bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on the co-combustion behavior of rice straw with coal gangue and fixation of alkali metals and ash melting characteristics
Authors: Jia Xiangru , Zhang Jian , Yun Feng , Liu Shaoqing , Yue Xia , Ding Yaqian , Xia Xuemin , Cheng Zhenbo
Published: March 2024

Because it is clean, low carbon, and renewable, biomass offers the greatest practical value. Nevertheless, during combustion, issues like slagging, agglomeration, and corrosion can occur due to the high concentration of Cl and alkali metals (K and Na), which lowers combustion efficiency. On the other hand, gangue (CG), when combined with biomass as an additive, can successfully prevent slagging during the burning process. However, more research is needed to determine how CG affects the properties of ash melting, alkali metal immobilization, and biomass combustion behavior. Thus, the impacts of CG on the co-combustion behavior, fugitive forms of alkali metals, and ash melting properties of rice straw (RS) were examined in this article. X-ray diffraction analysis, scanning electron microscopy, thermogravimetric-differential thermal analysis, ash melting temperature test, and tube furnace combustion studies were among the experimental techniques utilized to characterize the ash. The findings demonstrated that adding CG to biomass might enhance both the overall combustion performance and the flammability index, with notable synergistic effects connected to the ratio of biomass to CG. Alkali metals in the ash could be efficiently fixed by CG, and it was found that adding 20% of CG to the biomass had the best results. The degree of ash melt slagging was successfully reduced and controlled with a rise in the CG addition ratio, and silica-aluminate with a higher melting point and stable nature was produced, which could effectively raise the biomass's ash melting temperature.
Assessing Focal Spot Alignment in Clinical Linear Accelerators: A Comprehensive Evaluation with Triplet Phantoms
Authors: Riis Hans Lynggaard , Engstrøm Kenni Højsgaard , Slama Luke , Dass Joshua , Ebert Martin , Rowshanfarzad Pejman
Published: March 2024

Purpose
A fundamental parameter to evaluate the beam delivery precision and stability on a clinical linear accelerator (linac) is the focal spot position (FSP) measured relative to the collimator axis of the radiation head. The aims of this work were to evaluate comprehensive data on FSP acquired on linacs in clinical use and to establish the ability of alternative phantoms to detect effects on patient plan delivery related to FSP.
Methods
FSP measurements were conducted using a rigid phantom holding two ball-bearings at two different distances from the radiation source. Images of these ball-bearings were acquired using the electronic portal imaging device (EPID) integrated with each linac. Machine QA was assessed using a radiation head-mounted PTW STARCHECK phantom. Patient plan QA was investigated using the SNC ArcCHECK phantom positioned on the treatment couch, irradiated with VMAT plans across a complete 360° gantry rotation and three X-ray energies.
Results
This study covered eight Elekta linacs, including those with 6 MV, 18 MV, and 6 MV flattening-filter-free (FFF) beams. The largest range in the FSP was found for 6 MV FFF. The FSP of one linac, retrofitted with 6 MV FFF, displayed substantial differences in FSP compared to 6 MV FFF beams on other linacs, which all had FSP ranges less than 0.50 mm and 0.25 mm in the lateral and longitudinal directions, respectively. The PTW STARCHECK phantom proved effective in characterising the FSP, while the SNC ArcCHECK measurements could not discern FSP-related features.
Conclusions
Minor variations in FSP may be attributed to adjustments in linac parameters, component replacements necessary for beam delivery, and the wear and tear of various linac components, including the magnetron and gun filament. Consideration should be given to the ability of any particular phantom to detect a subsequent impact on the accuracy of patient plan delivery.
Molecular Characterization of the NAD1 Gene Region in Human, Sheep, and Cattle Cystic Echinococcosis Isolates
Authors: Halidi Ahmed Galip , Cengiz Zeynep Taş , Beyhan Yunus Emre
Published: March 2024

The study aims to molecularly characterize the mitochondrial NAD1 gene region in cyst samples from humans, sheep, and cattle with cystic echinococcosis. It used 75 human cyst materials and 25 each from sheep and cattle. All 125 samples underwent processes for molecular characterization of Echinococcus granulosus's NAD1 mitochondrial gene region. The distribution of hydatid cyst samples from humans showed similar lung localization in both genders, but a higher liver localization in males. In cattle, liver localization was primary, while in sheep, lung localization was more common. All samples produced a band of 864 bp in size upon amplification. Sequence comparison of the isolates with Genbank entries confirmed all our samples as E. granulosus sensu stricto. Among these, nine were identified as G3 strain and 51 as G1 strain. Host-wise, 24 of 30 human samples were G1, 6 were G3; in sheep, 13 were G1, 2 were G3; in cattle, 14 were G1 and one was G3. Comparison of the 51 G1 strain samples with Genbank's reference G1 strains showed that 42 matched 100%, while 9 had mutations in different regions, a new finding. The study concluded that the G1 strain is dominant in all three hosts and identified various mutations. These findings contribute to the molecular epidemiological data of cystic echinococcosis.
Assessing the distribution of cancer stem cells in tumorspheres
Authors: Fotinós Jerónimo , Marks María Paula , Barberis Lucas , Vellón Luciano
Published: March 2024

