bluuebunny/crossref_metadata_2025 huggingface dataset:
What Is a Child in What Is a Child?
Authors: Nam Yuna
Published: June 2023

This paper is an extended analysis of the English translation of Beatrice Alemagna’s picture book What is a Child? By extended analysis, I am referring to sustained engagement with the constitutive textual framing and narrative perspective of the picture book. Through this approach, my aim is to draw out the specific antagonisms necessary to its concept of ‘child’. The child, for What is a Child?, is never quite a self-evident and isolated identity. Rather, it is (to take just three examples): constituted by a perspective on it, and other to it; other to itself, because of the various contradictions in its pictorial and textual constructions; split between name and being. The understanding of the child that emerges runs counter to Marah Gubar’s subtle critique of the child as a contradictory identity, knowable, but only in a piece-meal fashion. My understanding of what Jacqueline Rose calls the ‘impossibility’ of the child is rooted, instead, in an understanding of it as self-cancelling, unavailable as an in-itself identity shorn of its constitutive others, an identity, I argue, that can be addressed only through an approach that is non-essentialist and narration-focused.
Identifying Core Items of the Japanese Version of the Mother-to-Infant Bonding Scale for Diagnosing Postpartum Bonding Disorder
Authors: Baba Kaori , Kataoka Yaeko , Kitamura Toshinori
Published: June 2023

The Japanese version of the mother-to-infant bonding scale (MIBS-J), a self-report of postpartum bonding disorder, is used in clinical settings for screening postpartum bonding disorder at various time points. However, its psychometric properties, particularly measurement invariance, have rarely been reported, and the validity of comparing scores across time points and sex is unclear. We aimed to select and validate the MIBS-J items suitable for parents at three time points. Postpartum mothers (n = 543) and fathers (n = 350) were surveyed at 5 days, 1 month, and 4 months postpartum. All participants were randomly divided into two subgroups, one for exploratory factor analyses (EFAs) and another for confirmatory factor analyses. Measurement invariance of the best model was tested using the entire sample, between fathers and mothers, and across the three observation periods. A three-item structure (items 1, 6, and 8) extracted through EFAs showed acceptable configural invariance. This model was accepted for scalar invariance between fathers and mothers and for metric invariance across the three time points. Our findings suggest that the three-item MIBS-J is sufficient for diagnosis of postpartum parental bonding disorder through continuous observation for at least 4 postpartum months, in order to detect the priority of parents who need support.
Implant-Based Breast Reconstruction after Risk-Reducing Mastectomy in BRCA Mutation Carriers: A Single-Center Retrospective Study
Authors: Cammarata Emanuele , Toia Francesca , Rossi Matteo , Cipolla Calogero , Vieni Salvatore , Speciale Antonino , Cordova Adriana
Published: June 2023

Women with BRCA gene mutations have a higher lifetime risk of developing breast cancer. Furthermore, cancer is usually diagnosed at a younger age compared to the wild-type counterpart. Strategies for risk management include intensive surveillance or risk-reducing mastectomy. The latter provides a significant reduction of the risk of developing breast cancer, simultaneously ensuring a natural breast appearance due to the preservation of the skin envelope and the nipple-areola complex. Implant-based breast reconstruction is the most common technique after risk-reducing surgery and can be achieved with either a submuscular or a prepectoral approach, in one or multiple stages. This study analyzes the outcomes of the different reconstructive techniques through a retrospective review on 46 breasts of a consecutive, single-center case series. Data analysis was carried out with EpiInfo version 7.2. Results of this study show no significant differences in postoperative complications between two-stage tissue expander/implant reconstruction and direct-to-implant (DTI) reconstruction, with DTI having superior aesthetic outcomes, especially in the prepectoral subgroup. In our experience, the DTI prepectoral approach has proven to be a safe and less time-consuming alternative to the submuscular two-stage technique, providing a pleasant reconstructed breast and overcoming the drawbacks of subpectoral implant placement.
Genome-Wide Identification of the RsSWEET Gene Family and Functional Analysis of RsSWEET17 in Root Growth and Development in Radish
Authors: Zhang Xiaoli , Cao Yang , Xin Ruixian , Xu Liang , Wang Yan , Wang Lun , Ma Yinbo , Liu Liwang
Published: June 2023

SWEET (Sugars Will Eventually be Exported Transporter) genes play essential roles in various biological processes, including phloem loading, sugar efflux, plant development and stress response. In this study, a total of 33 RsSWEET gene members were identified in the radish genome. They could be divided into four subfamilies and are distributed on eight radish chromosomes. Cis-acting regulatory element analysis indicated that these RsSWEET genes were potentially involved in the radish growth and development and stress response process, including circadian control and light response and responses to numerous stresses, including low-temperature and drought stress. Transcriptome data analysis revealed that a number of RsSWEET genes exhibited specific expression patterns in different tissues and developmental stages of radish. Moreover, several RsSWEET genes (e.g., RsSWEET2a, RsSWEET3a, RsSWEET16b and RsSWEET17) showed differential expression profiles under various abiotic stresses, including cold, heat, salt, Cd and Pb stress. Remarkably, the RsSWEET17 was specifically expressed in the cambium of radish. RsSWEET17 was heterologously expressed in yeast strain EBY.VW4000, which suggested that it has the ability to transport sugar. Notably, RsSWEET17-overexpressing Arabidopsis plants exhibited excessive root length, greater fresh weight and higher soluble sugar content (SSC) accumulation compared with wild-type (WT) plants, indicating that RsSWEET17 might positively regulate radish taproot development by strategically manipulating sugar accumulation. Collectively, these results clarify the molecular mechanisms underlying RsSWEET-mediated sugar accumulation and root growth and development in radish.
Pharmaceuticals in Water: Risks to Aquatic Life and Remediation Strategies
Authors: Khan Aqib Hassan Ali , Barros Rocío
Published: June 2023

