bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the implementation fidelity of basic emergency obstetrics and neonatal care services in Beyeda District, Northwest Ethiopia: a case study evaluation
Authors: Ejigu Hawltu Abeyu , Yazachew Lake , Amare Getasew , Tsehay Chalie Tadie , Hagos Asebe , Tafere Tesfahun Zemene
Published: September 2024

Background

Worldwide, nearly 830 women die from complications of pregnancy and childbirth daily. Ninety-nine per cent of these maternal deaths take place in low and middle-income countries. Basic Emergency Obstetric Care (BEmONC) is one method of reducing maternal mortality related to pregnancy and childbirth complications. However, the status of its implementation fidelity has not been investigated. Therefore, this study sought to evaluate the implementation fidelity of BEmONC services in Beyeda District, Northwest Ethiopia.

Evaluation methods

A single case study design with mixed method was employed from June 01 to July 30, 2022. 415 client exit interviews, 14 key informants’ interviews and 423 retrospective document reviews were conducted. Adherence, participant responsiveness and quality of delivery dimensions from Carroll's conceptual framework, with a total of 21 indicators were used in this evaluation. The overall implementation fidelity status of BEmONC service was judged based on the pre-seated judgmental criteria as; low, medium, and high fidelity.

Results

The overall degree of implementation fidelity of the BEmONC services was 74.5%. Moreover, the implementation fidelity status of adherence, quality of delivery, and participant responsiveness dimensions were 74.7%, 77.2%, and 71.5% respectively. Uterotonic drugs were not administered as per the recommended protocol. Participants’ engagement towards the neonatal resuscitation service delivery was inadequate. Likewise, healthcare providers’ respect for the clients was not sufficient. Furthermore, women aged >30 years, being government employed and ANC visits four and above were variables positively associated with the quality of delivery of BEmONC services.

Conclusion

The overall implementation fidelity of the BEmONC services was judged as implemented in medium fidelity. Moreover, the adherence, participant responsiveness and quality of delivery dimensions were found to be implemented in medium fidelity. Therefore, public health sectors at all levels should strive to enhance the implementation fidelity of BEmONC services. Moreover, healthcare providers should adhere to the BEmONC implementation protocol guideline during service delivery. Healthcare managers should facilitate a continuous awareness creation for mothers regarding the merit of neonatal resuscitation for neonatal complications. Furthermore, healthcare providers should give due respect to mothers while delivering the services.
Tumor-associated macrophages: orchestrators of cholangiocarcinoma progression
Authors: Chen Fei , Sheng Jian , Li Xiaoping , Gao Zhaofeng , Hu Lingyu , Chen Minjie , Fei Jianguo , Song Zhengwei
Published: September 2024

Cholangiocarcinoma (CCA) is a rare but highly invasive cancer, with its incidence rising in recent years. Currently, surgery remains the most definitive therapeutic option for CCA. However, similar to other malignancies, most CCA patients are not eligible for surgical intervention at the time of diagnosis. The chemotherapeutic regimen of gemcitabine combined with cisplatin is the standard treatment for advanced CCA, but its effectiveness is often hampered by therapeutic resistance. Recent research highlights the remarkable plasticity of tumor-associated macrophages (TAMs) within the tumor microenvironment (TME). TAMs play a crucial dual role in either promoting or suppressing tumor development, depending on the factors that polarize them toward pro-tumorigenic or anti-tumorigenic phenotypes, as well as their interactions with cancer cells and other stromal components. In this review, we critically examine recent studies on TAMs in CCA, detailing the expression patterns and prognostic significance of different TAM subtypes in CCA, the mechanisms by which TAMs influence CCA progression and immune evasion, and the potential for reprogramming TAMs to enhance anticancer therapies. This review aims to provide a framework for deeper future research.
Deciphering colorectal cancer radioresistance and immune microrenvironment: unraveling the role of EIF5A through single-cell RNA sequencing and machine learning
Authors: Zhong Yaqi , Chen Xingte , Wu Shiji , Fang Huipeng , Hong Liang , Shao Lingdong , Wang Lei , Wu Junxin
Published: September 2024

Background

Radiotherapy (RT) is a critical component of treatment for locally advanced rectal cancer (LARC), though patient response varies significantly. The variability in treatment outcomes is partly due to the resistance conferred by cancer stem cells (CSCs) and tumor immune microenvironment (TiME). This study investigates the role of EIF5A in radiotherapy response and its impact on the CSCs and TiME.

Methods

Predictive models for preoperative radiotherapy (preRT) response were developed using machine learning, identifying EIF5A as a key gene associated with radioresistance. EIF5A expression was analyzed via bulk RNA-seq and single-cell RNA-seq (scRNA-seq). Functional assays and in vivo experiments validated EIF5A’s role in radioresistance and TiME modulation.

Results

EIF5A was significantly upregulated in radioresistant colorectal cancer (CRC) tissues. EIF5A knockdown in CRC cell lines reduced cell viability, migration, and invasion after radiation, and increased radiation-induced apoptosis. Mechanistically, EIF5A promoted cancer stem cell (CSC) characteristics through the Hedgehog signaling pathway. Analysis of the TiME revealed that the radiation-resistant group had an immune-desert phenotype, characterized by low immune cell infiltration. In vivo experiments showed that EIF5A knockdown led to increased infiltration of CD8+ T cells and M1 macrophages, and decreased M2 macrophages and Tregs following radiation therapy, thereby enhancing the radiotherapy response.

