bluuebunny/crossref_metadata_2025 huggingface dataset:
Effective Strategies for Increasing the Uptake of Modern Methods of Family Planning in South Asia: A Systematic Review and Meta-analysis
Authors: Memon Zahid Ali , . Tahmeena , Fazal Syed Aleena , Reale Sophie , Spencer Rachael , Bhutta Zulfiqar Ahmed , Soltani Hora
Published: April 2023

Background Family planning (FP) interventions have improved the use of modern contraceptives, yet a high unmet need for contraception still exists in South Asia. This systematic review of existing research was conducted to identify effective FP interventions that led to an increase in the uptake of modern methods of contraception in South Asia.Methods Five electronic databases were searched for relevant studies published between January 2000 and May 2021. Experimental studies which reported data on the impact of FP interventions on modern contraceptive use among women of reproductive age (15–49 years) in the South Asian region were included. A random-effects Inverse Variance weighted model was employed to pool the adjusted odds ratio (OR) on modern contraceptive use and unmet need for contraception. In addition, we computed subgroup meta-estimates based on intervention type and the urban-rural divide.Results Among 513 studies identified, 21 met the inclusion criteria. The overall pooled odds ratio for modern contraceptive use was significantly higher (OR 1.51; 95% CI 1.35–1.70; heterogeneity; I2 = 81%) for FP interventions with a significant reduction in unmet need for contraception (OR 0.86; 95% CI 0.78–0.94, I2 = 50%). The subgroup analysis revealed demand-generation (OR 1.61; 95% CI 1.32–1.96), health system integrated (OR 1.53; 95% CI 1.07–2.20), and franchised FP clinic interventions (OR 1.32; 95% CI 1.21–1.44) had promoted the modern contraceptive uptake. Further, FP interventions implemented in urban settings showed a higher increase in modern contraceptive use (OR 1.73; 95% CI 1.44–2.07) compared to rural settings (OR 1.46; 95% CI 1.28–1.66). Given the considerable heterogeneity observed across studies and low degree of certainty indicated by GRADE summary for the primary outcome, caution is advised when interpreting the results.Conclusion The review collated experimentally evaluated FP interventions that increased modern contraception use and reduced the unmet need in South Asia. The demand generation interventions were found to be the most effective interventions in increasing the uptake of modern contraceptive methods. Furthermore, the urban environment provides a conducive environment for interventions to improve contraceptive usage. However, further studies should assess which aspects were most effective on attitudes towards contraception, selection of more effective methods, and contraceptive behaviors.
BH3 mimetics and azacitidine show synergistic effects on juvenile myelomonocytic leukemia
Authors: Erlacher Miriam , Wu Ying , Zehnle Patricia , Koleci Naile , Andrieux Geoffroy , Villar Lorena Gallego , Rajak Jovana , Aumann Konrad , Boerries Melanie , Niemeyer Charlotte , Bohler Sheila , Flotho Christian
Published: April 2023

Juvenile myelomonocytic leukemia (JMML) is an aggressive hematopoietic disorder of infancy and early childhood driven by constitutively active RAS signaling and characterized by abnormal proliferation of the granulocytic-monocytic blood cell lineage. Most JMML patients require hematopoietic stem cell transplantation for cure, but the risk of relapse is high for some JMML subtypes. Azacitidine was shown to effectively reduce both leukemic burden and risk of relapse. However, variable response rates to azacitidine and the risk of drug resistance highlight the need for novel therapeutic approaches. Since RAS signaling is known to interfere with the intrinsic apoptosis pathway, we combined various BH3-mimetic drugs with azacitidine in our previously established patient-derived xenograft model. We demonstrate that JMML cells require both MCL-1 and BCL-XL for survival, and that these proteins can be effectively targeted by azacitidine and BH3-mimetic combination treatment. In vivo azacitidine acts via downregulation of antiapoptotic MCL-1 but also promotes the differentiation of JMML cells towards mature myeloid cells. The combination of azacitidine with BCL-XL inhibition was superior to BCL-2 inhibition in eliminating JMML cells. Our findings emphasize the need to develop clinically applicable MCL-1 or BCL-XL inhibitors in order to enable novel combination therapies in JMML refractory to standard therapy.
Outbreak Prediction in Swine Populations with Machine Learning
Authors: Halev Avishai , Martínez-López Beatriz , Clavijo Maria , Gonzalez-Crespo Carlos , Kim Jeonghoon , Huang Chao , Robbins Rebecca , Liu Xin
Published: April 2023

The pork industry is an essential part of the global food system, providing a significant source of protein for people around the world. A major factor restraining productivity in the pork industry is disease outbreaks in pigs throughout the production process: widespread outbreaks can lead to losses as high as 10% of the U.S. pig population in extreme years. In this study, we present a model to predict the emergence of outbreaks of swine farms throughout the production process. We capture direct contact, spatio-temporal and historical predictors, each represented through a set of features, and then train and evaluate machine learning algorithms on our extracted feature sets. We perform a feature selection to determine the smallest subset of features that provides good performance and use the results to interpret the most valuable features and produce the most generalizable model to address issues caused by the curse of dimensionality. Finally, we evaluate the model's ability to predict outbreaks in both the near and distant future, which allows for advance warning of disease outbreak. We evaluate our model on two swine production systems; our results demonstrate good ability to predict outbreaks in both systems with a balanced accuracy of 0.798 on any disease in the first system and balanced accuracies of 0.638, 0.709, and 0.701 on porcine reproductive and respiratory syndrome, influenza A virus, and Mycoplasma hyopneumoniae in the second system, respectively.
Gas stripping-assisted vapour permeation using graphene oxide membrane-coated silicon carbide tube for effectively recovering ethanol from its diluted aqueous solution
Authors: Carrio Juan A. G. , Talluri VSSL Prasad , Toolahalli T. Swamy , Echeverrigaray Sergio G. , Neto Antonio H. C.
Published: April 2023

