bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular Disease and Stroke-Focused Competency Assessment Tools for Community Health Workers in the United States: A Scoping Review
Authors: Mallaiah Janhavi , Leon Reynaldo De , Williams Olajide , Allegrante John P.
Published: September 2022

Cardiovascular disease (CVD) and stroke are major contributors to chronic disease burden in the United States. Despite the high prevalence of stroke, 90% of all stroke events are preventable and can be attributed to seven key modifiable risk factors (MRFs)—high blood pressure (BP), high cholesterol, diabetes mellitus (DM), smoking, obesity, unhealthy diet, and physical inactivity. In the United States, stroke prevention interventions led by community health workers (CHWs) have been proven to be highly effective in preventing the onset of MRFs. We conducted a scoping review of the competency assessment methods used in CVD and stroke-focused CHW training programs. We searched six online databases: PubMed, Cochrane, CINAHL, Embase, Web of Science, and HaPI, from all available years until January 2021. Of the 1,774 initial articles found, we identified 30 eligible articles to be included in the review. Nine of these studies used previously validated instruments, whereas the remaining 21 studies used tools from the training curriculum or independently developed instruments. Only five of these validated tools reported psychometric properties; none of them were designed for the CHW population. Our scoping review of literature revealed that CHW-specific competency assessment methods were limited, with few or no domain-referenced tools on CVD or stroke risk factors that complied with established measurement standards. We conclude that there is an urgent need for the development of a comprehensive and valid assessment instrument in CVD and stroke prevention to evaluate CHW performance and optimize their credibility, representing important first steps toward integrating CHWs into health care systems.
Complex Endovascular Repair of Paravisceral Infective Native Aortic Aneurysms
Authors: Juszczak Maciej , Mann Harvinder , Riste Michael , Woodhouse Andrew , Sörelius Karl , Claridge Martin , Adam Donald J.
Published: September 2022

Objective:

To report the early and mid-term outcome of complex endovascular repair (EVAR) for paravisceral infective native aortic aneurysms (INAA).

Methods:

Interrogation of a prospectively maintained database identified consecutive patients who underwent non-elective complex EVAR for paravisceral INAAs in a single institution between December 2013 and June 2020. All patients were considered to have definite INAAs based on diagnostic criteria. Patients who had prior aortic repair were excluded.

Results:

A total of 26 patients (19 men; mean age 67 years [SD = 11.4]; median diameter 60 mm [IQR: 55–73]) with acute symptomatic (n = 24) or contained ruptured (n = 2) aneurysms underwent surgeon-modified fenestrated EVAR (SM-FEVAR; n = 24) or chimney-periscope EVAR (CHIMPS; n = 2). Median observed follow-up was 36.2 months (18.3–53.5). Nine patients had positive venous blood cultures and a further seven had recent or concomitant infection. All patients received pre- and post-operative antibiotic therapy and rifampicin-soaked endografts. A total of 95 vessels were targeted for preservation and 86 were stent-grafted. One vessel occluded intra-operatively and a further 3 occluded within 30 days. The 30-day/in-hospital mortality was 11.5% (n = 3), and the estimated 1- and 3-year survival (±SD) was 85% ± 7%. Infection-related complications (IRCs) occurred in two patients: both developed new INAA within 30 days of index repair and were treated by EVAR with no mortality. Estimated 3-year freedom from late re-intervention was 100%. One patient required infrarenal EVAR for a non-infective aneurysm at 43 months.

Conclusion:

Complex EVAR for paravisceral INAAs is associated with acceptable early and mid-term outcomes and is an acceptable alternative to open surgery. We propose that these patients are managed with long-term antimicrobials, impregnation of graft material with rifampicin, and rigorous post-operative surveillance.

Clinical Impact

A multi-disciplinary approach is required to deliver the best possible outcome for patients with this challenging aortic pathology.
The Progress of the Specific and Rapid Genetic Detection Methods for Ovarian Cancer Diagnosis and Treatment
Authors: Dong Kejun , Zhang Wei , Cheng Shuangshuang , Shu Wan , Zhao Rong , Wang Hongbo
Published: September 2022

Cancer is a public health problem that threatens human health. Due to the lack of specific and rapid diagnosis and treatment methods, the 5-year survival rate of patients has not been effectively improved in the past 10 years. Abnormal gene expression is closely related to the occurrence and development of cancer. Cancer diagnosis and treatment methods based on genetic testing have received extensive attention in recent years. It is essential to explore specific and rapid cancer genetic testing methods. Taking ovarian cancer as an example, we reviewed the progress of specific and rapid nucleic acid detection methods related to cancer risk assessment, low-abundance mutation detection, and methylation detection, to provide new strategies and ideas for related research.
Perceived Stress, Grit, and Self-Care Behaviors in First-Year Medical Students
Authors: Boyd Alan , Mealand Kyle , Briggs Early Kathaleen , Oestreich Emily
Published: September 2022

