bluuebunny/crossref_metadata_2025 huggingface dataset:
Lessons learned spanning 17 years of experience with three consecutive nationwide competency based medical education training plans
Authors: de Heer Merel H. , Driessen Erik W. , Teunissen Pim W. , Scheele Fedde
Published: February 2024

Introduction

Curricula for postgraduate medical education have transformed since the introduction of competency based medical education (CBME). Postgraduate training plans offer broader training with different competencies and an outcome-based approach, in addition to the medical technical aspects of training. However, CBME also has its challenges. Over the past years, critical views have been shared on the potential drawbacks of CBME, such as assessment burden and conflicts with practicality in the workplace. Recent studies identified a need for a better understanding of how the evolving concept of CBME has been translated to curriculum design and implemented in the practice of postgraduate training. The aim of this study was to describe the development of CBME translations to curriculum design, based on three consecutive postgraduate training programs spanning 17 years.

Method

We performed a document analysis of three consecutive Dutch gynecology and obstetrics training plans that were implemented in 2005, 2013, and 2021. We used template analysis to identify changes over time.

Results

Over time, CBME-based curriculum design changed in several domains. Assessment changed from a model with a focus on summative decision to one with an emphasis on formative, low-stakes assessments aimed at supporting learning. The training plans evolved in parallel to evolving educational insights, e.g., by placing increasing emphasis on personal development. The curricula focused on a competency-based concept by introducing training modules and personalized authorization based on feedback rather than on a set duration of internships. There was increasing freedom in personalized training trajectories in the training plans, together with increasing trust towards the resident.

Conclusion

The way CBME was translated into training plans has evolved in the course of 17 years of experience with CMBE-based education. The main areas of change were the structure of the training plans, which became increasingly open, the degree to which learning outcomes were mandatory or not, and the way these outcomes were assessed.
How the forebrain transitions to adulthood: developmental plasticity markers in a long-lived rodent reveal region diversity and the uniqueness of adolescence
Authors: Garduño B. Maximiliano , Hanni Patrick , Hays Chelsea , Cogram Patricia , Insel Nathan , Xu Xiangmin
Published: February 2024

Maturation of the forebrain involves transitions from higher to lower levels of synaptic plasticity. The timecourse of these changes likely differs between regions, with the stabilization of some networks scaffolding the development of others. To gain better insight into neuroplasticity changes associated with maturation to adulthood, we examined the distribution of two molecular markers for developmental plasticity. We conducted the examination on male and female degus (Octodon degus), a rodent species with a relatively long developmental timecourse that offers a promising model for studying both development and age-related neuropathology. Immunofluorescent staining was used to measure perineuronal nets (PNNs), an extracellular matrix structure that emerges during the closure of critical plasticity periods, as well as microglia, resident immune cells that play a crucial role in synapse remodeling during development. PNNs (putatively restricting plasticity) were found to be higher in non-juvenile (>3 month) degus, while levels of microglia (putatively mediating plasticity) decreased across ages more gradually, and with varying timecourses between regions. Degus also showed notable variation in PNN levels between cortical layers and hippocampal subdivisions that have not been previously reported in other species. These results offer a glimpse into neuroplasticity changes occurring during degu maturation and highlight adolescence as a unique phase of neuroplasticity, in which PNNs have been established but microglia remain relatively high.
The differential effect of two cereal foods on gut environment: a randomized, controlled, double-blind, parallel-group study
Authors: Yamauchi Yohsuke , Masutomi Hirofumi , Ishihara Katsuyuki , Hartanto Tenagy , Lee Chol Gyu , Fukuda Shinji
Published: February 2024

Background and aims

Cereal-based foods such as fruit granola (FG) and corn flakes (CF) form part of a fiber-rich diet. Dietary fiber has a good effect on human health. However, changes in gut microbiota and intestinal immunity have not been investigated. We conducted a randomized, double-blind, placebo-controlled trial to investigate the effects of FG and CF intake on gut microbiota, metabolome, and the immune system.

Methods

Subjects continuously consume CF or FG for 4 weeks. Stool samples, and questionnaires on defecation were collected before, 2 weeks after, and 4 weeks after intake. Gut microbiota was analyzed using 16S rRNA gene amplicon sequencing. Fecal metabolomes were analyzed using GC/MS and CE-TOF/MS. Fecal IgA was analyzed using ELISA.

Results

The defecation frequency after cereal based food intake was improved. The different cereal-based foods had different effects on gut microbiome. The increase in intestinal IgA levels was positively correlated with the relative abundance of Dialister and the Lachnospiraceae ND3007 group in CF and FG group, respectively. SCFAs showed a positive correlation with Prevotella 9 in the FG group.

