bluuebunny/crossref_metadata_2025 huggingface dataset:
Interrater Agreement of CT Grading of Blunt Splenic Injuries: Does the AAST Grading Need to Be Reimagined?
Authors: Adams-McGavin R. Chris , Tafur Monica , Vlachou Paraskevi A. , Wu Matthew , Brassil Michael , Crivellaro Priscila , Lin Hui-Ming , Gomez David , Colak Errol
Published: July 2023

Introduction: The Revised Organ Injury Scale (OIS) of the American Association for Surgery of Trauma (AAST) is the most widely accepted classification of splenic trauma. The objective of this study was to evaluate inter-rater agreement for CT grading of blunt splenic injuries. Methods: CT scans in adult patients with splenic injuries at a level 1 trauma centre were independently graded by 5 fellowship trained abdominal radiologists using the AAST OIS for splenic injuries – 2018 revision. The inter-rater agreement for AAST CT injury score, as well as low-grade (IIII) versus high-grade (IV-V) splenic injury was assessed. Disagreement in two key clinical scenarios (no injury versus injury, and high versus low grade) were qualitatively reviewed to identify possible sources of disagreement. Results: A total of 610 examinations were included. The inter-rater absolute agreement was low (Fleiss kappa statistic 0.38, P < 0.001), but improved when comparing agreement between low and high grade injuries (Fleiss kappa statistic of 0.77, P < .001). There were 34 cases (5.6%) of minimum two-rater disagreement about no injury vs injury (AAST grade ≥ I). There were 46 cases (7.5%) of minimum two-rater disagreement of low grade (AAST grade I-III) versus high grade (AAST grade IV-V) injuries. Likely sources of disagreement were interpretation of clefts versus lacerations, peri-splenic fluid versus subcapsular hematoma, application of adding multiple low grade injuries to higher grade injuries, and identification of subtle vascular injuries. Conclusion: There is low absolute agreement in grading of splenic injuries using the existing AAST OIS for splenic injuries.
Mowing the grass
Authors: Gibilisco Michael
Published: July 2023

Mowing the grass is a cyclical pattern in counterterrorism campaigns where governments attack to destroy terrorist capacity, thereby achieving a period of quiet as groups recover. If groups expect their capacity to be destroyed, why build their capabilities in the first place? I analyze an infinite-horizon dynamic game where a group endogenously builds capacity in the face of potential attacks and capacity is an evolving, persistent variable. The model highlights that terrorist groups and governments have incentives to create strategic uncertainty and thus explains attack cycles without punishment strategies, revenge preferences or imperfect/incomplete information. I calibrate the model to time-series data in the Israeli–Palestinian conflict describing rockets fired from Gaza. The results illustrate a peace-making dilemma: altering the government’s incentives will have comparatively minimal effects on long-term conflict dynamics, whereas changing the terrorists’ incentives to acquire capacity would either increase the frequency of high-capacity terrorism or government attacks.
Effectiveness of wake control optimization for multiple in-line wind turbines by combinatorial machine learning wake model
Authors: Zhang Bowen , Luo Wei , Luo Zhaohui , Xu Jian , Wang Longyan
Published: July 2023

In the wind turbine wake control research, the analytical wake model does not consider the influence of direct control parameters on the wind turbine wake flow field, and its prediction accuracy is by no means satisfying. The numerical simulation method can accurately predict the wake effect, but its low computational efficiency renders it unable to be used in the iterative control optimization study. In this paper, a new wake model coupled with the direct control parameters (tip speed ratio and pitch angle) of a single wind turbine is built based on the machine learning algorithm for which the widely applied Artificial Neural Network (ANN) is applied for instance. By combining the ANN wake model with different wake superposition models, the best combinatorial model for quantitative evaluation of multiple wake interferences is achieved, which not only has great accuracy but also ensures high calculation efficiency. On top of the established combinatorial wake model, three in-line wind turbines are investigated for assessing the effectiveness of wake control optimization with respect to the traditional greedy control. The results show that by optimizing the control parameters (tip speed ratio and pitch angle) of wind turbines, the total power of the three wind turbine units is increased by 1.15~3.48% depending on the incoming wind speeds and distances apart between wind turbines. The power variation of each wind turbine shows that the increase in total power is achieved by the decreased power of the first wind turbine and the increased power of the second and third wind turbines. The research verifies the effectiveness of adopting optimized wind turbine wake control on the total wind farm power improvement numerically.
The Neglected Campaign: The Italian Navy Contribution to the Siege of Leningrad
Authors: Fiore Massimiliano
Published: July 2023

German and Finnish forces encircled Leningrad in the fall of 1941, but were unable to complete the siege. A passage across Lake Ladoga, through which the Soviets sustained the defence of the city, remained open. To enforce the siege, the German Maritime Warfare Command ordered that light naval forces be transferred to Lake Ladoga. However, the Germans did not have those boats at their disposal and asked the Italians to provide them. Based on a critique of archival sources, this article analyses this largely neglected aspect of the Leningrad campaign and argues that, although the performance of the Regia Marina was excellent, its activity was not decisive in breaking Soviet resistance and forcing the fall of Leningrad. Even though circumstances prevented the Regia Marina from making the impact that its planners had wanted – a naval guerrilla force on Lake Ladoga could never have achieved a tight blockade of Leningrad – the campaign on Lake Ladoga offers an important and enlightening example of Axis wartime collaboration.
A concept analysis of misconduct: Application to nursing education
Authors: Al Abrawi Said
Published: July 2023

Background

Behavior is known as misconduct when individuals do not adhere to ethical standards, rules, or regulations. Several factors lead to misconduct, including the lack of understanding of what misconduct is among undergraduate students. However, misconduct as a concept needs more clarity and specificity.

