bluuebunny/crossref_metadata_2025 huggingface dataset:
Smart Tourism Applications and Information Quality Affect to Tourist’s Experience
Authors: Thai Son Le
Published: August 2023

This study investigates the relationship between smart tourism applications, information quality to influence tourists' perception and experience when they use mobile devices to travel in Dalat on the occasion of 2022 Flower Festival. Based on studies on smart tourism applications (STA), this study develops a model to examine visitor experience through their perception. Based on an online survey of tourists visiting Dalat on the occasion of the 2022 Flower Festival, this study examines the factors that influence tourists' experiences on this occasion. The results show that (1) Smart tourism applications, the quality of information affects three attributes of perception, namely Attitude, control ability, beliefs and subjective nbormss of tourists; (2) The ability to control, beliefs and subjective norms strongly influence the visitor's experience. Theoretical implications and pratical implications are discussed based on the research findings, then future research are suggested.
Metformin may improve the outcome of patients with breast cancer and type 2 diabetes mellitus through the effect of tumor immune microenvironment.
Authors: Shiba Satomi , Kitayama Joji , Harao Michiko , Saito Akira , Sakuragi Masako , Lefor Alan Kawarai , Sata Naohiro
Published: August 2023

The antidiabetic drug metformin has antitumor effects. We examined the outcome of 177 patients with type 2 diabetes mellitus who received surgery for breast cancer. Among them, 49 patients were treated with metformin. In those patients, recurrence in distant organs was less frequent and postoperative disease-free survival tended to be better than in those without metformin intake. In patients who received preoperative systemic therapy, the rate of pathologic complete response was higher in patients who were also treated with metformin (P < 0.05). Multiplex immunohistochemical staining of resected tumors revealed that the density of tumor-associated macrophages (TAMs), especially of CD68(+)CD163(+) M2-type TAMs, was lower in tumors treated with metformin. In contrast, the rate of the CD8(+) phenotype among CD3(+) tumor-infiltrating lymphocytes was higher in the metformin-treated group. The results suggest that metformin can change the immune microenvironment from a protumorigenic to an antitumorigenic status, thus supporting a favorable outcome in patients with breast cancer and type 2 diabetes mellitus.
Association Between Pulp Stone and Mediterranean Diet: A Clinical and Radiographic Study
Authors: Bagci Nuray , Yakuboğlu Seda Kan , Pamukcu Umut , Toraman Meryem
Published: August 2023

Objectives
The present study aimed to investigate the potential association between pulp stone and the Mediterranean Diet (MedDiet).
Material and Method:
In the study, systemically healthy patients aged 18 years and over were participated. Clinical and radiological examinations of the patients were performed. The patients were classified into 2 groups as study/control group according to presence/absent of pulp stone. The jaw, type, and number of the teeth affected by pulp stone were recorded, in study group. 14-questions of Mediterranean Diet Adherence Scale (MEDAS) were asked to all patients. The MEDAS score and adherence (low, medium, and high) to the MedDiet of the patients were determined. Data from the 2 groups were recorded, and a statistical analysis was performed.
Results
A total of 212 participants (study group = 105; control group = 107) were included. In the study group, the number female (n = 94, 89.5%) was greater than the number of male (n = 11, 10.4%). The teeth with pulp stone were mostly the maxillary first molars (9.0%). The MEDAS score and adherence to the MedDiet of the patients were statistically significant difference between the groups. MEDAS score and ratio of high adherence to the MedDiet of the study group was higher than the control group (p = 0.000).
Conclusion
The MEDAS score and adherence to the MedDiet were found to be significantly different between the study group and the control group.
Clinical Relevance:
Nutritional habits can be considered in pulp stone etiology. The present study findings can be used as references for further studies.
Development and Validation of Two Domain-Specific Information Privacy Competency Models
Authors: Soumelidou Aikaterini , Tsohou Aggeliki
Published: August 2023

The purpose of this paper is to present and validate two domain-specific information privacy competency models (IPCMs); the first for online consumers and the second for users of mobile applications (apps), which were developed conceptually by the authors. For the validation of the proposed competency models, we conducted qualitative research, using interviews to collect feedback by a group of nine information privacy experts. The development of the domain specific IPCMs demonstrated that core privacy competencies are pervasive to the two domains that we studied, but also that there are privacy competencies that are especially required per domain of activity. Regarding the evaluation, the experts commented largely positively for the structure and content of the IPCMs, as well as for the extent to which they achieve the intended goals. They also provided several points for improvements, which resulted in enhancing the quality of both IPCMs. This is the first study to examine the privacy competencies that users of specific technological contexts should hold. The IPCMs can be used not only by educators and privacy policy makers for the design of privacy interventions, but also by e-commerce and mobile-apps providers, who could gain important insights into the way that they can be more reliable for their users. Both consumers and users of mobile-apps could benefit from IPCMs by acquiring the necessary privacy competencies through training programs for the protection of their information privacy.
Influence of antiresorptive/antiangiogenic therapy on changes in periodontal and oral tissue structures: a histomorphometrical analysis in rats
Authors: Ramanauskaite Ausra , Mangold Katharina , Padhye Ninad , Obreja Karina , Borschert Fanya , Dahmer Iulia , Schwarz Frank
Published: August 2023

