bluuebunny/crossref_metadata_2025 huggingface dataset:
Static Stress Analysis and Fatigue Life Prediction of Rocket Motor Test Stand Using Numerical Simulation
Authors: Lasinta Ari Nendra Wibawa
Published: April 2023

The rocket motor test stand is the equipment used to test the rocket motor's performance under controlled conditions. This equipment is used to measure the thrust of the Dextrose rocket motor and test the ability of components such as the tube, fuel, nozzle and cap of the rocket itself. Before the Dextrose rocket flight test is carried out, it must go through this test. In this study, the variations in the thrust are 2000, 2250, 2500, 2750, and 3000 N. The rocket motor test stands used Aluminum 6063-T6 which has light density and medium strength. Numerical simulations were carried out with Ansys Workbench software using the finite element method. The results of the static stress analysis show that the greater the thrust, the greater the maximum von Mises stress and deformation. It is inversely related to the safety factor. The greater the thrust, the lower the safety factor of the rocket motor test stand. The results of the fatigue simulation show that the greater the thrust, the lower the prediction of fatigue life and the safety factor. Rocket motor test stand fails to reach a 1 million cycle life at 3000 N thrust.
Spontaneous Shrinkage of a Dumbbell-Shaped Schwannoma in the Cervical Spine: A Case Report
Authors: Lee Sang Yoon , Kim Kyung Hyun , Park Jeong Yoon , Chin Dong Kyu , Kim Keun Su , Cho Yong Eun , Jang Hyun Jun
Published: April 2023

Cervical dumbbell-shaped schwannomas are uncommon and challenging; clinicians often face the choice between performing incomplete tumor resection and sacrificing nerve roots. Aggressive and total resection is the treatment of choice for this tumor, although surgical resection in asymptomatic patients remains a matter of debate. We present a case report of spontaneous shrinkage of a dumbbell-shaped schwannoma of the cervical spine. A 68-year-old female patient first presented in 2013 with a progressive history of pain in the lower back and both buttocks over the previous 10 years. A dumbbell-shaped cervical spine tumor that had a 30-mm maximum diameter with a foraminal obstruction was identified, along with multiple tiny intradural extramedullary tumors in the lumbar spine. The cervical tumor gradually decreased in size during annual follow-up visits through 2015. Magnetic resonance imaging conducted in November 2017 revealed that this dumbbell-shaped tumor had shrunk significantly, leaving only the paravertebral section with a maximal diameter of 14 mm. This case demonstrated a schwannoma that naturally decreased in size with no treatment. Clinicians should consider the possibility of a spontaneous reduction in schwannoma size when making treatment decisions in asymptomatic patients, in whom avoiding unnecessary surgery may prevent nerve root damage.
Effects and mechanisms of Tai Chi on mild cognitive impairment and early-stage dementia: A scoping review
Authors: JASIM Nibras , Balakirishnan Darsiha , Zhang Han , Steiner-Lim Genevieve Z. , Karamacoska Diana , Yang Guo-Yan
Published: April 2023

Background:Dementia is associated with cognitive and functional decline that significantly impacts quality of life. There is currently no cure for dementia, thus, it is important to manage dementia in the early stages and delay deterioration. Previous studies have documented a range of health benefits of Tai Chi in people with early-stage dementia, however, none have systematically integrated these effects with their underlying mechanisms. The aims of this study were to: (1) identify the neurocognitive, psychological, and physical health benefits of Tai Chi oi people with early-stage dementia, and (2) explore the underlying mechanisms of these effects.Methods:We searched systematic reviews (SRs) and randomised control trials (RCTs) on Tai Chi for adults aged 50 years and older with mild cognitive impairment (MCI) or early-stage dementia in MEDLINE, PubMed, Cochrane Library, EMBASE, and major Chinese databases. No language or publication restrictions were applied. Risk of bias was assessed.Results:Eight SRs with meta-analyses and 6 additional published RCTs revealed inconsistent findings of Tai Chi on improving global cognitive function, attention and executive function, memory and language, and perceptual-motor function. There was no significant between-group difference in depressive symptoms. The results from the RCTs showed that Tai Chi can reduce arthritis pain and slow the progress of dementia. No studies on MCI or early-stage dementia investigating the underlying mechanisms of Tai Chi were identified. Instead, 9 mechanistic studies on healthy adults were included. These suggested that Tai Chi may improve memory and cognition via increased regional brain activity, large-scale network functional connectivity, and regional grey matter volume.Conclusion:The effects of Tai Chi on neurocognitive outcomes in people with MCI and early-stage dementia are still inconclusive. Further high-quality clinical trials and mechanistic studies are needed to understand if and how Tai Chi may be applied as a successful intervention to delay deterioration and improve quality of life in people with increased risk of cognitive decline.
Dynamic information transfer in vibration signal applied to early fault detection of hydropower generation unit
Authors: Wang Pengfei , Ren Shengmin , Deng Yuwen , Chen Diyi , Ma Chao , Yang Zhenbiao , Wu Yajun
Published: April 2023

