bluuebunny/crossref_metadata_2025 huggingface dataset:
Collateral Circulation Develops in Stenosis of the Celiac Trunk, and Superior Mesenteric Artery
Authors: Salim Hande , Ozgur Ozhan , Erman Kursat , Ozturk Serra , Dogan Merve Sarikaya , Sindel Timur , Sindel Muzaffer
Published: November 2022

Purpose
Mesenteric circulation is provided by the celiac artery (CA), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). The collateral circulation between CA and SMA and between SMA and IMA plays a protective role against intestinal ischemia in case of narrowing or occlusion of the mesenteric vessels. In our study, it is aimed to determine the CA and SMA stenosis rates in patients with CA and SMA stenosis from angiography images, the occurrence of the collateral variations, and the frequency of these variations.
Methods
A total of 408 nonselective or selective CA and SMA angiographic images were taken of 215 patients (130 males, 85 females) who were admitted to Akdeniz University Hospital with symptoms of chronic mesenteric ischemia (CMI) were included. Angiography images were analyzed in regards to CA and SMA stenosis rates, and the collateral variations between mesenteric vessels.
Results
Stenosis of CA was observed in 14 patients whereas the stenosis of the SMA was observed in 12 patients. The most common collateral vessel in these patients was the gastroduodenal artery. Both stenoses of CA and SMA were found in 9 patients. The Rioalan arch was the most common type of collateral vessel in these patients.
Conclusion
It was observed that mesenteric circulation was mainly provided by gastroduodenal in patients with isolated CA or SMA stenosis or occlusion while in patients with stenosis or occlusion of both CA and SMA, mesenteric circulation was mainly provided by the Riolan arc. A significant increase was observed in the prominence of collateral vessels in patients with stenosis of more than 70%.
Assessing the value of integrating national longitudinal shopping data into respiratory disease forecasting models
Authors: Dolan Elizabeth , Goulding James , Marshall Harry , Smith Gavin , Long Gavin , Tata Laila
Published: November 2022

The COVID-19 pandemic led to unparalleled pressure on healthcare services. Improved health-care planning in relation to diseases affecting the respiratory system has consequently become a key concern. We investigated the value of integrating sales of non-prescription medications commonly bought for managing respiratory symptoms, to improve forecasting of weekly registered deaths from respiratory disease at local levels across England, by using over 2 billion transactions logged by a UK high street retailer from March 2016 to March 2020. We report the results from the novel AI explainability variable importance tool Model Class Reliance implemented on the PADRUS model. PADRUS is a machine learning model optimised to predict registered deaths from respiratory disease in 314 local authority areas across England through the integration of shopping sales data and focused on purchases of non-prescription medications. We found strong evidence that models incorporating sales data significantly out-perform other models that solely use vari-ables traditionally associated with respiratory disease (e.g. sociodemographics and weather data). Accuracy gains are highest (increases in R2 between 0.09 to 0.11) in periods of maximum risk to the general public. Results demonstrate the potential to utilise sales data to monitor population health with information at a high level of geographic granularity.
Rationale for the selection of dual primary endpoints in prevention studies of cognitively unimpaired individuals at genetic risk for developing symptoms of Alzheimer’s disease
Authors: Caputo Angelika , Racine Amy , Paule Ines , Tariot Pierre N. , Langbaum Jessica B. , Coello Neva , Riviere Marie-Emmanuelle , Ryan J. Michael , Lopez Cristina Lopez , Graf Ana
Published: November 2022

Background: There is a critical need for novel primary endpoints designed to detect early and subtle changes in cognition in clinical trials targeting the asymptomatic (preclinical) phase of Alzheimer’s disease (AD). The Alzheimer’s Prevention Initiative (API) Generation Program, conducted in cognitively unimpaired individuals at risk of developing AD (e.g., enriched by the apolipoprotein E (APOE) genotype), used novel dual primary endpoints based on 1) time to event (TTE) – with an event defined as diagnosis of mild cognitive impairment (MCI) due to AD and/or dementia due to AD – and 2) change from baseline to Month 60 in the API preclinical composite cognitive (APCC) test score.
Methods: Historical observational data from three sources were used to fit models to describe the TTE and the longitudinal APCC decline, both in people who do and do not progress to MCI or dementia due to AD. Clinical endpoints were simulated based on the TTE and APCC models to assess the performance of the dual endpoints versus each of the two single endpoints, with the selected treatment effect ranging from a hazard ratio (HR) of 0.60 (40% risk reduction) to 1 (no effect).
Results: A Weibull model was selected for TTE, and power and linear models were selected to describe the APCC score for progressors and non-progressors, respectively. Derived effect sizes in terms of reduction of the APCC change from baseline to Year 5 were low (0.186 for HR=0.67). The power for the APCC alone was consistently lower compared to the power of TTE alone (58% [APCC] vs 84% [TTE] for HR=0.67). Also, the overall power was higher for the 80%/20% distribution (82%) of the family-wise type-1 error rate (alpha) between TTE and APCC compared to 20%/80% (74%).
Conclusions: Dual endpoints including TTE and a measure of cognitive decline perform better than the cognitive decline measure as a single primary endpoint in a cognitively unimpaired population at risk of AD (based on the APOEgenotype). Clinical trials in this population, however, need to be large, include older age, and have a long follow-up period of at least 5 years to be able to detect treatment effects.
Frequent copy number variants in a cohort of Mexican-Mestizo individuals
Authors: Sánchez Silvia , Juárez Ulises , Domínguez Julieta , Molina Bertha , Barrientos Rehotbevely , Martínez-Hernández Angélica , Carnevale Alessandra , Grether-González Patricia , Mayen Dora Gilda , Villarroel Camilo , Lieberman Esther , Yokoyama Emiy , Castillo Victoria Del , Torres Leda , Frias Sara
Published: November 2022

