bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal periodontal diseases affect the leukocyte profiles of umbilical cord blood: A cohort study
Authors: Zhao Dan , Cheng Tianfan , Hu Dangli , Xu Xiaoyi , Zhang Feng , Yu Rong , Li Huijun , Wen Ping , Chen Lihua , Fu Mali , Yang Hong , Zhang Hanyu , Yao Jilong , Jin Lijian
Published: July 2023

Aim

This study evaluated the connection of periodontal status with the leukocyte profiles of maternal peripheral blood (MPB) and umbilical cord blood (UCB).

Materials and Methods

Ninety‐nine pregnant females were recruited, and their data were collected via questionnaire and from medical records, including demographics, systemic conditions, complete blood count (CBC) and C‐reaction protein (CRP) level in MPB. Full‐mouth periodontal assessment was performed. CBC and CRP levels in UCB were measured after parturition.

Results

All subjects and their neonates were generally healthy. 30.3% of the participants presented with periodontal health condition, whereas 69.7% had different severities of periodontal diseases. The counts/percentages of eosinophils and monocytes in UCB from the subjects with periodontal diseases elevated, and the percentage of neutrophils decreased referencing to that from the counterparts (p < 0.05). There were positive correlations for total leukocyte count, neutrophils and lymphocytes counts/percentages in MPB and UCB among the periodontally healthy subjects (r > 0.4, p < 0.05), but such findings did not exist in those with periodontal diseases. Moreover, periodontal diseases independently accounted for the counts/percentages of neutrophils and eosinophils in UCB after controlling confounders in four testing models (ANCOVA, p < 0.05).

Conclusion

Maternal periodontal diseases could to some extent disturb the leukocyte profiles of umbilical cord blood.
Microvascular density analysis and histological parameters of oral cancer progression
Authors: Batistella Elis Angela , Miguel Andressa Fernanda Paza , Nascimento Nicole Lonni , Horta Martinho Campolina Rebello , Vieira Daniella Serafin Couto , Rivero Elena Riet Correa
Published: July 2023

Objectives

This study aimed to investigate the role of blood and lymphatic microvascular density in the progression of oral squamous cell carcinoma (OSCC).

Materials and Methods

The sample was composed of 54 cases of OSCC. The immunoexpression to anti‐alpha‐smooth muscle actin (α‐SMA) and to anti‐endoglin (CD105) was used to determine the microvessel density (MVD); anti‐podoplanin (D2‐40) was used to assess the lymphatic vessel density (LVD); vascular endothelial growth factor (VEGF) was evaluated in malignant cells. The histological differentiation, the worst pattern of invasion (WPOI), tumour thickness and tumour budding (TB) intensity were assessed using haematoxylin–eosin and anti‐pan‐cytokeratin (AE1/AE3). Patients' age and sex, TNM classification and follow‐up time were collected from the medical records.

Results

MVD markers presented a similar pattern of expression in blood vessels. However, only α‐SMA + MVD was significantly higher among women and in tumours ≤4 cm. LVD was lower in tumours with lymph node metastasis. Regarding the histological parameters, high TB intensity was associated with histological differentiation, advanced clinical stage, greater tumour thickness and reduced disease‐free survival. No difference was found in VEGF.

Conclusions

The decrease in OSCC LVD could be related to pathological node involvement, whereas high TB intensity could indicate OSCC progression and worse patient outcomes.
Oral tongue squamous cell carcinoma diagnosis from tissue metabolic profiling
Authors: Wang Shuai , Li Ke , Zhao Tong , Sun Yawei , Zeng Tao , Wu Yan , Ding Liang , Huang Xiaofeng , Celentano Antonio , Yang Xihu , Hu Qingang , Ni Yanhong
Published: July 2023

Objective

Disease metabolomes have been studied for identifying diagnostic and predictive biomarkers of pathology. Oral tongue squamous cell carcinoma (OTSCC) is one of the most prevalent subtypes of head and neck squamous cell carcinoma, yet the profile and diagnostic value of its tissue metabolite are unclear.

Subjects and Methods

Tumor tissue samples and matched normal mucosal tissue samples were collected from 40 OTSCC patients. Untargeted metabolic analysis by liquid chromatography–mass spectrometry/mass spectrometry, in positive and negative ion modes, was used to identify dysregulated metabolites in OTSCC. Further, utilizing LASSO regression and receiver operating characteristic analyses, biomarker metabolites were selected and validated, and a diagnostic model was established.

Results

One hundred and ninety metabolites were detected. The OTSCC had a total of 89 dysregulated metabolites, of which 73 were elevated. A diagnostic panel of nine metabolites was subsequently created that could accurately identify OTSCC with 100% sensitivity of 100%, 100% specificity and an AUC of 1.00.

Conclusions

This study identified distinct metabolic characteristics of OTSCC and established a diagnostic model. Our research also contributes to the investigation of the pathogenesis of OTSCC.
Stellate ganglion block to mitigate thalamic pain syndrome of an oncological origin
Authors: Wilkinson Alex J. , Yang Ajax , Chen Grant H.
Published: July 2023

Background

Thalamic pain syndrome (TPS) is an enigmatic and rare condition. Thalamic pain syndrome is under the umbrella of central pain syndrome, which is classically associated with multiple sclerosis, spinal cord injury, postamputation, epilepsy, stroke, tumor, and Parkinson's disease. The mainstay treatment of TPS is polypharmacy. There is uncertainty about the intermediate options to manage medication‐resistant TPS before resorting to invasive, and often expensive, intracranial therapies. Stellate ganglion block (SGB) has shown promise in reducing TPS symptoms of the upper extremity and face following a thalamic ischemic event.