Objective

This study aimed to examine the concept of misconduct from the literature and establish an operational definition for application to nursing education.

Research design

A concept analysis using Rodger’s evolutionary view was used to analyze the literature from the disciplines of: academics, business, law, and religious perspectives.

Findings and discussion

An operational definition was developed based on the multidisciplinary concept analysis. A concept map was designed to help visualize the antecedents, attributes, and consequences and to assist in the conceptualization of misconduct. Implications for nursing science, administration, and education are provided.

Conclusion

Understanding misconduct is necessary for nurse educators to ensure ethical practice within the academic context.
Newborn Screening: A Practical Guide to Pediatricians and Neonatologists
Authors: Anne Rajendra Prasad , Rahiman Emine A , Bharti Lalan K
Published: July 2023

Newborn screening, while universal in most high- and middle-income countries, is still in its nascent stages in India. It is estimated that only <3% of neonates born in India in 2021 were screened for disorders. The disorders that can be picked up early by newborn screening range across endocrine, metabolic, cardiac, hematological, visual, and auditory defects. The burden of disorders is higher in India than in the global estimates. As a result, many neonates with easily treatable disorders are being missed in the neonatal period, resulting in increased morbidity and mortality. Worldwide, studies have shown that universal newborn screening is feasible and cost effective. As India does not have a national policy and/or program existent on newborn screening, pediatricians and obstetricians have an important role to play to improve the newborn screening rates in India. Moreover, the screening needs to be comprehensive, extending beyond some limited blood tests, so that the neonates will be maximally benefited. With this background, we have provided a brief overview of newborn screening for practicing pediatricians and neonatologists. The purpose of this article is to help pediatricians and neonatologists to initiate newborn screening in their units.
Vericiguat reduces electrical and structural remodeling in a rabbit model of atrial fibrillation
Authors: Lou Qi , Li Luyifei , Liu Guangzhong , Li Tiankai , Zhang Li , Zang Yanxiang , Zhan Chengchuang , Wang Hong , Li Weimin
Published: July 2023

Purpose: The molecular etiology of atrial fibrillation (AF) and its treatment are poorly understood. AF involves both electrical and structural features. Vericiguat can ameliorate cardiac remodeling in heart failure. The effects of vericiguat on AF, however, are unclear. Here, the actions of vericiguat on atrial structural and electrical remodeling in AF and its possible mechanisms were investigated. Methods and Results: Thirty-six rabbits were randomly allocated to four groups, namely, sham, RAP (pacing with 600 beats/min over three weeks), vericiguat-treated (three weeks’ pacing plus daily oral dose of 1.5 mg/kg of vericiguat), and vericiguat-treated only. HL-1 cells received rapid pacing with or without vericiguat. Parameters including electrophysiology, echocardiography, histology, Ca2+ levels, and ICaL density, as well as levels of TRPC6, CaN, NFAT4, p-NFAT4, Cav1.2, collagen I, collagen III, and ST2 were measured. Significant changes of above proteins expression level, circulating biochemical indices, Ca2+ concentrations, and ICaL density in both animals and cell models, these effects were significantly restored by vericiguat. Vericiguat also reversed the enlarged atrium and significantly reduced myocardial fibrosis, together with preventing reduced atrial effective refractory periods (AERPs) and AF induction rate. Conclusion: Vericiguat thus ameliorated AF-associated structural and electrical remodeling. These findings suggest the potential of vericiguat for treating AF.
Evaluation of the Potential Diagnostic Role of the Lnc-MIAT, miR-29a-3p, and FOXO3a ceRNA Networks as Noninvasive Circulatory Bioindicator in Ductal Carcinoma Breast Cancer
Authors: Razi Shokufeh , Mozdarani Hossein , Behzadi Andouhjerdi Roudabeh
Published: July 2023

Background:

Over the last few decades, tremendous progress has been achieved in the early detection and treatment of breast cancer (BC). However, the prognosis remains unsatisfactory, and the underlying processes of carcinogenesis are still unclear. The purpose of this research was to find out the relationship between myocardial infarction–associated transcript ( MIAT), FOXO3a, and miRNA29a-3p and evaluated the expression levels in patients compare with control and their potential as a noninvasive bioindicator in whole blood in BC.