Background. The human genome presents variation at distinct levels, Copy number variants (CNV) are DNA segments of various lengths in bp that are present at a variable number of copies compared to a reference genome. CNV analysis has been done in almost all human populations and most of them have no apparent influence on the phenotype, yet some of them usually long sized, has been associated with pathologies. Recently however, the detection of common and benign CNV within different ethnic populations is becoming increasingly relevant as it helps in discerning real pathological variants and thus avoiding misinterpretations. The aim of this work is to describe four CNV frequently found in a cohort of 147 Mexican-Mestizo individuals.
Results: In this study we found four CNV 2p11.2, 8p11.22, 14q32.33 and 15q11.2, with a high frequency in the Mexican population when contrasted with the HapMap reference (ChAS), while when used an ethnically related population as a reference, the differences are reduced or disappear. The population studied does not show inbreeding or consanguinity.
Conclusion: CNV-type polymorphisms have frequencies that vary according to the ethnic group studied. It highlights the importance of analyzing the CNV of the studied individuals, with a reference group that -as far as possible- share the same ethnicity. These findings should be considered to avoid false associations of CNV with pathological conditions.
Age- and sex-specific trends of HOMA-IR values in adolescents from 2007–2010 to 2019–2020 in Korea
Authors: Kim Sujin , Song Kyungchul , Myeongsub Lee , Suh Junghwan , Chae Hyun Wook , Kim Ho-Seong , Kwon Ahreum
Published: November 2022

Background/Objectives: Changes in the percentile value of the homeostasis model assessment of insulin resistance (HOMA-IR) value in adolescents in Korea are yet to be elucidated. This study aimed to investigate the age- and sex-specific trends in insulin resistance (IR) according to the HOMA-IR in Korean adolescents, using data from the Korean National Health and Nutrition Examination Survey IV, VI, and VIII conducted between 2007–2010 and 2019–2020.
Subjects/Methods: Overall, 4621 adolescents (2484 boys and 2137 girls) aged 10–18 years were evaluated. Among them, 3473 subjects (1855 boys and 1618 girls) were from the 2007–2010 dataset, and 1148 subjects (629 boys and 519 girls) were from the 2019–2020 dataset. The subjects were grouped according to body mass index (BMI) and evaluated according to age and sex. Percentile curves of HOMA-IR were calculated as a function of age and stratified by sex and BMI group.
Results: In the normal weight group, HOMA-IR values peaked at age 12–14 years in boys and at age 10–12 years in girls. In the overweight/obese group, HOMA-IR values did not show a specific pattern according to age. In the normal-weight group, there was no difference in the mean HOMA-IR values between 2007–2010 and 2019–2020, but the distribution range was wider in 2019–2020 than in 2007–2010. Meanwhile, in the overweight/obese group, HOMA-IR values were significantly higher in 2019–2020 than in 2007–2010.
Conclusions: Percentiles of HOMA-IR vary significantly according to age, sex, and BMI among Korean adolescents. Therefore, because the value of HOMA-IR in adolescents is affected by several factors, including age, sex, weight status, and race, these factors should be considered when clinically utilizing HOMA-IR. In addition, active intervention for IR, especially during the growth spurt period, is needed.
Post-fumigation sub-lethal activities of phosphine and ethyl formate on survivorship, fertility and female sex pheromone production of Callosobruchus chinensis (L.)
Authors: Chiluwal Kashinath , Lee Byung Ho , Kwon Tae Hyung , Kim Junheon , Park Chung Gyoo
Published: November 2022

Phosphine (PH3) and ethyl formate (EF), the two popular fumigant disinfectants of stored product insect pests, are primarily evaluated for their knock down effects without considering their post-fumigation sub-lethal activities. The sub-lethal activities (adult survivorship, fecundity, sterility and female sex pheromone production) of the fumigants were evaluated on a field-to-storage insect pest adzuki bean beetle, Callosobruchus chinensis (L.). The adults’ survivorship and female fecundity, both were dose-dependently affected by sub-lethal PH3 and EF fumigation exposures. Hatchability of the eggs laid by fumigated female adults were also significantly affected. Gas-chromatography mass-spectrometry analysis of solid-phase micro-extraction from virgin fumigated C. cinensis females revealed that the PH3 LC25 (the lethal concentration required to kill the 25% of the population) fumigated female C. chinensis released significantly less amount of the pheromone components. In contrast, EF LC25 exposure did not affect the pheromone release. This study unveils the facts that the EF and PH3 fumigation have detrimental bioactivities against C. chinensis. Notably, this suggests to consider the sub-lethal EF and PH3 fumigation rather than the dose required to instantly kill all the C. chinensis individuals for disinfestation of stored adzuki bean.
The Relationship Between Fear of Surgery and Affecting Factors in Surgical Patients
Authors: Akutay Seda , Ceyhan Özlem
Published: November 2022

