bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial Variability and Moisture Tracks of Indian Monsoon Rainfall and Extremes
Authors: Thota Samba Siva Sai Prasad , Rajagopalan Balaji
Published: March 2023

We performed a systematic space-time analysis of monsoon seasonal (Jun-Sep) rainfall and extremes (3-day maximum rainfall) over India for the period 1951–2019. Employing Partition Around Medoid (PAM) clustering technique on the seasonal rainfall and extremes, six spatially coherent regions (clusters) were identified that are contiguous in space and consistent with the topography, which are: Central-West India (CW), Northwest and Northern India (NW), (WG) Western Ghats (WG), Deccan Plateau (DP), Central-East India including Indo-Gangetic plain (CE) and Northeast India (NE). Integrated Vertical Transport (IVT) of moisture composites for wet and dry years for each cluster indicated that Bay of Bengal is the major source of moisture for extreme rainfall for all of India, except for WG. Arabian Sea and Bay of Bengal both provide moisture for the seasonal rainfall for western and eastern halves of India, respectively. Trend analysis revealed decline in seasonal rainfall over CE, NE and WG clusters and increase in extreme rainfall over CW region. These are consistent with increasing IVT trends over Bay of Bengal and decreasing over Arabian Sea and Indian Ocean. Teleconnections to tropical Pacific Sea surface temperatures (SSTs) were reminiscent of El Nino Southern Oscillation (ENSO) patterns, with cooler SSTs in central and eastern Pacific favoring stronger monsoon rainfall and to a lesser extent the extremes. Further, warmer Indian Ocean in recent decades is likely a mediator in the moisture transport by reducing seasonal rainfall and enhancing the extremes. These interesting insights brighten the prospects for skillful forecast of monsoon rainfall and extremes.
Integration of systematic review and data mining techniques to reveal core anti-obesity medicinal plants
Authors: Ng Yan Jie Chester , Leong Kye Siong , Gan Ren-You , Yang Xian , Zhong Linda LD
Published: March 2023

Background: Obesity is a complex chronic disease that can lead to a variety of health problems. Despite its increasing frequency, there is still a lack of safe and effective treatment options. Traditional Chinese Medicine (TCM) herbal treatment is gaining medical attention as a potential alternative to disease treatment. Specifically, biomolecular interactions of the usage of paired herbs could yield essentially synergistic effects on the fight against obesity.
Objective: This study aims to investigate the combination of core herbs and clustering patterns in obesity treatment using various data mining techniques.
Methods: Eight electronic databases were searched from inception until December 2021 and 34 Randomized Control Trials (RCTs) were identified. Subsequently, 96 different herbs were extracted from the RCTs for association analysis and hierarchical clustering. The quality assessment of the trials was conducted using the Cochrane Collaboration’s Risk of Bias Tool.
Results: Association analysis identified the core herb combination of Coptis chinensis, Epimedium grandiflorum, Salvia miltiorrhiza, and Poria cocos. Hierarchical clustering also identified meaningful clustering patterns amongst herbs based on similar therapeutic effects and meridian entry.
Conclusion: Using an integrated approach of systematic review and data mining techniques has revealed core herbs for the treatment of obesity. However, more clinical trials/clinical studies are required to validate the clinical efficacy of the core herb combination.
Immune-related genes probably increase the occurrence of Interstitial Lung Disease in Dermatomyositis
Authors: Liu Changjian , Jiang Wei , Ge Yongpeng
Published: March 2023

Background Interstitial lung disease (ILD) is one of the significant complications of dermatomyositis (DM), but the mechanisms by which it occurs remain incompletely elucidated. This study aimed to explore further the possible genetic mechanisms by which this complication occurs.
Methods Gene expression profiles for dermatomyositis (GSE39454, GSE46239, GSE143323) and interstitial lung disease (GSE32537, GSE110147, GSE150910) were downloaded from the Gene Expression Omnibus (GEO) database. After identifying common differentially expressed genes (DEGs) to dermatomyositisand interstitial lung disease using the "limma" R package and the "VennDiagram" R package, functional annotation, relationship to immune cell infiltration, identification of transcription factors (TFs). We also collected clinical cases of dermatomyositis-associated interstitial lung disease (DM-ILD), including 3 cases of rapidly progressive interstitial lung diseases and 3 cases of none-rapidly progressive interstitial lung diseases, and explored whether there were differences in serum lymphocyte subpopulations.
Results A total of 4 common DEGs (SLAMF7, SPP1, TDO2, and VCAM1) were screened and GO enrichment analysis showed that these genes were mainly enriched in T cell activation, regulation of lymphocyte activation, lymphocyte differentiation, leukocyte proliferation and regulation of T cell activation. In terms of KEGG pathways, the three significantly enriched pathways were the PI3K-Akt signaling pathway, MAPK signaling pathway, and Cytokine-cytokine receptor interaction. In lung and muscle tissues, 21 and 3 TFs may regulate the expression of these genes, respectively. Finally, by analysing the serum lymphocyte subpopulations, we also found a decrease in the absolute number of CD8+ T cells and an increase in the CD4+ /CD8+ T cell ratio in dermatomyositis combined with rapidly progressive interstitial lung disease.
Conclusion These common pathways and key genes may provide new ideas for further research into DM-ILD.
Clinical analysis of low back pain in patients with lumbar degenerative disc disease with Modic I/II changes after percutaneous transforaminal endoscopic discectomy: a retrospective study
Authors: Zhang Zhezhe , Li Pengfei , Zhang Zuxue , Zeng Xianqi , Song Youxin
Published: March 2023

