bluuebunny/crossref_metadata_2025 huggingface dataset:
Chitosan’s effects on the acidity, copper ion release, deflection, and surface roughness of copper-nickel-titanium archwire
Authors: Devi Ika , Sufarnap Erliera , Finna  , Pane Eric Rionaldi P
Published: February 2023

Background: Chitosan has an antimicrobial effect in oral hygiene control. Orthodontists sometimes prescribe mouthwash to adolescent patients. Copper-nickel-titanium (CuNiTi) orthodontic archwire is widely used in orthodontic treatment. Chitosan’s effects on the CuNiTi properties of orthodontic archwire are not generally known. Purpose: This study aimed to measure the acidity, copper ion release, deflection, and surface roughness of CuNiTi orthodontic archwire immersed in artificial saliva and 2% chitosan. Methods: This study comprised experimental laboratory research. Forty-two CuNiTi orthodontic archwires were divided into three groups. Group A consisted of 18 archwires immersed in artificial saliva, Group B consisted of 18 archwires immersed in 2% chitosan, and Group C was six archwires for the baseline sample. The two intervention groups (A and B) were divided into three subgroups of six samples and were subjected to different immersion times—i.e., two, four, and six weeks. Acidity, copper ion release, deflection, and surface roughness were measured using pH meters, atomic absorption spectrophotometry (AAS), a universal testing machine (UTM), and a scanning electron microscope (SEM). Results: The results showed that Group A was more alkaline than Group B, and it was significantly different only in Week 2. Group B’s copper ion release was significantly lower than Group A for all the time observations (p<0.05), and the deflection analysis showed no significant difference in any of the groups (p>0.05). Furthermore, the SEM images showed CuNiTi in Group A at Week-6 had the most porosities and defects. Conclusion: The chitosan produces buffer effects on the pH; it also exhibits lower copper ion release, no differences in unloading forces, and subjectively has better surface roughness.
Physical characterization and analysis of tissue inflammatory response of the combination of hydroxyapatite gypsum puger and tapioca starch as a scaffold material
Authors: Naini Amiyatun , Rachmawati Dessy
Published: February 2023

Background: Cases of bone damage in the oral cavity are high, up to 70% of which consist of cases of fracture, tooth extraction, tumor, and mandibular resection. The high number of cases of bone damage will cause the need for bone graft material to increase. The bone graft material that we have developed is a combination of hydroxyapatite gypsum puger (HAGP) and tapioca starch (TS) scaffold. Purpose: This study analyzes the physical characterization and tissue inflammatory response of the combination of HAGP+TS as a scaffold for bone graft material. Methods: Eighteen Wistar rats were used. HAGP+TS were installed into the molar 1 socket for 7 and 14 days. First, HAGP was evaluated using XRF and SEM before setting up the in vivo experiment. A blood sample was drawn and then tested for TNF-α levels using ELISA. Results: The XRF revealed that the main constituents of hydroxyapatite were Ca and P. Next, SEM characterization on the HAGP+TS showed an average pore size of 112.42 µm2, which is beneficial for cell activity to grow as new bone tissue. In addition, TNF-α on days 7 and 14 on the HAGP+TS scaffold did not elicit an inflammatory response. Conclusion: The combination of HAGP+TS contains a high amount of Ca and also has excellent interconnectivity between pores. It also does not trigger an inflammatory response in the tissue; therefore, it is a good candidate as an alternative bone graft material.
Pain parameters for buffered and non-buffered anesthetic injections in children undergoing dental procedures
Authors: Puspitasari Theodora Erlin , Musnamirwan Iwan Ahmad , Gunawan Kirana Lina , Gartika Meirina
Published: February 2023

Background: Dental procedures, such as injections, usually cause pain and make children uncomfortable and uncooperative. One approach for reducing pain is the use of buffered anesthetics. Purpose: The research objective was to assess the pain parameters between buffered and non-buffered anesthetic injections, based on oxygen saturation, pulse rate, and the self-reporting of pain by the children. Methods: The research method was quasi-experimental, with purposive sampling of 19 children. Pain parameters, based on oxygen saturation and pulse rate, were measured using a pulse oximeter. The self-reporting of pain used the Wong–Baker FACES® pain rating scale. Statistical analysis used a t-test and Mann–Whitney test with P < 0.01 taken as statistically significant. Results: The results showed a significant difference in oxygen saturation before and after the injection of buffered and non-buffered anesthetics (P = 0.0002). Delivering the buffered anesthetics were reported to be less painful than non-buffered anesthetics. The oxygen saturation and pulse rate were inversely proportional to the self-reporting of pain in children. Statistical analysis showed no significant difference between oxygen saturation (P = 0.5) and pulse rate (P = 0.4886) in those receiving buffered and non-buffered anesthetics. However, there was a significant difference in the self-reporting of pain between the two groups (P = 0.00000262). Conclusion: Pain parameters could be measured physiologically and psychologically. This research concludes that physiologically, there was no difference in pain parameters, based on oxygen saturation and children’s pulse rate. Psychologically, there was a difference in the self-reporting of pain; 14 children reported that delivering the buffered anesthetic was painless.
Potential of Pigmented Rice Variety Cempo Ireng in Rice Breeding Program for Improving Food Sustainability
Authors: Dwiningsih Yheni , Alkahtani Jawaher
Published: February 2023