Medical students experience more stress than the general population, which over time can cause mental and physical disease, including burnout. Identifying factors impacting stress during early medical training could inform strategies to minimize its impacts throughout training and in clinical practice. This study surveyed 238 first-year osteopathic medical students to assess stress (Perceived Stress Scale; PSS), grit, sleep quality (Pittsburgh Sleep Quality Index; PSQI), physical activity (Godin-Shephard Leisure-Time Physical Activity Score; LTPA), and nutrition habits (Rapid Eating Assessment for Participants; REAP) within the first 2 weeks of starting medical school and again 10 weeks later. Incomplete responses were removed, leaving 204 study participants. We observed statistically significant decreases in grittiness (∆grit = −2.230%, P = .002) and physical activity (∆LTPA = −22.147%, P < .0001), while perceived stress (∆PSS = 34.548%, P < .0001) and poor sleep quality (∆PSQI% = 19.853, P < .0001) increased. Correlation analyses identified the strongest relationships were between ∆PSS vs ∆PSQI ( r = .47, P < .0001) and ∆PSS vs ∆LTPA ( r = −.20, P < .01). Multivariable linear regression analysis isolated ∆PSQI ( P < .0001) and ∆LTPA ( P = .012) as statistically significant predictors of ∆PSS. These results suggest early, repeated curricular interventions focused on physical activity and sleep hygiene may help students better manage stress during medical education.
Targeted muscle reinnervation: A narrative review of a novel tool for the management of neuropathic pathology in major lower extremity amputations
Authors: Phair John , Choinski Krystina , Inglesby Dani C , Diamond Shawn , Sultan Steven M
Published: September 2022

Objective

The purpose of this narrative review is to provide the vascular surgery community with updated recommendations and information regarding the use of Targeted Muscle Reinnervation (TMR) for both the prevention and treatment of chronic pain and phantom limb pain occurring in patients after undergoing lower extremity amputation for peripheral artery disease.

Methods

Current available literature discussing TMR is reviewed and included in the article in order to provide a succinct overview on the indications, clinical applications, and surgical technique for TMR. Additionally, early studies showing favorable long-term results after TMR are discussed. Patient consent for publication was obtained for this investigation.

Results

TMR has been demonstrated to be an effective means of both treating and preventing neuroma-related symptoms including chronic pain and phantom limb pain. It has been proven to be technically feasible, and can help patients to have improved utilization of prostheses for ambulation, which can conceivably lead to a reduction in mortality.

Conclusions

TMR is an important tool to consider for any patient undergoing lower extremity amputation for a vascular-related indication. A vascular-plastic surgeon dual team approach is an effective means to prevent and reduce neuromas and associated chronic pain in this patient population.
Multi-institutional outcomes after femoropopliteal bypass in octogenarians
Authors: Kim Young , Cho Bennet S , DeCarlo Charles S , Latz Christopher A , Majumdar Monica , Zacharias Nikolaos , Mohapatra Abhisekh , Dua Anahita
Published: September 2022

Objectives

Open lower extremity revascularization is controversial among octogenarians; however, the indications for surgical bypass are higher in the elderly population. The aim of the study was to compare postoperative outcomes between octogenarians and non-octogenarians following femoropopliteal bypass surgery.

Methods

Our regional, multi-institutional database was queried for femoropopliteal bypass procedures performed between 1995 and 2020. Electronic medical records were individually reviewed for operative and postoperative data. Univariable and multivariable logistic regression were utilized to determine predictors of postoperative outcomes.

Results

Among 1315 patients who underwent femoropopliteal bypass, 234 (17.8%) were octogenarians. Octogenarians more frequently underwent bypass for lower extremity tissue loss (48.7% vs 30.2%), whereas claudication was more common among non-octogenarians (24.0% vs 9.8%) ( p < .001). Below-knee bypass target (72.2% vs 59.3%) and prosthetic conduit utilization (58.5% vs 43.7%) were more frequent in octogenarians ( p < .001 each). Overall hospital length of stay was longer among patients > 80 years (median 6 days [interquartile range [IQR] 4–9] vs 5 days [IQR 4–8], p = .017). The overall 30-day (5.6% vs 1.5%) and one-year mortality rates (25.6% vs 7.9%) were higher among octogenarians ( p < .001 each). On multivariable analysis, age greater than 80 years was found to be an independent risk factor for postoperative mortality (OR 3.79 [1.75–8.20], p = .0007)

Conclusions

Octogenarians undergoing bypass femoropopliteal bypass surgery have considerably worse postoperative outcomes, compared with non-octogenarians. These data may help inform elderly patients prior to undergoing open lower extremity revascularization.
Negotiating treatment and managing expectations in chronic kidney disease: A qualitative study in Argentina
Authors: Roberti Javier E , Alonso Juan P , May Carl R
Published: September 2022

Objectives

To describe how patients with CKD negotiated assigned responsibilities in the management of their disease, resulting in potential relational nonadherence.

Methods

Qualitative study performed in two healthcare facilities in Buenos Aires, Argentina, including 50 patients and 14 healthcare providers. We conducted semistructured interviews which were analysed using a frame of reference with concepts of Burden of Treatment and Cognitive Authority theories.

Findings

Adherence to treatment defined “good patients”. Patients needed to negotiate starting treatment, its modality and dialysis schedule, although most patients felt they did not participate in the decision process and that providers did not acknowledge implications of these decisions on their routine. Some patients skipped dialysis if concerns were not attended. Regularly, patients negotiated frequency of visits, doses, dietary restrictions and redefined relationships with their support networks, sometimes with devasting effects. As a result of overwhelming uncertainty some patients refused enrolling into a transplant program. When the frequency of complications increased, patients considered abandoning dialysis.

