bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Diaphyseal Forearm Fracture Management with Biodegradable Poly-L-Lactide-Co-Glycolide (PLGA) Intramedullary Implants: A Longitudinal Study
Authors: Lőrincz Aba , Lengyel Ágnes Mária , Kedves András , Nudelman Hermann , Józsa Gergő
Published: June 2024

Background: Pediatric forearm fractures represent a substantial proportion of childhood injuries, requiring effective and minimally invasive treatments. Our study investigated the mid-term outcomes of biodegradable poly-L-lactide-co-glycolide (PLGA) intramedullary implants in managing diaphyseal forearm fractures in children. Methods: A follow-up cohort study was conducted with 38 patients treated with PLGA implants. Control examinations were performed one year post-operation, assessing bone healing through radiographic evaluations and functional outcomes using injured and uninjured limb range of motion (ROM) comparisons. Scarring was evaluated employing the Vancouver Scar Scale (VSS), and satisfaction via a questionnaire. Results: Children were predominantly female (76.4%), with a mean age of 9.71 (SD: 2.69) years. Effective fracture stabilization and bone healing were found in all patients, with a minor reduction (mean difference of -1.5°, p = 0.282) in elbow flexion on the operated side (139.3°) compared to the intact (140.8°). Elbow extension presented negligible average changes (0.2°, p= 0.098). Forearm movements were slightly reduced on the operated side (mean pronation: 80.8° vs. 83.7°, p= 0.166; average supination: 83.5° vs. 85.7°, p= 0.141). Wrist palmar flexion and dorsiflexion showed no significant differences. VSS ratings indicated minimal scarring (mean guardian and doctor scores were 1.13 and 0.55, respectively, p= 0.020), and all patients reported satisfaction with the treatment outcomes. Conclusion: Biodegradable implants are effective for pediatric forearm fractures, providing stable bone healing while preserving functional ROM with minimal scarring and high patient satisfaction. PLGA proved to be a viable alternative to traditional metal implants, eliminating secondary removal surgeries.
Understanding Postpartum Haemorrhage in Vietnam: A Comprehensive Review to Explore Current Status, Opportunities and Challenges
Authors: Nguyen Minh Hien , Le Khue , Phan Thuan
Published: June 2024

Postpartum haemorrhage remains a significant contributor to maternal mortality and morbidity worldwide, particularly in low- and middle-income countries. PPH continues to pose challenges in both developed and developing nations despite being preventable. This review examines the current state of knowledge regarding PPH within the context of Vietnam, a country with its unique healthcare landscape. This review identifies critical areas for improvement and future research directions based on a comprehensive literature analysis, including epidemiological insights, risk factors, prevention strategies, and management approaches. Discrepancies in PPH definitions and prevalence rates across regions highlight the need for tailored interventions and policies. Understanding the specific challenges and opportunities related to PPH in Vietnam is crucial for informing evidence-based interventions and policies to improve maternal health outcomes. This review contributes to the broader global effort to reduce maternal mortality by addressing gaps in knowledge and proposing strategies to enhance PPH prevention and management in Vietnam.
Health-Related Quality of Life and Satisfaction in Atrial Fibrillation Patients on Anticoagulant Therapy: Differences between Vitamin K Antagonists and Direct Oral Anticoagulants; Results from the Multicentre REGUEIFA Registry
Authors: Cabanas-Grandío Pilar , Gonzalez-Melchor Laila , Vázquez-Caamaño María , Fernandez-Obanza-Windscheid Emiliano , Piñeiro-Portela Miriam , Gonzalez-Babarro Eva , Duran-Bobin Olga , Prada-Delgado Oscar , Elices-Teja Juliana , Gutierrez-Feijoo Mario , Freire Evaristo , Díaz-Castro Oscar , Muñiz Javier , García Seara Javier , Gonzalez-Juanatey Carlos
Published: June 2024

Background
Oral anticoagulation (OAC) for atrial fibrillation (AF) patients is administered frequently. Vitamin K antagonist (VKA) and direct oral anticoagulants (DOACs) prevent thromboembolic events, but information about the quality of life (QoL) and patient satisfaction, related to both anticoagulants, is limited.
Methods
REGUEIFA is an observational and multicentre study that included patients with AF diagnosis treated by cardiologist. Those on OAC, VKA, and DOACs were selected. The EuroQol-5D (EQ-5D) questionnaire evaluated QoL, and the ACTS (Anti-Clot Treatment Scale) questionnaire investigated patient satisfaction with OAC.
Results
From a total of 1007 patients, 904 patients were on OAC, 532 on VKA and 372 on DOACs. In total, 846 patients completed the EQ-5D questionnaire, with results significantly worse in patients on VKA than on DOACs: (1) mobility limitations (37.6% vs. 24.2%, p
Characteristics of the Russian population of patients with coronary artery disease or peripheral artery disease in the XATOA registry
Authors: Arakelyan V. S. , Erlikh A. D. , Amirov N. Sh. , Dubar E. , Vogtlaender K. , Debus S.
Published: June 2024

Aim. To analyze demographic, anamnestic and clinical parameters in subjects with coronary artery disease (CAD) or peripheral artery disease (PAD) included in the XATOA study from Russian centers and to compare them with the total population of the international registry.

