bluuebunny/crossref_metadata_2025 huggingface dataset:
Trastornos alimentarios pediátricos con impacto nutricional severo
Authors: Saldaneri Mónica , Saure Carola , Filomena Graciela , Soraiz Guillermina , Esmoris Regina , Massa Sandra , González Moreira Dalma J.
Published: June 2024

Las dificultades en la alimentación tienen una prevalencia significativa en niños/as con desarrollo típico y aumentan, significativamente, cuando existen condiciones de salud comórbidas, siendo ésta una de las preocupaciones más frecuentes en la consulta pediátrica. La falta de una detección oportuna puede impactar de forma negativa en la salud integral de las niñeces.
El objetivo de este trabajo es describir el abordaje que se realizó en niños/as que presentaron trastornos alimentarios pediátricos con impacto nutricional severo en el contexto de la “Clínica interdisciplinaria de deglución y conducta alimentaria” que funciona en un hospital público en la Ciudad Autónoma de Buenos Aires, Argentina.
Se llevó a cabo un estudio de carácter descriptivo y retrospectivo. Se incluyeron en la muestra final a 16 familias. Los niños/as comprendían una franja etaria de 2 a 13 años. Los motivos de internación más prevalentes fueron impotencia funcional de miembros inferiores y alteraciones visuales. Un 93,75% de la población presentaba desafíos en su desarrollo. La edad promedio de aparición de las dificultades en la alimentación fue entre los 12 y 18 meses de edad. Un 56,25% había consultado, anteriormente, con algún profesional de la salud. El 56,25% no contaba con los apoyos terapéuticos adecuados. El 100% tenía dificultades en la conformación de rutinas.
Los trastornos alimentarios pediátricos constituyen un fuerte desafío para el equipo de salud. La detección precoz, las intervenciones oportunas y el enfoque centrado en la familia son fundamentales para evitar complicaciones severas y propiciar un vínculo placentero a la hora de comer.
Quantifying the effects of five rehabilitation training methods on the ability of elderly men to control bowel movements: a finite element analysis study
Authors: Wang Rui , Liu Guangtian , Jing Liwei , Zhang Jing , Ye Yan , Zhu Haoran
Published: June 2024

Purpose

The study aims to develop a finite element model of the pelvic floor and thighs of elderly men to quantitatively assess the impact of different pelvic floor muscle trainings and the urinary and defecation control ability.

Methods

A finite element model of the pelvic floor and thighs of elderly men was constructed based on MRI and CT. Material properties of pelvic floor tissues were assigned through literature review, and the relative changes in waistline, retrovesical angle (RVA) and anorectad angulation (ARA) to quantitatively verify the effectiveness of the model. By changing the material properties of muscles, the study analyzed the muscle strengthening or impairment effects of the five types of rehabilitation training for four types of urination and defecation dysfunction. The changes in four outcome indicators, including the retrovesical angle, anorectad angulation, stress, and strain, were compared.

Results

This study indicates that ARA and RVA approached their normal ranges as material properties changed, indicating an enhancement in the urinary and defecation control ability, particularly through targeted exercises for the levator ani muscle, external anal sphincter, and pelvic floor muscles. This study also emphasizes the effectiveness of personalized rehabilitation programs including biofeedback, exercise training, electrical stimulation, magnetic stimulation, and vibration training and advocates for providing optimized rehabilitation training methods for elderly patients.

Discussion

Based on the results of computational biomechanics, this study provides foundational scientific insights and practical recommendations for rehabilitation training of the elderly’s urinary and defecation control ability, thereby improving their quality of life. In addition, this study also provides new perspectives and potential applications of finite element analysis in elderly men, particularly in evaluating and designing targeted rehabilitation training.
A simplified method for estimating bridge frequency effects considering train mass
Authors: Rahman Aminur K. , Imam Boulent , Hajializadeh Donya
Published: June 2024

The dynamic response of a railway bridge depends on several parameters; the primary parameter is the fundamental natural frequency of vibration of the bridge itself. It is considered a critical parameter of the bridge as the driving or the forcing frequencies arising from moving trains may coincide with the fundamental frequency of the bridge and initiate a resonant response amplifying the bridge load effects. This condition may adversely affect the stresses experienced on bridge members and, consequently, the remaining fatigue life of the structure. Because the train adds additional time-varying mass to the bridge, this introduces a time-varying change in the bridge’s fundamental natural frequency of vibration. As a result, train critical speeds will have a certain range depending on the train configuration. This article presents a simplified method using a power-law relationship to predict the frequency characteristics of a bridge as a function of the train-to-bridge mass ratio. The method is presented in a generalized form, which enables the frequency characteristics to be determined for any given combination of trains and simply supported bridges of short to medium span typically found on the UK rail network. The method is then demonstrated in a case study of a single-span, simply supported plate girder bridge. By considering the BS-5400 train traffic types, the proposed method is used to calculate bridge frequency effects, dynamic amplification, and train critical speed bandwidth for each train type. The simplicity of the proposed method, as it does not require any complex computational modeling, makes it an ideal and effective tool for the practicing engineer to carry out a quick and economical assessment of a bridge for any given train configuration.
SFDRS as a metalanguage for ‘foodscaping’: adding a formal dimension to an interdisciplinary, multimodal approach to food
Authors: Kim Loli , Calway Niamh
Published: June 2024

