bluuebunny/crossref_metadata_2025 huggingface dataset:
Slow-wave sleep dysfunction in mild parkinsonism is associated with excessive beta and reduced delta oscillations in motor cortex
Authors: Verma Ajay K. , Nandakumar Bharadwaj , Acedillo Kit , Yu Ying , Marshall Ethan , Schneck David , Fiecas Mark , Wang Jing , MacKinnon Colum D. , Howell Michael J. , Vitek Jerrold L. , Johnson Luke A.
Published: February 2024

Increasing evidence suggests slow-wave sleep (SWS) dysfunction in Parkinson’s disease (PD) is associated with faster disease progression, cognitive impairment, and excessive daytime sleepiness. Beta oscillations (8–35 Hz) in the basal ganglia thalamocortical (BGTC) network are thought to play a role in the development of cardinal motor signs of PD. The role cortical beta oscillations play in SWS dysfunction in the early stage of parkinsonism is not understood, however. To address this question, we used a within-subject design in a nonhuman primate (NHP) model of PD to record local field potentials from the primary motor cortex (MC) during sleep across normal and mild parkinsonian states. The MC is a critical node in the BGTC network, exhibits pathological oscillations with depletion in dopamine tone, and displays high amplitude slow oscillations during SWS. The MC is therefore an appropriate recording site to understand the neurophysiology of SWS dysfunction in parkinsonism. We observed a reduction in SWS quantity (p = 0.027) in the parkinsonian state compared to normal. The cortical delta (0.5–3 Hz) power was reduced (p = 0.038) whereas beta (8–35 Hz) power was elevated (p = 0.001) during SWS in the parkinsonian state compared to normal. Furthermore, SWS quantity positively correlated with delta power (r = 0.43, p = 0.037) and negatively correlated with beta power (r = −0.65, p < 0.001). Our findings support excessive beta oscillations as a mechanism for SWS dysfunction in mild parkinsonism and could inform the development of neuromodulation therapies for enhancing SWS in people with PD.
Design and motion control of exoskeleton robot for paralyzed lower limb rehabilitation
Authors: Zhu Zhiyong , Liu Lingyan , Zhang Wenbin , Jiang Cong , Wang Xingsong , Li Jie
Published: February 2024

Introduction

Patients suffering from limb movement disorders require more complete rehabilitation treatment, and there is a huge demand for rehabilitation exoskeleton robots. Flexible and reliable motion control of exoskeleton robots is very important for patient rehabilitation.

Methods

This paper proposes a novel exoskeleton robotic system for lower limb rehabilitation. The designed lower limb rehabilitation exoskeleton robot mechanism is mainly composed of the hip joint mechanism, the knee joint mechanism and the ankle joint mechanism. The forces and motion of the exoskeleton robot were analyzed in detail to determine its design parameters. The robot control system was developed to implement closed-loop position control and trajectory planning control of each joint mechanism.

Results

Multiple experiments and tests were carried out to verify robot's performance and practicality. In the robot angular response experiments, the joint mechanism could quickly adjust to different desired angles, including 15°, 30°, 45°, and 60°. In the trajectory tracking experiments, the exoskeleton robot could complete tracking movements of typical actions such as walking, standing up, sitting down, go upstairs and go downstairs, with a maximum tracking error of ±5°. Robotic wearing tests on normal people were performed to verify the assistive effects of the lower limb rehabilitation exoskeleton at different stages.

Discussion

The experimental results indicated that the exoskeleton robot has excellent reliability and practicality. The application of this exoskeleton robotic system will help paralyzed patients perform some daily movements and sports.
Deficiencies in one-carbon metabolism led to increased neurological disease risk and worse outcome: homocysteine is a marker of disease state
Authors: Joshi Sanika M. , Jadavji Nafisa M.
Published: February 2024

Elevated plasma homocysteine levels have been identified as a significant, independent risk factor for the development of cognitive decline including Alzheimer’s disease. While several studies have explored the link between homocysteine and disease risk, the associations have not been entirely clear. Elevated levels of homocysteine serve as a disease marker and understanding the underlying cause of these increased levels (e.g., dietary or genetic deficiency in one-carbon metabolism, 1C) will provide valuable insights into neurological disease risk and outcomes. Previous cell culture experiments investigating the mechanisms involved used ultra-high levels of homocysteine that are not observed in human patients. These studies have demonstrated the negative impacts of ultra-high levels of homocysteine can have on for example proliferation of neuroprogenitor cells in the adult hippocampus, as well as triggering neuronal apoptosis through a series of events, including DNA damage, PARP activation, NAD depletion, mitochondrial dysfunction, and oxidative stress. The aim of this mini-review article will summarize the literature on deficiencies in 1C and how they contribute to disease risk and outcomes and that homocysteine is a marker of disease.
Predictive value of controlling nutritional status score for prostate cancer diagnosis
Authors: Huang Jiaguo , Sun Ji , Hua Runmiao , Fan Yi , Wang Kai , Zheng Liying , Qian Biao
Published: February 2024

Objective

This study aims to explore the predictive value of the Controlling Nutritional Status (CONUT) score for prostate cancer (PCa) diagnosis.

Methods

The data of 114 patients who underwent prostate needle biopsies from June 2020 to December 2022 were retrospectively analyzed. The relationship between CONUT score and various clinical factors as well as PCa diagnosis was evaluated.

