bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution of angle alpha and angle kappa measured by Lenstar 900 in a Chinese population
Authors: Liu Shuaishuai , Wang Ziqi , liu Yong
Published: October 2023

Purpose
To describe the distribution of angle alpha and angle kappa in a Chinese population.
Methods
Angle alpha, angle kappa, and other ocular biometric parameters were measured by the Lenstar 900 platform. The distributions of angle alpha and angle kappa and their associations with ocular parameters were assessed.
Results
This study included 9272 people for a total of 18544 eyes. The alpha angles of both eyes were 0.42 (0.26, 0.53) mm and 0.41 (0.26, 0.52) mm in the right eye and left eyes, respectively. The kappa angle values of both eyes were 0.24 (0.14, 0.31) mm in the right eye and 0.23 (0.13, 0.30) mm in the left eye. Angle alpha and angle kappa are mainly located in the temporal direction of the visual axis. Angle kappa and angle alpha were positively correlated with age and lens thickness and negatively correlated with anterior chamber depth, axial length, and corneal horizontal diameter (all P < 0.001). Angle alpha is positively correlated with angle kappa, and the angle alpha and angle kappa of both eyes are positively correlated. With increasing age, angle alpha and angle kappa gradually change in a nonlinear manner.
Conclusion
Angle alpha and angle kappa, both predominantly located temporal to the visual axis, were influenced by age, anterior chamber depth, axial length, and corneal horizontal diameter. As age increased, the changes in angle alpha and angle kappa were nonlinear, showing a downward then upward trend, with 20–30 years as the turning point.
Anti-inflammatory, Radical-Scavenging, and Chelating Activities of Nor-triterpenes from Galphimia spp. (Malpighiaceae)
Authors: León-Álvarez Eleazar , Pacheco César Millán , Gesto-Borroto Reinier , Acosta-Urdapilleta María de Lourdes , Téllez-Téllez Maura , González Rita Barreto , Núñez-Aragón Pablo Noé , Villarreal María Luisa , Cardoso-Taketa Alexandre
Published: October 2023

Anti-inflammatory and radical-scavenging activities of the methanolic extract from the leaves of Galphimia spp. collected in Morelos, Mexico, and isolated galphimidin (1) and galphimidin B (2), were evaluated. Nor-triterpenes 1 and 2 displayed anti-inflammatory activity inhibiting the nitric oxide production by the LPS-induced RAW 264.7 cell model, with IC50 values of 22.62 and 20.19 µg/mL, respectively, which were higher than the crude extract with an IC50 of 42.92 µg/mL. Furthermore, the TPA (12-O-tetradecanoylphorbol-13-acetate)-induced ear edema in mice assay displayed results of EC50 of 2.03 mg/ear to the methanolic extract, 1.91 mg/ear to 1, and 1.42 mg/ear to 2. Docking analysis of 1 and 2 at the iNOS active site indicated the negative influence of water molecules by mediating the ligand-protein interaction through hydrogen bonds interactions that increase the energy expenditure. These results explain the observed anti-inflammatory action of 1 and 2 by iNOS inhibition, which is better modulated in silico by the absence of water in the active site. The methanolic extract showed a low radical-scavenging activity inhibiting free radicals DPPH• with values of 57.33% compared to isoquercetin and rutin as positive controls. Nevertheless, the crude extract displayed high activity inhibiting ABTS•+ free radicals at 83.31% that was in accordance with high reducing potential of total polyphenols by Folin-Ciocalteu method with value of 3591.11 mg of gallic acid (GAE)/g of biomass. Compounds 1 and 2 did not present radical-scavenging activities but showed metal-chelating activity of 27.62% and 30.54%, which were higher values than EDTA as positive control.
A bio-inspired self-assembly strategy toward mechanically robust and flame retardant nanocomposites with ultra-sensitive and super-durable fire warning
Authors: Zhang Zhihao , Zhou Zhenzhu , Huang Junchao , Wang Yuhua
Published: October 2023

Poly(vinyl alcohol) (PVA) is widely applied in intelligence devices and energy storage, while its high flammability still challenges its development regarding the fire safety when employing in the regional heat accumulation circumstance. Herein, lamellar graphene oxide (GO) and bio-extracted phytic acid (PA) were introduced into PVA to fabricate a homogeneous PGP composite with excellent mechanical performance, flame retardancy and fire warning capacity through an eco-friendly water evaporation-induced self-assembly method. Via generating multiple interactions among PVA, GO and PA, the optimized cross-linked structure like hierarchical nacre was formed in PGP and presented simultaneously enhanced tensile strength and toughness than pure PVA. Owing to barrier effect of GO and free radical trapping and char catalyzing ability of PA, PGP composites showed excellent flame retardancy as the pHRR and THR decreased 88.6 and 66.5% compared to the pure PVA, and UL-94 level and LOI reached to V-0 rating and 36%, respectively. Moreover, the composite could maintain the structure integrity even after a longtime flame attack, displaying continuous warning ability over 2400 s. A fast dehydration and graphization process of the PGP composites allowed a rapid warning response within 2 s under fire. A better thermal accumulation endowed by GO lowered the response temperature to 150 ℃ which was sensitive to overheating. Besides, applying the PGP precursor solution as wood and cotton fabric coating could also improve the flame-retardant performance and endowed the fire warning capacity. Therefore, the composite fabricated in this work showed a great potential application in fire protection and warning.
Will Prosocial Behavior influence Intentions of Indian Investors to join Socially Responsible Investment?
Authors: Rana Priya , Sarva Mahesh , Verma Bhavisha
Published: October 2023

