bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of the cage height and positioning on clinical and radiographic outcome of lateral lumbar interbody fusion: a retrospective study
Authors: Wu Changyuan , Bian Hanming , Liu Jie , Zhao Dong , Yang Haiyun , Chen Chao , Sun Xun , Guan Binggang , Sun Guiming , Liu Gang , Xu Baoshan , Ma Xinlong , Wang Zheng , Yang Qiang
Published: December 2022

Background

The proper cage positioning and height in lateral lumbar interbody fusion (LLIF). This study evaluated their effects on clinical and radiographic outcome measures in patients undergoing LLIF.

Methods

This single-center retrospective study analyzed the characteristics and perioperative data of patients who underwent LLIF between January 2019 and December 2020. Radiographic (lumbar lordosis [LL], foraminal height, disc height [DH], segmental angle [SA], cross-sectional area [CSA] of thecal sac) and clinical (Oswestry Disability Index and Visual Analog Scale) outcomes were assessed preoperatively, postoperatively, and at the last follow-up. The effects of cage height and positioning on these parameters were also investigated.

Results

With a mean follow-up of 12.8 months, 47 patients with 70 operated level were analyzed. Data demonstrated that postsurgical clinical and radiographic outcome measures were significantly better than before surgery(P < 0.05). Cage height and positioning showed no significant difference with regarding to clinical outcome(P > 0.05). Subgroup analysis of the cage positioning showed that DH and SA were better restored by the final follow-up in patients with anteriorly placed cages than those with posteriorly placed cages (P < 0.05). Cages of posterior position showed significantly upgrading cage subsidence (P = 0.047). Cage height subgroup analysis showed that the preoperative forminal height, DH, and SA in the 11-mm cage group were significantly lower than in the 13-mm cage group; however, these parameters were comparable in the two groups postoperatively and at the final follow-up (P > 0.05). Furthermore, the postoperative and final follow-up degrees of DH, SA, and LL have improved in the 11-mm cage group more than the 13-mm cage group. The preoperative, postoperative, and final follow-up LL values in the 11-mm cage group were lower than in the 13-mm cage group(P < 0.01).

Conclusions

Cage height and positioning did not affect the clinical outcomes in the present study. Cages in anterior position showed better restoration in DH, SA and decreased the incidence of cage subsidence. A comparable radiographic outcome can be achieved by inserting an appropriate cage height based on preoperative radiography.
Enhancing docosahexaenoic acid production of Schizochytrium sp. by optimizing fermentation using central composite design
Authors: Ding Jun , Fu Zilin , Zhu Yingkun , He Junhao , Ma Lu , Bu Dengpan
Published: December 2022

Docosahexaenoic acid (DHA) can improve human and animal health, particularly including anti-inflammatory, antioxidant, anticancer, neurological, and visual functions. Schizochytrium sp. is a marine heterotrophic protist producing oil with high DHA content, which is widely used in animal and food production. However, different fermentation conditions have intensive impacts on the growth and DHA content of Schizochytrium sp. Thus, this study aimed to enhance the DHA yield and concentration of Schizochytrium sp. I-F-9 by optimizing the fermentation medium. First, a single-factor design was conducted to select a target carbon and nitrogen source from several generic sources (glucose, sucrose, glycerol, maltose, corn syrup, yeast extract, urea, peptone, and ammonium sulfate). The Plackett–Burman design and the central composite design (CCD) were utilized to optimize the fermentation mediums. Schizochytrium sp. in 50-mL fermentation broth was cultured in a 250 mL shake flask at 28 °C and 200 rpm for 120 h before collecting the cell pellet. Subsequently, the cell walls were destroyed with hydrochloric acid to extract the fatty acid using n-hexane. The DHA content was detected by gas chromatography. The single-factor test indicated that glucose and peptone, respectively, significantly improved the DHA content of Schizochytrium sp. compared to the other carbon and nitrogen sources. Glucose, sodium glutamate, and sea crystal were the key factors affecting DHA production in the Plackett–Burman test (P = 0.0247). The CCD result showed that DHA production was elevated by 34.73% compared with the initial yield (from 6.18 ± 0.063 to 8.33 ± 0.052 g/L). Therefore, the results of this study demonstrated an efficient strategy to increase the yield and content of DHA of Schizochytrium sp.
Accurate detection for dental implant and peri-implant tissue by transfer learning of faster R-CNN: a diagnostic accuracy study
Authors: Jang Woo Sung , Kim Sunjai , Yun Pill Sang , Jang Han Sol , Seong You Won , Yang Hee Soo , Chang Jae-Seung
Published: December 2022

Background

The diagnosis of dental implants and the periapical tissues using periapical radiographs is crucial. Recently, artificial intelligence has shown a rapid advancement in the field of radiographic imaging.

Purpose

This study attempted to detect dental implants and peri-implant tissues by using a deep learning method known as object detection on the implant image of periapical radiographs.

Methods

After implant treatment, the periapical images were collected and data were processed by labeling the dental implant and peri-implant tissue together in the images. Next, 300 images of the periapical radiographs were split into 80:20 ratio (i.e. 80% of the data were used for training the model while 20% were used for testing the model). These were evaluated using an object detection model known as Faster R-CNN, which simultaneously performs classification and localization. This model was evaluated on the classification performance using metrics, including precision, recall, and F1 score. Additionally, in order to assess the localization performance, an evaluation through intersection over union (IoU) was utilized, and, Average Precision (AP) was used to assess both the classification and localization performance.

