bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Benefit of Autologous Stem Cell Transplantation for Patients with Multiple Myeloma Achieving Undetectable Minimal Residual Disease after Induction Treatment
Authors: Liu Jiahui , Yan Wenqiang , Fan Huishou , Xu Jingyu , Li Lingna , Du Chenxing , Mao Xuehan , Yan Yuting , Xu Yan , Sui Weiwei , Deng Shuhui , Yi Shuhua , Anderson Kenneth C. , Qiu Lugui , Zou Dehui , An Gang
Published: August 2023

Attaining undetectable minimal residual disease (MRD) is the current therapeutic goal for multiple myeloma. But there is a current lack of data regarding the clinical benefit of autologous stem cell transplantation (ASCT) for patients with myeloma achieving early MRD-negative status after induction treatment, in addition to the interaction of longitudinal MRD status with ASCT. The current study included 407 patients with transplant-eligible multiple myeloma with available MRD status from the National Longitudinal Cohort of Hematological Diseases in China (NCT04645199), of whom 147 (34.4%) achieved early undetectable MRD and 182 (44.7%) received ASCT. Early MRD-negative status was associated with a lower risk of disease progression [HR = 0.447; 95% confidence interval (CI), 0.333–0.600; P < 0.001] and death (HR = 0.473; 95% CI, 0.320–0.700; P < 0.001). Of note, patients who achieved undetectable MRD early still benefitted from ASCT, with a remarkable improvement in the median MRD-negative duration (33.5–58.0 months, P < 0.001), progression-free survival (PFS; 46.0–88.3 months, P < 0.001), and overall survival (OS; 76.4 months to not reached, P = 0.003). These clinical benefits were more pronounced in patients with aggressive features (high-risk cytogenetic abnormalities or high tumor burden) compared with standard-risk patients. Similar results were observed in patients with detectable MRD after induction treatment. In addition, we identified four MRD-status transformation patterns following ASCT, which were strongly correlated with diverse survival outcomes (P < 0.001). Our study revealed the enhanced clinical significance of ASCT in patients with transplant-eligible myeloma, regardless of early MRD status, particularly for high-risk patients. Subsequent prospective trials are essential to validate these observations.

Significance:

Achieving and maintaining undetectable MRD is the current treatment goal for multiple myeloma. Our results emphasized the remarkable clinical benefit of ASCT on MRD-negative duration, PFS, and OS in patients with multiple myeloma regardless of early MRD status. These favorable impacts were more evident in patients with aggressive features. Importantly, dynamic MRD monitoring among ASCT could facilitate personalized stratification of therapeutic approaches.
Tornar visível o invisível: a aprendizagem escolar da leitura como um problema de percepção e de esquecimento
Authors: Amparo Patrícia Aparecida do
Published: August 2023

A partir da percepção e do esquecimento como metáforas, o ensaio tem como objetivo discutir a aprendizagem da leitura escolar, considerando que, para além de indícios de práticas, trata-se de um problema de reconhecimento da aprendizagem pelos sujeitos. As condições da aprendizagem parecem transitar por caminho que conduz a uma reflexão dos quadros do que é concebível – como algo a ser legitimamente ensinado e aprendido – e dos processos de esquecimento das práticas e representações não desejadas. Para tanto, dialoga com as formulações de Bernard Lahire e com estudantes do ensino médio, buscando configurar um ponto de vista que articula reflexões sociológicas, didáticas e experiências pessoais. O ensaio aposta na ideia de que tornar visíveis referências de leitura invisíveis no espaço escolar seria caminho promissor para a ampliação da compreensão do que se pode aprender nas instituições educativas.
Florestan Fernandes: entre o autodidatismo e o segundo nascimento
Authors: Silva Juliana de Souza
Published: August 2023

Este texto trata da trajetória escolar e acadêmica de Florestan Fernandes (1920-1995) e de suas contribuições para a compreensão da universidade e do ensino. Reflete sobre o aluno Florestan e o processo de adequar-se à cultura letrada, distante de seu cotidiano quando criança. Seus depoimentos apontam as dificuldades de ser estudante da USP durante o processo que equivaleu a um “segundo nascimento”, quando teve que assimilar saberes e formas de ser distantes de sua classe de origem. Frente às exigências docentes, viu-se impelido a recorrer ao autodidatismo para atender às expectativas e, a despeito das limitações, foi dotando-se das condições para ocupar o espaço. Assim, enquanto se aculturava, abandonava Vicente (nome que recebeu da patroa de sua mãe) para fazer nascer Florestan, o respeitado intelectual.
Mitos na Organização dos Elementos Químicos: uma análise das Controvérsias Científicas na História da Tabela Periódica à luz do referencial Fleckiano
Authors: Gomes Rodrigo Da Vitória , Aires Joanez Aparecida
Published: August 2023