Conclusion

When patients perceived demands were excessive or conflicting, they entered into negotiations. Relationally induced nonadherence may arise when professionals do not or cannot enter into negotiations over patients’ beliefs or knowledge about what is possible for them to do.
Time interval from last visit to imaging diagnosis influences outcome in pancreatic adenocarcinoma: A regional population-based study on linked medico-administrative and clinical data
Authors: Balzano Vittoria , Laurent Emeline , Florence Aline-Marie , Lecuyer Anne-Isabelle , Lefebvre Carole , Heitzmann Patrick , Hammel Pascal , Lecomte Thierry , Grammatico-Guillon Leslie
Published: September 2022

Background:

Excessive waiting time intervals for the diagnosis and treatment of patients with pancreatic cancer can influence their prognosis but they remain unclear. The objective was to describe time intervals from the medical visit to diagnostic imaging and to treatment and their prognostic impact in pancreatic cancer in one French region.

Methods:

This retrospective observational multicentre study included all patients with pancreatic cancer seen for the first time in 2017 in multidisciplinary team meetings (MTMs), where clinical data were collected. A probabilistic matching with the medico-administrative data from the French national healthcare database ( Système National des Données de Santé) was performed to define the care pathway from clinical presentation to the beginning of treatment. Median key time intervals were estimated for both resected and unresected tumours. Factors associated with 1-year survival were studied using Cox model.

Results:

A total of 324 patients (88% of total patients with MTM presentation) were matched and included: male 54%, mean age 72 years ±9.2, Eastern Cooperative Oncology Group (ECOG) PS > 1 19.5%, metastatic disease at diagnosis 47.4%, tumour resection 16%. At 1 year, 57% had died (65% in the unresected group and 17% in the resected group). The median time interval from the medical visit to diagnostic imaging was 15 days [Q1–Q3: 8–44]. After imaging, median time intervals to definite diagnosis and to first treatment were 11 and 20 days, respectively. Significant prognostic factors associated with the risk of death at 1 year were ECOG PS > 1 (hazard ratio (HR) 2.1 [1.4–3.0]), metastasis (HR 2.7 [1.9–3.9]), no tumour resection (HR 2.7 [1.3–5.6]) and time interval between the medical visit and diagnostic imaging ⩾25 days (HR 1.7 [1.2–2.3]).

Conclusion:

Delay in access to diagnostic imaging impacted survival in patients with pancreatic cancer, regardless of whether tumour resection had been performed.
Ibn al-Haytham's ground theory of distance perception
Authors: Sedgwick H. A.
Published: September 2022

The 11th-century Arab scholar, Ibn al-Haytham, in his Optics, offers a detailed, rigorous, empirically oriented explanation of distance perception that may be the first essentially modern, scientific theory of distance perception. Based on carefully described experiments, he argues that for distance to be perceived accurately: (1) the distance must lie along a continuous surface such as the ground; (2) the continuous surface must be visible; (3) the magnitudes of distances along the surface must be perceived and calibrated through bodily interaction (walking and reaching) with them; and finally (4) the distance must be moderate. Al-Haytham's work reached Europe early in the 13th century, and his was the dominant theory of distance perception there for about 400 years. It was superseded early in the 17th century by a theory, based on cues such as convergence and accommodation, of distance seen through empty, mathematized space. Around 1950, an explanation of distance perception strikingly like that of al-Haytham was independently developed by J. J. Gibson, who called his theory the “ground theory” of space perception.
Comparative study of different SES neighborhood clinics for health literacy and internet access
Authors: Livingood William C , Bautista Maria A B , Smotherman Carmen , Azueta Daidre , Coleman Jeremy , Grewal Reetu , Stewart Eric , Orlando Lori A. , Scuderi Christopher
Published: September 2022

Background

As healthcare services are increasingly dependent on patient utilization of technology to effectively deliver services, the digital divide has the potential to exacerbate health disparities if health literacy and internet access present formidable barriers to patient use of technology.

Methods

We examined the differences in health literacy and internet access between lower and upper SES neighborhood primary-care clinics in Northeast Florida. The REALM-SF for health literacy was used to assess health literacy and census survey questions were used to assess internet and technology access, during the Fall, 2020. The clinics were affiliated with a safety-net hospital in a major city in Southeastern U.S.

Results

Analysis of key demographic data confirmed that the responding patients from economically disadvantaged neighborhood clinics resided in economically disadvantaged zip codes (307 responding patients lived in lower SES neighborhoods) and did have lower education levels (3% of the patients from Upper SES clinics had 11 grade or lower education, compared to 21%–29% of patients from Lower SES clinics). Patient health literacy significantly differed between clinics located in economically disadvantaged neighborhoods and clinics located in more affluent neighborhoods, with Upper SES clinics being 2.4 times more likely to have 9th grade or higher reading level. Access to internet technology was also higher in the Upper SES clinics, with 59% of respondents from Upper SES clinics versus 32%–40% from Lower SES clinics owning a computer or an IPAD.

