bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness and safety of exenatide in the treatment of polycystic ovary syndrome: A systematic review and meta-analysis
Authors: Hu Yan , Song Xiangxin , Hamiti Shaila , Ma Yanyong , Yusufu Mainu , Zhang Kaidi , Guo Yanying , Wang Xing
Published: April 2023

Background
Polycystic ovary syndrome (PCOS) is the commonest cause of anovulatory infertility in women of childbearing age. Randomized controlled trials have reported that exenatide and metformin are effective in the treatment of PCOS. In this article, we aim to assess the effectiveness and safety of exenatide/exenatide + metformin in patients suffering from PCOS.
Methods
Randomized control trials (RCTs) of exenatide therapy were searched through electronic databases. Eligible studies were identified by two reviewers independently. Outcomes were analyzed through Revman 5.4.
Results
Nine RCTs of 96 studies on 1149 women with PCOS were included to be analyzed, and among the nine RCTs, eight studies compared exenatide with metformin. Our meta-analysis demonstrated that exenatide was more successfully tested in terms of pregnancy rate, menstrual frequency ratio (MFR), sex hormone binding globulin (SHBG), FSH. The reduction in total testosterone (TT), weight, BMI, waist circumference (WC), waist-hip ratio, fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR) were more significant after treatment with exenatide. In terms of safety, exenatide had a lower diarrhea rate, compared with metformin. In the other three studies, exenatide combined with metformin was compared with metformin. Exenatide combined metformin was more effective in improving SHBG, Matsuda index and reducing free androgen index (FAI), Weight and WC. There was no significant difference on other data.
Conclusions
Exenatide is more effective than metformin and has high safety for women with PCOS. Considering the evidence of effectiveness and safety, exenatide may be a better treatment method for women with PCOS.
Systematic Review Registration:
INPLASY https://inplasy.com/inplasy-protocols/ ID: 10.37766/inplasy2022.11.0055.
The Swedish Childhood Tumor Biobank: Systematic collection and molecular characterization of all pediatric CNS and other solid tumors in Sweden
Authors: de Ståhl Teresita Díaz , Shamikh Alia , Mayrhofer Markus , Juhos Szilvester , Basmaci Elisa , Prochazka Gabriela , Garcia Maxime , Somarajan Praveen Raj , Illies Christopher , Øra Ingrid , Siesjö Peter , Sandström Per-Erik , Stenman Jakob , Sabel Magnus , Gustavsson Bengt , Kogner Per , Pfeifer Susan , Zielinska-Chomej Katarzyna , Ljungman Gustaf , Sandgren Johanna , Nistér Monica
Published: April 2023

The Swedish Childhood Tumor Biobank (BTB) is a nonprofit national infrastructure for collecting tissue samples and genomic data from pediatric patients diagnosed with CNS and other solid tumors. The BTB is built on a multidisciplinary network established to provide the scientific community with standardized biospecimens and genomic data, thereby improving knowledge of the biology, treatment and outcome of childhood tumors. As of 2022, over 1100 fresh-frozen tumor samples are available for researchers. We present the workflow of the BTB from sample collection and processing to the generation of genomic data and services offered. To determine the research and clinical utility of the data, we performed bioinformatics analyses on next-generation sequencing (NGS) data obtained from a subset of 82 brain tumors and patient blood-derived DNA combined with methylation profiling to enhance the diagnostic accuracy and identified germline and somatic alterations with potential biological or clinical significance. The BTB procedures for collection, processing, sequencing, and bioinformatics deliver high-quality data. We observed that the findings could impact patient management by confirming or clarifying the diagnosis in 79 of the 82 tumors and detecting known or likely driver mutations in 68 of 79 patients. In addition to revealing known mutations in a broad spectrum of genes implicated in pediatric cancer, we discovered numerous alterations that may represent novel driver events and specific tumor entities. In summary, these examples reveal the power of NGS to identify a wide number of actionable gene alterations. Making the power of NGS available in healthcare is a challenging task requiring the integration of the work of clinical specialists and cancer biologists; this approach requires a dedicated infrastructure, as exemplified here by the BTB.
Effects of altitudes on secondary metabolite contents of Origanum majorana L.
Authors: Öner Emel Karaca , Yeşil Meryem
Published: April 2023

Altitude is an important ecological factor that significantly affects essential oil content, yield and composition. The Origanum majorana, belonging to Origanum genus of Lamiaceae family, is a species with antibacterial and antiviral effects, widely used as a spice and also used in folk medicine for treatment of diseases such as asthma, indigestion, headache and rheumatism. In this study, conducted to examine the effects of altitude on essential oil content and composition of origanum majorana, plant samples were collected from the southern region of Turkey at the beginning of flowering period from seven different altitudes (766 m, 890 m, 968 m, 1079 m, 1180 m, 1261 m and 1387 m) at 100 m intervals. The highest percentage of essential oil (6.50%) obtained by hydro-distillation was determined at 766 m altitudes. The GC-MS analyses revealed that low altitude affected some essential oil components positively. The linalool ratio, which is the major component of the essential oil of Origanum majorana species, was the highest at 766 m (79.84%) altitudes. Borneol (0.97%), linalool oxide (1.28%), trans-linalool oxide (1.47%), caryophyllene (2.78%), a- humulene (0.21%), germacrene-D (0.31%) and bicyclogermacrene (2.64%) components yielded high values at 890 m altitudes. Thymol (6.28%) and a-terpineol (1.04%), which have an important place in the essential oil composition, increased at 1180 m altitudes; a- terpinene (0.17%), cis-sabinene hydrate (0.82%), terpinene-4-ol (0.55%) and carvacrol (21.50%) increased at 1387 m altitudes.
KMT2D preferentially binds mRNAs of the genes it regulates, suggesting a role in RNA processing
Authors: Amin Harem Muhamad , Abukhairan Rawan , Szabo Beata , Schad Eva , Tantos Agnes
Published: April 2023