The presence of pharmaceuticals in the aquatic environment presents a challenge to modern science. The most significant impact this can induce is the emergence of antibiotic resistance, which can lead to a global health emergency. It is important to note that the impact of pharmaceuticals in the aquatic environment is not limited to antibiotic resistance. Pharmaceuticals can also affect the behaviour and reproductive systems of aquatic organisms, with cascading effects on entire ecosystems. Numerous studies have reported the emergence of pharmaceuticals due to the uncontrolled disposal of polluted domestic, agricultural, and industrial wastewater in water bodies. This work discusses the potential of pharmaceuticals that on one hand are highly important for mankind, yet their non-judicious usage and disposal induce equally intriguing and problematic conditions to the health of aquatic systems. Pathways through which pharmaceutics can make their way into water bodies are discussed. Furthermore, the risk imposed by pharmaceuticals on aquatic life is also elaborated. The possible and pragmatic remediation methods through which pharmaceutical products can be treated are also discussed. Emphasis is placed on the potential of phytoremediation and advanced oxidative process, and the factors affecting the efficacy of these remediation methods are discussed.
The Cantareira System, the Largest South American Water Supply System: Management History, Water Crisis, and Learning
Authors: Zuffo Antonio Carlos , Duarte Sergio Nascimento , Jacomazzi Marco Antonio , Cucio Maíra Simões , Galbetti Marcus Vinícius
Published: June 2023

Located in the southeast region of Brazil, the Cantareira System consists of six interconnected reservoirs and supplies around 14 million people in the state of São Paulo. Built in the 1970s, when extensive fluviometric series were not available in the region, the system underwent several operating rules that culminated in the water crisis caused by the 2014/2015 drought. This article makes a brief critical account of what has been experienced in these almost 50 years of operating the system, the factors that influenced the water crisis, and what has been learned.
Prevalence and Socio-Demographic Correlates of Dental Anxiety among a Group of Adult Patients Attending Dental Outpatient Clinics: A Study from UAE
Authors: Alansaari Al Batool Omer , Tawfik Abdelrahman , Jaber Mohamed A. , Khamis Amar Hassan , Elameen Essra Mohamed
Published: June 2023

Objectives: The aims of this paper were twofold: first, to evaluate dental anxiety levels among patients undergoing oral surgery procedures; second, to assess how dental anxiety and fear are connected to age, gender, educational background, past traumatic experiences, and the frequency of dental appointments. Methods: A cross-sectional Likert-scale questionnaire survey was conducted to collect quantitative data from 206 patients at the Oral Surgery Clinics at Dubai Dental Clinics, Dubai, United Arab Emirates. The reliability and validity of the questionnaire were tested using Cronbach’s alpha. The normality of the MDAS score was tested using the Kolmogorov–Smirnov test. The chi square and Kruskal–Wallis tests were used to determine the association between categorical variables. Descriptive statistics were used to describe continuous and categorical variables. The statistical significance was set at p-value ≤ 0.05. Results: The evaluation of the degree of dental anxiety among patients who visited the Dubai Dental clinics revealed that there was a considerably high level of moderate or high anxiety (72.3%). Tooth extraction and dental surgery procedures (95%), followed by local anesthetic injection in the gingiva (85%) and teeth drilling (70%), were the primary causes of anxiety, whereas scaling and polishing resulted in the lowest degree of anxiety (35%). There was no substantial difference in dental anxiety between male and female patients or among patients with different marital statuses. A total of 70% of patients preferred the tell-show-do method, whereas 65% chose communication strategies to reduce dental anxiety. Conclusions: The evaluation of the degree of dental anxiety among patients who visited Dubai Dental clinics revealed that there was a considerably high level of anxiety. Tooth extraction and dental surgery procedures, followed by local anesthetic injection and teeth drilling, were the primary causes of anxiety, whereas scaling and polishing resulted in the lowest degree of anxiety. Despite the use of a modified anxiety scale and a large and representative sample of oral surgery patients, more research is necessary to investigate the impact of various factors on dental anxiety.
Investigating the Joint Effect of Allostatic Load among Lesbian, Gay, and Bisexual Adults with Risk of Cancer Mortality
Authors: Moore Justin , Andrzejak Sydney , Casanova Tracy , Langston Marvin , Estvold Søren , Adsul Prajakta
Published: June 2023

