bluuebunny/crossref_metadata_2025 huggingface dataset:
Reinforcement Learning Adaptive Risk-Sensitive Fault-Tolerant IGC Method for a Class of STT Missile with Non-Affine Characteristics, Stochastic Disturbance and Unknown Uncertainties
Authors: Wang Zheng , Hao Yuting
Published: February 2023

In this paper, a novel reinforcement learning adaptive risk-sensitive fault-tolerant stochastic non-affine integrated guidance and control (NAIGC) method is proposed for a class of skid-to-turn (STT) missiles. The cost standard of the risk-sensitive index we coveted can be arbitrarily small, ensured by solving a specific inequality. Firstly, an extended integration system is introduced to solve the challenging control problem posed by the non-affine form of the control signal, taking into account the non-affine nature in the missile. Secondly, for random noise and unknown non-linearities in NAIGC systems, a reinforcement learning actor-critic adaptive risk-sensitive control method is proposed to ensure the input-state stability of the system. Subsequently, hyperbolic tangent functions and adaptive boundary estimation are used to reduce disturbance-induced jitter and actuator fault-induced bias in the control system. In addition, the proposed control strategy improves the missile's interception performance against maneuvering targets and reduces the conservatism of existing adaptive robust control methods. Ultimately, not only is the stability of the NAIGC closed-loop system demonstrated using Lyapunov theory, but the effectiveness and superiority of the method is also verified through numerical simulations.
Tocilizumab for the Management of Glucocorticoid-Refractory Idiopathic Orbital Inflammation
Authors: Wang Ping , Guo Chen-jun , Zhang Shao-bo , Ning Xiao-Na , Ma Dan , Li Yang-jun
Published: February 2023

Background: To demonstrate the efficacy of the anti-interleukin-6 receptor monoclonal antibody tocilizumab in patients with glucocorticoid-refractory idiopathic orbital inflammation (IOI).
Patients and Methods: A retrospective, observational case series study on 16 (10 females, 6 male) consecutive patients treated with TCZ for glucocorticoid-refractory IOI between September 2020 and January 2022. Median follow-up was 14.0±4.68 months (range, 9-24 months). The mean age of the patients was 34.5±9.93 years (range, 19-60 years), All patients had been treated with glucocorticoid but condition is repeatedly reactivated when steroid tapering for 0.5-3 years. Each patient underwent ophthalmological examinations, laboratory tests, CT/MRI of orbit, and received the initiated treatment with a monthly dose of 8 mg/kg TCZ for 2 to 6 cycles. TCZ was withdrawn due to low disease activity. Patient-reported outcomes, clinician-reported outcomes, and CT/MRI findings of the orbit after treatment were collected at the follow-up to assess the response.
Results: Among the patients, 7 (44%) had myositis, 5 (31%) had diffuse IOI, 2 (13%) had dacryoadenitis, and 2 (13%) had anterior IOI. All patients (100%) had eyelid swelling and oppressive orbital pain, 12 (75%) had diplopia and ocular motility restriction, 9 (56%) had ptosis, and 1 (6%) had vision decline. After one treatment with TCZ, the eyelid swelling, ptosis, and orbital pain improved in all patients and completely relieved after all treatments. The average numeric pain rating scale score of all patients was 4.88±2.18 (range, 2-9) and dropped to 0 before and after TCZ treatment respectively (P<0.01). At the last TCZ treatment, the diplopia had resolved in 67% (8/12) patients and significantly reduced in 33% (4/12) patients who had orbital biopsy operations or external beam radiotherapy history; the vision of the patient with the most serious diffuse IOI was improved from 0.1 to 1.0; 11 patients with single or multiple enlarged extraocular muscles showed a significant CT/MRI reduction of the orbital lesion and a stable clinical improvement for the follow-up time of observation. To date, no recurrence was occurred and no side effects of TCZ have been reported.
Conclusion: TCZ can reduce orbital pain, eyelid swelling, muscle enlarge, ocular motility limitation of glucocorticoid-refractory IOI. Treatment with TCZ appears to offer another therapeutic option in cases of recalcitrant or recurrent IOI in which conventional treatment fails or contraindications to intravenous glucocorticoid pulse therapy.
Detection of Abdominal Aortic Aneurysms via Bioelectrical Impedance Analysis – a pilot study
Authors: Hofmann Amun Georg , Shoumariyeh Tarik , Domenig Christoph , Skrabal Falko , Kovarik Johannes J.
Published: February 2023

Objective: To assess the feasibility of abdominal aortic aneurysm (AAA) detection based on parameters obtained from segmental bioimpedance measurements.
Design: Pilot study
Methods: In this single center exploratory pilot study, measurements were conducted in three different cohorts: patients with AAA, end stage renal disease patients without AAA, and healthy controls. The device used in the study, CombynECG, is an open market accessible device for segmental bioelectrical impedance analysis. The data was preprocessed and used to establish 4 different machine learning models on a randomized training sample. Each model was then evaluated on a test sample.
Results: The total sample included 22 patients with AAA, 16 chronic kidney disease patients, and 23 healthy controls. All four models showed strong predictive performance in the test partitions. Specificity ranged from 71.4 to 100 %, while sensitivity ranged from 66.7 to 100 %. The best performing model had 100% accuracy during classification on a test sample. Additionally, an exploratory analysis to approximate the maximum AAA diameter was conducted. An association analysis revealed potential variables that might hold predictive ability for aneurysm extent.
Conclusion: AAA detection via bioelectrical impedance analysis is technically feasible and appears to be a promising technology for large scale clinical studies as well as routine clinical screening assessment.
Oral-Health-Related Quality of Life in Adolescents: Umbrella Review
Authors: Chimbinha Italo Gustavo Martins , Ferreira Brenda Nayara Carlos , Miranda Giovana Pessoa , Guedes Renata Saraiva
Published: February 2023

