bluuebunny/crossref_metadata_2025 huggingface dataset:
Intenções de fecundidade: uma revisão da literatura acerca da variável em países de renda alta e no Brasil
Authors: Leocádio Victor , Verona Ana Paula , Wajnman Simone
Published: April 2023

A literatura sobre intenções de fecundidade tem ganhado crescente relevância em estudos demográficos porque, sendo um determinante próximo da fecundidade, auxilia o entendimento do comportamento reprodutivo de diferentes populações. Contudo, esta literatura não foi ainda organizada segundo os principais e mais recorrentes aspectos dispersos na literatura. Estudos geralmente utilizam uma única característica acerca das intenções de fecundidade, seja por meio dos seus conceitos, das principais teorias ou de principais indicadores. Este trabalho possui, portanto, o objetivo de organizar e articular os principais e mais recorrentes aspectos presentes nos estudos sobre intenções de fecundidade. Ao longo da discussão, aprofunda-se na relação existente entre intenções de fecundidade e fecundidade observada. A princípio, foca-se nos países de renda alta, sobre e para os quais a literatura referente ao tema foi desenvolvida. Contudo, também são abordados países de renda média e fecundidade baixa, com ênfase no Brasil, para os quais a produção, especialmente a partir de uma abordagem teórica, ainda é incipiente.
Распространение вариантов вируса SARS-COV-2, вызывающих интерес (VOI) и субвариантов Omicron, находящихся под наблюдением (VUM), на основе количества их геномов, депонированных в базу данных GISAID за неделю с 01.04.2023 г. по 07.04.2023 г.
Authors: Дмитриева Людмила , Краснов Ярослав , Чумачкова Елена , Осина Наталья , Зимирова Анастасия , Иванова Александра , Карнаухов Игорь , Караваева Татьяна , Щербакова Светлана , Кутырев Владимир
Published: April 2023

В обзоре представлена информация по циркулирующим в настоящее время вариантам вируса SARS-COV-2 вызывающих интерес (VOI) и субвариантов Omicron, находящихся под наблюдением (VUM), геномные последовательности которых размещены в международной базе данных GISAID за неделю с 1 по 7 апреля 2023 г.
Obturator Anterior Dislocation After Direct Anterior Total Hip Arthroplasty in a Patient with Ehlers-Danlos Syndrome
Authors: Powell Sarah N. , Nash Joseph K. , Kildow Beau J.
Published: April 2023

Case:

A 71-year-old woman with Ehlers-Danlos syndrome suffered an atraumatic obturator dislocation status post direct anterior total hip arthroplasty. A closed reduction under conscious sedation was attempted, but was unsuccessful. Repeat closed reduction under full general anesthesia with paralysis and fluoroscopic guidance was successful at reducing the femoral prosthesis out of the pelvis and back into an appropriate position.

Conclusion:

Atraumatic obturator dislocations after total hip arthroplasty are exceedingly rare. General anesthesia with full paralysis is helpful for a successful closed reduction, and open reduction may be necessary to remove the femoral prosthesis from the pelvis.
The behave pro-environmentally intention of Villagers in Rural Tourist Destinations under China's Environmental Remediation Policy
Authors: Tang Hongjiu , Hu Di , Long Yuelin , Zhao Yuqi
Published: April 2023

Background: The study examined the villagers' intention of pro-environmental behaviour while supporting the Fallow Remediation Policy in China, research team conducted field surveys on some villagers in four famous scenic spots of Cili county where near the world natural heritage Zhangjiajie natural landscape core area, it has developed rural tourism, many local villagers rely on rural tourism to obtain livelihood income, but it is now affected by the new environmental restoration policy called Fallow Policy, some cultivated land near the tourist area needs to be repaired, which affects the tourism livelihood income of some local villagers. So the local villagers are facing the contradiction between tourism development and environmental protection;
Methods: The study chose the change of local villagers' pro-environmental intention as the research content and adopted an empirically validated norm activation model (NAM) of Schwartz, then merged NAM with the Expectancy theory of Vroom. Based on 511 valid responses from the field questionnaire surveys, we aim to develop a theoretical framework for researchers to understand the influence change of villagers' pro-environmental behaviours when it comes to the sustainable development of rural tourism and tourism livelihood benefits;
Results: The sample data of 511 responses including seven latent variables and 25 observational items were from villagers in the Cili county. The structural equation modeling of each index of the responses was carried out, and the findings showed that the merged model has a 76.46% better predictive accuracy of villager's pro-environmental intentions than the original NAM alone; and
Conclusions: This study discovered that the motivational force of the newly discovered theory significantly influences the environmental personal norms, which comes from the joint impact of valence, instrumentality, and expectancy. It can be safely explained that villagers with a positive pro-environmental behaviour intention usually expect to have good tourism benefits and living environmental conditions under the impact of the Fallow Policy in rural tourism destination near the famous world natural heritage.
Hordeum vulgare ethanolic extract mitigates high salt-induced cerebellum damage via attenuation of oxidative stress, neuroinflammation, and neurochemical alterations in hypertensive rats
Authors: Farid Omar Abdel-Hamed Ahmed , Abd-Elrazek Areeg , Elwakel Hend , Mohamed Maha Mahmoud
Published: April 2023

