bluuebunny/crossref_metadata_2025 huggingface dataset:
Fitting Gaussian mixture models on incomplete data
Authors: McCaw Zachary R. , Aschard Hugues , Julienne Hanna
Published: June 2022

Background

Bioinformatics investigators often gain insights by combining information across multiple and disparate data sets. Merging data from multiple sources frequently results in data sets that are incomplete or contain missing values. Although missing data are ubiquitous, existing implementations of Gaussian mixture models (GMMs) either cannot accommodate missing data, or do so by imposing simplifying assumptions that limit the applicability of the model. In the presence of missing data, a standardad hocpractice is to perform complete case analysis or imputation prior to model fitting. Both approaches have serious drawbacks, potentially resulting in biased and unstable parameter estimates.

Results

Here we present missingness-aware Gaussian mixture models (), an package for fitting GMMs in the presence of missing data. Unlike existing GMM implementations that can accommodate missing data, places no restrictions on the form of the covariance matrix. Using three case studies on real and simulated’omicsdata sets, we demonstrate that, when the underlying data distribution is near-to a GMM, is more effective at recovering the true cluster assignments than either the existing GMM implementations that accommodate missing data, or fitting a standard GMM after state of the art imputation. Moreover, provides an accurate assessment of cluster assignment uncertainty, even when the generative distribution is not a GMM.

Conclusion

Compared to state-of-the-art competitors, demonstrates a better ability to recover the true cluster assignments for a wide variety of data sets and a large range of missingness rates. provides the bioinformatics community with a powerful, easy-to-use, and statistically sound tool for performing clustering and density estimation in the presence of missing data. is publicly available as an package on CRAN:https://CRAN.R-project.org/package=MGMM.
Genome-wide analyses reveal a strong association between LEPR gene variants and body fat reserves in ewes
Authors: Macé Tiphaine , González-García Eliel , Foulquié Didier , Carrière Fabien , Pradel Julien , Durand Christian , Douls Sebastien , Allain Charlotte , Parisot Sara , Hazard Dominique
Published: June 2022

Background

Among the adaptive capacities of animals, the management of energetic body reserves (BR) through the BR mobilization and accretion processes (BR dynamics, BRD) has become an increasingly valuable attribute for livestock sustainability, allowing animals to cope with more variable environments. BRD has previously been reported to be heritable in ruminants. In the present work, we conducted genome-wide studies (GWAS) in sheep to determine genetic variants associated with BRD. BR (i.e. levels) and BRD (i.e. changes over time) were obtained through body condition score measurements at eight physiological stages throughout each productive cycle in Romane ewes (n = 1034) and were used as phenotypes for GWAS. After quality controls and imputation, 48,593 single nucleotide polymorphisms (SNP) were included in the GWAS.

Results

Among the 23 QTL regions identified, a major QTL associated with BR during pregnancy and lactation was identified on chromosome 1. In this region, several significant SNPs mapped to the leptin receptor gene (LEPR), among which one SNP mapped to the coding sequence. The point mutation induces the p.P1019S substitution in the cytoplasmic domain, close to tyrosine phosphorylation sites. The frequency of the SNP associated with increased BR levels was 32%, and the LEPR genotype explained up to 5% of the variance of the trait. Higher fatness levels in ewes carrying the LEPR p.P1019S mutation were observed all along the productive cycle.

Conclusions

These results provide strong evidences for involvement of LEPR in the regulation of BR in sheep and highlight it as a major candidate gene for improving adaptive capacities by genetic selection.
Degradome sequencing reveals an integrative miRNA-mediated gene interaction network regulating rice seed vigor
Authors: Zhou Shiqi , Huang Kerui , Zhou Yan , Hu Yingqian , Xiao Yuchao , Chen Ting , Yin Mengqi , Liu Yan , Xu Mengliang , Jiang Xiaocheng
Published: June 2022

Background

It is well known that seed vigor is essential for agricultural production and rice (Oryza sativa L.) is one of the most important crops in the world. Though we previously reported that miR164c regulates rice seed vigor, but whether and how other miRNAs cooperate with miR164c to regulate seed vigor is still unknown.

Results

Based on degradome data of six RNA samples isolated from seeds of the wild-type (WT) indica rice cultivar ‘Kasalath’ as well as two modified lines in ‘Kasalath’ background (miR164c-silenced line [MIM164c] and miR164c overexpression line [OE164c]), which were subjected to either no aging treatment or an 8-day artificial aging treatment, 1247 different target transcripts potentially cleaved by 421 miRNAs were identified. The miRNA target genes were functionally annotated via GO and KEGG enrichment analyses. By STRING database assay, a miRNA-mediated gene interaction network regulating seed vigor in rice was revealed, which comprised at least four interconnected pathways: the miR5075-mediated oxidoreductase related pathway, the plant hormone related pathway, the miR164e related pathway, and the previously reported RPS27AA related pathway. Knockout and overexpression of the target gene Os02g0817500 of miR5075 decreased and enhanced seed vigor, respectively. By Y2H assay, the proteins encoded by five seed vigor-related genes, Os08g0295100, Os07g0633100, REFA1, OsPER1 and OsGAPC3, were identified to interact with Os02g0817500.