Material and methods. XATOA study is an international, multicenter, prospective registry, where characteristics of patients receiving dual pathway inhibition therapy with rivaroxaban 2,5 mg twice a day and low-dose acetylsalicylic acid (ASA) daily were analyzed. The secondary endpoint of the study was to assess clinical outcomes and bleeding rates in real world setting.

This analysis was based on the comparison of indicators presented in tables of descriptive statistics from the XATOA study database for subjects from Russia and the general study database respectively. The methodology of this sub-analysis is descriptive only and does not imply any statistical difference assessment.

Results. The Russian population included 795 subjects: 232 (29.2%) subjects with CAD; 293 (36.9%) subjects with PAD and 270 (34.0%) subjects with both. The average follow-up period was 14.4 months. The most common antithrombotic treatment regimen for patients with CAD or PAD prior enrollment in the registry was ASA monotherapy (81.3%); ACE inhibitors/ARBs were prescribed in 61.8%, lipid-l owering therapy in 68.9%. After the enrollment and prescription of rivaroxaban 2.5 mg BID + ASA, the incidence of myocardial infarction, stroke or cardio-v ascular death in subjects in the Russian Federation remained at 1.9%, and the incidence of major adverse limb events (MALE) at 0.8%, which corresponds to the results obtained in the COMPASS randomized controlled trial. Major bleeding was reported in 1 subject (<0.1%). Adherence to the therapy among subjects in the Russian Federation amounted to 89.8%.

Conclusion. Despite the increased incidence of concomitant diseases and insufficient use of routine cardiovascular therapy in subjects with CAD or PAD in the Russian Federation, the ischemic complications rate remains at a relatively low level while using antithrombotic treatment with rivaroxaban 2.5 mg twice a day + ASA 100 mg a day.
Pengembangan E-Modul Interaktif pada Materi Gelombang Bunyi Berbasis Problem Based Learning
Authors: Fitri Upik Rahma , Sunaryo  , Khairun Nisa Salsabila , Ziveria Mira
Published: June 2024

This study aims to develop an interactive e-module based on problem-based learning for teaching physics, specifically focusing on sound waves. The research method employed is Research and Development (R&D) utilizing a modified 4D development model, consisting of three stages: Define, Design, and Develop. This e-module is equipped with text, images, videos, animations, and interactive features such as quizzes, exercises, and navigation to facilitate user interaction with the learning materials. The problem-based learning model is applied to focus learning on problem-solving. Needs analysis conducted with 40 eleventh-grade students revealed that 60 percent chose sound waves as the preferred topic, hence it was selected as the research focus. Small and large-scale trials showed increased average scores, and students' response to this e-module was excellent. Validation by four experts yielded an average percentage of 91.5 percent, indicating that this problem-based learning interactive e-module is appropriate for use as a physics learning tool.
 
Abstrak
Penelitian ini bertujuan untuk mengembangkan e-modul interaktif berbasis problem-based learning pada materi gelombang bunyi yang layak digunakan dalam pembelajaran fisika. Metode penelitian yang digunakan adalah Research and Development (R&D) dengan model pengembangan 4D yang dimodifikasi menjadi tiga tahapan: Define (Pendefinisian), Design (Perancangan), dan Develop (Pengembangan). E-modul ini dilengkapi dengan teks, gambar, video, animasi, serta fitur interaktif seperti kuis, latihan soal, dan navigasi untuk memudahkan interaksi pengguna dengan materi pembelajaran. Model pembelajaran problem-based learning diterapkan untuk memfokuskan pembelajaran pada pemecahan masalah. Analisis kebutuhan dilakukan terhadap 40 peserta didik kelas XI, menunjukkan bahwa 60 persen memilih materi gelombang bunyi, sehingga dipilih sebagai fokus penelitian. Uji coba skala kecil dan skala besar menunjukkan peningkatan skor rata-rata, dan respon peserta didik terhadap e-modul ini adalah sangat baik. Validasi oleh empat ahli memberikan persentase rata-rata sebesar 91,5 persen, yang mengindikasikan bahwa e-modul interaktif berbasis problem-based learning ini layak digunakan sebagai media pembelajaran fisika.
A novel approach for dose distribution comparison based on image registration principle
Authors: Bellahsaouia Meryeme , Zidouh Ibtissam , Chfeq Wafae , Belhaj Omaima Essaad , Elaarabi Deiaa , Boukhal Hamid , Elkhoukhi Taher , Chakir Elmahjoub
Published: June 2024

Introduction:
Radiotherapy relies on accurate dose distribution comparison methods, but current approaches have limitations. This study introduces a novel algorithm based on image registration principles to address these limitations.
Materials & methods
The algorithm transforms an evaluated dose distribution into the coordinates of a reference dose distribution using an estimated transformation matrix. This matrix is obtained through a series of image registration steps, including detecting keypoints, constructing descriptors, matching keypoints, and estimating an affine transformation matrix. The resulting evaluated distribution has the same size as the reference, allowing for direct comparison using linear least squares regression.
Results
The algorithm was validated using 175 dose distribution pairs, showing its efficacy for distributions differing by a factor of 2 or less, with acceptable bias and precision. However, accuracy decreased for distributions with smooth dose contours lacking convexity defects (distinct features).
Conclusions
The algorithm validation yielded acceptable outcomes, supporting the potential use of this method in clinical practice. Nevertheless, further research is needed to improve its performance for smooth dose distributions.
Metacognition during fake news detection induces an ineffective demand for disambiguating information
Authors: Dreher Jean-Claude , Guigon Valentin , Villeval Marie Claire
Published: June 2024

