bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating equity dimensions of infant and child vitamin A supplementation programmes using Demographic and Health Surveys from 49 countries
Authors: Tang Kevin , Eilerts Hallie , Imohe Annette , Adams Katherine P , Sandalinas Fanny , Moloney Grainne , Joy Edward , Hasman Andreas
Published: March 2023

Objectives

Vitamin A deficiency affects an estimated 29% of all children under 5 years of age in low/middle-income countries, contributing to child mortality and exacerbating severity of infections. Biannual vitamin A supplementation (VAS) for children aged 6–59 months can be a low-cost intervention to meet vitamin A needs. This study aimed to present a framework for evaluating the equity dimensions of national VAS programmes according to determinants known to affect child nutrition and assist programming by highlighting geographical variation in coverage.

Methods

We used open-source data from the Demographic and Health Survey for 49 countries to identify differences in VAS coverage between subpopulations characterised by various immediate, underlying and enabling determinants of vitamin A status and geographically. This included recent consumption of vitamin A-rich foods, access to health systems and services, administrative region of the country, place of residence (rural vs urban), socioeconomic position, caregiver educational attainment and caregiver empowerment.

Results

Children who did not recently consume vitamin A-rich foods and who had poorer access to health systems and services were less likely to receive VAS in most countries despite potentially having a greater vitamin A need. Differences in coverage were also observed when disaggregated by administrative regions (88% of countries) and urban versus rural residence (35% of countries). Differences in vitamin A coverage between subpopulations characterised by other determinants of vitamin A status varied considerably between countries.

Conclusion

VAS programmes are unable to reach all eligible infants and children, and subpopulation differences in VAS coverage characterised by various determinants of vitamin A status suggest that VAS programmes may not be operating equitably in many countries.
Seasonal variation in gestational diabetes mellitus among women in Norway: a national population-based study
Authors: Stalheim Astrid Melteig , Iversen Marjolein Memelink , Jenum Anne Karen , Sletner Line , Stafne Signe N , Qvigstad Elisabeth , Sagedal Linda , Nilsen Roy Miodini , Aasheim Vigdis , Strandberg Ragnhild B
Published: March 2023

Objectives

Previous research on seasonal variation in the incidence of gestational diabetes mellitus (GDM) has shown inconclusive results. Furthermore, little is known about whether a seasonal variation in GDM might be associated with the maternal country of birth. We examined whether there was seasonal variation in GDM incidence by the maternal country background.

Design

National population-based registry study.

Setting and participants

We used national population-based data from the Medical Birth Registry of Norway (MBRN), n=1 443 857 (1990–2016) and data from four merged community-based studies (4GDM) with universal screening for GDM, n=2 978 (2002–2013).

Outcome measures

The association between season of pregnancy onset with incidence of GDM was examined separately in both datasets using logistic regression analyses, stratified by the mother’s country background using two broad geographical categories (MBRN: Norwegian and immigrant; 4GDM: European and African/Asian ethnicity). Winter season was used as reference category.

Results

The incidence of GDM in MBRN was highest when the pregnancy started during the winter (Norwegian-born: 1.21%; immigrants: 3.32%) and lowest when pregnancy started during the summer for both Norwegian and immigrant women (Norwegian-born: 1.03% (OR 0.85, 95% CI 0.81 to 0.98); immigrants: 2.99% (OR 0.90, 95% CI 0.84 to 0.96)). The 4GDM data showed that women with European ancestry had the highest incidence of GDM when pregnancy started during autumn (10.7%, OR 1.01, 95% CI 0.69 to 1.46) and winter (10.6%), while ethnic African and Asian women had the highest incidence when pregnancy onset was during the summer (15.3%, OR 1.17, 95% CI 0.54 to 2.53).

Conclusions

Based on national population-based data, this study suggests that GDM incidence varies by season in both Norwegian-born and immigrant women. The 4GDM dataset did not show a clear seasonal variation in GDM incidence, possibly due to the relatively small sample. Causes for the seasonal variation in GDM should be explored further.
Effect of ED-based transitional care interventions by healthcare professionals providing transitional care in the emergency department on clinical, process and service use outcomes: a systematic review
Authors: van den Broek Steef , Westert Gert P , Hesselink Gijs , Schoon Yvonne
Published: March 2023

Objective

Suboptimal transitional care (ie, needs assessment and coordination of follow-up care) in the emergency department (ED) is an important cause of ED revisits and hospital admissions and may potentially harm patients, especially frail older adults. We aimed to systematically review the effect of ED-based interventions by health professionals who are dedicated to providing transitional care to older adults.

Design

Systematic review.

Measurements

We searched five biomedical databases for published (quasi)experimental studies evaluating the effects of health professionals in the ED dedicated to providing transitional care to older ED patients on clinical, process and/or service use outcomes. Reviewers screened studies for relevance and assessed methodological quality with published criteria (Robins-1 and the Cochrane risk of bias tool). Data were synthesised around study and intervention characteristics and outcomes of interest.

Results

From the 6561 references initially extracted from the databases, 12 studies were eligible for inclusion. Two types of interventions were identified, namely, individual needs assessment of ED patients (8 studies; 75%) and discharge planning and coordination of services (4 studies; 25%). Structured individual needs assessment was associated with a significant decrease in hospital admissions, hospital readmissions and ED revisits. Individualised discharge plans from the ED were associated with a significant decrease in ED revisits and hospital readmission. The overall methodological quality of the included studies was relatively low.