Conclusions

miRNAs cooperate to regulate seed vigor in rice via an integrative gene interaction network comprising miRNA target genes and other functional genes. The result provided a basis for fully understanding the molecular mechanisms of seed vigor regulation.
Association between fluid intake and extubation failure in intensive care unit patients with negative fluid balance: a retrospective observational study
Authors: Li Tong , Zhou Dawei , Zhao Dong , Lin Qing , Wang Dija , Wang Chao
Published: June 2022

Background

Negative fluid balance (NFB) is associated with reduced extubation failure. However, whether achieving more NFB can further improve extubation outcome has not been investigated. This study aimed to investigate whether more NFB and restricted fluid intake were associated with extubation success.

Methods

We performed a retrospective study of adult patients with mechanical ventilation (MV) admitted to Medical Information Mart for Intensive Care (MIMIC-III) from 2001 to 2012. Patients with duration of MV over 24 hours and NFB within 24 hours before extubation were included for analysis. The primary outcome was extubation failure, defined as reintubation within 72 hours after extubation. Association between fluid balance or fluid intake and extubation outcome were investigated with multivariable logistic models.

Results

A total of 3433 extubation events were recorded. 1803 with NFB were included for the final analysis, of which 201(11.1%) were extubation failure. Compared with slight NFB (− 20 to 0 ml/kg), more NFB were not associated improved extubation outcome. Compared with moderate fluid intake (30 to 60 ml/kg), lower (< 30 ml/kg, OR 0.75, 95% CI [0.54, 1.05], p = 0.088) or higher (> 60 ml/kg, OR 1.63, 95% CI [0.73, 3.35], p = 0.206) fluid intake was not associated with extubation outcome. Duration of MV, chronic obstructive pulmonary disease (COPD), hypercapnia, use of diuretics, and SAPSIIscore were associated with extubation failure.

Conclusions

More NFB or restricted fluid intake were not associated with reduced extubation failure in patients with NFB. However, for COPD patients, restricted fluid intake was associated with extubation success.
A framework to model global, regional, and national estimates of intimate partner violence
Authors: Maheu-Giroux Mathieu , Sardinha Lynnmarie , Stöckl Heidi , Meyer Sarah R. , Godin Arnaud , Alexander Monica , García-Moreno Claudia
Published: June 2022

Background

Accurate and reliable estimates of violence against women form the backbone of global and regional monitoring efforts to eliminate this human right violation and public health problem. Estimating the prevalence of intimate partner violence (IPV) is challenging due to variations in case definition and recall period, surveyed populations, partner definition, level of age disaggregation, and survey representativeness, among others. In this paper, we aim to develop a sound and flexible statistical modeling framework for global, regional, and national IPV statistics.

Methods

We modeled IPV within a Bayesian multilevel modeling framework, accounting for heterogeneity of age groups using age-standardization, and age patterns and time trends using splines functions. Survey comparability is achieved using adjustment factors which are estimated using exact matching and their uncertainty accounted for. Both in-sample and out-of-sample comparisons are used for model validation, including posterior predictive checks. Post-processing of models’ outputs is performed to aggregate estimates at different geographic levels and age groups.

Results

A total of 307 unique studies conducted between 2000–2018, from 154 countries/areas, and totaling nearly 1.8 million unique women responses informed lifetime IPV. Past year IPV had a similar number of studies (n = 332), countries/areas represented (n = 159), and individual responses (n = 1.8 million). Roughly half of IPV observations required some adjustments. Posterior predictive checks suggest good model fit to data and out-of-sample comparisons provided reassuring results with small median prediction errors and appropriate coverage of predictions’ intervals.

Conclusions

The proposed modeling framework can pool both national and sub-national surveys, account for heterogeneous age groups and age trends, accommodate different surveyed populations, adjust for differences in survey instruments, and efficiently propagate uncertainty to model outputs. Describing this model to reproducible levels of detail enables the accurate interpretation and responsible use of estimates to inform effective violence against women prevention policy and programs, and global monitoring of elimination efforts as part of the Sustainable Development Goals.
Health knowledge and self-efficacy to make health behaviour changes: a survey of older adults living in Ontario social housing
Authors: Dzerounian Jasmine , Pirrie Melissa , AlShenaiber Leena , Angeles Ricardo , Marzanek Francine , Agarwal Gina
Published: June 2022

Background

Older adults living in social housing are a vulnerable population facing unique challenges with health literacy and chronic disease self-management. We investigated this population’s knowledge of cardiovascular disease and diabetes mellitus, and self-efficacy to make health behaviour changes (for example, physical activity). This study characterized the relationship between knowledge of health risk factors and self-efficacy to improve health behaviours, in order to determine the potential for future interventions to improve these traits.

Methods

A cross-sectional study (health behaviour survey) with adults ages 55+ (n = 599) from 16 social housing buildings across five Ontario communities. Descriptive analyses conducted for demographics, cardiovascular disease and diabetes knowledge, and self-efficacy. Subgroup analyses for high-risk groups were performed. Multivariate logistic regressions models were used to evaluate associations of self-efficacy outcomes with multiple factors.

