bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of presentation rate on auditory processing in Rett syndrome: event-related potential study
Authors: Kostanian Daria , Rebreikina Anna , Voinova Victoria , Sysoeva Olga
Published: October 2023

Background

Rett syndrome (RS) is a rare neurodevelopmental disorder characterized by mutations in the MECP2 gene. Patients with RS have severe motor abnormalities and are often unable to walk, use hands and speak. The preservation of perceptual and cognitive functions is hard to assess, while clinicians and care-givers point out that these patients need more time to process information than typically developing peers. Neurophysiological correlates of auditory processing have been also found to be distorted in RS, but sound presentation rates were relatively quick in these studies (stimulus onset asynchrony, SOA < 1000 ms). As auditory event-related potential (ERP) is typically increased with prolongation of SOA we aim to study if SOA prolongation might compensate for observed abnormalities.

Methods

We presented a repetitive stimulus (1000 Hz) at three different SOAs of 900 ms, 1800 ms, and 3600 ms in children with RS (N = 24, Mean age = 9.0 ± 3.1) and their typical development (TD) peers (N = 27, Mean age = 9.7 ± 3.4) while recording 28-channels electroencephalogram, EEG. Some RS participants (n = 10) did not show clear ERP and were excluded from the analysis.

Results

Major ERP components (here assessed as N1P1 and P2N1 peak-to-peak values) were smaller at SOA 900 than at longer SOAs in both groups, pointing out that the basic mechanism of adaptation in the auditory system is preserved in at least in RS patients with evident ERPs. At the same time the latencies of these components were significantly delayed in the RS than in TD. Moreover, late components (P2N1 and N2P2) were drastically reduced in Rett syndrome irrespective of the SOA, suggesting a largely affected mechanism of integration of upcoming sensory input with memory. Moreover, developmental stagnation of auditory ERP characterized patients with RS: absence of typical P2N1 enlargement and P1 and N1 shortening with age at least for shortest SOA.

Limitations

We could not figure out the cause for the high percentage of no-evident ERP RS participants and our final sample of the RS group was rather small. Also, our study did not include a control clinical group.

Conclusions

Thus, auditory ERPs inform us about abnormalities within auditory processing that cannot be fully overcomed by slowing presentation rate.
Facilitating exit from encampments: combining low-barrier transitional housing with stabilizing treatment for substance related problems
Authors: Komaromy Miriam , Stone Andrea , Peterson Alicia , Gott Jacqueline , Koenig Rob , Taylor Jessica L.
Published: October 2023

Background

Tent encampments in the neighborhood surrounding Boston Medical Center (BMC) grew to include 336 individuals at points between 2019 and 21, prompting public health concerns. BMC, the City of Boston, and Commonwealth of Massachusetts partnered in 2/2022 to offer low-barrier transitional housing to encampment residents and provide co-located clinical stabilization services for community members with substance use disorders (SUDs) experiencing homelessness.

Methods

To meet the needs of some of the people who had been living in encampments, BMC established in a former hotel: 60 beds of transitional housing, not contingent upon sobriety; and a low-barrier SUD-focused clinic for both housing residents and community members, offering walk-in urgent care, SUD medications, and infection screening/prevention; and a 24/7 short-stay stabilization unit to manage over-intoxication, withdrawal, and complications of substance use (e.g., abscesses, HIV risk, psychosis). A secure medication-dispensing cabinet allows methadone administration for withdrawal management. Housing program key metrics include retention in housing, transition to permanent housing, and engagement in SUD treatment and case management. Clinical program key metrics include patient volume, and rates of initiation of medication for opioid use disorder.

Results

Housing: Between 2/1/22–1/31/2023, 100 people entered the low-barrier transitional housing (new residents admitted as people transitioned out); 50 former encampment residents and 50 unhoused people referred by Boston Public Health Commission. Twenty-five residents transferred to permanent housing, eight administratively discharged, four incarcerated, and four died (two overdoses, two other substance-related). The remaining 59 residents remain housed; none voluntarily returned to homelessness. One hundred residents (100%) engaged with case management, and 49 engaged with SUD treatment. Clinical: In the first 12 months, 1722 patients (drawn from both the housing program and community) had 7468 clinical visits. The most common SUDs were opioid (84%), cocaine (54%) and alcohol (47%) and 61% of patients had a co-occurring mental health diagnosis in the preceding 24-months. 566 (33%) patients were started on methadone and accepted at an Opioid Treatment Program (OTP).

Conclusions

During the 1st year of operation, low-barrier transitional housing plus clinical stabilization care was a feasible and acceptable model for former encampment residents, 49% of whom engaged with SUD treatment, and 25% of whom transitioned to permanent housing.
Birth-related, medical, and diagnostic characteristics in younger versus older children with avoidant/restrictive food intake disorder (ARFID)
Authors: Brosig Luise , Düplois Dominik , Hiemisch Andreas , Kiess Wieland , Hilbert Anja , Schlensog-Schuster Franziska , Schmidt Ricarda
Published: October 2023

Background

Although avoidant/restrictive food intake disorder (ARFID) presents the replacement and extension of feeding disorders of infancy and childhood, previous research into ARFID concentrated mainly on older patients. While birth-related characteristics play an etiologic role in feeding disorders, virtually nothing is known so far in ARFID. Therefore, the first aim of the study was to identify differences in birth-related characteristics in younger vs. older children with ARFID. Second, differences in physical and mental comorbidities, and third, diagnostic features between age groups were analysed.

