bluuebunny/crossref_metadata_2025 huggingface dataset:
Allelochemicals of invasive tree species Senna spectabilis alleviate antioxidant enzymes activities in native plants of the Western Ghats
Authors: - SUBY , K Hrideek T , V Santhoshkumar A
Published: October 2023

Invasive alien species are major threats to biodiversity worldwide. Senna spectabilis is one such species that has been introduced to several countries, including India. This study aimed to investigate the allelopathic potential of S. spectabilis and its effects on seedlings of native plants over a period of three years. Assays such as metabolic activity, L-proline estimation, lipid peroxidation, antioxidant enzyme assay, and polyphenol oxidase activity were used to assess the allelopathic potential of S. spectabilis and finally, bioactive phytochemical components were identified by Gas chromatography coupled with mass spectrometry (GC–MS). The metabolic activity of treated seedlings decreased significantly, while lipid peroxidation and L-proline content increased. Antioxidant enzyme activities were also increased in response to S. spectabilis extract. GC-MS analysis detected 28 phytoconstituents in the leaf extracts prepared from 5 different solvents, and 7 plant allelochemicals were identified. The results showed that S. spectabilis extracts contained several allelochemicals, including phenolic compounds, fatty acids, and terpenoids. These findings suggest that S. spectabilis has strong allelopathic potential, which could contribute to its invasive potential. The present study highlights the need for effective management strategies to control the spread of this invasive species and the importance of selecting specific native species for restoration programme.
Profiles of Community Care Sites and provider Community Health Workers: A Case study at Gombe Matadi, Kenge and Kisantu Rural Health Zones in the Democratic Republic of Congo
Authors: Etshumba Jean Mukulukulu , Bebe Dosithee Ngo , Emina Jacques , Ndosimao Celestin Nsibu
Published: October 2023

Background: In sub-Saharan Africa, the DRC is ones of countries with high infant and child mortality. To solve this problem, the Ministry of Public Health has set up a new program: IMCI-C at the level of Community Care Sites managed by non-health professionals who are provider CHWs. Since its implementation, there have not yet been many studies that concretely describe the operation of CCS. It’s why we have chosen the Realist Evaluation Approach to analyze CCS functionality in the DRC.
Methods: To carry out this study which is a mixed method case study (qualitative and quantitative); we applied the fundamental principles of a realist evaluation which come down to Context – Mechanisms – Effects in the conceptual framework model that we developed with an emphasis on Mechanisms. Provider CHWs profile and CCSs functionality were defined after data collection through documentary review, CCS direct observation, in-depth interview with registered nurses and health zone team members using an interview guide with semi-structured questionnaire and a survey using a quantitative questionnaire with provider CHWs.
Results: CCS functionality was measured through the standards enacted for the implantation of CCS as well as the profile of provider CHWs which manage them. At the significance level (p=0.039) has been in place for 3 years or more increases by 7 times chance that it is functional (OR = 6.7; p = 0.000), has household is located less than 5 km from the CCS increases by 4 times chance that the CCS is functional (OR = 7.04; p = 0.034), has provider CHW is regularly trained and supervised increases by 10 times chance that the CCS is functional (OR = 10.01; p = 0.031), provider CHW participation in CAC meetings (OR = 4.34; p = 0.009) and CCS Management Team leads the management of CCS increase by 4 times chance that this CCS is functional (OR = 3.6; p = 0.002). Finally, if there is an initiative for funding CCS increases by 8 times CCS functionality (OR = 8.69; p = 0.009).
Conclusion: CCS are functional in the three RHZs. Their organization, establishment and operation are directly linked to the provision of services to populations living mainly in health areas with difficult access, the availability of inputs of three IMCI-C diseases management, namely uncomplicated malaria, diarrhea and pneumonia as well as building provider community health workers capacity to ensure their management. This study shows an effective contribution of provider CHWs on CCS functionality in health areas with difficult access.
A Fully Automated and Explainable Algorithm for the Prediction of Malignant Transformation in Oral Epithelial Dysplasia
Authors: Rajpoot Nasir , Shephard Adam , Bashir Raja , Mahmood Hanya , Jahanifar Mostafa , Minhas Fayyaz , Raza Shan E Ahmed , McCombe Kris , Craig Stephanie , James Jacqueline , Brooks Jill , Nankivell Paul , Mehanna Hisham , Khurram Syed Ali
Published: October 2023

Oral epithelial dysplasia (OED) is a premalignant histopathological diagnosis given to lesions of the oral cavity. Its grading suffers from significant inter-/intra-observer variability, and does not reliably predict malignancy progression, potentially leading to suboptimal treatment decisions. To address this, we developed a novel artificial intelligence (AI) algorithm, that assigns an Oral Malignant Transformation (OMT) risk score based on the Haematoxylin and Eosin (H&E) stained whole slide image (WSI). Our AI pipeline leverages an in-house segmentation model to detect and segment both nuclei and epithelium. Subsequently, a shallow neural network utilises interpretable morphological and spatial features, emulating histological markers, to predict progression. We conducted internal cross-validation on our development cohort (Sheffield; n = 193 cases) and independent validation on two external cohorts (Birmingham and Belfast; n = 89 cases). The proposed OMTscore achieved an AUROC ≥ 0.75 in predicting OED progression. Survival analyses showed the prognostic value of our OMTscore, compared to WHO and binary grades. Nuclear analyses elucidated the presence of peri-epithelial and epithelium-infiltrating lymphocytes in highly predictive patches of transforming cases (p < 0.0001). This is the first study to propose a completely automated, interpretable and externally validated algorithm for predicting OED transformation. Our algorithm shows better-than-human-level performance, offering a promising solution to the challenges of grading OED in routine clinical practice.
A service evaluation of non-contact vision-based patient monitoring technology for patients in a high-secure forensic psychiatric hospital: a qualitative study
Authors: Dewa Lindsay H , Broyd Josephine , Hira Rita , Dudley Alison , Hafferty Jonathan D , Bates Robert , Aylin Paul
Published: October 2023

