bluuebunny/crossref_metadata_2025 huggingface dataset:
“I’m 'just' a community pediatrician” views and challenges of pediatricians working in the community in Israel
Authors: Pinchover Shulamit , Berger-Raanan Rony , Yaari Maya , Rudolf Mary , Rubin Lisa , Idan-Prusak Dafna , Skvirsky Vera , Margolin Tirzah , Gadassi Hava
Published: April 2023

Background

There are ongoing changes around the world in the training and practice of pediatricians who work in the community. These changes are driven by the understanding that pediatricians are required to provide not only acute primary care but also to address more comprehensive concerns, particularly the ‘new morbidities’. The present study examines the professional identity of Israeli pediatricians in the community in light of these changes, the barriers and challenges to their work and professional adaptations in the field.

Methods

We used a mixed-methods approach, collecting the perspectives of 137 pediatricians who work in the community through an anonymous online survey, followed by in-depth semi-structured interviews with 11 community pediatricians.

Results

The survey results show that community pediatricians in Israel have limited knowledge on a variety of developmental, behavioral and emotional issues; that they lack working relationships with medical or other professionals; and are rarely engaged with other community services. Three main themes arose from the interviews that support and deepen the survey results: perceptions of the profession (pediatrics in the community vs. community pediatrics), the stature of pediatricians in the community (during residency, the choice to work in the community, their daily work) and barriers and change in community pediatrics (isolation, limited resources and challenges arising from the nature of community work).

Conclusions

The present study sheds light on the professional identity and the day-to-day challenges and successes of pediatricians working in the community. Continuing medical education, providing a supportive framework and professional community, better resources, more time with patients, and tools and opportunities for professional development would help pediatricians who work in the community to overcome some of these challenges. The research findings reinforce the need for policy change in the field of community pediatrics with a specific community training curriculum, provision of more resources and ongoing support for pediatricians. This requires partnership between the HMOs, the Ministry of Health, the Scientific Council (Israel Medical Association, professional organizations) and NGOs in order to turn individual-level solutions into system-level and policy-changing solutions.
Sialic acid exacerbates gut dysbiosis-associated mastitis through the microbiota-gut-mammary axis by fueling gut microbiota disruption
Authors: Zhao Caijun , Hu Xiaoyu , Qiu Min , Bao Lijuan , Wu Keyi , Meng Xiangyue , Zhao Yihong , Feng Lianjun , Duan Shiyu , He Yuhong , Zhang Naisheng , Fu Yunhe
Published: April 2023

Background

Mastitis is one of the most severe diseases in humans and animals, especially on dairy farms. Mounting evidence indicates that gastrointestinal dysbiosis caused by induction of subacute ruminal acidosis (SARA) by high-grain diet consumption and low in dietary fiber is associated with mastitis initiation and development, however, the underlying mechanism remains unknown.

Results

In the present study, we found that cows with SARA-associated mastitis have altered metabolic profiles in the rumen, with increased sialic acids level in particular. Consumption of sialic acid (SA) in antibiotic-treated mice, but not healthy mice, induced marked mastitis. SA treatment of antibiotic-treated mice also induced mucosal and systemic inflammatory responses, as evidenced by increased colon and liver injuries and several inflammatory markers. In addition, gut dysbiosis caused by antibiotic impaired gut barrier integrity, which was aggravated by SA treatment. SA potentiated serum LPS level caused by antibiotic treatment, leading to increased activation of the TLR4-NF-κB/NLRP3 pathways in the mammary gland and colon. Moreover, SA facilitated gut dysbiosis caused by antibiotic, and especially enhancedEnterobacteriaceaeandAkkermansiaceae, which correlated with mastitis parameters. Fecal microbiota transplantation from SA-antibiotic-treated mice mimicked mastitis in recipient mice. In vitro experiments showed that SA promptedEscherichia coligrowth and virulence gene expression, leading to higher proinflammatory cytokine production in macrophages. Targeting the inhibition ofEnterobacteriaceaeby sodium tungstate or treating with the commensalLactobacillus reuterialleviated SA-facilitated mastitis. In addition, SARA cows had distinct ruminal microbial structure by the enrichment of SA-utilizing opportunistic pathogenicMoraxellaceaeand the depletion of SA-utilizing commensalPrevotellaceae. Treating mice with the specific sialidase inhibitor zanamivir reduced SA production andMoraxellaceaeabundance, and improved mastitis in mice caused by ruminal microbiota transplantation from cows with SARA-associated mastitis.

Conclusions

This study, for the first time, indicates that SA aggravates gut dysbiosis-induced mastitis by promoting gut microbiota disturbance and is regulated by commensal bacteria, indicating the important role of the microbiota-gut-mammary axis in mastitis pathogenesis and suggesting a potential strategy for mastitis intervention based on gut metabolism regulation.
Cooling-induced permeability enhancement for networks of microfractures in superhot geothermal environments
Authors: Goto Ryota , Nakayama Daisuke , Takahashi Ryota , Pramudyo Eko , Takuma Kohei , Watanabe Noriaki
Published: April 2023