Methods:

Whole blood and BC tissue are taken from patients before radiotherapy and chemotherapy. Total RNA was extracted from BC tissue and whole blood to synthesize complementary DNA (cDNA). The expression of MIAT, FOXO3a, and miRNA29a- 3p was analyzed by the quantitative reverse transcription-polymerase chain reaction (RT-qPCR) method and the sensitivity and specificity of them were determined by the receiver operating characteristic (ROC) curve. Bioinformatics analysis was used to understand the connections between MIAT, FOXO3a, and miRNA29a- 3p in human BC to develop a ceRNA (competitive endogenous RNA) network.

Results:

We identified that in ductal carcinoma BC tissue and whole blood, MIAT and FOXO3a were more highly expressed, whereas miRNA29a- 3p was lower compared with those in nontumor samples. There was a positive correlation between the expression levels of MIAT, FOXO3a, and miRNA29a- 3p in BC tissues and whole blood. Our results also proposed miRNA29a- 3p as a common target between MIAT and FOXO3a, and we showed them as a ceRNA network.

Conclusions:

This is the first study that indicates MIAT, FOXO3a, and miRNA29a- 3p as a ceRNA network, and their expression was analyzed in both BC tissue and whole blood. As a preliminary assessment, our findings indicate that combined levels of MIAT, FOXO3a, and miR29a- 3p may be considered as potential diagnostic bioindicator for BC.
Counting bodies, preventing war: Future conflict and the ethics of fatality numbers
Authors: Rodehau-Noack Johanna
Published: July 2023

With conflict prevention as a commonplace agenda of international organisations, numerous instruments for gathering knowledge about potential armed conflict have emerged. This article focuses on the mode of knowing war through quantification in the form of fatality statistics or ‘death counts’, which are taken by analysts and policymakers to indicate the severity and extent of conflicts. Drawing on official documents and interviews, I argue that fatality numbers are productive of the reality of violent conflict as they shape what counts as conflict and what does not. In the reporting by prevention actors, such numbers indicate past and future trends of armed violence and, in this way, bolster the imperative to prevent by creating quantified futures of conflict. However, fatality numbers also normalise deadly violence as a baseline criterion, thus also limiting the scope of what is known as future conflict and omitting lived experiences from the abstractions behind such numbers.
Factors influencing burglary and home security measures in England and Wales
Authors: Bankiewicz Urszula , Papadouka Maria Eirini
Published: July 2023

Objectives: This exploratory study aims to investigate the relationship between the characteristics of the survey respondents, reported fear of burglary and installed home security measures. Methods: This study analyses secondary data from the Crime Survey for England and Wales 2017/18. The data was analysed using suitable statistical methods: regression modelling and factor analysis. Results: The main findings showed that the socioeconomic status of respondents and the status of the area they live in are the strongest predictors of the installation of deterrence home security measures. The findings further revealed that those of lower socioeconomic status are more afraid of burglary and more likely to have deterrence but not entry prevention home security installed. However, the direct impact of fear of burglary on the deterrence home security measures indicated a decrease in the likelihood of this type of home security measure being installed. This suggests that the affordability of home security measures plays an important role. Conclusion: Participants from lower socioeconomic status are more afraid of becoming victims of burglary and invest in cheaper home security measures to protect their homes, while wealthier participants do not feel the need to protect their homes since they are more likely to live in low-crime areas.
Preparation and electromagnetic performance of a light-weight, thin, and high-gain three-dimensional woven hollow structure microstrip antenna
Authors: Lyu Lihua , Wang Rongrui , Zhang Duoduo , Zhou Xinghai , Gao Yuan
Published: July 2023

With the popularity of 5 G, there is an increasing request for a light, high-performance, and stable structure for wireless communication. To solve the problems of delamination cracking and its own heavy weight of the conventional microstrip antenna, this study used ultra-high molecular weight polyethylene (UHMWPE) filament tows and purple copper filament tows as raw materials to prepare 3D woven hollow structure microstrip antenna preforms on a common loom. Using the prepared preforms for reinforcement and resin as the matrix, the VARTM process was used to prepare a 3D woven hollow structure microstrip antenna with a height of 6.8 mm, a weight of 35 g, and a bulk density of 0.7 g/cm3. The combination of the electromagnetic performance test and HFSS software simulation shows that the antenna has excellent radiation performance with a gain of 7.5 dB and a measured VSWR of 1.25. The mechanical performance test results show that it can withstand a maximum compression load of 2982 N and a maximum bending load of 364 N with no obvious delamination at the fracture. It is light, thin, and load-bearing with excellent radiation performance. There will be great potential in the unmanned field and the space field in the future.
Exercise Intolerance That Resolved After venous Stenting of the Inferior Vena Cava
Authors: Bakas Jay M. , Moelker Adriaan , Malskat Wendy S. J. , Van Rijn Marie Josee E.
Published: July 2023