Conclusion

EIF5A contributes to CRC radioresistance by promoting CSC traits via the Hedgehog pathway and modulating the TiME to an immune-suppressive state. Targeting EIF5A could enhance radiation sensitivity and improve immune responses, offering a potential therapeutic strategy to optimize radiotherapy outcomes in CRC patients.
The role of SLC7A11 in diabetic wound healing: novel insights and new therapeutic strategies
Authors: Zhang Wei , Feng Jiawei , Ni Yiming , Li Gen , Wang Yuqing , Cao Yemin , Zhou Mingmei , Zhao Cheng
Published: September 2024

Diabetic wounds are a severe complication of diabetes, characterized by persistent, non-healing ulcers due to disrupted wound-healing mechanisms in a hyperglycemic environment. Key factors in the pathogenesis of these chronic wounds include unresolved inflammation and antioxidant defense imbalances. The cystine/glutamate antiporter SLC7A11 (xCT) is crucial for cystine import, glutathione production, and antioxidant protection, positioning it as a vital regulator of diabetic wound healing. Recent studies underscore the role of SLC7A11 in modulating immune responses and oxidative stress in diabetic wounds. Moreover, SLC7A11 influences critical processes such as insulin secretion and the mTOR signaling pathway, both of which are implicated in delayed wound healing. This review explores the mechanisms regulating SLC7A11 and its impact on immune response, antioxidant defenses, insulin secretion, and mTOR pathways in diabetic wounds. Additionally, we highlight the current advancements in targeting SLC7A11 for treating related diseases and conceptualize its potential applications and value in diabetic wound treatment strategies, along with the challenges encountered in this context.
Seasonal biophysical interactions in tidal marsh evolution: insights from a synchronized dataset in Jiangsu, China
Authors: Chen Lei , Moeller Iris , Zhou Zeng , Hu Zhan , Zhang Yanan , Chu Mengwei , Jia Yifei , Townend Ian , Zhang Changkuan
Published: September 2024

Introduction

Tidal marsh wetlands provide essential and valuable services to the wider interconnected marine and coastal environment, although the complex intertwined processes in morphological evolution remain insufficiently understood owing to synchronized data scarcity, limiting the development of numerical models and management strategies.

Methods

This study investigated the hydrodynamic, biological, sediment and morphological processes on the Doulong tidal wetlands, Jiangsu, China, using a one-year field dataset that captured spatial and seasonal variations.

Results and discussion

Our results indicate that biophysical interactions among multiple processes could result in some overlooked sedimentary behaviours and bio-morphological patterns in tidal marsh wetlands. Firstly, the dominance of alongshore currents caused a rapid alongshore expansion of saltmarsh patches, by which the marsh edge achieved seaward advancing, markedly different from the widely reported cross-shore expansion. Secondly, results showed that the particle size of sediment near the marsh edge coarsened when plants withered and then fined when plants grew, indicating that the seasonal variation trend of sediment grain size in saltmarshes was opposite to the trend of vegetation biomass. Thirdly, the interaction between vegetation and stranded marine debris formed banded debris zones within the saltmarsh, where debris bands could cause a biomass reduction of up to 58%, disrupting the commonly-observed parabolic biomass-elevation relationship. Meanwhile, the seasonal variation of vegetation and hydrodynamics could alter the debris positions and hence result in the formation of multiple parallel debris bands. Overall, this study provides a synchronized dataset and elucidates specific bio-morphological relationships and processes that have thus far not been systematically documented, enhancing the comprehensive understanding of tidal marsh wetland evolution.
To explore the postoperative nutritional status and factors influencing prognosis in patients with chronic constipation complicated by malnutrition
Authors: Wang Le , Tian Hongliang , Li Long , Ye Chen , Cui Jiaqu , Lin Zhiliang , Yang Bo , Zhao Di , Li Ning , Feng Xiaobo , Chen Qiyi
Published: September 2024

Background

Many patients with constipation also suffer from varying degrees of malnutrition, and the relationship between the two conditions is a vicious cycle. Surgery is the final step in the treatment of constipation, with a success rate of up to 95%. This study aims to investigate the effects of surgical treatment on the nutritional status of patients with chronic constipation and malnutrition.

Methods

A total of 60 patients with chronic constipation and various degrees of malnutrition who underwent surgery in our department from January 2020 to March 2023 were included in this study. Biochemical tests including BMI, albumin, total protein, hemoglobin, cholesterol and lymphocyte count were conducted, as well as measurements of inflammatory markers such as Interleukin-6 (IL-6), Interleukin-8 (IL-8), and C-reactive protein (CRP). Additionally, multiple nutritional risk screening scales (NRS2002, MUST, NRI, and MNA) and the prognostic nutritional index (PNI) were used to assess the nutritional status of patients before surgery, as well as at 1 month, 3 months, and 6 months post-surgery. Finally, we analyzed the factors influencing postoperative recovery outcomes in patients.