Results

Considering the classification performance, precision = 0.977, recall = 0.992, and F1 score = 0.984 were derived. The indicator of localization was derived as mean IoU = 0.907. On the other hand, considering the indicators of both classification and localization performance, AP showed an object detection level of AP@0.5 = 0.996 and AP@0.75 = 0.967.

Conclusion

Thus, the implementation of Faster R-CNN model for object detection on 300 periapical radiographic images including dental implants, resulted in high-quality object detection for dental implants and peri-implant tissues.
Effect of virtual cement space and restorative materials on the adaptation of CAD-CAM endocrowns
Authors: Zheng Ziting , Wang Hebi , Mo Jiayao , Ling Zhiting , Zeng Yuting , Zhang Yuxin , Wang Jilei , Yan Wenjuan
Published: December 2022

Background

This study aimed to evaluate the effect of virtual cement space and restorative materials on the fit of computer-aided design and computer-aided manufacturing (CAD-CAM) endocrowns.

Methods

A mandibular first molar tooth model received a butt joint margin endocrown preparation with a 2-mm occlusal thickness. Then, using a 3D-printing system, 120 copies of this prepared die were printed and assigned equally to three groups with different cement space settings (30, 60, and 120 μm) during the chairside CAD design. In the milling process, CAD-based models with a particular space setting were subdivided into four groups (n = 10) and fabricated from different CAD-CAM materials: Vita Suprinity (VS), Celtra Duo (CD), Lava Ultimate (LU), and Grandio blocs (GR). Finally, the endocrowns were stabilized over their corresponding models with siloxane and subjected to micro-computed tomography to measure the fit.

Results

The cement space that was predesigned at 30 μm generated the largest marginal discrepancy (from 144.68 ± 22.43 μm to 174.36 ± 22.78 μm), which was significantly different from those at 60 μm and 120 μm (p < 0.001). The combination of VS or CD with a pre-setting cement space of 60 μm and the combination of LU or GR with a cement space of 120 μm showed better agreement between the predesigned and actual measured marginal gap widths. For internal adaptation, only the cement space set to 30 μm exceeded the clinically acceptable threshold (200 μm).

Conclusions

The setting of the cement space and restorative material significantly affected the marginal adaptation of CAD-CAM endocrown restorations. Considering the discrepancy between design and reality, different virtual cement spaces should be applied to ceramic and resin composite materials.
Factors influencing adoption of e-learning in healthcare: integration of UTAUT and TTF model
Authors: Abdekhoda Mohammadhiwa , Dehnad Afsaneh , Zarei Javad
Published: December 2022

Background

The importance of successful implementation of e-learning, especially since the emergence of the Covid-19 pandemic, has become increasingly apparent to universities. Thus, identifying the effective factors in adopting e-learning in the Covid-19 pandemic is crucial. This study was conducted to identify determining factors in adopting E-learning in healthcare.

Method

This was a descriptive-analytical study in which 143 faculty members from Iran were randomly selected. The faculty members’ intentions, concerning the adoption of e-learning, were assessed by the conceptual path model of integration of unified theory of acceptance and use of technology (UTAUT) and The Task-Technology Fit (TTF).

Results

The results showed that the combination of the two classical theories, UTAUT and TTF, was an appropriate model to explain faculty members’ intention in adopting e-learning. Moreover, the findings showed that technology and task characteristics, task- technology fit, social influences, effort expectancy, performance expectancy and facilitating conditions had direct and significant effect on e-learning adoption.

Conclusion

By presenting a conceptual path model to elucidate users’ behavior in adopting e-learning, this study investigated and identified the key determining factors in adopting e-learning. The findings of the present study can contribute to the design and implementation of e-learning by practitioners, policy makers, and curriculum designers.
Longitudinal association of childhood physical activity and physical fitness with physical activity in adolescence: insights from the IDEFICS/I.Family study
Authors: Breau Becky , Brandes Mirko , Veidebaum Toomas , Tornaritis Michael , Moreno Luis A. , Molnár Dénes , Lissner Lauren , Eiben Gabriele , Lauria Fabio , Kaprio Jaakko , De Henauw Stefaan , Ahrens Wolfgang , Buck Christoph ,   on behalf of the IDEFICS/I.Family consortia
Published: December 2022

Background

This study aimed to examine associations of early childhood physical fitness and physical activity (PA) with PA during later childhood/early adolescence while accounting for gender differences.

Methods

We selected data of N = 4329 children from the IDEFICS/I. Family cohort (age 2.4–11.7 years) with data on baseline fitness and accelerometer measurements. At baseline, physical fitness tests were conducted including Flamingo balance, Backsaver sit and reach, Handgrip strength, Standing Long Jump, 40-m sprint and 20-m Shuttle run (to estimate cardio-respiratory fitness levels). PA was measured with Actigraph accelerometers over 3 days at baseline (ActiTrainer or GT1M) and 7 days at follow-up (GT3X). Evenson cutpoints were used to determine moderate-to-vigorous PA (MVPA) time, and children with ≥60mins/day of average MVPA were deemed as having met WHO guidelines at baseline and follow-up. Linear and logistic regressions were performed to examine longitudinal associations between meeting WHO guidelines, MVPA, and physical fitness tests at baseline with meeting WHO guidelines and MVPA at follow-up. Models were conducted on the entire sample, the sex-stratified sample, and stratified by sex and pubertal status at follow-up.