Background
Technology has the potential to monitor patient safety in real-time that helps staff and without disturbing the patient. However, staff and patients’ perspectives on using passive monitoring within an inpatient setting is lacking. The study aim was to explore stakeholders’ perspectives about using Oxehealth passive monitoring technology within a high-secure forensic psychiatric hospital in the UK as part of a wider mixed-methods service evaluation.
Methods
Semi-structured interviews were conducted with staff and patients with experience of using Oxehealth technology face-to-face within a private room in Broadmoor Hospital. We applied thematic analysis to the data of each participant group separately. Themes and sub-themes were integrated, finalised, and presented in a thematic map. Design, management, and analysis was meaningfully informed by both staff and patients.
Results
Twenty-four participants were interviewed (n = 12 staff, n = 12 patients). There were seven main themes: detecting deterioration and improving health and safety, “Big Brother Syndrome”, privacy and dignity, knowledge and understanding, acceptance, barriers to use and practice issues and future changes needed. Oxehealth technology was considered acceptable to both staff and patients if the technology was used to detect deterioration and improve patient’s safety providing patient’s privacy was not invaded. However, overall acceptance was lower when knowledge and understanding of the technology and its camera was limited. Most patients could not understand why both physical checks through bedroom windows, and Oxehealth was needed to monitor patients, whilst staff felt Oxehealth should not replace physical checks of patients as it is mainly there to reassure staff on patient safety.
Conclusions
Oxehealth technology is considered viable and acceptable by both staff and patients. However, more support and education is needed for new patients and staff to better understand how it works in the short- and long-term. A feasibility study or pilot trial to compare the impact of Oxehealth with and without physical checks may be needed.
Responses of Soil Water Potential and Plant Physiological Status to Pulsed Rainfall Events in Arid Northwestern China: Implications to Disclose the Water-use Strategies of Desert Plants
Authors: Ma Yuanyuan , Liu Hu , Zhao Wenzhi , Guo Li , Yang Qiyue , Li Yulong , Liu Jintao , Yetemen Omer
Published: October 2023

Soil water potential (SWP) is vital for plant productivity and ecosystem functioning. This is especially true in arid regions, where rainfall typically falls in brief pulses of variable size. This work aims to improve understanding of the response of SWP to varied rainfall pulses, and of the water-use strategies of a typical desert plant (Haloxylon ammodendron, HA) in arid northwestern China. Rainfall manipulation experiments and field measurements were conducted on HA to explore the response features of SWP and plant physiological status to pulsed rainfall events of varied magnitudes and durations. Multivariate Adaptive Regression Splines (MARS) was used to rank the factors influencing the response patterns of these variables. The response rate and amplitude of SWP increased with rainfall magnitude, and was most affected by three vital factors (antecedent SWP, rainfall amplitude, and rainfall intensity). Very small rainfall (< 2 mm) can increase SWP in the 20-cm layer by nearly 30%, and thus is likely to contribute to the drought relief of HA under low antecedent SWP (< -3.5 MPa), while large rainfall events (> 15 mm) influence deep SWP (60 cm) and enhance the positive correlation between SWP and soil temperature. Very small events play a vital role in maintaining SWP and promoting water use of desert plants. With longer intervals between future rainfall events, HA will tend to improve its water utilization efficiency. Given the nature of plants' utilization of small rainfall events, re-examining ecologically valid SWP thresholds of HA and other similar desert plants is critical.
Diagnostic predictive value of peripheral blood count and inflammatory markers in gastric cancer
Authors: sun hongyang , Liu Jincheng , Lu Liang
Published: October 2023

ObjectiveTo investigate the correlation between the systemic immuno-inflammatory index (SII), platelet-to-lymphocyte ratio (PLR),monocyte/lymphocyte ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR) and gastric cancer and to evaluate the predictive value of SII, NLR, MLR and PLR for gastric cancer diagnosis.
Methods Clinical data (age, sex, BMI, blood indexes, carcinoembryonic antigen, and alpha-fetoprotein) were retrospectively collected from 318 patients with a primary diagnosis of gastric cancer, gastric polyps or chronic gastritis treated in Chaohu Hospital of Anhui Medical University. The patients were divided into training and validation groups at a ratio of 7:3 by applying the Rand random function. After identifying the indicators with significant intergroup differences, the receiver operator characteristic curves (ROC) were plotted, and the optimal cut-off value, area under the curve (AUC), OR and 95% confidence interval (95% CI) of the independent risk factors for the diagnostic prediction of gastric cancer were analyzed to establish a diagnostic prediction model. This model was applied to the validation group to assess the discriminatory degree of the model.
Results ROC analysis showed that the optimal thresholds for monocyte count, SII, NLR, MLR, PLR, methemoglobin, carcinoembryonic antigen, leukocytes, and lymphocytes were 0.41×109/L, 554.44, 3.14, 0.24, 151.54, 1.43 µg/L, 5.01 µg/L, 4.34×109/L, and 1.68× 109/L, respectively. Univariate analysis showed that sex, age, BMI, monocyte count, SII, NLR, MLR, PLR, alpha-fetoprotein, carcinoembryonic antigen, leukocyte count, and lymphocyte count were associated with gastric cancer. Multivariate analysis showed that the AUC of the diagnostic prediction model was 0.846 (95% CI 0.809-0.884, P < 0.001) in the training group, and when the diagnostic optimal critical value of the training group was applied to the validation group, the model had an AUC of 0.887 (95% CI 0.835-0.939, P < 0.001). These results suggest that the model has good differentiation. The SII, PLR and carcinoembryonic antigen values were lower in gastric cancer patients after treatment than before treatment.
Conclusion SII, NIR, MLR, and PLR are independent risk factors for gastric cancer, and MIR, PLR, alpha-fetoprotein, and carcinoembryonic antigen could be jointly used for the diagnosis and screening of gastric cancer.
Talazoparib enhances the Quinacrine-mediated apoptosis in patient-derived oral mucosa CSCs by inhibiting BER pathway through the modulation of GCN5 and P300
Authors: Das Chinmay , Dash Somya Ranjan , Sinha Saptarshi , Paul Subarno , Das Biswajit , Bhal Subhasmita , Sethy Chinmayee , Kundu Chanakya Nath
Published: October 2023