Cempo Ireng (Oryza sativa L. var. Cempo Ireng) is one of the black rice variety in Indonesia that consumed as functional food, not as a staple food because of the black rice contains anthocyanin pigment which has beneficial to human health. High concentration of anthocyanin reaching 393.93 ppm cause black color in the pericarp layer of Cempo Ireng which make this variety as an antioxidant source, low glycemic index, and free of gluten, leading to have higher price in the rice market. However, most of the farmers are not cultivate Cempo Ireng due to the longer vegetative phase up to 150 days compared to the white rice varieties which only takes 90 days, the taller phenotype of Cempo Ireng cause problems in cultivation, and also the purple color of Cempo Ireng attract birds and earhead bug (Leptocorisa oratorius) to feed on black rice caryopsis that cause severe yield loss. Transgenic methods, mutation technique, intensification systems, and physical treatment have been applied in Cempo Ireng to overcome those lack characteristics. In the future, Cempo Ireng also has a big potential to become a parent in cross breeding program because of the positive characters. The aim of this review is to describe the potential of Cempo Ireng in rice breeding program for improving food sustainability.
Prioritizing Tree Based Land Management Options for Optimizing Carbon Sink in the Indian sub-Himalayan Region
Authors: Dey Tanusri , S Dinesha , Singh Manendra , A Arshad , Tamang Mendup , N. Shahina N , Nath Arun Jyoti , Shukla Gopal , Chakravarty Sumit
Published: February 2023

Land resources have been under tremendous anthropogenic pressure with the consequence of their degradation. It is therefore necessary that the land resources must be managed effectively for sustainable development. Different from the developed countries, carbon inventories and data bank to monitor carbon sequestration potential of different ecosystems are unavailable in India. Micro-level studies are essential for sustainable land use management for a land scarce nation like India. To achieve the desirable goal of the present study, a total of 33 tree-based land uses were identified from forested and agricultural landscapes. Of these total land uses, five were in forest landscapes and rest in agricultural landscapes categorized into forest tree plantations (8 land uses), agroforestry (nine land uses), commercial crop plantations (six land uses) and fruit orchards (five land uses). A stratified random nested quadrate sampling method was adopted for vegetation analysis of the different land uses. The SOC, biomass and carbon accumulation in the tree-based land uses were significantly different from each other. Mixed forest soil had the highest amount of SOC, primary nutrients, standing biomass carbon, and ecosystem carbon. Positive correlations were observed between SOC, total standing biomass, litter production, and ecosystem carbon. The sequence of best tree based land uses in terms of total SOC (up to 60 cm depth), total plant biomass, total plant biomass carbon and ecosystem carbon was mixed species forest (126.67, 781.21, 390.61 and 517.27) > sole tree species stands in forest landscape (109.71, 192.56, 96.28 and 205.98) > tea plantations (103.19, 77.07, 38.54 and 141.74) > homegardens (90.34, 97.38, 48.69 and 139.02) > mixed plantation of Anthocephalus cadamba + Swietenia macrophylla (60.07, 111.86, 55.93 and 116.02) > Swietenia macrophylla based agroforestry (62.49, 83.82, 41.91 and 104.40) > mixed plantation of Tectona grandis + Milvus migrans (60.0, 85.97, 42.99 and 102.90). Similarly, the order of the major land uses was forest > commercial crop plantation > forest tree plantations > agroforestry > fruit orchards. The overall average ecosystem carbon accumulation in forests was 3.24 times more than the land uses in agricultural landscapes. The ecosystem carbon accumulation in the tree-based land uses in both forest and agricultural landscape was highly variable and was significantly different from each other. Land use conversion from forest to agriculture can reduce more than half of the carbon stock, but converting into homegardens, tree plantations or agroforestry enhanced carbon storage of the land use systems. The present findings can be used as baseline information for developing prediction models for probable effects of different land use, future intervention and sustainable management of land use systems.
A Concise Overview of the Vision-based Human Action Recognition Field
Authors: Camarena Fernando , Gonzalez-Mendoza Miguel , Chang Leonardo , Cuevas-Ascencio Ricardo J
Published: February 2023

Artificial intelligence’s rapid advancement has enabled various applications, including intelligent video surveillance systems, assisted living, and human-computer interaction. These applications often require one core task: video-based human action recognition. Research in human video-based human action recognition is vast and ongoing, making it difficult to assess the full scope of available methods and current trends. This survey provides an in-depth exploration of the vision-based human action recognition field, comprehensively offering the available techniques and their evolution, highlighting the cutting-edge ideas driving its development. We also analyze the most used keywords in research papers over the past years to identify trends and predict possible future directions. Hence, this concise survey helps researchers understand the breadth of existing approaches, evaluate current research trends, and stay up-to-date on potential developments.
Subacromial-Subdeltoid Bursitis With Rice Bodies After Rotator Cuff Repair With a Collagen Scaffold Implant
Authors: Root Kevin T. , Wright Jonathan O. , Mandato Nicholas , Stewart Brian D. , Moser Michael W.
Published: February 2023

Case:

We report the second-known case of subacromial-subdeltoid bursitis with rice bodies after rotator cuff repair with a Smith + Nephew REGENETEN bovine-derived bioinductive collagen scaffold implant. After the removal of rice bodies and a portion of implant that had not incorporated, the patient recovered well and made a full return to work and recreational activities.

