bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of intercostal muscles contraction on sonographic evaluation of lung sliding: a physiological study on healthy subjects
Authors: Biasucci Daniele Guerino , Cina Alessandro , Sandroni Claudio , Moscato Umberto , Dauri Mario , Vetrugno Luigi , Cavaliere Franco
Published: May 2024

Objectives

To investigate the following: (a) effects of intercostal muscle contraction on sonographic assessment of lung sliding and (b) inter-rater and intra-observer agreement on sonographic detection of lung sliding and lung pulse.

Methods

We used Valsalva and Muller maneuvers as experimental models in which closed glottis and clipped nose prevent air from entering the lungs, despite sustained intercostal muscles contraction. Twenty-one healthy volunteers underwent bilateral lung ultrasound during tidal breathing, apnea, hyperventilation, and Muller and Valsalva maneuvers. The same expert recorded 420 B-mode clips and 420 M-mode images, independently evaluated for the presence or absence of lung sliding and lung pulse by three raters unaware of the respiratory activity corresponding to each imaging.

Results

During Muller and Valsalva maneuvers, lung sliding was certainly recognized in up to 73.0% and up to 68.7% of imaging, respectively, with a slight to fair inter-rater agreement for Muller maneuver and slight to moderate for Valsalva. Lung sliding was unrecognized in up to 42.0% of tidal breathing imaging, and up to 12.5% of hyperventilation imaging, with a slight to fair inter-rater agreement for both. During apnea, interpretation errors for sliding were irrelevant and inter-rater agreement moderate to perfect. Even if intra-observer agreement varied among raters and throughout respiratory patterns, we found it to be higher than inter-rater reliability.

Conclusions

Intercostal muscles contraction produces sonographic artifacts that may simulate lung sliding. Clinical studies are needed to confirm this hypothesis. We found slight to moderate inter-rater agreement and globally moderate to almost perfect intra-observer agreement for lung sliding and lung pulse.

Trial registration

ClinicalTrials.gov registration number.

NCT 02386696.
Using the wavelet transform for seismic wave impedance inversion
Authors: Fu Zhiguo , Yin Cheng , Chen Tiansheng , Ji Yuxin , Liao Juan
Published: May 2024

Model-based inversion technology has become one of the necessary technologies in the seismic exploration industry. It is frequently used to estimate many subsurface attributes, i.e., velocity, impedance, attenuation, etc. It is important to note that the accuracy of model-based inversion relies on the precision of the initial model, which suffers from insufficiency of low-frequency information in seismic data. Enhancing the high-frequency content and accuracy of low frequencies in the initial model can improve solution accuracy. Conventional initial models fail to adequately represent the high-frequency details of lateral geologic variations and to capture low-frequency components accurately. We develop a wavelet transform solution for this problem. Initially, we demonstrate that seismic records approximate the wavelet transform of logarithmic impedance. Consequently, we use the wavelet inverse transform to reconstruct the mid- and high-frequency information of seismic impedance, highlighting the detailed spatial variations. Furthermore, we apply kriging interpolation, based on subspace interpolation principles, using well impedance and seismic record waveforms to derive the low-frequency impedance from the scale inverse transform. Wavelet transform theory ensures a perfect match between the low- and high-frequency components in the inversion result. The frequency components of the inversion result are balanced, with no deficiencies or redundancies within the seismic data’s high cutoff frequency band. Thus, our method of initial model building is a type of inversion method. In addition, this method is simple and efficient because fast convolution processing can be performed. Model experiments and practical data inversions confirm the method’s feasibility and its ability to enhance resolution.
Phase III Randomized, Placebo-Controlled Clinical Trial of Donepezil for Treatment of Cognitive Impairment in Breast Cancer Survivors After Adjuvant Chemotherapy (WF-97116)
Authors: Rapp Stephen R. , Dressler Emily V. , Brown W. Mark , Wade James L. , Le-Lindqwister Nguyet , King David , Rowland Kendrith M. , Weaver Kathryn E. , Klepin Heidi D. , Shaw Edward G. , Lesser Glenn J.
Published: May 2024

PURPOSE

To test efficacy of donepezil, a cognitive enhancer, to improve memory in breast cancer survivors who report cancer-related cognitive impairment 1-5 years postchemotherapy.

PATIENTS AND METHODS

Adult female BCS exposed to ≥4 cycles of adjuvant chemotherapy 1-5 years before enrollment who reported cancer-related cognitive impairment were eligible. Participants, enrolled at sites affiliated with the Wake Forest NCI Community Oncology Research Program (NCORP) Research Base, were randomly assigned to receive 5 mg of donepezil once daily for 6 weeks titrated to 10 mg once daily for 18 weeks or placebo. Cognition and self-report cognitive functioning was assessed at baseline, 12, 24 (end of intervention), and 36 (washout) weeks postrandomization. Mixed-effects repeated measures analysis of covariance models were used to assess treatment differences in immediate recall (primary outcome) on the Hopkins Verbal Learning Test-Revised (HVLT-R) and other cognitive domains (secondary outcomes) with covariates of treatment, time, time by treatment interaction, baseline outcome level, age stratification, and an unstructured covariance matrix to account for within participant correlation over time.