‘Foodscaping’ seeks to understand how meaning is made through humans’ interaction with food in particular environments through a multimodal and interdisciplinary analytical lens. As part of a foodscaping project, researchers often interpret food environments to which they are not intimately ‘local’. This presents cross-cultural limitations in the production of analysis. Most pertinently, how can personal interpretation be divorced from locally salient and meaningful discourses? This paper presents the findings of a pilot foodscaping analysis using the box notation style of Kim’s Korean Segmented Film Discourse Representation Structures (K-SFDRS). K-SFDRS notation, developed to provide both coarser- and finer-grained formal transcription for South Korean multimodal film discourse analysis, is tested as an analytic tool for an authentic South Korean foodscaping experience. This paper aims to ascertain whether the formal nature of K-SFDRS transcription is a useful aid to the analysis of a foodscape, which otherwise risks relying heavily on personal interpretation. This pilot study presents an introduction to both foodscaping and (K-)SFDRS, outlines the potentials of (K-)SFDRS notation within a foodscaping context, offers a step-by-step outline for constructing K-SFDRS box notation using an exemplar South Korean foodscape, and finally demonstrates how this box notation may be used in the support of foodscaping analysis in various interdisciplinary channels. During this pilot study, the authors make a novel methodological development in the form of what they term ‘cluster structures’, which overcome the problems presented by the lack of cinematic narrative editing in spontaneous discourse, segmenting meaning into logical forms within which structures of meaning are hierarchised without requiring the discourse relations to structure the logical forms themselves in narrative discourse following the original K-SFDRS methodology. The paper concludes that K-SFDRS, alongside the aforementioned methodological development, has potential to help foodscaping researchers constrain interpretation to salient discourses and direct foodscaping analysis down meaningful avenues. Through its culinary scope, this chapter adds a new disciplinary dimension to discussions of metalanguage and makes an innovative contribution to the current corpus of multimodal research.
Unveiling the core of IoT: comprehensive review on data security challenges and mitigation strategies
Authors: Kaur Kawalpreet , Kaur Amanpreet , Gulzar Yonis , Gandhi Vidhyotma
Published: June 2024

The Internet of Things (IoT) is a collection of devices such as sensors for collecting data, actuators that perform mechanical actions on the sensor's collected data, and gateways used as an interface for effective communication with the external world. The IoT has been successfully applied to various fields, from small households to large industries. The IoT environment consists of heterogeneous networks and billions of devices increasing daily, making the system more complex and this need for privacy and security of IoT devices become a major concern. The critical components of IoT are device identification, a large number of sensors, hardware operating systems, and IoT semantics and services. The layers of a core IoT application are presented in this paper with the protocols used in each layer. The security challenges at various IoT layers are unveiled in this review paper along with the existing mitigation strategies such as machine learning, deep learning, lightweight encryption techniques, and Intrusion Detection Systems (IDS) to overcome these security challenges and future scope. It has been concluded after doing an intensive review that Spoofing and Distributed Denial of Service (DDoS) attacks are two of the most common attacks in IoT applications. While spoofing tricks systems by impersonating devices, DDoS attacks flood IoT systems with traffic. IoT security is also compromised by other attacks, such as botnet attacks, man-in-middle attacks etc. which call for strong defenses including IDS framework, deep neural networks, and multifactor authentication system.
Risk factors for thrombotic events in systemic lupus erythematosus patients with antiphospholipid antibodies: insights from morphometric measurements of carotid arteries
Authors: Yang Qing , Liu Qi , Yin Changqing , Zhang Xiaoyu , Chen Xi , Pylypenko Dmytro , Chen Hao , Shu Qiang , Yu Dexin
Published: June 2024

Objective

To identify the correlation between thrombosis and atherosclerosis in systemic lupus erythematosus (SLE) patients with antiphospholipid antibodies (aPLs) (SLE/aPLs) through high-resolution magnetic resonance imaging (HR-MRI) of the carotid artery.

Methods

A single-center, cross-sectional study was conducted. We collected consecutive patients with SLE/aPLs and healthy controls who underwent carotid HR-MRI examinations. The morphometric characteristics of the common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), and carotid bulb (Sinus) were measured, and the differences in morphometric parameters between different groups were analyzed.

Results

A total of 144 carotid arteries were analyzed. Compared with the control group, the wall area, wall thickness (WT and WTmax), and normalized wall index of CCA, ICA, ECA, and Sinus were increased in patients with SLE/aPLs, and the total vascular area (TVA) of CCA, ICA, and Sinus, and the bifurcation angle (BIFA) of ICA-ECA were also increased. A negative lupus anticoagulant (LAC) (with or without positive anticardiolipin antibody (aCL) or anti-β2glycoprotein antibody (aβ2GPI)) contributed to illustrating lower increased TVA and thickened vessel walls of CCA and ICA in SLE/aPLs patients without thrombotic events. Logistic regression analysis showed that WTmaxSinus and WTmaxGlobal were independent risk factors for thrombotic events in SLE/aPLs patients. The receiver operator characteristic curve showed that the cut-off value of WTmaxSinus was 2.855 mm, and WTmaxGlobal was 3.370 mm.

