bluuebunny/crossref_metadata_2025 huggingface dataset:
What happened to the patients? Care trajectories for persons with a delayed hospital discharge during wave 1 of COVID-19 in Ontario, Canada; a population-based retrospective cohort study
Authors: Guilcher Sara J. T. , Bai Yu Qing , Wodchis Walter P. , Bronskill Susan E. , Rashidian Laleh , Kuluski Kerry
Published: September 2024

During the initial wave of coronavirus disease of 2019 (COVID-19), patients were rapidly discharged from acute hospitals in anticipation of an expected influx of patients with COVID-19. Patients that were no longer receiving acute medical care but were waiting for their next destination (i.e., delayed hospital discharge) were particularly affected. The objectives of this study were to examine the impact of COVID-19 onset on healthcare utilization and mortality among those who experienced delayed discharge from acute care. We conducted a population-based retrospective cohort study using linked administrative data. We included persons discharged from acute care who experienced a delayed hospital stay between April 1, 2019 and September 30, 2020. The onset of COVID-19 was the exposure (March 1, 2020), while the period of April 1, 2019 to February 29, 2020 was considered as a comparator. Primary outcomes included healthcare utilization and mortality following discharge, stratified by care setting (homecare, inpatient rehabilitation or long-term care). Multivariable logistic, zero-inflated Poisson regressions, and Cox proportional hazard models were used to examine the impact of COVID-19 on outcomes while adjusting for covariates. Those discharged home were more likely to receive homecare and physician visits within 30 days during COVID-19. The type of visits examined included both in-person as well as virtual visits. Individuals discharged to inpatient rehabilitation experienced lower rates of general physician visits but higher rates of specialist and homecare visits. Patients discharged to long-term care were significantly less likely to receive a physician visit following COVID-19, and significantly more likely to be readmitted within 7-days. There were no significant differences in mortality irrespective of discharge destination during the two time periods. Overall, the onset of the initial wave of COVID-19 significantly impacted healthcare utilization among those with a delayed discharge but varied depending on destination, with those in long-term care being most impacted.
Development of explicit definitions of potentially inappropriate prescriptions for antidiabetic drugs in patients with type 2 diabetes: A multidisciplinary qualitative study
Authors: Gerard Erwin , Quindroit Paul , Calafiore Matthieu , Baran Jan , Gautier Sophie , Genay Stéphanie , Decaudin Bertrand , Lemaitre Madleen , Vambergue Anne , Beuscart Jean-Baptiste
Published: September 2024

Purpose

The management of type 2 diabetes mellitus patients has changed over the past decade, and a large number of antidiabetic drug treatment options are now available. This complexity poses challenges for healthcare professionals and may result in potentially inappropriate prescriptions of antidiabetic drugs in patients with type 2 diabetes mellitus which can be limited using screening tools. The effectiveness of explicit tools such as lists of potentially inappropriate prescriptions has been widely demonstrated. The aim was to set up nominal groups of healthcare professionals from several disciplines and develop a list of explicit definition of potentially inappropriate prescriptions of antidiabetic drugs.

Methods

In a qualitative, nominal-groups approach, 30 diabetologists, general practitioners, and pharmacists in France developed explicit definitions of potentially inappropriate prescriptions of antidiabetic drugs in patients with type 2 diabetes mellitus. A nominal group technique is a structured method that encourages all the participants to contribute and makes it easier to reach an agreement quickly. Each meeting lasted for two hours.

Results

The three nominal groups comprised 14 pharmacists, 10 diabetologists, and 6 general practitioners and generated 89 explicit definitions. These definitions were subsequently merged and validated by the steering committee and nominal group participants, resulting in 38 validated explicit definitions of potentially inappropriate prescriptions of antidiabetic drugs. The definitions encompassed four contexts: (i) the temporary discontinuation of a medication during acute illness (n = 9; 24%), (ii) dose level adjustments (n = 23; 60%), (iii) inappropriate treatment initiation (n = 3; 8%), and (iv) the need for further monitoring in the management of type 2 diabetes mellitus (n = 3; 8%).

Conclusion

The results of our qualitative study show that it is possible to develop a specific list of explicit definitions of potentially inappropriate prescriptions of antidiabetic drugs in patients with type 2 diabetes mellitus by gathering the opinions of healthcare professionals caring for these patients. This list of 38 explicit definitions necessitates additional confirmation by expert consensus before use in clinical practice.
Influence of the internet celebrity’ attributes of the host on the loyalty of users on live platforms
Authors: Cui Tingyu , Dai Panqian , Xu Jing , Lu Yixuan , Wang Wenxuan
Published: September 2024