Methods

Among N = 51 in- and outpatient treatment-seeking patients, n = 23 patients aged 0–5 years (30% girls) and n = 28 patients aged 6–17 years (57% girls), with an interview-based diagnosis of ARFID were included. Data on the pre- and perinatal period and mental and physical comorbidities were derived from patients’ medical records, while diagnostic criteria, main ARFID presentation, and sociodemographic variables were collected through diagnostic interview.

Results

Significantly, younger patients with ARFID were born more often preterm and had more pre- and perinatal complications and a higher incidence of postnatal invasive procedures. Patients with ARFID aged 0–5 years presented significantly more physical comorbidities and conditions, especially congenital anomalies, while mental comorbidities, especially mood disorders, were significantly more common in patients with ARFID aged 6–17 years. No age differences were found for the distribution of diagnostic criteria and main ARFID presentation.

Conclusion

This is the first study which aimed to identify age-specific characteristics in patients with ARFID with potential relevance for diagnosis and treatment. Especially birth-related complications, including invasive procedures postnatally, may be associated with developing ARFID, highlighting the importance of a closer view on these potential risk factors of the disorder. Future research with longitudinal design and larger samples may allow more detailed information on further age-specific associations, symptom trajectories, and age-specific risk factors for ARFID.
Rater cognitive processes in integrated writing tasks: from the perspective of problem-solving
Authors: Jia Wenfeng , Zhang Peixin
Published: October 2023

It is widely believed that raters’ cognition is an important aspect of writing assessment, as it has both logical and temporal priority over scores. Based on a critical review of previous research in this area, it is found that raters’ cognition can be boiled to two fundamental issues: building text images and strategies for articulating scores. Compared to the scoring contexts of previous research, the TEM 8 integrated writing task scoring scale has unique features. It is urgent to know how raters build text images and how they articulate scores for text images in the specific context of rating TEM8 compositions. In order to answer these questions, the present study conducted qualitative research by considering raters as problem solvers in the light of problem-solving theory. Hence, 6 highly experienced raters were asked to verbalize their thoughts simultaneously while rating TEM 8 essays, supplemented by a retrospective interview. Analyzing the collected protocols, we found that with regard to research question 1, the raters went through two stages by setting building text images as isolated nodes and building holistic text images for each dimension as two sub-goals, respectively. In order to achieve the first sub-goal, raters used strategies such as single foci evaluating, diagnosing, and comparing; for the second sub-goal, they mainly used synthesizing and comparing. Regarding the second question, the results showed that they resorted to two groups of strategies: demarcating boundaries between scores within a dimension and discriminating between dimensions, each group consisting of more specific processes. Each of the extracted processes was defined clearly and their relationships were delineated, on the basis of which a new working model of the rating process was finalized. Overall, the present study deepens our understanding of rating processes and provides evidence for the scoring validity of the TEM 8 integrated writing test. It also provides implications for rating practice, such as the need for the distinction between two types of analytical rating scales.
A multi-analytical approach to identify ancient pigments used in pottery towers excavated from the Han Dynasty tombs
Authors: Go InHee , Wen Jingqi , He Xiang , Liu Naitao , Guo Hong
Published: October 2023

In 2013, several tombs were discovered and excavated in Southeastern Beijing, China, yielding various burial products. Among these were pottery towers, a representative artifact of the Han Dynasty rarely found in the area. Many studies on architectural aspects, such as construction type and construction situation, have been conducted based on the excavated pottery towers, but only a few have examined their raw materials or pigments. In this study, black, white, and red pigments were identified as carbon black, calcite, and cinnabar, respectively, through a multi-analysis approach. The manufacturing method of the pigment was established based on the crystal form and particle size of the pigment, by factoring in the pigment characteristics, which cannot be distinguished by component analysis and crystal structure analysis. We recommend that a continuous database be prepared and used in the future, not only for an interpretation of ancient pigments but also to identify the factors to be considered (physical characteristics, such as pigment particle size among others) when estimating the manufacturing process and conservation treatment.
Inhibition of pathogen and induction of resistance against early blight: Alternaria solani Sorauer in tomato plants (Solanum lycopersicum L.) through external application of compounds from seaweed Chaetomorpha antennina Bory
Authors: Chanthini Kanagaraj Muthu-Pandian , Senthil-Nathan Sengottayan , Sivanesh Haridoss , Ramasubramanian Ramakrishnan , Stanley-Raja Vethamonickam , Karthi Sengodan , Shyam-Sundar Narayanan , Ali Mohammad Ajmal , Alwahibi Mona S.
Published: October 2023

Background

The indiscriminate application of pesticides has depleted soil fertility. Marine algae are regarded as excellent sources of bioactive compounds that can stimulate plant growth and also enhance their resistance against biotic and abiotic stressors. Compounds derived from the marine algae Chaetomorpha antennina (Cladophoraceae) were analysed for their biocontrol efficiency against the tomato disease pathogen Alternaria solani as an alternate technique to preserve agricultural output sustainability.

