bluuebunny/crossref_metadata_2025 huggingface dataset:
Metacognitive accuracy differences in Parkinson’s disease and REM sleep behavioral disorder relative to healthy controls
Authors: Bălăeţ Maria , Alhajraf Falah , Bourke Niall J. , Welch Jessica , Razzaque Jamil , Malhotra Paresh , Hu Michele T. , Hampshire Adam
Published: May 2024

Background

Metacognition is the ability to monitor and self-assess cognitive performance. It can be impaired in neurodegenerative diseases, with implications for daily function, and the ability of patients to reliably report their symptoms to health professionals. However, metacognition has not been systematically assessed in early-mid stage Parkinson’s disease (PD) and REM sleep behavioral disorder (RBD), a prodrome of PD.

Objectives

This study aimed to evaluate metacognitive accuracy and self-confidence in PD and RBD patients across various cognitive tasks.

Methods

We conducted detailed computerized cognitive assessments with 19 cognitive tasks within an established PD and RBD cohort. Participants self-rated their performance post-task. Metacognitive accuracy was calculated by comparing these ratings against objective performance and further analyzed against clinical and mental health factors.

Results

PD and RBD patients’ metacognitive accuracy aligned with control subjects. However, they exhibited lower confidence across cognitive domains, reflecting their reduced cognitive performance. A notable inverse correlation was observed between their confidence and MDS-UPDRS I and II scales and HADS anxiety and depression scores.

Conclusion

Our findings indicate that patients with early to mid-stage PD and RBD are generally aware of their cognitive status, differing from other neurological disorders. The inverse relationship between patient confidence and symptoms of depression, anxiety, and daily life challenges underscores the impact of emotional and functional difficulties on their self-perception of cognitive abilities. This insight could be significant for understanding how these conditions affect mental health, aiding clinicians in developing more effective patient care strategies.
Association between blood pressure control during aneurysm clipping and functional outcomes in patients with aneurysmal subarachnoid hemorrhage
Authors: Han Xiangning , Luo Guogang , Li Jiahao , Liu Rui , Zhu Ning , Jiang Shiliang , Ma Wenlong , Cheng Yawen , Liu Fude
Published: May 2024

Objectives

We explored the relationship between blood pressure variability (BPV) during craniotomy aneurysm clipping and short-term prognosis in patients with aneurysmal subarachnoid hemorrhage to provide a new method to improve prognosis of these patients.

Methods

We retrospectively analyzed the differences between patient groups with favorable modified Rankin Scale (mRS ≤ 2) and unfavorable (mRS > 2) prognosis, and examined the association between intraoperative BPV and short-term prognosis.

Results

The intraoperative maximum systolic blood pressure (SBPmax, p = 0.005) and the coefficient of variation of diastolic blood pressure (DBPCV, p = 0.029) were significantly higher in the favorable prognosis group. SBPmax (OR 0.88, 95%CI 0.80–0.98) and Neu% (OR 1.22, 95%CI 1.03–1.46) were independent influence factors on prognosis. Patients with higher standard deviations of SBP (82.7% vs. 56.7%; p = 0.030), DBP (82.7% vs. 56.7%; p = 0.030), and DBPCV (82.7% vs. 56.7%; p = 0.030) had more favorable prognosis.

Conclusion

Higher SBPmax (≤180 mmHg) during the clipping is an independent protective factor for a 90-day prognosis. These results highlight the importance of blood pressure (BP) control for improved prognosis; higher short-term BPV during clipping may be a precondition for a favorable prognosis.
PyHySCO: GPU-enabled susceptibility artifact distortion correction in seconds
Authors: Julian Abigail , Ruthotto Lars
Published: May 2024

Over the past decade, reversed gradient polarity (RGP) methods have become a popular approach for correcting susceptibility artifacts in echo-planar imaging (EPI). Although several post-processing tools for RGP are available, their implementations do not fully leverage recent hardware, algorithmic, and computational advances, leading to correction times of several minutes per image volume. To enable 3D RGP correction in seconds, we introduce PyTorch Hyperelastic Susceptibility Correction (PyHySCO), a user-friendly EPI distortion correction tool implemented in PyTorch that enables multi-threading and efficient use of graphics processing units (GPUs). PyHySCO uses a time-tested physical distortion model and mathematical formulation and is, therefore, reliable without training. An algorithmic improvement in PyHySCO is its use of the one-dimensional distortion correction method by Chang and Fitzpatrick to initialize the non-linear optimization. PyHySCO is published under the GNU public license and can be used from the command line or its Python interface. Our extensive numerical validation using 3T and 7T data from the Human Connectome Project suggests that PyHySCO can achieve accuracy comparable to that of leading RGP tools at a fraction of the cost. We also validate the new initialization scheme, compare different optimization algorithms, and test the algorithm on different hardware and arithmetic precisions.
High sodium intake and fluid overhydration predict cardiac structural and functional impairments in chronic kidney disease
Authors: Duan Suyan , Ma Yuchen , Lu Fang , Zhang Chengning , Guo Honglei , Zeng Ming , Sun Bin , Yuan Yanggang , Xing Changying , Mao Huijuan , Zhang Bo
Published: May 2024

Background

High sodium intake and fluid overhydration are common factors of and strongly associated with adverse outcomes in chronic kidney disease (CKD) patients. Yet, their effects on cardiac dysfunction remain unclear.

