bluuebunny/crossref_metadata_2025 huggingface dataset:
Adult neurogenesis and the microbiota-gut-brain axis in farm animals: underestimated and understudied parameters for improving welfare in livestock farming
Authors: Hillerer Katharina M. , Gimsa Ulrike
Published: November 2024

Welfare in commercial livestock farming is becoming increasingly important in current agriculture research. Unfortunately, there is a lack of understanding about the neuronal mechanisms that underlie well-being on an individual level. Neuroplasticity in the hippocampus, the subventricular zone (SVZ), the olfactory bulb (OB) and the hypothalamus may be essential regulatory components in the context of farm animal behaviour and welfare that may be altered by providing environmental enrichment (EE). The importance of pre-and probiotics as a form of EE and the microbiota-gut-brain axis (MGBA) has come under the spotlight in the last 20 years, particularly in the contexts of research into stress and of stress resilience. However, it could also be an important regulatory system for animal welfare in livestock farming. This review aims to present a brief overview of the effects of EE on physiology and behaviour in farm animals and briefly discusses literature on behavioural flexibility, as well as inter-individual stress-coping styles and their relationship to animal welfare. Most importantly, we will summarise the literature on different forms of neural plasticity in farm animals, focusing on neurogenesis in various relevant brain regions. Furthermore, we will provide a brief outlook connecting these forms of neuroplasticity, stress, EE, the MGBA and welfare measures in modern livestock farming, concentrating on pigs.
Effect of histone demethylase KDM5B on long-term cognitive impairment in neonatal rats induced by sevoflurane
Authors: Wang Yanhong , Chen Yun , Zhang Mengxiao , Yuan Chengdong , Zhang Yu , Liu Xingjian , Zhang Yi , Liang Xiaoli
Published: November 2024

Introduction

Whether repeated inhalation of sevoflurane during the neonatal period causes long-term learning and memory impairments in humans is unclear. Some recent investigations have indicated that general anesthesia drugs affect histone methylation modification and may further affect learning and memory ability. This study aimed to explore the role and mechanism of histone methylation in long-term cognitive dysfunction caused by repeated inhalation of sevoflurane during the neonatal period.

Methods

Neonatal SD rats were assigned into three groups. Sevoflurane group and sevoflurane +AS8351 group were exposed to 2% sevoflurane for 4 h on postnatal day 7 (P7), day 14 (P7) and day 21 (P21), and the control group was inhaled the air oxygen mixture at the same time. From postnatal day 22 to 36, rats in the +AS8351 group were treated with AS8351 while those in the Sevoflurane group and control group were treated with normal saline. Half of the rats were carried out Y-maze, Morris water maze (MWM), western blot and transmission electron microscope at P37, and the remaining rats were fed to P97 for the same experiment.

Results

Neonatal sevoflurane exposure affected histone demethylase expression in hippocampus, changed histone methylation levels, Down-regulated synapse-associated protein expression, impaired synaptic plasticity and long-term cognitive dysfunction and KDM5B inhibitors partially restored the negative reaction caused by sevoflurane exposure.

Discussion

In conclusion, KDM5B inhibitor can save the long-term learning and memory impairment caused by sevoflurane exposure in neonatal period by inhibiting KDM5B activity.
Effect of chewing hard material on boosting brain antioxidant levels and enhancing cognitive function
Authors: Kim Seungho , Kim Ji-Hye , Lee Hansol , Jang Sung Ho , Noeske Ralph , Choi Changho , Chang Yongmin , Choi Youn-Hee
Published: November 2024

Introduction

Chewing has been reported to enhance cognitive function through the increase in cerebral blood flow. However, the mechanisms linking cerebral blood flow increase to metabolic changes in the brain affecting cognition remain unclear. We hypothesized that glutathione (GSH) plays a pivotal role in these mechanisms. Therefore, this study aimed to investigate changes in brain GSH levels following chewing and their association with cognitive function in healthy young adults.

Methods

A total of 52 university students were recruited, and the Korean version of the Repeatable Battery for the Assessment of Neuropsychological Status was used for the neurocognitive evaluations. Brain GSH levels following chewing gum or wood blocks were measured using MEscher-GArwood Point RESolved Spectroscopy (MEGA-PRESS) sequence, and their relevance to neurocognitive evaluation results was investigated.

Results

Chewing significantly increased brain GSH concentration, particularly in the wood-chewing group compared to the gum-chewing group, as observed in the anterior cingulate cortex. Furthermore, the rise in GSH concentration in the wood-chewing group was positively correlated with memory function.

Conclusion

Chewing moderately hard material elevates brain antioxidant levels such as GSH, potentially influencing cognitive function.
Anesthesia management of CRS and HIPEC in advanced ovarian cancer with ultra-high intra-abdominal pressure: a case report
Authors: Chen Suli , Lin Yanjun , Gao Shuncai , Liu Shuo , Yang Zhanmin , Ma Ruiqing , Lu Liangyuan
Published: November 2024

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a leading treatment for advanced ovarian cancer, significantly improving overall survival and disease-free survival. This case involves a patient with peritoneal metastasis and ultra-high intra-abdominal pressure (36 mmHg). CRS + HIPEC induces extensive pathological and physiological changes affecting respiratory, circulatory, renal, coagulation, and metabolic systems. Effective perioperative anesthesia management, including the type and volume of fluids administered, is crucial for optimizing patient outcomes. The complexities of anesthesia management in such cases present significant challenges.
Identification of intraoperative hypoxemia and hypoproteinemia as prognostic indicators in anastomotic leakage post-radical gastrectomy: an 8-year multicenter study utilizing machine learning techniques
Authors: Liu Yuan , Zhao Songyun , Shang Xingchen , Shen Wei , Du Wenyi , Zhou Ning
Published: November 2024

Background

Complications and mortality rates following gastrectomy for gastric cancer have improved over recent years; however, complications such as anastomotic leakage (AL) continue to significantly impact both immediate and long-term prognoses. This study aimed to develop a machine learning model to identify preoperative and intraoperative high-risk factors and predict mortality in patients with AL after radical gastrectomy.

