bluuebunny/crossref_metadata_2025 huggingface dataset:
Orthostatic Variation of Pulmonary Artery Pressure in Ambulatory Heart Failure Patients
Authors: Sethi Prince , Acharya Prakash , Lancaster Payton , Stack Brianna , Munshi Kartik , Ranka Sagar , Shah Zubair , Sauer Andrew J. , Gupta Kamal
Published: June 2023

Aim:
To study effect of change in position (supine and standing) on pulmonary artery pressure (PAP) in ambulatory heart failure (HF) patients.
Methods:
Seventeen patients with CardioMEMS® sensor and stable heart failure were consented and included in this single center study. Supine and standing measurements were obtained with at least 5 minutes interval between the two positions. These measurements included PAP readings utilizing the manufacturer handheld interrogator obtaining 10 second data in addition to the systemic blood pressure and heart rate recordings.
Results:
Mean supine and standing readings and their difference (Δ) were as follows respectively: Systolic PAP were 33.4 (± 11.19), 23.5 (± 10.1) and Δ was 9.9 mmHg (p = 0.006), diastolic PAP were 14.2 (± 5.6), 7.9 (± 5.7) and Δ was 6.3 mmHg (p = 0.001) and mean PAP were 21.8 (± 7.8), 14 (± 7.2) and Δ was 7.4 mmHg (p = 0.003) while the systemic blood pressure did not vary significantly.
Conclusion:
There is orthostatic variation of PAP in ambulatory HF patients demonstrating a mean decline with standing in diastolic PAP by 6.3 mmHg, systolic PAP by 9.9 mmHg and mean PAP by 7.4 mmHg in absence of significant orthostatic variation in systemic blood pressure or heart rate. These findings have significant clinical implications and inform that PAP in each patient should always be measured in the same position. Since initial readings at the time of implant were taken in supine position, it may be best to use supine position or to obtain a baseline standing PAP reading if standing PAP is planned on being used.
The Clinical relevance of Polygenic Risk Scores to Type 2 Diabetes Mellitus in Korean Population
Authors: Kim Na Yeon , Lee Haekyung , Kim Sehee , Kim Ye-Jee , Lee Hyunsuk , Lee Junhyeong , Kwak Soo Heon , Lee Seunggeun
Published: June 2023

The potential clinical utility of type 2 diabetes mellitus (T2DM) polygenic risk scores (PRS) is not thoroughly evaluated in the East Asian population. We aimed to assess whether T2DM PRS could have prognostic value and be used as a clinical instrument. We constructed T2DM PRS for Korean individuals using large East Asian Biobank data with samples of 269,487 and evaluated the PRS in a prospective longitudinal study of Korean with 5490 samples with baseline and additional seven follow-ups. Our analysis demonstrated that T2DM PRS could predict not only the progress from non-diabetes to T2DM, but also normal glucose tolerance to prediabetes and prediabetes to T2DM. Moreover, T2DM patients in the top decile PRS group were more likely to be treated with insulin with HR = 1.69 (p-value = 2.31E-02) than the remaining PRS groups. T2DM PRS was significantly high in severe diabetic subgroups with insulin resistance and \(\beta\)-cell dysfunction (p-value = 0.0012). PRS could modestly improve the prediction accuracy of the Harrel’s C-index by 9.88% (p-value < 0.001) in T2DM prediction models. By utilizing prospective longitudinal study data and extensive clinical risk factors, our analysis provides insights into the clinical utility of the T2DM PRS.
Enhanced Performance Of On-Chip Integrated Biosensor Using Deep Learning
Authors: Mikhail Thomas J. , Shamy Raghi El , Swillam Mohamed A. , Li Xun
Published: June 2023

A new approach for determining the concentration composition of a multi-element media using a micro-ring resonator (MRR) is proposed which allows for both electrical and thermal noise removal as well as moderately higher average accuracy. This method uses two neural networks, namely a convolutional neural network (CNN) and a deep neural network (DNN). The CNN differentiates the transmission spectrum from the noise. This spectrum is used to obtain selected features before being fed into the DNN, which determines the concentration of each chemical in the analyte. Both models are trained to work using simulated data from a silicon on-insulator ring resonator operating between the infrared wavelengths of λ=1.46 µm to λ=1.6 μm on mixtures of water, ethanol, methanol, and propanol, although the same approach can be used with other designs and substances. The CNN was trained using the MRR transmission spectra superimposed with white Gaussian noise as well as Poisson noise to mimic different noise sources, while the DNN underwent training on the extracted features. Average root-mean-square error for element concentration for the entire system is 0.083 % for a range of concentrations from 0.0357-0.75 %, and the largest error had a value of 0.68% concentration.
Awareness of Peri-Implantitis among General Dental Practitioners in the UK-A Questionnaire Study
Authors: Barrak Fadi , Thomas Sonu
Published: June 2023

Introduction: Dental Implants are a predictable prosthetic option for replacement of missing teeth with good survival rates. Peri-implant diseases are the main reason for implant failure by causing bone loss around the implant leading to implant loss. General dental practitioners see patients with dental implants routinely and therefore, awareness of risk factors for peri-implant disease and early diagnosis is essential for appropriate management. The aim of this study is to assess the awareness of general dental practitioners’ in diagnosing peri-implantitis with a view to identify any potential training needs.
Design, Setting, Materials and Methods: A quantitative study method was designed using an online questionnaire sent to closed social media groups in the UK. The significance level was taken as P<0.05. The Chi-square tests and Kruskal-Wallis tests were used with IBM SPSS software. Descriptive statistical analysis of data was also done.
Results and Conclusion: 224 responses were received in total. The results show that there is lack of awareness of diagnostic criteria of peri-implantitis among general dental practitioners. However, majority of practitioners are aware of the legal implications of failing to diagnose this condition. There is a perceived need for more undergraduate training in diagnosing peri-implant diseases.
USP4 promotes the proliferation and glucose metabolism of gastric cancer cells by upregulating PKM2
Authors: Chen Yuanyuan , Guo Yunfei , Yuan Mei , Guo Song , Cui Shuaishuai , Chen Dahu
Published: June 2023