Objective
The objective of this study was to investigate the influence of various antiresorptive and antiangiogenic medications on morphological changes in periodontal and oral tissue structures.
Materials and methods
Fifty-five Wistar rats randomly received dual application (i.e., at baseline and after 12-weeks) of the following medications: (1) amino-bisphosphonate [zoledronate (Zo)], (2) RANKL inhibitor [denosumab (De)], (3) antiangiogenic [bevacizumab (Be)], (4) Zo + Be, (5) De + Be or (6) no medication [Control (Co)]. Periodontal and oral tissue biopsies were obtained at 17 (n = 21 animals, Phase 1, (De = 3, De + Be = 3, Zo = 5, Be = 3, Zo + Be = 2, Co = 5) and 29 (n = 34 animals, (De = 8, De + Be = 6, Zo = 2, Be = 7, Zo + Be = 4, Co = 7, Phase 2) weeks after the second drug application. The following outcomes were histomorphometrically assessed: periodontal space width in the coronal (PLS-C, mm) and apical sections (PLS- A), number of empty alveolar bone lacunae in the coronal, apical sections and at the apex at respective tooth sites (EL – C, EL- A, EL- Ap), mucosal thickness at edentulous alveolar ridge areas (MT, mm), and, when present, associated areas of inflammatory cell infiltrates (ICI, mm2).
Results
Comparable mean PLS-C, PLS-A, ET-A, ET-C, ET-Ap, and MT values were observed in all experimental groups after Phases 1 and 2. The presence of ICI was identified in 3 animals in the Co group (Phase 1: 1, Phase 2: 2), and 17 animals in the test groups (Phase 1: 4; Phase 2: 14). The estimated ICI surface area was significantly higher in the Zo + Be group, followed by the Zo and Be groups compared to that measured in the Co group. The time (i.e., Phases 1 and 2) was not found to be a predictor for the extent of the ICI area. In all groups, the EL-C, EL-A, and EL-Ap values were significantly higher after Phase 2 compared to those assessed after Phase 1. The MT values were significantly reduced in all groups after Phase 2 compared to those measured after Phase 1.
Conclusions
The present analysis did not show any marked morphological effects of various antiresorptive and antiangiogenic medications on periodontal and oral tissue structures. The presence of inflammatory cell infiltrates was more frequently observed in the animals administered with antiresorptive and antiangiogenic medications as well as combinations thereof.
Clinical relevance:
Administration of antiresorptive and antiangiogenic medications may be capable of inducing inflammatory reactions in periodontal tissues.
Matlab Deep learning-based vehicular channel estimator in high mobility environments
Authors: Abderrahim Mountaciri , MyAbdelkader Youssefi , Elmostafa Makroum
Published: August 2023

communication performance in wireless networks are greatly affected by the fidelity of the channel estimator, revisiting old methods of the estimation of LS and MMSE channels by revealing their shortcomings, a new method based on deep-learning is proposed, demonstrating significant improvements in communications reliability as well as the reduction of the computational complexity of vehicular networks, under different high mobility environments ( high doppler frequency) with very short reflection times are tested by the new model Dl estimator
Who drives recent CO2 emissions in China, India and Brazil? A decomposition and decoupling analysis.
Authors: Koilakou Eleni , Hatzigeorgiou Emmanouil , Bithas Kostas
Published: August 2023

The study attempts to examine the driving factors of total energy-related and power-related (electricity-heat) CO2emissions for China, India and Brazil, three BRICS countries (including also Russia and South Africa) with vital economic and demographic dynamics. This paper conducts a decomposition analysis (DA) by applying the Long Mean Divisia Index (LMDI) technique for China, India and Brazil for the period of 2000–2018. The study investigates the impacts of the most prevailing factors in the released literature, as well as certain demographic ones (household size and household number) which introduced in the relevant literature for first time incorporating important social and demographic dynamics. The results show that income and population effects enlarge significantly the energy-related CO2emissions. Household size, household number and income effects are crucial for the increase of power-related CO2emissions. The crucial factors for the decrease of energy-related CO2emissions is energy intensity effect, while for power-related CO2emissions is the emission factor effect. In order to develop an integrated picture of the link between energy and economy we apply also the so-called decoupling analysis.
Why local hyper-softness is a more appropriate local reactivity descriptor than dual descriptor and Fukui function?
Authors: Martínez-Araya Jorge Ignacio
Published: August 2023