Results

Results showed that meeting WHO guidelines for MVPA at baseline was positively associated with MVPA (Standardized Beta (B) = 0.13, 95%CI:(5.6;11.1)) and meeting WHO guidelines at follow-up for the entire sample (OR = 2.1, 95%CI:(1.5; 3.14), and stratified by males (OR = 2.5, 95%CI:(1.5; 4.1)) and females (OR = 1.8, 95%CI:(1.0; 3.2)). This was also found for both male pre/early pubertal and pubertal groups but only in the female pre/early pubertal group, and not the female pubertal group (MVPA: B = .00, 95%CI:(− 6.1; 5.6), WHO: OR = 0.61, 95%CI:(0.23;1.6)). Models indicated that Standing Long jump, 40-m sprint, Shuttle run and Flamingo balance at baseline were associated with MVPA and meeting the guidelines at follow-up.

Conclusions

Meeting WHO guidelines and certain fitness tests at baseline were strongly associated with MVPA and meeting WHO guidelines at follow-up, but this association varied with sex and pubertal status. Consequently, these findings underline the importance of ensuring sufficient physical activity in terms of quality and quantity for children at the earliest stages of life.

Trial registration

ISRCTN62310987.
Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial
Authors: Wilcox Sara , Liu Jihong , Turner-McGrievy Gabrielle M. , Boutté Alycia K. , Wingard Ellen
Published: December 2022

Background

Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight.

Methods

Health In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based counseling calls with accompanying behavioral podcasts followed by weekly or biweekly counseling calls until delivery. The standard care group received monthly mailings and 10 podcasts focused on healthy pregnancy. PA (SenseWear armband), diet (ASA24), and HRQOL (SF-12) measures were obtained from blinded assessors at baseline (<16 weeks) and late pregnancy (32 weeks). Mixed model repeated measures regression models tested treatment (Group x Time) and within-group effects. We hypothesized that intervention participants would have higher levels of PA, a better-quality diet, and higher HRQOL than standard care participants. Exploratory analyses examined whether changes in outcomes over time differed according to whether participants had recommended, excessive, or inadequate weight gain.

Results

Treatment effects favored intervention participants for vegetable intake (d=0.40, p<0.05) and % whole grains (d=0.60, p<0.01). HRQOL mental component improved in both groups, but less in intervention than standard care participants (d=-0.33, p<0.05). Time effects demonstrated that total PA, steps/day, and HRQOL physical component declined significantly in both groups. Within-group effects showed that diet quality significantly improved in intervention participants. Moderate-intensity PA declined significantly in standard care participants, whereas light-intensity PA declined and sedentary behavior increased significantly in intervention participants. Finally, exploratory analyses showed that total PA and light PA increased whereas sedentary behavior decreased among those meeting guidelines for weight gain, with opposite patterns seen among those with excessive or inadequate weight gain.

Conclusions

The intervention improved several dietary outcomes but had modest impacts on PA and HRQOL, underscoring the challenge of behavior change during pregnancy.

Trial registration

This trial was registered in ClinicalTrials.gov on 10/09/2014. NCT02260518
A novel murine model of combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma
Authors: Xu Ru-Chen , Wang Fu , Sun Jia-Lei , Abuduwaili Weinire , Zhang Guang-Cong , Liu Zhi-Yong , Liu Tao-Tao , Dong Ling , Shen Xi-Zhong , Zhu Ji-Min
Published: December 2022

Primary liver cancer (PLC) is a common gastrointestinal malignancy worldwide. While hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are two major pathologic types of PLC, combined HCC and ICC (cHCC-ICC) is a relatively rare subtype that shares both hepatocyte and cholangiocyte differentiation. However, the molecular feature of this unique tumor remains elusive because of its low incidence and lack of a suitable animal model. Herein, we generated a novel spontaneous cHCC-ICC model using a Sleeping Beauty-dependent transposon plasmid co-expressing oncogenic Myc and AKT1 and a CRISPR-Cas9 plasmid expressing single-guide RNA targeting p53 into mouse hepatocytes via in situ electroporation. The histological and transcriptional analysis confirmed that this model exhibits cHCC-ICC features and activates pathways committing cHCC-ICC formation, such as TGF-β, WNT, and NF-κB. Using this model, we further screened and identified LAMB1, a protein involved in cell adhesion and migration, as a potential therapeutic target for cHCC-ICC. In conclusion, our work presents a novel genetic cHCC-ICC model and provides new insights into cHCC-ICC.
Effects of nasal inflammation on the olfactory bulb
Authors: LaFever Brandon J. , Imamura Fumiaki
Published: December 2022

