bluuebunny/crossref_metadata_2025 huggingface dataset:
PENYULUHAN PERAN REMAJA DAN MASYARAKAT DALAM MENCEGAH TUBERKULOSIS (TB)
Authors: Aini Aini , Pratiwi Elan , Halid Musparlin , Suhada Adriyan
Published: June 2023

Tuberkulosis merupakan penyakit yang disebabkan oleh mycobacterium tuberculosis. Kejadian terbaru khusus di Kabupaten Lombok Barat menempati urutan ketiga setelah Lombok Tengah dan Lombok Timur. Berbagai upaya yang dilakukan untuk menurunkan Angka kejadian tinggi oleh pemerintah. Mulai dari imunisasi program pos hingga program pengawasan minum obat untuk penderita yang telah didiagnosis tuberkulosis. Salah  satu yang merupakan elemen masyarakat produktif yang mampu memiliki peran dalam membantu pemerintah dalam upaya untuk pengawasan tuberculosis adalah remaja. Remaja memerlukan kegiatan yang selalu memberikan inovasi, yang tidak hanya terbatas pada pengobatan saja tetapi yang diperlukan lebih dari itu yaitu kegiatan yang sifatnya pencegahan dan promosi kesehatan seperti penyuluhan, penkes, dan sosialisasi.Tujuan dari kegiatan pengadian ini adalah untuk memberikan pemahaman pada generasi muda dalam memberikan pemahanan cara mencegah kejadian dan penyebaran tuberculosis. Kegiatan ini dilakukan di SMA 7 labuapi dan diikuti oleh 80 siswa. Kegiatan pengabdian dilakukan dalam bentuk sosialisasi untuk pemberian pehamanan terhadap 80 orang siwa. Evaluasi  hasil pengabdian dilakukan dalam bentuk kuesioner yang diberikan sebelum dan sesudah sosialisasi. Perbandingan hasil yang diperolah dari nilai sebelum dan sesudah sosialisasi.
Sosialisasi Keamanan Pangan Jajan Anak Sekolah sebagai Upaya Peningkatan Taraf Kesehatan Masyarakat
Authors: Ika Nurfajri Mentari  , Jumari Ustiawaty  , Roushandy Asri Fardani  , Desyani Ariza  , Mohd Nazil Bin Salleh  , Syahrul
Published: June 2023

Public health is a very important aspect to be considered in improving the welfare and progress of a country. Some of the health problems in childhood are stunting and nutritional imbalance. Conditions like this can have serious short-term impacts such as the risk of morbidity and mortality in infants and toddlers, medium-term impacts related to low intelligence and cognitive abilities, as well as long-term impacts related to the quality of human resources who experience degenerative disease disorders in the future. come. One of the efforts to avoid this is that the Health College Institution participates in providing knowledge to the community, especially elementary school children regarding school children's snacks. This activity was attended by 98 grade 5 and 6 students of SDN 1 Perampuan. The results obtained from these activities are that students understand and can distinguish between nutritious snacks and good for growth needs. In addition, students understand what will happen if they choose bad food with the ultimate goal of helping to improve people's lives, especially from the health aspect.
Biological nitrogen fixation by soybean (Glycine max [L.] Merr.), a novel, high protein crop in Scotland, requires inoculation with non-native bradyrhizobia
Authors: Maluk Marta , Giles Madeline , Wardell Grace E. , Akramin Aminin Taqrir , Ferrando-Molina Francesc , Murdoch Ashley , Barros Marta , Beukes Chrizelle , Vasconçelos Marta , Harrison Ellie , Daniell Tim J. , Quilliam Richard S. , Iannetta Pietro P. M. , James Euan K.
Published: June 2023

It is currently not recommended to grow soybean (Glycine max [L.] Merr.) further than 54° North, but climate change and the development of new high latitude-adapted varieties raises the possibility that it could be introduced into Scotland as a novel high protein crop deriving most of its nitrogen (N) requirements through biological N fixation (BNF). This was evaluated via field trials in 2017 and 2018 near Dundee (56.48°N). As there are no native soybean-nodulating bacteria (SNB) in UK soils, soybean requires inoculation to exploit its BNF potential. In 2017, three commercial inoculants containing elite Bradyrhizobium strains significantly increased plant biomass in plot trials with a soybean 000 maturity group variety (ES Comandor). Rhizobia were isolated from the nodules and identified as the original inoculant species, B. diazoefficiens and B. japonicum. One inoculant (Rizoliq Top) was used for larger-scale trials in 2018 with two varieties (ES Comandor, ES Navigator); inoculation doubled the grain yield to 1 t ha-1 compared to the uninoculated crop. The inoculated soybean obtained most of its N through BNF in both years regardless of plant genotype i.e. >73%Ndfa, with BNF contributions to aerial biomass exceeding 250 kg N ha-1 yr-1 in 2017 and that to grain 50 kg N ha-1 yr-1 in 2018. These data suggest that N-fixing soybean could be grown in Scotland without mineral N-fertiliser, either for forage as animal feed, or as green pods for human consumption (“edamame”), and potentially, even as dry grain. The potential for survival of the Bradyrhizobium inoculant strains in soils was also demonstrated through the detection of the inoculant strain B. diazoefficiens SEMIA 5080 at relatively high populations (104 g-1 dry soil) using a qRT-PCR method with SNB-specific nodZ primers. Microbiome data obtained from soil using 16S rRNA primers demonstrated that the diversity of bacteria belonging to the genus Bradyrhizobium increased in soybean-cropped soils compared to bulk soil regardless of inoculation status. The economic and practical implications of residual inoculum, as well as those arising from introducing a non-native plant and alien bacteria into Scottish soils in terms of their impact on the native soil microbiota are discussed.
A cell membrane model that reproduces cortical flow-driven cell migration and collective movement
Authors: Sato Katsuhiko
Published: June 2023