In previous theoretical research, we inferred that cancer stem cells (CSCs), the cells that presumably drive tumor growth and resistance to conventional cancer treatments, are not uniformly distributed in the bulk of a tumorsphere. To confirm this theoretical prediction, we cultivated tumorspheres enriched in CSCs, and performed immunofluorecent detection of the stemness marker SOX2 using a confocal microscope.
In this article, we present a method developed to process the images that reconstruct the amount and location of the CSCs in the tumorspheres. Its advantage is the use of a statistical criterion to classify the cells in stem and differentiated instead of setting an arbitrary threshold. From the analysis of the results of the methods using graph theory and computational modeling, we concluded that the distribution of Cancer Stem Cells in an experimental tumorsphere is non-homogeneous.
This method is independent of the tumorsphere assay being useful for analyzing images in which several different kinds of cells are stained with different markers.
Interactions between multiple serum metals and genetic variants for type 2 diabetes risk: A prospective Chinese cohort study
Authors: Shen Bohui , Liu Jia , Gong Yan , Guo Xiangxin , Shen Qian , Yang Man , Liu Yongchao , Chen Hai , Yang Zhijie , Liu Yaqi , Zhu Xiaowei , Wang Lu , Jin Guangfu , Qian Yun
Published: March 2024

Background: Relationships between metal exposure and type 2 diabetes (T2D) varied depending on the metal involved. In addition, there is limited epidemiological evidence on the interaction between metal exposure and genetic risk for T2D. Therefore, we analyzed the interaction effect of serum concentrations of multiple metals and genetic variants on T2D incidence in the general population.
Methods: A prospective cohort study with 14 years of follow-up was performed with 4507 participants without noncommunicable diseases in the Wuxi Non-Communicable Diseases (Wuxi NCDs) cohort. Twenty-one metals were measured using inductively coupled plasma‒mass spectrometry (ICP-MS). Eighty T2D-associated single nucleotide polymorphisms (SNPs) identified by GWAS were genotyped. Two polygenic risk score (PRS) models based on 46 SNPs from East Asians and 80 SNPs from Europeans and East Asians were constructed. A Cox regression model was used to explore the associations of serum metals and their interaction effects with T2D.
Results: Of the 4507 participants, 350 were newly diagnosed with T2D during the 14-year follow-up. After adjusting for age, smoking status, body mass index (BMI), hip circumference (HC), waist circumference (WC), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), fasting blood glucose (FBG), triglyceride (TG), and blood pressure (BP), serum vanadium (V), chromium (Cr), manganese (Mn), molybdenum (Mo), barium (Ba) and lead (Pb) levels were correlated with decreased T2D risk, while zinc (Zn) levels were correlated with elevated T2D risk (P<0.05). Mo, Ba and Pb showed interactive effects with the combined PRS derived from 80 SNPs and with the PRS specific for east Asians derived from 46 SNPs. Regardless of race, the risk of T2D increased with decreasing Mo, Ba, and Pb concentrations and increasing PRS. At the lowest Mo, Ba and Pb levels and the highest PRS derived from 80 SNPs, the risk of T2D was 4.18 times greater (HR=4.18, P value for interaction=1.14×10-4 for Mo and PRS), 1.77 times greater (HR=1.77, P value for interaction=0.012 for Ba and PRS) and 14.02 times greater (HR=14.02, P value for interaction=0.009 for Pb and PRS) than that of the reference group, respectively.
Conclusions: Our results showed that V, Cr, Mn, Mo, Ba and Pb were negatively correlated with T2D, while Zn was positively correlated. There was an interaction effect between serum Mo, Ba, and Pb levels and PRS on the occurrence of T2D.
Multicentre Case-Control Study of Pneumococcal Infections Among Children with Pneumonia in Peninsular Malaysia (MY Pneumo): A Study Protocol
Authors: Ramzi Nurul Hanis , Hoong Andrew Tan Chun , Johari Nur Alia , Nathan Anna Marie , Teh Cindy Shuan Ju , Sulaiman Norhayati Aida , Ilias Mohamad Ikram , Deris Zakuan Zainy , Hazlan Siti Nur Haidar , Nasir Nur Syafiqah Mohamad , Bakar Asrar Abu , Helmi Muhd Alwi Muhd , Juhari Wan Khairunnisa Wan , Kamarudin Norhidayah , Chong Chun Wie , Cleary David W. , Clarke Stuart C. , Sulaiman Lokman Hakim
Published: March 2024

