bluuebunny/crossref_metadata_2025 huggingface dataset:
Person-centered Care Assessment Tool, a focus in quality healthcare: A systematic review of psychometric properties
Authors: Bru-Luna Lluna María , Martí-Vilar Manuel , Merino-Soto César , Livia-Segovia José , Garduño-Espinosa Juan , Toledano-Toledano Filiberto
Published: May 2023

Background
The person-centered care (PCC) approach plays a fundamental role in ensuring quality healthcare. The Person-centered Care Assessment Tool (P-CAT) is one of the shortest and simplest tools available today to measure the PCC approac. This systematic review’s objective was to conduct a systematic review of the evidence in the validation studies of the P-CAT, taking the "Standards" as a frame of reference.
Methods
First, a systematic literature review was conducted following the PRISMA method. Second, a systematic descriptive literature review of validity tests was conducted following the "Standards" framework. The search strategy and information sources, was made through Cochrane, Web of Science (WoS), Scopus and PubMed databases were searched. Eligibility criteria and selection process, a protocol was registered in PROSPERO (CRD42022335866), and the articles had to meet inclusion criteria to be included in the systematic review.
Results
Empirical evidence indicated that these validations offer a high number of sources related to test content, internal structure for dimensionality and internal consistency. Moderate number of sources pertaining to internal structure in terms of test-retest reliability and for the relationship with other variables. And very low numbers of evidences for response processes, internal structure in measurement invariance terms, and test consequences.
Conclusions
The various validations of the P-CAT are not framed in a structured theoretical framework like the "Standards" are.This can affect clinical practice, as people's health may depend on it. The findings of this study show that validation studies continue to focus on the types of validity traditionally studied, leaving aside the interpretation of the scores in terms of their intended use.
Multi-response optimization of Mathematical, ANN, and ANFIS models using the Pareto search algorithm in combination with the I-optimal design of mixture experiments for WEDM of Inconel 718 superalloy
Authors: Hewidy Mahmoud , Salem Osama
Published: May 2023

Inconel 718 is a superalloy with a high nickel content that is widely used in applications requiring solid mechanical behavior and resistance to oxidation and corrosion at high temperatures. This alloy has numerous applications in manufacturing steam turbine and jet aircraft interiors, aviation sector manifolds, and rotary spindles. It can be classified as a difficult-to-cut material unsuitable for traditional machining. The purpose of this paper is to develop prediction models for a wire electrical discharge machining (WEDM) process using response surface methodology (RSM), artificial neural networks (ANN), and adaptive neuro-fuzzy inference systems (ANFIS) and to determine which model is better at making accurate predictions. Pulse_ontime, pulse_offtime, servo voltage, flushing pressure, and wire feed were considered the main factors affecting volumetric material removal rate (VMRR) and arithmetic surface roughness (Ra), which were evaluated as WEDM performance characteristics. I-optimal design made with a computer algorithm was employed to develop experimental models. The results reveal that the wire feed and pulse_ontime were the most vital factors influencing VMRR, respectively, and the most significant factor influencing Ra is the pulse_ontime. The total percentage error of the three models demonstrated that the ANN and ANFIS models are more reliable and accurate than the RSM mathematical model. Finally, multi-objective optimization using the Pareto search algorithm was used to optimize mathematical, ANN, and ANFIS models to determine the optimum WEDM process parameters for machining Inconel 718 superalloy.
Prevalence of tissue Transglutaminase Antibodies and IgA deficiency are not increased in Juvenile Idiopathic Arthritis: A case-control study.
Authors: Taneja Angela , Hersh Aimee O. , Ponder Lori , Chan Lai Hin Kimi , Rouster-Stevens Kelly A. , Tebo Anne E , Kugathasan Subra , Guthery Stephen L. , Bohnsack John F. , Prahalad Sampath
Published: May 2023

Background: The prevalence of Celiac Disease (CD) in Juvenile Idiopathic Arthritis (JIA) has been reported to be 0.1% to 7% in various small studies. As a result of the limited number of research and their inconclusive results there are no clear recommendations for routine CD screening in asymptomatic patients with JIA. Our aim is to estimate the prevalence of IgA deficiency and tissue transglutaminase (tTG) IgA in a cohort of JIA followed in two large academic medical centers.
Methods: Serum was collected and stored from all subjects and analyzed in a reference laboratory for total IgA (Quantitative Nephelometry) and tTG IgA antibody levels (Semi-Quantitative Enzyme-Linked Immunosorbent Assay). Fisher’s exact tests were performed for statistical significance. Risk estimates (odds ratios) with 95% confidence intervals were calculated.
Results: 808 JIA and 140 controls were analyzed. Majority were non-Hispanic whites (72% vs 68% p=ns). A total of 1.2% of cases were IgA deficient compared to none of the controls (p=0.373). After excluding IgA deficient subjects, 2% of cases had tTG IgA >4u/mL compared to 3.6% of controls (p=0.216) (OR = 0.5; 95% C.I= 0.1-1.4); and 0.8% of cases had tTG IgA >10u/mL compared to 1.4% of controls (p=0.627) (OR=0.5; 95%C.I=0.1-2.9).
Conclusions: Using the largest JIA cohort to date to investigate prevalence of celiac antibodies, the prevalence of positive tTG IgA was 0.8% and of IgA deficiency was 1.2%. The results did not demonstrate a higher prevalence of abnormal tTG IgA in JIA. The study did not support the routine screening of asymptomatic JIA patients for Celiac Disease (CD).
Transcriptional effects of carbon and nitrogen starvation on Ganoderma boninense, an oil palm phytopathogen
Authors: Nagappan Jayanthi , Ooi Siew-Eng , Chan Kuang-Lim , Kadri Faizun , Nurazah Zain , Halim Mohd Amin Ab , Sanusi Nik Shazana Nik Mohd , Angel Lee Pei Lee , Sundram Shamala , Chin Chiew Foan , May Sean T , Ong-Abdullah Meilina , Singh Rajinder , Low Eng Ti Leslie
Published: May 2023

