapy group will be treated with herbal acupoint application therapy, paraffin therapy group will be treated with paraffin therapy (the treatment of each group will be applied 3 times a week, once every 1-2 days, for 4 weeks). The primary outcome are changes in the SCA-FD from baseline to the end of 4-week intervention. The secondary outcome measures are changes in the SCA-FD at other time points, Hospital Anxiety Depression Scale (HADS), Perceived Stress Scale (PSS), Short Form 36-item Health Survey (SF-36), and Changes of skin temperature at selected acupoints. Laboratory tests and adverse events also will be recorded.
Discussion: If effective, this study will provide evidence for TCMPT in improving FD symptoms and mental health state of FD patients, and confirm that the effectiveness of TCMPT is better than herbal acupoint application therapy and paraffin therapy alone. The findings from this trial could be used to design new research protocols.
Trial registration: Chinese Clinical Trial Registry, ChiCTR2200061950, registered on 13 July 2022.
Blood glucose outcomes of anti-retroviral therapy naïve Ugandan people with HIV with pre-diabetes mellitus initiated on dolutegravir for 48 weeks
Authors: Mulindwa Frank , Schwarz Jean-Marc , Brusselaers Nele , Nabwana Martin , Bollinger Robert , Buzibye Allan , Amutuhaire Willington , Yendewa George , Laker Eva , Kiguba Ronald , Castelnuovo Barbara
Published: August 2023

Background:
The Uganda ministry of Health recommends frequent blood glucose monitoring for the first six months on dolutegravir, in people with HIV (PWH) having pre-diabetes mellitus (pre-DM). We sought to determine if indeed PWH with pre-diabetes started on dolutegravir had worse blood glucose outcomes at 48 weeks compared to those with normal blood glucose.
Methods:
In this matched cohort study, we compared 44 PWH with pre-DM and 88 PWH with normal blood glucose at baseline. The primary outcome was change in mean fasting blood glucose (FBG) from baseline to week 48 and 2-hour blood glucose (2hBG) from baseline to week 36 compared between the two groups.
Results:
There was significant increase in FBG in PWH with normal blood glucose (mean change in FBG(FBG): 3.9mg/dl, 95% confidence interval (95% CI): (2.2, 5.7), p value (p) = < 0.0001) and decrease in those with pre-DM (FBG: -6.1mg/dl, 95%CI (-9.1, -3.2), p = < 0.0001) at 48 weeks. 2hBG at 36 weeks was significantly lower than at baseline in both groups with the magnitude of reduction larger in those with pre-DM at 12 weeks (adjusted differences in mean drop in 2hBG (a2hBG): -19.69mg/dl, 95%CI (-30.19, -9.19), p = < 0.0001) and 36 weeks (a2hBG: -19.97mg/dl, 95%CI (-30.56, -9.39), p = < 0.0001).
Conclusion;
We demonstrated that Ugandan ART naïve PWH with pre-diabetes at enrollment have consistent improvement in both fasting blood glucose and glucose tolerance over 48 weeks on dolutegravir. Intensified blood glucose monitoring of these patients in the first six months of dolutegravir may be unnecessary.
Performance evaluation of three antibody binding assays, a neutralizing antibody assay, and an interferon-gamma release assay for SARS-CoV-2 according to vaccine type in vaccinated group
Authors: NAM MINJEONG , Cha Jae Hyun , Kim Sang-wook , Kim Sun Bean , Lee Ki-Byung , Chung You-Seung , Yun Seung Gyu , Nam Myung-Hyun , Lee Chang Kyu , Cho Yunjung
Published: August 2023