Background: S. pneumoniae (SPN) is the most common cause of pneumonia. The disease can be effectively prevented through immunisation. Since December 2020, the Malaysian Government has included the 10-valent pneumococcal conjugate vaccine (PCV10) for all infants born on or after 1 January 2020 as part of the National Immunisation Programme (NIP). However, the epidemiology of pneumonia remains poorly understood. To fill the knowledge gap, we established a multicentre surveillance study to understand the burden of pneumococcal pneumonia among young children in Peninsular Malaysia.
Methods: MY Pneumo is a multicentre prospective case-control study conducted in three sentinel sites located in three different states of Peninsular Malaysia – Kuala Lumpur, Pahang, and Kelantan. A cohort of at least 500 incident cases and 500 controls is enrolled beginning in October 2021 and matched for age. Cases are hospitalised children <5 years with radiologically confirmed pneumonia, and the controls are children without any features suggestive of pneumonia. Clinical samples, including nasopharyngeal swabs (NPS) and urine, are collected according to the study protocol. Biological fluids such as blood, cerebrospinal fluid (CSF) and pleural fluid are obtained from invasive pneumonia disease (IPD) patients, if available. All children are tested for SPN using polymerase chain reaction (PCR) and pneumococcal urine antigen test (PUAT) using BinaxNow.
Discussion: Surveillance data, including carriage rate, serotype variations and the phylogeny data structure of SPN among young children in Malaysia during PCV implementation, will be generated from this study. Trends and patterns of pneumococcal serotypes by different regions are important for targeted public health strategies. Our data will provide baseline information for estimating the impact of PCV10 implementation and will influence policymakers' decisions regarding the upgrade from PCV10 to a higher-valency conjugate vaccine in Malaysia.
Trial registration: This project was registered at ClinicalTrials.gov (NCT04923035) on June 11th, 2021. The study protocol was approved by the International Medical University Joint-Committee on Research & Ethics (4.15/JCM-216/2021) and the Institutional Review Board at sentinel sites (USM/JEPeM/21020190, IREC 2021-114, MREC ID No: 2021128-9769) and University of Southampton's Ethics and Research Governance (ERGo II 64844).
Eastern USA summer temperatures since 1461 CE show connections to volcanic forcing and jet stream dynamics
Authors: Harley Grant , Maxwell Justin , King Karen , Rayback Shelly , Cook Edward , Hansen Christopher , Maxwell Richard Stockton , Reinig Frederick , Esper Jan , Au Tsun Fung , Bergan Ellen , Brings Katherine , Koenig Nick , Lockwood Benjamin , Thaxton Richard
Published: March 2024

Contextualizing current increases in Northern Hemisphere temperatures is precluded by the short instrumental record of the past ca. 120 years and the dearth of temperature-sensitive proxy records, particularly at lower latitudes south of <50 °N. We develop a network of 29 blue intensity chronologies derived from tree rings of Tsuga canadensis (L.) Carrière and Picea rubens Sarg. trees distributed across the Mid-Atlantic and Northeast USA (MANE)---a region underrepresented by multi-centennial temperature records. We use this network to reconstruct March-September air temperatures back to 1461 CE based on a model that explains 62% of the instrumental temperature variance from 1901-1976 CE. Since 1998 CE, MANE summer temperatures are consistently the warmest within the context of the past 561 years exceeding the 1951-1980 mean +1.3 °C. Temperature variability across MANE is linked with the position and intensity of the Northern Hemisphere polar jet stream (NHJ), which triggers regional warm and cool extremes, respectively. The new network reveals a strong regional temperature response to large volcanic eruptions, with the most severe temperature departure of -1.05 °C following the eruption of Mount Tambora in 1815 CE. Expanding the MANE network to the west and south and combining it with existing temperature-sensitive proxies across North America is an important next step toward producing a gridded temperature reconstruction field for North America.
Concomitant Braf V600e and Nras Q61r Mutations in the Same Thyroid Nodule : a Case Report
Authors: Brogna M. , Collina F. , Losito S. , Clery E. , Montone A. , DelSesto M. , Schiano M. Rosaria , LaSala L. , Ferrara G.
Published: March 2024

Papillary thyroid cancer(PTC) is the most common type of well differentiated endocrine malignancy Generally thyroid nodules with multiple oncogenic mutations are uncommon with an occurrence whic may be related to more aggressive biological behavior of tumors. (6).
RET/PTC rearrangement, RAS, and BRAF mutations are considered to be mutually exclusive in papillary thyroid carcinoma (PTC) (8). Concomitant RET/PTC, RAS, or BRAF mutations have been documented, although the impact of these mutations for tumor growth and survival is debated (6,7,8).
CASE PRESENTATION: Here we present a rare case of woman 46 years old with a neck mass and thyroid nodule classified as TIR5 on cytological examination.
We found contemporary BRAF p.(Val600Glu) (p. (V600E); c. 1799T>A) and NRAS p. (Gln61Arg) (p. (Q61R); c.182A>G) mutations in morphologically different areas within the same lobe (the right one); The two lesions show different morphology. The mutated BRAF lesion showed morphological characteristics compatible with classic papillary carcinoma; The mutant NRAS lesion shows morphological features compatible with follicular variant papillary carcinoma.
To the best of our knowlodges, this is the first time that such mutations, which are normally mutually exclusive, have been detected at the same time.
CONCLUSIONS: The finding of synchronous mutations is a rare occurrence suggesting for intratumoral heterogeneity (ITH) even in PTC.
Patients with multiple mutations have a clinical worse prognosis, generally characterized by an aggressive thyroid cancer, which may influence the surgical treatment, chemotherapy, and BRAFV600E mutation-targeting therapy.
Optimized Bionic Drug Delivery Inducing Immunogenic Cell Death and cGAS-STING Pathway Activation for Enhanced Photochemotherapy-Driven Immunotherapy in Prostate Cancer
Authors: Wu Chunchen , Feng Dexiang , Xu Hongbo , He Zhangxin , Hou Jianquan
Published: March 2024

