bluuebunny/crossref_metadata_2025 huggingface dataset:
The cost effectiveness of intensity-modulated radiation therapy and three-dimensional conformal radiotherapy in the treatment of head and neck cancers
Authors: Varmaghani Mehdi , Amiri Malihe , Ebrahimpour Hossein , Salek Roham , Javan-Noughabi Javad
Published: August 2023

Purpose

Intensity-modulated radiotherapy is developed as a replacement for 3-dimensional conformal radiation therapy. Considering the difference in costs and effectiveness of these interventions, the aim of this study was to compare the cost effectiveness of intensity-modulated radiation therapy and three-dimensional conformal radiotherapy in the treatment of head and neck cancer in east of Iran.

Methods

A Markov model including six states based on xerostomia and dysphagia was developed to estimate the incremental cost effectiveness ratio from the perspective of societal. Cost and quality of life data were collected from 97 respondents via a checklist and EuroQol-5Dimension questionnaire. The robustness of results was examined by deterministic and probabilistic sensitivity analysis. All analysis were conducted with Treeage software.

Results

The results of this study showed that the cost and quality adjusted life years for 3-dimensional conformal radiation therapy were 9209.76 and 3.63 respectively. However, the cost and quality adjusted life years for intensity-modulated radiotherapy were 12562.90 and 3.17 respectively. Therefore, 3-dimensional conformal radiation therapy produced 0.45 more quality adjusted life years than intensity-modulated radiotherapy and saved $3353. According to the incremental cost effectiveness ratio, 3-dimensional conformal radiation therapy as compared to intensity-modulated radiotherapy saved $7367.27 per quality adjusted life years. These results confirmed by sensitivity analysis.

Conclusion

This study concluded that in the treatment of head and neck cancer, the 3-dimensional conformal radiation therapy method appears to be cost-effective when compared with intensity-modulated radiotherapy.
Mechanisms of Xiaozheng decoction for anti-bladder cancer effects via affecting the GSK3β/β-catenin signaling pathways: a network pharmacology-directed experimental investigation
Authors: Zhuang Jingming , Mo Jiahang , Huang Zhengnan , Yan Yilin , Wang Zeyi , Cao Xiangqian , Yang Chenkai , Shen Bing , Zhang Fang
Published: August 2023

Purpose

The combination of Xiaozheng decoction with postoperative intravesical instillation has been shown to improve the prognosis of bladder cancer patients and prevent recurrence. However, the mechanisms underlying the efficacy of this herbal formula remain largely unclear. This research aims to identify the important components of Xiaozheng decoction and explore their anti-bladder cancer effect and mechanism using network pharmacology-based experiments.

Methods

The chemical ingredients of each herb in the Xiaozheng decoction were collected from the Traditional Chinese Medicine (TCM) database. Network pharmacology was employed to predict the target proteins and pathways of action. Disease databases were utilized to identify target genes associated with bladder cancer. A Protein–Protein Interaction (PPI) network was constructed to illustrate the interaction with intersected target proteins. Key targets were identified using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analysis. A compound-target-pathway network was established after molecular docking predictions. In vitro experiments with bladder cancer cell lines were conducted using core chemical components confirmed by ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-qTOF-MS) to verify the conclusions of network pharmacology.

Results

45 active compounds were extracted, and their relationships with Traditional Chinese Medicines (TCMs) and protein targets were presented, comprising 7 herbs, 45 active compounds, and 557 protein targets. The intersection between potential TCM target genes and bladder cancer-related genes yielded 322 genes. GO and KEGG analyses indicated that these targets may be involved in numerous cancer-related pathways. Molecular docking results showed that candidate compounds except mandenol could form stable conformations with the receptor. In vitro experiments on three bladder cancer cell lines demonstrated that quercetin and two other impressive new compounds, bisdemethoxycurcumin (BDMC) and kumatakenin, significantly promoted cancer cell apoptosis through the B-cell lymphoma 2/Bcl-2-associated X (Bcl-2/BAX) pathway and inhibited proliferation and migration through the glycogen synthase kinase 3 beta (GSK3β)/β-catenin pathway.

Conclusion

By employing network pharmacology and conducting in vitro experiments, the mechanism of Xiaozheng decoction’s effect against bladder cancer was tentatively elucidated, and its main active ingredients and targets were identified, providing a scientific basis for future research.
m6A eraser FTO impairs gemcitabine resistance in pancreatic cancer through influencing NEDD4 mRNA stability by regulating the PTEN/PI3K/AKT pathway
Authors: Lin Kai , Zhou Endi , Shi Ting , Zhang Siqing , Zhang Jinfan , Zheng Ziruo , Pan Yuetian , Gao Wentao , Yu Yabin
Published: August 2023

Background

Gemcitabine resistance has brought great challenges to the treatment of pancreatic cancer. The N6-methyladenosine (m6A) mutation has been shown to have a significant regulatory role in chemosensitivity; however, it is not apparent whether gemcitabine resistance can be regulated by fat mass and obesity-associated protein (FTO).

Methods

Cells with established gemcitabine resistance and tissues from pancreatic cancer patients were used to evaluate FTO expression. The biological mechanisms of the effects of FTO on gemcitabine resistant cells were investigated using CCK-8, colony formation assay, flow cytometry, and inhibitory concentration 50. Immunoprecipitation/mass spectrometry, MeRIP-seq, RNA sequencing and RIP assays, RNA stability, luciferase reporter, and RNA pull down assays were employed to examine the mechanism of FTO affecting gemcitabine resistant pancreatic cancer cells.