RESULTS

Two hundred seventy-six BCS from 87 NCORP practices (mean age, 57.1, standard deviation [SD], 10.5) who were at a mean of 29.6 months (SD, 14.2) postchemotherapy were randomly assigned to donepezil (n = 140) or placebo (n = 136). At 24 weeks, treatment groups did not differ on HVLT-R scores (donepezil mean = 25.98, placebo = 26.50, P = .32). There were no statistically significant differences between treatments at 12, 24, or 36 weeks for attention, executive function, verbal fluency, processing speed, or self-reported cognitive functioning. Endocrine therapy and menopausal status did not affect results.

CONCLUSION

BCS 1-5 years after completing chemotherapy with documented memory problems, randomly assigned to 24 weeks of 5-10 mg of donepezil once daily, did not perform differently at the end of treatment on tests of memory, other cognitive functions, or subjective functioning than those randomly assigned to placebo.
Spontaneous and Treatment-Related Changes of Serum Calcitonin in Medullary Thyroid Cancer: Long-Term Experience in a Patient With Multiple Endocrine Neoplasia Type 2B
Authors: Réti Zsuzsanna , Tabák Ádám Gy. , Garami Miklós , Kalina Ildikó , Kiss Gergely , Sápi Zoltán , Tóth Miklós , Tőke Judit
Published: May 2024

PURPOSE

Medullary thyroid carcinoma (MTC) in MEN2B syndrome is associated with germline RET mutation. Patients harboring de novo mutations are usually diagnosed at more advanced disease stages. We present a young woman with Met918Th mutation diagnosed with stage IV MTC at age 10 years.

METHODS

The disease progressed despite total thyroidectomy and multiple surgical interventions for cervical lymph node recurrences, leading to distant metastases in the fifth year after the initial diagnosis. Subsequently, she underwent five different types of tyrosine kinase inhibitor (TKI) treatments. The 17-year disease course was divided into periods defined by four surgical interventions and sequential treatment intervals with four multikinase (sunitinib, vandetanib, cabozantinib, and lenvatinib) and one RET-selective TKI (selpercatinib). Tumor growth for different phases of spontaneous development and drug treatment intervals was characterized by changes in serial log-transformed calcitonin measurements (n = 114).

RESULTS

Three operations (one for calcitonin-producing adrenal pheochromocytoma) were associated with drops in calcitonin levels. All of the nonselective TKIs were stopped due to adverse effects. As reflected by the negative calcitonin doubling rate, the best treatment response was observed with selpercatinib, which was associated with an initial large drop followed by a decreasing calcitonin trajectory over 514 days without any major side effects.

CONCLUSION

This case of MEN2B medullary thyroid cancer with long-term survival presents how the effectiveness of different treatment modalities can be estimated using log-transformed calcitonin levels. Furthermore, our experience supports the view that serial calcitonin measurements may be more sensitive than radiological follow-up in advanced MTC. Our patient also represents a new case of rarely reported calcitonin-producing pheochromocytomas.
Timing and Ideal Patient for an Appropriate Search for Somatic RET Mutation in Medullary Thyroid Cancer
Authors: Matrone Antonio , Prete Alessandro , Gambale Carla , Elisei Rossella
Published: May 2024

RET somatic mutation analysis in sporadic MTC should be guided by postoperative evaluation results.
A Scoping Review of the Epidemiology, Management, and Outcomes of Golf-Related Fractures
Authors: Chen Bin , Williamson Tom , Murray Andrew , Zhou Haibin , Clement Nicholas
Published: May 2024

Golf is a popular sport; however, there is a paucity of data in relation to golf-associated fractures, and the rate and timing of returning to golf. The aim of this review is to describe golf-associated fractures, including epidemiology, management, and timing of returning to golf following treatment. A literature search was performed using MEDLINE/PubMed, Embase, and Web of Science. Data were extracted and summarized in a narrative synthesis. A total of 436 articles were identified with an initial search of which 58 met the inclusion criteria. Twelve anatomical sites of golf swing-related fractures were identified, of which 10 sites were specific for stress fractures. The most common sites of golf swing-related stress fractures were the ribs followed by the hook of hamate. There was a common theme of delay to diagnosis, being initially assigned to a soft tissue injury. Most golfers with swing-related stress fractures were able to return to golf with the exception of osteoporotic associated vertebral stress fractures. Timing of returning to golf was between 4 and 12 months for most of the golfers with stress fractures following conservative management. Operative intervention was an option of hook of hamate nonunion, following a stress fracture, and tibial shaft stress fractures. Golf equipment-related fractures were not rare and were associated with major trauma and in some cases associated with significant persistent morbidity. Golf-related stress fractures commonly involve the ribs and hook of hamate; knowledge of this may aid in early diagnosis and appropriate treatment when symptomatic golfers are encountered. Although golf is a noncontact sport, fractures associated with golf equipment can be life changing, and safety training guidelines should be established.
How Cyclical Is the User Cost of Labor?
Authors: Kudlyak Marianna
Published: May 2024

