bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Interstitial Nephritis in the Pediatric Population: A Review of Etiologic Associations, Histologic Findings, and Clinical Outcome
Authors: Biederman Laura E. , Conces Miriam , Shenoy Archana
Published: December 2022

Background:

Acute interstitial nephritis (AIN) is an infrequent cause of acute kidney injury in the pediatric population with a broad range of etiologies. This retrospective review attempts to characterize AIN in the pediatric population, delineate etiologic factors, histologic features, and clinical outcome.

Materials and Methods:

Institutional pathology reports were queried for a diagnosis of AIN between 1/2010 and 10/2021. Archived slides and reports and clinical records were reviewed.

Results:

Twenty-four patients were identified whose ages ranged from 5 to 20 years. A 8 cases (37.5%) were characterized as tubulointerstitial nephritis and uveitis (TINU), 4 cases (16.7%) were associated with an autoimmune disease, 4 cases (16.7%) were likely drug induced, and 8 cases (37.5%) had unclear etiology.

Discussion:

Although all cases of drug induced interstitial nephritis contained eosinophils they were not exclusive to drug induced interstitial nephritis. A prominent plasma cell infiltrate was seen in both cases of Sjögren’s associated interstitial nephritis. The vast majority (n = 18, 75%) showed an improved serum creatinine (<1 mg/dL) 1 year post diagnosis/at last follow-up. In this pediatric series of AIN, TINU contributed to a large subset of cases with known etiologies. On follow up, majority of the cases demonstrated recovery of renal function.
Transverse incision versus longitudinal incision in the implantation of PICC-port: A before-after study
Authors: Shen Yan , Wang Qianqian , Li Xin , Chang Jian , Zhou Xingmei
Published: December 2022

Background:

The peripherally inserted central catheter-port (PICC-port) technique is an innovation of the standard arm-totally implantable vascular access device. The design of surgical skin incision may have an important impact on the postoperative life of patients, the cosmetic result is important for patient satisfaction as well.

Objectives:

To compare two different incision methods in the implantation of PICC-port.

Design:

A before-after study.

Settings and participants:

A total of 62 adult patients with malignant tumor requiring chemotherapy in Shanghai General Hospital were selected by convenience sampling, 31 in each group. All participants agreed to install PICC-port with signature from 1 Jan to 30 April, 2022.

Methods:

31 patients were given longitudinal incision, about 3 cm below the puncture point obliquely. Another 31 patients were given transverse incision, about 3 cm below the puncture point. T-test, chi-square test and rank sum test were used to compare the differences between the two groups in incision healing, scar score, and operation time.

Results:

There was no statistically significant difference in incision healing between the two groups( p > 0.05). The scar scores of patients with transverse incision were higher than that of patients with longitudinal incision at 3 months ( p < 0.05). And the operation time of longitudinal incision group was longer than that of transverse incision group( p < 0.05).

Conclusions:

Our study revealed that PICC-port implantation could be considered as safe as PICC insertion conducted by nurse. During our follow-up, all patients with PICC-port implantation had good wound healing, and there were no complications such as local infection happened. The transverse incision was more easier to be operated in bag making in PICC-port implantation.
Dry sliding wear behavior of aluminum alloy 6082 - SiC composites through ex-situ casting process
Authors: S Surendarnath , G Ramesh , T Ramachandran , R Dharmalingam , S Murugapoopathi
Published: December 2022

The applications of AA6082 alloys in the structural and transport are found to be more due its light weight. To improve strength to weight ratio and stress resistance, the carbides/oxides are added and this will leads to improvement in the mechanical properties and high stress sustainability. In this research work, AA6082 Metal Matrix Composite (MMC) is manufactured through the ex-situ casting process with the Silicon Carbide (SiC) reinforcements of 2.5 & 5 wt% and the microstructure evolution, hardness, dry sliding wear behavior and tensile properties of MMCs are investigated. As-cast AA6082 showed the dendritic microstructure with intermetallic eutectics. The presence of SiC particulates in AA6082 resulted in decreased grain size and equixed grains. The hardness of the tested as casted AA6082 samples was found to be 81 HV which has been increased to 93 HV and 107 HV and the tensile strength of AA6082 is increased by 16% and 41% by addition of 2.5 wt% SiC and 5 wt%SiC respectively due to the presence of the SiC particulates. At the same time coefficient of friction of AA6082 is found to be decreased by 11.8% and 20.5% for the testing load of 10N and the corresponding decrease in wear rates were found to be 50.8% and 70.3% respectively. The worn surface showed the continuous groove parallel to sliding direction with short cracks, bidirectional rough grooves with peeled-off SiC, unidirectional smooth scratches along the sliding surfaces for as-cast AA6082, AA6082-2.5 wt SiC and AA6082-5 wt SiC respectively that indicates the significant effects of SiC particulates on wear mechanism.
Lubricant performance against white etching areas (WEAs) formation in AISI 52100 bearing steel under cyclic compressive loading
Authors: Linto D. , Ramkumar P.
Published: December 2022

