bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive Value of HE4 in Platinum-Based Chemotherapy for Ovarian Cancer: A Systematic Review
Authors: Han Yue , Jiang Lili , Liu Kuiran , Ouyang Ling , Li Yan
Published: July 2021

Objective

To evaluate the value of serum Human epididymis protein 4 (HE4) for predicting the resistance of ovarian cancer (OS) to platinum chemotherapy.

Method

We searched the MEDLINE (PubMed), EMBASE, Cochrane Central, Web of Science, SCOPUS, and CNKI databases and screened all studies evaluating serum HE4 for predicting OC resistance to treatment with platinum. Two researchers independently evaluated the quality of all eligible original studies using QUADAS-2. RevMan 5.4 was used to compile the quality evaluation form. We also performed a meta-analysis with STATA15.1, and Deek’s funnel plots were used to detect any publication bias.

Results

Eight studies were included in the final meta-analysis. Our results showed that the sensitivity and specificity of preoperative serum HE4 in predicting the resistance of OC to platinum chemotherapy was 80% and 67%, respectively. The diagnostic odds ratio was 8, and the AUC was 0.78 (95% CI: 0.75-0.82), whereas the pooled sensitivity and specificity of serum HE4 after the third-cycle of chemotherapies for predicting chemoresistance in OC was 86% and 85%, respectively, with a diagnostic odds ratio of 33 and AUC = 0.92 (95% CI: 0.89 – 0.94).

Conclusion

HE4 may be an effective predictor of platinum-based chemotherapeutic resistance of OC. Serum HE4 levels after the third chemotherapy cycle may be indicative for clinical practice. Further research is needed to validate the significance of HE4 in the long-term management of OC.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, PROSPERO (CRD42021220099).
Self-Reported Health in Adolescents With Exercise-Induced Laryngeal Obstruction; A Cross-Sectional Study
Authors: Benestad Merete R. , Drageset Jorunn , Clemm Hege , Røksund Ola D. , Vollsæter Maria , Halvorsen Thomas , Hysing Mari , Vederhus Bente J.
Published: July 2021

Background: Exercise-induced laryngeal obstruction (EILO) is common in young people with exertional breathing difficulties. Psychological characteristics have been proposed as underlying contributors; however, the evidence for this is limited.

Objectives: Describe self-reported health, self-efficacy, and anxiety symptoms in adolescents with EILO, and address possible associations with EILO subtypes and severity.

Methods: Cross-sectional study of 71/180 (39%) adolescents tested for EILO at Haukeland University Hospital during 2014–2016, age range 14–18 years. Validated questionnaires were used to assess general self-rated health, subjective health complaints (Health Behavior in School-aged Children-Symptom Check List; HBSC-SCL), general self-efficacy (GSE), and anxiety symptoms (SCARED). The outcomes were compared with normative data from comparable unselected populations.

Results: The HBSC-SCL items for somatic complaints revealed weekly or more often occurrence of headache in 42%, abdominal pain in 30%, backache in 31%, and dizziness in 32%. For psychological complaints, corresponding figures were 26% for feeling low, 43% for irritability or bad mood, 33% for feeling nervous, and 38% for sleep problems. Mean (range) GSE score was 3.13 (2.2–4.0), and reports suggesting anxiety symptoms were rare. The outcomes were in line with normative data from comparable unselected populations. Self-rated health, and scores obtained for HBSC-SCL, GSE, and SCARED were similarly distributed across EILO subtypes and severity.

Conclusion: Self-reported health, self-efficacy, and level of anxiety symptoms in adolescents with laryngoscopically confirmed EILO were similar to data obtained in comparable unselected populations, irrespective of EILO subtype and severity. The findings challenge the notion that pediatric EILO is causally related to psychological problems.
The Computerized Adaptable Test Battery (BMT-i) for Rapid Assessment of Children's Academic Skills and Cognitive Functions: A Validation Study
Authors: Billard Catherine , Thiébaut Eric , Gassama Sahawanatou , Touzin Monique , Thalabard Jean-Christophe , Mirassou Anne , Munnich Arnold
Published: July 2021

Background: Learning disabilities in children are a major public health concern worldwide, having a prevalence of 8%. They are associated with lost social, educational, and ultimately, professional opportunities for individuals. These disabilities are also very costly to governments and raise the issue of the appropriate means of screening. Unfortunately, validated tools for preliminary appraisal of learning and cognitive function in struggling children are presently restricted to specific age ranges and cognitive domains. This study sought to validate a first-line battery for assessment of academic skills and cognitive functions.

Materials and Methods: The computerized Adaptable Test Battery, or BMT-i, includes a panel of tests for the first-line assessment of children's academic skills and cognitive functions. The tests reflect expected abilities for the age group in question, exploring academic skills (written language and mathematical cognition) and cognitive domains (verbal, non-verbal, and attentional/executive functions). The authors relied on the results of these tests for a sample of 1,074 Francophone children representative of the mainland French school-age population (522 boys and 552 girls, ages 4–13, from 39 classes at 7 public and 5 private schools). Thirteen speech-language pathologists and neuropsychologists individually administered the tests.

Results: The psychometric characteristics of the empirical data obtained showed acceptable to good test homogeneity, internal consistency (Cronbach's alpha: > 0.70), test-retest reliability (intraclass correlation coefficients: ~0.80), and consistency with reference test batteries (r: 0.44–0.96).

