bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of diamond crystals from FeNiCo-C system with Ge doping under high pressure and high temperature
Authors: Li Yong , Xiao Hongyu , Ran Maowu , Xiao Zhengguo , Wang Ying , Hu Meihua
Published: February 2023

Various optical color centers in natural and synthetic diamond have attractive great attention of researched; to further investigate the effects of additive on diamond properties is of practical significance. In this work, diamond crystallization was investigated by temperature gradient
growth method with Ge additive at a set pressure of 6.5 GPa and synthesis temperature ranging from 1290 to 1310 °C. Scanning electron microscope (SEM), and spectral characterization including Fourier transform infrared spectroscopy (FTIR) and photoluminescence (PL) spectra were used to
investigate the surface growth mechanism of diamond. It was noticed that the visible inclusions gradually reduced in the as-grown diamond, accompanying with the increase of Ge additive in the synthesis cavity. The (111) surface of the synthesized diamond followed the layer growth pattern from
the SEM results. According to the measured FTIR results, the nitrogen impurity concentration values of the synthesized diamond crystals decreased from 500 to 90 ppm, confirming that Ge showed its own ability to remove nitrogen impurity in the growth stage of diamond. Additionally, the nickel-related
and nitrogen-related optical color centers of the obtained diamond were characterized by PL spectra. Characteristic peaks due to nickel-related optical color centers located at 515 or 535 nm, and Characteristic peaks attributing to nitrogen-related optical color centers located at 575 or 637
nm. We believe that the research is of great significance for the application of diamond in optical and quantum information science fields.
Global Climate Impacts of Greenland and Antarctic Meltwater: A Comparative Study
Authors: Li Qian , Marshall John , Rye Craig D. , Romanou Anastasia , Rind David , Kelley Maxwell
Published: February 2023

Both the Greenland and Antarctic ice sheets have been melting at an accelerating rate over recent decades. Meltwater from Greenland might be expected to initiate a climate response that is distinct, and perhaps different from, that associated with Antarctic meltwater. Which one might elicit a greater climate response, and what mechanisms are involved? To explore these questions, we apply climate response functions (CRFs) to guide a series of meltwater-perturbation experiments using a fully coupled climate model. In both hemispheres, meltwater drives atmospheric cooling, sea ice expansion, and strengthened Hadley and Ferrel cells. Greenland meltwater induces a slowdown of the Atlantic meridional overturning circulation (AMOC) and a cooling of the subsurface ocean in the northern high latitudes. Antarctic meltwater, instead, induces a slowdown of the Antarctic Bottom Water formation and a warming of the subsurface ocean around Antarctica. For melt rates up to 2000 Gt yr−1, the climate response is rather linear. However, as melt rates increase to 5000 Gt yr−1, the climate response becomes nonlinear. Due to a collapsed AMOC, the climate response is superlinear at high Greenland melt rates. Instead, the climate response is sublinear at high Antarctic melt rates, due to the halting of the northward expansion of Antarctic sea ice by warm surface waters. Finally, in the linear limit, we use CRFs and linear convolution theory to make projections of important climate parameters in response to meltwater scenarios, which suggest that Antarctic meltwater will become a major driver of climate change, dominating that of Greenland meltwater, as the current century proceeds.

Significance Statement

Melting of the Greenland and Antarctic ice sheets is one of the most uncertain potential contributors to future climate change. In this study, we address the comparative role of Greenland and Antarctic meltwater in the climate system and explore the differing mechanisms at work in each hemisphere. We find that the climate response is linear for low melt rates but becomes nonlinear for high melt rates. As the century proceeds, we speculate that Antarctic meltwater will increasingly dominate that of Greenland meltwater, leading to atmospheric cooling, Antarctic sea ice expansion, and contraction and warming of the Antarctic Bottom Water. Greenland meltwater will, instead, affect smaller changes in the Northern Hemisphere.
Impact of Mixed-Phase Cloud Parameterization on Warm Conveyor Belts and Upper-Tropospheric Dynamics
Authors: Mazoyer Marie , Ricard Didier , Rivière Gwendal , Delanoë Julien , Riette Sébastien , Augros Clotilde , Borderies Mary , Vié Benoit
Published: February 2023

This study investigates mixed-phase cloud (MPC) processes along the warm conveyor belts (WCBs) of two extratropical cyclones observed during the North Atlantic Waveguide and Downstream Impact Experiment (NAWDEX). The aim is to investigate the effect of two radically distinct parameterizations for MPCs on the WCB and the ridge building downstream: the first one (REF) drastically limits the formation of liquid clouds, while the second one (T40) forces the liquid clouds to exist. REF exhibits a stronger heating below 6-km height and a more important cooling above 6-km height than T40. The stronger heating at lower levels is due to more important water vapor depositional processes while the larger cooling at upper levels is due to differences in radiative cooling. The consequence is a more efficient potential vorticity destruction in the WCB outflow region and a more rapid ridge building in REF than T40. A comparison with airborne remote sensing measurements is performed. REF does not form any MPCs whereas T40 does, in particular in regions detected by the radar–lidar platform like below the dry intrusion. Comparison of both ice water content and reflectivity shows there may be too much pristine ice and not enough snow in REF and not enough cold hydrometeors in general in T40. The lower ice-to-snow ratio in T40 likely explains its better distribution of hydrometeors with respect to height compared to REF. These results underline the influence of MPC processes on the upper-tropospheric circulation and the need for more MPC observations in midlatitudes.

