bluuebunny/crossref_metadata_2025 huggingface dataset:
DESIGNING WEB-BASED LEARNING TO ENHANCE STUDENTS' HIGHER ORDER THINKING SKILLS (HOTS)
Authors: Handayani Sri , Suryana Nana , Adeliani Cindy Sri Meidina
Published: September 2024

The application of e-learning as a form of cyber teaching in learning practices is regarded as no longer a new term, however, it has become a strong demand for learning practitioners to result a competitive output. The research was focused on the enhancing students’ reading skill in the level of higher order thiking skills through exploring in depth the implementation of website-based learning media in literacy-based courses considered as one of the courses required to apply internet and information-based technology, provide a more interesting and broad experience with an easily accessible media, and fun learning material and practices. The activities of designing and formulating web-based media learning process of Reading for Academic Purposes course in one private university were explored as the main data of the research. The finds indicated that five main phases in designing and formulating the web-based learning media in Reading for Academic Purposes course had to be developed. Student learning activities for higher order thinking skills were emphasized on the learning activities at the level of analyzing, evaluating, and creating with the context of applying case studies in the daily life. Developing critical questions in reading response activities, then were developed to create students’ critical thinking skills. Web-based learning media got the positive response from the students. Seen from the terms of responses of Perceived Usefulness, Perceived Ease of Use, and attitude.
PRAGMATICS ANALYSIS OF DIRECTIVE ILLOCUTIONARY ACTS IN SPIDER-MAN: NO WAY HOME MOVIE
Authors: Insyra Zelika Salsabila , Supri Ida Zuraida
Published: September 2024

This research entitled "Pragmatic Analysis of Directive Illocutionary Acts in Spider-Man: No Way Home Movie" aims to (1) identify the types of directive illocutionary acts and (2) find out the form of utterance contained in the dialogue. In this study, the theory of types of directive illocutionary acts according to Bach and Harnish (1979) and the forms of utterance of speech acts according to Parker (1994) are used. This research uses qualitative-descriptive method with the following research steps: determining the topic, conducting preliminary research, formulating problems, determining research methods, collecting, classifying, and analyzing data, and drawing conclusions and suggestions. The results of the research show that (1) from 53 data found in the movie Spider-Man: No Way Home, there are five types of directive illocutionary acts found with the following details: 24 data are requestives, 20 data are requirements, 5 data are advisories, 3 data are prohibitives, and 1 data is questions. There are no directive illocutionary acts expressing permissives found. (2) Regarding the form of utterance, 35 data are delivered directly, and 18 data are delivered indirectly. This research concludes that the directive illocutionary acts in the movie "Spider-Man: No Way Home" are dominated by requestives. While the most dominant form of utterance is conveyed directly.
Radio-Ecological Situation in the Area of the Settlement of Narta (Kalmykia)
Authors:   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Titov A.V. , Belskikh Iu.S. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Isaev D.V. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Shandala N.K. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Doroneva T.A. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Krotkova Iu.V. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Semenova M.P. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Shitova A.A. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, Filonova A.A. ,   A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia
Published: September 2024

Purpose: To assess radio-ecological situation in the settlement of Narta and estimate current public doses. Material and methods: To measure the ambient dose equivalent rate (ADER), the pedestrian gamma survey method was used using a portable spectrometric complex MKS-01A “Multirad-M” and dosimeter-radiometer MKS- AT6101c. To measure the ADER in courtyards and indoors, a gamma radiation dosimeter DKG-02U “Arbiter” was used. The activity of gamma-emitting radionuclides in soil samples was measured using a stationary gamma spectrometer from CANBERRA. The activities of 210Po and 210Pb were measured using a radiometric installation UMF-2000 following their radiochemical separation from samples. Volumetric activity (VA) and equilibrium equivalent volumetric activity (EEVA) of radon were measured with an aerosol alpha radiometer for radon and thoron RAA-20P2 “Poisk”, REI-4 cameras with film track detectors of the TRACK-REI 1M set (Russia) and an integrated radon radiometer «Radon Scout PLUS». Public dose assessment was carried out in accordance with a guidelines MU 2.6.1.1088-02. Results: The average value of the ADER on the territory of the settlement is 0.10±0.01 µSv/h, and in the premises this value is 0.10±0.02 µSv/h. Average annual values of radon VA in dwellings range from 27 to 330 Bq/m3 (average value is 110 Bq/m3, median is 97 Bq/m3). Average annual individual effective radiation doses to the population from all natural factors range from 2.5 to 13 mSv, with an average value of 5.4 and a median of 4.9 mSv. Conclusions: The radio-ecological situation is the settlement of Narta does not differ from that in the background settlement – the village of Uldyuchiny. The average annual values of EEVA in dwellings and offices of the settlement do not exceed the permissible level for the operating buildings of 200 Bq/m3. The annual individual effective public dose in the village of Narta is higher than the average value for Kalmykia (3.4 mSv) due to increased dose values from the inhalation intake of radon and its daughter radionuclides in the premises.
Asuhan Keperawatan Keluarga dengan Pasien Pascastoke Menggunakan Pendekatan Model Adaptasi Roy: Studi Kasus
Authors: Khaerunnisa Milda , Sumarni Nina , Mulya Adelse Prima
Published: September 2024

