bluuebunny/crossref_metadata_2025 huggingface dataset:
30 Dissociation and its biological and clinical correlates in functional neurological disorder: a systematic review and meta-analysis
Authors: Campbell Malcolm C , Smakowski Abigail , Rojas-Aguiluz Maya , Goldstein Laura H , Cardeña Etzel , Nicholson Timothy R , Reinders Antje ATS , Pick Susannah
Published: December 2022

Objectives/Aims

Dissociation is a potential mechanism in FND. Although scientific studies report elevated rates of dissociative symptoms in FND, a systematic assessment of the biological and clinical correlates of dissociation in FND is lacking. We aimed to systematically review the current evidence describing dissociative symptoms and disorders in functional neurological disorder (FND), and additionally conduct a meta-analysis of dissociative symptom severity in FND. We also aimed to synthesise the existing data on biological and clinical correlates of dissociation in FND.

Methods

We systematically searched Embase, PsycINFO, and Medline, combining terms for FND and dissociation. Studies were eligible for inclusion if reporting on dissociative symptom scale scores or rates of dissociative disorder in FND samples. Studies were appraised for methodological quality using modified Newcastle-Ottawa criteria. Findings pertaining to dissociative symptoms or disorders, as well as biological and clinical correlates of dissociation in FND samples, were synthesised qualitatively. Dissociative symptom scores were included in a meta-analysis using random and mixed effects models.

Results

Two-thousand and eighty-eight records were screened and seventy-nine studies were included in the final review. Dissociative symptoms were elevated in FND. The meta-analysis demonstrated a significant elevation in dissociation in FND samples relative to neurological and healthy controls, but not psychiatric controls. Dissociative disorders were frequently co-morbid in FND samples. Psychoform (cognitive) dissociation was more prominent in FND-seizures, whereas somatoform (physical) dissociation tended to be more prominent in FND-motor symptom samples. Dissociation was associated with FND symptom severity or frequency, general psychopathology, and reduced quality of life. Biological correlates of elevated dissociation included structural and functional brain alterations in regions that have previously been implicated in FND, such as the anterior cingulate cortex.

Conclusions

Dissociative symptoms and disorders are common in FND, and different FND subgroups appear to endorse varying degrees of psychoform or somatoform dissociation. Presence of dissociative symptoms in FND is associated with adverse clinical features; there is therefore a clinical need to assess patients with FND for dissociative symptomatology and to address these symptoms during treatment. Future research should examine dissociation further in different FND subgroups, using measures that distinguish between different types of dissociation, alongside measures of underlying pathophysiology.
33 The link between migraine and functional neurological disorder
Authors: Nash Will , Bavington Jasmine , Coeburgh Jan
Published: December 2022

Objective/Aims

To determine the prevalence of migraine in functional neurological disorder (FND) (data still to collect). Of which patients with concomitant migraine and FND, what proportion ofpatients have adequate migraine treatment and prophylaxis.

Methods

Patient data was collected from clinic letters, ‘migraine’ was cross referenced across all electronic clinic letters from a regional functional neurology clinic between 2018–2019.

The number of patients with and without holistic migraine treatment, appropriate attack treatment and prophylactic treatment was recorded. The predisposing, precipitating and perpetuating factors for patients’ FND was also recorded.

By cross referencing ‘functional neurological disorder’ across the electronic clinic letters over the same period then prevalence data was obtained (data still to collect)

Results

50 patients with FND over the study period were identified to have a history of migraine, with 48 reporting active migraine and 2 reporting previous migraine.

Of these 39 had inadequate attack treatment, and 31 had inadequate migraine prophylaxis.

Migraine is a predisposing, precipitating and largely a perpetuating factor in 6, 8 and 24 FND patients respectively.

Migraine as a contributing perpetuating factor for FND in 24 patients was more common than other factors: 6 patients had anxiety, 5 patients had a mood disorder, and 3 patients had a traumatic life event.

Conclusions

There is minimal literature on the link between undertreated migraine and functional neurological disorder.

These results suggest an overall lack of treatment control of migraine in FND patients.

Seeing as migraine can play a role in predisposing, precipitating and perpetuating migraine it shows the importance of treating FND patients holistically.

It shows the importance of early detection, asking FND patients about migraine symptoms and ensuring treatment regimens are in place.

In the future, larger scale research into the link between migraine and FND will improve patient quality of life and how we treat functional neurological disorders.
34 A systematic review comparing symptomaticity and markers of interoception in patients with functional seizures, and dual diagnosis epilepsy with functional seizures
Authors: Kandasamy Rohan , May Felix , Yogarajah Mahinda
Published: December 2022

Introduction/Objectives

Comorbid/dual diagnosis (DD) epilepsy (ES) and functional seizures (FS) occur at a significant rate in adult populations but it is not known whether the underlying mechanism or aetiological models are similar to patients with FS alone. We conducted a systematic review of patients with dual diagnosis to understand more about underlying mechanisms and natural history, in comparison to patients with FS only.

Methods

The search strategy used the PRESS (Peer Review of Electronic Search Strategies) 2015 evidence-based checklist. We selected papers from MEDLINE, APA PsychInfo, and Google Scholar with search terms to identify primary research, on comorbid epilepsy and functional seizures confirmed by video EEG/telemetry, excluding people younger than 18 or over 75, and not including studies on populations with learning difficulties. Papers from the last 30 years were examined. Case reports were excluded. Papers were summarised by two authors and results corroborated.

