bluuebunny/crossref_metadata_2025 huggingface dataset:
Entrepreneurship Education at the Dawn of Generative Artificial Intelligence
Authors: Winkler Christoph , Hammoda Basel , Noyes Erik , Van Gelderen Marco
Published: August 2023

The rapid evolution, application and ubiquity of generative artificial intelligence (AI) tools seems to be indicative that our world has entered a paradigm shift that mirrors the beginning of a new era not seen since the dawn of the internet. As entrepreneurship educators, we are pushed to the frontline of this development, mandated to embrace this transformative innovation to not only educate our students but also use its potential to reshape our classrooms. To help better understand this paradigm shift, this editorial invites the larger entrepreneurship education community to innovate, experiment, and learn in order to advance our theoretical and practical understanding of generative AI’s present and future impact on our field. Furthermore, it presents a series of inquiry questions to help guide our community to advance our field through rigorous research and impactful learning innovations.
Pattern of Post COVID Fatigue in Elderly Patients
Authors: Gaber Tarek A
Published: August 2023

The incidence of Long COVID (LC) increases with age but then drops sharply in over 70-year-olds. The prevailing explanation is that different biases in data collection such as reluctance to report symptoms or attributing them to comorbidities may explain this pattern in this age group. Our local data suggested a similar pattern confirming the rarity of LC symptoms especially fatigue in the over 70s. Our data have also showed a different phenotype of post COVID fatigue which is not commonly associated with post exertional symptoms bringing into question the suggestion that bias in collecting data is the main cause. We explore several immunological, metabolic and epigenetic factors associated with aging that may explain such phenomenon.
Dissecting the role of SWI/SNF component ARID1B in steady-state hematopoiesis
Authors: Madan Vikas , Shyamsunder Pavithra , Dakle Pushkar , Woon Teoh Weoi , Han Lin , Cao Zeya , Nordin Hazimah Binte Mohd , Jizhong Shi , Shuizhou Yu , Hossain Md Zakir , Koeffler H. Phillip
Published: August 2023

The adenosine triphosphate (ATP)–dependent chromatin remodeling complex, SWItch/Sucrose Non-Fermentable (SWI/SNF), has been implicated in normal hematopoiesis. The AT-rich interaction domain 1B (ARID1B) and its paralog, ARID1A, are mutually exclusive, DNA-interacting subunits of the BRG1/BRM-associated factor (BAF) subclass of SWI/SNF complex. Although the role of several SWI/SNF components in hematopoietic differentiation and stem cell maintenance has been reported, the function of ARID1B in hematopoietic development has not been defined. To this end, we generated a mouse model of Arid1b deficiency specifically in the hematopoietic compartment. Unlike the extensive phenotype observed in mice deficient in its paralog, ARID1A, Arid1b knockout (KO) mice exhibited a modest effect on steady-state hematopoiesis. Nonetheless, transplantation experiments showed that the reconstitution of myeloid cells in irradiated recipient mice was dependent on ARID1B. Furthermore, to assess the effect of the complete loss of ARID1 proteins in the BAF complex, we generated mice lacking both ARID1A and ARID1B in the hematopoietic compartment. The double-KO mice succumbed to acute bone marrow failure resulting from complete loss of BAF–mediated chromatin remodeling activity. Our Assay for transposase-accessible chromatin with high-throughput sequencing (ATAC-seq) analyses revealed that >80% of loci regulated by ARID1B were distinct from those regulated by ARID1A; and ARID1B controlled expression of genes crucial in myelopoiesis. Overall, loss of ARID1B affected chromatin dynamics in murine hematopoietic stem and progenitor cells, albeit to a lesser extent than cells lacking ARID1A.
Enhancing structural plasticity of PC12 neurons during differentiation and neurite regeneration with a catalytically inactive mutant version of the zRICH protein
Authors: Bandla Ashoka C. , Sheth Aditya S. , Zarate Sara M. , Uskamalla Suraj , Hager Elizabeth C. , Villarreal Victor A. , González-García Maribel , Ballestero Rafael P.
Published: August 2023

Background

Studies of the molecular mechanisms of nerve regeneration have led to the discovery of several proteins that are induced during successful nerve regeneration. RICH proteins were identified as proteins induced during the regeneration of the optic nerve of teleost fish. These proteins are 2’,3’-cyclic nucleotide, 3’-phosphodiesterases that can bind to cellular membranes through a carboxy-terminal membrane localization domain. They interact with the tubulin cytoskeleton and are able to enhance neuronal structural plasticity by promoting the formation of neurite branches.

Results

PC12 stable transfectant cells expressing a fusion protein combining a red fluorescent protein with a catalytically inactive mutant version of zebrafish RICH protein were generated. These cells were used as a model to analyze effects of the protein on neuritogenesis. Differentiation experiments showed a 2.9 fold increase in formation of secondary neurites and a 2.4 fold increase in branching points. A 2.2 fold increase in formation of secondary neurites was observed in neurite regeneration assays.

Conclusions

The use of a fluorescent fusion protein facilitated detection of expression levels. Two computer-assisted morphometric analysis methods indicated that the catalytically inactive RICH protein induced the formation of branching points and secondary neurites both during differentiation and neurite regeneration. A procedure based on analysis of random field images provided comparable results to classic neurite tracing methods.