Many fundamental biological processes are dependent on cellular migration. Although the mechanical mechanisms of single-cell migration are relatively well understood, those underlying migration of multiple cells adhered to each other in a cluster, referred to as cluster migration, are poorly understood. A key reason for this knowledge gap is that many forces—including contraction forces from actomyosin networks, hydrostatic pressure from the cytosol, frictional forces from the substrate, and forces from adjacent cells—contribute to cell cluster movement, making it challenging to model, and ultimately elucidate, the final result of these forces. This paper describes a two-dimensional cell membrane model that represents cells on a substrate with polygons and expresses various mechanical forces on the cell surface, keeping these forces balanced at all times by neglecting cell inertia. The model is discrete but equivalent to a continuous model if appropriate replacement rules for cell surface segments are chosen. When cells are given a polarity, expressed by a direction-dependent surface tension reflecting the location dependence of contraction and adhesion on a cell boundary, the cell surface begins to flow from front to rear as a result of force balance. This flow produces unidirectional cell movement, not only for a single cell but also for multiple cells in a cluster, with migration speeds that coincide with analytical results from a continuous model. Further, if the direction of cell polarity is tilted with respect to the cluster center, surface flow induces cell cluster rotation. The reason why this model moves while keeping force balance on cell surface (i.e., under no net forces from outside) is because of the implicit inflow and outflow of cell surface components through the inside of the cell. An analytical formula connecting cell migration speed and turnover rate of cell surface components is presented.
Reduction of methicillin-resistant Staphylococcus aureus biofilm growth and development using arctic berry extracts
Authors: Aguilera-Correa John Jairo , Nohynek Liisa , Alakomi Hanna-Leena , Esteban Jaime , Oksman-Caldentey Kirsi-Marja , Puupponen-Pimiä Riitta , Kinnari Teemu J. , Perez-Tanoira Ramon
Published: June 2023

Introduction

Surgical site infection remains a devastating and feared complication of surgery caused mainly by Staphylococcus aureus (S. aureus). More specifically, methicillin-resistant S. aureus (MRSA) infection poses a serious threat to global health. Therefore, developing new antibacterial agents to address drug resistance are urgently needed. Compounds derived from natural berries have shown a strong antimicrobial potential.

Methods

This study aimed to evaluate the effect of various extracts from two arctic berries, cloudberry (Rubus chamaemorus) and raspberry (Rubus idaeus), on the development of an MRSA biofilm and as treatment on a mature MRSA biofilm. Furthermore, we evaluated the ability of two cloudberry seed-coat fractions, hydrothermal extract and ethanol extract, and the wet-milled hydrothermal extract of a raspberry press cake to inhibit and treat biofilm development in a wound-like medium. To do so, we used a model strain and two clinical strains isolated from infected patients.

Results

All berry extracts prevented biofilm development of the three MRSA strains, except the raspberry press cake hydrothermal extract, which produced a diminished anti-staphylococcal effect.

Discussion

The studied arctic berry extracts can be used as a treatment for a mature MRSA biofilm, however some limitations in their use exist.
Echocardiographic and clinical outcomes following beating heart NeoChord DS1000 mitral valve repair: a single centre case series
Authors: Brown Amy , Jefferson Hallie L. , Fatehi Hassanabad Ali , Noss Christopher , Webb Nicole , Fedak Paul W. M. , Kent William D. T. , Adams Corey
Published: June 2023

Background

The NeoChord DS1000 system implants artificial neochords transapically, through a left mini-thoracotomy to treat degenerative mitral valve regurgitation (MR). Performed without cardiopulmonary bypass, neochord implantation and length adjustment is guided by transesophageal echocardiography. We describe imaging and clinical outcomes for a single center case series using this innovative device platform.

Methods

In this prospective series, all study patients had degenerative MR and were considered for conventional mitral valve surgery. Moderate to high-risk candidates were screened for NeoChord DS1000 eligibility based on echocardiographic criteria. Study criteria included isolated posterior leaflet prolapse, leaflet-to-annulus index greater than 1.2, and coaptation length index greater than 5 mm. Patients with bileaflet prolapse, mitral annular calcification, and ischemic MR were excluded from our early experience.

Results

Ten patients underwent the procedure, including 6 males and 4 females, with a mean age of 76 ± 9.5 years. All patients had severe chronic MR and normal left ventricular function. One patient required conversion to an open procedure for failure to deploy neochords with the device transapically. The median number of NeoChord sets was 3 (IQR 2.3–3.8). Immediate post-procedure (POD#0) degree of MR on echocardiography ranged from mild or less, and on postoperative day 1 (POD#1) from moderate or less. Average length of coaptation was 0.85 ± 0.21 cm and average depth of coaptation was 0.72 ± 0.15 cm. At 1-month follow-up echocardiography, MR was graded from trivial to moderate and left ventricular inner diameter dimensions decreased from an average of 5.4 ± 0.4 cm to 4.6 ± 0.3 cm. None of the patients who had successful NeoChord implantation required blood products. There was 1 perioperative stroke with no residual deficits. There were no device-related complications or serious adverse events. The median length of hospital stay was 3 (IQR 2.3–10) days. 30-day and 6-weeks postoperative mortality and readmission rates were 0%.

