bluuebunny/crossref_metadata_2025 huggingface dataset:
Electroacupuncture for the treatment of cancer pain: a systematic review and meta-analysis of randomized clinical trials
Authors: Zhang Junning , Wu Weizhen , Ren Yuehan , Yuan Yi , Jia Liqun
Published: May 2023

Objective

This paper aims to review the current evidence on electroacupuncture as an effective and safe therapy for cancer pain management.

Methods

Five databases were searched from their inception through November 11, 2022. Only the randomized controlled trials that meet the eligibility criteria were finally included in the study. Literature screening and data extraction were performed independently by two reviewers, and RevMan 5.3 used for meta-analysis.

Results

A total of 17 RCTs met our inclusion criteria. We used 8 indicators to estimate the meta-analysis results, most of which proved statistically significant, including VAS scores, NRS scores, and KPS scores. To be specific, VAS scores (MD = −1.41, 95% CI: −2.42 to −0.41, P = 0.006) and NRS scores (MD = −1.19, 95% CI: −1.72 to −0.66, P < 0.0001) were significantly lower in the treatment group compared to the control group. The treatment group's KPS scores (MD = 5.48, 95% CI: 3.27 to 7.69, P < 0.00001) were higher than those of the control group. Also, in the treatment group, the number of burst pain (MD = −2.66, 95% CI: −3.32 to −1.99, P < 0.00001) and side effect rates (RR = 0.51, 95% CI: 0.39 to 0.67, P < 0.00001) greatly reduced, while the response rate (RR = 1.17, 95% CI: 1.09 to 1.26, P < 0.0001) significantly increased compared to the control group.

Conclusion

This study demonstrates the advantages of electroacupuncture in the treatment of cancer pain. Meanwhile, rigorous RCTs should be designed and conducted in the future to further demonstrate the exact efficacy of electroacupuncture.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022376148.
Maternal exposure to antibiotics and risk of atopic dermatitis in childhood: a systematic review and meta-analysis
Authors: Wan Mengjie , Yang Xiaoyang
Published: May 2023

Background

Although the association between maternal exposure to antibiotics and the risk of atopic dermatitis (AD) in childhood has been studied extensively, there still is a lack of clarity on the topic. The aim of this study was to summarize the published data and to examine if maternal exposure to antibiotics increases the risk of AD in childhood.

Methods

Systematic search was performed in PubMed, Scopus, Web of Science, and Embase for all types of studies on the review subject independent of any language restrictions and published up to 28th December 2022. Data was analyzed using random-effects model and presented as pooled odds ratio (OR) with 95% confidence intervals (CI).

Results

A total of 18 studies (5,354,282 mother-child pairs) were included. Maternal exposure to antibiotics was associated with an increased risk of AD in childhood (OR: 1.14, 95% CI: 1.06, 1.22, I2 = 85%, p = 0.0003). The significance of the results was not affected by the location of the study (Asia or Europe). While subgroup analysis based on exposure assessment or diagnosis of AD demonstrated a tendency of increased risk of AD, the association was not statistically significant in multiple subgroups. Segregating data based on the timing of exposure did not affect the significance of the results for studies on all trimesters. However, there was no association between antibiotic exposure in the third trimester or just before delivery and the risk of childhood AD.

Conclusion

The results of this meta-analysis suggest that maternal exposure to antibiotics may lead to a modestly increased risk of AD in offspring. The evidence is limited by high interstudy heterogeneity and bias in exposure and outcome assessment. Future studies are needed to explore if the timing of exposure, the dose, the number of prescriptions, and the type of antibiotic affect this association.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42023387233.
Analysis of congenital hearing loss after neonatal hearing screening
Authors: Verstappen Gill , Foulon Ina , Van den Houte Kelsey , Heuninck Emilie , Van Overmeire Bart , Gordts Frans , Topsakal Vedat
Published: May 2023

Introduction

Neonates undergo neonatal hearing screening to detect congenital hearing loss at an early stage. Once confirmed, it is necessary to perform an etiological workup to start appropriate treatment. The study objective was to assess the different etiologies, risk factors, and hearing results of infants with permanent hearing loss and to evaluate the efficacy and consequences of the different screening devices over the last 21 years.

Methods

We conducted a single-center retrospective cohort analysis for all neonatal hearing screening program referrals and performed an etiological workup in case of confirmed hearing loss. We analyzed the evolution of the etiological protocols based on these results.

Results

The governmental neonatal hearing screening program referred 545 infants to our center. Hearing loss was confirmed in 362 (66.4%) infants and an audiological workup was performed in 458 (84%) cases. 133 (24.4%) infants were diagnosed with permanent hearing loss. Ninety infants (56 bilateral and 34 unilateral) had sensorineural hearing loss, and the degree was predominantly moderate or profound. The most common etiology in bilateral sensorineural hearing loss was a genetic etiology (32.1%), and in unilateral sensorineural hearing loss, an anatomical abnormality (26.5%). Familial history of hearing loss was the most frequently encountered risk factor.

