bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of cybersickness in virtual nursing simulation: a German longitudinal study
Authors: Biniok Maria , Forbrig Theresa A. , Gellert Paul , Gräske Johannes
Published: March 2024

Background

Innovative educational approaches such as simulation-based nursing education using virtual reality (VR) technologies provide new opportunities for nursing education. However, there is a lack of information on side effects, especially health-related side effects, of head-mounted displays (HMDs) on the human body when using VR devices for nursing simulation. This study aims to validate the German version of the Virtual Reality Sickness Questionnaire (VRSQ) and to evaluate its associations with sex and age, as reflected in the VRSQG scores (total score, oculomotor, and disorientation) over time.

Methods

A longitudinal-sectional study was conducted. In addition to the VRSQG (pre-, post-, and 20 min post-intervention), participants (all nursing students) completed data on personal characteristics. Participants completed a VR simulation of a blood draw. Confirmatory factor analysis (CFA) was used to evaluate whether the measured construct was consistent with the original. In addition to the validity, internal consistency was analyzed and generalized linear models (GLMs) were used for data analysis.

Results

A total of 38 nursing students (mean age 26.8 years; SD = 7.1, 79.0% female) participated. The mean time spent in the VR simulation was 21 min. All participants completed the entire simulation. The CFA indicates (CFI = 0.981, SRMR = 0.040) VRSQG structure is given. Internal consistency showed low values for the subdomain Oculomotor (Cronbach alpha 0.670). For Disorientation and the Total score values showed a sufficient internal consistency. GLMs showed significant between subject associations with age over time with VRSQG total score, oculomotor, and disorientation. Older nursing students start with higher VRSQG-Scores. Over time, an approximation occurs, so that all participants reach a similar level by the final measurement point. No associations were found between sex (male/female) and VRSQG scores.

Conclusions

The VRSQG is a reliable and valid self-assessment for measuring cybersickness in VR based nursing simulations, with cybersickness symptoms positively associated with age. However, in depth-evaluation regarding age-associations with cybersickness should be done. As well as studies to explore additional associations and emphasizes the importance of establishing cut-off values to assess the clinical relevance of the scores.
Inverse association between plasma chlordecone concentrations and progression of alcoholic liver fibrosis: the role of liver metabolism
Authors: Gelu-Simeon Moana , Lafrance Marie-Josée , Michineau Leah , Saillard Eric , Thomé Jean Pierre , Emond Claude , Samson Michel , Multigner Luc
Published: March 2024

Background and Aims

Chlordecone is a persistent organochlorinated insecticide, extensively used in the French West Indies and has been contaminating the population for more than thirty years. Its potentiation effect on hepatotoxic agents has been demonstrated in animal models. We investigated the relationship between environmental exposure to chlordecone and the progression of liver fibrosis.

Methods

This study included 182 consecutive patients with chronic alcoholic hepatitis whose liver fibrosis was assessed using non-invasive methods. Measured plasma chlordecone concentrations at inclusion were used as surrogate of long-term exposure under steady-state conditions. As the pharmacokinetic processing of chlordecone is largely determined by the liver, we used a human physiologically based pharmacokinetic model to predict plausible changes in the steady-state blood chlordecone concentrations induced by liver fibrosis.

Results

With a median follow-up of 27.1 years after the onset of alcohol consumption, we found a significant decrease in the risk of advanced liver fibrosis with increasing plasma chlordecone concentration (adjusted hazard ratio = 0.56; 95% confidence interval: 0.34–0.95 for the highest vs. lowest tertile, p = 0.04). Changes induced by liver fibrosis influenced the pharmacokinetic processing of chlordecone, resulting in substantial modifications in its steady-state blood concentrations.

Conclusion

According to this human model of coexposure to alcohol, reverse causality is the most plausible explanation of this inverse association between plasma chlordecone concentrations and progression of liver fibrosis. This study underlines the importance of considering the pharmacokinetic of environmental contaminants in epidemiological studies when biomarkers of exposure are used to investigate their own impact on the liver.

Trial registration

ClinicalTrials.gov Identifier: NCT03373396.
PDGFRβ + cell HIF2α is dispensable for white adipose tissue metabolic remodeling and hepatic lipid accumulation in obese mice
Authors: Yao Tao , Wei Danni , Tian Xin , Zhao Lin , Wan Qiangyou , Zhang Xiaoli , Cai Juan , Li Siqi , Diao Bowen , Feng Suihan , Shan Bo , Shao Mengle , Wu Ying
Published: March 2024

Background

Obesity is associated with extensive white adipose tissue (WAT) expansion and remodeling. Healthy WAT expansion contributes to the maintenance of energy balance in the liver, thereby ameliorating obesity-related hepatic steatosis. Tissue-resident mesenchymal stromal cell populations, including PDGFRβ + perivascular cells, are increasingly recognized pivotal as determinants of the manner in which WAT expands. However, the full array of regulatory factors controlling WAT stromal cell functions remains to be fully elucidated. Hypoxia-inducible factors (HIFs) are critical regulators in WAT stromal cell populations such as adipocyte precursor cells (APCs). It is revealed that HIF1α activation within PDGFRβ + stromal cells results in the suppression of de novo adipogenesis and the promotion of a pro-fibrogenic cellular program in obese animals. However, the role of HIF2α in PDGFRβ + cells remains undetermined in vivo.