The mechanisms by which individuals evaluate the veracity of uncertain news and subsequently decide whether to seek additional information to resolve uncertainty remain unclear. In a controlled experiment participants assessed non-partisan ambiguous news and made decisions about whether to acquire extra information. Interestingly, confidence in their judgments of news veracity did not reliably predict actual accuracy, indicating limited metacognitive ability in navigating ambiguous news. Nonetheless, the level of confidence, although uncalibrated, was the primary driver of the demand for additional information about the news, with lower confidence driving a greater demand, regardless of its veracity judgment. This demand for disambiguating information, driven by the uncalibrated metacognition, was increasingly ineffective as individuals became more enticed by the ambiguity of the news. Our findings highlight how metacognitive abilities shape decisions to seek or avoid additional information amidst ambiguity, suggesting that interventions targeting ambiguity and enhancing confidence calibration could effectively combat misinformation. Main Text
Implementation of a parent training intervention (SPARCK) to prevent childhood mental health problems: study protocol for a pragmatic implementation trial in Norwegian municipalities
Authors: Grønlie Anette Arnesen , Backer-Grøndahl Agathe , Nes Ragnhild Bang , Gomez Maria Begoña , Tømmerås Truls
Published: June 2024

Background: Effective evidence-based interventions (EBI) are necessary to prevent and avoid negative life trajectories for children with mental health problems. Even though many EBIs prove effective when tested, few are successfully implemented and used in real world clinical practice. As a result, many children and families do not receive the best care in due time or at all. To reduce this research-practice gap, a combined RCT and implementation study of Supportive Parents – Coping Kids (SPARCK), a parent training intervention to prevent childhood mental health problems will be performed. This study protocol concerns the implementation part of the larger effectiveness-implementation project.
Methods: The study is a correlational multi-site implementation study of SPARCK performed alongside a two-armed RCT, in 24 Norwegian municipalities. A quantitative three-wave longitudinal web-based data collection will be conducted among SPARCK practitioners and leaders in relevant services.
We will investigate the relations between theory-driven and empirical implementation determinants and implementation outcomes, measured by fidelity, acceptability, appropriateness, and feasibility. In addition, we will examine how these implementation determinants and outcomes are associated with the clinical outcomes of SPARCK.
Discussion: The current study will investigate implementation determinants and their relation to indicators of implementation success, while simultaneously investigating effectiveness of an intervention optimized to the needs of both the target group and relevant stakeholders. Together, this may improve clinical effect, contextual fit, implementation success, and reduce the time lag between research findings and application in real-world settings.
Trial registration: ClinicalTrials.gov ID: NTCT05800522
Mott resistive switching initiated by topological defects
Authors: Giannetti Claudio , Milloch Alessandra , Figueruelo-Campanero Ignacio , Hsu Wei-Fan , Mor Selene , Mellaerts Simon , Maccherozzi Francesco , Veiga Larissa Ishibe , Dhesi Sarnjeet , Spera Mauro , Seo Jin , Locquet Jean-Pierre , Fabrizio Michele , Menghini Mariela
Published: June 2024

Avalanche resistive switching is the fundamental process that triggers the sudden change of the electrical properties in solid-state devices under the action of intense electric fields[1]. Despite its relevance for information processing, ultrafast electronics, neuromorphic devices, resistive memories and brain-inspired computation[1-14], the nature of the local stochastic fluctuations that drive the formation of metallic regions within the insulating state has remained hidden.
Here, using operando X-ray nano-imaging, we have captured the origin of resistive switching in a V2O3-based device under working conditions. V2O3 is a paradigmatic Mott material[3], which undergoes a first-order metal-to-insulator phase transition together with a lattice transformation that breaks the threefold rotational symmetry of the rhombohedral metallic phase[2,5,6,8-11,15]. We reveal a new class of volatile electronic switching triggered by nanoscale topological defects appearing in the shear-strain based order parameter that describes the insulating phase. Our results pave the way to the use of strain engineering approaches to manipulate such topological defects and achieve the full dynamical control of the electronic Mott switching. Topology-driven, reversible electronic transitions are relevant across a broad range of quantum materials, comprising transition metal oxides, chalcogenides and kagome metals.
Effect of the cervical and thoracic "Daoyin" training on posture and pulmonary function in patients with upper crossed syndrome: A randomized controlled trial
Authors: Guo Yue , Li Ming , Xie Chaowei , Liu Xiaoyan , Chen Yushan , Yang Jun , Wu Yuxue , Chen Shaoqing , Wang Shizhong , Lin Jianping
Published: June 2024

