bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of functional status and disability among patients living with chronic kidney diseases at St Paul’s hospital millennium Medical College, Ethiopia; findings from a cross-sectional study
Authors: Deme Sisay , Janakiraman Balamurugan , Alamer Abayneh , Wayessa Dechasa Imiru , Yitbarek Tesfalem , Sidiq Mohammad
Published: September 2023

Background
The rise in risk factors like obesity, hypertension, and diabetes mellitus has partly led to the increase in the number of patients affected by chronic kidney disease, affecting an estimated 843 million people which is near about 10% of the general population worldwide in 2017. Patients with CKD have an increased risk of functional difficulties and disability. This study aimed to assess the level of functional status and disability and its associated factors among patients with chronic kidney attending Saint Paul Hospital, Millennium Medical College, Addis Ababa, Ethiopia.
Methods
An institution-based cross-sectional study was conducted with 302 enrolled study participants through systematic random sampling techniques. Face-to-face interviews and chart reviews were used to collect data using a semi-structured questionnaire adapted from works of literature. The Health Assessment Questionnaire Disability Index (HAQ-DI) was used to assess the functional status and disability of the participants. Data was entered into EPI info version 7 and exported to SPSS version 23 for analysis. Bivariate logistic regression analysis was employed with a p-value less than 0.25. Finally, those variables having a p-value less than 0.05 with 95% CI in multivariate analysis were taken as statistically significant.
Results
A total of 219 (72.5%) CKD patients had moderate to severe functional limitation and disability (HAQ-Di > 0.5-3). Age > 50 years [AOR = 1.65; 95% CI (1.23, 3.15)], being at stage 2 and 3 CKD [AOR = 4.05; 95% CI (1.82, 9.21), being at stage 4 and 5 CKD [AOR = 2.47; 95% CI (1.87, 4.72)], and having MSK manifestations [AOR = 2.97; 95% CI (1.61, 5.55)] were significantly associated with functional status and disability.
Conclusion
The findings of this study suggest that CKD-associated functional disabilities are common. The advanced stage of CKD, higher age, and presence of musculoskeletal manifestations appear to be important variables predicting self-reported functional status. Healthcare professionals treating CKD shall be vigilant about the CKD-associated disability, the modifiable predictors, and interventions to limit the CKD-related disability.
Association of the universal free school lunch program with body mass index among Korean high school students, 2018-2021
Authors: Kim Jinhyun , Kim Hyunkyu , Park Eun-Cheol , Shin Jaeyong
Published: September 2023

Background:
We aimed to analyze the association between universal free school meal (UFSM) and body mass index (BMI) among Korean high school students, compared to selective free school meal programs for low-income households (conventional school meal [CSM] programs).
Methods:
Data from Korea Youth Risk Behavior Web-based Survey (KYRBS) conducted in 2018–2021 were utilized. We analyzed the likelihood of being underweight, overweight and obese before and after the UFSM introduction using multinomial logistic regression. The annual meal expenses per one student borne by school foodservice were considered. The year, grade, family composition, economic status, academic performance, eating habits, physical activity, sedentary time, sleep duration, self-reported health status, perceived stress level, drinking status, and smoking status were adjusted.
Results:
This study included 85,043 high school students from KYRBS were analyzed, including 43,424 boys (51.1%) and 41,619 girls (48.9%). Only girls under the UFSM program showed a higher likelihood of being overweight and obese (adjusted odds ratio: 1.181, confidence interval = 1.066–1.308). Female students with middle and high economic status and under the UFSM program had higher likelihood of overweight and obesity compared with those under the CSM program. Both male and female participants under the UFSM program with high meal expenses had higher likelihood of overweight and obesity.
Conclusions:
UFSM could be associated with adolescent overweight and obesity, particularly in girls. Due to possible concerns about overnutrition, further assessment and appropriate intervention should be considered.
Epidemic and pandemic preparedness and response in a multi-hazard context: COVID-19 pandemic as a point of reference
Authors: Kamalrathne Thushara , Amaratunga Dilanthi , Haigh Richard , Kodituwakku Lahiru , Rupasinghe Chintha , Ranaweera Prasad , Herath Heamantha
Published: September 2023

Background
Infectious diseases which manifest in the form of epidemics or pandemics not only cause devastating impacts on public health systems but disrupt the functioning of the entire socio-economic architecture. Further, risks associated with pandemics and epidemics become exacerbated with coincident compound hazards. The COVID-19 pandemic highlighted the need for a broader understanding of cascading and systemic challenges posed by epidemics and pandemics amidst compound hazards. This study explains key elements and components of epidemic and pandemic preparedness and response systems, aligned to key interventional phases, focusing to a multi-hazard context.
Methods
A systematic literature review was used to collect data through peer-reviewed journal articles. Manuscript search was conducted using three electronic databases: PubMed, Scopus and ScienceDirect. Thirty-eight research papers were included in the analysis and 17 experts were involved in the validation, which was conducted using three rounds of consultative meetings and a validation workshop.
Results
Epidemiological surveillance and early detection, risk and vulnerability assessments, preparedness, prediction and decision making, alerts and early warning, preventive strategies, control and mitigation, response, and elimination were identified as key elements associated with epidemic and pandemic preparedness and response systems amidst a multi-hazard context. All elements appear integrated within three interventional phases, identified as upstream, interface and downstream that are dedicated to specific interventions, ranging from decision-making to disease elimination. A conceptual framework on epidemic and pandemic preparedness and response systems was developed capturing key elements and interventional phases that relate to several epidemic and pandemic stages.
Conclusions
A holistic approach with a focus on all interventional phases is required for preparedness and response to pandemics and epidemics to counter their cascading and systemic effects. Further, a paradigm shift in the preparedness and response for multi-hazards during an epidemic or pandemic is essential due to the multiple challenges posed by concurrent hazards.
Protocol for cost-effectiveness analysis of a randomised trial of mHealth coaching (Bump2Baby and Me) compared to usual care for healthy gestational weight gain and postnatal outcomes in at-risk women and their offspring
Authors: Nørmark Laura Pirhonen , McAuliffe Fionnuala M , Maindal Helle Terkildsen , O’Reilly Sharleen , Davies Anna , Burden Christy , Skinner Timothy , Vrangbaek Karsten , Callander Emily
Published: September 2023