Conclusion: The BMT-i was validated in a large sample of children in mainstream French schools, paving the way for its use in first-line screening of learning disabilities among children with complaints, whether their learning difficulties have been flagged by their parents or by their teachers.
Possible Hepatoprotective Effect of Tocotrienol-Rich Fraction Vitamin E in Non-alcoholic Fatty Liver Disease in Obese Children and Adolescents
Authors: Al-Baiaty Farah D.R. , Ismail Aziana , Abdul Latiff Zarina , Muhammad Nawawi Khairul Najmi , Raja Ali Raja Affendi , Mokhtar Norfilza Mohd
Published: July 2021

Obesity has become a worldwide health concern among the pediatric population. The prevalence of non-alcoholic fatty liver disease (NAFLD) is growing rapidly, alongside the high prevalence of obesity. NAFLD refers to a multifactorial disorder that includes simple steatosis to non-alcoholic steatohepatitis (NASH) with or devoid of fibrosis. NAFLD is regarded as a systemic disorder that influences glucose, lipid, and energy metabolism with hepatic manifestations. A sedentary lifestyle and poor choice of food remain the major contributors to the disease. Prompt and timely diagnosis of NAFLD among overweight children is crucial to prevent the progression of the condition. Yet, there has been no approved pharmacological treatment for NAFLD in adults or children. As indicated by clinical evidence, lifestyle modification plays a vital role as a primary form of therapy for managing and treating NAFLD. Emphasis is on the significance of caloric restriction, particularly macronutrients (fats, carbohydrates, and proteins) in altering the disease consequences. A growing number of studies are now focusing on establishing a link between vitamins and NAFLD. Different types of vitamin supplements have been shown to be effective in treating NAFLD. In this review, we elaborate on the potential role of vitamin E with a high content of tocotrienol as a therapeutic alternative in treating NAFLD in obese children.
Triclabendazole Induces Pyroptosis by Activating Caspase-3 to Cleave GSDME in Breast Cancer Cells
Authors: Yan Liang , Liu Yi , Ma Xue-feng , Hou Dan , Zhang Yu-hui , Sun Yong , Shi Shan-shan , Forouzanfar Tim , Lin Hai-yan , Fan Jun , Wu Gang
Published: July 2021

Pyroptosis is a form of programmed cell death, in which gasdermin E (GSDME) plays an important role in cancer cells, which can be induced by activated caspase-3 on apoptotic stimulation. Triclabendazole is a new type of imidazole in fluke resistance and has been approved by the FDA for the treatment of fascioliasis and its functions partially acting through apoptosis-related mechanisms. However, it remains unclear whether triclabendazole has obvious anti-cancer effects on breast cancer cells. In this study, to test the function of triclabendazole on breast cancer, we treated breast cancer cells with triclabendazole and found that triclabendazole induced lytic cell death in MCF-7 and MDA-MB-231, and the dying cells became swollen with evident large bubbles, a typical sign of pyroptosis. Triclabendazole activates apoptosis by regulating the apoptoic protein levels including Bax, Bcl-2, and enhanced cleavage of caspase-8/9/3/7 and PARP. In addition, enhanced cleavage of GSDME was also observed, which indicates the secondary necrosis/pyroptosis is further induced by active caspase-3. Consistent with this, triclabendazole-induced GSDME–N-terminal fragment cleavage and pyroptosis were reduced by caspase-3–specific inhibitor (Ac-DEVD-CHO) treatment. Moreover, triclabendazole induced reactive oxygen species (ROS) elevation and increased JNK phosphorylation and lytic cell death, which could be rescued by the ROS scavenger (NAC), suggesting that triclabendazole-induced GSDME-dependent pyroptosis is related to the ROS/JNK/Bax-mitochondrial apoptotic pathway. Besides, we showed that triclabendazole significantly reduced the tumor volume by promoting the cleavage of caspase-3, PARP, and GSDME in the xenograft model. Altogether, our results revealed that triclabendazole induces GSDME-dependent pyroptosis by caspase-3 activation at least partly through augmenting the ROS/JNK/Bax-mitochondrial apoptotic pathway, providing insights into this on-the-market drug in its potential new application in cancer treatment.
Oxymatrine Synergistically Enhances Doxorubicin Anticancer Effects in Colorectal Cancer
Authors: Pan Di , Zhang Wen , Zhang Nenling , Xu Yini , Chen Yi , Peng Jianqing , Chen Yan , Zhang Yanyan , Shen Xiangchun
Published: July 2021