Background: This study aimed to explain the fear of surgery in surgical patients, the affecting factors, and their relationship.
Methods:This study was conducted as a descriptive and cross-sectional study. The study population consists of 300 patients undergoing surgical intervention. Data were collected using the "Patient Information Form" and "Surgical Fear Questionnaire". Parametric and nonparametric tests were used to evaluate the data. The relationship between the fear questionnaireand age, number of previous surgeries, and pre-operative pain were evaluated using Spearman correlation analysis. The relationship with emotional stress was evaluated with multiple linear regression analysis.
Results: In this study, it was determined that the predictors of the surgical fear level of the patients were age, gender, anesthesia type, and pre-operative pain experience. There was a negative correlation between the age of the patients and the fear of surgery score and a positive correlation between the pre-operative pain severity and the fear of surgery score. It was determined that the factors most associated with pre-operative fear levels were the patients' pre-operative sense of inadequacy (p <0.001), feeling anxious and unhappy, and confusion about the surgery decision (p <0.005).
Conclusion: According to the results of this study, it has been determined that the emotional states and fears of the patients before the surgery have significant effects on the fear of surgery. For this, it is recommended to determine the emotional states and fears of the patients before the surgery and to make appropriate interventions, as it will facilitate compliance with the surgical process.
Impact of the mental health reform in Israel on health care and mortality among people with severe mental illness
Authors: Gal Gilad , Levav Itzhak , Kodesh Arad
Published: November 2022

Objective
Reports show disparities in the health care of people with severe mental illness (SMI). Yet, the moderating effect of mental health reforms on the health care disparities remain unexplored. The current study aimed to investigate the outcomes of the mental health reform in Israel on the use of health services among people with SMI.
Method
A case-control epidemiological study comparing the use of health services 3.5 years before and after the mental health reform for service users diagnosed with schizophrenia, schizoaffective disorder, and bipolar disorder. Data on health services included: blood cholesterol test (LDL), hemogalobin-A1C test, and visits to GPs and specialists. Mortality was recorded.
Results
Following the reform the number of visits to GPs was decreased among service users of the three SMI groups, as well as visits to specialists among service users with a schizoaffective or bipolar disorder. Following the reform service users of the three SMI groups showed no-change in the performance of LDL test. Complex findings were noted with regard to the performance of Hemoglobin-A1C test. Mortality rates were higher among service users with SMI and did not change following the reform.
Conclusions
Users of the three SMI groups showed no benefits of the mental health reform in terms of use of health services. Improved health care can be attained by a closer collaboration between the primary physicians and community mental health services.
Disparities in Postoperative Opioid Prescribing by Race and Ethnicity: An Electronic Health Records-Based Observational Study
Authors: Romanelli Robert J. , Shenoy Rivfka , Martinez Meghan C. , Mudiganti Satish , Mariano Louis T. , Zanocco Kyle A. , Wagner Zachary , Kirkegaard Allison , Watkins Katherine E.
Published: November 2022

Background: Prior studies on disparities in postoperative opioid prescribing have focused primarily on in-hospital opioid administration or long-term opioid use, with fewer studies examining discharge opioid prescribing for adults, and no studies looking across different surgical subspecialties or service lines. We sought to examine racial and ethnic disparities in postoperative opioid prescribing to test the hypothesis that racial and ethnic minority groups receive opioid prescriptions at postoperative discharge with lower morphine milligram equivalents (MME) than non-Hispanic whites (NHW).
Methods: We utilized electronic health records (EHR) data across 24 hospitals from a healthcare delivery system in northern California from January 1, 2015 to February 2, 2020 (study period). The sample included adult patients undergoing a procedure during the study period, discharged to home with an opioid prescription. Cross-sectional, secondary data analyses were conducted to examine differences by race and ethnicity in opioid prescribing, measured as MME, among patients who underwent select, but commonly performed, surgical procedures. Linear regression models included adjustment for factors that would likely influence prescribing decisions and race and ethnicity-specific propensity weights. Opioid prescribing, overall and by race and ethnicity, was also compared to postoperative opioid guidelines.
Results: Among 61,564 patients, on adjusted regression analysis, non-Hispanic Black (NHB) patients received prescriptions with higher mean MME than NHW patients (+6.4% [95% confidence interval: 4.4%, 8.3%]), whereas Hispanic and non-Hispanic Asian patients received lower mean MME (-4.2% [-5.1%, -3.2%] and -3.6% [-4.8%, -2.3%], respectively). Nevertheless, 72.8% of all patients received prescriptions above guidelines, ranging from 71.0% to 80.3% by race and ethnicity. Disparities in prescribing were eliminated among Hispanic and NHB patients versus NHW patients when prescriptions were written within guideline recommendations.
Conclusions: Racial and ethnic disparities in opioid prescribing exist in the postoperative setting, yet all groups received prescriptions above guideline recommendations. Policies encouraging guideline-based postoperative prescribing can reduce disparities and overall excess prescribing.
The differentiation status of luminal-type breast cancer–derived organoids can be altered in vitro through the activation of NOTCH signaling
Authors: Uematsu Hiroyuki , Saito Chieko , Kondo Jumpei , Onuma Kunishige , Coppo Roberto , Mori Yukiko , Mutou Manabu , Kikawa Yuichiro , Tada Manami , Sugie Tomoharu , Inoue Masahiro
Published: November 2022

