bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of intensity Modulated Radiation therapy combined with Concurrent Chemoradiotherapy in the treatment of Recurrent Cervical Cancer
Authors: Jin Ge , Li Kuixiu , Niu Shuhuai , Fan Xiaomei , Guo Yunfeng
Published: May 2023

Objective: To evaluate the clinical value of intensity modulated radiation therapy (IMRT) combined with concurrent chemoradiotherapy in the treatment of recurrent cervical cancer.

Methods: This was a retrospective study. Eighty patients with recurrent cervical cancer were recruited and randomly divided into two groups: the experimental group and the control group, with 40 cases in each group at The Fourth Hospital of Hebei Medical University from April, 2017 to April, 2022. Patients in the control group were only given IMRT, while those in the experimental group were given concurrent chemoradiotherapy with paclitaxel and cisplatin based on IMRT. All patients were evaluated for clinical efficacy, adverse drug reactions, and differences in the levels of SCC-Ag, CEA and CA724 and other tumor markers before and after treatment.

Results: The total effective rate in the experimental group was significantly better than in the control group (p=0.02). The incidence of adverse reactions was 40% in the experimental group and 32.5% in the control group, with no statistically significant difference (p=0.48). After treatment, the levels of tumor markers in the experimental group were significantly lower than those in the control group, with a statistically significant difference (p=0.00). The three years survival rate was 80% in the experimental group and 55% in the control group (p=0.03). The five years survival rate was 65% in the experimental group and 42.5% in the control group, with a statistically significant difference (p=0.04).

Conclusion: Intensity modulated radiation therapy (IMRT) combined with concurrent chemoradiotherapy is a safe and effective regimen for recurrent cervical cancer, boasting significant clinical efficacy, reduced tumor markers, no significant increase in adverse reactions, and significantly improved three-years and five years survival rate.

doi: https://doi.org/10.12669/pjms.39.4.6784

How to cite this: Jin G, Li K, Niu S, Fan X, Guo Y. Efficacy and safety of intensity Modulated Radiation therapy combined with Concurrent Chemoradiotherapy in the treatment of Recurrent Cervical Cancer. Pak J Med Sci. 2023;39(4):---------.  doi: https://doi.org/10.12669/pjms.39.4.6784

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical changes of serum melatonin and ICAM-1 levels in patients with basal ganglia hypertensive intracerebral hemorrhage
Authors: Hou Hongbo , Li Xin
Published: May 2023

Objective: To investigate the clinical changes of serum melatonin and intercellular adhesion molecule-1 (ICAM-1) levels in patients with basal ganglia hypertensive intracerebral hemorrhage (HICH).

Methods: In this retrospective observational study, patients with HICH in Suzhou Hospital of Traditional Chinese and Western Medicine from January 2020 to January 2021 were included as the observation group (n=120), and 120 healthy volunteers who underwent physical examination were included as the control group. According to the Glasgow Coma Scale (GCS), the observation group was divided into four subgroups: normal group (n=27), mild group (n=51), moderate group (n=24), and severe group (n=18). Differences in serum melatonin and ICAM-1 were compared between the observation group and the control group, and between the subgroups. Logistic regression was used to analyze the risk factors of poor prognosis, and the ROC curve was used to analyze the influence of melatonin and ICAM-1 levels on patient prognosis.

Results: Serum melatonin levels were lower in the observation group compared to the control group, while ICAM-1 levels were higher (P<0.05). With the aggravation of brain injury, serum melatonin decreased and ICAM increased (P<0.05). Decreased serum melatonin and increased ICAM-1 were independent risk factors for poor prognosis in patients with HICH. The combined AUC of serum melatonin and ICAM-1 for the detection of poor prognosis in patients with HICH was 0.860, which was higher than that of the two alone (P<0.05).

Conclusions: Low serum melatonin levels and high ICAM-1 levels are associated with poor prognosis in patients with HICH and can be used as predictors of patients’ prognosis.

doi: https://doi.org/10.12669/pjms.39.4.7252

How to cite this: Hou H, Li X. Clinical changes of serum melatonin and ICAM-1 levels in patients with basal ganglia hypertensive intracerebral hemorrhage. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7252

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effects of Cognitive-Behavioral Therapy on Psychological Resilience, Social Adaptation and Clinical Efficacy of Patients with Bone Tumors
Authors: Gao Lei , Yu Weina , Wang Ce
Published: May 2023

Objective: To evaluate the effects of cognitive-behavioral therapy on psychological resilience, social adaptation and clinical efficacy in patients with bone tumors.

Methods: This is a retrospective study. Eighty patients with bone tumor admitted to Baoding No.1 Central Hospital were included and randomly divided into two groups: the experimental group and the control group, with 40 cases in each group from March 2020 to February 2022. Patients in the control group were given conventional specialist care, while those in the experimental group were given cognitive-behavioral therapy on top of the treatment in the control group. The differences in quality of life before and after treatment between the two groups were compared and analyzed.

