bluuebunny/crossref_metadata_2025 huggingface dataset:
DeepCAC: a deep learning approach on DNA transcription factors classification based on multi-head self-attention and concatenate convolutional neural network
Authors: Zhang Jidong , Liu Bo , Wu Jiahui , Wang Zhihan , Li Jianqiang
Published: September 2023

Understanding gene expression processes necessitates the accurate classification and identification of transcription factors, which is supported by high-throughput sequencing technologies. However, these techniques suffer from inherent limitations such as time consumption and high costs. To address these challenges, the field of bioinformatics has increasingly turned to deep learning technologies for analyzing gene sequences. Nevertheless, the pursuit of improved experimental results has led to the inclusion of numerous complex analysis function modules, resulting in models with a growing number of parameters. To overcome these limitations, it is proposed a novel approach for analyzing DNA transcription factor sequences, which is named as DeepCAC. This method leverages deep convolutional neural networks with a multi-head self-attention mechanism. By employing convolutional neural networks, it can effectively capture local hidden features in the sequences. Simultaneously, the multi-head self-attention mechanism enhances the identification of hidden features with long-distant dependencies. This approach reduces the overall number of parameters in the model while harnessing the computational power of sequence data from multi-head self-attention. Through training with labeled data, experiments demonstrate that this approach significantly improves performance while requiring fewer parameters compared to existing methods. Additionally, the effectiveness of our approach  is validated in accurately predicting DNA transcription factor sequences.
Functional and clinical outcomes of delusional disorder and schizophrenia patients after first episode psychosis: a 4-year follow-up study
Authors: Hui Christy Lai Ming , Chan Evie Wai Ting , Hui Priscilla Wing Man , Tao Tiffany Junchen , Ho Elise Chun Ning , Lam Bertha Sze Ting , Wah See Sally Hiu , Suen Yi Nam , Chang Wing Chung , Wa Sherry Kit , Lee Edwin Ho Ming , Chen Eric Yu Hai
Published: September 2023

Background

Literature has typically associated delusional disorder with a poorer prognosis relative to schizophrenia, without considering the confounding effect of age despite the differential age of onset. This study therefore aims to investigate the diagnostic stability, clinical, functional, and neurocognitive differences of Chinese first-episode psychosis age-matched patients with delusional disorder and schizophrenia at four years.

Methods

71 delusional disorder and 71 age-matched schizophrenia patients were followed up for four years after their initial episode. Their symptoms, insight in psychosis, side effects of medication, medication compliance, functioning, and neurocognitive performance were assessed at four years.

Results

At four years, 65% of DD patients maintained the same diagnosis, while the rest shifted to SZ. Only those without a diagnostic shift were included in the analysis. Delusional disorder patients (n = 46) experienced greater general psychopathology and poorer insight, but better attitude towards medication than schizophrenia patients (n = 71). Social and occupational functioning, quality of life, and cognitive functioning, however, were similar in delusional disorder and schizophrenia patients.

Conclusions

Results indicate that delusional disorder is less diagnostically stable than schizophrenia. Their outcomes in a Chinese population were largely similar at four years after removing the confounding age factor, implying that delusional disorder and schizophrenia may not be as distinct as previously thought.
Tai Chi for the prophylaxis of episodic migraine: protocol of a non-inferiority randomized controlled trial with mechanism exploration
Authors: Xie Yao Jie , Liao Xiaoli , Hui Stanley Sai-chuen , Tian Longben , Yeung Wing Fai , Lau Alexander Yuk-lun , Tyrovolas Stefanos , Gao Yang , Chen Xiangyan
Published: September 2023

Background

Migraine is a complex neurovascular disorder with considerable clinical, social and economic issues. Tai chi has the potential to be an alternative prophylactic treatment for migraine with high safety since the adverse effects and limited efficacy of available medications.

Aims

The proposed study aims to compare the prophylaxis efficacy of 24-week Tai Chi training on migraine attacks with the standard prophylactic medication; and to explore the mechanism of Tai Chi in preventing migraine attacks by analyzing the associations between changes of migraine attacks and changes of neurovascular functions and inflammatory makers.

Method

This is a two-arm parallel non-inferiority randomized controlled trial. In total 220 Hong Kong Chinese women aged 18–65 years with diagnosis of episodic migraine will be recruited and randomized to either the Tai Chi training group or the standard prophylactic medication group with 1:1 ratio, and receive the 24 weeks of modified 33-short form Yang-style Tai Chi training and the standard prophylactic medications, respectively. A 24-week follow-up will be implemented for both groups. For efficacy examination, the primary outcome was the frequency of migraine attacks measured by the migraine diary; and for the mechanism exploration, the primary outcome was the volume and number of white matter hyperintensity (WMH) measured by magnetic resonance imaging (MRI). The measurements will be conducted at the baseline, 24th weeks, and 48th weeks. Linear mixed model will be adopted to comprehensively analyze the changes of variables within and between groups.

Discussion

Given the importance of reducing disease burden and financial cost of migraine attacks, the findings of this study will provide new insights regarding the role of Tai Chi in alleviating migraine burden and further shed light on the mechanism action of Tai Chi on preventing headache attacks.

Trial registration

ClinicalTrials.gov NCT05690737. Registered on January 28, 2023.
Exploring the relationship between burnout and emotional intelligence among academics and clinicians at King Saud University
Authors: Almeneessier Aljohara S. , Azer Samy A.
Published: September 2023

Background

Academics and clinicians are exposed to significant workload pressures and are at a high risk of stress and burnout.

