bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the 12-month impact of COVID-19 and SARS on physiological capacity and health-related quality of life
Authors: Chan Ken Ka Pang , Ng Susanna So Shan , Lui Grace Chung Yan , Leung Ho Sang , Wong Ka Tak , Chu Winnie Chiu Wing , Chan Tat On , Yiu Karen Yee Shan , Tso Eugene Yuk Keung , To Kin Wang , Ngai Jenny Chun Li , Yip Tommy Wing Ho , Lo Rachel Lai Ping , Ng Joyce Ka Ching , Ko Fanny Wai San , Hui David Shu Cheong
Published: November 2023

Background

Little is known about the differences in medium to long-term recovery on spirometry, 6-minute walking distance (6MWD) and health-related quality of life (HRQoL) between COVID-19 and SARS.

Methods

We performed a 12-month prospective study on COVID-19 survivors. The changes in dynamic lung volumes at spirometry (%predicted FEV1, %predicted FVC), 6MWD and HRQoL at 1–3, 6 to 12 months were compared against a historical cohort of SARS survivors using the same study protocol. The residual radiological changes in HRCT in COVID-19 survivors were correlated with their functional capacity.

Results

108 COVID-19 survivors of various disease severity (asymptomatic 2.9%, mild 33.3%, moderate 47.2%, severe 8.3%, critical 8.3%) were recruited. When compared with 97 SARS survivors, 108 COVID-19 survivors were older (48.1 ± 16.4 vs. 36.1 ± 9.5 years, p < 0.001) and required less additional support during hospitalization; with lower dynamic lung volumes, shorter 6MWD and better physical component score. Both groups of survivors had comparable changes in these parameters at subsequent follow-ups. Both COVID-19 and SARS survivors had similar mental component score (MCS) at 6 and 12 months. COVID-19 survivors initially experienced less (between-group difference, -3.1, 95% confidence interval [CI] -5.5 to -0.7, p = 0.012) and then more improvement (between-group difference 2.9, 95%, CI 0.8 to 5.1, p = 0.007) than SARS survivors in the MCS at 1–3 to 6 months and 6 to 12 months respectively. Forty (44.0%) out of 91 COVID-19 survivors had residual abnormalities on HRCT at 12 months, with a negative correlation between the severity scores of parenchymal changes and 6MWD (r=-0.239, p < 0.05).

Conclusions

COVID-19 survivors demonstrated a similar recovery speed in dynamic lung volumes and exercise capacity, but different paces of psychological recovery as SARS survivors in the convalescent phase. The severity of parenchymal changes in HRCT is negatively correlated with the 6MWD of COVID-19 survivors.

Trial registration

This prospective study was registered at ClinicalTrials.gov on 2 November 2020 (Identifier: NCT04611243).
Prediction of postoperative complications after hepatectomy with dynamic monitoring of central venous oxygen saturation
Authors: Ida Shinya , Morita Yoshifumi , Matsumoto Akio , Muraki Ryuta , Kitajima Ryo , Furuhashi Satoru , Takeda Makoto , Kikuchi Hirotoshi , Hiramatsu Yoshihiro , Takeuchi Hiroya
Published: November 2023

Background

The usefulness of static monitoring using central venous pressure has been reported for anesthetic management in hepatectomy. It is unclear whether intra-hepatectomy dynamic monitoring can predict the postoperative course. We aimed to investigate the association between intraoperative dynamic monitoring and post-hepatectomy complications. Furthermore, we propose a novel anesthetic management strategy to reduce postoperative complication.

Methods

From 2018 to 2021, 93 patients underwent hepatectomy at our hospital. Fifty-three patients who underwent dynamic monitoring during hepatectomy were enrolled. Flo Trac system was used for dynamic monitoring. The baseline central venous oxygen saturation (ScvO2) was defined as the average ScvO2 for 30 min after anesthesia induction. ScvO2 fluctuation (ΔScvO2) was defined as the difference between the baseline and minimum ScvO2. Postoperative complications were evaluated using the comprehensive complication index (CCI).

Results

Patients with ΔScvO2 ≥ 10% had significantly higher CCI scores (0 vs. 20.9: p = 0.043). In univariate analysis, patients with higher CCI scores demonstrated significantly higher preoperative C-reactive protein-to-lymphocyte ratio (7.51 vs. 24.49: p = 0.039), intraoperative bleeding (105 vs. 581 ml: p = 0.008), number of patients with major hepatectomy (4/45 vs. 3/8: p = 0.028), and number of patients with ΔScvO2 ≥ 10% (11/45 vs. 6/8; p = 0.010). Multivariate logistic regression analysis revealed that ΔScvO2 ≥ 10% (odds ratio: 9.53, p = 0.016) was the only independent predictor of elevated CCI.

Conclusions

Central venous oxygen saturation fluctuation during hepatectomy is a predictor of postoperative complications. Anesthetic management based on intraoperative dynamic monitoring and minimizing the change in ScvO2 is a potential strategy for decreasing the risk of post-hepatectomy complications.
Effects of different removal methods of excess resin adhesive on the microleakage of alumina all-ceramic crowns
Authors: Zhang Haiyang , Yu Hao , Jiang Shangfei , Dong Haidao , Yan Chengdong , Liu Hong , Li Qing , Jiang Haiwei
Published: November 2023

Background

Microleakage is a common problem that affects the quality and longevity of all-ceramic crowns. It is influenced by factors such as the resin cement, crown margin design and curing technique. However, few studies focus on the effect of different methods of removing excess resin adhesive on the microleakage of all-ceramic crowns. This study aimed to compare two methods of removing excess resin adhesive (the small brush and sickle methods) on the microleakage of all-ceramic crowns with different marginal clearances.