Conclusion

We report the first Canadian case series using the NeoChord DS1000 system for off-pump, transapical, beating heart mitral valve repair, through a left mini-thoracotomy. The early surgical outcomes suggest this approach is feasible, safe, and effective in reducing MR. This novel procedure has the advantage of offering a minimally invasive, off-pump option for select patients with high surgical risk.
Evolving cardiovascular genetic counseling needs in the era of precision medicine
Authors: Morales Ana , Goehringer Jessica , Sanoudou Despina
Published: June 2023

In the era of Precision Medicine the approach to disease diagnosis, treatment, and prevention is being transformed across medical specialties, including Cardiology, and increasingly involves genomics approaches. The American Heart Association endorses genetic counseling as an essential component in the successful delivery of cardiovascular genetics care. However, with the dramatic increase in the number of available cardiogenetic tests, the demand, and the test result complexity, there is a need not only for a greater number of genetic counselors but more importantly, for highly specialized cardiovascular genetic counselors. Consequently, there is a pressing need for advanced cardiovascular genetic counseling training, along with innovative online services, telemedicine, and patient-facing digital tools, as the most effective way forward. The speed of implementation of these reforms will be of essence in the translation of scientific advancements into measurable benefits for patients with heritable cardiovascular disease and their families.
Fitness to fly for children and adolescents after Fontan palliation
Authors: Müller N. , Herberg U. , Breuer J. , Kratz T. , Härtel J. A.
Published: June 2023

Introduction

At cruising altitude, the cabin pressure of passenger aircraft needs to be adjusted and, therefore, the oxygen content is equivalent to ambient air at 2,500 masl, causing mild desaturation and a rising pulmonary vascular resistance (PVR) in healthy subjects. For Fontan patients with passive pulmonary perfusion, a rising PVR can cause serious medical problems. The purpose of this fitness to fly investigation (FTF) is to assess the risk of air travel for children and adolescents after Fontan palliation.

Methods

We investigated 21 Fontan patients [3–14y] in a normobaric hypoxic chamber at a simulated altitude of 2,500 m for 3 h. Oxygen saturation, heart rate, and regional tissue saturation in the forehead (NIRS) were measured continuously. Before entering the chamber, after 90 and 180 min in the hypoxic environment, blood gas analysis and echocardiography were performed.

Results

Heart rate and blood pressure did not show significant intraindividual changes. Capillary oxygen saturation (SaO2) decreased significantly after 90 min by a mean of 5.6 ± 2.87% without further decline. Lactate, pH, base excess, and tissue saturation in the frontal brain did not reach any critical values. In the case of open fenestration between the tunnel and the atrium delta, P did not increase, indicating stable pulmonary artery pressure.

Conclusion

All 21 children finished the investigation successfully without any adverse events, so flying short distance seems to be safe for most Fontan patients with good current health status. As the baseline oxygen saturation does not allow prediction of the maximum extent of desaturation and adaption to a hypoxic environment takes up to 180 min, the so-called hypoxic challenge test is not sufficient for these patients. Performing an FTF examination over a period of 180 min allows for risk assessment and provides safety to the patients and their families, as well as the airline companies.
Prospects for applying a theory of change model to the use of research evidence in autism education
Authors: Mintz Joseph , Roberts Amelia
Published: June 2023

Educators and educational researchers show continued interest in how schools can best make use of research evidence in bringing about change in practice in schools. A number of models have been developed to support schools in this challenge, such as research learning communities and lesson study. However, questions remain about the effectiveness of such models, their fit to the particular needs of schools and the extent to which they contribute meaningfully to the body of evidence used to inform changes to practice within the field of education. This issue is of particular relevance when considering the inclusion of autistic children in the classroom partly because of the large body of research being undertaken on autism across a range of domains with varying epistemological perspectives (e.g., neuroscience, psychology, pedagogy) and partly due to the widespread need to support autistic children in the classroom. Questions have also been raised about the evidence policy “agenda,” particularly in terms of reliance on positivist models centered on randomized controlled trials. These concerns focus on the extent to which performative or neoliberal perspectives on effectiveness might mask the complexity of how practice and knowledge (or evidence) are related in models of teacher professional working. One particular approach that could have potential in addressing these is that of Theory of Change (ToC). ToC models come from the field of theory-driven evaluation and draw on frameworks for relating practice to knowledge such as realist evaluations whereby the evaluation focuses on understanding how complex programs work in specific contexts by examining the mechanisms that lead to particular outcomes. ToC models consider under what conditions, for whom, and for what reasons or aims a given activity will achieve its intended outcomes. This paper considers the scope for the application of ToC models by reviewing a selected case from a completed study on the implementation of models for developing evidence informed practice in schools for autism education. By applying a ToC lens to what did happen in this case, we will “re-imagine” this case from a ToC perspective. This approach will serve to illustrate the possibilities for how ToC models could be used in future practice to advance evidence-informed practice in autism education.
Lateral neck dissection for the treatment of synchronous and metachronous lateral neck metastasis of N1b papillary thyroid cancer
Authors: Yun Hyeok Jun , Lee Jin Seok , Lee Jun Sung , Kim Seok Mo , Chang Hojin , Lee Yong Sang , Chang Hang-Seok , Park Cheong Soo
Published: June 2023

Introduction

Metachronous lateral neck recurrence after thyroidectomy for N1b papillary thyroid cancer is accompanied by high morbidity and increased difficulty of reoperation. From the perspective of recurrence, the objective of this study was to compare patients who underwent metachronous lateral neck dissection (mLND) despite initial thyroidectomy and patients who underwent synchronous lateral neck dissection (sLND) for papillary thyroid cancer and analyze the risk factors for recurrence after mLND.