Prostate cancer (PCa) presents a challenging disease as it is often characterized as an immunologically “cold” tumor, leading to suboptimal outcomes with current immunotherapeutic approaches in clinical settings. Photodynamic therapy (PDT) harnesses reactive oxygen species generated by photosensitizers (PSs) to disrupt intracellular redox equilibrium. This process induces DNA damage in both the mitochondria and nucleus, activating the process of immunogenic cell death (ICD) and cGAS-STING pathway. Ultimately, this cascade of events leads to the initiation of antitumor immune responses. Nevertheless, existing PSs face challenges, including suboptimal tumor targeting, aggregation-induced quenching, and insufficient oxygen levels in tumor regions. To this end, a versatile bionic nanoplatform (M-TPNPs), has been designed for the simultaneous delivery of the aggregation-induced emission PS TPAQ-Py-PF6 and paclitaxel (PTX). The cell membrane camouflage of the nanoplatform leads to its remarkable abilities in tumor targeting and cellular internalization. Upon laser irradiation, the utilization of TPAQ-Py-PF6 in conjunction with PTX showcases a notable and enhanced synergistic antitumor impact. Additionally, the nanoplatform has the capability to initiate the cGAS-STING pathway, leading to the generation of cytokines. The presence of damage-associated molecular patterns (DAMPs) induces ICD and collaborates with these aforementioned cytokines, leading to the recruitment and facilitation of dendritic cells (DCs) maturation. Consequently, this elicits a systemic immune response against tumors. In summary, this promising strategy highlights the use of a multifunctional biomimetic nanoplatform, combining chemotherapy, PDT, and immunotherapy to enhance the effectiveness of anti-tumor treatment.
Envisioning post pandemic digital social medical aftercare – opportunities and challenges
Authors: Albayrak Bilge , Reimann Margarete , Felderhoff-Mueser Ursula , Podeswik Andreas , Huening Britta Maria , Cordier Larissa Jane
Published: March 2024

Introduction: Socio-medical aftercare (SMN) is a service in Germany for chronically or severely ill children to facilitate transition from hospital to home. A multi-disciplinary team supports the families to organize and coordinate therapies and follow-up care with the goal to shorten hospital stay, ensure success of treatment, and improve self-efficacy and performance. Video consultations (VC) could help overcome challenges in structurally weak regions, complex illnesses, and language barriers.
Objective: 1) To assess the feasibility of this method and the satisfaction of families, we conducted standardized interviews after VC and home visits. 2.) To discuss additional areas where VC can be used to provide future-oriented care for these families.
Methods: A standardized interview with 21 questions using a 7-point Likert scale was applied to evaluate feasibility and parent satisfaction of SMN via VC. VC were conducted using a certified with end-to-end encryption.
Results: A total of 138 interviews with parents were conducted between March 2020 and February 2021 and compared (99 after VC and 39 after in-person consultations). There were no significant differences found between the VC and in-person home visit groups in terms of confidentiality, feasibility, and discussion of private and sensitive information. During home visits, parents reported that their child was more comfortable and that they better understood the instructions and explanations regarding their child's development. They were also more satisfied with the home visit and expressed a greater likelihood of requiring a future home visit.
Conclusions: Parents' acceptance and positive evaluations of the confidentiality of video-consultations offers the possibility of using them beyond the pandemic. However, home visits were preferred. Nevertheless, video consultations can expand the possibilities of SMN and can be a cost- and time-effective tool to reach out to families and their children who require support even in complex situations.
Assessing the impact of both Preimplantation Genetic Testing for Aneuploidy with blastocyst morphologic grade on live birth rates in frozen embryo transfers from fresh and frozen donor oocytes
Authors: Dennis Alyson , Jain Nirali , Clarke Emily Auran , Blakemore Jennifer
Published: March 2024

Purpose: To evaluate the live birth rate (LBR) following donor frozen embryo transfer (dFET) of preimplantation genetic testing for aneuploidy (PGT-A) versus untested donor embryos, stratified by blastocyst morphologic grade (MG).
Methods: This was a retrospective cohort study of 146 patients undergoing dFET of a single euploid blastocyst from fresh or frozen oocytes using PGT-A compared to age-matched controls (1:1 ratio) who did not use PGT-A.
Primary outcome was LBR. LBR was compared amongst cohorts, with further stratification by 1) high/low MG and 2) fresh/frozen oocyte status. Secondary outcomes included perinatal outcomes.
Result(s): Median age in both groups was 44.5 years (p=0.98).
LBR was similar amongst the two cohorts (PGT-A: 57.5% vs. Untested: 50.0%, p=0.20). There was similar LBR in fresh (PGT-A: 59.2% vs. Untested: 50.0%, p=0.20) and frozen (PGT-A: 47.6% vs. Untested: 50.0%, p=0.85) oocyte subgroups.
When stratified by MG, we appreciated similar LBR amongst high qualityblastocysts (PGT-A-High: 56.5% vs. Untested-High: 52.3%, p=0.49) amongst the whole cohort, as well as in fresh (Fresh-PGT-A-High: 58.3% vs. Fresh-Untested-High: 52.9%, p=0.46) and frozen (Frozen-PGT-A-High: 44.4% vs. Frozen-Untested-High: 51.7%, p=0.59) subgroups.
Similarly, we appreciated no difference in LBR amongst low quality blastocysts (PGT-A-Low: 75.0% vs. Untested-Low: 31.2%, p=0.08) amongst the whole cohort, as well as in the fresh (Fresh-PGT-A-Low: 80.0% vs. Fresh-Untested-Low: 16.1%, p=0.08) or frozen(Frozen-PGT-A-Low: 66.7% vs. Frozen-Untested-Low: 40.0%, p=0.56) subgroups.
Gestational age (37.8 weeks, p=1.0) and infant birth weight (PGT-A: 3128.0 grams vs. Untested: 3150.2 grams, p=0.60) were similar.
Conclusion(s): PGT-A did not improve LBR regardless of blastocyst quality from fresh and previously frozen donor oocytes.
Prevalence And Factor Associated of Sleep disturbance Community-Dwelling Older Adults in Indonesia
Authors: Andas Amzal , Wada Fauziah H , Puspitasari Indah , Shoaliha Marathun , Purnamasari Anisa , Andas Netty Huzniati
Published: March 2024

