bluuebunny/crossref_metadata_2025 huggingface dataset:
Induction and Characterization of Tetraploids from Astragalus membranaceus (Fisch.) Bge. Seeds
Authors: Zhang Shu-ling , Zhang Xin , Wang Meng , Dong Li-jun , Liu Gui-xia
Published: March 2024

Background

Astragalus membranaceus (Fisch.) Bge., as a Traditional Chinese Medicine, not only has ornamental and medicinal value but also plays a role in the effect of sand fixation. At present, the resources of wild A. membranaceus are exhausted with the deterioration of the ecological environment and the increase in market demand. Moreover, there are no excellent varieties for the artificial cultivation of A. membranaceus to meet the market demand.

Objectives

To establish a method to create an efficient induction of tetraploids by colchicine technique in A. membranaceus.

Materials and Methods

The germinating seeds were soaked in different concentrations of colchicine solution and exposure times to induce tetraploids in A. membranaceus, and the induced plants were identified by morphological characteristics comparison and root-tip chromosome determination. The contents of polysaccharides, saponins, and flavonoids and the activity of superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT) were measured in diploid and tetraploid plants.

Results

The results showed that the highest tetraploid induction ratio of germinating seeds in A. membranaceus is obtained from the 0.2% (w/v) colchicine treatment for 36 h, and the chromosome number of tetraploid seedlings was 2n = 4x = 32. The morphological traits and anatomical structure characteristics of leaves from tetraploid plants exhibited significant differences from the diploid plants. The contents of polysaccharides, saponins, and flavonoids and the activity of SOD, POD, and CAT are also increased in tetraploid plants.

Conclusion

In summary, our study provided an effective method to induce A. membranaceus polyploidy, which could be used to develop new germplasm innovations for improving the medicinal value of A. membranaceus.
Direct induction onto high-dose long-acting injectable buprenorphine: A case series
Authors: Naren Thileepan , Cook Jon , MacCartney Paul
Published: March 2024

Introduction

This case series reports on five patients with opioid use disorder (OUD) who were commenced directly onto high-dose long-acting injectable buprenorphine (LAIB).

Method

A retrospective audit and manual review of the electronic medical record at cohealth Innerspace was conducted for patients who had been directly inducted onto high-dose LAIB.

Results

Five cases were identified on retrospective manual file review. All patients identified were males aged between 33 and 60 years old and were treated with either high-dose Buvidal Weekly and Monthly preparations. No immediate significant adverse effects were noticed and 4 out of 5 remain engaged with treatment.

Conclusion

This case series shows it is possible to directly induct patients with OUD onto high-dose LAIB preparations without significant side effects or harm to the patient and could be considered a viable option in the treatment of patients with OUD.
The Contribution of Inherited Thrombophilia to Venous Thromboembolism in Cancer Patients
Authors: Costa José , Araújo António
Published: March 2024

Although the relationship between venous thromboembolism (VTE) and cancer has been a subject of study, knowledge of the contribution of thrombophilia to thrombosis in patients with cancer is still very limited. The aim of this article is to collect present knowledge on the contribution of inherited thrombophilia to VTE in cancer patients. We performed a search in Google Scholar and PubMed and selected 21 from 76 returned articles. Then we made a narrative review of the selected articles. We describe 11 studies on the contribution of inherited thrombophilia to VTE in cancer patients in general and 10 on that contribution in specific types of cancer: 1 in colorectal cancer, 4 in breast cancer, 1 in gynecologic cancer and 4 in hematopoietic malignancies. All studies investigate the relation of factor V Leiden (FVL) to VTE, 13 that of the prothrombin G20210A mutation (PTG20210A) and 7 studies also investigate other inherited thrombophilias, such methylenetetrahydrofolate reductase gene mutations, although only 2 investigate the contribution of deficiencies of the natural anticoagulants. Studies are very heterogeneous, in design and sample size and conclusions differ considerably. There is no consensus on the contribution of inherited thrombophilia to VTE in cancer patients except for acute lymphoblastic leukemia in children. Probably, that contribution is not the same for all types of cancer and more studies are needed to bring more knowledge on this subject.
Cost Overruns Arising From Government-Led Risks in Indonesian Toll Roads
Authors: Wibowo Andreas , Santoso Sudiro Roi
Published: March 2024

This paper aims to elucidate the phenomenon of cost overruns resulting from government-led risks, with a specific focus on contract changes within the context of 70 Indonesian toll road projects. The dataset demonstrates a broad spectrum of cost overrun rates (COR), from −34.43% to 356.54%, with a median of 0.00% (mean = 14.83%). Empirical evidence demonstrates that contract changes exert a discernible influence on cost overruns. Among the sampled projects, 39 out of 70 encountered changes in their original contracts, and within this subset of projects, the median COR was 7.00% (mean = 26.63%). In the case of projects experiencing cost overruns and underruns, the median COR amounted to 21.00% (mean = 44.55%, n = 27) and −13.50% (mean = −13.72%, n = 12), respectively. This paper delves into the correlations between the COR and various project attributes, providing elucidations grounded in the framework of multiple theories in the literature.
Management of symblepharon with Gore-tex as a novel treatment option for ocular chemical burns
Authors: Venugopal Anitha , Gurnani Bharat , Ravindran Meenakshi , Uduman Mohammed Sithiq
Published: March 2024

Purpose

To assess the clinical outcomes of symblepharon release in patients with ocular surface chemical injury using Gore-Tex as a novel treatment option.

