bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the trend of age-standardized mortality rates from cardiovascular disease in Malaysia: a joinpoint analysis (2010–2021)
Authors: Hasani Wan Shakira Rodzlan , Musa Kamarul Imran , Cheng Kueh Yee , Dass Sarat Chandra
Published: September 2024

Introduction

Cardiovascular disease (CVD) is a major health concern worldwide, particularly in low- and middle-income countries. The COVID-19 pandemic that emerged in late 2019 may have had an impact on the trend of CVD mortality. This study aimed to investigate the trend and changes in CVD mortality rates in Malaysia, using age-standardized mortality rates (ASMR) from 2010 to 2021.

Methods

The Malaysian population and mortality data from 2010 to 2021 were obtained from the Department of Statistics Malaysia (DOSM). ASMRs from CVD per 100,000 population were calculated based on the World Health Organization (2000–2025) standard population using the direct method. The ASMRs were computed based on sex, age groups (including premature mortality age, 30–69 years), and CVD types. The annual percent change (APC) and average annual percent change (AAPC) of the ASMR with corresponding 95% confidence intervals (95% CI) were estimated from joinpoint regression model using the Joinpoint Regression Program, Version 4.9.1.0.

Results

Throughout the study period (2010–2021), ASMRs for CVD exhibited an increase from 93.1 to 147.0 per 100,000, with an AAPC of 3.6% (95% CI: 2.1 to 5.2). The substantial increase was observed between 2015 and 2018 (APC 12.6%, 95% CI: 5.4%, 20.3%), with significant changes in both sexes, and age groups 50–69, 70 years and over, and 30–69 (premature mortality age). Notably, the ASMR trend remained consistently high in the premature mortality age group across other age groups, with males experiencing higher rates than females. No significant changes were detected before or after the COVID-19 pandemic (between 2019 and 2021), except for females who died from IHD (10.3% increase) and those aged 0–4 (25.2% decrease).

Conclusion

Overall, our analysis highlights the persistently high burden of CVD mortality in Malaysia, particularly among the premature mortality age group. These findings underscore the importance of continued efforts to address CVD risk factors and implement effective prevention and management strategies. Further research is needed to fully understand the impact of the COVID-19 pandemic on CVD mortality rates and to inform targeted interventions to reduce the burden of CVD in Malaysia.
Uncovering the relationship between trace element exposure, cognitive function, and dietary inflammation index in elderly americans from the National Health and Nutrition Examination Survey 2011–2014
Authors: Tang Chunlan , Shen Min , Hong Hang
Published: September 2024

Background

The consequences of trace element exposure on cognitive function in elderly adults have been recognized as primarily attributed to the inflammatory response. It is noteworthy that diet can either exacerbate or reduce the inflammatory response. Despite this, there have been limited studies about the effects of diet on the relationship between trace element exposure and cognitive function.

Methods

A cross-sectional study utilized data from the 2011–2014 NHANES survey to explore the association between trace element exposure and cognitive function in elderly adults. The study enrolled 1726 participants, and generalized linear regression model (GLM), Bayesian kernel machine regression model (BKMR), weighted quantile sum regression (WQS), and quantile g-computation regression analysis (Qg-comp) were conducted to assess the impact of five trace elements (lead, cadmium, mercury, manganese, and selenium) in blood on cognitive function under the anti-inflammatory and pro-inflammatory diet.

Results

The GLM analysis showed a positive correlation between selenium (Se) and both the instant recall test (IRT) and digit symbol substitution test (DSST) (β = 2.06, 95% CI: 0.70 ~ 3.41; and β = 6.41, 95% CI: 2.35 ~ 10.46, respectively). In contrast, cadmium (Cd) was negatively associated with DSST (β = -1.17, 95% CI: -2.13~ -0.22), and lead (Pb) was negatively associated with IRT (β = -0.47, 95% CI: -0.82~ -0.11). For the animal fluency test (AFT), the highest quartile of manganese (Mn) was negatively associated with the lowest quartile (β = -0.72, 95% CI: -1.34~-0.10), while mercury (Hg) showed no significant associations with cognitive function tests. Subgroup analysis revealed the effects of Cd on IRT and DSST and Se on DSST under the pro-inflammatory diet. Furthermore, The BKMR analysis showed an inverted U-shaped curve with the negative impact of trace element mixtures and DSST and a linearly negative trend with IRT in the pro-inflammatory diet. Among them, Cd was emphasized as the most potent risk factor, and Se was the most vital protective factor for IRT and DSST in WQS and Qg-comp analysis.

Conclusions

The study suggests that a high-quality diet might alleviate the adverse effects of Cd on IRT and DSST. High Se levels were also associated with better IRT and DSST scores in the pro-inflammatory diet. These findings provide valuable insights into the connection between diet, trace element exposure, and cognitive function in elderly adults.
Experiences as a clinical teaching fellow: interviews with clinical teaching fellows in the West Midlands
Authors: Harris Isobel Marion , Dennis Nicola , Ward Derek J , Sitch Alice J , Parry Jayne , Greenfield Sheila
Published: September 2024

Background

The majority of junior doctors in the UK do not proceed directly into specialty training after completing mandatory foundation training but instead take a year out of training. A common post undertaken during a year out of training is a clinical teaching fellow (CTF) role which is used to provide undergraduate medical student teaching. There is only a small amount of literature available regarding CTF posts, and very little of this explores experiences or reasons for taking up such as post. An understanding of the reasons why doctors are choosing to work as CTFs and what their experiences are in post will contribute to how the role is further developed and utilised within the NHS. This study aimed to explore the experiences of CTFs employed in the West Midlands at NHS hospital Trusts.