Results

Compared to pre-operation, the BMI of patients significantly increased at 1 month, 3 months, and 6 months after the operation, with statistically significant differences (p < 0.001). Multiple nutritional risk assessment tools (NRS2002, MUST, NRI, and MNA), as well as the prognostic nutritional index (NPI), indicated a reduction in nutritional risk and improvement in nutritional status at 1, 3, and 6 months post-surgery, compared to pre-surgery levels (p < 0.001). The levels of albumin, total protein, and hemoglobin in patients at 1, 3, and 6 months after the surgery were significantly higher than those before the surgery (p < 0.001). However, there was no significant change in the number of lymphocytes. Inflammatory markers such as IL-6, IL-8, and CRP exhibited a significant decrease after the surgery, reaching normal levels at 6 months post-surgery (p < 0.001). Low BMI, low PNI, and low cholesterol levels are independent risk factors for patient prognosis (p < 0.05).

Conclusion

Surgical treatment can enhance the nutritional status of constipation patients with malnutrition, which in turn promotes the restoration of intestinal motility. The patient’s nutritional status will impact the postoperative recovery outcomes.
A bibliometric analysis of the application of physical therapy in knee osteoarthritis from 2013 to 2022
Authors: Huang Chenglan , Hou Yutong , Yang Yunxiao , Liu Jiaqi , Li Ya , Lu Dezhi , Chen Sha , Wang Jinwu
Published: September 2024

Background

Knee osteoarthritis (KOA) is one of the most common chronic joint diseases. Physical therapy, a non-invasive approach, is extensively used in its treatment. Although bibliometrics is a reliable method to evaluate the significance and impact of research fields, systematic bibliometric analyses in this area are lacking. This study aims to perform a bibliometric analysis covering 2013 to 2022, to highlight the current state, key focuses, and trends in physical therapy for KOA.

Methods

This study utilizes the Web of Science Core Collection to gather relevant literature on physical therapy and KOA from 2013 to 2022. CiteSpace and VOSviewer software facilitated the visual analysis of the annual publications, geographic and institutional distributions, journals, authors, references, and keywords in this field.

Results

The study analyzed 1,357 articles, showing an overall increase in publications over time from 71 countries and 2,302 institutions. The United States and Australia emerged as leaders in this field. The analysis identified 6,046 authors, with Kim L. Bennell as the most prolific and Bellamy N. receiving the most citations. BMC Musculoskeletal Disorders published the most articles, while Osteoarthritis and Cartilage received the most citations. High-impact articles were authored notably by McAlindon TE, Bannuru RR, Fernandes L, and Bennell KL. Keyword analysis highlighted a strong focus on patient self-management, exercise therapy, physical factor therapy, and remote rehabilitation.

Conclusion

The bibliometric analysis confirms significant interest and ongoing research in physical therapy for KOA treatment from 2013 to 2022, indicating a growing field. Journals and authors in this area show influential and collaborative dynamics. Future research should focus on enhancing international and institutional collaboration and explore emerging trends like internet-guided treatments.
Targeted therapies for vascular malformations
Authors: Kane Gavin , Fernandez-Pineda Israel
Published: September 2024

Targeted medical therapies for the treatment of vascular malformations is an exciting and evolving area of research. As the identification of specific causative genetic mutations involved in vascular malformations becomes more accessible and inexpensive, the development of targeted therapies to address these genetic anomalies becomes all the more enticing. It is an excellent example of the potential of translational research where basic science discoveries are translated to clinical practise from ‘bench to bedside’. In this mini-review we aim to synopsise some of the recent studies published in this area with specific focus on the paediatric population. We also aim to highlight the growing demand for future research in the field to elucidate further the optimum duration of treatments, strategies for discontinuation, potential for combination of therapies and the effects of prolonged use of these medications.
Tetrodotoxin and the state-of-the-art progress of its associated analytical methods
Authors: Mi Wei , Liu Sha
Published: September 2024

Tetrodotoxin (TTX), which is found in various marine organisms, including pufferfish, shellfish, shrimp, crab, marine gastropods, and gobies, is an effective marine toxin and the cause of many seafood poisoning incidents. Owing to its toxicity and threat to public health, the development of simple, rapid, and efficient analytical methods to detect TTX in various food matrices has garnered increasing interest worldwide. Herein, we reviewed the structure and properties, origin and sources, toxicity and poisoning, and relevant legislative measures of TTX. Additionally, we have mainly reviewed the state-of-the-art progress of analytical methods for TTX detection in the past five years, such as bioassays, immunoassays, instrumental analysis, and biosensors, and summarized their advantages and limitations. Furthermore, this review provides an in-depth discussion of the most advanced biosensors, including cell-based biosensors, immunosensors, and aptasensors. Overall, this study provides useful insights into the future development and wide application of biosensors for TTX detection.
Transmission dynamics of ESBL/AmpC and carbapenemase-producing Enterobacterales between companion animals and humans
Authors: Menezes Juliana , Frosini Siân-Marie , Weese Scott , Perreten Vincent , Schwarz Stefan , Amaral Andreia J. , Loeffler Anette , Pomba Constança
Published: September 2024