High salt intake increases inflammatory and oxidative stress responses and causes an imbalance of neurotransmitters involved in the pathogenesis of hypertension that is related to the onset of cerebral injury. Using natural compounds that target oxidative stress and neuroinflammation pathways remains a promising approach for treating neurological diseases. Barley (Hordeum vulgare L.) seeds are rich in protein, fiber, minerals, and phenolic compounds, that exhibit potent neuroprotective effects in various neurodegenerative diseases. Therefore, this work aimed to investigate the efficacy of barley ethanolic extract against a high salt diet (HSD)-induced cerebellum injury in hypertensive rats. Forty-eight Wistar rats were divided into six groups. Group (I) was the control. The second group, the HSD group, was fed a diet containing 8% NaCl. Groups II and III were fed an HSD and simultaneously treated with either amlodipine (1 mg /kg b.wt p.o) or barley extract (1000 mg /kg b.wt p.o) for five weeks. Groups IV and V were fed HSD for five weeks, then administered with either amlodipine or barley extract for another five weeks. The results revealed that barley treatment significantly reduced blood pressure and effectively reduced oxidative stress and inflammation in rat's cerebellum as indicated by higher GSH and nitric oxide levels and lower malondialdehyde, TNF-α, and IL-1ß levels. Additionally, barley restored the balance of neurotransmitters and improved cellular energy performance in the cerebellum of HSD-fed rats. These findings suggest that barley supplementation exerted protective effects against high salt-induced hypertension by an antioxidant, anti-inflammatory, and vasodilating effects and restoring neurochemical alterations.
Effectiveness and brain mechanism of rTMS combined with quadriceps strength training in individuals with knee osteoarthritis: Study protocol for a randomized controlled trial
Authors: Lai Ming-Hui , Xu Hai-Chen , Ding Yu-Wu , Yang Kun , Xu Xue-Ping , Jiang Li-Ming
Published: April 2023

Background: Quadriceps training is necessary in function, activity of daily living and quality of life for patients with knee osteoarthritis (KOA) but it did not reduce the rate of surgical treatment (replacement of knee) for end-stage KOA in the long term. This may be related to brain structure changes and maladaptive plasticity in KOA patients. Transcranial magnetic stimulation (TMS), as a non-invasive brain stimulation technique, which uses magnetic pulse on the central nervous system, stimulates the excitability of nerve cells, enhances the functional connectivity of brain regions and improves maladaptive plasticity. However，the therapeutic effect of two rehabilitation techniques combination in patients with KOA remains unclear. Therefore, the purpose of this study is to investigate whether the high-frequency rTMS combined with quadriceps strength training can improve the function in KOA more effectively than quadriceps training alone and explore the brain mechanism of this combined rehabilitation.
Methods: This study is an assessor-blind, sham-controlled, randomized controlled trial involving 12 weeks intervention and 6 months follow-up. One hundred and twelve participants with KOA will be received usual care management and randomized into four subgroups including quadriceps strength training (QT); high-frequency rTMS training (HT); sham rTMS and quadriceps strength training (ST+Q); high-frequency rTMS and quadriceps strength training (HT+Q). The rehabilitation interventions in four groups will be carried out 5 days per week for a total of 12 weeks. All outcomes will be measured at baseline, 4 weeks, 8 weeks, and 12 weeks during intervention and 1 months, 3 months and 6 months during follow-up period. The primary outcomes are visual analog scale (VAS) and isokinetic muscle strength test. Secondary outcomes are include Knee Injury and Osteoarthritis Outcome Score (KOOS)，36-Item Short-Form Health Survey (SF-36), rTMS and magnetic resonance imaging (MRI).
Discussion: The study will provide evidence for the effects and brain mechanism of high frequency rTMS on improving function in KOA patients. High frequency rTMS can be added into the muscle training program for KOA patients as a supplementary therapy content if it is proved to be effective.
Trial registration: Chinese Clinical Trial Registry ChiCTR2300067617. Registered on Jan.13,2023.
Tissue-Specific Carbon Isotope Patterns of Amino Acids in Southern Sea Otters
Authors: Robinson Alana L , Smith Emma A Elliott , Besser Alexi C , Newsome Seth D
Published: April 2023

The measurement of stable isotope values of individual compounds, such as amino acids (AAs), has quickly become a powerful tool in animal ecology and ecophysiology. As with any emerging technique, fundamental questions remain regarding the capability and limitations of this approach, including how metabolism and tissue synthesis impact AA isotope values and patterns. We measured carbon isotope (d13C) values of essential (AAESS) and nonessential (AANESS) AAs in bone collagen, whisker, muscle, and liver from ten southern sea otters (Enhydra lutris nereis) stranded in Monterey Bay, California. Sea otters in this population exhibit high degrees of individual dietary specialization, making this an excellent opportunity to explore differences in AA d13C values among tissues in a wild population. We found the d13C values of glutamic acid, proline, serine, lysine, and threonine differed significantly among tissues, indicating possible isotopic discrimination during tissue synthesis. Threonine d13C values were higher in liver relative to bone collagen and muscle, which may indicate catabolism of threonine for gluconeogenesis, an interpretation further supported by statistically significant correlations between the d13C values of threonine and its gluconeogenic products glycine and serine. For 6/10 of the sea otters analyzed, tissues from the same individual sea otter classified with different primary producers in multivariate space. We thus recommend caution when using data from multiple tissues in an AAESSd13C fingerprinting framework. Broadly, our results indicate that metabolism influences both AAESS and AANESSd13C values and highlight the importance of gluconeogenesis in driving compound-specific isotope patterns in this endangered apex marine consumer.
Rhomboid intercostal block versus serratus block for postoperative analgesia after thoracoscopic sympathectomy for primary palmar hyperhidrosis: a randomized Controlled trial
Authors: Elhouty Mohamed G. , Elbahrawy Khaled , Elawady Mostafa S.
Published: April 2023