Significance Statement

The diabatic processes occurring in the warm conveyor belt (WCB) of extratropical cyclones impact the jet stream structure at midlatitudes. This study highlights some sensitivity of upper-level dynamics to mixed-phase-cloud-related processes. Comparisons of two different microphysical schemes for mixed-phase clouds shows that the ratio of liquid to solid clouds along the WCB ascents impacts the latent heat release and the radiation. Data from the NAWDEX campaign helps to determine room for improvement for both schemes and point out the need of a better understanding of these processes for an improved prediction of upper-level dynamics.
GACNNMDA: a computational model for predicting potential human microbe-drug associations based on graph attention network and CNN-based classifier
Authors: Ma Qing , Tan Yaqin , Wang Lei
Published: February 2023

As new drug targets, human microbes are proven to be closely related to human health. Effective computational methods for inferring potential microbe-drug associations can provide a useful complement to conventional experimental methods and will facilitate drug research and development. However, it is still a challenging work to predict potential interactions for new microbes or new drugs, since the number of known microbe-drug associations is very limited at present. In this manuscript, we first constructed two heterogeneous microbe-drug networks based on multiple measures of similarity of microbes and drugs, and known microbe-drug associations or known microbe-disease-drug associations, respectively. And then, we established two feature matrices for microbes and drugs through concatenating various attributes of microbes and drugs. Thereafter, after taking these two feature matrices and two heterogeneous microbe-drug networks as inputs of a two-layer graph attention network, we obtained low dimensional feature representations for microbes and drugs separately. Finally, through integrating low dimensional feature representations with two feature matrices to form the inputs of a convolutional neural network respectively, a novel computational model named GACNNMDA was designed to predict possible scores of microbe-drug pairs. Experimental results show that the predictive performance of GACNNMDA is superior to existing advanced methods. Furthermore, case studies on well-known microbes and drugs demonstrate the effectiveness of GACNNMDA as well. Source codes and supplementary materials are available at:https://github.com/tyqGitHub/TYQ/tree/master/GACNNMDA
Hyperoxia exposure upregulates Dvl-1 and activates Wnt/β-catenin signaling pathway in newborn rat lung
Authors: Zhu Yuting , Li Yawen , Jin Weilai , Li Zhengying , Zhang Le , Fang Yuanyuan , Zhang Yanyu
Published: February 2023

Background

Bronchopulmonary dysplasia is a serious and lifelong pulmonary disease in premature neonates that influences around one-quarter of premature newborns. The wingless-related integration site /β-catenin signaling pathway, which is abnormally activated in the lungs with pulmonary fibrosis, affects cell differentiation and lung development.

Methods

Newborn rats were subjected to hyperoxia exposure. Histopathological changes to the lungs were evaluated through immunohistochemistry, and the activation of disheveled and Wnt /β-catenin signaling pathway components was assessed by Western blotting and real-time PCR. The abilities of proliferation, apoptosis and migration were detected by Cell Counting Kit-8, flow cytometry and scratch wound assay, respectively.

Results

Contrasting with normoxic lungs, hyperoxia-exposed lungs demonstrated larger alveoli, fewer alveoli and thicker alveolar septa. Superoxide dismutase activity was significantly decreased (7th day: P < 0.05; 14th day: P < 0.01) and malondialdehyde significantly increased (7th day: P < 0.05; 14th day: P < 0.01) after hyperoxia exposure. Protein and mRNA expression levels of β-catenin, Dvl-1, CTNNBL1 and cyclin D1 were significantly upregulated by hyperoxia exposure on 7th day (P < 0.01) and 14th day (P < 0.01). In hyperoxic conditions, Dvl-l downregulation and Dvl-l downregulation + MSAB treatment significantly increased the proliferation rates, decreased the apoptosis rates and improved the ability of cell migration. In hyperoxic conditions, Dvl-l downregulation could decrease the mRNA expression levels of GSK3β, β-catenin, CTNNBL1 and cyclin D1 and decrease the protein relative expression levels of GSK3β, p-GSK3β, β-catenin, CTNNBL1 and cyclin D1.

Conclusions

We confirmed the positive role of Dvl-1 and the Wnt/β-catenin signaling pathway in promoting BPD in hyperoxia conditions and provided a promising therapeutic target.
The mediating roles of the oral microbiome in saliva and subgingival sites between e-cigarette smoking and gingival inflammation
Authors: Park Bongsoo , Koh Hyunwook , Patatanian Michael , Reyes-Caballero Hermes , Zhao Ni , Meinert Jill , Holbrook Janet T. , Leinbach Leah I. , Biswal Shyam
Published: February 2023

Background

Electronic cigarettes (ECs) have been widely used by young individuals in the U.S. while being considered less harmful than conventional tobacco cigarettes. However, ECs have increasingly been regarded as a health risk, producing detrimental chemicals that may cause, combined with poor oral hygiene, substantial inflammation in gingival and subgingival sites. In this paper, we first report that EC smoking significantly increases the odds of gingival inflammation. Then, through mediation analysis, we seek to identify and explain the mechanism that underlies the relationship between EC smoking and gingival inflammation via the oral microbiome.

