bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent advances in organocatalytic cascade reactions for enantioselective synthesis of chiral spirolactone skeletons
Authors: Yang Jun , Pan Bo-Wen , Chen Lin , Zhou Ying , Liu Xiong-Li
Published: February 2023

Chiral spirolactones, including spiropropyllactones, spirobutyrolactones, and spirovalerolactones, are important heterocyclic frameworks that attracted the attention of organic and medicinal chemists because these motifs constitute the core structure of several natural products and bioactive molecules. The absolute configuration and the substituents on the fully substituted spirocyclic stereocenter of the lactone can potentially enhance specificity for ligand-protein binding and enhance bioavailability, potency, and metabolic stability. So, intensive attention from chemists has been paid to the synthetic methods leading to such prominent structural motifs. The synthetic methods can be divided into two main classes. The first approach takes advantage of the presence of the existing lactone structure and focuses on its functionalization. The second approach is the lactone framework constructed from various precursors in a direct spirolactonization reaction. In this review, for convenience in reading, the recent advances in the synthesis of spirolactones are summarized and discussed according to the two major organocatalytic asymmetric synthetic routes: (i) using the lactone-related frameworks as building blocks; and (ii) direct spirolactonization reaction using various reagents. This review also describes both the mechanisms and related transformations, and gives some insights into challenging issues in this research field, which will enlighten the future development of this field.
Civilizational Challenges to Russia's Sustainable Development
Authors: Kravchenko S.
Published: February 2023

The liberal model of globalization, proceeding from the “naturalness” of the unipolar world, essentially personifies the “modern barbarism”: sustainable development of the Western civilization is a priori meant to be at the expense of other countries. Today, its functioning is running into the resistance from local civilizations, whose economic and political weight has increased significantly in the 21st century, allowing the non-Western countries to become important actors in international relations claiming to realize their national interests and own type of sustainable development. Alliances are emerging among these countries, based on an alternative type of globalization, which implies both mutually beneficial cooperation and national development outside anyone’s external dictate. In fact, a global-local reality is being formed in the context of the multipolar world formation. The reaction of the West is to maintain its dominance by all means, holding back the creation of new international poles. These processes demand “rediscovery” of the established “universalist” approaches to sustainable development of human civilization: the problem of its alternative type has an independent scientific and practical significance for Russia as well as for the countries of non-Western civilization. In this regard, the study on the mutual influence of global and local factors that produce complex risks to sustainable development is being updated. Their complex nature is manifested in the fact that under the influence of hybridization of socio-techno-natural realities and inter-civilizational confrontation, they simultaneously cover a number of life spheres, overlapping each other, thereby acquiring an interference character. The author sees the answer to the challenges of these risks in the actualization of long-term functioning factors of a humanistic nature, which should be included in Russia’s strategy of a global-local sustainable development.
Trade Pivot to the East: Where Russia Is Turning in Fact?
Authors: Arapova E.
Published: February 2023

The study aims to conceptualize Russia’s “Pivot to the East” phenomenon. The author suggests original system of criteria for measuring de facto pivot towards the particular region, focusing on Russia’s export flows, their geographic and commodity diversification as Russia’s key strategic priorities. Besides, she explores empirically the contemporary changes in Russia’s de facto export flows. The author concludes that the “pivot” was supported by the general course towards de-Westernization. Russia is definitely moving away from the West, although this progress is not rapid and systemic yet, but rather selective. However, having turned away from the West, Russia has not yet turned to the East. The pivot towards the Asian region is very limited. The two main directions of the pivot to the East are (1) small markets of South and Southeast Asia, whose share in Russian exports is extremely small, and (2) unfriendly Singapore, Japan, and South Korea. At the same time, despite the status of the largest regional partner, expanding trade with China do not correspond to the country’s strategic interests. The turn towards China contributes to de-industrialization and securing Russia’s role as a large supplier of raw materials. Trade complementarity is limited and asymmetric. Simultaneously, the export potential in trade with India is underestimated. Russia began to turn not towards the East, but rather towards the Global South. The process in accompanied by the growing importance of the Middle East and North Africa, as well as partially African and Latin American countries. At the same time, there is no direction towards the post-Soviet space (with the exception of a confident trade rapprochement with Kazakhstan and Tajikistan).
Model “Nearshoring” – the Concept of the New Economy of the Latin America
Authors: Yakovlev P.
Published: February 2023

In the vocabulary of world economics, the term “nearshoring” has become increasingly common. It implies the spread of business in its most diverse manifestations (e.g. foreign trade, cross-border investment, technology transfer, outsourcing, formation of value chains, etc.) mainly to neighboring countries. This growing trend was a response to the many problems that arose in the global economy and world trade during the coronavirus pandemic and the subsequent geopolitical upheavals. In fact, the process of neoliberal globalization, which for four decades was determining the development vector and the content of world economic relations, switched to low dynamics mode. Latin America, as an important part of a complex international economic hub, has actively participated in the globalization process, but has not become its beneficiary, unlike Asian states. Most of the Latin American economies based their development models on the intensive exploitation of vast natural resources in the interests of world markets. However, this neither brought the region to the forefront of the global economy, nor did it solve the acute social problems of Latin America. Therefore, in the conditions of the ongoing crisis, a growing number of Latin American states are ready to make adjustments to their development models, and focus on the strategy of “nearshoring” in order to maximize intraregional cooperation that would stimulate accelerated economic growth.
The Suboptimal WMT Test Sets and Its Impact on Human Parity
Authors: Kim Ahrii , Bak Yunju , Sun Jimin , Lyu Sungwon , Lee Changmin
Published: February 2023