Background
Gestational diabetes mellitus (GDM) and overweight are associated with an increased likelihood of complications during birth and for the newborn baby. These complications lead to increased immediate and long-term healthcare costs as well as reduced health and wellbeing in women and infants. This protocol presents the health-economic evaluation to investigate the cost-effectiveness of Bump2Baby and Me (B2B&Me), which is a health coaching intervention delivered via smartphone to women at risk of gestational diabetes.
Methods
Using data from the B2B&Me randomised controlled trial, this economic evaluation compares costs and health effects between the intervention and control group using the incremental cost-effectiveness ratio. Direct healthcare costs, costs of pharmaceuticals and intervention costs will be included in the analysis, body weight and quality-adjusted life years will serve as the effect outcomes. To investigate the long-term cost-effectiveness of the trial, a Markov model will be employed. Deterministic and probabilistic sensitivity analysis will be employed.
Discussion
GDM is a growing public health concern affecting both short and long-term health outcomes and healthcare costs. Identifying cost-effective options for prevention is an international global priority. This protocol describes the methods for calculating the short-term and long-term cost-effectiveness of an intervention aimed at preventing GDM, overweight and obesity amongst women during pregnancy and the first year postpartum.
Trial registration
Australian New Zealand Clinical Trials Registry ACTRN12620001240932. Registered on 19th November 2020
Inverse problems for climate policy mixes including geoengineering
Authors: Bodai Tamas , Lembo Valerio , Aneesh Sundaresan , Lee Sun-Seon , Ishuzu Miho , Franz Matthias O.
Published: September 2023

There is a palpable shift in mainstream attitude towards geoengineering, seen now as a potential part of a climate policy mix. Still, no-one wants to get on a slippery slope, compounding the risks, and, therefore, we should ask ourselves what is the minimal geoengineering that we can get away with. Such questions lead mathematically to inverse problems. Solving them is feasible only with lightweight models of the climate system, various types of which are nowadays often referred to as emulators – some more accurate than others. Here we develop an emulator using nonlinear response theory and apply it to two paradigmatic inverse problems relevant to climate policy. First, we investigate the attainability of the coveted Paris15 temperature targets. Second, through a simple multi-stable model, we determine what it takes to save the Greenland ice sheet (GrIS) as we know it. Our results suggest, first, that solar radiation management (SRM) geoengineering, most commonly envisaged as sulfate aerosol injection, will likely have to be part of our climate policy mix, because realistic CO2 abatement effort to come alone cannot restrict global temperatures below 1.5 ◦C change or below even higher levels of change. Minimal sulfate use for a threshold target is achieved by immediate and abrupt deployment. Second, we demonstrate also the importance of precisely knowing not only the stable but also the unstable so-called Melancholia states of climate tipping elements, such as the GrIS, as miscalculations can lead to acting too late – whether it is CO2 abatement on the short term or SRM geoengineering deployed in the far future.
Assessing the Yuli Surface Deformation from the 20220918 Chishang Earthquake: An Integrated RTK GPS Network Approach
Authors: Widiatmoko Fajar Rizki , Yen Jiun-Yee , Yen I-Chin , Huang Shao-Yi , Shih Nai-Wun
Published: September 2023

The 2022 0918 Taitung earthquake, or Chishang earthquake, impacted the Yuli area in eastern Taiwan, situated at the Philippine Sea Plate and Eurasian Plate boundary. This study uses RTK GPS measurements to characterize the earthquake's effects, revealing different coseismic displacement patterns in the Central Range, Coastal Range, and Longitudinal Valley blocks. Ruptures were mainly in the Longitudinal Valley, extending into Yuli downtown. The influence on these geological formations highlights the complex interactions between the structures and underlying tectonic forces. Data show the Central Range block experienced a 1.05 m SW horizontal displacement and 1.32 m vertical uplift, while the Coastal Range block displayed a 1.45 m NW horizontal displacement and 0.16 m subsidence. The Longitudinal Valley block was divided by recent ruptures, with its western part impacted by the Central Range block, experiencing a 0.74 m SW displacement and 0.97 m uplift, and its eastern part influenced by the Coastal Range block, experiencing a 0.96 m NW displacement and 0.14 m uplift. This suggests the seismic events were related to the Yuli Fault, a west-side up, reverse left-slip fault, likely triggered by the Central Range Fault, hinting at a Yuli Fault westward dip potentially connected to the Central Range Fault. Comparing our results with previous studies, we analyze Yuli's structural and tectonic features in Taiwan's broader geological context, contributing to the region's seismology, tectonics, and dynamic geology.
Protect the Recurrent Laryngeal Nerves in US-guided Microwave Ablation of Thyroid Nodules at Zuckerkandl tubercle: A Pilot Study
Authors: Hu Ziyue , Wang Lu , Lu Man , Yang Wei , Wu Xiaobo , Xu Jinshun , Zhuang Min , Wang Shishi
Published: September 2023

