bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Eﬀects of Diﬀerent Physiotherapy Programs on Motor Skills of Children with Mild and Moderate Motor Impairment
Authors: Tabarienė Kristina , Sipavičienė Saulė
Published: June 2023

Background. Children diagnosed with mild or moderate motor impairment not only face impairment of fine motor skills and problems with body balance in daily activities, they are also diagnosed with a decrease in muscle strength. Physiotherapy is prescribed to improve physical condition.

The aim of the study was to determine the effect of different physiotherapy programs on running speed, balance and leg strength in children with mild and moderate motor impairment.

Methods. 30 children (4–6 years old) with mild or moderate motor impairment participated in the study, and were randomly divided into two groups. The control group (n=15) received only conventional physiotherapy, while the experimental group (n=15) received a balance training program on the Abili Balance platform in addition to conventional physiotherapy. The duration of the interventions for both groups was 8 weeks. The subjects’ static and dynamic balance (according to Abili stability index and Berg scale), leg muscle strength (Broad jump) and running speed (Shuttle Run) were assessed before and after the interventions.

Results. After 8 weeks, children in both groups had longer forward jumps and shorter shuttle run test results (p<0.05); balance indicators improved (p<0.05). After the interventions, the postural stability and leg muscle strength of the children in the study group were higher (p<0.05) than in the control group; other indicators did not differ significantly.

Conclusions. Both applied 8-week physiotherapy programs were effective in improving children’s motor skills. Conventional physiotherapy combined with a balance training program was more effective than conventional physiotherapy in improving leg strength and postural stability in children with mild to moderate motor impairment, but not running speed and static and dynamic balance assessed by the Berg test.

Keywords: leg, muscle strength, balance, running speed.
Efcacy of Electrostimulation and Pelvic Floor Muscle Exercises in the Treatment of Stress Urinary Incontinence in Women: Randomised Controlled Trial
Authors: Nepaitė-Stabingė Vaiva , Katinė Anelė , Karkauskienė Erika , Dudonienė Vilma
Published: June 2023

Background. Pelvic ﬂoor muscle training (PFMT) is the most commonly used physiotherapy method in the treatment of female stress incontinence; pelvic ﬂoor muscles (PFM) can be trained not only with exercise but also with electrostimulation.
The aim. To determine the efcacy of four weeks of pelvic ﬂoor muscle exercises and electrical stimulation in the treatment of stress urinary incontinence in women.
Methods. The study involved 24 subjects who were randomly divided into two groups: pelvic ﬂoor muscle training (PFMT) and pelvic ﬂoor muscle exercises combined with electrostimulation (PFMES). Before and after the interventions, women’s quality of life (QoL) was assessed according to the International Incontinence Counselling Questionnaire – Short Form. Perineometry with Pelvexiser perineometer was used to measure pelvic ﬂoor muscle strength, endurance and vaginal resting pressure.
Results. Both interventions signifcantly reduced urinary incontinence episodes and improved the subjects’ quality of life. PFM strength improved after the interventions in the PFMT group from 12.33±3.37 to 19.97±3.38 mmHg (p=0.0008, d=2.26) and in the PFMES group from 8.31±2.41 to 11.84 ±2.78 mmHg (p=0.003, d=2.6). PFM endurance improved in the PFMT group from 3.50±1.15 to 4.53±1.12 s (p=0.03, d=0.9), and in PFMES from 2.92±0.47 to 3.67±0, 52 s (p=0.001, d=1.45). Resting vaginal pressure in the PFMT group improved from 5.3±0.85 to 6.44±1.03 mmHg (p=0.005, d=1.25) and in the PFMES group from 4.4±0.70 to 6.14± 1.47 mmHg (p=0.001, d=1.5).
Conclusions. PFMT and PFMES interventions signifcantly improved subjects’ PMF strength, endurance, resting vaginal pressure, and quality of life. Both applied interventions can be applied in the treatment of stress urinary incontinence, as they were safe and well tolerated by the patients. The trial is registered at ClinicalTrials.gov Identifer: NCT05871281.
Keywords: female, strength, endurance, incontinence, questionnaire.
Effects of Completion of Radiation Safety Management Training on Dental Radiation Safety Management Knowledge, Attitudes, and Behavior
Authors:   The Korean Society of Oral Health Science, Kim Hee-Jung , Kim Seul-Gi , Yoon Hyun-Seo , Kim Hye-Jin , Lee Min-Kyung
Published: June 2023

Objectives: The goal of this study is to understand the knowledge, attitudes, and behavior of dental radiation safety management before and after radiation safety management education. Methods: From May 6 to September 20, 2021, a questionnaire was distributed to dental hygienists who are currently performing radiography work. Results: Dental hygienists with less than five years of experience who completed radiation safety management training had greater knowledge, and better attitudes, and behavior levels than dental hygienists with more than six years of experience who had not completed radiation safety management. Conclusions: Customized educational programs should be provided via self-education or maintenance education at dental clinics for dental hygienists who have not already completed them.
Antibacterial Activity of Litsea cubeba (May Chang) Essential Oil Against Streptococcus mutans and Porphyromonas gingivalis
Authors:   The Korean Society of Oral Health Science, Park Chung-Mu , Yoon Hyun-Seo
Published: June 2023