Sexual minorities (SM) have higher chronic physiologic stress as indicated by allostatic load (AL), which may be explained in part by consistent experiences of discriminatory practices. This is one of the first studies to examine the joint effects of SM status and AL on the association with long-term risk for cancer death. Retrospective analyses were conducted on 12,470 participants using National Health and Nutrition Examination Survey (NHANES) from years 2001 through 2010 linked with the National Death Index through December 31, 2019. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) of cancer deaths between groups of SM (those reporting as gay, lesbian, bisexual, or having same-sex sexual partners) status and AL. SM adults living with high AL (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.55, 95% CI: 1.40–4.65) when compared to straight/heterosexual adults living with low AL (n = 6674). Among those living with high AL, SM (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.26, 95% CI: 1.33–3.84) when compared to straight/heterosexual adults with high AL (n = 4957). SM with high AL have an increased risk of cancer mortality. These findings highlight important implications for promoting a focused agenda on cancer prevention with strategies that reduce chronic stress for SM adults.
Dysfunctional Mitochondria in the Cardiac Fibers of a Williams–Beuren Syndrome Mouse Model
Authors: Abdalla Noura , Tobías-Baraja Ester , Gonzalez Alejandro , Garrabou Gloria , Egea Gustavo , Campuzano Victoria
Published: June 2023

Williams–Beuren syndrome (WBS) is a rare neurodevelopmental disorder that, together with a rather characteristic neurocognitive profile, presents a strong cardiovascular phenotype. The cardiovascular features of WBS are mainly related to a gene dosage effect due to hemizygosity of the elastin (ELN) gene; however, the phenotypic variability between WBS patients indicates the presence of important modulators of the clinical impact of elastin deficiency. Recently, two genes within the WBS region have been linked to mitochondrial dysfunction. Numerous cardiovascular diseases are related to mitochondrial dysfunction; therefore, it could be a modulator of the phenotype present in WBS. Here, we analyze mitochondrial function and dynamics in cardiac tissue from a WBS complete deletion (CD) model. Our research reveals that cardiac fiber mitochondria from CD animals have altered mitochondrial dynamics, accompanied by respiratory chain dysfunction with decreased ATP production, reproducing alterations observed in fibroblasts from WBS patients. Our results highlight two major factors: on the one hand, that mitochondrial dysfunction is probably a relevant mechanism underlying several risk factors associated with WBS disease; on the other, the CD murine model mimics the mitochondrial phenotype of WBS and could be a great model for carrying out preclinical tests on drugs targeting the mitochondria.
Delta/Notch-like Epidermal Growth Factor-Related Receptor (DNER), a Potential Prognostic Marker of Gastric Cancer Regulates Cell Survival and Cell Cycle Progression
Authors: To Han Thi Ngoc , Park Ji-Hong , Kim Jeong Won , Kang Dongchul
Published: June 2023

Upregulation of the expression of Delta/notch-like epidermal growth factor-related receptor (DNER) and its oncogenic role have been reported in several cancers, including gastric, breast, and prostate cancers. This study aimed to investigate the oncogenic role of DNER and the mechanisms behind its oncogenic role in gastric cancer. Analysis of the RNASeq data of gastric cancer tissues obtained from the TCGA database revealed that the expression of DNER was associated with the pathology of advanced gastric cancer and the prognosis of patients. DNER expression was increased upon stem cell-enriching cancer spheroid culture. Knockdown of DNER expression inhibited cell proliferation and invasion, induced apoptosis, enhanced chemosensitivity, and decreased spheroid formation of SNU-638 gastric cancer cells. DNER silencing elevated the expression of p53, p21cip/waf, and p27, and increased G1 phase cells at the expense of S phase cells. Knockdown of p21cip/waf expression in the DNER-silenced cells partially restored cell viability and S phase progression. DNER silencing also induced the apoptosis of SNU-638 cells. While both cleaved caspases-8 and 9 were detected in adherent cells, only cleaved caspase-8 was found to have increased in spheroid-cultured cells, suggesting a distinct activation pattern of caspase activation depending on the growth condition. Knockdown of p53 expression rescued the DNER-silenced cells from apoptosis and partially restored cell viability. In contrast, overexpression of the Notch intracellular domain (NICD) decreased the expression of p53, p21cip/waf, and cleaved caspase-3 in DNER-silenced cells. Moreover, NICD expression fully reverted the cell viability reduction, arrest in the G1 phase, and elevated apoptosis caused by DNER silencing, thereby suggesting activation of Notch signaling by DNER. Expression of a membrane-unbound mutant of mDNER also decreased cell viability and induced apoptosis. On the other hand, TGF-β signals were found to be involved in DNER expression in both adherent and spheroid-cultured cells. DNER could therefore be a link connecting TGF-β signaling to Notch signaling. Taken together, DNER regulates cell proliferation, survival, and invasive capacity of the gastric cancer cells through the activation of Notch signaling, which may facilitate tumor progression into an advanced stage. This study provides evidences suggesting that DNER could be a potential prognostic marker, a therapeutic target, and a drug candidate in the form of a cell-free mutant.
D-Chiro-Inositol in Endometrial Hyperplasia: A Pilot Study
Authors: Porcaro Giuseppina , Bilotta Gabriele , Capoccia Elena , Bezerra Espinola Maria Salomé , Aragona Cesare
Published: June 2023

