bluuebunny/crossref_metadata_2025 huggingface dataset:
An innovative web-based decision-aid about birth after cesarean for shared decision making in Taiwan: study protocol for a randomized control trial
Authors: Chen Shu Wen , Shorten Allison , Yeh Chang Ching , Kao Chien Huei , Lu Yu Ying , Hu Hsiang Wei
Published: February 2023

Background

Taiwan has a high national caesarean rate coupled with a low vaginal birth after caesarean (VBAC) rate. This study aims to develop and evaluate a web-based decision-aid with communication support tools, to increase shared decision making (SDM) about birth after caesarean.

Methods

A quantitative approach will be adopted using a randomized pre-test and post-test experimental design in a medical centre in northern Taiwan. The web-based decision aid consists of five sections. Section 1 provides a two-part video to introduce SDM and how to participate in SDM. Section 2 presents an overview of functions and features of the birth decision-aid. Section 3 presents relevant VBAC information, including definitions, benefits and risks, and an artificial intelligence (AI) calculator for rate and likelihood of VBAC success. Section 4 presents the information regarding elective repeat caesarean delivery (ERCD), involving definitions, benefits, and risks. Section 5 comprises four steps of decision making to meet women’s values and preferences. Pregnant women who have had one previous caesarean and are eligible for VBAC, will be recruited at 14–16 weeks. Participants will complete a baseline survey prior to random allocation to either the control group (usual care) or intervention group (usual care plus an AI-decision aid). A follow up survey at 35–38 weeks will measure change in decisional conflict, knowledge, birth mode preference, and decision-aid acceptability. Actual birth outcomes and satisfaction will be assessed one month after birth.

Discussion

The innovative web-based decision-aid with support tools will help to promote pregnant women’s decision-making engagement and communication with their providers and improve opportunities for supportive communication about VBAC SDM in Taiwan. Linking web-based AI data analysis into the medical record will also be assessed for feasibility during implementation in clinical practice.

Trial registration

ClinicalTrials.gov identifier (NCT05091944), Registered on October 24, 2021.
Efficacy and tolerability of a specific blend of amino acids in patients with anorexia nervosa treated in a hospital setting: study protocol for a randomized controlled trial
Authors: Dalle Grave Riccardo , Calugi Simona , Ruocco Chiara , Chimini Mirko , Segala Agnese , Ragni Maurizio , Carruba Michele , Valerio Alessandra , Nisoli Enzo
Published: February 2023

Background

Specific blends of essential amino acids (EAA) containing a high percentage of branched-chain amino acids preserves mitochondrial metabolism and higher physical resistance in elderly mice, increasing their survival and improving physical performance and cognitive functions in malnourished elderly patients. However, no study has been yet done on patients with anorexia nervosa (AN) who regain weight with specialized intensive treatment. The present study aims to evaluate the efficacy of supplementation with EAA on the change in lean body mass (LBM) and other physical and psychological outcomes in patients with AN who are undergoing specialist treatment for eating disorders.

Methods

This is a 13-week randomized, double-blind, placebo-controlled study. Patients will be randomized to either a mixture of a complex blend of EAA and intermediates of the tricarboxylic acid (TCA) cycle (citrate, malate, succinate) supplementation (or placebo) upon admission at the intensive residential and day-hospital treatment for eating disorders. Ninety-two participants with AN aged 16–50 years will be recruited from a specialized intensive treatment of eating disorders. Double-blind assessment will be conducted at baseline (T0) and the end of the 13 weeks of treatment (T1). The study’s primary aim is to evaluate the efficacy of supplementation with EAA and TCA intermediates on the change in lean body mass (LBM) with weight restoration in patients with AN who are undergoing specialist treatment for eating disorders. The secondary aims of the study are to assess the effect of dietary supplementation on physical fitness, weight restoration, modification of AN and general psychopathology, and psychosocial impairment.

Discussion

The study’s results will inform researchers and clinicians on whether supplementing a mixture of EAA and TCA cycle intermediates will improve the increase of LBM and other important physical and psychological outcomes in patients with AN who regain weight with specialized intensive treatment.

Trial registration

NCT, NCT05290285. Registered on 22 March 2022.
Regulation of seed oil accumulation by lncRNAs in Brassica napus
Authors: Li Yuqing , Tan Zengdong , Zeng Chenghao , Xiao Mengying , Lin Shengli , Yao Wei , Li Qing , Guo Liang , Lu Shaoping
Published: February 2023

Background

Studies have indicated that long non-coding RNAs (lncRNAs) play important regulatory roles in many biological processes. However, the regulation of seed oil biosynthesis by lncRNAs remains largely unknown.

Results

We comprehensively identified and characterized the lncRNAs from seeds in three developing stages in two accessions of Brassica napus (B. napus), ZS11 (high oil content) and WH5557 (low oil content). Finally, 8094 expressed lncRNAs were identified. LncRNAs MSTRG.22563 and MSTRG.86004 were predicted to be related to seed oil accumulation. Experimental results show that the seed oil content is decreased by 3.1–3.9% in MSTRG.22563 overexpression plants, while increased about 2% in MSTRG.86004, compared to WT. Further study showed that most genes related to lipid metabolism had much lower expression, and the content of some metabolites in the processes of respiration and TCA (tricarboxylic acid) cycle was reduced in MSTRG.22563 transgenic seeds. The expression of genes involved in fatty acid synthesis and seed embryonic development (e.g., LEC1) was increased, but genes related to TAG assembly was decreased in MSTRG.86004 transgenic seeds.