Premature bearing failures commonly occur in applications that operate under extreme boundary conditions. The lubrication engineers and tribologists are confronting a key challenge in these bearing failures associated with microstructure decay, such as White Etching Cracks (WECs) and White Etching Areas (WEAs). Lubricant degradation is one of the critical factors for the subsurface decay in the bearing steel. This work evaluates the performance of mineral oil (heavy paraffin oil) and synthetic poly alkyl glycol (PAG) against WEAs formation under pure sliding with cyclic compressive loading. The performance of lubricants was evaluated using Infrared Fourier Transform (FTIR) and Electron Spin Resonance (ESR) spectroscopy. The outcomes reveal that the free radical formation rate is higher for paraffin than PAG. This study found that WEAs formation in the bearing steel is delayed in the PAG tested samples compared to paraffin.
Scaffolded extensive reading: A concept drawn from two EFL reading programmes
Authors: Sun Xiaomei
Published: December 2022

Myriad studies have been conducted to test the benefits of extensive reading (ER) on second language (L2) acquisition, while limited research has addressed or sought solutions to the unpopularity of ER in L2 classrooms, especially in secondary teaching contexts. With the aim of exploring both teachers’ and students’ perceptions and practice of ER, this study reports on two reading programmes carried out in Chinese secondary schools with variations in educational development, teacher training opportunities, and students’ overall competence. Data were collected from a student questionnaire survey ( n = 86), two interviews with teacher participants ( n = 2), and one interview with student participants ( n = 9), teachers’ reflective journals, and various documents related to the reading programmes. Thematic analysis was adopted to analyse the qualitative data. A key finding of this study is that teachers’ scaffolding played a significant role in ER implementation. Without adequate teacher scaffolding, one reading programme only lasted for approximately two months. Based on the findings, scaffolded extensive reading (SER) is put forward and elucidated with its essential features. To provide some practical guidance for the implementation of SER in L2 classrooms, a three-stage model encompassing instructed ER, collaborative ER, and independent ER is presented and explicated to inform teachers in similar contexts.
The Changing Structure of Political Conflicts in the South of Europe: An Analysis of Issue Voting in Four Countries
Authors: Carrieri Luca , Morini Marco
Published: December 2022

This research analyses the demand-side of politics in Southern European countries, investigating how three relevant voting determinants have changed throughout time. The focus is on Greece, Italy, Portugal and Spain, and the examined variables are the European Union, immigration and state intervention in the economy. The period of analysis is 2009–2019 and we identify the structure of political conflicts from the point of view of voters. We find that the electoral support of parties has been increasingly influenced by party positions on immigration (with the partial exception of Portugal), but not on the European Union. Moreover, the issue of ‘state control and regulation of the economy’ is boosting its explanatory power in all the countries investigated in this study. Thus, new issue determinants have gradually reshaped the system of voting preferences across Southern Europe, with voter demands becoming more likely to match party supply on immigration and economic interventionism.
Seeking Help From Primary Health-Care Providers in High-Income Countries: A Scoping Review of the Experiences of Migrant and Refugee Survivors of Domestic Violence
Authors: Allen-Leap Molly , Hooker Leesa , Wild Kayli , Wilson Ingrid M. , Pokharel Bijaya , Taft Angela
Published: December 2022

