bluuebunny/crossref_metadata_2025 huggingface dataset:
Shot distribution in target archery, with application to arrow selection
Authors: Dall Ian , Park James L
Published: October 2022

This work examines the distribution of shots in target archery. In previous work, based on a small sample size, it was concluded that the radial distance [Formula: see text] from the centre of the target to the point of impact had a half-normal distribution. In this work, with a very large sample size, we find that [Formula: see text] follows a Rayleigh distribution very closely, and that only varying the scale, this holds for subpopulations of interest: compound, recurve, male, female, indoors, outdoors and from intermediate to elite skill level. The importance and utility of an accurate statistical model of shot distribution is demonstrated by developing a model of the expected increase in qualification score due to arrow diameter, and the probability of winning head-to-head matches, conducted under World Archery rules. It is concluded that the choice of shot distribution has a significant impact on the accuracy of predictive models of archery performance and that shot distribution is accurately characterized by the Rayleigh distribution. It is found that there are substantial benefits in selecting the maximum permitted arrows shaft diameter, for indoor archery. The benefits vary with archer skill level but are not confined to elite archers.
Serendipitous synergism – an exceptional response to treatment with pembrolizumab in the course of a natural immunovirotherapy: a case report and review of the literature
Authors: Khoury Lara M. , Burcher Kimberly M. , Ng Ronald T. , Song Alexander H. , Chang Mark J. , Gavrila Elena , Bloomer Chance H. , Robinson Mac B. , Kouri Brian E. , Waltonen Joshua D. , Bunch Paul M. , Lauer Ulrich M. , Porosnicu Mercedes
Published: October 2022

Immune checkpoint inhibitors (ICIs) are the current guideline recommended treatment for many malignancies considered to be terminal. Despite considerable advances, their utility remains limited, and the field requires synergistic partners to further improve outcomes. Oncolytic viruses (OV) are emerging as contenders for the role of the synergistic agent of choice due to their multi-mechanistic effect on activating the tumor ‘cold’ immune microenvironment. Herpes simplex virus 1, a naturally selective OV, is the most advanced virotherapeutic compound in clinical applications for use in combination with ICI. We here present the case of a 72 year-old patient with a heavily pre-treated, advanced maxillary sinus squamous cell cancer with distant metastases who developed complete response (CR) with only three administrations of a programmed death 1 inhibitor after treatment interference by a severe herpes zoster infection, based on the related alpha-herpesvirus varicella zoster virus (VZV). This exceptional response has been followed and confirmed with imaging studies over more than 5 years. Although the patient had several favorable predictors for response to immunotherapy, we reason that the exceptional response may in part be secondary to the serendipitous VZV infection. Documented cases of cancer patients that achieved CR after few administrations of treatment with ICI are rare, with most reporting follow up of just over 1 year or less. In this case, it is conceivable that the interference of the infection with VZV, soon after the start of immunotherapy with ICI, led to a lasting antitumor immunity and sustained CR. This hypothesis is supported by the concept of ‘oncolytic immunotherapy’ which is reviewed in this manuscript. In addition, persistence of a TP53 mutation found in a liquid biopsy, despite clinical and radiologic remission, is discussed.
Autologous conditioned serum for chronic pain in patients with osteoarthritis: A feasibility observational study
Authors: Ippolito Mariachiara , Spurio Giulia , Compagno Viviana , Rizzo Alessandra , Di Simone Marta , Corsale Anna Maria , Mazzola Giuseppina , Giarratano Antonino , Meraviglia Serena , Cortegiani Andrea , Alongi Antonietta
Published: October 2022

Background

Autologous conditioned serum is a product of blood origin, with fragmented evidence of therapeutic properties in osteoarthritis chronic pain. This pilot observational prospective study aimed to evaluate the feasibility of a treatment with conditional autologous serum (ACS) in patients with severe chronic pain and grade I-III osteoarthritis and to describe its cytokine content.

Methods

We prospectively collected data on consecutive patients affected by osteoarthritis grade I to III and treated with four weekly injections of ACS at our outpatient pain service. The primary outcome was pain intensity, measured with the visual analogic scale (VAS). Additional outcomes were symptoms evaluated using joint district-specific scales. The study also evaluated concentrations of 48 cytokines and chemokines involved in the balance pro-inflammation/anti-inflammation and tissue repair in the ACS.

Results

We included 26 patients, mostly female (65.4%), with a median age of 63.5 years [IQR 58.25–73]. A median reduction of VAS of −3 cm [−5; −1.25] was observed 6 months after the first injection of ACS. The analysis showed a statistically significant difference between the values of VAS ( p < .01; X2 = 69.6; df = 6, N = 26) at the different time points. No adverse events were observed or reported by patients during the entire study period.

Conclusions

Conditional autologous serum may be a feasible option for patients with chronic pain due to grade I-III osteoarthritis refractory to other treatments. These preliminary findings should be confirmed in studies with adequate design.
Quantitative spinal cord MRI and sexual dysfunction in multiple sclerosis
Authors: Seyman Estelle , Kim David , Bharatha Aditya , Casserly Courtney , Krysko Kristen , Chantal Roy-Hewitson , Alcaide-Leon Paula , Suthiphosuwan Suradech , Oh Jiwon
Published: October 2022

Background

Sexual dysfunction (SD) is frequently reported in multiple sclerosis (MS) and is likely related to MS-related damage to the spinal cord (SC).