Early fault detection of hydropower generation unit (HGU) is of great significance for the safe operation of the hydropower plant. Most of the related research focuses on the decomposition and feature extraction of single vibration monitoring signals. However, HGU is a typical coupling system with multi-channel vibration signals, and the subtle information transfer among signals is the precursor factor leading to the changes in the whole system. There has not been any research considering this potential factor in HGU or other system. Here, we proposed a novel monitoring method based on dynamic information transfer and principal component analysis (DIT-PCA). The process state of the unit is monitored by principal component analysis of the subtle dynamic transmitted information between the unit monitoring variables, which information is revealed for the first time. Normal monitoring samples are used for the offline training at first. Then, the confidence limits and fault contribution rates of two monitoring indicators Hotelling statistic and square prediction error of the model after training are applied to monitor the same test samples to achieve online fault detection and location. Moreover, the proposed model is applied to the state process of a real HGU, which has a superior sensitivity than two available detection methods. The results provide a direct reference for the early fault detection of the engineering system.
The Predictive Value of 3D Imaging Reconstruction Models in Patients with Vascular Resection for Pancreatic Surgery.
Authors: Quijano Yolanda , Vicente Emilio , Duran Hipolito , Diaz Eduardo , Fabra Isabel , Caruso Riccardo , Malave Luis , Ruiz Pablo , Naldini Chiara , De Nobili Giovanni , Ferri Valentina
Published: April 2023

Introduction
Vascular infiltration in pancreatic cancer represents the main limitation for surgery in locally advanced disease. Therefore an accurate preoperative study is mandatory to plan the most adequate surgical strategy. In the latest years, medical image fusion and three dimensional reconstruction models have gained wider acceptance in general surgery, especially in the hepatic field. Also for what concernes the pancreatic surgery, 3D reconstruction may allow a better preoperative staging if compared to traditional imaging studies.
The aim of this study is to compare 3D imaging reconstruction model with conventional CT scan, MRI and Ecoendoscopy performance in patients undergoing pancreatic surgery with associated vascular resection.
Materials and Methods
Patients with pancreatic cancer who underwent surgery with vascular resection at the Sanchinarro University Hospital from June 2020 to June 2021 were retrospectively reviewed. For each patient a preoperative 3D reconstruction with 3D Cella Medical Solutions (3D-MSP®) model was realised and then compared with traditional imaging methods (CT, MRI and Eco endoscopy).
Results
We enrolled 10 patients who underwent pancreatic surgery with associated vascular resection. The diagnostic accuracy in detection of celiac trunk involvement was of 100%, 80%, 70% and 90% for 3D-reconstruction, CT Scan, MRI and Ecoendoscopy groups respectively. On the other hand, in relation to the portal-mesenteric trunk invasion, 3D-reconstruction has demonstrated a 100% rate of accuracy comparing with an accuracy of 25%, 50% and 30% of CT scan, MRI and Ecoendoscopy respectively. As concerning the precision in estabilishing the tumor size, 3D model was superior to the CT and MRI at the Bland–Altman comparison.
Conclusion
3D imaging reconstruction technique is a helpful preoperatory tool in patients affected by pancreatic cancer with vascular involvement. More studies with larger series are needed to confirm these preliminary results.
Identity of tissue culture adapted Rift Valley Fever Virus (ZH501)
Authors: Said Taradi Abd El-Fattah , Ibrahim Sherif Mahmoud Mohamed Mohamed , Hammad Marwa Yehia , Youssef Noha Ezz-Eldeen
Published: April 2023

Rift Valley Fever (RVF) is still a threatening zoonotic disease with periodic reemergence in several countries. Egypt is endemic with RVF and uses an inactivated vaccine for control of the disease. Routine testing of the tissue culture adapted seed virus (ZH501-TC), to assess the effect of nucleotide mutations, is essential for the purpose of vaccine production. At the present work we have analyzed partial nucleotide and deduced amino acid sequence of amplified 745 bp product of M segment Gn ectodomain and checked virulence in mice. Allocation of ZH501-TC strain at the A designated lineage with the virulent parental RVFV isolated in 1977, ZH501 Egy Sh 77 indicates its genomic stability after passaging in tissue culture cells for vaccine preparation. Here we denoted a new missense nucleotide mutation A1312G corresponding to the amino acid mutation N371S, in current study the ZH501-TC strain (MZ218760) compared to the parental virulent RVFV isolate ZH501 Egy Sh 77 ( previous sequence ). That mutation enhanced ß sheet formation in ZH501-TC 367AQYASAYCS375 motif which might increase virus antigenicity. In addition, we have confirmed the presence of two sites of nucleotides substitutions; C1033T and A1206C, corresponding to two amino acids changes; T287I and S336R. Our study declared the false notion of the presence of one missense nucleotide mutation; A1252G corresponding to the amino acid mutation K351R, and two other silent nucleotide substitutions; T1257A and G1258C at the strain ZH501-VSVRI. Although we found these mutations, the virulence of the ZH501-TC strain was still present as approved by mice pathogenicity test.
A comprehensive Health Risk Assessment Associated with Bioaccumulation of Heavy Metals and Nutrients in selected Macrophytes of Loktak Lake, Manipur, India
Authors: Laishram Ranu Jajo , Singh Tensubam Basanta , ALAM WAZIR
Published: April 2023