Since 2019, live e-commerce has experienced significant growth, effectively driving consumption, with various e-commerce platforms, video platforms, enterprises, and businesses venturing into the live e-commerce sector. However, this development has brought forth several issues, one of which prominently pertains to the lack of customer loyalty. Hosts play a crucial role in live e-commerce. To investigate the impact of internet celebrity attributes on platform user loyalty, this study employed a survey questionnaire distributed on internet websites, collecting 200 valid samples. A research model based on the ABC attitude model was constructed, with customer satisfaction and customer trust as mediating variables. The findings indicate that the internet celebrity attributes of network popularity and interactivity positively influence customer loyalty through the mediation of customer satisfaction and customer trust. On the other hand, the host’s purpose as an internet celebrity attribute does not directly or indirectly affect customer loyalty. The primary reason for this discrepancy is that the host failed to establish trust and employ suitable methods to attain the goal of selling and promoting products. Consequently, platforms and businesses can enhance the network popularity of hosts through communication media, while fostering their literacy and professional skills. Moreover, strengthening communication and interaction between hosts and customers serves as a foundation for nurturing enduring and positive relationships.
Efficient lung cancer detection using computational intelligence and ensemble learning
Authors: Jain Richa , Singh Parminder , Abdelkader Mohamed , Boulila Wadii
Published: September 2024

Lung cancer emerges as a major factor in cancer-related fatalities in the current generation, and it is predicted to continue having a long-term impact. Detecting symptoms early becomes crucial for effective treatment, underscoring innovative therapy’s necessity. Many researchers have conducted extensive work in this area, yet challenges such as high false-positive rates and achieving high accuracy in detection continue to complicate accurate diagnosis. In this research, we aim to develop an ecologically considerate lung cancer therapy prototype model that maximizes resource utilization by leveraging recent advancements in computational intelligence. We also propose an Internet of Medical Things (IoMT)-based, consumer-focused integrated framework to implement the suggested approach, providing patients with appropriate care. Our proposed method employs Logistic Regression, MLP Classifier, Gaussian NB Classifier, and Intelligent Feature Selection using K-Means and Fuzzy Logic to enhance detection procedures in lung cancer dataset. Additionally, ensemble learning is incorporated through a voting classifier. The proposed model’s effectiveness is improved through hyperparameter tuning via grid search. The proposed model’s performance is demonstrated through comparative analysis with existing NB, J48, and SVM approaches, achieving a 98.50% accuracy rate. The efficiency gains from this approach have the potential to save a significant amount of time and cost. This study underscores the potential of computational intelligence and IoMT in developing effective, resource-efficient lung cancer therapies.
FEB-YOLOv8: A multi-scale lightweight detection model for underwater object detection
Authors: Zhao Yuyin , Sun Fengjie , Wu Xuewen
Published: September 2024

Underwater object detection plays a crucial role in safeguarding and exploiting marine resources effectively. Addressing the prevalent issues of limited storage capacity and inadequate computational power in underwater robots, this study proposes FEB-YOLOv8, a novel lightweight detection model. FEB-YOLOv8, rooted in the YOLOv8 framework, enhances the backbone network by refining the C2f module and introducing the innovative P-C2f module as a replacement. To compensate for any potential reduction in detection accuracy resulting from these modifications, the EMA module is incorporated. This module augments the network’s focus on multi-scale information, thus boosting its feature extraction capabilities. Furthermore, inspired by Bi-FPN concepts, a new feature pyramid network structure is devised, achieving an optimal balance between model lightness and detection precision. The experimental results on the underwater datasets DUO and URPC2020 reveal that our FEB-YOLOv8 model enhances the mAP by 1.2% and 1.3% compared to the baseline model, respectively. Moreover, the model’s GFLOPs and parameters are lowered to 6.2G and 1.64M, respectively, marking a 24.39% and 45.51% decrease from the baseline model. These experiments validate that FEB-YOLOv8, by harmonizing lightness with accuracy, presents an advantageous solution for underwater object detection tasks.
Distal Junctional Failure After Fusion Stopping at L5 in Patients With Adult Spinal Deformity: Incidence, Risk Factors, and Radiographic Criteria
Authors: Do Sung Ho , Bae Sungsoo , Jo Dae Jean , Choi Ho Yong
Published: September 2024

Objective: To identify risk factors and establish radiographic criteria for distal junctional failure (DJF) in patients with adult spinal deformity (ASD), who underwent fusion surgery stopping at L5.Methods: This retrospective study was undertaken from January 2016 to December 2020. Patients with ASD who underwent fusion surgery (≥5 levels) stopping at L5 were analyzed. DJF was defined as symptomatic adjacent segment pathology at the lumbosacral junction necessitating consideration for revision surgery. Demographic data and radiographic measurements were compared between the DJF and non-DJF groups. Receiver operating characteristic curve analysis was performed to identify the radiographic cutoff value for DJF.Results: Among 76 patients, 16 (21.1%) experienced DJF. DJF was associated with older age, antidepressant/anxiolytic medication, longer level of fusions, and worse preoperative sagittal alignment. Antidepressant/anxiolytic medication (odds ratio, 5.60) and preoperative pelvic incidence (PI)–lumbar lordosis (LL) mismatch>40° (odds ratio, 5.87) were independent risk factors for DJF. Without both factors, the incidence of DJF has been greatly reduced (9.1%). Two radiographic criteria were determined for DJF: last distal junctional angle (DJA)>-5° and Δ last DJA–post DJA>5°. When both criteria were met, the sensitivity and specificity of the DJF were 93.3% and 91.7%, respectively.Conclusion: Use of antidepressant/anxiolytic medication and preoperative PI–LL mismatch >40° were independent risk factors for DJF. DJF could be diagnosed using postoperative changes in the DJA. If both criteria were met, DJF could be strongly suggested.
A Self-Developed Mobility Augmented Reality System Versus Conventional X-rays for Spine Positioning in Intraspinal Tumor Surgery: A Case-Control Study
Authors: Hong Wenyao , Huang Xiaohua , Li Tian , Luo Juntao , Liu Yuqing , Huang Shengyue , Chen Zhongyi , He Bingwei , Wen Yuxing , Lin Yuanxiang
Published: September 2024