Background
Ganoderma boninense is a phytopathogen of oil palm, causing basal and upper stem rot diseases.
Methods
The genome sequence was used as a reference to study gene expression during growth in a starved carbon (C) and nitrogen (N) environment with minimal sugar and sawdust as initial energy sources. This study was conducted to mimic possible limitations of the C-N nutrient sources during the growth of G. boninense in oil palm plantations.
Results
Genome sequencing of an isolate collected from a palm tree in West Malaysia generated an assembly of 67.12 Mb encoding 19,851 predicted genes. Transcriptomic analysis from a time course during growth in this starvation media identified differential expressed genes (DEGs) that were found to be associated with 30 metabolic pathways. During the active growth phase (Day2), 27 DEGs related to four pathways, including secondary metabolite biosynthesis, carbohydrate metabolism, glycan metabolism and mycotoxin biosynthesis. G. boninense genes involved in the carbohydrate metabolism pathway that contribute to the degradation of plant cell walls were up-regulated. Interestingly, several genes associated with the mycotoxin biosynthesis pathway were identified as playing a possible role in pathogen-host interaction. Several genes associated with mycotoxin biosynthesis were associated with pathogen-host interactions. In addition, metabolomics analysis revealed six metabolites, maltose, xylobiose, glucooligosaccharide, glycylproline, dimethylfumaric acid and arabitol that were up-regulated on Day2 of the time course.
Conclusions
This study provides information on genes expressed by G. boninense in metabolic pathways that may play a role in the initial infection of the host.
Success of Caries and Periapical Infection Diagnoses on Panoramic images: Artificial Intelligence vsJunior and Specialist Dentists
Authors: Güneç Hüseyin Gürkan
Published: May 2023

Purpose: The aim of this study is to evaluate the success rate of radiological diagnoses regarding caries and periapical infection, comparing an artificial intelligence application against junior dentists, based on the valid determinations by specialist dentists.
Methods: In the initial stage of the study, 2 specialist dentists evaluated the presence of caries and periapical lesions on 500 digital panoramic radiographs, and the detection time was recorded in seconds. In the second stage, 3 junior dentists and an artificial intelligence application performed diagnoses on the same panoramic radiographs, and the diagnostic results and durations were recorded in seconds.
Results: The artificial intelligence and the three junior dentists, respectively, detected dental caries at an SEN of 0.907,0.889,0.491,0.907; a SPEC of 0.760,0.740,0.454,0.769660; a PPV of 0.693,0.470,0.155,0.666; an NPV of 0.505,0.415,0.275,0.367 and an F1-score of 0.786,0.615,0.236,0.768. The artificial intelligence and the three junior dentists respectively detected periapical lesions at an SEN of 0.973,0.962,0.758,0.958; a SPEC of 0.629,0.421,0.404,0.621; a PPV of 0.861,0.651,0.312,0.648; an NPV of 0.689,0.673,0.278,0.546 and an F1-score of 0.914,0.777,0.442,0.773.
Conclusion: The artificial intelligence application gave more accurate results, especially in detecting periapical lesions. On the other hand, in caries detection, the underdiagnosis rate was high for both artificial intelligence and junior dentists. Regarding the evaluation time needed, artificial intelligence performed faster, on average.
Effect of corneal collagen cross linking on crystalline lens clarity graded by Pentacam Nucleus Staging Software
Authors: Fahmy Amr Ehab , Barrada Ahmed Hassan , khalil Mahmoud Mohammed Ahmed Ali
Published: May 2023

Background
to describe the effect of ultraviolet rays dissipated during corneal collagen crosslinking on cataract development in keratoconus patient in Cairo, Egypt.
Methods
We performed a descriptive prospective study that will assess the influence of uneventful corneal collagen crosslinking in management of keratoconus on the crystalline lens clarity in one hundred Eye by oculus pentacam nucleus staging (PNS) for patients attending the specialist eye hospital at the military medical complex of Kobri el Kobba in collaboration with Al-Azhar university hospitals diagnosed from January 2021.
Results
Our study reported that corneal collagen crosslinking has a highly significant effect in developing lens opacities specially the older age and small AC depth and reported also its affection on visual acuity.
Conclusion
Corneal collagen cross linking as a method of stabilizing keratoconus progression results in significant changes and increase in the densitometry of the crystalline lens which is a problem that increase the risk in the development of cataract, this is particularly in patient more exposed to ultraviolet rays and pre CXL high lens densitometry.
Lubrication performance of nano molybdenum disulfide as additive in drilling fluid in polycrystalline diamond compacts
Authors: Gou Ruyi , Chen Jingjing , Li Jinhe , Luo Xun
Published: May 2023

