Browse Articles

Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase

Abstract The presence of significant liver inflammation is an important indication for antiviral therapy in immune-tolerant (IT)phase with chronic hepatitis B(CHB) patients. This study aims to establish a non-invasive model to assess significant liver inflammation in the IT-phase of CHB patients. This multicenter retrospective study included a total of 535 IT-phase CHB patients who underwent liver biopsy, and were randomly divided into a training and a validation set. In the training cohort, the relevant indices were initially screened using univariate analysis. Then the least absolute shrinkage and selection operator and multivariable logistic regression were used to identify the significant independent risk factors and establish a predictive model. A diagnostic nomogram was constructed. Calibration curves, decision curve analysis, and receiver operating characteristic curves were utilized to evaluate the performance of the nomogram. In this study, 37.0% of the patients exhibited significant liver inflammation. Baseline characteristics revealed a median age of 35.0 years, with males accounting for 51.7% of the cohort. Age, Aspartate aminotransferase (AST), Prothrombin (PT), Albumin (ALB) and Hepatitis B virus DNA (HBV DNA) were identified as independent predictors of significant liver inflammation in the immune-tolerant phase, and a nomogram was constructed based on these indicators. The predictive model demonstrated good calibration and discrimination in both the training set and the validation set (aera under the curve (AUC) of 0.741 and 0.740, respectively). The nomogram can accurately identify significant liver inflammation in immune-tolerant phase CHB patients and facilitate the early initiation of antiviral therapy, thereby reducing the need for clinical liver biopsies.

Analysis of the effect of joint roughness on the failure mechanism of jointed rock mass under direct shear loading

The mechanical properties of jointed rock bodies are important in guiding engineering design and construction. Using the particle flow software PFC2D, we conducted direct shear test simulations on joints with various inclinations and five different roughness levels to examine the models’ crack extension penetration paths, damage modes, and strength characteristics. The findings indicate that the direction of the joint influences the pattern of the rock crack and its penetration route. Under forward shear, the rock bridge creates a notched through surface, whereas under reverse shear it creates two adjacent through surfaces, categorised into four types of crack consolidation between joints with different inclinations: ‘end to end’, ‘the end is connected to the middle’, ‘end connection’, ‘first outward expansion and then rock bridge destruction’. Variations in joint inclination and roughness can alter the mechanical properties and damage patterns of joint specimens. The ‘climbing’ and ‘gnawing’ effects determine the peak shear strength of the rock body at the joint section. It is vital to consider these factors when assessing the joint’s characteristics. The damage effect is determined by the joint inclination and joint roughness. When the main damage effect changes from ‘creeping’ slip to ‘gnawing’ damage, increasing joint roughness enhances the shear strength. Nevertheless, under the same ‘gnawing’ damage effect, augmenting joint roughness weakens the mechanical properties of the rock bridge, and as roughness increases, the shear strength decreases. For example, at a joint inclination of 30°, the shear strength increases by 20.1% as the JRC (Joint Roughness Coefficient) increases from 0 to 5. At a joint inclination of 60°, the shear strength decreases by 10.7% as the JRC increases from 0 to 10.

Consequences of COVID-19 for geriatric patients during a pandemic

Abstract To investigate the outcomes of geriatric COVID-19 patients in a German academic setting during the pandemic. This study included 468 consecutive geriatric patients (≥ 70 years) who tested positive for SARS-CoV-2 and were treated at the University of Duisburg-Essen from 2/2020 to 3/2021. 74 patients were transferred to a geriatric hospital and a 12-month follow-up (prospective study) was performed in 51 patients. Clinical assessments evaluated depression (GDS), apathy (AES), cognitive status (MMST), mobility (TUG), health status (EQ-5D-5 L), and daily living activities (Barthel Index). Demographic and clinical data were also analyzed. Results showed that the mortality in this vulnerable group was 52% (n = 209). Long-term survival was higher in patients who received comprehensive geriatric treatment (74.3% vs. 51.8%). The duration of inpatient stay at the primary hospital was 13.3 ± 3.6 days, with 28.8% (n = 135) requiring intensive care. At the 12-month mark more patients with geriatric treatment lived in nursing homes. Barthel-Index/Timed-Up-and-Go-Test/MMST/AES/GDS, and EQ-5D-5 L indicated worse outcomes in the group who received geriatric treatment. Specialized geriatric care may improve survival in geriatric COVID-19 patients despite decreased long-term outcomes. Further research, including international studies like NAPKON, are encouraged to confirm these findings and explore potential interventions for improved outcomes in this vulnerable population.