Methods

Forty extracted third molars were prepared with a 90° shoulder margin and randomly divided into four groups according to their marginal lift (30, 60, 90 or 0 μm). Procera alumina crowns were fabricated using computer-aided design/computer-aided modelling and cemented onto the teeth with 3 M RelyX Unicem (3 M Company, United States) resin cement. Excess resin cement was removed by either the small brush or the sickle scalpel method. The marginal adaptation was observed with a digital microscope. After thermal cycling of the teeth, microleakage was assessed using the dye penetration test under a stereomicroscope. The Mann–Whitney U test and Kruskal–Wallis H test were used to compare the microleakage scores among different groups.

Results

The small-brush group showed significantly better marginal adaptation and lower microleakage scores than the sickle group (p < 0.05). There was no significant difference in the microleakage score (grade 0) among different marginal clearances within each group (p > 0.05).

Conclusion

The small-brush method was more effective than the sickle scalpel method in reducing the microleakage of all-ceramic crowns with different marginal clearances. This method can improve the marginal adaptation and sealability of all-ceramic crowns, thus preventing secondary caries and other complications.
Molecular-based classification of endometrial carcinoma in Northern Thailand: impact on prognosis and potential for implementation in resource-limited settings
Authors: Dankai Wiyada , Pongsuvareeyakul Tip , Phinyo Phichayut , Tejamai Chontichaporn , Teerapakpinyo Chinachote , Cheewakriangkrai Chalong , Lekawanvijit Suree , Siriaunkgul Sumalee , Khunamornpong Surapan
Published: November 2023

Background

Endometrial carcinoma is molecularly categorized into four subgroups: polymerase-E exonuclease domain-mutant (POLE-mut), mismatch repair-deficient (MMR-d), p53-abnormal (p53-abn), and no specific molecular profile (NSMP). This classification scheme has been included into clinical recommendation for post-operative risk-based management, although there have been few Asian studies on this topic. The present study aimed to evaluate the prevalence and clinical outcomes of endometrial carcinoma using this classification in Northern Thailand and the feasibility of implementation in resource-limited settings.

Methods

Endometrial carcinomas from hysterectomy specimens were classified using immunohistochemistry for MMR proteins and p53, as well as POLE mutation testing. Clinicopathological variables and outcomes were analyzed. The costs of the molecular information-based approach were compared to those incurred by the conventional approach (without molecular classification).

Results

Of 138 patients, 52.9% in the NSMP subgroup, 28.2% were in the MMR-d, 13.8% in the p53-abn, and 5.1% in the POLE-mut. After adjusting for other variables, patients with POLE-mut showed the most favorable outcomes, while those with p53-abn had the poorest survival. When estimating the costs for post-operative management, the use of molecular classification resulted in a 10% increase over the conventional approach. However, the cost increased only by 1% if only POLE testing was used to identify patients for treatment omission.

Conclusion

In Northern Thailand, endometrial carcinoma had comparable subgroup distribution and prognostic implications to previous reports, supporting the implementation of management guidelines that incorporate molecular information. In resource-limited settings, at least POLE mutation testing in early-stage patients should be considered.
Research protocol of the Laval-ROSA Transilab: a living lab on transitions for people living with dementia
Authors: Dufour Isabelle , Arsenault-Lapierre Geneviève , Guillette Maxime , Dame Nathalie , Poitras Marie-Eve , Lussier Marie-Thérèse , Fortier Annie , Brunet Julie , Martin Julie , Laverdure Micheline , Brousseau Ginette , Bergman Howard , Couturier Yves , Quesnel-Vallée Amélie , Vedel Isabelle
Published: November 2023

Background

The Laval-ROSA Transilab is a living lab that aims to support the Laval Integrated Health and Social Services Centres (Quebec, Canada) in consolidating the Quebec Alzheimer Plan. It aims to improve care transitions between different settings (Family Medicine Groups, home care, and community services) and as such improve the care of people living with dementia and their care partners. Four transition-oriented innovations are targeted. Two are already underway and will be co-evaluated: A) training of primary care professionals on dementia and interprofessional collaboration; B) early referral process to community services. Two will be co-developed and co-evaluated: C) developing a structured communication strategy around the dementia diagnosis disclosure; D) designation of a care navigator from the time of dementia diagnosis. The objectives are to: 1) co-develop a dashboard for monitoring transitions; 2) co-develop and 3) co-evaluate the four targeted innovations on transitions. In addition, we will 4) co-evaluate the impact and implementation process of the entire Laval-ROSA Transilab transformation, 5) support its sustainability, and 6) transfer it to other health organizations.

Methods

Multi-methods living lab approach based on the principles of a learning health system. Living labs are open innovation systems that integrate research co-creation and knowledge exchange in real-life settings. Learning health systems centers care improvement on developing the organization's capacity to learn from their practices. We will conduct two learning cycles (data to knowledge, knowledge to practice, and practice to data) and involve various partners. We will use multiple data sources, including health administrative databases, electronic health records data, surveys, semi-structured interviews, focus groups, and observations.

Discussion

Through its structuring actions, the Laval-ROSA Transilab will benefit people living with dementia, their care partners, and healthcare professionals. Its strategies will support sustainability and will thus allow for improvements throughout the care continuum so that people can receive the right services, at the right time, in the right place, and from the right staff.
Predicting micropapillary or solid pattern of lung adenocarcinoma with CT-based radiomics, conventional radiographic and clinical features
Authors: Wang Zhe , Zhang Ning , Liu Junhong , Liu Junfeng
Published: November 2023

Background

To build prediction models with radiomics features, clinical/conventional radiographic signs and combined scores for the discrimination of micropapillary or solid subtypes (high-risk subtypes) of lung adenocarcinoma.

