bluuebunny/crossref_metadata_2025 huggingface dataset:
Gut Microbiota Changes in response to Medical Nutrition Therapy for Different Subtypes of Gestational Diabetes Mellitus
Authors: Han Mengyuan , Lin Xiang , Lin Lihua , Wu Zhihui , Lin Yingying , Dong Jiayi , Lin Jiaying , Xie Qianwen , Shen Qi , Lin Juan
Published: July 2023

Background
Our research aimed to analyze differences in gut microbiota composition among pregnant women with different GDM subtypes and evaluated the impact of medical nutrition therapy.
Methods
124 pregnant women, including 33 non-GDM and 91 GDM were enrolled. The GDM group was divided into 2 subgroups according to their 75 g oral glucose tolerance test (OGTT) results: abnormal glucose tolerance (GDM1, n=66) and elevated fasting blood glucose + abnormal glucose tolerance (GDM2, n=25). Fecal samples were collected from groups GDM1 and GDM2 after the confirmation of GDM diagnosis by OGTT at 24-28 weeks of pregnancy prior to medical nutrition therapy and again 8 weeks after commencement of medical nutrition therapy (32-36 weeks of pregnancy). Fecal samples were collected from non-GDM group at the corresponding gestational weeks. The compositions and changes of gut microbiota from different groups were analyzed and compared.
Results
Compared to GDM with fasting blood glucose combined with glucose tolerance abnormalities, the gut microbiota Alpha diversity of GDM with isolated glucose tolerance abnormalities is closer to the normal group. Beta diversity between three groups were significant different. The 8-week medical nutrition therapy did not cause significant changes in the gut microbiota composition of GDM patients, the Alpha diversity and Beta diversity had no statistical differences. LEfSe differential analysis showed that the abundance of Bifidobacterium, Anaerostipes, Streptococcus and Streptococcaceaesignificantly increased, while the abundance of Klebsiella, Enterobacteriaceae, Raoultella, and Acidaminococcaceae significantly decreased in group GDM1 after medical nutrition therapy. While the abundance of unclassified.Clostridiales, Turicibacter significantly increased, and the abundance of Phascolarctobacterium significantly decreased in group GDM2.
Conclusions
The gut microbiotacomposition of different subtypes of GDM had different characteristics. The medical nutrition therapy did not cause significant changes to gut microbiota composition of GDM patients but promoted increased abundance of beneficial Bifidobacterium.
Construction of ceRNA prognostic model based on the CCR7/CCL19 chemokine axis as a biomarker in breast cancer
Authors: Ma Rufei , Guan Xiuliang , Teng Nan , Du Yue , Ou Shu , Li Xiaofeng
Published: July 2023

Background
The study of CCR7/CCL19 chemokine axis and BC (BC) prognosis and metastasis is a current hot topic. We constructed a ceRNA network and risk-prognosis model based on CCR7/CCL19.
Methods
Based on the lncRNA, miRNA and mRNA expression data downloaded from the TCGA database, we used the starbase website to find the lncRNA and miRNA of CCR7/CCL19 and established the ceRNA network. The 1008 BC samples containing survival data were divided into Train group (504 cases) and Test group (504 cases) using R "caret" package. Then we constructed a prognostic risk model using RNA screened by univariate Cox analysis in the Train group and validated it in the Test and All groups. In addition, we explored the correlation between riskScores and clinical trials and immune-related factors (22 immune-infiltrating cells, tumor microenvironment, 13 immune-related pathways and 24 HLA genes). After transfection with knockdown CCR7, we observed the activity and migration ability of MDA-MB-231 and MCF-7 cells using CCK8, scratch assays and angiogenesis assays. Finally, qPCR was used to detect the expression levels of five RNAs in the prognostic risk model in MDA-MB-231 and MCF-7 cell.
Results
Patients with high expression of CCR7 and CCL19 had significantly higher overall survival times than those with low expression. The ceRNA network is constructed by 3 pairs of mRNA-miRNA pairs and 8 pairs of miRNA-lncRNA. After multivariate Cox analysis, we obtained a risk prognostic model: riskScore= -1.544 *`TRG-AS1`+ 0.936 * AC010327.5 + 0.553 *CCR7 -0.208 *CCL19 -0.315 *`hsa-let-7b-5p. Age, stage and riskScore can all be used as independent risk factors for BC prognosis. By drug sensitivity analysis, we found 5 drugs targeting CCR7 (convolamine, amikacin, AH-23848, ondansetron, flucloxacillin). After transfection with knockdown CCR7, we found a significant reduction in cell activity and migration capacity in MDA-MB-231 cells.
Conclusion
we constructed the first prognostic model based on the CCR7/CCL19 chemokine axis in BC and explored its role in immune infiltration, tumor microenvironment, and HLA genes.
The relationship between physical activity and subjective well-being in Chinese university students: the mediating roles of perceived health, social support and self-esteem
Authors: Liao Tianzhi , Yin Yujia , Hu Xiaoyong , Shim Yunsik , Tang Saizhao
Published: July 2023

