bluuebunny/crossref_metadata_2025 huggingface dataset:
ProxyVis—A Proxy for Nighttime Visible Imagery Applicable to Geostationary Satellite Observations
Authors: Chirokova Galina , Knaff John A. , Brennan Michael J. , DeMaria Robert T. , Bozeman Monica , Stevenson Stephanie N. , Beven John L. , Blake Eric S. , Brammer Alan , Darlow James W. , DeMaria Mark , Miller Steven D. , Slocum Christopher J. , Molenar Debra , Hillger Donald W.
Published: August 2023

Visible satellite imagery is widely used by operational weather forecast centers for tropical and extratropical cyclone analysis and marine forecasting. The absence of visible imagery at night can significantly degrade forecast capabilities, such as determining tropical cyclone center locations or tracking warm-topped convective clusters. This paper documents ProxyVis imagery, an infrared-based proxy for daytime visible imagery developed to address the lack of visible satellite imagery at night and the limitations of existing nighttime visible options. ProxyVis was trained on the VIIRS day/night band imagery at times close to the full moon using VIIRS IR channels with closely matching GOES-16/17/18, Himawari-8/9, and Meteosat-9/10/11 channels. The final operational product applies the ProxyVis algorithms to geostationary satellite data and combines daytime visible and nighttime ProxyVis data to create full-disk animated GeoProxyVis imagery. The simple versions of the ProxyVis algorithm enable its generation from earlier GOES and Meteosat satellite imagery. ProxyVis offers significant improvement over existing operational products for tracking nighttime oceanic low-level clouds. Further, it is qualitatively similar to visible imagery for a wide range of backgrounds and synoptic conditions and phenomena, enabling forecasters to use it without special training. ProxyVis was first introduced to National Hurricane Center (NHC) operations in 2018 and was found to be extremely useful by forecasters becoming part of their standard operational satellite product suite in 2019. Currently, ProxyVis implemented for GOES-16/18, Himawari-9, and Meteosat-9/10/11 is being used in operational settings and evaluated for transition to operations at multiple NWS offices and the Joint Typhoon Warning Center.

Significance Statement

This paper describes ProxyVis imagery, a new method for combining infrared channels to qualitatively mimic daytime visible imagery at nighttime. ProxyVis demonstrates that a simple linear regression can combine just a few commonly available infrared channels to develop a nighttime proxy for visible imagery that significantly improves a forecaster’s ability to track low-level oceanic clouds and circulation features at night, works for all current geostationary satellites, and is useful across a wide range of backgrounds and meteorological scenarios. Animated ProxyVis geostationary imagery has been operational at the National Hurricane Center since 2019 and is also currently being transitioned to operations at other NWS offices and the Joint Typhoon Warning Center.
Impact of Limiting Vancomycin Loading Doses in Patients With Methicillin-resistant Staphylococcus aureus Infections After Hospital Protocol Revision
Authors: Raley Alec R. , Brown Matthew L. , Frawley Morgan , Oster Robert A. , Edwards William Seth
Published: August 2023

Background: Vancomycin loading doses are commonly used to quickly attain target serum concentrations; however, data supporting their effect on clinical patient outcomes is limited. In April 2020, our institution revised our pharmacist-driven vancomycin dosing protocol to reserve loading doses for hemodynamically unstable patients with suspected serious methicillin-resistant Staphylococcus aureus (MRSA) infections. Prior to the protocol update, all patients treated with vancomycin at our institution received a weight-based loading dose. The purpose of this study is to assess clinical efficacy and safety outcomes related to the use of vancomycin loading doses. Methods: A retrospective, quasi-experimental study was performed to compare clinical outcomes in adult patients treated with vancomycin for laboratory-confirmed MRSA infections. Patients who received vancomycin therapy prior to our institution’s vancomycin dosing protocol revisions (pre-intervention) were compared to patients who received vancomycin after the revisions (post-intervention). The primary outcome was all-cause, inpatient mortality. Secondary outcomes included persistent signs and symptoms of infection ≥5 days after vancomycin initiation, switch to alternative anti-MRSA therapy, and nephrotoxicity. Results: A total of 122 patients (63 pre-intervention patients and 59 post-intervention patients) were included. Receipt of a vancomycin loading dose did not impact the rate of inpatient mortality (4.76%vs 6.78%; OR 1.46, 95% CI [0.31, 6.79]). All secondary outcomes were similar between the two groups, including persistent signs and symptoms of infection, switch to alternative anti-MRSA therapy, and nephrotoxicity. Conclusions: Routine use of vancomycin loading doses is not associated with improved outcomes in hemodynamically stable patients with MRSA infections.
Interstate Resource Conflicts: A Network-Centric Resource Access Security Perspective
Authors: Bareis Luka
Published: August 2023

This paper introduces the theoretical concept of perceived resource access security in order to assess the link between natural resource scarcity and interstate conflict. It develops the hypothesis that resource access through international trade is an important determinant for conflict behaviour of states arising from resource concerns, implying a shift in focus away from endowments and towards competition for access. The main analysis is conducted in the form of a unit fixed effects logistic regression covering country-dyads of the period 1962–2010 with military interstate dispute (MID) initiation as dependent variable. The empirical findings consistently demonstrate that a diversified position in resource supply networks mitigates the conflict propensity of states characterized by outside dependence for access to natural resources, and thereby help to determine conditions under which trade reduces conflict.
Shame, Anger and Hope: The Messy Relations of Charitable Help within the Welfare State
Authors: Stambe Rose-Marie , Parsell Cameron
Published: August 2023