Results

116 papers (with 1854 participants) were included. Studies indicated patients with DD and FS were similar in the pre-ictal changes to heart-rate variability. Both showed similar degrees of suggestibility and similar semiology. Both had similar levels of, and features of, dissociation during FS. Studies identified differences in the psychiatric profile between these groups, and of symptom burden and comorbidities, especially somatovisceral disorders (e.g. irritable bowel, headache, gastro-oesophageal reflux, or pain) which were more common in patients with FS than patients with DD.

Discussion/Conclusion

Bayesian models of perception have been explored in functional conditions (Edwards, 2012),1suggesting functional symptoms emerge due to a disorder of bodily priors. Recent work on interoception seeks to characterise the contribution of these bodily afferent signals and explore a role of dysregulation in aetiology of FS and functional conditions in general.

Our findings suggest that, in the lead up to and during events, patients with DD and FS both experience disordered interoception as indexed by the development of subjective bodily symptoms, and objective changes in autonomic tone (changes in heart-rate variability). Interictally, however, patients with a dual diagnosis are less likely to report other generalised functional symptoms, compared to those with FS alone. Our findings suggest potentially different underlying mechanisms within a Bayesian framework. In patients with FS alone there may be a generalised disorder of hyper-precise bodily priors, while in DD patients the primary problem may be one of excessive attention to bottom-up bodily afferent signals and phenomena linked to their epilepsy.

Reference

Mark J Edwards, Rick A Adams, Harriet Brown, Isabel Pareés, Karl J Friston. A Bayesian account of ‘hysteria’,Brain2012;135(11): 3495–3512, https://doi.org/10.1093/brain/aws129
35 Processing speed (PS) improvement in alcohol related brain damage (ARBD)
Authors: Leong KK , Paramlall M , Swanepoel H , Herrod J
Published: December 2022

Introduction

ARBD is characterised by cognitive impairment, a causative link to excessive alcohol ingestion and thiamine deficiency. It is complex; with deficits in anterograde memory, executive function, attention, PS, visuospatial skills and IQ and approximately 25% have ischaemic or traumatic head injury events.1Oslin’s Alcohol Dementia Criteria2recommends assessment after three months for evaluation of long standing cognitive deficits due to abstinence related improvement; not observed in patients with concomitant vascular lesions. Domains studied include verbal fluency (VF), memory, abstraction and perceptual motor skills. There are no treatment guidelines for ARBD cognitive deficits. Various cognitive domains showed some improvement with Donepezil, Rivastigmine and Memantine; but not in PS. Our patient, showed such an improvement with Memantine.

Case summary

We present a case of a 68-year-old man with a 30 year history of alcohol dependence of 9 units per day (substantially increased in the 7 years pre-admission), resulting in self-neglect, impulsivity, aggression, hallucinations, and chronic neuropsychiatric sequelae and cognitive impairments. He met the criteria for ARBD1with prolonged cognitive impairment, causative association with alcohol use requiring thiamine replacement3; CT abdomen showed hepatic atrophy and MRI head demonstrated moderate small vessel disease. Self-neglect, impulsivity, aggression, and hallucinations improved with three month’s alcohol abstinence, however, neuropsychiatric complications persisted. Ten months abstinence- self report mood disorder screening and typical dementia blood screen were unremarkable. A Wechsler Adult Intelligence Scale (WAIS-IV UK) was performed and Memantine commenced (uptitrated to BNF maximum.)

Results

The WAIS-IV 3 month follow up showed statistical improvement in Perceptual reasoning, PS and General Ability index.

Discussion

Previous ARBD studies indicate abstinence related improvements in delayed recall, VF and general intellectual functioning, but, not in memory and inhibition4. Memantine (non-competitive NMDA antagonist) is associated with improved VF, confrontational naming, word list memory, constructional praxis recall and trail making A; no studies have measured PS using specific neuropsychological tests. PS is associated with the superior longditudinal fasiculus and white matter tracts within parietal and temporal cortices and left middle frontal gyrus5. Functional neuroimaging has shown white matter loss in the prefrontal cortex, superior prefrontal association cortex, cerebellum, hypothalmus and corpus callosum6. Alcohol possibly upregulates NMDA receptors and glutamate excitotoxicity with impaired oligodendrocyte function and white matter lesions7. Memantine, possibly prevents glutamate toxicity and may improve oligodendrocyte function myelination restoration. Therefore, PS improvements may be related to lesion repair secondary to Memantine effect on Oligodendrocyte function.
37 The medicolegal challenges in neuropsychiatry: an evaluation of mental capacity and legal frameworks
Authors: Moonga Julie
Published: December 2022

Assessments of mental capacity pose various legal challenging in neuropsychiatry. Currently, over two million individuals lack capacity to make decision for themselves in the UK. Those are vulnerable individuals, often subjected to deprivation of their liberty. The UN Declaration of Human Right (UNDHR) outlines the fundamental rights and freedom of all individuals. Furthermore, Article 5 of the European Convention on Human Rights (ECHR) prohibits arbitrary deprivation of liberty. The Mental Capacity Act (MCA) 2005, was introduced as a legal instrument for decision making on behalf of those lacking capacity. Subsequently, the Deprivation of Liberty Safeguards (DoLS), amended the MCA 2007, to protect liberty vulnerable individuals following the ‘Bournewood’ judgement. However, reports indicate a higher number of people are detained in hospital under the Mental Health Act (MHA). The interface between the two legislations (MHA and MCA) often causes confusions in their applications and arrangements within clinical practice. Since its implementation into the MCA in 2009, DoLS received many criticisms for being too narrow-focused, nor fit- for-purpose, and raise human rights concerns. Recent proposal from the Law Commission led the UK government to approve the Liberty Safeguards Protection (LPS) framework to replace DoLS. However, it remains unclear whether the new framework would efficiently address the medicolegal issues. This systematic review provides an in-depth evaluation of mental capacity, decision-making and the challenges implicating the legal framework and safeguarding challenges and their complex interplay in neuropsychiatry.