Conclusion

This study showed that the supplement in dietary fiber contained in CF and FG improves bowel movements. CF and FG each had different effects on gut microbes, metabolites and different relationships between fecal IgA or SCFAs and gut microbiota.
Beetroot juice supplementation and exercise performance: is there more to the story than just nitrate?
Authors: Zoughaib William S. , Fry Madison J. , Singhal Ahaan , Coggan Andrew R.
Published: February 2024

This mini-review summarizes the comparative effects of different sources of dietary nitrate (NO3−), beetroot juice (BRJ) and nitrate salts (NIT), on physiological function and exercise capacity. Our objectives were to determine whether BRJ is superior to NIT in enhancing exercise-related outcomes, and to explore the potential contribution of other putatively beneficial compounds in BRJ beyond NO3−. We conducted a comparative analysis of recent studies focused on the impact of BRJ versus NIT on submaximal oxygen consumption (VO2), endurance performance, adaptations to training, and recovery from muscle-damaging exercise. While both NO3− sources provide benefits, there is some evidence that BRJ may offer additional advantages, specifically in reducing VO2 during high-intensity exercise, magnifying performance improvements with training, and improving recovery post-exercise. These reported differences could be due to the hypothesized antioxidant and/or anti-inflammatory properties of BRJ resulting from the rich spectrum of phytonutrients it contains. However, significant limitations to published studies directly comparing BRJ and NIT make it quite challenging to draw any firm conclusions. We provide recommendations to help guide further research into the important question of whether there is more to the story of BRJ than just NO3−.
A study on the radiomic correlation between CBCT and pCT scans based on modified 3D-RUnet image segmentation
Authors: Yu Yanjuan , Gao Guanglu , Gao Xiang , Zhang Zongkai , He Yipeng , Shi Liwan , Kang Zheng
Published: February 2024

Purpose

The present study is based on evidence indicating a potential correlation between cone-beam CT (CBCT) measurements of tumor size, shape, and the stage of locally advanced rectal cancer. To further investigate this relationship, the study quantitatively assesses the correlation between positioning CT (pCT) and CBCT in the radiomics features of these cancers, and examines their potential for substitution.

Methods

In this study, 103 patients diagnosed with locally advanced rectal cancer and undergoing neoadjuvant chemoradiotherapy were selected as participants. Their CBCT and pCT images were used to divide the participants into two groups: a training set and a validation set, with a 7:3 ratio. An improved conventional 3D-RUNet (CLA-UNet) deep learning model was trained on the training set data and then applied to the validation set. The DSC, HD95 and ASSD were calculated for quantitative evaluation purposes. Then, radiomics features were extracted from 30 patients of the test set.

Results

The experiments demonstrate that, the modified model achieves an average DSC score 0.792 for pCT and 0.672 for CBCT scans. 1037 features were extracted from each patient’s CBCT and pCT images, 73 image features were found to have R values greater than 0.9, including three features related to the staging and prognosis of rectal cancer.

Conclusion

In this study, we proposed an automatic, fast, and consistent method for rectal cancer GTV segmentation for pCT and CBCT scans. The findings of radiomic results indicate that CBCT images have significant research value in the field of radiomics.
Landau model for illustrating the learning and unlearning process of nociplastic pain
Authors: Valenzuela Belén
Published: February 2024

Recent advancements in understanding the consolidation of nociplastic pain point to a complex, non-conscious learned process of threat perception. Neurobiological pain education is emerging as a promising approach to unlearn nociplastic pain, supported by biopsychosocial tools such as exposure to movement, mindfulness, and group sharing formats. However, this approach is still not well-known among clinicians and the society at large, creating a communication problem that unfortunately perpetuates the suffering of patients. Herein, we propose a Landau model to describe the learning and unlearning process of nociplastic pain, aiming to clarify this complex situation and facilitate communication across different sectors of the society. Nociplastic pain corresponds to a first-order transition, with attention more likely in the alert-protection state than in the trust-explore state. Two appealing results of the model are that the perception of the critical context depends on personal history regarding the symptom and that biopsychosocial loops are formed when there is alarming learned historical information about the symptom, along with confused and contradictory expert information, as seen in nocebo messages. Learning and unlearning in the model correspond to a chang in control parametrs that can weigh more on the alert-protection state, trust-explore state, uncertain state or neutral state. This description clarifies why neurobiological education is the foundational therapy from which others must be built to embody the accessible, clear, and trustworthy information.
Distinct neonatal hyperammonemia and liver synthesis dysfunction: case report of a severe MEGDHEL syndrome
Authors: Kirchberg Ina , Lainka Elke , Gangfuß Andrea , Kuechler Alma , Baertling Fabian , Schlieben Lea D. , Lenz Dominic , Tschiedel Eva
Published: February 2024

Background/purpose

MEGDHEL syndrome is a rare autosomal recessive metabolic disorder, which is characterized by 3-methylglutaconic aciduria with deafness-dystonia, hepatopathy, encephalopathy and Leigh-like syndrome. It is caused by biallelic pathogenic variants in the SERAC1 gene. Due to the unspecific symptoms and the diverse manifestations of the clinical phenotype, the diagnosis is challenging. Infantile MEGDHEL syndrome often has a severe disease course with acute liver failure. Differentiation from other metabolic disorders is difficult and requires a multidisciplinary approach.