A história da Tabela Periódica não é exatamente como é vista em livros didáticos e materiais de divulgação científica, os quais trazem mitos sobre os modelos de organização dos elementos químicos que já existiram e controvérsias sobre os mesmos. Alguns episódios históricos na proposição de um possível sistema periódico são relatados de forma fantasiosa, com o intuito de provocar interesse pelo assunto, mas que terminam por mostrá-lo inacessível. Neste estudo, realizou-se uma pesquisa histórica documental analisada a luz do referencial Fleckiano com objetivo apresentar os mitos, apólogos e as controvérsias científicas encontrados na organização dos elementos químicos, desmistificando a forma como cada modelo realmente foi idealizado e mostrando que por trás de um mito geralmente há inúmeras controvérsias. A partir dos resultados, ficou evidente que, a história da tabela periódica vem sendo apresentada de forma deturpada ou de pura fantasia, ou ainda, sobre as quais não há um parecer definitivo nem mesmo entre os historiadores da ciência. A determinação de um modelo periódico definitivo, ainda que importante, é apenas um aspecto desse complexo de interações.
Paulo Marques dos Santos (1927 – 2022) Meteorologista e Astrônomo. Crucial na institucionalização do IAG/USP
Authors: Matsuura Oscar Toshiaki
Published: August 2023

Paulo Marques dos Santos ingressou no IAG/USP em 1948 como Auxiliar Técnico em Meteorologia, tornando-se Encarregado da Estação Meteorológica do IAG/USP em 1955, cargo que manteve até sua aposentadoria compulsória em 1997. Ao mesmo tempo em que se tornou bacharel e licenciado em Física, mestre em Física Solar e doutor em Astrofísica, ele foi testemunha e participou ativamente de cada etapa da evolução institucional do Instituto Astronômico e Geofísico (hoje Instituto de Astronomia, Geofísica e Ciências Atmosféricas) da USP. Tendo ele falecido em 17/9/2022, esta é uma memória em sua homenagem, que tenta recapitular sua vida de entrega, esperança, renúncias e vitórias.
O Utilitarismo e a Fisiocracia nos Memorandos de Domingos Vandelli
Authors: Costa Ricardo Dalla
Published: August 2023

A partir do hedonismo grego sobre a utilidade, apresenta-se num primeiro momento uma revisão literária necessária a compreensão desse conceito nos escritos de Domingos Vandelli (1730-1816). Em complemento, a fisiocracia faz-se essencial na assimilação da ciência as questões econômicas a partir da metade do Século XVIII. Em se tratando do autor proposto, como deputado, estava constantemente envolvido no âmbito político, financeiro e diplomático do Reino português e buscava adequar assuntos econômicos as necessidades lusitanas durante o período de crise.
The Conquest of the Temple Scroll and the Creation of the Scholarly Text
Authors: Borchardt Francis
Published: August 2023

The story of the discovery of the Temple Scroll, frequently retold, is a gripping tale. It mixes archaeology with espionage, and even military victory. In that sense, it is unique. However, in other ways, it participates in conventions of discovery narratives nearly as old as writing itself. Like ancient find accounts, it establishes a provenance for the manuscript, details the labor involved in making the discovery available, and seeks to raise interest in the contents of the scroll. This all functions as a means of elevating the value of the text. This article argues that the narrative of the Temple Scroll’s discovery also performs another important function: it re-creates the scroll as a text ripe for scholarly analysis. In so doing, the narrative erases and/or diminishes the acts of translation and mediation necessary to accomplish this transformation from material to textual object.
The Passive Participle ‮כתוב‬‎—A Citation or Keyword Formula?
Authors: Klukowski Michal
Published: August 2023

The analysis of the uses of the passive participle ‮כתוב‬‎ in the halakhic section of MMT shows that the ‮כתוב‬‎ formula introduces keywords rather than summative quotations. By quoting keywords, the authors of MMT enable their addressee to easily identify a passage from Scripture. The way in which the scriptural passage is quoted suggests that the words introduced by the formula have been selected so that they are appropriate for only one passage, and that the addressee knows perfectly well to which passage the author refers. The selection of keywords does not allow us to note any exegetical act in it; it is only about quoting a text, which in itself is an argument in the polemic.
The Subdivision of Boys in the Leonidean Decree (IG V.1 19)
Authors: Bai Shanshan
Published: August 2023

This paper examines two problematic appellations of boy victors, παῖς καθαρός and παῖς κρίσεως τῆς Ἀγησιλάου, and the subdivision of boys in the Spartan festival Leonidea in inscription IG V.1 19. I propose several emendations to the edition of this inscription with the hope to correct a mistake and add two events into the athletic contest. I argue that age and birth were important criteria for the sub-classification of παῖδες, whereas physical development did not play a major role in the process. By means of adopting different categorizations in different games, Sparta memorialized its heroes, both warriors in the past Persian war and contemporary benefactors, innovated its traditions of athletic training and contests, and displayed its reputation of excellence in the Leonidea.
Preliminary records of abundance and morphometry of the tiger crab, Aegla concepcionensis (Schmitt, 1942) (Anomura, Aeglidae) in a lake of southern Chile
Authors: Ulloa-Yáñez Alfredo A. , Figueroa-Muñoz Guillermo , Núñez Daniela , Boyero Luz , De los Ríos-Escalante Patricio , Martin Juan , Jaque Ximena , Esse Carlos , Correa-Araneda Francisco
Published: August 2023