Background
Modic I/II has been associated with low back pain in some previous studies, but the majority of scholars still question this. This study investigated the changes of low back pain in patients with lumbar degenerative diseases and the recovery of low back and leg pain in patients after percutaneous transforaminal endoscopic lumbar discectomy (PTED) without fusion and decompression surgery alone.
Methods
Sixty-four patients (aged 57.86 ± 10.86 years) with lumbar degenerative diseases whose vertebral bone marrow showed Modic I/II signal were selected. All patients presented with low back and leg pain due to lumbar degeneration and underwent PTED without fusion. We evaluated changes in visual analogue scale (VAS) scores for low back pain and Oswestry disability index (ODI) before surgery, 1 month after surgery, 6 months after surgery, and 1 and 2 years after surgery.
Results
The mean age of the PTED group was 57.86 ± 10.86 years. The VAS leg, VAS back, and ODI scores were significantly improved after surgery compared with those before surgery. Notably, VAS back pain score and VAS leg pain score showed an increasing trend over time in the MCI group after PTED, and there were statistically significant differences in VAS back pain score and VAS leg pain score at 1 month and 2 years after surgery (P < 0.05).
Conclusions
PTED improves the condition of low back pain in patients with lumbar degenerative diseases. Low back pain in patients with lumbar degenerative diseases seems to arise primarily from nerve root compression, and the intuitive impact of MC on low back pain remains elusive. However, patients who presented with recurrent low back or leg pain within 2 years of surgery could be the result of progression of normal lumbar degeneration.
Application and exploration for the internationalization of medical education use TBL concept in dental teaching
Authors: Lin Baoxin , Wang Xu , Li Ruyi , Cai He , Pei Xibo
Published: March 2023

Objective: This study aimed to analyze and discuss the differences of medical education of West China School of Stomatology, Sichuan University, in the construction of first-class disciplines worldwide, to explore the reform of dental teaching, and to cultivate talent with international vision. Methods: This study investigated 112 undergraduate, master’s and doctoral students in the West China School of Stomatology, Sichuan University, from 2021 to 2022. The evaluation results of dental students in project courses under different teaching modes (traditional teaching methods and team cooperative learning) were explored. Subjects were divided into two groups: the control group (n=55) and the experimental group (n=57). Under the guidance of the instructor, the dental teaching application and exploration project was conducted. At the end of the project, a self-report questionnaire with 17 items was distributed to participants to evaluate three areas (the TBL teaching model, international curriculum evaluation and personal ability improvement). A total of 100 valid questionnaires were received, with a response rate of 89%. Results: Except for the first and sixth questions, there were significant differences in all the others. The other 11 questions showed that the scores of students in the control group were significantly higher than those in the experimental group with a p value less than 0.05, indicating that there was a significant difference and that experimental group had a significant effect in three areas compared with control group after course learning. In addition, in the two groups, most of the students (56% in the control group and 76% in the experimental group) hoped to participate in the international curriculum of medical education and gain an international perspective. In terms of personal ability improvement, the majority of students (62% - 76%) in the experimental group strongly agreed that they had improved in various aspects during the one-year course teaching and clinical training, while only 22% - 36% in the control group agreed with this statement. Conclusion: It was beneficial to improve the teaching level, academic research ability and teaching methods of colleges and universities by internationalizing medical education in combination with TBL dental teaching reform. This application and exploration project comprehensively promoted medical teaching reform and innovative talent training, encouraged the personalized development of students, and trained their clinical thinking, scientific research thinking and critical thinking to cultivate high-quality talent with innovative awareness and international vision.
PM2.5 Exposure Aggravates Kidney Injuries in Diabetic Mice
Authors: Peng Yanzhe , Shuai Dan , Deng Yiyao , Yu Jiali , Wu Yilin , Yuan Jing , Zha Yan
Published: March 2023

Background: PM2.5, the particles with diameters no larger than 2.5 micrometers, are important contributors to air pollution and have been related to diabetes and kidney injury. The present study aims to investigate whether PM2.5 aggravates kidney conditions in the context of diabetes.
Methods: Db/db mice were used to model diabetes and treated with escalating doses of PM2.5 particles. The treatments were performed through intratracheal instillation. Kidney conditions were assessed using a battery of histopathological staining and laboratory tests.
Results: PM2.5 treatment led to more severe phenotypes of kidney injury characterized by altered histology and overall deteriorated kidney functions. Many biological processes were implicated in the injury including progression of renal interstitial fibrosis, increased monocyte infiltration and an exhausted antioxidative defense system.
Conclusions: PM2.5 induces an additional detrimental effects on kidney conditions in diabetic mice, calling for focuses on the diabetes patients living at highly PM2.5-polluted environments.
“Transcriptional repression of lncRNA and miRNA subsets mediated by LRF during erythropoiesis”
Authors: Athanasopoulou Katerina , Chondrou Vasiliki , Xiropotamos Panagiotis , Psarias Georgios , Vasilopoulos Yiannis , Georgakilas Georgios , Sgourou Argyro
Published: March 2023