Purpose
The intent of this paper is to understand the effect of physical activity on university students' subjective well-being and to explore whether perceived health, social support, and self-esteem play roles as mediating variables.
Methods
Self-reported data from 404 college students (147 males and 257 females) were analyzed using structural equation modeling (SEM). The relationships between the study variables were tested by mediation models and 5000 bootstrap samples using AMOS version 24.
Results
(1) All of the first six hypotheses were supported in the measurement model in the results. Physical activity was significantly related to social support, to perceived health, and to self-esteem; social support, perceived health and self-esteem were all significantly related to subjective well-being. However, the direct positive effect of physical activity gradually decreased in the order of self-esteem, social support, and perceived health. The direct effect of perceived health, social support, and self-esteem on subjective well-being also decreased sequentially. (2) In the measurement model, all three hypotheses of mediation were supported, showing positive indirect effects between physical activity and subjective well-being. Of the three mediating effects, social support and self-esteem were not significantly different, and the mediating effect of perceived health showed the largest impact. This indicates that social support, perceived health, and self-esteem mediate the effects of physical activity, and subjective well-being regulation has positive indirect effects.
Conclusion
This study demonstrates the importance of meeting the needs of social support, perceived health, and self-esteem when designing interventions to promote college students' sports participation to enhance subjective well-being.
Clinical characteristics and outcomes of unvaccinated kidney transplant patients infected with SARS-CoV-2 omicron subvariant BA.5.2
Authors: Qu Yue , Zhuang Jing , Duan Yanya , Baibutihan Ahebaota , Maimaiti Zuolamu , Zhang Changrong , Niu Junqiao , Teng Wei , Ailimu Maierdang , Wei Xuemei , Qi Baowen , Li Jiuzhi , DU Shuang , Wang Dingding , Cao Ke , Wang Junyan , Lu Chen , Tian Xuefei , Jiang Hong
Published: July 2023

Background
Kidney transplant (KT) recipients, who are chronically immunocompromised, face increased risks due to COVID-19 and lower vaccination rates. Limited knowledge exists regarding the clinical characteristics of unvaccinated KT patients with COVID-19. This study aimed to examine the clinical features and outcomes of unvaccinated KT patients infected with SARS-CoV-2 omicron subvariant BA.5.2.
Methods
The study enrolled 36 unvaccinated KT patients with COVID-19 and compared them to 20 infected control cases without underlying medical conditions. Clinical characteristics, laboratory tests, treatment regimens, and outcomes were analyzed. RT-PCR confirmed SARS-CoV-2 Omicron BA.5.2 subvariant infection.
Results
The KT patients experienced severe disease, with 66.7% classified as severe/critical illness. Dyspnea on admission, lower blood leukocyte and lymphocyte counts, hemoglobin levels, and serum albumin levels were more prevalent in the KT group compared to the control group. Severe/critical illness was associated with factors such as age, diabetes mellitus, lung infection CT score, and elevated levels of D-dimer, IL-6, CRP, Procalcitonin, and ferritin. Blood lymphocyte counts and serum albumin levels were significantly lower in the severe/critical illness group in KT patients. Treatment included discontinuation of anti-metabolic drugs, reduction, or discontinuation of calcineurin inhibitor drugs, antiviral therapy, and early patient-tailored nutritional support. Acute kidney injury was observed in 19.4% of cases, and four patients died during the observation period.
Conclusions
Early diagnosis, personalized treatment regimens, and diligent monitoring are crucial for unvaccinated KT patients with COVID-19. These findings contribute to understanding the clinical characteristics and management of COVID-19 in the KT population.
Generative design of conformal cooling channels for hybrid-manufactured injection moulding tools
Authors: Wilson Neil , Gupta Manhar , Patel Milan , Mazur Maciej , Nguyen Vu , Gulizia Stefan , Cole Ivan
Published: July 2023

Effective cooling systems for injection moulding (IM) tools are critical to reducing manufacturing costs & cycle time for the polymer parts that they produce. This work presents a novel automated methodology for designing conformal cooling channels (CCCs) for injection moulding (IM) tools. This is done through existing commercial moulding simulation tools interlinked with custom scripts that adjust CCC design in response to the spatial variability in global andlocal temperature at the mould tool-part interface (MTPI). Four mould tool designs for a hollow cylinder were developed and analysed via both numerical simulation and experiments. These include (i) conventional IM tool with straight-drilled cooling channels made of tool steel, (ii) a manually designed CCC system with stainless steel, (iii) copper-aluminium bronze ‘core’ andstainless steel ‘shell’ with CCCs identical to (ii), and (iv) stainless steel with a CCC system automatically designed using generative design (GD) driven by a genetic algorithm. Tool (ii) cooled the part faster than conventional tool with a manually designed CCC system (i) (3-5% predicted vs. 40% measured), as did tool (iii) with the bronze core (9-12% predicted vs. 40% measured). The GD-optimised CCC tool (iv) cooled fastest in both the predicted results (15-30%, 11-25% & 1.5-25% faster than (i), (ii) & (iii)) andmeasured results (70%, 50% & 50% for (i), (ii) & (iii)). The predicted MTPI temperatures were also lower for the GD-optimised tool (65%, 75% & 34% below (i), (ii) & (iii)). Therefore, the novel methodology proposed here for automatically designing IM tool CCCs achieves reduced (a) maximum andspatial variability in MTPI temperatures, (b) cooling time, and (c) warpage.
WITHDRAWN: Augmented Reality as a Support in the Process of Spatial Development
Authors: Kaźmierczak Rafał , Szczepańska Agnieszka
Published: July 2023

