bluuebunny/crossref_metadata_2025 huggingface dataset:
Prosodic assessment in Egyptian children with specific language impairment
Authors: Shaheen Elham A. , Shohdi Sahar S. , Ahmed Nader N. , Ashour Heba
Published: September 2023

En

Abstract

Background

Prosody is the aspect of language that conveys emotion by changes in tone, rhythm, and emphasis during speech. Prosody includes aspects such as intonation and tone of voice. Specific language impairment (SLI) is a developmental disorder in which language development is below the chronological age despite normal nonverbal intelligence and no obvious neurological or physiological impairments or emotional and/or social difficulties that could impact language use. Most of these children experience considerable difficulty in language comprehension and/or production and experience specific problems in learning syntactic rules. In the speech stream, boundaries of major syntactic constituents are reliably marked by prosodic cues. Although deficits in related aspects of prosody have been hypothesized to underlie SLI, prosody has been little studied in Egyptian children having SLIs.

Objective

The objective of this work was to assess prosody in Egyptian children with an SLI in order to correlate the results with the clinical profile of the patients so as to choose the proper rehabilitation training program.

Participants and method

This study included 30 Egyptian children with SLIs and 30 normal children as a control group; their ages ranged between 4 and 6 years. Assessment included language assessment using the Arabic language test and prosodic assessment using the protocol of prosodic assessment, which was especially designed to assess prosodic abilities in Arabic-speaking children.

Results

Results revealed a significant difference in most of the individual and total subjective scores of prosodic skills between the control group and children with SLIs. Although the difference in the average of the total objective scores of prosodic assessment, which included pitch and energy, was highly significant, the average of total sentence duration was insignificant. There was significant correlation between the total language age and all subjective scores and an insignificant correlation with the total objective scores of prosodic assessment skills in SLI children.

Conclusion

SLI children have defective receptive, expressive, subjective, and objective scores of prosodic assessment skills that should be considered during the rehabilitation program for language stimulation for these children.
Newborn hearing screening: importance and characteristics of a high-risk register in a neonatal intensive care unit
Authors: Farid Ahmed Sameh , El Salam Seoud Iman Abd , El Dessouky Tarek Mohamed , El Shabrawy Marwa Mohamed , Mounir Zeinab Mohamed
Published: September 2023

En

Abstract

Background

Hearing loss is one of the most common congenital anomalies, occurring in approximately two to four infants per 1000. Children whose hearing loss is identified, and who receive appropriate intervention before 6 months of age, develop significantly better language ability than those who are identified later.

Objectives

To assess the failure rate of neonatal hearing screening in a high-risk register group of neonates and the relative importance of these risk factors in hearing impairment in the neonatal ICU (NICU) of the El-Mounira Children Hospital and identify the incidence of hearing loss.

Patients and methods

The study was carried out on 100 neonates in El-Mounira Children Hospital (NICU) and on 30 control neonates (15 boys and 15girls) chosen from Kasr El-Eini Maternity Hospital. All control cases aged 1–4 days had normal birth weight (2000–4000 g) and gestational age (35–40 weeks) and were delivered normally or by cesarean section without complications. The children in the study group were 3–23 days old (53 boys and 47 girls) and had birth weight ranging from 900 to 4000 g and gestational age ranging from 28 to 41 weeks. All the cases were screened for hearing loss using the transient evoked otoacoustic emission device (Echo-Screen), followed by a second-stage screening for those who failed the test with the transient evoked otoacoustic emission device. Those cases given a Refer were then made to undergo an Automated Auditory Brainstem Response test after 3–4 weeks.

Results

In the NICU group, 55% had hyperbilirubinemia, requiring exchange transfusion, 13% were of low birth weight (<1500 g), and 13% were on mechanical ventilation. Other risk factors such as cranio-facial anomalies showed a combined effect. In the first screening phase, 71% were given a Pass response and 29% were given a Refer response. In the second screening phase, 28% were given a Pass, 31% were given a Refer, and 41% were dropouts, as they had passed their critical stage and had been discharged. The highest referral rates were in neonates with multiple risk factors.

Conclusion

A comprehensive intervention and management program must be an integral part of the screening program in the postnatal period. Public awareness about the value of hearing screening is important for follow-up to be more effective. Monitoring of ototoxic drug administration and further assessment of the high prevalence of hyperbilirubinemia are needed. A team of obstetricians, pediatricians, and audiologists is needed to identify and assess risk factors.
Pragmatic assessment in Egyptian stuttering children
Authors: Shaheen Elham Ahmed , Anter Amr Abd-Elsalam , Hussin Nesreen Fathy
Published: September 2023

En

Abstract

Background

Pragmatics, the use of language in context, has been investigated only recently in the language of children who stutter. Some investigators have begun to address how the language and fluency of stuttering are influenced in different communicative settings. Some recent data have suggested that there may be a propensity for a delay or differences in certain areas of language learning for children who stutter compared with normal fluent children, specifically in vocabulary, pragmatic, or syntax development.

Aim

The aim of this study was to assess pragmatic skills in Egyptian Arabic-speaking children who stutter and to determine the relation between stuttering and the pragmatic aspect of language for future planning of a pragmatic-focused rehabilitation program for children who stutter.