With the advent of Neural Machine Translation, the more the achievement of human-machine parity is claimed at WMT, the more we come to ask ourselves if their evaluation environment can be trusted. In this paper, we argue that the low quality of the source test set of the news track at WMT may lead to an overrated human parity claim. First of all, we report nine types of so-called technical contaminants in the data set, originated from an absence of meticulous inspection after web-crawling. Our empirical findings show that when they are corrected, about 5% of the segments that have previously achieved a human parity claim turn out to be statistically invalid. Such a tendency gets evident when the contaminated sentences are solely concerned. To the best of our knowledge, it is the first attempt to question the “source” side of the test set as a potential cause of the overclaim of human parity. We cast evidence for such phenomenon that according to sentence-level TER scores, those trivial errors change a good part of system translations. We conclude that to overlook it would be a mistake, especially when it comes to an NMT evaluation.
Necessity to Use the True Gravity in Large Scale Atmospheric Modeling
Authors: Chu Peter C.
Published: February 2023

Newton’s law of universal gravitation applies between two point-masses. True gravitation of solid Earth is volume integration of gravitation of all point-masses inside the solid Earth on a point-mass in atmosphere. However, in meteorology the Earth “shrinks” into a point-mass located at Earth center with entire Earth mass to identify the Earth gravitation (untrue). Combination of untrue gravitational and centrifugal accelerations gives effective gravity (geff). Combination of true gravitational and centrifugal accelerations leads to true gravity (g). The true gravity g minus the effective gravity geff is the gravity disturbance vector, δg = g – geff. With the true gravity g used in the basic equations, seven non-dimensional numbers are proposed to identify the importance of δg versus traditional forcing terms such as horizontal pressure gradient force and Coriolis force. These non-dimensional numbers are calculated from two publicly available datasets with the geoid undulation (N) from the static gravity field model EIGEN-6C4 and long-term mean geopotential height (Z), wind velocity (u, v), and temperature (Ta) at 12 pressure levels in troposphere from the NCEP/NCAR reanalyzed climatology. The results demonstrate δg nonnegligible in hydrostatic equilibrium, geostrophic wind, geostrophic vorticity, Ekman pumping, Q vector, and Omega equation, but negligible in thermal wind relation.
A Systematic Review on Machine Learning Fundamentals for Smart Home: Towards Smart City Solution
Authors: Verma Anurag , Sahay Kuldeep , Prakash Surya , Kumar Ajay , Kumar Anuj , Lahza Hassan Fareed M. , Lahza Husam , Albahar Marwan Ali
Published: February 2023

The complexity and interconnection of smart cities provide huge political, technical, and socioeconomic challenges for the designers, integrators, and organisations who are responsible for the administration of these new entities. A growing number of studies are concentrating their attention on the safety, privacy, and potential dangers that exist within smart cities. These studies are drawing attention to the dangers that are associated with information security as well as the challenges that smart city infrastructure faces in the management and processing of personal data. This state of the art review of the literature analyses a number of issues pertaining to smart homes, offers a helpful synthesis of the important information found in the primary research, and creates a model for the interaction between smart cities. An overview of smart home research incorporating machine learning, including everything from definition to current research state. The state of art begins with a smart home definition, followed by descriptions of smart home elements, typical research projects, smart home network research status, smart home appliances, and difficulties. The term "smart home" refers to a subcategory of "everyday computing" that includes "smart technology" in order to improve a person's level of convenience, health, safety, and security while also reducing their When controlled by artificial intelligence, the applications for the smart home provide users with context-aware settings, services, and remote control, which significantly increases the level of user satisfaction.
Heterostructure, Morphology, and Adherence Evaluation of TiO2 Film Deposited on Stainless Steel 304 and 316L via Atomic Layer Deposition
Authors: Marques Vagner Eduardo , Manfroi Lucas Augusto , Vieira Angela Aparecida , Pereira Andre Luis de Jesus , Marques Francisco das Chagas , Vieira Lúcia
Published: February 2023

Titanium dioxide (TiO2) thin films have been widely used in transparent optoelectronic devices owing to their excellent optical properties also is used in photocatalysis, cosmetics, and many other biomedical applications. However, a lack of studies was published on microstructure and adherence comparison of the TiO2 deposited on both AISI substrates. In this work, TiO2 thin films were deposited onto AISI 304 and AISI 316L stainless steel (SS) substrates via atomic layer deposition. Its heterostructure, morphology, and adhesion were compared in both substrates looking for synergistic and multifunctional properties. Raman spectroscopy mapping and X-ray diffraction using the Rietveld refinement method showed that the films are composed of anatase and rutile phases in different percentages. Scratching tests were used to analyze the film adher-ence and friction between a diamond tip and TiO2 film, showing well adhered in both substrates.
Integrated Assessment Modelling of Future Air Quality in the UK to 2050, and Synergies with Net Zero Strategies
Authors: ApSimon Helen , Oxley Tim , Woodward Huw , Mehlig Daniel , Holland Mike , Reeves Sarah
Published: February 2023