Methods

CTFs working in Trusts in the West Midlands region registered as students on the Education for Healthcare Professionals Post Graduate Certificate course at the University of Birmingham in August 2019 and 2020 who were enrolled in a longitudinal study were invited to take part in an individual interview asking about their experiences as CTFs.

Results

Nine CTFs participated in an interview. Five main themes were identified which related to their experiences in post and plans for future careers. Participants reported choosing to undertake a CTF role due to wanting a break from clinical work and having previously enjoyed delivering teaching. Positive experiences in post included lifestyle related benefits and self-development opportunities. Challenges identified with the role included the impact of COVID-19 and volume of students.

Conclusion

This is the first study to use interview methodology to explore experiences of CTFs, and has provided a valuable insight into the experiences of those in post in the West Midlands region. Understanding why doctors chose this job and what their experiences are could help to further develop and refine the role. To guarantee demands for teaching staff are met those employing CTFs should be aware of reasons why doctors apply for the post and ensure the post remains a desirable option.
Enhancing clinical data retrieval with Smart Watchers: a NiFi-based ETL pipeline for Elasticsearch queries
Authors: Al-Agil Mohammad , Obee Stephen J. , Dinu Vlad , Teo James , Brawand David , Patten Piers E. M. , Alhaq Anwar
Published: September 2024

Background

The aim is to develop and deploy an automated clinical alert system to enhance patient care and streamline healthcare operations. Structured and unstructured data from multiple sources are used to generate near real-time alerts for specific clinical scenarios, with an additional goal to improve clinical decision-making through accuracy and reliability.

Methods

The automated clinical alert system, named Smart Watchers, was developed using Apache NiFi and Python scripts to create flexible data processing pipelines and customisable clinical alerts. A comparative analysis between Smart Watchers and the legacy Elastic Watchers was conducted to evaluate performance metrics such as accuracy, reliability, and scalability. The evaluation involved measuring the time taken for manual data extraction through the electronic patient record (EPR) front-end and comparing it with the automated data extraction process using Smart Watchers.

Results

Deployment of Smart Watchers showcased a consistent time savings between 90% to 98.67% compared to manual data extraction through the EPR front-end. The results demonstrate the efficiency of Smart Watchers in automating data extraction and alert generation, significantly reducing the time required for these tasks when compared to manual methods in a scalable manner.

Conclusions

The research underscores the utility of employing an automated clinical alert system, and its portability facilitated its use across multiple clinical settings. The successful implementation and positive impact of the system lay a foundation for future technological innovations in this rapidly evolving field.
Differences in changes of data completeness after the implementation of an electronic medical record in three surgical departments of a German hospital–a longitudinal comparative document analysis
Authors: Wurster Florian , Herrmann Christin , Beckmann Marina , Cecon-Stabel Natalia , Dittmer Kerstin , Hansen Till , Jaschke Julia , Köberlein-Neu Juliane , Okumu Mi-Ran , Pfaff Holger , Rusniok Carsten , Karbach Ute
Published: September 2024

Purpose

The European health data space promises an efficient environment for research and policy-making. However, this data space is dependent on high data quality. The implementation of electronic medical record systems has a positive impact on data quality, but improvements are not consistent across empirical studies. This study aims to analyze differences in the changes of data quality and to discuss these against distinct stages of the electronic medical record’s adoption process.

Methods

Paper-based and electronic medical records from three surgical departments were compared, assessing changes in data quality after the implementation of an electronic medical record system. Data quality was operationalized as completeness of documentation. Ten information that must be documented in both record types (e.g. vital signs) were coded as 1 if they were documented, otherwise as 0. Chi-Square-Tests were used to compare percentage completeness of these ten information and t-tests to compare mean completeness per record type.

Results

A total of N = 659 records were analyzed. Overall, the average completeness improved in the electronic medical record, with a change from 6.02 (SD = 1.88) to 7.2 (SD = 1.77). At the information level, eight information improved, one deteriorated and one remained unchanged. At the level of departments, changes in data quality show expected differences.

Conclusion

The study provides evidence that improvements in data quality could depend on the process how the electronic medical record is adopted in the affected department. Research is needed to further improve data quality through implementing new electronical medical record systems or updating existing ones.
Light sampling behaviour regulates circadian entrainment in mice
Authors: Steel Laura C. E. , Tam Shu K. E. , Brown Laurence A. , Foster Russell G. , Peirson Stuart N.
Published: September 2024

Background

The natural light environment is far more complex than that experienced by animals under laboratory conditions. As a burrowing species, wild mice are able to self-modulate their light exposure, a concept known as light environment sampling behaviour. By contrast, under laboratory conditions mice have little opportunity to exhibit this behaviour. To address this issue, here we introduce a simple nestbox paradigm to allow mice to self-modulate their light environment. Dark nestboxes fitted with passive infrared sensors were used to monitor locomotor activity, circadian entrainment, decision making and light environment sampling behaviour.

Results

Under these conditions, mice significantly reduce their light exposure to an average of just 0.8 h across a 24 h period. In addition, mice show a distinct pattern of light environment sampling behaviour, with peaks at dawn and dusk under a ramped light dark cycle. Furthermore, we show that the timing of light environment sampling behaviour depends upon endogenous circadian rhythms and is abolished in mice lacking a circadian clock, indicating a feedback loop between light, the circadian clock and behaviour.

