bluuebunny/crossref_metadata_2025 huggingface dataset:
Modification of Polyethylene Glycol and Citric Acid on Palm Fiber Waste Nanofibers on the Adsorption of Violet Crystal Dyes
Authors: Mahardiani Lina , Damayanti Nida , Maharani Rizki Deva , Saputro Sulistyo , Susilowati Endang , Ciptonugroho Wirawan , Nurhayati Nanik Dwi
Published: May 2024

This study developed nanofibers derived from sugar palm fiber waste, incorporating citric acid and polyethylene glycol (PEG) modifications to adsorb crystal violet (CV) dye. The synthesis process involved alkalization-acid hydrolysis and bleaching techniques. Subsequent analyses of nanofiber characteristics were conducted using Fourier-Transform Infrared Spectroscopy (FTIR), X-ray Diffraction (XRD), and Scanning Electron Microscopy-Energy Dispersive X-ray (SEM-EDX). The efficacy of these modified nanofibers in adsorbing CV was quantitatively measured using an Ultraviolet-Visible (UV-Vis) spectrophotometer. The study successfully synthesized nanofibers from sugar palm fiber waste with modifications: PEG-modified nanofibers (NP 2 and NP 24) and citric acid-modified nanofibers (NS 2 and NS 24). These modifications resulted in nanofibers with a smooth, white texture. FTIR analysis of the samples (N, NP 2, NP 24, NS 2, and NS 24) revealed the presence of functional groups essential for cellulose, specifically -OH, C-H, and C-O groups. The addition of citric acid introduced a new group, C=O, albeit with very weak intensity. PEG modifications were evident from the stretching observed in the -OH groups. SEM analysis confirmed the presence of a layer on the nanofibers, attributed to citric acid (NS 2 and NS 24) and PEG (NP 2 and NP 24). XRD results indicated that the pre-and post-modification nanofibers exhibited a semi-crystalline phase. The adsorption mechanism was predominantly guided by Van der Waals electrostatic interactions between the absorbent material and the adsorbate. Intriguingly, the citric acid and PEG modifications did not significantly alter the adsorption outcomes. The adsorption capacity remained stable over time, as evidenced by measurements of 0, 15, 30, 45, 60, 90, and 120 minutes.
The Effect of a Culturally Responsive Teaching Approach Integrated with Comics with the Think Talk Write Learning Model on Students’ Learning Activities and Achievement in Basic Law of Chemistry Topics
Authors: Khoirunnisa Afifah , Mulyani Bakti , Susanti Vh Elfi , Yamtinah Sri , Masykuri Mohammad , Ulfa Maria , Shidiq Ari Syahidul
Published: May 2024

This study examines the impact of integrating the Culturally Responsive Teaching (CRT) approach with comic-based learning and the Think Talk Write (TTW) model on student learning activities and achievements in fundamental chemistry. Focusing on chemical reactions (combustion, rusting, fermentation, etc.) and laws (Dalton’s, Proust’s, Gay-Lussac’s, etc.), the research adopts a pretest-posttest non-equivalent control group design in a quasi-experimental setting with 36 students divided equally between control and experimental groups. Comparative analysis shows that the experimental group outperforms the control group in learning activities and achievements. The experimental group, subjected to the CRT and TTW model, demonstrates significantly higher engagement in learning activities. The N-Gain Score test reveals a notable increase in learning effectiveness—56.40% for the experimental group versus 29.69% for the control group, indicating the latter's relative ineffectiveness. In learning achievement, the experimental group exhibits a considerable improvement of 67.20%, while the control group shows a moderate gain of 50.12%. The results of the Multivariate Analysis of Variance (MANOVA) test, with the positive effect of integrating CRT with comics and the TTW model on student learning activities and achievements. The study highlights the efficacy of this approach in enhancing students' understanding and engagement in chemistry, suggesting a promising direction for future educational practices.
Collage Innovations Enhancing Preschool Fine Motor Skills Globally
Authors: Adibah Sarah , IFFATUR ROCMAH LULUK
Published: May 2024

This study aims to explore the efficacy of collage activities using paper clay media in enhancing fine motor skills among 4-5-year-old children at TK Aisyiyah 2 Porong. Employing a classroom action research (CAR) design, the study progresses through planning, implementation, observation, and reflection stages. Data collection involved observation, documentation, and interviews, analyzed descriptively and quantitatively. The research found that fine motor skills significantly improved, with an average achievement in Cycle I at 70% and Cycle II at 83%. Teacher activity scores also increased from 2.3 to 3.8 between cycles. Results indicate the success of collage activities using paper clay in enhancing fine motor skills. The study underscores the importance of demonstration and practice methods in facilitating children's understanding and proficiency in fine motor activities. The findings offer implications for educators and curriculum developers seeking to enhance fine motor skills in early childhood education through innovative, hands-on approaches.
Highlight:

Improved skills: Collage boosts fine motor skills in preschoolers effectively.
Engaging methods: Demonstrations enhance understanding and engagement in motor activities.
Innovative media: Paper clay fosters creativity and fine motor development effectively.

