bluuebunny/crossref_metadata_2025 huggingface dataset:
The Queensland Virtual Integrated Practice (VIP) Partnership Program pilot study: An Australian-first model of care to support rural general practice
Authors: Lepre Breanna , Job Jennifer , Martin Zena , Kerrigan Natalie , Jackson Claire
Published: April 2023

Background There is a critical lack of medical workforce internationally, and this is particularly notable in rural and remote Australia where strategies to address workforce shortages are urgently required. This pilot study aimed to implement and evaluate a Virtual Integrated Practice (VIP) Program in the Australian rural primary care setting.Methods The VIP model was developed using co-creation methodology and involves an urban GP joining a rural general practice team to provide ongoing care to patients remotely via secure telehealth. The pilot study was conducted in two western Queensland general practices, commencing in October 2021 with one rural practice and extending to an additional rural practice from November 2022. Evaluation included a retrospective review of service, billing and cost data, and an online survey for patients. Ethical approval was obtained from the University of Queensland Human Research Ethics Committee (Project number: 2021/HE002434).Results There were 1468 services provided through to December 2022, including general consults (n = 1197), therapeutic procedures (n = 68), mental health treatment plans (n = 68) and chronic disease management plans (n = 59). Patients were predominantly female (73.1%) and did not have their appointment at the practice (57.8%). Among 1282 occasions of service, less than 20% of consultations (n = 224) required support from staff (e.g., a nurse), and more than half were repeat patient encounters (53.0%). Survey respondents (n = 45) indicated that they were satisfied (9.3%) or highly satisfied (90.7%) with the care provided, and importantly, 95.5% of respondents reported that the service improved their access to the GP. More than 20% of respondents indicated that they would attend the Emergency Department if virtual care was not available.Conclusions Data from this pilot study has informed translation to an additional 20 vulnerable rural general practices in three further rural regions in Queensland in 2023 and evaluation is ongoing. This pilot study demonstrates the feasibility and acceptability of an innovative, digitally supported community-focussed, healthcare initiative to arrest the decline in rural general practice workforce, improve patient care access and support rural practice viability.
Intra-cesarean post placental introducer withdrawal IUD insertion technique: A new standardized technique for IUD insertion during cesarean section. A randomized controlled trial
Authors: seleem mostafa , sedik mona m , megahed azza mm , nabil hala
Published: April 2023

Background: The insertion of IUDs during caesarean section reduces the need for more manipulation and discomfort. This study aims to find out a standard technique for IUD insertion during cesarean section with the least possible problems especially displacement and missed threads.
Methods: A randomized controlled study was conducted at Kasr Al-Ainy Maternity hospital, Cairo University, Egypt. The study was conducted over the period of 12 months in the period from September 2020 till September 2021. Two groups of patients were selected; each group included 420 patients with desire for IUD insertion during cesarean section. Group (A) (Control group) was subjected to post-placental intrauterine device (Cupper T380) during cesarean section using conventional manual method, Group (B) (Study group): the IUD (Cupper T380) was placed at the top of the uterine fundus using a new technique (intra-cesarean post placental introducer withdrawal IUD insertion technique).
Results: There was significant statistical difference between the two groups in the term of displacement of the IUDs at the end of puerperium, at 6 months, non-visualization of IUD threads and continuation of use with p-value<0.05. There was no significant statistical difference in the term of duration of surgery.
Conclusion: The new technique of post-placental IUD insertion can be the standard technique of intra-cesarean section IUD insertion as it is associated with more favorable outcomes among the included women in the form of lower incidence of IUD displacement, non-visualization of IUD strings and higher rates of continuation without increasing the duration of surgery as compared with the conventional manual technique.
Trial registration: ClinicalTrial.gov ID: NCT05788354, registration date: 28/03/2023 (retrospectively registered)
Relationship of Distress and Quality of Life with Gut Microbiome composition in Newly Diagnosed Breast Cancer Patients: a prospective, observational study
Authors: Lee Chi-Chan , Yang Horng-Woei , Liu Chih-Ju , Lee Fan , Ko Wen-Ching , Chang Yuan-Ching , Yang Po-Sheng
Published: April 2023

There is little research about the stress, quality of life (QOL) and gut microbiota in newly diagnosed breast cancer patients. We sought to determine the relationship of distress scale and FACT-B different domain and fecal microbial composition among newly diagnosed breast cancer patients. Total 82 newly diagnosed breast cancer patients were enrolled in this prospective, observational study. The mean score of the FACT-B was 104.5 (SD, 19.76). The mean DT score was 4.43, with 53.7% (44/82) of the patients reporting moderate to severe distress (score 5 or above). Several associations between distress, FACT-B different domain and microbial taxa were observed among this sample of breast cancer patients. Specifically, Alcaligenaceae and Sutterella were significantly more abundant in individuals with higher scores on the DT scale at the family and genus level, respectively (p = 0.017), while Streptococcaceae (p = 0.028) at the family level and Streptococcus (p = 0.023) at the genus level were significantly more abundant in individuals with lower scores on the DT scale. This study defines the relationships among stress, QOL and gut microbiota in newly diagnosed breast cancer patients and provides many useful information to find potential probiotics for decreasing stress and improving QOL in breast cancer patients.
A combination of air–liquid interface culture and differentiation factors promotes the formation of intestinal structure
Authors: 小川 勇 , Iwao Takahiro , Matsunaga Tamihide
Published: April 2023