Methods

This was a retrospective analysis of 23 eyes of 22 chemical injury patients done during a period of January 2014 to December 2021 at a tertiary eye care centre in South India. All patients underwent symblepharon lysis along with Gore-Tex application over the sclera with minimum 1 year follow up. The patients were assessed for demographic details, visual acuity, intraocular pressure, anterior and posterior segment details, photographic documentation, preoperative diagnosis, previous surgical details in recurrent cases, surgical procedures, final visual acuity, surgical outcomes, and complications. The clinical outcomes were assessed and outcomes were defined as success, partial success, or failure.

Results

The median age was 17 years (IQR, 12–39 years). Among them 10 eyes with symblepharon had grade 3 length, 12 eyes grade 3 width and 12 eyes had grade 3 loss of palisades of Vogt. The success was achieved in 52.2% of the patients; partial success in 34.8% and 13.3% had failure. The mean duration of recurrence was 6.75 ± 3.6 months. Failure was noted in young patients with mean age 9.75years and with grade 3c symblepharon. There was no sight threatening complications noted.

Conclusion

The study showed very good results with Gore-Tex as a novel treatment option for chemical injury patient with symblepharon formation. It can be easily employed to prevent the symblepharon recurrence of various ocular surface disorders.
Lesbian, gay, bisexual, transgender, and nonbinary representation on Australian scripted television in the 2000s and 2010s
Authors: O’Meara Damien John , Monaghan Whitney
Published: March 2024

Over the past few decades, there has been significant industry and scholarly interest in diversity, equity, and inclusion in television. Alongside this, attention has been paid to the politics of queer representation in screen and media contexts. Providing much-needed data on these issues, this article catalogues the representation of gay, lesbian, bisexual, transgender, and nonbinary characters in Australian scripted television since 2000. We highlight the inclusion of more queer characters onscreen and situate this in the context of two significant decades of change in the Australian television industry and the broader socio-political context. In teasing out recent trends around gender and sexually diverse representation, we identify shifts toward representing more complex and inclusive queer story worlds on Australian television. We also note significant tensions in these representations, highlighting how Australian television remains quite conservative in depicting queer sex, intersections between sexualities and gender identities, and bisexual identities.
A review on tribological behavior of nickel-based Inconel superalloy
Authors: Dubey Dhananjay , Mukherjee Rajdip , Singh Manjesh Kumar
Published: March 2024

Superalloys are a group of engineering alloys designed to operate at elevated temperatures, and they find application in various engineering sectors where a high-temperature application is required such as nuclear power plants, steam turbines, and aircraft. There are three important classes of superalloys, that is, iron-based, cobalt-based, and nickel-based superalloys. Among them, nickel-based superalloys find great application at both low and high temperatures due to their higher mechanical strength, good fatigue life, excellent wear, and corrosive resistance. This review article aims to review the tribological studies of the nickel-based Inconel superalloys. The article deals with the systematic studies of wear behavior, wear mechanism, and nanostructured glaze layer formation over the wear surfaces. The effect of load and temperatures influencing the wear rate and wear mechanisms of nickel-based superalloys are also discussed in detail. Along with that, the focus of this review article is to discuss the advancement in the tribological studies of the Inconel-718 superalloy. The development in the Inconel-718 alloys (surface alloying, laser shot peening, composites, microstructure engineering, etc.) to improve wear resistance is also discussed in a systematic manner. This article is expected to assist the researchers in identifying the trend and research gaps so that they can contribute to further tribological developments of nickel-based superalloys.
Lubricity performance of hydrogen-free CVD growth of graphene on copper particles as an additive in paraffin base oil
Authors: Rahman Nurul Liyana , Amiruddin Hilmi , Abdollah Mohd Fadzli Bin , Umehara Noritsugu
Published: March 2024

This study aims to examine the impact of carbon precursor materials, which are oil palm fiber (OPF) and waste polystyrene (PS), on friction and wear properties of paraffin base oil added with graphene-coated copper (Cu) additive. The graphene was synthesized on Cu particles via hydrogen-free chemical vapor deposition method. The graphene was characterized using Raman spectroscopy and transmission electron microscopy. The lubricity properties of 0.6 wt.% of synthesized graphene-coated Cu additive in paraffin base oil was analyzed based on its tribological behavior using a four-ball tribometer. From the quantitative and qualitative characterization analysis, graphene-coated Cu additive synthesized using 50 wt.% OPF carbon precursors has a good-quality graphene with minimal defects and a well-ordered lattice structure. From the tribological analysis, the paraffin base oil added with graphene-coated Cu additive synthesized using 50 wt.% OPF carbon precursor has the lowest coefficient of friction of 0.07 and wear rate of 1.6 × 10−5 mm3/min. Hence, it can be suggested that incorporating graphene-coated Cu particles, synthesized from a 50 wt.% OPF carbon precursor, into base oil shows great potential as an environmentally friendly additive, particularly in terms of enhancing lubrication performance.
Increasing primary care capacity and referral efficiency: A case study of a telehealth centre eConsult service in Brazil
Authors: Catapan Soraia de Camargo , Bruckmann Guilherme , Nilson Luana Gabrielle , Caffery Liam J , Kelly Jaimon T. , Calvo Maria Cristina Marino , Boing Antonio Fernando
Published: March 2024

Introduction

eConsults are asynchronous digital communications for primary care professionals to seek timely specialist advice. Potential benefits include increased primary healthcare capacity and referral efficiency. Santa Catarina Telehealth Centre in Brazil has offered eConsults for an increasing number of specialties since 2008. This study described the characteristics of this service, including referral efficiency, sustainability, and satisfaction.