The presence of cancer stem cells (CSCs) in the tumor microenvironment (TME) is majorly responsible for the development and recurrence of cancer. Earlier reports suggested that upon DNA damage, Poly-(ADP-ribose) Polymerase-1 (PARP-1) helps in chromatin modulation and DNA repair process, thereby promoting CSC survival. But whether a combination of DNA damaging agents along with PARP inhibitors can modulate chromatin assembly, inhibit DNA repair processes, and subsequently target CSCs is not known. Hence, we have investigated the effect of nontoxic bioactive compound quinacrine (QC) and a potent PARP inhibitor Talazoparib in patient-derived oral mucosa CSCs (OM-CSCs) and in vivo xenograft mice preclinical model systems. Data showed that QC + Talazoparib inhibited the PARP-1-mediated chromatin remodelers’ recruitment and deregulated HAT activity of GCN5 (general control nonderepressible-5) and P300 at DNA damage site, thereby preventing the access of repair proteins to the damaged DNA. Additionally, this combination treatment inhibited topoisomerase activity, induced topological stress, and induced apoptosis in OM-CSCs. Similar results were observed in an in vivo xenograft mice model system. Collectively, the data suggested that QC + Talazoparib treatment inhibited BER pathway, induced genomic instability and triggered apoptosis in OM-CSCs through the deregulation of PARP-1-mediated chromatin remodelers (GCN5 and P300) activity.
Fine-mapping and evolutionary history of R-BPMV, a dominant resistance gene to Bean pod mottle virus in Phaseolus vulgaris L.
Authors: MEZIADI Chouaïb , ALVAREZ-DIAZ Juan-Camilo , THAREAU Vincent , GRATIAS Ariane , MARANDE William , SOLER-GARZON Alvaro , MIKLAS Phillip N. , PFLIEGER Stéphanie , Geffroy Valerie
Published: October 2023

Bean pod mottle virus (BPMV) is a comovirus that infects common bean and legumes in general. BPMV is distributed throughout the world and is a major threat on soybean, a closely related species of common bean. In common bean, BAT93 was reported to carry the R-BPMV resistance gene conferring resistance to BPMV and linked with the I resistance gene. To fine map R-BPMV, 182 recombinant inbred lines (RILs) derived from the cross BAT93 x JaloEEP558 were genotyped with polymerase-chain (PCR)-based markers developed using genome assemblies from G19833 and BAT93, as well as BAT93 BAC clone sequences. Analysis of RILs carrying key recombination events positioned R-BPMV to a target region containing at least 16 TIR-NB-LRR (TNL) sequences in BAT93. Because the I cluster presents a suppression of recombination and a large number of repeated sequences, none of the 16 TNLs could be excluded as R-BPMV candidate gene. The evolutionary history of the TNLs for the I cluster were reconstructed using microsynteny and phylogenetic analyses within the legume family. A single I TNL was present in Medicago truncatula and lost in soybean, mirroring the absence of complete BPMV resistance in soybean. Amplification of TNLs in the I cluster predates the divergence of the Phaseolus species, in agreement with the emergence of R-BPMV before the separation of the common bean wild centers of diversity. This analysis provides PCR-based markers useful in marker-assisted selection (MAS) and laid the foundation for cloning of R-BPMV resistance gene in order to transfer the resistance into soybean.
Novel Genetic Variants of HLA Gene Associated with Thai Behcet’s Disease (BD) Patients Using Next Generation Sequencing Technology
Authors: Sornsamdang Gaidganok , Shobana John , Chanprapaph Kumutnart , Chantratita Wasun , Chotewutmontri Sasithorn , Limtong Preeyachat , O-charoen Pichaya , Sukasem Chonlaphat
Published: October 2023