Conclusion

Our results suggest that MSTRG.22563 might impact seed oil content by affecting the respiration and TCA cycle, while MSTRG.86004 plays a role in prolonging the seed developmental time to increase seed oil accumulation.
Delayed diagnosis of bacterial cervical lymphadenitis in the tropics: a case report
Authors: Olaniyi Oladosu , Ayotunde Ojo , Christabel Thomas , Idowu Odediran
Published: February 2023

Background

Lymphadenopathy refers to any disease process involving lymph nodes that are abnormal in size and consistency. There are multiple etiologies in the setting of a diseased lymph node, including conditions of infection, autoimmune diseases, and neoplasia. Lymphadenitis is a term that refers to lymphadenopathies that are due to inflammatory processes and can represent an acute bacterial infection resulting from streptococcal pharyngitis or a prior viral upper respiratory infection. Cervical lymphadenopathy refers to nodal swelling in the neck region. While cervical lymphadenitis is a common clinical finding in the setting of a transient response to a benign local or generalized infection, it may evade detection sometimes and thus account for a percentage of misdiagnosis or delayed diagnosis in the tropics. This case report is aimed at increasing the awareness about the presentation of bacterial cervical lymphadenitis and how it can sometimes mimic the presentation that is typical and regularly found with plasmodiasis. It contributes to improved awareness and high index of suspicion in clinic when dealing with patients in the tropics.

Case presentation

We present a case of delayed diagnosis of bacterial cervical lymphadenitis that initially presented with typical features of malaria from Plasmodium falciparum. A 26-year-old Nigerian woman presented to the outpatient department following complaints of a recurring fever of a month’s duration and bilateral neck swelling of about 2 weeks prior to presentation.

Conclusion

In the setting of a busy clinic, details are easily missed and salient features in the presentation of a patient that are needed for accurate diagnosis and management could go unrecognized. Hence, this case report highlights the importance of proper examination particularly of lymph nodes and use of different diagnostic modalities for the exact diagnosis of disease.
Relationship between occupational and leisure-time physical activity and the need for recovery after work
Authors: Karihtala Tiina , Valtonen Anu M. , Kautiainen Hannu , Hopsu Leila , Halonen Janne , Heinonen Ari , Puttonen Sampsa
Published: February 2023

Background

Health benefits of physical activity are very well acknowledged but the role of both occupational physical activity (OPA) and leisure time physical activity (LTPA) in recovery after work is not thoroughly understood. The purpose of this study was to investigate the association between accelerometer-measured OPA and LTPA and the need for recovery after work (NFR) in early childhood education and care (ECEC) professionals.

Methods

The study participants were 217 female ECEC professionals aged 17–64. Physical activity was recorded with a three-axis accelerometer (ActiGraph GT9X Link, ActiGraph, USA) for seven consecutive days. Separate analyses were conducted for both OPA and LTPA and reported as hours/day based on different intensity levels (light, moderate, vigorous, very vigorous). The NFR was measured with the Need For Recovery (NFR) scale (0%–100%).

Results

Participants’ average physical activity for both OPA and LTPA was about 4 h/day, and the mean NFR score was 38.4%. OPA was significantly associated with the NFR but not with LTPA. The relationship remained significant after adjustments for age, body mass index, work ability, mental health status, and sleep difficulties (p < 0.024).

Conclusion

According to this study, the OPA level is related to the level of the NFR in female ECEC professionals. Based on the results, it seems that LTPA has no relevance to the NFR. Results suggest that long-lasting OPA, even without strenuous physical activity at work, may predispose individuals to a high NFR.
The relationship between hospital ownership, in-hospital mortality, and medical expenses: an analysis of three common conditions in China
Authors: Xue Qingping , Xu Dong Roman , Cheng Terence C. , Pan Jay , Yip Winnie
Published: February 2023

Background

Private hospitals expanded rapidly in China since 2009 following its national health reform encouraging private investment in the hospital sector. Despite long-standing debates over the performance of different types of hospitals, empirical evidence under the context of developing countries remains scant. We investigated the disparities in health care quality and medical expenses among public, private not-for-profit, and private for-profit hospitals.

Methods

A total of 64,171 inpatients (51,933 for pneumonia (PNA), 9,022 for heart failure (HF) and 3,216 for acute myocardial infarction (AMI)) who were admitted to 528 secondary hospitals in Sichuan province, China, during the fourth quarters of 2016, 2017, and 2018 were selected for this study. Multilevel logistic regressions and multilevel linear regressions were utilized to assess the relationship between hospital ownership types and in-hospital mortality, as well as medical expenses for PNA, HF, and AMI, after adjusting for relevant hospital and patient characteristics, respectively.

Results

The private not-for-profit (adjusted OR, 1.69; 95% CI, 1.08, 2.64) and for-profit (adjusted OR, 1.67; 95% CI, 1.06, 2.62) hospitals showed higher in-hospital mortality than the public ones for PNA, but not for AMI and HF. No significant differences were found in medical expenses across hospital ownership types for AMI, but the private not-for-profit was associated with 9% higher medical expenses for treating HF, while private not-for-profit and for-profit hospitals were associated with 10% and 11% higher medical expenses for treating PNA than the public hospitals. No differences were found between the private not-for-profit and private for-profit hospitals both in in-hospital mortality and medical expenses across the three conditions.