Methods

Retrospective longitudinal analysis of eConsults activity data from 2015 to 2022 with three domains of the Model for Assessment of Telemedicine Applications used to structure the analysis.

Results

Characteristics of the application: The total number of eConsults performed in 2015 was 4764, reaching 41,178 in 2022. While 30.3% of eConsults were synchronous in 2015, only asynchronous communication remained from 2021. Clinical effectiveness: eConsults requested to refer patients to specialist care resulting in primary care management remaining above 30% of the total for all specialties from 2019 to 2022, with hematology having the highest percentage (>52%). Organizational aspects: Established workflows with local specialists responding to eConsults (cardiology, endocrinology, hematology and orthopaedics) kept a constant or increasing number of eConsults and maintained the proportion of primary care management from 2019 to 2022, once recovered from COVID-19 and funding restrictions-related reductions. Over 90% of primary care professionals are either satisfied or very satisfied with the eConsult service.

Conclusion

Over 8 years, 223,734 consultations were conducted, with high satisfaction, demonstrating the substantial potential for increased primary care-sensitive conditions management. Hiring local specialists, fostering integrated care, and enabling sustainable workflows are key to eConsults’ success.
Trends in social inequality in breastfeeding duration in Denmark 2002–2019
Authors: Carlsson Rikke R. , Pommerencke Lis Marie , Pant Sofie W. , Jørgensen Sanne E. , Madsen Katrine R. , Bonnesen Camilla T. , Kierkegaard Lene , Pedersen Trine P.
Published: March 2024

Aims:

The aim of the present study was to analyse trends in full breastfeeding for at least 4 months across socioeconomic position in Denmark over a 17-year-long period from 2002 to 2019 using parental education as the indicator of socioeconomic position.

Methods:

The study used data on full breastfeeding collected between 2002 and 2019 by community health nurses in the collaboration Child Health Database, n=143,075. Data were linked with five categories of parental education from population registers. Social inequality was calculated as both the relative (odds ratio) and absolute social inequality (slope index of inequality). A trend test was conducted to assess changes in social inequality over time.

Results:

A social gradient in full breastfeeding was found for the entire study period. The odds ratio for not being fully breastfed for at least 4 months ranged from 3.30 (95% confidence interval 2.83–3.84) to 5.09 (95% confidence interval 4.28–6.06) during the study period for infants of parents with the lowest level of education (primary school) compared with infants of parents with the highest level of education (5+ years of university education). The slope index of inequality was between −38.86 and −48.81 during the entire study period, P=0.80. This indicated that both the relative and absolute social inequality in full breastfeeding to at least 4 months of age was unchanged in the study period from 2002 to 2019.

Conclusions:

This study showed a persistent relative and absolute social inequality in full breastfeeding for at least 4 months from 2002 to 2019 in Denmark.
Experimental investigation of 3D printed bio-inspired Xylotus lattice structure for energy absorption under quasi-static axial loading conditions
Authors: Ramakrishnan R , Hemanth Kumar J , Titus Franklin , Maharshi P , Nithish R
Published: March 2024

The demand for robust, lightweight polymer components in various industries has prompted researchers to turn to nature's structures for inspiration. Leveraging Polymer Additive Manufacturing (PAM), specifically Fused Filament Fabrication (FFF), complex bio-inspired lattice polymer structures have been successfully realized. This experimental study focuses on the development of novel 3D printed bioinspired Xylotus lattice structure with elements inspired by xylem and lotus. The primary goal was to evaluate the deformation behaviour and energy absorption characteristics of 3D printed Xylotus lattice structure under quasi-static compressive loading and compare the results with existing research. The hybrid (Xylotus) structure of xylem and lotus exhibited a sequential failure pattern, starting with axial cracks and followed by buckling. Furthermore, an analysis of energy absorption showed that the xylem lattice outperformed the lotus lattice, thanks to its robust tubular elements. Notably, the Xylotus lattice displayed the highest energy absorption capabilities, capitalizing on features from both lotus and xylem. The energy absorption of the Xylotus lattice structure surpassed that of the xylem and lotus structures by 13% and 29.2%, respectively. The xylotus lattice structure exhibited 38% higher energy absorption compared to the existing research. Moreover, the specific energy absorption of the Xylotus lattice structure outperformed the lattice structures reported in the existing research by 37%. This study offers valuable insights into the structural behaviour, energy absorption, and specific energy absorption of bio-inspired lattice Xylotus structure. The findings contribute significantly to the design of resilient, lightweight components, supporting the advancement of bio-inspired structures for diverse applications in various industries.
Predictors of angiographic resolution in patients with presumed reversible cerebral vasoconstriction syndrome
Authors: Madapoosi Adrusht , McGuire Laura Stone , Hossa Jessica , Fuentes Angelica , Tshibangu Mpuekela , Theiss Peter , Amin-Hanjani Sepideh , Alaraj Ali
Published: March 2024

Introduction

Reversible cerebral vasoconstriction syndrome is a complex neurovascular syndrome that presents with varying neurological deficits as well as segmental vasoconstriction of the small and medium cerebral arteries. There is limited literature on pathologies that mimic reversible cerebral vasoconstriction syndrome, so this study aims to understand what factors may impact the angiographic confirmation of reversible cerebral vasoconstriction syndrome on follow-up and play a role in establishing the diagnosis.