Sinonasal diseases, such as rhinosinusitis, affect up to 12% of individuals each year which constitutes these diseases as some of the most common medical conditions in the world. Exposure to environmental pathogens and toxicants via the nasal cavity can result in a severe inflammatory state commonly observed in these conditions. It is well understood that the epithelial and neuronal cells lining the olfactory mucosa, including olfactory sensory neurons (OSNs), are significantly damaged in these diseases. Prolonged inflammation of the nasal cavity may also lead to hyposmia or anosmia. Although various environmental agents induce inflammation in different ways via distinct cellular and molecular interactions, nasal inflammation has similar consequences on the structure and homeostatic function of the olfactory bulb (OB) which is the first relay center for olfactory information in the brain. Atrophy of the OB occurs via thinning of the superficial OB layers including the olfactory nerve layer, glomerular layer, and superficial external plexiform layer. Intrabulbar circuits of the OB which include connectivity between OB projection neurons, OSNs, and interneurons become significantly dysregulated in which synaptic pruning and dendritic retraction take place. Furthermore, glial cells and other immune cells become hyperactivated and induce a state of inflammation in the OB which results in upregulated cytokine production. Moreover, many of these features of nasal inflammation are present in the case of SARS-CoV-2 infection. This review summarizes the impact of nasal inflammation on the morphological and physiological features of the rodent OB.
Strengthening integrated sexual reproductive health and rights and HIV services programs to achieve sustainable development goals 3 and 5 in Africa
Authors: Tazinya Rose-Mary Asong , Hajjar Julia Marie , Yaya Sanni
Published: December 2022

Each year, over 200 million women globally cannot prevent pregnancy through modern contraceptive methods, with 70–80% of these women residing in sub-Saharan Africa. Consequently, almost 50% of pregnancies are unintended and 35 million unsafe abortions occur annually in the region. Further, sub-Saharan Africa has the highest burden globally of Human Immune-Deficiency Virus (HIV) infection, and over 57% of those affected are women. Women with a positive HIV status in sub-Saharan Africa experience higher rates of unintended pregnancy and unsafe abortion practices. In this commentary, we propose strategies to strengthen integrated sexual and reproductive health and rights (SRHR) and HIV services programs to improve the sexual and reproductive health of girls and women and to work towards achieving SDGs 3 and 5 in sub-Saharan Africa. We suggest a focus on capacity building, strengthening intersectoral collaborations, and improving governance and financial investment.
Rectal retractor in prostate radiotherapy: pros and cons
Authors: Ghaffari Hamed , Mehrabian Arezoo
Published: December 2022

Dose escalation in prostate radiotherapy (RT) have led to improved biochemical controls and reduced the risk of distant metastases. Over the past three decades, despite technological advancements in RT planning and delivery, the rectum is a dose-limiting structure in prostate RT owing to the close anatomical proximity of the anterior rectal wall (ARW) to the prostate gland. RT-induced rectal toxicities remain a clinical challenge, limiting the prescribed dose during prostate RT. To address the spatial proximity challenge by physically increasing the distance between the posterior aspect of the prostate and the ARW, several physical devices such as endorectal balloons (ERBs), rectal hydrogel spacers, and rectal retractor (RR) have been developed. Previously, various aspects of ERBs and rectal hydrogel spacers have extensively been discussed. Over recent years, given the interest in the application of RR in prostate external beam radiotherapy (EBRT), this editorial will discuss opportunities and challenges of using RR during prostate EBRT and provide information regarding which aspects of this device need attention.
Prevalence of extra-articular tibia valga morphology in valgus knees and its implications for primary total knee arthroplasty
Authors: Sobhi Salar , Khan Riaz J. K. , Fick Daniel P. , Finsterwald Michael
Published: December 2022

Introduction

Tibia valga, an extra-articular valgus deformity of the tibia, is common in valgus knees and can result in component misplacement and early total knee arthroplasty (TKA) failure. However, the prevalence and importance of tibia valga in TKA have been seldom reported. This study aims to describe the prevalence and characteristics of tibia valga morphology in valgus knees and describe implications for surgical planning in primary TKA.

Methods

We prospectively examined pre-operative weightbearing whole-body EOS digital radiographs of patients with knee osteoarthritis listed for TKA between December 2018 and December 2020. Hip–knee–ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), joint line convergence angle (JLCA) and tibial morphology with centre of rotation of angulation of tibia (CORA-tibia) were measured and analysed.

Results

In 830 knees, 253 (30%) and 577 (70%) were classified as valgus and varus, respectively. In valgus knees, 89 knees (35%) had tibia valga. Median CORA-tibia was 2.8° (range 0.2°–10.9°). Tibia valga knees had no difference in mLDFA, higher HKA (5.0o versus 3.0°, p = 0.002) and mMPTA (89.6° versus 88.1°, p < 0.01), and lower JLCA (2.1° versus 2.3°, p < 0.01) compared to non-tibia valga knees. Tibia valga deformity was weakly positively correlated with valgus HKA (ρ = 0.23, p < 0.001) and mMPTA (ρ = 0.38, p < 0.001). In varus knees, there were 52 cases of tibia valga (9%) with median CORA-tibia of 3.0° (range 0.5°–5.5°). Tibia valga knees had higher mMPTA (87.0° versus 85.2°, p < 0.05) and no difference in HKA, mLDFA and JLCA. CORA-tibia was weakly positively correlated with mMPTA.