Graphical Abstract
Identification and interest of molecular markers to monitor plant Pi status
Authors: Cuyas Laura , David Pascale , de Craieye Damien , Ng Sophia , Arkoun Mustapha , Plassard Claude , Faharidine Mohamadi , Hourcade Delphine , Degan Francesca , Pluchon Sylvain , Nussaume Laurent
Published: August 2023

Background

Inorganic phosphate (Pi) is the sole source of phosphorus for plants. It is a limiting factor for plant yield in most soils worldwide. Due to economic and environmental constraints, the use of Pi fertilizer is and will be more and more limited. Unfortunately, evaluation of Pi bioavailability or Pi starvation traits remains a tedious task, which often does not inform us about the real Pi plant status.

Results

Here, we identified by transcriptomic studies carried out in the plant model Arabidopsis thaliana, early roots- or leaves-conserved molecular markers for Pi starvation, exhibiting fast response to modifications of phosphate nutritional status. We identified their homologues in three crops (wheat, rapeseed, and maize) and demonstrated that they offer a reliable opportunity to monitor the actual plant internal Pi status. They turn out to be very sensitive in the concentration range of 0-50 µM which is the most common case in the vast majority of soils and situations where Pi hardly accumulates in plants. Besides in vitro conditions, they could also be validated for plants growing in the greenhouse or in open field conditions.

Conclusion

These markers provide valuable physiological tools for plant physiologists and breeders to assess phosphate bio-availability impact on plant growth in their studies. This also offers the opportunity to cope with the rising economical (shortage) and societal problems (pollution) resulting from the management of this critical natural resource.
Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study
Authors: Jonker Deborah , Melly Brigitte , Brink Lucy T. , Odendaal Hein J. , Stein Dan J. , Donald Kirsten A.
Published: August 2023

Background

The negative impact of prenatal alcohol and tobacco exposure (PAE and PTE) on fetal development and birth outcomes are well described, yet pathophysiologic mechanisms are less clear. Our aim was to investigate (1) the associations between quantity, frequency and timing (QFT) of PAE and PTE with blood flow velocities in arteries of the fetal-placental-maternal circulation and (2) the extent to which combined effect of QFT of PAE and/or PTE and Doppler flow velocity waveforms (FWV) predict infant birth weight.

Methods

The Safe Passage Study is a cohort based in urban Cape Town, South Africa. Recruitment occurred between 2007 and 2015. Information on QFT of PAE and PTE was collected prospectively at up to 4 occasions during pregnancy using a modified Timeline Follow-Back approach. Ultrasound examinations consisted of Doppler flow velocity waveforms of the uterine, umbilical (UA) and fetal middle cerebral arteries for the pulsatility index (PI) at 20–24 and 34–38 weeks. Exclusion criteria included: twin pregnancies, stillbirths, participants exposed to other drugs. The sample was divided into three groups (controls, PAE and PTE) and included 1396 maternal-fetal-dyads assessed during the second trimester; 1398 assessed during the third trimester.

Results

PTE was associated with higher UA PI values in second and third trimesters (p < 0.001), compared to the PAE and control group. The total amount of cigarettes smoked during pregnancy was positively correlated with UA PI values (r = 0.087, p < 0.001). There was a positive correlation between cigarettes smoked per day in trimester one (r = 0.091, p < 0.01), and trimester two (r = 0.075, p < 0.01) and UA PI (in trimester two), as well as cigarettes smoked per day in trimester two (r = 0.058, p < 0.05) and trimester three (r = 0.069, p < 0.05) and the UA PI in trimester three. Generalized additive models indicated that PAE in trimester two, PTE in trimester one and Doppler FWV in trimester three were significant predictors of birth weight in this sample.

Conclusion

In our study, PTE in trimesters two and three resulted in increased vascular resistance of the placenta. These findings highlight nuance in associations between PAE, PTE and blood flow velocities in arteries of the fetal-placental-maternal circulation and birth weight, suggesting that quantity and timing are important factors in these relationships.
Exosomal ACADM sensitizes gemcitabine-resistance through modulating fatty acid metabolism and ferroptosis in pancreatic cancer
Authors: Yang Yuhan , Gu Haitao , Zhang Kundong , Guo Zengya , Wang Xiaofeng , Wei Qingyun , Weng Ling , Han Xuan , Lv Yan , Cao Meng , Cao Peng , Huang Chen , Qiu Zhengjun
Published: August 2023

This study aimed to evaluate the potential of exosomes from cancer cells to predict chemoresistance in pancreatic cancer (PC) and explore the molecular mechanisms through RNA-sequencing and mass spectrometry. We sought to understand the connection between the exosomal Medium-chain acyl-CoA dehydrogenase (ACADM) level and the reaction to gemcitabine in vivo and in patients with PC. We employed loss-of-function, gain-of-function, metabolome mass spectrometry, and xenograft models to investigate the effect of exosomal ACADM in chemoresistance in PC. Our results showed that the molecules involved in lipid metabolism in exosomes vary between PC cells with different gemcitabine sensitivity. Exosomal ACADM (Exo-ACADM) was strongly correlated with gemcitabine sensitivity in vivo, which can be used as a predictor for postoperative gemcitabine chemosensitivity in pancreatic patients. Moreover, ACADM was found to regulate the gemcitabine response by affecting ferroptosis through Glutathione peroxidase 4 (GPX4) and mevalonate pathways. It was also observed that ACADM increased the consumption of unsaturated fatty acids and decreased intracellular lipid peroxides and reactive oxygen species (ROS) levels. In conclusion, this research suggests that Exo-ACADM may be a viable biomarker for predicting the responsiveness of patients to chemotherapy.
Identifying depression in the United States veterans using deep learning algorithms, NHANES 2005–2018
Authors: Qu Zihan , Wang Yashan , Guo Dingjie , He Guangliang , Sui Chuanying , Duan Yuqing , Zhang Xin , Lan Linwei , Meng Hengyu , Wang Yajing , Liu Xin
Published: August 2023

Background

Depression is a common mental health problem among veterans, with high mortality. Despite the numerous conducted investigations, the prediction and identification of risk factors for depression are still severely limited. This study used a deep learning algorithm to identify depression in veterans and its factors associated with clinical manifestations.

