bluuebunny/crossref_metadata_2025 huggingface dataset:
BERT-5mC: an interpretable model for predicting 5-methylcytosine sites of DNA based on BERT
Authors: Wang Shuyu , Liu Yinbo , Liu Yufeng , Zhang Yong , Zhu Xiaolei
Published: December 2023

DNA 5-methylcytosine (5mC) is widely present in multicellular eukaryotes, which plays important roles in various developmental and physiological processes and a wide range of human diseases. Thus, it is essential to accurately detect the 5mC sites. Although current sequencing technologies can map genome-wide 5mC sites, these experimental methods are both costly and time-consuming. To achieve a fast and accurate prediction of 5mC sites, we propose a new computational approach, BERT-5mC. First, we pre-trained a domain-specific BERT (bidirectional encoder representations from transformers) model by using human promoter sequences as language corpus. BERT is a deep two-way language representation model based on Transformer. Second, we fine-tuned the domain-specific BERT model based on the 5mC training dataset to build the model. The cross-validation results show that our model achieves an AUROC of 0.966 which is higher than other state-of-the-art methods such as iPromoter-5mC, 5mC_Pred, and BiLSTM-5mC. Furthermore, our model was evaluated on the independent test set, which shows that our model achieves an AUROC of 0.966 that is also higher than other state-of-the-art methods. Moreover, we analyzed the attention weights generated by BERT to identify a number of nucleotide distributions that are closely associated with 5mC modifications. To facilitate the use of our model, we built a webserver which can be freely accessed at: http://5mc-pred.zhulab.org.cn.
Um estudo na literatura internacional sobre as dívidas públicas
Authors: Fernandes Cássio Aparecido Borges , De Oliveira Thalles Moreira , Campos Renato Silverio , Do Prado Jose Willer
Published: December 2023

As discussões acerca das dívidas públicas têm recebido cada vez mais atenção tanto na literatura nacional quanto na internacional. As dívidas públicas surgem quando os entes públicos precisam recorrer a empréstimos para cumprir suas obrigações, que incluem a manutenção de bens e a oferta de serviços para a sociedade. Essa temática tem despertado interesse de pesquisadores e estudiosos, devido à sua relevância para a sociedade. O objetivo deste artigo é realizar um levantamento dos artigos publicados sobre as dívidas públicas, identificando os autores mais citados e a quantidade de publicações, além de realizar uma análise sobre as publicações selecionadas. Para atender ao objetivo proposto, este artigo apresenta uma metodologia de pesquisa bibliométrica, utilizando dados da base Scopus. A natureza do estudo é descritiva, pois visa descrever os itens encontrados na análise bibliométrica dos 413 artigos selecionados no período de 2018 a 2022. Os resultados da pesquisa revelam que os Estados Unidos da América é o país que mais contribuiu com publicações sobre o tema das dívidas públicas. Por outro lado, o autor com maior número de artigos publicados sobre o assunto é da África do Sul. Além disso, os resultados também apontam para uma predominância euro-americana nas publicações, indicando que a maioria dos estudos e pesquisas são provenientes de países europeus e americanos.
Role of Selenium in the Body: A Narrative Review
Authors: Saini Urvashi Mohanlal , Ferdous Suraiya
Published: December 2023

The maintenance of required levels of essential micronutrients and macronutrients is necessary for the smooth and proper functioning of the body. Any increase or decrease in the levels of these required micronutrients will have an adverse effect on the metabolic activities carried out in the body. The intake of micronutrients differs from region to region, and many micronutrients do not function in their natural form. Selenium is one of the most vital micronutrients required by the body. Numerous organs and systems, such as the cardiovascular system and reproductive system, are affected by selenium deficiency, which is characterised by diminished activity. Consuming selenium in physiologically suitable doses is necessary for maintaining reproductive and general health. Selenium levels that are beyond the permissible range have been associated with infertility. Prolonged exposure to selenium in the environment has been shown to pose a significant danger to human health. It is still unknown how different dietary selenium sources are processed in human bodies, as well as the ideal type or quantity of dietary selenium to maintain metabolic homeostasis and enhance reproductive health. Throughout the world, selenium deficiency is a relatively prevalent cause of various diseases. It is possible to take supplements for selenium deficiency; however, increased levels of selenium, which are toxic, are very close to normal levels. Therefore, it is important to rule out the toxicity brought on by elevated selenium levels when determining the normal selenium concentration.
Importance of the Levothyroxine Absorption Test in an Adolescent Girl
Authors: Mondal Asish , Sinha Pradip Kumar , Roy Dipu , Ghosh Basudeb , Arif MD
Published: December 2023

Hypothyroidism is a commonly encountered problem in daily clinical practice. Although the management of hypothyroidism may seem straightforward, it can become challenging when patients’ Thyroid-Stimulating Hormone (TSH) values remain elevated despite treatment. Various factors, including non-adherence and malabsorption, can contribute to this issue. Consequently, it is crucial to identify the underlying cause of increased levothyroxine demand, as this will prevent unnecessary dosage adjustments of levothyroxine tablets. In this case, a 13-year-old girl patient, presented with a TSH level greater than 200 and an fT4 level of 0.34, along with absent secondary sexual characteristics, impaired memory, delayed puberty, easy susceptibility to anxiety, difficulty with memorisation, and poor academic performance. Despite repeated inquiries, neither she nor her mother reported any instances of non-compliance. Additionally, there were no signs suggestive of malabsorption, such as diarrhoea or oedema. Therefore, a levothyroxine absorption test was conducted to rule out pseudo-malabsorption. This test aids in distinguishing patients with non-compliance from those with true malabsorption, thereby avoiding unnecessary dosage adjustments of levothyroxine supplementation, a problem frequently encountered in day-to-day clinical practice.
Evaluating the Efficacy of Chewable Toothbrushes: A Scoping Review
Authors: Shukr Bandar
Published: December 2023

