bluuebunny/crossref_metadata_2025 huggingface dataset:
Gestão de risco em acordo de cooperação
Authors: De Andrade Floren Corrêa , Roberto José Carlos Alves , Da Cunha Edileuza Lobato , De Lima Orlem Pinheiro , De Araújo Paulo César Diniz , Maduro Márcia Ribeiro , De Oliveira Júnior Nilson José
Published: June 2023

O presente artigo aborda a gestão de risco em acordos de cooperação. O objetivo geral foi analisar os desafios e oportunidades relacionados à gestão de risco em acordos de cooperação. Para alcançar esse objetivo, a metodologia utilizada foi uma revisão sistemática da literatura. Os principais resultados indicam que a gestão de risco em acordos de cooperação é essencial para minimizar a possibilidade de perda de recursos e tempo, garantir a continuidade do projeto e a confiança entre as partes. Gerando a seguinte pergunta “De que forma as práticas de gerenciamento de risco são empregadas em Acordo de Cooperação no setor público?” Além disso, foi possível identificar que, para uma gestão de riscos eficiente, é importante que os parceiros envolvidos no acordo de cooperação estabeleçam processos e procedimentos claros, bem como identifiquem os riscos e implementem medidas preventivas e corretivas.
Effect of Topical Application of Breast Milk on Episiotomy Wound Healing: A Quasi-experimental Study
Authors: Patel Anjali , Makwana Angelina , Tiwari Anjali
Published: June 2023

Introduction: Many mothers are given an episiotomy during a normal vaginal delivery. There are many alternative interventions used by the community to heal the episiotomy wound. Applying breast milk topically to a wound is simple, free of charge and has no side-effects. Breast milk contains therapeutic qualities that aid in the healing of wounds. Aim: To evaluate the effect of topical breast milk application on postpartum women’s episiotomy wound healing. Materials and Methods: This pretest, post-test quasi-experimental study was conducted in three selected health centres of Central Gujarat from February 2022 to March 2022. Using a pretest, posttest control group design, the quantitative quasi-experimental study design was used. A total of 40 postnatal women were recruited for experimental (20) and control group (20). Intervention of topical application of breast milk was offered two times a day for seven continuous days in experimental group and routine care was provided to participants in control group. Participants of experimental and control group was assessed using Redness, Edema, Ecchymosis, Discharge and Approximation (REEDA) scale on 1st, 3rd, 5th and 7th day. Descriptive and inferential statistics was applied to analyse the data. Results: A total 40 postnatal mothers participated in the present study with mean age of 23.05±3.80 years. Topical application of breast milk displayed positive effect on episiotomy wound healing in experimental group. The result exhibited that the experimental group’s episiotomy wound healing significantly improved (before: 14.75±0.55, after: 4.55±1.32) as compared to the control group (before: 14.65±0.59, after: 9.35±1.46). Conclusion: The study proved that there was a significant gradual healing of episiotomy wound after the use of breast milk topically in postpartum women. This also indicates that human breast milk can be an alternative strategy for accelerating episiotomy wound healing process.
Association of Low Serum Albumin Levels and its In-hospital Adverse Outcomes among Patients Presenting with Acute Coronary Syndrome in a Tertiary Care Hospital of West Bengal, India
Authors: Biswas Bichitra , Mani Kuntolika , Bari Ranajit , Ghosh Sandip , Jana Chanchal Kumar
Published: June 2023

Introduction: Acute Coronary Syndrome (ACS) is characterised by hypercoagulability and inflammation. In acute presentation of Ischaemic Heart Disease (IHD), like ACS, serum albumin may also play an important role. Many patients with ischaemic cerebrovascular accident, a condition similar to ACS, had low serum albumin. Aim: To estimate serum albumin levels in patient with ACS and its relation to hospital adverse outcome. Materials and Methods: The present prospective observational study was conducted in the Department of General Medicine at R.G. Kar Medical College and Hospital, West Bengal, India. The duration of the study was 18 months, from July 2019 to October 2020. Patients with ACS were included irrespective of age, sex, race and predisposing factors such as Hypertension (HTN), Diabetes Mellitus (DM), hyperthyroidism and dyslipidaemia. A total of 125 patients included and details such as relevant history, examination findings, laboratory investigation, Electrocardiography (ECG), Echocardiography (ECHO), chest X-ray Posteroanterior (PA) view were included. Chi-square test and logistic regression were applied. Results: A total of 94 (75.2%) patients were males. 49 (39.2%) study patients had DM. Total 10 (8%) patients presented with cardiac arrest at admission. In-hospital death was happened in 9 (7.2%) cases. 59 (47.2%) patients had normal serum albumin level (3.5-4.5). 61 (48.8%) had mild to moderate hypoalbuminaemia (2.5-3.5) and only 5 (4%) had severe hypoalbuminaemia (<2.5). Association of inhospital complication vs serum albumin level was statistically significant (p<0.0001). A multivariate logistic regression analysis showed that male gender (p-value=0.026), smoking (p-value=0.008), arrhythmia (p-value=0.002), increased creatinine (p-value=0.032) and hypoalbuminaemia (p<0.001) were statistically significant independent predictors of inhospital adverse outcomes. Conclusion: The low serum albumin level, measured immediately on hospital admission in ACS patients was associated with in-hospital complications, and when adjusted for other covariates, hypoalbuminaemia predicts in-hospital adverse outcome independently.
Significance of Plasma Thromboplastin Cell Block Technique as an Adjunct to Fine Needle Aspiration Cytology in Diagnosis of Breast Lesions
Authors: Sundari Sivagama , Raghavan Vijayashree , Kanna Rajesh
Published: June 2023