In employment relationships, a wage is an installment payment on an implicit long-term agreement between a worker and a firm. The price of labor that impacts firm's hiring decisions, instead, reflects the hiring wage as well as the impact of economic conditions at the time of hiring on future wages. Measured by the labor's user cost, the price of labor is substantially more pro-cyclical than the new-hire wage or the average wage. The strong procyclicality of the price of labor calls for other forces for cyclical labor demand to explain employment fluctuations.
Effect of schizophrenia and substance use disorder on depressive symptoms and stressful life events
Authors: Karabanowicz Ewa , Tyburski Ernest Marek , Lutkiewicz Karolina , Radziwiłłowicz Wioletta
Published: May 2024

Aim of the study

The main aim of this study was to examine the mutual effect of schizophrenia and substance use disorder on depression and stress level.

Subject or material and methods

The sample comprised a total of 184 participants, including 51 patients with schizophrenia (S), 45 with dual diagnosis (DD), 44 with substance use disorder (SUD) and 44 healthy controls (HC). The Patient Health Questionnaire-9 and the Hamilton Depression Rating Scale were used to measure depressive symptom severity, while the Social Readjustment Rating Scale was used for the assessment of stressful life events.

Results

We found a greater main effect of substance use disorder relative to schizophrenia on the severity of depression symptoms and stressful life events. In addition, the observed significant interaction effect for stressful life events suggested that SUD patients experienced their greatest number while HC reported the fewest such incidents. Interestingly, significant links between stressful life events and depressive symptoms emerged in both SUD patients and HC. What is more, disease duration and exacerbations were significantly associated with depressive symptoms in DD and S patients.

Discussion

This study demonstrated the effect of schizophrenia and substance use disorders on depressive symptoms and the severity of stress. The relationship between stressful life events and depressive symptom severity was also investigated.

Conclusions

Compared to schizophrenia, substance use disorder has a stronger effect on the presence of depression symptoms and the occurrence of stressful life events. The factors modifying depression symptom severity in both schizophrenia groups differ from those found in SUD patients and HC.
Creation in Christ in Aquinas’s Creation Theology in the Light of His References to the Pauline Letters
Authors: Ang Kenny
Published: May 2024

This study delineates the main features of Aquinas's creation doctrine in the light of his commentaries on the Pauline letters. In the last decades of the twentieth century, counter to the unilateral depiction of Aquinas as a philosopher, there was a growing appreciation of his role as a biblical exegete. To unveil the significance of his scriptural commentaries, this study examines his creation theology whose preeminence in his doctrinal edifice is beyond doubt. By availing myself of the Index Thomisticus , I identified passages from Aquinas's commentaries on the Pauline letters and their corresponding scriptural verses relevant to the subject of creation. I also examined his references to those verses in his non-exegetical works. Based on my overall analysis, it becomes clear that (1) Aquinas's creation theology in the light of his comments on the Pauline letters focuses primarily on the topics of God the sole Creator and the goodness of creatures. Moreover, (2) it is theocentric insofar as he pays attention more to God the Creator than to creatures. (3) It is also optimistic in the sense that it spares no effort to defend the goodness of creatures. (4) It boasts a Christocentric dimension as well. He attributes the creation of all things to Christ in his divine nature and also, by virtue of communicatio idiomatum, to the man Christ. Besides, (5) it is ingenious. He demonstrates his adeptness at intuiting truths concerning creation in verses that prima facie do not relate to creation. Furthermore, (6) it is worth studying since some creation-related metaphors appear only in his exegetical works (eg, the sermo scientiae and the book of creatures). Lastly, (7) the subject of creation permeates his entire comments on the Pauline letters. It is absent only in his reflection on 1 and 2 Thessalonians.
Variación, discurso, humor Estudios sobre la lengua española
Authors: Méndez García de Paredes Elena
Published: May 2024

Esta obra recopila una serie de textos escritos por la profesora Elena Méndez García de Paredes en diversas épocas, medios y formatos. La selección realizada pretende ser representativa de las múltiples áreas de conocimiento que ha abordado en su dilatada carrera investigadora, organizadas en este volumen en torno a cuatro grandes bloques. En el primero, se recogen estudios vinculados a la norma y variación lingüística del español, partiendo de un necesario recorrido histórico que sirve de marco para entender su codificación normativa y su carácter pluricéntrico. El segundo bloque reúne trabajos relacionados con la lengua y los medios de comunicación, en los que se analizan la presencia de diversas voces enunciadoras en el lenguaje periodístico, así como el funcionamiento de determinados procedimientos sintácticos característicos. Siguiendo con el análisis del discurso en los medios audiovisuales, se ha reservado un tercer bloque para los trabajos que versan sobre el análisis del humor y, finalmente, el último apartado se dedica a un ámbito intensamente estudiado por la autora: la presencia de las hablas andaluzas, como contenido informativo y como objeto de manipulación ideológica, en la prensa y en la enseñanza. La lectura conjunta de esta compilación de trabajos ofrece una visión completa de un itinerario profesional en el que la autora ha sabido unir la dimensión histórica de la investigación con la preocupación por el lenguaje actual de los medios en sus múltiples formatos.
O wartościujących etykietach językowych używanych względem małych dzieci
Authors: Żebrowska-Mazur Barbara
Published: May 2024