Keywoard: Motor Skills, Collage, Paper Clay, Preschool, Action Research
Perspectives of Pregnant Women’s Infant Oral Health Knowledge and Beliefs: A Prenatal Survey
Authors:   Professor, Department of Pediatric Dentistry, CKS Theja Institute of Dental Sciences and Research, Chadalawada Nagar, Renigunta Road, Renigunta, Tirupati 517506, Andhra Pradesh, India., Srinivasan K.
Published: May 2024

Background: Early childhood caries is a virulent form of dental caries that can destroy the primary dentition of infants and preschool children. ECC is a preventable disease and prevention should begin in pre and perinatal. Mothers with poor oral health may be at greater risk of infecting their children. Biologically, the mother is the primary source of Streptococci and young children are dependent on their mother for oral hygiene. Aim: So, it’s essential to explore pregnant women and nursing mothers' knowledge, attitude, and practices as they affect the dental care children receive. Methodology: A survey was presented which was designed to assess the knowledge, attitude, and practices of pregnant women regarding infant’s oral health. A survey was conducted in and around Vellore at a government and private maternity hospital among pregnant women and new mothers. A self-administered questionnaire consisting of a total of 41 questions concerning basic information on proper infant oral hygiene procedures was given. A statistical analysis was performed. Results: A greater percentage of women were unaware of the importance of their oral hygiene, infant feeding practices and oral hygiene procedures. Conclusion: Based on these results there is a need for education for mothers and would-be mothers.
TINJAUAN FILSAFAT ILMU PADA PENGGUNAAN BAHAN ALAMI SEBAGAI PENGAWET DALAM INDUSTRI HASIL PERIKANAN
Authors: Al Afifah Luthfiah , Junianto Junianto
Published: May 2024

Latar belakang: Produk perikanan menjadi salah satu jenis makanan yang sangat disenangi masyarakat dikarenakan kandungan protein hewaninya yang besar. Disamping keunggulannya tersebut, ada juga kekurangannya yaitu ikan merupakan produk yang cepat busuk/ mudah rusak (high perishable) dan memiliki umur simpan yang pendek. Namun, mengawetkan produk perikanan merupakan tantangan penting dalam industri ini, karena kerentanannya terhadap kerusakan mikroba, oksidatif, dan enzimatik. Dalam beberapa dekade terakhir, terdapat peningkatan minat dalam pengembangan pengawet alami sebagai alternatif dari bahan pengawet sintetis yang seringkali memiliki dampak negatif terhadap lingkungan dan kesehatan manusia. Penggunaan bahan alami seperti ekstrak tumbuhan telah menarik perhatian sebagai opsi yang lebih ramah lingkungan dan lebih berkelanjutan. Meskipun demikian, penggunaan bahan alami sebagai pengawet dalam industri hasil perikanan tidak hanya melibatkan pertimbangan teknis dan ekonomi, tetapi juga pertimbangan filosofis dan etis. Tinjauan filosofis ilmu terhadap penggunaan bahan alami sebagai pengawet dapat memberikan wawasan yang mendalam tentang hubungan manusia dengan alam, etika penggunaan sumber daya alam, dan implikasi filosofis dari praktik industri. Tujuan: Penelitian ini bertujuan untuk memberikan wawasan lebih jauh mengenai pemanfaatan bahan alami sebagai bahan pengawet pada industri produk hasil perikanan, dengan memadukan sudut pandang ilmiah dan filosofis. Metode: Penelitian ini adalah Literature review yang menggunakan metode studi kepustakaan. Hasil: Industri hasil perikanan menggunakan bahan alami sebagai pengawet dapat dianggap sebagai penerapan prinsip ontologi realisme. Dalam situasi seperti ini, penggunaan bahan alami sebagai pengawet didasarkan pada keyakinan bahwa sifat pengawet alami memiliki sifat yang dapat diandalkan dan tidak bias. Epistemologi dalam penggunaan bahan alami sebagai pengawet dalam industri hasil perikanan melibatkan pemahaman tentang bagaimana pengetahuan diperoleh, dikembangkan, dan diterapkan dalam konteks tersebut. Aksiologi dalam penggunaan bahan alami sebagai pengawet dalam industri hasil perikanan melibatkan pertimbangan etika dan prinsip moral yang terkait dengan penggunaan bahan alami sebagai pengawet. penggunaan bahan-bahan alami sebagai bahan pengawet dalam industri produk hasil perikanan dapat memberikan alternatif yang lebih aman, berkelanjutan, dan etis bagi produsen dan konsumen. Simpulan: Penggunaan bahan alami dalam pengawetan merupakan pilihan yang tepat, tetapi diperlukan penelitian dan tindakan yang komprehensif dan berkelanjutan untuk memastikan bahwa penggunaan bahan alami sebagai bahan pengawet dapat memenuhi pertimbangan ontologis, epistemologis, dan aksiologis.
Study Protocol: COPD - Eosinophil-guided Reduction of Inhaled Corticosteroids (COPERNICOS)
Authors: Rønn Christian , Bonnesen Barbara , Alispahic Imane Achir , Toennesen Louise , Sivapalan Pradee , Kjærgaard Jakob Lyngby , Moberg Mia , Ulrik Charl Suppli , Harboe Zitta Barella , Browatzki Andrea , Jensen Torben Tranborg , Meyer Christian , Bødtger Uffe , Bendstrup Elisabeth , Johansson Sofie Lock , Kaiser Diana Utrecht , Hyldgaard Charlotte , Vestbo Jørgen , Jensen Jens Ulrik Stæhr
Published: May 2024