Methods

The Clinical Research Data Warehouse at this institution was employed to search the medical records for patients with diagnosis and treatment of reversible cerebral vasoconstriction syndrome between January 2010 and May 2021. After screening, 32 patients met the inclusion criteria for a presumed diagnosis of reversible cerebral vasoconstriction syndrome with both angiography on presentation and at three-month follow-up after treatment. Patients were divided into two categories: those with complete angiographic resolution, versus partial or no improvement on follow-up. Clinical and radiographic data were analyzed.

Results

Patients who had partial or no resolution were more likely to have a history of hypertension ( p = 0.001), higher systolic blood pressure on admission ( p = 0.047), and present with a recurrent thunderclap headache ( p = 0.038). Binary logistic regression selected for hypertension (odds ratio [OR] 18.35 [95% CI, 1.37–245.1]) as predictive of not having reversible cerebral vasoconstriction syndrome, as can be seen by partial or no resolution on follow-up angiography ( p = 0.028).

Conclusion

Complete resolution on follow-up angiography is a distinguishing factor of reversible cerebral vasoconstriction syndrome. Our analysis revealed that a history of hypertension is the most significant predictor of confirming that a patient may not have reversible cerebral vasoconstriction syndrome. This is due, in part, to increased atherosclerotic or hypertensive cerebral arterial changes, which can mimic reversible cerebral vasoconstriction syndrome and present as partial or no resolution on angiography.
Facilitating research ethics in qualitative research through doctoral supervision in the context of European Commission funding
Authors: Moe Cathrine , Uhrenfeldt Lisbeth , Kymre Ingjerd Gåre
Published: March 2024

The increasing need for innovative research driven by rapid global changes gives doctoral supervisors of early-stage researchers a significant role in facilitating the ethical conduct of qualitative research. In the context of European Commission funding, the demands of research ethics and integrity place a tremendous responsibility on the supervisors of early-stage researchers involved in cross-national projects. This document study seeks to illuminate the role of the supervisors in facilitating research ethics in these projects. Specifically, we describe and discuss the supervisor role associated with five approaches to doctoral supervision of qualitative research, namely those described as ‘Functional’, ‘Enculturation’, ‘Critical thinking’, ‘Emancipation’ and ‘Developing a quality relationship’. The main challenges for supervisors of cross-national research projects are the cultural and linguistic mobilisation of ethical principles in qualitative research processes and the management of the future use of open data. The results from this study have implications for planning and conducting cross-national studies within research involving human participants. These results can guide supervisors in the codification and mobilisation of ethical qualitative research in practice.
A systematic review of the outcomes of partial ulnar collateral ligament tears of the elbow in athletes treated non-operatively with platelet-rich plasma injection
Authors: Ifarraguerri Anna M , Berk Alexander N , Rao Allison J , Trofa David P , Ahmad Christopher S , Martin Anthony , Fleischli James E , Saltzman Bryan M
Published: March 2024

Background

This study aimed to analyze the effects of platelet-rich plasma (PRP) for partial ulnar collateral ligament (UCL) tears in athletes and predicted positive outcomes.

Methods

The researchers systematically reviewed the PubMed, Cochrane CENTRAL, MEDLINE, Scopus, and Google Scholar databases to identify studies with clinical outcomes of PRP for partial UCL tears. They excluded studies that did not stratify data by tear type or included surgical management.

Results

Five studies with 156 patients were included. The timing, amount, platelet concentration, type, and number of PRP injections were highly variable among the studies. However, 75% (n = 97/127) of athletes returned to sport (RTS) at a weighted average of 82.1 days (37–84) after PRP injection. One study showed significant improvements in patient-reported outcomes. Two studies showed positive outcomes in the modified Conway scale, complete reconstitution of the UCL in 87% of patients on MRI, and significant improvement in the humeral-ulnar joint space after PRP injection via ultrasound. The Coleman methodology score (CMS) averaged 48/100, indicating an overall poor quality of evidence.

Conclusion

This review demonstrates favorable RTS, clinical, and radiographic outcomes in patients receiving PRP for partial UCL tears, but the literature remains heterogeneous and of low quality.