Objectives

This study aimed to examine the relationship between burnout and emotional intelligence (EI) by comparing and corelating burnout and EI scores among academics and clinicians against several factors.

Methods

In this cross-sectional study, academics and clinicians at King Saud University and King Saud University Medical City and Affiliated Hospitals were invited to complete anonymous questionnaires: Maslach Burnout Inventory-Human Services Survey and the Trait Emotional Intelligence Questionnaire Short Form. The collected data were analyzed using the SPSS software for descriptive studies, group comparisons, regression analyses, and Pearson's (r) correlation tests.

Results

Study participants included 126 individuals (men = 65, 51.6%; women = 61, 48.4%). Of these, 65% were Saudi nationals and 35% were expatriates, and 76 were academics while 50 were clinicians. The mean (minimum to maximum) burnout total score was 55 ± 18.9 (8 to 97) and the global TEIQue-SF score ranged between 2.8 and 6.7 (5.04 ± 0.7). Burnout scores varied between departments and were higher among younger participants and non-Saudis. Age had a small direct correlation with self-control (r = .17, p = .05), and there was no statistically significant correlation with other EI factors. However, there was a moderate inverse correlation between age and emotional exhaustion (EE) (r = -0.33, p < 0.0001), and a small inverse correlation with depersonalization (DP) (r = -0.21, p = 0.02). T-tests demonstrated a statistically significant difference in EI factor "emotionality" among Saudis (5.2 ± .8) and non-Saudis (4.9 ± .8) (t124 = 2.2, p = 0.03), and for burnout subscales, there was a statistically significant difference in DP among Saudis (6.4 ± 4.8) and non-Saudis (8.5 ± 5.6), (p = 0.03). Moderate (r = -0.3, p = 0.01) and weak (r = -0.2, p = 0.05) negative correlations were found between EI factors and burnout subscales (EE, DP).

Conclusion

This study confirmed an inverse relationship between burnout and EI scores among academics and clinicians. The findings suggest the need for introducing measures and implementing a system for early detection of burnout among staff and providing support to enhance EI and requisite care for those undergoing burnout episodes.
The role of health insurance literacy in the process and outcomes of choosing a health insurance policy in the Netherlands
Authors: Holst Laurens , Brabers Adriana Elisabeth Maria , Rademakers Jeannette Josepha Dingena Johanna M , de Jong Judith Danielle
Published: September 2023

In several countries, citizens are expected to be critical consumers when choosing a health insurance policy. However, there are indications that citizens do not always have the sufficient skills, so called health insurance literacy (HIL), to do this. We investigated whether the level of HIL among Dutch citizens is related to the way in which they experience the process of choosing a policy, and furthermore whether it is related to their health insurance choices. We obtained information by sending questionnaires to members of the Nivel Dutch Health Care Consumer Panel in 2020. Of the 1,500 approached, 806 panel members participated (response rate 54%). Our results indicate that, compared to those with a high HIL, respondents with a low HIL more often find choosing a health insurance policy difficult, not interesting, and boring, and less often consider it important and worthwhile. Furthermore, they make less use of the opportunity to switch from one health insurer to another. However, they do still opt for a supplementary insurance policy and a voluntary deductible to the same extent as citizens with a high HIL. We conclude that the HIL level among Dutch citizens is related to the way in which they experience the process of choosing a health insurance policy and to the extent to which they switch from one insurer to another. But it is not related to their health insurance choices. Follow-up research should focus on how citizens with a low HIL can be better supported when choosing a health insurance policy.
Reconstruction with a double-constrained implant design after complex shoulder extra-articular resection
Authors: Lesensky Jan , Belzarena Ana C. , Daniel Matej
Published: September 2023

Background

Approximately, one-third of patients with tumors of proximal humerus will require an extra-articular resection to achieve oncologic margins. This procedure yields poor functional outcomes with a considerable rate of revisions. Unconstrained implants are prone to instability hindering also function of the elbow and hand, whereas constrained shoulder reconstructions suffer from early aseptic loosening of the glenoid component due to bone overload. The purpose of this study was to develop a constrained implant suitable for extra-articular resection with loss of function in deltoid and rotator cuff, which would provide both stability and passive motion, whilst also decreasing the risk of aseptic loosening of the glenoid component.

Methods

In cooperation with Czech Technical University in Prague, we devised an implant consisting of two constrained joints in series connected by a dumbbell piece. The biomechanical analysis showed a reduction of load transfer to the glenoid component with a torque of 8.6 Nm capable of generating an 865-N pulling force on bone screw to just 0.07 Nm, hence shielding the glenoid component from undesired forces and decreasing the risk of aseptic loosening. Three patients with extra-articular resection with a total loss of function of both rotator cuff and deltoid muscle received this type of reconstruction. The average follow-up was 16 months.

Results

The surgical technique is straightforward. The surgery took 175 min on average with average blood loss of 516 ml. There were no surgical- or implant-related complications. All three patients were pain-free and had a stable shoulder joint after the reconstruction. All had fully functional elbow, wrist, and hand joints. The average Musculoskeletal Tumor Society (MSTS) score was 21/30 (70%). All patients were pleased with the results.

