bluuebunny/crossref_metadata_2025 huggingface dataset:
Olutasidenib (FT-2102) induces durable complete remissions in patients with relapsed or refractory IDH1-mutated AML
Authors: de Botton Stéphane , Fenaux Pierre , Yee Karen , Récher Christian , Wei Andrew H. , Montesinos Pau , Taussig David C. , Pigneux Arnaud , Braun Thorsten , Curti Antonio , Grove Carolyn , Jonas Brian A. , Khwaja Asim , Legrand Ollivier , Peterlin Pierre , Arnan Montserrat , Blum William , Cilloni Daniela , Hiwase Devendra K. , Jurcic Joseph G. , Krauter Jürgen , Thomas Xavier , Watts Justin M. , Yang Jay , Polyanskaya Olga , Brevard Julie , Sweeney Jennifer , Barrett Emma , Cortes Jorge
Published: February 2023

Olutasidenib (FT-2102) is a potent, selective, oral, small-molecule inhibitor of mutant isocitrate dehydrogenase 1 (mIDH1). Overall, 153 IDH1 inhibitor–naive patients with mIDH1R132 relapsed/refractory (R/R) acute myeloid leukemia (AML) received olutasidenib monotherapy 150 mg twice daily in the pivotal cohort of this study. The median age of participants was 71 years (range, 32-87 years) and the median number of prior regimens received by patients was 2 (1-7). The rate of complete remission (CR) plus CR with partial hematologic recovery (CRh) was 35%, and the overall response rate was 48%. Response rates were similar in patients who had, and who had not, received prior venetoclax. With 55% of patients censored at the time of data cut-off, the median duration of CR/CRh was 25.9 months. The median duration of overall response was 11.7 months, and the median overall survival was 11.6 months. Of 86 patients who were transfusion dependent at baseline, a 56-day transfusion independence was achieved in 29 (34%), which included patients in all response groups. Grade 3 or 4 treatment-emergent adverse events (≥10%) were febrile neutropenia and anemia (n = 31; 20% each), thrombocytopenia (n = 25; 16%), and neutropenia (n = 20; 13%). Differentiation syndrome adverse events of special interest occurred in 22 (14%) patients, with 14 (9%) grade ≥3 and 1 fatal case reported. Overall, olutasidenib induced durable remissions and transfusion independence with a well-characterized and manageable side effect profile. The observed efficacy represents a therapeutic advance in this molecularly defined, poor-prognostic population of patients with mIDH1 R/R AML. This trial was registered at www.clinicaltrials.gov as #NCT02719574.
Ultralong Stretchable Soft Actuator (US2A): Design, Modeling and Application
Authors: Wang Wenbiao , Zhu Yunfei , Cai Shibo , Bao Guanjun
Published: February 2023

Actuator plays a significant role in soft robotics. This paper proposed an ultralong stretchable soft actuator (US2A) with a variable and sizeable maximum elongation. The US2A is composed of a silicone rubber tube and a bellows woven sleeve. The maximal extension can be conveniently regulated by just adjusting the wrinkles’ initial angle of the bellows woven sleeve. The kinematics of US2A could be obtained by geometrically analyzing the structure of the bellows woven sleeve when the silicone rubber tube is inflated. Based on the principle of virtual work, the actuating models have been established: the pressure-elongation model and the pressure-force model. These models reflect the influence of the silicone tube’s shell thickness and material properties on the pneumatic muscle’s performance, which facilitates the optimal design of US2A for various working conditions. The experimental results showed that the maximum elongation of the US2A prototype is 257%, and the effective elongation could be variably regulated in the range of 0 and 257%. The proposed models were also verified by pressure-elongation and pressure-force experiments, with an average error of 5% and 2.5%, respectively. Finally, based on the US2A, we designed a pneumatic rehabilitation glove, soft arm robot, and rigid-soft coupling continuous robot, which further verified the feasibility of US2A as a soft driving component.
Phenotypic variation of root-system architecture under high P and low P conditions in potato (Solanum tuberosum L.)
Authors: Kirchgesser Julian , Hazarika Mousumi , Bachmann-Pfabe Silvia , Dehmer Klaus J. , Kavka Mareike , Uptmoor Ralf
Published: February 2023

Background

Phosphorus (P) is an essential macronutrient required for plant metabolism and growth. Its acquisition by plants depends on the availability of dissolved P in the rhizosphere and on the characteristics of P uptake mechanisms such as root-system architecture (RSA). Compared to other crops, potato (Solanum tuberosumL.) has a relatively poor P acquisition efficiency. This is mainly due to its shallow and sparsely branched root system, resulting in a rather limited exploitable soil volume. Information about potato genotypes with RSA traits suitable to improve adaptation to nutrient scarcity is quite rare. Aim of this study is to assess phenotypic variation of RSA in a potato diversity set and its reactions to P deficiency.

Results

Only one out of 22 RSA-traits showed a significant increase under low-P conditions. This indicates an overall negative effect of P scarcity on potato root growth. Differences among genotypes, however, were statistically significant for 21 traits, revealing a high variability in potato RSA. Using a principal component analysis (PCA), we were able to classify genotypes into three groups with regard to their root-system size. Genotypes with both small and large root systems reacted to low-P conditions by in- or decreasing their relative root-system size to medium, whereas genotypes with an intermediate root system size showed little to no changes.