Background Inhaled corticosteroid (ICS) is frequently used for COPD. Based on the considerable adverse effects and the knowledge that many such patients do not gain benefit from this treatment, it remains unresolved whether ICS treatment can be managed with lower doses, or via an ICS-sparing strategy with periods with and without this medicine. The blood eosinophil count is a useful biomarker for steroid-responsive airway inflammation, and we want to investigate whether an individualized and eosinophil-guided approach on ICS treatment reduces ICS over-treatment and side effects. High dose (500 mg thrice weekly or 250 mg daily) long-term azithromycin has been shown to reduce acute exacerbations of COPD in selected patients. Frequent gastro-intestinal adverse effects remain a challenge, but many patients tolerate lower doses, however, the effect of the treatment at lower doses is unknown, although many physicians prefer such doses. We want to investigate whether oral low-dose prophylactic azithromycin 250 mg three times weekly reduces acute exacerbations of COPD and improves time alive and out of hospital. Methods This is an ongoing, actively recruiting randomized, double-blinded, multicenter, four-arm factorial intervention clinical trial aiming to recruit 444 patients with specialist verified COPD GOLD risk class E and/or FEV1 < 30% who are currently on ICS. The patients are followed for one year and are randomized 1:1:1:1 to one of the four treatment arms: (1) eosinophil-guided ICS sparing treatment and low dose azithromycin, (2) eosinophil-guided ICS treatment and placebo, (3) continued ICS treatment and low dose azithromycin, or (4) continued ICS treatment and placebo. If blood-eosinophils (measured every 3 months) are < 0.3 x 109 cells/L, ICS treatment will be paused in the arms with eosinophil-guided ICS sparing treatment. Azithromycin/placebo is double-blinded and administered three times weekly. The primary endpoints are (1) “days alive and out of hospital within 365 days after recruitment” and (2) number of hospitalization-requiring exacerbations and/or death within 365 days. Discussion Severe ICS-adverse effects like bacterial infections should be reduced. The ICS-sparing intervention, we test, may provide a useful tool to do this safely. Azithromycin low dose prophylaxis is practiced by many physicians. This trial will provide evidence of whether this is effective. Trial registration ClinTrials.gov. NCT04481555. Registered 14AUG2020, https://clinicaltrials.gov/study/NCT04481555.
NUP98/NSD1 and FLT3/ITD co-expression is an independent predictor of poor prognosis in pediatric AML patients.
Authors: Wang Jing-wen , Li Yu , Xu lv- Hong
Published: May 2024

Objective
Patients who carry NUP98/NSD1 or FLT3/ITD mutations are reported to have poor prognosis. Previous studies have confidently reported that the poor outcome in younger AML patients is owning to dual NUP98/NSD1 positivity and FLT3/ITD positivity, with a high overlap for those two genetic lesions. In this study, we assessed the prognostic value of the presence of both NUP98/NSD1 and FLT3/ITD in pediatric AML patients.
Methods
We screened a large cohort of 885 pediatric cases from the COG-National Cancer Institute (NCI) TARGET AML cohort and found 57 AML patients with NUP98 rearrangements.
Results
The frequency of NUP98 gene fusion was 6.4% in 885 patients. NUP98/NSD1 fusion was the most common NUP98 rearrangement, with a frequency of 59.6%(34 of 57). NUP98/NSD1-positive patients who carried FLT3/ITD mutations had a decreased CR1 or CR2 rate than those patients carried FLT3/ITD mutation alone (P < 0.001). Moreover, patients harboring both NUP98/NSD1 fusion and FLT3/ITD mutation exhibited inferior event-free survival (EFS) and overall survival (OS) than patients who were dual negative for these two genetic lesions (P < 0.0001). The presence of only NUP98/NSD1 fusion had no significant impact on EFS or OS. We also found that cases with high FLT3/ITD AR levels ( > = 0.5) with or without NUP98/NSD1 had inferior prognosis. Multivariate analysis demonstrated that the presence of both NUP98/NSD1 and FLT/ID3 was an independent prognostic factors for EFS (hazard ratio: 3.2, P = 0.001) in patients with pediatric AML. However, there was no obvious correlation with OS (hazard ratio: 1.3, P = 0.618). Allogeneic stem cell transplantation did not improve the survival rate of cases with NUP98 fusion or NUP98/NSD1 AML in terms of EFS or OS.
Conclusion
Presence of both NUP98/NSD1 and FLT3/ITD was found to be an independent factor for dismal prognosis. Notably, lack of FLT3/ITD mutations in NUP98/NSD1-positive patients did not retain its prognostic value.
Blink-related arousal network surges are shaped by cortical vigilance states
Authors: Demiral Sukru , Lildharrie Christina , Lin Esther , Benveniste Helene , Volkow Nora
Published: May 2024

The vigilance state and the excitability of cortical networks impose wide-range effects on brain dynamics that arousal surges could promptly modify. We previously reported an association between spontaneous eye-blinks and BOLD activation in the brain arousal ascending network (AAN) and in thalamic nuclei based on 3T MR resting state brain images. Here we aimed to replicate our analyses using 7T MR images in a larger cohort of participants collected from the Human Connectome Project (HCP), which also contained simultaneous eye-tracking recordings, and to assess the interaction between the blink-associated arousal surges and the vigilance states. For this purpose, we compared blink associated BOLD activity under a vigilant versus a drowsy state, a classification made based on the pupillary data obtained during the fMRI scans. We conducted two main analyses: i) Cross-correlation analysis between the BOLD signal and blink events (eye blink time-series were convolved with the canonical and also with the temporal derivative of the Hemodynamic Response Function, HRF) within preselected regions of interests (ROIs) (i.e., brainstem AAN, thalamic and cerebellar nuclei) together with an exploratory voxel-wise analyses to assess the whole-brain, and ii) blink-event analysis of the BOLD signals to reveal the signal changes onset to the blinks in the preselected ROIs. Consistent with our prior findings on 3T MRI, we showed significant positive cross correlations between BOLD peaks in brainstem and thalamic nuclei that preceded or were overlapping with blink moments and that sharply decreased post-blink. Whole brain analysis revealed blink-related activation that was strongest in cerebellum, insula, lateral geniculate nucleus (LGN) and visual cortex. Drowsiness impacted HRF BOLD (enhancing it), time-to-peak (delaying it) and post-blink BOLD activity (accentuating decreases). Responses in the drowsy state could be related to the differences in the excitability of cortical, subcortical and cerebellar tissue, such that cerebellar and thalamic regions involved in visual attention processing were more responsive for the vigilant state, but AAN ROIs, as well as cerebellar and thalamic ROIs connected to pre-motor, frontal, temporal and DMN regions were less responsive. Such qualitative and quantitative differences in the blink related BOLD signal changes could reflect delayed cortical processing and the ineffectiveness of arousal surges during states of drowsiness. Future studies that manipulate arousal are needed to corroborate a mechanistic interaction of arousal surges with vigilance states and cortical excitability.
Contextual factors in the implementation of the family support program A Healthy School Start in three municipalities in Sweden
Authors: Annerstedt Kristi Sidney , Kwak Lydia , Andermo Susanne , Patterson Emma , Norman Åsa , Raposo Sara , Stattin Nouha Saleh , Elinder Liselotte Schäfer
Published: May 2024