Aims

Discuss the effect and potential utility of SGB on ipsilateral headache, facial, and upper extremity neuropathic pain due to thalamic malignancies.

Materials and Methods

A review of two patient records that underwent SGB for treatment of TPS of oncologic origin.

Results

We present two cases of the successful use of SGB for the treatment of oncologic‐related TPS for patients who had failed other conservative pharmacologic measures.

Discussion

Chronic pain is a complex experience that often simultaneously involves psychosocial, neuropathic, and nociceptive constituents. Among advanced cancer patients, factors such as an individual's spirituality, psychological stressors, and views on their mortality add layers of intricacy in addressing their pain. While TPS has been characterized in both stroke populations and oncologic populations, the treatment of SGB for pain relief in TPS has been limited to the stroke population. Repeated SGB worked to alleviate the ipsilateral headache, facial, and upper extremity pain in these two patients. The benefits of utilization of SGB, with the possibility of pain relief, within the thalamic malignancy population cannot be understated.

Conclusion

In summary, ultrasound‐guided SGB may be considered in patients with TPS due to thalamic cancer, before pursuing more invasive intracranial surgeries to treat pain.
Outcomes of children treated for multiple Epstein–Barr virus‐associated post‐transplant tumors
Authors: Devine Kaitlin J. , Seif Alix E. , Reilly Anne F.
Published: July 2023

Background

After solid organ transplantation, children are at risk for Epstein–Barr virus‐associated post‐transplant lymphoproliferative disorder and smooth muscle tumors. Little is known about the clinical course, Epstein–Barr viral load variations, and optimal treatment for such patients. We set forth to understand the course of repeated episodes of post‐transplant lymphoproliferative disorder and smooth muscle tumors.

Methods

We performed a retrospective chart review of patients up to 21 years old with solid organ transplantation and post‐transplant lymphoproliferative disorder at the Children's Hospital of Philadelphia from January 2003 through June 30, 2020.

Results

Six patients had multiple episodes of Epstein–Barr virus‐associated post‐transplant lymphoproliferative disorder and smooth muscle tumors. When the second episode was discovered, only one patient was symptomatic. Histology differed from diagnosis in four patients. Treatment included viral‐specific T‐lymphocytes (2), rituximab (3), reduction in immunosuppression alone (1). Five patients had complete response, and one had stable disease, but three patients developed a subsequent tumor. Two patients developed Epstein–Barr virus‐associated smooth muscle tumors. Of these six patients, four are alive. The deaths were not related to their tumors.

Conclusions

Despite a complete response to initial therapy, children are at risk for repeated episodes of Epstein–Barr virus‐associated post‐transplant lymphoproliferative disorder and smooth muscle tumors. Histology and location were not typically consistent with initial diagnosis, suggesting these are second primaries rather than recurrences. Disease may be managed with individualized treatment plans but EBV‐specific T cells need further study in such tumors.
Multi‐omics approach to understand the impact of sun exposure on an in vitro skin ecosystem and evaluate a new broad‐spectrum sunscreen
Authors: Jacques Carine , Bacqueville Daniel , Jamin Emilien L. , Maitre Martine , Delsol Cécile , Simcic‐Mori Aimée , Bianchi Pascale , Noustens Anais , Jouanin Isabelle , Debrauwer Laurent , Bessou‐Touya Sandrine , Stockfleth Eggert , Duplan Hélène
Published: July 2023

A reconstructed human epidermal model (RHE) colonized with human microbiota and sebum was developed to reproduce the complexity of the skin ecosystem in vitro. The RHE model was exposed to simulated solar radiation (SSR) with or without SPF50+ sunscreen (with UVB, UVA, long‐UVA, and visible light protection). Structural identification of discriminant metabolites was acquired by nuclear magnetic resonance and metabolomic fingerprints were identified using reverse phase‐ultra high‐performance liquid chromatography–high resolution mass spectrometry, followed by pathway enrichment analysis. Over 50 metabolites were significantly altered by SSR (p < 0.05, log2 values), showing high skin oxidative stress (glutathione and purine pathways, urea cycle) and altered skin microbiota (branched‐chain amino acid cycle and tryptophan pathway). 16S and internal transcribed spacer rRNA sequencing showed the relative abundance of various bacteria and fungi altered by SSR. This study identified highly accurate metabolomic fingerprints and metagenomic modifications of sun‐exposed skin to help elucidate the interactions between the skin and its microbiota. Application of SPF50+ sunscreen protected the skin ecosystem model from the deleterious effects of SSR and preserved the physiological interactions within the skin ecosystem. These innovative technologies could thus be used to evaluate the effectiveness of sunscreen.
Activity level by clinical severity and sex differences in patients with Alzheimer disease and mild cognitive impairment
Authors: Kamizato Chiaki , Osawa Aiko , Maeshima Shinichiro , Kagaya Hitoshi , Arai Hidenori
Published: July 2023

Background

To determine how to maintain activity in persons with dementia and mild cognitive impairment, we examined the daily activity level by different degrees of clinical severity and sex differences in patients with Alzheimer's disease and mild cognitive impairment.

