bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-term effects of athletic taping techniques on calcaneal frontal angle in young female adults with flexible flatfoot
Authors: Tang Meihua , Wang Lin
Published: August 2023

Background
This study aimed to explore short-term effects of athletic taping techniques on calcaneal frontal range of motion (ROM) during walking in young female adults with flexible flatfoot (FFT).
Methods
Twenty young female adults with FFT were recruited. Each participant was randomly divided into two groups, namely, augmented low-Dye (ALD) and modified low-Dye (MLD) groups. The calcaneal frontal ROM was measured on the basis of the resting calcaneal stance position (RCSP), maximum calcaneal eversion, maximum calcaneal inversion and calcaneal frontal ROM. The measurements were collected at baseline, after taping and after 20-min walking.
Results
Compared with baseline, the RCSP values increased after 20-min walking with ALD (p = 0.004). After 20-min walking, ALD taping performed higher maximum calcaneal eversion (p = 0.02) and frontal ROM (p = 0.003) than post taping. MLD taping performed higher maximum calcaneal inversion (p = 0.001) and frontal ROM (p = 0.002) after 20-min walking than post taping.
Conclusions
This study indicated that in young female adults with FFT, the short-term effects of athletic taping on RCSP and calcaneal frontal angle during the gait support phase were limited, and ALD taping exhibited higher RCSP with walking time than MLD taping. Therefore, using two taping techniques as prescription basis for calcaneal eversion correction in young women with FFT in clinical practice is not recommended.
Trial registration:
This study was approved by the Ethics Committee of Shanghai University of Sport (No. 102772021RT026).
Detection of thyroid hormone transport inhibition in the Xenopus Eleutheroembryonic Thyroid Assay (XETA)
Authors: Batel Annika , Stilgenbauer Melissa , Spyridonov Inka Marie , Weltje Lennart
Published: August 2023

The Xenopus Eleutheroembryonic Thyroid Assay (XETA, OECD TG 248 was established as a non-animal alternative to the Amphibian Metamorphosis Assay (AMA, OECD TG 231) for the analysis of (anti-)thyroid activity of chemicals. Since the test employs animals which are physiologically not fully functional yet, there are limitations in the XETA to detect certain mechanisms along the HPT (Hypothalamic-Pituitary-Thyroid) axis. However, the inhibition of thyroid hormone transport should physiologically be detectable with the XETA but was not yet investigated thoroughly. Here, we tested three substances that are known to inhibit thyroid hormone transport by competitive binding to transthyretin in mammalian studies, namely pentachlorophenol (PCP, tested at 0.01, 0.1 and 1.0 mg/L), tetrabromo bisphenol A (TBBPA) and mefenamic acid (both tested at 0.25, 0.5, 1.0, 2.0 and 4.0 mg/L). X. laevis eleutheroembryos of Nieuwkoop-Faber stage 45 were exposed in 6-well plates (10 embryos in 8 mL test medium per well) for 72 hours at 21°C. Results show that especially for highly potent substances such as PCP and TBBPA, the XETA effectively detects their thyroid hormone transport inhibition potential, while for the lower potency substance mefenamic acid, a trend was visible, but a significant inhibition was not detected. Overall, the results indicate that in the XETA, the mechanism of thyroid hormone transport inhibition can be detected.
Hemophagocytic Lymphohistiocytosis caused by GATA2 deficiency : cases report
Authors: Wu Lin , Wang Jingshi , Song Deli , You Yahong , Wang Zhao
Published: August 2023

Background
Hemophagocytic lymphohistiocytosis (HLH) is a syndrome describing patients with severe systemic hyperinflammation. GATA binding protein 2 (GATA 2) is a transcription factor and key component in hematopoiesis and stem cell biology.
Case presentation:
Three patients with HLH, one with Mycobacterium avium, one with EBV infection, and one with Mycobacterium Kansas, all of which were subsequently found to be defective in the GATA2 gene by genetic testing.
Conclusions
GATA2 gene deficiency syndrome should be considered if the patient has myelodysplastic syndrome, non-tuberculous mycobacterium infection and HLH. In addition, the GATA2 gene mutation may be a gene defect other than the current primary HLH gene that can cause HLH. Further studies are needed to confirm the role of GATA2 gene defects in the pathogenesis of HLH.
BMI mediates the effects of gut microbes on bone mineral density in the "intestinal bone axis": an observational study versus a mediation Mendelian randomization study
Authors: Xu Wenchang , Zhang Fengjun , Xu Ziting , Li Xing , Li Hengbing , Zhang Weijie , Yu gongchang , Shi Bin
Published: August 2023