Conclusion

There is a significant number of false positives after the neonatal hearing screening. Permanent hearing loss is found only in a limited number of infants. During the 21 years of this study, we noticed an increase in etiological diagnoses, especially genetic causes, due to more advanced techniques. Genetic causes and anatomical abnormalities are the most common etiology of bilateral and unilateral sensorineural hearing loss, respectively, but a portion remains unknown after extensive examinations.
PTPN2 targets TAK1 for dephosphorylation to improve cellular senescence and promote adipose tissue browning in T2DM
Authors: Liu Yapeng , Han Lu , Zhu Ping , Song Ming , Zhang Yaoyuan , Meng Linlin , Zhang Wei , Zhang Cheng , Zhong Ming
Published: May 2023

Graphical Abstract

The timeline design of animal models.
Olmesartan alleviates SARS-CoV-2 envelope protein induced renal fibrosis by regulating HMGB1 release and autophagic degradation of TGF-β1
Authors: Zhou Shilin , Yu Zanzhe , Chen Zihui , Ning Fengling , Hu Xuetao , Wu Tiangang , Li Mingxue , Xin Hong , Reilly Svetlana , Zhang Xuemei
Published: May 2023

Background and aims: Renal damage in severe coronavirus disease 2019 (COVID-19) is highly associated with mortality. Finding relevant therapeutic candidates that can alleviate it is crucial. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) have been shown to be harmless to COVID-19 patients, but it remains elusive whether ACEIs/ARBs have protective benefits to them. We wished to determine if ACEIs/ARBs had a protective effect on the renal damage associated with COVID-19, and to investigate the mechanism.

Methods: We used the envelope (E) protein of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) to induce COVID-19-like multiple organ damage and observed renal fibrosis. We induced the epithelial–mesenchymal transformation of HK-2 cells with E protein, and found that olmesartan could alleviate it significantly. The protective effects of olmesartan on E protein-induced renal fibrosis were evaluated by renal-function assessment, pathologic alterations, inflammation, and the TGF-β1/Smad2/3 signaling pathway. The distribution of high-mobility group box (HMGB)1 was examined after stimulation with E protein and olmesartan administration.

Results: E protein stimulated HMGB1 release, which triggered the immune response and promoted activation of TGF-β1/Smad2/3 signaling: both could lead to renal fibrosis. Olmesartan regulated the distribution of HMGB1 under E protein stimulation. Olmesartan inhibited the release of HMGB1, and reduced the inflammatory response and activation of TGF-β1/Smad2/3 signaling. Olmesartan increased the cytoplasmic level of HMGB1 to promote the autophagic degradation of TGF-β1, thereby alleviating fibrosis further.

Conclusion: Olmesartan alleviates E protein-induced renal fibrosis by regulating the release of HMGB1 and its mediated autophagic degradation of TGF-β1.
Based on adaptive modulation laser communication multi-microgrids scheduling system
Authors: Chang Ying , Chang Dajun , Su Li
Published: May 2023

In order to improve the data sharing and comprehensive information processing capabilities between multi-microgrids in the power system, the multi-microgrids scheduling system based on laser communication has been proposed. In order to reduce the error rate of laser communication and reduce the impact of atmospheric turbulence on signal acquisition, an adaptive modulation algorithm has been designed. A mathematical model for laser communication modulation and demodulation based on adaptive modulation algorithm has been constructed. In simulation analysis, the target signal was extracted from the original signal superimposed with atmospheric turbulence noise through filtering and demodulation. The energy fluctuation of the extracted signal decreased from 47.3 to 5 mV. The energy attenuation trend of communication lasers within the range of 0–6 km was experimentally tested. Within 2.0 km, the energy demodulation results of both algorithms are similar, both below 10%. After exceeding 2.0 km, the calculation error of the adaptive modulation algorithm remains basically unchanged, while the error of traditional algorithms increases by about twice. For the APD response value, the adaptive modulation algorithm demodulation has a higher response range concentration ratio and the higher envelope recognition. Under different nominal atmospheric turbulence values, the maximum error rates of the adaptive modulation algorithm are 5.8 × 10−8, 8.9 × 10−8, and 1.2 × 10−7, respectively, while the maximum error rates of the amplitude coherent algorithm are 2.9 × 10−5, 6.3 × 10−5, and 1.05 × 10−4, respectively. It can effectively suppress the impact of atmospheric turbulence on the error rate of laser communication by adaptive modulation algorithm.
FTY720 in immuno-regenerative and wound healing technologies for muscle, epithelial and bone regeneration
Authors: Behara Monica , Goudy Steven
Published: May 2023

Graphical Abstract

A schematic summarizing the current delivery mechanisms of FTY720, organ systems and regenerative models reviewed and hall marks of wound healing upon FTY720 delivery.
Peripheral skin cooling during hyper-gravity: hemodynamic reactions
Authors: Kagelmann Niklas , Janke David , Maggioni Martina Anna , Gunga Hanns-Christian , Riveros Rivera Alain , Genov Magdalena , Noppe Alexandra , Habazettl Helmut , Bothe Tomas Lucca , Nordine Michael , Castiglioni Paolo , Opatz Oliver
Published: May 2023

Introduction: Orthostatic dysregulation occurs during exposure to an increased gravitational vector and is especially common upon re-entering standard Earth gravity (1 g) after an extended period in microgravity (0 g). External peripheral skin cooling (PSC) has recently been described as a potent countermeasure against orthostatic dysregulation during heat stress and in lower body negative pressure (LBNP) studies. We therefore hypothesized that PSC may also be an effective countermeasure during hyper-gravity exposure (+Gz).