A comprehensive assessment was conducted to evaluate the accumulation of selected heavy metals and nutrients in 10 dominant macrophyte species growing in the Loktak Lake, a Ramsar site, and to assess the potential health risks associated with the consumption of the edible plants. The concentrations of nutrients such as total phosphorus (TP), total nitrogen (TN), potassium (K), calcium (Ca), magnesium (Mg), and heavy metals such as copper (Cu), manganese (Mn), zinc (Zn), and iron (Fe) were measured, and found to be present in the order of plant > sediment > water. The bioaccumulation factors (BAFs) revealed high efficiency of most plants to accumulate heavy metals and nutrients in their tissues from the lake water and sediments, indicating their potential to be used as phytoremediators. Translocation factors (TFs) were also estimated to determine the efficiency of the plants to translocate elements from root to shoot. Colocasia esculenta and Polygonum perfoliatum were found to exhibit the highest BAF and TF values for most of the parameters. Target hazard quotients (THQs) revealed potential health risk associated with one or more heavy metals in the plants, except for Zn whose THQ values were below the level of concern in all the edible plant species. The hazard index (HI) signifying potential non-carcinogenic health risk from the combined effects of all the heavy metals was found to be highest for Polygonum perfoliatum, indicating a potentially higher risk to health if this edible macrophyte is regularly consumed in higher quantities and may pose long-term health effects to the exposed population.
Identification of Differentially Expressed Genes in two Types of Osteosarcoma cell lines upon Zinc Oxide Nanoparticles Treatment Using the RNA-seq Technique
Authors: He Guanping , Guo Xiangfei , Wang Linbang , Liu Xiaoguang
Published: April 2023

Osteosarcoma (OS) predominantly occurs in adolescents, and more often in males than females with characteristics of local invasive growth and early pulmonary metastases. Owing to highly selective and effectiveness, nanoparticles (NPs) have been a new alternative for traditional chemotherapeutic drugs. Previous studies have proved that zinc oxide nanoparticles (ZnO NPs) is one of a promising inorganic NPs in treatment of various tumors besides OS. In this study, we use RNA-seq analysis to deeply explore the potential biological mechanism in the process of ZnO NPs-treated different types of OS cell lines. We detected that 928 genes (DEGs) differentially expressed both in 143B and MG-63 cells, and the eight highest DEGs were verified by RT-qPCR. Gene Ontology (GO) categories analysis displayed regulation of transcription factor on nucleic acid binding in molecular function term, and extracellular space in cellular components term in both OS cell lines. Kyoto Encyclopedia of Genes and Genomes (KEGG) classification analysis found that the MAPK, Toll-like receptor and NF-κB pathways were co-enriched in both OS cell lines. The Protein-protein Interaction (PPI) revealed that HMOX1, MAFB, CXCL10 and CXCL11 were most involved in multiple aspects of biological events in OS cells under ZnO NPs treatment. Furthermore, the key protein molecules in differential signal pathways in both OS cell lines were detected and confirmed by Western Blot (WB). In conclusion, our findings unveiled a range of potential antitumor mechanisms and exploitable bioeffects of ZnO NPs treatment on OS.
Estimating the crashworthiness performances of Collision Boxes Using ANN
Authors: ADANUR Ömer
Published: April 2023

Studies on the development of energy absorbing systems that minimize vehicle chassis damage in traffic accidents are increasing day by day. Many designs have been made in the studies on crash boxes used to absorb the energy released in the event of an accident. The specific energy absorption/ energy/FP crashworthiness values used to determine the efficiency of the designed crash boxes in this study were estimated using the Artifical Neural Network (ANN). The input layer of the ANN model consists of materials (DP600, DP800 and DP1000), thickness of materials (between 0.8 and 2.2 mm) and initial speed (10m/s, 12m/s and 16 m/s). In the ANN model, 42 different models were created by changing the different training function (training, trainlm and trainrp), transfer function (tansig and logsig) and the number of neurons in the hidden layer (between 9 and 33). R2 and RSME methods were used to evaluate the efficiency of ANN models. The training function was found to be highly accurate (R2: 0.99999 and RSME: 0.314727E-05) when the training function was “Trainlm” and the number of neurons in the hidden layer was 33. The training and testing results of the ANN model show that ANN can be used to estimate the specific energy absorption/energy/PCH value of crash boxes.
Risk of bleeding and ischemia in elderly East Asian patients with diabetes mellitus treated with either clopidogrel or ticagrelor: From Korea Acute Myocardial Infarction Registry-V
Authors: Lee Sang Hoon , Jeong Myung Ho , Ahn Joon Ho , Hyun Dae Young , Cho Kyung Hoon , Kim Min Chul , Sim Doo Sun , Hong Young Joon , Kim Ju Han , Ahn Youngkeun , Hwang Jin Yong , Park Yong Hwan
Published: April 2023

Background: The risk of bleeding and ischemia in patients with acute myocardial infarction (AMI) who have undergone percutaneous coronary intervention (PCI) is a common concern for physicians, with added conflict over prescribing a potent P2Y12 inhibitor. In particular, elderly East Asian patients with diabetes mellitus (DM) invoke a heightened concern.
Methods: We analyzed 839 patients who were enrolled in the Korea Acute Myocardial Infarction Registry-V, older than 75 years, with DM, had an AMI, and had undergone PCI. Propensity score matching (PSM) and cox regression analyses were performed to compare the bleeding and ischemic risks between the two groups. After PSM, 699 patients (ticagrelor: clopidogrel = 233:466) were analyzed. Patients with Bleeding Academic Research Consortium (BARC) type ≥2 bleed and those at ischemic risk were analyzed based on major adverse cardiac and cerebrovascular events.
Results: Cox regression analyses showed the type of antiplatelet therapy did not affect the incidence of BARC type ≥2 bleeds (HR, 1.67; 95% CI: 0.86–3.22). Use of the transradial approach for PCI, use of statins, and successful PCI lowered the risk of bleeding. In contrast, low body mass index (BMI) increased the risk of bleeds. In the aspect of ischemia, there was no difference based on the antiplatelet agents used (HR, 1.00; 95% CI: 0.68–1.46). Low BMI, hemoglobin <9 g/dL, high Killip class, left ventricular ejection fraction <40%, and multivessel disease increased ischemic risk. Post thrombolysis in myocardial infarction flow grade ≥3, use of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, beta blockers and statins decreased the risk.
Conclusions: In this Korean prospective cohort study, there was no difference in the risks for bleeding and ischemia, based on the use of ticagrelor or clopidogrel, in elderly Korean patients with DM. To determine the optimal antiplatelet agents for these patients, large scale randomized controlled trials are warranted.
Trial registration: KCT0008355
Multiyear and seasonal global indicators for French surface waters contamination by WFD substances
Authors: Staub Pierre-François , Salomon Morgane , Assoumani Azziz , Zakar Adeline Blard-
Published: April 2023