Introduction: The Chewable Toothbrush (CB) is a recent innovation in mechanical plaque removal methods. With its unique design, this tiny compressible brush can be used in both chewing and brushing actions without the need for toothpaste or water. Aim: To provide an overview of the indications, contraindications, advantages, and disadvantages of CBs. Furthermore, the present study aims to summarise the current evidence on the efficacy of plaque removal compared to powered or manual toothbrushes in all age groups and in both orthodontic and non orthodontic patients. It also aims to report the evidence on the ability of CBs to prevent dental caries. Materials and Methods: The electronic databases of ‘Google Scholar,’ ‘PubMed,’ ‘Cochrane Database,’ and ‘Science Direct’ were searched for all studies that evaluated the efficacy of CBs in removing dental plaque or controlling dental caries. The eligibility criteria included any study written in English, involving all types of populations without any restrictions. A total of 14 articles were identified and included in the present review. A data-charting form was utilised to extract relevant information from eligible studies. Results: A review of the current published studies revealed inferior efficacy for CB compared to the powered brush, with inconsistent findings compared to the manual brush. Additionally, CB has demonstrated promising caries prevention capabilities in most studies. Conclusion: Based on its indications, CB might be an appropriate oral hygiene tool in situations where manual toothbrushing is difficult to perform, such as in individuals with physical disabilities, reduced manual dexterity, and those who lack brushing motivation or the appropriate brushing technique. The use of CB could be beneficial in individuals with a high-risk of caries due to its unique anticaries properties. However, more research is required to confirm these findings.
Impact of Oral Metronomic Chemotherapy in Locally Advanced Carcinoma of the Laryngopharynx: A Case Report
Authors: Mahani Anmol , Nautiyal Vipul , Gupta Meenu , Kumar Viney
Published: December 2023

Oral cancer continues to be a significant health concern in Southeast Asia. The primary treatment involves surgical resection with or without reconstruction, along with adjuvant therapy. However, the survival rates for patients with stage I-II oral cancer range from 70% to 80%, whereas in more advanced stage III-IV cancers, these rates drop significantly to 40%-50%. Unresectable oral cancers are primarily managed with palliative intent, utilising systemic therapy and/or radiotherapy. Unfortunately, a substantial portion of these cases (around 60%-80%) are diagnosed at an advanced stage due to delayed diagnosis, limited access to definitive treatment, and financial constraints. These challenges underscore the critical need for therapies that can effectively halt cancer progression, promote regression, and maintain the disease in an operable state while awaiting definitive treatment, typically involving surgery. In this context, Oral Metronomic Chemotherapy (OMCT) emerges as a promising alternative. OMCT offers costeffectiveness and involves the regular administration of chemotherapeutic drugs at low doses without interruption. The concept of “metronomic” chemotherapy draws inspiration from a metronome, which produces regular ticks representing a constant pulse. Herein, the authors presented case report of a 55-year-old male patient to compile evidence-based data on the use of OMCT in treating locally advanced carcinoma of the laryngopharynx. It explores the mechanism of action, utility, and potential future directions of OMCT. By analysing a real-world case, it seeks to highlight the effectiveness and advantages of OMCT as a treatment option for oral squamous cell carcinoma.
Implementation of Surviving Sepsis Campaign Guidelines in a Tertiary Care Hospital and Its Impact on Patient Outcomes: A Cross-sectional Study
Authors: Bhandary Roopa , Marla Amitha , Rao Sudesh , Rohith Y , Kumar Aishwarya Krishna
Published: December 2023

Introduction: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis care bundles, which incorporate key factors such as recognition, diagnosis, and early management, can help standardise the quality of care and have an impact on sepsis-related mortality rates. The Surviving Sepsis Campaign guidelines have formulated recommendations to be incorporated into sepsis care and management. Aim: To assess the compliance rate with the sepsis care bundle and study its impact on patient outcomes, specifically the mortality rate. Materials and Methods: This cross-sectional observational study was conducted at the AJ Institute of Hospital Administration in Dakshina Kannada, Karnataka, India, from October 2019 to December 2021. Adult patients in the Emergency Department with signs and symptoms of sepsis were diagnosed and categorised based on the Quick Sequential Organ Failure Assessment (qSOFA) tool. Patients with a qSOFA score >2 were further analysed using the SOFA score. The 2018 Surviving Sepsis care bundle was reviewed, and its utility in sepsis management was analysed. Empirical antibiotics to be administered to sepsis patients, in accordance with the hospital antibiogram, were shortlisted based on the category of sepsis at presentation. All sepsis patients were followed-up to track microbiological reports, appropriate escalation or de-escalation of antibiotics as per the hospital's antibiotic policy, and the condition on discharge to assess patient outcomes. The impact on mortality rate was analysed using the Chi-square test, relative risk, and 95% confidence interval to compare mortality between the compliant and non-compliant groups. Results: A total of 156 participants took part in the study, of which 109 (69%) were male and 47 (31%) were female. The median age of the study participants was 59.6 years. Patient outcomes were measured using the mortality rate for different SOFA scores. A significant difference in mortality was noted between bundle adherent cases and non-adherent cases for SOFA scores <2 and >2. Conclusion: The sepsis care bundle helps standardise care and can reduce mortality in sepsis patients.
A Case of Primary Mucinous Adenocarcinoma of the Renal Pelvis: A Rare Occurrence
Authors: Bera Sayanta , Dey Soumya , Bhattacharya Debashis , Mondal Madhumita , Sinha Mamata Guhamallick
Published: December 2023