Background: To evaluate the safety and efficacy of US-guided microwave ablation in patients with thyroid nodules at Zuckerkandl tubercle.
Methods: 113 consecutive patients with thyroid nodules at Zuckerkandl tubercle (ZTTN) were enrolled in this study from November 2017 to August 2021. Prior to the surgery or US-guided microwave ablation (MWA), preoperative ultrasound visualization of the recurrent laryngeal nerve (RLN) and ZTTN was performed, the size and the position relationship between them were observed. Patients were followed up at 1, 3, 6, and 12 months after MWA and the volume reduction rates (VRR) of the thyroid nodules were analyzed.
Results: All patients successfully had the RLN and ZTTN detected using ultrasound before surgery or ablation with a detection rate of 100%. For the 103 patients, the majority of ZTTN grades were categorized as grade 2, with the distance from the farthest outside of ZTTN to the outer edge of thyroid ranging between 6.0 and 10.0 mm. The position relationship between ZTTN and RLN was predominantly type A in 100 cases, with type D observed in 3 cases. After MWA, the median nodule volume had significantly decreased from 4.61 (2.34, 8.70) ml to 0.42 (0.15, 1.41) ml and the VRR achieved 84.36±13.87% at 12 months. No nodules regrew throughout the 12-month follow-up period. Of the 11 patients experienced hoarseness due to RLN entrapment before ablation, 7 recovered immediately after separation of the RLN and ZTTN during MWA, 2 recovered after one week, and the other 2 recovered after two months.
Conclusions: The RLN is closely related to ZTTN and mainly located at the back of ZTTN. The RLN can be separated from ZTTN by hydrodissection during MWA.US-guided MWA is a safe and effective treatment for ZTTN.
The CRAFT program: Clinical mentorship during first year of medical school can impact future career trajectory for choosing residency programs
Authors: Shidid Sarah , Abdelmajid Haram , Mekki Pakinam , Smith-Norowitz Tamar Anne
Published: September 2023

Background
The CRAFT Program is a volunteer student-run clinical mentorship program that started in 2015 at an academic medical center in the Mid-Atlantic region. Clinical exposure during the first year of medical school may influence a student’s decision to pursue Internal Medicine for their residency program of choice.
Methods
First year medical school students (N = 77) at an academic medical center in the Mid-Atlantic region (freshman classes of 2020–2022) who participated in clinically reimagined apprenticeship for physician training (CRAFT) program were followed from freshman year until their medical school graduation. Information regarding first year mentor’s specialty and student’s match list data were collected. A retrospective chart analysis of CRAFT program volunteers was conducted. Exclusion Criteria consisted of students who did not match into residency and those who took gap years during medical school, where match data was unavailable.
Results
Students (51%) who participated in CRAFT matched into the same specialty of medicine as their CRAFT program mentors (P = 0.765, Chi Square Test). Of students (23%) who chose mentors in Internal Medicine, 50% matched into Internal Medicine residency programs (P < 0.0001, Chi Square Test). Our results demonstrate the importance of early clinical mentorship in medical school.
Conclusion
Clinical mentorship programs during the first year of medical school may be important for choosing future residency programs, leading to successful career goals. Timely engagement with mentors can be crucial in influencing career choices in the field of Internal Medicine.
Novel synthesis of AuPt bimetallic nanocubes combined with graphene quantum dots for non-enzymatic sensor of glucose determination by electrochemical method
Authors: Tran Quyen Thi Bich , Phan Trang Ngoc Thien , Nguyen Huynh Nhu , Ngo My Nguyen Tra , Pham Toan Duy , Bui Tuan Le Anh , Huynh Nguyen Le Thanh
Published: September 2023

In this study, AuPt bimetallic nanocubes (AuPt NCBs) were successfully combined with graphene quantum dots (GQDs) by a simple and easy-to-implement method at 80oC for 90 min. In particular, graphene quantum dots (GQDs) nanoparticles were synthesized by hydrothermal method at 190oC for 8 h, using raw materials from wheat flour, which are environmentally friendly materials, available and abundant in nature. AuPt bimetallic nanocubes were obtained from the synthesis of Au nanocubes (Au NCBs), followed by AuPt nanoparticles obtained when reacted at 140oC for 2 h by hydrothermal method to form AuPt core/shell nanocubes (AuPt NCBs). Besides, the synthesized AuPt NCBs/GQDs nanocomposites were also characterized, shape, size and composition by: UV-vis, FTIR, XRD, TEM, EDX, XPS, and AFM. The obtained results show that the Au nanocubes (Au NCBs) have an average particle size of ~ 39 nm; the size of AuPt NCBs and GQDs nanoparticles are ~ 40–44 nm and ~ 3–5 nm in size, respectively. Furthermore, AuPt NCBs/GQDs nanocomposites are also used as non-enzymatic catalysts for the oxidation/reduction of glucose by cyclic voltammetry (CV). The obtained results indicate that the AuPt NCBs/GQDs nanocomposites with high catalytic activity are capable of detecting glucose in a wide concentration range from 10− 12 M to 1 M, with an extremely low limit of detection (LOD) of concentration glucose levels (~ 10− 12 M). Therefore, AuPt NCBs/GQDs are novel and promising nano-catalysts that can be applied as catalysts with high activity oriented to many fields such as environmental treatment, fuel energy cells, or sensors to make bio-chip devices for early diagnosis of serious diseases such as diabetes, gout or cancer, etc., in present and the future.
On the reduced GloSea6 hindcast skill in Northeast Asian Summer Rainfall associated with two extreme El Niño events
Authors: Hyun Seung-Hwon , Hwang Seung-On , An Soon-Il , Lee Johan , Hyun Yu-Kyung
Published: September 2023