The effects of nano-molybdenum disulfide (nano-MoS2) in drilling fluid and drilling fluid on the tribological behavior of polycrystalline diamond compact (PDC) with cobalt leaching depth of 422µm were studied by ball-on-disk friction test, and the effects of concentration and bearing capacity were evaluated respectively. The results showed that the addition of nano-MoS2 improves the lubrication effect of drilling fluid and the friction performance of PDC. The lubrication mechanism of drilling fluid and the mechanism of adding nano-MoS2 to improve tribological properties are discussed. The results further deepen the understanding of the friction and wear mechanism of PDC in lubricating environment, and provide a theoretical reference for the application of PDC in the future petroleum field.
Comparative efficacy and safety of anti-PD-1/L1 antibody plus anti-VEGF antibody and anti-PD-1/L1 antibody plus VEGFR-targeted tyrosine kinase inhibitor as first-line therapy for unresectable hepatocellular carcinoma (uHCC): a systematic review and network meta- analysis
Authors: Zhou Yiwen , Li Jingjing , Lu Beibei , Zheng Yuxi , Ying Jieer
Published: May 2023

Background
Anti-PD-1/L1 antibody + anti-VEGF antibody (A + A) and anti-PD-1/L1 antibody + VEGFR-targeted tyrosine kinase inhibitor (A + T) are both effective first-line therapies for uHCC. However, direct comparisons between them are not available. We conducted a network meta-analysis of them in terms of overall survival (OS), progression free survival (PFS), objective response rate (ORR) and incidence of treatment-related adverse events (TRAEs).
Methods
After a rigorous literature research, 6 phase III trials has been identified for the final analysis: IMbrave150, ORIENT-32, COSMIC-312, CARES-310, LEAP-002 and REFLECT. The experiments were classified into three groups: A + A, A + T and intermediate reference group. We derived hazard ratios (HR) with 95% confidence intervals (95%CI) for OS and PFS, odds ratio (OR) for ORR and relative risks (RR) for all grade and ≥ 3 TRAEs. With fixed effect models to estimate the indirect pooled HRs, ORs, RRs and 95%CI, a frequentist network meta-analysis was conducted using sorafenib as intermediate reference.
Results
With a P-score of 98%, A + A provided the greatest reduction in the risk of death, without significant difference from A + T (HR = 0.84, 95%CI: 0.66–1.06). Besides, A + T showed the greatest effect in prolonging PFS and improving ORR with 91% for P-score, but there are no statistical differences with A + A(HR = 1.06, 95%CI: 0.87–1.30, OR = 0.82, 95%CI: 0.47–1.46). A + A were significantly safer than A + T (RR = 0.91, 95%CI: 0.84–0.98) in all grade of TRAEs and ≥ 3 (RR = 0.91, 95%CI: 0.84–0.98).
Conclusions
A + A has the greatest probability of delivering the longest OS, while A + T is correlated with larger PFS benefit at the cost of a lower safety rate.
Characterization of Biofilm Structures Produced by Some Plant Growth Promoting Bacteria and Their Colonization on Plant Roots
Authors: Çiftçi Tacettin , Çınarlı Murat , Erdoğan İbrahim
Published: May 2023

Plant growth promoting rhizobacteria (PGPR) increase plant root development and provide plants with maximum nutrient uptake opportunities for better growth. Besides promoting growth, PGPRs have a number of functions including stress tolerance (heat, drought, salinity and disease), bioremediation of heavy metals, biodegradation of complex toxic organic compounds, biocontrol agents and biofilm formation. The interaction between various plant growth promoting rhizobacteria was mainly investigated under the planktonic growth mode. In-depth investigation of biofilm development on root surface and rhizosphere colonization is needed to improve understanding of plant-microorganism interaction. In this study; The biofilm structures formed by Bacillus drentensis, Bacillus mojavensis, Pseudomonas fluorescens, Pseudomonas putida and Arthrobacter nitroguajacolicus bacteria, which have plant growth promoting properties, were characterized by Raman and FT-IR Spectroscopy. In addition, the biofilm formation capacity of these bacteria on polystyrene surfaces was determined by the crystal violet test, and the colonization of Bacillus drentensis, Pseudomonas fluorescens and Arthrobacter nitroguajacolicus bacteria on Arabidopsis thaliana Columbia ecotype roots was determined by Scanning Electron Microscope (SEM) analysis.
Best of Both Worlds? Fixation of Distal Femur Fractures with the Nail-Plate Construct. Patient-Reported Outcomes and One-Year Results in a Heterogenous Population
Authors: Pfister Benjamin , Wilson Anthony , Drobetz Herwig
Published: May 2023

Objectives
Distal femoral fractures are a significant injury sustained by low- and high-energy trauma. Common treatment practices are lateral locking plate or intramedullary nail fixation, with disadvantages including risk of non- and mal-union and limited post-operative weightbearing status. Combining both techniques as a nail-plate construct (NPC) theoretically achieves enhanced fixation to allow immediate weightbearing. This study examines the functional, radiographic, and patient-reported outcomes of distal femur NPC fixation.
Methods
Single-centre combined prospective and retrospective study including all patients > 18 years who sustained distal femur fractures treated with NPC. The primary outcome was radiographic union and malunion at minimum one-year follow-up. Secondary outcome measures included patient reported outcome measures, post-operative mobility, length of stay and complications.
Results
Sixteen patients were included in the study. Rate of radiographic union was 100%. There was no case of malunion. All patients were allowed to full weight bear immediately post-operatively. Mean length of stay was 9.50 days, with 37.5% of patients discharged directly home. The majority (85.7%) of patients returned to pre-injury mobility. Early post-operative complications occurred in three patients. Three patients returned to theatre. The mean EQ-5D-5L index value was 0.713, with 71.4% describing no problems with self-care and 85.7% reporting no or slight problems with usual daily activities.
Conclusions
The NPC provided stable fixation permitting full weightbearing post-operatively with no cases of non- or malunion. Return to pre-injury mobility and activity are encouraging. Based on these results we support the use of nail-plate construct fixation in the management of distal femur fractures.
The first pilot study on remote monitoring of implantable cardiac electronic devices in South Korea: rationale and study protocol of a REMOTE-CARE
Authors: Hwang YouMi , Bae Hannah
Published: May 2023