Objective: To evaluate the efficacy of a self-developed mobile augmented reality navigation system (MARNS) in guiding spinal level positioning during intraspinal tumor surgery based on a dual-error theory.Methods: This retrospective study enrolled patients diagnosed with intraspinal tumors admitted to Fujian Provincial Hospital between May and November 2023. The participants were divided into conventional x-rays and self-developed MARNS groups according to the localization methods they received. Position time, length of intraoperative incision variation, and location accuracy were systematically compared.Results: A total of 41 patients (19 males) with intraspinal tumors were included, and MARNS was applied to 21 patients. MARNS achieved successful lesion localization in all patients with an error of 0.38±0.12 cm. Compared to x-rays, MARNS significantly reduced positioning time (129.00±13.03 seconds vs. 365.00±60.43 seconds, p<0.001) and length of intraoperative incision variation (0.14 cm vs. 0.67 cm, p=0.009).Conclusion: The self-developed MARNS, based on augmented reality technology for lesion visualization and perpendicular projection, offers a radiation-free complement to conventional x-rays.
The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Authors: Park Hangeul , Choi Yunhee , Lee Sungjoon , Lee Sun-Ho , Kim Eun-Sang , Jang Sun Woo , Park Jin Hoon , Cho Yunseong , Jang Giwuk , Ha Yoon , Dho Yun-Sik , Yoo Heon , Lee Sung Uk , Seo Seung-Ho , Kim Ki-Jeong , Sohn Seil , Chung Chun Kee
Published: September 2024

Objective: Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.Methods: This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.Results: Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.Conclusion: This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
Postoperative Coronal Imbalance in Lenke 5C Adolescent Idiopathic Scoliosis: Evolution, Risk Factors, and Clinical Implications
Authors: Fang Yinyu , Li Jie , Hu Zongshan , Zhu Zezhang , Qiu Yong , Liu Zhen
Published: September 2024

Objective: To explore the changes in coronal imbalance (CIB) in Lenke 5C adolescent idiopathic scoliosis (AIS) after posterior selective fusion surgery and determine their implications for surgical decision-making.Methods: One hundred twenty patients were categorized according to the preoperative coronal pattern (type A, coronal balance distance [CBD]<20 mm; type B, CBD≥20 mm and coronal C7 plumbline [C7PL] shifted to the concave side of the curve; type C, CBD≥20 mm and C7PL shifted to the convex side of the curve). CIB group (CIB+) was defined as having a CBD≥20 mm at the 2-year follow-up.Results: Compared to type A patients, the prevalence of postoperative CIB was higher in type C patients both immediately postoperative (22% vs. 38%, p<0.05) and at the final follow-up (5% vs. 29%, p<0.05), whereas type A patients showed a greater improvement in CBD (9 of 12 vs. 6 of 24, p<0.05) at the final follow-up. The majority of patients in all groups had recovered to type A at the final follow-up (96 of 120). The proximal Cobb-1 strategy reduced the incidence of postoperative CIB (1 of 38) at the 2-year follow-up, especially in preoperative type C patients. Multivariate logistic regression analysis revealed that type C and overcorrection of the thoracolumbar curve were risk factors for CIB at the 2-year follow-up (p=0.007 and p=0.026, respectively).Conclusion: Patients with type C CIB in AIS exhibited unsatisfactory restoration, with 29% of them exhibiting CIB at the final follow-up. The selective fusion strategy of proximal Cobb-1 may reduce the risk of postoperative CIB especially when the preoperative coronal pattern is type C.
Artificial Intelligence Detection of Cervical Spine Fractures Using Convolutional Neural Network Models
Authors: Liawrungrueang Wongthawat , Han Inbo , Cholamjiak Watcharaporn , Sarasombath Peem , Riew K. Daniel
Published: September 2024