Stroke merupakan salah satu penyakit yang menyebabkan kecacatan sehingga memerlukan waktu yang lama dalam proses rehabilitasinya. Keluarga memiliki peranan yang penting dalam merawat pasien dengan stroke. Untuk itu, keluarga maupun pasien perlu beradaptasi dengan penyakitnya. Salah satu model keperawatan yang membahas mengenai proses adaptasi adalah model keperawatan Roy yang dikenal dengan “model adaptif”. Tujuan dari penelitian ini adalah untuk mengetahui bagaimana pelaksanaan asuhan keperawatan keluarga dengan model adaptasi roy pada pasien stroke. Metode yang digunakan adalah studi kasus. Subjek dari penelitian ini yaitu keluarga yang salah satu anggotanya memiliki permasalahan kesehatan pasca stroke. Pengkajian hingga evaluasi berfokus pada empat mode adaptasi roy  (fisiologis, konsep diri, fungsi dan peran serta interdependensi). Masalah keperawatan yang diambil adalah gangguan mobilitas fisik dan manajemen kesehatan tidak efektif. Intervensi yang diberikan berupa edukasi, ROM serta mengikutsertakan klien dalam memenuhi kebutuhan dasarnya sendiri. Hasil menunjukan bahwa terjadi perilaku adaptif pada klien maupun keluarga setelah dilakukan implementasi sebanyak 10x pertemuan dimana terjadi peningkatan pengetahuan, kekuatan otot, tingkat kemandirian klien serta penurunan tekanan darah. Kesimpulan dari penelitian ini bahwa pelaksanaan model adaptasi roy dapat membawa perubahan adaptasi yang positif pada klien dan keluarga. Maka dari itu, penerapan model adaptasi roy dapat menjadi salah satu acuan perawat dan keluarga dalam membantu proses rehabilitasi pasien pasca stroke.
Tampão apical com cimento biocerâmico no tratamento de dentes com rizogênse incompleta: Relato de caso
Authors: Dias Lívia Corrêa , Victorino Maria Luiza Zamparoni , Rodrigues Beatriz Magalhães , Pereira Miguel Angelo , Silva Sara Goubetti , Campanelli Anna Julia Santiago , Almeida Gabriela Camarotto de , Camargo José Alexandre Felix de , Fokkema Nicole Catherine Goltz , Merlin Ana Gabrieli , Lima Danielle Pereira , Santos Denise Eduarda Marques dos , Cavasin Iara Liz Spoladore , Ogera Isadora Vermejo , Castro Kemilly Soares de , Cotrim Milena da Silva , Silva Rômulo Ruan da , Tuma Rafaela Maia , Wouk Letícia , Morais Carlos Alberto Herrero de
Published: September 2024

O objetivo deste trabalho é relatar um caso clínico em que foi realizada a técnica de apicificação com a confecção de tampão apical com cimento biocerâmico em um dente com rizogênese incompleta. A paciente fez tratamento endodôntico do dente 21 com necrose pulpar e lesão periapical na clínica da odontológica da residência em Endodontia da Universidade Estadual de Maringá. A técnica e o material utilizado para o tratamento deste caso consistiram na confecção de um tampão apical utilizando o cimento biocerâmico Sealer Plus BC® (MK Life). Os resultados apresentados mostraram a eficácia da técnica e do material biocerâmico utilizado na Odontologia. Esses materiais também são utilizados no tratamento das perfurações, reabsorções radiculares, canais com ápice aberto, entre outros casos, devido à excelente biocompatibilidade e capacidade de induzir a mineralização.
Comparação das complicações perioperatórias em artroplastia total de joelho: Abordagem robótica versus convencional – uma revisão da literatura
Authors: Oliveira Filho Otoni Lima de , Valle Arthur Lucena , Borba Pedro Henrique Cirne , Fabricio Maria Clara Fernandes , Pereira Rafael Cavalcanti , Ribeiro Diego Fabricio , Confessor Maine Virgínia Alves
Published: September 2024

As doenças osteomusculares afetam negativamente o sistema musculoesquelético, causando dor e limitação de movimento, assim como danos na cartilagem devido a traumas mecânicos, obesidade e movimentos excessivos, levando a um ciclo inflamatório que compromete a articulação. Este estudo objetiva avaliar as complicações dos procedimentos cirúrgicos robótico e tradicional na ATJ. O desenho do estudo foi feito na forma de uma revisão integrativa da literatura. Revisaram-se as complicações intraoperatórias associadas à ATJ e ATJR, analisando 32 artigos de 2018 a 2024. A ATJ convencional apresenta complicações como hipotensão, atelectasias, trombose venosa profunda (TVP) e dor pós-operatória, com uma taxa de insatisfação de aproximadamente 20%. A ATJR, apesar de maior tempo de operação, mostra menor variação na angulação da prótese e redução na necessidade de transfusões sanguíneas. No entanto, a ATJR tem custos mais altos e maior risco de infecções. O uso de torniquete durante a ATJ está associado a complicações como aumento de dor e risco de trombose, enquanto o ácido tranexâmico (TXA) demonstra eficácia na redução da perda sanguínea e necessidade de transfusões, sem impacto negativo significativo na dor ou amplitude de movimento. A infiltração periarticular (PAI) é mais eficaz na redução da dor pós-operatória comparada ao bloqueio do canal do adutor (ACB). Conclusivamente, a ATJR oferece vantagens na precisão e estabilidade da prótese, mas com desafios como maior custo e tempo de operação, devendo a escolha do método considerar as especificidades e riscos de cada abordagem.
Uso do sistema Computer Aided Design-Computer Aided Manufacturing (CAD-CAM) com suas indicações, vantagens e desvantagens: Uma revisão integrativa
Authors: Abreu Elizangela Andrade de , Galdino Jade , Baeder Fernando Martins , Zaffalon Gabriela Traldi , Baptista Ricardo dos Santos , Corazza Paola Fernanda Leal
Published: September 2024