Non-coding RNA (ncRNA) species, mainly long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) have been currently imputed for lesser or greater involvement in human erythropoiesis. These RNA subsets operate within a complex circuit with other epigenetic components and transcription factors (TF) affecting chromatin remodeling during cell differentiation. Lymphoma/Leukemia related (LRF) TF exerts higher occupancy on DNA CpG rich sites and is implicated in several differentiation cell pathways and erythropoiesis among them. Also, directs the epigenetic regulation of hemoglobin transversion from fetal (HbF) to adult (HbA) form by intervening in the γ-globin gene repression. We intended to investigate LRF activity in the evolving landscape of cells’ commitment to the erythroid lineage and specifically during HbF to HbA transversion, to qualify this TF as potential repressor of lncRNAs and miRNAs. Transgenic human erythroleukemia cells, overexpressing LRF and further induced to erythropoiesis, were subjected to expression analysis in high LRF occupancy genetic loci producing lncRNAs. LRF abundance in genetic loci transcribing for studied lncRNAs was determined by ChIP-Seq data analysis. qPCRs were performed to examine lncRNAs expression status. Differentially expressed miRNAs pre- and post-erythropoiesis induction were assessed by next generation sequencing (NGS) and their promoter regions were charted. Expression levels of lncRNAs were correlated with DNA methylation status of flanked CpG islands and contingent co-regulation of hosted miRNAs was considered. LRF binding sites were overrepresented in LRF overexpressing cell clones during erythropoiesis induction and exerted a significant suppressive effect towards lncRNAs and miRNA collections. Based on present data interpretation LRF’s multiplied binding capacity across genome is suggested to be transient and associated with higher levels of DNA methylation.
Continuous standard bupivacaine versus single liposomal bupivacaine injection for interscalene brachial plexus block for pain management after proximal humerus fracture fixation: a study protocol of a non-inferiority randomized controlled trial (CLIP-H study)
Authors: Chan Timmy CW , Lam David MH , Chan Will SH , Wong Stanley SC , Chan Manson TH , Wong Janus SH , Yee Dennis KH , Yung Colin S , Fang Evan J , Cheung CW , Fang Christian
Published: March 2023

Interscalene brachial plexus nerve blocks (ISB) are commonly used to reduce postoperative pain for proximal humerus fracture fixation. Good pain control minimizes opioid consumption, facilitates mobilization and enhances functional recovery. While ISB continuous nerve block infusion can prolong postoperative analgesia, it is technically demanding and associated with problems such as catheter displacement and obstruction. Liposomal bupivacaine allows prolonged duration of analgesia up to 72 hours after single injection. Single ISB injection using liposomal bupivacaine can perhaps provide extended pain relief without the potential problems associated with continuous nerve catheters. The analgesic efficacy of single injection of liposomal bupivacaine versus continuous nerve infusion with standard bupivacaine has not been investigated. In this study protocol, we describe a single centre, double blind, non-inferiority randomized controlled trial to compare the analgesic effect of single ISB injection using liposomal bupivacaine (LP-ISB group) versus continuous ISB nerve infusion using standard bupivacaine (C-ISB) after proximal humeral fracture fixation. Seventy-eight patients will be recruited after obtaining informed consent. Patients in the LP-ISB group will receive ISB injection with 10ml of 1.33% liposomal bupivacaine, followed by nerve catheter infusion using normal saline at 5ml/hr. Patients in the C-ISB group will receive ISB injection with 10ml of 0.25% standard bupivacaine, followed by nerve catheter infusion with 0.2% standard bupivacaine at 5ml/hr. All patients will receive the same perioperative general anaesthetic and analgesic management. The primary outcome is the weighted AUC NRS pain score (scale 0-10) at rest and with movement during the acute postoperative period. Secondary outcomes in the acute postoperative period include postoperative opioid consumption, overall analgesic benefit score and adverse effects. Longer-term secondary outcomes that will be assessed include health related quality of life, upper limb functional scores (QuickDASH) and chronic pain. This clinical study has been registered at ClinicalTrials.gov (NCT04928664).
Single-cell transcriptomics identifies the differentiation trajectory from inflammatory monocytes to pro-resolving macrophages in skin allergy
Authors: Miyake Kensuke , Ito Junya , Takahashi Kazufusa , Nakabayashi Jun , Shichino Shigeyuki , Yoshikawa Soichiro , Karasuyama Hajime
Published: March 2023

Both monocytes and macrophages are heterogeneous populations. It was traditionally understood that Ly6Chi classical (inflammatory) monocytes differentiate to pro-inflammatory Ly6Chi macrophages. Accumulating evidence has suggested that Ly6Chi classical monocytes can also differentiate into Ly6Clo pro-resolving macrophages under certain conditions, while their differentiation trajectory remains to be fully elucidated. The present study with scRNA-seq and flow cytometric analyses revealed that Ly6ChiPD-L2lo classical monocytes recruited to the allergic skin lesion sequentially differentiate into Ly6CloPD-L2hi pro-resolving macrophage, via intermediate Ly6ChiPD-L2hi macrophages but not Ly6Clo non-classical monocytes, in an IL-4 receptor-dependent manner. Along the differentiation, classical monocyte-derived macrophages displayed anti-inflammatory signatures followed by metabolic rewiring concordant with their ability to phagocytose apoptotic neutrophils and allergens, therefore contributing to the resolution of inflammation. The failure in the generation of these pro-resolving macrophages drove the IL-1α-mediated vicious cycle of inflammation with abscess-like accumulation of necrotic neutrophils. Thus, we clarified the stepwise differentiation trajectory from Ly6Chi classical monocytes toward Ly6Clo pro-resolving macrophages that restrain neutrophilic aggravation of skin allergic inflammation.
Effects of Five Sources of Mixing Water on Durability of Concrete
Authors: Elshami Ahmed. A.
Published: March 2023