Behcet’s disease (BD) is a recurring inflammatory condition that mostly affects the eyes, mouth, and genitals, with organ involvement in the worst-case scenario. Along with environmental and other patient-related factors, genetic polymorphisms play a huge role in BD. This study aimed to investigate the susceptible genetic variants of HLA gene in 56 Thai BD patients and 192 healthy controls. HLA Genotyping was performed by next-generation sequencing (NGS) using a PacBio kit. The association was calculated by the multivariate logistic regression analysis. We found that the following alleles were found to be associated with BD: HLA-A*26:01:01 (OR=6.02, 95% CI=1.45-22.37, p=0.031), HLA-B*39:01:01 (OR=12.59, 95% CI=1.82-78.50, p=0.005), HLA-B*51:01:01 (OR=3.36, 95% CI=1.18-9.54, p=0.023), HLA-DQB1*05:03:01 (OR=9.35,95%CI=3.72-23.39, p=0.0001), and HLA-DRB1*14:54:01 (OR=32.48, 95% CI=18.11-60.78, p=0.001). When the association analysis was performed for a specific BD phenotype (ocular), HLA-DRB1*14:54:01 (OR=11.67, 95% CI=2.86-47.57, p = 0.001), HLA-B* 51:01:01 (OR=5.47, 95% CI=0.99-90.12, p = 0.05), and HLA-B* 51:01:02 (OR=5.33, 95% CI=1.23-23.06, p = 0.025) alleles had the association with ocular involvement in BD, and the HLA DRB1*14:54:01 (OR=3.35, 95% CI=1-11.99, p = 0.04) allele was found to be linked to vascular involvement in BD patients. In conclusion, for the first time in the Thai population, our study discovered susceptible novel alleles in BD patients such as HLA-A*26:01:01, HLA-B*39:01:01, HLA-B*51:01:01, HLA-DRB1*14:54:01, and HLA-DQB1*05:03:01. This highlights the necessity of genetic testing of the disease's risk alleles to diagnose BD. Despite these alleles have a lower positive predictive value, nearly all the observed risk alleles have significant negative predictive values.
The role of desire over obligation in explaining continued smoking abstinence
Authors: Cox Sharon , Brown Jamie , Perski Olga , Tattan-Birch Harry , Shahab Lion
Published: October 2023

Objective: To assess the role of self-reported desire over obligation in explaining continued smoking abstinence in recent ex-smokers.
Method: A 12-month prospective study of 230 (45.2% female; mean age 45.4 years) adults in England who confirmed they had made a serious quit attempt and were not currently smoking at baseline. The predictor variable was assessed at baseline through responses to the statement: “I am stopping smoking because I want to rather than because I feel I have to” on a 7-point Likert scale (1 = ‘strongly disagree’; 7 = ‘strongly agree’). The outcome was smoking status at 12-month follow-up. Covariates were baseline sociodemographic and smoking-related characteristics. Associations were assessed with logistic regression.
Results: At 12-month follow-up, 59.1% (n=136) reported they were still not smoking and 40.9% (n=94) had restarted smoking. Longer time since quit was positively associated with quit success maintenance at 12-months (adjusted Odds Ratio (AOR) 1.28, 95% Confidence Interval (CI) 1.04-1.58). People who were more strongly motivated to quit by desire were equally or less likely to still be abstinent at 12-months than those who were more motivated by obligation (AOR 0.85, 95%CI 0.70-1.01).
Conclusion: Being motivated by desire does not appear to be positively associated with continued smoking abstinence at 12-month follow-up. By contrast, our findings indicate that obligation may play a role in sustaining quit attempts, but more data across multiple time points are needed to understand this association.
Identifying Barriers and Facilitators to Care for Infants with Bronchopulmonary Dysplasia After NICU Discharge: A Prospective Study of Parents and Clinical Stakeholders
Authors: Lagatta Joanne , Harris Melissa , Cusatis Rachel , Malnory Margaret , Dawson Sara , Konduri Girija
Published: October 2023

Objective Understand barriers and facilitators to follow-up care for infants with bronchopulmonary dysplasia (BPD).Methods Qualitative study of parents and clinical stakeholders caring for infants with BPD. The interview guide was developed by a mother of a former 23-week preterm infant, neonatologist, pulmonologist, nurse, and qualitative researcher. Purposive sampling obtained a heterogenous sociodemographic and professional cohort. Subjects discussed their experience with BPD, barriers to care, caregiver quality of life and health education. Interviews were audio-recorded, transcribed and coded. Thematic analysis was used.Results Eighteen parents and 20 stakeholders completed interviews. Family-level themes included pragmatic barriers like transportation being multi-faceted; and caregiving demands straining mental health. System-level themes included caregiver education needing to balance process needs with future trajectories; and integration of primary care, specialty care, and community supports.Conclusions Individual and system barriers impact follow-up for infants with BPD. This conceptual framework can be used to measure and improve care.
Air quality monitoring device to mitigate the spread of COVID-19 in educational buildings.
Authors: Quiroga Diego , Diaz Sergio , Pastrana Homero F.
Published: October 2023