Results

The active fraction from the methanol extract of C. antennina (CA-F8) proved effective against the pathogen in vitro by affecting A. solani's spore germination (92.13%) along with their mycelial growth thereby decreasing their dry weight (44.71%). GC–MS examination revealed the presence of fatty acids (defence pathway activators), terpenes (antimicrobial compound) and antioxidants (deactivators of pathogen enzymes). Seaweed compounds also elicited polyphenol oxidase (PPO) (78.8%) and peroxidase (PO) (54.6%) synthesis, along with stimulating the accumulation of foliar phenols (67.5%) that are components of jasmonic acid defense pathway, higher compared to control plants. Salicylic acid was detected only in treated plants, thereby offering efficient disease control.

Conclusions

By triggering natural systemic defences, salicylate (SA) and jasmonate (JA) mediated pathways; the study demonstrates the elicitor potentials of chemicals from C. antennina that was efficient in controlling early blight (EB) disease. In addition to providing a different method for crop protection to reduce or replace the demand for chemical pesticides, this study reveals unique projections.

Graphical Abstract
Organic fertilizer and hydrothermal conditions change the distribution of Medicago sativa L. productivity and soil bacterial diversity in coastal saline soil
Authors: Cao Jing , Li Zhensong , He Feng , Tong Zongyong , Wang Yu , Wang Lixue , Zheng Guiliang , Zhang Yiwei
Published: October 2023

Background

Alfalfa (Medicago sativa L.) is a perennial leguminous forage that can improve the properties of saline soil. In addition, the supplementation with fertilizer to promote soil bacterial activity is critical to improve the productivity of coastal saline soils. However, the association between fertilizer application, bacterial community characteristics, and alfalfa yield in saline soil remains unclear.

Aim

To understand the interaction of different fertilizer and environmental factors on soil bacterial diversity and alfalfa yield in coastal saline soil.

Results

A 4-year field study was conducted to examine the interaction of different fertilizer treatments and environmental factors on soil bacterial diversity and alfalfa yield in coastal saline soil in China. Three organic fertilizer treatments (fulvic acid potassium, fulvic acid potassium + wood vinegar, and fulvic acid potassium + Bacillus), one biochar treatment (bio-charcoal), one inorganic fertilizer treatment (diammonium phosphate), and a control (no fertilizer) were included. The effects of the  six treatments and 15 cutting times on alfalfa yield and soil bacterial community diversity were assessed. The productivity in fulvic acid potassium + Bacillus and fulvic acid potassium treatments was 68.37 and 67.90 t·hm−2 in 4 years, which was significantly higher than that in the bio-charcoal treatment and control. Hydrothermal conditions and timing of alfalfa harvest had significant effects on the soil bacterial community. Proteobacteria, Acidobacteria, and Actinobacteria were the principal bacterial phyla detected in the soil samples, collectively accounting for approximately 60% of the total bacterial abundance. The relative abundance of Bacteroidetes, Firmicutes, and Nitrospirae was significantly correlated with alfalfa yield, and the abundance of these phyla was also affected by the maximum temperature and precipitation. Fertilizer supplementation in coastal saline soil can effectively increase the yield of alfalfa. Among the fertilizers tested, fulvic acid potassium had the strongest effect, whereas bio-charcoal fertilizer had little effect on alfalfa yield.

Graphical Abstract
Reducing dropout rate through a deep learning model for sustainable education: long-term tracking of learning outcomes of an undergraduate cohort from 2018 to 2021
Authors: Shiao Yi-Tzone , Chen Cheng-Huan , Wu Ke-Fei , Chen Bae-Ling , Chou Yu-Hui , Wu Trong-Neng
Published: October 2023

In recent years, initiatives and the resulting application of precision education have been applied with increasing frequency in Taiwan; the accompanying discourse has focused on identifying potential applications for artificial intelligence and how to use learning analytics to improve teaching quality and learning outcomes. This study used the established dropout risk prediction model to improve student learning effectiveness. The model was based on the academic portfolios of past students and built with statistical learning and deep learning methods. This study used this model to predict the dropout risk of 2205 freshmen enrolled in the fall semester of 2018 (graduated in June 2022) in the field of sustainable education. A total of 176 students with a dropout risk of more than 20% were considered high-risk students. After tracking and the appropriate guidance, the dropout risk of 91 students fell from > 20% to < 20%. To discuss the results from the perspective of gender and financial disadvantages, the improvement rate of the dropout risk for male students was 10.2% better than that of female students at 2.9%. The improvement rate in dropout risk for students with disadvantageous financial situations was as high as 12.0%, surpassing the 5.9% rate among general students. Overall, the dropout rate in the second year of the 2018 freshman cohort was lower than that of the 2016 and 2017 freshman cohorts. A predictive model established by statistical learning and deep learning methods was used as a tool to promote precision education, accurately and efficiently identifying students who are having difficulty learning, as well as leading to a better understanding of AI (artificial intelligence) in smart learning for sustainable education.
Cross-sectional study: prevalence of oedema disease Escherichia coli (EDEC) in weaned piglets in Germany at pen and farm levels
Authors: Berger Pia I. , Hermanns Steffen , Kerner Katharina , Schmelz Friederike , Schüler Verena , Ewers Christa , Bauerfeind Rolf , Doherr Marcus G.
Published: October 2023

Background

Escherichia colibacteria capable of producing the toxin Stx2e and possessing F18-fimbriae (edema diseaseE. coli,EDEC) are considered causative agents of porcine oedema disease. This disease, which usually occurs in piglets shortly after weaning, has a high lethality in affected animals and can lead to high economic losses in piglet rearing. The aim of this cross-sectional field study was to determine the prevalence of EDEC in weaned piglets in Germany at pen and farm levels.