Introduction: Despite the fact that Fine Needle Aspiration Cytology (FNAC) has been widely utilised in the preoperative diagnosis of breast lumps, the Conventional Smears (CS) have drawbacks, including difficulty in understanding the pattern or architecture of the lesion, determining invasiveness, Immunohistochemistry (IHC), false positives, and false negatives. Cytologists advise using Cell Blocks (CB) to increase the diagnostic precision of FNAC. In this study, the significance of using Plasma Thromboplastin Cell Block (PTCB) routinely as an addition to CS in FNAC of palpable breast lesions. Aim: To determine the significance of PTCB as an adjunct in addition to CS to diagnose breast lesions. Materials and Methods: The present prospective observational study was conducted in the Department of Pathology, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India, between July 2021 and June 2022 on 30 samples of palpable breast lesions. From the fine needle aspirates, smears were prepared and stained with Leishman and Papanicolaou stains. The residual material in the hub was rinsed in saline. The plasma-thromboplastin method was used to prepare CB, and Haematoxylin and Eosin (H&E) sections were made. A point scoring system was used and findings were compared to histopathology. IHC markers namely Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal Growth Factor Receptor-2 (HER2), Proliferation marker Ki-67 was utilised wherever appropriate. The results were analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0. Results: Out of total 30 subjects, majority (n=9, 30%) were in the age group of 41-50 years. The mean scores of CS {background (0.93±0.25), cellularity (1.7±0.55), morphology (1.7±0.47) and architecture (1.03±0.32)} and PTCB {background (1.77±0.43), cellularity (1.77±0.48), morphology (1.8±0.48) and architecture (1.5±0.57)} were compared using the point scoring system. Though the mean scores of all four parameters were higher in PTCB than in CS, the statistically significant difference was seen in background (p-value=0.001) and architecture categories (p-value=0.0001). The PTCB finding as a screening test for predicting histopathological diagnosis showed a sensitivity of 94.44%, specificity of 100%, Positive Predictive Value (PPV) of 100%, Negative Predictive Value (NPV) of 92.3%, and 96.67% accuracy. IHC staining was feasible in CB and findings were comparable to biopsy. Conclusion: The routine use of PTCB technique in FNAC of breast lesions, along with smears, will aid in IHC, reducing diagnostic pitfalls, thereby reducing misdiagnosis and invasive procedures, particularly in suspicious for malignancy cases, which can lead to inappropriate radical treatment causing physical and psychological stress to patients.
Cleaning Efficacy of Regular, Orthodontic and Electric Toothbrushes around Orthodontic Brackets: An In-vitro Study
Authors: Rebekah R , Navaneethan R
Published: June 2023

Introduction: Plaque formation increases when mechanical disruption occurs in the oral cavity’s self-cleaning systems during fixed orthodontic therapy. Hence, it is imperative that oral prophylaxis must be performed with more care in orthodontic patients. This can be efficiently done with the help of toothbrushes. There are various types of toothbrushes such as regular, orthodontic and electric toothbrushes which are most commonly used by patients to maintain proper oral hygiene and prevent plaque accumulation. Aim: To identify which toothbrush has the best cleaning efficiency, when used around orthodontic brackets. Materials and Methods: This in-vitro study was conducted in the laboratory set-up at Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India. The study was conducted for a period of two weeks from 17th January 2022 to 30th January 2022, and used 24 permanent premolars extracted for orthodontic purposes which were divided into three groups: regular, orthodontic and electric toothbrushes. There were eight tooth samples in each group. Following premolar bracket bonding, a biofilm was formed around the teeth using E.faecalis culture in-vitro for three days. The samples were then carefully removed and treated with a disclosing agent before being put through a brushing simulation. The “Plaque index for Orthodontic Patients” (PIOP) index was used to estimate plaque scores before and after brushing based on how much biofilm was remaining on the tooth surfaces. Oneway Analysis of Variance (ANOVA) and Tukey's Post-hoc tests were used to determine the statistical significance. Results: The mean plaque scores after simulation in the toothbrush groups were 3±0.75 (regular), 1.75±0.70 (orthodontic) and 2.37±0.74 (electric). There was a statistically significant difference in mean plaque scores between groups as determined by one-way ANOVA {F(p=0.008)}. A Tukey's Post-hoc test revealed that the cleaning efficacy of orthodontic toothbrushes was statistically significant compared to the other two groups. Conclusion: The orthodontic toothbrushes produced a statistically greater level of tooth-cleaning effectiveness.
Electrocardiographic Changes among Moderate and Severe COVID-19 Patients in a Tertiary Care Teaching Hospital at Shahdol, Madhya Pradesh, India: A Record-based Study
Authors: Gupta Rupesh Kumar , Sharma Jeetendra , Agrawal Roopa , Sahu Rupesh , Chenchula Santenna , Pathak Pradeep Kumar
Published: June 2023