Design solutions for methods of future spatial development, contained in planning documents, are presented as 2D graphics with supplementary descriptions. Lack of specialist knowledge and in-sufficient spatial imagination in various readers of such documents results in problems with ab-sorbing the document contents, both in their graphical and textual parts. In consequence, objects can be constructed that disrupt the spatial order, although with no legal violation. This problem can be solved by applying augmented reality (AR) in spatial planning. This paper presents the capabilities of a method for visualizing different variants of spatial development, with buildings as examples. A building plot with its surrounding area, covered by a local spatial development plan, was used as a model. By modelling future land development with AR technology, it was possible to demonstrate a lack of precision of the plan and its potential impact on the method of spatial development, with resulting deterioration of the spatial order. The utility of 3D visualization of a plan to an average reader was also presented, which can be used at the stage of preparing planning documents (community participation, adopting the plan) and at the stage of passing by-laws (councilors) and when it is in force (investors’ decisions).
Efficacy of second-line chemotherapy after treatment with gemcitabine plus nab-paclitaxel or FOLFIRINOX in patients with metastatic pancreatic cancer: results from the NAPOLEON study
Authors: Fukahori Masaru , Okabe Yoshinobu , Shimokawa Mototsugu , Otsuka Taiga , Koga Futa , Ueda Yujiro , Nakazawa Junichi , Komori Azusa , Otsu Satoshi , Arima Shiho , Makiyama Akitaka , Taguchi Hiroki , Honda Takuya , Ushijima Tomoyuki , Miwa Keisuke , Shibuki Taro , Nio Kenta , Ide Yasushi , Ureshino Norio , Mizuta Toshihiko , Mitsugi Kenji , Shirakawa Tsuyoshi
Published: July 2023

First-line chemotherapy for patients with metastatic pancreatic cancer (MPC) includes gemcitabine plus nab-paclitaxel (GnP) and FOLFIRINOX (FFX). However, the efficacy of second-line chemotherapy and the role of combination chemotherapy in clinical practice is still unknown. Data was gathered from 14 hospitals in the Kyushu area of Japan from December 2013 to March 2017. The median overall survival (mOS) from second-line treatment was contrasted between patients who received second-line chemotherapy (CT group) and those who received the best supportive care (BSC group). Furthermore, the mOS of combination chemotherapy was compared to mono chemotherapy in the CT group. To control possible bias in the selection of treatment, we performed a propensity score-adjusted analysis. A total of 255 patients received GnP or FFX as first-line chemotherapy. There were 156 in the CT group and 77 in the BSC group of these. The CT group had a significantly longer mOS than the BSC group (5.2 vs. 2.6 months; adjusted hazard ratio (HR) 0.38; 95% CI: 0.27–0.54). In the CT group, 89 patients received combination chemotherapy while 67 received mono chemotherapy. The mOS did not differ significantly between the combination and mono chemotherapy groups (5.5 vs. 4.8 months; adjusted HR 0.88; 95% CI: 0.58–1.33). Among patients with MPC receiving second-line treatment, the CT group had a significantly longer mOS than the BSC group, but combination chemotherapy conferred no improvement in survival compared to mono chemotherapy.
Myristoylated, Alanine-rich C-kinase Substrate (MARCKS) regulates Toll-like receptor 4 signaling in macrophages
Authors: Issara-Amphorn Jiraphorn , Sjoelund Virginie , Smelkinson Margery , Yoon Sung Hwan , Manes Nathan P. , Nita-Lazar Aleksandra
Published: July 2023

MARCKS (Myristoylated Alanine-rich C-kinase Substrate) is a membrane protein expressed in many cell types, including macrophages. MARCKS is functionally implicated in cell adhesion, phagocytosis, and inflammation. LPS (lipopolysaccharide) triggers inflammation via TLR4 (Toll-like receptor 4). The presence of MARCKS and the formation of phospho-MARCKS in macrophages have been described, but the role(s) of MARCKS in regulating macrophage functions remain unclear. To investigate the role of MARCKS during inflammation, we activated macrophages using LPS with or without the addition of a PKC inhibitor. We found that PKC inhibition substantially decreased macrophage IL6 and TNF cytokine production. In addition, confocal microscopy revealed that MARCKS and phospho-MARCKS increased localization to endosomes and the Golgi apparatus upon LPS stimulation. CRISPR-CAS9 mediated knockout of MARCKS in macrophages downregulated TNF and IL6 production, suggesting a role for MARCKS in inflammatory responses. Our comprehensive proteomics analysis together with real-time metabolic assays comparing LPS-stimulation of WT and MARCKS knock-out macrophages provided insights into the involvement of MARCKS in specific biological processes and signaling pathways, uncovering specific proteins involved in regulating MARCKS activity upon LPS stimulation. MARCKS appears to be a key regulator of inflammation whose inhibition might be beneficial for therapeutic intervention in inflammatory related diseases.
Effectiveness of a telehealth-delivered clinician-supported exercise and weight loss program for hip osteoarthritis – protocol for the Better Hip randomised controlled trial
Authors: Bennell Kim L , Keating Catherine , Lawford Belinda , Graham Bridget , Hall Michelle , Simpson Julie A , McManus Fiona , Hosking Brinley , Sumithran Priya , Harris Anthony , Woode Maame Esi , Francis Jill J , Marlow Jennifer , Poh Sharon , Hinman Rana S
Published: July 2023

