bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing progression limits in different grades of keratoconus from a novel perspective: precision of measurements of the corneal epithelium
Authors: Ning Rui , Wang Yiran , Xu Zhenyu , Gustafsson Ingemar , Li Jiawei , Savini Giacomo , Schiano-Lomoriello Domenico , Xiao Yichen , Chen Aodong , Wang Xiaoying , Zhou Xingtao , Huang Jinhai
Published: January 2024

Background

To assess repeatability and reproducibility of corneal epithelium thickness (ET) measured by a spectral-domain optical coherence tomographer (SD-OCT)/Placido topographer (MS-39, CSO, Florence, Italy) in keratoconus (KC) population at different stages, as well as to determine the progression limits for evaluating KC progression.

Methods

A total of 149 eyes were enrolled in this study, with 29 eyes in the forme fruste keratoconus (FFKC) group, 34 eyes in the mild KC group, 40 eyes in the moderate KC group, and 46 eyes in the severe KC group. Employing the within-subject standard deviation (Sw), test-retest variability (TRT), coefficient of variation (CoV), and intraclass correlation coefficient (ICC) to evaluate intraoperator repeatability and interoperator reproducibility.

Results

The repeatability and reproducibility of MS-39 in patients with KC were acceptable, according to ICC values ranging from 0.732 to 0.954. However, patients with more severe KC and progressive peripheralization of the measurement points had higher TRTs but a thinning trend. The current study tended to set the cut-off values of mild KC, moderate KC, and severe KC to 4.9 µm, 5.2 µm, and 7.4 µm for thinnest epithelium thickness (TET). When differences between follow-ups are higher than those values, progression of the disease is possible. As for center epithelium thickness (CET), cut-off values for mild KC, moderate KC, and severe KC should be 2.8 µm, 4.4 µm, and 5.3 µm. This might be useful in the follow-up and diagnosis of keratoconus.

Conclusions

This study demonstrated that the precision of MS-39 was reduced in measuring more severe KC patients and more peripheral corneal points. In determining disease progression, values should be differentiated between disease-related real changes and measurement inaccuracies. Due to the large difference in ET measured by MS-39 between various stages of disease progression, it is necessary to accurately grade KC patients to avoid errors in KC clinical decision-making.
Anchorage mechanism of bamboo-steel composite rockbolts subjected to the coupled effect of tensile and shear stress
Authors: Ren Feifan , Huang Qiangqiang , Wang Guan , Li Zhuang
Published: January 2024

Background

Earthen heritage sites have high cultural and scientific value. However, most of earthen heritage sites have been severely damaged and are in urgent need of restoration. To address this issue, a novel rockbolt, bamboo-steel composite rockbolt (BSCR), was proposed and widely employed in earthen site protection. However, the research on the anchorage mechanism of BSCR lags behind engineering practice, particularly with regard to its behavior under the coupled effect of tensile and shear stress.

Case Presentation

In this study, based on centrifugal test results, a numerical model was established and validated and a comparative analysis of the anchorage mechanism between conventional rockbolt (CR) and BSCR was also conducted. Various parameters, including rockbolt diameter, bending stiffness, inclination angle, and length, were systematically investigated to elucidate their influence on protective efficacy.

Conclusion

BSCR has a larger diameter and bending stiffness, and is superior to CR in protecting earthen heritage sites. In addition, reducing the rockbolt inclination angle and increasing the number of rockbolt layers can reduce slope deformation caused by the coupling effect of tensile and shear stress. Increasing the length of BSCR can enhance the stability of the anchored slopes; however, due to the influence of the effective anchorage length of the rockbolt, excessively extending the rockbolt length is inefficient. These research results provide valuable insights into the application of BSCR in earthen site protection and can provide a reference for further research on its anchorage mechanism under complex stress conditions.
Disentangling the effects of PTSD from Gulf War Illness in male veterans via a systems-wide analysis of immune cell, cytokine, and symptom measures
Authors: Sultana Esha , Shastry Nandan , Kasarla Rishabh , Hardy Jacob , Collado Fanny , Aenlle Kristina , Abreu Maria , Sisson Emily , Sullivan Kimberly , Klimas Nancy , Craddock Travis J. A.
Published: January 2024

Background

One-third of veterans returning from the 1990–1991 Gulf War reported a myriad of symptoms including cognitive dysfunction, skin rashes, musculoskeletal discomfort, and fatigue. This symptom cluster is now referred to as Gulf War Illness (GWI). As the underlying mechanisms of GWI have yet to be fully elucidated, diagnosis and treatment are based on symptomatic presentation. One confounding factor tied to the illness is the high presence of post-traumatic stress disorder (PTSD). Previous research efforts have demonstrated that both GWI and PTSD are associated with immunological dysfunction. As such, this research endeavor aimed to provide insight into the complex relationship between GWI symptoms, cytokine presence, and immune cell populations to pinpoint the impact of PTSD on these measures in GWI.

Methods

Symptom measures were gathered through the Multidimensional fatigue inventory (MFI) and 36-item short form health survey (SF-36) scales and biological measures were obtained through cytokine & cytometry analysis. Subgrouping was conducted using Davidson Trauma Scale scores and the Structured Clinical Interview for Diagnostic and statistical manual of mental disorders (DSM)-5, into GWI with high probability of PTSD symptoms (GWIH) and GWI with low probability of PTSD symptoms (GWIL). Data was analyzed using Analysis of variance (ANOVA) statistical analysis along with correlation graph analysis. We mapped correlations between immune cells and cytokine signaling measures, hormones and GWI symptom measures to identify patterns in regulation between the GWIH, GWIL, and healthy control groups.