Background:
Effective implementation and sustainability of evidence-based public health interventions is vital to reducing the burden of chronic diseases. Suboptimal implementation due to contextual barriers reduce effectiveness and can be difficult to identify and predict. The aim of this study was to investigate the change in readiness and implementation outcomes of school staff implementing the universal family support program A Healthy School Start pre- and post-intervention in three municipalities in Sweden.
Methods:
Embedded in a hybrid type 3 implementation-effectiveness trial, validated questionnaires were used to assess readiness and implementation outcomes (acceptability, appropriateness, feasibility) at two time points. Data was collected from 39 school principals (implementation leader), 72 teachers (providing a classroom component to children) and 39 school nurses (providing a health talk with parents) between September 2021 – May 2023. A summative score was created for the outcomes. Median and interquartile ranges (IQR) were presented.
Results: Readiness scores of all personnel were positively correlated with the acceptability (0.66), appropriateness (0.70), and feasibility (0.71) pre-intervention scores in the municipalities. Three distinct patterns were found in the implementation outcomes in the municipalities (M). In M1, all three implementation outcomes were high pre-intervention (16 IQR:14-19, 16 IQR:15-18, 16 IQR:14-18). Post-intervention acceptability and feasibility significantly decreased (12.5 IQR:9-17 and 15 IQR:9-17). In M2, implementation outcomes were low (12 IQR:10-16, 12.5 IQR:10-16.5, and 12 IQR:8-16) pre-intervention and remained low post-intervention. In M3, all three outcomes were high pre-intervention (16 IQR:14-18, 16 IQR:14-18, 16 IQR:13.5-17.5) and remained unchanged. School personnel in M3 experienced higher readiness and acceptability (53%) than in M1 (45%) and M2 (23%). School nurses scored lower (p=0.059) than principals and teachers regarding their perception of the feasibility of the program both pre- and post- implementation.
Conclusion: This study provides useful insights into the implementation of a new school-based family support program in three municipalities. Further studies are needed to identify factors at school and municipality level which may have influenced the school personnel’s readiness to implement the program. A combined pre-implementation assessment of readiness, and acceptability, appropriateness and feasibility could be one way to identify organizations which are not yet ready to adopt a new program.
Trial registration: Registered prospectively at ClinicalTrials.gov ID: NCT04984421, registered July 30, 2021
Geographic distribution of extended spectrum beta-lactamase (ESBL) uropathogens and social vulnerability and pollution
Authors: Tamas Vanessa , Bialostozky Mario , Nguyen Margaret
Published: May 2024

Background Children are vulnerable to poor health outcomes from pollution exposure and pollution can adversely affect urinary health. Geospatial analysis has demonstrated extended spectrum beta-lactamase (ESBL) uropathogen clusters at a community level, and further analysis has the potential identify any associated geographic, social vulnerability, or environmental risk factors.Methods Urine cultures, from children aged < 18 years from January 1, 2013, to December 31, 2018, obtained from a tertiary pediatric emergency department and its affiliated urgent care center were screened for inclusion. Urine cultures with a valid geocoded address were aggregated into census tracts. The primary outcome for this study was the proportion of positive ESBL uropathogens of all the ESBL-capable uropathogens by unit of the census tract. We used Anselin Local Moran’s I statistic to assess spatial clusters and spatial outliers. Social vulnerability index and pollution indicators were used to characterize locations with and without clustering.Results Of the 6,529-culture confirmed UTIs, 251 (3.8%) were ESBL positive. We identified high clusters (n = 4, p-value ≤ 0.05) and high outliers (n = 10, p-value < 0.05) within metro and rural eastern San Diego County. Census tracts with ESBL uropathogens had higher scores across all themes of social vulnerability and had increased pollution exposure.Conclusions ESBL uropathogens exist in distinct clusters within San Diego County and the census tracts with ESBL uropathogens demonstrate increased social vulnerability and experience greater air pollution. This study is limited by specific patient-level analysis.
Abca4 inhibition in the cone-rich rodent Psammomys obesus leads to Stargardts Disease type 1-like retinal degeneration
Authors: Sassone Fabiana , Estay-Ahumada Cathy , Roux Michel J. , Ciocca Dominique , Rossolillo Paola , Birling Marie-Christine , Sparrow Janet R. , Montenegro Diego , Hicks David
Published: May 2024

