bluuebunny/crossref_metadata_2025 huggingface dataset:
A Retrospective Audit of Treatment Non-Compliance among Osteosarcoma Patients from a Developing Country
Authors:   Department of Orthopedic Surgery, Dow University of Health Sciences, Karachi, Pakistan., Sahito Badaruddin , Ali Sheikh Muhammad Ebad ,   Department of Orthopedic Surgery, Dow University of Health Sciences, Karachi, Pakistan., Saleem Mustafa ,   Department of UGME, Dow University of Health Sciences, Karachi, Pakistan., Soomro Noor Muhammad ,   Department of Orthopedic Surgery, Dow University of Health Sciences, Karachi, Pakistan., Katto Muhammad Soughat ,   Department of Orthopedic Surgery, Dow University of Health Sciences, Karachi, Pakistan., Jatoi Asif ,   Department of Orthopedic Surgery, Dow University of Health Sciences, Karachi, Pakistan.
Published: July 2023

Abstract: Background: The study aims to assess the non-compliance rate along with the factors affecting the non-compliance among osteosarcoma patients presenting in our institution. Materials and Methods: Osteosarcoma patients who were treated at our institution between January 2014 to December 2020 were included in this study. Records were searched from Departmental Cancer Registry for details regarding treatment plans and follow-ups. The data of outcomes were compared with the standard guidelines. Patients who did not attend follow-ups, surgery or chemotherapy were termed as non-compliant. The patients or their next of kins were inquired about the factors behind non-compliance. Results: The study sample included 46 participants where 34 (74.9%) and 12 (26.1%) were male and females, respectively with a mean age of 19.7± 9.7 years. 11 (23.91%) participants were compliant with the prescribed treatment plans that included surgery, neoadjuvant, and adjuvant treatments whereas 35 (76.1%) of the participants were non-compliant either with surgery or chemotherapy. Amongst all included participants, the neoadjuvant chemotherapy plan was followed by 18 (39.13%) and adjuvant chemotherapy was followed by 10 (21.74%) candidates. Surgery was performed in 22 (44.9%). The patients who did not received chemotherapy was attributed to affordability (P=0.008) and patients’ or next to kins’ choices (P=0.02) while age (P=0.039), patients’ consent not given (78.3%; P=0.05), and stage II (52.2%; P=0.048) were predictors of surgical non-compliance. Conclusion: We conclude that the care deferred significantly from the guidelines regarding surgery and chemotherapy. Age, affordability, late stage, and personal choices are the significant predictors for non-compliance for chemotherapy and surgery.
Current Trends Regarding Perioperative Pharmacological Anticoagulation in Lower Limb Surgeries among Orthopedic Surgeons of Pakistan -An Audit
Authors:   Department of Orthopaedic Surgery, Dow University of Health Sciences, Karachi, Pakistan., Ali Sheikh Muhammad Ebad , Sahito Badaruddin ,   Department of Orthopaedic Surgery, Dow University of Health Sciences, Karachi, Pakistan., Qadri Syeda Iqra ,   Department of UGME, Dow University of Health Sciences, Karachi, Pakistan., Naviwala Hira Iqbal ,   Department of UGME, Dow University of Health Sciences, Karachi, Pakistan., Khan Hina ,   Department of UGME, Karachi Medical and Dental College, Karachi, Pakistan., Awan Omer ,   Department of Emergency, Jinnah Postgraduate Medical Center, Karachi, Pakistan., Mushtaq Muhammad Mohsin ,   Department of Emergency, Dow University of Health Sciences, Karachi, Pakistan
Published: July 2023

Abstract:Perioperative anticoagulation has been recommended by AAOS, AACP, and ASH during orthopedic procedures of the lower limb. Guidelines show a difference of opinion regarding the optimum duration and drug of choice giving a way to use different methods of anticoagulation. This audit assessed the preferences for pharmacological anticoagulation in lower limb surgeries among orthopedic surgeons of Pakistan. Materials and Methods: An online questionnaire-based cross-sectional study was started from June-September 2021 in Dr Ruth K.M. Pfau Civil Hospital Karachi where Orthopedic surgeons (n=632) were invited to fill those questionnaires. A total of 85 orthopedic surgeons responded completely. An electronic eight-question survey was designed which included questions about demographics of surgeons, the drug of choice, perioperative duration, preferred surgeries, and average incidence of thromboembolism per year. Results: 12.9% surgeons use anticoagulation for all surgeries while 82.3% of orthopedic surgeons use anticoagulants in selective surgeries. LMWH (94.1%) and Rivaroxaban (17.6%) were the drug of choice for most surgeons. 70.6% of respondents never used anticoagulation preoperatively. 17.7% used it three days preoperatively. 28.24% of surgeons prescribed anticoagulation for 3 days postoperatively while 17.7% of surgeons prescribed anticoagulation for 2 weeks postoperatively. 10.6% of surgeons never used anticoagulation postoperatively. Arthroplasty (71.7%), trauma (55.3%), and pelvis and acetabulum (54.1%) were the subspecialties with routine anticoagulation. 81.2% and 17.7% of surgeons reported less than 1% and 1% to 3% incidence of thromboembolism, respectively. No surgeon reported any incidence of thromboembolism above 5%. Conclusion: Use of anticoagulation is prevalent among orthopedic surgeons in Pakistan. However, significant differences are observed regarding the perioperative duration. The surgeons need to prescribe DOAC such as Rivaroxaban and Dabigatran as agents of choice while extended postoperative pharmacological anticoagulation of 28-35 days needs to be adopted.
Inherited Bone Marrow Failure Syndromes – Challenges and Updates
Authors:   Department of Pathology, Chandka Medical College @ Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan., Jiskani Shahzad Ali , Shaikh Saleem Akhtar ,   Department of Pathology, Chandka Medical College @ Shaheed Mohtarma Benazir Bhutto Medical University, Larkana,  Pakistan., Talpur Rizwan Ali ,   Department of Physiology, Bilawal Medical College, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro,  Pakistan.
Published: July 2023