Background: Previous studies have demonstrated that remote cardiac device monitoring reduces unnecessary outpatient visits and increases patient satisfaction. As domestic research on remote monitoring in Korea is lacking, there is a need for more evidence in order to develop remote monitoring-related policies or insurance standards. Based on our previous research on patient requirements for remote monitoring, we designed the first Korean study on remote cardiac device monitoring, including a 1-year follow-up period, to examine the patient satisfaction, medical safety, and efficacy of remote monitoring.
Methods: The REMOTE-CARE study is a single university hospital observational survey study that will include 100 cardiac implantable electronic devices, including pacemakers (PMs), implantable cardioverter defibrillators (ICD), and cardiac resynchronisation therapy (CRT), compatible with the Biotronik Home Monitoring system. All study participants will be provided CardioMessenger Smart for remote monitoring during enrolment. Regular in-office visits will be planned every 6–12 months for patients with PM and every 3–6 months for those with ICD and those undergoing CRT. The time/medical cost efficacy and satisfaction index will be evaluated using electronic medical records during the 12-month follow-up period. Pre- and post-questionnaires will be administered before and at 1 year after remote monitoring, respectively.
Discussion: The REMOTE-CARE study is the first prospective study to provide further insights on domestic remote monitoring applications based on patient perspectives in South Korea. The study will also provide evidence for developing policy or insurance standards for remote monitoring in Korea.
Registration: The REMOTE-CARE study is registered at ClinicalTrials.gov with study ID NCT04557111. This study was approved by the Institutional Review Board (IRB) of the Catholic University of Korea St. Vincent’s Hospital (Suwon, South Korea; IRB No. VC20DISF0160).
Curcumin Shows Neuroprotection against Oxidative Damage and Alters APP Processing Involving GSK-3β-mediated Protein O-GlcNAcylation
Authors: Wang Zhun , Tao Pei-Fei , Sun Yu-Ying , Song Xi-Jun , Huang Han-Chang
Published: May 2023

Alzheimer’s disease (AD) is a neurodegenerative disease. Senile plaque is one of the pathological hallmarks in the AD brains, and Amyloid-β (Aβ) peptides are the main components in the senile plaque. The amyloidogenic cleavage of Amyloid-β precursor protein (APP) is a key event for Aβ product and further the formation of senile plaque. Recently, O-GlcNAcylation is suggested to regulate the pathways of APP cleavage. The neurotrophic effects of curcumin on AD rat and the mechanisms on APP O-GlcNAcylation and cleavage were investigated in this study. The hippocampal expression of human APPswe (the Swedish mutation of APP) resulted in the decline of learning and memory and the increase of neuronal oxidative damage and Aβ product. Curcumin relieved these AD-like symptoms and altered Aβ secretion. Like PugNAc (an inhibitor of O-GlcNAcase), curcumin upregulated the O-GlcNAcylation level of APP and switched APP cleavage from amyloidogenic pathway to nonamyloidogenic pathway. GSK-3β participated in APP O-GlcNAcylation and its silence through shRNA interference blocked curcumin-induced protein O-GlcNAcylation. These results indicated that curcumin downregulates APP cleavage of amyloidogenic pathway, involving GSK-3β-mediated protein O-GlcNAcylation. This study implied that GSK-3β is a potential target for regulating APP processing in AD treatment.
Submerged friction stir welding of Al/Cu dissimilar metals: revealing the action mechanism of water cooling on intermetallic compounds layer
Authors: Mao Yue , Wu Run , Guo Hanlin , Xiao Xuan , Qin Dingqiang , Fu Li
Published: May 2023

In order to fabricate high-performance dissimilar joints of Al and Cu, it is critical to inhibit the growth of the hard and brittle intermetallic compounds (IMCs) at the Al/Cu interface. Therefore, submerged friction stir welding (SFSW) technology was conducted to join the Al/Cu dissimilar metals. The results revealed that the SFSW process with water cooling distinctly reduced the thickness of interfacial IMCs layer, and finer grains were formed at the Al side in nugget zone of SFSW joint compared to conventional friction stir welding (FSW). The mechanical properties of the joints produced by SFSW were improved. The tensile strength of the SFSW joint reached up to 221.5 MPa, which was 24.02% higher than that of the FSW joint. In addition, the SFSW could change the fracture location of joints, resulting in the fracture in the Al matrix.
Correlation Between Condylar Structure and Temporomandibular Articular Disc Injury in Adolescents
Authors: Ye Hao , Xu Lei , Zhao Zhoujing , Bai Guanghui , Ge Huaizhi
Published: May 2023