Endometrial hyperplasia is a threatening pathology driven by unopposed estrogen stimulus. Moreover, insulin may act on the endometrium, prompting further growth. We aimed at assessing whether D-chiro-Inositol, an insulin sensitizer with estrogen-lowering properties, might improve the condition of patients with simple endometrial hyperplasia without atypia. We enrolled women with simple endometrial hyperplasia without atypia and related symptoms, including abnormal uterine bleeding. We treated the patients with one tablet per day, containing 600 mg of D-chiro-inositol for six months. Patients underwent ultrasound to assess the thickness of the endometrium at baseline, after three months, and at the end of this study. Endometrial thickness went from 10.82 ± 1.15 mm to 8.00 ± 0.81 mm after three months (p < 0.001) and to 6.9 ± 1.06 mm after six months (p < 0.001 versus baseline; p < 0.001 versus three months). D-chiro-inositol treatment also improved heavy menstrual bleeding and the length of menstruation. Despite the fact that our data should be validated in larger studies with appropriate control groups, our promising results support the hypothesis that D-chiro-inositol may represent a useful treatment in the case of endometrial hyperplasia without atypia.
Identification of New Potential Prognostic and Predictive Markers in High-Grade Osteosarcoma Using Whole Exome Sequencing
Authors: Gaeta Raffaele , Morelli Mariangela , Lessi Francesca , Mazzanti Chiara Maria , Menicagli Michele , Capanna Rodolfo , Andreani Lorenzo , Coccoli Luca , Aretini Paolo , Franchi Alessandro
Published: June 2023

Conventional high-grade osteosarcoma (OS) is the most common primary cancer of bone and it typically affects the extremities of adolescents. OS has a complex karyotype, and molecular mechanisms related to carcinogenesis, progression and resistance to therapy are still largely unknown. For this reason, the current standard of care is associated with considerable adverse effects. In this study, our aim was to identify gene alterations in OS patients using whole exome sequencing (WES) to find new potential prognostic biomarkers and therapeutic targets. We performed WES on formalin-fixed paraffin-embedded (FFPE) biopsy materials collected from 19 patients affected by conventional high-grade OS. The clinical and genetic data were analyzed according to response to therapy, presence of metastasis and disease status. By comparing good and poor responders to neoadjuvant therapy, we detected a clear prevalence of mutations in the ARID1A, CREBBP, BRCA2 and RAD50 genes in poor responders that negatively influence the progression-free survival time. Moreover, higher tumor mutational burden values correlated with worse prognosis. The identification of mutations in ARID1A, CREBBP, BRCA2 and RAD50 may support the use of a more specific therapy for tumors harboring these alterations. In particular, BRCA2 and RAD50 are involved in homologous recombination repair, and could thus be used as specific therapy targets of inhibitors of the enzyme Poly ADP Ribose Polymerase (PARP). Finally, tumor mutational burden is found to be a potential prognostic marker for OS.
Biochemical Targets and Molecular Mechanism of Matrine against Aging
Authors: Sun Kaiyue , Zhang Yingzi , Li Yingliang , Yang Pengyu , Sun Yingting
Published: June 2023

The aim of this study is to explore the potential targets and molecular mechanism of matrine (MAT) against aging. Bioinformatic-based network pharmacology was used to investigate the aging-related targets and MAT-treated targets. A total of 193 potential genes of MAT against aging were obtained and then the top 10 key genes (cyclin D1, cyclin-dependent kinase 1, Cyclin A2, androgen receptor, Poly [ADP-ribose] polymerase-1 (PARP1), histone-lysine N-methyltransferase, albumin, mammalian target of rapamycin, histone deacetylase 2, and matrix metalloproteinase 9) were filtered by the molecular complex detection, maximal clique centrality (MMC) algorithm, and degree. The Metascape tool was used for analyzing biological processes and pathways of the top 10 key genes. The main biological processes were response to an inorganic substance and cellular response to chemical stress (including cellular response to oxidative stress). The major pathways were involved in cellular senescence and the cell cycle. After an analysis of major biological processes and pathways, it appears that PARP1/nicotinamide adenine dinucleotide (NAD+)-mediated cellular senescence may play an important role in MAT against aging. Molecular docking, molecular dynamics simulation, and in vivo study were used for further investigation. MAT could interact with the cavity of the PARP1 protein with the binding energy at −8.5 kcal/mol. Results from molecular dynamics simulations showed that the PARP1-MAT complex was more stable than PARP1 alone and that the binding-free energy of the PARP1-MAT complex was −15.962 kcal/mol. The in vivo study showed that MAT could significantly increase the NAD+ level of the liver of d-gal-induced aging mice. Therefore, MAT could interfere with aging through the PARP1/NAD+-mediated cellular senescence signaling pathway.
Comparison of Overall Sensitivity and Specificity across Different Newborn Screening Algorithms for Congenital Cytomegalovirus
Authors: Schleiss Mark R. , Panther Lori , Basnet Sandeep , Workneh Meklit , Diaz-Decaro John
Published: June 2023

Screening newborns for congenital cytomegalovirus (cCMV) infection is critical for early detection and prompt diagnosis of related long-term consequences of infection, such as sensorineural hearing loss and neurodevelopmental delays. The objective of this study was to describe the validity of different newborn cCMV infection screening approaches and compare the expected number of cCMV cases detected across targeted and universal screening algorithms. The overall sensitivity (OSn) of targeted screening algorithms that required failure of auditory brain stem response and transient evoked otoacoustic emissions (TOAE; two-fail serial testing) or TOAE only (one-fail serial testing) before diagnostic CMV testing using saliva and urine PCR tests was 79% and 88%, respectively. The OSn for two-fail serial testing with diagnostic CMV testing using dried blood spot (DBS) was 75%. In contrast, OSn was 90% for universal screening (saliva and urine PCR tests) and 86% for universal screening with DBS testing alone. Overall, specificities were 100% across all algorithms. Universal screening using DBS testing and universal screening using saliva and urine testing can potentially detect 312 and 373 more cCMV cases per 100,000 live births, respectively, than two-fail serial testing. Overall, implementing universal cCMV newborn screening would improve cCMV detection, ultimately leading to better health outcomes.
Detection of Abnormal Patterns in Children’s Handwriting by Using an Artificial-Intelligence-Based Method
Authors: Villegas-Ch William , Urbina-Camacho Isabel , García-Ortiz Joselin
Published: June 2023