The COVID-19 pandemic brought significant consequences on healthcare systems, economy and politics. Nowadays, we know that the pathogen responsible for COVID-19 is transmitted mainly by aerosol droplets exhaled by infected individuals, which remain suspended in indoor air. There has been widespread interest in monitoring the CO2 levels in indoor spaces since an infected patient exhales CO2 and infectious aerosols when breathing. So, we designed and built an Air Quality Monitoring Device (AQMD) that measures and analyzes the levels of CO2 and particulate matter in the classrooms of a university with the aim of mitigating the spread of COVID-19. We divided the AQMD design into 2 phases: i) Data measurement and ii) Estimation of infection risk. Specifically, we measured the air quality in 3 classrooms of a university during different types of activities. Using these data, we calculated the recommended CO2 threshold for our classroom setting and estimated the probability of COVID-19 infection of a susceptible person. Our research shows that indoor CO2 concentrations and the probability of COVID-19 infection are influenced mainly by the type of activity and the number of windows open; besides, the number of students does not significantly impact the indoor CO2 concentrations levels because the range of students in the test scenario (18 to 31) was relatively small.
Ammonia is associated with liver-related complications and predicts mortality in acute-on-chronic liver failure patients.
Authors: Thanapirom Kessarin , Treeprasertsuk Sombat , Choudhury Ashok , Verma Nipun , Dhiman Radha Krishan , Mahtab Mamun Al , Devarbhavi Harshad , Shukla Akash , Hamid Saeed Sadiq , Jafri Wasim , Tan Soek Siam , Lee Guan H. , Ghazinyan Hasmik , Sood Ajit , Kim Dong Joon , Eapen C. E. , Tao Han , Yuemin Nan , Dokmeci A. Kadir , Sahu Manoj , Arora Anil , Kumar Ashish , Kumar Ramesh , Prasad V. G. Mohan , Shresta Ananta , Sollano Jose , Payawal Diana Alcantara , Lau George , Sarin Shiv Kumar
Published: October 2023

Background and aims: The relationship between ammonia and liver-related complications (LRCs) in acute-on-chronic liver failure (ACLF) patients is not well defined. This study aimed to evaluate the association of ammonia levels with LRCs in patients with ACLF. The study also evaluated the role of ammonia in predicting mortality and progression of LRCs.
Methods: ACLF patients using the APASL definition were prospectively recruited from the ACLF Research Consortium (AARC) between 2009 and 2019. A total of 3,871 cases were recruited, with most subjects caused by alcohol and HBV infection. Patients with baseline ammonia were enrolled for analysis. LRCs were a composite endpoint of bacterial infection, overt HE, and ascites.
Results: A total of 701 ACLF patients were enrolled. Ammonia levels were significantly higher in patients with LRCs than those without. Ammonia was significantly higher in ACLF patients with overt HE and ascites, but not in those with bacterial infection. Multivariate analysis revealed that AARC score, and ammonia were independently associated with LRCs. Within a month after admission, 350 patients (49.9%) died. Multivariate analysis demonstrated that older age, low haemoglobin, high INR, creatinine, ALT, and ammonia levels were independent predictors of 30-day mortality. Baseline ammonia ≥ 78 µmol/L was independently related to LRCs with an AUROC of 0.74 (p<0.001). Patients who had ammonia ≥ 78 µmol/L faced a higher risk of death within 30 days.
Conclusions: In ACLF patients, baseline arterial ammonia levels are associated with LRCs, mainly overt HE and ascites. Ammonia was also an independent predictor of 30-day mortality.
Self-inflicted ingestion of harmful chemicals in adolescents and adults: Risk factors and characteristics
Authors: Govender Rajen , Tonder Wayne van , Niekerk Ashley van
Published: October 2023

Background: Injury due to ingestion of harmful chemicals has become an area of concern globally. A specific category of such injuries is those that are self-inflicted. Although intentionality for self-infliction may be difficult to determine, key explanatory risks and demographic factors may contribute towards a better understanding of self-inflicted and harmful chemical ingestion injuries.
Methods: This study used secondary data that had been collected on burn injuries due to injection of harmful chemicals in a sample of South Africans from low-income communities close to major metropolitan centres. Logistic regression was used to determine how the risk for self-inflicted ingestion was differentiated from ingestion due to the actions of another person (other-inflicted ingestion) by sex and age cohort of the victim, and the presence of alcohol by examining paraffin ingestion versus that of other chemicals.
Results:The current findings indicate that sex, age cohort, presence of alcohol, and chemicals other than paraffin are key explanatory factors for an increased risk for self-inflicted ingestion of harmful chemicals.
Conclusions: The study empirically confirms the role of several key risk factors in what remains a largely unreported and understudied phenomenon. The findings contribute towards improved safety policies on availability and sale of chemical products and more focussed community interventions for at-risk individuals such as females and young people. It also flags the importance of assessing for alcohol use and alcohol use disorders at hospital admission of self-ingestion injuries.
A comparative analysis of antioxidant and bioactive constituents in micropropagated and wild Lindernia pusilla medicinal herb
Authors: Baro Tikendrajit , Das Debjani , Boro Sibo , Ali Raju , Kour Sharmistha Brahma , Das Sandeep
Published: October 2023

Lindernia pusila is one of the important medicinal herbs which is being used to treat various diseases. The present experiment is aimed to develop an efficient protocol for in vitro mass propagation of L. pusila and to study somaclonal variations in the micro propagated plants using RAPD technique. Surface sterilization of collected explants of L. pusila was performed using 0.1% mercuric chloride and cultured in MS media with different concentrations of growth regulators. Explant surface sterilization was most effective at 2 & 3 minutes of treatment with 0.1% mercuric chloride resulting in 75% of the explant survival. The media MS + 1 mg/L BAP + 0.2 mg/L NAA showed maximum shoot proliferation and multiplication per explant. After hardening of tissue cultured plants, the whole genome of wild and micro propagated plants was isolated using the DNeasy Plant Mini Kit and RAPD assay was performed using 14 different RAPD primers. Among the 14 RAPD primers, 7 primers formed polymorphic DNA bands in tissue-cultured Lindernia pusila plants. Comparatively the tissue cultured plant extract showed higher content of phenols, flavonoids, and anti-oxidant properties than the wild extracts of L. pusilla. In Chromatographic study of gallic acid, the tissue cultured extract showed more gallic acid concentration (42.9mg/g) than the wild sample (10.9mg/g) and the quercetin constituent of tissue cultured plant was higher than the wild extract. The volatile bioactive components found in the wild and tissue cultured extracts were studied using GC-MS analysis.
Analysis of Dynamic Changes and Driving Factors of Small Wetlands Around Chaohu Lake Based on Remote Sensing Images
Authors: Ding WenQing , Zhou Jiaqi , Deng Qing , Miao Haojie , Shi Guangzhi , Jin Jing
Published: October 2023