The conventional methods for ethanol recovery in low concentrations from diluted aqueous solutions are limited by the high energy consumed. Therefore, developing a cost-effective advanced membrane process for ethanol recovery and concentration is still necessary. A gas stripping-assisted vapour permeation (GSVP) process was applied to concentrate ethanol by the selective removal of water using hydrophilic graphene oxide (GO) membranes. Silicon carbide porous tubes were internally coated with GO-based membranes with an average thickness of 1.1 µm as a selective layer. Dry N2 was bubbled into the feed solution, carrying the saturated vapours to the separation module. The modified GSVP process was implemented to recover ethanol at lower temperatures than direct distillation and close-ended GSVP processes. The performance of the membrane-coated tubes was evaluated as a function of temperature and feed concentration, ranging from 23°C to 60°C and 10 wt% to 50 wt%. Distillates with 67 wt% and 87 wt% were obtained from feeds with 10 and 50 wt% ethanol at 50°C, respectively. The evaporation energy spent by the modified GSVP process using GO-coated SiC tubes was 22% and 31% lower than the traditional distillation and vapour stripping processes.
Associations of neighborhood social vulnerability with emergency department visits and readmissions among infants with bronchopulmonary dysplasia
Authors: Nelin Timothy , Yang Nancy , Radack Joshua , Lorch Scott , DeMauro Sara , Bamat Nicolas , Jensen Erik , Gibbs Kathleen , Just Allan , Burris Heather
Published: April 2023

Objectives
To characterize associations of the CDC Social Vulnerability Index (SVI) with medically attended acute respiratory illness among infants with bronchopulmonary dysplasia (BPD).
Study Design:
Retrospective cohort of 378 preterm infants with BPD from a single center. Multivariable logistic regression quantified associations of SVI with medically attended acute respiratory illness, defined as emergency department (ED) visits or hospital readmissions within a year after first hospital discharge. Mediation analysis quantified the extent to which differences in SVI may explain known Black-White disparities in medically attended acute respiratory illness.
Results
SVI was associated with medically attended respiratory illness (per SVI standard deviation increment, aOR 1.44, 95%CI: 1.17–1.78). Adjustment for race/ethnicity attenuated the association (aOR 1.27, 95%CI: 0.97–1.64). SVI significantly mediated 31% of the Black-White disparity in ED visits (p = 0.04).
Conclusions
SVI was associated with, and may partially explain racial disparities in, medically attended acute respiratory illness among preterm infants with BPD.
Early PSA Decline after Starting Second-Generation Hormone Therapy in the Post-Docetaxel Setting Predicts Cancer-Specific Survival in Metastatic Castrate-Resistant Prostate Cancer
Authors: Ahmed Mohamed , Lee Matthew , Mahmoud Ahmed , Joshi Vidhu , Gopalakrishna Ajay , Bole Raevti , Haloi Rimki , Kendi Ayse , Bold Michael , Bryce Alan , Karnes R Jeffrey , Kwon Eugene , Childs Daniel , Andrews Jack
Published: April 2023

Background
The objective of this study was to evaluate the prognostic value of early PSA decline following initiation of second-generation hormone therapy (2nd HT), namely abiraterone acetate or enzalutamide, in patients with taxane-refractory metastatic castrate-resistant prostate cancer (mCRPC) and evaluate utility of this metric in informing intensified surveillance/imaging protocols.
Methods
We retrospectively identified 75 mCRPC patients treated with 2nd HT following docetaxel failure (defined as PSA rise and radiographic progression). Patients were categorized patients into two cohorts based on the first PSA within 3 months after initiation of therapy: PSA reduction ≥ 50% (Group A) and PSA reduction < 50% (Group B). The primary endpoint was cancer-specific mortality (CSM). The secondary endpoint was radiographic disease progression (rDP) on 2nd HT. In univariate and multivariate analyses, we investigated factors associated with rPD and CSM.
Results
We included 75 patients (52 in Group A, 23 in Group B) in the analytic cohort. Baseline clinico-demographic characteristics, including median age, primary Gleason score risk group, median pre-treatment PSA, disease burden, site of metastases, and pre-treatment ECOG score were not statistically different between the two groups. Median follow up time was 30 months and the median time to radiographic disease progression was 28.1 and 12.5 months (p = 0.002) in cohorts A and B, respectively. On univariate and multivariate analyses, both PSA reduction ≥ 50% and volume of metastatic disease were significantly associated with a decreased risk of radiographic disease progression (HR 0.41, 95% CI 0.21–0.80, p = 0.0113) as well as a decreased risk of cancer-specific mortality (HR 0.29, 95% CI 0.09–0.87, p = 0.0325).
Conclusion
PSA reduction ≥ 50% within 3 months of starting 2nd HT was associated with significantly improved radiographic disease progression-free survival and 3-year cancer-specific mortality. This suggests using PSA 50%-decline metric in surveillance patients with on 2nd HT and identifies patients who require further evaluation with imaging.
Clinical efficacy of hyperextension bicondylar tibial plateau fractures fixed by medial and lateral dual plates and spinal cage
Authors: Xu Yibo , Lu Yao , Huang Qiang , Ren Cheng , Li Ming , Zhao Guolong , Wang Qian , Bai Huanan , Du Bing , Ma Teng , Li Zhong , Zhang Kun
Published: April 2023