Results

The results revealed that FTO was substantially expressed in cells and tissues that were resistant to gemcitabine. Functionally, the gemcitabine resistance of pancreatic cancer could be enhanced by FTO, while its depletion inhibited the growth of gemcitabine resistant tumor cells in vivo. Immunoprecipitation/mass spectrometry showed that the FTO protein can be bound to USP7 and deubiquitinated by USP7, leading to the upregulation of FTO. At the same time, FTO knockdown significantly decreased the expression level of NEDD4 in an m6A-dependent manner. RNA pull down and RNA immunoprecipitation verified YTHDF2 as the reader of NEDD4, which promoted the chemoresistance of gemcitabine resistant cells. FTO knockdown markedly increased the PTEN expression level in an NEDD4-dependent manner and influenced the chemosensitivity to gemcitabine through the PI3K/AKT pathway in pancreatic cancer cells.

Conclusion

In conclusion, we found that gemcitabine resistance in pancreatic cancer can be influenced by FTO that demethylates NEDD4 RNA in a m6A-dependent manner, which then influences the PTEN expression level and thereby affects the PI3K/AKT pathway. We also identified that the FTO level can be upregulated by USP7.
Evidence for a personalized early start of norepinephrine in septic shock
Authors: Monnet Xavier , Lai Christopher , Ospina-Tascon Gustavo , De Backer Daniel
Published: August 2023

During septic shock, vasopressor infusion is usually started only after having corrected the hypovolaemic component of circulatory failure, even in the most severe patients. However, earlier administration of norepinephrine, simultaneously with fluid resuscitation, should be considered in some cases. Duration and depth of hypotension strongly worsen outcomes in septic shock patients. However, the response of arterial pressure to volume expansion is inconstant, delayed, and transitory. In the case of profound, life-threatening hypotension, relying only on fluids to restore blood pressure may unduly prolong hypotension and organ hypoperfusion. Conversely, norepinephrine rapidly increases and better stabilizes arterial pressure. By binding venous adrenergic receptors, it transforms part of the unstressed blood volume into stressed blood volume. It increases the mean systemic filling pressure and increases the fluid-induced increase in mean systemic filling pressure, as observed in septic shock patients. This may improve end-organ perfusion, as shown by some animal studies. Two observational studies comparing early vs. later administration of norepinephrine in septic shock patients using a propensity score showed that early administration reduced the administered fluid volume and day-28 mortality. Conversely, in another propensity score-based study, norepinephrine administration within the first hour following shock diagnosis increased day-28 mortality. The only randomized controlled study that compared the early administration of norepinephrine alone to a placebo showed that the early continuous administration of norepinephrine at a fixed dose of 0.05 µg/kg/min, with norepinephrine added in open label, showed that shock control was achieved more often than in the placebo group. The choice of starting norepinephrine administration early should be adapted to the patient’s condition. Logically, it should first be addressed to patients with profound hypotension, when the arterial tone is very low, as suggested by a low diastolic blood pressure (e.g. ≤ 40 mmHg), or by a high diastolic shock index (heart rate/diastolic blood pressure) (e.g. ≥ 3). Early administration of norepinephrine should also be considered in patients in whom fluid accumulation is likely to occur or in whom fluid accumulation would be particularly deleterious (in case of acute respiratory distress syndrome or intra-abdominal hypertension for example).
Complex physical therapy employing self-adjusting garment (ReadyWrap®) in breast cancer-related lymphedema cases in Brazilian women: a protocol for a randomized controlled trial
Authors: da Silva Jéssica Malena Pedro , Araújo Raul Denner Duarte , da Silva Santos Francisca Cristina , Fabro Erica Alves Nogueira , de Mello Pinto Marcus Vinicius , de Aguiar Suzana Sales , Thuler Luiz Claudio Santos , Bergmann Anke
Published: August 2023

Background

Lymphedema is a common complication following breast cancer treatment. The aim of this study is to evaluate the effectiveness of a self-adjusting compression garment (ReadyWrap®) in reducing (phase 1) and maintaining (phase 2) upper limb volume in women presenting breast cancer-related lymphedema.

Methods

This study will comprise a randomized, controlled, single-blind clinical trial concerning women with breast cancer-related lymphedema undergoing treatment at a public cancer treatment reference hospital in the city of Rio de Janeiro, Brazil. The intervention will be carried out by adapting self-dressing versus the standard treatment of compressive bandaging (phase 1) and compressive mesh (phase 2). Both groups will be assessed at the beginning and end of intensive treatment and followed up for up to 12 months to evaluate immediate and late outcomes. Assessments will be carried out by physical upper limb examination (inspection, palpation, volume, dynamometry, and thermography) and questionnaires application to assess patient’s quality of life pertaining to the health, functionality, and symptoms of the affected upper limb, as well adverse effects and adherence to treatment. Data will be analyzed descriptively and analytically through univariate and multiple linear regressions. P values < 0.05 will be considered statistically significant.

Discussion

This study will evaluate the effectiveness of a self-adjustable garment (ReadyWrap®) in the treatment of lymphedema secondary to breast cancer in Brazilian women compared to the gold standard treatment for limb volume reduction (phase 1) and maintenance (phase 2) phases comprising, respectively, a compressive bandaging and a compressive mesh. The outcome results will provide data based on both quantitative responses and self-reported participant outcomes. The study will also assess the cost-effectiveness of the ReadyWrap® treatment versus standard care. Finally, we expect to reaffirm one more product/therapy as a treatment for this extremely complex and impactful condition following the data analysis.