Methods

Our data originated from the National Health and Nutrition Examination Survey (2005–2018). A dataset of 2,546 veterans was identified using deep learning and five traditional machine learning algorithms with 10-fold cross-validation. Model performance was assessed by examining the area under the subject operating characteristic curve (AUC), accuracy, recall, specificity, precision, and F1 score.

Results

Deep learning had the highest AUC (0.891, 95%CI 0.869–0.914) and specificity (0.906) in identifying depression in veterans. Further study on depression among veterans of different ages showed that the AUC values for deep learning were 0.929 (95%CI 0.904–0.955) in the middle-aged group and 0.924(95%CI 0.900-0.948) in the older age group. In addition to general health conditions, sleep difficulties, memory impairment, work incapacity, income, BMI, and chronic diseases, factors such as vitamins E and C, and palmitic acid were also identified as important influencing factors.

Conclusions

Compared with traditional machine learning methods, deep learning algorithms achieved optimal performance, making it conducive for identifying depression and its risk factors among veterans.
Association between pyrethroid exposure and osteoarthritis: a national population-based cross-sectional study in the US
Authors: Liang Zhuoshuai , Sun Xiaoyue , Lan Jia , Guo Ruifang , Tian Yuyang , Liu Yawen , Liu Siyu
Published: August 2023

Background

With the restriction of organophosphorus and other insecticides, pyrethroids are currently the second most-used group of insecticides worldwide due to their advantages such as effectiveness and low toxicity for mammalian. Animal studies and clinical case reports have documented associations between adverse health outcomesand exposure to pyrethroids. At present, the association between chronic pyrethroid exposure and osteoarthritis (OA) remains elusive.

Methods

Cross-sectional data from the National Health and Nutrition Examination Survey 1999–2002 and 2007–2014 were used to explore the associations of pyrethroid exposure and OA. Urinary level of 3-phenoxybenzoic acid (3-PBA) in urine samples was used to evaluate the exposure of pyrethroid, and OA was determined on the basis of self-reported physician diagnoses. Multivariable logistic regression models were used to investigate the association between pyrethroid exposure and OA.

Results

Among the 6528 participants, 650 had OA. The weighted geometric mean of urinary volume-based 3-PBA concentration were 0.45 µg/L. With adjustments for major confounders, compared to participants in the lowest quartile of urinary volume-based 3-PBA, those in the highest quartilehad higher odds of OA (odds ratio, 1.39; 95% confidence interval: 1.01, 1.92). There was no nonlinear relationship between urinary volume-based 3-PBA and OA (P for non-linearity = 0.89).

Conclusion

High urinary 3-PBA concentration was associated with increased OA odds in the US adults. Pyrethroid exposure in the population should be monitored regularly.
Complications and radiographic changes after implantation of interspinous process devices: average eight-year follow-up
Authors: Li Kai-Yu , Li Hua-Lin , Chen Lin-Jie , Xiang Jian-Wei , Li Chen-Chao , Weng Jun-Jie , Tian Nai-Feng
Published: August 2023

Purpose

This study aims to evaluate complications, clinical outcomes, and radiographic results following Coflex implantation.

Methods

We retrospectively studied 66 patients who had decompressive surgery combined with Coflex implantation to treat lumbar spinal stenosis. All imaging data were collected and examined for imaging changes. Clinical outcomes, included Oswestry Disability Index (ODI), back and leg visual analog scale (VAS) scores, were evaluated before surgery, six months after surgery and at the last follow-up. The number of complications occurring after five years of follow-up was counted. All reoperation cases were meticulously recorded.

Results

66 patients were followed up for 5–14 years. The VAS and ODI scores were significantly improved compared with baseline. Heterotopic Ossification (HO) was detectable in 59 (89.4%). 26 (39.4%) patients had osteolysis at the contact site of Coflex with the spinous process. Coflex loosening was detected in 39 (60%) patients. Spinous process anastomosis was found in 34 (51.5%) patients. There was a statistically significant difference in the VAS score of back pain between patients with and without spinous process anastomosis. Nine cases of lumbar spinal restenosis were observed, and prosthesis fracture was observed in one case.

Conclusion

Our study identified various imaging changes after Coflex implantation, and majority of them did not affect clinical outcomes. The majority of patients had HO, but osteolysis and Coflex loosening were relatively rare. The VAS score for back pain of these patients was higher if they have spinous process anastomosis. After five-year follow-up, we found lumbar spinal restenosis and prosthesis fracture cases.
A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?
Authors: Chaouch Mohamed Ali , Hussain Mohammed Iqbal , Gouader Amine , Lahdhiri Abdallah Amine , Mazzotta Alessandro , da Costa Adriano Carneiro , Krimi Bassem , Noomen Faouzi , Oweira Hani
Published: August 2023

Background

There is no consensus regarding hernia sac management during laparoscopic hernia repair, and this systematic review and meta-analysis aimed to compare the postoperative outcomes of sac reduction (RS) and sac transection (TS) during laparoscopic mesh hernia repair.

