bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual Reality-based Vision Therapy Versus OBVAT in the Treatment of Convergence Insufficiency, Accommodative Dysfunction: A Randomized Controlled Trial
Authors: Li Shijin , Tang Angcang , Yang Bi , Wang Jianglan , Liu Longqian 
Published: October 2021

Abstract
Background: Virtual reality is being increasingly applied in vision therapy. However, the differences in effectiveness, optimal treatment cycle, and prognosis between virtual reality-based vision therapy and traditional therapies remain unknown. The purpose of this study was to compare the effectiveness of virtual reality-based vision therapy and office-based vergence/accommodative therapy in young adults with convergence insufficiency or accommodative dysfunction.Methods: The patients were randomly assigned to either the virtual reality-based vision therapy group or the office-based vergence/accommodative therapy group. The vision therapy lasted 12 weeks (1 h/week) in both groups. Binocular visual functions (vergence and accommodation) were measured and a subjective questionnaire-based assessment was performed at baseline and after 6 and 12 weeks of therapy.Results: In total, 33 patients with convergence insufficiency and 30 with accommodative dysfunction completed the study. After 12 weeks of treatment for convergence insufficiency, the Convergence Insufficiency Symptom Survey score (F2,31 = 13.704, P < 0.001), near point of convergence (F2,31 = 21.774, P < 0.001), positive fusional vergence (F2,31 = 71.766, P< 0.001), and near horizontal phoria (F2,31 = 16.482, P < 0.001) improved significantly in both groups. Moreover, the monocular accommodative amplitude (F2,25 = 22.154, P < 0.001) and monocular accommodative facility (F2,25 = 86.164, P < 0.001) improved significantly in both groups after 12 weeks of treatment. A statistically significant difference was observed in monocular accommodative facility (F1,25 = 8.140, P = 0.009) between the two groups, but not in other vergence and accommodative functions (0.098 < P < 0.687).Conclusion: Virtual reality-based vision therapy significantly improved binocular vision functions and symptoms in patients with convergence insufficiency and accommodative dysfunction, thereby suggesting its effectiveness as a new optional or additional treatment for young adults with these conditions.Trial registration: This study was registered at the Chinese Clinical Trials Registry on 16/04/2019 (identifier: ChiCTR1900022556).
Termination of Pregnancy for Fetal Anomaly: A Systematic Review of the Healthcare Experiences and Needs of Parents
Authors: Heaney Mrs Suzanne , Tomlinson Professor Mark , Aventin ine 
Published: October 2021

Abstract
BackgroundImproved technology and advances in clinical testing have resulted in increased detection rates of congenital anomalies during pregnancy, resulting in more parents being confronted with the possibility of terminating a pregnancy for this reason. There is a large body of research on the psychological experience and impact of terminating a pregnancy for fetal anomaly. However, there remains a lack of evidence on the holistic healthcare experience of parents in this situation. To develop a comprehensive understanding of the healthcare experience and needs of parents, this systematic review sought to summarise and appraise the literature on parents’ experiences following a termination of pregnancy for fetal anomaly.Review Question:What are the healthcare experiences and needs of parents who undergo a termination of pregnancy following an antenatal diagnosis of a fetal anomaly?MethodsA systematic review was undertaken with searches completed across six multi-disciplinary electronic databases (Medline, Embase, PsycINFO, CINAHL, Web of Science, and Cochrane). Eligible records were qualitative, quantitative or mixed methods studies, published between January 2010 and August 2021, reporting the results of primary data on the healthcare experiences or healthcare needs in relation to termination of pregnancy for fetal anomaly for either or both parents. Findings were synthesised using Thematic Analysis.ResultsA total of 30 records were selected for inclusion in this review of which 24 were qualitative, five quantitative and one mixed-methods. Five overarching themes emerged from the synthesis of findings: (1) Context of Care, (2) Person-centred Care, (3) Compassionate Care, (4) Co-ordinated Care, and (5) Inclusive Care.ConclusionCompassionate healthcare professionals who provide non-judgemental and sensitive care can impact positively on parents’ satisfaction with the care they receive. A well organised and co-ordinated healthcare system is needed to provide an effective and high-quality service.Registration:PROSPERO registration number: CRD42020175970
Ophthalmic and Genetics Profiles of Cystinosis in Tunisian Patients
Authors: Chkioua Latifa , Amri Yessine , Saheli Chayma , Mili Wassila , Mabrouk Sameh , Chabchoub Imen , Boudabous Hela , Azzouz Wissem Ben , Turkia Hadhami Ben , Ferchichi Salima , Tebib Neji , Massoud Taieb , Ghorbel Mohamed , Laradi Sandrine 
Published: October 2021