Conclusion:

This case demonstrates that persistent pain, swelling, or decreased range of motion for several months after rotator cuff repair with the use of a collagen implant may warrant a relatively early magnetic resonance imaging to evaluate for underlying pathology. It also provides a framework for physicians who may see similar patients in the future.
Swainson’s Hawk Nesting Population in the Antelope Valley of the Western Mojave Desert, California
Authors: Bloom Peter H. , Barton Rainey G. , Kuehn Michael J.
Published: February 2023

The Swainson’s Hawk (Buteo swainsoni) has a long history of breeding in California, but a severe decline in the statewide breeding population was identified in 1979, when in all of southern California only two pairs were found, one in the Antelope Valley of the western Mojave Desert. That area was little studied until we began banding Swainson’s Hawks there in 1997. Over 20 breeding seasons between 1979 and 2022, we documented in the Antelope Valley 124 attempts to nest, in which the mean clutch and brood sizes were 2.49 and 2.37, respectively. From 2004 through 2006, we observed two to four breeding pairs annually; from 2009 through 2022, three to 14 breeding pairs. The rate of success of the 91 nests revisited to determine if any young fledged was 64%. Nest trees consisted of 81.5% non-native species, 13.7% native species, including Joshua trees (Yucca brevifolia), and 4.8% unidentified deciduous trees. Between 1997 and 2022, in 50 nests, we recorded 170 vertebrate prey items, of which 90 were gophers (Thomomys bottae). Though the Antelope Valley population has grown since 1980, its nesting and foraging habitat now face multiple threats. To conserve occupied nesting territories, we recommend creation of nesting and foraging habitat reserves that include both native desert and cultivated alfalfa close to existing conserved land.
Status of the Western Snowy Plover in Coastal Los Angeles and Orange Counties, California
Authors: Ryan Thomas P. , Vigallon Stacey , Griswold Ross , Plauzoles Lucien , Egger Cheryl , Sheakley Susan , Nguyen Lana , Schallmann Robert
Published: February 2023

From 2004 to 2021 we monitored the Western Snowy Plover (Charadrius nivosus nivosus) in coastal Los Angeles and Orange counties, California. Following an absence of 68 years, it returned to nest in 2017. Since then, the plovers have nested at three locations in Los Angeles County and four in Orange County, where numbers of nests at Anaheim Bay, Bolsa Chica State Beach, and Huntington State Beach increased. Protective beach management and nest enclosures presumably contributed to the increase of nests and hatching success at these sites. However, the number of nonbreeding Snowy Plovers in coastal Los Angeles County has declined, most steeply at Zuma Beach. At nonbreeding roosts in Orange County numbers at Balboa Beach and San Onofre State Beach declined, but countywide numbers were stable. All sites at which plovers roost experience human-related disturbance, which may include vehicles driving through them regularly, beach grooming that removes wrack and foraging resources, dogs chasing and flushing roosting plovers, and nearby large recreational events and summer camps as nonbreeding plovers return in July. Most sites lack consistent protective measures. Plover mortality has resulted from vehicle strikes and dogs. We recommend management that includes the establishment of special protection zones, restrictions on sand grooming, wrack removal, and vehicle traffic, and installation of protective enclosures around roost sites.
Obesity-associated changes in molecular biology of primary breast cancer
Authors: Desmedt Christine , Nguyen Ha-Linh , Geukens Tatjana , Maetens Marion , Aparicio Samuel , Bassez Ayse , Borg Åke , Brock Jane , Broeks Annegien , Caldas Carlos , Cardoso Fatima , De Schepper Maxim , Delorenzi Mauro , Drukker Caroline , Glas Annuska , Green Andrew , Isnaldi Edoardo , Eyfjörd Jórunn , Khout Hazem , Knappskog Stian , Krishnamurthy Savitri , Lakhani Sunil , Langerod Anita , Martens John , Reed Amy McCart , Murphy Leigh , Naulaerts Stefan , Nik-Zainal Serena , Nevelsteen Ines , Neven Patrick , Piccart Martine , Poncet Coralie , Punie Kevin , Purdie Colin , Rakha Emad , Richardson Andrea , Rutgers Emiel , Vincent-Salomon Anne , Simpson Peter , Schmidt Marjanka , Sotiriou Christos , Span Paul , Tan Kiat Tee Benita , Thompson Alastair , Tommasi Stefania , Baelen Karen Van , de Vijver Marc van , Laere Steven Van , Veer Laura Van 'T , Viale Giuseppe , Viari Alain , Vos Hanne , Witteveen Anke , Wildiers Hans , Floris Giuseppe , Garg Abhishek , Smeets Ann , Lambrechts Diether , Biganzoli Elia , Richard François
Published: February 2023