In this paper, the reason why local hyper-softness (LHS) allows to make comparisons of local reactivities among molecular systems of similar or different sizes as scientific literature has evidenced in the last ten years is analyzed. This lies on the fact that LHS is an intensive property. On the contrary, dual descriptor and Fukui functions are not. The Euler's homogeneous function theorem is invoked with the aim of providing a support that establishes the intensive nature of local softness and local hyper-softness, while confirming the sub-intensive feature of the Fukui functions and dual descriptors thus preventing to use these two latter for making comparisons of local reactivities among different size molecular systems.
Study of NaY@LDHs Adsorbing Low Concentration Toluene under Dry and Wet Conditions
Authors: Li Yanyao , Yin Tao , Xu Jiawen , Liu Naiwang , Shi Li , Meng Xuan
Published: August 2023

The industrial production process often produces VOC containing water vapor, and the adsorbent can effectively adsorb VOC. There is a competitive adsorption between water molecules and VOC molecules in the adsorption process, so it is of great significance to improve the hydrophobicity of the adsorbent. In this paper, LDHs (layered double hydroxides) were treated with aqueous miscible organic solvents and then loaded on the surface of NaY zeolite to form NaY @ LDHs core-shell structure. Nitrogen adsorption and desorption experiment, XRD characterization and toluene dynamic adsorption experiment were carried out. The results showed that when the Mg/Al molar ratio was 2:1, the LDHs treated with anhydrous ethanol had the best effect. LDHs grow vertically on the NaY zeolite to form an air layer, and the lamellar stacking generates mesopore volume, so as to effectively improve the toluene adsorption capacity and hydrophobicity.
Diagnosis and prognosis model for breast cancer based on DNAH10 which contributes to tumor immune infiltration and progression
Authors: Wang Lu , Chen Keyu , Wu Weizhu , Ding Jinhua , Zhou Yuxin , Wan Lin , Wang Xiaojia , Zhang Ziwen
Published: August 2023

Background Targeted therapy plays an important role in the treatment of breast cancer. However, more biomarkers are still needed to distinguish breast cancer subgroups and further achieve precise targeted therapy.Methods This study analyzed the mutation database of breast cancer and found the gene DNAH10 with high mutation frequency and significant impact on prognosis. The differential genes between the DNAH10 mutant group and the wild-type group were further analyzed, and independent prognostic factors were identified from them.Results A prognostic model was established based on CCL8, FLT3, KLHDC7B, DCD, and GBP2 genes. This model divides breast cancer patients into high-risk group and low-risk group, which has a good predictive value for the prognosis of patients. In addition, analysis of tumor immune microenvironment infiltration revealed that memory B cells, CD8 + T cells, monocytes had higher infiltration scores in the low-risk group than in the high-risk group. And both MHC I and MHC II were higher in the low-risk group. It is suggested that the low-risk group may respond better to immunotherapy. Different DNAH10 copy number variants were also associated with tumor immune microenvironment infiltration. It was further verified by in vitro experiments that DNAH10 mutation promoted tumor proliferation, invasion and migration.Conclusion Our predictive model may be an effective tool for precise diagnosis and treatment of breast cancer, helping to select populations susceptible to chemotherapy and immunotherapy.
Analysis of Policy Incentive for Chillers With Thermal Storage: a Case Study From India
Authors: Kale Shivaji , Mahesh Shelar , Sanjay Barahate , Mugdha Bhadak
Published: August 2023

Centralized chiller plants with thermal energy storage helps in saving electrical costs in utilities with differential tariff system but its effect on energy savings needs investigation. Even regarding cost savings, life cycle analysis is required to be done. The recent studies have highlighted the potential of energy savings from the centralized chiller plants with the thermal energy storage in commercial complexes response to the differential electricity prices. Traditionally Glycol storage is used for the diurnal load shifting in large multi-chiller plants in India. However, modeling and the dynamic analysis of these thermal storages are not reported extensively in the literature and rule of the thumb for sizing is a practice which leads to the erroneous sizing of the storage and ultimately energy losses. To help the modeling of the thermal energy storages, this paper presents the analysis of the actual data captured from the existing 1050 TR chiller plant of the commercial complex with the glycol storage. The system is analyzed for the effect of the diurnal thermal storage on the performance of the chillers and potential cost savings under various times of the day tariff rates. Deficiencies of the thermal energy storage sizing by comparing with the cooling load curve and time of day tariffs are highlighted. The over sizing of the thermal storage leads to the significant increase in energy up to 43% and cost is increased by 27%. The methodology presented here exemplified the need of fully coupled analysis of thermal storage with respect to the differential tariff and variation of COP of the system in site specific assessment
The effect of inhaled steroids on the incidence of respiratory infections in patients with asthma and COPD
Authors: hasan Layan Essam Ali , Alfawares Maamoun , Bardan Housam
Published: August 2023