Participants and methods

The sample in this study included 20 Egyptian Arabic-speaking children diagnosed to have stuttering and 20 children with normally developed language who spoke fluently. Both groups were of average intelligence; their age ranged between 4 and 7 years. All were from the same socioeconomic strata and were selected from the outpatient clinic Kasr El-Aini Hospital. All participants were subjected to a pragmatic assessment and language assessment applied in the Phoniatric Unit, Kasr El-Aini hospital.

Results

Scores of pragmatic skills were significantly lower in the stuttering group than the control group, except in object function skills. Preverbal communication skills decreased with increasing degree of stuttering and with an increase in Bloodstein stages of stuttering. Otherwise, other pragmatic skills showed no linear correlation with increasing degree of stuttering severity or an increase in Bloodstein stages of stuttering

Conclusion

Scores of pragmatic skills were significantly deficient in the stuttering group. All this should be considered during planning of a rehabilitation program for stuttering.
Communication skills, sensory integration functions, and auditory brainstem response: findings in a group of Egyptian children with autistic features
Authors: Samy Kamal L. , Osman Dalia M. , Selim Mona H. , Mohamed Reham A.
Published: September 2023

En

Abstract

Objectives

The aim of this work was to study the correlation between communication skills, sensory integration dysfunction, and auditory brainstem response (ABR) findings in a group of children with autistic features in order to gain a better understanding of some of the communication deficits commonly encountered in these children.

Methods

The study was conducted on 25 Egyptian children with autistic features and 25 age-matched and sex-matched typically developing children. All the children’s age ranged from 4 to 9 years. Each child was subjected to the following: history taking, communication assessment, sensory integration dysfunction questionnaire, psychometric evaluation, the Childhood Autism Rating Scale, basic audiological evaluation, and assessment of ABR (20 and 70 c/s). The results obtained from the two groups were then compared. In addition, correlation studies of all the results obtained were carried out.

Results

There were significant differences between the two groups under study in terms of communication skills, sensory integration dysfunction, and ABR waves III, III–V, V (20 c/s), I–V, and Vº (70 c/s). There was a significant negative correlation between ABR waves I and III and behavior, intentionality, capacity of symbols, reasoning, and total communication scores. There was a significant negative correlation between ABR waves III and V and forms, behaviors, intentionality, capacity of symbols, imitation, and total communication scores. There was a significant positive correlation between auditory sensory dysfunction scores and ABR wave V and waves III–V. There was a significant negative correlation between sensory integration dysfunction and intelligent quotient and communication skills. There was a significant positive correlation between sensory integration dysfunction scores and the severity of autism.

Conclusion and recommendations

Some of the communication difficulties shown by children with autism might be related to sensory integration dysfunction. Auditory defects in autism may involve lower levels of neural transmission. Reducing sensory integration deficits can aid in minimizing some of the features commonly encountered in children with autism. This would also aid in further development of their sociocommunication skills. ABR, as an objective tool, may be used as a prognostic indicator.
Assessment of saccular function using cervical vestibular-evoked myogenic potentials in children with sensorineural hearing loss
Authors: Selim Mona H. , El-Abd Shereen M. , El-Minawi Mohamed S. , Nassef Amr A. F. , Yousef Beatrice M.
Published: September 2023

En

Abstract

Objectives

The aim of this work was to examine saccular function using cervical vestibular-evoked myogenic potentials (cVEMPs) in children with congenital or acquired sensorineural hearing loss (SNHL).

Study design

Descriptive cross-sectional study.

Participants and methods

This study was carried out on 30 children with different degrees of SNHL with normal middle ear function and 25 age-matched and sex-matched typically developing children. All the participants’ age ranged from 5 to 18 years. For each child, the following were administered: history taking, an otologic examination, a basic audiological evaluation in the form of pure tone audiometry and immittancemetry, air-conducted cVEMPs, and computed tomography scan of the temporal bone. The results obtained from the two groups were then compared. In addition, correlation studies between all the results obtained were carried out.

Results

There was a statistically nonsignificant difference between the patients and the controls in cVEMP P13 and N23 latencies, whereas the cVEMP P13–N23 amplitude and threshold results showed a highly significant difference. cVEMP measurements in relation to sex within the patient group showed that the cVEMP threshold was the only positive outcome that showed a significant difference, and was higher in females. There was a highly significant positive correlation between hearing loss and the cVEMP threshold among the patient groups with different degrees of hearing losses. In addition, there was a significant positive correlation between age and cVEMP P13 and N23 latencies among the patient group.

Conclusion

SNHL is associated with saccular dysfunction in the pediatric population in the form of decreased cVEMP P13–N23 amplitudes and elevated cVEMP thresholds. Females presented with higher cVEMP threshold values than men, and cVEMP latencies appear to increase with age. An increase in hearing loss is associated with an increase in the cVEMP threshold and cVEMP amplitude appears to decrease with hearing loss irrespective of its degree. We recommend the inclusion of cVEMPs in the battery of evaluation of children with SNHL to detect early subtle changes in saccular function. Future research focusing on the genes causing SNHL and its relation to VEMP findings should be carried out.
The effect of treatment of nasal and sinus diseases on the success rate of palatal surgery for obstructive sleep apnea
Authors: Nassim Nassim T. , Elhoshy Hassan M. , Fattah Ahmed F. A. , Safwat Sherif F. , Atef Ahmed M.
Published: September 2023

En

Abstract

Objective

Many patients with obstructive sleep apnea (OSA) have coexisting nasal and sinus problems. In the absence of major anatomical abnormalities, these problems may be overlooked, hence jeopardizing the success rate of palatal surgery. Our objective was to identify the effect of medical management of nasal and sinus diseases on the success rate of palatal surgery in mild to moderate cases of OSA.