A introdução do CAD-CAM na odontologia revolucionou tecnologicamente a maneira como os tratamentos odontológicos são planejados, projetados e fabricados. O sistema CAD/CAM refere-se a um conjunto de tecnologias utilizadas para design e fabricação de próteses odontológicas, como coroas, facetas, próteses, entre outros dispositivos. Os sistemas CAD/CAM podem ser uma ferramenta útil no diagnóstico, planejamento e tratamentos reabilitadores. Com o objetivo de apresentar as indicações, vantagens e desvantagens da tecnologia CAD/CAM, realizou-se uma pesquisa nas bases de dados Google acadêmico, Pubmed, Lilacs e Scilo acerca do tema com o objetivo de apresentar as indicações, vantagens e desvantagens da tecnologia CAD/CAM. Como conclusão verificamos que essa tecnologia oferece benefícios significativos, incluindo maior precisão, diminuição no tempo de tratamento para os pacientes e redução da necessidade de moldagens tradicionais desconfortáveis. No entanto, o custo inicial dos equipamentos e materiais pode ser um desafio para algumas clínicas ou consultórios odontológicos.
Future changes in rainfall variability for the mainland Indochina southwest monsoon
Authors: Oo KT , Kazora J , Ayugi BO
Published: September 2024

Researching future changes in rainfall variability is critical for mitigating the possible effects of global warming, especially in areas where vulnerability is high, such as Indochina. While changes in mean and extreme rainfall have received a great deal of attention, rainfall variability has been poorly researched, despite its importance. We endeavored to determine the anticipated changes in rainfall variability during the mainland Indochina southwest monsoon (MSWM) by utilizing data derived from 5 ensemble models participating in the Coupled Model Intercomparison Project Phase 6 (CMIP6). Employing band pass filtering techniques on daily rainfall data, we discerned variability across an expansive spectrum of temporal scales. Our research indicates that, in the event of global warming, the variability in MSWM rainfall is expected to increase by approximately 10-25% throughout the whole region. Notably, this increased unpredictability appears uniformly throughout a wide range of time intervals. Changes in average rainfall significantly aid in explaining the majority of the intermodal variance in the predicted MSWM rainfall variability. To gain further insight into this phenomenon, we examined the effects of elevated atmospheric moisture content through the estimation of modifications resulting from idealized local thermodynamic enhancement. We showed that increased atmospheric moisture, as suggested by the Clausius-Clapeyron relation, accounts for most of the predicted changes in rainfall variability at all time scales.
Scottish in the Margins of New France: Marie Hiroüin de la Conception, a Nun at the Hôtel-Dieu Hospital in Seventeenth-Century Québec
Authors: Cowan Mairi
Published: September 2024

Marie Hiroüin, a nun at the Hôtel-Dieu in Québec, was identified as a Scottish noblewoman in the margin of one of her community’s records. An examination of how she came to be in New France, then an analysis of why the nuns at the hospital chose to emphasise her Scottishness and her nobility, offer new insights into migration, national identity, and religion in the seventeenth century. Hiroüin’s family, the Irvines of Hilton, remained Catholic through Scotland’s Protestant Reformation. Some family members stayed in Scotland, while others went to France, Italy, and North America. In New France, nuns commemorated the commitment of Hiroüin’s family to Catholicism and alliance to Mary, Queen of Scots. This commemoration shows the long reach over both space and time of early modern British politics and religion. At a hospital in a small settlement on the banks of the Saint Lawrence River, far from the centres of power in either Britain or France, nuns were using the Scottishness and nobility of Marie Hiroüin to demonstrate to themselves and their successors the virtues of their religious vocation in colonial North America.
Czechoslovak Land Reform on the Estates of British Subjects, 1918-1938
Authors: Horčička Václav
Published: September 2024

This article offers a view of the as yet unexplored aspect of British-Czechoslovak relations in the interwar period. It focuses on the way in which the land reform was carried out on the estates of British subjects located in Czechoslovakia. Attention is paid both to the diplomatic aspect of the problem as well as the analysis of the way the reform was applied. The author poses the question to what degree did the reform impact the bilateral relations of both countries. Meanwhile, he builds on the fact that the United Kingdom, a key ally of Czechoslovakia in the Great War, had an adequately strong position in Prague in order to request an accommodating course of the reform for its citizens. The author answers the question whether this was actually the case. He finally comes to the conclusion that Czechoslovak authorities had an interest in carrying out the reform as amicably as possible; however, they were not willing to completely leave British subjects out of it.
Upregulated Gene Expression of Histone Deacetylases (HDAC) 1, 2, and 11 in Peripheral Blood Mononuclear Cells of Rheumatoid Arthritis Patients
Authors: Enayati Samaneh , Moharamoghli Mozhgan , Farazmand Ali , Hassan-Zadeh Vahideh , Poursani Shiva , Madreseh Elham , Akhtari Maryam , Akhlaghi Masoumeh , Farhadi Elham , Hadjiabbasi Asghar , Jamshidi Ahmadreza , Mahmoudi Mahdi
Published: September 2024

Background: The histone deacetylase (HDAC) family consists of epigenetic modifiers that demonstrate anti-inflammatory activities, and hence they might have a substantial role in auto-inflammatory disorders including rheumatoid arthritis (RA). Therefore, the aim of this study is to investigate the expression of HDAC1, HDAC2, and HDAC11 genes in peripheral blood mononuclear cells (PBMCs) of RA cases compared to healthy controls.