Conclusion

The presented innovative implant design has demonstrated to be a promising alternative for reconstruction in these challenging cases.
The true natural cycle frozen embryo transfer - impact of patient and follicular phase characteristics on serum progesterone levels one day prior to warmed blastocyst transfer
Authors: Mumusoglu Sezcan , Erden Murat , Ozbek Irem Yarali , Ince Onur , Esteves Sandro C. , Humaidan Peter , Yarali Hakan
Published: September 2023

Background

In a true-natural cycle (t-NC), optimal progesterone (P4) output from the corpus luteum is crucial for establishing and maintaining an intrauterine pregnancy. In a previous retrospective study, low P4 levels (< 10 ng/mL) measured one day before warmed blastocyst transfer in t-NC were associated with significantly lower live-birth rates. In the current study, we aim to examine the relationship between patient, follicular-phase endocrine and ultrasonographic characteristics, and serum P4 levels one day prior to warmed blastocyst transfer in t-NC.

Method

178 consecutive women undergoing their first t-NC frozen embryo transfer (FET) between July 2017-August 2022 were included. Following serial ultrasonographic and endocrine monitoring, ovulation was documented by follicular collapse. Luteinized unruptured follicle (LUF) was diagnosed when there was no follicular collapse despite luteinizing-hormone surge (> 17 IU/L) and increased serum P4 (> 1.5 ng/mL). FET was scheduled on follicular collapse + 5 or LH surge + 6 in LUF cycles. Primary outcome was serum P4 on FET − 1.

Results

Among the 178 patients, 86% (n = 153) experienced follicular collapse, while 14% (n = 25) had LUF. On FET-1, the median serum luteal P4 level was 12.9 ng/mL (IQR: 9.3–17.2), ranging from 1.8 to 34.4 ng/mL. Linear stepwise regression revealed a negative correlation between body mass index (BMI) and LUF, and a positive correlation between follicular phase peak-E2 and peak-P4 levels with P4 levels on FET-1. The ROC curve analyses to predict < 9.3 ng/mL (< 25th percentile) P4 levels on FET-1 day showed AUC of 0.70 (95%CI 0.61–0.79) for BMI (cut-off: 23.85 kg/m2), 0.71 (95%CI 0.61–0.80) for follicular phase peak-P4 levels (cut-off: 0.87 ng/mL), and 0.68 (95%CI 0.59–0.77) for follicular phase peak-E2 levels (cut-off: 290.5 pg/mL). Combining all four independent parameters yielded an AUC of 0.80 (95%CI 0.72–0.88). The adjusted-odds ratio for having < 9.3 ng/mL P4 levels on FET-1 day for patients with LUF compared to those with follicle collapse was 4.97 (95%CI 1.66–14.94).

Conclusion

The BMI, LUF, peak-E2, and peak-P4 levels are independent predictors of low serum P4 levels on FET-1 (< 25th percentile; <9.3 ng/ml) in t-NC FET cycles. Recognition of risk factors for low serum P4 on FET-1 may permit a personalized approach for LPS in t-NC FET to maximize reproductive outcomes.
Fibroblast diversity and plasticity in the tumor microenvironment: roles in immunity and relevant therapies
Authors: Xu Yashi , Li Wei , Lin Shitong , Liu Binghan , Wu Peng , Li Li
Published: September 2023

Cancer-associated fibroblasts (CAFs), enriched in the tumor stroma, have received increasing attention because of their multifaceted effects on tumorigenesis, development, metastasis, and treatment resistance in malignancies. CAFs contributed to suppressive microenvironment via different mechanisms, while CAFs also exerted some antitumor effects. Therefore, CAFs have been considered promising therapeutic targets for their remarkable roles in malignant tumors. However, patients with malignancies failed to benefit from current CAFs-targeted drugs in many clinical trials, which suggests that further in-depth investigation into CAFs is necessary. Here, we summarize and outline the heterogeneity and plasticity of CAFs mainly by exploring their origin and activation, highlighting the regulation of CAFs in the tumor microenvironment during tumor evolution, as well as the critical roles performed by CAFs in tumor immunity. In addition, we summarize the current immunotherapies targeting CAFs, and conclude with a brief overview of some prospects for the future of CAFs research in the end.
Dysregulation of inflammasome activation in glioma
Authors: Sim JeongMin , Park JeongMan , Moon Jong-Seok , Lim Jaejoon
Published: September 2023

Gliomas are the most common brain tumors characterized by complicated heterogeneity. The genetic, molecular, and histological pathology of gliomas is characterized by high neuro-inflammation. The inflammatory microenvironment in the central nervous system (CNS) has been closely linked with inflammasomes that control the inflammatory response and coordinate innate host defenses. Dysregulation of the inflammasome causes an abnormal inflammatory response, leading to carcinogenesis in glioma. Because of the clinical importance of the various physiological properties of the inflammasome in glioma, the inflammasome has been suggested as a promising treatment target for glioma management. Here, we summarize the current knowledge on the contribution of the inflammasomes in glioma and therapeutic insights.
Perioperative safety and efficacy of robot-assisted total hip arthroplasty in ERAS-managed patients: a pilot study
Authors: Lu Hanpeng , Sun Haocheng , Xiao Qiang , Xu Hong , Zhou Qi , Li Linyuan , Yan Tingfang , Wang Duan , Zhou Zongke
Published: September 2023

Aims

Robot-assisted total hip arthroplasty (rTHA) boasts superior accuracy in implant placement, but there is a lack of effective assessment in perioperative management in the context of enhanced recovery after surgery (ERAS). This study aimed to compare the effectiveness and safety of rTHA versus conventional total hip arthroplasty (cTHA) in ERAS-managed patients.