Methods

This retrospective study enrolled 351 patients with and without high-risk subtypes. Least Absolute Shrinkage and Selection Operator (LASSO) regression with cross-validation was performed to determine the optimal features of radiomics model. Missing clinical data were imputed by Multiple Imputation with Chain Equations (MICE). Clinical model with radiographic signs was built and scores of both models were integrated to establish combined model. Receiver operating characteristics (ROC) curves, area under ROC curves and decision curve analysis (DCA) were plotted to evaluate the model performance and clinical application.

Results

Stratified splitting allocated 246 patients into training set. MICE for missing values obtained complete and unbiased data for the following analysis. Ninety radiomic features and four clinical/conventional radiographic signs were used to predict the high-risk subtypes. The radiomic model, clinical model and combined model achieved AUCs of 0.863 (95%CI: 0.817–0.909), 0.771 (95%CI: 0.713–0.713) and 0.872 (95%CI: 0.829–0.916) in the training set, and 0.849 (95%CI: 0.774–0.924), 0.778 (95%CI: 0.687–0.868) and 0.853 (95%CI: 0.782–0.925) in the test set. Decision curve showed that the radiomic and combined models were more clinically useful when the threshold reached 37.5%.

Conclusions

Radiomics features could facilitate the prediction of subtypes of lung adenocarcinoma. A simple combination of radiomics and clinical scores generated a robust model with high performance for the discrimination of micropapillary or solid subtype of lung adenocarcinoma.
Simultaneous upper and lower body perfusion using hypothermia during thoracoabdominal aortic surgery
Authors: Kise Yuya , Kuniyoshi Yukio , Ando Mizuki , Miyaishi Keita , Higa Shotaro , Maeda Tatuya , Nakaema Moriyasu , Inafuku Hitoshi , Furukawa Kojiro
Published: November 2023

Background

In open thoracoabdominal aortic aneurysm (TAAA) repair, we have been performing vascular reconstruction under moderate to deep hypothermia and assisted circulation using simultaneous upper and lower body perfusion. This method is effective for protecting the spinal cord and the brain, heart, and abdominal organs and for avoiding lung damage.

Methods

TAAA repair was performed under hypothermia at 20–28 °C in 18 cases (Crawford type I in 0 cases, type II in 5, type III in 3, type IV in 4, and Safi V in 6) between October 2014 and January 2023. Cardiopulmonary bypass was conducted by combined upper and lower body perfusion, with perfusion both via the femoral artery and either transapically or via the descending aorta or the left brachial artery.

Results

The ischemic time for the artery of Adamkiewicz and the main segmental arteries was 40–124 min (75 ± 33 min). No spinal cord ischemic injury or brain or heart complications occurred. One patient with postoperative right renal artery occlusion and one with an infected aneurysm required tracheostomy, but the intubation time for the other 16 was 32 ± 33 h. The duration of postoperative intensive care unit stay was 6.5 ± 6.2 days, the length of hospital stay was 29 ± 15 days, and no in-hospital deaths occurred.

Conclusions

Simultaneous upper and lower body perfusion under moderate to deep hypothermia during thoracoabdominal aortic surgery may avoid not only spinal cord injury, but also cardiac and brain complications.
An anatomical approach to the tarsal tunnel syndrome: what can ankle's medial side anatomy reveal to us?
Authors: Lopes Jorge Gomes , Rodrigues‐Pinho André , Neves Maria Abreu , Pinto Filipe Fonseca , Relvas‐Silva Miguel , Vital Luísa , Serdoura Francisco , Nogueira‐Sousa António , Madeira Maria Dulce , Pereira Pedro Alberto
Published: November 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%, on top of the DML in 12,5% and distal in none of the feet. The Baxter's nerve (BN) originated proximally in 50%, on top of the DML in 12,5% and distally in 37.5% of the cases. There was a strong and significant correlation between the length of DML and the distance from the center of the medial malleolus (MM) to the lateral plantar nerve (LPN), medial plantar (MPN) nerve, BN and Medial Calcaneal Nerve (MCN) (ρ: 0.910, 0.866, 0.970 and 0.762 respectively, p <  0.001).

Conclusions

In our sample the TN divides distal to DML in none of the cases. We also report a strong association between ankle size and the distribution of the MPN, LPN, BN and MCN. We hypothesize that location of these branches on the medial side of the ankle could be more predictable if we take into consideration the distance between the MM and the medial process of the calcaneal tuberosity.
Professional prehospital clinicians’ experiences of ethical challenges associated with the collaboration with organised voluntary first responders: a qualitative study
Authors: Sørensen Oliver Beierholm , Milling Louise , Laerkner Eva , Mikkelsen Søren , Bruun Henriette
Published: November 2023

Background

Volunteer First Responders are used worldwide. In the Region of Southern Denmark, two types of programs have been established. One of these programs consists of voluntary responders without any requirements of education or training who are summoned to prehospital cardiac arrests. The other type of program is established primarily in the rural areas of the region and consists of volunteers with some mandatory education in first aid. These volunteers are summoned to all urgent cases along with the ambulances. Cooperation between professional healthcare workers and nonprofessionals summoned through official channels may be challenging. This study aimed to explore prehospital clinicians’ experiences of ethical challenges in cooperation with volunteer first responders.

Methods

We conducted 16 semi-structured interviews at four different ambulance stations in the Region of Southern Denmark. Five emergency physicians and 11 emergency medical technicians/paramedics were interviewed. The interviews were transcribed, and the data were analysed using systematic text condensation.

Results

The study's 16 interviews resulted in the identification of some specific categories that challenged the cooperation between the two parties. We identified three main categories: 1. Beneficence, the act of doing good, 2. The risk of harming patients’ autonomy 3. Non-maleficence, which is the obligation not to inflict harm on others.

