bluuebunny/crossref_metadata_2025 huggingface dataset:
New-onset refractory status epilepticus (NORSE) in paediatric patients: causes, characteristics and outcomes
Authors: Tainski de Azevedo Ana Luiza , Tedesco Tonial Cristian , Andrades Gabriela Rupp Hanzen , Abud Drumond Costa Caroline , Crestani Francielly , Rodrigues Lessa Alessandra , Bruno Francisco , Carvalho Paulo , Eckert Guilherme , Piva Jeferson , Celiny Ramos Garcia Pedro
Published: December 2022

Background

New-onset refractory status epilepticus (NORSE) refers to patients without a previous history of seizures who have refractory status epilepticus for at least 72 hours without an identified aetiology. Despite the severe neurological sequelae of NORSE, little is known about this condition in paediatric patients.

Objective

To describe the profile of paediatric patients with NORSE, the profile of seizures, possible causes attributed to this condition, treatments offered to patients and the outcomes at discharge from the paediatric intensive care unit (PICU).

Methods

This retrospective, multicentre, descriptive study (case series) was conducted in the PICUs of three tertiary hospitals. We reviewed the medical records of all patients aged 0–16 years admitted to the participating PICUs between December 2013 and December 2017 with refractory status epilepticus, without a previous history of seizures or neurological disease.

Results

Fifteen patients (2.4%) had NORSE. The median age of patients was 62.3 (IQR 26.2–75.4) months. All patients experienced prodromes before progressing to refractory status epilepticus. Twelve patients (80%) had fever up to 24 hours before seizures. NORSE was classified as cryptogenic in 66% of patients. Twelve patients were treated with complementary therapies, in addition to anticonvulsants. There was no standardisation in the treatment of patients. The overall mortality rate was 20%.

Conclusions

NORSE is associated with high morbidity and mortality, without an identified aetiology in most cases and with a wide range of proposed therapies.
Ethical theories as multiple models
Authors: Wagner Isaac A
Published: December 2022

Hardman and Hutchinson claim that ethics is ‘grounded in particular, everyday concerns’. According to them, an implication of this is that ethics courses for (future) clinicians should de-emphasise teaching the theories and principles of philosophical ethics and focus instead on pedagogical activities more closely related to everyday concerns, for example, exposure to real patient accounts. I respond that, even if ethics is an ‘everyday’ phenomenon, learning philosophical ethics may be of significant practical benefit to clinicians. I argue that the theories of philosophical ethics can reasonably be interpreted as partial, simplified descriptions—or models—of moral phenomena, and that they can be effectively deployed in tandem by clinicians as complementary decision-making tools for help in navigating ethically complex situations in the clinic.
Increasing frequency of multiple herbicide-resistant kochia (Bassia scoparia) in Alberta
Authors: Geddes Charles M. , Pittman Mattea M. , Hall Linda M. , Topinka A. Keith , Sharpe Shaun M. , Leeson Julia Y. , Beckie Hugh J.
Published: December 2022

Multiple herbicide-resistant kochia [ Bassia scoparia (L.) A.J. Scott] is a growing weed management concern for farmers in the Canadian prairies. A randomized–stratified survey of 319 sites in Alberta was conducted in 2021 to determine the frequency and incidence of glyphosate, fluroxypyr, and dicamba resistance in kochia samples four and nine years after the previous rounds of surveys. Kochia samples exhibiting resistance to glyphosate, fluroxypyr, and dicamba were found at 78%, 44%, and 28% of the sites, respectively. Triple herbicide-resistant kochia samples, resistant to acetolactate synthase inhibitors, glyphosate, and at least one synthetic auxin, were found at 45% of the sites.
Theory, phenomenology, and experimental avenues for dark showers: a Snowmass 2021 report
Authors: Albouy Guillaume , Barron Jared , Beauchesne Hugues , Bernreuther Elias , Bona Marcella , Cazzaniga Cesare , Cesarotti Cari , Cohen Timothy , de Cosa Annapaola , Curtin David , Demiragli Zeynep , Doglioni Caterina , Elliot Alison , DiPetrillo Karri Folan , Eble Florian , Erice Carlos , Freer Chad , Garcia-Bellido Aran , Gemmell Caleb , Genest Marie-Hélène , di Cortona Giovanni Grilli , Gustavino Giuliano , Hemme Nicoline , Holmes Tova , Kar Deepak , Knapen Simon , Kulkarni Suchita , Lavezzo Luca , Lowette Steven , Maier Benedikt , Mee Seán , Mrenna Stephen , Nair Harikrishnan , Niedziela Jeremi , Papageorgakis Christos , Parmar Nukulsinh , Paus Christoph , Pedro Kevin , Peixoto Ana , Perloff Alexx , Plehn Tilman , Scherb Christiane , Schwaller Pedro , Shelton Jessie , Singh Akanksha , Sinha Sukanya , Sjöstrand Torbjörn , Spourdalakis Aris G. B. , Stolarski Daniel , Strassler Matthew J. , Usachov Andrii , Sierra Carlos Vázquez , Verhaaren Christopher B. , Wang Long
Published: December 2022