Results

The pathological results classified patients into the PCa (n = 38) and non-PCa (n = 76) groups. Compared with the non-PCa group, the PCa group exhibited statistically significant differences in age, prostate-specific antigen (PSA), PSA density (PSAD), the proportion of PI-RADS ≥ 3 in mpMRI, and the CONUT score, prostate volume, lymphocyte count, and total cholesterol concentration (p < 0.05). ROC curve analyses indicated the diagnostic accuracy as follows: age (AUC = 0.709), prostate volume (AUC = 0.652), PSA (AUC = 0.689), PSAD (AUC = 0.76), PI-RADS ≥ 3 in mpMRI (AUC = 0.846), and CONUT score (AUC = 0.687). When CONUT score was combined with PSA and PSAD, AUC increased to 0.784. The AUC of CONUT score combined with PSA, PSAD, and mpMRI was 0.881, indicates a higher diagnostic value. Based on the optimal cut-off value of CONUT score, compared with the low CONUT score group, the high CONUT score group has a higher positive rate of PCa diagnosis (p < 0.05).

Conclusion

CONUT score is an excellent auxiliary index for PCa diagnosis in addition to the commonly used PSA, PSAD, and mpMRI in clinical practice. Further prospective trials with a larger sample size are warranted to confirm the present study findings.
Current treatment strategies targeting histone deacetylase inhibitors in acute lymphocytic leukemia: a systematic review
Authors: Zhang Yingjun , Zhang Ge , Wang Yuefang , Ye Lei , Peng Luyun , Shi Rui , Guo Siqi , He Jiajing , Yang Hao , Dai Qingkai
Published: February 2024

Acute lymphocytic leukemia is a hematological malignancy that primarily affects children. Long-term chemotherapy is effective, but always causes different toxic side effects. With the application of a chemotherapy-free treatment strategy, we intend to demonstrate the most recent results of using one type of epigenetic drug, histone deacetylase inhibitors, in ALL and to provide preclinical evidence for further clinical trials. In this review, we found that panobinostat (LBH589) showed positive outcomes as a monotherapy, whereas vorinostat (SAHA) was a better choice for combinatorial use. Preclinical research has identified chidamide as a potential agent for investigation in more clinical trials in the future. In conclusion, histone deacetylase inhibitors play a significant role in the chemotherapy-free landscape in cancer treatment, particularly in acute lymphocytic leukemia.
Humoral immunoprofiling identifies novel biomarkers and an immune suppressive autoantibody phenotype at the site of disease in pancreatic ductal adenocarcinoma
Authors: Maimela Pamela Winnie M. , Smith Muneerah , Nel Andrew J. M. , Bernam Suba Dharshanan P. , Jonas Eduard G. , Blackburn Jonathan M.
Published: February 2024

Pancreatic ductal adenocarcinoma (PDAC) is a heterogeneous cancer, with minimal response to therapeutic intervention and with 85% of cases diagnosed at an advanced stage due to lack of early symptoms, highlighting the importance of understanding PDAC immunology in greater detail. Here, we applied an immunoproteomic approach to investigate autoantibody responses against cancer-testis and tumor-associated antigens in PDAC using a high-throughput multiplexed protein microarray platform, comparing humoral immune responses in serum and at the site of disease in order to shed new light on immune responses in the tumor microenvironment. We simultaneously quantified serum or tissue IgG and IgA antibody isotypes and subclasses in a cohort of PDAC, disease control and healthy patients, observing inter alia that subclass utilization in tumor tissue samples was predominantly immune suppressive IgG4 and inflammatory IgA2, contrasting with predominant IgG3 and IgA1 subclass utilization in matched sera and implying local autoantibody production at the site of disease in an immune-tolerant environment. By comparison, serum autoantibody subclass profiling for the disease controls identified IgG4, IgG1, and IgA1 as the abundant subclasses. Combinatorial analysis of serum autoantibody responses identified panels of candidate biomarkers. The top IgG panel included ACVR2B, GAGE1, LEMD1, MAGEB1 and PAGE1 (sensitivity, specificity and AUC values of 0.933, 0.767 and 0.906). Conversely, the top IgA panel included AURKA, GAGE1, MAGEA10, PLEKHA5 and XAGE3aV1 (sensitivity, specificity, and AUC values of 1.000, 0.800, and 0.954). Assessment of antigen-specific serum autoantibody glycoforms revealed abundant sialylation on IgA in PDAC, consistent with an immune suppressive IgA response to disease.
Clinical analysis of 82 cases of acute promyelocytic leukemia with PML-RARα short isoform in children and adults
Authors: Huang Qiaolin , Zhang Yicheng , Zheng Miao
Published: February 2024

Background

Acute promyelocytic leukemia (APL) with PML/RARα fusion gene is a distinct variant of acute myeloid leukemia. According to the different break sites of the PML gene, there are three transcripts: Long (bcr1), Variant (bcr2) and Short (bcr3).

Methods

We retrospectively analyzed 82 APL cases with PML-RARα short isoform.