Conclusions

Comprehensive assessment of patient needs and ED discharge planning and coordination of services by health professionals interested in transitional care can help optimise the transition of care for older ED patients and reduce the risk of costly and potentially harmful (re)admissions for this population. However, more robust research is needed on the effectiveness of these interventions aiming to improve clinical, process and service use outcomes.

PROSPERO registration number

CRD42021237345.
Classification of symptom subtypes in patients with multiple myeloma during treatment: a cross-sectional survey study in China
Authors: Yu Chunfang , Cai Tingting , Zhou Tingting , Zeng Ning , Liang Xin , Pan Guihua , Ouyang Wei , Yuan Changrong
Published: March 2023

Objectives

To classify subgroups of cancer-related symptoms in patients with multiple myeloma (MM) during treatment and examine between-group differences in demographic and clinical characteristics in addition to functional status.

Design

Cross-sectional survey study.

Setting

Haematology department of two tertiary hospitals affiliated with Guilin Medical University in China.

Participants

Using a convenience sampling method, questionnaires were distributed to patients with MM visiting two hospitals in Guilin, China.

Interventions

The patients were categorised into subgroups based on cancer-related symptoms using a latent class analysis. An analysis of covariance was performed to examine how demographic and clinical characteristics and functional status differed among the subgroups.

Results

In total, 216 patients completed the survey, with an average age of 60.3 years. A three-class solution was identified: low symptom burden group (class 1, 36.6%), moderate symptom burden group (class 2, 34.2%) and high symptom burden group (class 3, 29.2%). Patients with low monthly family income (OR=3.14, p=0.010) and complications of MM bone disease (OR=2.95, p=0.029) were more likely to belong to class 2. The predictors of high-burden symptoms were treated with painkillers, antidepressants or hypnotic drugs (OR=3.68, p=0.012) and <5000 daily step counts (OR=2.52, p=0.039) in class 3. Functional status was correlated with symptom burden, with patients in classes 3 and 1 reporting significantly higher and lower functional status, respectively (p<0.05).

Conclusions

Patients with MM experienced varying degrees of symptoms during treatment. The identification of patients with high symptom burden management should focus on the assessment of demographic and clinical characteristics, in addition to functional status.
Identifying the prevalence and correlates of multimorbidity in middle-aged men and women: a cross-sectional population-based study in four African countries
Authors: Micklesfield Lisa K , Munthali Richard , Agongo Godfred , Asiki Gershim , Boua Palwende , Choma Solomon SR , Crowther Nigel J , Fabian June , Gómez-Olivé Francesc Xavier , Kabudula Chodziwadziwa , Maimela Eric , Mohamed Shukri F , Nonterah Engelbert A , Raal Frederick J , Sorgho Hermann , Tluway Furahini D , Wade Alisha N , Norris Shane A , Ramsay Michele
Published: March 2023

Objectives

To determine the prevalence of multimorbidity, to identify which chronic conditions cluster together and to identify factors associated with a greater risk for multimorbidity in sub-Saharan Africa (SSA).

Design

Cross-sectional, multicentre, population-based study.

Setting

Six urban and rural communities in four sub-Saharan African countries.

Participants

Men (n=4808) and women (n=5892) between the ages of 40 and 60 years from the AWI-Gen study.

Measures

Sociodemographic and anthropometric data, and multimorbidity as defined by the presence of two or more of the following conditions: HIV infection, cardiovascular disease, chronic kidney disease, asthma, diabetes, dyslipidaemia, hypertension.

Results

Multimorbidity prevalence was higher in women compared with men (47.2% vs 35%), and higher in South African men and women compared with their East and West African counterparts. The most common disease combination at all sites was dyslipidaemia and hypertension, with this combination being more prevalent in South African women than any single disease (25% vs 21.6%). Age and body mass index were associated with a higher risk of multimorbidity in men and women; however, lifestyle correlates such as smoking and physical activity were different between the sexes.

Conclusions

The high prevalence of multimorbidity in middle-aged adults in SSA is of concern, with women currently at higher risk. This prevalence is expected to increase in men, as well as in the East and West African region with the ongoing epidemiological transition. Identifying common disease clusters and correlates of multimorbidity is critical to providing effective interventions.
Cost-effectiveness of running a paediatric oncology unit in Ethiopia
Authors: Kiros Mizan , Memirie Solomon Tessema , Tolla Mieraf Taddesse Taddesse , Palm Michael Tekle , Hailu Daniel , Norheim Ole F
Published: March 2023

Objective

To estimate the cost-effectiveness of running a paediatric oncology unit in Ethiopia to inform the revision of the Ethiopia Essential Health Service Package (EEHSP), which ranks the treatment of childhood cancers at a low and medium priority.

Methods

We built a decision analytical model—a decision tree—to estimate the cost-effectiveness of running a paediatric oncology unit compared with a do-nothing scenario (no paediatric oncology care) from a healthcare provider perspective. We used the recently (2018–2019) conducted costing estimate for running the paediatric oncology unit at Tikur Anbessa Specialized Hospital (TASH) and employed a mixed costing approach (top-down and bottom-up). We used data on health outcomes from other studies in similar settings to estimate the disability-adjusted life years (DALYs) averted of running a paediatric oncology unit compared with a do-nothing scenario over a lifetime horizon. Both costs and effects were discounted (3%) to the present value. The primary outcome was incremental cost in US dollars (USDs) per DALY averted, and we used a willingness-to-pay (WTP) threshold of 50% of the Ethiopian gross domestic product per capita (USD 477 in 2019). Uncertainty was tested using one-way and probabilistic sensitivity analyses.