Histone lysine methyltransferases (HKMTs) perform vital roles in cellular life by controlling gene expression programs through the posttranslational modification of histone tails. Many of them are intimately involved in the development of different diseases, including several cancers, understanding the molecular mechanisms that control their target recognition and activity is therefore vital for the treatment and prevention of such conditions. RNA binding has been shown to be an important regulatory factor in the function of several HKMTs, such as the yeast Set1 and the human Ezh2. Moreover, many HKMTs are capable of RNA binding in the absence of a canonical RNA binding domain. Here, we explored the RNA binding capacity of KMT2D, one of the major H3K4 monomethyl transferases in enhancers, using RNA immunoprecipitation sequencing. We identified a broad range of coding and non-coding RNAs associated with KMT2D and confirmed their binding through RNA immunoprecipitation and quantitative PCR. We also showed that a separated RNA binding region within KMT2D is capable of binding a similar RNA pool, but differences in the binding specificity indicate the existence of other regulatory elements in the sequence of KMT2D. Analysis of the bound mRNAs revealed that KMT2D preferentially binds contranscriptionally to the mRNAs of the genes under its control, while also interacting with super enhancer- and splicing-related non-coding RNAs. These observations, together with the nuclear colocalization of KMT2D with differentially phosphorylated forms of RNA Polymerase II suggest a so far unexplored role of KMT2D in the RNA processing of the nascent transcripts. Overexpression of the RNA binding region with the polyQ region known to drive phase separation of KMT2D revealed that while RNA binding and phase separation are both necessary and sufficient to target KMT2D to super enhancer condensates, a fully functional protein is indispensable for the proper assembly and functioning of the transcription factory.
Expressed emotion and associated factors among care givers of schizophrenia patient attending mental health service in Dilla University Refferal Hospital, Dilla, Southern Ethiopia, 2022
Authors: Sime Yohanes , Mohammed Mubarak , Kebede Daniel , Kidane Mahder , Negash Misrak , Adamu Yayeh , Gashaw Anteneh
Published: April 2023

Background: Expressed emotion (EE) is an attitude, feeling, or behavior based on the emotional responses of the family caregiver in response to and reaction towards the ill family members. This concept has long been used to investigate the family environment of patients with mental disorders which reflects the extent to which family members close to a patient express critical comments, hostile and emotionally over-involved attitudes or warmth when talking about the patient. Given the paucity of research on this subject in Ethiopia and the area under study, it is important to evaluate caregivers of schizophrenic patients' expressed emotion and the elements that are related to it.
Objective: To assess prevalence of expressed emotion and associated factors among care givers of schizophrenic patient attending mental health service in DURH, Dilla, and southern Ethiopia.
Method and material: An institution-based cross-sectional study design was employed at DURH psychiatry clinic. Data was collected using face to face interview by interviewer administered questionnaire by using a mobile software epi.INFO version 7 and medical chart review was used to take the diagnosis of the patient and any comorbid disorder. Systematic random sampling was used to collect sample. The collected data was exported to SPSS version 22 for analysis, Bivariate and multivariable logistic regression analysis was conducted to identify associated factors of expressed emotion among caregivers of schizophrenic patient attending mental health service in DURH. The statistical significance was set at P-value <0.05.
Result: High expressed emotion was observed in 50.5% (43.1-57.4) of respondents. Caring for schizophrenic patients for about 6-8 years (AOR=3.5; 95%CI: 2.1-6.3), being female caregiver (AOR=1.2; 95%CL: 1.15-4.1), caregiver moderate to severe overload (AOR=2.0; 95%CI: 1.81-5.4) and 6-10 years total duration of illness (AOR=1.6; 95%CI: 1.42-3.9) were significantly associated with high expressed emotion.
Conclusion: Since the present study reported high level of EE in almost half family members, there is need for psychosocial nursing care for every family members of schizophrenia patient which will help them to effectively cope with the stress of managing the mentally ill family member at home.
Origins of Southern Ocean warm SST bias in CMIP6 models
Authors: Ying Jun , Fengyun Luo , Liu Tongya , Chen Dake
Published: April 2023

The robust warm sea surface temperature (SST) bias in the Southern Ocean (SO) has persisted in several generations of Coupled Model Inter-comparison Project (CMIP) models, yet the origins of such bias remain controversial. Here by using the latest released CMIP6 multi-models, we find that the common warm SST bias in the SO features a zonally oriented non-uniform pattern mainly located between the north and south fronts of the Antarctic Circumpolar Current. Such bias is supposed to be not caused by the biases in the surface heat flux and the strength of the Atlantic meridional overturning circulation (AMOC) —the two sources of the SO warm SST bias that have been revealed based on CMIP5 models. Instead, it could be linked to the robust common warm bias in the Northern Atlantic deep ocean through the AMOC transportation in an adiabatic process, even though there is no systematic bias in the strength of AMOC. Our findings highlight that comprehensively considering physically-connected remote biases might help to improve the SO warm SST bias in CMIP models.
Relationship between visceral and subcutaneous fat and bone health in American adults: a cross-sectional study
Authors: Lin Yanze , Zhong Xugang , Yao Wenchao , Wu Ruiji , Feng Fabo , Zhou Jinlei
Published: April 2023