Factors influencing the adoption of e-government by female university students

The primary purpose of electronic government (e-government) is to promote transparency, facilitate access to government services, and strengthen the accountability of public institutions in the digital transformation age. However, few studies have explored the factors that affect women’s adoption of e-government, especially in emerging economies. Consequently, this study aims to identify the factors that influence the adoption of e-government services by young women in Medellín, Colombia. To achieve this objective, a questionnaire was administered to a sample of 223 women, focusing on the factors proposed in the Technology Acceptance Model (TAM). The results were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The findings confirmed the validity of both the measurement and structural models, providing evidence for their predictive power. In addition, seven out of the eight hypotheses were confirmed, particularly highlighting the positive influence of ease of use on perceived usefulness, as well as the positive relationship between intention to use and actual use of the system. The results underscore the importance of reaching a more equitable and empowering participation of women in the digital government sphere. Moreover, they provide valuable insights for formulating policies and strategies that promote the effective adoption of e-government services by the demographic group under study.

Inversion of interlayer scale using dynamic data of production wells in bottom water reservoirs: Sangtamu Oilfield, Tarim basin

Abstract The target reservoir is a typical blocky bottom water reservoir. There are several interlayers of varying scales inside it, which impact the characteristics of the oil production and water breakthrough curves of the wells in the water flooding development oilfield, resulting in strong heterogeneity within the reservoir. The Sangtamu Oilfield has an average well spacing of approximately 600 m, causing a challenge in accurately identifying the range of small-scale interlayer spreading. This, in addition, challenges the subsequent 3D geological modeling process. This paper proposes a method to accurately characterize the size of various interlayers in a reservoir by using production dynamics data from bottom water reservoirs to invert the interlayer scale. By classifying the water breakthrough curve styles derived from theoretical testing, the range of reservoir internal interlayer scales is compared and inverted based on the actual water breakthrough styles of wells in the Sangtamu oil field. In the process, many interlayer scales derived from various types of geologic data acquisition were combined to form a quantitative geologic knowledge database of interlayers that synthesizes both dynamic and static data. This method has been applied in the Tarim Basin’s Sangtamu Oilfield, where the reservoir numerical simulation history was used to fit the model. This resulted in an overall fitting coincidence rate of 96% in the Sangtamu Oilfield and a single-well fitting coincidence rate of over 90% in well LN14. This method offers a new viewpoint on characterizing the interlayer’s scale in the area of the non-dense well network.

Exploring entrepreneurial intention among European Union youth by education and employment status

The relatively high vulnerability of young Europeans in the labour market compared to other age groups has led many to seek alternative employment solutions, such as entrepreneurship. While not a comprehensive solution, entrepreneurial initiatives among youth can offer a valuable opportunity for their integration into stable and decent work. This research uses Flash Eurobarometer 513—Social Entrepreneurship and Youth to explore entrepreneurial intentions among European Union youth. The study’s novelty consists of the division of the target population into four distinct categories based on educational and employment status. The results indicate that EU youth are not a homogeneous group. While the motivation to create their own jobs—is a common feature of all young individuals with entrepreneurial intentions, suggesting a necessity-driven entrepreneurial intention, significant differences emerge among sub-groups. Young people who are only studying exhibit an interest in exploiting business opportunities, highlighting the role of education in fostering opportunity-driven entrepreneurship, while NEETs and employed youth are primarily motivated by better income prospects in the intention to start a business. Additionally, youth engaged in education and those integrated into the labour market are better informed about financing and training opportunities Perceived barriers include a lack of education for NEETs and financial risks for others. Funding preferences also differ: NEETs would rely on personal savings, while those balancing study and work would explore diverse sources, including venture capital and incubator support for starting businesses. Our study enhances the understanding of entrepreneurial intentions among EU young people, offering insights that can guide more effective support strategies for fostering entrepreneurial success.