Integrated assessment modelling (IAM) has been successfully used in the development of international agreements to reduce transboundary pollution in Europe, based on the GAINS model of IIASA. At a national level in the UK a similar approach has been taken with the UK Integrated Assessment Model, UKIAM, superimposing pollution abatement measures and behavioural change on energy projections designed to meet targets set for reduction of greenhouse gas emissions, and allowing for natural and imported contributions from other countries and shipping. This paper describes how UKIAM has been used in development of proposed targets for reduction of fine particulate PM2.5 in the Environment Act, exploring scenarios encompassing different levels of ambition up to 2050 with associated health and other environmental benefits. There are two PM2.5 targets, an annual mean concentration target setting a maximum concentration to be reached by a future year, and a population exposure reduction target with benefits for health across the whole population. The work goes further, to also demonstrate links to social deprivation. There is a strong connection between climate measures aimed at reducing net GHG emissions to zero by 2050 and future air quality, which may be positive or negative, as illustrated by sectoral studies for road transport where electrification of the fleet needs to match the evolution of energy production, and for domestic heating where use of wood for heating is an air quality issue. UKIAM has been validated against air pollution measurements and other modelling, but there are many uncertainties including future energy projections. New work is beginning to link UKIAM directly with the TIMES model addressing future energy projections, to explore different uptake scenarios for hydrogen production and use with respect to air quality.
Salair–Gornaya Shoria Junction (Northwestern Central Asian Orogenic Belt): Deep Structure and Tectonics from Magnetotelluric Data
Authors: Zhimulev F.I. , Pospeeva E.V. , Potapov V.V. , Novikov I.S. , Kotlyarov A.V.
Published: February 2023

—The Salair fold-thrust orogenic belt (Salair orogen, Salair) is located in the northwestern Altai–Sayan fold area within the Central Asian Orogenic Belt. The Salair orogen is an allochthon overriding the Kuznetsk Basin on a system of imbricate thrusts. The southern flank of the Salair thrust system is tectonically juxtaposed against the Gornaya Shoria terrane which differs markedly from Salair in its geological setting. The Salair and Gornaya Shoria terranes are separated by the Nenya-Chumysh Basin, a deep Mesozoic trough. The Salair orogen is composed of Cambrian–Early Ordovician island arc volcanic and sedimentary rocks, widespread garnet amphibolites and gneisses of the Angurep complex in its southern flank, and the Shalap subduction-related melange in the Alambai ophiolite suture. The southern Salair orogen and its junction with Gornaya Shoria have been imaged down to the lower crust by magnetotelluric (MT) soundings, which is an efficient tool for investigating the deep structure and tectonic history of orogenic areas. The MT surveys were performed at 25 stations on a 120 km long profile. MT data revealed an up to 70 km wide low-resistivity zone (a conductor) traceable till a depth of 20 km between the Salair and Gornaya Shoria terranes. The low-resistivity zone has a complex structure with its outer and interior boundaries dipping almost vertically. The conductor lies under several major geological structures: the Shalap melange, the Nenya-Chumysh Basin, and the NE trending Altai–Salair right-lateral strike-slip fault. The Altai–Salair fault, along which the Salair allochthon was displaced relative to Gorny Altai and Gornaya Shoria, joins the Salair system of imbricate thrusts. The Nenya-Chumysh Basin at the Salair–Gornaya Shoria junction is a deep trough having an asymmetric transversal profile with a steep western side and a shallower-dipping stepped eastern side. The southeastern flank of the basin is a wide area of thin sediments over the Paleozoic basement dipping gently in the northwestern direction. The revealed deep structure of the Nenya-Chumysh trough is consistent with its tectonic model implying an Early Cretaceous basin superposed over an early Jurassic pull-apart basin. Early Mesozoic motions on major faults is a regional-scale phenomenon known from many areas of southern West Siberia.
Sexo y facultad como variables predictoras del consumo de cannabis en estudiantes universitarios. Un análisis mediante modelo estructural
Authors: Soler Roca Cristian , Molina Milán Luis Mateo , Romera Pérez Alejandro , Mompeán Cabrera Alejandro
Published: February 2023