Trial registration

NCT04934098 [Clinical trials phase 1]. Registered on June 22, 2021. NCT04881604 [Clinical trials phase 2]. Registered on May 11, 2021.
Molecular characterization of Carbapenem-resistant Escherichia coli isolates from sewage at Mulago National Referral Hospital, Kampala: a cross-sectional study
Authors: Bagaya Jamidah , Ssekatawa Kenneth , Nakabiri Gloria , Nsubuga Julius , Kitibwa Anna , Kato Charles Drago , Sembajwe Lawrence Fred
Published: August 2023

Background

Escherichia coli (E. coli) is one of the most frequent causes of fatal bacterial infections affecting both humans and animals. The resistance to Carbapenems is mainly associated with enzyme-mediated resistance mechanism, through the acquisition of Carbapenemase genes. In Uganda, no studies have been done to detect presence of Carbapenem-resistant E. coli in sewage. We therefore carried out a study to characterize Carbapenem-resistant E. coli from sewage from Mulago National Referral Hospital.

Methods and results

In this cross-sectional study, a total of 104, sewage samples were aseptically collected, cultured on MacConkey agar supplemented with Meropenem 1 µg/ml with other standard microbiology methods to screen for Carbapenem-resistant E. coli (CREC). Antimicrobial susceptibility testing was performed on the CREC, using Imipenem (10 mg/disc) and Meropenem (10 mg/disc), Carbapenem drugs readily available on market. Multiplex PCR was performed on selected Carbapenem-resistant and susceptible isolates to detect Carbapenemase genes. Later the isolates were pathotyped for virulence genes that included pathogenicity islands (PAIs) and phylogenetic markers. The results showed that the Carbapenem-resistant E. coli isolates were more resistant to Meropenem (64%) than Imipenem (60%). KPC gene was the most predominant (75%), followed by NDM gene (30%) while no OXA-48, IMP-1, and IMP-2 genes were detected. Pathotyping of virulence genes showed presence of eae gene, as the most predominant (40%), followed by elt gene (25%) and negative for stx and aggR genes. For PAI markers, only the PAI IV536 gene was detected at 10%. Then, pathotyping of the phylogenetic markers was present in 85% of the typed isolates with yjaA gene the most abundant (60%) while both chuA and TSPE4.C2 were detected in 5% of the isolates.

Conclusion

Both pathogenic and non-pathogenic Carbapenem-resistant E. coli strains are present in the sewage of Mulago National Referral Hospital in Uganda.
Bioenergetic profile and redox tone modulate in vitro osteogenesis of human dental pulp stem cells: new perspectives for bone regeneration and repair
Authors: Agriesti Francesca , Landini Francesca , Tamma Mirko , Pacelli Consiglia , Mazzoccoli Carmela , Calice Giovanni , Ruggieri Vitalba , Capitanio Giuseppe , Mori Giorgio , Piccoli Claudia , Capitanio Nazzareno
Published: August 2023

Background

Redox signaling and energy metabolism are known to be involved in controlling the balance between self-renewal and proliferation/differentiation of stem cells. In this study we investigated metabolic and redox changes occurring during in vitro human dental pulp stem cells (hDPSCs) osteoblastic (OB) differentiation and tested on them the impact of the reactive oxygen species (ROS) signaling.

Methods

hDPSCs were isolated from dental pulp and subjected to alkaline phosphatase and alizarin red staining, q-RT-PCR, and western blotting analysis of differentiation markers to assess achievement of osteogenic/odontogenic differentiation. Moreover, a combination of metabolic flux analysis and confocal cyto-imaging was used to profile the metabolic phenotype and to evaluate the redox tone of hDPSCs.

Results

In differentiating hDPSCs we observed the down-regulation of the mitochondrial respiratory chain complexes expression since the early phase of the process, confirmed by metabolic flux analysis, and a reduction of the basal intracellular peroxide level in its later phase. In addition, dampened glycolysis was observed, thereby indicating a lower energy-generating phenotype in differentiating hDPSCs. Treatment with the ROS scavenger Trolox, applied in the early-middle phases of the process, markedly delayed OB differentiation of hDPSCs assessed as ALP activity, Runx2 expression, mineralization capacity, expression of stemness and osteoblast marker genes (Nanog, Lin28, Dspp, Ocn) and activation of ERK1/2. In addition, the antioxidant partly prevented the inhibitory effect on cell metabolism observed following osteogenic induction.

Conclusions

Altogether these results provided evidence that redox signaling, likely mediated by peroxide species, influenced the stepwise osteogenic expansion/differentiation of hDPSCs and contributed to shape its accompanying metabolic phenotype changes thus improving their efficiency in bone regeneration and repair.
Comparative efficacy of oral drugs for chronic radiation proctitis — a systematic review
Authors: Liu Liangzhe , Xiao Nana , Liang Jinjun
Published: August 2023

Background

Chronic radiation proctitis (CRP) is a long-term complication of pelvic radiotherapy that manifests as rectal bleeding, diarrhoea, fistula formation and obstruction. Treatments such as endoscopic argon plasma coagulation, hyperbaric oxygen therapy and rectal topical formalin have imposed a significant medical burden on CRP patients. In contrast, oral therapies offer a more accessible and acceptable option for managing CRP. Here, we conducted a systematic review of the efficacy of oral treatments for CRP to assess their potential as an effective and convenient treatment option for this condition.