Background The pyruvate kinase enzyme PKM2 catalyzes the final step in glycolysis and converts phosphoenolpyruvate (PEP) to pyruvate. PKM2 is often overexpressed in cancer and plays a role in the Warburg effect. The expression of PKM2 can be regulated at different levels. While it has been proven that PKM2 can be regulated by ubiquitination, little is known about its de-ubiquitination regulation. Methods Immunoprecipitation was applied to identify the PKM2 interaction protein and to determine the interaction region between PKM2 and USP4. Immunofluorescence was performed to determine the cellular localization of USP4 and PKM2. The regulation of PKM2 by USP4 was examined by western blot and ubiquitination assay. MTT assays, glucose uptake, and lactate production were performed to analyze the biological effects of USP4 in gastric cancer cells. Results USP4 interacts with PKM2 and catalyzes the de-ubiquitination of PKM2. Overexpression of USP4 promotes cell proliferation, glucose uptake, and lactate production in gastric cancer cells. Knockdown of USP4 reduces PKM2 levels and results in a reduction in cell proliferation and the glycolysis rate. Conclusions USP4 plays a tumor-promoting role in gastric cancer cells by regulating PKM2.
Psychological impact of additional findings detected by genome-wide Non-Invasive Prenatal Testing (NIPT): TRIDENT-2 study
Authors: Henneman Lidewij , Vliet-Lachotzki Elsbeth van , Martin Linda , Wal Janneke Gitsels - van der , Polak Marike , Bekker Mireille , Galjaard Robert-Jan , Consortium The Dutch NIPT , Bakkeren Iris
Published: June 2023

In the Netherlands, genome-wide non-invasive prenatal testing (NIPT) is offered to all pregnant women as part of the nationwide TRIDENT-2 study. Findings other than trisomy 21, 18 or 13, additional findings, are reported only on request of the pregnant woman. This study examined: 1) women's pre-test perceptions and reasons to opt for additional findings and 2) women's experiences with- and the psychological impact of being informed about an additional finding. A questionnaire, consisting of the anxiety measure State Trait Anxiety Inventory (STAI), distress measure Impact of Event Scale (IES) and questions developed specifically for this study, was retrospectively administered to 402 women who received an additional finding. A total of 227 (56.5%) women completed the questionnaire. Most (60.2%) chose to know additional findings because they wanted as much information as possible about the health of their fetus. Almost all (92%) stated that receiving the additional finding was unexpected, a shock, and/or they were in disbelief, for 85% it caused a lot of worry. Post-test, high anxiety (STAI) levels were reported in 15.5% of women, and 7.5% reported severe distress (IES). Women who gave birth to an affected child (n = 10) experienced most psychological impact (STAI and IES). Eighty-six percent of women with a fetal aberration would opt for additional findings again, compared to 49.2% of women whose result was confined to the placenta. Pre-test counselling should focus on explaining the different results NIPT can generate. Post-test counselling should focus on guiding pregnant women through this uncertain and anxious time.
Physics-informed interpretable machine learning method for DOC monitoring in peripheral milling
Authors: Li Guochao , Jiang Ru , Zheng Hao , Xu Shixian , Sun Li
Published: June 2023

On-line monitoring of DOC (DOC) is an essential way to avoid machining defects, such as over-cutting and machining chatter. Data-driven machine learning algorithm play a principal role to realize the monitor. However, deficient training data and un-interpretable algorithm made it difficult to application. Therefore, a physics-informed interpretable machine learning algorithm was proposed. Firstly, a physics simulation model was established with DOC, rotation speed and feed speed as its inputs and time-domain signals of milling force as its outputs. The output force signals were quantitatively presented by the characteristic values of time domain, frequency domain and waveform parameters. Secondly, six dimensionless characteristics, namely the kurtosis, skewness, waveform factor, peak factor, pulse factor and margin factor of the resultant milling force, were explored through sensitivity analysis method. They were sensitive to DOC but insensitive to milling force coefficient, speed and feed speed. Then, a quantitative relationship model between features and DOC was established by using the least squares linear regression algorithm, which has an intrinsic interpretability. The model was trained by a labeled 100 groups test data. The experiments show that the accuracy of the proposed model for DOC monitoring is greater than 90%.
Fabrication, Design and In-vivo investigation of Mesoporous Silica Based Docetaxel Trihydrate Nanoparticles for Colonic Drug Delivery
Authors: Majumdar Subhabrota , Mondal Mohini , Bose Anirbandeep , Kar Ayan Kumar , Mazumder Rana
Published: June 2023