Background: Although thoracoscopic sympathectomy is made via small incisions, it is associated with severe postoperative pain. Both Rhomboid intercostal block (RIB) and serratus anterior plane block (SABP) are recent techniques used for pain control after such procedures. Herein, we compared RIB and SAPB regarding pain control in patients undergoing thoracoscopic sympathectomy for palmar hyperhidrosis.
Patients and methods: Three groups were enrolled in this prospective randomized study (71 patients in each group); Group S received SAPB, Group R received RIB and Group C as controls. The block procedures were performed after general anesthesia and prior to the skin incision.
Results: The three groups showed comparable demographics and operative time (P ˃ 0.05). Pain scores showed a significant decline with the two block procedures compared to controls during the first day following surgery (P ˂ 0.05), but Group R had better scores compared to Group S. Both block techniques were associated with a significant prolongation of the time to first rescue analgesic and less fentanyl consumption compared to controls (P ˂ 0.05). However, both parameters were improved with RIB rather than SAPB (P ˂ 0.05). Both blocks led to a significant improvement in patient satisfaction, which was comparable between the two approaches P ˃ 0.05), and better than Group C (P ˂ 0.05).
Conclusion: Both RIB and SAPB are safe and effective in pain reduction after thoracoscopic sympathectomy procedures in patients with hyperhidrosis. However, RIB is superior to SAPB as it is associated with better analgesic outcomes.
Clinical trial registration number: Pan African Trial Registry PACTR202203766891354.
https://pactr.samrc.ac.za/Researcher/TrialRegister.aspx?TrialID=21522
Whole-genome sequencing and analysis of Apocynum cannabinum
Authors: Li Guoqi , Song Lixiao , Che Jinfeng , Chen Yanyun
Published: April 2023

Backgroud
Apocynum cannabinum is an important plant resource from the Apocynaceae family. However, the lack of complete genome information has severely impeded research progress of molecular biology research in this plant. Whole-genome sequencing can provide an in-depth understanding of species growth, development, and evolutionary origin, and is the most effective method for scientifically exploring the ecological and economic value of a plant.
Methods and results
In this study, we employed Illumina HiSeq, single-molecule real-time sequencing, 10X genomics linked reads, and chromatin interaction (Hi-C), a new assembly technique, to successfully assemble the whole draft genome for A.cannabinum (260 Mb). The super-scaffold N50 genome size from the Hi-C assisted assembly was 21.16 Mb and was anchored to 11 chromosome, resulting in a high-quality reference genome at the chromosome level (2n = 2x = 22). We further annotated, analyzed, and predicted 22,793 protein-coding genes, of which the functions of 95.6% were already annotated, 92.3% contained conserved protein domains, and 78.7% were aligned to known metabolic pathways.
Colclushions
This high-quality A.cannabinum genome can be used to analyze growth and development and evaluate gene evolution at the genome level, as well as assist in the comparative genomics and genetic modification of other important medicinal plants in Apocynaceae. Comparative analysis of the gene families showed that A. cannabinum speciated around 35.8 (27.0–46.9) million years ago.
Prevalence of functional disability and associated factors among patients with schizophrenia attending psychiatry outpatient clinic at Muhimbili national hospital, Dar es Salaam: A cross-sectional survey
Authors: kitomary Nuruel R. , Likindikoki Samuel
Published: April 2023

BackgroundThe available literatures worldwide, mention the functional disability as the one of dangerous corollary of schizophrenia, while it is among the intrinsic complications of schizophrenia. Functional disability among the patients with schizophrenia is of greater concerns because patients remain dependent with hopeless life. Many factors are associated with functional disability such as age, sex, marital status, level of education, age at the diagnosis of schizophrenia, regimen of antipsychotics on use, frequency of admission and psychotherapy in among the patients with schizophrenia.ObjectiveThe study aimed to determine the prevalence of functional disability and associated factors among patients with schizophrenia attending psychiatric outpatient clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.DesignA cross-sectional surveySettingApsychiatric outpatient clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.Participants281 adults were confirmed to have diagnosis of schizophrenia using MINI International neuropsychiatric interview for psychotic disorders studies (MINI version 7.0.2). World Health Organization Disability Scale-short version 12-items (WHODAS-12) used to measure functional disability among participants.ResultsThe overall prevalence of functional disability was 71.9%. About a third (33.5%), (30.6%) and about 1 in every 13 participants (7.8%) had mild, moderate, and severe functional disability, respectively. Increased odds of functional disability was independently associated with; the frequency of admission; 1-5 times (AOR=16.76, 95%CI: 4.74-59.33), ≥6times (AOR= 9.34 95%CI: 2.38-38.28), typical (AOR=2.76 95%CI: 1.29-5.89), mixed (atypical and typical) antipsychotics (AOR=13.92 95%CI: 2.20-80.04); Not receiving psychotherapy during treatment (AOR=2.62 95%CI: 1.27-5.41) and substance use for the past twelve months (AOR=3.00 95%CI: 1.24-7.24) but male participants had decreased odds (AOR=0.40 95%CI: 0.18-0.87) of functional disability.ConclusionPatients with schizophrenia have relatively higher prevalence of functional disability. Frequency of admission, male gender, using typical antipsychotics and mixed antipsychotics, not getting psychotherapy were independent predictors of functional disability. Routine assessment of functional disability among patients with schizophrenia attending clinic with early occupational therapy interventions is highly recommended.
Developing a pseudo-lentivirus-based neutralization assay against SARS-CoV-2
Authors: Soltani Elahe , Pouriayevali Mohammad Hassan , Salehi-Vaziri Mostafa , Bahonar Ali Reza
Published: April 2023

