bluuebunny/crossref_metadata_2025 huggingface dataset:
A Multilevel Temporal Convolutional Network Model with Wavelet Decomposition and Boruta Selection for Forecasting Monthly Precipitation
Authors: Tao Lizhi , He Xinguang , Li Jiajia , Yang Dong
Published: October 2023

In this study, a multilevel temporal convolutional network (MTCN) model is proposed for 1-month-ahead forecasting of precipitation. In the MTCN model, à trous wavelet transform (ATWT) is first utilized to decompose the standardized monthly precipitation anomaly and its candidate predictors into their components with the different time scales. Then, at each of the time levels, a temporal convolutional network (TCN) model is built to forecast the precipitation anomaly component by combining with the Boruta selection algorithm (TCN-B) for identifying important model inputs from corresponding predictor components. Finally, the precipitation forecast is achieved by summing all the forecasted anomaly components and applying the inverse transform of the standardized monthly precipitation. The proposed MTCN is tested and compared to the TCN-B and TCN using monthly precipitation at 189 stations in the Yangtze River basin. The TCN-B is formed by coupling the TCN with the Boruta algorithm. The comparison results show that the TCN-B outperforms the TCN, and the MTCN has the best performance among the three models. Compared to the TCN, the MTCN provides a significant improvement for all stations, especially for the eastern stations of the basin. It is also shown that all three models perform better in spring and summer and have the weakest abilities in winter. The MTCN has a great improvement in predicting precipitation of all four seasons compared with the other two models. Additionally, all three models exhibit better prediction performance in the western region than in the eastern region of the basin, which is strongly related to the spatial distribution of precipitation variability.
Maintaining Active Lifestyle Through Pickleball: A Qualitative Exploration of Older Pickleball Players
Authors: Heo Jinmoo , Ryu Jungsu
Published: October 2023

This study aimed to explore the experiences of older adults engaged in pickleball. In particular, we collected views from the USA Pickleball Association (USAPA) ambassadors to identify how their experiences facilitate successful aging. A qualitative case study was utilized to obtain naturalistic data. Purposive sampling was used to recruit a total of 15 USAPA ambassadors, all of whom were interviewed in person. Data were analyzed using interpretive thematic analysis, and four overarching themes were generated: (a) a new way to stay active, (b) pickleball is social, (c) an intergenerational pastime, and (d) reestablishing an identity through pickleball. The findings support the view that engaging in pickleball is a promising means of achieving a healthy life as a senior citizen. The participants maintained a physically and mentally active lifestyle through pickleball, and their commitment to this sport led to their engagement as ambassadors in their communities.
Politics Matters for Life Satisfaction of Mainland Chinese Spouses in Taiwan
Authors: Wang Weinan , Zhai Yida
Published: October 2023

This study examined how politics, along with familial and socioeconomic factors, influence the life satisfaction of marriage migrants in Taiwan. We conducted a social survey in Taiwan and offered a multidimensional and dynamic view on adaptation and life satisfaction among them. The results showed that in Taiwan, family relationships and socioeconomic class were significant factors of life satisfaction among mainland Chinese marriage migrants. A high level of social integration was positively related to life satisfaction, while the prejudice faced from neighbors, rather than from the media, was negatively related. Regarding political factors, political disagreement with their Taiwanese partners undermined life satisfaction among spouses from mainland China. However, those who possessed a dual identity (i.e., both Chinese and Taiwanese) and those who viewed mainland China and Taiwan as two separate entities tended to have high levels of life satisfaction.
Compatibilizing effect of grafted recycled graphene on the viscoelasticity and mechanical performance of polypropylene composites
Authors: Şahin Dündar Gülayşe , Saner Okan Burcu
Published: October 2023

The interface problem encountered with the graphene addition in polyolefin composites is an important issue and it is necessary to use various compatibilizers to overcome this problem. Maleic anhydride grafted Polypropylene (MAPP), which is an extensively used compatibilizer in PP composites tends to eliminate these interfacial problems by interacting physically through PP chains and allows easier stress transmission from matrix to reinforcer. However, there is a lack of understanding about how this compatibilizer works with graphene-based PP composite systems since MAPP is mostly used to harmonize hydrophilic surfaces of fillers with non-polar PP. With this study, instead of direct usage of MAPP and GNP separately, waste tyre driven graphene nanoplatelets (GNP) was grafted by MAPP and the resulted material (MAPP-g-GNP) was compounded with PP by applying high shear rates at a melt phase. Effect of MAPP-g-GNP on the processability, viscoelastic response, and mechanical performance of PP composites were investigated, and high degree of interfacial enhancement was achieved by chemically combined MAPP with amphiphilic type of GNP in PP matrix. The use of MAPP-g-GNP at a loading ratio of 0.1 wt% resulted in 38% increase in flexural modulus and 26% in flexural strength and tensile modulus compared to neat PP. The two additives used in the PP composite (2 wt% MAPP and 0.1 wt % GNP) were reduced to a single additive (PP/MAPP-g-GNP) with a 95% weight reduction in the additive content of PP. Rheological studies support that MAPP is not as successful as MAPP-g-GNP in strengthening the interface when used alone with GNP due to the lower complex viscosity and the higher crossover frequency. This study contributes to the production of high-performance PP materials with a very low amount of combined GNP and compatibilizer by integrating the circularity approach in compound development by using GNP obtained from recycled and upcycled waste tyres.
Comprehensive Long-Term Outcomes Following Mandibular Distraction Osteogenesis
Authors: Kosyk Mychajlo S. , Salinero Lauren K. , Morales Carrie Z. , Shakir Sameer , Cielo Christopher M. , Scott Michelle , Nah Hyun-Duck , Bartlett Scott P. , Taylor Jesse A. , Swanson Jordan W.
Published: October 2023