Background: With the growing ubiquity of electronic devices, the incidence of upper crossed syndrome (UCS) is increasing every year and tends to affect younger populations. The study designed to assess the effect of cervical and thoracic "Daoyin" training on pain, posture, pulmonary function, cervical range of motion, and emotional state in college students with UCS.
Methods: We conducted a parallel-group randomized control study, assigning 74 college students to intervention group (IG) and control group (CG) at Fujian Medical University, Fujian, China. Instructed cervical and thoracic "Daoyin" training was given to students in the IG for eight weeks, five days a week for 45 minutes, whereas students in the CG continued with their usual activities. Primary outcomes, including forward head and shoulder angles, pain and cervical spine function, as well as secondary outcomes, such as pulmonary function, cervical range of motion and emotional state were measured at baseline and at a follow-up of eight weeks. These measurements were conducted using photogrammetry, visual analog scale(VAS), Neck Disability Index(NDI), pulmonary function, cervical range of motion test and Self-rating Anxiety Scale, respectively. We analyzed the effect of cervical and thoracic "Daoyin" training on college students with UCS using a general linear model.
Results: Analyses using general linear model revealed that the IG had a obvious improvement in the forward head angle, forward shoulder angle, and emotional state compared with the CG from baseline to eight weeks post-intervention (F=11.415, P<0.001; F=5.490, P=0.020; F=4.411, P=0.037). In addition, there were significant improvements in VAS (d=0.854, P<0.001), NDI (d=0.754, P=0.005), pulmonary function (forced vital capacity (FVC) (d=0.531, P=0.025), forced expiratory volume in 1 second (FEV1) (d=0.521, P=0.028), FEV1/FVC (d=0.540, P=0.034), maximal voluntary ventilation (MVV) (d=0.888, P<0.001) and cervical range of motion in forward flexion (FF) (d=0.353, P=0.029) at the end of 8-week intervention in IG. No side-effects were observed in this study.
Conclusion: Cervical and thoracic “Daoyin” training can improve the pain, posture, cervical spine function, pulmonary function, cervical range of motion in forward flexion , and emotional state of college students with UCS to some extent.
Trial registration: ChiCTR2300072669 (20/06/2023), Prospective registration, www.chictr.org.cn
Prevalence and factors associated with fatigue in patients with psoriatic arthritis: a systematic review and meta-analysis
Authors: Tang Haoming , Chew Tricia Li Ting , Fong Warren
Published: June 2024

Objectives: Fatigue is a prominent symptom in patients with psoriatic arthritis (PsA). There was a wide variety of statistics previously reported on fatigue prevalence in patients. This systematic review examined the current literature to derive the overall prevalence of fatigue and risk factors in PsA patients.
Methods:
A systematic review of the literature with subsequent meta-analyses was conducted. Publications assessing fatigue severity and prevalence in patients with PsA using validated measurement scores were identified from seven online databases (Cochrane, CINAHL, EMBASE, Google Scholar, MEDLINE, PubMed, and Web of Science), from inception until April 2023. Employing a random effects model, we calculated the pooled fatigue prevalence. Quality assessment of included studies was performed utilising the Joanna Briggs Critical Appraisal Tool.
Results:
The final analysis included 15 studies with 6482 PsA patients. Pooled fatigue prevalence was 0.51 (95% CI: 0.41, 0.61; I2 = 97.4%). There was substantial heterogenicity across the studies, with biologics use and geographical location in terms of Western versus Eastern countries being possible sources of heterogeneity. Age, disease duration, gender, tender joint count, swollen joint and enthesitis count are among the most commonly reported risk factors for fatigue in multivariate logistic regressions.
Conclusions:
Approximately half of the patients with PsA experienced fatigue. Biologics use and geographical location of the study were possible sources of heterogeneity in the subgroup analysis.
Targeting of SUMOylation leads to cBAF complex stabilization and disruption of the SS18::SSX transcriptome in Synovial Sarcoma
Authors: Faber Anthony , Floors Konstantinos , Fairchild Carter , Li Jinxiu , Zhang Kun , Roberts Jane , Kurupi Richard , Hu Bin , Kraskauskiene Vita , Hosseini Nayyerehalsadat , Shen Shanwei , Inge Melissa , Smith-Fry Kyllie , Li Li , Sotiriou Afroditi , Dalton Krista , Jose Asha , Abdelfadiel Elsamani , Xing Yanli , Hill Ronald , Slaughter Jamie , Shende Mayuri , Lorenz Madelyn , Hinojosa Mandy , Belvin Benjamin , Lai Zhao , Books sosipatros , Stamatouli Angeliki , Lewis Janina , Manjili Masoud , Valerie Kristoffer , Li Renfeng , Banito Ana , Poklepovic Andrew , Koblinski Jennifer , Siggers Trevor , Dozmorov Mikhail , Jones Kevin , Radhakrishnan Senthil
Published: June 2024

Synovial Sarcoma (SS) is driven by the SS18::SSX fusion oncoprotein and is ultimately refractory to therapeutic approaches. SS18::SSX alters ATP-dependent chromatin remodeling BAF (mammalian SWI/SNF) complexes, leading to the degradation of canonical (cBAF) complex and amplified presence of an SS18::SSX-containing non-canonical BAF (ncBAF or GBAF) that drives an SS-specific transcription program and tumorigenesis. We demonstrate that SS18::SSX activates the SUMOylation program and SSs are sensitive to the small molecule SAE1/2 inhibitor, TAK-981. Mechanistically, TAK-981 de-SUMOylates the cBAF subunit SMARCE1, stabilizing and restoring cBAF on chromatin, shifting away from SS18::SSX-ncBAF-driven transcription, associated with DNA damage and cell death and resulting in tumor inhibition across both human and mouse SS tumor models. TAK-981 synergized with cytotoxic chemotherapy through increased DNA damage, leading to tumor regression. Targeting the SUMOylation pathway in SS restores cBAF complexes and blocks the SS18::SSX-ncBAF transcriptome, identifying a therapeutic vulnerability in SS, positioning the in-clinic TAK-981 to treat SS.
Different species of Tillandsia can be biomonitors of carbon and nitrogen emissions: the case of a tropical metropolitan area in Mexico
Authors: Tirado Paula Zamora , Perroni Yareni , Álvarez Edison Armando Diaz
Published: June 2024