Adenocarcinoma represents only 1% of renal pelvis malignancies and can have three subtypes: tubulovillous, mucinous, and papillary non intestinal. Primary mucinous adenocarcinomas are very rare in the renal pelvis. We report a case of a 62-year-old male patient who presented with bilateral dull aching flank pain for 15 years. No flank tenderness was observed on clinical examination. Magnetic Resonance Imaging of the Kidney, Ureters, and Bladder (MRI KUB) showed marked dilation of the left kidney's pelvicalyceal system with irregular thinning of renal parenchyma, as well as a large filling defect. Percutaneous Nephrolithotomy (PCNL) obtained gelatinous material, and the Carcinoembryonic Antigen (CEA) level was found to be high. The patient underwent left radical nephrectomy, and gross examination of the kidney revealed staghorn calculi and multiple cavities filled with pus and gelatinous material. Microscopic examination showed atypical glands infiltrating the parenchyma with abundant extracellular mucin. Immunohistochemical (IHC) examination showed cytoplasmic positivity for CK7, CK20, and CEA, while PAX8 and GATA3 were negative. The Ki67 labeling index was more than 20%. The case was diagnosed as mucinous adenocarcinoma of the renal pelvis.
Serum Omentin-1 Levels in Patients with Type 2 Diabetes Mellitus and their Correlation with Lipid Profile: A Case-control Study
Authors: Monika N , Beegum M Saboora , Jabbar PK , Jessy SJ
Published: December 2023

Introduction: Type 2 Diabetes Mellitus (T2DM) is characterised by a variable degree of insulin resistance, leading to hyperglycemia. Serum omentin-1, an important adipocytokine, plays a role in maintaining tissue sensitivity to insulin and lipid metabolism. Therefore, circulating omentin-1 can serve as a biomarker for obesity, diabetes, and dyslipidemia. Aim: The aim of this study was to compare serum omentin-1 levels between type 2 diabetic cases and non diabetic controls, and to investigate the correlation of omentin-1 levels with the lipid profile. Materials and Methods: A hospital-based case-control study was conducted at Government Medical College, Trivandrum, from December 2017 to November 2018. The study included 30 T2DM patients and 30 non diabetic controls. Serum omentin-1 levels, fasting blood sugar, glycated haemoglobin (HbA1C), and serum lipid profile were measured in all study subjects. Statistical analysis included Student’s t-test and Pearson’s correlation coefficient to assess the correlation between variables. Chi-square test was performed to analyse age and sex distribution among the study groups. Results: The mean age of diabetic cases was 56.7±7.9 years, while the mean age of non diabetic controls was 52.9±5.5 years. Among the subjects, 43% of diabetics and 50% of non diabetics were male, while 57% of diabetics and 50% of non diabetics were female. The mean value of serum omentin-1 levels was significantly lower in the diabetic population (273.37±60.18 ng/mL) compared to the non diabetic controls (573.4±51.6 ng/mL) with a p-value of <0.001. Serum omentin-1 showed a significantly strong negative correlation with total cholesterol, low-density lipoproteins (LDL), and triglycerides, and a positive correlation with high-density lipoproteins (HDL). Conclusion: In the present study, serum omentin-1 levels were significantly lower in the diabetic population, and their lipid profile exhibited abnormal values. This suggests that omentin promotes insulin sensitivity and affects lipid metabolism, thus preventing insulin resistance and dyslipidemia in T2DM patients. Therefore, omentin may play a role in reducing cardiovascular complications.
Diagnosis of Disseminated Intravascular Coagulation in Patients Suffering from Sepsis using the Modified International Society of Thrombosis and Haemostasis Criteria and Japanese Association of Acute Medicine Criteria
Authors: Vobbilisetty Deepti Ravi , Pore Shubhajyoti N , Joshi Anil R
Published: December 2023