Objective

To describe long-term outcomes and complications following mandibular distraction osteogenesis (MDO) in a diverse patient cohort

Design

Cross-sectional study

Setting

Single tertiary-care pediatric center

Patients

Forty-eight patients previously undergoing MDO with minimum 4-year follow-up

Main Outcome Measures

Respiratory outcomes, feeding patterns, dental development, motor/sensory nerve function, temporo-mandibular joint function, and postsurgical scarring

Results

Forty-six patients with a median age of 7 years were evaluated. Of 20 nonsyndromic patients, none required additional airway procedures, none required continuous positive airway pressure (CPAP) during sleep, and 19 (95%) fed exclusively by mouth. Among 26 syndromic patients, 7 (27%) required CPAP and 8 (31%) were tube fed. Permanent first molar differences were seen in the majority of subjects; patterns of damage interfering with function were more common in syndromic (13/28, 46%) compared to nonsyndromic (5/24, 21%; P = .014) subjects. MDO prior to age two was associated with more frequent and worse dental damage ( P = .001). Inferior alveolar nerve and marginal mandibular nerve function were fully intact in 37 (80%) and 39 (85%) of patients, respectively. Three patients (6%), all with associated genetic syndromes, demonstrated severe nerve impairment. By the Vancouver scar scale, ≥ 80% of surgical scars were rated in the most favorable category for each quality assessed. Temporomandibular joint dysfunction was rare.

Conclusions

MDO shows highly favorable long-term respiratory, feeding, nerve, and scar outcomes in nonsyndromic patients, although permanent molar changes not precluding tooth viability are commonly seen. Patients with associated syndromes demonstrate respiratory and feeding benefits, but higher rates of dental and nerve abnormalities.
Impact analysis of compression preloaded honeycomb sandwich structures
Authors: Fischer Chris , Hähnel Falk , Wolf Klaus , Markmiller Johannes
Published: October 2023

Honeycomb cores made of phenol resin impregnated paper are widely used in sandwich structures of aircraft. Owing to the rather weak core material, this kind of sandwich is prone to a range of damages as a result of impact loading which may accidentally occur during operation. When employed in aircraft these structures have to be damage tolerant. This means barely visible damages have to be considered in the structural design process. In the standard design process for damage tolerant aircraft structures especially the effect of impacts has to be considered but is mostly investigated on unloaded sandwich components. However, aircraft structures are not completely stress free, even when the aircraft is in parking position. At least the structural weight will cause a permanent static preload. In the literature there are only few investigations dealing with the impact behaviour of preloaded honeycomb sandwich structures. In general, studies on composite structures have shown that tension preloads lead to higher structural impact resistance, while prestressing in compression reduces mechanical properties such as impact strength and stiffness of the structure. For this reason, a compression preload is considered as the more critical load case. In order to evaluate the effect of static compression preloads an experimental study on five different honeycomb sandwich configurations was conducted. The experimental investigations showed that even low preloads cause a higher structural damage area, which results in a lower residual strength of the structure. The results indicated that it is recommendable to consider structural compression preloads in the aircraft structural design process.
Developing a framework for a games-based injury prevention exercise programme for post-primary (12–18 years) physical education class: A Delphi poll study
Authors: Devereux Frank , Whyte Enda , Gavigan Nathan , O’Connor Siobhan
Published: October 2023

Despite calls for injury prevention exercise programmes (IPEPs) to move to school settings for the general adolescent population, current research has had mixed outcomes regarding their efficacy in schools as many of the traditional barriers to IPEP implementation still exist, for example, lack of engagement with the programme. A games-based approach may negate some of these barriers as it has been shown to increase participation and adherence to activity. The aim of this study was to achieve consensus on the fundamental framework for the development of a games-based IPEP for physical education (PE) class. Nineteen academic and practitioner experts in the areas of PE, injury prevention and adolescent coaching took part in a four-round Delphi poll, consisting of an opening exploration round followed by three subsequent rounds of questions. Agreement of at least 67% was required for consensus to be deemed achieved on outcomes. Agreement was reached on the key components of an IPEP and potential layouts of the programme. Requirements for an activity/exercise to be deemed games-based and key outcome measures for a games-based IPEP for PE class were established. Finally, PE teacher supports and resources required for implementing a games-based IPEP in PE class were determined, including supports for PE teachers and IPEP location within the class. The recommendations of this study provide a fundamental framework for the development of future games-based IPEPs that could be applied internationally as it provides the flexibility to be adapted to suit various constraints of PE classes across the globe.
“Truman syndrome” induced by online education: A case report in adolescent-Onset psychosis
Authors: Yildirim Budak Burcu , Yazici Karabulut Irem
Published: October 2023