Conclusion

This study provides an in-depth insight into the ethical challenges between prehospital clinicians and voluntary first responders from the perspective of the prehospital clinicians. Both programs are considered to have value but only when treating patients with cardiac arrest. Our study highlights potential areas of improvement in the two Danish voluntary programs in their current form.
Functional recovery in a cohort of ECMO and non-ECMO acute respiratory distress syndrome survivors
Authors: Snyder Mackenzie , Njie Binta Y. , Grabenstein Ilana , Viola Sara , Abbas Hatoon , Bhatti Waqas , Lee Ryan , Traficante Rosalie , Yeung Siu Yan Amy , Chow Jonathan H. , Tabatabai Ali , Taylor Bradley S. , Dahi Siamak , Scalea Thomas , Rabin Joseph , Grazioli Alison , Calfee Carolyn S. , Britton Noel , Levine Andrea R.
Published: November 2023

Background

The mortality benefit of VV-ECMO in ARDS has been extensively studied, but the impact on long-term functional outcomes of survivors is poorly defined. We aimed to assess the association between ECMO and functional outcomes in a contemporaneous cohort of survivors of ARDS.

Methods

Multicenter retrospective cohort study of ARDS survivors who presented to follow-up clinic. The primary outcome was FVC% predicted. Univariate and multivariate regression models were used to evaluate the impact of ECMO on the primary outcome.

Results

This study enrolled 110 survivors of ARDS, 34 of whom were managed using ECMO. The ECMO cohort was younger (35 [28, 50] vs. 51 [44, 61] years old, p < 0.01), less likely to have COVID-19 (58% vs. 96%, p < 0.01), more severely ill based on the Sequential Organ Failure Assessment (SOFA) score (7 [5, 9] vs. 4 [3, 6], p < 0.01), dynamic lung compliance (15 mL/cmH20 [11, 20] vs. 27 mL/cmH20 [23, 35], p < 0.01), oxygenation index (26 [22, 33] vs. 9 [6, 11], p < 0.01), and their need for rescue modes of ventilation. ECMO patients had significantly longer lengths of hospitalization (46 [27, 62] vs. 16 [12, 31] days, p < 0.01) ICU stay (29 [19, 43] vs. 10 [5, 17] days, p < 0.01), and duration of mechanical ventilation (24 [14, 42] vs. 10 [7, 17] days, p < 0.01). Functional outcomes were similar in ECMO and non-ECMO patients. ECMO did not predict changes in lung function when adjusting for age, SOFA, COVID-19 status, or length of hospitalization.

Conclusions

There were no significant differences in the FVC% predicted, or other markers of pulmonary, neurocognitive, or psychiatric functional recovery outcomes, when comparing a contemporaneous clinic-based cohort of survivors of ARDS managed with ECMO to those without ECMO.
Efficient synthesis of 3-alkyl-2-(-1H-1,2,3-triazolyl)methyl)thio)-2,3-dihydroquinazolin-4(1H)-one derivative via multistep synthesis approach by novel Cu@Py-Oxa@SPION catalyst
Authors: Sherafati Alireza , Moradi Shahram , Mahdavi Mohammad
Published: November 2023

In this pared, an efficient method is introduced for the synthesis of 3-alkyl-2-(((4-(2-oxopropyl)-1H-1,2,3-triazol-1-yl)alkyl)thio)-2,3-dihydroquinazolin-4(1H)-one derivatives. These novel products have both 1,2,3-triazole and quinazolinone in their structures. For the synthesis of these products, a novel catalyst is designed, synthesized, and characterized by the immobilization of copper onto modified magnetic iron oxide. The catalyst (denoted: Cu@Py-Oxa@SPION) was characterized by several characterization techniques. In this regard, 16 3-alkyl-2-(((4-(2-oxopropyl)-1H-1,2,3-triazol-1-yl)alkyl)thio)-2,3-dihydroquinazolin-4(1H)-one derivatives were synthesized in high isolated yields (77–86%). As an advantage, the catalyst is highly recoverable and its activity has not decreased after 7 sequential runs. The method is very efficient for the synthesis of the products in high isolated yields under mild reaction conditions in a green solvent. The scope of the method is broad and several examples were successfully synthesized using starting materials with different functional groups.
Effect of exercise interventions based on family management or self-management on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis
Authors: Dong Chenyang , Liu Ruoya , Huang Zhiyang , Yang Yang , Sun Shiyuan , Li Ran
Published: November 2023

Background

Most studies about exercise interventions for patients with type 2 diabetes mellitus (T2DM) have been conducted in hospitals or labs, but it is unclear whether study findings from this specific condition can be generalised to real-life T2DM communities. If patients with T2DM can exercise on their own or with family members, it may also reduce the need for patient supervision by medical staff, thereby reducing the burden of medical treatment and improving condition management's cost-effectiveness and practicability. Much of the current research on exercise interventions for T2DM was focused on the type of exercise and less on the mode of management, so we aimed to examine the effect of exercise interventions based on family management or self-management on glycaemic control in patients with T2DM.

Methods

Articles were searched from eight Chinese and English databases. Randomized control trials (RCTs) published in English and Chinese, from inception to October 17, 2022, were included in this review. The methodological quality of the included studies was assessed using the RCT risk of bias assessment tool provided by the Cochrane Collaboration’s tool. Meta-analysis was performed using Rev Man 5.4 and Stata 15.0 software. Heterogeneity was investigated using sensitivity analysis and subgroup analyses. Publication bias was tested by funnel plot and Egger's asymmetry tests.