Recent researches have proposed the use of enhanced geothermal system reservoirs consisting of dense networks of microfractures, created by hydraulic and/or thermal fracturing in superhot/supercritical geothermal environments, because of their suitability for thermal energy harvesting. During fracturing and energy extraction, the fracture networks are exposed to cooling due to the injection of cold fluid into the reservoirs. Previous studies showed such cooling enhanced reservoir permeability in conventional geothermal environments. However, the cooling may result in a higher risk of seismicity, owing to decreased normal stress on the fractures. Nevertheless, it is unclear whether cooling-induced permeability enhancement and a higher risk of seismicity occurs within networks of microfractures which consist of numerous interconnected microfractures at various orientations to the in situ triaxial stress. Thus, no dominant fractures have the possibility to cause permeability enhancement/induced seismicity. In this study, results are presented for borehole cooling experiments on a dense network of microfractures in granite, at 400 °C, under true triaxial stress. Permeability and acoustic emissions were measured with decreases in borehole temperature (up to ~ 90 °C). Results showed that permeability increased with increasing temperature drop at relatively low stress levels (15 and 20 MPa). The permeability enhancement occurred without intensive failure, and was reversible. However, permeability was almost constant at a higher stress level (65 MPa). Results showed that permeability enhancement required a thermal stress equivalent to the mean stress, so that the normal stress was reduced to near-zero, for a considerable amount of the microfractures. Additionally, the permeability of dense microfracture networks can be increased by cooling primarily through thermo-elastic deformation (without intensive failure), which may be useful to compensate for the reduction in injectivity due to cooling-induced fluid property changes.
Twitter sentiment analysis using hybrid gated attention recurrent network
Authors: Parveen Nikhat , Chakrabarti Prasun , Hung Bui Thanh , Shaik Amjan
Published: April 2023

Sentiment analysis is the most trending and ongoing research in the field of data mining. Nowadays, several social media platforms are developed, among that twitter is a significant tool for sharing and acquiring peoples’ opinions, emotions, views, and attitudes towards particular entities. This made sentiment analysis a fascinating process in the natural language processing (NLP) domain. Different techniques are developed for sentiment analysis, whereas there still exists a space for further enhancement in accuracy and system efficacy. An efficient and effective optimization based feature selection and deep learning based sentiment analysis is developed in the proposed architecture to fulfil it. In this work, the sentiment 140 dataset is used for analysing the performance of proposed gated attention recurrent network (GARN) architecture. Initially, the available dataset is pre-processed to clean and filter out the dataset. Then, a term weight-based feature extraction termed Log Term Frequency-based Modified Inverse Class Frequency (LTF-MICF) model is used to extract the sentiment-based features from the pre-processed data. In the third phase, a hybrid mutation-based white shark optimizer (HMWSO) is introduced for feature selection. Using the selected features, the sentiment classes, such as positive, negative, and neutral, are classified using the GARN architecture, which combines recurrent neural networks (RNN) and attention mechanisms. Finally, the performance analysis between the proposed and existing classifiers is performed. The evaluated performance metrics and the gained value for such metrics using the proposed GARN are accuracy 97.86%, precision 96.65%, recall 96.76% and f-measure 96.70%, respectively.
DSN enzyme recognition initiated rolling circle amplification (DiRCA) for accurate miRNA detection in immune response and immune repair after trauma
Authors: Mei Yi , Zhang Jun , Zhu Li , Li Tianjiao , Zhou Hong , Xie Mingjia , Zeng Dongmei , Gou Yajun
Published: April 2023

Recent studies have reported that miRNA plays an important role in immune response and immune repair after trauma. By regulating the expression of related target genes, miRNA regulates the production, proliferation, development and immune response of immune cells. Therefore, it is in urgent demand to develop an novel method for miRNA analysis. Rolling circle amplification (RCA), as an attractive isothermal signal amplification strategy, has been widely utilized in constructing miRNA detection assays. However, accurate and sensitive miRNA quantitative determination remains a huge challenge for RCA based approaches. Herein, we propose a DSN enzyme based signal cycle initiated Rolling Circle Amplification assay (DiRCA) for sensitive and accurate miRNA detection. In DiRCA, target miRNA unfolds hairpin structure probe in the detection scaffold, forming a RNA–DNA duplex. DSN enzyme is utilized to specifically digest the DNA sequence in RNA–DNA duplex, releasing miRNA to form a signal cycle; its capability to distinguish one base pair mismatch in RNA–DNA duplex endows DiRCA a high selectivity. Meanwhile, DSN enzyme based cleavage initiates RCA, transcribing G-rich sequences for signal generation. Based on the DSN assisted signal cycle and RCA, DiRCA shows a low limit of detection of 0.43 fM and a superior capability in selectively detecting mismatched miRNA sequences, showing a promising prospect in the early-diagnosis of disease.
Stabilization and structuralization: transformations of China's labor market from the perspective of new institutionalism (2006–2017)
Authors: Zhu Bin
Published: April 2023

Precarious work in China has drawn increasing attention, and this paper examines its changing trends from 2006 to 2017. It finds that as the state intensifies its intervention in the labor market, employers face a conflicting institutional environment with the demands of the technological environment. Employers meet the legitimacy requirements of state policy by increasing the number of stable jobs on the one hand and reducing the labor costs of unstable workers on the other hand to smooth out the increase in labor costs caused by the increase in stable workers, resulting in a stronger segmentation of the “stable–unstable” dichotomy. These two processes are more pronounced in the private sector because of the stronger tensions between legitimization and performance maximization.
Food insecurity, body mass index, socio-economic status, and food intake in lactating and non-lactating mothers with children under two years
Authors: Rajabzadeh-Dehkordi Milad , Mohammadi-Nasrabadi Fatemeh , Nouri Mehran , Ahmadi Ali , Faghih Shiva
Published: April 2023

Background

food insecurity (FI) is considered as an essential public health problem which may have detrimental effects on people’s health. The aim of present study was to evaluate FI, body mass index, quantity and quality of food intake in lactating and non-lactating mothers with children under two years.