Results

A total of 384 patients with APL were seen, of which 85(22.14%) had PML/RARα short isoform (bcr3) and 82 met the inclusion criteria. The median age was 33.5 years (range, 2-72 years). The incidences of hemorrhage in the intermediate- and high-risk group were higher, but only the incidence between medium and low risk differed statistically (P=0.006), and the incidences of fever, fatigue, splenomegaly, and lymph node enlargement and differentiation syndrome (DS) in those groups were not statistically significant (P>0.05). FLT3 gene mutation rate and the mortality rate of the high-risk group were significantly higher than that of other groups (P=0.040 and P=0.004, P=0.041 and P=0.037, respectively). The mortality rate was lowest (4.26%) in the group treated with ATRA combined with arsenic and anthracycline. The 3-year OS and the 3-year DFS of the low and intermediate-risk group were better (P=0.019 and P=0.017, respectively).

Conclusions

ATRA combined with arsenic and anthracycline had significant impact on outcomes in APL with PML-RARα short isoform.
Breathing across ages: a systematic review on challenges and components of transitional care for young people with asthma
Authors: Antonino Luna , Van Hoorenbeeck Kim , van Olmen Josefien , Vanharen Yaël , Janssens Natwarin , Verhulst Stijn , Goossens Eva
Published: February 2024

Introduction

Asthma is a chronic condition that affects millions of adolescents and young adults (AYA) worldwide. The transition from pediatric to adult care presents unique challenges for this population, affecting their self-management, quality of life and overall health outcomes. This systematic review aims to consolidate the available evidence on challenges encountered by AYA with asthma during the transition period from child to AYA and on the key elements of transitional care for AYAs with asthma including the outcomes achieved, ultimately enhancing outcomes.

Methodology

A systematic literature search was performed in PubMed, Embase, Medline, Scopus, and Web of Science from their inception to October 2, 2023, to provide an overview of currently available literature. Primary quantitative and qualitative studies, published in peer-reviewed journals that focused on AYA with a confirmed diagnosis of asthma were considered if they focused on challenges encountered by AYA with asthma during the transition process and/or components of transitional care and their outcomes assessed.

Results

A total of 855 studies were initially identified and 6 articles were included in this systematic literature review. Several challenges experienced by AYA with asthma were identified including maintaining medication adherence, the need to take responsibility and being involved, understanding their condition and its severity, feeling left out of the care system, and experiencing a lack of engagement. The identified transitional care components included a standardized form for medical data transmission, a joint consultation and to offer several longer consultations.

Conclusion

Several international guidelines for asthma care recommend implementing transition programs in the care for AYA with asthma. Such transition programs should include a comprehensive and individualized approach addressing several challenges faced, to ensure optimal outcomes post-transition. However, to date, data on effective components of transitional care facilitating good outcomes were found to be limited. This systematic review underscores the need for larger studies evaluating the effect of the components of transition programs.
Liver-boosting potential: chicory compound-mediated silver nanoparticles for hepatoprotection—biochemical and histopathological insights
Authors: Siddiqa Ayesha , Qureshi Rahmatullah , Raja Naveed Iqbal , Khan Imtiaz Ahmed , Ahmad Muhammad Zishan , Rafique Shaista , Ali Amir , Ahmad Ajaz , Kaushik Prashant
Published: February 2024

Background: Liver disease is a serious health concern in today’s world, posing a challenge to both healthcare providers and pharmaceutical companies. Most synthetic drugs and chemicals cause liver damage accounting for approximately 10% of acute hepatitis and 50% of acute liver failure.

Purpose: The present study aimed to evaluate the hepato-protective activity of an extract of chicory formulation assisted by silver nanoparticles against carbon tetra chloride (CCl4)-induced hepatic damage in rat’s liver.

Methods: Rats of the Wistar strain (Rattus norvegicus) were used to test the in vivo hepato-protective efficacy at various doses. Rats were randomly divided into nine groups, each containing six rats. The groups were as follows: first group (control), second group (CCl4), third group, silymarin (20 mg/kg of body weight), fourth group (CCl4+chicory) (1.75 mg/kg of b. wt), fifth group (CCl4 + chicory at the dose of 2.35 mg/kg), sixth group (CCl4 + chicory of 3.25 mg/kg), seventh group (CCl4 +AgNPs 1.75 mg/kg of b. wt.), eighth group (CCl4 + AgNPs 2.35 mg/kg of body weight), and ninth group (CCl4 + AgNPs 3.25 mg/kg of b. wt.). Blood samples were taken 24 h after the last administration (i.e., 30th day). The blood samples were analyzed for different serum enzymes such as ALP (alkaline phosphatase), ALT (alanine transaminase), bilirubin (Blr), triglyceride, and cholesterol. Histology liver sections were performed.

Results: Treatment with AgNPs and chicory extract showed significant hepato-protective activity in a dose-dependent manner. In three doses, the chicory extract at a rate of 3.25 mg/kg of body weight significantly reduced elevated levels of biochemical markers in comparison to CCl4-intoxicated rats. Histology of the liver sections from CCl4-treated rats revealed inflammation of hepatocytes, necrosis, cytoplasmic degeneration, vacuolization, and a deformed central vein. The chicory formulation extract exhibited a remarkable recovery percentage in the liver architecture that was higher than the drug (i.e., silymarin). While treatment with AgNPs also repaired the degenerative changes and restored the normal form of the liver, chicory formulation extract possessed more hepato-protective potential as compared to AgNPs by regulating biochemical and histo-pathological parameters.