Results: The levels of SAS and SDS were significantly lower in the experimental group compared to the control group, with statistically significant differences (p<0.05). The satisfaction level in the experimental group was higher than in the control group, with statistically significant difference (p=0.04). In addition, the psychological resilience scores of adaptability, toughness, control and goal achievement in the experimental group were significantly improved compared with those in the control group, with statistically significant differences (p<0.05); The cognitive scores in the experimental group were significantly higher than those in the control group, with statistically significant difference (p<0.05).

Conclusion: Cognitive-behavioral therapy is an effective regimen for patients suffering from bone tumors, boasting various benefits such as significantly enhanced patient compliance with treatment, improved quality of life, increased resilience, ameliorated anxiety and depressive states, and improved treatment efficacy and patient satisfaction.

doi: https://doi.org/10.12669/pjms.39.4.7279

How to cite this: Gao L, Yu W, Wang C. Effects of Cognitive-Behavioral Therapy on Psychological Resilience, Social Adaptation and Clinical Efficacy of Patients with Bone Tumors. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7279

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Blood product transfusion practices in pediatric critically ill patients at a tertiary care hospital, Pakistan
Authors: Muhammad Rafique  , Sharmeen Nasir  , Amber Kamran  , Jamal Ammarah
Published: May 2023

Objective: To determine the frequency of inappropriate blood product transfusions in pediatric critically ill patients.

Methods: We collected data for this descriptive study from January to December 2020 at the Pediatric Intensive Care Unit (PICU) of Dr. RKMP Civil Hospital, Karachi. We included all patients one month to 12 years of age, admitted to pediatric intensive care unit and received any blood product transfusion. We reviewed their medical records and noted the demographic and clinical variables, type of blood product transfused with its indication and determined whether transfusion was appropriate or not, as per the standard guidelines and consensus recommendations.

Results: Number of patients who were transfused was n=39, out of which females were 51.3%. Mean age of the patients was 49.0 months ±50.9 months. Total number of transfusions done were n=135, with most common blood product transfused being Fresh Frozen plasma (FFP) in 44.4%. A total of n=117 (86.66%) transfusion were appropriate as per the standard guidelines, while 18 (13.33%) were inappropriate (P-value <0.5). The most common indication of FFP transfusion was INR>2.0 in 51.6%, for Packed red cell transfusion was hemoglobin between 5 and 7 gm/dl in 35.5% and for Platelets was <20,000 with risk of bleeding in 36.6%.

Conclusion: This study highlights the occurrence of inappropriate transfusions in critically ill pediatric patients. We need to reinforce the knowledge of our health care workers and display the guidelines in intensive care units.

doi: https://doi.org/10.12669/pjms.39.4.7503

How to cite this: Rafique M, Nasir S, Kamran A, Jamal A. Blood product transfusion practices in pediatric critically ill patients at a tertiary care hospital, Pakistan. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7503

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Potential clinical usage of ashwagandha root extract: A review
Authors: Potocka Zofia , Borycka Aleksandra , Jędrzejewska Barbara , Kotulska Maria , Laskus Paulina , Lichman Martyna , Lubczyńska Zuzanna , Przeradzki Jakub , Rząd Katarzyna
Published: May 2023

INTRODUCTION AND OBJECTIVE

Ashwagandha, an herb commonly used in traditional Indian medicine, has been gathering attention as a potential drug in various specialties such as psychiatry, neurology, or endocrinology and even as a possible cancer treatment. In this review we aim to summarize reports form recent years on potential clinical usage of Ashwagandha.

REVIEW METHODS

The literature review was conducted using PubMed and Google Scholar online databases.

THE STATE OF KNOWLEDGE

Several studies evaluating potential pharmacological uses of Ashwagandha root extract has been published. There are clinical trials conducted in India using the plant in treatment of insomnia that resulted in improved sleep quality. Ashwagandha root extract has been successfully administered in stress-related disorders. There are reports of improvement in cognitive functions in patients with mild cognitive impairment and better symptom control in obsessive-compulsive disorder after Ashwagandha supplementation. Ashwagandha has been studied in endocrine diseases, showing potential in alleviating climacteric symptoms during perimenopause and in subclinical hypothyroidism. The study aimed to assess effect of Ashwagandha on vitality and hormonal changes in elderly men showed mixed results, with improvement in some hormonal levels and not statistically significant improvement in quality of life compared to placebo group. It has also been noted that ashwagandha root extract has positive effect on cardiovascular system, as well as enhancing muscle strength and recovery in otherwise healthy adults.