Venous stenting could alleviate exercise intolerance associated with chronic inferior vena cava (IVC) obstruction. We describe a 36-year-old male patient with an unknown IVC-obstruction. The obstruction was discovered after a bi-iliac deep vein thrombosis (DVT). The thrombus was resolved using thrombolysis. In the chronic phase, the patient developed exercise intolerance without any leg-specific symptoms or signs. Venous stenting was performed to open the IVC-obstruction, 1 year after the acute DVT. His physical condition improved, but cardiac magnetic resonance imaging at rest did not reveal hemodynamical changes after stenting. The Short Form Health Survey (SF-36) physical and mental component summaries were increased from 40.3 to 46.1 and 42.2 to 53.7, respectively. In patients with iliocaval obstruction, improved venous flow without changes in resting hemodynamics can enhance exercise intolerance and quality of life, even in the absence of leg symptoms. Diagnostic tools performed only at rest may miss abnormalities.
Impact of the introduction of medical cannabis in the UK on risk perception and recreational use of cannabis: A longitudinal and cross-sectional analysis
Authors: Waldron Jon , Grabski Meryem , Freeman Tom P , van Laar Margriet , Curran H Valerie
Published: July 2023

Background

Cannabis was rescheduled in the UK in November 2018 so that it can now be prescribed as a treatment for certain medical conditions. It is not yet known whether this has had an impact on peoples’ perception of its risk or on their recreational use of cannabis.

Methods

This study used data from longitudinal and cross-sectional components of an online survey investigating drug use and nightlife behaviours, comparing data before and after rescheduling of cannabis in November 2018. Participants’ awareness of the change in policy and its impact on cannabis use were assessed for participants in both the cross-sectional and longitudinal arms. The perception of the risk of recreational cannabis use, past 12-month use and use frequency were assessed pre- and post-policy change among the longitudinal sample.

Results

414 longitudinal (57.3% response rate) and 2001 cross-sectional participants completed the online survey, resulting in a total sample size of 2415. Just over half the sample (53.5%) were aware of the change in policy to allow for the medical provision of cannabis, with almost 90% saying this would have no impact on their recreational and approximately 80% no impact on their medical use of cannabis, irrespective of prior awareness. No significant differences were found with respect to risk perception, past 12-month cannabis use, or use frequency pre- and post-policy change among the longitudinal sample.

Conclusions

The change in UK policy to allow for the medical provision of cannabis for some conditions had a limited impact on intentions to use cannabis, and was not associated with longitudinal changes in risk perception or temporal use patterns.
Impact of Supportive Supervisor on Doctoral Students’ Research Productivity: The Mediating Roles of Academic Engagement and Academic Psychological Capital
Authors: Khuram Waqas , Wang Yanqing , Ali Mudassar , Khalid Aisha , Han Heesup
Published: July 2023

This research investigates the impact of supportive supervisors on doctoral students’ research productivity, with parallel mediation effects of academic engagement and academic psychological capital as two mediators. Data has been collected through an online survey from international doctoral students ( N = 415) studying in six research-oriented universities in mainland China. Confirmatory factor analysis and structural modeling were used in the analysis and mediation analysis conducted by adopting the 04 Model in PROCESS. The results indicated that a supportive supervisor is positively related to research productivity. Student psychological factors—academic engagement and academic psychological capital—partially mediate the relationship between supportive supervisors and research productivity. The findings suggest that the supervisor’s supportive behavior is essential for encouraging students’ academic engagement and academic psychological capital. Furthermore, students are more productive, and their engagement and psychological resources are increased under supportive supervision, which ultimately significantly increases their research productivity.
Modelling urban transition with coupled housing and labour markets
Authors: Ge Jiaqi , Furtado Bernardo Alves
Published: July 2023

This study develops an agent-based model of urban transition, U-TRANS, with coupled housing and labour markets to simulate the transition of a city during a major industrial shift. We propose a dynamic, bottom-up framework incorporating the key interacting factors and micro mechanisms that drive the transition paths of cities. Using U-TRANS, we simulate a number of distinctive urban transition paths, from total collapse to weak recovery to enhanced training to global recruit, and analyse the resulting outcomes on economic growth, employment, inequality, housing price and the local neighbourhoods. We find that poor neighbourhoods benefit the most from growth in the new industry, whereas rich neighbourhoods do better than the rest when growth stagnates and the city declines. We also find there is a subtle trade-off between growth and equality in development strategy. By aggressively recruiting a large number of skilled workers from outside of the city in a short time, the division between local and non-local workers can be widened. The study contributes to the understanding of the dynamic process and micro mechanisms underlying urban transition. It helps explain why some cities starting from seemingly similar initial conditions may go on divergent development paths at critical moments in the history. It also demonstrates the heterogeneous impact of industrial shift on different urban neighbourhoods. The model can be used as a policy testbed for different development strategies to help cities navigate through a major industrial revolution.
Caste Identity of Contemporary Naxalites: Reading the Battles of the Naxals Against the Caste Hierarchy Through a Close Reading of A Naxal Story (2008)
Authors: Sarkar Pritha , Chattopadhyay Sayan
Published: July 2023