Introduction: Electrocardiographic (ECG) abnormalities in Coronavirus Disease 2019 (COVID-2019) patients are largely unknown. ECG changes in COVID-19 disease may guide to initiate therapeutic anticoagulation, more so in moderate and severe disease. Aims: To identify various ECG changes in moderate and severe COVID-19 patients and to ascertain the association between initial ECG changes and disease outcome. Materials and Methods: This was retrospective record-based study was conducted in the Department of Internal Medicine, Birsa Munda Medical College, Shahdol, Madhya Pradesh, India, on 216 patients with laboratory-confirmed COVID-19 in a tertiary care teaching hospital from March 2021 to June 2021. Demographic and clinical data including ECG were extracted from medical records of the patients and if needed, the patients were followed-up till outcome. COVID-19 disease severity was considered based on oxygen saturation at room air (moderate: 94%-90%; severe: <90%). Data were entered using the Epicollect5 mobile application to minimise errors. Results: A total of 216 patients were included (35 to 54 years), the majority were male. Mortality rate was 46.3%. Total 57.4% of ECG changes were classified as abnormal. Sinus tachycardia was the most common abnormality followed by ischaemic changes. Left axis deviation in ECG was more commonly seen than right axis deviation. Total 53.2% of patients with abnormal ECG findings and 36.9% with normal ECG findings died. Mortality was very high in patients with ischaemic changes. Conclusion: COVID-19 patients with ischaemic changes in ECG were significantly associated with increased mortality. Hence, early detection of these changes in COVID-19 patients is vital and will help primary care physicians to intervene early and help in deciding therapeutic anticoagulation requirements in patients with COVID-19.
Exploring Women Tea Plantation Workers' Interest in Varied Income-Generating Activities and Decision Making Pattern in Jorhat District of Assam
Authors: Jumi Toko , Borah Sayanika , Saikia Anadi Ranjan , Borah Monsumi , Saikia Bhaskar
Published: June 2023

The present study was carried out in Jorhat district of Assam. Four (4) tea gardens under public corporation from Jorhat sub-division were selected using purposive sampling method. A total of 100 women tea plantation workers were selected for the present study. It was found that majority of the household decisions were taken jointly by their husbands followed by independent decision. It was further found that respondents spent the majority of time (7.94 hours) in working at tea garden. The majority (51.00%) of the respondents were mostly interested in poultry farming followed by goat rearing (14.00%).
Modeling Maternal Factors for Predicting Birth Outcomes in Ghana
Authors: Baazand Atiah Dominic , Dioggban Jakperik , Mensah Engmann Gideon
Published: June 2023

This study was conducted to identify the various maternal and neonatal factors that influence birth outcomes. Maternal and neonatal factors are key determinants of birth outcomes and the health of a newborn baby is very crucial in the first six months of the baby’s life. Neonatal mortality and low birth weight are worrying problems for stakeholders in the health sector. Logistic regression and multilevel regression were used to study various factors that influence birth outcomes. Secondary data was therefore collected from the War Memorial Hospital, Navrongo for the purpose of the study. The results show that weight, birth weight, gestation weeks and hemoglobin were observed as significant risk factors for birth outcomes whilst age, weight, hemoglobin, mode of delivery and gestation weeks were identified as significant factors that influence birth weight. The study identified weight, hemoglobin, birth weight, gestation weeks and age as factors that influence birth outcomes in the Kassena-Nankana Municipality.
Intake of Fruits and Vegetables as Self Prescribed Weight Reducing and DASH Diets among Obese-Hypertensive Individuals Attending Irrua Specialist Teaching Hospital Irrua, Edo State, Nigeria
Authors: Babangida Peter M. , Ofili Charles , Peters Esegbue , Nwose Ezekiel U.
Published: June 2023

Background: Five servings of fruits and vegetables each day, along with relatively unprocessed whole grains or legumes with each meal, are essential for reducing the risk of obesity, hypertension and other related non communicable diseases. While being low or relatively low in calories, fruits and vegetables include a large amount of dietary fiber and a range of micronutrients, antioxidants and phytochemicals which are all essential for health.

Aims: To investigate the intake of fruits and vegetables as self prescribed weight reducing and DASH (Dietary Approach to Stop Hypertension) diets among obese - hypertensive individuals attending Irrua Specialist Teaching Hospital Irrua, Edo State.

Methods: A descriptive cross sectional study design was used with a sample size of 440 obese hypertensive individuals (with body mass index of = or > 30Kg/m2 and blood pressure of = or > 140/90mmHg). Questionnaires, personal interviews and anthropometric measurements were used to collect data using purposive sampling technique. Data collected were analyzed using Statistical Package for the Social Sciences (IBM SPSS) 22 Version.

Results: A total of 440 respondents were used in the study and data were elicited from all of this number giving a 100% response rate. A total of 242 (55.0%) and 215 (48.9%) of the respondents consumed fruits and vegetables only one to two days per week with only 36 (8.2%) and 26 (5.9%) consuming fruits and vegetables every day.

Conclusion: It can be concluded based on the key findings of this study that there is statistically significant mean difference in fruits and vegetables consumption amongst obese - hypertensive individuals attending Irrua Specialist Teaching Hospital, Edo State, Nigeria (p<0.05).
Biosimilars for the Treatment of Psoriasis
Authors: Phan Duc Binh , Elyoussfi Sarah , Stevenson Michael , Lunt Mark , Warren Richard B. , Yiu Zenas Z. N.
Published: May 2023

Importance

Biosimilars have the potential to reduce costs for the management of moderate-to-severe psoriasis compared with originators. However, the extrapolation of evidence enables the approval of a biosimilar for use in indications held by the originator without directly being studied in clinical trials. Thus, biosimilars can be approved for psoriasis based on extrapolated evidence from other diseases. The availability of evidence for the effectiveness and safety of biosimilars for the treatment of psoriasis is therefore unclear.

Objective

To compare the efficacy/effectiveness and safety of biosimilars with originator biologics for the treatment of patients with psoriasis.