Conclusion

The public hospitals had at least equal or even higher healthcare quality and lower medical expenses than the private ones in China, while private not-for-profit and for-profit hospitals had similar performances in these aspects. Our results added evidences on hospitals’ performances among different ownership types under China’s context, which has great potential to inform the optimization of healthcare systems implemented among developing countries confronted with similar challenges.
Identifying and addressing challenges to antimicrobial use surveillance in the human health sector in low- and middle-income countries: experiences and lessons learned from Tanzania and Uganda
Authors: Kiggundu Reuben , Lusaya Edgar , Seni Jeremiah , Waswa J. P. , Kakooza Francis , Tjipura Dinah , Kikule Kate , Muiva Cecilia , Joshi Mohan P. , Stergachis Andy , Kitutu Freddy Eric , Konduri Niranjan
Published: February 2023

Background

Antimicrobial resistance (AMR) is a global health security threat and is associated with increased morbidity and mortality. One of the key drivers of AMR is the inappropriate use of antibiotics. A key component of improving antibiotic use is conducting antimicrobial use (AMU) surveillance.

Methods

USAID Medicines Technologies and Pharmaceutical Services Program has supported the implementation of antimicrobial stewardship activities, including setting up systems for AMU surveillance in Tanzania and Uganda. Results from both countries have been previously published. However, additional implementation experience and lessons learned from addressing challenges to AMU surveillance have not been previously published and are the subject of this narrative article.

Results

The team identified challenges including poor quality data, low digitalization of tools, and inadequate resources including both financial and human resources. To address these gaps, the Program has supported the use of continuous quality improvement approaches addressing gaps in skills, providing tools, and developing guidelines to fill policy gaps in AMU surveillance. Recommendations to fill these gaps, based on the Potter and Brough systematic capacity building model have been proposed.

Conclusions

Strengthening AMU surveillance through using a capacity-building approach will fill gaps and strengthen efforts for AMR control in both countries.
Childbirth-related post-traumatic stress disorder symptoms and mother–infant neurophysiological and behavioral co-regulation during dyadic interaction: study protocol
Authors: Pinto Tiago Miguel , Jongenelen Inês , Lamela Diogo , Pasion Rita , Morais Ana , Costa Raquel
Published: February 2023

Background

Mother’s childbirth-related posttraumatic stress disorder (PTSD) symptoms have a negative impact on mother and infant’s behaviors during dyadic interactions which may increase mother–infant neurophysiological and behavioral co-regulation difficulties, leading to dysregulated mother–infant interactions. This study was specifically designed to analyze: (1) the sociodemographic and obstetric factors associated with mother’s childbirth-related PTSD symptoms; (2) mother–infant neurophysiological functioning and behavioral co-regulation during dyadic interaction; (3) the impact of mother’s childbirth-related PTSD symptoms on neurophysiological and behavioral mother–infant co-regulation during dyadic interaction; (4) the moderator role of previous trauma on the impact of mother’s childbirth-related PTSD symptoms on neurophysiological and behavioral mother–infant co-regulation during dyadic interaction; and (5) the moderator role of comorbid symptoms of anxiety and depression on the impact of mother’s childbirth-related PTSD symptoms on neurophysiological and behavioral mother–infant co-regulation during dyadic interaction.

Methods

At least 250 mothers will be contacted in order to account for refusals and dropouts and guarantee at least 100 participating mother–infant dyads with all the assessment waves completed. The study has a longitudinal design with three assessment waves: (1) 1–3 days postpartum, (2) 8 weeks postpartum, and (3) 22 weeks postpartum. Between 1 and 3 days postpartum, mothers will report on-site on their sociodemographic and obstetric characteristics. At 8 weeks postpartum, mothers will complete online self-reported measures of birth trauma, previous trauma, childbirth-related PTSD, anxiety, and depressive symptoms. At 22 weeks postpartum, mothers will complete online self-reported measures of childbirth-related PTSD, anxiety, and depressive symptoms. Mothers and infants will then be home-visited to observe and record their neurophysiological, neuroimaging and behavioral data during dyadic interactions using the Still-face Paradigm. Activation patterns in the prefrontal cortices of mother and infant will be recorded simultaneously using hyperscanning acquisition devices. Unadjusted and adjusted multilevel linear regression models will be performed to analyze objectives 1 to 3. Moderation models will be performed to analyze objectives 4 and 5.

Discussion

Data from this study will inform psychological interventions targeting mother–infant interaction, co-regulation, and infant development. Moreover, these results can contribute to designing effective screenings to identify mothers at risk of perinatal mental health problems and those who may need specialized perinatal mental health care.
Arabic translation, cultural adaptation, and validation of the BDDQ-AS for rhinoplasty patients
Authors: Abdelhamid Ahmed S. , Elzayat Saad , Amer Mohamed A. , Elsherif Hossam S. , Lekakis Garyfalia , Most Sam P.
Published: February 2023

Background

Body Dysmorphic Disorder (BDD) is a significant aspect that compromises patient satisfaction after rhinoplasty. BDDQ-AS (Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery) is a validated, simple, reliable patient-reported outcome measure. It is a screening tool to detect body dysmorphic disorder in rhinoplasty patients. This study aimed to translate, culturally adapt, and validate BDDQ-AS to Arabic as a novel tool for screening and detecting BDD in Arabic rhinoplasty individuals.

Methods

BDDQ-AS was translated from English to Arabic following the international consensus guidelines. We tested the translation on ten Arabic-speaking rhinoplasty patients to ensure that the final version was understandable and acceptable. The proposed Arabic version was then completed by 112 patients whose average age was 28.79 ± 9.32 years. The screening is assumed positive if the patients expressed bother and preoccupation about their appearance (questions 1 and 2 “yes”), as well as a moderately disrupted everyday life (question 7 “yes” or questions 3, 4, 5, or 6 are equal to or greater than “3′′). The internal consistency, test–retest reliability, and item-response theory (IRT) were used to evaluate psychometric validations.