Background
Convenient and reliable neutralization assays are vital for development of accurate diagnosis and new vaccine/drug production. Present research aimed to produce a SARS-COV-2 pseudo-lentivirus to evaluate neutralizing antibodies in the convalescent patients from Covid-19 and to assess the ability of the pseudovirus to infect different cell lines.
Methods
Lentix 293T cell line was employed for the transfection of the plasmid, and SARS-CoV-2 S gene was codon-optimized, synthesized, and cloned into the pcDNA3.1-SARS-CoV-2 plasmid followed by amplification and transforming into E. coli DH5α. Confirmation of the extracted plasmid was performed by gel electrophoresis. ThepcDNA3.1-SARS-CoV-2 plasmid, psPax-2 and reporter plasmid pLOX-CWgfp were transfected into Lentix 293T cells using the Turbofect transfection reagent. Western blot assay was undertaken to conform the SARS-CoV-2 S-protein transfection, and the titer of the produced SARS-CoV-2 pseudovirus was assessed by the Real-Time PCR. Sera samples of 24 convalescent patients and five samples of healthy persons (negative control) were tested by both the EUROIMMUN Anti‐SARS‐CoV‐2 QuantiVac ELISA (IgG) and the neutralization assay.
Results
By ELISA and neutralizing antibody assays 24 (100%) and 17 (70.83%) samples were detected as positive, respectively. Calculation of Kappa coefficient exhibited a medium correlation agreement. By Pearson correlation coefficient no significant (p=0.24) was seen between the two assays. Further, the positive predictive value for the presence of high neutralizing antibodies was 100%, whereas the negative predictive value for low neutralizing antibodies was 41.66%.
Conclusion
Based on WHO guidelines neutralization assays are considered as the gold standard for assessing the protective potential of antibodies induced by the SARS-CoV-2 vaccines. Given these results, by optimizing the pseudoviral production and neutralization assay, we will be able to determine a threshold between the two assays.
Role of Family Factors in Provision and Perception of Social Support for Older People in Iran: A Cross-Sectional Survey
Authors: Tajvar Maryam , Grundy Emily , Fletcher Astrid , Allen Elizabeth , Karami Badrye
Published: April 2023

Background
Iran has experienced a very fast fertility transition. The process of demographic transition, coupled with modernization, has had considerable consequences for the structure and function of families. There is rising concern in Iran about a potential decline in family care and support for older people as a result of these changes. The main aim of this study was to provide a benchmark by examining current associations between family factors and older people’s social support, both perceived and received.
Methods
We conducted a cross-sectional survey of a random sample of 644 people aged 60 + years resident in Tehran stratified by socioeconomic status of area. Multilevel mixed-effects models were used to examine the hypotheses.
Results
The analyses showed that most of the family factors measured, including family size, living arrangements, and amount of contact with family members were associated with older people’s receipt of instrumental social support, as expected. Living arrangements and quality of relationships with family members were associated with older people’s perceptions of social support.
Conclusion
Implications of these findings for older people currently living in Iran are considered. These findings may also provide important insights into the implications of demographic and associated family changes for older people in the future.
Index of consciousness monitoring during general anesthesia may effectively enhance rehabilitation in elderly patients undergoing laparoscopic urological surgery: a randomized controlled clinical trial
Authors: Qi Fengling , Fan Long , Wang Chunxiu , Liu Yang , Yang Shuyi , Fan Zhen , Miao Fangfang , Kan Minhui , Feng Kunpeng , Wang Tianlong
Published: April 2023

Background Elderly patients are at a significantly higher risk of perioperative complications. Based on electroencephalogram (EEG) analysis, index of consciousness (IoC) monitoring is a new technique for monitoring anesthesia depth. IoC is divided into two parts: IoC1(depth of sedation) and IoC2(depth of analgesia). There have only been a few studies in which IoC1and IoC2are simultaneously monitored to speed up postoperative recovery. We investigated whether combined monitoring of IoC1and IoC2can effectively improve postoperative recovery in elderly patients undergoing laparoscopic urological surgery under general anesthesia. Methods A prospective, randomized, controlled, double-blind trial was carried out on elderly patients scheduled for laparoscopic urological surgery under total intravenous anesthesia. Patients were assigned to either the IoC group (n = 60) or control group (n = 60) at random. The prevalence of postoperative cognitive dysfunction (POCD) was the primary endpoint. Inflammatory markers, arterial blood gas analysis, postoperative complications, and length of hospital stay were among the secondary endpoints. Results The study included 120 patients with an average age of 71.20 ± 5.06 years. Compared to the control group, the incidence of POCD was significantly lower (19(31.7%) vs. 6(10%);P = 0.003), and serum C-reactive protein(CRP) and glial fibrillary acidic protein(GFAP) concentrations were lower at the end of surgery (CRP: 5.36 ± 3.36 vs. 3.11 ± 2.62;P = 0.000, GFAP: 3.29 ± 1.22 vs. 2.42 ± 1.38;P = 0.000) and 24h after surgery (CRP:11.75 ± 7.52 vs. 8.15 ± 5.24;P = 0.003, GFAP: 4.84 ± 1.20 vs. 3.96 ± 2.23;P = 0.008) in the IoC group. Blood glucose levels at the end of surgery (9.17 ± 2.04 vs. 7.11 ± 1.35;P = 0.000) and the total rate of complications at 7 days after surgery (16(26.7%) vs. 7(11.7%),P = 0.037) were significantly lower in the IoC group. Conclusion IoC monitoring for managing elderly surgical patients can hasten postoperative recovery by reducing intraoperative stress and the resulting systemic and neuroinflammation.TRIAL REGISTRATION:Chinese Clinical Trial Registry Identifier: ChiCTR1900025241（17/08/2019）.
A comparison of the most intense periods (MIPs) during competitive matches and training over an 8-week period in a male elite field hockey team
Authors: Büchel Daniel , Döring Michael , Baumeister Jochen
Published: April 2023