In this study, the GloSea6 hindcast (HCST) of UK Met Office is used to investigate how this climate model explains the features of such opposite teleconnections on the following summer in decaying periods for two extreme El Niño cases ('97/'98 and '15/'16). In addition, the associated atmospheric and oceanic characteristics are analyzed to explore the reason of the inaccurate simulation of GloSea6. Results show that the ocean-atmosphere patterns such as an intensified Western North Pacific Anomalous Anticyclone (AAC) during both spring and summer in '98 HCST are broadly similar patterns to the observation in spite of the relatively weaker intensities of the atmospheric anomaly over monsoonal region and the northeast Asian summer rainfall anomaly (NASRA). Meanwhile, '16 HCST does not capture the observed spatial pattern of precipitation and SST. Actually, it simulates the teleconnection closer to '98 observation rather than '16 observation. '16 observation shows a weak formation of AAC and an extensive dry anomaly in the northeast Asia, but '16 HCST shows a meridional dipole of the rainband associated with AAC formation. The poor performance of the GloSea6 for the '16 case may be due to stronger simulated capacitor effect on the Indian Ocean than the observed, which is caused by higher sensitivity of atmospheric convective activity to the eastern equatorial Pacific SST and slower decaying of the warmed Indian Ocean during the spring season than the observation.
Knowledge of Cervical Cancer Screening among Omani Women Attending a University Teaching Hospital: A Cross-Sectional Study
Authors: Kindi Rahma Al , Sumri Hana Al , Muhdhoori Tasneem Al , Mamari Khoula Al , Kalbani Mouza Al , Al-Azri Mohammed
Published: September 2023

Objectives: This study aimed to assess knowledge, attitudes, and practices regarding cervical cancer and Pap smear screening among Omani women attending a tertiary clinic in Muscat, Oman, and to establish correlations with selected sociodemographic factors.
Methods: A cross-sectional survey was carried out at the clinic of the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, from October 2019 to February 2020. A total of 380 women were recruited. A validated Arabic-language questionnaire was utilized to collect data regarding the participants’ sociodemographic characteristics, knowledge of cervical cancer and related risk factors, and knowledge, attitudes, and practices related to cervical cancer screening and Pap smear testing.
Results: Of the 380 respondents, 85.5% and 55.0% had previously heard of cervical cancer and Pap smear testing, respectively; however, only 26.1% were knowledgeable concerning these topics. Knowledge scores were significantly associated with various sociodemographic factors, including marital status, and a previous awareness of cervical cancer (Odds Ratio >1, p <0.05). Only 20.5% had themselves previously undergone Pap smear testing; however, 74.5% reported being willing to undergo such screening in future.
Conclusions: Knowledge regarding cervical cancer-related risk factors and Pap smear screening was poor among a cohort of Omani women attending a tertiary clinic in Muscat, Oman. This may play a role in the increased frequency of cervical cancer cases observed in Oman over recent years. As such, a well-structured public awareness and educational program is recommended to raise awareness of this issue.
Synthetic CT and Dosimetry Uncertainty in CBCT-based Online Adaptive Radiotherapy For Pleural Metastases With Significant Inter-fractional Tumor Volume Reduction
Authors: Chiou Yu-Rou , Ji Jin-Huei , Shiau An-Cheng , Pan Chia-Hsin , Huang Chi-Hsien , Liang Ji-An , Lin Ting-Chun
Published: September 2023

Purpose
Online adaptive radiotherapy (oART) dose calculation relies on synthetic computed tomography (sCT), which is significantly affected by anatomical changes. In this study, we present how significant inter-fractional tumor volume reduction can lead to uncertainties in sCT generation and dose distribution.
Methods
We exported the sCT and cone-beam CT (CBCT) images of each treatment session and analyzed a total of 20 adaptive plans. On each sCT, we overrode the CT number of the dissipated tumor volume with the CT number of the lungs. We recalculated each adaptive plan using the overridden sCT and compared the dose-volume histogram (DVH), Dmean, Dmax, and Dmin between the adaptive plans with the override and the adaptive plans without the override. We also applied linear regression analysis, percentage dose difference, and 2D gamma analysis to quantify and qualify dose variability.
Results
As the tumor volume shrank, the sCT at each radiotherapy session resembled the simulation CT and increasingly deviated from daily CBCT. Recalculated plans using the overridden sCT showed right-shifted DVH curves for the targets and right lung. Not only did the Dmean and Dmax of the targets and the right lung increase, but also the location of hotspots shifted toward the direction of tumor shrinkage and beam arrangement in the plans with the override.
Conclusion
As the pleural tumor volume reduced, the adaptive plans underestimated dose distribution and shifted the location of hotspots. Thus, for synthetic CT-based oART, if targets show unexpected drastic volume change, adaptive plans should be evaluated with caution, and re-simulation should be considered.
Model based on the automated AI-Driven CT quantification is effective for the diagnosis of refractory Mycoplasma pneumoniae pneumonia
Authors: Qian Yali , Tao Yunxi , Wu Lihui , Zhou Changsheng , Liu Feng , Xu Shenglong , Miao Hongjun , Gao Xiucheng , Ge Xuhua
Published: September 2023