Objective

To assess associations between SD and quantitative MRI measures in people with MS (pwMS).

Methods

This pilot study included 17 pwMS with SD who completed questionnaires assessing SD, mood, and fatigue. All participants underwent brain, cervical, and thoracic SC-MRI at 3T. Quantitative brain and SC-MRI measures, including brain/SC atrophy, SC lesion count, diffusion-tensor imaging (DTI) indices (fractional anisotropy [FA], mean, perpendicular, parallel diffusivity [MD, λ⊥, λ||]) and magnetization-transfer ratio (MTR) were obtained. Associations between quantitative MRI measures and SD were assessed while controlling for the extent of mood and fatigue symptomatology.

Results

Subjects were a mean age of 46.9 years and 29% female. All subjects had self-reported SD (MSISQ-19 = 40.7, SQoL: 55.9) and 65% had a concurrent psychiatric diagnosis. When correlations between SD severity were assessed with individual brain and SC-MRI measures while controlling for psychiatric symptomatology, no associations were found. The only variables showing independent associations with SD were anxiety ( p = 0.03), depression ( p = 0.05), and fatigue ( p = 0.04).

Conclusion

We found no correlations between quantitative MRI measures in the brain and SC and severity of SD in pwMS, but psychiatric symptomatology and fatigue severity demonstrated relationships with SD. The multifactorial nature of SD in pwMS mandates a multidisciplinary approach.
Widening inequality: The evolution of the motherhood penalty in China (1989–2015)
Authors: Shen Chao
Published: October 2022

The motherhood penalty is an important issue in the field of family and gender inequality research. China has experienced rapid economic growth and drastic social change in recent decades, but existing studies fail to provide an overview of changes in the effect of the motherhood penalty during this period. This article uses data from the China Health and Nutrition Survey from 1989 to 2015 and applies a multi-layer mixed-effects model to study the severity of the motherhood penalty and the various mechanisms affecting it over that period. This study shows the following: (a) childbirth has a negative impact on women's wages and the severity of this impact continues to increase, showing that the effect of the motherhood penalty has become harsher over time; (b) although the motherhood penalty was initially lower for single mothers than for married ones, it has increased for both groups of women over the period and the rate of growth has been much faster for single mothers and, thus, the difference between the two groups in terms of the effect of the motherhood penalty has narrowed gradually over the period; (c) the long-term effect of the motherhood penalty is normally less pronounced than the short-term effect, but the long-term effect has grown at a much quicker rate over recent years compared with the short-term effect, and in more recent years these two effects are almost the same; (d) the higher the education level of women, the lower the effect of the motherhood penalty, but as the effect of the penalty has intensified over the period of study, the difference across different education levels has decreased; and (e) the effect of the motherhood penalty on female employees in the non-state sector is greater than that on female employees in the state sector, and the effect of the motherhood penalty on female employees in the non-state sector has increased rapidly, while the change has remained slow in the state sector, resulting in a widening gap between the two sectors. This study shows that the dramatic social and economic change in recent decades has subjected women to greater and greater maternal responsibilities but has afforded them disproportionately fewer benefits in relation to economic development.
Percutaneous Closure of Ruptured Sinus of Valsalva Aneurysm in a Child Using a Patent Ductus Arteriosus Device
Authors: Peirone Alejandro , Contreras Alejandro , Guevara Antonio , Allub Alejandro , Bueno Nora , Banille Edgardo , Díaz Juan , Juaneda Ignacio
Published: October 2022

Ruptured sinus of Valsalva aneurysm is rare, although if left untreated, potentially fatal disease. Surgical approach has been the main treatment in most series; nevertheless, percutaneous closure has been described in selected cases. We report a 5-year-old boy presenting with rapid clinical deterioration who underwent percutaneous closure using a patent ductus arteriosus device, with the resolution of symptoms. Descriptions of this technique being utilized in children are infrequent in the literature.
Compliance Burden and Tax Gap Among Micro and Small Businesses: Evidence From Ghana
Authors: Peprah James Atta , Andoh Francis Kwaw , Avorkpo Eric Atsu , Dafor Kwabena Nkansah , Afful Benedict , Obeng Camara Kwasi
Published: October 2022

The question of how much of the potential tax revenue is actually obtained remains very critical in Ghana’s efforts to improve domestic revenue mobilization. This paper computes and examines tax gap and compliance burden among micro and small businesses which constitute more than 90% of Ghana’s informal economy. Using data on 485 businesses in Ghana, the study finds that while some businesses underpay their taxes, surprisingly others actually pay more than expected. The average tax gap is computed to be about GHC 109.2 (US$19.2). Small businesses are associated with a higher tax gap of 24.9% compared to their micro counterparts. Moreover, we find that as compliance burden increases, the tax gap also increases, albeit significant variation in the effect of compliance burden on tax gap across regions and different tax handles.