Background
Several pieces of evidence suggest a strong association between gut microbiota (GM) and bone mineral density (BMD), but the intermediate factors between them are still unknown. While one study proposes that body mass index (BMI) might serve as an intermediary factor between gut microbiota and bone mineral density, there is insufficient evidence to substantiate this claim. We conducted an observational study and a mediation mendelian randomization analysis to investigate whether BMI could function as a mediator between gut microbiota and bone mineral density, thereby addressing this gap in knowledge.
Methods
We conducted an observational study using data from the National Health and Nutrition Examination Survey (NHANES) collected between 2013 and 2018. The independent effect of BMI on BMD was verified by using multiple linear regression analysis to exclude interference from confounders. We subsequently performed three-category Mendelian randomization analyses ((a) We used 211 categories of gut microbes as the exposure and eBMD as the outcome; (b) we used 211 categories of gut microbes as the exposure and BMI as the outcome; (c) we used BMI as the exposure and eBMD as the outcome). Ultimately, we identified one bacterium that could act as a mediator in multivariable and mediation Mendelian randomization analysis. For the primary analysis, we employed inverse variance weighting (IVW) and combined it with four other analysis methods and multiple sensitivity analyses, including heterogeneity analysis, horizontally pleiotropic analysis, "leave-one-out" analysis, MR-PRESSO, and MR-LASSO.
Results
Our multiple linear regression analysis showed that BMI had an independent influence on BMD (β = 0.011, t = 8.155, P < 0.05), after adjusting for other confounding factors. The results of our Mendelian randomization analysis revealed that eight bacterial genera were significantly associated with eBMD, while 15 bacterial genera were significantly associated with BMI. The results of the multivariate MR analysis of phylum-Actinobacteria showed that BMI acted as a mediator between phylum-Actinobacteria and eBMD, with BMI accounting for 84.9% of the intermediate effect.
Conclusion
Our study found that BMI fully mediated the association between phylum-Actinobacteria and eBMD. However, we cannot extrapolate this finding to suggest that BMI can mediate the association between other gut microbiota and eBMD. Our findings suggest that phylum-Actinobacteria could potentially serve as a biomarker or therapeutic target for osteoporotic patients who are obese. Modulating the relative abundance of phylum-Actinobacteria may be particularly effective in obese patients with osteoporosis. Further studies are required to confirm these findings.
Sustainable pathways for attaining net-zero emissions in European emerging countries – the nexus between renewable energy sources and ecological footprint
Authors: Tiwari Sunil , Sharif Arshian , Nuta Florian , Nuta Alina Cristina , CUTCU Ibrahim , EREN Mehmet Vahit
Published: August 2023

This study aims to investigate the relationship between renewable energy and ecological footprint during the period of 1994–2018 from selected developing countries in Europe (Czechia, Croatia, Poland, Romania, Romania, and Turkey). In this context, the ecological footprint (EF), which has recently been the most widely used environmental indicator in the literature and is known as the most comprehensive because it includes many environmental factors, has been determined as the dependent variable. As independent variables, renewable energy consumption (REC), energy-related tax revenue (ETR), and energy productivity (EP) are included in the model. GDP and development of environment-related technologies (DET), which affect the ecological footprint in the model, are determined as control variables. As a result of the panel data analysis, according to the Durbin–Hausman cointegration test result, a long-term relationship between the variables was determined. According to the CCE estimator analysis, it can be said that there is a positive relationship between ETR and GDP variables and EF. For the AMG estimator analysis, it can be said that there is a positive relationship between GDP and EP variables and EF. Finally, according to the results of the Konya Causality test, a unidirectional causality relationship is detected from environmental technologies to the ecological footprint in Turkey, and a unidirectional causality relationship from the ecological footprint to GDP in Czechia, Romania, and Turkey. Furthermore, no causality relationship is detected between other variables. Based on the results, several policy implications are suggested.
Optimisation of Preventive Maintenance Regime and Spare Part Inventory based on Failure Mode System Modelling
Authors: Alamri Theyab O. , Mo John P.T.
Published: August 2023

Preventive maintenance schedules are increasingly important in today's complex and diverse production systems as they help to ensure the continuous operation of systems and reduce overall maintenance costs. This paper presents a novel method for designing a preventive maintenance schedule and spare parts inventory based on failure modes for complex systems with multiple components, using the Failure Modes and Effects Analysis (FMEA) method. The objective is to ensure the continuity of system outputs by modeling subsystems and components as parallel and series arrangements, and using a genetic algorithm to determine the optimal replacement intervals and spare parts inventory based on failure modes. In addition to ensuring the continuity of production outputs during maintenance activities, the approach is also useful in reducing system maintenance costs and increasing system reliability. The proposed approach is applied to a packaging system, and the effects of changing lead time, preventive replacement intervals, and production lost costs on the optimal policy are also examined. The proposed approach is expected to improve system reliability, reduce maintenance costs, and be applicable to any type of complex system at any stage of its development.
Functional near-infrared spectroscopy-based neurofeedback training induces changes in cortico-striatal functional connectivity: A proof of concept study
Authors: Godet Ambre , Serrand Yann , Léger Brieuc , Moirand Romain , Bannier Elise , Val-Laillet David , Coquery Nicolas
Published: August 2023

Due to its central role in cognitive control, the dorso-lateral prefrontal cortex (dlPFC) has been the target of multiple brain modulation studies. In the context of the present pilot study, the dlPFC was the target of 8 repeated neurofeedback (NF) sessions with functional near infrared spectroscopy (fNIRS) to assess the brain response during NF and with functional and resting state magnetic resonance imaging (task-based fMRI and rsMRI) scanning. Fifteen healthy participants were recruited. Cognitive task fMRI and rsMRI were performed during the 1st and the 8th NF sessions. During NF, our data revealed an increased activity in the dlPFC as well as in brain regions involved in cognitive control and self-regulation learning (pFWE < 0.05). Changes in functional connectivity between the 1st and the 8th session revealed increased connectivity between the posterior cingulate cortex and the dlPFC, and between the posterior cingulate cortex and the dorsal striatum (pFWE < 0.05). Decreased left dlPFC-left insula connectivity was also observed. Behavioural results revealed a significant effect of hunger and motivation on the participant control feeling and a lower control feeling when participants did not identify an effective mental strategy, providing new insights on the effects of behavioural factors that may affect the NF learning.
PET/CT Radiomics Integrated with Clinical Indexes as A Tool to Predict Ki67 in Breast Cancer: A Pilot Study
Authors: Ding Hui , Li Yan , Liang Ting , Liao Yuting , Yu Xiao , Duan Xiaoyi , Shen Cong
Published: August 2023