SUMMARYAshwagandha root extract seems to possess beneficial properties that allow for its use in several branches of medicine. However as current findings are reported from small sample studies, further research on a larger scale is needed.
Buttered Knuckles of the Martial Arts World – A Comprehensive Review on Boxer’s Knuckle
Authors: Szala-Czerwonka Karolina , Rejmer Adrian , Woś Natalia , Rojek Katarzyna , Bednarz Lucjan , Wijas Karolina , Bialic Kinga , Bakalarczyk Rafał , Bialic Artur , Majewski Paweł
Published: May 2023

Introduction:

Boxer's knuckle is a common injury that occurs due to repetitive trauma to the hand, often seen in those who engage in boxing or other similar combat sports. It is a painful condition that can cause swelling, tenderness, and limited movement in the affected area. In some cases, boxer's knuckle can be severe enough to require medical attention and even surgery. This injury can have a significant impact on an athlete's training and overall performance, and it is important to take preventative measures to avoid its occurrence. Understanding the causes, symptoms, and treatment options for boxer's knuckle is essential for any athlete who regularly engages in combat sports or any activity that involves repeated hand trauma.

Objective of the study:The objective of this review study is to analyze and summarize the literature related to boxer's knuckle, including its epidemiology, pathophysiology, clinical features, diagnosis, and management. The study aims to provide a comprehensive understanding of the condition, its causes, risk factors, and treatments, and to identify the gaps and limitations in the existing literature. Furthermore, this review intends to provide evidence-based recommendations and guidelines for the prevention, assessment, and treatment of boxer's knuckle in athletes and other individuals who are at risk of developing the condition. Ultimately, the study seeks to contribute to the development of a more precise and effective approach to managing this common hand injury.

Material and methods:

Review of PubMed articles using the following keywords: “mcp joint rupture boxing”, “boxer's knuckle”, “metacarpophalangeal joint boxing”, “extensor hood injuries”. Additionally, related articles proposed by the PubMed website were checked. Single citations that were not in the PubMed database but, in the opinion of the authors, contained valuable knowledge worthy of inclusion in the article were also reviewed.
Inmigrantes haitianos: institucionalidad, informalidad y acceso a la vivienda en Chile
Authors: Rodríguez Torrent Juan Carlos , Gissi Barbieri Nicolás
Published: May 2023

Lo que planteamos a continuación se realiza en clave antropológica, en un contexto de excepcionalidad sanitaria y de crisis institucional y de ciudadanía. Refiere a una población joven de residentes haitianos con dificultades para ejercer su derecho a la ciudad dentro de los principios de sostenibilidad, democracia, equidad, justicia social, quienes han sido alterizados de manera subalterna. Revisamos algunas de las acciones adoptadas por las autoridades chilenas en 2020, en el marco de la pandemia, para analizar cómo les afectaron desde la perspectiva de sus derechos ciudadanos, con énfasis en la informalidad, el trabajo, el acceso a la vivienda y la evaluación del arraigo del proyecto migratorio.
Análisis comparado de la garantía de derechos urbanos en la aglomeración urbana de Rionegro, oriente de Antioquia (2014-2018)
Authors: Pamplona Maria José , Piedrahita Bustamante Pedro
Published: May 2023

El artículo es un análisis de las estrategias para la garantía de los derechos urbanos como la vivienda, el espacio público, la movilidad y el gobierno urbano que implementan los munici­pios que conforman la aglomeración de Rionegro (Rionegro, Marinilla, La Ceja, Guarne y El Carmen de Viboral) en la subregión del oriente de Antioquia a través de sus planes de desarro­llo y ordenamiento territorial vigentes entre 2014 y 2018. Esto se realizó a través del método comparado que permite comprobar que los municipios no están desarrollando mecanismos de cooperación ni coordinación que permitan garantizar las demandas y derechos ciudadanos más allá de los límites político-administrativos frente a la existencia de un fenómeno de aglomeración.
As we celebrate the 75th anniversary of the NHS, many challenges remain
Authors: McMahon Alex , Tranka Sue , McIlgorm Maria , May Ruth
Published: May 2023

Despite the pressures facing nurses, NHS Chief Nursing Officers for Scotland, Wales, Northern Ireland and England Alex McMahon, Sue Tranka, Maria McIlgorm and Ruth May look forward to new opportunities and projects to retain and develop existing staff and initiatives to attract potential recruits to the profession
E-nursing homes: transforming access to nurses in nursing homes in response to the staffing crisis
Authors: Thomas Anne , Edwards Katie J , Bradwell Hannah L , Chatterjee Arunangsu , Jones Ray B
Published: May 2023

The UK is facing a nationwide staffing crisis within adult social care, due to difficulties in recruiting and retaining registered nurses. Current interpretation of legislation means nursing homes must always have the physical presence of a registered nurse on duty within the home. With the shortage of registered nurses increasing, reliance on agency workers is commonplace, a practice impacting service cost and continuity of care. Lack of innovation to tackle this issue means the question of how to transform service delivery to combat staffing shortages is open for debate. The potential for technology to augment the provision of care was highlighted during the COVID-19 pandemic. In this article the authors present one possible solution focused on the provision of digital nursing care within nursing homes. Anticipated benefits include enhanced accessibility of nursing roles, reduced risk of viral spread and opportunities for upskilling staff. However, challenges include the current interpretation of legislation.
Just culture development and patient safety in the NHS
Authors: Tingle John
Published: May 2023