Methods

This study included 92 patients with Alzheimer's disease and 33 patients with mild cognitive impairment who visited our rehabilitation department. The Frenchay Activities Index was used to assess the level of activity.

Results

Women had high Frenchay Activities Index scores for household activities, such as meal preparation, washing clothes, and light housework, whereas men had high Frenchay Activities Index scores for social occasions and walking outside. Although activity decreased with the severity of dementia in women, there was no difference in men. Additionally, a negative correlation was observed between the number of people living together and activity in women.

Conclusions

To maintain and improve activities in persons with Alzheimer's disease and mild cognitive impairment, it is important to suggest activities that fit the lifestyle of the individual and family caregivers and to provide lifestyle instructions that consider sex differences.
Correlation between sentence topic and discourse topic in French and Chinese: annotation issues and contrastive analysis
Authors: Hou Jiaqi , Landragin Frédéric
Published: July 2023

This paper aims to investigate the correlation between “sentence topic (ST)” and “discourse topic (DT)”, both based on an “aboutness” relation. It also compares the degrees of correlation between French and Chinese, considered respectively as a subject‐prominent and a topic‐prominent language. Kendall's correlation tests, Poisson models and z‐tests were conducted using manually annotated textual data. The results confirm a positive correlation between STs and DTs in both languages. Although the correlation coefficients are higher in Chinese, z‐tests' results do not show a significant difference between the two languages. We explain that the two languages differ not only in the more or less frequent topic‐comment constructions, but also in the choice of more or less accessible referential markers which represent the STs, or in the more or less tacit way that STs of different sentences are related to each other.
Multi‐hazard assessment using machine learning and remote sensing in the North Central region of Vietnam
Authors: Nguyen Huu Duy , Dang Dinh‐Kha , Bui Quang‐Thanh , Petrisor Alexandru‐Ionut
Published: July 2023

Natural hazards constitute a diverse category and are unevenly distributed in time and space. This hinders predictive efforts, leading to significant impacts on human life and economies. Multi‐hazard prediction is vital for any natural hazard risk management plan. The main objective of this study was the development of a multi‐hazard susceptibility mapping framework, by combining two natural hazards—flooding and landslides—in the North Central region of Vietnam. This was accomplished using support vector machines, random forest, and AdaBoost. The input data consisted of 4591 flood points, 1315 landslide points, and 13 conditioning factors, split into training (70%), and testing (30%) datasets. The accuracy of the models' predictions was evaluated using the statistical indices root mean square error, area under curve (AUC), mean absolute error, and coefficient of determination. All proposed models were good at predicting multi‐hazard susceptibility, with AUC values over 0.95. Among them, the AUC value for the support vector machine model was 0.98 and 0.99 for landslide and flood, respectively. For the random forest model, these values were 0.98 and 0.98, and for AdaBoost, they were 0.99 and 0.99. The multi‐hazard maps were built by combining the landslide and flood susceptibility maps. The results showed that approximately 60% of the study area was affected by landslides, 30% by flood, and 8% by both hazards. These results illustrate how North Central is one of the regions of Vietnam that is most severely affected by natural hazards, particularly flooding, and landslides. The proposed models adapt to evaluate multi‐hazard susceptibility at different scales, although expert intervention is also required, to optimize the algorithms. Multi‐hazard maps can provide a valuable point of reference for decision makers in sustainable land‐use planning and infrastructure development in regions faced with multiple hazards, and to prevent and reduce more effectively the frequency of floods and landslides and their damage to human life and property.
Oral transmission of Chagas disease from a One Health approach: A systematic review
Authors: López‐García Alejandra , Gilabert Juan A.
Published: July 2023

Objective

To analyse acute Chagas disease (CD) outbreaks through a qualitative systematic review and discuss the determinants for its prevention and control.

Methods

Review of studies in which clinical cases of oral transmission were confirmed by parasitological and/or serological tests that included an epidemiological investigation of sources of infection, vectors and reservoirs.

Results

Thirty‐two outbreaks (1965–2022) were analysed. The main foods involved in oral transmission outbreaks are homemade fruit juices. Different species of vectors were identified. Reservoirs were mainly dogs, rodents and large American opossums (didelphids).

Conclusion

Under a One Health approach, environmental changes are one of the factors responsible of the rise of oral transmission of CD. Entomological surveillance of vectors and control of the changes in wild and domestic reservoirs and reinforcement of hygiene measures around food in domestic and commercial sites are needed.
Variables affecting surgeons’ use of, and preferences for, instrumentation in veterinary laparoscopy
Authors: Smith Meghan R. , Buote Nicole J. , Sumner Julia P. , Freeman Lynetta J.
Published: July 2023

Objective

To investigate the impact of variables on use and preference of common laparoscopic instruments.

Study design

Online survey.

Sample population

Surgeons (n = 140) with 3 years or more laparoscopic experience.

Methods

Electronic survey distributed via specialty group LISTSERVEs and Facebook groups. Responses collected included surgeon attributes, preferences, and surgical practice data. Statistical analysis was performed using Fishers exact, ANOVA, Tukey Kramer honestly significant difference (HSD) test, linear regression, and logistic regression.