Antimicrobial resistance mediated by extended-spectrum beta-lactamase (ESBL)- and plasmid-mediated cephalosporinase (AmpC)-producing Enterobacterales, as well as carbapenemase-producing Enterobacterales have globally increased among companion animals, posing a potential health risk to humans in contact with them. This prospective longitudinal study investigates the transfer of ESBL/AmpC- and carbapenemase-producing Enterobacterales between companion animals and their cohabitant humans in Portugal (PT) and the United Kingdom (UK) during animal infection. Fecal samples and nasal swabs collected from dogs and cats with urinary tract infection (UTI) or skin and soft tissue infection (SSTI), and their cohabitant humans were screened for resistant strains. Relatedness between animal and human strains was established by whole-genome sequencing (WGS). ESBL/AmpC-producing Enterobacterales were detected in companion animals (PT = 55.8%; UK = 36.4%) and humans (PT = 35.9%; UK = 12.5%). Carbapenemase-producing Enterobacterales carriage was observed in one dog from Portugal (2.6%) and another dog from the UK (4.5%). Transmission of index clinical ESBL-producing Escherichia coli and Klebsiella pneumoniae strains to cohabitant humans was observed in three Portuguese households (6.9%, n = 43), with repeated isolation of the index strains on fecal samples from the animals and their cohabiting humans. In addition, longitudinal sharing of E. coli strains carried by companion animals and their owners was observed in other two Portuguese households and two households from the UK. Furthermore, a multidrug-resistant ACT-24-producing Enterobacter hormaechei subsp. hoffmannii strains were also shared within another Portuguese household. These results highlight the importance of the household as an epidemiological unit in the efforts to mitigate the spread of antimicrobial resistance, further emphasizing the need for antimicrobial surveillance in this context, capable of producing data that can inform and evaluate public health actions.
Capturing biomarkers associated with Alzheimer disease subtypes using data distribution characteristics
Authors: Smith Kenneth , Climer Sharlee
Published: September 2024

Late-onset Alzheimer disease (AD) is a highly complex disease with multiple subtypes, as demonstrated by its disparate risk factors, pathological manifestations, and clinical traits. Discovery of biomarkers to diagnose specific AD subtypes is a key step towards understanding biological mechanisms underlying this enigmatic disease, generating candidate drug targets, and selecting participants for drug trials. Popular statistical methods for evaluating candidate biomarkers, fold change (FC) and area under the receiver operating characteristic curve (AUC), were designed for homogeneous data and we demonstrate the inherent weaknesses of these approaches when used to evaluate subtypes representing less than half of the diseased cases. We introduce a unique evaluation metric that is based on the distribution of the values, rather than the magnitude of the values, to identify analytes that are associated with a subset of the diseased cases, thereby revealing potential biomarkers for subtypes. Our approach, Bimodality Coefficient Difference (BCD), computes the difference between the degrees of bimodality for the cases and controls. We demonstrate the effectiveness of our approach with large-scale synthetic data trials containing nearly perfect subtypes. In order to reveal novel AD biomarkers for heterogeneous subtypes, we applied BCD to gene expression data for 8,650 genes for 176 AD cases and 187 controls. Our results confirm the utility of BCD for identifying subtypes of heterogeneous diseases.
Volition and control in law and in brain science: neurolegal translation of a foundational concept
Authors: Christensen Julia F. , Rödiger Caroline , Claydon Lisa , Haggard Patrick
Published: September 2024

The law assumes that healthy adults are generally responsible for their actions and have the ability to control their behavior based on rational and moral principles. This contrasts with some recent neuroscientific accounts of action control. Nevertheless, both law and neuroscience acknowledge that strong emotions including fear and anger may “trigger” loss of normal voluntary control over action. Thus, “Loss of Control” is a partial defense for murder under English law, paralleling similar defenses in other legal systems. Here we consider the neuroscientific evidence for such legal classifications of responsibility, particularly focussing on how emotional states modulate voluntary motor control and sense of agency. First, we investigate whether neuroscience could contribute an evidence-base for law in this area. Second, we consider the societal impact of some areas where legal thinking regarding responsibility for action diverges from neuroscientific evidence: should we be guided by normative legal traditions, or by modern understanding of brain functions? In addressing these objectives, we propose a translation exercise between neuroscientific and legal terms, which may assist future interdisciplinary research.
The role of ALDH2 rs671 polymorphism and C-reactive protein in the phenotypes of male ALS patients
Authors: Huang Lifang , Liu Mao , Tang Jiahui , Gong Zhenxiang , Li Zehui , Yang Yuan , Zhang Min
Published: September 2024

Background

The aldehyde dehydrogenase 2 (ALDH2) rs671 (A) allele has been implicated in neurodegeneration, potentially through oxidative and inflammatory pathways. The study aims to investigate the effects of the ALDH2 rs671 (A) allele and high sensitivity C-reactive protein (hs-CRP) on the clinical phenotypes of amyotrophic lateral sclerosis (ALS) in male and female patients.