Air pollution affects human health and ecosystems all over the world. However, little attention is paid to its monitoring in tropics, mainly due to the high costs of automated monitoring systems. Biomonitoring may be an alternative, particularly for species of Tillandsia genus, although most species are not yet calibrated for this purpose. Therefore, 1) to determine the biomonitoring potential of T. juncea and T. schiedeana and, 2) to compare the sources and magnitudes of atmospheric pollutants at five urban parks and one rural site in a tropical metropolitan area in Mexico, we measured the elemental and isotopic composition of carbon (C) and nitrogen (N) of four Tillandsia species. The C content averaged 44.6 ± 0.5% (dry weight; p > 0.05). The N content ranged from 0.6 ± 0.1% for the rural site and 2.0 ± 0.1% for an urban site (p < 0.001). The lowest value of δ13C was − 15.9 ± 0.1‰ for T. usneoides for all urban parks, and the highest was − 14.3 ± 0.2‰ for T. juncea in the rural area (p < 0.001). The lowest δ15N of − 12.1 ± 0.2‰ was recorded for T. usneoides in the rural area, and the highest of − 0.5 ± 0.5‰ were recorded for T. schiedeana in one of the urban sites. The four species can be used as biomonitors of C and N emissions, since their specific variations reflect the source and concentration of these atmospheric pollutants. Furthermore, the tillandsias showed that pollution in the metropolitan area is different depending on the activity at each site.
Controlling mechanism of shale palaeoenvironment on its resistivity and polarizability: A case study of the Longmaxi Formation in Southern Sichuan
Authors: Yang Kai , Zhang Bing , Wang Xuben , Cao Gaoquan
Published: June 2024

The mineral composition, content, and organic matter enrichment in shale are significantly influenced by the sedimentary environment. However, there is a limited understanding of how the sedimentary environment impacts the electrical resistivity and polarization properties of shale. This study conducts experimental tests on shale from the Longmaxi Formation in the extensively explored Sichuan Basin of China, employing techniques such as complex resistivity, X-ray diffraction, organic geochemistry, porosity analysis, elemental geochemistry, and argon-ion polishing scanning electron microscopy. The experimental findings reveal the following key points: 1) The core resistivity of the Longmaxi Formation shale ranges from 14.56 Ω·m to 115.96 Ω·m, with an average value of 64.08 Ω·m. The polarization rate ranges from 0.07 to 0.32, with an average of 0.15. 2) Redox conditions and paleoproductivity primarily influence TOC content and the formation of biogenic quartz. The content of pyrite is influenced by redox environments, while clay minerals and terrigenous quartz content are affected by paleoclimate and terrigenous input. 3) The interconnected network of organic matter pores with other types of pores and the content of pyrite are the main controlling factors affecting resistivity. The pyrite content also influences the polarization effect of shale. 4) Redox conditions and paleoproductivity positively influence conductivity and polarization, whereas terrigenous input and paleoclimate have inhibitory effects on both. This study provides essential theoretical insights for logging interpretation, electromagnetic exploration of shale gas and subsequent monitoring of hydraulic fracturing.
Antecedent neonatal hypoglycaemic brain injury, the most common cause of early childhood epilepsy in Indian children
Authors: Gupta Chitra , Narang Bhuvandeep , SJ Thernal , Sharma Rakhi , Chatterjee Sagnik , V Ramprasad , Murugan Sakthivel , Goyal Pradeep , Bansal Rajiv Kumar , Jain Vivek
Published: June 2024

Prospective research from low- and middle-income countries on aetiologies of early childhood epilepsies using advanced diagnostic methods (3T-MRI and genetic testing), is lacking. Data on epilepsy outcomes is also not available in these patients.
We enrolled consecutive patients with epilepsy onset upto five years of age, over 12 months. After ruling out a structural-acquired cause on MRI, genetic testing with exome sequencing (ES) and if required, chromosomal microarray (CMA)/multiplex ligand PCR assay (MLPA) was performed. Following this evaluation, patients were classified into aetiological groups defined by the International League Against Epilepsy. The epilepsy outcomes at 24-month follow-up was also confirmed. Novel data on differences in epilepsy and neurodevelopmental profile of the two common perinatal causes namely, neonatal hypoglycaemic brain injury (NHBI) and neonatal asphyxial brain injury (NABI), are also presented.
Two hundred thirty-one children were recruited. The aetiology could be confirmed in 172 (74%) patients. The structural group (including structural-genetic) was the most common [126 (55%)], followed by genetic [41(18%)] and metabolic [5 (2%)]. The unknown group comprised [48 (21%)] patients. Eleven (5%) patients were ‘incompletely investigated’ (normal MRI but family refused genetic evaluation).
Antecedent NHBI [50 (22%)] was the commonest cause of epilepsy. On comparing the phenotypic differences between the two common perinatal causes, the initial epileptic seizure was more often focal in NHBI (P<0.001) and infantile spasm in NABI patients (P=0.05). NABI patients were more likely to be assigned to epilepsy syndrome (P= 0.03) as compared to NHBI. Autistic features (P=.05) and hypotonia (P=.03) were more frequent in NHBI while NABI patients were more often hypertonic or dystonic (both P <0.001).
In assessing the utility of investigations, MRI was helpful in 126 (54.5%) patients. Genetic evaluation was diagnostic in 57 (50%) of the 113 tested. The genetic yield was more likely with seizure onset in the first year (P=0.03), developmental and epileptic encephalopathy (P=0.01), developmental delay or hypotonia (both P<0.001).
At the 24-month follow-up, 57 of 207 (28%) patients had poor seizure control. On multivariate regression, developmental delay (P=.04) had a negative effect while increasing age at seizure onset had a positive effect (P=0.018) on seizure control.
In this study, we could confirm that NHBI, a preventable condition, was the commonest underlying cause of epilepsy. Our data also emphasizes the urgent need for developing guidelines to change the current newborn feeding practices in India which could decrease the subsequent risk of epilepsy in infancy and early childhood.
Multidrug resistance in urinary E. coli higher in males compared to females
Authors: Khanal Narayan , Cortie Colin , Story Chloe , Jones Sandra , Mansfield Kylie , Miyakis Spiros , Keighley Caitlin
Published: June 2024