Background Drug therapy of luminal-type breast cancer has advanced remarkably; however, its effectiveness continues to be limited by primary and acquired treatment resistance. To identify the means of overcoming such resistance,in vitrodisease models that faithfully reproduce the characteristics of original patient tumors must be developed. Although the three-dimensional culturing of breast cancer cells has been improved, the changes in differentiation status and underlying mechanisms require further elucidation. Methods The organoids from 33 luminal-type breast cancers were prepared using a method developed by us. Using immunohistochemistry and gene expression profiling, the levels and time courses of estrogen receptor, progesterone receptor, Ki67, and differentiation marker expression were monitored during culture as well as the variation among the patients and individual organoids. Furthermore, we examined the effect of NOTCH inhibitor treatment on differentiation status. Results We successfully prepared organoids from samples obtained from 33 patients with luminal-type breast cancer and studied their ER expression. The expression status was well maintained in primary organoids, whereas it decreased after passaging in most of the cases. In fact, the studied organoid lines were classified into those that retained a high level of ER expression (9%), those that completely lost it (9%), and those that repressed it to varying degrees (82%). In some cases, the ER expression was suddenly and drastically decreased after passaging. Marker protein immunohistochemistry revealed that after passaging, the differentiation status shifted from a luminal- to a basal-like status. Differentially expressed genes suggested the activation of NOTCH signaling in the passaged organoids, wherein a NOTCH inhibitor was able to substantially rescue the decreased ER expression and alter the differentiation status. Conclusions Our findings suggest that the differentiation status of luminal-type cancer cells is quite flexible, and that by inhibiting the NOTCH signaling we can preserve the differentiation status of luminal-type breast cancer organoids.
Machine Learning Algorithms Predict Successful Weaning from Mechanical Ventilation Before Intubation
Authors: Kim Hyung-Jun , Kim Jinchul , Kim Yun Kwan , Kim Hyeyeon , Jung Hyojung , Koh Soonjeong , Kim Yujeong , Yoon Dukyong , Yi Hahn
Published: November 2022

Prediction of successful weaning from mechanical ventilation in advance to intubation can facilitate discussions regarding end-of-life care before unnecessary intubation. In this context, we aimed to develop a machine-learning-based model that predicts successful weaning from ventilator support based on routine clinical and laboratory data taken before or immediately after intubation. We used the Medical Information Mart for Intensive Care-IV database, including adult patients who underwent mechanical ventilation in intensive care at the Beth Israel Deaconess Medical Center, USA. Clinical and laboratory variables collected before or within 24 hours of intubation were used to develop machine-learning models that predict the probability of successful weaning within 14 days of ventilator support. Of 23,242 patients, 19,025 (81.9%) patients were successfully weaned from mechanical ventilation within 14 days. We selected 46 clinical and laboratory variables to create machine-learning models. The machine-learning-based ensemble voting classifier revealed the area under the receiver operating characteristic curve of 0.863 (95% confidence interval 0.855–0.870), which was significantly better than that of Sequential Organ Failure Assessment (0.588 [0.566–0.609]) and Simplified Acute Physiology Score II (0.749 [0.742–0.756]). The top features included lactate, anion gap, and prothrombin time. The model’s performance achieved a plateau with approximately the top 21 variables. We developed machine learning algorithms that can predict successful weaning from mechanical ventilation in advance to intubation in the intensive care unit. Our models can aid in appropriate management for patients who hesitate to decide on ventilator support or meaningless end-of-life care.
Association between eating alone and depression by income level
Authors: Min Ju-Hong , Jung Hye-Sun
Published: November 2022

Background
In Korea, the number of single-person households is increasing annually, with increases from 23.9% in 2010 to 27.9% in 2016, and 31.7% in 2020. As the number of single-person household increases, the number of people eating alone also increases. As a result, mental health problems such as depression and stress have occurred. This phenomenon may show a different tendency depending on socioeconomic levels.
Methods
Frequency analysis was conducted to understand the general characteristics of the study subjects. In addition, a chi-squared test was conducted to verify the difference in income levels according to the characteristics of the study subjects. To verify the differences between the characteristics and depression in the study subjects by income level, a chi-squared test was conducted. Multiple logistic regression analysis was conducted to confirm the factors affecting depression by income level.
Results
In the case of commensality, 75.7% of the group with high-income levels were higher than 67.4% of the group with low-income levels. In the case of depression, 18.6% of the low-income group was higher than 11.3% of the high-income group. When divided according to income level, in the low-income group, the group that eats alone had 1.46-times (95% confidence interval (CI): 1.077~2.066) higher depression than the group that does not eat with others. In contrast, in the high-income group, eating alone did not have a significant effect on depression.
Conclusion
The effect of eating alone on depression varies depending on the income level. Thus, other factors may have affected depression in the high-income group rather than eating alone. In the low-income group, it is necessary to improve the environment so that they can eat together for healthy eating and mental health, and promotion or education should be provided.
Nonlinear Feedback Synthesis and Control of Periodic, Quasiperiodic, Chaotic and Hyper-Chaotic Oscillations in Mechanical Systems
Authors: Kundu Prasanjit Kumar , Chatterjee Shyamal
Published: November 2022