The combination of chemotherapy with natural products is a common strategy to enhance anticancer effects while alleviating the dose-dependent adverse effects of cancer treatment. Oxymatrine (OMT) has been extensively reported as having anticancer activity. Doxorubicin (DOX) is a chemotherapeutic DNA-damaging agent used for the treatment of carcinoma. In this study, we investigated whether synergistic effects exist with the combination treatment with OMT and DOX using human colorectal cancer cell (CRC) lines and the potential mechanisms involved in in vitro and in vivo activities. The MTT and colony formation assay results showed that compared to either OMT or DOX monotherapy, the combination of OMT + DOX markedly inhibited the growth of HT-29 and SW620 cells. Wound healing assays showed significant inhibition of cell migration with co-treatment, supported by the change in E-cadherin and N-cadherin expressions in Western blotting. Furthermore, flow cytometry analysis revealed that OMT + DOX co-treatment enhanced cell apoptosis as a result of ROS generation, whereas NAC attenuated OMT + DOX–induced apoptosis. Similarly, the apoptosis-related proteins (cleaved caspase-3, cleaved caspase-9, and the ratio of Bax/Bcl-2) were determined by Western blotting, which showed that the expressions of these markers were notably increased in the co-treatment group. Furthermore, co-administration of a low dose of DOX and OMT inhibited xenograft tumor growth in a dose-dependent manner. TUNEL assay and Ki67 staining images indicated more apoptosis and less proliferation occurred in OMT plus DOX-treated xenograft tumors. Meanwhile, the combination strategy decreased cardiotoxicity, which is the most serious side effect of DOX. RNA sequencing was performed to explore the precise molecular alterations involved in the combination group. Among the numerous differentially expressed genes, downregulated FHL-2 and upregulated cleaved SPTAN1 were validated in both mRNA and protein levels of HT-29 and SW620 cells. These two proteins might play a pivotal role involving in OMT + DOX synergistic activity. Overall, OMT in combination with DOX presented an outstanding synergistic antitumor effect, indicating that this beneficial combination may offer a potential therapy for CRC patients.
Relationship Between Medication Literacy and Frailty in Elderly Inpatients With Coronary Heart Disease: A Cross-Sectional Study in China
Authors: Qu Jiling , Zhou Ting , Xue Mengxin , Sun Huiping , Shen Yijing , Liu Yongbing
Published: July 2021

Background: Mastering medication literacy may be related to medication safety, and the identification of frailty is very important for the prognosis of coronary heart disease (CHD). Few studies have examined the relationship between medication literacy and frailty in patients with CHD. The aim of this study was to investigate the state of medication literacy and frailty in patients with CHD and to explore the relationship between medication literacy and frailty.

Methods: A cross-sectional investigation evaluated 295 inpatients with CHD recruited from hospitals in Yangzhou, China. Demographic and clinical data on participants were collected using a general information questionnaire. The Chinese medication literacy scale was used to evaluate medication literacy. The Fried Frailty Phenotype scale was used to evaluate frailty. Univariate analysis employed chi-square test and Kruskal-Wallis H test to examine the potential factors affecting frailty. Taking frailty status as the outcome variable, the ordered logistic regression model was used to analyze the relationship between the degree of medication literacy and frailty. Spearman’s correlation analysis was used to analyze the correlation between medication literacy and frailty.

Results: A total of 280 elderly CHD inpatients were included in the analysis. There were 116 (41.4%) individuals with inadequate medication literacy and 89 (31.8%) frail individuals. Ordered logistic regression analysis showed that the age (p < 0.001, OR = 1.089), Charson Comorbidity Index (p = 0.029, OR = 1.300), number of medications taken (p = 0.012, OR = 1.137), and medication literacy (p < 0.05, OR > 1) were independent predictors of debilitating risk factors. The population with inadequate medication literacy had a 2.759 times greater risk of frailty than adequate medication literacy (p < 0.001, OR = 2.759); The population with marginal medication literacy had a 2.239 times greater risk of frailty than adequate medication literacy (p = 0.010, OR = 2.239). Spearman’s correlation analysis showed that the medication literacy grade was associated with the frailty grade in elderly CHD patients (R = -0.260, p < 0.001).

Conclusion: The study showed a significant correlation between medical literacy and frailty in patients with CHD. The results suggested that medication literacy was an important consideration in the development, implementation, and evaluation of frailty.
Function and Mechanism of Trimetazidine in Myocardial Infarction-Induced Myocardial Energy Metabolism Disorder Through the SIRT1–AMPK Pathway
Authors: Luo Xiu-ying , Zhong Ze , Chong Ai-guo , Zhang Wei-wei , Wu Xin-dong
Published: July 2021

Myocardial energy metabolism (MEM) is an important factor of myocardial injury. Trimetazidine (TMZ) provides protection against myocardial ischemia/reperfusion injury. The current study set out to evaluate the effect and mechanism of TMZ on MEM disorder induced by myocardial infarction (MI). Firstly, a MI mouse model was established by coronary artery ligation, which was then treated with different concentrations of TMZ (5, 10, and 20 mg kg–1 day–1). The results suggested that TMZ reduced the heart/weight ratio in a concentration-dependent manner. TMZ also reduced the levels of Bax and cleaved caspase-3 and promoted Bcl-2 expression. In addition, TMZ augmented adenosine triphosphate (ATP) production and superoxide dismutase (SOD) activity induced by MI and decreased the levels of lipid peroxide (LPO), free fatty acids (FFA), and nitric oxide (NO) in a concentration-dependent manner (all P < 0.05). Furthermore, an H2O2-induced cell injury model was established and treated with different concentrations of TMZ (1, 5, and 10 μM). The results showed that SIRT1 overexpression promoted ATP production and reactive oxygen species (ROS) activity and reduced the levels of LPO, FFA, and NO in H9C2 cardiomyocytes treated with H2O2 and TMZ. Silencing SIRT1 suppressed ATP production and ROS activity and increased the levels of LPO, FFA, and NO (all P < 0.05). TMZ activated the SIRT1–AMPK pathway by increasing SIRT1 expression and AMPK phosphorylation. In conclusion, TMZ inhibited MI-induced myocardial apoptosis and MEM disorder by activating the SIRT1–AMPK pathway.
In vitro Assays and Imaging Methods for Drug Discovery for Cardiac Fibrosis
Authors: Palano Giorgia , Foinquinos Ariana , Müllers Erik
Published: July 2021