Reproducing intestinal cells in vitro is important in pharmaceutical research and drug development. Currently, Caco-2 cells and human induced pluripotent stem cell (iPS cell)-derived intestinal epithelial cells are widely used, but there are a few evaluation systems that mimic the three-dimensional structure of the crypt-villus-like structure. Therefore, we attempted to generate intestinal cells mimicking the three-dimensional structure from human iPS cells.
After inducing the differentiation of iPS cells into intestinal organoids, they became single-celled and were cultured two-dimensionally. Air–liquid interface culture was used, and CHIR99021, forskolin , and A-83-01 were used as key compounds. In addition to general analyses, the 3D structure of cells in culture was observed using Cell3iMager Estier to quantify cell irregularities and height. Long-term culture was also performed by adding Wnt3a, Noggin, and RSPO1, which are frequently used in organoid culture.
For results, the combination of air–liquid interface culture and several compounds successfully induced the formation of a crypt-villus-like structure, which grew rapidly around day 6. The expression of pharmacokinetic genes such as CYP3A4 was also enhanced. Moreover, the addition of Wnt3a, Noggin, and RSPO1 stabilized the expression of genes involved in the maintenance of intestinal stem cells, and the cells were successfully cultured for a long period of 22 days.
We were able to construct a crypt-villus-like convexitystructure on a very simple culture platform, viz., cell culture inserts. The characteristics of this structure were extremely similar to those of living intestinal tissues, and it might possess homeostatic mechanisms similar to those of living organisms.
Galectin-1 promotes gastric cancer peritoneal metastasis through peritoneal fibrosis
Authors: Shen Xianhe , Liu Huilan , Zhou Haihua , Cheng Zhiyi , Liu Guiyuan , Huang Chuanjiang , Dou Rongrong , Liu Fuxing , you Xiaolan
Published: April 2023

Peritoneal metastasis is one of the main causes of death in patients with gastric cancer (GC). Galectin-1 regulates various undesirable biological behaviors in GC and may be key in GC peritoneal metastasis. In this study, we elucidated the regulatory role of galectin-1 in GC cell peritoneal metastasis. GC and peritoneal tissues underwent hematoxylin–eosin (HE), immunohistochemical (IHC), and Masson trichrome staining to analyze the difference in galectin-1 expression and peritoneal collagen deposition in different GC clinical stages. The regulatory role of galectin-1 in GC cell adhesion to mesenchymal cells and in collagen expression was determined using HMrSV5 human peritoneal mesothelial cells (HPMCs). Collagen and corresponding mRNA expression were detected with western blotting and reverse transcription RT-PCR, respectively. The promoting effect of galectin-1 on GC peritoneal metastasis was verified in vivo. Collagen deposition and collagen I, collagen III, and fibronectin 1 (FN1) expression in the peritoneum of the animal models were detected by Masson trichrome and IHC staining. Galectin-1 and collagen deposition in the peritoneal tissues was correlated with GC clinical staging and were positively correlated. Galectin-1 enhanced the ability of GC cells to adhere to the HMrSV5 cells by promoting collagen I, collagen III, and FN1 expression. The in vivo experiments confirmed that galectin-1 promoted GC peritoneal metastasis by promoting peritoneal collagen deposition. To conclude, galectin-1-induced peritoneal fibrosis may create a favorable environment for GC cell peritoneal metastasis.
Machine learning for the development of diagnostic models of decompensated heart failure or exacerbation of chronic obstructive pulmonary disease.
Authors: Gálvez-Barrón César , Pérez-López Carlos , Villar-Álvarez Felipe , Ribas Jesús , Formiga Francesc , Chivite David , Boixeda Ramón , Iborra Cristian , Rodríguez-Molinero Alejandro
Published: April 2023

Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are two chronic diseases with the greatest adverse impact on the general population, and early detection of their decompensation is an important objective. However, very few diagnostic models have achieved adequate diagnostic performance. The aim of this trial was to develop diagnostic models of decompensated heart failure or COPD exacerbation with machine learning techniques based on physiological parameters. A total of 135 patients hospitalized for decompensated heart failure and/or COPD exacerbation were recruited. Each patient underwent three evaluations: one in the decompensated phase (during hospital admission) and two more consecutively in the compensated phase (at home, 30 days after discharge). In each evaluation, heart rate (HR) and oxygen saturation (Ox) were recorded continuously (through a pulse oximeter) during a period of walking for 6 minutes, followed by a recovery period of 4 minutes. To develop the diagnostic models, predictive characteristics related to HR and Ox were initially selected through classification algorithms. Potential predictors included age, sex and baseline disease (heart failure or COPD). Next, diagnostic classification models (compensated vs. decompensated phase) were developed through different machine learning techniques. The diagnostic performance of the developed models was evaluated according to sensitivity (S), specificity (E) and the accuracy (A). Data from 22 patients with decompensated heart failure, 25 with COPD exacerbation and 13 with both decompensated pathologies were included in the analyses. Of the 99 characteristics of HR and Ox initially evaluated, 19 were selected. Age, sex and baseline disease did not provide greater discriminative power to the models. The techniques with S and E values above 80% were logistic regression (S: 80.83%; E: 86.25%; A: 83.61%) and the support vector machine (S: 81.67%; E: 85%; A: 82.78%). The diagnostic models developed achieved good diagnostic performance for decompensated HF or COPD exacerbation. To our knowledge, this study is the first to report diagnostic models of decompensation potentially applicable to both COPD and HF patients. However, these results are preliminary and it warrants further investigation to be confirmed.
A Multi-stage Neural Network Approach for Coronary 3D Reconstruction from Uncalibrated X-ray Angiography Images
Authors: Iyer Kritika , Nallamothu Brahmajee K. , Figueroa C. Alberto , Nadakuditi Raj R.
Published: April 2023