Results

GWI with comorbid PTSD symptoms resulted in poorer health outcomes compared with both Healthy control (HC) and the GWIL subgroup. Significant differences were found in basophil levels of GWI compared with HC at peak exercise regardless of PTSD symptom comorbidity (ANOVA F = 4.7, P = 0.01,) indicating its potential usage as a biomarker for general GWI from control. While the unique identification of GWI with PTSD symptoms was less clear, the GWIL subgroup was found to be delineated from both GWIH and HC on measures of IL-15 across an exercise challenge (ANOVA F > 3.75, P < 0.03). Additional differences in natural killer (NK) cell numbers and function highlight IL-15 as a potential biomarker of GWI in the absence of PTSD symptoms.

Conclusion

We conclude that disentangling GWI and PTSD by defining trauma-based subgroups may aid in the identification of unique GWI biosignatures that can help to improve diagnosis and target treatment of GWI more effectively.
Health-related quality of life and its associated factors among hemophilia patients: experience from Ethiopian Hemophilia Treatment Centre
Authors: Iyar Sitina , Gebremariam Girma Tekle , Beyene Dessale Abate , Gebremedhin Amha , Tadesse Tamrat Assefa
Published: January 2024

Background

Hemophilia is a rare genetic condition that is often overlooked and underdiagnosed, particularly in low-income countries. Long-term spontaneous joint bleeding and soft tissues can have a significant negative impact on a patient’s health-related quality of life (HRQoL). The objective of this study was to assess HRQoL and its associated factors in Ethiopian patients with hemophilia.

Methods

A cross-sectional survey was conducted among patients with hemophilia at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. Patients were recruited consecutively during follow-up visits. The European Quality of Life Group’s 5-Domain Questionnaires at five levels (EQ-5D-5L) and Euro Quality of Life Group’s Visual Analog Scale (EQ-VAS) instruments were used to assess HRQoL. The EQ-5D-5L utility score was computed using the disutility coefficients. We applied the Krukal-Wallis and Mann–Whitney U tests to determine the differences in EQ-5D-5L and EQ-VAS utility scores between patient groups. A multivariate Tobit regression model was used to identify factors associated with HRQoL. Statistical analyses were performed using STATA version 14 and statistical significance was determined at p < 0.05.

Results

A total of 105 patients with hemophilia participated in the study, with a mean (standard deviation (SD) age of 21.09 (± 7.37] years. The median (IQR) EQ-5D-5L utility and EQ-VAS scores were 0.86 (0.59–0.91) and 75 (60.0–80.0), respectively. Age was significantly negatively associated with the EQ-5D-5L utility index and EQ-VAS (β = -0.020, 95 CI = -0.034, -0.007) and β = -0.974, 95% CI = -1.72, 0.225), respectively. The duration since hemophilia diagnosis (β-0.011, 95% CI, 0.001–0.023) and living out of Addis Ababa (β = -0.128, 95% CI, -0.248-, -0.007) were also significantly negatively associated with the EQ-5D-5L utility index..

Conclusion

The median EQ-5D-5L utility and EQ-VAS scores of patients with hemophilia were 0.86 (0.59–0.91) and 75 (60.0–80.0), respectively. Older age, living far from the Hemophilia Treatment Center (HTC), and longer duration since diagnosis were significantly negatively associated with HRQoL. HRQoL may be improved by providing factor concentrates, decentralizing HTCs in different parts of the country, increasing awareness of bleeding disorders among health professionals, and providing psychosocial support to affected patients.
Occurrence of multiple fistulas decades after ingestion and neglect of numerous thermometers: a case report
Authors: Schulte Katrin , Wolf Henning Wendelin
Published: January 2024

Background

Ingestion of thermometers is a very rare occurrence and associated with penetrations of hollow organs. An event decades ago can lead to the development of fistulas.

Case presentation

We present a case of a 62-year-old male who swallowed multiple thermometers with a length of up to 22 cm over a period of 40 years. Diagnostic imaging presented a retroperitoneal abscess due to a duodenal perforation of the longest thermometer as well as multiple other thermometers stuck in the small intestine. After all thermometers were removed and the abscess drained, the patient showed a clinical deterioration. In further operations we found a duodeno-sigmoid fistula and a gastro-thoracal fistula, which were not visible in the initial operations and imaging.

Conclusion

We recommend an active search for fistulas especially in the case of long-foregone ingestion.
Effects of vitamin B12 supplementation on oxidative stress markers and pro-inflammatory cytokines during pregnancy and postpartum among Bangladeshi mother–child pairs
Authors: Siddiqua Towfida Jahan , Akhtar Evana , Haq Md. Ahsanul , Shahab-Ferdows Seterah , Hampel Daniela , Islam Sharmin , Ahmed Tahmeed , Allen Lindsay H. , Raqib Rubhana
Published: January 2024

Background

There is limited research to determine whether vitamin B12 (B12) supplementation during pregnancy and lactation is protective against oxidative stress and pro-inflammatory cytokines and whether this effect is transferred to breastfed infants via milk. In addition, associations among maternal plasma/ milk and infant B12 status and immune function markers are poorly characterized.