Level of Evidence

III
Quantitative Evaluation of Digital Economy Policy in Heilongjiang Province of China Based on the PMC-AE Index Model
Authors: Wang Gaofei , Yang Yi
Published: March 2024

The digital economy has gradually become an important support for high-quality economic development, but the speed of digital economy development is affected by policies. A reasonable digital economy policy system has practical significance for the development of the digital economy. This study takes the digital economy policy text published by Heilongjiang Province from 2015 to 2022 as the research object, uses the method of text mining and content analysis, innovatively introduces AE automatic coding technology into the PMC index model, constructs the PMC-AE index model, and quantitatively evaluates and analyzes the policy text. The study found that the digital economy policy of Heilongjiang Province is at a good level as a whole, but there is still room for improvement. The digital economy policy of Heilongjiang Province is mainly based on guiding policies. The richness of policy types, participants, and incentives is insufficient. The limitation of policy timeliness is strong, and the cooperation of the issuing agencies is not sufficient. Based on the research results, it is suggested that policymakers should pay attention to the combination of macro and micro policies, promote multi-agent participation, enrich incentive measures, develop both policy guidance and supervision, improve the timeliness and consistency of policies, and strengthen the communication between the Issuing Departments. In addition, this study puts forward policy suggestions for specific government departments from four aspects of digital industrialization, industrial digitization, digital governance, and data value. This study not only provides policy recommendations for policymakers but also expands the field of policy evaluation.
Exploring Spatial Variation of Women’s Tetanus Vaccination in Ethiopia: Spatial Analysis of Ethiopian Demographic and Health Survey 2016
Authors: Belay Alebachew Taye , mulugeta Solomon Sisay , Agegn Setegn Bayabil , Erega Besfat Berihun
Published: March 2024

Tetanus is a bacterial infection that causes painful muscular contractions throughout the body, usually starting in the jaw. Every year, 15,000 to 30,000 maternal deaths occur due to tetanus related to the delivery process. Exploring variations of women’s tetanus immunization is crucial for programmers’ planning and monitoring. As a result, this study aims to evaluate the spatial distribution of women’s tetanus vaccination coverage and risk areas of women’s tetanus vaccination clustering in Ethiopia. The study used Ethiopian Demographic and Health Survey data, which was conducted in 2016 using the Ethiopia Population and Housing Census 2007 sampling frame. From 15,683 women aged 15 to 49, a sample of 7,193 women was selected using eligible criteria. This study used spatial data analysis. To determine geographical danger zones for tetanus vaccination of women, cluster, hotspot analysis, spatial interpolation, and spatial scan statistics were used. At the regional level of Ethiopia, tetanus vaccination was spatially clustered (Global Moran’s I = 0.066, p = .0001). Western Tigray, eastern SNNP, and northern Oromia were identified as hotspots of poor tetanus vaccine coverage, whereas western Oromia, Afar, and southeast Amhara regions were designated as non-risky areas of Ethiopia. The spatial Bayesian kriging interpolation analysis predicted high-risk areas were the southwestern and eastern parts of Oromia, western Tigray, Harari, and Dire Dawa Western Tigray, the eastern SNNP, southern Amhara, and northern Oromia have been recognized as a significant hotspot. Health workers, programmers, government, and non-governmental organizations in Ethiopia will implement spatially based strategic interventions for women’s tetanus immunization.
The Effect of a Group-Based Mindfulness and Acceptance Training on Psychological Flexibility and Adherence to Antiretroviral Therapy Among Adolescents in Uganda: An Open-Label Randomized Trial
Authors: Musanje Khamisi , Kamya Moses R. , Kasujja Rosco , Vanderplasschen Wouter , Sinclair Deborah L. , Baluku Martin M. , Odokonyero Raymond F. , Namisi Charles P. , Mukisa John , White Ross G. , Camlin Carol S.
Published: March 2024

Adherence to antiretroviral therapy (ART) is lower in adolescents with HIV (AWH) than in any other age group, partly due to self-regulatory challenges during development. Mindfulness and acceptance training have been shown to support psychological flexibility, a self-regulatory skill that potentially improves adolescent adherence to medication. We assessed the effect of weekly group-based mindfulness and acceptance training sessions on ART adherence among older adolescents (15–19 years) in Kampala, Uganda. One hundred and twenty-two AWH (median age 17, range 15–19 years, 57% female) receiving care at a public health facility in Kampala were randomized 1:1 to receive 4 weekly 90-min group sessions facilitated by experienced trainers or standard-of-care ART services. The training involved (Session 1) clarifying values, (Session 2) skillfully relating to thoughts, (Session 3) allowing and becoming aware of experiences non-judgmentally, and (Session 4) exploring life through trial and error. At baseline, postintervention, and 3-month follow-up, psychological flexibility was measured using the Avoidance and Fusion Questionnaire for Youth (AFQ-Y8), and self-reported ART adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8). At baseline, the intervention and standard-of-care arms had similar psychological flexibility (AFQ-Y8 score:15.45 ± 0.82; 15.74 ± 0.84) and ART adherence (MMAS-8 score: 5.32 ± 0.24; 5.13 ± 0.23). Retention through the study was moderate (71%). Completion of mindfulness and acceptance training was associated with a significant reduction in psychological inflexibility at the 3-month follow-up (AFQ-Y8 score: 12.63 ± 1.06; 14.05 ± 1.07, P = .006). However, no significant differences were observed in self-reported adherence to ART at the 3-month follow-up (MMAS-8 score: 5.43 ± 0.23; 4.90 ± 0.33, P = .522). Group-based mindfulness and acceptance training improved psychological flexibility in this population of adolescents on ART in Uganda but did not significantly improve ART adherence. Future research should explore integrated approaches that combine behavioral management training with other empowerment aspects to improve ART adherence among AWH.
Exploring Positive Youth Development Approach in Indian Context
Authors: Yesudhas Ronald , PV Laavanya
Published: March 2024