Methods

New genetic models were employed in which HIF1α (encoded by the Hif1a gene) and HIF2α (encoded by the Epas1 gene) are selectively inactivated in PDGFRβ + cells in an inducible manner using tamoxifen (TAM). With these models, both in vitro and in vivo functional analysis of PDGFRβ + cells lacking HIF proteins were performed. Additionally, comprehensive metabolic phenotyping in diet-induced mouse models were performed to investigate the roles of PDGFRβ + cell HIF proteins in WAT remodeling, liver energy balance and systemic metabolism.

Results

Unlike HIF1α inactivation, the new findings in this study suggest that inducible ablation of HIF2α in PDGFRβ + cells does not cause apparent effects on WAT expansion induced by obesogenic diet. The adipogenic ability of PDGFRβ + APCs is not significantly altered by genetic HIF2α ablation. Moreover, no difference of key parameters associated with healthy WAT remodeling such as improvements of WAT insulin sensitivity, reduction in metabolic inflammation, as well as changes in liver fat accumulation or systemic glucose metabolism, is detected in PDGFRβ + cell Epas1-deficient mice.

Conclusion

The new findings in this study support that, in contrast to HIF1α, PDGFRβ + cell HIF2α appears dispensable for WAT metabolic remodeling and the resulting effects on liver metabolic homeostasis in diet-induced obesity, underscoring the isoform-specific roles of HIFα proteins in the regulation of adipose tissue biology.
Asiatic acid cyclodextrin inclusion micro-cocrystal for insoluble drug delivery and acute lung injury therapy enhancement
Authors: Shen Huan , Pan Li , Ning Keke , Fang Yuefei , Muhitdinov Bahtiyor , Liu Ergang , Huang Yongzhuo
Published: March 2024

Background

Acute lung injury (ALI) is a fatal respiratory disease caused by overreactive immune reactions (e.g., SARS-CoV-2 infection), with a high mortality rate. Its treatment is often compromised by inefficient drug delivery barriers and insufficient potency of the currently used drugs. Therefore, developing a highly effective lung-targeted drug delivery strategy is a pressing clinical need.

Results

In this study, the micro-sized inclusion cocrystal of asiatic acid/γ-cyclodextrin (AA/γCD, with a stoichiometry molar ratio of 2:3 and a mean size of 1.8 μm) was prepared for ALI treatment. The dissolution behavior of the AA/γCD inclusion cocrystals followed a “spring-and-hover” model, which meaned that AA/γCD could dissolve from the cocrystal in an inclusion complex form, thereby promoting a significantly improved water solubility (nine times higher than free AA). This made the cyclodextrin-based inclusion cocrystals an effective solid form for enhanced drug absorption and delivery efficiency. The biodistribution experiments demonstrated AA/γCD accumulated predominantly in the lung (Cmax = 50 µg/g) after systemic administration due to the micron size-mediated passive targeting effect. The AA/γCD group showed an enhanced anti-inflammatory therapeutic effect, as evidenced by reduced levels of pro-inflammatory cytokines in the lung and bronchoalveolar lavage fluids (BALF). Histological examination confirmed that AA/γCD effectively inhibited inflammation reactions.

Conclusion

The micro-sized inclusion cocrystals AA/γCD were successfully delivered into the lungs by pulmonary administration and had a significant therapeutic effect on ALI.

Graphic abstract
Long-term outcomes of robot-assisted versus minimally invasive esophagectomy in patients with thoracic esophageal cancer: a propensity score-matched study
Authors: Sakurai Toru , Hoshino Akihiro , Miyoshi Kenta , Yamada Erika , Enomoto Masaya , Mazaki Junichi , Kuwabara Hiroshi , Iwasaki Kenichi , Ota Yoshihiro , Tachibana Shingo , Hayashi Yutaka , Ishizaki Tetsuo , Nagakawa Yuichi
Published: March 2024

Background

Recently, robot-assisted minimally invasive esophagectomy (RAMIE) has gained popularity worldwide. Some studies have compared the long-term results of RAMIE and minimally invasive esophagectomy (MIE). However, there are no reports on the long-term outcomes of RAMIE in Japan. This study compared the long-term outcomes of RAMIE and MIE.

Methods

This retrospective study included 86 patients with thoracic esophageal cancer who underwent RAMIE or MIE at our hospital from June 2010 to December 2016. Propensity score matching (PSM) was employed, incorporating co-variables such as confounders or risk factors derived from the literature and clinical practice. These variables included age, sex, body mass index, alcohol consumption, smoking history, American Society of Anesthesiologists stage, comorbidities, tumor location, histology, clinical TNM stage, and preoperative therapy. The primary endpoint was 5-year overall survival (OS), and the secondary endpoints were 5-year disease-free survival (DFS) and recurrence rates.

Results

Before PSM, the RAMIE group had a longer operation time (min) than the MIE group (P = 0.019). RAMIE also exhibited significantly lower blood loss volume (mL) (P < 0.001) and fewer three-field lymph node dissections (P = 0.028). Postoperative complications (Clavien–Dindo: CD ≥ 2) were significantly lower in the RAMIE group (P = 0.04), and postoperative hospital stay was significantly shorter than the MIE group (P < 0.001). After PSM, the RAMIE and MIE groups consisted of 26 patients each. Blood loss volume was significantly smaller (P = 0.012), postoperative complications (Clavien–Dindo ≥ 2) were significantly lower (P = 0.021), and postoperative hospital stay was significantly shorter (P < 0.001) in the RAMIE group than those in the MIE group. The median observation period was 63 months. The 5-year OS rates were 73.1% and 80.8% in the RAMIE and MIE groups, respectively (P = 0.360); the 5-year DFS rates were 76.9% and 76.9% in the RAMIE and MIE groups, respectively (P = 0.749). Six of 26 patients (23.1%) in each group experienced recurrence, with a median recurrence period of 41.5 months in the RAMIE group and 22.5 months in the MIE group.