Results

The incremental cost and DALYs averted per child treated in the paediatric oncology unit at TASH were USD 876 and 2.4, respectively, compared with no paediatric oncology care. The incremental cost-effectiveness ratio of running a paediatric oncology unit was USD 361 per DALY averted, and it was cost-effective in 90% of 100 000 Monte Carlo iterations at a USD 477 WTP threshold.

Conclusions

The provision of paediatric cancer services using a specialised oncology unit is most likely cost-effective in Ethiopia, at least for easily treatable cancer types in centres with minimal to moderate capability. We recommend reassessing the priority-level decision of childhood cancer treatment in the current EEHSP.
Retrospective cross-sectional study examining the association between loneliness and unmet healthcare needs among middle-aged and older adults using the Canadian Longitudinal Study of Aging (CLSA)
Authors: Chamberlain Stephanie , Savage Rachel D , Bronskill Susan E , Griffith Lauren E , Rochon Paula , Batara Jesse , Gruneir Andrea
Published: March 2023

Objectives

Our primary objective was to estimate the association between loneliness and unmet healthcare needs and if the association changes when adjusted for demographic and health factors. Our secondary objective was to examine the associations by gender (men, women, gender diverse).

Design, setting, participants

Retrospective cross-sectional data from 44 423 community-dwelling Canadian Longitudinal Study on Aging participants aged 45 years and older were used.

Primary outcome measure

Unmet healthcare needs are measured by asking respondents to indicate (yes, no) if there was a time when they needed healthcare in the last 12 months but did not receive it.

Results

In our sample of 44 423 respondents, 8.5% (n=3755) reported having an unmet healthcare need in the previous 12 months. Lonely respondents had a higher percentage of unmet healthcare needs (14.4%, n=1474) compared with those who were not lonely (6.7%, n=2281). Gender diverse had the highest percentage reporting being lonely and having an unmet healthcare need (27.3%, n=3), followed by women (15.4%, n=887) and men (13.1%, n=583). In our logistic regression, lonely respondents had higher odds of having an unmet healthcare need in the previous 12 months than did not lonely (adjusted odd ratios (aOR) 1.80, 95% CI 1.64 to 1.97), adjusted for other covariates. In the gender-stratified analysis, loneliness was associated with a slightly greater likelihood of unmet healthcare needs in men (aOR 1.90, 95% CI 1.64 to 2.19) than in women (aOR 1.73, 95% CI 1.53 to 1.95). In the gender diverse, loneliness was also associated with increased likelihood of having an unmet healthcare need (aOR 1.38, 95% CI 0.23 to 8.29).

Conclusions

Loneliness was related to unmet healthcare needs in the previous 12 months, which may suggest that those without robust social connections experience challenges accessing health services. Gender-related differences in loneliness and unmet needs must be further examined in larger samples.
Error disclosure in neonatal intensive care: a multicentre, prospective, observational study
Authors: Passini Loïc , Le Bouedec Stephane , Dassieu Gilles , Reynaud Audrey , Jung Camille , Keller Marie-Laurence , Lefebvre Aline , Katty Therese , Baleyte Jean-Marc , Layese Richard , Audureau Etienne , Caeymaex Laurence
Published: March 2023

Importance

Surveys based on hypothetical situations suggest that health-care providers agree that disclosure of errors and adverse events to patients and families is a professional obligation but do not always disclose them. Disclosure rates and reasons for the choice have not previously been studied.

Objective

To measure the proportion of errors disclosed by neonatal intensive care unit (NICU) professionals to parents and identify motives for and barriers to disclosure.

Design

Prospective, observational study nested in a randomised controlled trial (Study on Preventing Adverse Events in Neonates (SEPREVEN); ClinicalTrials.gov). Event disclosure was not intended to be related to the intervention tested.

Setting

10 NICUs in France with a 20-month follow-up, starting November 2015.

Participants

n=1019 patients with NICU stay ≥2 days with ≥1 error.

Exposure

Characteristics of errors (type, severity, timing of discovery), patients and professionals, self-reported motives for disclosure and non-disclosure.

Main outcome and measures

Rate of error disclosure reported anonymously and voluntarily by physicians and nurses; perceived parental reaction to disclosure.

Results

Among 1822 errors concerning 1019 patients (mean gestational age: 30.8±4.5 weeks), 752 (41.3%) were disclosed. Independent risk factors for non-disclosure were nighttime discovery of error (OR 2.40; 95% CI 1.75 to 3.30), milder consequence (for moderate consequence: OR 1.85; 95% CI 0.89 to 3.86; no consequence: OR 6.49; 95% CI 2.99 to 14.11), a shorter interval between admission and error, error type and fewer beds. The most frequent reported reasons for non-disclosure were parental absence at its discovery and a perceived lack of serious consequence.

Conclusion and relevance

In the particular context of the SEPREVEN randomised controlled trial of NICUs, staff did not disclose the majority of errors to parents, especially in the absence of moderate consequence for the infant.