Objective: The relationship between fat accumulation in visceral or subcutaneous tissue and bone mineral density (BMD) remains unclear. In this study, we aim to shed light on this relationship by examining a large, nationally representative population.
Methods: A weighted multiple linear regression model was established to evaluate the relationship between visceral fat, subcutaneous fat and BMD. Additionally, the potential nonlinear relationship was explored using smooth curve fitting method.
Results: A total of 10455 participants between the ages of 20 and 59 were included in this study. Various weighted multiple linear regression models revealed a negative correlation between lumbar BMD T-score and visceral mass index (VMI) and subcutaneous mass index (SMI). However, the association between VMI and lumbar BMD T-score was U-shaped when we did smooth curve fitting, and the inflection point of 0.304kg/m² was determined using a two-stage linear regression model.
Conclusions: Subcutaneous fat and BMD T-score were found to have a negative association, and visceral fat and BMD T-score were discovered to have a U-shaped connection. It is the significance of taking body composition and weight control into account while treating and preventing osteoporosis.
Cellulose nanofiber reinforced starch film with pH- responsive weakening and marine-degradability
Authors: Hamid Izzah Durrati Binti Haji Abdul , Soni Raghav , Hsu Yu-I , Uyama Hiroshi
Published: April 2023

Conventional marine-degradable plastics can remain in seawater for several years without losing their strength and stability, creating major environmental problems and threatening marine life. In this study, we prepared a cellulose nanofiber-reinforced starch film with pH-responsive weakening in seawater and marine-microbial degradability. The TEMPO-oxidized cellulose nanofiber (TCNF) was blended with hydroxypropyl starch (HPS) and di-aldehyde starch to develop a TCNF/modified starch film. pH-responsive swelling and weakening were performed in freshwater and seawater. Moreover, marine microbial degradability was evaluated in an artificial marine environment. TCNF/modified starch film rapidly loses up to 80 % of its strength in seawater and has higher marine microbial growth and degradability than TCNF film. The TCNF/HPS film demonstrates pH-responsive weakening with adequate microbial degradability. Therefore, it is a potential next-generation packaging material that can help address the problem of floating debris.
Socioeconomic Status, Reserve Capacity, and Depressive Symptoms Predict Pain in Rheumatoid Arthritis: An Examination of the Reserve Capacity Model
Authors: Azizoddin Desiree , Olmstead Richard , Anderson Kris-Ann , Hirz Alanna E. , Irwin Michael R. , Gholizadeh Shadi , Weisman Michael , Ishimori Mariko , Wallace Daniel , Nicassio Perry
Published: April 2023

Background
Guided by the reserve capacity model, we examined the roles of socioeconomic status (SES), reserve capacity, and negative emotions as determinants of pain in patients with Rheumatoid Arthritis (RA).
Methods
The study used cross-sectional baseline data from 106 adults in a clinical trial comparing behavioral treatments for RA. Structural equation modeling evaluated the direct effects of SES, reserve capacity (helplessness, self-efficacy, social support) and negative emotions (stress and depressive symptoms) on pain, and the indirect effects of SES as mediated by reserve capacity and negative emotions.
Results
Results showed that low SES contributed to greater pain, through lower reserve capacity and higher negative emotions. Mediational analyses showed that reserve capacity and negative emotions partially mediated the effect of SES on pain.
Conclusions
The findings indicate that interventions that target negative emotions in patients with low SES may facilitate better pain control with RA.
Trial registration
clinicaltrials.gov NCT00072657; 02/2004
Advanced scheduling algorithm for multi resource scheduling with minimum time consumption
Authors: Shakya Santosh Shakya Santosh , Tripathi Priyanka Tripathi Priyanka
Published: April 2023

The scheduling of appropriate resources for cloud workloads is a difficult task, as it depends on the quality of service needs of cloud applications. Due to their limited data storage and energy capabilities, IoT applications demand high-speed data transfer and low latency. Many IoT devices generate data continuously and want to store it on the cloud quickly and efficiently. Dynamic virtual machine (VM) allocation in cloud data centers (DCs) is taking advantage of the cloud computing paradigm. Each VM request is characterized by four parameters: CPU, RAM, disk, and bandwidth. Allocators are designed to accept as many VM requests as possible, considering the power consumption of the IoT device's network. Resource scheduling and time consumption is the two most significant problems in cloud computing. To overcome this problem, in this paper, the author has extended CloudSim with a multi-resource scheduling and minimum time consumption model that allows a more accurate valuation of time consumption in dynamic multi-resource scheduling. The author proposes a new scheduling algorithm advance scheduling algorithm(ASA), which provides a better solution to other scheduling algorithms like Ant Colony Optimization (ACO), Particle Swarm Optimization (PSO) and Artificial Bee Colony(ABC). also tries to reduce energy consumption and time to give a task to the VM.
Cold storage as part of a Varroa management strategy: Effects on honey bee colony performance, mite levels and stress biomarkers
Authors: Meikle William , Corby-Harris Vanessa , Ricigliano Vincent , Snyder Lucy , Weiss Milagra
Published: April 2023