Positive youth development (PYD), which arose as a counterbalance to the treatment models in youth work, stresses the role of family, community and other change agents, such as NGOs and educational institutions, in creating services, opportunities and support systems for young people to excel. The article tries to locate the context of PYD approach. Single case study method is employed to document the historical emergence of the Anubhav Shiksha Kendra (ASK) and its adoption of PYD approach. Though the study cannot be generalised, it provides a framework for future empirical studies on PYD in India.
Characterisation and reproducibility of the HumanMethylationEPIC v2.0 BeadChip for DNA methylation profiling
Authors: Peters Timothy J. , Meyer Braydon , Ryan Lauren , Achinger-Kawecka Joanna , Song Jenny , Campbell Elyssa M. , Qu Wenjia , Nair Shalima , Loi-Luu Phuc , Stricker Phillip , Lim Elgene , Stirzaker Clare , Clark Susan J. , Pidsley Ruth
Published: March 2024

Background

The Illumina family of Infinium Methylation BeadChip microarrays has been widely used over the last 15 years for genome-wide DNA methylation profiling, including large-scale and population-based studies, due to their ease of use and cost effectiveness. Succeeding the popular HumanMethylationEPIC BeadChip (EPICv1), the recently released Infinium MethylationEPIC v2.0 BeadChip (EPICv2) claims to extend genomic coverage to more than 935,000 CpG sites. Here, we comprehensively characterise the reproducibility, reliability and annotation of the EPICv2 array, based on bioinformatic analysis of both manifest data and new EPICv2 data from diverse biological samples.

Results

We find a high degree of reproducibility with EPICv1, evidenced by comparable sensitivity and precision from empirical cross-platform comparison incorporating whole genome bisulphite sequencing (WGBS), and high correlation between technical sample replicates, including between samples with DNA input levels below the manufacturer’s recommendation. We provide a full assessment of probe content, evaluating genomic distribution and changes from previous array versions. We characterise EPICv2’s new feature of replicated probes and provide recommendations as to the superior probes. In silico analysis of probe sequences demonstrates that probe cross-hybridisation remains a significant problem in EPICv2. By mapping the off-target sites at single nucleotide resolution and comparing with WGBS we show empirical evidence for preferential off-target binding.

Conclusions

Overall, we find EPICv2 a worthy successor to the previous Infinium methylation microarrays, however some technical issues remain. To support optimal EPICv2 data analysis we provide an expanded version of the EPICv2 manifest to aid researchers in understanding probe design, data processing, choosing appropriate probes for analysis and for integration with methylation datasets from previous versions of the Infinium Methylation BeadChip.
SNP-based and haplotype-based genome-wide association on drug dependence in Han Chinese
Authors: Xu Hanli , Kang Yulin , Liang Tingming , Lu Sifen , Xia Xiaolin , Lu Zuhong , Hu Lingming , Guo Li , Zhang Lishu , Huang Jiaqiang , Ye Lin , Jiang Peiye , Liu Yi , Xinyi Li , Zhai Jin , Wang Zi , Liu Yangyang
Published: March 2024

Background

Drug addiction is a serious problem worldwide and is influenced by genetic factors. The present study aimed to investigate the association between genetics and drug addiction among Han Chinese.

Methods

A total of 1000 Chinese users of illicit drugs and 9693 healthy controls were enrolled and underwent single nucleotide polymorphism (SNP)-based and haplotype-based association analyses via whole-genome genotyping.

Results

Both single-SNP and haplotype tests revealed associations between illicit drug use and several immune-related genes in the major histocompatibility complex (MHC) region (SNP association: log10BF = 15.135, p = 1.054e-18; haplotype association: log10BF = 20.925, p = 2.065e-24). These genes may affect the risk of drug addiction via modulation of the neuroimmune system. The single-SNP test exclusively reported genome-wide significant associations between rs3782886 (SNP association: log10BF = 8.726, p = 4.842e-11) in BRAP and rs671 (SNP association: log10BF = 7.406, p = 9.333e-10) in ALDH2 and drug addiction. The haplotype test exclusively reported a genome-wide significant association (haplotype association: log10BF = 7.607, p = 3.342e-11) between a region with allelic heterogeneity on chromosome 22 and drug addiction, which may be involved in the pathway of vitamin B12 transport and metabolism, indicating a causal link between lower vitamin B12 levels and methamphetamine addiction.

Conclusions

These findings provide new insights into risk-modeling and the prevention and treatment of methamphetamine and heroin dependence, which may further contribute to potential novel therapeutic approaches.
Deciphering the regulatory role of PheSnRK genes in Moso bamboo: insights into hormonal, energy, and stress responses
Authors: Zheng Huifang , Xie Yali , Mu Changhong , Cheng Wenlong , Bai Yucong , Gao Jian
Published: March 2024