Background
Inhaled corticosteroids (ICS) are the most effective controllers of asthma. They primarily suppress inflammation by inhibiting several activated inflammatory genes by reversing histone acetylation via histone deacetylase 2 (HDAC2). There has been significant progress in understanding the molecular mechanisms whereby ICS suppress inflammation in asthma. Progress has also been made in understanding the molecular mechanisms of corticosteroid resistance in severe asthma and chronic obstructive pulmonary disease. There is no doubt that the early use of ICS revolutionized the management of asthma, with a marked reduction in asthma morbidity and improvement in health status. The efficacy of ICS has now been emphasized in short- and long-term studies in adults and children, but there are still concerns about side effects, especially in children and when high doses of inhalation are used.
Methods and materials
An observational study of the type of cross-sectional study. This study targeted the patients of Damascus Hospital. The sample was randomly selected, and about (100) patients were selected who met specific acceptance criteria, the most important of which is the presence of adequate information in the file, while all patients were excluded according to specific criteria.
Results
In our study, the results indicated differently from previous studies in that the difference between patients who used inhalers and those who did not use inhalers is not statistically significant in either asthma or COPD patients. This is when looking at cases of developing pulmonary infections of all kinds. Our study also has several limitations related to the study pattern, small sample size, and relatively short follow-up period. It is important to note that the risks associated with the use of inhalers must be weighed against the benefits of managing asthma and COPD symptoms. Proper inhalation technique and adherence to treatment regimens can help reduce the risk of developing lung infections.
Conclusion and Recommendations
Inhalers are commonly used by patients with asthma and chronic obstructive pulmonary disease to control their symptoms. There is some concern that use of inhalers may be associated with an increased risk of lung infections in these patients. Studies have found that use of inhaled corticosteroids (ICS) may be associated with a small but statistically significant increase in the risk of developing pneumonia and lower respiratory tract infections (LRTIs) in patients with chronic obstructive pulmonary disease, but not in patients with asthma. While in the study the women from us there is no significant association. The risks associated with the use of inhalers must be weighed against the benefits of symptomatic management of asthma and COPD. Proper inhalation technique and adherence to treatment regimens can help reduce the risk of developing lung infections.
SHoC-IVC: Does assessment of the inferior vena cava by point of care ultrasound independently predict fluid status in spontaneously breathing patients with undifferentiated hypotension?
Authors: Atkinson Paul
Published: August 2023

Background
Accurately determining the fluid status of a patient during resuscitation in the emergency department (ED) helps guide appropriate fluid administration in the setting of undifferentiated hypotension. Our goal was to determine the diagnostic utility of point of care ultrasound (PoCUS) for inferior vena cava (IVC) size and collapsibility in predicting a volume overload fluid status in spontaneously breathing hypotensive ED patients.
Methods
This was a post-hoc secondary analysis of the SHOC-ED data, a prospective randomized controlled trial investigating PoCUS in patients with undifferentiated hypotension. We prospectively collected data on IVC size and collapsibility for 138 patients in the PoCUS group using a standard data collection form, and independently assigned a fluid status (volume overloaded, normal, volume deplete) from a composite clinical chart review blinded to PoCUS findings. The primary outcome was the diagnostic performance of IVC characteristics on PoCUS in the detection of an volume overloaded fluid status.
Results
129 patients had completed determinant IVC assessment by PoCUS, with 125 receiving successful final fluid status determination, of which 107 were classified as volume deplete, 13 normal, and 7 volume overloaded. A receiver operating characteristic (ROC) curve was plotted using several IVC size and collapsibility categories. The best overall performance utilized the combined parameters of a dilated IVC (> 2.5cm) with minimal collapsibility (less than 50%) which had a sensitivity of 85.7% and specificity of 86.4% with an area under the curve (AOC) of 0.92 for predicting an volume overloaded fluid status.
Conclusion
IVC PoCUS is feasible in spontaneously breathing hypotensive adult ED patients, and demonstrates potential value as a predictor of a volume overloaded fluid status in patients with undifferentiated hypotension. IVC size may be the preferred measure.
The limits of inductive reasoning for clinical evidence appraisal – a simulation study (Preprint)
Authors: Mickenautsch Steffen , Yengopal Veerasamy
Published: August 2023