Conclusions

Our results highlight the important role of behaviour in modifying the light signals available for circadian entrainment under natural conditions.
The Abl1 tyrosine kinase is a key player in doxorubicin-induced cardiomyopathy and its p53/p73 cell death mediated signaling differs in atrial and ventricular cardiomyocytes
Authors: Borlak Jürgen , Ciribilli Yari , Bisio Alessandra , Selvaraj Saravanakumar , Inga Alberto , Oh Jung-Hwa , Spanel Reinhard
Published: September 2024

Background

Doxorubicin is an important anticancer drug, however, elicits dose-dependently cardiomyopathy. Given its mode of action, i.e. topoisomerase inhibition and DNA damage, we investigated genetic events associated with cardiomyopathy and searched for mechanism-based possibilities to alleviate cardiotoxicity. We treated rats at clinically relevant doses of doxorubicin. Histopathology and transmission electron microscopy (TEM) defined cardiac lesions, and transcriptomics unveiled cardiomyopathy-associated gene regulations. Genomic-footprints revealed critical components of Abl1-p53-signaling, and EMSA-assays evidenced Abl1 DNA-binding activity. Gene reporter assays confirmed Abl1 activity on p53-targets while immunohistochemistry/immunofluorescence microscopy demonstrated Abl1, p53&p73 signaling.

Results

Doxorubicin treatment caused dose-dependently toxic cardiomyopathy, and TEM evidenced damaged mitochondria and myofibrillar disarray. Surviving cardiomyocytes repressed Parkin-1 and Bnip3-mediated mitophagy, stimulated dynamin-1-like dependent mitochondrial fission and induced anti-apoptotic Bag1 signaling. Thus, we observed induced mitochondrial biogenesis. Transcriptomics discovered heterogeneity in cellular responses with minimal overlap between treatments, and the data are highly suggestive for distinct cardiomyocyte (sub)populations which differed in their resilience and reparative capacity. Genome-wide footprints revealed Abl1 and p53 enriched binding sites in doxorubicin-regulated genes, and we confirmed Abl1 DNA-binding activity in EMSA-assays. Extraordinarily, Abl1 signaling differed in the heart with highly significant regulations of Abl1, p53 and p73 in atrial cardiomyocytes. Conversely, in ventricular cardiomyocytes, Abl1 solely-modulated p53-signaling that was BAX transcription-independent. Gene reporter assays established Abl1 cofactor activity for the p53-reporter PG13-luc, and ectopic Abl1 expression stimulated p53-mediated apoptosis.

Conclusions

The tyrosine kinase Abl1 is of critical importance in doxorubicin induced cardiomyopathy, and we propose its inhibition as means to diminish risk of cardiotoxicity.
Fatal infection caused by a genetically distinct elephant endotheliotropic herpesvirus type 5 in a captive Asian elephant in Germany
Authors: Abdelgawad Azza , Nascimento Mariana , Prahl Adriane , Flügger Michael , Szentiks Claudia A. , Holtze Susanne , Hildebrandt Thomas B. , Trimpert Jakob
Published: September 2024

Background

Elephant endotheliotropic herpesvirus (EEHV) infection is the most common cause for lethal hemorrhagic disease in captive juvenile Asian elephants (Elephas maximus). Although EEHV1 is known as the most likely cause of fatal haemorrhagic disease in Asian elephants, EEHV5 was lately involved in lethal cases of haemorrhagic disease in captive elephants.

Case presentation

Here we report the first death of a four-year old Asian elephant diagnosed with EEHV5 in Germany. Molecular diagnosis yielded detection of EEHV5 DNA in all tested tissues. Histopathological examination revealed typical features of hemorrhagic disease in all examined organs. EEHV5 was sequenced from total DNA isolated from heart tissue by Illumina and Nanopore sequencing. Sequencing data showed 3,881 variants, distributed across the entire genome, compared to the published EEHV5 sequence.

Conclusions

We have detected EEHV5 in a fatal disease case of a male Asian elephant. Whole genome sequencing revealed substantial differences of our DNA isolate compared to available EEHV5 sequences. This report of fatal haemorrhagic disease associated with EEHV5 infection should raise awareness for EEHV5 as an important elephant pathogen. Genome sequencing and downstream SNPs analysis will further encourage future research to understand genetic diversity, pathogenesis and virulence of EEHVs with respect to developing new diagnostic methods, prophylactic strategies, and implementation of surveillance and control measures.
Effects of chia seed (Salvia hispanica L.) supplementation on cardiometabolic health in overweight subjects: a systematic review and meta-analysis of RCTs
Authors: Karimi Mehdi , Pirzad Samira , Shirsalimi Niyousha , Ahmadizad Sajad , Hashemi Seyyed Mohammad , Karami Shaghayegh , Kazemi Kimia , Shahir-Roudi Erfan , Aminzadeh Anita
Published: September 2024

Background

Obesity is a significant public health issue associated with various chronic diseases. Research has indicated that chia seeds have the potential to improve cardiometabolic health. However, due to the diversity of research and inconsistencies in study design, further investigation is needed to fully understand their clinical effects on overweight individuals. This review aims to comprehensively analyze the available evidence on the effects of chia seeds on cardiometabolic indices in overweight populations through a meta-analysis.