Methods

We searched the Cochrane Central Register of Controlled Trials, PubMed, Web of Science, China National Knowledge Infrastructure and Chinese VIP in February 2021. We included post-radiotherapy participants with CRP that compared oral medicine alone or in combination with other treatments versus control treatments. The primary outcomes were bleeding, diarrhoea and symptom score. Heterogeneity between studies was checked using Cochrane Q test statistics and I2 test statistics. The Cochrane risk-of-bias tool was used to assess the quality of the included studies.

Results

We included 10 randomised controlled trials (RCTs) and 1 retrospective study with 898 participants. Three placebo-controlled trials evaluated the effects of oral sucralfate on CRP, with meta-analysis showing no significant different with placebo arm. Four trials on TCM demonstrated significant improvement of symptoms, especially for the 3 trials on oral TCM drinks. Retinyl palmitate and high-fibre diet were found to reduce rectal bleeding. The combination of oral pentoxifylline and tocopherol did not significantly change the process of CRP.

Conclusions

Our study implies that oral TCM drinks, retinyl palmitate and a high-fiber diet showed significant improvement in CRP symptoms, but not with the combination of oral pentoxifylline and tocopherol. Further multicentre, larger-scale RCTs are needed to confirm the efficacy and safety of these treatments and optimize treatment strategies, ultimately improving the quality of life for patients with CRP.
Effect of an integrated maternal and neonatal health intervention on maternal healthcare utilisation addressing inequity in Rural Bangladesh
Authors: Ahmed Anisuddin , Rahman Fariya , Sayeed Abu , Tanwi Tania Sultana , Siddique Abu Bakkar , Hossain Aniqa Tasnim , Ether Saraban Tahura , Akter Ema , Tahsina Tazeen , Rahman Syed Moshfiqur , Arifeen Shams El , Rahman Ahmed Ehsanur
Published: August 2023

Background

Although Bangladesh has made significant improvements in maternal, neonatal, and child health, the disparity between rich and poor remains a matter of concern.

Objective

The study aimed to increase coverage of skilled maternal healthcare services while minimising the inequity gap among mothers in different socioeconomic groups.

Methods

We implemented an integrated maternal and neonatal health (MNH) intervention between 2009 and 2012, in Shahjadpur sub-district of Sirajganj district, Bangladesh. The study was quasi-experimental in design for the evaluation. Socioeconomic status was derived from household assets using principal component analysis. Inequity in maternal healthcare utilisation was calculated using rich-poor ratio and concentration index to determine the changes in inequity between the baseline and the endline time period.

Result

The baseline and endline surveys included 3,158 (mean age 23.5 years) and 3,540 (mean age 24.3 years) recently delivered mothers respectively. Reduction in the rich-poor ratio was observed in the utilisation of skilled 4+ antenatal care (ANC) (2.4:1 to 1.1:1) and related concentration index decreased from 0.220 to 0.013 (p < 0.001). The rich-poor ratio for skilled childbirth reduced from 1.7:1 to 1.0:1 and the related concentration index declined from 0.161 to -0.021 (p < 0.001). A similar reduction was also observed in the utilisation of skilled postnatal care (PNC); where the rich-poor gap decreased from 2.5:1 to 1.0:1 and the related concentration index declined from 0.197 to -0.004 (p < 0.001).

Conclusion

The MNH intervention was successful in reducing inequity in receiving skilled 4+ ANC, delivery, and PNC in rural Bangladesh.
Prevalence of oral complications in the course of severe SARS-CoV-2 infection under mechanical non-invasive ventilation
Authors: Paszynska Elzbieta , Gawriolek Maria , Hernik Amadeusz , Otulakowska-Skrzynska Justyna , Winiarska Hanna , Springer Daria , Roszak Magdalena , Slebioda Zuzanna , Krahel Anna , Cofta Szczepan
Published: August 2023

Background

The management of oral health during severe symptoms of Covid-19 is still a challenge, especially in intensive care units under invasive/noninvasive ventilation in hospital. Understanding the cause-and-effect relationships may allow for individual adjustment of oral care recommendations during Covid-19 disease. The study’s objective was to assess Covid-19 patients’ oral health status under hospital treatment due to pulmonary adverse Covid-19 outcomes.

Material and methods

Covid-19 patients (mean age 74.4 ± 15.4; n = 120, male n = 50/female n = 70) were admitted to hospital in the acute phase of Covid-19 between January and March 2022 who required oxygen therapy due to pneumonia, rapid respiratory failure, low saturation. Blood and radiological tests were taken according to National Health Fund guidelines. The condition of teeth (Decayed, Missing, Filled teeth as DMFT index), dental hygiene (Plaque Control Record as PCR index), periodontal status (probing depth PD, clinical attachment CAL, bleeding on probing BOP) and oral mucosa (BRUSHED and Beck scores) were examined.