Purpose: The purpose of the paper is to exam in the impact of pro social behaviour on Indian investor intentional to participate it socially responsible investment taking attitude as mediated with special reference to all Indian states.
Design/methodology/approach: For achieving the objective of this study, the model was tested through PLS SEM software. Research Scales from the literature were used in modified version according to the suitability. Data were collected from 216 respondents.
Findings :The findings suggest that the factors of Perceived Consumer Effectiveness, Perceived Behavioral Control, and Perceived Financial Performance directly influence individuals' attitudes. These attitudes, in turn, have a significant impact on investors' intentions to engage in Socially Responsible Investment (SRI). Additionally, the study adopted the Theory of Planned Behavior framework to gain insights into SRI intentions with a focus on prosocial motivations. Therefore, the employed model for elucidating these variables yielded positive and promising results.
Originality/value:The literature supports that attitude plays a mediating role in forming intentions for green purchase behaviour only a few have examined the role of prosocial behaviour as a driver for SRI adoption intention. The current study aims to link prosocial behaviours of investors to the Theory of Planned Behaviour, a less explored approach in previous research.
Surplus Value Quantification of Overdue Medical Devices Based on Kohonen Network Algorithm
Authors: Tan Xiaomei , Mao Yajie , Zhang Jin , Li Jiansheng
Published: October 2023

With the continuous updating and progress of medical equipment, overdue medical device has problems such as management difficulties, resource waste and potential security risks. Therefore, this paper used Kohonen network algorithm to quantitatively evaluate and analyze the surplus value of overdue medical devices. In this paper, Kohonen network algorithm was used to build a quantitative model of the surplus value of overdue medical device, and the self-organization characteristics and data-driven learning ability of Kohonen network were used to more accurately predict the surplus value of equipment. Support vector machine was used to quantitatively evaluate and predict the surplus value of overdue medical device, and further optimize the model performance, so as to provide more accurate and reliable decision support for medical equipment management. The Kohonen network algorithm used in this paper well evaluated the correlation between the service life and maintenance cost of eight types of overdue medical device, and quantitatively predicted the surplus value of overdue medical device with the random forest algorithm. According to the comparison of prediction bias, the Kohonen network algorithm in this paper has better prediction performance than the random forest algorithm. In the experiment of comparative analysis and verification by introducing decision tree algorithm, the average error rate of Kohonen network algorithm in this paper was only 20.57%, which was far lower than 46.34% of random forest algorithm and 65.31% of decision tree algorithm. The Kohonen network algorithm used in this paper can effectively quantitatively evaluate and predict the surplus value of overdue medical device, thus improving the efficiency of medical equipment management, reducing costs and ensuring patient safety.
Female and smokers are associated with acute and long COVID-19 symptoms among 32,528 vaccination individuals: a cross-sectional and nationwide study from China
Authors: Su Zheng , Li Yinghua , Xie Ying , Huang Zhenxiao , Cheng Anqi , Zhou Xinmei , Li Jinxuan , Qin Rui , Wei Xiaowen , Liu Yi , Xia Xin , Song Qingqing , Zhao Liang , Liu Zhao , Xiao Dan , Wang Chen
Published: October 2023

Backgrounds
To our knowledge, there is no available nationwide data on omicron symptom patterns in China mainland. We aim to determine the acute and long COVID-19 symptoms in the omicron-dominant period and to evaluate its association with age, sex and smoking status.
Methods
We designed a cross-sectional nationwide study and data about self-reported symptoms were collected by an online platform named Wenjuanxing. Eligible participants were aged 25–65 years and were symptomatic. To improve the representativeness of sample size, the ratios of the number of people of different ages and genders were weighted by the data from the Seventh National Census (2020 years), and validated by a published nationwide representative study through comparing smoking rates. Descriptive analysis was conducted to report information on demographic characteristics, diagnosis ways and duration time, acute symptoms, hospitalization, severity and long COVID-19 symptoms. And, multivariate Logistic regression models were used to explore the effect of age, sex and smoking on acute and long COVID-19 symptoms.
Results
A total of 32,528 individuals diagnosed as COVID-19 infection from October 1, 2022 to February 21, 2023 were included. The top three acute symptoms of COVID-19 infection were fever (69.90%), headache (62.63%), sore throat (54.29%). The rates of hospitalization within 7 days, symptoms disappear within 21 days were 3.07% and 68.84%, respectively. Among 3983 COVID-19 patients with 3 months or more time difference between first infection and participation into the study, the long COVID-19 rate was 19.68% and the primary symptoms were muscle weakness (19.39%), headache (17.98%) and smell/taste disorder (15.18%). Compared with male and never smokers, female and current smokers were risk factors for each acute CVOID-19 symptoms, and also had a higher risk for fatigue among long COVID-19 symptoms. Lastly, female and current smokers also were related with more number of symptoms during acute infection period.
Conclusions
Omicron variant to be milder in terms of severity in China mainland. And, more attention should be given to high-risk population (current smokers and women) to control disease burden caused by COVID-19.
Modulation of response times in early-stage Parkinson’s disease during emotional processing of embodied and non-embodied stimuli
Authors: Botta Alessandro , Pelosin Elisa , Lagravinese Giovanna , Marchese Roberta , Biasio Francesca Di , Bonassi Gaia , Terranova Sara , Ravizzotti Elisa , Putzolu Martina , Mezzarobba Susanna , Cosentino Carola , Avenanti Alessio , Avanzino Laura
Published: October 2023