Methods

We collected saliva and subgingival samples from 75 EC users and 75 non-users between 18 and 34 years in age and profiled their microbial compositions via 16S rRNA amplicon sequencing. We conducted raw sequence data processing, denoising and taxonomic annotations using QIIME2 based on the expanded human oral microbiome database (eHOMD). We then created functional annotations (i.e., KEGG pathways) using PICRUSt2.

Results

We found significant increases in α-diversity for EC users and disparities in β-diversity between EC users and non-users. We also found significant disparities between EC users and non-users in the relative abundance of 36 microbial taxa in the saliva site and 71 microbial taxa in the subgingival site. Finally, we found that 1 microbial taxon in the saliva site and 18 microbial taxa in the subgingival site significantly mediated the effects of EC smoking on gingival inflammation. The mediators on the genus level, for example, includeActinomyces,Rothia, Neisseria,andEnterococcusin the subgingival site. In addition, we report significant disparities between EC users and non-users in the relative abundance of 71 KEGG pathways in the subgingival site.

Conclusions

These findings reveal that continued EC use can further increase microbial dysbiosis that may lead to periodontal disease. Our findings also suggest that continued surveillance for the effect of ECs on the oral microbiome and its transmission to oral diseases is needed.
Contemporary in-hospital and long-term prognosis of patients with acute ST-elevation myocardial infarction depending on renal function: a retrospective analysis
Authors: Engelbertz Christiane , Feld Jannik , Makowski Lena , Kühnemund Leonie , Fischer Alicia Jeanette , Lange Stefan A. , Günster Christian , Dröge Patrik , Ruhnke Thomas , Gerß Joachim , Freisinger Eva , Reinecke Holger , Köppe Jeanette
Published: February 2023

Background

Cardiovascular disease is often associated with chronic kidney disease (CKD), resulting in an increased risk for poor outcome. We sought to determine short-term mortality and overall survival in ST-elevation myocardial infarction (STEMI) patients with different stages of CKD.

Methods

In our retrospective cohort study with health insurance claims data of the Allgemeine Ortskrankenkasse (AOK), anonymized data of all STEMI patients hospitalized between 2010 and 2017 were analyzed regarding presence and severity of concomitant CKD.

Results

A total of 175,187 patients had an index-hospitalisation for STEMI (without CKD: 78.6% patients, CKD stage 1: 0.8%, CKD stage 2: 4.8%, CKD stage 3: 11.7%, CKD stage 4: 2.8%, CKD stage 5: 0.7%, CKD stage 5d: 0.6%). Patients with CKD were older and had more co-morbidities than patients without CKD. With increasing CKD severity, patients received less revascularization therapies (91.2%, 85.9%, 87.0%, 81.8%, 71.7%, 76.9% and 78.6% respectively,p < 0.001). After 1 year, guideline-recommended medications were prescribed less frequently in advanced CKD (83.4%, 79.3%, 81.5%, 74.7%, 65.0%, 59.4% and 53.7%, respectively,p < 0.001). CKD stages 4, 5 and 5d as well as chronic limb threatening ischemia (CLTI) were associated with decreased overall survival [CKD stage 4: hazard ratio (HR) 1.72; 95% CI 1.66–1.78; CKD stage 5: HR 2.55; 95% CI 2.37–2.73; CKD stage 5d: 5.64; 95% CI 5.42–5.86; CLTI: 2.06; 95% CI 1.98–2.13; allp < 0.001].

Conclusions

CKD is a frequent co-morbidity in patients with STEMI and is associated with a worse prognosis especially in advanced stages. Guideline-recommended therapies in patients with STEMI and CKD are still underused.
ST-segment elevation predicts the occurrence of malignant ventricular arrhythmia events in patients with acute ST-segment elevation myocardial infarction
Authors: Wang Xianpei , Wei Lifang , Wu Ying , Yan Juanjuan , Zhao Linwei , Yue Xinjie , Gao Chuanyu
Published: February 2023

Background

ST-segment elevation (STE) represents a repolarization dispersion marker underlying arrhythmogenesis in ST-segment elevation myocardial infarction (STEMI); however, its value for predicting malignant ventricular arrhythmia events (MVAEs) remains uncertain.

Methods

In total, 285 patients with STEMI and those with or without MVAEs who presented within 6 h of symptom onset were enrolled. The relationships between STE and clinical characteristics of MVAEs (defined as ventricular tachycardia or ventricular fibrillation) were analyzed using t-test, chi-square test, binary multivariate logistic regression, and receiver operating characteristic curve analysis.

Results

Patients with STEMI and MVAEs had a shorter time from symptom onset to balloon time (p = 0.0285) and greater STE (p < 0.01) than those without MVAEs. The symptom-to-balloon time, age, and STE were associated with MVAEs after stepwise regression analysis in all cases. Only STE was significantly associated with the occurrence of MVAEs (all, p < 0.01). The area under the curve (AUC) of STE for predicting MVAEs was 0.905, and the cut-off value was 4.5 mV. When only infarct-related arteries were included in the analysis, the AUC of the left anterior descending artery was 0.925 with a cut-off value of 4.5 mV, that of the right coronary artery was 0.915 with a cut-off value of 4.5 mV, and that of the left circumflex artery was 0.929 with a cut-off value of 4.0 mV.