This study offers an unprecedented valuation of the French surface waters WFD chemical monitoring dataset, covering 100 substances (metals, industrial and POPs compounds, PPP and biocides active substances, combustion residues) measured monthly on 4000 sites of the 6 main continental river basins, during 12 years (2009–2020). The concentration data were first made comparable through an original process removing the bias induced by the space-and-time heterogeneity of the monitoring labs performance, to gather a reference workable set of monthly contamination indicators. These were then used to display the substances’ seasonal and interannual timeseries, revealing, e.g., the succession of PPP active substances contamination peaking periods in the 6 basins, or the long-term trends of the concentrations of the various chemicals, sometimes evidencing insufficiencies in the monitoring performance. These statements are put in regard of the knowledge of the substances ban, restriction or reduction measures, to assess how streams’ chemical quality responds to them. Additionally, the observed features and their variations over the years are discussed in terms of changes in their usages, product substitution, emission sources, and linked to environmental processes like runoff, river dilution and physicochemical conditions. We provide some original statements and interpretation on Glyphosate and AMPA wide-scale data inter-relation, and some light is cast on the efficacy of the recent national policies restricting pesticides use in populated areas. For PPPs, our water contamination indicators were compared to tonnage data. We assessed their degree of linear relationship, which we propose to quantitatively express through a substance specific basin-to-river contamination coefficient. The interannual variations of this coefficient appear as nicely correlated to the changes in the water contamination seasonal patterns. We were able to describe and validate the dependency of this coefficient to the molecular properties of the substances, conferring some capabilities for predicting the relative environmental risk induced by non-yet monitored compounds. We finally discuss the relevance of the developed indicators to complement the national chemical pollutants management system currently in place.
Integration of routine hematological indicators for early diagnosis of occupational silicosis
Authors: Sun Guokang , Zhang Jing , Xiang Pinpin , Wu Ling
Published: April 2023

Objectives To explore the value of a logistic regression model based on haematological parameters for the early diagnosis of silicosis by comparing the differences in haematological parameters between silicosis patients and healthy physical examiners.Methods A total of 390 individuals, including 195 silicosis patients and 195 normal participants were included in the training cohort. Then, 65 silicosis patients and 65 healthy individuals were enrolled in the validation cohort. Whole blood samples were collected from all participants, and hematological indicator characteristics were determined. Features with statistical significance in the univariate analysis of the training cohort and reported significant features were included in the logistic regression analysis to determine the independent factors influencing the diagnosis of silicosis and to construct a logistic diagnostic model. A receiver operating characteristic (ROC) curve was plotted to evaluate the accuracy of the model in diagnosing silicosis.Results In the training cohort, several hematological indicators were significantly different in silicosis patients, including Hematocrit(HCT), Hemoglobin(HGB), Mean corpuscular volume(MCV), Red Blood Cell Count(RBC), White blood cell count (WBC), Mon#, Mon%, Neu#, Neu%, Red blood cell distribution width coefficient of variation(RDW_CV), C-reactive protein(CRP), Hydroxybutyrate dehydrogenase (HBDH), Lactate dehydrogenase(LDH), Prothrombin time(PT), International normalized ratio(INR), Fibrinogen(FIB), and D-Dimer(DD) levels, all with statistical significance (P < 0.05). The silicosis diagnostic model performed well in the training cohort (Area Under Curve, AUC = 0.943) and had high diagnostic sensitivity (83.1%) and specificity (92.3%). The diagnostic model also effectively distinguished between silicosis patients and the control cohort in the validation cohort (AUC = 0.936).Conclusions This study confirmed that Age, CRP, LDH, Macro%, and INR were independent factors influencing the diagnosis of silicosis, and the logistic regression model based on these indicators could provide a reliable basis for predicting silicosis diagnosis.
Creation and validation of a patient-derived cancer model using peritoneal and pleural effusion samples from patients with ovarian cancer
Authors: Nishie Ruri , Tanaka Tomohito , Murakami Hikaru , Tsuchihashi Hiromitsu , Toji Akihiko , Daimon Atsushi , Miyamoto Shunsuke , Ueda Shoko , Hashida Sousuke , Terada Shinichi , Maruoka Hiroshi , Kogata Yuhei , Hirosuna Kensuke , Taniguchi Kohei , Komura Kazumasa , Ohmichi Masahide
Published: April 2023