We present a multi-stage neural network approach for 3D reconstruction of coronary artery trees from uncalibrated 2D X-ray angiography images. This method uses several binarized images from different angles to reconstruct a 3D coronary tree without any knowledge of image acquisition parameters. The method consists of a single backbone network and separate stages for vessel centerline and radius reconstruction. The output is an analytical matrix representation of the coronary tree suitable for downstream applications such as hemodynamic modeling of local vessel narrowing (i.e., stenosis). The network was trained using a dataset of synthetic coronary trees from a vessel generator informed by both clinical image data and literature values on coronary anatomy. Our multi-stage network achieved sub-pixel accuracy in reconstructing vessel radius (RMSE = 0.16 ± 0.07mm) and stenosis radius (MAE = 0.27 ± 0.18mm), the most important feature used to inform diagnostic decisions. The network also led to 52% and 38% reduction in vessel centerline reconstruction errors compared to a single-stage network and projective geometry-based methods, respectively. Our method demonstrated robustness to overcome challenges such as vessel foreshortening or overlap in the input images. This work is an important step towards automated analysis of anatomic and functional disease severity in the coronary arteries.
Dexmedetomidine as an anesthetic adjunct is associated with reduced complications and CICU length of stay after heart valve surgery
Authors: Fan Zhi-Wei , Tang Yu-Xian , Pan Tuo , Zhang Hai-Tao , Zhang He , Yan Da-Liang , Wang Dong-Jin , Li Kai
Published: April 2023

Background: We sought to explore the relationship between dexmedetomidine as an anesthetic adjuvant in cardiac surgery and postoperative complications and length of stay (LOS) in the cardiac intensive care unit (CICU).
Methods: We conducted a retrospective study of patients aged 18 years and older who underwent heart valve surgery between October 2020 and June 2022. The study endpoints were a combination of adverse outcomes, which included major postoperative complications (cardiac arrest, atrial fibrillation, myocardial injury/infarction, heart failure) and prolonged CICU LOS (defined as LOS≥90th percentile). Multivariate logistic regression analysis was performed for variables that were significant in the univariate analysis.
Results: A total of 856 patients entered our study. Of these, 283（33.06%） patients experienced at least one adverse outcome and the remaining 573 were included in the prognostic control group. Multivariate logistic regression analysis revealed that age > 60years (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.27–2.37; p=0.01), cardiopulmonary bypass( CPB)> 190min (OR, 1.58; 95% CI, 1.01-2.48; p = 0.04) and postoperative mechanical ventilation time > 10 h (OR, 2.03; 95% CI, 1.49-2.77; p < 0.01) were independent risk factors for major complications and prolonged CICU length of stay in patients undergoing heart valve surgery. Intraoperative use of dexmedetomidine as an anesthetic adjuvant was a protective factor for such patients (odds ratio, 0.53; 95% confidence interval, 0.37-0.78; p = 0.01).
Conclusions: Age, duration of cardiopulmonary bypass, and duration of mechanical ventilation are associated with major complications and increased CICU stay after heart valve surgery. Intraoperative use of dexmedetomidine may improve such clinical outcomes.
Online Education Isn’t the Best Choice: Evidence-Based Medical Education in the Post-epidemic Era—A Cross-Sectional Study
Authors: Liu Jiarui , Liang Jun , Lang Jie , Zhang Lijia , Tang Mingwen , Chen Xinyu , Xie Yan , Zhang Jianling , Su Liyu , Wang Xin , Zhang Yi
Published: April 2023