Small wetlands are widely distributed in urban and rural areas, serving as important water resources and water environment control units, as well as migratory habitats for flora and fauna and sites for biodiversity conservation. However, they are facing threats from climate change and the transformation of the interface between urban and rural spatial dynamics. Based on Gaofen remote sensing images, this study extracted and validated the extraction accuracy of small wetlands and other land use types around Chaohu Lake from 2015 to 2021 using three techniques, namely, random forest (RF), support vector machine (SVM), and maximum likelihood (MLE). Changes in the number of areas of small wetlands and the main driving factors during the period of 6 years were computed using ArcGIS. The results are as follows: (1) The overall classification accuracy and Kappa coefficient trends for 2015, 2018, and 2021 were all RFt > SVM > MLE, and the RF classification effect was the best. (2) The area of small wetlands around Chaohu Lake increased from 9114.42 hm2 in 2015 to 10706.84 hm2 in 2021, but the number decreased from 22279 to 21338. (3) The interaction between two factors has a greater impact on the area of small wetlands than a single factor. The interaction intensity of construction land, annual average precipitation, and altitude is relatively strong with others, which has the strongest impact on the dynamic changes of wetlands. The results emphasize that the accuracy of basic research data on small wetlands can be improved by using high-resolution remote sensing images and selecting classifiers, and that reducing disturbance from anthropogenic construction is a prerequisite for protecting and maintaining the ecological functions of small wetlands, and provide decision-making basis for the sustainable development of small wetlands.
Klebsiella pneumoniae invasive syndrome with liver, lung and brain abscesses complicated with pulmonary fungal infection: a case report and review of the literature
Authors: Luo Yunhao , Hu Wen , Wu Lingna , Duan Shijie , Zhong Xingmei
Published: October 2023

Background: Klebsiella pneumoniae invasion syndrome (KPIS)is a severe multi-site infection that is usually caused by hypervirulent Klebsiella pneumoniae. The bacteria are relatively common in Asian diabetics and can cause organ abscesses or sepsis. When patients develop intracranial infection, the prognosis is poor. After anti-infective treatment, the Klebsiella pneumoniae-induced liver and lung abscessesand pulmonary fungal infection were relieved, but the brain abscess worsened. Such complex and severe infection cases are rarely reported. Early identification of intracranial infection, selection of antibiotics with high concentrations in cerebrospinal fluid, and active treatment of complications such as diabetes and fungal infection are of great significance for the prognosis of patients.
Case presentation: A 71-year-old patient diagnosed with liver abscess in another hospital was transferred to our hospital due to a worsening condition. On day 1 (day of admission), the patient was given invasive mechanical ventilation, continuous renal replacement therapy combined with endotoxin adsorption, antimicrobial treatment with imipenem-cilastatin, and percutaneous catheter drainage for liver abscess. Metagenomic next-generation sequencing in bronchoalveolar lavage fluid indicated Klebsiella pneumoniae, Candida albicans, and Pseudomonas aeruginosa, and no viruses were detected. Blood and pus cultures revealed K. pneumoniae that was sensitive to piperacillin/tazobactam. The anti-infection therapy was adjusted to piperacillin/tazobactam combined with voriconazole.On day 14, a head computed tomography scan showed no significant changes, and a chest CT scan showed absorption of multiple abscesses in both lungs. The patient was still unconscious. After the endotracheal tube was removed, cranial magnetic resonance imaging showed multiple brain abscesses. Finally, his family gave up, and the patient was discharged and died in a local hospital.
Conclusion: In cases of Klebsiella pneumoniae infection, the possibility of intracranial, liver, lung, or other site infections should be considered, and physicians should be vigilant for the occurrence of KPIS. For patients suspected of developing an intracranial infection, cerebrospinal fluid should be tested and cultured as soon as possible, head MRI should be performed, and antibiotics with high distribution in cerebrospinal fluid should be used early. When patients are complicated with diabetes, in addition to glycemic control, vigilance for concurrent fungal infections is also needed.
Organ-specific Response with First-line Atezolizumab-Bevacizumab versus Lenvatinib for Patients with Advanced Hepatocellular Carcinoma
Authors: Kim Hyung-Don , Park Young-Gyu , Kim Sejin , Kim Kyu-Pyo , Park Sook-Ryun , Ryu Min-Hee , Ryoo Baek-Yeol , Yoo Changhoon
Published: October 2023