We evaluated the performance of SARS-CoV-2 assays in the vaccinated group using receptor-binding domain antibody assays (RBD Ab assay), neutralizing antibody assay (nAb assay), and interferon-gamma release assay (IGR assay). We also compared the performance of the SARS-CoV-2 assays based on vaccine type in a large population. We collected 1,851 samples from vaccinated individuals with vector, mix-and-match (MM), and mRNA vaccines. The performance of the RBD Ab assays was assessed by SARS-CoV-2 IgG II Quant (Abbott Laboratories, Sligo, Ireland), SARS-CoV-2 IgG (Beckman Coulter, CA, USA), and anti-SARS-CoV-2 S (Roche Diagnostics GmbH, Mannheim, Germany). The nAb assay was assessed by cPass SARS-CoV-2 neutralization antibody detection kits (GenScript, NJ, USA). The IGR assay was assessed by QuantiFERON (Qiagen, Venlo, The Netherlands). Median values of the RBD Ab assays and nAb assay sequentially increased after the 1st and 2nd vaccinations. RBD Ab assays and nAb assay showed very strong correlations. The median values of the RBD Ab, nAb, and IGR were higher in the mRNA vaccine group than in the vector and MM vaccine groups. The agreement and correlation among the RBD Ab assays, nAb assay, and IGR assay were higher in the mRNA vaccine group than in the vector and MM vaccine groups. We compared the performance of the RBD Ab assay, nAb assay, and IGR assay based on the vaccine types using the RBD Ab, nAb, and IGR assays. This study provides a better understanding of the assessment of humoral and cellular immune responses after vaccination.
Factors associated with retention of Health workers in remote Public Health Centers in Northern Uganda: a cross-sectional study
Authors: Twineamatsiko Andrew , Mugenyi Nathan , Kuteesa Yvonne Nabachwa , Livingstone Ejalu David
Published: August 2023

Background: Health worker retention in remote and hard-to-reach areas remains a threat in most low- and middle-income countries, and this negatively impacts health service delivery.
Objective: This paper explores factors associated with retention of health workers in remote public health centers in Lira district in Northern Uganda.
Methods: A descriptive cross-sectional study with quantitative methods of data collection was used among health workers. The study utilized a structured questionnaire with closed ended questions to obtain quantitative information.
Results: Most of the health workers were attached to HC IIIs (61.28), females (62.90%), married (84.62%), with certificate level (55.74%), and nurses (36.60%). Likewise, most of the health workers were from within 5kms from the place they grew up from (37.45%), not staying with their families at the health facility (65.11%), of age group 31-40 years (42.98%), had worked at facility and with employer for 2-5 years or above 5 years (56.6%) and 45.96% respectively.
The average retention rate of health workers was 87.04%. Several individual, health system and career related factors were significantly associated.
Conclusion: The retention rate of health workers in the remote rural public health centers of Lira District is within the same ranges as other places in the world. The study established that indeed several individual and social demographics, health system and career related factors are significantly associated with retention of Health workers in the rural public health facilities.
Research on Intelligent Grading Method of Beef Marble Pattern Based on Few-shot Learning
Authors: LIU Chao , CHEN Kunjie , Wen Hongyuan , ZHANG Jiayu , QI Chao
Published: August 2023

The beef quality grading model based on deep learning requires a large number of samples. Obtaining accurate beef samples requires manual classification or classification through more complex process methods, and the workload is huge. Aiming at the above problems, a beef marble pattern recognition model based on small sample learning is proposed. According to the national standard, a beef marble pattern grading data set was established by artificial classification method, and a lightweight CNN network was designed for image feature extraction. The pre-training of CNN was completed on the mini-ImageNet data set. The cross entropy loss function is updated with support set samples and the entropy regularization function is updated with query set samples to further optimize the parameter weights in the softmax classifier. Using cosine similarity to compare image feature vectors, softmax as a classifier to complete the task of image classification. The results show that the classification effect of this model is the best, and the highest accuracy of beef marble pattern recognition is 96.66 %. Under the premise of the same number of training samples, it is obviously better than other models.
A method for using the cell-penetrating peptides for loading plasmid DNA into secreted extracellular vesicles
Authors: Nebogatova Jekaterina , Härk Heleri Heike , Puskar Anett , Porosk Ly , Guazzi Paolo , Dowaidar Moataz , Langel Ülo , Kurrikoff Kaido
Published: August 2023

The low bioavailability and high toxicity of pDNA-based therapeutics make their application in vivo challenging. Extracellular vesicles (EVs) have great potential to overcome those limitations, thus they are biocompatible native cargo carriers. Various strategies to load EVs with pDNA, such as electroporation, sonication, and co-incubation, have been previously investigated, but with questionable success. In this work, we report a unique method of loading EVs through transient transfection of donor cells with complexes formed between pDNA and CPPs. With this method, we achieve up to 104 fold higher expression levels of the luciferase reporter protein in recipient cells compared to the untreated cells. This indicates high transfection efficacy and bioavailability of delivered encapsulated nucleic acid. Also, the in vivo experimental data indicates that the use of pDNA-loaded-EV as the native delivery vehicle reduces the toxic effects associated with traditional nucleic acid (NA) delivery and treatment.
Development and validation of a prognostic model of survival for classic heatstroke patients: A multicenter study
Authors: Wang Yu , Li Donglin , Wu Zongqian , Zhong Chuan , Tang Shengjie , Hu Haiyang , Lin Pei , Yang Xianqing , Liu Jiangming , Zhou Haining , Liu Fake , He Xinyi
Published: August 2023