Background The COVID-19 pandemic led many educational institutions to shift to online courses, making blended education a significant trend in teaching. We examined the effectiveness of blended learning in an evidence-based medicine course.Methods We compared the examination scores of a blended learning group, an online only group, and a traditional offline group and conducted a questionnaire survey on students’ preferences for different learning modes and the reasons for their preferences. A total of 2100 undergraduate students in clinical medicine were included in this cross-sectional study. Examination results were collected, and questionnaires were administered to the study participants. We compared the mean theoretical scores and exam pass rates of the three teaching groups using ANOVA and c2test for multiple comparisons.Results The blended group’s theoretical scores and pass rate were significantly higher than those of the offline and online groups. Furthermore, 71.6% preferred the blended teaching mode. Most students believed that blended teaching was the most effective mode—offline education: 7.86%; online education: 26.14%; blended education: 66%. Subsequently, in a questionnaire administered to a blended group of students, their foremost reason for liking online instruction was ‘flexible in time and space’ (99%), followed by ‘can be viewed repeatedly, facilitating a better understanding of knowledge points’ (98%). Their foremost reason for liking offline teaching was ‘helps to create a good learning atmosphere’ (97%), followed by ‘teachers can control students’ learning status in real time’ (89%).Conclusions This study explored the effectiveness of learning in evidence-based medicine courses by comparing the learning outcomes and personal perceptions of three different teaching modes. This is the first cross-sectional study in which three different teaching models are compared and discussed in an evidence-based medicine course. We also elaborate on the specific instructional protocols for each model. This study shows that using a blended education approach in evidence-based medicine courses can improve students’ learning motivation, autonomy, and satisfaction. It also enhances instructional efficiency, thereby improving students’ understanding of the course content.
Mist CVD-based growth of crystalline alpha chromium oxide (α-Cr2O3) on c-plane sapphire substrate with chromium acetylacetonate as a precursor
Authors: Sadullah Md , Hussain Syed Mohd , Ghosh Kunal
Published: April 2023

α-Cr2O3 is used as a buffer layer for the growth of α-Ga2O3 on sapphire for power devices. Presently, the growth of crystalline corundum-structured metal oxides, except for αCr2O3 are performed with metal acetylacetonates. In this paper, we report, for the first time, the development of a crystalline α-Cr2O3 on c-plane sapphire with chromium acetylacetonate as precursor over a wide temperature range varying from 400 oC to 550 oC. The temperature range not only ensures the compatibility of the process with α-Ga2O3 technology but also satisfies the requirement that the window is large enough to adequately optimize the quality of crystalline α-Cr2O3 thin film. XRD, SEM, AFM and XPS was performed to analyse the quality of the crystalline α-Cr2O3 layer. The best quality α-Cr2O3 is obtained at 500°C with the molarity of chromium acetylacetonate being 0.05, with a deposition rate of 35.37 nm/min and a crystallite size of 31.21 nm.
Comparison of efficacy and safety between PD-1 inhibitors and PD- L1 inhibitors plus platinum-etoposide as first-line treatment for extensive-stage small-cell lung cancer: a multicenter, real-world analysis
Authors: Wang Yanrong , Li Lingling , Hu Jia , Zhao Yan , Yan Huan , Gao Ming , Yang Xuejiao , Zhang Xia , Ma Junxun , Dai Guanghai
Published: April 2023

Background Immunotherapy in combination with platinum-etoposide (EP) chemotherapy has been approved as a first-line treatment for extensive-stage small cell lung cancer (ES-SCLC). However, real-world (RW) data regarding the use of immune checkpoint inhibitors (ICIs) in ES-SCLC are lacking. We aimed to assess the differences between programmed death protein 1 (PD-1) inhibitors and programmed death ligand 1 (PD-L1) inhibitors plus EP chemotherapy as first-line treatment for ES SCLC.
Methods We conducted a real-world, multicenter, retrospective cohort, controlled study to compare the prognosis, efficacy, and safety of PD-1 and PD-L1 inhibitors along with chemotherapy for patients with ES-SCLC. Each patient received up to six cycles of etoposide, carboplatin, or cisplatin combined with ICIs drugs, including PD-1 and PD-L1 inhibitors. The primary endpoints were investigator-assessed progression-free survival (PFS) and overall survival (OS). The secondary endpoints were investigator-assessed objective response rate (ORR), disease control rate (DCR), and duration of response (DOR)according to the Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1).
Results Between January 2017 and December 2021, 194 patients with ES-SCLC from three clinical centers in a PLA general hospital were included in our study, including 93 patients in the PD-1 group and 101 patients in the PD-L1 group. At the time of data cutoff, progression-free survival in the PD-1 group (median PFS, 6.8months; 95%CI, 5.3-8.1) was similar to the PD-L1 group (median PFS, 6.4months; 95%CI, 5.5-7.5); the stratified hazard ratio for PFS was 1.12 (95%CI, 0.83-1.53; P=0.452). The median OS was similar in the PD-1 and PD-L1 group (15.8m vs 17.7m, P = 0.566); the hazard ratio was 0.90 (95% CI, 0.62-1.30, P=0.566). The two groups had comparable investigator-assessed confirmed objective response rates (ORR) (76.3% vs 76.2%) and median duration of response (DOR) (6.2m vs 6.1m). Adverse effects (AEs) related discontinuation occurred in 4(4.3%) patients in the PD-1 group and 2(2.0%) patients in the PD-L1 group. Deaths due to AEs of any cause occurred in 2(2.2%) patients in the PD-1 inhibitor group and 1(1.0%) patient in the PD-L1 inhibitor group, separately.
Conclusions Our research revealed that no significant differences in efficacy or prognosis were observed between PD-1 inhibitor + EP chemotherapy and PD-L1 inhibitor + EP chemotherapy. The two groups seemed to have comparable safety profiles, but the number of discontinuation or death events is too few to draw a firm conclusion.
Transient power equalization control strategy of virtual synchronous generator in isolated island microgrid with heterogeneous power supply
Authors: Gao Changwei , Sun Yongchang , Zheng Weiqiang , Wang Wei
Published: April 2023