Worldwide, there is a growing proportion of women who are overweight or obese. While obesity has been associated with an increased risk of developing breast cancer (BC) and worse prognosis in BC patients, yet the impact of adiposity (abnormal or excess body fat) on BC biology remains understudied in humans. This retrospective study aimed to investigate how the biology of primary BC would differ according to patients’ body mass index (BMI). We examined clinicopathological data (including BMI at the time of diagnosis) and molecular data (including genomic, bulk and single-cell transcriptomic data) of treatment-naïve (early stage) BC patients from five cohorts (N = 2071). We identified several genomic alterations considered actionable or of potential clinical relevance which had a different prevalence in overweight or obese patients compared to lean patients, for instances, less PIK3CA gene mutations, and more CCND1, CCNE1 and IGFR1 amplifications. Moreover, we found evidence supporting an ageing accelerating effect of obesity at the genetic level, through its association with an age-associated mutational signature. We showed that BMI-associated differences in transcriptomic profile were subtle at the bulk resolution while single cell profiling allowed detection of more pronounced changes in different cell compartments. Investigation at the single cell resolution revealed an elevated and unresolved inflammation of the BC tumor microenvironment (TME) associated with obesity, which had distinct characteristics contingent on the estrogen receptor status. Collectively, analyses at both genomic and transcriptomic levels implied that obesity is associated with an inflammaging-like phenotype of the TME. Our results indicate that patient adiposity might play a significant role in the heterogeneity of BC and should be considered in the context of precision medicine.
A review of reviews exploring patient and public involvement in population health research
Authors: Vinnicombe Soo , Noyes Jane
Published: February 2023

Introduction

Patient and public involvement (PPI) is increasingly seen as something that is integral to research and of importance to research funders. There is general recognition that PPI is the right thing to do for both moral and practical reasons. The aim of this review of reviews is to examine how PPI can be done ‘properly’ by looking at the evidence that exists from published reviews and assessing it against the UK Standards for Public Involvement in Research, as well as examining the specific features of population health research that can make PPI more challenging.

Methods

A review of reviews was carried out following the 5-stage Framework Synthesis method.

Results

In total 31 reviews were included. There is a lack of current research or clarity around Governance and Impact when findings are mapped against UK Standards for Public Involvement in Research. It was also clear that there is little knowledge around PPI with under-represented groups. There are gaps in knowledge about how to ensure key specific attributes of population health research are addressed for PPI team members – particularly around how to deal with complexity and the data-driven nature of the research. Two tools were produced for researchers and PPI members to further improve their PPI activity within population health research and health research more generally: A framework of recommended actions to address PPI in population health research, and guidance on integrating PPI based on the UK Standards for Public Involvement in Research.

Conclusions

Facilitating PPI in population health research is challenging due to the nature of this type of research and there is far less evidence on how to do PPI well in this context. The tools can help researchers identify key aspects of PPI that can be integrated when designing PPI within projects. Findings also highlight specific areas where more research or discussion is needed.
Prognostic value of deep learning based mitotic count in hormonal receptor- and HER2-positive breast cancer
Authors: Balkenhol Maschenka , Mercan Caner , Tessier Leslie , Tellez David , Salgado Roberto , Joensuu Heikki , Loi Sherene , Michiels Stefan , Larsimont Denis , Wegscheider Anne-Sophie , Niendorf Axel , Sherman Mark , Bult Peter , Ciompi Francesco , Laak Jeroen van der
Published: February 2023

The discovery of molecular subtypes has corroborated the heterogeneity of breast cancers. But in clinical routine, treatment selection relies on measuring the aggressiveness of the tumor via histopathology, which is routinely based on grading, a prognostic yet laborious, poorly reproducible, and subjective procedure defined more than 30 years ago, before molecular subtypes existed.
In this paper, we present an interpretable deep learning-based computer-aided diagnosis method to automate mitotic count, one of the components of grading; the method complies with current guidelines and automates hot-spot finding on full digital whole-slide images of routinely prepared pathologic slides stained with hematoxylin and eosin. We use the computer model to query the current “one-size-fits-all” mitotic count procedure by investigating subtype-specific prognostic value of mitotic count using an external independent large-scale multicentric dataset of 1,709 breast cancers.
We show that for human epidermal growth factor-2 (HER2) positive tumors, mitotic count was not prognostic. In hormone-receptor positive/HER2 negative cancers, an average mitotic count density different from clinically used cut offs predicted worse recurrence free survival in multivariable analysis, adjusted for known clinical prognosticators. We provided some first experimental evidence that the prognostic role of mitotic count should be reviewed.
Three-dimensional nonlinear coupling vibration of drill string in deepwater riserless drilling and its influence on wellbore pressure field
Authors: Chen Yili , Liu Jun , Cai Mengqi
Published: February 2023

In deepwater riserless drilling operations, the vibration behavior of drill string may have a significant impact on wellbore pressure, which leads to serious risks of drilling accidents such as well leakage and well collapse in shallow risk areas. In order to solve this problem, based on Hamilton's principle, a three-dimensional nonlinear coupling dynamics model of drill string in deepwater riserless drilling is established to simulate the dynamic behavior of drill string under offshore drilling conditions, considering the influence of heave and offset motion of offshore platform, ocean current load, drillstring-borehole contact and bit-rock interaction. The Newmark-β method is used to solve the nonlinear discrete equations of the system, and the effectiveness of the model and calculation program is verified by the field test data. Meanwhile, a wellbore pressure field model under axial, lateral and torsional motion modes of drill string in deepwater riserless drilling is established. The three-dimensional nonlinear coupling vibration characteristic of drill string and its influence on wellbore pressure fluctuation are investigated. The results indicate that: excitation and natural frequency play a leading role in axial vibration response; the collision between the drill string and the borehole wall mostly occurs in the middle part of the formation section, and the lateral vibration at the bit is the most intense; and the closer to the upper platform, the more high-frequency components of torsional vibration response and the stronger the chaos. The larger the axial vibration amplitude of drill string is, the greater the influence on wellbore pressure field is; for the lateral vibration, the middle and bit position have great influence on the wellbore pressure field; for the torsional vibration, the bottom position has the greatest influence on wellbore pressure field. Compared with the axial and torsional vibration, the lateral vibration of drill string has the greatest influence on the wellbore pressure field.
Research on fault current control method of DC microgrid battery energy storage system
Authors: Wei Tianliu , Li Weiwei , Guo Fang , Wang Ruiyang , Wei Chengzhi , Zheng Bingyao , Jiang Jiaxi
Published: February 2023