Evidence Review

MEDLINE, EMBASE, Cochrane Library, ClinicalTrials.gov, and The European Union Clinical Trials Register were searched in August 2022. Eligible studies were appraised using the Cochrane Risk of Bias 2 and ROBINS-I tools. All analyses were conducted from September 2022 to November 2022.

Findings

Fourteen trials (10 adalimumab, 2 etanercept, 1 infliximab, and 1 ustekinumab) and 3 cohort studies (1 adalimumab, 1 etanercept, 1 infliximab and etanercept) were included. Twelve trials compared biosimilars with originators in originator-naive patients (starters), and 11 trials compared switching from originator to biosimilar (switchers) with continuous originator treatments. There was no clinically or statistically significant difference in rates of achieving 75% improvement in Psoriasis Area and Severity Index scores and risks of adverse events (AEs) at week 16 and week 52 between the comparators. Two cohort studies showed no difference in effectiveness and safety outcomes between originators and biosimilars, whereas 1 study reported more AEs in patients who switched to biosimilars of adalimumab at 12 months. Three trials showed low risk of bias, whereas 11 trials had moderate risk of bias. All cohort studies had moderate to high risk of bias.

Conclusions and Relevance

In this systematic review, there was no clinically or statistically significant difference in the efficacy and safety between biosimilars and originators for the treatment of patients with psoriasis. Most of the available evidence was based on randomized clinical trials, although high-quality real-world evidence was lacking. Future studies are needed to examine the long-term effectiveness and safety of biosimilars for the treatment of patients with psoriasis.
Weekly Adaptive Radiotherapy vs Standard Intensity-Modulated Radiotherapy for Improving Salivary Function in Patients With Head and Neck Cancer
Authors: Castelli Joël , Thariat Juliette , Benezery Karen , Hasbini Ali , Gery Bernard , Berger Antoine , Liem Xavier , Guihard Sébastien , Chapet Sophie , Thureau Sébastien , Auberdiac Pierre , Pommier Pascal , Ruffier Amandine , Perrier Lionel , Devillers Anne , Campillo-Gimenez Boris , de Crevoisier Renaud
Published: June 2023

Importance

Xerostomia is a major toxic effect associated with intensity-modulated radiotherapy (IMRT) for oropharyngeal cancers.

Objective

To assess whether adaptive radiotherapy (ART) improves salivary function compared with IMRT in patients with head and neck cancer.

Design, Setting, and Participants

This phase 3 randomized clinical trial was conducted in 11 French centers. Patients aged 18 to 75 years with stage III-IVB squamous cell oropharyngeal cancer treated with chemoradiotherapy were enrolled between July 5, 2013, and October 1, 2018. Data were analyzed from November 2021 to May 2022.

Interventions

The patients were randomly assigned (1:1) to receive standard IMRT (without replanning) or ART (systematic weekly replanning).

Main Outcomes and Measures

The primary end point was the frequency of xerostomia, measured by stimulating salivary flow with paraffin. Secondary end points included salivary gland excretory function measured using technetium-99m pertechnetate scintigraphy, patient-reported outcomes (Eisbruch xerostomia-specific questionnaire and the MD Anderson Symptom Inventory for Head and Neck Cancer questionnaire), early and late toxic effects, disease control, and overall and cancer-specific survival.

Results

A total of 132 patients were randomized, and after 1 exclusion in the ART arm, 131 were analyzed: 66 in the ART arm (mean [SD] age at inclusion, 60 [8] years; 57 [86.4%] male) and 65 in the standard IMRT arm (mean [SD] age at inclusion, 60 [8] years; 57 [87.7%] male). The median follow-up was 26.4 months (IQR, 1.2-31.3 months). The mean (SD) salivary flow (paraffin) at 12 months was 630 (450) mg/min in the ART arm and 584 (464) mg/min in the standard arm (P = .64). The mean (SD) excretory function of the parotid gland at 12 months, measured by scintigraphy, improved in the ART arm (48% [17%]) compared with the standard arm (41% [17%]) (P = .02). The 2-year-overall survival was 76.9% (95% CI, 64.7%-85.4%) in both arms.

Conclusions and Relevance

This randomized clinical trial did not demonstrate a benefit of ART in decreasing xerostomia compared with standard IMRT. No significant differences were found in secondary end points except for parotid gland excretory function, as assessed by scintigraphy, or in survival rates.

Trial Registration

ClinicalTrials.gov Identifier: NCT01874587
Approaches to Continuing COVID-19–Related Clinical Research Practices After the Pandemic—Must Cinderella Leave the Ball?
Authors: Gerber David E. , Barksdale Elizabeth K. S.
Published: June 2023

This Viewpoint reviews relevant components of federal regulation and guidance followed during the COVID-19 pandemic that may still be feasible and beneficial after the public health emergency ends.
Bibliometric Analysis of Ophthalmic Journals
Authors: Nichols Jason J. , Morgan Philip B. , Jones Lyndon W. , Efron Nathan
Published: June 2023

Importance

The primary vehicle for reporting and testing advances in eye care is refereed ophthalmic journals, which can be characterized using targeted bibliometric analyses.

Objective

To identify all ophthalmic journals and evaluate citation metrics relating to articles, journals, authors, institutions, and countries published therein.

Design and Setting

A bibliometric analysis was undertaken of all ophthalmic journals included in the Scopus database (Elsevier). The search was restricted to all article types published in ophthalmic journals in English from inception through November 18, 2022. After excluding general medical journals, journals published in a language other than English, and spurious titles unrelated to the ophthalmic field, the Scopus database was found to list 335 ophthalmic journal titles that have published 471 184 articles, constituting the data set for this analysis. The 20 most highly cited articles were identified. Rank-order lists by article count were assembled for journals, authors, institutions, and countries.