The tiger crab, Aegla concepcionensis, is a threatened endemic freshwater decapod of Chile, distributed throughout small areas of the Mediterranean region of Central Chile (37°30′-38°00′S). Its habitat includes streams and lakes with riparian areas dominated by native plants, with little or null human intervention. To our knowledge, the tiger crab’s distribution is limited and human stressors (e.g., water withdrawal, exotic tree plantations and climate change) have led to degradation of its habitat. Based on the presence of these stressors and the virtual lack of knowledge of its ecology, the tiger crab has been categorized as Endangered (EN). This study presents a preliminary description of the species’ ecology based on its abundance and its morphometrics, as well as on its feeding habits in Caburgua lake, South Central Chile. We established 16 sampling points, half of which in the shallow bathymetric stratum (0-10 m depth) of the lake itself, and half in the Lumaco stream, one of the lake’s tributaries. We used baited traps to capture specimens. A. concepcionensis appeared to be found in the lake’s shallow bathymetric stratum, but not in the stream. Individuals showed negative allometric growth, males were larger than females, and they showed scavenger feeding behaviour. Our findings provide useful information to help with tiger crab conservation, although more extensive surveys will be required to collect sufficient data for establishing a robust conservation program for the species in the study area.
Judicial Review and the Jordanian Constitutional Court: False Start or Slow Start?
Authors: Al-Shibli Farouq Saber , Alkhalaileh Mohamad , Brown Nathan J.
Published: August 2023

Judicial review of the constitutionality of legislation has moved in recent decades from being the exception to the rule among Arab states. Not only has it spread, but contests about adjudication of constitutional disputes have become much more prominent and political reform efforts have sometimes included a great emphasis on establishing or strengthening constitutional courts. In Jordan, longstanding calls for a constitutional court were finally met in 2011 and the Jordanian Constitutional Court began operating the following year. This article traces the background to establishing the court and analyzes its structure. It then assesses the Jordanian Constitutional Court in operation, first by examining its short history and then by analyzing why its emergence as a judicial actor has been slow and uneven and how this might be changed.
Synoptic Revision of Aspleniaceae (Asplenium, Hymenasplenium) of Rwanda
Authors: FISCHER EBERHARD , LOBIN WOLFRAM
Published: August 2023

Forty-four species of Asplenium and one species of Hymenasplenium are recorded for Rwanda. Three species, Asplenium markusbeckeri Eb.Fisch. & Lobin, A. ramicola Eb.Fisch. & Lobin, and A. uschiae Eb.Fisch. & Lobin are described as new to science. The new species are illustrated and their affinities are discussed. Eleven species represent new country records for Rwanda: Asplenium adiantum-nigrum var. adiantum-nigrum, A. africanum, A. boltonii, A. burundense, A. cancellatum, A. ceii, A. christii, A. inaequilaterale, A. lividum, A. trichomanes subsp. quadrivalens and Hymenasplenium kenyense. A key to all Aspleniaceae recorded from Rwanda is provided, and representative specimens from Rwanda are cited. The phytogeography of the Aspleniaceae of Rwanda is discussed. Two lectotypes are designated for Asplenium mildbraedii and A. trichomanes subsp. quadrivalens. Three species previously recorded for Rwanda (Asplenium goetzei, A. kassneri, A. lademannianum) are excluded from the flora.
Exochorion in the tribe Nymphalini (Lepidoptera: Nymphalidae): the genus Hypanartia Hübner, [1821] and comparison with related genera
Authors: LLORENTE-BOUSQUETS JORGE , NIEVES-URIBE SANDRA , FLORES-GALLARDO ADRIÁN
Published: August 2023

We describe and compare the exochorion of six species of Hypanartia (H. paullus, H. bella, H. lethe, H. godmanii, H. dione disjuncta, and H. trimaculata autumna) using specimens collected in the field and deposited in entomological collections. We used a standard staining technique and scanning electron microscopy to visualize and describe the main exochorionic characters, especially the ridges and the differentiation in the micropylar, perimicropylar, and transition zones in the apical region. We included plates with photographs, drawings, and schemes for clearer visualization of these structures, which are tabulated for comparison. For our characterization, we considered the ridges in colonnade as the main exochorionic feature in the Nymphalini. Thus, we made brief comparisons of these features among several species of the tribe, particularly with the genus Antanartia. The exochorionic characters agree with the separation of groups (paullus group and dione group). By examining the characteristics of H. paullus, the basal species of the paullus group, we found that ridges with conspicuous columns (e.g., in one section only) appears to be the plesiomorphic state, while those with elongated shafts and walls only in the intercolumn represent the apomorphic state.
Adaptive shifts in Neotropical planthoppers: new troglobitic species and the first surface species of Ferricixius Hoch & Ferreira, 2012 (Hemiptera: Fulgoromorpha: Cixiidae) from Brazilian caves
Authors: SANTOS JÚLIO CÉSAR DO CARMO VAZ , HOCH HANNELORE , ZAMPAULO ROBSON DE ALMEIDA , SIMÕES MATHEUS HENRIQUE , FERREIRA RODRIGO LOPES
Published: August 2023

Here we describe three cixiid species new to science which we assign to the hitherto monotypic genus Ferricixius Hoch & Ferreira, 2012 from Brazil. Ferricixius michaeli sp. nov. and F. goliathi sp. nov. of the new species are—like the type species Ferricixius davidi Hoch &Ferreira, 2012—obligately cavernicolous and display varying degrees of troglomorphy, such as the reduction of compound eyes, wings, and bodily pigmentation, while F. urieli sp. nov. displays well developed compound eyes and wings, and—although so far only found inside caves—is ecologically classified as either epigean, or subtroglophile. We provide a modified diagnosis for the genus and an identification key to the species of Ferricixius, as well as information on the distribution, ecology, and habitat of the three new species herein described. Evolutionary implications are discussed, and adaptive shifts from epigean to subterranean habitat are presumed to be the most likely scenario underlying the evolution of cave dwelling Ferricixius.
The Vanguard Brigade: An Appraisal of the United Nations’ Rapid Deployment Capabilities
Authors: Venkataraman M. , Vignesh R.
Published: August 2023