JEL Classification: H25, H26, H27, H32
Emerging challenges to prisoners vaccination of covid-19: Historical, legal and humanitarian view
Authors: Irawan Benny , Yulia Rena
Published: October 2022

This research aims to present a legal history of the prisoners’ treatment in global crises along with presenting an overview of prisoners’ treatment during Covid-19 in view of International Humanitarian Laws. Using the formative research method with a conceptual approach and statute approach, data was gathered from various legal documents related to prisoners’ health laws linked to legal purpose theories. This study further explains the need to treat old age prisoners on a priority basis and to what extent international health organizations are making efforts to establish criteria to vaccinate this societal segment. The international regulatory framework was deeply analyzed to draw conclusions and recommendations along with WHO efforts. It was revealed that there exist adequate laws regarding priority health treatment of the prisoners in crises times but existed an enormous need to highlight and address the sensitive humanitarian issue. Additionally, WHO and other international organizations have also revised the international laws during Covid-19 to treat the prisoners. However, there is an immense need to devise explicit regulations regarding the accessibility of the vaccine to all the groups of society, including prisoners. The provision of a detailed overview of international laws and treaties regarding prisoners’ priority health treatment is a major advance of this research. Further recommendations for the developed and developing nations and future research directions are suggested.
Caregiving for People With Dementia or Cognitive Impairment During the COVID-19 Pandemic: A Review
Authors: Chyu Joanna , Cantu Philip , Mehta Neil , Markides Kyriakos
Published: October 2022

The COVID-19 pandemic has been a major source of stress for informal caregivers for people with dementia. Studies show the unique challenges caregivers face, such as social isolation, extended work hours, and adherence to public health guidelines. We conducted a narrative review of factors impacting well-being of informal caregivers of older adults with dementia during the COVID-19 pandemic. Sixty-four papers were identified as published between June 2020 and December 2021. All studies were conducted in the U.S. or other Western countries and were cross-sectional and conducted prior to COVID-19 vaccines. Articles highlighted increasing burdens such as financial and physical stress, as well as worsened psychological well-being from anxiety and depression. Protective factors such as social support and telehealth interventions also emerged. Limitations include lack of longitudinal information to identify broader themes on caregiving during the pandemic. Studies not only identified new, pandemic-related risk factors, but also a heightened effect of pre-existing risk factors (e.g., income, living situation) on caregiver burden.
Marginality, Educational Opportunity and Access to Higher Education: Experiences of Scheduled Caste and Tribe Students in India
Authors: Bhoi Dhaneswar , Lakra Neelima Rashmi
Published: October 2022

This paper is based on the empirical data of the marginal section students who have come under the purview of the National Fellowship system at higher education level in India. The objective of the study is to find out their experiences with respect to the national fellowship system as a public policy measure and their educational attainment, participation and achievements within public policy discourse. Also, the study explores the educational opportunity, cultural capital and the socio-economic and political attainment of the marginal section students. Where, the study is based on both quantitative and qualitative approaches. The data are analysed through descriptive and thematic analysis methods. It addresses the major questions like: does the state become cultural capital for the marginal section students? How do the students from marginal backgrounds capitalize the public policy meant for them for higher education and what are their difficulties to avail this public policy?
A necessary evil? Examining the complexities of care and commodification
Authors: MacKay Carley
Published: October 2022

In this article, I draw on a case study of interviews with Ontario grass-fed beef farmers about cow welfare and theorize these using the analytics of animal geographies and biopolitics. I engage with the former's work on animal agency and subjectivity, and the latter's focus on animal commodification, showing how welfare practices impact cows’ subjectivities, agencies, bodies, and interrelations. I make clear that cows exercise agency in their relationships with farmers, despite and in response to the different forms of governance that shape cows’ welfare and relationships with farmers. Analyzing welfare practices as different forms of biopower, I show how cows’ liveliness impacts their commodity value and describe the contexts in which farmers build emotional and disciplinary connections to cows. Central to my argument is that cows’ subjective and agentic features complement and complicate their commodification. Fusing animal geographies and biopolitics, I extend my analysis of cow welfare into a discussion of the emotional, economic, and ethically complex relationships between farmers and cows. Lastly, I contribute to emerging debates in literature on the complexities of caring and killing in human-animal relations through my analyses of welfare as an avenue for exploring the function of care, commodification, and killing in farmer-cow relations. Attending to these complexities, I argue, disrupts fixed logic about the ethics of animal production, while prompting us to rethink the way we relate with animals we call food.
The Consortium on Newborn Screening in Africa for sickle cell disease: study rationale and methodology
Authors: Green Nancy S. , Zapfel Andrew , Nnodu Obiageli E. , Franklin Patience , Tubman Venée N. , Chirande Lulu , Kiyaga Charles , Chunda-Liyoka Catherine , Awuonda Bernard , Ohene-Frempong Kwaku , Inusa Baba P. D. , Ware Russell E. , Odame Isaac , Ambrose Emmanuela E. , Dogara Livingstone G. , Oron Assaf P. , Willett Chase , Thompson Alexis A. , Berliner Nancy , Coetzer Theresa L. , Novelli Enrico M.
Published: October 2022