The shame of being poor and asking for charity has been a key theme in sociological research on poverty. This article draws on ethnographic research across two charity centres in Australia to address the overemphasis on shame as the dominant feeling of being poor and trying to help. We find that hope and anger are key emotions that sit alongside shame. Service providers tried to cultivate hope for a brighter poverty-free future. Hope was important for people in poverty, but they had smaller versions of hope informed by their everyday struggle. They were also angry at hope lost. Participants co-constructed charity and their experiences of poverty as a messy problem space where difficult and hopeful emotions hang together. The article contributes to the literature by coupling ‘negative’ and ‘positive’ feelings of poverty to trace a ‘political economy of hope’ within the welfare state that nuances people’s experiences of charitable help.
Examining ‘Good’ Mothering and Value Transmission: How British-Born South-Asian Mothers Seek Generational Change
Authors: Kerrane Katy , Dibb Sally , Lindridge Andrew , Kerrane Ben
Published: August 2023

Sociological literature has begun to examine how mothers occupying non-normative positions negotiate the transmission of cultural capital and habitus, and how the norms of good mothering shape this process. However, less is known about second-generation mothers’ experiences, despite evidence of changing gender relations within ethnic minority communities. Drawing on interviews with British-born South-Asian mothers who held upwardly mobile aspirations, we highlight several forms of departure from intensive, middle-class mothering. Informants face additional responsibilities for transmitting cultural and religious capital, pursuing the ideal of the child as ‘skilled cultural navigator’, enabling their children to negotiate hybridised identities. They reinterpret the norms of intensive mothering, pushing against key tropes including expert-dependence, self-sacrifice and overprotection. These findings extend knowledge of the mother’s role in creating a reflexive habitus, by showing how second-generation mothers socialise their children with reflexively chosen cultural and religious practices, based on egalitarian gender norms.
On-ramp or speed bump? How boards influence the internationalisation of international new ventures
Authors: Fiedler Antje , Fath Benjamin , Sinkovics Noemi , Sinkovics Rudolf R
Published: August 2023

This article aims to explore how the boards of international new ventures (INVs) develop throughout the internationalisation and growth phases of the firm. Specifically, the study explores how the nature and extent of the board’s role changes over time in facilitating the INV’s knowledge and network acquisition. We draw on qualitative data, including 18 interviews with INVs and three interviews with experts on New Zealand’s high-technology sector. The data analysis yielded four main patterns. INVs that relied on an informal board during the initial market entry phase remained flexible in exploring multiple markets before transitioning to a formal board (Pattern 1). INVs that established a formal board during the initial market entry phase achieved accelerated internationalisation only when the board remained flexible (Pattern 2a). Where the formal board did not remain flexible, they became a ‘speed bump’ in the post-entry phase growth process, unless the management team could counter-balance this deceleration effect with bringing in informal board members (Pattern 2b). The findings suggest that the absence of a formal board also reduces internationalisation speed if the founder does not have the discipline to follow through with the exploitation of the perceived opportunities (Pattern 3).
An accurate measurement method of gear transmission error based on a double-angle measurement device
Authors: Cao Ke , Qiu Cheng , Gong Yu , Li Jinfeng
Published: August 2023

In this paper, a geometric model of a grating and reading head was established, where the relationship between the angle deviation, which was compensated for by double reading heads, and the actual angle is deduced. A new measurement method was proposed by applying the clock pulse counting method to the measurement of the transmission error of the gear pair input-and-output angle encoder while taking into account the gear pair’s transmission error. To demonstrate the feasibility of this measurement method, a transmission error test bench of involute gear pairs was built. Based on the output gear, the counted pulses were divided into integer pulses and non-integer pulses, and a transmission error curve was obtained by processing the pulses. The transmission errors of a helical gear with untrimmed angles and a gear pair with trimmed angles were also measured. Compared with the untrimmed gear pair, the first-order amplitude of the trimmed gear pair was reduced by 25.25%, 0.79%, and 16.9%, but other whole-order full-harmonic amplitudes were excited. However, the peak value of the single tooth surface of the trimmed gear pair was generally less than that of the untrimmed gear pair. The peak transmission error and the amplitude of the tooth harmonic frequency had good repeatability, within 16%, which verified the feasibility of the transmission error test method. The measurement precision reached 1 arcsecond in the tooth frequency.
Factors Contributed to Bully Victimization Among 6- to 13-Year-Old Children Cared by Parents or Relative/Nonrelative Caregivers: A Multiple Disadvantage Model
Authors: Cheng Tyrone C. , Lo Celia C.
Published: August 2023