Objective: To evaluate the correlation between temporomandibular joint (TMJ) disc injury and condylar structure in adolescents.
Methods: A total of 94 temporomandibular joints were studied in 47 patients who underwent MRI examination of TMJ in our hospital from April 2019 to December 2020, including 32 in the non-displacement group(ND), 22 in the reducible displacement group(RD), and 40 in the non-reducible displacement group(NRD). For them, a 3.0T MRI scan was performed with conventional sequences, as well as 3D-CUBE T2 and T2-mapping sequences. Maximum left-right and antero-posterior diameters of condyles were measured by multi-plane recombination (MPR) on 3D-CUBE T2 sequence images, whose product and quotient were also calculated. Qualitative and quantitative indicators were included for evaluation of articular disc injury. By reading the films of conventional sequences comprehensively, articular disc displacement was qualitatively classified into non-displacement, reducible displacement and non-reducible displacement. The T2 value of the articular disc was measured on the T2-mapping sequence as a quantitative indicator. Four parameters of condylar structure and 2 indicators of articular disc injury were analyzed using descriptive statistics, one-way analysis of variance and Pearson correlation analysis.
Results: There were statistically significant differences in three structural parameters of the condyle (left-right and antero-posterior diameters and their products) among the non-displacement, reducible and non-reducible displacement groups (P<0.001), and the corresponding mean values were ranked in descending order: values in the non-displacement group > values in the reducible group > values in the non-reducible group. The left-right and antero-posterior diameters and their products were slightly positively correlated with the T2 values of the articular disc (r=0.262, r=0.317, r=0.386, P<0.05).
Conclusion: The left-right diameter, antero-posterior diameter and product of the condyle decreased with aggravation of TMJ disc injury, they can be used as the indirect imaging features of temporomandibular disorder.
Health Risk Assessment of Organic Compounds and Heavy Metals in Electronic Cigarettes
Authors: Zhao Siyuan , Zhang Xi , Wang Junji , Lin Jianzai , Cao Deyan , Zhu Meilin
Published: May 2023

E-cigarettes are now very popular in the world. Compared to traditional cigarettes, e-cigarettes are often considered safer and healthier. However, their safety remains controversial and requires further research and regulation. In this study, we aimed to understand the possible hazards to humans of four compounds (formaldehyde, acetaldehyde, acrolein, and acetone) and seven heavy metals (arsenic, cadmium, manganese, lead, copper, nickel, and chromium) contained in e-cigarette liquids and aerosols and perform a health risk assessment. We searched PUBMED, CNKI, and other databases for relevant literature to obtain data on organic compounds and heavy metals in e-cigarette liquids and aerosols, and conducted acute, chronic, and carcinogenic risk assessments of various chemicals by different exposure routes. This study showed that exposure to four organic compounds and seven heavy metals in e-cigarette aerosols and e-liquids can cause varying levels of health risks in humans through different routes, with the inhalation route posing a higher overall risk than dermal exposure and oral intake. Various chemicals at high exposure doses can produce health risks beyond the acceptable range. E-cigarette designers must improve their products by changing the composition of the e-liquid and controlling the power of the device to reduce the health effects on humans.
The Trojan Horse of Inflammation: Extracellular Vesicles and their Functionally Active Receptors
Authors: Tapken Ines , Kroh Keshia , Bhongir Ravi Kiran Varma , Rahman Milladur , Baumgarten Maria , Smeds Emanuel , Neumann Ariane , Veerla Srinivas , Olinder Jon , Thorlacus Henrik , Ryden Cecilia , Bartakova Eva , Holub Michal , Herwald Heiko , Papareddy Praveen
Published: May 2023

Extracellular vesicles (EVs) play a crucial role in intercellular communication by transferring bioactive molecules, including proteins, lipids, nucleic acids, and small metabolites, from donor to recipient cells. As a result, EV fusion leads to the modulation of cellular functions and has an impact on both physiological and pathological processes in the recipient cell. In this study, we investigated the effects of EV fusion on cellular responses to inflammatory signaling. We found that the fusion renders non-responsive cells susceptible to inflammatory signaling, as evidenced by increased NF-κB activation and the release of inflammatory mediators. Our results further show that STXBP1 is essential for the merge and activation of intracellular signaling. Subsequent analysis revealed that EVs transfer their functionally active receptors to target cells, making them prone to an otherwise unresponsive state. EVs in complex with their agonist, require no further stimulation of the target cells to trigger mobilization of NF-kB. While receptor antagonists were unable to inhibit NF-kB activation, blocking of the fusion between EVs and their target cells with heparin mitigated inflammation in mice challenged with EVs. Together, our findings highlight EVs as important mediators for the inductions of systemic inflammatory reactions.
Dynamics Changes and Predication of Ecosystem Services in the Qinghai-Tibet Plateau, China
Authors: Xue Jian , Li Zongxing
Published: May 2023

The Qinghai-Tibet Plateau (QTP) is an important ecological security barrier and a key region for biodiversity conservation in China. Assessing ecosystem services (ESs) on the QTP over long time series is of great significance. In this study, we quantified and analyzed the ESs of the QTP based on modeling combined with multivariate data. The results showed that habitat quality, water conservation, carbon storage and soil retention of the QTP from 1985 to 2020 were generally positive, and the quality of ESs and the distribution of cold hot spots were spatially consistent. The conservation of forest, shrub and grassland on the QTP contributed to the improvement of ESs. The supply capacity of ESs was higher in the southeastern of the QTP while the areas with higher demand were located in the northeast. Based on quadrant division, it was found that the mismatch between supply and demand of ESs of the QTP was mainly "low supply and low demand" and "high supply and low demand". From 2020 to 2050, ESs on the QTP show varying degrees of increase under all scenarios, with greater changes in ESs under the SSP3-7.0 scenario and the slowest growth in ESs under the SSP5-8.5 scenario.
Effectiveness of Virtual Reality in Nursing Education: A Systematic Review and Meta-analysis
Authors: Liu Kai , Zhang Weiwei , Li Wei , Wang Ting , Zheng Yanxue
Published: May 2023