Methods

Clinical data and ALDH2 rs671 genotype of 143 ALS patients, including 85 males and 58 females, were collected from January 2018 to December 2022. All patients underwent assessment using the Chinese version of the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). Complete blood count and metabolic profiles were measured. Clinical and laboratory parameters were compared between carriers and non-carriers of the rs671 (A) allele in males and females, respectively. The significant parameters and rs671 (A) Allele were included in multivariate linear regression models to identify potential contributors to motor and cognitive impairment. Mediation analysis was employed to evaluate any mediation effects.

Results

Male patients carrying rs671 (A) allele exhibited higher levels of hs-CRP than non-carriers (1.70 mg/L vs. 0.50 mg/L, p = 0.006). The rs671 (A) allele was identified as an independent risk factor for faster disease progression only in male patients (β = 0.274, 95% CI = 0.048−0.499, p = 0.018). The effect of the rs671 (A) allele on the executive function in male patients was fully mediated by hs-CRP (Indirect effect = −1.790, 95% CI = −4.555−−0.225). No effects of the rs671 (A) allele or hs-CRP were observed in female ALS patients. The effects of the ALDH2 rs671 (A) allele and the mediating role of hs-CRP in male patients remained significant in the sensitivity analyses.

Conclusion

The ALDH2 rs671 (A) allele contributed to faster disease progression and hs-CRP mediated cognitive impairment in male ALS patients.
Diagnostic accuracy of cytology and urine methylation test in patients with non-muscle invasive bladder cancer: a systematic review and meta-analysis
Authors: Yao Zhuoyue , Wang Tao , Liu Jingpeng , Zhou Zhongbao , Zhang Yong
Published: September 2024

Background

Multiple clinical studies have demonstrated the numerous advantages of urine methylation test over cytology for monitoring patients with non-muscle invasive bladder cancer (NMIBC) following surgery. This research aims to provide a systematic review and meta-analysis to evaluate the efficacy and limits of urine methylation test in the clinical management of NMIBC.

Methods

This research was carried out by conducting a comprehensive search of clinical trials comparing cytology and urine methylation test for NMIBC follow-up using databases such as PubMed, Embase, Web of Science, and the Cochrane Library up until May 2023, including references from relevant articles. The study is registered on PROSPERO with ID CRD42023398969.

Result

This study comprised six studies with a total of 1676 patients. The analysis revealed that the AUC of urine methylation test had a greater AUC than that of the cytology examination (0.89 vs 0.71). In post-operative follow-up of patients with NMIBC, the urine methylation test demonstrated a significant sensitivity (0.69 vs 0.52), but with lower specificity (0.87 vs 0.93) than cytology examination.

Conclusion

The urine methylation test and cytology examination have both shown strong diagnostic performance in screening for NMIBC patients. However, urine methylation test outperforms cytology examination in terms of accuracy and sensitivity.

Systematic review registration

PROSPERO, identifier CRD42023398969.
Artificial intelligence techniques in liver cancer
Authors: Wang Lulu , Fatemi Mostafa , Alizad Azra
Published: September 2024

Hepatocellular Carcinoma (HCC), the most common primary liver cancer, is a significant contributor to worldwide cancer-related deaths. Various medical imaging techniques, including computed tomography, magnetic resonance imaging, and ultrasound, play a crucial role in accurately evaluating HCC and formulating effective treatment plans. Artificial Intelligence (AI) technologies have demonstrated potential in supporting physicians by providing more accurate and consistent medical diagnoses. Recent advancements have led to the development of AI-based multi-modal prediction systems. These systems integrate medical imaging with other modalities, such as electronic health record reports and clinical parameters, to enhance the accuracy of predicting biological characteristics and prognosis, including those associated with HCC. These multi-modal prediction systems pave the way for predicting the response to transarterial chemoembolization and microvascular invasion treatments and can assist clinicians in identifying the optimal patients with HCC who could benefit from interventional therapy. This paper provides an overview of the latest AI-based medical imaging models developed for diagnosing and predicting HCC. It also explores the challenges and potential future directions related to the clinical application of AI techniques.
Impact of lung adenocarcinoma subtypes on survival and timing of brain metastases
Authors: Zhou Chuyan , Zhang Xiaofang , Yan Xingyu , Xie Haitao , Tan Hao , Song Yingqiu , Li Mo , Jin Yi , Wang Tianlu
Published: September 2024

Purpose

Lung cancer is a devastating disease, with brain metastasis being one of the most common distant metastases of lung adenocarcinoma. This study aimed to investigate the prognostic characteristics of individuals with brain metastases originating from invasive lung adenocarcinoma of distinct pathological subtypes, providing a reference for the management of these patients.

Methods

Clinical data from 156 patients with lung adenocarcinoma-derived brain metastases were collected, including age, sex, smoking status, Karnofsky Performance Status scores, pathological subtype, lymph node metastasis, tumor site, treatment mode, T stage, and N stage. Patients were classified into two groups (highly differentiated and poorly differentiated) based on their pathological subtypes. Propensity score matching was used to control for confounding factors. The prognostic value of pathological subtypes was assessed using Kaplan-Meier analysis and Cox proportional hazards regression modeling.