Trial registration number

NCT02598609.
Primary prevention of cardiovascular disease in women with a Mediterranean diet: systematic review and meta-analysis
Authors: Pant Anushriya , Gribbin Sarah , McIntyre Daniel , Trivedi Ritu , Marschner Simone , Laranjo Liliana , Mamas Mamas A , Flood Victoria , Chow Clara K , Zaman Sarah
Published: March 2023

Background

Dietary modification is a cornerstone of cardiovascular disease (CVD) prevention. A Mediterranean diet has been associated with a lower risk of CVD but no systematic reviews have evaluated this relationship specifically in women.

Objective

To determine the association between higher versus lower adherence to a Mediterranean diet and incident CVD and total mortality in women.

Methods

A systematic search of Medline, Embase, CINAHL, Scopus, and Web of Science (2003–21) was performed. Randomised controlled trials and prospective cohort studies with participants without previous CVD were included. Studies were eligible if they reported a Mediterranean diet score and comprised either all female participants or stratified outcomes by sex. The primary outcome was CVD and/or total mortality. A random effects meta-analysis was conducted to calculate pooled hazard ratios (HRs) and confidence intervals (CIs).

Results

Sixteen prospective cohort studies were included in the meta-analysis (n=7 22 495 female participants). In women, higher adherence to a Mediterranean diet was associated with a lower CVD incidence (HR 0.76, 95% CI 0.72 to 0.81; I2=39%, p test for heterogeneity=0.07), total mortality (HR 0.77, 95% CI 0.74 to 0.80; I2=21%, p test for heterogeneity=0.28), and coronary heart disease (HR 0.75, 95% CI 0.65 to 0.87; I2=21%, p test for heterogeneity=0.28). Stroke incidence was lower in women with higher Mediterranean diet adherence (HR 0.87, 95% CI 0.76 to 1.01; I2=0%, p test for heterogeneity=0.89), but this result was not statistically significant.

Conclusion

This study supports a beneficial effect of the Mediterranean diet on primary prevention of CVD and death in women, and is an important step in enabling sex specific guidelines.
Factors associated with the retention of secukinumab in patients with axial spondyloarthritis in real-world practice: results from a retrospective study (FORSYA)
Authors: Dougados Maxime , Lucas Julien , Desfleurs Emilie , Claudepierre Pascal , Goupille Philippe , Ruyssen-Witrand Adeline , Saraux Alain , Tournadre Anne , Wendling Daniel , Lukas Cédric
Published: March 2023

Background

Secukinumab efficacy and retention data are emerging in patients with axial spondyloarthritis (axSpA) in real-world settings. However, limited data are available on the predictive factors that affect the retention rate. The key objective was to determine whether objective signs of inflammation (OSI) were predictive of secukinumab retention at 1 year.

Methods

FORSYA is a French, multicentric, non-interventional, retrospective study in adult axSpA patients who received secukinumab treatment between its launch (11 August 2016) and 31 August 2018. The time to secukinumab discontinuation and retention were analysed using a Kaplan-Meier (KM) analysis. OSI was predefined by at least one of the criteria: C reactive protein ≥5 mg/L or erythrocyte sedimentation rate ≥28 mm/hour at secukinumab initiation or MRI inflammation at the sacroiliac or spine level.

Results

In total, 906 patients from 48 centres were included in the analysis, 42.2% of whom were men, with a mean age of 46.2±11.7 years and a mean disease duration of 9.3±9.1 years. The 1-year KM retention rate (95% CI) for secukinumab was 59% (55%–62%), whereas for patients with and without OSI, it was 58% (54%–62%) and 63% (53%–73%), respectively. In multivariate analysis, lack of prior exposure to tumour necrosis factor inhibitor (TNFi), absence of OSI and inflammatory bowel disease (IBD) were associated with a better retention of secukinumab at 1 year.

Conclusion

Following its approval in France, ~59% of axSpA patients retained secukinumab in daily practice, at 1 year. Prior exposure to TNFi, OSI and IBD were identified as risk factors for secukinumab discontinuation.
Enhancing Translation Competence via Flipping the EFL Translation Classroom in China
Authors: Qiao Chengche , Huang Xiaodong
Published: March 2023

The ultimate goal of translation teaching is to cultivate the students’ translation competence. Inspired by the PACTE (PACTE, 2003) about the definition of translation competence, we further break down the translation competences into five sub-competences with more explicit teaching goals: lexical variety, grammatical correctness, stylistic appropriateness, fluency and coherence competence, which is vital for the cultivation of translation competence of engineering students. Then, an experimental method is used to compare the outcomes of students enrolled in a flipped and a traditional version of a EFL (English as a Foreign Language) Translation Course at a university in China. This empirical study aims to determine the effectiveness of flipped classroom model (FCM) in translation class. 60 undergraduates majoring in science and technology are involved in this research. Pre- and post- tests are used as instruments and data are analyzed using descriptive and inferential statistics. Quantitative data analysis reveals that comparing with traditional classroom flipped classroom can promote the cultivation of lexical variety, stylistic appropriateness, fluency and coherence competence. Considering the positive results obtained in the study, the article points out the use of the flipped approach as an example of good practice for cultivating the translation competence in EFL translation course.
Contrastive Adversarial Training for Multi-Modal Machine Translation
Authors: Huang Xin , Zhang Jiajun , Zong Chengqing
Published: March 2023