Background:Immune checkpoint inhibitor (ICI)-based treatments have become the mainstay of first-line treatment for unresectable hepatocellular carcinoma (HCC), but there has been a concern that intrahepatic HCC lesions may be less responsive to ICI monotherapy. We aimed to investigate the organ-specific response patterns among unresectable HCC patients treated with first-line atezolizumab-bevacizumab or lenvatinib.Methods:This retrospective study included 386 patients with Child-Pugh A unresectable HCC who were treated with first-line atezolizumab-bevacizumab (n = 217) or lenvatinib (n = 169). The organ-specific response was separately evaluated according to the site of the lesions: liver, lung, lymph node (LN), and intra-abdomen based on a radiological evaluation adopted from RECIST v 1.1.Results:The median age was 60 years. Hepatitis B infection was the most common etiology (n = 270, 69.9%), and 291 (75.4%) patients had a viral etiology. The proportion of patients achieving a ≥ 30% reduction in the tumor burden for each organ category was overall higher in the atezolizumab-bevacizumab group than in the lenvatinib group: 20.2% vs. 11.8%, 23.0% vs. 12.2%, 27.9% vs. 17.9% and 33.3% vs. 15.0% for intrahepatic, lung, LN and intra-abdominal lesions, respectively. The corresponding values for the subgroup with a viral etiology were 17.3% vs. 8.1%, 18.8% vs. 13.3%, 28.9% vs. 3.6% and 36.0% vs. 12.5%, respectively.Conclusion: Compared to lenvatinib, atezolizumab-bevacizumab was associated with a favorable organ-specific response regardless of the site of the tumor lesions. Unlike anti-PD-1 monotherapy, atezolizumab-bevacizumab had a comparable organ-specific response between intrahepatic and extrahepatic lesions, especially for those with viral etiology HCCs.
Age-related Difference in Oral Adaptation to Masticatory Perturbation
Authors: Lin Chia-Shu , Chen Yi-Chen , Chao Li-Jung , Kao Wei-Chieh , Chen Ta-Chung
Published: October 2023

Objectives: Mastication can be interfered with by intraoral perturbation (e.g., hard food). We developed the masticatory perturbation task (MPT) to assess the perturbation effect during mastication and quantify the degree of adaptation to masticatory perturbation in younger (YA) and older adults (OA).
Materials and Methods: 38 YA and 38 OA performed the MPT, which consists of three trials of assessment of masticatory performance (MP) without perturbation (i.e., the baseline condition), and three trials with perturbation (i.e., the perturbation condition). Perturbation was implemented by concurrently chewing testing food on the preferred side and a drinking straw on the non-preferred side. We estimated perturbation effect as ΔMP between the baseline vs. perturbation condition, and adaptation effect as ΔMP between the third vs. the first trial, for both age groups.
Results: We found significant perturbation effect, i.e., lower MP in the perturbation vs. the baseline condition, and adaptation effect, i.e., return of MP from the third trial to the first trial, in both groups. Moreover, the OA group showed a lower degree of adaptation compared to the YA group.
Discussion: The MPT is valid for assessing oral adaptation to masticatory perturbation
Conclusion: Increased age may be associated with lower degree of masticatory adaptation.
The effect of the amount of filler in iron on corrosion
Authors: Sedlarikova Marie , Kuchařík Jan , Gunther Fafilek , Zatloukal Miroslav , Čudek Pavel
Published: October 2023

The influence of the quantity of polymeric binder in the sintering of commercially obtained iron powder was investigated. Hydrogen-reduced iron powder with grain sizes below 50 µm was mixed with spherical polystyrene dissolved in 5 cm3 of acetone. The resulting dough-like mixture was cast into a mold and subsequently dried at 37°C. After drying, a two-phase firing process was carried out in a protective argon atmosphere. The fired samples were immersed in a 0.9% NaCl solution, and their corrosion current was continuously monitored. The use of polystyrene as a binder offers the advantage of maintaining a stable shape both after drying and firing. Dimensional stability is preserved. Three different quantities of polystyrene, namely 0.5g, 1.0g, and 1.5g, were used. The amount of added polystyrene influenced both the microscopic structure and the measured corrosion current. This research highlights the significance of binder selection and quantity in achieving the desired properties of iron powder compacts, emphasizing the pivotal role played by polymeric binders in the powder metallurgy process.
Epidemiology and factors associated with preterm births in multiple pregnancy: A retrospective cohort study
Authors: Seetho Samita , Kongwattanakul Kiattisak , Saksiriwuttho Piyamas , Thepsuthammarat Kaewjai
Published: October 2023

Objective
Multiple pregnancies carry an increased risk of maternal and perinatal complications, notably prematurity. There is a limited number of studies evaluating the risk factors for preterm births in multiple pregnancies within the Thai population. This study aims to ascertain maternal and perinatal outcomes and identify factors linked to preterm births in multiple pregnancies.
Methods
This study was carried out at the Khon Kaen University Faculty of Medicine Department of Obstetrics and Gynecology in Thailand. We included women with multiple pregnancies who delivered at a gestational age of more than 20 weeks between January 1, 2012, and December 31, 2021. Medical records were meticulously reviewed. We excluded patients with incomplete data or those for whom data were missing.
Results
Out of 21,400 pregnancies, 427 were multiple pregnancies, constituting approximately 1.99%. Over the ten-year period, 269 multiple pregnancies (65.1%) resulted in preterm births. Of these, 173 (64.3%) were monochorionic twins, and 96 (35.7%) were dichorionic twins. Monochorionic twins had a notably higher rate of preterm delivery (AOR, 2.06; 95%CI 1.29–3.30). Vaginal delivery was observed in 7.9% of the cases, while cesarean sections were performed for both twins in 91.5% of cases. In 0.5% of the cases, only the second twin was delivered by cesarean section. With regard to neonatal outcomes, 160 infants (19.4%) weighed less than 1500 grams at birth, and there were 78 perinatal deaths (9.4%). Birth asphyxia was noted in 97 cases (20.2%) among monochorionic twins and in 28 cases (8.1%) for dichorionic twins.
Conclusion
The prevalence of multiple pregnancies was 1.99%, with 65.1% resulting in preterm births. Neonatal complications were notably more frequent in monochorionic twins. The monochorionic placenta and antepartum complications emerged as significant risk factors for preterm birth.
The Nursing Student’s Ethical Sensitivity Scale: Development Using Item Response Theory
Authors: Torabizadeh Camellia , Gholamzadeh Sakineh , bagheri Zahra , Ebadi Abbas , Shayestehfard Marzieh , khah houshyari
Published: October 2023