The present study of 6- to 13-year-old children in the United States examined bullying victimization’s relationships with social disorganization, social structural factors, social relationships, mental health, access to health insurance, and caregiver types. A sample of 12,966 children aged 6 to 13 years was extracted from the 2018 National Survey of Children’s Health for secondary data analysis. Logistic regression results indicated that these children’s likelihood of being bullied was positively associated with racial discrimination, family violence, child mental health problems (depression, anxiety, attention-deficit/hyperactivity disorder, and behavioral/conduct problems), girls, children aged 6 to 10 years, caregiver education level, and nonrelative caregivers; such likelihood also had negative associations with Blacks, Hispanics, Asians, other ethnic minorities, family cohesiveness, caregiver mental health, and caregiver age. Implications included interventions for family support and bullied children’s mental health problems.
ARNI Versus Perindopril for Remodeling in HFrEF. A Cohort Study
Authors: Bin Atan Noor Muhammad Azlan Shah , Bin Hadi Mohd Firdaus , Teoh Victoria Wen Yeng , Danaee Mahmoud , Loch Alexander
Published: August 2023

Introduction: Ventricular remodeling is a mal-adaptive process. Both angiotensin-converting enzyme inhibitors and sacubitril/valsartan have been shown to reverse remodeling in mostly uncontrolled observational studies. There is a lack of head-to-head studies. Methods: This cohort study compares the remodeling effects of angiotensin receptor blockers combined with a neprilysin inhibitor (ARNI) and perindopril in heart failure with reduced ejection fraction (HFrEF) patients between January 2017 and December 2020. Inclusion criteria: (i) age > 18 years, (ii) recent diagnosis of de-novo HFrEF (EF < 40%), (iii) baseline echocardiography performed not more than 2 months prior to treatment onset, and (iv) follow-up echocardiography performed not earlier than 6 months and not later than 18 months posttreatment onset. No prior treatment with renin–angiotensin–aldosterone system inhibitors was permitted in the ARNI group. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), and left ventricular end-systolic volume (LVESV) were analyzed. A two-way repeated measure ANOVA (for normally distributed) and generalized estimating equation test for nonnormally distributed interval dependent variables. Mean comparison between and within groups was performed using the Bonferroni test. Results: Following an average treatment period of 9 months, LVEF improved from 24.9% to 36.4% for ARNI and from 28.7% to 40.5% for perindopril, increments of 11.5% and 11.8% resp. (Bonferroni test [ P ≤ .05]). LVEDV was reduced by 8.4 mL and 3.2 mL, and LVESV by 17.9 mL and 10.8 mL for ARNI and perindopril resp. Only the reduction of LVESV for ARNI was statistically significant ( P = .007). Conclusion: Both ARNI and perindopril yielded a significant improvement in the LVEF within 9 months. The remodeling effect of ARNI seems stronger because of the greater improvements in left ventricular volumes.
An adaptive feedforward method in active vibration control for the propulsion shafting system
Authors: Duan Ningyuan , Ni Zhen , Zhang Zhenguo , Hua Hongxing
Published: August 2023

This paper proposes a new adaptive feedforward control method for the rejection of multiple periodic disturbances in the propulsion shafting system. The active vibration control scheme of the propulsion shafting system is established by employing the equivalent-input-disturbance principle which reduces the complexity of the control system in applications. The adaptive control algorithm is designed by taking the scale transformation procedure and the frequency-tracking technique into consideration. The scale transformation normalizes the iso-surface of the optimization function by the frequency response characteristics of the control channel, which immensely improves the convergence rate of the control algorithm for multi-harmonic disturbance. Moreover, the adaptive controller tracks the fluctuating frequencies in a direct method, enhancing the efficiency and robustness of the algorithm for eliminating time-varying disturbances. Finally, numerical simulation and experimental validation are carried out to show that the proposed method has good performance on the application of the active vibration control of the propulsion shafting system.
Writing About Dance: Representations of Strength in the Struggle for Social Justice
Authors: Lowery Kendra
Published: August 2023

The purpose of this article is to demonstrate how I grappled with questions about the meaning, purpose, and process of playful writing to represent a dance performance based on the oral history narrative of Sybil Jordan Hampton, the sole African American enrolled in her class at Little Rock Central High in Arkansas from 1959 to 1962. Through the presentation of six moments from the dance that I captured through photographs, I explore the possibilities of writing about dance using graphic art to invoke critical reflection and social justice-oriented action, rather than solely as a representation of the dance performance. I examine the complexities surrounding playful writing, layered representations in writing about dance that represents lived experience, and consider whether nontraditional text presented as graphic art enhances the potential for meaning making about social justice action.
Patient knowledge and preferences for peripheral artery disease treatment
Authors: Smolderen Kim G , Romain Gaëlle , Gosch Kensey , Arham Ahmad , Provance Jeremy B , Spertus John A , Poosala Anwesh B , Shishehbor Mehdi H. , Safley David , Scott Kate , Stone Nancy , Mena-Hurtado Carlos
Published: August 2023

Background:

Shared medical decision making requires patients’ understanding of their disease and its treatment options. Peripheral artery disease (PAD) is a condition for which preference-sensitive treatments are available, but for which little is known about patients’ knowledge and treatment preferences as it relates to specific treatment goals.