Conclusion: This study can be used as confirmation of the hepato-protective potential of chicory compounds for possible use in the development programs of drugs to treat liver diseases.
Iterative solution of the fractional Wu-Zhang equation under Caputo derivative operator
Authors: Yasmin Humaira , Alderremy A. A. , Shah Rasool , Hamid Ganie Abdul , Aly Shaban
Published: February 2024

In this study, we employ the effective iterative method to address the fractional Wu-Zhang Equation within the framework of the Caputo Derivative. The effective iterative method offers a practical approach to obtaining approximate solutions for fractional differential equations. We seek to provide insights into its solution and behavior by applying this method to the Wu-Zhang Equation. Through numerical analysis and the presentation of relevant tables and Figures, we demonstrate the accuracy and efficiency of this method in solving the fractional Wu-Zhang Equation. This research contributes to the understanding and solution of fractional-order differential equations and their applications in various scientific and engineering domains.
Enhancement of specialized metabolites using CRISPR/Cas gene editing technology in medicinal plants
Authors: Das Swati , Kwon Moonhyuk , Kim Jae-Yean
Published: February 2024

Plants are the richest source of specialized metabolites. The specialized metabolites offer a variety of physiological benefits and many adaptive evolutionary advantages and frequently linked to plant defense mechanisms. Medicinal plants are a vital source of nutrition and active pharmaceutical agents. The production of valuable specialized metabolites and bioactive compounds has increased with the improvement of transgenic techniques like gene silencing and gene overexpression. These techniques are beneficial for decreasing production costs and increasing nutritional value. Utilizing biotechnological applications to enhance specialized metabolites in medicinal plants needs characterization and identification of genes within an elucidated pathway. The breakthrough and advancement of CRISPR/Cas-based gene editing in improving the production of specific metabolites in medicinal plants have gained significant importance in contemporary times. This article imparts a comprehensive recapitulation of the latest advancements made in the implementation of CRISPR-gene editing techniques for the purpose of augmenting specific metabolites in medicinal plants. We also provide further insights and perspectives for improving metabolic engineering scenarios in medicinal plants.
Studies on pollen micro-morphology, pollen storage methods, and cross-compatibility among grape (Vitis spp.) genotypes
Authors: Rane Prabhanjan , Thakre Madhubala , Verma Mahendra Kumar , Kumar Chavlesh , Prakash Jai , Srivastava Vartika , P. R. Shashank , Murukan Niranjana , Chawla Gautam , Mandal Pranab Kumar , Kumar Harshit , Jadhav Amol K. , Varghese Eldho , Patel Vishaw Bandhu , Singh Sanjay Kumar
Published: February 2024

The knowledge of pollen morphology, suitable storage condition, and species compatibility is vital for a successful grapevine improvement programme. Ten grape genotypes from three different species, viz., Vitis vinifera L., Vitis parviflora Roxb., and Vitis champini Planc., were studied for their pollen structure and pollen storage with the objective of determining their utilization in grape rootstock improvement programs. Pollen morphology was examined through the use of a scanning electron microscope (SEM). The viability of the pollen was assessed using 2,3,5-triphenyltetrazolium chloride (TTC). In vitro pollen germination was investigated using the semi-solid medium with 10 % sucrose, 100 mg/L boric acid, and 300 mg/L calcium nitrate. The results revealed variations in pollen micro-morphology in 10 genotypes, with distinct pollen dimensions, shapes, and exine ornamentation. However, species-wise, no clear difference was found for these parameters. Pollen of V. parviflora Roxb. and Dogridge was acolporated and did not germinate. The remaining eight genotypes exhibited tricolporated pollen and showed satisfactory in vitro pollen germination. Storage temperature and duration interactions showed that, at room temperature, pollen of most of the grape genotypes can be stored for up to 1 day only with an acceptable pollen germination rate (>30 %). However, storage for up to 7 days was successfully achieved at 4 °C, except for ‘Pearl of Csaba’. The most effective storage conditions were found to be at −20 °C and −196 °C (in liquid N2), enabling pollen storage for a period of up to 30 days, and can be used for pollination to overcome the challenge of asynchronous flowering. Four interspecific combinations were studied for their compatibility, among which V. parviflora Roxb. × V. vinifera L. (Pusa Navrang) and V. parviflora Roxb. × V. champini Planc. (Salt Creek) showed high cross-compatibility, offering their potential use for grape rootstock breeding. However, V. parviflora Roxb. × V. vinifera L. (Male Hybrid) recorded the lowest compatibility index among studied crosses. In the case of self-pollinated flowers from V. parviflora Roxb. and V. parviflora Roxb. × V. champini Planc. (Dogridge), pollen failed to germinate on the stigma due to male sterility caused by acolporated pollen. As a result, the flowers of these genotypes functioned as females, which means they are ideal female parents for grape breeding without the need for the tedious process of emasculation.
When waiting means trouble: an enquiry into the approach toward prevention against jihadism in Senegal
Authors: Bangura Ibrahim , Owusu Augustine , Quaye Andrea Samantha
Published: February 2024