Results

A total of 10 studies with a total of 913 subjects were finally included in this review. The Meta-analysis showed that exercise interventions based on family management or self-management were more effective than control groups in reducing HbA1c (Z = 3.90; 95% CIMD = − 0.81; − 1.21 to − 0.40; P < 0.0001), fasting glucose (Z = 4.63; 95% CI MD = − 1.17; − 1.67 to − 0.68; P < 0.00001), 2-h plasma glucose (Z = 5.53; 95% CI MD = − 1.84; − 2.50 to − 1.19; P < 0.00001), and Low-density lipoproteins levels (Z = 3.73; 95% CIMD = − 0.38; − 0.58 to − 0.18; P = 0.0002).

Conclusions

Exercise interventions based on family management or self-management can significantly reduce glycosylated haemoglobin, fasting glucose, 2-h plasma glucose, and Low-density lipoproteins levels in patients with T2DM, which can effectively delay disease progression and reduce the risk of developing complications. In the future, for exercise interventions based on family or self-management, this review recommended that exercise intervention programmes should be formulated according to 30–60 min per session, more than three times per week, for more than six months of aerobic exercise or aerobic combined with resistance exercise.
A novel tetra-primer ARMS-PCR for genotyping of the OPRM1 gene rs1799971 variant associated with opioid use disorders
Authors: Wijekumar P. J. , Ranadeva N. D.K. , Jayamaha A. R. , Herath H. M.N.D.M. , Noorden N. , Fernando S. S.N.
Published: November 2023

Objectives

A SNV is a single nucleotide change that can occur at any point in the genome. SNVs are the most common genetic variants that occur in the human genome, and a number of SNVs have been found to be associated with human traits and disease. Researchers genotype SNVs using TaqMan technology, DNA microarray, MALDI-TOF mass spectrometry, and automated sequencing, which are expensive and time-consuming. The OPRM1 gene rs1799971 (A118G) has been identified for its association with Opioid use disorder (OUD). The present study focused on developing a single step identification test using Tetra-Primer Amplification Refractory Mutation System-PCR (T-ARMS-PCR) to detect the presence of SNV OPRM1 rs1799971 (A118G). This study was performed to optimize the protocol for the designed four primers and validate it using a total of 52 buccal samples from volunteers who are currently under rehabilitation for the drug abuse disorder.

Results

Utilizing 52 DNA samples, a novel T-ARMS-PCR assay was successfully developed, tested, and validated. The products of the T-ARMS PCR for rs1799971 contained 395 bp as the control band, 186 bp as G allele (variant) and 257 bp as A allele (wild type), which were observed in the gel image. The genotype frequencies for the OPRM1 gene rs1799971 (A118G) were 44% (22/52) of homozygous variant type (GG), 28.9% (15/52) of homozygous wild type (AA) and 28.9% (15/22) of heterozygous (AG). The G allele frequency was 56.7% and A allele frequency was 43.3%.
Model-based optimal action selection for Dyna-Q reverberation suppression cognitive sonar
Authors: Fu Yubin , Ma Xiaochuan , Feng Chao , Pei Xingxuan , Li Pengzhuo
Published: November 2023

The Doppler shift of low-speed targets is frequently disturbed by the reverberation Doppler spread clutter under the shallow sea. The clutter is generated by underwater scatterers, which increases the difficulty of Doppler estimation. To solve this problem, a reverberation target resolution function based on the Doppler spread clutter statistical model is proposed in this paper. Through the width of reverberation Doppler clutter, this function adjusts the waveform parameters by determining whether the target is discriminable. In addition, the reverberation Doppler spread clutter is time-spatial varying and affected by grazing angle, waves, wind speed, fish and other effects. Thus, the sonar waveform parameters need to be adjusted constantly. Therefore, this paper combines the cognitive sonar based on reinforcement learning with the reverberation target resolution function to evaluate different waveforms in different environments. Consequently, the sonar can adjust the waveform parameters in real-time and obtain the optimal waveform in different environments. Meanwhile, in this paper, the action selection strategy of Dyna-Q reinforcement learning is optimized, and the model-based maximum action selection Dyna-Q algorithm (Dyna-Q-Max-Action) is proposed. Compared with the traditional Dyna-Q and Q-learning algorithms, the proposed algorithm needs fewer episodes. Finally, numerical simulation verified the effectiveness of the proposed algorithm.
What is the carbon footprint of reverse osmosis in water treatment plants? A systematic review protocol
Authors: Abolli Samaneh , Ghordouei Milan Esfandiar , Bashardoust Parnia , Alimohammadi Mahmood
Published: November 2023

Background

“Carbon footprint” (CF) is a direct measure of greenhouse gas emissions caused by a defined activity and can demonstrate global warming effects. The emissions of Greenhouse gases (GHGs) in water projects start from the primary water sources, followed by transportation, construction, and operation phases in the final treatment plants. Due to their possible environmental impacts, the water treatment plants equipped with Reverse Osmosis (RO) units will be investigated for their carbon footprint.

Methods

The research question is “What is the carbon footprint of reverse osmosis in water treatment plants?”. The literature search in this study will be divided into two sequential sections; in the first section, the search will be limited to Scopus, Science Direct, EMBASE, and PubMed databases. The keywords of water, “water treatment plants”, “water purification”, desalination, “reverse osmosis”, RO, “carbon emission”, “carbon dioxide/CO2 emission”, “carbon footprint”, “Life Cycle Assessment” and, LCA will be used. The carbon footprint of RO will be expressed based on the direct and indirect effects based on RO capacity. In the second section, the internet and specialist search will be done, and the search will be updated. No date limitation will be considered, and the main search will be done in English. When the search is completed, the screening will be performed. After removing duplicates, the title and abstract will be examined. The full text will be read if the title and abstract are not helpful for decision-making. In addition, the bibliography and references will proceed after the full-text screening. The Collaboration for Environmental Evidence (CEE) Critical Appraisal Tool will be used for risk of bias checking and study validity assessment. After full-text evaluation, data will be collected and categorized by two authors. If there is enough data, meta-analysis will be performed.