Conclusions

We observed a huge variation in both the potato root system itself and its adaptation to P deficiency. This may enable the selection of potato genotypes with an improved root-zone exploitation. Eventually, these could be utilized to develop new cultivars adapted to low-P environments with better resource-use efficiencies.
Genome-wide identification and characterization of polycomb repressive complex 2 core components in upland cotton (Gossypium hirsutum L.)
Authors: Cheng Kai , Lei Cangbao , Zhang Siyuan , Zheng Qiao , Wei Chunyan , Huang Weiyi , Xing Minghui , Zhang Junli , Zhang Xiangyu , Zhang Xiao
Published: February 2023

Background

The evolutionarily conserved Polycomb Repressive Complex 2 (PRC2) plays a vital role in epigenetic gene repression by depositing tri-methylation on lysine residue K27 of histone H3 (H3K27me3) at the target loci, thus participating in diverse biological processes. However, few reports about PRC2 are available in plant species with large and complicated genomes, like cotton.

Results

Here, we performed a genome-wide identification and comprehensive analysis of cotton PRC2 core components, especially in upland cotton (Gossypium hirsutum). Firstly, a total of 8 and 16 PRC2 core components were identified in diploid and tetraploid cotton species, respectively. These components were classified into four groups, E(z), Su(z)12, ESC and p55, and the members in the same group displayed good collinearity, similar gene structure and domain organization. Next, we cloned G. hirsutum PRC2 (GhPRC2) core components, and found that most of GhPRC2 proteins were localized in the nucleus, and interacted with each other to form multi-subunit complexes. Moreover, we analyzed the expression profile of GhPRC2 genes. The transcriptome data and quantitative real-time PCR (qRT-PCR) assays indicated that GhPRC2 genes were ubiquitously but differentially expressed in various tissues, with high expression levels in reproductive organs like petals, stamens and pistils. And the expressions of several GhPRC2 genes, especially E(z) group genes, were responsive to various abiotic and biotic stresses, including drought, salinity, extreme temperature, and Verticillium dahliae (Vd) infection.

Conclusion

We identified PRC2 core components in upland cotton, and systematically investigated their classifications, phylogenetic and synteny relationships, gene structures, domain organizations, subcellular localizations, protein interactions, tissue-specific and stresses-responsive expression patterns. Our results will provide insights into the evolution and composition of cotton PRC2, and lay the foundation for further investigation of their biological functions and regulatory mechanisms.
Exosomal HSP90 induced by remote ischemic preconditioning alleviates myocardial ischemia/reperfusion injury by inhibiting complement activation and inflammation
Authors: Cheng Xiao-Fang , He Shi-Tao , Zhong Guo-Qiang , Meng Jian-Jun , Wang Min , Bi Qi , Tu Rong-Hui
Published: February 2023

Background/Aims

The activation of the complement system and subsequent inflammatory responses are important features of myocardial ischemia/reperfusion (I/R) injury. Exosomes are nanoscale extracellular vesicles that play a significant role in remote ischemic preconditioning (RIPC) cardioprotection. The present study aimed to test whether RIPC-induced plasma exosomes (RIPC-Exo) exert protective effects on myocardial I/R injury by inhibiting complement activation and inflammation and whether exosomal heat shock protein 90 (HSP90) mediates these effects.

Methods

Rat hearts underwent 30 min of coronary ligation followed by 2 h of reperfusion. Plasma exosomes were isolated from RIPC rats and injected into the infarcted myocardium immediately after ligation. Sixty rats were randomly divided into Sham, I/R, I/R + RIPC-Exo (50 µg/µl), and RIPC-Exo + GA (geldanamycin, 1 mg/kg, administration 30 min before ligation) groups. Cardiomyocyte apoptosis, the release of myocardial markers (LDH, cTnI and CK-MB), infarct size, the expression of HSP90, complement component (C)3, C5a, c-Jun N-terminal kinase (JNK), interleukin (IL)-1β, tumor necrosis factor (TNF)-alpha and intercellular adhesion molecule -1 (ICAM-1) were assessed.

Results

RIPC-Exo treatment significantly reduced I/R-induced cardiomyocyte apoptosis, the release of myocardial markers (LDH, cTnI and CK-MB) and infarct size. These beneficial effects were accompanied by decreased C3 and C5a expression, decreased inflammatory factor levels (IL-1β, TNF-α, and ICAM-1), decreased JNK and Bax, and increased Bcl-2 expression. Meanwhile, the expression of HSP90 in the exosomes from rat plasma increased significantly after RIPC. However, treatment with HSP90 inhibitor GA significantly reversed the cardioprotection of RIPC-Exo, as well as activated complement component, JNK signalling and inflammation, indicating that HSP90 in exosomes isolated from the RIPC was important in mediating the cardioprotective effects during I/R.