The SnRK (sucrose non-fermentation-related protein kinase) plays an important role in regulating various signals in plants. However, as an important bamboo shoot and wood species, the response mechanism of PheSnRK in Phyllostachys edulis to hormones, low energy and stress remains unclear. In this paper, we focused on the structure, expression, and response of SnRK to hormones and sugars. In this study, we identified 75 PheSnRK genes from the Moso bamboo genome, which can be divided into three groups according to the evolutionary relationship. Cis-element analysis has shown that the PheSnRK gene can respond to various hormones, light, and stress. The PheSnRK2.9 proteins were localized in the nucleus and cytoplasm. Transgenic experiments showed that overexpression of PheSnRK2.9 inhibited root development, the plants were salt-tolerant and exhibited slowed starch consumption in Arabidopsis in the dark. The results of yeast one-hybrid and dual luciferase assay showed that PheIAAs and PheNACs can regulate PheSnRK2.9 gene expression by binding to the promoter of PheSnRK2.9. This study provided a comprehensive understanding of PheSnRK genes of Moso bamboo, which provides valuable information for further research on energy regulation mechanism and stress response during the growth and development of Moso bamboo.
The role of perioperative sedative anesthetics in preventing postoperative delirium: a systematic review and network-meta analysis including 6679 patients
Authors: Huang Jin-Xiang , Zhang Shan-Shan , Wang Shu-Xian , Xi Da-Shuang , Luo Fang-Ru , Liu Cheng-Jiang , Li Hong
Published: March 2024

Objective

Postoperative delirium is a common and debilitating complication that significantly affects patients and their families. The purpose of this study is to investigate whether there is an effective sedative that can prevent postoperative delirium while also examining the safety of using sedatives during the perioperative period.

Methods

The net-meta analysis was used to compare the incidence of postoperative delirium among four sedatives: sevoflurane, propofol, dexmedetomidine, and midazolam. Interventions were ranked according to their surface under the cumulative ranking curve (SUCRA).

Results

A total of 41 RCT studies involving 6679 patients were analyzed. Dexmedetomidine can effectively reduce the incidence of postoperative delirium than propofol (OR 0.47 95% CI 0.25–0.90), midazolam (OR 0.42 95% CI 0.17-1.00), normal saline (OR 0.42 95% CI 0.33–0.54) and sevoflurane (OR 0.39 95% CI 0.18–0.82). The saline group showed a significantly lower incidence of bradycardia compared to the group receiving dexmedetomidine (OR 0.55 95% CI 0.37–0.80). In cardiac surgery, midazolam (OR 3.34 95%CI 2.04–5.48) and normal saline (OR 2.27 95%CI 1.17–4.39) had a higher rate of postoperative delirium than dexmedetomidine, while in non-cardiac surgery, normal saline (OR 1.98 95%CI 1.44–2.71) was more susceptible to postoperative delirium than dexmedetomidine.

Conclusion

Our analysis suggests that dexmedetomidine is an effective sedative in preventing postoperative delirium whether in cardiac surgery or non-cardiac surgery. The preventive effect of dexmedetomidine on postoperative delirium becomes more apparent with longer surgical and extubation times. However, it should be administered with caution as it was found to be associated with bradycardia.
A case report of youth-onset lipoprotein glomerulopathy with APOE Chicago mutation
Authors: Liu Yuhao , Cheng Yaqi , Wen Yubing , Li Chao , Chen Gang , Li Mingxi
Published: March 2024

Background

This article reports an extremely rare case of lipoprotein glomerulopathy (LPG) with apolipoprotein E gene (APOE) Chicago mutation in a young Chinese male. Only five cases or families with APOE Chicago mutations have been reported in the literature.

Case presentation

The young male patient is manifested with nephrotic syndrome, accompanied by hyperlipidemia with a preferable increase in triglycerides and elevated ApoE level. Renal biopsy of the patient showed highly dilated glomerular capillaries filled with vacuolar lipids, segmentally fused podocyte foot processes, vacuolar degeneration of renal tubular epithelial cells and absence of electron-dense material, which indicates the diagnosis of LPG. Whole-exome gene sequencing identified the heterozygous mutation of NM_000041.4:c.494G > C (p.Arg165Pro), which is in the exon 4 of the APOE gene and also known as APOE Chicago mutation, a rare mutation of LPG. Further family pedigree gene analysis clarified that the mutation was inherited from the patient’s mother, who does not have high ApoE levels or renal manifestations. This is also consistent with the incomplete penetrance of APOE gene mutations in LPG. Under lipid-lowering treatments, including a low-fat diet and fenofibrate, the patient’s urinary protein was partially controlled, and the albumin level was recovered.

Conclusion

Patients with nephrotic syndrome and elevated ApoE levels should be prompted into renal biopsy to avoid delay of appropriate treatment and unnecessary use of glucocorticoids. This case of LPG was diagnosed by renal biopsy and further verified with genetic sequencing. The timely diagnosis and treatment improved the patient’s symptoms. This case is one of only six reported LPG cases or families with APOE Chicago mutation in the world.
Peritoneal dialysis vs. hemodialysis among patients with end-stage renal disease in Iran: which is more cost-effective?
Authors: Yousefi Mahmood , Rezaei Satar , Hajebrahimi Sakineh , Falsafi Niloofar , Keshvari-Shad Fatemeh
Published: March 2024

Background

There is little economic evidence on different modalities among patients with end-stage renal disease (ESRD) in Iran. This study aimed to assess the cost-utility of peritoneal dialysis (PD) and hemodialysis (HD) among ESRD patients in Iran.