Methods

A comprehensive literature search was performed across PubMed, Web of Science, Scopus, and Embase databases from their inception until 01-03-2024 to identify randomized controlled trials (RCTs) evaluating the effect of chia on cardiometabolic indices in overweight subjects. The search strategy incorporated both Medical Subject Headings (MeSH). Following the screening, ten RCTs were finally included. The data, including subject characteristics, study design, and changes in serum biomarkers, were extracted and analyzed using Stata software version 18.

Results

The meta-analysis results reveal that chia supplementation no significant changes in lipid profile, including triglycerides (TG) (MD: − 5.80 mg/dL, p = 0.47), total cholesterol (TC) (MD: − 0.29 mg/dL, p = 0.95), high-density lipoprotein (HDL) (MD: 1.53 mg/dL, p = 0.33), and low-density lipoprotein (LDL) (MD: 0.63 mg/dL, p = 0.88). Similarity fasting blood glucose (FBG) (MD: − 0.03 mg/dL, p = 0.98), hemoglobin A1c (HbA1c) (MD: − 0.13%, p = 0.13), and insulin levels (MD: 0.45 µIU/mL, p = 0.78). However, chia seed supplementation was associated with a significant reduction in C-reactive protein (CRP) (MD: − 1.18 mg/L, p < 0.0001), but no significant changes were observed in interleukin-6 (IL-6) (MD: − 0.15, p = 0.70) or tumor necrosis factor-alpha (TNF-α) (MD: 0.03, p = 0.91). There was no significant effect on body mass index (BMI) (MD: 0.1 kg/m2, p = 0.91), but a significant reduction in waist circumference (WC) (MD: − 2.82 cm, p < 0.001) was noted. Additionally, chia seed supplementation resulted in a significant reduction in systolic blood pressure (BP) (MD: − 3.27 mmHg, p = 0.03), though diastolic BP changes were non-significant (MD: − 2.69 mmHg, p = 0.09). The studies showed low to moderate heterogeneity in outcome measures, with I2 < 50%.

Conclusion

Chia seed supplementation does not significantly impact most lipid profile parameters and glycemic markers. However, it shows potential benefits in reducing WC, BP, and CRP. While chia seeds can be a valuable addition to cardiometabolic health management, they should be part of a broader health strategy that includes a balanced diet, exercise, and lifestyle modifications for optimal results.
Optimization of ribosome profiling in plants including structural analysis of rRNA fragments
Authors: Ting Michael K. Y. , Gao Yang , Barahimipour Rouhollah , Ghandour Rabea , Liu Jinghan , Martinez-Seidel Federico , Smirnova Julia , Gotsmann Vincent Leon , Fischer Axel , Haydon Michael J. , Willmund Felix , Zoschke Reimo
Published: September 2024

Background

Ribosome profiling (or Ribo-seq) is a technique that provides genome-wide information on the translational landscape (translatome). Across different plant studies, variable methodological setups have been described which raises questions about the general comparability of data that were generated from diverging methodologies. Furthermore, a common problem when performing Ribo-seq are abundant rRNA fragments that are wastefully incorporated into the libraries and dramatically reduce sequencing depth. To remove these rRNA contaminants, it is common to perform preliminary trials to identify these fragments because they are thought to vary depending on nuclease treatment, tissue source, and plant species.

Results

Here, we compile valuable insights gathered over years of generating Ribo-seq datasets from different species and experimental setups. We highlight which technical steps are important for maintaining cross experiment comparability and describe a highly efficient approach for rRNA removal. Furthermore, we provide evidence that many rRNA fragments are structurally preserved over diverse nuclease regimes, as well as across plant species. Using a recently published cryo-electron microscopy (cryo-EM) structure of the tobacco 80S ribosome, we show that the most abundant rRNA fragments are spatially derived from the solvent-exposed surface of the ribosome.

Conclusion

The guidelines presented here shall aid newcomers in establishing ribosome profiling in new plant species and provide insights that will help in customizing the methodology for individual research goals.
Process evaluation of two large randomized controlled trials to understand factors influencing family physicians’ use of antibiotic audit and feedback reports
Authors: Shuldiner Jennifer , Lacroix Meagan , Saragosa Marianne , Reis Catherine , Schwartz Kevin L. , Gushue Sharon , Leung Valerie , Grimshaw Jeremy , Silverman Michael , Thavorn Kednapa , Leis Jerome A. , Kidd Michael , Daneman Nick , Tradous Mina , Langford Bradley , Morris Andrew M. , Lam Jonathan , Garber Gary , Brehaut Jamie , Taljaard Monica , Greiver Michelle , Ivers Noah Michael
Published: September 2024

Background

Unnecessary antibiotic prescriptions in primary care are common and contribute to antimicrobial resistance in the population. Audit and feedback (A&F) on antibiotic prescribing to primary care can improve the appropriateness of antibiotic prescribing, but the optimal approach is uncertain. We performed two pragmatic randomized controlled trials of different approaches to audit and feedback. The trial results showed that A&F was associated with significantly reducing antibiotic prescribing. Still, the effect size was small, and the modifications to the A&F interventions tested in the trials were not associated with any change. Herein, we report a theory-informed qualitative process evaluation to explore potential mechanisms underlying the observed effects.

Methods

Ontario family physicians in the intervention arms of both trials who were sent A&F letters were invited for one-on-one interviews. Purposive sampling was used to seek variation across interested participants in personal and practice characteristics. Qualitative analysis utilized inductive and deductive techniques informed by the Clinical Performance Feedback Intervention Theory.