Purpose
Wearables serve to quantify the on-court activity in intermittent sports such as field hockey (FH). Based on the objective data, benchmarks can be elaborated to tailor training intensity and volume. Next to average and accumulated values, the most intense periods (MIPs) during competitive FH matches are from special interest, since these quantify the peak intensities players experience throughout the intermittent matches. The aim of this study was to retrospectively compare peak intensities between training and competition sessions in a male FH team competing in the first german division.
Methods
Throughout an 8-week in-season period, 372 individual activity datasets (144 datasets from competitive sessions) were recorded using the Polar Team Pro sensor (Kempele, Finland). MIPs were calculated applying a rolling window approach with predefined window length (1 to 5 minutes) and calculated for Total distance, High-Intensity-Running distance (> 16 km/h), Sprinting distance (> 20 km/h) and Acceleration load. Significant differences between training and competition MIPs were analysed through unpaired t-tests (p < .05).
Results
Analyses revealed higher MIPs during competition for all considered outcomes (p < .001). Effect size estimation revealed strongest effects for sprinting distance (d = 1.89 to d = 1.22) and lowest effect sizes for acceleration load (d = 0.92 to d = 0.49).
Conclusion
The present findings demonstrate that peak intensities during training do not reach those experienced during competitive sessions in a male FH team. Training routines such as manipulations of court-dimensions and team sizes might contribute to this discrepancy. Coaches should compare training and competition intensities to recalibrate training routines to optimize athletes’ preparation for competition.
Risk factor analysis and nomogram prediction model construction for NEC complicated by intestinal perforation
Authors: Huang Pei , Luo Nandu , Shi Xiaoqi , Yan Jiahong , Huang Jiaojiao , Chen Yan , Du Zuochen
Published: April 2023

Objective To investigate the clinical characteristics of neonatal necrotizing enterocolitis (NEC) complicated by intestinal perforation and predict the incidence of intestinal perforation in NEC. Methods Neonates diagnosed with NEC at the Affiliated Hospital of Zunyi Medical University from January 2012 to May 2022 were enrolled, and the clinical data were collected and analyzed retrospectively. The patients were divided into two groups based on intestinal perforation occurrence or not. Mann-Whitney U tests, t-tests, chi-square tests, and fisher's exact tests were performed between-group comparisons. Logistic and lasso regressions were applied to screen independent risk factors for concomitant bowel perforation, and R software (RMS package) was used to formulate the nomogram prediction model. In addition, the receiver operating curve (ROC) and the calibration curve were drawn to verify the predictive power, while decision curve analysis (DCA) was constructed to evaluate the clinical applicability of the nomogram model. Results 180 neonates with NEC were included, of which 48 had intestinal perforations, and 132 did not; the overall incidence of intestinal perforation was 26.67% (48/180). Bloody stool (OR = 5.60), APTT ≥ 50s (OR = 3.22), thrombocytopenia (OR = 4.74), and hypoalbuminemia (OR = 5.56) were identified as independent risk variables for NEC intestinal perforation (P < 0.05) through multivariate logistic regression analysis. These factors were then applied to develop a nomogram prediction model (C-index = 0.838) by using the R software. The area under the curve (AUC) for the nomogram in the training and validation cohorts were 0.838 (95% Cl: 0.768, 0.908) and 0.802 (95% CI: 0.659, 0.944), respectively. The calibration curve shown that the nomogram has a good predictive ability for predicting the risk of intestinal perforation occurrence. And the decision curve and clinical impact curve analyses demonstrated good clinical utility of the nomogram model. Conclusion We found that Bloody stool, APTT ≥ 50s, Thrombocytopenia, and hypoalbuminemia could be used as independent risk factors for predicting intestinal perforation in neonates with NEC. The nomogram model based on these variables had high predictive values to identify NEC patients with intestinal perforation.
GWAS for Systemic Sclerosis Identified six novel susceptibility loci including penetrating Fcγ-Receptor Region
Authors: Ishikawa Yuki , Tanaka Nao , Asano Yoshihide , Kodera Masanari , Shirai Yuichiro , Akahoshi Mitsuteru , Hasegawa Minoru , Matsushita Takashi , Saito Kazuyoshi , Motegi Sei-ishiro , Yoshifuji Hajime , Yoshizaki Ayumi , Komoto Tomohiro , Takagi Kae , Oka Akira , Kanda Miho , Tanak Yoshihito , Ito Yumi , Nakano Kazuhisa , Kasamatsu Hiroshi , Utsunomiya Akira , Sekiguchi Akiko , Niro Hiroaki , Jinnin Masatoshi , Makino Katsunari , Makino Takamitsu , Ihn Hironobu , Yamamoto Motohisa , Suzuki Chisako , Takahashi Hiroki , Nishida Emi , Morita Akimichi , Yamamoto Toshiyuki , Fujimoto Manabu , Kondo Yuya , Goto Daisuke , Sumida Takayuki , Ayuzawa Naho , Yanagida Hidetashi , Horita Tetsuya , Atsumi Tatsuya , Endo Hirahito , Shima Yoshihito , Kumanogoh Atsushi , Hirata Jun , Otomo Nao , Suetsugu Hiroyuki , Koike Yoshinao , Tomizuka Kohei , Yoshino Soichiro , Liu Xiaoxi , Ito Shuji , Hikino Keiko , Suzuki Akari , Momozawa Yukihide , Ikegawa Shiro , Tanaka Yoshiya , Ishikawa Osamu , Takehara Kazuhiko , Torii Takeshi , Sato Shinichi , Okada Yukinori , Mimori Tsuneyo , Matsuda Fumihiko , Matsuda Koichi , Amariuta Tiffany , Imoto Issei , Matsuo Keitaro , Kuwana Masataka , Kawaguchi Yasushi , Ohmura Koichiro , Terao Chikashi
Published: April 2023