In this work, we consider the case of a strongly coupled dark/hidden sector, which extends the Standard Model (SM) by adding an additional non-Abelian gauge group. These extensions generally contain matter fields, much like the SM quarks, and gauge fields similar to the SM gluons. We focus on the exploration of such sectors where the dark particles are produced at the LHC through a portal and undergo rapid hadronization within the dark sector before decaying back, at least in part and potentially with sizeable lifetimes, to SM particles, giving a range of possibly spectacular signatures such as emerging or semi-visible jets. Other, non-QCD-like scenarios leading to soft unclustered energy patterns or glueballs are also discussed. After a review of the theory, existing benchmarks and constraints, this work addresses how to build consistent benchmarks from the underlying physical parameters and present new developments for the pythia Hidden Valley module, along with jet substructure studies. Finally, a series of improved search strategies is presented in order to pave the way for a better exploration of the dark showers at the LHC.
Solving the $$H_{0}$$ tension in f(T) gravity through Bayesian machine learning
Authors: Aljaf Muhsin , Elizalde Emilio , Khurshudyan Martiros , Myrzakulov Kairat , Zhadyranova Aliya
Published: December 2022

Bayesian Machine Learning (BML) and strong lensing time delay (SLTD) techniques are used in order to tackle the $$H_{0}$$

H
0

tension in f(T) gravity. The power of BML relies on employing a model-based generative process which already plays an important role in different domains of cosmology and astrophysics, being the present work a further proof of this. Three viable f(T) models are considered: a power law, an exponential, and a squared exponential model. The learned constraints and respective results indicate that the exponential model, $$f(T)=\alpha T_{0}\left( 1-e^{-p T / T_{0}}\right) $$

f

(
T
)

=
α

T
0

1
-

e

-
p
T
/

T
0

, has the capability to solve the $$H_{0}$$

H
0

tension quite efficiently. The forecasting power and robustness of the method are shown by considering different redshift ranges and parameters for the lenses and sources involved. The lesson learned is that these values can strongly affect our understanding of the $$H_{0}$$

H
0

tension, as it does happen in the case of the model considered. The resulting constraints of the learning method are eventually validated by using the observational Hubble data (OHD).
MODELING THE DYNAMICS OF CHRONIC MYELOGENOUS LEUKEMIA THROUGH FRACTIONAL-CALCULUS
Authors: TANG TAO-QIAN , JAN RASHID , UR REHMAN ZIAD , SHAH ZAHIR , VRINCEANU NARCISA , RACHERIU MIHAELA
Published: December 2022

Although the therapy of chronic myelogenous leukemia (CML) has progressed because of imatinib (IM) and other tyrosine kinase inhibitors (TKIs), the majority of patients still do not recover. To better regulate the remaining leukemic cell population, TKI combo therapy may be improved with a deeper understanding of the underlying mechanisms. We employed a mathematical system which incorporated the intricate phenomena of immune system to CML. We use a fractional derivative framework in this work to understand the dynamics of CML. Additionally, in our work, we concentrate on the qualitative characterization and dynamical behavior of CML interactions. For the proposed model, we examine the singularity and existence using fixed point theorems by Banach and Schaefer. We provide the necessary criteria for our suggested fractional model’s Ulam–Hyers stability. The influence of the factors on the dynamics of CML is highlighted by closely examining the solution paths by using a numerical scheme. To be more precise, we emphasized how the suggested system’s dynamic and chaotic behavior varied depending on the fractional order and other system factors. Policymakers are advised to consider the most crucial elements of CML dynamics. In order to inform policymakers and health authorities about the systems essential for control and treatment, it is crucial to investigate the dynamic characteristics of CML disease.
Effect of laser acupuncture combined with electrical stimulation on recovery from exercise fatigue in mice
Authors: Liu Shupeng , Xia Yudan , Hou Zehai , Hong Haotian , Chen Na , Li Taihao , Shan Chunlei , Zhang Heng
Published: December 2022

In sports events, the rapid recovery after high-intensity training or sport competition performance is very important for athletes’ performance and health. The aim of this study is to evaluate the effect of laser acupuncture and electrical stimulation on the recovery from exercise fatigue, using mice with swimming fatigue as experimental model and the electromyography (EMG) and the Raman spectroscopy of blood as evaluation indicators. Root mean square (RMS) and mean power frequency (MPF) of EMG were analyzed after laser acupuncture and electrical stimulation. The amplitude frequency combined analysis (JASA) showed that the proportion of muscles in the fatigue recovery area of the control group, the laser acupuncture group, the multi-channel laser acupuncture group and the laser combined with electrical stimulation group were 34.78%, 39.13%, 39.13% and 43.48%, respectively. Raman spectroscopy of the mice blood during fatigue recovery showed there is a significant difference between the multi-channel laser acupuncture group and the laser combined with electric stimulation group compared with the recovery period and fatigue period ([Formula: see text]) at the peak of 997[Formula: see text]cm[Formula: see text] and the laser combined electrical stimulation group had a statistical difference in the recovery period compared with the fatigue period ([Formula: see text]) at the peak of 1561[Formula: see text]cm[Formula: see text]. The results showed that laser acupuncture combined with electrical stimulation was beneficial to fatigue recovery in mice, and had the potential value in sports fatigue recovery.
The Role of Damping Rate Amplitude in the Synchronization of Two Coupled Oscillators
Authors: Hamadeh A. , Koujok A. , Medlej I. , Pirro P. , Petit S.
Published: December 2022