Background
Classic heatstroke (CHS) is a life-threatening illness characterized by extreme hyperthermia, dysfunction of the central nervous system and multiorgan failure. Accurate predictive models are useful in the treatment decision-making process and risk stratification.This study was to develop and externally validate a prediction model of survival for hospitalized patients with CHS.
Methods
In this retrospective study, we enrolled patients with CHS who were hospitalized from June 2022 to September 2022 at 3 hospitals in Southwest Sichuan (training cohort) and 1 hospital in Central Sichuan (external validation cohort). Prognostic factors were identified utilizing least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate Cox regression analysis in the training cohort. A predictive model was developed based on identified prognostic factors, and a nomogram was built for visualization. The areas under the receiver operator characteristic (ROC) curves (AUCs) and the calibration curve were utilized to assess the prognostic performance of the model in both the training and external validation cohorts. The Kaplan‒Meier method was used to calculate survival rates.
Result
A total of 189 patients (median age, 75 [68–81] years) were included. Social isolation, self-care ability, comorbidities, body temperature, heart rate, Glasgow Coma Scale (GCS), procalcitonin (PCT), aspartate aminotransferase (AST) and diarrhea were found to have a significant or near-significant association with worse prognosis among hospitalized CHS patients. The AUCs of the model in the training and validation cohorts were 0.994 (95% [CI], 0.975–0.999) and 0.815 (95% [CI], 0.596–0.956), respectively. The model's prediction and actual observation demonstrated strong concordance on the calibration curve regarding 7-day survival probability. According to K‒M survival plots, there were significant differences in survival between the low-risk and high-risk groups in the training cohort and borderline significant differences in the external validation cohort.
Conclusion
We designed and externally validated a prognostic prediction nomogram for CHS. This model has promising predictive performance and could be applied in clinical practice for managing patients with CHS.
Measurement of vitreous humor pressure in vivo using an optic-fiber pressure sensor
Authors: Mimura Masashi , Akagi Tadamichi , Kohmoto Ryosuke , Fujita Yasushi , Sato Yohei , Ikeda Tsunehiko
Published: August 2023

We conducted a study to assess the pressure difference between the aqueous and vitreous humors in rabbit eyes using a direct intraocular pressure (IOP) measurement method. A micro-optic-fiber pressure sensor was utilized for this purpose. Preliminary experiments with enucleated porcine eyes confirmed the sensor's accuracy in measuring both aqueous and vitreous humor pressure. The main study involved six healthy albino rabbits, where the sensor measured the pressure in the anterior chamber (aIOP) and posterior vitreous-cavity (pIOP). These measurements were compared to aIOP values obtained through rebound tonometry. Additionally, pre- and postoperative pressure comparisons were made after performing a vitrectomy. Results revealed a significant disparity between aqueous and vitreous humor pressures. Prior to vitrectomy, pIOP was 22.8mmHg, over twice as high as aIOP (11.0mmHg), but decreased to a similar level following the procedure. Comparison between the sensor measurements and rebound tonometry showed agreement in aIOP values. In conclusion, our study demonstrates that vitreous humor pressure is consistently higher than aqueous humor pressure, reaching the upper limit of normal IOP. Furthermore, vitrectomy effectively reduces pIOP, aligning it with aIOP. These findings contribute valuable insights into intraocular pressure dynamics and have implications for clinical interventions targeting ocular pressure regulation.
Processing of boar spermatozoa with cold PBS induces an increase in p32
Authors: Martín-Hidalgo David , Izquierdo Mercedes , Bartolomé-García Paloma , Macías-García Beatriz , González-Fernández Lauro
Published: August 2023