Objectives: This study analyzed the antibacterial effects of Litsea cubeba essential oil (LCEO) against both Streptococcus mutans and Porphyromonas gingivalis, as well as inhibitory effect on biofilm formation. Methods: Antibacterial activity of LCEO was analyzed by minimum inhibition concentration on bacterial growth, disk diffusion and growth inhibitory assays. In addition, growth inhibitory effect of LCEO was also evaluated by biofilm formation assay. Results: LCEO significantly inhibited growth of S. mutans and P. gingivalis in a dose dependent manner. In addition, these results were coincided with the result of biofilm formation assay. Conclusions: LCEO exhibited potent antibacterial activity against both pathogens, which provides that LCEO might be used as a potential candidate for oral healthcare supplies.
Расчет здания на сейсмическое воздействие в условиях многолетнемерзлых грунтов
Authors: КЕЛАСЬЕВ Николай Геннадьевич , АВДЕЕВ Кирилл Владимирович , ТЕРИН Вячеслав Дмитриевич , ЛЕВИН Дмитрий Иванович
Published: June 2023

В статье приводятся сценарии, которые необходимо учитывать при расчетах зданий, проектируемых по первому принципу строительства на многолетнемерзлых грунтах в сейсмических районах и с течением времени подверженных изменению температурного режима грунтов основания. Приводится способ моделирования грунтового основания в нелинейной постановке с использованием одноузловых конечных элементов, при этом учитывается возможное изменение жесткости основания во времени. Выполнен расчет здания в нелинейной постановке на сейсмическое воздействие с изменением температурного режима многолетнемерзлых грунтов основания. Показано, что при сейсмическом воздействии и при неравномерных осадках здания возникает большая вероятность образования пластических шарниров в колоннах, вследствие чего возникает риск разрушения здания. Предложены способы защиты здания от разрушения в сложных геофизических условиях строительства с использованием арматуры с повышенными физико-механическими свойствами.
Влияние карбонизации защитного слоя бетона на прочность при неразрушающем контроле
Authors: ТЕРЕХОВ Иван Александрович , ТРЕКИН Николай Николаевич , КОДЫШ Эмиль Наумович , БЫБКА Александр Валерьевич
Published: June 2023

Коррозионные процессы в арматуре могут начаться не только при фактическом разрушении защитного слоя бетона, но и в случае утраты бетоном своих защитных свойств без нарушения целостности. Рассмотрен процесс карбонизации, при котором углекислый газ проникает сквозь поверхность бетона вглубь конструкции, вступая в реакцию с цементным камнем. Приведен общий случай процесса карбонизации, который описывается первым законом А. Фика, а также вероятностный подход к определению минимальной необходимой толщины защитного слоя бетона через характеристику безопасности (индекс надежности). Наиболее распространенный тест, позволяющий определить глубину карбонизации бетона при проведении обследования, - фенолфталеиновый тест. На двух однотипных объектах со сроком эксплуатации до трех лет в процессе обследования был произведен контроль прочности бетона методами ударного импульса и отрыва со скалыванием с определением глубины карбонизации. По результатам сравнения полученных прочностных показателей было отмечено, что с ростом глубины карбонизации по методу ударного импульса наблюдается завышение фактической прочности.
Pengembangan Rancangan Pembelajaran Massive Open and Online Courses (MOOCs) Public Speaking
Authors: Nila Kusuma Windrati  , Isma Dwi Fiani  , Arifah Bintarti  , Asih Irsanti Widuri
Published: June 2023

Artikel ini menjelaskan hasil penelitian tentang pengembangan rancangan pembelajaran dalam Massive Open and Online Courses (MOOCs) Public Speaking. Penelitian ini dilatarbelakangi oleh hasil evaluasi yang menunjukan bahwa MOOCs Public Speaking dinilai belum optimal dari sisi rancangan pembelajaran program, materi pembelajarannya, hingga tes kompetensi. Hasil penelitian digunakan untuk menyempurnakan program MOOCs Public Speaking yang telah dikembangkan oleh Universitas Terbuka agar memenuhi aspek keabsahan dan kelayakan. Metode penelitian yang digunakan adalah kualitatif dengan teknik pengumpulan data melalui wawancara mendalam dengan pakar public speaking, praktisi public speaking, pakar desain instruksional dan dosen UT pengembang MOOCs. Temuan studi menunjukan bahwa secara ideal, pembelajaran Public Speaking secara jarak jauh tetap membutuhkan praktik secara syncrounus dengan jumlah peserta di satu kelas tidak lebih dari 15 untuk mencapai efektivitas program pembelajaran. Apabila diterapkan pada program MOOCs yang sifatnya masif dan self paced, maka dianggap sulit untuk mengakomodasi kebutuhan pembelajaran MOOCs Public Speaking yang ideal.
 