Background To investigate the clinical efficacy of medial and lateral dual plates with spinal cage for the treatment of hyperextension bicondylar tibial plateau fractures.Methods A retrospective analysis was conducted on 12 patients with hyperextension bicondylar tibial plateau fractures who were surgically treated at the Lower Limb Surgery Ward of Traumatic Orthopedic Department, Xi’an Honghui Hospital from January 2020 to January 2022. The gender, age, cause of injury, associated injury, the preoperative and postoperative posterior tibial slope angle (pTSA), duration between injury and operation, surgical duration, intraoperative blood loss, complications, time of bone healing, time of weight bearing, Rasmussen radiological criteria and HSS scores were collected and analyzed.Results We analyzed 12 patients (9 males and 3 females, aged ranging from 27 to 66 years with mean age of 46.0 ± 12.3 years) with Schatzker type VI fractures. The patients were successfully followed up for an average of 12.50 ± 3.37 months (8 to 18 months). The postoperative pTSA was significantly improved related to the preoperative pTSA (P < 0.001). The average duration between injury and operation was 6.08 ± 2.78 days, the average surgical duration was 131.67 ± 32.71 min, and the average intraoperative blood loss was 320.83 ± 113.73ml. Furthermore, the average time of bone healing was 13.58 ± 2.57 weeks and the average time of weight-bearing was 8.33 ± 2.93 weeks. In addition, 33.33% of postoperative complications was observed in 1 case of superficial wound infection and dehiscence, 1 case of delayed union combined with limited range of motion of the knee joint and 2 cases of deep vein thrombosis. The excellent and good rates of Rasmussen radiological criteria and HSS scores were 83.33% and 91.67% respectively.Conclusion Fracture reduction and fixation by medial and lateral dual plates and spinal cage is an effective method for the treatment of hyperextension bicondylar tibial plateau fractures, which showed advantages such as favorable bone healing time, weight bearing time, radiographic and clinical functional outcomes.
Highly efficient endosperm and pericarp protoplast preparation system for transient transformation of endosperm-related genes in wheat
Authors: Han Shichen , Qu Ge , Li Xiaohui , Zhang Feixiong
Published: April 2023

Plant protoplasts constitute a versatile system for transient gene expression and have frequently been used in high-throughput to screen and identify functional characterization of plant genes. Wheat (Triticum aestivum L.) is one of the most important crops for our daily life. Endosperm-trait related genes are associated with grain yield or quality in wheat. However, very few studies have explored on the use of protoplasts isolated from endosperm and pericarp tissue of developing grain. In this study, endosperm tissues of developing wheat grains at 8 DPA (days post-anthesis) were collected. It was shown that, after being digested with the enzymolysis solution containing 13% mannitol for 2 h, total 1.1×105 of intact protoplasts containing 80% vital individuals were isolated from 0.6 g samples. Pericarp protoplasts were successfully purified from wheat grains at 4 DPA using the optimized method. To identify the activity of the protoplasts, transcription factor TaABI5 and amyloplast protein TaSSIIIa were transfected to the protoplasts, and they were successfully localized in the nucleus and the surface of starch granule, respectively. It is an effective and reproductive method for endosperm and pericarp protoplast isolation and of great importance to further investigate gene’s functions and regulations related to endosperm development and differentiation in plants.
Rural health dialogue for the sustainability of help-seeking behaviors among older patients: Grounded theory approach
Authors: Ohta Ryuichi , Sano Chiaki
Published: April 2023

Background Help-seeking behaviors (HSBs) are essential for disease prevention and health promotion. Dialogues with peers and medical professionals can improve HSBs, both qualitatively and quantitatively. Rural communities lacking healthcare resources require effective HSBs for healthcare sustainability. The current study aimed to investigate the effect of health dialogues between medical professionals and rural citizens on their HSBs.Methods All procedures complied with the Declaration of Helsinki and its subsequent amendments. The Unnan City Hospital Clinical Ethics Committee approved the study protocol (No. 20220002). A grounded theory approach was employed for the health dialogue participants in rural communities. Health dialogues with family physicians were conducted once a month at rural community centers. The dialogues and focus group interviews were recorded and coded to investigate changes in participants’ perceptions and behaviors regarding HSBs.Results Twenty-one dialogues were conducted in two rural community centers, with a total of 112 participants. The average age of the participants was 70.2 years (standard deviation = 5.4), with 24% being males. Analysis of the grounded theory approach revealed four themes, namely joy-driven dialogue driving the realization of HSBs, reflection on personal HSBs through learning from others, revising HSBs based on rural social resources, and familiarity with physicians, hence motivating safe and secure HSBs.Conclusions Mitigation of barriers between citizens and medical professionals and improvement of psychological safety in communities can drive effective HSBs in rural communities.
Old and new anthropometric indices in relation to blood pressure among the elderly: Birjand longitudinal aging study
Authors: Pakmehr Azin , Hezaveh Zohreh Sajadi , Fakhrzadeh Hossein , Moodi Mitra , Khorashadizadeh Masoumeh , Marvasti Fateme Ettehad , Taghavi MinaSadat , Ejtahed Hanieh-Sadat , Sharifi Farshad
Published: April 2023