We conducted a Japanese GWAS for systemic sclerosis (SSc) comprising 1,428 cases and 112,599 controls, the largest Asian GWAS for SSc ever, and identified three novel signals. The lead SNP in FCGR/FCRL region had a strong effect size (OR 2.05, P = 4.9×10−11). The complete LD SNP, rs10917688, was found in a cis-regulatory element and a part of binding motifs for IRF8. IRF8 was a significant locus in the European GWAS and rs10917688 showed an association only in the presence of the risk allele of IRF8 in Japanese. rs10917688 was marked with H3K4me1 in primary B cells, and the heritability was enriched in active histone marks of primary B cells. A meta-analysis with the latest European GWAS found additional 30 significant loci including three novel signals. PRS constructed with the effect sizes of the meta-analysis indicated potential portability of genetic associations beyond populations (AUC: 0.593). The fitting of PRS was improved by further prioritizing the top 5% SNPs of IRF8 biding sites in B cells, underscoring common genetic architecture across populations and critical roles of B cells and IRF8 for SSc development.
Signature based Ransomware detection based on optimizations approaches using RandomClassifier and CNN algorithms
Authors: Sangher Kanti Singh , Singh Archana , Pandey Hari Mohan
Published: April 2023

As Ransomware encrypts user files to prevent access to infected systems its harmful impacts must be quickly identified and remedied. It can be challenging to identify the metrics and parameters to check, especially when using unknown ransomware variants in tests. The proposed work uses machine learning techniques to create a general model that can be used to detect the variations of ransomware families while observing the characteristics of malware. However, early detection is impeded by a dearth of data during the initial phases of an attack, which results in low detection accuracy and a high proportion of false alarms.To overcome these restrictions, our research suggests a revolutionary technique, in machine learning techniques we have proposedRandomClassifier with SMOTE optimizer based on the results received from LazyPredictAutoML and then deep learning algorithm ANN using Root Mean Square Propagation (adam) has been implemented to get the hidden patterns which were not accessible in machine learning approach. Further study focused on improving CNN's performance over RMSProp& Adam, which maintains per-parameter learning rates that are adjusted based on the average of most recent weight gradient magnitudes, using the Adam optimizer. The best option for internet and non-stationary issues is CNN with Adam (e.g. noisy). As gradients grow sparser toward the end of optimization, Adam somewhat surpasses RMSprop. Adam uses CNN and uses the average of the second moments of the gradients (the uncentered variance). The proposed model reported 5.14ms of prediction time and 99.18% accuracy.
Characterization and predictive risk scoring of long COVID in a South Indian cohort after breakthrough COVID infection; a prospective single centre study
Authors: Nair Pranav , Nair Chithira V , Kulirankal Kiran G , Corley Elizabeth M , Edathadathil Fabia , Gutajhr Georg , Moni Merlin , Sathyapalan Dipu T
Published: April 2023

Background
The majority of existing literature on long COVID has been focused on hospitalised patients. However, in the real-world setting of the post-vaccination era where breakthrough infections are the norm, it becomes a priority to assess the clinical profile of long COVID symptoms among such individuals. Through our study, we aim to describe the incidence, characterise and stratify the risk of developing long COVID breakthrough infections.
Methods
This prospective observational study included adult patients with breakthrough COVID-19 infections diagnosed at a tertiary hospital in India. Post-COVID symptoms at weeks 2, 6 and 12 after testing negative were extracted using a questionnaire after which multi-variate analysis was done.
Results
Out of 414 patients analysed, 164 reported post-COVID symptoms beyond 6 weeks of the infection. Univariate analysis showed that the presence of long COVID was found to be significantly higher among patients above 65 years of age at 31.3% in comparison to the long COVID presence at 29.4% among those below age 65 (p < 0.001). Systemic hypertension was also significantly associated with the presence of long COVID (72.3%), along with bronchial asthma (68.8%) with a p-value of < 0.0001 in both instances. Backwards selection was used leading to a reduced model consisting of age OR 1.053, 95% CI 0.097–1.07), p < 0.001), hypertension (OR 2.59, 95% CI 1.46–4.59, p = 0.001) and bronchial asthma (OR 3.7176, 95% CI 1.24–11.12, p = 0.018) to be significant predictors of long COVID incidence. These were used to develop a propensity score (C statistics – 80.9%).
Conclusions
A significant presence of long COVID at 12 weeks among non-hospitalised breakthrough infections calls for a series of review check-ups for the early detection of long-term complications. The proposed predictive risk scoring based on significant risk factors may assist clinicians in identifying patients at risk of developing long COVID, leading to appropriate, individualised management.
Clinical features of Shwachman-Diamond syndrome: A systematic review
Authors: Xue Han , Shuanglong Lu , Changjuan Gu , Zhuli Bian , Xiaotian Xie , Xiaohong Qiao
Published: April 2023