As a result of stress, injury, or aging, cardiac fibrosis is characterized by excessive deposition of extracellular matrix (ECM) components resulting in pathological remodeling, tissue stiffening, ventricular dilatation, and cardiac dysfunction that contribute to heart failure (HF) and eventually death. Currently, there are no effective therapies specifically targeting cardiac fibrosis, partially due to limited understanding of the pathological mechanisms and the lack of predictive in vitro models for high-throughput screening of antifibrotic compounds. The use of more relevant cell models, three-dimensional (3D) models, and coculture systems, together with high-content imaging (HCI) and machine learning (ML)-based image analysis, is expected to improve predictivity and throughput of in vitro models for cardiac fibrosis. In this review, we present an overview of available in vitro assays for cardiac fibrosis. We highlight the potential of more physiological 3D cardiac organoids and coculture systems and discuss HCI and automated artificial intelligence (AI)-based image analysis as key methods able to capture the complexity of cardiac fibrosis in vitro. As 3D and coculture models will soon be sufficiently mature for application in large-scale preclinical drug discovery, we expect the combination of more relevant models and high-content analysis to greatly increase translation from in vitro to in vivo models and facilitate the discovery of novel targets and drugs against cardiac fibrosis.
Phylogenomics With Hyb-Seq Unravels Korean Hosta Evolution
Authors: Yoo Mi-Jeong , Lee Byoung-Yoon , Kim Sangtae , Lim Chae Eun
Published: July 2021

The genus Hosta (Agavoideae and Asparagaceae) is one of the most popular landscaping and ornamental plants native to temperate East Asia. Their popularity has led to extensive hybridization to develop various cultivars. However, their long history of hybridization, cultivation, and selection has brought about taxonomic confusion in the Hosta species delimitation along with their indistinguishable morphology. Here, we conducted the first broad phylogenetic analyses of Hosta species based on the most comprehensive genomic data set to date. To do so, we captured 246 nuclear gene sequences and plastomes from 55 accessions of Korean Hosta species using the Hyb-Seq method. As a result, this study provides the following novel and significant findings: (1) phylogenetic analyses of the captured sequences retrieved six species of Hosta in South Korea compared to five to eleven species based on the previous studies, (2) their phylogenetic relationships suggested that the large genome size was ancestral and the diversification of Korean Hosta species was accompanied by decreases in genome sizes, (3) comparison between nuclear genes and plastome revealed several introgressive hybridization events between Hosta species, and (4) divergence times estimated here showed that Hosta diverged 35.59 million years ago, while Korean Hosta species rapidly diversified during the late Miocene. Last, we explored whether these genomic data could be used to infer the origin of cultivars. In summary, this study provides the most comprehensive genomic resources to be used in phylogenetic, population, and conservation studies of Hosta, as well as for unraveling the origin of many cultivars.
Evolvability of Drought Response in Four Native and Non-native Conifers: Opportunities for Forest and Genetic Resource Management in Europe
Authors: Schueler Silvio , George Jan-Peter , Karanitsch-Ackerl Sandra , Mayer Konrad , Klumpp Raphael Thomas , Grabner Michael
Published: July 2021

Intraspecific genetic variation in drought response is expected to play an important role in determining the persistence of tree populations in global change as it (1) allows for spontaneous selection and local adaptation of tree populations, (2) supports assisted seed transfer of less-drought-sensitive provenance, and (3) enables the integration of drought-sensitivity traits into tree breeding. Estimating the potential of such adaptation options requires quantitative genetic knowledge of drought sensitivity across significant parts of species distributions and a comparative assessment of genetic variation within economically and ecologically important tree species. We quantified genetic variation within and among populations of four conifers growing within common garden experiments in the drought-prone eastern Austria. This region experienced three strong drought periods between 1980 and 2010 that resulted in significant reductions in radial growth. Among the four tested species, Douglas-fir revealed the highest resistance during drought and silver fir the best recovery after drought, while European larch and Norway spruce showed the lowest resistance. High genetic variation among populations and phenotypic stability across all three drought events was found for Norway spruce and silver fir, but not for the other species. Heritability and evolvability of drought traits, both approximated via genetic repeatability, revealed strong differences among populations of all four species. Repeatability and evolvability for resistance were highest in Norway spruce and, for recovery, highest in European larch. Our comparison indicates that the mean drought sensitivity of a species is not related to the intraspecific genetic variation in drought response. Thus, also highly drought-sensitive species, such as Norway spruce and European larch, harbor significant genetic variation in drought response within and among populations to justify targeted tree breeding, assisted gene flow, and supportive forest management to foster local adaptations to future conditions.
Actual Self-Image Versus Ideal Self-Image: An Exploratory Study of Self-Congruity Effects on Gambling Tourism
Authors: Li Mao-Hua , Lai Ivan Ka Wai
Published: July 2021