Abstract: Congenital or inherited bone marrow failure syndromes are hereditary syndromes of diverse nature which are characterized by inadequate production of blood cells causing cytopenias. Failure of bone marrow can be limited to one or more lineages of blood cells, along with symptoms specified to lineage, through it can affect all cell lineages leading to clinical picture like aplastic anemia. These syndromes are genetic diseases of heterogenous nature caused by germline mutations affecting basic pathways of cell including telomerase biology, biogenesis of ribosomes, structural proteins, and repair of DNA. Common inherited bone marrow failure syndromes consist of Schwachman – Diamond syndrome, Diamond – Blackfan anemia, Fanconi anemia, and Dyskeratosis Congenita. These syndromes have different prognosis and tendency to develop solid or hematological malignancies. Therefore, the adequate diagnosis of these disorders and their differentiation from other bone marrow failure syndromes and/or other etiologies of the boe marrow failure is very significant for surveillance and management of patients. Acquired causes may also lead to bone marrow failure including radiations, chemicals, drugs, immune diseases, viral infections, myelodysplastic syndromes, large granular lymphocytic leukemia, or paroxysmal nocturnal hemoglobinuria (PNH). Inherited bone marrow failure syndromes are heritable and affects family members as well, therefore need genetic counselling. In this review, differential diagnosis, various causes, and their pathogenesis are discussed for better understanding of inherited bone marrow failure syndromes.
Pantothenate Kinase Deficiency Related Neurodegeneration (PKAN) – An Ultra Rare Inherited Metabolic Disorder
Authors:   Department of Pediatrics, Azra Naheed Medical College, Lahore, Pakistan., Saeed Mahnoor , Saeed Muhammad ,   Department of Pediatrics, Armed Forces Hospital, Southern Region, KSA., Maqbool Ali ,   Department of Pediatrics, Aga Khan Medical College, Karachi, Pakistan., Alasmari Badriah G. ,   Department of Pediatrics, Azra Naheed Medical College, Lahore, Pakistan., Tahir Ali Mujtaba ,   Department of Pediatrics, Azra Naheed Medical College, Lahore, Pakistan.
Published: July 2023

Abstract: Pantothenate Kinase-related Neurodegeneration (PKAN) is an Autosomal Recessive (AR) inherited disease identified by focal iron accumulation in the basal ganglia. Formerly recognized as Hallervorden-Spatz disease. PKAN is now considered to be one of several diseases that clinically presents with Neurodegeneration due to deposition of iron in brain (NBIA). Here, we describe an eleven-year-old boy identified as typical PKAN.
Mineral–Geochemical and Geotectonic Features of the Lotmvara-II Ultrabasic Sill, Serpentinite Belt (Kola Peninsula)
Authors: Barkov A.Y. , Nikiforov A.A. , Korolyuk V.N. , Martin R.F.
Published: July 2023

—In this paper, we present a description of the characteristics of the Lotmvara-II sill, which is a representative of the Serpentinite Belt (SB) composed of a series of shallowly emplaced ultrabasic intrusive bodies. The Paleoproterozoic SB complexes were derived from a large-scale mantle plume of komatiitic melt. The sill consists predominantly of fine-grained (locally nearly micrograined) harzburgites with subordinate zones of dunites and orthopyroxenites, located in the central and marginal parts, respectively. It formed from an Al-undepleted komatiitic magma of extremely high Mg content and may represent a near-surface laccolithic “ridge.” In general, the sill is comparatively homogeneous and does not have distinct zoning in the distribution of Mg# values in rock compositions (Mg# = 84.2–88.9, average 86.7). Detailed studies show that olivine, chromian spinel, and ilmenite are the most strongly magnesian in the central part of the body. The maximum values of Mg# equal to 90.7–91.4 in the compositions of olivine at the center of the sill are interpreted as “centers of initial crystallization”. The low values of Mg# equal to 73.4–76.4 are attributed to manifestations of the recurrent generation of olivine. The values of Mg# of orthopyroxene in the sill are within the range 84.6 to 92.3. Orthopyroxene grains in a porphyritic texture are surrounded by a rim of calcic amphibole (autometasomatic in origin); they do not differ compositionally from normal grains. The Zn content of the chromian spinel generally decreases toward the marginal parts of the sill. There is an insignificant degree of magmatic differentiation in the sill with respect to the principal components, but incompatible elements (REE and HFSE) locally show increased levels of their relative enrichment, which is reflected in the nature of the mineral associations described. Thus, the sill has a cryptic zonal structure, which is consistent with its overall crystallization from the center to the edges. The data gathered suggest the presence and significant development of volatile components, halogens, CO2, and especially magmatic H2O, which are capable of strongly lowering the liquidus and reducing the density and viscosity of the high-magnesium melt, thereby improving its mobility during ascent from the mantle to the near-surface level of the crust. An increase in fO2 is observed during in situ subvolcanic crystallization of the sill, as noted earlier in the related complexes of the belt. The relatively small volume of the komatiitic magma in the sill crystallized fairly quickly, resulting in unusual mineral intergrowths. Thus, the Lotmvara-II sill is a novel member in the Serpentinite Belt–Tulppio Belt (SB–TB) in the Paleoproterozoic SB–TB megastructure of the Fennoscandian Shield.
Grado de fiabilidad de la evaluación del análisis de Bolton en modelos virtuales tridimensionales versus modelos de yeso. Una revisión
Authors: Loma Salcedo Humberto , Huasco-Huarcaya Nelly Erlinda
Published: July 2023