Objectives

To evaluate effects of oral B12 supplementation during pregnancy and postpartum on maternal and infant 8-hydroxy-2′-deoxyguanosine (8-OH-dG, an oxidative stress marker) and proinflammatory cytokine levels, and examine associations between maternal plasma, breastmilk and infant B12 status as well as immune function markers.

Method

In a blinded, placebo-controlled trial, Bangladeshi women (n = 68, 18–35 years, hemoglobin < 11 g/dL, gestational weeks 11–14) received either 250 μg/day B12 or placebo throughout pregnancy up to 3-months postpartum. Samples were collected from mothers at baseline and 3-months postpartum and from infants at 3-months to measure B12 status indicators, 8-OH-dG and proinflammatory cytokines.

Results

Maternal postpartum B12 was positively associated with infant plasma B12. Higher milk B12 concentrations were associated with increased infant B12 (beta (β) = 277, 95% confidence interval (CI) = (132, 423), p<0.001) and lower total homocysteine (β = -7.63, 95% CI = (-12.40, -2.86), p = 0.002) levels. Maternal B12 supplementation reduced plasma 8-OH-dG concentrations among postpartum mothers and infants compared to the placebo group. Supplementation increased plasma TNF-α and IL-6 levels among mothers and IL-10 and IFN-γ levels among infants.

Conclusion

Milk and maternal plasma B12 at 3 months were associated with infant B12. Maternal B12 supplementation modulates 8-OH-dG and several cytokines which may protect against immune response-induced oxidative stress.

Trial registration

(clinicaltrials.gov: NCT01795131- 1st posted on 20/02/2013).
Fruits and vegetables intake improves birth outcomes of women with gestational diabetes mellitus and hypertensive disorders of pregnancy
Authors: Sewor Christian , Obeng Akua A. , Eliason Sebastian , Agbeno Evans K. , Amegah A. Kofi
Published: January 2024

Background

Disorders of pregnancy such as hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) have been associated with adverse birth outcomes. However, the ameliorating role of maternal nutrition in the relationship between disorders of pregnancy and adverse birth outcomes has received very little attention. We investigated the relationship between HDP and GDM, and adverse birth outcomes in a Ghanaian population and evaluated the effect modifying role of fruits and vegetables consumption in the relationship.

Methods

We conducted a cross-sectional study among 799 mothers who had recently delivered singletons in the Cape Coast Metropolis, Ghana. Information on HDP, GDM and birth outcomes were retrieved from the maternal health book of the mothers. A food frequency questionnaire was used to assess fruits and vegetables intake during pregnancy. Modified Poisson regression was used to investigate the association between pregnancy disorders, and preterm birth (PTB) and low birth weight (LBW). Stratified analysis was used to assess the effect modifying role of fruits and vegetables consumption in the relationship.

Results

The proportion of mothers with HDP and GDM was 11.3% and 7.5%, respectively. The proportion of the mothers with both conditions was 0.9%. The prevalence of PTB and LBW in the population was 27.9 and 7.3%, respectively. These disorders of pregnancy were associated with increased risk of PTB (Adjusted Prevalence Ration [APR] = 3.02; 95% CI: 2.42, 3.77) and LBW (APR = 5.32; 95% CI: 3.19, 8.88). In the stratified analysis, risk of PTB was higher among mothers classified in tertile I compared to mothers classified in tertiles II and III. For LBW, the risk increased with increasing fruits and vegetables consumption. The interaction p values were 0.0043 and 0.1604 for PTB and LBW, respectively.

Conclusions

We found mothers who were diagnosed with GDM and HDP to have increased risk of delivering a PTB and LBW baby. We also found fruits and vegetables consumption to modify the observed relationship. Mothers diagnosed with GDM and HDP should be advised during antenatal care visits to increase intake of fruits and vegetable consumption to help safeguard their health and that of the developing foetus.
Epimorphic development in tropical shallow-water Nymphonidae (Arthropoda: Pycnogonida) revealed by fluorescence imaging
Authors: Arango Claudia P. , Brenneis Georg
Published: January 2024

Background

Extant lineages of sea spiders (Pycnogonida) exhibit different types of development. Most commonly, pycnogonids hatch as a minute, feeding protonymphon larva with subsequent anamorphic development. However, especially in cold water habitats at higher latitudes and in the deep sea, some taxa have large, lecithotrophic larvae, or even undergo extended embryonic development with significantly advanced postlarval hatching stages. Similar biogeographic trends are observed in other marine invertebrates, often referred to as “Thorson’s rule”.

Results

To expand our knowledge on the developmental diversity in the most speciose pycnogonid genus Nymphon, we studied the developmental stages of the two tropical representatives N. floridanum and N. micronesicum., We compared classical scanning electron microscopy with fluorescence-based approaches to determine which imaging strategy is better suited for the ethanol-fixed material available. Both species show epimorphic development and hatch as an advanced, lecithotrophic postlarval instar possessing the anlagen of all body segments. Leg pairs 1–3 show a considerable degree of differentiation at hatching, but their proximal regions remain coiled and hidden under the cuticle of the hatching instar. The adult palp and oviger are not anteceded by three-articled larval limbs, but differentiate directly from non-articulated limb buds during postembryonic development.