Abstract
Background: Ocular cystinosis is a rare autosomal recessive disorder characterized by intralysosomal cystine accumulation in renal, ophthalmic (cornea, conjunctiva), and other organ abnormalities. Patients with ocular cystinosis are mostly asymptomatic and typically experience mild photophobia due to cystine crystals in the cornea observed accidently during a routine ocular examination. The ocular cystinosis is associated with different mutations in CTNS gene. Cysteamine therapy mostly corrects the organ abnormalities. Methods: This study was performed in collaboration with the department of ophthalmology of Farhat Hached Hospital. The Optical Coherence Tomography (OCT) of the cornea and retinal photography were used to search cystine crystals within the corneas and conjunctiva in eight Tunisian patients. Screening for the common 57-kb deletion was performed by standard multiplex PCR, followed by direct sequencing of the entire CTNS gene. Results: The studied patients were found to have cystine crystal limited anterior corneal stroma and the conjunctiva associated with retinal crystals accumulation. CTNS gene sequencing disclosed 7 mutations: three missense mutations (G308R, p.Q88K, and p.S139Y); one duplication (C.829dup), one framshift mutation (p.G258f), one splice site mutation (c.681+7delC) and a large deletion (20327-bp deletion). Crystallographic structure analysis suggests that the novel mutation p.S139Y is buried in a first transmembrane helix closed to the lipid bilayer polar region, introducing a difference in hydrophobicity which could affect the hydrophobic interactions with the membrane lipids. The second novel mutation p.Q88K which is located in the lysosomal lumen close to the lipid membrane polar head region, introduced a basic amino acid in a region which tolerate only uncharged residue. The third missense mutation introduces a positive change in nonpolar tail region of the phospholipid bilayer membrane affecting the folding and stability of the protein in the lipid bilayer. Conclusion: Our data demonstrate that impaired transport of cystine out of lysosomes is the most common, which is obviously associated with the mutations of transmembrane domains of cystinosine resulting from a total loss of its activity.
RNA-seq Explores the Mechanism of Oxygen-Boosted Sonodynamic Therapy Based on All-in-One Nanobubbles to Enhance Ferroptosis for the Treatment of HCC
Authors: Chen Yichi , Shang Haitao , Wang Chunyue , Zeng Jiaqi , Zhang Shentao , Wu Bolin , Cheng Wen 
Published: October 2021