Refractory Mycoplasma pneumoniae pneumonia（RMPP）prediction is a challenging but clinically significant challenge. A model based on AI-derived quantitative determination of lung lesions extent on initial computed tomography (CT) scan and clinical indicators has the potential to facilitate early RMPP prediction in hospitalized children. In this study, we conducted a retrospective cohort as a training set including 126 children with M. pneumoniae pneumonia (MP) admitted to Children’s Hospital of Nanjing Medical University, China from January 2019 to December 2020. We defined a constant Φ which can combine the volume and CT value of pulmonary lesions and be further used to calculate the logarithm of Φ to the base of 2 (Log2Φ). Finally, a clinical-imaging prediction model was developed using Log2Φ and clinical characteristics. The area under the receiver operating characteristic curve (ROC-AUC) was applied to performance evaluation. Then we conducted a prospective study including 54 children with MP as a test set to validate the predictive model for RMPP from January to December 2021. The clinical model yielded the AUC of 0.810 and 0.782, and the imaging model yielded the AUC of 0.764 and 0.769 in the training set and the test set, respectively. The clinical-imaging model combining Log2Φ, temperature(T), aspartate aminotransferase (AST), preadmission fever duration (PFD), and preadmission macrolides therapy duration (PMTD) produced the highest AUC values of 0.897 and 0.895 in the training set and the test set, respectively. Our work demonstrated that using automated quantification of lung disease at CT combined with clinical data in MPP is useful to predict RMPP.
Parasympathetic nervous function and prevalence of prediabetes/diabetes mellitus: a cross-sectional study: WASEDA'S Health Study
Authors: Konishi Masayuki , Nakamura Nobuhiro , Kawakami Ryoko , Tabata Hiroki , Tanisawa Kumpei , Sawada Susumu , Ito Tomoko , Tamura Yoshifumi , Ishii Kaori , Oka Koichiro , Suzuki Katsuhiko , Higuchi Mitsuru , Sakamoto Shizuo
Published: September 2023

Purpose:Limited data are available on the relationship of parasympathetic nervous function with the prevalence of prediabetes and diabetes in men and women. We conducted a cross-sectional study to investigate the relationship between diving reflex - markers of parasympathetic nervous function - with the prevalence of prediabetes and diabetes among men and women in WASEDA'S Health Study.
Methods: Participants were 199 men and 75 women who completed a medical examination, maximal exercise test, and diving reflex test. The participants were divided into tertiles based on the diving reflex indexes. The diving reflex indexes were the peak value of the R–R interval during the test (R–Rmax) and the relative difference between the baseline and peak response due to the test (R–Rchange). Odds ratios and 95% confidence intervals for the prevalence of prediabetes and diabetes were obtained using logistic regression models while adjusting for sex, age, body fat percentage, family history of diabetes, smoking status, and drinking status, sleeping hours, energy intake, and peak oxygen uptake.
Results: Forty-one participants had prediabetes (n=24) or diabetes (n=17). Using the lowest diving reflex indexes as reference, we calculated odds ratios and 95% confidence intervals for the outcomes if interests. We found inverse relationships between R-Rmax and prediabetes and diabetes (P for trend = 0.104) as well as R-Rchange and diabetes (P for trend = 0.023).
Conclusions: In this cross-sectional analysis, the data suggest diving reflex indexes, especially R-Rchange, may be related to the prevalence of diabetes.
The Interrelationship between Obesity and Race in Breast Cancer Prognosis: A Prospective Cohort Study
Authors: Schindler Emma Armstrong , Takita Cristiane , Collado-Mesa Fernando , Reis Isildinha M. , Zhao Wei , Yang George R. , Acosta Laura G. , Hu Jennifer J.
Published: September 2023

Purpose
Obesity is associated with an increased breast cancer risk in postmenopausal women and may contribute to worse outcomes. Black women experience higher obesity and breast cancer mortality rates than non-Black women. We examined associations between race, obesity, and clinical tumor stage with breast cancer prognosis.
Methods
We conducted a prospective cohort study in 1,110 breast cancer patients, using univariable and multivariable Cox regression analyses to evaluate the effects of obesity, race/ethnicity, and clinical tumor stage on progression-free and overall survival (PFS and OS).
Results
22% of participants were Black, 64% were Hispanic White, and 14% were non-Hispanic White or another race. 39% of participants were obese (body mass index [BMI] ≥ 30 kg/m2). In univariable analyses, tumor stage III-IV was associated with worse PFS and OS compared to tumor stage 0-II (hazard ratio [HR] = 4.68, 95% confidence interval [CI] = 3.52–6.22 for PFS and HR = 5.92, 95% CI = 4.00-8.77 for OS). Multivariable analysis revealed an association between Black race and worse PFS in obese (HR = 2.19, 95% CI = 1.06–4.51) and non-obese (HR = 2.11, 95% CI = 1.05–4.21) women with tumors staged 0-II. Obesity alone was not associated with worse PFS or OS.
Conclusion
Results suggest a complex interrelationship between obesity and race in breast cancer prognosis. The association between Black race and worse PFS in tumor stages 0-II underscores the importance of early intervention in this group. Future studies are warranted to evaluate whether alternative measures of body composition and biomarkers are better prognostic indicators than BMI among Black breast cancer survivors.
Dietary xylo-oligosaccharides and arabinoxylans improved growth efficiency by reducing gut epithelial cell turnover in broiler chickens
Authors: Castro Carla , Niknafs Shahram , Gonzalez-Ortiz Gemma , Tan Xinle , Bedford Michael , Roura Eugeni
Published: September 2023