Valence (positive and negative) and content (embodied vs. non-embodied) characteristics of visual stimuli have been shown to influence motor readiness, as tested with response time paradigms. Both embodiment and emotional processing are affected in Parkinson’s disease (PD) due to basal ganglia dysfunction. Here we aimed to investigate, using a two-choice response time paradigm, motor readiness when processing embodied (emotional body language [EBL] and emotional facial expressions [FACS]) vs non-embodied (emotional scenes [IAPS]) stimuli with neutral, happy, and fearful content.
We enrolled twenty-five patients with early-stage PD and 25 age matched healthy participants. Motor response during emotional processing was assessed by measuring response times (RTs) in a home-based, forced two-choice discrimination task where participants were asked to discriminate the emotional stimulus from the neutral one. Rating of valence and arousal was also performed. A clinical and neuropsychological evaluation was performed on PD patients.
Results showed that RTs for PD patients were longer for all conditions compared to HC and that RTs were generally longer in both groups for EBL compared to FACS and IAPS, with the sole exception retrieved for PD, where in discriminating fearful stimuli, RTs for EBL were longer compared to FACS but not to IAPS. Furthermore, in PD only, when discriminating fearful respect to neutral stimuli, RTs were shorter when discriminating FACS compared to IAPS.
This study shows that PD patients were faster in discriminating fearful embodied stimuli, allowing us to speculate on mechanisms involving an alternative, compensatory, emotional motor pathway for PD patients undergoing fear processing.
Inhomogeneity of regional ventilation during awake pronation with helmet CPAP in COVID-19 ARDS patients
Authors: Fossali Tommaso , Locatelli Martina , Colombo Riccardo , Veronese Alice , Borghi Beatrice , Ballone Elisabetta , Castelli Antonio , Rech Roberto , Catena Emanuele , Ottolina Davide
Published: October 2023

Introduction: prone positioning with continous positive airway pressure (CPAP) is widely used for respiratory support in awake patients with COVID-19 associated acute respiratory failure. We aimed to assess the respiratory mechanics and distribution of ventilation in COVID-19 associated ARDS treated by CPAP in awake prone position. Methods: we studied sixteen awake COVID-19 patients with moderate to severe ARDS. The study protocol consisted of a randomized sequence of supine and prone position with imposed PEEP of 5 and 10 cmH2O delivered by helmet CPAP. Respiratory mechanics and distribution of ventilation were assessed through esophageal pressure (PES) and electrical impedance tomography (EIT). At the end of each 20 minutes phase, arterial blood gas analysis was performed, and PES swing and EIT tracings were recorded for the calculation of the respiratory mechanics and regional ventilation. Results: the patient’s position had no significant effects on respiratory mechanics. EIT analysis did not detect differences among global indices of ventilation. A significant proportion of pixel in the sternal region of interest showed increase of compliance from supine to prone position and PaO2/FIO2 increased accordingly. The best improvement of both PaO2/FIO2 and sternal compliance was obtained in prone position with PEEP 10 cmH2O. Conclusions: in the studied subjects, prone positioning during CPAP treatment raised oxygenation without improvement of “protective” ventilation or of global ventilatory inhomogeneity indices. Prone positioning with higher PEEP significantly increased the recruitment of sternal regions.
Construction of a risk prediction model for the development of purulent meningitis in neonatal sepsis
Authors: Shen MengJun , Zhang Hui , Peng WenJia , Wang QingYun , Peng Wan Sheng
Published: October 2023

Introduction: This study aims to construct a risk prediction model for septic meningitis in neonates with sepsis and to provide a basis for the early identification of high-risk children. Methods: Infants were selected and divided into modeling and validation cohorts. Least absolute shrinkage and selection operator (LASSO) regression was used to screen predictors in the modeling cohort. Predictive models were developed by incorporating multifactorial logistic regression analysis and were presented in the form of column-line graphs and web calculators. Receiver operating characteristic (ROC) curves and calibration curves were used to evaluate model discrimination and calibration. Internal validation was performed using the bootstrap self-sampling method. The clinical validity of the model was evaluated by decision curve analysis. Results: A total of 689 full-term infants with sepsis who were admitted to met the inclusion criteria and were selected. The infants were divided into modeling and validation cohorts. Through LASSO regression and multifactorial stepwise logistic regression, six predictors were selected. These factors were included in the model to create a column chart, and a successful predictive model for the development of septic meningitis in neonates with sepsis. The calibration curves indicated good calibration.
Absorption and Sensitivity Measurements of Noble Metals (Au, Ag, Cu) Thin Film Biosensor Based on SPR Simulation Characterizations
Authors: A.Ahmad Omar , Alrashid Said Naif Turki , K.Khalaf Mohammed
Published: October 2023