Conclusion

HR-MRI ensures the complete and accurate measurement of carotid morphometric parameters. Compared with the control group, the carotid artery in patients with SLE/aPLs is mainly characterized by diffusely thickened vessel walls, and the patients with thrombotic events showed additional higher vascular area of CCA and ICA, and BIFA of ICA-ECA without significant change in lumen area. The carotid arteries of SLE/aPLs patients with thrombotic events exhibited significant vessel wall thickening in all segments except ECA compared to those without thrombotic events. LAC-negative and non-thrombotic events distinguish relatively early atherosclerosis in the carotid arteries in patients with SLE/aPLs. Patients with SLE/aPLs that possess circumscribed thickened carotid vessel walls (>3.370 mm), particularly thickened at the Sinus (>2.855 mm), may require management strategies for the risk of thrombotic events.
Same-day discharge after percutaneous closure of persistent foramen ovale using intracardiac echocardiography and the Gore Septal Occluder
Authors: Steiner Kristoffer , Sjöberg Gunnar , Damlin Anna , Settergren Magnus , Verouhis Dinos
Published: June 2024

Aim

Periprocedural and postinterventional care of patients undergoing closure of patent foramen ovale (PFO) varies significantly across care providers. Same-day discharge (SDD) after transcatheter interventions is an evolving concept. This study aimed to assess the same-day discharge rate and incidence of complications in patients undergoing PFO closure with intracardiac echocardiography (ICE) using the Gore®Cardioform Septal Occluder (GSO) device. The secondary aim was to analyse the efficacy of femoral vein closure with Perclose ProGlide.

Methods

Patients who underwent PFO closure with the GSO device at a university hospital in Stockholm, Sweden, were retrospectively included between March 1, 2017, and June 30, 2020, all with cryptogenic stroke as the indication for the procedure. All patients underwent PFO closure with conscious sedation and local anaesthesia. The indication for all patients was a cryptogenic stroke. Periprocedural imaging was performed using ICE and fluoroscopy in all patients. Patient characteristics and periprocedural data were collected from patient charts. Patients were kept on bed rest for 4–6 h post-intervention. Transthoracic echocardiography and clinical examination, including groin status, were performed before discharge. No clinical routine follow-up was performed the day following the intervention. Clinical follow-up was done by phone call two weeks after the procedure, and echocardiographic follow-up was done after 12 months. Data were analysed using linear and logistic regression models.

Results

In total, 262 patients were included, of which 246 (94%) had SDD. 166 patients (63%) received the ProGlide™ system for femoral vein access closure. Post-procedural arrhythmias occurred in 17 (6%) patients, and vascular complications in 9 patients (3%). The overall closure rate at follow-up was 98.5%. 25 out of 264 patients (9.5%) had to be readmitted within the first eight weeks after PFO closure, 16 due to atrial fibrillation warranting electric cardioversion, one due to an arteriovenous fistula that was operated, four due to chest pain/pain at the access site, and four patients developed fever. There was no difference in SDD among patients who received ProGlide™ vs. patients who did not receive ProGlide™.

Conclusion

SDD appears safe after transcatheter PFO closure with the GSO device with high procedural success rates. Low rates of complications and readmissions make the intervention suitable for this patient-friendly and cost-effective concept.
MedT5SQL: a transformers-based large language model for text-to-SQL conversion in the healthcare domain
Authors: Marshan Alaa , Almutairi Anwar Nais , Ioannou Athina , Bell David , Monaghan Asmat , Arzoky Mahir
Published: June 2024

Introduction

In response to the increasing prevalence of electronic medical records (EMRs) stored in databases, healthcare staff are encountering difficulties retrieving these records due to their limited technical expertise in database operations. As these records are crucial for delivering appropriate medical care, there is a need for an accessible method for healthcare staff to access EMRs.

Methods

To address this, natural language processing (NLP) for Text-to-SQL has emerged as a solution, enabling non-technical users to generate SQL queries using natural language text. This research assesses existing work on Text-to-SQL conversion and proposes the MedT5SQL model specifically designed for EMR retrieval. The proposed model utilizes the Text-to-Text Transfer Transformer (T5) model, a Large Language Model (LLM) commonly used in various text-based NLP tasks. The model is fine-tuned on the MIMICSQL dataset, the first Text-to-SQL dataset for the healthcare domain. Performance evaluation involves benchmarking the MedT5SQL model on two optimizers, varying numbers of training epochs, and using two datasets, MIMICSQL and WikiSQL.

Results

For MIMICSQL dataset, the model demonstrates considerable effectiveness in generating question-SQL pairs achieving accuracy of 80.63%, 98.937%, and 90% for exact match accuracy matrix, approximate string-matching, and manual evaluation, respectively. When testing the performance of the model on WikiSQL dataset, the model demonstrates efficiency in generating SQL queries, with an accuracy of 44.2% on WikiSQL and 94.26% for approximate string-matching.