In this paper, we investigate the synchronization phenomenon between two Spin-transfer Torque Nanooscillators (STNOs) of different frequencies in two pillar systems under vortex configuration detunings or driving frequencies. The oscillators’ mutual synchronization occurs through magnetic dipolar interaction. Our micromagnetic simulations show that an amplitude fluctuation referred to as [Formula: see text] has a significant impact on determining the synchronization frequency. The evolution of frequency and amplitude fluctuation rate in two different oscillator sizes versus external perpendicular field will be compared and discussed. Our results reveal that the oscillator with lower [Formula: see text], referred to as the “Leader” oscillator, leads the synchronization process. As such, the “follower” oscillator adjusts its frequency as to that of the “Leader”, thus achieving synchronization. We believe that taking [Formula: see text] into consideration can help in controlling synchronization frequencies in future building blocks of any network multi-array spintronics’ devices.
SPK-CG: Siamese Network based Posterior Knowledge Selection Model for Knowledge Driven Conversation Generation
Authors: Ma Tinghuai , Zhang Zheng , Rong Huan , Al-Nabhan Najla
Published: December 2022

Building a human-computer conversational system that can communicate with humans is a research hotspot in the field of artificial intelligence. Traditional dialogue systems tend to produce irrelevant and non-information responses, which reduce people’s interest in engaging in a conversation. This often leads to boring conversations. To alleviate this problem, many researchers use external knowledge to assist conversation generation. The accuracy of knowledge selection is the prerequisite to ensure the quality of knowledge conversation. This approach has worked positively to a certain extent, but generally only searches knowledge information based on entity words themselves, without considering the specific conversation context. Therefore, if irrelevant knowledge is retrieved, the quality of conversation generation will be reduced. Motivated by this, we propose a novel neural knowledge-based conversation generation model, namedSiamese Network based Posterior Knowledge Selection Model for Knowledge Driven Conversation Generation (SPK-CG). We have designed a novel knowledge selection mechanism to obtain knowledge information that is highly relevant to the context of the conversation. Specifically, the posterior knowledge distribution is used as a soft label to make the prior distribution consistent with the posterior distribution in the training process. At the same time, in order to narrow the gap between prior and posterior distributions and improve the accuracy of knowledge selection, we leverage siamese network and design multi-granularity matching module for knowledge selection. Compared with previous knowledge-based models, our method can select more appropriate knowledge and use the selected knowledge to generate responses that are more relevant to the conversation context. Extensive automatic and human evaluations demonstrate that our model has advantages over previous baselines.
Punctuation Prediction in Bangla Text
Authors: Rahman Habibur , Rahin Md. Rezwan Shahrior , Mahbub Araf Mohammad , Islam Md. Adnanul , Mukta Md. Saddam Hossain , Rahman Md. Mahbubur
Published: December 2022

Punctuation prediction is critical as it can enhance the readability of machine-transcribed speeches or texts significantly by adding appropriate punctuation. Furthermore, systems like
Automatic Speech Recognizer (ASR)
produce texts that are unpunctuated, making the readability difficult for humans and also hampers the performance of various
natural language processing (NLP)
tasks. Such NLP related tasks have been investigated thoroughly for English; however, very limited work is done for punctuation prediction in the Bangla language. In this study, we train a
bidirectional recurrent neural network (BRNN)
along with Attention model with a plausibly large Bangla dataset. Afterwards, we apply extensive postprocessing techniques for predicting punctuation more accurately with the employed model. Initially, we perform experimentation with a relatively imbalanced dataset, and our model shows promising results
F1=56.9
for Period) in punctuation prediction. Later, we also investigate the model’s performance using a balanced Bangla dataset to achieve higher performance scores (
F1=62.2
for Question). Thus, the goal of this study is to propose an efficient approach that can predict punctuation in Bangla texts effectively. Our study also includes investigation on how our postprocessing techniques affect the prediction performance. Being an early attempt for the punctuation prediction in Bangla text, our work is expected to significantly contribute in the NLP field for the Bangla language, and will pave the way for future work with the Bangla language in this direction.
Attitudes of Healthcare Workers about Prevention and Control of Nosocomial Multidrug-Resistant Tuberculosis Infection in Two Top-Ranked Tuberculosis Specialized Public Hospitals of Ethiopia
Authors: Kebede Taye , Molla Sisay Million
Published: December 2022

Background. Tuberculosis (TB) exists as a human curse since antiquity. Around 9.5 million cases and 1.5 million deaths were reported due to TB in 2021. Ethiopia is one of the high-burdenmultidrug-resistant (MDR) TB countries. MDR-TB is acquired either by poor adherence to treatment or by primary infection with a drug-resistant strain, which has a high transmission rate from patients to healthcare workers (HCWs). Hospital outbreaks of MDR-TB are common in Africa. Hence, this study aimed to score the attitude of HCWs working in the two nationally top-rankedTB-specialized hospitals in Ethiopia, Saint Peter’s and ALERT TB-specialized public hospitals about the infection prevention and control (IPC) of nosocomial MDR-TB. Methods. A cross-sectional study was conducted from December 1, 2020, to March 31, 2021. A simple random sampling method was applied to select 384 HCWs. The data collection tool was a self-administered interview structured questionnaire. The data were analyzed using SPSS software. Descriptive statistics were applied to score attitude. Bivariate and multivariable logistic regression models were performed to identify the independent determinants of attitude. The odds ratio was used to test the degree of association between variables at a 95% confidence interval (CI). The level of statistical significance was fixed at p value < 0.05. Results. Among the respondents, 87% of the HCWs held favourable attitudes about the nosocomial MDR-TB-IPC. The favourable attitude score had a significant association with the monthly salary earned between 7001 and 9000 ETB (Ethiopian Birr) (AOR = 3.34, 95% CI: 1.11, 10.05) and the previous training obtained on TB/MDR-TB (AOR = 2.96, 95% CI: 1.32, 6.62). Conclusions. Almost one in seven HCWs has an unfavourable attitude. Prior training received and earning monthly income above 7000 ETB are independent determinants of a favourable attitude score. Refreshment training and a reasonable increment in monthly income should be strengthened in TB-specialized hospitals in Ethiopia.
Genetic Diversity of Merozoite Surface Protein-1 and -2 Genes in Plasmodium falciparum Isolates among Asymptomatic Population in Boset and Badewacho Districts, Southern Ethiopia
Authors: Chekol Tsegaye , Alemayehu Gezahegn Solomon , Tafesse Weynshet , Legesse Gudeta , Zerfu Biruk , File Temesgen , Wolde Mistire , Golassa Lemu
Published: December 2022