Methods: In the current study, PBMCs were isolated after blood collection from 50 RA patients and 50 healthy controls. Afterward, RNA extraction and cDNA synthesis was performed. The expression of target genes was investigated utilizing the real-time polymerase chain reaction (PCR) with a relative quantification method.

Results: Overexpression of HDAC1 (Fold change= 1.91, P-value <0.001), HDAC2 (Fold change= 1.47, P-value=0.001), and HDAC11 (Fold change= 7.77, P-value= 0.001) were observed in PBMCs of RA individuals in comparison to healthy subjects. Besides, a strong correlation was found between the expressions of these three genes in PBMCs.

Conclusion: Regarding the histones and non-histone proteins that are targeted by HDACs and are involved in inflammatory responses, the significant increase in the expression of HDAC1, HDAC2, and HDAC11 suggests that these genes may have an important role in RA pathogenesis.
HFNC EXPERIENCE IN A NEWLY ESTABLISHED PEDIATRIC INTENSIVE CARE UNIT IN EASTERN ANATOLIA
Authors: Sinanoğlu Muhammed Selçuk , Aslan Nagehan , Arıkanoğlu Emrullah , Avci Nizami , Saraç Uğur , Yıldızdaş Dinçer
Published: September 2024

High-flow nasal cannula oxygen therapy (HFNC) is increasingly used in the treatment of acute respiratory failure. It has important effects in patients with respiratory distress. In our study, we planned to share our HFNC experiences in our newly established pediatric intensive care unit. All children between the ages of 1 month and 18 years were included in this retrospective study. Of the 126 patients, 74 (58.7%) were male. The mean age was 59.8±66.7 months. Significant differences were observed between the heart rate, oxygen saturation and respiratory rate of the patients before treatment and at the 1st, 8th and 24th hours after treatment. 16 (12.7%) of the patients were intubated due to HFNC failure. The SpO2/FiO2 ratio at presentation of those who were intubated was found to be significantly lower than the value of those who were not intubated (p
REPAIR-EDS: Rehabilitation Enhanced by Partial Arterial Inflow Restriction (REPAIR) in Eheler-Danlos Syndrome (EDS) Patients
Authors: Laferrier Justin Z. , Mederios Taylor , Shin Kenneth , Valdes Sebastian , Furmanek Mariusz
Published: September 2024

The purpose of the current study was to test the effectiveness of combining blood flow restriction with standard physical therapy (PT BFR) exercises when compared to physical therapy exercises alone in a population of individuals living with Ehlers-Danlos Syndrome (EDS). EDS encompasses a complex spectrum of heritable connective tissue disorders characterized by genetic mutations affecting collagen synthesis and processing [1]. These mutations are inherited in varying patterns including autosomal dominant, recessive, and de novo mutations and lead to joint hypermobility, dermal dysplasia, and tissue fragility among other symptoms [2,3]. The most recent EDS classifications comprise at least 14 subtypes [4], each presenting unique clinical features and severity levels, affecting an estimated prevalence of 1 in 600 to 1 in 900 individuals depending on subtype [4-6]. Depending on the subtype, the syndrome can significantly impact functional capacity, quality of life, and longevity due to chronic pain, neuromusculoskeletal deficits, and other associated complications [7-12].Historically, traditional therapeutic approaches for EDS, which include pain management, surgery, and rehabilitation aimed at correcting deficits and improving strength and joint stability, often fall short of achieving long-term efficacy [13]. This inadequacy necessitates exploration of innovative interventions capable of addressing the underlying muscle weakness and functional impairments characteristic of the syndrome.
Development and Psychometric Evaluation of the Symptom Assessment Scale for Turkish Children with Cancer
Authors: Akdeniz Kudubeş Aslı , Bektaş Murat
Published: September 2024

Objective: The present study was conducted to developed the Symptom Assessment Scale for Children with Cancer (SAS-CC) and assessed its reliability and validity for Turkish children.
Methods: This research was conducted among in 497 children with cancer who were between 7 and 18 years old. The data were collected with a demographic form and SAS-CC. Descriptive statistics, reliability and validity analysis were used to analyze the data.
Results: The mean age of children with cancer was 12.02 +3.38 years. The scale consists of 16 items and 3 sub-dimensions. Total factor loads were more than 0.30 in factor analyses. The confirmatory factor analysis revealed all fit indexes as higher than 0.91, and the root mean square error of approximation (RMSEA) was less than 0.080. Cronbach’s alpha values of total was 0.96. According to the split-half analysis, α values of the first and second halves were 0.94 and 0.93, respectively.
Conclusions: This study demonstrated that SAS-CC is the first study to develop and test and a valid scale to evaluate symptoms in children with cancer. Effective strategies of coping with symptoms in children with cancer are required to improve prognosis, increase survival, and improve the quality of life. Therefore, assessing symptoms and their frequency in children with cancer is an majority initiative of nurses
working in the pediatric oncology clinic.
Two-year clinical outcome of patients with mildly reduced ejection fraction after acute myocardial infarction: insights from the prospective KAMIR-NIH Registry
Authors: Jeon Ho Sung , Lee Jun-Won , Moon Jin Sil , Kang Dae Ryong , Lee Jung-Hee , Youn Young Jin , Ahn Min-Soo , Ahn Sung Gyun , Yoo Byung-Su
Published: September 2024

Background

Left ventricular ejection fraction (LVEF) is a crucial prognostic indicator of acute myocardial infarction (AMI). However, there is a lack of studies on the clinical characteristics and prognosis of patients with mildly reduced ejection fraction (EF) after AMI.