Background: This study aimed to investigate whether or not anthropometric indices are associated with hypertension in a sample of Iranian older adults.
Methods: This cross-sectional study used the data from the first wave of Birjand Longitudinal Aging Study (BLAS) (n=1364). Body mass index (BMI) and waist circumference (WC) were assessed as the old anthropometric indices, and body roundness index (BRI) and a body shape index (ABSI) were assessed as new body composition indices. Both systolic and diastolic blood pressure (SBP & DBP) were measured and used to assess hypertension (HTN). Analyses were conducted using binary logistic regression and receiver-operating characteristic curves (AUC) analysis.
Results: Prevalence of obesity was the highest based on BMI (59%). The best predictor of HTN were WC and BMI (AUC= 0.6 and 0.62). Before and after adjusting for confounders, high BMI and high WC had the strongest direct association with the presence of HTN, high SBP and high DBP in total population and in men and women separately. In women, BRI was significantly associated with DBP (OR: 1.60, 95%CI: 1.01; 2.52, P= 0.04. ABSI was not associated with blood pressure (P> 0.05).
Conclusions: The result of this study showed that old obesity indices are better predictors of HTN and BMI and WC are more strongly associated with HTN than the new indices. BRI is only associated with DBP in women.
Caregivers’ burden in Parkinson’s Disease: a study on related features and attachment styles
Authors: Carpinelli Luna , Savarese Giulia , Russo Claudio , Stornaiuolo Giovanna , Luisi Ettore , Pellegrino Francesca , Mollo Monica , Pellecchia Maria Teresa
Published: April 2023

Background: Parkinson's disease (PD) is a chronic progressive neurological disease clinically characterized bymotor and non-motor symptoms, with an increasing impact on quality of life not only for the patient, but also for the caregivers.
Methods: Twenty-six primary caregivers (female= n°19; mean age= 57.04, SD= 10.64) of PD patients were consecutively recruited. Several psychological aspects were verified through clinical screening tests: EQ-5D and PQoL CARER for quality of life, Hospital Anxiety and Depression Scale(HADS), Caregiver Burden Inventory(CBI), Family Strain Questionnaire(FSQ), Adult Attachment Questionnaire.
Results: We found that the burden was generally higher in cohabiting female caregivers of patients with dementia as compared with not cohabiting caregivers. Severe burden emerged in 7.7% of the participants according to the PQoL. The mean score of this scale was higher in cohabiting caregivers. Finally, according to the CBI, 19.2% of the participants suffered from severe burden, with mean scores of the CIB-S and CIB-E subscales higher in cohabitants.
Conclusions: Our study highlights the need to investigate more thoroughly the burden of caregivers of PD patients and its associated factors, and to pay more attention to the physical and psychological health of caregivers to improve their quality of life.
Hybrid image encryption using advanced Least Significant Bit Algorithm, Chaotic Maps and DNA Encoding for Digital Healthcare
Authors: B Selvakumar , S Sheron , T Smitha Rajini
Published: April 2023

Security and privacy are major concerns in this modern world. Medical documentation of patient data needs to be transmitted between hospitals for medical experts opinions on critical cases and sharing among chains of hospitals to make the patient’s data available which may cause delay and threats to the data. Nowadays most of the hospitals use electronic methods to store and transmit data with basic security measures, but these methods are still vulnerable. There is no perfect solution that solves all the problems in any industry, especially healthcare. So, to cope with the arising need to increase the security of the data from being identified and manipulated the proposed method uses a hybrid image encryption technique to hide the data in an image so it becomes difficult to sense the presence of data in the image while transmission. It combines Least Significant Bit Algorithm using Arithmetic Division Operation along with Canny edge detection algorithm to embed the patient data in medical images. The image is subsequently encrypted using keys of six different chaotic maps sequentially using XOR operation to improve reliability by preventing intrusion. The encrypted image is further converted into DNA sequence using DNA encoding rule and compressed using Bz2 algorithm.
Spread of Staphylococcus aureus resistant genes to antibiotics: Clones and genetic elements (toxin genes)
Authors: Vittorakis Eftychios , Vica Mihaela Laura , Zervaki Calina-Oana , Vittorakis Evangelos , Maraki Sofia , Mavromanolaki Viktoria Eirini , Schürger Michael Ewald , Neculicioiu Vlad Sever , Papadomanolaki Evangelia , Maragoudakis Spyridon , Junie Lia Monica
Published: April 2023