Early-onset schizophrenia (EOS) is an important psychiatric problem characterized by the onset of psychotic symptoms before the age of 18 years. We present the case of a 14-year-old girl who had social anxiety symptoms in the premorbid period and whose psychotic symptoms increased with pandemic restrictions and online education. Our patient’s distance from the peer environment and school as well as the fact that she used webcams and online education more frequently in her daily life were risk factors for EOS. In accordance with the case of Truman syndrome, she has delusions that her daily life is secretly filmed and that she is a “TV star.” Anti-anxiety treatments were initiated during the pre-pandemic period. After a diagnosis of schizophrenia was made, antipsychotic treatment was initiated. A significant response was observed after paliperidone (extended release) treatment. Close follow-ups revealed decreased delusions and increased functionality. Further studies are required to elucidate whether Truman syndrome and social anxiety are different aspects of a similar spectrum. With increasing digitalization, the direction of psychiatric diseases, including EOS, and measures that can be taken for adolescent mental health in crisis, such as pandemics, should be discussed in future research.
Feasibility, acceptability and preliminary effectiveness of a mental health drop-in centre for the siblings of young people attending a paediatric hospital
Authors: Bennett Sophie D , Rojas Natalia , Catanzano Matteo , Roach Anna , Ching Brian CF , Coughtrey Anna E , Heyman Isobel , Liang Holan , Project Team Lucy , Shafran Roz
Published: October 2023

Siblings of children with long-term conditions (LTCs) can have significantly elevated mental health needs, but these are often overlooked. A pragmatic single-arm feasibility pilot assessed feasibility, acceptability and preliminary effectiveness of a drop-in centre in a paediatric hospital addressing mental health needs of patients with LTCs, their carers and siblings. The drop-in centre accepted self-referral and supplemented existing provision offering a suite of interventions, including signposting, diagnostic assessments and/or guided self-help. This paper reports on feasibility, acceptability and preliminary outcomes of this centre for siblings. Eighteen siblings aged 2–17 used the centre. Sixteen of their parents completed the Strengths and Difficulties Questionnaires at baseline and 6 months post-baseline, and ten completed parent-reported PedsQL across two time points. Preliminary effectiveness results demonstrated a decrease in mental health symptoms with large effect size (score reduction of 3.44, 95% CI [1.25, 5.63], d = 0.84) and small effect on quality of life, with scores increasing from a median of 69.91, 95% CI [53.57, 91.67], to a median of 80.44, 95% CI [67.39, 89.13], r = 0.11 for these siblings. 88% of parents were satisfied with this provision for their sibling child. This study highlights the feasibility and value of assessing siblings for emotional and behavioural difficulties and providing them with an accessible, effective and acceptable intervention.
The ethics of informed consent for infants born to adolescents: A case study from Malaysia
Authors: Lee Jeffrey Soon-Yit , Ng Benjamin Wei-Liang , bin Abdul Aziz Mohammad Firdaus
Published: October 2023

Adolescent pregnancy results from the complex interaction between various internal and external vulnerabilities. These vulnerabilities persist after the infant's birth when the adolescent becomes a parent. Adolescent parents are unfairly stereotyped as unmotivated and incompetent. Some legislations prohibit adolescents from giving consent on the grounds of incompetency. Despite being different, “competency” is frequently used interchangeably with “capacity”; thus, incompetent individuals are often mistaken to lack capacity. Consequently, legally incompetent adolescents who became parents are frequently disregarded during their infant's decision-making process. This article discusses the distinction between the competence and capacity of adolescent parents, the various vulnerabilities that contribute to an adolescent's incompetency, and advocates respect for the adolescent's capacity in making decisions for her infant. We propose a workflow for obtaining informed consent for infants born to adolescents ethically guided by the respect for individuals principle while staying within the country's legal framework.
COVID-19? Let me see your hands
Authors: Bernal-Bello David , Lara-Montes Celia , Jaenes-Barrios Beatriz
Published: October 2023

During the first wave of the COVID�19 pandemic, a patient with anti-synthetase syndrome (ASS) was misdiagnosed as having bilateral severe acute respiratory syndrome coronavirus 2 pneumonia on admission. A comprehensive clinical evaluation would have led to the correct diagnosis earlier, as he had some data consistent with ASS on both physical examination and laboratory tests that were initially overlooked. In addition, a malignant lesion in the colon was found on screening for underlying malignancy. In this context, ASS has been considered a low-risk subgroup for cancer among idiopathic inflammatory myopathies. However, this should be interpreted cautiously and should not lead to neglect of adequate cancer screening adjusted for age, sex and other potential risk factors.
Revisiting the Effect of Hosting Large-Scale Sport Events on International Tourist Inflows
Authors: Drapkin Igor , Ivan Savin , Ilya Zverev
Published: October 2023