Self-excited periodic, quasiperiodic and chaotic oscillations have many significant applications in engineering devices and processes. In the present paper a centralized nonlinear controller is proposed to artificially generate and control self-excited periodic, quasiperiodic, chaotic and hyper-chaotic oscillations of required characteristics in a fully-actuated n-DOF spring-mass-damper mechanical system. The analytical relations among the amplitude, frequency and controller parameters for minimum control energy have been obtained using the method of two-time scale. It is shown that the proposed control can generate modal and nonmodal self-excited periodic and quasiperiodic oscillations of desired amplitude and frequency for minimum control energy. The analytical results have been verified numerically with MATLAB SIMULINK. Bifurcation analysis and extensive numerical simulations reveal a region of multistability in the plane of control parameters, where system responses may be periodic, quasiperiodic, chaotic and hyper-chaotic depending on initial conditions. However, it has been shown that the probability of obtaining chaotic and hyper-chaotic oscillations are very high for a wide range of controller parameters. The procedures of controlling the amplitude, frequency and characteristics of chaotic oscillations are also discussed. The results of the present paper is expected to find applications in various macro and micro mechanical systems and applications.
Impact of Right Ventricular Stiffness on Discordance between Hemodynamic Parameter and Regurgitant Volume in Patients with Pulmonary Regurgitation
Authors: Motoi Ko , Iwano Hiroyuki , Tsuneta Satonori , Ishizaka Suguru , Tamaki Yoji , Aoyagi Hiroyuki , Nakamura Kosuke , Murayama Michito , Nakabachi Masahiro , Yokoyama Shinobu , Nishino Hisao , Kaga Sanae , Takeda Atsuhito , Anzai Toshihisa
Published: November 2022

Background
Accurate detection of significant pulmonary regurgitation (PR) is critical in management of patients after right ventricular (RV) outflow reconstruction in Tetralogy of Fallot (TOF) patients, because of its influence on adverse outcomes. Although pressure half time (PHT) of PR velocity is one of the widely used echocardiographic markers of the severity, shortened PHT is suggested to be seen in conditions with increased RV stiffness with mild PR. However, little has been reported about the exact characteristics of patients showing discrepancy between PHT and PR volume in this population.
Methods
Echocardiography and cardiac magnetic resonance imaging (MRI) were performed in 74 TOF patients after right ventricular outflow tract (RVOT) reconstruction [32 ± 10 years old]. PHT was measured from the continuous Doppler PR flow velocity profile and PHT < 100 ms was used as a sign of significant PR. Presence of end-diastolic RVOT forward flow was defined as RV restrictive physiology. By using phase-contrast MRI, forward and regurgitant volumes through the RVOT were measured and regurgitation fraction was calculated. Significant PR was defined as regurgitant fraction ≥ 25%.
Results
Significant PR was observed in 53 of 74 patients. While PHT < 100 ms well predicted significant PR with sensitivity of 96%, specificity of 52%, and c-index of 0.72, 10 patients showed shortened PHT despite regurgitant fraction < 25% (discordant group). Tricuspid annular plane systolic excursion and left ventricular (LV) ejection fraction were comparable between discordant group and patients showing PHT < 100 ms and regurgitant fraction ≥ 25% (concordant group). However, discordant group showed significantly smaller mid RV diameter (30.7 ± 4.5 vs 39.2 ± 7.3 mm, P < 0.001) and higher prevalence of restrictive physiology (100% vs 42%, P < 0.01) than concordant group. When mid RV diameter ≥ 32 mm and absence of restrictive physiology were added to PHT, the predictive value was significantly improved (c-index: 0.89, P < 0.001 vs PHT alone by multivariable logistic regression model).
Conclusion
Patients with increased RV stiffness and non-enlarged right ventricle showed short PHT despite mild PR. Although it has been expected, this was the first study to demonstrate the exact characteristics of patients showing discrepancy between PHT and PR volume in TOF patients after RVOT reconstruction.
The Power of Rotation Schedules on the Career Selection Decisions of Medical Students
Authors: Bechara John P. , Shah Priti Pradhan , Lindor Keith
Published: November 2022

Choosing a career pathway in medicine is a high stakes decision for both medical students and the field of medicine as a whole. While past research has examined how characteristics of the medical student or specialties influence this decision, we introduce temporal elements as novel variables influencing career selection decisions in medicine. Specifically, we investigate how timing and duration of residency options, based on a rotation schedule that medical students have limited control over, influence their career selection decisions. An archival study investigating 5 years of medical student rotation schedules (N = 115) reveals that clinical rotation options appearing earlier and more often in the schedule were more likely to be selected. Moreover, timing and duration of exposure interacted such that such that residency options appearing later in the schedules were more likely to be selected if they also appeared more often. Conditional logistic regressions using student fixed-effects to control for idiosyncratic medical student differences (i.e., gender, & debt, etc.), and residency fixed-effects to control for idiosyncratic residency differences (income, and lifestyle, etc.), revealed the rotation schedule had a significant impact on residency selection decisions even when controlling for factors typically influencing this decision. Medical students’ career decisions are influenced by when and how long different choice options appear in their rotation schedule, especially when they have limited influence over this schedule. The results have implications for healthcare policy by highlighting a tool for adjusting physician workforce composition by broadening exposure to a greater array of career options.
The Tolerance of Refractive Errors of Extended Depth of Focus Intraocular Lens in Patients with Previous Corneal Refractive Surgery
Authors: Zheng Hansong , Tan Qian , Zhou Suowang , Luo Wenjing , Ortega-Usobiaga Julio , Wang Li , Wang Yong
Published: November 2022