Background. The genetic variation of Plasmodium falciparum has been studied to assess local malaria transmission genetic profile using evidence-based intervention measures. However, there are no known previous reports of P. falciparum polymorphism in Badewacho and Boset districts, Southern Ethiopia. The purpose of this study was to determine the genetic diversity of the merozoite surface protein-1 and -2 (msp-1 and msp-2) allelic families in P. falciparum isolates from an asymptomatic populations. Methods. This study was conducted from finger-prick blood samples spotted on 3 mm Whatman filter paper collected during a community-based cross-sectional study. Nested polymerase chain reaction amplification was used to type the allelic variants of msp-1 and msp-2. Results. From 669 asymptomatic study participants, a total of 50 samples positive for P. falciparum were included for molecular analysis. Of 50 positive samples, 43 P. falciparum isolates were successfully amplified for the msp-1 and msp-2 allelic families. A total of twelve different allele sizes (75–250 bp) were identified within the three allelic families of msp-1, whereas ten different allele sizes (250–500 bp) were detected within the two allelic families of msp-2. MAD20 had a higher allelic proportion, 65% among allelic families of msp-1, whereas the 3D7 allelic family 90.7% was higher in msp-2. A slightly higher frequency of polyclonal infection 53.5% was found in msp-2 allelic family, whereas a low proportion polyclonal infection 46.5% was found in msp-1 allelic family. The overall mean multiplicity of infection (MOI) for msp-1 and msp-2 was identical (MOI = 1.56). Correspondingly, the expected heterozygosity (He) value for msp-1 (He = 0.23) and msp-2 (He = 0.22) was almost similar. Conclusions. The findings of this study revealed low genetic diversity of the msp-1 and msp-2 allelic families in P. falciparum isolates. However, continued monitoring status of the local genetic diversity profile in the P. falciparum population is required to support current malaria control and elimination strategies.
Application of Mesopore-Activated Red Mud for Phosphorus Adsorption
Authors: Trung Nguyen Dinh , Ping Ning , Dan Ho Kim
Published: December 2022

In this paper, the mesopore-activated red mud (M-ARM) was prepared by treating red mud (RM) with acid under an ultrasonic batch and through heat treatment at 750 C. The surface area and adsorption average pore width of M-ARM were calculated and obtained values of 13.408 m2 g-1 and 25.160 nm, respectively. Therefore, the maximum adsorption capacity of M-ARM for phosphorus was [Formula: see text] at 318 K and [Formula: see text]. At a low initial concentration (75 mg L-1), the phosphorus removal capacity by M-ARM material was up to [Formula: see text] at 313 K. With the temperature scales varying from 298 to 313 K, the values of Gibbs free energy change ([Formula: see text]) were negative and also vary from -37.47 to -36.68. The phosphorus adsorption process in an aqueous solution is spontaneous, and this adsorption process was exothermic with enthalpy change [Formula: see text]. From the results of investigations and calculations of thermodynamic values, kinetics, and adsorption capacity of materials, we can confirm that the materials in this study had a low-cost and potential material for applications to treat phosphorus-contaminated water. In addition, the adsorption kinetics of this material for phosphorus were also studied and discussed.
Prognostic Signature for Human Umbilical Cord Mesenchymal Stem Cell Treatment of Ischemic Cerebral Infarction by Integrated Bioinformatic Analysis
Authors: Wen Zhifeng , Liu Fangxi , Lin Xinyu , Zhong Shanshan , Zhang Xiuchun , Zhou Zhike , Jolkkonen Jukka , Liu Chang , Zhao Chuansheng
Published: December 2022

In recent studies, stem cell‐based therapy is a potential new approach in the treatment of stroke. The mechanism of human umbilical cord mesenchymal stem cell (hUMSC) transplantation as one of the new approaches in the treatment of ischemic stroke is still unclear. The aim of this study was to determine the traits of immune responses during stroke progression after treatment with human umbilical cord blood MSCs by bioinformatics, to predict potential prognostic biomarkers that could lead to sex differences, and to reveal potential therapeutic targets. The microarray dataset GSE78731 (mRNA profile) of middle cerebral artery occlusion (MCAO) rats was obtained from the Gene Expression Omnibus (GEO) database. First, two potentially expressed genes (DEGs) were screened using the Bioconductor R package. Ultimately, 30 specific DEGs were obtained (22 upregulated and 353 downregulated). Next, bioinformatic analysis was performed on these specific DEGs. We performed a comparison for the differentially expressed genes screened from between the hUMSC and MCAO groups. Gene Ontology enrichment and pathway enrichment analyses were then performed for annotation and visualization. Gene Ontology (GO) functional annotation analysis shows that DEGs are mainly enriched in leukocyte migration, neutrophil activation, neutrophil degranulation, the external side of plasma membrane, cytokine receptor binding, and carbohydrate binding. KEGG pathway enrichment analysis showed that the first 5 enrichment pathways were cytokine‐cytokine receptor interaction, chemokine signal pathway, viral protein interaction with cytokine and cytokine receptor, cell adhesion molecules (CAMs), and phagosome. The top 10 key genes of the constructed PPI network were screened, including Cybb, Ccl2, Cd68, Ptprc, C5ar1, Il-1b, Tlr2, Itgb2, Itgax, and Cd44. In summary, hUMSC is likely to be a promising means of treating IS by immunomodulation.
Successful Intubation of a Patient with Pierre Robin Sequence Outside an Operating Theatre after Repeated Failed Trials: A Case Report
Authors: Ibrahim Hashey Ahmed Maher , Nour Nadine
Published: December 2022