In this paper, we investigate the influence of varying the thickness of noble metals, namely gold (Au), silver (Ag), and copper (Cu), and the incident light wavelength on the surface plasmon resonance (SPR) properties for biosensor applications. Our analysis employs the Fresnel equations to examine the absorption characteristics of these metals. We explore metal layer thicknesses ranging from d = 30 to 70 nm and incident light wavelengths of λ = 500 and 600 nm, with incident angles (θ) ranging from 0° to 90°. Utilizing simulation analysis in MATLAB, we simulate the SPR responses of these metals when deposited on N_LASF9 and BK-7 glass prisms, with air as the surrounding medium. Our calculations reveal the absorption properties of Au, Ag, and Cu, as indicated by the angle of incidence (θSPR). Our findings demonstrate that the highest absorption occurs with copper (Cu) at A = 0.999 (a.u.) for λ = 500 nm and d = 30 nm. When λ is adjusted to 600 nm, gold (Au) exhibits the highest absorption at A = 0.997 (a.u.) with a thickness of d = 40 nm. Additionally, we calculate sensitivity values for all three metals, with copper (Cu) yielding the highest sensitivity of 101.6 Reflected Index Units (RIU− 1) for both λ = 500 and 600 nm. Furthermore, we compute the figure of merit (FOM), with silver (Ag) achieving the highest FOM of 443 at λ = 500 nm and 451 at λ = 600 nm. These findings provide valuable insights into the SPR properties of noble metals for biosensing applications and offer guidance for optimizing biosensor designs.
Integrative data of an unknown ciliate (Alveolata, Ciliophora) propose the establishment of Caudidiodeviata nov. gen.
Authors: Liao Lijian , Jiang Limin , Hu Xiaozhong
Published: October 2023

Background
As unicellular eukaryotes, ciliates are an indispensable component of ecosystems that play the role of intermediate nutrition link between bacteria or algae and meifauna. Recent faunistic surveys have discovered many new taxa of hypotrich ciliates, indicating their diversity is greater than previously thought. Here we document an undescribed form isolated from an artificial brackish water pond in East China. Examination of its morphology, ontogenesis and molecular phylogeny suggests it represents a new genus.
Results
The new genus is distinguished from its relatives by having a dorsomarginal kinety, frontoventral and caudal cirri. It also has five frontoventral cirral anlagen, and oral primordium originated apokinetally between right and left cirral field. The diagnostic traits of the new species include three frontal cirri, one buccal cirrus, one or two parabuccal cirri, a row of four to six frontoventral cirri, three left and two right marginal rows, and one bipolar dorsal kinety with one or two caudal cirri at its rear end. Its main morphogenetic features are: (i) the old oral apparatus is completely inherited by the proter except undulating membranes, which are reorganized in situ; (ii) anlagen for marginal rows and the left dorsal kinety develop intrakinetally in both proter and opisthe; (iii) dorsal kinety 2 is generated dorsomarginally; (iv) in the proter, anlagen I and II originate from the parental undulating membranes and the buccal cirrus, respectively, anlage III from anterior parabuccal cirrus, anlage IV from the parental frontoventral cirri; (v) anlagen I–IV of the opisthe are all generated from oral primordium, and (vi) anlage V occur in the innermost parental right marginal row in both dividers. The phylogenetic analysis suggests that the new species is closely related to the newly described Heterodeviata sinica Song et al., 2023, and then form a robust clade with other deviatids, which corroborates the familial assignment of our form.
Conclusions
The study of the morphology, and ontogenesis of a new brackish-water taxon increases the overall knowledge about the biodiversity of this ciliate group. It also adds to the genetic data available and further confirms the monophyly of family Deviatidae Foissner, 2016.
Prediction of Axillary Lymph Node Stages According to Sentinel Lymph Nodes Involvement and Luminal Subtypes in Patients Receiving Neoadjuvant Chemotherapy
Authors: YILMAZ Latif , Kus Tulay , Aytekin Alper , Aktas Gokmen , Uzun Evren , Maralcan Gokturk
Published: October 2023

Background: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for assessing axillary lymph node status in clinically node-negative breast cancer patients. However, the approach to axillary surgery after neoadjuvant treatment is still controversial. In this present study, our objective is to predict the pathological nodal stage based on the SLNB results and the clinicopathological characteristics of patients who initially presented with clinical N1 positivity but converted to clinical N0 status after neaoadjuvant chemotherapy (NAC).
Materials and Methods: After NAC, clinically node-negative150 patients were included The relationship between clinicopathologic parameters, the number of positive lymph nodes in SLNB and ALND was assessed through binary/multivariate logistic regression analysis.
Results: Among 150 patients, 78 patients had negative SLNB and 72 patients had positive SLNB. No additional nodes positive at ALND ((y)pN1) varied among patients with SLNB 1+, 2+, and 3+ was 80.8%, 41.7%, and 13.6%, respectively. Following the detection of SLNB 1+ positivity, the rates of complete lymph node response ((y)pN1) were 75%, 100%, and 100%, in luminal A/B, HER-2 positive, and triple-negative subtypes, respectively. Lower T stage (T1-3 vs. T4), having fewer than 4 clinical nodes before NAC (<4 vs. ≥4), post-operative Ki-67 decrease (<10% vs. stable/increase), and being in the triple-negative or HER2-positive subgroup compared to Luminal A/B (Luminal A/B vs. HER2-positive/triple-negative) were found to be predictive parameters for (y)pN1 in both univariate and multivariate analyses.
Conclussion: The number of SLNB-positive nodes and tumor-related parameters as well as the response to treatment, may predict no additional nodes positive at ALND ((y)pN1).
Prevalence and Factors Associated with Uptake of Modern Contraceptive Method Post-Abortion at Mbagala Hospital, Temeke, Dar es Salaam, Tanzania
Authors: Temu Sadick Zephania , Kilewo Charles , Msuya Sia , Mvunta David H.
Published: October 2023