Results

Ninety‐eight of 140 respondents answered instrument‐related questions and the completion rate of these questions was 76%: 48% of females and 49% of males responded to the survey. The median glove size of respondents was size 7 (range, 5.5 to 8.5). Closing laparoscopic Babcock forceps (p = .018), rotating cup biopsy forceps (p = .003), and manipulating endoscopic staplers (p < .001) were more difficult for surgeons with smaller glove sizes. The median difficulty score for the endoscopic stapler was 4/10 and the median percentage of time this was found difficult was 25%. Reusable instruments were preferred over disposable single‐use instruments. The pistol grip was preferred for grasping and retracting (54/98, 55%) and fine dissection (46/96, 48%), while the axial grip was preferred for suturing and knot tying (61/98, 62%).

Conclusion

Surgeons with smaller glove sizes (<6.5) experience more difficulty when using common laparoscopic instruments. The endoscopic stapler was the most difficult to use.

Clinical significance

When purchasing laparoscopic instrumentation, surgeons should review all available options in handle size and design to improve ergonomics during minimally invasive procedures.
Acceptance of xenotransplantation by patients waiting for organ donation: A qualitative study
Authors: Şahin Akboğa Özlem , Rukiye Hobek Akarsu
Published: July 2023

Background

The aim of this study was to determine the acceptance and barriers to xenotransplantation in patients waiting for organ transplantation.

Methods

It is qualitative and descriptive research. It was completed with 18 patients receiving treatment and waiting for organ transplantation in a dialysis center located in the inner region of Turkey between January 26, 2023 and February 3, 2023. Data were collected with an introductory information form and a semi‐structured interview form. The research data were collected through face‐to‐face in‐depth interviews. The content analysis method was used to analyze the data. In line with the goal of reaching data saturation, in‐depth interviews were conducted with 18 participants who were open to communication.

Results

Two main themes, “Values” and “Thoughts”, and five sub‐themes, “social and religious values, positive, negative and future thoughts”, were identified. Thirteen codes were created including “not being understood by the society, xenotransplantation prejudice, fear of ridicule and exclusion, religious pressure, desire for unconditional acceptance/rejection” and “thought of survival, hope, thought of sinning, submission to doctors, the attitude of religious men and excessive demand”.

Conclusions

Patients awaiting organ transplantation need religious, social, and community support for xenotransplantation.
ThePhyloCode: The logical outcome of millennia of evolution of biological nomenclature?
Authors: Laurin Michel
Published: July 2023

Biological nomenclature harks back to a remote prehistoric past, as shown by the universality of fairly sophisticated folk taxonomies and nomenclatures found on all inhabited continents. Ethnobiologists have suggested that these nomenclatures include cryptic ‘ethnotaxonomic ranks’, although the existence of these ranks has been increasingly questioned recently. The fact that no trace of such ranks has been evoked in Aristotle's classification of animals but that they have been described in antique Roman ethnotaxonomies casts further doubts about these cryptic ranks. The advent of rank‐based nomenclature (RN) in the mid‐18th century has had a pervasive, but not only positive, influence on biological nomenclature. The use of a single type and of a subjective, artificial nomenclatural rank does not delimit taxa under RN. This is even a goal of RN, according to Principle 2 of theZoological Code. This contrasts with the nomenclatures of other fields, some of which are designed to delimit entities fairly precisely (e.g. geopolitics, stratigraphy, chemistry), and in which ranks are either defined more objectively (e.g. geopolitics, chemistry), or used informally and relegated to a secondary role (e.g. biogeography, paleobiogeography), or vary in time (e.g., paleobiogeography) or space (e.g., stratigraphy). A trend towards more explicit and precise delimitation of entities over time is also discernible in some fields, especially geopolitics and stratigraphy. In this context, the development of phylogenetic nomenclature (PN) and the recent advent of thePhyloCodeappear as the logical outcome of the development of evolutionary biology and phylogenetics.
Membrane Distillation for Desalination and Current Advances in MD Membranes
Authors: Bin Abid Monis , Abdul Wahab Roswanira , Gzara Lassaad
Published: July 2023

Desalination is a great technique to address the growing demand for water because it is essential for humans. Water treatment and desalination are two common uses for the membrane-based, non-isothermal MD (Membrane Distillation) process. It works at low pressure and temperature, and heat from waste and solar energy can meet the process's heat requirements. In MD, dissolved salts and nonvolatile contaminants are rejected as the vapors go through the membrane's pores and start condensing at the permeate side. However, because to the lack of a suitable and adaptable membrane, biofouling, wetting and water efficacy are the main problems for MD. Many researchers have recently worked on membrane composites and attempted to create effective, appealing, and unique membranes for membrane distillation. This review article talks about water shortages in the 21st century, the rise of desalination, the use of membrane distillation (MD), recent developments in membrane distillations, developments in pilot scale MD technologies, New developments in membrane fabrication and modification, the desired properties of membranes, and desalination membranes.
Grand Challenges in the Development of Adsorptive Membrane for Water and Wastewater Treatment
Authors: Mohd Nasir Atikah , Adam Mohd Ridhwan , Hubadillah Siti Khadijah
Published: July 2023