Results

Modifications to the intervention design tested in the trial did not alter prescribing patterns beyond the changes made in response to the A&F overall for various reasons. Change in antibiotic prescribing in response to A&F depended on whether it led to the formation of specific intentions and whether those intentions translated to particular behaviours. Those without intentions to change tended to feel that their unique clinical context was not represented in the A&F. Those with intentions but without specific actions taken tended to express a lack of self-efficacy for avoiding a prescription in contexts with time constraints and/or without an ongoing patient relationship. Many participants noted that compared to overall prescribing, A&F on antibiotic prescription duration was perceived as new information and easily actionable.

Conclusion

Our findings indicate that contextual factors, including the types of patients and the setting where they are seen, affect how clinicians react to audit and feedback. These results suggest a need to test tailored feedback reports that reflect the context of how, where, and why physicians prescribe antibiotics so that they might be perceived as more personal and more actionable.

Trial registration

Clinical Trial registration IDs: NCT04594200, NCT05044052.
The improvement of modified Si-Miao granule on hepatic insulin resistance and glycogen synthesis in type 2 diabetes mellitus involves the inhibition of TNF-α/JNK1/IRS-2 pathway: network pharmacology, molecular docking, and experimental validation
Authors: Cao Zebiao , Wang Xianzhe , Zeng Zhili , Yang Zhaojun , Lin Yuping , Sun Lu , Lu Qiyun , Fan Guanjie
Published: September 2024

Background

Modified Si-Miao granule (mSMG), a traditional Chinese medicine, is beneficial for T2DM and insulin resistance (IR), but the underlying mechanism remains unknown.

Methods

Using network pharmacology, we screened the compounds of mSMG and identified its targets and pathway on hepatic IR in T2DM. Using molecular docking, we identified the affinity between the compounds and hub target TNF-α. Then these were verified in KK-Ay mice and HepG2 cells.

Results

50 compounds and 170 targets of mSMG against IR in T2DM were screened, and 9 hub targets such as TNF and MAPK8 were identified. 170 targets were mainly enriched in insulin resistance and TNF pathway, so we speculated that mSMG might act on TNF-α, JNK1 and then regulate insulin signaling to mitigate IR. Experimental validation proved that mSMG ameliorated hyperglycemia, IR, and TNF-α, enhanced glucose consumption and glycogen synthesis, relieved the phosphorylation of JNK1 and IRS-2 (Ser388), and elevated the phosphorylation of Akt (Ser473) and GSK-3β (Ser9) and GLUT2 expression in KK-Ay mice. Molecular docking further showed berberine from mSMG had excellent binding capacity with TNF-α. Then, in vitro validation experiments, we found that 20% mSMG-MS or 50 μM berberine had little effect in IR-HepG2 cell viability, but significantly increased glucose consumption and glycogen synthesis and regulated TNF-α/JNK1/IRS-2 pathway.

Conclusion

Network pharmacology and molecular docking help us predict potential mechanism of mSMG and further guide experimental validation. mSMG and its representative compound berberine improve hepatic IR and glycogen synthesis, and its mechanism may be related to the inhibition of TNF-α/JNK1/IRS-2 pathway.
Exploring ambulance clinicians’ clinical reasoning when training mass casualty incidents using virtual reality: a qualitative study
Authors: Heldring S. , Lindström V. , Jirwe M. , Wihlborg J.
Published: September 2024

Background

How ambulance clinicians (ACs) handle a mass casualty incident (MCI) is essential for the suffered, but the training and learning for the ACs are sparse and they don’t have the possibility to learn without realistic simulation training. In addition, it is unclear what type of dilemmas ACs process in their clinical reasoning during an MCI. With virtual reality (VR) simulation, the ACs clinical reasoning can be explored in a systematic way. Therefore, the objective was to explore ambulance clinicians’ clinical reasoning when simulating a mass casualty incident using virtual reality.

Methods

This study was conducted as an explorative interview study design using chart- stimulated recall technique for data collection. A qualitative content analysis was done, using the clinical reasoning cycle as a deductive matrix. A high-fidelity VR simulation with MCI scenarios was used and participants eligible for inclusion were 11 senior ACs.

Results/conclusion

All phases of the clinical reasoning cycle were found to be reflected upon by the participants during the interviews, however with a varying richness of analytic reflectivity. Non-analytic reasoning predominated when work tasks followed specific clinical guidelines, but analytical reasoning appeared when the guidelines were unclear or non-existent. Using VR simulation led to training and reflection on action in a safe and systematic way and increased self-awareness amongst the ACs regarding their preparedness for MCIs. This study increases knowledge both regarding ACs clinical reasoning in MCIs, and insights regarding the use of VR for simulation training.
Group A Streptococcus infections in children and adolescents in the post-COVID-19 era: a regional Italian survey
Authors: Cinicola Bianca Laura , Sani Ilaria , Pulvirenti Federica , Capponi Martina , Leone Fabrizio , Spalice Alberto , Montalbano Agata , Macari Alessandra , Fonte Maria Teresa , Giampietro Paolo Gianni , Buonsenso Danilo , Zicari Anna Maria , Rongai Teresa ,   On behalf of the Italian Pediatrician Federation (FIMP), Lazio Region, Baldini Ferroli B , Brugnoli R , Carpita FM , Caruso G , Castellano C , Cives C , Costabile L , D’agostino R , De Vittori V , Fostira A , Grassi C , La Bella I , Le Pera AM , Masetti A , Morano D , Pontesilli C , Ragno A , Reali L , Rotili PL , Serafinelli J , Triarico S , Zirletta E
Published: September 2024

Background

Despite the worldwide increasing incidence of Group A Streptococcus (GAS) infections reported since December 2022, data on noninvasive GAS (nGAS) infections in the post COVID-19 era are limited. By a self-reported survey performed in an outpatient setting, we investigated the number and clinical features of GAS infections, the diagnostic work-up and the type of treatment utilized. In addition, the rate of influenza vaccination was evaluated.