Introducción: El análisis de Bolton se emplea para determinar anomalías con respecto a la masa dentaria, con fines de diagnóstico y planificación del tratamiento, la posibilidad de utilizar un método digital, que fue introducido y probado para medir el tamaño del diente mesiodistal, es una alternativa atractiva; además, la creciente aceptación de la tecnología dental digital, generó que los modelos de estudio digitales se vuelvan populares en entorno a la ortodoncia. Objetivo: evaluar el grado de fiabilidad de la evaluación del análisis de Bolton en modelos virtuales tridimensionales versus modelos de yeso por medio de una revisión de la literatura. Materiales y métodos: Se realizó una búsqueda en las principales bases de datos de la literatura científica internacional sobre ciencias de la salud: Medline, a través de PubMed, SciELO, Lilacs, Embase. Se incluyeron artículos de revisión publicados entre el año 2000 hasta octubre 2021. Resultados: El escáner de sobremesa fue la mejor opción para la digitalización de modelos dentales, pero esto no quita mérito alguno al CBCT y al escáner láser intraoral, que siguen siendo una opción asequible válida para la digitalización de modelos 3D con resultados que se encuentran dentro del rango “clínicamente aceptable”. Conclusiones: Los modelos digitales 3D generados con escáneres intraorales y escáneres extraorales son confiables y precisos en comparación con las impresiones convencionales y ahorran tiempo. En la mayoría de los casos, se hallaron diferencias estadísticamente significativas, pero de poca relevancia clínica.
Porcentaje de infección respiratoria aguda en menores de cinco años en México. Ensanut Continua 2022
Authors: Ferreira-Guerrero Elizabeth , Delgado-Sánchez Guadalupe , Mongua- Rodríguez Norma , Martínez-Hernández Maribel , Canizales-Quintero Sergio , Ferreyra-Reyes Leticia Dolores , Téllez-Vázquez Norma Araceli , Cruz-Salgado Arturo , Ferreyra-Reyes Leticia Dolores , García-García Lourdes
Published: July 2023

Objetivo. Estimar el porcentaje de infección respiratoria aguda (IRA) en menores de cinco años en las últimas dos semanas en México, de acuerdo con los datos de la Encuesta Nacional de Salud y Nutrición Continua 2022 (Ensanut Continua 2022). Material y métodos. Se analizaron datos de la Ensanut Continua 2022. Resultados. El porcentaje de IRA fue de 27.6% (IC95%: 25.2,30.1). La prevalencia fue mayor en el primer tercil socioeconómico (44.1% [IC95%: 38.0,50.4]). El signo de alarma IRA más identificado fue “verse más enfermo” 33.0% (IC95%: 30.1,36.0) y el menos identificado fue “salir pus del oído” (1.5% [IC95%: 0.9,2.7]). Conclusiones. Las IRA afectan cerca de una tercera parte de los niños y las niñas menores de cinco años en México, particularmente de los hogares con menores capacidades económicas. Es necesario fortalecer las estrategias de prevención, entre ellas la vacunación, el control y la promoción de la salud.
Estado de nutrición de niñas y niños menores de cinco años en México. Ensanut 2022
Authors: Cuevas-Nasu Lucía , Muñoz-Espinosa Alicia , Shamah-Levy Teresa , García-Feregrino Raquel , Gómez-Acosta Luz María , Ávila-Arcos Marco Antonio , Rivera-Dommarco Juan A
Published: July 2023

Objetivo. Actualizar las prevalencias de desnutrición infantil y de sobrepeso más obesidad en menores de cinco años de México, en el ámbito nacional y por grupos de edad y su distribución por variables sociodemográficas. Material y métodos. Se analizó la información de 1 684 menores de cinco años de la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). Se estimaron prevalencias con IC95%, ajustadas por el diseño del estudio, de bajo peso, baja talla, emaciación y sobrepeso más obesidad y su distribución por variables sociodemográficas: tipo de localidad y región de residencia. Resultados. Actualmente, 4.1% tienen bajo peso, 12.8% baja talla y 0.8% emaciación. El sobrepeso más obesidad es de 7.7%. En el Pacífico-Sur y la Península, la baja talla es de 20%. Conclusión. La baja talla es el principal problema de nutrición entre los preescolares, notablemente en los mayores de 24 meses y en los estados del sur. En 12 años se ha estancado la desnutrición crónica en México. La Ensanut 2022 contribuye con información actualizada que permite la focalización de las estrategias hacia las zonas y grupos más vulnerables en México.
Patrones de consumo de alcohol en adolescentes y adultos mexicanos: Ensanut Continua 2022
Authors: Ramírez-Toscano Yenisei , Canto-Osorio Francisco , Carnalla Martha , Colchero M. Arantxa , Reynales-Shigematsu Luz Myriam , Barrientos-Gutiérrez Tonatiuh , López-Olmedo Nancy
Published: July 2023