Integrating nanotechnology and membrane technology has resulted in the development of adsorptive nanocomposite membranes with exceptional properties for various applications, including water reclamation. The application of adsorptive membranes in wastewater treatment is a promising technology that combines the advantages of adsorption and membrane filtration techniques. Literature reviews reported that various adsorptive membranes were successfully developed and efficiently removed emerging contaminants such as heavy metals and persistent organic pollutants from water over the last decades. However, grand challenges in developing adsorptive membranes require more attention, such as aggregation and agglomeration of nanoadsorbents within membrane matrix, mechanical strength distortion, extreme water permeability, and alterations in surface charge. These challenges, as mentioned earlier, could deteriorate the performance of adsorptive membranes. Consequently, future research should focus on overcoming these challenges to employ adsorptive membranes to preserve the environment.
The electromagnetic waves generated by a cluster of nanoparticles with high refractive indices
Authors: Cao Xinlin , Ghandriche Ahcene , Sini Mourad
Published: July 2023

We estimate the electromagnetic field generated by a cluster of dielectric nanoparticles embedded into a background made up of a vacuum. The dielectric nanoparticles are small scaled but enjoy high contrast of their relative permittivity. Such scales/contrasts can be ensured using the Lorentz model with incident frequencies chosen appropriately close to the undamped resonance frequency (appearing in the Lorentz model). Under certain ratio between their size and contrast, these nanoparticles generate resonances, called dielectric resonances. These resonances are characterized and computed via the spectrum of the electric Newtonian potential operator, stated on the support of nanoparticles, and projected on the space of divergence‐free fields with vanishing boundary normal components. We characterize the dominant field generated by a cluster of such dielectric‐resonating nanoparticles. In this point‐interaction approximation, the nanoparticles can be distributed to occupy volume‐like domains or low‐dimensional hypersurfaces where periodicity is not required. The form of these approximations suggests that the effective electromagnetic medium, equivalent to the cluster of such nanoparticles, is a perturbation of the magnetic permeability and not the electric permittivity. The cluster can be tuned such that the equivalent permeability has positive or negative values (while the permittivity stays unchanged).
Dynamics of the System Drilling Riser–BOP–Well Casing—Wellhead Casing Fatigue Analysis
Authors: Guimarães Fabiano
Published: July 2023

This paper presents a fully coupled solution in the time-domain, using the finite-differences method to the system of equations that model the dynamic behavior of the riser, blow-out preventer (BOP), and casing strings, when connected for well drilling/completion—the model is suitable to evaluate wellhead fatigue, even when the amplitude of oscillation and accelerations of the BOP are high. Sensibility analysis is used to show the effect of changing the Riser Top Tension to the resulting maximum values of wellhead bending moment and casing stress ranges. For the case where the rig is oscillating around a fixed position and there is no current, using a regular wave, the results show that there are some wave periods for which an increase in the Riser Top Tension reduces the maximum wellhead bending moment and the max casing stress range, therefore increasing fatigue life of the casing and wellhead. The effects of varying the weight of the BOP and soil parameters and the effect of the phase difference between the wave and first-order vessel motion are analyzed. The proposed solution can also be used to perform riser and casing analysis during drift-off/drive-off.
Evaluation of Power Transmission Lines Hardening Scenarios Using a Machine Learning Approach
Authors: Montoya-Rincon Juan P. , Gonzalez-Cruz Jorge E. , Jensen Michael P.
Published: July 2023

The power transmission infrastructure is vulnerable to extreme weather events, particularly hurricanes and tropical storms. A recent example is the damage caused by Hurricane Maria (H-Maria) in the archipelago of Puerto Rico in September 2017, where major failures in the transmission infrastructure led to a total blackout. Numerous studies have been conducted to examine strategies to strengthen the transmission system, including burying the power lines underground or increasing the frequency of tree trimming. However, few studies focus on the direct hardening of the transmission towers to accomplish an increase in resiliency. This machine learning-based study fills this need by analyzing three direct hardening scenarios and determining the effectiveness of these changes in the context of H-Maria. A methodology for estimating transmission tower damage is presented here as well as an analysis of impact of replacing structures with a high failure rate with more resilient ones. We found the steel self-support-pole to be the best replacement option for the towers with high failure rate. Furthermore, the third hardening scenario, where all wooden poles were replaced, exhibited a maximum reduction in damaged towers in a single line of 66% while lowering the mean number of damaged towers per line by 10%.
Path Planning for Autonomous Systems Design: A Focus Genetic Algorithm for Complex Environments
Authors: Hu Chuanhui , Jin Yan
Published: July 2023

Path planning has been a hot research topic in robotics and is a vital functionality for autonomous systems. As the time complexity of traditional path planning algorithms grows rapidly with the complexity of the problem, evolutionary algorithms are widely applied for their near-optimal solutions. However, evolutionary algorithms can be trapped in a local optimum or converge to infeasible solutions, especially for large search spaces. As the problem scale increases, evolutionary algorithms often cannot find feasible solutions with random exploration, making it extremely challenging to solve long-range path-planning problems in environments with obstacles of various shapes and sizes. For long-range path planning of an autonomous ship, the current downsampling map approach may result in the disappearance of rivers and make the problem unsolvable. This paper introduces a novel area-based collision assessment method for genetic algorithm (GA) that can always converge to feasible solutions with various waypoints in large-scale and obstacle-filled environments. Waypoint-based crossover and mutation operators are developed to allow GA to modify the length of the solution during planning. To avoid the premature problem of GA, the mutation process is replaced by a self-improving process to let the algorithm focus the operations on any potential solutions before discarding them in the selection process. The case studies show that the proposed GA-focus algorithm converges faster than RRT* and can be applied to various large-scale and challenging problems filled with obstacles of different shapes and sizes, and find high-quality solutions.
A Pilot Study of Exercise Training for Children and Adolescents With Inflammatory Bowel Disease: An Evaluation of Feasibility, Safety, Satisfaction, and Efficacy
Authors: Bjelica Mila , Walker Rachel G. , Obeid Joyce , Issenman Robert M. , Timmons Brian W.
Published: July 2023