Method

This retrospective study involved 1,760 patients who underwent lateral neck dissection for papillary thyroid cancer at the Gangnam Severance Hospital, a tertiary medical center in Korea, from June 2005 to December 2016. The primary outcome was structural recurrence, and secondary outcome measures were risk factors of recurrence in the mLND group.

Result

A total of 1,613 patients underwent thyroidectomy and sLND at diagnosis. In 147 patients, thyroidectomy alone was performed at the time of diagnosis, and mLND was performed when recurrence to the lateral neck lymph node was confirmed. During a median follow-up of 102.1 months, 110 (6.3%) patients experienced a recurrence. There was no significant difference in the recurrence between the sLND and mLND groups (6.1% vs 8.2%, P=.32). The period from lateral neck dissection to recurrence was longer in the mLND group than in the sLND group (113.6 ± 39.4 months vs 87.0 ± 33.8 months, respectively, P<.001). Age ≥50 years (adjusted HR=5.209, 95% CI=1.359–19.964; P=.02), tumor size >1.45 cm (adjusted HR=4.022, 95% CI=1.036–15.611; P=.04), and lymph node ratio in the lateral compartment (adjusted HR=4.043, 95% CI=1.079–15.148; P=.04) were independent variables predictive of recurrence after mLND.

Conclusion

mLND is suitable for treating lateral neck recurrence in patients with N1b papillary thyroid cancer who previously underwent thyroidectomy. Lateral neck recurrence after treatment in patients who underwent mLND was predicted by age, tumor size, and lymph node ratio in the lateral compartment.
Breaking down the tumor immune infiltration within pediatric sarcomas
Authors: Weil Rachel , Loeb David
Published: June 2023

Immunotherapies are a promising therapeutic option, yet for a variety of reasons, these treatments have achieved limited success against sarcomas. The immunosuppressive tumor microenvironment (TME) of sarcomas as well as lack of predictive biomarkers, decreased T-cell clonal frequency, and high expression of immunosuppressive infiltrating cells has thus far prevented major success using immunotherapies. By breaking down the TME into its individual components and understanding how the various cell types interact with each other as well as in the context of the complex immune microenvironment, can lead to effective therapeutic immunotherapy treatments, potentially improving outcomes for those with metastatic disease.
Analysis of the gains and losses of ecosystem service value under land use change and zoning in Qiqihar
Authors: Zuo Zhiqian , Yang Yanzhao , Wang Ran , Li Jinxiao , Zhang Pengtao
Published: June 2023

Under a background of uncoordinated economic development and the ecological environment, quantifying the ecological effect brought by land resource changes, have become research key and hotspots. To explore land use change and its impact on ecosystem service value (ESV), the land use change analysis method, ecosystem service evaluation model, flow direction analysis model and two-dimensional graph theory clustering method were used to analyze the profit and loss of ESV in Qiqihar in 2010 and 2020 and the division of ecological function areas with counties as units. The results show that: 1) The land use change in Qiqihar city is more obvious, Among them, the area of cultivated land, wetland, construction land and other increases, Woodland, grassland, water area decreased, The changed land area accounts for 30.95% of the total area; 2) The ESV in Qiqihar city increased by 869 million yuan, The sum of the value of cultivated land and wetland exceeded 70.0% of the ESV, is the main source of ESV in Qiqihar city; 3) Not all land-use shifts are conducive to ESV growth. The increase of ESV mainly comes from the flow of cultivated land and grassland to the wetland; Conversion of woodlands, water area, wetlands to other types causes ESV loss, the most loss is the conversion of wetlands to cultivated land; 4) Qiqihar city is divided into the central wetland ecological conservation area, the western characteristic agriculture and dotted wetland ecological function area, and the northeast agricultural ecological environment construction functional area. Three policies were proposed to improve ESV:(1) give play to the radiation role of wetland nature reserves; (2) popularize the black land protection technology model; and (3) prevent and control agricultural non-point source pollution and promote clean agriculture.
Rice-Magnaporthe transcriptomics reveals host defense activation induced by red seaweed-biostimulant in rice plants
Authors: Banakar Sahana N. , Prasannakumar M. K. , Parivallal P. Buela , Pramesh D. , Mahesh H. B. , Sarangi Aditya N. , Puneeth M. E. , Patil Swathi S.
Published: June 2023