Results

The Arabic BDDQ had a high level of internal consistency, as measured by Cronbach's alpha 0.995. The A-BDDQ-AS was deemed reliable with an Intraclass Correlation Coefficient (ICC) of 0.989. A-BDDQ had good discrimination scores (above 2.0) with adequate difficulty parameters. The overall scale content validity average was 0.83, affirming that all items were relevant, clear, and straightforward.

Conclusion

The Arabic version of the BDDQ-AS is reliable, culturally adapted, and psychometrically validated to be readily used and incorporated into clinical practice. It is a beneficial tool that can guide the screening of Arabic rhinoplasty patients suffering from body dysmorphic disorder and be utilized in further studies to optimize patient outcomes.

Graphical Abstract
Common molecular features of H3K27M DMGs and PFA ependymomas map to hindbrain developmental pathways
Authors: Pun Matthew , Pratt Drew , Nano Patricia R. , Joshi Piyush K. , Jiang Li , Englinger Bernhard , Rao Arvind , Cieslik Marcin , Chinnaiyan Arul M. , Aldape Kenneth , Pfister Stefan , Filbin Mariella G. , Bhaduri Aparna , Venneti Sriram
Published: February 2023

Globally decreased histone 3, lysine 27 tri-methylation (H3K27me3) is a hallmark of H3K27-altered diffuse midline gliomas (DMGs) and group-A posterior fossa ependymomas (PFAs). H3K27-altered DMGs are largely characterized by lysine-to-methionine mutations in histone 3 at position 27 (H3K27M). Most PFAs overexpress EZH inhibitory protein (EZHIP), which possesses a region of similarity to the mutant H3K27M. Both H3K27M and EZHIP inhibit the function of the polycomb repressive complex 2 (PRC2) responsible for H3K27me3 deposition. These tumors often arise in neighboring regions of the brainstem and posterior fossa. In rare cases PFAs harbor H3K27M mutations, and DMGs overexpress EZHIP. These findings together raise the possibility that certain cell populations in the developing hindbrain/posterior fossa are especially sensitive to modulation of H3K27me3 states. We identified shared molecular features by comparing genomic, bulk transcriptomic, chromatin-based profiles, and single-cell RNA-sequencing (scRNA-seq) data from the two tumor classes. Our approach demonstrated that 1q gain, a key biomarker in PFAs, is prognostic in H3.1K27M, but not H3.3K27M gliomas. Conversely, Activin A Receptor Type 1 (ACVR1), which is associated with mutations in H3.1K27M gliomas, is overexpressed in a subset of PFAs with poor outcome. Despite diffuse H3K27me3 reduction, previous work shows that both tumors maintain genomic H3K27me3 deposition at select sites. We demonstrate heterogeneity in shared patterns of residual H3K27me3 for both tumors that largely segregated with inferred anatomic tumor origins and progenitor populations of tumor cells. In contrast, analysis of genes linked to H3K27 acetylation (H3K27ac)-marked enhancers showed higher expression in astrocytic-like tumor cells. Finally, common H3K27me3-marked genes mapped closely to expression patterns in the human developing hindbrain. Overall, our data demonstrate developmentally relevant molecular similarities between PFAs and H3K27M DMGs and support the overall hypothesis that deregulated mechanisms of hindbrain development are central to the biology of both tumors.
Application of low-temperature plasma for the removal of copper chloride layers on bronze Wares
Authors: Jiao Ranran , Sun Fuwei , Li Jiaxing
Published: February 2023

Archaeological objects based on copper alloys (such as bronze wares) usually suffer from “bronze disease” that results from the existence of CuCl on the surfaces. The surface-coating Cu2(OH)3Cl can release Cl− and lead to further corrosion during the storage procedure. The central aim of the work is the verity the effectiveness of low-temperature radio-frequency (RF) plasma for the removal of CuCl and Cu2(OH)3Cl from the bronze wares. In this work, CuCl and Cu2(OH)3Cl patina were synthesized on copper by a simple solution method. The chemical and aesthetic features before and after plasma treatment were characterized using optical microscopy (OM), SEM-EDS, XRD, and XPS. The results show that Ar-H2 plasma could reduce the CuCl to Cu efficiently, which achieves pleasing esthetics as well as removes the chlorine (Cl atomic ratio decrease from 46.0 to 3.6%). For Cu2(OH)3Cl, the air plasma treatment exhibit better performance compared to the Ar-H2 plasma treatment, judging from the aesthetic effect and the removal effect of chlorine (Cl atomic ratio decrease from 14.8 to 3.3%).
PISTACHIo (PreemptIon of diSrupTive behAvior in CHIldren): real-time monitoring of sleep and behavior of children 3–7 years old receiving parent–child interaction therapy augment with artificial intelligence — the study protocol, pilot study
Authors: Saliba Maria , Drapeau Noelle , Skime Michelle , Hu Xin , Accardi Carolyn Jonas , Athreya Arjun P. , Kolacz Jacek , Shekunov Julia , Jones Dean P. , Croarkin Paul E. , Romanowicz Magdalena
Published: February 2023

Background

Emotional behavior problems (EBP) are the most common and persistent mental health issues in early childhood. Early intervention programs are crucial in helping children with EBP. Parent–child interaction therapy (PCIT) is an evidence-based therapy designed to address personal difficulties of parent–child dyads as well as reduce externalizing behaviors. In clinical practice, parents consistently struggle to provide accurate characterizations of EBP symptoms (number, timing of tantrums, precipitating events) even from the week before in their young children. The main aim of the study is to evaluate feasibility of the use of smartwatches in children aged 3–7 years with EBP.