Background: Children with inflammatory bowel disease (IBD) experience extraintestinal side effects including altered body composition, impaired muscle strength, and aerobic capacity. Exercise training may remedy these issues. Purpose: To assess the feasibility, safety, participant satisfaction, and efficacy of a training program for youth with IBD. Methods: Children with IBD completed 16 weeks of training (2 supervised + 1 home sessions per week). Feasibility was assessed by tracking recruitment, adherence, and compliance rates. Safety was assessed by tracking symptoms and adverse events. Posttraining interviews gauged satisfaction. Circulating inflammatory markers, body composition, muscle strength, aerobic fitness, and habitual physical activity were measured at baseline, midtraining (8 wk), and posttraining. Results: Eleven youth were recruited and 10 completed the study. Participants adhered to 28 (1) of 32 prescribed supervised sessions and 8 (4) of 16 prescribed home sessions. There were no adverse events, and overall feedback on training was positive. Posttraining, we observed an increase in lean mass (+2.4 [1.1] kg), bone density (+0.0124 [0.015] g·cm−2), aerobic fitness (+2.8 [5.7] mL·kg LM−1· min−1), and vigorous physical activity levels (+13.09 [8.95] min·h−1) but no change in inflammation or muscle strength. Conclusion: Supervised exercise training is feasible, safe, and effective for youth with IBD and should be encouraged.
Family experiences of antenatal counselling of spina bifida: a systematic review
Authors: Agrawal Shreya , Hobson Esther V , Hart Anthony Richard
Published: July 2023

Objective

To describe families’ experiences of antenatal counselling of spina bifida.

Design

Systematic review.

Methods

MEDLINE, CINAHL, PsycINFO and Embase databases were searched using a combination of Medical Subject Headings and text/abstract terms. Case reports, survey results and qualitative interview data were included. The quality of research was evaluated using the Critical Appraisal Skills Programme checklist.

Results

8 papers were included. Families described shock and grief at diagnosis, with some immediately offered termination of pregnancy (TOP) even though they knew little about the condition. Positive and negative aspects of care were found. Teams that were gentle, kind and empathetic, who did not use jargon, and highlighted positive and negative aspects of the baby’s life were seen favourably. Callous language, and overly negative or incorrect counselling was not, particularly if there was pressure to agree to TOP. Families based their decisions on how they would cope, the effect on siblings and the baby’s likely quality of life. Prenatal surgery was viewed positively. The views of families who chose TOP, were happy with their care, partners, families, and the LGBTQ+ community were under-represented in the literature.

Conclusions

Unlike other conditions where limited data on outcome exist or the spectrum is genuinely broad, the outcomes of children with spina bifida is well described. Poor aspects of antenatal counselling were described frequently by families, and further work is needed to capture the full spectrum of views on antenatal counselling, how it can be improved, and what training and resources healthcare professionals need to perform it better.
Allergic bronchopulmonary aspergillosis presenting as complete lung collapse with respiratory failure
Authors: Palaniappan Muthuraman , Ayub Irfan Ismail , Joseph Santhosh , Thangaswamy Dhanasekar
Published: July 2023

Allergic bronchopulmonary aspergillosis (ABPA) is an allergic fungal disease that commonly complicates the natural course of patients with asthma and cystic fibrosis. Patients with ABPA commonly present with recurrent pulmonary infiltrates or bronchiectasis. They also experience difficulty treating asthma. Characteristic radiological findings include central bronchiectasis and high-attenuation mucus. Complete unilateral lung collapse is an uncommon presentation of ABPA, with few cases reported in published literature. We present a case of a man in his mid-40s, with acute cerebrovascular disease, who subsequently developed neurological deterioration, compounded by development of respiratory failure attributed to a complete left lung collapse, requiring invasive mechanical ventilation. Initially suspected to have aspiration pneumonia, he was eventually diagnosed with ABPA and was treated accordingly. This case illustrates an uncommon aetiology for complete lung collapse in this clinical setting and serves to remind us to consider ABPA as a differential diagnosis in such patients as well.
Comparative mortality and its determinants in community-based people with type 1 diabetes: the Fremantle Diabetes Study Phase I
Authors: Rajapaksa Ruwani , Davis Wendy A , Davis Timothy M E
Published: July 2023

Introduction

The aim of this study was to compare mortality in community-based Australians with type 1 diabetes (T1D), without diabetes, or with type 2 diabetes (T2D).

Research design and methods

The longitudinal observational Fremantle Diabetes Study Phase I (FDS1) T1D cohort, matched people without diabetes from the FDS1 catchment area, and matched FDS1 participants with T2D were followed up from entry (1993–1996) to death/end-2017. Mortality rates (MRs) and mortality rate ratios (MRRs) were calculated. Cox regression models identified independent determinants of death.