Red seaweed extracts have been shown to trigger the biotic stress tolerance in several crops. However, reports on transcriptional modifications in plants treated with seaweed biostimulant are limited. To understand the specific response of rice to blast disease in seaweed-biostimulant-primed and non-primed plants, transcriptomics of a susceptible rice cultivar IR-64 was carried out at zero and 48 h post inoculation with Magnaporthe oryzae (strain MG-01). A total of 3498 differentially expressed genes (DEGs) were identified; 1116 DEGs were explicitly regulated in pathogen-inoculated treatments. Functional analysis showed that most DEGs were involved in metabolism, transport, signaling, and defense. In a glass house, artificial inoculation of MG-01 on seaweed-primed plants resulted in the restricted spread of the pathogen leading to the confined blast disease lesions, primarily attributed to reactive oxygen species (ROS) accumulation. The DEGs in the primed plants were defense-related transcription factors, kinases, pathogenesis-related genes, peroxidases, and growth-related genes. The beta-D-xylosidase, a putative gene that helps in secondary cell wall reinforcement, was downregulated in non-primed plants, whereas it upregulated in the primed plants indicating its role in the host defense. Additionally, Phenylalanine ammonia-lyase, pathogenesis-related Bet-v-I family protein, chalcone synthase, chitinases, WRKY, AP2/ERF, and MYB families were upregulated in seaweed and challenge inoculated rice plants. Thus, our study shows that priming rice plants with seaweed bio-stimulants resulted in the induction of the defense in rice against blast disease. This phenomenon is contributed to early protection through ROS, protein kinase, accumulation of secondary metabolites, and cell wall strengthening.
Effector T cell chemokine IP-10 predicts cardiac recovery and clinical outcomes post-myocardial infarction
Authors: Sopova Kateryna , Tual-Chalot Simon , Mueller-Hennessen Matthias , Vlachogiannis Nikolaos I. , Georgiopoulos Georgios , Biener Moritz , Sachse Marco , Turchinovich Andrey , Polycarpou-Schwarz Maria , Spray Luke , Maneta Eleni , Bennaceur Karim , Mohammad Ashfaq , Richardson Gavin David , Gatsiou Aikaterini , Langer Harald F. , Frey Norbert , Stamatelopoulos Kimon , Heineke Joerg , Duerschmied Daniel , Giannitsis Evangelos , Spyridopoulos Ioakim , Stellos Konstantinos
Published: June 2023

Background and aims

Preclinical data suggest that activation of the adaptive immune system is critical for myocardial repair processes in acute myocardial infarction. The aim of the present study was to determine the clinical value of baseline effector T cell chemokine IP-10 blood levels in the acute phase of ST-segment elevation myocardial infarction (STEMI) for the prediction of the left ventricular function changes and cardiovascular outcomes after STEMI.

Methods

Serum IP-10 levels were retrospectively quantified in two independent cohorts of STEMI patients undergoing primary percutaneous coronary intervention.

Results

We report a biphasic response of the effector T cell trafficking chemokine IP-10 characterized by an initial increase of its serum levels in the acute phase of STEMI followed by a rapid reduction at 90min post reperfusion. Patients at the highest IP-10 tertile presented also with more CD4 effector memory T cells (CD4 TEM cells), but not other T cell subtypes, in blood. In the Newcastle cohort (n=47), patients in the highest IP-10 tertile or CD4 TEM cells at admission exhibited an improved cardiac systolic function 12 weeks after STEMI compared to patients in the lowest IP-10 tertile. In the Heidelberg cohort (n=331), STEMI patients were followed for a median of 540 days for major adverse cardiovascular events (MACE). Patients presenting with higher serum IP-10 levels at admission had a lower risk for MACE after adjustment for traditional risk factors, CRP and high-sensitivity troponin-T levels (highest vs. rest quarters: HR [95% CI]=0.420 [0.218-0.808]).

Conclusion

Increased serum levels of IP-10 in the acute phase of STEMI predict a better recovery in cardiac systolic function and less adverse events in patients after STEMI.
Financing marine conservation from restructured debt: a case study of the Seychelles
Authors: Booth Mara , Brooks Cassandra M.
Published: June 2023

In the face of the threats posed to the oceans by a changing climate, the need for marine conservation programs grows rapidly. Scaling with this need demands sufficient funding to support ambitious conservation projects. This funding must be obtained from increasingly varied and innovative sources since private grants and government allocated funds has proved insufficient. Debt-for-nature swaps are a financial mechanism seeking to improve debt burden while setting up environmental programs. This method of debt restructuring has existed for decades, but is seeing a resurgence of use and interest in recent years. Here we present an exploratory case study of a Seychelles debt-for-nature swap which examines this financial mechanism’s ability to fund impactful conservation projects, particularly in marine Economic Exclusion Zones (EEZ) of Small Island Developing States (SIDS). The Seychelles finalized a conversion of their sovereign debt with Paris Club creditors and The Nature Conservancy as a broker in 2015 with the goal of creating a robust marine spatial plan (MSP). They received notable recognition for multiple novel aspects of this deal as well as the sheer scale of the marine space protected (400,000 sq. km), and thus serves as a robust case study to analyze if debt-for-nature swaps have evolved since its theoretical conception in 1984. Our research favors qualitative data by employing a case study approach which draws on semi-structured interviews with key informants, content analysis of online resources, and a literature review. This research suggests that while the model has yet to be cemented, the Seychelles case study is representative of a coming evolution in debt-for-nature swap practices. By examining the critical governance factors that were employed in the Seychelles, this research reveals key takeaways for future implementation and establishing national candidacy. The findings highlight debt status relative to the economy, political willpower, funding streams utilized, and the use of co-production practices. We show how the Seychelles case study demonstrates marked progress from the historical standard regarding sovereignty concerns and governance, but not concerning timescales and low converted sum. However, we note that this innovative debt-for-nature swap suggests that a new standard is possible and provides a new framework and set of best practices. In doing so, the Seychelles MSP can potentially lead the way for additional marine debt-for-nature swaps.
Research on mechanical properties and impact resistance of origami-based metamaterial for GIL
Authors: Xu Wei , Huang Yinmao , Li Haoran , Luo Yan , Wu Yang
Published: June 2023