Objective: To develop and evaluate a technique using convolutional neural networks (CNNs) for the computer-assisted diagnosis of cervical spine fractures from radiographic x-ray images. By leveraging deep learning techniques, the study might potentially lead to improved patient outcomes and clinical decision-making.Methods: This study obtained 500 lateral radiographic cervical spine x-ray images from standard open-source dataset repositories to develop a classification model using CNNs. All the images contained diagnostic information, including normal cervical radiographic images (n=250) and fracture images of the cervical spine fracture (n=250). The model would classify whether the patient had a cervical spine fracture or not. Seventy percent of the images were training data sets used for model training, and 30% were for testing. Konstanz Information Miner (KNIME)’s graphic user interface-based programming enabled class label annotation, data preprocessing, CNNs model training, and performance evaluation.Results: The performance evaluation of a model for detecting cervical spine fractures presents compelling results across various metrics. This model exhibits high sensitivity (recall) values of 0.886 for fractures and 0.957 for normal cases, indicating its proficiency in identifying true positives. Precision values of 0.954 for fractures and 0.893 for normal cases highlight the model’s ability to minimize false positives. With specificity values of 0.957 for fractures and 0.886 for normal cases, the model effectively identifies true negatives. The overall accuracy of 92.14% highlights its reliability in correctly classifying cases by the area under the receiver operating characteristic curve.Conclusion: We successfully used deep learning models for computer-assisted diagnosis of cervical spine fractures from radiographic x-ray images. This approach can assist the radiologist in screening, detecting, and diagnosing cervical spine fractures.
Efficacy of Ustekinumab Intravenously q12 Weeks for Maintenance Therapy for Crohn's Disease
Authors: Masood Hamza , Waghela Rajdeepsingh , Amini Shayan , Fan Christopher , Abraham Bincy P.
Published: September 2024

Ustekinumab is a monoclonal antibody administered as a weight-based intravenous (IV) induction, followed by 90 mg subcutaneous injections every 8 weeks for the treatment of Crohn's disease. We report 6 patients who were administered IV ustekinumab every 12 weeks for maintenance therapy due to financial constraints in place of the standard dosing regimen. All patients tolerated IV ustekinumab, and no adverse events occurred to this point. Two patients achieved clinical and endoscopic remission, and 4 patients achieved clinical remission and are awaiting future endoscopic assessment.
Hyaluronic Acid in Managing Deep Residual Pockets in Stage III-IV Periodontitis: A Randomized Controlled Trial
Authors:   Periodontal Specialist Clinic of Jalan Perak, Ministry of Health Malaysia, 11600, Penang, Malaysia., madibjaafar@gmail.com, Adib Jaafar Mohamad , Voo Vui Ching Esther ,   Periodontal Specialist Clinic of Mak Mandin, Ministry of Health Malaysia, 13400, Penang, Malaysia., Nisha Ali Sharul ,   Periodontal Specialist Clinic of Mak Mandin, Ministry of Health Malaysia, 13400, Penang, Malaysia., Subramaniam Jeyanthi ,   Sungai Dua Dental Clinic, Ministry of Health Malaysia, 13800, Butterworth, Penang, Malaysia, Ahmad Yaziz Yuhaniz ,   Periodontal Specialist Unit, Kota Setar Dental Specialist Clinic, Lebuhraya Darul Aman, Ministry of Health Malaysia, 05100, Kedah, Malaysia.
Published: September 2024

Objective: The purpose of this study was to determine the adjunctive clinical effect of hyaluronic acid (HA) in the non-surgical treatment of subjects with residual pockets (≥ 6 mm) at the maintenance phase. Methods: 36 systemically healthy subjects in the periodontal maintenance phase were included in this 3-month randomized clinical trial. Subjects received a course of full-mouth, scaling and root debridement (SRD). In the test group (n = 18), HA 0.8% was applied subgingivally immediately after SRD. The control group (n = 18) was treated with SRD only. Subjects in both groups were required to apply HA 0.2% twice a day for 2 weeks. Clinical parameters collected at baseline and 3 months post-treatment were periodontal pocket depth (PPD), bleeding on probing (BOP), and clinical attachment level (CAL). Results: In both groups, all parameters were significantly reduced (p < 0.05) after treatment. Subjects treated with HA 0.8% showed a greater gain in mean CAL and higher percentage of ‘healthy pocket’ (PPD ≤ 3 mm) than the control group. However, no statistical difference was observed. Conclusion: The overall results show that treatment with HA 0.8% has a potential improvement in periodontal health.
Analysis of plasma‐derived small extracellular vesicle characteristics and microRNA cargo following exercise‐induced skeletal muscle damage in men
Authors: Lovett Jason , McColl Rhys S. , Durcan Peter , Vechetti Ivan , Myburgh Kathryn H.
Published: September 2024

Extracellular vesicle (EV) cargo is known to change in response to stimuli such as muscle damage. This study aimed to assess particle size, concentration and microRNA (miR) content within small EV‐enriched separations prepared from human blood taken before and after unaccustomed eccentric‐biased exercise‐induced muscle damage. Nine male volunteers underwent plyometric jumping and downhill running, with blood samples taken at baseline, 2, and 24 h post‐exercise. EVs were separated using size exclusion chromatography (SEC) and their characteristics evaluated by nanoparticle tracking. No changes in EV size or concentration were seen following the muscle‐damaging exercise. Small RNA sequencing identified 240 miRs to be consistently present within the EVs. RT‐qPCR analysis was performed: specifically, for known muscle‐enriched/important miRs, including miR‐1, −206, −133a, −133b, −31, −208b, −451a, −486 and − 499 and the immune‐important miR‐21, −146a and − 155. Notably, none of the immune‐important miRs within the EVs tested changed in response to the muscle damage. Of the muscle‐associated miRs tested, only the levels of miR‐31‐5p were seen to change with decreased levels at 24 h compared to baseline and 2 h, indicating involvement in the damage response. These findings shed light on the dynamic role of EV miRs in response to exercise‐induced muscle damage.
Green Basic Income: Evaluating the Bolsa Verde Project in the Brazilian Amazon
Authors: MacNeill Timothy , Drummond Clarisse
Published: September 2024