Background
Mesoporous silica-loaded docetaxel trihydrate nanoparticles are the potential to target drug delivery toward a specific region with high stability and predictable release at the target region. They have large surface areas and mesoporous structures with large pore volumes, leading to high bioavailability and therapeutic efficacy at the disease site. This study demonstrates how nanoparticles can be prepared using an emulsion technique.
Results
The ratios of eudragit S100 to eudragit L100 polymers, along with phosphatidylcholine, were varied according to the response surface methodology. DSC and FTIR studies showed that mesoporous silica particles were successful. All formulations had average particle sizes ranging from 70.65 to 143.01nm, with a range of zeta potential from 17.6 ± 026 to 21 ± 011. In-vitro drug delivery studies were achieved for all formulations with a zeta potential of 17.6 ± 026 to 21 ± 011. After oral administration of the docetaxel, plasma levels were measured in vivo bioavailability testing of docetaxel. Docetaxel nanosuspension had a significantly higher Cmax amount than docetaxel micro-suspension (98.03 ± 23.40 ng/ml and 213.67 ± 72.21 ng/ml, respectively, with tmax 45 minutes). Docetaxel was more bioavailable in nanosuspension formulations, according to a bioavailability test of rats.
Conclusion
The results suggested that the mesoporous silica could be a great potential nanocarrier in colonic delivery with optimal drug content and controlled release docetaxel trihydrate.
Lower-dose Intravenous Immunoglobulin Therapy for Geriatric Inflammatory Bowel Disease Accompanied by COVID-19 Multisystem Inflammatory Syndrome: a Case Report
Authors: ZHANG Peng , ZHAO Wenbin , LIU Juan
Published: June 2023

Background
this article presents a noteworthy case of SARS-CoV-2-associated inflammatory bowel disease (IBD) in an elderly individual who endured three hospitalizations without favorable response to conventional treatment. Ultimately, the patient's symptoms subsided following the administration of intravenous immunoglobulin (IVIg).
Case presentation
: the patient, an elderly individual, experienced short-term fever and sore throat after encountering the COVID-19 pandemic. Despite receiving a three-dose inactivated COVID-19 vaccine, the patient tested positive for SARS-CoV-2 antigen and developed worsening symptoms, including diarrhea and recurrent fever. Initial antibiotic treatment for bacterial enteritis proved ineffective. Further evaluation, including endoscopy and pathology, confirmed the diagnosis of IBD with concurrent multisystem inflammatory syndrome (MIS) in adults. Following lower-dose IVIg administration, the patient's symptoms improved, with resolution of fever, diarrhea, and inflammation.
Conclusions
the case highlights the complexity of diagnosis and treatment in geriatric with IBD and MIS, emphasizing the importance of early intervention with IVIg. Further research is needed to explore the relationship between COVID-19 infection, MIS, and acute autoimmune diseases, as well as the efficacy of IVIg in these conditions.
Evaluation of Antimicrobial usage in Companion Animals at a Tertiary Veterinary Teaching Hospital for Context – Specific interventions in Nigeria
Authors: Adebowale Oluwawemimo , Jimoh Afeez , Adebayo Olufunke , Alamu Aderonke , Adeleye Adenike , Fasanmi Olubunmi Gabriel , olasoju Mary , Soladoye Pius , Fasina Folorunso
Published: June 2023

This study investigated various qualitative and quantitative indices of antimicrobial use in companion animals at a Veterinary Teaching Hospital (VTH-A) and its annex (VTH- B) from 2019-2021. Antimicrobial administrations (AADs) for documented 694 animals was 5, 278 of which 98.8% (5217) and 1.2% (61) were in dogs and cats respectively. At the VTH- A, oxytetracycline (1185 times) was most administered in dogs and metronidazole (26 times) in cats. Similarly, at VTH- B, oxytetracycline was administered 895 times in dogs while amoxicillin was given 7 times in cats. The prescription diversity (PD) was estimated at 0.73 and 0.82 in A and B respectively. Quantity of AMs used was 10.1 Kg (A, 6.2 Kg and B, 3.9 Kg). Oxytetracycline administrations and quantity of metronidazole (P <0.0001) were higher than other AIs. Furthermore, 16.5% of AIs were classified as critically important antibiotics (CIA) with highest priority, while enrofloxacin, ciprofloxacin and azithromycin fell under the World Health Organisation (WHO) Watch group. The In-depth interview (IDI) indicated that the high frequency of oxytetracycline administrations was linked with clinicians’ preference for blood parasites treatment at the hospital. The quantity of metronidazole used was perceived to be higher due to clinician’s preference for treatment of acute gastroenteritis, its wider dose range, and frequency of administration (bi-daily). The study provides a baseline data on antimicrobial use indices in companion animals, for development stewardship and communication training, and policy modifications to enhance antimicrobial therapy optimization in tertiary veterinary hospital care in Nigeria.
Approximate solution to solve non-linear integro-differential type defined using boundary value problems
Authors: HamaRashid Hawsar A. , Hama Mudhafar
Published: June 2023

In this paper, we analyze a boundary value problem (BVP) for a nonlinear integro-Volterra-Fredholm integral equation with variable coefficients. We employ common numerical methods such as the homotopy analysis technique developed by Liao and the modified Adomain decomposition technique to construct an approximate numerical solution. Graphical representations show that these methods are the most efficient and convenient. Additionally, we examine the conditions that guarantee the existence and distinctiveness of the solution for different types of kernels and levels of non-linearity. We provide numerical examples to demonstrate the applicability of our main theorems, and to determine the convergence and accuracy of our proposed technique.
Extraction of capsaicin from Capsicum chinense (cv Bhut Jolokia) using supercritical fluid technology and degradation kinetics
Authors: KSH VIKONO , Anand Vishnu , Rana Virendra Singh , Mishra Jigni , Varghese Eldho , Upadhyay Neelam , Kaur Charanjit
Published: June 2023