Gas insulated metal enclosed transmission line (GIL) is a high voltage, high current power transmission equipment, widely used in large hydropower stations, large-scale energy hubs and other occasions. Aiming at the shock environment that GIL may face, such as earthquake shock and water flow shock, a mirror folded mechanical metamaterial based on the Miura-ori patterned is proposed in this paper, and its mechanical responses and shock resistance performance were studied through the numerical simulation and experiment. The results showed that compared with the single-layer folded structure, the mirror connection mode increased the plastic hinge in the deformation process of the structure, causing the better energy absorption. Moreover, the parameters research indicated that reducing the plane angle and increasing the dihedral angle can improve the energy absorption. Most importantly, the structure can achieve more than 60% energy absorption under the impact load, showing a good buffer energy absorption effect. This paper can provide some significant reference and guidance for the impact resistance of the GIL in the practical engineering.
Cognitive biases and moral characteristics of healthcare workers and their treatment approach for persons with advanced dementia in acute care settings
Authors: Erel Meira , Marcus Esther-Lee , DeKeyser Ganz Freda
Published: June 2023

Introduction

Palliative care (PC) delivery for persons with advanced dementia (AD) remains low, particularly in acute-care settings. Studies have shown that cognitive biases and moral characteristics can influence patient care through their effect on the thinking patterns of healthcare workers (HCWs). This study aimed to determine whether cognitive biases, including representativeness, availability, and anchoring, are associated with treatment approaches, ranging from palliative to aggressive care in acute medical situations, for persons with AD.

Methods

Three hundred fifteen HCWs participated in this study: 159 physicians and 156 nurses from medical and surgical wards in two hospitals. The following questionnaires were administered: a socio-demographic questionnaire; the Moral Sensitivity Questionnaire; the Professional Moral Courage Scale; a case scenario of a person with AD presenting with pneumonia, with six possible interventions ranging from PC to aggressive care (referring to life-prolonging interventions), each given a score from (−1) (palliative) to 3 (aggressive), the sum of which is the “Treatment Approach Score;” and 12 items assessing perceptions regarding PC for dementia. Those items, the moral scores, and professional orientation (medical/surgical) were classified into the three cognitive biases.

Results

The following aspects of cognitive biases were associated with the Treatment Approach Score: representativeness—agreement with the definition of dementia as a terminal disease and appropriateness of PC for dementia; availability—perceived organizational support for PC decisions, apprehension regarding response to PC decisions by seniors or family, and apprehension regarding a lawsuit following PC; and anchoring—perceived PC appropriateness by colleagues, comfort with end-of-life conversations, guilt feelings following the death of a patient, stress, and avoidance accompanying care. No association was found between moral characteristics and the treatment approach. In a multivariate analysis, the predictors of the care approach were: guilt feelings about the death of a patient, apprehension regarding senior-level response, and PC appropriateness for dementia.

Conclusion

Cognitive biases were associated with the care decisions for persons with AD in acute medical conditions. These findings provide insight into the potential effects of cognitive biases on clinical decisions, which may explain the disparity between treatment guidelines and the deficiency in the implementation of palliation for this population.
Surgical resection for second primary colorectal cancer: a population-based study
Authors: Li Ting , Liu Zhenyang , Bai Fei , Xiao Hua , Zhou Huijun
Published: June 2023

Background

Second primary colorectal cancer (CRC) is attributed to a crucial component of the CRC population. Still, its treatments remain unclear due to the troublesome conditions originating from multiple primary cancers and the lack of quality evidence. This study aimed to determine that which type of surgical resection is the eligible treatment for second primary CRC among patients with a prior cancer history.

Methods

This cohort study retrospectively collected patients with second primary stage 0-III CRC in the Surveillance, Epidemiology, and End Results database from 2000 to 2017. Prevalence of surgical resection in second primary CRC, overall survival (OS) and disease-specific survival (DSS) of patients who received different surgical interventions were estimated.

Results

A total of 38,669 patients with second primary CRC were identified. Most of the patients (93.2%) underwent surgical resection as initial treatment. Approximately 39.2% of the second primary CRCs (N = 15,139) were removed with segmental resection, while 54.0% (N = 20,884) were removed through radical colectomy/proctectomy. Surgical resection was associated with a significantly favorable OS and DSS compared to those not receiving any surgical operations for second primary CRC [OS: adjusted Hazard ratios (adjusted HR): 0.35; 95% CI: 0.34–0.37, p < 0.001; DSS: adjusted HR: 0.27; 95% CI: 0.25–0.29, p < 0.001]. Segmental resection considerably outperformed radical resection in terms of OS and DSS (OS: adjusted HR: 0.97; 95% CI: 0.91–1.00, p = 0.07; DSS: adjusted HR: 0.92; 95% CI: 0.87–0.97, p = 0.002). Segmental resection was also associated with a significantly reduced cumulative mortality of postoperative non-cancer comorbidities.

Conclusion

Surgical resection demonstrated excellent oncological superiority for second primary CRC and was used to remove the vast majority of second primary CRCs. In comparison to radical resection, segmental resection offered a better prognosis and reduced postoperative non-cancer complications. The second primary colorectal cancers should be resected if the patients can afford surgical operations.
The value of histopathology combined with CapitalBio Mycobacterium real-time polymerase chain reaction test for diagnosing spinal tuberculosis
Authors: Yao Liwei , Bu Caifang , Zhang Jinjuan , Zhang Dandan
Published: June 2023

Purpose

To evaluate the diagnostic efficacy of CapitalBio Mycobacterium real-time polymerase chain reaction assay (CapitalBio test) in spinal tuberculosis (STB). The value of histopathology combined with the CapitalBio test in diagnosing STB was also assessed.