Objetivo. Con este estudio se pretende elaborar un modelo explicativo del consumo de cannabis a partir de las variables sexo y facultad. Método. Se utilizó una metodología cuantitativa basada en la técnica de modelos estructurales para el análisis de los datos mientras que su recogida se realizó mediante una encuesta en la población universitaria de la Universidad de Alicante, con un muestreo estratificada por sexo y facultad, cuyo tamaño fue de 378 encuestados. Resultados. Los resultados obtenidos indican que tanto el sexo como la facultad no tienen un efecto directo en el consumo de cannabis, pero sí influyen en el de manera indirecta a partir de las variables intervinientes sobre la percepción de riesgos y las actitudes favorables hacia el consumo. Conclusiones. Se concluye que el proceso de feminización del consumo de drogas continua y tiene implicaciones cada vez mayores no solo en las drogas legales como indican estudios anteriores, sino también en otras ilegales como el cannabis, al menos entre la población universitaria.
Predictores de abuso de alcohol en adultos con pareja estable
Authors: Quiroga-Garza Angélica , Canales Vela Mariana , Cañamar Decanini Priscila , De la Peña Zambrano Ximena , García Puerta María José , Moreno Saldaña Sofía , Piñeyro Velázquez Ana Regina
Published: February 2023

Introducción. El abuso de alcohol es considerado como un problema de salud pública, socialmente generalizado y normalizado. Contribuye a más de 60 enfermedades y problemas sociales, violencia familiar, problemas de pareja y económicos, comportamiento impulsivo, accidentes automovilísticos y una menor productividad laboral. Objetivo. Encontrar el valor predictivo de las variables psicológicas de búsqueda de sensaciones, resiliencia, funcionalidad de pareja y autoeficacia laboral sobre el consumo de alcohol. Método. De corte cuantitativo y alcance explicativo, en el estudio se aplicó en línea una batería de pruebas validada a 249 personas adultas en un rango de edad entre 21 y 65 años (M = 46.7; DT = 11.0) de población mexicana entre 21 y 65 años con pareja y empleo estables. Resultados. Se encontró que las variables de búsqueda de sensaciones y funcionalidad de pareja son las que tienen un mayor valor predictivo en el consumo de alcohol. Un aporte importante de este estudio es el hallazgo de que la funcionalidad de pareja funciona como factor protector del consumo de alcohol aún y cuando alguna de las dos personas de la relación presente búsqueda de sensaciones alta. Conclusiones. Es importante considerarlo en programas de intervención individual, de parejas, en pláticas prematrimoniales y estudios de caso.
Expanding on the Cinema of Prayōga as an Embodied Approach to Experimental Film
Authors: Subramanian Kalpana
Published: February 2023

In this paper I revisit the concept of Cinema of Prayoga, a theoretical framework for the study of experimental film and video proposed by Indian film critic Amrit Gangar. I re-evaluate its potential as an alternative approach to experimental film. In particular I articulate how the Yoga philosophy can further be explored within the context of this framework, to address notions of embodiment in experimental film. I point to how Indian philosophy can be useful towards interpreting cinema globally, with the specific example of American avant-garde film.
Semianalytical Model for Monitoring Fracture Liquid-Loading in Vertical Fractured Gas Wells
Authors: Wang Zhipeng , Ning Zhengfu , Guo Wenting
Published: February 2023

Liquid loading seriously affects gas wells production and even causes gas wells abandonment. Many researchers still focus on correcting a critical liquid-loading flow rate to alleviate these problems. However, they still cannot reasonably be explained. Gas flow rate is higher than the critical liquid-loading flow rate, but liquid loading can still occur. Therefore, until an accurate critical fluid-loading flow rate is discovered, we should monitor the fluid-loading phenomenon to prevent it from affecting production gas wells’ performance. In this work, a fracture liquid-loading monitoring (FLLM) model is proposed and solved for the timely monitoring of fracture liquid-loading (FLL) positions and volume. The Newman product and Green function methods are used to develop and solve the FLLM model. The fracture is discretized into 2nxnz grids to describe an FLL volume and position. The numerical simulation method is used to verify the accuracy of the FLLM model. As a result, four innovative flow regimes, including fracture cavity liquid-loading flow, fracture root liquid-loading flow, transitional flow considering fracture cavity liquid-loading flow, and transitional flow considering fracture root liquid-loading flow, are identified on the pressure response curves. The pressure response of the same gas well at different times is well matched by the model in this paper, and the obtained parameters are more reasonable. The FLLM model can correct for magnified permeability, shortened half-length, and magnified wellbore storage coefficient. In conclusion, the FLLM model is established to monitor FLL, and alert engineers to remove liquid loading on time to prevent water from suddenly rushing into a wellbore and causing gas wells abandonment.
Individuals with severe psychiatric disorders display altered pattern of plasma immunometabolites
Authors: Hylén Ulrika , Särndahl Eva , Bejerot Susanne , Humble Mats B , Hyötyläinen Tuulia , Salihovic Samira , Eklund Daniel
Published: February 2023