Methods

This randomized double-blind controlled study aims to recruit a total of 100 participants, consisting of 50 children aged 3–7 years with an EBP measure rated above the clinically significant range (T-score ≥ 60) (Eyberg Child Behavior Inventory-ECBI; Eyberg & Pincus, 1999) and their parents who are at least 18 years old. Participants are randomly assigned to the artificial intelligence-PCIT group (AI-PCIT) or the PCIT-sham biometric group. Outcome parameters include weekly ECBI and Pediatric Sleep Questionnaire (PSQ) as well as Child Behavior Checklist (CBCL) obtained weeks 1, 6, and 12 of the study. Two smartphone applications (Garmin connect and mEMA) and a wearable Garmin smartwatch are used collect the data to monitor step count, sleep, heart rate, and activity intensity. In the AI-PCIT group, the mEMA application will allow for the ecological momentary assessment (EMA) and will send behavioral alerts to the parent.

Discussion

Real-time predictive technologies to engage patients rely on daily commitment on behalf of the participant and recurrent frequent smartphone notifications. Ecological momentary assessment (EMA) provides a way to digitally phenotype in-the-moment behavior and functioning of the parent–child dyad. One of the study’s goals is to determine if AI-PCIT outcomes are superior in comparison with standard PCIT. Overall, we believe that the PISTACHIo study will also be able to determine tolerability of smartwatches in children aged 3–7 with EBP and could participate in a fundamental shift from the traditional way of assessing and treating EBP to a more individualized treatment plan based on real-time information about the child’s behavior.

Trial registration

The ongoing clinical trial study protocol conforms to the international Consolidated Standards of Reporting Trials (CONSORT) guidelines and is registered in clinicaltrials.gov (ID: NCT05077722), an international clinical trial registry.
Short-term in vivo testing to discriminate genotoxic carcinogens from non-genotoxic carcinogens and non-carcinogens using next-generation RNA sequencing, DNA microarray, and qPCR
Authors: Furihata Chie , Suzuki Takayoshi
Published: February 2023

Next-generation RNA sequencing (RNA-Seq) has identified more differentially expressed protein-coding genes (DEGs) and provided a wider quantitative range of expression level changes than conventional DNA microarrays. JEMS·MMS·Toxicogenomics group studied DEGs with targeted RNA-Seq on freshly frozen rat liver tissues and on formalin-fixed paraffin-embedded (FFPE) rat liver tissues after 28 days of treatment with chemicals and quantitative real-time PCR (qPCR) on rat and mouse liver tissues after 4 to 48 h treatment with chemicals and analyzed by principal component analysis (PCA) as statics. Analysis of rat public DNA microarray data (Open TG-GATEs) was also performed. In total, 35 chemicals were analyzed [15 genotoxic hepatocarcinogens (GTHCs), 9 non-genotoxic hepatocarcinogens (NGTHCs), and 11 non-genotoxic non-hepatocarcinogens (NGTNHCs)]. As a result, 12 marker genes (Aen, Bax, Btg2, Ccnf, Ccng1, Cdkn1a, Gdf15, Lrp1, Mbd1, Phlda3, Plk2, and Tubb4b) were proposed to discriminate GTHCs from NGTHCs and NGTNHCs. U.S. Environmental Protection Agency studied DEGs induced by 4 known GTHCs in rat liver using DNA microarray and proposed 7 biomarker genes, Bax, Bcmp1, Btg2, Ccng1, Cdkn1a, Cgr19, and Mgmt for GTHCs. Studies involving the use of whole-transcriptome RNA-Seq upon exposure to chemical carcinogens in vivo have also been performed in rodent liver, kidney, lung, colon, and other organs, although discrimination of GTHCs from NGTHCs was not examined. Candidate genes published using RNA-Seq, qPCR, and DNA microarray will be useful for the future development of short-term in vivo studies of environmental carcinogens using RNA-Seq.
Vitamin D3-Loaded Nanoemulsions as a Potential Drug Delivery System for Autistic Children: Formulation Development, Safety, and Pharmacokinetic Studies
Authors: Asfour Marwa Hasanein , Abd El-Alim Sameh Hosam , Kassem Ahmed Alaa , Salama Abeer , Gouda Amr Sobhi , Nazim Walaa Samy , Nashaat Neveen Hassan , Hemimi Maha , Abdel Meguid Nagwa
Published: February 2023