Discussion

Results indicate improved performance with increased training epochs. This work highlights the potential of fine-tuned T5 model to convert medical-related questions written in natural language to Structured Query Language (SQL) in healthcare domain, providing a foundation for future research in this area.
Daily standing time, dietary fiber, and intake of unsaturated fatty acids are beneficially associated with hepatic insulin sensitivity in adults with metabolic syndrome
Authors: Laine Saara , Sjöros Tanja , Garthwaite Taru , Honka Miikka-Juhani , Löyttyniemi Eliisa , Eskola Olli , Saarenhovi Maria , Kallio Petri , Koivumäki Mikko , Vähä-Ypyä Henri , Sievänen Harri , Vasankari Tommi , Hirvonen Jussi , Laitinen Kirsi , Houttu Noora , Kalliokoski Kari , Saunavaara Virva , Knuuti Juhani , Heinonen Ilkka H.A.
Published: June 2024

Background

Obesity is associated with impaired glucose metabolism and hepatic insulin resistance. The aim was to investigate the associations of hepatic glucose uptake (HGU) and endogenous glucose production (EGP) to sedentary behavior (SB), physical activity (PA), cardiorespiratory fitness, dietary factors, and metabolic risk markers.

Methods

Forty-four adults with metabolic syndrome (mean age 58 [SD 7] years, BMI ranging from 25–40kg/; 25 females) were included. HGU was measured by positron emission tomography during the hyperinsulinemic-euglycemic clamp. EGP was calculated by subtracting the glucose infusion rate during clamp from the glucose rate of disappearance. SB and PA were measured with hip-worn accelerometers (26 [SD3] days). Fitness was assessed by maximal bicycle ergometry with respiratory gas measurements and dietary intake of nutrients by 4-day food diaries.

Results

HGU was not associated with fitness or any of the SB or PA measures. When adjusted for sex, age, and body fat-%, HGU was associated with whole-body insulin sensitivity (β=0.58), water-insoluble dietary fiber (β=0.29), energy percent (E%) of carbohydrates (β=-0.32), saccharose (β=-0.32), mono- and polyunsaturated fatty acids (β=0.35, β=0.41, respectively). EGP was associated with whole-body insulin sensitivity (β=-0.53), and low-density lipoprotein cholesterol [β=-0.31], and when further adjusted for accelerometry wear time, EGP was associated with standing [β=-0.43]. (p-value for all< 0.05).

Conclusions

Standing more, consuming a diet rich in fiber and unsaturated fatty acids, and a lower intake of carbohydrates, especially sugar, associate beneficially with hepatic insulin sensitivity. Habitual SB, PA, or fitness may not be the primary modulators of HGU and EGP. However, these associations need to be confirmed with intervention studies.
Emerging chemotherapy-based treatments in anaplastic thyroid cancer: an updated analysis of prospective studies
Authors: Wang Bi-Cheng , Lin Guo-He , Kuang Bo-Hua , Cao Ru-Bo
Published: June 2024

Background

For patients with anaplastic thyroid cancer (ATC) without mutational driver genes, chemotherapy is suggested to be the first-line treatment option. However, the benefits of chemotherapy in treating ATC are limited. In this analysis, we collected the prospective data reported since 2010 to analyze the emerging chemotherapy-based treatments in ATC comprehensively.

Methods

For this updated analysis, we searched PubMed (MEDLINE), Web of Science, Embase, and Cochrane CENTRAL databases from 1 January 2010 to 7 February 2024 for prospective clinical studies that contained chemotherapy-based treatments. This analysis was done to pool overall survival (OS), progression-free survival (PFS), objective response rates (ORRs), disease control rates (DCRs), and grade 3 or worse treatment-related adverse events (TRAEs).

Results

Six prospective clinical trials with 232 patients were included. Chemotherapy was commonly combined with targeted therapy or radiotherapy. The pooled median OS was 6.0 months (95% CI 4.1–9.7), and the median PFS was 3.2 months (95% CI 1.9–6.0) in patients with ATC who received chemotherapy-based strategies. The integrated ORR and DCR were 21% (95% CI 15%–27%) and 64% (95% CI 55%–72%), respectively. Regarding the grade 3 or worse TRAE, the pooled incidence was 68% (95% CI 47%–86%).

Conclusion

Although the emerging chemotherapy-based treatments showed antitumor activity in patients with ATC, these strategies failed to prolong the survival time substantially. More practical, safe, and novel therapeutic regimens for patients with ATC warrant further investigations.
Rainfall classification and forecasting based on a novel voting adaptive dynamic optimization algorithm
Authors: Elkenawy El-Sayed M. , Alhussan Amel Ali , Eid Marwa M. , Ibrahim Abdelhameed
Published: June 2024