This paper contributes to the literature examining the impact of large-scale sport events (LSEs) on international tourist inflows from 1995 to 2019. Our proposed method involves the calculation of tourist potential and the analysis of actual-to-potential ratios before and after the event. This approach allows us to measure the effect of LSE on a particular hosting country rather than its average effect. Our findings demonstrate a strong “crowding-out” effect for international tourists, with only four out of 18 LSEs resulting in a positive effect on tourist arrivals in the host country.
Wisdom and the Other: Responsiveness in development between the egocentric and xenocentric style
Authors: Streib Heinz
Published: October 2023

This text networks contributions from three disciplines: phenomenological-philosophical perspectives on the Other, current discussions in wisdom research, and developmental models of social perspective-taking. The common theme is the concept of the “other,” which is ambivalent, because, on the one hand, it may produce othering that can be the entry point into vicious circles of xenophobia, hate, and annihilation, but the Other may be the source of responsiveness and wisdom, on the other hand. A deeper understanding of responsiveness in the self-other relation results from a reading of Waldenfels’ philosophy. This sharpens the perspective on wisdom emerging from the relation to the Other, for which the neologism “xenosophia” is suggested, which supports the view that wisdom as xenosophia and xenophobia are opposites. The implications of Waldenfels’ responsive phenomenology for wisdom research are exemplified for two key concepts, intellectual humility and perspective-taking. Finally, for a developmental perspective on responsiveness to the Other, a typological model is proposed with reference to models of social perspective-taking in the tradition of Piaget and Selman. The proposed typology includes four styles of responsiveness: the egocentric, conventional, negotiatory, and xenocentric style. Implications for research are discussed.
Optimizing Hyperspectral Imaging Classification Performance with CNN and Batch Normalization
Authors: Zhang Guyang , Abdulla Waleed
Published: October 2023

Background: Hyperspectral imaging systems face numerous challenges in acquiring accurate spatial-spectral hypercubes due to sample surface heterogeneity, environmental instability, and instrumental noise. Preprocessing strategies such as outlier detection, calibration, smoothing, and normalization are typically employed to address these issues, selecting appropriate techniques based on prediction performance evaluation. However, the risk of misusing inappropriate preprocessing methods remains a concern. Methods: In this study, we evaluate the impact of five normalization methods on the classification performance of six different classifiers using honey hyperspectral images. Our results show that different classifiers have varying compatible normalization techniques and that using Batch Normalization with Convolutional Neural Networks (CNN) can significantly improve classification performance and diminish the variations among other normalization techniques. The CNN with Batch Normalization can achieve a macro average F1 score of ≥0.99 with four different normalization methods and ≥0.97 without normalization. Furthermore, we analyze kernel weights' distribution in the CNN models' final convolutional layers using statistical measurements and kernel density estimation (KDE) graphs. Results: We find that the performance improvements resulting from adding BatchNorm layers are associated with kernel weight range, kurtosis, and density around 0. However, the differences among normalization methods do not show a strong correlation with kernel weight distribution. In conclusion, our findings demonstrate that the CNN with Batch Normalization layers can achieve better prediction results and avoid the risk of inappropriate normalization.
Single-cell characterization of self-renewing primary trophoblast organoids as modeling of EVT differentiation and interactions with decidual natural killer cells
Authors: Zhuang Bai-Mei , Cao Dan-Dan , Li Tian-Xi , Liu Xiao-Feng , Lyu Min-Min , Wang Si-Dong , Cui Xin-Yuan , Wang Li , Chen Xiao-Lin , Lin Xiao-Li , Lee Cheuk-Lun , Chiu Philip C.N. , Yeung William S.B. , Yao Yuan-Qing
Published: October 2023

Background

Extravillous trophoblast cell (EVT) differentiation and its communication with maternal decidua especially the leading immune cell type natural killer (NK) cell are critical events for placentation. However, appropriate in vitro modelling system and regulatory programs of these two events are still lacking. Recent trophoblast organoid (TO) has advanced the molecular and mechanistic research in placentation. Here, we firstly generated the self-renewing TO from human placental villous and differentiated it into EVTs (EVT-TO) for investigating the differentiation events. We then co-cultured EVT-TO with freshly isolated decidual NKs for further study of cell communication. TO modelling of EVT differentiation as well as EVT interaction with dNK might cast new aspect for placentation research.

Results

Single-cell RNA sequencing (scRNA-seq) was applied for comprehensive characterization and molecular exploration of TOs modelling of EVT differentiation and interaction with dNKs. Multiple distinct trophoblast states and dNK subpopulations were identified, representing CTB, STB, EVT, dNK1/2/3 and dNKp. Lineage trajectory and Seurat mapping analysis identified the close resemblance of TO and EVT-TO with the human placenta characteristic. Transcription factors regulatory network analysis revealed the cell-type specific essential TFs for controlling EVT differentiation. CellphoneDB analysis predicted the ligand-receptor complexes in dNK-EVT-TO co-cultures, which relate to cytokines, immunomodulation and angiogenesis. EVT was known to affect the immune properties of dNK. Our study found out that on the other way around, dNKs could exert effects on EVT causing expression changes which are functionally important.