Conclusions

Compared with MIE, RAMIE led to no differences in long-term results, suggesting that RAMIE is a comparable technique.
Development and validation of predictive models for myopia onset and progression using extensive 15-year refractive data in children and adolescents
Authors: Zhao Jing , Yu Yanze , Li Yiming , Li Feng , Zhang Zhe , Jian Weijun , Chen Zhi , Shen Yang , Wang Xiaoying , Ye Zhengqiang , Huang Chencui , Zhou Xingtao
Published: March 2024

Background

Global myopia prevalence poses a substantial public health burden with vision-threatening complications, necessitating effective prevention and control strategies. Precise prediction of spherical equivalent (SE), myopia, and high myopia onset is vital for proactive clinical interventions.

Methods

We reviewed electronic medical records of pediatric and adolescent patients who underwent cycloplegic refraction measurements at the Eye & Ear, Nose, and Throat Hospital of Fudan University between January 2005 and December 2019. Patients aged 3–18 years who met the inclusion criteria were enrolled in this study. To predict the SE and onset of myopia and high myopia in a specific year, two distinct models, random forest (RF) and the gradient boosted tree algorithm (XGBoost), were trained and validated based on variables such as age at baseline, and SE at various intervals. Outputs included SE, the onset of myopia, and high myopia up to 15 years post-initial examination. Age-stratified analyses and feature importance assessments were conducted to augment the clinical significance of the models.

Results

The study enrolled 88,250 individuals with 408,255 refraction records. The XGBoost-based SE prediction model consistently demonstrated robust and better performance than RF over 15 years, maintaining an R2 exceeding 0.729, and a Mean Absolute Error ranging from 0.078 to 1.802 in the test set. Myopia onset prediction exhibited strong area under the curve (AUC) values between 0.845 and 0.953 over 15 years, and high myopia onset prediction showed robust AUC values (0.807–0.997 over 13 years, with the 14th year at 0.765), emphasizing the models' effectiveness across age groups and temporal dimensions on the test set. Additionally, our classification models exhibited excellent calibration, as evidenced by consistently low brier score values, all falling below 0.25. Moreover, our findings underscore the importance of commencing regular examinations at an early age to predict high myopia.

Conclusions

The XGBoost predictive models exhibited high accuracy in predicting SE, onset of myopia, and high myopia among children and adolescents aged 3–18 years. Our findings emphasize the importance of early and regular examinations at a young age for predicting high myopia, thereby providing valuable insights for clinical practice.
The implications of the Sudan war on healthcare workers and facilities: a health system tragedy
Authors: Badri Rawa , Dawood Iyas
Published: March 2024

In light of a collapsing healthcare system in Sudan, attacks on healthcare institutions and staff have markedly increased since the eruption of war on the 15th of April, costing many precious lives and valuable hospitals. Around 60 attacks on health facilities have been reported so far, many occupied by one or the other sides of the conflict, and the rest exhibit medication shortages and safety issues; hence, two-thirds of the medical centers are nonfunctioning. More than 200 violations against medical staff were recorded all over the country, which led to the death of 38 healthcare workers. Killing, kidnapping, and assaulting doctors, consequently led to a huge shortage in staff in the few barely working facilities, as the remaining health workers were concerned regarding their safety. Recommendations consisted of ceasing fire, restoring and resuming healthcare services, and insurance of a safe working environment. International collaboration and sufficient financial support are crucial to restore the healthcare system in Sudan.
Deubiquitinase PSMD7 facilitates pancreatic cancer progression through activating Nocth1 pathway via modifying SOX2 degradation
Authors: Luo Chen , Yu Yi , Zhu Jinfeng , Chen Leifeng , Li Dan , Peng Xingyu , Liu Zitao , Li Qing , Cao Qing , Huang Kai , Yuan Rongfa
Published: March 2024

Background

Ubiquitination is a critical post-translational modification which can be reversed with an enzyme family known as deubiquitinating enzymes (DUBs). It has been reported that dysregulation of deubiquitination leads to carcinogenesis. As a member of the DUBs family, proteasome 26 S subunit non-ATPase 7 (PSMD7) serves as an underlying tumour-promoting factor in multiple cancers. However, the clinical significance and biological functions of PSMD7 in pancreatic cancer (PC) remain unclear.

Results

In this study, we first reported frequent overexpression of PSMD7 in PC tissues, and high levels of PSMD7 were markedly linked to shorter survival and a malignant phenotype in PC patients. An array of in vitro and in vivo gain/loss-of-function tests revealed that PSMD7 facilitates the progression of PC cells. Additionally, we found that PSMD7 promotes PC cell progression by activating the Notch homolog 1 (Notch1) signalling. Interestingly, in PC cells, the inhibitory effect of PSMD7 knockdown on cellular processes was comparable to that observed upon Notch1 knockdown. Mechanistically, PSMD7 deubiquitinated and stabilised sex determining region Y (SRY)-box 2 (SOX2), a key mediator of Notch1 signalling. The stabilisation of SOX2, mediated by PSMD7, dramatically increased SOX2 protein levels, subsequently activating the Notch1 pathway. Finally, restoration of SOX2 expression abrogated the PSMD7-silenced antitumour effect.