We aimed to investigate the impact of processing boar spermatozoa with phosphate-buffered saline (PBS) at 4 ˚C on acrosomal integrity and increase in phosphorylation in tyrosine residues of the p32 protein. Following cold PBS washing, we observed a significant increase in p32 levels and in the proportion of non-viable spermatozoa with compromised acrosomal integrity compared to sperm washing using PBS at room temperature. Interestingly, this increase in p32 was effectively inhibited when cold PBS was supplemented with 1 mM AEBSF, a serine protease inhibitor. Our findings suggest that the induction of p32 in response to cold PBS washing in boar spermatozoa is associated with enhanced protease activity in dead spermatozoa.
Epidemiological trends of pyogenic spondylodiscitis in Germany: An EANS Spine Section Study
Authors: Kramer Andreas , Thavarajasingam Santhosh G. , Neuhoff Jonathan , Ponniah Hariharan Subbiah , Ramsay Daniele S. C. , Demetriades Andreas K. , Davies Benjamin M. , Shiban Ehab , Ringel Florian
Published: August 2023

Background: Pyogenic spondylodiscitis presents significant diagnostic and therapeutic challenges. In Germany, comprehensive understanding of its epidemiology and inpatient management outcomes is limited, hindering the optimisation of therapeutic strategies. This study aimed to characterise the evolving epidemiological trends of pyogenic spondylodiscitis in Germany, and concurrently evaluate inpatient management strategies and outcomes.
Methods: We performed a retrospective population-based study of spondylodiscitis cases in Germany from 2005 to 2021, utilising data from the German Federal Statistical Office database. The parameters assessed were incidence trends, demographic characteristics, inpatient management strategies, and inpatient mortality.
Results: The study found a significant rise in the population-adjusted incidence of spondylodiscitis in Germany from 2005 to 2021, increasing by 104% from 5.4 to 11.0 cases per 100,000 individuals (p<0.001). The highest number of diagnoses was recorded in 2019. Age group-adjusted data revealed the largest relative changes in the "90+" age group, followed by the "80-89" and "70-79" age groups. These increases were not solely attributable to population changes but were also confirmed after calculating the age-group-adjusted incidence rates. Additionally, our statistical analysis demonstrated that both age and year significantly influenced the incidence of spondylodiscitis. Over the same period, inpatient mortality also surged significantly by 347% (p<0.001), with the highest increase recorded in the 90+ age group, observing a 2450% rise (p<0.001). The mean length of inpatient stay decreased by 15% (p<0.05). Concurrently, there was a significant increase in surgical interventions using spinal stabilisation procedures (p<0.001), which might suggest a shift in the treatment paradigm for spondylodiscitis.
Conclusion: The results underscore a concerning rise in spondylodiscitis incidence and mortality in Germany, affecting the ageing population in particular. A notable shift towards surgical intervention was observed. The data highlights the urgent necessity for high-level evidence studies comparing surgical versus conservative treatment, thereby guiding optimised therapeutic strategies.
Synthesis of Enhanced Crosslinker and Its Effect on Rheological Properties of Hydrophobic Polymers
Authors: YANG Wen-wen , LAI xiao-juan , WEI Hui-ning , HE Xiao-gen , WANG lei , WEN xin
Published: August 2023

Objective:Taking zirconium oxychloride as the main body and ethylene glycol/cocamidopropyl dimethylamine glycolactone as the ligand, a surface-active enhanced cross-linking agent UF-4 was obtained, and the synthesis of the product was proved by infrared spectrometer.
Results:The obtained UF-4 and the hydro phobically associative polyacrylamide polymer GS709 were formed into a polymer gel, and it was found that "secondary cross-linking" could be achieved during the cross-linking process. The microstructure and rheological properties of the gel were characterized by scanning electron microscope and rotary rheometer. The results showed that the enhanced cross-linking agent UF-4 promoted the polymer gel to show excellent temperature and salt resistance. After shearing at 130 ℃ for 1 h, the viscosity in clear water was 120 mPa ·s and the viscosity was 110 mPa ·s in 20000 mg/L sodium chloride solution.
Through dynamic rheological frequency scanning and stress scanning, it is found that the formed polymer gel fluid shows elastic characteristics and obvious "secondary cross-linking" phenomenon.
A Soft Obstacle Search Strategy for Various Solitary Robots in an Unknown Environment
Authors: Masakuna Jordan F. , Kafunda Pierre K.
Published: August 2023