Background:
Hip osteoarthritis (OA) is a leading cause of chronic pain and disability worldwide. Self-management is vital with education, exercise and weight loss core recommended treatments. However, evidence-practice gaps exist, and service models that increase patient accessibility to clinicians who can support lifestyle management are needed. The primary aim of this study is to determine the effectiveness of a telehealth-delivered clinician-supported exercise and weight loss program (Better Hip) on the primary outcomes of hip pain on walking and physical function at 6 months, compared with an information-only control for people with hip OA.
Methods:
A two-arm, parallel-design, superiority pragmatic randomised controlled trial. 212 members from a private health insurance fund aged 45 years and over, with painful hip OA will be recruited. Participants will be randomly allocated to receive either: i) Better Hip; or ii) web-based information only (control). Participants randomised to the Better Hip program will have six videoconferencing physiotherapist consultations for education about OA, prescription of individualised home-based strengthening and physical activity programs, behaviour change support, and facilitation of other self-management strategies. Those with a body mass index >27kg/m2, aged <80 years and no specific health conditions, will also be offered six videoconferencing dietitian consultations to undertake a weight loss program. Participants in the control group will be provided with information about managing hip OA via a custom website. All participants will be reassessed at 6 and 12 months. Primary outcomes are hip pain on walking and physical function. Secondary outcomes include measures of pain; hip function; weight; health-related quality of life; physical activity levels; global change in hip problem; willingness to undergo hip replacement surgery; rates of hip replacement; and use of oral pain medications. A health economic evaluation at 12 months will be conducted and reported separately.
Discussion:
Findings will determine whether a telehealth-delivered clinician-supported lifestyle management program including education, exercise/physical activity and, for those with overweight or obesity, weight loss, is more effective than information only in people with hip OA. Results will inform the implementation of such programs to increase access to core recommended treatments.
Trial registration:
Australia New Zealand Clinical Trials Registry (ACTRN12622000461796)
Differential silica nanoparticles functionalized with branched poly(1-Vinyl-1,2,4-triazole): antibacterial, antifungal, and cytotoxic qualities
Authors: Usul Sedef Kaptan , Lüleci Hatice Büşra , Değirmenci Nurdan Sena , Ergüden Bengü , Aslan Ayşe
Published: July 2023

This research aims to improve antimicrobial materials based on functional silica nanoparticles. Three different methods were used in the study to create silica nanoparticles with other properties. The nanoparticles' morphological structures are porous, hollow, and filled with spherical forms. The surface of these nanoparticles was grafted with poly(1-vinyl-1,2,4-triazole) (PVTri). The morphological properties of nanocomposites were used for analyze. In contrast, thermal gravimetric analysis was used to characterize the thermal properties of nanocomposites (TGA). The silica nanoparticles were evaluated for them in vitro antimicrobial activity against, Escherichia coli, Staphylococcus aureus, Saccharomyces cerevisiae using minimum inhibitory concentration (MIC) measurement. Silica nanoparticles have different antifungal and antibacterial properties related to their structure. The cytotoxic effects of the silica nanoparticles on HaCaT cells were performed with an MTS assay. In this study, we observed that high doses of HSS and e-SiO2 decreased cell growth, while HSS and e-SiO2 composite with PVTri increased cell proliferation.
Ceramide synthase CERS4 gene downregulation is associated with KRAS mutation in colorectal cancer
Authors: Hayama Tamuro , Hama Kotaro , Ozawa Tsuyoshi , Fujiwara Yuko , Nozawa Keijiro , Matsuda Keiji , Yokoyama Kazuaki , Hashiguchi Yojiro , Ochiai Hiroki , Misawa Takeyuki , Fukagawa Takeo
Published: July 2023

Background
Ceramide, the central molecule in sphingolipid synthesis, is a bioactive lipid that serves as a regulatory molecule in the anti-inflammatory responses, apoptosis, programmed necrosis, autophagy, and cell motility of cancer cells. In particular, the authors have reported differences in sphingolipid content in colorectal cancer tissues. The associations among genetic mutations, clinicopathological factors, and sphingolipid metabolism in colorectal cancer (CRC) have not been investigated.
Purpose
The aim of this study was to clarify the relationships among mutations of genes associated with sphingolipid metabolism and clinicopathological factors in CRC.
Patients and Methods
We performed a cohort study of the medical records of 82 consecutive patients with stage I-IV CRC who underwent tumor resection at a single institution in 2019–2021. We quantified the expression levels of genes involved in sphingolipid metabolism and analyzed the correlation between these gene expression profiles and the clinical data of each patient.
Results:
When relationships between patients’ KRAS mutation status and levels of ceramide synthase (CERS), N-acylsphingosine amidohydrolase (ASAH) and alkaline ceramidase (ACER) genes, all involved in sphingolipid metabolism, the CRES4 expression level was significantly lower in the KRAS mutant group (p = 0.004). In terms of clinicopathological measures, the rate of venous invasion was significantly higher in the low-CERS4-expression group (p = 0.0057).
Conclusions
By examining the correlation between sphingolipid gene expression and clinical factors, we were able to identify cancer types in which sphingolipid metabolism is particularly relevant. CERS4 expression was significantly reduced in KRAS mutant CRC. Moreover, CRC with decreased CERS4 showed significantly more frequent venous invasion.
The Effect of High-Pressure Cutting Fluid Supply on the Chip Breakability of Lead-Free Brass Alloys
Authors: Müller Magdalena Susanne , Brans Kilian , Meurer Markus , Sørby Knut , Bergs Thomas
Published: July 2023