Antibiotic overuse has led to the emergence of resistant strains of bacteria, such as Methicillin-resistant Staphylococcus aureus (MRSA), which has become a global public health concern. The aim of this study was to investigate the genetic and microbiological characteristics of MRSA in hospitals in Crete, located in the southeastern Balkan region. S. Aureus samples were collected from hospitalized patients and tested for antibiotic susceptibility using the Kirby-Bauer disk diffusion method. The presence of mecA, enterotoxin genes (sem gene or seg genes), agr genes, and PVL genes was detected using PCR. Of the 141 S. Aureus strains tested, 102 (72.34%) were found to have the genes of interest, with 69 MRSA (48.9%) mecA+ strains and 33 methicillin-susceptible S. Aureus (MSSA) mecA negative strains. The most prevalent gene detected was the agr gene (48.93%), followed by the enterotoxin gene (44.68%). Four agr groups (I – IV) were detected in 69 MRSA isolates (48.9%). This study highlights the prevalence of MRSA in hospitals in Crete and emphasizes the importance of appropriate antibiotic use and infection control measures to prevent the spread of antibiotic-resistant bacteria. Although a correlation between the presence of the detected genes and certain resistance phenotypes was not observed, the findings indicate the necessity to trace these genes using PCR and involve them in clinical diseases. The circulation of sensitive strains to antibiotics and resistant strains to some antibiotics with different resistance phenotypes was also noted in the hospital. Overall, this study provides important insights into the genetic and microbiological characteristics of MRSA in the southeastern Balkan region, and the results can inform future efforts to control the spread of antibiotic-resistant bacteria.
Experimental and numerical investigations on the dynamic characteristics of a spar-type offshore wind turbine under irregular waves
Authors: Kamal Ahmed Youssef , Abou-Rayan Ashraf M. , Shalabe Amal , Samy Mohamed
Published: April 2023

The authors have requested that this preprint be removed from Research Square.
Combining geophysical and geological datasets to improve a conceptual aquifer model of the Oak Openings Region in northwest Ohio, USA
Authors: Ogunkoya Akinwale O. , Martin-Hayden James M. , Fisher Timothy G. , Doro Kennedy O.
Published: April 2023

In this study, geophysical and geologic data were combined to develop a 3D conceptual hydrogeological model of a section of the Oak Openings Region (OOR) in northwest Ohio with a globally rare ecosystem of oak savanna and grassland prairie. The presence of a rhythmically laminated silt and clay unit underlying the study area is now widely realized. Assessing the influence of this unit on the interaction between shallow unconfined, sandy, and confined carbonate bedrock aquifers requires an appropriate groundwater model. A first step to this is to update the current conceptual hydrogeological model of the region, which either neglects the rhythmites or combines it with the till as a single hydrogeological unit. To do this, twenty electrical resistivity soundings and eleven 166 m long 2D transects of electrical resistivity data were combined with refraction seismic data acquired along a 96 m long transect. The geophysics results were validated with lithological data from a public database and two wells drilled during the study. A digital elevation model and stratigraphic layers extracted from the geophysics result were used to create a 3D site model. The model shows four layers consisting of a carbonate bedrock aquifer, confining till layer, rhythmically laminated silt and clay, and a sandy aquifer in a bottom-up sequence. The rhythmites consist of horizontal laminae that are more permeable than the underlying till. Combining geophysics with geologic data distinguished the till from rhythmites and defines the hydrostratigraphic layers used to refine the aquifer conceptual model across sections of the OOR.
Exploration of urban sustainability of India through the lens of sustainable development goals
Authors: Roy Ajishnu , Garai Nandini , Biswas Jayanta Kumar
Published: April 2023

Sustainable Development Goal (SDG) index is a recognized metric for measuring progress in the UN SDGs. However, national or multinational-level analyses are more prevalent than sub-national types. We analysed the performance of 14 SDGs for 56 Indian cities (grouped into 6 regions) with available 77 indicators (2020–2021). Pearson’s correlation, hierarchical clustering, data envelopment analysis etc. were used to infer existing status, interactions, efficiency, and interrelationships. Finally, we offer policy suggestions coupled with limitations to mitigate the drawbacks of the Indian city SDG framework. The findings reveal the asynchronous nature of SDGs. 18% of Indian cities register a poor track record of converting environmental performance into socioeconomic prosperity while 55% of cities are lagging in performance than respective states. A significant degree of inequality reigns among cities of various regions towards achieving SDGs. In a race to be economically powerful, the environment is being adversely affected. So, mainstreaming the environment into development planning is urgently warranted.
SH2 Superbinder Inhibits Autophagy of Pancreatic Cancer Cells by Blocking DDR1-Mediated Signaling
Authors: Liu An-Dong , Hou Guo-Qing , Sang Ya-Zhou , Lin Li , Gan Xiao-Cai , Xu Hui , Cao Xuan
Published: April 2023

BackgroundPancreatic cancer is highly lethal, of which 90% is pancreatic ductal adenocarcinoma (PDAC), with a 5-year survival rate of less than 12%, lacking effective treatment options and late diagnosis. Furthermore, the tumors show an intense resistance to cytotoxic chemotherapies. As autophagy is elevated in PDAC, targeting the autophagic pathway is regarded as a promising strategy for cancer treatment.MethodsImmunofluorescence and transmission electron microscopy were utilized to assess the autophagic flux. Label-free quantitative phosphoproteomics was used to figure out critically altered tyrosine phosphorylation of the proteins. Tumor-bearing mice were used to validate that SH2 TrM-(Arg)9 restrained the growth of tumor cells.ResultsSH2 TrM-(Arg)9 inhibited collagen-induced autophagy via blocking the DDR1/PYK2/ERK signaling cascades. SH2 TrM-(Arg)9 improved the sensitivity of PANC-1/GEM cells to gemcitabine (GEM). Inhibition of autophagy by SH2 TrM-(Arg)9 may synergized with chemotherapy and robusted tumor suppression in pancreatic cancer xenografts.ConclusionsSH2 TrM-(Arg)9 could enter into PDAC cells and blockade autophagy through inhibiting DDR1/PYK2/ERK signaling and may be a new treatment strategy for targeted therapy of PDAC.
Description of Sporanaerobium hydrogeniformans gen. nov., sp. nov., an obligately anaerobic, hydrogen producing bacterium of Lachnospiraceae family isolated from Aravali hot spring in India
Authors: Hivarkar Sai Suresh , Vasudevan Gowdaman , Dhakephalkar Prashant K. , Dagar Sumit Singh
Published: April 2023