Conclusion

Exosomal HSP90 induced by RIPC played a significant role in cardioprotection against I/R injury, and its function was in part linked to the inhibition of the complement system, JNK signalling and local and systemic inflammation, ultimately alleviating I/R-induced myocardial injury and apoptosis by the upregulation of Bcl-2 expression and the downregulation of proapoptotic Bax.
A qualitative evaluation and conceptual framework on the use of the Birth weight and Age-at-death Boxes for Intervention and Evaluation System (BABIES) matrix for perinatal health in Uganda
Authors: Dynes Michelle M. , Daniel Gaea A. , Mac Valerie , Picho Brenda , Asiimwe Alice , Nalutaaya Agnes , Opio Gregory , Kamara Vincent , Kaharuza Frank , Serbanescu Florina
Published: February 2023

Background

Perinatal mortality (newborn deaths in the first week of life and stillbirths) continues to be a significant global health threat, particularly in resource-constrained settings. Low-tech, innovative solutions that close the quality-of-care gap may contribute to progress toward the Sustainable Development Goals for health by 2030. From 2012 to 2018, the Saving Mothers, Giving Life Initiative (SMGL) implemented the Birth weight and Age-at-Death Boxes for Intervention and Evaluation System (BABIES) matrix in Western Uganda. The BABIES matrix provides a simple, standardized way to track perinatal health outcomes to inform evidence-based quality improvement strategies.

Methods

In November 2017, a facility-based qualitative evaluation was conducted using in-depth interviews with 29 health workers in 16 health facilities implementing BABIES in Uganda. Data were analyzed using directed content analysis across five domains: 1) perceived ease of use, 2) how the matrix was used, 3) changes in behavior or standard operating procedures after introduction, 4) perceived value of the matrix, and 5) program sustainability.

Results

Values in the matrix were easy to calculate, but training was required to ensure correct data placement and interpretation. Displaying the matrix on a highly visible board in the maternity ward fostered a sense of accountability for health outcomes. BABIES matrix reports were compiled, reviewed, and responded to monthly by interprofessional teams, prompting collaboration across units to fill data gaps and support perinatal death reviews. Respondents reported improved staff communication and performance appraisal, community engagement, and ability to track and link clinical outcomes with actions. Midwives felt empowered to participate in the problem-solving process. Respondents were motivated to continue using BABIES, although sustainability concerns were raised due to funding and staff shortages.

Conclusions

District-level health systems can use data compiled from the BABIES matrix to inform policy and guide implementation of community-centered health practices to improve perinatal heath. Future work may consider using the Conceptual Framework on Use of the BABIES Matrix for Perinatal Health as a model to operationalize concepts and test the impact of the tool over time.
A phenomenological study on recurrent teenage pregnancies in effutu municipality- Ghana.the experiences of teenage mothers
Authors: Boateng Agartha Afful , Botchwey Charles Owusu-Aduomi , Adatorvor Bruce Afeti , Baidoo Michael Afari , Boakye Dorothy Serwaa , Boateng Richard
Published: February 2023

Background

Generally, recurrent teenage pregnancies are public health menaces that impede the quality of life of teenage mothers, their offspring, and society as a whole. However, there is paucity of information regarding factors influencing this social issue especially, in developing countries where Ghana is no exception. Moreover, this menace has been least investigated from the perspective of the teenager with multiple pregnancies. Hence, this study aimed at identifying the factors influencing recurrent teenage pregnancies and the challenges confronted by these teenage mothers.

Method

This study is a phenomenological qualitative study that was conducted in the Effutu Municipality in the Central Region of Ghana. Employing convenience and snowball sampling, 40 participants who were residents of the study area, had a child each, and were pregnant at the time of the study were included. Other participants included teenage mothers who had at least two (2) children. A face-to-face in-depth interview with the help of an interview guide was conducted. Proceedings were recorded, transcribed, and analysed using thematic analysis. Quotations were used in the result presentation.

Results

The results of the study revealed that factors influencing recurrent teenage pregnancies are multifactorial. It includes peer pressure, parental neglect, poverty, living with a partner, and inadequate knowledge of family planning. The teenager with recurrent pregnancy is confronted with financial difficulties and is faced with stigmatisation in the society where she finds herself.

Conclusion

To this effect, it is important to intensify education on family planning and good parental practices among parents with teenage mothers while providing a similar form of sensitization for members of the society about the harmful effects of stigmatisation on the teenage mother and her children. Again, a social support network for teenagers with recurrent pregnancies could be formed to help curb this public health menace.
E-cigarette product preferences of Australian adolescent and adult users: a 2022 study
Authors: Jongenelis Michelle I
Published: February 2023

Background

Research that comprehensively documents preferences for different types of novel nicotine products in Australia is lacking, making it difficult for policymakers to determine where public health efforts should be focused. This study thus sought to explore Australian adolescent and adult e-cigarette users’ preferences for different types of e-cigarettes and e-liquids. Purchasing behaviours and sources of e-liquid were also examined.

Methods

An online survey was administered to 4,617 Australians aged 12 + years, 636 of whom had used an e-cigarette in the last 30 days and were the focus of this study. Among users, 45% also smoked tobacco cigarettes, 41% were non-smokers, and 14% had never smoked.