Purpose
To evaluate the tolerance of refractive errors and visual outcomes of extended depth of focus intraocular lens (EDOF IOLs) in patients with previous corneal refractive surgery for myopia.
Methods
Patients from Wuhan Aier Eye Hospital with previous myopia excimer laser correction underwent cataract surgery and implantation of an EDOF IOL. The follow-up period was three months. The uncorrected distance, intermediate, and near visual acuities (UDVA, UIVA, UNVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), defocus curve, optical quality, including modulation transfer functions (MTF) and Strehl ratio (SR), National Eye Institute Visual Functioning Questionnaire-14 for Chinese people (VF-14-CN), spectacle independence, and dysphotopsia were assessed.
Results
At the final visit, UDVA, CDVA, UIVA, and UNVA (logMAR) were 0.07 ± 0.09, 0.01 ± 0.04, 0.10 ± 0.08, 0.20 ± 0.11, respectively. The mean spherical equivalent (SE) was ± 0.75 ± 0.49D, where 42% (21 eyes) were within ± 0.50D, 70% (35 eyes) were within ± 1.00D, and 98% (49 eyes) were within ± 1.50D. The defocus curve showed that visual acuity could reach 0.1 in the refractive range of 0 ~ -1.5D. SR and MTF values of 10, 15, 20, 35, and 30 c/d spatial frequency were measured with a 3 mm pupil diameter after removing the influence of low-order aberrations, which were all higher than the values before the operation. The mean VF-14-CN questionnaire score was 51.02 ± 2.95 out of 56.
Conclusion
The EDOF IOLs have a certain tolerance for refractive errors, and they are recommended for patients with prior myopia excimer laser surgery to achieve satisfactory visual performance.
A Combined Synchronization Index for Grassroots Activism on Social Media
Authors: Ng Lynnette Hui Xian , Carley Kathleen M
Published: November 2022

Social media has provided a citizen voice, giving rise to grassroots collective action, where users deploy a concerted effort to disseminate online narratives and even carry out offline protests. Sometimes these collective action are aided by inorganic synchronization, which arise from bot actors. It is thus important to identify the synchronicity of emerging discourse on social media and the indications of organic/inorganic activity within the conversations. This provides a way of profiling an event for possibility of offline protests and violence. In this study, we build on past definitions of synchronous activity on social media – simultaneous user action – and develop a Combined Synchronization Index (CSI) which adopts a hierarchical approach in measuring user synchronicity. We apply this index on six political and social activism events on Twitter and analyzed three action types: synchronicity by hashtag, URL and @mentions.The CSI provides an overall quantification of synchronization across all action types within an event, which allows ranking of a spectrum of synchronicity across the six events. Human users have higher synchronous scores than bot users in most events; and bots and humans exhibits the most synchronized activities across all events as compared to other pairs (i.e., bot-bot and human-human). We hope this work aids in investigating synchronized action within social media in a collective manner.
Is it possible to derive a mathematical physical form for Euler’s formula in the reality of complex harmonic oscillator?
Authors: Sanduk Mohammed
Published: November 2022

Euler’s formula is a pure mathematical formula. In spite of its nonphysical nature, the form of this formula has a genuine fundamental role in quantum mechanics, but with no physical reason for this role. Philosophically, Heisenberg has proposed Kantian ideas in physics like “nature in itself”, unobservable nature, and “nature as appears”. He proposed a possibility of mathematical formulation for a system in nature in itself. In the present work, a mathematical model of rolling circles in real space has been proposed as a model for a system in nature in itself. Observation process acts as a transformation of the system to a model in observable nature. Partial observation transforms the real position vector of a point in that system to a form similar to the Euler’s formula. That causes the appearance of the imaginary unit. Interestingly, the transformed real kinematical forms exhibit similarity with the forms of relativistic quantum mechanics.
Decay-times of pions and kaons formed by laser-induced nuclear processes in ultra-dense hydrogen H(0)
Authors: Holmlid Leif
Published: November 2022

Laser-induced nuclear reactions in ultra-dense hydrogen H(0) (see review in Physica Scripta 2019) create mesons (kaons, pions) with up to 100 MeV thus velocity 0.55 c for the kaons. The pion decay-time is determined to be 25.92 ± 0.04 ns (standard fit error) in agreement with the tabulated results from the Particle Data Group. The same general behaviour is found with either deuterium or normal hydrogen forming the ultra-dense phase H(0) on the laser target. Many mesons decay close to the target and generate muons with relativistic energies at current densities of 1–10 mA cm-2 per laser pulse of < 0.4 J energy as measured at 1–2 m distances. This corresponds to 1013 muons and a similar number of initially created mesons per laser pulse. The large number of mesons created proves that they are formed from the baryons in H(0). Here the decay-times of the initially formed kaons and pions are measured accurately. Their kinetic energies are determined from their dilated decay-times. A baryon annihilation process agrees with the observed particle types and their energies (Holmlid, Int. J. Hydrogen Energy 2021, Holmlid and Olafsson High Energy Density Physics 2021). It gives creation of a pair of kaons and of two pairs of pions from a pair of baryon-antibaryon with accurate energy.
Assessment of trace metal accumulation potentials and Health risk of three selected edible mushroom species from Ehime Mbano Imo state, Nigeria.
Authors: Eze Sunday , Okechukwu Chioma , Okechukwu Victor , Omokpariola Daniel , Umeh Chisom , Morah Ebele , Omokpariola Patrick , Akolawole Joseph , Ifeagwu Ogochukwu
Published: November 2022