Results

Charateristics of the teeth (dental caries 35.2%, DMFT Median 22), plaque retention (83.4%), advanced periodontitis (48.3%), xerostomia (74.2%), oral mucosa inflammation (80.8%), angular cheilitis (53.3%), hemorrhagic (21.7%) showed a high incidence of harmful oral conditions. BRUSHED model and Beck score indicated moderate oral dysfunction and need for oral care every 8 h. Spearman’s analysis revealed a significant positive correlation between pneumonia and neutrophile, interleukin-6 IL-6, C-reactive protein CRP (p = 0.01, p < 0.001, p < 0.001), negative to lymphocyte count (p < 0.001). Multiple and logistic regressions selected the following risk predictors for pneumonia as IL-6, CRP, obesity and for severe COVID-19 symptoms D-dimer level and a lack of targeted vaccination (p < 0.001). Among oral predictors, the PCR index and Beck score were significant for both outcomes (respectively p < 0.001, p < 0.012). Patients who received oxygen therapy with face masks had more often angular heilitis and debris (p = 0.025, p = 0.035).

Conclusions

COVID-19 hospitalised patients with severe symptoms crossing with poor oral health-related conditions. This may exacerbate a response for COVID infection, and play a role in cytokine storm. For Covid-19 management, to inhibit extraoral/intraoral complications, it is recommended to adjust oral hygiene procedures, including antibacterial, protective, moisturising agents after individual oral health assessment.
Heliocentric distance dependence of zodiacal light observed by Hayabusa2#
Authors: Tsumura Kohji , Matsuura Shuji , Sano Kei , Iwata Takahiro , Yano Hajime , Kitazato Kohei , Takimoto Kohji , Yamada Manabu , Morota Tomokatsu , Kouyama Toru , Hayakawa Masahiko , Yokota Yasuhiro , Tatsumi Eri , Matsuoka Moe , Sakatani Naoya , Honda Rie , Kameda Shingo , Suzuki Hidehiko , Cho Yuichiro , Yoshioka Kazuo , Ogawa Kazunori , Shirai Kei , Sawada Hirotaka , Sugita Seiji
Published: August 2023

Zodiacal light (ZL) is sunlight scattered by interplanetary dust particles (IDPs) at optical wavelengths. The spatial distribution of IDPs in the Solar System may hold an important key to understanding the evolution of the Solar System and material transportation within it. The number density of IDPs can be expressed as $$n(r) \sim r^{-\alpha }$$

n

(
r
)

∼

r

-
α

, and the exponent $$\alpha \sim 1.3$$

α
∼
1.3

was obtained by previous observations from interplanetary space by Helios 1/2 and Pioneer 10/11 in the 1970s and 1980s. However, no direct measurements of $$\alpha $$
α
based on ZL observations from interplanetary space outside Earth’s orbit have been performed since then. Here, we introduce initial results for the radial profile of the ZL at optical wavelengths observed over the range 0.76$$-$$
-
1.06 au by ONC-T aboard the Hayabusa2# mission in 2021-2022. The ZL brightness we obtained is well reproduced by a model brightness, although there is a small excess of the observed ZL brightness over the model brightness at around 0.9 au. The radial power-law index we obtained is $$\alpha = 1.30 \pm 0.08$$

α
=
1.30
±
0.08

, which is consistent with previous results based on ZL observations. The dominant source of uncertainty arises from the uncertainty in estimating the diffuse Galactic light (DGL).

Graphical Abstract
Management of chronic and neuropathic pain—journey mapping in Egypt
Authors: Khaled Sherif Ahmed Radwan , Nasef Nasef Mohamed , Arifeen Shams , Youssef Mina , Nessim Sameh , Yazicioğlu Mehmet Cüneyt
Published: August 2023

Background

Epidemiological studies on the prevalence and management of chronic low back pain (CLBP), osteoarthritis (OA), and diabetic peripheral neuropathy (DPN) are limited in Egypt. This review aimed to map and identify data gaps in the patient journey touchpoints for CLBP, OA, and DPN.

Main body of the abstract

An evidence-based mapping approach using MEDLINE, Embase, and Biosis databases were used to identify records between January 2010 and December 2019. Quantitative data synthesis was performed using simple mean or weighted mean, whereas qualitative information was synthesized using a narrative summary. For CLBP, of the 79 records retrieved, 11 were eligible for final analysis (7 CLBP and 4 OA records), and for DPN, of 42 records identified, 13 studies were eligible. For CLBP, data available for prevalence, awareness, and treatment were 34.3%, 39.5%, and 70.0%, respectively. The prevalence of OA was 43.0%. The majority (98.6%) of patients with OA adhered to the treatment, and in 96.2% of the patients’ symptoms were controlled. The prevalence of DPN was estimated to be 42.7%, synthesized evidence indicated that 14.1% of patients were aware of DPN and 22.7% underwent screening.

Conclusion

As the existing literature is limited, further evidence-based studies are required to accurately understand the complexity of patient journey touchpoints in Egypt. Although the studies on musculoskeletal chronic pain syndrome are limited, the high prevalence of chronic low back pain, osteoarthritis and peripheral neuropathy should urge the health care system to organize the research groups and health care facilities to focus on these disorders and to consider them in the global health care plans.
Simulation of CuO-water nanofluid natural convection in a U-shaped enclosure with a T-shaped baffle
Authors: Zemani Farah , Ladjedel Omar , Sabeur Amina
Published: August 2023