Conclusion

Results of this study have important implications for patient-engaged use of digital technology for health. Healthcare and public health clinics should be aware of the difference in health literacy and internet access when implementing technology-based services, so that advances in medicine, including precision medicine and telehealth, can be disseminated and implemented with broad populations, including disadvantaged groups.
Building bridges from different settings to a common ground – Strengthening transitions for older patients with multiple chronic conditions: A qualitative descriptive design
Authors: Møller Nicoline , Lerbæk Birgitte , Kollerup Mette Geil , Berthelsen Connie
Published: September 2022

The role of transitional care nurses is sparsely described and knowledge is needed on their specific tasks and responsibilities to ensure continuity in transitions for older patients with multiple chronic conditions. The aim of this study was to explore and describe transitional care nurses’ practices related to transitional trajectories of older patients with multiple chronic conditions, to gain an insight into their experiences of their role and tasks. Twelve transitional care nurses from hospital and municipality settings participated in focused participant observations and/or group interviews from January to February 2021. The study was reported in line with the COREQ guidelines. A thematic analysis revealed the overarching theme of ‘Building bridges from different settings to a common ground’, supported by three parallel sub-themes. To ensure safe transitions between hospital and home for older patients, collaboration and communication must be strengthened between the health sectors.
Forming a Learning Environment Within a Senior-Citizen Community of Practice
Authors: Gau Wen-Bing
Published: September 2022

Senior citizens’ communities of practice (CoPs) in Taiwan focus on the sharing of experiences and expertise, and engagement with issues of mutual concern. Because most of their members have a wealth of social experiences, as well as the time and strong motivation to learn new skills, these CoPs have strong potential to become learning environments aimed at the sharpening of expertise. To better understand the senior citizens’ interactions in such an environment, the research team conducted a qualitative study of six CoPs in Taiwan, guided by the following research question: What are the key factors to construct the learning environment of senior citizens’ CoPs? The researchers visited selected CoPs, including two self-sponsored groups, two interest groups, and two volunteer groups. In total, 24 interviewees were recruited, and the semi-structured interview method was employed to explore how a learning environment is created for a senior citizen CoP. The findings highlight that a free-yet-practical communicative environment with a culture of respect for the individual fosters practice-oriented mutual engagement and joint enterprise. A facilitation-based method of building up senior-citizen learning environments is recommended. Collaborative tasks trigger comparisons and self-reflection. When sense-making activities work well, ample time will be needed to cement these activities into organizational routines, so that shared repertoires can be formed. The study also explained how the keys work as a whole.
Fifty public-standpipes: Politicians, local elections, and struggles for water in Barranquilla
Authors: Acevedo-Guerrero Tatiana
Published: September 2022

Throughout the late 1980s and 1990s, the Barranquilla World Bank Project aimed to expand water supply to the southwestern sector of the city, populated mainly by low-income communities. Anticipating the duration of the works, the project included a short-term solution: it would install 50 public-standpipes during the first months of implementation. Through archival work, this article tells the story of the World Bank Project and the fifty public-standpipes —which were never built. Its purpose is to analyse how water/power distributions were reworked and consolidated, highlighting tensions triggered by the project. It evidences the messiness of formal politics and the complexity of political parties (their competing interests, and the fact that these changed over time). This is of interest as it focuses on professional politics, a subject rarely touched by the political ecology literature. I argue that when examining water’s urbanization and the implementation of policy reforms in the global South, political ecology should engage in reflections about local professional politicians and party life as one that is not homogeneous nor static, where different ideas concerning water and the city emerge, clash, and converge.
The nature of “you 有” in the “you 有+verb” structure of oracle bone inscriptions
Authors: Yang Runlong , Ma Junjun , Deng Fei
Published: September 2022

A large volume of published studies have described the part of speech of “ you 有” in the “ you 有+verb phrase (VP)” structure of oracle bone inscriptions. However, much of the literature lacks a fine-grained classification of the VP following “ you 有.” This article starts with the structure of the VP and analyzes the syntactic and semantic relationship between “ you 有” and the VP. It is found that when “ you 有” is used in conjunction with different VPs, it has changed the lexical meaning and syntactic function from a verb indicating existence to an adverb denoting emphasis on the VP, with the pragmatic effect of focus-marking. Several factors could explain this change, ranging from syntactic structure to frequency of use and subjectivity.
Relationship between multimorbidity and composite lifestyle status in Shenzhen, China
Authors: Yang Hua-Lu , Mo Bei-Rong , Molassiotis Alex , Wang Mian , He Gui-Lan , Xie Yao Jie
Published: September 2022

Objective

The study aimed to understand multimorbidity among adults in a high-tech city in southern coastal China that has undergone rapid economic development and to investigate its relationship with lifestyle status.

Methods

A population-based survey was conducted among 24 community centers in the Nanshan District of Shenzhen from February to December of 2018. Participants were recruited using a stratified random sampling approach. A self-administered questionnaire on typical chronic diseases, lifestyle factors, body composition, and social demographics was used to collect data. Multimorbidity was defined as two or more chronic diseases coexisting in a single person. An algorithm on body mass index, physical activity, drinking, smoking, and sleep quality was used to calculate lifestyle scores (0–9), with higher scores predicting a healthier lifestyle.