Objetivo. Caracterizar los patrones de consumo (actual y excesivo) de alcohol en adolescentes y adultos mexicanos. Material y métodos. Se analizó información de la Encuesta Nacional de Salud y Nutrición Continua 2022 (Ensanut Continua 2022) representativa a nivel nacional y regional. Se estimaron las prevalencias de consumo de alcohol actual y consumo excesivo de alcohol en los últimos 12 meses y 30 días. Resultados. En adolescentes, las prevalencias de consumo actual de alcohol, excesivo en los últimos 12 meses y 30 días fueron de 20.6, 13.9 y 5.2%. En adultos, las prevalencias de consumo actual de alcohol, excesivo en los últimos 12 meses y 30 días fueron 55.5, 40.4 y 19.1%. Las prevalencias fueron mayores en hombres que en mujeres, con diferencias significativas en adultos. En adolescentes, las prevalencias fueron mayores a mayor edad, nivel socioeconómico y en aquellos sin estudios. En adultos, las prevalencias fueron mayores a menor edad, mayor nivel socioeconómico y escolaridad, y en áreas metropolitanas. Conclusión. Estos resultados muestran la necesidad de fortalecer las acciones de implementación, seguimiento y protección ofrecidas por la estrategia SAFER para prevenir y reducir el consumo nocivo de alcohol en adolescentes y adultos.
Mapping the virtual water trade in water-scarce basin: An environmentally extended input-output analysis in the Yellow River Basin of China
Authors: Zhang Bin , Niu Niu , Li Hao , Tao Huawei , Wang Zhaohua
Published: July 2023

The mismatch between the distribution of water resources and the industrial structure has led to an increasingly prosperous regional trade, with many water resources flowing from the production to the consumption regions. This paper maps the inside and outside virtual water trade of the Yellow River Basin, applying the environmentally extended input-output model to evaluate the external dependence of water in the Yellow River Basin. The results show that the Yellow River Basin mobilizes 27.2 billion of virtual water flowing into other regions despite water scarcity, equivalent to half the runoff of the Yellow River. The leading destination for outflow is the Eastern coast, and the largest virtual water outflow sector is Agriculture and Manufacturing. The inequity of the inside virtual water trade of the Yellow River Basin is severe, with large amounts of virtual water flowing from poor to rich regions. It exacerbates water scarcity in poor regions.
Economic Sanctions and Environmental Degradation in Iran
Authors: Maddah Majid
Published: July 2023

Iran faces three issues: severe international sanctions, environmental problems, and low institutional quality. Their coexistence makes it challenging to achieve sustainable development goals. While considering the relationship between three issues of sanctions, environmental quality, and corruption, this study investigates the effect of economic sanctions on environmental degradation in Iran using the Partial Least Square of Structural Equation Modeling (PLS-SEM) method during the years 1996-2019. According to the findings, in the short run, economic sanctions directly and positively affect environmental degradation in Iran. Sanctions also have an indirect positive and significant effect on environmental degradation in such a way that intensifying sanctions threaten the environmental quality through corruption channel. Our findings highlight the international attention to the environmental effects of economic sanctions against Iran.
JEL Classification: F51, Q56, D73, C39, O53.
Testing Pathways to Scale: Study Protocol for a Three-arm Randomized Controlled Trial of a Centralized and a Decentralized (“Train the Trainers”) Dissemination of a Mental Health Program for Kenyan Adolescents
Authors: Ochuku Brenda , Osborn Tom L. , Nerima Daisy , Markt Afra van der , Rusch Thomas , Omune Herman , Akello Solace , Ndetei David M , Venturo-Conerly Katherine E
Published: July 2023

Background
Providing mental health care in Kenya to all youth in need is difficult because of a shortage of professional providers and societal stigma. Previous trials of the Anansi model, which involves delivering low-touch mental health interventions through a tiered caregiving model (including lay-providers, supervisors, and clinical experts), have shown its effectiveness for reducing depression and anxiety symptoms in school-going Kenyan adolescents. In this trial, we aim to assess two different scale-up strategies by comparing centralized implementation (i.e., by the organization that designed the Anansi model) against implementation through an implementing partner.
Methods
In this three-arm trial, 1600 adolescents aged 13 to 20 years will be randomized to receive the Shamiri intervention from either the Shamiri Institute or an implementation partner, or to be placed in the treatment as usual (TAU) control group. The implementation partner will be trained and supplied with protocols to ensure that the same procedures are followed by both implementors. Implementation activities will run concurrently for both implementors. The Shamiri intervention will be delivered by trained lay providers to groups of 10–15 adolescents over four weekly sessions which will take place in secondary schools in Machakos and Makueni counties in Kenya. The TAU group will receive the usual care offered by their respective schools. Outcomes will be assessed at baseline, midpoint (two weeks), endpoint (four weeks), and one month follow-up. The analysis will be based on an intent-to-treat approach. Mixed effects models will be used to assess trajectories over time of the primary outcomes (anxiety and depressive symptoms, mental well-being, perceived social support, and academic performance) and secondary outcomes for the intervention groups and the control group. Effect sizes will be computed for the mean differences of the intervention and control arms at midpoint, endpoint, and follow-up.
Discussion
This trial will provide insight into the comparative effectiveness of different strategies for scaling a school-based mental health care model. Findings will also indicate areas for improved efficiency of the model to enhance its replicability by other implementors.
Trial registration
Pan African Clinical Trials Registry (PACTR) (ID: PACTR202305589854478, Approved: 02/05/2023).
Bending Mechanics of the Soft Pneumatic Single Air Chamber Bending Actuator
Authors: Gariya Narendra , Asrani Anjas , Kumar Sanjeev , Nautiyal Hemant
Published: July 2023