ON EVALUATIVE LINGUISTIC LABELS USED IN REGARD TO YOUNG CHILDREN
The author of the article attempts to describe the linguistic phenomenon of labelling and stigmatization concerning children. In the introduction, the issue of child discrimination, known as adultism, is addressed. Then, the author discusses the origins and mechanisms of pejorative terms which frequently appear in online discussions related to motherhood and parenthood. In the analytical section, the author presents the most commonly used and negatively charged personal expressions, extracted,e. g. from the Monco PL search engine: bombelek, gówniak, kaszojad, purchlę and purchlak [pejorative terms denoting children]. Possible etymologies and usage examples are provided. Originally unequivocally negative terms for children also permeate colloquial language and gradually become neutralized or serve to distance oneself from parenthood. However, in this context, it’s worth referring to the ethics of language and promoting inclusive communication, which should also extend to talking about children and communicating with them.
Ethnographic Investigations into Medical Violence in Nepali Healthcare Facilities
Authors: Dahal Kapil Babu
Published: May 2024

Introduction: Violence is not an inherent byproduct of human relationships, but conflicts are. The factors and circumstances that lead to tension and conflicts between health seekers and Nepali medical establishments and staff members who work there are examined in this article. Development: Embedded with relevant literature review, through the analysis of qualitative information, this part of the article is developed into four different sections. The first part deals with the context of the medical consultations that result in the development of a problematic relationship. This is followed by the examination of different types of violence, confrontations, and protests that emerge through such relationships. The implications of swelling medical promises and consequent heightened expectations are analyzed in the third part whereas the fourth part highlights how the typical medical practices that exist in Nepali hospitals itself is increasing the possibility of confrontations and violence. Conclusions: The frequent occurrence of tussles and medical violence in both public and private hospitals in Nepal suggests that they can happen in any hospital, irrespective of ownership. There is always a communication gap between the service providers and the patient party because of the esoteric nature of medicine. Conflict and violence towards service providers can also thrive in the context of a differential explanatory model of the two sides. The mounting animosity also signals a decline in trust between healthcare providers and seekers in Nepal.
Screening programmes for diabetes in the UK
Authors: Bashir Tahira
Published: May 2024

With the prevalence of diabetes increasing substantially, Tahira Bashir provides an overview of diabetes screening in the UK, including benefits and areas for improvement.
Understanding and Managing Inherited Platelet Disorders: A Case Study of Storage Pool Disease
Authors: Giuseppa Ingrascì Manuela , Cammarata Claudia , Siragusa Sergio , Mattana Marta , Napolitano Mariasanta
Published: May 2024

Inherited platelet disorders, including platelet storage pool diseases (SPDs), manifest in various bleeding symptoms, with severity often categorized based on their effects on either the surface receptors or internal structures of platelets [1]. This rare condition, characterized by defects in platelet granules, exhibits broad phenotypic variability, ranging from mild bruising to severe hemorrhages. Diagnosis involves specialized analyses such as platelet aggregation and genetic studies, necessitating a multidisciplinary approach for management [2]. Our case report describes a child with recurrent epistaxis, initially diagnosed with immune thrombocytopenia. Subsequent presentations led to suspicion of von Willebrand disease, but further examinations revealed a platelet function disorder. Genetic testing confirmed mutations associated with SPD. Treatment options include desmopressin, antifibrinolytic agents, and platelet transfusions, tailored to individual needs. The discussion underscores the diverse manifestations of SPD, emphasizing the importance of thorough diagnostic assessments. Treatment strategies aim to alleviate bleeding symptoms and mitigate associated risks, with a strong focus on personalized care. Challenges in managing SPD include missed diagnoses and the influence of genetic variations on disease severity. Ultimately, early detection and individualized therapies are essential for effectively managing SPD, underscoring the ongoing need for research to enhance outcomes for affected individuals.
Ship Operation Analysis and Optimization via Mobile Application
Authors: Zhukov Yuriy , Zivenko Oleksii
Published: May 2024

This paper is devoted to studying the structure and prospects of ship operations analysis and optimization via mobile applications, focusing on integrating multiple existing onboard monitoring and control systems. The main parts of the paper describe the current state of the most essential components of future overall shipping and ship design optimization using onboard and cloud-based monitoring systems from a dual transition point of view. Special attention is paid to the ship’s and its equipment’s efficiency improvements, fuel consumption and emissions reduction, cost-effectiveness enhancement, metrological accuracy, and compliance with current regulations. Timely development and deployment of the proposed onboard monitoring systems, in combination with up-to-date mobile applications and cloud computing, should play a crucial role in promoting sustainable and environmentally friendly shipping practices, improving operational performance, and reducing risks to human life at sea and the environmental impact of shipping. Another objective of this research is to review the current state of infrastructure used for fuel control, focusing on measurement systems and related analytics using appropriate mobile applications. The recommendations for integrating new and adopting existing monitoring systems and equipment for promising alternative fuels must be given to meet current regulations and provide required safety levels and measurement quality.
Mobile Recognition of Image Components Based on Machine Learning Methods
Authors: Kondratenko Galyna , Sidenko Ievgen , Saliutin Maksym , Kondratenko Yuriy
Published: May 2024