Introduction: The international task force defines sepsis as ‘life- threatening organ dysfunction caused by a dysregulated host response to infection’. Disseminated Intravascular Coagulation (DIC) is a coagulopathy syndrome that causes microvascular and macrovascular thrombosis and increases the risk of bleeding due to consumptive coagulopathy. Sepsis causes dysfunction in coagulation due to release of inflammatory markers which leads to inappropriate deposition of intravascular fibrin. In order to facilitate the diagnostic process for detecting DIC, the scoring system recommended by International Society of Thrombosis and Haemostasis (ISTH) and Japanese Association of Acute Medicine (JAAM) were used which are based on the global coagulation tests such as the platelet count, Prothrombin time, International Normalised Ratio (INR) and Fibrin Degradation Products (FDPs)/D-dimer. Aim: To determine the prevalence and outcome of DIC in patients suffering from sepsis using ISTH criteria and JAAM criteria. Materials and Methods: A prospective cohort was carried out from January 2021 to July 2022 in the haematology section of pathology department of Government Medical College and Hospital, Aurangabad, Maharashtra, India. Hundred patients suffering from clinically suspected sepsis were included in the study. Venous blood was collected from patients in Ethylene Diamine Tetra-acetic Acid (EDTA) and Citrate bulbs. The tests performed were Complete Blood Count (CBC), Prothrombin Time (PT), INR and D-Dimer. CBC was performed on Fully automated three part cell counter. PT, INR, D-Dimer testing was done on fully automated coagulometer. The above test results were used to diagnose DIC in patients suffering from sepsis using the modified ISTH and JAAM criterias. The results were analysed using Microsoft excel 2019 i.e., chi-square test was applied for p-value calculation. Results: Out of 100 patients with clinically suspected sepsis 35 patients (35%) suffered from Overt DIC using ISTH criteria and 58 patients (58%) suffered from DIC using JAAM criteria. The total mortality in patients with sepsis in the present study was 40%. The mortality in patients with DIC in sepsis using the ISTH criteria was 26 patients (74.28%) and 37 patients (63.79%) using the JAAM criteria. Conclusion: Coagulation abnormalities are widely prevalent in patients with sepsis and are likely to play a key role in multi- organ dysfunction. Both ISTH and JAAM criteria are good predictors of mortality.
Orbital Adnexal Malignant Tumours: A Report of Two Cases
Authors: Singh Deepali , Halder Doyel , Mandal Ankita Pranab , Sinha Mamata Guha Mallick
Published: December 2023

Sebaceous carcinoma of the eyelid is a very rare malignant tumour, accounting for 1-1.5% of total eyelid malignancies. It typically arises from the meibomian glands, making it more common in the upper eyelids. It predominantly affects individuals in their sixth to eighth decade, with a higher incidence in females. Histologically, the tumour cells are arranged in well-defined lobules with circumscribed borders. These cells exhibit pleomorphism, eccentric hyperchromatic nuclei, inconspicuous nucleoli, and multivacuolated cytoplasm. The clinical course of sebaceous carcinoma is aggressive, often characterised by recurrences and metastasis to regional lymph nodes. Unfortunately, it is not commonly considered in the differential diagnosis of eyelid tumours, leading to delayed treatment. Thus, it is crucial to raise awareness about this uncommon neoplasm occurring at unusual sites in order to improve patient survival. In the present case report, the authors present two cases: a 54-year-old male patient with intraocular sebaceous carcinoma, which recurred, and an 83-year-old male patient with extraocular sebaceous carcinoma. In both the cases, imaging and other investigations were performed, followed by excision of the mass and confirmation of the diagnosis through histopathological reporting. Subsequent follow-up was conducted for both cases and the postoperative recovery was uneventful.
Integrated Effect of Vermicompost and Chemical Fertilizers on the Yield & Yield Contributing Characteristics of Brinjal (Solanum melongena L.)
Authors: Jannat Sharmin Ara , Haque Md. Azizul , Nahar Kamrun , Ali Md. Khan Jahan , Chowhan Sushan , Hossian Md. Maruf , Rahman Md. Habibur
Published: December 2023

Field experiment was conducted at the BINA Sub-Station, Ishurdi to investigate the integrated effect of vermicompost and chemical fertilizers on the yield and yield contributing characters of brinjal. Seven treatments were used in the experiment. The treatments used in the experiments were T1: Control; T2: Recommended fertilizer (RF); T3: 75% RF + 3 tha-1 Vermicompost (VC); T4: 75% RF + 5 tha-1 VC; T5: 50% RF + 3 tha-1 VC; T6: 50% RF + 5 tha-1 VC; T7: 5 tha-1 VC. The experiment was conducted in a Randomized Complete Block Design with three replications. The treatment T4 (75% RF + 5 tha-1) gave maximum yield (7.8 tha-1) of brinjal followed by the treatment T6 (6.88 tha-1).  But the treatments T3 and T5 gave identical yields of brinjal. Therefore, fertilizer doses of N101.25, P27, K52.5, S3.75, Zn0.75 kgha-1 with VC @ 5 tha-1 for Ishurdi could be adopted in the cultivation of brinjal for getting maximum yields.
Millet's Role as a Climate Resilient Staple for Future Food Security: A Review
Authors: Ashoka P.  , Raut Dnyaneshwar , Sudeepthi B. , Gawande Kunal Nitin , Reddy Gurrala. Sai Vamsi , Padhan Smruti Ranjan , Panigrahi Chandan Kumar
Published: December 2023