Abstract
Background
The combination of sonodynamic therapy and oxygenation strategy is widely used in cancer treatment. However, due to the complexity, heterogeneity and irreversible hypoxic environment produced by Hepatocellular carcinoma (HCC) tissues, oxygen-enhancing sonodynamic therapy (SDT) have failed to achieve the desired results. With the emergence of ferroptosis with reactive oxygen species (ROS) cytotoxicity, this novel cell death method has attracted widespread attention.
Methods
In this study, nanobubbles (NBs) were connected with the sonosensitizer Indocyanine green (ICG) to construct a 2-in-1 nanoplatform loaded with RAS-selective lethal (RSL3, ferroptosis promoter) (RSL3@O2-ICG NBs), combined with oxygen-enhanced SDT and potent ferroptosis. In addition, nanobubbles (NBs) combined with low-frequency ultrasound (LFUS) are called ultrasound-targeted nanobubble destruction (UTND) to ensure specific drug release and improve safety.
Results
MDA/GSH and other related experimental results show that RSL3@O2-ICG NBs can enhance SDT and ferroptosis. Through RNA sequencing (RNA-seq), the differential expression of LncRNA and mRNA before and after synergistic treatment was identified, and then GO and KEGG pathways were used to enrich and analyze target genes and pathways related ferroptosis sensitivity. Then we searched for the expression of differentially expressed genes in the TCGA Hepatocellular carcinoma cohort. At the same time, we evaluated the proportion of immune cell infiltration and the identification of co-expression network modules and related prognostic analysis. We found that it was significantly related to the tumor microenvironment of hepatocellular carcinoma. The prognostic risk genes "SLC37A2" and "ITGB7" may represent new hepatocellular carcinoma ferroptosis-inducing markers and have guiding significance for treating hepatocellular carcinoma.
Conclusions
The therapeutic effect of the in vitro synergistic treatment has been proven to be significant, revealing the prospect of 2-in-1 nanobubbles combined with SDT and ferroptosis in treating HCC.
Comparing NKp44+ and NKp44− ILC3s in Human Lung Cancer via Transcriptional Sequencing
Authors: Cheng Hang , Zhu Shan , Jin Chengyan , Wu Jing , Lv Xinping , Li Tete , Zang Guoxia , Gao Bao , Yang Zhiguang , Cui Jiuwei , Ueno Hideki , Liu Yong-Jun , Chen Jingtao 
Published: October 2021

Abstract
Purpose: Innate lymphoid cells (ILCs) play essential roles in mucosal innate immunity. The presence and function of ILCs in human lung cancer have not been extensively studied. This study aimed to identify and analyze the characteristics of the predominant subgroups in lung cancer. Methods: Single-cell suspensions were obtained from lung tissue diseased regions, non-diseased regions, and peripheral blood. The distribution of the ILC subgroups was analyzed by flow cytometry. The RNA of all samples was sequenced by BGI Group. Differentially expressed genes (DEGs) were assessed by functional and pathway enrichment analyses. Results: ILC3s were exclusively increased in the lung cancer diseased region. The NKp44 + ILC3 subgroup was found in the diseased and non-diseased regions, but not in the peripheral blood. RNA sequencing indicated similar basic transcripts in NKp44 − ILC3s and NKp44 + ILC3s, but more enrichment in the signal transduction pathway and signaling molecules and interaction pathway in NKp44 + ILC3s. Compared with in NKp44 − ILC3s, gene transcripts tended to be upregulated in NKp44 + ILC3s in the Ras, RAP1, Jak-STAT, Notch, NF-κB, and Toll-like receptor signaling pathways and downregulated in the TGF-β signaling pathway. In the signaling molecules and interaction pathway, levels of most key molecules were higher in NKp44 + ILC3s in the cell adhesion molecules and cytokine-cytokine receptor interaction pathways. Conclusion: ILC3s was the dominant group in lung cancer and NKp44 + ILC3s was significant in diseased region. By transcripts analysis, the upregulated pathways in NKp44 + ILC3s enable survival, proliferation, activation, interleukin production, and antigen presentation. Our results provide the transcript landscape of DEGs in NKp44 + and NKp44 − ILC3s in lung cancer, providing a theoretical basis for further study of potential therapies.
Willingness to Pay for a National Health Insurance (NHI) in Saudi Arabia: A Cross-sectional Study
Authors: Alharbi Abeer 
Published: October 2021