Results

Ninety-nine farms with unknown history of infections with shigatoxin-producingE. coli(STEC) and oedema disease were sampled. On each farm, up to five pens were selected for sampling (n = 481). The piglets in these pens were at an age 1–3 weeks after weaning. Single faecal samples (n = 2405) and boot swabs (n = 479) were collected from the floor. On 50 farms, cotton ropes were additionally used to collect oral fluid samples (n = 185) and rope wash out samples (n = 231) from the selected pens. All samples were analyzed by bacterial culture combined with a duplex PCR for the presence of the corresponding genesstx2eandfedA(major subunit protein of F18 fimbriae). In addition, whole DNA specimens extracted from boot swabs, oral fluid samples, and rope wash out samples were directly examined by duplex PCR for DNA ofstx2eandfedA.A pen was classified as positive if at least one of the samples, regardless of the technique, yielded a positive result in the PCR, and farms were considered positive if at least one pen was classified as positive. Overall, genesstx2eandfedAwere found simultaneously in 24.9% (95% CI 22.1–29.1%) of sampled pens and in 37.4% (95% CI 27.9–47.7%) of sampled farms. Regardless of the presence of F18-fimbriae,Escherichia coliencoding for Stx2e (STEC-2e) were found in 35.1% (95% CI 31.0–39.1%) of the pens and 53.5% (95% CI 44.4–63.6%) of the farms sampled.

Conclusions

Escherichia colistrains considered capable to cause oedema disease in swine (EDEC) are highly prevalent in the surveyed pig producing farms in Germany. Due to intermittent shedding of EDEC and a potentially low within-farm prevalence, we recommend a combination of different sampling techniques for EDEC monitoring at pen and farm levels. Further studies are needed to understand which STEC-2e strains really pose the risk of causing severe porcine disease.
Mapping stunted children in Ethiopia using two decades of data between 2000 and 2019. A geospatial analysis through the Bayesian approach
Authors: Atalell Kendalem Asmare , Techane Masresha Asmare , Terefe Bewuketu , Tamir Tadesse Tarik
Published: October 2023

Background

Childhood stunting is a major public health problem globally, resulting in poor cognition and educational performance, low adult wages, low productivity, and an increased risk of nutrition-related chronic diseases in adulthood life. Accurate and reliable data on the prevalence of stunting over time with a sub-national estimate are scarce in Ethiopia.

Objective

Our objective was to investigate the spatiotemporal distributions and ecological level drivers of stunting among under-five children over time in Ethiopia.

Methods

A geospatial analysis using the Bayesian framework was employed to map the spatial variations of stunting among children aged less than five years. The data for the primary outcome were obtained from the Ethiopian Demographic and Health Surveys (2000–2019) and covariates data were accessed from different publicly available credible sources. The spatial binomial regression model was fitted to identify drivers of child stunting using the Bayesian approach.

Result

The national prevalence of stunting was 47.9 in 2000, 43.3 in 2005, 37.3 in 2011, 36.6 in 2016, and 35.9 in 2019, with a total reduction rate of 25%. Substantial spatial clustering of stunting was observed in the Northern (Tigray), Northcentral (Amhara), and Northwestern (Amhara) parts of Ethiopia. Temperature (mean regression coefficient (β): −0.19; 95% credible interval (95% CrI): −0.25, −0.12) and population density (β: −0.012; 95% CrI: −0.016, −0.009) were negatively associated with stunting, whereas travel time to the nearest cities (β: 0.12; 95% CrI: 0.064, 0.17) was positively associated with child stunting in Ethiopia.

Conclusion

The prevalence of stunting varied substantially at subnational and local levels over time. Clustering of stunted children were observed in the Northern parts of Ethiopia. Temperature, population density and travel time to the nearest cities were identified as the drivers of stunting in children. Improving community awareness of child nutrition through community health extension programs should be strengthened.
AI-generated feedback on writing: insights into efficacy and ENL student preference
Authors: Escalante Juan , Pack Austin , Barrett Alex
Published: October 2023

The question of how generative AI tools, such as large language models and chatbots, can be leveraged ethically and effectively in education is ongoing. Given the critical role that writing plays in learning and assessment within educational institutions, it is of growing importance for educators to make thoughtful and informed decisions as to how and in what capacity generative AI tools should be leveraged to assist in the development of students’ writing skills. This paper reports on two longitudinal studies. Study 1 examined learning outcomes of 48 university English as a new language (ENL) learners in a six-week long repeated measures quasi experimental design where the experimental group received writing feedback generated from ChatGPT (GPT-4) and the control group received feedback from their human tutor. Study 2 analyzed the perceptions of a different group of 43 ENLs who received feedback from both ChatGPT and their tutor. Results of study 1 showed no difference in learning outcomes between the two groups. Study 2 results revealed a near even split in preference for AI-generated or human-generated feedback, with clear advantages to both forms of feedback apparent from the data. The main implication of these studies is that the use of AI-generated feedback can likely be incorporated into ENL essay evaluation without affecting learning outcomes, although we recommend a blended approach that utilizes the strengths of both forms of feedback. The main contribution of this paper is in addressing generative AI as an automatic essay evaluator while incorporating learner perspectives.
Comparative study on regression time of block and adverse effects of nalbuphine and fentanyl as an adjuvant to intrathecal bupivacaine: a prospective randomized double-blind study
Authors: Deori Kamal Chandra , Taye Mrinal Kanti , Lahkar Babita
Published: October 2023