This review comprehensively examines the role of millets as a sustainable and resilient food source in the context of global climate change and escalating food security challenges. Millets, a group of small-seeded grasses traditionally grown in semi-arid regions of Africa and Asia, are re-emerging as crops of significance due to their remarkable adaptability to harsh environmental conditions and their rich nutritional profile. The review begins by outlining the various types of millets, including pearl, finger, and foxtail millet, and their geographic distribution, emphasizing their adaptability to diverse climatic conditions. It then delves into the nutritional aspects of millets, highlighting their high content of dietary fiber, vitamins, minerals, and essential amino acids, making them a potent solution to combat malnutrition and micronutrient deficiencies prevalent in many developing regions. A critical focus is placed on the climate resilience of millets. Their exceptional drought tolerance, ability to thrive in poor soil conditions, lower water, and nutrient requirements compared to staple crops like wheat and rice, and resistance to pests and diseases underscore millets' potential as sustainable crops in increasingly unpredictable climatic scenarios. This resilience not only promises to bolster food security but also contributes to sustainable agricultural practices. It explores the challenges and limitations in millet cultivation, processing, consumer acceptance, and market integration. It highlights the current gaps in millet-focused agricultural policies, the need for improved processing technologies, and strategies to enhance consumer appeal and marketability. Innovations in millet breeding for enhanced traits, advances in processing technologies, and the impact of biotechnology and climate-smart agricultural practices are examined. These technological and scientific advancements present opportunities for overcoming existing challenges and enhancing the role of millets in global food systems. Also presents case studies from various countries, particularly India, illustrating successful initiatives in millet cultivation, integration into national food policies, and community-led efforts. These examples offer valuable insights into practical approaches for promoting millets.
Standardisation of Temperature Induction Response Technique: A Promising Method for Screening of Maize Genotypes for Thermotolerance at Seed Level
Authors: Raviteja Doddaghatta H. , Dhanoji M. M. , Kuchanur P. H. , Amaregouda A.  , Patil R. P. , Shrikanth B
Published: December 2023

Climate change adversely affects global agriculture. Heat stress is a major problem for crop production, which detrimentally affects plant growth and development. Maize is a diverse crop widely used as food, feed and fodder. Heat stress affects maize growth and development significantly, reducing the yield and quality of the crop. Crop improvement is critical for heat stress. With the advancement in omics technologies, developing tolerant genotypes has become a great option. The crop improvement involves screening and evaluation of the diverse maize genotypes, which is laborious and time-consuming. The temperature induction response technique (TIR) is one of the reliable and robust techniques that can be used for screening a large population of genotypes. It is based on the concept of acquired thermotolerance and lethal dose 50, but it is crop-specific. Hence, the present study standardized the TIR technique in maize at the seed level. The Lethal temperature standardised for maize seeds was 50°C for three hours, while the induction or sublethal temperature standardised was gradual exposure of maize seeds to 32-50°C for 4.5 hours. After a recovery period of 24 hours under room conditions, the seeds were tested for germination and recovery growth was measured as a means of thermotolerance. The standardized TIR in maize can be a reliable and robust technique for evaluating and screening the maize genotypes for thermotolerance at the seed stage itself.
Role of Diffusion-Weighted Magnetic Resonance Imaging in Differential Diagnosis of Splenic Focal Lesions
Authors: El-Bagoury Shereen Essam , Hefeda Mohamed Mohamed , Teama Atef Hammad
Published: December 2023

Background: In computed tomography (CT) and magnetic resonance imaging (MRI), enhancement patterns observed following the injection of a contrast agent are typically used to non-invasively distinguish between malignant and benign localised splenic lesions (MRI). Diffusion-weighted magnetic resonance imaging (DWI) is useful for staging and subsequent imaging of malignant tumours because it gives function information and may be utilised to identify and characterise pathologic processes, including malignant tumours.

Aim of the Work: This study's main objective was to assess the extra value of diffusion-weighted MRI in the detection and classification of splenic localised lesions.

Patient and Methods: Thirty patients with splenic focal lesions, of both gender, participated in this prospective investigation. All patients had complete information about the patient, examination findings, including an abdominal and general examination, an ultrasound, an abdominal MRI, and a DWI investigation.

Results: Considering the mean ADC value of the examined group, we discovered that the benign lesions group's mean ADC value was (1.46) x 10-3 sec/mm2, whereas the malignant lesions group's mean ADC value was (0.73) x 10-3 sec/mm2. In the individuals under study, we discovered a strong correlation between clinicopathological results and DW-MRI data. (p<0.001). With a sensitivity of 83.33% and specificity of 94.44%, the kind of lesion was a statistically significant predictor of ADC values.

Conclusions: When used with conventional MRI, diffusion-weighted imaging enhances the ability to distinguish between splenic localised lesions. To verify our findings and resolve any discrepancies with the literature, more research is required.
Social Adjustment Patterns of Tribal Students: Exploring Family Dynamics
Authors: Sing Sankar , Mohakud Lalit Lalitav , Kisku Anirban , Khan Sharif
Published: December 2023

This research delves into the intricate aspects of social adjustment among Scheduled Tribe students within the secondary school environment. The study explored the influences of family related factors (family dynamics) such as gender, family type, number of siblings, father’s education and occupation, and familial monthly income on the social adjustment abilities of these students. Based on a cross-sectional survey conducted on randomly selected 310 bengali medium secondary school students from three subdivisions of Purba Medinipur District in West Bengal, the study revealed compelling insights. Bengali translated version of the Bell’s Adjustment Inventory (Social Adjustment Subscale) was used as research instrument. Data were analysed through independent samples t-test and one-way ANOVA. The gender-based analysis highlights that female (Mean=7.64) students within the Scheduled Tribe community face more significant adjustment challenges and exhibit lower social adjustment compared to their male counterpart (Mean=6.20) (P=.000). The influence of family type is also substantial, with students from nuclear families (Mean=7.22) encountering higher adjustment difficulties and more downward social adjustment than those from joint families (Mean=5.86) (P=.000). The examination of family size indicated that students with two siblings (in comparison to students who are single child, having one sibling and having three or more siblings) experience heightened adjustment difficulties and lower social adjustment (P=.025). Furthermore, the study underscored the role of socio-economic factors, revealing significant relationships between the father’s occupation (P=.04) and educational qualifications (P=.05) with students’ social adjustment abilities. While overall differences in familial monthly income did not prove statistically significant (P=.134), selected pairwise comparisons were also showed variations. Collectively, these findings contribute to a nuanced understanding of the factors shaping social adjustment among Scheduled Tribe students. The implications extend to the development of tailored interventions and support systems that address the unique needs of these students within the educational context.
Clinician-Created Video Education for Patients With AF
Authors: McIntyre Daniel , Kovoor Joshua G. , Chow Clara K. , Quintans Desi , Marschner Simone , Thomas Stuart , Kovoor Pramesh , Thiagalingam Aravinda
Published: December 2023