Conclusions

Valgus knees may have an extra-articular deformity of the tibia which might be the primary contributor of the overall valgus HKA deformity rather than the distal femoral anatomy. To detect the deformity, full leg-length radiographs should be acquired pre-operatively. Intramedullary instrumentation should be used cautiously in knees with tibia valga when performing TKA.
Stress distributions of the short stem and the tapered wedge stem at different alignments: a finite element analysis study
Authors: Kaku Nobuhiro , Pramudita Jonas A. , Yamamoto Kansei , Hosoyama Tsuguaki , Tsumura Hiroshi
Published: December 2022

Background

The mechanical effects of stem length reduction and stem alignment on the surrounding femur remain unknown. This study directly compared the stress distribution on the surrounding femur of existing tapered wedge stems and short stems and examined the properties of stress distribution at different stem alignments in three dimensions.

Methods

Finite element analysis was conducted for standing and walking. The cementless stem was appropriately sized to ensure adequate contact with the medial cortical bone line that contours the medullary cavity. The stem neck axis was aligned with the femoral neck axis in the mid-position and placed in 2° of the varus and valgus, 3° of flexion and extension, and 10° and 40° of anteversion.

Results

Regardless of stem length, the trend of stress distribution was similar. The short stem generated less stress around the stem than the tapered wedge stem. In the coronal plane, the effect of varus and valgus deflection was small. In the sagittal plane, the stress generated around the stem was higher in the extended position than in the flexed position. In the horizontal plane, the stress generated around the stem was higher when the stem anteversion was smaller.

Conclusions

Depending on the design, short stems can reduce the stress on the surrounding bone, compared to a longer tapered wedge with similar stress distribution. Additionally, a short stem can reduce the effect of the varus position. Stems should be placed to achieve stable initial fixation while noting that stresses increase with extension and reduced anteversion.
Multimodal pain therapy for persistent idiopathic facial pain - a pilot study
Authors: Foerster Zita , Kleinmann Barbara , Schlueter Nadine , Vach Kirstin , Wolter Tilman
Published: December 2022

Objective

Persistent Idiopathic Facial Pain (PIFP) is a pain syndrome with missing evidence-based therapy recommendations. According to the biopsychosocial pain model, multidisciplinary pain treatment (MPT) offers a promising therapeutic option for chronic pain syndromes. MPT is an interprofessional treatment procedure, consisting of medical, physiotherapeutic and psychotherapeutic treatment units, which has not yet been studied in PIFP.

Methods

This retrospective study included 25 patients with PIFP, who had been treated with MPT. Pain intensity on the numerical rating scale (NRS), perceived disability, habitual well-being, as well as anxiety/depression and stress scales were recorded. Moreover, the patients evaluated the efficacy of each type of the single therapeutic interventions.

Results

There was a highly significant decrease in the characteristic pain intensity. Also habitual well-being improved significantly, as did anxiety and depression. The perceived disability and stress also improved, but without statistical significance. Physiotherapy was rated as the most effective therapeutic unit. Among the medical measures, consultations took first place (40% of the participants). Nearly three-fourths of the patients (72%) would recommend MPT.

Conclusion

The present study shows beneficial outcomes in patients with PIFP following MPT. Patients evaluate physiotherapeutic treatment as particularly efficacious. Therefore, MPT can be considered as a therapeutic option in patients with PIFP.
Effectiveness and safety of a model predictive control (MPC) algorithm for an artificial pancreas system in outpatients with type 1 diabetes (T1D): systematic review and meta-analysis
Authors: Kang Su Lim , Hwang Yoo Na , Kwon Ji Yean , Kim Sung Min
Published: December 2022

Background

The purpose of this study was to assess the effectiveness and safety of a model predictive control (MPC) algorithm for an artificial pancreas system in outpatients with type 1 diabetes.

Methods

We searched PubMed, EMBASE, Cochrane Central, and the Web of Science to December 2021. The eligibility criteria for study selection were randomized controlled trials comparing artificial pancreas systems (MPC, PID, and fuzzy algorithms) with conventional insulin therapy in type 1 diabetes patients. The heterogeneity of the overall results was identified by subgroup analysis of two factors including the intervention duration (overnight and 24 h) and the follow-up periods (< 1 week, 1 week to 1 month, and > 1 month).

Results

The meta-analysis included a total of 41 studies. Considering the effect on the percentage of time maintained in the target range between the MPC-based artificial pancreas and conventional insulin therapy, the results showed a statistically significantly higher percentage of time maintained in the target range in overnight use (10.03%, 95% CI [7.50, 12.56] p < 0.00001). When the follow-up period was considered, in overnight use, the MPC-based algorithm showed a statistically significantly lower percentage of time maintained in the hypoglycemic range (−1.34%, 95% CI [−1.87, −0.81] p < 0.00001) over a long period of use (> 1 month).