Methods: To investigate this, we designed a randomized short-arm human centrifuge (SAHC) experiment (“Coolspin”) to investigate whether PSC could act as a stabilizing factor in cardiovascular function during +Gz. Artificial gravity between +1 g and +4 g was generated by a SAHC. 18 healthy male volunteers completed two runs in the SAHC. PSC was applied during one of the two runs and the other run was conducted without cooling. Each run consisted of a 10-min baseline trial followed by a +Gz step protocol marked by increasing g-forces, with each step being 3 min long. The following parameters were measured: blood pressure (BP), heart rate (HR), stroke volume (SV), total peripheral resistance (TPR), cardiac output (CO). Furthermore, a cumulative stress index for each subject was calculated.

Results: +Gz led to significant changes in primary as well as in secondary outcome parameters such as HR, SV, TPR, CO, and BP. However, none of the primary outcome parameters (HR, cumulative stress-index, BP) nor secondary outcome parameters (SV, TPR, CO) showed any significant differences—whether the subject was cooled or not cooled. Systolic BP did, however, tend to be higher amongst the PSC group.

Conclusion: In conclusion, PSC during +Gz did not confer any significant impact on hemodynamic activity or orthostatic stability during +Gz. This may be due to lower PSC responsiveness of the test subjects, or an insufficient level of body surface area used for cooling. Further investigations are warranted in order to comprehensively pinpoint the exact degree of PSC needed to serve as a useful countermeasure system during +Gz.
Phylogenetic relationships and biogeography of Asia Callicarpa (Lamiaceae), with consideration of a long-distance dispersal across the Pacific Ocean —insights into divergence modes of pantropical flora
Authors: Cai Huimin , Liu Xing , Wang Wenqiao , Ma Zhonghui , Li Bo , Bramley Gemma L. C. , Zhang Dianxiang
Published: May 2023

There are about 140 species of Callicarpa L. 1753 (Lamiaceae), with more species richness in tropical to subtropical Asia and the New World. The genus might provide an insight into the amphi-Pacific disjunction pattern of tropical and subtropical vegetation. This study has greatly improved the phylogenetic underpinning for Callicarpa, derived from more inclusive taxonomic samplings, and employing data on both two-nuclear and eight-chloroplast regions. To address time and patterns of diversification in Callicarpa, we conducted divergence time and biogeographic analyses, and inferred shifts in the distribution areas across the phylogenetic clades. Our phylogenetic results show that Callicarpa is monophyletic with respect to the groups considered, and eight well-supported primary clades were discerned in the combined analyses. Our estimates indicated that the crown group of Callicarpa originates around the Late-Eocene (ca. 36.23 Ma) and diversification within most clades is concentrated in the Miocene and continued to the Pleistocene. In addition, our biogeographic analyses suggested that the probable ancestor of the Callicarpa crown clade originated in East Asia and Southeast Asia. Multiple dispersal and vicariance events contributed to the current distribution of the taxa. Furthermore, this genus expanded eastward out of East and Southeast Asia to the New World by long-distance dispersal, which inspired us to better understand the amphi-Pacific disjunct distribution.
Modification of the therapist’s facial expressions using virtual reality technology during the treatment of social anxiety disorder: a case series
Authors: Horigome Toshiro , Yoshida Shigeo , Tanikawa Tomohiro , Mimura Masaru , Kishimoto Taishiro
Published: May 2023

Exposure therapy is a mainstream of treatment for social anxiety disorder (SAD). However, effort and time are required to recreate interpersonal situations that produce moderate anxiety. On the other hand, virtual reality exposure therapy can easily control anxiety-inducing conditions and allow for graduated exposure. However, artificial intelligence and animations that speak as naturally as actual humans are not yet practical, adding to the limitations of these treatments. The authors propose the use of a virtual reality technology that can transform facial expressions into smiling or sad faces in real time and display them on a monitor, potentially solving the above-mentioned problems associated with virtual reality animations. This feasibility study was conducted to determine whether this system can be safely applied to the treatment of SAD patients. A total of four SAD patients received 16 exposure therapy sessions led by an experienced therapist over a monitor; throughout the sessions, the facial expressions of the therapist were modified using software to display expressions ranging from smiling to sad on the monitor that was being viewed by the patient. Client satisfaction, treatment alliance, and symptom assessments were then conducted. Although one patient dropped out of the study, treatment satisfaction and treatment alliance were scored high in all the cases. In two of the four cases, the improvement in symptoms was sustained over time. Exposure therapy in which the interviewer’s facial expressions are modified to induce appropriate levels of anxiety in the patient can be safely used for the treatment of SAD patients and may be effective for some patients.
Influence of sound and light combined conditions in urban environments on residents’ tolerance limits in pre sleep state
Authors: Yu Yue , Feng Danya , Zhang Xin , Kang Jian
Published: May 2023

To determine the sound and light combined conditions pollution in urban residential environments at night, this paper comprehensively evaluates cross-visual and auditory sensory channels in the laboratory. Experimental variables include extremum and gradient, and the working state of the participants was determined and verified. A subjective evaluation experiment on 18 combined conditions was carried out by synthesizing real-world data. Results from the sound and light combined conditions experiment show that there are significant differences in the tolerance limits of participants to different content sound variables (p = 0.000 < 0.05, p = 0.033 < 0.05, p = 0.002 < 0.05). Among them, the traffic noise (p = 0.000 < 0.05) has the greatest impact on the tolerance limits of people, followed by birdsong (p = 0.033 < 0.05) and human voice (p = 0.002 < 0.05). There is no difference in the tolerance limits of light pollution (p = 0.288 > 0.05, p = 0.122 > 0.05, p = 0.146 > 0.05) at different color temperatures. The tolerance limits of participants will not be reduced due to the superposition of two interference variables: sound pollution and light pollution. Adding light pollution to sound pollution can increase the tolerance limits of participants, while adding sound pollution to light pollution has no significant effect on the tolerance limits. The study also found that adding light with different color temperatures to the human voice can increase participants’ tolerance limit to human voice (1% -2%), indicating that visual elements can change individuals’ perception of sound. In addition, the physiological and psychological differences between participants may affect the performance differences of individual participants in sound and light combined conditions.
Using a comfort zone model and daily life situations to develop entrepreneurial competencies and an entrepreneurial mindset
Authors: Van Gelderen Marco
Published: May 2023