Background: To evaluate oral conditions, demographic and socioeconomic characteristics of oral health-related quality of life in adolescents.
Methods: umbrella review, conducted according to the PRISMA checklist. The search strategy used a combination of words, applied in the electronic databases PubMed, WebScience, Embase, Lilacs, Scopus and Cochrane. Included publications until January 2022, without restrictions. Data collection took place with systematized practices and the eligibility criteria were studies focusing on quality of life related to oral health; teenagers; present the term “systematic review” and/or “meta-analysis” in the title or abstract. The quality assessment used the Assessment of Multiple Systematic Reviews (AMSTAR2) and the adherence of the article to the Preferred Reporting Items for Systematic Reviews and Meta Analyzes (PRISMA) was verified.
Results: 361 articles identified. 21 included. Systematic reviews focus on the English language, between 2009 and 2022 they showed heterogeneity in the methodological structuring process and were considered of low or critically low quality. Clinical conditions associated with worsening in quality of life were dental caries, malocclusion, dental trauma, toothache, edentulism, need for orthodontic treatment, irregular brushing and periodontal disease. Socioeconomic factors related to housing, parental education, access to health care, absence of siblings and nuclear family influence HRQoL. Completion of orthodontic treatment, health promotion programs, dental care and safe housing all have a positive impact.
Conclusion: Worse oral health status, older age, female sex and worse socioeconomic status were significantly associated with worse HRQoL.Registration :PROSPERO CRD4202129352
Oxalate nephropathy in an elderly patient with newly diagnosed celiac disease – a case report
Authors: Zijlstra Hendrik Wietse , Stegeman Coen A.
Published: February 2023

Oxalate nephropathy has widely been described in gastrointestinal disease,. This is only the second publication of oxalate nephropathy in newly diagnosed celiac disease. A 72-year-old Caucasian male presented to the hospital with abdominal discomfort and acute renal insufficiency with a creatinine of 290 µmol/L. The clinical course, laboratory results and urinalysis was suspect for tubular injury. Renal biopsy showed calcium oxalate depositions. Elevated serum and urine oxalate levels established the diagnosis oxalate nephropathy. The abdominal complaints, with steatorrhea and positive anti-tissue transglutaminase antibodies were diagnosed as celiac disease, which was confirmed after duodenal biopsies. Treatment with prednisone, gluten-free, low oxalate and normal calcium diet, lowered the serum oxalate levels and improved his renal function. Decreased absorption of free fatty acids can lead to increased free oxalate in the colon, due to the binding of free fatty acids to calcium, preventing the formation of the less absorbable calcium oxalate in the colon. Oxalate dispositions in the kidney can lead to acute tubular injury and chronic renal insufficiency. Celiac disease is therefore one of the intestinal diseases that can lead to hyperoxaluria and oxalate nephropathy.
Therapeutic effect of Ginsenoside Rb1 against mechanical trauma in a rat model of postpartum stress urinary incontinence
Authors: Chen Shaohui , Zhang Sanyuan , Wei Bingyan
Published: February 2023

Objective
The aim of the present study was to investigate the therapeutic effect of ginsenoside Rb1(GS-Rb1) on urethral mechanical trauma in a rat model of stress urinary incontinence (SUI) and the underlying mechanisms.
Design
24 female rats were divided into four groups: (1) control; (2) SUI; (3) SUI+ L-Rb1; (4) SUI+ H-Rb1 group. SUI models were induced via vaginal dilation (VD). Control rats received sham surgery.
Methods
The treatment rats received oral doses of ginsenoside Rb1 (4.5 mg/kg and 18 mg/kg, for the L and H groups, respectively) once per day for one week. Rats in the SUI group received the same volume of saline. On day 7, the leak point pressure (LPP) and maximum bladder capacity were evaluated and the rats were sacrificed. Urethral and vaginal wall tissue was examined using histology, immunohistochemistry, western blotting, and qPCR.
Results:
GS-Rb1 treatment was found to reduce urethral mechanical trauma, allowing periurethral tissue recovery. GS-Rb1 also reduced the numbers of fragmented and disorganized elastic and muscle fibers through activation of Nrf2/AREand TGF-β1/Smad3, leading to increased collagen synthesis and ameliorating damage to the urethral fibromuscular system.
Conclusion:
GS-Rb1 effectively reduced mechanical trauma to the urethral fibromuscular system in an SUI rat model. This was mediated by activation of Nrf2 antioxidant activity and TGF-β1/Smad3 signaling.
DNA methylation aberrancy is a reliable prognostic tool in uveal melanoma
Authors: Soltysova Andrea , Dvorska Dana , Kajabova Viera Horvathova , Pecimonova Martina , Cepcekova Klaudia , Ficek Andrej , Demkova Lucia , Buocikova Verona , Babal Pavel , Juras Ivan , Janikova Katarina , Kasubova Ivana , Samec Marek , Brany Dusan , Lyskova Darina , Dankova Zuzana , Smolkova Bozena , Furdova Alena
Published: February 2023