Methods

in this cross-sectional study 307 mothers (237 lactating and 70 non-lactating) were participated. Socio-economic and demographic information were gathered by questionnaires. FI of families was evaluated by the questionnaire of the United States Department of Agriculture (USDA) Household Food Security. For assessing quality and quantity of food intake of mothers, dietary diversity score (DDS), diet quality index-international (DQI-I) and nutrient adequacy ratio (NAR) were calculated. Weight and height of participants were measured and body mass index (BMI) was calculated. Finally, Chi-squared test, analysis of variance (ANOVA) and linear regression were used for statistical analysis.

Results

in this study the rate of underweight, normal weight, overweight, and obesity in mothers was 0.3%, 39.2%, 42.3%, and 18.2%, respectively. Among the determinants of BMI, household food security status had the greatest effect (Beta=-1.584, P < 0.001) and mother age had the least effect (Beta = 0.101, P = 0.013). Mother’s occupational and educational status, having facilities, physiological status of mother, and house size had significant correlation with NAR. Mother’s occupational and educational status, and having facilities had significant relationship with DDS, too. Also, the significant correlation of Mother’s education, having facilities, and physiological status of mother with DQI-I were found.

Conclusions

we found that Household food security status had the most effect on BMI of mothers. In this study, the best nutrient adequacy and dietary diversity were found in the obese group and the most diet quality was found in the normal weight group.
Predominance of multidrug-resistant bacteria causing urinary tract infections among men with prostate enlargement attending a tertiary hospital in Dar es Salaam, Tanzania
Authors: Niccodem Elieshiupendo M. , Mwingwa Anthon , Shangali Aminiel , Manyahi Joel , Msafiri Frank , Matee Mecky , Majigo Mtebe , Joachim Agricola
Published: April 2023

Background

Patients with prostate enlargement have an increased risk of recurrent urinary tract infections. This study determined the resistance profile of bacteria causing urinary tract infection (UTI) and the magnitude of multidrug-resistant (MDR) bacteria among patients with symptomatic prostate enlargement in a tertiary hospital in Dar es Salaam.

Methods

This cross-sectional study was conducted at Muhimbili National Hospital between August 2021 and January 2022. Male patients aged 40–90 years with symptomatic enlarged prostate, confirmed by digital rectal examination, were enrolled consecutively. We used conventional biochemical methods and analytical profile index (API) 20-E & API 20-NE to identify the uropathogens. In addition, antimicrobial susceptibility testing was performed using the Kirby–Bauer disc diffusion method.

Results

A total of 422 participants were enrolled, of whom 196 (46.4%) had laboratory-confirmed UTI. In total, 203 bacterial pathogens were isolated. Gram-negative bacteria (GNB) were the predominant uropathogens accounting to 165/203 (81.3%). The prevalent isolates were E. coli 49 (24.1%), followed by K. pneumoniae 40 (19.7%). Most, 157 (77.3%) pathogens were MDR, of which 33 (21.0%) were resistant to all tested antibiotic classes. The proportion of methicillin-resistant Staphylococcus aureus was 75.8%, while 45.5% of S. aureus were inducible clindamycin resistant. Among Enterobacterales, 98 (70.5%) were Extended-spectrum beta-lactamases (ESBL) producers, and 33 (20.0%) were carbapenem resistant. Four of forty-one (9.6%) non-ESBL producers were class C β-lactamase producers.

Conclusions

There is a relatively high proportion of MDR strains of uropathogens, which limits treatment options for UTI among men with prostate enlargement. These findings call for the revision of the current UTI treatment guidelines and continuous antimicrobial resistance surveillance to monitor antibiotic resistance and guide treatment options within the hospital.
Novel technique in detecting marginal adaptation of all ceramic restoration after cementation: case report
Authors: El Basha Sara Hussein , Hassanien Eman Ezzat Youssef , Elnaggar Gihan Abdelhady
Published: April 2023

Background

Accurate marginal adaptation of dental restorations guarantees their long-term success and longevity. Clinical evaluation of marginal adaptation is done using different techniques utilizing conventional tools such as mirrors and probes, which are subjective and non-standardized. Precise determination of restorations marginal gap intraorally, represents a challenge, especially when conducting clinical research testing newly introduced restoration designs or materials.

Case presentation

A 31-years-old female patient came to dental clinic seeking full coverage restoration for an endodontically treated upper left maxillary first premolar. After the patient received an all ceramic Bruxzir crown, the marginal adaptation and precise gap determination were evaluated intraorally utilizing digital microscope, aided with a novel custom-made microscope-holding device that facilitated standardization and handling.

Conclusions

The described method aided with the novel custom-made microscope holding device proved to be an easy, time saving and precise technique in evaluating the marginal gap directly inside patient’s mouth especially in clinical researches.
Posterior mediastinal Ewing sarcoma with multiple metastases on FDG PET/CT: a rare entity
Authors: Singh Man Mohan , Verma Shashwat , Thakur Priyamedha Bose , Kakkar Lavish , Deswal Satyawati
Published: April 2023

Background

Ewing sarcoma and peripheral primary neuroendocrine tumors are aggressive neoplasms which consist of small, round, blue cells of neuroectodermal origin. They usually arise from the skeleton and consist of genetic mutations EWSR1 in chromosome 22 and FL1 gene on chromosome 11. Extraskeletal Ewing sarcomas (EES) are rare entities with most common sites of EES being extremities, head and neck region and retroperitoneum. Posterior mediastinal Ewing sarcoma is rare. For its evaluation, 18F-fluorodeoxyglucose positron emission tomography (18F FDG PET/CT) plays significant role in staging, management planning and prognostication.