Objective/Aims

To evaluate the MCA legal frameworks, DoLS and the new LPS as safeguarding instruments.

To assess their application and effectiveness in protecting individuals lacking capacity to make decision for themselves.

To outline the complexity and medicolegal implications.

Methods

The PRISMA framework is used for this systematic review. This research presents an in-depth analysis of the necessary steps in the decision-making process and application of the MCA.

Result

The MCA provides empowering mechanisms for decision-making in the best interests of individuals lacking capacity. However, the safeguarding process remains problematic. Both DoLS and LPS offer principles with justifiable steps. The narrow focus of DoLS intensified criticisms for its incompatibility. LPS as a simpler and easier guidance is designed for a better fit into the empowering framework of the MCA. The best interests approach is valuable exercise for the decision-maker.

Conclusion

The MCA is an important legal instrumental in neuropsychiatry. However, many challenges remain in the steps toward decision-making. Applications of legal frameworks are not necessarily always about the restriction of rights but rather a best interest’s mechanism to protect those lacking capacity to decide for themselves.
7 Dissociating dimensions of interoception in neuropsychiatry
Authors: Garfinkel Sarah
Published: December 2022

Sarah Garfinkel is Professor at the Institute of Cognitive Neuroscience, University College London (UCL), where she leads the Clinical and Affective Neuroscience Group. She completed her PhD at the University of Sussex, a training fellowship in Psychiatry and Neuroscience at the University of Michigan and her first faculty position at the Brighton and Sussex Medical School. Her research focuses on brain-body interactions in different clinical conditions. In 2018, Sarah was named by the journal Nature as one of 11 ‘Rising Star’ researchers and in 2021 she was awarded the Mid-Career Prize in Cognitive Neuroscience by the British Association for Cognitive Neuroscience.

Cognitive and emotional processes are shaped by the dynamic integration of brain and body. A major channel of interoceptive information comes from the heart, where phasic signals are conveyed to the brain to indicate how fast and strong the heart is beating. This talk will detail how cardiac afferent signals can interact with neuronal mechanisms to alter emotion processing. This interoceptive channel is disrupted in distinct ways in neuropsychiatric conditions; specific interoceptive disturbances may contribute to our understanding of symptoms in these clinical conditions, including changes in emotion, dissociation and anxiety. The discrete cardiac effects on emotion and cognition have broad relevance for clinical neuroscience, with implications for peripheral treatment targets and behavioural interventions focused on the heart.
9 Psychopathology & the nature of the Self
Authors: Oyebode Femi
Published: December 2022

Femi Oyebode graduated from University of Ibadan with distinction in Medicine in 1977 & trained as a psychiatrist in Newcastle-Upon-Tyne. He has been Consultant Psychiatrist in Birmingham since 1986 & retired in 2021. He has been Honorary Professor of Psychiatry at the University of Birmingham since 1999. He was Head of Department of Psychiatry from 2003–2009. He is Honorary Professor, Department of Anthropology & African Studies University of Birmingham. He is Associate Editor the British Journal of Psychiatry, & on the Editorial Boards of BJPsych Bulletin and BJPsych Advances. He was Chief Examiner of the Royal College of Psychiatrists from 2002 to 2005. He has been ASB Visiting Professor at University of Auckland, Raine Visiting Professor at University of Western Australia, & Visiting Professor University of Ibadan. His research interests include clinical psychopathology, delusional misidentification syndromes, medical humanities and medical ethics. He is author of Sims’ Symptoms in the Mind (4–6th editions), Psychopathology of Rare and Unusual Syndromes, Madness and the Theatre and edited Mindreadings: Literature and Psychiatry. He is also a poet and literary critic. His volumes of poetry include Naked to your softness & other dreams, Master of the Leopard Hunt and Adagio for Oblong Mirrors. He contributed critical essays to the Oxford Companion to 20th century Poetry and Oxford Companion to Modern Poetry. He received the Royal College of Psychiatrists’ Lifetime Achievement Award in 2016 and the highest award of the Royal College of Psychiatrists, the Honorary FRCPsych., in 2019.

Psychopathology is the systematic study of abnormal psychological experience and includes the precise description, definition and categorisation of abnormal phenomena. In this lecture I will focus on the potential role of psychopathology as a means of revealing the underlying brain processes that make possible our experience of reality. I will examine phantom limb phenomenon, Charles Bonnet Syndrome, musical hallucinations and autoscopy to illustrate and develop my thesis. My ultimate aim is to demonstrate that the value of psychopathology is over and above the merely descriptive and that its value includes theorising about neural mechanisms.
Examining associations of e-cigarette flavour restrictions with e-cigarette use and success quitting smoking among US adults
Authors: Bold Krysten W , Krishnan-Sarin Suchitra , O'Malley Stephanie , Morean Meghan E
Published: December 2022

Introduction

Restricting available e-cigarette flavours to only tobacco and menthol may reduce appeal among youth; it is unknown how flavour restrictions impact adults using e-cigarettes to quit smoking cigarettes.