Methods

In this prospective trial, a total of 60 eligible patients aged between 18 and 80 years were randomly divided into two groups to undergo either rTHA or cTHA. The primary outcomes included blood loss parameters. Secondary outcomes were the duration of the operation, surgical time, WOMAC pain score, WOMAC stiffness score, WOMAC physical function score, Harris score, and postoperative complications.

Results

The study cohort analyzed 59 eligible participants, 30 of whom underwent rTHA and 29 of whom underwent cTHA. Analysis could not be conducted for one patient due to severe anemia. Notably, the cTHA group had a significantly shorter surgical time than the rTHA group (69.49 ± 18.97 vs. 104.20 ± 19.63 min, P < 0.001). No significant differences were observed between the rTHA and cTHA groups for blood loss parameters, including total blood loss (1280.30 ± 404.01 vs. 1094.86 ± 494.39 ml, P = 0.137) and drainage volume (154.35 ± 121.50 vs. 159.13 ± 135.04 ml, P = 0.900), as well as intraoperative blood loss (126.67 ± 38.80 vs. 118.52 ± 60.68 ml, P = 0.544) and hidden blood loss (982.43 ± 438.83 vs. 784.00 ± 580.96 ml, P = 0.206). Only one patient in the cTHA group required allogeneic blood transfusion. At 3 months postoperatively, both groups showed improvements in WOMAC pain score, WOMAC stiffness score, WOMAC physical function score, and Harris score, with no significant differences found between the two groups. Few complications were reported in both groups without significant differences.

Conclusions

Despite the longer surgical time, rTHA did not negatively affect blood loss, pain, or functional recovery or lead to an increased risk of complications in ERAS-managed patients, suggesting that rTHA can be safely and effectively incorporated into an ERAS program for primary THA.
Risk stratification tools for patients with syncope in emergency medical services and emergency departments: a scoping review
Authors: uit het Broek Lucia G. , Ort B. Bastiaan A. , Vermeulen Hester , Pelgrim Thomas , Vloet Lilian C.M. , Berben Sivera A.A.
Published: September 2023

Background

Patients with a syncope constitute a challenge for risk stratification in (prehospital) emergency care. Professionals in EMS and ED need to differentiate the high-risk from the low-risk syncope patient, with limited time and resources. Clinical decision rules (CDRs) are designed to support professionals in risk stratification and clinical decision-making. Current CDRs seem unable to meet the standards to be used in the chain of emergency care. However, the need for a structured approach for syncope patients remains. We aimed to generate a broad overview of the available risk stratification tools and identify key elements, scoring systems and measurement properties of these tools.

Methods

We performed a scoping review with a literature search in MEDLINE, CINAHL, Pubmed, Embase, Cochrane and Web of Science from January 2010 to May 2022. Study selection was done by two researchers independently and was supervised by a third researcher. Data extraction was performed through a data extraction form, and data were summarised through descriptive synthesis. A quality assessment of included studies was performed using a generic quality assessment tool for quantitative research and the AMSTAR-2 for systematic reviews.

Results

The literature search identified 5385 unique studies; 38 were included in the review. We discovered 19 risk stratification tools, one of which was established in EMS patient care. One-third of risk stratification tools have been validated. Two main approaches for the application of the tools were identified. Elements of the tools were categorised in history taking, physical examination, electrocardiogram, additional examinations and other variables. Evaluation of measurement properties showed that negative and positive predictive value was used in half of the studies to assess the accuracy of tools.

Conclusion

A total of 19 risk stratification tools for syncope patients were identified. They were primarily established in ED patient care; most are not validated properly. Key elements in the risk stratification related to a potential cardiac problem as cause for the syncope. These insights provide directions for the key elements of a risk stratification tool and for a more advanced process to validate risk stratification tools.
A fluorescence-based assay for Trichomonas vaginalis drug screening
Authors: Chen Qianqian , Li Jingzhong , Wang Zhensheng , Meng Wei , Wang Heng , Wang Zenglei
Published: September 2023

Background

The emergence and spread of drug resistance in Trichomonas vaginalis parasites has become an important concern in trichomoniasis treatment. Fast and reliable growth assessment is critical for validating in vitro drug susceptibility and high-throughput screening of newly developed drugs.

Methods

Modified media without yeast extract were evaluated for their ability to support the growth of T. vaginalis parasites. The potential of the nucleic acid-binding dye SYBR Green I for detecting T. vaginalis drug resistance was characterized, and seeding parasite concentration and incubation time were optimized. The fluorescence assay based on SYBR Green I was further validated in four T. vaginalis isolates with different susceptibilities to the antibiotics metronidazole, tinidazole, ornidazole and secnidazole, and compared with the traditional method that detects minimum lethal concentrations (MLCs).