This research aims to develop learning designs in Massive Open and Online Courses (MOOCs) of Public Speaking. This research is compiled based on the previous research results, which show that MOOCs Public Speaking is not yet optimal regarding program learning design, learning materials, and competency evaluation. The results of this study will benefit improving the MOOCs Public Speaking program developed by Universitas Terbuka (UT) to meet the feasibility aspect. This research used the research and development method to design a syllabus or learning strategy for the MOOCs Public Speaking program. Data collection techniques were conducted through in-depth interviews with informants, including public speaking experts, public speaking practitioners, instructional design experts and UT lecturers who developed MOOCs. The study findings show that, ideally, distance learning Public Speaking course still requires synchronous mode with no more than 15 participants in one class to achieve the learning program's effectiveness. On the other side, when applied to the massive and self-paced MOOCs program, it is considered challenging to accommodate the ideal learning needs of MOOCs Public Speaking.
The Development Process of Innovation of Accounting Cycle Simulation
Authors: Daurrohmah Eka Wirajuang
Published: June 2023

Basic accounting learning is about the accounting cycle. One of the competency achievements of undergraduate accounting students is to be able to understand the accounting cycle and make financial reports. However, not a few accounting students who when they graduate from the course still do not understand the accounting cycle and make financial reports, especially with the open distance learning system. This paper aims to create learning innovations about the accounting cycle so that students easily understand the accounting cycle and can make financial reports. This learning innovation uses virtual reality and gamification technology. The methods used in this study is research and development study and ADDIE model used to the development model. The result of this study is the development of innovation of accounting cycle simulation can make more interesting and easier to understand about accounting cycle learning for student.
Persepsi Mahasiswa Terhadap Pemanfaatan Bahan Ajar Digital Interaktif dalam Pembelajaran di Universitas Terbuka
Authors: Sadjati Ida Malati , Limbong Asnah MN , Suciati
Published: June 2023

Penelitian ini bertujuan untuk mengetahui persepsi mahasiswa Universitas Terbuka (UT) telah menginisiasi pengembangan prototipe Bahan Ajar Digital Interaktif (BA Digital Interaktif) untuk MK MPDR5204 Difusi Inovasi Pendidikan pada tahun 2017. Dua puluh orang mahasiswa dari UPBJJ-UT Bandung dan Surakarta yang meregistrasi MK MPDR5204 pada semester 2 dipilih sebagai responden dalam uji coba evaluasi one-to-one pemanfaatan BA Digital Interaktif dalam pembelajaran di UT. Aspek BA Digital Interaktif yang di uji coba meliputi kepemilikan gadget mahasiswa, kemudahan/kesulitan proses download reader dan BA Digital Interaktif, kualitas cover depan, kualitas dan manfaat audio dan video dalam BA Digital Interaktif, navigasi, tanggapan mahasiswa terhadap tugas, rangkuman dan tes formatif, sumber pustaka, dan kemudahan pemanfaatan BA Digital Interaktif secara umum dalam pembelajaran. Data dan informasi dianalisis secara deskriptif dan ditabulasi berdasarkan rekaman wawancara dan catatan peneliti. Hasil uji coba menunjukkan bahwa sebagian mahasiswa mempunyai persepsi yang positif dan berminat menggunakan BA Digital Interaktif. Sedangkan mahasiswa yang lain berpendapat lebih menyukai bahan ajar dalam bentuk tercetak. Keragaman persepsi ini disebabkan oleh beragamnya kondisi mahasiswa pengguna, yang mencakup ketersediaan perangkat, sinyal, dan kemenarikan bahan ajar.
Relationship Between Food Acceptability and The Amount of Leftover Food Among Patients in The Rehabilitation Room of Drug Dependence Hospital of Jakarta
Authors: Puspitasari Eka , Khasanah Tri Ardianti , Fayasari Adhila
Published: June 2023

Acceptability of food is influenced by many related factors such as individual factor, food factor and environmental factor. The success of a food administration is often associated with the presence of leftover food consumed by the patient. Leftover food is also an indicator of the success of nutrition services in hospitals. This study aims to determine the relationship between food acceptability and the amount of leftover food among patients in the rehabilitation room of Drug Dependence Hospital of Jakarta. This was a descriptive study with a cross sectional approach. The study samples were selected using purposive sampling technique as many as 33 respondents. The results of bivariate analysis showed that there was a relationship between the leftover food and food temperature (p 0.017), the food serving time (p 0.006), and the suitability of cutlery used (p 0.009) with food acceptability. It can be concluded that there was a relationship between food acceptability and leftover food among patients in the rehabilitation room of Drug Dependence Hospital of Jakarta. It is recommended to conduct further study with a larger number of samples and involve other variables to find out which variables are related to food acceptability and food lefovers.
History of Chronic Energy Deficiency (CED) during Pregnancy and the Incidence of Stunting among Children Aged 0-59 Months in East Jakarta
Authors: Ramadhani Hesty Ayu Nurranti , Ronoatmodjo Sudarto
Published: June 2023

Based on SSGI data (2021), the prevalence of stunting among under-five children in DKI Jakarta Province was 16.8%. Meanwhile, based on the Ministry of Health Republic of Indonesia Performance Report for 2021, there were 3.1% of pregnant women with Chronic Energy Deficiency (CED) in DKI Jakarta Province. This study aims to determine the correlation between a history of Chronic Energy Deficiency (CED) during pregnancy and the incidence of stunting among children aged 0-59 months in East Jakarta. This study involved secondary data derived from the e-PPGBM application for the City of East Jakarta in 2021 with a sample size of 2,688 people and data were analyzed using Cox-regression. Based on the results of data analysis, it was found that the proportion of pregnant women with a history of CED was 3.7% and the proportion of under-five children with stunting was 21.1%. The multivariate analysis on the correlation between a history of CED during pregnancy and the incidence of stunting after being controlled by the potential confounder variable obtained a PR of 1.354 (95% CI: 0.922-1.988). It can be concluded that there was no significant correlation between a history of CED during pregnancy and the incidence of stunting in the East Jakarta area in 2021 after being controlled by the potential confounder variable. However, there are still possible confounder factors that should be analyzed further.
Implementation of Aseptic Dispensing for Non-Cytostatic Injectable Drugs in the Internal Medicine Inpatient Ward of 'X' Hospital, West Java
Authors: Sari Novita , Sumarny Ros , Laksmitawati Dian R. , Nurcholis Waras
Published: June 2023