Objectives
To establish the possible likelihood of a body of evidence, inductively judged to be of ‘low bias risk’/‘high-quality’ according to a limited set of appraisal criteria, of actually being error-free.
Methods
A total of 45 simulation trials were generated and randomly assigned to 0–5 errors out of a total of 65 error domains. The trials were then appraised for errors with a simulated appraisal tool consisting of five pre-specified error domains. Trial appraisal yielded either true positive, true negative, false negative or false positive results. From these values, the negative likelihood ratio (–LR) with 95% confidence interval (CI) was computed. –LR computation was repeated 25 times, each with newly generated random values for all 45 trials. The individual results of all 25 runs were statistically pooled. The pooled –LR result with 95% CI was interpreted as how likely a ‘low bias risk’/‘high-quality’ rated body of evidence is actually error-free.
Results
The pooled –LR was 0.84 (95% CI: 0.80–0.88, I2 = 0.0%). The result suggests that error-free evidence is only 1.2 times more likely to be rated as ‘low bias risk’/‘high-quality’ than evidence containing some form of error.
Conclusion
The likelihood of a ‘low bias risk’/‘high-quality’ rated body of evidence being actually error-free is small and the inductive generalisation from any limited, pre-specified set of appraisal criteria rarely justifies a high level of confidence that a ‘low bias risk’/‘high-quality’ rating of clinical evidence reflects the true effect of a certain treatment without being affected by error.
n-3 PUFAs synergistically enhance the efficacy of Doxorubicin by inhibiting the proliferation and invasion of breast cancer cells
Authors: Gurav Pradnya , Patade Tanvi , Hajare Shubham , R.N. Kedar
Published: August 2023

Breast cancer is a major cause of cancer-related deaths for women all over the world. It has a poor prognosis and low survival rates and is typically treated with chemotherapy. Doxorubicin (DOXO) is a potent anti-tumor agent commonly used against breast cancer. However, many patients develop resistance to treatment, leading to a higher risk of relapse and negative outcomes. N-3 polyunsaturated fatty acids are essential fatty acids. They have demonstrated potential in targeting cancerous cells, triggering apoptosis, and preventing tumor growth and spread. Combining these supplements, such as EPA/DHA with DOXO, can enhance the effectiveness of treatment. This study used the combination of DHA, EPA, and DOXO on breast cancer cell line-MCF-7. We observed a significant increase in the cytotoxicity in the combination compared to the DOXO alone. Similarly, the enhancement in the inhibition of metastasis was observed in the combination compared to the DOXO. Cell cycle study results indicated that cells treated with the combination are arrested more in the G1 phase suggesting that the combination is more effective in preventing the cells from entering into the doubling phase. Overall, the combination of n-3 polyunsaturated fatty acids (n-3 PUFAs) is effective in enhancing the effectivity of DOXO by preventing the growth and spread of breast cancer cells.
Strategies for addressing the needs of children with or at risk of developmental disabilities in early childhood by 2030: a systematic umbrella review
Authors: Smythe Tracey , Scherer Nathaniel , Nanyunja Carol , Tann Cally , Olusanya Bolajoko O.
Published: August 2023

Background: There are over 53million children worldwide under five with developmental disabilities, necessitating effective interventions to alleviate the impact of these conditions. However, challenges in delivering interventions persist due to various barriers, particularly in low-income and middle-income countries.
Methods: We conducted a global systematic umbrella review to assess the evidence on early detection, prevention, and rehabilitation interventions for child functioning outcomes related to developmental disabilities in children under five years. We focused on prevalent disabilities worldwide and identified evidence-based interventions at the primary, secondary, and tertiary levels. We searched Medline, Embase, PsychINFO, and Cochrane Library for relevant literature from 1st January 2013 to 14th April 2023. A narrative synthesis approach was used to summarise the findings of the included meta-analyses. The results were presented descriptively, including study characteristics, interventions assessed, and outcomes reported. Further, we presented the global prevalence of each disability in 2019 from the Global Burden of Disease study, identified the regions with the highest burden and the top ten affected countries. This study is registered with PROSPERO, number CRD42023420099.
Results: We included 18 reviews from 883 citations, which included 1,273,444 children under five with or at risk of developmental disabilities from 251 studies across 30 countries. The conditions with adequate data were cerebral palsy, hearing loss, cognitive impairment, autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder. ASD was the most prevalent target disability (n=8 reviews, 44%). Most reviews (n=12, 67%) evaluated early interventions to support behavioural functioning and motor impairment. Only 33% (n=10/30) of studies in the reviews were from middle-income countries, with no studies from low-income countries. Regarding quality, half of reviews were scored as high confidence (n=9/18, 50%), seven as moderate (39%), and two (11%) as low.
Conclusion: We identified geographical and disability-related inequities. There is a lack of evidence from outside high income settings. The study underscores gaps in evidence concerning prevention, identification, and intervention, revealing a stark mismatch between the available evidence base and the regions experiencing the highest prevalence rates.
Prevalence and Gender Differences of Emotional and Behavioral Problems Among Children With Down Syndrome
Authors: Shahzad Ruhaba , Alkarim Alyza , Iqbal Ayesha , Motiwala Oruba
Published: August 2023