Case presentation

We describe a rare case of EES of posterior mediastinum in a 20-year-old boy who presented with signs of upper motor neuron lesion below D10 level. Contrast-enhanced magnetic resonance imaging (CEMRI) showed a heterogeneously enhancing posterior mediastinal mass in pre- and paravertebral region with intraspinal extension in D2-D4 levels. Fluorodeoxyglucose PET/CT showed a metabolically active mass occupying the superior, middle and posterior mediastinum on the left, displacing the trachea and esophagus toward the right side and causing complete collapse of the left lung. Posteriorly the mass was seen destroying the D2-D5 vertebrae with intraspinal extension at D2-D4 level. Metabolically active metastatic disease was seen in pleura, skull, D12 vertebra, right iliac bone and bilateral proximal femorae. Biopsy obtained from lung and adjacent pleura showed features of a round cell tumor positive for NKX 2.2, weak positive for FLI 1 and negative for PAN CK, LCA, Vimentin and TLE-1, suggestive of Ewing sarcoma. Based on these investigations, a diagnosis of EES of posterior mediastinum was made.

Conclusion

Extraskeletal Ewing sarcoma of posterior mediastinum is a rare and aggressive entity. Management of metastatic EES comprises radiotherapy and systemic chemotherapy which reduces tumor burden and micrometastasis. However, response to treatment in metastatic EES is poorer than in localized disease with overall 5-year survival rates of less than 30%. Fluorodeoxyglucose PET/CT can be a useful tool to accurately detect the extent of local disease in the presence of atelectasic lung for radiotherapy planning as well as evaluating response to therapy.
Plasma copeptin level in type 2 diabetic patients and its role in diabetic nephropathy
Authors: El-Soudany Nevein Nabil , Bessa Sahar Saad El-Din , Morad Heba Ahmed , Selim Amal Abdel Moniem
Published: April 2023

Background

Copeptin, the stable COOH-terminal portion of pre-provasopressin and a surrogate marker of vasopressin, was shown to be positively associated with the decline in kidney function in the general population. However, the impact of copeptin on renal function in diabetic patients remains unclear. This study aims to assess the clinical significance of plasma copeptin level in type 2 diabetic patients with and without nephropathy and to evaluate its relation to various clinical and laboratory parameters.

Methods

This study was carried out on 45 type 2 diabetic patients, divided according to urinary albumin/creatinine ratio into 15 with normoalbminuria, 15 with microalbminuria and 15 with macroalbminuria. Also, 15 healthy subjects were included as a control group. Plasma copeptin level, glycosylated hemoglobin percentage, urinary albumin/ creatinine ratio and serum creatinine were measured. Estimated glomerular filtration rate (eGFR) was calculated.

Results

The mean plasma copeptin level was statistically significantly higher in patients with microalbuminuria as compared to the control and normoalbuminuric groups. It was also, higher in patients with macroalbuminuria as compared to the control, normoalbuminuric and microalbuminuric groups. Plasma copeptin level was positively correlated with glycosylated hemoglobin, urinary albumin /creatinine ratio and serum creatinine but negativey correlated with eGFR.

Conclusion

An increased plasma copeptin level is considered as a good predictor for deterioration of renal function in diabetic patients, suggesting that copeptin can be used to identify diabetics at risk for diabetic kidney disease development. Clearly, further well-designed prospective studies are required to prove this hypothesis.
Comparison of the healthcare-associated infections in intensive care units in Turkey before and during COVID-19
Authors: Sarı Sema , Arslan Ferhat , Turan Sema , Mengi Tuğçe , Ankaralı Handan , Sarı Ahmet , Altınkaya Çavuş Mine , Bayındır Dicle Çilem , Tatlısuluoğlu Derya , Arıcan Hüseyin , Tahta Yahya , Vahaboğlu Haluk
Published: April 2023

Background

Secondary bacterial infections are an important cause of mortality in patients with coronavirus disease 2019 (COVID-19). All healthcare providers acted with utmost care with the reflex of protecting themselves during the COVID-19 period. We aimed to compare the rates of ventilator-associated pneumonia (VAP) and bloodstream infections (BSIs) in our intensive care units (ICUs) before and during the COVID-19 outbreak surges.

Methods

This multicenter, retrospective, cross-sectional study was performed in six centers in Turkey. We collected the patient demographic characteristics, comorbidities, reasons for ICU admission, mortality and morbidity scores at ICU admission, and laboratory test data.

Results

A total of 558 patients who required intensive care from six centers were included in the study. Four hundred twenty-two of these patients (males (62%), whose mean age was 70 [IQR, 58–79] years) were followed up in the COVID period, and 136 (males (57%), whose mean age was 73 [IQR, 61–82] years) were followed up in the pre-COVID period. BSI and VAP rates were 20.7 (19 events in 916 patient days) and 17 (74 events in 4361 patient days) with a −3.8 difference (P = 0.463), and 33.7 (31 events in 919 patient days) and 34.6 (93 events in 2685 patient days) with a 0.9 difference (P = 0.897), respectively. The mortality rates were 71 (52%) in pre-COVID and 291 (69%) in COVID periods.