This paper is related to the recognition of certain components in images using machine learning methods and mobile technologies. The main result of this work is a developed system for recognizing the presence of a mask on the face using an image, which provides all the necessary information in real-time about the presence or absence of a mask on the face. When the program is turned off, statistics about the presence/absence of the mask will be recorded in the database. To achieve the goal, the following tasks were solved: the current state of the task of recognizing the presence of a mask on a person’s face was analysed; existing analogs of the systems were analysed; the necessary neural network architecture was selected as one of the machine learning methods; developed a system for recognizing the presence of a mask on the face using the necessary libraries; a user graphical interface, a database model for recording statistics and additional functionality have been developed; conduct testing. Practical application has a fairly wide range, in particular, the developed intelligent system is intended for use in the subway, industrial enterprises, state institutions, educational institutions, offices, and other public places. The developed system recognizes and records statistics about the presence of a mask on a person’s face using neural networks.
High-accuracy fiber Bragg grating inclinometer
Authors: Cao Yujia , Wu Xi , Teng Yuntian , Qiu Liansong
Published: May 2024

Inclination monitoring plays a significant role in research on deformation monitoring of slopes, inclination monitoring of bridges, earthquake monitoring, and other areas of monitoring. Existing electromagnetic signal-based inclinometers face practical issues such as difficulty adapting to harsh environments, poor large-scale networking capabilities, and unstable signal transmission. Hence, what we believe to be a novel inclinometer based on fiber sensing principles is proposed. The sensor employs suspension sensing based on the plumb principle, using bearings to overcome mechanical friction caused by rigid fixation between the mass block and the cantilever, thereby improving sensitivity and accuracy of the sensor. Key structural parameters of the sensor were optimized and simulated, followed by fabrication of the sensor and performance test on an inclination test platform. Experimental results indicate that, within a measurement range of ±9∘, the sensor exhibited a sensitivity of 305.2 pm/°, a resolution of approximately 3.3×10−4∘, an accuracy of 2%, a repeatability error of 1.9%, and favorable creep resistance stability for long-term measurement, thus addressing the requirements for slope deformation monitoring.
Mapping geographic and demographic shifts for container breeding mosquito-borne disease transmission suitability in Central and South America in a warming world
Authors: Ryan Sadie J. , Lippi Catherine A. , Stewart-Ibarra Anna M.
Published: May 2024

The recent Intergovernmental Panel on Climate Change Sixth Assessment Report (IPCC-AR6) brought into sharp relief the potential health impacts of a changing climate across large geographic regions. It also highlighted the gaps in available evidence to support detailed quantitative assessments of health impacts for many regions. In an increasingly urbanizing world, there is a need for additional information about the risk of mosquito-borne diseases from vectors adapted to human water storage behavior. Specifically, a better understanding of the geographic distribution of disease risk under different climate warming scenarios and human population shifts. We present novel geospatial descriptions of risk for transmission for five mosquito-borne disease systems under future projected climate and demographic scenarios, including the potential risk for malaria in the event of the introduction and establishment of a vector of high global concern, Anopheles stephensi. We then present country-level and IPCC geospatial sub-regional risk descriptions under baseline and future projected scenarios. By including demographic projections using the shared socioeconomic pathway (SSP) scenarios, we capture potential future risk in a way that is transparent and straightforward to compare and replicate. The goal of this paper is to report on these model output data and their availability. From a sub-regional perspective, the largest proportional gains in risk will be seen in the Southwestern South America (SWS) sub-region, comprising much of the southwestern coastline, for which the suitability for Aedes aegypti-transmitted dengue and Zika will see massive increases with warming, putting a large number of people at risk under future scenarios. In contrast, at the country level, the largest projected population impacts will be seen in Brazil for both arboviral and potential introduced malaria risk, despite some risks projected to decrease as parts of the country are too hot to sustain transmission. This paper provides modeled outputs for future use, in addition to broad summary descriptions at regional and country levels.
Natural resistance to meglumine antimoniate is associated with treatment failure in cutaneous leishmaniasis caused by Leishmania (Viannia) panamensis
Authors: Fernández Olga Lucía , Rosales-Chilama Mariana , Sánchez-Hidalgo Andrea , Gómez Paola , Rebellón-Sánchez David Esteban , Regli Ivo B. , Díaz-Varela Míriam , Tacchini-Cottier Fabienne , Saravia Nancy Gore
Published: May 2024