Mutations in the gene ABCA4 coding for photoreceptor-specific ATP-binding cassette subfamily A member 4, are responsible for Stargardts Disease type 1 (STGD1), the most common form of inherited macular degeneration. STGD1 typically declares early in life and leads to severe visual handicap. Abca4 gene deletion mouse models of STGD1 accumulate lipofuscin, a hallmark of the disease, but unlike the human disease show no or only moderate structural changes and no functional decline. The human macula is highly enriched in cones, and reasoning that the low cone percentage in mice retinas (<3%) might compromise faithful modelling of human maculopathies, we performed sub-retinal injections of CRISPR/Cas9-abca4 Adeno-Associated Virus constructs into young Sand Rats (Psammomys obesus), a diurnal rodent containing >30% cones. Compared to control injections of AAV-abca4-GFP, treated eyes exhibited extensive retinal degeneration by two months. Sanger sequencing of the CRISPR targeted sequence show a clear edition of Abca4 gene. Non-invasive fundus imaging showed widespread photoreceptor loss, confirmed by ocular coherence tomography. Functional recording by single flash and flicker electroretinography showed significant decline in photopic (cone) light responses. Post-mortem real-time PCR, immunohistochemistry and western blotting showed significant decrease of cone-specific (MW cone opsin) but not rod-specific (rhodopsin) markers. Transmission electron microscopy showed large numbers of lipid inclusions in treated but not control retinal pigmented epithelium. Finally, ultra-high performance liquid chromatography analysis of whole P. obesus eyes showed the presence of all-trans retinal-dimer, not detected in rod-rich rat eyes. In conclusion, Abca4 knockout in P. obesus results in a predominantly cone degeneration phenotype, more accurately reflecting the etiology of human STGD1, and should be valuable for characterizing pathogenic pathways and exploring treatment options.
Ethically informed urban planning: measuring distributive spatial justice for neighbourhood accessibility
Authors: Nelson Ruth , Warnier Martijn , Verma Trivik
Published: May 2024

Studies in accessibility have advanced our understanding of social and spatial inequalities in the distribution of urban resources in cities worldwide. In response, prominent discourse is shifting to embed justice in urban planning. However, the operationalisation of metrics of distributive spatial justice linked to specific ethical principles at the neighbourhood scale are still lacking. In this work, we propose a reproducible framework that measures distributive spatial justice at the neighbourhood scale based on specific ethical principles of Equality, Utilitarianism and Rawls’ Egalitarianism. We evaluate neighbourhood accessibility to opportunities (places of employment) in cities located in the Netherlands, Mexico and South Africa employing urban network models integrating transportation, land use, and street networks created from open-source data. Across the cases and ethical perspectives, we find that justice is mediated by a neighbourhood's proximity to local mixed land use for shorter commuting times. Whereas for longer commutes, justice is dependent on a neighbourhood's access to the Central Business District of each region, through transportation infrastructure. Our findings underscore the scale, contextual and value-reliant nature of distributive spatial justice. This framework offers a means to support ethically informed urban planning and facilitate comparative urban analysis revealing universal and/or context-specific factors contributing to spatial justice.
Deep Learning-based Automated Identification of Knee Arthroplasty Implants
Authors: Gong Zibo , He Xiaoxin , He Ming , Fu Xinzhe , Fu Yonghui
Published: May 2024

Background: A critical step in preoperative planning for revision knee arthroplasty is the identification of the failed implant. The purpose of this study was to develop and evaluate the performance of deep learning methods based on convolutional neural networks (CNN) to detect and identify specific knee arthroplasty models.
Methods: In this study, we propose a novel deep learning-based approach to identify knee arthroplasty implants’ design using both anterior-posterior (AP) and lateral images. We harness the pre-trained ResNet50 CNN model and employ transfer learning methods to adapt the model for implants identification task using a total of 1814 radiographs of 8 different knee arthroplasty implant designs. Performance was compared with operative note and crosschecked with implant sheets. We also evaluate the difference of performance of models trained with AP images, lateral images or both.
Results: The training and validation data sets were comprised of 907 AP and 907 lateral view radiographs across 733 patients and included 8 knee arthroplasty implants from 5 leading implant manufactures. After 1000 training epochs the model classified 8 implant models with very high accuracy. Our results showed that jointly using AP images and lateral images improved the classification accuracy of the CNN model.
Conclusion: CNN can accurately distinguish between specific knee arthroplasty designs. This technology could offer a useful adjunct to the surgeon in preoperative identification of the prior implant. Furthermore, using both AP images and lateral images to train the CNN is more effective than using images from only one perspective.
The INFLUENCE 3.0 model: updated predictions of locoregional recurrence and contralateral breast cancer, now also suitable for patients treated with neoadjuvant systemic therapy
Authors: Maaren MC van , Hueting TA , Uden DJP van , Hezewijk M van , de Munck L , Mureau MAM , Seegers PA , Voorham QJM , Schmidt MK , Sonke GS , Groothuis-Oudshoorn CGM , Siesling S , group NABOR project
Published: May 2024