In the last decade, West Africa has experienced increased activities by Jihadist groups, especially after the fall of the Muammar Qaddafi regime in Libya in 2012. The activities of these groups have gradually spread in the region, with countries such as Mali and Burkina Faso experiencing continued attacks. Taking the current socio-economic, religious and political context of Senegal into consideration, this study interrogates the factors that have so far prevented attacks by Jihadist groups in Senegal, the role that women and youth could play in mitigating jihadism in Senegal, and how the existing social capital in the country, could be further mobilized to foster trust building and social cohesion, thereby enhancing the prevention of violent extremism in the country? Furthermore, the study explores the need for a regional approach in dealing with the existing and emerging threats posed by Jihadist activities in the region. Methodologically, this study uses interviews and Focus Group Discussions to collect primary data from government officials, academics, civil society and international development partners. Secondary data from a wide range of sources are used to analyze the case of Senegal.
Antisocial personality disorder and therapeutic pessimism – how can mentalization-based treatment contribute to an increased therapeutic optimism among health professionals?
Authors: Flaaten Emilie , Langfeldt Maria , Morken Katharina T. E.
Published: February 2024

Antisocial personality disorder (ASPD) is associated with therapeutic pessimism among health professionals. Several variables are associated with obstacles in therapist’s willingness to treat ASPD. Variables that are relevant are (i) confusion associated with the term ASPD, (ii) characteristics of the disorder, (iii) attitudes, experiences, and knowledge clinicians possess, and (iv) insufficient management of countertransference. We assume that therapeutic pessimism is related to the lack of evidence-based, effective treatment for individuals with ASPD. This is problematic because ASPD is associated with large socio-economic costs and considerable suffering for the individual and the society. Mentalization-based treatment (MBT) was developed in treating borderline personality disorder (BPD) and is now considered an effective treatment for this group. Mentalization is defined as the process by which individuals make sense of themselves and others in terms of subjective states and mental processes. This ability affects an individual’s psychological functioning, mental health, self-organization, and interpersonal relationships. The overall goal of MBT is to strengthen the individual’s mentalizing abilities and facilitate more adaptive handling of problematic, internal states. Recently, a version of MBT tailored for individuals with ASPD (MBT-ASPD) has been developed. The purpose of this review is to investigate how MBT-ASPD relates to the major obstacles that contribute to the therapeutic pessimism toward this group. Despite a limited evidence base, preliminary studies indicate promising results for MBT-ASPD. More research is still required, this review suggests MBT-ASPD can contribute to increased therapeutic optimism and demonstrate specific characteristics of MBT-ASPD that contribute to management of therapeutic pessimism.
Patterns of C-reactive protein trends during clozapine titration and the onset of clozapine-induced inflammation: a case series of weekly and daily C-reactive protein monitoring
Authors: Kikuchi Yuki , Tanifuji Hiroaki , Ueno Sota , Onuma Yoshifumi , Goto Masatomo , Ishihara Masato , Toraiwa Takeshi , Komatsu Hiroshi , Tomita Hiroaki
Published: February 2024

Background

International guidelines for clozapine titration recommend measuring C-reactive protein (CRP) weekly for 4 weeks after clozapine initiation to prevent fatal inflammatory adverse events, including myocarditis. However, limited evidence exists regarding whether weekly CRP monitoring can prevent clozapine-induced inflammation.

Aims

We examined the relationship between CRP trends and the development of clozapine-induced inflammation. We also explored the usefulness and limitations of CRP monitoring during clozapine titration.

Method

This study presents 17 and 4 cases of weekly and daily CRP monitoring during clozapine initiation, respectively.

Results

Among 17 patients with weekly CRP measurements, 7 had fever. Elevated CRP levels were detected before the onset of fever in two of the seven patients. Of the five remaining patients, the CRP levels on a previous test had been low; however, the fever developed suddenly. Of the 10 patients with no fever under weekly CRP monitoring, three had elevated CRP levels >3.0 mg/dL. Refraining from increasing the clozapine dose may have prevented fever in these patients. Among four patients with daily CRP measurements, two became febrile. In both cases, CRP levels increased almost simultaneously with the onset of fever.

Conclusion

Weekly and daily CRP monitoring during clozapine titration is valuable for preventing clozapine-induced inflammation, assessing its severity, and guiding clozapine dose adjustments. Weekly CRP monitoring may not adequately predict clozapine-induced inflammation in some cases. Consequently, clinicians should be aware of the sudden onset of clozapine-induced inflammation, even if CRP levels are low. Daily CRP monitoring is better for detecting clozapine-induced inflammation.
Achieving Surgical, Obstetric, Trauma, and Anesthesia (SOTA) care for all in South Asia
Authors: Zadey Siddhesh , Rao Shirish , Gondi Isha , Sheneman Natalie , Patil Chaitrali , Nayan Anveshi , Iyer Himanshu , Kumar Arti Raj , Prasad Arun , Finley G. Allen , Prasad Chellapuram Raja Krishna , Chintamani  , Sharma Dhananjaya , Ghosh Dhruva , Jesudian Gnanaraj , Fatima Irum , Pattisapu Jogi , Ko Justin Sangwook , Bains Lovenish , Shah Mashal , Alam Mohammed Shadrul , Hadigal Narmada , Malhotra Naveen , Wijesuriya Nilmini , Shukla Prateek , Khan Sadaf , Pandya Sunil , Khan Tariq , Tenzin Tashi , Hadiga Venkat Raja , Peterson Daniel
Published: February 2024

