bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fractures
Authors: Cirillo Juan Ignacio , Farias Ignacio , Pino Cristóbal del , Gimbernat Marcos , Urzúa Alejandro , Tapia Carlos , Zamorano Juan José
Published: April 2023

Background
thoracolumbar burst fractures are associated with spinal canal occupation. The indirect decompression of the spinal canal and reduction of the fragment can be achieved with the distraction of the middle column and ligamentotaxis. Nevertheless, the factors that influence the effectiveness of this procedure and its temporality are controversial.
Methods
The aim of this observational, cross-sectional study was to evaluate the effectiveness of indirect reduction by ligamentotaxis in thoracolumbar burst fractures according to the fracture's radiologic characteristics and the procedure's temporality. Patients diagnosed with a thoracolumbar burst fracture between 2010 and 2021 were submitted to indirect reduction by distraction and ligamentotaxis. A retrospective analysis of radiologic characteristics and temporality of the procedure was performed with an independent sample t-test or Pearson's correlation coefficient, as required.
Results
A total of 58 patients were included in the analysis. Postoperatively, ligamentotaxis significantly improved all radiologic parameters (canal occupation, endplates distance, and vertebra height). Still, none of the radiological characteristics of the fracture (width, height, position, sagittal angle) were associated with the postoperative change in canal occupation. The endplates distance and the temporality of ligamentotaxis significantly predicted the reduction of the fracture.
Conclusion
Fragment reduction effectiveness is more significant when performed as early as possible and adequate distraction is achieved using the internal fixator system. The radiologic characteristics of the fractured fragment do not determine its reduction capacity.
Risk factors for moderate-to-severe acute pain after hepatobiliary and pancreatic surgery: a single-center retrospective study
Authors: Zhang Hui , Yang Yitian , Jiang Lulu , Xu Xiaodong , Zhang Jiaqiang , Zhang Lianzhong
Published: April 2023

Background
Inadequate postoperative analgesia is related to increased risks of many postoperative complications, prolonged hospital stay, declined quality of life, and increased costs.
Objectives
This study investigated the risk factors for moderate-to-severe postoperative pain during the first 24 hours and 24–48 hours after major hepatobiliary pancreatic surgery.
Methods
Data of patients who underwent surgery at the Department of Hepatobiliary Surgery in Henan Provincial People's Hospital were collected from January 2018 to August 2020. Univariate and multivariate logistic regression analyses were used to identify the risk factors of postoperative pain.
Results
In total, 2,180 patients were included in the final analysis. 183 patients (8.4%) suffered moderate-to-severe pain within 24 hours after operation. The independent risk factors associated with moderate-to-severe pain 24 hours after procedures were younger age (OR, 0.97; 95% CI, 0.95 to 0.98, P < 0.001), lower BMI (OR, 0.94; 95% CI, 0.89 to 0.98, P = 0.018), open surgery (OR, 0.34; 95% CI, 0.22 to 0.52, P < 0.001), and postoperative analgesia protocol with sufentanil (OR, 4.38; 95% CI, 3.2 to 5.99, P < 0.001). Postoperative hospital stay was longer in patients with inadequate analgesia (P < 0.05).
Conclusion
Age, BMI, laparoscopic surgery, and different analgesic drugs were significant predictors of postoperative pain after major hepatobiliary and pancreatic surgery.
Trial registration:
Chinese Clinical Trial Registry ChiCTR2100049726
An Observational Study of the Pharmacokinetics of Adductor Canal Block using Liposomal Bupivacaine and in Total Knee Arthroplasty
Authors: Chan Will Shing Him , Chan Timmy Chi Wing , Mak Henry Chi Yeung , Chan Manson Tak Hei , Cheung Clement Hoo Chun , Leung Susan Wai Sum , Li Steve Po Yam , Wong Stanley Sau Ching , Cheung Chi Wai
Published: April 2023

BackgroundPeriarticular local infiltration of analgesia (LIA) and regional nerve block using adductor canal block (ACB) have been described as effective in managing postoperative pain for total knee arthroplasty (TKA). It has been shown that combining ACB with LIA can significantly reduce pain scores and postoperative consumption of morphine compared with LIA alone. However, this may raise concerns about the potential risk of local anesthetic systemic toxicity (LAST), especially with the large doses of total local anesthetic used in both LIA and ACB. The purpose of this study was to evaluate the plasma level of bupivacaine over a 72-hour period following ACB using 66.5 mg of liposomal bupivacaine (LB) in patients undergoing TKA with LIA using 300 mg ropivacaine. This study aims to provide some pharmacokinetic (PK) data of LB in ACB for future dose defining study on LB in ACB together with LIA.MethodsThis was a prospective observational study.Ethical approval for this study (Reference Number UW 20 -589) was provided by the Ethical Committee, Institutional Review Board of the University of Hong Kong / Hospital Authority Hong Kong West Cluster, Queen Mary Hospital, Hong Kong (Chairman Prof. Brian Lang) on 6 October 2020.Ten patients undergoing primary, unilateral, simple revision TKA were included in the study from December 2020 – February 2022. The primary outcomes were the time to peak plasma concentration (Tmax) of bupivacaine and the peak plasma concentration (Cmax) of bupivacaine. The secondary outcome was the presence of LAST.ResultsTmaxof bupivacaine was 48 hours while Cmax of bupivacaine was 88 mcg/L, this value was far below 2000 mcg/L, the defined toxic plasma concentration of bupivacaine.ConclusionsThe report's only validity resides with the dataset describing Tmax and Cmax of LB in a small cohort undergoing TKR.Trial registrationThe clinical trial was registered at ClinicalTrials.gov on 07/06/2021 with registration number NCT04916392.
Implementing telehealth interventions between medical care and nursing homes in rural areas of Germany to enable regular medical support in everyday care procedures – a qualitative pre-post study
Authors: Brandt¹ Benigna , May Susann , Münte Catharina , Zahn Thomas , Heinze Martin
Published: April 2023