Seventy-six years after its establishment, the United Nations (UN) today stands at a critical juncture where it must undertake radical reforms to remain relevant in the changing face of the twenty-first century. Such reforms are essential to prevent the UN from becoming redundant and being pushed to the sidelines of great power politics in the emerging multipolar world. While there has been much political clamour among the international community calling for the restructuring of the UN Security Council, which is also in the interest of India, an appraisal of the UN’s military capability to intervene in Contemporary Armed Conflicts under Chapter VII of its Charter needs to be assessed. The absence of a standing reserve and the procedural complexities involved in deriving the manpower for peacekeeping operations from the member states have undermined the UN’s capability to swiftly intervene in an escalating armed conflict even after getting approval from the Security Council. At present, a plethora of factors have resulted in the increasing volatility of contemporary armed conflicts. Under these circumstances, the UN’s capacity for swift intervention after the outbreak of a conflict has become even more relevant today than in the past. The creation of a UN Vanguard Brigade based on the recommendations given by the 2015 High-Level Independent Panel on Peace Operations is a major step in that direction. Using a case analysis of the Rwandan genocide, this article critically examines the challenges of the vanguard brigade to optimise the UN’s capability for rapid deployment of peacekeepers for swift intervention in an escalating Armed Conflict. The article is largely descriptive and analytical, using predominantly secondary sources and UN documents.
An Enormous Reckoning: Unfinished Projects and New Agendas for the History and Philosophy of Science and Education
Authors: Raina Dhruv
Published: August 2023

This article takes up the argument from an earlier article and seeks to detail the importance and role of the history and philosophy of science (HPS), conceived as a unitary interdisciplinary field, in science education. However, on this count, it not only seeks to ground the salience for science education at the school level but also its role in higher education. While elaborating upon its importance in school education, it charts out additional areas where the HPS could enrich the already existing objectives envisaged. Furthermore, the article highlights the importance of HPS both at the level of the pedagogy of undergraduate education as well as research mentorship at the graduate level. While, for analytic purposes, these two spheres are addressed separately, the article argues for the need to forge linkages between them.
Epidemiological analysis of death among patients on maintenance hemodialysis: results from the beijing blood purification quality Control and Improvement Center
Authors: Liu Jing , Zhang Huixian , Diao Zongli , Guo Wang , Huang Hongdong , Zuo Li , Liu Wenhu
Published: August 2023

Background

China has the largest number of patients on maintenance hemodialysis (MHD) worldwide. Despite continuous improvements in hemodialysis techniques, patients on MHD have a higher mortality rate than the general population. Understanding the characteristics of death in this population can better promote clinical practice, thereby improving patients’ survival.

Methods

We collected demographic and clinical data for patients on MHD registered in the Beijing Blood Purification Quality Control and Improvement Center database from 2014 to 2020. The annual mortality rate was calculatedand the primary cause of end-stage renal disease (ESRD), dialysis vintage, and cause of death among deceased patients were analyzed.

Results

(1) 24,363 patients on MHD were included, of which 6,065 patients died from 2014 to 2020. The annual mortality rate fluctuated between 7.4% and 8.0%. The median age of death was 70.0 (60.8–79.0) years and the male to female ratio was 1.27:1 (2). The top three primary causes of ESRD in deceased patients were chronic glomerulonephritis (CGN), diabetic nephropathy (DN), and hypertensive nephropathy (HN). Comparison of the annual mortality rate showed DN > HN > CGN (3). The median dialysis vintage of deceased patients was 3.7 (1.8–6.9) years, which slowly increased annually. Patients with diabetes had a shorter dialysis vintage than patients without diabetes (3.4 vs. 4.1 years, Z = 8.3, P < 0.001) (4). The major causes of death were cardiovascular disease (20.2%), sudden death (18.1%), infection (17.9%), and cerebrovascular disease (12.6%). Proportions of death from cardiovascular disease, infection, and sudden death were higher in patients with diabetes (22.2%, 20.2%, and 20.0%) than patients without diabetes (18.4%, 15.8%, and 16.3%). Sudden death was the leading cause of death in young (18–44 years; 27.0%) and middle aged (45–64 years; 20.8%) patients, whereas infection was the leading cause of death in patients aged ≥ 75 years (24.5%).

Conclusion

The annual mortality rate of patients on MHD in Beijing was relatively stable from 2014 to 2020. Sudden death was more likely to occur in young and middle-aged patients, and more patients aged ≥ 75 years died from infections.
Contributing factors of birth asphyxia in Thailand: a case–control study
Authors: Rattanaprom Panida , Ratinthorn Ameporn , Sindhu Siriorn , Viwatwongkasem Chukiat
Published: August 2023

Background

Birth asphyxia is of significant concern because it impacts newborn health from low to severe levels. In Thailand, birth asphyxia remains a leading cause of delayed developmental health in children under 5 years old. The study aimed to determine the maternal, fetal and health service factors contributing to birth asphyxia.