Background: Despite outstanding advances in understanding the genetic background of uveal melanoma (UM) development and prognosis, the role of DNA methylation reprogramming remains elusive. This study aims to clarify the extent of DNA methylation deregulation in the context of gene expression changes and its utility as a reliable prognostic biomarker.
Methods: Transcriptomic and DNA methylation landscapes in 25 high- and low-risk UMs were interrogated by Agilent SurePrint G3 Human Gene Expression 8×60K v2 Microarray and Human Infinium Methylation EPIC Bead Chip array, respectively. DNA methylation and gene expression of the nine top discriminatory genes, selected by the integrative analysis, were validated by pyrosequencing and qPCR in 58 tissues.
Results: Among 2,262 differentially expressed genes discovered in UM samples differing in metastatic risk, 60 were epigenetic regulators, mostly histone modifiers and chromatin remodelers. A total of 44,398 CpGs were differentially methylated, 27,810 hypomethylated, and 16,588 hypermethylated in high-risk tumors, with Δβ values ranging between -0.78 and 0.79. By integrative analysis, 944 differentially expressed DNA methylation-regulated genes were revealed, 635 hypomethylated/upregulated, and 309 hypermethylated/downregulated. Aberrant DNA methylation in high-risk tumors was associated with the deregulation of key oncogenic pathways such as EGFR tyrosine kinase inhibitor resistance, focal adhesion, proteoglycans in cancer, PI3K-Akt signaling, or ECM-receptor interaction. Notably, the DNA methylation values of nine genes, HTR2B, AHNAK2, CALHM2, SLC25A38, EDNRB, TLR1, RNF43, IL12RB2, and MEGF10, validated by pyrosequencing, demonstrated excellent risk group prediction accuracies (AUCs ranging between 0.870 and 0.956). Moreover, CALHM2 hypomethylation and MEGF10, TLR1 hypermethylation, as well as two three-gene methylation signatures, Signature 1 combining AHNAK2, CALHM2, and IL12RB and Signature 2 AHNAK2, CALHM2, and SLC25A38 genes, correlated with shorter overall survival (HR = 4.38, 95% CI 1.30-16.41, HR = 5.59, 95% CI 1.30-16.41; HR = 3.43, 95% CI 1.30-16.41, HR = 4.61, 95% CI 1.30-16.41 and HR = 4.95, 95% CI 1.39-17.58, respectively).
Conclusions: Our results demonstrate a significant role of DNA methylation aberrancy in UM progression. The advantages of DNA as a biological material and the excellent prediction accuracies of methylation markers open the perspective for their more extensive clinical use.
Smartphone-based surface plasmon resonance sensor for glyphosate detection: different pH and concentrations
Authors: Valle Anderson , Ferreira Kaline , Goulart Luiz , Freire Carmonizia , Medeiros Eliton , Filho Carlos Souza , Cruz Rossana , Rodrigues Luciano , Moreira Cleumar
Published: February 2023

Glyphosate [(N-phosphonomethyl) Glycine], one of the most worldwide commercialized herbicides, has provoked many debates about its carcinogenic effects. Here, a smartphone-based surface plasmon resonance (SPR) sensor is proposed for glyphosate detection using different pH and concentrations. CuO nanoparticles have been added to glyphosate samples, diluted in ultra-pure water solutions, to enhance its detection. An increase of sensitivity was observed in acidic solutions reaching a dilution of 10−8 (v/v), which is equivalent to 5·10−7 ppm. This novel smartphonebased SPR device for glyphosate detection besides presenting very high sensitivity, it has also favorable features such as easy handling, portability, and real-time analysis.
Correlation between long-term glycemic variability and cognitive function in middle-aged and elderly patients with type 2 diabetes mellitus
Authors: Ding Jingcheng , Shi Qian , Tao Qian , Su Hong , Du Yijun , Pan Tianrong , Zhong Xing
Published: February 2023

Objective
To investigate the correlation associated with long-term glycemic variability on cognitive function in middle-aged and elderly patients with T2DM.
Methods
This study was a single-institution, retrospective analysis of data. A total of 138 patients who were hospitalized in the Department of Endocrinology, the Second Affiliated Hospital of Anhui Medical University from June 2021 to November 2022 were recruited. The Montreal Cognitive Assessment (MoCA) was applied to assess the cognitive function of the patients, which were divided into MCI and non-MCI. Glycated hemoglobin A1c standard deviation (HbAlc-SD) and fasting plasma glucose standard deviation (FPG-SD) were used to measure long-term blood glucose fluctuations. General clinical data, blood biochemical indicators, and glycemic variability indicators were compared between the two groups of patients. The differences between the groups were compared using t-test, x2 test, ornonparametric test. Correlation and diagnostic power were further analyzed using multiple logistic regression analysis and ROC curve analysis.
Results
The differences in age, BMI, HbA1c-M, HbA1c-SD, FPG-M, FPG-SD, GFR, 24h urinary protein, and UACR were statistically significant between the two groups (P<0.05). In a multiple logistic regression analysis, HbA1c-SD and FPG-SD were found to be risk factors for cognitive dysfunction and eGFR to be a protective factor. The area under the curve (AUC) of HbA1c-SD for predicting MCI prevalence was 0.828 (95% CI 0.754～0.887, P<0.001), with a sensitivity of 62.69%, a specificity of 94.29%, and an optimal diagnostic value 1.01. The area under the curve (AUC) of FPG-SD for predicting MCI prevalence was 0.737 (95% CI 0.655～0.808, P<0.001), with a sensitivity of 76.12%, a specificity of 61.43%, and an best diagnostic value 0.94. The area under the curve (AUC) of eGFR for prediction of MCI prevalence was 0.712 (95% CI 0.628～0.786, P<0.01), with a sensitivity of 70.15 %, a specificity of 64.29 %, and an optimal diagnostic value 79.82 ml/min/1.73m2.
Conclusions
Long-term blood glucose variability affects cognitive function in middle-aged and elderly T2DM patients, and cognitive function is poorer in those with high blood glucose variability, for whom renal function is a protective factor.
Effect of Multiple Gestation delays in a Prey-Predator Food Chain System with Infected Class of Prey
Authors: Gupta Jyoti , dhar Joydip Dhar , Sinha Poonam
Published: February 2023