Background
Currently, there is a shortage of general practitioners and specialists in rural areas in Germany. In particular, people who are not mobile are at risk of not being provided adequately with medical care. This development is expected to increase in the coming years. One approach to counteracting this problem is the use of telemedicine. In two rural areas in Brandenburg/Germany, a telemedical intervention (video consultation and data exchange) is therefore to be tested in the general practitioner care of people living in nursing homes. The aim of this study is to investigate the expectations, experiences, barriers and motivation for the use from the perspective of the professional groups involved (physicians, nurses, software developers, legal supervisors).
Methods
The duration of the telemedicine intervention was six months. Following a qualitative pre-post design, interviews with the professionals were conducted at two time points, before the implementation of telemedicine interventions (t0) and after the implementation (t1). For the analysis of the interviews, the inductive-deductive approach according to Kuckartz was followed.
Results
In total 20 interviews were conducted. At t0 a positive influence on time savings, more efficient cooperation between nursing and medical care, an improved image of the institution and higher satisfaction of nursing home residents was expected. At t1, an improved quality of care, more efficient work, as well as an attractive image for the institution were positively emphasized. Enormous obstacles resulted from the fact that the technical interfaces of the different documentation systems were not compatible or technically unattainable. Video consultation and data exchange worked particularly well in cases where: 1. where patients/residents changed settings (e.g., from hospital back to nursing home) 2. frequent physician visits were required (e.g., wound checks) 3. routine appointments between physician and nurses with little or no contact with patients.
Conclusions
Telemedicine interventions such as video consultation and shared documentation systems can relieve the existing care structures and supplement them with additional elements, provided that the technical and legal framework conditions allow this. However, the use of telemedical interventions cannot replace the personal visit but is to be understood as an additional option.
Early detection of vaccine-derived poliovirus outbreaks using nested PCR and nanopore sequencing in the Democratic Republic of Congo, 2021-2022
Authors: Shaw Alexander , Mampuela Tresor Kabeya , Lofiko Emmanuel Lokilo , Pratt Catherine , Troman Catherine , Bujaki Erika , O'Toole Aine , Akello Joyce , Aziza Adrienne Amuri , Lusamaki Eddy Kinganda , Cigolo Jean-Claude Makangara , Akonga Marceline , Lay Yvonne , Nsunda Bibiche , White Bailey , Jorgensen David , Pukuta Elisabeth , Riziki Yogolelo , Rankin Kathleen , Rambaut Andrew , Ahuka-Mundeke Steve , Muyembe Jean-Jacques , Martin Javier , Grassly Nicholas , Mbala-Kingebeni Placide
Published: April 2023

Delayed detection of poliovirus outbreaks is a major threat to polio eradication. Direct molecular Detection and Nanopore Sequencing (DDNS) of stool samples shows promise as a faster method to detect and confirm polio cases compared with cell culture but has not been assessed prospectively during routine surveillance. We report on the implementation of prospective testing of all stool samples received from suspected polio cases and their contacts in the Democratic Republic of Congo between 10th August 2021 to 4th February 2022. DDNS detected polioviruses in 62/2339 (2.7%) of samples whilst the standard algorithm of cell culture, qPCR and Sanger sequencing detected 51/2339 (2.2%). The sensitivity and specificity of DDNS was not significantly different from cell culture. DDNS provided the VP1 sequence required for case confirmation on average 7 days after sample receipt compared with 30 days for the standard algorithm, allowing detection of three new cVPDV2 outbreaks a mean of 23 days earlier (range 6-30 days) and was estimated to cost less per sample tested. The mean sequence similarity between sequences obtained by the two methods was 99.98%. Continued implementation of DDNS in DRC and expansion to other countries will allow further evaluation of this method and inform its potential recommendation by the Global Polio Laboratory Network.
Design and application of cloud computing recommendation based on genetic algorithm in piano online course video system
Authors: Fang Bing , Liang XiaoMei
Published: April 2023

The current research papers mostly focus on the analysis of the teaching value of online piano courses, and do not design the video system of online piano courses. By using the cloud computing recommendation of genetic algorithm, this paper provides optimization countermeasures in terms of optimizing curriculum design according to the characteristics of students' piano practice, strengthening interaction with students' practice and guiding learning methods by establishing a cooperative learning system for teachers, aiming at the problems of piano teaching knowledge, skills and comprehensive ability in the offline practice process of piano majors, and the lack of self-management ability in the teaching process. Genetic algorithm provides a general framework for the complex multi constraint problem of online teaching system, and provides a good solution to the system design problem of multi-objective optimization. Using the optimization model obtained by big data sorting and multiple genetic operations, and discussing the application value of optimization methods in the design of piano online teaching video system, this paper will further take the piano online teaching video system as a research case, and draw a conclusion that the model has been significantly improved in various indicators. The results show that the cloud computing recommended optimized piano online course video system has high performance.
Economic Burden and Coping Mechanisms by Tuberculosis Treatment Supporters: A Mixed Method Approach from Bono Region, Ghana
Authors: Bio Robert Bagngmen , Akweongo Patricia , Adomah-Afari Augustine , Koduah Augustina
Published: April 2023