Results

The majority (82%) of e-cigarette users surveyed reported using nicotine-containing e-liquid in their devices. Fewer (60%) reported using non-nicotine e-liquid. The preference for nicotine over non-nicotine e-liquid was observed among all age and smoking groups. Most users (89%) reported using flavoured e-liquids, with adolescents (96%) significantly more likely than young adults (90%) and adults aged 25 + years (85%) to report using such e-liquids. Fruit flavours were the most popular among all subgroups. In terms of device type, disposable e-cigarettes were the most common product used among almost all groups; the exception being adults aged 25 + years who preferred systems with refillable tanks. Friends and tobacco retailers were the most frequently nominated sources of nicotine e-liquid among adolescents and young adults. Among adults aged 25 + years, tobacco retailers and the Internet were the most frequently nominated sources of these products.

Conclusion

Disposable e-cigarettes with flavoured, nicotine-containing e-liquid are popular among users of the devices, including adolescents. Measures that restrict the accessibility and availability of flavoured e-liquids and disposable e-cigarettes, and greater enforcement of laws regarding the sale and importation of nicotine e-liquids, are urgently needed to protect youth and never smokers from these products.
The impact of smoking on periodontitis patients’ GCF/serum cytokine profile both before and after periodontal therapy: a meta-analysis
Authors: Hao Chun-Ping , Cao Nan-Jue , Zhu Yu-He , Wang Wei
Published: February 2023

Background

Smoking is an established modifying factor for the host immune response of periodontitis patients. However, its exact influence remains unclear. We aimed to compare the cytokine profile of periodontitis patients with and without smoking habits both before and after periodontal therapy to preliminarily explore its influence on the host immune response to periodontitis.

Methods

The protocol of the present meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the code CRD42021255656. Meta-analysis was performed for each cytokine if at least three studies were included. We synthesized the evidence to compare the cytokine profile of periodontitis with and without smoking both in gingival cervical fluid (GCF) and serum to explore the impact of smoking on periodontitis both locally and systemically. Moreover, we also compared the cytokine profile of the two groups of patients after periodontal therapy to explore the effect of smoking on the outcome of periodontal therapy.

Results

Fifteen studies were included in this meta-analysis. We found that there was no significant difference between the two groups of patients in the baseline cytokine profile. However, after periodontal therapy, smoking periodontitis patients showed significantly higher IL-1β levels in their GCF than nonsmoking patients.

Discussion

There was no significant difference between smoking and nonsmoking periodontitis patients in the baseline cytokine profile. However, after periodontal therapy, smoking periodontitis patients showed significantly higher IL-1β levels in their GCF than nonsmoking patients, which indicates that smoking may impair the response of periodontitis to periodontal treatment.
FoCUS cardiac ultrasound training for undergraduates based on current national guidelines: a prospective, controlled, single-center study on transferability
Authors: Weimer Johannes , Rolef Peter , Müller Lukas , Bellhäuser Henrik , Göbel Sebastian , Buggenhagen Holger , Weimer Andreas , Waezsada Elias , Kirchhoff Friederike , Weinmann-Menke Julia
Published: February 2023

Introduction

In emergency and critical-care medicine, focused cardiac ultrasound (FoCUS) is indispensable for assessing a patient’s cardiac status. The aim of this study was to establish and validate a peer-to-peer–supported ultrasound course for learning FoCUS-specific skills during undergraduate studies at a German university.

Methods

A 1-day, 12 teaching units training course was developed for students in the clinical section of medical college, with content based on the current national guidelines. A total of 217 students participated in the study (97 in the course group and 120 in the control group). The course and the participants’ subjective assessment of improved skills were evaluated using a questionnaire (7-point Likert scale; 7 = complete agreement and 1 = no agreement at all). Objective learning gains were assessed by tests before and after the course. These consisted of a test of figural intelligence (eight items) and a test of technical knowledge (13 items).

Results

The course participants experienced significant improvement (P < 0.001) from before to after the course, with a large effect size of η2part = 0.26. In addition, the course group had significantly better results (P < 0.001) than the control group in the post-test, with a medium to large effect size of η2part = 0.14. No significant differences (P = 0.27) were detected in the test section on figural intelligence. The evaluations showed that the participants had a high degree of satisfaction with the course approach, teaching materials, and tutors. There was also a positive increase in their subjective assessment of their own skills, including areas such as technical knowledge, ultrasound anatomy, and performance of the examination.

Conclusion

The results of both the objective learning assessment and the subjective evaluations suggest that a FoCUS course originally intended for qualified physicians is equally suitable for students. With the development and provision of modern digital teaching media, even more students will be able to benefit from this approach in the future.
Final-year medical student mental wellness during preparation for the examination for specialty in Turkey: a cross-sectional survey study
Authors: Karabacak Mert , Hakkoymaz Muberra , Ukus Berke , Ozturk Ece , Kaya Busra , Ozcan Zeynep , Ozkara Burak Berksu
Published: February 2023

Background

In Turkey, most final-year medical students prepare for the Examination for Specialty in Medicine in a high-stress environment. To the best of our knowledge, this is the first study on final-year medical student general psychological distress during preparation for the Examination for Specialty in Turkey. We aim to evaluate psychological distress and understand the variables associated with depression, anxiety, and stress levels among final-year medical students preparing for the Examination for Specialty.