Methodology

This prospective study included 28 patients divided in two groups; group A was treated medically with antibiotics and local steroids before palatal surgeries, whereas group B was not treated medically before palatal surgeries. Assessment was made preoperatively and postoperatively using polysomnography.

Results

Group A showed more improvement in the apnea hypopnea index than group B.

Conclusion

Management of nasal and sinus problems improves the results of palatal surgery in cases of mild to moderate OSA.
Assisted locoregional anaesthesia for endoscopic endonasal dacryocystorhinostomy with concomitant septoplasty
Authors: Aboud Saleh K. , Aini AbAziz , Gendeh Balwant S.
Published: September 2023

The standard treatment for nasolacrimal duct obstruction has been dacryocystorhinostomy (DCR) surgery. Endoscopic endonasal dacryocystorhinostomy (EnDCR) has been gaining popularity, largely because of technological advances in endoscopes and other modern instruments used for rhinologic surgery. EnDCR can be performed under locoregional anaesthesia in elderly and medically unfit patients for general anaesthesia. The EnDCR often requires septal or turbinate surgery to optimize access to the lacrimal area. Here, we report a revision EnDCR using cold steel tools with powered drills under locoregional anaesthesia in an unfit elderly patient with chronic excessive tearing because of chronic dacryocystitis.
Palonosetron in preventing postoperative nausea and vomiting in middle ear surgery: a randomized-controlled study
Authors: Elahl Mohamed I. , Badea Michel
Published: September 2023

En

Abstract

Background

This study aimed to evaluate the efficacy of palonosetron, the 5-hydroxytryptamine-3 (5-HT3) receptor antagonist, in preventing postoperative nausea and vomiting (PONV) after middle ear surgery.

Patients and methods

Sixty-two ASA I and II patients who had undergone middle ear surgery under general anesthesia were included in a double-blind, placebo-controlled study and were enrolled into two groups: palonosetron group (P) and placebo control group (C). Patients were administered 0.075 mg of palonosetron or isotonic saline, respectively. The incidence of PONV and requirement of rescue antiemetics were assessed. The severity of nausea was evaluated according to the visual analogue scale. Patients who had not experienced any attack of vomiting or received rescue drug were considered to have a complete response.

Results

The incidence of PONV was significantly lower in group P than that in the control group C during (0–4 h) P-value less than 0.001 and (4–24 h) 0.05 periods, and the incidence of complete response was 83.7% in group P and 6.5% in group C (P<0.001).

Conclusion

Palonosetron could provide effective prophylactic antiemetic control to prevent PONV after middle ear surgery under general anesthesia.
Vitamin B12 deficiency presenting with pulmonary embolism: An unusual presentation
Authors: Ndaba L W , Van Blydenstein S A , Hodkinson K E
Published: September 2023

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Automatic sleep staging by a hybrid model based on deep 1D-ResNet-SE and LSTM with single-channel raw EEG signals
Authors: Li Weiming , Gao Junhui
Published: September 2023

Sleep staging is crucial for assessing sleep quality and diagnosing sleep disorders. Recent advances in deep learning methods with electroencephalogram (EEG) signals have shown remarkable success in automatic sleep staging. However, the use of deeper neural networks may lead to the issues of gradient disappearance and explosion, while the non-stationary nature and low signal-to-noise ratio of EEG signals can negatively impact feature representation. To overcome these challenges, we proposed a novel lightweight sequence-to-sequence deep learning model, 1D-ResNet-SE-LSTM, to classify sleep stages into five classes using single-channel raw EEG signals. Our proposed model consists of two main components: a one-dimensional residual convolutional neural network with a squeeze-and-excitation module to extract and reweight features from EEG signals, and a long short-term memory network to capture the transition rules among sleep stages. In addition, we applied the weighted cross-entropy loss function to alleviate the class imbalance problem. We evaluated the performance of our model on two publicly available datasets; Sleep-EDF Expanded consists of 153 overnight PSG recordings collected from 78 healthy subjects and ISRUC-Sleep includes 100 PSG recordings collected from 100 subjects diagnosed with various sleep disorders, and obtained an overall accuracy rate of 86.39% and 81.97%, respectively, along with corresponding macro average F1-scores of 81.95% and 79.94%. Our model outperforms existing sleep staging models in terms of overall performance metrics and per-class F1-scores for several sleep stages, particularly for the N1 stage, where it achieves F1-scores of 59.00% and 55.53%. The kappa coefficient is 0.812 and 0.766 for the Sleep-EDF Expanded and ISRUC-Sleep datasets, respectively, indicating strong agreement with certified sleep experts. We also investigated the effect of different weight coefficient combinations and sequence lengths of EEG epochs used as input to the model on its performance. Furthermore, the ablation study was conducted to evaluate the contribution of each component to the model’s performance. The results demonstrate the effectiveness and robustness of the proposed model in classifying sleep stages, and highlights its potential to reduce human clinicians’ workload, making sleep assessment and diagnosis more effective. However, the proposed model is subject to several limitations. Firstly, the model is a sequence-to-sequence network, which requires input sequences of EEG epochs. Secondly, the weight coefficients in the loss function could be further optimized to balance the classification performance of each sleep stage. Finally, apart from the channel attention mechanism, incorporating more advanced attention mechanisms could enhance the model’s effectiveness.
A spatially variant high-order variational model for Rician noise removal
Authors: Phan Tran Dang Khoa
Published: September 2023