Battery energy storage system has become an important link to maintain the stable operation of DC microgrid because of its flexible control and fast response speed. As the battery storage system generally does not have fault current control capability, when a fault occurs between the poles of the system, the battery storage system will provide a great short-circuit current to the fault point, which will cause a great danger to the system operation and equipment safety. At this stage, current-limiting reactors or fault current limiters are generally added to the ports of the energy storage system to reduce the fault current, which has the disadvantage of limited current-limiting effect or high cost and large area, so it is not suitable for wide application in DC microgrid. This paper proposes a fault current control method for DC microgrid battery storage system, which enables the battery storage system to be connected to DC microgrid through Buck DC/DC by increasing the rated voltage of the battery stack.The control mode of the battery storage system is power control mode when the DC microgrid is running on grid, and it will be changed to voltage control mode when the DC microgrid is running off-grid. In case of inter-pole fault, the Buck DC/DC of the battery storage system is controlled to operate with reduced voltage to achieve fault current limit. This scheme does not affect the normal operation of the system, and can quickly limit the peak short-circuit current without adding additional equipment, making the short-circuit current flexible and controllable. Therefore, this scheme has good fault current limiting capability and greatly reduces the technical requirements of DC microgrid for protection. Finally, this paper verifies the feasibility of the proposed scheme and its control strategy through PSCAD/EMTDC modeling simulation.
Does macauba cake alter nutrient digestibility and microorganism population in the rumen of sheep?
Authors: Geraseev Luciana Castro , Duarte Eduardo Robson , Vieira Edvaldo Alves , Ibarra Niurca González , Chaves Amália Saturnino , Santos Sarah Silva , Azevedo Alcinei Mistico , Passetti Rodrigo Augusto Cortêz
Published: February 2023

This study aimed to determine the effects of including macauba cake (MC) in the diets of Santa Ines sheep on nutrients digestibility, and the population of microorganism in the rumen (total bacteria, anaerobic fungi, methanogenic organisms,Ruminococcus flavefaciens, andFibrobacter succinogenes). Twenty male sheep were distributed in a randomized block design with four MC treatment diets (0, 10, 20, and 30% of total dry matter). MC inclusion did not affect the dry matter, organic matter, or crude protein intake, but increased the ether extract, neutral detergent fiber, and acid detergent fiber intake, mainly because of changes in the concentrations of these components in diets with a higher level of MC. With MC inclusion, a linear decreasing effect was observed for the dry matter and organic matter digestibility, and a quadratic effect with a maximum point of 21.5% was observed for the acid detergent fiber digestibility. MC inclusion reduced anaerobic fungal populations and increased methanogenic populations. The increase in methanogenic organisms can be associated with the higher fiber content in diets containing MC. The inclusion of macauba cake in the diet of lambs reduced the dry matter digestibility, promoted an antifungal effect and increased the methanogenic population.
The Impact of COVID-19 on Clerkship Preparedness in Third Year Medical Students
Authors: Lee Cynthia , Andersen Shaun , Patel Deepal , Leon Genesis , Simanton Edward
Published: February 2023

Background:
The COVID-19 pandemic presented a unique challenge to medical education, as students were abruptly required to adapt to a remote learning format. Previous studies show a decline in examination performance among medical students during their initial semester of the pandemic, relative to pre-COVID cohorts. The purpose of our study was to investigate whether such negative outcomes affected medical students’ preparedness for clerkship training.
Methods:
Medical students at the Kirk Kerkorian School of Medicine, consisting of both third-year students who completed pre-clinical training amid the COVID-19 pandemic, and fourth-year students from the pre-pandemic cohort, were administered a Qualtrics survey to assess their perceived preparedness for clerkship training. Students’ confidence in key clinical skills were measured, such as taking patient histories, conducting physical exams, and communicating with medical staff. Students rated the relative importance of didactic lectures versus experiential learning for clerkship preparation. Performance on National Board of Medical Examiners shelf examinations were compared.
Results:
There was a significant difference in perception of disadvantage prior to starting clerkships between the COVID-cohort and their pre-COVID counterparts (mean ratings of 4.3/5 vs. 3.4/5). A greater proportion of the COVID cohort deemed experiential learning as more important than didactic lectures (37.5% vs. 62.5%) as opposed to the pre-COVID cohort which considered didactic lectures as more important (53.2% vs. 46.8%). This difference in perception did not translate to a significant difference in academic performance in the six NBME subject exams taken: Family Medicine, Internal Medicine, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery.
Conclusion:
The implementation of online learning during the COVID-19 pandemic did not have a significant impact on the self-perceived preparedness for clerkship training among medical students. Despite the perception of disadvantage among students who matriculated during the pandemic, overall levels of preparedness do not appear to be affected by the shift to remote instruction. This may be due to a phenomenon the authors deem as the “Grass is Greener,” where individuals perceive that they have missed out on resources that were given to others.
Building an inpatient addiction medicine consult service in Sudbury, Canada: preliminary data and lessons learned in the era of COVID-19
Authors: Leary Tara , Aubin Natalie , Marsh David C , Roach Michael , Nikodem Paola , Caswell Joseph M , Irwin Bridget , Pillsworth Emma , McLelland Maureen , Long Brad , Bhagavatula Sastry , Eibl Joseph K , Morin Kristen A
Published: February 2023