In the parallel supply system of synchronous generator and virtual synchronous generator, the physical structure and control structure of the two kinds of power supply are quite different, and it is difficult to distribute the transient power of the two kinds of power supply evenly when the load changes abruptly. Especially in the case of sudden load increase, virtual synchronous generator bears too much load in the transient process because of its fast adjustment speed, and even causes short-term overload, which makes the capacity of virtual synchronous generator can not be fully utilized. In view of this problem, firstly, the mechanism of transient power uneven distribution of two heterogeneous power sources is explained from the differences of frequency modulation, voltage regulation and output impedance. Secondly, virtual speed regulation, virtual excitation and dynamic virtual impedance are added to the traditional virtual synchronous generator control to simulate the speed regulation characteristics and electromagnetic transient characteristics of the synchronous generator, so as to realize the transient and steady-state power equalization between heterogeneous power supplies when the virtual synchronous generator and the synchronous generator run in parallel. Thirdly, in order to ensure the fast dynamic response characteristics of the virtual synchronous generator in independent operation mode, the traditional virtual synchronous generator control algorithm is still maintained in independent operation mode, and the mode switching control link based on state tracking is designed to realize smooth switching between the two working modes. Finally, the hardware in loop experiment results based on RT-LAB show that the proposed control method can realize the transient and steady-state power equalization when the virtual synchronous generator and the synchronous generator operate in parallel, it can keep the fast voltage regulation and frequency modulation ability when the virtual synchronous generator operates independently, and can realize smooth switching between independent and parallel operation modes.
Integrated Geotechnical and Mineralogical Evaluation of the Subgrade of some failed Pavements along Enugu-Onitsha Expressway Southeastern Nigeria
Authors: Ukor Kelechi Paulinus , igwe ogbonnaya , Onwuka Obialo Solomon , Nzereogu Stella Kosi , Nnaji Eze Kelechi , Echezona Pearl Elochukwu
Published: April 2023

This research is focused on the constant pavement failure in parts of the Enugu-Onitsha expressway. The failed portions are constructed on the natural subgrade known to be the Shale of Enugu and Mamu Formations. Five (5) samples each were obtained from the Formations and were subjected to geotechnical test, mineralogical analysis, scanning electron microscopy (SEM) and, statistical analysis. The outcome of the geotechnical test revealed that the liquid limits (LL) are of high plasticity with values ranging from 57.69–62.61% and 53.57–56.24%, plasticity index (PI) values ranging from 20.32–24.37% and 13.37–15.32%, Slake durability index (SDI) values ranging from 0.55–31.8% and 63.4–71.6%, for Enugu and Mamu Shales respectively. From the Unconfined compressive strength (UCS) test, the cohesion (C) values ranged from 37.36–43.89KPa and 24.22- 27.07KPa, soaked California bearing ratio (CBR) values ranged from 1.03–1.22% and 0.90–1.60% for Enugu and Mamu Shales respectively. The test results are below the requirements laid down by the Federal Ministry of Works and Housing (FMWH) for pavement construction. X-Ray Diffraction (XRD) analysis revealed major minerals to be quartz and kaolinite. Moreover, kaolinite disperses and migrates when moist hence geotechnical failure. Images from SEM revealed the presence of micropores and fractures which can be used as a reference to the geotechnical test results. Statistical analysis of key geotechnical parameters such as SDI, PI, C, and CBR revealed a strong correlation. The evaluated results pointed out that the underlined natural subgrade is poor for pavement construction, and thus requires stabilization.
A novel prognostic risk model construction and immune landscape analysis of gastric cancer based on disulfidptosis-related lncRNAs
Authors: tian yuan , Wang Guanlong , Li Rui , Xu Kai , Li Hongxia , He lei
Published: April 2023

Background: Disulfidptosis is a novel form of cell death that induces disulfide stress leading to cell death. Therefore, this may be a new direction for future cancer therapy. More and more studies have shown that long non-coding RNAs (lncRNAs) can regulate gastric cancer-related biological processes. At present, there is no research on disulfidptosis-related lncRNAs (DRLs) in GC.
Methods: The Cancer Genome Atlas (TCGA) was used to retrieve information about RNA sequencing data, clinical data, and genetic mutation data of GC patients. RNA sequencing data, clinical data, and genomic mutation data of GC patients were downloaded from the Cancer Genome Atlas. First, TCGA data are randomly assigned to the training set and the validation set. Then, a predictive risk model was built in the training set using univariate and multivariate Cox regression models, as well as the least absolute shrinkage and selection operator (LASSO). The predictive value of the model was verified by receiver operating characteristic (ROC) curves and the concordance index (C-index) in the validation set and the entire set. The univariate and multivariate Cox regression analysis, nomogram, and correlation analysis of clinicopathological characteristics were used to confirm the clinical utility of the prognostic risk model. Finally, we further used tumor mutation burden (TMB) and tumor immune dysfunction and exclusion (TIDE) scores to evaluate the effectiveness of immunotherapy and analyze the sensitivity of related drugs.
Results: Six prognostically-related DRLs (TNFRSF10A-AS1, LINC02829, LINC00460, AL139147.1, IGFL2-AS1, and AC104123.1) were used to construct the model. The overall survival (OS) of the high-risk group and the low-risk group was statistically significant, according to the Kaplan-Meier survival graph. The ROC and C-index show that the model has the good predictive ability. Risk score was revealed to be an independent prognostic factor by univariate and multivariate Cox regression analysis. The prognostic risk model was negatively correlated with TMB. According to the results of TIDE, immunotherapy has a better therapeutic effect on the high-risk group. In addition, the prognostic risk model of GC was significantly correlated with drug sensitivity.
Conclusions: In summary, this study identified six DRLs as predictors of GC prognosis, which may be a potential biomarker for predicting drug sensitivity and immunotherapy efficacy of GC in the future.
SNX14 inhibits autophagy via the PI3K/AKT/mTOR signaling cascade in breast cancer cells
Authors: Lv Sha , Jiang Hongyan , Yu Lingyan , Zhang Yafei , Sun Liangliang , Xu Junjun
Published: April 2023