The effects of processing on the chemical properties (proximate, mineral, vitamins, as well as anti-nutritional factors and oil characterization) of Mucuna flagellipes seeds and seed oil were assessed. Mucuna flagellipes seeds were purchased from a local market in Isiagu, Ebonyi State, Nigeria and divided into three equal portions, which were further processed by frying, boiled, and roasted. Samples were analyzed by official methods of analysis as results generated were subjected to one-way analysis of variance (ANOVA). The proximate compositions showed a significant difference at (P < 0.05) in some nutrients evaluated. In terms of moisture content, all the fried samples were lower (5.00%) than the boiled (14.53%) and roasted (11.87%) samples. The protein content of the processed samples was low, and no significant difference (P < 0.05) was observed. The seed oil was extracted with (40–60°C) n-hexane and the oil was separated from the solvent using a rotary evaporator. The saponification value, peroxide value, and iodine value showed significant differences (P < 0.05). The fat content showed lower values of 5.13%, 3.87%, and 4.87% for fried, boiled, and roasted Mucuna flagellipes seed oil. The seed samples contained no less than 0.60 mg/100 g of oxalate, 0.70 mg/kg of phytate in addition to high alkaloid, terpenoid, cyanide, and flavonoid values. The predominant mineral was sodium in all the processed samples with the values ranging from (119.48mg/kg) to (102.20mg/kg) followed by magnesium 8.53mg/100ml, 7.12mg/100ml, and 7.03mg/100ml for fried, boiled, and roasted Mucuna flagellipes, while all the processed samples were significantly low in potassium (0.37 to 0.30mg/kg). There was a significant difference (P < 0.05) observed in some of the vitamin content. These research results may offer a scientific basis for the use of the processed Mucuna flagellipes seeds as food for humans and its oil extracts for the manufacture of industrial products.
40 years of actigraphy in sleep medicine: where do we stand on the state-of-the-art algorithms?
Authors: Patterson Matthew , Nunes Adonay , Gerstel Dawid , Pilkar Rakesh , Guthrie Tyler , Neishabouri Ali , Guo Christine
Published: November 2022

For the last 40 years, actigraphy or wearable accelerometry has provided an objective, low- burden and ecologically valid approach to assess real-world sleep and circadian patterns, contributing valuable data to epidemiological and clinical insights on sleep and sleep disorders. The proper use of wearable technology in sleep research requires validated algorithms that can derive sleep outcomes from the sensor data. Since the publication of the first automated scoring algorithm by Webster in 1982, a variety of sleep algorithms have been developed and contributed to sleep research, including many recent ones that leverage machine learning and / or deep learning approaches. However, it remains unclear, how these algorithms compare to each other on the same data set and if these modern data science approaches improve analytical validity of sleep outcomes based on wrist-worn acceleration data. This work provides a systematic evaluation across 8 state-of-the-art sleep algorithms on a common sleep data set with polysomnography (PSG) as ground truth. Despite the inclusion of recently published complex algorithms, simple regression-based and heuristic algorithms demonstrated slightly superior performance in sleep-wake classification and sleep outcome estimation. The performance of complex machine learning and deep learning models seem to suffer from poor generalization. This independent and systematic analytical validation of sleep algorithms provides key evidence on the use of wearable digital health technologies for sleep research and care.
EGR-mediated relapse mechanisms in infant t(4;11) acute lymphoblastic leukemia
Authors:   , Külp Marius
Published: November 2022

KMT2A-rearrangements are causative for 70-80% all infant acute lymphoblastic leukemias (Pieters et al., 2019, 2007). Among these, the translocation t(4;11)(q21;23) generating the oncogenic fusion genes KMT2A::AFF1 and AFF1::KMT2A is the most frequent one, accounting for almost every second case of KMT2A-r infant ALL (Meyer et al., 2018). Despite passing a multimodal chemotherapy, 64% of patients achieve an event including relapse or death within four years from diagnosis, and overall survival three years from relapse remains poor with only 17% (Driessen et al., 2016; Pieters et al., 2019, 2007). Vari-ous studies have shown that relapse and therapy resistance were not mediated by chemotherapy-induced mutagenesis as there was no accumulation of secondary mutations in the dominant leukemic clone between diagnosis and relapse (Agraz-Doblas et al., 2019; Andersson et al., 2015; Bardini et al., 2011; Dobbins et al., 2013; Driessen et al., 2013; Mullighan et al., 2007). Intriguingly, exclusively infant t(4;11) ALL patients were reported to subdivide in two groups depending on the level of HOXA gene cluster expression (Trentin et al., 2009). The HOXAlo group displayed a high expression of IRX1 and the HOXAhi group a low expression of IRX1 (Symeonidou and Ottersbach, 2021; Trentin et al., 2009). Importantly, the HOXAlo/IRX1hi group was characterized to possess a strongly ele-vated relapse incidence compared to the HOXAhi/IRX1lo group (Kang et al., 2012; Stam et al., 2010). IRX1 was identified to upregulate the Early growth response genes EGR1, EGR2 and EGR3 (Kühn et al., 2016). The doctoral project “EGR-mediated relapse mechanisms in infant t(4;11) acute lymphoblastic leuke-mia” aimed to investigate a potential correlation between the HOXAlo-IRX1-EGR axis and relapse development in infant t(4;11) ALL. The primary objective was to clarify through which molecular mechanism(s) relapse development despite continuous chemotherapy could be achieved. In this context, the role of the EGR genes has been investigated. In addition, this project aimed to disclose molecular targets which could offer novel therapeutic interventions to interfere with therapy resistance and relapse formation.
Kajian Ukuran Rajungan (Portunus pelagicus) Menurut Jenis Kelamin, Tingkat Kematangan Gonad dan Faktor Kondisi di Perairan Pulau Baai Bengkulu
Authors: Maylandia Chantika Rachma , Matondang Dina Ratnasari , Ilhami Sitti Alya , Parapat Andreas Jorghy , Bakhtiar Deddy
Published: November 2022