This paper presents the experimental approach and the first results obtained as a result of the effect of five Sources of mixing water on produce more durable concrete. Five types of water were used, namely simulated acid rain (AR), Rain water (RW), tap water (TW), Zamzam water (ZW) and sea water (SW) as mixing water for ordinary portland cement concrete OPCC. The durability of these different types of water were tested toward their capacity to prevent the rebar corrosion. The results of workability, pH value, compressive strength, chlorides penetration and microstructure of different specimens mixed with each type of water were compared with those mixed with tap water (TW).
Professional Dental Care to Reduce the Recurrence of Aspiration Pneumonia: A Prospective Cohort Study
Authors: Miyagami Taiju , Nishizaki Yuji , Imada Ryoko , Yamaguchi Kohei , Nojima Masanori , Kataoka Koshi , Sakairi Mizuki , Aoki Nozomi , Furusaka Takayuki , Kushiro Seiko , Yang Kwang-Seok , Morikawa Toru , Tohara Haruka , Naito Toshio
Published: March 2023

BACKGROUNDAspiration pneumonia has a high recurrence rate, and oral care by dentists has been reported to be effective in preventing the onset of aspiration pneumonia; however, this has not been evaluated using prospective studies. Therefore, we conducted a prospective study to evaluate the effectiveness of professional oral care by dentists in reducing the recurrence of aspiration pneumonia in older adult patients.METHODSThis was a prospective cohort study to evaluate a dental oral care intervention with a historical control. It was conducted at a single-center regional core hospital in Japan that serves a large number of patients aged > 80 years. Patients who were hospitalized for aspiration pneumonia were included in this study. The historical control group received oral care from nurses as usual and was followed retrospectively for 1 year. The dentist oral care group received weekly professional oral care from a dentist and was followed prospectively for 1 year. A Kaplan–Meier analysis was used to evaluate the timing of recurrent aspiration pneumonia or death events. A Cox proportional hazards model was used to obtain a hazard ratio and to determine the 95% confidence intervals.RESULTSThere were 91 participants in the dentist oral care group and 94 in the control group. The mean age of participants in this study was 85 years, and 75 (40.5%) were women. The recurrence rate was 27.5% in the dentist oral care group and 44.7% in the control group, a statistically significant difference (P= 0.005). Dentist oral care reduced the risk of recurrence of aspiration pneumonia by approximately 50% (adjusted hazard ratio, 0.465; 95% confidence interval, 0.278–0.78).CONCLUSIONSDentist-provided professional oral care was associated with a lower rate of aspiration pneumonia recurrence than nurse-provided conventional oral care.
Gene expression profile of HCT-8 cells following single or co-infections with Cryptosporidium parvum and bovine coronavirus
Authors: JIMENEZ-MELENDEZ Alejandro , SHAKYA Ruchika , MARKUSSEN Turhan , ROBERTSON Lucy J. , MYRMEL Mette , MAKVANDI-NEJAD Shokouh
Published: March 2023

Among the causative agents of neonatal diarrhoea in calves, two of the most prevalent are bovine coronavirus (BCoV) and the intracellular parasite Cryptosporidium parvum. Although several studies indicate that co-infections are associated with greater symptom severity, the host-pathogen interplay remains unresolved. Here, our main objective was to investigate the modulation of the transcriptome of HCT-8 cells during single and co-infections with BCoV and C. parvum. For this, HCT-8 cells were inoculated with (1) BCoV alone, (2) C. parvum alone, (3) BCoV and C. parvum simultaneously. After 24 and 72 h, cells were harvested and analyzed using high-throughput RNA sequencing. Following differential expression analysis, over 6000 differentially expressed genes (DEGs) were identified in virus and co-infected cells at 72 hpi, whereas only 52 DEGs were found in C. parvum-infected cells at the same time point. Pathway (KEGG) and gene ontology (GO) analysis showed that DEGs in the virus-infected and co-infected cells were mostly associated with immune pathways (such as NFKβ, TNFα or, IL-17), apoptosis and regulation of transcription, with a more limited effect exerted by C. parvum. Although the modulation observed in the co-infection was apparently dominated by the virus, over 800 DEGs were uniquely expressed in co-infected cells at 72 hpi. Our findings provide insights on possible biomarkers associated with co-infection, which could be further explored using in vivo models.
Heterogeneity in conformational state space enhances the force-tolerance of mechanosensory proteins
Authors: Saha Pritam , Vashisht Vishavdeep , Singh Ojas , Bhati Gaurav , Garg Surbhi , Rakshit Sabyasachi
Published: March 2023