The multifactorial basis of therapeutic response can obscure the relation between antimicrobial drug susceptibility and clinical outcome. To discern the relationship between parasite susceptibility to meglumine antimoniate (SbV) and therapeutic outcome of cutaneous leishmaniasis, risk factors for treatment failure were considered in evaluating this relationship in ninety-one cutaneous leishmaniasis patients and corresponding clinical strains of Leishmania (Viannia) panamensis. Parasite susceptibility to 32 μg SbV/mL (plasma Cmax) was evaluated in primary human macrophages, PBMCs, and U937 macrophages. Early parasitological response to treatment was determined in lesions of a subgroup of patients, and pathogenicity of Sb-resistant and sensitive clinical strains was compared in BALB/c mice. Parasite survival in cell models and patient lesions was determined by qRT-PCR of Leishmania 7SLRNA transcript. Parasite loads in BALB/c mice were quantified by limiting dilution analysis. The disparate Sb-susceptibility of parasite subpopulations distinguished by isoenzyme profiles (zymodemes) was manifest in all cell models. Notably, Sb-resistance defined by parasite survival, was most effectively discerned in U937 macrophages compared with primary human host cells, significantly higher among strains from patients who failed treatment than cured and, significantly associated with treatment failure. Each unit increase in transformed survival rate corresponded to a 10.6-fold rise in the odds of treatment failure. Furthermore, treatment failure was significantly associated with naturally Sb-resistant zymodeme 2.3 strains, which also produced larger lesions and parasite burdens in BALB/c mice than Sb-sensitive zymodeme 2.2 strains. The confounding effect of host risk factors for treatment failure in discerning this association was evidenced in comparing strains from patients with and without the defined risk factors for treatment failure. These results establish the association of natural resistance to meglumine antimoniate with treatment failure, the importance of host risk factors in evaluating drug susceptibility and treatment outcome, and the clinical and epidemiological relevance of natural Sb-resistance in L. (V.) panamensis subpopulations.
Mapping lower secondary school students’ conceptions of three aspects critical for understanding the nervous system
Authors: Kvello Pål
Published: May 2024

Understanding the nervous system is an important but perhaps ambitious goal, particularly for students in lower secondary education. It is important because of its’ direct role in both mental and physical health, and it is ambitious because instruction focuses on the human nervous system, which is extremely complex, and subject to numerous misconceptions. Despite its’ complexity, the science curricula, both nationally and internationally, emphasize an understanding of the system, and not just knowledge of isolated facts. But what does it mean to understand this system, and what content knowledge is critical for understanding it? Unfortunately, the curricula are usually too general to answer these questions, therefore other sources of information are needed. Using the science literature, the present study defines the system level of the nervous system and proposes three basic aspects necessary to understand it: 1) neural circuit architecture, 2) synaptic action, and 3) nerve signal origin. With this background, the aim of the present study is to identify lower secondary school students’ conceptions of these three aspects, and to determine how they impact students’ understanding of the system. To reach this aim, the study used a questionary which allowed for a mixed method design, and the results show that many students have an immediate conception of the brain as the origin of nerve signals. In addition, many students hold the alternative conceptions that 1) synaptic action is exclusively excitatory, and that 2) neural circuits consists of neurons connected in a chain, one single neuron after another. These alternative conceptions prevent students from understanding the system. Implications for instruction are discussed in the context of conceptual learning theories, and teaching strategies are proposed. Since similar curricula goals and textbook content exist in several countries, the present results may be representative across nations.
Developing Bayesian EWMA chart for change detection in the shape parameter of Inverse Gaussian process
Authors: Javed Amara , Abbas Tahir , Abbas Nasir
Published: May 2024

Bayesian Control charts are emerging as the most efficient statistical tools for monitoring manufacturing processes and providing effective control over process variability. The Bayesian approach is particularly suitable for addressing parametric uncertainty in the manufacturing industry. In this study, we determine the monitoring threshold for the shape parameter of the Inverse Gaussian distribution (IGD) and design different exponentially-weighted-moving-average (EWMA) control charts based on different loss functions (LFs). The impact of hyperparameters is investigated on Bayes estimates (BEs) and posterior risks (PRs). The performance measures such as average run length (ARL), standard deviation of run length (SDRL), and median of run length (MRL) are employed to evaluate the suggested approach. The designed Bayesian charts are evaluated for different settings of smoothing constant of the EWMA chart, different sample sizes, and pre-specified false alarm rates. The simulative study demonstrates the effectiveness of the suggested Bayesian method-based EWMA charts as compared to the conventional classical setup-based EWMA charts. The proposed techniques of EWMA charts are highly efficient in detecting shifts in the shape parameter and outperform their classical counterpart in detecting faults quickly. The proposed technique is also applied to real-data case studies from the aerospace manufacturing industry. The quality characteristic of interest was selected as the monthly industrial production index of aircraft from January 1980 to December 2022. The real-data-based findings also validate the conclusions based on the simulative results.
Joint effect of abnormal systemic immune-inflammation index (SII) levels and diabetes on cognitive function and survival rate: A population-based study from the NHANES 2011–2014
Authors: Chen Wanying , Sun Xinyue , Han Jiaxin , Wu Xiaoyu , Wang Qingfan , Li Mengmeng , Lei Xiangyu , Wu Yixuan , Li Zhiheng , Luo Guogang , Wei Meng
Published: May 2024

Objective

The purpose of this study was to investigate whether the combination of abnormal systemic immune-inflammation index (SII) levels and hyperglycemia increased the risk of cognitive function decline and reduced survival rate in the United States.