To improve machinability and in particular chip breakability, brass alloys are usually alloyed with small quantities of lead. Due to environmental and health concerns, the use of lead has been restricted in the last years. As lead-free brass alloys are progressively implemented in the industry, challenges arise due to their differing properties from traditional leaded brass alloys. One of the main challenges in automated continuous cutting processes is the worse chip breakability of lead-free brass alloys leading to longer and tangled chips. Hence, the impact of a high-pressure cutting fluid supply, as well as the impact of a chip-breaking geometry and the combined effect of both, has been investigated at different feeds. The three brass alloys CuZn37 (CW508L), CuZn38As (CW511L), and CuZn42 (CW510L) were studied at varying cutting fluid supply pressure levels and feed rates in a radial cutting operation. Cutting forces were measured, and chips were analyzed. No overall systematic impact of the cutting fluid supply pressure on the cutting forces was observed. In conclusion, increased pressure levels, a chip-breaking geometry, and an increased feed rate enhance the chip breakability of the investigated alloys.
Assessment of ambient air quality in the industrial areas of Ahmedabad, Gujarat (India)
Authors: Thakur Bignesh , Sharma Chandramauly , Agrawal Yadvendra
Published: July 2023

Air pollution stands as the paramount global environmental menace, casting its shadow over public health and claiming a staggering estimate of 7 million lives prematurely each year. The intertwining relationship between air pollution and climate change cannot be ignored, as their shared sources and impact on the climate reveal a profound connection. The battle for improved air quality holds the key to unlocking not only health benefits but also developmental progress and a sustainable environment. In our pursuit to comprehend the state of ambient air quality, our study zoomed in on the peripheral industrial areas of Ahmedabad city in Gujarat, India. These areas, representing the bustling industrial zones of Ahmedabad, became the focal point of our analysis. With utmost care, we strategically selected five sampling sites, alongside a control site, based on traffic density — a pivotal factor shaping our investigation. Our gaze then shifted towards the concentration of key pollutants NOx, SOx, PM 10, and PM 2.5 measured in the ambient air. The range of these pollutants varied between 22.63 µg/m3 and 112 µg /m3 for NOx, 10.78 ug/m3 and 88.50 µg /m3 for SOx, 8.70 µg /m3 and 51.30 µg /m3 for PM10, and 13.53 µg /m3 and 38.50 µg /m3 for PM 2.5. These figures serve as tangible evidence, shining a light on the concerning state of pollution plaguing the region. However, our endeavour transcended the mere numerical analysis. We dived deeper, exploring the intricate relationship between weather conditions and air quality. In deciphering general patterns, average values, and trends of wind direction and seasonal variations, we unearthed hidden insights. This holistic approach granted us a comprehensive understanding of the interplay between varying weather conditions and the quality of the ambient air. To provide a meaningful context, we compared our findings with the National Ambient Air Quality Standards (NAAQS), allowing us to interpret the state of the ambient air quality in the context of established guidelines. The results and subsequent discussion shed light on the implications of our findings, providing a foundation for informed decision-making and potential interventions to address this pressing issue.
Robotics for electric vehicles battery packs disassembly towards sustainable remanufacturing
Authors: Villagrossi Enrico , Dinon Tito
Published: July 2023

The automotive industry is involved in a massive transformation from standard endothermic engines to electric propulsion. The core element of the Electic Vehicle (EV) is the battery pack. Battery pack production misses regulations concerning manufacturing standards and safety-related issues. In such a fragmented scenario, the increasing number of EVs in circulation is growing exponentially, opening new challenges for managing the end-of-life of their battery packs.
This paper analyses the use of robotics for EVs' battery pack disassembly to enable the extraction of the battery modules preserving their integrity for further reuse or recycling. The analysis highlights that a complete automatic disassembly remains difficult, while human-robot cooperative disassembly guarantees high flexibility and productivity. The paper introduces guidelines for designing a robotic cell to disassemble a battery pack in collaboration with an operator. The design of the workcell evaluates the technological requirements for disassembly, the analysis of potentially explosive atmospheres (ATEX) of the area around the battery pack, and the design and optimisation of robotics tools in the ATEX zone. The work proposes solutions according to the current international standards.
Anticancer drugs versus supportive care for advanced esophageal cancer: a systematic review of randomized clinical trials and meta-analysis
Authors: Santero Marilina , Meade Adriana , Selva Anna , Savall Olga , Bracchiglione Javier , Macías Ismael , Leache Leire , Cerdà Paula , Cosp Xavier Bonfill
Published: July 2023

Background Esophageal cancer (EC) is a global health concern and a leading cause of death. A large number of patients are diagnosed with advanced-stage EC, with very poor survival rates Anticancer drugs have limited effectiveness and severe side effects, but new therapies like immunotherapy show potential despite associated adverse events. This review aims to assess the efficacy and safety of anticancer drugs versus supportive care for advanced esophageal cancer (EC).Methods We searched (May 2022) MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Epistemonikos, and trial registries (ClinicalTrials.gov and PROSPERO) for randomised controlled trials (RCTs) comparing anticancer drugs (chemotherapy, immunotherapy, or biological/targeted therapy) with supportive care in advanced EC. The results were summarized using GRADE summary of finding tables.Results We included 15 RCTs. Most studies did not have a special focus on EC, did not detail the treatment lines in all patients, and did not evaluate all outcomes. Anticancer drugs may result in a slight increase in overall survival (OS) (HR 0.78; 95% CI 0.71, 0.86; MD 0.83 months) and better progression free survival (PFS) (HR 0.56 95% CI 0.49, 0.64, MD 0.68 months), but also may increase toxicity (RR 1.37; 95% CI 1.13, 1.65), without a significant improvement in quality of life. The certainty of evidence was low or very low due to indirectness of results and lack of specific focus on EC in some studies.Conclusion RCTs on advanced EC lack specificity, detailed treatment line information, and evaluation of all relevant outcomes. Moreover, when they find any benefit, this is negligible. Therefore, the certainty to justify anticancer drug treatments instead of BSC in advanced EC is low or very low and it is essential to weigh the potential benefits and risks carefully with active involvement of patients.Registration: The study protocol was registered in OSF (https://doi.org/10.17605/OSF.IO/7CHX6) on 2022-03-29.
Reshaping the Peripersonal Space in Virtual Reality
Authors: Petrizzo Irene , Mikellidou Kyriaki , Avraam Savvas , Avraamides Marios , Arrighi Roberto
Published: July 2023