Background: The global population is undergoing a shift in age structure due to increased life expectancy and declining birth rates, particularly in the elderly demographic. The elderly population in Indonesia, specifically in Bekasi District, has experienced a significant rise. Sleep disorders among the elderly have become a serious concern, especially given the escalating risks of degenerative and non-communicable diseases associated with sleep quality. This research focuses on four sub-districts in Bekasi District, aiming to assess the prevalence of sleep disorders among the elderly.
Method: This study employs a quantitative approach with a descriptive analytical design. Stratified Random Sampling technique was utilized to select samples from the elderly population aged 55-90 years in Bekasi District. The Sleep Quality Scale (SQS) was employed as an instrument to measure respondents' sleep disorders. Data analysis involved the use of the Chi-Square test to evaluate the relationship between demographic characteristics, medical history, and the level of sleep disorders.
Results: The study revealed that out of 200 elderly respondents, 75% experienced sleep disorders at a moderate level, 13% at a poor level, and 0.5% at a very poor level. Age, gender, hypertension, diabetes, smoking history, and caffeine consumption were significantly associated with the level of sleep disorders. These factors emerged as independent predictors of sleep disorders in the elderly.
Conclusion: The prevalence of sleep disorders among the elderly in Bekasi District is relatively high. Factors such as age, gender, medical history, and lifestyle behaviors significantly contribute to the level of sleep disorders. Comprehensive prevention and intervention efforts are needed to enhance the sleep quality of the elderly and prevent potential complications arising from sleep disorders.
The psychological impact of the fear index and the spillover effect of fluctuations during the covid-19 epidemic crisis on the stock market using the panel var approach
Authors: gachi vahid
Published: March 2024

The COVID-19 pandemic has turned a health crisis into an economic one, causing stock market fluctuations and affecting macroeconomic indicators in various nations. The behavioral finance field elucidates that investment choices are influenced by "Investor Sentiment," subsequently impacting the valuation of diverse asset classes. Consequently, this study aims to examine the psychological repercussions of the fear index during the initial COVID-19 pandemic outbreak on stock markets in fifteen countries, categorized as either developed or developing. This examination spans two distinct time frames and facilitates a comparative analysis. Empirical findings reveal that during the first surge of the pandemic, the daily influx of new COVID-19 cases globally disrupted investor sentiment, leading to an unprecedented negative return in the market. The market's resilience and the transmission of epidemic-induced fluctuations were notably more conspicuous during the first wave of the pandemic compared to the second. Moreover, the volatility index reached its highest point for the first time after the global financial crisis. This significant upswing in the volatility index highlights the substantially increased demand for put options as a safeguard against the uncertainties caused by the pandemic. Conversely, during the second wave, the results show a noticeable divergence from the first wave, indicating different market trends.
JEL code: I10, I12, I18, G01, G41
Detection and Haplotype Construction of ring Chromosome 17 for Carrier Screening in Preimplantation Genetic Testing
Authors: Zhang Zhiqiang , Gu Mengnan , Huang Yijuan , Ding Taoli , He Shujing , Xu Linan , Li Xiaolan , Xu Ruixia , Kong Lingyin , Zeng Haitao , Ren Zi
Published: March 2024

Background: While preimplantation genetic testing (PGT) carrier screening has proven efficacious in improving assisted reproduction outcomes for individuals with balanced translocations and chromosome inversions, the accurate identification of embryos carrying ring chromosomes remains a substantial challenge, undermining the efficacy of PGT. This study aims to address this gap by pioneering an advanced proband-independent haplotyping technology based on Linked-Read Sequencing technology designed to overcome the limitations of traditional molecular approaches.
Results: Our integrated approach resulted in the identification of an 804 kb copy number variation (CNV) deficiency in the 17q25.3 region by CMA. Pacbio HiFi and Nanopore sequencing techniques refined breakpoint characterization, confirming telomere fusion events in chromosome 17, validated by FISH analysis. Linked-Read Sequencing technology played a pivotal role in precisely detecting CNV breakpoints and confirming end-to-end connections on chromosome 17 by linked reads. This critical insight supported the construction of a specific ring chromosome 17 haplotype for Preimplantation Genetic Testing (PGT) applications.
Conclusions: This study represents a significant advancement in accurately identifying carriers of ring chromosomes and elucidating their impact on Preimplantation Genetic Testing (PGT). Our results underscore the efficacy of Linked-Read Sequencing as a robust and superior method for detecting and precisely localizing ring chromosome breakpoints, offering relatively longer DNA sequences compared to both PacBio and Nanopore technologies. Through the integration of exact breakpoint identification with haplotype linkage analysis, we were able to distinguish embryos carrying ring chromosomes from those with normal karyotypes effectively. This approach is particularly vital for chromosomes with telomeric region fusion, facilitating the construction of distinct haplotypes for affected and unaffected embryos. The methodological advancements achieved in this research significantly enhance the capabilities of PGT, marking a pivotal contribution to genetic diagnostics.
Synthesis and Properties of Functional Polycarbonate Polyurethane Networks Based on Star-shaped Polycarbonate Polyols
Authors: Liu jie , Miao pengcheng , Leng xuefei , Che Jian , Ren zifei , Li yang
Published: March 2024