Background: The Directly Observed Therapy Short Course (DOTS) strategy recommended by World Health Organization for tuberculosis control requires multiple clinic visits which may place economic burden on treatment supporters especially those with low socio-economic status. The End tuberculosis goal targeted eliminating all tuberculosis associated costs. However, the economic burden and coping mechanisms by treatment supporters is unknown in Ghana.
Objectives: The study determined the economic burden and coping mechanism by treatment supporters in Bono Region of Ghana.
Methods: Cross-sectional study using mixed method approach for data collection. For the quantitative data, a validated questionnaire was administered to 385 treatment supporters. Sixty in-depth interviews with treatment supporters to elicit information about their coping mechanisms using a semi-structured interview guide for the qualitative data. Descriptive statistics, costs estimation, thematic analysis and bivariate techniques were used for the data analysis.
Results: Averagely, each treatment supporter spent GHS 112.4 (US$21.1) on treatment support activities per month which is about 19% of their monthly income. Borrowing of money, sale of assets, used up saving were the major coping mechanisms used by treatment supporters. Highest level of education, household size, marital status and income level significantly influence both the direct and indirect costs associated with tuberculosis treatment support. The significant levels were set at 95% confidence interval and p <0.05.
Conclusion: We concludes that the estimated cost and coping mechanisms associated with assisting tuberculosis patients with treatment is significant to the tuberculosis treatment supporters. If not mitigated these costs have the tendency to worsen the socio-economic status and future welfare of tuberculosis treatment supporters.
Effectiveness of Mindfulness Based Intervention In Anxiety Disorder: A Qualitative Case Study
Authors: Bhattacharya Suvosree , Mukhopadhyay Pritha
Published: April 2023

Background
Mindfulness based interventions (MBIs) have shown effectiveness in anxiety disorders with most studies suggesting moderate level of efficacy. Majority of the studies are based on outcome and efficacy measures of intervention. Enough attention on the process of intervention and mechanism of change in MBI has not been widely explored. In this context, the present study focused on the process through which MBI brings about a change.
Methodology
The study was a case study with three participants. All of them had a primary diagnosis of anxiety and underwent MBI spanning over 3 months approximately. Two interviews (pre and post) treatment was conducted and analyzed using Interpretative Phenomenological Analysis as a method.
Result Analysis
The analysis revealed significant improvement in participants and three important themes came up which explained this process of change- The first theme centered on the participants’ experience of living with anxiety. The second theme centered on the individual’s utilization of available resources to cope with anxiety and how the nature and characteristics of these resources shifted from pre- to the post- intervention phase. The third theme (the evolved self) featured on the participants’ perception of self as they completed the MBI program and learned to view the world through its lenses.
Conclusion
This study revealed that MBI was effective in participants diagnosed with anxiety disorder. The participants reported that when faced with challenging situations they were better able to handle their emotions and felt more in control of themselves. Their anxiety did not make them feel entrapped like before and they could carry on productive work much better. There was enhanced sense of self confidence and improved Quality of life in the participants
Assortative mixing of opinions about COVID-19 vaccination in personal networks
Authors: Hâncean Marian-Gabriel , Lerner Jürgen , Perc Matjaž , Molina José Luis , Geantă Marius
Published: April 2023

Many countries worldwide had difficulties reaching a sufficiently high vaccination uptake during the COVID-9 pandemic. To understand this hesitancy better, we performed cross-sectional research on a panel of 30,000 individuals which were representative for the population of Romania -- a country in Eastern Europe with a low 42.6% vaccination rate -- to determine whether people are more likely to be connected to peers displaying similar opinions about COVID-19 vaccination. We have extracted 443 personal networks amounting to 4430 alters, and we have used opinions, quantitative network measures, and socio-demographic features to predict individual opinions about COVID-19 vaccination. Our evidence indicates that the likelihood of having a positive opinion increases when peers have on average a more positive attitude than the rest of the nodes in the network. Also, we find that individuals with higher education and age are more likely to hold a positive opinion, and that positive opinions about COVID-19 vaccination are clustered. With the given empirical data, our study cannot reveal whether this assortative mixing of opinions is due to social influence or due to social selection, but it may nevertheless have implications for public health interventions, especially in countries that strive to reach higher uptake rates.
Reliability and validity of the Chinese version of the Hypertension Belief Assessment Tool in hypertensive patients
Authors: Yang Xue , Mei Yujin , Li Yuqing , Zhang Xiaoyun , Gui Jiaofeng , Wang Ying , Chen Wenyue , Chen Mingjia , Liu Changjun , Zhang Lin
Published: April 2023