Capsaicin (CC), the dominant pungent compound in hot chilies, is widely used as a flavouring agent, preservative, active compound in packaging film and functional foods. Capsicum chinense cv Bhut Jolokia is one of the richest sources of CC, yet scarcely studied. The present investigation aimed to optimize a clean and green method for extracting CC through supercritical fluid extraction (SFE) method. Low-grade, culled, and discarded fruits were used for the extraction, and process was optimized through central composite design of RSM. The optimized extraction condition, 68.31 ℃/347.98 bars/102.50 min, resulted in maximum CC content (367.14 ± 1.12 mg/g) and oleoresin yield (7.23 ± 2.15 %) in a shorter extraction time (< 2 h). Accelerated thermal stability study suggested first-order degradation kinetics of CC at temperatures from 80 to 140 ℃. The activation energy (kJ/mol) of the reaction was 71.86, while Q10 for 80 to 100 ℃, 100 to 120, and 120 to 140 were 0.0548, 0.0574, and 0.1456, respectively. Valorisation of Bhut Jolokia for targeting an oleoresin with maximum CC opens a new window for its commercial exploitation in food industry. Furthermore, the study opens avenues for exploration of SFE-based extraction as clean, and sustainable method with reduced carbon footing.
Drop Set versus Traditional Strength Training Protocols Equated in Volume on Muscle Thickness in Women
Authors: Vilaça-Alves José , Brito João Paulo , Machado Beatriz , Canário-Lemos Rui , Moreira Tiago , Matos Filipe , Peixoto Rafael , Monteiro Gabriéla , Garrido Nuno , Casanova Filipe , Costa Pablo , Reis Victor Machado
Published: June 2023

PurposeThe aim of this study was to investigate the effects of two strength training protocols, equated in volume, on the elbow flexor muscle thickness (MT) in women. Methods Twenty-seven women (mean±sd, age 21.89±2.85 years; stature,167.82±5.90 cm; body mass 63.01±7.20 kg; estimate of body fat mass, 19.19±2.88%) were divided in three experimental groups: a drop-set (DS), a traditional (TR), and a control group (CG). The CG maintained regular strength training without perform any upper body exercises. The participants performed a dumbbell biceps curl for two days per week for 12 weeks 4 sets of 3 blocks of 10 repetitions at 75%, 55%, and 35% of their 1 Repetition Maximum (RM) for the DS group, and 8 sets of 11 repetitions at 75% of the 1RM for the TR protocol. Rest interval between sets was 120 seconds for both groups. The MT was acquired in the anterior face of both upper arms at 50% and 60% of the distance between the lateral epicondyle of the humerus and the acromial process of the scapula before (T0) and after the 24 training sessions (T1).ResultsThere was a significant increase in all MT measurements between T0 and T1for the training groups(p<0.05). In addition, significantly higher values of MT were found in the training groups compared to the control group for all local measurements in T1 (p<0.05). No significant differences were found between training the groups for MT.ConclusionIt appears that both training groups (DS and TR), were effective in promoting MT of the elbow flexors muscles of young women with no differences between training strategies.
Feature pyramid-based convolutional neural network image inpainting
Authors: Wang Shengbo , Wang Xiouyou
Published: June 2023

With the widespread adoption of deep learning-based methods in image processing, they have achieved remarkable results in the challenging task of filling large missing images. However, these methods often produce blurred filling when processing irregularly broken images. The main reason for this phenomenon is that the semantic information of feature maps at different scales cannot effectively complement each other and the underlying information is underutilized. Therefore, we propose a feature pyramid-based network structure. In the first stage, we set the expansion factor to avoid the grid effect during the convolution process and maximize the utilization of the underlying feature map information while increasing the perceptual field. The second stage of the network includes a convolution branch and a feature fusion branch, both of which are parallel structures. The feature fusion branch first samples the feature maps to construct the feature pyramid, and then fuses the feature maps with different resolutions and semantic strengths. Finally, the feature maps are deconvoluted by a decoder to generate images. Our experimental results show that this method produces coherent, clear, visually reasonable recovery areas and excels over other methods in terms of image quality.
Statistics on Gynecologic Cancer in Japan
Authors: Nakai Hidekatsu , Matsumura Noriomi
Published: June 2023

In Japan, high-quality cancer statistics data have been collected through cancer registries, but these data are rarely summarized and reported in research articles. Here, we compiled statistical data on malignant tumors originating from gynecologic organs (ovary, corpus uteri, cervix uteri) in Japan. The number of patients in 2019 was 13,380, 17880, and 10879, respectively, and the number of deaths in 2021 was 5081, 2741, and 2894, respectively. Compared with 40 years ago, the incidence of ovarian cancer has tripled, the incidence of uterine corpus cancer (mainly endometrial cancer) has increased 15-fold, the mortality rate of uterine corpus cancer has tripled, and the incidence of cervical intraepithelial cancer has increased 10-fold in data standardized by the world population. Compared with the United States, the incidence rate of ovarian cancer has overtaken and the mortality rate of uterine corpus cancer is the same, while both the incidence and mortality rates of cervical cancer are higher in Japan. Immediate action is needed in Japan to prevent gynecologic cancers.
Differences in the association of oral health knowledge, attitudes, and practices with frailty among community-dwelling older people in China
Authors: Cao Chenglin , Liao Shengdong , Cao Wenwen , Guo Ying , Hong Zixuan , Ren Bohua , Hu Zhi , Bai Zhongliang
Published: June 2023