Conclusion

Protective measures that prioritize healthcare workers rather than patients and exceed standard measures made no difference in terms of reducing mortality.
Olfactory and gustatory outcomes following endoscopic transsphenoidal hypophysectomy
Authors: Ainer Indumathi , Husain Salina , Hamizan Aneeza Khairiyah Wan , Zahedi Farah Dayana , Thanabalan Jegan
Published: April 2023

Objective

The aim of this study was to evaluate olfactory, gustatory, and quality-of-life outcomes in patients who underwent endonasal transsphenoidal hypophysectomy.

Methods

In this prospective study, the patients were assessed subjectively using the Malay version of sQOD-NS (short questionnaire of olfactory disorders in a negative statement) and objectively using the culturally adapted Sniffin’ Sticks smell test and taste test preoperatively and 3 months postoperatively. The Sniffin’ Sticks smell test consists of odor identification, odor discrimination, and odor threshold tests. The taste test consists of different sweet, salt, sour, and bitter concentrations.

Results

Twenty patients were enrolled in the study. The study comprises 45% female and 55% male. On average patients’ ages were 49.5 years. In this study we found a significantly reduced in odor identification score (p = 0.049) post-surgery; however, there was no statistically significant difference in odor threshold, odor discrimination, and taste. The olfactory quality of life outcome based on the Malay version of sQOD-NS (p = 0.001) was significantly reduced after surgery. There was no significant difference in the Sniffin’ Sticks smell test (p < 0.178) and taste test (p < 0.425) pre-surgery and post-surgery. The tumor’s location, either sellar or suprasellar, did not influence the smell outcome of patients postoperatively (p = 0.056).

Conclusion

The study showed that the endoscopic transsphenoidal technique for pituitary surgery does not pose permanent olfactory disability.
Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies
Authors: Bell Vaughan , Tamayo-Agudelo William , Revill Grace , Okai David , Poole Norman
Published: April 2023

Background

Both stroke and psychosis are independently associated with high levels of disability. However, psychosis in the context of stroke has been under-researched. To date, there are no general population studies on their joint prevalence and association.

Aims

To estimate the joint prevalence of stroke and psychosis and their statistical association using nationally representative psychiatric epidemiology studies from two high-income countries (the UK and the USA) and two middle-income countries (Chile and Colombia) and, subsequently, in a combined-countries data-set.

Method

Prevalences were calculated with 95% confidence intervals. Statistical associations between stroke and psychosis and between stroke and psychotic symptoms were tested using regression models. Overall estimates were calculated using an individual participant level meta-analysis on the combined-countries data-set. The analysis is available online as a computational notebook.

Results

The overall prevalence of probable psychosis in stroke was 3.81% (95% CI 2.34–5.82) and that of stroke in probable psychosis was 3.15% (95% CI 1.94–4.83). The odds ratio of the adjusted association between stroke and probable psychosis was 3.32 (95% CI 2.05–5.38). On the individual symptom level, paranoia, hallucinated voices and thought passivity delusion were associated with stroke in the unadjusted and adjusted analyses.

Conclusions

Rates of association between psychosis and stroke suggest there is likely to be a high clinical need group who are under-researched and may be poorly served by existing services.
Phase III Study of Pemetrexed in Combination With Cisplatin Versus Cisplatin Alone in Patients With Malignant Pleural Mesothelioma
Authors: Vogelzang Nicholas J. , Rusthoven James J. , Symanowski James , Denham Claude , Kaukel E. , Ruffie Pierre , Gatzemeier Ulrich , Boyer Michael , Emri Salih , Manegold Christian , Niyikiza Clet , Paoletti Paolo
Published: April 2023

PURPOSE

Patients with malignant pleural mesothelioma, a rapidly progressing malignancy with a median survival time of 6 to 9 months, have previously responded poorly to chemotherapy. We conducted a phase III trial to determine whether treatment with pemetrexed and cisplatin results in survival time superior to that achieved with cisplatin alone.

PATIENTS AND METHODS

Chemotherapy-naive patients who were not eligible for curative surgery were randomly assigned to receive pemetrexed 500 mg/m2 and cisplatin 75 mg/m2 on day 1, or cisplatin 75 mg/m2 on day 1. Both regimens were given intravenously every 21 days.

RESULTS

A total of 456 patients were assigned: 226 received pemetrexed and cisplatin, 222 received cisplatin alone, and eight never received therapy. Median survival time in the pemetrexed/cisplatin arm was 12.1 months versus 9.3 months in the control arm ( P = .020, two-sided log-rank test). The hazard ratio for death of patients in the pemetrexed/cisplatin arm versus those in the control arm was 0.77. Median time to progression was significantly longer in the pemetrexed/cisplatin arm: 5.7 months versus 3.9 months ( P = .001). Response rates were 41.3% in the pemetrexed/cisplatin arm versus 16.7% in the control arm ( P < .0001). After 117 patients had enrolled, folic acid and vitamin B12 were added to reduce toxicity, resulting in a significant reduction in toxicities in the pemetrexed/cisplatin arm.