Background: Hypertension is prevalent in China. Hypertensive patients suffered from many health problems in life. As time goes by, this will cause them to lack of healthy beliefs. Nevertheless, one’s beliefs about managing their hypertension level and a battery of health habits it is still indistinct. So, it is extremely vital to find a suitable instrument to comprehend the health beliefs of patients and provide seasonable help to keep their body and mind healthy. This Study intended to translate the Hypertension Belief Assessment Tool (HBAT) into Chinese and to explore the validity and reliability of the Chinese version in hypertensive patients.
Methods: This is a cross-sectional study. We translated the HBAT into Chinese, and tested the validity and reliability of the Chinese version among 325 hypertensive patients.
Results: The Cronbach’s α coefficient of the scale was 0.803. Exploratory factor analysis (EFA) supported a six-factor structure block for the HBAT, and the model was qualified in our confirmatory factor analysis. With modified confirmatory factor analysis, the fit indices were chi-square/degree of freedom (CMIN/DF) =2.491, comparative fit index (CFI)=0.952, incremental fit index (IFI)=0.952, root-mean-square error of approximation (RMSEA)=0.068, Tucker Lewis index (TLI)=0.941. The high score group (27%) and low score group (27%) all showed significant differences (P<0.001).
Conclusion: The HBAT has good validity and reliability and it can evaluate the beliefs of Chinese hypertensive patients.
Design of Enterprise Financial Performance Prediction Model Based on Artificial Intelligence Algorithm
Authors: Jing Wang , Anhang LI
Published: April 2023

With the rapid and sustainable development of China's economy, enterprises are faced with the dual challenges of structural and cyclical factors, and the uncertainty of business operations and the intensity of competition are getting higher and higher. Therefore, stakeholders will pay close attention to the company's financial status. Based on this background, forecasting and evaluating the company's financial performance has important research value and significance for realizing the sustainable development of the company. BP neural network can automatically learn historical experience from data samples, and automatically estimate the function that can best describe the law of sample data. Therefore, this paper first analyzes the basic principles of BP neural network and artificial intelligence technology, and then evaluates its benefits, anti-risk ability, development ability and turnover ability, and designs the financial performance prediction and evaluation model from the above four perspectives to evaluate the 12 of the index system. Two secondary indicators are used as the input vector, and the comprehensive performance score is used as the output vector to create the BP neural network model. Finally, using the data of four companies as test samples, model training and simulation verification are carried out on the comprehensive performance of the sample companies, and the comprehensive performance of the sample companies is analyzed and explained according to the comparison of the prediction results. The results show that the prediction and evaluation method of enterprise financial performance based on BP neural network is feasible. In this paper, the artificial intelligence algorithm is introduced into the design of the financial prediction model of enterprise performance and efficiency by studying the artificial intelligence algorithm, so as to effectively assist the enterprise management.
Prognosis and Immune Correlation Analysis of m1A/m5C/m6A/m7G Regulated Genes in Gastric Cancer
Authors: Chen Xiaomei , Wang Anqi , Luo Tian , Yu Miao
Published: April 2023

Background
In gastric cancer (GC), biomarkers that reliably predict prognosis and patient response to immune checkpoint blockade (ICB) are lacking. Accumulating evidence indicate that RNA modification of m1A/m5C/m6A/m7G has a close relationship with the initiation and progression of cancer, particularly in GC. Here, our objective is to identify a significant signature based on m1A/m5C/m6A/m7G-regulated genes for prognosis prediction and immune correlation analysis in GC.
Methods
Firstly, The Cancer Genome Atlas (TCGA)-GC dataset was sifted for m1A/m5C/m6A/m7G-regulated genes that were significantly differentially expressed in normal and GC samples. By combining clinical survival prognostic information of the samples, the most optimal gene combination that was significantly associated with GC prognosis was then systematically sifted. Following that, a novel prognostic risk score (RS) model was constructed. The GSE62254 dataset was used for the RS model validation, with own RT-qPCR conducted for biological validation. Furthermore, a nomogram was founded to better predict the overall survival (OS) of GC. Finally, the RS model and its relevance to immune infiltration, drug sensitivity and pathway enrichment were investigated.
Results
On the basis of the m1A/m5C/m6A/m7G-regulated genes, we developed a prognostic RS model that classified GC patients as high or low risk. The predicted capability of the RS model was well validated in both TCGA-GC training and GSE62254 validation sets. After identifying the RS model as an independent prognostic factor via univariate and multivariate analyses, we built a nomogram with high accuracy to enhance the RS model's clinical suitability. When compared to low-risk patients, high-risk patients had a shorter OS and more activated oncogenic pathways. More importantly, the high-risk group exhibited higher ESTIMATE, immune, and stromal scores, as well as higher expression of immune checkpoint-related genes and human leukocyte antigen (HLA)-related genes. Lastly, we observed that the majority of commonly used GC chemotherapeutic agents had lower IC50 values in high-risk patients.
Conclusion
We created a reliable prognostic RS model based on m1A/m5C/m6A/m7G regulated genes that can predict GC prognosis and guide individualized treatment decisions-making.
Deep tiering Planolites isp. in the oolitic limestones of Cambrian Series 3, western Henan, China
Authors: Li Da , He Xitong , Liu Bingchen , Zheng Wei , Xing Zhifeng , Qi Yong’an
Published: April 2023