Migrant and refugee women experiencing domestic violence (DV) may face compounding factors that impact their ability and experiences of seeking help. Health-care providers are in a unique position to identify and assist victims of DV, however, they often lack the confidence and training to do this well. Little is known of the health-care experiences of migrant and refugee women experiencing abuse when they access primary health care (PHC). Using scoping review methodology, we undertook a systematic search of seven databases (Medline, Scopus, ProQuest, CINAHL, Informit Complete, and Google Scholar). We sought peer-reviewed and grey literature, published in English between January 1980 and August 2021 that identified women (18+) who had experienced DV, from low- or middle-income countries (LMICs), seeking help or health care in a primary care setting of a high-income country (HIC). Nine articles met the inclusion criteria. Findings identify sociocultural and sociopolitical barriers for migrant and refugee women seeking help for DV, which are contextualized within the ecological model. Migration-related factors and fear were major barriers for migrant and refugee women, while kindness, empathy and trust in health-care providers, and children’s well-being were the strongest motivators for help-seeking and disclosure. This review provides insight into an under-researched and marginalized group of victim-survivors and highlights the need for increased awareness, guidance, and continuing education for health-care providers and health-care systems to provide best practice DV care for migrant and refugee women.
Perceived Impact of the COVID-19 Pandemic on Adults with Intellectual and Developmental Disability: A Qualitative Study
Authors: Randall Kristina N. , McKown Georgia L.
Published: December 2022

The current study examined the impact that the COVID-19 pandemic and resulting restrictions have had on individuals with intellectual and developmental disability. Semi-structured focus groups were conducted to collect data from participants who attended day programming by local community agency. Results indicate that the COVID-19 pandemic and its safety restrictions impacted participants’ knowledge of the disease, programming and work, relationships, activities, and emotions in ways that were both similar to and different from other findings in other populations. Implications of these findings for research and practice are discussed.
The history of GP training
Authors: McConville Kevin
Published: December 2022

It is 70 years since the formation of the RCGP in 1952. Over this time, GP training has been an integral part of our profession’s history, shaping the identity of GP trainers and having a powerful influence on the creation of GPs and our role in the community. Understanding the route to becoming a GP trainer is important in maintaining a line of teachers to support aspiring GPs. This article aims to provide a brief overview of the history of GP training, and also to promote understanding of the pathway to becoming a GP trainer.
Politics of data reuse in machine learning systems: Theorizing reuse entanglements
Authors: Thylstrup Nanna Bonde , Hansen Kristian Bondo , Flyverbom Mikkel , Amoore Louise
Published: December 2022

Policy discussions and corporate strategies on machine learning are increasingly championing data reuse as a key element in digital transformations. These aspirations are often coupled with a focus on responsibility, ethics and transparency, as well as emergent forms of regulation that seek to set demands for corporate conduct and the protection of civic rights. And the Protective measures include methods of traceability and assessments of ‘good’ and ‘bad’ datasets and algorithms that are considered to be traceable, stable and contained. However, these ways of thinking about both technology and ethics obscure a fundamental issue, namely that machine learning systems entangle data, algorithms and more-than-human environments in ways that challenge a well-defined separation. This article investigates the fundamental fallacy of most data reuse strategies as well as their regulation and mitigation strategies that data can somehow be followed, contained and controlled in machine learning processes. Instead, the article argues that we need to understand the reuse of data as an inherently entangled phenomenon. To examine this tension between the discursive regimes and the realities of data reuse, we advance the notion of reuse entanglements as an analytical lens. The main contribution of the article is the conceptualization of reuse that places entanglements at its core and the articulation of its relevance using empirical illustrations. This is important, we argue, for our understanding of the nature of data and algorithms, for the practical uses of data and algorithms and our attitudes regarding ethics, responsibility and regulation.
The medical profession transformed by artificial intelligence: Qualitative study
Authors: Mosch Lina , Fürstenau Daniel , Brandt Jenny , Wagnitz Jasper , Klopfenstein Sophie AI , Poncette Akira-Sebastian , Balzer Felix
Published: December 2022

Background

Healthcare delivery will change through the increasing use of artificial intelligence (AI). Physicians are likely to be among the professions most affected, though to what extent is not yet clear.

Objective

We analyzed physicians’ and AI experts’ stances towards AI-induced changes. This concerned (1) physicians’ tasks, (2) job replacement risk, and (3) implications for the ways of working, including human–AI interaction, changes in job profiles, and hierarchical and cross-professional collaboration patterns.

Methods

We adopted an exploratory, qualitative research approach, using semi-structured interviews with 24 experts in the fields of AI and medicine, medical informatics, digital medicine, and medical education and training. Thematic analysis of the interview transcripts was performed.

Results

Specialized tasks currently performed by physicians in all areas of medicine would likely be taken over by AI, including bureaucratic tasks, clinical decision support, and research. However, the concern that physicians will be replaced by an AI system is unfounded, according to experts; AI systems today would be designed only for a specific use case and could not replace the human factor in the patient–physician relationship. Nevertheless, the job profile and professional role of physicians would be transformed as a result of new forms of human–AI collaboration and shifts to higher-value activities. AI could spur novel, more interprofessional teams in medical practice and research and, eventually, democratization and de-hierarchization.