Methods

For this investigation, 906 patients diagnosed with gastric cancer were enrolled and evaluated, with a comprehensive set of 36 feature variables collected. We employed three distinct machine learning algorithms—extreme gradient boosting (XGBoost), random forest (RF), and k-nearest neighbor (KNN)—to develop our models. To ensure model robustness, we applied k-fold cross-validation for internal validation of the four models and subsequently validated them using independent datasets.

Results

In contrast to the other machine learning models employed in this study, the XGBoost algorithm exhibited superior predictive performance in identifying mortality risk factors for patients with AL across one, three, and five-year intervals. The analysis identified several common risk factors affecting mortality rates at these intervals, including advanced age, hypoproteinemia, a history of anemia and hypertension, prolonged operative time, increased intraoperative bleeding, low intraoperative percutaneous arterial oxygen saturation (SPO2) levels, T3 and T4 tumors, tumor lymph node invasion, and tumor peripheral nerve invasion (PNI).

Conclusion

Among the three machine learning models examined in this study, the XGBoost algorithm exhibited superior predictive capabilities concerning the prognosis of patients with AL following gastrectomy. Additionally, the use of machine learning models offers valuable assistance to clinicians in identifying crucial prognostic factors, thereby enhancing personalized patient monitoring and management.
The combined assessment of p16INK4a and Mib/Ki-67 in oral squamous cell carcinoma
Authors: Richter Maximilian , Doll Christian , Mrosk Friedrich , Hofmann Elena , Koerdt Steffen , Heiland Max , Neumann Konrad , Beck Marcus , Dommerich Steffen , Jöhrens Korinna , Raguse Jan-Dirk
Published: November 2024

Objective

Despite numerous studies addressing the impact of p16INK4a in oral squamous cell carcinoma (OSCC), consistent data regarding survival and tumor proliferation behavior are lacking. Although some authors investigate both p16INK4a and Mib/Ki-67 in their cohorts, direct correlations are consistently missing. The aim of this study was to investigate the combined influence of p16INK4a and Mib/Ki-67 status on prognosis in OSCC.

Materials and methods

Clinical data of all patients diagnosed with OSCC and treated curatively between 2005 and 2011 were collected retrospectively. Tissue microarrays of formalin-fixed paraffin-embedded specimens were stained for p16INK4a and Mib/Ki-67 using the CINtec Histology V-Kit or MIB-1 antibody and correlated with the clinical outcome.

Results

A total of 316 patients, with a mean age of 61.7 years were included. Tumor tissues that were tested p16INK4a positive with low Mib/Ki-67 expression demonstrated a remarkable 5-year survival rate of 83% with an improved RFS compared to all other subgroups (p=0.034; p=0.017; p=0.026) and an improved OS compared to those with high Mib/Ki-67 expression (p=0.026; p=0.020). Cox regression identified the combined p16INK4a and Mib/Ki-67 status as a risk factor on OS (HR 6.25; CI1.26-31.0; p=0.025) and RFS (HR 5.88; CI1.19-29.20; p=0.030).

Conclusion

These results underscore the importance of a combined assessment of p16INK4a and Mib/Ki-67 in evaluating the prognosis of OSCC, leading to the identification of distinct subgroups that may serve as risk factors for treatment stratification.
Non-oral pharmacological interventions in the management of herpes zoster-related pain: a review of current research
Authors: Wang Yaojun , Shen Yanxia , Guo Haixue , You Dongcai , Jia Shimin , Song Ge , You Xiaobing
Published: November 2024

Herpes zoster-associated pain is a difficult-to-treat pathologic pain that seriously affects patients' quality of life. In recent years, emerging therapeutic techniques such as autologous platelet-rich plasma, sympathetic nerve block and pulsed radiofrequency have been gradually applied in the field of pain with the advantages of less trauma, quicker recovery and significant efficacy. These therapeutic options have become a new hope for the treatment of herpes zoster-associated pain. This article reviews the studies on herpes zoster-associated pain in non-oral drug therapy, summarizes the efficacy, safety, and possible mechanisms, and provides a reference basis for clinical treatment.
Transforming a hospital's organizational culture to promote parent-child relationships and child development
Authors: Benjamin Mariel , Quinn Carrie , Pressman Aliza , Fattah Layla , Parlakian Rebecca , Galinsky Ellen , Hammond Blair
Published: November 2024

Introduction

Early caregiving interactions and experiences profoundly shape a child's brain development. The American Academy of Pediatrics (AAP) recently advocated for a public-health approach to promoting safe, stable, nurturing relationships that is “founded on universal primary preventions”, including consistent messaging on fostering family resilience, nurturing connections, and positive childhood experiences. Hospitals have unique access to families with children ages 0–5 and therefore play a key role in supporting these early experiences. This project sought to shift the organizational culture of maternity and pediatric units at a hospital towards promoting early relationships and child development through a physical messaging campaign paired with staff training. This study examined whether the messaging campaign and staff training shifted staff's self-reported knowledge, attitudes, and behavior.