Abstract
Background Public health services in Saudi Arabia are provided free of charge to its citizens at the point of use. Recently, however, the government has realized that this model is unsustainable in the long run. Therefore, Saudi decision-makers are seeking to have a sustainable health system through the introduction of a contributory National Health Insurance that require making regular financial contributions from its members. Objective This study aims to explore the people’s willingness to pay for a National Health Insurance system in Saudi Arabia. The study also aims to understand the factors affecting their willingness or unwillingness to pay NHI, such as, their demographic and socio-economic characteristics, the type of their usual health care provider, and their satisfaction with the current healthcare services.Methods A cross-sectional study design with Contingent Valuation (CV) technique was used to measure the value of National Health Insurance based on an individual’s willingness to pay. The data were collected from 475 participants using an online survey via Google Forms between March 2021 and April 2021. Frequencies, logistic regression, and linear regression, were conducted to answer the research questions.Results The percentage of individuals who was willing to pay for NHI was higher than those who were not willing to pay (62.9%) vs (37.1%). There was a significant association between the type of usual healthcare provider and the likelihood of paying for NHI (OR CI = 0.20 to 0.51, p< 0.05=0.00). Also, there was a significant association between satisfaction with healthcare services and the likelihood of paying for NHI (OR CI = 0.02 to 0.31, p< 0.05=0.00). The median amount of money the people were willing to pay as a monthly contribution for NHI was 100 SAR (26.5 USD) with the average being 152 SAR (40 USD). There was a significant association between age and the maximum amount the participants were willing to pay (ß=-0.15,t=-2.55,p<0.05=0.01). In addition, the results show a significant relationship between income and the maximum amount of money people were willing to pay (ß=-0.25,t=3.81,p<0.05=0.001).Conclusion This study provided some evidence that most of the population of Saudi Arabia were willing to pay for NHI if implemented. The factors that appeared to influence the willingness to pay and the amount of monthly payment included the type of usual source of care, satisfaction with current public services, age, and income.
Experimental Study on the Structural Features and Corrosion Characteristics of Dolomite and Limestone in the Karst Stone Mountainous Areas in Northern Guangxi
Authors: Gu Zhanfei , Liu Zhikui 
Published: October 2021

Abstract
Taking dolomite and limestone in Guilin and Liuzhou regions in the north of Guangxi Province as research objects, this paper analyzed their mineral composition and chemical composition, and then carried out the chemical corrosion test, the corrosion test under the chemical-temperature actions, and the corrosion test under the action of vibration load, respectively. The results showed that: (i) the dolomite in northern Guangxi mainly has fine crystalline texture and massive structure with low content of acid insoluble matters, while limestone mainly has powder crystalline texture and massive structure with high content of acid insoluble matters, and the purity of both dolomite and limestone are very high; (ii) the difference of corrosion between dolomite and limestone mainly depends on the ratio of CaO/MgO in their chemical composition, and the content of silica and acid insoluble matters; (iii) the corrosion rates of the pure dolomite and the pure limestone are basically the same under the same external conditions; (iv) temperature and vibration load have relatively large influence on the corrosion rates of dolomite and limestone, and the corrosion rates of dolomite and limestone increase with the increase of temperature, but the influence of vibration load on the corrosion rate is more significant than temperature. This research can provide theoretical basis and technical support for large-scale engineering construction and prevention of karst geologic disasters in karst stone mountainous areas in the northern Guangxi.
Keywords: dolomite and limestone; structural features; corrosion characteristics; northern Guangxi
Privacy Preserving model for patient centric health record management using chaincode
Authors: mani vinodhini , M Prakash 
Published: October 2021

Abstract
Cloud computing poses a challenge to the healthcare infrastructure, as it affects privacy, confidentiality, and security rules concerning large binary objects such as x-rays and CT scan reports. However, health records are stored and accessed using an encryption hash which is stored in the interplanetary file system (IPFS), called a peer-to-peer system. But the patient’s data is sold, share for research purposes by their healthcare providers without their knowledge as it affects their privacy and security. In the healthcare industry today, customers face the issue of health record that lacks interoperability, resulting in difficulty aggregating and examining patient data. The objective of this research is to develop cybersecurity measurement approaches that ensure patient information security by protecting against cyber threats using blockchain technology based on healthcare IT. Consequently, this paper proposes an innovative solution to the problem, namely Patient-centric healthcare data management (PCHDM). It was built using IPFS, a permissioned distributed ledger system that uses Hyperledger Fabric, which stores health records, but only with the permission of the owner. A unique cryptographic public key encryption algorithm is used to encrypt IPFS data to build an electronic health record blockchain system. Our platform offers two types of solutions: (i) a solution that utilizes a database of hyper ledger fabric, which is an on-chain database, (ii) off-chain solutions which encrypt data and store it securely off-chain using IPFS. A robust blockchain solution for PCHDM will be created by encrypting the data stored in IPFS using appropriate public key cryptographic algorithms. To determine which blocks should be incorporated into the blockchain, the Byzantine Fault Tolerance is applied in the health chain architectural model. This system hosts smart contracts and application logic as well as smart contracts known as "chain code" via container technology. As part of this research, health record hashes were stored on the blockchain and the actual health data was stored off-chain in IPFS, which is the decentralized cloud storage system that achieves scalability. Due to the encryption of healthcare records with a hash, this model proves that unauthorized access is impossible because the records are more scalable, interoperable, and reliable. Stakeholders are more confident in collaborating and sharing their medical records with this model.
Adaptive treatment allocation and selection in multi-arm clinical trials: a Bayesian perspective
Authors: Arjas Elja , Gasbarra Dario 
Published: October 2021