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses several reports looking at the development of just cultures
Supporting international recruits
Authors: Foster Sam
Published: May 2023

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the issues faced by internationally recruited nurses and areas where retention strategies could be focused
The management of recurrent urinary tract infections within a nurse-led urology team
Authors: Churchill Kevin
Published: May 2023

The aim of this article is to share experience and learning of managing recurrent urinary tract infections (UTIs) within a specialist urology nurse-led team based at a district general hospital. It looks at current practice and supporting evidence for how to manage and treat recurrent UTIs in both male and female patients. Two case studies are presented to illustrate the management strategies and outcomes, demonstrating a planned approach that informs the design of a local management guideline to organise patients' care.
Bracken poisoning
Authors: Bates Nicola
Published: May 2023

Bracken (Pteridium species) is an ancient, large and very widespread fern that has long been recognised as poisonous. It contains several toxic compounds including ptaquiloside and thiaminase. Bracken toxicosis manifests as different clinical syndromes in different animals. Cattle develop an acute haemorrhagic syndrome leading to widespread haemorrhage and death. With more chronic ingestion enzootic bovine haematuria occurs, which is characterised by tumours of the upper alimentary tract and urinary bladder. Sheep also develop acute haemorrhage syndrome and cancer, but chronic bracken ingestion causes retinal neuropathy, which can lead to permanent blindness. Bracken toxicosis in monogastric animals such as pigs is because of an induced avitaminosis B1. Diagnosis of bracken toxicosis is based on clinical signs, history of exposure and characteristic findings at postmortem. In cattle and sheep the clinical syndromes are progressive and humane euthanasia is usually necessary in animals with advanced disease. In pigs with bracken toxicosis signs are often non-specific and lead to sudden death, but supplementation with thiamine can be effective.
Parasite control in regenerative livestock farming
Authors: Forbes Andrew , Ellis Kathryn
Published: May 2023

Advocates of regenerative livestock farming claim a multitude of benefits following adoption of practices based on high intensity, short duration, long rest rotational grazing, amongst which is a reduction in parasitism and the use of anthelmintics. There are limited scientific data to support such claims and much of what little evidence there is emanates from North America and South Africa, so it would be useful if the observations and experiences of UK adoptees could be backed up with some well-controlled field studies. In their absence, considerations of some aspects of known parasite biology, such as the larval ecology of parasitic nematodes, can shed light on likely outcomes of various types of pasture, grazing and animal management. Minimising the use of anthelmintics in regenerative systems requires effective monitoring to ensure that animal performance and health do not suffer as a result of parasitism; for youngstock, growth rate is the most reliable marker for subclinical parasitic gastroenteritis. Consideration should also be given to other parasites that can affect grazing livestock, such as lungworm, fluke, ticks and flies, in order to determine the influence of regenerative management on the parasite fauna and their collective impact on sheep and cattle.
Cattle Review
Authors: Barrett David C
Published: May 2023

Introduction:

In this Cattle Review we consider a paper on prioritising practical skills for UK veterinary graduates, and two recent papers featuring antimicrobial resistance related research undertaken in Canada. All three papers are open access and easily available.
Equine Review
Authors: Stevenson Anne
Published: May 2023

Introduction:

This edition of the Equine Review discusses papers on macrocyclic lactone resistance in cyathostomins, the reactions of horses to overhead drones, and effective cleaning and sanitising of Streptococcus equi-contaminated equipment.
Statistical properties of a partially coherent azimuthally polarized beam with an astigmatic phase
Authors: Zhou Yunqin , Han Yiping
Published: May 2023

An analytical expression for a partially coherent azimuthally polarized beam with an astigmatic phase (PCAPBAP) is derived. The statistical properties of the PCAPBAP propagating in a paraxial-focused system are studied through numerical examples. It is shown that the beam’s shape changes in a unique way during propagation, and this type of change is related to the rotating factor of the astigmatic phase. Moreover, the influence of the rotating factor and source coherence length on the beam’s polarization and coherence is investigated in detail. The results show that the coherence and polarization properties of the beam also change obviously due to the astigmatic phase’s effect. This paper will be helpful to the fields of optical tweezers, optical needles, imaging, and so on.
Decomposition-learning-based thick-mask model for partially coherent lithography system
Authors: Li Ziqi , Dong Lisong , Ma Xu , Wei Yayi
Published: May 2023