β-strands in proteins undergo anti-cross correlated crankshaft-type motions and adapt to the input mechanical cues. However, a direct study to reveal the molecular relation of force-adaptability with crankshaft motions of β-strands is long-awaited. To elucidate, here we explore the differences in mechanical tolerance of a gating-spring protein in hearing, cadherin-23, with genotypic and phenotypic variations on a single residue. Though the variants possess comparable topology, differ in contact-orders. Higher contact-order induces higher crankshaft. We identified that the variants with higher crankshaft exhibit larger heterogeneity in the conformational state space and thus, higher force-tolerance. However, protein-variants with lower contact-orders possess higher folding-cooperativity and faster intrinsic-folding, though their folding-energy landscape is most prone to distortion under tension. Overall, our study provides a unique relation between the transition-cooperativity amongst the sparsely populated conformational states and the force-adaptations by β-rich proteins. The use of phenotype and genotype variants also help us to deduce the mechanical fingerprinting of healthy spring and malicious spring.
Plasma Lipid Profile of the Iranian Adult Population: Findings of the Nationally Representative STEPs Survey 2021
Authors: Khanali Javad , Ghasemi Erfan , Rashidi Mohammad-Mahdi , Ahmadi Naser , Ghamari Seyyed-Hadi , Azangou-Khyavy Mohammadreza , Malekpour Mohammad-Reza , Abbasi-Kangevari Mohsen , Hashemi Seyedeh Melika , Naderian Mohammadreza , Rezaei Negar , Dilmaghani-Marand Arezou , Farzi Yosef , Kazemi Ameneh , Yoosefi Moein , Hajebi Amirali , Rezaei Shahabeddin , Azadnajafabad Sina , Fattahi Nima , Nasserinejad Maryam , Abdolhamidi Elham , Haghshenas Rosa , Rezaei Nazila , Djalalinia Shirin , Larijani Bagher , Farzadfar Farshad
Published: March 2023

The study aimed to estimate the prevalence of lipid abnormalities in Iranian adults by demographic characterization, geographical distribution, and associated risk factors using national and sub-national representative samples of the STEPs 2021 survey in Iran. In this population-based household survey, a total of 18,119 individuals aged higher than 25 years provided blood samples for biochemical analysis. Dyslipidemia was defined by the presence of at least one of the lipid abnormalities of hypertriglyceridemia (≥ 150 mg/dL), hypercholesterolemia (≥ 200 mg/dL), high LDL-C (≥ 130 mg/dL), and low HDL-C (< 50 mg/dL in women, < 40 mg/dL in men), or self-reported use of lipid-lowering medications. Mixed dyslipidemia was characterized as the coexistence of high LDL-C with at least one of the hypertriglyceridemia and low HDL-C. The prevalence of each lipid abnormality was determined by each population strata, and the determinants of abnormal lipid levels were identified using a multiple logistic regression model. The prevalence was 39.7% for hypertriglyceridemia, 21.2% for hypercholesterolemia, 16.4% for high LDL-C, 68.4% for low HDL-C, and 81.0% for dyslipidemia. Hypercholesterolemia and low HDL-C were more prevalent in women, and hypertriglyceridemia was more prevalent in men. The prevalence of dyslipidemia was higher in women (OR = 1.8), obese (OR = 2.8) and overweight (OR = 2.3) persons, those residents in urban areas (OR = 1.1), those with inappropriate physical activity (OR = 1.2), patients with diabetes (OR = 2.7) and hypertension (OR = 1.9), and participants with a history (OR = 1.6) or familial history of CVDs (OR = 1.2). Mixed dyslipidemia prevalence was 13.6% in women and 11.4% in men (P < 0.05). The prevalence of lipid abnormalities was highly heterogeneous among provinces, and East Azarbaijan with 85.3% (81.5–89.1) and Golestan with 68.5% (64.8–72.2) had the highest and lowest prevalence of dyslipidemia, respectively. Although the prevalence of high cholesterol and LDL-C had a descending trend in the 2016–2021 period, the prevalence of dyslipidemia remained unchanged. There are modifiable risk factors associated with dyslipidemia that can be targeted by the primary healthcare system. To modify these risk factors and promote metabolic health in the country, action plans should come to action through a multi-sectoral and collaborative approach.
Availability and readiness of healthcare facilities and their effects on antenatal care services uptake in Bangladesh: analysis of linked data
Authors: Khan Md. Nuruzzaman , Alam Md. Badsha , Chowdhury Atika Rahman , Kabir Md. Awal , Khan Md. Mostaured Ali
Published: March 2023

Background: Sustainable Development Goals 3.7 targets to ensure universal access to sexual and reproductive healthcare services, where antenatal care (ANC) is a core component. This study aimed at examining the influence of health facility availability and readiness on uptake of four or more ANC in Bangladesh.
Methods: The 2017/18 Bangladesh Demographic and Health Survey data were linked with the 2017 Health Facility Survey and analysed in this study. The associations of health facility level factors with recommended number of ANC uptake were determined. Multilevel mixed-effect poison regression model was used to determine the association adjusting for potential confounders.
Results: Nearly 44% of mothers reported four or more ANC uptake with significant variations across several areas in Bangladesh. The average distance of mothers' homes from the nearest health facilities was 6.12 km, which was higher in Sylhet division (7.90 km) and lower in Dhaka division (4.01 km). The overall uptake of the recommended number of ANC visits was positively associated with higher scores for the management (adjusted prevalence ratio (APR) 1.85; 95% CI, 1.16-2.82) and infrastructure (APR, 1.59; 95% CI, 1.09-1.82) of health facilities closest to mothers' homes. The APRs for mothers reporting using the recommended number of ANC were increased to 3.02 (95% CI, 2.01-4.19) and 2.36 (95% CI, 2.09-4.16) times for each unit increase in the availability and readiness scores to provide ANC services at the closest health facilities, respectively. Every kilometre increase in the average regional-level distance between mothers' homes and the nearest health facilities reduced the likelihood of receiving the recommended number of ANC visits by nearly 42%.
Conclusion: The availability of healthcare facilities closes to residence as well as their improved management, infrastructure, and readiness to provide ANC play crucial role to increase ANC services uptake. Policies and programmes should prioritise to increase availability, accessibility, and readiness of health facilities to provide ANC services.
The effect of perceived professional benefits on health professionals’ job engagement: The role of psychological availability and future perceived professional benefits
Authors: Wan Jin , Zhou Wenjun , Qin Mingyue , Zhou Haiming
Published: March 2023