This article aims to study the relationship between caste and contemporary Naxal organizations through A Naxal Story (2008) by Diptendra Raychaudhuri. Through the text, the article explores how the caste identity and attempt to eradicate the intricate web of caste hierarchy played a prominent role in the formation of one of the contemporary Naxal organizations. The interweaving of the historical facts and the literary depiction is one of the prime reasons for choosing this text. This text acts as forming a bridge between the 70s’ Naxalbari movement and the contemporary organizations. It traces the political lineage of the Naxalbari movement and how the gap in recognizing the caste inequality acted as a motive in the formation of some of the new organizations. Through the attempt of the protagonist and its failure, the text reveals the reality of the caste scenario in India and the endeavour of at least a few left-militant organizations to end the structure despite the regular repression by state machinery and militant upper-caste organizations. Hence, this article traces the presence of caste inequality and how the caste identities contribute to the creation and development of contemporary radical Naxal organizations as well as militant Hindu organizations.
Caste-based Discrimination in Mid-day Meal Scheme: An Empirical Study of Moradabad District
Authors: Bhandari Garima , Mishra Anindya Jayanta
Published: July 2023

Mid-day meal scheme is one of the largest schemes of its kind, which deals with the nutritional intake of children, student retention, gender equality and socialization values among primary and upper primary schools. It addresses pressing social concerns to make school education accessible to all. One of the major restraints in the effective implementation of the scheme is the caste prejudice against the Dalits, as there has always been an unequal relationship between food and caste hierarchy. To study this, in-depth interviews were taken in the schools of the Moradabad district, Uttar Pradesh, and secondary sources were used. This article analyses how identity-based discrimination is driven and reproduced on the school’s premises with the mid-day meal workers. The findings show that implicit caste biases still exist within the social structures despite various positive affirmations that impact the effective implementation of the mid-day meal scheme. It indicates that sub-categorization discrimination is practised within the ambit of the Scheduled Caste community that could not be revealed from a macro-perspective. Therefore, a discourse is needed regarding caste or identity-based discrimination until a stigma is attached to an individual’s identity.
Restorative Justice for Sexual Violence Offences in England and Wales: The Challenges Ahead
Authors: Cawley Philip Anthony , Kewley Stephanie , Burke Lol , Wager Nadia
Published: July 2023

While an increased number of restorative justice (RJ) cases involving sexual violence are observed across England and Wales, the extent and scope of its use remain unclear. This article presents the findings of a brief survey distributed amongst RJ practitioners across England and Wales which aimed to understand the use of RJ in cases of sexual violence. We found that while RJ is widely used in such cases, a comprehensive national picture remains unknown. We found problems both collating and analysing the data because of definitional differences, varying organizational recording mechanisms (within and between organizations and geographical boundaries) plus a lack of national direction across the criminal justice system. We call for the development of a sound evidence base that will promote and support the use of RJ for cases involving sexual violence.
Comparison of the effect of vaginal vitamin E cream with conjugated estrogen vaginal cream on vulvovaginal atrophy and overactive bladder syndrome: a randomized controlled trial
Authors: Azari Nazila , Mehrabi Esmat , Javadzadeh Yousef , Hakimi Sevil
Published: July 2023

Objectives

The present study aimed to investigate the effect of vitamin E on vulvovaginal atrophy (VVA) and overactive bladder syndrome (OABS).

Materials and methods

This trial was conducted on 72 postmenopausal women referring to health centers. Participants were randomly divided into the intervention (vitamin E, vaginal cream) and control (conjugated estrogen, vaginal cream) groups. The duration of the intervention was eight weeks, as they took medicine every day in the first week and then, twice a week. The primary outcome is to compare the symptoms of VVA in the intervention and control groups, and the secondary outcome includes the comparison of the mean score of OABS, pH, vaginal health index (VHI), and side effects eight weeks after treatment.

Results

The mean score of VVA in both groups improved significantly during eight-week, and the difference between the groups was not statistically significant [Adjusted mean difference (AMD): 0.63, 95% Confidence interval (CI) − 1.03–2.28, p = 0.449]. The mean score of OABS decreased significantly in both groups, and the difference between the groups was not statistically significant [AMD: 0.261, 95% CI − 1.278–1.799, p = 0.736]. The mean score of VHI increased significantly in both groups, and the difference between the groups was not significant [AMD: 0.64, 95% CI − 0.13–1.42, p = 0.101].

Conclusion

Vaginal vitamin E cream may be an alternative to vaginal estrogen in the symptom relief of vaginal atrophy and OABS among postmenopausal women, especially those who cannot use hormone therapy.
Antibiotic resistance, biofilm formation, and virulence genes of Streptococcus agalactiae serotypes of Indian origin
Authors: Verma Shalini , Kumari Monika , Pathak Anurag , Yadav Vikas , Johri Atul Kumar , Yadav Puja
Published: July 2023

Background

Group B Streptococcus (GBS) is a causative agent of various infections in newborns, immunocompromised (especially diabetic) non-pregnant adults, and pregnant women. Antibiotic resistance profiling can provide insights into the use of antibiotic prophylaxis against potential GBS infections. Virulence factors are responsible for host–bacteria interactions, pathogenesis, and biofilm development strategies. The aim of this study was to determine the biofilm formation capacity, presence of virulence genes, and antibiotic susceptibility patterns of clinical GBS isolates.