This article presents a novel experiential learning format that aims to develop participants' entrepreneurial competencies and entrepreneurial mindset. Furthermore, this study investigates factors that promote individuals' competency development and mindset formation when using this learning format. In this format, students practice enterprising behavior in daily life, rather than by starting a venture. Teams of participants receive a set of eight to 10 challenges. Each challenge asks participants to create value for other people. The challenges are not revealed until the exercise starts, and they are worked on for 1 or 2 days full-time. Each challenge allows participants to practice the competencies of generating ideas for opportunities, taking action, perseverance, networking and network utilization, teamwork, and convincing others. Collectively, this contributes to developing an enterprising mindset. This format is based on a comfort zone model and aims to promote significant learning in a short time. After a week, each participant submits a reflection on their actions during the experiential part. In this study, we analyze the experiences of 198 participating students from six courses in five countries to bring out the factors that contribute to students staying in versus leaving their comfort zone, and the types of learning which result. Learning occurs when participants leave their comfort zone and have experiences that surprise them, leading to novel realizations. Key to learning is the element of surprise.
Aerosols, airflow, and more: examining the interaction of speech and the physical environment
Authors: Everett Caleb , Darquenne Chantal , Niles Renee , Seifert Marva , Tumminello Paul R. , Slade Jonathan H.
Published: May 2023

We describe ongoing efforts to better understand the interaction of spoken languages and their physical environments. We begin by briefly surveying research suggesting that languages evolve in ways that are influenced by the physical characteristics of their environments, however the primary focus is on the converse issue: how speech affects the physical environment. We discuss the speech-based production of airflow and aerosol particles that are buoyant in ambient air, based on some of the results in the literature. Most critically, we demonstrate a novel method used to capture aerosol, airflow, and acoustic data simultaneously. This method captures airflow data via a pneumotachograph and aerosol data via an electrical particle impactor. The data are collected underneath a laminar flow hood while participants breathe pure air, thereby eliminating background aerosol particles and isolating those produced during speech. Given the capabilities of the electrical particle impactor, which has not previously been used to analyze speech-based aerosols, the method allows for the detection of aerosol particles at temporal and physical resolutions exceeding those evident in the literature, even enabling the isolation of the role of individual sound types in the production of aerosols. The aerosols detected via this method range in size from 70 nanometers to 10 micrometers in diameter. Such aerosol particles are capable of hosting airborne pathogens. We discuss how this approach could ultimately yield data that are relevant to airborne disease transmission and offer preliminary results that illustrate such relevance. The method described can help uncover the actual articulatory gestures that generate aerosol emissions, as exemplified here through a discussion focused on plosive aspiration and vocal cord vibration. The results we describe illustrate in new ways the unseen and unheard ways in which spoken languages interact with their physical environments.
The relative reinforcing efficacy of nicotine in an adolescent rat model of attention-deficit hyperactivity disorder
Authors: Smethells John R. , Burroughs Danielle , Saykao Amy , LeSage Mark G.
Published: May 2023

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is an independent risk factor for tobacco use disorder. Individuals with ADHD are more likely to begin smoking at a younger age, become a daily smoker sooner, smoke more cigarettes per day, and exhibit greater nicotine dependence than individuals without ADHD. It is unclear whether these findings are due to the reinforcing efficacy of nicotine per se being greater among individuals with ADHD. The purpose of the present study was to examine this issue using an animal model of ADHD, the spontaneously hypertensive rat (SHR) strain.

Methods

Adolescent SHR and Wistar (control) rats were given access to a typically reinforcing nicotine unit dose (30 μg/kg), a threshold reinforcing nicotine dose (4 μg/kg), or saline under an FR 1 (week 1) and FR 2 (week 2) schedule during 23 h sessions to examine acquisition of self-administration. Behavioral economic demand elasticity was then evaluated at the 30 μg/kg dose through an FR escalation procedure.

Results

At the 30 μg/kg dose, SHR rats exhibited a lower average response rate, lower mean active to inactive lever discrimination ratio, and lower proportion of rats acquiring self-administration compared to control rats. During demand assessment, SHR rats showed no significant difference from Wistars in demand intensity (Q0) or elasticity (α; i.e., reinforcing efficacy). In addition, no strain difference in acquisition measures were observed at the 4 μg/kg dose.

Discussion

These findings suggest that the increased risk of tobacco use disorder in adolescents with ADHD may not be attributable to a greater reinforcing efficacy of nicotine, and that other aspects of tobacco smoking (e.g., non-nicotine constituents, sensory factors) may play a more important role. A policy implication of these findings is that a nicotine standard to reduce initiation of tobacco use among adolescents in the general population may also be effective among those with ADHD.
COVID-19 responses and coping in young Malaysians from low-income families
Authors: Wong Li Ping , Farid Nik Daliana Nik , Alias Haridah , Yusop Sofia Md , Musa Zuhrah , Hu Zhijian , Lin Yulan
Published: May 2023

Introduction

This study aimed to shed light on how young people from low-income families were responding to COVID-19.