Methods

Non-physician staff across six pediatric and maternity units in a large urban hospital participated in the intervention. Staff completed surveys before and after message installation and training.

Results

Analysis of 356 pre-intervention surveys and 320 post-intervention surveys showed significant changes in staff's knowledge, attitudes, and behaviors that promote early learning and parent-child relationships. Most staff also reported feeling more empowered in their work (88%) and that the hospital environment had become a friendlier place for parents and families (89%).

Discussion

A messaging and training intervention can create a culture whereby staff support early caregiving and child development in the hospital setting. Further research is needed to understand whether the intervention impacts caregivers and their children.
High NT pro-BNP levels in children with malignant disorder receiving intensive fluid treatment: a prospective comparative study
Authors: Pawlik Weronika , Strzemecka Joanna , Stachura Albert , Królak Aleksandra , Ociepa Tomasz
Published: November 2024

Hematologic malignancies are a well-known risk factor for cardiovascular disease development. Chemotherapeutic protocols commonly include intensive fluid therapy (IFT), which may negatively influence the cardiovascular system and predispose to arterial hypertension. This study aims to evaluate atrial natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hs-TnT), and changes in blood pressure in children with hematological malignancies undergoing intensive fluid therapy. This prospective cohort study comprised thirteen children. 24-h ambulatory blood pressure monitoring (ABPM) and concentrations of NT-proBNP and hs-TnT were performed on the first day of IFT and during follow-up. There were no statistically significant differences in 24-h, daytime, night-time systolic (SBP) and diastolic blood pressure (DBP), SBP and DBP dipping, and the number of non-dippers during intensive fluid therapy compared to the control points. The mean NT-proBNP concentration at 24 h was 321.27 ± 318.08 pg/mL and was significantly higher compared with baseline (79.13 ± 105.42 pg/mL) and follow-up (175.92 ± 241.48 pg/mL); p-values 0.005 and p = 0.006 respectively. Troponin T concentration at 24 h was not significantly different compared with baseline and follow-up. These results show no significant influence of intensive fluid therapy on blood pressure profile. In contrast, an increase in NT-proBNP values 24 h after the start of fluid therapy may reflect the impact of fluid overload on the cardiovascular system.
Case Report: Early-onset or recalcitrant cytopenias as presenting manifestations of activated PI3Kδ syndrome
Authors: Remiker Allison S. , Lopes Joao Pedro Matias , Jesudas Rohith , Superdock Alexandra , Park Nami , Pateva Irina
Published: November 2024

Background

Patients with recurrent, chronic, or refractory cytopenias represent a challenging subgroup that may harbor an underlying diagnosis, such as an inborn error of immunity (IEI). Patients with IEIs such as activated phosphoinositide 3-kinase delta syndrome (APDS), frequently have hematologic manifestations, but these are not often reported as presenting symptoms. As a result, IEIs may be overlooked in patients presenting with early and/or recalcitrant cytopenias. Here, we describe the diagnostic journey and management of three patients who presented to a pediatric hematologist/oncologist with early-onset or recalcitrant cytopenias and were ultimately diagnosed with APDS.

Case presentations

Patients presented with early-onset and/or refractory cytopenias, with two of the three developing multilineage cytopenias. Prior to an APDS diagnosis, two patients underwent a total of approximately 20 procedures, including biopsies, invasive endoscopies, and imaging, with one undergoing eight differential diagnoses that were ruled out through additional testing. Recalcitrant cytopenias, a history of infection, and a family history of lymphoproliferation, infection, or autoimmunity raised suspicion of an underlying IEI, leading to genetic testing. Genetic testing identified a pathogenic variant of PIK3CD in each patient, resulting in the diagnosis of APDS. Following these diagnoses, two patients underwent modifications in the management of care with the administration of intravenous immunoglobulin therapy (IVIG), the mTOR inhibitor sirolimus, or surgical procedures. These treatment modifications either improved or resolved the cytopenias. The third patient showed improvement in immune thrombocytopenia with IVIG 1 month prior to receiving a definitive diagnosis. Following diagnosis, follow-up genetic testing of family members led to the identification of additional cases of APDS.

Conclusions

These cases highlight the importance of early genetic evaluation in patients with early-onset or recalcitrant cytopenias and demonstrate the challenges of differential diagnosis. In addition, these cases demonstrate beneficial changes in management and outcomes that can follow a definitive diagnosis, including the identification of targeted treatment options. Collectively, this case series supports the notion that underlying IEIs should be considered in the workup of early-onset or recalcitrant cytopenias, particularly in patients who present with a combination of hematologic and immunologic manifestations that are refractory to treatment, manifest at an unusually young age, or can be tied to family history.
Successful tocilizumab treatment for rapidly progressive interstitial lung disease with anti-MDA5-positive juvenile dermatomyositis: a case report and literature review
Authors: Qiu Lingzhi , Shao Xiaoyan , Ma Le , Fan Zhidan , Yu Haiguo
Published: November 2024

Background

Currently, no established integrated treatment regimen exists for anti-melanoma differentiation-associated gene 5 (anti-MDA5)-positive juvenile dermatomyositis (JDM) complicated by rapidly progressive interstitial lung disease (RP-ILD). We present a case of refractory anti-MDA5-positive JDM with RP-ILD that was successfully treated using a combination of tocilizumab and plasma exchange, along with a review of the relevant literature.