Conclusions

In patients with STEMI presenting within 6 h of symptom onset, age, symptom-to-balloon time, and STE were the main predictors for MVAEs. However, among these, STE was the strongest predictor for MVAEs and was an index for repolarization dispersion of cardiomyocytes in infarcted and non-infarcted areas.
Low detection rate of RT-PCR-confirmed COVID-19 using IgM/IgG rapid antibody tests in a large community sample in Lima, Peru
Authors: Law Stephanie , Tovar Marco A. , Franke Molly F. , Calderon Roger , Palomino Santiago , Valderrama Gissella , Llanos Fernando , Velásquez Gustavo E. , Mitnick Carole D. , Lecca Leonid
Published: February 2023

Background

Rapid IgM/IgG antibody tests were largely used in lieu of RT-PCR tests as part of COVID-19 public health response activities in Lima, Peru. To assess their utility, we explored the relationship between the time since onset of several COVID-19-related symptoms and the sensitivity of a rapid combined IgM/IgG antibody test.

Methods

We collected data from a community sample of individuals (n = 492) who received concurrent RT-PCR and rapid IgM/IgG antibody testing between May 2020 and March 2021. We estimated the sensitivity of the antibody test, against the RT-PCR test, by weeks since symptom onset via segmented regression analysis.

Results

The overall sensitivity of the rapid IgM/IgG antibody test was 46.7% (95% CI, 42.4–51.2%). Among 372 (75.6%) participants who reported COVID-19-related symptoms, sensitivity increased from 30.4% (95% CI, 24.7–36.6%) in week 1 after symptom onset to 83.3% (95% CI, 41.6–98.4%) in week 4. The test sensitivity increased by 31.9% (95% CI, 24.8–39.0%) per week until week 2 to 3, then decreased by − 6.0% (95% CI, − 25.7–13.7%) per week thereafter.

Conclusion

Rapid antibody tests are a poor substitute for RT-PCR testing, regardless of presenting symptoms. This highlights the need for future pandemic planning to include timely and equitable access to gold-standard diagnostics, treatment, and vaccination.
Automated assessment of the smoothness of retinal layers in optical coherence tomography images using a machine learning algorithm
Authors: Saeidian Jamshid , Mahmoudi Tahereh , Riazi-Esfahani Hamid , Montazeriani Zahra , Khodabande Alireza , Zarei Mohammad , Ebrahimiadib Nazanin , Jafari Behzad , Afzal Aghaei Alireza , Azimi Hossein , Khalili Pour Elias
Published: February 2023

Quantifying the smoothness of different layers of the retina can potentially be an important and practical biomarker in various pathologic conditions like diabetic retinopathy. The purpose of this study is to develop an automated machine learning algorithm which uses support vector regression method with wavelet kernel and automatically segments two hyperreflective retinal layers (inner plexiform layer (IPL) and outer plexiform layer (OPL)) in 50 optical coherence tomography (OCT) slabs and calculates the smoothness index (SI). The Bland–Altman plots, mean absolute error, root mean square error and signed error calculations revealed a modest discrepancy between the manual approach, used as the ground truth, and the corresponding automated segmentation of IPL/ OPL, as well as SI measurements in OCT slabs. It was concluded that the constructed algorithm may be employed as a reliable, rapid and convenient approach for segmenting IPL/OPL and calculating SI in the appropriate layers.
Serum and plasma levels of Ba, but not those of soluble C5b-9, might be affected by renal function in chronic kidney disease patients
Authors: Yamane Ryoko , Yasuda Yoshinari , Oshima Aki , Suzuki Yasuhiro , Kojima Hiroshi , Kim Hangsoo , Fukui Sosuke , Maruyama Shoichi , Ito Yasuhiko , Mizuno Masashi
Published: February 2023

Background

During the last few decades, pathogenic mechanisms associated with uncontrolled activation of the complement (C) system and development of anti-C agents have been closely investigated in the field of nephrology. The usefulness of some C products such as C5a and sC5b-9 for diagnostic and prognostic purposes remains controversial. On the other hand, decreased renal function is being observed in many patients with or without nephritis as a background factor in progressively aging societies. We therefore investigated whether renal function influenced the evaluation of various complement components and activation products.

Methods

To investigate the influence of renal function on evaluations of C3, C4, CH50, Ba, C5a and sC5b-9, 40 patients were retrospectively chosen from among 844 patients without active glomerulonephritis from 2009 to 2016. We measured plasma and serum levels of C3, C4, CH50, Ba, C5a and sC5b-9 using enzyme-linked immunosorbent assays and compared the findings with inulin clearance (Cin) as a marker of preserved renal function.

Results

Both plasma and serum levels of Ba correlated significantly with Cin, but other values did not. Compared with patients with Cin ≥ 60 or ≥ 30 mL/min/1.73 m2, plasma and serum levels of Ba were increased in patients with Cin decreased to < 60 or < 30 mL/min/1.73 m2, but levels of C5a and sC5b-9 were not.