Methods

A self-reporting, anonymous, cross-sectional survey with 21 items consisting of demographic variables, custom variables directed for this study, and the DASS-21 was utilized. Survey results were expounded based on univariate analysis and multivariate linear regression analysis.

Results

Our study revealed four variables associated with impaired mental wellness among final-year medical students during preparation for the examination for Specialty: attendance to preparatory courses, duration of preparation, consideration of quitting studying, and psychiatric drug usage/ongoing psychotherapy.

Discussion

Considering that physician mental wellness is one of the most crucial determinants of healthcare quality, impaired mental wellness among future physicians is an obstacle to a well-functioning healthcare system. Our study targets researchers and authorities, who should focus on medical student mental wellness, and medical students themselves.
Cultural competence among nursing students and nurses working in acute care settings: a cross-sectional study
Authors: Osmancevic Selvedina , Großschädl Franziska , Lohrmann Christa
Published: February 2023

Background

The increasing cultural diversity in healthcare in European countries, including Austria, has highlighted the need to enhance nurses’ cultural competence. Assessing cultural competence and identifying relevant influencing factors can help to improve culturally competent care. The aim of this study was to assess the cultural competence of nurses and nursing students working in Austrian acute care settings and to identify influencing factors using the Cultural Competence Assessment scale.

Methods

A cross-sectional design was used. Data collection was carried out in March 2021 with nurses and nursing students in the last year of their studies who were working in Austrian acute care settings. Descriptive analysis was applied to display the general characteristics of the study participants and the levels of their overall cultural competence. A multiple linear regression analysis was conducted to analyze the influencing factors of cultural competence.

Results

The nurses’ cultural competence level was moderate to high (mean = 3.89; SD = .48). Their age, educational level, cultural diversity training and self-perceived cultural competence significantly influenced the level (F (6, 875) = 18.971, p < .0000, adj. R2 = 1.09).

Conclusions

Providing culturally competent healthcare services for culturally diverse patients is essential for all healthcare professionals, and especially for nurses who spend the most time with patients. Effective interventions, such as educational training, need to be implemented in order to deliver culturally competent care and potentially reduce disparities in healthcare and improve patient outcomes.
Comparison of the prognostic value of stromal tumor-infiltrating lymphocytes and CD3 + T cells between schistosomal and non-schistosomal colorectal cancer
Authors: Wang Weixia , Zhang Yingyi , Liu Jican , Jing Hongyan , Lu Kui , Wang Limei , Zhu Ting , Xu Yanchao , Bu Dacheng , Cheng Meihong , Liu Jing , Shen Weidong , Yao Junxia , Huang Sinian
Published: February 2023

Aim

To compare the prognostic value of tumor-infiltrating lymphocytes (TILs) and CD3 + cells and CD20 + cells between schistosomal colorectal cancer (SCRC) and non-schistosomal CRC (NSCRC).

Background

Although schistosomiasis has been basically eliminated, it has not been completely extinction in China, and occasional outbreaks occur in Europe recently. The role of immune cells in the immune microenvironment of SCRC and NSCRC is remaining obscure, and the inflammation-based prognostic systems of SCRC has rarely been reported.

Methods

HE-stained sections of 349 colorectal cancer (CRC) tumors, which were completely resected, were evaluated for density of TILs. Meanwhile, we evaluated CD3 + T lymphocytes and CD20 + B lymphocytes by immunochemistry. The relationship of these infiltrating immune cells with clinicopathological features, including schistosomiasis, and clinical outcomes was evaluated, and the prognostic roles of TILs in SCRC and NSCRC were explored.

Results

Except for age (P < 0.0001), there were no significant differences between NSCRC and SCRC patients in clinicopathological features (P > 0.05). Beside, the positive expression pattern of sTILs, iTILs, CD3, and CD20 between NSCRC and SCRC patients was also similar (P > 0.05). In the whole cohort, sTILs and CD3 were defined as independent prognostic factors (P = 0.031 and P = 0.003, respectively). CD3 was an independent prognostic factor both in the NSCRC and SCRC set (P = 0.026 and P = 0.045, respectively). Higher sTILs, CD3, and CD20 were correlated with less aggressive tumor characteristics in the whole cohort and in subgroups.

Conclusion

Although CD3 was an independent prognostic factor for both NSCRC and SCRC set, there were no significant differences between SCRC and NSCRC patients in sTILs, CD3, CD20, and in other clinicopathological features.
Cost-effectiveness of seven-days-per-week rehabilitation schedule for acute stroke patients
Authors: Morii Yasuhiro , Abiko Kagari , Osanai Toshiya , Takami Jiro , Tanikawa Takumi , Fujiwara Kensuke , Houkin Kiyohiro , Ogasawara Katsuhiko
Published: February 2023

Background

Rehabilitation is an essential medical service for patients who have suffered acute stroke. Although the effectiveness of 7-days-per-week rehabilitation schedule has been studied in comparison with 5- or 6-days-per-week rehabilitation schedule, its cost-effectiveness has not been analyzed. In this research, to help formulate more cost-effective medical treatments for acute stroke patients, we analyzed the cost-effectiveness of 7-days-per-week rehabilitation for acute stroke from public health payer’s perspective, and public healthcare and long-term care payerʼs perspective in Japan.