Methods

We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 and AMSTAR 2 (Assessing the Methodological Quality of Systematic Reviews) guidelines. We used the RevMan 5.4 statistical package from the Cochrane collaboration for meta-analysis. A random effects model was used.

Results

The literature search yielded six eligible studies including 2941 patients: 821 patients in the TS group and 2120 patients in the RS group. In the pooled analysis, the TS group was associated with a lower incidence of seroma (OR = 1.71; 95% CI [1.22, 2.39], p = 0.002) and shorter hospital stay (MD = -0.07; 95% CI [-0.12, -0.02], p = 0.008). There was no significant difference between the two groups in terms of morbidity (OR = 0.87; 95% CI [0.34, 2.19], p = 0.76), operative time (MD = -4.39; 95% CI [-13.62, 4.84], p = 0.35), recurrence (OR = 2.70; 95% CI [0.50, 14.50], p = 0.25), and Postoperative pain.

Conclusions

This meta-analysis showed that hernia sac transection is associated with a lower seroma rate and shorter hospital stay with similar morbidity, operative time, recurrence, and postoperative pain compared to the reduction of the hernia sac.

Protocol

The protocol was registered in PROSPERO with ID CRD42023391730.
Highly multiplexed targeted sequencing strategy for infectious disease surveillance
Authors: Hernández-Neuta Iván , Magoulopoulou Anastasia , Pineiro Flor , Lisby Jan Gorm , Gulberg Mats , Nilsson Mats
Published: August 2023

Background

Global efforts to characterize diseases of poverty are hampered by lack of affordable and comprehensive detection platforms, resulting in suboptimal allocation of health care resources and inefficient disease control. Next generation sequencing (NGS) can provide accurate data and high throughput. However, shotgun and metagenome-based NGS approaches are limited by low concentrations of microbial DNA in clinical samples, requirements for tailored sample and library preparations plus extensive bioinformatics analysis. Here, we adapted molecular inversion probes (MIPs) as a cost-effective target enrichment approach to characterize microbial infections from blood samples using short-read sequencing. We designed a probe panel targeting 2 bacterial genera, 21 bacterial and 6 fungi species and 7 antimicrobial resistance markers (AMRs).

Results

Our approach proved to be highly specific to detect down to 1 in a 1000 pathogen DNA targets contained in host DNA. Additionally, we were able to accurately survey pathogens and AMRs in 20 out of 24 samples previously profiled with routine blood culture for sepsis.

Conclusions

Overall, our targeted assay identifies microbial pathogens and AMRs with high specificity at high throughput, without the need for extensive sample preparation or bioinformatics analysis, simplifying its application for characterization and surveillance of infectious diseases in medium- to low- resource settings.
Rehabilitation professionals’ perspectives and experiences with the use of technologies for violence prevention: a qualitative study
Authors: Grigorovich Alisa , Kontos Pia , Popovic Milos R.
Published: August 2023

Background

There is growing public policy and research interest in the development and use of various technologies for managing violence in healthcare settings to protect the health and well-being of patients and workers. However, little research exists on the impact of technologies on violence prevention, and in particular in the context of rehabilitation settings. Our study addresses this gap by exploring the perceptions and experiences of rehabilitation professionals regarding how technologies are used (or not) for violence prevention, and their perceptions regarding their efficacy and impact.

Methods

This was a descriptive qualitative study with 10 diverse professionals (e.g., physical therapy, occupational therapy, recreation therapy, nursing) who worked across inpatient and outpatient settings in one rehabilitation hospital. Data collection consisted of semi-structured interviews with all participants. A conventional approach to content analysis was used to identify key themes.

Results

We found that participants used three types of technologies for violence prevention: an electronic patient flagging system, fixed and portable emergency alarms, and cameras. All of these were perceived by participants as being largely ineffective for violence prevention due to poor design features, malfunction, limited resources, and incompatibility with the culture of care. Our analysis further suggests that professionals’ perception that these technologies would not prevent violence may be linked to their focus on individual patients, with a corresponding lack of attention to structural factors, including the culture of care and the organizational and physical environment.

Conclusions

Our findings suggest an urgent need for greater consideration of structural factors in efforts to develop effective interventions for violence prevention in rehabilitation settings, including the design and implementation of new technologies.
The use of locum doctors in the NHS – results of a national survey of NHS Trusts in England
Authors: Stringer Gemma , Ferguson Jane , Walshe Kieran , Grigoroglou Christos , Allen Thomas , Kontopantelis Evangelos , Ashcroft Darren M.
Published: August 2023

Background

Locum working in healthcare organisations has benefits for individual doctors and organisations but there are concerns about the impact of locum working on continuity of care, patient safety, team function and cost. We conducted a national survey of NHS Trusts in England to explore locum work, and better understand why and where locum doctors were needed; how locum doctors were engaged, supported, perceived and managed; and any changes being made in the way locums are used.