This study aimed to shed some light on the emotional and behavioral issues faced by Down syndrome children and their gender differences. Based on evidence gathered from past research following two hypotheses were formed: There will be emotional and behavioral problems among children with Down syndrome; there will be significant gender differences in emotional and behavioral problems faced by children with Down syndrome. A total of 18 Down Syndrome children werethrough Snowball Sampling on whom The Strength and Difficulties Questionnaire was used. The findings showed no significant gender differences in emotional and behavioral problems of children with Down syndrome. However, comparatively, females were shown to have slightly elevated levels of conduct issues.
Reckoning with comparison in the quest for a “better life”: Insights from Cuban and Ecuadorian migration
Authors: Simoni Valerio , Voirol Jérémie , Hjalmarson Elise
Published: August 2023

Looking at the trajectories, experiences, and aspirations of Cuban and Ecuadorian migrants living in Spain or who returned to their homeland following the 2008 economic crisis, this article focuses on the quandaries of comparison involved in the appraisal of different places, values, and visions of a “better life”. Our study leads us to move beyond comparison as a method and heuristic commonly based on the juxtaposition of community-based case studies, toward an analysis of how migrants with different backgrounds and trajectories themselves deploy comparison, which helps shed new light on the motives, stakes, and effects of their endeavors. The approach we propose contributes to advancing our understanding of how migrants cope with the dominant comparative scripts and hierarchies that migration activates, notably by either conforming, subverting, or unravelling them. It also draws attention to comparison’s entanglements with issues of choice, belonging, and its experiential and emotional effects, including the suffering it may elicit. A multi-dimensional exploration of the different ways in which comparison plays out among migrant populations opens promising research avenues to understand the ways it informs transnational living and shapes daily experiences and pursuits of a “better life”, while also raising ethical and epistemological questions for comparative field research on migration.
Genetic Variations in Spike Protein and Linking SARS-CoV-2 Variants to Clinical Outcomes
Authors: Rashid Peshnyar M.A. , Salih Gaza F.
Published: August 2023

The COVID-19 pandemic has witnessed the emergence of diverse variants of SARS-CoV-2, with spike proteins playing a pivotal role in mutation due to their extracellular projection and exposure to immune system pressures. Clinical manifestations of COVID-19 have shown significant variation, ranging from severe symptoms requiring ICU admission or resulting in fatality to asymptomatic cases. This study aims to investigate genetic variations in the spike protein among two distinct groups of SARS-CoV-2 sequences: asymptomatic and ICU/deceased patients. The objective is to explore the viral genetic factors associated with these two clinical outcomes. Our analysis reveals that four spike protein mutations (P26S, D253G, K417N, and D614G) may be partially linked to the ICU/deceased outcome. Additionally, the Omicron and Delta variants exhibit the highest proportions of overall asymptomatic and ICU/deceased patients, respectively. Further evaluation of the ratio of asymptomatic cases to ICU/deceased within a singular variant demonstrates that the Beta and Gamma variants elicit the greatest proportion of asymptomatic and ICU/deceased cases, respectively. In conclusion, our findings suggest a possible association between four spike protein mutations and the outcome of ICU admission or death. The Gamma variants demonstrate greater lethality, while the Delta variants are associated with higher mortality rates.
A study of chronic suppurative otitis media among patients in Damascus Hospital
Authors: Mansour Lyan Mhd Walid , boutros Paula Ehad , Nahas Louei Darjazini
Published: August 2023

Introduction
Otitis media is one of the most common causes of fever in children. The Eustachian tube plays an important role in this disease, and a defect in this tube is found in about 70% of patients who undergo middle ear surgery. The etiology is usually multifactorial. The most common pathogen found in this disease is Staphylococcus aureus (MRSA). Children most at risk are those with low incomes. Chronic suppurative otitis media presents most of the time with pain and discharge of pus from the ear, although the ear can also be dry. Symptoms that can be found but are not essential for making the diagnosis are hearing impairment, tinnitus, and auditory fullness.
Materials and methods
An observational study of the type of cross-sectional study. This study targeted the patients of Damascus Hospital. Where the sample was randomly selected, about (81) patients were selected who meet specific acceptance criteria, the most important of which is the presence of adequate information in the file, while all patients were excluded according to specific exclusion criteria. Data related to this study were collected using paper questionnaires. The information necessary to fill out these forms was collected by returning to the files of the Auriculares Department in the archives of Damascus Hospital.
Results
In this study, we initially evaluated the distribution of a sample of patients with chronic suppurative otitis media according to sex, and we found that the percentage of females was significantly higher compared to males. We also found a higher incidence of chronic suppurative otitis media in the left ear compared to the right, with a close distribution to a large extent. Persistent otorrhea was the most common symptom. As for the degree of hearing loss among the sample, most of them were suffering from mild hearing loss. We found that central tympanic membrane perforation was more common than marginal perforation
Conclusion and Recommendations
Our study found a high incidence of mixed and conductive hearing loss compared to sensorineural in patients with chronic suppurative otitis media. Hearing loss in patients with chronic suppurative otitis media is often mild to moderate in severity. Surgical management is the ideal and most effective option for chronic suppurative otitis media. Therefore, we recommend working on providing effective treatment options that are commensurate with the degree and pattern of chronic suppurative otitis media, so that they are directed to each individual. And work to reduce the development of risk factors for chronic suppurative otitis media in order to prevent its occurrence.
The Validity and Reliability of Malay Version Child Exposure to Domestic Violence Scale
Authors:   Department of Pediatric, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia, Norazman Tina Azreen , Yusoff Surini ,   Department of Pediatric, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia, Mohd Niza@Nizal Hanif ,   Department of Paediatric, Hospital Tuanku Fauziah, Perlis, Malaysia, Taib Fahisham ,   Department of Pediatric, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Paediatric, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Published: August 2023