This study aims to apply self-congruity theory to examine the relationship between self-congruity of tourists and their perceived image of a gambling destination. This study employs the Euclidean distance model and extends Malhotra's pars of adjectives with five new items about gambling motives. A face-to-face questionnaire survey was used, and a total of 152 samples were collected from tourists in Macau. The results show that the actual self-image of tourists is more related to their perception of Macau image. For actual congruence, tourists exhibit a greater tendency to match the informal, liberal, and emotional image of Macau. For ideal congruence, they have a tendency to match the contemporary, organized, and pleasant image of Macau. This study makes up for the deficiency of self-congruity theory in tourism research. This study helps tourism departments to develop appropriate strategies to promote gambling tourism and disseminate relevant information that can bring gambling destinations closer to tourists.
Cyber-Personality and Liking Expression: A Study From WeChat Users in China
Authors: Li Haojian , Wang X.T.
Published: July 2021

Clicking the like button following a post on social media has become a common means of expressing and gathering social support online. Little is known about how liking expression is linked and regulated by personality traits and communication motives. Following a preliminary survey (n = 168) about the usage of the like function on WeChat, a Chinese social media platform, we conducted an online study (n = 183) to map the Big-Five personality traits and five communication motives to the frequency (likelihood) of liking expression. The results showed that each user had, on average, 385 WeChat friends and spent 2.2 hours and used the liking function 1.1 times each day on WeChat. The personality trait conscientiousness was negatively related to the liking expression (β = −0.505, p < 0.05). In contrast, agreeableness promoted the expression of liking directly (β = 0.153, p < 0.05) and indirectly via two communication motives, enjoyment (a: β = 0.377, p < 0.01; b: β = 0.433, p < 0.001) and passing time (c: β = 0.578, p < 0.05; d: β = 0.523, p < 0.001). The liking expression may serve as a simple index for understanding dispositional underpinnings of social media networking.
Prosocial Orientation of Russians During the COVID-19 Pandemic: Caring for Others and Yourself
Authors: Kislyakov Pavel A. , Shmeleva Elena A.
Published: July 2021

To mitigate the potentially devastating effects of the COVID-19 pandemic, it is vital to identify psychosocial and moral resources. The care, preservation, protection, and well-being of social communities are attributes of prosocial behavior that can be such a resource. The purpose of the study is to identify the features of prosocial orientation of Russian youth during the COVID-19 pandemic, as well as to identify strategies for prosocial behavior during the COVID-19 pandemic. The sample consisted of 447 people. The study was conducted in May 2020 in the form of an online survey of subjects using Google Forms (“Moral Foundations Questionnaire method” and “Portrait Values Questionnaire”). The research made it possible to establish that Russians were dominated by norms of care, fairness, purity; values of benevolence-universalism, security, and self-direction. During the COVID-19 pandemic, the prosocial orientation of Russians may manifest itself in the following behavioral strategies: proactive prosocial strategy of “caring for others” (true altruism, expressed in forms of volunteering, helping a stranger, and charity despite the risk of contracting a coronavirus infection); egoistic strategy of prosocial behavior “self-care through caring for others” (volunteering based on self-development; helping a stranger to improve your own psychological well-being); conventional prosocial strategy “self-care” (self-isolation and preventive behavior). In the long run, it is necessary to identify personal and environmental resources that allowed people to effectively implement a prosocial self-isolation strategy during the COVID-19 pandemic, as well as various forms of volunteerism.
Customers’ Experiences of Compassion and Brand Attitude: Evidence From Low-Cost Carriers
Authors: Ko Sung-Hoon , Choi Yongjun , Kim Jongsung
Published: July 2021

The purpose of this study is to examine the effect of compassion experienced by low-cost carriers customers on their brand attitudes. Specifically, this study aims to unbox the mechanisms through how the customers’ experiences of compassion influence the formation of positive brand attitudes. Using the data from 423 low-cost carriers customers in South Korea, this study found that the more low-cost carriers’ customers experience compassion, the more positive their brand attitudes are toward the low-cost carriers. Notably, this study demonstrated that the positive relationship between compassion and brand attitudes is serially mediated by positive emotion and positive brand image. The results from this study contribute to the literature on the airline industry by examining the roles of compassion, which is relatively new to the field, and also provide practical insights for a low-cost carrier to come up with competitive strategies to achieve a competitive advantage over its competitors in the industry.
Avatar-User Bond as Meta-Cognitive Experience: Explicating Identification and Embodiment as Cognitive Fluency
Authors: Sah Young June , Rheu Minjin , Ratan Rabindra
Published: July 2021