Placing honey bee colonies in cold storage has been proposed as a way to induce a pause in brood production as part of a Varroa mite treatment plan. Here, we exposed colonies to combinations of with or without a late summer-early fall cold storage period and with or without a subsequent miticide application, and then measured the effects of those treatments on colony-level variables (i.e. colony size, Varroa density, and hive temperature) and pooled individual-level variables that are associated with nutritional and stress responses. Colonies were assessed before and after cold storage, and post winter, and the experiment was conducted twice. The cold storage plus miticide treatment strategy did not have a major impact on colony health. Cold storage did induce a brood pause: little brood was present after cold storage, and hive temperature data indicated that most or all brood had emerged after about two weeks. However, Varroa levels in February after treatments were not significantly affected by treatment, and we found comparatively few effects on either the colony or individual level because of the cold storage or miticide application. The two experiments were very different: rainfall, and bee forage availability, were much higher the second year, and colonies were over 2.5 times larger on average the second year compared to the first, both in terms of adult bee mass and brood area. Expression levels of nutrition and stress response genes were also significantly higher the second year. Colony survivorship from September to February was 42% the first year and 60% the second year. The results indicate that limited cold storage itself would likely have little impact on most colony- and individual measures of health, but for such a strategy to succeed levels of stressors, such as Varroa, may also need to be low.
Phenotypic And Genotypic Characterization of Extended Spectrum Beta- Lactamase-Producing Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in Two Kenyan Facilities: A National Referral and a Level Five Hospital
Authors: Maveke Sylvia M. , Aboge Gabriel O. , Kanja Laetitia W. , Mainga Alfred O. , Mureithi Naftaly G. , Muchira Beatrice W. , Moriasi Gervason A.
Published: April 2023

Background
The emergence of antimicrobial resistance (AMR) and multidrug resistance (MDR) among Escherichia coli and Klebsiella pneumoniae, especially through the production of extended spectrum β-lactamases (ESBLs), limits therapeutic options and poses a significant public health threat.
Objective
The aim of this study was to phenotypically and genotypically characterise the ESBL-associated AMR and MDR of Escherichia coli and Klebsiella pneumoniae isolates from patient samples in two Kenyan Hospitals.
Methods
We collected 138 E. coli and 127 K. pneumoniae isolates from various clinical specimens at the two health facilities from January 2020 to Feb 2021. ESBL production and antibiotic susceptibility of the isolates were phenotypically confirmed using a standard procedure. Molecular analysis was done through conventional Polymerase Chain Reaction (PCR) with appropriate primers for gadA, rpoB, blaTEM, blaSHV, blaOXA, blaCTX-M-group-1, blaCTX-M-group-2, blaCTX-M-group-9, and blaCTX-M-group-8/25 genes, sequencing and BLASTn analysis.
Results
Most E. coli (82.6%) and K. pneumoniae (92.9%) isolates were ESBL producers, with the highest resistance was against Ceftriaxone (69.6% among E. coli and 91.3% among K. pneumoniae) and Amoxicillin/clavulanic acid (70.9% among K. pneumoniae). The frequency of MDR was 39.9% among E. coli and 13.4% among K. pneumoniae isolates. The commonest MDR phenotypes among the E. coli isolates were CRO-FEB-AZM-LVX and CRO-AZM-LVX, while the FOX-CRO-AMC-MI-TGC-FM, FOX-CRO-FEP-AMC-TZP-AZM-LVX-MI, and CRO-AMC-TZP-AZM-MI were the most frequent among K. pneumoniae isolates. Notably, the FOX-CRO-FEP-AMC-TZP-AZM-LVX-MI phenotype was observed in both ESBL-positive and ESBL-negative K. pneumoniae isolates. The most frequent ESBL genes were blaTEM (42%), blaSHV (40.6%), and blaOXA (34.1%) among E. coli, and blaTEM (89%), blaSHV (82.7%), blaOXA (76.4%), and blaCTX−M−group−1 (72.5%) among K. pneumoniae isolates. The blaSHV and blaOXA, and blaTEM genotypes were predominantly associated with FOX-CRO-FEP-MEM and CRO-FEP MDR, and CRO AMR phenotypes, among E. coli isolates from Embu Level V (16.7%) and Kenyatta National Hospital (7.0%) respectively.
Conclusions
The high proportion of ESBL-producing E. coli and K. pneumoniae isolates increases the utilization of last-resort antibiotics, jeopardizing antimicrobial chemotherapy. Furthermore, the antimicrobial resistance patterns exhibited towards extended-spectrum cephalosporins, beta-lactam/beta-lactamase inhibitor combinations, fluoroquinolones, and macrolides show the risk of co-resistance associated with ESBL-producing isolates responsible for MDR.
Prediction of spontaneous circulation recovery in out-of-hospital cardiac arrest cardiopulmonary resuscitation patients using machine learning algorithms.
Authors: Chen Ying , Zhang Jiaqi , Li Wentao , Tian Jiangtao , Nie Yingjie , Li Ruiyue , Hao Meilin , zhang yingqi
Published: April 2023