Conclusions

Fluorescence imaging yielded more reliable morphological data than classical scanning electron microscopy, being the method of choice for maximal information gain from rare and fragile sea spider samples fixed in high-percentage ethanol. The discovery of epimorphic development with lecithotrophic postlarval instars in two small Nymphon species from tropical shallow-water habitats challenges the notion that this developmental pathway represents an exclusive cold-water adaptation in Nymphonidae. Instead, close phylogenetic affinities to the likewise more direct-developing Callipallenidae hint at a common evolutionary origin of this trait in the clade Nymphonoidea (Callipallenidae + Nymphonidae). The lack of functional palpal and ovigeral larval limbs in callipallenids and postlarval hatchers among nymphonids may be a derived character of Nymphonoidea. To further test this hypothesis, a stable and well-resolved phylogenetic backbone for Nymphonoidea is key.
Elitist-opposition-based artificial electric field algorithm for higher-order neural network optimization and financial time series forecasting
Authors: Nayak Sarat Chandra , Dehuri Satchidananda , Cho Sung-Bae
Published: January 2024

This study attempts to accelerate the learning ability of an artificial electric field algorithm (AEFA) by attributing it with two mechanisms: elitism and opposition-based learning. Elitism advances the convergence of the AEFA towards global optima by retaining the fine-tuned solutions obtained thus far, and opposition-based learning helps enhance its exploration ability. The new version of the AEFA, called elitist opposition leaning-based AEFA (EOAEFA), retains the properties of the basic AEFA while taking advantage of both elitism and opposition-based learning. Hence, the improved version attempts to reach optimum solutions by enabling the diversification of solutions with guaranteed convergence. Higher-order neural networks (HONNs) have single-layer adjustable parameters, fast learning, a robust fault tolerance, and good approximation ability compared with multilayer neural networks. They consider a higher order of input signals, increased the dimensionality of inputs through functional expansion and could thus discriminate between them. However, determining the number of expansion units in HONNs along with their associated parameters (i.e., weight and threshold) is a bottleneck in the design of such networks. Here, we used EOAEFA to design two HONNs, namely, a pi-sigma neural network and a functional link artificial neural network, called EOAEFA-PSNN and EOAEFA-FLN, respectively, in a fully automated manner. The proposed models were evaluated on financial time-series datasets, focusing on predicting four closing prices, four exchange rates, and three energy prices. Experiments, comparative studies, and statistical tests were conducted to establish the efficacy of the proposed approach.
Sex disparities in physical activity domains and hypertension prevalence
Authors: Cho Min Jeong , Jung Yong Joon , Min Ho Jeong , Kim Hyun Jeong , Kunutsor Setor K. , Jae Sae Young
Published: January 2024

Background

This study aimed to examine the associations of leisure time physical activity (LTPA) and occupational physical activity (OPA) with the prevalence of hypertension, while exploring the sex disparities in these associations.

Methods

A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey between 2014 and 2019 (n = 26,534). Hypertension was defined as the use of antihypertensive drugs or systolic and diastolic blood pressure ≥ 140/90 mm Hg. Self-reported physical activity (PA), assessed by the global PA questionnaire, was categorized into three domains: total PA, LTPA and OPA. Each PA domain was classified based on METs-min/wk and intensity.

Results

In a multivariable adjusted model, the odds ratio (OR) with 95% confidence intervals (CIs) for the prevalence of hypertension in the active versus inactive group, based on METs, was 0.92 (95% CI 0.85–0.99) for total PA, 0.90 (95% CI 0.83–0.98) for LTPA and 1.21 (95% CI 1.05–1.38) for OPA. Compared to the inactive group, moderate to vigorous intensity was associated with a lower odds of hypertension for total PA and LTPA (total PA: OR 0.95, 95% CI 0.89-1.00 and LTPA: OR 0.92, 95% CI 0.86–0.98), but a higher odd for OPA (OR 1.17, 95% CI 1.05–1.30). Subgroup analyses showed significant evidence of effect modification by sex on the associations of total PA and LTPA (METs and intensity) with hypertension prevalence (p-values for interaction < 0.01); the associations were generally stronger for women. OPA was associated with a higher prevalence of hypertension in women, but not in men (p-value for interaction > 0.05).

Conclusions

Higher levels of total PA and LTPA were associated with lower prevalence of hypertension in both men and women, with slightly stronger associations for women. However, higher OPA was associated with a higher prevalence of hypertension in women. These findings support the PA health paradox hypothesis and highlight the sex disparities in the association between OPA and hypertension prevalence.
Use of computed tomography coronary calcium score for prediction of cardiovascular events in cancer patients: a retrospective cohort analysis
Authors: Patel Sinal , Franco Francisco X. , McDonald Malcolm , Rivera Carlos , Perez-Villa Bernardo , Collier Patrick , Moudgil Rohit , Gupta Neha , Sadler Diego B.
Published: January 2024

Background

CT- coronary calcium score, is one of the most studied and widely available modalities in cardiovascular medicine. Coronary artery calcium score (CACS) is an established predictor of coronary artery disease. The ‘standard of care’ diagnostic modality to measure CACS is ECG-gated Cardiac Multi-Detector Computed Tomography. There is convincing evidence of a strong association between CACS and major cardiovascular (CV) events in asymptomatic individuals. Cancer patients (C) may have a higher risk for CV disease than non-cancer patients (NC) related not only to cancer treatments but also to shared biological factors and pathways. Thus, identifying tools for early detection of CV disease in this population is of utmost importance.