Purpose
Individual risk prediction of 5-year locoregional recurrence (LRR) and contralateral breast cancer (CBC) supports decisions regarding personalised surveillance. The previously developed INFLUENCE tool was rebuild, including a recent population and patients who received neoadjuvant systemic therapy (NST).
Methods
Women, surgically treated for nonmetastatic breast cancer, diagnosed between 2012-2016, were selected from the Netherlands Cancer Registry. Cox regression with restricted cubic splines was compared to Random Survival Forest (RSF) to predict five-year LRR and CBC risks. Separate models were developed for NST patients. Discrimination and calibration were assessed by 100x bootstrap resampling.
Results
In the non-NST and NST group, 49,631 and 10,154 patients were included, respectively. Age, mode of detection, histology, sublocalisation, grade, pT, pN, hormonal receptor status±endocrine treatment, HER2 status±targeted treatment, surgery±immediate reconstruction±radiation therapy, and chemotherapy were significant predictors for LRR and/or CBC in non-NST patients. For NST patients this was similar, but excluding (y)pT and (y)pN status, and including presence of ductal carcinoma in situ, axillary lymph node dissection and pathologic complete response.
For non-NST patients, the Cox and RSF models were integrated in the online tool with 5-year AUCs of 0.77 (95%CI:0.77-0.77) and 0.68 (95%CI:0.67-0.68)] for LRR and CBC prediction, respectively. For NST patients, the RSF model performed best (AUCs 0.77 (95%CI:0.76-0.78) and 0.73 (95%CI:0.69-0.76) for LRR and CBC, respectively). Regarding calibration, observed-predicted differences were all <1%.
Conclusion
This INFLUENCE 3.0 models showed moderate performance in LRR and CBC prediction. The models have been made available as online tool to enable clinical decision support regarding personalised follow-up.
The Relationship between Mindfulness, Psychological Flexibility, and Symptom Severity in Persons with Schizophrenia-Spectrum-Disorders – a Cross-Sectional Study
Authors: Hahne Inge , Segerer Julia , Zierhut Marco , Bergmann Niklas , Ta Thi Minh Tam , Hahn Eric , Böge Kerem
Published: May 2024

The effectiveness of mindfulness-based interventions (MBIs) in enhancing mental well-being and reducing positive, negative, and depressive symptoms in schizophrenia spectrum disorders (SSD) has been demonstrated by a growing body of evidence. However, the underlying mechanisms of MBIs still need further examination. Psychological flexibility (PF), generally assessed by cognitive fusion, has been shown to be associated with clinical change in MBIs. This study used a cross-sectional design to investigate the interplay of mindfulness, PF, and symptom severity in SSD. In total, N = 94 individuals with SSD were included. Correlation and mediation analyses were performed using PROCESS analysis with positive, negative, and depressive symptom severity as outcome variables, measured by the Positive and Negative Syndrome Scale (PANSS) and the Depression Anxiety Stress Scale (DASS-21), respectively. Findings indicated that mindfulness was significantly negatively correlated with positive and depressive symptoms, as well as significantly positively related to PF. A significant mediating effect of PF was found for the relationship between mindfulness and negative as well as depressive symptoms. The current study supports previous research about PF as a possible mechanism of action in MBIs. Still, future research using longitudinal designs, more fine-grained analyses, and mixed-method approaches regarding assessment tools are warranted.
Diaphite: diamond-graphene hybrid nanostructures grown in CH4/H2/N2 chemistry
Authors: Sodisetti Venkateswara Rao , Bhattacharyya Somnath
Published: May 2024

Here, we demonstrate the deposition of Diaphitic domains (diamond-graphene composite nanostructure) in a hydrogen (H2)-rich plasma gas chemistry. The distinct structural characteristics formed within ultra-nanocrystalline diamond (UNCD) films, with varying nitrogen (N2) concentrations in the gas mixture from 5% to 20%, were examined using a combination of electron microscopy and diffraction methods. Atomic force microscopy (AFM) and X-ray diffraction (XRD) measurements indicated the formation of an average diamond grain size of ∼ 5 nm. High-resolution transmission electron microscopy (HR-TEM) and selected area electron diffraction (SAED) revealed the presence of five-fold, six-fold and twelve-fold symmetry features, along with a forbidden {200} crystallographic reflection associated with the Diaphite structure in the UNCD films. These hybrid features, which combine elements of both diamond and graphene, were observed in both 5% and 10% N2-doped UNCD films and are the result of the interface between sp3 and sp2 domains, where sp3 grains are covalently bonded with sp2 grains.The emergence of these unconventional features in artificially grown diamonds is linked to nitrogen doping and secondary nucleation initiated by H2, leading to non-equilibrium growth conditions that potentially induce polymorphism in the diamond.Our discoveries offer insights into the creation of structural defects that are correlated with N2 doping in a plasma mixture of CH4/H2, thus enabling the development of novel nanodiamond structures through regulated doping.
Haploid Regeneration System Suitable for Various Genotypes of Thin-Skinned Melons
Authors: Li Man , Hou Yaxin , Luo Xianyang , Zhang Haxiang , Zhou FUuxuan , Xie zhao , Hu zongwei , RAN JIAJUN , Zhu Shidong
Published: May 2024

Cucumis melo ssp. agrestis is a vital crop in the Cucurbitaceae family. Traditional breeding has been the primary method, but prolonged artificial selection has led to a gradual decline in the genetic diversity of thin-skinned sweet melon. An efficient induction system for thin-skinned sweet melon haploids has been established to innovate germplasm resources. Initially, unfertilized ovules treated with low temperature are peeled and inoculated onto the callus induction medium (CIM) for 2 days of dark culture, followed by 30 days of culture under subdued light to induce callus formation. Subsequently, the callus tissue is transferred to a proliferation medium (PM) and cultured under intense light until green cells and bud differentiation occur. Finally, rooting induction medium (RIM) induces rooting to form complete plants. Through validation with eight genotypes of disease-resistant thin-skinned sweet melon, this method exhibits a haploid induction rate of 12.26%, a diploid induction rate of 54.72%, and a tetraploid induction rate of 33.02%. Incorporating molecular marker-assisted breeding techniques, we have developed usable plants resistant to powdery mildew, downy mildew, and frost mold.
PLCXD2 expression relates to the immune microenvironment and prognosis of head and neck squamous cell carcinoma
Authors: Han Liang , Tang Mingming , Zhang Zihao , Xu Xinjiang , Chen Qingwen , Wei Yingze , Qian Hongyan , Wu Hao
Published: May 2024