Sickle cell disease (SCD) is a common condition within sub-Saharan Africa and associated with high under-5 mortality (U5M). The American Society of Hematology instituted the Consortium on Newborn Screening in Africa (CONSA) for SCD, a 7-country network of sites to implement standardized newborn hemoglobinopathy screening and early intervention for children with SCD in sub-Saharan Africa. CONSA’s overall hypothesis is that early infant SCD screening and entry into standardized, continuous care will reduce U5M compared with historical estimates in the region. Primary trial objectives are to determine the population-based birth incidence of SCD and effectiveness of early standardized care for preventing early mortality consortium-wide at each country’s site(s). Secondary objectives are to establish universal screening and early interventions for SCD within clinical networks of CONSA partners and assess trial implementation. Outcomes will be evaluated from data collected using a shared patient registry. Standardized trial procedures will be implemented among designated birth populations in 7 African countries whose programs met eligibility criteria. Treatment protocol includes administering antibacterial and antimalarial prophylaxis and standard childhood vaccinations against infections commonly affecting children with SCD. Infants with a positive screen and confirmation of SCD within the catchment areas defined by each consortium partner will be enrolled in the clinical intervention protocol and followed regularly until age of 5 years. Effectiveness of these early interventions, along with culturally appropriate family education and counseling, will be evaluated by comparing U5M in the enrolled cohort to estimated preprogram data. Here, we describe the methodology planned for this trial.
Efficacy of three COVID-19 vaccine doses in lung transplant recipients: a multicentre cohort study
Authors: Dauriat Gaëlle , Beaumont Laurence , Luong Nguyen Liem Binh , Renaud Picard Benjamin , Penhouet Morgane , Coiffard Benjamin , Salpin Mathilde , Demant Xavier , Saint Raymond Christel , Carlier Nicolas , Messika Jonathan , Reynaud Gaubert Martine , Danner Isabelle , Gallais Floriane , Roux Antoine , Le Pavec Jérôme
Published: October 2022

Question addressed by the study

Do three coronavirus disease 2019 (COVID-19) vaccine doses induce a serological response in lung transplant recipients?

Methods

We retrospectively included 1071 adults (551 (52%) males) at nine transplant centres in France. Each had received three COVID-19 vaccine doses in 2021, after lung transplantation. An anti-spike protein IgG response, defined as a titre >264 BAU·mL−1after the third dose (median (interquartile range (IQR)) 3.0 (1.7–4.1) months), was the primary outcome and adverse events were the secondary outcomes. Median (IQR) age at the first vaccine dose was 54 (40–63) years and median (IQR) time from transplantation to the first dose was 64 (30–110) months.

Results

Median (IQR) follow-up after the first dose was 8.3 (6.7–9.3) months. A vaccine response developed in 173 (16%) patients. Factors independently associated with a response were younger age at vaccination, longer time from transplantation to vaccination and absence of corticosteroid or mycophenolate therapy. After vaccination, 51 (5%) patients (47 non-responders (47/898 (5%)) and four (4/173 (2%)) responders) experienced COVID-19, at a median (IQR) of 6.6 (5.1–7.3) months after the third dose. No responders had severe COVID-19 compared with 15 non-responders, including six who died of the disease.

Conclusions

Few lung transplant recipients achieved a serological response to three COVID-19 vaccine doses, indicating a need for other protective measures. Older age and use of mycophenolate or corticosteroids were associated with absence of a response. The low incidence of COVID-19 might reflect vaccine protectionviacellular immunity and/or good adherence to shielding measures.
Prediction and Minimization of the Heat Treatment Induced Distortion in 8620H Steel Gear: Simulation and Experimental Verification
Authors: Shao Wen , Yi Mohan , Tang Jinyuan , Sun Siyuan
Published: October 2022

The considerable heat treatment induced runout value in the end face of the automobile main reducer gear is always dimensionally out of tolerance. It directly affects the dimensional accuracy, the grade of carburized and hardened gears, and the post-quenching manufacturing costs. In this study, three dimensional numerical models were developed to simulate the carburizing-quenching process of gear based on the multi-field coupling theory using DEFORM software. The results indicated that the ununiform cooling rate of the gear caused by the asymmetry of the web structure would result in the ununiform distribution of martensite, leading to the large runout value at the end face of the gear. Therefore, a novel method was proposed to minimize the heat treatment induced runout value. It was found that the heat treatment induced runout value could be effectively controlled by the addition of a compensation ring and the support of a rod structure. Further experiments showed that the average runout value of the gear end face before and after the proposed heat treatment method were about 0.023 mm and 0.059 mm respectively, which was in good agreement with the simulated results. The novel approach proposed in this study led to a reduction of the gear runout value by 70.0%‒76.9% compared to that of the original heat treatment process, which may serve as a practical and economical way to predict and minimize the heat treatment induced distortion in drive gear.
Construction and analysis of sample-specific driver modules for breast cancer
Authors: Chen Yuanyuan , Li Haitao , Sun Xiao
Published: October 2022

Background

It is important to understand the functional impact of somatic mutation and methylation aberration at an individual level to implement precision medicine. Recent studies have demonstrated that the perturbation of gene interaction networks can provide a fundamental link between genotype (or epigenotype) and phenotype. However, it is unclear how individual mutations affect the function of biological networks, especially for individual methylation aberration. To solve this, we provided a sample-specific driver module construction method using the 2-order network theory and hub-gene theory to identify individual perturbation networks driven by mutations or methylation aberrations.