Methods

Cost-effectiveness of 7-days-per-week rehabilitation for acute stroke patients was analyzed based on the result from a previous study using a Japanese database examining the efficacy of 7-days-per-week rehabilitation. Cost utility analysis was conducted by comparing 7-days-per-week rehabilitation with 5- or 6-days-per-week rehabilitation, with its main outcome incremental cost-effectiveness ratio (ICER) calculated by dividing estimated incremental medical and long-term care costs by incremental quality-adjusted life years (QALY). The costs were estimated using the Japanese fee table and from published sources. The time horizon was 5 years, and Markov modeling was used for the analysis.

Results

The ICER was $6339/QALY from public health payer’s perspective, lower than 5,000,000 Yen/QALY (approximately US$37,913), which was the willingness-to-pay used for the cost-effectiveness evaluation in Japan. The 7-day-per-week rehabilitation was dominant from public healthcare and long-term care payerʼs perspective. The result of sensitivity analysis confirmed the results.

Conclusion

The results indicated that 7-days-per-week rehabilitation for acute stroke rehabilitation was likely to be cost-effective.
Hypothyroidism in hibernating brown bears
Authors: Frøbert Anne Mette , Nielsen Claus G. , Brohus Malene , Kindberg Jonas , Fröbert Ole , Overgaard Michael T.
Published: February 2023

Brown bears hibernate throughout half of the year as a survival strategy to reduce energy consumption during prolonged periods with scarcity of food and water. Thyroid hormones are the major endocrine regulators of basal metabolic rate in humans. Therefore, we aimed to determine regulations in serum thyroid hormone levels in hibernation compared to the active state to investigate if these are involved in the adaptions for hibernation.

We used electrochemiluminescence immunoassay to quantify total triiodothyronine (T3) and thyroxine (T4) levels in hibernation and active state in paired serum samples from six subadult Scandinavian brown bears. Additionally, we determined regulations in the liver mRNA levels of three major thyroid hormone-binding proteins; thyroxine-binding globulin (TBG), transthyretin (TTR), and albumin, by analysis of previously published grizzly bear RNA sequencing data.

We found that bears were hypothyroid when hibernating with T4 levels reduced to less than 44% (P = 0.008) and T3 levels reduced to less than 36% (P = 0.016) of those measured in the active state. In hibernation, mRNA levels of TBG and albumin increased to 449% (P = 0.031) and 121% (P = 0.031), respectively, of those measured in the active state. TTR mRNA levels did not change.

Hibernating bears are hypothyroid and share physiologic features with hypothyroid humans, including decreased basal metabolic rate, bradycardia, hypothermia, and fatigue. We speculate that decreased thyroid hormone signaling is a key mediator of hibernation physiology in bears. Our findings shed light on the translational potential of bear hibernation physiology to humans for whom a similar hypometabolic state could be of interest in specific conditions.
Comparative evaluation of the efficacy of customized maxillary oral appliance with mandibular advancement appliance as a treatment modality for moderate obstructive sleep apnea patients—a randomized controlled trial
Authors: Belkhode Vikram , Godbole Surekha , Nimonkar Sharayu , Pisulkar Sweta , Nimonkar Pranali
Published: February 2023

Background

Obstructive sleep apnea (OSA) is quite common among the adult population, according to recent epidemiological studies. The most frequently suggested alternate treatment for mild to moderate OSA is oral appliances (OA). The purpose of the present study was to assess as well as compare the effectiveness of custom-made maxillary oral appliances against mandibular advancement appliances in the care of individuals suffering from moderate obstructive sleep apnea.

Methods

A prospective interventional research was carried out with 40 participants. Polysomnography (PSG) was done and the participants with an apnea-hypopnea index (AHI) >15–30 were involved in the research. Study participants were randomly split up into two test groups: group I was the “Control Group” (group treated with a mandibular advancement device (MAD), n=20), while group II was exposed to a “customized maxillary oral appliance” (CMOA, n=20). Both groups had reference measures for AHI, blood oxygen saturation (SpO2), oro-nasal airflow via respiratory disturbance index (RDI), and the Epworth Sleepiness Scale (ESS). Appliances were fabricated and delivered to the respective study group participants. PSG was again conducted after a period of 1 and 3 months of appliance delivery and re-evaluation was done for all the parameters and was compared with reference measurements. The facts were analyzed using descriptive and analytical statistical methods. The statistical program utilized in the study was “SPSS (Statistical Package for Social Sciences) Version 20.1.” After 1 and 3 months, the statistical significance between the two study groups was assessed at P<0.05.