Objective: The goal of this study was to 1) Describe the patient population of a newly implemented addiction medicine consult service (AMCS); 2) Evaluate referrals to community-based addiction support services and acute health service use, over time; 3) Provide lessons learned.
Methods: A retrospective observational analysis was conducted at Health Sciences North in Sudbury, Ontario, Canada, with a newly implemented AMCS from November 2018 and July 2021. Data were collected using the hospital's electronic medical records. The primary outcome was the number of referrals to community-based addiction support services over time. The secondary outcomes included the number of emergency department visits, inpatient admissions and re-visits over time. An interrupted time-series analysis was performed to measure the effect of AMCS implementation on acute health service use at Health Sciences North.
Results: From November 2019 to December 2020, 833 unique patients were assessed through the AMCS. A total of 1,294 referrals were made to community-based addiction support services, with the highest proportion of referrals between August and October 2020. The post-intervention trend for ED visits, ED re-visits, ED length of stay, inpatient visits, re-visits and inpatient length of stay did not significantly differ from the pre-intervention period.
Conclusion:Implementation of an AMCS provides a focused service for patients using substances of diagnosed with substance use disorders. The service resulted in a high referral rate to community-based addiction support services and limited changes in health service usage.
Clinical, Etiological and Management Aspects of Spondyloarthritis in Guinea
Authors: Condé Kaba , Othon Guelngar Carlos , Barry Abdoulaye , Touré Moriba , Kamissoko Alybadara , Cissé FodéAbass
Published: February 2023

Introduction- Spondyloarthritis is classically considered rare in sub-Saharan Africa where the majority of the population is considered HLA-B27 negative.The objective of this study was to describe the profile of spondyloarthritis in the rheumatology department of the Ignace Deen National Hospital in Conakry, Guinea.
Patients and method -This was a descriptive and analytical cross-sectional study, with both prospective and retrospective data collection over a 4-year period. The diagnosis of SpA was made in accordance with the ASAS (Assessment of Spondyloarthrisis) and modified New York criteria.
Results -During the study period, we evaluated 275 patients with spondyloarthritis. The mean age was 39.7 ±11 years with extremes (20 and 75 years), 150 patients (54.5%) were men. A history of familial SpA was present in 95 (34.5%) of the patients. The mean time to diagnosis was 8 ± 4 years. Axial involvement was dominated by involvement of the lumbar spine 225 (82%). Ankylosing spondylitis was the most common form in 198 (72%) of the cases. Extra-articular manifestations were dominated by uveitis in 55 (20%) of cases. HLA-B27 phenotyping was performed in 125 patients, 62 patients were HLA-B27 positive (49.6%). The treatment was based on nonsteroidal anti-inflammatory drugs 225 (81.8%).
Conclusion -SpA are growing in Guinean hospitals, the HLA-B27 antigen is increasingly found in African series. Treatment is mainly based on non-steroidal anti-inflammatory drugs.
CD40LG-associated X-linked Hyper-IgM Syndrome (XHIGM) with Pulmonary Alveolar Proteinosis: A Case Report
Authors: Xu Hongbo , Tian Maoqiang , Bai Yonghua , Ran Xiao , Li Lei , Chen Yan
Published: February 2023

Background: D40LG-associated X-linked hyper-IgM syndrome with pulmonary alveolar proteinosis has rarely been reported, and its genotype-phenotypic correlation remains elusive.
Case Presentation: We describe a five-month-old boy with CD40LG mutation (c.516T>A, p.Tyr172Ter) X-linked hyper-IgM syndrome with pulmonary alveolar proteinosis as the first manifestation. The patient completely recovered after immunotherapy and allogeneic hematopoietic stem cell transplantation. In addition, four previously reported patients with CD40LG mutation with pulmonary alveolar proteinosis were also analyzed. All of these patients presented with early onset of pulmonary infections and a good response to immunotherapy. The structural model of CD40LG indicated that all mutations caused the X-linked hyper-IgM syndrome with pulmonary alveolar proteinosisto be located within the tumor necrosis factor homology domain.
Conclusions: A case was presented, and the characteristics of four cases of CD40LG-associated X-linked hyper-IgM syndrome with pulmonary alveolar proteinosis were summarized. The variant locations may explain the phenotypic heterogeneity of patients with the CD40LG mutation.
New insights into method development and characterization of amorphous silica from wheat straw
Authors: Ramasamy Sangeetha Piriya , Veeraswamy Davamani , Ettiyagounder Parameswari , Arunachalam Lakshmanan , Devaraj Sivakumar Senjeriputhur , Krishna Kadirvelu , Oumabady Sadish , Sakrabani Ruben
Published: February 2023