Conclusion

Our study documented a single-cell atlas for TO and its applications on EVT differentiation and communications with dNKs, and thus provide methodology and novel research cues for future study of human placentation.
Dynamic characteristics and functional analysis provide new insights into the role of GauERF105 for resistance against Verticillium dahliae in cotton
Authors: Wang Yanqing , Umer Muhammad Jawad , Cai Xiaoyan , Yang Mengying , Hou Yuqing , Xu Yanchao , Batool Raufa , Mehari Teame Gereziher , Zheng Jie , Wang Yuhong , Wang Heng , Li Zhikun , Zhou Zhongli , Liu Fang
Published: October 2023

Background

The cotton industry suffers significant yield losses annually due to Verticillium wilt, which is considered the most destructive disease affecting the crop. However, the precise mechanisms behind this disease in cotton remain largely unexplored.

Methods

Our approach involved utilizing transcriptome data from G. australe which was exposed to Verticillium dahliae infection. From this data, we identified ethylene-responsive factors and further investigated their potential role in resistance through functional validations via Virus-induced gene silencing (VIGS) in cotton and overexpression in Arabidopsis.

Results

A total of 23 ethylene response factors (ERFs) were identified and their expression was analyzed at different time intervals (24 h, 48 h, and 72 h post-inoculation). Among them, GauERF105 was selected based on qRT-PCR expression analysis for further investigation. To demonstrate the significance of GauERF105, VIGS was utilized, revealing that suppressing GauERF105 leads to more severe infections in cotton plants compared to the wild-type. Additionally, the silenced plants exhibited reduced lignin deposition in the stems compared to the WT plants, indicating that the silencing of GauERF105 also impacts lignin content. The overexpression of GauERF105 in Arabidopsis confirmed its pivotal role in conferring resistance against Verticillium dahliae infection. Our results suggest that WT possesses higher levels of the oxidative stress markers MDA and H2O2 as compared to the overexpressed lines. In contrast, the activities of the antioxidant enzymes SOD and POD were higher in the overexpressed lines compared to the WT. Furthermore, DAB and trypan staining of the overexpressed lines suggested a greater impact of the disease in the wild-type compared to the transgenic lines.

Conclusions

Our findings provide confirmation that GauERF105 is a crucial candidate in the defense mechanism of cotton against Verticillium dahliae invasion, and plays a pivotal role in this process. These results have the potential to facilitate the development of germplasm resistance in cotton.
OsCBL1 modulates rice nitrogen use efficiency via negative regulation of OsNRT2.2 by OsCCA1
Authors: Hu Zhao , Guo Yutan , Ying Suping , Tang Yunting , Niu Jiawei , Wang Ting , Huang Ruifeng , Xie Hongwei , Wang Wenya , Peng Xiaojue
Published: October 2023

Background

For cereal crop breeding, it is meaningful to improve utilization efficiency (NUE) under low nitrogen (LN) levels while maintaining crop yield. OsCBL1-knockdown (OsCBL1-KD) plants exhibited increased nitrogen accumulation and NUE in the field of low N level.

Results

OsCBL1-knockdown (OsCBL1-KD) in rice increased the expression of a nitrate transporter gene OsNRT2.2. In addition, the expression of OsNRT2.2, was suppressed by OsCCA1, a negative regulator, which could directly bind to the MYB-binding elements (EE) in the region of OsNRT2.2 promoter. The OsCCA1 expression was found to be down-regulated in OsCBL1-KD plants. At the low Nitrogen (N) level field, the OsCBL1-KD plants exhibited a substantial accumulation of content and higher NUE, and their actual biomass remained approximately as the same as that of the wild type.

Conclusion

These results indicated that down-regulation of OsCBL1 expression could upregulate the expression of OsNRT2.2 by suppressing the expression of OsCCA1and then increasing the NUE of OsCBL1-KD plants under low nitrogen availability.
Gender differences in caregiver attitudes and unmet needs for activities of daily living (ADL) assistance among older adults with disabilities
Authors: Woo Selin , Cui Ying , Kim Suyeon , Choi Mankyu
Published: October 2023

Background

With a rapidly ageing population and a decline in the availability of family caregivers, the number of older adults with disabilities who have unmet long-term care needs is gradually increasing worldwide. However, whether there are gender differences in the association between primary caregivers or their attitudes and unmet needs for activities of daily living (ADL) assistance remains largely unknown.

Methods

This study used the latest 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), containing the data of 1187 older adults with disabilities aged 65 and older, to identify gender differences in the attitudes of primary caregivers toward the unmet needs for ADL assistance among with disabilities adults in China. Binary logistic regression analysis was conducted to determine the effects of primary caregivers and their caregiving attitudes on the unmet care experiences of older adults with ADLs. In addition, a gender-stratified analysis was conducted to compare the differences based on older adults’ gender.

Results

The results revealed that the lack of positive attitudes from primary caregivers might create a situation of unmet needs for ADL assistance among older adults. When family members carry the main burden of care, older adults with disabilities, especially older women, have a lower level of unmet needs for ADL assistance. Therefore, it is important to consider gender-specific interventions to improve ADL assistance among older adults.