IntroductionPsychiatric disorders are common and significantly impact the quality of life. Inflammatory processes are proposed to contribute to the emergence of psychiatric disorders. In addition to inflammation, disturbances in metabolic pathways have been observed in individuals with different psychiatric disorders. A suggested key player in the interaction between inflammation and metabolism is the Nod-like receptor 3 (NLRP3) inflammasome, and NLRP3 is known to react to a number of specific metabolites. However, little is known about the interplay between these immunometabolites and the NLRP3 inflammasome in mental health disorders.AimTo assess the interplay between immunometabolites and inflammasome function in a transdiagnostic cohort of individuals with severe mental disorders.MethodsMass spectrometry-based analysis of selected immunometabolites, previously known to affect inflammasome function, were performed in plasma from low-functioning individuals with severe mental disorders (n=39) and sex and aged-matched healthy controls (n=39) using a transdiagnostic approach. Mann Whitney U test was used to test differences in immunometabolites between psychiatric patients and controls. To assess the relationship between inflammasome parameters, disease severity, and the immunometabolites, Spearman’s rank-order correlation test was used. Conditional logistic regression was used to control for potential confounding variables. Principal component analysis was performed to explore immunometabolic patterns.ResultsAmong the selected immunometabolites (n=9), serine, glutamine, and lactic acid were significantly higher in the patient group compared to the controls. After adjusting for confounders, the differences remained significant for all three immunometabolites. No significant correlations were found between immunometabolites and disease severity.ConclusionPrevious research on metabolic changes in mental disorders has not been conclusive. This study shows that severely ill patients have common metabolic perturbations. The changes in serine, glutamine, and lactic acid could constitute a direct contribution to the low-grade inflammation observed in severe psychiatric disorders.
Seroma control in axillary lymphadenectomy with Glubran 2® without drain. Multicenter, prospective, randomized, clinical trial. GALA-ND Study (Glubran, Axillary Lymphadenectomy, Ambulatory, No Drain)
Authors: Gordo Sandra López , Ruiz-Edo Neus , Fernández-Planas Maria Teresa , Viscaya-Martín Sara , Serra-serra Cristina
Published: February 2023

Background: Seroma after breast cancer surgery is a frequent entity, therefore different products have been described in literature with the aim to reduce it. The most studied ones have been the sealants products, being tested with aspirative drains. Symptomatic seroma represents the 19% after axillary lymphadenectomy without drains. The aim of this study is to analyse the effect of a sealant in the seroma control after axillary lymphadenectomy without drains and identify the risk factors related to symptomatic seroma.
Methods:
This is a prospective, multicenter, international and randomized clinical trial. Patients undergoing conservative surgery and axillary lymphadenectomy for breast cancer will be randomized to control group (lymphadenectomy without sealant) or interventional group (lymphadenectomy with sealant Glubrand 2®). In any of the study groups drains are placed. Patients who received neoajuvant treatment are included. Measurements of the study outcomes will take place at baseline, at 7-14-30 days post-surgery and at 6-12 months. The primary outcome is symptomatic seroma. Secondary outcomes are seroma volume, morbidity, quality of life and lymphedema.
Discussion:
Several studies compare the use of sealant products in axillary lymphadenectomy but generally with drains. We would like to demonstrate that patients who underwent axillary lymphadenectomy could benefit from an axillary sealant without drains and reduce axillary discomfort while maintaining a good quality of life. Assessing the relationship between axillary volume, symptoms and related risk factors can be of great help in the control of seroma in patients who received breast cancer surgery.
Trial registration: ClinicalTrials.gov, NCT05280353. Registration date 02 August 2022
Semi-synthesis of Novel Thebaine Derivatives and their Anti-bacterial and Wound Healing Properties
Authors: Hasanpour Zahra , Salehi Peyman , Aliahmadi Atusa , Hoseinpour Mahdieh , Behboodi Hossein , Staerk Dan , Bararjanian Morteza
Published: February 2023

In the present study, some new 1,2,3-triazole-tethered analogues of N-northebaine were designed and synthesized. The anti-bacterial properties of novel thebaine derivatives were studied on Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). Based on the results, compounds 5b, 5j and 5m showed the best activities against S. aureus (minimum inhibitory concentration (MIC) ~ 25 µM) compared to the parent compound (MIC = 321 µM). The most active anti-bacterial derivatives (i.e., 5b, 5j and 5m) and thebaine were considered as potent anti-bacterial wound healing agents. In this regard, fibroblast cell cytotoxicity and proliferation as well as anti-hemolytic activities of the mentioned compounds were studied. The cytotoxicity assay by using 3-[4,5-dimethylthiazol-2-yl] 2,5-diphenyltetrazolium bromide (MTT) on Human dermal fibroblast cell lines (HDF) revealed that products 5j and 5m didn’t show inhibition of cell line growth after 24 hours and no further cytotoxic activity for a longer period (72 hours). Based on the investigation results on blood cell disruption for releasing of hemoglobin, compound 5j didn’t exhibit any hemolysis activity in different doses.
CD44 is a potential immunotherapeutic target and affects macrophage infiltration leading to poor prognosis
Authors: Liu Shuangqing , Liu Zehan , Shang Aichen , Xun Jing , Lv Zongjing , Zhou Siying , Liu Cui , Zhang Qi , Yang Yuming
Published: February 2023