The simulation of thick-mask diffraction near-field (DNF) is an indispensable process in aerial image calculation of immersion lithography. In practical lithography tools, the partially coherent illumination (PCI) is applied since it can improve the pattern fidelity. Therefore, it is necessary to precisely simulate the DNFs under PCI. In this paper, a learning-based thick-mask model proposed in our previous work is extended from the coherent illumination condition to PCI condition. The training library of DNF under oblique illumination is established based on the rigorous electromagnetic field (EMF) simulator. The simulation accuracy of the proposed model is also analyzed based on the mask patterns with different critical dimensions (CD). The proposed thick-mask model is shown to obtain high-precise DNF simulation results under PCI, and thus is suitable for 14 nm or larger technology nodes. Meanwhile, the computational efficiency of the proposed model is improved up to two orders of magnitude compared to the EMF simulator.
A 200Gb/s Low Power DSP-Based Optical Receiver and Transmitter with Integrated TIA and Laser Drivers
Authors: Zafrany A. , Burgos D. , Cai L. , Chong S. , Cramm C. , Dadash S. , Giridharan V. , Gurumoorthy V. , Helal B. , Ho C. , Iyer A. , Jantzi S. , Loi C. , Nguyen T. , Parker K. , Pillai E. , Raviprakash K. , Ray S. , Rossi P. , Sun Z. , Tan A. , Tse L. , Wall B. , Wang L. , Wang J. , Wu T.
Published: May 2023

Fully integrated low power 200Gb/s DSP based optical transmitter and receiver ICs with transmitter chip incorporating fully integrated laser drivers and receiver chip with fully integrated Transimpedance amplifier (TIA) in 16nm FinFet using wirebond technology.
Optical micro-phase-shift dropvolume in a diffractive deep neural network
Authors: Xiao Yong-Liang , Zhang Zhi-Gang , Li Sikun , Zhong Jianxin
Published: May 2023

To provide a desirable number of parallel subnetworks as required to reach a robust inference in an active modulation diffractive deep neural network, a random micro-phase-shift dropvolume that involves five-layer statistically independent dropconnect arrays is monolithically embedded into the unitary backpropagation, which does not require any mathematical derivations with respect to the multilayer arbitrary phase-only modulation masks, even maintaining the nonlinear nested characteristic of neural networks, and generating an opportunity to realize a structured-phase encoding within the dropvolume. Further, a drop-block strategy is introduced into the structured-phase patterns designed to flexibly configure a credible macro–micro phase dropvolume allowing for convergence. Concretely, macro-phase dropconnects concerning fringe griddles that encapsulate sparse micro-phase are implemented. We numerically validate that macro–micro phase encoding is a good plan to the types of encoding within a dropvolume.
One-time readout temporal single-pixel imaging
Authors: O-oka Yoshiki , Keyaki Ryota , Fujisawa Shunsuke , Fukatsu Susumu
Published: May 2023

Ghost imaging (GI) allows retrieval of the images of an uninterrogated object nonlocally based on cross correlation of photons. Central to GI is the integration of sparse detection events, i.e., bucket detection, even in the time domain. Here we report temporal single-pixel imaging of a non-integrating class as a viable GI variant that obviates the need for constant vigil. Mere division of the otherwise distorted waveforms by the known impulse response function of the detector makes the corrected waveforms readily available. This tempts us to use slow and as such less costly commercially available optoelectronic devices like light-emitting diodes and solar cells for imaging purposes on a one-time readout basis.
Thermo-optical measurements using quantitative phase microscopy
Authors: Tanjaya Nicholaus Kevin , Toda Keiichiro , Ideguchi Takuro , Ishii Satoshi
Published: May 2023

Quantitative phase microscopy (QPM) literally images the quantitative phase shift associated with image contrast, where the phase shift can be altered by laser heating. In this study, the thermal conductivity and thermo-optic coefficient (TOC) of a transparent substrate are simultaneously determined by measuring the phase difference induced by an external heating laser using a QPM setup. The substrates are coated with a 50-nm-thick titanium nitride film to photothermally generate heat. Then, the phase difference is semi-analytically modeled based on the heat transfer and thermo-optic effect to simultaneously extract the thermal conductivity and TOC. The measured thermal conductivity and TOC agree reasonably well, indicating the potential for measuring the thermal conductivities and TOCs of other transparent substrates. The concise setup and simple modeling differentiate the advantages of our method from other techniques.
Lymphatic filariasis endgame strategies: Using GEOFIL to model mass drug administration and targeted surveillance and treatment strategies in American Samoa
Authors: Shaw Callum , McLure Angus , Graves Patricia M. , Lau Colleen L. , Glass Kathryn
Published: May 2023