The multi-modal machine translation task is to improve translation quality with the help of additional visual input. It is expected to disambiguate or complement semantics while there are ambiguous words or incomplete expressions in the sentences. Existing methods have tried many ways to fuse visual information into text representations. However, only a minority of sentences need extra visual information as complementary. Without guidance, models tend to learn text-only translation from the major well-aligned translation pairs. In this article, we propose a contrastive adversarial training approach to enhance visual participation in semantic representation learning. By contrasting multi-modal input with the adversarial samples, the model learns to identify the most informed sample that is coupled with a congruent image and several visual objects extracted from it. This approach can prevent the visual information from being ignored and further fuse cross-modal information. We examine our method in three multi-modal language pairs. Experimental results show that our model is capable of improving translation accuracy. Further analysis shows that our model is more sensitive to visual information.
Co-design of Human-centered, Explainable AI for Clinical Decision Support
Authors: Panigutti Cecilia , Beretta Andrea , Fadda Daniele , Giannotti Fosca , Pedreschi Dino , Perotti Alan , Rinzivillo Salvatore
Published: March 2023

eXplainable AI (XAI) involves two intertwined but separate challenges: the development of techniques to extract explanations from black-box AI models and the way such explanations are presented to users, i.e., the explanation user interface. Despite its importance, the second aspect has received limited attention so far in the literature. Effective AI explanation interfaces are fundamental for allowing human decision-makers to take advantage and oversee high-risk AI systems effectively. Following an iterative design approach, we present the first cycle of prototyping-testing-redesigning of an explainable AI technique and its explanation user interface for clinical Decision Support Systems (DSS). We first present an XAI technique that meets the technical requirements of the healthcare domain: sequential, ontology-linked patient data, and multi-label classification tasks. We demonstrate its applicability to explain a clinical DSS, and we design a first prototype of an explanation user interface. Next, we test such a prototype with healthcare providers and collect their feedback with a two-fold outcome: First, we obtain evidence that explanations increase users’ trust in the XAI system, and second, we obtain useful insights on the perceived deficiencies of their interaction with the system, so we can re-design a better, more human-centered explanation interface.
How Instructions, Learning, and Expectations Shape Pain and Neurobiological Responses
Authors: Atlas Lauren Y.
Published: March 2023

Treatment outcomes are strongly influenced by expectations, as evidenced by the placebo effect. Meta-analyses of clinical trials reveal that placebo effects are strongest in pain, indicating that psychosocial factors directly influence pain. In this review, I focus on the neural and psychological mechanisms by which instructions, learning, and expectations shape subjective pain. I address new experimental designs that help researchers tease apart the impact of these distinct processes and evaluate the evidence regarding the neural mechanisms by which these cognitive factors shape subjective pain. Studies reveal that expectations modulate pain through parallel circuits that include both pain-specific and domain-general circuits such as those involved in affect and learning. I then review how expectations, learning, and verbal instructions impact clinical outcomes, including placebo analgesia and responses to pharmacological treatments, and discuss implications for future work.
Neural Circuits for Emotion
Authors: Malezieux Meryl , Klein Alexandra S. , Gogolla Nadine
Published: March 2023

Emotions are fundamental to our experience and behavior, affecting and motivating all aspects of our lives. Scientists of various disciplines have been fascinated by emotions for centuries, yet even today vigorous debates abound about how to define emotions and how to best study their neural underpinnings. Defining emotions from an evolutionary perspective and acknowledging their important functional roles in supporting survival allows the study of emotion states in diverse species. This approach enables taking advantage of modern tools in behavioral, systems, and circuit neurosciences, allowing the precise dissection of neural mechanisms and behavior underlying emotion processes in model organisms. Here we review findings about the neural circuit mechanisms underlying emotion processing across species and try to identify points of convergence as well as important next steps in the pursuit of understanding how emotions emerge from neural activity.
Diffusion Controlled Features of Microwave Assisted ZnS/ZnO Nanocomposite with Reduced Band Gap
Authors: Phogat Peeyush , Shreya  , Jha Ranjana , Singh Sukhvir
Published: March 2023

ZnS and ZnO are both wide band gap semiconductors. Their nanocomposites have high potential for photocatalytic activity and useful for different applications such as optical sensor, photoconductor, catalysts and anode material for solar cells. In the present investigations an effort has been made to synthesize ZnS/ZnO nanocomposites by inducing microwave treatment before hydrothermal process in order to increase the reaction rate of ZnS/ZnO and to reduce the optical band gap and particle size of the material. X-ray diffraction data revealed the formation of ZnS as well as ZnO phases. W-H plot and Size-Strain plot revealed information of size and strain present in the material. UV–vis spectroscopy analysis showed a reduced band gap of 3.14 eV and the refractive index of 2.36 for the material. Microstructural and morphological investigations as carried out by TEM and FESEM showed spherical shaped particles having average crystallite size of about 26 nm. Elemental compositional analysis of the material depicted the presence of zinc, oxygen and sulphur. FTIR study revealed the formation of Zn-S bond and presence of adsorbed oxygen in the as-synthesized material. The electrochemical studies include cyclic voltammetry (CV) and Potentiostatic Electrochemical Impedance Spectroscopy (PEIS). Cyclic voltammetry depicted the diffusion-controlled behaviour of the ZnS/ZnO nanocomposites and the reduction in specific capacitance with increasing scan rate. PEIS studies were analyzed by Nyquist and Bode plot which also confirmed the diffusion behaviour of material by Randle’s Circuit and its parameters. ZnS/ZnO showed diffusion controlled features indicating that the excitons control the current in the material and thus has a good prospect for solar cell applications.
Local Channels under Decomposition of Quantum Gates in Bipartite Systems
Authors: Lao Yihui , Wang Pei , Liao Shanli
Published: March 2023