Methods

A retrospective cohort analysis was performed with patients from Cleveland Clinic Florida and Ohio who had CACS from 2017 to 2021. Patients who had cancer diagnosis prior to CACS were matched to NC for age and sex. CV events after their index CACS events were compared between C and NC, and matched control and propensity analysis were conducted.

Results

Ten thousand seven hundred forty-two patients had CACS; 703 cancer patients had CACS and were eligible. Extensive CACS (> 400) were significantly higher in cancer, 94 (13.37%) vs non-cancer patients, 76 (10.83%),P = 0.011. Furthermore, after propensity matched analysis, CACS > 400 was 14.8% in C vs 9.6% in NC,P =  < 0.05. CV events were similar in both cohorts (p = NS), despite less CV risk factors in cancer patients (P =  < 0.05). For the combined moderate (101–400) & extensive (> 400) CACS, the prevalence of stroke and peripheral arterial disease, a marker of systemic atherosclerosis, was significantly higher in patients with cancer (P < 0.01).

Conclusions

Despite having fewer CV risk factors in our study, similar CACS in cancer patients are suggestive of a higher prevalence of CV disease independent of traditional risk factors. High CACS and the overall prevalence of vascular events were more frequent in patients with cancer. Higher prevalence of peripheral arterial disease and cerebrovascular accident further suggests the increased atherosclerotic burden in C.
Investigating time to first birth among women of reproductive age in Bangladesh: a survival analysis of nationwide cross-sectional survey data
Authors: Sobhan Abdus , Moinuddin Mohammed , Hossain Md. Moyazzem
Published: January 2024

Background

The birth of the first child is an important turning point in a woman’s life as it is the starting point of the demanding responsibilities of motherhood and childcare. This study aimed to explore the waiting time and the significant indicators of time to the first birth of aged 15–49 years of ever-married women in Bangladesh.

Methods

The study considered the most recent country-representative data collected from Bangladesh Demographic and Health Survey (BDHS) in 2017/18. The log-rank test was used to assess the statistical significance of the observed difference between waiting time to first birth and various socio-economic and demographic factors. The Cox proportional hazard model is applied to identify the influential factors for waiting time to first birth.

Results

About 55% of the respondents’ age at their first birth was less than 18 years. More than 21% of them were 20 years and above at their first birth. Findings revealed a higher mean age at first birth in urban areas than in rural areas. Also, in Dhaka and Sylhet region, women have a higher age at first than in other regions of Bangladesh. Results show that the place of residence, region, age at first marriage, age at first sex, respondent’s education, employment status, contraceptive use, and mass media exposure were found to be statistically significant determinants of the age of respondents at the time of first birth. Findings also show that a woman from rural areas was likely to be 5% smaller in age at the time of first birth than their counterpart (aHR 1.05; 95% CI 1.01–1.10). The age at first birth of a woman in Chattogram was 24% shorter, while in Rangpur and Barishal, that age was increased by 14% and 8%, respectively. A woman with no education, primary, and secondary education had 28%, 38%, and 29%, respectively, shorter age at first birth than that of the higher educated women. Mass media unexposed women were shorter aged at first birth by 27% (aHR 1.27; 95% CI 1.10–1.47) compared to the women who were mass media exposed.

Conclusion

It is necessary to increase the age of mothers at first birth which may help to reduce the prevalence of child marriage in Bangladesh. The study findings will be helpful to the policymakers in identifying the gap and designing the programmes targeting the early timing of first birth to reduce child mortality as well as poor maternal outcomes which will be beneficial for achieving the Sustainable Development Goal-3 in Bangladesh.
Network pharmacology to unveil the mechanism of suanzaoren decoction in the treatment of alzheimer’s with diabetes
Authors: Chen Tao , Lei Yining , Li Manqin , Liu Xinran , Zhang Lu , Cai Fei , Gong Xiaoming , Zhang Ruyi
Published: January 2024

Background

Suanzaoren Decoction (SZRD), a well-known formula from traditional Chinese medicine, has been shown to have reasonable cognitive effects while relaxing and alleviating insomnia. Several studies have demonstrated significant therapeutic effects of SZRD on diabetes and Alzheimer’s disease (AD). However, the active ingredients and probable processes of SZRD in treating Alzheimer’s with diabetes are unknown. This study aims to preliminarily elucidate the potential mechanisms and potential active ingredients of SZRD in the treatment of Alzheimer’s with diabetes.

Methods

The main components and corresponding protein targets of SZRD were searched on the TCMSP database. Differential gene expression analysis for diabetes and Alzheimer’s disease was conducted using the Gene Expression Omnibus database, with supplementation from OMIM and genecards databases for differentially expressed genes. The drug-compound-target-disease network was constructed using Cytoscape 3.8.0. Disease and SZRD targets were imported into the STRING database to construct a protein-protein interaction network. Further, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses were performed on the intersection of genes. Molecular docking and molecular dynamics simulations were conducted on the Hub gene and active compounds. Gene Set Enrichment Analysis was performed to further analyze key genes.