Methods

This cross-sectional study recruited young people aged between 18 and 24 years from the low-income-group communities. A convenience sampling approach was used. Google Surveys were used to gather data from the survey. The questionnaire consisted of an assessment of demographic characteristics, lifestyle factors, parent–youth conflict (Parental Environment Questionnaire, PEQ), resilient coping (Brief Resilient Coping Scale, BRCS), and psychological distress (Depression, Anxiety, and Stress Scale-short form, DASS-21).

Results

A total of 561 complete responses were received. The results showed a low level of parent–child conflict in the overall study population, with a median PEQ of 48.0 [interquartile range (IQR) 36–48]. Higher parent–child conflicts were found in females than in males (OR = 1.75, 95% CI 1.19–2.57) and in youth from households with an income below MYR 2000 than those earning MYR 3,001–5,000 (OR = 4.39, 95% CI 2.40–8.03). A low prevalence of depression (12.5%), anxiety (15.2%), and stress (6.4%) was found. Parent–child conflict remains the strongest significant predictor for higher levels of depression (OR = 10.90, 95% CI 4.31–27.57), anxiety (OR = 11.92, 95% CI 5.05–28.14), and stress (OR = 4.79, 95% CI 1.41–16.33) symptoms. Poor resilient coping was the second strongest predictor for depression and anxiety symptoms. Regarding lifestyle factors, a lower level of physical exercise was associated with higher symptoms of depression. By demographics, females reported more severe symptoms of depression and anxiety than males. Young people from low-income households reported greater severity in symptoms of depression, anxiety, and stress than those from high-income households. Young people who are employed also reported greater severity of anxiety symptoms than those who are unemployed.

Discussion

The COVID-19 pandemic continues to have an unpredictable impact on the lives of vulnerable youth in low-income families that warrants attention in future advocacy efforts.
Post-COVID-19 syndrome and quality of life impairment in severe COVID-19 Mexican patients
Authors: Román-Montes Carla Marina , Flores-Soto Yesenia , Guaracha-Basañez Guillermo Arturo , Tamez-Torres Karla María , Sifuentes-Osornio José , González-Lara Ma. Fernanda , León Alfredo Ponce de
Published: May 2023

Introduction

Post-COVID-19 syndrome (PCS) usually occurs 3 months after the onset of COVID-19 with a symptom duration of at least 2 months without an alternative diagnosis.

Objective

This study aimed to describe the prevalence, characteristics, and impact on the quality of life (QoL) of post-COVID-19 syndrome in patients with a history of hospitalization for COVID-19.

Materials and methods

We conducted a cross-sectional study. Patients who required hospitalization due to COVID-19 between March 2020 and October 2021 were invited to answer a PCS questionnaire and the EQ-5D instrument. A total of 246 patients were included: 187 (76%) met the definition of PCS and 54% were men, with a median age of 50 years (IQR 41–63).

Results

From 187 patients with PCS, the median time to symptom onset after hospital discharge was 1 day (IQR 1–20), and the median symptom duration was 150 days (IQR 90–225). A total of 27 different symptoms were reported; the most frequent were difficulty concentrating (81%), dyspnea (75%), arthralgia (71%), fatigue (68%), and hair loss (60%). Some symptoms, such as difficulty concentrating, arthralgia/myalgia, and hair loss, were more prevalent in women with PCS. Patients with PCS had a higher frequency of tobacco smoking (37 vs. 4%, p = 0.02) and increased severity of lung involvement in the initial chest tomography (75 vs. 58%, p = 0.01) than those without PCS. Patients with PCS were less likely to receive antivirals (15.5 vs. 27%, p = 0.04). No difference between ICU admission, mechanical ventilation, and length of hospital stay was found. Patients with PCS had a lower visual analog scale result for EQ-5D vs. those without (80 [IQR 70–90] vs. 89.5 [IQR 75–90], p = 0.05). All five QoL dimensions were affected in PCS patients, showing increased pain/discomfort (67 vs. 39%, p = < 0.001), difficulties in performing usual activities (39.2 vs. 20.3%, p = 0.03), and anxiety/depression (57.5 vs. 37%, p = 0.02).

Conclusion

PCS occurred in 76% of hospitalized patients with prolonged duration and QoL impairment. Neurological symptoms such as difficulty concentrating were the most frequent symptoms. Timely diagnostic and therapeutic interventions are required.
Evolution of rehabilitation services in response to a global pandemic: reflection on opportunities and challenges ahead
Authors: Bossuyt Fransiska M. , Bogdanova Yelena , Kingsley Kristine T. , Bergquist Thomas F. , Kolakowsky-Hayner Stephanie A. , Omar Zaliha Binti , Popova Evguenia S. , Tobita Mari , Constantinidou Fofi
Published: May 2023

The rapidly evolving COVID-19 public health emergency has disrupted and challenged traditional healthcare, rehabilitation services, and treatment delivery worldwide. This perspective paper aimed to unite experiences and perspectives from an international group of rehabilitation providers while reflecting on the lessons learned from the challenges and opportunities raised during the COVID-19 pandemic. We discuss the global appreciation for rehabilitation services and changes in access to healthcare, including virtual, home-based rehabilitation, and long-term care rehabilitation. We illustrate lessons learned by highlighting successful rehabilitation approaches from the US, Belgium, and Japan.
Four-dimensional characterization of a PFOA-contaminated fractured rock aquifer (FRA) in Bennington, Vermont, U.S.A
Authors: Kim Jonathan J. , Ryan Peter C. , Schroeder Timothy , Romanowicz Edwin , Boutt David , Belaval Marcel , Shanley James
Published: May 2023