Results

Kaplan-Meier analysis indicated that patients in the moderately to highly differentiated group had better prognoses. Multivariate analysis revealed that being in the poorly differentiated group was a risk factor for poorer prognosis. Thoracic tumor radiation therapy, chemotherapy, and surgery positively influenced the time interval between lung cancer diagnosis and brain metastasis.

Conclusions

The pathological subtypes of lung adenocarcinoma-derived brain metastases are associated with patient prognosis. Patients in the poorly differentiated group have worse prognoses compared to those in the moderately to highly differentiated group. Therefore, patients in the poorly differentiated group may require more frequent follow-ups and aggressive treatment.
A predictive model for stunting among children under the age of three
Authors: Xiong Yuxiang , Hu Xuhuai , Cao Jindan , Shang Li , Niu Ben
Published: September 2024

Background

In light of the global effort to eradicate stunting in childhood, the objective of this research endeavor was to assess the prevalence of stunting and associated factors, simultaneously construct and validate a risk prediction model for stunting among children under the age of three in Shenzhen, China.

Methods

Using the stratified random sampling method, we selected 9,581 children under the age of three for research and analysis. The dataset underwent a random allocation into training and validation sets, adhering to a 8:2 split ratio. Within the training set, a combined approach of LASSO regression analysis and binary logistic regression analysis was implemented to identify and select the predictive variables for the model. Subsequently, model construction was conducted in the training set, encompassing model evaluation, visualization, and internal validation procedures. Finally, to assess the model's generalizability, external validation was performed using the validation set.

Results

A total of 684 (7.14%) had phenotypes of stunt. Utilizing a combined approach of LASSO regression and logistic regression, key predictors of stunting among children under three years of age were identified, including sex, age in months, mother's education, father's age, birth order, feeding patterns, delivery mode, average daily parent-child reading time, average time spent in child-parent interactions, and average daily outdoor time. These variables were subsequently employed to develop a comprehensive prediction model for childhood stunting. A nomogram model was constructed based on these factors, demonstrating excellent consistency and accuracy. Calibration curves validated the agreement between the nomogram predictions and actual observations. Furthermore, ROC and DCA analyses indicated the strong predictive performance of the nomograms.

Conclusions

The developed model for forecasting stunt risk, which integrates a spectrum of variables. This analytical framework presents actionable intelligence to medical professionals, laying down a foundational framework and a pivot for the conception and execution of preemptive strategies and therapeutic interventions.
Association between parental factors and child's behaviors during moderate sedation in pediatric dental care
Authors: Alanbari Mohamad A. , Hamdan Hebah M. , Bawazir Omar A. , Sulimany Ayman M.
Published: September 2024

Background/Aim

Managing young children with negative behaviors can be challenging in dental settings. Moderate sedation (MS) is often used as a treatment option for such children. However, children's behavior during MS may vary depending on several variables. These variables include parental factors, such as parental anxiety, coping strategies, and pain catastrophizing. However, this area, particularly in Saudi Arabia, remains underexplored. Therefore, this study aimed to assess the association among parental anxiety, coping style, pain catastrophizing, and children's behavior during MS among Saudi children.

Methods

Based on sample size calculation, this cross-sectional observational study included 85 children aged 3–5 years undergoing dental treatment under MS at King Saud University, Riyadh, Saudi Arabia. Parental anxiety, coping styles, and pain catastrophizing were assessed using the Modified Dental Anxiety Scale, Brief Coping Orientation to Problems Experienced Scale, and Pain Catastrophizing Scale. Child behavior was evaluated using the Houpt scale during sedation visits, which was video-recorded and independently analyzed by a single evaluator. Data were analyzed using Pearson's chi-squared test, Mann–Whitney U test, and stepwise multivariate logistic regression analyses.

Results

The results showed no significant association among parental dental anxiety, pain catastrophizing, and child behaviors during MS. Specific parental coping strategies, such as acceptance, were positively associated with positive sedation outcomes (P = 0.03), while active coping strategies were linked to less favorable outcomes (P = 0.03). Female children had higher sedation failure rates (P = 0.02), and the number of dental treatments was positively associated with success rates (P = 0.03).

Conclusion

Parental anxiety and pain catastrophizing did not significantly affect the success of sedation. However, acceptance as a coping strategy was significantly associated with sedation success in pediatric dental care under MS, whereas active coping strategies were associated with less favorable outcomes.
Early detection of N, P, K deficiency in Choy Sum using hyperspectral imaging-based spatial spectral feature mining
Authors: Teo Valerie Xinhui , Dhandapani Savitha , Ang Jie Randall , Philip Vidya Susan , Teo Ju Teng Mark , Zhang Shuyan , Park Bong Soo , Olivo Malini , Dinish U. S.
Published: September 2024