Results

A modified medium consisting of RPMI 1640 and Tryptone Plus as replacements for yeast extract and tryptone, respectively, in traditional trypticase-yeast extract-maltose (TYM) medium exhibited similar performance as TYM medium in maintaining T. vaginalis growth, while it showed much lower background fluorescent signals. The T. vaginalis SYBR Green I-based fluorescence (TSF) drug assay was found to have to satisfy one of two conditions to demonstrate the 50% inhibitory concentration of metronidazole for the sensitive isolate TV-334: (i) a seeding density of 3 × 104 parasites/ml and an incubation time of 48 h; or (ii) a seeding density of 1 × 104 parasites/ml and an incubation time of 72 h. Subsequent validation experiments revealed that the 48-h incubation/3 × 104 parasites/ml seeding density condition had a greater sensitivity to detect drug resistance than the 72-h condition. The TSF assay also exhibited high efficiency in identifying parasite drug resistance, as evidenced by its strong correlation with the standard MLC assay results (P = 0.003).

Conclusions

This study presents a robust TSF assay that has the potential to facilitate high-throughput, automated in vitro anti-trichomoniasis susceptibility testing for drug resistance monitoring and drug development. In comparison to the standard MLC method, this assay offers the advantages of reduced labor and elimination of subjective examination.

Graphical Abstract
On generalization of Levinson’s inequality involving averages of 3-convex functions
Authors: Aras-Gazić G. , Pečarić J. , Vukelić A.
Published: September 2023

By using an integral arithmetic mean, a generalization of Levinson’s inequality given in (Pečarić et al. in Convex Functions, Partial Orderings, and Statistical Applications. Mathematics in Science and Engineering, vol. 187, 1992) and results from (Vukelić in Appl. Anal. Discrete Math. 14:670–684, 2020), we give extension of Wulbert’s result from (Wulbert in Math. Comput. Model. 37:1383–1391, 2003). Also, we obtain inequalities with divided differences for the functions of higher order.
Soil fauna accelerated litter C and N release by improving litter quality across an elevational gradient
Authors: Zhang Li , Liu Jingru , Yin Rui , Xu Zhenfeng , You Chengming , Li Han , Wang Lixia , Liu Sining , Xu Hongwei , Xu Lin , Liu Yang , Wang Yong , Tan Bo
Published: September 2023

Background

Soil fauna is an important driver of carbon (C) and nitrogen (N) release from decomposing litter in forest ecosystems. However, its role in C and N cycling concerning climate and litter traits remains less known. In a 4-year field experiment, we evaluated the effects of soil fauna on litter C and N release across an elevation gradient (453, 945, 3023, and 3582 m) and litter traits (coniferous vs. broadleaf) in southwestern China.

Results

Our results showed that N was retained by –0.4% to 31.5%, but C was immediately released during the early stage (156–516 days) of decomposition for most litter species. Soil fauna significantly increased the peak N content and N retention across litter species, but reduced the C/N ratio for certain species (i.e., Juniperus saltuaria, Betula albosinensis, Quercus acutissima, and Pinus massoniana litter), leading to more C and N being released from decomposing litter across the elevation gradient. Contributions of soil fauna to C and N release were 3.87–9.90% and 1.10–8.71%, respectively, across litter species after 4 years of decomposition. Soil environment and initial litter quality factors caused by elevation directly affected litter C and N release. Changes in soil fauna resulting from elevation and fauna exclusion factors had a direct or indirect impact on C and N release during litter decomposition.

Conclusions

Our findings suggest that soil fauna promote C and N release from decomposing litter in different magnitudes, mainly controlled by environmental conditions (i.e., temperature and moisture), litter quality (i.e., lignin and cellulose content, and lignin/cellulose), and its diversity across the elevation gradient.
National prevalence and risk factors for tungiasis in Kenya
Authors: Elson Lynne , Kamau Christopher , Koech Sammy , Muthama Christopher , Gachomba George , Sinoti Erastus , Chondo Elwyn , Mburu Eliud , Wakio Miriam , Lore Jimmy , Maia Marta , Adetifa Ifedayo , Orindi Benedict , Bejon Phillip , Fillinger Ulrike
Published: September 2023

Background

Tungiasis is a highly neglected tropical skin disease caused by the sand flea, Tunga penetrans, the female of which burrows into the skin, causing pain and itching. The disease occurs throughout South America and sub-Saharan Africa but there are few systematic data on national disease burdens. The tungiasis research community is keen to develop survey methods to fill this gap. Here we used a school-based, thorough examination method to determine the prevalence and risk factors for tungiasis in Kenya.

Methods

We conducted the first nationally representative survey of tungiasis, including nine counties covering the major ecological zones of Kenya. A stratified multistage random sampling was used to select 22 primary schools from each of the nine counties and to select up to 114 pupils aged 8 to 14 years in each school. Pupils were examined thoroughly for tungiasis. Two surveys were conducted, the first between May and July 2021 and the second between October 2021 and April 2023 when pupils were also interviewed for risk factors. Mixed effect logistic regression models were used to test associations of independent variables with tungiasis using the school as a random effect.

Results

The overall prevalence of tungiasis in the first survey was 1.35% [95% confidence interval (CI): 1.15–1.59%], and 0.89% in the second survey. The prevalence ranged from 0.08% (95% CI: 0.01–0.59%) in Taita Taveta county to 3.24% (95% CI: 2.35–4.44%) in Kajiado county. Tungiasis infection was associated with county of residence, male sex [adjusted odds ratio (aOR) = 2.01, 95% CI: 1.52–2.67], and lower age (aOR = 0.81, 95% CI: 0.75–0.88). For the first time we demonstrate an association with attending public schools rather than private schools (aOR = 5.62, 95% CI: 1.20–26.22) and lower socioeconomic status (aOR = 0.10, 95% CI: 0.03–0.33). Using a rapid screening method of the top of feet only, would have missed 62.9% of all cases, 78.9% of mild cases and 20.0% of severe cases.