Between 2016 and 2019, the Vermont Department of Environmental Conservation discovered that groundwater from over 50% (355/628) of wells and springs in the Bennington area had perfluorooctanoic acid (PFOA) concentrations > 20 parts/trillion (ppt) (Vermont action level). The distribution of contaminated wells was complex, with very different PFOA concentrations in closely-spaced wells (<100 m apart). PFOA was introduced into the environment by a factory that produced Teflon™-coated fabrics from about 1978–2002. Manufacturing involved PFOA expulsion from smokestacks followed by atmospheric transport, deposition, and downward leaching to the aquifer system. The fractured rock aquifer was characterized through physical components (geologic mapping, spatial analysis of wells, and geophysical logging) to build a Three-dimensional conceptual model and then map the spatial distribution of chemical groundwater tracers (PFOA, major and trace elements, stable isotopes, and and recharge ages), adding a fourth temporal dimension. The field area consists of four imbricated metamorphic rock slices bounded by thrust faults. The dominant fracture sets that overprint these slices control the N-S and E-W topographic “grain.” Geophysical logging divided wells into those completed internal to or on the margins of thrust slices. Major and trace element analysis shows that groundwater can be spatially discriminated into carbonate (TDS, Ca, Mg, HCO3), shaly (Sr, U, SO4), and siliceous (K, Si) groups. Depleted H2O stable isotope signatures characterize the siliceous group. Recharge-ages determined from CFC11, 12, and 113 and tritium correlate with geochemical groups and were divided into “older” (~1953–73) and “younger” (1963–88), which predate and are synchronous with factory operation, respectively. Our conceptual model shows recharge from highlands to the west and east flowing toward the Bennington valley where it is locally tapped by wells along thrust faults or fracture zones. This water has older recharge ages and anomalously low PFOA concentrations (<6.7 ppt in 12 of 15 samples, mean = 7.9 ppt) compared to the majority of wells in this region, which are completed in the internal portions of thrust slices. These wells contain groundwater with younger recharge ages and high PFOA concentrations (mean = 290 ppt) and occurrence (>20 ppt in 28/36 samples), indicating mixing of younger and older waters.
Modernising Receiver Operating Characteristic (ROC) Curves
Authors: Pendrill Leslie R. , Melin Jeanette , Stavelin Anne , Nordin Gunnar
Published: May 2023

The justification for making a measurement can be sought in asking what decisions are based on measurement, such as in assessing the compliance of a quality characteristic of an entity in relation to a specification limit, SL. The relative performance of testing devices and classification algorithms used in assessing compliance is often evaluated using the venerable and ever popular receiver operating characteristic (ROC). However, the ROC tool has potentially all the limitations of classic test theory (CTT) such as the non-linearity, effects of ordinality and confounding task difficulty and instrument ability. These limitations, inherent and often unacknowledged when using the ROC tool, are tackled here for the first time with a modernised approach combining measurement system analysis (MSA) and item response theory (IRT), using data from pregnancy testing as an example. The new method of assessing device ability from separate Rasch IRT regressions for each axis of ROC curves is found to perform significantly better, with correlation coefficients with traditional area-under-curve metrics of at least 0.92 which exceeds that of linearised ROC plots, such as Linacre’s, and is recommended to replace other approaches for device assessment. The resulting improved measurement quality of each ROC curve achieved with this original approach should enable more reliable decision-making in conformity assessment in many scenarios, including machine learning, where its use as a metric for assessing classification algorithms has become almost indispensable.
Comparison of Cassava Chips and Winged Bean Tubers with Various Starch Modifications on Chemical Composition, the Kinetics of Gas, Ruminal Degradation, and Ruminal Fermentation Characteristics Using an In Situ Nylon Bag and an In Vitro Gas Production Technique
Authors: Unnawong Narirat , Suriyapha Chaichana , Khonkhaeng Benjamad , Chankaew Sompong , Rakvong Teppratan , Polyorach Sineenart , Cherdthong Anusorn
Published: May 2023

This research assessed the impact of cassava chips (CSC) and winged bean tubers (WBT) with various starch modification methods on the chemical composition, ruminal degradation, gas production, in vitro degradability, and ruminal fermentation of feed using an in situ and in vitro gas production technique. Experimental treatments were arranged for a 2 × 5 factorial, a completely randomized design with two sources of starch and five levels of modification treatments. Two sources of starch were CSC and WBT, while five modification treatments of starch were: no modification treatment, steam treatment, sodium hydroxide (NaOH) treatment, calcium hydroxide (CaOH2) treatment, and lactic acid (LA) treatment. The starch modification methods with NaOH and CaOH2 increased the ash content (p < 0.05), whereas the crude protein (CP) content was lower after treatment with NaOH (p < 0.05). Steam reduced the soluble fraction (a) and effective dry matter degradability of WBT in situ (p < 0.05). In addition, the WBT steaming methods result in a lower degradation rate constant in situ (p < 0.05). The degradation rate constants for the insoluble fraction (c) in the untreated CSC were higher than those of the other groups. Starch modification with LA reduced in vitro dry matter degradability at 12 and 24 h of incubation (p < 0.05). The starch modification method of the raw material showed the lowest pH value at 4 h (p < 0.05). The source of starch and starch modification methods did not influence the in vitro ammonia nitrogen concentrations, or in vitro volatile fatty acids. In conclusion, compared to the CSC group and untreated treatment, treating WBT with steam might be a more effective strategy for enhancing feed efficiency by decreasing or retarding ruminal starch degradability and maintaining ruminal pH.
IT-Based Decision Support for Holistic Healthcare Management in Times of VUCA, Disorder, and Disruption
Authors: Steffen Barbara , Braun von Reinersdorff Andrea , Rasche Christoph
Published: May 2023