American Samoa underwent seven rounds of mass drug administration (MDA) for lymphatic filariasis (LF) from 2000-2006, but subsequent surveys found evidence of ongoing transmission. American Samoa has since undergone further rounds of MDA in 2018, 2019, and 2021; however, recent surveys indicate that transmission is still ongoing. GEOFIL, a spatially-explicit agent-based LF model, was used to compare the effectiveness of territory-wide triple-drug MDA (3D-MDA) with targeted surveillance and treatment strategies. Both approaches relied on treatment with ivermectin, diethylcarbamazine, and albendazole. We simulated three levels of whole population coverage for 3D-MDA: 65%, 73%, and 85%, while the targeted strategies relied on surveillance in schools, workplaces, and households, followed by targeted treatment. In the household-based strategies, we simulated 1-5 teams travelling village-to-village and offering antigen (Ag) testing to randomly selected households in each village. If an Ag-positive person was identified, treatment was offered to members of all households within 100m-1km of the positive case. All simulated interventions were finished by 2027 and their effectiveness was judged by their ‘control probability’—the proportion of simulations in which microfilariae prevalence decreased between 2030 and 2035. Without future intervention, we predict Ag prevalence will rebound. With 3D-MDA, a 90% control probability required an estimated ≥ 4 further rounds with 65% coverage, ≥ 3 rounds with 73% coverage, or ≥ 2 rounds with 85% coverage. While household-based strategies were substantially more testing-intensive than 3D-MDA, they could offer comparable control probabilities with substantially fewer treatments; e.g. three teams aiming to test 50% of households and offering treatment to a 500m radius had approximately the same control probability as three rounds of 73% 3D-MDA, but used < 40% the number of treatments. School- and workplace-based interventions proved ineffective. Regardless of strategy, reducing Ag prevalence below the 1% target threshold recommended by the World Health Organization was a poor indicator of the interruption of LF transmission, highlighting the need to review blanket elimination targets.
Testing the effects of group-affirmation in active conflict: Ukrainians’ trust toward Russia
Authors: Chung Eunbin , Pechenkina Anna O.
Published: May 2023

How can states with a history of recent armed conflict trust one another? Political psychology offers two competing approaches to increase trust between the publics of different countries: appealing to an overarching, common identity above the national level vs. affirming a sense of national identity. This study aims to examine the scope conditions of group-affirmation effects on trust in active conflicts by testing which group-affirmation approach increases trust towards Russia among the Ukrainian public. Distrust between Ukraine and Russia aggravates security fears and limits hope for a meaningful resolution of the bloodiest armed conflict in Europe since 1994. Hostility levels have risen dramatically between the populations of Ukraine and Russia after the events of 2013–2015. The study employs a survey experiment (between-subjects design) to evaluate these competing approaches. The survey was fielded in late May-June 2020 by a reputable public opinion research firm, the Kyiv International Institute of Sociology (KIIS), based in Ukraine. The results suggest that in areas where conflict is salient, national identity affirmation can increase trust in subsamples that hold preexisting baseline levels of affinity toward the outgroup. When combined with the more anti-Russian Ukrainians however, this positive effect was cancelled out. In contrast, emphasis on an overarching, common ingroup identity did not raise trust in any subgroups. Examining the disparate effects of national identity affirmation in anti-Russian and pro-Russian regional subsamples helps specify the scope conditions of which group-affirmation can be most effective.
Ultrasound evaluation of vagus nerve cross-sectional area in a community-dwelling elderly Japanese cohort
Authors: Oura Kazumasa , Akasaka Hiroshi , Ishizuka Naoki , Sato Yuriko , Kudo Masahiro , Yamaguchi Takashi , Oura Mao Yamaguchi , Itabashi Ryo , Maeda Tetsuya
Published: May 2023

Objectives

Although the vagus nerve (VN) is easily observed by ultrasonography, few studies have evaluated the cross-sectional area (CSA) of the VN in healthy older individuals from East Asia. In this study, we aimed to report reference values for the CSA of the VN in community-dwelling elderly Japanese individuals and to identify any associated medical history and/or lifestyle factors.

Methods

The present study included 336 participants aged ≥ 70 years from a prospective cohort study conducted in Yahaba, Japan from October 2021 to February 2022. The CSA of the VN was measured bilaterally at the level of the thyroid gland by ultrasonography. Simple linear regression analysis and generalized estimating equation were conducted to identify the associations between clinical and background factors and the CSA of the VN.

Results

In our cohort, the median CSA of the VN was 1.3 mm2 (interquartile range [IQR] 1.1–1.6) on the right side and 1.2 mm2 (IQR 1.0–1.4) on the left side. Generalized estimating equation showed that history of head injury (β = 0.19, p < .01), current smoking habit (β = -0.09, p = .03), and BMI (β = 0.02, p < .01) were independently associated with the CSA of the VN.