Methods

An online survey was sent to 191 NHS Trusts and 98 were returned (51%) including 66 (67%) acute hospitals, 26 (27%) mental health and six (6%) community health providers. Data was analysed using frequency tables, t-tests and correlations. Free-text responses were analysed using thematic analysis.

Results

Most NHS Trusts use locums frequently and for varying lengths of time. Trusts prefer to use locums from internal locum banks but frequently rely on locum agencies. The benefits of using locums included maintaining workforce capacity and flexibility. Importantly, care provided by locums was generally viewed as the same or somewhat worse when compared to care provided by permanent doctors. The main disadvantages of using locum agencies included cost, lack of familiarity and impact on organisational development. Some respondents felt that locums could be unreliable and less likely to be invested in quality improvement. NHS Trusts were broadly unfamiliar with the national guidance from NHS England for supporting locums and there was a focus on processes like compliance checks and induction, with less focus on providing feedback and support for appraisal.

Conclusions

Locum doctors provide a necessary service within NHS Trusts to maintain workforce capacity and provide patient care. There are potential issues related to the way that locums are perceived, utilised, and supported which might impact the quality of the care that they provide. Future research should consider the arrangements for locum working and the performance of locums and permanent doctors, investigating the organisation of locums in order to achieve safe and high-quality care for patients.
Maternal pre-pregnancy BMI, offspring epigenome-wide DNA methylation, and childhood obesity: findings from the Boston Birth Cohort
Authors: Si Jiahui , Meir Anat Yaskolka , Hong Xiumei , Wang Guoying , Huang Wanyu , Pearson Colleen , Adams William G. , Wang Xiaobin , Liang Liming
Published: August 2023

Background

Maternal pre-pregnancy obesity is an established risk factor for childhood obesity. Investigating epigenetic alterations induced by maternal obesity during fetal development could gain mechanistic insight into the developmental origins of childhood obesity. While obesity disproportionately affects underrepresented racial and ethnic mothers and children in the USA, few studies investigated the role of prenatal epigenetic programming in intergenerational obesity of these high-risk populations.

Methods

This study included 903 mother–child pairs from the Boston Birth Cohort, a predominantly urban, low-income minority birth cohort. Mother-infant dyads were enrolled at birth and the children were followed prospectively to age 18 years. Infinium Methylation EPIC BeadChip was used to measure epigenome-wide methylation level of cord blood. We performed an epigenome-wide association study of maternal pre-pregnancy body mass index (BMI) and cord blood DNA methylation (DNAm). To quantify the degree to which cord blood DNAm mediates the maternal BMI-childhood obesity, we further investigated whether maternal BMI-associated DNAm sites impact birthweight or childhood overweight or obesity (OWO) from age 1 to age 18 and performed corresponding mediation analyses.

Results

The study sample contained 52.8% maternal pre-pregnancy OWO and 63.2% offspring OWO at age 1–18 years. Maternal BMI was associated with cord blood DNAm at 8 CpG sites (genome-wide false discovery rate [FDR] < 0.05). After accounting for the possible interplay of maternal BMI and smoking, 481 CpG sites were discovered for association with maternal BMI. Among them 123 CpGs were associated with childhood OWO, ranging from 42% decrease to 87% increase in OWO risk for each SD increase in DNAm. A total of 14 identified CpG sites showed a significant mediation effect on the maternal BMI-child OWO association (FDR < 0.05), with mediating proportion ranging from 3.99% to 25.21%. Several of these 14 CpGs were mapped to genes in association with energy balance and metabolism (AKAP7) and adulthood metabolic syndrome (CAMK2B).

Conclusions

This prospective birth cohort study in a high-risk yet understudied US population found that maternal pre-pregnancy OWO significantly altered DNAm in newborn cord blood and provided suggestive evidence of epigenetic involvement in the intergenerational risk of obesity.
Chronic kidney disease in a giant panda (Ailuropoda melanoleuca): a case report
Authors: Chang Lingling , Wang Xiangyang L. , Yu Chenfei , Liu Chen-Hsuan , Zhang Qiang , Wu Yaping , Jia Ruoyi , Ma Qingyi , Pan Guanglin , Tong Dewen , Wang Xinglong
Published: August 2023

Background

Chronic kidney disease (CKD) is a common cause of morbidity and mortality in captive wildlife species. However, CKD has been rarely documented in giant pandas.

Case presentation

The following report describes a case of an eight-year-old female giant panda showing clinical signs of epistaxis, bloody diarrhea, polyuria, azotemia and anemia. The animal died despite of supportive treatments. Necropsy was performed. Grossly, both kidneys were shrunken and scarred with pallor. Subcutis edema and petechia on the epicardium of the heart were observed. The tissue samples were made into paraffin sections and stained by H.E and special staining including Periodic Acid-Schiff (PAS), von Kossa, Masson’s trichrome, Phosphotungstic acid-hematoxylin (PTAH), and Congo red. Histopathology examination revealed severe chronic tubulointerstitial nephritis with marked interstitial fibrosis, glomerulosclerosis, tubular atrophy and calcification in kidneys, and acute necrotizing hemorrhagic myocarditis with calcification in heart. Other lesions included intestinal hemorrhage, hepatic fatty degeneration and necrosis with hemosiderin, and splenic hemosiderin.