South Asia is a demographically crucial, economically aspiring, and socio-culturally diverse region in the world. The region contributes to a large burden of surgically-treatable disease conditions. A large number of people in South Asia cannot access safe and affordable surgical, obstetric, trauma, and anesthesia (SOTA) care when in need. Yet, attention to the region in Global Surgery and Global Health is limited. Here, we assess the status of SOTA care in South Asia. We summarize the evidence on SOTA care indicators and planning. Region-wide, as well as country-specific challenges are highlighted. We also discuss potential directions—initiatives and innovations—toward addressing these challenges. Local partnerships, sustained research and advocacy efforts, and politics can be aligned with evidence-based policymaking and health planning to achieve equitable SOTA care access in the South Asian region under the South Asian Association for Regional Cooperation (SAARC).
Left atrial diastasis strain slope is a marker of hemodynamic recovery in post-ST elevation myocardial infarction: the Laser Atherectomy for STemi, Pci Analysis with Scintigraphy Study (LAST-PASS)
Authors: Kato Yoko , Lee Wei Hao , Natsumeda Makoto , Ambale-Venkatesh Bharath , Takagi Kensuke , Ikari Yuji , Lima Joao A. C.
Published: February 2024

Background

Left atrial (LA) mechanics are strongly linked with left ventricular (LV) filling. The LA diastasis strain slope (LADSS), which spans between the passive and active LA emptying phases, may be a key indicator of the LA–LV interplay during diastole.

Aim

This study aimed to investigate the LA–LV interdependencies in post-ST elevation myocardial infarction (STEMI), with particular focus on the LADSS.

Materials and methods

Patients with post-anterior STEMI who received primary percutaneous coronary intervention underwent contrast cardiac magnetic resonance imaging (MRI) during acute (5–9 days post-STEMI) and chronic (at 6 months) phases. The LADSS was categorized into three groups: Groups 1, 2, and 3 representing positive, flat, and negative slopes, respectively. Cross-sectional correlates of LADSS Group 2 or 3 compared to Group 1 were identified, adjusting for demographics, LA indices, and with or without LV indices. The associations of acute phase LADSS with the recovery of LV ejection fraction (LVEF) and scar amount were investigated.

Results

Sixty-six acute phase (86.4% male, 63.1 ± 11.8 years) and 59 chronic phase cardiac MRI images were investigated. The distribution across LADSS Groups 1, 2, and 3 in the acute phase was 24.2%, 28.9%, and 47.0%, respectively, whereas in the chronic phase, it was 33.9%, 22.0%, and 44.1%, respectively. LADSS Group 3 demonstrated a higher heart rate than Group 1 in the acute phase (61.9 ± 8.7 vs. 73.5 ± 11.9 bpm, p < 0.01); lower LVEF (48.7 ± 8.6 vs. 41.8 ± 9.9%, p = 0.041) and weaker LA passive strain rate (SR) (−1.1 ± 0.4 vs. −0.7 [−1.2 to −0.6] s−1, p = 0.037) in the chronic phase. Chronic phase Group 3 exhibited weaker LA passive SR [relative risk ratio (RRR) = 8.8, p = 0.012] than Group 1 after adjusting for demographics and LA indices; lower LVEF (RRR = 0.85, p < 0.01), higher heart rate (RRR = 1.1, p = 0.070), and less likelihood of being male (RRR = 0.08, p = 0.058) after full adjustment. Acute phase LADSS Groups 2 and 3 predicted poor recovery of LVEF when adjusted for demographics and LA indices; LADSS Group 2 remained a predictor in the fully adjusted model (β = −5.8, p = 0.013).

Conclusion

The LADSS serves both as a marker of current LV hemodynamics and its recovery in post-anterior STEMI. The LADSS is an important index of LA–LV interdependency during diastole.

Clinical Trial Registration

https://clinicaltrials.gov/, identifier NCT03950310.
Towards co-design of rehabilitation technologies: a collaborative approach to prioritize usability issues
Authors: Clanchy K. , Mitchell J. , Mulholland K. , Jurd E. , Kendall E. , Lloyd D. G. , Palipana D. , Pizzolato C. , Shirota C.
Published: February 2024

Introduction

Early stakeholder engagement is critical to the successful development and translation of rehabilitation technologies, a pivotal step of which is usability testing with intended end-users. To this end, several methods employ end-user feedback to identify usability and implementation issues. However, the process of prioritizing identified issues seldom leverages the knowledge and expertise of the range of stakeholders who will ultimately affect the demand and supply of a device. This paper describes a novel method to prioritize end-user feedback using transdisciplinary stakeholder consultation and address it in subsequent product development. The proposed approach was demonstrated using a case study relating to the development of a novel technology for neural recovery after spinal cord injury.

Method

Feedback from five individuals with chronic spinal cord injury was collected during two-hour usability evaluation sessions with a fully functional high-fidelity system prototype. A think-aloud and semi-structured interview protocol was used with each participant to identify usability and acceptability issues relating to the system in a 3-phase approach. Phase 1 involved extracting usability issues from think-aloud and semi-structured interview data. Phase 2 involved rating the usability issues based on their significance, technical feasibility, and implementation priority by relevant internal and external stakeholders. Finally, Phase 3 involved aggregating the usability issues according to design and implementation elements to facilitate solution generation, and these solutions were then raised as action tasks for future design iterations.

Results

Sixty usability issues representing nine facets of usability were rated. Eighty percent of issues were rated to be of moderate to high significance, 83% were rated as being feasible to address, and 75% were rated as addressable using existing project resources. Fifty percent of the issues were rated to be a high priority for implementation. Evaluation of the grouped issues identified 21 tasks which were mapped to the product roadmap for integration into future design iterations.

