bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic impact of tumor size reduction assessed by magnetic resonance imaging after radiochemotherapy in patients with locally advanced cervical cancer
Authors: Cordoba Abel , Durand Benedicte , Escande Alexandre , Taieb Sophie , Amor Mariem Ben Haj , Le Deley Marie Cecile , Michel Andree , Le Tinier Florence , Hudry Delphine , Martinez Carlos , Leblanc Eric , Becourt Stephanie , Abdedaim Cyril , Bresson Lucie , Lartigau Eric , Mirabel Xavier , Narducci Fabrice
Published: December 2022

Objective

Pelvic magnetic resonance imaging (MRI) is a key exam used for the initial assessment of loco-regional involvement of cervical cancer. In patients with locally advanced cervical cancer, MRI is used to evaluate the early response to radiochemotherapy before image-guided brachytherapy, the prognostic impact of which we aimed to study.

Methods

Patients with locally advanced cervical cancer treated using concomitant radiochemotherapy followed by closure treatment between January 2010 and December 2015 were included in this study. Clinical, anatomopathological, radiological, therapeutic, and follow-up data were evaluated.

Results

After applying the inclusion and exclusion criteria to the initially chosen 310 patients, 232 were included for evaluation (median follow-up period, 5.3 years). The median age was 50 years (range, 25–83 years), and the median tumor size was 47.5 mm (range, 0–105 mm). Based on the International Federation of Gynaecology and Obstetrics classification system, 9 patients were in stage IB2; 20, IB3; 2, IIA; 63, IIB; 4, IIIA; 7, IIIB; and 127, IIIC1 or higher. The re-evaluation MRI was performed at the median dose of 55.5 Gy, and median reduction in tumor size was 55.2% (range, −20–100%). There was a difference between the disease-free and overall survival rates of the patients with a tumor response greater or lesser than 50%. The risk of recurrence or death reduced by 39% in patients with a tumor size reduction >50%. The overall 5-year survival rate of patients with a response greater and lesser than 50% were 77.7% and 61.5%, respectively. The 5-year disease-free survival rate for these two groups of patients were 68.8% and 51.5%, respectively.

Conclusion

Our study confirms the prognostic impact of tumor size reduction using MRI data obtained after radiochemotherapy in patients with locally advanced cervical cancer.
Case report: Pembrolizumab plus Axitinib related hypothyroid myopathy in two kidney cancer patients
Authors: Boutros Andrea , Vera Lara , Gatto Federico , Fornarini Giuseppe , Zanardi Elisa
Published: December 2022

The first-line therapy in advanced kidney cancer has changed in recent years due to the introduction of combinations of tyrosine kinase inhibitors (TKIs) of vascular endothelial growth factor receptors (VEGFR) and immune checkpoint inhibitors (ICIs). Although immune-related adverse events are well-known, in the case of combination treatments, the determination of which drug is related to an adverse event may be challenging. We reported two cases of patients who developed muscle enzyme elevation in association with hypothyroidism during therapy with pembrolizumab plus axitinib for metastatic kidney cancer. The myopathy rapidly resolved after hormone replacement therapy with levothyroxine. Hypothyroid myopathy is a scarcely known and underreported adverse event. This adverse event may be relevant in the differential diagnosis with immune-related myositis, which has an autoimmune pathogenesis and a potentially fatal course.
A tumor-associated autoantibody panel for the detection of non-small cell lung cancer
Authors: Cai Ruijun , Zhao Feng , Zhou Haiying , Wang Zengsong , Lin Dang , Huang Lu , Xie Wenling , Chen Jiawen , Zhou Lamei , Zhang Ni , Huang Chaoyuan
Published: December 2022

Lung cancer is the second most frequent malignancy and the leading cause of cancer-associated death worldwide. Compared with patients diagnosed at advanced disease stages, early detection of lung cancer significantly improved the 5-year survival rate from 3.3% to 48.8%, which highlights the importance of early detection. Although multiple technologies have been applied to the screening and early diagnosis of lung cancer so far, some limitations still exist so they could not fully suit the needs for clinical application. Evidence show that autoantibodies targeting tumor-associated antigens(TAAs) could be found in the sera of early-stage patients, and they are of great value in diagnosis. Methods, we identified and screened TAAs in early-stage non-small cell lung cancer(NSCLC) samples using the serological analysis of recombinant cDNA expression libraries(SEREX). We measured the levels of the 36 autoantibodies targeting TAAs obtained by preliminary screeningvialiquid chip technique in the training set(332 serum samples from early-stage NSCLC patients, 167 samples from patients with benign lung lesions, and 208 samples from patients with no obvious abnormalities in lungs), and established a binary logistic regression model based on the levels of 8 autoantibodies to distinguish NSCLC samples. Results, We validated the diagnostic efficacy of this model in an independent test set(163 serum samples from early-stage NSCLC patients, and 183 samples from patients with benign lung lesions), the model performed well in distinguishing NSCLC samples with an AUC of 0.8194. After joining the levels of 4 serum tumor markers into its independent variables, the final model reached an AUC of 0.8568, this was better than just using the 8 autoantibodies (AUC:0.8194) or the 4 serum tumor markers alone(AUC: 0.6948). In conclusion, we screened and identified a set of autoantibodies in the sera of early-stage NSCLC patients through SEREX and liquid chip technique. Based on the levels of 8 autoantibodies, we established a binary logistic regression model that could diagnose early-stage NSCLC with high sensitivity and specificity, and the 4 conventional serum tumor markers were also suggested to be effective supplements for the 8 autoantibodies in the early diagnosis of NSCLC.
Diagnostic value of dual-layer spectral detector CT in differentiating lung adenocarcinoma from squamous cell carcinoma
Authors: Mu Ronghua , Meng Zhuoni , Guo Zixuan , Qin Xiaoyan , Huang Guangyi , Yang Xuri , Jin Hui , Yang Peng , Deng Meimei , Zhang Xiaodi , Zhu Xiqi
Published: December 2022