Methods

In June 2023 family pediatricians involved in the study sent the survey to parents of patients aged 0–16 years. The survey included questions on GAS infections that occurred from January 1 to May 31, 2023.

Results

Among 3580 children, 20.3% had a GAS infection (0,8% < 1 year, 16,4% 1–3 years, 42,3% 3–6 years, 26,5% 6–9 years, 11,4%, 9–12 years, and 2,6% 12–16 years). Symptoms reported were sore throat (76.9%), fever (75.2%), tonsillar exudate (25.2%), lymphadenopathy (21.8%), and scarlet fever (14.7%). A single patient was hospitalized due to GAS meningitis.

Twenty four percent of children had more than one GAS infection. In this group, frequencies of symptoms reported in the first and in the following infection were similar, except for fever and scarlet fever which were less frequent during relapses. GAS was identified by rapid antigen detection test in 81.0% of children. Eighty-nine per cent of children were treated with antibiotics, mostly amoxicillin/clavulanate (40.4%) and amoxicillin (39.4%). Thirty four percent of children received influenza vaccine. No difference was observed among immunized and not immunized regarding the number and characteristics of GAS infection.

Conclusions

We reported a certain prevalence of nGAS infections in children, mainly those aged 3–6 years age, who were mostly characterized by a low score of symptoms, and in most of the cases diagnosed and treated using a microbiological test as confirmatory tool.

In this new clinical setting, a national study would be useful to reach more significant data for the definition of a correct diagnosis and clinical management of nGAS infections in children. Moreover, it is important to improve flu vaccination campaign and coverage to protect children from coinfections that could worsen the disease and misdiagnose the etiology of pharyngitis.
Clinical characteristics and risk factors of severe COVID-19 in hospitalized neonates with omicron variant infection: a retrospective study
Authors: Wei Huijing , Wei Fu , Peng Xiaokang , Liu Pan , Tang Li , Liu Yishan , Liao Shan , Bo Yajing , Zhao Yuzhen , Li Ruina , Liu Xiaoguai , Ji Fanpu
Published: September 2024

Background

Reports on coronavirus disease 2019 (COVID-19) in neonates are limited, especially in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) Omicron variant. This study aims to analyze the clinical characteristics and identify risk factors associated with severe COVID-19 in neonates infected with Omicron variant.

Methods

The study population was represented by neonates with COVID-19, who were admitted to The Affiliated Children’s Hospital of Xi’an Jiaotong University in northwest China, from December 10, 2022 to January 20, 2023. Chinese Center for Disease Control and Prevention (CDC) announced that all local COVID-19 cases were infected with Omicron variant during the study period. Clinical and laboratory data were collected retrospectively. We used logistic regression analysis to investigate the risk factors for severe COVID-19, and derived odds ratios (ORs) and the corresponding 95% confidence intervals (CIs).

Results

A total of 108 neonates, with median age of 18.1 days (interquartile range 9.4–23.0), were affected by COVID-19, of whom 84 had a mild disease, while 24 a severe one (22.2%). Of them, 6.5% were premature. No deaths were observed in the study population. The most common clinical manifestations were fever (88.9%) and cough (55.6%), with 5 cases (4.6%) complicated by pneumonia. 4 cases (3.7%) received respiratory support, including 2 cases of high-flow oxygen and 2 cases of continuous positive airway pressure. Gestational age at birth (OR: 0.615; 95% CI: 0.393–0.961), neutrophil count (NEU) (OR:0.576; 95% CI : 0.344–0.962) and lymphocyte count (LYM) (OR: 0.159; 95% CI: 0.063–0.401) were independent risk factors for severe COVID-19. The combination of NEU and LYM had the largest receiver operating characteristic area under the curve [0.912 (95% CI:0.830–0.993)] for identifying severe COVID-19, with a sensitivity of 0.833 and a specificity of 0.917.

Conclusions

The general presentations and outcomes of neonatal COVID-19 caused by Omicron variant were not severe, and very few patients required respiratory support. The simultaneous decrease in NEU and LYM can be used to identify severe infection.
Atlas of telomeric repeat diversity in Arabidopsis thaliana
Authors: Tao Yueqi , Xian Wenfei , Bao Zhigui , Rabanal Fernando A. , Movilli Andrea , Lanz Christa , Shirsekar Gautam , Weigel Detlef
Published: September 2024

Background

Telomeric repeat arrays at the ends of chromosomes are highly dynamic in composition, but their repetitive nature and technological limitations have made it difficult to assess their true variation in genome diversity surveys.