Methods

A case–control design was conducted on a sample of 4256 intrapartum chart records. The samples were selected based on their Apgar scores in the first minute of life. A low Apgar score (≤ 7) was chosen for the case group (852) and a high Apgar score (> 7) for the control group (3408). In addition, a systematic random technique was performed to select 23 hospitals, including university, advanced and secondary, in eight health administration areas in Thailand for evaluating the intrapartum care service. Data analysis was conducted using SPSS statistical software.

Results

The odds of birth asphyxia increases in the university and advanced hospitals but the university hospitals had the highest quality of care. The advanced and secondary hospitals had average nurse work-hours per week of more than 40 h. Multivariable logistic regression analysis found that intrapartum care services and maternal–fetal factors contributed to birth asphyxia. The odd of birth asphyxia increases significantly in late–preterm, late–term pregnancies, low-birth weight, and macrosomia. Furthermore, maternal comorbidity, non-reassuring, and obstetric emergency conditions significantly increase the odd of birth asphyxia. In addition, an excellent quality of intrapartum care, a combined nursing model, low nurse work-hours, and obstetrician-conducted delivery significantly reduced birth asphyxia.

Conclusion

Birth asphyxia problems may be resolved in the health service management offered by reducing the nurse work-hours. Excellent quality of care required the primary nursing care model combined with a team nursing care model. However, careful evaluation and monitoring are needed in cases of comorbidity, late–preterm, late–term pregnancies, low-birth weight, and macrosomia. Furthermore, increasing the obstetrician availability in obstetric emergencies and non-reassuring fetal status is important.
Validation of the Generalized Anxiety Disorder-7 in patients with COPD: a cross-sectional study
Authors: Liu Meishan , Wang Dong , Fang Jiexin , Chang Yuhan , Hu Yongdong , Huang Kewu
Published: August 2023

Background

Patients with chronic obstructive pulmonary disease (COPD) often have comorbid generalized anxiety disorder (GAD), which requires early screening in respiratory clinics. The Generalized Anxiety Disorder-7 (GAD-7) questionnaire is a brief and commonly used screening tool for GAD but has not been validated among patients with COPD in China.

Methods

Stable patients with COPD from a cross-sectional observational study were assessed using the GAD-7 questionnaire and then assessed by a senior psychiatrist to confirm a diagnosis of GAD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Demographic characteristics, spirometry, and patient-reported outcomes were collected. Cronbach’s α coefficient was calculated, and receiver operating curve (ROC) analysis was performed to validate the GAD-7.

Results

A total of 226 patients with COPD were enrolled, and 50 (22.1%) of these patients were diagnosed with GAD. The Cronbach’s α coefficient for the GAD-7 was 0.869, which indicated good internal consistency. ROC curve analysis showed that the GAD-7 had an area under the curve (AUC) value of 0.829 (95% CI: 0.774–0.876) for identifying GAD. The optimal cut-off score was ≥ 4, with a sensitivity of 66.0% and a specificity of 89.2%. Higher GAD-7 scores were significantly associated with health-related quality of life and the symptom burden of COPD. The discriminatory power of GAD-7 did not differ statistically when stratified by COPD severity.

Conclusions

The GAD-7 was shown to be a reliable and valid screening tool for patients with COPD in China, and its screening performance for GAD was not influenced by disease severity.
The impact of moderate to severe osteoarthritis on the physical performance and quality of life: a cross-sectional study in Greek patients (PONOS study)
Authors: Savvari P. , Skiadas I. , Papadakis S. A. , Psychogios V. , Argyropoulou O. D. , Pastroudis A. P. , Skarpas G. A. , Tsoutsanis A. , Garofalakis A. , Katsifis G. , Boumpas D. , Menegas D.
Published: August 2023

Background

Osteoarthritis (OA) represents a leading cause of disability with limited data available for the Greek patients.

Objectives

To evaluate the impact of moderate to severe symptomatic hip/knee OA under treatment on physical performance and quality of life.

Methods

A non-interventional, cross-sectional, epidemiological study of patients with moderate/severe OA, recruited in a single visit from 9 expert sites in Athens, Greece. Assessments were based on commonly used outcome scales: the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the EuroQol-5-Dimensions 3-levels questionnaire (EQ-5D-3L).

Results

One hundred sixty-four patients were included in the analysis. Most of the patients were females (78.7%), with a mean age of 70.5 ± 10.2 years. Comorbidities were reported by 87.2% of patients with hypertension being the most frequently reported (53.7%), followed by dyslipidemia (31.1%), obesity (24.4%) and diabetes mellitus (23.2%). Paracetamol was the most common treatment (96%), followed by NSAIDs (75%), opioids (50%) and locally applied medications (42.7%). Both hip and knee OA patients showed substantial deterioration in health-related quality of life (QoL) and health status as reflected by the HOOS/KOOS (Function in sport and recreation was the most impaired subscale, followed by Hip- or Knee-related QoL). The mean EQ-5D-3L index score was 0.396 ± 0.319 and the mean EQ-VAS score was 52.1 ± 1.9. When compared indirectly to the local population norms our OA population had worse QoL indices.