Aims

The study aimed to explore the impact of salt and volume overload on cardiac alterations in non-dialysis CKD.

Methods

In all, 409 patients with CKD stages 1–4 (G1–G4) were enrolled. Daily salt intake (DSI) was estimated by 24-h urinary sodium excretion. Volume status was evaluated by the ratio of extracellular water (ECW) to total body water (TBW) measured by body composition monitor. Recruited patients were categorized into four groups according to DSI (6 g/day) and median ECW/TBW (0.439). Echocardiographic and body composition parameters and clinical indicators were compared. Associations between echocardiographic findings and basic characteristics were performed by Spearman’s correlations. Univariate and multivariate binary logistic regression analysis were used to determine the associations between DSI and ECW/TBW in the study groups and the incidence of left ventricular hypertrophy (LVH) and elevated left ventricular filling pressure (ELVFP). In addition, the subgroup effects of DSI and ECW/TBW on cardiac abnormalities were estimated using Cox regression.

Results

Of the enrolled patients with CKD, the median urinary protein was 0.94 (0.28–3.14) g/d and estimated glomerular filtration rate (eGFR) was 92.05 (IQR: 64.52–110.99) mL/min/1.73 m2. The distributions of CKD stages G1–G4 in the four groups was significantly different (p = 0.020). Furthermore, compared to group 1 (low DSI and low ECW/TBW), group 4 (high DSI and high ECW/TBW) showed a 2.396-fold (95%CI: 1.171–4.902; p = 0.017) excess risk of LVH and/or ELVFP incidence after adjusting for important CKD and cardiovascular disease risk factors. Moreover, combined with eGFR, DSI and ECW/TBW could identify patients with higher cardiac dysfunction risk estimates with an AUC of 0.704 (sensitivity: 75.2%, specificity: 61.0%). The specificity increased to 85.7% in those with nephrotic proteinuria (AUC = 0.713). The magnitude of these associations was consistent across subgroups analyses.

Conclusion

The combination of high DSI (>6 g/d) and high ECW/TBW (>0.439) independently predicted a greater risk of LVH or ELVFP incidence in non-dialysis CKD patients. Moreover, the inclusion of eGFR and proteinuria improved the risk stratification ability of DSI and ECW/TBW in cardiac impairments in CKD.
Exploring the clinical complexity of cardio-facio-cutaneous syndrome: insights from a pediatric case series
Authors: Ou Yuexu , Cao Jie , Duan Yuanhui , Chen FengHua , Zhou Jiwei , Li Jieling , Gan Xiaoming
Published: May 2024

Background

Cardio-Facio-Cutaneous syndrome (CFCS) is a rare autosomal dominant genetic disorder primarily caused by BRAF gene mutations, posing diagnostic challenges due to its multifaceted clinical presentation.

Objective

To elucidate the clinical characteristics of pediatric CFCS patients, expanding the phenotypic spectrum to enhance early diagnostic capabilities, while also presenting the relationship between genotye and corresponding phenotype severity.

Methods

From January 2015 to March 2022, four children diagnosed with CFCS in Children's Hospital of Chongqing Medical University were included for analysis. Whole exome sequencing (WES) was conducted to identify the types and locations of possible gene mutations. Neurological development was assessed using electroencephalography (EEG), magnetic resonance imaging (MRI) and Gesell developmental evaluation.

Results

All four CFCS patients exhibited de novo BRAF gene mutations, manifesting with cardiac malformations, distinctive facial features, skin and hair changes, and neurological abnormalities. WES revealed that the specific BRAF mutations were closely linked to their clinical severity. Three patients displayed milder symptoms (case 1–3, genotype I or II), demonstrating stability or slight improvement, whereas one patient (case 4, genotype III) suffered from a severe phenotype characterized by profound neurological and digestive system impairments, leading to a significantly reduced quality of life and a grim prognosis.

Conclusion

In CFCS patients, severe developmental delay and seizures are predominant neurological features, possibly accompanied by continuous spike-and-wave during sleep (CSWS) and severe sleep disturbances. CFCS generally carries a poor prognosis, underscoring the importance of disease awareness and early genetic testing.
Cardiac sympathetic overdrive, M2 macrophage activation and fibroblast heterogeneity are associated with cardiac remodeling in a chronic pressure overload rat model of HFpEF
Authors: Sun Fengjiao , Yuan Ling , Wang Zi , Cui Xiaoxue , Lv Nan , Zhang Ting , Zhang Yan , Cai Jun
Published: May 2024