Objective
Virtual Reality (VR) has shown significant potential in transforming nursing education by providing immersive and interactive learning experiences. To systematically evaluate and meta-analyze the effect of virtual reality technology in teaching nursing students.
Methods
Computer searches of PubMed, Web of Science, Wiley Online Library, Zhiwang database, Wanfang database and China Biomedical Literature Service (SinoMed) were conducted to collect randomized controlled trial studies on the use of virtual reality technology for teaching nursing students built up to March 2023, and the Cochrane The quality of the included literature was evaluated using the quality evaluation criteria for randomized controlled trial studies provided in the evaluation manual. Meta-analysis was performed using Review Manager 5.3 software. Results A total of 12 randomized controlled trials including 1167 students were included. Meta-analysis results showed that virtual reality technology could better improve nursing students' theoretical knowledge [SMD = 0.97, 95%CI [0.48,1.46], p < 0.001] and practical skills [SMD = 0.52, 95% CI [0.33,1.46],p < 0.001] compared to other or traditional nursing teaching methods. 95% CI [0.33, 0.71], P < 0.001] and satisfaction [SMD = 1.14, 95% CI [0.85, 1.43], P < 0.001], but there was no significant effect in improving nursing students' critical thinking skills [SMD = 0.79, 95%CI [-0.05,1.64], P = 0.07].
Conclusion
Compared with other or traditional nursing teaching methods, virtual reality can better improve nursing students' theoretical knowledge,practice skill level and satisfaction, but virtual reality technology has no significant advantage in improving acritical thinking skills of nursing students.
Elder relatives in waking life correlated with both elder relatives in dreams and animals in dreams
Authors: Wang Jiaxi , Feng Xiaoling
Published: May 2023

There are dream metaphors that express waking-life experiences indirectly. Animals in dreams has been speculated to be related to dream metaphors. Here we explored if there was correlation between daily diaries related to elder relatives and animals in dreams. Methods: for one day, 270 participants recorded waking-life experiences in daily diaries before sleeping, and recorded their dreams upon waking. Two external judges rated if there were any content related to elder relatives in both daily diaries and dreams, and rated if both daily diaries and dreams contained content related to animals. Results: the frequency for daily diaries related to elder relatives was 19.6%; the frequency for daily diaries related to animals was 2.6%; the frequency for animals in dreams was 13.7%; the frequency for elder relatives in dreams was 21.5%. The most two frequency animals in dreams were dogs and cats. Recording daily diaries related to elder relatives was correlated with both dreaming about elder relatives and dreaming about animals. In addition, recording daily diaries related to animals was correlated with dreaming about animals. Conclusion: Results supported the continuity hypothesis. In addition, some animals in dreams represented elder relatives in waking life metaphorically.
The effect of frailty in pleural disease using the SAIL Databank: a study protocol.
Authors: Verduri Alessia , Carter Ben , Barton Eleanor , Short Roxanna , Maskell Nick A , Hewitt Jonathan
Published: May 2023

Background
Frailty can impact on patient care and its assessment may improve patient management and clinical outcomes. Pleural disease is common and associated with increased mortality and symptoms, but prediction of outcomes is limited and there is currently no evidence available on the relationship between frailty and outcomes in these patients. This protocol describes an observational study which sets out to assess whether frailty correlates with survival and morbidity in patients with malignant or non-malignant pleural disease.
Methods
Participants with a first episode of pleural disease after 1st January 2005 will be identified from the SAIL Databank using ICD-10 read codes. The electronic frailty index (eFI), included within the databank and measured at the time of first diagnosis of pleural disease, will provide stratification of patients by frailty status. Baseline data collection will also include: patient demographics, presence of comorbidities, smoking status, date of death. The eFI will be correlated with clinical outcomes, including survival, index hospitalisation, length of stay, readmissions, total number of hospitalisations. Our primary analysis will be all-cause mortality by eFI, adjusted for age (≤ 64, 65–74, 75–84, and ≥ 85), sex, ethnicity, deprivation score, smoking status, Charlson Comorbidity Index. The secondary analyses will be pleural disease-specific mortality, time to first hospital admission (all-cause and disease-specific), total length of stay, and readmissions. All analyses will be presented as crude and adjusted HR and OR with associated 95% CIs and p values.
Discussion
The aim of this study is to collect targeted data from a large dataset of subjects with a wide range of pleural disease and provide first data of size reviewing the link between frailty and pleural disease. The eFI can be a potential tool to guide clinical decision making in pleural disease.
Trial registration
Retrospectively registered.
Is robotic ventral mesh rectopexy for pelvic floor disorders better than laparoscopic approach at the beginning of the experience? A retrospective single-center study
Authors: DUMAS Clotylde , DUCLOS Julie , NHO Remy LE HUU , FERMO Magali , GOMEZ Emilie , HENIN Aurélia , VAISSE Camille , PIRRO Nicolas , AUBERT Mathilde , MEGE Diane
Published: May 2023