Using camera-based algorithms to detect abnormal patterns in children’s handwriting has become a promising tool in education and occupational therapy. This study analyzes the performance of a camera- and tablet-based handwriting verification algorithm to detect abnormal patterns in handwriting samples processed from 71 students of different grades. The study results revealed that the algorithm saw abnormal patterns in 20% of the handwriting samples processed, which included practices such as delayed typing speed, excessive pen pressure, irregular slant, and lack of word spacing. In addition, it was observed that the detection accuracy of the algorithm was 95% when comparing the camera data with the abnormal patterns detected, which indicates a high reliability in the results obtained. The highlight of the study was the feedback provided to children and teachers on the camera data and any abnormal patterns detected. This can significantly impact students’ awareness and improvement of writing skills by providing real-time feedback on their writing and allowing them to adjust to correct detected abnormal patterns.
A Propensity-Matched Comparison of Ischemic Brain Lesions on Postprocedural MRI in Endovascular versus Open Carotid Artery Reconstruction
Authors: Mihály Zsuzsanna , Booth Samuel , Nguyen Dat Tin , Vecsey-Nagy Milán , Vértes Miklós , Czinege Zsófia , Péter Csongor , Sótonyi Péter , Varga Andrea
Published: June 2023

(1) Study purpose: The aim of our prospective single-center, matched case–control study was to compare the number and volume of acute ischemic brain lesions following carotid endarterectomy (CEA) versus carotid artery stenting (CAS) using a propensity-matched design. (2) Methods: Carotid bifurcation plaques were analyzed by using VascuCAP software on CT angiography (CTA) images. The number and volume of acute and chronic ischemic brain lesions were assessed on MRI scans taken 12–48 h after the procedures. Propensity score-based matching was performed at a 1:1 ratio to compare the ischemic lesions on postinterventional MR. (3) Results: A total of 107 patients (CAS, N = 33; CEA, N = 74) were included in the study. There were significant differences in smoking (p = 0.003), total calcification plaque volume (p = 0.004), and lengths of the lesion (p = 0.045) between the CAS and CEA groups. Propensity score matching resulted in 21 matched pairs of patients. Acute ischemic brain lesions were detected in ten patients (47.6%) of the matched CAS group and in three patients (14.2%) in the matched CEA group (p = 0.02). The volume of acute ischemic brain lesions was significantly larger (p = 0.04) in the CAS group than in the CEA group. New ischemic brain lesions were not associated with neurological symptoms in either group. (4) Conclusions: Procedure-related new acute ischemic brain lesions occurred significantly more frequently in the propensity-matched CAS group.
Classification Model for Epileptic Seizure Using Simple Postictal Laboratory Indices
Authors: Jin Sun Jin , Lee Taesic , Moon Hyun Eui , Park Eun Seok , Lee Sue Hyun , Roh Young Il , Seo Dong Min , Kim Won-Joo , Hwang Heewon
Published: June 2023

Distinguishing syncope from epileptic seizures in patients with sudden loss of consciousness is important. Various blood tests have been used to indicate epileptic seizures in patients with impaired consciousness. This retrospective study aimed to predict the diagnosis of epilepsy in patients with transient loss of consciousness using the initial blood test results. A seizure classification model was constructed using logistic regression, and predictors were selected from a cohort of 260 patients using domain knowledge and statistical methods. The study defined the diagnosis of seizures and syncope based on the consistency of the diagnosis made by an emergency medicine specialist at the first visit to the emergency room and the diagnosis made by an epileptologist or cardiologist at the first outpatient visit using the International Classification of Diseases 10th revision (ICD-10) code. Univariate analysis showed higher levels of white blood cells, red blood cells, hemoglobin, hematocrit, delta neutrophil index, creatinine kinase, and ammonia levels in the seizure group. The ammonia level had the highest correlation with the diagnosis of epileptic seizures in the prediction model. Therefore, it is recommended to be included in the first examination at the emergency room.
Diagnostic Performance and Cell Count of EBUS–TBNA Needle Gauges: A Prospective Trial
Authors: Guarize Juliana , Diotti Cristina , Casiraghi Monica , Donghi Stefano , Di Tonno Clementina , Mancuso Patrizia , Zorzino Laura , Sedda Giulia , Radice Davide , Bertolaccini Luca , Spaggiari Lorenzo
Published: June 2023

Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established diagnostic procedure for evaluating hilar and mediastinal lymphadenopathies and is the gold standard for lung cancer diagnosis and staging. Recent studies assessed the effectiveness of the 19-G flex needle in obtaining larger EBUS-TBNA samples, and prospective small series gave similar results in terms of diagnostic yield when testing different gauge needles. The lack of homogeneity between series and the small sample size of some prospective cohorts poses a limit to the validity of those results. This prospective controlled study compared the 19-G flex and 22-G needles in terms of diagnostic yield. An objective laboratory method was used to count cells and compare the two needles’ cytologic yields. Material. A prospective controlled study was conducted on 90 patients undergoing EBUS-TBNA for the diagnosis of hilar and mediastinal lymphadenopathies. The institutional ethic committee (IEO573) approved the study, and informed consent was obtained from all patients. Results. A total of 90 patients were enrolled in this study, 84.4% of whom were diagnosed with malignancy and 15.6% with non-neoplastic disease. Sensitivity for malignancy was 93.4% (CI: 87.4–97.1%) for the 19-G needle and 92.6% (CI: 86.3–96.5%) for the 22-G needle (p = 0.80). The percentage of malignant cells in the cell block was 63.9% and 61.5% for the 22-G and 19-G needles, respectively. The cell count assessed by flow cytometry was 2071 cells/µL (IQR: 600,2265) with the 22-G needle and 2761 cells/µL (IQR: 505,3250) with the 19-G needle (p = 0.79). The malignant cell count was 0.05 × 103 cells/µL with the 22-G and 0.08 × 103 cells/µL with the 19-G needle (p = 0.70). There was no difference in the presence of tissue cores in the samples, and rapid on-site evaluation (ROSE) cellularity was comparable between the two needles. Conclusions. The 19-G flex EBUS-TBNA needle is comparable to the 22-G needle in terms of diagnostic yield for cyto-histological evaluation of hilar and mediastinal lymphadenopathies. There is no difference between the 19-G and 22-G needle cell counts evaluated by flow cytometry.
Use of Automated Machine Learning for Classifying Hemoperitoneum on Ultrasonographic Images of Morrison’s Pouch: A Multicenter Retrospective Study
Authors: Jeong Dongkil , Jeong Wonjoon , Lee Ji Han , Park Sin-Youl
Published: June 2023

This study evaluated automated machine learning (AutoML) in classifying the presence or absence of hemoperitoneum in ultrasonography (USG) images of Morrison’s pouch. In this multicenter, retrospective study, 864 trauma patients from trauma and emergency medical centers in South Korea were included. In all, 2200 USG images (1100 hemoperitoneum and 1100 normal) were collected. Of these, 1800 images were used for training and 200 were used for the internal validation of AutoML. External validation was performed using 100 hemoperitoneum images and 100 normal images collected separately from a trauma center that were not included in the training and internal validation sets. Google’s open-source AutoML was used to train the algorithm in classifying hemoperitoneum in USG images, followed by internal and external validation. In the internal validation, the sensitivity, specificity, and area under the receiver operating characteristic (AUROC) curve were 95%, 99%, and 0.97, respectively. In the external validation, the sensitivity, specificity, and AUROC were 94%, 99%, and 0.97, respectively. The performances of AutoML in the internal and external validation were not statistically different (p = 0.78). A publicly available, general-purpose AutoML can accurately classify the presence or absence of hemoperitoneum in USG images of the Morrison’s pouch of real-world trauma patients.
Deep Learning and Machine Learning, Better Together Than Apart: A Review on Biometrics Mobile Authentication
Authors: Kokal Sara , Vanamala Mounika , Dave Rushit
Published: June 2023

Throughout the past several decades, mobile devices have evolved in capability and popularity at growing rates while improvement in security has fallen behind. As smartphones now hold mass quantities of sensitive information from millions of people around the world, addressing this gap in security is crucial. Recently, researchers have experimented with behavioral and physiological biometrics-based authentication to improve mobile device security. Continuing the previous work in this field, this study identifies popular dynamics in behavioral and physiological smartphone authentication and aims to provide a comprehensive review of their performance with various deep learning and machine learning algorithms. We found that utilizing hybrid schemes with deep learning features and deep learning/machine learning classification can improve authentication performance. Throughout this paper, the benefits, limitations, and recommendations for future work will be discussed.
The Development of Flexible Problem Solving: An Integrative Approach
Authors: Bobrowicz Katarzyna , Thibaut Jean-Pierre
Published: June 2023

Flexible problem solving, the ability to deal with currently goal-irrelevant information that may have been goal-relevant in previous, similar situations, plays a prominent role in cognitive development and has been repeatedly investigated in developmental research. However, this research, spanning from infancy to the school years, lacks a unifying framework, obscuring the developmental timing of flexible problem solving. Therefore, in this review paper, previous findings are gathered, organized, and integrated under a common framework to unveil how and when flexible problem solving develops. It is showed that the development of flexible problem solving coincides with increases in executive functions, that is, inhibition, working memory and task switching. The analysis of previous findings shows that dealing with goal-irrelevant, non-salient information received far more attention than generalizing in the presence of goal-irrelevant, salient information. The developmental timing of the latter can only be inferred from few transfer studies, as well as executive functions, planning and theory of mind research, to highlight gaps in knowledge and sketch out future research directions. Understanding how transfer in the presence of seemingly relevant but truly irrelevant information develops has implications for well-balanced participation in information societies, early and lifespan education, and investigating the evolutionary trajectory of flexible problem solving.
Experimental Study of Mechanical Properties and Fracture Characteristics of Conglomerates Based on Mohr–Coulomb Criteria
Authors: Liu Pengyu , Shen Yinghao , Meng Mianmo , Luo Senlin , Zhong Yi , Cen Qiming
Published: June 2023