Aseptic Dispensing activity is a procedure to minimize pharmaceutical preparations from the threats of pyrogens and contaminants. This study aims to determine the implementation of aseptic dispensing for non-cytostatic injectable drugs and the sterility of intravenous mixed preparations in the Internal Medicine Inpatient Ward of 'X' hospital, West Java for the period January - February 2022. This was a descriptive observational prospective study with a cross sectional approach. Researchers made direct observations of dispensing personnel, room and equipment as well as the process of aseptic dispensing activities including the stages of preparation, mixing, storage and disposal as well as sterility test of aseptic dispensing products. Based on the study results, it was obtained that of the 150 intravenous mixed preparations collected, there were 40 activities of diluting intravenous preparations, 100 activities of packaging into ready-to-use preparations and 10 activities of mixing intravenous preparations into infusion fluids, room suitability by 74%, preparations arrangement procedure by 68%, mixing procedure by 44%, storage procedure by 100% and disposal procedure by 63%. It can be concluded that the aseptic dispensing of non-cytostatic injection drugs in the internal medicine inpatient ward of 'X' hospital, West Java was not in accordance with the guidelines, especially at the mixing procedure stage (≤50). Compliance of dispensing personnel and room cleanliness during the process of mixing intravenous preparations need to be considered. The result of the identification of contamination during  the aseptic dispensing activity of non-cytostatic injectable drugs showed that 1 in 150 samples (0.66%) was contaminated.
Inhibiting Back Pain and Enhancing Comfort During Pregnancy with The Power of Endorphin Massage
Authors: Anggraeni Surti , Miskiyah Miskiyah
Published: June 2023

Back pain and anxiety during pregnancy can cause discomfort and interfere with activities in meeting daily needs. Endorphin massage is known to reduce back pain and make a person calmer so that it can reduce anxiety, but research on the effect of endorphin massage in dealing with back pain and anxiety is still minimally reviewed. The study aims to should be to find out the effect of endorphin massage for back pain and anxiety in third trimester pregnant women. The one-group pretest-posttest research method used a quasi-experimental design involving 42 respondents from 2 selected villages using a purposive sampling technique. The endorphin massage intervention was carried out 18 times with 2 observations, during the pretest and after the end of the intervention 18 times. After the analysis using the t-test, it is known that endorphin massage affects reducing back pain and anxiety in pregnant women. The analysis's findings demonstrated that there was an intervention effect on anxiety and back pain, with a p-value of 0.000, compared to a p-value of 0,042 for the control group. It was concluded that there is influence of endorphins to inhibiting back pain, enhancing comfort during pregnancy and it is very important to educate pregnant women about physical and psychological discomfort so that they can be anticipated in carrying out their daily activities. It is also recommended to consider the presence of the husband when implementing this activity.
Early inhalant allergen sensitization at component level: an analysis in atopic Dutch children
Authors: Landzaat Lonneke J. , Emons Joyce A. M. , Sonneveld Laura J. H. , Schreurs Marco W. J. , Arends Nicolette J. T.
Published: June 2023

Background

Allergic rhinitis is a common respiratory disease in children and sensitization to inhalant allergens plays a significant role in its development. However, limited knowledge exists regarding sensitization profiles of inhalant allergen components in atopic children, particularly in the very young individuals. Understanding these profiles could provide insights into the early development of allergic rhinitis. The objective of this cross-sectional retrospective study was to evaluate the IgE-sensitization profiles to multiple inhalant allergen components and their clinical relevance in Dutch atopic children, with specific focus on children under the age of 4 years.

Methods

A total of 243 atopic children were included in the study and sensitization profiles were analyzed using multiplex microarray analysis (ISAC). Clinical information was obtained from records of a pediatric allergy outpatient clinic between 2011 and 2020. Specific IgE responses to inhalation allergen components from five allergen sources (grass pollen, tree pollen, house dust mite, cat and dog), were examined. The study encompassed children of different age groups and compared those with and without symptoms.

Results

The results demonstrated that sensitization to inhalant allergen components was present in 92% of the cohort. Sensitization was already evident at a young age (87%), including infancy, with a rapid increase in prevalence after 1 year of age. House dust mite emerged as the most predominant sensitizing allergen in early childhood, followed by tree pollen in later years. Sensitization patterns were similar between symptomatic and asymptomatic children, although symptomatic children exhibited higher frequencies and values. The sensitization profiles in very young children were comparable to those of children across all age groups.