Background
Recent advancements in medicine and the increasingly complex healthcare environment have led to various challenging ethical dilemmas. Nursing students must be prepared to navigate these ethical issues in their future roles. Ethical sensitivity plays a crucial role in the ethical decision-making process, making it necessary to develop a valid and reliable scale to measure nursing students' ethical sensitivity. Therefore, we developed a scale and assessed its psychometric properties using item response theory.
Methods
The Nursing Student's Ethical Sensitivity Scale (NS-ESS) was developed in three phases. First, questionnaire items were formulated based on a literature review and interviews with nursing students. Next, an expert panel and nursing students examined its face and content validity. Finally, a final draft of the scale was administered to 300 nursing students. Data on the sub-scales of students' ethical sensitivity were analyzed using the generalized partial credit item response theory model.
Results
All items showed acceptable fit, except for four items in the ethical perception category, five items in the moral affectivity category, two items in the critical cognitive processing category, and six items in the intimate participation category. Individual item information function analysis for NS-ESS items indicated that most items in the four subscales provided moderate to high information. Evaluation of item difficulty parameters revealed that approximately half of all items had high difficulty values. Sixty percent of the items demonstrated high discrimination power, effectively differentiating between various levels of students' ethical sensitivity. A closer examination of the individual item information functions for the NS-ESS items revealed that the majority of items across the four subscales exhibited moderate to high levels of information.
Conclusion
Item response theory procedures can provide more informative insights into item and test reliability compared to classical true score theory. The NS-ESS is a valid and reliable questionnaire that can be used to assess ethical sensitivity in nursing students, providing measures that are not dependent on the sample used.
Cell-Free DNA Methylation Analysis as a Marker of Malignancy in Pleural Fluid
Authors: Bixby Billie , Vrba Lukas , Lenka Jyoti , Oshiro Marc , Watts George S. , Hughes Trina. , Erickson Heidi , Chopra Madhav , Knepler James L. , Knox Kenneth S , Jarnagin Lisa , Alalawi Raed , Kala Mrinalini , Bernert Richard , Routh Joshua , Roe Denise J. , Garland Linda L. , Futscher Bernard W. , Nelson Mark A.
Published: October 2023

Background
Diagnosis of malignant pleural effusion (MPE) is made by cytological examination of pleural fluid or histological examination of pleural tissue from biopsy. Unfortunately, detection of malignancy using cytology has an overall sensitivity of 50%, and is dependent upon tumor load, volume of fluid assessed, and cytopathologist experience. The diagnostic yield of pleural fluid cytology is also compromised by low abundance of tumor cells or when morphology is obscured by inflammation or reactive mesothelial cells. A reliable molecular marker that may complement fluid cytology malignant pleural effusion diagnosis is needed. The purpose of this study was to establish a molecular diagnostic approach based on pleural effusion cell-free DNA methylation analysis for the differential diagnosis of malignant pleural effusion and benign pleural effusion.
Results
This was a blind, prospective case-control biomarker study. We recruited 104 patients with pleural effusion for the study. We collected pleural fluid from patients with: MPE (n = 48), PPE (n = 28), and benign PE (n = 28), and performed the Sentinel-MPE liquid biopsy assay. The methylation level of Sentinel-MPE was markedly higher in the MPE samples compared to BPE control samples (p < 0.0001) and the same tendency was observed relative to PPE (p = 0.004). We also noted that the methylation signal was significantly higher in PPE relative to BPE (p < 0.001). We also assessed the diagnostic efficiency of the Sentinel-MPE test by performing receiver operating characteristic analysis (ROC). For the ROC analysis we combined the malignant and paramalignant groups (n = 76) and compared against the benign group (n = 28). The detection sensitivity and specificity of the Sentinel-MPE test was high (AUC = 0.912). The Sentinel-MPE appears to have better performance characteristics than cytology analysis. However, combining Sentinel-MPE with cytology analysis could be an even more effective approach for the diagnosis of MPE.
Conclusions
The Sentinel-MPE test can discriminate between BPE and MPE. The Sentinel-MPE liquid biopsy test can detect aberrant DNA in several different tumor types. The Sentinel-MPE test can be a complementary tool to cytology in the diagnosis of MPE.
Exploratory Study of Neighborhood Change Effect on Mental Health in a Highly Gentrifying Neighborhood
Authors: Williams Christopher , Woodard Nathaniel , Kuo Charlene Chao-Li
Published: October 2023

Neighborhood change (NC) is a social determinant of health with direct psychosocial and economic impacts. Our objective was to assess the association between perceptions of NC and self-perceived mental health in a community experiencing intense neighborhood change. We conducted a cross-sectional study using random and convenience sampling from September 2020 to February 2021. Our measures included a combination of scales and indexes that were used for conducting bivariate and cluster analyses. We conducted a regression analysis to determine the variables most influencing mental health. Two clusters were most often significantly different – those with high negative and positive perceptions of NC. There was a positive association between poor or fair mental health and the perceived negative impact of NC. Cluster membership is an important aspect to understanding NC effects on mental health. The negative impact based on self-perception and vulnerable populations was shown to a strong predictor in regression analyses.