Background: The application of personalized cancer treatment based on genetic information and surgical samples has begun in the field of cancer medicine. However, biopsy may be painful for patients with advanced disease that do not qualify for surgical resection. Patient-derived xenografts (PDXs) are cancer models in which patient samples are transplanted into immunodeficient mice. PDXs are expected to be useful for personalized medicine. The aim of this study was to establish a PDX from body fluid (PDX-BF), such as peritoneal and pleural effusion samples,to provide personalized medicine without surgery.
Methods PDXs-BF were created from patients with ovarian cancer who had positive cytology findings based on peritoneal and pleural effusion samples. PDXs were also prepared from each primary tumor. The pathological findings based on immunohistochemistry were compared between the primary tumor, PDX, and PDX-BF. Further, genomic profiles and gene expression were evaluated using DNA and RNA sequencing to compare primary tumors, PDXs, and PDX-BF.
Results Among the 15 patients, PDX-BF was established for 8 patients (5 high-grade serous carcinoma, 1 carcinosarcoma, 1 low-grade serous carcinoma, and 1 clear cell carcinoma); the successrate was 53%. Histologically, PDXs-BF have features similar to those of primary tumors and PDXs. In particular, PDXs-BF had similar gene mutations and expression patterns to primary tumors and PDXs.
Conclusions PDX-BF reproduced primary tumors in terms of pathological features and genomic profiles, including gene mutation and expression. Thus, PDX-BF may be a potential alternative to surgical resection for patients with advanced disease.
A method of locating tropical cyclone center based on gaussian model
Authors: You Qingxiang , Li Zhenqing , Qian Cheng , Wang Tian
Published: April 2023

The Tropical cyclones usually refer to low-pressure eddies that rotate rapidly in the tropics. It seriously threatens the life and property safety,Therefore, the prediction of both the accurate location of the tropical cyclone center and the tropical cyclone path is the key to preventing tropical cyclone disasters. In this paper, a fast method for calculating the center of tropical cyclone using infrared satellite image or visible satellite image is proposed. A two-dimensional Gaussian normal distribution model is used to simulate the gray characteristics of tropical cyclone images. The gray distribution of tropical cyclone satellite image approximates to a two-dimensional Gaussian distribution. In multiple directions, the pixel gray values of tropical cyclone are accumulated, and a set of one-dimensional Gaussian normal distribution functions are used to fit these accumulated values. The peak positions of these one-dimensional Gaussian functions are calculated by derivation. Then, a linear function is fitted according to the relationship between the peak position of the group of Gaussian functions and the selected angle. The coefficient of the fitting linear function is exactly the central coordinate of the tropical cyclone. The proposed method for locating the center of tropical cyclone is tested using visible and infrared satellite images. The results are compared with the best trajectory provided by the Japan Meteorological Agency.
Research on the optimization of urban residents' travel structure based on big data visualization
Authors: Li Wenrui , Chen Ziyi , Li Xueyuan , Shi Su , JU Kechun , Li Yiyang
Published: April 2023

The travel patterns of urban inhabitants are not optimized and require improvement. By utilizing big data visualization, the optimization of urban residents' travel structure can be efficiently achieved, resulting in the reduction of urban traffic and the promotion of a healthier lifestyle for individuals. Through the utilization of big data visualization, the optimization of urban residents' travel structure can be comprehended by means of a mathematical model and the implementation of effective policies aimed at enhancing human settlement. This can also serve as a significant point of reference for exploring future studies in this field. The focus of this paper is to examine the influence of big data visualization technologies that offer insights into the routes of transportation and the movements of pedestrians, as captured by public cameras situated worldwide. In the course of transportation planning, conventional statistical methodologies and extensive data analysis techniques are employed to optimize the travel patterns of urban residents using a basic programming language such as Python. The research has confirmed the efficiency of big data visualization technologies in ameliorating the transportation framework of city dwellers.
Newborn and child health national and provincial clinical practice guidelines in South Africa, Nigeria and Malawi: a scoping review
Authors: Mthethwa Mashudu , Mbeye Nyanyiwe Masingi , Effa Emmanuel , Arikpo Dachi , Blose Ntombifuthi , Brand Amanda , Chibuzor Moriam , Chipojola Roselyn , Durao Solange , Esu Ekpereonne , Kallon Idriss Ibrahim , Kunje Gertrude , Lakudzala Suzgika , Naude Celeste , Leong Trudy , Lewin Simon , Matheba Denny , Mccaul Michael , Meremikwu Martin , Vandvik Per Olav , Kredo Tamara
Published: April 2023