Background: Domestic violence has a significant impact on growing children. However, existing evidence is limited and often under reported. Consequently, the Child Exposure to Domestic Violence (CEDV) scale has been developed for global use. This study aims to provide a cross-cultural translation, adaptation and validation of the CEDV based on Malay language. Methods: CEDV scale was translated from the original English version to Malay. Content and face validity were examined before field-testing. The study comprised a cross sectional study using the Malay version of the CEDV (CEDV-M) scale conducted at a secondary school in Perlis, Malaysia and investigated 235 children aged 13 years old–16 years old using an online platform. The construct validity, internal consistency and stability of the tool were assessed. Results: The CEDV-M scale’s content and face validity both yielded a value exceeding 0.80. Furthermore, the tool demonstrated has good stability reliability, using the intra-class correlation value for all items ranging from 0.659 to 1.00. The exploratory factor analysis of the 36 items of the CEDV scale revealed possibilities of five or six factor domains. However, the five factor domains were most conceptually equivalent. Consequently, this study found that the CEDV-M scale is reliable with a total Cronbach’s alpha of 0.87. Conclusion: CEDV-M scale is a valid and reliable tool for measuring a child’s experience of domestic violence. Fut
The Key Aspects of Neonatal and Infant Neurological Examination: The Ballard Score, the Infant’s Head with Hydrocephalus and Assessment in a Clinical Setting
Authors:   Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia, Zakaria Zaitun ,   Department of Neurosciences, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia,   Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia, Van Rostenberghe Hans ,   Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Paediatrics, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia, Ramli Noraida ,   Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Paediatrics, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia, Suhaimi Mohamad Syahrain ,   Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Paediatrics, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia, Hazlan Siti Nur Haidar ,   Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Paediatrics, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia, Abdullah Jafri Malin ,   Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Department of Neurosciences, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kelantan, Malaysia,   Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
Published: August 2023

The physical examination of the newborn is essential in diagnosing neurological or neurosurgical conditions in the newborn. This article focuses on three clinical assessments of newborns and infants that are especially important if neurological problems are suspected: The Ballard score, the examination of the head in a baby with (suspected) hydrocephalus, and the neurological and developmental evaluation of an infant in an ambulatory setting. A textual description and a link to a video describe each assessment.
Antibody Response against Severe Acute Respiratory Syndrome Coronavirus 2 Messenger Ribonucleic Acid Vaccines in Infected Individuals: A Systematic Review
Authors:   Department of Biomedical Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia, Roslan Madihah , Mohd Nisfu Farah Ratulfazira ,   Department of Biomedical Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia, Arzmi Mohd Hafiz ,   Department of Fundamental Dental and Medical Sciences, Kulliyyah of Dentistry, International Islamic University Malaysia, Pahang, Malaysia, Abdul Wahab Ridhwan ,   International Medical School, Management and Science University, Selangor, Malaysia, Zainuddin Norafiza ,   Department of Biomedical Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
Published: August 2023