Background and objective

The pathological type of non–small cell lung cancer is considered to be an important factor affecting the treatment and prognosis. The purpose of this study was to investigate the diagnostic value of spectral parameters of dual-layer spectral detector computed tomography (DLCT) in determining efficacy to distinguish adenocarcinoma (AC) and squamous cell carcinoma (SC), and their combined diagnostic efficacy was also analyzed.

Methods

This is a single-center prospective study, and we collected 70 patients with lung SC and 127 patients with lung AC confirmed by histopathological examination. Morphological parameters, plain scan CT value, biphasic enhanced CT value, and spectral parameters were calculated. The diagnostic efficiency of morphological parameters, spectral parameters, and spectral parameters combined with morphological parameters was obtained by statistical analysis.

Results

In univariate analysis, seven morphological CT features differed significantly between SC and AC: tumor location (distribution), lobulation, spicule, air bronchogram, vacuole sign, lung atelectasis and/or obstructive pneumonia, and vascular involvement (all p < 0.05). In the arterial phase and the venous phase, the spectral parameters of AC were higher than those of SC (AP-Zeff: 8.07 ± 0.23 vs. 7.85 ± 0.16; AP-ID: 1.41 ± 0.47 vs. 0.94 ± 0.28; AP-NID: 0.13 ± 0.04 vs. 0.09 ± 0.03; AP-λ: 3.42 ± 1.10 vs. 2.33 ± 0.96; VP-Zeff: 8.26 ± 0.23 vs. 7.96 ± 0.16; VP-ID: 1.18 ± 0.51 vs. 1.16 ± 0.30; VP-NID: 0.39 ± 0.13 vs. 0.29 ± 0.08; VP-λ: 4.42 ± 1.28 vs. 2.85 ± 0.72; p < 0.001). When conducting multivariate analysis combining CT features and DLCT parameters with the best diagnostic efficacy, the independent predictors of AC were distribution on peripheral (OR, 4.370; 95% CI, 1.485–12.859; p = 0.007), presence of air bronchogram (OR, 5.339; 95% CI, 1.729–16.484; p = 0.004), and presence of vacuole sign ( OR, 7.330; 95% CI, 1.030–52.184; p = 0.047). Receiver operating characteristic curves of the SC and AC showed that VP-λ had the best diagnostic performance, with an area under the curve (AUC) of 0.864 and sensitivity and specificity rates of 85.8% and 74.3%, respectively; the AUC was increased to 0.946 when morphological parameters were combined, and sensitivity and specificity rates were 89.8% and 87.1%, respectively.

Conclusion

The quantitative parameters of the DLCT spectrum are of great value in the diagnosis of SC and AC, and the combination of morphological parameters and spectral parameters is helpful to distinguish SC from AC.
Molecular diagnosis of autosomal dominant congenital cataract in two families from North India reveals a novel and a known variant in GJA8 and GJA3
Authors: Vanita Vanita , Goyal Shiwali , Tibrewal Shailja , Ganesh Suma
Published: December 2022

Aims

The study aims to detect the underlying genetic defect in two autosomal dominant congenital cataract (ADCC) families.

Methods

A detailed family history was collected, pedigrees were drawn, and slit-lamp examination and lens photography were performed. Mutation screening was carried out in the genes for crystallins and connexins by PCR and Sanger sequencing. Ethnically matched controls were tested for the identified variants. Different bioinformatics tools were used to assess the pathogenicity of the observed variants.

Results

In an ADCC family with total cataract, a novel change (c.166A > G) (p.Thr56Ala) in GJA8 was identified. In another ADCC family with nuclear cataract, c.134G > C (p.Trp45Ser) in GJA3 has been detected. These variants co-segregated completely in patients in their respective families and were neither observed in unaffected family members nor in ethnically matched 100 controls, excluding them as polymorphisms.

Conclusions

The present study identifies a novel variant c.166A > G (p.Thr56Ala) in GJA8 in an ADCC family having total cataract and a previously known mutation c.134G > C (p.Trp45Ser) in GJA3 in another ADCC family. Thr56 in GJA8 seems to be a mutation hotspot, as previously an ADCC Mauritanian family harbored a different substitution (p.Thr56Pro) at the same codon, although for a different phenotype (nuclear cataract). Similarly, Trp45 in GJA3 appears as a mutation hotspot, as p.Trp45Ser has previously been reported for nuclear cataract in a Chinese ADCC family. p.Thr56 (GJA8) and p.Trp45 (GJA3) are in the extracellular loop 1 (EL1) in their respective connexin proteins, which, along with EL2, are essential for gap junction formation, hemichannel docking, and regulating the voltage gating of the channels. Hence, residues in these regions seem crucial for maintaining eye lens transparency.
Measurement of the morphological data of primary teeth in northwest China
Authors: Lu Xiao-Xi , Yang Kuan , Zhang Bai-Ze , Wang Jun-Hui , Du Yang , Chen Yu-Jiang , Wang Xiao-Jing
Published: December 2022

Objective

This study aims to digitally obtain the morphological data of children's primary teeth in northwest China and evaluate the reliability of digitally obtaining the anatomical morphological data of primary teeth.