Results

A total of 2,905 participants were included in the analysis, with men accounting for 52.4%, and single for 25%. The prevalence of multimorbidity was 4.8%, and the mean lifestyle score was 4.79 ± 1.55. People who were old, retired, married, and had less education were more likely to have multimorbidity (all P < .05). A higher prevalence of multimorbidity was found among those who were obese, less engaged in physical activity, consumed more alcohol, and had poorer sleep quality (all p < .05). After adjusting for age, employment, education, and marital status, one unit increase in lifestyle score was associated with 0.74 times lower to have multimorbidity (OR: 0.74; 95% CI: 0.63–0.87, p < .05).

Conclusion

The prevalence of multimorbidity was relatively low in economically developed Shenzhen. Keeping a healthy lifestyle was related to the lower possibility of suffering from multiple chronic diseases.
Synthesis of Porous Hollow Spheres Co@TiO2−x-Carbon Composites for Highly Efficient Lithium-Ion Batteries
Authors: Liang Chunyong , Huang Zhongliang , Wang Hongshui , Yang Tai , Liu Ning , Liao Tingdi , Wang Feng , Wang Xi
Published: September 2022

The hollow TiO2 anode material has received great attention for next-generation LIBs because of its excellent stability, environmental friendly, and low volume change during lithiation/delithiation. However, there are some problems associated with the current anatase TiO2 anode materials in practical application owing to low lithium-ion diffusivity and poor reversible theoretical capacities. The introduction of defects has been turned out to be a significant and effective method to improve electronic conductivity, especially oxygen vacancies. In this paper, a facile hydrothermal reaction and subsequent chemical vapor deposition method were successfully used to fabricate Co@TiO2−x-carbon hollow nanospheres. These results suggest that the synthesized product exhibits good rate performance and superior cycling stability.
SUBATOMIC: a SUbgraph BAsed mulTi-OMIcs clustering framework to analyze integrated multi-edge networks
Authors: Loers Jens Uwe , Vermeirssen Vanessa
Published: September 2022

Background

Representing the complex interplay between different types of biomolecules across different omics layers in multi-omics networks bears great potential to gain a deep mechanistic understanding of gene regulation and disease. However, multi-omics networks easily grow into giant hairball structures that hamper biological interpretation. Module detection methods can decompose these networks into smaller interpretable modules. However, these methods are not adapted to deal with multi-omics data nor consider topological features. When deriving very large modules or ignoring the broader network context, interpretability remains limited. To address these issues, we developed a SUbgraph BAsed mulTi-OMIcs Clustering framework (SUBATOMIC), which infers small and interpretable modules with a specific topology while keeping track of connections to other modules and regulators.

Results

SUBATOMIC groups specific molecular interactions in composite network subgraphs of two and three nodes and clusters them into topological modules. These are functionally annotated, visualized and overlaid with expression profiles to go from static to dynamic modules. To preserve the larger network context, SUBATOMIC investigates statistically the connections in between modules as well as between modules and regulators such as miRNAs and transcription factors. We applied SUBATOMIC to analyze a compositeHomo sapiensnetwork containing transcription factor-target gene, miRNA-target gene, protein–protein, homologous and co-functional interactions from different databases. We derived and annotated 5586 modules with diverse topological, functional and regulatory properties. We created novel functional hypotheses for unannotated genes. Furthermore, we integrated modules with condition specific expression data to study the influence of hypoxia in three cancer cell lines. We developed two prioritization strategies to identify the most relevant modules in specific biological contexts: one considering GO term enrichments and one calculating an activity score reflecting the degree of differential expression. Both strategies yielded modules specifically reacting to low oxygen levels.

Conclusions

We developed the SUBATOMIC framework that generates interpretable modules from integrated multi-omics networks and applied it to hypoxia in cancer. SUBATOMIC can infer and contextualize modules, explore condition or disease specific modules, identify regulators and functionally related modules, and derive novel gene functions for uncharacterized genes. The software is available athttps://github.com/CBIGR/SUBATOMIC.
The landscape of immune cell infiltration in the glomerulus of diabetic nephropathy: evidence based on bioinformatics
Authors: ZHOU Wei , LIU Yaoyu , Hu Qinghong , ZHOU Jiuyao , LIN Hua
Published: September 2022

Background

Increasing evidence suggests that immune cell infiltration contributes to the pathogenesis and progression of diabetic nephropathy (DN). We aim to unveil the immune infiltration pattern in the glomerulus of DN and provide potential targets for immunotherapy.

Methods

Infiltrating percentage of 22 types of immune cell in the glomerulus tissues were estimated by the CIBERSORT algorithm based on three transcriptome datasets mined from the GEO database. Differentially expressed genes (DEGs) were identified by the “limma” package. Then immune-related DEGs were identified by intersecting DEGs with immune-related genes (downloaded from Immport database). The protein–protein interactions of Immune-related DEGs were explored using the STRING database and visualized by Cytoscape. The enrichment analyses for KEGG pathways and GO terms were carried out by the gene set enrichment analysis (GSEA) method.