CONCLUSION

Treatment with pemetrexed plus cisplatin and vitamin supplementation resulted in superior survival time, time to progression, and response rates compared with treatment with cisplatin alone in patients with malignant pleural mesothelioma. Addition of folic acid and vitamin B12 significantly reduced toxicity without adversely affecting survival time.
Synthesis, Characterization, and Photoluminescence Properties of Boron Tropolonate Complexes: From Fluorescence to Room Temperature Phosphorescence
Authors: Ogoshi Hikari , Ito Shunichiro , Tanaka Kazuo
Published: April 2023

Boron complexes based on tropolone, a seven-membered non-benzenoid aromatic compound, were synthesized. We revealed that the aromaticity of tropolone was enhanced by boron complexation. Importantly, all boron complexes exhibited photoluminescence, and room-temperature phosphorescence (RTP) was observed from the halogenated derivatives, BrTpB and ITpB in the crystalline states. Furthermore, a non-substituted complex, TpB, showed phosphorescence without any heavy atoms in the solution state at 77 K. DFT calculation data suggest that TpB should have large enough spin-orbit coupling (SOC) constants to accept the intersystem crossing. The RTP of halogenated complexes were achieved by heavy atom effects. Significantly, this is the first report of RTP from boron tropolonate complexes.
Restoring Balance: A Physical Activity Intervention for Native American Cancer Survivors and Their Familial Support Persons
Authors: Bea Jennifer W. , de Heer Hendrik ‘Dirk’ , Lane Taylor , Charley Brenda , Yazzie Etta , Yellowhair Janet , Hudson Jennifer , Kinslow Brian , Wertheim Betsy C. , Roe Denise J. , Schwartz Anna
Published: April 2023

Introduction/Purpose

Exercise interventions among Native American cancer survivors are lacking, despite major cancer health disparities in survivorship. The purpose of this study was to evaluate a 12-wk randomized controlled trial (RCT) of culturally tailored exercise on cancer risk biomarkers and quality of life among Native American cancer survivors and family members.

Methods

Participants were randomized to immediate start versus 6-wk waitlist control at two rural and two urban sites. Participants enrolled in a small feasibility pilot study (only cancer survivors evaluated, n = 18; cohort 1) or larger efficacy pilot study where cancer survivors (n = 38; cohort 2) and familial supporters (n = 25; cohort 3) were evaluated concurrently. Resistance, aerobic, flexibility, and balance exercises were tailored by cultural experts representing 10 tribes. Exercises were supervised on-site 1 d·wk−1 and continued in home-based settings 2–5 d·wk−1. Fat mass, blood pressure, hemoglobin A1c, 6-min walk, sit-to-stand test, and quality of life (Patient-Reported Outcomes Measurement Information System Global Health short form and isolation subscale) were measured. Mixed-effects models evaluated differences between RCT arms from baseline to 6 wk, and 12-wk intervention effects in combined arms.

Results

There were no consistent differences at 6 wk between randomized groups. Upon combining RCT arms, 6-min walk and sit-to-stand tests improved in all three cohorts by 12 wk (both survivors and familial support persons, P < 0.001); social isolation was reduced in all three cohorts (P ≤ 0.05). Familial support persons additionally improved blood pressure and hemoglobin A1c (P ≤ 0.05).

Conclusions

Exercise improved cardiorespiratory fitness and physical function among Native American cancer survivors and familial supporters. A longer intervention may influence other important health outcomes among Native American survivors. Additional improvements demonstrated among Native American family members may have a meaningful impact on cancer prevention in this underserved population with shared heritable and environmental risks.
Epidemiological profile and diabetes control of Type 1 Diabetes Mellitus patients in Karbala Governorate, Iraq
Authors: Oleiwi Jasim Abdul Razzaq , Abdul Razzaq Noor , Thoulfikar A. Imeer Ali , Mahdi Rahem Rahem , H. Kadhum Abdul Amir , A. Al-Amiery Ahmed
Published: April 2023

Background: Type1 Diabetes Mellitus is a common chronic diseases among children, and associated with morbidity, mortality, and enormous healthcare expenditures. 

Objectives; to estimate the prevalence, incidence, and describe the epidemiological characteristics of Type 1 Diabetes Mellitus among children in Karbala governorate,

Methods:   A cross-sectional study was conducted among all children who attended the main DM center in Karbala Teaching Hospital for Children, Public Clinics, and Primary Health Care centers. Data was collected by structured questionnaire and biochemical and anthropometric measurements. The statistical analysis data entry was conducted using Statistical Package for Social Sciences.

Results: Total number of Type 1 Diabetes Mellitus patients aged 0-15 years in Karbala in 2015 was 199; making 44.66/1005. Fifty-four patients were newly diagnosed patients making an incidence of 12.11/1005. There was nearly equal distribution among both sexes. Most of the cases were from urban areas and most of the patients had a Family history of Type 2 Diabetes Mellitus. Diabetic ketoacidosis was reported in 16.8% of the patients. Only 31.6% of patients had HbA1c < 7%. Half of the patients had a history of admission to the hospital for diabetes. Logistic regression analysis revealed that the only independent variables significantly correlated with poor glycemic control were lack of Self-Monitoring Blood Glucose, irregular visits to the Diabetic Center, and positive family history of diabetes.