The problem of coordination without a priori informationabout the environment is important in robotics. Applications vary fromformation control to search and rescue. This paper considers the problemof search by a group of solitary robots: self-interested robots without apriori knowledge about each other, and with restricted communicationcapacity. When the capacity of robots to communicate is limited, theymay obliviously search in overlapping regions (i.e. be subject to inter-ference). Interference hinders robot progress, and strategies have beenproposed in the literature to mitigate interference (Wellman et al., 2011;Hourani et al., 2013). Interaction of solitary robots has attracted muchinterest in robotics, but the problem of mitigating interference when timefor search is limited remains an important area of research. We proposea coordination strategy based on the method of cellular decomposition(Choset, 2001) where we employ the concept of soft obstacles: a robotconsiders cells assigned to other robots as obstacles. The performance ofthe proposed strategy is demonstrated by means of simulation experi-ments in both actual and simulated environments. Simulations indicatethe utility of the strategy in situations where a known upper bound onthe search time precludes search of the entire environment.
Comparison of kinematics and myoelectrical activity during deadlift, with and without variable banded resistance, in healthy, trained athletes
Authors: Lohman Everett B. , Alameri Mansoor , Cakir Fulden , Chia Chih Chieh , Shih Maxine , Mulay Owee , Marceline Kezia , Jaisinghani Simran , Bains Gurinder , DeLeon Michael , Daher Noha
Published: August 2023

Background
The conventional deadlift is a popular exercise for improving trunk, core, and lower extremity strength due to its functional nature and engagement of multiple joints. However, its use in sports medicine facilities is limited due to concerns about potential lumbar injuries despite evidence supporting the safety and rehabilitative benefits of deadlifts. Understanding lifting mechanics and muscle activation is crucial for optimizing muscle activation using resistive bands in variable resistance therapy. We explored the feasibility of using resistive bands in the conventional deadlift to reduce initial trunk load during forward trunk inclination while gradually increasing resistance as the deadlift progresses. A secondary objective was to provide customized resistance recommendations for injured athletes during the deadlift exercise, based on findings from healthy participants and utilizing dose-response band selection.
Methods
Surface electromyography recorded muscle activity in the trunk and lower extremities during lifting, with normalization to the isometric Floor Lift using Maximal Voluntary Contraction. Kinematics were measured using inclinometer sensors to track hip and trunk sagittal plane angles. To prevent fatigue, each subject only used one of the three pairs of bands employed in the study.
Results
Forty-five healthy subjects (mean age: 30.4 ± 6.3 years) participated. Baseline characteristics were similar among the three study groups, except for years of lifting and strength-to-years-of-lifting ratio. Compared to the conventional deadlift group, different resistance band groups showed significantly higher muscle activity in various muscles during different phases of the deadlift. The minimal resistance band group had significantly higher muscle activity in trunk, core, and lower extremity muscles, particularly in the end phase. The moderate resistance band group exhibited higher muscle activity in the mid- and end-phases. The maximum resistance band group had higher muscle activity in several specific muscles during the early phase and overall increased activity in all trunk and lower extremity muscles during the mid and end phases of the deadlift (p < 0.05).
Conclusion
Findings provide valuable insights into the differential muscle activation associated with various resistance bands during deadlift exercise in the clinic and gym settings. There appears to be a dose-response relationship between increased resistance band width, external load, myoelectric activation, and range.
The Octahedral Collision-Based Periodic Orbit in the Three-Dimensional Eight-Body Problem
Authors: Simmons Skyler
Published: August 2023

We construct a highly-symmetric periodic orbit of six bodies in three dimensions. In this orbit, binary collisions occur at the origin in a regular periodic fashion, rotating between pairs of bodies located on the coordinate axes. Regularization of the collisions in the orbit is achieved by an extension of the Levi-Civita method. Initial conditions for the orbit are found numerically. In contrast to an earlier periodic collision-based orbit in three dimensions, this orbit is shown to be unstable.
Enhanced antimicrobial activity and In-vitro local anaesthetic activity of bupivacaine adsorbed reduced graphene oxide
Authors: Li Haoyu , Xie Ming
Published: August 2023