Background: The uptake of modern contraceptives post-abortion care bridges the gap of unmet need for modern contraceptives which can reduce the rate of unintended pregnancies and recurrent abortion, thus improving women's health. Studies have demonstrated variations in the uptake of modern contraceptives, even within the same country.
Objective: To assess the factors associated with the uptake of modern contraceptive methods among women who received care at a comprehensive post-abortion care (cPAC) unit at Mbagala Hospital in Temeke, Dar es Salaam, after having an abortion.
Methodology: A cross-sectional analytical study involving 234 post-abortion women was conducted at Mbagala Hospital in Temeke, Dar es Salaam, from October 2020 to March 202. The convenient sampling technique was employed to collect data using a pretested structured questionnaire. Subsequently, the data was cleaned and analyzed using SPSS Version 23. A Chi-square test with a significance level set at P-value < 0.2 was used to test associations, and multivariable analysis was employed to identify independent factors associated with the uptake of modern contraceptives, with a P-value of less than 0.05 being significant.
Results: The uptake of modern contraceptives post-abortion was 67% among 234 post-abortion women, with the most commonly used method being injectable (35.9%). Higher uptake of modern contraceptives was observed in those aged 15 to 19 years with an Adjusted Odds Ratio (AOR) of 5.97 (95% CI 1.24-28.58), and in those aged 20 to 24 years, with an AOR of 3.55 (95%CI 1.54-8.18). Self-employed individuals also showed higher uptake with an AOR of 2.59 (95%CI 1.13-5.91). On the other hand, nulliparous and primiparous women were less likely to use modern contraceptives, with AORs of 0.12 (95%CI 0.02-0.60) and 0.22 (95% CI 0.16-1.70), respectively.
Conclusion and Recommendation: Two-thirds of the women (67%) received modern contraceptives as part of post-abortion care. However, there was a missed opportunity to prevent unwanted pregnancies in 33% of the women who received care. Greater efforts should be made to reach out to older women (aged 25 years or older), those who are employed, and those with four or more children in order to increase the uptake rate.
MedGAN: Optimized Generative Adversarial Network with Graph Convolutional Networks for Novel Molecule Design
Authors: Macedo Bruno , Ribeiro-Vaz Inês , Taveira-Gomes Tiago
Published: October 2023

Generative Artificial Intelligence can be an important asset in the process of drug discovery to answer the demand for novel medicines. This work outlines the optimization and fine-tuning steps of MedGAN, a deep learning model based in Wasserstein Generative Adversarial Networks and Graph Convolutional Networks, developed to generate new quinoline-scaffold molecules from complex molecular graphs, including hyperparameter adjustments and evaluations of drug-likeness attributes like pharmacokinetics, toxicity, and synthetic accessibility. The best model performance metrics achieved 0.25 validity, 0.62 connectivity, 0.92 quinoline scaffold, 0.93 novelty and 0.95 uniqueness, preserving chirality, atom charge and favourable drug-like properties while generating 4,831 novel quinolines. These results emphasizes valuable insights into how activation functions, optimizers, learning rates, neuron units, molecule size and constitution, and scaffold structure affect the performance of generative models, and their potential to create new molecular structures, enhancing deep learning applications in computational drug design.
Multiple Mediation of the Association between Childhood Emotional Abuse and Adult Obesity by Anxiety and Bulimia
Authors: Zhang Hongwei , Liu Ziqi , Zheng Hui , Xu Ting , Liu Lin , Xu Tao , Yuan Ti-Fei , Han Xiaodong
Published: October 2023

Bulimia is the most primitive reason for overweight and obesity. The extended literature has indicated that childhood emotional abuse has a close relationship with adverse mood states, bulimia, and obesity. To comprehensively understand the potential links among these factors, we evaluated a multiple mediation model in which anxiety/depression and bulimia were mediators between childhood emotional abuse and body mass index (BMI). A set of self-report questionnaires, including the Childhood Trauma Questionnaire (CTQ), Beck Anxiety Inventory [1], Beck Depression Inventory (BDI), and Eating Disorder Inventory (EDI), was sent out. Clinical data from 37 obese patients (age: 29.65 ± 5.35, body mass index (BMI): 37.59 ± 6.34) and 37 demographically well-matched healthy people with normal body weight (age: 31.35 ± 10.84, BMI: 22.16 ± 3.69) were included in the investigation. We first performed an independent t test to compare all scales or subscale scores between the two groups. Then, we conducted Pearson correlation analysis to test every two variables’ pairwise correlation. Finally, multiple mediation analysis was performed with BMI as the outcome variable, childhood emotional abuse as the predictive variable, and “anxiety → bulimia”/“depression → bulimia” as the mediating variables. The results show that the obese group reported higher childhood emotional abuse (t = 2.157, p = 0.034), worse mood state (anxiety: t = 5.466, p < 0.001; depression: t = 2.220, p = 0.030), and higher bulimia (t = 3.400, p = 0.001) than the healthy control group. Positive correlations were found in every pairwise combination of BMI, childhood emotional abuse, anxiety, and bulimia. Multiple mediation analyses indicate that childhood emotional abuse is positively linked to BMI (β = 1.312, 95% CI = 0.482–2.141). The “anxiety → bulimia” model is attested to play multiple mediating roles in the relationship between childhood emotional abuse and obesity (indirect effect = 0.739, 95% CI = 0.261–1.608, 56.33% of the total effect). These findings confirm that childhood emotional abuse contributes to adulthood obesity through the multiple mediating effects of anxiety and bulimia. The present study adds another potential model to facilitate our understanding of the eating psychopathology of obesity.
Clinical Safety and Feasibility of a Novel Implantable Neuroimmune Modulation Device for the Treatment of Rheumatoid Arthritis: Initial Results From the Randomized, Double-Blind, Sham-controlled Reset RA Study
Authors: Peterson Daniel , Poppel Mark Van , Boling Warren , Santos Perry , Schwalb Jason , Eisenberg Howard , Mehta Ashesh , Spader Heather , Botros James , Vrionis Frank D. , Ko Andrew , Adelson P. David , Lega Bradley , Konrad Peter , Calle Guillermo , Vale Fernando L. , Bucholz Richard , Richardson Mark
Published: October 2023