Planolitesisp.is teeming within the oolitic limestone units in the Changhsia Formation of Cambrian Series 3 in western Henan, and its morphology is characterized by a horizontal or low-angle oblique curved cylindrical tube. These burrows occur on a easily migrating sedimentary substrate (oolitic beach), but have no lining walls and are filled with micritic, indicating that thePlanolitesisp.burrows were formed in a low energy microenvironment under the background of high energy oolitic shoals, where they are not susceptible to turbulent flow. Detailed analysis of thePlanolitesisp.burrows suggest that the trace makers should be a detritus feeder in deep tieringof sediments. Microscopic observation of ooids and the filling of burrows shows that there are some cyanobacterial filaments in the sediments around the ooids and bit of masticated and partially digested cyanobacterial filamentous fragments within the burrow infilling. indicating the trace makers ofPlanolitesisp. feeds on the cyanobacteriabetween the ooids. The emergence of this kind of deep tiering trace fossils and the unique feeding mode represented by them reveal a more complex survival strategy than that of benthic organisms in the early Cambrian, which provides valuable materials for the study of the evolution of benthic organisms during the Cambrian Explosion.
Molecular evolution of respiratory syncytial virus subgroup A collected in north Viet Nam between 2017-2020
Authors: Ung Trang Thi Hong , Hoang Phuong Vu Mai , Nguyen Hoang Huy , Nguyen Hang Le Khanh , Nguyen Son Vu , Le Thanh Thi , Vuong Cuong Duc , Tran Huong Thi Thu , Nguyen Anh Phuong , Le Mai Thi Quynh
Published: April 2023

The respiratory syncytial virus is a major cause of acute respiratory tract infection in young children. However, molecular characteristics analysis was not as much of its’ burden, especially in developing countries as well as Viet Nam. Therefore, we performed molecular evolutionary analyses of the G gene of RSV-A sequences which were collected from pediatric severe acute respiratory infection patients in north Viet Nam from 2017–2020. The Bayesian Markov Chain Monte Carlo method was used to conduct phylogenetic analyses and a time scale for evolution. We also calculated population dynamics, estimated the natural selection pressure and potential N-glycosylation sites. The results indicated the majority of study sequences were classified into the ON1 genotype. There were three strains belonging to the non-ON1 genotype with p-distance = 0.048. Besides, even though most of the Vietnamese sequences were identified as ON1 genotype, all of them had no 72-nucleotide duplication in the second hypervariable region of the G gene. The molecular evolutionary rate of the RSV-A G gene in northern Viet Nam was estimated to be 1.32 × 10− 3 substitutions/site/year. Each year, the shifts of the N-glycosylation pattern within the G gene of Vietnamese sequences were observed. Moreover, five amino acid substitution sites were related to positive selection pressure. These results were the first report of the molecular evolution of the RSV-A G gene detected in Viet Nam after 2015.
STAT3 and HIF1α cooperatively mediate the transcriptional and physiological responses to hypoxia
Authors: Argenton Francesco , Martello Graziano , Tiso Natascia , Dinarello Alberto , Betto Riccardo , Meneghetti Giacomo , Diamante Linda , Peron Margherita , Ghirardo Rachele , Laquatra Claudio , Cioccarelli Chiara , Tesoriere Annachiara
Published: April 2023

STAT3 and HIF1α are two fundamental transcription factors involved in many merging processes, like angiogenesis, metabolism, and cell differentiation. Notably, under pathological conditions, the two factors have been shown to interact genetically, but both the molecular mechanisms underlying such interactions and their relevance under physiological conditions remain unclear. In mouse embryonic stem cells (ESCs) we manage to determine the specific subset of hypoxia-induced genes that need STAT3 to be properly transcribed and, among them, fundamental genes like Vegfa, Hk1, Hk2, Pfkp and Hilpda are worth mentioning. Unexpectedly, we also demonstrated that the absence of STAT3 does not affect the expression of Hif1a mRNA nor the stabilization of HIF1a protein, but the STAT3-driven regulation of the hypoxia-dependent subset of gene could rely on the physical interaction between STAT3 and HIF1a. To further elucidate the physiological roles of this STAT3 non-canonical nuclear activity, we used a CRISPR/Cas9 zebrafish stat3 knock-out line. Notably, hypoxia-related fluorescence of the hypoxia zebrafish reporter line (HRE:mCherry) cannot be induced when Stat3 is not active and, while Stat3 Y705 phosphorylation seem to have a pivotal role in this process, S727 does not affect the Stat3-dependent hypoxia response. Hypoxia is fundamental for vascularization, angiogenesis and immune cells mobilization; all processes that, surprisingly, cannot be induced by low oxygen levels when Stat3 is genetically ablated. All in all, here we report the specific STAT3/HIF1a-dependent subset of genes in vitro and, for the first time with an in vivomodel, we determined some of the physiological roles of STAT3-hypoxia crosstalk.
Zonotopic estimation for switched systems with parameter uncertainty and asynchronous switching
Authors: Ma Xiang , Liu Xinggao
Published: April 2023