Environmental issues of rainfall are basic in terms of understanding and management of ecosystems and natural resources. The rainfall patterns significantly affect soil moisture, vegetation growth and biodiversity in the ecosystems. In addition, proper classification of rainfall types helps in the evaluation of the risk of flood, drought, and other extreme weather events’ risk, which immensely affect the ecosystems and human societies. Rainfall classification can be improved by using machine learning and metaheuristic algorithms. In this work, an Adaptive Dynamic Puma Optimizer (AD-PO) algorithm combined with Guided Whale Optimization Algorithm (Guided WOA) introduces a potentially important improvement in rainfall classification approaches. These algorithms are to be combined to enable researchers to comprehend and classify rain events by their specific features, such as intensity, duration, and spatial distribution. A voting ensemble approach within the proposed (AD-PO-Guided WOA) algorithm increases its predictive performance because of the combination of predictions from several classifiers to localize the dominant rainfall class. The presented approach not only makes the classifying of rain faster and more accurate but also strengthens the robustness and trustworthiness of the classification in this regard. Comparison to other optimization algorithms validates the effectiveness of the AD-PO-Guided WOA algorithm in terms of performance metrics with an outstanding 95.99% accuracy. Furthermore, the second scenario is applied for forecasting based on the long short-term memory networks (LSTM) model optimized by the AD-PO-Guided WOA algorithm. The AD-PO-Guided WOA- LSTM algorithm produces rainfall prediction with an MSE of 0.005078. Wilcoxon rank test, descriptive statistics, and sensitivity analysis are applied to help evaluating and improving the quality and validity of the proposed algorithm. This intensive method facilitates rainfall classification and is a base for suggested measures that cut the hazards of extreme weather events on societies.
Economic impact of immunoglobulin replacement therapy in secondary immunodeficiency to hematological cancer: a single center observational study
Authors: Guerola Luciana del Campo , Sacristán Ana Andrea García , Portolés Antonio , Jasso Maricruz , Guerra-Galán Teresa , de la Fuente-Munoz Eduardo , Palacios-Ortega María , Fernández-Arquero Miguel , Cuesta-Mínguez Cristina , Rodríguez-Sanz Aránzazu , Peña-Cortijo Ascensión , Polo Marta , Morales Marta Mateo , Anguita-Mandly Eduardo , Benítez Jiménez Teresa , Benavente Cuesta Celina , Sánchez-Ramón Silvia
Published: June 2024

This is the first report of the health economic benefits derived from preventing infections through Immunoglobulin Replacement Therapy (IgRT) in patients with secondary immunodeficiency due to hematological malignancies. We conducted a retrospective population-based cohort study using patient medical history and pharmacy data from the Hospital Clínico San Carlos for 21 patients between 2011 and 2020. The pharmacoeconomic impact of using prophylactic IgRT was assessed by comparing characteristics of the SID patients 1 year before and after initiating IgRT measured by direct medical and tangible indirect costs. Results indicate a marked reduction in hospitalization days following IgRT initiation, decreasing from an average of 13.9 to 6.1 days per patient, with the elimination of ICU admissions. While emergency department visits decreased significantly, the number of routine consultations remained unchanged. Notably, absenteeism from work dropped substantially. The financial analysis revealed significant reductions in medication use and fewer ancillary tests, resulting in considerable cost savings. Specifically, total expenditure dropped from €405,088.18 pre-IgRT to €295,804.42 post-IgRT—including the cost of IgRT itself at €156,309.60. Overall, the annual savings amounted to €109,283.84, validating the cost-effectiveness of IgRT in managing SID in patients with hematological cancers.
Adaptation of functional traits in Gracilaria dura with the local environment: implications for resource management and exploitation
Authors: Vieira Vasco M. N. C. S. , Dawange Pankaj S. , Jaiswar Santlal , Sardinha José P. , Mantri Vaibhav A.
Published: June 2024

Seaweed functional traits provide insights on natural populations, their adaptations to the local environment, which can be utilized for commercial exploitation. Here, we analyzed the functional traits of Gracilaria dura from two intertidal populations in Veraval and Adri, from the coast of Gujarat, India, over a period of three months. Functional traits were measured by analyzing growth rates, respiration, primary production, antioxidant activity and the content of plant growth hormones. The weight-to-length allometric exponent ≈3 indicated that G. dura grew almost isometrically. Furthermore, frond shape was not significantly different. Fronds in Veraval, resting submerged, grew faster than the fronds in Adri, which, lay exposed in the flat bare rock during low tide. Accordingly, the simultaneous increase in antioxidant activity, O2 production and chlorophyll content in fronds from Adri suggests that stress from desiccation and UV led to the detrimental accumulation of Reactive Oxygen Species, leading to decreased growth and decreased production of growth hormones. The increased Chl-a may indicate enhanced non-photochemical quenching (NPQ) for the dissipation of excess absorbed light. These results aid in establishing the best practices for maximizing biomass yield or the yield of specific molecules. For maximized biomass yield, fronds should not be subject to emersion nor cultivated on the sea-surface. On the other hand, fronds grown subject to emersion or at the sea-surface yield less biomass but more content on molecules such as antioxidants (flavonoids, phenolics, enzymes), that fight stress from desiccation high temperatures and UV. In this case, stress should still be avoided during the initial growth, at the onset of the growth season, in order to not disrupt the production of growth hormones. The increased O2 production at Adri was initially mistakenly perceived as enhanced Net Primary Production. Only a posterior holistic perspective over the whole data allowed to conclude that it was likely the stress-induced detrimental accumulation of Reactive Oxygen Species. More robust experiments are required to establish if the differences observed between locations have led to the evolution of genetic strains specific to each habitat that may show different performances and yields when cultivated in similar environments.
A meta-analysis of the effects of transnasal high-flow oxygen therapy in gastrointestinal endoscopy
Authors: Wei Chen , Ma Shaoyong , Jiang Lili , Wang Jingwen , Yuan Liping , Wang Yingying
Published: June 2024

Purpose

This study aimed to systematically evaluate the clinical effects of using transnasal high-flow nasal cannula (HFNC) and conventional oxygen therapy (COT) in patients undergoing gastrointestinal endoscopy.