Heart failure with preserved ejection fraction (HFpEF) is a multifaceted pathogenesis disease and the exact mechanisms driving HFpEF have not been completely elucidated. Pressure overload hypertrophy (POH) related fibroblasts and M2 macrophages in HFpEF myocardium have been recently identified and are now of great interest. Sympathetic overdrive has also been implicated in HFpEF. This study is designed to dynamically observe the potential roles of aforementioned mechanisms in pathological remodeling and cardiac dysfunction in chronic PO rats. Surgical constriction of the abdominal aorta was used for induction of HFpEF. Echocardiography, electrocardiogram, hemodynamic measurement, hematoxylin and eosin staining, Masson staining, immunohistochemistry and immunofluorescence were performed to assess the changes in heart dysfunction, cardiac remodeling and driving mechanisms at different time points (2, 18, 24 weeks). The PO induced HFpEF model was well established, which was confirmed by the persistent increase in carotid artery systolic and diastolic blood pressure, and left ventricle hypertrophy at the corresponding postoperative stage. Meanwhile, PO hypertrophy gradually developed into HFpEF, associated with QT and QTc intervals prolongation, normal systolic (EF was maintained at >50%) but impaired diastolic function (increasing LVEDP and LV -dP/dtmin, abnormal E/A ratio), increased myocytes size, and observed relatively slight inflammatory infiltration but robust reactive fibrosis. IHC staining further confirmed that macrophages (CD68) but not neutrophils (MPO) or T cells (CD3) accounted for a predominant proportion of infiltrating cells. Mechanistically, we found that the infiltrating macrophages in the heart expressed high levels of CD206 which was simultaneously adjacent to POH fibroblasts appeared to overexpression of α-SMA in PO rats at late stages. Interestingly, we distinguished two different POHF sub-populations during PO induced HFpEF development, according to non overlapping signals of α-SMA and PDGFRα/β proteins. Additionally, PO led to a pronounced exaggeration in sympathetic fibers at all time points. These findings suggest that the establishing model here begins with cardiac sympathetic overdrive, subsequently along with immune cells especially M2 macrophage accumulation and fibroblast heterogeneity at later stages is associated with the development of cardiac maladaptive remodeling and diastolic dysfunction thus further progression to HFpEF.
The value of plasma omega-3 polyunsaturated fatty acids in predicting the response and prognosis of cervical squamous cell carcinoma patients to concurrent chemoradiotherapy
Authors: Ping Pengbin , Li Juan , Xu Xiaoying
Published: May 2024

Background: In recent years, abnormalities in plasma omega-3 polyunsaturated fatty acids (omega-3 PUFAs) have been proven to be related to the risk of cancer, but their prognostic value for cancer is unclear. The purpose of this study was to retrospectively evaluate the response and prognostic significance of plasma omega-3 PUFAs in patients with cervical squamous cell carcinoma (CSCC) treated with concurrent chemoradiotherapy (CCRT). Spearman rank correlation analysis was used to analyze the correlation between omega-3 PUFAs and squamous cell carcinoma antigen (SCC-Ag) levels.

Methods: A total of 89 patients with CSCC who underwent CCRT were evaluated retrospectively. Binary logistic regression analysis was used to analyze the independent predictors related to complete response (CR) after CCRT. A Cox proportional hazard model and Kaplan-Meier analysis were utilized to perform survival analysis.

Results: According to multivariate logistic regression analyses, a high level of plasma EPA was independently correlated with an increased incidence of CR after CCRT (odds ratio (OR), 0.980; 95% confidence interval (CI), 0.962–0.999, p = 0.038). With a median follow-up of 41.3 months, the CSCC patients in the high EPA (≥46.0 nmol/mL) group exhibited longer OS and PFS. According to our multivariate analysis, pretreatment plasma EPA level was an independent prognostic factor for PFS in patients with CSCC who underwent CCRT (hazard ratio (HR), 0.263; 95% CI, 0.089–0.782, p = 0.016). However, it was not an independent prognostic factor of OS. Spearman rank correlation analysis revealed was a negative correlation between pretreatment SCC-Ag (pre SCC-Ag) levels and EPA levels (r = −0.305, p = 0.004), and a weak negative correlation between posttreatment SCC-Ag (post SCC-Ag) levels and EPA levels (r = −0.251, p = 0.018).

Conclusion: Plasma omega-3 PUFAs are related to the response and survival outcome of patients with CSCC who underwent CCRT. Pretreatment plasma EPA levels may be a promising biomarker for predicting the response and prognosis of patients with CSCC who undergo CCRT. In addition, the pretreatment plasma EPA levels presented a negative correlation with the SCC-Ag levels.
Chinese herbal medicine Shufeng Jiedu capsule for mild to moderate COVID-19: a multicenter, randomized, double-blind, placebo-controlled phase II trial
Authors: Lu Chun-li , Yang Liu-qing , Jin Xin-yan , Friedemann Thomas , Li Yu-fei , Liu Xue-han , Chen Xiao-ying , Zou Xiang-yun , Zhang Bing-rui , Wang Fu-xiang , Lin Yuan-long , Tang Yi-min , Cao Meng-li , Jiang Ya-lin , Gao You-fang , Liu Kui , Tao Zhen-gang , Robinson Nicola , Schröder Sven , Liu Jian-ping , Lu Hong-zhou
Published: May 2024

Background: The COVID-19 pandemic has had a profound global impact, although the majority of recently infected cases have presented with mild to moderate symptoms. Previous clinical studies have demonstrated that Shufeng Jiedu (SFJD) capsule, a Chinese herbal patent medicine, effectively alleviates symptoms associated with the common cold, H1N1 influenza, and COVID-19. This study aimed to assess the efficacy and safety of SFJD capsules in managing symptoms of mild to moderate COVID-19 infection.

Methods: A randomized, double-blind, placebo-controlled trial was conducted from May to December 2022 at two hospitals in China. Mild and moderate COVID-19-infected patients presenting respiratory symptoms within 3 days from onset were randomly assigned to either the SFJD or placebo groups in a 1:1 ratio. Individuals received SFJD capsules or a placebo three times daily for five consecutive days. Participants were followed up for more than 14 days after their RT-PCR nucleoid acid test for SARS-CoV-2 turned negative. The primary outcome measure was time to alleviate COVID-19 symptoms from baseline until the end of follow-up.