Current work proposed an easy, one-pot and green strategy for graphene oxide deoxygenation with the help of quercetin, which acts as a reducing agent in presence of bupivacaine. This synthetic approach avoids the use of harmful reducing agents. The descriptive results of Transmission electron microscopy (TEM), X-ray photo electron spectroscopy (XPS), X-ray diffraction (X-RD), Ultra violet visible (UV-Vis) spectroscopy for reduced graphene oxide (RGO) and synthesized graphene oxide (GO) indicates the oxygen containing groups removal followed by reduction process thereafter, stabilization using bupivacaine. Transparent and thin silk-like graphene sheets was exhibited by TEM analysis. Graphene sheets stabilization using oxidized form of quercitin molecules was proved by the analysis of Fourier transform infra-red (FT-IR) spectroscopy. The deoxygenation of GO to RGO was represented by the analysis of XPS and XRD. These outcomes show that this synthetic strategy is the best approach for large scale preparation of RGO in an easy, eco-friendly and cost effective method. Furthermore, the local anaesthetic activity was studied in guinea pig and frogs, which revealed the substantial local anaesthetic activity of prepared BRGO. Also, antimicrobial studies performed using the MTT assay, CFU enumeration, and growth curve analysis, which revealed that BRGO exhibited strong antimicrobial activity against dental pathogens. These findings suggest that BRGO could serve as a promising antibacterial material for dental care and therapy.
External Validation of Updated Prediction Models for Neurological Outcomes at 90 Days in Patients with Out-of-Hospital Cardiac Arrest
Authors: Nishioka Norihiro , Yamada Tomoki , Nakao Shunichiro , Yoshiya Kazuhisa , Park Changhwi , Nishimura Tetsuro , Ishibe Takuya , Yamakawa Kazuma , Kiguchi Takeyuki , Kishimoto Masafumi , Ninomiya Kohei , Ito Yusuke , Sogabe Taku , Morooka Takaya , Sakamoto Haruko , Hironaka Yuki , Onoe Atsunori , Matsuyama Tasuku , Okada Yohei , Matsui Satoshi , Yoshimura Satoshi , Kimata Shunsuke , Kawai Shunsuke , Makino Yuto , Zha Ling , Kiyohara Kosuke , Kitamura Tetsuhisa , Iwami Taku
Published: August 2023

Background
The accurate prediction of neurological outcomes in patients with out-of-hospital cardiac arrest (OHCA) with post-cardiac arrest syndrome is crucial for determining the optimal treatment or termination of resuscitation efforts. Hence, this study aimed to externally validate updated prediction models for OHCA outcomes using a large nationwide dataset.
Methods
Existing prediction models for adult patients with non-traumatic OHCA who achieved return of spontaneous circulation were refined using data obtained from the CRITICAL study, a multicentre registry in Osaka, Japan, between January 2013 and December 2019. The primary outcome was a dichotomised 90-day Cerebral Performance Category score. The model was updated using logistic regression with least absolute shrinkage and selection operator regularisation. External validation was performed using data from the JAAM-OHCA registry between January 2014 and December 2019. This is a nationwide multicentre registry in Japan that represents a geographically distinct population from the derivation set. The model performance was evaluated using a validation set.
Results
Two models (Model 1 included patient demographics, pre-hospital information, and the initial rhythm upon hospital admission; Model 2 included information obtained in the hospital immediately after the return of spontaneous circulation) were updated using the derivation set (n = 3337). In the validation set (n = 4250), Model 1 and 2 exhibited a C-statistic of 0.945 (95% confidence interval (CI): 0.935–0.955) and 0.958 (95% CI: 0.951–0.960), respectively. Both models were well-calibrated to the observed outcomes. Model 2 demonstrated higher net benefits at all risk thresholds according to the decision curve analysis. A web-based calculator was developed to estimate the probability of poor outcomes (https://pcas-prediction.shinyapps.io/90d_lasso/).
Conclusions
In the validation set, the updated model demonstrated excellent performance in predicting neurological outcomes at 90 days in patients with OHCA. The model, enhanced by incorporating hospital-available information as a predictor, reduced reliance on ambiguous predictors and improved prediction accuracy.
Local Delivery of Bcar3 siRNA by Nano-Self-Assembly for Treating Pulmonary Fibrosis via Blocking the Interaction of Macrophages and Fibroblasts
Authors: Zeng Chenxi , Wang Qi , liu Xuhan , Wang Congjian , Zhou Qing , Fu Xiangning , Yu Jun , Xiong Weining , Wang Yi , Ju Xuetao
Published: August 2023