This article investigates a tri-trophic food chain model with the epidemic at the bottom level (prey) and gestation delays for the next two levels( the intermediate predator and top predator). The steady states' positivity, boundedness, existence, and stability have been analyzed. The study of Hopf bifurcation has been carried out for different steady states. It is shown that when the gestation delay for intermediate predator τ1 is absent, the interior equilibrium is locally stable for gestation delays of top predators τ2 ∈ (0,τ20+) and performs Hopf bifurcation for all τ2 >τ20+. Further, in the presence both the delay τ1 and τ2, the system becomes unstable when τ1, τ2 crosses their critical values τ10++}, τ20++ respectively and executes Hopf bifurcation τ1>τ10++, τ2>τ20++. Moreover, the proposed system is stable for τ1>τ10++, τ2<τ20++ and unstable for τ1<τ10++, τ2>τ20++. The sensitivity analysis of the system at coexistence steady state are presented to identify the effect of system parameters on the variables. Finally, we have presented a numerical simulation to verify our analytical findings.
Mathematics Subject Classification (2000) 34C23 · 34D20 · 92B05 · 92D30
Efficacy of photodynamic therapy in the treatment of actinic keratosis: a network meta-analysis
Authors: Wan Yuanyuan , Zeng Qinghai , Jiang Ling , Fu Chuhan , Mao Shunmin , Zhang Lan , Zhang Yushan , Zhang Xiaolin , Zhu Lu , Zhang Fan , Chen Jing , Lei Li
Published: February 2023

Background: Photodynamic therapy (PDT) is a highly effective treatment for actinic keratosis (AK), and uses different light sources as well as photosensitizers. In addition, PDT is often combined with other physical therapies or drugs. A network meta-analysis (NMA) allows for comparison between treatments not directly compared in randomized controlled trials (RCTs). This study’s objective was to compare the efficacy of different PDTs against AK lesions based on complete response rate (CR) by conducting a NMA.
Methods: The RCTs on the treatment of AK using PDT were screened, and a Bayesian model was developed using GeMTC 0.14.3 software to perform a NMA. The subgroups demarcated on the basis of the light sources and photosensitizers were also compared. RevMan 5.4.0 software was used to compare the outcome measure of different light sources in terms of relative risk ratio (RR) and a 95% confidence interval (CI). The therapeutic effects of different photosensitizers were compared using R 4.2.1 software and gemtc package version 1.0-1. The quality of the included literature was evaluated using the risk of bias assessment tool in RevMan 5.4.0, and the network plots between studies were drawn using STATA 16.0 software.
Results: Twenty-six trials involving 2285 patients and 14 treatments were included in the NMA. The results of the NMA showed that ablative fractional laser (AFL)-assisted methyl 5-aminolevulinic acid (MAL)-light-emitting diode (LED)-PDT had the best possible efficacy (Rank 1=0.56), followed by calcipotriol (CAL)-assisted MAL-LED-PDT (Rank 1=0.34) and 5-aminolaevulinic acid (ALA)-LED-PDT (Rank 1=0.05). The subgroup analysis showed that MAL-based PDT had better efficacy when using LED versus other light sources (RR：1.05，95% CI：1.03-1.07), and LED-based PDT resulted in the best possible efficacy when using ALA (Rank 1=0.47) versus other photosensitizers.
Conclusions: AFL combined with MAL-LED-PDT is most likely the best treatment option for AK. In case of monotherapies, PDT based on LED light source and ALA photosensitizer is a suitable choice.
Breast Cancer Screening Awareness among Women of Reproductive Age in Ghana
Authors: Shirazu I. , Mumuni A. N. , Mensah Y. B. , Sackey T. A. , Hasford F. , Awua A. K. , Manson Eric Naab
Published: February 2023

Background
Breast cancer is the commonest cancer and the leading cause of cancer deaths among women. However, information about breast cancer is still limited in most parts of the developing world among reproductive-aged women. This has consequences for timely diagnosis and intervention, resulting in high mortalities in most cases. Effective breast screening practices play a vital role in early detection and treatment of breast cancers. The aim of this study was to assess the awareness and practice of breast cancer screening examination among reproductive-aged women in Ghana.
Methods
A cross-sectional descriptive survey of 1672 reproductive-aged women was conducted in the northern and southern sectors of the country. All consented participants were aged 18–60 years, sampled randomly from communities in Tamale and Accra, and never reported to any health facility for any breast-related complications. A semi-structured questionnaire was used to gather responses about awareness about screening programmes, knowledge about breast screening methods, knowledge about self-breast examination, willingness to undergo clinical-breast examination, and practice of breast examination. Responses were presented as frequency tabulations, while associations between the responses and age, education, marital status, employment status and religion were assessed by Chi-squared analysis, significant at p < 0.05.
Results
The results showed that awareness and practice of breast cancer screening methods were higher among the younger women (aged 18–30 years), who were educated up to tertiary level, married, employed and were predominantly Christians. Significant associations were found between knowledge, practice and all the factors except religion.
Conclusion
Even though most women were aware about breast cancer and mammography as the commonest examination method, practice of breast cancer screening examination was rather low. Efforts should therefore be made by government and other stakeholders in healthcare to focus on education and health policies that will impact on acceptance of women to undergo screening, particularly those in the lower socioeconomic and educational brackets
ECDBMFA: Design of an Ensemble engine for Crop Disease detection via Bioinspired Multidomain Feature Analysis
Authors: Malathi Chilakalapudi , Sheela J
Published: February 2023