Scholars have not reached an agreement on a theoretical foundation that underlies the psychological effects of avatar use on users. One group of scholars focuses on the perceptual nature of avatar use, proposing that perceiving the self-being represented by a virtual representation leads to the effects (i.e., Proteus effect). Another group suggests that social traits in avatars prime users causing them to behave in accordance with the social traits (i.e., priming effects). We combine these two theoretical explanations and present an alternative approach, hinging on a concept of meta-cognitive experience. The psychological mechanism of the avatar-user bond is explicated in terms of cognitive fluency, a type of meta-cognitive experience reflecting an awareness of how readily or easily information is processed. Under this explication, two concepts related to avatar-user bond, identification and embodiment, are understood as the meta-cognitive experience of cognitive fluency at the level of one’s identity and physical body, respectively. Existing empirical evidence on avatar effects is revisited to explore how this new theoretical framework can be applied.
Harnessing the Spatial Foundation of Mind in Breaking Vicious Cycles in Anxiety, Insomnia, and Depression: The Future of Virtual Reality Therapy Applications
Authors: Jerath Ravinder , Beveridge Connor
Published: July 2021

Mental Illnesses, particularly anxiety, insomnia, and depression often involve vicious cycles which are self-perpetuating and can trap one into a more chronic state. For example in the case of insomnia, sympathetic overactivity, intrusive thoughts, and emotional instability due to sleep loss can perpetuate further sleep loss the next night and so on. In this article, we put forward a perspective on breaking these vicious cycles based on preeminent theories in global and spatial cognition, that the foundation of the conscious mind is a spatial coordinate system. Based on this we discuss the potential and future of virtual reality therapeutic applications which utilize massive virtual spaces along with biofeedback designed to help break perpetual cycles in depression, anxiety, and insomnia. “Massive spaces” are those which are truly expansive such as when looking to the clear night sky. These virtual realities may take the form of a night sky, fantastical cosmic scenes, or other scenes such as mountain tops. We also hope to inspire research into such a spatial foundation of mind, use of perceived massive spaces for therapy, and the integration of biofeedback into virtual therapies.
A Qualitative Endline Evaluation Study of Male Engagement in Promoting Reproductive, Maternal, Newborn, and Child Health Services in Rural Kenya
Authors: Lusambili Adelaide M. , Wisofschi Stefania , Shumba Constance , Muriuki Peter , Obure Jerim , Mantel Michaela , Mossman Lindsay , Pell Rachel , Nyaga Lucy , Ngugi Anthony , Orwa James , Luchters Stanley , Mulama Kennedy , Wade Terrance J. , Temmerman Marleen
Published: July 2021

Background: Globally, male involvement in reproductive, maternal, newborn, and child health (RMNCH) is associated with increased benefits for women, their children, and their communities. Between 2016 and 2020, the Aga Khan University implemented the Access to Quality of Care through Extending and Strengthening Health Systems (AQCESS), project funded by the Government of Canada and Aga Khan Foundation Canada (AKFC). A key component of the project was to encourage greater male engagement in RMNCH in rural Kisii and Kilifi, two predominantly patriarchal communities in Kenya, through a wide range of interventions. Toward the end of the project, we conducted a qualitative evaluation to explore how male engagement strategies influenced access to and utilization of RMNCH services. This paper presents the endline evaluative study findings on how male engagement influenced RMNCH in rural Kisii and Kilifi.

Methods: The study used complementing qualitative methods in the AQCESS intervention areas. We conducted 10 focus group discussions (FGDs) with 82 community members across four groups including adult women, adult men, adolescent girls, and adolescent boys. We also conducted 11 key informant interviews (KIIs) with facility health managers, and sub-county and county officials who were aware of the AQCESS project.

Results: Male engagement activities in Kisii and Kilifi counties were linked to improved knowledge and uptake of family planning (FP), spousal/partner accompaniment to facility care, and defeminization of social and gender roles.

Conclusion: This study supports the importance of male involvement in RMNCH in facilitating decisions on women and children's health as well as in improving spousal support for use of FP methods.
Diagnostic Accuracy of Machine Learning Models to Identify Congenital Heart Disease: A Meta-Analysis
Authors: Hoodbhoy Zahra , Jiwani Uswa , Sattar Saima , Salam Rehana , Hasan Babar , Das Jai K.
Published: July 2021

Background: With the dearth of trained care providers to diagnose congenital heart disease (CHD) and a surge in machine learning (ML) models, this review aims to estimate the diagnostic accuracy of such models for detecting CHD.

Methods: A comprehensive literature search in the PubMed, CINAHL, Wiley Cochrane Library, and Web of Science databases was performed. Studies that reported the diagnostic ability of ML for the detection of CHD compared to the reference standard were included. Risk of bias assessment was performed using Quality Assessment for Diagnostic Accuracy Studies-2 tool. The sensitivity and specificity results from the studies were used to generate the hierarchical Summary ROC (HSROC) curve.

Results: We included 16 studies (1217 participants) that used ML algorithm to diagnose CHD. Neural networks were used in seven studies with overall sensitivity of 90.9% (95% CI 85.2–94.5%) and specificity was 92.7% (95% CI 86.4–96.2%). Other ML models included ensemble methods, deep learning and clustering techniques but did not have sufficient number of studies for a meta-analysis. Majority (n=11, 69%) of studies had a high risk of patient selection bias, unclear bias on index test (n=9, 56%) and flow and timing (n=12, 75%) while low risk of bias was reported for the reference standard (n=10, 62%).