Conclusions

Taken together, our work identifies and validates PSMD7 as a promoter of PC progression through augmentation of the Notch1 signalling pathway mediated by SOX2. This finding suggests that PSMD7 holds promise as a potential therapeutic target for the management of this refractory disease.
Predictive value of the Adult Comorbidity Evaluation 27 on adverse surgical outcomes and survival in elderly with advanced epithelial ovarian cancer undergoing cytoreductive surgery
Authors: Zhao Mengna , Gao Yang , Yang Junyuan , He Hao , Su Min , Wan Shimeng , Feng Xiaoye , Wang Hua , Cai Hongbing
Published: March 2024

Objective

We aimed to evaluate the ability of Adult Comorbidity Evaluation 27 (ACE-27) to predict perioperative outcomes and survival in elderly women with advanced epithelial ovarian cancer (AEOC) undergoing cytoreductive surgery.

Methods

We collected patients with AEOC in our hospital between January 1, 2012 and January 1, 2021. Patients younger than 65 years old or those with non-epithelial ovarian cancer were excluded. ACE-27 was applied retrospectively to assess comorbidities in the selected patients, who were then classified into two groups based on their ACE-27 scores: low ACE-27 score group (none to mild) and high ACE-27 score group (moderate to severe).

Results

A total of 222 elderly women with AEOC were included, of whom 164 patients accepted debulking surgery. Among those who have undergone surgery, Clavien–Dindo grade III + perioperative complications or unintended intensive care unit (ICU) admission occurred more often in patients of high ACE-27 score group, with statistically significant difference (odds ratio [OR]: 4.21, 95% confidence interval [CI], 1.28–14.35, p = 0.018). Further stratified analyses by age, BMI, FIGO stage and pathology also prove that OS of patients graded severe was shorter than patients graded none to moderate in cohort of age < 70, BMI < 25 kg/m2, FIGO III stage and pathology of serous, respectively. Kaplan–Meier survival curves analyzed by log-rank test showed that the overall survival (OS) of patients with severe comorbidities were shorter than with none to moderate (HR 3.25, 95%CI 1.55–6.79, p = 0.002).

Conclusions

Our findings demonstrate the ability of ACE-27 to predict grade III + perioperative complications or unintended ICU admission and survival in elderly patients with AEOC. This highlights the possibility for ACE-27 to play an instrumental role in identifying AEOC patients who are more susceptible to adverse surgical outcomes and have a poor survival rate and assisting in decisions regarding treatment.
Pathological characterization of pulmonary lesion and identification of associated bacteria and parasite infection in sheep and goat slaughtered at Dessie municipal abattoir, North-East Ethiopia
Authors: Teshale Nuredin , Amare Abadi , Feyisa Abdi , Abosse Jirata Shiferaw
Published: March 2024

Background

Lung is susceptible and vulnerable to many infectious and non-infectious agents. From this, a large number of specific and nonspecific diseases conditions can be diagnosed. A cross-sectional study design was conducted from December 2022 to May 2023 on major pulmonary lesion of sheep and goat slaughtered at Dessie municipal abattoir with the objective of characterizing the pulmonary pathological lesions, and isolating and identifying potential aerobic bacteria and parasite from pneumonic lung.

Materials and Methods

A total of 420 (302 sheep and 118 goats) were examined for gross lung lesions and histopathological investigation using standard techniques. Additionally, detailed pathological investigation was conducted on purposively selected lung lesions. Besides, pneumonic lesions were subjected to routine bacteriological and parasitological analysis.

Results

The overall abattoir prevalence of pulmonary abnormalities in sheep and goat was 81.2% (341/420). The common gross lesions encountered were Pneumonia (55.5%), emphysema (7.1%), atelectasis (3.3%), Hydatid cyst (4.3%), congestion (2.4%), haemorrhage (3.1%), Anthracosis (0.9%), adhesion (0.7%), and Bronchoectasis (0.7%) respectively. Pneumonia, hydatidosis, and pulmonary emphysema were significantly associated (p < 0.05) with animal age groups. Pneumonia was the most common disorder, accounting for 233 (55.5%). Dictyocaulus filaria (47.7%), Mullerius capillaries (23.2%) and Protostrongylus rufescens (17.16%) were isolated lung worm parasites; whereas E. coli (20.6%), Klebsiella Pneumoniae (12.7%), Mannheimia haemolytica (10.8%), Streptococcus species (4.9%), Staphylococcus aurous (7.8%) and Pasteurella multocida (2.9%), Pseudomonas (6.9%), Proteus (1.9%) and Cornybacterium (1%) were the isolated bacteria. Moreover, 18 (4.3%) Hydatid cysts were identified by cyst viability test. The pulmonary disorder of sheep and goats in the study are relatively high prevalent and posing great health and economic impacts.

Conclusion

Pulmonary infection with different agents is very common in the study areas. Feasible and affordable control measures and using latest diagnostic techniques like molecular detections of bacteria, viruses, and fungi, is necessary.
Persistent Opioid Use After Hospital Admission From Surgery in New Zealand: A Population-Based Study
Authors: Gong Jiayi , Jones Peter , Frampton Chris , Beyene Kebede , Chan Amy Hai Yan
Published: March 2024

BACKGROUND:

Persistent opioid use (POU) is common after surgery and is associated with an increased risk of mortality and morbidity. There have been no population-based studies exploring POU in opioid-naïve surgical patients in New Zealand (NZ). This study aimed to determine the incidence and risk factors for POU in opioid-naïve patients undergoing surgery in all NZ hospitals.