Results

11 types of immune cell were revealed to be significantly altered in the glomerulus tissues of DN (Up: B cells memory, T cells gamma delta, NK cells activated, Macrophages.M1, Macrophages M2, Dendritic cells resting, Mast cells resting; Down: B cells naive, NK cells resting, Mast cells activated, Neutrophils). Several pathways related to immune, autophagy and metabolic process were significantly activated. Moreover, 6 hub genes with a medium to strong correlation with renal function (eGFR) were identified (SERPINA3, LTF, C3, PTGDS, EGF and ALB).

Conclusion

In the glomerulus of DN, the immune infiltration pattern changed significantly. A complicated and tightly regulated network of immune cells exists in the pathological of DN. The hub genes identified here will facilitate the development of immunotherapy.
Concentrated transdiagnostic and cross-disciplinary group treatment for patients with depression and with anxiety: a pilot study
Authors: Kvale Gerd , Wilhelmsen-Langeland Ane , Jürgensen Marte , Hystad Sigurd William , Öst Lars-Göran , Søfteland Eirik , Børtveit Tore
Published: September 2022

Background

A number of treatment approaches have shown efficacy for depression and/or anxiety, yet there is a paucity of research on potentially cost-effective concentrated approaches. Based on our previous experience with concentrated treatment in disorders such as Obsessive–Compulsive Disorder and chronic fatigue, we proposed that this novel approach could be useful for other conditions, including depression and/or anxiety. As a pre-requisite for a future randomized controlled trial, the aim of this study was to investigate the acceptability, satisfaction and effectiveness of a transdiagnostic, interdisciplinary group treatment delivered during 5 consecutive days to groups of 6–10 patients with depression and/or anxiety.

Methods

This was a non-randomized clinical intervention pilot study in line with a published protocol. Forty-two consecutively referred patients, aged 19–47 (mean age 31.7, SD = 8.12) were included and completed treatment. All had a severity of their problems that entitled them to care in the specialist public mental health care. Self-reported age when the symptoms became a problem was 20.9 years. Mean number of prior treatment courses was 2.77 (SD = 2.19; range 0–8). Acceptability was defined as the proportion of eligible patients who accepted and completed the treatment. Satisfaction was evaluated by Client Satisfaction Questionnaire-8. Secondary objectives were to assess the treatment effectiveness by questionnaires at pre-treatment, seven days post-treatment and three months follow-up.

Results

The treatment was highly acceptable (91.3% accepted, all completed), and patients were highly satisfied with the treatment, including the amount. Functional impairment, as measured by Work and Social Adjustment Scale (WSAS) improved significantly (p < .0005) from “severe” (mean 25.4 SD = 6.59) to “less severe” (mean 13.37, SD = 9.43) at 3 months follow-up. Using the Generalized Anxiety Disorder Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), the effect sizes at 3 months follow-up were 1.21 for anxiety and 1.3 for depression. More than 80% reported reduced utilization of mental health care, and 67% had not used, or had used the family doctor less, for anxiety or depression. 52% had not used, or had reduced, medication for their disorder.

Conclusions

 The concentrated, interdisciplinary treatment approach yielded promising results. Long-term follow up is warranted.

Trial registration

This study is registered in Clinical Trials, identifier NCT05234281 and approval date 09/02/2022.
Light-curing process for clear aligners’ attachment reproduction: comparison between two nanocomposites cured by the auxiliary of a new tool
Authors: Gazzani Francesca , Bellisario Denise , Quadrini Fabrizio , Danesi Carlotta , Alberti Andrea , Cozza Paola , Pavoni Chiara
Published: September 2022

Background

Attachments’ configuration play an important role during Clear Aligner Treatment (CAT) for aligner retention and control of movements planned. The aims were to compare the macroscopic morphology of attachments reproduced with flowable (FNC) and conventional (CNC) composites and the effects on them of two light-guide tips with different dimensions.

Methods

4 resin casts derived from the initial scan of the same patient were obtained. 10 vestibular attachments were replaced on both upper and lower arches of each model with CNC (Models A, B) and FNC (Models C, D). Each composite was cured by means of the same LED lamp with both regular light-guide (Models A, B) and push and light tool® (Models C, D). The 80 attachments were qualitative analyzed by means of a digital stereo microscope. Surface roughness and waviness measurements were assessed by contact probe surface profiler (TalySurf CLI 2000; Taylor Hobson, Leicester, United Kingdom). Statistical analysis was performed with independent samples t-tests. Significance was established at the P < 0.05 level.

Results

Model A showed lower values of surface roughness (Ra − 1.41 µm, Rt − 3.46 µm) and waviness (Wa − 2.36 µm, Wt − 10.95 µm) when compared with Model C. Significant reduction of waviness (Wa − 3.85 µm, Wt − 4.90 µm) was observed on Model B when compared with Model D. Significant increase of roughness and waviness parameters (Ra 3.88 µm, Rt 21.07, Wa 2.89 µm, Wt 14.74 µm) was found when CNC sample (Model A) was cured with regular light-guide tip. Higher values (Ra 2.33 µm, Rt 24.07 µm, Wa 1.67 µm, Wt 20.79 µm) were observed after regular light-guide tips curing on FNC sample (Model C).