Background
Idiopathic pulmonary fibrosis (IPF) is a life-threatening progressive interstitial lung disease with limited therapeutic options, characterized by macrophage infiltration and fibroblast activation in response to chronic lung injury. Specifically, the interaction of macrophages and fibroblasts is critical for facilitating IPF progression. However, no valuable therapeutic strategy has been proposed to inhibit this crosstalk.
Results
In this study, we investigated the role of breast cancer anti-estrogen resistance 3 (Bcar3), an adaptor molecule in the mitogenic signaling pathway, in IPF pathogenesis. We found that Bcar3 expression was upregulated in the lung tissues of both IPF patients and fibrotic mice. Furthermore, Bcar3 facilitated macrophage activation and fibroblast differentiation induced by IL-4 and TGF-β1, respectively. Mechanistically, Bcar3 up-regulation depended on Stat6 in macrophages and TGFβR1/Smad3 in fibroblasts. Furthermore, Bcar3 enhanced IL-4/Stat6 and TGF-β/Smad3 signaling in macrophages and fibroblasts, respectively, establishing a reciprocal activation loop between these two cell types, thus accelerating lung fibrogenesis. Additionally, intratracheal administration of Bcar3 siRNA-loaded liposomes afforded a precise delivery of gene therapeutics to macrophages and fibroblasts in the lung, protecting mice against FITC or bleomycin-induced lung fibrosis, as well as in human precision-cut lung slices stimulated with TGF-β1.
Conclusions
Overall, our study not only highlights the critical role of Bcar3 in the interaction between macrophages and fibroblasts during the progression of pulmonary fibrosis but also demonstrates that strategies aimed at targeting Bcar3 could be considered a promising therapeutic strategy for managing IPF.
Zinc overload induces mitochondrial dysfunction and ROS-mediated mitophagy
Authors: Yang Ying , Wang Pei , Guo Jiabao , Ma Tingting , Hu Youcheng , Huang Luyao , Xing Bohan , He Yonggui , Xi Jinkun
Published: August 2023

Zinc homeostasis is essential for maintaining redox balance, cell proliferation, and apoptosis. However, excessive zinc exposure is toxic and leads to mitochondrial dysfunction. In this study, we established a zinc overload model by treating rat cardiomyocyte H9c2 cells with ZnCl2 at different concentrations. Our results showed that zinc overload increased LDH and reactive oxygen species (ROS) levels, leading to cell death, mitochondrial membrane potential decrease and impaired mitochondrial function and dynamics. Furthermore, zinc overload activated the PINK1/Parkin signaling pathway and induced mitochondrial autophagy via ROS, while NAC inhibited mitophagy and weakened the activation of PINK1/Parkin pathway, thereby preserving mitochondrial biogenesis. In addition, our data also showed that Mfn2 deletion increased ROS production and exacerbated cytotoxicity induced by zinc overload. Our results therefore suggest that ZnCl2-induced ROS generation causes mitochondrial autophagy and mitochondrial dysfunction, damaging H9c2 cardiomyocytes. Additionally, Mfn2 may play a key role in zinc ion-mediated endoplasmic reticulum and mitochondrial interactions.
Nomograms for predicting early death in elderly colorectal cancer patients based on the SEER database
Authors: He Lulu , Chen Yan , Huang Huanhuan , Wu Yufei , Zhao Chenyi , Lu Yujie , Wang Xiaoyan , Gu Dingyi , Li Jiamin , Guo Feng
Published: August 2023

Background: Elderly colorectal cancer (ECRC) patients are generally in poor physical condition due to long-term tumor consumption, and are prone to severe complications or treatment failure. This study found out the risk factors that are related to early death in ECRC patients. A predictive model was then developed. This model can be used to calculate the risk of all-cause and cancer-specific early death in ECRC patients. Methods: Data were obtained from the Surveillance, Epidemiology and End Results (SEER) database. Patients with ECRC between 2010 and 2015 were included, and cases with complete data were screened using established criteria. The study then used univariate logistic regression analyses and multivariate logistic regression analyses (stepwise selection method) to identify the most relevant factors among the many variables associated with early death in ECRC patients. On this basis, nomogram prediction models were constructed. These models can be used to predict the risk of early death in ECRC patients. Finally, the model was evaluated in the experiment using receiver operating characteristic (ROC) curves, decision curve analysis (DCA), calibration curves, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: 16,512 ECRC patients were selected for study from SEER. Of these, 3443 patients died early ( death within 3 months of initial diagnosis). The early deaths of 2387 patients were cancer-specific early deaths. Race, Grade, AJCC stage, T stage, N stage, surgery, chemotherapy, radiotherapy, bone metastasis, lung metastasis, and primary site were independent risk factors for predicting all-cause early death in ECRC patients. Race, Grade, AJCC stage, T-stage, N-stage, surgery, chemotherapy, radiotherapy, bone, brain, liver and lung metastases and tumour size were independent risk factors to predict cancer-specific early death in ECRC patients. Then, the nomogram predictive models were built, using these identified variables. These models showed good concordance and accuracy in early mortality risk. Conclusion: Nomogram predictive models developed in this research is a practical tool. This model can help clinicians easily and quickly recognise high-risk ECRC patients. It can also be used as a reference for developing personalised treatment plans for patients.
Is it the Patient or is it the Disease – Considerations when Applying Different Cost Effectiveness Thresholds in Making Reimbursement Decisions
Authors: Coyle Doug
Published: August 2023