Conclusion

The influence of renal function might need to be considered when evaluating Ba, but not C5a and sC5b-9, in plasma and serum samples from chronic kidney disease patients.
Breastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis
Authors: Scime Natalie V. , Metcalfe Amy , Nettel-Aguirre Alberto , Nerenberg Kara , Seow Cynthia H. , Tough Suzanne C. , Chaput Kathleen H.
Published: February 2023

Background

Breastfeeding difficulties frequently exacerbate one another and are common reasons for curtailed breastfeeding. Women with chronic conditions are at high risk of early breastfeeding cessation, yet limited evidence exists on the breastfeeding difficulties that co-occur in these mothers. The objective of this study was to explore clusters of breastfeeding difficulties experienced up to 6 weeks postpartum among mothers with chronic conditions and to examine associations between chronic condition types and breastfeeding difficulty clusters.

Methods

We analyzed 348 mothers with chronic conditions enrolled in a prospective, community-based pregnancy cohort study from Alberta, Canada. Data were collected through self-report questionnaires. We used latent class analysis to identify clusters of early breastfeeding difficulties and multinomial logistic regression to examine whether types of chronic conditions were associated with these clusters, adjusting for maternal and obstetric factors.

Results

We identified three clusters of breastfeeding difficulties. The “physiologically expected” cluster (51.1% of women) was characterized by leaking breasts and engorgement (reference outcome group); the “low milk production” cluster (15.4%) was discerned by low milk supply and infant weight concerns; and the “ineffective latch” cluster (33.5%) involved latch problems, sore nipples, and difficulty with positioning. Endocrine (adjusted relative risk ratio [RRR] 2.34, 95% CI 1.10–5.00), cardiovascular (adjusted RRR 2.75, 95% CI 1.01–7.81), and gastrointestinal (adjusted RRR 2.51, 95% CI 1.11–5.69) conditions were associated with the low milk production cluster, and gastrointestinal (adjusted RRR 2.44, 95% CI 1.25–4.77) conditions were additionally associated with the ineffective latch cluster.

Conclusion

Half of women with chronic conditions experienced clusters of breastfeeding difficulties corresponding either to low milk production or to ineffective latch in the first 6 weeks postpartum. Associations with chronic condition types suggest that connections between lactation physiology and disease pathophysiology should be considered when providing breastfeeding support.
Cardiac and obstetric outcomes of pregnancies for women after cardiotoxic therapy in childhood: a single center observational study
Authors: Heemelaar Julius C. , Heemelaar Steffie , Hertel Svenja N. , Jukema J. Wouter , Sueters Marieke , Louwerens Marloes , Antoni M. Louisa
Published: February 2023

Background

Childhood cancer survivors (CCS) are at increased risk of cardiomyopathy during pregnancy if they have prior cardiotoxic exposure. Currently, there is no consensus on the necessity, timing and modality of cardiac monitoring during and after pregnancy. Therefore, we examined cardiac function using contemporary echocardiographic parameters during pregnancy in CCS with cardiotoxic treatment exposure, and we observed obstetric outcomes in CCS, including in women without previous cardiotoxic treatment exposure.

Method

A single-center retrospective cohort study was conducted among 39 women enrolled in our institution’s cancer survivorship outpatient clinic. Information on potential cardiotoxic exposure in childhood, cancer diagnosis and outcomes of all pregnancies were collected through interviews and review of health records. Echocardiographic exams before and during pregnancy were retrospectively analyzed for left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) if available. The primary outcomes were (i) left ventricular dysfunction (LVD) during pregnancy, defined as LVEF < 50% or a decline of ≥ 10% in LVEF below normal (< 54%), and (ii) symptomatic heart failure (HF). Rate of obstetric and fetal complications was compared to the general population through the national perinatal registry (PERINED).

Results

All pregnancies (91) of 39 women were included in this study. The most common malignancy was leukemia (N = 17, 43.6%). In 22 patients, echocardiograms were retrospectively analyzed. LVEFbaseline was 55.4 ± 1.2% and pre-existing subnormal LVEF was common (7/22, 31.8/%). The minimum value of LVEF during pregnancy was 3.8% lower than baseline (p = 0.002). LVD occurred in 9/22 (40.9%) patients and HF was not observed. When GLS was normal at baseline (< -18.0%; N = 12), none of the women developed LVD. Nine of out ten women with abnormal GLS at baseline developed LVD later in pregnancy. In our cohort, the obstetric outcomes seemed comparable with the general population unless patients underwent abdominal irradiation (N = 5), where high rates of preterm birth (only 5/18 born at term) and miscarriage (6/18 pregnancies) were observed.

Conclusion

Our study suggests that women with prior cardiotoxic treatment have a low risk of LVD during pregnancy if GLS at baseline was normal. Pregnancy outcomes are similar to the healthy population except when patients underwent abdominal irradiation.
Bionic reconstruction of tension trabeculae in short-stem hip arthroplasty: a finite element analysis
Authors: Ding Zhentao , Wang Jun , Wang Yanhua , Zhang Xiaomeng , Huan Yong , Zhang Dianying
Published: February 2023

Background

Short-stem hip arthroplasty (SHA) is characterized by metaphyseal load transfer that effectively preserves the bone stock, but still suffers from stress shielding in the proximal femur. We designed a tension screw to mimic tension trabeculae in the new bionic collum femoris preserving (BCFP) short stem for bionic reconstruction, aiming to restore the biomechanics of hip joint.