Background
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes persistent synovitis, bone damage, and progressive joint destruction. Neuroimmune modulation through electrical stimulation of the vagus nerve activates the inflammatory reflex and has been shown to inhibit the production and release of inflammatory cytokines and decrease clinical signs and symptoms in RA. The RESET-RA study was designed to determine the safety and efficacy of an active implantable device for treating RA.
Methods
The RESET-RA study is a randomized, double-blind, sham-controlled, multi-center, two-stage pivotal trial that enrolled patients with moderate-to-severe RA who were incomplete responders or intolerant to at least one biologic or targeted synthetic disease-modifying anti-rheumatic drug. A predefined blinded interim analysis was performed in patients enrolled in the study's initial stage (Stage 1) that included demographics, enrollment rates, device implantation rates, and safety of the surgical procedure, device, and stimulation over 12 weeks of treatment.
Results
Sixty patients were implanted during Stage 1 of the study. All device implant procedures were completed without intraoperative complications, infections, or surgical revisions. No unanticipated adverse events were reported during the perioperative period and at the end of 12 weeks of follow-up. No study discontinuations were due to adverse events, and no serious adverse events were related to the device or stimulation. Two serious adverse events were related to the implantation procedure: vocal cord paresis and prolonged hoarseness. These were reported in two patients and are known complications of surgical implantation procedures with vagus nerve stimulation devices. The adverse event of vocal cord paresis resolved after vocal cord augmentation injections with filler and speech therapy. The prolonged hoarseness had improved with speech therapy but mild hoarseness persists.
Conclusions
The surgical procedures for implantation of the novel neuroimmune modulation device for the treatment of RA were safe, and the device and its use were well tolerated.
Trial registration:
NCT04539964; registered August 31, 2020, https://www.clinicaltrials.gov/study/NCT04539964
Food-web complexity, consumer behavior and diet specialism: impacts on ecosystem stability
Authors: Perälä Tommi , Kuisma Mikael , Uusi-Heikkilä Silva , Kuparinen Anna
Published: October 2023

Ecological stability is a fundamental aspect of food web dynamics. In this study, we explore the factors influencing stability in complex ecological networks, characterizing it through biomass oscillations and species persistence. Using an Extended Niche model, we generate diverse food web structures and investigate the effects of intraspecific consumer interference, network size, connectance, and diet specialism on stability. Our findings reveal that intraspecific consumer interference plays a pivotal role in shaping stability. Higher interference results in stable dynamics, reducing oscillations and extinctions. Additionally, differences emerge between food webs comprised of invertebrate consumers and those of ectotherm vertebrates, with the latter showing higher oscillations. Network size and connectance also influence stability, where larger and more connected webs tend to exhibit reduced oscillations. Overall, our study sheds light on the complex interplay of factors affecting ecological stability in food webs. Understanding these dynamics is crucial for biodiversity conservation and ecosystem management.
Administration of a Combination of COX-2/TGF-β1 siRNAs Induces Hypertrophic Scar Fibroblast Apoptosis through a TP53 mediated Caspase Pathway
Authors: Fu Rao , Zhou Sizheng , Liu Chuanqi , Zhou Jia , Li Qingfeng
Published: October 2023

Hypertrophic scar (HTS) formation is a pathological fibrotic skin disease, with no satisfactory treatments available currently. Inducing apoptosis of HTS-derived fibroblasts (HSFs) are becoming promising approaches. In this research, we aim to improve the technology with co-delivery COX-2 and TGF-β1 siRNAs and further investigate the underlying mechanism. Firstly, the HSFs were transfected with 1 µg/ml COX-2 and/or TGF-β1 siRNAs, and proved that the apoptosis of HSFs was greater induced by COX-2/TGF-β1 siRNAs than either COX-2 or TGF-β1 siRNA alone by flow cytometry. To investigate the impact of co-silencing TGF-β1 and COX-2 mRNA expression in vivo, we established HTSs model in rat tails. Our results confirmed that co-silencing of TGF-β1 and COX-2 mRNA expression could significantly alleviate the HTS formation in vivo. Furthermore, we explored the potential molecular mechanism and revealed that the protein levels of TP53, Bcl-2 and Caspase-3 were downregulated while Bax and Cleaved Caspase-3 were upregulated in the COX-2/TGF-β1 siRNA groups compared with HKP group. Taken together, our results demonstrated that simultaneous silencing of COX-2 and TGF-β1 expression by siRNAs induced HSF apoptosis through a TP53 mediated caspase pathway. Therefore, COX-2/TGF-β1 siRNAs might serve as a novel and effective therapeutic alternative for HTSs treatments.
Attitudes and Perceptions toward Neurology and Neurosurgery among Zambian Medical Students: An e-survey
Authors: mukambo emmanuel , Mbiydzenyuy Ngala Elvis
Published: October 2023