Background
Sorting nexin 14 (SNX14) is a member of the sorting junction protein family. Its specific roles in cancer development remain unclear. Therefore, in this study, we aimed to determine the effects and underlying mechanisms of SNX14on autophagy of breast cancer cells to aid in the therapeutic treatment of breast cancer.
Methods
In this study, we performed in vitro experiments to determine the effect of SNX14 on breast cancer cell growth. Moreover, we used an MCF7 breast cancer tumor-bearing mouse model to confirm the effect of SNX14 on tumor cell growth in vivo. We also performed western blotting and quantitative polymerase chain reaction to identify the mechanism by which SNX14 affects breast cancer MCF7 cells.
Results
We found that SNX14 regulated the onset and progression of breast cancer by promoting the proliferation and inhibiting the autophagy of MCF7 breast cancer cells. In vivo experiments further confirmed that SNX14 knockdown inhibited the tumorigenicity and inhibited the growth of tumor cells in tumor tissues of nude mice. In addition, western blotting analysis revealed that SNX14 modulate the autophagy of MCF7 breast cancer cells via the phosphoinositide 3-kinase/protein kinase B/mechanistic target of rapamycin kinase signaling pathway.
Conclusion
Our findings indicate that SNX14 is an essential tumor-promoting factor in the development of breast cancer.
An online cross-sectional survey investigating community pharmacists’ information needs for evidence-based self-medication counselling
Authors: Alexa Jennifer Maria , Bertsche Thilo
Published: April 2023

Background
Community pharmacists play an important role in healthcare. They are the only professional point of contact for all self-medication-related matters. Little research has been done regarding the information needs of pharmacists for evidence-based self-medication counselling.
Aim
To explore pharmacists’ information needs in 5 predefined areas of information needs: individual needs, quality needs, utilization needs, implication needs, and access needs.
Setting
Community pharmacies in Germany.
Method
After ethical approval, we conducted a mixed-methods study in form of an exploratory, semi-quantitative, cross-sectional online survey. Members of 3 different chambers of pharmacists were invited to participate anonymously in the survey and without any incentives after giving informed consent.
Main outcome measure
Quantitative outcome: Frequency of relevance / importance of items within predefined information needs areas, except for access needs. Qualitative outcome: Open-text responses concerning all information needs.
Results
Data from a total of 823 participants, who completed the survey, were analyzed. General and specific information such as dosage (74.2 % [611/823]) and when to refer to a physician (64.6 % [532/823]) as well as an over-the-counter-product’s effectiveness according to medical guidelines (71.4 % [588/823]) were rated as very important. Participants reported to prefer digital information sources (50.5 % [416/823] strongly agreed), especially in the form of an easily accessible database (61.6 % [507/823] strongly agreed) that contains regularly updated, manufacturer independent, critically appraised, concise information.
Conclusion
Community pharmacists expressed distinct information needs for evidence-based self-medication counselling. Further information on essential evidence-based pharmacy knowledge may be necessary to support the correct implementation.
Increased scale and accessibility of sediment transport research in rivers through practical, open-source turbidity and depth sensors
Authors: Langhorst Theodore , Pavelsky Tamlin , Eidam Emily , Cooper Lillian , Davis Julianne , Spellman Katie , Clement Sarah , Arp Christopher , Bondurant Allen , Friedmann Elisa , Gleason Colin
Published: April 2023

Open-source designs for turbidity and depth sensors are becoming increasingly capable and available, but the knowledge required to construct them limits their use compared to expensive, commercial sensors. Here, we present an open-source optical backscatter and water pressure sensor that can be ordered almost fully assembled, requires no coding to deploy, and costs approximately $50 USD. We share three examples of these sensors’ ability to facilitate new research. First, we observed complex changes in spatial and temporal patterns of suspended sediment transport in the Arctic Sagavanirktok River using a network of sensors. Second, we measured turbidity during the freeze-up period in the Tanana River, a period of high risk to sensors. Last, we built and deployed sensors with middle-school students to monitor turbidity under full ice cover on the Tanana River. The success of open-source sensors in these examples shows a marked increase in scale and accessibility of river science.
Development of service standards and manpower calculation criteria for hospital clinical pharmacies in South Korea: a survey-based study
Authors: Lee Mirinae , Kim Seung-Eun , Jung Ji-Hye , Park Yoon-Hee , Han Hyewon
Published: April 2023