The resources of the blue swim crab are currently under pressure on survival due to the increasing effort to catch in nature. Management of blue swim crab resources requires information on the biological conditions of the crab to determine the size, sex, and number that can be caught. This study aims to analyze the structure of carapace width concerning differences in sex, gonad maturity level, and crab condition factors. The method used is the method of observation by measuring the length, weight, and maturity level of the gonads and then analyzed descriptively. The results showed that the size of the crabs was included in the category of juvenile to adult crabs for both male and female crabs. The growth pattern of male crabs with a coefficient of b value of 2.47 and female crabs of 2.78 shows that the growth patterns of crabs in Pulau Baai waters are negative allometric. Most of the female crabs are in the immature stage of the gonads, so the condition factor for the female crabs tends to be lower than the male crabs, this is because most of the female crabs have just passed the spawning phase.
Microbiological Analysis of Liquid Lipstick Products Used by Makeup Artists
Authors: Rahmah Chairunnisaa Jabal , Pujiyanto Sri , Rukmi Isworo
Published: November 2022

AbstractLipstick is a non-sterile pharmaceutical product that is used for make-up on the lips. Liquid lipstick used by makeup artists may have a high level of microbial contamination because they are applied to different clients in turn. This study aims to determine the microbiological quality of liquid lipstick used by makeup artists based on the result of the Bacterial Total Plate Count (TPC), Yeast and Mold Count (YMC), and the presence of pathogenic microbes. Three samples of liquid lipstick were taken from three different makeup artists and one sample was a new liquid lipstick product. The Bacterial TPC test was carried out on TSA media and the YMC test was carried out on SDA with the spread plate technique. The presence of microbial pathogens P. aeruginosa, S. aureus, and C. albicans were carried out on selective media. The results of bacterial TPC was 9.0 × 103 to 3.0 × 104 CFU/mL, while the YMC was 1.1 × 103 to 3.1 × 103 CFU/mL. The pathogenic microbes detected were S. aureus in 2 samples and C. albicans in 1 sample. The bacterial TPC and YMC values exceed the contamination limit based on BPOM Regulation No. 12/2019.
N-FORMYL-Tripeptides Substituted at The Methionine Residue By an Aspartic QR Glutamic Acid: Effects on Neutrophil Biological Activity
Authors: Ferretti Maria E. , Spisani Susanna , Fabbri Elena , Alvoni Serena , Cavicchioni Giorgio
Published: November 2022

The formyl-peptides for-Glu-Leu-Phe-OMe 1 and for-Asp-Leu-Phe-OMe 2 were synthesized in order to study the influence of a net negative charge, along the side chain of the first residue, on human neutrophil biological responses. The compounds exert a weak chemotactic as well as secretory activity. Moreover, they are neither able to enhance intracellular calcium levels nor to elicit oxygen-dependent mechanisms.We suggest that the receptor pocket does not accept a net negative charge on the side chain of the first residue.
Early Cognitive Impairment at Acute Stage After Intracerebral Hemorrhage
Authors: Hu Hua , You Shoujiang , Cao Yongjun , huang Yaqian , Gu Cong , Zhang Wei , Wang Jiayun , Xu Jiaping , Liu Jing
Published: November 2022

Background:

Cognitive impairment after acute intracerebral hemorrhage (ICH) is common.
While the evidence of early cognitive impairment at the acute stage after ICH is limited. We
determined the frequency and risk factors of early cognitive impairment at the acute stage and investigated
its association with delayed cognitive impairment after ICH.

Methods:

A total of 208 patients with acute ICH were enrolled from January 2017 to February
2019. Cognitive function was assessed during the acute stage and at follow-up using Montreal Cognitive
Assessment (MoCA) score. Significant cognitive impairment was defined as having a MoCA
score <20 at the acute stage (within 1 week after hospital admission) or during follow-up.

Results:

The mean observation period was 20 (IQC 17-23) months, and follow-up cognitive function
data were collected from 185 patients. 89 (42.8%) and 86 (46.5%) patients had an acute stage
and delayed significant cognitive impairment, respectively. Older age, large baseline hematoma
volume, more severe ICH, and low level of education were significantly associated with significant
cognitive impairment at the acute stage (all P ≤ 0.009). In the multivariable logistic regression model,
the low MoCA score (odds ratio [OR] 0.59; 95% confidence interval [CI] 0.48-0.71; P＜0.001)
at the acute stage was independently associated with delayed significant cognitive impairment after
ICH.

Conclusion:

Near half of the patients had significant cognitive impairment at the acute stage after
ICH. Cognitive impairment is more frequent in the elderly, those with large baseline hematoma
volume, and more severe initial neurological deficit. Having a lower MoCA score during the acute
phase was independently associated with an increased risk of delayed cognitive impairment.