Background Urinary tract infections (UTIs) are common however the widespread use of antibiotics has led to a rise in antimicrobial resistance (AMR) amongst uropathogens, rendering a significant proportion of infections resistant to first line treatment. AMR in UTIs may differentially affect men and women, younger and older patients. The purpose of this study was to investigate MDR (multi-drug resistance) and AMR in males and females in an Australian health district.Methods There were 85,844 E. coli urinary isolates (2007–2020) analysed from adult patients. An E. coli isolate with MDR was defined as resistant to at least 1 agent in ≥ 3 antimicrobial classes. Chi-square tests and relative risk were calculated comparing resistance in males and females and by age for antibiotics commonly used to treat UTIs in hospital and community collected samples.Results There was a higher proportion of MDR E. coli in males compared to females in both the community (6.4% vs 5.2%, P < 0.001) and hospital datasets (16.5% vs 12.8%, P < 0.001). The proportions of MDR for both males and females were significantly higher in the hospital setting. Resistance rates were higher in males compared to females for amoxycillin/ampicillin, amoxycillin/clavulanate, cephalexin and norfloxacin (p < 0.005), though not for trimethoprim. Antibiotic resistance was seen to increase over time.Conclusions A higher proportion of MDR E. coli were noted in urine samples from males compared with females, possibly due to the increased likelihood of complicated UTIs in men. Antimicrobial stewardship interventions could be targeted towards this cohort to address increasing rates of AMR.
Characterizing the Impact of the Covid-19 Pandemic on Adults with Autosomal Dominant Polycystic Kidney Disease: A Cross-Sectional Study
Authors: Shetty Alok , Atalla Anthony , Diggs Charalett , Watnick Terry , Seliger Stephen
Published: June 2024

Background
The Covid-19 pandemic greatly affected those with chronic diseases, impacting healthcare access and healthcare seeking behaviors. The impact of the pandemic on adults with Autosomal Dominant Polycystic Kidney Disease (ADPKD) has not been investigated.
Methods
Participants were recruited from a cohort of 239 ADPKD patients enrolled in a longitudinal study at the University of Maryland. Patients on renal replacement therapy were excluded. N = 66 patients participated in a phone questionnaire from June 2022-December 2022 about ADPKD-related complications, concern about contracting Covid-19, healthcare-seeking behaviors, and telehealth utilization before and after March 2020.
Results
N = 34 (51.5%) of participants reported a positive Covid-19 test result and N = 29 (44%) expressed high concern of contracting Covid-19. Those who avoided medical care at least once (N = 17, 25.8%) had similar demographics and ADPKD severity to those who did not, but reported greater telehealth utilization (88.2% vs. 42.9%, p = 0.002), greater use of non-prescribed medication for Covid-19 treatment or prevention (35.3% vs. 8.2%, p = 0.01), and were more likely to contract Covid-19 (76.5% vs. 42.9%, p = 0.02). Among the N = 53 who reported very good or excellent ADPKD disease management pre-pandemic, N = 47(89%) reported no significant change during the pandemic.
Conclusions
In this highly educated, high-income cohort with a mean age of 46.1 years, most people reported well-managed ADPKD prior to the pandemic. This may explain why less than half of participants expressed high concern for contracting Covid-19. Overall, there was no significant pandemic-related decline in self-reported ADPKD management, like due to excellent access to, and uptake of, telehealth services. Notably, 1 in 4 participants reported healthcare avoidant behavior, the effect of which may only be seen years from now. Future studies should investigate potential impacts of avoidant behaviors, as well as expand investigation to a more diverse cohort whose care may not have been as easily transitioned to telehealth.
Spiritual Needs and Satisfaction with Life: An Exploration of Mediating Pathways
Authors: Kwok Gary , Astrow Alan , Sulmasy Daniel , Devine Katie
Published: June 2024