Pierre Robin sequence (PRS) is a rare congenital birth defect characterized by an underdeveloped jaw, backward displacement of the tongue, and upper airway obstruction. Babies born with PRS commonly experience trouble breathing and feeding, early in life, resulting from the tongue’s position, smaller jaw size, and the cleft palate formation. In this report, we will discuss the approach of emergency intubation outside an operating theatre in a 2-week-old preterm female neonate (33 weeks) weighing 2.2 kg diagnosed with PRS and an associated complete cleft palate. She needed emergency intubation immediately after admission due to desaturation and respiratory distress.
New and Repurposed Drugs for the Treatment of Active Tuberculosis: An Update for Clinicians
Authors: Aguilar Diaz Jessica M , Abulfathi Ahmed A , te Brake Lindsey HM , van Ingen Jakko , Kuipers Saskia , Magis-Escurra Cecile , Raaijmakers Jelmer , Svensson Elin M , Boeree Martin J
Published: December 2022

Although tuberculosis (TB) is preventable and curable, the lengthy treatment (generally 6 months), poor patient adherence, high inter-individual variability in pharmacokinetics (PK), emergence of drug resistance, presence of comorbidities, and adverse drug reactions complicate TB therapy and drive the need for new drugs and/or regimens. Hence, new compounds are being developed, available drugs are repurposed, and the dosing of existing drugs is optimized, resulting in the largest drug development portfolio in TB history. This review highlights a selection of clinically available drug candidates that could be part of future TB regimens, including bedaquiline, delamanid, pretomanid, linezolid, clofazimine, optimized (high dose) rifampicin, rifapentine, and para-aminosalicylic acid. The review covers drug development history, preclinical data, PK, and current clinical development.
The barriers of home environments for obesity prevention in Indonesian adolescents
Authors: Agung Fransisca Handy , Sekartini Rini , Sudarsono Nani Cahyani , Hendarto Aryono , Dhamayanti Meita , Werdhani Retno Asti , Sawyer Susan M.
Published: December 2022

Background

Obesity and its related cardiovascular-metabolic diseases are growing public health concerns. Despite global attention to obesity, its prevalence is steeply increasing in developing countries, especially in children and adolescents. Eating behaviours and physical activity are modifiable risk factors for obesity that can variably be shaped by families. Eating behaviours and physical activity are especially important during adolescence, given its significance as a foundational period for developing healthy lifestyles. This qualitative study aimed to explore barriers and opportunities around creating healthy lifestyles among adolescents in Indonesia, focussing on family environments from diverse socio-demographic backgrounds.

Method

In-depth interviews using a semi-structured guide were undertaken with consecutively recruited 10–18-year-old adolescents with overweight or obesity, and their parents, from three different sites: urban (Jakarta, the capital city of Indonesia), peri-urban (West Java Province) and rural (Banten Province). Thematic analysis was used to identify patterns of meaning.

Results

Nineteen dyads were interviewed. Thematic analysis revealed four themes: limited knowledge of healthy lifestyles; healthy lifestyles not a concern of daily life; limited parenting skills, including inequity around gender roles; and aspects of availability and accessibility. These interconnected barriers influenced lifestyle practices at home within the context of daily preferences and decisions around food and activities. Gender role inequity and healthy food accessibility were more prominent in rural families than in those from urban or peri-urban settings.

Conclusions

Healthy lifestyles in adolescence may be supported by strategies to enhance parenting skills, build individual motivation, and support the development of more enabling environments.
The role of trauma and positive youth development in polysubstance use among rural middle school students: a latent class analysis
Authors: Zervos Andrew P. , Hensel Devon J. , James Rebecca , Hunt Abby , Ott Mary A.
Published: December 2022

Background

Rural youth often begin developing polysubstance use and other risk behaviors during middle school. However, little polysubstance use research focuses on rural middle school youth. Our research uses Latent Class Analysis to understand existing patterns of rural middle school polysubstance use and risk and protective factors associated with polysubstance use.

Methods

We used survey data from a rural middle school pregnancy prevention program (N = 2,708). The survey included measures of demographics, lifetime substance use, trauma (adverse childhood experiences and bullying victimization) and aspects of youth development (parent communication on drugs and alcohol, parent connectedness and school connectedness). We used latent class analysis to produce participant polysubstance use profiles and multinomial regression to examine associations between polysubstance use, demographics, trauma and aspects of youth development.

Results

We categorized our participants into four latent classes. Our analysis classified 2.2% of participants as Regular Polysubstance users, 6.9% as Polysubstance experimenters, 19% as Vape + Alcohol experimenters and 71.9% as Non-Users. More adverse childhood experiences were associated with greater risk of polysubstance use and experimentation. Bullying was positively associated with greater risk of vape and alcohol experimentation. Higher reported parental and school connectedness were associated with lower risk of high frequency polysubstance use. Higher reported school connection was also associated with lower risk of polysubstance experimentation.