For a bipartite quantum system with Hilbert space

H

m

⊗

H

n

, this paper considers a quantum channel

ϕ

from the system to itself which preserves the set of separable states. Within this class of quantum channels, the paper characterizes those channels which preserve the Tsallis entropy of combinations of separable states through decomposing quantum gates, where the characterization is given in terms of the action of the channel on separable states.
Stem Cell Applications and Tenogenic Differentiation Strategies for Tendon Repair
Authors: Yuan Ziyang , Yu Haomiao , Long Huibin , Dai Yike , Shi Lin , Zhao Jiaming , Guo Ai , Diao Naicheng , Ma Lifeng , Yin Heyong
Published: March 2023

Tendons are associated with a high injury risk because of their overuse and age-related tissue degeneration. Thus, tendon injuries pose great clinical and economic challenges to the society. Unfortunately, the natural healing capacity of tendons is far from perfect, and they respond poorly to conventional treatments when injured. Consequently, tendons require a long period of healing and recovery, and the initial strength and function of a repaired tendon cannot be completely restored as it is prone to a high rate of rerupture. Nowadays, the application of various stem cell sources, including mesenchymal stem cells (MSCs) and embryonic stem cells (ESCs), for tendon repair has shown great potential, because these cells can differentiate into a tendon lineage and promote functional tendon repair. However, the mechanism underlying tenogenic differentiation remains unclear. Moreover, no widely adopted protocol has been established for effective and reproducible tenogenic differentiation because of the lack of definitive biomarkers for identifying the tendon differentiation cascades. This work is aimed at reviewing the literature over the past decade and providing an overview of background information on the clinical relevance of tendons and the urgent need to improve tendon repair; the advantages and disadvantages of different stem cell types used for boosting tendon repair; and the unique advantages of reported strategies for tenogenic differentiation, including growth factors, gene modification, biomaterials, and mechanical stimulation.
Successful Management of Peri-Implant Infection from the Endodontic Lesion of Adjacent Natural Tooth
Authors: Gong Jiaming , Al-Sosowa Abeer A. , Zhao Ruimin , Li Jianxue , Mei Mei
Published: March 2023

Recently, dental implants have had the most important role in oral rehabilitation. Peri-implantitis is considered a common complication of dental implants. Adjacent natural teeth with untreated endodontic pathology may be a potential risk for implant placement. Retrograde/periapical peri-implantitis (RPI), the inverting of the progress direction of peri-implantitis. Radiographically, it is characterized by signs of periapical bone loss and normal coronal osteointegration of the implant; and its prevalence is closely associated with endodontic lesions of adjacent teeth. Another novel separate disease entity is known as the endodontic peri-implant defects (endo-implant defects), manifesting as the peri-implant marginal bone loss due to endodontic pathology of adjacent teeth, to which endodontists and implantologists are supposed to attach great importance. This current study presented two cases of different types of peri-implant infection in which conducting proper intervention to the endodontic lesions of adjacent teeth resulted in full radiographic and clinical resolution of peri-implant defects.
Acupuncture for Chronic Prostatitis or Chronic Pelvic Pain Syndrome: An Updated Systematic Review and Meta-Analysis
Authors: Pan Juanhong , Jin Song , Xie Quan , Wang Ying , Wu Zhipeng , Sun Jianfeng , Guo Tai Pin , Zhang Di
Published: March 2023

Background. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex male dysfunction, mostly seen in young and middle-aged men with a history of more than 3 months. As a traditional therapy of Traditional Chinese Medicine, acupuncture has been proven an effective method to treat CP/CPPS in recent years. Though some meta-analyses on acupuncture for chronic prostatitis were published in 2018 and 2019, most of the included studies were low in quality according to the JADAD score (JADAD < 4). The conclusions of acupuncture for CP/CPPS remain indefinite. Purpose. This review aims to evaluate the efficacy of acupuncture for CP/CPPS by including high-quality literature only (JADAD ≥ 4) to provide a reliable basis for clinical applications and research. Method. Nine electronic databases were searched from inception to March 1, 2022, and only randomized controlled trials (RCT) with high-quality (JADAD ≥ 4) were included. Data were analyzed using Review Manager 5.3. and was verified through trial sequential analysis (TSA). We carried out a sensitivity analysis for the heterogeneity (I2 ≥ 50%). Publication bias was explored using a funnel plot. Result. Ten RCTs (11 trials) of high-quality methodology involving 798 patients were included. Meta-analysis showed that compared to sham acupuncture (SAT) and western medicine (WM), acupuncture (AT) played superior roles for CP/CPPS patients in pain score, NIH-CPSI score, quality of life score, urinary symptom, and efficacy rate. As for the adverse effects, 4 RCTs described mild hematoma and pain in AT and SAT groups, while specific symptoms including nausea, abdominal pain, dizziness, and low blood pressure were reported in WM groups. Conclusion. This meta-analysis indicated that acupuncture has measurable benefits on CP/CPPS, and security has also been ensured. However, this meta-analysis only included 10 RCTs; thus, RCTs with a larger sample size and longer-term observation are required to verify the effectiveness of acupuncture further in the future.
Clinical and Genetic Characteristics of Patients with Unexplained Intellectual Disability/Developmental Delay without Epilepsy
Authors: Gerik-Celebi Hamide Betul , Aydin Hilal , Bolat Hilmi , Unsel-Bolat Gul
Published: March 2023