We analyze the Bolsa Verde Program, arguing that it likely was the world’s first largescale institution of a Green Basic Income Program. As such, the initiative presents a unique opportunity to evaluate the potential environmental uses and implications of Basic Income initiatives. Our study relies on a socially-embedded analysis of the program as it functioned in the context of the Brazilian Amazon. This involves analysis of qualitative data from former program beneficiaries, community leaders, program evaluators, and managers. This research suggests that the program operated socially as a de facto Green Basic Income program, despite being designed as a hybrid Payment for Environmental Services initiative. Our analysis suggests that Bolsa Verde was successful in reducing both deforestation and poverty, and these successes were achieved without undermining collective community institutions that could have positive anti-poverty and environmental protection benefits of their own.
The Research on the Impact of Regional Trade Network Relationships on Value Chain Resilience in China’s Service Industry
Authors: Zhang Hanmei , Dai Tianle
Published: September 2024

Regional trade network relationships are not only a medium for transmitting shocks to value chains, but also an important vehicle for reconfiguring value chains. This article applies social network analysis, combines regional trade agreements, and describes the current status of regional trade network development in North America, the European Union, and “the Belt and Road,” as well as the individual characteristics of China’s service industry in each regional trade network by using the indicators of trade relations to construct the network density, connectedness, and centrality through clustering analysis. The research found that the complexity of regional trade network relationships has increased over the years. Additionally, the developing trend of equalization is accelerating but still exhibits a “Core-Periphery” structure. Additionally, subregional groups within the regional trade network are increasingly obvious. Further study on the impact of industry regional centrality on value chain resilience revealed that the increase of degree centrality and the betweenness centrality of China’s service industry can conspicuously strengthen value chain resilience in regional trade network relationships. Moreover, balanced regional trade network relationships can reinforce this effect. In contrast, the degree of the polarity of regional trade network relationships exacerbates the weakening motivation of centrality for value chain resilience.
Effects of an 8-week intervention of anulom vilom pranayama combined with heartfulness meditation on psychological stress, autonomic function, inflammatory biomarkers, and oxidative stress in healthcare workers during COVID-19 pandemic: a randomized controlled trial
Authors: Sharma Vivek Kumar , Barde Pradip B , Kathrotia Rajesh , Sharma Gaurav , Chitturi Vinay , Parmar Naresh , Dhruva Gauravi , Kavathia Ghanshyam , Rajendran Rajathi
Published: September 2024

Objectives

Health care workers were exposed to huge stress during COVID-19 pandemic affecting their physical and mental health. Practice of anulom vilom pranayama and heartfulness meditation (AVPHFN) can improve mental and physical health and counter stress. The present study explored the effect of 8-week AVPHFN intervention on autonomic functions, emotional stress, oxidative stress, and inflammation markers in the nurse group of health-care givers.

Methods

This was a randomized controlled trial where 50 nurses underwent AVPHFN and 50 participated as controls. At baseline and after 8 week intervention of AVPHFN anthropometric parameters, cardiovascular parameters, autonomic function including time and frequency domain parameters, biochemical parameters, and psychological stress using the questionnaire were assessed.

Results

Forty nurses in AVPHFN group and 46 in control group completed the study. AVPHFN intervention resulted in a significant reduction in cardiovascular parameters heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product (p<0.001, p<0.001, p<0.001, p<0.001, and p<0.001, respectively), perceived stress score and depression, anxiety, and stress scale psychological variables of depression, and stress compared to the control group. Total power, ratio of low frequency to high frequency and change in successive normal sinus (NN) intervals exceeds 50 ms (p<0.01, p=0.05, and p<0.01 respectively) suggesting parasympathodominance due to higher vagal efferent activity. Serum cortisol, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha, interleukin (IL)-1, IL-6 and telomerase significantly decreased in AVPHFN group post intervention.

Conclusions

Eighty-week intervention of AVPHFN improved psychophysiological, autonomic and biochemistry profile of nurse group of health-care workers. AVPHFN module may be beneficial for curtailing stress and improving well-being.
“Understanding and treating baras (vitiligo) in unani medicine: historical perspectives, pathophysiology, and therapeutic approaches”
Authors: Shah Nadeem A. , Mir Rayees A. , Saltanat Sabba
Published: September 2024