Methods

Online US survey data were collected in summer 2021 from 857 adults who reported using e-cigarettes in a recent attempt to quit smoking. Survey items assessed e-cigarette flavours used during their quit attempt, whether e-cigarette flavour bans restricted access to flavours they like, and what impact the restrictions had on e-cigarette behaviour. Multivariable logistic regression models were used to examine the associations of flavour bans with success quitting smoking for 1 month or longer.

Results

30.2% (N=259) reported restricted access to e-cigarette flavours they like. During their quit attempt, 64.9% (N=168) used tobacco or menthol-flavoured e-cigarettes, and 90.7% (N=235) used another flavour that could be affected by restrictions, most commonly fruit, mint, and candy/dessert. Responses to flavour restrictions included switching devices to continue using preferred flavours (39.4%), using the same device only with available flavours (35.9%), buying preferred flavours elsewhere (eg, online) (19.3%), making flavours (3.5%) and ‘other’ (eg, no longer using e-cigarettes) (1.9%). The odds of quitting smoking for 1 month or longer were not significantly different between those experiencing flavour restrictions (vs not), preferring tobacco/menthol (vs restricted) flavour, or switching flavours in response to the bans (vs finding another way to obtain restricted flavours) (p>0.11).

Conclusion

Experiencing e-cigarette flavour restrictions was not associated with success quitting smoking among adults using e-cigarettes to try to quit.
Development of quick seismic evaluation procedure for existing buildings in Canada
Authors: Fathi-Fazl Reza , Fazileh Farrokh , Cai Zhen , Cortés-Puentes W. Leonardo
Published: December 2022

The National Research Council Canada (NRC) is currently developing seismic evaluation and upgrading guidelines for existing buildings in Canada. The seismic evaluation guidelines consist of three tiers of seismic evaluation procedures, that is, Tier 1 Quick Evaluation, Tier 2 Deficiency-Based Evaluation, and Tier 3 Detailed Evaluation. This paper presents the Tier 1 Quick Evaluation procedure, which aims to update the initial quick evaluation procedure in the existing seismic evaluation guidelines developed by the NRC in early 1990s. The proposed procedure covers seismic assessment of both structural and non-structural elements, and requires the review of construction documents, on-site inspection, and calculations. A set of checklists are contained to uncover potential key seismic deficiencies of the building under evaluation. The checklists are in the form of evaluation statements that relate to potential seismic deficiencies in the structural systems and non-structural components. The proposed procedure is demonstrated by conducting the seismic evaluation of an existing building that is part of a pilot study.
Three-dimensional thermoelastic analysis of a functionally graded truncated conical shell with piezoelectric layers
Authors: Mehditabar Aref , Razmkhah Sajjad , Sadrabadi Saeid Ansari , Peng Xiongqi , Yuan Sichen , Abot Jandro L.
Published: December 2022

In this study, three-dimensional thermoelastic behavior of a functionally graded (FG) truncated conical shell with piezoelectric layers perfectly bonded to its inner and outer surfaces under electro–thermo–mechanical loads is investigated. The material properties of the FG truncated conical shell are assumed to be graded along the thickness according to a power-law function while the Poisson’s ratio is considered constant. The differential quadrature method (DQM) is utilized to obtain numerical results. The findings of this method are compared with the results published in the literature and excellent agreement with significantly fast convergence is shown. Parametric studies are performed to demonstrate the effects of the FG grading index, edge boundary conditions, semi-vertex angle of the shell, and thickness of the piezoelectric layers on the distribution of stress components, displacements, and electric potential.
Electrocardiography (ECG) analysis using MATLAB
Authors: Subhani Sheraz Arif
Published: December 2022

The purpose our work is to analyze and study the waveform of the Electrocardiograph (ECG). Basically, ECG signal is the electrical activity of the heart over a period. So, by analysis of the Electrocardiograph signal we get the condition of heart. We can do this by numerous methods for the detection of the cardiac diseases for example, Wavelet Transform, FFT (Fast Fourier Transformers) as well as MATLAB etc. But currently, we only do this on MATLAB that’s multipurpose tool. MATLAB is multipurpose software that’s very efficiently by using its different techniques and algorithms we can find out the abnormalities that’s present in Electrocardiograph signal.
Clinical Outcomes of Soft Tissue Sarcoma around the Elbow Joint: A Retrospective Single Institution Study
Authors: Azurin Edelyn S. , Yamamoto Norio , Hayashi Katsuhiro , Takeuchi Akihiko , Tada Kaoru , Miwa Shinji , Igarashi Kentaro , Higuchi Takashi , Yonezawa Hirotaka , Morinaga Sei , Asano Yohei , Saito Shiro , Tsuchiya Hiroyuki
Published: December 2022