Conclusion

Rural substance use prevention programs should begin during middle school, as polysubstance use development is common among rural middle schoolers. These programs should be trauma informed and focus on connectedness as a modifiable factor to reduce risk of polysubstance use development.

Trial registration

This article does not report results of a health care intervention on human participants.
Biomechanical assessment of disease outcome in surgical interventions for medial meniscal posterior root tears: a finite element analysis
Authors: Xu Zhi , Li Yuwan , Rao Jingcheng , Jin Ying , Huang Yushun , Xu Xing , Liu Yi , Tian Shoujin
Published: December 2022

Background

The adverse consequences of medial meniscus posterior root tears have become increasingly familiar to surgeons, and treatment strategies have become increasingly abundant. In this paper, the finite element gait analysis method was used to explore the differences in the biomechanical characteristics of the knee joint under different conditions.

Methods

Based on CT computed tomography and MR images, (I) an intact knee (IK) model with bone, cartilage, meniscus and main ligaments was established. Based on this model, the posterior root of the medial meniscus was resected, and (ii) the partial tear (PT) model, (iii) the entire radial tear (ERT) model, and (iv) the entire oblique tear (EOT) model were established according to the scope and degree of resection. Then, the (v) meniscus repair (MR) model and (vi) partial meniscectomy (PM) model were developed according to the operation method. The differences in stress, displacement and contact area among different models were evaluated under ISO gait loading conditions.

Results

Under gait loading, there was no significant difference in the maximum stress of the medial and lateral tibiofemoral joints among the six models. Compared with the medial tibiofemoral joint stress of the IK model, the stress of the PM model increased by 8.3%, while that of the MR model decreased by 18.9%; at the same time, the contact stress of the medial tibiofemoral joint of the ERT and EOT models increased by 17.9 and 25.3%, respectively. The displacement of the medial meniscus in the ERT and EOT models was significantly larger than that in the IK model (P < 0.05), and the tibial and femoral contact areas of these two models were lower than those of the IK model (P < 0.05).

Conclusions

The integrity of the posterior root of the medial meniscus plays an important role in maintaining normal tibial-femoral joint contact mechanics. Partial meniscectomy is not beneficial for improving the tibial-thigh contact situation. Meniscal repair has a positive effect on restoring the normal biomechanical properties of the medial meniscus.
Conversion surgery for stage IV gastric cancer: a multicenter retrospective study
Authors: Kano Yosuke , Ichikawa Hiroshi , Hanyu Takaaki , Muneoka Yusuke , Ishikawa Takashi , Aizawa Masaki , Matsuki Atsushi , Yabusaki Hiroshi , Bamba Takeo , Nakagawa Satoru , Kobayashi Kazuaki , Kuwabara Shirou , Makino Shigeto , Kawachi Yasuyuki , Naito Tetsuya , Tani Tatsuo , Hirukawa Hiroshi , Tada Tetsuya , Shimada Yoshifumi , Sakata Jun , Wakai Toshifumi
Published: December 2022

Background

Recent improvements in systemic chemotherapy have provided an opportunity for patients with stage IV gastric cancer (GC) to undergo conversion surgery (CS). The aim of this study was to evaluate the long-term outcomes of patients who underwent CS and to elucidate the prognostic factors for CS in stage IV GC.

Methods

A total of 79 patients who underwent CS with the aim of R0 resection for stage IV GC at six institutions from January 2008 to July 2019 were enrolled. We retrospectively reviewed the clinicopathological data and prognosis.

Results

Of the 79 patients, 23 (31.1%) had initially resectable disease (IR) before chemotherapy, defined as positive for cancer on peritoneal cytology (CY1), resectable hepatic metastasis, or para-aortic lymph node No. 16a2/b1 metastasis. Of the 56 remaining patients with primary unresectable disease, 39 had peritoneal dissemination. R0 resection was accomplished in 63 patients (79.7%). The 3-year OS rates for patients with IR and unresectable disease were 78.3% and 44.5%, respectively. Multivariate analysis showed that IR (P = 0.014) and R0 (P = 0.014) were statistically significant independent prognostic factors for favorable OS. Among patients with peritoneal dissemination alone, OS was significantly better for patients with R0 resection than for patients with R1/2 resection, with the 3-year OS rates of 65.5% and 23.1%, respectively (P = 0.011).

Conclusions

CS is a treatment option for selected patients with stage IV GC. Patients with IR and patients who achieve R0 resection may obtain a survival benefit from CS.
IFN-γ differential expression in the hypothalamus-pituitary-ovary axis of thyroidectomized rats
Authors: Wei Jingjie , Liang Yan , Jiang Ningbo , Hu Ge
Published: December 2022