Conclusions

The findings suggest that the presence of a family member as a caregiver has a significant effect on unmet needs for ADL assistance in women, highlighting the importance of developing an emotional bond with the caregiver. Given that the availability of informal caregivers, such as family members, is declining, it is crucial to provide financial assistance and formal services, such as paid home services and community-based care services, and reduce the burden on family caregivers to address the unmet needs for ADL assistance among older adults with disabilities in China.
Dynamic evaluation of unruptured intracranial aneurysms by 4D-CT angiography: comparison with digital subtraction angiography (DSA) and surgical findings
Authors: Yang Liping , Gao Xing , Gao Chao , Xu Shichuan , Cao Shaodong
Published: October 2023

Background

This study was to prospectively investigate the feasibility of four-dimensional computed tomography angiography (4D-CTA) with electrocardiogram-gated (ECG) reconstruction for preoperative evaluation of morphological parameters, and compared with digital subtraction angiography (DSA). We also aimed to detect pulsation in unruptured intracranial aneurysms (UIAs) by using 4D-CTA, as a potential predicting factor of growth or rupture.

Materials

64 patients with 64 UIAs underwent ECG-gated dynamic 4D-CTA imaging before treatment, of which 46 patients additionally underwent DSA. Original scanning data were reconstructed to produce 20 data sets of cardiac cycles with 5%-time intervals. The extent of agreement on UIAs morphological features assessed with 4D-CTA and DSA was estimated using the k coefficient of the Kappa test. The radiation doses were also calculated and compared between 4D-CTA and DSA. In the aneurysmal surgically treated in our institution, we were able to compare the surgical findings of the aneurysm wall with 4D-CTA images. We performed long-term follow-up on untreated patients.

Results

The morphological characteristics detected by 4D-CTA and DSA were consistent in aneurysm location (k = 1.0), shape (k = 0.76), maximum diameter (k = 0.94), aneurysm neck (k = 0.79) and proximity to parent and branch vessels (k = 0.85). 4D-CTA required lower radiation doses (0.32 ± 0.11 mSv) than DSA (0.84 ± 0.37 mSv, P < 0.001). Pulsation was detected in 26 of the 64 unruptured aneurysms, and all underwent neurosurgical clipping or interventional embolization. In aneurysms surgically treated in our hospital, we observed a significant correlation between 4D-CTA findings and surgical evaluation of the aneurysmal wall, in particular the irregular pulsations detected on 4D-CTA have demonstrated to correspond to dark-reddish thinner wall at surgery.

Conclusions

In this proof-of-concept study, 4D-CTA provided real-time, non-invasive preoperative assessments of UIAs comparable to DSA. Moreover, optimal correlation between the irregular pulsation detected by 4D-CTA and the surgical findings support a possible role of this technique to identify aneurysms with a higher risk of rupture.
Identifying key genes for diabetic kidney disease by bioinformatics analysis
Authors: Xu Yushan , Li Lan , Tang Ping , Zhang Jingrong , Zhong Ruxian , Luo Jingmei , Lin Jie , Zhang Lihua
Published: October 2023

Background

There are no reliable molecular targets for early diagnosis and effective treatment in the clinical management of diabetic kidney disease (DKD). To identify novel gene factors underlying the progression of DKD.

Methods

The public transcriptomic datasets of the alloxan-induced DKD model and the streptozotocin-induced DKD model were retrieved to perform an integrative bioinformatic analysis of differentially expressed genes (DEGs) shared by two experimental animal models. The dominant biological processes and pathways associated with DEGs were identified through enrichment analysis. The expression changes of the key DEGs were validated in the classic db/db DKD mouse model.

Results

The downregulated and upregulated genes in DKD models were uncovered from GSE139317 and GSE131221 microarray datasets. Enrichment analysis revealed that metabolic process, extracellular exosomes, and hydrolase activity are shared biological processes and molecular activity is altered in the DEGs. Importantly, Hmgcs2, angptl4, and Slco1a1 displayed a consistent expression pattern across the two DKD models. In the classic db/db DKD mice, Hmgcs2 and angptl4 were also found to be upregulated while Slco1a1 was downregulated in comparison to the control animals.

Conclusions

In summary, we identified the common biological processes and molecular activity being altered in two DKD experimental models, as well as the novel gene factors (Hmgcs2, Angptl4, and Slco1a1) which may be implicated in DKD. Future works are warranted to decipher the biological role of these genes in the pathogenesis of DKD.
Completeness of regional cancer registry data in Northwest Russia 2008-2017
Authors: Barchuk Anton , Tursun-zade Rustam , Nazarova Ekaterina , Komarov Yuri , Tyurina Ekaterina , Tumanova Yulia , Belyaev Alexey , Znaor Ariana
Published: October 2023

Background

A national framework for population-based cancer registration was established in Russia in the late 1990s. Data comparability and validity analyses found substantial differences across ten population-based cancer registries (PBCRs)in Northwest Russia, and only four out of ten met international standards. This study aimed to assess the completeness of the PBCR data of those registries.

Methods

Qualitative and quantitative methods recommended for completeness and timeliness assessment were applied to the data from ten Russian regional PBCRs in Northwest Russia, covering a population of 13 million. We used historic data methods (using several European PBCRs reference rates), mortality-to-incidence ratios (M:I) comparison, and death certificate methods to calculate the proportion of unregistered cases (Lincoln-Petersen estimator and Ajiki formula).