Results

Through the Gene Expression Omnibus database, we obtained 1977 diabetes related genes and 622 AD related genes. Among drugs, diabetes and AD, 97 genes were identified. The drug-compound-target-disease network revealed that quercetin, kaempferol, licochalcone a, isorhamnetin, formononetin, and naringenin may be the core components exerting effects. PPI network analysis identified hub genes such as IL6, TNF, IL1B, CXCL8, IL10, CCL2, ICAM1, STAT3, and IL4. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses showed that SZRD in the treatment of Alzheimer’s with diabetes is mainly involved in biological processes such as response to drug, aging, response to xenobiotic, and enzyme binding; as well as signaling pathways such as Pathways in cancer, Chemical carcinogenesis - receptor activation, and Fluid shear stress and atherosclerosis. Molecular docking results showed that licochalcone a, isorhamnetin, kaempferol, quercetin, and formononetin have high affinity with CXCL8, IL1B, and CCL2. Molecular dynamics simulations also confirmed a strong interaction between CXCL8 and licochalcone a, isorhamnetin, and kaempferol. Gene Set Enrichment Analysis revealed that CXCL8, IL1B, and CCL2 have significant potential in diabetes.

Conclusion

This study provides, for the first time, insights into the active ingredients and potential molecular mechanisms of SZRD in the treatment of Alzheimer’s with diabetes, laying a theoretical foundation for future basic research.

Graphical Abstract
Leadership of school principals for school health implementation among primary schools in Mataram, Indonesia: a qualitative study
Authors: Sasaki Hirono , Sari Dian Puspita , Warnaini Cut , Andiwijaya Fahrin Ramadan , Takeuchi Rie , Kadriyan Hamsu , Shibuya Fumiko , Kobayashi Jun
Published: January 2024

Background

Health-promoting schools (HPS) are acknowledged as a comprehensive approach to improving children’s health and educational outcomes through learning and school life. Principals are key players in HPS implementation. However, concrete leadership practices in HPS in low- to middle-income countries have not been clarified. Therefore, this study aimed to explore and generate themes surrounding the leadership practices of principals in implementation of school health in Indonesia, a predominantly Muslim country consisting of diverse religions that have expanded HPS at the national level.

Methods

In-depth interviews and focus group discussions (FGDs) were conducted with the principals, teachers, parent representatives, and school board committee members in 10 target schools. FGDs were conducted with school health supervisory board members in Mataram City. All interviews were recorded and transcribed. Thematic analysis was undertaken to generate themes.

Results

The principals demonstrated leadership practices based on their religious beliefs, values, and morals. This may suggest that beliefs and morals support an understanding of their responsibility to ensure the well-being of all school community members, regardless of religion, in a diverse environment that is predominantly Muslim but also multicultural and multi-religious. Further, these beliefs and morals might reinforce implementation of school health. Importantly, the principals’ coordination skills in cooperating with multiple sectors might contribute to successful implementation of school health. Also, principals emphasized they were tasked to develop capacity for implementation of school health. Thus, principals should understand leadership in the implementation of school health as their duty from the training stage to encourage health at the school level.

Conclusion

In this study, “have professional educators’ beliefs and religious beliefs and Indonesia’s morals” was generated as a new theme, whereas several common themes were found as in previous studies. The results of this study suggested the importance of leadership by principals in the implementation of school health. Strengthening the capacity of school principals by integrating the contents of school health leadership practice into pre- and in-service training through the development of a policy on principals’ duties in school health might contribute to the successful implementation of school health.
Impact of El Niño on public health and its preparedness measures
Authors: Rony Moustaq Karim Khan , Wahiduzzaman Md. , Rahman Muhammad Mostafijur , Bala Shuvashish Das
Published: January 2024

Background

El Niño events disrupt atmospheric and oceanic interactions, leading to shifts in precipitation, temperature, and extreme weather events. Such alterations have the potential to exacerbate heatwaves, increase vector-borne and waterborne diseases, and compromise air quality. Understanding the connection between El Niño and public health vulnerabilities is crucial for effective mitigation and preparedness.

Main body of the abstract

This article aimed to investigate the impact of El Niño on public health and its preparedness measures. A comprehensive literature review was conducted, involving systematic searches across academic databases, scientific journals, and relevant grey literature. Inclusion criteria encompassed studies that explored the link between El Niño and public health outcomes, as well as strategies for enhancing preparedness. Thematic analysis was employed to synthesize findings and identify key themes. This article revealed that El Niño events contribute to a spectrum of public health challenges, including heat-related illnesses and compromised air quality. Vulnerable populations, such as the elderly, children, and those with pre-existing medical conditions, are particularly at risk. Early warning systems, health infrastructure readiness, communication strategies, and collaborative efforts emerged as vital preparedness measures.