While much research has been developed on polycarbonate polyurethanes (PCUs) based on trimethylene carbonate, there is a dearth of effort in functional PCU networks. In this study, we attempted to introduce a class benzene ring functional cyclic carbonate monomer to prepare PCUs with self-healing, reprocessable, and excellent mechanical properties. Firstly, we prepared functional hydroxyl-terminated 3-arm star-shaped polycarbonate polyols by ring-opening polymerization, in which the molar ratios of trimethylene carbonate (TMC) and cyclic carbonate (PTO) were varied. Then, the PCU networks were prepared from polycarbonate polyols and hexamethylene diisocyanate, with stannous octoate (Sn(Oct)2) as the catalyst. All PCUs were then subjected to DSC, DMA, and uniaxial tensile testing. The results exhibited that the values of Tg and tensile strength increased with increasing the content of PTO. When the molar content of PTO reaches 25%, the tensile strength of the material is 19.6 MPa, which is a significant increase of 227% compared to the PTMC without adding PTO monomer. Under the influence of catalyst, the urethane bonds exchange within PCUs enables effective self-healing properties and reprocessability. This study offers a feasibility assessment for the design of a functional PCU material with excellent properties.
Correlation between medical coping style and mindfulness level of hospitalized elderly
Authors: YANG KUN , BAI JINWEN , ALISWAG EMERSON GALANG , SONG JIAN
Published: March 2024

Background
The mindfulness level of hospitalized elderly is affected by various individual factors. However, little is known regarding the relationship between medical coping styles and mindfulness levels of hospitalized elderly. The aims of this study were to examine the relationship between medical coping style and the mindfulness level of the hospitalized elderly and provide a theoretical basis for improving the mindfulness level of the hospitalized elderly.
Methods
A survey of 253 elderly patients was conducted in the Department of Geriatrics of a 3A hospital in Tangshan from September to November 2022 using the General Questionnaire, Medical Coping Style Questionnaire (MCMQ), and Mindfulness-Attention Awareness Scale (MAAS).
Results
The average mindfulness level score of the hospitalized elderly was (59.71 ± 13.90), with a scoring rate of 66.34%, at a moderate mindfulness level. This study results revealed a positive correlation between confrontation coping and the average score of mindfulness level (r = 0.725, P < 0.05); a negative correlation between avoidance coping and the average score of mindfulness level (r = -0.604, P < 0.05); and a negative correlation between acceptance-resignation coping and the average score of mindfulness level (r = -0.800, P < 0.05).
Conclusion
The mindfulness level of the hospitalized elderly must be improved, their coping styles are closely related to their mindfulness level, and positive coping styles can help improve the mindfulness level of the hospitalized elderly. This study suggested that medical staff can formulate targeted intervention measures, guide patients to establish positive coping styles, and improve the mindfulness level of hospitalized elderly people.
ABLE-SCORE, a simplified risk score for major adverse cardiovascular outcomes in left ventricular noncompaction: a multicenter longitudinal cohort study
Authors: Liu Limin , Zeng Rui , Ding Ligang , Cai Simin , Chen Aiyue , Dong Yuchen , Zhou Likun , Xu Mengtong , Xu Yuanwei , Li Le , Zhang Zhenhao , Hu Zhao , Zhang Zhuxin , Xiong Yulong , Hu Zhicheng , Li Yongqing , Lu Minjie , Wu Lingmin , Zheng Lihui , Fan Xiaohan , Li Tan , Yao Yan
Published: March 2024

Background
Left ventricular noncompaction (LVNC) is a heterogeneous entity with life-threatening complications and variable prognosis. However, there are limited prediction models available to identify individuals at high risk of adverse outcomes, and the current risk score in LVNC is comparatively complex for clinical practice. This study aimed to develop and validate a simplified risk score to predict major adverse cardiovascular events (MACE) in LVNC.
Methods
This multicenter longitudinal cohort study consecutively enrolled morphologically diagnosed LVNC patients between January 2009 and December 2020 at Fuwai Hospital (derivation cohort n = 300; internal validation cohort n = 129), and between January 2014 and December 2022 at two national-level medical centers (external validation cohort n = 95). The derivation/internal validation cohorts and the external validation cohort were followed annually until December 2022 and December 2023, respectively. MACE was defined as a composite of all-cause mortality, heart transplantation/left ventricular assist device implantation, cardiac resynchronization therapy, malignant ventricular arrhythmia, and thromboembolism. A simplified risk score, the ABLE-SCORE, was developed based on independent risk factors in the multivariable Cox regression predictive model for MACE, and underwent both internal and external validations to confirm its discrimination, calibration, and clinical applicability.
Results
A total of 524 LVNC patients (43.5 ± 16.6 years, 65.8% male) were included in the study. The ABLE-SCORE was established using four easily accessible clinical variables: age at diagnosis, N-terminal pro-brain natriuretic peptide levels, left atrium enlargement and left ventricular ejection fraction ≤ 40% measured by echocardiography. The risk score showed excellent performance in discrimination, with Harrell’s C-index of 0.821 [95% confidence interval (CI), 0.772–0.869], 0.786 (95%CI, 0.703–0.869), and 0.750 (95%CI, 0.644–0.856) in the derivation, internal validation, and external validation cohort, respectively. Calibration plots of the three datasets suggested accurate agreement between the predicted and observed 5-year risk of MACE in LVNC. According to decision curve analysis, the ABLE-SCORE displayed greater net benefits than the existing risk score for LVNC, indicating its strength in clinical applicability.
Conclusions
A simplified and efficient risk score for MACE was developed and validated using a large LVNC cohort, making it a reliable and convenient tool for the risk stratification and clinical management of patients with LVNC.
Telomere-related gene risk model for prognosis and drug treatment efficiency prediction in esophageal carcinoma
Authors: Chen Shihui , Li Xiaopeng , Ye Changchun , Zhao Chenye , Dong Zepeng , Yuan Hang , Gu Shuyuan , Sun Xuejun , Zhao Wei
Published: March 2024