Methods

A literature review was conducted to gain insights into the clinical features and treatment strategies for managing refractory anti-MDA5-positive JDM complicated by RP-ILD.

Results

We report a case of successful management of anti-MDA5-positive JDM complicated by RP-ILD using a combination of immunosuppressive agents, plasma exchange, and tocilizumab.

Conclusion

Tocilizumab may serve as an effective adjunctive treatment option for patients with refractory anti-MDA5-positive JDM complicated by RP-ILD who do not respond to conventional intensive immunosuppressive therapies.
Population pharmacokinetics and dose optimization of ceftazidime in critically ill children
Authors: Li Mengting , Gao Liuliu , Wang Zuo , Zeng Lingkong , Chen Chen , Wang Jun , Li Sichan , Liu Maochang , Wang Yang
Published: November 2024

Objective

The aim of this study was to develop a population pharmacokinetic model for ceftazidime in critically ill children in the pediatric intensive care unit (PICU) and optimize an appropriate dosing regimen for this population.

Methods

We performed a prospective pharmacokinetic study on critically ill children aged 0.03–15 years. A population pharmacokinetic model was developed using the NLME program. Statistical and graphical methods were used to assess the stability and predictive performance of the model. Monte Carlo simulations were conducted to determine the optimal ceftazidime dosing regimen to achieve 70% fT > minimum inhibitory concentration (MIC).

Results

This study included 88 critically ill children and 100 ceftazidime serum concentrations. The pharmacokinetic characteristics of ceftazidime were best described by a one-compartment linear elimination model. The weight and estimated glomerular filtration rate (eGFR) were determinant covariates for the clearance (CL) of ceftazidime. The recommended ceftazidime dosage regimens achieved a probability of target attainment (PTA) >90% for critically ill children at MIC values of 2, 4, and 8 mg/L. For bacterial infection at an MIC of 16 mg/L, it is difficult to achieve effective pharmacodynamic (PD) targets in vivo with the commonly used dose of ceftazidime.

Conclusion

The population pharmacokinetic model of ceftazidime was established in critically ill children. Based on this model, we recommend evidence-based, individualized dosing regimens for subgroups with different weights and renal functions. The current daily dosage for children adequately meets the treatment requirements for MICs of 2, 4, and 8 mg/L, while for bacterial infection at an MIC of 16 mg/L, an elevated dosage regimen may be required.

Clinical Trial Registration

https://www.medicalresearch.org.cn/login, Identifier MR-42-22-000220.
The reporting of disproportionality analysis in pharmacovigilance: spotlight on the READUS-PV guideline
Authors: Fusaroli Michele , Salvo Francesco , Khouri Charles , Raschi Emanuel
Published: November 2024

Disproportionality analyses are the most-commonly used study design used in the post-marketing phase to detect suspected adverse drug reactions in individual case safety reports. Recent years have witnessed an exponential increase in published articles on disproportionality analyses, thanks to publicly accessible databases. Unfortunately, this trend was accompanied by concerns on lack of transparency and misinterpretation of results, both generating unjustified alarm and diluting true signals into overwhelming noise. The READUS-PV guideline for reporting disproportionality analysis was developed to tackle this emerging issue. In this perspective article, we describe the rationale behind the development of the READUS-PV guideline, the first collaborative initiative to harmonize the reporting of disproportionality analyses. The adoption of the checklists will assist researchers, regulators, and reviewers in the reporting, assessment, and publication of disproportionality analyses. Acknowledging the challenges ahead of effective implementation, we advocate for a global endorsement by Pharmacology Journals. A wide dissemination of the READUS-PV guideline is crucial to foster transparency and reproducibility of pharmacovigilance research, supporting an effective exploitation of disproportionality analysis among other irreplaceable post-marketing research tools to ensure drug safety.
Empagliflozin improves pressure-overload-induced cardiac hypertrophy by inhibiting the canonical Wnt/β-catenin signaling pathway
Authors: Yuan Xun , Pan Li , Zhang Chi , Zhu Qiulian , Huang Zexin , Qin Yuan , Zhang Guiping , Feng Zhimei , Yang Caixian , Hou Ning
Published: November 2024

Background

Empagliflozin (EMPA) is an SGLT-2 inhibitor that can control hyperglycemia. Clinical trials have indicated its cardio-protective effects against cardiac remodeling in diabetes or non-diabetes patients. However, the underlying molecular mechanisms of EMPA’s cardio-protective effects remain elusive.

Methods

We evaluated whether the EMPA attenuated the pressure-overload-induced cardiac hypertrophy by inhibiting the Wnt/β-catenin pathway. Furthermore, the effects of the EMPA on a mouse model of transverse aortic constriction (TAC) induced cardiac hypertrophy was also evaluated. Mice were administrated with 0.5% CMC-Na as a vehicle or EMPA (10 mg/kg/day, daily, throughout the study) by intragastric gavage.