Results

Our method integrated multi-omics of breast cancer, including genomics, transcriptomics, epigenomics and interactomics, and provided new insight into the synergistic collaboration between methylation and mutation at an individual level. A common driver pattern of breast cancer was identified from a novel perspective of a driver module, which is correlated to the occurrence and development of breast cancer. The constructed driver module reflects the survival prognosis and degree of malignancy among different subtypes of breast cancer. Additionally, subtype-specific driver modules were identified.

Conclusions

This study explores the driver module of individual cancer, and contributes to a better understanding of the mechanism of breast cancer driven by the mutations and methylation variations from the point of view of the driver network. This work will help identify new therapeutic combinations of gene mutations and drugs in humans.
Comparative analysis of the complete chloroplast genomes of six threatened subgenus Gynopodium (Magnolia) species
Authors: Xie Huanhuan , Zhang Lei , Zhang Cheng , Chang Hong , Xi Zhenxiang , Xu Xiaoting
Published: October 2022

Background

The subgenus Gynopodium belonging to genus Magnolia have high ornamental, economic, and ecological value. Subgenus Gynopodium contains eight species, but six of these species are threatened. No studies to date have characterized the characteristics of the chloroplast genomes (CPGs) within subgenus Gynopodium species. In this study, we compared the structure of CPGs, identified the mutational hotspots and resolved the phylogenetic relationship of subgenus Gynopodium.

Results

The CPGs of six subgenus Gynopodium species ranged in size from 160,027 bp to 160,114 bp. A total of 131 genes were identified, including 86 protein-coding genes, eight ribosomal RNA genes, and 37 transfer RNA genes. We detected neither major expansions or contractions in the inverted repeat region, nor rearrangements or insertions in the CPGs of six subgenus Gynopodium species. A total of 300 large repeat sequences (forward, reverse, and palindrome repeats), 847 simple sequence repeats, and five highly variable regions were identified. One gene (ycf1) and four intergenic regions (psbA-trnH-GUG, petA-psbJ, rpl32-trnL-UAG, and ccsA-ndhD) were identified as mutational hotspots by their high nucleotide diversity (Pi) values (≥ 0.004), which were useful for species discrimination. Maximum likelihood and Bayesian inference trees were concordant and indicated that Magnoliaceae consisted of two genera Liriodendron and Magnolia. Six species of subgenus Gynopodium clustered as a monophyletic clade, forming a sister clade with subgenus Yulania (BS = 100%, PP = 1.00). Due to the non-monophyly of subgenus Magnolia, subgenus Gynopodium should be treated as a section of Magnolia. Within section Gynopodium, M. sinica diverged first (posterior probability = 1, bootstrap = 100), followed by M. nitida, M. kachirachirai and M. lotungensis. M. omeiensis was sister to M. yunnanensis (posterior probability = 0.97, bootstrap = 50).

Conclusion

The CPGs and characteristics information provided by our study could be useful in species identification, conservation genetics and resolving phylogenetic relationships of Magnoliaceae species.
Exploring carer resilience in the context of dementia: a meta-synthesis
Authors: Kim Eun Young , Chang Sung Ok
Published: October 2022

Aims

The aim of this literature review is to integrate the results of qualitative research on the resilience experiences of family carers of people with dementia (PWD).

Design

A qualitative meta-synthesis study was conducted.

Methods

The meta-ethnography method of Noblit and Hare (1988) was used. We searched five electronic bibliographic databases (PubMed, EMBASE, CINAHL, PsycINFO and Web of Science) using the keywords “caregivers”, “family caregivers”, “spouse caregivers”, “qualitative research”, “resilience, psychological” and “dementia.” The inclusion criteria of the literature search found studies that explored the resilience experience of family carers of PWD, were qualitative, were published in English, and had participants 18 years of age or older.

Results

Eleven studies, 1 from Australia, 4 from USA and 6 from UK, were included in the analysis. Through the process, three themes emerged: ‘Seeing the life of a carer as one’s duty’, ‘Setting boundaries in life’, ‘Moving forward toward a developing life.’ These themes illustrated how family carers of PWD overcome the adversities they encounter.