Conclusion: ML models such as neural networks have the potential to diagnose CHD accurately without the need for trained personnel. The heterogeneity of the diagnostic modalities used to train these models and the heterogeneity of the CHD diagnoses included between the studies is a major limitation.
Identifying Lung Cancer Patients Suitable for Segmentectomy: A Brief Review
Authors: Wang Chunguo , Wu Sikai , Zhang Rongwei , Jin Ke , Qian Yicheng , Mao Ning , Liu Yun , Zhang Miao , Zhang Ke , Wang Renfeng , Huang Gang , Zhang Min , Chen Baofu , Shen Jianfei
Published: July 2021

Background: In 1995, a clinical randomized controlled study (RCT) conducted by the Lung Cancer Study Group (LCSG) pointed out that the lobectomy was the gold standard for treating early lung cancer. However, with the development of technology, the results of several retrospective studies have shown that the efficacy of pulmonary segmentectomy is equivalent to that of lobectomy. Currently, it is still controversial whether segmental resection or lobectomy should be performed for early lung cancer. Thus, we aim to summarize the indications of segmentectomy.

Methods: To conduct the review, previous researches involving indications of segmentectomy were collected from the literature using Pubmed. These articles were published and accepted in English in the medical literature from 2013 to 2020. We have focused on segmentectomy and its indications.

Results: A total of 176 articles were retrieved from the Pubmed database, of which 31 articles included indications for segmentectomy. We summarized the relevant content, and the potential and prospect of segmentectomy for the treatment of lung cancer were emphasized.

Conclusions: These findings have a number of important implications for future practice. Pulmonary segmentectomy is a very vital surgical procedure for select patients with lung cancer, which provides a novel approach for the treatment of lung cancer and the survival of lung cancer patients.
Grief in Response to Uncertainty Distress Among Veterinary Students During the Early Stages of the COVID-19 Pandemic
Authors: Carney Kimberly , Thompson R. Randall
Published: July 2021

The abrupt and life-altering shifts brought on by the COVID-19 pandemic have stimulated research in fields ranging from social sciences to virology. This study explored perceptions and experiences of COVID-19's impact on students at Lincoln Memorial University–College of Veterinary Medicine (LMU-CVM) and considered how to respond to these. Semistructured interviews were conducted with 20 students from LMU-CVM. Thematic analysis elucidated five subthemes that were combined into two main themes based on Bertuccio's framework of grief in response to uncertainty distress. Uncertainty and disruption of routine were subthemes of ambiguous loss, while lost opportunities, milestones missed, and risk concern came under anticipatory grief. There was overlap and fluidity within these themes, with frustration, stress, and unexpected benefits pervading all categories. Differences were noted between classes, with clinical students expressing concern over graduation and lack of preparedness, and preclinical students with online assessment, lost opportunities for clinical experiences, and the loss of social connections. These results point to mitigation strategies for the adverse effects of COVID-19-related stressors specific to this population that encompass academic, physical, and mental well-being concerns. Clear communication, assurance of quality education, flexibility for meeting family needs, financial assistance, and mental health support are the areas evident from the interviews where successful responses might be targeted. This study also highlights areas for future research, including follow-up interviews, given the prolonged timeline of COVID-19, surveys of beliefs and practices across a larger university population, and exploration of the long-term impact on academic and practice success of the affected cohorts.
Direct Drive Servovalves Actuated by Amplified Piezo-Stacks: Assessment through a Detailed Numerical Analysis
Authors: Tamburrano Paolo , Distaso Elia , Plummer Andrew R. , Sciatti Francesco , De Palma Pietro , Amirante Riccardo
Published: July 2021

This paper presents a feasibility study using commercially available amplified piezo-stacks for the direct actuation of four-way three-position (4/3) direct drive servovalves. The prospect of using amplified piezo-stacks in place of linear force motors is very attractive by virtue of their fast response speed and low weight. Piezo-stacks equipped with mechanical amplification systems can give levels of displacement suitable for this application. A very effective amplification system has recently been produced by some manufacturers and is based on a temperature-independent diamond structure. This paper details simulations of a 4/3 servovalve directly actuated by such a piezoelectric actuator with a diamond structure. To this end, well-established equations, implemented in Simulink by means of the libraries of Simscape Fluids, are used. The proposed architecture shows simplicity of construction; in addition, very good step response speed and frequency response are predicted by the simulations.
Large-Eddy Simulation of Low-Pressure Turbine Cascade with Unsteady Wakes
Authors: Robison Zachary , Gross Andreas
Published: July 2021

To better understand the wake effects at low Reynolds numbers, large-eddy simulations of a 50% reaction low-pressure turbine stage and a linear cascade with two different bar wake generators were carried out for a chord Reynolds number of 50,000. For the chosen front-loaded high-lift airfoil, the endwall structures are stronger than for more traditional mid-loaded moderate-lift airfoils. By comparing the 50% reaction stage results with the bar wake generator results, insight is gained into the effect of the three-dimensional wake components on the downstream flow field.For the cases with bar wake generator, the endwall boundary layer is growing faster because of the relative motion of the endwall with respect to the freestream. The half-width of the wake is approximately matched for the larger one of the two considered bar wake generators. To improve the quality of the phase-averaged flow fields, the proper orthogonal decomposition was employed as a filter to remove the low-energy unsteady flow field content. Both the mean flow and filtered phase-averaged flow fields were analyzed in detail. Visualizations of the phase-averaged flow field reveal a periodic suppression of the laminar suction side separation from the downstream airfoil even for the smaller bar wake generator. The passage vortex is entirely suppressed for the 50% reaction stage and for the larger bar wake generator. Furthermore, the phase-averaged data for the 50% reaction stage reveal a new longitudinal flow structure that is traced back to near-wall wake vorticity. This flow structure is missing for the bar wake generator cases.
Managing Crop Load in European Pear (Pyrus communis L.)—A Review
Authors: Bound Sally A.
Published: July 2021