Conclusions

In summary, chronic kidney disease was finally diagnosed based on the association of clinical, gross, and histopathological findings. Heart failure secondary to CKD is the leading cause of death in this giant panda. The potential cause of CKD in this animal is possibly due to long term and uncontrolled hypertension. Blood pressure monitoring is essential in establishing the diagnosis and management of hypertension in giant panda.
Clinical practice of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease
Authors: Elshof Judith , Vonk Judith M. , van der Pouw Anouschka , van Dijk Cella , Vos Petra , Kerstjens Huib A.M. , Wijkstra Peter J. , Duiverman Marieke L.
Published: August 2023

Background

Non-invasive ventilation (NIV) is an evidence-based treatment for acute respiratory failure in chronic obstructive pulmonary disease (COPD). However, suboptimal application of NIV in clinical practice, possibly due to poor guideline adherence, can impact patient outcomes. This study aims to evaluate guideline adherence to NIV for acute COPD exacerbations and explore its impact on mortality.

Methods

This retrospective study was performed in two Dutch medical centers from 2019 to 2021. All patients admitted to the pulmonary ward or intensive care unit with a COPD exacerbation were included. An indication for NIV was considered in the event of a respiratory acidosis.

Results

A total of 1162 admissions (668 unique patients) were included. NIV was started in 154 of the 204 admissions (76%) where NIV was indicated upon admission. Among 78 admissions where patients deteriorated later on, NIV was started in 51 admissions (65%). Considering patients not receiving NIV due to contra-indications or patient refusal, the overall guideline adherence rate was 82%. Common reasons for not starting NIV when indicated included no perceived signs of respiratory distress, opting for comfort care only, and choosing a watchful waiting approach. Better survival was observed in patients who received NIV when indicated compared to those who did not.

Conclusions

The adherence to guidelines regarding NIV initiation is good. Nevertheless, further improving NIV treatment in clinical practice could be achieved through training healthcare professionals to increase awareness and reduce reluctance in utilizing NIV. By addressing these factors, patient outcomes may be further enhanced.
Accumulation of oxysterols in the erythrocytes of COVID-19 patients as a biomarker for case severity
Authors: Khedr Alaa , Khayat Maan T. , Khayyat Ahdab N. , Asfour Hany Z. , Alsilmi Rahmah A. , Kammoun Ahmed K.
Published: August 2023

Background

Due to the high risk of COVID-19 patients developing thrombosis in the circulating blood, atherosclerosis, and myocardial infarction, it is necessary to study the lipidome of erythrocytes. Specifically, we examined the pathogenic oxysterols and acylcarnitines in the erythrocyte homogenate of COVID-19 patients. These molecules can damage cells and contribute to the development of these diseases.

Methods

This study included 30 patients and 30 healthy volunteers. The erythrocyte homogenate extract was analyzed using linear ion trap mass spectrometry combined with high-performance liquid chromatography. The concentrations of oxysterols and acylcarnitines in erythrocyte homogenates of healthy individuals and COVID-19 patients were measured. Elevated levels of toxic biomarkers in red blood cells could initiate oxidative stress, leading to a process known as Eryptosis.

Results

In COVID-19 patients, the levels of five oxysterols and six acylcarnitines in erythrocyte homogenates were significantly higher than those in healthy individuals, with a p-value of less than 0.05. The mean total concentration of oxysterols in the red blood cells of COVID-19 patients was 23.36 ± 13.47 μg/mL, while in healthy volunteers, the mean total concentration was 4.92 ± 1.61 μg/mL. The 7-ketocholesterol and 4-cholestenone levels were five and ten times higher, respectively, in COVID-19 patients than in healthy individuals. The concentration of acylcarnitines in the red blood cell homogenate of COVID-19 patients was 2 to 4 times higher than that of healthy volunteers on average. This finding suggests that these toxic biomarkers may cause the red blood cell death seen in COVID-19 patients.

Conclusions

The abnormally high levels of oxysterols and acylcarnitines found in the erythrocytes of COVID-19 patients were associated with the severity of the cases, complications, and the substantial risk of thrombosis. The concentration of oxysterols in the erythrocyte homogenate could serve as a diagnostic biomarker for COVID-19 case severity.

Graphical abstract
Integrating competency analysis into national rehabilitation workforce evaluation: a case study
Authors: Mills Jody-Anne , Krzepkowska Weronika , Cieza Alarcos , Cuchi Paloma , Zurn Pascal , Short Stephanie Doris , Middleton James W.
Published: August 2023

Background

Establishing a workforce capable of meeting population needs is contingent on evaluation that can inform sound policy and planning. Health workforce evaluation has traditionally relied on health labour market analysis and workload estimations. To date, competency analysis has not been included in national health workforce evaluation, despite that fact that the findings may go far in guiding decisions around workforce composition, optimisation and education and training. This case study sought to assess the feasibility and perceived added value of integrating competency analysis into national rehabilitation workforce evaluation, and to determine how competency analysis can shape rehabilitation workforce planning. The findings of the case study can be used to explore the integration of competency analysis in the evaluation of other health-related occupational groups.

Methods

Participant observation was complemented by key informant interviews with experts engaged in the national rehabilitation workforce evaluation in Poland. These experts represented stakeholders in policy, education, research, clinical practice and professional associations.