Results

We have comprehensively characterized the sequence variation immediately adjacent to the canonical telomeric repeat arrays at the very ends of chromosomes in 74 genetically diverse Arabidopsis thaliana accessions. We first describe several types of distinct telomeric repeat units and then identify evolutionary processes such as local homogenization and higher-order repeat formation that shape diversity of chromosome ends. By comparing largely isogenic samples, we also determine repeat number variation of the degenerate and variant telomeric repeat array at both the germline and somatic levels. Finally, our analysis of haplotype structure uncovers chromosome end-specific patterns in the distribution of variant telomeric repeats, and their linkage to the more proximal non-coding region.

Conclusions

Our findings illustrate the spectrum of telomeric repeat variation at multiple levels in A. thaliana—in germline and soma, across all chromosome ends, and across genetic groups—thereby expanding our knowledge of the evolution of chromosome ends.
Deep-learning generated B-line score mirrors clinical progression of disease for patients with heart failure
Authors: Baloescu Cristiana , Chen Alvin , Varasteh Alexander , Hall Jane , Toporek Grzegorz , Patil Shubham , McNamara Robert L. , Raju Balasundar , Moore Christopher L.
Published: September 2024

Background

Ultrasound can detect fluid in the alveolar and interstitial spaces of the lung using the presence of artifacts known as B-lines. The aim of this study was to determine whether a deep learning algorithm generated B-line severity score correlated with pulmonary congestion and disease severity based on clinical assessment (as identified by composite congestion score and Rothman index) and to evaluate changes in the score with treatment. Patients suspected of congestive heart failure underwent daily ultrasonography. Eight lung zones (right and left anterior/lateral and superior/inferior) were scanned using a tablet ultrasound system with a phased-array probe. Mixed effects modeling explored the association between average B-line score and the composite congestion score, and average B-line score and Rothman index, respectively. Covariates tested included patient and exam level data (sex, age, presence of selected comorbidities, baseline sodium and hemoglobin, creatinine, vital signs, oxygen delivery amount and delivery method, diuretic dose).

Results

Analysis included 110 unique subjects (3379 clips). B-line severity score was significantly associated with the composite congestion score, with a coefficient of 0.7 (95% CI 0.1–1.2 p = 0.02), but was not significantly associated with the Rothman index.

Conclusions

Use of this technology may allow clinicians with limited ultrasound experience to determine an objective measure of B-line burden.
Genetic composition, virulence factors, and antimicrobial resistance profiles of Bacillus cereus and Bacillus subtilis isolates from food vendors in Ondo State, Nigeria: implications for food safety
Authors: Fayanju Aderonke Mary , Akinyele Bamidele Juliet , Oladejo Babayemi Olawale , Osunla Ayodeji Charles
Published: September 2024

Background

This study investigated Bacillus cereus and Bacillus subtilis from food vendors in Ondo State, Nigeria.

Methods

A comprehensive whole-genome sequencing (WGS) analysis of Bacillus genomes, including genome assembly, plasmid prediction, species identification, antimicrobial resistance (AMR) gene identification, virulence gene identification, and multilocus sequencing typing, was conducted.

Results

The genome assembly revealed a B. cereus genome with 87 contigs, a length of 5,798,917 base pairs, and a GC content of 34.79%, whereas B. subtilis had a genome length of 4,238,143 bp and was composed of 253 contigs with a contig L50 of 24, a contig N50 of 55,053, and a GC content of 43.14904%. Plasmid prediction revealed the absence of prominent plasmids in the assembled B. cereus genome, whereas the repUS12 plasmid was recognized with an identity of less than 95.63% for the B. subtilis genome. Species identification via the average nucleotide identity (ANI) calculation confirmed that Bacillus cereus had a 98.97% ANI value, whereas a 98.39% ANI value was confirmed for B. subtilis WAUSV36. AMR genes were identified, with virulence genes such as the alo, cytK, and hbl genes also detected in B. cereus, whereas clpX, codY, purA, and purB genes were detected in B. subtilis. Multiple-locus sequence typing (MLST) revealed that B. cereus belongs to sequence type 73 with 100% identity, identifying housekeeping gene alleles, including glp_13, gmk_8, and ilv_9, whereas B. subtilis belongs to sequence type 130, with the ilvD gene showing a perfect match and the highest allele length of 471 for the housekeeping genes identified.

Conclusions

This detailed WGS analysis provides valuable insights into the genetic composition, potential virulence factors, and resistance profiles of B. cereus and B. subtilis, enhancing the understanding of their pathogenicity and epidemiology. The genomic analysis of B. cereus and B. subtilis revealed potential genomic applications in the context of food safety.
Uncovering the knowledge about systemic amyloidosis relevant to the rheumatologists
Authors: Pereira Ivanio Alves , Neto Nilton Salles Rosa , do Nascimento Renan Rodrigues Neves Ribeiro , Freire Eutilia Andrade Medeiros , Neves Fabricio de Souza , Bica Blanca Elena Rios Gomes , Pinheiro Frederico Augusto Gurgel , Perazzio Sandro Félix , Cordeiro Rafael Alves , Giardini Henrique Ayres Mayrink , Azevedo Valderilio Feijo , Sztajnbok Flavio Roberto
Published: September 2024