Vitiligo, also known as baras in Unani medicine, causes patches of depigmented skin due to the loss of melanocytes. According to ancient Unani scholars, factors like excessive phlegm in the blood and weakened color-controlling power were believed to be the cause. This study dives into the historical insights of luminaries like Majūsī and Hakim Akbar Arzānī, alongside modern medical understanding. It explores the pathophysiology, epidemiology, and clinical features of vitiligo, while also addressing confusing definitions, dietary influences, and demographic patterns. We take a close look at the classification, prognosis, and investigative methods. The aim of this research is to bring together traditional and modern perspectives to fully understand vitiligo, covering its cultural, historical, and scientific aspects. By incorporating epidemiological data, dietary considerations, and insights into the underlying mechanisms, we enhance diagnostic and treatment approaches. In conclusion, this study establishes a cohesive connection between the historical wisdom of Unani medicine and the current scientific discourse on vitiligo. By merging these perspectives, we gain a comprehensive understanding of the condition, enabling a more holistic approach to diagnosis and management. As dermatological research continues to evolve, the integration of traditional and modern insights becomes crucial in effectively addressing complex skin disorders like vitiligo.
The crystal structure of alogliptinium meta-chlorobenzoate
Authors: Ma Yu-Heng , Ma Wen-Jing , Yang Kang , Zhang Kai-Yue , Zhang Qiao , Hu Qing , Shan Wu-Guang , Wang Yi-Hong
Published: September 2024

C18H22N5O2·C7H4ClO2, orthorhombic, P212121 (no. 19), a = 8.9188(2) Å, b = 10.8391(2) Å, c = 25.9295(5) Å, V = 2506.65(9) Å3, Z = 4, Rgt
(F) = 0.0357, wRref
(F
2) = 0.1085, T = 293(2) K.
From nominal source to demonstrative: a case of grammaticalization in Standard Arabic
Authors: Jaradat Abdulazeez
Published: September 2024

There is a debate concerning the history of demonstratives. Are they primitive or grammaticalized elements in languages? Moreover, notwithstanding the relevance of demonstratives to NP, nominals are not regarded as a potential source of grammaticalized demonstratives. The present study, based on synchronic observations, argues that the proximal demonstratives ða ‘this’ and ʔulaaʔ ‘these’, which constitute the nucleus of the demonstrative system of Standard Arabic, are grammaticalized elements. It also offers a new grammaticalization pathway and a new source of demonstratives. Arabic proximal demonstratives evolve from possessive adjectives, which are themselves grammaticalized from nominals that mean ‘oneself’ and ‘companion’. The motive underpinning this pathway is that the lexical sources and the grammaticalized elements share the property of being egocentric. Concerning medial and distal demonstratives, two further stages of grammaticalization occur: (1) the phonological derivation of two medial demonstratives from their corresponding proximal demonstratives and (2) the phonological derivation of two distal demonstratives from their corresponding medial demonstratives. The extended grammaticalization pathway is as follows: nominals that mean ‘self’ and ‘companion’ > possessive adjectives > proximal demonstratives > medial > distal. This pathway implies that the source of demonstratives may comprise more than one lexical word; however, they are meaningfully related, and their grammaticalization pathway towards forming the demonstrative system of Standard Arabic applies uniformly.
Embodied movement as a stratified semiotic mode: how movement, gaze and speech mean together in the classroom
Authors: Wu Xiaoqin
Published: September 2024

This paper develops a model to map out embodied movement as a stratified semiotic mode, that is, a conventionalized set of resources for meaning making. The model describes movement structure as a system that realizes specific meanings activated by contexts of situation. The model establishes an explicit link between contextual meanings and textual patterning by theorizing connections between genre, metafunction, and structure. Drawing upon an empirical study of one teacher’s embodied movement in the classroom, this paper maps out movement structure as distinct choices and reveals how movement, gaze and speech function rhythmically to construe information prominence and information boundaries at different levels of discourse organization, which further contributes to coherence and periodicity for the information flow and semantic flow in the lesson. Additionally, the paper reveals that the synthesis of different modes can enact semantic convergence and divergence to aggregate knowledge in pedagogic contexts. The analysis contributes to a systematic understanding of the types of meaning that embodied movement can realize and of the ways in which they are realized together with speech and gaze. The intertwined nature of movement structures, meanings and contexts also indicates that pedagogy is an embodied and situated construction.
Effect of silibinin on GAS6/sAXL and JAK/STAT pathways in human cholangiocarcinoma cell line
Authors: Caliskan Zehra Nur , Ozel Yetkin Merve , Baskol Mevlut , Baskol Gulden
Published: September 2024

Objectives

Cholangiocarcinoma (CCA) is a highly heterogeneous biliary malignant tumor. Studies have demonstrated that JAK/STAT signaling is activated in many types of cancer. In addition, JAK/STAT is activated downstream of AXL, and the AXL receptor is activated by its ligand, GAS6. In this study, we investigated the anticarcinogenic effect of silibinin and its relationship with the GAS6/AXL ve JAK/STAT pathway in the human EGI-1 cell line.

Methods

Cell viability, apoptosis, and cell cycle were measured by Muse Cell Analyzer. All the protein levels were determined by the ELISA method.

Results

We observed that silibinin significantly reduced cell proliferation and colony formation (p<0.05, p<0.001, respectively). Silibinin also significantly induced total apoptosis and the G0/G1 phase of the cell cycle (p<0.01). We observed that silibinin significantly decreased JAK2 levels while increased STAT1 levels compared to the controls respectively (p<0.001; p<0.001). Besides, silibinin statistically decreased the levels of sAXL; however, numerically, but not statistically, it increased the level of GAS6 (p>0.05).