Results

The results indicated that competency analysis can be feasibly integrated into national rehabilitation workforce evaluation, particularly when implementation is supported through the use of online platforms. However, the collection of additional data using other tools, such as a survey of the behaviours and tasks of a wider sample of rehabilitation workers, could strengthen data reliability. Experts perceived findings of the competency analysis to be valuable for expanding the understanding of rehabilitation, shedding light on task allocation and deployment of the existing rehabilitation workforce, and advocating for the rehabilitation workforce to be strengthened, especially in relation to those occupations which may not be recognised or valued as rehabilitation workers. Although it was not possible to fully explore the impact of competency analysis data on rehabilitation workforce planning and development in this study, experts suggested that its availability would likely foster greater cooperation among occupations, which has been missing at the policy and planning level to date. It further demonstrates what competency data should be collected and reported, and provides richer information to guide decisions.

Conclusions

Competency analysis complements traditional labour market analysis and workload estimates, adding depth to the understanding of how members of the workforce perform and perceive themselves, and how deficiencies in the workforce impact on the provision of care to specific population groups.
Artificial intelligence in orthodontics and orthognathic surgery: a bibliometric analysis of the 100 most-cited articles
Authors: Wong Ka Fai , Lam Xiang Yao , Jiang Yuhao , Yeung Andy Wai Kan , Lin Yifan
Published: August 2023

Background

The application of artificial intelligence (AI) in orthodontics and orthognathic surgery has gained significant attention in recent years. However, there is a lack of bibliometric reports that analyze the academic literature in this field to identify publishing and citation trends. By conducting an analysis of the top 100 most-cited articles on AI in orthodontics and orthognathic surgery, we aim to unveil popular research topics, key authors, institutions, countries, and journals in this area.

Methods

A comprehensive search was conducted in the Web of Science (WOS) electronic database to identify the top 100 most-cited articles on AI in orthodontics and orthognathic surgery. Publication and citation data were obtained and further analyzed and visualized using R Biblioshiny. The key domains of the 100 articles were also identified.

Results

The top 100 most-cited articles were published between 2005 and 2022, contributed by 458 authors, with an average citation count of 22.09. South Korea emerged as the leading contributor with the highest number of publications (28) and citations (595), followed by China (16, 373), and the United States (7, 248). Notably, six South Korean authors ranked among the top 10 contributors, and three South Korean institutions were listed as the most productive. International collaborations were predominantly observed between the United States, China, and South Korea. The main domains of the articles focused on automated imaging assessment (42%), aiding diagnosis and treatment planning (34%), and the assessment of growth and development (10%). Besides, a positive correlation was observed between the testing sample size and citation counts (P = 0.010), as well as between the time of publication and citation counts (P < 0.001).

Conclusions

The utilization of AI in orthodontics and orthognathic surgery has shown remarkable progress, particularly in the domains of imaging analysis, diagnosis and treatment planning, and growth and development assessment. This bibliometric analysis provides valuable insights into the top-cited articles and the trends of AI research in this field.
Immersion ultrasound improves the repeatability of shear-wave elastography for measuring median nerve elasticity
Authors: Zhang Zhijun , Wang Hui , Ding Xiaoya , He Shu
Published: August 2023

Objective

To study the factors that influence the measurement of median nerve elasticity, to provide a more reproducible test for the assessment of median nerve elasticity using shear wave elasticity (SWE), and to reduce operator empirical dependence. To compare the repeatability of the median nerve elasticity measurement using immersion SWE with that using contact SWE, analyze the factors affecting SWE measurement, and provide a more repeatable method for doctors without SWE operation experience.

Methods

Two doctors without SWE operation experience measured the median nerve mean elastic modulus (Emean) at the same position and at different time points on the right wrist of 58 healthy volunteers using immersion and contact ultrasound methods. The intraobserver and interobserver repeatability of measurements was assessed using the interclass correlation coefficient (ICC), while the repeatability was assessed using the Bland–Altman diagram.

Results

The intraobserver and interobserver repeatability of the median nerve elasticity measured via contact SWE by inexperienced operators were classified as good, with ICCs of 0.633 (95% CI 0.380–0.783) and 0.552 (95% CI 0.243–0.735), respectively. The intraobserver and interobserver repeatability of the median nerve elasticity measured by immersion SWE were very good, with ICCs of 0.975 (95% CI 0.958–0.985) and 0.942 (95% CI 0.902–0.966), respectively. The intraobserver and interobserver Bland–Altman diagram of median nerve elasticity measured by immersion SWE showed that 98% of the points fell within the 95% limits of agreement. The intraobserver and interobserver Bland–Altman diagram of median nerve elasticity measured by contact SWE showed that 94% of the points fell within the 95% limits of agreement.

Conclusion

Immersion ultrasound can improve the repeatability of median nerve elasticity measurements by inexperienced operators.
Long-term results following atrioventricular septal defect repair
Authors: Schumacher Katja , Marin Cuartas Mateo , Meier Sabine , Aydin Muhammed Ikbal , Borger Michael Andrew , Dähnert Ingo , Kostelka Martin , Vollroth Marcel
Published: August 2023

Background

Atrioventricular septal defects (AVSD) represent 4–7% of congenital cardiac malformations. Definitive early repair is favored over prior pulmonary artery banding and delayed definitive repair in many centers. The aim of this study was to analyze long-term outcomes following AVSD repair over a 21-year period.

Methods

A total of 202 consecutive patients underwent surgical AVSD correction between June 1999 and December 2020. Surgery was performed using the double-patch technique. The study data were prospectively collected and retrospectively analyzed. Primary outcomes were In-hospital mortality and overall long-term freedom from reoperation.