Methods

We categorized 6,553 patients with AMI from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH) between November 2011 and December 2015 into three groups based on their EF, as assessed by echocardiography during index hospitalization: reduced EF (LVEF ≤40%), mildly reduced EF (LVEF 41%–49%), and preserved EF (LVEF ≥50%). The primary outcome was all-cause death within 2 years. The secondary outcomes included myocardial infarction (MI), revascularization, and patient-oriented composite endpoint (POCE), which was defined as a composite of all-cause death, any MI, or revascularization.

Results

Of the total 6,553 patients, 884 (13.5%) were classified into the reduced EF group, 1,749 (26.7%) into the mildly reduced EF group, and 3,920 (59.8%) into the preserved EF group. Patients with mildly reduced EF exhibited intermediate mortality (reduced EF, 24.7%; mildly reduced EF, 8.3%; preserved EF, 4.6%; p < 0.0001), MI (3.9% vs. 2.7% vs. 2.6%; p < 0.0046), and POCE (33.0% vs. 15.6% vs. 12.4%; p < 0.0001) rates, albeit closer to those of the preserved EF. After adjustment for demographics, risk factors, admission status, and discharge medications, patients with mildly reduced EF showed a lower risk of all-cause death than those with reduced EF (mildly reduced EF group as a reference: HR, 1.74; 95% CI, 1.40–2.18; p < 0.001), but it did not differ significantly from those with preserved EF (HR, 0.94; 95% CI, 0.75–1.18; p = 0.999)

Conclusions

Over a 2-year follow-up period, patients with AMI and mildly reduced EF demonstrated better prognoses than those with reduced EF, but did not differ significantly from those with preserved EF.

Clinical Trial Registration

cris.nih.go.kr, identifier: KCT−0000863.
Risk prediction of diabetic retinopathy based on visit-to-visit fasting blood glucose indices
Authors: Ju Ying , Guo Zhengyang , Ai Jiaqi , Yang Kai , Zhu Xiaoxuan , Shi Keai , Li Chunmei , Yu Tianyun , Xiao Yunfan , Su Binbin , Yan Jinxia , Li Ziyu , Lian Wei , Wang Zhenqin , Ding Shasha , Wang Yudie , Lu Fan , Cui Lele , Li Ming
Published: September 2024

Objective

The long-term glucose monitoring is essential to the risk assessment of diabetic retinopathy (DR), the aim of this study was to investigate the predictive ability of visit-to-visit fasting blood glucose (FBG) indices on the risk of DR.

Methods

This was a community-based, cohort study conducted from 2013 to 2021. DR was diagnosed by digital fundus photography. The FPG indices included FBG, var. Associations of each FBG indices and DR were estimated using multinomial logistic regression models adjusting for confounders, and discrimination was determined by area under the curve (AUC). Predictive utility of different models was compared by changes in AUC, integrated discrimination improvement (IDI), and net reclassification index (NRI).

Results

This study analyzed 5054 participants, the mean age was 46.26 ± 11.44 years, and 2620 (51.84%) were women. After adjustment for confounders, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for FBG, SD, CV, VIM, ARV, M-FBG, and cumulative FBG load were 1.62 (1.52—1.73), 2.74 (2.38—3.16), 1.78 (1.62—1.95), 1.11 (0.95—1.29), 1.72 (1.56—1.91), 2.15 (1.96—2.36), and 2.57 (2.31—2.85), respectively. The AUC of the model with separate cumulative FBG load and classical risk factors was 0.9135 (95%CI 0.8890—0.9380), and no substantive improvement in discrimination was achieved with the addition of other FBG indices once cumulative FBG load was in the model.

Conclusions

Cumulative FBG load is adequate for capturing the glucose-related DR risk, and the predictive utility of cumulative FBG load is not significantly improved by adding or replacing other FBG indices in the assessment of DR risk.
Generating advanced CAR-based therapy for hematological malignancies in clinical practice: targets to cell sources to combinational strategies
Authors: Zhou Shu , Yang Yuhang , Jing Yulu , Zhu Xiaoying
Published: September 2024

Chimeric antigen receptor T (CAR-T) cell therapy has been a milestone breakthrough in the treatment of hematological malignancies, offering an effective therapeutic option for multi-line therapy-refractory patients. So far, abundant CAR-T products have been approved by the United States Food and Drug Administration or China National Medical Products Administration to treat relapsed or refractory hematological malignancies and exhibited unprecedented clinical efficiency. However, there were still several significant unmet needs to be progressed, such as the life-threatening toxicities, the high cost, the labor-intensive manufacturing process and the poor long-term therapeutic efficacy. According to the demands, many researches, relating to notable technical progress and the replenishment of alternative targets or cells, have been performed with promising results. In this review, we will summarize the current research progress in CAR-T eras from the “targets” to “alternative cells”, to “combinational drugs” in preclinical studies and clinical trials.
Connectivity of high-frequency bursts as SOZ localization biomarker
Authors: Pinto-Orellana Marco , Lopour Beth
Published: September 2024