Methods

From the health system perspective and with a 10-year time horizon, we conducted a cost-utility analysis based on a Markov model to compare three strategies of PD and HD [the second scenario (30% PD, 70% HD), the third scenario (50% PD, 50% HD) and the fourth scenario (70% PD, 30% HD)] among ESRD patients with the current situation (PD, 3% vs. HD, 97%) as the basic scenario (the first scenario) in Iran. Cost data for PD, HD and kidney transplantation were extracted from the medical records of 720 patients in the Health Insurance Organization (HIO) database. The Iranian version of the EQ-5D-5 L questionnaire was filled out through direct interview with 518 patients with ESRD to obtain health utility values. Other variables such as transition probabilities and survival rates were extracted from the literature. To examine the uncertainty in all variables included in the study, a probabilistic sensitivity analysis (PSA) was performed. TreeAge Pro 2020 software was used for data analysis.

Findings

: Our analysis indicated that the average 10-year costs associated with the first scenario (S1), the second scenario (S2), the third scenario (S3) and the fourth scenario (S4) were 4750.5, 4846.8, 4918.2, and 4989.6 million Iranian Rial (IRR), respectively. The corresponding average quality-adjusted life years (QALYs) per patient were 2.68, 2.72, 2.75 and 2.78, respectively. The ICER for S2, S3 and S4 scenarios was estimated at 2268.2, 2266.7 and 2266.7 per a QALY gained, respectively. The analysis showed that at a willingness-to-pay (WTP) threshold of 3,000,000,000 IRR (2.5 times the GDP per capita), the fourth scenario had a 63% probability of being cost-effective compared to the other scenarios.

Conclusion

Our study demonstrated that the fourth scenario (70% PD vs. 30% HD) compared to the current situation (3% PD vs. 97% HD) among patients with ESKD is cost-effective at a threshold of 2.5 times the GDP per capita (US$4100 in 2022). Despite the high cost of PD, due to its greater effectiveness, it is recommended that policymakers pursue a strategy to increase the use of PD among ESRD patients.
The effect of polyethylene cover intervention on ocular surface disorder of intensive care unit patients: a systematic review and meta-analysis
Authors: Askaryzadeh Mahani Maryam , Nematollahi Monirosadat , Bahramnezhad Fatameh , Farokhzadian Jamileh
Published: March 2024

Background

Polyethylene covers have been proven to be effective in protecting the eyes in patients with decreased or disappeared blink reflexes, but their advantages compared to other conventional methods are still unclear. This systematic review and meta-analysis study aimed to elucidate the impact of polyethylene covers in the prevention of ocular surface disease (OSD) in patients admitted to the intensive care unit (ICU).

Methods

We searched the Scopus, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify randomized controlled trial studies. This study followed the PRISMA guidelines and used the Cochrane Collaboration tool to assess the risk of bias.

Results

The findings were expressed as risk ratio (RR) with 95% confidence intervals. The incidence of OSD in the polyethylene cover group was lower than that in the eye drops group (RR = 0.27; 95% CI (0.07, 1.09), P = 0.07) and adhesive tape group (RR = 0.11, 95%CI (0.04, 0.31), P < 0:0001) but the polyethylene cover group showed no significant difference compared to the eye gel group (RR = 0.79, 95%CI (0.18, 3.51), P = 0.76) and the eye ointment group (RR = 0.85; 95% CI (0.36, 1.99), P = 0.71).

Conclusion

This study showed that polyethylene covers, eye gels, and eye ointments had an equal effect on preventing OSD in ICU patients, and eye drops and adhesive tapes were relatively less effective. However, other intervention methods had not been compared due to the small number of articles. Hence, further studies should assess the available methods to choose the best practical method.
Development and validation of self-assessment instrument to measure the digital professionalism of healthcare professionals using social media
Authors: Imran Shazia , Yasmeen Rahila , Mansoor Memoona
Published: March 2024

Background

The use of social media across the globe has risen incrementally. During the COVID-19 pandemic, these sites undeniably provided new avenues for professional networking but also led to a surge in cases of online misconduct. Professionalism instruments and scales do not assess the digital attitude and behaviour of healthcare professionals (HCPs). The purpose of this study was to identify the domains and items of digital professionalism related to social media use and to validate a self-assessment instrument to assess the digital professionalism of HCPs using social media.

Methods

An instrument development multiphase mixed method study (exploratory sequential) was conducted in two phases: item development and qualitative content validation followed by validation of the instrument. Feedback was taken from 15 experts for qualitative content validation in phase 1. In phase 2, content validity was established through three rounds of modified Delphi. Validity evidence was collected for the content (content validity index), response process (cognitive interviews), internal structure (confirmatory factor analysis), and internal consistency (Cronbach’s alpha).

Results

The 48-item preliminary instrument was reduced to a 28-item instrument with eight domains: self-anonymity, privacy settings, maintenance of boundaries and confidentiality, conflict of interest, accountability, respect for colleagues, and ethics. The content validity index of the scale was 0.91. The reliability and construct validity of the instrument was established by responses from 500 healthcare professionals from multiple hospitals. Confirmatory factor analysis showed a model with a goodness-of-fit index of 0.86, root mean square error of approximation of 0.06, and observed normed χ2 of 2.7. The internal consistency through Cronbach's alpha α was 0.96.

Conclusion

The digital professionalism self-assessment instrument (DP-SAI) has an appropriate level of content and measures the construct reliably. It can be used by medical doctors, dental clinicians, nurses, physiotherapists, and clinical pharmacists to self-assess and reflect on their social media practices. This will help to address these issues to enhance the quality of online communication through various social media platforms.