Variant aircraft is one of the typical applications of switched systems. A zonotopic estimation method for uncertain switched systems with asynchronous switching is proposed in this article because the influence of external disturbance and parameter perturbation widely exists in the flight process of variant aircraft. On the basis of a designed robust observer, the states, errors, disturbances, and uncertain parameters are all described with zonotopes. The ultimate estimation is also derived by utilizing the center vector and generator matrix of zonotope. This method solves the problem of obtaining state information of variant aircraft during flight. Moreover, the interval estimation is verified to be bounded via P-radius definition of zonotope and robust stability theory, and the global optimization of the performance is achieved during the estimation process. Finally, a direct method is used to decrease the computing time and improve the estimation accuracy. The methodology is illustrated to be effective through a simulation of the variant aircraft system.
Predictors of mortality among under-five children in rural Ethiopia: a cross sectional study
Authors: Gebrerufael Gebru Gebremeskel , Hagos Bsrat Tesfay
Published: April 2023

Background:The under-five children mortality (UFCM) is one of the major significant and sensitive indicators of the health status of the public. Although the world has seen a remarkable and substantial decrease in UFCM since 1990, its progression rate still remains alarmingly high in Sub-Saharan African (SSA) countries, particularly in Ethiopia. Therefore, this study aimed to assess predictors of mortality among under-five children in rural Ethiopia.Methods:This study used a secondary data analysis of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) report. A total of 4,425 under-five children were included in the final analysis. The Kaplan-Meier (K-M) and Cox proportional hazard (PH) model analyses were utilized to estimate survival time and to investigate the major predictors of mortality under-five children, respectively. An Adjusted Hazard Ratio (AHR) along with a 95% Confidence Interval (CI) was employed to measure the impact size and direction of the association.Results: The study showed that 6.2% (95% CI: (5.43, 6.86)) of children died beforehand celebrating their fifth birthday in rural Ethiopia. The multivariable Cox PH regression model analysis revealed, predictors of large spacing preceding birth interval (16–26 months) (AHR = 0.61; 95% CI: (0.402–0.920)), 27–38 months (AHR =0.72; 95% CI: (0.496–1.03)), and ≥39 months, multiple births (AHR = 3.9; 95% CI: (2.77–5.62)), being breastfeeding (AHR =0.13; 95% CI: (0.099–0.162)), and unvaccinated child (AHR =11.6; 95% CI: (1.62–83.1)) were significant predictors of under-five children mortality.Conclusions:In this study, under-five children death rate was alarmingly high in the rural areas of Ethiopia. The birth type, preceding birth interval, vaccination of child, and breastfeeding are identified as significant predictors of under-five children mortality in rural Ethiopia. Therefore, public health interventionsshould be given attention to multiple births, unvaccinated and non-breastfeeding children, as well as mothers’ better encouragement to having a large spacing preceding birth interval.
Chinese herbal prescription Qing-Xin-Jie-Yu granule combined with conventional treatment for intermediate coronary lesions: study protocol for a randomized, double-blinded, placebo-controlled trial
Authors: Chen Luying , Dai Lulu , Xu Jiawei , Duan Lian , Hou Xiaoxia , Zhang Lanfeng , Zhang Lu , Song Libo , Zhao Fangfang , Jiang Yuerong
Published: April 2023

Background
Intermediate coronary lesion (ICL) is a critical stage affecting coronary artery disease’s progression and prognosis and may quickly progress to acute coronary syndrome. However, percutaneous coronary intervention therapy and conventional drug therapy have certain limitations. Qing-Xin-Jie-Yu Granules (QXJYG), a Chinese herbal prescription with a pre-research basis, has the potential to be a complementary treatment for ICL. Previous studies have shown that QXJYG combined with conventional drug therapy could alleviate angina symptoms and reduce the incidence of composite ‘hard’ endpoint in treating stable coronary artery disease. However, for ICL, the effect of this prescription on the degree of coronary stenosis, plaque stability, and long-term efficacy remains unclear. Therefore, we designed this study to evaluate the efficacy and safety of QXJYG in patients with ICL.
Methods
This is a multi-center, block-randomized, double-blinded, placebo-controlled trial. One hundred and twenty participants with ICL will be randomly assigned to two groups in a 1:1 ratio. Based on conventional intervention, the participants of the treatment group will receive QXJYG orally, and the participants of the control group will receive placebo for six successive months. The primary outcomes involve the degree of coronary stenosis, including the percentage of diameter stenosis and the percentage of area stenosis measured by coronary CT angiography. The secondary outcomes involve coronary artery calcification score, Gensini score, CT-fractional flow reserve, angina symptom score, traditional Chinese medicine syndrome score, blood lipids, inflammatory factors, carotid artery ultrasound parameters, and major adverse cardiovascular events. Safety will be assessed by adverse events and laboratory examinations. Measurements will be performed at baseline (visit 1), months 2 (visit 2), months 4 (visit 3), months 6 (visit 4), and months 12 (visit 5).
Discussion
The results of this trial will verify the efficacy and safety of QXJYG in treating ICL, thus adding to the existing knowledge for resolving the problem in ICL.
Trial registration:
This trial is registered at the Chinese Clinical Trial Registry (www.chictr.org.cn). Registration number: ChiCTR2200059262. Register date: April 27, 2022.
Application of the Herbal chemical Marker Ranking System (Herb MaRS) to standardization of herbal pharmaceutical raw materials-a case study
Authors: Kaggwa Bruhan , Anywar Godwin , Munanura Edson Ireeta , Wangalwa Raphael , Kyeyune Henry , Okella Hedmon , Kamba Fadhiru Pakoyo , Engeu Ogwang Patrick
Published: April 2023