Background: Prevalence and incidence of organic and non-organic brain diseases have skyrocketed over the past decades, while on the other hand, the number of trained neurologists and neurosurgeons has not kept pace. Building a larger, robust neurological/neurosurgical workforce, therefore, becomes an apparent solution. However, the fear of neurosciences and clinical neurology represents an important perceptual impediment that limits consideration of a career in these fields.
Objective: To assess the attitudes and perceptions of Zambian medical students towards a career specialty in neurosurgery and neurology.
Methodology: This was a cross-sectional survey of medical students from six (6) Zambian medical universities. A 20-item online survey containing multiple choice, Likert-scale, and free-response questions was adapted from prior literature and administered through social media. Preliminary information that explains the objectives of the study and asks for the participants’ consent was sent with the questionnaire.
Results: A total of 1236 complete responses were obtained from medical students across Zambia. Most students (70.9%) considered neurology and neurosurgery as difficult subjects because of the very long training time and were majorly dissuaded from pursuing a career in these fields because of their perceived inability to maintain a work-life balance. Neurosurgery (36.6%) and neurology (28.1%) were ranked 7th and 8th respectively on a list of 10 medical and surgical specialties. Eighty-one percent and 89% of participants who considered neurosurgery and neurology as future careers respectively agreed that insufficient knowledge of the students about neurology/neurosurgery and the difficulty of neurological disorders contribute to consideration of neurology and neurosurgery as difficult specialties (p<0.01).
Conclusion: Numerous factors are associated with medical students’ attitudes. Most of these significantly stem from inadequate or absent early career exposure to these career specialties. Therefore, the incorporation of earlier, rigorous, and focused neurology/neurosurgery education programs in medical pedagogy would be a cornerstone effort toward an improved understanding and positive perception of neurology and neurosurgery among medical students.
Apps for ADHD Management: A Scoping Review
Authors: Capistrán Jonathan Hernández- , Alor-Hernández Giner , Sánchez-Morales Laura Nely , Machorro-Cano Isaac
Published: October 2023

Background
Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder diagnosed using DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria. Medications are the primary treatment, leading to the emergence of mobile apps as alternative solutions to support people with ADHD.
Purpose
This review uses the Arksey and O'Malley scoping framework to assess mobile apps for ADHD. It examines their characteristics, target users, treatment modalities, treatment techniques, gamification elements, and medical support.
Methods
We searched for relevant records published within the 2013–2023 period in eight digital libraries and explored two virtual app stores (Google Play Store and Apple’s App Store). We found 1,562 potentially relevant apps, 63 of which were analyzed in the review. The apps were categorized as either commercial or non-commercial and further divided into video game and non-video game apps. The study revolved around six research questions.
Results
The majority (27%) of ADHD apps promote cognitive treatment, while 16% clinical diagnosis aid. The prioritized treatment techniques are cognitive (15.5%) and executive functions (10.85%) techniques. Only two of the 35 commercial apps are medically endorsed. Levels and statistics are the most popular gamification elements.
Conclusions
The study demonstrates the wide availability of mental health apps catering to individuals diagnosed with ADHD as well as parents and caregivers. Furthermore, it highlights various areas for future research and development, aiming to facilitate the integration of digital health interventions, particularly mobile apps, to aid in the diagnosis and treatment of ADHD.
A rare and unique manifestation of a huge penile tumor , think traumatic origin : a case report and review of literature
Authors: huang Xi , yang Tineng , peng Xiaoyang , cao Peng , chen Hua lei
Published: October 2023

Giant fibroepithelial polyps of mesodermal and ectodermal origin are rare benign tumors of the penis; mostly exhibiting aggressive growth patterns and known classically to be one of the transformable forms of advanced penile cancer with high capabilities of forming a spectrum of heterogeneous lesions. There are currently only a few reported cases in the medical literature. We present a single case of a 57-year-old man born and raised in a tropical island of Southern China with symptomatic urinary retention due to an enlarging penile mass on the glans of the penis of approximately 19 years duration, which was associated with post-trauma-induced paraplegia of the lower limbs and subsequent urogenital infections. The patient had notable general history, followed by consultation for more than four years of aggressive penile mass not improving under the patient’s decision to resort only to usual home treatments. He was reconciled when his symptoms worsened and the biopsy examination revealed a possible penile fibromatosis, there was no known metastasis on systemic examination as the mass was localized on the glans of the penis from the top to the base, with no obvious palpable mass or bumps on both sides of the scrotum. The penile mass was large, measuring 18 × 9 centimeters by length and width, as its thickest part is covered with cauliflower-like lumps which are hard in texture and are pink to reddish-brown. On excision of the tumor perioperatively, the corpus cavernosum and urethral cavernous body were exposed, and there was a fistula of about 0.3cm*0.2cm on the surface of the cavernous urethra, consistent with penile fibromatosis of the penis, with highly important clinical characteristics of value to medical literature during the supportive therapy, surgical total radical resection and urethroplasty of the penis. This case report is the longest and largest mass of its kind to be reported on the penis. It provides guidance for the clinical treatment and research of penile cancer.
Long-term outcomes of the application of fibrin sealant in the prevention of cervical anastomotic leakage after McKeown esophagectomy
Authors: Huang Yan , Li Zhichao , Fu Jianhua , Huang Sheng , Wu Jiadi , Fang Caiyan , Chen Jiyang , Su Huilin , Yang Hong , Lin Yaobin
Published: October 2023