Conclusions

The study highlights changes in job profiles of physicians and outlines demands for new categories of medical professionals considering AI-induced changes of work. Physicians should redefine their self-image and assume more responsibility in the age of AI-supported medicine. There is a need for the development of scenarios and concepts for future job profiles in the health professions as well as their education and training.
Insights from Social Media on the Patient Experience of Living With Rare Eosinophil-Driven Diseases
Authors: Strobel Mary Jo , Alves Debbie , Roufosse Florence , Antoun Zeina , Kwon Namhee , Baylis Lee , Wechsler Michael E
Published: December 2022

Eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES) are driven by persistently high eosinophil numbers, causing damage to tissues and organs. As rare diseases, they are often underappreciated by healthcare professionals. Using a social listening analysis, we collected patient and caregiver comments relating to EGPA and HES made on online social platforms between 1 January 2019 and 31 May 2020, in English, French, and German. Results were classified into key areas of interest. In total, 746 comments with consent to publish were collected mentioning EGPA, and 39 were identified mentioning HES. The most common theme was sharing of personal experiences (EGPA: 77%; HES: 100%). Diagnosis, including diagnosis delays and misdiagnosis, was mentioned in 33% of comments for EGPA, and 82% for HES. Other common themes included seeking and giving advice, symptoms, and treatments. These insights highlight the views and unmet needs of people living with EGPA and HES. Further work should improve disease awareness and effective communications among healthcare professionals and patients with these conditions.
Translocation capacity of some heavy metals in aquatic food chain of crude oil impacted community of Imiringi in Bayelsa state, Nigeria
Authors: Agoro Eni-yimini S , Ikimi Charles G
Published: December 2022

The translocation capacity of metals (Cd, Cr, As, Pb, and Hg) was determined in water and fish, and in the serum and vitreous humor harvested from New Zealand White (albino) rabbits fed with the processed fish. The sample size comprised 12 male rabbits divided equally into control and experimental groups. Both groups were fed with normal rabbit meal void of detectable metals for 3 months. Only animals grouped under the experimental group were fed fish meal harvested from River Imiringi, Bayelsa State, Nigeria. The metals of interest were estimated using Atomic Absorption Spectroscopy. Similarly, the choice statistical tool was the student t-test analyzed on SPSS version 18–22. The findings revealed that the studied heavy metal concentrations were higher in water and fish sourced from River Imiringi when compared with the World Health Organization’s minimum permissible limits. In the same vein, concentrations of cadmium, chromium, and total arsenic were significantly higher, whereas mercury was lower in fish when compared to that in the water. In addition, vitreous cadmium and lead concentrations were higher in the experimental group when compared with the control group, whereas vitreous chromium was lower. Furthermore, serum cadmium and chromium concentration comparisons were similar to that in the vitreous. The findings are indicative of the translocation capacity of metals from water to fish and then to serum and vitreous humor of rabbits. The increase in metal concentrations and their translocation capacity are potential risks to inhabitants of Imiringi that depends heavily on the river water resources.
Social attention during object engagement: toward a cross-species measure of preferential social orienting
Authors: Weichselbaum Claire , Hendrix Nicole , Albright Jordan , Dougherty Joseph D. , Botteron Kelly N. , Constantino John N. , Marrus Natasha
Published: December 2022

Background

A central challenge in preclinical research investigating the biology of autism spectrum disorder (ASD) is the translation of ASD-related social phenotypes across humans and animal models. Social orienting, an observable, evolutionarily conserved behavior, represents a promising cross-species ASD phenotype given that disrupted social orienting is an early-emerging ASD feature with evidence for predicting familial recurrence. Here, we adapt a competing-stimulus social orienting task from domesticated dogs to naturalistic play behavior in human toddlers and test whether this approach indexes decreased social orienting in ASD.

Methods

Play behavior was coded from the Autism Diagnostic Observation Schedule (ADOS) in two samples of toddlers, each with and without ASD. Sample 1 (n = 16) consisted of community-ascertained research participants, while Sample 2 involved a prospective study of infants at a high or low familial liability for ASD (n = 67). Coding quantified the child’s looks towards the experimenter and caregiver, a social stimulus, while playing with high-interest toys, a non-social stimulus. A competing-stimulus measure of “Social Attention During Object Engagement” (SADOE) was calculated by dividing the number of social looks by total time spent playing with toys. SADOE was compared based on ASD diagnosis and differing familial liability for ASD.