Methods:

In a prospective, multicenter registry that involved patients with PAD experiencing claudication, the PORTRAIT Knowledge and Preferences Survey was administered at 1 year. It asks questions about PAD treatment choices, symptom relief options, disease management, and secondary prevention. PAD treatment preferences were also queried, and patients ranked 10 PAD treatment goals (1–10 Likert scale; 10 being most important).

Results:

Among 281 participants completing the survey (44.8% women, mean age 69.6 ± 9.0 years), 54.1% knew that there was more than one way to treat PAD symptoms and 47.1% were offered more than one treatment option. Most (82.4%) acknowledged that they had to manage their PAD for the rest of their life. ‘Avoid loss of toes or legs,’ ‘decreased risk of heart attack/stroke,’ ‘long-lasting treatment benefit,’ ‘living longer,’ ‘improved quality of life,’ and ‘doing what the doctor thinks I should do’ had mean ratings > 9.0 (SD ranging between 1.21 and 2.00). More variability occurred for ‘avoiding surgery.’ ‘cost of treatment,’ ‘timeline of pain relief,’ and ‘return to work’ (SD ranging between 2.76 and 3.58). The single most important treatment goal was ‘improving quality of life’ (31.3%).

Conclusions:

Gaps exist in knowledge for patients with PAD who experience claudication, and there is a need for increased efforts to improve support for shared decision-making frameworks for symptomatic PAD. (ClinicalTrials.gov Identifier: NCT01419080)
Removal of indoor aerosol particles generated in a medically relevant space using a portable airborne particle filtration device
Authors: Carroll Gregory T , Kirschman David L
Published: August 2023

Aerosol generating procedures expose operating room personnel to pathogens. Applying localized negative pressure within the proximity of a patient’s airway is expected to reduce the amount of bioaerosols dispersed within the vicinity of a healthcare worker applying an aerosol generating procedure. Nebulized saline was used as a proxy for bioaerosols and was produced with an aerosol generator placed near the centre of a simulated operating room. A particle counter was placed nearby to detect aerosols and determine their size distribution. A portable filtration unit was placed at fixed distances from the site of aerosol emittance to reduce the concentration of aerosols. In the presence of vacuum at distances of 10, 20, 30 and 40 cm from the site of aerosol emittance, the reduction in the average concentrations of 0.5, 0.7, 1.0 and 3.0 μm particles relative to the control ranged from 87 to 99% depending on the distance and particle size. The efficiency of particle capture was dependent on the distance of the vacuum inlet to the aerosol outlet. At all distances tested, significant aerosol reduction was observed ( p < 0.05), indicating that the portable filtration unit has the potential to increase safety without contacting the patient.
Comparison of pipeline embolization device, flow re-direction endoluminal device and surpass flow diverters in the treatment of intracerebral aneurysms
Authors: Field Nicholas C. , Custozzo Amanda , Gajjar Avi A , Dalfino John C. , Boulos Alan S. , Paul Alexandra R.
Published: August 2023

Objectives

The use of flow diversion for the treatment of intracranial aneurysms has gained broad acceptance. Three flow-diverting stents are approved by the Food and Drug Administration for use in the United States. We sought to compare the outcomes and safety profiles between the three devices at our institution.

Methods

A retrospective review of aneurysms treated with pipeline embolization device (PED), flow re-direction endoluminal device (FRED), and SURPASS was performed for aneurysms treated between 2018 and 2022 at our institution.

Results

The study cohort consisted of 142 patients. Precisely, 86 aneurysms were treated with a pipeline, 33 aneurysms were treated with FRED, and 23 aneurysms were treated with SURPASS. The 1-year complete occlusion rates were 59.4%, 60%, and 65%, respectively (0.91). Linear regression models found that only adjunctive coiling predicted aneurysm occlusion at 6 months ( p = 0.02), but this effect was lost at 1 year and beyond. There was no significant difference in acute thrombotic or acute hemorrhagic complications between the three cohorts. There was a higher rate of delayed hemorrhagic complications in the SURPASS cohort (10%) compared to the PED (1.3%) and FRED (0%) cohorts ( p = 0.04). There was also a higher rate of in-stent stenosis in the SURPASS cohort (20%) compared to the PED (5%) and FRED (3.1%) cohorts ( p < 0.01).

Conclusions

Treatment with PED, FRED, and SURPASS all resulted in similar complete occlusion rates at 6 months and 1 year. SURPASS was associated with higher in-stent stenosis as well as delayed hemorrhagic complications. Additional future studies evaluating the newest generation of flow-diverting stents with long-term follow-up will be necessary to make any definitive conclusions.
When a bank becomes a bank, and a bank is the bank but not the bank: Multistability of homonyms’ meaning
Authors: Styrnal Malin , Carbon Claus-Christian , Pastukhov Alexander
Published: August 2023