Background
CD44 is the most common surface marker of CSCs (cancer stem cells) and plays a key role in the communication of CSCs with the microenvironment and the regulation of stem cell properties.
Methods
UALCAN was used to analyze the expression of CD44 in BLCA and normal tissue. Kaplan–Meier plotter and UALCAN were utilized to analyze the prognostic value of CD44 in BLCA. The TIMER database was used to explore the relationship between CD44 and tumor-infiltrating immune cells. The expression of CD44, the macrophage marker (CD68+), and the M2-type marker (CD163+) was evaluated using immunohistochemistry in 15 BLCA samples. GeneMania and Metascape were used to analyze protein-protein interaction investigations and functional enrichment analysis
Results
We found that patients with bladder cancer with high CD44 expression had worse survival than those with low CD44 expression (P < 0.05). Furthermore, CD44 expression is significantly associated with PD-L1 expression. Immune infiltration analysis showed that CD44 expression levels in BLCA were significantly correlated with immune infiltration levels of different immune cells. And the analysis showed that infiltration of macrophages means a worse prognosis for patients. Immunohistochemical (IHC) staining results further confirmed that the expression of CD44 was positively associated with the expression of CD68+ and CD163+ (P < 0.05).
Conclusion
Our results suggest that CD44 may be a potential immunotherapeutic target for bladder cancer, and macrophage infiltration in bladder cancer has prognostic value for bladder cancer patients. CD44 may be a key regulator of tumor macrophage infiltration and may be involved in M2 macrophage polarization. Our study sheds new light on prognosis and immunotherapy in bladder cancer patients by targeting macrophage infiltration and immune checkpoints.
Evaluating the implementation of Group Empowerment and Training (GREAT) for diabetes in South Africa: Convergent mixed methods
Authors: Mash Robert , Schouw Darcelle
Published: February 2023

Background
Diabetes is a leading contributor to the burden of disease in South Africa. The new National Strategic Plan for non-communicable diseases aims to achieve control in 50% of patients. Currently, in the Western Cape, only 25% are controlled and a lack of patient education and counselling is a key factor. Group empowerment and training (GREAT) for diabetes is a feasible and cost-effective intervention in our setting. This study aimed to evaluate the scale-up and implementation of GREAT for diabetes in primary care across five provinces.
Methods
A convergent mixed methods study evaluated a range of implementation outcomes. Descriptive exploratory individual semi-structured interviews were conducted with 31 key stakeholders from national policymakers to primary care providers. Five focus group interviews were held with patients. Qualitative data explored the acceptability, appropriateness, adoption, feasibility, fidelity and sustainability of GREAT. Quantitative data was collected on the training course, observations of GREAT, coverage and cost.
Results
Five out of nine provinces implemented GREAT, despite the challenges of the COVID-19 pandemic. The findings informed the design of a programme theory using a health system framework. Health system structures required support from National and Provincial level policymakers, identification of high prevalence districts and allocation of funds. Health system inputs required attention to physical space for groups, sufficient staff numbers to facilitate groups, availability of the resource materials and monitoring within the health information system. Key activities included adaptation to the model of care (selection of facilities, patients, adjustment of patient flow and appointment systems and leadership of local managers across the whole clinical team), training of facilitators and trainers and inclusion in systems for quality improvement. Identified outputs related to the availability of GREAT and improved quality of care (viz person-centredness, self-management, social support and health literacy). Expected outcomes related to improved coverage, diabetic control and patient satisfaction.
Conclusions
Key lessons were learnt on how to implement GREAT for diabetes in a middle-income country primary care system. The programme theory will guide further scale-up in each province and scale-out to provinces that have not yet implemented.
Reminiscent music therapy combined with robot-assisted rehabilitation for older patients with upper limb dysfunction after stroke: protocol for a randomized controlled trial
Authors: Liu Qian , Liu Zuoyan , Cheng Hong , Xu Yang , Wang Fang , Liu Li , Hu Xiuying
Published: February 2023

Background

Stroke is the main disease that causes the burden of neurological disease in elderly people, leading to upper limb dysfunction and affecting their self-care ability. Robot-assisted rehabilitation therapy has been gradually used in the rehabilitation of upper limb function after stroke. However, it is necessary to add auxiliary intervention to relieve negative emotions and post-stroke fatigue, and improve rehabilitation outcomes. This paper presents a protocol for a randomized controlled trial that aims to evaluate the effectiveness of reminiscent music therapy combined with robot-assisted rehabilitation in older patients with upper limb dysfunction after stroke.

Methods

This trial is a single-blind, three-arm randomized controlled trial. Older stroke patients with upper limb dysfunction will be recruited and followed up for 4 weeks. All participants will be randomly assigned to receive usual rehabilitation treatment and care (control), usual rehabilitation treatment and care plus robot-assisted rehabilitation and reminiscent music therapy (experimental group 1), or usual rehabilitation treatment and care plus robot-assisted rehabilitation (experimental group 2). Usual rehabilitation treatment, including drug treatment, comprehensive training of hemiplegic limbs and physical therapy, will be formulated by rehabilitation doctors and neurologists according to the specific conditions of the participants. Robot-assisted rehabilitation will be conducted by rehabilitation doctors for 4 weeks. In experimental group 1, a reminiscent song list will be played for patients with a wireless headset when they are training. The primary outcome is activities of daily living and secondary outcomes include self-esteem, rehabilitation self-efficacy, positive emotion and upper limb function. All outcomes will be evaluated at baseline, after 2 weeks of the intervention, in the week immediately post-intervention and at 4-week post-intervention.