Background:
Oral health and frailty are significantly related and should be well examined, especially in late life. Few studies have explored the relationship of oral health knowledge, attitudes, and practices with frailty and examined sociodemographic variations in this association. This study aimed to examine the association between oral health knowledge, attitudes, practices and frailty, with a special focus on comparing differences in their association among the Chinese community-dwelling older population.
Methods:
This study included 4218 community-dwelling older adult (aged ≥ 60 years) who participated in a cross-sectional survey. Sociodemographic characteristics, oral health knowledge, attitudes, practices, and frail status (non-frailty, pre-frailty and frailty) were collected with a face-to-face questionnaire-based interview. Multivariate logistic regression models were used to evaluate the association of oral health knowledge, attitudes, and practices with frailty.
Results:
Of the 4218 participants, 36.2% (n = 1527) and 18.8% (n = 792) were classified as pre-frailty and frailty. Age, gender and educational attainments differences existed in the association of oral health knowledge with frailty. Urban-rural differences in the association of oral health knowledge and practices with frailty were also found. Specifically, oral health knowledge was significantly related to frailty only among participants aged 70–79 years (adjusted odds ratio [95% confidence interval]) (1.08 [1.02–1.15]), females (1.05 [1.00–1.10]), rural residents (1.06 [1.01–1.12]), and those who were primary school and lower education (1.06 [1.01–1.11]), whereas oral health practices were related to frailty only among urban participants (0.96 [0.92–1.00]).
Conclusion:
This study confirmed the different associations of oral health knowledge and practices with frailty among community-dwelling older people in China. Further research is needed to better understand the abovementioned differences and public health strategies are required to improve oral health literacy and thereby contain the development of frailty in later life.
Encoding a magic state with beyond break-even fidelity
Authors: Gupta Riddhi , Sundaresan Neereja , Alexander Thomas , Wood Christopher , Merkel Seth , Healy Michael , Hillenbrand Marius , Wootton James , Jochym-O'Connor Tomas , Yoder Theodore , Cross Andrew , Takita Maika , Brown Benjamin
Published: June 2023

We distill magic states to complete a universal set of fault-tolerant logic gates that is needed for large-scale quantum computing. By encoding better quality input states for our distillation procedure, we can reduce the considerable resource cost of producing magic states. We demonstrate an error-suppressed encoding scheme for a two-qubit input magic state, that we call the CZ state, on an array of superconducting qubits. Using a complete set of projective logical Pauli measurements, that are also tolerant to a single circuit error, we propose a circuit that demonstrates a magic state prepared with infidelity (1.87 ± 0.16) x 10-2. Additionally, the yield of our scheme increases with the use of adaptive circuit elements that are conditioned in real time on mid-circuit measurement outcomes. We find our results are consistent with variations of the experiment, including where we use only post-selection in place of adaptive circuits, and where we interrogate our output state using quantum state tomography on the data qubits of the code. Remarkably, the error-suppressed preparation experiment demonstrates a fidelity exceeding that of the preparation of the same unencoded magic-state on any single pair of physical qubits on the same device.
Randomized Controlled Trial of Liberal vs. Standard Fasting Instructions in Percutaneous Cardiac Procedures
Authors: Atkinson Derek J , Romeiser Jamie L , Almasry Ibrahim O , Tannous Henry J , Parikh Puja B , Bennett-Guerrero Elliott E
Published: June 2023

Background
Pre-procedural fasting to reduce aspiration risk is usual care prior to surgery requiring anesthesia. Prolonged fasting, however, can result in dehydration and may adversely affect patient experience and outcomes. Previous studies suggest that providing a supplemental beverage to patients undergoing cardiac and a variety of other surgical procedures improves patients’ subjective assessment of thirst and hunger and potentially decreases the need for inotrope and vasopressor therapy. Less is known, however, about the effects of ad libitum clear liquids up to 2 hours prior to surgery.
Methods
Adult patients undergoing transcatheter aortic valve replacement (TAVR) or arrhythmia ablation were randomized (1:1) to ad libitum clear liquids up to 2 hours prior to their procedure vs. nil per os (NPO) after midnight (control group, usual care). The primary endpoint was a composite satisfaction score that included patient-reported thirst, hunger, headache, nausea, lightheadedness, and anxiousness prior to surgery. The incidence of case-delay was recorded. Intraoperative vasopressor administration, changes in creatinine, anti-emetic use, and hospital length of stay (LOS) were recorded. Safety endpoints including aspiration were assessed.
Results
A total of 200 patients were randomized and 181 patients were included in the final analysis. Overall, 92% of patients were ASA class III or IV and 23% of patients had NYHA class III or IV symptoms. Groups were well balanced with no significant differences in age, sex or baseline cardiac or renal disease. The composite satisfaction score (primary endpoint) was not significantly different between groups (Ad libitum median = 12, IQR = [6, 17], vs Standard NPO median = 10, IQR = [5, 15], [95% CI = [-1, 4]). No significant differences between the two groups were observed in any of the individual survey questions (thirst, hunger, headache, nausea, lightheadedness, anxiousness). No significant differences between groups were observed for intra-operative vasopressor use, changes in creatinine, rescue anti-emetic use or hospital LOS. There were no case delays attributed to the intervention. There were no cases of suspected aspiration.
Conclusion
No adverse events or case delays were observed in the ad libitum clears group. No significant benefit, however, was observed in patient satisfaction or any of the pre-specified secondary endpoints in patients randomized to ad libitum clear liquids up to 2 hours prior to their procedure.
WHO, WHEN, HOW: a scoping review on flexible at-home respite for informal caregivers of older adults
Authors: Viens Maude , Éthier Alexandra , Provencher Véronique , Carrier Annie
Published: June 2023