METHOD:

We included all opioid-naïve patients who underwent surgery without a concomitant trauma diagnosis and received opioids after discharge from any NZ hospital between January 2007 and December 2019. Patients were considered opioid naïve if no opioids had been dispensed to them or if they did not have a prior diagnosis of an opioid-use disorder up to 365 days preceding the index date. The primary outcome was the incidence of POU, defined a priori as opioid use after discharge between 91 and 365 days. We used a multivariable logistic regression to identify risk factors for POU.

RESULTS:

We identified 1789,407 patients undergoing surgery with no concomitant diagnosis of trauma; 377,144 (21.1%) were dispensed opioids and 260,726 patients were eligible and included in the analysis. Of those included in the final sample, 23,656 (9.1%; 95% confidence interval [CI], 9.0%–9.2%) developed POU. Risk factors related to how opioids were prescribed included: changing to different opioid(s) after discharge (adjusted odds ratio [aOR], 3.21; 95% CI, 3.04–3.38), receiving multiple opioids on discharge (aOR, 1.37; 95% CI, 1.29–1.45), and higher total oral morphine equivalents (>400 mg) (aOR, 1.23; 95% CI, 1.23–1.45). Conversely, patients who were coprescribed nonopioid analgesics on discharge had lower odds of POU (aOR, 0.91; 95% CI, 0.87–0.95). Only small differences were observed between different ethnicities. Other risk factors associated with increased risk of POU included undergoing neurosurgery (aOR, 2.02; 95% CI, 1.83–2.24), higher comorbidity burden (aOR, 1.90; 95% CI, 1.75–2.07), preoperative nonopioid analgesic use (aOR, 1.65; 95% CI, 1.60–1.71), smoking (aOR, 1.44; 95% CI, 1.35–1.54), and preoperative hypnotics use (aOR, 1.35; 95% CI, 1.28–1.42).

CONCLUSIONS:

Approximately 1 in 11 opioid-naïve patients who were dispensed opioids on surgical discharge, developed POU. Potentially modifiable risk factors for POU, related to how opioids were prescribed included changing opioids after discharge, receiving multiple opioids, and higher total dose of opioids given on discharge. Clinicians should discuss the possibility of developing POU with patients before and after surgery and consider potentially modifiable risk factors for POU when prescribing analgesia on discharge after surgery.
Leg Lymphoedema After Inguinal and Ilio-Inguinal Lymphadenectomy for Melanoma: Results from a Prospective, Randomised Trial
Authors: Lee T. S. , Li I. , Peric B. , Saw R. P. M. , Duprat J. P. , Bertolli E. , Spillane J. B. , van Leeuwen B. L. , Moncrieff M. , Sommariva A. , Allan C. P. , de Wilt J. H. W. , Jones R. Pritchard- , Geh J. L. C. , Howle J. R. , Spillane A. J.
Published: March 2024

Background

The Evaluation of Groin Lymphadenectomy Extent for Melanoma (EAGLE FM) study sought to address the question of whether to perform inguinal (IL) or ilio-inguinal lymphadenectomy (I-IL) for patients with inguinal nodal metastatic melanoma who have no clinical or imaging evidence of pelvic disease. Primary outcome measure was disease-free survival at 5 years, and secondary endpoints included lymphoedema.

Methods

EAGLE FM was designed to recruit 634 patients but closed with 88 patients randomised because of slow recruitment and changes in melanoma management. Lymphoedema assessments occurred preoperatively and at 6, 12, 18, and 24 months postoperatively. Lymphoedema was defined as Inter-Limb Volume Difference (ILVD) > 10%, Lymphoedema Index (L-Dex®) > 10 or change of L-Dex® > 10 from baseline.

Results

Prevalence of leg lymphoedema between the two groups was similar but numerically higher for I-IL at all time points in the first 24 months of follow-up; highest at 6 months (45.9% IL [CI 29.9–62.0%], 54.1% I-IL [CI 38.0–70.1%]) and lowest at 18 months (18.8% IL [CI 5.2–32.3%], 41.4% I-IL [CI 23.5–59.3%]). Median ILVD at 24 months for those affected by lymphoedema was 14.5% (IQR 10.6–18.7%) and L-Dex® was 12.6 (IQR 9.0–17.2). There was not enough statistical evidence to support associations between lymphoedema and extent of surgery, radiotherapy, or wound infection.

Conclusions

Despite a trend for patients who had I-IL to have greater lymphoedema prevalence than IL in the first 24 months after surgery, our study’s small sample did not have the statistical evidence to support an overall difference between the surgical groups.
Multilevel Langevin Pathwise Average for Gibbs Approximation
Authors: Egéa Maxime , Panloup Fabien
Published: March 2024

We propose and study a new multilevel method for the numerical approximation of a Gibbs distribution π on [Formula: see text], based on (overdamped) Langevin diffusions. This method relies on a multilevel occupation measure, that is, on an appropriate combination of R occupation measures of (constant-step) Euler schemes with respective steps [Formula: see text]. We first state a quantitative result under general assumptions that guarantees an ε-approximation (in an L2-sense) with a cost of the order [Formula: see text] or [Formula: see text] under less contractive assumptions. We then apply it to overdamped Langevin diffusions with strongly convex potential [Formula: see text] and obtain an ε-complexity of the order [Formula: see text] or [Formula: see text] under additional assumptions on U. More precisely, up to universal constants, an appropriate choice of the parameters leads to a cost controlled by [Formula: see text] (where [Formula: see text] and [Formula: see text] respectively denote the supremum and the infimum of the largest and lowest eigenvalue of [Formula: see text]). We finally complete these theoretical results with some numerical illustrations, including comparisons to other algorithms in Bayesian learning and opening to the non–strongly convex setting.