Results: A total of 478 participants were screened; ultimately, 407 completed the trial after randomization (SFJD, n = 203; placebo, n = 204). No statistically significant difference in baseline parameters was observed between the two groups. The median time to alleviate all symptoms was 7 days in the SFJD group compared to 8 days in the placebo group (p = 0.037). Notably, the SFJD group significantly attenuated fever/chills (p = 0.04) and headache (p = 0.016) compared to the placebo group. Furthermore, the median time taken to reach normal body temperature within 24 h was reduced by 7 hours in the SFJD group compared to the placebo group (p = 0.033). No deaths or instances of serious or critical conditions occurred during this trial period; moreover, no serious adverse events were reported.

Conclusion: The trial was conducted in a unique controlled hospital setting, and the 5-day treatment with SFJD capsules resulted in a 1-day reduction in overall symptoms, particularly headache and fever/chills, among COVID-19-infected participants with mild or moderate symptoms. Compared to placebo, SFJD capsules were found to be safe with fewer side effects. SFJD capsules could potentially serve as an effective treatment for alleviating mild to moderate symptoms of COVID-19.

Clinical Trial Registration: https://www.isrctn.com/, identifier ISRCTN14236594.
Efficacy and safety of anti-angiogenic drug monotherapy and combination therapy for ovarian cancer: a meta-analysis and trial sequential analysis of randomized controlled trials
Authors: Xie Yao , Zhou Fei
Published: May 2024

Background

As the development of novel anti-angiogenic drugs and the continuous evolution of guideline recommendations, the efficacy and safety of anti-angiogenic agents in ovarian cancer (OC) remains unclear. Consequently, a meta-analysis was carried out to assess the efficacy and safety of anti-angiogenic drug monotherapy and combination therapy for OC.

Methods

An exhaustive literature review was performed across multiple databases, including PubMed, Embase, Web of Science, and Cochrane, encompassing all relevant randomized controlled trials (RCTs) up until 6 April 2024. The evaluation of efficacy outcomes incorporated progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Safety was assessed through the occurrence of any grade adverse events (AEs) and grade ≥3 AEs. Synthesis of the data involved the calculation of hazard ratios (HRs), relative risks (RRs), and their corresponding 95% confidence intervals (CIs) and prediction intervals (PIs). Trial sequential analysis was executed employing TSA v0.9.5.10 Beta software, STATA 12.0, and R software 4.3.1.

Results

In this meta-analysis, 35 RCTs were included, encompassing 16,199 subjects in total. The overall analysis indicated that anti-angiogenic drug combination therapy significantly improved PFS (HR [95% CI] = 0.678 [0.606–0.759], 95% PI: 0.415–1.108), OS (HR [95% CI] = 0.917 [0.870–0.966], 95% PI: 0.851–0.984), and ORR (RR [95% CI] = 1.441 [1.287–1.614], 95% PI: 1.032–2.014), but also increased the incidence of grade ≥3 AEs (RR [95% CI] = 1.137 [1.099–1.177], 95% PI: 1.011–1.252). The analysis did not corroborate any benefit of anti-angiogenic monotherapy over placebo concerning PFS (HR [95% CI] = 0.956 [0.709–1.288], 95% PI: 0.345–2.645) and OS (HR [95% CI] = 1.039 [0.921–1.173], 95% PI: 0.824–1.331). However, it was observed that monotherapy with anti-angiogenic drugs did increase the incidence of any grade AEs (RR [95% CI] = 1.072 [1.036–1.109], 95% PI: 0.709–1.592).

Conclusion

Our study confirmed the PFS, OS, and ORR benefits of anti-angiogenic drug combination therapy for OC patients. The efficacy results of anti-angiogenic monotherapy necessitates further evaluation as more RCTs become available. Clinicians should be vigilant of AEs when administering anti-angiogenic agents in a clinical setting.
Investigating the influence of gamification on motivation and learning outcomes in online language learning
Authors: Shen Zijun , Lai Minjie , Wang Fei
Published: May 2024

Introduction

This study investigates the influence of gamification integration on language learning achievement among Chinese students while probing the mediating role of learners' motivation. Furthermore, it extends the boundaries of this investigation by exploring the moderating effect of digital literacy as a psychological predisposition.

Methods

Data is collected through surveys from Chinese students enrolled in linguistic programs, employing a stratified random sampling technique and analyzed via SmartPLS SEM.

Results

The findings affirm the significant and positive impact of gamification integration on language learning achievement. The study introduces a moderated mediation model where learners' motivation serves as the mediator, and digital literacy acts as a moderator, further accentuating the significant impact of this integrated approach.

Discussion

This research advances our theoretical understanding of language learning, validating gamification's effectiveness as a motivational tool, and introduces digital literacy as a critical factor, providing deeper insights into personalized language learning experiences.
Decolonial identities in the leadership coaching space: against neoliberal leader identity regulation
Authors: Seyama-Mokhaneli Sadi , Belang Thato
Published: May 2024