Methods

A comprehensive literature search was conducted from 2004 to April 2024 to collect relevant studies on the application of HFNC in patients undergoing gastrointestinal endoscopy. Multiple Chinese and English databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data, Web of Science, PubMed, and Cochrane Library, were searched systematically for randomized controlled trials (RCTs). Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. RevMan 5.4 software was utilized for conducting the network meta-analysis.

Results

A total of 12 RCTs involving 3,726 patients were included. Meta-analysis results showed that HFNC reduced the incidence of hypoxemia and improved the minimum oxygen saturation (SpO2) compared with COT [odds ratio (OR) = 0.39, 95% confidence interval (CI): 0.29–0.53], [mean difference (MD) = 4.07, 95% CI: 3.14–5.01], and the difference was statistically significant. However, the baseline SpO2 levels and incidence of hypercapnia were not statistically significantly different between the HFNC and COT groups [MD = −0.21, 95% CI: −0.49–0.07]; [OR = 1.43, 95% CI: 0.95–2.15]. In terms of procedure time, the difference between HFNC and COT was not statistically significant, and subgroup analyses were performed for the different types of studies, with standard deviation in the gastroscopy group (MD = 0.09, 95% CI: −0.07–0.24) and the endoscopic retrograde cholangiopancreatography group (MD = 0.36, 95% CI: −0.50–1.23). The results demonstrated a significant reduction in the adoption of airway interventions in the HFNC group compared to the COT group (OR = 0.16, 95% CI: 0.05–0.53), with a statistically significant difference; this result was consistent with those of the included studies.

Conclusion

The application of HFNC improves the incidence of hypoxemia, enhances oxygenation, and reduces airway interventions during gastrointestinal endoscopy. However, HFNC does not significantly affect baseline SpO2, hypercapnia, or procedure time. The limitations of this study must be acknowledged, and further high-quality studies should be conducted to validate these findings.
Impact of three exogenous phosphorus-solubilizing bacteria on zinc and selenium contents and rhizosphere soil nutrients of Longjing and Huangjinya tea plants
Authors: Guo JinMei , Zhang ShuQing , Li JianFeng
Published: June 2024

Phosphate-solubilizing bacteria (PSB) enhance plant phosphorus utilization through their ability to dissolve phosphorus. To address the low utilization of nitrogen, phosphorus, potassium, zinc, and selenium by tea plants in acidic, selenium-rich soils, the study aimed to investigate the impact of exogenous PSB on soil nutrients and the absorption of zinc and selenium by tea plants. Following the inoculation of potted Longjing and Huangjinya varieties with exogenous phosphorus-solubilizing bacteria, we determined the concentrations of AN, AP, AK, Zn, and Se in their rhizosphere soil, in addition to the Zn and Se contents in their aboveground and belowground parts. The results show that after respective treatment with the three PSB, the concentration of available P in the tea plant rhizosphere soil significantly increased, with PMS08 having the most pronounced effect.After the same treatment, In the rhizosphere soil of Longjing tea plants, the AN content increased by 26.47%, 18.41%, and 7.51%, respectively, relative to the control, while the AK content decreased in the rhizosphere soil of Huangjinya tea plants. Inoculation with the three PSB resulted in a greater content of available Se in both the aboveground and belowground parts of the two tea plants. After inoculation with PMS20, the available Zn content of the belowground parts of Longjing and Huangjinya tea plants respectively decreased by 13.42% and 15.69% in comparison with the control. Additionally, after inoculating Longjing tea plants with PSt09 and Huangjinya tea plants with PMS08, the content of available Zn in their belowground parts significantly decreased by 9.22% and 35.74%, respectively. Evidently, the inoculation with the three phosphorus-solubilizing bacteria is beneficial for the uptake of available P by tea plants, promoting the utilization and accumulation of available Se. However, the content of AN or AK in rhizosphere soil varies between different tea plant varieties inoculated with the same kind of phosphorus-solubilizing bacteria. Moreover, the content of available Zn in tea plants also differs, highlighting the need to further investigate the differential effects of phosphorus-solubilizing bacteria on different plant varieties.
Treatment effects in epilepsy: a mathematical framework for understanding response over time
Authors: Harrington Elanor G. , Kissack Peter , Terry John R. , Woldman Wessel , Junges Leandro
Published: June 2024

Epilepsy is a neurological disorder characterized by recurrent seizures, affecting over 65 million people worldwide. Treatment typically commences with the use of anti-seizure medications, including both mono- and poly-therapy. Should these fail, more invasive therapies such as surgery, electrical stimulation and focal drug delivery are often considered in an attempt to render the person seizure free. Although a significant portion ultimately benefit from these treatment options, treatment responses often fluctuate over time. The physiological mechanisms underlying these temporal variations are poorly understood, making prognosis a significant challenge when treating epilepsy. Here we use a dynamic network model of seizure transition to understand how seizure propensity may vary over time as a consequence of changes in excitability. Through computer simulations, we explore the relationship between the impact of treatment on dynamic network properties and their vulnerability over time that permit a return to states of high seizure propensity. For small networks we show vulnerability can be fully characterised by the size of the first transitive component (FTC). For larger networks, we find measures of network efficiency, incoherence and heterogeneity (degree variance) correlate with robustness of networks to increasing excitability. These results provide a set of potential prognostic markers for therapeutic interventions in epilepsy. Such markers could be used to support the development of personalized treatment strategies, ultimately contributing to understanding of long-term seizure freedom.
Efficacy and cerebral mechanisms of acupuncture for chronic obstructive pulmonary disease: study protocol for a multicenter, randomized controlled neuroimaging trial
Authors: Chen Xugui , Xiong Chan , Xiao Wei , Du Longyi , Liu Meilu , Yu Yan , Liao Chunyu , Zhang Chengshun , Li Yu , Mao Bing , Fu Juanjuan
Published: June 2024