Results

Of 121 participants with T1D and 484 age/sex/postcode-matched people without diabetes (pooled mean±SD age 43.1±15.3 years, 59.2% men), 55 (45.5%, MR 25.7 (95% CI 19.4 to 33.5)/1000 person-years) and 88 (18.2%, MR 8.5 (95% CI 6.8 to 10.4)/1000 person-years), respectively, died during 12 541 person-years of follow-up (MRR 3.04 (95% CI 2.13 to 4.31), p<0.001). Among participants with T1D, diagnosis at age 18–27 years and baseline HbA1c, urinary albumin:creatinine ratio, and retinopathy were independent predictors of death (p≤0.011). Twenty-five FDS1 participants died from cardiovascular disease (MR 11.7 (95% CI 7.6 to 17.3)/1000 person-years) vs 28 residents without diabetes (MR 2.7 (95% CI 1.8 to 3.9)/1000 person-years; MRR (95% CI) 4.34 (2.43, 7.73) (p<0.001). There were 93 FDS1 participants with T1D who were age/sex matched with an FDS1 participant with T2D and 53 (57.0%) and 37 (39.8%), respectively, died (p=0.027). In pooled Cox regression analysis, T1D was not a determinant of mortality (HR 1.18 (95% CI 0.71 to 1.97), p=0.523).

Conclusions

T1D substantially increases the risk of death, especially when diagnosed in late adolescence/young adulthood. Diabetes type does not influence mortality after adjustment for key confounding variables.
Study protocol of the WashT Trial: transfusion with washed versus unwashed red blood cells to reduce morbidity and mortality in infants born less than 28 weeks’ gestation - a multicentre, blinded, parallel group, randomised controlled trial
Authors: Stark Michael J , Collins Carmel T , Andersen Chad C , Crawford Tara M , Sullivan Thomas R , Bednarz Jana , Morton Rachael , Marks Denese C , Dieng Mbathio , Owen Louise S , Opie Gillian , Travadi Javeed , Tan Kenneth , Morris Scott
Published: July 2023

Introduction

Many extremely preterm newborns develop anaemia requiring a transfusion, with most receiving three to five transfusions during their admission. While transfusions save lives, the potential for transfusion-related adverse outcomes is an area of growing concern. Transfusion is an independent predictor of death and is associated with increased morbidity, length of hospital stay, risk of infection and immune modulation. The underlying mechanisms include adverse pro-inflammatory and immunosuppressive responses. Evidence supports an association between transfusion of washed red cells and fewer post-transfusion complications potentially through removal of chemokines, lipids, microaggregates and other biological response modifiers. However, the clinical and cost-effectiveness of washed cells have not been determined.

Methods and analysis

This is a multicentre, randomised, double-blinded trial of washed versus unwashed red cells. Infants <28 weeks’ gestation requiring a transfusion will be enrolled. Transfusion approaches will be standardised within each study centre and will occur as soon as possible with a recommended fixed transfusion volume of 15 mL/kg whenever the haemoglobin is equal to or falls below a predefined restrictive threshold, or when clinically indicated. The primary outcome is a composite of mortality and/or major morbidity to first discharge home, defined as one or more of the following: physiologically defined bronchopulmonary dysplasia; unilateral or bilateral retinopathy of prematurity grade >2, and; necrotising enterocolitis stage ≥2. To detect a 10% absolute reduction in the composite outcome from 69% with unwashed red blood cell (RBCs) to 59% with washed RBCs with 90% power, requires a sample size of 1124 infants (562 per group). Analyses will be performed on an intention-to-treat basis with a prespecified statistical analysis plan. A cost-effectiveness analysis will also be undertaken.

Ethics and dissemination

Ethics approval has been obtained from the Women’s and Children’s Health Network Human Research Ethics Committee (HREC/12/WCHN/55). The study findings will be disseminated through peer-reviewed articles and conferences.

Trial registration number

ACTRN12613000237785 Australian New Zealand Clinical Trials Registry.
Two-stage method of free gingival graft prior to periodontal regenerative surgery for the treatment of intrabony defects with insufficient keratinised tissue width: a study protocol for an open-label randomised controlled trial
Authors: Liu Haohao , Liu Jialiang , Guo Mudi , Chen Xiaofeng , Chen Meihua
Published: July 2023

Introduction

Guided tissue regeneration (GTR) combined with bone grafting for periodontal regenerative surgery has ideal clinical results for intrabony defect. However, some sites of intrabony defects often suffer from insufficient keratinised gingival width, which affects the efficacy and long-term prognosis of periodontal tissue regeneration. Free gingival graft (FGG) is an effective surgical procedure to widen the keratinised gingiva, but there are few clinical studies on FGG prior to GTR combination with bone grafting to improve clinical outcomes.

Methods

This study is an open-label randomised controlled trial. 68 patients with periodontitis with at least one intrabony defect depth with ≥3 mm are recruited and randomly grouped. In the test group, FGG is performed first, followed by GTR and bone grafting 3 months later; while in the control group, only periodontal tissue regenerative procedures are performed. After completion of all procedures, the patients will be recalled at 3 months, 6 months and 12 months and the relevant clinical and radiographic examinations will be carried out and statistical analysis of the data will also be performed. The present research has received approval from the Ethics Committee of Shanghai Stomatological Hospital (No.2022–007) on 4 August 2022.