The study uses the decolonial lens to disrupt the contentious dominance of whiteness in leadership development, not to mention in coaching, in management and organization studies (MOS). It contributes insights into how a decolonizing coaching space enables and guides a coachee to reflect and rethink the navigation of the realities of her decolonial identity. The decolonial identity encapsulates the authentic self and the neoliberal identity is the plastic self in a neoliberal university context. Universities' pervasive and normalized neoliberal discourse has become a “paradigm”—the overarching worldview through which universities' visions, missions, strategic objectives, and values are constructed. For academics to thrive in their performance and “walk on water” in achieving performance targets, they ought to embrace being academic capitalists, which shapes idealized neoliberal identities—conforming identities, complicit in undermining social, economic, and epistemic justice. Qualitative research methods were utilized to conduct a reflexive study, and data collected from the reflections and reflexive dialogues in leadership development coaching sessions and journals were thematically analyzed. The study reveals that the coach and coachee's shared decolonial identity offered counter-narratives that unmask the dominant great “white” man leadership in organizations. It also illuminates insights into the significance of black feminist pedagogy in the coaching process to honor the coachee's decolonial identity and rich cultural experiences. It enabled her to explore them critically and derive meanings from developing decolonizing, critically conscious leadership strategies for emerging transformation challenges. Meaningful dialogue dimensions emerged, which served as lenses that steered a decolonial approach in supporting the coachee to reflect and rethink the leadership performance vision, strategic objectives, action plans, implementation, and monitoring.
The impact of genre-based instruction on Saudi university students’ English writing performance and motivation: a mixed-method study
Authors: Abdel Latif Muhammad M. M. , Alghizzi Talal Musaed , Alshahrani Tahani Munahi
Published: May 2024

Despite the important role motivation plays in students’ writing learning and development, not much attention has been given to experimenting particular instructional techniques for developing students’ writing motivation. One of the least researched teaching techniques in writing motivation studies is genre-based instruction. In this study, we examined the impact of genre-based instruction on 21 Saudi university students’ English argumentative and classification essay writing performance and their writing motivation dimensions (writing apprehension, anxiety, self-efficacy and self-concept). Drawing upon the quasi-experimental research design and non-random sampling technique, we used genre-based instruction with a representative intact class of English-as-a-foreign-language (EFL) writing students at a Saudi university. To examine the potential impact of the treatment, we collected pre- and post-instruction data, along with data gathered through an open-ended questionnaire. The results showed that genre-based instruction has contributed significantly to improving the students’ writing performance and also their writing motivation dimensions. These positive gains varied from one writing quality aspect and motivational variable to another. The students’ answers to the open-ended questionnaire also showed the positive writing learning and motivation improvements they experienced. It is generally concluded that developing students’ language and rhetorical awareness and text composition performance seems to be a prerequisite for improving their writing motivation levels. The paper ends with discussing the implications of the results.
Working with patients’ treatment expectations – what we can learn from homeopathy
Authors: Wilhelm Marcel , Hermann Christiane , Rief Winfried , Schedlowski Manfred , Bingel Ulrike , Winkler Alexander
Published: May 2024

The usual homeopathic remedy, “globules,” does not contain any pharmacologically active ingredient. However, many patients and practitioners report beneficial effects of homeopathic treatment on various health outcomes. Experimental and clinical research of the last two decades analyzing the underlying mechanisms of the placebo effect could explain this phenomenon, with patients’ treatment expectations as the predominant mechanism. Treatment expectations can be optimized through various factors, such as prior information, communication, and treatment context. This narrative review analyses how homeopathy successfully utilizes these factors. Subsequently, it is discussed what evidence-based medicine could learn from homeopathic practice to optimize treatment expectations (e.g., using an empathic, patient-centered communication style, deliberately selecting objects in practice rooms, or using clear treatment rituals and salient contextual stimuli) and thereby treatment effectiveness. Homeopathic remedy does not work beyond the placebo effect but is recommended or prescribed as an active treatment by those who believe in it. Thus, practitioners need to understand the manner in which homeopathy (as an example of inert treatment) works and are advised to reintegrate its underlying effective placebo mechanisms into evidence-based medicine. This promises to increase treatment efficacy, tolerability, satisfaction, and compliance with evidence-based treatments, and addresses the desires patients are trying to satisfy in homeopathy in an ethical, fully informed way that is grounded in evidence-based medicine.
Anthropology and ethnobotany in health mediation: an illustration of a clinical, personalized approach for Haitian migrants in a French Guianese hospital
Authors: Tareau Marc-Alexandre , Demars Yoris , Alcouffe Leslie , Pierre-Louis Ruth , Walter Gaelle , Djossou Félix , Vignier Nicolas , About Frédégonde
Published: May 2024

Introduction

In French Guiana, a European territory in Guiana shield in the Amazon area, close to 40% of the current population was born abroad. In this context, it is important to listen to the experiences of migrants to better understand the difficulties encountered within the healthcare pathways. This is the aim of ANRS Parcours d’Haïti project, an epidemiological, biographical and socio-anthropological study conducted on a representative sample of the Haitian community in French Guiana and focusing on the social determinants of health.

Methodology

Within the framework of this study, the Infectious and Tropical Diseases clinical team of Cayenne Hospital has established close collaboration with health mediators and the ethnobotanist anthropologist of the study. To illustrate the contribution of a personalized approach to health mediation, we report the case of a migrant woman of Haitian origin admitted to the Infectious and Tropical Diseases Unit. We highlight the different socio-cultural aspects addressed and their place in the care process through a thematic discussion and socio-anthropological analysis of the care relationship, based on participatory ethnography and inductive analysis of an in-depth interview with the patient.