An obligately anaerobic bacterium XHS1971T, capable of degrading cellulose and xylan, was isolated from the sediment sample of a hot spring located in Aravali, Ratnagiri, India. Cells of strain XHS1971T were Gram-stain-negative, spore-forming, motile, long rods. Growth of strain XHS1971T was observed at temperatures 30–50°C (optimum 40–45°C), pH 5.0–10.0 (optimum pH 8.0) and NaCl concentrations 0–0.5% (optimum 0%). The generation time of strain XHS1971T was 5 h under the optimized growth conditions. The strain XHS1971T showed the ability to metabolize different complex and simple sugars constituting lignocellulosic biomass. The strain fermented glucose, majorly into hydrogen, formic acid, acetic acid, and ethanol, whereas carbon dioxide, butyric acid, lactic acid and succinic acid were produced in traces. The major cellular fatty acids (> 5%) were C14:0, C16:0, C18:0, and C16:1 ω7c. The 16S rRNA gene analysis of the strain XHS1971T revealed the highest homology of < 94.5% with Cellulosilyticum lentocellum DSM 5427T followed by Cellulosilyticum ruminicola JCM 14822T, identifying it as a distinct member of family Lachnospiraceae. The genome size of the strain was 3.74 Mb with a G + C content of 35.3 mol% and predicted to have 3828 protein-coding genes. Of these, 357 genes were annotated to carbohydrate metabolism, including genes involved in the degradation of cellulose and xylan and the production of hydrogen, ethanol and acetate. The results indicate the potential use of strain XHS1971T in biomass-derived biofuel production. The uniqueness of our strain was further validated by digital DNA-DNA hybridization (dDDH), Average Nucleotide Identity (ANI), and Average Amino Acid Identity (AAI) values of 22%, 80%, and 63%, respectively, with nearest phylogenetic affiliates. Based on the detailed analyses, we propose a new genus and species, Sporanaerobium hydrogeniformans gen. nov., sp. nov., for strain XHS1971T (= MCC 3498T = KCTC 15729T = JCM 32657T) within the family Lachnospiraceae.
Feasibility of a reconfigured domestic violence and abuse training and support intervention responding to affected women, men, children and young people through primary care
Authors: Szilassy Eszter , Coope Caroline , Emsley Elizabeth , Williamson Emma , Barbosa Estela Capelas , Johnson Medina , Dowrick Anna , Feder Gene
Published: April 2023

Background
Identification in UK general practice of women affected by domestic violence and abuse (DVA) is increasing, but men and children/young people (CYP) are rarely identified and referred for specialist support. To address this gap, we collaborated with IRISi (UK social enterprise) to strengthen elements of the IRIS+ intervention which included the identification of men, direct engagement with CYP, and improved guidance on responding to information received from other agencies. IRIS+ was an adaptation of the national IRIS (Identification and Referral to Improve Safety) model focused on the needs of female victim-survivorsof DVA. Without diminishing the responses to women, IRIS+ also responded to the needs of men experiencing or perpetrating DVA, and CYP living with DVA and/or experiencing it in their own relationships. Our study tested the feasibility of the adapted IRIS+ intervention in England and Wales between 2019-21.
Methods
We used mixed method analysis to triangulate data from various sources (pre/post intervention questionnaires with primary care clinicians; data extracted from medical records and DVA agencies; semi-structured interviews with clinicians, service providers and referred adults and children) to assess the feasibility and acceptability of the IRIS+ intervention.
Results
The rate of referral for women doubled (21.6/year/practice) from the rate (9.29/year/practice) in the original IRIS trial. The intervention also enabled identification and direct referral of CYP (15% of total referrals) and men (mostly survivors, 11% of total referrals). Despite an increase in self-reported clinician preparedness to respond to all patient groups, the intervention generated a low number of male perpetrator referrals (2% of all referrals). GPs were the principal patient referrers. Over two-thirds of referred women and CYP and almost half of all referred men were directly supported by the service. Many CYP also received IRIS+ support indirectly, via the referred parents. Men and CYP supported by IRIS+ reported improved physical and mental health, wellbeing, and confidence.
Conclusions
Although the study showed acceptability and feasibility, there remains uncertainty about the effectiveness, cost-effectiveness, and scalability of IRIS+. Building on the success of this feasibility study, the next step should be trialling the effectiveness of IRIS+ implementation to inform service implementation decisions.
Analysis of prognostic value of lactate metabolism-related genes in ovarian cancer based on bioinformatics
Authors: Sun Jinrui , Xu Yingying , Liu Ping , Wu Yumei
Published: April 2023