For patients with refractory epilepsy, the seizure onset zone (SOZ) plays an essential role in determining the specific regions of the brain that will be surgically resected. High-frequency oscillations (HFOs) and connectivity-based approaches have been identified among the potential biomarkers to localize the SOZ. However, there is no consensus on how connectivity between HFO events should be estimated, nor on its subject-specific short-term reliability. Therefore, we propose the channel-level connectivity dispersion (CLCD) as a metric to quantify the variability in synchronization between individual electrodes and to identify clusters of electrodes with abnormal synchronization, which we hypothesize to be associated with the SOZ. In addition, we developed a specialized filtering method that reduces oscillatory components caused by filtering broadband artifacts, such as sharp transients, spikes, or direct current shifts. Our connectivity estimates are therefore robust to the presence of these waveforms. To calculate our metric, we start by creating binary signals indicating the presence of high-frequency bursts in each channel, from which we calculate the pairwise connectivity between channels. Then, the CLCD is calculated by combining the connectivity matrices and measuring the variability in each electrode’s combined connectivity values. We test our method using two independent open-access datasets comprising intracranial electroencephalography signals from 89 to 15 patients with refractory epilepsy, respectively. Recordings in these datasets were sampled at approximately 1000 Hz, and our proposed CLCDs were estimated in the ripple band (80–200 Hz). Across all patients in the first dataset, the average ROC-AUC was 0.73, and the average Cohen’s d was 1.05, while in the second dataset, the average ROC-AUC was 0.78 and Cohen’s d was 1.07. On average, SOZ channels had lower CLCD values than non-SOZ channels. Furthermore, based on the second dataset, which includes surgical outcomes (Engel I-IV), our analysis suggested that higher CLCD interquartile (as a measure of CLCD distribution spread) is associated with favorable outcomes (Engel I). This suggests that CLCD could significantly assist in identifying SOZ clusters and, therefore, provide an additional tool in surgical planning for epilepsy patients.
Utilization of tissue-free minimal residual disease testing in colorectal cancer patients from Asia and Middle East
Authors: Jain Suyog , Dawood Shaheenah , Lavingia Viraj , Aderka Dan , Tahover Esther , Hsieh Yao-Yu , Temper Mark , Goldman Alesya , Akasheh Marwan AI. , Olsen Steve , Hsing Sandra San , Joshi Nisarg , Jen Hsiao-Yu
Published: September 2024

Introduction

The presence of minimal residual disease (MRD) after curative-intent surgery for early-stage cancers is associated with disease recurrence. Circulating tumour deoxyribonucleic acid (ctDNA) has emerged as a promising biomarker for MRD assessment in patients with colorectal cancer (CRC) who have undergone surgery or completed adjuvant therapy. MRD tests are already available for use in clinics; however, treatment decisions following MRD results obtained in routine practice are infrequently described.

Methods

In this observational study, we report on the real-world clinical use of Guardant Reveal, a validated tissue-free MRD assay, in the first 215 consecutive patients (279 samples) with CRC tested in Asia and the Middle East.

Results

Overall, 22% of patients had ctDNA detected in their first MRD test, and the frequency of ctDNA positivity increased with increasing tumour stage. 132 samples were tested with an earlier version of Guardant Reveal, one that assessed both genomic and epigenomic features. An updated version of the assay assesses only ctDNA methylation data and was used for the remaining 147 samples. In patients with stage II CRC, 71% of tests were ordered within 12 weeks after tumour resection, while for patients with stage III disease, 69% of tests were ordered after completion of all curative-intent treatment.

Discussion

Clinical cases utilizing tissue-free MRD assessment are described.
Oral cancer in young adults: incidence, risk factors, prognosis, and molecular biomarkers
Authors: Lenoci Deborah , Moresco Elisa , Cavalieri Stefano , Bergamini Cristiana , Torchia Erica , Botta Laura , Canevari Silvana , Trama Annalisa , Licitra Lisa , De Cecco Loris
Published: September 2024

Oral cavity squamous cell carcinoma (OCSCC) predominantly affects the tongue and the floor of the mouth, primarily in patients over 50 years of age. Incidence and mortality rates vary significantly worldwide, influenced by geographic areas and demographic characteristics. Epidemiological studies revealed an increase in incidence of OCSCC among young adults (YA) <44 years old. This narrative review, provides updated information on the incidence, risk factors, and prognosis of YA-OCSCC using data published from 2018 to 2023 from different geographic locations. The studies indicate that the incidence of YA-OCSCC in Asia is approximately twice that in the US and that the incidence is strongly linked to risk factors such as betel quid chewing, tobacco use, and high alcohol consumption. The prognosis for YA-OCSCC, compared to that in older patients, shows similar or better overall survival, even in cases with relapses, but worse 5-year disease-free survival, despite receiving similar treatments. Consequently, a concerted effort is crucial to raise awareness about the cessation of tobacco and areca nut use, alcohol control, and the promotion of healthy lifestyle behaviors. Recent molecular data on YA-OCSCC suggests a potential profile characterized by epidermal growth factor receptor overexpression, low tumor mutation burden and an attenuated immune response. Upon confirmation in larger cohorts of YA-OCSCC patients from different geographical areas, the validated markers could aid in selecting tailored treatments.
The effect of athletes' training satisfaction on competitive state anxiety—a chain-mediated effect based on psychological resilience and coping strategies
Authors: Yu Xiaomei , Yang Yang , He Bo
Published: September 2024

Introduction

This study aimed to investigate the relationship between athletes' training satisfaction and competitive state anxiety, by examining the mediating roles of psychological resilience and coping strategies. The findings provide a theoretical foundation and practical recommendations for enhancing athletes' training and mental health services.

Methods

A questionnaire was utilized to assess training satisfaction, psychological resilience, coping strategies, and Competitive State Anxiety among a sample of 447 athletes. The data was examined through descriptive statistics, correlation analysis, and structural equation modeling, employing SPSS and the Process 3.5 plug-in.