Background: In this study, we develop a machine learning algorithm for the prediction of spontaneous circulation recovery in out-of-hospital cardiac arrest (OHCA) and cardiopulmonary resuscitation (CPR) patients. This will provide data support for the improvement of CPR success rates in OHCA patients.
Methods and Results: We identified 463 patients who had undergone CPR following OHCA between September 2018 and April 2022 from the emergency digital intelligence platform(EDIP).The study endpoint was ROSC,defined as the restoration of a palpable pulse and an autonomous cardiac rhythm lasting for at least 20 minutes after the completion or cessation of CPR.The data were preprocessed with Pandas in python,and the 14 variables with the highest accuracy were determined in combination with clinical characteristics. 75% of the samples were divided into training sets to build the model,and the data were trained and tested using four machine learning algorithms:Logistic regression, XGBClassifier, Gradient Boosting Trees, and Random forest. 25% of the samples were divided into test sets for verification, and the performance of the model was evaluated according to the accuracy,precision,recall,relative operating characteristic curve (ROC curve) of the subjects,and the appropriate model was selected for impact factor analysis. The area under the curve (AUC) values of the four learning models of Logical regression, Random forest, XGBClassifier and Gradient Boosting Trees are 0.73,0.87,0.90 and 0.86 respectively.Select the Random forest(accuracy 0.89, precision 0.90,recall 0.89,AUC 0.87) to calculate the importance of each characteristic value,we concluded that the main predictors of autonomic circulation recovery in OHCA patients are age,speed of CPR initiation,history of cardiopulmonary conditions,another person is present when cardiac arrest occurs,chest compressions and defibrillation.
Conclusions: Machine learning has the potential to predict the recovery of spontaneous circulation in OHCA patients treated with CPR. A Random Forest model was found to provide the most accurate predictions for this purpose. This can be used to provide data support and as a reference source to improve the success rate of CPR.
Predictive Value of monocyte to HCL-C ratio for Coronary Artery Lesion and Intravenous Immunoglobulin Resistance in Kawasaki Disease
Authors: Wang Jia-Ran , Zhao Hai-Zhao , Chang Lu-Jie , Xu Xue , Gao Yuan , Li Meng , Kong Qing-Yu , Wang Min-Min , Zhao Cui-Fen
Published: April 2023

Purpose
We aimed to investigate the predictive validity of monocyte to high-density lipoprotein cholesterol ratio (MHR) for coronary artery lesions (CALs) and intravenous immunoglobulin (IVIG) resistance in Kawasaki disease (KD).
Methods
MHR values of a total of 207 KD patients were calculated and analyzed with regard to their clinical characteristics and outcomes. We compared the differences in clinical data and laboratory parameters between CAL + group and CAL- group as well as between IVIG-resistant group and IVIG-responsive group. Spearman correlation analysis was applied to evaluate the correlation between C-reactive protein (CRP) and MHR. Multivariate logistic regression was used to identify risk factors of CALs and IVIG resistance. Receiver operating characteristic (ROC) curve analysis was chosen to determine the optimal cutoff value of MHR and its validity in predicting CALs and IVIG resistance.
Results
The MHR level was significantly higher in CAL + group, with cut-off value of 1.30 g/L, yielding sensitivity of 0.753 and specificity of 0.805, as well as in IVIG-resistant group, with cut-off value of 1.03 g/L, yielding sensitivity of 0.97 and specificity of 0.485. Multivariate logistic regression showed that MHR was an independent risk factor for CALs but not for IVIG resistance. According to the Spearman correlation analysis, CRP was positively correlated with the MHR.
Conclusions
As a practical, cost-effective inflammatory biomarker, MHR has a significantly predictive value in KD children complicated with CALs and IVIG-resistance. Paying more attention to the changes of MHR in KD children may contribute to better understanding of KD development and prognosis in clinical practice.
Development, Implementation, and Usability Evaluation of a Chatbot to Effectively Provide Information on the Human Papillomavirus Vaccine
Authors: Alzughaibi Saleh , Luo Jake , Nazareth Derek , Wu Min , Fink Jennifer T.
Published: April 2023

The Human papillomavirus (HPV) vaccine has been shown to provide protection against HPV infections, which can cause genital warts and some forms of cancer. Lack of information about the virus and the vaccine represents one of the major challenges to reaching national HPV vaccination goals. Advancements in natural language processing have facilitated the effectiveness of chatbots in interacting with users. Chatbots have been increasingly employed in health and medical care settings, assisting physicians during consultations, helping with behavior change issues, and supporting patients and the elderly in their daily lives. A potential opportunity to improve vaccination rates is to provide health information through unconventional methods by utilizing chatbots. This work describes the design, implementation, and evaluation of a chatbot called GARDI, created to disseminate information about HPV infection and vaccine. The Chatbot Usability Questionnaire (CUQ) was employed to evaluate GARDI. The mean CUQ score was 66.6, which is marginally below the suggested benchmark for evaluation of chatbots. An examination of CUQ subscales indicated that GARDI was considered to be easy to use and navigate, provided useful, appropriate, and informative responses, and welcoming in nature.
Liposome doxorubicin attenuates cardiotoxicity by reducing ferritinophagy
Authors: Yu Yating , Niu Haiyue , Zhang Mengying , Liu Mengyuan , Zhang Yue , Yang Jinyue , Liu Yumei , Xing Limin , Shao Zonghong , Fu Rong , Wang Huaquan
Published: April 2023

Background
Doxorubicin (DOX) is widely used in lymphoma, myeloma, breast cancer, and other malignant tumors, and it significantly improves the prognosis of these patients. However, its side effects, especially cardiotoxicity, must be taken seriously. Studies have shown that liposome doxorubicin (L-DOX), compared with DOX, has increased anti-tumor activity and decreased cardiac toxicity. Our aim is to investigate the mechanism of myocardial injury in mice caused by these two drugs, to identify potential mitigation strategies.
Methods
In this study, mice or HL-1 cells were treated with DOX or L-DOX, and the cardiac morphology, hemodynamic effect, laboratory examination, and expression of ferritinophagy-related proteins were compared with the control group.
Results
DOX significantly induced myocardial cell death, while L-DOX had little effect on myocardial injury. Additionally, DOX significantly increased the level of autophagy and ferroptosis in cardiac myocytes. Further analysis revealed that NCOA4-mediated ferritinophagy played a key role in the mechanism of doxorubicin-induced cardiotoxicity (DIC). Importantly, the addition of ferrostatin-1 (a ferroptosis inhibitor) was able to rescue DIC. In contrast, L-DOX reduced the damage to cardiac myocytes by reducing ferritinophagy.
Conclusion
We have found that a significant relationship between the mechanism of DIC and NCOA4-mediated ferritinophagy. L-DOX has been shown to reduce the damage to myocardial cells by reducing NCOA4-mediated ferritinophagy. Thus, NCOA4 has the potential to be a drug target for the cardiac protection of DIC. However, further research is need to investigate the specific role of NCOA4 in the pathogenesis of DIC.
Seascape connectivity: ontogenetic migration model for Haemulon flavolineatum
Authors: Rodriguez-Torres Carolina , Acosta Alberto
Published: April 2023