Conclusions

Tungiasis is widely but heterogeneously distributed across Kenya. School-based surveys offer an efficient strategy for mapping tungiasis distribution.

Graphical Abstract
Psychometric properties of an Arabic translation of the body appreciation scale (BAS-2) and its short forms (BAS-2SF) in a community sample of Lebanese adults
Authors: Fekih-Romdhane Feten , Azzi Vanessa , Malaeb Diana , Sarray El Dine Abir , Obeid Sahar , Hallit Souheil
Published: September 2023

Objectives

The present study sought to examine the factor structure, reliability, validity and gender invariance of the Arabic Body Appreciation Scale (BAS-2), and its two short forms (the 3-item and 2-item BAS-2SF) among community Lebanese Arabic-speaking adults.

Methods

We carried-out an online cross-sectional survey. The 10-item BAS-2, the functionality appreciation scale and the Eating Attitudes Test-26 were completed by 826 Lebanese community adults (57.9% females, aged 25.42 ± 8.44 years).

Results

The Arabic 10-item, 3-item and 2-item BAS-2 converged on a one-factor solution, and demonstrated high internal consistency (McDonald’s ω value of .92, .88, and .86 respectively). All indices suggested that configural, metric, and scalar invariance was supported across gender. The 3-item and 2-item BAS-2SF were highly correlated with the original BAS-2 (r > 0.9). Higher 10-item, 3-item and 2-item BAS-2 scores correlated significantly and strongly with more positive eating attitudes and greater functionality appreciation, and higher 10-item BAS-2 scores correlated positively and weakly with BMI, supporting convergent validity.

Conclusion

The present work contributes to the literature by providing a psychometrically sound Arabic-translation of the BAS-2 and short-forms, benefitting both researchers and clinicians.
A toxic gain-of-function mechanism in C9orf72 ALS impairs the autophagy-lysosome pathway in neurons
Authors: Beckers Jimmy , Tharkeshwar Arun Kumar , Fumagalli Laura , Contardo Matilde , Van Schoor Evelien , Fazal Raheem , Thal Dietmar Rudolf , Chandran Siddharthan , Mancuso Renzo , Van Den Bosch Ludo , Van Damme Philip
Published: September 2023

Background

Motor neurons (MNs), which are primarily affected in amyotrophic lateral sclerosis (ALS), are a specialized type of neurons that are long and non-dividing. Given their unique structure, these cells heavily rely on transport of organelles along their axons and the process of autophagy to maintain their cellular homeostasis. It has been shown that disruption of the autophagy pathway is sufficient to cause progressive neurodegeneration and defects in autophagy have been associated with various subtypes of ALS, including those caused by hexanucleotide repeat expansions in the C9orf72 gene. A more comprehensive understanding of the dysfunctional cellular mechanisms will help rationalize the design of potent and selective therapies for C9orf72-ALS.

Methods

In this study, we used induced pluripotent stem cell (iPSC)-derived MNs from C9orf72-ALS patients and isogenic control lines to identify the underlying mechanisms causing dysregulations of the autophagy-lysosome pathway. Additionally, to ascertain the potential impact of C9orf72 loss-of-function on autophagic defects, we characterized the observed phenotypes in a C9orf72 knockout iPSC line (C9-KO).

Results

Despite the evident presence of dysfunctions in several aspects of the autophagy-lysosome pathway, such as disrupted lysosomal homeostasis, abnormal lysosome morphology, inhibition of autophagic flux, and accumulation of p62 in C9orf72-ALS MNs, we were surprised to find that C9orf72 loss-of-function had minimal influence on these phenotypes. Instead, we primarily observed impairment in endosome maturation as a result of C9orf72 loss-of-function. Additionally, our study shed light on the pathological mechanisms underlying C9orf72-ALS, as we detected an increased TBK1 phosphorylation at S172 in MNs derived from C9orf72 ALS patients.

Conclusions

Our data provides further insight into the involvement of defects in the autophagy-lysosome pathway in C9orf72-ALS and strongly indicate that those defects are mainly due to the toxic gain-of-function mechanisms underlying C9orf72-ALS.
Cycling knee brace design analysis using 3D virtual clothing program to assess clothing pressure distribution and variance
Authors: Kim Hee Young , Oh Kyung Wha
Published: September 2023

This study analyzed the functional design by investigating the distribution of clothing pressure of cycling knee brace using a three-dimensional virtual clothing program. Based on the average body size of Korean men in their 40 s, clothing pressure in wearing and cycling condition were collected on five knee brace products. According to the results, bonding fabric products had a high possibility of increasing inconvenience, as they had a higher clothing pressure at all measurement points and soared in motion application. It could be adjusted differently depending on the location by mixing materials or using details, so the design with thick pile fabric or velcro strap fastening added more pressure to the lower part of the knee. The length and circumference size also affected the clothing pressure. The design with tight upper and lower circumference pressured excessively the legs and rolled up and clumped together, while the one with loose lower circumference lacked the sufficient strength to support the knees. Also, the design with a curved outline due to the difference in the length of the front and back, increased the clothing pressure on the lower thigh or the upper calf. Therefore, the functional design of cycling knee braces requires comprehensive consideration of material thickness and structure, detailed size of length and circumference, fastening details, to reduce the pressure at the center and top of the knee and to support the lower part with proper pressure, as reflecting the pressure on the body location that come into contact during the motion.
Pseudophakic macular edema in nondiabetic and diabetic patients without diabetic retinopathy treated with intravitreal dexamethasone implant
Authors: Rodrigues Magna Vanessa , Garcia Jose Mauricio Botto , Pacheco Katia Delalibera , Borges Fabricio Tadeu , Isaac David Leonardo Cruvinel , Avila Marcos
Published: September 2023

Background

The purpose of this study was to compare the impact of intravitreal dexamethasone (DEX) implant during a 12-month period in nondiabetic and diabetic patients without diabetic retinopathy (DR) as a treatment for refractory pseudophakic cystoid macular edema (PCME) following prior treatment with topical nepafenac 0.1% and prednisolone 1%.