Background: Breast cancer (BC) represents the second cause of cancer-related death among women globally, and Ki67 was demonstrated as an important predictive biomarker in worse survival and neoadjuvant treatment in BC. This study aims to investigate the value of radiomics features derived from18F-FDG PET/CT combined with clinical characteristics in predicting Ki67 in patients with BC. Methods: A total of 114 patients diagnosed as BC and examined using18F-FDG PET/CT were included in this study. Patients were randomly separated into a training set (n = 79, with 55 cases of Ki67 + and 24 cases of Ki67-) and a validation set (n = 35, with 24 cases of Ki67 + and 11 cases of Ki67-) at a ratio of 7:3. Thirteen clinical characteristics and 704 radiomics features were extracted, and the univariance logistic analysis, max-Relevance and Min-Redundancy, the least absolute shrinkage and selection operator regression, and the Spearman test were applied for feature selection. Three models were developed, including the clinical model, the radiomics model, and the combined model, and a nomogram of the combined model was constructed. The predictive performance of all three models was examined by the receiver operating characteristic (ROC) curve. Clinical utility was validated by decision curve analysis (DCA). Results: The N stage, tumor morphology, maximal standard uptake value, and the longest diameter were significantly different in Ki67 + and Ki67- groups (P < 0.05) and were selected as the most discriminative clinical features. Eight radiomics features were selected for the radiomics model. In total, 7 radiomics and the above 4 clinical characteristics were selected for the combined model. The AUC of the combined model in the training and test group was 0.90 (95% Confidence Interval (CI): 0.82–0.97) and 0.81 (95% CI: 0.64–0.99), respectively. The combined model significantly outperformed the radiomics model and the clinical model alone (P < 0.05). The DCA curve showed the advantages of the combined model over the clinical model and radiomics model. Conclusions: The radiomics-derived features combined with the clinical features could effectively predict Ki67 expression in BC based on PET/CT images. Trial registration: This study was registered at ClinicalTrials Gov (number NCT05826197) on 7th, May 2023.
Enhanced osteochondral repair by leukocyte-depleted platelet-rich plasma in combination with adipose-derived mesenchymal stromal cells encapsulated in a three-dimensional photocrosslinked injectable hydrogel in a rabbit model
Authors: Iseki Tomoya , Rothrauff Benjamin B. , Kihara Shinsuke , Overholt Kalon J. , Taha Tarek , Lin Hang , Alexander Peter G. , Tuan Rocky S.
Published: August 2023

Introduction:Intra-articular injection of adipose-derived mesenchymal stromal cells (ASCs) and/or platelet-rich plasma (PRP) have been reported to independently and synergistically improve healing of osteochondral lesions in animal models. However, their independent and combined effects when localized to an osteochondral lesion by encapsulation within a photocrosslinkable methacrylated gelatin hydrogel (GelMA) have not been explored. Herein we investigated a unique combination of allogeneic ASCs and PRP embedded in GelMA as a single-stage treatment for osteochondral regeneration in a rabbit model.Methods:Thirty mature rabbits were divided into six experimental groups: (1) Sham; (2) Defect; (3) GelMA; (4) GelMA + ASCs; (5) GelMA + PRP; and (6) GelMA + ASCs + PRP.At 12 weeks following surgical repair, osteochondral regeneration was assessed on the basis of gross appearance, biomechanical properties, histological and immunohistochemical characteristics, and subchondral bone volume.Results:In terms of mechanical property reflecting the ability of neotissue to bear stress, PRP only group were significantly lower than the Sham group (p = 0.0098). On the other hand, ASCs only and ASCs combined with PRP groups did not exhibit significantly difference, which suggesting that incorporation of ASCs assists in restoring the ability of the neotissue to bear stresses similarly to native tissue (p= 0.346,p= 0.40, respectively). Safranin O in ASCs combined with PRP group was significantly higher than the Defect and GelMA only groups (p= 0.0009,p= 0.0017, respectively). Additionally, ASCs only and ASCs combined with PRP groups presented especially strong staining for collagen type II. Surprisingly, PRP only and PRP + ASCs groups tended to exhibit higher collagen type I and collagen type X staining compared to ASCs only group, suggesting a potential PRP-mediated hypertrophic effect.Conclusion:Regeneration of a focal osteochondral defect in a rabbit model was improved by a single-stage treatment of a photocrosslinked hydrogel containing allogenic ASCs and autologous PRP, with the combination of ASCs and PRP producing superior benefit than either alone. No experimental construct fully restored all properties of the native, healthy osteochondral unit, which may require longer follow-up or further modification of PRP and/or ASCs characteristics.
Automated mood disorder symptoms monitoring from multivariate time-series sensory data: Getting the full picture beyond a single number.
Authors: Corponi Filippo , Li Bryan , Anmella Gerard , Mas Ariadna , Pacchiarotti Isabella , Valentí Marc , Fullana Iria Grande i , Benabarre Antonio , Garriga Marina , Vieta Eduard , Lawrie Stephen , Whalley Heather , Hidalgo-Mazzei Diego , Vergari Antonio
Published: August 2023