Discussion

Exploring the effectiveness of the two-stage approach of FGG prior to periodontal tissue regenerative surgery for the treatment of keratinised gingival width deficient intrabony defects can provide a high-level evidence-based basis for the formulation of relevant treatment strategies in clinical practice.

Ethics and dissemination

The present research has received approval from the Ethics Committee of Shanghai Stomatological Hospital (No.2022–007) on 4 August 2022. The patients will be incorporated into this trial only after their written informed consent has been obtained. The study will be performed according to the 2013 revision of the Helsinki Declaration of 1975. Personal information of all subjects will be stored in the Department of Periodontology of Shanghai Stomatological Hospital. Data of the present research will be registered with the Clinical Trials Registry Platform. Additionally, we will disseminate the results through scientific journals.

Trial registration

Chinese Clinical Trial Registry, ID: ChiCTR 2200063180. Registered on 1 September 2022.
Landscape of team-based care to manage hypertension: results from two surveys in low/middle-income countries
Authors: Ogungbe Oluwabunmi , Cazabon Danielle , Moran Andrew E , Neupane Dinesh , Himmelfarb Cheryl Dennison , Edward Anbrasi , Pariyo George W , Appel Lawrence J , Matsushita Kunihiro , Hongwei Zhang , Tong Liu , Dessie Girma A , Worku Addisu , Choudhury Sohel Reza , Jubayer Shamim , Bhuiyan Mahfuzur Rahman , Islam Shahinul , Osi Kufor , Odu Joseph , Obagha Emmanuel Chijioke , Ojji Dike , Huffman Mark D , Commodore-Mensah Yvonne
Published: July 2023

Objectives

Team-based care is essential for improving hypertension outcomes in low-resource settings. We assessed perceptions of country representatives and healthcare workers (HCWs) on team-based hypertension care in low/middle-income countries.

Design

Two cross-sectional surveys.

Setting

The first survey (Country Profile Survey) was conducted in 17 countries and eight in-country regions: Algeria, Bangladesh, Burundi, Chile, China (Beijing, Henan, Shandong), Cuba, Ethiopia, India (Kerala, Madhya Pradesh, Maharashtra, Punjab, Telangana), Nepal, Nigeria, Philippines, Saint Lucia, Sri Lanka, Thailand, Turkey, Uganda and Vietnam. The second survey (HCW Survey) was conducted in four countries: Bangladesh, China, Ethiopia and Nigeria.

Participants

Using convenience sampling, participants for the Country Profile Survey were representatives from 17 countries and eight in-country regions, and the HCW Survey was administered to HCWs in Bangladesh, China, Ethiopia and Nigeria.

Outcome measures

Country-level use of team-based hypertension care framework, comprising administrative, basic and advanced clinical tasks. Current practices of different HCW cadres, perspectives on team-based management of hypertension, barriers and facilitators.

Results

In the Country Profile Survey, all (23/23, 100%) countries/regions surveyed integrated team-based care for basic clinical hypertension management tasks, less for advanced tasks (7/23, 30%). In the HCW Survey, 854 HCWs participated, 47% of whom worked in rural settings. Most HCWs in the sample acknowledged the value of team-based hypertension care. Although there were slight variations by country in the study sample, overall, barriers to team-based hypertension care were identified as inadequate training (83%); regulatory issues (76%); resistance by patients (56%), physicians (42%) and nurses (40%). Facilitators identified were use of treatment algorithms (94%), telehealth/m-health technology (92%) and adequate compensation for HCWs (80%).

Conclusions

Our findings revealed key lessons for health systems and governments regarding team-based care implementation. Specifically, policies to facilitate additional training, optimise HCWs’ roles within care teams, use of hypertension treatment protocols and telehealth/m-health technology will be essential to promote team-based care.
Retinopathy of prematurity among infants admitted to two neonatal intensive care units in Ethiopia
Authors: Sherief Sadik Taju , Taye Kalekirstos , Teshome Tiliksew , Demtse Asrat , Gilbert Clare
Published: July 2023

Objective

This study was conducted to determine the prevalence and risk factors for retinopathy of prematurity (ROP) in two neonatal intensive care units (NICUs) in Addis Ababa, Ethiopia.

Methods and analysis

A prospective screening survey was conducted from June 2019 to June 2020 in two level 3 public NICUs. Infants with a birth weight (BW) of ≤1500 g or gestational age (GA) of ≤32 weeks and those with a BW of >1500 g and GA of >32 weeks with an unstable clinical course were included. Data on demographic and neonatal characteristics, neonatal and maternal comorbidities, and therapeutic interventions were collected. Logistic regression analysis was used to identify predictors of ROP.

Results

Two hundred and two infants were included: mean BW: 1658g (range: 700–2400 g) and mean GA: 32.4 weeks (range: 26–34 weeks). 32.2% had any stage of ROP, and 6.4% had Type 1 ROP. Lower BW, smaller GA and total days on oxygen were independent risk factors for severe ROP (Type 1 or worse). All 13 neonates with severe ROP were treated.

Conclusion

ROP is emerging as a concern in Ethiopia. ROP screening should include neonates with BW of <1800 g or GAs of ≤33 weeks, but further studies are needed in level 2 and private NICUs. Screening guidelines need to be developed and implemented in all hospitals with NICUs.