Introduction Shwachman-Diamond syndrome (SDS) is an autosomal recessive inherited bone marrow failure (IBMF) with exocrine pancreatic dysfunction and diverse clinical phenotype. To summarize the clinical features, epidemiology and treatment of SDS, we reviewed internationally published reports of patients with SDS.
Materials and methods With "Shwachman-Diamond syndrome", "SDS", "SBDS gene" and "inherited bone marrow failure" as keywords, the search period was setted from January 2002 to October 2022, and the relevant literatures of WangFang Database and China national knowledge infrastructure database was collected. In addition, using "Shwachman-diamond syndrome" as the keyword, literature reports from Web of Science, PubMed, and MEDLINE databases from January 2002 to October 2022 were retrieved, and a child with SDS treated in Tongji Hospital was also included.
Results The clinical features of 156 SDS patients were summarized. Three major SDS clinical features were cytopenia (94%), exocrine pancreatic dysfunction (83%), and failure to thrive (83%). The detection rate of SDS gene mutation was 94.6% (125/132). Mutations in SBDS, DNAJC21, SRP54, ELF6 and ELF1 genes have been reported. The male to female ratio is about 1.3/1. The median age at onset was 1.9 months, but the median age at diagnosis was 15.6 months.
Conclusion Common initial symptoms were pancreatic exocrine insufficiency and growth failure. The onset age of SDS in children is early and the individual difference is obvious. Comprehensively collecting and analyzing case related data can help clinicians understand the clinical characteristics of SDS, which may improve early diagnosis and effective clinical intervention of SDS.
Continuous electroencephalogram (cEEG) findings and neurodevelopmental outcomes in neonates with congenital heart disease (CHD) at 12-24 months of age
Authors: Padiyar Swetha , Friedman Neil , Pestana-Knight Elia , Franic Linda , Worley Sarah , Aly Hany
Published: April 2023

Objective

This study aims to assess the role of continuous EEG (cEEG) background patterns and duration of cross-clamp time and cardiopulmonary bypass (CPB) to predict abnormal neurodevelopmental outcomes at 12–24 months on Bayley Scales of Infant and Toddler Development (BSID-III).
Study design: This retrospective cohort study included infants with CHD and cEEG monitoring, who underwent surgery by 44 weeks gestational age.
Results: 34 patients were included, who were operated at median age − 7 days. Longer duration of cross- camp time was associated with poor language composite scores (LCS) (p value = 0.036). A significant association existed between severity of encephalopathy in 24-hour post-operative period and poor LCS (p value = 0.026).
Conclusion: Majority of neonates with CHD have below average cognitive, language and motor composite scores on BSID-III. Longer duration of cross-clamp time and severity of encephalopathy during 24-hour post-operative EEG monitoring are associated with poor LCS.
Association between systemic lupus erythematosus and pulmonary hypertension: Evidence from Meta-Analysis and Mendelian Randomization
Authors: Wei Yining , Cheng Xiaoxue , Zhang Yu , Liu Anlin , Ruan Honglian , Wang Tao
Published: April 2023

Background
Pulmonary hypertension (PH) is one of the most severe pulmonary complications of systemic lupus erythematosus (SLE). Nevertheless, studies of the prevalence of PH in SLE diversify tremendously, and the prevalence has not been updated for a long time. With the aim of estimating a more accurate prevalence of PH in SLE patients, we commenced a meta-analysis. Further analysis using the mendelian randomization (MR) approach was conducted to investigate whether SLE has a causal association with PH.
Methods
Pubmed, Embase, Web of Science and Cochrane Library were searched until October 2022 to identify eligible studies. We performed a heterogeneity and evaluated publication bias. Regional subgroup analyses were also performed. To further investigate the causal relationship between genetically predisposed SLE and PH, a two example mendelian randomization was performed. With 86 single nucleotide polymorphisms (SNPs) of mixed ancestors from the latest GWAS of SLE and 39 SNPs from another cohort as the replication group, we applied the inverse variance weighted (IVW) method to further estimate the causality, and conducted sensitivity analysis to measure the robustness of our results.
Results
Random effect model analysis showed a combined prevalence of 3.2% (95%CI 2.3-4.0%). However, the funnel plot showed a certain publication bias (p = 0.009). Subgroup analyses carried out on the basis of different regions demonstrated a salient difference in PH prevalence in SLE patients. Correspondingly, the mendelian randomization results showed that systemic lupus erythematosus was causally related to a higher risk of pulmonary hypertension among mixed ancestors (OR 1.33; 95%CI 1.04–1.69; P = 0.023), while no significant result was observed among European patients (OR 1.06; 95%CI 0.95–1.19; P = 0.297). Moreover, the results of MR sensitive analysis confirm the robustness of our causal estimates.
Conclusion
Our study suggested that a relatively low prevalence of PH in SLE when using right heart catheterization (RHC) to diagnose, but it was significantly different between regions. MR analysis also suggested that SLE might contribute to the progression of PH. The underlying mechanism regarding the causality between the two diseases requires further investigations.
In Vitro Screening of Selected Medicinal Plants for Their Anti-bacterial Efficacy Against Few Clinical Isolates
Authors: Sharmah Himangsu , Manickam Mathiyazhagan , Chaubey Binay , K Meenakshi Sundaram , Prathap Lavanya
Published: April 2023