Results

Majority were female (75.6%), white (89.4%), and completed high school or less (68.7%). Some chronic disease subgroups had higher knowledge for those conditions. Significant (p < 0.05) associations were observed between self-efficacy to increase physical activity and knowledge, intent to change, and being currently active; self-efficacy to increase fruit/vegetable intake and younger age, knowledge, and intent to change; self-efficacy to reduce alcohol and older age; self-efficacy to reduce smoking and intent to change, ability to handle crises, lower average number of cigarettes smoked daily, and less frequent problems with usual activities; self-efficacy to reduce stress and ability to handle crises.

Conclusions

Those with chronic diseases had greater knowledge about chronic disease. Those with greater ability to handle personal crises and intention to make change had greater self-efficacy to change health behaviours. Development of stress management skills may improve self-efficacy, and proactive health education may foster knowledge before chronic disease develops.
The joint effects of physical activity and air pollution on type 2 diabetes in older adults
Authors: Ao Linjun , Zhou Junmin , Han Mingming , Li Hong , Li Yajie , Pan Yongyue , Chen Jiayi , Xie Xiaofen , Jiang Ye , Wei Jing , Chen Gongbo , Li Shanshan , Guo Yuming , Hong Feng , Li Zhifeng , Xiao Xiong , Zhao Xing
Published: June 2022

Background

Older adults with type 2 diabetes are at higher risk of developing common geriatric syndromes and have a lower quality of life. To prevent type 2 diabetes in older adults, it’s unclear whether the health benefits of physical activity (PA) will be influenced by the harms caused by increased exposure to air pollution during PA, especially in developing countries with severe air pollution problem. We aimed to investigate the joint effects of PA and long-term exposure to air pollution on the type 2 diabetes in older adults from China.

Methods

This cross-sectional study was based on the China Multi-Ethnic cohort (CMEC) study. The metabolic equivalent of PA was calculated according to the PA scale during the CMEC baseline survey. High resolution air pollution datasets (PM10, PM2.5and PM1) were collected from open products. The joint effects were assessed by the marginal structural mean model with generalized propensity score.

Results

A total of 36,562 participants aged 50 to 79 years were included in the study. The prevalence of type 2 diabetes was 10.88%. The mean (SD) level of PA was 24.93 (18.60) MET-h/d, and the mean (SD) level of PM10, PM2.5, and PM1were 70.00 (23.32) µg/m3, 40.45 (15.66) µg/m3and 27.62 (6.51) µg/m3, respectively. With PM10 < 92 µg/m3, PM2.5 < 61 µg/m3, and PM1 < 36 µg/m3, the benefit effects of PA on type 2 diabetes was significantly greater than the harms due to PMs when PA levels were roughly below 80 MET-h/d. With PM10 ≥ 92 µg/m3, PM2.5 ≥ 61 µg/m3, and PM1 ≥ 36 µg/m3, the odds ratio (OR) first decreased and then rose rapidly with confidence intervals progressively greater than 1 and break-even points close to or even below 40 MET-h/d.

Conclusions

Our findings implied that for the prevention of type 2 diabetes in older adults, the PA health benefits outweighed the harms of air pollution except in extreme air pollution situations, and suggested that when the air quality of residence is severe, the PA levels should ideally not exceed 40 MET-h/d.
Multimorbidity patterns and associated factors in older Chinese: results from the China health and retirement longitudinal study
Authors: Zhang Quan , Han Xiao , Zhao Xinyi , Wang Yue
Published: June 2022

Background

This study aimed to investigate multimorbidity patterns and their associated factors among elderly population in China.

Methods

A total of 10,479 participants aged at least 60 years were drawn from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). Latent class analysis (LCA) was performed to identify distinct multimorbidity classes based on 14 self-reported chronic conditions. The multinomial logit model was used to analyze the associated factors of multimorbidity patterns, focusing on individuals' demographic characteristics, socioeconomic status (SES), and health behaviors.

Results

Among the 10,479 participants (mean age [SD]: 69.1 [7.1]), 65.6% were identified with multimorbidity. Five multimorbidity clusters were identified by LCA: relatively healthy class (49.8%), vascular class (24.7%), respiratory class (5.6%), stomach-arthritis class (14.5%), and multisystem morbidity class (5.4%). Multinomial logit analysis with the relatively healthy class as the reference showed that participants of older age and female sex were more likely to be in the vascular class and multisystem morbidity class. The probability of being in the vascular class was significantly higher for those with high SES. Ever smoking was associated with a higher probability of being in the respiratory class and multisystem morbidity class. Physical activity was associated with lower odds of being assigned to the vascular class, respiratory class, and multisystem class.

Conclusion

The distinct multimorbidity patterns imply that the prevention and care strategy should target a group of diseases instead of a single condition. Prevention interventions should be paid attention to for individuals with risk factors.
Prevalence of and factors associated with herpes zoster in England: a cross-sectional analysis of the Health Survey for England
Authors: Cadogan Sharon L. , Mindell Jennifer S. , Breuer Judith , Hayward Andrew , Warren-Gash Charlotte
Published: June 2022

Background

Herpes zoster (commonly called shingles) is caused by the reactivation of varicella zoster virus, and results in substantial morbidity. While the risk of zoster increases significantly with age and immunosuppression, relatively little is known about other risk factors for zoster. Moreover, much evidence to date stems from electronic healthcare or administrative data. Hence, the aim of this study was to explore potential risk factors for herpes zoster using survey data from a nationally-representative sample of the general community-dwelling population in England.