Results

The resistance rate was highest for penicillin (27%; n = 8 strains) among all the tested antibiotics, which indicates the emergence of penicillin resistance among GBS strains. The susceptibility rate was highest for ofloxacin (93%; n = 28), followed by azithromycin (90%; n = 27). Most GBS strains (70%; n = 21) were strong biofilm producers and the rest (30%; n = 9) were moderate biofilm producers. The most common virulence genes were cylE (97%), pavA (97%), cfb (93%), and lmb (90%). There was a negative association between having a strong biofilm formation phenotype and penicillin susceptibility, according to Spearman’s rank correlation analysis.

Conclusion

About a third of GBS strains exhibited penicillin resistance and there was a negative association between having a strong biofilm formation phenotype and penicillin susceptibility. Further, both the strong and moderate biofilm producers carried most of the virulence genes tested for, and the strong biofilm formation phenotype was not associated with the presence of any virulence genes.
Effects of editing DFR genes on flowers, leaves, and roots of tobacco
Authors: Jiang Jiarui , Huang Haitao , Gao Qian , Li Yong , Xiang Haiying , Zeng Wanli , Xu Li , Liu Xin , Li Jing , Mi Qili , Deng Lele , Yang Wenwu , Zhang Jianduo , Yang Guangyu , Li Xuemei
Published: July 2023

Background

DFR is a crucial structural gene in plant flavonoid and polyphenol metabolism, and DFR knockout (DFR-KO) plants may have increased biomass accumulation. It is uncertain whether DFR-KO has comparable effects in tobacco and what the molecular mechanism is. We employed the CRISPR/Cas9 method to generate a knockout homozygous construct and collected samples from various developmental phases for transcriptome and metabolome detection and analysis.

Results

DFR-KO turned tobacco blossoms white on homozygous tobacco (Nicotiana tabacum) plants with both NtDFR1 and NtDFR2 knockout. RNA-seq investigation of anthesis leaf (LF), anthesis flower (FF), mature leaf (LM), and mature root (RM) variations in wild-type (CK) and DFR-KO lines revealed 2898, 276, 311, and 101 differentially expressed genes (DEGs), respectively. DFR-KO primarily affected leaves during anthesis. According to KEGG and GSEA studies, DFR-KO lines upregulated photosynthetic pathway carbon fixation and downregulated photosystem I and II genes. DFR-KO may diminish tobacco anthesis leaf photosynthetic light reaction but boost dark reaction carbon fixation. DFR-KO lowered the expression of pathway-related genes in LF, such as oxidative phosphorylation and proteasome, while boosting those in the plant–pathogen interaction and MAPK signaling pathways, indicating that it may increase biological stress resistance. DFR-KO greatly boosted the expression of other structural genes involved in phenylpropanoid production in FF, which may account for metabolite accumulation. The metabolome showed that LF overexpressed 8 flavonoid metabolites and FF downregulated 24 flavone metabolites. In DFR-KO LF, proteasome-related genes downregulated 16 amino acid metabolites and reduced free amino acids. Furthermore, the DEG analysis on LM revealed that the impact of DFR-KO on tobacco growth may progressively diminish with time.

Conclusion

The broad impact of DFR-KO on different phases and organs of tobacco development was thoroughly and methodically investigated in this research. DFR-KO decreased catabolism and photosynthetic light reactions in leaves during the flowering stage while increasing carbon fixation and disease resistance pathways. However, the impact of DFR-KO on tobacco growth steadily declined as it grew and matured, and transcriptional and metabolic modifications were consistent. This work offers a fresh insight and theoretical foundation for tobacco breeding and the development of gene-edited strains.
Elevated non-HDL-C/HDL-C ratio increases the 1-year risk of recurrent stroke in older patients with non-disabling ischemic cerebrovascular events: results from the Xi’an Stroke Registry Study of China
Authors: Liu Zhongzhong , Lin Xuemei , Zeng Lingxia , Zhang Huan , Guo Weiyan , Lu Qingli , Huang Congli , Wang Jing , Liu Pei , Chang Qiaoqiao , Zhang Mi , Huo Yan , Wang Yan , Wang Fang , Wu Songdi
Published: July 2023

Background

Few studies have explored the prognostic role of nontraditional lipid-related indicators in non-disabling ischemic cerebrovascular events (NICE). In this study, we aimed to investigate the relationship between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (non-HDL-C/HDL-C) and the1-year risk of recurrent stroke in patients with NICE.

Methods

Total cholesterol (TC), HDL-C, and patient information were collected at admission. Recurrent stroke events were followed up 3, 6, and 12 months after onset. Non-HDL-C levels were calculated by subtracting HDL-C from TC. The non-HDL-C/HDL-C ratio was treated as a continuous variable and in quartiles (Q1–Q4). Stratified multivariate Cox regression was used to investigate the relationship between the non-HDL-C/HDL-C ratio and the 1-year risk of recurrent stroke in patients with NICE.