Funding: The authors are grateful to the SIRIC ILIAD Nantes-Angers program, supported by the French National Cancer Institute [INCA-DGOS-Inserm Grant 12558].
Profiles of Teacher-Student Relationships and Classroom Management Practices: How They Relate to Self-Efficacy, Work Stress, and Classroom Climate
Authors: Jiang Shan , Guo Lu , Tomek Sara
Published: March 2024

Teachers' classroom practice encompasses diverse facets of teacher behavior. Understanding teachers’ classroom practice is important as the literature has been well documented its association with student, teacher, and classroom outcomes. Positive teacher-student relationships and proper classroom management, both are important aspects of teachers’ classroom practices, have been empirically linked to increasing student academic performance and reducing problem behaviors. This study explored patterns of teacher classroom practices across teacher-student relationships and classroom management and validated them using a person-oriented approach, k-means clustering, on three sets of data with over 600 participants. Using indicators of classroom assessment scoring system (CLASS), three distinct teacher profiles were identified: supportive, intermediate, and detached. Supportive teachers demonstrated high levels of teacher-student relationships and classroom management, while detached teachers showed low levels of both. Intermediate teachers fell between these two groups. The study also compared these profiles based on teacher self-efficacy, work stress, and classroom climate. Supportive teachers had the highest classroom climate scores, followed by intermediate and detached. Work stress was comparable for intermediate and supportive teachers, but both were lower than detached. No group differences were found for self-efficacy. This study contributes to the understanding of teacher behaviors with students in the lower grades.
Metacognitive Awareness as a Predictor of Mathematical Modeling Competency Among Preservice Elementary Teachers
Authors: Oficiar John Rey G. , Ibañez Edwin D. , Pentang Jupeth T.
Published: March 2024

Mathematical modeling offers a promising approach to improving mathematics education. This study aims to determine if the concept of metacognitive awareness in the learning process is associated with mathematical modeling. This study also considers the interaction effect of sex and academic year level on both variables. Focusing the study on preservice elementary teachers might address potential issues and targeted intervention in their preparation program concerning their ability to teach and guide young learners in modeling activities. The research sample includes 140 preservice elementary teachers at Central Luzon State University, Philippines. Data collection used an adapted metacognitive awareness inventory and a validated researcher-made mathematical modeling competency test aligned with the K-12 mathematics curriculum in the Philippines. Results revealed that the preservice elementary teachers had a high metacognitive awareness and mathematical modeling competency, ranging from 22 to 31 out of 36 points. Besides, Factorial ANOVA indicates that academic year level positively affects both variables regardless of sex, and stepwise regression analysis unveiled that information management, declarative knowledge, and planning significantly predict 41.4% of the mathematical modeling competency variance. This suggests that developing metacognitive awareness supports preservice elementary teachers in performing modeling tasks that improve their competency level in mathematics.
The Impact of Proactive Behaviors of Vocational College Teachers on Teaching Performance: The Mediating Role of Organizational Support Perception
Authors: Li Pengfei , Zhang Cangkai
Published: March 2024

This study aims to explore the relationship between proactive behaviors, teaching performance, and organizational support among vocational college teachers. Based on the theory of organizational support, we conducted a survey of 373 teachers from four vocational colleges in Shanxi Province, using scales for proactive behaviors, organizational support, and teaching performance. The results indicate that: (a) There is a significant correlation between teachers' proactive behaviors and teaching performance; (b) There is a significant correlation between teachers' proactive behaviors and organizational support; (c) Organizational support plays a significant mediating role in the relationship between teachers' proactive behaviors and teaching performance. This study enriches the application of organizational support in vocational colleges, providing empirical evidence for improving teachers' proactive behaviors in higher education institutions, which could be useful for central or local education policy decision-makers and implementing units. Additionally, this model could be further applied beyond vocational education to other contexts or policies, demonstrating both theoretical and practical significance.
An Improvement in Regression Estimator Through Exponential Estimator Using Two Auxiliary Variables
Authors: Malik Sachin , Kanika  , Atul
Published: March 2024

For the case of simple random sampling, we are introducing a new regression estimator for the population mean with the supporting values of two auxiliary variables. The results for the mean square error (MSE) of the new form of regression estimator is fined. The mean square error’s results have also been checked through numerical illustration. It is observed that our introduced estimator is having less mean square error than the traditional ratio and regression estimator for two auxiliary variables.
Study of electric consumption of individual housing construction facilities of different stories and area
Authors: Akhmetshin Azat R.
Published: March 2024