Methods

Native femur finite element model was constructed to investigate the biomechanics of hip joint based on computed tomography (CT) data. The maximum absolute principal stress/strain cloud chart allowed the direction of stress/strain to be assessed. Six BCFP models with different screw angles (5°, 10°, 15°, 20°, 25°, and 30°) and the Corail model were created. The stress/strain distribution and overall stiffness were compared between each of the BCFP and Corail implanted models.

Results

The native model visualized the transfer pathways of tensile and compressive stress. The BCFP stems showed significantly higher stress and strain distribution in the greater trochanteric region compared to conventional total hip arthroplasty (THA). In particular, the BCFP-5° stem demonstrated the highest average strain in both medial and lateral regions and the overall stiffness was closest to the intact femur.

Conclusions

Stress transfer pathways of trabecular architecture provide biomechanical insight that serves as the basis for bionic reconstruction. The tension screw improves load transfer pattern in the proximal femur and prevents stress reduction in the greater trochanteric region. The BCFP-5° stem minimizes the stress shielding effect and presents a more bionic mechanical performance.
Evaluating the association between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, mental health, and cardio-metabolic risk factors among individuals with obesity
Authors: Ardekani Abnoos Mokhtari , Vahdat Sahar , Hojati Ali , Moradi Hadi , Tousi Ayda Zahiri , Ebrahimzadeh Farnoosh , Farhangi Mahdieh Abbasalizad
Published: February 2023

Background

Several previous investigations have examined the brain-protective role of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. However, more knowledge is needed about the MIND diet's other favorable impacts. The purpose of this study was to examine the relationship between the MIND diet, mental health, and metabolic markers in individuals with obesity.

Methods

In this cross-sectional study, we included 339 individuals with obesity (BMI ≥ 30 kg/m2) aged 20–50 years. We utilized a semi-quantitative Food Frequency Questionnaire (FFQ), we assessed dietary intake, including 168 food items, and calculated the value of MIND. Metabolic syndrome (MetS) was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) guidelines. We assessed biochemical parameters using Enzymatic methods. Blood pressure and body composition were also determined.

Results

Higher tertiles of the MIND diet score were associated with significantly higher energy intake, macronutrients, and brain-healthy food intakes (P < 0.001). Among the brain-unhealthy foods, only the intake of sweets and pastries was significantly lower in the highest versus lowest MIND tertiles. We also observed lower odds of stress (P < 0.05) and higher insulin sensitivity (P < 0.05) in the highest versus lowest MIND diet tertiles. We witnessed no significant changes in other parameters.

Conclusion

Lower stress levels and higher insulin sensitivity independent of some confounders like age, BMI, sex, and physical activity were associated with the highest tertile of MIND diet score.
Psoriasis and oral health in adult United States population: a cross-sectional study
Authors: Hussein Mai , Farag Youssef M. K. , Sonis Stephen
Published: February 2023

Objectives

To detect the association between psoriasis as an exposure and oral health conditions as outcomes represented by periodontal and dentition status. This was addressed by analysis of a large number of adults in the United States.

Methods

By using The National Health and Nutrition Examination Survey datasets from 2009 to 2014, we performed a cross-sectional analysis of 11,726 participants included in our study population. For participants aged ≥ 30 years, the psoriasis status was assessed from the medical questionnaire. We used data from periodontal and oral examinations to assess the oral conditions of our participants. We examined the association between psoriasis as exposure and moderate/severe periodontitis and non-functional dentition as outcomes.

Results

The weighted prevalence of psoriasis was 3%, 44% for moderate/severe periodontitis, and 20.5% for non-functional dentition. The fully adjusted model showed no significant association between psoriasis and moderate/severe periodontitis (Prevalence Ratio 1.02, 95% CI 0.9–1.2, p = 0.8). There was no statistically significant association between psoriasis and non-functional dentition except in the fully adjusted model it became statistically significant (Prevalence Ratio 0.8, 95% CI 0.7–0.9, p = 0.04).

Conclusion

Our results showed no association between psoriasis and periodontal or dentition status except in a fully adjusted model for non-functional dentition.
The effect of online video-assisted teaching program on medical students learning procedure of fractional curettage
Authors: Chucherd Oracha , Vallibhakara Sakda Arj-Ong , Paiwattananupant Krissada , Puranitee Pongtong , Wattanayingcharoenchai Rujira , Vallibhakara Orawin
Published: February 2023

Objectives

Since 2020, with the entire world in crisis over the coronavirus pandemic (COVID-19), medical students have adapted to hybrid and distance learning. This study aims to compare the learning outcomes of students learning the procedure of fractional curettage in an online video-assisted teaching program to those of students learning the procedure in a traditional class.

Methods

A quasi-experimental study was conducted among fourth-year medical students who rotated to Obstetrics and Gynecology courses between April 2021 and October 2021. Participants in the first two rotations were enrolled in traditional classes, and the online video-assisted teaching program was introduced in the subsequent two rotations. Both study groups took OSCEs (objective structured clinical examinations), a pre-test and post-test with MCQs (multiple choice questions), and a confidence and satisfaction level questionnaire.