Methods

Forty-two consecutive medical records of patients diagnosed with PCME after uneventful cataract surgery were included. The outcomes measured included best corrected visual acuity (BCVA) and central foveal thickness (CFT). Linear regression analysis was statistically applied.

Results

Following topical treatment, nondiabetic and diabetic subjects presented a mean ± SD gain of − 0.11 ± 0.11 and − 0.18 ± 0.11 BCVA logMAR and a CFT reduction of − 43.42 ± 53.66 µm and − 58.76 ± 36.28 µm, respectively. The mean BCVA gain at month 12 subsequent to DEX implantation was − 0.35 ± 0.17 in nondiabetic (p < 0.001) and − 0.55 ± 0.26 in diabetic patients (p < 0.001), with CFT reductions of − 195.71 ± 93.23 µm (p < 0.001) and − 260.81 ± 198.69 µm (p < 0.001), respectively. Patients who responded with better VA after topical treatment presented better visual outcomes at month 12 following DEX implantation (r2 = 0.46; rho = − 0.71, p < 0.01).

Conclusion

Nondiabetic and diabetic patients without DR demonstrated similar results after DEX implant after combined topical therapy, suggesting that selected diabetic patients may have a response comparable to that of nondiabetic patients with PCME.
Anesthetic management for renal transplant in patients with grade III diastolic dysfunction: case reports
Authors: Kapoor Hemlata , Sarin Bipan Chander , Shah Milin Raju
Published: September 2023

Background

Left ventricular diastolic dysfunction is frequently noticed in patients with multiple co-morbidities. Echocardiography is used to determine the presence of diastolic dysfunction and to grade its severity. In left ventricular diastolic dysfunction, the ventricular diastolic distensibility, filling, or relaxation is abnormal; however, the left ventricular ejection fraction may be normal or decreased.

Case presentation

We present anesthetic management of two patients with diastolic dysfunction grade III for renal transplant. During declamping in renal transplant, high central venous pressures are required for adequate perfusion of the transplanted kidney. In the operation theater standard monitors including NIBP, SpO2 and five lead ECG were attached. An arterial line (radial) and central line (right internal jugular) were established for IBP and CVP monitoring. Infusions of furosemide and dopamine were started. Nitrogycerine and milrinone infusions were prepared but were not required intraoperatively. Both the patients were extubated at the end of surgery.

Conclusions

Increased incidence of major adverse cardiovascular events has been reported in surgical patients having grade III diastolic dysfunction. Hemodynamic instability and fluid overload in this set of patients are known to generate pulmonary edema.
Direct and indirect effects of fire on germination of shortleaf pine seeds
Authors: Fillingim Hope , Knapp Benjamin O. , Kabrick John M. , Stambaugh Michael C. , Elliott Grant P. , Dey Daniel C.
Published: September 2023

Background

Shortleaf pine is a fire-adapted tree species, and prescribed fire is commonly used to increase its regeneration success, improve wildlife habitat, and reach conservation objectives associated with open forest ecosystems. We studied direct effects of heat and smoke on shortleaf pine germination in a greenhouse study and effects of season of burning on the number of new germinants in a field study. Improved understanding of fire effects on shortleaf pine seed and regeneration success can help refine burn prescriptions to better meet specific management objectives.

Results

Temperatures ≥ 120 °C eliminated germination of shortleaf pine seeds in a greenhouse trial, and exposure of seeds to 60 °C resulted in no reduction in germination compared to the unheated control regardless of duration of exposure. At 80 °C, duration of heat exposure mattered, with exposure for 10 min reducing germination compared to unheated controls. Smoke exposure had no effect on germination. A field experiment showed that fall burns (prior to seedfall) resulted in greater initial germinant counts than early spring burns (after seedfall but before germination) or unburned controls, which both resulted in greater initial germinant counts than late spring burns (after germination).

Conclusions

Season of prescribed burning can affect the success of shortleaf pine germination. Late spring burning resulted in high mortality of young germinants. Burning in early spring likely resulted in direct damage to some seeds due to heating but may have also had indirect benefit by exposing mineral soil. Fall burning, before the dispersal of shortleaf pine seed, yielded the highest germinant count and is recommended if improving natural regeneration from seed is the primary objective.
Using normalisation process theory for intervention development, implementation and refinement in musculoskeletal and orthopaedic interventions: a qualitative systematic review
Authors: Carter Hayley , Beard David , Harvey Alison , Leighton Paul , Moffatt Fiona , Smith Benjamin , Webster Kate , Logan Pip
Published: September 2023

Background

Normalisation process theory (NPT) provides researchers with a set of tools to support the understanding of the implementation, normalisation and sustainment of an intervention in practice. Previous reviews of published research have explored NPT’s use in the implementation processes of healthcare interventions. However, its utility in intervention research, specifically in orthopaedic and musculoskeletal interventions, remains unclear. The aim of this review is to explore how NPT (including extended NPT, ENPT) has been used in orthopaedic/musculoskeletal intervention research.