The effect of aspect ratio and baffle shape on natural convection patterns in a U-shaped cavity filled with CuO water-based nanofluid is examined in detail, with a T-shaped baffle attached to the cold wall. To solve the coupled continuity, momentum, and energy equations, a finite volume method is used, and the pressure–velocity coupling is iteratively solved with the SIMPLE algorithm. The study investigates the impact of Rayleigh number (104–106), cavity aspect ratio (Ar = 0.4, 0.6), and nanoparticle volume fraction (0 ≤ ϕ ≤ 0.05) on flow pattern and heat transfer features. The results are presented graphically in the form of streamlines, isotherms, mean, and local Nusselt numbers. It is observed that the mean Nusselt number increases with an increase in Rayleigh number, nanoparticle volume fraction, and aspect ratio, resulting in an improvement in heat transfer. The T-shaped baffle enhances heat transfer compared to other baffles. Though changing the aspect ratio (0.4 ≤ Ar ≤ 0.6) does not alter the flow pattern, an increase in Ar leads to an enhancement in the heat transfer rate.
Folic acid prescription and suicide attempt prevention: effect of past suicidal behaviour, psychiatric diagnosis and psychotropic medication
Authors: Mann J. John , Hur Kwan , Lavigne Jill E. , Gibbons Robert D.
Published: August 2023

We previously showed that folic acid prescriptions for any indication were associated with lower rates of suicidal behaviour. Given that future randomised clinical trials are likely to focus on psychiatric disorders carrying elevated risk for suicide, we now report on the moderating effects of prior suicidal behaviour, psychiatric diagnoses and psychotropic medications on potential antisuicidal effects of folic acid. Data were obtained from the MarketScan Commercial Claims and Encounters databases that cover 164 million insured persons from 2005–2017, from which a cohort of 866 586 patients was derived. Analysis revealed no significant moderation effects on the antisuicidal effect of folic acid. These findings indicate that the potential benefit of folic acid for preventing suicidal behaviour is comparable in psychiatric populations at higher risk of suicide and that it may be additive to any benefit from psychotropic medications.
CD133/Prom1 marks proximal mouse oviduct epithelial progenitors and adult epithelial cells with a low generative capacity
Authors: Ford Matthew J. , Harwalkar Keerthana , Kazemdarvish Hengameh , Yamanaka Nobuko , Yamanaka Yojiro
Published: August 2023

The epithelium lining the oviduct or fallopian tube consists of multiciliated and secretory cells, which support fertilization and preimplantation development, however, its homeostasis remains poorly understood. CD133/Prom1 expression has been used as a marker to identify adult stem cell populations in various organs and often associated with cancer cells that have stem-like properties. Using an antibody targeted to CD133 and a Cre recombinase-based lineage tracing strategy, we found that CD133/Prom1 expression is not associated with a stem/progenitor population in the oviduct but marked predominantly multiciliated cells with a low generative capacity. Additionally, we have shown that CD133 is disparately localised along the oviduct during neonatal development, and that Prom1 expressing secretory cells in the ampulla rapidly transitioned to multiciliated cells and progressively migrated to the ridge of epithelial folds.
Effects of particle size and thickness of quartz sand on the webbed foot kinematics of mallard (Anas platyrhynchos)
Authors: Han Dianlei , Liu Hairui , Hu Jinrui , Yang Qizhi
Published: August 2023

The webbed foot structure of mallards (Anas platyrhynchos) exhibits effective anti-subsidence properties when walking on soft ground. To investigate the effects of quartz sand particle size and thickness on joint angles and the movement patterns of webbed feet, we created a testing substrate with quartz sand and utilized high-speed cameras and kinematic analysis tools for data acquisition. Mallards mainly adjusted the tarsometatarso-phalangeal joint (TMTPJ) during touch-down and lift-off stages in response to increasing particle size or enhanced ground roughness. Conversely, adjustments to the intertarsal joint (ITJ) predominantly took place during mid-stance. Conversely, mallards predominantly adjusted the ITJ during touch-down and lift-off when coping with increased quartz sand thickness, with TMTPJ adjustments mainly occurring at touch-down. As quartz sand particle size increased, the TMTPJ angle increased, the ITJ angle decreased, toe closure advanced, and the duty factor decreased throughout the entire stride cycle. In contrast, increasing quartz sand thickness led to more delayed TMTPJ adjustments, slower webbed foot closure, and an increased duty factor throughout the stride cycle. Mallards modify their leg posture to notably decrease the touch-down foot angle upon encountering sandy terrain. This action subsequently forms a depression beneath their feet, contributing to sand consolidation and limiting flow. During the stance phase, the mallard's weight is distributed across the webbed foot, generating minimal pressure and preventing significant subsidence while walking on sandy ground.
Biochemical and genetic dissection of the RNA-binding surface of the FinO domain ofEscherichia coliProQ
Authors: Stein Ewa M. , Wang Suxuan , Dailey Katherine G. , Gravel Chandra M. , Wang Shiying , Olejniczak Mikołaj , Berry Katherine E.
Published: August 2023