Conclusions

Silibinin reduces colony formation, inducing apoptosis and arresting cancer cells in the G0/G1 phase, which is an indicator of its anticancer activity. In addition, silibinin decreased the levels of JAK2 and sAXL, which contributes to the development of cancer, and increased the levels of STAT1, suggesting silibinin’s antiproliferative effects.
The antibacterial efficacy of reduced graphene oxide (rGO) and rGO/ZnO composites produced through thermal pyrolysis method against various bacterial strains
Authors: Philip Reshma S , Narayanankutty Arunaksharan , Mathew Meril
Published: September 2024

Antibacterial agents are essential to maintain the health of living beings. The misuse and overuse of antibiotics have led to the development of resistance against antibiotics in microbes. To address this issue, efficient, cost-effective, and biocompatible alternatives for conventional antibiotics need to be developed. Reduced graphene oxide (rGO), ZnO, and their composite have been identified as being efficient in disinfecting bacterial strains. The synthesis of rGO, ZnO, and their composite is usually a multi-step, time-consuming process that uses harmful reagents and catalysts. In this study, we prepared rGO from sucrose and rGO/ZnO composite from sucrose and zinc acetate by a single-step heating process. The method is green, eco-friendly and only uses commonly available non-hazardous precursors for preparation. The characterisation techniques, XRD, XPS, FE-SEM, and HR-TEM, displayed the formation of rGO and ZnO in the samples. The antibacterial efficiency of the samples rGO, the composites ZG-10, ZG-40, ZG-60 and ZnO (ZG-100) were evaluated against Gram-positive and Gram-negative bacterial strains using the agar disc diffusion method. The samples showed remarkable bactericidal activity against all the tested bacterial strains, and their zone of inhibition was comparable to that of conventional antibiotics. Different samples are proven to be effective for different bacterial strains. The sample rGO was found to be more efficient in inhibiting Escherichia coli with a zone of inhibition of 19.5 mm, whereas the ZG-10 composite exhibited superior efficiency against Pseudomonas aeruginosa with a zone of inhibition of 20.5 mm. The sample ZG-100 showed high disinfection efficiency against Staphylococcus aureus and Salmonella enteritidis with zones of inhibition of 22.8 and 23 mm, respectively. The minimum inhibitory concentration and cytotoxicity of the samples were also tested. From the analysis, the tested samples demonstrate strong antibacterial efficacy and less cytotoxicity, positioning them as a promising material for biomedical applications.
The clinical diversity of primary hypothyroidism presenting as a spontaneous ovarian hyperstimulation syndrome
Authors: Prabha Krishna , Jebasingh K Felix , Londhe Vaibhav , Thomas Nihal
Published: September 2024

Ovarian hyperstimulation syndrome (OHSS) usually occurs in patients undergoing assisted reproduction techniques and ovulation induction. Its variant, spontaneous ovarian hyperstimulation syndrome, a potentially life-threatening disorder, is uncommon and only a few cases have been reported in association with hypothyroidism. This study analysed five patients with untreated chronic hypothyroidism presenting with multicystic ovaries, isosexual precocious puberty, and delayed bone age; subsequently, the follow-up and regression of ovarian pathology was assessed. Two patients had presented to the emergency department with menorrhagia and hypotension, of these, one had ovarian torsion at presentation. Three patients presented to the outpatient department: one for evaluation of short stature, one for premature menarche, and another with polycystic ovaries. They were all diagnosed with long-standing, untreated chronic hypothyroidism. There was regression of the size of the cystic ovaries on subsequent follow-up. In all these patients, long-standing hypothyroidism had resulted in ovarian hyperstimulation syndrome. The potentially life-threatening complications of this syndrome may be prevented by careful screening and a strong index of clinical suspicion at the outset.

Learning points

Long-standing, untreated primary hypothyroidism may result in spontaneous ovarian hyperstimulation syndrome.

A high index of suspicion is required for an early and accurate diagnosis.

The requirement for interdepartmental collaboration between gynaecology and endocrinology departments is essential for the successful management of this life-threatening but easily treatable disorder.
First reported case of multiple endocrine neoplasia type 1 in an Australian Aboriginal
Authors: Mignone Edward , Neal Kirsten
Published: September 2024

Multiple endocrine neoplasia type 1 (MEN1) requires a high level of suspicion, and late diagnosis can lead to dire outcomes. Genetic counselling is an important part of management, with a lack of evidence surrounding an optimal approach in Aboriginal Australian populations. Our case surrounds a remote-dwelling 48-year-old Aboriginal Australian female who was reviewed by an inpatient endocrine team in 2020 for persistent hypercalcaemia on a background of a parathyroidectomy in 2011 for primary hyperparathyroidism (PHPT), while she was admitted to a local hospital for acute chronic abdominal pain. Relevant medical history included multiple pulmonary embolisms/deep vein thrombosis, myocardial infarction, atrial fibrillation, chronic thromboembolic pulmonary hypertension, right heart failure, human T-lymphotropic virus 1, recurrent abdominal pain, and gastro-oesophageal reflux disorder. Gastroscopies from 2013 and 2015 demonstrated chronic gastritis with hundreds of gastric polyps. Subsequent laboratory studies, neuroendocrine tumour (NET) screening, and CT imaging demonstrated a recurrence of PHPT and a new diagnosis of Zollinger–Ellison syndrome. A 68-gallium-DOTATATE PET/CT was in keeping with metastatic NET. Pituitary studies were normal. Genetic testing confirmed a rare heterozygous variant of c.207dupC in exon 2 of the MEN1 gene. Treatment was symptom based due to terminal comorbidities. Genetic counselling was attempted; however, cultural and logistical barriers were identified and the family declined further testing. Unfortunately, she died in 2021 from multifactorial respiratory failure. This case highlights the need for better approaches to genetic counselling systems for remote Aboriginal Australians and emphasizes the importance of early recognition and the challenges faced in remote areas in making such rare diagnoses.