Results

The analysis of mean AHI, SPO2, RDI, and ESS for both test groups manifested statistically significant measures (P<0.001). The study results revealed a statistically significant depletion in mean AHI scores, improvement in mean SPO2 scores, and reduction in mean RDI scores and ESS scores when compared with reference measurements to 1 month, 1 to 3 months, and between reference measurements and 3 months.

Conclusion

The CMOA was effective in managing moderate OSA and has great therapeutic potential. It can be an option for the MAD for treating patients suffering from moderate obstructive sleep apnea.

Trial registration

The study was registered under Clinical Trials Registry-India and the registration number is CTRI/2020/07/026936. Registered on 31 July 2020
Combining single-cell transcriptomics and CellTagging to identify differentiation trajectories of human adipose-derived mesenchymal stem cells
Authors: Lin Kai , Yang Yanlei , Cao Yinghao , Liang Junbo , Qian Jun , Wang Xiaoyue , Han Qin
Published: February 2023

Background

Mesenchymal stromal cells (MSCs) have attracted great attention in the application of cell-based therapy because of their pluripotent differentiation and immunomodulatory ability. Due to the limited number of MSCs isolated from donor tissues, a large number of MSCs need to be expanded in a traditional two-dimensional cell culture device to obtain a sufficient therapeutic amount. However, long-term cultivation of MSCs in vitro has been proven to reduce their differentiation potential and change their immunomodulatory characteristics. We aimed to explore the cellular heterogeneity and differentiation potential of different MSCs expanded in vitro and reconstruct the complex cloning track of cells in the process of differentiation.

Methods

Single cell transcriptome sequencing was combined with ‘CellTagging’, which is a composite barcode indexing method that can capture the cloning history and cell identity in parallel to track the differentiation process of the same cell over time.

Results

Through the single-cell transcriptome and CellTagging, we found that the heterogeneity of human adipose tissue derived stem cells (hADSCs) in the early stage of culture was very limited. With the passage, the cells spontaneously differentiated during the process of division and proliferation, and the heterogeneity of the cells increased. By tracing the differentiation track of cells, we found most cells have the potential for multidirectional differentiation, while a few cells have the potential for unidirectional differentiation. One subpopulation of hADSCs with the specific osteoblast differentiation potential was traced from the early stage to the late stage, which indicates that the differentiation trajectories of the cells are determined in the early stages of lineage transformation. Further, considering that all genes related to osteogenic differentiation have not yet been determined, we identified that there are some genes that are highly expressed specifically in the hADSC subsets that can successfully differentiate into osteoblasts, such as Serpin Family E Member 2 (SERPINE2), Secreted Frizzled Related Protein 1 (SFRP1), Keratin 7 (KRT7), Peptidase Inhibitor 16 (PI16), and Carboxypeptidase E (CPE), which may be key regulatory genes for osteogenic induction, and finally proved that the SERPINE2 gene can promote the osteogenic process.

Conclusion

The results of this study contribute toward the exploration of the heterogeneity of hADSCs and improving our understanding of the influence of heterogeneity on the differentiation potential of cells. Through this study, we found that the SERPINE2 gene plays a decisive role in the osteogenic differentiation of hADSCs, which lays a foundation for establishing a more novel and complete induction system.
Application-based principles of islamic geometric patterns; state-of-the-art, and future trends in computer science/technologies: a review
Authors: Ranjazmay Azari Mohammadreza , Bemanian Mohammadreza , Mahdavinejad Mohammadjavad , Körner Axel , Knippers Jan
Published: February 2023

Currently, there is a tendency to use Islamic Geometric Patterns (IGPs) as important identities and cultural elements of building design in the Middle East. Despite high demand, lack of information about the potential of IGPs principles have led to formal inspiration in the design of existing buildings. Many research studies have been carried out on the principles of IGPs. However, comprehensive studies relating to new possibilities, such as structure-based, sustainable-based, and aesthetic-based purposes, developed by computer science and related technologies, are relatively rare. This article reviews the state-of-the-art knowledge of IGPs, provides a survey of the main principles, presents the status quo, and identifies gaps in recent research directions. Finally, future prospects are discussed by focussing on different aspects of the principles in accordance with collected evidence obtained during the review process.
Integrating intercultural communicative competence into an online EFL classroom: an empirical study of a secondary school in Thailand
Authors: Lee Tzu-Yin , Ho Yun-Chi , Chen Che-Han
Published: February 2023

Intercultural communicative competence (ICC) has been widely acknowledged as a core element of today’s foreign language education. However, even though the importance of intercultural language teaching is commonly recognized among adult learners and at the post-secondary level, teachers of adolescent English learners often find it hard to effectively incorporate culture into English learning because of the lack of an instructional model facilitating their students’ intercultural development and English learning experiences. Therefore, this study aims to investigate whether integrating intercultural learning into an online EFL curriculum can elevate teenage EFL students’ L2 motivation, intercultural communicative competence, and English proficiency. The researchers used a quasi-experimental design by randomly selecting two eighth-grade classes in a secondary school in northern Thailand, with one class designated as the experimental group (N = 31) and the other as the control group (N = 28). The effects of this teaching experiment were then examined using both quantitative and qualitative data. The findings demonstrated that the students in the experimental group showed a greater improvement compared with those of the students in the control group after an 8-week, interculturally embedded English curriculum. The results suggested that ICC is conducive to adolescent EFL students’ intercultural development as well as their English learning motivation and outcome. The applications of ICC-based EFL instruction in similar contexts are discussed.
Is telerehabilitation an effective maintenance strategy for patients with chronic obstructive pulmonary diseases: a systematic review
Authors: Uche-Okoye Demelum , Ajemba Michael Nnaemeka , Amy Bendall , Arene Ebube Chinwe , Ugo Chinemerem Henry , Eze Ngozi Perpetua , Anyadike Ikenna Kelechi , Onuorah Uju Maryanne , Chiwenite Chijioke Michael
Published: February 2023