Systematic review registration PROSPERO CRD42022327572.
Evaluating residual tumor after neoadjuvant chemotherapy for muscle-invasive urothelial bladder cancer: diagnostic performance and outcomes using biparametric vs. multiparametric MRI
Authors: Woo Sungmin , Becker Anton S. , Das Jeeban P. , Ghafoor Soleen , Arita Yuki , Benfante Nicole , Gangai Natalie , Teo Min Yuen , Goh Alvin C. , Vargas Hebert A.
Published: November 2023

Background

Neoadjuvant chemotherapy (NAC) before radical cystectomy is standard of care in patients with muscle-invasive bladder cancer (MIBC). Response assessment after NAC is important but suboptimal using CT. We assessed MRI without vs. with intravenous contrast (biparametric [BP] vs. multiparametric [MP]) for identifying residual disease on cystectomy and explored its prognostic role.

Methods

Consecutive MIBC patients that underwent NAC, MRI, and cystectomy between January 2000–November 2022 were identified. Two radiologists reviewed BP-MRI (T2 + DWI) and MP-MRI (T2 + DWI + DCE) for residual tumor. Diagnostic performances were compared using receiver operating characteristic curve analysis. Kaplan-Meier curves and Cox proportional-hazards models were used to evaluate association with disease-free survival (DFS).

Results

61 patients (36 men and 25 women; median age 65 years, interquartile range 59–72) were included. After NAC, no residual disease was detected on pathology in 19 (31.1%) patients. BP-MRI was more accurate than MP-MRI for detecting residual disease after NAC: area under the curve = 0.75 (95% confidence interval (CI), 0.62–0.85) vs. 0.58 (95% CI, 0.45–0.70; p = 0.043). Sensitivity were identical (65.1%; 95% CI, 49.1–79.0) but specificity was higher in BP-MRI compared with MP-MRI for determining residual disease: 77.8% (95% CI, 52.4–93.6) vs. 38.9% (95% CI, 17.3–64.3), respectively. Positive BP-MRI and residual disease on pathology were both associated with worse DFS: hazard ratio (HR) = 4.01 (95% CI, 1.70–9.46; p = 0.002) and HR = 5.13 (95% CI, 2.66–17.13; p = 0.008), respectively. Concordance between MRI and pathology results was significantly associated with DFS. Concordant positive (MRI+/pathology+) patients showed worse DFS than concordant negative (MRI-/pathology-) patients (HR = 8.75, 95% CI, 2.02–37.82; p = 0.004) and compared to the discordant group (MRI+/pathology- or MRI-/pathology+) with HR = 3.48 (95% CI, 1.39–8.71; p = 0.014).

Conclusion

BP-MRI was more accurate than MP-MRI for identifying residual disease after NAC. A negative BP-MRI was associated with better outcomes, providing complementary information to pathological assessment of cystectomy specimens.
Nitrogen allocation in PM2.5 smoke-exposed plants: implications for ecosystem nitrogen cycling and stress response
Authors: Lin Haichuan , Ma Yuanfan , Zhao Pingxin , Huang Ziyan , Zhan Xiaoyu , Tigabu Mulualem , Guo Futao
Published: November 2023

Background

With the increase in forest fire emissions, an increasing amount of nitrogen is released from combustibles and taken up by plant leaves in the form of PM2.5 smoke deposition. Concurrently, the stress from PM2.5 also disrupts the physiological processes of plants. This study aims to reveal the migration paths of N in combustibles in smoke and plants during forest fires and the stress response of plant leaves to smoke particle deposition. This study conducted a simulated smoke deposition treatment on Schima superba and Cunninghamia lanceolata, analyzing the changes in plant 15N content and stress-related products.

Results

The main findings include the following: (1) Nitrogen in combustibles can be transported to plant leaves via PM2.5 smoke during combustion and can be allocated and assimilated in various parts of the plant after being absorbed by the leaves. (2) The stress response of Schima superba to PM2.5 is less pronounced than that of Cunninghamia lanceolata. (3) Under PM2.5 stress, the correlation between nitrogen accumulation in the leaves of Schima superba and Cunninghamia lanceolata and their respective stress responses differs.

Conclusions

In forest fires involving different tree species, there are variations in the migration pathways of nitrogen and the stress effects of PM2.5 on leaves, with a significant correlation observed between leaf nitrogen accumulation and stress response.

Graphical Abstract
Downregulation of RNA binding protein 47 predicts low survival in patients and promotes the development of renal cell malignancies through RNA stability modification
Authors: Wang Cheng , Li Weiquan , Meng Xiangui , Yuan Hongwei , Yu Tiexi , Yang Wei , Ni Dong , Liu Lei , Xiao Wen
Published: November 2023

RNA binding proteins (RBPs) are crucial for cell function, tissue growth, and disease development in disease or normal physiological processes. RNA binding motif protein 47 (RBM47) has been proven to have anti-tumor effects on many cancers, but its effect is not yet clear in renal cancer. Here, we demonstrated the expression and the prognostic role of RBM47 in public databases and clinical samples of clear cell renal carcinoma (ccRCC) with bioinformatics analysis. The possible mechanism of RBM47 in renal cancer was verified by gene function prediction and in vitro experiments. The results showed that RBM47 was downregulated in renal cancers when compared with control groups. Low RBM47 expression indicated poor prognosis in ccRCC. RBM47 expression in renal cancer cell lines was reduced significantly when compared to normal renal tubular epithelial cells. Epithelial-mesenchymal transition (EMT) and transforming growth factor-β signaling pathway was associated with RBM47 in ccRCC by Gene set enrichment analysis. RBM47 expression had a positive correlation with e-cadherin, but a negative correlation with snail and vimentin. RBM47 overexpression could repress the migration, invasion activity, and proliferation capacity of renal cancer cells, while RBM47 inhibition could promote the development of the malignant features through EMT signaling by RNA stability modification. Therefore, our results suggest that RBM47, as a new molecular biomarker, may play a key role in the cancer development of ccRCC.
Building an enhanced case-based reasoning and rule-based systems for medical diagnosis
Authors: Mustafa Eslam M. , Saad Mahmoud M. , Rizkallah Lydia Wahid
Published: November 2023