Conclusion

These findings highlight the presence of sensitization to inhalant allergen components and the early onset of allergic rhinitis before the age of 4, including infancy, in Dutch atopic children. Notable allergen molecules in Dutch atopic children under the age of 4 years include Bet v 1, Fel d 1, Der f 1, Der p 1, Der p 10 and Phl p 4, with house dust mite sensitization being the most common among Dutch infants. Moreover, the prevalence of sensitization to inhalant allergens in this Dutch cohort surpassed that of general European populations, emphasizing the importance of early assessment and management of allergic rhinitis in young atopic children.
Multi-parameter comprehensive early warning of coal pillar rockburst risk based on DNN
Authors: Guo Ying , Gu Shitan , Du Ruimin , Shen Jianbo
Published: June 2023

A multi-parameter comprehensive early warning method for coal pillar-type rockburst risk based on the deep neural network (DNN) is proposed in this study. By utilizing preprocessed data from the surveillance of coal pillar impact hazards in Yangcheng Coal Mine, this study incorporates training samples derived from three distinct coal pillar-type impact hazard monitoring methodologies: microseismic monitoring, borehole cutting analysis, and real-time stress monitoring. The data characteristics of the monitoring data were extracted, evaluated, classified, and verified by monitoring the data of different working faces. This method was applied to develop the depth of multi-parameter neural network comprehensive early warning software in engineering practice. The results showed that the accuracy of the depth for burst monitoring data processing is improved by 6.89%–16.87% compared to the traditional monitoring methods. This method has a better early warning effect to avoid the occurrence of coal pillar rockburst hazard.
Primary school teachers’ patterns in using communication-supporting strategies following a professional development program: lessons learned from an exploratory study with three teachers
Authors: Edlund Karin , Kjellmer Liselotte , Hemmingsson Helena , Berglund Eva
Published: June 2023

Oral language skills underpin later literacy achievement and life prospects, and many children struggle with oral language for various reasons. Hence, it is crucial for teachers to provide a learning environment with rich opportunities for all children to practice their oral language. The aim of this exploratory study was to explore a professional development (PD) program designed to coach teachers in using communication-supporting strategies during verbal teacher-child interactions in regular classrooms. In focus were five strategies from the Communication Supporting Classroom Observation Tool. The study used a mixed-method case design with multiple observations across four time points over 10 weeks and a follow-up observation after two months. Outcome measures were collected at pre-and, post-intervention and at follow-up. The cases were two intervention teachers and one comparison teacher in second grade in Swedish primary schools. The teachers were directly observed and video-recorded during teacher-child structured small group conversations while discussing different texts with two groups of children each. The groups were mixed and comprised both children struggling with oral language as well as more typically developing children. To further understand the verbal interactions, the teachers’ amount of talk in relation to the children was analyzed in terms of the percentage distribution of the total number of words per minute. The overall patterns of strategy use showed that the two intervention teachers applied more varied strategies from the PD program during the intervention period, but this was not maintained at the follow-up. The amount of teacher talk appeared stable over time, with individual differences in the three teachers. We also discuss the teachers’ own insights and our experience in the design of the PD program, which may guide future research and applications of the PD program.
New anti-diabetic agents for the treatment of non-alcoholic fatty liver disease: a systematic review and network meta-analysis of randomized controlled trials
Authors: Kongmalai Tanawan , Srinonprasert Varalak , Anothaisintawee Thunyarat , Kongmalai Pinkawas , McKay Gareth , Attia John , Thakkinstian Ammarin
Published: June 2023

Objectives

This network meta-analysis aims to compare the efficacy and safety of new anti-diabetic medications for the treatment of non-alcoholic fatty liver disease (NAFLD).

Materials and methods

PubMed and Scopus were searched from inception to 27th March 2022 to identify all randomized controlled trials (RCTs) in NAFLD patients. Outcomes included reductions in intrahepatic steatosis (IHS) and liver enzyme levels. The efficacy and safety of DPP-4 inhibitors, GLP-1 agonists, SGLT-2 inhibitors, and other therapies were indirectly compared using a NMA approach. Unstandardized mean difference (USMD) with 95% confidence intervals (CI) were calculated.

Results

2,252 patients from 31 RCTs were included. “Add-on” GLP-1 agonists with standard of care (SoC) treatment showed significantly reduced IHS compared to SoC alone [USMD (95%CI) -3.93% (-6.54%, -1.33%)]. Surface under the cumulative ranking curve (SUCRA) identified GLP-1 receptor agonists with the highest probability to reduce IHS (SUCRA 88.5%), followed by DPP-4 inhibitors (SUCRA 69.6%) and pioglitazone (SUCRA 62.2%). “Add-on” GLP-1 receptor agonists were also the most effective treatment for reducing liver enzyme levels; AST [USMD of -5.04 (-8.46, -1.62)], ALT [USMD of -9.84 (-16.84, -2.85)] and GGT [USMD of -15.53 (-22.09, -8.97)] compared to SoC alone. However, GLP-1 agonists were most likely to be associated with an adverse event compared to other interventions.