Discussion

To the best of our knowledge, we are conducting the first randomized controlled trial on the effects of reminiscent music therapy combined with robot-assisted rehabilitation in older stroke patients with upper limb dysfunction. It is expected that this study, if proven effective in improving the activities of daily living in older stroke patients with upper limb dysfunction, will provide evidence-based rehabilitation strategies for medical staffs.
Trial registration: This trial was registered at ChiCTR.org.cn (registration number is ChiCTR2200063738 and registered on September 15, 2022).
Characterization of the Stanford Integrated Psychosocial Assessment for Transplant for Heart, Liver, and Kidney Transplant Candidates in Japan
Authors: Takano Kosuke , Oshibuchi Hidehiro , Kobayashi Sayaka , Tsutsui Junko , Ito Satoko , Kamba Rumiko , Akaho Rie , Nishimura Katsuji
Published: February 2023

Background The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a comprehensive psychosocial assessment proven useful for predicting the outcomes of organ transplantation and is expected to be used in Japan. However, the characteristics of organ-specific SIPAT scores for organ transplant recipient candidates in Japan are unclear, and to date the SIPAT has not been properly utilized in clinical practice. The purpose of this study was to present relevant data that can be used to establish the criteria for accurately assessing the risk of post-transplant outcomes and the current status of psychosocial support by examining the SIPAT scores and distribution of organ transplant recipient candidates in Japan as well as organ-specific characteristics. Methods This study included 167 transplant recipient candidates (25 heart, 71 liver, and 71 kidney) who completed a semi-structured interview based on the Japanese version of the SIPAT (J-SIPAT) prior to transplantation. The differences between organs in terms of SIPAT scores and differences in SIPAT scores based on demographic data were comparatively analyzed. Results The total SIPAT scores were higher for liver recipient candidates than for heart recipient candidates (P = .019). Regarding the subscales, SIPAT B (social support system) scores were higher for liver and kidney recipient candidates than for heart recipient candidates (P = .021); SIPAT C (psychological stability and psychopathology) scores were higher for liver recipient candidates than for kidney recipient candidates (P = .002). Recipient candidates with a history of psychiatric treatment and those who were unemployed had higher SIPAT scores, regardless of the transplant organ, than recipient candidates without a history of psychiatric treatment and those who were employed (P < .001, P = .016). Conclusions There were notable differences in the total J-SIPAT and subscale scores among the liver, heart, and kidney recipient candidates. Each organ was associated with specific psychosocial issues that should be addressed before transplantation. Interventions such as information provision and patient education based on SIPAT assessment results for each organ may improve recipient post-transplant outcomes.
Non-Technical Skills Training for Nigerian Interprofessional Surgical Teams: Which Way Forward? A Cross-sectional Survey
Authors: Alayande Barnabas Tobi , Forbes Callum , KingPriest Paul , Adejumo Adeyinka , Williams Wendy , Wina Felix , Christian Agbo , Omolabake Bamidele , Bekele Abebe , Ismaila Bashiru O , Kerray Fiona , Sule Augustine , Abahuje Egide , Robertson Jamie , Yule Steven , Riviello Robert , Isichei Mercy
Published: February 2023

Introduction
Non-technical skills (NTS) like situational awareness, decision making, leadership, communication, and teamwork, are critical elements for enhancing surgical safety. In low-income contexts, NTS are often considered soft skills and therefore not included in formal medical education curriculums or continuing medical education. A survey was designed to explore exposure to NTS for interprofessional teams in North-Central Nigeria and identify perceived barriers and facilitates to surgical safety to inform the design of a contextualized curriculum.
Methods
Six institutions with high surgical volumes, including private not-for-profit and government-owned teaching hospitals, were purposively identified. Using snowball sampling through surgical team leads, a 19-item, web-based cross-sectional survey was distributed to 71 surgical providers, anaesthetists and perioperative nurses between August and November 2021. Data was analysed using proportions and Fisher's exact test.
Results
The survey had a 95.7% completion rate. Respondents included 17 anaesthetists, 21 perioperative nurses, and 29 surgeons. Over half were unaware of the concept of NTS, and 96% had never heard of a NTS framework for variable resource contexts. Only 8% had received NTS training. Communication and teamwork were considered the most deficient personal skills (38, 57%), and the most needed for team improvement (45, 67%). There was a high demand for training by all team members (64, 96%), motivated by expectations of improved patient safety and better team dynamics. Respondents preferred week-long, hybrid training courses with in-person and online components. Perceived barriers to attendance were time conflicts and costs. Perceived facilitators included a desire for self-improvement and patient safety.
Conclusions
Interprofessional surgical teams in the Nigerian context have a high degree of interest in NTS training, believing it can improve patient safety, team dynamics and personal performance. Implementation of NTS training programs should emphasize interprofessional communication and teamwork.
Rice ragged stunt virus mediates immune responses in Nilaparvata lugens against Metarhizium anisopliae YTTR infection: evidence from two novel genes NlK-serpin and NlVenomase
Authors: Li Xuewen , Liu Jian-li , Ou-yang Yu-ying , Zhang Bang , Zhao Shu-jiao , Chai Xue-qing , Ma Yong-le , Liu Jian , You Min-sheng , Lin Sheng
Published: February 2023