Expert systems are computer programs that use knowledge and reasoning to solve problems typically solved by human experts. Expert systems have been used in medicine to diagnose diseases, recommend treatments, and plan surgeries. Interpretability of the results in medical applications is crucial since the decision that will be taken based on the system’s output has a direct effect on people’s health and lives which makes expert systems ideal choices when dealing with these applications in contrast to other machine learning approaches. An expert system has the ability to explain its own line of reasoning providing a robust way of diagnosis. This paper presents two types of expert systems for medical diagnosis. The first system is a case-based reasoning system using a database of previously diagnosed cases to diagnose a new case. The second system is a rule-based expert system that uses a set of if–then rules extracted from a decision tree classifier to make diagnoses. In this paper, machine learning-based similarity functions are proposed and compared with other traditional similarity functions. The results of this study suggest that expert systems can be a valuable tool for medical diagnosis. The two systems presented in this paper achieved competitive results, and they provide diagnoses similar to those made by human experts.
(W)uman Tong(ue): Writing a Bilingual Newspaper Column in “Postcolonial” Jamaica
Authors: Cooper Carolyn
Published: November 2023

The cantankerous public discourse generated by the author’s bilingual newspaper columns published in the Jamaica Observer (May 1993 to January 1998) and the Jamaica Gleaner (March 2013 to the present) illustrates the conservative, neocolonial language ideology that still prevails in Jamaica. The essay demonstrates how contestations around national identity are articulated in a repressive language of moral authority. Speakers of “good” (English) and “bad” (Jamaican) language varieties become embattled in a struggle for the control of public terrain. The essay concludes that the “bilingual” model of Jamaican/English language identity has very little currency in a society that still privileges the “command” of English as a sign of the intellectual abilities of its habitual speakers/writers and that disparages competence in Jamaican as a marker of intellectual deficiency. Nevertheless, the author sees hopeful signs that the Jamaican language is gradually gaining national prominence.
Din as Discourse in the Anglophone Caribbean
Authors: Nair Supriya M.
Published: November 2023

This essay discusses Belinda Edmondson’s Creole Noise: Early Caribbean Dialect Literature and Performance (2022). The author shows how Edmondson challenges Standard English dismissals of anglophone Caribbean vernaculars as an inferior form of English and reorients the historical legacy of Anglo-Creoles by pushing against the assumption that these Creoles are a lingua franca restricted to Black folk cultures in the Caribbean. Beginning with European migration to the Caribbean, Creole Noise charts the colonial and postcolonial emergence of robust, creative vernaculars in the anglophone context. The lively, well-written book reveals how multiple constituencies have contributed culturally to the unique Caribbean language variants that refashioned the English language and enriched global literature.
Insurgent Knowledges: Reading How Europe Underdeveloped Africa alongside the Rupture in Guyana
Authors: Trotz D. Alissa , Westmaas Nigel
Published: November 2023

This essay offers a modest attempt to read Walter Rodney’s How Europe Underdeveloped Africa (1972) alongside the political tragedy that was unfolding in 1960s Guyana, which Rodney was thinking and writing about before and during his Dar es Salaam years. The authors suggest that this historical conjuncture and such a relational reading—in contrast to one that considers Rodney’s Caribbean, African, and Guyanese years separately or with little attention to the dynamic overlap of context—provide important insights into Rodney’s radical historical praxis as a model for transnational liberation.
Responsiveness of Patient-Reported and Device-based Physical Activity Measures: Secondary Analysis of Four Randomised Trials
Authors: Baldwin Jennifer N. , He Jialan , Oliveira Juliana S. , Bates Amanda , Tiedemann Anne , Hassett Leanne , Sherrington Catherine , Pinheiro Marina B.
Published: November 2023

Purpose

This study aimed to compare the responsiveness of patient-reported and device-based instruments within four physical activity trials.

Methods

This was a secondary analysis of four randomised trials that used both a patient-reported outcome measure (the Incidental and Planned Exercise Questionnaire, IPEQ) and a device-based instrument (ActiGraph or ActivPAL) to measure physical activity. The four trials included were (i) Activity and MObility UsiNg Technology (AMOUNT): digitally-enabled exercises in those undertaking aged care and neurological rehabilitation; (ii) Balance Exercise Strength Training (BEST) at Home: home-based balance and strength exercises in community-dwelling people aged ≥65 years; (iii) Coaching for Healthy AGEing (CHAnGE): physical activity coaching and fall prevention intervention in community-dwelling people aged ≥60 years; and (iv) Fitbit trial: fall prevention and physical activity promotion with health coaching and activity monitor in community-dwelling people aged ≥60 years. We estimated treatment effects for all variables within each physical activity instrument using regression analyses and expressed results as effect sizes (ES).

Results

Overall, device-based instruments were more responsive among healthy older adults (ES range: 0.01 to 0.32), whereas the IPEQ was more responsive among adults requiring rehabilitation (ES range: -0.06 to 0.35). Both the IPEQ and device-based instruments were more responsive in trials that promoted walking via coaching participants to increase their daily steps (AMOUNT [ES range: -0.06 to 0.35], CHAnGE [ES range: -0.24 to 0.22] and Fitbit trial [ES range: -0.23 to 0.32]). Individual variables within the IPEQ and device-based instruments varied in their responsiveness (ES range: -0.13 to 0.20).