Methods

This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) database from 2011–2014 and enrolled 1,447 participants aged 60 years or older. Restricted cubic splines (RCS), linear regression and kaplan-meier(KM) curve were employed to explore the combined effects of abnormal SII and hyperglycemia on cognitive function and survival rate, and subgroup analysis was also conducted.

Results

The RCS analysis revealed an inverted U-shaped relationship between lgSII levels and cognitive function. Linear regression analysis indicated that neither abnormal SII nor diabetes alone significantly contributed to the decline in cognitive function compared to participants with normal SII levels and blood glucose. However, when abnormal SII coexisted with diabetes (but not prediabetes), it resulted to a significant decline in cognitive function. After adjusting for various confounding factors, these results remained significant in Delayed Word Recall (β:-0.76, P<0.05) and Digit Symbol Substitution tests (β:-5.02, P<0.05). Nevertheless, these results showed marginal significance in Total Word Recall test as well as Animal Fluency test. Among all subgroup analyses performed, participants with both abnormal SII levels and diabetes exhibited the greatest decline in cognitive function compared to those with only diabetes. Furthermore, KM curve demonstrated that the combination of abnormal SII levels and diabetes decreased survival rate among participants.

Conclusion

The findings suggest that the impact of diabetes on cognitive function/survival rate is correlated with SII levels, indicating that their combination enhances predictive power.
Developing a risk framework for assembly construction based on stakeholder theory and structural equation modelling
Authors: Junjia Yin , Xiaoxiang Qin , Alias Aidi Hizami , Haron Nuzul Azam , Abu Bakar Nabilah
Published: May 2024

Occupational injuries in the construction industry have plagued many countries, and many cases have shown that accidents often occur because of a combination of project participants. Assembled construction (AC) projects have received extensive attention from Chinese scholars as a future trend, but few studies have explored the interrelationships and potential risks of various stakeholders in depth. This study fills this research gap by proposing a multi-stakeholder AC risk framework. The study surveyed 396 stakeholders, then analyzed the collected data and created a risk framework based on Structural Equation Modelling (SEM) and the CRITIC weighting method. The results revealed that factors like "regular supervision is a formality," "blindly approving the wrong safety measures," and "failure to organize effective safety education and training." are vital risks in AC of China. Finally, the study validates the risk factors and the framework with 180 real-life cases, which shows that the proposed framework is theoretically grounded and realistic. The study also suggests multi-level strategies such as introducing AI-based automated risk monitoring, improving the adaptability of normative provisions to technological advances, and advancing the culture of project communities of interest to ensure AC’s safe practices.
Energy landscape analysis and time-series clustering analysis of patient state multistability related to rheumatoid arthritis drug treatment: The KURAMA cohort study
Authors: Yamamoto Keiichi , Sakaguchi Masahiko , Onishi Akira , Yokoyama Shinichiro , Matsui Yusuke , Yamamoto Wataru , Onizawa Hideo , Fujii Takayuki , Murata Koichi , Tanaka Masao , Hashimoto Motomu , Matsuda Shuichi , Morinobu Akio
Published: May 2024

Rheumatoid arthritis causes joint inflammation due to immune abnormalities, resulting in joint pain and swelling. In recent years, there have been considerable advancements in the treatment of this disease. However, only approximately 60% of patients achieve remission. Patients with multifactorial diseases shift between states from day to day. Patients may remain in a good or poor state with few or no transitions, or they may switch between states frequently. The visualization of time-dependent state transitions, based on the evaluation axis of stable/unstable states, may provide useful information for achieving rheumatoid arthritis treatment goals. Energy landscape analysis can be used to quantitatively determine the stability/instability of each state in terms of energy. Time-series clustering is another method used to classify transitions into different groups to identify potential patterns within a time-series dataset. The objective of this study was to utilize energy landscape analysis and time-series clustering to evaluate multidimensional time-series data in terms of multistability. We profiled each patient’s state transitions during treatment using energy landscape analysis and time-series clustering. Energy landscape analysis divided state transitions into two patterns: “good stability leading to remission” and “poor stability leading to treatment dead-end.” The number of patients whose disease status improved increased markedly until approximately 6 months after treatment initiation and then plateaued after 1 year. Time-series clustering grouped patients into three clusters: “toward good stability,” “toward poor stability,” and “unstable.” Patients in the “unstable” cluster are considered to have clinical courses that are difficult to predict; therefore, these patients should be treated with more care. Early disease detection and treatment initiation are important. The evaluation of state multistability enables us to understand a patient’s current state in the context of overall state transitions related to rheumatoid arthritis drug treatment and to predict future state transitions.
The causal role of multiple psycho-emotional disorders in gastroesophageal reflux disease: A two-sample Mendelian randomized study
Authors: Wang Jing , Song Meng , Cao Mingbo
Published: May 2024

Background

Observational studies have previously shown a potential link between psycho-emotional disorders, such as mood swings, highly strung, anxious feelings, and gastroesophageal reflux disease (GERD). However, the credibility of these associations could be influenced by various confounding factors. Consequently, our study sought to employ a Mendelian randomization (MR) approach to elucidate a potential causal relationship between psycho-emotional disorders and GERD.