Methods

A total of 308 extracted primary teeth and cone-beam computed tomography (CBCT) images of 407 primary teeth were collected in northwest China. Electronic digital Vernier callipers (accuracy: 0.01 mm) were used to measure the mesiodistal and buccolingual diameters and crown length of the extracted primary teeth and calculate the crown area and crown index. Each sample was scanned with an intraoral scanner (Trios2 3shape, Denmark), and the resulting stl format files were imported into Geomagic Wrap 2015 to measure the axial and buccolingual diameters and crown length. The crown area and crown index were then calculated. After verifying the accuracy of the CBCT image measurement, the CBCT image data of 407 samples were measured in SmartV software using the “measure length” function by referring to the coronal, sagittal, and horizontal planes to adjust the position of the reference line.

Results

Northern Chinese have larger primary teeth than other populations (Japanese, white American, African, Icelander, Spanish, and Dominican Mestizo) but smaller primary teeth than native Australians. Compared to Indian primary teeth, northwest Chinese's primary teeth have larger diameters on the central axis and smaller diameters on the buccolingual surface. Male teeth are usually larger than female teeth. Compared with the results of Wang Huiyun's study, the axial and buccolingual diameters and crown length of all native tooth types in this total sample were significantly smaller at the 0.1% level, and only the axial diameters of the upper first molar and lower second molar and the crown length of the lower lateral incisor were significantly smaller at the 1% level. The results of the intraclass correlation coefficient of 308 extracted primary teeth expressed an excellent degree of agreement between the callipers and intraoral scanner for the following: mesiodistal diameter (0.956–0.991), buccolingual diameter (0.963–0.989), crown length [0.864–0.992, except for the upper canine (0.690)], crown index (0.850–0.975), and crown area (0.946–0.993).

Conclusion

The digital measurements of the intraoral scanner and CBCT image are in good agreement with the manual measurement of the Vernier calliper. The difference between the anatomical morphology size of the primary teeth measured in this study and the results of different populations could be due to different genetic backgrounds and environmental factors.
Effect of puberty on the immune system: Relevance to multiple sclerosis
Authors: Ucciferri Carmen C. , Dunn Shannon E.
Published: December 2022

Puberty is a dynamic period marked by changing levels of sex hormones, the development of secondary sexual characteristics and reproductive maturity. This period has profound effects on various organ systems, including the immune system. The critical changes that occur in the immune system during pubertal onset have been shown to have implications for autoimmune conditions, including Multiple Sclerosis (MS). MS is rare prior to puberty but can manifest in children after puberty. This disease also has a clear female preponderance that only arises following pubertal onset, highlighting a potential role for sex hormones in autoimmunity. Early onset of puberty has also been shown to be a risk factor for MS. The purpose of this review is to overview the evidence that puberty regulates MS susceptibility and disease activity. Given that there is a paucity of studies that directly evaluate the effects of puberty on the immune system, we also discuss how the immune system is different in children and mice of pre- vs. post-pubertal ages and describe how gonadal hormones may regulate these immune mechanisms. We present evidence that puberty enhances the expression of co-stimulatory molecules and cytokine production by type 2 dendritic cells (DC2s) and plasmacytoid dendritic cells (pDCs), increases T helper 1 (Th1), Th17, and T follicular helper immunity, and promotes immunoglobulin (Ig)G antibody production. Overall, this review highlights how the immune system undergoes a functional maturation during puberty, which has the potential to explain the higher prevalence of MS and other autoimmune diseases seen in adolescence.
Xenon attenuated neonatal lipopolysaccharide exposure induced neuronal necroptosis and subsequently improved cognition in juvenile rats
Authors: Liao Zhimin , Ou Xiaofeng , Zhou Cheng , Ma Daqing , Zhao Hailin , Huang Han
Published: December 2022

Background: Neonatal sepsis is known to cause neurodevelopment impairment and has been reported to increase risks for neurological/psychiatric disorders. In this study, we investigated the effect of xenon, a well-known potent neuroprotective gas, on neonatal sepsis-induced neurodevelopment impairment in rats together with underlying mechanism by focusing on receptor-interacting protein kinase (RIP) mediated neuronal necroptosis.

Methods: 3-day-old Sprague–Dawley rat pups were exposed to either 70% xenon or N2 balanced with O2 for 6 h, during which lipopolysaccharide (LPS) was injected intraperitoneally for 3 times (500 μg/kg for the 1st and 250 μg/kg for the second and third dose; n = 6–10/group). In another cohort of 3-day-old rat pups, intracerebroventricular injection of necrostatin-1 (4 µg in 4 µl saline, a RIP-1-targeted inhibitor of necroptosis) was performed 20 min after the third dose of LPS. The learning ability and memory were assessed 25 days after LPS injection. Then, their hippocampus was collected for neuronal necroptosis with RIP and MIKL assessments using western blot and in situ immunostaining. Systemic and neuro-inflammation was also assessed.