Case presentation

A two-day-old small for gestational age neonate was admitted to our pediatric intensive care unit (PICU) due to severe liver failure with distinct hyperammonemia and hypoglycemia without elevation of transaminases or cholestasis. Due to high ammonia level, continuous hemodialysis was established immediately after admission. In addition, protein intake was stopped, and the patient anabolized with intravenous glucose. Temporary stabilization could be achieved after four days. In the further course, severe neurological and cardiocirculatory complications occurred, which ultimately led to the infant's death. In the metabolic diagnostics, a pronounced lactate acidosis and in urine an increased excretion of 3-methylglutaconic acid as well as other metabolites of mitochondrial energy metabolism has been the leading findings besides the hyperammonemia. Post-mortem trio whole genome analysis detected a homozygous pathogenic variant in SERAC1 with evidence of SERAC1 deficiency leading to the diagnosis of infantile MEGDHEL syndrome.

Conclusion

When pediatricians are faced with hepatopathy or even acute liver failure without elevation of transaminases or cholestasis in newborns, SERAC1 deficiency should be considered as a potential differential diagnosis. The initial treatment is based on the recommended management of suspected metabolic disorders. Even while no cure is available yet, patients should be offered proper supportive management through a multidisciplinary team. In addition, genetic confirmation of the diagnosis is important for the families, especially regarding further family planning.

If a newborn presents with hyperammonemia, hypoglycemia and impaired liver synthesis function without elevation of transaminases or cholestasis, the possible presence of MEGDHEL syndrome due to a SERAC1 mutation should be considered.
Harti Hauora Tamariki: randomised controlled trial protocol for an opportunistic, holistic and family centred approach to improving outcomes for hospitalised children and their families in Aotearoa, New Zealand
Authors: Scott Nina , Atatoa Carr Polly E. , Jones Amy R. , Sandiford Peter , Masters-Awatere Bridgette , Clark Helen
Published: February 2024

Background

Health and wellbeing inequities between the Indigenous Māori and non-Māori populations in Aotearoa, New Zealand continue to be unresolved. Within this context, and of particular concern, hospitalisations for diseases of poverty are increasing for tamariki Māori (Māori children). To provide hospitalised tamariki Māori, and their whānau (families) comprehensive support, a wellbeing needs assessment; the Harti Hauora Tamariki Tool (The Harti tool) was developed. The purpose of this study is to determine how effective the Harti tool is at identifying wellbeing needs, ensuring the documentation of needs, enabling access to services and improving wellbeing outcomes for tamariki and their whānau.

Methods

The study uses a Kaupapa Māori methodology with qualitative and quantitative methods. Qualitative methods include in-depth interviews with whānau. This paper presents an overview of a randomised, two parallel, controlled, single blinded, superiority trial for quantitative evaluation of the Harti programme, and hospital satisfaction with care survey. Participants will be Māori and non-Māori tamariki/children aged 0–4 years admitted acutely to the paediatric medical wards at Waikato Hospital, Hamilton, Aotearoa New Zealand. They will be randomised electronically into the intervention or usual care group. The intervention group will receive usual care in addition to the Harti programme, which includes a 24-section health needs assessment delivered by trained Māori navigators to whānau during the time they are in hospital. The primary endpoint is the relative risk of an acute hospital readmission in the 30 days following discharge for the intervention group patients compared with control group patients. Secondary outcomes include access and utilisation of preventative health services including: oral health care, general practice enrolment, immunisation, healthy home initiatives, smoking cessation and the Well Child Tamariki Ora universal health checks available free of charge for children in Aotearoa New Zealand.

Discussion

Randomised controlled trials are a gold standard for measuring efficacy of complex multifaceted interventions and the results will provide high quality evidence for implementing the intervention nationwide. We expect that this study will provide valuable evidence for health services and policy makers who are considering how to improve the configuration of paediatric hospital services.

Trial registration

The study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number: ACTRN12618001079235.
Dynamics analysis and optimal control study of uncertain information dissemination model triggered after major emergencies
Authors: Li Bowen , Li Hua , Sun Qiubai , Lv Rongjian , Yan Huining
Published: February 2024

In order to effectively prevent and combat online public opinion crises triggered by major emergencies, this paper explores the dissemination mechanism of uncertain information on online social platforms. According to the decision-making behavior of netizens after receiving uncertain information, they are divided into eight categories. Considering that there will be a portion of netizens who clarify uncertain information after receiving it, this paper proposes a SEFTFbTbMR model of uncertain information clarification behavior. The propagation dynamics equations of the model are given based on the theory of differential equations, the basic regeneration number R0 of the model is calculated, and the existence and stability of the equilibrium point of the model are analyzed. The theoretical analysis of the model is validated using numerical simulation software, and sensitivity analysis is performed on the parameters related to R0. In order to reduce the influence caused by uncertain information, the optimal control strategy of the model is proposed using the Hamiltonian function. It is found that the dissemination of uncertain information among netizens can be suppressed by strengthening the regulation of social platforms, improving netizens’ awareness of identifying the authenticity of information, and encouraging netizens to participate in the clarification of uncertain information. The results of this work can provide a theoretical basis for future research on the uncertain information dissemination mechanism triggered by major emergencies. In addition, the results can also provide methodological support for the relevant government departments to reduce the adverse effects caused by uncertain information in the future.
Study on the cut-off point and the influencing factors of distress in newly diagnosed breast cancer patients
Authors: Liu Ling , Wang Rong , Sun Yiming , Xiao Ying , Du Guangsheng , Zhang Qingling
Published: February 2024

Objective

Our aim is to investigate the cut-off point of distress and the influencing factors associated with distress in patients with newly diagnosed breast cancer.