In the seascape, species migrate between ecosystems to complete their life cycles, such ontogenetic migrations create functional connections between ecosystems. Nevertheless, the scarcity of information on patch distribution, species life history and ecology limit its application in MPA management. We use a potential connectivity model approach to predict how Haemulon flavolineatum might move through a complex and diverse seascape, by simulating part of its life cycle among three ecosystems (reef, mangrove, and seagrass) in the MPA of Bahía Portete-Kaurrele (BPK). We used available ecosystem cover maps to conduct habitat fragmentation analyses and evaluate structural connectivity in BPK (PLAND, LPI, AREA, ENN, NP, SHAPE, CONTAG and IJI indices). With published information on H. flavolineatum home range and its ontogenetic migration distances, we estimated the potential functional connectivity (CONNECT and migration distances) between ecosystems by building bipartite graphs. Patches of different ecosystems were highly intermixed (76%) rather than grouped (58%) reflecting appropriate structural connectivity; particularly for reefs followed by mangrove and seagrass; this seascape promote the potential migration of stage 5, juveniles from mangroves to the reefs (328 links, mainly in the BPK’s southern zone). Meanwhile, the structural configuration could reduce functional connectivity of stage 4 juveniles from seagrass to mangrove (mainly in the northern and central zone; 94 and 49 links respectively). Our model is a novel methodological approach for marine species with ontogenetic migration, which integrates ecological information and the seascape to predict their life cycle. We discuss the need for ecological information of French grunts to validate future models.
Troubleshooting Design of the Drainage Pipe Treatment Project of the Higher Education Expo Park in Ouhai District, Wenzhou City
Authors: Bai Fang , Hai-zhong Yu , Ran-mao Hu
Published: April 2023

Taking the Higher Education Expo Park in Ouhai District, Wenzhou City as an example, this paper introduced the troubleshooting and design process of the drainage pipe treatment project (non-direct sewage discharge project) for residential areas. The analysis of troubleshooting results, project design ideas and specific design methods were also described in detail. Through the analysis on COD sampling results before and after transformation of the project, the project had achieved a very good rain-sewage diversion effect and the design purpose. It had been proved that the combination of troubleshooting and design was an effective mode for the drainage pipeline treatment projects.
Machine Learning Applications for Early Detection of Esophageal Cancer: A Systematic Review
Authors: Hosseini Farhang , Asadi Farkhondeh , Emami Hassan , Ebnali Mahdi
Published: April 2023

Introduction: Esophageal cancer (EC) is a significant global health problem, with an estimated 7th highest incidence and 6th highest mortality rate. Timely diagnosis and treatment are critical for improving patients' outcomes, as over 40% of patients with EC are diagnosed after metastasis. Recent advances in machine learning (ML) techniques, particularly in computer vision, have demonstrated promising applications in medical image processing, assisting clinicians in making more accurate and faster diagnostic decisions. Given the significance of early detection of EC, this systematic review aims to summarize and discuss the current state of research on ML-based methods for the early detection of EC.
Methods: We conducted a comprehensive systematic search of five databases (PubMed, Scopus, Web of Science, Wiley, and IEEE) using search terms such as "ML", "Deep Learning (DL(", "Neural Networks (NN)", "Esophagus”, “EC" and “Early Detection”. After applying inclusion and exclusion criteria, 31 articles were retained for full review.
Results: The results of this review highlight the potential of ML-based methods in the early detection of EC. The average accuracy of the reviewed methods in the analysis of endoscopic and computed tomography (CT (images of the esophagus was over 89%, indicating a high impact on early detection of EC. Additionally, the highest percentage of clinical images used in the early detection of EC with the use of ML was related to white light imaging (WLI) images. Among all ML techniques, methods based on convolutional neural networks (CNN) achieved higher accuracy and sensitivity in the early detection of EC compared to other methods.
Conclusion: Our findings suggest that ML methods may improve accuracy in the early detection of EC, potentially supporting radiologists, endoscopists, and pathologists in diagnosis and treatment planning. However, the current literature is limited, and more studies are needed to investigate the clinical applications of these methods in early detection of EC. Furthermore, many studies suffer from class imbalance and biases, highlighting the need for validation of detection algorithms across organizations in longitudinal studies.
Frequent Upregulation Of HER2 Protein In Hormone Receptor-Positive HER2-Negative Breast Cancer After Short-Term Neoadjuvant Endocrine Therapy
Authors: Chaudhary Lubna Naaz , Jorns Julie , Sun Yunguang , Cheng Yee Chung , Kamaraju Sailaja , Burfeind John , Gonyo MaryBeth , Kong Amanda , Patten Caitlin , Yen Tina , Cortina Chandler , Carson Ebony , Johnson Nedra , Bergom Carmen , Tsaih Shirng-Wern , Banerjee Anjishnu , Wang Yu , Chervoneva Inna , Weil Elizabeth , Chitambar Christopher R , Rui Hallgeir
Published: April 2023