Background.One of the main roles of the intestinal mucosa is to protect against environmental hazards. Supplementation of xylo-oligosaccharides (XOS) is known to selectively stimulate the growth of beneficial intestinal bacteria and improve gut health and function in chickens. XOS may have an impact on the integrity of the intestinal epithelia where cell turnover is critical to maintain the compatibility between the digestive and barrier functions. The aim of the study was to evaluate the effect of XOS and an Arabinoxylan-rich fraction (AXRF) supplementation on gut function and epithelial integrity in broiler chickens.MethodsA total of 128 broiler chickens (Ross 308) were assigned into one of two different dietary treatments for a period of 42 d: 1) control diet consisting of a corn/soybean meal-based diet; or, 2) a control diet supplemented with 0.5% XOS and 1% AXRF. Each treatment was randomly distributed across eight pens (n = 8) with eight chickens each. Feed intake and body weight were recorded weekly. On d 42, one male chicken per pen was selected based on average weight and euthanized, jejunum samples were collected for proteomics analysis.Results.XOS/AXRF supplementation improved feed efficiency (P < 0.05) from d 1 to 42 compared to the control group. Proteomic analysis was used to understand the mechanism of improved efficiency uncovering 346 differentially abundant proteins (DAP) (adj.P < 0.00001) in supplemented chickens compared to the non-supplemented group. In the jejunum, the DAP translated into decreased ATP production indicating lower energy expenditure by the tissue (e.g., inhibition of glycolysis and tricarboxylic acid cycle pathways). In addition, DAP were associated with decreased epithelial cell differentiation, and migration by reducing the actin polymerization pathway.ConclusionsDietary XOS/AXRF supplementation improved growth efficiency by reducing epithelial cell migration and differentiation (hence, turnover), actin polymerization, and consequently energy requirement for maintenance of the jejunum of broiler chickens.
Investigating the Effects of Stereotactic Body Radiation Therapy on Pancreatic Tumor Hypoxia and Microvasculature in an Orthotopic Mouse Model using Intravital Fluorescence Microscopy
Authors: Samuel Timothy , Rapic Sara , Lindsay Patricia , DaCosta Ralph S.
Published: September 2023

Despite decades of improvements in cytotoxic therapy, the current standard of care for locally advanced pancreatic cancer (LAPC) provides, on average, only a few months of survival benefit. Stereotactic Body Radiation Therapy (SBRT), a technique that accurately delivers high doses of radiation to tumors in fewer fractions, has emerged as a promising therapy to improve local control of LAPC; however, its effects on the tumor microenvironment and hypoxia remain poorly understood. To explore how SBRT affects pancreatic tumors, we combined an orthotopic mouse model of pancreatic cancer with an intravital microscopy platform to visualize changes to the in vivo tumor microenvironment in real-time. Mice received SBRT (5×8Gy) or were left untreated and were imaged before and 1, 4, 7, and 14 days after treatment (n = 7–10/group). A fluorescent human pancreatic cancer cell line (BxPC3-DsRed) engineered to express GFP under hypoxic conditions (driven by hypoxia-inducible factor, HIF) was used to monitor tumor hypoxia. Immunohistochemical staining was also performed on tissues to validate in vivo data. Our findings demonstrate a persistent decrease in pancreatic tumor hypoxia as early as one day after SBRT. This coincided with a decrease in both tumor cell proliferation and cell density in the SBRT group. Reduced demand for oxygen after SBRT (due to cell death and growth arrest from treatment) significantly contributed to reoxygenation of the pancreatic TME. Understanding how this reoxygenation phenomenon occurs in a dose-dependent manner will help improve dosing and fractionation schemes for clinical SBRT.
3D Geological Modeling with Petrel Software: Estimating Original Oil in Place of Lower Cretaceous Y- Formation: A Case Study in a Selected Oilfield
Authors: Khashman Mohammed A. , Shirazi Hamed
Published: September 2023

Three-dimensional (3D) geological modeling for predicting reservoir performance and acquisition a better understanding of the unique characteristics of the Y- Formation (an important oil reservoir). The study uses geostatistics and computer visualization technology to quantitatively characterize various geological attributes in 3D space, storing the results as grid data. It focuses on building a 3D reservoir geological model of the X oilfield by using Petrel software. The model integrates data from 14 wells, including geology, geophysics, and petrophysics, to accurately depict the subsurface internal structure and reservoir heterogeneity. The data of the Y- Formation (Lower Cretaceous Carbonates) were taken from 14 wells of X Oilfield, Selected oilfield (Well-1, Well-2, Well-3, Well-5, Well-6, Well-9, Well-10, Well-11, Well-12, Well-13, Well-14, Well-15, Well-25, Well-34 and Well-35). The input data is used to build the structural model, Facies model, and Petrophysical properties (porosity, permeability, saturation, and N/G model), ultimately determining the reservoir volume. The 3D model visualizes the distribution of Petrophysical properties and classifies the formation into distinct layers or reservoir units (MA, MB, and MC). Petrophysical modeling for Y- Formation was set-up from values of CPI using Sequential Gaussian Simulation algorithm. This research has indicated the reliability of the three-dimensional model technique as a suitable tool to provide a sufficient understanding of Petrophysical distribution. Original oil in place (OOIP) refer to the volume of hydrocarbons initially stored in a reservoir prior to production. Volumetric approaches of estimating HIIP can be employed immediately after first discovery, before production initiates. The aim of the study is to estimate the oil in place from the available data in Y- Formation. After finalizing the Petrophysical distribution and applying the volumetric calculation, oil in place estimated by the geological model equal to (658 *106 SM3 or 4132.24 million barrels).
Interactions of coreopsin with CYP3A4/CYP2D6 by multi-spectroscopy analysis and computer simulation
Authors: lian di , tao yanzhou , Cui Jinging , Wang Meizi , wang suqing , li yuan , Du Yutong , Li Li
Published: September 2023