Results

The in vivo echocardiography and histologic morphological analyses revealed that EMPA attenuated TAC-induced cardiac hypertrophy. Moreover, it also ameliorated TAC-induced cardiac fibrosis and decreased the cell size of the cardiomyocytes in isolated adult cardiomyocytes. Molecular mechanism analysis revealed that the EMPA reduced the TAC-induced enhanced expression of the Wnt/β-catenin pathway in vivo. For in vitro assessments, isolated neonatal rat cardiomyocytes (NRCMs) were treated with Angiotensin II (AngII) and EMPA; the results showed that in the absence of EMPA, the expression of the Wnt/β-catenin pathway was enhanced. In the trans-genetic heterozygous β-catenin deletion mice, EMPA attenuated TAC-induced cardiac remodeling by reducing the Wnt/β-catenin pathway. In addition, molecular docking analysis indicated that EMPA interacts with FZD4 to inhibit the TAC and AngII induced Wnt/β-catenin pathway in cardiomyocytes.

Conclusion

Our study illustrated that EMPA might directly interact with FZD4 to inhibit the TAC and AngII-induced activation of the Wnt/β-catenin pathway to attenuate the adverse cardiac remodeling.
On the analytical soliton-like solutions to (2+1)-dimensional fractional asymmetric Nizhnik-Novikov-Veselov system arising in incompressible fluids
Authors: Yasmin Humaira , Alrowaily Albandari W. , Areshi Mounirah , Shah Rasool , El-Tantawy S. A.
Published: November 2024

Due to the numerous applications of the Nizhnik-Novikov-Veselov system (NNVS) in fluid mechanics, thus, the current investigation is focused on studying the fractional form of this model to reveal the ambiguity around many nonlinear phenomena that arise in different fluid medias. Accordingly, we aim to derive several families of symmetric solitons and traveling wave solutions to the (2 + 1)-dimensional fractional asymmetric NNVS (FANNVS), defined in conformable fractional derivatives’ sense. For this purpose, a groundbreaking analytical technique known as the modified extended direct algebraic method (mEDAM) is utilized to solve and analyze the FANNVS. According to this method, four cases with several families of soliton-like solutions are derived. Our research uncovers various soliton solutions, including solitary waves, periodic waves, shocks, dual shock waves (lump waves), and anti-shock waves. These solutions are graphically discussed to understand their dynamical proprieties against the fractional parameters. This broad range of soliton-like solutions supports the relevance of our findings and demonstrates the effectiveness of our methodology. These findings significantly advance the field by deepening our understanding of solitonic behavior in FANNVS and demonstrating the effectiveness of the medium approach in solving challenging nonlinear systems.
Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillation
Authors: Gigli Lorenzo , Preda Alberto , Coluzzi Davide , Sartore Marta , Vila Muhamed , Carbonaro Marco , Baroni Matteo , Varrenti Marisa , Vargiu Sara , Guarracini Fabrizio , Frontera Antonio , Pannone Luigi , Chierchia Gian Battista , De Asmundis Carlo , Mazzone Patrizio , Sassi Roberto
Published: November 2024

Background

Electrical remodeling has been linked to the progression and recurrence of atrial fibrillation (AF) after catheter ablation (CA). Substrate mapping based solely on a voltage amplitude electrogram (EGM) does not provide a comprehensive understanding of the left atrial (LA) disease. The aim of this study is to assess left atrial spatial entropy (LASE) from voltage maps routinely obtained during AF ablation to further characterize the LA substrate.

Materials and Methods

High-density electroanatomic maps (EAMs) of 27 patients with paroxysmal or persistent AF undergoing routine CA were prospectively collected. Computational post-processing was performed on the voltage maps. Using the Shannon entropy model, the probability distribution of the amplitude range values associated with each point of the map was used to measure LASE. Finally, correlations between LASE and clinical and electrophysiological characteristics of AF were explored.

Results

LASE differentiated between patients with paroxysmal and persistent AF (6.45 ± 0.41 vs. 5.87 ± 0.53; p = 0.028) and patients with normal and abnormal LA substrate (6.42 ± 0.42 vs. 5.87 ± 0.56; p = 0.043), independent of the basal rhythm during EM acquisition (6.33 ± 0.41 vs. 6.11 ± 0.63; p = 0.619). Accordance between LASE and EAMs was assessed by ROC analysis (AUC: 0.81; C.I.: 0.62–0.99; Youden index: 6.06; sensitivity: 80%; and specificity: 80%). Patients with the lowest LASE reported AF recurrence at the follow-up.

Conclusion

LASE may play a role in the further characterization of the LA substrate and the type of AF, independent of basal rhythm.
AppleLeafNet: a lightweight and efficient deep learning framework for diagnosing apple leaf diseases
Authors: Ali Muhammad Umair , Khalid Majdi , Farrash Majed , Lahza Hassan Fareed M. , Zafar Amad , Kim Seong-Han
Published: November 2024

Accurately identifying apple diseases is essential to control their spread and support the industry. Timely and precise detection is crucial for managing the spread of diseases, thereby improving the production and quality of apples. However, the development of algorithms for analyzing complex leaf images remains a significant challenge. Therefore, in this study, a lightweight deep learning model is designed from scratch to identify the apple leaf condition. The developed framework comprises two stages. First, the designed 37-layer model was employed to assess the condition of apple leaves (healthy or diseased). Second, transfer learning was used for further subclassification of the disease class (e.g., rust, complex, scab, and frogeye leaf spots). The trained lightweight model was reused because the model trained with correlated images facilitated transfer learning for further classification of the disease class. A dataset available online was used to validate the proposed two-stage framework, resulting in a classification rate of 98.25% for apple leaf condition identification and an accuracy of 98.60% for apple leaf disease diagnosis. Furthermore, the results confirm that the proposed model is lightweight and involves relatively fewer learnable parameters in comparison with other pre-trained deep learning models.
Validation of the Italian version of the Eating-Related Eco-Concern Questionnaire: insights into its relationship with orthorexia nervosa
Authors: Tecuta Lucia , Casu Giulia , Tomba Elena
Published: November 2024

Introduction

Urgent calls for research on the relationship between climate change concerns and eating disorder risk have been made. This study aimed to validate an Italian version of the Eating-Related Eco-Concern Questionnaire (EREC), a brief unidimensional measure of eating behaviors related to eco-concern.