The present study aims to quantify the bending of soft pneumatic actuators used in soft robots for different loading conditions. The bending angle was measured for the Ecoflex-OO50 silicone rubber-made hollow beam of different top layer thickness (1, 1.5, and 2 mm) under the pneumatic pressure of 10, 20, 30, 40, and 50 kPa using the analytical modeling using Euler Bernoulli beam theory and FEM analysis tools. The increase in top layer thickness exhibited a decrease in bending angle, while an increase in pressure exhibits an increase in bending angle, from both tools of analysis. However, the modeling technique gave pretty high bending angle values as those obtained from FEM analysis. For the validation, Ecoflex-OO50 (silicon rubber) specimens of the same dimensions, as used in the FEM analysis and analytical model were taken and applied with the same pressure intensity, as in the FEM analysis and analytical model. The values obtained from the actual testing of the material were closer to the value of FEM analysis, the reason for the large difference in actual bending angle values and values obtained by the modeling is the assumptions taken into consideration while applying Euler Bernoulli beam theory.
Deconstructing Job Search Behavior
Authors: Banfi Stefano , Choi Sekyu , Roldan Benjamin Villena
Published: July 2023

We use online job board data to document novel facts regarding unemployment and on-the-job searches. We define a relevant set of job ads using the bipartite network between ads and applicants and show how applications are affected by demographics such as gender, age, and marital status as well as timing variables like unemployment duration, job tenure, and cyclical conditions. We also study the selective margin, i.e., how the posted-expected wage gap and the applicant fit into ad requirements such as education, experience, location, and occupation affect applications. This evidence can help discipline current and future search theories.
JEL Codes: E24, J40, J64
Non-volatile rippled-assisted optoelectronic array for all-day motion detection and recognition
Authors: Wang Yang , Pang Xingchen , zhang zhenhan , Xiang Du , Wu Haoqi , Jiang Yongbo , Liu Zizheng , Liu Xiaoxian , Liu Chunsen , Hu Weida , Zhou Peng
Published: July 2023

In-sensor processing has the potential to reduce the energy consumption and hardware complexity of motion detection and recognition (MDR). However, the state-of-the-art all-in-one array integration technologies with simultaneous broadband spectrum image capture (sensory), image memory (storage) and image processing (computation) functions like snake vision systems are still insufficient. Here, macroscale (2 × 2 mm2) integration of a rippled-assisted optoelectronic (RAO) array (18 × 18 pixels) mimics the characteristics of snake vision systems for all-day motion detection and recognition. The RAO array exhibits remarkable uniformity in the memory window, optically stimulated non-volatile positive and negative photoconductance (NV-PPC and NV-NPC). Importantly, the array achieves an extensive optical storage dynamic range exceeding 106, and exceptionally high room-temperature mobility up to 406.7 cm2 V-1 s-1, four times higher than the International Roadmap for Device and Systems (IRDS) 2028 target. Additionally, the spectral range of each RAO processor covers visible to near-infrared (405 nm to 940 nm), achieving detection and recognition of a man riding an electrical bicycle in both bright and dark environments.
Risk Factors for Falls in the Older Adult with Diabetes Mellitus: Systematic Review and Meta-Analysis
Authors: Freire Larissa Barros , Neto Joaquim Pereira Brasil , Silva Marianne Lucena , Cruz Lorranne Matos , Miranda Milena Gonçalves Cruz , Martins Wagner Rodrigues , Paz Leonardo Petrus da Silva
Published: July 2023

Aim
To identify risk factors for falls in the older adults with Type 2 Diabetes Mellitus (T2DM).
Methods
The eligible studies identified factors associated with the risk of falls in older adults with DM. We searched PubMed, Cinahl, Web of Science, Scopus, and the Cochrane Library databases for studies beginning April 2020 through July 2021 (CRD42020193461).
Results
Twelve studies met the inclusion criteria, and eight studies were included in the meta-analysis. These studies included a total of 40,778 older adults with T2DM 60 to 101 years in. The risk of falls in T2DM older adults is 63% compared to the occurrence of falls in the non-diabetics (HR 1.63; 95% CI [1.30–2.05]). While the chance of falls in older adults with T2DM is 59% than non-diabetic older adults (OR 1.59; 95% CI [1.36–1.87]) and the chance of falls in older adults with T2DM who take insulin is 162% (OR 2.62; 95% CI [1.87–3.65]). No results were found in studies on diabetic polyneuropathy.
Conclusion
T2DM older adults have a higher risk of falls compared to non-diabetics. Among the T2DM older adults, the most important factor associated with a higher risk of falls was insulin use.
Trial registration:
Registered in the International Prospective Register of Systematic Reviews (CRD42020193461).
The global distribution and climate resilience of marine heterotrophic prokaryotes
Authors: Heneghan Ryan , Holloway-Brown Jacinta , Gasol Josep , Herndl Gerhard , Morán Xosé Anxelu , Galbraith Eric
Published: July 2023

Heterotrophic Bacteria and Archaea (prokaryotes) are a major component of marine food webs and global biogeochemical cycles. Yet, there is limited understanding about how prokaryotes vary across global environmental gradients, and how they may be affected by climate change. Here, using parametric statistical models fit to a global dataset of prokaryotic abundance and cell carbon, we find that prokaryotic biomass varies by only 2-fold across the global ocean’s surface waters, despite phytoplankton varying by >2 orders of magnitude, while prokaryote abundance increases with temperature by 2.6% per °C. As a result, in contrast to the 10% projected decline in global biomass of larger heterotrophs (zooplankton and fish), prokaryote biomass will decline only 3% by 2100 under climate change. Thus, future oceans could be increasingly dominated by heterotrophic prokaryotes, diverting a larger share of primary production away from larger heterotrophs and into microbial food webs.
An anatomical approach to the Tarsal Tunnel Syndrome: What can ankle’s medial side anatomy reveal us?
Authors: Lopes Jorge , Rodrigues-Pinho André , Relvas-Silva Miguel , Vital Luisa , Serdoura Francisco , Sousa António Nogueira , Pinto Filipe Fonseca , Neves Maria Abreu , Madeira Dulce , Pereira Pedro
Published: July 2023