Abstract
Background: Adaptive designs offer added flexibility in the execution of clinical trials, including the possibilities of allocating more patients to the treatments that turned out more successful, and early stopping due to either declared success or futility. Commonly applied adaptive designs, such as group sequential methods, are based on the frequentist paradigm and on ideas from statistical significance testing. Interim checks during the trial will have the effect of inflating the Type 1 error rate, or, if this rate is controlled and kept fixed, lowering the power. Results: The purpose of the paper is to demonstrate the usefulness of the Bayesian approach in the design and in the actual running of randomized clinical trials during Phase II and III. This approach is based on comparing the performance of the different treatment arm in terms of the respective joint posterior probabilities evaluated sequentially from the accruing outcome data, and then taking a control action if such posterior probabilities fall below a pre-specified critical threshold value. Two types of actions are considered: treatment allocation, putting on hold at least temporarily further accrual of patients to a treatment arm (Rule 1), and treatment selection, removing an arm from the trial permanently (Rule 2). The main development in the paper is in terms of binary outcomes, but extensions for handling time-to-event data, including data from vaccine trials, are also discussed. The performance of the proposed methodology is tested in extensive simulation experiments, with numerical results and graphical illustrations documented in a Supplement to the main text. As a companion to this paper, an implementation of the methods is provided in the form of a freely available R package. Conclusion: The proposed methods for trial design provide an attractive alternative to their frequentist counterparts.
Transcriptional Profiling of Macrophages Reveals Distinct Parasite Stage-driven Signatures During Early Infection by Leishmania Donovani
Authors: Chaparro Visnu , Graber Tyson E. , Alain Tommy , Jaramillo Maritza 
Published: October 2021

Abstract
Macrophages undergo swift changes in mRNA abundance upon pathogen invasion. Herein we describe early remodelling of the macrophage transcriptome during infection by amastigotes or promastigotes of Leishmania donovani. Approximately 10% - 16% of host mRNAs were differentially modulated in L. donovani-infected macrophages when compared to uninfected controls. This response was partially stage-specific as a third of changes in mRNA abundance were either exclusively driven by one of the parasite forms or significantly different between them. Gene ontology analyses identified categories associated with immune functions (e.g. antigen presentation and leukocyte activation) among significantly downregulated mRNAs while cytoprotective-related categories (e.g. DNA repair and apoptosis inhibition) were enriched in upregulated transcripts during amastigote infection. Interestingly a combination of upregulated (e.g. cellular response to IFNβ) and repressed (e.g. leukocyte activation, chemotaxis) immune-related transcripts were overrepresented in the promastigote-infected dataset. In addition, Ingenuity Pathway Analysis (IPA®) coupled specific mRNA subsets with a number of upstream transcriptional regulators predicted to be modulated in macrophages infected with L. donovani amastigotes (e.g. STAT1 inhibition) or promastigotes (e.g. NRF2, IRF3, and IRF7 activation). Overall, our results indicate that early parasite stage-driven transcriptional remodelling in macrophages contributes to orchestrate both protective and deleterious host cell responses during L. donovani infection.