Learning points

Remote healthcare systems often lack access to adequate specialist care, resulting in delayed diagnosis of rare conditions and leading to morbidity and mortality.

Further research and work need to be done to provide culturally appropriate genetic counselling systems in remote Aboriginal Australians.

A high index of suspicion is required to diagnose MEN1.

Consider MEN1 in any patient diagnosed with primary hyperparathyroidism, with age <40, and/or with the presence of multiglandular disease or with the presence of Zollinger–Ellison syndrome.

MEN1 may be under-recognized in Aboriginal Australians.
REPRODUCTIVE HEALTH IN TRANS AND GENDER-DIVERSE PATIENTS: Gonadal tissue cryopreservation in transgender and gender-diverse people
Authors: Ausavarungnirun Chatchanan , Orwig Kyle E
Published: September 2024

In brief

Gender-affirming treatments for gender dysphoria can impact fertility. This review describes the impact of gender-affirming treatments on fertility and options to preserve fertility in transgender or gender-diverse children, adolescents, and young adults.

Transgender individuals who pursue alignment with their gender identity through medical treatments or surgery face challenges to family building because the medical community lacks the understanding or infrastructure to serve the reproductive needs of transgender or non-binary people. Fertility preservation (FP) offers a crucial opportunity for the transgender community, enabling individuals to exercise autonomy over their reproductive choices. While fertility preservation has been extensively studied in other populations such as cancer patients, the unique biology and clinical care of transgender and gender-diverse (TGD) individuals have challenged the direct translation of what can be offered for cisgender individuals. Additionally, the FP services in transgender communities are reportedly under-utilized, despite the prevalent desire of TGD individuals to have children. This review aims to provide up-to-date information on the current standard of care and experimental FP options available to TGD individuals and their potential reproductive outcomes. We will also discuss the barriers to the success of FP utilization from both the biology/medical aspect and the perspectives of the TGD population. By recognizing the unique family-building challenges faced by TGD people and potential areas of improvement, appropriate adjustments can be made to better support fertility preservation in the TGD community.
Preparation of Stellera chamaejasme L. mesoporous activated carbon by rubidium chloride chemical method
Authors: Dang Shimin , Guo Jianxia , Liu Ze , Li Haichao
Published: September 2024

To make use of rubidium salt resources in the Qinghai Salt Lake and to valorize Stellera chamaejasme L., mesoporous activated carbon was prepared by a chemical activation method using rubidium chloride as an activator. Using methylene blue and iodine as pollutant models, the adsorption capacity of mesoporous activated carbon was determined. The specific surface area, pore structure, and surface functional groups of mesoporous activated carbon were determined using a fully automated specific surface area analyzer, X-ray diffractometer (XRD), Raman spectrometer, scanning electron microscope (SEM), Fourier transform infrared spectrometer (FT- IR), and an X-ray electron spectrometer (XPS). The surface functional groups of mesoporous activated carbon were found to be mainly comprised of carbon and oxygen. The mesoporous activated carbon had a certain graphitized microcrystalline structure. The carbon yield of the mesoporous activated carbon was 13.55% ± 0.41%, the specific surface area was 877.02 m2/g, the adsorption amount of iodine, 891.35 mg/g, and the adsorption amount of methylene blue, 256.95 mg/g. The dominant pore size was 0.945 nm, the average pore size was 2.43 nm, and the pore volume was 0.26 cm3/g.
Perceptual imagery of soft sofa fabrics based on visual-tactile evaluation
Authors: Tu Ziyao , Wang Wei
Published: September 2024

In the contemporary era of quality and personalization, this article explores how soft sofa fabrics enhance users’ emotional experience and convey perceptual images. Users’ visual-tactile perception data on 10 common soft sofa fabrics were gathered by questionnaire surveys, utilizing the Kansei engineering approach, and the visual-tactile evaluation theory. With SPSS software, the data were processed and examined in-depth using a variety of techniques, including cluster analysis and factor analysis. The experiment screened fabric samples and emotional vocabularies via the KJ method and expert evaluation, and questionnaires were designed and implemented based on the semantic differential method and Likert scale. Fabrics were categorized into four groups based on cluster analysis, which are suitable for users pursuing different home environments. The two primary factors that comprise the fundamental aspects of the perceptual image of soft sofa fabrics were found to be the texture, quality experience factor, and the typical emotional reaction factor, which were extracted by factor analysis. Both theory and practice were considered, enriching the theoretical framework of emotional imagery and user emotion research while offering valuable practical guidance for the design, production, and marketing of soft sofas.