Main Outcomes and Measures

An h-index for ophthalmic journal articles was derived from citations and article counts for each constituent of each category.

Results

The h-index for ophthalmic journal articles was determined to be 494. The journal with the highest h-index was Ophthalmology (h-index, 297). The journal with the greatest number of articles was American Journal of Ophthalmology (38 441 articles). The most highly cited article was by Quigley and Broman, 2006 (5147 citations), concerning the epidemiology of glaucoma. The author with the highest h-index for ophthalmic journal articles was Ronald Klein, MD (h-index, 126), and the most prolific was Carol L. Shields, MD (1400 articles). Johns Hopkins University (h-index, 215) was the institution with the highest h-index for ophthalmic journal articles, and Harvard University was the most prolific (10 071 articles). The United States was the nation with the highest h-index for ophthalmic journal articles (h-index, 444) and was the most prolific (180 017 articles).

Conclusions and Relevance

In this study, the most highly cited articles published in ophthalmic journals were revealed, as well as the leading journals, authors, institutions, and countries. While excluding ophthalmology articles in general medical journals, this investigation affords a means of identifying highly cited authors, institutions, and countries which individuals or institutions can use as a guide regarding contributions to the field.
The FGFR inhibitor PD173074 binds to the C‐terminus of oncofetal HMGA2 and modulates its DNA‐binding and transcriptional activation functions
Authors: Ahmed Syed Moiz , Ragunathan Priya , Shin Joon , Peter Sabrina , Kleissle Sabrina , Neuenschwander Martin , Schäfer Reinhold , Kries Jens Peter V. , Grüber Gerhard , Dröge Peter
Published: June 2023

The architectural chromatin factor high‐mobility group AT‐hook 2 (HMGA2) is causally involved in several human malignancies and pathologies. HMGA2 is not expressed in most normal adult somatic cells, which renders the protein an attractive drug target. An established cell‐based compound library screen identified the fibroblast growth factor receptor (FGFR) inhibitor PD173074 as an antagonist of HMGA2‐mediated transcriptional reporter gene activation. We determined that PD173074 binds the C‐terminus of HMGA2 and interferes with functional coordination of the three AT‐hook DNA‐binding domains mediated by the C‐terminus. The HMGA2‐antagonistic effect of PD173074 on transcriptional activation may therefore result from an induced altered DNA‐binding mode of HMGA2. PD173074 as a novel HMGA2‐specific antagonist could trigger the development of derivates with enhanced attributes and clinical potential.
Epigenome‐wide DNA methylation analysis of myasthenia gravis
Authors: Lin Jingjing , Tao Linshuang , Deng Lu , Zhou Ruyi , Lou Shuyue , Chen Songfang , Chen Xuanyu , Lu Chunxing , Li Peijun , Hu Beilei
Published: May 2023

Myasthenia gravis (MG) is a common neuromuscular junction disorder and autoimmune disease mediated by several antibodies. Several studies have shown that genetic factors play an important role in MG pathogenesis. To gain insight into the epigenetic factors affecting MG, we report here genome‐scale DNA methylation profiles of MG. DNA was extracted from eight MG patients and four healthy controls for genome‐wide DNA methylation analysis using the Illumina HumanMethylation 850K BeadChip. Verification of pyrosequencing was conducted based on differential methylation positions. Subsequently, C2C12 and HT22 cell lines (derived from mouse) were treated with demethylation drugs. Transcribed mRNA of the screened differential genes was detected using quantitative real‐time PCR. The control and MG group were compared, and two key probe positions were selected. The corresponding genes were CAMK1D and CREB5 (P < 0.05). Similarly, the myasthenic crisis (MC) and non‐MC group were compared and four key probe positions were selected. The corresponding genes were SAV1, STK3, YAP1, and WWTR1 (P < 0.05). Subsequently, pyrosequencing was performed for verification, revealing that hypomethylation of CAMK1D was significantly different between the MG and control group (P < 0.001). Moreover, transcription of CREB5, PKD, YAP1, and STK3 genes in the C2C12 cells was downregulated (P < 0.05) after drug treatment, but only YAP1 mRNA was downregulated in HT22 cells (P < 0.05). This is the first study to investigate genome‐scale DNA methylation profiles of MG using 850 K BeadChip. The identified molecular markers of methylation may aid in the prevention, diagnosis, treatment, and prognosis of MG.
In Situ Co‐transformation of Reduced Graphene Oxide Embedded in Laser‐Induced Graphene and Full‐Range On‐Body Strain Sensor
Authors: Yoon Hyosang , Lee Kyoungryul , Shin Hanho , Jeong Seongeun , Lee Yi Jae , Yang Sungwook , Lee Soo Hyun
Published: June 2023