Methods

Six hundred and sixty-three adults (85% females, mean age 37 ± 12 years) completed the EREC, Climate Change Worry Scale (CCWS), Eating Disorder Examination-Questionnaire (EDE-Q), Eating Habits Questionnaire for orthorexia nervosa symptoms (EHQ-21), and questions on dietary habits and motivations, and past experiences of extreme climate events.

Results

Confirmatory factor analysis results indicated that the original one-factor model showed acceptable fit to the data after including the error covariation between two pairs of items. Internal consistency was adequate, and EREC scores correlated positively and strongly with CCWS scores. Participants scored significantly lower in EREC than in CCWS, indicating greater climate-related concerns in general terms than relating specifically to eating. While EREC was unrelated to EDE-Q scores, weak-to-moderate correlations were observed with EHQ-21 subscale and total scores. Pro-environmental and/or ethical reasons for current diet and personal experience of extreme climate events were associated with significantly higher EREC scores.

Discussion

The Italian EREC appears to be a valid and reliable tool for the screening of eating-related concerns and behaviors related to climate change. Ecological concerns may represent a healthy adaptive response, but the EREC can serve as a valuable tool to identify individuals whose eating behaviors related to eco-concern might warrant further clinical attention due to potential risks of developing rigid or unhealthy patterns.
Affectivity as stance: multimodal stance-taking in audiovisual documentations of Polish and German parliamentary debates
Authors: Müller Cornelia , Karpiński Maciej , Kindler-Mathôt Clara , Klessa Katarzyna , Jarmołowicz-Nowikow Ewa , Junge Jana Katharina , Papadopoulou Katerina , Sawicka-Stępińska Brygida
Published: November 2024

This paper presents a media-aesthetic framework to study affectivity as a stance. This framework opens up a new perspective on multimodal affective stance-taking in the context of specific media ecologies. It exemplifies this new approach with case studies of the official audiovisual documentation of political debates in the German Bundestag and the Polish Sejm. This new approach addresses the intertwining of audiovisual multimodality with verbo-gestural expressivity (or the multimodality of speaking). Adopting a phenomenological position, we are interested in how the orchestration of the debates as audiovisual events moves the spectators. The concepts ‘Expressive Movement’ and ‘Dynamic Forms of Vitality’ serve as theoretical and methodological references to capture the affective dynamics of audiovisual debates and how these audiovisual images modulate the perceptions and experiences of the spectators. To illustrate and substantiate this approach for linguistic and media analyses of affective stance-taking, the paper outlines basic assumptions and methods. It offers two exemplary case studies from German and Polish parliamentary debates. It is concluded that bringing together media-aesthetic with linguistic analyses of multimodal communication and interaction provides not only a valid starting point for future research of multimodal stance-taking in different media ecologies but also allows researchers to address how and why spectators of audiovisual media performances are moved affectively.
The relationship between impostor phenomenon and career decision-making difficulties among nursing interns: the mediating role of psychological resilience
Authors: He Meina , Li Yao , Hu Hui , Yu Zuqiang , Cai Cong , Cheng Yao , Ma Lu , Liu Shanshan
Published: November 2024

Background

In the face of a global nursing shortage, nursing interns are crucial to sustaining the healthcare workforce. However, these interns encounter significant challenges in career decision-making, often exacerbated by the impostor phenomenon, which impedes their capacity to make informed choices. Despite its importance, little research has been reported on the specific conditions and contributing factors that affect nursing interns’ career decision-making processes.

Objective

To understand the current status of nursing interns’ impostor phenomenon, psychological resilience, and career decision-making difficulties, and to validate the mediating role of psychological resilience between impostor phenomenon and career decision-making difficulties using structural equation modeling.

Methods

Five hundred eighty-two nursing interns from four tertiary hospitals in Wuhan City, Hubei Province of China were selected by stratified random sampling. Data were collected with the Clance Impostor Phenomenon Scale, Career Decision-Making Difficulties Questionnaire, and the 10-item Connor–Davidson Resilience Scale through an online survey. Mediation effect tests were conducted using SPSS 26.0 and PROCESS software.

Results

(1) The score for career decision-making difficulties was 99.34 (SD = 21.78), the score for impostor phenomenon was 57.58 (SD = 12.13), and the score of psychological resilience was 32.11 (SD = 8.50); (2) Psychological resilience had a significant negative correlation with career decision-making difficulties (r = −0.724, p < 0.01), and impostor phenomenon had a significant negative correlation with psychological resilience (r = −0.608, p < 0.01), and had a significant positive correlation with career decision-making difficulties (r = 0.700, p < 0.01). Psychological resilience played a partial mediating role between impostor phenomenon and career decision-making difficulties (p < 0.01), with the mediating effect (Effect Value = 0.518, Bootstrap 95% CI: 0.430, 0.610) accounting for 41.27% of the total effect.