Background. Endocrine resistant metastatic disease develops in ~20-25% of hormone-receptor positive (HR+) breast cancer (BC) patients despite endocrine therapy (ET) use. Upregulation of HER family receptor tyrosine kinases (RTKs) represent escape mechanisms in response to ET in some HR+ tumors. Short-term neoadjuvant ET (NET) offers the opportunity to identify early endocrine escape mechanisms initiated in individual tumors.
Methods. This was a single arm, interventional phase II clinical trial evaluating 4 weeks (+/-1 week) of NET in patients with early-stage HR+/HER2-negative (HER2-) BC. The primary objective was to assess NET-induced changes in HER1-4 proteins by immunohistochemistry (IHC) score. Protein upregulation was defined as an increase of ≥1 in IHC score following NET.
Results. Thirty-seven patients with cT1-T3, cN0, HR+/HER2- BC were enrolled. In 35 patients with evaluable tumor HER protein after NET, HER2 was upregulated in 48.6% (17/35; p=0.025), with HER2-positive status (IHC 3+ or FISH-amplified) detected in three patients at surgery, who were recommended adjuvant trastuzumab-based therapy. Downregulation of HER3 and/or HER4 protein was detected in 54.2% of tumors, whereas HER1 protein remained low and unchanged in all cases. While no significant volumetric reduction was detected radiographically after short-term NET, significant reduction in tumor proliferation rates were observed. No significant associations were identified between any clinicopathologic covariates and changes in HER1-4 protein expression on multivariable analysis.
Conclusion. Short-term NET frequently and preferentially upregulates HER2 over other HER-family RTKs in early-stage HR+/HER2- BC and may be a promising strategy to identify tumors that utilize HER2 as an early endocrine escape pathway.
Trial registration number: NCT03219476
Date of registration for prospectively registered trials: July 17, 2017
Difference in the cumulative incidence of aneurysmal occlusion by Flow Re-direction Endoluminal Device and Pipeline Embolization Device in the treatment of unruptured internal carotid artery aneurysms: A propensity score-matched cohort study
Authors: Matsukawa Hidetoshi , Uchida Kazutaka , Rajbhandari Saujanya , Shirakawa Manabu , Yoshimura Shinichi
Published: April 2023

Object:The introduction of flow diverters (FDs) has represented a paradigm shift in the management of unruptured cerebral aneurysms (UCA). Flow Re-Direction Endoluminal Devices (FREDs) and Pipeline Embolization Devices (PEDs) have gained widespread popularity. We aimed to investigate the cumulative incidence of aneurysm occlusion.Methods:A total of 195 patients with 199 UCAs were analyzed retrospectively. The outcomes were aneurysmal occlusion during the follow-up, a modified Rankin Scale score of 0–2 at 90-day, additional treatment, and major stroke, and steno-occlusive events of FD. Propensity score-matched analysis was performed controlling for age, sex, aneurysmal size, and location of internal carotid artery (ICA) aneurysm. Non-ICA aneurysms were excluded from matching.Results:During the follow-up period (median, 366 days), complete and satisfactory aneurysmal occlusions were observed in 128 (68%) and 148 (78%) of 189 UCAs in unmatched cohort. The 142 (71 each) propensity score-matched cohort was complied. The FRED group had a higher cumulative incidence of ICA aneurysm occlusion (complete: HR 2.7, 95% CI 1.4–5.1, p=0.0025; satisfactory: HR 2.4, 95% CI 1.1–5.2, p=0.025). Proportion of additional treatment was significantly smaller in the FRED group (OR 0.077, 95% CI 0.010-0.57, p=0.0007). Other outcomes showed no significant differences.Conclusion:Propensity score-matched analysis showed that FRED had a higher cumulative incidence of aneurysmal occlusion in the treatment of unruptured ICA aneurysms. Whether a cumulative incidence of aneurysmal occlusion may differ by the type of FDs warrants further investigation.
Approximations of Parallel Surfaces Along Curves
Authors: Köse Büşra , Yaylı Yusuf
Published: April 2023

In this paper, we study developable surfaces which are flat and normal approximation of parallel surfaces along curves associated with three special vector fields. We investigate singularities of such developable surfaces. We show that under what conditions the approach surfaces are parallel. Also, we show that the approach surfaces are constant angle ruled surfaces if the curves selected on the surfaces are isophote, relatively normal-slant helix and helix.
Mathematics Subject Classification (2010). Primary 53Axx; Secondary 57R45.
Enforcement of environmental protection protocols and compliance amongst Micro Small and Medium Enterprises inZimbabwe: Is institutional credibility effectual in the presence of corruption tendencies?
Authors: Kairiza Terrence , Chigusiwa Lloyd , Kavu Ambrose , Sonobe Tetsushi
Published: April 2023

There are growing concerns surrounding the environmental degradation that is caused by the operations of the expanding Micro, Small, and Medium Enterprises (MSMEs) engaged in manufacturing activities in developing countries. This is more so given the weak regulatory environments and low levels of institutional trust amongst entrepreneurs in a context where the potential to bribe environmental enforcement agents is rife as in a sizeable number of developing countries. We investigate the efficacy of regulatory inspections in inducing compliance with environmental protection standards and the heterogeneity that is brought about by institutional trust and corruption based on a nationally representative survey of MSMEs engaged in manufacturing activities in Zimbabwe. We deal with the problem of the endogeneity of regulatory inspections by using the doubly robust Inverse Probability Weighted Regression Adjusting method. We offer four major findings: First, regulatory inspections induce MSMEs’ compliance with environmental protection standards. Second, the impact of regulatory inspections on compliance with environmental protection standards is higher when MSMEs’ owners trust the regulatory institutions than when they do not. Third, regardless of the level of trust in institutions by entrepreneurs, the potential for entrepreneurs to bribe the regulatory agency officers subdues the potency of regulatory inspections in inducing compliance with environmental protection standards. Finally, in the absence of trust in the institutions by entrepreneurs, regulatory inspections on environmental protection standards have no statistically significant effect on compliance for corrupt entrepreneurs.
JEL: D22; K32; L51; Q56; Q58
Efficacy of using Maryland forceps versus electrocoagulation hooks in da Vinci robot-assisted thoracoscopic mediastinal tumor resection
Authors: Hong Ziqiang , Bai Xiangdou , Sheng Yannan , Cui Baiqiang , Lu Yingjie , Cheng Tao , Wu Xusheng , Jin Dacheng , Gou Yunjiu , Zhao Jing
Published: April 2023