Methods

Data were extracted from the 2015 Health Survey for England, an annual cross-sectional representative survey of households in England. The lifetime prevalence of self-reported herpes zoster was described by age, gender and other socio-demographic factors, health behaviours (physical activity levels, body mass index, smoking status and alcohol consumption) and clinical conditions, including; diabetes, respiratory, digestive and genito-urinary system and mental health disorders. Logistic regression models were then used to identify possible factors associated with shingles, and results were presented as odds ratios with 95% confidence intervals.

Results

The lifetime prevalence of shingles among the sample was 11.5% (12.6% among women, 10.3% among men), which increased with age. After adjusting for a range of covariates, increased age, female gender (odds ratio: 1.21; 95%CI: 1.03, 1.43), White ethnic backgrounds (odds ratio: 2.00; 95%CI: 1.40, 2.88), moderate physical activity 7 days per week (odds ratio: 1.29; 95%CI: 1.01, 1.66) and digestive disorders (odds ratio: 1.51; 95%CI: 1.13, 1.51) were each associated with increased odds of having had herpes zoster.

Conclusions

Age, gender, ethnicity and digestive disorders may be risk factors for herpes zoster among a nationally representative sample of adults in England. These potential risk factors and possible mechanisms should be further explored using longitudinal studies.
Understanding the patient experience of chronic kidney disease stages 2–3b: a qualitative interview study with Kidney Disease Quality of Life (KDQOL-36) debrief
Authors: Rydén Anna , Nolan Stephen , Maher Joshua , Meyers Oren , Kündig Anna , Bjursell Magnus
Published: June 2022

Background

Qualitative patient interviews and patient-reported outcome instruments are important tools to understand the patient experience of disease. The aim of this study was to use patient interviews to identify concepts relevant and important to patients living with chronic kidney disease (CKD) stages 2–3b, develop a comprehensive conceptual model of the patient experience and debrief the Kidney Disease Quality of Life 36-item instrument (KDQOL-36) for patients with CKD stages 2–3b.

Methods

Concept elicitation interviews were conducted with patients with CKD stages 2–3b to identify signs/symptoms and impacts most relevant and important to patients (i.e., ‘salient’ concepts) and develop a conceptual model for the disease. Based on the salient concepts identified in the interviews, new items were proposed to supplement the KDQOL-36. Cognitive debriefing was performed to evaluate the KDQOL-36 and the additional items.

Results

A total of 31 patients were interviewed in this study (22 for concept elicitation and 15 for cognitive debriefing). The interviews identified 56 concepts (33 signs/symptoms and 23 impacts), 17 of which had not been identified in a previous literature review. Four signs/symptoms (‘fatigue/lack of energy/tiredness’, ‘sleep problems’, ‘increased urination [including nocturia]’ and ‘swelling in legs/ankles/feet’) and two impacts (‘anxiety/worry’ and ‘general negative emotional/mental impact’) were identified as salient. Of the salient signs/symptoms, three were not covered by the KDQOL-36 (sleep problems, increased urination and swelling in legs/ankles/feet) and were represented during cognitive debriefing interviews through four additional items (trouble falling asleep, trouble staying asleep, increased urination [including nocturia] and swelling in legs/ankles/feet) generated in the style of the KDQOL-36. All patients found the KDQOL-36 plus the four additional items relevant, and the majority found them clear.

Conclusions

By identifying previously unknown concepts and augmenting the understanding of which are most important to patients, a comprehensive conceptual model was developed for patients who have CKD stages 2–3b. This study also demonstrates the suitability of the KDQOL-36 for patients who have CKD stages 2–3b and provides suggestions for how the instrument could be further developed to more comprehensively capture patient experience.
A combined behavioural economics- and simulation-based medical education to promote effectiveness among medical residents in coping with workplace violence in Northern China: a quasi-experimental study
Authors: Liu Chao , Liu Weijing , Jiao Mingli , Li Ye , Zhang Gangyu , Wei Lifeng , Zhou Shuang , Li Yuanheng , Sha Zhuowa , Hao Yanhua , Wu Qunhong
Published: June 2022

Background

Workplace violence is internationally recognised as a major concern for the workforce, which entails serious consequences, and research shows that medical residents are more likely than other doctors to experience violence in the workplace. This study first examines the effectiveness of simulation-based medical education, and then simulation-based medical education combined with behavioural economics as interventions in medical residents' perception of, attitude toward, and self-efficacy in coping with violence in the workplace.

Methods

A quasi-experimental design was used, 190 participants were randomised into three study groups to respectively test the effect of simulation-based medical education only and simulation-based medical education plus behavioural economics interventions, compared with a control group. Data were obtained from structured questionnaires, including (1) a perception of aggression scale, a management of aggression and violence attitude scale, a general self-efficacy scale, and (2) socio-demographic characteristics.