Methods

A qualitative systematic review was conducted. Two bibliographic databases (Scopus and Web of Science) and a search engine (Google Scholar) were searched for peer-reviewed journal articles citing key papers outlining the development of NPT, related methods, tools or the web-based toolkit. We included studies of any method, including protocols, and did not exclude based on published language. A data extraction tool was developed, and data were analysed using a framework approach.

Results

Citation searches, of the 12 key studies, revealed 10,420 citations. Following duplicate removal, title, abstract and full-text screening, 14 papers from 12 studies were included. There were 8 key findings assessed against GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research). Five were of high confidence supporting NPT/ENPT’s use in the implementation process for interventions targeting a range of MSK/orthopaedic conditions. NPT/ENPT offers a useful analytical lens to focus attention and consider implementation factors robustly. There is limited evidence for the selection of NPT/ENPT and for the use of the Normalisation Measure Development instrument. Three findings of moderate confidence suggest that coherence is seen as a fundamental initial step in implementation, there is limited evidence that study population limits NPT’s utility and the application of ENPT may pose a challenge to researchers.

Conclusion

This review demonstrates NPT’s utility in supporting intervention implementation for orthopaedic and musculoskeletal conditions. We have theorised the benefits ENPT offers to intervention development and refinement and recommend future researchers consider its use. We also encourage future researchers to offer clear justification for NPT’s use in their methodology.

Trial registration

The review protocol is registered with PROSPERO (CRD42022358558).
Assessing the expression of differentiation antagonizing non-protein coding RNA (DANCR) in newly diagnosed Egyptian acute myeloid leukemia patients
Authors: Rasheed Nour Mohammed , Nounou Howaida Attia , Eltabakh Soad Mohamed , Hamed Nahla A. M. , Darwish Ayman Ahmed
Published: September 2023

Background

Role of Long non-coding RNAs in cancer research in the recent years have been highlighted with evidence to their involvement in cancer disease pathogenesis and progression. One of these emerging long non-coding RNAs is differentiation antagonizing non-protein coding RNA (DANCR). DANCR distinct expression in different cancers and implication in tumor signaling pathways made it a promising therapeutic target for cancer.

The purpose of this study was to evaluate DANCR expression in de novo acute myeloid leukemia (AML) patients and to assess DANCR expression in relation to cytogenetics and French American British (FAB) AML classification as well as correlate DANCR expression with patients’ response to treatment.

The present study included 60 newly diagnosed AML patients and 30 healthy subjects as controls. Relative DANCR expression was done using real time qPCR method.

Results

DANCR was significantly downregulated in AML patients compared to controls (p = 0.038). In addition, DANCR showed significantly lower expression in M4 and M5 compared to M0, M1, and M2 groups (p < 0.001). Furthermore, DANCR expression was significantly downregulated in cytogenetically normal AML patients compared to the controls (p = 0.011).

Conclusion

Significant downregulation of DANCR in AML suggests a potential tumor suppressor role and variable expression of DANCR among AML subtypes suggests that DANCR action may be different among AML subtypes. Also, M1 subtype patients with higher DANCR expression were less refractory to treatment and therefore less resistant to cytarabine.
Opioid Monitoring Using Urine Toxicology Screens in Outpatient Oncology Palliative Medicine
Authors: Patel Jai N. , Jandrisevits Elizabeth , Boselli Danielle , Michalowski Tiffany , Parala-Metz Armida , Walsh Declan
Published: September 2023

More than half of patients in oncology palliative medicine had noncompliant urine toxicology screens
Perspective on the spatio-temporal spread of epidemics in metapopulation networks
Authors: Wang Jianbo , Du Zhanwei , Li Hui-Jia , Wang Lei , Xu Xiao-Ke , Wang Zhen , Wang Lin , Li Xiang
Published: September 2023

We review the recent progress of epidemic dynamics in metapopulation networks. Firstly, we give an introduction of the concepts about epidemic models and metapopulation network. Then, the theoretical characterization of epidemics spread in metapopulation networks is summed up. The measures of how to curb the spread of epidemics are summarized. The applications of inferring epidemic pathways based on epidemic data and reconstruction of epidemic transmission by phylogeographic are introduced. Finally, we present the outlooks about further research of epidemic dynamics on metapopulation networks.
Human upper limb positional analysis using homogenous transformation matrix
Authors: Musunoiu Novetschi Monica , Mereuta Elena , Nazer Tarek , Ganea Daniel , Mereuta Claudiu
Published: September 2023

A mathematical model is presented to determine the spatial displacement of an endeffector attached to the human upper limb kinematic chain. The proposed method in-volves the successive application of the homogenous rotation matrices associated with each element movement to determine the general transfer matrix or the so-called homoge-neous transformations matrix. This method is proven to be an error free method for esti-mating the position and orientation of an end-effector attached to a kinematic chain. The methodology presented in this paper combines a well know mathematical technique used in engineering (in the development of space robots) and the anatomical features of the human upper limb to estimate not only the end-effector 3D position but also the limb pos-es during a particular displacement.