Natural repeated backcrosses lead to triploidy and tetraploidy in parthenogenetic butterfly lizards (Leiolepis: Agamidae)

Assessing a bundle of peer counseling, mobile phone messages, and mama kits in promoting timely initiation of and exclusive breastfeeding in Uganda: A cluster randomized controlled study

Background Timely initiation of and exclusive breastfeeding have been recommended as key interventions to enable countries to attain the sustainable development target of reducing neonatal mortality to no more than 12 deaths per 1000 live births and to reduce mortality of children under 5 years to no more than 25 deaths per 1000 live births. Methods We conducted a cluster randomized controlled trial with the main objective to assess the effect of an integrated package consisting of: peer counseling, mobile phone messages, and mama kits on promoting health facility births between January 2018 and February 2019, in Lira district, Northern Uganda. In this article, we assessed the effect of the intervention on our two secondary objectives: timely initiation of and exclusivity of breastfeeding. We used a generalized estimation equation of the Poisson family, with a log or identity link, taking clustering into account to estimate prevalence ratios and prevalence differences. Results A total of 64% (594/926) of participants in the intervention arm initiated breastfeeding within the first hour after birth compared to 60% (493/829) in the control arm. The proportion of participants in the intervention arm that initiated breastfeeding within the first hour of life did not significantly differ from that in the control arm [Prevalence Ratio (PR) 1.08 (0.97 to 1.21)] and [Prevalence Difference (PD) 0.05 (-0.02 to 0.12)]. When we restricted the analysis to only mothers who decided on when to breastfeed, there was some evidence of intervention effectiveness [PR 1.20, 95% CI (0.99–1.5)]. In the intervention arm, 89% (804/904) of participants exclusively breastfed their infants in the first month of life compared to 81% (656/813) in the control arm. Participants in the intervention arm were 10% more likely to have exclusively breastfed in the preceding 24 hours compared to mothers in the control arm [PR 1.10 (1.04 to 1.17)] and [PD 0.08 (0.04 to 0.13)], and 16% more likely to have exclusively breastfed since birth compared to mothers in the control arm [PR 1.16 (1.03 to 1.30)] and [PD 0.12 (0.03 to 0.20]. Conclusion The intervention improved the proportion of mothers who practiced exclusive breastfeeding in the first month of life, but did not increase the proportion of mothers who initiated breastfeeding in the first hour of life. Future breastfeeding promotion interventions should consider including a health facility component and improving maternal autonomy to promote timely initiation of breastfeeding.

A data driven machine learning approach for predicting and optimizing sulfur compound adsorption on metal organic frameworks

Assessment of the bypass of obturation materials beyond fractured instruments after using different obturation techniques in simulated curved canals (An in-vitro study)

This study evaluated the extent to which obturation materials bypass fractured endodontic instruments positioned in the middle and apical thirds of severely curved simulated root canals using different obturation techniques. Sixty resin blocks with simulated root canals were used, each with a 50° curvature, a 6.5 mm radius of curvature, and a length of 16.5 mm, prepared to an ISO #15 diameter and taper. Canals were shaped using ProTaper Universal files (Dentsply Maillefer) attached to an X-smart Plus endo motor (Dentsply), set at 3.5 Ncm torque and 250 rpm, up to size S2 at working length. To simulate fractures, F2 and F3 files were weakened 3 mm from the tip, then twisted to break in the apical and middle sections of the canal, respectively. All samples were sealed with GuttaFlow 2 and divided into three groups (n = 20/group) according to obturation technique: A) single cone, B) lateral condensation with a rotary spreader, and C) softcore obturators. Each group was then divided into two subgroups (n = 10) based on the instrument fracture location (1 = apical, 2 = middle). The linear intrusion of obturation materials through the fractured instruments was measured using ImageJ software and analyzed statistically with ANOVA, Tukey tests, and independent t-tests, with significance set at p<0.05. Material bypass in group B1 (3.27 ± 0.63 mm) was significantly greater than in group A1 (2.39 ± 0.44 mm) and group C1 (2.91 ± 0.77 mm). In group C2, bypass (5.76 ± 0.64 mm) was significantly higher than in group A2 (3.82 ± 0.2 mm) and group B2 (2.27 ± 0.96 mm). Additionally, bypass in group A2 was greater than in group B2, and group B1 had more bypass than B2, while group C2 exceeded C1. The lateral condensation technique with a rotary spreader and softcore obturators increased the bypass of obturation materials through fractured instruments in simulated curved canals. These techniques may thus enhance material flow in endodontic procedures involving instrument fractures.