Background
The heel is a complex anatomical region and is very often the source of pain complaints. The medial heel contains a number of structures, capable of compressing the main nerves of the region and knowing its anatomical topography is mandatory. The purpose of this work is to evaluate if tibial nerve (TN) and its main branches relate to the main anatomical landmarks of the ankle’s medial side and if so, do they have a regular path after emerging from TN.
Methods
The distal part of the legs, ankles and feet of 12 Thiel embalmed cadavers were dissected. The pattern of the branches of the (TN) was registered and the measurements were performed according to the Dellon–McKinnon malleolar-calcaneal line (DML) and the Heimkes Triangle (HT).
Results
The TN divided proximal to DML in 87.5% and distal in none of the feet. The Baxter’s nerve (BN) originated proximally in 50% and distally in 12.5% of the cases. The correlation between specimens’ height and DML’s length was weak (ρ: 0.336). There was a significant correlation between the length of DML and the distance from the center of the medial malleolus to the lateral plantar (LPN) and medial plantar (MPN) nerves (ρ: 0.910 and 0.866, respectively, p < 0.01) but not to BN (ρ: 0.083; p value: 0.70).
Conclusions
In our sample the TN divides distal to DML in none of the cases. Therefore, a compression of the TN itself can be a more uncommon cause of heel pain. We also report a strong association between ankle size and the distribution of the MPN and LPN but not for BN.
Peri-partum Respiratory Management of Pregnant Women With Neuro-muscular Disorders: a Prospective Observational Study (IT-NEUMA-Pregn study)
Authors: Racca Fabrizio , Longhitano Yaroslava , Zanza Christian , Balzanelli Mario , Draisci Gaetano , Stoia Paolo Augusto , Gollo Evelina , Maio Mariella , Grattarola Claudia , Astuto Marinella , Ciccarelli Antonio , Racca Giulia , Romenskaya Tatsiana , Giordano Benedetta , Serraino Alessandra , Sansone Valeria Ada Maria , Gregoretti Cesare , CONTI GIORGIO , PICCOLELLA FABIO , Vachetto Rosanna
Published: July 2023

Background.
Pregnant women with neuromuscular diseases (NMDs) often display respiratory muscle impairment which increases the risk for pulmonary complications (PCs). The aim of this study was to identify pregnant NMDs patients with pulmonary risk factors and to apply in these women non-invasive ventilation (NIV) combined with mechanical insufflation-exsufflation (MI-E) in the peri-partum period.
Methods.
We conducted a multicenter observational study on women with NMDs undergoing cesarean section or spontaneous labor in a network of 7 national hospitals. In these subjects we applied a protocol for screening and preventing PCs, and we evaluated PCs rate, maternal and neonatal outcome.
Results.
Twenty-four patients out of the 94 enrolled pregnant women were at risk for PCs and were trained or retrained to use NIV and/or MI-E before delivery. After delivery, 17 patients required NIV with or without MI-E. Despite nine out of the 24 women at pulmonary risk developed postpartum PCs, none of them needed reintubation nor tracheostomy. In addition, the average birth weight and Apgar score were normal. Only one patient without pulmonary risk factors developed postpartum PCs.
Conclusion.
This study showed the feasibility of applying a protocol for screening and treating pregnant NMDs women with pulmonary risk. Despite a PCs rate of 37% was observed in these patients, maternal and neonatal outcome were favorable.
Raman Spectroscopy-based Prediction of Ofloxacin Concentration in Solution Using a Novel Loss Function and an Improved GA-CNN Model
Authors: Ma Chenyu , Shi Yuanbo , Huang Yueyang , Dai Gongwei
Published: July 2023

Background: A Raman spectroscopy method can quickly and accurately measure the concentration of ofloxacin in solution. This method has the advantages of accuracy and rapidity over traditional detection methods. However, the manual analysis methods for the collected Raman spectral data often ignore the nonlinear characteristics of the data and cannot accurately predict the concentration of the target sample.
Methods: To address this drawback, this paper proposes a novel Kernel-Huber loss function that combines the Huber loss function with the Gaussian kernel function.This function is used with an improved Genetic Algorithm-Convolutional Neural Network (GA-CNN) to model and predict the Raman spectral data of different concentrations of ofloxacin in solution. In addition, the paper introduces recurrent neural networks (RNN), long short-term memory (LSTM), bidirectional long short-term memory (BiLSTM) and gated recurrent units (GRU) models to conduct multiple experiments and use root mean square error (RMSE) and residual predictive deviation (RPD) as evaluation metrics.
Results: The proposed method achieved an R2 of 0.9989 on the test set data and improved by 3.03% over the traditional CNN. Multiple experiments were also conducted using RNN, LSTM, BiLSTM, and GRU models and evaluated their performance using RMSE, RPD, and other metrics. The results showed that the proposed method consistently outperformed these models.
Conclusions: This paper demonstrates the effectiveness of the proposed method for predicting the concentration of ofloxacin in solution based on Raman spectral data, in addition to discussing the advantages and limitations of the proposed method, and the study proposes a solution to the problem of deep learning methods for Raman spectral concentration prediction.
Added value of Eastern Cooperative Oncology Group-Performance Status to Quick Sequential Organ Failure Assessment for predicting 30-day mortality in older patients admitted with suspected infections
Authors: Kudo Masataka , Sasaki Sho , Takada Toshihiko , Fujii Kotaro , Yagi Yu , Yano Tetsuhiro , Sada Ken-ei , Fukuhara Shunichi , Suganuma Narufumi
Published: July 2023