Background: As the world population is aging, considerable efforts need to be put towards developing and maintaining evidenced based care for older adults. Respite services are part of the selection of home care offered to informal caregivers. Although current best practices around respite are rooted in person centeredness, no integrated synthesis of its flexible components exists. Such a synthesis could offer a better understanding of key characteristics of flexible respite and, as such, support its implementation and use.
Methods: To map the literature around the characteristics of flexible at-home respite for informal caregivers of older adults, a scoping study was conducted. Qualitative data from the review was analyzed using content analysis. The characterisation of flexible at-home respite was built on three dimensions: WHO, WHEN and HOW. To triangulate the scoping results, an online questionnaire was distributed to home care providers and informal caregivers of older adults.
Results: A total of 42 documents were included in the review. The questionnaire was completed by 105 participants. The results summarize the characteristics of flexible at-home respite found in the literature. Flexibility in respite can be understood through three dimensions: 1) WHOis tendering it, 2) WHEN it is tendered and 3) HOW it is tendered. Firstly, human resources (WHO) must be compatible with the homecare sector as well as being trained and qualified to offer respite to informal caregivers of older adults. Secondly, flexible respite includes considerations of time, duration, frequency, and predictability (WHEN). Lastly, flexible at-home respite exhibits approachability, appropriateness, affordability, availability, and acceptability (HOW). Overall, flexible at-home respite adjusts to the needs of the informal caregiver and care recipient in terms of WHO, WHEN, and HOW.
Conclusion: This review is a step towards defining more precisely flexible at-home respite. Flexibility of home care, in particular respite, as to be taken into account when designing, implementing and evaluating services.
Urine apoptosis inhibitor of macrophage is an early predictor of acute kidney injury post- cardiac surgery
Authors: Nishijima Shuhei , Miyazaki Toru , Nakamura Yoshitsugu , Asao Mayu , Murakami Yusuke , Ohiro Yoshiyuki , Saito Satoshi , Niinami Hiroshi
Published: June 2023

Background: Acute kidney injury (AKI) has high morbidity and mortality. Apoptosis inhibitor of macrophage (AIM) is key to improving AKI, enhancing the phagocytic clearance of dead cells within proximal renal tubules. Free AIM (fAIM) comprises short fAIM (S-fAIM) and full-length fAIM (F-fAIM). Although S-fAIM and F-fAIM appear in the urine during AKI, the association between AKI prognosis and AIM remains unclear.
Methods: We studied 102 patients who underwent cardiac surgery from December 2020 to June 2021. Urine was sampled before and after surgery. fAIM and F-fAIM were analysed using a bioluminescent enzyme immunoassay. Other markers of AKI were also measured.
Results:Thirty-seven patients developed AKI post-surgery, diagnosed according to the KDIGO guidelines. Mean fAIM and F-fAIM concentrations were significantly higher in patients with AKI than in patients without AKI 0 h post-surgery (p < 0.001 and p = 0.003, respectively) but decreased rapidly 3 h later. Urinary fAIM and F-fAIM had an area under the curve values of 0.72 and 0.67, respectively, 0 h post-surgery. fAIM and F-fAIM levels showed similar kinetics to those of neutrophil gelatinase-associated lipocalin and liver-type fatty acid-binding protein.
Conclusions: Urinary fAIM and F-fAIM excretion may be useful early biomarkers for predicting AKI in adults following cardiac surgery. fAIM and F-fAIM may be comparable in their diagnostic ability with the currently known markers of AKI.
Experimental study on the dynamics of droplet impacting on a hydrophobic surface
Authors: Li JiangFeng , Zhao Chen , Wang ChengYao
Published: June 2023

An experimental visualization is undertaken to investigate the impact dynamic behaviors of water, absolute ethanol, and low surface energy droplets with different viscosities impacting on hydrophobic surfaces. The behaviors of droplets, including spreading, rebounding and oscillation retraction are observed and quantitatively characterized by transient spreading factor and maximum spreading diameter. Effects of droplet impact velocity, surface wettability, and droplet viscosity on the impact dynamics are explored and analyzed. As the droplet impact velocity increases, the droplet kinetic energy increases, resulting in that the spreading factor and spreading velocity increase simultaneously and the maximum spreading diameter of droplets increases with a gradual slower speed. Hydrophobic surfaces are not easily wetted by water droplets due to their low surface energy, leading to the partial rebound of water droplets when they impact on the hydrophobic surfaces. However, this phenomenon does not occur when low surface energy droplets such as absolute ethanol and simethicone impact on hydrophobic surfaces at the same velocity. The increasing droplet viscosity enhances the viscous dissipation, slowing down the impact process and inhibiting the droplet spreading, oscillation and retraction behaviors. Based on the energy conservation method, a universal model for the maximum spreading factor of low surface energy droplets with different viscosities impacting hydrophobic surface was established. According the experimental results, a new spreading time model tm=2D0/U0 was proposed to enhance applicability of the model for low surface energy droplets with high viscosity, reducing the calculation error to less than 10%.
Research On Driving Behavior Recognition By Smart Car Sensors
Authors: Hao Aoxing , Qi Huanwei , Liang Hongbin
Published: June 2023