The aim of the current study is the development of a vitamin D3 (VD3)-loaded nanoemulsion (NE) formulation to improve VD3 oral bioavailability for management of vitamin D inadequacy in autistic children. Eight NE formulations were prepared by high-speed homogenization followed by ultrasonication. Four vegetable oils were employed along with two concentrations of Span 20 as the emulsifier. Glycerol, fructose, and mango flavor were included as viscosity modifier, sweetening, and flavoring agents, respectively. The prepared VD3-loaded NE formulations exhibited high drug content (> 98%), droplet size (DS) ranging from 61.15 to 129.8 nm with narrow size distribution, zeta potential values between − 9.83 and − 19.22 mV, and acceptable pH values (4.59–5.89). Storage stability showed that NE formulations underwent coalescence and phase separation during 6 months at room temperature, whereas at refrigerated conditions, formulations showed slight creaming. The optimum formulation (VD3-NE6) revealed a non-significant DS growth at refrigerated conditions and spherical morphology under transmission electron microscopy. VD3-NE6 did not produce any toxic effects to rats treated orally for 3 months, where normal blood picture and kidney and liver functions were observed compared to control rats. Also, serum calcium, oxidative stress, and apoptosis biomarkers remained within normal levels, indicating the safety of the optimum formulation. Furthermore, evaluation of VD3-NE6 oral bioavailability depicted a significant increase in AUC0–72 and Cmax with decreased Tmax compared to plain VD3. The optimum formulation demonstrated improved stability, safety, and oral bioavailability indicating the potential for successful management of vitamin D deficiency in autistic children.
Balanced Nonopioid General Anesthesia With Lidocaine Is Associated With Lower Postoperative Complications Compared With Balanced Opioid General Anesthesia With Sufentanil for Cardiac Surgery With Cardiopulmonary Bypass: A Propensity Matched Cohort Study
Authors: Guinot Pierre-Grégoire , Andrei Stefan , Durand Bastien , Martin Audrey , Duclos Valerian , Spitz Alexandra , Berthoud Vivien , Constandache Tiberiu , Grosjean Sandrine , Radhouani Mohamed , Anciaux Jean-Baptiste , Nguyen Maxime , Bouhemad Belaid
Published: February 2023

BACKGROUND:

There are no data on the effect of balanced nonopioid general anesthesia with lidocaine in cardiac surgery with cardiopulmonary bypass. The main study objective was to evaluate the association between nonopioid general balanced anesthesia and the postoperative complications in relation to opioid side effects.

METHODS:

Patients undergoing cardiac surgery with cardiopulmonary bypass between 2019 and 2021 were identified. After exclusion of patients for heart transplantation, left ventricular assistance device, and off-pump surgery, we classified patients according to an opioid general balanced anesthesia or a nonopioid balanced anesthesia with lidocaine. The primary outcome was a collapsed composite of postoperative complications that comprise respiratory failure and confusion, whereas secondary outcomes were acute renal injury, pneumoniae, death, intensive care unit (ICU), and hospital length of stay.

RESULTS:

We identified 859 patients exposed to opioid-balanced general anesthesia with lidocaine and 913 patients exposed to nonopioid-balanced general anesthesia. Propensity score matching yielded 772 individuals in each group with balanced baseline covariates. Two hundred thirty-six patients (30.5%) of the nonopioid-balanced general anesthesia versus 186 patients (24.1%) presented postoperative composite complications. The balanced lidocaine nonopioid general anesthesia group was associated with a lower proportion with the postoperative complication composite outcome OR, 0.72 (95% CI, 0.58–0.92; P = .027). The number of patients with acute renal injury, death, and hospital length of stay did not differ between the 2 groups.

CONCLUSIONS:

A balanced nonopioid general anesthesia protocol with lidocaine was associated with lower odds of postoperative complication composite outcome based on respiratory failure and confusion.
Beauty Regimes
Authors: Clutario Genevieve Alva
Published: February 2023

Genevieve Alva Clutario traces how beauty and fashion in the Philippines shaped the intertwined projects of imperial expansion and modern nation building during the turbulent transition between Spanish, US, and Japanese empires.
Visual Evoked Potential Can Predict Deterioration of Visual Function After Direct Clipping of Paraclinoid Aneurysm With Anterior Clinoidectomy
Authors: Kawajiri Satoshi , Isozaki Makoto , Komori Osamu , Yamada Shinsuke , Higashino Yorhifumi , Yamauchi Takahiro , Akazawa Ayumi , Kidoguchi Masamune , Yomo Munetaka , Kodera Toshiaki , Arishma Hidetaka , Awara Kousuke , Inatani Masaru , Kikuta Kenichiro
Published: February 2023

BACKGROUND:

The role of visual evoked potential (VEP) in direct clipping of the paraclinoid internal carotid artery (ICA) aneurysm remains uncertain.

OBJECTIVE:

To examine whether intraoperative neuromonitoring with VEP can predict deterioration of visual function after direct clipping of the paraclinoid ICA aneurysm with anterior clinoidectomy.

METHODS:

Among consecutive 274 patients with unruptured cerebral aneurysm, we enrolled 25 patients with paraclinoid ICA aneurysm treated by direct clipping after anterior clinoidectomy with intraoperative neuromonitoring with VEP in this study. We evaluated the visual acuity loss (VAL) and visual field loss (VFL) before surgery, 1 month after surgery, and at the final follow-up.

RESULTS:

The VAL at 1 month after surgery (VAL1M) and VAL at the final follow-up (Final VAL) were significantly related to the reduction rate of VEP amplitude at the end of surgery (RedEnd%), more than 76.5%, and the maximal reduction rate of VEP amplitude during surgery (MaxRed%), more than 66.7% to 70%. The VFL at 1 month after surgery (VFL1M) and the VFL at the final follow-up (Final VFL) were significantly related to MaxRed% more than 60.7%.