Amorphous silica is extensively extracted from agricultural residues. Wheat straws are a rich source of silica that have earlier been overlooked however demand for value addition. The proposed study describes an innovative approach for extracting silica from wheat straw and evaluating its structural, textural, and physico-chemical characteristics. Optimum temperature, concentration and pH were identified for the cleaner production of silica. The crystallographic properties analysed by the X-Ray diffraction revealed amorphous nature of silica extracted from ash at 650°C for 4h. The structure of phytolith present in the wheat straw was observed in the form of articulated elongate undulate epidermal phytolith under scanning electron microscope. The energy dispersive X-ray spectrum exhibited higher amount of silica (Si %) of 70.10% with a minimal percentage of potassium (9.96%). The sharp bend at 1025 cm-1 attributed the siloxane (Si-O-Si) vibrations in Fourier transform infrared spectroscopic graph of amorphous silica. The specific surface area measurements of amorphous silica showed type II isotherm curve with a hysteresis of H3 type. The optimum conditions to obtain amorphous silica were 3M NaOH, 3M H2SO4 and pH 9.
Assessing PE teachers perceptions of the barriers to physical activity for inactive children and young people in secondary schools and identifying facilitators to support future public health intervention design using the COM-B model
Authors: Moore Richard , Edmondson Lee , Gregory Maxine , Griffiths Kerry , Freeman Elizabeth
Published: February 2023

Background: Research shows that schools’ efforts to improve children and young people’s (CYP) physical activity (PA) behaviours have been largely unsuccessful. The study investigates Physical Education (PE) teachers’ perceptions of barriers to physical activity (PA) for inactive CYP in secondary schools and to identify facilitators to support future public health intervention design, using the COM-B model of behaviour change and Theoretical Domains Framework.
Method: This study is a qualitative examination of the perceptions of PE teachers of inactive CYP in deprived secondary schools in England. The method involved structured telephone interviews with 156 Heads of PE in schools and analysed the data with thematic analysis.
Results: The study provides a comprehensive understanding of the barriers to PA in secondary schools from the unique perspective of PE teachers. The research identifies 21 barriers to PA and details the main sources of behaviour, intervention functions, policy functions and behaviour change tools that can be applied to support behaviour change for inactive adolescents. The authors suggest the use of digital approaches, particularly conversational AI, to provide a more personalised, natural language experience to engage CYP at scale and overcome barriers to PA.
Conclusion: The study is the first to apply the COM-B model, Behaviour Change Wheel, and TDF Framework to understand the habits and behaviours of inactive CYP. The findings of this study have important implications for policy and practice, providing a deeper understanding of the barriers to physical activity and potential solutions to overcome them.
The effect of preemptive middle glenohumeral ligament release in arthroscopic rotator cuff repair to reduce postoperative stiffness: A retrospective comparative study
Authors: Takahashi Ryosuke , Kajita Yukihiro , Harada Yohei , Iwahori Yusuke
Published: February 2023

Background: This study aimed to evaluate the efficacy of preemptive middle glenohumeral ligament (MGHL) release in arthroscopic rotator cuff repair (ARCR) to reduce postoperative stiffness.
Methods: Patients who underwent ARCR were enrolled and allocated into two groups retrospectively: the preemptive MGHL release group (n=44) and the preemptive MGHL non-release group (n=42). Clinical outcomes were assessed and compared between the two groups, including the range of motion, Japanese Orthopedic Association Shoulder Score, Constant Shoulder Score, and the University of California, Los Angeles Score preoperatively and 3 months, 6 months, and 12 months postoperatively and complications. The integrity of the repaired tendon was assessed at the 12-month follow-up using magnetic resonance imaging.
Results: There were no significant differences between the groups in all range of motion and all functional scores at any of the assessed time points. There was also no significant difference in the healing failure rate 2.3% in the preemptive MGHL group and 2.4% in the preemptive MGHL non-release group (p=.97), and postoperative stiffness was 2.3% in the preemptive MGHL group and 7.1% in the preemptive MGHL non-release group (p=.28). There was no postoperative instability in both group.
Conclusion: ARCR effectively facilitates the recovery of range of motion and function in patients with a rotator cuff tear. However, preemptive MGHL release could not be an effective method to reduce postoperative stiffness.
The coagulation-related genes for prognosis and tumor microenvironment in pancreatic ductal adenocarcinoma
Authors: Wang Di , Cui Song-ping , Chen Qing , Ren Zhang-yong , Lyu Shao-Cheng , Zhao Xin , Lang Ren
Published: February 2023