Results: LPS insult resulted in elevation of pro-inflammatory cytokine TNF-𝝰 and IL-6, caused neuronal necroptosis and damaged synaptic integrity at the brain developing stage, which finally led to the long-term cognitive impairment. Xenon inhibited necroptosis associated mediator RIP-1, RIP-3, and MLKL activation, protected neurons and attenuated cognitive dysfunction induced by LPS. Like xenon, the similar pattern changes induced by a RIP-1 inhibitor Necrostatin-1 were also found.

Conclusion: This study indicates that necroptosis is involved in neonatal sepsis-induced neurofunctional impairments and xenon may be a novel therapeutic strategy to prevent/treat cognitive impairment in neonatal septic patients.
Evaluation of the pharmacological effects and exploration of the mechanism of traditional Chinese medicine preparation Ciwujia tablets in treating insomnia based on ethology, energy metabolism, and urine metabolomic approaches
Authors: Liu Hongda , Yang Le , Wan Chunlei , Li Zhineng , Yan Guangli , Han Ying , Sun Hui , Wang Xijun
Published: December 2022

Ciwujia Tablets (CWT) are produced by concentrating and drying the extract solution of the dried rhizome of Eleutherococcus senticosus (Rupr. & Maxim.) Maxim [Araliaceae; E. senticosus radix et rhizoma]. Besides, CWT is included in the 2020 edition of Chinese Pharmacopoeia and is widely used in the treatment of insomnia. It mainly contains eleutheroside B, eleutheroside E, isofraxidin, eleutheroside C, ciwujiatone, and chlorogenic acid, as well as other chemical components. Although the clinical efficacy of CWT in treating insomnia has been confirmed, its functions and pharmacological effects have not been systematically evaluated and its mechanism of action in the treatment of insomnia remains unclear. Therefore, in this study, behavioral, energy metabolism, and metabonomics methods were applied to systematically evaluate the effect of CWT on insomnia. Additionally, urine metabonomics based on UPLC-Q-TOF-MS/MS were utilized to identify potential endogenous biomarkers of insomnia, detect the various changes before and after CWT treatment, explore the metabolic pathway and potential target of CWT, and reveal its pharmacological mechanism. Results revealed that CWT increased inhibitory neurotransmitter (5-HT and GABA) content and reduced the content of excitatory neurotransmitters (DA and NE). Moreover, CWT enhanced autonomous behavioral activity, stabilized emotions, and promoted the return of daily basic metabolic indexes of insomniac rats to normal levels. The urine metabolomics experiment identified 28 potential endogenous biomarkers, such as allysine, 7,8-dihydroneopterin, 5-phosphonooxy-L-lysine, and N-acetylserotonin. After CWT treatment, the content of 22 biomarkers returned to normal levels. The representative markers included N-acetylserotonin, serotonin, N-methyltryptamine, and 6-hydroxymelatonin. Additionally, the metabolic pathways in rats were significantly reversed, such as tryptophan metabolism, folate biosynthesis, phenylalanine metabolism, and tyrosine metabolism. Ultimately, it is concluded that CWT regulated tryptophan metabolism, folate biosynthesis, phenylalanine metabolism, and other metabolic levels in the body. This drug has been confirmed to be effective in the treatment of insomnia by regulating the content of serotonin, 6-hydroxymelatonin, N-acetylserotonin, and N-methyltryptamine to a stable and normal level in tryptophan metabolism.
Banxia baizhu tianma decoction, a Chinese herbal formula, for hypertension: Integrating meta-analysis and network pharmacology
Authors: Lin Jianguo , Wang Qingqing , Xu Siyu , Zhou Simin , Zhong Dongsheng , Tan Meng , Zhang Xiaoxiao , Yao Kuiwu
Published: December 2022

Hypertension is a major cardiovascular risk factor, which seriously affects the quality of life of patients. Banxia Baizhu Tianma Decoction (BXD) is a Chinese herbal formula that is widely used to treat hypertension in China. This study aimed to evaluate the efficacy and potential mechanism of BXD for hypertension by meta-analysis and network pharmacology. Meta-analysis was performed to explore the efficacy and safety of BXD combined with conventional treatment for hypertension. Network pharmacology was used to explore the molecular mechanism of BXD in antihypertension. A total of 23 studies involving 2,041 patients were included. Meta-analysis indicated that compared with conventional treatment, combined BXD treatment was beneficial to improve clinical efficacy rate, blood pressure, blood lipids, homocysteine, endothelial function, inflammation, and traditional Chinese medicine symptom score. In addition, meta-analysis indicated that BXD is safe and has no obvious adverse reactions. Network pharmacology showed that the antihypertensive targets of BXD may be AKT1, NOS3, ACE, and PPARG. The antihypertensive active ingredients of BXD may be naringenin, poricoic acid C, eburicoic acid, and licochalcone B. Due to the poor methodological quality of the Chinese studies and the small sample size of most, the analysis of this study may have been affected by bias. Therefore, the efficacy and safety of BXD for hypertension still need to be further verified by high-quality clinical studies.

Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42022353666
Anti-inflammatory and antioxidant activity of astragalus polysaccharide in ulcerative colitis: A systematic review and meta-analysis of animal studies
Authors: Hu Heng-Chang , Zhang Wei , Xiong Pei-Yu , Song Li , Jia Bo , Liu Xing-Long
Published: December 2022

Background: Accumulated evidence indicates that astragalus polysaccharide (APS) may have a beneficial impact on ulcerative colitis (UC) by suppressing inflammation and decreasing oxidative stress. Nevertheless, the credibility of the evidence for this practice is unclear. Therefore, we intended to conduct a systematic review and meta-analysis of animal studies to assess the anti-inflammatory and antioxidant activity of APS when used in the treatment of UC.

Methods: Electronic bibliographic databases including PubMed, EMBASE, Web of Science, Chinese Biomedical Literature (CBM), Wanfang Database, CQVIP Database and China National Knowledge Infrastructure (CNKI) were retrieved for relevant animal studies. The methodological quality of animal studies was evaluated based on the SYstematic Review Center for Laboratory animal Experimentation (SYRCLE’s RoB tool). A meta-analysis was performed according to the Cochrane Handbook for Systematic Reviews of Interventions by using STATA 12.0 software. This study was registered with PROSPERO, number CRD42021272595.

Results: Twenty qualified publications involving 591 animals were included in this study. There was a significant association of APS with levels of disease activity index (DAI), colon macroscopic damage index (CMDI), colon histopathologic score (CHS), myeloperoxidase (MPO), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β), superoxide dismutase (SOD) and malondialdehyde (MDA) compared with that in the control group. Sensitivity analysis that eliminated one study at each stage did not change these results. Egger’s test and funnel plot showed that publication bias was existed.

Conclusion: In this meta-analysis, APS treatment significantly mitigated colonic damage by reducing the levels of MPO, TNF-α, IL-6, IL-1β, and MDA and recovering the SOD activity. These results demonstrated a protective role of APS in the treatment of UC and showed that the anti-inflammatory and antioxidant activity were implicated in the underlying mechanisms. Hence, APS may represent a promising candidate for treating UC. However, due to potential publication bias, a cautious interpretation is needed.

Systematic Review Registration: (https://www.crd.york.ac.uk/PROSPERO/).
Ferroptosis plays a novel role in nonalcoholic steatohepatitis pathogenesis
Authors: Xiong Fei , Zhou Qiao , Huang Xiaobo , Cao Peng , Wang Yi
Published: December 2022

Ferroptosis relies on iron, and ferroptotic cell death is triggered when the balance of the oxidation-reduction system is disrupted by excessive lipid peroxide accumulation. A close relationship between ferroptosis and nonalcoholic steatohepatitis (NASH) is formed by phospholipid peroxidation substrates, bioactive iron, and reactive oxygen species (ROS) neutralization systems. Recent studies into ferroptosis during NASH development might reveal NASH pathogenesis and drug targets. Our review summarizes NASH pathogenesis from the perspective of ferroptosis mechanisms. Further, we discuss the relationship between mitochondrial dysfunction, ferroptosis, and NASH. Finally, potential pharmacological therapies directed to ferroptosis in NASH are hypothesized.
Heart rate reduction as a marker to optimize carvedilol treatment and enhance myocardial recovery in pediatric dilated cardiomyopathy
Authors: Adorisio Rachele , Pontrelli Giuseppe , Cantarutti Nicoletta , Bellettini Elisa , Caiazza Martina , Mencarelli Erica , Limongelli Giuseppe , Poli Daniela , Drago Fabrizio , Kirk Richard , Amodeo Antonio
Published: December 2022

Introduction: An elevated heart rate is associated with an increased risk of death or cardiac transplant in children with dilated cardiomyopathy (DCM). Whether heart rate is a clinical marker to address therapy, is poorly investigated in children.

Aim: To investigate the relationship between heart rate reduction (HRR) and left ventricular ejection fraction (LVEF) in DCM, treated with carvedilol.

Methods: This is a multi center retrospective analysis conducted on all children with DCM (aged <18 years) between 2013 and 2020, with LVEF <40% and treated with carvedilol. Carvedilol was up titrated to the maximal tolerated dose or to 1 mg/kg/day. Echocardiographic data on left ventricular function and dimension were collected. The relationship between HRR and LVEF, left ventricular end-diastolic (LVEDd) and end-systolic diameter (LVESd) was assessed before and after HRR with carvedilol, using regression analysis.

Results: 100 patients were enrolled (M: 51%; age 7 ± 8 years). The mean LVEF was 30.2 ± 10% before treatment and 43.7 ± 9.6% after treatment, at the maximum therapeutic dose (p < 0.0001). There was a positive relationship between HRR and increase in LVEF (R2 = 0.06, p = 0.014). A HRR of >20% correlated with an improvement in LVEF >13%. At 3 years follow up, HRR demonstrated a significant reduction of LVESd (R2 = 0.1, p = 0.003) LVEDd (R2 = 0.07, p = 0.008) and LVEF recovery up to 15% (p < 0.0001). No deaths or heart transplant occurred during follow-up.