Importance

Patient education is a critical aspect of atrial fibrillation (AF) management. However, there is limited time to provide effective patient education during routine care, and resources available online are of variable quality.

Objective

To determine whether clinician-led creation of video-based AF education is feasible and improves knowledge of AF.

Design, Setting, and Participants

This single-center randomized clinical trial was conducted between 2020 and 2022. Outcomes were assessed prior to their clinic visit and 2 and 90 days after the visit by blinded assessors. Participants included adults with AF and congestive heart failure, hypertension, age at least 75 years (doubled), diabetes, prior stroke or transient ischemic attack or thromboembolism (doubled), vascular disease, age 65 to 74 years, and sex category scores of 1 or greater presenting for routine care at publicly funded outpatient cardiology clinics within a tertiary teaching hospital. Individuals too unwell to participate or with limited English were excluded. Data were assessed as intention to treat and analyzed from December 2022 to October 2023.

Intervention

Intervention participants viewed a series of 4 videos designed and narrated by clinicians that aimed to improve understanding of AF pathophysiology, clinical presentation, diagnosis, and management. After viewing the videos, participants received weekly email links to review the videos. The control group received usual care.

Main Outcomes and Measures

The prospectively selected primary outcome was AF knowledge at 90 days, measured by the validated Jessa Atrial Fibrillation Knowledge Questionnaire (JAFKQ).

Results

Among 657 individuals screened, 208 adults with AF were randomized (mean [SD] age, 65.0 [12.2] years; 133 [65.2%] male) and included in analysis. Participants were randomized 1-to-1, with 104 participants in the control group and 104 participants in the video intervention group. At 90 days after the baseline clinic visit, intervention participants were more likely to correctly answer JAFKQ questions than control participants (odds ratio [OR], 1.23 [95% CI, 1.01-1.49]). The difference was greater in participants who remotely accessed videos on 3 or more occasions during the study (OR, 1.46 [95% CI, 1.14-1.88]).

Conclusions and Relevance

In this randomized clinical trial of patients with AF, remotely delivered, clinician-created video education improved medium-term AF knowledge beyond usual care of standard in-clinic education. The improvement demonstrated in this study provides support for the implementation of clinician-created educational resources across the care continuum. Further work is needed to assess for impact on clinical outcomes.

Trial Registration

anzctr.org.au Identifier: ANZCTRN12620000729921
Urban Living Environment and Myopia in Children
Authors: Li Xiaotong , Li Lihua , Qin Wen , Cao Qing , Mu Xin , Liu Tiange , Li Zhen , Zhang Wei
Published: December 2023

Importance

The global prevalence of myopia has shown a steady increase over recent decades, with urban areas seemingly experiencing a more significant impact.

Objective

To assess the association between urbanization and the prevalence, incidence, progression, and severity of myopia.

Design, Setting, and Participants

This cohort study included students in grades 1 to 6 in Tianjin, China, who underwent 3 vision examinations conducted over a 2-year period, from March 1, 2021, to March 31, 2023. Participants from grades 1 to 4 completed the 2-year follow-up.

Exposures

Urban living environment

Main Outcomes and Measures

The association of urbanization with the incidence, progression, prevalence, and severity of myopia. To quantify urbanization, an urban score was constructed using satellite data and an iterative exploratory factor analysis.

Results

Of 177 894 students (51.7% male; mean [SD] age, 10.27 [1.75] years) included in the study, 137 087 students (52.3% male; mean [SD] age, 8.97 [1.21] years) were followed up for 2 years. A positive association was identified between myopia incidence and urbanization. Specifically, each 1-unit increment in the urban score was associated with an increased risk of myopia over a 1-year period (odds ratio [OR], 1.09; 95% CI, 1.01-1.15; P = .02) and a 2-year period (OR, 1.53; 95% CI, 1.50-1.57; P < .001). Conversely, each 1-unit increase in the urban score was associated with a significant decrease in myopia progression at 1 year (OR, 0.84; 95% CI, 0.82-0.86; P < .001) and 2 years (OR, 0.73; 95% CI, 0.70-0.75, P < .001). In a cross-sectional data analysis, the urban score was positively associated with myopia prevalence (OR, 1.62; 95% CI, 1.08-2.42; P = .02) and negatively associated with myopia severity, as indicated by spherical equivalent refraction (OR, 1.46; 95% CI, 1.07-1.99; P = .02).

Conclusions and Relevance

This study exploring urban living environments and myopia revealed dual associations of urban living with both the incidence and the progression of myopia. The observed patterns emphasize the urgency of promptly implementing myopia control strategies in less urbanized regions, where myopia progression may be accentuated.
Sex and Race Differences in Obesity-Related Genetic Susceptibility and Risk of Cardiometabolic Disease in Older US Adults
Authors: Yu Hairui , Armstrong Nicole , Pavela Greg , Kaiser Kathryn
Published: December 2023

Importance

The fat mass and obesity–associated gene (FTO) is associated with obesity phenotypes, but the association is inconsistent across populations. Within-population differences may explain some of the variability observed.