CONCLUSION:

VAL1M, Final VAL, VFL1M, and Final VFL could be significantly predicted by the value of RedEnd% and MaxRed% in direct clipping of Al-Rodhan group Ia, Ib, and II paraclinoid ICA aneurysms with anterior clinoidectomy.
Perioperative Systemic Therapy Versus Cytoreductive Surgery and HIPEC Alone for Resectable Colorectal Peritoneal Metastases: Patient-Reported Outcomes of a Randomized Phase II Trial
Authors: Bakkers C. , Rovers K. P. , Rijken A. , Simkens G. A. A. M. , Bonhof C. S. , Nienhuijs S. W. , Burger J. W. A. , Creemers G. J. M. , Brandt-Kerkhof A. R. M. , Tuynman J. B. , Aalbers A. G. J. , Wiezer M. J. , de Reuver P. R. , van Grevenstein W. M. U. , Hemmer P. H. J. , Punt C. J. A. , Tanis P. J. , Mols F. , de Hingh I. H. J. T. ,   the Dutch Peritoneal Oncology Group and the Dutch Colorectal Cancer Group, Thijs A. M. J. , Lurvink R. J. , Madsen E. V. E. , van Meerten E. , Kusters M. , Versteeg K. S. , Kok N. F. M. , Buffart T. E. , Boerma D. , Los M. , de Wilt J. H. W. , Verheul H. M. W. , Kruijff S. , de Groot D. J. A. , Koopman M.
Published: February 2023

Background

As part of a randomized phase II trial in patients with isolated resectable colorectal peritoneal metastases (CPMs), the present study compared patient-reported outcomes (PROs) of patients treated with perioperative systemic therapy versus cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS–HIPEC) alone. Also, PROs of patients receiving perioperative systemic therapy were explored.

Patients and Methods

Eligible patients were randomized to perioperative systemic therapy (experimental) or CRS–HIPEC alone (control). PROs were assessed using EORTC QLQ-C30, QLQ-CR29, and EQ-5D-5L questionnaires at baseline, after neoadjuvant treatment (experimental), and at 3 and 6 months postoperatively. Linear mixed modeling was used to compare five predefined PROs (visual analog scale, global health status, physical functioning, fatigue, C30 summary score) between arms and to longitudinally analyze PROs in the experimental arm.

Results

Of 79 analyzed patients, 37 (47%) received perioperative systemic therapy. All predefined PROs were comparable between arms at all timepoints and returned to baseline at 3 or 6 months postoperatively. The experimental arm had worsening of fatigue [mean difference (MD) + 14, p = 0.001], loss of appetite (MD + 15, p = 0.003), hair loss (MD + 18, p < 0.001), and loss of taste (MD + 27, p < 0.001) after neoadjuvant treatment. Except for loss of appetite, these PROs returned to baseline at 3 or 6 months postoperatively.

Conclusions

In patients with resectable CPM randomized to perioperative systemic therapy or CRS–HIPEC alone, PROs were comparable between arms and returned to baseline postoperatively. Together with the trial’s previously reported feasibility and safety data, these findings show acceptable tolerability of perioperative systemic therapy in this setting.
The Prognostic Value of Distinct Histological Growth Patterns of Colorectal Peritoneal Metastases: A Pilot Study
Authors: El Asmar Antoine , Demetter Pieter , Fares Fahd , Sclafani Francesco , Hendlisz Alain , Donckier Vincent , Vermeulen Peter , Liberale Gabriel
Published: February 2023

Background

Different histological growth patterns (HGP) describing the tumor-to-liver interface have been described in colorectal liver metastases and have been associated with a strong prognostic value. However, HGP of peritoneal metastases (PM) of colorectal cancer (CRC) have not yet been described. Our objective was to determine whether distinct HGP can be identified in PMCRC and to evaluate their potential prognostic value in these patients.

Methods

This retrospective study included 38 patients who underwent curative-intent surgery for PMCRC between July 2012 and March 2019, with PCI≤6, and who had not received preoperative chemotherapy. In each patient, the tumor-to-peritoneum interface was evaluated in the excised peritoneal nodules. The association between HGP and postoperative survival was analyzed by using the Kaplan–Meier method.

Results

Two distinct HGP were identified: a pushing-type (P-HGP), characterized by a fibrous rim separating the PM and peritoneum, and an infiltrating-type (I-HGP), characterized by focal penetration of tumor cells into the surrounding peritoneal lining without a fibrous rim. Fifteen patients had dominant P-HGP, and 23 patients had dominant I-HGP. Patients with dominant P-HGP (>50% tumor-peritoneum interface) had a significantly better DFS (30 months) than those with P-HGP <50% (9 months; p = 0.029). Patients with a P-HGP dominance >60% had better OS (131 months) than those with P-HGP <60% (41 months; p = 0.044).

Conclusions

This is the first description of two distinct, reproducible HGP in PMCRC. The dominant P-HGP is associated with a favorable prognosis in patients with PMCRC, compared with I-HGP, suggesting that this parameter could ultimately represent a new prognostic biomarker.
Identification of Up47 in three thermophilic archaea, one mesophilic archaeon, and one hyperthermophilic bacterium
Authors: Wolff Philippe , Lechner Antony , Droogmans Louis , Grosjean Henri , Westhof Eric
Published: February 2023

Analysis of the profile of the tRNA modifications in severalArchaeaallowed us to observe a novel modified uridine in the V-loop of several tRNAs from two species:Pyrococcus furiosusandSulfolobus acidocaldarius. Recently, Ohira and colleagues characterized 2′-phosphouridine (Up) at position 47 in tRNAs of thermophilicSulfurisphaera tokodaii, as well as in several other archaea and thermophilic bacteria. From the presence of the genearkIcorresponding to the RNA kinase responsible for Up47 formation, they also concluded that Up47 should be present in tRNAs of other thermophilicArchaea. Reanalysis of our earlier data confirms that the unidentified residue in tRNAs of bothP. furiosusandS. acidocaldariusis indeed 2′-phosphouridine followed by m5C48. Moreover, we find this modification in several tRNAs of otherArchaeaand of the hyperthermophilic bacteriumAquifex aeolicus.
Prevalence and determinants of obesity among individuals with diabetes in Indonesia
Authors: Azam Mahalul , Sakinah Luluk Fadhoh , Kartasurya Martha Irene , Fibriana Arulita Ika , Minuljo Tania Tedjo , Aljunid Syed Mohamed
Published: February 2023

Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia.

Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33.905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects.

Results: Of the 3911DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity  among DM subjects; while high HDL (POR=0.60; 95% CI: 0.46-0.78 higher education (POR=0.64; 95% CI: 0.53-0.78) and married (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects.

Conclusions:. The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.
Corrosion of copper nickel titanium archwire in chlorhexidine, sodium fluoride, and chitosan mouthwashes
Authors: Sufarnap Erliera , Harahap Kholidina Imanda , Adiana Ika Devi , Lim Davin , Lim Chatty , Christy Christy
Published: February 2023

Background: Copper (Cu), nickel (Ni), chromium (Cr) ion release, and surface topography change from the orthodontic wire are the initial processes of corrosion that may affect the mechanical properties of the archwire.  In this study, we aim to evaluate the effect of CHX, NaF, and chitosan on the corrosion of  CuNiTi wire nickel and copper ions released, surface roughness change, and archwire deflection.

Methods: Ninety samples of CuNiTi Tanzo™ archwires were divided into five groups according to their immersion solution: Artificial Saliva, CHX, NaF, CHX-NaF, and chitosan group. Each group was further divided into three subgroups (n=6) corresponding immersion time, i.e., two, four, and six weeks. The corrosion of the samples was analyzed with an atomic absorption spectrophotometer (AAS), scanning electron microscope (SEM), and universal testing machine (UTM).

Results: The amount of nickel ion releases was increasing, but the copper ion releases were reduced by the time of observations. The highest nickel ion was released in the CHX-NaF group and the lowest in the chitosan group for six-week immersion. It also corresponded to the surface topography by SEM analysis which showed the most extended cracks and deep pits in the CHX-NaF group and a smoother surface in the chitosan group. Copper ion release showed the highest ion release in the NaF group and the lowest release in the chitosan group. The unloading force of CuNiTi archwire deflection remains the same at week two and week four for all mouthwashes.

Conclusion: The use of mouthwashes that contained CHX, NaF, and chitosan could further alter the passive layer and cause higher nickel and copper ion release and increased CuNiTi archwire surface structure porosity. But there is no distinction between mouthwashes to release the unloading force within two until four weeks.
Automatic logarithm and associated measures
Authors:   Texas A&M University, Grigorchuk R. , Kogan R. ,   Texas A&M University, Vorobets Y. ,   Texas A&M University
Published: February 2023

We introduce the notion of the automatic logarithm LogA(B) of a finite initial Mealy automaton B, with another automaton A as the base. It allows one to find for any input word w a power n such that B(w)=An(w). The purpose is to study the expanding properties of graphs describing the action of the group generated by A and B on input words of a fixed length interpreted as levels of a regular d-ary rooted tree T. Formally, the automatic logarithm is a single map LogA(B):∂T→Zd from the boundary of the tree to the d-adic integers. Under the assumption that theaction of the automaton A on the tree T is level-transitive andof bounded activity, we show that LogA(B) can be computed bya Moore machine. The distribution of values of the automatic logarithm yields a probabilistic measure μ on ∂T, which in some cases can be computed by a Mealy-type machine (we then say that μ is finite-state). We provide a criterion to determine whether μ is finite-state. A number of examples with A being the adding machine are considered.
On the structure of low-dimensional Leibniz algebras: some revision
Authors:   Oles Honchar Dnipro National University, Kurdachenko L. A. , Pypka O. O. ,   Oles Honchar Dnipro National University, Subbotin I. Ya. ,   National University
Published: February 2023

Let L be an algebra over a field F with the binary operations + and [·,·]. Then L is called a left Leibniz algebra if [[a,b],c]=[a,[b,c]]−[b,[a,c]] for all a, b, c ∈ L. We describe the inner structure of left Leibniz algebras having dimension 3.
A forensic method for investigating manipulated video recordings
Authors: Kara Ilker , Korkmaz Ceren , Karatatar Alihan , Aydos Murat
Published: February 2023

Forensic image analysis can be used to resolve difficult incidents, such as the increasing number of child sexual abuse cases. Although the United Nations and European Union countries are trying to fight these crimes, criminals are developing new methods to circumvent the measures taken. Sharing videos that do not contain any criminal elements and inserting child sexual abuse videos between frames is a new method that has been seen recently. This article proposes a new method to analyse the videos prepared this way. The proposed method is particularly advantageous for detecting and analysing videos that have been manipulated and embedded in different content and can be applied as a new technique.
Virtuous Cycles
Authors: Schuhmann D , Oppelt Fabio , Merkel M , Harrison DK
Published: February 2023

AS HYBRIDIZATION AND ELECTRIFICATION EVOLVE FROM AUTOMOTIVE TO OFF-HIGHWAY, THE ADOPTION OF NEW DRIVING CYCLES WILL HELP TO ENABLE MORE ACCURATE AND EFFECTIVE VEHICLE DESIGN
Aero pace
Authors: Goold Ian
Published: February 2023

After a pause in the flight test program, A330-800 flying has resumed apace, building on the success of the larger -900 variant