Objective — Despite the advances in oncology, the prognosis of head and neck squamous cell carcinoma (HNSC) patients remains dismal. In this study, we aimed to determine the relevance of PLCXD2 expression in the tumor microenvironment to the HNSC patient clinicopathological features.
Methods — Gene expression analysis and multicolor immunofluorescence histochemistry with HNSC tissuemicroarrays were conducted to examine the relation between PLCXD2 expression and patient outcomes. Additionally, Spearman correlation analysis was used to assess the relationship between PLCXD2 protein expression and tumor immune infiltrating cells (TIICs), as well as immune checkpoints (PD-1, PD-L1, and CTLA-4) in HNSC tissue, while Chi-square test and Cox proportional-hazards models were employed to validate the correlation between PLCXD2 protein levels and clinicopathological characteristics with patient survival.
Results — Our findings revealed higher PLCXD2 expression in HNSC tissue compared to control benign tissues. Additionally, we observed a distinct association between the presence of PLCXD2 protein in cancer nests and various TIICs, including CD4+ T cells, CD8+ T cells, dendritic cells, as well as CTLA-4+ cells in HNSC tissues. Furthermore, we demonstrated a correlation between PLCXD2 protein expression in cancer cells and advanced TNM stage, as well as a poorer prognosis.
Conclusion — Taken together, this study supports PLCXD2 as an independent prognostic marker and a potentially promising target for immunotherapy in HNSC.
Construction of breast cancer-related gene prognostic signature in endometrial cancer
Authors: Xu Junling , Zhang Hualing , Qin Xiaochen , Zhang Kaili , He Tianjiao , Ma Xiaoyi , Su Yun , Che Yanci
Published: May 2024

Objective
Breast cancer (BC) and endometrial cancer (EC) both originate from sex hormone-dependent organs, yet their interaction mechanisms remain unclear. This study aims to explore the common genetic and molecular characteristics between BC and EC, predicting their potential roles in EC treatment and prognosis evaluation.
Methods
Data on BC and EC were retrieved from The Cancer Genome Atlas Program (TCGA) and the International Cancer Genome Consortium (ICGC) databases. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were conducted to identify shared genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed on the shared genes. Single-factor Cox analysis, least absolute shrinkage and selection operator (LASSO) regression, and multivariate Cox regression were employed to identify potential breast cancer-related genes (BCRGs), and a prognostic risk scoring system was developed. Additionally, we examined the relationship between risk groups and clinicopathological features, immune infiltration, tumor mutation burden, and drug sensitivity.
Results
A total of 367 breast cancer-related DEGs were identified in EC, and 113 potentially prognostic DEGs were screened. From these, 11 key BCRGs significantly associated with the overall survival rate of EC patients were identified. Patients in the low-risk group exhibited longer overall survival (OS) compared to those in the high-risk group. Additionally, significant differences in clinical characteristics, tumor immune cell infiltration, somatic mutations, and drug sensitivity were observed between risk groups, with the low-risk group showing a higher likelihood of benefiting from immunotherapy.
Conclusion
The risk score established in this study demonstrates prognostic ability, potentially aiding in identifying patients who may benefit from immunotherapy and targeted therapy after breast cancer diagnosis.
Trend of the causes of neonatal deaths in Northwest China, 2016-2020: a multi- center study of clinical outcomes
Authors: Yang Xue , Wang Baozhu , Yu Xiping , Zhang Juan , Yang Jiaomei
Published: May 2024

Although the rates of neonatal deaths has declined, the number of neonatal deaths is still high in China. The aim of this study was to explore the trend and distribution of neonatal mortality in Northwest China. In this multi-center prospective observation study, all neonates who were hospitalized between January 2016 and December 2020 were included. Data on livebirths were extracted from medical records. Linear trend test was used to explore the trend of neonatal mortality rate. Multivariable logistic regression models were used to analyze the distribution of the causes of neonatal deaths between different populations. We included 73,967 admissions and identified 420 neonatal deaths during the study period. The neonatal mortality rate was 0.57%, with the highest of 0.74% in 2017 and the lowest of 0.39% in 2020. The main causes of death were neonatal respiratory distress syndrome (NRDS, 23.8%), birth asphyxia (19.8%), neonatal septicemia (19.3%), and congenital anomalies (13.6%). The proportion of NRDS in the causes of neonatal deaths significantly decreased (p = 0.037), while birth asphyxia shown a non-significant growing trend, with the highest percentage of 32.7% in 2020. Further analysis showed that cesarean delivery (OR = 1.75; 95% CI, 1.00-3.05) and primigravida (OR = 1.77; 95% CI, 1.03–3.05) were significantly associated with an increased occurred of neonates died of birth asphyxia in the causes of deaths compared to vaginal delivery and multigravida, respectively. These findings highlight the critical need to focus on birth asphyxia within public health policies. Efforts to enhanced antenatal care and expanding neonatal intensive care units should be considered as an essential components of a long-term prevention strategy to mitigate preventable neonatal mortality in Northwest China.
Descriptive Analysis of Therapeutic Outcomes between Thoracoscopic and Transsternal Thymectomy in Myasthenia Gravis Patients from 2011 to 2021
Authors: Lashkarizadeh Mahdiye , Haghollahi Vahid , Nezhad Nazanin Zeinali , Lashkarizadeh Mohammadreza , Shahpar Amirhossein
Published: May 2024