Individuals with a history of coronavirus disease 2019 (COVID-19) exhibit memory immunity acquired during natural infection. However, a decline in immunity after infection renders these individuals vulnerable to re-infection, in addition to a higher risk of infection with new variants. This systematic review examined related studies to elucidate the antibody response in these infected individuals after messenger ribonucleic acid (mRNA) vaccination. Hence, the focus of this review was to ascertain differences in the concentration of binding and neutralising antibodies of previously infected individuals in comparison to those of infection-naïve individuals after administration of two doses of mRNA vaccination through available case-control and cohort studies. Positive reverse transcriptase-polymerase chain reaction (RT-PCR) test or detectable anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies at the baseline in included studies showed categorisation of infected and uninfected individuals. This review utilised three online databases: PubMed, Scopus and Cochrane with the following keywords: (COVID-19 OR ‘Coronavirus Disease 2019’ OR SARS-CoV-2) AND Immun* AND (Pfizer OR BioNTech OR BNT162b2 OR Comirnaty OR Moderna OR mRNA-1273) from January 2019 to July 2021. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) 2020 guidelines and assessment based on the Crowe Critical Appraisal Tool (CCAT), we included 13 related qualified papers of observational studies discerning the binding and neutralising antibody concentrations of infected and uninfected individuals after administration of mRNA vaccines, such as the BNT162b2 and mRNA-1273 vaccine. The mRNA vaccines induced robust binding and neutralising antibody responses in both groups. However, infected individuals showed induction of higher antibody responses in a shorter time compared to uninfected individuals. Hence, a single dose of mRNA vaccination for infected individuals may be sufficient to reach the same level of antibody concentration as that observed in uninfected individuals after receiving two doses of vaccination.
Immunodiagnosis of Fascioliasis in Ruminants by ELISA Method: A Mini-Review
Authors:   School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia, Sudirman Nur Hafizah , Jamil Noor Izani Noor ,   School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia, Mohamad Ahmad Najib ,   Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Kelantan, Malaysia, Wan Abdul Wahab Wan-Nor-Amilah ,   School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
Published: August 2023

Fascioliasis is an important zoonotic disease prevalent in domestic animals and it leads to socioeconomic impact in rural farming communities of the developing world. The gold standard diagnosis of ruminant fascioliasis involves coprological detection of Fasciola spp. eggs or recovery of flukes in infected livers. Coprological analysis is unreliable in the patent period of chronic infection, and even then, its sensitivity is relatively low. Robust diagnostic tools that can promptly and accurately detect an active infection are crucial to avoid complications and further losses in ruminant livestock productivity, as well as to preserve the livelihood of communities at risk. Immunodiagnosis determined by antibody and antigen detection in the sera and faeces of infected ruminants provides a valuable alternative to the parasitological diagnostic approach. This review discusses current developments in immunological techniques by enzyme-linked immunosorbent assay (ELISA) in the detection of ruminant fascioliasis and summarises the performance of various ELISAs in studies conducted to date. Indirect ELISAs demonstrated effective immunodiagnostic performance with high sensitivities and specificities. Cathepsin L ELISA is the most favourable antigen in serodiagnosis, among other recombinant and native proteins evaluated. Sandwich ELISA provides excellent sensitivity and specificity, which correlates well with the fluke burden. Utilising monoclonal antibodies in sandwich ELISA reduces the detection time and performance variations that commonly occur in polyclonal antibody ELISA.
Characteristics of ABO Antibodies in Group O Malaysian Blood Donors Contributors
Authors:   Department of Haematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Kelantan, Malaysia, Saidin Nur Ilyia Syazwani ,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Mohd Noor Noor Haslina ,   Department of Haematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Mohamed Yusoff Shafini ,   Department of Haematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Sauli Mohd Shafiq ,   Department of Haematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Published: August 2023

Background: Haemolytic transfusion reactions (HTRs) due to anti-A and anti-B antibodies in Group O blood products are rare but potentially fatal. This study aimed to identify the prevalence of high ABO antibody titre and the immunoglobulin (Ig) classes (IgM only or with IgG) and the prevalence of haemolysin antibodies in Group O blood donors. Methods: Plasma from Group O blood donors was tested by using antibody titration at room temperature. Titres ≥ 64 were considered high. The plasma was treated with 0.01 M dithiothreitol (DTT) to determine the presence of IgG antibodies and titre. IgG titres ≥ 64 were considered high. Tests for haemolysis were conducted by mixing the plasma with 3% fresh A1 and B cell suspensions and incubating at 37 °C. The haemolysis was observed macroscopically. Results: Of 311 donors, 238 (76.5%) showed high anti-A and/or anti-B antibody titres. The highest antibody titre obtained was 256. Female and younger donors (< 40 years old) had higher anti-A and anti-B titres. The anti-B titre showed an association with gender (P < 0.001), and was high in female donors (77.8%). Males aged over 50 years old were found to have low mean titre antibodies. Most donors had both IgM and IgG ABO antibodies. The prevalence of haemolysins in our population was 3.5%. Conclusion: Most of our O blood donors had a high ABO antibody titre but a low prevalence of haemolysins. Males aged over 50 years old are the best O donors for preventing HTRs, particularly when mismatch transfusion is required. We recommend a transfusion unit screen for ABO antibody titre in younger female donors (< 40 years old), to prevent the transfusion of high titre O blood products into non-O recipients.