Perceptual multistability is well-known and mostly visually demonstrated: Common examples are Necker's cube or Rubin's face-vase that produce qualitatively different percepts continuously oscillating between the solutions despite physically stable stimuli. We lack knowledge about similar phenomena in other domains, for instance in linguistics, where we are faced with homonyms that create multistability of cognitive semantics, differently assigned meanings of identical words. Our participants listened to repeated presentations of homonyms for which two or even three meanings could be assigned, and they reported the dominant meaning perceived at a certain point in time. Results showed that most participants experienced multistability of meaning for homonyms, with semiperiodic changes in dominant meaning similar to multistabity in perception. These findings suggest that multistability is a general property of the brain's neural architecture that resolves ambiguity irrespective of the level of representation.
Mission and Dialogue: An Assessment of the Interaction of Orthodox Theology and Practice with the Reformation
Authors: Voulgaraki-Pissina Evi
Published: August 2023

This article examines the mutual influence between the Reformers and the Orthodox in mission and interfaith dialogue. Relations between the two began soon after the Reformation itself, and since the founding of the modern Greek state (1830) three main historical phases can be distinguished: an initial phase during which the Protestants viewed the Orthodox (Greek) world itself as a mission field; a second phase, in the first part of the twentieth century which saw the emergence of missionary awareness among the Orthodox, significantly influenced by the large international mission conferences; a third (continuing) phase marked by the growth of the ecumenical movement and a more ecumenical understanding of mission.
The OptimaMed intervention to reduce medication burden in nursing home residents with severe dementia: results from a pragmatic, controlled study
Authors: Kröger Edeltraut , Wilchesky Machelle , Morin Michèle , Carmichael Pierre-Hugues , Marcotte Martine , Misson Lucie , Plante Jonathan , Voyer Philippe , Durand Pierre
Published: August 2023

Background

Nursing home (NH) residents with severe dementia use many medications, sometimes inappropriately within a comfort care approach. Medications should be regularly reviewed and eventually deprescribed. This pragmatic, controlled trial assessed the effect of an interprofessional knowledge exchange (KE) intervention to decrease medication load and the use of medications of questionable benefit among these residents.

Methods

A 6-month intervention was performed in 4 NHs in the Quebec City area, while 3 NHs, with comparable admissions criteria, served as controls. Published lists of “mostly”, “sometimes” or “exceptionally” appropriate medications, tailored for NH residents with severe dementia, were used. The intervention included 1) information for participants’ families about medication use in severe dementia; 2) a 90-min KE session for NH nurses, pharmacists, and physicians; 3) medication reviews by NH pharmacists using the lists; 4) discussions on recommended changes with nurses and physicians. Participants’ levels of agitation and pain were evaluated using validated scales at baseline and the end of follow-up.

Results

Seven (7) NHs and 123 participants were included for study. The mean number of regular medications per participant decreased from 7.1 to 6.6 in the intervention, and from 7.7 to 5.9 in the control NHs (p-value for the difference in differences test: < 0.05). Levels of agitation decreased by 8.3% in the intervention, and by 1.4% in the control NHs (p = 0.026); pain levels decreased by 12.6% in the intervention and increased by 7% in the control NHs (p = 0.049). Proportions of participants receiving regular medications deemed only exceptionally appropriate decreased from 19 to 17% (p = 0.43) in the intervention and from 28 to 21% (p = 0.007) in the control NHs (p = 0.22). The mean numbers of regular daily antipsychotics per participant fell from 0.64 to 0.58 in the intervention and from 0.39 to 0.30 in the control NHs (p = 0.27).

Conclusions

This interprofessional intervention to reduce inappropriate medication use in NH residents with severe dementia decreased medication load in both intervention and control NHs, without important concomitant increase in agitation, but mixed effects on pain levels. Practice changes and heterogeneity within these 7 NHs, and a ceiling effect in medication optimization likely interfered with the intervention.

Trial registration

The study is registered at ClinicalTrials.gov: # NCT05155748 (first registration 03–10-2017).
Regional with urban–rural variation in low birth weight and its determinants of Indian children: findings from National Family Health Survey 5 data
Authors: Kundu Ramendra Nath , Ghosh Anushka , Chhetri Birshikha , Saha Indranil , Hossain Md. Golam , Bharati Premananda
Published: August 2023

Background

Low birth weight is a key indicator for child health, especially a concern in low-middle-income countries. However, health and medically-related reforms are being actively implemented in some middle-income countries like India. Identifying low birth weight (LBW) babies with their determinants across the whole country is essential to formulate regional and area-specific interventions. The objective of this study was to find out the burden and determinants of LBW on the regional and residential (rural–urban) divisions of India.

Methods

The present study was based on the NFHS-5 dataset (2019–21), a nationally representative survey in India. A total of 209,223 births were included in this study. A newborn weighing less than 2500 g was considered as LBW. According to the objectives, we used frequency distribution, chi-square test and binary logistic regression analysis for analysing the data.

Results

About 18.24% of the babies were LBW in India, significantly higher in rural areas than in urban areas (18.58% vs 17.36%). Regionally prevalence was more frequent in western (20.63%) and central (20.16%) rural areas. Regarding maternal concerns, in the eastern and southern regions of India, mothers aged 25–34 were less likely to have LBW children than mothers aged 35–49 years. It was found that the risk of LBW was more likely among the children born out of unintended pregnancies in almost all regions except for eastern part. In rural India, women who delivered children at home were more likely to have LBW children in India (AOR = 1.19, CI: 1.12–1.28,p < 0.001) and its central, northern, and southern regions than those who gave birth in institutions. The study indicates that LBW coexists with lower maternal education levels and poor household wealth index across all regions. About 58% and 57% of cumulative effects of independent variables on LBW can be distinguished in urban and rural India, respectively.