Conclusion

Our findings suggest the functional disability and impaired QoL of Greek patients with moderate/severe hip/knee OA under treatment emphasizing the need for novel treatments that will reduce the burden of the disease.
Prevalence, persistence, clearance and risk factors for HPV infection in rural Uyghur women in China
Authors: Tuerxun Gulixian , Abudurexiti Guligeina , Abulizi Guzalinuer
Published: August 2023

Background

The incidence of cervical cancer in Uyghur women ranks first among those in Han and other ethnic minority groups. We aimed to understand the natural history of HPV in Uyghur women.

Methods

A longitudinal cohort study on the natural history of HPV infection in rural Uyghur women in China was conducted between May 2013 and May 2014. A total of 11000 women from South Xinjiang underwent HPV screening by careHPV and liquid-based cytology. Ultimately, a total of 298 women with positive HPV and normal biopsy results or CIN1 were enrolled to participate in a study including follow-up HPV testing for two years.

Results

The HPV infection rate in Uyghur women was 9.15%. Among the participants, the careHPV test showed that 298 women were HPV-positive, and histology showed CIN1 or normal results for these women at baseline. Among these patients, after 24 months of initial recruitment, 92 (30.87%) patients had persistent HPV infections, and 206 (69.13%) had cleared HPV infection. Univariate analysis showed that persistent HPV infection was associated with age and shower frequency (P < 0.001 and P = 0.047, respectively).

Conclusions

Our results suggest that women over the age of 50 years who have been infected with HR-HPV for more than 1 year should be regularly screened and monitored for HPV. In addition, education should be strengthened to improve poor health habits in these women.
Psychometric properties of the persian version of the Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS)
Authors: Moodi Ghalibaf AmirAli , Moghadasin Maryam , Emadzadeh Ali , Mastour Haniye
Published: August 2023

Introduction

There are numerous cases where artificial intelligence (AI) can be applied to improve the outcomes of medical education. The extent to which medical practitioners and students are ready to work and leverage this paradigm is unclear in Iran. This study investigated the psychometric properties of a Persian version of the Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS) developed by Karaca, et al. in 2021. In future studies, the medical AI readiness for Iranian medical students could be investigated using this scale, and effective interventions might be planned and implemented according to the results.

Methods

In this study, 502 medical students (mean age 22.66(± 2.767); 55% female) responded to the Persian questionnaire in an online survey. The original questionnaire was translated into Persian using a back translation procedure, and all participants completed the demographic component and the entire MAIRS-MS. Internal and external consistencies, factor analysis, construct validity, and confirmatory factor analysis were examined to analyze the collected data. A P ≤ 0.05 was considered as the level of statistical significance.

Results

Four subscales emerged from the exploratory factor analysis (Cognition, Ability, Vision, and Ethics), and confirmatory factor analysis confirmed the four subscales. The Cronbach alpha value for internal consistency was 0.944 for the total scale and 0.886, 0.905, 0.865, and 0.856 for cognition, ability, vision, and ethics, respectively.

Conclusions

The Persian version of MAIRS-MS was fairly equivalent to the original one regarding the conceptual and linguistic aspects. This study also confirmed the validity and reliability of the Persian version of MAIRS-MS. Therefore, the Persian version can be a suitable and brief instrument to assess Iranian Medical Students’ readiness for medical artificial intelligence.
Point-of-care testing for cerebral edema types based on symmetric cancellation near-field coupling phase shift and support vector machine
Authors: Li Mingyan , Zhu Rui , Li Gen , Yin Shengtong , Zeng Lingxi , Bai Zelin , Chen Jingbo , Jiang Bin , Li Lihong , Wu Yu
Published: August 2023

Background

Cerebral edema is an extremely common secondary disease in post-stroke. Point-of-care testing for cerebral edema types has important clinical significance for the precise management to prevent poor prognosis. Nevertheless, there has not been a fully accepted bedside testing method for that.

Methods

A symmetric cancellation near-field coupling phase shift (NFCPS) monitoring system is established based on the symmetry of the left and right hemispheres and the fact that unilateral lesions do not affect healthy hemispheres. For exploring the feasibility of this system to reflect the occurrence and development of cerebral edema, 13 rabbits divided into experimental group (n = 8) and control group (n = 5) were performed 24-h NFCPS continuous monitoring experiments. After time difference offset and feature band averaging processing, the changing trend of NFCPS at the stages dominated by cytotoxic edema (CE) and vasogenic edema (VE), respectively, was analyzed. Furthermore, the features under the different time windows were extracted. Then, a discriminative model of cerebral edema types based on support vector machines (SVM) was established and performance of multiple feature combinations was compared.

Results

The NFCPS monitoring outcomes of experimental group endured focal ischemia modeling by thrombin injection show a trend of first decreasing and then increasing, reaching the lowest value of − 35.05° at the 6th hour. Those of control group do not display obvious upward or downward trend and only fluctuate around the initial value with an average change of − 0.12°. Furthermore, four features under the 1-h and 2-h time windows were extracted. Based on the discriminative model of cerebral edema types, the classification accuracy of 1-h window is higher than 90% and the specificity is close to 1, which is almost the same as the performance of the 2-h window.