Transposon mediated functional genomic screening for BRAF inhibitor resistance reveals convergent Hippo and MAPK pathway activation events

Abstract Genotype-informed anticancer therapies such as BRAF inhibitors can show remarkable clinical efficacy in BRAF-mutant melanoma; however, drug resistance poses a major hurdle to successful cancer treatment. Many resistance events to targeted therapies have been identified, suggesting a complex path to improve therapeutics. Here, we showed the utility of a piggyBac transposon activation mutagenesis screen for the efficient identification of genes that are resistant to BRAF inhibition in melanoma. Although several forward genetic screens performed in the same context have identified a broad range of resistance genes that poorly overlap, an integrative analysis revealed a much smaller functional diversity of resistance mechanisms, including reactivation of the MAPK pathway, PI3K-AKT pathway, and Hippo pathway, suggesting that a relatively small number of therapeutic strategies might overcome resistance manifested by a large gene set. Moreover, we illustrated the pivotal role of the Hippo pathway effector TAZ (encoded by the WWTR1 gene) in mediating BRAF inhibition resistance through transcriptional regulation of receptor tyrosine kinases and through interactions with the E3 ubiquitin ligase NEDD4L.

Evaluating the performance of a new ergonomic laparoscopic needle holder for intracorporeal suturing

In laparoscopy, the absence of ergonomics in the instruments affects the performance and efficiency of the surgeon, increasing the likelihood of developing musculoskeletal injuries. This article presents the development of a laparoscopic needle holder with an ergonomic handle and the experience in its use with surgeons in the intracorporeal suturing task. The handle of the laparoscopic needle holder consists of a semi-spherical piece that easily adapts to the palm of the surgeon’s hand and improves the posture and ergonomics of the wrist, allowing the direct transmission of rotational movements around the longitudinal axis of the instrument towards the tip. Moreover, a spring-loaded mechanism allows the tip of the tool to be opened and closed in a normally closed configuration, with enough pressure to hold different surgical needles. Twenty-two pediatric surgery surgeons and residents, without upper extremity musculoskeletal disorders, participated in this study. Each participant performed the intracorporeal suturing task using two laparoscopic needle holders (conventional and with ergonomic handle) in a laparoscopic simulator. Motion data from both instruments were captured and the performance was assessed by means of 16 motion analysis parameters (MAPs). The performance of the residents improved markedly using the laparoscopic needle holder with ergonomic handle, obtaining statistically significant differences in 10 MAPs evaluated. The comparison of the results of each instrument showed that this ergonomic laparoscopic needle holder stood out over the conventional tool, improving psychomotor skills and the ability to control the angular position and rotational movements of the instrument on its own axis, indispensable for intracorporeal suturing. The innovative design of the laparoscopic needle holder with ergonomic handle allows for better transfer of rotational movements from the surgeon’s hand directly with the longitudinal axis to the tip, reducing extreme wrist positions and excessive effort to open and close the tip of the instrument during intracorporeal suturing.

Optimization of dried garlic physicochemical properties using a self-organizing map and the development of an artificial intelligence prediction model

Abstract The experiments were conducted at different levels of infrared power, airflow, and temperature. The relationships between the input process factors and response factors’ physicochemical properties of dried garlic were optimized by a self-organizing map (SOM), and the model was developed using machine learning. Artificial Neural Network (ANN) with 99% predicting accuracy and Self-Organizing Maps (SOM) with 97% clustering accuracy were used to determine the quality characteristics of garlic. Specifically, five key areas were identified, and valuable insights were offered for optimizing garlic production and improving its overall quality. The (aw) values for the sample ranged from 0.43 to 0.48. The maximum vitamin C content was 0.112 mg/g, followed by an air temperature of 40 °C and 0.7 m/s air velocity under 1500 W/m². The total color change values increased with IR and higher air temperature but declined with higher air velocity. Also, the garlic’s flavor strength, allicin content, water activity, and vitamin C levels decreased as the IR and air temperature increased. The results demonstrated a significant impact of the independent parameters on the response parameters (P < 0.01). Interestingly, the machine learning predictions closely matched the test data sets, providing valuable insights for understanding and controlling the factors affecting garlic drying performances.