Conclusion

GLP-1 agonists may represent the most promising anti-diabetic treatment to reduce hepatic steatosis and liver enzyme activity in T2DM and NAFLD patients. Nevertheless, longer-term studies are required to determine whether this delays progression of liver cirrhosis in patients with NAFLD and T2DM.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42021259336.1.
Norms of evidence in the classification of living fossils
Authors: Sterner Beckett
Published: June 2023

Some species have held fast for millions of years as constants in a changing world. Often called “living fossils,” these species capture scientific and public interest by showing us the vestiges of an earlier world. If living fossils are defined by a holistic pattern of low evolutionary rates or stasis, however, then classifying a species as a living fossil involves the application of sophisticated norms of scientific evidence. Using examples from Crocodilia and the tuatara (Sphenodon punctatus), I show how scientists’ evidential criteria for classifying living fossils are contentious and underspecified in many cases, threatening the concept’s explanatory interest and its adequacy for sustaining a collective problem agenda as proposed by Scott Lidgard and Alan Love. While debates over the definition of the living fossil concept may appear fruitless, I suggest they can be productive insofar as the debate leads to clarified and improved evidential standards for classification. To this end, I formulate a view of the living fossil concept as an investigative kind, and compare two theoretical frameworks as a basis for shared evidential norms: the Zero Force Evolutionary Law framework, introduced by Daniel McShea and Robert Brandon, and the statistical model selection framework first developed by Gene Hunt in the 2000s.
The genetic basis of onset age in schizophrenia: evidence and models
Authors: Zhan Na , Sham Pak C. , So Hon-Cheong , Lui Simon S. Y.
Published: June 2023

Schizophrenia is a heritable neurocognitive disorder affecting about 1% of the population, and usually has an onset age at around 21–25 in males and 25–30 in females. Recent advances in genetics have helped to identify many common and rare variants for the liability to schizophrenia. Earlier evidence appeared to suggest that younger onset age is associated with higher genetic liability to schizophrenia. Clinical longitudinal research also found that early and very-early onset schizophrenia are associated with poor clinical, neurocognitive, and functional profiles. A recent study reported a heritability of 0.33 for schizophrenia onset age, but the genetic basis of this trait in schizophrenia remains elusive. In the pre-Genome-Wide Association Study (GWAS) era, genetic loci found to be associated with onset age were seldom replicated. In the post-Genome-Wide Association Study era, new conceptual frameworks are needed to clarify the role of onset age in genetic research in schizophrenia, and to identify its genetic basis. In this review, we first discussed the potential of onset age as a characterizing/subtyping feature for psychosis, and as an important phenotypic dimension of schizophrenia. Second, we reviewed the methods, samples, findings and limitations of previous genetic research on onset age in schizophrenia. Third, we discussed a potential conceptual framework for studying the genetic basis of onset age, as well as the concepts of susceptibility, modifier, and “mixed” genes. Fourth, we discussed the limitations of this review. Lastly, we discussed the potential clinical implications for genetic research of onset age of schizophrenia, and how future research can unveil the potential mechanisms for this trait.
Polyfunctional antibodies: a path towards precision vaccines for vulnerable populations
Authors: Purcell Ruth A. , Theisen Robert M. , Arnold Kelly B. , Chung Amy W. , Selva Kevin J.
Published: June 2023

Vaccine efficacy determined within the controlled environment of a clinical trial is usually substantially greater than real-world vaccine effectiveness. Typically, this results from reduced protection of immunologically vulnerable populations, such as children, elderly individuals and people with chronic comorbidities. Consequently, these high-risk groups are frequently recommended tailored immunisation schedules to boost responses. In addition, diverse groups of healthy adults may also be variably protected by the same vaccine regimen. Current population-based vaccination strategies that consider basic clinical parameters offer a glimpse into what may be achievable if more nuanced aspects of the immune response are considered in vaccine design. To date, vaccine development has been largely empirical. However, next-generation approaches require more rational strategies. We foresee a generation of precision vaccines that consider the mechanistic basis of vaccine response variations associated with both immunogenetic and baseline health differences. Recent efforts have highlighted the importance of balanced and diverse extra-neutralising antibody functions for vaccine-induced protection. However, in immunologically vulnerable populations, significant modulation of polyfunctional antibody responses that mediate both neutralisation and effector functions has been observed. Here, we review the current understanding of key genetic and inflammatory modulators of antibody polyfunctionality that affect vaccination outcomes and consider how this knowledge may be harnessed to tailor vaccine design for improved public health.
Revealing ecotype influences on Cistanche sinensis: from the perspective of endophytes to metabolites characteristics
Authors: Zhang Min , Miao Yujing , Zhang Xinke , Sun Xiao , Li Minhui , Huang Linfang
Published: June 2023

Introduction

Plant microorganism is critical to plant health, adaptability, and productive forces. Intriguingly, the metabolites and microorganisms can act upon each other in a plant. The union of metabolomics and microbiome may uncover the crucial connections of the plant to its microbiome. It has important benefits for the agricultural industry and human being health, particularly for Chinese medical science investigation.

Methods

In this last 2 years study, on the strength of the UPLC–MS/MS detection platform, we accurately qualitatively, and quantitatively measured the Cistanche sinensis fleshy stems of two ecotypes. Thereafter, through high-throughput amplicon sequencing 16S/ITS sequences were procured.