Background Low and middle-income countries remain disproportionately affected by high rates of childhood mortality, often caused by preventable conditions. Clinical practice guidelines (CPGs) are essential policy tools in supporting implementation of effective, safe, and cost-effective healthcare. High-quality evidence-based CPGs play a key role in improving clinical management aiming to impact child mortality. We aimed to identify and assess the quality of CPGs for newborn and child health published in South Africa, Nigeria and Malawi.Methods We searched relevant websites (June–July 2022), for publicly available national and subnational de novo or adapted CPGs, addressing newborn and child health in the three countries. Pairs of reviewers independently extracted information from eligible CPGs (scope, topic, target population and users, responsible developers, stakeholder consultation process, adaptation description, assessment of evidence certainty). We appraised CPG quality using the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument.Results We identified 40 CPGs from the three countries. Of these, 8/40 reported being adopted from a parent CPG. More CPGs (n = 19) provided guidance on communicable diseases than on non-communicable diseases (n = 8). CPGs were most often developed by national health ministries and professional societies. Eighteen CPGs reported on stakeholder consultation; with Nigeria (10/11) and Malawi (3/6) faring better than South Africa (5/23) in reporting this activity. GRADE was used in 1/7 CPGs that reported assessing certainty of evidence. Overall CPGs scored well on two AGREE II domains: scope and purpose median (IQR) score 68% (IQR 47–83), and clarity of presentation 81% (67–94). Domains critical for ensuring credible guidance scored below 20%: rigour of development 11% (4–32) and editorial independence 6% (0–27).Conclusion Topics covered by the identified CPGs did not always match country level burden of disease likely representing substantial gaps in available guidance for healthcare providers, parents, caregivers, and patients. Our study found low AGREE II scores for CPG development processes, possibly undermining the credibility of the available CPGs to provide evidence-informed care. Our findings highlight the importance of ongoing efforts to strengthen capacity and support CPG development with collaboration between policymakers, researchers and the public.
Assessment of the Impact of Two-Jaw Orthognathic Surgery on 3D Airway Volume in Patients with Skeletal Class III Patterns
Authors: Hsu Tzu-Chuan , Lai Jui-Pin , Lin Shiu-Shiung , Chang Yu-Jen
Published: April 2023

The purpose of this study was to assess the impact of two-jaw orthognathic surgery on the 3D airway volume in patients with skeletal Class III patterns. The study included 27 adult patients with dental Class III malocclusion and mandibular prognathism who underwent two-jaw orthognathic surgery. The changes in airway volume were evaluated using computed tomography simulation and segmentation was carried out using 3D Slicer. Results showed that the average upper airway volume increased by 1979.1 mm3, the oropharyngeal airway volume increased by 336.4 mm3, and the hypopharyngeal airway volume decreased by 1087.5 mm3. Despite this decrease, the overall airway volume still increased by an average of 1228.1 mm3. The findings suggest that two-jaw orthognathic surgery has a positive impact on the overall airway volume in patients with skeletal Class III patterns.
Clinical Trial Registration Number: IRB No: 202101949B0C501
Survival Analysis of Diabetic Colorectal Cancer Patients On Metformin in Brunei Darussalam
Authors: Wong Alex Brandon , Patnaik Ravi , Chaw Li Ling , Lu Shir Kiong , Lim Ya Chee
Published: April 2023

Metformin, an antihyperglycemic drug, has been associated with antineoplastic effects and could potentially improve colorectal cancer prognosis. There are several conflicting data with regards to the association between metformin use and CRC survival. This study aims to provide more information on the subject while addressing certain limitations. The study was a retrospective cohort study that included colorectal cancer patients from the only cancer centre in the country, The Brunei Cancer Center (TBCC), treated between July 2014 and July 2019. Kaplan-Meier and multivariate Cox proportional hazard regression models were used to analyze the data, construct survival curves and adjust for comorbidities. Of a total of 112 diabetic patients, 79 patients (70.5%) were on metformin and 33 patients (29.5%) were on other anti-hyperglycemic medications. An association between metformin use and lower incidence of stage IV colorectal cancer (p = 0.046) was observed, but no significant difference between the metformin group and the non-metformin group in terms of survival probability (log rank p = 0.13) was shown. Analysis using multivariate models showed that metformin reduces the hazard ratio by 31.2%, although, this value is statistically insignificant (HR, 0.688; 95% CI 0.286 – 1.654; p = 0.403). Among the diabetic colorectal cancer patients, there was no association between survival and metformin therapy. This data reflects the correlation of metformin use and CRC survival within the nation for all CRC diabetic patients diagnosed between July 2014 and July 2019. However, for further extrapolation of data, the association between cancer progression and metformin use requires further investigation and high-powered clinical trials are needed to support these findings.
Socioeconomic determinants of myalgic encephalomyelitis/chronic fatigue syndrome in Norway: a registry study
Authors: Hilland Geir Haakon , Anthun Kjartan Sarheim
Published: April 2023

Background: Previous research has shown that socioeconomic status (SES) is a strong predictor of chronic disease. However, to the best of our knowledge, there has been no studies of how SES affects the risk of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that has not been based upon self-reporting or retrospectively screening of symptoms. As far as we know, this is therefore the first study that isolate and describe socioeconomic determinants of ME/CFS and calculate how these factors relate to the risk of ME/CFS diagnosis by utilizing individual level registry data, which allows for objective operationalization of the ME/CFS population, and the utilization of different control groups.
Data and methods: We utilize health registry data from all adult patients diagnosed with ME/CFS from 2016-2018 in Norway, coupled with socioeconomic data from statistics Norway from 2009-2018. We operationalize SES as household income and educational attainment fixed at the beginning of the study period. We compare the effects of SES on the risk of ME/CFS diagnosis to a population of patients with hospital diagnoses that share clinical characteristics of ME/CFS and a healthy random sample of the Norwegian population. Our models are estimated by logistic regression analyses.
Results: When comparing the risk of ME/CFS diagnosis with a population consisting of people with four specific chronic diseases, we find that high educational attainment is associated with a 19% increase (OR: 1.19) in the risk of ME/CFS and that high household income is associated with a 18% increase (OR:0.82) in risk of ME/CFS. In model 2, when comparing with a healthy population sample, we find that low educational attainment is associated with 69% decrease (OR:0.31) in the risk of ME/CFS and that low household income is associated with a 53% increase (OR: 1.53).
Conclusion: We find statistically significant associations between SES and the risk of ME/CFS. However, our more detailed analyses shows that our findings vary according to which population we compare the ME/CFS patients with, and that the effect of SES is larger when comparing with a healthy population sample, as opposed to controls with selected hospital diagnoses.
Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit
Authors: Braun Matthias , Ruscher Lea , Fuchs Alexander , Kämpfer Martina , Huber Markus , Lüdi Markus , Riva Thomas , Vogt Andreas , Riedel Thomas
Published: April 2023