Mood disorders (MDs) are among the leading causes of disease burden worldwide. Limited specialized care availability remains a major bottleneck thus hindering pre-emptive interventions. MDs manifest with changes in mood, sleep, and motor activity, observable in ecological physiological recordings thanks to recent advances in wearable technology. Therefore, near-continuous and passive collection of physiological data from wearables in daily life, analyzable with machine learning (ML), could mitigate this problem, bringing mood disorders monitoring outside the clinician’s office. Previous works predict a single label, either the disease state or a psychometric scale total score. However, clinical practice suggests that the same label may underlie different symptom profiles, requiring specific treatments. Here we bridge this gap by proposing a new task: inferring all items in HDRS and YMRS, the two most widely used standardized scales for assessing MDs symptoms, using physiological data from wearables. To that end, we develop a deep learning pipeline to score the symptoms of a large cohort of MD patients and show that agreement between predictions and assessments by an expert clinician is clinically significant (quadratic Cohen’s κ and macro-average F1 score both of 0.609). While doing so, we investigate several solutions to the ML challenges associated with this task, including multi-task learning, class imbalance, ordinal target variables, and cross-subject invariant representations. Lastly, we illustrate the importance of testing on out-of-distribution samples.
Correlation between salivary cytokine profiles and white spot lesions in adolescent patients receiving clear aligner orthodontic treatment
Authors: Luo Houzhuo , Guo Tao , Dang Wei , Song Zhixin , Wen Yi , Jin Zuolin , Liu Qian , Wang Axian
Published: August 2023

Background
To explore the relationship between changes in salivary cytokine levels and the occurrence of white spot lesions in adolescents receiving clear aligner orthodontic treatment and investigate the predictive value of various factors for lesion occurrence.
Methods
68 adolescent patients who received clear aligner orthodontics in our hospital were randomly divided into two groups according to the occurrence or aggravation of white spot lesions after treatment. The general condition of the oral cavity was analyzed, saliva was collected, and inflammation-related cytokines with varying transcription levels between groups were screened by transcriptome analysis. The expression levels of inflammatory cytokines in the saliva of the patients in the two groups were measured, and the risk factors for white spot lesions were screened by correlation analysis and binary logistic regression analysis. The value of the independent and combined application of risk factors for predicting the occurrence of white spot lesions in adolescent patients after invisible orthodontic treatment was analyzed by receiver operating characteristic (ROC) curve analysis.
Results
Transcriptome and GO and KEGG pathway analyses showed that there were differences in the transcription levels of inflammatory cytokines such as CXCL1, CXCL2, CXCL8, CCL3, CCL4, IL-1 β and IL-2 between groups. The levels of CXCL8, CCL3, CCL4, IL-1 β and IL-2 in the saliva of patients with white spot lesions were significantly higher in patients after invisible orthodontic treatment (P < 0.05). Correlation analysis and binary logistic regression analysis showed that elevated levels of CXCL8, IL-1β and IL-2 were independent risk factors for the occurrence of white spot lesions (P < 0.05). CXCL8 had the highest independent predictive value for the occurrence of white spot lesions (AUC = 0.773, P < 0.05), and the combination of IL-1β and IL-2 was also of high value in predicting the occurrence of white spot lesions.
Conclusion
After invisible orthodontic treatment, the oral microenvironment, including inflammatory cytokine levels, in adolescent patients changes; in particular, the levels of inflammatory cytokines such as CXCL and IL change. CXCL8 expression is significantly associated with the occurrence of white spot lesions and is an important potential target for the prevention and treatment of white spot lesions in the future.
Refractive error prevalence, effective refractive error coverage and spectacle coverage among school children in Telangana, South India
Authors: Khanna Rohit , Prakash Winston , Marmamula Srinivas , Keeffe Jill
Published: August 2023

Background
Refractive error (RE) is one of the leading causes of childhood vision impairment. Increasing effective refractive error coverage (e-REC) is one of the main goals of WHO’s 2030 global eye health targets. The aim of this study is to estimate the prevalence of RE, e-REC, risk factors and spectacle coverage among school children in Telangana, South India.
Methods
School children aged 4-15 years in the study locations underwent vision screening using 6/12 tumbling E optotype by trained community eye health workers in the schools. Those failing the initial vision screening and/or found to be having eye conditions were referred to a nearby referral centre appropriately, where they underwent detailed eye examination.
Results
A total of 774 184 children were screened in schools of which 51.49% were boys. The mean age was 9.40 ± 3.27 years. The prevalence of RE was 1.44% (95%CI:1.41-1.46) of which myopia was 1.38% (95%CI: 1.35-1.41). In multivariate analysis, the risk of myopia was higher among older children (Adj.OR: 17.04; 95%CI: 14.64-19.85), those residing in urban areas (Adj.OR:3.05, 95%CI:2.60-3.57), those with disabilities (Adj.OR:2.61, 95%CI:2.00-3.39) and among girls (Adj.OR:1.30, 95%CI:1.25-1.35) (P=0.00). The overall e-REC was 56.97% and the spectacle coverage was 62.83%.
Conclusion
Myopia being the most common type of RE, the risk factors included increasing age, urban location, and presence of disability. The need for interventions to improve e-REC to achieve 2030 global eye health target is also eminent among children in this region.
Smokeless and Combustible Tobacco Use Among 148,944 South Asian Adults: a Cross-Sectional Study from the South Asia Biobank
Authors: Xie Wubin , Mridha Malay Kanti , Gupta Anaya , Kusuma Dian , Butt Awais , Hasan Mehedi , Brage Soren , Loh Marie , Khawaja Khadija Irfan , Pradeepa Rajendra , Jha Vinita , Kasturiratne Anuradhani , Katulanda Prasad , Anjana Ranjit Mohan , Chambers John C
Published: August 2023