Background

Pulmonary rehabilitation (PR) has proven to improve the physical and psychosocial function in patients with chronic obstructive pulmonary disease (COPD). However, the gains achieved during pulmonary rehabilitation diminish over time without an effective maintenance strategy. With several factors affecting access to pulmonary rehabilitation, calls for innovative models were made, which saw the emergence of studies exploring telerehabilitation (TR) as an alternative to traditional pulmonary rehabilitation models. Although there are current reviews exploring the effectiveness of telerehabilitation as an alternative for conventional PR, no review has considered telerehabilitation effectiveness in the long term. Hence, this review aims at examining the effectiveness of telerehabilitation following to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease.

Main body

A systematic review of the literature using CINAHL, MEDLINE, SCOPUS, Web of science PEDRO, AMED and EMBASE databases was conducted to assess the effectiveness of telerehabilitation following PR in patients with COPD. Health-related quality of life (HRQoL) and exercise capacity was maintained within 6–12 months of a TR maintenance programme. However, there was no significant increase in HRQoL and exercise capacity between the intervention and control groups in 6–12 months.

Conclusions

This review suggests that a TR maintenance strategy effectively maintains benefits gained and may improve HRQoL and exercise capacity within 6–12 months for patients with COPD. Nonetheless, it is impossible to extrapolate the findings to the general population due to the paucity of included studies. Further high quality randomised controlled trials examining TR in the long-term is required in the future.
RBFK cipher: a randomized butterfly architecture-based lightweight block cipher for IoT devices in the edge computing environment
Authors: Rana Sohel , Mondal M. Rubaiyat Hossain , Kamruzzaman Joarder
Published: February 2023

Internet security has become a major concern with the growing use of the Internet of Things (IoT) and edge computing technologies. Even though data processing is handled by the edge server, sensitive data is generated and stored by the IoT devices, which are subject to attack. Since most IoT devices have limited resources, standard security algorithms such as AES, DES, and RSA hamper their ability to run properly. In this paper, a lightweight symmetric key cipher termed randomized butterfly architecture of fast Fourier transform for key (RBFK) cipher is proposed for resource-constrained IoT devices in the edge computing environment. The butterfly architecture is used in the key scheduling system to produce strong round keys for five rounds of the encryption method. The RBFK cipher has two key sizes: 64 and 128 bits, with a block size of 64 bits. The RBFK ciphers have a larger avalanche effect due to the butterfly architecture ensuring strong security. The proposed cipher satisfies the Shannon characteristics of confusion and diffusion. The memory usage and execution cycle of the RBFK cipher are assessed using the fair evaluation of the lightweight cryptographic systems (FELICS) tool. The proposed ciphers were also implemented using MATLAB 2021a to test key sensitivity by analyzing the histogram, correlation graph, and entropy of encrypted and decrypted images. Since the RBFK ciphers with minimal computational complexity provide better security than recently proposed competing ciphers, these are suitable for IoT devices in an edge computing environment.
Is CRT-D superior to CRT-P in patients with nonischemic cardiomyopathy?
Authors: Al-Sadawi Mohammed , Aslam Faisal , Tao Michael , Salam Shafqat , Alsaiqali Mahmoud , Singh Abhijeet , Fan Roger , Rashba Eric J.
Published: February 2023

Background

Recent studies have questioned the role of implanted cardiac defibrillators (ICDs) in nonischemic cardiomyopathy (NICM). Cardiac resynchronization therapy (CRT) can be delivered by a pacemaker (CRT-P) or an ICD (CRT-D). This meta-analysis assessed the effect of CRT-P versus CRT-D on mortality in patients with NICM.

Methods

Databases were searched for studies reporting the effect of CRT on all-cause mortality in patients with nonischemic cardiomyopathy (Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL). The primary endpoint was all-cause mortality. The minimum duration of follow-up required for inclusion was one year. The search was not restricted to time or publication status.

Results

The literature search identified 955 candidate studies, 15 studies and 22,763 patients were included. Mean follow-up was 53 months (17–100 months). CRT-D in NICM was associated with lower all-cause mortality (log HR − 0.169, SE 0.055; p = 0.002) compared to CRT-P. Heterogeneity: df = 15 (P 0.03), I2 = 43; test for overall effect: Z = − 3.043 (P = 0.002).

Conclusion

CRT-D in NICM was associated with lower all-cause mortality than CRT-P.