Crop disease detection models require integration of multimodal tasks including contextual segmentation, feature representation & selection, classification & post-processing operations. A wide variety of machine learning & deep learning techniques are proposed by researchers to design such models, but most of them are either highly complex, or have limited efficiency when applied to real-time farm fields. To overcome these issues, this text proposes design of an efficient & novel ensemble engine for crop disease detection via bioinspired multidomain feature analysis. The proposed model uses Fuzzy Saliency Maps for identification of contextual disease regions, which are represented into multidomain feature sets. These sets use Fourier, Gabor, Convolutional, Wavelet and Cosine operations, which assist in extraction of multiple high-density features. The extracted features are reduced via a Bacterial Foraging Optimization (BFO) Model, which retains only higher variance feature sets. The retained features are classified by an ensemble model, that combines Naïve Bayes (NB), Multilayer Perceptron (MLP), Logistic Regression (LR), k Nearest Neighbors (kNN) and Support Vector Machine (SVM) classifiers. These classifiers are combined using a boosting model, that assists in retaining unique-correct class training information sets. Due to which the proposed model is able to improve the classification accuracy for Wheat, Tomato, Rice & Corn diseases by 9.4%, while improving precision by 3.5%, recall by 5.9% and reducing delay by 4.3% when compared with existing classification models under similar disease types.
Development of a clinically useful multi-segment kinetic foot model
Authors: Zhu Songlin , Jenkyn Thomas
Published: February 2023

Background
Most gait analysis studies treat the foot as a single, rigid segment, leaving movements and loadings within the foot undetected. In addition, very few data of multi-segment foot kinetics were presented due to measurement and equipment limitations. As a result, this study aims to develop a novel multi-segment kinetic foot model that is clinically feasible and enables both kinematic and kinetic analysis of large patient groups.
Results
Outcome measurements include rotation angles of intersegmental dorsi/plantar flexion, inversion/eversion, and internal/external rotation, joint moments, joint powers and the medio-longitudinal arch (MLA) height/length ratio. Repeatability of joint motions was calculated using coefficients of multiple correlation. Most joint motions (24/27) measured by this foot model showed strong test-retest and within-subject reliability (R > 0.7) in healthy adults. Outcome measures were in agreement with other multi-segment foot models found in the biomechanics literature.
Conclusions
This novel multi-segment foot model is able to quantify intra-segment foot kinetics and can be a clinically useful tool for research and assessments on clinical populations.
System Interventions to Support Rural Access to Maternity Care: An Analysis of the Rural Surgical Obstetrical Networks program
Authors: Kornelsen Jude , Lin Stephanie , Williams Kim , Skinner Tom , Ebert Sean
Published: February 2023

Background: The Rural Surgical Obstetrical Networks (RSON) project was developed in response to the persistent attrition of rural maternity services across Canada over the past two decades. While other research has demonstrated the adverse health and psychosocial consequences of losing local maternity services, this paper explores the impact of a program designed to increase the sustainability of rural services themselves, through the funding of four “pillars”: increased scope and volume, clinical coaching, continuous quality improvement (CQI) and remote presence technology.
Methods: We conducted in-depth, qualitative research interviews with rural health care providers and administrators in eight rural communities across British Columbia to understand the impact of the RSON program on maternity services. Researchers used thematic analysis to generate common themes across the dataset and interpret findings.
Findings: Participants articulated six themes regarding the sustainability of maternity care as actualized through the RSON project: safety and quality through quality improvement opportunities, improved access to care through increased surgical volume and OR backup, optimized team function through innovative models of care, improved infrastructure, local innovation surrounding workforce shortages, and locally tailored funding models.
Conclusion: Rural maternity sites benefited from the funding offered through the RSON pillars, as demonstrated by larger volumes of local deliveries, nearly unanimous positive accounts of the interventions by health care providers, and evidence of staffing stability during the study time frame. As such, the interventions provided through the Rural Surgical Obstetrical Networks project as well as study findings on the common themes of sustainable maternity care should be considered when planning core rural health services funding schemes.
A Psychosocial Empowerment Program to Reduce High-Risk Behaviors in Adolescent Girls with Substance Use Disorders: A Mixed-Methods Protocol Study
Authors: Ghelbash Zakiye , Alavi Mousa , noroozi Mahnaz , far Masuood Mahdavian
Published: February 2023