Results

PhGs metabolites including echinacoside, isoacteoside, and cistanoside A were significantly downregulated at two ecotypes of C. sinensis. Add up to 876 metabolites were monitored and 231 differential metabolites were analyzed. Further analysis of 34 core differential metabolites showed that 15 compounds with up-regulated belonged to phenolic acids, flavonoids, and organic acids, while 19 compounds with down-regulated belonged to phenolic acids, flavonoids, alkaloids, amino acids, lipids, and nucleotides. There was no noteworthy discrepancy in the endophytic bacteria’s α and β diversity between sandy and loam ecotypes. By comparison, the α and β diversity of endophytic fungi was notably distinct. The fungal community of the loam ecotype is more abundant than the sandy ecotype. However, there were few such differences in bacteria. Most abundant genera included typical endophytes such as Phyllobacterium, Mycobacterium, Cistanche, Geosmithia, and Fusarium. LEfSe results revealed there were 11 and 20 biomarkers of endophytic bacteria and fungi in C. sinensis at two ecotypes, respectively. The combination parsing of microflora and metabolites indicated noteworthy relativity between the endophytic fungal communities and metabolite output. Key correlation results that Anseongella was positive relation with Syringin, Arsenicitalea is negative relation with 7-methylxanthine and Pseudogymnoascus is completely positively correlated with nepetin-7-O-alloside.

Discussion

The aim of this research is: (1) to explore firstly the influence of ecotype on C. sinensis from the perspective of endophytes and metabolites; (2) to investigate the relationship between endophytes and metabolites. This discovery advances our understanding of the interaction between endophytes and plants and provides a theoretical basis for cultivation of C. sinensis in future.
Evaluation of the effectiveness and mechanism of action of the Chang-Kang-Fang formula combined with bifid triple viable capsules on diarrhea-predominant irritable bowel syndrome
Authors: Sun Jing , Zhang Mengqiu , Liu Wei , Liu Youqian , Zhang Dongjian , Fan Xinyu , Zhang Jian , Li Tian , Lu Min
Published: June 2023

Introduction

The Chang-Kang-Fang (CKF) formula, a traditional Chinese herbal formula, can decrease serotonin (5-HT) levels and treat irritable bowel syndrome (IBS). Probiotics have a better synergistic effect on diarrhea-predominant IBS (IBS-D) when combined with 5-HT3 receptor antagonists. The present study aimed to elucidate the efficacy and the mechanisms of action of the CKF formula combined with bifid triple viable capsules (PFK) against IBS-D.

Methods

The rat models of IBS-D were induced by gavage with senna decoction plus restraint stress. The CKF formula, PFK and their combination were administered to the rats. Their effects were evaluated based on general condition of the rats and the AWR score. The levels of 5-HT and fos protein in the colon and hippocampus were measured by immunohistochemistry. The levels of SP and VIP, as well as ZO-1 and occludin in the colon, were determined by enzyme-linked immunosorbent assay and immunohistochemistry. The intestinal microbiota in faeces was analyzed by 16S rRNA high-throughput sequencing.

Results

The results showed that the oral CKF formula combined with PFK (CKF + PFK) could significantly relieve the symptoms of IBS-D, including elevating the weight rate and decreasing the AWR score. Compared with the MC group, administration of CKF + PFK significantly reduced the expression of fos in the colon and hippocampus and that of 5-HT, SP and VIP in the colon and increased the levels of 5-HT in the hippocampus and ZO-1 and occludin in the colon. The above indexes exhibited statistical significance in the CKF + PFK group relative to those in the other groups. Moreover, treatment with CKF + PFK improved the diversity of intestinal microbiota and the abundance of Firmicutes, Lachnospiraceae and Ruminococcaceae but decreased those of Bacteroidetes and Prevotellaceae.

Conclusions

The CKF formula combined with PFK may have a synergistic effect on IBS-D by slowing gastrointestinal motility, lowering visceral hypersensitivity, enhancing the intestinal barrier function and modulating the composition of intestinal microbiota.
Map-based experience replay: a memory-efficient solution to catastrophic forgetting in reinforcement learning
Authors: Hafez Muhammad Burhan , Immisch Tilman , Weber Tom , Wermter Stefan
Published: June 2023

Deep reinforcement learning (RL) agents often suffer from catastrophic forgetting, forgetting previously found solutions in parts of the input space when training new data. Replay memories are a common solution to the problem by decorrelating and shuffling old and new training samples. They naively store state transitions as they arrive, without regard for redundancy. We introduce a novel cognitive-inspired replay memory approach based on the Grow-When-Required (GWR) self-organizing network, which resembles a map-based mental model of the world. Our approach organizes stored transitions into a concise environment-model-like network of state nodes and transition edges, merging similar samples to reduce the memory size and increase pair-wise distance among samples, which increases the relevancy of each sample. Overall, our study shows that map-based experience replay allows for significant memory reduction with only small decreases in performance.
RB1 aberrations predict outcomes of immune checkpoint inhibitor combination therapy in NSCLC
Authors: Wang Qian , Yu Tao , Ke Zi-Hao , Wang Fu-Feng , Yin Jia-Ni , Shao Yang , Lu Kai-Hua
Published: June 2023

Introduction

Immune checkpoint inhibitors (ICI) have changed the treatment of non-small cell lung cancer (NSCLC). Furthermore, compared with monotherapy, ICI combination therapy had better efficacy and partly different mechanism. Therefore, we aim to investigate and improve biomarkers specialized for ICI combination therapy.

Methods

We enrolled 53 NSCLC patients treated with ICI combination therapy and collected their tissue and plasma samples to perform next-generation sequencing (NGS) with a 425-gene panel.