Rician noise removal is an important problem in magnetic resonance (MR) imaging. Among the existing approaches, the variational method is an essential mathematical technique for Rician noise reduction. The previous variational methods mainly employ the total variation (TV) regularizer, which is a first-order term. Although the TV regularizer is able to remove noise while preserving object edges, it suffers the staircase effect. Besides, the adaptability has received little research attention. To this end, we propose a spatially variant high-order variational model (SVHOVM) for Rician noise reduction. We introduce a spatially variant TV regularizer, which can adjust the smoothing strength for each pixel depending on its characteristics. Furthermore, SVHOVM utilizes the bounded Hessian (BH) regularizer to diminish the staircase effect generated by the TV term. We develop a split Bregman algorithm to solve the proposed minimization problem. Extensive experiments are performed to demonstrate the superiority of SVHOVM over some existing variational models for Rician noise removal.
Decline in the Cultivation of Minor Millets in Tamil Nadu: A Time-Series Analysis of Cultivation Area, Production, and Productivity (1952-53 to 2021-22)
Authors: Karthick R. , Arulmani K. , Ravi K.
Published: September 2023

Aims: In India and Tamil Nadu, millets, often referred to as "smart food" for their nutritional, environmental, and agronomic benefits, have historically taken a back seat to other staple grains like rice and wheat. These resilient crops thrive in challenging conditions, requiring minimal resources. However, minor millets, a subset of these grains, have been overlooked in research despite their potential for climate-smart agriculture and superior nutrition.
Data: This study delves into time-series data spanning from 1952-53 to 2021-22, focusing on the cultivation area, production, and productivity of minor millets in both India as a whole and Tamil Nadu.
Objective: To analyze historical trends, assess the impact of factors like rainfall on crop cultivation, and explore the relationships between key variables.
Methodology: A combination of methodologies was employed. Compound Annual Growth Rate (CAGR) analysis was conducted to assess the historical trends in minor millets cultivation, production, and productivity. Correlation coefficient analysis examined the relationship between rainfall and selected crop cultivation areas. The Cobb-Douglas production function was employed to model the relationship between production, rainfall, and cultivated area of minor millets, while regression analysis using an exponential function further explored the relationship between rainfall and crop cultivation of selected crops.
Results: The results reveal nuanced trends in minor millets cultivation, showing fluctuations in cultivation areas, production, and productivity over the years. The analysis underscores the impact of changing agricultural practices, preferences, and external factors such as climate variability on minor millets cultivation. Specifically, the correlation analysis highlights the varying sensitivities of different crops to rainfall patterns.
Conclusion: This comprehensive study provides critical insights into the historical dynamics and prospects of minor millets cultivation in India and Tamil Nadu. The findings offer valuable information for agricultural planning, resource allocation, and strategies to promote sustainable agriculture and nutrition in the region.
Overview of Research on Team Development for Preschool Teachers
Authors: Thang Nguyen Bach , Tien Huynh Thanh , Huyen Tran Thi , Hanh Le Thi Hong , Chausoryaly
Published: September 2023

Developing teams of teachers in Vietnamese preschools is an important task of the Ministry of Education and Training in order to improve the quality of child care and nurturing. To see the need for developing preschool teachers, the author has reviewed domestic and international research works related to how to enhance the quality of preschool teachers. The review has synthesized academic documents with focusing on human resource development and preschool teachers' development. Findings showed that it a need to develop kindergarten teachers in order to improve their quality, which contributes to the effective implementation of the task of training and education in the current period of preschool teachers innovation.
Spatio-Temporal Analysis of Irrigation Development in Southwestern Haryana, India
Authors: Nancy  , Kumar Satish
Published: September 2023

Haryana is an agricultural developed state in India and agriculture here plays a significant role in the economic development of the state. However, the state is heterogeneous in terms of physiography and such difference in topography clearly distinguishes Southwestern Haryana from the rest of state. Southwestern Haryana is less developed than Rest of Haryana from agricultural point of view. There are various factors behind such a difference in the agricultural development of this region and irrigation is one of the most important one. In the Southwestern Haryana development of canals and, tubewells is different from Rest of Haryana. In this background, the present study aims to examine the development of irrigation in Southwestern Haryana from spatial and temporal prospectives using secondary sources of data. In particular, the methodology was based on trends analysis, least squares technique and cartographic representation. The finding of the study reveals that development of canals irrigation in Southwestern Haryana is in infancy stage. Out of all districts of this region Bhiwani & Charkhi Dadri district shows a measurable growth in canals irrigation with negative trends. Due to its rugged topography, Southwestern Haryana mainly depends on tubewell irrigation. Such a dependency can be justified with the positive trends of tubewell irrigation in this region. The trends of tubewells irrigation in Southwestern Haryana are ahead of Rest of Haryana. The study also reveals that except for Gurugram & Nuh district, irrigation intensity is increasing in the study area. Bhiwani has the highest per unit change in irrigation intensity over a particular period of time, while Gurugram & Nuh shows negative change from 1990-91 to 2020-21.
Detection of Fraudulent Health Insurance Claims Based on Decision Tree with Principal Component Analysis
Authors: Kenechukwu Nwosu Ifeanyi , Anyachebelu Kene Tochukwu , Abdullahi Muhammad, Umar
Published: September 2023