Background
Tobacco use, in both smoking and smokeless forms, is highly prevalent among South Asian adults. The aims of the study were twofold: 1) describe patterns of SLT and combustible tobacco product use in four South Asian countries stratified by country and sex, and 2) assess the relationships between SLT and smoking intensity, smoking quit attempts, and smoking cessation among South Asian men.
Methods
Data were obtained from South Asia Biobank Study, collected between 2018 and 2022 from 148,944 men and women aged 18 years and above, living in Bangladesh, India, Pakistan, or Sri Lanka. Mixed effects multivariable logistic and linear regression were used to quantify the associations of SLT use with quitting smoking attempt, cessation, and intensity.
Results
Among the four South Asian countries, Bangladesh has the highest rates of current smoking (39.9% for male, 0.4% for female) and current SLT use (24.7% for male and 23.4% for female). Among male adults, ever SLT use was associated with a higher odds of smoking cessation in Bangladesh (OR, 2.88; 95% CI, 2.65, 3.13), India (OR, 2.02; 95% CI, 1.63, 2.50), and Sri Lanka (OR, 1.36; 95% CI, 1.14, 1.62). Ever SLT use and current SLT use was associated with lower smoking intensity in all countries.
Conclusions
In this large population-based study of South Asian adults, rates of smoking and SLT use vary widely by country and gender. Men who use SLT products are more likely to abstain from smoking compared with those who do not.
Association of childhood socio-economic status and health with depressive symptoms among older adults in India
Authors: Khanal Gayatri , Selvamani Y.
Published: August 2023

Background
Childhood adverse experience has been linked with poor health outcomes across the life course. Nevertheless, whether such an association or direction could be projected to older people’s life remains still unclear and needs to generate more evidence, particularly in India. Therefore, this study was conducted to examine the association of childhood socio-economic status and health with depressive symptoms amongst older adults in India.
Methods
Cross-sectional study from the first wave of the national representative survey “Longitudinal Ageing Study in India (LASI)” was used. Multivariable regression analysis was used to examine the association of childhood socioeconomic status and health with depressive symptoms in the older population.
Results
Poor childhood health was significantly and positively associated with depressive symptoms (AoR: 1.372, CI: 1.09, 1.727). Likewise, respondents who were bedridden for a month during their childhood had high odds of developing depressive symptoms (AoR: 1.154 CI: 1.008, 1.322). In addition to this, the odds of having depressive symptoms increased significantly among the average (AoR: 1.276 CI: 1.025, 1.588) and poor childhood socioeconomic status group (AoR: 1.259 CI: 1.007, 1.573) as compared to the higher childhood socioeconomic status category.
Conclusions
Childhood socioeconomic status and health have a statistically significant role in determining mental health in later life. Results suggest that considering childhood socioeconomic status and health is important while diagnosing depression in older population in order to identify the significant associated factors in early childhood and thus help in preventing depressive symptoms in later life.
Streamlining the totally extraperitoneal approach for laparoscopic inguinal hernia repair: the 3-2-1 method
Authors: Zhou Xue-Lu
Published: August 2023

Background The total extraperitoneal (TEP) technique is known for its complexity compared to the transabdominal preperitoneal technique (TAPP). This study aimed to streamline the TEP procedure by introducing the 3-2-1 method, which involves creating three surgical planes, implementing two transitions, and establishing a spacious preperitoneal space. The objective was to comprehensively evaluate the safety, efficacy, and reliability of this approach.
Methods A total of 358 patients with 380 inguinal hernias underwent TEP repair using the 3-2-1 method via the retromuscular approach. Patient characteristics, operative time, hospital stay, complications, and recurrence rates were assessed.
Results Among the hernias, 190 were on the right side, 140 on the left side, and 50 were bilateral. The distribution of hernia types included indirect hernia (201), direct hernia (132), compound hernia (16), complex hernia (6), and femoral hernia (3). The average operative time was 58 minutes for unilateral hernias and 110 minutes for bilateral hernias. Postoperative complications occurred in 32 cases (8.9%), but no serious complications were observed. The average hospital stay was 7 days, and patients were followed up for an average of 49 months. There were no cases of chronic pain or recurrence.
Conclusions The 3-2-1 method for laparoscopic TEP repair of inguinal hernias proves to be a simple, safe, effective, and reliable approach.
Process evaluation of school-based high-intensity interval training interventions for children and adolescents: a systematic review and meta-analysis of randomized controlled trials
Authors: Liu Yong , Wadey Curtis A. , Barker Alan R. , Williams Craig A.
Published: August 2023