Amyloidosis is a localized or systemic disease caused by deposition of proteins in the extracellular space of various organs and tissues. As part of the disease, proteins that were originally soluble misfold and acquire a fibrillar conformation that renders them insoluble and resistant to proteolysis. Systemic amyloidosis is a rare, often underdiagnosed condition. In recent years, the incidence of newly diagnosed cases of amyloidosis has been increasing in association with the aging of the population and greater access to diagnostic tests. From a clinical perspective, systemic amyloidosis is frequently associated with involvement of the kidneys (causing nephrotic syndrome), heart (cardiac failure and arrhythmia), and peripheral nervous system (sensorimotor polyneuropathy and autonomic dysfunction). This condition is important to the rheumatologist for several reasons, such as its systemic involvement that mimics autoimmune rheumatic diseases, its musculoskeletal manifestations, which when recognized can allow the diagnosis of amyloidosis, and also because reactive or secondary AA amyloidosis is a complication of rheumatic inflammatory diseases. The treatment of amyloidosis depends on the type of amyloid protein involved. Early recognition of this rare disease is fundamental for improved clinical outcomes.
Ultra-lightweight convolution-transformer network for early fire smoke detection
Authors: Chaturvedi Shubhangi , Shubham Arun Chandravanshi , Singh Thakur Poornima , Khanna Pritee , Ojha Aparajita
Published: September 2024

Background

Forests are invaluable resources, and fire is a natural process that is considered an integral part of the forest ecosystem. Although fire offers several ecological benefits, its frequent occurrence in different parts of the world has raised concerns in the recent past. Covering millions of hectares of forest land, these fire incidents have resulted in the loss of human lives, wild habitats, civil infrastructure, and severe damage to the environment. Around 90% of wildland fires have been caused by humans intentionally or unintentionally. Early detection of fire close to human settlements and wildlife centuries can help mitigate fire hazards. Numerous artificial intelligence-based solutions have been proposed in the past decade that prioritize the detection of fire smoke, as it can be caught through remote sensing and provide an early sign of wildland fire. However, most of these methods are either computationally intensive or suffer from a high false alarm rate. In this paper, a lightweight deep neural network model is proposed for fire smoke detection in images captured by satellites or other remote sensing sources.

Results

With only 0.6 million parameters and 0.4 billion floating point operations per second, the hybrid network of convolutional and vision transformer blocks efficiently detects smoke in normal and foggy environmental conditions. It outperforms seven state-of-the-art methods on four datasets, including a self-collected dataset from the “Moderate Resolution Imaging Spectroradiometer” satellite imagery. The model achieves an accuracy of more than 99% on three datasets and 93.90% on the fourth dataset. The t-distributed stochastic neighbor embedding of extracted features by the proposed model demonstrates its superior feature learning capabilities. It is remarkable that even a tiny occurrence of smoke covering just 2% of the satellite image area is efficiently detected by the model.

Conclusions

With low memory and computational demands, the proposed model works exceedingly well, making it suitable for deployment in resource constrained devices for forest surveillance and early fire smoke detection.
Unveiling spindle cell lipoma: a radiological case report
Authors: Raj Joe Vimal , Vigneshwaran B. , Subbiah Yamini , Padmanaban Elamparidhi , Amirthalingam Umamageswari , Balavaitheeswar R. L.
Published: September 2024

Background

Spindle cell lipoma is a benign adipocytic tumour, commonly occuring in the subcutis of posterior neck, upper back and shoulder, particularly in middle aged males. It is often composed of relatively equal ratio of fat and spindle cells, yet either component may predominate. Because of its variable ratio, a spindle cell lipoma may mimic liposarcoma radiologically. This article aimed to describe the MRI characteristics that assist in diagnosing spindle cell lipoma.

Case presentation:

A 45-year-old female presented with a gradually progressive neck swelling along the posterior aspect over a period of 2 years. Physical examination revealed a firm, mobile, non-tender mass in the left suboccipital region. Radiographic imaging showed a well-defined heterogeneous, minimally enhancing soft tissue swelling with areas of macroscopic fat and multiple macrocalcifications in the left suboccipital region extending to the left parapharyngeal space, showing loss of fat plane with adjacent muscles. Differential diagnoses of soft tissue neoplasms such as atypical lipoma and low-grade liposarcoma were considered. Surgical excision confirmed a myxoid variant of spindle cell lipoma upon histopathological examination.

Conclusion

Spindle cell lipomas, commonly found in the posterior neck, have varied imaging features that are not distinctive. Despite their non-specific nature, radiologists should recognize these features, as the tumor can be treated effectively with simple excision. When encountering a well-defined, complex fatty mass in the subcutaneous tissue of the posterior neck, consider a diagnostic possibility of spindle cell lipoma.
Thyroid Hormone Regulates Postnatal Development of the Rete Testis in Mice
Authors: Kulibin Andrey Yu , Malolina Ekaterina A
Published: September 2024

Thyroid hormone regulates the rate of testis maturation in mammals. Manipulations of thyroid hormone levels in neonatal animals affect various aspects of testis biology. However, there have been no studies examining the effects of thyroid hormone on the rete testis (RT). Here, we used animal models of neonatal hyperthyroidism (injections of triiodothyronine, or T3) and hypothyroidism (goitrogen 6-propyl-2-thiouracil [PTU] treatment) and found that higher levels of thyroid hormone accelerate RT development, while lower levels of thyroid hormone delay it. T3 and PTU treatments influence RT size, proliferation of RT cells, and expression of DMRT1 and androgen receptor in the RT. T3 supplementation accelerates RT development in an organ testicular culture, which indicates the local action of thyroid hormone. Additionally, it was found that follicle-stimulating hormone could be involved in the regulation both of RT proliferation and RT size. The fact that RT cells in a cell culture do not respond to T3 suggests indirect action of thyroid hormone on the RT in vivo or the loss of the responsiveness to the hormone in vitro.