Results

A total of 106 fourth-year medical students, 54 in the traditional group and 52 in the online video-assisted teaching program, were recruited. The online video-assisted group showed a statistically better mean OSCE score (85.67 ± 11.29 vs. 73.87 ± 13.01, p < 0.001) and mean post-test MCQ score than the traditional group (4.21 ± 0.87 vs. 3.80 ± 0.98, p = 0.0232). Moreover, the mean difference between the two groups' pre and post-test MCQ scores was significantly different (0.96 ± 1.37 vs. 1.79 ± 1.50 in traditional and online video-assisted teaching program groups, respectively, P = 0.0038). The participants in the experimental group reported significantly greater confidence (P < 0.001) in performing the fractional curettage procedure. However, the mean satisfaction score was significantly higher in the control group (p = 0.0053).

Conclusion

The online video-assisted teaching program on the fractional curettage procedure, a necessary and skill-demanding procedure, is an effective and advantageous education tool that improves skills, knowledge, and confidence in fourth-year medical students. We recommend that the video-assisted teaching program is another effectively procedural teaching method for medical students.
Design, implementation, and evaluation of the computer-aided clinical decision support system based on learning-to-rank: collaboration between physicians and machine learning in the differential diagnosis process
Authors: Miyachi Yasuhiko , Ishii Osamu , Torigoe Keijiro
Published: February 2023

Background

We are researching, developing, and publishing the clinical decision support system based on learning-to-rank. The main objectives are (1) To support for differential diagnoses performed by internists and general practitioners and (2) To prevent diagnostic errors made by physicians. The main features are that “A physician inputs a patient's symptoms, findings, and test results to the system, and the system outputs a ranking list of possible diseases”.

Method

The software libraries for machine learning and artificial intelligence are TensorFlow and TensorFlow Ranking. The prediction algorithm is Learning-to-Rank with the listwise approach. The ranking metric is normalized discounted cumulative gain (NDCG). The loss functions are Approximate NDCG (A-NDCG). We evaluated the machine learning performance on k-fold cross-validation. We evaluated the differential diagnosis performance with validated cases.

Results

The machine learning performance of our system was much higher than that of the conventional system. The differential diagnosis performance of our system was much higher than that of the conventional system. We have shown that the clinical decision support system prevents physicians' diagnostic errors due to confirmation bias.

Conclusions

We have demonstrated that the clinical decision support system is useful for supporting differential diagnoses and preventing diagnostic errors. We propose that differential diagnosis by physicians and learning-to-rank by machine has a high affinity. We found that information retrieval and clinical decision support systems have much in common (Target data, learning-to-rank, etc.). We propose that Clinical Decision Support Systems have the potential to support: (1) recall of rare diseases, (2) differential diagnoses for difficult-to-diagnoses cases, and (3) prevention of diagnostic errors. Our system can potentially evolve into an explainable clinical decision support system.
Physician altruism under the change from pure payment system to mixed payment schemes: experimental evidence
Authors: Zhang Yue , Li Xing , Zhang Xinyuan , Li Xinyan , Lin Xing , Han Youli
Published: February 2023

Background

Mixed payment schemes have become one of the effective measures to balance medical costs and quality of medical services. However, altruism as an intrinsic motivation may influence the effect of switching from a pure payment system to mixed payment schemes. This study aimed to quantify physicians’ altruism and analyze the effect of changes of payment system on physicians’ altruism and thus proposed references for the reform of payment system.

Methods

We simulated an exogenous payment system in a controlled laboratory with five experimental groups and 150 medical student subjects. Physicians’ altruism was measured by estimating altruistic parameter and marginal rate of substitution. The non-parametric test and the least square regression analysis were used to analyze the differences of altruistic parameters between pure payment systems and mixed payment schemes. Finally, we analyzed the effect of changes in payment system accompanied by changes in trade-off range on physicians’ altruism.

Results

We find that the mean value of individual altruistic parameter is 0.78 and the marginal rate of substitution is 1.078. Their estimates at the individual level were significantly positively correlated (Spearman’s ρ = 0.715, p < 0.01). The shift from pure payment system to mixed payment scheme reduced the altruistic parameter. However, the altruistic parameter increased with the increase of the trade-off range. Physicians who were more altruistic generated higher patients’ health benefit. For each unit increase in altruistic parameter, the increase in patients’ health benefit was lower in mixed payment scheme than in the pure payment system.

Conclusion

The estimates of altruistic parameters are reliable. Physicians attach a higher weight to patients’ benefit than to their own profit. Mixed payment schemes improve physicians’ behavior and relate to lower altruistic parameters; physicians only need to sacrifice less personal profits to generate the same or even higher altruistic parameter as under the pure payment system. The design of mixed payment schemes that make the interests of physicians and patients close to each other by reducing the trade-off range can provide implication for the reform of payment system in which the physicians’ interest and the patients’ benefit are consistent.
High-energy diet modify rumen microbial composition and microbial energy metabolism pattern in fattening sheep
Authors: Ge Ting , Yang Chen , Li Bo , Huang Xiaoyu , Zhao Leiyun , Zhang Xiaoqiang , Tian Lintao , Zhang Enping
Published: February 2023