Result

This example illustrates the need for a multidisciplinary approach to ensure culturally adapted care for patients. Personal interviews are important because they allow to better take into account the cultural specificities of patients’ experiences and the socio-cultural environment in which they live (and especially, in the case of Haitian patients, their religious affiliation). By allowing them to speak and express themselves freely, they integrate not only their own cultural baggage, but also their own expectations and representations of the disease they suffer from and how it should be treated. Ultimately, this tripartite collaboration between patient, caregiver, and anthropologist or health mediator leads to a better therapeutic alliance.

Conclusion

The analysis of this health care relationship is emblematic of the issue of cultural competence and pre-conceptualizes what intercultural mediation in health care could be, as close as possible to the caregiver and the individual.
Association between the arm circumference and non-alcoholic fatty liver disease in American children and adolescence: a population-based analysis
Authors: Weng Xiaolu , Xu Jing , Yang Shouxing
Published: May 2024

Background

The arm circumference (AC) has been used as an important tool to access the risk of non-alcoholic fatty liver disease (NAFLD) in adults. However, the association between AC and NAFLD in children and adolescence remains unclear. This study aims to explore the relationship between AC and NAFLD in American children and adolescence.

Methods

2017–2020 National Health and Nutrition Examination Survey (NHANES) was used to carry out the cross-sectional study. The association between AC and the risk of NAFLD, and liver steatosis was analyzed using weighted multivariable logistic regression and multivariate linear regression. Additionally, a two-part linear regression model was used to identify threshold effects in this study. Subgroup analysis, interaction tests and receiver operating characteristic (ROC) curve analysis were also carried out.

Results

A total of 1,559 children and adolescence aged 12–18 years old were included, and the prevalence of NAFLD was 27.3%. AC was positively correlated with the risk of NAFLD (OR = 1.25, 95% CI: 1.19, 1.32) and liver steatosis (β = 4.41, 95% CI: 3.72, 5.09). Subgroup analysis stratified by age and race showed a consistent positive correlation. A non-linear relationship and saturation effect between AC and NAFLD risk were identified, with an S shaped curve and an inflection point at 34.5 cm. Area under the ROC of AC to NAFLD was 0.812, with the sensitivity of 67.6%, the specificity of 83.8% and the cutoff value of 31.7 cm.

Conclusion

Our study shows that AC is independently correlated with an increased risk of NAFLD and the severity of liver steatosis in American children and adolescence.
Myotonometry and extended field-of-view ultrasound imaging allow reliable quantification of patellar tendon stiffness and length at rest and during maximal load, whereas several restrictions exist for the Achilles tendon
Authors: Wegener Florian , Ritterbusch Arne , Saal Christian , Baumgart Christian , Hoppe Matthias W.
Published: May 2024

Introduction

Stiffness and length are well-established tendon parameters in sports and medicine. Myotonometry and ultrasound imaging are the commonly used methods to quantify these parameters. However, further studies are needed to clarify the reliability of these methods, especially when assessing maximally loaded tendons and when conducted by different experienced investigators. This study aimed to determine the intra- and interrater reliabilities of measuring the stiffness and length of the patellar tendon (PT) and Achilles tendon (AT) using the myotonometry method and the extended field-of-view ultrasound (EFOV-US) technique at rest and maximal load performed by different experienced investigators.

Methods

Twenty-seven participants were examined on three different days by one experienced investigator and one novice investigator. Primary outcomes were the intraclass correlation coefficient (ICC) and associated 95% confidence interval (95% CI), coefficient of variation (CV), standard error of measurement (SEM), and minimal detectable change (MDC) across the measurement days and investigators.

Results

For PT measurements at rest and maximal load, the estimated ICCs for stiffness and length were ≥.867 and ≥.970, respectively, with 95% CIs ranging from poor (.306) to excellent (.973) and good (.897) to excellent (.999). The CV, SEM, and MDC for PT stiffness and length were ≤5.2% and ≤2.0%, ≤39.3 N/m and ≤0.9 mm, and ≤108.9 N/m and ≤2.6 mm, respectively. For AT measurements, some restrictions were evident for stiffness at rest and both parameters at maximal load. However, regarding AT length at rest, the estimated ICC was ≥.996, with an excellent 95% CI (.987–.999). The CV, SEM, and MDC for AT length at rest were 2.8%, ≤1.1 mm, and ≤2.9 mm, respectively.

Conclusion

The estimated ICCs show good to excellent reliability for the myotonometry method and the EFOV-US technique for measuring PT stiffness and length at rest and maximal load for experienced and novice investigators. However, some restrictions are evident for the AT, especially for measurements at maximal load.
Bottom ash from combustion of chicken manure as a fertiliser material
Authors: Bernal María Pilar , Álvarez-Robles María José , Bernal-Molina Paula , Clemente Rafael
Published: May 2024