In the previous research on driving behavior, based on multi-source sensor data, the traditional method adopts the method of manually designing features, which has a large number of features and involves many professional fields. Most of the research on multi-source time series sensor data mainly focuses on the extraction of time series features, ignoring the connection between feature channels. Therefore, this chapter uses the GRU-FCN (Gated Recurrent Unit-Fully Convolutional Network) neural network model based on channel attention to study driving behavior recognition. A fully convolutional neural network (FCN) neural network that can automatically extract features is used to replace the traditional manual feature extraction method. At the same time, the Gated Recurrent Unit (GRU) is used to act on multi-source sensor data. Experiments show that GRU is even better than the LSTM model in some tasks, which can greatly improve the training efficiency. Finally, in order to pay special attention to the contribution of certain feature channels to classification and improve the accuracy of classification, this chapter introduces a squeeze-and-excitation block (SE block) to adaptively adjust the weight of each feature channel (channel attention), and recalibrate the features to improve the representation ability of the network.
Cell Phone Microscopy Enabled Low-cost Manufacturable Colorimetric Urine Glucose Test
Authors: Meng Zhuolun , Raji Hassan , Tayyab Muhammad , Javanmard Mehdi
Published: June 2023

Glucose is a crucial biomarker for monitoring and diagnosing various diseases, such as hypoglycemia, hyperglycemia, and diabetes, which can cause severe symptoms in human beings. Therefore, there is a growing demand for fast, affordable, and easy-to-use diagnostic tools. In this paper, we present a novel glucose sensor that accurately measures glucose concentration in urine, meeting the ASSURED criteria (Affordable, Sensitive, Specific, User-friendly, Rapid, and Equipment-free). The glucose sensor we developed is based on microfluidic devices made from disposable and medical-grade tapes, as well as glucose urine analysis strips on a microscope glass slide. The microfluidic channels were fabricated using laser cutting instead of traditional cleanroom methods, which makes this glucose sensor rapid, economical, and equipment-free to produce. After absorbing the target solution, the disposable device is placed in a 3D-printed box and the phone camera is used to capture images of the analysis strips for further colorimetric processing. Our paper demonstrates the capability of the glucose sensor to quantify glucose in sucrose water using an exponential regression model that specifies the relationship between glucose concentrations and average RGB values.
A Study on IOT Technology and Its Application in the Appreciation of Tang and Song Literature
Authors: Sheng Jinhui , Jia Xiumei
Published: June 2023

How to achieve efficient appreciation and intelligent parsing of Tang and Song literatures are two major difficulties in the field of studying Tang and Song literatures nowadays. Based on this, this paper investigates the application of multidimensional spatio-temporal IoT parsing model combined with cone stacking algorithm in the appreciation of Tang and Song literatures. Firstly, we summarize the current research status of Tang and Song literature appreciation, and propose a multidimensional spatio-temporal IoT analysis model based on cone stacking algorithm according to the characteristics of Tang and Song literature, and combine the application ideas of various appreciation models in Tang and Song literature appreciation to normalize the multidimensional analysis of traditional Tang and Song literature database to achieve accurate appreciation from different perspectives, and then analyze the accuracy and objectivity of the appreciation model. The accuracy and objectivity of the appreciation model are then analyzed. Secondly, the set of evaluation functions of the multidimensional spatio-temporal IoT analysis model in this application is constructed, and the characteristics and appreciation ideas of current literary masters are combined in the optimal appreciation, and the error of the composite appreciation analysis function is improved, while the cone stacking algorithm is combined with the multidimensional spatio-temporal IoT analysis appreciation model to realize the internal intelligent learning. Finally, a validation experiment is designed, and the results show that the multidimensional spatio-temporal IoT analysis model based on the cone stacking algorithm can quickly and accurately achieve the appreciation of conventional Tang and Song literature from multiple levels.
Relationship Between Bone Mineral Density and Serum Cystatin C in Nephrotic Syndrome
Authors: NADİR EBRU , NOYAN AYTÜL
Published: June 2023

Background The aim of this study was to investigate the effect of steroid therapy on bone metabolism in children with nephrotic syndrome to demonstrate that serum cystatin C is a parameter of bone resorption, and to detect early stages of bone resorption.Methods The study included 69 patients with idiopathic nephrotic syndrome and 21 controls. Patients were divided into three groups for the study. Biochemical markers of bone metabolism ,serum cystatin C levels and Lumbar Bone Mineral Dencity Z score of patients was measured.Results Our study found that patients with nephrotic syndrome who received steroid therapy had a lower lumbar BMD-Z score than those who did not receive steroid therapy and higher serum cystatin C values. Serum cystatin C levels of patients in remission who continued steroid treatment were found to be higher than those in remission who did not receive steroid treatment and controls (p = 0.007), (p = 0.037). The Bone Mineral Dencity-Z score of patients treated with steroids in remission and active nephrotic period was found to be statistically significantly lower than that of healthy children (p = 0.016), (p = 0.003).Conclusion Bone mineral density decreases while serum cystatin C levels increase in patients with nephrotic syndrome treated with steroids. This suggested that an increase in cystatin C could be an early sign of bone resorption and could be used as a parameter of bone resorption.
Comparison of postoperative adjuvant platinum-based chemotherapy and no further therapy after radical surgery in intermediate-risk early-stage cervical cancer
Authors: Nishimura Hiroki , Amano Tsukuru , Yoneoka Yutaka , Tsuji Shunichiro , Taga Yukiko , Aki Megumi , Uno Masaya , Moritani Suzuko , Murakami Ryusuke , Kato Tomoyasu , Murakami Takashi
Published: June 2023