Conclusion

This meta-synthesis showed how family carers of PWD adapt to and overcome the difficult situations they are confronted with as carers. This review suggests an important direction for enhancing the resilience of family carers of PWD.
Surgical efficacy and survival prediction of patients with unspecified malignant bone tumors
Authors: He Shaohui , Jiang Runyi , Sun Haitao , Yang Jian , Ye Chen , Liu Weibo , Yang Xinghai , Cai Xiaopan , Xiao Jianru
Published: October 2022

Background

The surgical efficacy and prognostic outcomes of patients with unspecific malignant bone tumors (UMBTs) remain unclear. The study is to address: 1) What are the clinicopathological features and prognostic determinants for patients with UMBTs? 2) Can a nomogram be developed for clinicians to predict the short and long-term outcomes for individuals with UMBTs? 3) Does surgery improve outcomes for UMBT patients who received radiotherapy or chemotherapy after balancing the confounding bias?

Methods

400 UMBT patients were filtrated from the Surveillance, Epidemiology, and End Results database to assess the clinicopathological features, treatments, and factors affecting prognosis. The optimal cutoff values of continuous variables were identified by the x-tile software. Kaplan-Meier method and multivariate Cox proportional hazard modeling were performed to evaluate the independent prognostic factors. Nomogram was further developed by using R software with rms package. The surgical efficacy was further assessed for patients receiving radiotherapy or chemotherapy after performing propensity score matching.

Results

The enrolled cohort included 195 (48.8%) female and 205 (51.2%) male patients. The 2- and 5-year cancer-specific survival (CSS) and overall survival (OS) rate were 58.2 ± 3.0%, 46.8 ± 3.2%, and 46.5 ± 2.6%, 34.4 ± 2.5%, respectively. Nomogram was finally developed for CSS and OS according to the identified independent factors: age, tumor extent, primary tumor surgery, tumor size, and pathology grade. For UMBT patients who received radiotherapy or chemotherapy, surgical intervention was associated with better CSS (pr = 0.003, pc = 0.002) and OS (pr = 0.035, pc = 0.002), respectively.

Conclusions

Nomogram was developed for individual UMBT patient to predict short and long-term CSS and OS rate, and more external patient cohorts are warranted for validation. Surgery improves outcomes for UMBT patients who received either radiotherapy or chemotherapy.
Differential distribution of steroid hormone signaling networks in the human choroid-retinal pigment epithelial complex
Authors: Galindez Sydney M. , Keightley Andrew , Koulen Peter
Published: October 2022

Background

The retinal pigment epithelium (RPE), a layer of pigmented cells that lies between the neurosensory retina and the underlying choroid, plays a critical role in maintaining the functional integrity of photoreceptor cells and in mediating communication between the neurosensory retina and choroid. Prior studies have demonstrated neurotrophic effects of select steroids that mitigate the development and progression of retinal degenerative diseases via an array of distinct mechanisms of action.

Methods

Here, we identified major steroid hormone signaling pathways and their key functional protein constituents controlling steroid hormone signaling, which are potentially involved in the mitigation or propagation of retinal degenerative processes, from human proteome datasets with respect to their relative abundances in the retinal periphery, macula, and fovea.

Results

Androgen, glucocorticoid, and progesterone signaling networks were identified and displayed differential distribution patterns within these three anatomically distinct regions of the choroid-retinal pigment epithelial complex. Classical and non-classical estrogen and mineralocorticoid receptors were not identified.

Conclusion

Identified differential distribution patterns suggest both selective susceptibility to chronic neurodegenerative disease processes, as well as potential substrates for drug target discovery and novel drug development focused on steroid signaling pathways in the choroid-RPE.
Comparison of visual outcomes of a diffractive trifocal intraocular lens and a refractive bifocal intraocular lens in eyes with axial myopia: a prospective cohort study
Authors: Sun Tong , Liu Yiyun , Gao Yufei , Tang Chuhao , Lan Qianqian , Yang Tingting , Zhao Xiaorui , Qi Hong
Published: October 2022

Background

To assess and compare the efficacy, safety, accuracy, predictability and visual quality of a diffractive trifocal intraocular lens (IOL) and a refractive rotationally asymmetric bifocal IOL in eyes with axial myopia.

Methods

This prospective cohort study enrolled patients with implantation of the diffractive trifocal IOL or the refractive bifocal IOL. Eyes were divided into four groups according to the IOL implanted and axial length. Manifest refraction, uncorrected and corrected visual acuity at far, intermediate and near distances, prediction error of spherical equivalent (SE), contrast sensitivity and aberrations were evaluated three months after surgery.

Results

In total, 80 eyes of 80 patients were included: 20 eyes in each group. Three months postoperatively, the corrected distance visual acuity of two trifocal groups were significantly better than the axial myopia bifocal group (P = 0.007 and 0.043). There was no significant difference of postoperative SE (P = 0.478), but the SE predictability of the trifocal IOL was better, whether in axial myopia groups (P = 0.015) or in control groups (P = 0.027). The contrast sensitivity was similar among four groups. The total aberration, higher order aberration and trefoil aberration of bifocal groups were significantly higher (all P < 0.001).

Conclusions

The diffractive trifocal IOL and the refractive bifocal IOL both provided good efficacy, accuracy, predictability and safety for eyes with axial myopia. By contrast, the trifocal IOL had a better performance in corrected distance visual acuity and visual quality.