Conclusions

Targeted-specific strategies need to be undertaken as per region and geographical variations. Then only India should be able to decline LBW as proposed by National Health Policy.
Cuproptosis related gene PDHB is identified as a biomarker inversely associated with the progression of clear cell renal cell carcinoma
Authors: Wang Hu , Yang Zhan , He Xingyu , Guo Fengran , Sun Hao , Xu Sen , Xu Chao , Wang Zhu , Wen Hongzhuang , Teng Zhihai , Wang Yaxuan , Han Zhenwei
Published: August 2023

Background

Cuproptosis is a newly discovered programmed cell death dependent on mitochondrial respiratory disorder induced by copper overload. Pyruvate dehydrogenase E1 subunit beta (PDHB) is one of the cuproptosis genesand is a nuclear-encoded pyruvate dehydrogenase, which catalyzes the conversion of pyruvate to acetyl coenzyme A. However, the mechanism of PDHB in clear cell renal cell carcinoma (ccRCC) remains unclear.

Methods

We used data from TCGA and GEO to assess the expression of PDHB in normal and tumor tissues. We further analyzed the relationship between PDHB and somatic mutations and immune infiltration. Finally, we preliminarily explored the impact of PDHB on ccRCC.

Results

The expression level of PDHB was lower in tumor tissue compared with normal tissue. Meanwhile, the expression level of PDHB was also lower in high-grade tumors than low-grade tumors. PDHB is positively correlated with prognosis in ccRCC. Furthermore, PDHB may be associated with decreased risk of VHL, PBRM1 and KDM5C mutations. In 786-O cells, copper chloride could promote the expression of cuproptosis genes (DLAT, PDHB and FDX1) and inhibit cell growth. Last but not least, we found that PDHB could inhibit the proliferation and migration of ccRCC cells.

Conclusion

Our results demonstrated that PDHB could inhibit the proliferation, migration and invasion in ccRCC cells, which might be a prognostic predictor of ccRCC. Targeting this molecular might provide a new therapeutic strategy for patients with advanced ccRCC.
Pterygium combined with corneal perforation: a case report
Authors: Yang Tianqi , Chan Sun Yuet , Liu Jie , Chen Zhiwei , Yu Guocheng , He Xiaojuan , Meng Jing
Published: August 2023

Background

Pterygium is a common ocular surface disease. Pterygium combined with corneal perforation is rare.

Case presentation

A 28-year-old female patient visited our outpatient clinic due to sudden onset of blurred vision and increased tearing in her left eye. The visual acuity was 1.0 OD and intraocular pressure (IOP) of 19.5 mmHg for the right eye with no significant abnormalities found in the anterior and posterior segments. The visual acuity of her left eye was 0.06, and IOP was 6.2 mmHg. A triangular vascular membranous tissue was seen in her left eye below the nose growing into the cornea and the pupil area was not touched. Slit-lamp examination revealed a tiny round corneal perforation in 8 o’clock position of the lesion area. Hospital diagnosis was given as pterygium combined with corneal perforation. The patient was treated with levofloxacin eye drops and autologous serum-based eye drops.

Conclusions

We report a rare case of pterygium combined with corneal perforation. Perforation is a very rare complication of pterygium. This patient received proper treatment and good result was seen. This article aimed to improve clinicians’ understanding of pterygium.
Pulmonary hypertension— a novel phenotypic hypothesis of Kabuki syndrome: a case report and literature review
Authors: Deng Xiao-xian , Jin Bo-wen , Li Shan-shan , Zhou Hong-mei , Shen Qun-shan , Li Yun-yan
Published: August 2023

Background

Pediatric pulmonary hypertension (PH) is a serious and rare disease that is often derived from genetic mutations. Kabuki syndrome (KS) is a chromosomal abnormality disease that has its origin in the mutation of lysine methyltransferase 2D(KMT2D). Recent evidence has shown that KMT2D mutations are associated with pediatric pulmonary disorders. However, the relationship between the clinical courses of PH and the KMT2D mutation is reported in extremely few cases. Therefore, in this paper, a case was presented and previous literature was reviewed for better understanding of the correlation between pediatric PH and KMT2D mutations.

Case presentation

A 3-year-old girl was transferred to our center for severe cough, shortness of breath, fatigue and fever. Physical examination revealed facial deformities and growth retardation. Echocardiography showed a small atrial septal defect (ASD), and right heart catheterization indicated a significant increase in pulmonary vascular pressure and resistance. The genetic test suggested that she had a KMT2D gene mutation. The patient was finally diagnosed with KS. She was given targeted drugs to reduce pulmonary vascular pressure, but the effect was unsatisfactory.