Objective

To investigate sex differences in the association between FTO single-nucleotide variants (SNVs) and obesity traits among self-identified non-Hispanic Black and non-Hispanic White US adults, to examine whether the SNVs were associated with cardiometabolic diseases, and to evaluate whether obesity mediated the association between FTO SNVs and cardiometabolic diseases.

Design, Setting, and Participants

This cross-sectional study used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a US population-based cohort study with available genetic data (assayed in 2018) and phenotypic data at baseline (enrolled 2003-2007). Participants were aged 45 to 98 years at baseline. Data were analyzed from October 2021 to October 2022.

Exposures

Eleven SNVs in the FTO gene present among both Black and White participants.

Main Outcomes and Measures

Objectively measured obesity indicators (body mass index and waist-to-height ratio), objectively measured and/or self-reported cardiometabolic diseases (hypertension, stroke history, heart disease, and diabetes), and self-reported social-economic and psychosocial status.

Results

A total of 10 447 participants (mean [SD] age, 64.4 [9.7] years; 5276 [55.8%] women; 8743 [83.7%] Black and 1704 [16.3%] White) were included. In the White group, 11 FTO SNVs were significantly associated with obesity, hypertension, and diabetes using linear models (eg, body mass index: β = 0.536; 95% CI, 0.197-0.875), but none of the FTO SNVs were associated with obesity traits in the Black group. White males had a higher risk of obesity while White females had a higher risk of hypertension and diabetes. However, 1 FTO SNV (rs1121980) was associated with a direct increase in the risk of heart disease in Black participants not mediated by obesity (c′ = 0.145 [SE, 0.0517]; P = .01).

Conclusions and Relevance

In this cross-sectional study of obesity phenotypes and their association with cardiometabolic diseases, the tested FTO SNVs reflected sex differences in White participants. Different patterns of associations were observed among self-identified Black participants. Therefore, these results could inform future work discovering risk alleles or risk scores unique to Black individuals or further investigating genetic risk in all US residents.
Topiramate dosage optimization for effective antiseizure management via population pharmacokinetic modeling
Authors: Lee Seolah , Kim Hyun Chul , Jang Yoonhyuk , Lee Han Sang , Ahn Seon‐Jae , Lee Soon‐Tae , Jung Keun‐Hwa , Park Kyung‐Il , Jung Ki‐Young , Oh Jaeseong , Lee SeungHwan , Yu Kyung‐Sang , Jang In‐Jin , Lee Soyoung , Chu Kon , Lee Sang Kun
Published: December 2023

Objective

Despite the suggested topiramate serum level of 5–20 mg/L, numerous institutions have observed substantial drug response at lower levels. We aim to investigate the correlation between topiramate serum levels, drug responsiveness, and adverse events to establish a more accurate and tailored therapeutic range.

Methods

We retrospectively analyzed clinical data collected between January 2017 and January 2022 at Seoul National University Hospital. Drug responses to topiramate were categorized as “insufficient” or “sufficient” by reduction in seizure frequency ≥ 50%. A population pharmacokinetic model estimated serum levels from spot measurements. ROC curve analysis determined the optimal cutoff values.

Results

A total of 389 epilepsy patients were reviewed having a mean dose of 178.4 ± 117.9 mg/day and the serum level, 3.9 ± 2.8 mg/L. Only 5.6% samples exhibited insufficient response, with a mean serum level of 3.6 ± 2.5 mg/L while 94.4% demonstrated sufficient response, with a mean 4.0 ± 2.8 mg/L, having no statistical significance. Among the 69 reported adverse events, logistic regression analysis identified a significant association between ataxia and serum concentration (p = 0.04), with an optimal cutoff value of 6.5 mg/L.

Interpretation

This study proposed an optimal therapeutic concentration for topiramate based on patients' responsiveness to the drug and the incidence of adverse effects. We recommended serum levels below 6.5 mg/L to mitigate the risk of ataxia‐related side effects while dose elevation was found unnecessary for suboptimal responders, as the drug's effectiveness plateaus at minimal doses.
Development of the Takayasu Arteritis Integrated Disease Activity Index
Authors: Marvisi Chiara , Bolek Ertugrul Cagri , Ahlman Mark A. , Alessi Hugh , Redmond Christopher , Muratore Francesco , Galli Elena , Ricordi Caterina , Kaymaz‐Tahra Sema , Ozguven Salih , Alibaz‐Oner Fatma , Direskeneli Haner , Salvarani Carlo , Quinn Kaitlin A. , Grayson Peter C.
Published: December 2023

Objective

Accurate clinical assessment of disease activity in Takayasu arteritis (TAK) can be challenging. 18F‐fluorodeoxyglucose–positron emission tomography (FDG‐PET) can directly measure vascular inflammation. This study details the development of a new type of disease activity index called the Takayasu's Arteritis Integrated Disease Activity Index (TAIDAI).