Trial registration

The study was retrospectively registered and posted on clinicaltrials.gov at 12/02/2020 (NCT04265846).
Evaluation of two social norms nudge interventions to promote healthier food choices in a Canadian grocery store
Authors: Suleman Selina , Sweeney-Magee Molly , Pinkney Susan , Charbonneau Kimberly , Banh Kelly , Hale Ilona , Amed Shazhan
Published: October 2022

The objective of this study was to determine the impact of two nudge interventions on customers’ produce purchases at a rural Canadian grocery store. A pre- and post-intervention observational study design was used. Sales data were gathered before and after the staggered implementation of two nudge-based interventions to encourage produce purchases: grocery cart dividers to encourage shoppers to fill one-third of their cart with produce and grocery cart plaques with information about how many fruits and vegetables were typically purchased in the store. The proportion of total sales accounted for by produce was compared between baseline and implementation of the first intervention (Phase 1), between implementation of the first intervention and the addition of the second intervention (Phase 2), and between baseline and post-implementation of both interventions together. There was a 5% relative increase (0.5% absolute increase) in produce spending between baseline and post-implementation of both interventions (10.3% to 10.8%, p < 0.001, 95% CI 0.2%, 0.7%). Intervention phase-specific produce spending showed no significant change in the percentage of produce spending from baseline to Phase 1 of the intervention, and an 8% relative increase (0.8% absolute increase) in the percentage of produce spending from Phase 1 to Phase 2 of the intervention (10.3% to 11.1%, p < 0.001, 95% CI 0.5, 1.1%). Simple, low-cost nudge interventions were effective at increasing the proportion of total grocery spend on produce. This study also demonstrated that partnerships with local businesses can promote healthier food choices in rural communities in Canada.
Aesthetic reconstruction of onco-surgical maxillary defects using free scapular flap with and without CAD/CAM customized osteotomy guide
Authors: Alwadeai Mohamed Salah , Al-aroomy Leena Ali , Shindy Mostafa Ibrahim , Amin Ayman Abdel-Wahab , Zedan Mohamed Hamdallah
Published: October 2022

Background

Reconstruction of the maxillary defects following tumor ablation remains to be a challenge for surgeons. Virtual surgical planning (VSP), intraoperative cutting guides and stereolithographic models provides the head and neck reconstructive surgeon with powerful tools for complex reconstruction planning. Despite its use in fibular osteocutaneous reconstruction, application to the scapular free flap has not been as widely reported. The aim of this study was to compare aesthetic results and operation time of free scapular flap, with and without computer-aided design and computer-aided manufacturing (CAD/CAM) customized osteotomy guide, for reconstruction of maxillary defects.

Methods

In this prospective randomized controlled clinical trial study, we randomly assigned 22 patients with maxillary defects who were scheduled to undergo maxillary reconstruction with either free scapular flap with CAD/CAM customized osteotomy guide; study group (n = 11) or free scapular flap without CAD/CAM customized osteotomy guide; control group (n = 11). All patients were followed up for 3 months. The aesthetic outcome, operation and ischemic times were evaluated and compared.

Results

Aesthetic outcomes were evaluated objectively by means of differential surface area (sagittal and axial) measurement, which showed improved aesthetic outcome (contour symmetry) in the study group with a mean of (241.39 ± 113.74 mm2), compared to patients in control group with a mean of (358.70 ± 143.99 mm2). There were significant differences between the two groups (P < 0.05). Aesthetic outcomes were also evaluated subjectively by means of visual analogue scale (VAS) and patient’s satisfaction score (PSS). The postoperative aesthetic appearance was better in the study group with more patients satisfied than that in control group and there were statistically significant differences (P = 0.039). The mean total operative time was 678.81 min and 777.18 min in the study group and control group respectively (P < 0.05) and the mean ischemia time was 133.18 min and 195.72 min for study group and control group respectively (P < 0.05). The ischemia time and total operative time were shorter in the study group compared to those in the control group and there were no flap losses in both groups.

Conclusion

The use of CAD/CAM prefabricated cutting guides facilitates scapular flap molding and placement, minimizes ischemic time and operating time as well as improves aesthetic outcomes.

Trialregistration This trial was registered at ClinicalTrials.gov. Registration number: NCT03757286. Registration date: 28/11/2018
Comprehensive analysis of lncRNA-mediated ceRNA regulatory networks and key genes associated with papillary thyroid cancer coexistent with Hashimoto’s thyroiditis
Authors: Zhang Yuepeng , Tian Yueli
Published: October 2022

Objective

The incidence of papillary thyroid cancer (PTC) concomitant with Hashimoto’s thyroiditis (HT) is gradually increasing over the past decades. This study aims to identify differentially expressed lncRNAs between tumor tissues of PTC with or without HT and further to confer a better understanding of lncRNA-based competing endogenous RNA (ceRNA) network in PTC with HT.

Methods

GSE138198 containing tissue mRNA data and GSE192560 containing lncRNA data were utilized to perform differentially expression analysis. The ceRNA network was constructed based on miRNA-mRNA interactions merging with lncRNA-microRNA interactions. Functional enrichment analysis and protein–protein interaction (PPI) analysis were performed. The mRNA levels of core genes in the PPI analysis in tumor tissues collected from 112 PTC patients including 35 cases coexistent with HT were determined by quantitative real-time polymerase chain reaction (qRT-PCR).