Background and objective: adolescent girls with substance use disorders are at risk of numerous psychosocial risks; tendency to high-risk behaviors, such as suicide, high-risk sexual behavior, and violence are among important consequences of substance use. Today, programs are designed with an empowerment approach, as important practical strategies for management of issues associated with health and social welfare. Thus, in this study, we intend to design a comprehensive psychosocial empowerment program with an approach of reducing high-risk behaviors in adolescent girls with substance use disorder.
Methods: Using the Talbot and Verrinder model, this study will be designed in three steps. In the first step, the researcher will identify the experiences of adolescent girls with substance use disorder, as well as their psychosocial needs using a qualitative approach. Then, through a review of literature, the needs and strategies will be completed and enriched. Thereafter, using a Delphi technique, the relevant needs and strategies identified in previous stages will be prioritized. In the second step, the program's draft will be designed based on the results obtained from the previous step. The developed program includes introduction, goals, specific objectives, strategies associated with specific objectives separately. During the third phase, the content of the program will be evaluated by a panel of experts. The fourth, fifth and sixth steps of the model, which are dedicated to the implementation, monitoring and evaluation of the program, can be implemented in the future as an interdisciplinary program with the participation of health and social welfare experts and related organizations.
Conclusion: It is expected that, in the case of its effective implementation by social welfare and health organizations, the empowerment program would have the potential to have a considerable effect on reducing or controlling high-risk behaviors in adolescent girls with substance use disorder.
Methods for Numerical Simulation of Soft Actively Contractile Materials
Authors: Li Yali , Goulbourne Nakhiah C.
Published: February 2023

Soft materials that can demonstrate on demand reconfigurability and changing compliance are highly sought after as actuator materials in many fields such as soft robotics and biotechnology. Whilst there are numerous proof of concept materials and devices, rigorous predictive models of deformation have not been well-established or widely adopted. In this paper, we discuss programming complex three-dimensional deformations of a soft intrinsically anisotropic material by controlling the orientation of the contractile units and or direction of the applied electric field. Programming is achieved by patterning contractile units and or selectively activating spatial regions. A new constitutive model is derived to describe the soft intrinsic anisotropy of soft materials. The model is developed within a continuum mechanics framework using an invariant-based formulation. Computational implementation allows us to simulate the complex three-dimensional shape response when activated by electric field. Several examples of the achievable Gauss-curved surfaces are demonstrated. Our computational analysis introduces a mechanics-based framework for design when considering soft morphing materials with intrinsic anisotropy, and is meant to inspire the development of new soft active materials.
Long-term outcomes of surgical repair of isolated coarctation of the aorta in different age groups
Authors: Al-Dairy Alwaleed
Published: February 2023

Background: Coarctation of the aorta (CoA) is one of the most common congenital heart defects (5-8% of all CHD). Treatment of native CoA may be accomplished surgically, or through an interventional approach. Surgical repair of CoA remains an important option for treatment of aortic coarctation during childhood, although it is mostly performed in neonates and young infants.
Objectives: In this retrospective study, we sought to share the long-term outcomes of different surgical techniques for repair of coarctation of the aorta in different age groups.
Materials and Methods: This is a retrospective single-center clinical study that included 228 consecutive patients (age: 1 day- 41years) in whom surgical repair of isolated native coarctation of the aorta was performed with different surgical techniques.
Results: Immediate results were excellent; however, the mortality rate were higher in the infants. Complications rate and incidence of recoarctation, both were comparable between different age groups and different surgical techniques.
Conclusions:
Surgical repair of CoA remains an important option for treatment of aortic coarctation in different age groups with low morbidity and mortality. We did not find any significant difference between different surgical techniques regarding the development of recoarctation.
Leveraging Bulk Transcriptome and Single-Cell Sequencing reveals the Potential Mechanism of Curcumin in the Treatment of Periodontitis
Authors: Huang Xufeng , Wang Qi , Zhou Shujing , Rehman Hafiz Muzzammel , Li Zhengrui
Published: February 2023

Background
Periodontitis is the most common long-term oral disease worldwide. Compared with non-surgical therapy and antibiotics application, natural products are recommended as a treatment for their minor side effects. For example, Curcumin has been used since ancient times, while its underlying mechanism remains controversial. Therefore, we performed computational simulations to unravel its secret.
Methods
Single-cell analysis was conducted using the GSE164241 dataset through R "Seurat package." Bulk RNA sequencing data were curated from GSE10334 and GSE16134, and processed by R package "Limma." The marked genes of distinct cell type populations and differentially expressed genes (DEGs) in the bulk transcriptome were combined. The KEGG and GO enrichment analyses were carried out to enhance the understanding of their functionalities. Key targets were mined from the topological pattern of their protein-protein interaction (PPI) network. performed molecular docking for them. Then, the top-ranked pose obtained was subjected to Molecular Dynamics (MD) Simulations to investigate the stability of the protein-ligand complex. The RMSD pattern revealed the stability of the protein-ligand complex throughout the simulated trajectory.
Results
FOS, CXCL1, CXCL8, and IL1B, were filtered after selected processes. The molecular modeling results suggested that except for IL1B, the Vena Scores of the rest exceeded − 5 kcal/mol. Furthermore, the molecular dynamic simulation indicated that the binding mode of the CXCL8-Curcumin complex was stable over the entire 100ns simulation.
Conclusion
The complex target screening and molecular modeling revealed that the binding modes of CXCL1, FOS, and CXCL8 with the Curcumin molecule were relatively stable, especially for CXCL8.
Evaluation of microplastic contamination by metals in a controlled environment: A risk to be considered
Authors: Bernardino Cassiano Augusto Rolim , Mahler Claudio Fernando , Fernandes Julia Oliveira , Lopes Claudio Sabbatini Capella , Braz Bernardo Ferreira , Archanjo Braulio Soares , Santelli Ricardo Erthal , Cincotto Fernando Henrique
Published: February 2023