Short conclusion

El Niño’s impact on public health and preparedness measures is a complex and multifaceted issue that requires a unified and proactive approach. By understanding the interplay between El Niño events and health vulnerabilities, communities can better prepare for and mitigate the health risks posed by these climatic fluctuations. Strengthened early warning systems, improved healthcare infrastructure, effective communication strategies, and collaborative efforts between various stakeholders are crucial in enhancing preparedness and safeguarding public health in the face of El Niño’s capricious influence.
Hydrothermal synthesis of zeolites from residual waste generated via indirect carbonation of coal fly ash
Authors: Shin Seonmi , Kim Myoung-Jin
Published: January 2024

Indirect carbonation, a technology to store CO2 and produce stable CaCO3 and MgCO3, involves elution of Ca and Mg from industrial waste and subsequent carbonation. Although substantial residual waste is generated after the elution of Ca and Mg, its recycling attributes have not been adequately scrutinized. The residual waste has lower Ca and Mg contents and higher Si and Al contents than those of the raw material (i.e., industrial waste). This study involves the hydrothermal synthesis of zeolite-P using residual waste from indirect carbonation, conducted at both 100 and 180 ℃. The properties of these zeolites are compared with those synthesized from coal fly ash (CFA). The synthesized zeolites were characterized by X-ray diffraction, field emission scanning electron microscope, thermogravimetric analyzer, and Brunauer–Emmett–Teller (BET). A high zeolite conversion efficiency was achieved through a hydrothermal reaction (up to 87%), even though Si and Al were not added to the residual waste. Additionally, the cation exchange capacity and BET specific surface area of the synthesized zeolites were high (200 cmol kg−1 and 73 m2 g−1, respectively). These findings highlight the possibility of synthesizing zeolites using the residual waste from indirect carbonation as an alternative to conventional zeolite synthesis using industrial waste such as CFA. The synthesized zeolite-P is expected to be effective in wastewater treatment, detergent manufacturing, and water softening.
Diffusion tensor imaging of brain changes in patients with chronic kidney disease before cognitive impairment with 3 T MRI device
Authors: Moustafa Sherif Abdel Fattah , Rizk Dina Abd Elnasser , El Serougy Lamiaa Galal , El Said El Azab Mohamed , Mustafa Wessam
Published: January 2024

Background

Patients with chronic kidney disease (CKD) are at risk of a many of central nervous system complications such as stroke and cognitive impairment. Studies based on diffusion tensor imaging (DTI) confirmed that the integrity of white matter in CKD patients has changed and these alterations can be observed before tissue morphological changes occurring on conventional MRI. Early use of DTI in CKD patients can distinguish early individuals with normal cognitive system function and will develop cognitive impairment in later stages.

Results

As compared with controls, patients with CKD showed increased MD and decreased FA values in different brain regions with frontal, parietal regions and genu of corpus callosum more affected more than the occipital regions. For combined FA and MD in differentiating cases with CKD, there was statistically significant difference in both thalami, internal capsule, CC, cingulum, ILF and CST as p value < 0.05.

Conclusions

DTI with fiber tractography can present the mainstay of imaging in evaluating the white matter integrity in CKD patient has normal conventional MRI with better diagnostic accuracy in differentiation between healthy and altered white matters.
Predictors of COVID-19 outcome in type 2 diabetes mellitus: a hospital-based study
Authors: Elsayed Amira M. , Elsayed Mohamad S. , Mansour Ahmed E. , Mahedy Ahmed W. , Araby Eman M. , Morsy Maha H. , Abd Elmoniem Rasha O.
Published: January 2024

Background

Diabetes has become a significant risk factor for COVID-19-related severe illness and death.

Methods

This was a retrospective cohort study of 104 patients, with or without type 2 (diabetes mellitus) DM, diagnosed with COVID-19 between June and September 2021 in Benha University Hospital, Egypt. Outcome measures including discharge after recovery, transfer to ICU and intubation, or death were recorded. Univariate and multivariate logistic regression analysis was done for the prediction of death in diabetic patients.

Results

Length of hospital stay was significantly higher in diabetic (median 15 days) compared to non-diabetic patients (median 10 days). ICU admission and intubation among diabetic patients were substantially higher than non-diabetics. Univariate regression analysis established that old age (p = 0.02: OR = 1.03: CI 1.00–1.07), multiple comorbidities (p = 0.005: OR = 8.66: CI 1.9–38.5), diabetic complications (p = 0.000: OR = 6.401:CI 2.5–16.3), HbA1c (p = 0.01: OR = 1.22: CI 1.04–1.43), length of hospital stay (p = 0.005: OR = 1.07: CI 1.02–1.12), and ICU admission (p = 0.00: OR = 44.1: CI 9.4–205.3) were predictors of death for diabetic patients as well as neutrophilic count, D-dimer, and CRP levels. Multivariate regression analysis concluded that ICU admission was the most significant predictor of death in diabetic patients.

Conclusion

Type 2 DM patients, infected with the COVID-19 virus exhibited more admission to ICU and intubation with longer hospital stays compared to those without diabetes with a similar death rate. Old age, HbA1C, comorbidities, diabetic complications, length of hospital stay and ICU admission, and inflammatory parameters were significant predictors of death in diabetic patients.
A meta-analysis of randomized clinical trials on the effect of metformin vs. pioglitazone monotherapy on plasma adiponectin levels among patients with diabetes mellitus
Authors: Arbas Roselle , Dayrit Sofia Alexis , Dimalanta Arah , Flores John Ashley , Mañalac Arch Raphael , Soriano Dinah Rose , Vallo Johana , Tiongco Raphael Enrique , Pineda-Cortel Maria Ruth
Published: January 2024

Background

Limited and contradicting findings were observed on the effects of both metformin (MET) and pioglitazone (PIO) on adiponectin (ADP) levels. Hence, we performed a meta-analysis of randomized control trials to obtain more precise estimates. Studies were searched, screened, and identified through different database sites. Data from included studies were extracted, pooled, and analyzed. Mean and standardized mean differences were computed with their corresponding confidence intervals.