Results

The results show that the scores attained by simulation-based medical education (SBME) and simulation-based medical education combined with behavioural economics (SBME + BE) interventions for perception, attitude, and self-efficacy were significantly higher than those in the control group (p < .01). The SBME + BE group recorded a greater improvement in perception, which could be ascribed to the behavioural economics effect. Furthermore, the higher perception of workplace violence is correlated with single residents and those with more work experience, prior experiences of violence in the workplace, and training related to workplace violence. A higher positive correlation of workplace violence was recorded by female and widowed residents,and a higher level of self-efficacy related to violence in the workplace correlated with male, widowed,and senior (third-year) residents.

Conclusions

This study contributes important evidence regarding changes in the perception, attitude, and self-efficacy of subjects following both the SBME + BE and SBME interventions among medical residents in coping with workplace violence, the biggest perception change having been recorded after the SBME + BE intervention, which can be explained by the inclusion of behavioural economics.
Plasma fibrinogen: a sensitive biomarker for the screening of periprosthetic joint infection in patients undergoing re-revision arthroplasty
Authors: Xu Hong , Liu Li , Xie Jinwei , Huang Qiang , Lai Yahao , Zhou Zongke
Published: June 2022

Background

Although serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), plasma fibrinogen and neutrophil–lymphocyte ratio (NLR) are promising biomarkers for screening PJI in patients undergoing revision arthroplasty, their efficacy with respect to re-revision arthroplasty remains unclear.

Methods

We included patients who underwent re-revision arthroplasty at our hospital during 2008–2020, and stratified them into two groups whether they had been diagnosed with PJI (infected) or aseptic failure (non-infected) according to the 2013 International Consensus Meeting criteria. We evaluated the diagnostic performance of CRP, ESR, fibrinogen and NLR, both individually and in combinations, based on sensitivity, specificity, and area under the receiver operating characteristic curve.

Results

Of the 63 included patients, 32 were diagnosed with PJI. The area under the ROC curve was 0.821 for CRP, 0.794 for ESR, 0.885 for fibrinogen and 0.702 for NLR. CRP gave a sensitivity of 87.5% and specificity of 74.2% with an optimal predictive cut-off of 8.50 mg/mL. ESR gave a sensitivity of 81.3% and specificity of 71.0% with an optimal predictive cut-off of 33 mm/h. Plasma fibrinogen gave a comparatively higher sensitivity of 93.8% and specificity of 77.4% with an optimal predictive cut-off of 3.55 g/L, while NLR gave a moderate sensitivity of 84.4% but low specificity of 54.8% with an optimal predictive cut-off of 2.30. The combination of fibrinogen and CRP gave a high AUC of 0.897, an acceptable sensitivity of 75% and a high specificity 93.5%.

Conclusions

Plasma fibrinogen is a cost-effective, convenient biomarker that can be used to rule out PJI in patients scheduled for re-revision arthroplasty. In combination with CRP, it may be effective in diagnosing PJI in such patients.
Effective methods to enhance medical students’ cardioversion and transcutaneous cardiac pacing skills retention - a prospective controlled study
Authors: Kowalski Christian , Boulesteix Anne-Laure , Harendza Sigrid
Published: June 2022

Background

Guideline-based therapy of cardiac arrhythmias is important for many physicians from the beginning of their training. Practical training of the required skills to treat cardiac arrhythmias is useful for acquiring these skills but does not seem sufficient for skill retention. The aim of this study was to compare different retention methods for skills required to treat cardiac arrhythmias with respect to the performance of these skills in an assessment.

Methods

Seventy-one final-year medical students participated in a newly designed workshop to train synchronized cardioversion (SC) and transcutaneous cardiac pacing (TCP) skills in 2020. All participants completed an objective structured clinical examination (OSCE 1) one week after the training. Afterwards, the participants were stratified and randomized into three groups. Nine weeks later, one group received a standard operating procedure (SOP) for the skills, one group participated in a second workshop (SW), and one group received no further intervention (control). Ten weeks after the first training, all groups participated in OSCE 2.

Results

The average score of all students in OSCE 1 was 15.6 ± 0.8 points with no significant differences between the three groups. Students in the control group reached a significantly (p < 0.001) lower score in OSCE 2 (-2.0 points, CI: [-2.9;-1.1]) than in OSCE 1. Students in the SOP-group achieved on average the same result in OSCE 2 as in OSCE 1 (0 points, CI: [-0.63;+0.63]). Students who completed a second skills training (SW-group) scored not significantly higher in OSCE 2 compared to OSCE 1 (+0.4 points, CI: [-0.29;+1.12]). The OSCE 2 scores in groups SOP and SW were neither significantly different nor statistically equivalent.

Conclusions

Partial loss of SC and TCP skills acquired in a workshop can be prevented after 10 weeks by reading an SOP as well as by a second workshop one week before the second assessment. Refreshing practical skills with an SOP could provide an effective and inexpensive method for skills retention compared to repeating a training. Further studies need to show whether this effect also exists for other skills and how frequently an SOP should be re-read for appropriate long-term retention of complex skills.
Exploring the relationship between co-worker and supervisor support, self- confidence, coping skills and burnout in residential aged care staff
Authors: Low Yin Siu , Bhar Sunil , Chen Won Sun
Published: June 2022

Background

Staff working in residential aged care facilities face unique challenges and stressors in their workplaces which increase their risk for occupational burnout. Burnout in this workforce results in low job satisfaction, increased levels of absenteeism and poor retention rates. Given Australia’s ageing population and the demand for residential aged care staff, it is imperative to explore predictors of burnout in this cohort in order to help staff prevent and manage burnout.