The healthcare landscape is facing serious changes driven by digitalization and its VUCA (volatile, uncertain, complex, and ambiguous) conditions. These disrupt the stability of the old order and its static routines. In addition, the global pandemic, technological advances, and patients’ desire for customer rights are reinforcing the need for an accelerated paradigm shift in established healthcare organizations. However, most healthcare organizations are still struggling to close the digitalization gap. They are unprepared to evolve into dynamic VUCA service organizations. To help healthcare organizations to better understand and adapt to the new conditions, we propose an IT-based multi-perspective analysis process enabling holistic understanding and decision-making to derive customized digitalization strategies. To achieve this, it is essential to develop a semantic layer of knowledge mapping and integration. This article introduces the GOLD Framework and its corresponding IT-tool support to derive a holistic understanding based on selecting and connecting suitable methods/theories and guiding the users in their correct use. The required formalization of the IT-tool support ensures consistency and is the basis for continuous improvement. The approach covers the complete process, from sensing new opportunities and/or threats to seizing organization-specific strategies to transforming towards digitally enabled service organizations. Its novelty is threefold: (1) It offers a new level of shared understanding and stakeholder alignment by making the holistic dependencies visible and tangible; (2) it guides the diverse stakeholders step by step; (3) and is based on a standardized approach which however also enables and supports the customization of steps and guidance to better suit the targeted domain and its needs.
Monoclonal Antibody-Based Colorimetric Lateral Flow Immunoassay for the Detection of Pyridaben in the Environment
Authors: Chen He , Liu Hao , Ji Yanran , Sha Zekun , An Li , Li Meng , Zhang Di , Wu Xujin , Hua Xiude
Published: May 2023

Pyridaben, a broad-spectrum pyridazinone acaricide that is widely used in agricultural production, can induce neurotoxicity and reproductive abnormalities, and is highly toxic to aquatic organisms. In this study, a pyridaben hapten was synthesized and used to prepare monoclonal antibodies (mAbs), among which 6E3G8D7 showed the highest sensitivity in indirect competitive enzyme-linked immunosorbent assay, with a 50% inhibitory concentration (IC50) of 3.49 ng mL−1. The mAb, 6E3G8D7, was further applied to a gold nanoparticle-based colorimetric lateral flow immunoassay (CLFIA) for pyridaben detection, according to the signal intensity ratio of the test line to the control line, which showed a visual limit of detection of 5 ng mL−1. The CLFIA also showed high specificity and achieved excellent accuracy in different matrices. In addition, the amounts of pyridaben in blind samples detected by the CLFIA, were consistent with high-performance liquid chromatography. Therefore, the developed CLFIA is considered a promising, reliable, and portable method for pyridaben on-site detection in agro-products and environmental samples.
Wearable Triboelectric Nanogenerator with Ground-Coupled Electrode for Biomechanical Energy Harvesting and Sensing
Authors: Su Kangyu , Lin Xiaobo , Liu Zhangwei , Tian Yun , Peng Zhengchun , Meng Bo
Published: May 2023

Harvesting biomechanical energy for electricity as well as physiological monitoring is a major development trend for wearable devices. In this article, we report a wearable triboelectric nanogenerator (TENG) with a ground-coupled electrode. It has a considerable output performance for harvesting human biomechanical energy and can also be used as a human motion sensor. The reference electrode of this device achieves a lower potential by coupling with the ground to form a coupling capacitor. Such a design can significantly improve the TENG’s outputs. A maximum output voltage up to 946 V and a short-circuit current of 36.3 μA are achieved. The quantity of the charge that transfers during one step of an adult walking reaches 419.6 nC, while it is only 100.8 nC for the separate single-electrode-structured device. In addition, using the human body as a natural conductor to connect the reference electrode allows the device to drive the shoelaces with integrated LEDs. Finally, the wearable TENG is able to perform motion monitoring and sensing, such as human gait recognition, step count and movement speed calculation. These show great application prospects of the presented TENG device in wearable electronics.
Evaluation of Gliomas with Magnetic Resonance Fingerprinting with PET Correlation—A Comparative Study
Authors: Marik Wolfgang , Cardoso Pedro Lima , Springer Elisabeth , Bogner Wolfgang , Preusser Matthias , Widhalm Georg , Hangel Gilbert , Hainfellner Johannes A. , Rausch Ivo , Weber Michael , Schmidbauer Victor , Traub-Weidinger Tatjana , Trattnig Siegfried
Published: May 2023