In this study, different spectral methods, molecular docking, dynamics simulation are applied for revealing the binding mechanisms of coreopsin to CYP3A4/CYP2D6. Coreopsin quenches CYPs mainly in static mode and supplement in dynamic mode. The Kb values of the CYPs are within 104 ~ 105 L·mol-1, indicating that coreopsin has moderate and stronger affinity with CYPs. Meanwhile, the binding ability of CYP3A4- coreopsin is stronger than that of CYP2D6-coreopsin at the same temperature. It is also demonstrated that coreopsin has significant effects on the secondary structure of CYPs through hydrogen bonds together with van der Waals force. The optimal binding mode, specific binding sites of the two complexes are determined by molecular docking, and stability of the two complexes formed by coreopsin and CYPs are verified using molecular simulation dynamics.
Influences of specialty identity when implementing a new emergency department in Denmark: a qualitative study
Authors: Kirk Jeanette , Lindstroem Mette Bendtz , Stefánsdóttir Nina Thórný , Andersen Ove , Powell Byron J. , Nilsen Per , Tjørnhøj-Thomsen Tine
Published: September 2023

Background
The Danish Health Authority recommended the implementation of new types of emergency departments. Organizational changes in the hospital sector challenged the role, identity, and autonomy of medical specialists. They tend to identify with their specialty, which can challenge successful implementation of change. However, investigations on specialty identity are rare in implementation science, and how the co-existence of different specialty identities influences the implementation of new emergency departments needs to be explored for the development of tailored implementation strategies. The aim of this study was to examine how medical specialty identity influences collaboration between physicians when implementing a new emergency department in Denmark.
Methods
Qualitative methods in the form of participants’ observations at 13 oilcloth sessions (a micro-simulation method) were conducted followed up by 53 individual semi-structured interviews with participants from the oilcloth sessions. Data were analysed deductively inspired by Social Identity Theory.
Results
The analysis yielded three overarching themes: (1) ongoing creation and re-creation of specialty identity through boundary drawing; (2) social categorization and power relations; and (3) the patient as a boundary object.
Conclusions
Specialty identity is an important determinant of collaboration among physicians when implementing a new emergency department. Specialty identity involves social categorization, which entails ongoing creation and re-creation of boundary drawing and exercising of power among the physicians. In some situations, the patient became a positive boundary object, increasing the possibility for a successful collaboration and supporting successful implementation, but direct expressions of boundaries and mistrust were evident. Both were manifested through a dominating power expressed through social categorization in the form of in- and out-groups and in an “us and them” discourse, which created distance and separation among physicians from different specialties. This distancing and separation became a barrier to the implementation of the new emergency department.
Structural and biophysical comparisons of the pomalidomide- and CC-220-induced interactions of SALL4 with cereblon
Authors: Ma Xiaolei , Leon Barbara , Ornelas Elizabeth , Dovala Dustin , Tandeske Laura , Luu Catherine , Pardee Gwynn , Widger Stephania , Solomon Jonathan M. , Beckwith Rohan E.J. , Moser Heinz , Clifton Matthew C. , Wartchow Charles A.
Published: September 2023

The design of cereblon-binding molecular glues (MGs) that selectively recruit a desired protein while excluding teratogenic SALL4 is an area of significant interest when designing therapeutic agents. Previous studies show that SALL4 is degraded in the presence of IKZF1 degraders pomalidomide, and to a lesser extent by CC-220. To expand our understanding of the molecular basis for the interaction of SALL4 with cereblon, we performed biophysical and structural studies demonstrating that SALL4 zinc finger domains one and two (ZF1-2) interact with cereblon (CRBN) in a unique manner. ZF1 interacts with the N-terminal domain of cereblon and ZF2 binds as expected in the C-terminal IMiD-binding domain. Both ZF1 and ZF2 contribute to the potency of the interaction of ZF1-2 with CRBN:MG complexes and the affinities of SALL4 ZF1-2 for the cereblon:CC-220 complex are less potent than for the corresponding pomalidomide complex. Structural analysis provides a rationale for understanding the reduced affinity of SALL4 for cereblon in the presence of CC-220, which engages both ZF1 and ZF2. These studies further our understanding of the molecular glue-mediated interactions of zinc finger-based proteins with cereblon and may provide structural tools for the prospective design of compounds with reduced binding and degradation of SALL4.
Conjunctival Ultraviolet Autofluorescence as a Biomarker of Outdoor Exposure in Myopia: A Systematic Review and Meta-analysis.
Authors: Rodríguez Natali , Claici Aura , Castañeda Jorge , González-Zamora Jorge , Bilbao-Malavé Valentina , Puente Miriam de la , Fernandez-Robredo Patricia , Parra Sandra , Garza-Leon Manuel , Recalde Sergio
Published: September 2023