Background. We report a retrospective case series analysis of clinical outcomes of patients with soft tissue sarcoma around the elbow. Methods. Twenty-two patients underwent surgical tumor excision between January 1999 and May 2017, with a mean follow-up of 85.2 months. Results. Six tumors were localized in the upper arm, nine in the elbow, and seven in the forearm. Sixteen tumors were deep-seated, and six were superficially located. Fifteen patients underwent wide excision, including one amputation, and 18 achieved (81.8%) negative margins histologically. Two local recurrences and four distant metastases developed. The mean Musculoskeletal Tumor Society score was 92.0% (range, 33.3–100). The 5-year local recurrence-free survival rate, metastasis-free survival rate, and overall survival rate were 90.0%, 77.0%, and 79.7%, respectively. Conclusions. Local control and limb function can have favorable outcomes when the tumor excised has a histologically negative margin without sacrificing the major structure.
The Use of Simulated Patients Is more Effective than Student Role Playing in Fostering Patient‐Centred Attitudes during Communication Skills Training: A Mixed Method Study
Authors: Gorski Stanislaw , Prokop-Dorner Anna , Pers Michal , Stalmach-Przygoda Agata , Malecki Łukasz , Cebula Grzegorz , Bombeke Katrien
Published: December 2022

Objective. While simulated patients (SPs) are considered a standard tool in communication skills training, there is no evidence thus far of their comparative benefit to the more cost‐effective option of student role playing. We compared the effectiveness of both approaches in developing patient‐centred attitudes in students. Methods. We retrospectively compared students who participated in the clinical communication course (CCC), based on student role playing (CCCsp‐, n = 160), to students who participated in the CCC with SPs (CCCsp+, n = 146), and students with no formal CCC (CCC‐, n = 122). We used validated questionnaires to assess patient centredness. We also conducted focus group interviews (FGI) to better understand the impact of CCC with sp. Results. Students after the CCC with simulated patients achieved a significantly higher score in the patient‐practitioner orientation scale than other groups (p < 0.001). Conclusions. There is a strong positive correlation between the implementation of simulated patients and patient‐centred attitudes among students. Data from the FGI revealed that students perceived training with SP as more realistic, safe, and engaging than student role playing. Practice Implications. Our research provides evidence to justify costs and resources invested in simulated patient programs.
Estimation of Vehicle Dynamic Response from Track Irregularity Using Deep Learning Techniques
Authors: Yang Fei , Hao Xiaoli , Zhang Hang , Jiang Jie , Fan Zhixing , Wei Zilong
Published: December 2022

To improve the quality of track maintenance work, it is a desire to estimate vehicle dynamic behavior from track geometry irregularities. This paper proposes a deep learning model to predict vehicle responses (e.g., vertical wheel-rail forces, wheel unloading rate, and car body vertical acceleration) using deep learning techniques. In the proposed CA-CNN-MUSE model, convolutional neural networks (CNNs) are used to learn features of track irregularities, and multiscale self-attention mechanisms (MUSE) are employed to capture the long-term and short-term trends of sequences. Coordinate attention (CA) is introduced into CNN to focus on important interchannel relationships and important spatial mileage points. The experiments were performed on a multibody simulation model of the vehicle system and the measured data of the actual high-speed line. The results show that the CA-CNN-MUSE has high prediction accuracy for vertical vehicle responses and fast computation speed. The predicted time-domain waveforms and power spectral densities (PSDs) agree well with the actual vehicle responses. The main features of the lateral vehicle responses can also be captured by the proposed method, yet the results are not as good as the vertical ones.
Clinical Outcomes Based on the Attainment of Low-Density Lipoprotein Cholesterol Targets in Patients with Acute Coronary Syndrome in Real-World Practice
Authors: Lee Wei-Chieh , Tsai Yi-Hsuan , Hsieh Yun-Yu , Fang Yen-Nan , Fang Chih-Yuan , Wu Po-Jui , Chen Huang-Chung , Liu Ping-Yen , Fang Hsiu-Yu
Published: December 2022

Objective. A target of low-density lipoprotein cholesterol (LDL-C) <70 mg/dL or ≥50% reduction should be set. This study aimed to explore the information required to attain the optimal goal of lipid control for patients with ACS in real-world practice using big database analysis. Methods. Patients with ACS were enrolled between January 2005 and December 2019, and their medical history was obtained from the Chang Gung Research database. According to the attainment of LDL-C levels, the study population was divided into groups with and without ≥50% reduced LDL-C levels. In the group that achieved ≥50% reduced LDL-C levels, the study population was subdivided into groups with and without achievement of LDL-C level < 70 mg/dL. Results. This study enrolled 14,520 participants, out of whom only 3,367 patients (23.2%) achieved ≥50% reduced LDL-C levels. At the 3-year follow-up periods, higher incidences of cardiovascular (CV) mortality and all-cause mortality were absorbed in patients without ≥50% reduced LDL-C levels, especially in subgroups of hypertension and diabetes mellitus (DM). When comparing different percentages of reduced LDL-C levels, the significantly lowest hazard ratio (HR) of CV and all-cause mortality was noted at ≥50% reduced LDL-C levels (CV mortality; HR: 0.64; all-cause mortality; HR: 0.57). Conclusion. In the ACS population, better clinical outcomes were yielded in patients with ≥50% reduced LDL-C levels, especially in the hypertension and DM populations. However, strict lipid control did not show better clinical outcomes in patients with ≥50% reduction and <70 mg/dL in LDL-C levels.
Pancancer Analysis of the Prognostic and Immunotherapeutic Value of Progestin and AdipoQ Receptor 4
Authors: Yang Ziyue , Zhu Yuanyuan , Li Zhenfen , Pu Zhangya , Lin Ying , Deng Ying , Li Ning , Peng Fang
Published: December 2022