Background Recent studies have provided evidence supporting the functional role and mechanism of lactate in suppressing anticancer immunity. However, there is no systematic analysis of lactate metabolism-related genes (LMRGs) and ovarian cancer (OV) prognosis.Results Six genes (CCL18, CCND1, MXRA5, NRBP2, OLFML2B and THY1) were selected as prognostic genes and a prognostic model was utilized. Kaplan-Meier (K-M) and Receiver Operating Characteristic (ROC) analyses were further performed and indicated that the prognostic model was effective. Subsequently, the neoplasm_cancer_status and RiskScore were determined as independent prognostic factors, and a nomogram was established with relatively accurate forecasting ability. Additionally, 2 types of immune cells (Central memory CD8 T cell and Immature B cell), 4 types of immune functions (APC co inhibition, DCs, Tfh and Th1 cells), 9 immune checkpoints (BTLA, CTLA4, IDO1, LAG3, VTCN1, CXCL10, CXCL9, IFNG, CD27) and tumor immune dysfunction and exclusion (TIDE) scores were significantly different between risk groups. The expression of 6 genes were verified by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) and the expression of 6 genes were higher in the high-grade serous carcinoma (HGSC) samples.Conclusion A prognostic model related to lactate metabolism was established for OV based on six genes (CCL18, CCND1, MXRA5, NRBP2, OLFML2B and THY1) that could provide new insights into therapy.
Prognostic factors and construction of a nomogram prediction model for ductal adenocarcinoma of the prostate based on the SEER database
Authors: Li Cheng , Wan Zhengqiang , Wang Yinglei , Shan Gaungming , Yang Baoquan
Published: April 2023

Background: The aim of this study was to determine the prognostic factors associated with survival in patients with ductal carcinoma of the prostate (DAC) and to develop a nomogram model for them that can be individually predicted.
Methods: We explored prognostic factors affecting patients with ductal adenocarcinoma of the prostate using univariate and multifactorial COX regression analyses, Kaplan-Meier method, using clinical data from DAC patients collected between 2003-2017 from the Surveillance, Epidemiology and End Results (SEER) database. Nomogram models predicting overall survival in DAC patients were drawn based on the results of the multifactorial analysis, and the discriminatory power and ability of the prediction models were assessed by prediction curves, the area under the curve(AUC) and decision curve analysis (DCA).
Results: A total of 834 patients were included in this study and were randomized in a 7:3 ratio into a training cohor (n = 585) and a validation cohor (n = 249). After univariate and multivariate Cox regression analyses, we identified that eight independent risk factors (age, T-stage, N-stage, M-stage, surgery, lymph node dissection, Gleason score, PSA) were identified for patients with DAC, and subsequently the first static and online nomogram for predicting overall survival for patients with DAC were created, respectively. Calibration curves were plotted and found that predicted survival closely matched actual survival, with AUC for the training cohort at 1-, 3-, 5-year being 0.807, 0.841 and 0.850 respectively. Further internal validation was performed and the AUC for the internal Validation cohort were 0.887, 0.848 and 0.817 respectively. The AUC and DCA were better than the TNM system. In addition, our study also found that patients with non-metastatic DAC who underwent the RP surgical approach or surgery combined with lymph node dissection had a better prognosis.Finally patients in the training and validation cohort were divided into high and low risk groups based on nomogram scores.
Conclusion:We constructed and validated the first static and online nomogram for predicting patients with DAC. The high predictive accuracy and reliability of this study will help physicians to analyse the prognosis of patients and individualise treatment.
Multidrug-resistant gram-negative bacterial infections and associated factors in a Kenyan intensive care unit: A cross-sectional study
Authors: Maina Jane Wairimu , Onyambu Frank Gekara , Shikuku Peter Kibet , Musyoki Abednego Moki
Published: April 2023

Background: Patients admitted to intensive care units (ICU) are at risk of Gram-negative bacteria (GNB) infections, especially those caused by multidrug-resistant (MDR) isolates, increasing morbidity, mortality, and increased healthcare costs. However, epidemiological surveillance data on MDR bacteria to inform infection prevention and control (IPCs) interventions is limited in our study setting. Here we assessed the prevalence and factors associated with GNB infections in ICU- patients admitted in our study setting.
Methods: This was a hospital-based cross-sectional study among patients admitted to the ICU at the Nairobi West Hospital, Kenya, between January and October 2022. A total of 162 patients were recruited, excluding those hospitalized for less than 48 hours and declining consent. We collected the participants' demographics and clinical data by case report form. Samples were collected and transported to the hospital microbiology laboratory in a cool box and processed, within 2 hours, by standard bacteriological and automated methods.
Results: The prevalence of GNB infections was 55.6%, predominated by urinary tract infections (UTIs). We recovered 13 GNB types, with Escherichia coli (33.3%) and Klebsiella pneumoniae (31.1%) as the most common isolates. Factors associated with GNB infections were a history of antibiotic use (aOR = 4.23, p =0.001), nasogastric tube use (NGT, aOR = 3.04, p = 0.013), respiratory tract (RT, aOR = 5.3, p= 0.005) and cardiovascular (CV, aOR = 5.7, p = 0.024 conditions. About 92% of the GNB isolates were MDR, predominately Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa.
Conclusion: We report a high prevalence of MDR-GNB infections, predominated by UTI, in ICU, where patients with a history of antibiotic use, using the NGT, and having RT and CV conditions were at increased risk. In our study setting, improving ICU patient management warrants strict adherence to IPC policies and implementation of antimicrobial stewardship programs in line with the global and national antimicrobial action plans.
Water Body Change Detection and Estimation From Landsat Satellite Images Using Deep Learning
Authors: Devaki M. , Jayanthi K. B.
Published: April 2023