Methods

A cross-sectional survey of distress was conducted in 167 patients with newly diagnosed breast cancer admitted to the Department of General Surgery of a tertiary care hospital from July 2020 to March 2022. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the Distress Thermometer (DT) questionnaire within 3 days of admission. The HADS ≥15 was used as the gold standard, and the cut-off point of the DT measure was analyzed using the Receiver Operating Characteristic (ROC) curve. The cut-off point obtained by ROC curve analysis was used to analyze the influencing factors of distress in breast cancer patients by univariate and multivariate regression analysis.

Results

A total of 167 patients completed the survey, with an average HADS score of 8.43 ± 5.84 and a total HADS score of ≥15 in 37 (22.16%) patients, the mean DT score was 2.96 ± 1.85. ROC curve analysis showed an area under the curve of 0.885, with a maximum Jorden index (0.723) at a DT score of 4, the sensitivity was 100.0% and specificity was 72.3%. There were 73 (43.71%) patients with DT score ≥ 4. Regression analysis showed that insurance/financial problems, dealing with partner problems, tension, bathing/dressing problems, pain, and sleep problems were independent risk factors for l distress in newly diagnosed breast cancer patients.

Conclusion

A DT score 4 is the cut-off point for distress in patients with newly diagnosed breast cancer. In clinical practice, target intervention should be carried out according to the risk factors of distress of patients.
Untargeted urine metabolomics and machine learning provide potential metabolic signatures in children with autism spectrum disorder
Authors: Liu Xian , Sun Xin , Guo Cheng , Huang Zhi-Fang , Chen Yi-Ru , Feng Fang-Mei , Wu Li-Jie , Chen Wen-Xiong
Published: February 2024

Background

Complementary to traditional biostatistics, the integration of untargeted urine metabolomic profiling with Machine Learning (ML) has the potential to unveil metabolic profiles crucial for understanding diseases. However, the application of this approach in autism remains underexplored. Our objective was to delve into the metabolic profiles of autism utilizing a comprehensive untargeted metabolomics platform coupled with ML.

Methods

Untargeted metabolomics quantification (UHPLC/Q-TOF-MS) was performed for urine analysis. Feature selection was conducted using Lasso regression, and logistic regression, support vector machine, random forest, and extreme gradient boosting were utilized for significance stratification. Pathway enrichment analysis was performed to identify metabolic pathways associated with autism

Results

A total of 52 autistic children and 40 typically developing children were enrolled. Lasso regression identified ninety-two urinary metabolites that significantly differed between the two groups. Distinct metabolites, such as prostaglandin E2, phosphonic acid, lysine, threonine, and phenylalanine, were revealed to be associated with autism through the application of four different ML methods (p<0.05). The alterations observed in the phosphatidylinositol and inositol phosphate metabolism pathways were linked to the pathophysiology of autism (p<0.05).

Conclusion

Significant urinary metabolites, including prostaglandin E2, phosphonic acid, lysine, threonine, and phenylalanine, exhibit associations with autism. Additionally, the involvement of the phosphatidylinositol and inositol phosphate pathways suggests their potential role in the pathophysiology of autism.
Willingness to receive the second booster of COVID-19 vaccine among older adults with cancer: a stratified analysis in four provinces of China
Authors: Zhang Liangyuan , Yang Jianzhou , Su Rila , Lan Xinquan , Song Moxin , Zhang Lei , Xu Junjie
Published: February 2024

Background

Despite the elevated COVID-19 risk for older adults with cancer, vaccine hesitancy poses a significant barrier to their immunization. Intriguingly, there is limited research on the prevalence of willingness to receive the second booster dose and associated determinants in older adults with cancer.

Objective

Our objective was to ascertain the level of awareness about COVID-19 vaccines and to uncover the factors influencing the willingness to receive the second booster among Chinese cancer patients aged 65 years and over.

Methods

To achieve our objective, we conducted a multicenter cross-sectional study in four tertiary hospitals from four provinces of China. This involved using a Health Belief Model (HBM) based self-administered questionnaire and medical records. Subsequently, we employed multivariable logistic regression to identify factors influencing the second COVID-19 booster vaccine willingness.

Results

Our results showed that among 893 eligible participants, 279 (31.24%) were aged 65 years and over, and 614 (68.76%) were younger. Interestingly, the willingness to receive the second COVID-19 booster vaccine was 34.1% (95/279) (OR: 1.043, 95% CI: 0.858, 1.267) in participants aged 65 years and over, which was similar to participants aged under 65 years (34.1% vs. 35.5%, p = 0.673). Furthermore, our findings revealed that a positive attitude toward the booster and recommendations from healthcare providers and family members were positively associated with vaccine willingness. Conversely, perceptions of negative impacts on cancer control and vaccine accessibility regarding the second COVID-19 booster were inversely related to the outcome event (all p < 0.05).