Methods

This study examined the extent to which co-worker and supervisor support, self-confidence and adaptive coping skills predicted burnout among residential aged care staff, after controlling for staff demographics, organisational climate and work patterns. One hundred and thirty three residential aged care staff across Australia were surveyed using online questionnaires measuring levels of co-worker and supervisor support, self- confidence, adaptive coping skills and burnout.

Results

Regression analyses indicated that, overall, co-worker and supervisor support, self-confidence, and adaptive coping predicted each dimension of burnout (emotional exhaustion, depersonalization and personal accomplishment). After controlling for covariates and other predictors: confidence significantly predicted all three dimensions; support significantly predicted emotional exhaustion and depersonalization, and adaptive coping significantly predicted emotional exhaustion.

Conclusion

These findings suggest that co-worker and supervisor support, self- confidence and adaptive coping skills need to be addressed to prevent and manage occupational burnout for residential aged care staff in Australia.
Experiences of Norwegian child and school health nurses with the “Starting Right™” child health assessment innovation: a qualitative interview study
Authors: Robstad Nastasja , Westergren Thomas , Mølland Eirin , Abildsnes Eirik , Haraldstad Kristin , Stamnes Köpp Unni Mette , Håland Åshild Tellefsen , Fegran Liv
Published: June 2022

Background

Although child health services are well established in Norway, the use of information technology for the systematic collection of evidence-based child- and proxy-reported health measures may be beneficial in the early identification of child development problems. The Norwegian “Starting Right™” health service innovation consists of parent- and child-reported online structured health assessments tools, including practical routines for child and school health assessments. The aim of this study was to explore the experiences of child and school health nurses with the Starting Right innovation.

Methods

We used a qualitative design and conducted three focus group interviews with 18 child and school health nurses from three child health centres one year after the implementation of the innovation.

Results

The experiences of professionals with the Starting Right innovation were captured by three themes: (1) the digital innovation could be used to obtain a good overview of a child’s health and development; (2) interpreting the questionnaires was a challenge; and (3) implementing the new digital innovation was time-consuming.

Conclusions

Overall, the child and school health nurses experienced that the Starting Right innovation was useful for providing a comprehensive overview of child development and health. The challenges related to interpreting the parents’ scores and follow-up of children, as well as providing the questionnaires in relevant foreign languages, should be addressed to allow all children and families to be reached.
Post-translational modifications on the retinoblastoma protein
Authors: Zhou Linbin , Ng Danny Siu-Chun , Yam Jason C. , Chen Li Jia , Tham Clement C. , Pang Chi Pui , Chu Wai Kit
Published: June 2022

The retinoblastoma protein (pRb) functions as a cell cycle regulator controlling G1 to S phase transition and plays critical roles in tumour suppression. It is frequently inactivated in various tumours. The functions of pRb are tightly regulated, where post-translational modifications (PTMs) play crucial roles, including phosphorylation, ubiquitination, SUMOylation, acetylation and methylation. Most PTMs on pRb are reversible and can be detected in non-cancerous cells, playing an important role in cell cycle regulation, cell survival and differentiation. Conversely, altered PTMs on pRb can give rise to anomalies in cell proliferation and tumourigenesis. In this review, we first summarize recent findings pertinent to how individual PTMs impinge on pRb functions. As many of these PTMs on pRb were published as individual articles, we also provide insights on the coordination, either collaborations and/or competitions, of the same or different types of PTMs on pRb. Having a better understanding of how pRb is post-translationally modulated should pave the way for developing novel and specific therapeutic strategies to treat various human diseases.
Patients phenotypes and cardiovascular risk in type 2 diabetes: the Jackson Heart Study
Authors: Echouffo-Tcheugui Justin B. , Musani Solomon K. , Bertoni Alain G. , Correa Adolfo , Fox Ervin R. , Mentz Robert J.
Published: June 2022

Background

Cardiovascular prognosis related to type 2 diabetes may not be adequately captured by information on comorbid conditions such as obesity and hypertension. To inform the cardiovascular prognosis among diabetic individuals, we conducted phenotyping using a clustering approach based on clinical data, echocardiographic indices and biomarkers.

Methods

We performed a cluster analysis on clinical, biochemical and echocardiographic variables from 529 Blacks with diabetes in the Jackson Heart Study. An association between identified clusters and major adverse cardiovascular events (MACE- composite of coronary heart disease, stroke, heart failure and atrial fibrillation) was assessed using Cox proportional hazards modeling.

Results

Cluster analysis separated individuals with diabetes (68% women, mean age 60 ± 10 years) into three distinct clusters (Clusters 1,2 &3 - with Cluster 3 being a hypertrophic cluster characterized by highest LV mass, levels of brain natriuretic peptide [BNP] and high-sensitivity cardiac troponin-I [hs-cTnI]). After a median 12.1 years, there were 141 cardiovascular events. Compared to Cluster1, Clusters 3 had an increased risk of cardiovascular disease (hazard ratio [HR] 1.60; 95% confidence interval [CI] 1.08, 2.37), while Cluster 2 had a similar risk of outcome (HR 1.11; 95% CI 0.73, 168).