Results

Incidence rate trends of different cancer types were stable over time (except one region - Leningrad oblast). A slight drop in incidence rates in older age groups for several sites in the Northwestern regions was observed compared to the reference from European countries. Comparing M:I ratios against five-year survival revealed systematic differences in Leningrad oblast and Vologda oblast. Assessment of completeness revealed low or unrealistic estimates in Leningrad oblast and completeness below 90% in St. Petersburg. In other regions, the completeness was above 90%. The national annual report between 2008-2017 did not include about 10% of the cases collected later in the registry database of St. Petersburg. This difference was below 3% for Arkhangelsk oblast, Murmansk oblast, Novgorod oblast, Vologda oblast and the Republic of Karelia.

Conclusions

Eight out of ten regional PBCRs in Northwest Russia collected data with an acceptable degree of completeness. Mostly populated St. Petersburg and Leningrad oblast did not reach such completeness. PBCR data from several regions in Northwest Russia are suitable for epidemiological research and monitoring cancer control activities.
BUB1, BUB1B, CCNA2, and CDCA8, along with miR-524-5p, as clinically relevant biomarkers for the diagnosis and treatment of endometrial carcinoma
Authors: Hao Qirong , Wu Hongqin , Liu Erniao , Wang Lina
Published: October 2023

Background

Endometrial carcinoma (EC) is a malignant tumor of the female reproductive tract that has been associated with increased morbidity and mortality. This study aimed to identify biomarkers and potential therapeutic targets for EC.

Methods

A publicly available transcriptome data set comprising 587 EC cases was subjected to a comprehensive bioinformatics analysis to identify candidate genes responsible for EC occurrence and development. Next, we used clinical samples and cell experiments for validation.

Results

A total of 1,617 differentially expressed genes (DEGs) were identified. Analysis of patient survival outcomes revealed that BUB1, BUB1B, CCNA2, and CDCA8 were correlated with prognosis in patients with EC. Moreover, assessment of clinical samples confirmed that BUB1, BUB1B, CCNA2 and CDCA8 were strongly expressed in EC tissues. Additionally, bioinformatics and luciferase reporter assays confirmed that miR-524-5p can target and regulate these four genes. Overexpression of miR-524-5p significantly inhibited EC Ishikawa cells viability, migration and invasion. Inhibition of miR-524-5p showed the opposite results.

Conclusions

Expression of miR-524-5p reduced the migration and invasion of Ishikawa EC cells, and decreased BUB1, BUB1B, CCNA2, and CDCA8 expression. miR-524-5p, as well as BUB1, BUB1B, CCNA2, and CDCA8, may be clinically relevant biomarkers for the diagnosis and treatment of EC.
Visuospatial ability and attention as risk factors for suicidal ideation in middle-aged and elderly schizophrenia patients: a cross-sectional study
Authors: Wang Qiongzhang , Tang Wei , Zhang Junjie , Wang Yiwei , Wang Qing , Ma Yimin , Mao Jian Kai , Ye Chengyu , Yu Xin
Published: October 2023

Background

Schizophrenia patients have a high risk of suicide, and their cognition function is impaired with increasing age. The association between neurocognitive and suicidality in schizophrenia patients are heterogeneous. We aimed to explore the relationship between neurocognitive function and suicidal ideation in schizophrenia patients across age groups.

Methods

A total of 587 patients with schizophrenia were enrolled in this study. The schizophrenia patients were divided into young group (aged 18–44) and middle-aged and elderly group (aged 45–70). The schizophrenia patients were divided into suicidal ideation group and non-suicidal ideation group according to the evaluation results of the Beck Scale for Suicide Ideation. Insomnia symptoms were measured by the Insomnia Severity Index (ISI). Psychotic symptoms were measured by the Positive and Negative Syndrome Scale (PANSS), and cognitive function was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).

Results

There was a negative correlation between the age and attention scores of RBANS (P = 0.018). The young schizophrenia patients had higher risk of suicidality than middle-aged and elderly schizophrenia patients (P = 0.001). In the logistic regression analysis, the scores of ISI and positive symptoms scores of PANSS were associated with suicidal ideation among young schizophrenia patients (All P < 0.05). Age, BMI, the scores of ISI, general symptoms scores of PANSS, visuospatial scores of RBANS and attention scores of RBANS were associated with suicidal ideation in middle-aged and elderly schizophrenia patients (All P < 0.05).

Conclusions

High visuospatial scores of RBANS and attention scores of RBANS were risk factors for suicidal ideation in middle-aged and elderly schizophrenia patients.
Prevalence and characteristics of comorbid stroke and traumatic brain injury in a real-world population: findings from a nationally representative cross-sectional survey in China
Authors: Jiang Bin , Sun Dongling , Sun Haixin , Ru Xiaojuan , Liu Hongmei , Ge Siqi , Fu Jie , Wang Wenzhi
Published: October 2023

Background

In China, data on the prevalence and characteristics of comorbid stroke and traumatic brain injury (TBI) in real-world populations are still lacking but of paramount importance for the evidence-based prevention and control of the comorbidity of the two diseases. This study aimed to investigate the prevalence and characteristics of comorbid stroke and TBI in a real-world population.