Background
Anastomotic leakage remains an issue after esophagectomy. Previous studies have indicated that the intraoperative application of fibrin sealant could reduce the incidence of anastomotic leakage. This study reported survival outcomes among EC or EJC patients who received the intraoperative application of fibrin sealant during McKeown esophagectomy.
Methods
We designed a retrospective study including 227 patients with esophageal or esophagogastric junction cancer undergoing McKeown esophagectomy performed by our team between January 2018 and December 2019, of whom 86 patients were included in the FS group and 141 patients were included in the control group. Intraoperatively, 2.5 ml of porcine fibrin sealant was applied circumferentially to the cervical anastomosis in the FS group. The primary outcome was the impact of applying fibrin sealant to cervical anastomosis on the survival of patients after surgery.
Results
The median follow-up was 41 months (range, 0–52). The three-year overall survival (FS group vs. control group: 75.6% vs. 74,4%, p = 0.96) and the three-year disease-free survival (82% vs. 74,4%, p = 0.116) were not significantly different between the two groups. In the long-term follow-up, the total rates of AL between the two groups were 4.7% vs. 19.9% (p = 0.003), while the total rates of anastomotic stricture were 2.3% vs. 7.1% (p = 0.139). Cervical local recurrence was 4.7% versus 2.1% (p = 0.431). Cox regression analyses showed that the application of FS was not a predictor for overall survival.
Conclusions
The intraoperative application of fibrin sealant could prevent cervical anastomotic leakage after McKeown esophagectomy but did not improve survival outcomes. Further prospective clinical trials are warranted.
Exploring Antibiotic Appropriateness and Clinical Outcomes among Adult Intensive Care Unit Patients in Two Tertiary Hospitals in Ethiopia: A Prospective Observational Study
Authors: Tilahun Zerihun , Kumsa Legese , Gebre Mohammed , Fisseha Henok , Chelkeba Legese
Published: October 2023

Background: Antimicrobial resistance, driven by antimicrobial misuse, poses a global threat. Research on antibiotic utilization in Ethiopian intensive care units (ICUs) is lacking. This study seeks to assess the judiciousness of antibiotic utilization and its ramifications on clinical outcomes for adult ICU patients in two tertiary hospitals.
Methods: This study, conducted between April 1, 2021, and September 30, 2021, examined antibiotic appropriateness in adult ICU patients, following Infectious Disease Society of America (IDSA) guidelines. Data, including socio-demographics, clinical profiles, antibiotic use, and clinical outcomes, were analyzed using EpiData version 4.6 and SPSS version 25. Logistic regression and Cox proportional hazard ratios identified factors associated with inappropriate antibiotic use and ICU mortality.
Results: The study enrolled a total of 206 participants, with 113 (54.9%) being male and 124 (60.2%) residing in urban areas. Approximately 24.8% of patients received antibiotics in a manner inconsistent with IDSA guidelines. Independent factors associated with inappropriate antibiotic use included male gender (Adjusted Odds Ratio [AOR] = 3.6, 95% Confidence Interval [CI] 1.65, 7.70) and the administration of two or more antibiotics (AOR = 4.5, 95% CI 1.29, 15.84). The ICU mortality rate was 21.8%, with comorbid conditions (Adjusted Hazard Ratio [AHR] = 3.7, 95% CI 1.55, 8.87) and inappropriate antibiotic administration (AHR = 10.7, 95% CI 4.56, 25.1) identified as independent risk factors exacerbating ICU mortality.
Conclusion: Inappropriate antibiotic use is a pressing public health concern in the study's setting, underscoring the need for robust policies to reduce it in ICUs. The study found that male gender and the concurrent use of multiple antibiotics are significant factors linked to inappropriate antibiotic utilization in ICUs. Targeted interventions are essential to enhance patient care and combat antimicrobial resistance.
Whole genome analysis of rare deleterious variants adds further evidence to BRSK2 and other risk genes in Autism Spectrum Disorder
Authors: Bacchelli Elena , Viggiano Marta , Ceroni Fabiola , Visconti Paola , Posar Annio , Scaduto Maria , Sandoni Laura , Baravelli Irene , Cameli Cinzia , Rochat Magali , Maresca Alessandra , Vaisfeld Alessandro , Gentilini Davide , Calzari Luciano , Carelli Valerio , Zody Michael , Maestrini Elena
Published: October 2023

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with a strong genetic component in which rare variants contribute significantly to risk. We have performed whole genome and/or exome sequencing (WGS and WES) and SNP-array analysis to identify both rare sequence and copy number variants (SNVs and CNVs) in 435 individuals from 116 ASD families. We identified 37 rare potentially damaging de novo SNVs (pdSNVs) in cases (n = 144). Interestingly, two of them (one stop-gain and one missense variant) occurred in the same gene, BRSK2. Moreover, the identification of 9 severe de novo pdSNVs in genes not previously implicated in ASD (RASAL2, RAP1A, IRX5, SLC9A1, AGPAT3, MGAT3, RAB8B, MGAT5B, YME1L1), highlighted novel candidates. Potentially damaging CNVs (pdCNVs) provided support to the involvement of inherited variants in PHF3, NEGR1, TIAM1 and HOMER1 in neurodevelopmental disorders (NDD), although mostly acting as susceptibility factors with incomplete penetrance. Interpretation of identified pdSNVs/pdCNVs according to the ACMG guidelines led to a molecular diagnosis in 19/144 cases, but this figure represents a lower limit and is expected to increase thanks to further clarification of the role of likely pathogenic variants in new ASD/NDD candidates. In conclusion, our study strengthens the role of BRSK2 and other neurodevelopmental genes in ASD risk, highlights novel candidates and contributes to characterize the allelic diversity, mode of inheritance and phenotypic impact of de novo and inherited risk variants in ASD/NDD genes.