The etiology of attention deficit disorder with hyperactivity: A protocol for an umbrella review

Introduction Attention deficit hyperactivity disorder (ADHD) is one of the common neurodevelopmental disorders and is widely prevalent worldwide. The primary symptoms of ADHD include inattention, impulsivity, and hyperactivity, which significantly impact the cognitive, behavioral, and emotional dimensions of individuals. These disorders often continue throughout adulthood and, along with associated complications, affect various domains such as personal health, academic achievement, and social interactions. The pathogenesis and contributing causes of ADHD remain unclear at present. Therefore, this study aims to perform an umbrella review of systematic reviews and meta-analyses (SRMAs) to systematically assess the quality of methodologies, potential biases, and validity of all epidemiological evidence related to risk factors for ADHD while offering a comprehensive summary of the evidence regarding these risk factors. Methods and analysis This study follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and Cochrane Handbook. We will systematically search 6 databases, including The Cochrane Library Central, PubMed, Embase, Web of Science, CINAHL, and Scopus from the initial period up until 2024 (last update). We will assess the quality of the included SRMAs using the tool to assess risk of bias in systematic reviews (ROBIS), the methodological quality of systematic reviews (AMSTAR)-2, PRISMA-2020, and the grade of recommendations assessment, development and evaluation (GRADE). Two authors will use the ecological models of health behavior to classify the causes and risk factors of ADHD. Finally, we will provide descriptive and comprehensive recommendations for clinical practice and future research. Trial registration PROSPERO (CRD42024597126).

Revolutionary bamboo crash barriers utilizing sustainable materials for enhanced road safety

Systematic review on the compliance of WHO guidelines in the management of patients with advanced HIV disease in Africa: The case of cryptococcal antigen screening

Background The World Health Organization (WHO) recommended cryptococcal antigen (CrAg) screening for people presenting with advanced HIV disease (AHD) and for those with positive CrAg without evidence of meningitis to initiate preemptive antifungal medication. Data on the implementation of WHO recommendations regarding CrAg screening is limited. We estimated pooled prevalence of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis and initiation of preemptive antifungal medication from available eligible published studies conducted in Africa. Methods PubMed, Cochrane Library and Embase were searched for articles published between January 2011 and December 2023. CrAg uptake was defined as percentage of eligible people (CD4 ≤ 200 cells/mm3 or WHO stage III/IV) who received cryptococcal antigen testing. Stratified analysis to compare uptake and cryptococcal antigenemia between studies that involved multiple vs single sites was performed. Using random effects models, we computed the pooled estimate of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis, preemptive antifungals treatment and 95% confidence intervals (CIs). Results Ten studies with 18,820 individuals with AHD were analyzed. Overall, the pooled estimate of CrAg screening uptake was 57.1% (95% CI: 41.4–72.7). CrAg screening uptake was significantly lower among studies that involved multiple sites compared to those that involved single site, (47.3% vs 73.3%; p<0.001). Overall, the pooled prevalence of cryptococcal antigenemia was 9.6% (95% CI:6.4–12.9). Cryptococcal antigenemia was significantly lower among studies that involved multiple sites compared to those that involved single site, (9.1% vs 10.4%; p<0.001). Among those who tested positive for CrAg, 84.6% (95% CI: 54.1–99.0) received preemptive antifungal treatment, though nearly 25% did not undergo lumbar puncture, highlighting gaps in diagnostic follow-up. Six studies evaluated CrAg positive patients with lumbar puncture and the overall prevalence of lumbar puncture was 74.9% (48.0–94.8). The overall prevalence of cryptococcal meningitis was 58.1% (46.6–69.6). Conclusions Not screening for CrAg among people with AHD and failure to initiate antifungal medications among eligible patients with cryptococcal antigenemia presents a significant missed opportunity. Emphasis on improving CrAg screening is critical given its proven cost-effective benefits.