Conclusions

Overnight use of the MPC-based artificial pancreas system statistically significantly improved glucose control while increasing time maintained in the target range for outpatients with type 1 diabetes. Results of subgroup analysis revealed that MPC algorithm-based artificial pancreas system was safe while reducing the time maintained in the hypoglycemic range after an overnight intervention with a long follow-up period (more than 1 month).
Altered frontal connectivity as a mechanism for executive function deficits in fragile X syndrome
Authors: Schmitt Lauren M. , Li Joy , Liu Rui , Horn Paul S. , Sweeney John A. , Erickson Craig A. , Pedapati Ernest V.
Published: December 2022

Background

Fragile X syndrome (FXS) is the leading inherited monogenic cause of intellectual disability and autism spectrum disorder. Executive function (EF), necessary for adaptive goal-oriented behavior and dependent on frontal lobe function, is impaired in individuals with FXS. Yet, little is known how alterations in frontal lobe neural activity is related to EF deficits in FXS.

Methods

Sixty-one participants with FXS (54% males) and 71 age- and sex-matched typically-developing controls (TDC; 58% males) completed a five-minute resting state electroencephalography (EEG) protocol and a computerized battery of tests of EF, the Test of Attentional Performance for Children (KiTAP). Following source localization (minimum-norm estimate), we computed debiased weighted phase lag index (dWPLI), a phase connectivity value, for pairings between 18 nodes in frontal regions for gamma (30–55 Hz) and alpha (10.5–12.5 Hz) bands. Linear models were generated with fixed factors of group, sex, frequency, and connection. Relationships between frontal connectivity and EF variables also were examined.

Results

Individuals with FXS demonstrated increased gamma band and reduced alpha band connectivity across all frontal regions and across hemispheres compared to TDC. After controlling for nonverbal IQ, increased error rates on EF tasks were associated with increased gamma band and reduced alpha band connectivity.

Limitations

Frontal connectivity findings are limited to intrinsic brain activity during rest and may not generalize to frontal connectivity during EF tasks or everyday function.

Conclusions

We report gamma hyper-connectivity and alpha hypo-connectivity within source-localized frontal brain regions in FXS compared to TDC during resting-state EEG. For the first time in FXS, we report significant associations between EF and altered frontal connectivity, with increased error rate relating to increased gamma band connectivity and reduced alpha band connectivity. These findings suggest increased phase connectivity within gamma band may impair EF performance, whereas greater alpha band connectivity may provide compensatory support for EF. Together, these findings provide important insight into neurophysiological mechanisms of EF deficits in FXS and provide novel targets for treatment development.
Acceptability and feasibility of continuous glucose monitoring in people with diabetes: protocol for a mixed-methods systematic review of quantitative and qualitative evidence
Authors: Brown Jennifer V. E. , Ajjan Ramzi , Siddiqi Najma , Coventry Peter A.
Published: December 2022

Background

Good glycaemic control is a crucial part of diabetes management. Traditional assessment methods, including HbA1c checks and self-monitoring of blood glucose, can be unreliable and inaccurate. Continuous glucose monitoring (CGM) offers a non-invasive and more detailed alternative. Availability of this technology is increasing worldwide. However, there is no current comprehensive evidence on the acceptability and feasibility of these devices. This is a protocol for a mixed-methods systematic review of qualitative and quantitative evidence about acceptability and feasibility of CGM in people with diabetes.

Methods

We will search MEDLINE, Embase, CINAHL, and CENTRAL for qualitative and quantitative evidence about the feasibility and acceptability of CGM in all populations with diabetes (any type) using search terms for “continuous glucose monitoring” and “diabetes”. We will not apply any study-type filters. Searches will be restricted to studies conducted in humans and those published from 2011 onwards. We will not restrict the search by language. Study selection and data extraction will be carried out by two reviewers independently using Rayyan and Eppi-Reviewer, respectively, with disagreements resolved by discussion. Data extraction will include key information about each study, as well as qualitative evidence in the form of participant quotes from primary studies and themes and subthemes based on the authors’ analysis. Quantitative data relating to acceptability and feasibility including data loss, adherence, and quantitative ratings of acceptability will be extracted as means and standard deviations or n/N as appropriate. Qualitative evidence will be analysed using framework analysis informed by the Theoretical Framework of Acceptability. Where possible, quantitative evidence will be combined using random-effects meta-analysis; otherwise, a narrative synthesis will be performed. The most appropriate method for integrating qualitative and quantitative findings will be selected based on the data available.

Discussion

Ongoing assessment of the acceptability of interventions has been identified as crucially important to scale-up and implementation. This review will provide new knowledge with the potential to inform a programme theory of CGM as well as future roll-out to potentially vulnerable populations, including those with severe mental illness.

Systematic review registration

PROSPERO CRD42021255141.
Improving the estimation of thermospheric neutral density via two-step assimilation of in situ neutral density into a numerical model
Authors: Corbin Armin , Kusche Jürgen
Published: December 2022