Background Quick Sequential Organ Failure Assessment (qSOFA) is a simple and easy tool for identifying patients with suspected infection, who are at a high risk of poor outcome. However, its predictive performance is still insufficient. The Eastern Cooperative Oncology Group performance status (ECOG-PS) score, a tool to evaluate physical function, has been recently reported to be useful in predicting the prognosis of patients with pneumonia. We aimed to evaluate the added value of ECOG-PS to qSOFA in predicting 30-day mortality in older patients admitted with suspected infections.Methods Between 2018 and 2019, we prospectively collected data from adults aged 65 years or older, admitted with suspected infection at two acute care hospitals. Predictive performance was compared between two logistic regression models: one using qSOFA score alone (qSOFA model) and the other in which ECOG-PS was added to qSOFA (extended model).Results Of the 1536 enrolled patients, 135 (8.8%) died within 30 days. The area under the curve of the extended model was significantly higher than that of the qSOFA model (0.68 vs. 0.64, p = 0.008). When the risk groups were categorized as follows: low (< 5%), intermediate (5–10%), and high (≥ 10%), 5.0% of those who died and 2.1% of those survived were correctly reclassified by the extended model with an overall categorized net reclassification improvement of 0.03 (95% confidence interval: -0.06 to 0.30).Conclusions Adding the ECOG-PS score could improve the performance of qSOFA in predicting mortality in older patients admitted with suspected infection.
Current cough and sputum assessed by the Cough And Sputum Assessment-Questionnaire (CASA-Q) is associated with quality of life impairment in cystic fibrosis
Authors: Charon Lucie , Launois Claire , Perotin Jeanne-Marie , Ravoninjatovo Bruno , Mulette Pauline , Ancel Julien , Guillard Thomas , Muggeo Anaëlle , Dormoy Valérian , Griffon Muriel , Carré Sophie , Lebargy François , Deslée Gaëtan , Dury Sandra
Published: July 2023

Background Cough and sputum are major symptoms in cystic fibrosis (CF) that contribute to the impairment of quality of life.Methods This prospective monocentric cross-sectional pilot study aimed to describe the results of the Cough and Sputum Assessment Questionnaire (CASA-Q) in CF adult patients at stable state, and to analyse associations with clinical, functional, microbiological, radiological data, and two quality of life scales: the Cystic Fibrosis Questionnaire Revised (CFQ-R) and the Saint George Respiratory Questionnaire (SGRQ).Results Forty-eight patients were included in this analysis (69% men; median age of 27.8 years; median body mass index of 21.8 kg/m²; mean FEV1 of 64% of the predicted value). The mean values of the CASA-Q domains were 58 for cough symptoms, 77 for cough impact, 62 for sputum symptoms and 84 for sputum impact. Impairment in CASA-Q cough and sputum domains was associated with dyspnea mMRC scale and exacerbations in the previous year. We also found correlations between all domains of the CASA-Q and quality of life questionnaires including SGRQ and to a lesser extend CFQ-R. We identified a clinical phenotype (female gender, ΔF508 heterozygous mutation, dyspnea mMRC scale) associated with an impairment of CASA-Q score and quality of life.Conclusions CASA-Q allows the assessment of cough and sputum in CF adult patients and is associated with quality of life impairment. This simple easy-to-use tool could be used in routine clinical practice and in clinical studies to assess cough and sputum in CF patients.Trial Registration The study was registered on ClinicalTrials.gov (NCT02924818) on 5th October 2016.
PVA enema ameliorates DSS-induced acute colitis in mice
Authors: Zhang Zhiyong , Kong Lingnan , Lv Ming , Yao Yukuan , Gao Li , Zhou Ruchen , Ma Wenlong , Li Jing
Published: July 2023

Background
Polyvinyl alcohol (PVA) solution is a biodegradable polymer material with the main component of glue. PVA can now be used in the medical field. Ulcerative colitis (UC) is a clinically intractable disease with persistent damage to the colonic epithelial mucosa as the main pathological change. The research aims to explore the therapeutic effect of PVA water solution on UC in mice.
Methods
The UC model was induced by dextran sulfate sodium, and the therapeutic effects of different concentrations of PVA water solution on the model mice were observed. Besides the changes in mouse body weight, clinical disease activity index, and colon length were recorded. Histopathological examination staining and inflammatory factors levels were used to evaluate the degree of colonic tissue damage and inflammation. Furthermore, mouse colon organoids were cultured, which were used to assess the effects of different concentrations of PVA aqueous solution on the number of organoids in vitro.
Results
We reported that treatment with PVA aqueous solution (1 mg/ml and 3 mg/ml) can significantly alleviate the weight loss of the colitis group, and dramatically improve histopathology scores, meanwhile the levels of inflammatory factors in intestinal mucosal tissue were decreased. It was also confirmed that PVA could greatly increase the number of colonic organoids in vitro.
Conclusions
In summary, PVA can relieve tissue damage and clinical symptoms of ulcerative colitis. We infer that the underlying mechanism may be related to promoting intestinal stem cell proliferation by PVA, which might in turn promote the repair of intestinal mucosal damage. This study might provide a new candidate for the clinical treatment of ulcerative colitis.
Value of Endoscopic Ultrasonography in Diagnosis and Invasion Risk Classification of Submucosal Tumors
Authors: Dai Li , Ning Bo
Published: July 2023