Conclusions

Among Blacks with diabetes, cluster analysis identified three distinct echocardiographic and biomarkers phenotypes, with cluster 3 (high LV mass, high cardiac biomarkers) associated with worse outcomes, thus highlighting the prognostic value of subclinical myocardial dysfunction.
Intestinal metastasis from choriocarcinoma: a case series and literature review
Authors: Wang Yuting , Wang Zhe , Zhu Xiaoxu , Wan Qihong , Han Peilin , Ying Jun , Qian Jianhua
Published: June 2022

Background

Gestational choriocarcinoma is a rare trophoblastic tumor that spreads mainly to the lung, liver, and central nervous system. Fewer than 5% of patients present with metastasis to the gastrointestinal system and have a poor prognosis

Case presentation

We describe four cases of patients with intestinal metastasis from choriocarcinoma who visited the First Affiliated Hospital of Zhejiang University School of Medicine and the First People’s Hospital of Hangzhou between April 2012 and October 2019. Four patients presented with gastrointestinal symptoms or developed gastrointestinal symptoms during treatment for choriocarcinoma. Three patients had these intestinal lesions surgically removed, and the postoperative pathology results suggested choriocarcinoma. All patients received multiple chemotherapy regimens during treatment for suboptimal human chorionic gonadotropin (hCG) levels; one patient died 22 months after a definitive diagnosis was made, and the other three patients are still undergoing regular follow-up.

Conclusion

Given the low incidence of intestinal metastases from choriocarcinoma, the metastatic route of intestinal metastases from choriocarcinoma remains to be elucidated, and diagnosis mainly depends on pathology findings. An effective treatment has not been determined, and surgical excision with chemotherapy is generally accepted.
Extracellular vesicle PD-L1 dynamics predict durable response to immune-checkpoint inhibitors and survival in patients with non-small cell lung cancer
Authors: de Miguel-Perez Diego , Russo Alessandro , Arrieta Oscar , Ak Murat , Barron Feliciano , Gunasekaran Muthukumar , Mamindla Priyadarshini , Lara-Mejia Luis , Peterson Christine B. , Er Mehmet E. , Peddagangireddy Vishal , Buemi Francesco , Cooper Brandon , Manca Paolo , Lapidus Rena G. , Hsia Ru-Ching , Cardona Andres F. , Naing Aung , Kaushal Sunjay , Hirsch Fred R. , Mack Philip C. , Serrano Maria Jose , Adamo Vincenzo , Colen Rivka R. , Rolfo Christian
Published: June 2022

Background

Immune-checkpoint inhibitors (ICIs) changed the therapeutic landscape of patients with lung cancer. However, only a subset of them derived clinical benefit and evidenced the need to identify reliable predictive biomarkers. Liquid biopsy is the non-invasive and repeatable analysis of biological material in body fluids and a promising tool for cancer biomarkers discovery. In particular, there is growing evidence that extracellular vesicles (EVs) play an important role in tumor progression and in tumor-immune interactions. Thus, we evaluated whether extracellular vesicle PD-L1 expression could be used as a biomarker for prediction of durable treatment response and survival in patients with non-small cell lung cancer (NSCLC) undergoing treatment with ICIs.

Methods

Dynamic changes in EV PD-L1 were analyzed in plasma samples collected before and at 9 ± 1 weeks during treatment in a retrospective and a prospective independent cohorts of 33 and 39 patients, respectively.

Results

As a result, an increase in EV PD-L1 was observed in non-responders in comparison to responders and was an independent biomarker for shorter progression-free survival and overall survival. To the contrary, tissue PD-L1 expression, the commonly used biomarker, was not predictive neither for durable response nor survival.

Conclusion

These findings indicate that EV PD-L1 dynamics could be used to stratify patients with advanced NSCLC who would experience durable benefit from ICIs.
Depleting receptor tyrosine kinases EGFR and HER2 overcomes resistance to EGFR inhibitors in colorectal cancer
Authors: Yang Lu , Bhattacharya Arup , Li Yun , Sexton Sandra , Ling Xiang , Li Fengzhi , Zhang Yuesheng
Published: June 2022

Background

Epidermal growth factor receptor (EGFR) inhibitors, including cetuximab and panitumumab, are valuable therapeutics for colorectal cancer (CRC), but resistance to these inhibitors is common. The reason for such resistance is not well understood, which hampers development of better therapeutic strategies. Although activating mutations in KRAS, BRAF and PIK3CA are considered major drivers of CRC resistance to EGFR inhibitors, therapeutic targeting of these drug resistance drivers has not produced substantial clinical benefit.

Methods

We exploited cell lines and mouse tumor models (cell line xenografts and patient derived xenografts) for experiments of genetic and pharmacologic depletion of EGFR and/or its family member HER2, including EGFR mutants, inhibition of EGFR ligand shedding, and biochemical analysis of signaling proteins, to delineate the mechanism of CRC resistance to EGFR inhibitors and to assess the therapeutic activity of PEPDG278D, which is a recombinant human protein that induces the degradation of both EGFR and HER2.