Neutral thermospheric density is an essential quantity required for precise orbit determination of satellites, collision avoidance of satellites, re-entry prediction of satellites or space debris, and satellite lifetime assessments. Empirical models of the thermosphere fail to provide sufficient estimates of neutral thermospheric density along the orbits of satellites by reason of approximations, assumptions and a limited temporal resolution. At high solar activity these estimates can be off by 70% when comparing to observations at 12-hourly averages. In recent decades, neutral density is regularly observed with satellite accelerometers on board of low Earth orbiting satellites like CHAMP, GOCE, GRACE, GRACE-FO, or Swarm. When assimilating such along-track information into global models of thermosphere–ionosphere dynamics, it has been often observed that only a very local sub-domain of the model grid around the satellite’s position is updated. To extend the impact to the entire model domain we suggest a new two-step approach: we use accelerometer-derived neutral densities from the CHAMP mission in a first step to calibrate an empirical thermosphere density model (NRLMSIS 2.0). In a second step, we assimilate—for the first time—densities predicted for a regular three-dimensional grid into the TIE-GCM (Thermosphere Ionosphere Electrodynamics General Circulation Model). Data assimilation is performed using the Local Error-Subspace Transform Kalman Filter provided by the Parallel Data Assimilation Framework (PDAF). We test the new approach using a 2-week-long period containing the 5 April 2010 Geomagnetic storm. Accelerometer-derived neutral densities from the GRACE mission are used for additional evaluation. We demonstrate that the two-step approach globally improves the simulation of thermospheric density. We could significantly improve the density prediction for CHAMP and GRACE. In fact, the offset between the accelerometer-derived densities and the model prediction is reduced by 45% for CHAMP and 20% for GRACE when applying the two-step approach. The implication is that our approach allows one to much better ’transplant’ the precise CHAMP thermospheric density measurements to satellites flying at a similar altitude.

Graphical Abstract
Swarm Thermal Ion Imager measurement performance
Authors: Burchill Johnathan K. , Knudsen David J.
Published: December 2022

We assess the performance of the thermal ion imaging (TII) technique as conceived for the Swarm Earth Explorer satellites. Analysis, simulation, and laboratory testing performed prior to flight provided estimates of systematic and random error sources of the electric field instrument’s vector ion drift, electric field, and ion kinetic temperature measurements. An end-to-end instrument simulator, consisting of models of the TIIs on a prototypical Swarm satellite orbiting Earth with ionospheric plasma, electric field, and magnetic field inputs, was used to generate TII sensor data (level 0 instrument data). These data were processed with a prototype processor (the level 1b processor) to characterize theoretical measurement performance. We describe the methodology used to assess TII measurement uncertainty and present the main findings of the end-to-end measurement performance study. In addition, we assess the measurement performance achieved during approximately eight years of orbital operations. Example measurements demonstrate the quality of ion drift velocity. Unprocessed TII imagery reveals spurious signals which can affect measurement performance. Availability of such imagery has proven vital for diagnosing measurement anomalies associated with sensor operation and spacecraft–plasma interactions.

Graphical Abstract
Evaluation of pretreatment ADC values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer - a multicenter study
Authors: Surov Alexey , Pech Maciej , Meyer Hans-Jonas , Bitencourt Almir G. V. , Fujimoto Hiroshi , Baxter Gabrielle C. , Santamaría Gorane , Gilbert Fiona J. , Wienke Andreas
Published: December 2022

Background

Magnetic resonance imaging (MRI) can be used to diagnose breast cancer. Diffusion weighted imaging (DWI) and the apparent diffusion coefficient (ADC) can reflect tumor microstructure in a non-invasive manner. The correct prediction of response of neoadjuvant chemotherapy (NAC) is crucial for clinical routine.

Our aim was to compare ADC values between patients with pathological complete response (pCR) and non-responders based upon a multi-center design to improve the correct patient selection, which patient would more benefit from NAC and which patient would not.

Methods

For this study, data from 4 centers (from Japan, Brazil, Spain and United Kingdom) were retrospectively acquired. The time period was overall 2003–2019. The patient sample comprises 250 patients (all female; median age, 50.5). In every case, pretreatment breast MRI with DWI was performed. pCR was assessed by experienced pathologists in every center using the surgical specimen in the clinical routine work up. pCR was defined as no residual invasive disease in either breast or axillary lymph nodes after NAC. ADC values between the group with pCR and those with no pCR were compared using the Mann–Whitney U test (two-group comparisons). Univariable and multivariabe logistic regression analysis was performed to predict pCR status.

Results

Overall, 83 patients (33.2%) achieved pCR. The ADC values of the patient group with pCR were lower compared with patients without pCR (0.98 ± 0.23 × 10− 3 mm2/s versus 1.07 ± 0.24 × 10− 3 mm2/s, p = 0.02). The ADC value achieved an odds ratio of 4.65 (95% CI 1.40–15.49) in univariable analysis and of 3.0 (95% CI 0.85–10.63) in multivariable analysis (overall sample) to be associated with pCR status. The odds ratios differed in the subgroup analyses in accordance with the molecular subtype.

Conclusions

The pretreatment ADC-value is associated with pathological complete response after NAC in breast cancer patients. This could aid in clinical routine to reduce treatment toxicity for patients, who would not benefit from NAC. However, this must be tested in further studies, as the overlap of the ADC values in both groups is too high for clinical prediction.
Chemopreventive effects and anti-tumorigenic mechanisms of Actinidia arguta, known as sarunashi in Japan toward 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)- induced lung tumorigenesis in a/J mouse
Authors: Takata Jun , Miyake Naoko , Saiki Yusuke , Tada Misako , Sasaki Kensuke , Kubo Toshio , Kiura Katsuyuki , Arimoto-Kobayashi Sakae
Published: December 2022

Background

Previously, we reported the inhibitory effect ofActinidia argutajuice, known as sarunashi juice (sar-j) in Japan, on mutagenesis, inflammation, and mouse skin tumorigenesis. The components ofA. argutaresponsible for the anti-mutagenic effects were identified to be water-soluble, heat-labile phenolic compounds. We proposed isoquercetin (isoQ) as a candidate anticarcinogenic component. In this study, we sought to investigate the chemopreventive effects ofA. argutajuice and isoQ on 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-induced lung tumorigenesis in A/J mice, and identify the possible mechanisms underlying the anti-tumorigenic effects ofA. arguta.