Background
An optimal treatment for intermediate-risk early-stage cervical cancer has not been reported. The aim of this study was to identify populations that require platinum-based adjuvant chemotherapy and those who require no further therapy for intermediate-risk early-stage cervical cancer.
Methods
Between January 2007 and December 2018, we reviewed the records of patients diagnosed with cervical cancer International Federation of Gynecology and Obstetrics stage IA2-IIA2, and who were classified as intermediate-risk group for recurrence. These patients were either treated with chemotherapy or received no further therapy after radical hysterectomy. We examined the overall survival and recurrence-free survival rates in the chemotherapy group and the group that received no further therapy.
Results
Of the 151 patients, 55 underwent chemotherapy and 96 received no further therapy. In the group that received no further therapy, the squamous cell carcinoma group with three risk factors and the non-squamous cell carcinoma group with two to three risk factors had significantly poorer recurrence-free-survival rates than the other groups, and chemotherapy significantly improved the recurrence-free-survival rates in this group. Recurrence-free-survival rates were not significantly different between the squamous cell carcinoma group with one to two risk factors and non-squamous cell carcinoma group with one risk factor.
Conclusion
CT is essential for the SCC group with three risk factors and non-SCC group with two to three risk factors. NFT was preferable for the other groups with fewer risk factors.
Outcomes of sentinel node biopsy according to MRI response in an association with the subtypes in cN1-3 breast cancer after neoadjuvant systemic therapy, Multicenter Cohort Study
Authors: Bae Soong June , Chun Jung Whan , Lee Sae Byul , Ryu Jai Min , Nam Seok Jin , Jeong Joon , Park Hyung Seok , Ahn Sung Gwe
Published: June 2023

Background
This study investigated the feasibility of sentinel lymph node biopsy (SLNB) after neoadjuvant systemic therapy (NAST) in patients with initially high nodal burden.
Methods
In the multicenter retrospective cohort, 388 individuals with cN1-3 breast cancer who underwent NAST and had SLNB followed by completion axillary lymph node dissection (ALND) were included. In an external validation cohort, 267 patients with HER2+ or triple-negative breast cancer (TNBC) meeting similar inclusion criteria were included. Primary outcome was the false-negative rates (FNRs) of SLNB according to the MRI response and subtypes. We defined complete MRI responders as patients who experienced disappearance of suspicious features in the breast and axilla after NAST.
Results.
In the multicenter retrospective cohort (n = 388), 130 (33.5%) patients were cN2-3, while 55 (14.2%) showed complete MRI responses. In hormone receptor-positive HER2- (n=207), complete and non-complete responders had a high FNRs (31.3% [95% CI, 8.6–54.0] and 20.9% [95% CI, 14.1–27.6], respectively). However, in HER2+ or TNBC (n=181), the FNR of complete MRI responders was 0% (95% CI, 0–0), whereas that of non-complete responders was 33.3% (95% CI, 20.8–45.9). When we validated our findings in the external cohort with HER2+ or TNBC (n = 267), of which 34.2% were cN2-3, the FNRs of complete were 7.1% (95% CI, 0–16.7).
Conclusions
Our findings suggest that SLNB can be a reliable option for nodal status evaluation in selected patients who have responded well to NAST, especially in HER2+ and TNBC patients who show a complete MRI response.
The impact of microsatellite instability in patients with locally advanced resectable gastric cancer undergoing perioperative therapy
Authors: Sun Henian , Nered Sergei Nikolaevich , Tryakin Alexey Alexandrovich , Zhong Baojun , Bugaev Vladislav Evgenievich , Kalinin Oleksiy Evgenievich , Stilidi Ivan Socratovich
Published: June 2023

Background
According to TCGA (The Cancer Genome Atlas) and ACRG (Asian Cancer Research Group) classifications, tumors with high microsatellite instability (MSI-H) are classified as a specific group. Currently, perioperative chemotherapy is a standard of care in patients with locally advanced resectable gastric cancer (LARGC) in Western countries. Immune checkpoint inhibitors (ICIs) have shown efficacy in the treatment of metastatic gastric cancer, but their role in the neoadjuvant setting has not been studied. It is still unknown whether MSI-H tumors can benefit from perioperative therapy.
Methods
We analyzed patients with LARGC who had perioperative therapy from September 2019 to March 2023 at N.N.Blokhin National Medical Research Center of Oncology (Russia Federation). All patients were analyzed for MSI using PCR. Clinico-pathological factors, tumor regression grade (according to Mandard classification), disease-free (DFS), and overall survival (OS) were calculated and correlated with MSI status. Patients with MSI-H after December 2021 received perioperative chemoimmunotherapy (FOLFOX + nivolumab).
Results
The MSI-H phenotype was indicated in 29 (10.35%) out of 280 analyzed tumors. In 272 patients who received perioperative chemotherapy, the 2-year DFS was 51.40% in MSI-H tumors vs. 68.35% in MSS tumors (HR = 2.22, 95% CI 1.08–4.54, p = 0.028). The 2-year OS was 62.1% in MSI-H tumors vs. 83.27% in MSS tumors (HR = 2.71, 95% CI 1.12–6.53, p = 0.026). 3 (37.5%) patients out of 8 with MSI-H status who received perioperative chemoimmunotherapy had a complete pathologic response (TRG-1).
Conclusion
Our study shows diminished survival in patients with MSI-H gastric cancer undergoing perioperative chemotherapy. Then introduction of immunotherapy into perioperative treatment in patients with MSI-H gastric cancer demonstrates encouraging activity.