Background

The study was done to observe the effectiveness of nalbuphine as an adjuvant to intrathecal bupivacaine heavy, and hence, it was compared in terms of regression time of sensory and motor block and adverse effects with that of fentanyl as an adjuvant. The study design was a prospective randomized double-blind study. Total number of patients were 100. They were randomly allocated into two groups. Group N (n = 50) received 3.2 ml of 0.5% heavy bupivacaine and 0.5 ml (0.8 mg) of nalbuphine, a total of 3.7 ml. Group F (n = 50) received 3.2 ml of 0.5% heavy bupivacaine and 0.5 ml (25 µg) of fentanyl, a total of 3.7 ml. Assessment of sensory and motor blockade and analgesia was done by visual analogue scale and modified Bromage scale.

Results

On comparing the spinal block characteristics among two groups to reach, Bromage-3 motor block was found to be significantly shorter in group F (p = 0.03777). The regression time of both sensory and motor block was significantly prolonged in group N (P < 0.0001). No patients required additional analgesic intraoperatively, and intraoperative VAS scores and adverse effects were comparable in the two groups.

Conclusions

On comparing nalbuphine 0.8 mg and fentanyl 25 µg as an adjuvant to intrathecal bupivacaine, it has been observed that nalbuphine significantly prolongs regression time of sensory and motor block indicating the effectiveness of nalbuphine as an alternative to fentanyl and for prolong surgeries. The incidence of adverse effects was similar in both groups.
Protrieve sheath utilization for capturing supra-filter thrombus during a retrieval of thrombosed and embedded IVC filter
Authors: Shewarega Annabella , Powell Taylor M. , Silin Douglas
Published: October 2023

Background

Inferior vena cava (IVC) filters, while effective in preventing pulmonary embolism, can increase the risk of IVC thrombosis. IVC filter (IVCF) thrombosis can result from emboli getting trapped within the filter, extension of deep vein thrombosis (DVT), or the device’s inherent thrombogenicity causing in situ thrombosis. This condition can cause noticeable clinical symptoms and complicate the removal of the filter due to the potential for thromboembolism, often resulting in temporary filters remaining unextracted. This case report highlights a novel approach employed to mitigate the risk of thromboembolism during the procedure by capturing mobilized thrombus proximally to the entrapped IVCF.

Case presentation

A 54-year-old woman with a complex medical history including cerebral palsy, Crohn’s disease, and transfusion-dependent iron-deficiency anemia experienced a pulmonary embolism. Due to failed anticoagulation therapy resulting in gastrointestinal bleeding and high transfusion requirements, she underwent placement of an IVCF as a preventive measure against recurrent pulmonary embolism. Three years later, the patient presented with lower extremity swelling and a sudden decline in hemoglobin levels. Diagnostic imaging revealed adherent nonocclusive thrombus within and above the indwelling IVCF. Utilizing the novel Protrieve sheath with the self-expandable Nitinol funnel, successful endovascular removal of the embedded IVCF and adherent thrombus was performed, while mitigating the risk of intraprocedural pulmonary embolism.

Conclusions

The successful intraprocedural trapping and removal of mobilized thrombus from the IVCF removal was achieved using the Protrieve sheath and Nitinol funnel. This approach provides a promising solution to reduce the risk of embolization during the removal of thrombosed IVCFs, potentially outweighing the complications associated with filter removal.
Maternal immunoglobulin treatment can reduce severity of fetal acetylcholine receptor antibody-associated disorders (FARAD)
Authors: Wassenberg Matthias , Hahn Andreas , Mück Anna , Krämer Heidrun H.
Published: October 2023

Background

Fetal acetylcholine receptor antibody-associated disorders (FARAD), caused by in utero exposure to maternal antibodies directed against the fetal acetylcholine receptor (AChR), is a rare condition occurring in newborns of myasthenic mothers. Only two cases of FARAD children born to asymptomatic mothers are published.

Case

We report a completely asymptomatic mother of two FARAD children presenting exclusively with positive AChR antibodies. After birth, the first child needed intensive care therapy due to generalized hypotonia, respiratory problems, dysphagia, necessitating tube feeding and gastrostomy. FARAD was suspected because of ptosis, a hypomimic face, and confirmed by increased AChR antibodies in the mother. The mother became pregnant again 2 years later. Since FARAD is likely to reoccur and it is known that intensity of maternal myasthenia gravis treatment determines postnatal outcome, monthly intravenous immunoglobulin (IVIG) therapy was started at 12 weeks gestational age. The second child needed a short mask ventilation for initial stabilization at birth, but her muscle weakness improved rapidly and tube feeding was not necessary. Similar to her sister a tent-shaped mouth and a somewhat myopathic face persisted, but motor milestones were reached in time.