Conclusions

KS can be complicated with multiple organ malformations and dysfunction. With the progress of next generation sequencing, an increasing number of new phenotypes related to KMT2D mutations have been reported. A bold hypothesis is proposed in this article, that is, PH may be a new phenotype associated with KMT2D mutations. It is suggested that KS and PH should be differentiated from each other to avoid delayed diagnosis and treatment in clinical practice. There is no specific drug for KS treatment. The prognosis of children with inherited PH is usually poor, and lung transplantation may increase their survival rates.
Decisional conflict, caregiver mastery, and depression among Chinese parental caregivers of children with leukemia
Authors: Liu Mowen , Tang Weizhou , Zhang Ye , Sun Wenjun , Wang Yang
Published: August 2023

Background

Informal caregivers of children with leukemia can be emotionally and psychiatrically vulnerable when facing difficult treatment decisions (e.g., chemotherapy, targeted therapy, radiation, transplantation). A common behavioral manifestation of decisional conflict is the verbalized expression of uncertainty about which medical treatment plan to take. The study aims to examine the associations between decisional conflict, mastery, and depressive symptoms among parental caregivers of children with leukemia in China. It explored the mediating role of mastery in the relationship.

Methods

A cross-sectional survey design was adopted. A total of 386 parental caregivers were recruited, and 325 valid questionnaires remained. The mean age of caregivers was 37.7 years, and 61.5% caregivers were female. We used Question Format Decisional Conflict Scale to assess decisional conflict, Pearlin’s Mastery Scale to assess mastery, and Center for Epidemiological Studies Depression 10 to assess depressive symptoms. We used mediation analyses to test the mediating effect of mastery.

Results

The total score of decisional conflict scale, along with its dimensions of uncertainty, support, and effective decision were found negatively associated with depressive symptoms. In contrast, the dimension of information and value were not significantly associated with depressive symptoms. Mediation analyses demonstrated the direct effects of overall decisional conflict and uncertainly were fully mediated by mastery, while the direct effect of support and effective decision were partially mediated.

Conclusions

Efforts should be made to alleviate parental caregivers’ decisional conflict and enhance sense of mastery. Particular attention should be paid to the psycho-social support to relieve uncertainties and ineffectiveness in decision making.
Body mass index and cervical cancer screening among women aged 15–69 years in Eswatini: evidence from a population-based survey
Authors: Motsa Mfundi P. S. , Estinfort Wanda , Phiri Yohane V. A. , Simelane Maswati S. , Ntenda Peter A. M.
Published: August 2023

Background

Cervical cancer stands as one of the most prevalent cancer types among women, despite its preventable nature through early screening and vaccination strategies. The link between being overweight or obese and various adverse health outcomes, including an elevated cancer risk, is well established. Within this study, our central objective was to explore the correlation between body mass index (BMI) and cervical cancer screening (CCS) rates. Moreover, we sought to investigate whether socioeconomic status potentially modulates this relationship.

Methods

Our analysis encompassed 1791 respondents who participated in the World Health Organization’s STEPwise approach to noncommunicable disease risk factor surveillance carried out in Eswatini in 2014. We assessed the connection between BMI, along with other determinants, and CCS through both unadjusted and adjusted logistic regression models.

Results

The uptake of CCS was 14.4% and the prevalence of overweight and obesity was estimated at 28.1 and 34.9% respectively. After accounting for other pertinent variables, the likelihood of obtaining CCS was amplified for individuals classified as obese (adjusted odds ratio [aOR] = 1.99, 95% confidence interval [CI] = 1.26–3.12) or overweight (aOR = 1.98, 95% CI = 1.05–3.74). Furthermore, factors such as being separated or divorced (aOR = 2.03, 95% CI = 1.11–3.72) and engaging in regular physical exercise (aOR = 3.02, 95% CI = 1.21–6.02) were associated with increased odds of undergoing CCS.

Conclusions

This study underscores the noteworthy role played by both overweight and obesity, in conjunction with various socioeconomic factors, in shaping CCS patterns among the surveyed women. For Eswatini, targeted interventions aimed at enhancing CCS participation should take into account the multifaceted factors highlighted within this investigation.
The diagnostic accuracy of spirometry as screening tool for adult patients with a benign subglottic stenosis
Authors: Schuering Juliëtta H.C. , Halperin Ilan J. Y. , Ninaber Maarten K. , Willems Luuk N.A. , van Benthem Peter Paul G. , Sjögren Elisabeth V. , Langeveld Antonius P.M.
Published: August 2023

Background

There is a considerable diagnostic delay in the diagnosis ‘benign acquired subglottic stenosis in adults’ (SGS, diagnosed by the reference standard, i.e. laryngo- or bronchoscopy). Patients are frequently misdiagnosed since symptoms of this rare disease may mimic symptoms of ‘asthma.’ The ‘Expiratory Disproportion Index’ (EDI) obtained by spirometry, may be a simple instrument to detect an SGS-patient. The aim of this study was to evaluate the diagnostic accuracy of the EDI in differentiating SGS patients from asthma patients.

Methods

We calculated the EDI from spirometry results of all SGS-patients in the Leiden University Medical Center (LUMC), who had not received treatment 2 years before their spirometry examination. We compared these EDI results with the EDI results of all true asthma patients between 2011 and 2019, who underwent a bronchoscopy (exclusion of SGS by laryngo- or bronchoscopy).