Fraudulent health insurance claims pose a significant challenge to insurance companies and healthcare providers, leading to substantial financial losses and compromised service quality. In this study, we focused on detecting fraudulent health insurance claims using the decision tree algorithm and principal component analysis (PCA). The objective was to gain valuable insights and extract meaningful patterns from the dataset to enhance fraud detection capabilities. We developed a comprehensive method that employed the decision tree algorithm to build a decision tree-based model and the PCA for dimensionality reduction. By analyzing the data using these algorithms, we were able to capture important patterns and relationships within the dataset. The decision tree algorithm demonstrated reasonable performance, while the PCA exhibited even better results, leveraging the advantage of dimensionality reduction. The findings of this study have significant implications for fraud detection in the healthcare industry. The insights gained from applying the decision tree algorithms and PCA can aid in making informed decisions, identifying trends, and uncovering hidden patterns within the data. Our study recommends implementing advanced fraud detection systems that incorporate these algorithms, continuous monitoring and evaluation, collaboration and data sharing, further research and development, and adherence to regulatory compliance. By following these recommendations, stakeholders in the insurance and healthcare industries can strengthen their fraud detection capabilities, protect their organizations from financial losses, and maintain the integrity of their services. The use of decision tree algorithms and PCA, combined with effective strategies, can significantly contribute to the detection of fraudulent health insurance claims and the overall security and sustainability of the healthcare system.
Norm-Attainable Operators and Polynomials: Theory, Characterization, and Applications in Optimization and Functional Analysis
Authors: Evans Mogoi N. , Okwany Isaac O.
Published: September 2023

This research paper offers a comprehensive investigation into the concept of norm-attainability in Banach and Hilbert spaces. It establishes that norm-attainable operators exist if and only if the target space is a Banach space and that norm-attainable polynomials are inherently linear. In convex optimization scenarios, norm-attainable polynomials lead to unique global optima. The paper explores the norm of norm-attainable operators, revealing its connection to supremum norms. In Hilbert spaces, norm-attainable operators are self-adjoint. Additionally, it shows that in finite-dimensional spaces, all bounded linear operators are norm-attainable. The research also examines extremal polynomials and their relationship with derivative roots, characterizes optimal solutions in norm-attainable operator contexts, and explores equivalence between norm-attainable operators through invertible operators. In inner product spaces, norm-attainable polynomials are identified as constant. Lastly, it highlights the association between norm-attainable operators and convex optimization problems, where solutions lie on the unit ball's boundary. This paper offers a unified perspective with significant implications for functional analysis, operator theory, and optimization in various mathematical and scientific domains.
Evaluation of Ameliorative Effects of Phyllantus amarus and Senna alata in Acetaminophen-induced Hepato-nephro Toxicity in Rats
Authors: Okwulu O. J.  , Lawal I.
Published: September 2023

Background: Liver and kidney are basic organs in the body because they perform vital functions in the system, the prevention of injury to them is necessary as well as the management of injury on them is vital. P. amarus and S. alata were plants that had been used to protect the liver by traditionalist, but there was no study to evaluate their ameliorative effects on liver and kidney damage and to comparatively identify the one that has more efficacy in managing the organs.

Study Design: Experimental Design

Place and Duration of Study: Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Research and Development, Idu, Abuja, between February to April 2023.

Methods: The hydroethanolic (70%) extract of both plants were obtained by maceration. Experimental animals were divided into 8 groups, group I were given distilled water, group II were given acetaminophen (ACP) only, group III-V were given ACP (850mg/kg) before Phyllantus amarus (PAM) 100mg/kg, 300mg/kg, and 900mg/kg respectively while group VI-VIII were given ACP before Senna alata (SA) at same three doses for 14 days. Acetaminophen (850mg/kg) was administered a day after fasting before the extract(s); Gross weighing of the organs was done, and samples for biochemical analysis and organs for histopathological evaluation were collected.

Results: P. amarus at all the doses demonstrated ameliorative effects, reducing the weight of the liver at 300mg/kg and 900mg/kg (P≤.01), decreased significantly (P≥.0001) the elevated level of all the parameters (ALP,AST,ALT,BUN,T.BIL) with no visible lesion in the his picture of the organs. S alata significantly decreased (P≥.0001) the biochemical parameters at 300mg/kg

Conclusion: The result of this study showed that both plants have ameliorative effects but P. amarus has more ameliorative potentials.
Antidiabetic Activity of Apigenin (4, 5, 7 – Trihydroxy Flavone) from Leaves of Stachytarpheta jamaicensis (L) Vahl (Verbennaceae)
Authors: Odoh Uchenna Estella , Sangwan Payare Lal , Odoh Ikenna Stanley
Published: September 2023

Background: Apigenin is a polyphenolic compound that belongs to the class of flavonoids and is considered highly therapeutic.