Purpose
To compare perioperative results of laparoscopic and robotic ventral mesh rectopexy for pelvic floor disorders at the beginning of the surgical experience.
Methods
Between 2017 and 2022, the first 30 laparoscopic ventral mesh rectopexies and the first 30 robotic ventral mesh rectopexies at the beginning of the experience of 2 surgeons were retrospectively analyzed. Perioperative (demographic characteristics, surgical indication, conversion rate, operative time), and postoperative (complications, length of stay, unplanned reintervention) data were compared between groups.
Results
Demographic characteristics were similar between groups. Conversion rate was lower (0 vs 17%, p=0.05), but the operative time was significantly longer (192 ±37 vs 153 ±43 minutes, p<0.0001) during robotic procedure when compared with laparoscopic approach. In terms of learning curve, the number of procedures to obtain the same operative time between the 2 approaches was 15.
Postoperative results were similar between groups, in terms of pain (visual analogic scale = 2.5 ±2 vs 4 ±2, p=0.07), morbidity (17 vs 3%, p=0.2), and unplanned reintervention (0 vs 1%, p=0.99). Mean length of stay was significantly reduced after robotic approach when compared with laparoscopic approach (3 ±2 vs 5 ±2.5 days, p<0.01).
Functional results were better after robotic than laparoscopic ventral mesh rectopexy, with higher satisfaction rate (93 vs 75%, p=0.05), and reduced recurrence rate (0 vs 14%, p=0.048).
Conclusion
Despite longer operative time at the beginning of the learning curve, robotic ventral mesh rectopexy was associated with similar or better perioperative results than laparoscopic ventral mesh rectopexy.
Mixed Hypogonadism: A New Type of Hypogonadism
Authors: wu xueyan , Zhang Rui , Yu Bingqing , Wang Xi , Nie Min , Ma Wanlu , Ji Wen , Huang Qibin , Zhu Yiyi , Sun Bang , Zhang Junyi , Zhang Wei , Liu Hongying , Mao Jiangfeng
Published: May 2023

Purpose
Kallmann syndrome is a rare disease characterized by delayed puberty, infertility and anosmia. We report the clinical and genetic characteristics of four patients with Kallmann syndrome who presented with Klinefelter syndrome or primary testicular disease and defined a new type of hypogonadism as mixed hypogonadism.
Methods
Clinical data and examinations were obtained, including laboratory examination and magnetic resonance imagination (MRI) of the olfactory structures. Idiopathic hypogonadotropic hypogonadism (IHH) related genes were screened by next generation sequencing (NGS).
Results
Four patients with Kallmann syndrome were included. Patient 1–3 had co-existence with Klinefelter syndrome and showed hypogonadotropic hypogonadism. Patient 1 was complicated with germinoma. Patient 4 had a history of hypogonadotropic hypogonadism and cryptorchidism, and then gradually converted to hypergonadotropic hypogonadism during follow-up.
Conclusion
Mixed hypogonadism was defined as hypogonadotropic hypogonadism in Klinefelter syndrome or primary testicular disease. Clinicians should be alert to mixed hypogonadism when spermatogenesis induction failed in patients with IHH or gonadotropin levels decrease in patients with Klinefelter syndrome.
Incidental Multiple Myeloma in a Patient with Idiopathic Neuroretinitis: A Case Report
Authors: Joo Taesung , Kim Tae Gi , Moon Sang Woong
Published: May 2023

Background Neuroretinitis is classically defined as a clinical triad of unilateral, painless vision loss, accompanied by optic disc edema and characteristic macular star formation. Dyschromatopsia, relative afferent pupillary defects, and visual field abnormalities may also occur. The causes of neuroretinitis are diverse and can be categorized as infectious, non-infectious, and idiopathic. Formulating a differential diagnosis and careful evaluation are required, owing to the various etiologies and masqueraders.Case presentation A 54-year-old woman presented to the clinic with blurred vision in both eyes. Complete ophthalmic examination revealed optic disc edema with blurred margins and macular exudates, intraretinal edema in the temporal peripapillary area, and subretinal fluid with neurosensory retinal detachment in the macular area. Systemic laboratory investigations showed no signs of infection or inflammation. However, bone marrow suppression was suspected based on the results of the complete blood count test, and the patient was diagnosed with multiple myeloma.Conclusion Although neuroretinitis is rarely accompanied by hematological malignancy, it is important to be mindful of the latter because ophthalmic manifestations are a common feature of hematological malignancies and lesions occur in nearly every ocular structure.
Introducing Braining - Physical Exercise as Adjunctive Therapy in psychiatric care: a Retrospective Cohort Study of a new method.
Authors: Anger Åsa , Wallerblad Anna , Kaaman Leida , Broman Rebecka , Holmberg Johan , Lundgren Tobias , Salomonsson Sigrid , Sundberg Carl Johan , Martinsson Lina
Published: May 2023

Background: Patients with severe mental disorders suffer from higher rates of poor somatic health and have shorter life expectancy than the average population. Physical activity (PA) can treat and prevent several diseases,e.g.cardiovascular and metabolic disorders as well as psychiatric symptoms. It is therefore of utmost importance to develop effective methods to integrate PA into psychiatric care. To meet this need, the PA intervention Braining was developed. This study aims to describe Braining, to assess the number of patients reached by the intervention during the first years of pilot testing, to analyze clinical data in the group of patients participating in Braining 2017-2020 and to assess the intervention. Methods: In this descriptive retrospective study we analyzed data from all patients participating in Braining training sessions ≥ 3 times (n=239), thus called Braining participants. Regular patients at the clinic served as a comparison. Furthermore, medical records were studied for a smaller cohort (n=51), the Braining Pilot Cohort. Results: During the introduction period of Braining, 580 patients attended an information meeting about Braining, or at least one training session. 239 patients participated in ≥ 3 training sessions, considered to be participants of Braining. These Braining participants (n=239), ages 19 to 82, males 23.4%, attended between 3 and 308 training sessions (median 9). The main diagnoses were depression, bipolar disorders, anxiety disorders, PTSD, ADHD, and autism. Number of diagnoses ranged from 0 to 10 (median=2). For the subsample, the Braining Pilot Cohort (n=51), participants attended between 3 and 208 training sessions (median=20). Twelve percent were working full-time, and symptom severity of depression and general anxiety was moderate. Two thirds had ≥ 3 different classes of medication. Regarding metabolic morbidity, 28 had been diagnosed with hypertension, though blood lipids, blood glucose as well as blood pressure were within the normal range. Thirty-seven percent were prescribed Physical Activity on Prescription (PAP) during 2017-2020. One severe adverse event was reported. Conclusions: The Braining intervention reached all age-groups and patients with a wide and representative diagnostic panorama, suggesting that Braining could be a promising and safe method for implementing PA in a psychiatric patient population.
Effects of dietary glutamine supplementation on growth performance, intestinal digestive ability, antioxidant status and hepatic lipid accumulation in Xenocypris davidi Bleeker.
Authors: Wang Yuehan , Peng Zuxiang , Yan Lin , Gao Xin , Wu Lin , Cui Shuchang , Zhou Mengyuan , Ren Tongjun , Wang Wei , Sun Shuhao , Han Yuzhe , Sun Hang
Published: May 2023