Background Obese patients frequently develop pulmonary atelectasis upon general anesthesia. The risk is increased during laparoscopic surgery. This prospective, observational single-center study evaluated atelectasis dynamics using Electric Impedance Tomography (EIT) in patients undergoing laparoscopic bariatric surgery.Methods We included adult patients with ASA physical status I-IV and a BMI ≥40. Exclusion criteria were known severe pulmonary hypertension, home oxygen therapy, heart failure, and recent pulmonary infections. The primary outcome was the proportion of poorly ventilated lung regions (silent spaces) and the global inhomogeneity (GI) index assessed by EIT before discharge from the Post Anesthesia Care Unit compared to these same measures prior to initiation of anesthesia.Results The median [IQR] proportion of silent spaces at the different analysis points were T1 10.8% [3.6%–15.1] and T5 10.3% [2.6–18.9%]; the mean difference was − 0.7% (95%-CI: -5.8%-4.5%); i.e., lower than the predefined non-inferiority margin of 5% (p = 0.022). There were no changes at the four additional time points compared to T1 or postoperative pulmonary complications during the 14 days following the procedure.Conclusions We found that obese patients undergoing laparoscopic bariatric surgery don’t leave the Post Anesthesia Care Unit with increased silent spaces compared to preoperatively.Trial registration NCT05187039
Poor immune response to inactivated COVID-19 vaccine in patients with hypertension
Authors: Yang Lei , Zhang ZhiHuan , Guo Qiao , Yang Lei , Ren Hong
Published: April 2023

Purpose: The safety and efficacy of vaccination in people with hypertension (HTN) is important. There are currently just a few data on the immunogenicity and safety of inactivated SARS-CoV-2 vaccinations in hypertension patients.
Methods: After receiving a two-dose immunization, 94 hypertension patients and 74 healthy controls(HCs) in this study, the evaluation included looking at antibodies(Abs) against receptor binding domain (RBD) IgG, neutralizing antibodies(NAbs), RBD-specific B cells and memory B cells(MBCs).
Results: There was no discernible difference in the overall adverse events(AEs) over the course of seven or thirty days between HTN patients and HCs. HTN patients had lower frequencies of RBD-specific memory B cells and the seropositivity rates and titers of Abs compared to HCs(all, p < 0.05). HTN patients may exhibit comparable immunological responses in with or without concomitant cardiovascular and cerebrovascular conditions(CCVD). We again discovered a correlation between a weak Ab response and the interval time following a two-dose immunization.
Conclusion: Inactivated COVID-19 vaccinations were safe in hypertension patients, however humoral immune was limited.
Identification of pyroptosis-related lncRNAs as potential prognostic biomarkers in patients with adenocarcinoma of the esophagogastric junction
Authors: Zeng Bing , Gan Wenchang , Huang Enmin , Ma Tao , Liu Fuheng , Chen Shuang , Zhou Taicheng , Cai Canfeng , Li Yingru
Published: April 2023

Background Adenocarcinoma of esophagogastric junction (AEG) is a high-mortality gastrointestinal cancer lacking effective prognostic markers. Pyroptosis, a form of programmed cell death, is vital in inflammation and immune response. However, the prognostic role of pyroptosis-related lncRNA in AEG has not been explored.Methods Clinical information and gene expression data for AEG were obtained from The Cancer Genome Atlas (TCGA). The least absolute shrinkage and selection operator (LASSO) was used to narrow down candidate lncRNAs and develop the pyroptosis-related lncRNA risk model. Kaplan-Meier analysis, Multivariate Cox regression, and nomogram were used to assess the risk model. Functional enrichment analysis was used to reveal potential pathways in AEG. The ESTIMATE, TIMER, XCELL, CIBERSORT, ssGSEA, and EPIC algorithms were used to investigate the immune status in different risk groups. The oncoPredict R package was used to identify candidate drugs.Results Pearson correlation analysis identified 816 pyroptosis-related lncRNAs, from which three prognostic lncRNAs (LINC01537, CTD-2033D15.2, ENTPD1-AS1) were selected to construct a risk model using LASSO Cox regression analysis. Kaplan-Meier curve analysis revealed that patients with low-risk scores had superior overall survival (OS) compared to those in the high-risk groups (HR = 1.86, 95% CI 1.21–2.87, p = 0.004). Multivariate analysis demonstrated that the 3 prognostic lncRNA risk score was an independent prognostic factor with a significant predictive value for AEG. A low-risk score indicated an increased infiltration of activated memory CD4 + T cells and was associated with pathways such as DNA replication, cell cycle, mismatch repair, aminoacyl-tRNA biosynthesis, and seleno amino acid metabolism. Additionally, a low-risk score was associated with increased sensitivity to Paclitaxel and KRAS (G12C) inhibitor drugs.Conclusion These results provide new insights into the potential use of the proposed pyroptosis-related lncRNA signature as a prognostic tool and potential therapeutic targets for AEG.
Relationship between visit-to-visit blood pressure variability and depressive mood in Korean primary care patients
Authors: Lee Ga Hee , Lee Jung Ah , Sunwoo Sung , Kim Young Sik
Published: April 2023