AdipoQ receptor 4 (PAQR4) belongs to the family of progestin and AdipoQ receptors. PAQR4 plays an oncogenic role in lung and breast cancer. However, systematic pancancer analyses of PAQR4 have not been performed. The purpose was to investigate the prognostic and immunological significance of PAQR4 across 31 tumor types. Data were obtained from the following sources: TCGA, GEO, UALCAN, TIMER, GEPIA2, KM plotter, and TISIDB databases. The results proved that PAQR4 expression was significantly elevatory in most cancer types. We then explored the utility of PAQR4 as a prognostic indicator across all cancers. Using Cox proportional risk regression models, it has been demonstrated that PAQR4 is an independent risk factor in. High PAQR4 expression was not associated with other prognostic indicators, including overall survival, disease-free interval, disease-specific survival, and progression-free period. Subsequently, we explored the immunological value of PAQR4 and found that PAQR4 expression significantly correlated with tumor mutational burden, microsatellite instability, neoantigen, and immune checkpoint genes in tumors. It also significantly negatively correlated with most tumors’ ESTIMATE scores, indicating that PAQR4 can influence the cellular composition of the tumor microenvironment. Our findings suggest the immunotherapeutic potential of PAQR4 in tumors. Finally, we explored the role of PAQR4 in tumor drug resistance and found that PAQR4 expression affected the sensitivity to multiple chemotherapeutic agents. A significant role for PAQR4 in tumor immunity is evident in these studies, as well as its potential role in cancer diagnosis, prognosis, and treatment precision.
Systems Pharmacology-Based Strategy to Investigate the Mechanism of Ruangan Lidan Decoction for Treatment of Hepatocellular Carcinoma
Authors: Chen Cuilan , Liang Ting , Wu Qihui , Zhou Zheyi , Zhang Mingmin , Feng Dongshan , Tao Jingrui , Si Tao , Cai Min
Published: December 2022

epatocellular carcinoma (HCC) is one of the leading contributors to cancer mortality worldwide. Currently, the prevention and treatment of HCC remains a major challenge. As a traditional Chinese medicine (TCM) formula, Ruangan Lidan decoction (RGLD) has been proved to own the effect of relieving HCC symptoms. However, due to its biological effects and complex compositions, its underlying mechanism of actions (MOAs) have not been fully clarified yet. In this study, we proposed a pharmacological framework to systematically explore the MOAs of RGLD against HCC. We firstly integrated the active ingredients and potential targets of RGLD. We next highlighted 25 key targets that played vital roles in both RGLD and HCC disease via a protein-protein interaction (PPI) network and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Furthermore, an ingredient-target network of RGLD consisting of 216 ingredients with 306 targets was constructed, and multilevel systems pharmacology analyses indicated that RGLD could act on multiple biological processes related to the pathogenesis of HCC, such as cellular response to hypoxia and cell proliferation. Additionally, integrated pathway analysis of RGLD uncovered that RGLD might treat HCC through regulating various pathways, including MAPK signaling pathway, PI3K/Akt signaling pathway, TNF signaling pathway, and ERBB signaling pathway. Survival analysis results showed that HCC patients with low expression of VEGFA, HIF1A, CASP8, and TOP2A were related with a higher survival rate than those with high expression, indicating the potential clinical significance for HCC. Finally, molecular docking results of core ingredients and targets further proved the feasibility of RGLD in the treatment of HCC. Overall, this study indicates that RGLD may treat HCC through multiple mechanisms, which also provides a potential paradigm to investigate the MOAs of TCM prescription.
S. gallolyticus Aortic Valve Endocarditis with Mitral Valve Leaflet Aneurysm
Authors: Poddi S. , Tropea I. , Faggian G. , De Feo S. , Zordan M. , Rungatscher A.
Published: December 2022

S. gallolyticus is one of the pathogenic agents of endocarditis, and mitral valve aneurysm is a rare but potentially devastating complication. We present a case of S. gallolyticus aortic valve endocarditis with concomitant anterior mitral valve leaflet aneurysm. Patient underwent surgery before aneurysm perforation, and postoperative course was uneventful. Time of surgery is crucial to avoid severe complications due to aneurysm rupture.
Clinical Effect of Photobiomodulation on Wound Healing of Diabetic Foot Ulcers: Does Skin Color Needs to Be Considered?
Authors: Dhlamini Thabo , Houreld Nicolette Nadene
Published: December 2022

Diabetic foot ulcers (DFUs) are one of the most common complications of diabetes. DFUs impede patients’ quality of life and are known to be unresponsive to conventional therapy. Photobiomodulation (PBM) is a pain-free, noninvasive treatment method that has been shown to promote chronic wound healing and has been successfully used for the treatment of DFUs. Since skin tone and color can affect the way light interacts with tissue, studies should take this into consideration when determining protocols for the use of PBM. This review is aimed at critically evaluating data of existing studies conducted to evaluate the clinical effect of PBM on DFUs, taking skin color into consideration. A literature search was conducted and resulted in articles on cell studies, animal studies, and clinical trials. Only 13 clinical trials and 2 clinical case studies were adopted and used in this review. All the clinical trials adopted for this review show evidence that PBM together with conventional treatment results in an increased healing rate of DFUs; however, only one study adjusted their protocol according to skin color. There are not enough studies conducted on people of color to determine the safety and efficacy of PBM therapy in such ethnic groups. Future randomized, placebo-controlled clinical trials are necessary on PBM and DFUs and should take skin color into consideration.
Carriage of Ser217Leu and Ala541Thr Variants of ELAC2 Gene and Risk Factors in Patients with Prostate Cancer in Burkina Faso
Authors: Traoré Aïda Djé Djénèba , Ky Bienvenu Désiré , Traoré Lassina , Zohoncon Théodora M. , Zouré Abdou Azaque , Yonli Albert Théophane , Sombié Herman Karim , Sorgho Pegdwendé Abel , Elvira Bazié Bapio Valery Jean Télesphore , Tovo Sessi Frida Appoline , Kadanga Essonan , Bakyono Bélélé Siméon , Traore Kalifou , Ouédraogo Teega-Wendé Clarisse , Djigma Florencia W. , Simpore Jacques
Published: December 2022