Conclusion

We have reported reference VN CSA values for community-dwelling elderly Japanese individuals. In addition, we showed that the CSA of the VN was positively associated with a history of head injury and BMI and inversely associated with current smoking habit.
Biophysical and biochemical studies support TP0094 as a phosphotransacetylase in an acetogenic energy-conservation pathway in Treponema pallidum
Authors: Brautigam Chad A. , Deka Ranjit K. , Tso Shih-Chia , Liu Wei Z. , Norgard Michael V.
Published: May 2023

The mechanisms of energy generation and carbon-source utilization in the syphilis spirochete Treponema pallidum have remained enigmatic despite complete genomic sequence information. Whereas the bacterium harbors enzymes for glycolysis, the apparatus for more efficient use of glucose catabolites, namely the citric-acid cycle, is apparently not present. Yet, the organism’s energy needs likely exceed the modest output from glycolysis alone. Recently, building on our structure-function studies of T. pallidum lipoproteins, we proposed a “flavin-centric” metabolic lifestyle for the organism that partially resolves this conundrum. As a part of the hypothesis, we have proposed that T. pallidum contains an acetogenic energy-conservation pathway that catabolizes D-lactate, yielding acetate, reducing equivalents for the generation and maintenance of chemiosmotic potential, and ATP. We already have confirmed the D-lactate dehydrogenase activity in T. pallidum necessary for this pathway to operate. In the current study, we focused on another enzyme ostensibly involved in treponemal acetogenesis, phosphotransacetylase (Pta). This enzyme is putatively identified as TP0094 and, in this study, we determined a high-resolution (1.95 Å) X-ray crystal structure of the protein, finding that its fold comports with other known Pta enzymes. Further studies on its solution behavior and enzyme activity confirmed that it has the properties of a Pta. These results are consistent with the proposed acetogenesis pathway in T. pallidum, and we propose that the protein be referred to henceforth as TpPta.
Automated 3-dimensional MRI segmentation for the posterosuperior rotator cuff tear lesion using deep learning algorithm
Authors: Lee Su Hyun , Lee JiHwan , Oh Kyung-Soo , Yoon Jong Pil , Seo Anna , Jeong YoungJin , Chung Seok Won
Published: May 2023

Introduction

Rotator cuff tear (RCT) is a challenging and common musculoskeletal disease. Magnetic resonance imaging (MRI) is a commonly used diagnostic modality for RCT, but the interpretation of the results is tedious and has some reliability issues. In this study, we aimed to evaluate the accuracy and efficacy of the 3-dimensional (3D) MRI segmentation for RCT using a deep learning algorithm.

Methods

A 3D U-Net convolutional neural network (CNN) was developed to detect, segment, and visualize RCT lesions in 3D, using MRI data from 303 patients with RCTs. The RCT lesions were labeled by two shoulder specialists in the entire MR image using in-house developed software. The MRI-based 3D U-Net CNN was trained after the augmentation of a training dataset and tested using randomly selected test data (training: validation: test data ratio was 6:2:2). The segmented RCT lesion was visualized in a three-dimensional reconstructed image, and the performance of the 3D U-Net CNN was evaluated using the Dice coefficient, sensitivity, specificity, precision, F1-score, and Youden index.

Results

A deep learning algorithm using a 3D U-Net CNN successfully detected, segmented, and visualized the area of RCT in 3D. The model’s performance reached a 94.3% of Dice coefficient score, 97.1% of sensitivity, 95.0% of specificity, 84.9% of precision, 90.5% of F1-score, and Youden index of 91.8%.

Conclusion

The proposed model for 3D segmentation of RCT lesions using MRI data showed overall high accuracy and successful 3D visualization. Further studies are necessary to determine the feasibility of its clinical application and whether its use could improve care and outcomes.
Health services use among formerly incarcerated Louisiana Medicaid members within one year of release
Authors: Wennerstrom Ashley , Sugarman Olivia K. , Reilly Bruce , Armstrong Andrea , Whittington Angel , Bachhuber Marcus A.
Published: May 2023

Objectives

To determine the association between enrollment in Medicaid prior to release compared with post-release, and the use of health services and time to the first service use after release among Louisiana Medicaid members within one year of release from Louisiana state corrections custody.

Methods

We conducted a retrospective cohort study linking Louisiana Medicaid and Louisiana state corrections release data. We included individuals ages 19 to 64 years released from state custody between January 1, 2017 and June 30, 2019 and enrolled in Medicaid within 180 days of release. Outcome measures included receipt of general health services (primary care visits, emergency department visits, and hospitalizations), cancer screenings, specialty behavioral health services, and prescription medications. To determine the association between pre-release Medicaid enrollment and time to receipt of health services, multivariable regression models were used which accounted for significant differences in characteristics between the groups.

Results

Overall, 13283 individuals met eligibility criteria and 78.8% (n = 10473) of the population was enrolled in Medicaid pre-release. Compared with those enrolled in Medicaid prior to release, those enrolled post-release were more likely to have an emergency department visit (59.6% versus 57.5%, p = 0.04) and hospitalization (17.9% versus 15.9%, p = 0.01) and less likely to receive outpatient mental health services (12.3% versus 15.2%, p<0.001) and prescription drugs. Compared with those enrolled in Medicaid prior to release, those enrolled post-release had a significantly longer time to receiving many services including a primary care visit (adjusted mean difference: 42.2 days [95% CI: 37.9 to 46.5; p<0.001]), outpatient mental health services (42.8 days [95% CI: 31.3 to 54.4; p<0.001]), outpatient substance use disorder service (20.6 days [95% CI: 2.0 to 39.2; p = 0.03]), and medication for opioid use disorder (40.4 days [95% CI: 23.7 to 57.1; p<0.001]) as well as inhaled bronchodilators and corticosteroids (63.8 days [95% CI: 49.3 to 78.3, p<0.001]), antipsychotics (62.9 days [95% CI: 50.8 to 75.1; p<0.001]), antihypertensives (60.5 days [95% CI: 50.7 to 70.3; p<0.001]), and antidepressants (52.3 days [95% CI: 44.1 to 60.5; p<0.001]).