Conclusions

CNC resins determine more regular surfaces of attachments profiles. The additional use of a smaller light- guide of the LED push and light tool® allows to improve the macroscopic morphology of the attachments and to maximize light irradiance delivering by enhancing the polymerization process and the integrity of the features during the treatment.
Biocompatibility and antioxidant activity of a novel carrageenan based injectable hydrogel scaffold incorporated with Cissus quadrangularis: an in vitro study
Authors: Sairaman Sruthi , Nivedhitha M. S. , Shrivastava Deepti , Al Onazi Meshal Aber , Algarni Hmoud Ali , Mustafa Mohammed , Alqahtani Ali Robaian , AlQahtani Nouf , Teja Kavalipurapu Venkata , Janani Krishnamachari , Eswaramoorthy Rajalakshmanan , Sudhakar M. P. , Alam Mohammad Khursheed , Srivastava Kumar Chandan
Published: September 2022

Background

Over the past years, polysaccharide-based scaffolds have emerged as the most promising material for tissue engineering. In the present study, carrageenan, an injectable scaffold has been used owing to its advantage and superior property. Cissus quadrangularis, a natural agent was incorporated into the carrageenan scaffold. Therefore, the present study aimed to assess the antioxidant activity and biocompatibility of this novel material.

Methods

The present in vitro study comprised of four study groups each constituting a sample of 15 with a total sample size of sixty (n = 60). The carrageenan hydrogel devoid of Cissus quadrangularis acted as the control group (Group-I). Based on the concentration of aqueous extract of Cissus quadrangularis (10% w/v, 20% w/v and 30% w/v) in carrageenan hydrogel, respective study groups namely II, III and IV were considered. Antioxidant activity was assessed using a 1,1-diphenyl-2-picrylhydrazyl radical scavenging assay, whereas the biocompatibility test was performed using a brine shrimp lethality assay. The microstructure and surface morphology of the hydrogel samples containing different concentrations of Cissus quadrangularis aqueous extract was investigated using SEM. One-way ANOVA with the post hoc tukey test was performed using SPSS software v22.

Results

A significant difference (P < 0.05) in the antioxidant activity was observed among the study groups. Group III reported the highest activity, whereas the control group showed the least antioxidant activity. Additionally, a significant (P < 0.01) drop in the antioxidant activity was observed in group IV when compared with group III. While assessing the biocompatibility, a significant (P < 0.001) dose-dependent increase in biocompatibility was observed with the increasing concentration of aqueous extract of Cissus quadrangularis. SEM analysis in group III showed even distribution throughout the hydrogel although the particles are close and densely arranged. Reduced antioxidant activity in group IV was probably due to clumping of the particles, thus reducing the active surface area.

Conclusion

Keeping the limitations of in vitro study, it can be assumed that a carrageenan based injectable hydrogel scaffold incorporated with 20% w/v Cissus quadrangularis can provide a favourable micro-environment as it is biocompatible and possess better antioxidant property.
Diagnosis of in vivo vertical root fracture using deep learning on cone-beam CT images
Authors: Hu Ziyang , Cao Dantong , Hu Yanni , Wang Baixin , Zhang Yifan , Tang Rong , Zhuang Jia , Gao Antian , Chen Ying , Lin Zitong
Published: September 2022

Objectives

Evaluating the diagnostic efficiency of deep learning models to diagnose vertical root fracture in vivo on cone-beam CT (CBCT) images.

Materials and methods

The CBCT images of 276 teeth (138 VRF teeth and 138 non-VRF teeth) were enrolled and analyzed retrospectively. The diagnostic results of these teeth were confirmed by two chief radiologists. There were two experimental groups: auto-selection group and manual selection group. A total of 552 regions of interest of teeth were cropped in manual selection group and 1118 regions of interest of teeth were cropped in auto-selection group. Three deep learning networks (ResNet50, VGG19 and DenseNet169) were used for diagnosis (3:1 for training and testing). The diagnostic efficiencies (accuracy, sensitivity, specificity, and area under the curve (AUC)) of three networks were calculated in two experiment groups. Meanwhile, 552 teeth images in manual selection group were diagnosed by a radiologist. The diagnostic efficiencies of the three deep learning network models in two experiment groups and the radiologist were calculated.

Results

In manual selection group, ResNet50 presented highest accuracy and sensitivity for diagnosing VRF teeth. The accuracy, sensitivity, specificity and AUC was 97.8%, 97.0%, 98.5%, and 0.99, the radiologist presented accuracy, sensitivity, and specificity as 95.3%, 96.4 and 94.2%. In auto-selection group, ResNet50 presented highest accuracy and sensitivity for diagnosing VRF teeth, the accuracy, sensitivity, specificity and AUC was 91.4%, 92.1%, 90.7% and 0.96.