Objectives
This cross-sectional study seeks to understand how unmet spiritual needs are associated with lower satisfaction with life by investigating the mediating roles of perception of quality of care and satisfaction with care among a sample of racially/ethnically and religiously diverse hematology and oncology patients.
Methods
We constructed a path analysis relating spiritual needs, perception of quality of care, satisfaction with care, and satisfaction with life.
Results
Seven hundred twenty-seven hematology and oncology patients (MAge = 59.0, 67.8% female) were recruited from four outpatient hematology/medical oncology sites. We found support for a serial multiple mediation hypothesis in which spiritual needs were indirectly associated with satisfaction with life through perception of quality of care and satisfaction with care. Specifically, higher spiritual needs were associated with a lower perception of quality of care (b = -0.73, p < 0.001), which, in turn, was associated with lower satisfaction with care (b = 0.26, p < 0.001) and subsequently resulted in lower satisfaction with life (b = 0.40, p < 0.001).
Conclusions
The findings suggest that non-biomedical elements are important mechanisms through which spiritual needs are indirectly associated with satisfaction with life through the care cancer patients receive. In addition to addressing the quality of care, providers should pay attention to patients’ spiritual needs (e.g., ask questions regarding spiritual needs as part of psychosocial history, refer to chaplains, etc.). Improving spiritual needs may lead patients to experience higher-quality care and, subsequently, a better quality of life.
A case of chronic myelomonocytic related lysozyme-induced nephropathy
Authors: Kansal Abhik , Peiris Thanushi , Ramnarain Jaineel , Wang Joan , Daneshvar Simin , Chow Fiona , Fleming Shaun
Published: June 2024

Background Lysozyme-induced nephropathy (LyN) is a rare cause of acute kidney injury (AKI) in patients with chronic myelomonocytic leukemia (CMML). Diagnosing LyN is challenging due to the numerous potential and concurrent aetiologies. Previous case reports have demonstrated the diagnostic utility of serum and urinary lysozyme measurements, which may correlate with renal dysfunction; however, the role of renal imaging remains unclear and renal biopsy remains essential for diagnosis.Case presentation An independent 80-year-old male presented to an Australian tertiary hospital with stage 3 AKI on a background of CMML previously treated with thioguanine and hydroxycarbamide. Renal tract ultrasound revealed expansile, non-vascular material bilaterally in renal collecting systems which was confirmed by renal biopsy to be lysozyme-induced nephropathy causing renal dysfunction. Despite escalated anti-leukaemic treatment he progressed to stage 4 chronic kidney disease contributing to increasing frailty and eventually pursued voluntary assisted dying after a fall with terminal traumatic injuries.Conclusions LyN is a rare cause of acute kidney injury amongst patients with chronic myelomonocytic leukaemia. This case highlights a rare instance of LyN and illustrates potential radiological markers that may aid in diagnosis. It also emphasizes the complexity of managing LyN in the context of underlying haematological malignancies.
The Relationship Between Dynamic Changes in The Insulin Resistance Related Indexes and Metabolic Syndrome in Middle-aged and Elderly Population
Authors: Li Xinfeng , Li Xiaohui , Ma Chifa , Li Chenfei , Yuan Mingxia
Published: June 2024

Background
Insulin resistance is the central pathogenesis of metabolic syndrome. The ratio of triglyceride/high-density lipoprotein cholesterol, the metabolic score of insulin resistance, and the triglyceride glucose index in conjunction with body mass index have been verified as surrogate indices of insulin resistance and shown to be used in identifying the metabolic syndrome. Remnant cholesterol is a newly proposed indicator that potentially correlates with insulin resistance. The present study aims to explore the predictive value of the above four insulin resistance related indices for the metabolic syndrome and the association between dynamic changes in these indices and the metabolic syndrome.
Methods
3,526 participants aged ≥ 45 years were enrolled from the China Health and Retirement Dynamic Study. After 4 years’ follow-up, 761 participants developed metabolic syndrome. Logistic regression was used to analyze the association of the indexes with the occurrence of metabolic syndrome. The impact of dynamic changes in these indices on the metabolic syndrome was explored furthermore. The receiver operating characteristic curves was used to evaluate the predictive value. The restricted cubic spline was used to explore the presence of a nonlinear relationship between different indices and metabolic syndrome.
Results
The increase in the four insulin resistance indices is significantly associated with an increased risk of metabolic syndrome. Compared with the other three indices, TyG-BMI has a better predictive ability for the metabolic syndrome (AUC = 0.703). Participants with low-high and high-high variability patterns have an increased risk of metabolic syndrome compared with participants consistently low levels of the index during follow-up. For TG/HDL-c, the high-low pattern is also associated with a higher risk of developing metabolic syndrome. For TyG-BMI, METS-IR, and RC, the high-low pattern of change do not increase the risk of metabolic syndrome.
Conclusions
TyG-BMI could be a better index for predicting the occurrence of metabolic syndrome in middle-aged and elderly population. Dynamic variety of these indexes, including TG/HDL-c, METS-IR, TyG-BMI, and RC could predict the risk of the incidence of metabolic syndrome. Monitoring the dynamic changes in the above insulin resistance indices could contribute to prevent the occurrence of metabolic syndrome in middle-aged and elderly populations.
Using a self-developed panel to explore its performance for biogeographic ancestry inference and analyze the genetic background of three Tibetan groups
Authors: Lin Yifeng , Yuan Xi , Wang Xi , Li Shuanglin , Yao Hongbin , Lei Fanzhang , Dong Bonan , Zhu Bofeng
Published: June 2024