Aim: To evaluate the antidiabetic activity of apigenin isolated from dichloromethane: methanol extract of leaves of Stachytarpheta jamiacensis (L) Vahl (Verbennaceae) in alloxan-induced diabetic rats.

Methods: Cold maceration was used to extract the S. jamiacensis powdered leaves with dichloromethane: methanol (1:1). Hexane, dichloromethane, and aqueous methanol fractions of the extract were obtained through fractionation. To isolate the bioactive molecule, the dichloromethane fraction (DCMF) was then subjected to column chromatography and eluted with several solvent mixtures in ascending polarity order. With the aid of data from FTIR, UV, GC-MS, 1HNMR (400MHz), and 13CNMR (101MHz), the structure of the isolated compound was identified. The Phytochemical analysis of the isolate and acute toxicity study was done following standard procedures. The anti-diabetic potential of the isolate was assessed by determining fasting blood glucose levels on alloxan-induced rats at the dose of 25 and 50 mg/kg body weight.

Results: The compound was identified as apigenin  (4, 5, 7 – trihydroxy flavones) and showed significant (p<0.05) reduction of 79.56 and 81.74 % in fasting blood glucose levels at the dose of 25 and 50 mg/kg respectively when compared with the standard drug (glibenclamide 83.40 %). The isolate's phytochemical analysis revealed flavonoids and the LD50 test demonstrates that apigenin was not harmful.

Conclusion: The findings show that the apigenin from Stachytarpheta jamaicensis (L) Vahl has potent anti-diabetic properties.
Case Study of a Zoonotic Infection Caused by Streptococcus suis Reported for the First Time in Goa Region, India
Authors: Gaonkar Shradha R. , Naik Rajeshwar V. , Kalekar Sushanta , Sagar Alka
Published: September 2023

This is a case study on epidemiological factor clinical spectrum and drug susceptibility of a rare zoonotic infection caused by Streptococcus sui in a 60 year female patient. Presented with fever and altered sensorium. Blood culture analysis revealed the causative agent to be Streptococcus sui. Antibiotic sensitivity screening of the culture was also performed. So while recording the case history it was noted that the patient was in close contact with pigs on regular basis. The patient was treated with ceftriaxone antibiotic and responded favorably to the therapy. We represent the first human case of Streptococcus sui from Goa.
Clinical Care for People Who Survive Childhood Cancer
Authors: Bhatia Smita , Tonorezos Emily S. , Landier Wendy
Published: September 2023

Importance

An estimated 15 000 children and adolescents aged 0 to 19 years are diagnosed with cancer each year in the US, and more than 85% survive for at least 5 years. By 45 years of age, approximately 95% of people who survive childhood cancer will develop a significant health problem related to the childhood cancer diagnosis or its treatment.

Observations

Approximately 500 000 people currently alive in the US have survived childhood cancer. The most common severe or life-threatening chronic health problems related to childhood cancer or its treatment are endocrine disorders such as hypothyroidism or growth hormone deficiency (44%), subsequent neoplasms such as breast cancer or thyroid cancer (7%), and cardiovascular disease such as cardiomyopathy or congestive heart failure, coronary artery disease, and cerebrovascular disease (5.3%). Medical conditions related to a cancer diagnosis during childhood or adolescence are most commonly caused by the radiation therapy and the chemotherapies used to treat cancer and may develop at varying lengths of time after exposure to these treatments. Individuals at highest risk for developing treatment-related health problems include patients with brain cancer treated with cranial irradiation (approximately 70% develop severe or life-threatening health problems) and allogeneic hematopoietic stem cell transplant recipients (approximately 60% develop severe or life-threatening health problems). Individuals at the lowest risk for developing treatment-related health problems include those who survived solid tumors (such as Wilms tumor) treated with surgical resection alone or with minimal chemotherapy, for whom the prevalence of subsequent health problems is similar to people who did not have cancer during childhood or adolescence. People diagnosed with childhood cancer in the 1990s who survived for at least 5 years after the cancer diagnosis have a shorter lifespan (by about 9 years) vs children who were not diagnosed with cancer in the 1990s.

Conclusions and Relevance

Approximately 500 000 individuals currently alive in the US have survived childhood cancer. The most common adverse effects in individuals who survived childhood cancer are endocrine disorders, subsequent neoplasms, and cardiovascular disease. There is a need for clinicians and patients to have heightened awareness of these complications.
ACC/AHA Hypertension Guidelines and CHA2DS2-VASc Up-Scoring in Patients With Atrial Fibrillation
Authors: Pundi Krishna , Gosch Kensey L. , Perino Alexander C. , Jones Philip G. , Desai Nihar R. , Maddox Thomas M. , Turakhia Mintu
Published: September 2023

This cohort study compares rates of hypertension among nonhypertensive patients with atrial fibrillation using JNC 8 vs ACC/AHA thresholds.
Sodium-Glucose Cotransporter 2 Inhibitors vs Incretin-Based Drugs and Risk of Fractures for Type 2 Diabetes
Authors: Ko Hwa Yeon , Bea Sungho , Jeong Han Eol , Park Sohee , Cho Young Min , Kong Sung Hye , Shin Ju-Young
Published: September 2023

Importance

Postmenopausal individuals with type 2 diabetes are susceptible to fractures due to the interaction of elevated blood glucose levels and a deficiency of the hormone estrogen. Despite continued concerns of fracture risks associated with sodium-glucose cotransporter 2 inhibitors (SGLT2i), existing evidence in this high-risk population is lacking.