In the Russian Federation, the construction of individual housing construction projects is being carried out at an increasing pace, for the construction of electrical networks for which there are no regulatory documents with an adequate methodology for calculating electrical loads. This situation led to low load on power grid equipment, and accordingly, investments became non-refundable. Sustainable development of private and industrial construction of individual housing projects is possible only with the development of regulatory technical documents that meet modern trends. To accomplish this task, research work was carried out to develop regulatory documents used in the design of electrical networks in cottage villages, taking into account the different number of floors and area of individual housing construction projects. Using the example of two cottage villages in Kazan, based on the parameter of daily and monthly electricity consumption, it was possible to obtain a sample whose data obeys the law of normal distribution. The analysis of sample sets of cottages in the villages shows that according to the power consumption parameter they can be grouped depending on the number of floors and area of the houses. The results obtained make it possible to formulate a future methodology for calculating electrical loads with amendments to the Federal Code of Rules.
Dynamics of Lamins B and A/C and Nucleoporin Nup160 during Meiotic Maturation in Mouse Oocytes
Authors: Nikolova Venera P. , Delimitreva S. , Chakarova I. , Zhivkova R. , Hadzhinesheva V. , Markova M.
Published: March 2024

This study was aimed at elucidating the fate of three important nuclear envelope components – lamins B and A/C and nucleoporin Nup160, during meiotic maturation of mouse oocytes. These proteins were localized by epifluorescence and confocal microscopy using specific antibodies in oocytes at different stages from prophase I (germinal vesicle) to metaphase II. In immature germinal vesicle oocytes, all three proteins were detected at the nuclear periphery. In metaphase I and metaphase II, lamin B co-localized with the meiotic spindle, lamin A/C was found in a diffuse halo surrounding the spindle and to a lesser degree throughout the cytoplasm, and Nup160 was concentrated to the spindle poles. To our knowledge, this is the first report on nucleoporin localization in mammalian oocytes and the first successful detection of lamins in mature oocytes. While the distribution patterns of both lamins closely paralleled the respective stages of mitosis, Nup160 localization in metaphase oocytes corresponded to that in mitotic prometaphase rather than metaphase. The peculiar distribution of this nucleoporin in oocytes may reflect its role in meiosis-specific mechanisms of spindle assembly and its regulation.
The Effect of Ibuprofen on Cytokine Production by Mononuclear Cells from Schizophrenic Patients
Authors: Bessler Hanna , Cohen-Terica D. , Djaldetti M. , Sirota P.
Published: March 2024

The existence of a restrained inflammatory state in schizophrenic individuals posed the question whether anti-inflammatory drugs may exert antipsychotic effects. Therefore, the effect of ibuprofen (IB) on cytokine production by human peripheral blood mononuclear cells (PBMC) from schizophrenic patients was examined and compared to that of healthy subjects. PBMC from 25 schizophrenic patients and 24 healthy volunteers were incubated for 24 h with lipopolysaccharide (LPS) in the absence or presence of various concentrations of IB. The levels of IL-1β, IL-6, TNF-α, IL-10 and IL-1ra in the supernatants were tested applying ELISA kits. The secretion of TNF-α by cells from schizophrenic patients was significantly lower compared with controls. IB caused stimulation of TNF-α and IL-6 production by cells of the two groups and enhanced IL-1β secretion by cells from schizophrenic patients. IB inhibited IL-1ra and IL-10 generation by cells from the two groups. Without IB, IL-1ra secretion was negatively correlated with the disease severity, while 200 μg/ml of IB positively correlated with the PANSS total score. IL-10 production was positively correlated with the PANSS positive subscale score both in the absence or presence of IB. The findings suggest that the effect of IB on the production of inflammatory cytokines may benefit the health of schizophrenic patients.
MIS (Kawasaki-like multisystem inflammatory syndrome) as a manifestation of SARS-CoV-2 in newborns: a review of the literature
Authors:   SI Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine, Kyiv, Vorobіova O.V. , Melnyk O.O. ,   Donetsk National Medical University, Lyman, Ukraine
Published: March 2024

The coronavirus disease (COVID-19) has become a global problem for countries all over the world. People of all age groups are prone to infection and newborns make no exception. Рurpose - to analyze and summarize information on the characteristics of the course, clinical manifestations, complications and ways to overcome coronavirus infection in newborns from mothers who contracted COVID-19 during pregnancy. The results of clinical observations of this pathology in the perinatal period are of particular interest to doctors of related specialties, because the question simultaneously concerns the life of the mother and her child. The article in particular is an attempt to tackle changes in the “mother–fetus–newborn” system under the influence of the virus. SARS-CoV-2 causes a clinical syndrome in babies, called Multisystem Inflammatory Syndrome in Newborns and Children (MIS-N, MIS-C - Multisystem Inflammatory Syndrome - depending on the age of the child). It occurs after an acute infection with COVID-19, the clinical picture is very similar to Kawasaki disease and manifestations of multiple organs failure in infants. The article analyzes the latest data from foreign and domestic literature of publicly available scientific sources, which present modern views on the clinical features of the course of COVID-19 in the context of Kawasaki-like multisystem inflammatory syndrome in newborns, summarizes the issues of etiology, pathogenesis, features of clinical manifestations of coronavirus infection in newborns, as well as diagnosis and disease management options in the neonatal period. No conflict of interests was declared by the authors.
Idiopathic short stature: characteristics of polymorphism of the Taql gene of vitamin D receptor
Authors:   SI V.P. Komisarenko Institute of Endocrinology and Metabolism of the NAMS of Ukraine, Kyiv, Bolshova O.V. , Ryznychuk M.O. ,   Bukovinian State Medical University, Chernivtsi, Ukraine
Published: March 2024