Conclusion

In manual selection group, ResNet50 presented higher diagnostic efficiency in diagnosis of in vivo VRF teeth than VGG19, DensenNet169 and radiologist with 2 years of experience. In auto-selection group, Resnet50 also presented higher diagnostic efficiency in diagnosis of in vivo VRF teeth than VGG19 and DensenNet169. This makes it a promising auxiliary diagnostic technique to screen for VRF teeth.
Antidiabetic potential of Lysiphyllum strychnifolium (Craib) A. Schmitz compounds in human intestinal epithelial Caco-2 cells and molecular docking-based approaches
Authors: Noonong Kunwadee , Pranweerapaiboon Kanta , Chaithirayanon Kulathida , Surayarn Kantamat , Ditracha Phicharinee , Changklungmoa Narin , Kueakhai Pornanan , Hiransai Poonsit , Bunluepuech Kingkan
Published: September 2022

Background

Lysiphyllum strychnifolium (Craib) A. Schmitz, a traditional Thai medicinal plant, is mainly composed of polyphenols and flavonoids and exhibits several pharmacological activities, including antioxidant, anticancer, antimicrobial, and antidiabetic activities. However, the mechanism by which pure compounds from L. strychnifolium inhibit glucose catalysis in the small intestine and their effect on the glucose transporter remain unknown.

Methods

The objectives of this research were to examine the effect of 3,5,7-trihydroxychromone-3-O-𝛼-L-rhamnopyranoside (compound 1) and 3,5,7,3’,5’-pentahydroxy-flavanonol-3-O-𝛼-L-rhamnopyranoside (compound 2) on the inhibition of α-amylase and α-glucosidase, as well as glucose transporters, such as sodium-glucose cotransporter 1 (SGLT1), glucose transporter 2 (GLUT2), and glucose transporter 5 (GLUT5), using Caco-2 cells as a model of human intestinal epithelial cells. Additionally, the binding affinity and interaction patterns of compounds against two receptor proteins (SGLT1 and GLUT2) were determined for the first time utilizing a molecular docking approach.

Results

In the α-amylase inhibition assay, a concentration-dependent inhibitory response was observed against the enzyme. The results indicated that compound 1 inhibited α-amylase activity in a manner similar to that of acarbose (which exhibit IC50 values of 3.32 ± 0.30 µg/mL and 2.86 ± 0.10 µg/mL, respectively) in addition to a moderate inhibitory effect for compound 2 (IC50 = 10.15 ± 0.53 µg/mL). Interestingly, compounds 1 and 2 significantly inhibited α-glucosidase and exhibited better inhibition than that of acarbose, with IC50 values of 5.35 ± 1.66 µg/mL, 510.15 ± 1.46 µg/mL, and 736.93 ± 7.02 µg/mL, respectively. Additionally, α-glucosidase activity in the supernatant of the Caco-2 cell monolayer was observed. In comparison to acarbose, compounds 1 and 2 inhibited α-glucosidase activity more effectively in Caco-2 cells without cytotoxicity at a concentration of 62.5 µg/mL. Furthermore, the glucose uptake pathways mediated by SGLT1, GLUT2, and GLUT5- were downregulated in Caco-2 cells treated with compounds 1 and 2. Additionally, molecular modeling studies revealed that compounds 1 and 2 presented high binding activity with SGLT1 and GLUT2.

Conclusion

In summary, our present study was the first to perform molecular docking with compounds present in L. strychnifolium extracts. Our findings indicated that compounds 1 and 2 reduced glucose uptake in Caco-2 cells by decreasing the expression of glucose transporter genes and inhibiting the binding sites of SGLT1 and GLUT2. Therefore, compounds 1 and 2 may be used as functional foods in dietary therapy for postprandial hyperglycemia modulation of type 2 diabetes.
Machine learning algorithms for predicting low birth weight in Ethiopia
Authors: Bekele Wondesen Teshome
Published: September 2022

Background

Birth weight is a significant determinant of the likelihood of survival of an infant. Babies born at low birth weight are 25 times more likely to die than at normal birth weight. Low birth weight (LBW) affects one out of every seven newborns, accounting for about 14.6 percent of the babies born worldwide. Moreover, the prevalence of LBW varies substantially by region, with 7.2 per cent in the developed regions and 13.7 per cent in Africa, respectively. Ethiopia has a large burden of LBW, around half of Africa. These newborns were more likely to die within the first month of birth or to have long-term implications. These are stunted growth, low IQ, overweight or obesity, developing heart disease, diabetes, and early death. Therefore, the ability to predict the LBW is the better preventive measure and indicator of infant health risks.

Method

This study implemented predictive LBW models based on the data obtained from the Ethiopia Demographic and Health Survey 2016. This study was employed to compare and identify the best-suited classifier for predictive classification among Logistic Regression, Decision Tree, Naive Bayes, K-Nearest Neighbor, Random Forest (RF), Support Vector Machine, Gradient Boosting, and Extreme Gradient Boosting.

Results

Data preprocessing is conducted, including data cleaning. The Normal and LBW are the binary target category in this study. The study reveals that RF was the best classifier and predicts LBW with 91.60 percent accuracy, 91.60 percent Recall, 96.80 percent ROC-AUC, 91.60 percent F1 Score, 1.05 percent Hamming loss, and 81.86 percent Jaccard score.

Conclusion

The RF predicted the occurrence of LBW more accurately and effectively than other classifiers in Ethiopia Demographic Health Survey. Gender of the child, marriage to birth interval, mother’s occupation and mother’s age were Ethiopia’s top four critical predictors of low birth weight in Ethiopia.