Exploring the relationship between physical activity and Inhibitory Function in College Students with depressive symptoms through EEG

Study protocol for a hybrid implementation-effectiveness trial of Game Changers for Cervical Cancer Prevention in Uganda

Introduction Cervical cancer (CC) is the leading cause of cancer-related deaths among Uganda women, yet rates of CC screening are very low. Training women who have recently screened to engage in advocacy for screening among women in their social network is a network-based strategy for promoting information dissemination and CC screening uptake. Methods Drawing on the Exploration, Preparation, Implementation and Sustainment (EPIS) framework for implementation science, this hybrid type 1 randomized controlled trial (RCT) of a peer-led, group advocacy training intervention, Game Changers for Cervical Cancer Prevention (GC-CCP), will examine efficacy for increasing CC screening uptake as well as how it can be implemented and sustained in diverse clinic settings. In the Preparation phase we will prepare the four study clinics for implementation of GC-CCP and the expected increase in demand for CC screening, by using qualitative methods (stakeholder interviews and client focus groups) to identify and address structural barriers to easy access to CC screening. In the Implementation phase, GC-CCP will be implemented over 36 months at each clinic, with screened women (index participants) enrolled as research participants receiving the intervention in the first 6 months as part of a parallel group RCT overseen by the research study team to evaluate efficacy for CC screening uptake among their enrolled social network members. All research participants will be assessed at baseline and months 6 and 12. Intervention implementation and supervision will then be transitioned to clinic staff and offered as part of usual care in the subsequent 30 months as part of the Sustainability phase. Using the RE-AIM framework, we will evaluate engagement in GC-CCP and CC advocacy (reach), alter CC screening (effectiveness), adoption into clinic operations, implementation outcomes (acceptability, feasibility, fidelity, cost-effectiveness) and maintenance. Discussion This is one of the first studies to use a network-driven approach and empowerment of CC screened peers as change agents to increase CC screening. If shown to be an effective and sustainable implementation strategy for promoting CC screening, this peer advocacy model could be applied to other preventative health behaviors and disease contexts. Trial registration NIH Clinical Trial Registry NCT06010160 (clinicaltrials.gov; date: 8/17/2023).

Case studies of different types of precipitation at Ny-Ålesund, Arctic

Secondary metabolites of Alternaria alternate appraisal of their SARS-CoV-2 inhibitory and anti-inflammatory potentials

This study identifies the secondary metabolites from Alternaria alternate and evaluates their ACE-2: Spike RBD (SARS-CoV-2) inhibitory activity confirmed via immunoblotting in human lung microvascular endothelial cells. In addition, their in vitro anti-inflammatory potential was assessed using a cell-based assay in LPS-treated RAW 264.7 macrophage cells. Two novel compounds, altenuline (1), phthalic acid bis (7’/7’’ pentyloxy) isohexyl ester (2), along with 1-deoxyrubralactone (3) alternariol-5-O-methyl ether (4) and alternariol (5) were identified. Molecular docking and in vitro studies showed that compounds 2 and 4 were promising to counteract SARS-CoV-2 attachment to human ACE-2. Thus, they are considered promising natural anti-viral agents. SwissADME in silico analysis was conducted to predict the drug-like potential. Immunoblotting analysis confirmed that the tested compounds (1–4) demonstrated downregulation of ACE-2 expression in the endothelial cells from the lungs with variable degrees. Furthermore, the tested compounds (1–4) showed promising anti-inflammatory activities through TNF-α: TNFR2 inhibitory activity and their inhibitory effect on the proinflammatory cytokines (TNF-α and IL-6) in LPS-stimulated monocytes. In conclusion, our study, for the first time, provides beneficial experimental confirmation for the efficiency of the A. alternate secondary metabolites for the treatment of COVID-19 as they hinder SARS-CoV-2 infection and lower inflammatory responses initiated by SARS-CoV-2. A. alternate and its metabolites are considered in developing preventative and therapeutic tactics for COVID-19.