Conclusions

Both the IPEQ and device-based instruments are able to detect small changes in physical activity levels. However, responsiveness varies across different interventions and populations. Our findings provide guidance for researchers and clinicians in selecting an appropriate instrument to measure changes in physical activity.
Αγία Γραφή και Ιερά Παράδοση στους επίσημους διμερείς διαλόγους της Ορθόδοξης Εκκλησίας
Authors: Αβαγιάννης Σταύρος
Published: November 2023

Σκοπός της παρούσας διατριβής είναι η διεξοδική μελέτη και διερεύνηση ,των κειμένων συμφωνίας των επίσημων διμερών θεολογικών διαλόγων της Ορθόδοξης Εκκλησίας στη βάση της Αγίας Γραφής και της Ιερής Παράδοσης ώστε να υπάρξει μία συνολική καταγραφή και αποτίμηση του υλικού, αλλά και να δειχθεί πόσο δύσκολο είναι να επιτευχθεί μία ουσιαστική συμφωνία, ακόμα και σε θέματα στα οποία υπάρχει μία αυτονόητη συναίνεση. Η σειρά της έκθεσης του υλικού ακολούθησε την αναλυτική πορεία ανά συγκεκριμένο διάλογο με κάθε «Εκκλησία», ενώ δεν έγινε μία προσπάθεια οριζόντιας διασύνδεσης και κατηγοριοποίησης ανά θέμα. Η διατριβή είναι πρωτότυπη καθώς για πρώτη φορά στην ελληνική και διεθνή έρευνα πραγματοποιείται καταγραφή των θεμάτων και των αποτελεσμάτων των επίσημων διμερών θεολογικών διαλόγων της Ορθόδοξης Εκκλησίας κατά τρόπο συστηματικό, μεθοδολογικό και αναλυτικό τρόπο με βάση την Αγία Γραφή και την Αγία Γραφή. Παράδοση.
Η αξία της νυχτερινής παλμικής οξυμετρίας σε παιδιά με σύνδρομο αποφρακτικής άπνοιας στον ύπνο
Authors: Παππά Παναγιώτα
Published: November 2023

Εισαγωγή: Η νυχτερινή παλμική οξυμετρία (NOx) έχει προταθεί ως εναλλακτική της πολυϋπνογραφίας (PSG) για τη διάγνωση παιδιών με σύνδρομο αποφρακτικής άπνοιας στον ύπνο (OSAS). Ωστόσο, η NOx δεν μπορεί να αποκλείσει αξιόπιστα την ύπαρξη OSAS διότι πολλά παιδιά, ακόμη και με σημαντική νόσο, δεν παρουσιάζουν σημαντικούς αποκορεσμούς και δεν μπορούν να εντοπιστούν με αυτή τη μέθοδο. Σκοπός: Σκοπός αυτής της μελέτης ήταν η εφαρμογή προηγμένης ανάλυσης σήματος για τη δημιουργία νέων δεικτών NOx που θα μπορούσαν να βελτιώσουν τη διάγνωση του OSAS. Μέθοδος: Μέσω μιας αντίστροφης προσέγγισης μελετήσαμε παιδιά ηλικίας 3-10 ετών που υποβλήθηκαν σε αδενοειδοαμυγδαλεκτομή λόγω κλινικών συμπτωμάτων OSAS (βαθμολογία ερωτηματολογίου ύπνου ≥ 0,35) και υπερτροφία αμυγδαλών (κλίμακα Friedman > 2). Όλοι οι συμμετέχοντες πραγματοποίησαν NOx πριν την επέμβαση καθώς και τρεις μήνες αργότερα, και αξιολογήθηκαν οι αλλαγές στην κλίμακα οξυμετρίας McGill(MOS), στον δείκτη αποκορεσμών ≥3% (ODI3), στον δείκτη αποκορεσμών ≥4% (ODI4) και στις νέες παραμέτρους αθροιστική περιοχή κορεσμού (CSA) και δειγματική εντροπία του SpΟ2 (SSE). Αποτελέσματα: 45 παιδιά πραγματοποίησαν επιτυχώς και τις δύο καταγραφές NOx. ΤοMOS ήταν ασαφές ή μη διαγνωστικό στο 37,8% των συμμετεχόντων. Υπήρξε σημαντική μείωση στο ODI3 (από 17,8 ± 13,4 σε 1,7 ± 1,2 συμβάντα ανά ώρα, P <0,001) και στο ODI4 (από 12,1 ± 11,6 σε 0,6 ± 0,6 συμβάντα ανά ώρα, P <0,001), και σημαντική αύξηση στον μέσο SpO2 (από 96,2 ± 1,4 % σε 98,2 ± 0,6 %, P <0,001) μετά την αδενοειδοαμυγδαλεκτομή. Η CSA μειώθηκε από 473 ± 136 σε 245 ± 30 (P <0,001) και ηSSE μειώθηκε από 1,46 ± 0,30 σε 0,58 ± 0,19 τρεις μήνες μετά την επέμβαση. Το MOS είχε μια περιοχή κάτω από την καμπύλη (AUC) 0,811 με 63,2% ευαισθησία και 100% ειδικότητα για τιμές >1. Η AUC του ODI3 ήταν 0,994, με 97,8% ευαισθησία και 91,1% ειδικότητα για τιμές >3,6 συμβάντα ανά ώρα. Το CSA και το SSE είχαν AUC 1,00, με100% ευαισθησία και ειδικότητα για τιμές >293 και >0,99, αντίστοιχα. Συμπεράσματα: Οι νέοι δείκτες CSA και SSE είναι πολλά υποσχόμενοι για τη βελτίωσητης διαγνωστικής ικανότητας της NOx σε παιδιά ύποπτα για OSAS.