Conclusion

Our study concludes with the finding of a low willingness toward the second COVID-19 booster in Chinese cancer patients, particularly in the older adults, a fact which warrants attention. This reluctance raises their risk of infection and potential for severe outcomes. Consequently, we recommend using media and community outreach to dispel misconceptions, promote the booster’s benefits, and encourage vaccine discussions with healthcare providers and family members.
Identification of regulons modulating the transcriptional response to SARS-CoV-2 infection in humans
Authors: Padilla-Gálvez Mónica , Arteaga-Vazquez Leo J. , Villaseñor-Altamirano Ana B. , Balderas-Martínez Yalbi Itzel , Collado-Torres Leonardo , De Las Rivas Javier , Blanco-Melo Daniel , Medina-Rivera Alejandra
Published: February 2024

The pathophysiology underlying coronavirus disease 2019 (COVID-19) across tissues and cell types upon severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains to be fully characterized. Diverse cellular processes have been described, including interferon (IFN) and pro-inflammatory responses and functions of ACE2 and TMPRSS2 proteins. Characterizing how transcriptional programs are activated or repressed could give us a better understanding of the disease progression; this can be better understood via gene regulatory network reverse engineering. Here, we make use of multiple publicly available transcriptional data, such as primary cells and tissue samples obtained from COVID-19 patients’ lung autopsies, to build the transcriptional regulatory networks for each condition. Our results describe the regulatory mechanisms underlying SARS-CoV-2 infection across tissues and cell lines, identifying antiviral and pro-inflammatory networks.
Effects of alkaline and ultrasonication on duckweed (Wolffia arrhiza) protein extracts’ physicochemical and techno-functional properties
Authors: Nitiwuttithorn Chotika , Wongsasulak Saowakon , Vongsawasdi Punchira , Yongsawatdigul Jirawat
Published: February 2024

Wolffia is a protein-rich aquatic plant with the potential to help address food sustainability issues; however, a more efficient extraction process must be sought due to limited yield with conventional methods. This study aimed to investigate the effects of duckweed forms (fresh and dried), duckweed-to-aqueous solution ratio (DSR), as well as alkaline and ultrasonication extractions on yields, physicochemical and techno-functional properties of duckweed protein extracts (DPE). Three extraction methods were used: alkaline extraction (AE), ultrasound-assisted alkaline extraction (UAAE), and ultrasound-assisted water extraction (UAWE). The study showed fresh duckweed resulted in a 2.5-fold higher yield and protein recovery than oven-dried duckweed. UAE significantly enhanced extraction yield and protein recovery. The optimal extraction process was a DSR of 1:6 using UAAE at pH 8.5, resulting in a 16% yield and 34% protein recovery. Furthermore, the study found that UAE facilitated the extraction of non-polar/hydrophobic amino acids while AE proved to be efficient in extracting sulfur-containing amino acids. This study, for the first time, revealed the role of UAE and AE in promoting the extraction of different profiles of amino acids. The DPE produced using UAAE contained 65% protein, meeting the WHO/FAO/UNU recommended protein intake for preschool-aged children. Furthermore, the DPE exhibited excellent emulsifying properties and oil-holding capacity comparable to commercial soy protein isolates. Overall, UAAE was identified as a promising approach for producing techno-functional and nutritious protein ingredients from Wolffia. The resulting DPE proved to show great potential for functional plant-based food and feed applications.
Heterogeneity of Lithium Distribution in the Graphite Anode of 21700-Type Cylindrical Li-Ion Cells during Degradation
Authors: Petz Dominik , Baran Volodymyr , Park Juyeon , Schökel Alexander , Kriele Armin , Rebelo Kornmeier Joana , Paulmann Carsten , Koch Max , Nilges Tom , Müller-Buschbaum Peter , Senyshyn Anatoliy
Published: February 2024

Structural and spatial aspects of cell degradation are studied using a combination of diffraction-and imaging-based tools applying laboratory X-rays, neutron scattering and synchrotron radiation with electrochemical and thermal characterization. Experimental characterization is carried out on cylindrical cells of 21700-type, where four regimes of cell degradation are identified, which are supplemented by an increased cell resistance and surface temperature during cell operation. The amount of intercalated lithium in the fully charged anodes in the fresh and aged states is determined by ex situ X-ray diffraction radiography and in situ X-ray diffraction computed tomography. The qualitatively similar character of the results revealed a loss of active lithium along with the development of a complex heterogeneous distribution over the electrode stripe.
Stereotactic Body Radiotherapy for Extracranial Oligometastatic Disease from Head and Neck Primary Cancers: A Systematic Review and Meta-Analysis
Authors: Mutsaers Adam , Akingbade Aquila , Louie Alexander V. , Id Said Badr , Zhang Liying , Poon Ian , Smoragiewicz Martin , Eskander Antoine , Karam Irene
Published: February 2024