Conclusion: This study demonstrates that HRR is safe and improvement in LVEF is related to the degree of HRR. The magnitude of LVEF improvement was enhanced by a major reduction in HR. It provides evidence that HRR could be used as a clinical marker to treat HF in children.
A framework for computing angle of progression from transperineal ultrasound images for evaluating fetal head descent using a novel double branch network
Authors: Bai Jieyun , Sun Zhanhang , Yu Sheng , Lu Yaosheng , Long Shun , Wang Huijin , Qiu Ruiyu , Ou Zhanhong , Zhou Minghong , Zhi Dengjiang , Zhou Mengqiang , Jiang Xiaosong , Chen Gaowen
Published: December 2022

Background: Accurate assessment of fetal descent by monitoring the fetal head (FH) station remains a clinical challenge in guiding obstetric management. Angle of progression (AoP) has been suggested to be a reliable and reproducible parameter for the assessment of FH descent.

Methods: A novel framework, including image segmentation, target fitting and AoP calculation, is proposed for evaluating fetal descent. For image segmentation, this study presents a novel double branch segmentation network (DBSN), which consists of two parts: an encoding part receives image input, and a decoding part composed of deformable convolutional blocks and ordinary convolutional blocks. The decoding part includes the lower and upper branches, and the feature map of the lower branch is used as the input of the upper branch to assist the upper branch in decoding after being constrained by the attention gate (AG). Given an original transperineal ultrasound (TPU) image, areas of the pubic symphysis (PS) and FH are firstly segmented using the proposed DBSN, the ellipse contours of segmented regions are secondly fitted with the least square method, and three endpoints are finally determined for calculating AoP.

Results: Our private dataset with 313 transperineal ultrasound (TPU) images was used for model evaluation with 5-fold cross-validation. The proposed method achieves the highest Dice coefficient (93.4%), the smallest Average Surface Distance (6.268 pixels) and the lowest AoP difference (5.993°) by comparing four state-of-the-art methods. Similar results (Dice coefficient: 91.7%, Average Surface Distance: 7.729 pixels: AoP difference: 5.110°) were obtained on a public dataset with >3,700 TPU images for evaluating its generalization performance.

Conclusion: The proposed framework may be used for the automatic measurement of AoP with high accuracy and generalization performance. However, its clinical availability needs to be further evaluated.
The cuter, the better? The impact of cuteness on intention to purchase AI voice assistants: A moderated serial-mediation model
Authors: Yu Xintao , Xu Zhen , Song Yifan , Liu Xiaochen
Published: December 2022

Due to the lockdown, more and more people are used to communicating with AI voice assistants during the post-COVID era. This study investigates the relationship between the perceived cuteness of AI voice assistants and the intention to purchase via a moderated serial-mediation model. We tested a PLS-SEM model with 284 survey data from an online experiment. The findings indicate that: (1) different cuteness appearances lead to different levels of perceived cuteness; (2) perceived cuteness positively affects intention to purchase; (3) the positive direct effect is serial mediated by social presence and user engagement; (4) the serial mediation effect is negatively moderated by perceived risk of service failure, which means the positive influence of perceived cuteness on intention to purchase is weakened at a high level of perceived risk. Our research has both theoretical and managerial contributions, which also reminds enterprises to grasp the cuteness degree of the product.
Associations between anxiety, depression, and risk of suicidal behaviors in Chinese medical college students
Authors: Li Jia , Zhang Yaru , Siu Man Chan Bella , Tan Sun Nee , Lu Jianping , Luo Xuerong , Shen Yanmei , Zhang Xiang Yang
Published: December 2022

Background

Previous studies have established a strong association between depression and suicidal behaviors, yet the relationship between anxiety and suicidal behaviors remains unclear. This study examines whether anxiety and depression are independent risk factors for suicidal behaviors in medical college students, and further, whether anxiety may increase the greater risk of suicidal behaviors (SB) in participants with depression.

Methods

This cross-sectional study was conducted among 4,882 medical students. Demographic information, anxiety, and depression data were collected using online questionnaires or through a widely used social media app named WeChat.

Results

Anxiety and depression were independent risk factors for suicidal behaviors, and levels of risk correlated positively with the severity of both anxiety and depressive symptoms. A dose–response relationship was identified between the severity of anxiety and the risk of SB, as well as the severity of depression and SB. Furthermore, anxiety increased the risk of suicidal behaviors in participants with depression, with a dose–response relationship between the severity of anxiety symptoms and the risk of SB.

Conclusion

The findings highlight the importance of screening for anxiety and depressive symptoms in medical college students, as well as reducing anxiety in addition to depressive symptoms in treatment. This study provides valuable data as a reference for clinicians for suicide risk assessments.
Food-based dietary guidelines for children and adolescents
Authors: Corrêa Rezende Júlia Laura , de Medeiros Frazão Duarte Maria Carolina , Melo Giselle Rhaisa do Amaral e , Santos Luana Caroline dos , Toral Natacha
Published: December 2022

Objective

This study aimed at reviewing food-based dietary guidelines (FBDGs) with content targeted at children and adolescents to present their main characteristics, thus enabling comparisons among countries.

Design

We conducted a search of the FBDGs available on the Food and Agriculture Organization (FAO) website, followed by a scoping review with a gray literature search to find FBDGs for children or adolescents non-listed on the FAO's website. Data extraction included the year of publication, language, and guidelines for the target group.