Background After the revision of the Korean Pharmaceutical Affairs Act, the certification of specialized pharmacists is scheduled to be legally recognized in 2023. Considering that the specialized pharmacist certification was developed based on the working model of hospital clinical pharmacists, standards for clinical pharmacists in hospital and appropriate manpower calculation are needed.
AimTo develop practical standards for clinical pharmacists and to present the standards for calculating the level of manpower based on the actual workload survey.
Method In order to develop clinical pharmacy services standards, literature review was performed. To classify essential tasks, a modified Delphi study was performed in a tertiary hospital. Based on this, manpower calculation was performed through a multi-center survey for pharmacists in hospitals with more than 1,000 beds. The survey respondents were working in one out of four fields: pediatrics, organ transplantation, oncology, and critical care.
Results Clinical pharmacy services were classified into 4 types: medication therapy management, medication education, medication use evaluation, and multidisciplinary team activities. Essential tasks accounted for 93% of the total tasks for clinical pharmacy services. The required full-time equivalent (FTE) through workload calculation was 2.5±1.9 on average for each field, while the FTE allocated to actual practice was 2.1±1.6.
Conclusion An agreement was reached on the essential work of clinical pharmacy services. However, the FTE of clinical pharmacists in actual practice was insufficient compared to the required amount. In order to establish and expand clinical pharmacy services in hospital, it is necessary to ensure manpower for essential tasks.
Positive Association between Dispositional Mindfulness and Knee OsteoarthritisCommon Health Problems
Authors: chu su feng , Chiu Aih-Fung , Wang Hsiu-Hung
Published: April 2023

Background Knee Osteoarthritis is one of the most common chronic illnesses that often cause health problems. The objective of our study is to explore whether dispositional mindfulness is associated with knee OA patient’s common health problems of physical, psychological, and activity behavior.Methods A cross-sectional study and purposive sampling were performed by orthopedic clinic patients in hospitals in Southern Taiwan. A total has 250 adults completed the study questionnaires. Multiple linear regression was used to explore potentially related factors for dispositional mindfulness.Results We found that higher dispositional mindfulness is associated with married or spouse, better-perceived health status, lower depression, and greater physical activity in the knee OA population. Dispositional mindfulness was not related to joint pain, joint stiffness, physical function, fear of falling, and exercise self-efficacy. However, this study demonstrated that dispositional mindfulness is positively associated with Knee OA common health problems. These relationships help distinguish knee OA’s at a high risk of lower dispositional mindfulness.Conclusions We found that persons without close partners (single, widowed, or divorced) may with lower dispositional mindfulness and need to pay attention to them. Also, more studies are desired to clarify and explain the role-playing of dispositional mindfulness on pain and physical activity. We suggest further study to assess whether the cultivation of mindfulness (e.g., mindfulness-based interventions) may lead to improved physical, psychological, and activity behavior in the knee OA population are needed.
Using ChatGPT to Predict the Future of Personalized Medicine
Authors: Hasanzad Mandana , Patrinos George , Sarhangi Negar , Sarrami Behnaz , Larijani Bagher
Published: April 2023

Personalized medicine is a novel frontier in health care that is based on each person’s unique genetic makeup. It represents an exciting opportunity to improve the future of individualized health care for all individuals. Pharmacogenomics, as the main part of personalized medicine, aims to optimize and create a more targeted treatment approach based on genetic variations in drug response. It is predicted that future treatments will be algorithm-based instead of evidence-based that will consider a patient’s genetic, transcriptomic, proteomic, epigenetic, and lifestyle factors resulting in individualized medication. A generative pretrained transformer (GPT) is an artificial intelligence (AI) tool that generates language resembling human-like writing enabling users to engage in a manner that is practically identical to speaking with a human being. GPT's predictive algorithms can respond to questions that have never been addressed. Chat Generative Pretrained Transformer (ChatGPT) is an AI chatbot's advanced with conversational capabilities. In the present study, Questions were asked from ChatGPT about the future of personalized medicine and pharmacogenomics. ChatGPT predicted both to be a promising approach with a bright future that holds great promises in improving patient outcomes and transforming the field of medicine.
Machine learning predictive approaches for Cu-Au mineral prospectivity map in theSonajil, NW of Iran: An improvement by Bayesian semi-supervised algorithm
Authors: Mohammadjafar Mohammadzadeh , Majid Mahboubiaghdam , Moharram Jahangiri , Aynur Nasseri
Published: April 2023