Objective
To investigate the impact of perceived professional benefits on the job engagement of health professionals.
Methods
Correlation analysis, hierarchical regression analysis and bootstrap tests were used to analyze the influence of perceived professional benefits on the job engagement of health professionals and to examine the mediating effect of psychological availability and the moderating effect of future perceived professional benefits.
Result
Health professionals’ perceived professional benefits have a positive impact on their job engagement; psychological availability plays a mediating role between perceived professional benefits and job engagement. Future perceived professional benefits not only positively regulate the impact of perceived professional benefits on health professionals’ psychological availability but also positively regulate the mediating role of psychological availability between perceived professional benefits and job engagement.
Conclusion
Perceived professional benefits can improve the job engagement of health professionals by improving their psychological availability. However, for health professionals with low future perceived professional benefits, perceived professional benefits do not have a significant impact on their job engagement through psychological availability. Therefore, while improving health professionals’ perceived professional benefits, we should also improve their future perceived professional benefits.
Prediction of severe haemolysis during extracorporeal membrane oxygenation (ECMO) using multiple machine learning
Authors: liu kepeng , Wang Qi , Liang Yan , Zhang Yan , Gu Chen , Zheng Qiuyue , Liao Xiaozu , Li Binfei
Published: March 2023

Objective
We examine whether machine learning can be used to predict severe haemolysis in patients during extracorporeal membrane oxygenation.
Methods
The present study is a reanalysis of public data from 1063 ECMO patients. We trained the corresponding model using 5 machine learning and built a machine learning prediction model in Python.
Results
The top 5 factors found to influence haemolysis by data analysis were Sequential Organ Failure Assessment(SOFA), pump head thrombosis(PHT), platelet concentrate(PC)/ days, lactate dehydrogenase(LDH) pre, and fresh frozen plasma(FFP)/days, respectively. In the training group, among the algorithms, the highest AUC values rate was that of GradientBoosting (0.886). Our validation in the test group by different machine learning algorithms found that the three algorithms with the highest AUC values were 0.806, 0.781, and 0.759 for XGB, GradientBoosting, and Randomforest, respectively. In addition, among the algorithms, XGB had the highest accuracy with a value of 0.913.
Conclusions
According to our results, XGB performed best overall, with an AUC >0.8, an accuracy >90%. Besides, the top 5 factors found to influence haemolysis by data analysis were SOFA, PHT, PC/days, LDH pre, and FFP/days. Therefore, machine learning studies have better predictive value for whether patients develop severe haemolysis during ECMO.
Fingerprinting Hyperglycemia using Predictive Modelling Approach based on Low-Cost Routine CBC and CRP Diagnostics
Authors: Tahir Amna , Asghar Kashif , Shafiq Waqas , Batool Hijab , Khan Dilawar , Chughtai Omar , Chaudhary Safee Ullah
Published: March 2023

Hyperglycemia is an outcome of dysregulated glucose homeostasis in the human body and may induce chronic elevation of blood glucose levels. Lifestyle factors such as overnutrition, physical inactivity, and psychosocials coupled with systemic low-grade inflammation have a strong negative impact on glucose homeostasis, in particular, insulin sensitivity. Together, these factors contribute to the pathophysiology of diabetes (DM) and expanding landscape of its prevalence regionally and globally. The rapid rise in the prevalence of type 2 diabetes, therefore underscores the need for its early diagnosis and treatment. In this work, we have evaluated the discriminatory capacity of different diagnostic markers including inflammatory biomolecules and RBC (Red Blood Cell) indices in predicting the risk of hyperglycemia and borderline hyperglycemia. For that, 208,137 clinical diagnostic entries obtained over five years from Chugtai Labs, Pakistan, were retrospectively evaluated. The dataset included HbA1c (n = 142,011), complete blood count (CBC, n = 84,263), fasting blood glucose (FBG, n = 35,363), and C-reactive protein (CRP, n = 9,035) tests. Our results provide four glycemic predictive models for two cohorts HbA1c and FBG) each having an overall predictive accuracy of more than 80% (p-value < 0.0001). Next, multivariate analysis (MANOVA) followed by univariate analysis (ANOVA) was employed to identify predictors with the highest discriminatory capacity for different levels of glycemia. We show that the interplay between inflammation, hyperglycemic-induced derangements in RBC indices, and altered glucose homeostasis could be employed efficaciously for prognosticating hyperglycemic outcomes. Our results then conclude a highly sensitive and specific glycemic predictor that employs inflammatory markers coupled with RBC indices to predict glycemic outcomes (ROC p-value < 0.0001). Taken together, this study outlines a predictor of glycemic outcomes which could assist as a prophylactic intervention in predicting the early onset of hyperglycemia and borderline hyperglycemia.
Automated and Intelligent Synthesis of Oxygen-Producing Catalysts from Martian Meteorites by Robotic AI-Chemist
Authors: Jiang Jun , Zhu Qing , Huang Yan , Zhou Donglai , Zhao Luyuan , Guo Lulu , Yang Ruyu , Sun Zixu , Luo Man , Zhang Fei , Xiao Hengyu , Tang Xinsheng , Zhang Xuchun , Song Tao , Li Xiang , Chong Baochen , Zhou Junyi , Zhang Yihan , Zhang Baicheng , Cao Jiaqi , Zhang Guozhen , Wang Song , Ye Guilin , Zhang Wanjun , Zhao Haitao , Cong Shuang , Li Huirong , Shang Weiwei , Luo Yi
Published: March 2023