Background To compare the difference of short-term curative effect between the use of Maryland forceps (MF) and electrocoagulation hooks (EH) in da Vinci robot-assisted thoracoscopic mediastinal tumor resection. Methods Analyze retrospectively 84 patients with mediastinal tumors treated with robot-assisted thoracoscopic surgery (RATS) at the Department of Thoracic Surgery of Gansu Provincial Hospital from February 2019 to February 2023. Two groups were divided according to the intraoperative use of energy devices, including 41 cases in the MF group and 43 cases in the EH group. Perioperative clinical data were collected to compare the recent outcomes of patients in both groups. Results There were no statistically significant differences between the two groups in terms of baseline indicators such as sex, age, and tumor size. Compared with the EH group, patients in the MF group have lower operative time, intraoperative bleeding, postoperative hospital stay and the levels of IL-6, IL-8, TNF-α, and cortisol were lower in the MF group than that in the EH patients, with statistically significant differences (P < 0.05). Conclusion RATS for mediastinal tumors using MF is safe and effective, which can reduce the amount of bleeding and reduce the degree of inflammatory reaction.
Epidemic trends of dyslipidemia in young adults: a real-world study including more than 20,000 samples
Authors: Liu Liang-Yu , Zheng Ying-Ying , Aimaiti Xiyidan , Zhi Xiao-Yu , Wang Zhi-Long , Yin Xin , Pan Ying , Wu Ting-Ting , Xie Xiang
Published: April 2023

Background
There is an urgent need to learn more about the epidemiological features of dyslipidemia in youth, in order to address the high burden of cardiovascular disease.
Methods
This experiment was an observational, cross-sectional study. The samples were collected from 22,379 college students in Xinjiang Medical University.
Result
The overall prevalence of dyslipidemia was 13.17%, significantly higher in men (23%) than in women (7.2%). Similarly, the proportion of obesity in men (32.6%) was significantly higher than that in women (24.1%). The composition of blood lipids, such as triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) began to increase gradually from the age of 22 and showed a sharp increase after the age of 30, however a reverse trend was presents in high density lipoprotein cholesterol (HDL-C). In terms of the proportion of dyslipidemia in both men and women, low HDL-C accounted for the largest proportion (74%), followed by TG (14.5%). The overall distribution of the incidence of dyslipidemia, so as to the ratios of low HDL-C and excess weight showed a U-shaped trend with age growing, which presents the lowest in the 20–24 age group.
Conclusion
Our study confirmed the crucial role of low HDL-C to dyslipidemia and reveal the U-shaped trend of obesity and dyslipidemia in young adults. Based on our results, we suggest age 22 to be the key time node for early intervention. This study enriches the limited data available on dyslipidemia and provides a reference for close monitoring and control of risk factors to reduce the occurrence and progression of atherosclerotic cardiovascular disease event.
ADAMTS12 mediates vascular abnormality to enhance chemoresistance via the MAPK/VEGF signaling pathway in gastric cancer
Authors: Jiang Yingming , Huang Jintuan , Huang Zhenze , Tan Rongchang , Li Tuoyang , Chen Zijian , Tang Xiaocheng , Zhao Yandong , Qiu Jun , Li Chujun , Chen Hao , Yang Zuli
Published: April 2023

Purpose: A disintegrin and metalloproteinase with thrombospondin motifs 12 (ADAMTS12) is involved in the angiogenesis and tumorigenesis of gastrointestinal cancer. However, the exact molecular and biological mechanisms of ADAMTS12 in gastric cancer (GC) remain unclear. This study aims to explore the exact underlying mechanisms of ADAMTS12 and provide a biomarker for prognosis and chemotherapy in GC.
Methods: Gain- and loss-of-function assays were used to reveal the effect of ADAMTS12 on cell proliferation, migration, invasion, tube formation and chemoresistance in vitro and in vivo. IHC was used to analyze the expression and the correlation between ADAMTS12, VEGF and CD31 in gastric cancer tissues with or without neoadjuvant chemotheraphy.
Results: ADAMTS12 promotes cell proliferation, angiogenesis and chemoresistance in vitro and in vivo. ADAMTS12 upregulates VEGF expression through ERK activation, which in turn, promoting angiogenesis and reducing sensitivity to oxaliplatin in GC. In GC tissues, ADAMTS12 was positively correlated with VEGF and microvessel density (MVD). Furthermore, patients with high ADAMTS12 level had poor overall survival (OS) and poor response to neoadjuvant chemotherapy.
Conclusion: ADAMTS12 enhances chemoresistance to oxaliplatin in normoxic and hypoxic microenvironments via the MAPK/VEGF signaling pathway in GC. High ADAMTS12 levels have prognostic significance for poor survival, and indicator of vascular abnormality and chemoresistance in GC.