IFN-γ is critical for both thyroid and ovarian function, while thyroxine, secreted from the thyroid gland, regulates the ovarian function via the hypothalamus-pituitary -ovary axis. However, the effect of thyroxine on INF-γ involved in the regulation of hypothalamic pituitary ovarian axis ovarian function is hitherto unknown. Therefore, we set up three groups including a sham-operated group, an experimental thyroidectomized group, and an experimental thyroidectomized group treated with T4 to reveal the IFN-γ expression levels in the in the hypothalamus, pituitary gland, and ovary by immunohistochemical staining, RT-PCR, and Western blotting. IFN-γ-like immunoreactive-positive substances were visualized in the hypothalamus, pituitary gland, and ovary, which were located mainly in the cytoplasm of the hypothalamic neurons anterior pituitary cells, luteal cells, and theca cells in the ovary of hypothyroidism rats, respectively. RT-PCR and Western blotting showed that the rats in the experimental thyroidectomized group treated with T4 had significantly elevated expression of IFN-γ at both the mRNA and protein levels. Thyroxine affects the expression of IFN-γ in the thalamus-pituitary-ovarian axis, which may influence the secretion of IFN-γ to regulate ovarian function during hypothyroidism. This work highlights the potential effect of thyroxine on the involvement of INF-γ in the modulation of the ovarian function in the hypothalamic-pituitary-ovarian axis.
Deep learning based fetal distress detection from time frequency representation of cardiotocogram signal using Morse wavelet: research study
Authors: Daydulo Yared Daniel , Thamineni Bheema Lingaiah , Dasari Hanumesh Kumar , Aboye Genet Tadese
Published: December 2022

Background

Clinically cardiotocography is a technique which is used to monitor and evaluate the level of fetal distress. Even though, CTG is the most widely used device to monitor determine the fetus health, existence of high false positive result from the visual interpretation has a significant contribution to unnecessary surgical delivery or delayed intervention.

Objective

In the current study an innovative computer aided fetal distress diagnosing model is developed by using time frequency representation of FHR signal using generalized Morse wavelet and the concept of transfer learning of pre-trained ResNet 50 deep neural network model.

Method

From the CTG data that is obtained from the only open access CTU-UHB data base only FHR signal is extracted and preprocessed to remove noises and spikes. After preprocessing the time frequency information of FHR signal is extracted by using generalized Morse wavelet and fed to a pre-trained ResNet 50 model which is fine tuned and configured according to the dataset.

Main outcome measures

Sensitivity (Se), specificity (Sp) and accuracy (Acc) of the model adopted from binary confusion matrix is used as outcome measures.

Result

After successfully training the model, a comprehensive experimentation of testing is conducted for FHR data for which a recording is made during early stage of labor and last stage of labor. Thus, a promising classification result which is accuracy of 98.7%, sensitivity of 97.0% and specificity 100% are achieved for FHR signal of 1st stage of labor. For FHR recorded in last stage of labor, accuracy of 96.1%, sensitivity of 94.1% and specificity 97.7% are achieved.

Conclusion

The developed model can be used as a decision-making aid system for obstetrician and gynecologist.
Costs associated with adverse events from remission induction for children with Acute Lymphoblastic Leukemia (ALL)
Authors: Mejía-Aranguré Eréndira , Reyes-López Alfonso , Juárez-Villegas Luis Enrique , Hernández-Olivares Yosef Olaf , Saucedo-Campos Alberto Daniel , Hernández-Pliego Gabriela , Martínez-Valverde Silvia , Barajas-Nava Leticia A. , Garduño-Espinosa Juan
Published: December 2022

Background

ALL is the most frequent hematological tumor in children, so during remission induction chemotherapy protocol (RICP) adverse events (AEs) may appear. The public program in Mexico in charge of financial support to oncologic children without social security delivered a fix amount for ALL chemotherapy, but additional money needed to treat any other unexpected condition should be taken from the budget of the oncologic healthcare providers. So the purpose of our study was to estimate and evaluate the direct medical costs associated to EAs during RICP in children with ALL.

Methods

This study was retrospective, longitudinal, and observational based on medical records review of patients in RICP. The CTCAE was used to identify and classify AEs according to a SOC category. We focused on extracting resources data that were consumed both for inpatients and outpatients AEs. A micro-costing approach was adopted which involve quantification of each healthcare resource consumed by the hospital multiplying them by unit cost. The probability distributions of data were evaluated to identify the appropriated statistical tests to be used for comparisons between groups that were performed with Wilcoxon rank sum test. Generalized linear models (GLM) were adjusted to evaluate the effects of patient characteristics on total cost.

Results

Forty patients accumulated 204 inpatient and 81 outpatient AEs during RICP. Comparison of total costs between groups showed an incremental cost of $7,460.23 likewise attributable to AEs. The total cost of a pediatric patient undergoing RICP without adverse events was $3,078.36 and the total cost of a patient with AEs exceeds it threefold.

Conclusions

The costs associated with AEs during RICP in Mexican children with ALL representing a high burden for the healthcare provider. Generalized linear models showed that variables such as sex, risk category and alive status are associated with the total costs of AEs. This is the first study aiming to analyze the effect of ALL-related AEs on health care costs in pediatric population, so our results may help not only to local decision making but also it may contribute to the research agenda in this field.
Measuring the accuracy of cardiac output using POCUS: the introduction of artificial intelligence into routine care
Authors: Shaikh Faisal , Kenny Jon-Emile , Awan Omar , Markovic Daniela , Friedman Oren , He Tao , Singh Sidharth , Yan Peter , Qadir Nida , Barjaktarevic Igor
Published: December 2022

Background

Shock management requires quick and reliable means to monitor the hemodynamic effects of fluid resuscitation. Point-of-care ultrasound (POCUS) is a relatively quick and non-invasive imaging technique capable of capturing cardiac output (CO) variations in acute settings. However, POCUS is plagued by variable operator skill and interpretation. Artificial intelligence may assist healthcare professionals obtain more objective and precise measurements during ultrasound imaging, thus increasing usability among users with varying experience. In this feasibility study, we compared the performance of novice POCUS users in measuring CO with manual techniques to a novel automation-assisted technique that provides real-time feedback to correct image acquisition for optimal aortic outflow velocity measurement.