Discussion

This paper presents a method for meaningful transdisciplinary stakeholder engagement in rehabilitation technology development that can extended to other projects. Alongside a worked example, we offer practical considerations for others seeking to co-develop rehabilitation technologies.
New insights into the role of the oral leukoplakia microenvironment in malignant transformation
Authors: González-Arriagada Wilfredo Alejandro , Canedo-Marroquin Gisela , Adorno-Farías Daniela , Fernández-Ramires Ricardo
Published: February 2024

Oral leukoplakia is the most frequent and potentially malignant lesion of the oral cavity. Although dysplasia grading remains the main factor for risk assessment, challenges persist in determining the exact risk of transformation, and the literature has focused on studying alternative biomarkers. The interaction between dysplastic epithelial cells and the microenvironment starts early, and the communication is mainly mediated by lymphocytes, inflammatory factors, fibroblasts, and the extracellular matrix, leading to dysplastic progression. Leukoplakia-infiltrating leukocytes (LILs) and leukoplakia-associated fibroblasts (LAFs) play crucial roles in the dysplastic microenvironment. The immune response is related to intraepithelial T lymphocyte infiltration, mechanisms of immunosuppression coordinated by regulatory T cells, M2 macrophage polarization, and increased numbers of Langerhans cells; in contrast, fibroblastic and extracellular matrix factors are associated with increased numbers of pro-tumorigenic myofibroblasts, increased expression of metalloproteinases vs. decreased expression of TIMPs, and increased expression of chemokines and other inflammatory mediators. The microenvironment offers insights into the progression of leukoplakia to carcinoma, and understanding the complexity of the oral microenvironment in potentially malignant diseases aids in determining the risk of malignant transformation and proposing new therapeutic alternatives.
Deep Convolutional LSTM for improved flash flood prediction
Authors: Oddo Perry C. , Bolten John D. , Kumar Sujay V. , Cleary Brian
Published: February 2024

Flooding remains one of the most devastating and costly natural disasters. As flooding events grow in frequency and intensity, it has become increasingly important to improve flood monitoring, prediction, and early warning systems. Recent efforts to improve flash flood forecasts using deep learning have shown promise, yet commonly-used techniques such as long short term memory (LSTM) models are unable to extract potentially significant spatial relationships among input datasets. Here we propose a hybrid approach using a Convolutional LSTM (ConvLSTM) network to predict stream stage heights using multi-modal hydrometeorological remote sensing and in-situ inputs. Results suggest the hybrid network can more effectively capture the specific spatiotemporal landscape dynamics of a flash flood-prone catchment relative to the current state-of-the-art, leading to a roughly 26% improvement in model error when predicting elevated stream conditions. Furthermore, the methodology shows promise for improving prediction accuracy and warning times for supporting local decision making.
Modeling the influence of climate on groundwater flow and heat regime in Brandenburg (Germany)
Authors: Tsypin Mikhail , Cacace Mauro , Guse Björn , Güntner Andreas , Scheck-Wenderoth Magdalena
Published: February 2024

This study investigates the decades-long evolution of groundwater dynamics and thermal field in the North German Basin beneath Brandenburg (NE Germany) by coupling a distributed hydrologic model with a 3D groundwater model. We found that hydraulic gradients, acting as the main driver of the groundwater flow in the studied basin, are not exclusively influenced by present-day topographic gradients. Instead, structural dip and stratification of rock units and the presence of permeability contrasts and anisotropy are important co-players affecting the flow in deep seated saline aquifers at depths >500 m. In contrast, recharge variability and anthropogenic activities contribute to groundwater dynamics in the shallow (<500 m) freshwater Quaternary aquifers. Recharge fluxes, as derived from the hydrologic model and assigned to the parametrized regional groundwater model, reproduce magnitudes of recorded seasonal groundwater level changes. Nonetheless, observed instances of inter-annual fluctuations and a gradual decline of groundwater levels highlight the need to consider damping of the recharge signal and additional sinks, like pumping, in the model, in order to reconcile long-term groundwater level trends. Seasonal changes in near-surface groundwater temperature and the continuous warming due to conductive heat exchange with the atmosphere are locally enhanced by forced advection, especially in areas of high hydraulic gradients. The main factors controlling the depth of temperature disturbance include the magnitude of surface temperature variations, the subsurface permeability field, and the rate of recharge. Our results demonstrate the maximum depth extent and the response times of the groundwater system subjected to non-linear interactions between local geological variability and climate conditions.
Risk factors for avian influenza in Danish poultry and wild birds during the epidemic from June 2020 to May 2021
Authors: Liu Yangfan , Kjær Lene Jung , Boklund Anette Ella , Hjulsager Charlotte Kristiane , Larsen Lars Erik , Kirkeby Carsten Thure
Published: February 2024