From ancient times, plants have been the primary source of several phytochemicals that have been crucial in maintaining human health. A variety of antibiotics including secondary metabolites that plants produce while under stress. Due to the advent of several multi-drug resistant strains, commonly available antibiotics lost their effectiveness, and it became the second biggest cause of death globally. It was critical to create brand-new, highly efficient antibacterial medications from plant sources that were affordable, had fewer side effects, and worked quickly to treat bacterial illnesses. This study examines the effectiveness of nine methanolic plant extracts against nine bacterial diseases that are frequently caused by bacteria.
Effect of Group-based Acceptance and Commitment Therapy on Elderly Stroke Survivors: study protocol for a randomized controlled trial
Authors: Chen Furong , Zhou Qiao , Wu Junqi , Xu Xianghua
Published: April 2023

Introduction: Elderly stroke survivors usually experience various psychology disorders, such as post-stroke depression (PSD), which may be associated with high empirical avoidance (EA) and can seriously affect their quality of life. To date, the efficacy of group-based acceptance and commitment therapy (ACT) for elderly stroke survivors has not been established. The aim of this study is to investigate the effectiveness of group-based ACT on EA, PSD, psychological distress, and quality of life in elderly stroke survivors after group-based ACT.
Methods and analysis: This study is a randomized, single-blind, wait-list controlled, parallel-arm trial. A total of 66 stroke survivors will be randomly assigned to wait-list control group or intervention group. Participants in wait-list control group will receive treatment as usual (TAU), while the intervention group will receive group-based ACT once a week for eight weeks. The primary outcome measure being EA, and the secondary outcome measures being PSD, psychological distress, and quality of life. Results of the two groups will be blindly assessed by professional evaluators at baseline (T0), post-treatment (T1), and one-month follow up (T2).
Discussion: The results of this study will provide the first evidence for the effectiveness of a group-based ACT intervention in reducing EA, PSD, psychological stress, and improving quality of life for post-stroke survivors.
Trial Registration: ChiCTR2200066361.
The Prognostic Value of Pretreatment A Composite Biomarker of Natrium and Myeloid to Lymphoid lineage ratio in Patients With Advanced or Metastatic Gastric Cancer Treated With Immunotherapy
Authors: Pan Yuting , Dai Guanghai
Published: April 2023

Background Immunotherapy is effective for only some patients with advanced gastric cancer (AGC). Screening and determining patients who are suitable for immunotherapy is a difficult task in the field of tumor immunology. Patients with tumors often have sodium ion imbalance and changes in tumor microenvironment. The correlation between serum sodium level and tumor prognosis has been incredibly concerning. Targeting the tumor immune microenvironment to enhance the anti-tumor ability of immune cells, and thus improving the effect of therapeutic treatment of tumors is a research hotspot in recent years. However, the correlation between serum sodium level and immunotherapy has not been reported. Therefore, we collected the clinical records and follow-up data of 268 patients with AGC who received immunotherapy, and deeply analyzed whether a composite biomarker of natrium (Na) and myeloid to lymphoid lineage ratio (M:L) is suitable as a prognostic indicator for screening patients for immunotherapy.
Methods The median of 3.58 was taken as the optimal cut-off value. The optimal cut-off value was determined according to M:L, and the patients were then divided based on M:L into two groups: Low-level group (< 3.58) and High-level group (≥ 3.58). The optimal cut-off value of serum Na was 135mmol/L, which was the lowest limit of the normal range of blood biochemical results in the Cancer Center Department of PLA General Hospital. According to the optimal cut-off value of serum Na and M:L, patients were divided into two groups: The good Na/M:L group (145mmol/L > Na ≥ 135mmol/L and M:L < 3.58) and intermediate/poor Na/M:L group (Na < 135mmol/L and M:L ≥ 3.58 ). The differences in progression-free survival (PFS) and overall survival (OS) in the two Na/M:L groups were compared by survival analysis and log-rank test. COX was used for univariate and multivariate analysis to determine the presence of correlation between Na/M:L grouping and OS and PFS.
Results Patients in the good Na/M:L group were associated with longer PFS and OS compared to the intermediate/poor Na/M:L group (6.3 vs 3.6 months, 15.8 vs 9.5 months). The intermediate/poor Na/M:L group was independently associated with a 1.9-fold greater risk of disease progression (HR=1.584; 95% CI, 1.206-2.080; P=0.001) and more than 1.4-fold greater risk of death (HR=1.466; 95% CI, 1.069-2.011; P=0.018), compared to the good group.
Conclusion This study confirms for the first time that the composite biomarker of Na and M:L is an independent factor affecting survival of AGC patients receiving immunotherapy. Thus, patients in the good Na/M:L group could be identified to benefit from immunotherapy.