Introduction

Although acupuncture is recommended by chronic obstructive pulmonary disease (COPD) treatment guidelines owing to its effects on dyspnea, the underlying neurobiological mechanisms of these effects remain unclear. This study aims to evaluate the efficacy of acupuncture in patients with stable COPD and explore the possible involvement of specific brain regions.

Methods

This is a prospective, multicenter, single-blind, randomized controlled trial. A total of 90 participants will be recruited from three centers and will be randomly assigned in a 1:1 ratio to undergo acupuncture at acupoints on the disease-affected meridian (DAM) or non-acupoints on the non-affected meridian (NAM), in addition to routine pharmacological treatments. All participants will undergo 30 min of acupuncture three times a week for 8 weeks and will be followed up for 12 months. The primary outcome will be the severity of dyspnea, as measured using the Borg Dyspnea Scale and a visual analog scale at rest and after exercise. The secondary outcomes will include the multidimensional profile of dyspnea using Dyspnea-12, the modified Medical Research Council Dyspnea Scale, and the COPD assessment test; quality of life assessments using St George's Respiratory Questionnaire and the Hospital Anxiety and Depression Scale; and additional measurements of exacerbation frequency, pulmonary function, and the 6-min walking distance. Magnetic resonance imaging (MRI) will be performed before and after exercise to explore the potential neurobiological mechanisms of exertional dyspnea. Anxiety and depression will be measured and analyzed for their correlation with the activation of specific brain areas involved in dyspnea.

Discussion

This randomized controlled trial aims to use a multidimensional evaluation of the efficacy of acupuncture in relieving dyspnea in patients with COPD in terms of emotion and quality of life and explore the neurobiological mechanisms underlying the effects of acupuncture on dyspnea from an imaging perspective. It is expected to provide strong evidence to support the use of acupuncture in relieving dyspnea in patients with COPD and those with aother diseases involving dyspnea. Additionally, it provides novel insights into the central mechanisms of acupuncture intervention and dyspnea.

Trial registration

Chinese Clinical Trial Registry (https://www.chictr.org.cn/): ChiCTR2300071725.
Image synthesis of interictal SPECT from MRI and PET using machine learning
Authors: Fard Azin Shokraei , Reutens David C. , Ramsay Stuart C. , Goodman Steven J. , Ghosh Soumen , Vegh Viktor
Published: June 2024

Background

Cross-modality image estimation can be performed using generative adversarial networks (GANs). To date, SPECT image estimation from another medical imaging modality using this technique has not been considered. We evaluate the estimation of SPECT from MRI and PET, and additionally assess the necessity for cross-modality image registration for GAN training.

Methods

We estimated interictal SPECT from PET and MRI as a single-channel input, and as a multi-channel input to the GAN. We collected data from 48 individuals with epilepsy and converted them to 3D isotropic images for consistence across the modalities. Training and testing data were prepared in native and template spaces. The Pix2pix framework within the GAN network was adopted. We evaluated the addition of the structural similarity index metric to the loss function in the GAN implementation. Root-mean-square error, structural similarity index, and peak signal-to-noise ratio were used to assess how well SPECT images were able to be synthesised.

Results

High quality SPECT images could be synthesised in each case. On average, the use of native space images resulted in a 5.4% percentage improvement in SSIM than the use of images registered to template space. The addition of structural similarity index metric to the GAN loss function did not result in improved synthetic SPECT images. Using PET in either the single channel or dual channel implementation led to the best results, however MRI could produce SPECT images close in quality.

Conclusion

Synthesis of SPECT from MRI or PET can potentially reduce the number of scans needed for epilepsy patient evaluation and reduce patient exposure to radiation.
Assessment tools for cognitive performance in Parkinson’s disease and its genetic contributors
Authors: Cao Ling-Xiao , Kong Wee Lee , Chan Piu , Zhang Wei , Morris Margaret J. , Huang Yue
Published: June 2024

Background

We have shown that genetic factors associating with motor progression of Parkinson’s disease (PD), but their roles in cognitive function is poorly understood. One reason is that while cognitive performance in PD can be evaluated by various cognitive scales, there is no definitive guide indicating which tool performs better.