Results

From FAO website searches, 109 documents were found, and 17 of them could not be translated. The Scoping review search conducted in 5,190 articles, and none led to new guidelines, nor from the gray literature. Regarding the 92 FBDGs explored, 41 were specific for infants under 24 months old, children, and/or adolescents, and 51 were for the general population with information for the studied group. Twelve percent of the general FBDG and 35% of the specific ones have food icons. All of the guidelines were published after 2001. Latin America and the Caribbean were the regions that presented more specific FBDGs and the majority of countries with guidelines for fruits and vegetables. The information about fat (15 countries) and sugar (26 countries) consumption reduction is frequent. Reduction of sodium intake appears to be in the majority of guidelines after 2015. Food hygiene guidelines are recurrent in Latin American documents. NOVA classification was adopted in five countries and 21 countries approach recommendations for mealtimes. Both exclusive and continued breastfeeding guidance and healthy complementary feeding orientation are present in over 50% of the specific FBDG for infants and children under 24 months old.

Conclusion

Food-based dietary guidelines are diverse due to both the nutritional and political aspects of each region. Latin America stands out for its orientations for the studied group. Further studies should measure the possible impacts and comprehension of FBDGs.
Water supply emergency preparedness and response in health care facilities: A systematic review on international evidence
Authors: van der Heijden Sophie , Cassivi Alexandra , Mayer Aljoscha , Sandholz Simone
Published: December 2022

Introduction

Enabling health care facilities to deal with impairments or outages of water supply and sewage systems is essential and particularly important in the face of growing risk levels due to climate change and natural hazards. Yet, comprehensive assessments of the existing preparedness and response measures, both in theory and practice, are lacking. The objective of this review is to assess water supply and wastewater management in health care facilities in emergency settings and low-resource contexts. It thereby is a first step toward knowledge transfer across different world regions and/or contexts.

Method

A systematic review was performed to identify published articles on the subject using online MEDLINE and Web of Science. The initial searches yielded a total of 1,845 records. Two independent reviewers screened identified records using selection criteria. A total of 39 relevant studies were identified. Descriptive analyses were used to summarize evidence of included studies.

Results

Overall, water supply was far more discussed than wastewater management. Studies on emergency preparedness identified back-up water storage tank, additional pipelines, and underground wells as key sources to supply health care facilities with water during an emergency. In emergency response, bottled of water, followed by in-situ back-up water storage tanks previously installed as part of disaster preparedness measures, and tanker trucks to complete were most used. Questions on how to improve existing technologies, their uptake, but also the supplementation by alternative measures remain unanswered. Only few guidelines and tools on emergency preparedness were identified, while multiple studies formulated theoretical recommendations to guide preparedness. Recovery planning was rarely discussed, despite many studies mentioning the importance of the reconstruction and restoration phases. Literature focus on recovery is mostly on technical aspects, while organizational ones are largely absent. Despite their key role for preparedness and response, citizens and patients' perspectives are hugely underrepresented. This fits into the bigger picture as communication, awareness raising and actor cooperation in general is addressed comparatively little.

Discussion

Combining organizational and technical aspects, and intersecting theory and practice will be necessary to address existing gaps. Improving both, preparedness and response, is key to maintaining public health and providing primary care.
Drivers' unsafe behaviors in Iran: An investigation in West Azerbaijan
Authors: Bakhtari Aghdam Fatemeh , Shaheian Karim , Sadeghi-Bazargani Homayoun , Kousha Ahmad , Ponnet Koen , Abbasalizad Farhangi Mahdieh , Jahangiry Leila
Published: December 2022

Background

The present study aims to investigate one of the major causes of traffic accidents: drivers' unsafe behaviors while driving.

Methods

In this cross-sectional study, the behaviors of 946 drivers at traffic lights were observed in the morning, at noon, and in the evening using direct in-field observation. The unsafe behaviors of the drivers included not fastening the seat belt, using a cellphone or handsfree device, smoking, being distracted by a child, talking with passengers, not observing the stop line, eating and drinking, and getting out of the car, letting out a passenger, or arguing with a passenger at the traffic light.

Results

Of the drivers at the traffic light, 60% did not obey the stop line, and 72% did not fasten their seat belt. Also, 13.6% used their cellphones, and 22% talked with passengers. The frequency of the other unsafe behaviors was <3%. For wearing seat belts, drivers aged 41–50 years wore seat belts almost five times more than drivers under 25 years of age (4.94 [2.36–10.320]; p < 0.001), and drivers aged 50 years and older were almost three times likelier to wear seat belts than drivers under 25 years of age (2.8 [1.31–6.08]; p < 0.001). The results showed that the drivers were significantly likelier to wear seat belts on Saturdays (after the weekend) (0.56 [0.40–0.78]; p = 0.001). Regarding using mobile phones while driving, women were twice as likely to use mobile phones as men (2.20 [1.30–3.72]; p < 0.001). Drivers aged 26–40 years used mobile phones significantly less than drivers under 25 years of age (0.24 [0.14–0.43]; p < 0.001) and drivers aged 41–50 years were significantly less likely to use mobile phones than drivers under 25 years of age (0.19 [1.31–6.08]; p < 0.001).