Conclusion: Only one-third of T1DM children in Karbala city had controlled blood sugar. Lack of regular blood glucose monitoring and irregular contact with health care providers were the main determinants of uncontrolled blood sugar.
Associations between psychological factors and religious/spiritual beliefs and behaviours in a prospective cohort study (ALSPAC) in Southwest England: A descriptive study
Authors: Major-Smith Daniel , Morgan Jimmy , Tohidinik Hamid Reza , Goulding Neil , Iles-Caven Yasmin , Golding Jean , Northstone Kate , Halstead Isaac
Published: April 2023

Background: Many factors are believed to shape an individual’s religious/spiritual beliefs and behaviours (RSBB) as part of their wider social behaviour, including psychological traits such as intelligence, personality and social cognition. To explore these patterns further, we examined associations between multiple psychological factors and RSBBs in the offspring and parental generations of the Avon Longitudinal Study of Parents and Children (ALSPAC).

Methods: Three RSBB outcome measures were assessed: religious belief (belief in God/a divine power; yes/not sure/no), religious affiliation (Christian/none/other) and religious attendance (frequency of attendance at a place of worship) in approximately 4,400 offspring (aged 28 years), 12,000 mothers and 9,500 of their partners from a prospective birth cohort study in Southwest England (ALSPAC). We explored age-adjusted (and sex-adjusted for offspring) associations between various psychological factors and each of the RSBB outcomes using multinomial regression. These psychological factors included intelligence/cognitive ability, personality, social cognition, locus of control, prosociality and self-esteem. Exposure-sex interactions were also examined for offspring, and exposure-age interactions for parents.

Results: Many psychological factors were associated with RSBB in this cohort, although relationships sometimes differed between cohorts or by RSBB outcome. For instance, in both offspring and mothers, intelligence scores were negatively associated with religious belief and affiliation, but positively associated with religious attendance. An external locus of control was negatively associated with religious belief and attendance in mothers and partners, but little association with religious belief was found in the offspring generation. Some age- and sex-interactions were reported. Most pseudo-R2 values were below 0.5%.

Conclusion: Psychological factors are associated with RSBB in this population, although they explain relatively little of the variation in RSBB. Results are correlational, but suggest that associations between psychological factors and RSBB are present, and can be explored in more detail in future work to assess whether these relationships are causal.
Relational trauma
Authors: Draczyńska Dorota
Published: April 2023

Celem artykułu jest krótkie przedstawienie aktualnej wiedzy na temat definicji traumy relacyjnej, miejsca w klasyfikacjach, rozpowszechnienia, konsekwencji oraz stosowanych metod terapeutycznych. Raporty z wielu krajów informują, iż w relacji z dorosłymi, zwykle rodzicami, od których dziecko jest zależne przez wiele lat, może dochodzić do różnych form krzywdzenia związanych nie tylko z przemocą, ale także z zaniedbaniem w sferze emocjonalnej, fizycznej, intelektualnej. Poza nimi, ukryty jest nierejestrowany obszar awersyjnych doświadczeń dzieci, które z doświadczeniem traumy relacyjnej wkraczają w dorosłość. Te wczesnodziecięce doświadczenia urazowe w znaczący sposób wpływają na ich całościowe funkcjonowanie w dorosłości. Badacze zjawiska od lat zwracają uwagę na istnienie odrębnej jednostki nozologicznej związanej z traumą relacyjną. 11 edycja Międzynarodowej Klasyfikacji Chorób (ICD-11, ang. International Classification of Diseases) wprowadza nowe rozpoznanie: złożony zespół stresu pourazowego (Complex PTSD, cPTSD, ang. complex Post-Traumatic Stress Disorder). Pojawiają się nowe metody oddziaływania terapeutycznego, a walidacja tych metod i wyjaśnianie mechanizmów działania to praca badawcza na najbliższe lata.
Inverted meniscus intraocular lens as a better optical surrogate of the crystalline lens
Authors: Artal Pablo , Ginis Harilaos , Christaras Dimitrios , Villegas Eloy A. , Tabernero Juan , Prieto Pedro M.
Published: April 2023

Current intraocular lenses (IOLs) are designed to substitute the cataractous crystalline lens, optimizing focus at the fovea. However, the common biconvex design overlooks off-axis performance, leading to a reduced optical quality in the periphery of the retina in pseudophakic patients compared to the normal phakic eye. In this work, we designed an IOL to provide better peripheral optical quality, closer in that respect to the natural lens, using ray-tracing simulations in eye models. The resulting design was a concave-convex inverted meniscus IOL with aspheric surfaces. The curvature radius of the posterior surface was smaller than that of the anterior surface by a factor that depended on the IOL power. The lenses were manufactured and evaluated in a custom-built artificial eye. Images of a point source and of extended targets were directly recorded at various field angles with both standard and the new IOLs. This type of IOL produces superior image quality in the whole visual field, being a better surrogate for the crystalline lens than the commonly used thin biconvex intraocular lenses.
Dynamic frequency slot allocation on IP-over-EON access links with multiple-type and time-varying traffic
Authors: Shao Junyi , Zhang Shuai , Sun Weiqiang , Hu Weisheng
Published: April 2023