Background
As the telomere functions continued to be unraveled, we aim to develop a prognostic gene signature that telomere-related features for patients with esophageal carcinoma.
Methods
First, differentially expressed genes (DEGs) related to telomere in ESCA were detected, Based on telomere-related DEGs, variables were determined by the LASSO regression and multivariate Cox, and a prognostic signature was established. The prognostic value of the signature was evaluated by the Kaplan–Meier method, time-dependent ROC, and univariate and multivariate analyses. Independent GEO dataset were employed for external validation. Gene set enrichment analysis (GSEA), gene set variation analysis (GSVA), and immune infiltration analysis were performed to investigate the underlying mechanisms. The sensitivity to common chemotherapeutic drugs was estimated based on the GDSC2 database. Finally, we selected MAPK12 involved in the signature, which has not been reported in ESCA, for further experimental validation.
Results
ESCA patients with differentially expressed genes (DEGs) related to telomere exhibited related GO and KEGG terms. The prognostic signature incorporated 3 genes and stratified patients into high- and low-risk groups by median value splitting. The areas under the ROC curves were 0.75 (1-year), 0.75 (3-year) and 0.69 (5-year). The Kaplan–Meier survival analysis revealed a significantly poorer overall survival in the high-risk group in the TCGA cohort (p < 0.001). In addition, both univariate and multivariate Cox regression analyses indicated that the prognostic model was the individual factor affecting the overall survival of ESCA patients. Through GSEA and GSVA, we found that tumor progression and metastasis-related pathways were enriched in the high-risk group. Additionally, patients with high-risk scores showed higher sensitivity to chemotherapeutic drugs. The in vitro experiments further confirmed that MAPK12 could promote the proliferation and migration of ESCA cells.
Conclusions
We first developed and validated a new signature that incorporates genes that relate to telomeres in ESCA patients. Our study explored the potential clinical significance of this biomarker. Our prognostic model is capable of independently predicting survival of ESCA patients, as demonstrated by the high-throughput data mining results. The theoretical basis provided by these results can be used to further explore the molecular pathogenesis of ESCA and identify therapeutic approaches.
Utility of colposcopy for the screening and management of cervical cancer in Africa: a cross-sectional analysis of providers’ training and practices
Authors: Domgue Joel Fokom , Issimouha Dille , Gnangnon Freddy , Kapambwe Sharon , Bouchard Celine , Mbatani Nomonde , Gauroy Elodie , Ambounda Nathalie Ledaga , Yu Robert , Sidibe Fatoumata , Kamgno Joseph , Traore Bangaly , Tebeu Pierre-Marie , Halle-Ekane Gregory , Diomande Mohenou Isidore , Dangou Jean-Marie , Lecuru Fabrice , Adewole Isaac , Plante Marie , Basu Partha , Shete Sanjay
Published: March 2024

Introduction: Cervical cancer is a public health issue in Africa with devastating socioeconomic consequences due to the lack of organized screening programs. The success of screening programs depends on the appropriate investigation and management of women who test positive for screening. Colposcopic assessment following positive screening results is a noteworthy issue in Africa. This study aimed to assess the utilization of colposcopy by providers in the region.
Methods: A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior colposcopy training, whether they performed colposcopy and the indications of colposcopy in their practice.
Results: Of the 130 providers from 23 African countries who responded to the survey (mean age [SD]: 39.0 years [9.4]), half were female (65 [50.0%]), and 90.7% were working in urban areas. Overall, only 12.6% of respondents indicated having received prior training on colposcopy, and 11.7% reported that they were performing colposcopy in their current practice. Among the providers who reported performing colposcopy in their practice, colposcopy was indicated for routine visual screening in 21.2% of clinicians, to visualize the transformation zone in 15.2% of respondents, to assess vascularization of cervical mucosa in 33.3% of respondents, and to determine treatment modality in 12.1% of respondents.
Conclusion: Providers’ training and utilization of colposcopy for cervical cancer screening remain suboptimal in Africa. To increase utilization of colposcopy in the region, further training is needed to improve providers' knowledge and engagement. With the development of lower-cost and portable colposcopes, efforts to equip cervical cancer prevention programs and facilities with colposcopy should be enhanced to ensure that women can be screened and managed appropriately in the clinical setting and communities.
Feedback-induced dispositional changes in risk preferences
Authors: Palminteri Stefano , Nasioulas Anronios , Lebreton Maël
Published: March 2024

Contrary to the normative decision-making standpoint, empirical studies have repeatedly reported that risk preferences are affected by the disclosure of choice outcomes (feedback). Although no consensus has yet emerged regarding the properties and mechanisms of this effect, a widespread and intuitive hypothesis is that repeated feedback affects risk preferences by means of learning, which alters the representation of subjective probabilities. Here, we ran a series of seven experiments, tailored to decipher the effects of feedback on risk preferences. Our results indicate that the presence of feedback consistently increases risk-taking, even when the risky option is less advantageous. Crucially, risk-taking increases immediately after the instructions, before participants experience any feedback and trial-by-trial analysis directly falsified learning accounts. These results challenge the learning account in favor of a dispositional effect, induced by the anticipation of feedback information. Epistemic curiosity and regret avoidance may drive this effect in partial and complete feedback conditions.
A literature Review of the Effectiveness of Green Environment on Mental Health and Medical Illness
Authors: Battat Maher , Sarhan Adnan
Published: March 2024