Conclusion

Career decision-making difficulties are common among nursing interns. Effective strategies should address the impostor phenomenon and promote psychological resilience to enhance self-awareness and create a supportive environment.
Risk factors for psychiatric disorders following traumatic brain injury: a multivariate logistic regression analysis
Authors: Liu Hanyu , Yi Tongjun
Published: November 2024

Objective

This study aimed to investigate the incidence and risk factors of psychiatric disorders following traumatic brain injury (TBI).

Methods

A total of 232 patients with closed TBI admitted to our hospital from January 2021 to January 2023 were included. Basic demographic data, injury circumstances, and psychiatric conditions during hospitalization were collected. Patients were followed up at 9 months post-injury, and based on clinical interviews, symptoms, and questionnaires, they were categorized into those with post-TBI psychiatric disorders and those without. The study aimed to explore the predictive factors for psychiatric disorders after TBI.

Results

Among the 232 patients, 104 developed psychiatric disorders by the end of the 9-month follow-up, resulting in an incidence rate of 44.83%. The employment rate was significantly lower in the psychiatric disorder group compared to the non-psychiatric disorder group. Additionally, the GCS scores upon admission were significantly higher in the psychiatric disorder group, along with a greater proportion of limb injuries, post-traumatic coma, intracranial hematomas, and frontal lobe injuries. The results of the multivariate logistic regression analysis indicated that unemployment (caused by poor recovery from TBI), lower GCS scores at admission, limb injuries, post-traumatic coma, frontal lobe injuries, and the presence of psychiatric symptoms during hospitalization were independent predictors of psychiatric disorders following TBI.

Conclusion

Unemployment, lower GCS score on admission, limb injury, post-traumatic coma, frontal lobe injury, onset of psychiatric symptoms during hospitalization was identified as independent predictors of post-traumatic psychiatric disorders. Routine mental health screenings for conditions such as depression and anxiety should be integrated into the care of TBI patients.
Associations of the Charlson comorbidity index with depression and mortality among the U.S. adults
Authors: Wang Ying-Zhao , Xue Chun , Ma Chao , Liu An-Bang
Published: November 2024

Background

Chronic comorbidities are often associated with higher risks of depression and mortality. This study aims to explore the relationships between the Charlson Comorbidity Index (CCI) and depression, and their combined effect on mortality.

Methods

This study made use of data gathered in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, including a collective of 23,927 adult participants. According to CCI score distribution, CCI was categorized into three groups (T1 with CCI = 0; T2 with CCI = 1; T3 with CCI ≥ 2). In the CCI ≥ 2 group, patients may have two or more chronic diseases. Multivariable logistic regression models were employed to explore the relationship between CCI and depression. The study utilized the Cox proportional hazards model to investigate the association between CCI, the combination of CCI and depression, and all-cause mortality.

Results

Our analysis revealed that after adjusting for potential confounders, a positive association was found between CCI and depression (OR = 1.25, 95% CI: 1.21, 1.29). Moreover, a greater CCI was found to be closely linked to higher mortality in individuals with depression (HR = 1.14, 95% CI 1.11, 1.18). Stratifying CCI into tertiles, higher tertiles of CCI (T2, T3 vs T1) also showed positive associations with depression and all-cause mortality. For patients with CCI ≥2 (T3) combined with depression, the risk of mortality was significantly elevated compared to those with CCI = 0 (T1) and non-depressed participants (HR = 2.01, 95% CI: 1.60, 2.52).

Conclusion

The study findings demonstrate a positive correlation between CCI and the risk of depression, along with an association with increased all-cause mortality among depression patients. Hence, it is important to prioritize the clinical care of patients with a high CCI (≥2) and depression in order to lower the chances of mortality.
Relationship between Geriatric Nutritional Risk Index with all-cause and CVD mortality in osteopenia and osteoporosis
Authors: Guo Tianting , Feng Haorong , Xiong Lijiao , Mo Jianwen , Zhang Xiaoan , Xie Junbin , Hu Hongkai
Published: November 2024

Purpose

This study investigated the relationship between Geriatric Nutritional Risk Index (GNRI), and all-cause, cardiovascular (CVD) mortality, in individuals with osteopenia and osteoporosis.

Methods

Using NHANES data from 2005 to 2019, 6,824 participants diagnosed with osteopenia and osteoporosis were analyzed. Participants were categorized based on GNRI tertiles, and statistical methods like the fitted curves, Kaplan-Meier curves, cox regression, and subgroup analyses were employed.

Results

Lower GNRI tertiles correlated with older age, male gender, and more comorbidities. Mortality rates differed significantly across GNRI tertiles over an average 7.9-year follow-up, with a notable inverse J-shaped association between GNRI and mortality. Adjusted HRs indicated a 1.6-2-fold increase in all-cause mortality for the lowest GNRI tertile, persisting across comprehensive adjustments. CVD mortality followed a similar trend.

Conclusions

This study illuminates a robust correlation between GNRI levels and mortality risks in osteopenia and osteoporosis. Its consistent dose-response relationship across all-cause, and CVD mortality underscores its pivotal role as a prognostic factor.
Combined empowerment, continuous appraisal, psychological and career counseling improve medical cadets' satisfaction and may potentially offset burnout during internship year. An 18-months successful experience in a tertiary medical center
Authors: Shoham Reut , Robinson Hanni , Yehiel Noy , Robinzon Vered , Nir Yael Frenkel , Segal Gad
Published: November 2024

Background

Following graduation, Israeli medical cadets complete a 12-months training period in hospitals, having profound influence on their future career. Burnout, sense of personal and professional uncertainty and disorientation are already notable in this group. The aim of the current study was to assess the potential impact of empowerment, psychological and career counseling on the level of satisfaction and burnout of medicine cadets during their internship year in a tertiary medical center.