Objectives: Advanced MR imaging of brain tumors is still mainly based on qualitative imaging. PET imaging offers additive metabolic information, and MR fingerprinting (MRF) offers a novel approach to quantitative data acquisition. The purpose of this study was to evaluate the ability of MRF to predict tumor regions and grading in combination with PET. Methods: Seventeen patients with histologically verified infiltrating gliomas and available amino-acid PET data were enrolled. ROIs for solid tumor parts (SPo), perifocal edema (ED1), and normal-appearing white matter (NAWM) were selected on conventional MRI sequences and aligned to the MRF and PET images. The predictability of gliomas by region and grading as well as intermodal correlations were assessed. Results: For MRF, we calculated an overall predictability by region (SPo, ED1, and NAWM) for all of the MRF parameters of 76.5%, 47.1%, and 94.1%, respectively. The overall ability to distinguish low- from high-grade gliomas using MRF was 88.9% for LGG and 75% for HGG, with an accuracy of 82.4%, a ppV of 85.71%, and an npV of 80%. PET positivity was found in 13/17 patients for solid tumor parts, and in 3/17 patients for the edema region. However, there was no significant difference in region-specific MRF values between PET positive and PET negative patients. Conclusions: MRF and PET provide quantitative measurements of the tumor tissue characteristics of gliomas, with good predictability. Nonetheless, the results are dissimilar, reflecting the different underlying mechanisms of each method.
Efficacy and Safety of First-Line Cytokines Versus Sunitinib and Second-Line Axitinib for Patients with Metastatic Renal Cell Carcinoma (ESCAPE Study): A Phase III, Randomized, Sequential Open-Label Study
Authors: Kadono Yoshifumi , Konaka Hiroyuki , Nohara Takahiro , Izumi Kouji , Anai Satoshi , Fujimoto Kiyohide , Koguchi Tomoyuki , Ishibashi Kei , Kawai Noriyasu , Nakane Keita , Iba Akinori , Masumori Naoya , Takahara Shizuko , Mizokami Atsushi
Published: May 2023

Background: The sequence of first-line cytokine and second-line molecular targeted therapies may be suitable for some patients with metastatic renal cell carcinoma (mRCC) because of the expectation of complete remission and durable response achieved with cytokine therapy. Methods: This was a phase III randomized controlled trial investigating the outcomes of low-dose interleukin-2 (IL-2) plus interferon alfa (IFNα) versus sunitinib as the first line and axitinib as the second line in patients with low- and intermediate-risk mRCC. Results: Thirty-five patients were randomly assigned. The total progression-free survival (PFS) to the end of the second line was 29.0 months (95% CI, 11.7–46.3) in the IL-2 + IFNα group and 16.3 months (95% CI, 6.3–26.4) in the sunitinib group. The PFS hazard ratio for the IL-2 + IFNα group relative to the sunitinib group was 0.401 (95% CI, 0.121–1.328; p = 0.135). The hazard ratio for overall survival (OS) was 1.675 (95% CI, 0.418–6.705; p = 0.466), which was better in the sunitinib group than in the IL-2 + IFNα group but not statistically significant. The types of adverse events (AEs) differed significantly, although there was no significant difference in the incidence of AEs. Conclusions: There was a trend toward better total PFS for IL-2 + IFNα, but it was not significant. There was also no advantage of IL-2 + IFNα in terms of OS. The study was underpowered to draw any definitive conclusions. The results showed no clear advantage of IL-2 + IFNα over sunitinib in the first-line setting; however, it may be an option in some relatively low-risk mRCC cases due to the difference in the AE profile. This trial was registered with the University Hospital Medical Information Network (UMIN), center identifier UMIN 000012522.
Preoperative Dose-Escalated Intensity-Modulated Radiotherapy (IMRT) and Intraoperative Radiation Therapy (IORT) in Patients with Retroperitoneal Soft-Tissue Sarcoma: Final Results of a Clinical Phase I/II Trial
Authors: Seidensaal Katharina , Dostal Matthias , Kudak Andreas , Jaekel Cornelia , Meixner Eva , Liermann Jakob , Weykamp Fabian , Hoegen Philipp , Mechtersheimer Gunhild , Willis Franziska , Schneider Martin , Debus Jürgen
Published: May 2023

Background: To report the final results of a prospective, one-armed, single-center phase I/II trial (NCT01566123). Methods: Between 2007 and 2017, 37 patients with primary or recurrent (N = 6) retroperitoneal sarcomas were enrolled. Treatment included preoperative IMRT of 45–50 Gy with a simultaneous integrated boost of 50–56 Gy, surgery and IORT. The primary endpoint was local control (LC) at 5 years. The most common histology was dedifferentiated liposarcoma (51%), followed by leiomyosarcoma (24%) and well-differentiated liposarcoma (14%). The majority of lesions were high-grade (FNCLCC G1: 30%, G2: 38%, G3: 27%, two missing). Five patients were excluded from LC analysis per protocol. Results: The minimum follow-up of the survivors was 62 months (median: 109; maximum 162). IORT was performed for 27 patients. Thirty-five patients underwent gross total resection; the pathological resection margin was mostly R+ (80%) and, less often, R0 (20%). We observed 10 local recurrences. The 5-year LC of the whole cohort was 59.6%. Eleven patients received a dose > 50 Gy plus IORT boost; LC was 64.8%; the difference, however, was not significant (p = 0.588). Of 37 patients, 15 were alive and 22 deceased at the time of final analysis. The 5-year OS was 59.5% (68.8% per protocol). Conclusions: The primary endpoint of a 5-year LC of 70% was not met. This might be explained by the inclusion of recurrent disease and the high rate of G3 lesions and leiomyosarcoma, which have been shown to profit less from radiotherapy. Stratification by grading and histology should be considered for future studies.