Background
In many jurisdictions, decision makers are considering whether in making decision about reimbursing health technologies they should prioritise specific patient populations or diseases: e.g., cancer or rare disease. This can be achieved through applying higher willingness to pay thresholds which implicitly involves the application of equity weighting of outcomes such as QALYs. Decision makers, however, must choose whether to apply equity weights to a specific disease or to the patient with this disease. The objective of this study is to examine the potential impact of implementation of equity weights under either scenario.
Methods
In a health care system with a constrained budget, applying equity weights leads to a reduction in the cost effectiveness threshold for those treatments not meeting criteria for prioritization. For illustration, two hypothetical case studies relating to a rare disease illustrate the repercussions of the two potential approaches to equity weights on funding decisions.
Results
The first case study demonstrates how applying equity weights only to the treatment of the rare disease of interest can lead to a patient with that rare disease accruing less benefits at a higher cost to the payer. The second case study demonstrates that if equity weights are applied to the patient who have a specific rare disease, then funding of a treatment for a common disease may be restricted only to the subset of patients who have this rare disease as a comorbidity. In this scenario, the treatment of the common disease may be restricted to those patients for whom treatment is more costly and less effective.
Conclusions
As discussions continue with respect to applying equity weights and adopting differential funding criteria for different patient populations it is important that these repercussions are recognised.
Superhydrophobicity Graving on Metallic Surface via Hierarchical Structure
Authors: Zheng Que , Lang Sue , Feng Shinhao
Published: August 2023

Using a sub-five picosecond laser, we investigated the creation of diverse surface structures on carbon nanotube-reinforced polymer composites. The composite material exhibited a transition in surface properties, beginning with laser-induced periodic surface structures (LIPSS) at a scale of approximately 1 μm, transforming into a double structure consisting of grains and LIPSS with mountain-like features. By conducting contact angle measurements, we assessed the wettability of the composite surface and observed a remarkable shift from hydrophilicity (63.6°) to superhydrophobicity (160.0°) as a result of the laser processing. This change led to an increase in the contact angle by approximately 100.0°, which was attributed to the creation of hierarchical surface structures showcasing the rose petal effect. Additionally, we quantified the contact angle hysteresis and surface roughness for further characterization. The utilization of a picosecond laser in generating such surfaces represents a promising and cost-effective alternative to femtosecond laser techniques.
Willingness to Accept Keratorefractive Surgery and Its Barriers Among Myopes at Eye Foundation Hospital Group, Nigeria.
Authors: AGU OBIAJULU
Published: August 2023

OBJECTIVES
The objective of the study was to determine the willingness to accept keratorefractive surgical procedures and its barriers to uptake of among myopes at Eye Foundation Hospital Group, Nigeria.
MATERIALS & METHODS
A descriptive, cross-sectional study was carried out at Eye foundation hospital group, involving consecutive consenting new patients diagnosed with any form of myopia. The research involved the administration of semi-structured questionnaires, in-depth interviews and focused group discussions, which were used to collect information on socio-demographic characteristics, willingness to accept the procedure and barriers to uptake of keratorefractive surgery.
RESULTS
The study involved 302 participants who were enrolled, and their ages ranged from 18 years to 57 years old, with an average age of 30.48 ± 8.44 years. Twenty-one percent of the participants were willing to accept the surgery if offered, 45% of the participants were not willing to accept the procedure while 34% of the participants were not sure if there would accept it or not. Participants with high myopia (chi-square p < 0.001) were more willing to accept keratorefractive surgery. Reasons for accepting to do surgery keratorefractive surgery were; tired of using spectacles/contacts (87.3%), career reason (11.1%), do not want to use spectacles (6.3%), beautification (6.3%) and leisure (1.6%). The reasons for not opting for keratorefractive surgery were; fear of damage (59.1%), lack of awareness (41.6%) and financial constraints (40.9%).
CONCLUSION
The willingness to accept keratorefractive surgical services in this study was low. The main barriers to the uptake of the services were fear of damage, lack of awareness and financial constraints and there is a need for patient education to improve surgical uptake.