Methods

Clinical symptoms for TAIDAI were identified from a literature review. Each symptom was paired with FDG‐PET findings in corresponding arterial territories. Constitutional symptoms were paired with acute phase reactant levels. One point was given for each clinical symptom paired with supporting FDG‐PET or laboratory abnormalities and summed into the TAIDAI score. A TAIDAI of ≥1 defined active disease. To assess performance of TAIDAI, face validity, content validity, and sensitivity to change were evaluated within a prospective observational cohort study of patients with TAK.

Results

Seventeen clinical symptoms were paired with imaging or laboratory abnormalities. In a cohort of 96 patients contributing 204 study visits, TAIDAI showed excellent sensitivity (96.3%) and good specificity (79.2%) compared to physician's clinical assessment. TAIDAI significantly correlated with physician global assessment, PET Vascular Activity Score, patient global assessment, and acute phase reactant levels. In patients treated with either tumor necrosis factor inhibitors or tocilizumab, a TAIDAI of 0 was achieved in 21 (91%) of 23 patients who met a predefined definition of clinical response.

Conclusion

TAIDAI is new type of disease activity index in TAK in which clinical symptoms are integrated with specific laboratory and imaging findings. TAIDAI should be validated in future randomized controlled trials in TAK.
Impact of Chemotherapeutic Stress Depends on The Nature of Breast Cancer Spheroid and Induce Behavioral Plasticity to Resistant Population
Authors: Gayan Sukanya , Teli Abhishek , Sonawane Akshay , Dey Tuli
Published: December 2023

Cellular or tumor dormancy, identified recently as one of the main reasons behind post‐therapy recurrence, can be caused by diverse reasons. Chemotherapy has recently been recognized as one of such reasons. However, in‐depth studies of chemotherapy‐induced dormancy are lacking due to the absence of an in vitro human‐relevant model tailor‐made for such a scenario. This report utilized multicellular breast cancer spheroid to create a primary platform for establishing a chemotherapy‐induced dormancy model. It is observed that extreme chemotherapeutic stress affects invasive and non‐invasive spheroids differently. Non‐invasive spheroids exhibit more resilience and maintain viability and migrational ability, while invasive spheroids display heightened susceptibility and improved tumorigenic capacity. Heterogenous spheroids exhibit increased tumorigenic capacity while show minimal survival ability. Further probing of chemotherapeutically dormant spheroids is needed to understand the molecular mechanism and identify dormancy‐related markers to achieve therapeutic success in the future.
Multi‐Field Coupled Motion Induces Electromagnetic Wave Absorbing Property Regeneration of Elastomer in Marine Environment
Authors: Tao Jiaqi , Zhou Jintang , Yao Zhengjun , Wang Jin , Xu Linling , Tao Xuewei , Wu Hongjing
Published: December 2023

The mechanical‐electromagnetic dual healing system equips warships with the same reproducibility as biological skin, enabling rapid restoration of electromagnetic stealth and overcoming disturbances in the marine environment. However, the principle of electromagnetic wave absorption (EWA) property regeneration and co‐healing model are still largely unknown. Herein, a bio‐inspired intelligent elastomer is created that combines 2D EWA mediums with an underwater self‐healing fluoropolymer framework, realizing multifunctional integration. It demonstrates excellent broadband EWA characteristics (8.68 GHz, 2.16 mm) and promising underwater self‐healing (23.73%, 3 h). Notably, the dynamic interweaving motion between chemical and physical fields (i.e., dielectric and magnetic fields) facilitates positive chain effects of mechanical healing on electromagnetic function. Consequently, this interdependence drives efficient EWA property regeneration (94.1%, 3 h), including but not limited to underwater and air. Furthermore, the system boasts excellent hydrophobicity and chemical stability for seawater and strong alkali. Overall, this work is the first to present an effective strategy for quickly restoring electromagnetic stealth in marine environments, which expands the feasibility boundary of the interdisciplinarity.
Instant Self‐Assembly of Functionalized MXenes in Organic Solvents: General Fabrication to High‐Performance Chemical Gas Sensors
Authors: Kim Soobin , Ko Tae Yun , Jena Ajit K. , Nissimagoudar Arun S. , Lee Juyun , Lee Seongeun , Oh Taegon , Kang Yun Chan , In Insik , Bhattacharjee Satadeep , Koo Chong Min , Lee Seung‐Cheol , Kim Seon Joon
Published: December 2023

MXenes are a promising class of two‐dimensional transition metal carbides, nitrides, and carbonitrides, widely utilized in diverse fields such as energy storage, electromagnetic shielding, electrocatalysis, and sensing applications. Their potential in chemical sensing is particularly noteworthy, where optimizing surface chemistry for strong interaction with target analytes and increasing surface area for efficient gas adsorption are crucial factors. In this study, a versatile and general self‐assembly method for fabricating nanometer‐scale thin films of surface‐functionalized MXene, enabling high‐performance gas sensors is developed. By dropping MXene dispersed in organic solvents onto nonsolvents, rapid formation of nanometer‐scale films is achieved. This method allows easy adjustment of film properties by using different solvent‐nonsolvent combinations, leading to improved optoelectronic properties compared to conventional techniques. The surface‐functionalized MXenes using ADOPA ligands greatly enhance the gas response and long‐term environmental stability compared to pristine MXenes. Computational methods are also employed to gain insights into the molecular interactions and changes in electronic structure that contribute to the enhanced sensing properties. Furthermore, the environmental stability of MXene sensors is largely enhanced after surface functionalization, which can be attributed to increased surface hydrophobicity. Overall, this innovative technique opens up opportunities for tailoring MXene thin films for specific applications.