Reducing levels of fruit set is often desirable in many European pear (Pyrus communis L.) cultivars. With a negative linear relationship between crop load and fruit size, crop load management early in the season minimises wastage of tree carbohydrate resources and provides maximum benefits in terms of fruit size and quality. There are several tools available for managing crop load including hand thinning, chemical thinning, photosynthetic inhibition through shading or application of chemicals, mechanical thinning and pruning. While hand thinning is the most accurate method of reducing excessive crop loads, there are some major drawbacks. With awareness that the early thinning offered by chemical thinning provides distinct advantages with regard to fruit size and other quality parameters, chemical thinning is gaining increasing acceptance in pear production. Some chemicals are used worldwide for thinning, but there are differences between countries and growing regions on recommended application timing and concentrations. The risks involved in chemical thinning can be mitigated by use of a structured approach, using a sequential spray program with both bloom and post-bloom thinners. Knowledge of conditions that impact the carbon balance of the tree and the ability to make use of carbon-deficit conditions are likely to improve the predictability of chemical thinning. Mechanical thinning has potential as a thinning tool, with advantages over chemical thinning in that it is environmentally friendly, can be used in organic production and is not weather dependent. Although artificial bud extinction has not been trialled on pears to date, it has been shown to be economically viable in apple. As it is a precision crop load management method that minimises tree resource wastage, it should be given serious consideration. As growers require large annual yields of high-quality fruit, the aim of this review was to examine current and potential crop load management methods for European pear cultivars and provide a portfolio of available options that can be integrated into a systematic approach for managing crop load.
Weed Suppression, Biomass and Nitrogen Accumulation in Mixed-Species and Single-Species Cover Crops in a Tropical Sugarcane Fallow
Authors: Di Bella Lawrence , Zahmel Megan , van Zwieten Lukas , Rose Terry J.
Published: July 2021

While mixed-species cover crops are gaining worldwide popularity, their utility in the ‘plough-out’ period in tropical sugar cane systems has not been investigated. Field trials investigating weed suppression (one season only), biomass production and nitrogen accumulation of single-species and mixed-species cover crops were conducted over two seasons on a commercial sugarcane farm in the Australian tropics. Mixed-species cover crops showed strong weed suppression, and were among the top treatments for biomass production each year, but did not yield the highest biomass in either season. Sunn hemp (Crotalaria juncea cv. Global sunn) produced the most biomass in the drier-than-average 2016–2017 season (>10 t dry matter ha−1), while soybean (Glycine max cv. Leichardt) produced the most biomass (5.3 t dry matter ha−1) in the wetter-than-average 2018–2019 season, highlighting the influence of seasonal conditions on species’ biomass production. The inclusion of multiple species in a short-term cover crop in the tropics where extreme weather events can occur can thus be seen as a risk mitigation strategy given the risk of failure of any given species in a given season.
Prevalence and Impact of Biofilms on Bloodstream and Urinary Tract Infections: A Systematic Review and Meta-Analysis
Authors: Pinto Henrique , Simões Manuel , Borges Anabela
Published: July 2021

This study sought to assess the prevalence and impact of biofilms on two commonly biofilm-related infections, bloodstream and urinary tract infections (BSI and UTI). Separated systematic reviews and meta-analyses of observational studies were carried out in PubMed and Web of Sciences databases from January 2005 to May 2020, following PRISMA protocols. Studies were selected according to specific and defined inclusion/exclusion criteria. The obtained outcomes were grouped into biofilm production (BFP) prevalence, BFP in resistant vs. susceptible strains, persistent vs. non-persistent BSI, survivor vs. non-survivor patients with BSI, and catheter-associated UTI (CAUTI) vs. non-CAUTI. Single-arm and two-arm analyses were conducted for data analysis. In vitro BFP in BSI was highly related to resistant strains (odds ratio-OR: 2.68; 95% confidence intervals-CI: 1.60–4.47; p < 0.01), especially for methicillin-resistant Staphylococci. BFP was also highly linked to BSI persistence (OR: 2.65; 95% CI: 1.28–5.48; p < 0.01) and even to mortality (OR: 2.05; 95% CI: 1.53–2.74; p < 0.01). Candida spp. was the microorganism group where the highest associations were observed. Biofilms seem to impact Candida BSI independently from clinical differences, including treatment interventions. Regarding UTI, multi-drug resistant and extended-spectrum β-lactamase-producing strains of Escherichia coli, were linked to a great BFP prevalence (OR: 2.92; 95% CI: 1.30–6.54; p < 0.01 and OR: 2.80; 95% CI: 1.33–5.86; p < 0.01). More in vitro BFP was shown in CAUTI compared to non-CAUTI, but with less statistical confidence (OR: 2.61; 95% CI: 0.67–10.17; p < 0.17). This study highlights that biofilms must be recognized as a BSI and UTI resistance factor as well as a BSI virulence factor.