Background Several systematic reviews have been published to investigate the effectiveness of high-intensity interval training (HIIT) in schools. However, there has been limited attention given to understanding the functioning of the intervention processes, which is of paramount importance for interpreting and translating the intervention effectiveness. The aim of this systematic review is to determine the extent to which process evaluation is measured in school-based HIIT interventions and to explore the effects of process evaluation and intervention characteristics on cardiorespiratory fitness (CRF), body composition, muscular strength, and blood pressure. Methods A comprehensive search was conducted in SPORT Discus (EBSCOhost), Web of Science, Scopus, Medline (Ovid) and Cochrane Central Register of Controlled Trials. The extent to which process evaluation is measured was narratively reported, alongside with the guidance of process evaluation of complex interventions by UK Medical Research Council. Meta-analyses and meta-regressions were conducted to determine the effects of process evaluation and intervention characteristics to the intervention outcomes. Results The literature search identified 77 studies reporting on 45 school-based HIIT interventions. In total, five interventions reported process evaluation in a section or in a separate study, and only one intervention adopted a process evaluation framework. On average, 6 out of 12 process evaluation measures were reported in all interventions. Subgroup analyses did not indicate any beneficial treatment effects for studies with process evaluation group, whereas all pooled data and studies without process evaluation group showed significant improvement for CRF and body composition. Conclusion Process evaluation is frequently omitted in the literature of school-based HIIT in children and adolescents. Although reporting of process evaluation measures may not directly associate with better intervention outcomes, it allows accurate interpretation of intervention outcomes, thereby enhancing the generalisability and dissemination of the interventions.
Maternal socio-demographic, medical and nutritional predictors of low birth weight neonates delivered in a civil unrest setting: A case study of Bosaso general hospital, North Eastern Somalia
Authors: Buzigi Edward , Mohammed Barkhadle Abdirahman
Published: August 2023

Background Low birth weight (LBW) defined as a newborn weighing less than 2.5 kilograms (kg) is a leading predictor of morbidity and mortality in either childhood or adulthood. The prevalence and predictors of LBW in Somalia are scarce. This study determined the maternal socio-demographic, medical, and nutritional predictors of delivering LBW neonates in Bosaso Hospital, Somalia. Methods This cross-sectional study of 1074 randomly selected mothers who delivered babies in Bosaso general Hospital from November 2022 to April 2023. A neonate was considered to be LBW if it weighed less than 2.5kg. Data for predictor variables were collected from mothers or by reviewing antenatal and postnatal registers. The association between predictor variables and LBW was tested by multivariate logistic regression analysis using STATA 15 by reporting an adjusted odds ratio (AOR) and 95% confidence interval (CI). A statistical test was considered significant at p < 0.05. Results The prevalence of LBW was 18%. Mothers with the following social demographic characteristics were likely to deliver LBW neonates: teenagers, AOR 1.3 (95%CI:1.2–1.5); residing in internally displaced persons (IDP) camp, AOR 1.2(95% C1:1-1.9); no formal education, AOR 1.4(95%CI:1.2–1.5); unemployed, AOR 1.2(95%CI:1.1–1.3); divorced, AOR 1.3 (95% CI:1.1–1.4); and widowed, AOR 1.3 (95%CI:1.2–1.5). Women with the following medical factors were likely to deliver LBW neonates: having less than 8 ANC visits, AOR 1.2 (95%CI:1.1–1.5); primigravida, AOR1.2 (95%CI:1.1–1.6), history of delivering a LBW, AOR 1.2 (95% CI:1.1–1.4); history of preterm birth, AOR 1.6(1.3–1.8); birth interval less than 3 years, AOR 1.2(95% CI: 1.3–1.4); malaria during pregnancy, AOR 1.3(95%CI:1.1–1.6). Women with the following medical factors were less likely to deliver LBW neonates: Having the 1st ANC visit in the 1st trimester, AOR 0.6(0.3–0.7); using an insecticide-treated mosquito net, AOR 0.5(95%CI: 0.2–0.6); swallowed sulfadoxine-pyrimethamine under directly observed treatment (DOT), AOR 0.6 (95% CI: 0.2–0.8), and DOT with deworming tablets, AOR 0.6(95%CI:0.2–0.7). Mothers with the following nutritional characteristics were likely to deliver LBW neonates: maternal height < 150cm, AOR 1.2 (95% CI: 1.1–1.3); anemia at full term, AOR 1.4(95%CI: 1.3–1.7); mid-upper arm circumference < 23 cm, AOR 2.1(95% CI: 1.2–2.3). Mothers who received iron-folic acid supplementation, AOR 0.4(95%CI: 0.2–0.7), had a lower risk of delivering LBW neonates. Conclusion In Bosaso general hospital, delivering a LBW neonate was likely to be among pregnant mothers who: were teenagers, stunted, residing in IDP camps, unemployed, divorced or widowed, primigravida, had attended < 8 ANC visits, no formal education, with a history of preterm birth or LBW, birth interval < 3years, malaria during pregnancy, were anemia and wasted at term.
Purification of wastewater generated from methane fermentation using a semi-closed system with hydroponically grown lettuce plants
Authors: Ohyama Katsumi , Sumino Kaho , Awai Erdoo Paula , Niki Kaori , Endo Ryosuke
Published: August 2023