Introduction: Global developmental delay (DD), intellectual disability (ID), and autism spectrum disorder (ASD) are mainly evaluated under the neurodevelopmental disorder framework. In this study, we aimed to determine the genetic diagnosis yield using step-by-step genetic analysis in 38 patients with unexplained ID/DD and/or ASD. Methods: In 38 cases (27 male, 11 female) with unexplained ID/DD and/or ASD, chromosomal microarray (CMA) analysis, clinical exome sequencing (CES), and whole-exome sequencing (WES) analysis were applied, respectively. Results: We found a diagnostic rate of only CMA analysis as 21% (8/38) presenting 8 pathogenic and likely pathogenic CNVs. The rate of patients diagnosed with CES/WES methods was 32.2% (10/31). When all pathogenic and likely pathogenic variants were evaluated, the diagnosis rate was 44.7% (17/38). A dual diagnosis was obtained in a case with 16p11.2 microduplication and de novo SNV. We identified eight novel variants: TUBA1A (c.787C>G), TMEM63A (c.334-2A>G), YY1AP1 (c.2051_2052del), ABCA13 (c.12064C>T), ABCA13 (c.13187G>A), USP9X (c.1189T>C), ANKRD17 (c.328_330dup), and GRIA4 (c.17G>A). Conclusion: We present diagnostic rates of a complementary approach to genetic analysis (CMA, CES, and WES). The combined use of genetic analysis methods in unexplained ID/DD and/or ASD cases has contributed significantly to diagnosis rates. Also, we present detailed clinical characteristics to improve genotype-phenotype correlation in the literature for rare and novel variants.
Immunomodulation Effect of Regional Citrate Anticoagulation in Acute Kidney Injury Requiring Renal Replacement Therapy
Authors: Kaewdoungtien Piyanut , Tachaboon Sasipha , Kangsumrith Natamon , Srisawat Nattachai
Published: March 2023

Introduction: Acute kidney injury (AKI) is a common syndrome in critically ill patients. Continuous renal replacement therapy (CRRT) is the standard treatment for patients with AKI. Research on the immunomodulating effects of regional citrate anticoagulation (RCA) remains limited in patients with AKI receiving CRRT. We aimed to evaluate the immunomodulating effects of RCA in patients with AKI receiving CRRT. Methods: A randomized controlled trial study on critically ill adult patients with AKI undergoing CRRT was undertaken. Participants were randomized into either a regional citrate group or control group (either heparin anticoagulant or normal saline). Measurements were taken at baseline, 6 and 24 h after commencing CRRT for CD11b expression, C3a, C5a, and plasminogen activator inhibitor-1 (PAI-1) levels. Clinical outcomes assessed were 28-day survival rate, length of ICU stay, renal support duration, and renal function at discharge. Results: Thirty patients were recruited and randomized into 2 groups of 15 subjects. Baseline demographic and clinical data were comparable between groups. In the citrate group, CD11b expression was significantly decreased at 24 h compared to the control group (1.84% [1.18–3.32] versus 4.92% [2.63–6.93], p < 0.01). The complement level, including c3b and c5a, was stable during CRRT. Additionally, the PAI-1 levels were significantly decreased at 24 h compared to the control group (114 ng/mL [19–193] versus 359 ng/mL [264–491], p < 0.01). No significant difference in survival rate was observed. Conclusions: RCA may have the potential to mitigate the inflammatory response by decreasing CD11b expression of neutrophil and improve fibrinolysis activity through a reduction of PAI-1 levels. Larger clinical trials are warranted to test this immunomodulation effect of RCA.
Immediate and Delayed Salivary Cytokine Responses during Repeated Exposures to Cold Pressor Stress
Authors: Larra Mauro F. , Capellino Silvia , Schwendich Elena , von Haugwitz Leon , Reinders Jörg , Wascher Edmund
Published: March 2023

Introduction: Excessive stress is increasingly recognized as an important trigger of many diseases prevalent in modern societies, and monitoring such stress-related effects could aid prevention. The measurement of salivary markers of inflammation is emerging as a promising tool to non-invasively quantify stress’ effects on immune processes in everyday life and thereby detect early aberrations before the manifestation of serious health problems. However, more laboratory-controlled research is needed in order to establish the timescale and determinants of salivary cytokine responses to acute stress. Methods: We repeatedly exposed participants to Cold Pressor Stress Test (CPT) or a control procedure and measured a wide array of salivary cytokines as well as subjective, cardiovascular, and cortisol stress reactions. CPT exposure was repeated every 15 min, 3 times in total, with a duration of 3 min each. Saliva was sampled immediately after the first two exposures as well as in 15-min intervals until 60 min after the onset of the first intervention. Results: We found that many cytokines were detectable in saliva. Specific stress effects were limited to IL-8 and IL-6, however, which decreased immediately or 15 min after stress onset, respectively. Moreover, IL-8 was negatively correlated to cortisol output in the stress but not in the control group. Significant increases were also observed in salivary TNFα and IFNγ; however, these effects were similar under both stress and control conditions. Discussion: Our results show that particular salivary cytokines may be sensitive to immediate effects of acute CPT-induced stress and also highlight the importance of employing control procedures to discern stress effects from unrelated variations in salivary cytokines.
Patterns of Renal Dysfunction and Profile of Kidney Biopsies in Hematopoietic Stem Cell Transplant Recipients
Authors: John Elenjickal Elias , Roy Sanjeet , Devasia Anup J. , Karuppusami Reka , Jose Nisha , Mani Selvin Sundar Raj , Eapen Jeethu Joseph , Yusuf Sabina , Thomas Athul , Valson Anna T. , David Vinoi George , Mathews Vikram , George Biju , Varughese Santosh , Alexander Suceena
Published: March 2023