Methods

In a tertiary hospital's education authority, we offer constructed, personalized psychological and counseling services with continuous process of appraisal. During an 18-month period we followed their monthly feedback relating to satisfaction, learning experience and level of socialization. The study was designed as comparative research assessing cadets' satisfaction before, and after intervention as a surrogate marker for their burnout.

Results

Comparison of measured parameters showed statistically significant improvement, with interns stationed in the surgical departments (n = 86) showing the highest degree of improvement: the extent of acquiring new knowledge and competencies (1 to 5 Likert) went from 2.2 ± 1.0 to 3.3 ± 1.42; p < 0.005; experience from the absorption process into the department (LQR from 2.6 ± 1.2 to 3.5 ± 1.56; p < 0.05), degree of motivation to recommend peers to apply for residency (LQR from 2.3 ± 1.0 to 3.1 ± 1.6; p = 0.05) and the experience of being accepted to the department by the staff nurses (LQR from 2.7 ± 1.3 to 3.5 ± 1.1; p < 0.05).

Conclusions

A combined, ongoing process of appraisal, empowerment, psychological and career counseling seems promising in the relenting effort to improve cadets' satisfaction and hopefully withhold the burnout process of young physicians.
Nomogram model for screening the risk of frailty in older adult atrial fibrillation patients: a cross-sectional study
Authors: Lin Hairong , Lin Mei , Xu Zhiying , Li Hong , Sun Dingce
Published: November 2024

Background

Frailty is common in atrial fibrillation (AF) patients, but the specific risk factors contributing to frailty need further investigation. There is an urgent need for a risk prediction model to identify individuals at high risk of frailty.

Aims and objectives

This cross-sectional study aims to explore the multiple risk factors of frailty in older adult patients with AF and then construct a nomogram model to predict frailty risk.

Methods

We recruited 337 hospitalized patients over the age of 60 (average age: 69, 53.1% male) with AF between November 2021 and August 2022. Data collected included patient demographics, disease characteristics, sleep patterns, mental health status, and frailty measures. We used LASSO and ordinal regression to identify independent risk factors. These factors were then incorporated into a nomogram model to predict frailty risk. The model’s performance was assessed using the concordance index (C-index) and calibration curves.

Results

Among the AF patients, 23.1% were classified as frail and 52.2% as pre-frail. Six risk factors were identified: age, gender, history of coronary heart disease, number of chronic conditions, sleep disruption, and mental health status. The internal validation C-index was 0.821 (95% CI: 0.778–0.864; bias-corrected C-index: 0.795), and the external validation C-index was 0.819 (95% CI: 0.762–0.876; bias-corrected C-index: 0.819), demonstrating strong discriminative ability. Calibration charts for both internal and external validations closely matched the ideal curve, indicating robust predictive performance.

Conclusion

The nomogram developed in this study is a promising and practical tool for assessing frailty risk in AF patients, aiding clinicians in identifying those at high risk.

Relevance to clinical practice

This study demonstrates the utility of a comprehensive predictive model based on frailty risk factors in AF patients, offering clinicians a practical tool for personalized risk assessment and management strategies.
Socioeconomic and ethnic inequalities increase the risk of type 2 diabetes: an analysis of NHS health check attendees in Birmingham
Authors: Au-Yeung Chung Him , Ellis David , Dallaway Alexander , Riley Jenny , Varney Justin , Howell-Jones Rebecca
Published: November 2024

Introduction

Birmingham has a significantly higher type-II diabetes prevalence than the national average. This study aimed to investigate the association of socioeconomic deprivation and ethnicity on the risk of diabetes in Birmingham.

Methods

Data were included from 108,514 NHS Health Checks conducted in Birmingham between 2018 and 2023. Attributable fraction and multinomial logistic regression were used to estimate the number of events avoidable and the prevalence odds ratios (POR) of determinants respectively.

Results

Attributable fraction analysis estimated that 64% of diabetes and 44% of pre-diabetes cases could be attributed to socioeconomic deprivation. Specifically, if Asian attendees in the least deprived areas had the same risk as White individuals in the least deprived areas, there would have been 1,056 fewer cases of diabetes and 2,226 fewer cases of pre-diabetes. Diabetes was significantly associated with Asian ethnicity (POR = 5.43, p < 0.001), Black ethnicity (POR = 3.15, p < 0.001) and Mixed ethnicity (POR = 2.79, p < 0.001). Pre-diabetes was also significantly associated with Asian ethnicity (POR = 3.06, p < 0.001), Black ethnicity (POR = 2.70, p < 0.001) and Mixed ethnicity (POR = 2.21, p < 0.001). The interaction effects between ethnicity and deprivation posed a greater risk of diabetes, especially for Asian attendees in the first (POR = 9.34, p < 0.001) and second (POR = 6.24, p < 0.001) most deprived quintiles.

Discussion

The present findings demonstrate the association of ethnicity and socioeconomic deprivation on the risk of diabetes and pre-diabetes. It underscores the necessity for targeted interventions and policies to address these inequalities.