Methods

We retrospectively analyzed the medical information of suspected STB. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of histopathology, CapitalBio test, and histopathology combined with CapitalBio test were calculated to evaluate their diagnostic efficacy compared with a composite reference standard.

Results

A total of 222 suspected STB patients were included in the study. The sensitivity, specificity, PPV, NPV, and AUC of histopathology for STB were recorded to be 62.0, 98.0, 97.4, 68.3%, and 0.80, respectively. The sensitivity, specificity, PPV, NPV, and AUC of the CapitalBio test were 75.2, 98.0, 97.9, 76.7%, and 0.87, respectively, while that of histopathology combined with the CapitalBio test was 81.0, 96.0, 96.1, 80.8%, and 0.89, respectively.

Conclusion

Histopathology and CapitalBio test exhibited high accuracy and are recommended in diagnosing STB. Histopathology combined with the CapitalBio test might give the best efficacy in STB diagnosis.
Evaluation of diagnostic accuracy of dual-energy computed tomography in patients with chronic thromboembolic pulmonary hypertension compared to V/Q-SPECT and pulmonary angiogram
Authors: Schüssler Armin , Lug Quirin , Kremer Nils , Harth Sebastian , Kriechbaum Steffen D. , Richter Manuel J. , Guth Stefan , Wiedenroth Christoph B. , Tello Khodr , Steiner Dagmar , Seeger Werner , Krombach Gabriele Anja , Roller Fritz Christian
Published: June 2023

Purpose

The relevance of dual-energy computed tomography (DECT) for the detection of chronic thromboembolic pulmonary hypertension (CTEPH) still lies behind V/Q-SPECT in current clinical guidelines. Therefore, our study aimed to assess the diagnostic accuracy of DECT compared to V/Q-SPECT with invasive pulmonary angiogram (PA) serving as the reference standard.

Methods

A total of 28 patients (mean age 62.1 years ± 10.6SD; 18 women) with clinically suspected CTEPH were retrospectively included. All patients received DECT with the calculation of iodine maps, V/Q-SPECT, and PA. Results of DECT and V/Q-SPECT were compared, and the percent of agreement, concordance (utilizing Cohen's kappa), and accuracy (kappa2) to PA were calculated. Furthermore, radiation doses were analyzed and compared.

Results

In total, 18 patients were diagnosed with CTEPH (mean age 62.4 years ± 11.0SD; 10 women) and 10 patients had other diseases. Compared to PA, accuracy and concordance for DECT were superior to V/Q-SPECT in all patients (88.9% vs. 81.3%; k = 0.764 vs. k = 0.607) and in CTEPH patients (82.4% vs. 70.1%; k = 0.694 vs. k = 0.560). Furthermore, the mean radiation dose was significantly lower for DECT vs. V/Q-SPECT (p = 0.0081).

Conclusion

In our patient cohort, DECT is at least equivalent to V/Q-SPECT in diagnosing CTEPH and has the added advantage of significantly lower radiation doses in combination with simultaneous assessment of lung and heart morphology. Hence, DECT should be the subject of ongoing research, and if our results are further confirmed, it should be implemented in future diagnostic PH algorithms at least on par with V/Q-SPECT.
Successful regression of newly formed corneal neovascularization by subconjunctival injection of bevacizumab in patients with chemical burns
Authors: Peng Wen-yan , He Li-wen , Yin Xiao-fang , Zhou Bin-Bing , Zhou Tao , Zhou Shi-you
Published: June 2023

Purpose

To investigate the effect and timing of subconjunctival bevacizumab injection on inhibiting corneal neovascularization (CorNV) in patients after chemical burns.

Methods

Patients with CorNV secondary to chemical burns were involved. Two subconjunctival injections of bevacizumab (2.5 mg/0.1 mL per involved quadrant) with an interval of 4 weeks were administered, and followed up a year. The area occupied by neovascular vessels (NA), accumulative neovascular length (NL), mean neovascular diameter (ND), best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were evaluated. Complication was also recorded.

Results

Eleven patients with CorNV were involved. Eight patients had a history of surgery (four had amniotic grafts, one had keratoplasty, and three had amniotic grafts and keratoplasty). Decreasing in NA, NL, and ND were statistically significant at each time point compared to the baseline (p < 0.01). CorNV that developed within 1 month was considerably regressed, and vessels with fibrovascular membranes were found to be narrower and shorter than pretreatment. BCVA improved in five patients (from one to five lines), remained unchanged in five patients, and decreased in one patient compared to pretreatment.