Introduction: Stereotactic body radiotherapy (SBRT) is increasingly used to treat disease in the oligometastatic (OM) setting due to mounting evidence demonstrating its efficacy and safety. Given the low population representation in prospective studies, we performed a systematic review and meta-analysis of outcomes of HNC patients with extracranial OM disease treated with SBRT. Methods: A systematic review was conducted with Cochrane, Medline, and Embase databases queried from inception to August 2022 for studies with extracranial OM HNC treated with stereotactic radiotherapy. Polymetastatic patients (>five lesions), mixed-primary cohorts failing to report HNC separately, lack of treatment to all lesions, nonquantitative endpoints, and other definitive treatments (surgery, conventional radiotherapy, and radioablation) were excluded. The meta-analysis examined the pooled effects of 12- and 24-month local control (LC) per lesion, progression-free survival (PFS), and overall survival (OS). Weighted random-effects were assessed using the DerSimonian and Laird method, with heterogeneity evaluated using the I2 statistic and Cochran Qtest. Forest plots were generated for each endpoint. Results: Fifteen studies met the inclusion criteria (639 patients, 831 lesions), with twelve eligible for quantitative synthesis with common endpoints and sufficient reporting. Fourteen studies were retrospective, with a single prospective trial. Studies were small, with a median of 32 patients (range: 6–81) and 63 lesions (range: 6–126). The OM definition varied, with a maximum of two to five metastases, mixed synchronous and metachronous lesions, and a few studies including oligoprogressive lesions. The most common site of metastasis was the lung. Radiation was delivered in 1–10 fractions (20–70 Gy). The one-year LC (LC1), reported in 12 studies, was 86.9% (95% confidence interval [CI]: 79.3–91.9%). LC2 was 77.9% (95% CI: 66.4–86.3%), with heterogeneity across studies. PFS was reported in five studies, with a PFS1 of 43.0% (95% CI: 35.0–51.4%) and PFS2 of 23.9% (95% CI: 17.8–31.2%), with homogeneity across studies. OS was analyzed in nine studies, demonstrating an OS1 of 80.1% (95% CI: 74.2–85.0%) and OS2 of 60.7% (95% CI: 51.3–69.4%). Treatment was well tolerated with no reported grade 4 or 5 toxicities. Grade 3 toxicity rates were uniformly below 5% when reported. Conclusions: SBRT offers excellent LC and promising OS, with acceptable toxicities in OM HNC. Durable PFS remains rare, highlighting the need for effective local or systemic therapies in this population. Further investigations on concurrent and adjuvant therapies are warranted.
Microbiota Alterations in Lung, Ileum, and Colon of Guinea Pigs with Cough Variant Asthma
Authors: Dou Chongyang , Hu Lin , Ding Xian , Chen Fangfang , Li Xi , Wei Guihua , Yan Zhiyong
Published: February 2024

Alterations in the microbiota composition, or ecological dysbiosis, have been implicated in the development of various diseases, including allergic diseases and asthma. Examining the relationship between microbiota alterations in the host and cough variant asthma (CVA) may facilitate the discovery of novel therapeutic strategies. To elucidate the diversity and difference of microbiota across three ecological niches, we performed 16S rDNA amplicon sequencing on lung, ileum, and colon samples. We assessed the levels of interleukin-12 (IL-12) and interleukin-13 (IL-13) in guinea pig bronchoalveolar lavage fluid using the enzyme-linked immunosorbent assay (ELISA). We applied Spearman’s analytical method to evaluate the correlation between microbiota and cytokines. The results demonstrated that the relative abundance, α-diversity, and β-diversity of the microbial composition of the lung, ileum, and colon varied considerably. The ELISA results indicated a substantial increase in the level of IL-13 and a decreasing trend in the level of IL-12 in the CVA guinea pigs. The Spearman analysis identified a correlation between Mycoplasma, Faecalibaculum, and Ruminococcus and the inflammatory factors in the CVA guinea pigs. Our guinea pig model showed that core microorganisms, such as Mycoplasma in the lung, Faecalibaculum in the ileum, and Ruminococcus in the colon, may play a crucial role in the pathogenesis of CVA. The most conspicuous changes in the ecological niche were observed in the guinea pig ileum, followed by the lung, while relatively minor changes were observed in the colon. Notably, the microbial structure of the ileum niche approximated that of the colon niche. Therefore, the results of this study suggest that CVA development is closely related to the dysregulation of ileal, lung, and colon microbiota and the ensuing inflammatory changes in the lung.
A Non-Parametric Sequential Procedure for the Generalized Partition Problem
Authors: Solanky Tumulesh K. S. , Zhou Jie
Published: February 2024

In selection and ranking, the partitioning of treatments by comparing them to a control treatment is an important statistical problem. For over eighty years, this problem has been investigated by a number of researchers via various statistical designs to specify the partitioning criteria and optimal strategies for data collection. Many researchers have proposed designs in order to generalize formulations known at that time. One such generalization adopted the indifference-zone formulation to designate the region between the boundaries for “good” and “bad” treatments as the indifference zone. Since then, this formulation has been adopted by a number of researchers to study various aspects of the partition problem. In this paper, a non-parametric purely sequential procedure is formulated for the partition problem. The “first-order” asymptotic properties of the proposed non-parametric procedure are derived. The performance of the proposed non-parametric procedure for small and moderate sample sizes is studied via Monte Carlo simulations. An example is provided to illustrate the proposed procedure.
Editorial for Special Issue “Effects of Probiotics on Health”
Authors: Heczko Piotr
Published: February 2024