Outdoor activity (OA) is considered the main modifiable risk factor for myopia development. Quantifying the association between Conjunctival Ultraviolet Autofluorescence (CUVAF) area and OA can be useful as a biomarker for myopia control. The purpose of this study is to quantify the association between CUVAF area and myopia. The articles included populations from different geographic areas (Europe/Asia/Australia) and ages.
The bibliographic research was accomplished between June-August of 2022 with the following databases: MEDLINE/SCIENCE DIRECT/GOOGLE SCHOLAR/WEB OF SCIENCE/SCOPUS with all the terms related of "conjunctival ultraviolet autofluorescence” (2006-2022). Cross-sectional and case-control studies were included. The differences between CUVAF area and the hours of OA performed by myopic and non-myopic patients and the correlation of OA with the size of the CUVAF area were analyzed.
The meta-analysis of the CUVAF area between myopic and non-myopic patients showed statistically smaller areas (-3.30 mm²-CI95%[-5.5;-1.06]). Stratified sub-analysis by different geographic areas showed that Australia-Asia patients showed a greater difference in CUVAF area (-4.92 mm²-CI95%[-9.5;-0.29]) compared to Europe patients (-1.97 mm²;CI95%;-2.8;-1.14, p= 0.007). Myopic reported less OA vs non-myopic (-3.38 hours/week-CI95%[-4.6;-2.09]), and the correlation between CUVAF area and OA was 0.14 (CI95%[0.09;0.19]).
A strong relationship was observed between CUVAF, myopia and OA in different studies and geographic locations. The importance of this validation is that CUVAF is a simple, fast and non-invasive quantitative method to evaluate the control of myopia.
Managed Care Updates of Subscriber Jail Release to Prompt Community Suicide Prevention: Clinical Trial Protocol
Authors: Arias Sarah A. , Sperber Kimberly , Jones Richard , Taxman Faye S. , Miller Ted R. , Zylberfuden Sarah , Weinstock Lauren M. , Brown Gregory K. , Ahmedani Brian , Johnson Jennifer E.
Published: September 2023

Background. Recent jail detention is a marker for trait and state suicide risk in community-based populations. However, healthcare providers are typically unaware that their client was in jail and few post-release suicide prevention efforts exist. This protocol paper describes an effectiveness-implementation trial evaluating community suicide prevention practices triggered by advances in informatics that alert CareSource, a large managed care organization (MCO), when a subscriber is released from jail.
Methods. This randomized controlled trial investigates two evidence-based suicide prevention practices triggered by CareSource’s jail detention/release notifications, in a partial factorial design. The first phase randomizes ~43,000 CareSource subscribers who pass through any Ohio jail to receive Caring Contact letters sent by CareSource or to Usual Care after jail release. The second phase (running simultaneously) involves a subset of ~6,000 of the 43,000 subscribers passing through jail who have been seen in one of 12 contracted behavioral health agencies in the 6 months prior to incarceration in a stepped-wedge design. Agencies will receive: (a) notifications of the client’s jail detention/release, (b) instructions for re-engaging these clients, and (c) training in suicide risk assessment and the Safety Planning Intervention for use at re-engagement. We will track suicide-related and service linkage outcomes 6 months following jail release using claims data.
Conclusions. This design allows us to rigorously test two intervention main effects and their interaction. It also provides valuable information on the effects of system-level change and the scalability of interventions using big data from a MCO to flag jail release and suicide risk.
Trial Registration: The trial is registered at clinicaltrials.gov (NCT05579600). Registered 27 June, 2023,
https://beta.clinicaltrials.gov/study/NCT05579600?cond=Suicide&term=Managed%20Care&rank=1
Baked hydrogel from palm starch and modified chitosan for water contaminant removal
Authors: Restu Witta Kartika , Mawarni Rista Siti , Triwulandari Evi , Ghozali Muhammad , Zahra Tazkia Qonita , Rachmadona Nova , Sugita Purwantiningsih , Agusnar Harry
Published: September 2023

The present study synthesized baked hydrogels by crosslinking reactions from the sugar palm starch and modified chitosan using citric acid as a cross-linker and potassium persulfate as the free radical initiator. Sugar palm starch was derived from the sugar palm (Arenga pinnata) plant, extracted from the stem when it no longer produces sugar and fruits. Baked hydrogels were characterized by their physical and chemical properties, including moisture content, water solubility, swelling capacity, and contact angle. From the variation of the obtained baked hydrogels, the moisture contents varied around 11-15%, water solubility was in the range of 28-38% and the degree of swelling was about 153-283%. In terms of contact angle measurement, the highest value was around 65°. The structure formation of chemical linkages among raw materials of the baked hydrogels was studied using Fourier transform infrared spectroscopy (FTIR). The morphology was observed with scanning electron microscopy (SEM), showing the porosity in the structure. The thermal properties were marked using differential scanning calorimetry (DSC) with a range of glass transition temperature of 47-60°C and melting temperature from 190 to 203°C. In their application as the removal of methylene blue as the targeted water contaminant, the baked hydrogels of HSC 3 can absorb methylene blue solution with the highest degradation percentage, reaching 63.10%. This confirmed that sugar palm starch and modified chitosan in baked hydrogel can be applied in the environment for contaminant removal.