Conclusion

This study proves the feasibility of NFCPS technology combined with SVM to distinguish cerebral edema types in a short time, which is promised to become a new solution for immediate and precise management of dehydration therapy after ischemic stroke.
Factors associated with exclusive breastfeeding of children under six months of age in Cote d’Ivoire
Authors: Koffi Ibrahima , Essis Esme Marie Laure , Bamba Iba , Assi Kaudjhis Rh , Konan Loukou Léandre , Aka Joseph
Published: August 2023

Background

Despite benefits of exclusive breastfeeding (EBF) and its strategic place in the national guidelines for infant and young child feeding, its practice remains insufficient in Cote d’Ivoire. It is therefore important to identify its early stopping associated factors. We aimed to (i) assess the extent of children’s exposure to exclusive breastfeeding and the associated explanatory factors for discontinuation before six months, and (ii) to profile non-exclusively breastfed children and interrelationships between these factors.

Methods

A secondary analysis of data from the 2016 Cote d’Ivoire Fifth Multi Indicator Cluster Survey (MICS5) of 980 children under six months of age was conducted in this study. Data were analyzed using the actuarial method of survival hazard estimation combined with the Wilcoxon (Gehan) test, discrete time proportional hazards regression models, and Multiple Correspondence Analysis (MCA) to profile the children.

Results

Maternal exposure to counseling session, age at delivery, and child sex were significantly associated with the likelihood of discontinuing exclusive breastfeeding before the first six months of life. Children deprived of EBF resided in urban areas, in high and very high economic welfare households. Their mothers had a secondary education or higher and had three or fewer children.

Logistic analysis showed that health status and sex of the child were significantly associated (P < 0.001) with exclusive breastfeeding. An extremely important and rarely studied factor is that children who were sick in weeks prior to the survey were more likely to remain exclusive breastfeeding (adjusted OR 1.80; 95% Confidence Interval (CI) 1.452, 2.234). Girls are less likely to be exclusively breastfed than boys (adjusted OR 1.48; 95% CI 1.22, 1.798). Low standard of living was associated with early cessation of EBF (adjusted OR 2.15; CI 1.325, 3.499). The duration of the exclusive breastfeeding was significantly longer among mothers with high exposure to medical discourse (adjusted OR 0.74; CI 0.595, 0.91).

Conclusions

Improving the practice of exclusive breastfeeding in Cote d’Ivoire requires strengthening the capacities of health professionals in terms of advice and assistance to mothers for the practice of exclusive breastfeeding and its maintenance until six months of age, regardless of the health status and sex of the child.
Determinants of early cessation of exclusive breastfeeding practices among rural mothers from Jaffna District of Sri Lanka
Authors: Karthigesu Kandeepan , Balakumar Sandrasegarampillai , Arasaratnam Vasanthy
Published: August 2023

Background

Sri Lanka is an upper-middle-income country with excellent health statistics. However, 2016 Demographic and Health Survey data have shown 82% and 64% of mothers exclusively breastfed infants aged 0–6 months and 4–5 months, respectively. The short duration of exclusive breastfeeding (EBF) has an impact on the growth and development of babies. Since no studies have been reported on EBF practices of the rural mothers in Jaffna District, an administrative district among 25 districts of Sri Lanka, this study aimed to assess the factors influencing the early cessation of EBF.

Methods

For this community-based cross-sectional study, 338 mother–child pairs were selected from 2013–14. EBF was defined as children not receiving any food or drink, including complementary foods, formula milk or milk products except for medicines and vitamins or mineral drops, other than breast milk since birth. Socio-economic and demographic factors, the influence of the mode of delivery, and knowledge on EBF were obtained using an interviewer-administered questionnaire. The details of EBF and reasons for the cessation of breastfeeding before six months were obtained from a subgroup of mothers (n = 208). Multivariate analysis was performed to explore the correlates of breastfeeding.

Results

In this study, 71.2% (95% CI 64.5, 77.2) had practiced EBF for six months. Early discontinuation of EBF was practiced by employed mothers (AOR 4.3; 95% CI 1.3, 13.9), mothers of low birth weight babies (AOR 3.6; 95% CI 1.6, 8.2) and those who experienced Cesarean section birth (AOR 2.9; 95% CI 1.2, 6.9). The EBF practiced by mothers of rural Jaffna was not associated with the gender of the babies, type of family, number of children in a family, religion of the household, knowledge on EBF, or family income.

Conclusion

The prevalence of EBF up to six months was low in rural Jaffna, and it was influenced by employment, birthweight of the babies, and the mode of delivery. To enhance EBF, the Regional Directorate of Health Service, Jaffna, should take necessary action with policymakers to increase maternity leave for at least six months, reduce the Cesarean section rate, and provide nutritional support to pregnant mothers.
Predicting the impact of sequence motifs on gene regulation using single-cell data
Authors: Hepkema Jacob , Lee Nicholas Keone , Stewart Benjamin J. , Ruangroengkulrith Siwat , Charoensawan Varodom , Clatworthy Menna R. , Hemberg Martin
Published: August 2023

The binding of transcription factors at proximal promoters and distal enhancers is central to gene regulation. Identifying regulatory motifs and quantifying their impact on expression remains challenging. Using a convolutional neural network trained on single-cell data, we infer putative regulatory motifs and cell type-specific importance. Our model, scover, explains 29% of the variance in gene expression in multiple mouse tissues. Applying scover to distal enhancers identified using scATAC-seq from the developing human brain, we identify cell type-specific motif activities in distal enhancers. Scover can identify regulatory motifs and their importance from single-cell data where all parameters and outputs are easily interpretable.
BamQuery: a proteogenomic tool to explore the immunopeptidome and prioritize actionable tumor antigens
Authors: Cuevas Maria Virginia Ruiz , Hardy Marie-Pierre , Larouche Jean-David , Apavaloaei Anca , Kina Eralda , Vincent Krystel , Gendron Patrick , Laverdure Jean-Philippe , Durette Chantal , Thibault Pierre , Lemieux Sébastien , Perreault Claude , Ehx Grégory
Published: August 2023