Results

A total of 57 genes and 40 lncRNAs, with value of |log2 fold change (FC)|≥ 1 and the adjusted P-value < 0.05, were deemed as differentially expressed genes and lncRNAs between PTC with and without HT. The pathways most significantly enriched by differentially expressed genes between PTC with and without HT were viral protein interaction with cytokine and cytokine receptor and cytokine-cytokine receptor interaction. CXCL10, CXCL9, CCL5, FCGR3A, and CCR2 owned degree values not less than 10 were deemed as core genes differentially expressed between PTC with and without HT. A total of 76 pairs of lncRNA-miRNA-mRNA ceRNA were obtained. Results of qRT-PCR partially demonstrated the bioinformatics results that the mRNA levels of CXCL10, CXCL9, CCL5, and CCR2 were remarkably elevated in tumor tissues collected from PTC patients coexistent with HT than those without HT (P < 0.001).

Conclusion

Our study offers a better understanding of the lncRNA-related ceRNA network involved in PTC with HT, providing novel key genes associated with PTC coexistent with HT.
The blacksmith approach: a strategy for teaching and learning in the medical anatomy course (a qualitative study)
Authors: Shojaei Arash , Feili Amin , Kojuri Javad , Norafshan Ali , Bazrafkan Leila
Published: October 2022

Background:

Anatomy is a symbolic, essential core topic and one of the fundamental pillars of medical and paramedical knowledge. Nevertheless, few exploratory data analyses have focused on how students approach learning anatomy. This study examined how students perceive their learning experience during anatomy lessons and how to make a model which promotes their meaningful learning and professional identity.

Methods:

Using purposive sampling with maximum variation, we conducted a qualitative content analysis at the Shiraz University of Medical Sciences in Iran (2020 to 2021). Twenty-four medical students and twelve faculty members of Iran’s medical science universities were enrolled in the study. The data were collected through semi-structured interviews and analyzed according to the theme.

Results:

A conceptual model emerged from the data analysis with the main theme calledthe blacksmith approach, which included Three sub-themes: (1) making a new forge (adequate preparation and mindful beginning), (2) heating the students’ hearts (considering supporting systems that learners need) and (3) using Sledgehammer’s approach (teaching anatomy by using more active methods and engaging all neuroanatomical regions) and (Using fun for enjoyable learning). All the concepts were related to each other.

Conclusion:

Medical students experience a challenging fundamental evolution into professional doctors. Educational systems focus primarily on teaching and learning, while students’ transition can be facilitated by a three-step model called the Blacksmith Approach. It best serves as an educational framework for any pivotal, preclinical course capable of helping students acquire new roles and tackle challenges. Further research should be conducted to confirm how hard work leads to satisfying results with the opportunity to create enjoyable learning.
Trends in inequality in maternal and child health and health care in Uganda: Analysis of the Uganda demographic and health surveys
Authors: Kakama Alex Ayebazibwe , Basaza Robert
Published: October 2022

Background

Uganda has made great strides in improving maternal and child health. However, little is known about how this improvement has been distributed across different socioeconomic categories, and how the health inequalities have changed over time. This study analyses data from Demographic and Health Surveys (DHS) conducted in 2006, 2011, and 2016 in Uganda, to assess trends in inequality for a variety of mother and child health and health care indicators.

Methods

The indicators studied are acknowledged as critical for monitoring and evaluating maternal and child health status. These include infant and child mortality, underweight status, stunting, and prevalence of diarrhea. Antenatal care, skilled birth attendance, delivery in health facilities, contraception prevalence, full immunization coverage, and medical treatment for child diarrhea and Acute Respiratory tract infections (ARI) are all health care indicators. Two metrics of inequity were used: the quintile ratio, which evaluates discrepancies between the wealthiest and poorest quintiles, and the concentration index, which utilizes data from all five quintiles.

Results

The study found extraordinary, universal improvement in population averages in most of the indices, ranging from the poorest to the wealthiest groups, between rural and urban areas. However, significant socioeconomic and rural-urban disparities persist. Under-five mortality, malnutrition in children (Stunting and Underweight), the prevalence of anaemia, mothers with low Body Mass Index (BMI), and the prevalence of ARI were found to have worsening inequities. Healthcare utilization measures such as skilled birth attendants, facility delivery, contraceptive prevalence rate, child immunization, and Insecticide Treated Mosquito Net (ITN) usage were found to be significantly lowering disparity levels towards a perfect equity stance. Three healthcare utilization indicators, namely medical treatment for diarrhea, medical treatment for ARI, and medical treatment for fever, demonstrated a perfect equitable situation.

Conclusion

Increased use of health services among the poor and rural populations leads to improved health status and, as a result, the elimination of disparities between the poor and the wealthy, rural and urban people.

Recommendation

Intervention initiatives should prioritize the impoverished and rural communities while also considering the wealthier and urban groups.