Conclusion

The results showed that the occurrence of wearing a seat belt in Shahin Dej was low. We observed a significant association between wearing a seat belt, age, whether it was Saturday (a day after weekend for Iranians). Additionally, similar associations were observed between using mobile phones and gender, age, and day of the week.
Preferring self-management behavior of patients with chronic kidney disease
Authors: He Xiaoli , Wang Yu , Feng Chenchen , Luo Le , Khaliq Usama , Rehman Faheem Ur , Zhang Xinli
Published: December 2022

This study explores the preferred behavior of self-management among chronic kidney disease (CKD) patients and offers suggestions for different patients from personalized medicine. According to some related references, a questionnaire was designed in 2020 to collect data from 131 patients with CKD in a general hospital. The Sampling patients showed no difference in their disease progress. The questionnaire covered two aspects of demographic and behavior with 29 items on six dimensions. Statistical methods such as a descriptive analysis of the F test in behavior dimensions on demographic characteristics and Principal component analysis from items have been applied to classify some kinds of self-management behavior into different groups. In the demographic insight, employment status closely relates to self-management behavior, and income is insignificant. In the behavior aspects, according to some key items, we found four types of self–management behavior preferred in the sorting: cognitive-knowledge, Diet-exercise-medical, emotion management, and exercise-medical, which were defined by behavior dimensions. Although patients had the same disease progress, their self-management behavior mainly existed in four types based on critical factors. According to their favorite behavior and personality group, healthcare stakeholders can offer lean support for improving patients' self-management of CKD in China.
Travel across time zones and the implications for human performance post pandemic: Insights from elite sport
Authors: Jasper Stephen C. , Leenders Mark A. A. M. , O'Shannassy Tim
Published: December 2022

Notwithstanding technological innovation, the COVID-19 pandemic, and new communication tools, the need for travel is growing again and, in some travel segments, it is stronger than ever. Interestingly, the public health implications of traveling across time zones are still poorly understood and this is especially true for organizations that send their workers across the globe. Using data from 173 Olympic teams over 15 Olympic Games, we show that crossing multiple time zones has negative implications for human (sports) performance. More importantly, the results indicate that performance impairment is especially visible after flying east, with peak performance particularly impaired, leading to a “gold demotion effect” of gold medals to silver medals as a result. Given that Olympic sporting teams typically have dedicated medical staff and active mitigation strategies, these findings have important public health implications. For example, organizations are demanding their workers to be on “top of their game” while traveling, without providing them with the support and tools to do so. The implications for public health management and human resource management are discussed.
AmericasNLI: Machine translation and natural language inference systems for Indigenous languages of the Americas
Authors: Kann Katharina , Ebrahimi Abteen , Mager Manuel , Oncevay Arturo , Ortega John E. , Rios Annette , Fan Angela , Gutierrez-Vasques Ximena , Chiruzzo Luis , Giménez-Lugo Gustavo A. , Ramos Ricardo , Meza Ruiz Ivan Vladimir , Mager Elisabeth , Chaudhary Vishrav , Neubig Graham , Palmer Alexis , Coto-Solano Rolando , Vu Ngoc Thang
Published: December 2022

Little attention has been paid to the development of human language technology for truly low-resource languages—i.e., languages with limited amounts of digitally available text data, such as Indigenous languages. However, it has been shown that pretrained multilingual models are able to perform crosslingual transfer in a zero-shot setting even for low-resource languages which are unseen during pretraining. Yet, prior work evaluating performance on unseen languages has largely been limited to shallow token-level tasks. It remains unclear if zero-shot learning of deeper semantic tasks is possible for unseen languages. To explore this question, we present AmericasNLI, a natural language inference dataset covering 10 Indigenous languages of the Americas. We conduct experiments with pretrained models, exploring zero-shot learning in combination with model adaptation. Furthermore, as AmericasNLI is a multiway parallel dataset, we use it to benchmark the performance of different machine translation models for those languages. Finally, using a standard transformer model, we explore translation-based approaches for natural language inference. We find that the zero-shot performance of pretrained models without adaptation is poor for all languages in AmericasNLI, but model adaptation via continued pretraining results in improvements. All machine translation models are rather weak, but, surprisingly, translation-based approaches to natural language inference outperform all other models on that task.
Primary care dental professionals' experiences of sharp injuries in Qatar: A cross-sectional study
Authors: Marji Tamara , Syed Mohamed Ahmed
Published: December 2022

Objectives

Very few studies assess sharp injuries solely among dental professionals globally. This study aims to understand the experiences of sharp injuries among primary care dental professionals in Qatar.

Methods

This is a cross-sectional study where dental professionals working at the Primary Health Care Corporation (PHCC), a public sector healthcare organization and Qatar's largest primary care provider with 27 primary healthcare centers in Qatar, were invited to participate. An online questionnaire was administered to understand participants' experience of sharp injuries and access to occupational health services and training.

Findings

A total of 114 dental professionals participated in this study. In total, 68.42% (N=78) of participants reported experiencing a sharp injury in the 12 months prior to the survey. Majority (N=58; 75.36%) of the reported causes of sharp injuries were related to dental explorers (N=31; 40.26%) and dental injection needles (N=27; 40.26%). Of those who had experienced a sharp injury, 84.47% (N=87) did not report them.

Conclusion

In conclusion, the results highlight that sharp injuries are common among primary care dental professionals, and despite having good access to occupational support services, most dental professionals did not report their injuries. Continuous education and training programs must be implemented to improve knowledge and raise awareness to reduce the burden of sharp injuries among dental professionals. More studies from other dental settings are needed to better understand dental professionals' experiences of sharp injuries in Qatar and elsewhere.