RNA-binding proteins play important roles in bacterial gene regulation through interactions with both coding and noncoding RNAs. ProQ is a FinO-domain protein that binds a large set of RNAs inEscherichia coli, though the details of how ProQ binds these RNAs remain unclear. In this study, we used a combination of in vivo and in vitro binding assays to confirm key structural features ofE. coliProQ’s FinO domain and explore its mechanism of RNA interactions. Using a bacterial three-hybrid assay, we performed forward genetic screens to confirm the importance of the concave face of ProQ in RNA binding. Using gel shift assays, we directly probed the contributions of ten amino acids on ProQ binding to seven RNA targets. Certain residues (R58, Y70, and R80) were found to be essential for binding of all seven RNAs, while substitutions of other residues (K54 and R62) caused more moderate binding defects. Interestingly, substitutions of two amino acids (K35, R69), which are evolutionarily variable but adjacent to conserved residues, showed varied effects on the binding of different RNAs; these may arise from the differing sequence context around each RNA’s terminator hairpin. Together, this work confirms many of the essential RNA-binding residues in ProQ initially identified in vivo and supports a model in which residues on the conserved concave face of the FinO domain such as R58, Y70, and R80 form the main RNA-binding site ofE. coliProQ, while additional contacts contribute to the binding of certain RNAs.
Ageism and Its Impact on Quality of Life Among Older Persons Experiencing Difficulties with Activities of Daily Living
Authors: Sandoval Garrido Felipe Alfonso , Bolt Timothy , Taniguchi Yuta , Lloyd-Sherlock Peter
Published: August 2023

Background: As the number of older persons increases globally, so does ageism, or being discriminated against because of their age. The overlap between ageism and ableism, which is discrimination based on impairments or disability may put persons having difficulties with their basic (ADL) or instrumental activities of daily living (IADL) at a higher risk of discrimination. Discrimination leads to poorer quality of life. However, ageism remains understudied, particularly in the UK.

Methods: Data from the English Longitudinal Study of Ageing (ELSA) collected in the 2010-2011 period (Wave 5) was used to assess ageism, ADL/IADL status, and quality of life (CASP-19) at baseline. Multivariable linear regression was used to estimate the changes in the quality of life while adjusting for covariates and their baseline values in two following periods: 2016-2017 (Wave 7) and 2018-2019 (Wave 9).

Results: At baseline, quality-of-life scores were significantly lower among individuals dealing with difficulties (33.6 points) compared to those without them (41.5 points), with a difference of 7.9 points (p < .001). In the following waves, age discrimination was found to have a negative effect on the quality of life of all the participants regardless of ADL/IADL difficulties (B: -1.106, p=<0.001), and also among those without difficulties (B=-1.401, p=<0.001). However, among those with difficulties, no such association was found in any of the analyses.

Conclusions: Discrimination has a detrimental effect on quality of life, but this effect may be mediated by characteristics of the older persons suffering from loss of independence, such as coping mechanisms, resilience, social support, personality, and other latent characteristics that may be associated with ADL/IADL difficulties not included in this study. These findings underscore the importance of understanding the driving elements of quality of life among older persons to effectively inform future intervention strategies, especially for those at risk of ageism.
Auditing cesarean section indications in women of Groups 1 to 4 of Robson's Ten-Group Classification System: A descriptive study at a university hospital in Thailand
Authors: Witsawapaisan Waratchaya , Komwilaisak Ratana , Sothornwit Jen , Kongwattanaku Kiattisak , Jampathong Nampet , Dumont Alexander , Pilar Betrán Ana , Robson Michael , Duangkum Chatuporn , Saksiriwuttho Piyamas , Chaiyarach Sukanya , Lumbigano Pisake
Published: August 2023

Aim: To determine the appropriateness of indication for cesarean section in women at term with a single fetus in cephalic presentation without previous CS irrespective of parity and how labor started (Robson's Ten-Group Classification System [RTGCS] groups 1-4). 

Methods: This was a descriptive study assessing medical records of 311 women in RTGCS groups 1- 4, between 1st January 2020 and 31st December 2020 who underwent a CS in Srinagarind Hospital, a university hospital, Khon Kaen, Thailand. Appropriateness of CS indications was assessed using criteria developed by our institute. Indications were classified into three categories: cephalopelvic disproportion (CPD), fetal indications, and other maternal indications.

Results: The overall appropriate rate of CS indications in RTGCS groups 1-4 was 32.5% (95% CI 26.8% – 38.7%). The appropriate rates of CS indications in RTCGS group 1, 2a, 2b, 3, 4a, and 4b were 43.0% (95% CI 35.2% - 51.2%), 10.6% (95% CI 0.0% - 24.9%), 11.7% (95% CI 0.0% - 25.0%), 50.0% (95% CI 32.1% - 68.6%), 0% (95% CI 0.0% - 100%), and 40.0% (95% CI 20.0% - 74.8%) respectively.

Conclusion: Low appropriateness in CS indications in RTGCS groups 1-4 leads to high CS rates. Increasing appropriateness of CS indications in this population will reduce unnecessary CS. Interventions focusing on increasing appropriateness in CS indications are urgently required to achieve appropriate use of CS.
The impact of childbirth on women's sexuality and methods of treating its disorders
Authors: Matkowski Igor , Bigos Paula , Dendys Konrad , Bieniasz Jan , Kuźnicki Wojciech , Potyrała Piotr
Published: August 2023

Postpartum sexual disorders can significantly impact individuals and their partner relationships, affecting a considerable percentage of women, with reduced libido being the most common symptom. Factors such as breastfeeding, postpartum depression, and communication issues with partners increase the risk of experiencing these disorders.

This review aimed to explore scientific reports on the frequency, contributing factors, and treatment options for postpartum sexual disorders. The analysis was conducted by reviewing literature available in PubMed.

The mode of delivery (natural or cesarean) does not significantly differ in its impact on postpartum sexual disorders.