Background
Myasthenia gravis is an autoimmune disease with high prevalence of thymus disorders, in which, thymectomy is considered one of the therapeutic approaches in improving the patients’ clinical outcomes. Today, thoracoscopic thymectomy has received significant attention than the classic transsternal approach due to fewer complication. Therefore, this study was designed with the aim of investigating the therapeutic outcomes of thymectomy in patients with myasthenia gravis in the Afzalipour Hospital of Kerman between 2011–2021.
Methods
The current study is a descriptive analytical study on patients with myasthenia gravis who underwent surgical thymectomy within 2011–2021. Demographic and clinical characteristics of patients from the time of operation to three years of follow-up were extracted and recorded from clinical records or by phone calls. Data were analyzed using SPSS software.
Results
The data of 70 patients who underwent surgical thymectomy were analyzed. Thymectomy caused a significant reduction in the severity of the disease according to the Osserman classification (P = 0.001). It also significantly reduced the use of corticosteroids (P = 0.001) and IVIG (P = 0.015) compared to the time before the surgery. 78.57% of patients needed to take less medicine than before surgery. Left VATS was associated with less post-operative severity of the disease (P = 0.023). There were only two deaths during the follow-up period.
Conclusion
Overall, the findings of the present study demonstrated that thoracoscopic thymectomy is a useful surgical approach that leads to faster recovery, reducing the severity of the disease, need for medication, and complications in patients with myasthenia gravis, In comparison with the transsternal approach.
Visual acuity screening by school teachers in Far West Nepal: A randomized trial of alternate screening models.
Authors: Awasthi Suresh , Reddy Priya Adhisesha , Bassett Ken L.
Published: May 2024

Background: School vision screening programs are more effective and less costly in comparison to primary eye care model. However, studies have not examined alternate school visual acuity screening methods in Nepal in terms of accuracy and cost. This study was conducted to validate recent evidence from India of the effectiveness and cost of alternate school visual acuity screening models involving all class teachers (ACTs) versus a few selected teachers (STs) from schools in Far West Nepal.
Methods: Nine schools in Far West Nepal were randomly selected for the ACTs which is the intervention arm or STs which is the standard arm. Teachers from both arms were trained to identify children aged 6 years and above with visual acuity 6/9 or worse in either eye as well as obvious ocular abnormalities and refer them to an ophthalmic team from Geta Eye Hospital who visited the schools to examine all children regardless of initial screening. Mean values were compared using student t and Wilcoxon rank sum tests, and proportions were compared between study groups using chi square statistics.
Results: A total of 3793 children in 5 ACTs schools and 2144 children in 4 STs schools were included. ACTs (80 teachers) screened 3713 children and STs (9 teachers) screened 2064 children aged 6 to 15 years. ACTs had better sensitivity (95.1% [95% CI: 91.9- 98.2]) and specificity (92.8% [95% CI: 92.0%-93.6%]) compared to STs: sensitivity (73.2% [95% CI: 64.4- 82.0]) and specificity (85.3% [95% CI: 83.8-86.7]). More children from ACTs than STs reached the Geta Eye Hospital for further investigation within 3 months (n= 10/30 [33.3%] versus n= 5/18 [27.7%]) for ACTs and STs respectively but the difference was not statistically significant. The cost of screening per child with refractive error and or other ocular abnormalities was $3.05 for ACTs and $ 5.29 for STs.
Conclusion: A school vision screening program involving ACTs in Nepal was more accurate than ST screening in identifying refractive error and or other ocular abnormalities at approximately 60% of the cost.
Validation of in vivo dose using EPID combined with fan-beam CT guidance in post-breast-conserving radiotherapy for early-stage breast cancer
Authors: zhu wanli , Fang Jia , Dai Chunyan , Liao Can , Zhao Fei , Wang Yu , Mo Zijie , Zhang Yi , Chen Meiqin , Zhang Hongzhi , Ding Shubo
Published: May 2024

Objective
To explore the application of in vivo dose validation during post-breast-conserving radiotherapy for early breast cancer and the impact of image guidance on validation outcomes, as well as to examine the influence of inter- and intra-fractional variances on dose distribution.
Methods
Twenty-six patients undergoing post-breast-conserving radiotherapy for early-stage breast cancer were selected for in-treatment in vivo dose validation. The retrospective analysis examined the results of in vivo dose validation across different image-guided modalities. Utilizing the image-guided images, the target area and organs at risk were redefined to quantitatively assess the effect of inter- and intra-fractional differences on the dose distribution.
Results
The 3mm3%/3mm5% 2Dγ-pass (gamma pass) rates in the image-guided radiotherapy(IGRT) group were significantly higher than those in the non-IGRT(N-IGRT) group for both left and right breast cancer (p<0.05). Additionally, the 3mm 5% 2Dγ-pass rate of fan beam CT(FBCT) group was higher than that of IGRT group, and was statistically significant (p<0.05). The inter-fractional differences in the left breast cancer patients mainly affected the target area parameters primary gross tumor volume(PGTV) D95, PGTV D2, planning target volume(PTV) D95, PTV D90, heart Dmean and V5, lung V5, and were statistically significant (p<0.05). The effects of intra-fractional differences on dose distribution were statistically significant except for cardiac Dmean (p<0.05). Similarly, inter-fractional differences in right breast cancer patients significantly affected the dose distribution of parameters such as PGTV D95, PGTV D2, PTV D95, PTV D90, Heart Dmean, Lung V5, and were statistically significant (p<0.05), while the effect of intra-fractional differences on dose distribution was statistically significant for all parameters (p<0.05).
Conclusion
Electronic portal imaging device (EPID) in vivo dose validation combined with fan-beam CT image guidance offers an accurate assessment of real-time dose delivery in breast cancer radiotherapy patients. This approach provides a foundation for implementing respiratory motion management and adaptive radiotherapy strategies for breast cancer treatment.