Exploring the risk factors of avian influenza (AI) occurrence helps us to monitor and control the disease. Since late 2020, the number of avian influenza outbreaks in domestic and wild birds has increased in most European countries, including Denmark. This study was conducted to identify potential risk factors for wild birds and poultry during the epidemic in 2020/2021 in Denmark. Using Danish AI surveillance data of actively surveyed poultry and passively surveyed wild birds from June 2020 to May 2021, we calculated geographical attributes for bird locations and assessed the potential risk factors of AI detections using logistic regression analyses. 4% of actively surveyed poultry and 39% of passively surveyed wild birds were detected with AI circulating or ongoing at the time. Of these, 10 and 99% tested positive for the H5/H7 AI subtypes, respectively. Our analyses did not find any statistically significant risk factors for actively surveyed poultry within the dataset. For passively surveyed wild birds, bird species belonging to the Anseriformes order had a higher risk of being AI virus positive than five other taxonomic bird orders, and Galliformes were of higher risk than two other taxonomic bird orders. Besides, every 1 km increase in the distance to wetlands was associated with a 5.18% decrease in the risk of being AI positive (OR (odds ratio) 0.95, 95% CI 0.91, 0.99), when all other variables were kept constant. Overall, bird orders and distance to wetlands were associated with the occurrence of AI. The findings may provide targets for surveillance strategies using limited resources and assist in risk-based surveillance during epidemics.
Improved Decentralized Fractional-Order Control of Higher-Order Systems Using Modified Flower Pollination Optimization
Authors: Hamza Mukhtar Fatihu
Published: February 2024

Due to increased complexity and interactions between various subsystems, higher-order MIMO systems present difficulties in terms of stability and control performance. This study effort provides a novel, all-encompassing method for creating a decentralized fractional-order control technique for higher-order systems. Given the greater number of variables that needed to be optimized for fractional order control in higher-order, multi-input, multi-output systems, the modified flower pollination optimization algorithm (MFPOA) optimization technique was chosen due to its rapid convergence speed and minimal computational effort. The goal of the design is to improve control performance. Maximum overshoot (Mp), rising time (tr), and settling time (ts) are the performance factors taken into consideration. The MFPOA approach is used to improve the settings of the proposed decentralized fractional-order proportional-integral-derivative (FOPID) controller. By exploring the parameter space and converging on the best controller settings, the MFPOA examines the parameter space and satisfies the imposed constraints by maintaining system stability. To evaluate the suggested approach, simulation studies on two systems are carried out. The results show that by decreasing the loop interactions between subsystems with improved stability, the decentralized control with the MFPOA-based FOPID controller provides better control performance.
Stress Appraisals and Coping across and within Academic, Parent, and Peer Stressors: The Roles of Adolescents’ Emotional Problems, Coping Flexibility, and Age
Authors: Zimmer-Gembeck Melanie J. , Skinner Ellen A.
Published: February 2024

The aim of this study was to determine whether adolescents’ emotional problems, coping flexibility, age, and stress appraisals account for ways of coping, which include engagement and disengagement coping, with academic-, parent-, and peer-related stressful events. Stress appraisals were defined as perceived threats to the psychological needs of relatedness, competence, and autonomy. Models were fit at a higher order level, indicated by adolescents’ appraisals and intended ways of coping with stress in three domains (i.e., academic, parent, and peer) and tested at the lower level within each domain. Adolescents (N = 410; age 10–15; Mage = 12.5; 50% girls) reported their emotional problems (combined depressive and anxiety symptoms) and coping flexibility six months prior to completing an analogue task. The task involved viewing six short film clips portraying stressful events (e.g., obtaining a worse than expected exam grade or arguing with a parent) and reporting three stress appraisals and eight ways of coping after each stressor. The ways of coping were analyzed as four composite scores reflecting engagement coping (active coping, self-reliance) or disengagement coping (withdrawal coping, helplessness). In structural equation models, adolescents who appraised more threat reported more withdrawal coping and helplessness but also more active coping and self-reliance. Adolescents with more emotional problems appraised more threat and anticipated using less constructive ways of coping, whereas adolescents higher in coping flexibility intended to use more constructive ways of coping, with these associations sufficiently modeled at the general (across stress domains) level. Improvement in the model fit was found when appraised threat–coping associations were modeled at the lower (specific stressor domain) level, suggesting differences by stressor domain. Age was associated with more self-reliance and helplessness, with self-reliance being specific to parent stressors and helplessness specific to peer stressors.
Performance of Symmetric Double Flat Fan Nozzles against Fusarium Head Blight in Durum Wheat
Authors: Vučajnk Filip , Spanic Valentina , Trdan Stanislav , Košir Iztok Jože , Ocvirk Miha , Vidrih Matej
Published: February 2024

Four types of nozzles were tested on large-scale trials with a 40 m2 plot unit size. The Avi Twin 110-01 (80 L ha−1), 110-02 (160 L ha−1), 110-03 (240 L ha−1), and 110-04 (320 L ha−1) symmetric double fan injector nozzles were tested during the 2020/2021 and 2021/2022 growing seasons. This study aimed to evaluate the performance of spray nozzles with regard to deoxynivalenol (DON) accumulation in durum wheat grains. Artificial inoculation with Fusarium spp. was performed after durum heads were protected with fungicide. The percentage of heads covered with fungicide droplets, grain yield, yield-related traits, technological quality parameters, and concentrations of DON were determined. Compared to the control (without fungicide treatment), the Avi Twin 04 nozzle caused a reduction of 45.0% in the DON concentration on average across both growing seasons. This positively corresponded to the percentage of heads covered with fungicide droplets, which was highest when this nozzle was utilized. In both trial years, the DON reduction caused by the 110-04 twin nozzle was higher than that caused by the 110-01 nozzle. Treatment with the 110-04 nozzle more effectively improved the grain yield, 1000-kernel weight, and test weight compared to treatment with the 110-01 nozzle and the untreated control. The differences in technological quality were less pronounced when different spray nozzles were used.