Since 1987, when Professor Sherwood Gorbach discovered, characterized, and commercialized the first probiotic Lactobacillus rhamnosus GG, a total of over 17,000 publications have been indexed in PubMed under “probiotic” and “health”, which is an extensive amount of research on the specific bacteria and yeasts defined as “live microorganisms that, when administered in adequate amounts, exert a health benefit on the host” [...]
Geochemical Record of Late Quaternary Paleodepositional Environment from Lacustrine Sediments of Soda Lake, Carrizo Plain, California
Authors: Rodriguez Alejandro , Guo Junhua , O’Sullivan Katie , Krugh William
Published: February 2024

This study investigates the responses of the depositional environments of Soda Lake sediments to climatic shifts from the Last Glacial Maximum to the Holocene epoch based on the results of major and trace elements of the North Soda Lake (NSL) NSL1A core. The NSL1A core records the sedimentary evolution of the Soda Lake watershed since at least 25 cal ka BP. Element analyses provide evidence that Soda Lake sediments are mostly derived from marine sequences in the Southern Coast Ranges of California. Variation in proxies for paleoweathering, paleoclimate, paleosalinity, paleoproductivity, paleoredox, and water depth is utilized to reconstruct the evolution of the sedimentary environment. The Chemical Index of Alteration (CIA) values indicate low to moderate chemical weathering in the sediment source regions. Paleoredox proxies indicate that the NSL1A core formed in a mainly subreduction environment. The NSL1A core is divided into four zones based on the results of the proxies. Zone 4 (5.0–5.8 m) of the sediment core indicates stable hydroclimatic conditions with low and constant sand and silt content, suggesting a warm and relatively humid environment. Zone 3 (3.35–5.0 m) represents the early half of the Last Glacial Maximum interval and a high lake stand. The elevated sand content suggests postflood events due to the northerly migration of westerly storm tracks. Zone 2 (1.075–3.35 m) reveals nuanced changes, including decreasing salinity, slight increases in wetness, detrital trace metals, and paleoproductivity. These subtle shifts suggest a multifaceted environmental evolution: a trend toward wetter conditions alongside a prolonged shift from cooler to warmer periods. Zone 1 (0.15–1.075 m) spans the Lateglacial to Holocene transition as well as Early and Middle Holocene, marked by significant hydrologic and ecologic variability including rapid warming during the Bølling–Allerød and rapid cooling linked to the Younger Dryas.
Establishment of quality standards for syrup from viburnum fruit meal
Authors:   Federal State Budgetary Educational Institution of Higher Education «Dagestan State Medical University» of the Ministry of Health of the Russian Federation, Kadilaeva Z. A.
Published: February 2024

An adjusted dosage form has been developed in the form of a syrup using low-waste technology — from the meal of the fruits of Viburnum viburnum. Viburnum fruit meal contains higher fatty acids, triterpenoids, phytosterols, and carotenoids. Medicines of plant origin have a number of undeniable advantages compared to synthetic ones, since their composition ensures safety and better tolerability due to the variety of biologically active substances (BAS) of plants, they can have a complex effect on the body, and they can be used for a long time. However, the main issue is that, despite their high bioavailability and cost-effectiveness, herbal medicines are complex to design and require the development of a number of technological solutions. Equally important are the issues of establishing quality standards — standardization of the developed dosage form. The syrup was prepared from simple sugar syrup with the addition of dry extract from viburnum fruit meal. Purpose of work. Development and establishment of quality standards for the developed dosage form — syrup from viburnum fruit meal. Materials and methods. High performance liquid chromatography (HPLC) method. Let us use it to establish standards in quantitative terms for chlorogenic acid. Permanganatometry. This technique was used to determine the quantitative content of the amount of tannins in terms of gallic acid. Results. It was established that the content of chlorogenic acid in the developed syrup is 0.214 ± 0.006 %, the content of tannins in terms of gallic acid is 0.494 ± 0.014 %. Indicators acidity (pH) — 3–5, density — 1,360 to 1,420 g/cm3, microbiological purity — category 3 B. Conclusion. The result of the research was the establishment of the main indicators of syrup quality, namely the quantitative content of the main biologically active substances — chlorogenic acid and tannins in terms of gallic acid. In addition, such indicators as acidity (pH), density, and microbiological purity were determined.
Cloning of recombinant thyroglobulin
Authors:   Institute of Biochemical Technology and Nanotechnology, Peoples’ Friendship University of Russia, Moscow, Russia, Khreim Wael B. W. , Zubkov A. V. ,   Institute of Biochemical Technology and Nanotechnology, Peoples’ Friendship University of Russia, Moscow, Russia
Published: February 2024

The aim of the study is to clone cDNA fragments of mRNA of the thyroglobulin gene into а vector and introduce it into prokaryotic cell lines for possible use in the diagnosis of autoimmune and oncological diseases of the human thyroid gland. Thyroid hormones are synthesized by thyrocytes of mammalian thyroid tissue from the large protein thyroglobulin having a molecular weight of 330 kDa. The thyroid hormones thyroxine and triiodothyronine are small molecules that have large biological effects. They regulate metabolism in almost all cells, and are important for the development of the central nervous system, musculoskeletal system and lungs. These are also the only hormones that contain iodine and are synthesized partly inside and partly outside of cells. A dimeric glycoprotein is called thyroglobulin.
Investigation of the Effect of Layer Thickness of Adhesive Material on Metal to Composite Joints
Authors: Borhy Levente , Szebényi Gábor
Published: February 2024