Gravel is one of the main factors affecting the mechanical properties of conglomerates, which plays a decisive role in crack propagation. In this paper, taking the conglomerate of the Baikouquan Formation in Mahu Sag of Xinjiang as the research object, a three-dimensional model of the conglomerate is constructed by the discrete element numerical simulation method, and the triaxial compression experiment under different confining pressures is simulated. The mechanical properties and fracture morphology of conglomerate are analyzed with gravel content as a variable and verified by laboratory tests. In this simulation, with the increase of gravel content, the compressive strength of the conglomerate decreases, angle of internal friction decreases, and the fractures show different forms. The results show that the gravel morphology, spatial location, and gravel content have an impact on the mechanical properties of the conglomerate. The gravel content affects the formation process of the dominant fracture surface by controlling the distance between gravels so as to control the internal friction angle and it is the main controlling factor for the mechanical properties of the conglomerate. Gravel cracks initiate at the edge of gravel. Stress controls the formation of main cracks under low gravel content, and the influence of gravels under high gravel content makes cracks more discrete and complex.
Luteodorsum huanglongense (Gomphaceae, Gomphales), a New Genus and Species of Gomphoid Fungus from the Loess Plateau, Northwest China
Authors: Peng Zijia , Wu Yiming , Luo Zeyu , Xiong Chaowei , Liu Xiaoyong , Wang Bin , Ma Baoyou , Wei Jianxian , Yu Zhongdong
Published: June 2023

During an investigation of the macrofungal flora in the Huanglong Mountains of the Loess Plateau, northwest China, a unique gomphoid fungus was discovered and collected. After morphological identification and molecular phylogenetic analyses, a new genus named Luteodorsum and its type species, L. huanglongense, were proposed. Phylogenetic analyses were conducted using datasets of nuclear ribosomal DNA 28S large subunit (LSU), mitochondrial (mt) adenosine triphosphatase (ATPase) subunit 6 (atp6), and mt small-subunit rDNA (mtSSU). The results confirmed that L. huanglongense forms an independent clade within Gomphales, with full maximum likelihood bootstrap support (MLBS), maximum parsimony bootstrap support (MPBS), and Bayesian posterior probability (BPP). L. huanglongense is characterized by its sandy-brown, orange-brown, or coffee-brown color; clavate to infundibuliform shape; wrinkled and ridged hymenophore; ellipsoid to obovoid warted basidiospores; cylindrical to clavate flexuous pleurocystidia; and crystal basal mycelium. Overall, this study contributes to the growing body of knowledge on the diversity and evolution of Gomphales and provides valuable insights into the unique fungal flora found in the Huanglong Mountains.
COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit Patients from Poland
Authors: Skóra Magdalena , Gajda Mateusz , Namysł Magdalena , Wordliczek Jerzy , Zorska Joanna , Piekiełko Piotr , Żółtowska Barbara , Krzyściak Paweł , Heczko Piotr B. , Wójkowska-Mach Jadwiga
Published: June 2023

Coronavirus disease 2019 (COVID-19) has been shown to be a favoring factor for aspergillosis, especially in a severe course requiring admission to the intensive care unit (ICU). The aim of the study was to assess the morbidity of CAPA among ICU patients in Poland and to analyze applied diagnostic and therapeutic procedures. Medical documentation of patients hospitalized at the temporary COVID-19 dedicated ICU of the University Hospital in Krakow, Poland, from May 2021 to January 2022 was analyzed. In the analyzed period, 17 cases of CAPA were reported with an incidence density rate of 9 per 10 000 patient days and an incidence rate of 1%. Aspergillus fumigatus and Aspergillus niger were isolated from lower respiratory samples. Antifungal therapy was administered to 9 patients (52.9%). Seven patients (77.8%) received voriconazole. The CAPA fatality case rate was 76.5%. The results of the study indicate the need to increase the awareness of medical staff about the possibility of fungal co-infections in ICU patients with COVID-19 and to use the available diagnostic and therapeutic tools more effectively.
Invasive Fungal Infections Associated with COVID-19
Authors: Hlaing Kyaw M. , Monday Lea M. , Nucci Marcio , Nouér Simone A. , Revankar Sanjay G.
Published: June 2023

The COVID-19 pandemic caused >6 million deaths worldwide, often from respiratory failure. Complications frequently occurred in hospitalized patients, particularly in the intensive care unit. Among these, fungal infections were a cause of high morbidity and mortality. Invasive aspergillosis, candidiasis and mucormycosis were the most serious of these infections. Risk factors included alterations in immune defense mechanisms by COVID-19 itself, as well as immunosuppression due to various therapies utilized in severely ill patients. Diagnosis was often challenging due to lack of sensitivity of current testing. Outcomes were generally poor, due to significant co-morbidities and delayed diagnosis, with mortality rates >50% in some studies. High index of clinical suspicion is needed to facilitate early diagnosis and initiation of appropriate antifungal therapy.
Eco-Cultural Development of a Restored Lake Environment: The Case Study of Lake Karla (Thessaly, Greece)
Authors: Trakala Georgia , Tsiroukis Achilleas , Martinis Aristotelis
Published: June 2023