Methods

Data were obtained from the Parkinson’s Progression Markers Initiative, where cognitive performance was assessed using five cognitive screening tools, including Symbol Digit Modalities Test (SDMT), Montreal Cognitive Assessment, Benton Judgment of Line Orientation, Modified Semantic Fluency Test, and Letter Number Sequencing Test, at baseline and subsequent annual follow-up visit for 5 years. Genetic data including ApoE and other PD risk genetic information were also obtained. We used SPSS-receiver operating characteristic and ANOVA repeated measures to evaluate which cognitive assessment is the best reflecting cognitive performance in PD at early stage and over time. Logistic regression analyses were used to determine the genetic associations with the rapidity of cognitive decline in PD.

Results

SDMT performed better in detecting mild cognitive impairment at baseline (AUC = 0.763), and SDMT was the only tool showing a steady cognitive decline during longitudinal observation. Multigenetic factors significantly associated with cognitive impairment at early stage of the disease (AUC = 0.950) with IP6K2 rs12497850 more evident, and a significantly faster decline (AUC = 0.831) within 5 years after motor onset, particularly in those carrying FGF20 rs591323.

Conclusion

SDMT is a preferable cognitive assessment tool for PD and genetic factors synergistically contribute to the cognitive dysfunction in PD.
A comparative study on anti-MOG and anti-AQP4 associated optic neuritis following mild COVID-19: insights from a Chinese single-center experience
Authors: Sun Liang , Wang Jiawei , Yang Qinglin , Guo Yanjun
Published: June 2024

Background

Research on the relationship between mild COVID-19 and the subsequent development of isolated optic neuritis (ON) with antibodies specific to myelin oligodendrocyte glycoprotein (MOG-ON) and aquaporin 4 (AQP4-ON) is limited, particularly case–control studies that directly compare these conditions within the same affected population.

Methods

A retrospective analysis of initial MOG-ON and AQP4-ON cases during the COVID-19 peak and subsequent months. Patients were classified as possible COVID-19 related ON (PCRON) or non-COVID-19 related ON (NCRON). The study compared epidemiology, comorbidities, and clinical features between these groups.

Results

Patients with MOG-ON tended to develop ON symptoms closer in time to a mild COVID-19 infection compared to those with AQP4-ON (6.87 ± 6.25 weeks vs. 11.06 ± 5.84 weeks; p = 0.038), a significantly higher proportion of patients with MON-ON developing symptoms within 6 weeks after COVID-19 compared to those with AQP4-ON (15/23 [65.2%] vs. 5/17 [29.4%]; p = 0.025). Comparing MOG-ON and AQP4-ON patients, MOG-ON patients were more likely to have a recent infection before ON onset (73.1% vs. 30%; p = 0.007) and had better peak and post-treatment visual acuity (p = 0.01; p < 0.001). In contrast, AQP4-ON patients frequently showed comorbid connective tissue diseases (30.0% vs. 0%, p = 0.004) and antinuclear antibody abnormalities (40.0% vs. 7.7%, p = 0.012). Among MOG-ON patients, PCRON had increased rates of atherosclerotic vascular diseases (AVDs) (53.3% vs. 9.1%, p = 0.036), phospholipid antibody abnormalities (60.0% vs. 18.2%, p = 0.04), and bilateral visual impairment (66.7% vs. 9.1%, p = 0.005). Multivariate analysis pinpointed AVDs (OR = 15.21, p = 0.043) and bilateral involvement (OR = 25.15, p = 0.015) as independent factors related to COVID-19 associated MOG-ON, with both being good discriminators for PCRON (AUC = 0.879). No differences were found between the PCRON and NCRON groups in AQP4-ON patients.

Conclusion

Mild COVID-19 is more likely associated with MOG-ON than AQP4-ON. MOG-ON that develops within 6 weeks following a COVID-19 infection may be associated with the COVID-19 infection. AVDs may have a synergistic effect on MOG-ON in patients with COVID-19, which warrants further investigation. COVID-19 related MOG-ON often affects both eyes, and acute visual function damage can be severe, but generally has a good prognosis.
Treadmill running on neuropathic pain: via modulation of neuroinflammation
Authors: He Wei-Chun , Hou Shuang-Long , Wang Kai-Bin , Xu Ning , Li Ke , Xiong Ting , Luo Jing
Published: June 2024

Neuropathic pain is a type of chronic pain caused by an injury or somatosensory nervous system disease. Drugs and exercise could effectively relieve neuropathic pain, but no treatment can completely stop neuropathic pain. The integration of exercise into neuropathic pain management has attracted considerable interest in recent years, and treadmill training is the most used among exercise therapies. Neuropathic pain can be effectively treated if its mechanism is clarified. In recent years, the association between neuroinflammation and neuropathic pain has been explored. Neuroinflammation can trigger proinflammatory cytokines, activate microglia, inhibit descending pain modulatory systems, and promote the overexpression of brain-derived neurotrophic factor, which lead to the generation of neuropathic pain and hypersensitivity. Treadmill exercise can alleviate neuropathic pain mainly by regulating neuroinflammation, including inhibiting the activity of pro-inflammatory factors and over activation of microglia in the dorsal horn, regulating the expression of mu opioid receptor expression in the rostral ventromedial medulla and levels of γ-aminobutyric acid to activate the descending pain modulatory system and the overexpression of brain-derived neurotrophic factor. This article reviews and summarizes research on the effect of treadmill exercise on neuropathic pain and its role in the regulation of neuroinflammation to explore its benefits for neuropathic pain treatment.