Background. Genetic factors are one of the significant contributors to prostate cancer (PCa) development, and hereditary prostate cancer 2 (HPC2) locus gene ELAC2 is considered a PCa susceptibility region. The HPC2/ELAC2 gene has been identified by linkage analysis in familial prostate cancer patients in the United States but has never been studied in Burkina Faso. The objective of the present study was to analyze the carriage of the C650T (Ser217Leu) and G1621A (Ala541Thr) mutations of the ELAC2 gene and the risk factors in prostate cancer patients in Burkina Faso. Methods. This case-control study included 76 participants, including 38 histologically confirmed prostate cancer cases and 38 healthy controls without prostate abnormalities. PCR combined with restriction fragment length polymorphism (RFLP) was used to characterize the genotypes of the Ser217Leu and Ala541Thr polymorphisms of the ELAC2 gene. The correlations between the different genotypes and risk factors for prostate cancer were investigated. Results. The C650T mutation was present in 44.73% of prostate cancer cases and 47.37% of controls. The G1621A mutation was present in 26.32% of prostate cancer cases and 15.79% of controls. We did not detect an association between prostate cancer risk and the Ser217Leu (

p
=
0.972

) and Ala541Thr (

p
=
0.267

) variants of the ELAC2 gene. Also, the two ELAC2 SNPs did not correlate with clinical stage, prostate-specific antigen (PSA) level at diagnosis, or the Gleason score on biopsies. However, we found that 100% of homozygous carriers of the T650 mutation have an A1621 mutation (

p
≤
0.001

). Conclusion. Ser217Leu and Ala541Thr polymorphisms of ELAC2, considered alone or in combination, are not associated with prostate cancer risk.
Boron-Doped Graphene Quantum Dots (BGQDs) from Spent Coffee Ground for Glucose Sensor
Authors: Hadish Filimon , Chiang Meng-Hsuan , Hsieh Yi-Fang , Wu Shao-Yu , Jou Shyankay
Published: December 2022

We have prepared graphene quantum dots (GQDs) and boron-doped GQDs (BGQDs) utilizing spent coffee grounds (SCGs) via a simple one-step hydrothermal process for glucose sensor application. FTIR and XPS characterizations reveal that the boron atoms have been successfully doped into graphene structures. BGQDs on glassy carbon electrode (GCE) in PBS were found to be two times as active compared to GCE/GQDs electrodes. The significant difference in electrochemical activity shown by BGQDs is evidence that boron from boric acid was doped into the graphene dominion. The generation of boronic acid groups on the boron-doped graphene quantum dots (BGQDs) surfaces facilitates the application of GQDs as a new photoluminescence (PL) probe for label-free glucose sensing. The photoluminescence of developed GQDs showed a linear response to glucose over a concentration range of 5–45 mM with a limit of detection of 12.45 mM whereas BGQDs biosensor was found to exhibit a higher sensitivity over the same concentration range with limit of detection of 3.23 mM towards glucose sensing. These results demonstrate that the synthesized BGQD has a promising potential in electrochemical activity and efficient to the PL enhancement mechanism determination of glucose.
A Trust Scale for Human-Robot Interaction: Translation, Adaptation, and Validation of a Human Computer Trust Scale
Authors: Pinto Ana , Sousa Sónia , Simões Ana , Santos Joana
Published: December 2022

Recently there has been an increasing demand for technologies (automated and intelligent machines) that brings benefits to organizations and society. Similar to the widespread use of personal computers in the past, today’s needs are towards facilitating human-machine technology appropriation, especially in highly risky and regulated industries like robotics, manufacturing, automation, military, finance, or healthcare. In this context, trust can be used as a critical element to instruct how human-machine interaction should occur. Considering the context-dependency and multidimensional trust, this study seeks to find a way to measure the effects of perceived trust in a collaborative robot (cobot), regardless of its literal credibility as a real person. This article aims at translating, adapting, and validating a Human-Computer Trust Scale (HCTM) in human-robot interaction (HRI) context and its application to cobots. The Human-Robot Interaction Trust Scale (HRITS) involved 239 participants and included eleven items. The 2nd order CFA with a general factor called “trust” have proven to be empirically robust (

CFI
=
.94

;

TLI
=
.93

;

SRMR
=
.04

; and

RMSEA
=
.05

) [

CR
=
.84

;