Lake Karla is the first reconstructed lake in the EU, supporting agriculture, biodiversity and cultural activities and being part of the Natura 2000 protected area network. In order to investigate opportunities for the sustainable development of the wider lake area, this study aims to identify and assess current ecosystem services in the catchment basin of lake Karla with focus on cultural ecosystem services and in particular on eco-cultural tourism routes and trails. Based on recent literature and field surveys the main results of the study include mapping of ecosystem types and a first overview of potential ecosystem services. Additionally, mapping, assessment and proposal of selected eco-cultural routes alongside with estimation on their carrying capacity is also presented. Finally, discussion on future steps and policy recommendations is provided, towards the integrated, sustainable management of the protected area.
10-Year Risk for Cardiovascular Disease Associated with COMISA (Co-Morbid Insomnia and Sleep Apnea) in Hypertensive Subjects
Authors: Draelants Laura , Point Camille , Wacquier Benjamin , Lanquart Jean-Pol , Loas Gwenolé , Hein Matthieu
Published: June 2023

Due to the few studies available, this study aimed to investigate the 10-year risk for cardiovascular disease (CVD) associated with COMISA (co-morbid insomnia and sleep apnea) in hypertensive subjects. Clinical data of 1009 hypertensive subjects extracted from the Sleep Laboratory database were analyzed. Framingham Risk Score ≥ 10% was used as a cut-off to identify hypertensive subjects with high 10-year risk for CVD. The association between 10-year risk for CVD and COMISA was investigated using logistic regression analyses. 65.3% of hypertensive subjects from our sample presented a high 10-year risk for CVD. After controlling for major confounding factors, multivariate logistic regression analyses demonstrated that unlike its components present separately, COMISA was significantly associated with high 10-year risk for CVD in hypertensive subjects (OR 1.88, 95% CI 1.01–3.51). In this study, we have demonstrated that the negative synergy between obstructive sleep apnea syndrome and insomnia disorder seems to play a central role in the 10-year risk for CVD in hypertensive subjects, which seems to indicate that the establishment of a systematic research and an adapted treatment of COMISA could open new perspectives to promote a better cardiovascular outcome in this specific subgroup of patients.
The Role of Cosolvent–Water Interactions in Effects of the Media on Functionality of Enzymes: A Case Study of Photobacterium leiognathi Luciferase
Authors: Lisitsa Albert E. , Sukovatyi Lev A. , Deeva Anna A. , Gulnov Dmitry V. , Esimbekova Elena N. , Kratasyuk Valentina A. , Nemtseva Elena V.
Published: June 2023

A complex heterogeneous intracellular environment seems to affect enzymatic catalysis by changing the mobility of biomolecules, their stability, and their conformational states, as well as by facilitating or hindering continuously occurring interactions. The evaluation and description of the influence of the cytoplasmic matrix components on enzymatic activity are problems that remain unsolved. In this work, we aimed to determine the mechanisms of action of two-component media with cosolvents of various molecular sizes on the complex multi-stage bioluminescent reaction catalyzed by bacterial luciferase. Kinetic and structural effects of ethylene glycol, glycerol, sorbitol, glucose, sucrose, dextran, and polyethylene glycol on bacterial luciferase were studied using stopped-flow and fluorescence spectroscopy techniques and molecular dynamics simulations. We have found that diffusion limitations in the presence of cosolvents promote the stabilization of flavin substrate and peroxyflavin intermediate of the reaction, but do not provide any advantages in bioluminescence quantum yield, because substrate binding is slowed down as well. The catalytic constant of bacterial luciferase has been found to be viscosity-independent and correlated with parameters of water–cosolvent interactions (Norrish constant, van der Waals interaction energies). Crowding agents, in contrast to low-molecular-weight cosolvents, had little effect on peroxyflavin intermediate decay and enzyme catalytic constant. We attributed specific kinetic effects to the preferential interaction of the cosolvents with enzyme surface and their penetration into the active site.
The Splicing Factor SR45 Negatively Regulates Anthocyanin Accumulation under High-Light Stress in Arabidopsis thaliana
Authors: Albaqami Mohammed
Published: June 2023

High-intensity light (HL) greatly induces the accumulation of anthocyanin, a fundamental compound in photoprotection and antioxidation. Many mechanisms regulating anthocyanin biosynthesis are well-characterized across developmental and environmental conditions; however, post-transcriptional regulation of its biosynthesis remains unclear. RNA splicing is one mechanism of post-transcriptional control and reprogramming in response to different developmental cues and stress conditions. The Arabidopsis splicing modulator SR45 regulates a number of developmental and environmental stress responses. Here, we investigated the role of SR45 and its isoforms in HL-induced anthocyanin accumulation. We found that the SR45 promoter contains light-responsive cis-elements, and that light stress significantly increases SR45 expression. Furthermore, we found that mutant plants lacking SR45 function (sr45) accumulate significantly more anthocyanin under HL. SR45 is alternatively spliced to produce two proteins, SR45.1 and SR45.2, which differ by seven amino acids. Intriguingly, these isoforms exhibited distinct functions, with only SR45.1 reversing anthocyanin accumulation in the sr45 plants. We also identified possible SR45 target genes that are involved in anthocyanin synthesis. Consistent with the antioxidant role of anthocyanin, we found that sr45 mutants and SR45.2 overexpression lines accumulate anthocyanin and better tolerate paraquat which induces oxidative stress. Collectively, our results reveal that the Arabidopsis splicing regulator SR45 inhibits anthocyanin accumulation under HL, which may negatively affect oxidative stress tolerance. This study illuminates splicing-level regulation of anthocyanin production in response to light stress and offers a possible target for genetic modification to increase plant stress tolerance.