Peripersonal space (PPS) refers to the space around us that lies within reach, in which most of our interactions with the environment occur. However, the PPS is not a static bubble surrounding our body. Rather, it can be dynamically reshaped in size, for instance as a consequence of the use of tools extending the arm’s reach. Here we employed a visuo-tactile detection task in an immersive VR environment to measure the size of participants’ PPS before and after different kinds of tool training. A short training period in which participants pulled objects from the Extrapersonal space (EPS) towards themselves via a tool was effective in enlarging the PPS, a result that nicely complements previous studies carried out in real life studies. However, no significant change in PPS size was achieved via training with other motor routines such as pulling, hammering or shooting, each of which involving a different kind of interaction between the agent and the targets. Taken together, our results suggest that the reshaping of the PPS is a complex phenomenon in which the kind of motor routines exploited to interact with the surrounding objects, plays a critical role.
Impact of portraiture photography on orthodontic treatment - A systematic review and meta-analysis
Authors: Alam Mohammad Khursheed , Abutayyem Huda , Alotha Salah Nazal , Alsiyat Basant Mousa H , Alanazi Saif , Alserhani Ebtehal Dhyab M , Albalawi Raghad Fayez H , Alshammri Buthainah Saleh , Alswairki Haytham Jamil , Alfawzan Ahmed Ali , Hajeer Mohammad Younis , Shrivastava Deepti , Srivast Kumar Chandan
Published: July 2023

Background and Objective: Due to the clear depiction of facial aesthetics and other craniofacial parameters, portraiture photography (PP) is becoming more and more necessary in modern clinical practice. The studies chosen for this review's inclusion looked at how PP affected the orthodontic treatment and diagnostic procedure on the subjects who were watched in the studies.
Materials & Methods: Studies published within the last decade precisely from 2013 onwards were searched for across major online databases after devising a proper search strategy. Multiple reviewers created a specific data extraction form that was used for the investigation, followed by the evaluation of bias and the variables found in each of the chosen papers. This form was meant for the assessment for various variables encountered in this study.
Results: One research reported a less than ideal 30%, and one study reported variable percentages, but more than 60% of the studies found that respondents had a favorable opinion of the use of PP in an orthodontic setting. In order to improve the effectiveness of their respective results, PP was used as a diagnostic tool in half of the selected studies and at the beginning of the orthodontic treatment plan in five of the studies that were chosen. According to the meta-analysis, using PP was related with a statistically significant decrease in the risk of orthodontic treatment and diagnostic modalities, with odds ratios (OR) of 0.52 with a 95% confidence interval (CI) of [0.28, 0.96] and a relative risk (RR) of 0.66 with a CI of [0.45, 0.96].
Conclusion: In orthodontics, PP is an important tool that offers useful data for diagnosis, treatment planning, and tracking treatment success. To validate the results of studies like ours, a sizable evidence sample is required due to the limited number of trials that have been performed in this area
Design and Experiment of a Soybean Shaftless Spiral Seed Discharge and Seed Delivery Device
Authors: Zhu Huibin , Wu Xian , Bai Lizhen , LI Rongdong , Guo Guanyu , Qin Jin , Zhang Yuanyuan , Li Hui
Published: July 2023

In response to the problem of poor flatness caused by straw and root stubble on the no-till surface during the operation of the driven stubble-breaking and anti-blocking no-till planter, poor performance of seed discharge by the seed rower and seed guide operation by the seed guide tube and the overall vibration of the tool during the stubble-breaking and anti-blocking operation in the southwest, a soybean shaftless spiral seed discharge and seed delivery device was designed based on the principle of screw conveying. The optimum seed filling size and speed range of the spiral blade was obtained by analyzing size, force and motion of soybean seeds of "ZhongHuang 37". The quadratic regression orthogonal rotation test and response surface method were used to analyze the operating parameters of the shaftless spiral seed discharge and seed delivery device by joint EDEM(Discrete Element Method)-RecurDyn simulation. The optimum parameters were obtained: the spacing of spiral was 11.4 mm, spiral outer radius was 5.5 mm, spiral inner radius was 2.9 mm and rotation speed was 10.4 r·s− 1. Based on simulation and optimization results, the device was trialed and its field performance was tested. The results show that the average seeding qualification index, reseeding index, missing index and damage index of the shaftless spiral seed discharge and delivery device were 92.6%, 5.03%, 2.4% and 0.92%, respectively, at an average surface level of 8.9 cm, which met the local agronomic requirements. The designed soybean shaftless spiral seed discharge and seed delivery device meets the requirements of the quality of no-till seeding and can provide reference for the design and improvement of seed discharger and seed guide tube under poor ground leveling and long-distance seed delivery conditions.
Mortality Following Proximal Femoral Fractures: A Large Retrospective Cohort Study of Incidence and Risk Factors
Authors: Baghdadi Soroush , Kiyani Maryam , Kalantar Seyyed Hadi , Shiri Samira , Sohrabi Omid , Fard Shahabaldin Beheshti , Afzal Sina , Khabiri Seyyed Saeed
Published: July 2023