Living on Mars requires ability to synthesize living products locally using Martian resources. The synthesis of necessary chemicals from local materials, especially oxygen, which is essential for survival, is a challenging task. Here, we demonstrate a robotic AI-Chemist that automatically synthesizes and intelligently optimizes usable oxygen evolution reaction catalysts from Martian meteorites. The entire process including Martian ore pre-treatment, catalyst synthesis, characterization, and testing, and most importantly, the search of optimal formula, was performed without human intervention. Using a machine learning model derived from both first-principles data and experimental measurements, this methodology automatically and rapidly identified a globally optimal synthetic formula from more than 3 million possible compositions. The synthesized catalyst offers state-of-the-art performance with a current density of 10 mA/cm2 at an overpotential of 445.1 mV for more than 550,000 s, convincingly demonstrating the feasibility of the robotic AI-Chemist in the automatic synthesis of chemicals/materials for Mars exploration.
Flexible Phase Change Materials for Overheating Protection of Electronics
Authors: Feng Chang-Ping , Guan Xiao , Shi Meng , Wei Fang , Lan Hong-Bo , Yang Wei
Published: March 2023

With the increase of power density of electronics, adequate overheating protection of electronics is quite urgent, especially for wearable electronics integrated with biological tissues. Herein, flexible leakage-proof phase change materials (PCMs) with state-of-the-art overheating protection capability were fabricated by a novel static polymer swelling method. The resultant flexible PCMs exhibited a high latent heat energy storage density of 136.5 J/g and pronounced shape stability even with a temperature resistance of 120 °C. The demonstration of wearable electronics with our fabricated flexible PCMs as the overheating protection substrate illustrated that the generated heat of wearable electronics could be absorbed by flexible PCMs-based overheating protection substrate without causing a significant rise of skin and electronics temperature. The present study represents an important route to solve the overheating problem of wearable electronics integrated with biological tissues.
Trends and Geospatial Distribution of Stillbirths in Uganda, 2014 - 2020
Authors: Nakamya Petranilla , Komakech Allan , Migamba Stella M. , Biribawa Claire , Kwesiga Benon , Bulage Lilian , Ario Alex R. , Ocom Felix
Published: March 2023

Introduction

Uganda with 17.8 stillbirths per 1,000 deliveries in 2021, is among the countries with a high burden of stillbirths globally. In 2014, Uganda adopted the World Health Organization Every New-born Action Plan (ENAP), which targets < 10 stillbirths per 1,000 deliveries by 2035. Little is known about the trends of stillbirth burden since ENAP was introduced. We assessed the temporal, and spatial distribution of stillbirths, in Uganda, 2014–2020, to inform programming for safe pregnancies and deliveries.

Methods

We obtained and analysed stillbirth surveillance data from the District Health Information System, 2014–2020. A stillbirth was defined as the death of a foetus > 28 weeks of pregnancy or weighing > 1000g before or during birth and reported to a health facility. We calculated annual incidence rates of stillbirths per 1,000 deliveries at district, regional, and national levels. We used logistic regression to determine the significance of trends.

Results

The overall national annual incidence of stillbirths decreased from 24/1,000 deliveries in 2014 to 17/1,000 deliveries in 2020. During the same period, reporting rates declined from 71% in 2014 to 46% in 2020. The central region continuously had the highest incidence rate for the past 5 years despite the largest decline (OR = 0.79; CI = 0.77–0.83, P < 0.001) while the eastern region had the smallest decline (OR = 0.59; CI = 0.57–0.61, P < 0.001). Districts with persistently high annual incidence rates of stillbirths (> 30/1000) included Mubende, Kalangala, Hoima, and Nebbi. There was no difference in the reporting rates of the most- vs least-affected districts.

Conclusion

Even with suboptimal reporting, the incidence of stillbirths remained above the national target. Specific areas in the country appear to have particularly high stillbirth rates. We recommend continuous capacity building in managing pregnant women with an emphasis on the most affected districts, and investigation into the reasons for low reporting.
Electromyography Signal Based Hand Gesture Classification System Using Hilbert Huang Transform and Deep Neural Networks
Authors: S Mary Vasanthi , T Jayasree , A HAITER LENIN
Published: March 2023