Results

Training satisfaction had a significant positive effect on psychological resilience (β = 0.726, p<0.001), while training satisfaction (β = 0.178, p<0.001) and psychological resilience (β = 1.138, p<0.001) were found to have a significant positive effect on strategy. Additionally, training satisfaction, psychological resilience, and coping strategies all demonstrated a significant negative effect on competitive state anxiety (p<0.001). Training satisfaction indirectly influenced competitive state anxiety through psychological resilience (indirect effect 1), coping strategies (indirect effect 2), and the combined mediating effect of psychological resilience and coping strategies (indirect effect 3), resulting in a total indirect effect of −0.385 [95% CI = (−0.433, −0.337)].

Discussion

In conclusion, enhancing athletes' training satisfaction can help reduce competitive state anxiety by improving psychological resilience and fostering positive coping mechanisms.
Unveiling frailty: comprehensive and sex-specific characterization in prematurely aging PolgA mice
Authors: Yılmaz Dilara , Singh Amit , Wehrle Esther , Kuhn Gisela A. , Mathavan Neashan , Müller Ralph
Published: September 2024

Frailty, a geriatric syndrome, is assessed using the frailty phenotype (FP) and frailty index (FI). While these approaches have been applied to aging mice, their effectiveness in prematurely aging mouse models such as PolgAD257A/D257A (PolgA) has not been completely explored. We demonstrated that frailty became evident in PolgA mice around 40 weeks, validated through body weight loss, reduced walking speed, decreased physical activity, and weaker grip strength. Moreover, we also identified sex differences in these mice with females exhibiting slightly more physical decline compared to males. Frailty prevalence in PolgA mice at 40 weeks parallels that observed in naturally aging mice at 27 months and aging humans at 65–70 years. These findings contribute to understanding frailty onset and sex-specific patterns in this prematurely aging mouse model, emphasizing the significance of the PolgA mouse model in investigating aging and related disorders.
An Efficient Drogue Detection Algorithm for Unmanned Aerial Vehicle Autonomous Refueling Docking Phase
Authors: Zhai Mingyuan , Hu Shiming , Xiao Dong , Zhang Hanquan , Xu Mengyuan , Mao Yachun
Published: September 2024

Autonomous aerial refueling technology can significantly extend the operational endurance of unmanned aerial vehicles (UAVs), enhancing their ability to perform long-duration missions efficiently. In this paper, we address the identification of refueling drogues in the close docking phase of autonomous aerial refueling. We propose a high-precision real-time drogue recognition network called DREP-Net. The backbone of this network employs the DGST module for efficient feature extraction and improved representation of multi-scale information. For occlusion and complex background problems, we designed the RGConv module, which combines the re-parameterization module with the GhostNet idea to improve the detection of an occluded drogue. Meanwhile, we introduced the efficient local attention mechanism into the neck network to enhance the overall attention to the target region. Then, we designed Phead, a lightweight detection head that combines the advantages of decoupling and coupling heads to improve the detection speed. Finally, we compared our network with mainstream algorithms on a real drogue dataset, and the results show that DREP-Net has 2.7% higher mean average precision (mAP) compared to the YOLOv8n model, and the detection speed is improved by 31.4 frames per second.
Fixed-Time Anti-Saturation Tracking Control for Agile Missiles with Multiple Actuators
Authors: Li Jiaxun , Yu Jianqiao
Published: September 2024

This paper investigates the fixed-time tracking control problem for agile missiles with multiple heterogeneous actuators in the presence of saturation constraints and external disturbances. To reduce the turning radius and promote maneuvering envelope, a novel combination scheme for blended actuators is introduced in this paper, consisting of a flexible mechanism control system (FCS), reaction-jet control system (RCS), and aerodynamic control. Based on the proposed nonsingular terminal sliding mode surface, a fixed-time anti-saturation controller with an auxiliary system is presented first to ensure global fixed-time stability and to compensate for the adverse effects of input saturation. Subsequently, a fixed-time disturbance observer is constructed to estimate uncertainties and lumped disturbances, and to address the chattering problem. To assign the total virtual control command to different actuators, a control allocation based on dynamic programming considering actuator dynamics is established. Finally, detailed numerical simulations and comparisons are provided to verify the effectiveness and superiority of the proposed control scheme.
Clostridioides difficile Infection-Related Hepatic Abscess: A Review of the Literature
Authors: Vongsavath Tahne , Chun Magnus , Tun Kyaw Min , Manne Vignan
Published: September 2024

Hepatic abscesses (HAs) are suppurative cavities caused by the infiltration of liver parenchyma by microbes. The etiology of HAs can include biliary disease, intra-abdominal infections, bile duct ischemia following pancreaticoduodenectomy, liver transplantation, and rarely septicemia, among others. While HA of a bacterial origin is rare, intra-abdominal biliary infections can be seen after appendicitis or proctitis. Empiric treatment generally involves antibiotic coverage and percutaneous drainage. Due to a high health care association, Clostridioides difficile infection (CDI) is becoming more frequent and has increasing antibiotic resistance. While generally limited to the gastrointestinal tract, extra intestinal CDIs are generally related to bacteremia, and related HAs are even rarer, with their prognostic courses not well described. A literature search was performed evaluating case reports and manuscripts relating to CDI-related HA. Articles with relevant information were analyzed for quality. Those fitting predetermined selection criteria and the level of evidence were included in this study. While most affected patients reported recent hospitalization and significant comorbidities, some of them reported no apparent risk factors at all. While all included individuals had HA, only 33.3% had CD-related bacteremia. Treatment of HA was managed with drainage as well as antibiotics and was generally successful, with one death. As CDI becomes more prevalent, studies such as this will be needed to address the management of associated HA.
Antimicrobial and Phylogenomic Characterization of Bacillus cereus Group Strains Isolated from Different Food Sources in Italy
Authors: Farina Donatella , Bianco Angelica , Manzulli Viviana , Castellana Stefano , Parisi Antonio , Caruso Marta , Fraccalvieri Rosa , Serrecchia Luigina , Rondinone Valeria , Pace Lorenzo , Fasanella Antonio , Vetritto Valerio , Difato Laura Maria , Cipolletta Dora , Iatarola Michela , Galante Domenico
Published: September 2024