Conclusion

Subconjunctival bevacizumab injection has a particular potential for the regression of CorNV, especially newly formed within 1 month in patients after chemical burns.
Genome engineering of Stx1-and Stx2-converting bacteriophages unveils the virulence of the dairy isolate Escherichia coli O174:H2 strain UC4224
Authors: Milani Giovanni , Belloso Daza Mireya Viviana , Cortimiglia Claudia , Bassi Daniela , Cocconcelli Pier Sandro
Published: June 2023

The past decade witnessed the emergence in Shiga toxin-producing Escherichia coli (STEC) infections linked to the consumption of unpasteurized milk and raw milk cheese. The virulence of STEC is primarily attributed to the presence of Shiga toxin genes (stx1 and stx2) carried by Stx-converting bacteriophages, along with the intimin gene eae. Most of the available information pertains to the “Top 7” serotypes associated with STEC infections. The objectives of this study were to characterize and investigate the pathogenicity potential of E. coli UC4224, a STEC O174:H2 strain isolated from semi-hard raw milk cheese and to develop surrogate strains with reduced virulence for use in food-related studies. Complete genome sequence analysis of E. coli UC4224 unveiled the presence of a Stx1a bacteriophage, a Stx2a bacteriophage, the Locus of Adhesion and Autoaggregation (LAA) pathogenicity island, plasmid-encoded virulence genes, and other colonization facilitators. In the Galleria mellonella animal model, E. coli UC4224 demonstrated high pathogenicity potential with an LD50 of 6 CFU/10 μL. Upon engineering E. coli UC4224 to generate single and double mutant derivatives by inactivating stx1a and/or stx2a genes, the LD50 increased by approximately 1 Log-dose in the single mutants and 2 Log-doses in the double mutants. However, infectivity was not completely abolished, suggesting the involvement of other virulence factors contributing to the pathogenicity of STEC O174:H2. Considering the possibility of raw milk cheese serving as a reservoir for STEC, cheesemaking model was developed to evaluate the survival of UC4224 and the adequacy of the respective mutants as reduced-virulence surrogates. All tested strains exhibited the ability to survive the curd cooking step at 48°C and multiplied (3.4 Log CFU) in cheese within the subsequent 24 h. These findings indicate that genomic engineering did not exert any unintended effect on the double stx1-stx2 mutant behaviour, making it as a suitable less-virulent surrogate for conducting studies during food processing.
Acupuncture and related therapies for tension-type headache: a systematic review and network meta-analysis
Authors: Hu Jinglin , Wang Xichen , Jia Siqi , Kong Lingzu , Wang Yining , Xin Xiaoqi , Hu Yinghua , Chen Xinhua
Published: June 2023

Background

Tension-type headache (TTH) is one of the most common primary headaches. Several studies have confirmed the efficacy of acupuncture therapies for TTH, but it is uncertain which treatment is most effective.

Objective

This study aimed to compare the effectiveness and safety of different acupuncture therapies for TTH using Bayesian Network Meta-analysis to provide new ideas for treating TTH.

Methods

Nine databases were searched for randomized controlled trials (RCTs) about different acupuncture therapies for TTH up to December 1, 2022. The outcome indicators analyzed in our study were total effective rate, visual analog scale (VAS), headache frequency, and safety. Pairwise meta-analysis and risk of bias assessment were performed using Review Manager 5.4. Stata 15.0 generated a network evidence plot and detected publication bias. Finally, a Bayesian network meta-analysis of the data was used by RStudio.

Results

The screening process resulted in 30 RCTs that met the inclusion criteria, including 2,722 patients. Most studies failed to report details of trials and were therefore assessed as unclear risks. Two studies were considered high risk because they did not report on all pre-specified outcome indicators or had incomplete data on outcome indicators. The NMA results showed that for total effective rate, bloodletting therapy had the most considerable SUCRA value (0.93156136), for VAS, head acupuncture combined with Western medicine ranked first (SUCRA = 0.89523571), and acupuncture combined with herbal medicine was the most effective in improving headache frequency (p > 0.05).

Conclusion

Acupuncture can be used as one of the complementary or alternative therapies for TTH; bloodletting therapy better improves the overall symptoms of TTH, head acupuncture combined with Western medicine is more effective in reducing VAS scores, and acupuncture combined with herbal medicine seems to reduce headache frequency, but the difference is not statistically significant. Overall, acupuncture for TTH is effective with mild side effects, but future high-quality studies are still necessary.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, PROSPERO [CRD42022368749].
Efficient strategies for finger movement classification using surface electromyogram signals
Authors: Prabhakar Sunil Kumar , Won Dong-Ok
Published: June 2023

One of the famous research areas in biomedical engineering and pattern recognition is finger movement classification. For hand and finger gesture recognition, the most widely used signals are the surface electromyogram (sEMG) signals. With the help of sEMG signals, four proposed techniques of finger movement classification are presented in this work. The first technique proposed is a dynamic graph construction and graph entropy-based classification of sEMG signals. The second technique proposed encompasses the ideas of dimensionality reduction utilizing local tangent space alignment (LTSA) and local linear co-ordination (LLC) with evolutionary algorithms (EA), Bayesian belief networks (BBN), extreme learning machines (ELM), and a hybrid model called EA-BBN-ELM was developed for the classification of sEMG signals. The third technique proposed utilizes the ideas of differential entropy (DE), higher-order fuzzy cognitive maps (HFCM), empirical wavelet transformation (EWT), and another hybrid model with DE-FCM-EWT and machine learning classifiers was developed for the classification of sEMG signals. The fourth technique proposed uses the ideas of local mean decomposition (LMD) and fuzzy C-means clustering along with a combined kernel least squares support vector machine (LS-SVM) classifier. The best classification accuracy results (of 98.5%) were obtained using the LMD-fuzzy C-means clustering technique classified with a combined kernel LS-SVM model. The second-best classification accuracy (of 98.21%) was obtained using the DE-FCM-EWT hybrid model with SVM classifier. The third best classification accuracy (of 97.57%) was obtained using the LTSA-based EA-BBN-ELM model.