In this paper, classification of hand gestures for the smart control of prosthetic hands is proposed. The surface Electromyography (sEMG) signals are used for classifying the hand gestures. The important attributes of the signal are extracted by finding Hilbert Huang Transform (HHT). These features are given as input to the Deep Neural Network (DNN) classifier for further classification. The experimental results show that high classification accuracy can be achieved for the proposed method compared to the other techniques.
Body mass index-based inflammation index is a promising prognostic predictor in older adult cancer patients
Authors: Huang Jiaxin , Zhang Xi , Tang Meng , Zhang Qi , Deng Li , Song Chunhua , Li Wei , Shi Han-Ping , Cong Ming-Hua
Published: March 2023

Background: Older patients with cancer often have a worse prognosis than the general cancer patient population due to decreased immune responses, chronic inflammation status, and malnutrition. The present study aimed to develop a novel body mass index (BMI)-based inflammation index and investigate its prognostic significance in older patients with cancer.
Methods: A total of 2376 patients were enrolled in this study. Concordance index (C-index) and receiver operating characteristic (ROC) curves were applied to compare the prognostic value of BMI-based inflammation indices. The overall survival (OS) was calculated and compared using the Kaplan–Meier method generated by the log-rank test. A Cox proportional hazard regression model was performed to identify independent predictors associated with OS.
Results: We recorded 1112 death cases during a median follow-up of 17.43 months. Both the area under ROC curves and the C-index of the BMI to C-reactive protein/lymphocyte ratio (BCLR) were higher than other inflammation indices. There was a significant L-shaped association between BCLR and all-cause mortality in older patients with cancer (P<0.001). A low BCLR was significantly associated with shortened OS and served as an independent risk factor for survival in older patients with cancer (hazard ratio=1.51, 95% confidence interval=1.32–1.73, P<0.001). In the subgroup analysis, a low BCLR was an independent risk factor for prognosis inpatients with lung cancer, upper gastrointestinal cancer, hepatobiliary and pancreatic cancer and colorectal cancer. In addition, the prognostic value of low BCLR was also confirmed in underweight, normal as well as overweight and obesity populations. Multivariate logistic regression models showed that a low BCLR was an independent risk factor associated with short-term mortality, malnutrition and cancer cachexia in older patients with cancer.
Conclusion: The BCLR is a promising indicator to assess nutritional-inflammatory status in older patients with cancer and can be used to identify patients with worse prognoses.
Blood proteins self-assembly, staphylococcal enterotoxins-interaction, antibacterial synergistic activities of biogenic carbon/FeSO 4 /Cu/CuO nanocomposites modified with three antibiotics
Authors: Alavi Mehran , Karimi Nasser
Published: March 2023

Nanocomposites based on copper, iron, and carbon materials are novel nanomaterials with both antibacterial and biocompatibility properties considerable to fight against multidrug-resistant bacteria. In this study, phytogenic carbon/FeSO4/Cu/CuO nanocomposites modified by three antibiotics including tetracycline, amoxicillin, and penicillin were employed to hinder antibiotic resistant bacteria of Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Interaction of albumin and hemoglobin as major blood proteins with these nanocomposites were evaluated by SEM, FTIR, and AFM techniques. As in silico study, molecular docking properties of staphylococcal enterotoxin toxin A and B with (Z)-α-Bisabolene epoxide, (E)-Nerolidol, α-Cyperone, daphnauranol C, nootkatin, and nootkatone as major secondary metabolites of Daphne mucronata were obtained by AutoDock Vina program. Results of both in vitro and in silico surveys disclosed significant antibacterial activity of antibiotic functionalized carbon/FeSO4/Cu/CuO nanocomposites compared to antibiotics alone towards Gram-negative and Gram-positive bacteria. Synergistic activity of bio-fabricated carbon/FeSO4/Cu/CuO nanocomposites with antibiotics may be affected by main parameters of concentration and ratio of antibacterial agents, physicochemical properties of nanocomposites, bacterial type (Gram-negative or Gram-positive), antibacterial mechanisms, and chemical structure of antibiotics.
Enhancing spatiotemporal reconstructions of hydroclimate variability across the Mediterranean during the last millennium
Authors: Anchukaitis Kevin , Touchan Ramzi , Meko David , Kherchouche Dalila , Slimani Said , Sivrikaya Fatih , Ilmen Rachid , Mitsopoulos Ioannis , Stephan Jean , Attieh Jihad , Hasnaoui Foued , Camarero J. Julio , Sánchez-Salguero Raúl , Guibal Frederic , Piermattei Alma , Christou Andreas , Krcmaric Jordan , Cook Benjamin
Published: March 2023

The Mediterranean region is projected to experience severe drying trends and more extreme hydroclimate events as a consequence of anthropogenic climate change over the next century. In some places this signal may have already emerged from natural variability. Here we provide context for recent and future changes with a new high-resolution (0.5$^o$) spatial reconstruction of the Palmer Drought Severity Index (PDSI) using a tree-ring network that spans much of the last millennium. This network provides new information that extends and enhances the existing Old World Drought Atlas (OWDA), and we identify and attribute the differences between the OWDA and our reconstruction. We also reexamine previous conclusions about the severity of recent drought in the context of earlier centuries. We find that, in both the western Mediterranean and the Levant, recent dry periods are indeed the worst in at least the last 500 years, but our assessment of the significance and uncertainty of this finding is affected by differences in the tree-ring networks used for the reconstructions. Long millennium-length hydroclimate reconstructions in the Mediterranean provide the opportunity to understand variability and trends in the hydroclimate of the region, while extant uncertainties arising from the existing tree-ring chronology network and methodological choices call attention to locations that require further proxy collection and statistical scrutiny.