Background: Global prevalence of osteoporosis and fragility fractures is increasing due to the aging population. Proximal femoral fractures are among the most common orthopedic conditions in elderlt that significantly cause health deterioration and mortality. Here, we aimed to evaluate the mortality rates and risk factors, besides the functional outcomes after these injuries.
Methods: In a retrospective cohort study, all patients admitted with a femoral neck or intertrochanteric fracture between 2016 and the end of 2018 were enrolled in this study. Medical records were reviewed to include patients over 60 years of age who had a proximal femoral fracture and had a complete medical record and radiographs available. Exclusion criteria included patients with pathological fractures, cancer under active treatment, follow-up loss, and patient access loss. Demographic and clinical features of patients alongside the details of fracture and patient management were recorded and analyzed. In-hospital and post-discharge mortalities at one and 12 months due to included types of fractures were the primary outcome. Modified Harris Hip Scores (mHHS) was the emasure of functional outcome.
Results: A total of 788 patients including 412 females (52.3%) and 376 males (47.7%) with a mean age of patients was 76.05 ± 10.01 years were included in this study. Among patients, 573 (72.7%) had an intertrochanteric fracture, while 215 (27.3%) had a femoral neck fracture, and 97.1% of all received surgical treatment. With a mean follow-up of 33.31 months, overall mortality rate was 33.1%, and 5.7% one-month and 20.2% 12-months rates. Analysis of 1-month mortality showed a significant mortality difference in patients operated after 48 hours of fracture (p=0.01) and in patients withAmerican Society of Anesthesiologists (ASA) scores of 3-4 compared to ASA scores of 1-2 (p=0.001). One-year mortality data showed that the mortality rate in femoral neck fractures was lower compared to other types of fracture. Surgical delay of >48 hours, ASA scores of 3-4, and treatment by proximal femoral plate were associated with shorter survival. The overall mean mHHS score was 53.80 ± 20.78.
Conclusion: We found several risk factors of mortality, including age ≥80 years, a >48-hour delay to surgery, and pre-operative ASA scores of 3-4 in patients with proximal femoral fracture. Furthermore, the use of a proximal femoral plate was a significant risk factor for mortality and lower mHHS scores.
Activation of Persulfate for the Degradation of Ethyl-parathion in Soil: Combined Effects of Microwave with Biochar
Authors: Zhao Song , Liu Jinbo , Miao Duo , Sun Hongwen , Zhang Peng , Jia Hanzhong
Published: July 2023

Sulfate radical (SO4−•), formed by persulfate (PS) activation during advanced oxidation process, can be used for the remediation of organic contaminated soil. However, the role of biochar and microwave (MW) in the activation of PS are not fully understood, especially the corresponding mechanism. Herein, biochar combined with MW were used to activate PS for the remediation of ethyl-parathion (PTH)-polluted soil. The dynamic evolutions of PTH under different conditions, such as biochar content, types, and reaction temperature, and the degradation mechanisms of PTH were also systematically investigated. Significant enhancement performance on PTH removal was observed after adding BC, which was increased from 75.35–88.78% within 80 min. Meanwhile, activating temperature and the PFRs in biochar exhibited remarkable abilities to activate PS for PTH removal. Furthermore, chemical probe tests coupled with quenching experiments confirmed that biochar combined with MW system contributed to the decomposition of PS into active species, such as SO4−•, •OH and O2−•, which could oxidize PTH into oxidative products, including paraoxon, p-nitrophenol, and hydroquinone. The results of this study provided valuable insights into the synergistic effects of biochar and MW in the PS activation, which is helpful for the potential application of biochar materials combined with MW-activated PS in the remediation of pesticide-polluted soils.
Morphological and molecular characterization of two populations ex situ regenerated from a germplasm bank accession of the wild potato Solanum chacoense Bitter
Authors: Hornum Anabela Poulsen , Camadro Elsa Lucila
Published: July 2023

Crop wild relatives are conserved in germplasm banks as original accessions or their ex situ regenerated progenies. The commonly used sexual regeneration method in wild potatoes (FAO 2013) -cultivation of 20-25 plants/accession (N), hand-pollination with pollen mixtures when a percentage of the plants are in bloom, and composition of the regenerated accession without controlling the number of seeds provided by each female progenitor- does not consider the action of internal reproductive barriers. However, wild potatoes -mostly diploid and obligate out-crossers- may present internal pre-zygotic, post-zygotic, or both types of complete or incomplete reproductive barriers, which can reduce the effective number of progenitors (Ne) in relation to N. To evaluate possible phenotypic and genetic changes during a sexual reproduction cycle, two regeneration protocols were followed with one accession of Solanum chacoense Bitter: the current one and the proposed by Camadro (2012). The original accession and the two regenerated populations were morphologically and molecularly characterized. Twenty-one morphological characters (quantitative and qualitative) were considered, and the data were subjected to univariate and multivariate analyses. Allele frequencies were calculated for six microsatellite markers (SSR) and compared among populations with a chi-square test (α= 0.05). Great morphological variability for morphological phenotypes and four of the six analyzed SSR, as well as changes in allele frequencies (including allele loss) were revealed within and among the three populations. Therefore, it is advisable to consider aspects of reproductive and population genetics in developing regeneration protocols to prevent or reduce the risks of genetic erosion in sexual regeneration cycles.
Impact of proficiency in the Transcatheter Aortic Valve Implantation procedure on clinical outcomes: A single center retrospective study
Authors: Miyoshi Hirotsugu , Kamiya Satoshi , Ikeda Tsuyoshi , Narasaki Soshi , Kondo Takashi , Syourin Daiki , Sumii Ayako , Kido Kenshiro , Otsuki Sachiko , Kato Takahiro , Nakamura Ryuji , Tsutsumi Yasuo M
Published: July 2023