Results

Overall, 1,659 patients with NICE were enrolled. For each unit increase in the non-HDL-C/HDL-C ratio, the 1-year risk of recurrent stroke in patients aged ≥ 65 years (older patients) with NICE increased by 64% in the adjusted model (hazard ratio [HR]: 1.64, 95%confidence interval [CI]:1.18–2.27, P = 0.003), and the HRs were 3.21 and 4.24 times higher in the Q3 and Q4 groups than that in the Q1 group, which was considered to be the reference (adjusted model Q3: HR: 3.21, 95%CI: 1.05–9.83, P = 0.041; adjusted model Q4: HR: 4.24, 95%CI: 1.30–13.85, P = 0.017). However, there was no significant difference in patients younger than 65 years. Both curve fitting and Kaplan–Meier cumulative risk analysis showed that an elevated non-HDL-C/HDL-C ratio significantly increased the 1-year risk of recurrent stroke in older patients with NICE. The optimal range for the non-HDL-C/HDL-C ratio should be no higher than the Q2 group (2.256–2.939). Stratified Cox regression analysis showed that these results tended to be stable for different comorbidities (all P for interaction > 0.05).

Conclusions

Elevated non-HDL-C/HDL-C ratios significantly increased the 1-year risk of recurrent stroke in older patients with NICE. Therefore, clinicians need to pay more attention to this indicator when managing older patients with NICE.
A method of motion estimation of segmental ventricular wall with tracking of ultrasonic echocardiogram
Authors: Liu Shanna , Zhang Hao , Li Chang , Dai Weifang , Wu Jinyu , Wu Yuanyuan , Su Wenwen , Xia Bin , Zhou Jiayu , Shen Yuqiang , Zhu Xinjian
Published: July 2023

Background

Ultrasonic echocardiography is commonly used for monitoring myocardial dysfunction. However, it has limitations such as poor quality of echocardiography images and subjective judgment of doctors.

Methods

In this paper, a calculation model based on optical flow tracking of echocardiogram is proposed for the quantitative estimation motion of the segmental wall. To improve the accuracy of optical flow estimation, a method based on confidence-optimized multiresolution(COM) optical flow model is proposed to reduce the estimation errors caused by the large amplitude of myocardial motion and the presence of “shadows” and other image quality problems. In addition, motion vector decomposition and dynamic tracking of the ventricular region of interest are used to extract information regarding the myocardial segmental motion. The proposed method was validated using simulation images and 50 clinical cases (25 patients and 25 healthy volunteers) for myocardial motion analysis.

Results

The results demonstrated that the proposed method could track the motion information of myocardial segments well and reduce the estimation errors of optical flow caused due to the use of low-quality echocardiogram images.

Conclusions

The proposed method improves the accuracy of motion estimation for the cardiac ventricular wall.
Association between physical activity education and prescription during prenatal care and maternal and fetal health outcomes: a quasi-experimental study
Authors: Saidi Latifa , Godbout Pierre D. , Morais-Savoie Camille , Registe Pierre Philippe Wilson , Bélanger Mathieu
Published: July 2023

Background

Physical activity (PA) during pregnancy is associated with healthy gestational weight gain (GWG) and a reduced risk of developing gestational diabetes (GD), gestational hypertension (GHT) and fetal macrosomia. However, in Canada, less than 20% of pregnant women meet PA recommendations. This study assessed associations between an intervention including PA education by prenatal nurses and a PA prescription delivered by physicians and fetal and maternal outcomes.

Methods

This is a quasi-experimental study. Two groups of women who received their prenatal care at the obstetrics clinic of a university hospital were created. In the first group, 394 pregnant women followed at the clinic received standard care. In the second group, 422 women followed at the clinic received standard care supplemented with education on the relevance of PA during pregnancy and a prescription for PA. Data for both study groups were obtained from the medical records of the mothers and their newborns. Logistic regressions were used to compare the odds of developing excessive GWG, GD, GHT, and fetal macrosomia between the two study groups.

Results

The addition of PA education and PA prescription to prenatal care was associated with 29% lower odds of developing excessive GWG (adjusted odds ratios (OR) 0.71, 95% confidence intervals (CI) 0.51–0.99), 73% lower odds of developing GHT (0.27, 0.14–0.53), 44% lower odds of fetal macrosomia (> 4 kg) (0.56, 0.34–0.93), and 40% lower odds of being large for gestational age (0.60, 0.36–0.99). The intervention was not associated with a difference in odds of developing GD (0.48, 0.12–1.94).

Conclusions

The inclusion of education and prescription of PA as part of routine prenatal care was associated with improvements in maternal and fetal health outcomes, including significantly lower odds of GWG, GHT and macrosomia.
Developing tumor-specific PRO-CTCAE item sets: analysis of a cross-sectional survey in three German outpatient cancer centers
Authors: Günther Maximilian , Hentschel Leopold , Schuler Markus , Müller Theresa , Schütte Katharina , Ko Yon-Dschun , Schmidt-Wolf Ingo , Jaehde Ulrich
Published: July 2023

Background

To include the patient perspective in the assessment of adverse events in oncology, a patient-reported outcomes (PRO) version of the Common Terminology Criteria for Adverse Events (CTCAE) was developed by the US National Cancer Institute, the so called PRO-CTCAE. The objective of this study was the development of disease-specific PRO-CTCAE item sets for patients with breast cancer (BC), multiple myeloma (MM), and prostate cancer (PC).