Identification of urban water bodies from satellite images has been extensively explored in the recent past. Different types of mechanisms have been developed to delineate water bodies from distinct satellite images differing in spatial and temporal aspects. The problem of identifying urban water body with abundant sureness materializes in several applications. Amongst them, natural resource mapping like forest and urban water bodies utilizing satellite image has received much significance over the past few years. This is owing to the reason than both forest and water resources are dependent on each other to enormous exploitation and hence monitoring them at regular time intervals is highly essential for their sustainable management. At the same time, different methods have been adopted to select the pertinent features from satellite images using machine learning and each method has its own advantages and disadvantages. In this work, a method called, Nonlinear Recursive Filter used to preprocessing the satellite image and Convolution neural network (Deep learning method) used for urban water body identification from satellite images is proposed. The proposed CNN method is split into three parts. First, with the satellite images of water bodies taken as input, significant amount of noise are removed and also preserving the edges for future reference with the aid of Nonlinear Recursive Filter-based Preprocessing model. Second with the noise minimized preprocessed water body images, relevant features are selected in Convolution neural network Deep learning model. Finally, appropriate classification between the water bodies and non-water bodies are made by utilizing CNN Model. Experiments are conducted using water body images and simulations are performed to analyze PSNR, water body identification justify that accuracy, Spatial and Temporal analysis.
Perceived Disrespectful Treatment in Low Income Healthcare Settings Through the Lens of Intersectionality
Authors: Sntiselaar Sara , Carr Deborah
Published: April 2023

Race and gender differences in the quality of one’s health care encounters are widely documented, but few studies explore the multiplicative impacts of race and gender. Drawing on intersectionality frameworks, we contrast white, Black, Hispanic, Asian, and Native American men’s and women’s perceptions of disrespectful treatment from health care providers and staff (e.g., receptionists, clerks) in low-income health settings. Data are from the 2014 Health Center Patient Survey (N=5,385), a nationally representative survey of community-dwelling patients receiving care at health centers funded through Section 330 of the Public Health Service Act. Our results show race and sex differences in the study outcomes, yet weaker support for intersectional effects. Asian men and women report significantly more disrespectful treatment from providers and staff, relative to other ethnic groups. Across race and ethnic groups, women are more likely than men to report disrespectful treatment from staff. Health care providers and staff may require training focused on the distinctive needs of Asian patients, for whom “saving face” is a salient goal. Structural changes to reduce wait times and employ medical interpreters, and staff training focused on verbal and nonverbal communication may mitigate against actions perceived as disrespectful in low-income health settings.
Kinetic and Mechanistic Studies of Forskolin Oxidation By hexavalent Chromium, N-halosuccinimides, Ceric Ammonium Nitrate In Perchloric and Nitric acid Media.
Authors: Bibballi Sridhar Swamy
Published: April 2023

This study is dealing with the natural product forskolin (ROH) oxidation, by using various oxidants such as hexavalent chromium, N-halosuccinimides, ceric ammonium nitarte in solvent 'DMF-Perchloric acid' and 'methanol- nitric acid' medium. The pseudo firstorder kineticks followed for the oxidation process to investigate the linear energy solvent relation ship for better scope of thermodynamic properties change, nature of reactive species involved (anoinic, cationic, radical or complex) in transition state. The reaction theme is is to compare the efficiency and selectivity of the different oxidants and discuss the factors influencing in favor of oxidation, finally the most suaitable oxidants are figured out and substantiated with the reaction mechanism.
The Sharks Are Circling: A Qualitative Study of Living with Metastatic Breast Cancer
Authors: Visovsky Constance , Marshall Victoria K. , Moreno Maria , Advani Pooja , Mussallem Dawn , Tofthagen Cindy
Published: April 2023

Purpose: The purpose of this phenomenological study was to gain an understanding of the intersection of continued treatment and quality of life in women living with metastatic breast cancer (MBC).
Methods: This was a qualitative study in which women with MBC were interviewed about their perceptions how MBC affected their physical, emotional, and role functioning.
Results: Participants (n=16) were mostly Caucasian (86.7%) and non-Hispanic (93.3%). The mean age was 55.62 years. Most women were on their third or greater line of treatment (68.5%). Themes identified from analysis of the transcripts revealed: 1) shock and devastation of the initial diagnosis; 2) feeling as if the sharks are circling; 3) cancer is a rollercoaster with never-ending treatments; 4) individual definitions of quality of life and; 5) you are not the person you once were.
Conclusions: Symptoms, ongoing treatments, treatment changes, and disease progression negatively influence physical, emotional, and role function. Women with MBC define quality of life in different ways, and while symptoms and functional limitations are present, the cancer experience causes some to reevaluate their lives and focus on their individual priorities and values.
Implications for Cancer Survivors: Although newly developed treatments increase survival among women with MBC, the symptoms, concerns, and issues surrounding QOL remain unresolved. The relatively high price of continuous treatment and disease exacerbation is indicative of the need for multi-pronged intervention strategies that address physical, mental and emotional aspects of living with MBC.