Access links that connect client networks to public networks have to carry multiple-type and time-varying traffic. Those hybrid traffic flows compete for limited bandwidth, yet at the same time have drastically different performance requirements. As planning the link capacity for peak traffic demand is not economically viable, it is important that bandwidth on the access links is shared between different traffic classes in a way that maximal network utility can be achieved. In this paper, we study the frequency slot allocation problem on IP-over-elastic optical network (EON) access links that carry three types of traffic, namely, packet streams, latency critical circuit connections (e.g., video conferencing), and delay tolerant circuit connections (e.g., bulk data transfers). We define four network operation states; in each of which an access link serves traffic with different levels of fulfillment. We then formulate the allocation problem into a weak-constrained optimization problem and propose a genetic algorithm to solve it in real time. Numerical results show that the relative error of the genetic algorithm is within 3% and the access link keeps maintaining the optimal achievable network operation state. We also show that, by increasing the storage size, the access link can adapt to the increasing traffic load within a certain range without upgrading the expensive access link bandwidth. Our study provides useful insights in managing and operating IP-over-EON access links, and the concept of multiple network operation states can be generalized to networks that serve more than one type of traffic.
Sub-pm linewidth, high pulse energy, high beam quality microsecond-pulse Ti:sapphire laser at 766.699 nm
Authors: Xu Chang , Zuo Jun-Wei , Bo Yong , Gao Hong-Wei , Peng Qin-Jun , Han Yue-heng , Zhang Feng-Chun , Yang Long-Gang , Ding Xiao-Kang , Mu Xue-Feng , Chen Bai-Zhong
Published: April 2023

In this letter, a sub-pm linewidth, high pulse energy and high beam quality microsecond-pulse 766.699 nm Ti:sapphire laser pumped by a frequency-doubled Nd:YAG laser is demonstrated. At an incident pump energy of 824 mJ, the maximum output energy of 132.5 mJ at 766.699 nm with linewidth of 0.66 pm and a pulse width of 100 µs is achieved at a repetition rate of 5 Hz. To the best of our knowledge, this is the highest pulse energy at 766.699 nm with pulse width of hundred micro-seconds for a Ti:sapphire laser. The beam quality factor M2 is measured to be 1.21. It could be precisely tuned from 766.623 to 766.755 nm with a tuning resolution of 0.8 pm. The wavelength stability is measured to be less than ±0.7 pm over 30 min. The sub-pm linewidth, high pulse energy and high beam quality Ti:sapphire laser at 766.699 nm can be used to create a polychromatic laser guide star together with a home-made 589 nm laser in the mesospheric sodium and potassium layer for the tip-tilt correction resulting in the near-diffraction limited imagery on a large telescope.
Volume nanogratings inscribed by ultrafast IR laser in alumino-borosilicate glasses
Authors: Yao Heng , Xie Qiong , Cavillon Maxime , Neuville Daniel R. , Pugliese Diego , Janner Davide , Dai Ye , Poumellec Bertrand , Lancry Matthieu
Published: April 2023

Self-assembled nanogratings, inscribed by femtosecond laser writing in volume, are demonstrated in multicomponent alkali and alkaline earth containing alumino-borosilicate glasses. The laser beam pulse duration, pulse energy, and polarization, were varied to probe the nanogratings existence as a function of laser parameters. Moreover, laser-polarization dependent form birefringence, characteristic of nanogratings, was monitored through retardance measurements using polarized light microscopy. Glass composition was found to drastically impact the formation of nanogratings. For a sodium alumino-borosilicate glass, a maximum retardance of 168 nm (at 800 fs and 1000 nJ) could be measured. The effect of composition is discussed based on SiO2 content, B2O3/Al2O3 ratio, and the Type II processing window is found to decrease as both (Na2O + CaO)/Al2O3 and B2O3/Al2O3 ratios increase. Finally, an interpretation in the ability to form nanogratings from a glass viscosity viewpoint, and its dependency with respect to the temperature, is demonstrated. This work is brought into comparison with previously published data on commercial glasses, which further indicates the strong link between nanogratings formation, glass chemistry, and viscosity.
High-resolution silicon photonics focused ultrasound transducer with a sub-millimeter aperture
Authors: Nagli Michael , Koch Jürgen , Hazan Yoav , Levi Ahiad , Ternyak Orna , Overmeyer Ludger , Rosenthal Amir
Published: April 2023

We present an all-optical focused ultrasound transducer with a sub-millimeter aperture and demonstrate its capability for high-resolution imaging of tissue ex vivo. The transducer is composed of a wideband silicon photonics ultrasound detector and a miniature acoustic lens coated with a thin optically absorbing metallic layer used to produce laser-generated ultrasound. The demonstrated device achieves axial resolution and lateral resolutions of 12 μm and 60 μm, respectively, well below typical values achieved by conventional piezoelectric intravascular ultrasound. The size and resolution of the developed transducer may enable its use for intravascular imaging of thin fibrous cap atheroma.
Differential synthetic illumination based on multi-line detection for resolution and contrast enhancement of line confocal microscopy
Authors: Yuan Jing , Qiao Wei , Li Yafeng , Ning Kefu , Luo Qingming , Gong Hui
Published: April 2023

Line confocal (LC) microscopy is a fast 3D imaging technique, but its asymmetric detection slit limits resolution and optical sectioning. To address this, we propose the differential synthetic illumination (DSI) method based on multi-line detection to enhance the spatial resolution and optical sectioning capability of the LC system. The DSI method allows the imaging process to simultaneously accomplish on a single camera, which ensures the rapidity and stability of the imaging process. DSI-LC improves X- and Z-axis resolution by 1.28 and 1.26 times, respectively, and optical sectioning by 2.6 times compared to LC. Furthermore, the spatially resolved power and contrast are also demonstrated by imaging pollen, microtubule, and the fiber of the GFP fluorescence-labeled mouse brain. Finally, Video-rate imaging of zebrafish larval heart beating in a 665.6×332.8μm² field-of-view is achieved. DSI-LC provides a promising approach for 3D large-scale and functional imaging in vivo with improved resolution, contrast, and robustness.