MHC-I-associated peptides deriving from non-coding genomic regions and mutations can generate tumor-specific antigens, including neoantigens. Quantifying tumor-specific antigens’ RNA expression in malignant and benign tissues is critical for discriminating actionable targets. We present BamQuery, a tool attributing an exhaustive RNA expression to MHC-I-associated peptides of any origin from bulk and single-cell RNA-sequencing data. We show that many cryptic and mutated tumor-specific antigens can derive from multiple discrete genomic regions, abundantly expressed in normal tissues. BamQuery can also be used to predict MHC-I-associated peptides immunogenicity and identify actionable tumor-specific antigens de novo.
Governance of rangeland in Bhutan: Institutions and policy initiatives
Authors: Wangchuk Kesang , Wangdi Jigme , Dorji Tashi
Published: August 2023

High-altitude rangelands support the economies of mountain communities in the Himalayas. This article highlights institutions and policy initiatives for good governance of rangelands in Bhutan and draws lessons from previous efforts to mainstream rangeland development. Both formal and informal institutions support the rangeland governance in Bhutan. The article elaborates on critical rangeland-related amendments to the Bhutanese Land Act. Rangeland stewardship and access rights are outlined, along with alternative governance approaches that rely on pastoralists’ traditions and indigenous knowledge. It highlights concerns and disputes about using and managing rangelands and explains traditional institutions and practices of conflict resolution. The article’s final section discusses the challenges of rangeland governance and the aspirations of herding communities under the new Land Act. Rangeland owners have reconciled with the amendments to the Act. They are willing to work with the government to implement the Act’s provisions and bring the desired reforms in rangeland governance.
Microbiological quality of some packed and unpacked bread products in Alexandria, Egypt
Authors: Ali Manal A. , Hashish Mona H. , Fekry Marwa M.
Published: August 2023

Background

Bakery products are important food snacks consumed by people of all ages and economic groups. The growth of unwanted microorganisms that deteriorate products such as bacteria, moulds, and fungi in these foodstuffs may offer risks to consumers’ health and generate considerable economic losses. This work aimed to assess the microbiological quality of some packed and unpacked bread products in Alexandria, Egypt.

Methods

This cross-sectional comparative study involved 168 local and branded bakery products that were collected randomly from 2 districts in Alexandria. Hygienic practices such as covering of the bread and wearing gloves during handling were observed and recorded. All bread samples were tested to determine the total plate count (TPC), presence/absence of Staphylococcus aureus (S. aureus), total yeasts and moulds in CFU/g and total coliform count (TC) in MPN/g.

Results

The mean of the total yeasts and moulds and TC in the packed bread was lower than that of the unpacked bread (3.40 × 103 CFU/g and 3.25 MPN/g versus 6.37 × 103 CFU/g and 31.61 MPN/g, respectively). However, the mean of TPC in the packed bread was higher than that of the unpacked bread (1.39 × 106versus 2.07 × 105 CFU/g, respectively). The mean TPC, total yeasts and moulds and TC was higher in the studied flatbread than Fino bread and toast (3.4 × 106, 1.14 × 104 CFU/g and 24.6 MPN/g, respectively). The presence of S. aureus was higher in flat, unpacked bread, bread displayed outside the shop and handled without gloves.

Conclusion

Bread produced by local bakeries showed lower standards in packaging and microbial quality. Better manufacturing, packaging, storage, and handling initiatives should be introduced to avoid related food safety concerns in the future. The formal authorities should define and clarify standards and rules on bread safety.
Diagnostic performance of US LI-RADS in hepatocellular carcinoma surveillance
Authors: Abduljabbar Ahmed Haitham , Wazzan Mohammad A.
Published: August 2023

Background

Liver cirrhosis and chronic infection with hepatitis B virus are major risk factors for hepatocellular carcinoma (HCC). Guidelines recommend ultrasound (US) surveillance for population at risk of HCC. The US Liver Imaging Reporting and Data System (LI-RADS) aims at standardization of interpretation, reporting, and management recommendations for US surveillance examinations. The aim of this study is to assess the diagnostic accuracy of US LI-RADS in early HCC detection in patients at risk.

Results

This retrospective study included patients with surveillance US between January 2018 and January 2020 who had a contrast-enhanced CT or MRI of the liver within 1 month from the date of US examination. Visualization scores and US categories were assigned according to the US LI-RADS lexicon. A total of 264 participants were eligible for the study. HCC was diagnosed in 33 participants. The US-3 category had a 39.4% sensitivity and 93.5% specificity for HCC detection. The US-2 category had a 45.4% sensitivity and 87% specificity for HCC detection. The visualization score C showed the highest number of HCC (19/33) and had the highest false-negative rate (76%, 13 of 17).

Conclusions

Both US-2 and US-3 categories showed high specificity and low sensitivity for HCC detection in the setting of surveillance of patients at high risk. Visualization score C had the highest risk for HCC and the highest rate of false-negative results. Intense surveillance by contrast-enhanced CT or MRI might be beneficial for patients with limited visualization scores B and C.