Introduction
Phytochemical standardization of herbal materials involves establishing consistent levels of one or more active ingredients or markers. It ensures the authenticity and quality ofherbal materials, extracts, and medicinal products. We successfully applied the Herbal chemical Markers ranking system (Herb MaRS) originally proposed for quality assurance of complex herbal products, to establish markers for controlling the quality of herbal raw materials. We used the most commercially consumed plant materials in Uganda, as a case study.
Methods
The assessment of compounds for suitability as markers were based on the Herb MaRS, with minor modifications as follows: For more objective scoring, evidence of biological activity of the potential marker compound (s) was determined at three levels based on the number of symptoms of the disease condition a compound can treat or alleviate; (i) one symptom (1 point), two symptoms (2 points), 3 and more symptoms (3 points). We also scored the reported concentrations of the compounds (concentration not determined (0 points), concentration ≥5ppm (1 point), (concentration ≥50ppm, 2 points) and availability of analytical standards (1 point); lastly, we scored the compounds for the availability of an analytical method (1 point). Compounds scored from 0 to 8; where 8 indicated the most suitable chemical marker.
Results
The selected markers were as follows: Eucalyptus globulus (aromadendrine, α-terpineol, globulol, and 1-8, cineol);Aloe barbadensis (aloin, aloe emodin, acemannan), Albizia coriaria (lupeol, lupenone, betulinic acid, betulin, and catechin);Mangifera indica (mangiferin, catechin, quercetin, and gallic acid);Warburgia ugandensis (polygodial); Azadirachta indica (azadirachtin, nimbin, nimbidin); and Zingiber officinalis (6, 8, 10-gingerols, and 6-shogaol).
Conclusions
Herb MaRScan be efficiently applied to select marker compounds for quality control of herbal materials. The markers identified should be incorporated into chromatographic fingerprints as well as quantitative methods and evaluated for applicability at the various stages of the production chain of herbal medicines. There is a need to build local capacity to isolate marker compounds, particularly those that are not sold by current vendors.
Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea
Authors: Ghebremeskel Ghirmay Ghebrekidan , Kahsay Meron Tesfay , Gulbet Mengisteab Embaye , Mehretab Awet ghebreberhan
Published: April 2023

Background:
The lack of hospital based data limits understanding of potential leading indicators to formulate evidence based intervention efforts. This study explores maternal length of hospital stay (LOS) following child birth and associated factors in a rural health facility in Eritrea.
Methodology:
A retrospective study of all mothers that delivered in Nakfa hospital between 2020 and 2022 was conducted. Factors associated with postpartum LOS were evaluated for both vaginal delivery (VD) and cesarean delivery (CD). Determinants of LOS following vaginal delivery were explored using negative binomial regression.
Results:
A total of 2025 mothers [1975 (97.5%) VD and 50 (2.5%) CD] with a median age 26 (IQR: 22-30) years were included in the study. The median LOS following childbirth was 1 (IQR: 0-1) day for VD and 6 (IQR: 4-8) days for CD. Substantial mothers were found to have inadequate stay following VD [29% (95% CI: 27-31)] whereas [68 % (95% CI: 54%-81%)] stayed for > 4 days following CD. Following CD, LOS > 4 days was significantly associated with emergency CD (90.6% Vs 9.4% respectively, p- value< 0.001) as compared to elective CD. Meanwhile in VD; 5 minute Apgar score < 4 was significantly associated with prolonged LOS as compared to score of 4-6 and > 6 (24.1% Vs 9.1% and 8.2% respectively, p-value= 0.001). Moreover, VD that were attended by physicians had no inadequate stay whereas 27.4 % of deliveries attended by midwives and 31.3% by associate nurse resulted in inadequate stay (P-value <0.001). Determinants of LOS following VD were: presence of maternal complication (IRR=2.8, 95% CI: 1.6-5, p-value < 0.001), delivery year 2020 and 2021 (IRR= 1.5, 95% CI: 1.2-1.8, p-value <0.001 and IRR= 1.4 95% CI: 1.2-1.7, p-value <0.001 respectively) and delivery hour interval 23:00-7:00 (IRR= 0.8, 95% CI: 0.7-0.9, p-value=0.03).
Conclusion:
Substantial proportion of mothers stay too short post VD to allow adequate postnatal care whereas LOS post CD was high, particularly following emergency operation. Going forward, focus should be placed on enforcing adherence to guidelines on LOS, investment in hospital infrastructure, and personnel through provision of in-service training and upscale coverage antenatal care for early diagnosis of maternal complication in pregnancy.
Evaluation of the Efficacy of Sacubitril/valsartan on Radiofrequency Ablation in Patients with Hypertension and Persistent Atrial Fibrillation
Authors: Zang Xiaobiao , Zhao Zhihan , Chen Ke , Song Weifeng , Ma Jifang , Zhou You , Liang Erpeng , Fu Haixia , Wang Xianqing , Zhao Yonghui , Zhang Rongfeng
Published: April 2023