The metal contamination and the degradation of polyethylene terephthalate (PET) due to human activities have contributed to the worsening of environmental problems in aquatic systems. Therefore, the study aimed to evaluate PET microplastic adsorption levels when exposed to high amounts of Ni, Cu and Co. The PET microplastic was characterized by scanning electron microscopy, surface area, porosity, and Fourier transform infrared spectroscopy with attenuated total reflectance. The results showed that the surface area, the presence of macro and mesopores, and the functional groups influence the adsorption of metals on the surface of PET microplastic. The construction and shape of the adsorption isotherms confirmed the presence of mesoporosity and macroporosity on the PET microplastic surface. The Freundlich and Langmuir models were used to study the adsorption capacity. The kinetics of adsorptions were interpreted using pseudo-first order and pseudo-second order models. The results indicated that the Langmuir isotherm and the pseudo-second order adequately described the adsorption of metals by the PET microplastic. The removal rates by the PET microplastic varied from 8 to 34 % for Ni, 5 to 40 % for Cu and 7 to 27 % for Co after a period of 5 days. Furthermore, the adsorption was predominantly chemical and extremely fast, indicating that the presence of microplastics in the environment can lead to a rapid metal accumulation which elevates the hazards potential of microplastic in living beings.
Improving CNNs classification with pathologist-based expertise: the Renal Cell Carcinoma case study
Authors: Ponzio Francesco , Descombes Xavier , Ambrosetti Damien
Published: February 2023

The prognosis of renal cell carcinoma (RCC) malignant neoplasms deeply relies on an accurate determination of the histological subtype, which currently involves the light microscopy analysis of histological slides, considering notably tumor architecture and cytology. RCC subtyping is therefore a time-consuming and tedious process, sometimes requiring expert review, with great impact on diagnosis, prognosis and treatment of RCC neoplasms. In this study, we investigate the automatic RCC subtyping classification of 91 patients, diagnosed with clear cell RCC, papillary RCC, chromophobe RCC, or renal oncocytoma, through deep learning based methodologies. We show how the classification performance of several state-of-the-art Convolutional Neural Networks (CNNs) are perfectible among the different RCC subtypes. Thus, we introduce a new classification model leveraging a combination of supervised deep learning models (specifically CNNs) and pathologist’s expertise, giving birth to a hybrid approach that we termed ExpertDeepTree (ExpertDT). Our findings prove ExpertDT’s superior capability in theRCC subtyping task, with respect to traditional CNNs, and suggest that introducing some expert-based knowledge into deep learning models may be a valuable solution for complex classification cases.
The HUSH-SETDB1-MORC2 epigenetic repressor complex restricts herpesvirus infection in association with PML nuclear bodies
Authors: Roubille Simon , Juillard Franceline , Escure Tristan , Binda Olivier , Corpet Armelle , Bloor Stuart , Cohen Camille , Texier Pascale , Oziol Noémie , Haigh Oscar , Pascual Olivier , Ganor Yonatan , Magdinier Frédérique , Labetoulle Marc , Lehner Paul , Lomonte Patrick
Published: February 2023

The establishment of latent herpes simplex virus 1 (HSV-1) infection is controlled by promyelocytic leukemia nuclear bodies (PML NBs). Viral genomes are recruited to PML NBs structures and chromatinized by repressive H3.3K9me3 modified H3.3 histone variant to form viral DNA-containing PML-NBs (vDCP NBs). Exactly how this occurs is unclear. Here we identify an essential role for the HUSH complex and its SETDB1 and MORC2 effectors in the establishment and maintenance of latent herpes simplex virus 1 (HSV-1) infection. We show that the formation of repressive heterochromatin is dependent on HUSH, SETDB1 and MORC2 in vDCP NBs, and depletion of any of these components prior to viral infection decreases H3K9me3 levels over latent/quiescent HSV-1 genomes. Once latency is established, depletion of HUSH, SETDB1, or MORC2 by shRNAs or the HIV-2 Vpx protein, induces the reactivation of HSV-1 in infected primary human fibroblasts as well as human induced pluripotent stem cell-derived sensory neurons (hiPSDN). Our data demonstrate the potent antiviral restriction activity of the HUSH/SETDB1/ MORC2 complex to a non-integrated human herpesvirus, its close association with PML NBs, and introduces a new target for anti-herpesvirus therapy.
Effect of Heat Treatment Atmospheres on Microstructure Evolution and corrosion resistance of 2205 Duplex Stainless Steel weldments
Authors: Mohamed Abdelkarim Yousif Mohamed , Mohamed Ahmed Hussein Abdelraheem , Hamid Zainab Abdel , Farahat Ahmed Ismail Zaky , El-Nikhaily Ahmed
Published: February 2023

The effects of post heat treatment atmosphere on microstructure and corrosion resistance of duplex stainless steel welded joints were investigated. Post weld heat treatment (PWHT) was carried out with and without protective different atmospheres. Nitrogen and argon are used as protective gases individually. Detailed microstructure examination (optical and SEM) demonstrates that nitrides precipitates are highly observed in the welded zones for nitrogen protected samples. An observed drop of ferrite volume fraction in post weld heat treated samples compared with welded samples without heat treatment leading to corrosion resistance enhancement of heat treated welded joints. An exception for using nitrogen as heat treatment atmosphere a decreased corrosion resistance of weldments is investigated due to nitride precipitates.
Simulating a Complex Giant System: A Case Study on Yellow River Basin
Authors: Zhang Yuansheng , Zhang Jinliang , Cao Zhiwei , Luo Qiushi , Wang Dongfan , Lu Jun , Liu Jixiang , Jin Xin , Luo Yuan
Published: February 2023