The causes of idiopathic short stature (IS) are diverse and not well understood, including polymorphisms of the vitamin D receptor (VDR) gene, dysfunction of growth hormone (GH) secretion, or certain structural abnormalities of the GH cannot be denied. The Taql polymorphism is located at the exon-intron junction and can potentially affect the stability of the VDR gene mRNA and, consequently, the child's height. Purpose - to study of the influence of the Taql polymorphism of the VDR gene in children with IS on certain indicators of bone metabolism. Materials and methods. We studied 22 children aged 10.68±3.28 years diagnosed with idiopathic short stature. The following data were taken into account: sex and age of the patient, anthropometric data, blood vitamin D level, bone age, basal and after stimulation tests, and Taql polymorphism of the VDR gene. All data were analyzed by non-parametric methods of variational statistics using the computer program MedCals (2006). Results. All children with IS had low vitamin D levels, regardless of the Taql polymorphic locus of the vitamin D receptor gene. All children with IS, regardless of the Taql polymorphic locus of the vitamin D receptor gene, were found to have low vitamin D levels. The basal level of GH in all patients was low, while the stimulated level of GH was normal in all patients. Conclusions. In the group of patients with IS, the frequency of the T/C (TaqI T/C, g.65058 T>C) genotype is 1.63 times higher than in the group of healthy subjects. Carriage of allele C of the polymorphic locus rs731236 Tagl of the VDR gene is significantly associated with the risk of developing idiopathic short stature - OR (Odds ratio) =1.68 (95% CI (confidence interval): 1.41-2.01; p<0.001), and in the presence of the T/C genotype the risk of this pathology is significantly high - OR=3.78 (95% CI: 1.23-11.63; p<0.02). Vitamin D deficiency was found in children with the T/T polymorphism, and vitamin D deficiency was found in patients with the T/C and C/C polymorphisms. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Onychocryptosis in children: literature review and generalization of treatment experience at the clinic of pediatric surgery of National Pirogov Memorial Medical Universiy
Authors:   National Pirogov Memorial Medical University, Ukraine, Konoplitskyi V.S. , Pohorilyi V.V. ,   National Pirogov Memorial Medical University, Ukraine, Dymchyna Yu.A. ,   National Pirogov Memorial Medical University, Ukraine, Mykhalchuk T.I. ,   National Pirogov Memorial Medical University, Ukraine, Korobko Yu.Ye. ,   National Pirogov Memorial Medical University, Ukraine, Olkhomiak O.O. ,   National Pirogov Memorial Medical University, Ukraine
Published: March 2024

Onychocryptosis in children is a medico-social problem, since the suffering associated with this pathology affects the general state of health and the formation of children's psyche, which significantly worsens the quality of life in pediatric practice. Purpose - to highlight the problem of treatment of an ingrown toenail in children to determine the optimal therapeutic and diagnostic tactics. The article analyzes the possible causes and risk factors of ingrown toenails, describes the symptoms of this disease. The experience of treating onychocryptosis in children is considered, namely, the methods of surgical intervention, taking into account the frequency of relapses, treatment terms, levels of trauma, and cosmetic results. The work summarizes the experience of treating 167 patients with onychocryptosis who were treated in the pediatric surgery clinic of the National Pirogov memorial Medical University from 2011 to 2020. A clinical case of operative treatment of onychocryptosis using the Schmiden method is demonstrated. Conclusions. The appearance of an ingrown toenail in children is explained by various congenital and acquired causes. Onychocryptosis occurs mainly in adolescence. The choice of the method of surgical treatment depends on the severity of local pathological changes and the presence of complications, the frequency of relapses, and the duration of treatment. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Manajemen Kelas Konstruktivistik dalam Menunjang Pendidikan saat Pandemi:
Authors: Supriyanto
Published: March 2024

Kondisi pandemi menyulitkan banyak pihak, tak terkecuali para pengelola pendidikan. Di Madrasah Diniyah Miftahul Huda Senjayan Nganjuk memiliki strategi khusus untuk menanggulangi masalah ini. Penelitian ini menggunakan kajian lapangan (field reseach)-kualitatif yang bertempat di Madrasah Diniyah Miftahul Huda Senjayan Kedungglugu Gondang Nganjuk. Pendekatan kajian ini adalah pengelolaan kelas konstruktivistik. Hasil penelitian ini adalah: Pertama, Pembelajaran dilakukan secara biasa (tatap muka) dengan hasil musyawarh dari yayasan, ustadz-ustadzah, wali santri dan masyarakat. Kedua, tetap menggunakan RPP dan kartu ngaji seperti biasanya. Ketiga, tempat belajar dilakukan secara fleksibel, yaitu kapasitas kelas dikurangi 50 % dari biasanya dan kekurangan kelas itu ditempatkan di mushala atau datang ke rumah gurunya. Keempat, tidak ada pengurangan jam pelajaran atau penambahan. Kelima, semua menerapkan protokol kesehatan seperti memakai masker, menjaga jarak, cek suhu badan, dan handsanitizer. Kelima, jika ada yang sakit tidak diperkenankan masuk. Evaluasi pembelajaran dalam kondisi ini yang paling ketat dilakukan adalah penerapan protokol kesehatan. Selain itu, evaluasi seperti biasanya juga masih berjalan dengan normal yaitu diadakan penilaian kemampuan siswa dengan stadar nilai A, B, C, dan D. Bagi yang memperoleh nilai A dan B boleh meneruskan ngajinya dan bagi yang memperoleh nilai C dan D harus mengulang kembali.