Higher dietary energy is often used to achieve better animal performance in mutton sheep production. Notably, changing the diet formula affects rumen fermentation and the microbiota of ruminants. In this study, we investigated the effect of dietary energy on rumen fermentation and ruminal microbiota in fattening sheep. Fifteen 2-month-old white-headed Suffolk sheep (♂) × Hu sheep (♀) crossbred lambs were randomly divided into three treatments based on the dietary energy of the feeds fed: 8.67 MJ/kg (Low energy (LE); n = 5), 10.38 MJ/kg (standard energy (CON); n = 5), and 12.31 MJ/kg (high energy (HE); n = 5) groups. After 70 days of feeding, sheep were slaughtered and the ruminal fluids were collected and analyzed to determine fermentation parameters. Microbiota was determined using metagenomics sequencing. Notably, the microbial cell protein (MCP) and butyric acid concentrations were significantly high in the HE group. Metagenomic sequencing revealed that ACE and Chao indexes of the HE group were significantly decreased. Four genera among the major classified taxa across all the kingdoms differed in relative abundance in the three dietary energy levels. The relative abundances of Prevotella_brevis, Succiniclasticum_ruminis, Prevotellace-ae_bacterium, and Lachnospiraceae_bacterium were significantly correlated with rumen fermentation. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis further revealed that a high-energy diet increased lipid metabolism of microbiota. The Carbohydrate Active enzymes (CAZy) gene, which participates in energy metabolism, was upregulated, while genes regulating plant cell wall degradation were downregulated in the HE group. These results suggest that a high-energy diet had minimal influence on the rumen fermentation pattern but altered the composition of the rumen microbiota, enhancing microbial lipid metabolism and limiting crude fiber metabolism. The findings of this study provide scientific evidence of the effect of dietary energy on ruminant fermentation and fattening sheep production.
Treatment of infected thoracic aortic aneurysm with combined abscess debridement and stent-graft wrapping using pedicled latissimus dorsi muscle flaps after thoracic endovascular aortic repair
Authors: Matsushima Hirokazu , Ishimine Tohru , Taniguchi Naoki , Tengan Toshiho
Published: February 2023

Background

Open thoracic surgery (with infected lesion removal, prosthetic graft replacement, and pedicled tissue flap) has remained the main treatment for infected thoracic aortic aneurysms to date. Recent reports have highlighted good prognostic outcomes with thoracic endovascular aortic repair. However, thoracic endovascular aortic repair for infected thoracic aortic aneurysms is associated with an exacerbation of infection due to residual infected tissues. We discuss the control of refractory infections following endovascular treatment of infected thoracic aortic aneurysms.

Case presentation

An 81-year-old man, with a history of insulin-dependent diabetes mellitus and pancreaticoduodenectomy, presented to our emergency department with a fever. Blood tests revealed a markedly elevated leukocyte count, and contrast-enhanced computed tomography suggested a descending thoracic aortic pseudoaneurysm. We diagnosed the patient with an infected descending thoracic aortic aneurysm, and performed urgent thoracic endovascular aortic repair; he was started on an intravenous antibiotic treatment. Postoperatively, blood tests revealed a decreased leukocyte count and the patient remained afebrile. However, computed tomography revealed temporal enlargement of the abscess cavity; therefore, an abscess debridement and stent graft wrapping with pedicled latissimus dorsi muscle flaps were performed, which successfully controlled the infection. Six weeks after abscess debridement, the patient was switched to an oral antibiotic therapy. There was no evidence of recurrence of infection 8 months after the surgery.

Conclusions

A combined abscess debridement and pedicled tissue flap approach is useful for patients with poor surgical tolerance in whom infection control is difficult after thoracic endovascular aortic repair for infected thoracic aortic aneurysms. Pedicled latissimus dorsi muscle flaps are useful when using the omentum for pedicled tissue flap is difficult.
Recruitment across two decades of NIH-funded Alzheimer’s disease clinical trials
Authors: Ritchie Marina , Gillen Daniel L. , Grill Joshua D.
Published: February 2023

Background

Timely accrual of a representative sample is a key factor in whether Alzheimer’s disease (AD) clinical trials successfully answer the scientific questions under study. Studies in other fields have observed that, over time, recruitment to trials has become increasingly reliant on larger numbers of sites, with declines in the average per-site recruitment rate. Here, we examined the trends in recruitment over a 20-year period of NIH-funded AD clinical trials conducted by the Alzheimer’s Disease Cooperative Study (ADCS), a temporally consistent network of sites devoted to interventional research.

Methods

We performed retrospective analyses of eleven ADCS randomized clinical trials. To examine the recruitment planning, we calculated the expected number of participants to be enrolled per site for each trial. To examine the actual trial recruitment rates, we quantified the number of participants enrolled per site per month.

Results

No effects of time were observed on recruitment planning or overall recruitment rates across trials. No trial achieved an overall recruitment rate greater than one subject per site per month. We observed the fastest recruitment rates in trials with no competition and the slowest in trials that overlapped in time. The highest recruitment rates were consistently seen early within trials and declined over the course of studies.

Conclusions

Trial recruitment projections should plan for fewer than one participant randomized per site per month and consider the number of other AD trials being conducted concurrently.