The accumulation of excess manure and the energy costs of the buildings housing the animals are the most important problems that chicken farms have to face nowadays. The combustion of chicken manure to obtain thermal energy for animal holdings has been demonstrated through the research project AVIENERGY, in Spain. To ensure the circularity of the process, the combustion by-product, bottom ash, needs to be recycled and used. This work studies the agricultural use of ash from chicken manure combustion as a fertiliser product and determines its capacity for mineral fertiliser substitution. Ashes from co-combustion of chicken (broiler) manure with wood at different proportions were chemically analysed to determine their nutrient concentrations and availabilities. Then, one ash sample was used as a fertiliser for lettuce cultivation in a pot experiment. Different application rates were tested according to the phosphorus (P) content of the ash, being equivalent to 50, 65, 80 and 100% of the standard inorganic P fertilisation. The results indicate that the ash from combustion of chicken manure meets the requirements for inclusion in the fertiliser component material category ‘CMC 13’, and can be used for the preparation of fertiliser ‘PFC 1(C)(I)(a)(ii): Compound Solid Inorganic Macronutrient Fertiliser (multi-nutrients)’, and also possesses characteristics of “PFC 2: Liming Material” according to the EU legislation for fertiliser products. Although plant production was slightly reduced with ash fertilisation, the ashes reached a fertiliser capacity able to substitute 80% of the mineral P fertiliser, with a liming capacity of 30%. Hence, the ash from chicken manure combustion could be applied to soil, especially if acidic, in partial substitution of mineral fertilisers, to supply P.
The effect of an intraoperative patient-specific, surgery-specific haemodynamic algorithm in improving textbook outcomes for hepatobiliary–pancreatic surgery: a multicentre retrospective study
Authors: Carp Bradly , Weinberg Laurence , Fletcher Luke R. , Hinton Jake V. , Cohen Adam , Slifirski Hugh , Le Peter , Woodford Stephen , Tosif Shervin , Liu David , Muralidharan Vijaragavan , Perini Marcos V. , Nikfarjam Mehrdad , Lee Dong-Kyu
Published: May 2024

Background

The concept of a “textbook outcome” is emerging as a metric for ideal surgical outcomes. We aimed to evaluate the impact of an advanced haemodynamic monitoring (AHDM) algorithm on achieving a textbook outcome in patients undergoing hepatobiliary–pancreatic surgery.

Methods

This retrospective, multicentre observational study was conducted across private and public teaching sectors in Victoria, Australia. We studied patients managed by a patient-specific, surgery-specific haemodynamic algorithm or via usual care. The primary outcome was the effect of using a patient-specific, surgery-specific AHDM algorithm for achieving a textbook outcome, with adjustment using propensity score matching. The textbook outcome criteria were defined according to the International Expert Delphi Consensus on Defining Textbook Outcome in Liver Surgery and Nationwide Analysis of a Novel Quality Measure in Pancreatic Surgery.

Results

Of the 780 weighted cases, 477 (61.2%, 95% CI: 57.7%–64.6%) achieved the textbook outcome. Patients in the AHDM group had a higher rate of textbook outcomes [n = 259 (67.8%)] than those in the Usual care group [n = 218 (54.8%); p < 0.001, estimated odds ratio (95% CI) 1.74 (1.30–2.33)]. The AHDM group had a lower rate of surgery-specific complications, severe complications, and a shorter hospital length of stay (LOS) [OR 2.34 (95% CI: 1.30–4.21), 1.79 (95% CI: 1.12–2.85), and 1.83 (95% CI: 1.35–2.46), respectively]. There was no significant difference between the groups for hospital readmission and mortality.

Conclusions

AHDM use was associated with improved outcomes, supporting its integration in hepatobiliary–pancreatic surgery. Prospective trials are warranted to further evaluate the impact of this AHDM algorithm on achieving a textbook impact on long-term outcomes.
Data-Driven Load Frequency Control for Multi-Area Power System Based on Switching Method under Cyber Attacks
Authors: Tian Guangqiang , Wang Fuzhong
Published: May 2024

This paper introduces an innovative method for load frequency control (LFC) in multi-area interconnected power systems vulnerable to denial-of-service (DoS) attacks. The system is modeled as a switching system with two subsystems, and an adaptive control algorithm is developed. Initially, a dynamic linear data model is used to model each subsystem. Next, a model-free adaptive control strategy is introduced to maintain frequency stability in the multi-area interconnected power system, even during DoS attacks. A rigorous stability analysis of the power system is performed, and the effectiveness of the proposed approach is demonstrated by applying it to a three-area interconnected power system.
Gaze Movements of Helicopter Pilots during Real and Simulated Take-Off and Landing Maneuvers
Authors: Greiwe Daniel H. , Friedrich Maik
Published: May 2024

Most accidents and serious incidents of commercial air transport helicopters occur during standard flight phases, whereby a main cause is pilots’ situational awareness. Enabling pilots to better assess their situational awareness can make an important contribution in reducing the risk of fatal accidents. One approach is to examine a pilot’s gaze behavior with the help of eye tracking. This paper reports the results of a case study with eye tracking measurements during real flight and simulator studies of a standard mission profile. The general gaze behavior is characterized by a dominant, external view, and the airspeed and altitude indicator as the most important flight instruments. A real-world applicability of gaze data obtained in the simulator could be shown.
Anti-Icing System Performance Prediction Using POD and PSO-BP Neural Networks
Authors: Mao Handong , Lin Xiaodan , Li Zhimao , Shen Xiaobin , Zhao Wenzhao
Published: May 2024

The anti-icing system is important for ice protection and flight safety. Rapid prediction of the anti-icing system’s performance is critical to reducing the design time and increasing efficiency. The paper proposes a method to quickly predict the anti-icing performance of the hot air anti-icing system. The method is based on Proper Orthogonal Decomposition (POD) and Back Propagation (BP) neural networks improved with the Particle Swarm Optimization (PSO) algorithm to construct the PSO-BP neural network. POD is utilized for data compression and feature extraction for the skin temperature and runback water obtained by numerical calculation. A lower-dimensional approximation is derived from the projection subspace, which consists of a set of basis modes. The PSO-BP neural network establishes the mapping relationship between the flight condition parameters (including flight height, atmospheric temperature, flight speed, median volume diameter, and liquid water content) and the characteristic coefficients. The results show that the average absolute errors of prediction with the PSO-BP neural network model on skin temperature and runback water thickness are 3.87 K and 0.93 μm, respectively. The method can provide an effective tool for iteratively optimizing hot air anti-icing system design.
Effects of Different Structural Film Cooling on Cooling Performance in a GO2/GH2 Subscale Thrust Chamber
Authors: Xiang Jixin , Jia Yujie , Li Zhiqiang , Ren He
Published: May 2024