On‐body strain information provides various indicators such as heart rate, physiological pulse, voice waveform, respiratory rate, and body motion status. Recent advances in wearable strain sensors using nanomaterials have significantly enhanced sensor performance with regard to sensitivity, detectable range, and response time. However, it is still challenging to obtain all types of body strain information, from small vibrations to joint movements, using one type of sensor. Herein, a full‐range on‐body strain (FROS) sensor covering ultrasmall‐to‐large strains such as vocal vibration and joint movement is reported. To achieve an ultrawide detectable range, reduced graphene oxide (rGO)‐embedded laser‐induced graphene (LIG) is synthesized by laser engraving on a graphene oxide (GO)‐embedded polyimide (PI) complex film. An rGO‐LIG homostructure based on sp2‐carbons is photothermally reconstructed from the GO‐PI heterostructure in a complex film by in situ co‐transformation and then transferred to an elastomer substrate. The fabricated FROS sensor successfully performs on‐body strain monitoring of various indicators, such as physiological pulse, vocal sound waveform, and body movement, as well as American sign language translation. Furthermore, it is believed that this rGO‐LIG homostructure‐based material synthesized by in situ co‐transformation can potentially provide novel functionalities in fields such as wearable electronics, humanoid, soft robotics, and intelligent prosthetics.
Autonomous Self‐Sustained Liquid Crystal Actuators Enabling Active Photonic Applications
Authors: Zheng Ren , Ma Lingling , Feng Wei , Pan Jintao , Wang Zeyu , Chen Zhaoxian , Zhang Yiheng , Li Chaoyi , Chen Peng , Bisoyi Hari Krishna , Li Bingxiang , Li Quan , Lu Yanqing
Published: May 2023

Advances in biomimicry have led to the rise of advanced robotics, posing promising revolutions across a variety of fields. Programmable self‐sustained actuation in nature, such as human's heart beating, bird's wingbeats, and penguin's waddling, are intriguing and inspiring but challenging for device innovation, which hinders the emergence of autonomous self‐feedback applications, especially in optics and photonics. Herein, the design, fabrication, and operation of crosslinked liquid crystal actuators are described that combine the programming of microstructures and the engineering of macroscopic shape morphing for active optics and photonics. The actuators consist of twisted nematic liquid crystal molecules with both elastic and optical anisotropies, resulting in large bending deformations in response to heat. Programmable bending motions and self‐sustained waddling oscillations are demonstrated, further contributing to the achievements of dynamic 2D beam steering and self‐sustained light field modulation. It is envisioned that these actuators with self‐sustained performances without requiring turning the stimulus on‐off will find applications in autonomous active optical systems, photonic applications, as well as self‐governing robotics with the core feature of thermo‐mechanical‐optical transduction.
Modeling of Void‐Mediated Cracking and Lithium Penetration in All‐Solid‐State Batteries
Authors: Wang Wei , Wang Jiaxuan , Lin Chen , Ruan Haihui
Published: June 2023

All‐solid‐state batteries (ASSBs) are expected to have an exceptional energy density and safety owing to the possibilities of direct usage of lithium as an anode and the suppression of dendrites by a solid‐state electrolyte (SSE). However, recent experiments unveil discharging‐induced voids in lithium‐SSE interfaces and charging‐induced cracks in SSE, wherein lithium penetration occurs. To avoid such cell failures, a theoretical model rendering high‐credibility simulations is needed to assist ASSB designs. Herein, such a model coupling the electrochemical processes and mechanical responses of an ASSB are proposed, in which the kinetics of voids and cracks are the key ingredients. Numerical simulations based on the model reveal that void growth is the result of stripping with disparate diffusivity in the surface layer and the bulk of lithium. They bring about the non‐uniform distribution of Li+ during electroplating, a damage zone near the interface, SSE cracking, and then lithium plating in the cracks. It is noted that the cracks and lithium dendrites revealed by the simulations are very similar to those observed in in situ experiments and that a high stack pressure cannot inhibit cracking and lithium penetration. Instead, suitable lateral compressive stresses can prevent SSE from cracking and therefore inhibit lithium dendrites.
Defining Integrin Tension Required for Chemotaxis of Metastatic Breast Cancer Cells in Confinement
Authors: Kim Young , Tram Le Thi Hong , Kim Kyung Ah , Kim Byoung Choul
Published: May 2023

Cancer metastasis is affected by chemical factors and physical cues. From cell adhesion to migration, mechanical tension applied to integrin expresses on the cell membrane and physical confinement significantly regulates cancer cell behaviors. Despite the physical interplay between integrins in cells and ligands in the tumor microenvironment, quantitative analysis of integrin tension during cancer cell migration in microconfined spaces remains elusive owing to the limited experimental tools. Herein, a platform termed microconfinement tension gauge tether to monitor spatial integrin tension with single‐molecule precision by analyzing the epithelial‐growth‐factor‐induced chemotaxis of metastatic human breast cancer cells in microfluidic channels is developed. The results reveal that the metastatic cancer cells exert the strongest integrin tension in the range of 54–100 pN at the leading edges of cells during chemokinetic migration on a planar surface, while the cells exert the strongest integrin tension exceeding 100 pN at the cell rear when entering microconfinement. Further analysis demonstrates that cells undergo mesenchymal migration under high integrin tension and less confinement, which is converted to amoeboid migration under low integrin tension or high confinement. In summary, the results identify a basic mechanism underlying the mechanical interactions between integrin tension and microenvironment that determines cancer invasion and metastasis.
SrCuSi4O10/GelMA Composite Hydrogel‐Mediated Vital Pulp Therapy: Integrating Antibacterial Property and Enhanced Pulp Regeneration Activity
Authors: Qiu Yu , Tian Jun , Kong Siyi , Feng Yanping , Lu Yangyu , Su Lefeng , Cai Yanling , Li Mengjie , Chang Jiang , Yang Chen , Wei Xi
Published: June 2023