Introduction: Post hematopoietic stem cell transplant (HSCT), kidney can be subjected to injury by various causes. Of these, graft versus host disease (GvHD) affecting the kidney is an under-recognized entity with no clear guidelines on its diagnosis, clinicopathological manifestations, and outcomes. Material and Methods: Out of 2,930 patients who underwent HSCT at our center between 2005 and 2020, kidney biopsy was performed in 19 allogenic and 5 autologous recipients. Results: The mean age of the cohort at transplant was 33.2 ± 7 years, and 15 (62%) were males. Median time to kidney biopsy from HSCT was 14 (IQR, 9–30) months. Aplastic anemia was the most common underlying hematological disease (54.2%). All 19 allogenic recipients were classified based on clinicopathological manifestations into either thrombotic microangiopathy (TMA, 12/19 [63%]) or nephrotic syndrome (NS, 7/19 [37%]) pattern. Glomerular tuft “mesangiolysis” was the dominant pattern of injury noted in 9/12 cases of TMA pattern. There was a predominance of acute microangiopathic changes restricted primarily to the glomerular compartment. Of the 7 patients with NS pattern, membranous nephropathy was seen in 4 (57%) and minimal change disease in 3 (43%) patients. Thirty-nine percent (7/18) stained positive for C4d which was predominantly glomerular. Allogenic recipients who did not receive immunosuppression (IS) for renal disease had a lower eGFR at biopsy, a longer latency between withdrawal of GvHD prophylaxis and biopsy, and were significantly at a higher risk of kidney failure (IS: 2/11, 18.1% vs. no IS: 2/6, 33.3%, p = 0.04). “Associated extra-renal GvHD” occurred in 11/19 (57.9%) allogenic recipients. Patients with “associated extra-renal GvHD” had significantly more deaths (6/11, 60% vs. 0, p = 0.02) but comparable renal outcomes. Conclusion: Renal GvHD can present with or without “associated extra-renal GvHD” after a prolonged period of withdrawal of GvHD prophylaxis, requiring careful diagnostic vigilance and consideration of IS.
Ultrasound Verification of Plaque Brachytherapy Placement in Patients Treated for Primary Uveal Melanoma: A Single-Center Experience
Authors: Grimes Joseph M. , Zhou Henry , Dal Col Alexis K. , Gershkovich Alexandra , Bogomolny Dmitry , Marr Brian P.
Published: March 2023

Introduction: Proper plaque positioning is essential for effective episcleral plaque brachytherapy and can be verified using ultrasound. In this study, we show our center’s protocol for intraoperative ultrasound verification of plaque placement and present our single-center local recurrence data in patients with primary UM involving the choroid and/or ciliary body. We also indicate our center’s distance metastasis rate for patients presenting with primary UM. Methods: All patients who presented to our institution with UM of the choroid and/or ciliary body between May 2017 and March 2022 and treated with plaque brachytherapy were enrolled. Endpoints include the 24-month local recurrence-free rate (primary) and 24-month metastasis rate (secondary), both estimated using the Kaplan-Meier method (KM). Results: Local Recurrence: 176 patients met the study criteria with median follow-up of 23.2 months. The 24-month recurrence-free probability for this cohort was estimated at 99.1% (95% confidence interval: 0.974–1.00). Metastatic Recurrence: 136 of these patients underwent at least one follow-up surveillance scan. The 24-month metastasis-free survival probability in our cohort was estimated at 87% (95% confidence interval: 81–94%). Conclusions: We show improved local control utilizing ultrasound verification compared to historical controls who received TTT and brachytherapy without intraoperative ultrasound confirmation.
Design of a 175 GHZ SiGe-based voltage-controlled oscillator with greater than 7.6 dBm power
Authors: Damilola Oyeleke Oluseun , Danjuma Usman Aliyu , Ahmad Abubilal Kabir , Bello Habeeb , Idowu-Bismark Olabode
Published: March 2023

In this research, we present a low phase noise (PN) and wide tuning range 175 GHz inductors and capacitors (LC) voltage-controlled oscillator (VCO) based on a differential Colpitts oscillator that was designed using a 0.13 μm bipolar complementary metal oxide semiconductor (BiCMOS) and simulated. The square of the tank Q-factor and the square of the oscillation amplitude were both maximized to reduce PN. With an extensive examination of parasitic, mathematical analysis of load impedances, and implementation of differential design, the PN was reduced, and the output power was enhanced. Using a supply voltage of 1.6 V, the VCO consumes 41.9 mA, resulting in a total power usage of 67 mW to prevent undesirable PN deterioration, an inter-stage LC filter at the VCO-buffer interface increases the swing at the buffer input. To make a better output, a buffer is used to isolate the load from the VCO core. In addition, the VCO has a high linearity and the overall, the VCO presented in this study demonstrates excellent performance and has the potential to be used in a wide range of applications that require a high-performance, low-power VCO.