As agriculture accounts for approximately 70% of global water consumption, water recycling (e.g., the use of wastewater) is required. Similar to water recycling, food recycling is a major concern in urban areas. Here, we aimed to investigate the water balance of a semi-closed system and the quality of recovered wastewater and collected water. From a semi-closed system in which lettuce plants (Lactuca sativa L.) were grown hydroponically using bio-oxidized wastewater (or digestate) from methane fermentation with food waste as the substrate, evapotranspirated water was recovered using cooling devices. The evapotranspiration and water recovery rates tended to increase with increasing photosynthetic photon flux density (PPFD). During the 24-h experiment (performed in triplicate), approximately 50% of the evapotranspirated water was harvested. The electrical conductivity, pH, and relative illuminance of the adenosine triphosphate were lower in the recovered water than in the wastewater. The NO3-N PO4-P, K, Ca, Mg, SO4-S, Fe, Mn, and Mo concentrations were also lower in the recovered water than in the wastewater. Although a long-term experiment is required to draw more explicit conclusions, these results indicate the potential of wastewater recovery systems in producing plants and generating water with low contaminant levels.
Heterogeneity of prostate-specific membrane antigen (PSMA) and PSMA-ligand uptake detection combining autoradiography, histopathology and immunohistochemistry in primary prostate cancer
Authors: Wang Hui , Remke Marianne , Horn Thomas , Schwamborn Kristina , Chen Yiyao , Steiger Katja , Weichert Wilko , Wester Hans-Jürgen , Schottelius Margret , Weber Wolfgang , Eiber Matthias
Published: August 2023

Background Targeting prostate-specific membrane antigen (PSMA) has been highly successful for imaging and treatment of prostate cancer. However, heterogeneity in immunohistochemistry indicates limitations in the effect of imaging and radionuclide therapy of multifocal disease. 99mTc-PSMA-I&S is a γ-emitting probe, which can be used for intraoperative lesion detection and postsurgical autoradiography (ARG). We aimed to study its intraprostatic distribution and compared it with (immuno)-histopathology.Results Seventeen patients who underwent RGS between 11/2018 and 01/2020 with a total of 4660 grids were included in the preliminary analysis. Marked intratumor and intrapatient heterogeneity of PSMA expression was detected, and PSMA negative foci were observed in all samples (100%). Heterogeneous intrapatient PSMA-ligand uptake was observed, and no significant correlation was present between the degree of heterogeneity of PSMA expression and PSMA-ligand uptake. Higher PSMA-ligand uptake was observed in GS ≥ 8 than GS < 8 (p < 0.001). The appearance of GP 4 was strongly associated with higher uptake (coefficient: 0.43, p < 0.001), while GP 5 also affected the uptake (coefficient: 0.07, p < 0.001).Conclusion PSMA expression and PSMA-ligand uptake show marked heterogeneity. Prostate carcinoma with GP 4 showed significantly higher uptake compared with non-neoplastic prostate tissue. Our analyses extend the scope of applications of radiolabeled PSMA-ligands to ARG for identifying high-grade disease and using its signal as a noninvasive biomarker in prostate cancer.
Virtual Reality and Behaviour Management in Paediatric Dentistry: A Systematic Review
Authors: Padilha Diana , Veiga Nélio Jorge , Moura Anna Carolina , Correia Patrícia
Published: August 2023

Background:Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology helps distract and engage young patients during dental procedures, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry.Methods:A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS, and Web of Science databases were searched and analysed.Results:Search queries identified a total of 525 abstracts from three different databases. Duplicate articles were removed (n=79), leaving a total of 446 abstracts. After reading the title and abstract, 392 records were excluded. In the end, 22 articles were considered suitable for this systematic review.Conclusions:VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. By offering an engaging and immersive experience, VR effectively diverts patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is crucial to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.
Fuel Treatment Response Groups for Fire Prone Sagebrush Landscapes
Authors: Chambers Jeanne C. , Brown Jessi L. , Reeves Matthew C. , Strand Eva K. , Ellsworth Lisa M. , Tortorelli Claire M. , Urza Alexandra K. , Short Karen C.
Published: August 2023