Most machine learning monitored algorithms used in the preparation of mineral potential prediction maps, require noise-free data to achieve high-performance and reliable results. To discover the hidden structures of a data set, unsupervised clustering methods are highly efficient. Therefore, in this paper, a combination of supervised and unsupervised methods was attempted using training and testing data to prepare a potential map with high accuracy in the Sonajil copper-gold deposit, located in NW of Iran. Here a semi-supervised Bayesian algorithm utilized to map the mineral landscape. At First, raster layers of 10 exploratory features were prepared. Then, 27 exploratory boreholes drilled were divided into 4 classes C1 to C4 based on the copper concentration, and from each class, two boreholes were selected and 100-meter buffering was performed around these boreholes to extract 1113 training data. Then, the existing data were clustered by the FCM method and the whole data and clustering data were entered into the Bayesian algorithm to evaluate the accuracy of Bayesian classifier method in 5 different clusters. The results show an increase in the average accuracy while using the clustered data instead of whole data for MPM mapping. Also, in case of not using cluster 5 data, it has the highest accuracy of 96%. To validate the Bayesian semi-supervised method, boreholes that were not used in data training were employed. Overall results based on the classification of boreholes and prepared potential map indicate accuracy of the Bayesian semi-supervised method as an optimal result for further exploration and delimiting more mineralization targets.
The pelagic food web of the Western Adriatic Sea: a focus on the role of small pelagics
Authors: FANELLI EMANUELA , Ros Zaira Da , Menicucci Samuele , Malavolti Sara , Biagiotti Ilaria , Canduci Giovanni , De Felice Andrea , Leonori Iole
Published: April 2023

Small pelagic fishes play a crucial role in pelagic food webs as both top-down and bottom-up controllers. Their role as predators could also exert a wasp-waist flow control. The Adriatic basin is one of the largest areas of occurrence of small pelagic shared stocks and the most exploited basin of the Mediterranean Sea. Here, we analyzed the ontogenetic and spatial variations in the stable isotope composition of three small pelagic fishes (i.e., Engraulis encrasicolus, Sardina pilchardus, and Sprattus sprattus) collected throughout the western side of the basin and relate such differences to both resource availability and environmental variables. Medium-sized specimens of the three species mostly fed on small zooplankton, while adult sprats relied on large copepods and those of sardine and anchovy seemed to shift on phytoplankton, confirming the high trophic plasticity of these two dominants small pelagic species. Resource partitioning occurred at each size and in each sub-area, also favored by the high productivity and in turn high resource availability of the basin, especially in the northern part. These small pelagic fish were located at different, but very close, trophic position with other small pelagic species, and thus competition might occur in the future driven by modified feeding conditions as consequence of increasing sea temperatures.
Extraction and Characterization of Bast Fiber from Xanthium Oriental plant
Authors: Azanaw Aklilu , Haile Adane , Birlie Bantamlak
Published: April 2023

The textile fiber market is dominated by synthetic fibers and costly natural fibers. The dual perspective with regards to finding substitutes for costly natural fibers and disadvantages due to environmental burden cum health problems by synthetic fibers need to be addressed as both entail sustainable improvement of the textile industry. The potential route for tackling such problems is utilizing unlimited plant resources in developing countries like Ethiopia. The objective of this study is to extract, characterize, and chemically treated xanthium oriental bast fiber extracted from the plant using the conventional water retting method. In the invitation, the experimental design was based on Central Composite Design (CCD) method, and treatment parameters were selected, specifically NaOH concentration, and treatment temperature. Analysis of variance (ANOVA) was used to analyze the significance of the results. The chemical composition analysis revealed 72% cellulose, 18% hemicellulose, and 10% lignin. Xanthium oriental fiber has a diameter of 26.85 μm, a fineness of 1.76tex, and a length of 110–145 cm with reduced values for fiber treated at different alkali concentrations. The moisture content of the extracted fiber was 12.74%. The raw fiber sample showed lower crimp (1.04%) as compared with those treated at different caustic soda concentrations. Moreover, scanning electron microscopy (SEM), thermogravimetric analysis (TGA), and Fourier transform infrared spectroscopy (FTIR) was used to analyze the changes in surface, weight loss, and composition of xanthium oriental bast fiber treated with alkali under optimum conditions compared with untreated to obtain a deeper insight into the influential mechanisms of alkali treatment.
Delivery room intubation and severe intraventricular hemorrhage in extremely preterm infants without low Apgar scores: A Japanese retrospective cohort study
Authors: Tamai Kei , Matsumoto Naomi , Yorifuji Takashi , Takeuchi Akihito , Nakamura Makoto , Nakamura Kazue , Kageyama Misao
Published: April 2023

The purpose of this study was to assess the associations between delivery room intubation (DRI) and severe intraventricular hemorrhage (IVH), as well as other neonatal outcomes, among extremely preterm infants without low Apgar scores using data from a large-scale neonatal registry data in Japan. We analyzed data for infants born at 24–27 gestational weeks between 2003 and 2019 in Japan using robust Poisson regression. Infants with low Apgar scores (≤ 1 at 1 minute or ≤ 3 at 5 minutes) were excluded. The primary outcome was severe IVH. Secondary outcomes were other neonatal morbidities and mortality. The full cohort included 16081 infants (intubation cohort, 13367; no intubation cohort, 2714). The rate of DRI increased over time (78.6%, 2003–2008; 83.4%, 2009–2014; 87.8%, 2015–2019), while the rate of severe IVH decreased (7.1%, 2003–2008; 5.7%, 2009–2014; 5.3%, 2015–2019). Infants with DRI had a higher risk of severe IVH than those without DRI (6.8% vs. 2.3%; adjusted risk ratio, 1.86; 95% confidence interval, 1.33–2.58). The results did not change substantially when stratified by gestational age. Despite conflicting changes over time in DRI and severe IVH, DRI was associated with an increased risk of severe IVH among extremely preterm infants in Japan.