The effects of different concentrations of glutamine on host performance are important in the context of aquaculture. Here, four diets were fed to Xenocypris davidi Bleeker, with 0, 3, 6, and 9 g/kg of glutamine supplementation, for a period of 8 weeks. The results showed that supplementation with 6 and 9 g/kg of glutamine significantly increased the final body weight (FBW), weight gain rate (WGR), and specific growth rate (SGR) of the fish (P < 0.05). Conversely, there was a decreasing trend observed in the condition factor (CF), viscerosomatic index (VSI), hepatosomatic index (HSI), and feed conversion ratio (FCR) with increased glutamine supplementation. Dietary glutamine was found to improve the intestinal structure and function of X. davidi. This was achieved through an increase in the digestive and antioxidant enzyme activities in the intestine, as well as an increase in the muscle layer thickness (MT), villus height (VH), and villus width (VW) of the intestine. These effects were particularly evident in the 6 and 9 g/kg glutamine supplementation groups. This finding was further corroborated by oil red O staining and the relative areas of lipid droplets. A gradual increase in plasma total protein (TP) concentrations with increasing glutamine supplementation was observed, and was considerably higher in the 9 g/kg group than in the control group (P < 0.05). In contrast, plasma total cholesterol (TC) and triglyceride (TG) concentrations were decreased significantly after fish were fed with diets with appropriate glutamine supplementation levels. Notably, we further constructed the correlation analysis to find and verify the important factors that affect the growth performance of host after feeding glutamine. In the present study, we observed that PEP and AMS (belong to digestive enzymes), MT, VH and VW (belong to intestinal morphology), crude protein (belong to proximate composition) showed significant positive correlation with FBW, WGR, SGR (belong to growth performance, P < 0.05). Overall, these findings suggest that dietary glutamine can enhance host performance in X. davidi, particularly when supplemented at 9 g/kg. This may have important implications for the aquaculture industry, as it can improve the health and growth of farmed fish.
Polyhydrido Copper Nanocluster [Cu14H10(PPh3)8(SPhMe2)3]+ : Symmetry-Breaking by Thiolate Ligands to form Racemic Pairs of Chiral Clusters in Solid-State
Authors: Zeng Shuhuan , Ge Xin , Deng Hongwen , Hao Shuwei , Zhang Zhiye , Teo Boon K. , Sun Cunfa
Published: May 2023

A polyhydrido copper nanocluster, [Cu14H10(PPh3)8(SR)3]+ (HSR = 2,4-dimethylbenzenethiol), adopting a distorted fcc structure is reported. One copper atom is “pulled” from the center of the fcc metal framework by the three thiolate ligands. The twisting of the three thiolate ligands about the threefold axis lowers the symmetry from Oh (Cu14) to C3, forming racemic pairs of intrinsic chiral clusters in solid-state.
RANKL inhibition reduces lesional cellularity, Gαs variant expression and enables osteogenic maturation in fibrous dysplasia
Authors: de Castro Luis , Whitlock Jarred , Michel Zachary , Pan Kristen , Taylor Jocelyn , Szymczuk Vivian , Boyce Brendan , Martin Daniel , Chernomordik Leonid , Collins Mike , Boyce Alison
Published: May 2023

Fibrous dysplasia (FD) is a rare, disabling skeletal disease with no established treatments. Growing evidence supports inhibiting the osteoclastogenic factor receptor activator of nuclear Kappa-B ligand (RANKL) as a potential treatment strategy. In this study, we investigated mechanisms underlying RANKL neutralization with the monoclonal antibody denosumab on FD osteoprogenitors, by evaluating human FD tissue pre- and post-treatment, and in murine in vivo and ex vivo pre-clinical models. Histological analysis of human and mouse tissue demonstrated increased osteogenic maturation, reduced cellularity, and reduced expression of the pathogenic Gαs variant in FD lesions after RANKL neutralization. RNA sequencing of human and mouse tissue supported these findings. Interplay between osteoclasts and mutant osteoprogenitors was further assessed in an ex vivo lesion model, indicating that the proliferation of abnormal FD osteoprogenitors was dependent on osteoclastogenesis. Results from this study demonstrate that, beyond its expected anti-osteoclastic effects, denosumab reduces FD lesion activity by decreasing FD cell proliferation and increasing osteogenic maturation, leading to increased lesional bone formation. These findings highlight an unappreciated role for cellular crosstalk between osteoclasts and pre-osteoblast/osteoblasts as a driver of FD pathology, and demonstrate a novel mechanism of denosumab action in the treatment of bone disease.
TRIAL REGISTRATION: ClinicalTrials.gov NCT03571191