Method

Information on independent genetic variants linked to mood swings, highly strung, and anxious feelings was gathered from European populations participating in the IEU Open GWAS research. The FinnGen Consortium provided the genome-wide association study (GWAS) summary statistics for GERD. Our analysis employed the inverse variance weighted (IVW) method under the random effects model as the main analytical method. To further bolster our findings, we employed the weighted median and MR Egger methods. In addition, we conducted a series of sensitivity analyses.

Results

Our study supports the existence of a causal relationship between psycho-emotional disorders and GERD. Mood swings, highly strung, and anxious feelings adversely affected GERD risk (mood swings: OR 2.21, 95% CI 1.19–5.59, p = 3.09 × 10–2; highly strung: OR 5.63, 95% CI 1.77–17.94, p = 3.42 × 10–3; anxious feelings: OR 2.48, 95% CI 1.08–4.33, p = 2.89 × 10–2).

Conclusion

This Mendelian randomization study provides robust support for the notion that mood swings, highly strung and anxious feelings, are associated with an increased risk of developing GERD.
Impact of depression on self-efficacy, illness perceptions and self-management among people with type 2 diabetes: A systematic review of longitudinal studies
Authors: Derese Andualem , Gebreegzhiabhere Yohannes , Medhin Girmay , Sirgu Sisay , Hanlon Charlotte
Published: May 2024

Background

Treating comorbid depression does not always improve outcomes for people with type 2 diabetes. Evidence is lacking on potential psychological and behavioural intermediaries of the impact of depression on diabetes outcomes.

Objective

To synthesise evidence on the impact of comorbid depression on self-efficacy, illness perceptions, and self-management in people with type 2 diabetes.

Data sources

We searched PubMed, Embase, PsycINFO, and Global Health databases from inception up to 29th March 2023.

Study eligibility criteria

Only prospective studies (cohort or intervention studies) were included, with no restrictions on language. The outcomes were self-efficacy, illness perceptions, and self-management.

Participants

People with type 2 diabetes in community or health settings.

Exposure

Comorbid depression or depressive symptoms in people with type 2 diabetes.

Synthesis of results

A narrative review of heterogeneous studies.

Risk of bias

The risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) quality assessment tool for quantitative studies.

Results

Twenty-five studies were included, all from high-income countries. Depression was associated with lower self-efficacy (2 studies), poor illness perception (1 study), and poor self-management practices (17 studies) in people with type 2 diabetes. In 6/7 studies, depressive symptoms predicted less adherence to dietary recommendations, 8/10 studies found depressive symptoms were associated with poor medication adherence, 1/3 study found that depressive symptoms were associated with poor weight control, 3/4 with less physical exercise, and 2/3 with general self-care practices.

Limitations

There were no studies from low- and middle-income countries and non-Western settings, and we cannot assume the mechanisms linking comorbid depression with diabetes outcomes are similar.

Conclusions

Comorbid depression was associated with lower self-efficacy, poorer self-management, and less adaptive illness perceptions among people with diabetes.
Associations of body adiposity index, body mass index, waist circumference, and percentage of body fat in young female Emirati adults
Authors: Haroun Dalia , Darwish Maryam , Ehsanallah Aseel
Published: May 2024

Body Adiposity Index (BAI), which relies on an individual’s hip circumference and height, was proposed as an alternative anthropometric measurement to Body Mass Index (BMI). Although this measure has been validated across different populations, its accuracy in predicting percent body fat (%BF) in the United Arab Emirates has not yet been assessed. The objective of this study was to examine the association between BAI, BMI, Waist Circumference (WC), and %BF in young female Emirati adults and determine the relative accuracy of BAI when predicting %BF. A retrospective cross-sectional study was conducted among 95 Emirati women between the ages of 17 and 27. The %BF was measured using the dual-energy X-ray absorption (DXA) scanner. Anthropometric measurements were collected, and BMI and BAI were calculated. BMI and %BF (r = 0.823, p <0.001) showed a greater association than that between BAI and %BF (r = 0.702, p <0.001). A linear regression analysis revealed that BMI was the single best predictor of %BF in the sample (r2 = 0.678, p<0.001). The variation around the regression line for BAI comparisons with %BF (standard error of estimate = 4.879) was greater than BMI comparisons (standard error of estimate = 3.889). BAI was found to significantly underestimate %BF at higher adiposity levels (mean difference = 8.7%). The ROC curve analysis demonstrated that BMI had a higher discriminatory capacity (AUC = 0.891) over WC and BAI. The results demonstrated that BMI was a better predictor of %BF in the sample than BAI and WC. Thus, BMI may be more useful in assessing adiposity in young female Emirati adults than BAI. However, the potential of BAI as an alternative measure of adiposity should continue to be examined.