Methods

28 junior critical care trainees with limited experience in POCUS performed manual and automation-assisted CO measurements on a single healthy volunteer. CO measurements were obtained using left ventricular outflow tract (LVOT) velocity time integral (VTI) and LVOT diameter. Measurements obtained by study subjects were compared to those taken by board-certified echocardiographers. Comparative analyses were performed using Spearman’s rank correlation and Bland–Altman matched-pairs analysis.

Results

Adequate image acquisition was 100% feasible. The correlation between manual and automated VTI values was not significant (p = 0.11) and means from both groups underestimated the mean values obtained by board-certified echocardiographers. Automated measurements of VTI in the trainee cohort were found to have more reproducibility, narrower measurement range (6.2 vs. 10.3 cm), and reduced standard deviation (1.98 vs. 2.33 cm) compared to manual measurements. The coefficient of variation across raters was 11.5%, 13.6% and 15.4% for board-certified echocardiographers, automated, and manual VTI tracing, respectively.

Conclusions

Our study demonstrates that novel automation-assisted VTI is feasible and can decrease variability while increasing precision in CO measurement. These results support the use of artificial intelligence-augmented image acquisition in routine critical care ultrasound and may have a role for evaluating the response of CO to hemodynamic interventions. Further investigations into artificial intelligence-assisted ultrasound systems in clinical settings are warranted.
Gut microbiota in the early stage of Crohn’s disease has unique characteristics
Authors: Ma Xianzong , Lu Xiaojuan , Zhang Wenyu , Yang Lang , Wang Dezhi , Xu Junfeng , Jia Yan , Wang Xin , Xie Hui , Li Shu , Zhang Mingjie , He Yuqi , Jin Peng , Sheng Jianqiu
Published: December 2022

Background

Emerging evidence suggests that gut microbiota plays a predominant role in Crohn’s disease (CD). However, the microbiome alterations in the early stage of CD patients still remain unclear. The present study aimed to identify dysbacteriosis in patients with early CD and explore specific gut bacteria related to the progression of CD.

Methods

This study was nested within a longitudinal prospective Chinese CD cohort, and it included 18 early CD patients, 22 advanced CD patients and 30 healthy controls. The microbiota communities were investigated using high-throughput Illumina HiSeq sequencing targeting the V3–V4 region of 16S ribosomal DNA (rDNA) gene. The relationship between the gut microbiota and clinical characteristics of CD was analyzed.

Results

Differential microbiota compositions were observed in CD samples (including early and advanced CD samples) and healthy controls samples. Notably, Lachnospiracea_incertae_sedis and Parabacteroides were enriched in the early CD patients, Escherichia/Shigella, Enterococcus and Proteus were enriched in the advanced CD patients, and Roseburia, Gemmiger, Coprococcus, Ruminococcus 2, Butyricicoccus, Dorea, Fusicatenibacter, Anaerostipes, Clostridium IV were enriched in the healthy controls [LDA score (log10) > 2]. Furthermore, Kruskal–Wallis Rank sum test results showed that Blautia, Clostridium IV, Coprococcus, Dorea, Fusicatenibacter continued to significantly decrease in early and advanced CD patients, and Escherichia/Shigella and Proteus continued to significantly increase compared with healthy controls (P < 0.05). The PICRUSt analysis identified 16 remarkably different metabolic pathways [LDA score (log10) > 2]. Some genera were significantly correlated with various clinical parameters, such as fecal calprotectin, erythrocyte sedimentation rate, C-reactive protein, gland reduce, goblet cells decreased, clinical symptoms (P < 0.05).

Conclusions

Dysbacteriosis occurs in the early stage of CD and is associated with the progression of CD. This data provides a foundation that furthers the understanding of the role of gut microbiota in CD’s pathogenesis.
The Yellow-browed Warbler (Phylloscopus inornatus) as a model to understand vagrancy and its potential for the evolution of new migration routes
Authors: Dufour Paul , Åkesson Susanne , Hellström Magnus , Hewson Chris , Lagerveld Sander , Mitchell Lucy , Chernetsov Nikita , Schmaljohann Heiko , Crochet Pierre-André
Published: December 2022

Why and how new migration routes emerge remain fundamental questions in ecology, particularly in the context of current global changes. In its early stages, when few individuals are involved, the evolution of new migration routes can be easily confused with vagrancy, i.e. the occurrence of individuals outside their regular breeding, non-breeding or migratory distribution ranges. Yet, vagrancy can in theory generate new migration routes if vagrants survive, return to their breeding grounds and transfer their new migration route to their offspring, thus increasing a new migratory phenotype in the population. Here, we review the conceptual framework and empirical challenges of distinguishing regular migration from vagrancy in small obligate migratory passerines and explain how this can inform our understanding of migration evolution. For this purpose, we use the Yellow-browed Warbler (Phylloscopus inornatus) as a case study. This Siberian species normally winters in southern Asia and its recent increase in occurrence in Western Europe has become a prominent evolutionary puzzle. We first review and discuss available evidence suggesting that the species is still mostly a vagrant in Western Europe but might be establishing a new migration route initiated by vagrants. We then list possible empirical approaches to check if some individuals really undertake regular migratory movements between Western Europe and Siberia, which would make this species an ideal model for studying the links between vagrancy and the emergence of new migratory routes.