Background We evaluated the effect of depressive mood on long-term visit-to-visit blood pressure (BP) variability (BPV) in primary care patients in Korea.Methods The Family Cohort Study in Primary Care (FACTS) used a prospective cohort that was established to investigate the relationship between the familial environment and health in Korean primary care patients. Depressive mood was assessed as a score of 21 points or more on a Korean-type Center for Epidemiologic Studies Depression scale. BP was measured at the initial visit and first and second follow-up visits. BPV was calculated using the average of the differences between the measurements at the initial visit and first follow-up visit and at the first and second follow-up visits. High visit-to-visit BPV was defined when the average difference fell within the fourth quartile. Logistic regression analysis was used to estimate the association of high BPV with depressive mood and a range of variables.Results Of the 371 participants, 43 (11.6%) had depressive mood according to the depression score. In multivariate analysis, the odds ratio (OR) (OR: 2.26, 95% confidence interval (CI): 1.11–4.60) for high systolic BP (SBP) variability in participants with depressive mood was more than twice that in participants without depressive mood. Additionally, older age (OR: 31.91, 95% CI: 3.74–272.33 among participants aged ≥ 70 years) and use of antihypertensive medication (OR: 1.77, 95% CI: 1.02–3.05) were associated with high SBP variability.Conclusions Depressive mood was associated with high visit-to-visit SBP variability in primary care patients. Older age and use of antihypertensive medication were also associated with high SBP variability.
Human leukocyte antigen HLA-B*57:01 status in HIV-1 patients developing hypersensitivity reactions in Benin: a pilot study
Authors: ADECHINA Adefounke Prudencia , ASSOGBA Pierrot Yaou , TCHIAKPE Edmond , YESSOUFOU Akadiri
Published: April 2023

Background: Antiretroviral drugs in people living with HIV-1 (PLHIV-1) often trigger side effects which may lead to discontinuation or failure of treatment. Human Leukocyte Antigen B*57:01 (HLA-B*57:01) allele is known to predict hypersensitivity reactions to Abacavir. Very few data are available on the prevalence of HLA-B*57:01 allele in PLHIV-1 in African countries. This study aimed to screen for HLA-B*57:01 allele in PLHIV-1 in Benin.
Methods: This pilot study was carried out on one hundred ten PLHIV-1 enrolled in two health facilities in Benin. Socio-demographic and clinical data were collected. Biological data were determined and HLA-B*57:01 allele was genotyped, using Single Specific Primer-Polymerase Chain Reaction in blood samples.
Results: Seventy percent of participants were female. PLHIV-1 were under TDF+3TC+DTG (47.2%) or TDF+3TC+EFV (57.3%). Their median age was 41 [36-48.75] years and the average CD4+ T cell count was 249 [130-381.25] cells/µl. The average viral load in treatment failure PLHIV-1 was 4.7 [3.9-5.2] Log10. At the inclusion date, twenty-nine (26.4%) PLHIV-1 under TDF+3TC+EFV have developed hypersensitivity reactions. None of 110 patients had shown HLA-B*5701 allele.
Conclusion: Our study revealed that HLA-B*57:01 allele was very rare in PLHIV-1 in Benin, suggesting that its screening before starting the Abacavir regimen did not seem necessary.
Effect of acupuncture or moxibustion at Acupoints Weizhong or Chize on the change in lumbar temperature in healthy adults: a study protocol for a randomized controlled trial with a 2 × 2 factorial design
Authors: Zheng Siyi , Shen Qiongying , Lyu Zhengyi , Tian Shuxin , Huang Xiaoxiao , Liu Yiyue , Yu Xiaoshuai , Pan Wei , Nie Na , Liang Yi , Fang Jianqiao
Published: April 2023

BackgroundLow back pain is a common complaint among adults, and moxibustion and acupuncture are commonly used treatments. According to traditional theory, acupoint Weizhong is a popular choice, with the saying “Yao Bei Wei Zhong Qiu.” However, the difference in efficacy between acupuncture and moxibustion remains unclear. Therefore, this trial compared the thermal effects of acupuncture and moxibustion at Weizhong and Chize point in healthy adults to provide more objective evidence of the lumbar-Weizhong relationship.Method/designThe trial will use a two-by-two factorial design, randomly assigning 140 participants to four groups (acupuncture at Weizhong, acupuncture at Chize, moxibustion at Weizhong, and moxibustion at Chize) in a ratio of 1:1:1:1. Each group will receive a 30-minute intervention, with the primary outcome being the change in average temperature in the lumbar area from baseline to 30 minutes post-intervention. Secondary outcomes include changes in maximum lumbar temperature, changes in average lumbar temperature at various time points during and post-intervention, changes in average temperature in the Bladder meridian, and the warming sensation questionnaire. The results of the warming sensation questionnaire will be utilized for subgroup stratification in the BL40 group. Additionally, an intention-to-treat analysis will be conducted regardless of adherence.DiscussionThis study will be the first one to compare the thermal effect difference at lumbar area between acupuncture and moxibustion in healthy individuals. The findings of this study will provide new insights for the "Yao Bei Wei Zhong Qiu" theory of traditional Chinese medicine.Trial registrationClinicalTrials.gov, Trial number: NCT05665426. Registered on 26 December 2022.