Objective:To explore the value of endoscopic ultrasonography (EUS) in the diagnosis and invasion risk classification of submucosal tumor (SMT).
Method:197 patients with gastric SMT diagnosed by EUS in Second Affiliated Hospital of Chongqing Medical University were enrolled by retrospective study, with a total of 197 lesions.Taking the results of pathological examination as the diagnostic gold standard, the coincidence rate of EUS diagnosis and pathological examination results in patients with gastric SMT was calculated.The demographic data and EUS characteristics of patients were collected, and the patients with gastric SMT were divided into coincidence group and non-coincidence group, and the factors affecting the coincidence rate were analyzed.Patients with gastric stromal tumor(GST) and other types of gastric SMT were divided into very low, low, medium and high-risk groups, and the factors predicting the invasion risk classificationwere analyzed.Finally, the coincidence rate between the preoperative plan based on EUS diagnosis and the final actual surgical plan is calculated.
Result:The coincidence rate of EUS diagnosis and pathological examination results in patients with gastric SMT was 69.04%(136/197).The coincidence ratewas higher in older patients over 60(P<0.05). The proportion of ultrasonic inhomogeneity inside the lesions that meet the diagnosis is significantly higher than that inside the lesions that do not meet the diagnosis (P<0.05).The patient's age > 60 years old and the ultrasonic inhomogeneitywere independent influencing factors of the coincidence rate (P<0.05).The higher the risk of invasion, the more common ultrasonic inhomogeneity, blood flow signal inside the lesions and unclear boundary (P<0.05).Ultrasonic inhomogeneity and blood flow signal inside the lesions were independent influencing factors to predict the invasion risk classification(P<0.05).One patient failed to isolate the lesion during the surgery, and the others were successful.The coincidence rate of surgical plan was 99.49%(196/197).
Conclusion:The results of EUS diagnosis and pathological examination in patients with gastric SMT have good consistency.The patient's age is over 60 years old, ultrasonic inhomogeneityinside the lesions, and the coincidence rate of EUS is higher.The EUS characteristics of gastric SMT patients with different invasion risk classification are different.Ultrasonic inhomogeneityand blood flow signal inside the lesions are important signs to predict the invasion risk classification.EUS can help doctors choose the surgical plan.
Acoustic Performance of Flexible Polyurethane Composite Foams Filled with Melamine Particles
Authors: Yun Dongju , Kim Jung H
Published: July 2023

PU foams are widely used in the automobile industry for their lightweight properties, and as sound-absorbing and seat cushioning materials. The effects of additives on the sound absorption properties of PU composite foams were investigated. PU foams containing 3 wt% melamine particles showed excellent sound absorption properties. However, when the filler content exceeded 3 wt%, particle agglomeration occurred, leading to reduced sound absorption properties. A dispersant was added during the fabrication process to improve the interfacial compatibility between the PU matrix and melamine particles, resulting in a well-developed cavity and pore structure. The sound absorption characteristics of the PU composite foams were significantly improved in the frequency range below 2000 Hz. Our study highlights the importance of adjusting the concentration of additives and optimizing the cavity and pore structure of the material for achieving better sound absorption properties in PU composite foams.
Woven-like internal carotid artery anomaly associated with transient ischemic attack: A case report
Authors: Mei Yuexin , Chen Hongbing , Chen Xinran
Published: July 2023

Background: Woven-like arteries represent a rare congenital vascular variation with only a handful of cases documenting for coronary arteries. The standard diagnostic approach employs angiographic imaging. This vascular anomaly often mimics other vascular diseases, such as stenosis, dissection, or recanalization following a thrombotic occlusion. Accurate differential diagnosis of such woven-like lesions plays an important role in defining treatment strategies.
Case presentation: A 62-year-old female presented with intermittent numbness and weakness on her right side. She was diagnosed with transient ischemic attack, which was associated with woven-like changes in the ipsilateral internal carotid artery revealed by cerebral angiography. Following the diagnosis, the patient was started on secondary preventative strategy to mitigate the risk of an ischemic stroke. Over a follow-up period of 2 years, the patient showed no significant signs of a cerebrovascular event.
Conclusions: To our knowledge, this case presents the first recorded instance of a woven-like change in the internal carotid artery. Identification of this rare vascular anomaly is of great clinical significance. This case underscores the importance of including rare vascular variations in the differential diagnosis to help make effective and personalized patient management choices.
The self-assembly of L-histidine might be the cause of histidinemia
Authors: Narayanan Sunilkumar , Ajikumar Ajitha , Premkumar Anakha
Published: July 2023

L-histidine is an essential amino acid with unique biochemical and physiological properties. Histidinemia is a disease condition caused by the elevated level of L-histidine in our blood. Mutations in the histidase, an enzyme for the breakdown of histidine, is the cause of the rise in histidine concentration. To our knowledge, no research has been done on why a high concentration of histidine causes histidinemia. In this study, we provide a potential explanation why the elevated levels of histidine in the human body causes histidinemia. In this study we have found that L-histidine self-assembled in water to form nano sheet structures at physiological pH and temperature, using NMR spectroscopy and Scanning Electron Microscope techniques. The kinetics of self-assembly has been studied using real time NMR spectroscopy. We observed that both the aromatic ring and aliphatic part are equally contributing to the self-assembly of L-histidine. The symptoms of histidinemia, neurological deficits and speech delays, are similar to that of the neurodegenerative diseases caused by the self-assembly of peptides and proteins. We speculate that the self-assembly of L-histidine might be the cause of histidinemia