AVE
=
.58

, and

MaxR

H

=
.92

]; results indicated a good measurement of the general factor trust, and the model satisfied the criteria for measure trust. An analysis of the differences in perceptions of trust by gender was conducted using a

t

-test. This analysis showed that statistical differences by gender exist (

p
=
.04

). This study’s results allowed for a better understanding of trust in HRI, specifically regarding cobots. The validation of a Portuguese scale for trust assessment in HRI can give a valuable contribution to designing collaborative environments between humans and robots.
UAV Path Planning in Dynamical Environment: A Novel ICACO-IDWA Algorithm
Authors: Yu Jiayang , Guo Jiansheng , Zhang Xiaofeng , Zhou Chuhan , Xie Tao
Published: December 2022

In this paper, a novel UAV path planning algorithm based on improved cellular ant colony algorithm and dynamic window algorithm (ICACO-IDWA) is proposed to solve the problem of dynamically changing threat during actual flight. The main innovations of this paper are as follows. (a) The hexagon grid method is proposed to model the UAV flight space, which solves the problem of inconsistent simulation time step. (b) A novel ICACO-IDWA algorithm is proposed. In the first stage, the optimal path is obtained by the improved cellular ant colony algorithm (ICACO). In the second stage, the improved dynamic window algorithm (IDWA) is used to optimize the optimal path considering dynamic threat. Through the algorithm, the UAV path planning with dynamic threat change is realized. Finally, simulation results verify the effectiveness of the proposed model and algorithm.
Anti-SARS-Cov-2 S-RBD IgG Formed after BNT162b2 Vaccination Can Bind C1q and Activate Complement
Authors: Abu-Humaidan Anas H. A. , Ahmad Fatima M. , Awajan Dima , Jarrar Raba’a F. , Alaridah Nader
Published: December 2022

Background. The ability of vaccine-induced antibodies to bind C1q could affect pathogen neutralization. In this study, we investigated C1q binding and subsequent complement activation by anti-spike (S) protein receptor-binding domain (RBD) specific antibodies produced following vaccination with either the mRNA vaccine BNT162b2 or the inactivated vaccine BBIBP-CorV. Methods. Serum samples were collected in the period of July 2021-March 2022. Participants’ demographic data, type of vaccine, date of vaccination, as well as adverse effects of the vaccine were recorded. The serum samples were incubated with S protein RBD-coated plates. Levels of human IgG, IgA, IgM, C1q, and mannose-binding lectin (MBL) that were bound to the plate, as well as formed C3d, and C5b-9 were compared between different groups of participants. Results. A total of 151 samples were collected from vaccinated (

n
=
116

) and nonvaccinated (

n
=
35

) participants. Participants who received either one or two doses of BNT162b2 formed higher levels of anti-RBD IgG and IgA than participants who received BBIBP-CorV. The anti-RBD IgG formed following either vaccine bound C1q, but significantly more C1q binding was observed in participants who received BNT162b2. Subsequently, C5b-9 formation was significantly higher in participants who received BNT162b2, while no significant difference in C5b-9 formation was found between the nonvaccinated and BBIBP-CorV groups. The formation of C5b-9 was strongly correlated to C1q binding and not to MBL binding, additionally, the ratio of formed C5b-9/bound C1q was significantly higher in the BNT162b2 group. Conclusion. Anti-RBD IgG formed following vaccination can bind C1q with subsequent complement activation, and the degree of terminal complement pathway activation differed between vaccines, which could play a role in the protection offered by COVID-19 vaccines. Further investigation into the correlation between vaccine protection and vaccine-induced antibodies’ ability to activate complement is required.
Hepatorenal Protective Effects of Hydroalcoholic Extract of Solidago canadensis L. against Paracetamol-Induced Toxicity in Mice
Authors: Rahimi Omid , Asadi Louie Nilufar , Salehi Alireza , Faed Maleki Firouz
Published: December 2022

Paracetamol (AKA acetaminophen) is a widely used drug and is used for mild to moderate pains, such as mild osteoarthritis, toothache, headache, and pain caused by minimally invasive surgeries. Despite being a harmless drug in lower doses, acetaminophen can be toxic to the liver and kidneys if overdosed and even results in death. In this study, the therapeutic effects of Solidago canadensis L. extract (SCE) were investigated. 48 adult male Swiss albino mice (20–30 grams) were randomly divided into six groups of 8. The control group was gavaged with normal saline every 12 hours for 6 days. The second group received paracetamol at a 500 mg/kg intraperitoneally (i.p) dose on the sixth day. The third, fourth, and fifth groups were gavaged doses of 125, 250, and 500 mg/kg of SCE every 12 hours for six days, respectively, and on the sixth day, we received paracetamol at a dose of 500 mg/kg i.p. The sixth group only received SCE every 12 hours at a dose of 1000 mg/kg via gavaging for six days. On the seventh day (24 hours after paracetamol injection), blood samples were collected to measure the serum level of creatinine, uric acid, blood urea nitrogen (BUN), total protein, albumin, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and total and direct bilirubin, and liver and kidney tissues were also sampled for histopathological examination. It was observed that paracetamol caused a considerable increase in the ALT, AST, ALP, uric Acid, and BUN levels (

P
<
0.01

), while those in SCE-treated groups were significantly lower. In addition, various lesions in the paracetamol group were observed, while in the SCE-receiving groups, receiving prophylactic SCE inhibited the high-intense lesions such as the infiltration of inflammatory cells, hyperemia, and vacuolar degeneration, which decreased significantly in the control group in comparison with that of the paracetamol group (

P
<
0.05

). In conclusion, SCE can have substantial protective effects against paracetamol’s hepatorenal toxicity.