Conclusions

These observations highlight that FARAD is an important differential diagnosis of genetically determined congenital neuromuscular disorders even in asymptomatic mothers, and that IVIG therapy during the pregnancy has the potential to improve the outcome of the children.
Regulation of epithelial-mesenchymal transition in retinal pigment epithelium and its associated cellular signaling cascades: an updated review
Authors: Gelat Brijesh , Malaviya Pooja , Rathaur Pooja , Trivedi Krupali , Chaudhary Priya , Patel Binita , Johar Kaid , Gelat Rahul
Published: October 2023

Background

The epithelial-mesenchymal transition (EMT) affects the retinal pigment epithelium's natural homeostasis. According to observations from around the world, numerous oculopathies, including proliferative vitreoretinopathy (PVR), diabetic retinopathy (DR), and other macular degenerative illnesses such as age-related macular degeneration (AMD), have been linked to the epithelial-mesenchymal transition of retinal pigment epithelium (EMT of RPE). Retinopathy is referred to as an impairment in the retina, where AMD is characterized as an alteration in the macula region, DR as an impairment in the microvascular system, and PVR as an alteration in the subretinal bands, fibrovascular membranes, and fibrotic alteration in the detached retina. To find molecular targets and therapeutic drugs to protect and restore RPE function, a connection between EMT-related signaling pathways and RPE degeneration must be established.

Main body of abstract

Studies conducted in vivo and in vitro indicate that several signaling pathways, including the Rho pathway, the transforming growth factor-β (TGFβ) pathway, the Jagged/Notch pathway, mitogen-activated protein kinase (MAPK)-dependent pathway, and Wnt/β-catenin pathway, are activated in RPE cells during PVR and AMD. In order to discover the most suitable candidate for retinopathy therapies, it is necessary to determine the relationship between the regulators of the EMT and the degeneration of the RPE. To treat retinopathies, particularly those that are brought on by the EMT of retinal pigment epithelial cells, it is necessary to investigate prospective pharmaceutical candidates.

Conclusion

TGFβ's intracellular cascade, which comprises both canonical (SMAD-associated) and non-canonical (SMAD-nonassociated) pathways, is shown to be the most active signaling pathway in the degeneration of the RPE caused by EMT.
Therapeutic benefits of gossypin as an emerging phytoconstituents of Hibiscus spp.: a critical review
Authors: Jejurkar Gayatri , Chavan Machindra
Published: October 2023

Background

Flavonoids are one of the crucial secondary metabolites as several functions are carried out by flavonoids, including regulating cell growth, luring insects and pollinators, and defending against biotic and abiotic stressors. They are found in fruits, whole grains, vegetables, spices, tea, wine, herbs, and seeds. More than 4000 flavonoid compounds have been discovered and extracted through different techniques. Most flavonoids are frequently utilized in pharmaceuticals, nutraceuticals, cosmetics, and other products. A flavonol glucoside called gossypin is the primary phytochemical of herbs that comes under the "Malvaceae" family and can be found in many species, including Hibiscus esculentus, Gossypium indicum, and Hibiscus vitifolius, all have it in their flowers. Gossypin shows not only significant pharmacological activities but also a defence mechanism and protects against pathogens, UV radiation, etc. It has drawn much interest from researchers and scholars due to its benefits of few adverse effects, high efficacy, and simple preparation. Thus, the current review focuses primarily on the pharmacological accounts of gossypin in various acute and chronic diseases. The various assays and animal studies conducted in the past supported gossypin effects as supporting the concept of the objective of the title. The review also highlights various patents filled on gossypin’s importance and current market scenario.

Conclusion

Therefore, the technical contents based on pharmacological activities, patents and current market scenario provided in this paper for the improvement of research in numerous scientific fields will be helpful to researchers for suitable alternative designs of gossypin in various disorders.

Graphical abstract
Chinese herbal extracts with antiviral activity: evaluation, mechanisms, and potential for preventing PRV, PEDV and PRRSV infections
Authors: Sun Yumei , Li Chang , Liu Zhongzhu , Zeng Wei , Ahmad Muhammad Jamil , Zhang Mengjia , Liu Lina , Zhang Shujun , Li Wentao , He Qigai
Published: October 2023

The rapid expansion of large-scale pig farming has brought about a surge in viral diseases with high morbidity rates and diverse manifestations. This widespread occurrence of multiple viral diseases in pig farms has inflicted severe economic losses on the global swine industry. Consequently, there is an urgent need for eco-friendly and efficient antiviral drugs that can effectively combat viruses and prevent diseases such as PEDV, PRRSV, PRV, and other viral infections. To this end, we conducted a study on the antiviral activity and cytotoxicity of eleven different Chinese herbal extracts (CHE) against PRV. In vitro testing of several extracts, namely, Echinacea, Ilex purpurea Hassk, Ganoderma lucidum Kars, Taraxacum mongolicum, and Ilex rotunda Thunb, exhibited remarkable inhibition of PRV infection without causing any cytotoxic effects. Specifically, their antiviral selectivity indexes were significantly higher, with values ranging from 6- to 144-fold. The antiviral efficacy of five CHEs was evaluated against other RNA viruses, including PRRSV and PEDV. The extracts showed substantial inhibition of PEDV and PRRSV proliferation. Echinacea and Ilex purpurea Hassk extracts exhibited the highest virus inhibitory effects. To understand the antiviral mechanisms underlying their potent activity, a time-of-addition experiment was conducted. The results indicated that these extracts effectively targeted the early infection and postinfection stages of PRV, PEDV, and PRRSV. The study found that the Chinese herbal extracts, Echinacea and Ilex purpurea Hassk, had both direct and indirect effects on virus particles and cellular targets, demonstrating broad-spectrum antiviral activity against multiple clinical strains of PRV and PEDV. These findings provide a strong foundation for the development of herbal medicines to prevent and treat infections caused by PRV, PEDV and PRRSV in the swine industry. The identified extracts show great promise for the formulation of effective and environmentally friendly antiviral interventions.