Conclusion

Compared with Medicaid enrollment post-release, pre-release Medicaid enrollment was associated with higher proportions of, and faster access to, a wide variety of health services. Regardless of enrollment status, we found prolonged times between release and receipt of time-sensitive behavioral health services and prescription medications.
On the fractal patterns of language structures
Authors: Ribeiro Leonardo Costa , Bernardes Américo Tristão , Mello Heliana
Published: May 2023

Natural Language Processing (NLP) makes use of Artificial Intelligence algorithms to extract meaningful information from unstructured texts, i.e., content that lacks metadata and cannot easily be indexed or mapped onto standard database fields. It has several applications, from sentiment analysis and text summary to automatic language translation. In this work, we use NLP to figure out similar structural linguistic patterns among several different languages. We apply the word2vec algorithm that creates a vector representation for the words in a multidimensional space that maintains the meaning relationship between the words. From a large corpus we built this vectorial representation in a 100-dimensional space for English, Portuguese, German, Spanish, Russian, French, Chinese, Japanese, Korean, Italian, Arabic, Hebrew, Basque, Dutch, Swedish, Finnish, and Estonian. Then, we calculated the fractal dimensions of the structure that represents each language. The structures are multi-fractals with two different dimensions that we use, in addition to the token-dictionary size rate of the languages, to represent the languages in a three-dimensional space. Finally, analyzing the distance among languages in this space, we conclude that the closeness there is tendentially related to the distance in the Phylogenetic tree that depicts the lines of evolutionary descent of the languages from a common ancestor.
Integrated optimization of urban rail transit line planning, timetabling and rolling stock scheduling
Authors: Li Chao , Tang Jinjin , Zhang Jun , Zhao Qingqing , Wang Lingli , Li Jian
Published: May 2023

Urban rail transit train operation plan is a comprehensive production plan encompassing line planning, timetabling, and rolling stock scheduling. In order to solve the problem of infeasibility of the line plan and timetable because the number of rolling stocks could be only precisely considered in the rolling stock scheduling. An integrated optimization solution is proposed which considers the line plan, timetable, and rolling stock schedule. Candidate service routes are generated according to the layout of the turn-back stations. Considering the constraints of operation and passenger flow demand, an integer nonlinear programming model is established to minimize the cost of operation and passenger waiting time. The model complexity is analyzed and based on its decomposability a deterministic search algorithm is designed. Taking Chongqing Metro Line 3 in China as an example to verify the effectiveness of the proposed model and algorithm. Compared with the train operation plan based on manual experience and compiled by stages, the integrated optimization model can better improve the quality of train operation plan.
Combinatorial expression of ebony and tan generates body color variation from nymph through adult stages in the cricket, Gryllus bimaculatus
Authors: Inoue Shintaro , Watanabe Takahito , Hamaguchi Taiki , Ishimaru Yoshiyasu , Miyawaki Katsuyuki , Nikawa Takeshi , Takahashi Akira , Noji Sumihare , Mito Taro
Published: May 2023

Insect body colors and patterns change markedly during development in some species as they adapt to their surroundings. The contribution of melanin and sclerotin pigments, both of which are synthesized from dopamine, to cuticle tanning has been well studied. Nevertheless, little is known about how insects alter their body color patterns. To investigate this mechanism, the cricket Gryllus bimaculatus, whose body color patterns change during postembryonic development, was used as a model in this study. We focused on the ebony and tan genes, which encode enzymes that catalyze the synthesis and degradation, respectively, of the precursor of yellow sclerotin N-β-alanyl dopamine (NBAD). Expression of the G. bimaculatus (Gb) ebony and tan transcripts tended to be elevated just after hatching and the molting period. We found that dynamic alterations in the combined expression levels of Gb’ebony and Gb’tan correlated with the body color transition from the nymphal stages to the adult. The body color of Gb’ebony knockout mutants generated by CRISPR/Cas9 systemically darkened. Meanwhile, Gb’tan knockout mutants displayed a yellow color in certain areas and stages. The phenotypes of the Gb’ebony and Gb’tan mutants probably result from an over-production of melanin and yellow sclerotin NBAD, respectively. Overall, stage-specific body color patterns in the postembryonic stages of the cricket are governed by the combinatorial expression of Gb’ebony and Gb’tan. Our findings provide insights into the mechanism by which insects evolve adaptive body coloration at each developmental stage.