Methods

The cross-sectional survey was conducted at three German outpatient cancer centers. Prevalence and importance of the 78 PRO-CTCAE symptoms were assessed using a patient questionnaire. To select the most relevant PRO-CTCAE items for each tumor entity, symptoms were ranked based on patient answers.

Results

101 patients with BC, 107 with MM, and 66 with PC participated. The final item sets contained 21 symptoms (BC) or 19 symptoms (MM and PC), respectively. Eight symptoms (fatigue, muscle pain, insomnia, joint pain, general pain, dizziness, shortness of breath, and swelling) were represented in all three item sets. Fatigue was the symptom with the highest ranking across item sets followed by insomnia. Symptoms with the highest rankings represented in only one item set were symptoms affecting the urogenital system in the PC item set, blurred vision in the BC item set, and decreased appetite in the MM item set.

Conclusions

Individual PRO-CTCAE item sets for a German patient population were developed for the three tumor entities on the basis of patients’ differences in symptom profiles and perceptions. The quality and psychometric criteria of the newly compiled item sets should be evaluated in validation studies.
Treatment compliance among adult cervical cancer patients receiving care at Uganda cancer institute, Uganda: a retrospective data review
Authors: Najjemba Josephine Irene , Ndagire Regina , Mulamira Pius , Kibudde Solomon , Lwanira Catherine Nassozi
Published: July 2023

Background

Cervical cancer is one of the most common cancers and a major cause of morbidity among women globally. Chemoradiation therapy is the preferred standard treatment for women with stage IB to IVA. However, the benefits of this treatment can only be achieved if patients adhere to the treatment guidelines. In this study, the proportion of compliance or adherence to chemo-radiation treatment among cervical cancer patients at Uganda Cancer Institute (UCI) was determined.

Methods

This was a cross-sectional study that reviewed data retrospectively for 196 cervical cancer patients who were prescribed to chemo-radiation therapy at UCI between November 2020 to May 2021, having been diagnosed with disease stage IB to IVA. Patient data and information on treatment uptake was obtained by review of the patient’s medical records. Treatment compliance was determined by calculating the number of participants who completed the prescribed treatment (definitive pelvic concurrent chemoradiation to 50 Gy external beam radiotherapy with weekly concurrent cisplatin followed by intracavitary brachytherapy 24 Gy in 3 fractions at 8 Gy once a week over 3 weeks). Associations between patient factors and treatment adherence were determined using logistic regression analysis. In all statistical tests, a P- value of < 0.05 was considered as significant.

Results

The proportion of patients who were administered with external beam radiation (EBRT), chemotherapy and brachytherapy were 82.6%, 52.04% and 66.2% respectively. However, only 23 of 196 patients (11.7%) were found to have adhered to the treatment plan by completion of all definitive pelvic concurrent chemoradiation to 50 Gy external beam radiotherapy (5 weeks) with weekly concurrent cisplatin (5 cycles) followed by intracavitary brachytherapy 24 Gy in 3 fractions at 8 Gy once a week over 3 weeks (3 sessions). There were no significant associations between patient factors and treatment adherence after multivariable analysis.

Conclusions

Treatment compliance was found in only 12% of the cohort participants. No association of patient factors with treatment compliance was found. Additional studies on treatment adherence with larger sample sizes are needed to confirm the associations.
The government of masks in sentinel territories against Covid-19: Dakar and Seine-Saint-Denis
Authors: Keck Frédéric , Macia Enguerran
Published: July 2023

The pandemic of Covid-19 has led to reluctance or resistance to wear a mask in countries that made it compulsory. The acceptance to wear a mask against respiratory diseases depends on conceptions of scientific authority and of the personality in the public space. It has material and symbolic dimensions that can be covered under the term “government of masks”. We have questioned populations on these two aspects in territories we call sentinel because they are more exposed than others to emerging infectious diseases: Dakar (Senegal) and Seine-Saint-Denis (France). In France, school students have asked 250 people in public places on their perception of masks following a questionnaire, while in Senegal a team of master students went in 606 people’s houses to ask questions following the same questionnaire. Despite these methodological differences, our results show that the perception of the State in these territories influences the uses of masks against Covid-19 at symbolic and material levels. While in Seine-Saint-Denis, the State provides more masks than in Dakar, the trust in the efficacy of mask wearing is lower. From a symbolic point of view, the mask is for many people an intrusion of the State into the private sphere, which hinders physical contact between family members. On the contrary, from the material point of view, the mask is a need that manifests the presence of the welfare State to watch over the health of the population. This comparative study suggests that a State that is at the same time coercive and protective produces a lower level of adherence to mask-wearing recommendations than a State where religious authorities are included in the prescription and where individuals contribute to making masks.