Graphical Abstract
Artificial intelligence and increasing misinformation
Authors: Monteith Scott , Glenn Tasha , Geddes John R. , Whybrow Peter C. , Achtyes Eric , Bauer Michael
Published: October 2023

With the recent advances in artificial intelligence (AI), patients are increasingly exposed to misleading medical information. Generative AI models, including large language models such as ChatGPT, create and modify text, images, audio and video information based on training data. Commercial use of generative AI is expanding rapidly and the public will routinely receive messages created by generative AI. However, generative AI models may be unreliable, routinely make errors and widely spread misinformation. Misinformation created by generative AI about mental illness may include factual errors, nonsense, fabricated sources and dangerous advice. Psychiatrists need to recognise that patients may receive misinformation online, including about medicine and psychiatry.
Why Am I Ill? Beliefs in Supernatural and Natural Causes of Ill Health at the Time of Diagnostic Workup of Patients With Esophageal Cancer in Tanzania
Authors: Simba Hannah , Mmbaga Blandina T. , Serventi Furaha , Mremi Alex , Motlhale Melitah , Espina Carolina , Mwasamwaja Amos , Schuz Joachim , McCormack Valerie , Prah Efua
Published: October 2023

PURPOSE

An understanding of the cultural and context-specific perceptions of the causes of cancer is an important prerequisite for designing effective primary health prevention and early detection strategies. We aimed to use the Murdock Ill Health Theoretical Model to conceptualize views on illness causation among dysphagia-suffering patients undergoing diagnostic workup for esophageal cancer (EC) in Tanzania.

METHODS

At the end of a structured interview on lifestyle habits, patients with suspected EC were asked about beliefs on the reasons behind their illness through (1) a set of questions with fixed binary answers, whose determinants were analyzed using logistic regression, and (2) a single question with free-text answers. Responses were coded using a hierarchy of natural and supernatural (godly and social constructs) causes.

RESULTS

Among 322 patients interviewed between November 2015 and December 2019, we found complex and varied views about the origins of their illness. Overall, 49% of patients attributed illness to natural causes and 39% to supernatural causes. Natural causes ranged from infection, use of alcohol and tobacco, other ailments, and the environment. The supernatural causes included attributing illness to God, curses, and spells from personal acquaintances. Belief in supernatural causes was more common in the less educated and those who sought help first via a traditional healer.

CONCLUSION

The results underscore the need for increased community awareness of biomedical causes of ill health and patient-based participatory research to inform prevention programs. The results also highlight the importance of building health systems that support a series of health-seeking behaviors that acknowledge both biomedical and local traditional healing belief systems.
Long-Term Follow-Up of the Response-Adjusted Therapy for Advanced Hodgkin Lymphoma Trial
Authors: Luminari Stefano , Fossa Alexander , Trotman Judith , Molin Daniel , d'Amore Francesco , Enblad Gunilla , Berkahn Leanne , Barrington Sally F. , Radford John , Federico Massimo , Kirkwood Amy A. , Johnson Peter W.M.
Published: October 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

We analyzed long-term results of the response-adapted trial for adult patients with advanced-stage Hodgkin lymphoma. The aim was to confirm noninferiority of treatment de-escalation by omission of bleomycin from doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) for interim fluorodeoxyglucose positron emission tomography (iPET)–negative patients and assess efficacy and long-term safety for iPET-positive patients who underwent treatment intensification with escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone (BEACOPP/BEACOPP14). The median follow-up is 7.3 years. For all patients, the 7-year progression-free survival (PFS) and overall survival (OS) are 78.2% (95% CI, 75.6 to 80.5) and 91.6% (95% CI, 89.7 to 93.2), respectively. The 1.3% difference in 3-year PFS (95% CI, –3.0 to 4.7) between ABVD and doxorubicin, vinblastine, and dacarbazine (AVD) now falls within the predefined noninferiority margin. Among 172 patients with positive iPET, the 7-year PFS was 65.9% (95% CI, 58.1 to 72.6) and the 7-year OS was 83.2% (95% CI, 76.2 to 88.3). The cumulative incidence of second malignancies at 7 years was 5.5% (95% CI, 4.0 to 7.5) for those receiving ABVD/AVD and 2.5% (95% CI, 0.8 to 7.7) for those escalated to BEACOPP. With extended follow-up, these results confirm noninferiority of treatment de-escalation after a negative iPET. Escalation with BEACOPP for iPET-positive patients is effective and safe, with no increase in second malignancies.
Association between pre-diagnosis financial strain and later stage cancer presentation.
Authors: Khor Sara , Yu Kaiyue , Fedorenko Catherine R. , Rivers Zachary , Kestner Shannon , Shankaran Veena
Published: October 2023