Leafy vegetables are widely consumed around the world for their rich nutritional qualities. To ensure a reliable and cost-effective supply of leafy vegetables in the future, advancements in their production are essential. Deficiencies of nitrogen (N), phosphorus (P), and potassium (K) impair growth of leafy vegetables and the ensuing visual symptoms make the plants unmarketable. We studied the use of non-contact large area hyperspectral imaging (HSI) for early detection of N, P and K deficiencies in the leafy vegetable, Choy Sum, before the appearance of visual symptoms. The wide spectral data of 500–900 nm extracted from the plants were subjected to advanced feature mining, facilitating the creation of novel spectral indices tailored to each vital nutrient by leveraging the Pearson’s correlations of 0.85 for N, 0.64 for P, and 0.68 for K with gold standard elemental concentration data. Early detection of deficiencies and timely replenishment of macronutrient(s) can prevent the development of obvious symptoms and thus maintain the visual quality of Choy Sum. These newly created spectral indices hold the potential to provide non-destructive estimation of nutrient content in plants, offering a promising avenue for future advancements in precision agriculture and resource-efficient crop management.
Hydrogen sulfide alleviates pericarp browning in lichi fruit by modulating energy and sugar metabolisms
Authors: Gao Zhaoyin , Zhao Kunkun , Zhang Zhengke , Nizamani Mir Muhammad , Li Songgang , Li Min , Gong Deqiang , Wang Jiabao , Hu Meijiao
Published: September 2024

Postharvest litchi is susceptible to browning that limits the development of litchi industry. Hydrogen sulfide (H2S) is an important bioactive molecule that can regulate many physiological processes. This study examined the effects of exogenous H2S on pericarp browning and related physiological mechanisms in postharvest litchi. The results exhibited that exogenous H2S treatment delayed the browning of litchi pericarp and reduced the damage to cell membrane integrity during storage. This treatment inhibited the energy losses of litchi fruit by increasing the activities of H+-ATPase, Ca2+- ATPase, cytochrome C oxidase (CCO) and succinate dehydrogenase (SDH) and regulating the expression of energy metabolism-related genes, including LcAtpB, LcSnRK2, LcAAC1, LcAOX1 and LcUCP1. In addition, H2S treatment increased the levels of fructose, glucose, sucrose, inositol, galactose and sorbose in litchi fruit, and promoted sucrose synthesis by regulating the activities of sucrose phosphate synthase (SPS), sucrose synthase (SS), acid invertase (AI) and neutral invertase (NI). Based on the current findings, we suggest that exogenous H2S enhances the energy supply and antioxidant activity of litchi by modulating energy and sugar metabolism, thereby inhibiting fruit browning and senescence. These results indicated that H2S treatment is an effective approach to maintaining the quality of litchi fruit and extending its shelf life.
Response of submerged macrophytes of different growth forms to multiple sediment remediation measures for hardened sediment
Authors: Chao Chuanxin , Chen Xiaorong , Wang Jie , Xie Yonghong
Published: September 2024

Climate change and intensified human activities have disrupted the natural hydrological regime and rhythm of river-connected lakes, extending the dry season, increasing water loss, and exposing previously submerged lake floors. This exposure has led to significant sediment hardening, which directly impacts submerged macrophytes. However, strategies to mitigate the negative effects of hardened sediments and promote the growth and development of submerged macrophytes remain largely unexplored. In this study, we selected typical hardened sediment from Dongting Lake to investigate the response of different growth forms of submerged macrophytes to multiple sediment remediation measures (loosening and litter addition) using a mesocosm experiment. The results indicated that loosening alone uniformly benefited all submerged macrophytes by increasing total biomass, relative growth rate (RGR), and the root/shoot ratio. Additionally, loosening altered the root traits of submerged macrophytes, promoting maximum root length (MRL) while reducing average root diameter (ARD). Moreover, different submerged macrophytes exhibited species-specific responses to the combination of loosening and litter addition. Notably, the combination of loosening and adding Miscanthus lutarioriparius litter had an antagonistic effect on the growth of Potamogeton wrightii and Myriophyllum spicatum. The response of functional traits of submerged macrophytes with similar growth forms to the same treatment was consistent. Our findings suggest that future sediment remediation efforts should consider matching specific treatments with the growth forms of submerged macrophytes to achieve optimal outcomes.
Theocratically bounded communal self-governance: a pre-modern solution for the modern world?
Authors: Rahimi Haroun
Published: September 2024

Shadi Hamid proposes “democratic minimalism” as a system and means of governing and rotating power with no prejudice to substantive ideological outcomes. Democratic minimalism is meant to decouple the question of actualizing an ideal society, even a liberal one that provides maximum freedom for the maximum groups of people, from the mechanism of transferring power between groups with opposing beliefs. I sympathize with Hamid’s arguments. Hamid, I believe, correctly identifies the tension between liberal democracy and Islam in the Muslim world in that Muslims if given the choice may not support liberal policies. He also, I think, rightly concludes that the way to live with this dilemma consists of preserving plurality and the possibility of change through persuasion and thoughtful contestation, and not autocratic leadership. However, I argue, he does not sufficiently problematize the nation-state in his analysis. Drawing on the Islamic tradition, I argue we can make progress in this regard by deconstructing the nation-state to make room for communal self-governance and moral heterodoxies.
The feasibility of occupational therapy using Zones of Regulation™ Concepts in an equine environment
Authors: Peters B. Caitlin , Gabriels Robin L. , Schmid Arlene A. , Pan Zhaoxing , Merritt Tamara , Hoffman Arielle , Hepburn Susan
Published: September 2024

Introduction

The current paper aimed to assess the feasibility of a modified intervention protocol named “Occupational Therapy using Zones of Regulation Concepts in an Equine Environment” (OT-ZOR Equine).