Results

The line of treatment was the only clinical factor significantly affecting objective response rate (ORR) and progression-free survival (PFS). Surprisingly, classical markers PD-L1 and TMB only had limited predictive values in the ICI combination therapy. Instead, we found RB1 mutation was significantly associated with prognosis. Patients with mutated RB1 had shorter PFS than those with wild RB1 (134d vs 219d, p=0.018). Subsequent analysis showed the RB1 related mutated cell cycle and chromosomal instability were also deleterious to prognosis (103d vs 411d, p<0.001; 138d vs 505d, p=0.018). Additionally, patients with more circulating tumor DNA (ctDNA) had significantly shorter PFS (41d vs 194d, p=0.0043).

Conclusion

This study identified that NSCLC patients with mutated RB1 were less sensitive to ICI combination therapy. RB1 mutations and following cell cycle abnormalities and chromosomal instability can potentially guide clinical management.
Efficacy and safety comparison of esketamine-propofol with nalbuphine-propofol for upper gastrointestinal endoscopy in children: a multi-center randomized controlled trial
Authors: Zheng Xiaosu , Huang Jinjin , Wei Sisi , Tao Yingying , Shen Yang , Wang Yanting , He Pan , Zhang Mazhong , Sun Ying
Published: June 2023

Background and Aims

Anesthetics such as propofol, esketamine and nalbuphine are used during the upper gastrointestinal endoscopy to achieve and maintain the desired sedation level. The aim of the study was to evaluate the effectiveness and safety of propofol-nalbuphine and propofol-esketamine in children.

Methods

A multi-centered study was performed at three tertiary class-A hospitals. Children between 3 and 12 years old undergoing diagnostic painless upper gastrointestinal endoscopy were included and randomly divided into esketamine or nalbuphine group to estimate the primary outcome of successful endoscope insertion. The patients were given esketamine 0.5 mg/kg and propofol 2 mg/kg intravenously in esketamine group, with nalbuphine 0.2 mg/kg and propofol 2 mg/kg in the nalbuphine group. The primary outcome was success rate for the first attempt of endoscope insertion in each group. Secondary outcomes included the safety of both anesthesia regimens and gastroenterologist's satisfaction. We used the Face, Leg, Activity, Cry and Consolability (FLACC) scale to evaluate the level of pain before and during the procedure and the Pediatric Anesthesia Emergence Delirium (PAED) scale to assess the level of agitation and delirium after awakening from anesthesia.

Results

Among 246 patients, 200 were randomly included in the final intention-to-treat analysis, with 100 patients in each group. The success rate for the first attempt of endoscope insertion in the esketamine group was higher than the nalbuphine group (97% vs. 66%; P < 0.01). The heart rate and mean arterial pressure after intraoperative administration in the esketamine group were higher than those in the nalbuphine group, while the delirium incidence during awakening was higher in esketamine group (all P < 0.05).

Conclusion

The success rate for the first attempt of endoscope insertion of children undergoing upper gastrointestinal endoscopy in the esketamine group was higher than the nalbuphine group, propofol-related hemodynamic changes were reduced accordingly, while the incidence of esketamine-related adverse effects could be high.

Clinical Trial Registration

Chinese Clinical Trial Registry: ChiCTR2000040500.
Case report: Laparoscopic gastrojejunostomy for duodenal atresia with situs inversus and preduodenal portal vein: a report of two cases
Authors: Nakagawa Yoichi , Sumida Wataru , Makita Satoshi , Uchida Hiroo , Hinoki Akinari , Shirota Chiyoe , Tainaka Takahisa , Yokota Kazuki , Amano Hizuru , Yasui Akihiro , Takimoto Aitaro , Kato Daiki , Maeda Takuya , Gohda Yousuke
Published: June 2023

Congenital duodenal atresia with situs inversus is occasionally accompanied by a preduodenal portal vein (PDPV), which is incidentally diagnosed during surgery. Duodenoduodenostomy is the most common and effective treatment. However, some patients require other anastomoses. Here, we present two cases of laparoscopic gastrojejunostomy for congenital duodenal atresia with situs inversus and PDPV and describe the reason for selecting gastrojejunostomy. The optimal surgical strategy is patient specific and should be determined based on the patient's general and physical condition.
Issues and opportunities of digital phenotyping: ecological momentary assessment and behavioral sensing in protecting the young from suicide
Authors: Pizzoli Silvia Francesca Maria , Monzani Dario , Conti Lorenzo , Ferraris Giulia , Grasso Roberto , Pravettoni Gabriella
Published: June 2023

Digital phenotyping refers to the collection of real-time biometric and personal data on digital tools, mainly smartphones, and wearables, to measure behaviors and variables that can be used as a proxy for complex psychophysiological conditions. Digital phenotyping might be used for diagnosis, clinical assessment, predicting changes and trajectories in psychological clinical conditions, and delivering tailored interventions according to individual real-time data. Recent works pointed out the possibility of using such an approach in the field of suicide risk in high-suicide-risk patients. Among the possible targets of such interventions, adolescence might be a population of interest, since they display higher odds of committing suicide and impulsive behaviors. The present work systematizes the available evidence of the data that might be used for digital phenotyping in the field of adolescent suicide and provides insight into possible personalized approaches for monitoring and treating suicidal risk or predicting risk trajectories. Specifically, the authors first define the field of digital phenotyping and its features, secondly, they organize the available literature to gather all the digital indexes (active and passive data) that can provide reliable information on the increase in the suicidal odds, lastly, they discuss the challenges and future directions of such an approach, together with its ethical implications.