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Background: Poverty and community-level deprivation have been shown to be associated with later stage cancer diagnosis. However, few studies have used objective financial data to study the link between individual financial strain and cancer stage at diagnosis. Our goal was to assess the associations between pre-diagnosis financial strain (FS) as measured by credit reports and later stage cancer diagnosis. Methods: Records from cancer patients diagnosed with solid tumors between 2014 and 2018 from the Western Washington SEER cancer registry and quarterly credit report data from a large credit-reporting agency TransUnion were linked and deidentified. Patients diagnosed with late-stage cancer (stages III and IV) were matched 1:1 to patients diagnosed with early-stage cancer (stages I and II) by age, year of diagnosis, cancer type, and insurance status. We assessed the association between FS (defined as any records of third-party collections, charge-offs, delinquent mortgage payments, tax liens, foreclosures, repossessions, and bankruptcies within 2 years prior to diagnosis) and late-stage diagnosis using conditional logistic regression to account for matching, adjusting for race, sex, marital status, area deprivation, and rurality. We performed stratified analyses by insurance enrollment. Separately, among a subset of unmatched insured breast cancer patients eligible for cancer screening (ages 50-74), we used multivariable logistic regressions to exam how the nonreceipt of screening mammography within 2 years of diagnosis mediated the relationship between FS and late-stage diagnosis. Results: After matching, 27916 patients were included in the analysis (mean age 66, 47% female, 84% White race, 7% Asian or Pacific Islander, 4% Black, and 3% Hispanic). Almost one in three patients (32%) had experienced FS before diagnosis. FS was associated with higher odds of late-stage cancer diagnosis (adjusted OR, aOR 1.18, 95%CI 1.1-1.3), and this association remained significant among insured patients (aOR 1.13, 95%CI 1.03-1.2). Among a subset of insured breast cancer patients (n=6934), FS was associated with nonreceipt of mammography (aOR 1.88, 95%CI 1.5-2.4). The association between FS and late-stage diagnosis became insignificant after we accounted for nonreceipt of mammography (aOR reduced from 1.65 (95%CI 1.4-1.9) to 1.04 (95%CI 0.8-1.4)). Conclusions: FS is associated with a later stage cancer diagnosis, which could in turn lead to adverse cancer outcomes. Among breast cancer patients, this association can be largely explained by nonreceipt of mammography. Our findings suggest that even with insurance coverage, individual’s financial stress may create an additional barrier to timely medical attention for suspicious cancer symptoms or routine screening, further exacerbating cancer disparities. This research highlights the need to develop strategies to improve access to care for these individuals.
The association of Supplemental Nutrition Assistance Program (SNAP) benefits and breast, cervix, and colorectal cancer screening.
Authors: Kazmi Ali Rashed , Barnes Justin Michael
Published: October 2023

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Background: Food insecurity is associated with healthcare access and utilization. The Supplemental Nutrition Assistance Program (SNAP) was created to reduce food insecurity for low-income households and hence may enhance health-seeking behaviors. However, it is unknown whether receipt of SNAP benefits is associated with rates of cancer screening. Our objective was to quantify the relationship of SNAP benefit receipt with cancer screening among low income individuals at high risk for food insecurity. Methods: The National Health Interview Survey (NHIS) provided by the Center for Disease Control and Prevention was utilized to identify high-risk adults ages 21 to 74 years eligible for screening for female cervix (21-65 years), colorectal (40-74 years), and/or female breast cancer (40-74 years). Data was included from the 2019 and 2021 surveys, with 2020 excluded due to limited cancer screening information. High-risk was defined as low or very low food security, household income < 125% federal poverty level, or having Medicaid insurance. Up to date cancer screening was defined as receipt of mammography within 2 years for breast cancer; receipt of a cervical cancer test within 5 years for cervix cancer; and receipt of sigmoidoscopy within the past 5 years, colonoscopy within 10 years, fecal immunohistochemistry (FIT) testing within 1 year, or sDNA-FIT testing within 3 years for colorectal cancer. We utilized logistic regression to compare screening rates by receipt of SNAP benefits and accounted for the complex survey design of the NHIS. Models were adjusted for covariates including age, race, ethnicity, sex (colorectal cancer screening only), income, education, marital status, insurance status, metropolitan residence status, survey year, food insecurity, and comorbidities. Results: A total of 6,111, 4,141, and 7,015 respondents were identified for cervix, breast, and colorectal cancer screening analyses, respectively. Among these respondents, 67%, 61%, and 60% were up to date on cervix, breast, and colorectal cancer screenings, respectively. Among this high-risk cohort, 43% of respondents reported receipt of SNAP benefits. Receipt of SNAP benefits was associated with increased odds of cervical cancer screening (OR = 1.18, 95% CI = 1.00 – 1.39, P=.046), which was limited to females ages 21-39 (OR = 1.36, 95% CI = 1.05 – 1.77, P=.022). Receipt of SNAP benefits was not associated with increased rates of breast or colorectal cancer screening. Conclusions: Receipt of SNAP benefits is associated with higher rates of cervical cancer screening among low-income females at high risk of food insecurity, particularly among young adults. These data suggest that efforts to address social determinants of health may improve access to care.