Background: Bacillus cereus is a widespread environmental Gram-positive bacterium which is especially common in soil and dust. It produces two types of toxins that cause vomiting and diarrhea. At present, foodborne outbreaks due to Bacillus cereus group bacteria (especially Bacillus cereus sensu stricto) are rising, representing a serious problem in the agri-food supply chain. Methods: In this work, we analyzed 118 strains belonging to the Bacillus cereus group, isolated from several food sources, for which in vitro and in silico antibiotic resistance assessments were performed. Results: Many strains showed intermediate susceptibility to clindamycin, erythromycin, and tetracycline, suggesting an evolving acquisition of resistance against these antibiotics. Moreover, one strain showed intermediate resistance to meropenem, an antibiotic currently used to treat infections caused by Bacillus cereus. In addition to the phenotypic antimicrobial resistance profile, all strains were screened for the presence/absence of antimicrobial genes via whole-genome sequencing. There was inconsistency between the in vitro and in silico analyses, such as in the case of vancomycin, for which different isolates harbored resistance genes but, phenotypically, the same strains were sensitive. Conclusions: This would suggest that antibiotic resistance is a complex phenomenon due to a variety of genetic, epigenetic, and biochemical mechanisms.
Exploring the Role of Reactive Oxygen Species in the Pathogenesis and Pathophysiology of Alzheimer’s and Parkinson’s Disease and the Efficacy of Antioxidant Treatment
Authors: Gogna Talin , Housden Benjamin E. , Houldsworth Annwyne
Published: September 2024

Alzheimer’s (AD) and Parkinson’s Disease (PD) are life-altering diseases that are characterised by progressive memory loss and motor dysfunction. The prevalence of AD and PD is predicted to continuously increase. Symptoms of AD and PD are primarily mediated by progressive neuron death and dysfunction in the hippocampus and substantia nigra. Central features that drive neurodegeneration are caspase activation, DNA fragmentation, lipid peroxidation, protein carbonylation, amyloid-β, and/or α-synuclein formation. Reactive oxygen species (ROS) increase these central features. Currently, there are limited therapeutic options targeting these mechanisms. Antioxidants reduce ROS levels by the induction of antioxidant proteins and direct neutralisation of ROS. This review aims to assess the effectiveness of antioxidants in reducing ROS and neurodegeneration. Antioxidants enhance major endogenous defences against ROS including superoxide dismutase, catalase, and glutathione. Direct neutralisation of ROS by antioxidants protects against ROS-induced cytotoxicity. The combination of Indirect and direct protective mechanisms prevents ROS-induced α-synuclein and/or amyloid-β formation. Antioxidants ameliorate ROS-mediated oxidative stress and subsequent deleterious downstream effects that promote apoptosis. As a result, downstream harmful events including neuron death, dysfunction, and protein aggregation are decreased. The protective effects of antioxidants in human models have yet to directly replicate the success seen in cell and animal models. However, the lack of diversity in antioxidants for clinical trials prevents a definitive answer if antioxidants are protective. Taken together, antioxidant treatment is a promising avenue in neurodegenerative disease therapy and subsequent clinical trials are needed to provide a definitive answer on the protective effects of antioxidants. No current treatment strategies have significant impact in treating advanced AD and PD, but new mimetics of endogenous mitochondrial antioxidant enzymes (Avasopasem Manganese, GC4419 AVA) may be a promising innovative option for decelerating neurodegenerative progress in the future at the mitochondrial level of OS.
LDL-c/HDL-c Ratio and NADPH-Oxidase-2-Derived Oxidative Stress as Main Determinants of Microvascular Endothelial Function in Morbidly Obese Subjects
Authors: Santos Jorge , La Fuente José M. , Fernández Argentina , Ruano Paula , Angulo Javier
Published: September 2024

The identification of obese subjects at higher risk for cardiovascular disease (CVD) is required. We aimed to characterize determinants of endothelial dysfunction, the initial step to CVD, in small omental arteries of visceral fat from obese subjects. The influences of analytical parameters and vascular oxidative stress mediated by NADPH-oxidase-2 (NOX2) on endothelial function were determined. Specimens were obtained from 51 obese subjects undergoing bariatric surgery and 14 non-obese subjects undergoing abdominal surgery. Obese subjects displayed reduced endothelial vasodilation to bradykinin (BK). Endothelial vasodilation (pEC50 for BK) among obese subjects was significantly and negatively associated with low-density lipoprotein cholesterol (LDL-c)/high-density lipoprotein cholesterol (HDL-c) ratio (r = -0.510, p = 0.0001) in both women and men, while other metabolic parameters and comorbidities failed to predict endothelial function. The vascular expression of NOX2 was upregulated in obese subjects and was related to decreased endothelial vasodilation (r = −0.529, p = 0.0006, n = 38) and increased oxidative stress (r = 0.783, p = 0.0044, n = 11) in arterial segments. High LDL-c/HDL-c (>2) and high NOX2 (above median) were independently associated with reduced endothelial function, but the presence of both conditions was related to a further impairment. Concomitant elevated LDL-c/HDL-c ratio and high vascular expression of NOX2 would exacerbate endothelial impairment in obesity and could reveal a deleterious profile for cardiovascular outcomes among obese subjects.