Methods

A single arm A-B feasibility study was conducted, involving 14 autistic youth ages 6-13 years who first received 10-weeks of occupational therapy without horses (OT-ZOR Clinic) followed by 10-weeks of OT-ZOR Equine.

Results

All participants completed the study and attended 95% of OT-ZOR Equine sessions. Occupational therapists maintained 91% fidelity to the OT-ZOR Equine intervention protocol and there were no serious adverse events. All participants’ caregivers and study occupational therapists rated being satisfied or very satisfied with the OT-ZOR Equine intervention. Youth demonstrated improved self-regulation following participation in the OT-ZOR Clinic and OT-ZOR Equine interventions. However, participants’ social functioning only improved after OT-ZOR Equine.

Discussion

This study demonstrated that OT-ZOR Equine is feasible to implement, acceptable to recipients and providers, and may offer additive benefits in social functioning compared to occupational therapy intervention without horses. The current study provides a foundation for future efficacy research aimed at quantifying additive benefits of integrating horses into occupational therapy for autistic youth.
Fracturing the affordance space: an account of digitalized alienation
Authors: Butler Michael
Published: September 2024

This paper investigates the lived experience of alienation as a form of mental strife or pathology as it is connected to the digitalization of modern life. To do so, I deploy the concept of affordances from ecological psychology, phenomenology, and embodied cognition. I propose an affordance-based model for understanding digitalized alienation. First, I argue that the lived sense of alienation is best understood as a fracturing of the affordance space, where possibilities for action are lived as disconnected from one another and therefore from one’s personal development and search for meaning. Using this model, I show how the process of digitalization can lead to a lived sense of alienation for modern subjects. On this model, digitalization is alienating insofar as it fractures the affordance space into disconnected fields that invite determinate, separate, and repeatable tasks—swiping, clicking, scrolling, etc.—rather than offering opportunities for the development of new cognitive and bodily skills that are mutually informing and enriching across different affordance fields.
The Chinese version of the tendency to stigmatize epidemic diseases scale: a translation and validation study
Authors: Wang Xin , Wang Yuecong , Ge Yuanhui , Liu Yuxiu , Niu Riyu , Guo Zhengxiang , Ge Dongfang
Published: September 2024

Objective

To translate the Tendency to Stigmatize Epidemics Diseases Scale (TSEDS) into Chinese and to evaluate its psychometric properties.

Methods

Translation and cross-cultural adaptation using the Brislin translation model, and pre-testing to form a Chinese version of TSEDS. A total of 434 adults participated in the study and the TSEDS were measured using the critical ratio method, Pearson correlation analysis, retest reliability, content validity, structural validity, and concurrent validity.

Results

The Chinese version of the TSEDS scale contains 27 items in 5 dimensions, including structural stigma, perceived stigma, organizational stigma, internalized stigma, and social stigma. The average content validity index of the scale was 0.975. The goodness of fit index (χ2/df= 1.981, RMSEA = 0.067, CFI= 0.930, IFI = 0.931, TLI = 0.922) indicated a good model fit. The Cronbach’s alpha coefficient was 0.962 and the dimensionality ranged from 0.882 to 0.928. The retest reliability was 0.912.

Conclusion

The Chinese version of TSEDS has good reliability and validity, which can be used to assess the epidemiological stigma tendency of Chinese adults.
Choosing the right treatment - combining clinicians’ expert knowledge with data-driven predictions
Authors: Maekawa Eduardo , Jensen Esben , van de Ven Pepijn , Mathiasen Kim
Published: September 2024

Context

This study proposes a Bayesian network model to aid mental health specialists making data-driven decisions on suitable treatments. The aim is to create a probabilistic machine learning model to assist psychologists in selecting the most suitable treatment for individuals for four potential mental disorders: Depression, Panic Disorder, Social Phobia, or Specific Phobia.

Methods

This study utilized a dataset from 1,094 individuals in Denmark containing socio-demographic details and mental health information. A Bayesian network was initially employed in a purely data-driven approach and was later refined with expert knowledge, referred to as a hybrid model. The model outputted probabilities for each disorder, with the highest probability indicating the most suitable disorder for treatment.

Results

By incorporating expert knowledge, the model demonstrated enhanced performance compared to a strictly data-driven approach. Specifically, it achieved an AUC score of 0.85 vs 0.80 on the test data. Furthermore, we evaluated some cases where the predictions of the model did not match the actual treatment. The symptom questionnaires indicated that these participants likely had comorbid disorders, with the actual treatment being proposed by the model with the second highest probability.

Conclusions

In 90.1% of cases, the hybrid model ranked the actual disorder treated as either the highest (67.3%) or second-highest (22.8%) on the test data. This emphasizes that instead of suggesting a single disorder to be treated, the model can offer the probabilities for multiple disorders. This allows individuals seeking treatment or their therapists to incorporate this information as an additional data-driven factor when collectively deciding on which treatment to prioritize.