Objective：To evaluate whether the effect of radiofrequency ablation can be improved by using Sacubitril/Valsartan (S/V) to control blood pressure in hypertensive patients with persistent atrial fibrillation.
Methods: A total of 63 and 67 hypertension patients with persistent atrial fibrillation were enrolled in an S/V group and ACEI/ARB group, respectively. All patients underwent radiofrequency ablation (RFCA). The blood pressure of the two groups was controlled within the range of 100–140 mmHg (high pressure) and 60–90 mmHg (low pressure). The clinical indexes of the two groups were observed after 12 months of follow-up.
Results: No significant differences in blood pressure were observed between the S/V and ACEI/ARB group. In addition, the recurrence rate of atrial fibrillation between the two groups was not different. The left atrial diameter was an independent predictor of recurrence (HR = 1.063, P = 0.008). However, in the heart failure subgroup, the recurrence rate of S/V was significantly lower than that of the ACEI/ARB group (P = 0.005), and cox regression analysis showed that the recurrence risk of atrial fibrillation of the S/V group was 0.302 lower than that of the ACEI/ARB group. NT ProBNP, LVEF, and LAD were significantly improved in hypertension patients with heart failure when comparing cases before and at the end of follow-up.
Conclusions: S/V is better than ACEI/ARB in reducing the recurrence of persistent atrial fibrillation in patients with hypertension and heart failure after RFCA.
A DNA assembly toolkit to unlock the CRISPR/Cas9 potential for metabolic engineering
Authors: Yuzbashev Tigran , Yuzbasheva Evgeniya , Melkina Olga , Patel Davina , Bubnov Dmitrii , Dietz Heiko , Ledesma-Amaro Rodrigo
Published: April 2023

CRISPR/Cas9-based technologies are revolutionising the way we engineer microbial cells. One of the key advantages of CRISPR in strain design is that it enables chromosomal integration of marker-free DNA, eliminating laborious and often inefficient marker recovery procedures. Despite the benefits, assembling CRISPR/Cas9 editing systems is still not a straightforward process, which may prevent its use and applications. In this work, we have identified some of the main limitations of current Cas9 toolkits and designed improvements with the goal of making CRISPR technologies easier to access and implement. These include 1) A system to quickly switch between marker-free and marker-based integration constructs using both a Cre-expressing and standard Escherichia coli strains, 2) the ability to redirect multigene integration cassettes into alternative genomic loci via Golden Gate-based exchange of homology arms, 3) a rapid, simple in-vivo method to assembly guide RNA sequences via recombineering between Cas9-helper plasmids and single oligonucleotides. We combine these methodologies with well-established technologies into a comprehensive toolkit for efficient metabolic engineering using CRISPR/Cas9. As a proof of concept, we generated and characterized a library of 137 promoters and built a de novo Yarrowia lipolytica strain synthetizing 373.8 mg/L homogentisic acid.
Chemical Doping to Control the In-Situ Formed Doping Structure in Light-Emitting Electrochemical Cells
Authors: Huseynova Gunel , Rafols-Ribe Joan , Auroux Etienne , Huang Ping , Tang Shi , Larsen Christian , Edman Ludvig
Published: April 2023

The initial operation of a light-emitting electrochemical cell (LEC) constitutes the in-situ formation of a p-n junction doping structure in the active material by electrochemical doping. It has been firmly established that the spatial position of the emissive p-n junction in the interelectrode gap has a profound influence on the LEC performance because of exciton quenching and microcavity effects. Hence, practical strategies for a control of the position of the p-n junction in LEC devices are highly desired. Here, we introduce a “chemical pre-doping” approach for the rational shifting of the p-n junction for improved performance. Specifically, we demonstrate, by combined experiments and simulations, that the addition of a strong chemical reductant termed “reduced benzyl viologen” to a common active-material ink during LEC fabrication results in a filling of deep electron traps and an associated shifting of the emissive p-n junction from the center of the active material towards the positive anode. We finally demonstrate that this chemical pre-doping approach can improve the emission efficiency and stability of a common LEC device.
CFD Modeling of a Multichannel Fischer–Tropsch Reactor Module with Microscale Cooling Channels: Effects of Mirrored Structure Cooling Layers
Authors: Woo Yesol , Oh Da Bin , Park Jae Eun , Han Seung Ju , Lee Yun-Jo , Park Myung-June
Published: April 2023

Computational fluid dynamics (CFD) modeling of a multichannel Fischer–Tropsch reactor with microscale cooling channels was addressed in this study, wherein detailed mass, momentum, and energy balances were solved to retrieve detailed distributions of the conversion and temperature of both catalytic and cooling layers. A comparison between experimental data and simulation results showed relative errors of 6.73% and 1.22% for conversion and C5 + selectivity, respectively, which proves the validity of the proposed model. The novel structure of the reactor composed of mirrored structure cooling layers was suggested to prevent the thermal instability of a large-scale reactor module. The simulation showed that the symmetric distribution of the dense cooling channel area in the early part of the reactor decreased peak temperatures (ΔTmax = 28.6°C), whereas the nonmirrored case resulted in hot spots caused by the limited heat transfer capacity (ΔTmax = 39.2°C). The effects of the feed/coolant temperature, space velocity, and pressure were evaluated, and high temperatures and pressures resulted in a steep temperature increase in the early part of the reactor whereas the high space velocity showed an increase in the area of peak temperature. Further, the analysis showed trade-offs of operating conditions between the conversion and selectivity of desired products.