Background
Sagebrush shrublands in the Great Basin, US, are experiencing widespread increases in wildfire size and area burned resulting in new policies and funding to implement fuel treatments. However, we lack the spatial data needed to optimize the types and locations of fuel treatments across large landscapes and mitigate fire risk. To address this, we developed Treatment Response Groups (TRGs) – sagebrush and pinyon-juniper vegetation associations that differ in resilience to fire and resistance to annual grass invasion (R&R) and thus responses to fuel treatments.
Results
We developed spatial layers of the dominant sagebrush associations by overlaying LANDFIRE Existing Vegetation Type, Biophysical Setting, and Mapping Zone, extracting vegetation plot data from the LANDFIRE 2016 LF Reference Database for each combination, and identifying associated sagebrush, grass, shrub, and tree species. We derived spatial layers of pinyon-juniper (PJ) cover and expansion phase within the sagebrush associations from the Rangeland Analysis Platform and identified persistent PJ woodlands from the LANDFIRE Biophysical Setting. TRGs were created by overlaying dominant sagebrush associations, with and without PJ expansion, and new indicators of resilience and resistance. We assigned appropriate fuel treatments to the TRGs based on prior research on treatment responses. The extent of potential area to receive fuel treatments was constrained to 52,940 km2 (18.4%) of the dominant sagebrush associations (272,501 km2) largely because of extensive areas of low R&R (68.9%), which is expected to respond poorly to treatment. Prescribed fire was assigned to big sagebrush associations with moderate or higher resilience and moderately low or higher resistance (14.2%) due to higher productivity, fuels, and recovery potential. Mechanical treatments were assigned to big sagebrush associations with moderately low resilience and to low, black, and mixed low sagebrush associations with moderately low or higher R&R (4.2%) due to lower productivity, fuels, and recovery potential. Persistent PJ woodlands represent high value resources and were not assigned treatments (9%).
Conclusions
Mapped TRGs can help identify the dominant sagebrush associations and determine appropriate fuel treatments at project area scales and provide the basis for quantitative wildfire risk assessments and outcome-based scenario planning to prioritize fuel treatment investments at landscape scales.
Complier average causal effect is a better estimate of the true causal treatment effect than intention-to-treat estimand in the presence of low treatment compliance: Insights from an instrumental variable approach
Authors: Ali Sumera Aziz , Paniagua-Avila Alejandra , Lamb Matthew R
Published: August 2023

Background
In the presence of substantial non-compliance to intervention, intention to treat (ITT) analysis may underestimate the effect of intervention on the outcome. In contrast, the complier average causal effect (CACE) provides a valid causal estimate of receiving intervention in the presence of non-compliance. This paper provides a user’s guide to estimating CACE following the instrumental variable approach in a simulated dataset of an individual-level randomized controlled trial (RCT) with non-compliance.
Methods
We simulated data for an RCT utilizing the simstudy R package, which generated potential outcomes and observed outcomes based on the assigned intervention and subgroups (Always Takers, Compliers, and Never Takers). Using the instrumental variable approach, we performed 20 simulations against all possible proportions of compliance ranging from 5 to 99% to generate an average for the true causal effect, ITT, and CACE. We created a graph comparing the averages of the three parameters i.e., true causal effect, ITT, and CACE by the proportion of compliance.
Results
We found that at an extremely low proportion of treatment compliance (i.e., below 10%), neither CACE nor ITT equaled the true causal effect. Above 10% compliance, the CACE (0.79–0.80) very closely approximated the true causal effect (0.80). However, the ITT (0.08 to 0.68) greatly underestimated the true causal effect at compliance of 10 to 85%. As the proportion of compliers increased above 85%, the ITT moved closer to the true causal effect, but it only became equivalent to the true causal effect when compliance was 99%.
Conclusion
The CACE estimand may be an alternative approach to ITT for estimating the causal effect of interventions in RCTs, particularly in the context of non-compliance. We recommend against the exclusive use of ITT when the proportion of compliers is below 85%. Instead of relying exclusively on the ITT to estimate the causal treatment effect in RCTs, we recommend using CACE in addition to ITT to allow for less biased estimates.
Bioinformatics analysis and machine learning identification of ferroptosis-related biomarkers in epilepsy
Authors: Wang Yao , Li Hong-Wei , Zhuo Zhi-hong , Xu Yi-ran , Wei Guang-shuai , Wang Jian-dong , Wang Huai-li
Published: August 2023

Background Epilepsy is one of the common nervous system diseases, and early diagnosis has an important impact on prognosis. Ferroptosis plays an important role in the pathogenesis of epilepsy. Using bioinformatics analysis and machine learning, we aimed to identify hub genes associated with ferroptosis and provide therapeutic targets for epilepsy.Methods Through bioinformatics analysis of datasets GSE49030 and GSE88992, differentially expressed genes(DEGs) related to ferroptosis in epilepsy were identified. Functional enrichment of ferroptosis-related DEGs was performed, and a protein interaction network was used to identify the top 30 node genes. LASSO, SVM-RFE, and random forest machine learning algorithms were employed to screen for hub genes. We analyzed the infiltration of immune cells in epilepsy and the control group and analyzed the correlation between hub genes and immune cells. Finally, the value of hub genes in the diagnosis of epilepsy was evaluated in the training set (GSE49030 and GSE88992) and validation set (GSE16969).Results GSE49030 and GSE88992 obtained a total of 1550 DEGs, including 55 ferroptosis-related DEGs. Enrichment analysis showed that ferroptosis, oxidative stress, and inflammatory signaling pathways were enriched. Jun and Wwtr1 were screened as hub genes. Immunological analysis showed that 9 kinds of cells were differentially expressed between the epilepsy group and control group. Two hub genes were mainly associated with NK cell activation. Jun and Wwtr1 were up-regulated in epilepsy, with AUROC of 0.978 and 0.973 for the diagnosis of epilepsy, respectively, and were verified in dataset DSE16969.Conclusion Our results suggest that Jun and Wwtr1 are potential biomarkers of epilepsy and NK cells ferroptosis can influence both the onset and progression of epilepsy. These results provide more evidence for the role of ferroptosis in the pathogenesis of epilepsy.