Vital pulp therapy (VPT) is considered a conservative treatment for preserving pulp viability in caries‐induced dental pulp infections. However, bacterial contamination negatively affects dentine‐pulp complex repair. The common capping materials show limited antimicrobial effects against some microorganisms. To improve the VPT efficacy, capping materials with increased antibacterial properties and enhanced odontogenic and angiogenic activities are needed. Herein, a SrCuSi4O10/gelatin methacrylate(SC/Gel) composite hydrogel has been proposed for infected dental pulp treatment. SrCuSi4O10 (SC) is a microscale bioceramic composed of assembled multilayered nanosheets that possesses good near‐infrared photothermal conversion ability and multiple bioactivities due to sustained Sr2+, Cu2+, and SiO32− ion release. It is shown that the SC/Gel composite hydrogel efficiently eliminates Streptococcus mutans and Lactobacillus casei and inhibits biofilm formation under photothermal heating, while the ion extract from SC promotes odontogenesis of rat dental pulp stem cells and angiogenesis of human umbilical vein endothelial cells. The as‐designed therapeutic effect of SC/Gel composite hydrogel‐mediated VPT has been proven in a rat dental pulp infection model and yielded improved dentine‐pulp complex repair compared with the commercially used iRoot® BP Plus. This study suggests that the SC/Gel composite hydrogel is a potential pulp‐capping material with improved effects on dentine−pulp complex repair in infected pulp.
A Non‐G‐Quadruplex DNA Aptamer Targeting NCL for Diagnosis and Therapy in Bladder Cancer
Authors: Liu Yunyi , Hu Bei , Pei Xiaming , Li Juan , Qi Dan , Xu Yuxi , Ou Hailong , Wu Yatao , Xue Lei , Huang Jason H. , Wu Erxi , Hu Xiaoxiao
Published: June 2023

Bladder cancer (BC) is a highly aggressive malignant tumor affecting the urinary system, characterized by metastasis and a poor prognosis that often leads to limited therapeutic success. This study aims to develop a novel DNA aptamer for the diagnosis and treatment of BC using a tissue‐based systematic evolution of ligands by an exponential enrichment (SELEX) process. By using SELEX, this work successfully generates a new aptamer named TB‐5, which demonstrates a remarkable and specific affinity for nucleolin (NCL) in BC tissues and displays marked biocompatibility both in vitro and in vivo. Additionally, this work shows that NCL is a reliable tissue‐specific biomarker in BC. Moreover, according to circular dichroism spectroscopy, TB‐5 forms a non‐G‐quadruplex structure, distinguishing it from the current NCL–targeting aptamer AS1411, and exhibits a distinct binding region on NCL compared to AS1411. Notably, this study further reveals that TB‐5 activates NCL function by promoting autophagy and suppressing the migration and invasion of BC cells, which occurs by disrupting mRNA transcription processes. These findings highlight the critical role of NCL in the pathological examination of BC and warrant more comprehensive investigations on anti‐NCL aptamers in BC imaging and treatment.
Short‐Wavelength Infrared Organic Light‐Emitting Diodes from A–D–A′–D–A Type Small Molecules with Emission beyond 1100 nm
Authors: Liu Wansheng , Deng Suinan , Zhang Lianjie , Ju Cheng‐Wei , Xie Yuan , Deng Wanyuan , Chen Junwu , Wu Hongbin , Cao Yong
Published: June 2023

Short‐wavelength infrared (SWIR) organic light‐emitting diodes (OLEDs) have attracted great interest due to their potential applications in biological imaging, infrared lighting, optical communication, environmental monitoring, and surveillance. Due to an intrinsic limitation posed by the energy‐gap law, achieving high‐brightness in SWIR OLEDs remains a challenge. Herein, the study reports the use of novel A–D–A′–D–A type small molecules NTQ and BTQ for high‐performance SWIR OLEDs. Benefiting from multiple D–A effect in conjugated skeleton, the small molecules NTQ and BTQ exhibit narrow optical gaps of 1.23 and 1.13 eV, respectively. SWIR electroluminescence (EL) emission from OLEDs based on NTQ and BTQ is achieved, with emission peaks at 1140 and 1175 nm, respectively. Not only owing to a negligible efficiency roll‐off across the full range of applied current density but also the ability to afford a high operation current density of 5200 mA cm−2, the resultant SWIR OLEDs based on NTQ exhibit a maximal radiant exitance of =1.12 mW cm−2. Furthermore, the NTQ‐based OLEDs also possess sub‐gap turn‐on voltage of 0.85 V, which is close to the physical limits derived from the generalized Kirchhoff and Planck equation. This work demonstrates that A–D–A′–D–A type small molecules offer significant promise for NIR/SWIR emitting material innovations.
Carboline Regioisomers Based on Unified Synthetic Approaches
Authors: Arshad Ahmad Saifuddin Mohamad , Mordi Mohd Nizam
Published: May 2023

Carbolines are a prominent class of tricyclic alkaloids omnipresent in natural products and bioactive compounds. Four different carboline regioisomers are known (α‐, β‐, γ‐, and δ‐carbolines), which can be classified according to the nitrogen atom position inside the pyridine ring. As an emerging structural motif in drug discovery, a multitude of synthetic methods have been established for the construction of carboline frameworks, which in general requires customized approaches for the assembly of each regioisomer. Distinguishingly, their frameworks are also accessible from unified approaches, which are capable of generating multiple regioisomers, thus suitable for introducing diversity in isomeric carbolines. In this review, the construction of isomeric carbolines based on unified synthetic approaches is summarized.
A Generic “Engraving in Aprotic Medium” Strategy toward Stabilized Zn Anodes
Authors: Zou Yuhan , Su Yiwen , Qiao Changpeng , Li Weiping , Xue Zaikun , Yang Xianzhong , Lu Miaoyu , Guo Wenyi , Sun Jingyu
Published: June 2023