Results

Fifty patients with SGS and 32 true asthma patients were included. Median and IQR ranges of the EDI for SGS and asthma patients were 67.10 (54.33–79.18) and 37.94 (32.41–44.63), respectively. Area under the curve (ROC) of the accuracy of the EDI at discriminating SGS and asthma patients was 0.92 (95% CI = 0.86–0.98). The best cut-off point for the EDI was > 48 (i.e. possible upper airway obstruction), with a sensitivity of 88.0%% (95%CI = 77.2-95.0%%) and specificity of 84.4% (95%CI = 69.4-94.1%).

Conclusions

The EDI has a good diagnostic accuracy discriminating subglottic stenosis patients from asthma patients, when compared to the reference standard. This measurement from spirometry may potentially shorten the diagnostic delay of SGS patients. Further studies are needed to evaluate clinical reproducibility.
Pharmacodynamic and pharmacokinetic properties of the combined preparation of levothyroxine plus sustained- release liothyronine; a randomized controlled clinical trial
Authors: Mehran Ladan , Amouzegar Atieh , Foroutan Seyed Mohsen , Masoumi Safdar , Tohidi Maryam , Abdi Hengameh , Aghaei Ali , Saghafinia Amir Esmaeel , Azizi Fereidoun
Published: August 2023

Background

Understanding pharmacokinetics (PK) and pharmacodynamics (PD) of the sustained-release liothyronine (SR-T3) is of paramount importance to design therapeutic regimens that are able to simulate normal thyroid hormone secretion while avoiding excursions in the T3 serum concentration. Here, we designed a parallel randomized clinical trial to characterize the PK and PD of the combined preparations of LT4 + SR-T3 in hypothyroid patients.

Methods

Radioiodine-treated hypothyroid patients over 20 years of age, who attained euthyroidism with LT4 monotherapy were recruited from the Endocrine Clinic in Tehran. The patients were allocated to two intervention groups of group A: 9 µg SR-T3 plus 68.5 μg LT4 (ratio 1:7.5) and group B: 12 µg SR-T3 plus 60 µg LT4 (ratio 1:5), and a control group with LT4 monotherapy. For PD study, thyroid hormone profile was evaluated at 8 and 12 weeks intervals after intervention. To assess PK properties of SR-T3, T3-Cmax, T3-Tmax and AUC0 − 24 were calculated at the last visit.

Results

Serum T4 and FT4 concentrations decreased in the intervention groups after 3 months. No significant difference was observed in serum T3 and FT3 concentrations before and after intervention. Serum T3/T4 ratio increased significantly in the intervention groups after intervention, with the highest increase in group B from 8.6 ± 2.03 at baseline to 12.2 ± 1.6. Comparison of trial groups at follow-up showed no differences in serum TSH, T4, T3 and T3/T4 concentrations among different groups. During 24 h, minimal variation in serum T3 concentration was observed in group B with mean ∆T3 of 15.4 ± 10.5 ng/dl. T3-Tmax, T3-Cmax and AUC0 − 24 in the combined sustained-release preparation were 4.38 ± 1.1 h., 101.0 ± 5.7 ng/dl and 2257 ± 110 ng.h/L, respectively which were significantly different from the control group.

Conclusion

Combined treatment with a single dose of SR-T3 plus LT4 is associated with increased serum T3/T4 ratio and minimal excursions in serum T3 concentration during 24 h; however, it was not significantly different from the control group. To incorporate sustained-release T3 in the management of hypothyroidism, a higher ratio of SR-T3 to LT4 than that of the previously recommended by the international organizations is suggested.

IRCT registration number

IRCT20100922004794N13. https://www.irct.ir/search/result?query=IRCT20100922004794N13. Registration date: 08/12/2021.
A case of Marine Lenhart syndrome with Hashimoto’s thyroiditis that mimicked thyroid carcinoma
Authors: Ye Peng , Li Lan , Wei Dong , Li Fan , Zhong Yuan , Zeng Jing
Published: August 2023

Background

Marine Lenhart syndrome is a rare disease and causes refractory hyperthyroidism. So far, little evidence on the combination of both Marine Lenhart syndrome and Hashimoto's thyroiditis is available. We suspect that Marine Lenhart syndrome when combined with Hashimoto's thyroiditis might have its particular features, which are not exactly the same as those of the isolated Marine Lenhart syndrome.

Case presentation

A 56-year-old middle-aged man presented with recurrent hyperthyroidism, and Graves' disease combined with Hashimoto's thyroiditis was considered. Radionuclide imaging showed a hot nodule, but ultrasonography suggested the possibility of malignancy with a category of 4B according to the Chinese-Thyroid Imaging-Reporting and Data System (C-TIRADS) model. Fine needle aspiration cytology (FNAC) revealed eosinophilic follicular lesions with papillary features, and prompted that papillary thyroid carcinoma could not be excluded. Partial thyroidectomy was performed and the nodule was proven to be benign by histopathology. The final diagnosis was atypical Marine Lenhart syndrome with Hashimoto's thyroiditis.

Conclusions

Marine Lenhart syndrome combined with Hashimoto's thyroiditis has its particular characteristics, showing some signs mimicking malignancy. Limitations of ultrasonography and FNAC in diagnosis should be noted in these scenarios.