Objective

To assess the risk of fractures associated with SGLT2i vs incretin-based drugs of dipeptidyl-peptidase 4 inhibitors (DPP4i) and glucagon-like peptide 1 receptor agonists (GLP1RA), separately, in postmenopausal individuals with type 2 diabetes.

Design, Setting, and Participants

This active-comparator, new-user cohort study used nationwide claims data of Korea and took place from January 1, 2013, to December 31, 2020. Postmenopausal individuals (aged ≥45 years) with type 2 diabetes were included.

Exposures

New users of SGLT2i or comparator drugs.

Main Outcomes and Measures

The primary outcome was overall fractures, comprising vertebral, hip, humerus, and distal radius fractures. Patients were followed up from the day after drug initiation until the earliest of outcome occurrence, drug discontinuation (90-day grace period) or switch, death, or end of the study period. After propensity score fine stratification, hazard ratios (HRs) with 95% CIs were estimated using weighted Cox models.

Results

Among 37 530 (mean [SD] age, 60.6 [9.7] years) and 332 004 (mean [SD] age, 60.6 [9.9] years) new users of SGLT2i and DPP4i, respectively, a lower rate of incident overall fractures was presented with SGLT2i vs DPP4i (weighted HR, 0.78; 95% CI, 0.72-0.84). Among 111 835 (mean [SD] age, 61.4 [9.8] years) and 8177 (mean [SD] age, 61.1 [10.3] years) new users of SGLT2i and GLP1RA, respectively, no association with an increased risk of overall fractures was presented with SGLT2i vs GLP1RA (weighted HR, 0.92; 95% CI, 0.68-1.24). Results from several subgroup and sensitivity analyses presented consistent results from main analysis.

Conclusions and relevance

This population-based cohort study suggests that SGLT2i was not associated with an increased rate of incident fractures compared with DPP4i and GLP1RA, separately, among postmenopausal individuals with type 2 diabetes.
Glycated hemoglobin A1c, cerebral small vessel disease burden, and disease severity in Parkinson's disease
Authors: Ma Xinxin , Li Shuhua , Liu Fengzhi , Du Yu , Chen Haibo , Su Wen
Published: September 2023

Objective

Our study aimed to investigate the glucose levels in PD and controls. We also examine whether glucose control is associated with PD severity regardless of diabetic status, and test whether the correlation is mediated by cerebral small vessel disease (CSVD) burden.

Methods

A total of 100 patients with idiopathic PD and 100 age‐ and sex‐matched controls who underwent brain magnetic resonance imaging (MRI) were enrolled in this study. We collected the clinical data and blood parameters, including fasting blood glucose (FBG), glycated hemoglobin A1c (HbA1c), and blood lipid. Patients with PD were divided into early (n = 61) and advanced (n = 39) subgroups, based on Hoehn and Yahr (H&Y) stages. Differences between the PD and controls, PD with and without diabetes, and between two PD subgroups were compared. CSVD markers were assessed, including lacunes, white matter hyperintensities, enlarged perivascular spaces, and cerebral microbleeds. Multivariable logistic regressions were used to test the association between HbA1c and H&Y stages. Interaction between HbA1c and CSVD burden in relation to H&Y stages was also analyzed.

Results

PD group exhibited higher HbA1c (p < 0.001), lower high‐density lipoprotein cholesterol (p < 0.001) and triglyceride (p = 0.049) than controls. Advanced PD patients showed higher HbA1c than early PD group (p = 0.022). Increasing HbA1c (OR = 1.54, 95% CI 1.03–2.32, p = 0.036) along with longer disease duration (OR = 1.14, 95% CI 1.01–1.27, p = 0.028) and higher UPDRS III score (OR = 1.07, 95% CI 1.02–1.11, p = 0.002) increased the risk of belonging to the higher H&Y stage. However, interaction between HbA1c and CSVD burden in relation to H&Y stages was not significant.