In this research, fiberglass-reinforced epoxy composite plates and additively manufactured titanium inserts are adhesively bonded. The samples are investigated by tensile and shear bond test methods. After the mechanical tests, topographical evaluations are conducted over the failure surface areas. A 3D profiling method for the inspection of bonded joints has been developed to quantify and compare failure types. It was found that varying the thickness of the adhesive has a significant effect on the load-carrying capacity of the structure under normal direction loading, whereas under shear loading the effect is modest. The research methodology used allows for the qualification and comparison of further bonded structures.
Medical Device Design to Support Hand Movement
Authors: Egerszegi Boglárka Fanni
Published: February 2024

After accidents, neurological disorders, and cerebrovascular diseases, patients must learn to perform their daily tasks with their new, changed life situation, in which they can be helped by various ergotherapy aids. In the course of my work, I aimed to develop an aid that not only tries to correct the errors of products found on the market, but also a multifunctional aid that serves several types of disability, and which can be worn by individuals with upper limb involvement and living with locomotor diseases/locomotor disorders/changes. An important aspect in the design of the aid was, among other things, that it can be used in any environment and during any activity and that it should be comfortable to wear.
The Effect of Salt Water on the Properties of Basalt Fibre Reinforced Composites
Authors: Tamás-Bényei Péter
Published: February 2024

The use of natural or naturally derived reinforcing materials in polymer composites is increasing, thanks to the growing importance of sustainable economy and environmental consciousness. The most promising natural reinforcing material is basalt fibre, which has a very similar chemical structure to glass fibre, which is widely used. However, due to the difference in chemical structure, basalt fibre may be more resistant to more aggressive environments, such as seawater. In this research, the effect of salt water on basalt fibre and its composites was analysed. Unimpregnated basalt, glass and carbon fibre as well as impregnated composites with different concentrations of saltwater solutions were treated for different durations. The effect of salt water was studied by mechanical and morphological tests.
ATUAÇÃO DO ENFERMEIRO NA CLASSIFICAÇÃO DE RISCO NO SERVIÇO DE URGÊNCIA E EMERGÊNCIA
Authors: Da Silva Salazar Kelly Andresa , Avellaneda Fabiana
Published: February 2024

Introdução: Os serviços de urgência e emergência são a principal porta de entrada dos usuários, onde é oferecido atendimento imediato àqueles que mais precisam. Para a identificação destes pacientes, é realizado a classificação de risco. Objetivo: identificar as evidências da literatura sobre o papel do enfermeiro frente à classificação de risco nos serviços de urgência e emergência. Método: revisão integrativa de literatura, nas bases de dados LILACS, SCIELO E BDENF, realizada de março a junho de 2021. Utilizado os DECS: acolhimento e serviço hospitalar de emergência. Buscaram-se artigos publicados em português, sem limite de período. Resultados: a amostra final foi constituída de 7 artigos. Discussão: a atuação do enfermeiro é destacada em todas as publicações elencadas como sinônimo de protagonismo dentro do serviço de saúde, exercendo papel de liderança e responsabilidade. Conclusão: É de fundamental importância que novos estudos sejam realizados, pois percebe-se uma carência desta temática abordada.
EFFECT OF ECOLOGICAL CONDITIONS ON DESI AND FAYOUMI CHICKEN TRAITS AT DISTRICT KASHMORE, SINDH-PAKISTAN
Authors: Ali Shahid , Ujan Javed Ahmed , Ujjan Safdar Ali
Published: February 2024

The present study was undertaken to evaluate the different body organs measurement and multiple phenotypic traits of desi and fayoumi selected chicken breeds under free range and intensive management conditions during, 2021. Host birds were collected from local peoples and hatcheries of district Kashmore and brought through intensive care management system in Animal Husbandry, Department of Zoology, Shah Abdul Latif University Khairpur Mirs. Both chicken male and female populations were reared separately in the same ecology and F1 generation chickens were obtained. The feeding and rearing procedures were followed by NRC and ISA recommended guidelines. The average values of phenotypic traits like neck length of desi and fayoumi males measured in cm (20.4±1.9), (16.5±1.4) body height (43.4±3.2), (33.7±3.2) shank length (12.5±0.82) (8.3±0.72) beak length (3.6±0.21) (2.7±0.16) and wings span (23.7±1.6) (18.3±1.5) in intensive conditions. While as, in the free range conditions the neck length of desi and fayoumi males was recorded in cm (18.7±1.6) (16.4±1.3) body height (38.7±3.2) (34.6±3.1), shank length (10.3±0.97) (9.4±0.94), length of beak (3.3±0.24) (2.7±0.18), and wing span (20.4±1.5) (18.5±1.4), in both chicken breeds. The different phenotype traits of desi and fayoumi chicken breeds viz., the color of eyes, comb, plumage, feather, barbell, mumps, and beak colors percentage were found with variation in intensive and free range conditions. Concludingly, desi chickens were found with larger body parts with dark color variants. The present study suggests, more work should be carried on other characteristics to enhance poultry quality and quantity in future endeavors.