Background: Pancreatic ductal adenocarcinoma (PDAC) is the malignancy with difficult early diagnosis and poor prognosis. The coagulation is believed to affect tumor microenvironment of PDAC. The purpose of this study is to further identify the coagulation-related genes and explore immune infiltration in PDAC.
Methods: Two coagulation-related subtypes genes were collected in KEGG database. We obtained the transcriptome sequencing data and clinical information in PDAC from The Cancer Genome Atlas (TCGA) database. Patients were divided into different clusters using the unsupervised clustering method. We further explored the mutation frequency to study the genomic features. Enrichment analysis was performed and explored the pathways by Gene Ontology(GO) and Kyoto Encyclopedia of Genes(KEGG). The relationship between tumor immune infiltration and two clusters was analyzed by CIBERSORT. The prognostic model was constructed for risk stratification and the nomogram was established to facilitate the risk score. The response to immunotherapy was evaluated by IMvigor210 cohort. Finally, we recruit PDAC patients and collect the experiment samples to validate the Neutrophils infiltration using immunohistochemistry and identify the ITGA2 expression and function by Single cell sequencing analysis.
Results: Two coagulation-related clusters were divided based on the coagulation pathways in PDAC patients. Functional enrichment analysis showed different pathways in two clusters. The DNA mutation of coagulation-related genes occurred in about 49.4% of PDAC patients. Then the patients in two clusters had significant difference in immune cell infiltration, immune checkpoint, tumor microenvironment and TMB. We established the 4-genes prognostic stratified model through LASSO analysis. The nomogram based on risk score can accurately predict the prognosis in PDAC patients. We identified the hub gene ITGA2. ITGA2 was correlated with poor overall survival (OS) and short disease free survival (DFS). Single cell sequencing analysis showed that ITGA2 was expressed by Epithelial cells and high expression may enhance the function of tumor metastasis in PDAC.
Conclusions: We demonstrated the correlation the coagulation-related genes with tumor immune microenvironment, and the stratified model can predict the prognosis and calculate the drug therapy benefits, which provide the recommendation for clinical personalized treatment.
Valuation of provisioning ecosystem services and household dependency for livelihood: Empirical evidence from a tropical dry forest, India
Authors: Sharma Anil , Patel Sanoj Kumar , Singh Rinku , Tiwari Amit Kumar , Singh Gopal Shankar
Published: February 2023

The present study investigated the contribution of provisioning ecosystem services (PES) to the annual incomes of rural households in Vindhyan highlands, India. Household surveys, focus group discussions and key informant interviews were used to collect data, which was stratified by household size. A total of 225 households were chosen for further investigation from three villages adjacent to the forest. We employed one way ANOVA and Pearson’s correlation to analyze the quantitative data. The findings demonstrate that PES are critical in supplying rural livelihoods with fuelwood, fodder, leaves, wild edibles, medicines, oil seeds and resins. The overall value was estimated to be 24,781.66, 25,552.95, 16,494.46 INR per household per year for large size and 5467.39, 2671.12, 2029.62 INR per household per year for small size among the three villages. The results revealed that large households earn more than middle and small households in study area. The relationship between variables (household size, age, education, distance to forests and time spent) and PES income was tested using Pearson's correlation. The results exhibited that socio-economic factors impacted PES income substantially (p < 0.01, p < 0.05) in this study. The findings of this study can help policymakers to create mechanisms in conservation policies and regulations so that adjacent forest households can benefit from ecosystem provisions.
A simple model for pink noise from amplitude modulations
Authors: Morikawa Masahiro , Nakamichi Akika
Published: February 2023

We propose a simple model for the origin of pink noise (or 1/f fluctuation) based on the beat of cooperative waves. These cooperative waves arise spontaneously in a system with synchronization, resonance, and infrared divergence. Many cooperative waves with close frequencies can produce signals of arbitrary small frequencies from a system of small size. This beat mechanism can be understood as amplitude modulation. The pink noise can appear after the demodulation process, which produces a variety of pink noise in many fields. The pink noise thus formed from the beat has nothing to do with dissipation or long-time memory. We also suggest new ways of looking at pink noise in shallow earthquakes, solar flares, and stellar activities.
Outcomes of Neurorehabilitation Amongst Patients with Prolonged Disorders of Consciousness
Authors: Mohammed Mohammed Saif , Sharbatti Shatha Al , Nemmar Anas , Kumar Sharanya Suresh , Sharma Krishna Prasad , Banu Sharmila , Khan Asma Misal , Mahmoud Iman
Published: February 2023

Background: Less is known about the impact of Neurorehabilitation on patients with Prolonged Disorder of Consciousness. We assessed the Range of Motion, Muscle Girth and Power, Level of Consciousness, Development of Deformity, and Superficial Sensation.
Methods: A record-based study was done, including the data of patients diagnosed with prolonged disorder of consciousness who were admitted at the Long-term Rehabilitation Center-Thumbay Hospital, Ajman UAE, between 2020-2022. Data on the “Range of Motion”, “Muscle Girth and Power”, “Level of Consciousness”, “Development of Deformity”, and “Superficial Sensation” were collected and analysed. SPSS software version 27 was used for analysis. The Chi-square test was used to assess association, and the t-test was used to test the mean difference.
Results: We assessed the data of 21 patients with a prolonged disorder of consciousness. The Superficial sensation had a significant increment (p<0.025). There was a decrease in the proportion of patients with deformities during the follow-up period. The Range of Motion, Muscle Girth, and Muscle Power were also preserved without significant deterioration. However, the level of consciousness measured by the Glasgow Coma Scale (GCS) showed no improvement.
Conclusions: Our research showed that neurorehabilitation has a significant impact on improving superficial sensation and in the prevention of the development of deformities. However, the mean level of consciousness remained the same. There was also no decrease in the Range of Motion. The Muscle girth and power both were preserved over the course of 2 years.