The Green environment is increasingly recognized as a natural healing intervention that promotes mental health and well-being. This paper provides an overview of the literature on the effects of the Green environment on mental health and medical illness. A comprehensive literature review was conducted using electronic databases, including PubMed, Google Scholar, Research Gate, and Science Direct. Twenty-seven articles were reviewed, focusing on the impact of the Green environment on mental health, mental illness, and its association with medical conditions in the context of mental health. The findings suggest that exposure to the Green environment improves adaptation, cognitive performance, mood, well-being, and self-esteem in adults. Children also benefit from improved cognitive abilities and social interactions. The Green environment has been associated with reduced stress, anxiety, depression, mood disorders, suicide, mental fatigue, and dementia. It has also shown to facilitate mental rehabilitation for mentally ill patients, promoting inclusivity with community participation. Furthermore, the Green environment has been linked to lower risks of depression and improvements in healing and individual function in cancer patients, cardiovascular diseases, and during the COVID-19 pandemic. In conclusion, exposure to the Green environment has positive effects on mental health, emotional stability, cognitive development, and social relationships. It serves as a valuable tool in treating mental and medical illnesses, providing stress management techniques, and enhancing overall quality of life and well-being.
Binary modified Cat and Mouse based Optimizer for medical feature selection: A COVID-19 case study
Authors: Parizi Morteza Karimzadeh
Published: March 2024

Recent technological advances in medical diagnosis have led to the generation of high-dimensional datasets. The presence of redundant and irrelevant features in these datasets can have adverse effects on the performance of machine learning (ML) methods and reduce the accuracy of their results. Therefore, feature selection (FS), i.e., a popular preprocessing method in ML, is used to select the optimal subsets of features to improve the accuracy of ML methods. This performance enhancement is more crucial while addressing high-dimensional medical issues. Since FS is a multiobjective binary optimization problem, it is necessary to develop efficient FS algorithms. Although metaheuristic algorithms (MAs) have been widely used for FS in medicine, they face different challenges in most applications, e.g., a lack of sufficient effectiveness and scalability to select the most effective features in small and large medical datasets. The cat and mouse-based optimizer (CMBO) is a novel MA based on the natural competitive behavior of cats and mice. Despite its acceptable performance in a variety of problems, the CMBO faces various challenges such as limited exploitation abilities, an unbalanced search mechanism, and high fluctuation in solutions to complex problems, e.g., FS. This paper proposes a modified and binary version of the CMBO called the BMCMBO to enhance the performance in selecting effective features from medical datasets. The BMCMBO involves significant modifications to the method of updating the positions of search agents, the method of selecting mice, the effect of the positional information of the most optimal member of the population, and the addition of the adaptive step size. These modifications are meant to improve the exploitation abilities, boost the accuracy of the solutions, and balance the search process when dealing with the FS problem in medical datasets. The performance of the proposed algorithm on 12 real medical datasets was compared with the performance of the most effective MA and CMBO variants. The statistical results demonstrated that BMCMBO was more effective than other evaluated methods. In addition, the BMCMBO algorithm was employed to select features and diagnose COVID-19 in a real case study. The proposed algorithm identified healthy and infected COVID-19 correctly samples with an accuracy of 98.4\%, demonstrating its superiority.
Implementation of A New Residential Drug Dependence Treatment Model in the Philippines: A Qualitative Study
Authors: Kanamori Shogo , Shirasaka Tomohiro , Iñigo Ma. Teresa , Villaroman Alfonso , Noguera-Caoile Rosalina , Mizusawa Aya , Peralta Jasmin , Harada Takayuki
Published: March 2024

Background
There is an increased demand for quality treatment and rehabilitation services for people who use drugs (PWUDs). In response, the Philippines Government’s Department of Health (DOH) has established a new residential treatment model, Intensive Treatment and Rehabilitation Program for Residential Treatment and Rehabilitation Centers (INTREPRET), and integrated it into the existing treatment service platform of 21 DOH-owned Treatment and Rehabilitation Centers (TRCs). We conducted a qualitative study to identify the changes engendered by the implementation of this treatment model.
Methods
Data were collected through individual face-to-face interviews. We interviewed purposefully selected 29 patients and 35 facilitators of INTREPRET group sessions in seven TRCs. We transcribed the interview records and organized the narrative information into key themes using thematic analysis during the coding process.
Results
The changes perceived by the study participants included the attitude and behavior of patients, attitude and competency of facilitators, relationship between facilitators and patients, treatment planning and review process, efficient and standardized treatment services, and monitoring mechanisms of the patient’s recovery process. Participants also noted challenges in INTREPRET implementation, including family participation in therapy sessions, lack of facilitators, securing a conducive place for conducting sessions, and reproducing workbooks.
Conclusion
The results imply that the introduction of INTREPRET could improve treatment service quality and the effectiveness of treatment, which is primarily caused by patients’ behavioral changes. However, despite the positive changes perceived, certain challenges pertaining to family participation in therapy sessions and the lack of resources must be addressed by the government to ensure the effectiveness and sustainability of INTREPRET.