Non-pharmacological treatments encompass psychotherapy, from which mindfulness-based cognitive is the most effective and physical exercises. Engaging in regular physical exercises contributes to enhanced sexual experiences, notably in terms of sexual arousal and offers other health benefits. Moreover, Kegel exercises have been demonstrated as a method to increase sexual satisfaction.

Medications used to treat libido dysfunction include flibanserin, bremelanotide, and bupropion. For women experiencing depression and sexual dysfunction, antidepressants with a lesser impact on sexual function may be considered.

Vaginal dryness can be effectively addressed with moisturizing gels, globules, and lubricants.

When considering pharmacotherapy, it is essential to evaluate the severity of symptoms, potential side effects for both the woman and her child being breastfed, and psychological discomfort. Physicians play a vital role, as women with sexual disorders may find it challenging to express their concerns. Partner support is crucial in improving a woman's sexual life.
Midwives’ perceptions of enablers and barriers to pertussis and influenza vaccination in pregnancy and information sharing
Authors: Young Amber , Willing Esther , Gauld Natalie , Dawson Pauline , Charania Nadia A. , Norris Pauline , Turner Nikki
Published: August 2023

Background: Vaccination in pregnancy against influenza and pertussis protects the pregnant woman/person and their infant against severe disease. Aotearoa New Zealand has a lower uptake of vaccination in pregnancy than some other countries, despite this immunisation being publicly funded. Coverage is also inequitable, with Māori, Pacific people, and people from high deprivation areas less likely to be vaccinated. Many barriers exist to vaccinations in pregnancy, e.g., access barriers and lack of knowledge about vaccination. Discussions about recommended vaccines with healthcare professionals, particularly midwives, may have a positive impact on vaccine decision-making. Aim: This study aimed to investigate midwives’ perceptions of enablers and barriers with discussions about vaccinations in pregnancy, barriers to vaccination in pregnancy, and influences on vaccine decision-making in pregnancy. The study also aimed to gather midwives’ insights into what might improve vaccination uptake. Method: A structured questionnaire was developed containing a mix of closed and open-ended questions. The questionnaire was sent out to 3002 midwives registered in Aotearoa New Zealand in October 2021, using REDCap electronic data capture tools. Simple descriptive statistics were undertaken on the quantitative data. The answers to the open-ended questions were analysed using a direct, qualitative content analysis approach. Findings: Fifty-one midwives’ responses were included in the analysis (1.8% response rate). Almost all reported sufficient knowledge of vaccinations in pregnancy but had varying levels of confidence when discussing them. The most common enablers to conversations were good relationships, easy communication, and having the time and resources available. Respondents perceived that barriers to conversations were negative preconceptions, communication difficulties and lack of time. Lack of awareness, cost to access services and competing priorities for time were also thought to reduce the likelihood of vaccination in pregnancy. To improve vaccine uptake, respondents identified the need for accessible and suitable vaccination venues, appropriate information and the support of all healthcare professionals involved in maternal healthcare. Conclusion: Midwives surveyed understand the importance of vaccination in pregnancy but there may be lack of confidence, time or resources to effectively engage in discussions. A trusting relationship is important but this can be affected by disengagement or late presentation to healthcare services. Resources to counter pre-existing negative ideas and support communication would help midwives to provide useful information about vaccination. Furthermore, respect and cultural understanding of hapū Māori and their needs will positively support their ability to make informed decisions.
D-Optimal Data Fusion: Exact and Approximation Algorithms
Authors: Li Yongchun , Fampa Marcia , Lee Jon , Qiu Feng , Xie Weijun , Yao Rui
Published: August 2023

We study the D-optimal Data Fusion (DDF) problem, which aims to select new data points, given an existing Fisher information matrix, so as to maximize the logarithm of the determinant of the overall Fisher information matrix. We show that the DDF problem is NP-hard and has no constant-factor polynomial-time approximation algorithm unless P = NP. Therefore, to solve the DDF problem effectively, we propose two convex integer-programming formulations and investigate their corresponding complementary and Lagrangian-dual problems. Leveraging the concavity of the objective functions in the two proposed convex integer-programming formulations, we design an exact algorithm, aimed at solving the DDF problem to optimality. We further derive a family of submodular valid inequalities and optimality cuts, which can significantly enhance the algorithm performance. We also develop scalable randomized-sampling and local-search algorithms with provable performance guarantees. Finally, we test our algorithms using real-world data on the new phasor-measurement-units placement problem for modern power grids, considering the existing conventional sensors. Our numerical study demonstrates the efficiency of our exact algorithm and the scalability and high-quality outputs of our approximation algorithms.

History: Accepted by Andrea Lodi, Area Editor for Design & Analysis of Algorithms—Discrete.

Funding: Y. Li and W. Xie were supported in part by Division of Civil, Mechanical and Manufacturing Innovation [Grant 2046414] and Division of Computing and Communication Foundations [Grant 2246417]. J. Lee was supported in part by Air Force Office of Scientific Research [Grants FA9550-19-1-0175 and FA9550-22-1-0172]. M. Fampa was supported in part by Conselho Nacional de Desenvolvimento Científico e Tecnológico [Grants 305444/2019-0 and 434683/2018-3]. F. Qiu and R. Yao were supported in part by the U.S. Department of Energy Advanced Grid Modeling Program under [Grant DE-OE0000875].

Supplemental Material: The e-companion is available at https://doi.org/10.1287/ijoc.2022.0235 .