Results

Median age at operation was 120 days (IQR 94–150), median weight was 5.0 kg (4.2–5.3). None of the patients died within the first 30 postoperative days. In-hospital mortality was 0.5% (1/202 patients). Median follow-up was 57 months (11–121). Overall freedom from reoperation at 5, 10 and 15 years was 91.8%, 86.9% and 86.9%, respectively.

Conclusion

AVSD repair with the double-patch technique is a safe and effective procedure with good early postoperative outcomes and low long-term reoperation rates.
Prenatal diagnosis of paternal uniparental disomy for chromosome 2 in two fetuses with intrauterine growth restriction
Authors: Tan Xuemei , Liu Bailing , Yan Tizhen , Wei Xiaobao , Qin Yanfeng , Zeng Dingyuan , Yuan Dejian
Published: August 2023

Uniparental disomy (UPD) is when all or part of the homologous chromosomes are inherited from only one of the two parents. Currently, UPD has been reported to occur for almost all chromosomes. In this study, we report two cases of UPD for chromosome 2 (UPD2) encountered during prenatal diagnosis. The ultrasound findings of the fetuses from two unrelated families showed intrauterine growth restriction. The karyotype analyses were normal. The two fetuses both had complete paternal chromosome 2 uniparental disomy detected by whole-exome sequencing, but their clinical outcomes were significantly different, with fetal arrest in case 1 and birth in case 2. In this report, we analyzed and discussed the phenotypes of the fetuses in these two cases and reviewed the literature on UPD2.
Anxiety in adults with asthma during the coronavirus disease 2019 pandemic: a Canadian perspective
Authors: Linton Sophia , Xu Kayley , Hossenbaccus Lubnaa , Botting Hannah , Garvey Sarah , Sunavsky Adam , Steacy Lisa M. , Tripp Dean A. , Ellis Anne K.
Published: August 2023

Background

Asthma is a chronic airway inflammatory disease that affects millions of Canadians and often contributes to higher levels of anxiety among patients. Since the coronavirus disease 2019 (COVID-19) pandemic was a time of increased anxiety and fear among the Canadian population, it was thought that those with asthma may experience heightened anxiety levels due to uncertain access to care, the potential to misinterpret asthma symptoms for symptoms of COVID-19 (or vice versa), and the concern about being treated differently by those around them when experiencing asthma symptoms. Therefore, this study sought to perform a cross-sectional analysis of the asthma-anxiety relationship in adults with and without asthma in the unique context of the COVID-19 pandemic from a Canadian perspective.

Methods

This study employed the COVID-19 Associated Anxiety in Allergic Rhinitis and Asthma patients Experiencing Symptoms (CAAARES) survey, consisting of COVID-19-specific questions, the Generalized Anxiety Disorder Assessment-7 (GAD-7) and the Asthma Control Questionnaire-6 (ACQ-6). Data collection occurred through the Qualtrics XM platform and data analyses were conducted with the IBM SPSS Statistics 28 software.

Results

A total of 741 valid responses were collected (asthma group, n = 244; control group, n = 497). 31.6% and 26.2% of respondents in the asthma and control groups, respectively, met the diagnostic criteria for GAD. There was no significant difference (p = .067) in mean GAD-7 scores between the two groups. A Hierarchal Multiple Regression (HMR) model was developed, and neither asthma status nor ACQ-6 score had a significant predictive effect on the GAD-7 score. There was a statistically significant (p < .001) weak positive correlation (r = .22) between GAD-7 and ACQ-6 scores. In a simple mediation (SMM) model, perceived COVID-19 stress of others was not identified as a significant mediator of the relationship between ACQ-6 and GAD-7 (indirect effect β = 0.014).

Conclusion

Our study of a Canadian cohort demonstrates elevated levels of anxiety overall, amongst both asthma and control groups. While AR status was significantly greater in the asthma group, it was not a significant predictive variable of GAD-7 score. Our data suggests that COVID-19-specific factors appear to have a greater contribution to anxiety than asthma status or control.
Emergence of melioidosis in Brazil: a case series
Authors: Velôso Dilbert Silva , da Silva Samuel Pinheiro , de Coelho Conceição Maria Sousa , Parente José Miguel Luz , Veloso Thaline Alves Elias , Lima Murilo Moura , Sampaio Caroline Torres , de Freitas Maria Fátima Alencar Bezerra , Rolim Dionne Bezerra , de Lemos Elba Regina Sampaio , Horta Marco Aurélio Pereira
Published: August 2023

Background

Melioidosis is a serious disease caused by the bacterium Burkholderia pseudomallei which affects humans and animals. It results in a wide spectrum of clinical manifestations, mainly in the respiratory tract, progressing to septic shock and death.

Case presentation

Herein, we present a series of seven patients (median age: 41 years) with confirmed melioidosis, treated at a public hospital in Piauí State, Brazil between 2019 and 2021. The most common clinical presentations were fever, cough, pneumonia, and abdominal pain. The mean duration of antibacterial therapy with 1 g of meropenem was 28.6 ± 1.1 days. Six patients recovered and one died. The mean hospitalization time was 51.0 ± 39.2 days.

Conclusions

Melioidosis is an emerging infectious disease in Brazil. Health professionals in endemic areas need to be aware of the clinical presentation and appropriate clinical management of the disease because early diagnosis and early initiation of antibiotic therapy can be life-saving.