Background
In this study, we used a panel consisting of 56 autosomal AIM-InDels, three Y-InDels, and one Amelogenin gene for biogeographic ancestry inference and verified the performance of the panel for biogeographic ancestry inference in Gannan Tibetan, Qinghai Tibetan, and Tibet Tibetan groups. Meanwhile, we analyzed the genetic structure of three Tibetan groups.
Results
The results showed that the 56 AIM-InDels performed better in classifying African and East Asian individuals in the absence of noise labels. With the introduction of noise labels, the model was more robust when the proportion of noise labels was small. As the proportion of noisy labels increased, the performance of the model in classifying the five intercontinental populations decreased. Still, the African and East Asian populations showed better performance than the other three intercontinental populations. Analysis of the three Tibetan groups showed that their genetic structures were similar to those of the reference East Asian populations.
Conclusions
This panel can be used effectively not only for biogeographic ancestry inference in African and East Asian populations but also to provide insights into the genetic structure of the three studied groups.
Repeatability of Dual Rotating Scheimpflug-Placido Camera according to the Topographical Position of the Cornea
Authors: Hwang Sunjin , Kim Dae Sung , Kim Duroo , Hong Eun Hee , Shin Yong Un , Kim Yoo Jung , Kang Min Ho
Published: June 2024

We aimed to investigate the reproducibility of various corneal measurements according to topographical location in the entire cornea measured by dual rotating Scheimpflug-Placido camera and to explore the differences in reproducibility between patients with mild dry eye and those with normal eyes. In both the normal and dry eye groups, divided based on BUT or the height of the tear film, there were no statistically significant differences in the ratio of unacceptable variation (RUV) and ICC. The consistency of the examination of the anterior and posterior refractive values and corneal thickness according to the corneal location, measured three times repeatedly using the Galilei anterior segment camera, was high. There was no difference based on the height of the tear film or the tear film break-up time. However, caution is needed when interpreting the values of the anterior corneal refractive values, as there can be changes of more than 0.5D within 3mm of the central area.
ERF1 of Plumbago indica L. receives ethylene signaling and regulates cold tolerance together with the DREB-COR pathway
Authors: Zhao Zi-An , Li Yi-Rui , Lei Ting , Liu Cai-Lei , Zeng Qing-Xiao , Liu Xuan , Yang Li-Juan , Li Jia-Ni , Gao Su-Ping
Published: June 2024

Ethylene is an essential regulatory factor in the signaling pathway of plant responses to abiotic stress, included cold stress, and also plays a regulatory role in cold response. Recent studies have shown that exogenous application of ACC (1-aminocyclopropane-1-carboxylate), an ethylene promoter, affects plant cold hardiness. It is well known that the cold-responsive specific gene DREB (dehydration-responsive element (DRE)-binding protein) plays a crucial role in enhancing cold hardiness in plants by activating some cold-responsive (CORs) genes. However, the molecular mechanism of how the ethylene biosynthesis pathway regulated this gene in the cold response of thermophilic plants had yet to be well explained. In this study, using the thermophilic plant P. indica ( Plumbago indica L.) as an example, physiological and transcriptomic analyses revealed that cold stress treatment induced the synthesis of endogenous ACC and regulated the ethylene signaling activator PiERF1, while cold signaling also activated PiDERB1A. Spraying experiments were also showed that ACC-induced up-regulation of the PiERF1 gene reduced cold tolerance of P. indica, and decreased the expression level of the PiDREB1A gene; reverse experiments have shown that spraying AVG (aminoethoxyvinylglycine) resulted in the down-regulation of the PiERF1 gene, while the expression level of PiDREB1A was increased, and chilled symptoms were alleviated. These results indicated that ethylene signaling directly regulates the downstream gene PiERF1 and initiates the DREB-COR cold-responsive signaling pathway to regulate cold hardiness, exhibiting negative regulation of cold hardiness in thermophilic plants.
Do people only believe what they want to believe? An empirical analysis of the Pygmalion effect in telemedicine platforms based on linear regression algorithms
Authors: Shen Xin , Yan Yulin , Liu Huikang
Published: June 2024

In addition to exploring how people's expectations and beliefs about healthcare information and services affect their actual health outcomes, this study aims to empirically analyze whether there is a Pygmalion effect in healthcare platforms using machine learning and natural language processing. Regression modeling will be used to provide treatment recommendations for more common diseases. We gathered a 10-month panel dataset from a major Chinese online medical portal, containing information from 10,243 physicians. We discovered a strong linear correlation between users' expectations for their final level of recovery and satisfaction and their access to doctors, medical information, treatment alternatives, and healthcare experiences. People's choice of therapy for more complicated illnesses, like heart valve lesions and breast cancer, should lean more away from conventional information sources. Patients' expectations and treatment adherence are strongly connected with the expectations of their doctors, and treatment outcomes are also significantly influenced by the beliefs and expectations of the patients themselves. Using sentiment analysis and multiple robustness polls of user ratings on healthcare platforms, we demonstrate that the treatment choices made by users are distributed linearly across various complexity levels of diseases. As a result, this study highlights the real influence of patient and physician expectations and beliefs on healthcare outcomes, proves the presence of the Pygmalion effect on healthcare platforms, and explores it for particular diseases. This has real-world implications for raising patient happiness, enhancing medical service quality, and strengthening the doctor-patient bond.