To investigate the wall cooling of the thrust chamber in an engine, two film-cooling structures, namely, a circular hole structure and a slot structure, were designed. Numerical simulations were performed to study the coupled flow and regenerative cooling heat transfer in thrust chambers with different structures. The influences of parameters such as the film mass flow rate and film hole size on wall cooling were analyzed. Experiments were conducted in a thrust chamber to validate the accuracy of the numerical calculation method. The results indicate that the slot-structured film adheres better to the wall than the circular-hole-structured film, and the film closely adhering to the wall provides better insulation against hot gas, resulting in a reduction of approximately 6% in wall temperature. When the film hole size changes, the change in circumferential wall temperature in the upstream region of the slot-structured film is more pronounced. This paper aims to provide a reference for the design of the cooling structure at the head of the thrust chamber in engineering and suggests directions for optimization and improvement.
Isolation of Bacillus velezensis from Silage and Its Effect on Aerobic Stability and In Vitro Methane Production of Whole-Plant Corn Silage
Authors: Zhang Chen , Zhang Zimo , Zhu Mengfan , Wang Yongliang , Zhou Tangtang , Wan Fachun , Zhang Yunhua , Chen Lijuan
Published: May 2024

Once a silo has been opened, the silage inside will face challenges such as aerobic deterioration, rot, and contamination. Biocontrol bacteria, as a kind of biological antiseptic, are highly effective and natural and are gaining increasing attention. This study aimed to screen a strain with anti-microbial activity against silage spoilage microorganisms and examine its effects on the fermentation quality, aerobic stability, in vitro digestion, and methane production of silage. Lactic acid bacteria, pathogenic and rot-causing microorganisms, were used as indicators to screen the strains for putrefactive silage. The bacteriostatic spectrum, growth performance, and tolerance to the silage environment of the strain were tested. A strain named D-2 was screened from rotten whole-plant corn silage and identified as Bacillus velezensis through physiological and biochemical tests as well as 16S rDNA sequencing. This study found that D-2 exhibits antibacterial effects on several microorganisms, including Escherichia coli, Staphylococcus aureus, Salmonella enteritidis, Aspergillus niger, Saccharomyces cerevisiae, Fusarium oxysporum, and Fusarium graminearum. However, it has no adverse effect on Lactobacillus reuteri, Enterococcus faecium, or Lactobacillus casei. D-2 can attain a stable stage within 10 h and withstand temperatures of up to 70 °C. Moreover, this study found that D-2 had a high survival rate of over 97% after 48 h in a lactic acid environment with pH 4. Freshly chopped whole-plant corn was inoculated without or with D-2 and ensiled for 60 days. The results show that D-2 inoculations increase the content of water-soluble carbohydrates, acetic acid, and propionic acid in the silage and decrease the number of yeasts and molds, the NH4+-N/TN ratio, and the pH. We also found that fermenting whole-plant corn with D-2 significantly increased the in vitro digestibility and the propionic acid content, while also significantly inhibiting methane production. After being exposed to air for 10 days, D-2 can still effectively reduce the total number of yeasts and molds, prevent the decrease in lactic acid bacteria, and inhibit the increase in the pH and NH4+-N/TN ratio of silage products. Overall, D-2 is resistant to pathogenic and rot-causing microorganisms, allowing for easy adaptation to silage production conditions. D-2 can effectively improve aerobic stability and reduce losses in the nutritional value of silage, indicating possible applications for the prevention of silage rot and methane production.
Calibration and Testing of Discrete Elemental Simulation Parameters for Pod Pepper Seeds
Authors: Chen Xingye , Bai Jing , Wang Xinzhong , Fang Weiquan , Hong Tianyu , Zang Nan , Fang Liangliang , Wang Gaoliang
Published: May 2024

The discrete elemental parameters of pod pepper seeds were calibrated for future numerical optimization of the pod pepper seed cleaning device. The study concentrates on calibrating the intrinsic and contact parameters of pod pepper seeds utilizing the discrete element method. Compression tests were performed to ascertain intrinsic parameters such as Poisson’s ratio and the seeds’ elastic modulus. The static friction coefficient and collision restitution coefficient between the seeds and steel plates were identified through incline and free-fall tests. Plackett–Burman, steepest ascent, and Box–Behnken experiments were performed to establish a second-order regression model correlating significant parameters with the angle of repose. The optimal parameter combination, based on the measured angle of repose (32.45°), yielded static friction coefficients between seeds, rolling friction coefficients between seeds, and static friction coefficients between seeds and steel plates of 0.608, 0.018, and 0.787, respectively. The two-sample t-test of the physical and simulated repose angles yielded p > 0.05, and the relative error of the physical and simulated repose angles was 0.68%, which confirmed the reliability of the calibration parameters. The findings indicate that the calibration method for pod pepper seeds effectively informs the calibration of parameters for other irregular crops.