In this study, two vital genes in the serine protease cascade, NlK-serpin and NlVenomase, were identified. Two genes show differential responses in brown planthopper (Nilaparvata lugens, BPH) carrying the insect fungal pathogen Metarhizium anisopliae YTTR and/or the plant viral pathogen rice ragged stunt virus (RRSV). RNA interference (RNAi) combined with/without M. anisopliae YTTR were used to explore the genes’ functions. And BPH mortality, the transcriptional response of four antimicrobial peptides (AMPs) genes, and the phenoloxidase (PO) activity were measured to unveil the underlying mechanism. Results showed that the coding sequences (CDSs) of NlK-serpin and NlVenomase contained 291-bp and 1,194-bp nucleotides, respectively. Phylogenetic analysis showed both genes have the closest kinship to Laodelphax striatellus. NlK-serpin is highly expressed in the adult and 3rd -instar stages and NlVenomase is highly expressed in 2nd and 3rd -instar nymphs. Both genes possess high expression in the fat body. Synthesized dsRNAs have strong interference efficiency against the expression of target genes. DsNlK-serpin injection significantly reduced BPHs survival rates in RRSV-free BPHs. However, when RRSV existed, the differences in survival rates among the three dsRNA treatments were insignificant. DsRNA combined with M. anisopliae YTTR produced a synergistic effect leading to higher BPHs mortality. Results of AMPs expression and PO activity indicated that NlK-serpin and NlVenomase play a vital role in BPH humoral immunity against M. anisopliae YTTR infection. And both genes participate in the process of RRSV-mediated immune responses of BPH to M. anisopliae YTTR infection by regulating AMPs expression and PO activity. Our study provided new targets for BPH control and laid a solid foundation for further research the interaction of “plant virus- insect vector- entomopathogenic fungus”.
Copper and zinc transfer limits to soil solution of mixtures containing different clay and organic matter contents
Authors: Morais Gildean Portela , Comin Jucinei José , Lourenzi Cledimar Rogério , Tiecher Tadeu Luis , Soares Cláudio Roberto Fonsêca Sousa , Gatiboni Luciano Colpo , Loss Arcângelo , Couto Rafael da Rosa , Ferreira Guilherme Wilbert , Severgnini Milena , Trapp Talita , Brunetto Gustavo
Published: February 2023

Establishing Cu and Zn transport limits to soil solution, may be a parameter to regulate maximum allowable concentrations of these heavy metals in soils. The study aimed to estimate Cu and Zn contents in soil mixtures with varying clay and soil organic matter (SOM) contents, from which the two heavy metals are transported to the soil solution. Samples of the Bw horizon of a Oxisol and of the A horizon of a Inceptisol were used to make soil mixtures with clay contents ranging from 170 to 700 g kg− 1 and SOM ranging from 18 to 95 g kg− 1. Cu and Zn adsorption curves were obtained to determine the maximum adsorption capacities (MAC) using the Langmuir model. Cu transport limits ranged from 118 to 187 mg kg− 1 the lowest values were found in soil mixtures containing lower clay contents in combination with higher SOM contents. Zn transport limits ranged from 61 to 116 mg kg− 1 the highest values were found in soil mixtures containing lower clay contents combined with higher SOM contents. Cu and Zn transport limits can be used as safe limits for supervisory bodies, technical assistance institutions and farmers to monitor the potential for environmental contamination.
Optimizing the Sequence of Surgical Procedures in an Operating Room to Reduce Post-Anesthesia Care Unit Utilization During After-Hours Using Machine Learning
Authors: Tully Jeffrey L. , Zhong William , Simpson Sierra , Curran Brian P. , Macias Alvaro A. , Waterman Ruth S. , Gabriel Rodney A.
Published: February 2023

PURPOSE
The post-anesthesia care unit (PACU) length of stay is an important perioperative efficiency metric. The aim of this study was to develop machine learning models to predict ambulatory surgery patients at risk for prolonged PACU length of stay - using only pre-operatively identified factors - and then to simulate the effectiveness in reducing the need for after-hours PACU staffing.
METHODS
Several machine learning classifier models were built to predict prolonged PACU length of stay (defined as PACU stay ≥ 3 hours) on a training set. A case resequencing exercise was then performed on the test set, in which historic cases were re-sequenced based on the predicted risk for prolonged PACU length of stay. The frequency of patients remaining in the PACU after-hours (≥ 7:00 pm) were compared between the simulated operating days versus actual operating room days.
RESULTS
There were 10,928 ambulatory surgical patients included in the analysis, of which 580 (5.31%) had a PACU length of stay ≥ 3 hours. XGBoost with SMOTE performed the best (AUC = 0.712). The case resequencing exercise utilizing the XGBoost model resulted in an over three-fold improvement in the number of days in which patients would be in the PACU past 7pm as compared with historic performance (41% versus 12%, P<0.0001).
CONCLUSION
Predictive models using preoperative patient characteristics may allow for optimized case sequencing, which may mitigate the effects of prolonged PACU lengths of stay on after-hours staffing utilization.