Background
We used transcatheter aortic valve implantation (TAVI) procedure time to investigate the association between surgical team maturity and outcome.
Methods
Among patients who underwent TAVI between October 2015 and November 2019, those who had Sapien™ implanted with the transfemoral artery approach were included in the analysis. We used TAVI procedure time and surgery number to draw a learning curve. Then, we divided the patients into two groups before and after the number of cases where the sigmoid curve reaches a plateau. We compared the two groups regarding the surveyed factors and investigated the correlation between the TAVI procedure time and survey factors.
Results
Ninety-nine of 149 patients were analysed. The sigmoid curve had an inflection point in 34.7 cases and reached a plateau in 43.0 cases. Patients in the Late group had a shorter operating time, less contrast media, less radiation exposure, and less myocardial escape enzymes than the Early group. Surgical procedure time showed the strongest correlation with the surgical case number.
Conclusion
The number of cases required for surgeon proficiency in TAVI was approximately 43. This number may serve as a guideline for switching the anesthesia management of TAVI from general to local anesthesia.
Body Mass Index as a Dominant Risk Factor for Metabolic Syndrome among Indonesian Adults: A 6-year Prospective Cohort Study of Non-Communicable Diseases
Authors: Rahmawati Nurul Dina , Andriani Helen , Wirawan Fadila , Farsia Latifah , Waits Alexander , Taufiqurahman Khobir Abdul Karim
Published: July 2023

Background
Non-communicable diseases (NCDs) are the leading cause of death globally. Metabolic syndrome (MetS) refers to a cluster of conditions that significantly increase the risk of some NCDs, in particular cardiovascular disease and type 2 diabetes mellitus. MetS risk factors have been extensively researched using cross-sectional and longitudinal study designs, however, few studies have tried to understand the course of the disease based on established risk factors. This study aimed to track changes in adult MetS risk in a cohort based in Bogor District, one of the most populated areas of Indonesia.
Methods
This prospective open cohort study analysed secondary data from the Special Research - Cohort Study of Non-Communicable Diseases by the Ministry of Health, Republic of Indonesia from 2011 to 2018. The final sample was 1,376 Indonesian adult participants, all residents of Bogor District. MetS outcome, dietary assessment, physical activity, and biomarkers were analysed every two consecutive years.
Results
The risk of overweight and obese participants developing MetS was 2.4 and 4.4 times higher, respectively (p < 0.001, 95% CI: 1.176–3.320 and 3.345–5.740) than those with body mass index (BMI) in the normal range. Participants who reported less intentional physical exercise had a MetS risk 1.5 times higher (p = 0.032, 95% CI: 1.034–2.109) than those with more intentional physical exercise. The role of diet is also significant, evidenced by a 30% reduction in MetS risk for people with fat intakes in the 2nd quartile compared to the 1st quartile (p-value = 0.033, 95% CI: 0.505–0.972). Meanwhile, a carbohydrate intake in the 2nd quartile increased the risk of MetS 1.5 times (p = 0.023, 95% CI: 1.063–2.241) in comparison with the 1st quartile.
Conclusions
After controlling for confounding factors, overweight and obesity, sedentary lifestyle, and a higher quartile of carbohydrate consumption were observed to increase MetS risk. The highest cumulative survival of MetS was recorded for participants with underweight BMI, and the lowest cumulative survival was recorded for participants with obese BMI. These findings indicate immediate strategic actions are required to improve an existing early detection and NCD monitoring programme that promotes a community-based healthy lifestyle in Bogor District, Indonesia.
Evaluations of exercise intolerance with cardiopulmonary exercise tests in a 24-year-old young male with obesity with tetrahydrobiopterin deficiency: A case report
Authors: Chen Chun Yu , Chang Shin Tsu , Lin Ko Long
Published: July 2023

Background: Phenylketonuria (PKU) is a rare amino acid metabolism genetic disorder. Tetrahydrobiopterin (BH4) metabolism defects cause variant PKU. BH4 coenzyme deficiency disables phenylalanine metabolism into tyrosine, causing brain damage and intellectual impairment. Patients follow a low-phenylalanine diet for life, increasing the risk of obesity, hypertension, and metabolic syndrome.
Case Presentation: A 24-year-old male patient with BH4 deficiency underwent a pulmonary function test and cardiopulmonary exercise test (CPET). Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were within normal values, with an 80.68% ratio. The 20-watt bicycle exercise test indicated moderate functional impairment (27.3 ml/kg/min of peak oxygen intake). The test achieved 81% and 70% of the target and reserve heart rates, respectively. The patient’s body mass index was 29.9 kg/m2, causing a high resting metabolic rate and oxygen uptake. The need for oxygen uptake is more prominent during high-intensity exercise, thus his functional impairment was caused by obesity.
Conclusion: CPET evaluates cardiorespiratory fitness in patients with PKU, providing appropriate aerobic and resistance training to improve prognosis with a weight control program.