Results

The sensitivity of CRC cells to cetuximab and panitumumab correlates with the ability of these drugs to induce EGFR downregulation. PEPDG278D strongly inhibits oncogenic signaling and growth of CRC cells by causing profound depletion of EGFR and HER2, regardless of activating mutations of KRAS, BRAF and PIK3CA. siRNA knockdown of EGFR or HER2 also inhibits CRC cells resistant to EGFR inhibitors. Tumors harboring mutated KRAS, BRAF and/or PIK3CA also overexpress EGFR ligands, further suggesting that EGFR signaling remains important to the tumors. While excessive tumor-generated high-affinity EGFR ligands block target engagement by PEPDG278D, aderbasib, an inhibitor of ADAM10 and ADAM17, enables PEPDG278D to exert strong antitumor activity by inhibiting ligand shedding. Moreover, adding fluorouracil, which is commonly used in CRC treatment, to the combination of PEPDG278D and aderbasib further enhances tumor inhibition.

Conclusions

Our study shows that CRC resistance to EGFR inhibitors results primarily from the inability of the inhibitors to downregulate their target and that a PEPDG278D-based combination treatment overcomes the resistance.
Retraction Note: Increased Aβ42-α7-like nicotinic acetylcholine receptor complex level in lymphocytes is associated with apolipoprotein E4-driven Alzheimer’s disease pathogenesis
Authors: Wang Hoau-Yan , Trocmé-Thibierge Caryn , Stucky Andres , Shah Sanket M. , Kvasic Jessica , Khan Amber , Morain Philippe , Guignot Isabelle , Bouguen Eva , Deschet Karine , Pueyo Maria , Mocaer Elisabeth , Ousset Pierre-Jean , Vellas Bruno , Kiyasova Vera
Published: June 2022

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13195-017-0280-8.
Pastoral livelihood pathways transitions in northern Kenya: The process and impact of drought
Authors: Kirui Leonard K. , Jensen Nathaniel D. , Obare Gideon A. , Kariuki Isaac M. , Chelanga Philemon K. , Ikegami Munenobu
Published: June 2022

Recurrent droughts and long-term changes to climate, social structures, and the economy in the world’s arid and semi-arid lands have impacted pastoralists’ livelihood activities over time, resulting in different livelihood pathways. Some pastoralists continue to follow more traditional strategies of herd accumulation, while others frequently engage in livestock markets and value addition activities, and others still are dropping out of pastoralism. Using data collected over 6 years from 924 households in northern Kenya and applying a generalized structural dynamic multinomial logit model, this study quantitatively determined the dynamic transitions between livelihood categories conditional on drought incidences. From the results, there were considerable and frequent transitions between livelihood pathways within the panel period (2009–2015). Notably, many households that started in the low-cash income, larger herd size category denoted as hanging in, were transitioning to lower cash income with small herds (dropping out). At the same time, there was a great deal of back and forth between the category with low-cash income and small herd size (dropping out) and the category with higher cash income and small herd size (moving out), indicating that moving out was the only way out of poverty. Also, an increase in vegetation index from a drought season where the index was at a 10% level to a good season where the level was 90% decreased the likelihood of households dropping out from a predicted probability of 37.9 to 28.7% and increased the likelihood of moving up and moving out from 22.2 to 25.0% and 22.6 to 34.3%, respectively, unconditionally. The study findings imply that any livelihood interventions aimed at reducing the impact of drought and alleviating poverty among pastoral households should support the transition to market-oriented, relatively successful pathways and also protect households from falling back into the ranks of poverty by dropping out.
Online sex-seeking among Chinese heterosexual men who seek care in sexually transmitted infections clinics: a cross-sectional study
Authors: Li Changchang , Tang Weiming , Ho Hung Chak , Zhao Peizhen , Chen Lei , Wang Yajie , Xiong Mingzhou , Yang Bin , Zheng Heping , Wang Cheng
Published: June 2022

Background

The Internet has become an important virtual venue for men who have sex with men to seek sexual partners, with a high potential threat to spread sexually transmitted infections (STIs). However, the online sex-seeking use and its risk causing STIs spread remain unclear among heterosexual men. We conducted a cross-sectional study to investigate the use of online sex-seeking venues and the related risky sex activities (e.g. condomless sex, quick sex) in STIs clinics in Guangdong, China.

Methods

These STIs clinics were involved in the Guangdong governmental sentinel network and we recruited heterosexual men (age >  = 18) between March and August 2018. Multivariable logistic regression models were used to identify the factors associated with online sex-seeking use and risky sex activities with online sex partners.

Results

191 of 2,154 participants (8.9%) ever sought sex online. Among users,16.8% met their partners in-person within 24 h, 31.4% engaged in condomless sex with their last online partner. Online sex-seeking was positively associated with a) Ever been diagnosed with STIs (aOR = 3.0, 95%CI:2.0–4.6), and b) Had casual sex in the last three months (aOR = 3.3, 95%CI 2.4–4.6). Condomless sex with the last online partner was negatively associated with the correct answer of “Having only one partner can reduce the risk to infect HIV” (aOR = 0.3, 95%CI:0.1–0.8).

Conclusion

In China, online sex-seeking and its related risky sexual activities are not rare among heterosexual men. Future prevention strategies to reduce STIs incidence should especially target heterosexual men engaging in online sex-seeking.