Zn foil pretreatment is a direct route to alleviating Zn anode instability and maintaining high energy performance in Zn metal batteries. Unfortunately, prevailing methods for achieving an ideal Zn surface texture do not enable durable operation under a large depth of discharge, thus impairing the Zn utilization ratio. Zn etching is a more feasible way to control the surface texture, but this approach remains relatively unexplored. In this study, a general strategy is reported for Zn foil engraving in aprotic media to realize efficient anode pretreatment in terms of stability. These tests are performed using high‐valence metal ions (especially Mo5+) in an aprotic environment as the key etchant to render a homogenously‐distributed, 3D porous architecture on the Zn foil surface. Comprehensive experimental results and theoretical simulations revealed enhanced Zn nucleation and growth. This specially designed electrode exhibited a long lifespan with a large depth of discharge of 88% in symmetric cells. When assembled with a ZnxV2O5 cathode, the constructed cell demonstrated nearly full capacity retention even under stringent conditions (e.g., an N/P capacity ratio of 5.5). This study demonstrates the potential of a Zn etching pretreatment to address the prototypical instability issues of Zn anodes.
Time from Onset to Remote Ischemic Conditioning and Clinical Outcome After Acute Moderate Ischemic Stroke
Authors: Cui Yu , Chen Yi‐Ning , Nguyen Thanh N. , Chen Hui‐Sheng
Published: May 2023

Objective

We conducted a post hoc exploratory analysis of Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke (RICAMIS) to determine whether early remote ischemic conditioning (RIC) initiation after stroke onset was associated with clinical outcome in patients with acute moderate ischemic stroke.

Methods

In RICAMIS, patients receiving RIC treatment in the intention‐to‐treat analysis were divided into 2 groups based on onset‐to‐treatment time (OTT): early RIC group (OTT ≤ 24 hours) and late RIC group (OTT 24–48 hours). Patients receiving usual care without RIC treatment from intention‐to‐treat analysis were assigned as the control group. The primary outcome was excellent functional outcome at 90 days.

Results

Among 1,776 patients from intention‐to‐treat analysis, 387 were in the early RIC group, 476 in the late RIC group, and 913 in the control group. In the post hoc exploratory analysis, a higher proportion of excellent functional outcome was found in the early RIC versus control group (adjusted absolute difference = 8.1%, 95% confidence interval [CI] = 2.5%–13.8%, p = 0.005), but no difference in outcomes was detected in the late RIC versus control group (adjusted absolute difference = 3.3%, 95% CI = −2.1% to 8.6%, p = 0.23), or in the early RIC versus late RIC group (adjusted absolute difference = 5.0%, 95% CI = −1.3% to 11.2%, p = 0.12). Similar results were found in the per‐protocol analysis.

Interpretation

Among patients with acute moderate ischemic stroke who are not candidates for intravenous thrombolysis or endovascular therapy, early RIC initiation within 24 hours of onset may be associated with higher likelihood of excellent clinical outcome. ANN NEUROL 2023;94:561–571
Control of Quantum‐Memory Induced by Generated Thermal XYZ‐Heisenberg Entanglement: y‐Component DM Interaction
Authors: Aldosari Fahad M. , Alsahli Abdallah M. , Mohamed Abdel‐Baset A. , Rahman Atta
Published: May 2023

This study explores the thermal quantum‐memory‐assisted entropic uncertainty relation (QM‐EUR) and entanglement in a general two‐qubit XYZ‐Heisenberg spin chain model in the presence of the Dzyaloshinskii–Moriya (DM) interaction. The characterization of y‐component DM and spin–spin interactions are particularly focused. It is found that the DM and spin–spin interaction strengths highly regulate the flow behavior and the initial final levels of QM‐EUR and entanglement. In comparison, the spin–spin interaction strength in the z‐direction remains useful in both ferromagnetic and anti‐ferromagnetic regimes for entropic uncertainty suppression and entanglement generation. Additionally, the negative and the positive directed DM values can usefully turn classical states into resourceful quantum states. The dynamics of thermal QM‐EUR and entanglement‐of‐formation have symmetric behaviors only with respect to y‐component DM and z‐component spin–spin interaction. Finally, different critical points of temperature, component DM as well as spin–spin interaction are encountered, which should be opted to preserve quantum correlations and degrade uncertainty.
Totalsynthese von Thiamyxin A–C und Thiamyxin E, potente RNA‐Virus inhibierende (Cyclo)depsipeptide
Authors: Bauer Kevin , Kazmaier Uli
Published: May 2023

Wir präsentieren die erste Totalsynthese der Thiamyxine A–C und des jetzt vollständig charakterisierten Thiamyxins E, einer interessanten Klasse thiazol‐ und thiazolinreicher Depsipeptide mit vielfältiger antiviraler Aktivität. Die Synthese zeichnet sich aus durch einen parallelen Ringschluss zu zwei Methylthiazolin‐Einheiten unter geringer Epimerisierung des sehr labilen benachbarten stereogenen Zentrums. Des Weiteren wird die dreistufige Synthese einer ungewöhnlichen Hydroxysäure sowie die oxidationsfreie Eliminierung eines Phenylselenids zum Dehydroalanin gezeigt. Die Ausnutzung des säurelabilen Stereozentrums am Isoleucin‐Rest und die erneute Öffnung der Makrolactone ermöglichen den Zugang zu den vier Thiamyxinen in guten Ausbeuten und Diastereomerenverhältnissen aus einem einzigen Vorläufer. Durch die modular gestaltete Totalsynthese sind weitere Bioaktivitätstests und die Erforschung eines Pharmakophors über die Synthese weiterer Derivate möglich.