The Yellow River is the second longest river in China and the longest turbid river in the world. The Yellow River basin forms a giant, complex system that is one of the cradles of human civilization; it is also a region where rapid economic and social development is taking place. However, the excessive exploitation of resources in the basin has caused instability in the basin system, which is now restricting sustainable social and economic development in the region. This poses a considerable challenge to a deep understanding of its dynamics, and an effective approach to systematically examining the development status and evolution of river system is urgently required. This system is based on information entropy theory and dissipative structure theory and determines the basin status by quantifying the amount of indicator information and the degree of order in the system by considering related trends. As a result, this evaluation system provides not only a basis for characterizing the status of the Yellow River basin and associated trends, but also the evidence to support the planning of strategic development, particularly the early stages of major projects.
Perfusion Deficits in Different Mechanisms of Two Subtypes of Acute Stroke with Diffusion MRI confirmation
Authors: Zhu Cuiting , Qin Wei , Hu Wenli
Published: February 2023

Background: Branch atheromatous disease (BAD) and lacunar infracts (LI) are the different mechanisms of subtypes of acute stroke. We aimed to investigate perfusion deficits and clinical characteristics of the different mechanisms of two subtypes of acute stroke.
Methods: Five-hundred and ninety-nine CTP examinations were retrospectively reviewed between January and December 2021 in patients with acute stroke symptoms with CTP within 12 hours and MRI within 7 days of symptom onset. The subtype of ischemic stroke was diagnosed according to DWI imaging. Baseline characteristics between normal and abnormal CTP results in BAD and LI were compared with chi-square or Fisher’s exact test for categorical. The t-test or Mann-Whitney U test was performed for continuous variables.
Results: One hundred thirty-three patients met the inclusion criteria (26.3% female). The BAD group was present in 104 of 133 (78.2%), and the LI group 29 of 133 (21.8%). Based on CT perfusion, 42 of 78 (53.8%) the BAD group and 5 of 18 (27.8%) the LI group had perfusion deficits in the supratentorial region. The BAD group had a higher proportion of abnormal perfusion than the LI group, with a significant difference (P < 0.05). The sensitivity of CTP ranged from 21.4% (CBV) to 90.5% (TTP); specificity ranged from 97.2% (TTP) to 100% (CBV, CBF, and MTT) in the BAD patients.
Conclusions: Compromised perfusion deficits are more presented in BAD patients compared with LI. CT perfusion imaging may be useful for determining the clinical significance of perfusion abnormalities in BAD occurrence.
Relationship between mental health and stressors among fathers of children with chronic illnesses and cognitive structure of fathers’ stress experiences
Authors: HARAGUCHI Masahiro
Published: February 2023

Background: To clarify the relationship between stressor and mental health of the fathers with children with chronic illnesses and to examine the cognitive structure of fathers’ stress experiences.Methods: A self-reported questionnaire survey was conducted on 137 respondents. The dependent variables were the stressors of the fathers and depression. Focusing on the data of 51 fathers of children with chronic illness, for 21 items related to the stressful experiences had been identified in a previous study, an exploratory factor analysis using the principal factor method was performed.Findings: Logistic regression analysis results showed that the items “There are children with chronic illness” and “The large number of medical treatments required for the children” were significantly associated with the fathers’ poor mental health. In the factor analysis, the following three factors were extracted as a recognition of the fathers’ stress experiences. The fathers positively recognized their role as a father and a husband, perceiving it in a positive light despite their negative feelings.Discussion: The mental health of fathers of children with chronic illnesses while being exposed to stressors in daily life should be maintained. The positive psychology approach theory, nursing support and maintaining the father's mental health might be useful.
A structural model of the iRhom-ADAM17 sheddase complex reveals functional insights into its trafficking and activity
Authors: Kahveci-Türköz Selcan , Bläsius Katharina , Wozniak Justyna , Rinkens Cindy , Seifert Anke , Kasparek Petr , Ohm Henrike , Oltzen Shixin , Nieszporek Martin , Schwarz Nicole , Babendreyer Aaron , Preisinger Christian , Sedlacek Radislav , Ludwig Andreas , Düsterhöft Stefan
Published: February 2023

Several membrane-anchored signal mediators such as cytokines (e.g., TNFα) and growth factors are proteolytically shed from the cell surface by the metalloproteinase ADAM17, which thus has an essential role in inflammatory and developmental processes. The membrane proteins iRhom1 and iRhom2 are instrumental for the transport of ADAM17 to the cell surface and its regulation. However, the structure-function determinants of the iRhom-ADAM17 complex are poorly understood. We used AI-based modelling to gain insights into the structure-function relationship of this complex. We identified different regions in the iRhom homology domain (IRHD) that are differentially responsible for iRhom functions. We have supported the validity of the predicted structure-function determinants with several in vitro, ex vivo and in vivo approaches and demonstrated the regulatory role of the IRHD for iRhom-ADAM17 complex cohesion and forward trafficking. Overall, we provide mechanistic insights into the iRhom-ADAM17-mediated shedding event, which is at the centre of several important cytokine and growth factor pathways.