Results

Overall, five studies were included in the meta-analysis. Pooled outcomes suggest that patients with diabetes receiving PIO treatment have significantly increased ADP levels. On the other hand, no significant differences were observed for those treated with MET. Other diabetes-related parameters were tested, comparing the effect of MET vs. PIO treatment, and yielded significant results for HOMA-IR and BMI.

Conclusion

Our study suggests that PIO significantly affects ADP levels compared to MET among patients with diabetes mellitus. However, further studies are needed to verify these claims.
Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: a case report and review of literature
Authors: Bouchaala Abderrahmane , Nguadi Jaouad , Mouine Najat , Bouzelmat Hicham , Benyass Aatif
Published: January 2024

Background

Diabetic ketoacidosis (DKA) is a serious, life-threatening condition known for its profound hydro electrolytic disturbances and multiple complications, including cerebral edema and circulatory collapse. While this complication is traditionally associated with patients suffering from type 1 diabetes, numerous studies have documented its non-negligible incidence in type 2 diabetics. However, conductive disorders that manifest during its course, such as sinus arrest, are poorly reported and can be life-threatening on their own when not promptly recognized and treated. The primary objective of this report is to increase awareness regarding the uncommon conduction complications associated with diabetic ketoacidosis, even in the absence of overt hyperkalemia, and to underscore the critical significance of early diagnosis and prompt intervention in managing these complications.

Case presentation

We present the case of a middle-aged man with past history of type 2 diabetes whose symptoms included asthenia and consciousness disorder concomitant with ketoacidosis decompensation. Electrocardiogram (ECG) revealed the presence of sinus arrest with ventricular escaping rhythm. Rapid management of the diabetic decompensation led to spontaneous restoration of normal sinus rhythm, thus obviating the necessity for permanent pacing in the patient.

Conclusions

Atypical complications arising during ketoacidosis decompensation, including conditions like sinus arrest, are frequently overlooked and tend to carry a guarded prognosis. Proper recognition and prompt treatment are imperative to achieve the optimal clinical outcome.
Accurate compressive strength prediction using machine learning algorithms and optimization techniques
Authors: Lan Wenbin
Published: January 2024

Numerous components' complex interrelationships and interconnectedness present a formidable obstacle in developing mix designs for high-performance concrete (HPC) formulation. The effectiveness of machine learning (ML) algorithms in resolving this paradox has been illustrated. However, they are classified as opaque black-box models due to the lack of a discernible correlation between blend ratios and compressive durability. The present study proposes a semi-empirical methodology that integrates various techniques, including non-dimensionalization and optimization, to overcome this constraint. The methodology exhibits a noteworthy level of accuracy when forecasting compressive strength (CS) across a spectrum of divergent datasets, thus evincing its extensive and all-encompassing efficacy. Moreover, the precise relationship that semi-empirical equations convey is of great significance to practitioners and researchers in this field, especially with respect to their predictive abilities. The determination of CS in concrete is a critical facet of the design of HPC. An exhaustive comprehension of the intricate interplay between manifold factors is requisite to attain an ideal blend proportion. The study’s findings indicate that$$RF$$RFcan accurately predict$$CS$$CS. Moreover, the combination of optimization algorithms significantly enhances the model’s effectiveness. Among the three Optimization Algorithms under consideration, the COA optimizer has exhibited superior performance in augmenting the accuracy and precision of the RF prediction model for CS. As a result, RFCO obtained the more suitable value ofR2and RMSE obtained 0.998 and 0.88, alternatively.
A decade of technology advancement in seismic processing: A case study from reprocessing legacy sparse OBC data in Kashagan Field
Authors: Park Jaewoo , Hyslop Craig , Ouzounis Ares , Wawrzynski Alecia , Vdovina Tetyana , Lee Sunwoong , Hasner Katja , Ibanez William D. , Schreuder Steve , Tapalov Zharas , Gabdullin Assembek , Yergaliyev Nurzhan
Published: January 2024

Ceaseless advancements in seismic data processing technology and workflow enable the extraction of increasing amounts of subsurface information essential for derisking and optimizing natural resource development. The Kashagan oil field, one of the world's largest carbonate reservoirs, is faced with significant development optimization challenges due to a combination of complex geology and suboptimal seismic data coverage. The latest processing technologies were applied to the 2001–2002 vintage sparse ocean-bottom cable data and produced step-change improvements over the 2010–2011 legacy processing and imaging results. Such significant image uplift is representative of technology advancements over the span of a decade fully leveraging the newly preprocessed input data, including (1) an integrated model building workflow, (2) adaptive application of full-waveform inversion, (3) geologically constrained reflection tomography, and (4) least-squares imaging. The new seismic results improved the structural and stratigraphic imaging of multiple layers of shallow carbonates, mitigated fault shadow and other complex overburden effects, increased the resolution of subsalt carbonate reservoir features such as karst and internal fractures, improved well marker depth misfit, and ultimately influenced the placement of upcoming wells and reservoir development plans. Further improvements in seismic imaging would be feasible with a modern acquisition of more densely sampled seismic data, which would allow the full potential of the latest seismic processing technologies and workflows to be unlocked.