Results

The number of tumor nodules per mouse lung in the group injected with NNK and administeredA. argutajuice orally was significantly lower than that in the group injected with NNK only. Oral administration of isoQ also reduced the number of nodules in the mouse lungs. As expected, the mutagenicity of NNK and 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) detected usingS. typhimuriumTA1535 decreased in the presence of sar-j. However, NNK and MNNG mutagenicity detected usingS. typhimuriumYG7108, a strain lacking the O6-methylguanine DNA methyltransferases (ogtSTandadaST) did not decrease in the presence of sar-j suggesting that sar-j may mediate its antimutagenic effect by enhancing the DNA damage repair byogtSTandadaST. Phosphorylation of Akt, with or without epidermal growth factor stimulation, in A549 cells was significantly decreased following sar-j and isoQ treatment, indicating that components in sar-j including isoQ suppressed the PI3K/AKT signaling pathways.

Conclusions

Sar-j and isoQ reduced NNK-induced lung tumorigenesis. Sar-j targets both the initiation and growth/progression steps during carcinogenesis, specifically via anti-mutagenesis, stimulation of alkyl DNA adduct repair, and suppression of Akt-mediated growth signaling. IsoQ might contribute in part to the biological effects of sar-j via suppression of Akt phosphorylation, but it may not be the main active ingredient.
“Day 25”: a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load
Authors: Osman Nancy A. , Hashish Mona H. , Bakr Wafaa M. K. , Osman Nermin A. , Omran Eman A.
Published: December 2022

Introduction

The relationship between SARS-CoV-2 viral load and hospitalization and mortality among COVID-19 patients has been established. However, the estimation of the duration of time after which the risk of mortality of these patients stops escalating was not extensively discussed earlier. Stratifying patients according to their risk of mortality would optimize healthcare services and costs and reduce mortality.

Methodology

In this retrospective observational study, hospital records were used to collect data of 519 COVID-19 patients from May through November 2020. Data included the clinical condition of patients, their viral loads, their admission chest computed tomography results (CO-RAD scale), and the duration of their hospitalization. A Kaplan–Meier analysis was constructed to estimate mortality risk concerning viral load.

Results

By the end of the study, 20.42% of patients were deceased. The cumulative mortality was: 36.1% (75/208) among patients with high viral load, 12.6% (28/222) in those with moderate viral load, and 3.4% (3/89) among those with low viral load. Predictors of mortality were: older age [adjusted hazard ratio (aHR) = 1.02, 95% CI: [1.00–1.03], (p = 0.05)], "being female" [aHR = 1.53 with 95% CI: [1.03–2.26], (p = 0.031), "high CO-RAD scale" [aHR = 1.32 (1.06–1.64), p = 0.013], "high viral load" [aHR = 4.59 (2.38–20.92), p = 0.017, ICU admission [aHR = 15.95; 95%CI:7.22–35.20, p < 0.001] and lymphocytosis [aHR = 1.89 45;95%CI:1.04–3.45, p = 0.036]. In the ICU-admitted patients, the median survival was 19 days and mortality stabilized at "day 25". For patients with high viral load, mortality rates stabilized at "day 25 post-admission" after which the risks of mortality did not change until day 40, while patients with low and moderate viral loads reached the peak and stabilized at day "20 post-admission".

Conclusions

Initial high SARS-CoV-2 viral load might be used as an indicator of a delayed stabilization of mortality risk among COVID-19 patients.
Hydromagnetic free convection flow in a vertical microporous channel with Hall current and ion-slip effect
Authors: Jha Basant K. , Malgwi Peter B.
Published: December 2022

In the present work, steady-state hydromagnetic analysis and flow formation of Newtonian viscous fluid through a vertical microporous channel is studied theoretically. The transport governing equations include the effect of Hall current and ion-slip effects in the microchannel slip regime. Unlike the usual employed thermal properties of constant heat flux/temperature at the boundary, the current work assumes that the microporous walls are influenced by different surrounding wall temperatures. Solution to the governing equations depending on Prandtl number, rarefaction parameter, Hall current parameter, ion-slip parameter, Hartmann number and suction/injection parameter are obtained by utilizing the method of undetermined coefficient. Results demonstrating the effect of these parameters on different flow features are presented graphically in MATLAB. The results reveal that in the simultaneous occurrence of Hall and ion-slip currents, higher values of rarefaction parameter enhance the momentum boundary layer in both primary and secondary flow directions. In addition, results from this analysis also reveal that the main component of fluid velocity remains unaffected to higher values of Hall current, whereas it decreases along the induced flow directions. Furthermore, for a specific value of Hall parameter and ion-slip current, injection weakens the buoyancy drive resulting in a reduction in volume flow rate. The contrast is true with suction.