Methods

In 2013, a nationally representative, door-to-door survey on stroke and TBI using a complex, multistage, probability sampling design was conducted among approximately 600,000 participants from 155 urban and rural areas in China (Ethic ID: KY2013-006-01). The weighted prevalence of comorbid stroke and TBI was estimated using individuals’ final weight. A Poisson regression analysis was used to compare the rate ratio of the comorbidity prevalence among different subgroups of the population, including age, sex, place of residence, and geographic location subgroups. For analyses of associations between the comorbidities and predictors of interest, all other variables were adjusted for in a multinomial logistic regression model.

Results

Among the 596,536 people, 219 patients with comorbid stroke and TBI were identified. The point prevalence of comorbid stroke and TBI weighted to the China 2010 census population was 29.30 (95% CI: 22.69–37.84) per 100,000 population in China. The adjusted prevalence of post-TBI stroke in patients with previous TBI was significantly higher than that of post-stroke TBI in patients with previous stroke (6021.3 vs. 811.1 per 100,000 people; rate ratio: 11.001; 95% CI: 8.069–14.998). Patients with nonconcussion had significantly higher rates of both pre-stroke TBI (odds ratio: 4.694; 95% CI: 3.296–6.687) and post-stroke TBI (odds ratio: 6.735; 95% CI: 3.719–12.194) than patients with concussion. Compared to patients with ischaemic stroke, patients with subarachnoid haemorrhage (odds ratio: 2.044; 95% CI: 1.097–3.809) and intracerebral haemorrhage (odds ratio: 1.903; 95% CI: 1.296–2.795) had significantly higher rates of post-TBI stroke.

Conclusions

The high prevalence of stroke among TBI patients is becoming a new public health issue. TBI patients, especially those with nonconcussion TBI, are more likely to develop comorbid stroke and TBI than stroke patients, especially ischaemic stroke patients.
Familial dysalbuminemic hyperthyroxinemia combined with Graves’ disease: a rare case report
Authors: Li Yuanmeng , Chi Yue , Chai Xiaofeng , Liu He , Li Naishi , Lian Xiaolan
Published: October 2023

Background

Familial dysalbuminemic hyperthyroxinemia (FDH) is an autosomal dominant disease characterised by an abnormally increased affinity of albumin for serum thyroxine. Assay interference and differential diagnosis remain challenging for FDH. The condition is more complicated when FDH is combined with primary thyroid diseases. Co-occurrence of FDH and Graves’ disease is rare.

Case presentation

We report the case of a 28-year-old woman with complex FDH and coexisting Graves’ disease. Initially, the existence of FDH was not recognised. Graves’ disease was relieved after treatment with antithyroid drugs and two administrations of radioactive iodine therapy. She subsequently developed primary hypothyroidism and was prescribed levothyroxine replacement. However, thyroid function failed to normalise despite frequent levothyroxine dose adjustments. Ultimately, syndromes involving the inappropriate secretion of thyroid-stimulating hormone (IST) were considered, and FDH was successfully differentiated from other causes of IST.

Conclusions

A greater focus on FDH when investigating the causes of IST is critical to correctly evaluate thyroid function status and avoid inappropriate treatment, especially in complicated cases with concurrent FDH and primary thyroid diseases.
Resource use and cost associated with computerized decision support system and usual care in managing patients with atrial fibrillation: analysis of IMPACT-AF randomized trial data
Authors: Humphries Brittany , Cox Jafna L , Parkash Ratika , Thabane Lehana , Foster Gary A , MacKillop James , Nemis-White Joanna , Hamilton Laura , Ciaccia Antonio , Choudhri Shurjeel H , Kovic Bruno , Xie Feng
Published: October 2023

Background

IMPACT-AF is a prospective, randomized, cluster design trial comparing atrial fibrillation (AF) management with a computerized decision support system (CDS) to usual care (control) in the primary care setting of Nova Scotia, Canada. The objective of this analysis was to compare the resource use and costs between CDS and usual care groups.

Methods

Case costing data, 12-month self-administered questionnaires, and monthly diaries from IMPACT-AF were used in this analysis. Descriptive statistics were used to compare costs and resource use between groups. All costs are presented in 2021 Canadian dollars and cover the 12-month period of participation in the study.

Results

A total of 1,145 patients enrolled in the trial. Case costing data were available for 466 participants (41.1%), 12-month self-administered questionnaire data for 635 participants (56.0%) and monthly diary data for 223 participants (19.7%). Emergency department visits and hospitalizations comprised the most expensive component of AF care. Across all three datasets, there were no statistically significant differences in costs or resource use between CDS and usual care groups.

Conclusions

Although there were no significant differences in resource use or costs among CDS and usual care groups in the IMPACT-AF trial, this study provides insight into the methodology and practical challenges of collecting economic data alongside a trial.

Registration

Clinicaltrials.gov (registration number: NCT01927367, date of registration: 2013-08-20).