Interpretation

HbA1c is independently associated with H&Y stages in PD, and this correlation may not be mediated by CSVD burden.
Perpetually preoccupied: Applying interference framework to understand the effects of smartphone use and vibrations on an academic task
Authors: O'Toole Kathryn J.
Published: September 2023

Smartphones are useful—albeit disruptive—devices. Cognitive control research conceptualizes smartphone disruption as external interference. Actively using a smartphone and hearing smartphone notifications while trying to accomplish a goal can impair performance. In the current project, performance was compared across these contexts. Participants were presented with reading passages and retention was assessed through a quiz. The reading portion was completed without interference (control), while a hidden smartphone vibrated, or while participants responded to text messages. Participants in the interference conditions performed equally poor and worse than those in the control condition. Completion time followed a different pattern. Participants in the vibration condition took longer to complete the quiz than those in the texting condition but did not differ from those in the control condition. Results are situated in Clapp and Gazzaley's (2012) interference framework and suggest that smartphone vibrations are an external stimulus that can trigger internal interference.
Systematic Review of Health‐Related Quality of Life Impact in Juvenile Localized Scleroderma
Authors: Sanchez‐Espino Luis F. , Luca Nadia , Pope Elena , Laxer Ronald M. , Knight Andrea M. , Sibbald Cathryn
Published: September 2023

Objective

The prevalence and types of psychosocial complications of juvenile localized scleroderma (JLS), also known as morphea, an inflammatory and sclerosing disease involving the skin, fascia, muscle, and bone, are poorly understood.

Methods

We performed a systematic review of literature published between 2000 and 2020 in PubMed, EMBASE, the Cochrane Skin Group Specialized Register, the Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature using the search terms “scleroderma, localized,” “Morphea,” “anxiety,” “depression,” “resilience,” “social stigma,” “quality of life,” “mood,” or “stress” and limited the search to pediatric patients and English language. Patient demographics, characteristics of JLS, and comorbidities were extracted. The outcomes included measures of health‐related quality of life (HRQoL), psychosocial functioning, evaluation of self‐perception, and the treatment burden of the study population. The protocol was registered with PROSPERO (CRD42021257124). Thematic synthesis generated descriptive analysis.

Results

Thirteen studies fulfilled the inclusion criteria: three retrospective cohort studies, two prospective cohort studies, and eight cross‐sectional studies. A total of 690 pediatric patients with JLS were included (n = 484 with linear scleroderma). Six studies used the Children's Dermatology Life Quality Index, reporting little to no effect on HRQoL. One study used the Health‐Related Quality of Life in Children and Adolescents Questionnaire and did not find differences between children with JLS or atopic dermatitis and healthy controls. One study used a self‐perception questionnaire that showed normal self‐worth of patients with JLS. Two studies used focus groups, both reporting elevated levels of stress, decreased self‐worth, “feeling different,” and bullying/teasing in patients with JLS. These emotions were associated with skin symptoms (pain, itch, and tightness), physical limitations, and treatment burden.

Conclusion

Overall, quantitative studies did not report a statistically significant impairment in HRQoL in JLS. However, qualitative studies (focus groups) reported significant psychosocial impacts related to JLS. There is a need to develop a JLS‐specific tool for the HRQoL evaluation of this population.
Photothermal Excitation of Neurons Using MXene: Cellular Stress and Phototoxicity Evaluation
Authors: Wang Yingqiao , Hartung Jane E. , Goad Adam , Preisegger Matías A. , Chacon Benjamin , Gold Michael S. , Gogotsi Yury , Cohen‐Karni Tzahi
Published: September 2023

Understanding the communication of individual neurons necessitates precise control of neural activity. Photothermal modulation is a remote and non‐genetic technique to control neural activity with high spatiotemporal resolution. The local heat release by photothermally active nanomaterial will change the membrane properties of the interfaced neurons during light illumination. Recently, it is demonstrated that the two‐dimensional Ti3C2Tx MXene is an outstanding candidate to photothermally excite neurons with low incident energy. However, the safety of using Ti3C2Tx for neural modulation is unknown. Here, the biosafety of Ti3C2Tx‐based photothermal modulation is thoroughly investigated, including assessments of plasma membrane integrity, mitochondrial stress, and oxidative stress. It is demonstrated that culturing neurons on 25 µg cm−2 Ti3C2Tx films and illuminating them with laser pulses (635 nm) with different incident energies (2–10 µJ per pulse) and different pulse frequencies (1 pulse, 1 Hz, and 10 Hz) neither damage the cell membrane, induce cellular stress, nor generate oxidative stress. The threshold energy to cause damage (i.e., 14 µJ per pulse) exceeded the incident energy for neural excitation (<10 µJ per pulse). This multi‐assay safety evaluation provides crucial insights for guiding the establishment of light conditions and protocols in the clinical translation of photothermal modulation.
Theoretical and Experimental Research on Active Suspension System with Time‐Delay Control
Authors: Wu Kaiwei , Ren Chuanbo , Li Lin , Sun Zehao
Published: September 2023

Time‐delay significantly impacts the control system's performance and even leads to the unexpected instability of the control system. This paper aims at the adverse effect of time‐delay on the control effect and stability of the active suspension system. This paper proposes to suppress vehicle body vibration by applying time‐delay displacement feedback. In this paper, the time‐delay control characteristics of the system are studied by combining theory with experiment. This paper first establishes the suspension system's dynamic Equation with time‐delay. Then, the frequency domain sweep method is used to analyze the stability of the control system. Finally, the time‐delay simulation model is established, and the single‐frequency excitation is used as the external excitation to compare with passive and backstepping control. The simulation results verify the superiority of the time‐delay control under external excitation. In this paper, through the 1/4 model bench test of the active suspension system, the simulation results and the test results under the same working conditions are compared, and it is found that the two have good consistency. The results show that the research is credible and can provide a reference for the actual design and application of active vehicle suspension controllers.