Results

In both samples, toddlers with ASD exhibited significantly lower SADOE compared to toddlers without ASD, with large effect sizes (Hedges’ g ≥ 0.92) driven by a lower frequency of child-initiated spontaneous looks. Among toddlers at high familial likelihood of ASD, toddlers with ASD showed lower SADOE than toddlers without ASD, while SADOE did not differ based on presence or absence of familial ASD risk alone. SADOE correlated negatively with ADOS social affect calibrated severity scores and positively with the Communication and Symbolic Behavior Scales social subscale. In a binary logistic regression model, SADOE alone correctly classified 74.1% of cases, which rose to 85.2% when combined with cognitive development.

Conclusions

This work suggests that a brief behavioral measure pitting a high-interest nonsocial stimulus against the innate draw of social partners can serve as a feasible cross-species measure of social orienting, with implications for genetically informative behavioral phenotyping of social deficits in ASD and other neurodevelopmental disorders.
Development of an image classification pipeline for atherosclerotic plaques assessment using supervised machine learning
Authors: Kunchur Natasha N. , Mostaço-Guidolin Leila B.
Published: December 2022

Background

During atherosclerosis, the narrowing of the arterial lumen is observed through the accumulation of bio compounds and the formation of plaque within artery walls. A non-linear optical imaging modality (NLOM), coherent anti-stokes Raman scattering (CARS) microscopy, can be used to image lipid-rich structures commonly found in atherosclerotic plaques. By matching the lipid’s molecular vibrational frequencies (CH bonds), it is possible to map the accumulation of lipid-rich structures without the need for exogenous labelling and/or processing of the samples. CARS allows for the visualization of the morphological features of plaque. In combination with supervised machine learning, CARS imaged morphological features can be used to characterize the progression of atherosclerotic plaques. 

Results

Based on a set of label-free CARS images of atherosclerotic plaques (i.e. foam cell clusters) from a Watanabe heritable hyperlipidemic rabbit model, we developed an automated pipeline to classify atherosclerotic lesions based on their major morphological features. Our method uses image preprocessing to first improve the quality of the CARS-imaged plaque, followed by the segmentation of the plaque using Otsu thresholding, marker-controlled watershed, K-means segmentation and a novel independent foam cell thresholding segmentation. To define relevant morphological features, 27 quantitative features were extracted and further refined by a novel coefficient of variation feature refinement method in accordance with filter-type feature selection. Refined morphological features were supplied into three supervised machine learning algorithms; K-nearest neighbour, support vector machine and decision tree classifier. The classification pipeline showcased the ability to exploit relevant plaque morphological features to accurately classify 3 pre-defined stages of atherosclerosis: early fatty streak development (EFS) and advancing atheroma (AA) with a greater than 85% class accuracy

Conclusions

Through the combination of CARS microscopy and computational methods, a powerful classification tool was developed to identify the progression of atherosclerotic plaque in an automated manner. Using a curated dataset, the classification pipeline demonstrated the ability to differentiate between EFS, EF and AA. Thus, presenting the opportunity to classify the onset of atherosclerosis at an earlier stage of development
eSMC: a statistical model to infer admixture events from individual genomics data
Authors: Wang Yonghui , Zhao Zicheng , Miao Xinyao , Wang Yinan , Qian Xiaobo , Chen Lingxi , Wang Changfa , Li Shuaicheng
Published: December 2022

Background

Inferring historical population admixture events yield essential insights in understanding a species demographic history. Methods are available to infer admixture events in demographic history with extant genetic data from multiple sources. Due to the deficiency in ancient population genetic data, there lacks a method for admixture inference from a single source. Pairwise Sequentially Markovian Coalescent (PSMC) estimates the historical effective population size from lineage genomes of a single individual, based on the distribution of the most recent common ancestor between the diploid’s alleles. However, PSMC does not infer the admixture event.

Results

Here, we proposed eSMC, an extended PSMC model for admixture inference from a single source. We evaluated our model’s performance on both in silico data and real data. We simulated population admixture events at an admixture time range from 5 kya to 100 kya (5 years/generation) with population admix ratio at 1:1, 2:1, 3:1, and 4:1, respectively. The root means the square error is $$\pm 7.61$$

±
7.61

kya for all experiments. Then we implemented our method to infer the historical admixture events in human, donkey and goat populations. The estimated admixture time for both Han and Tibetan individuals range from 60 kya to 80 kya (25 years/generation), while the estimated admixture time for the domesticated donkeys and the goats ranged from 40 kya to 60 kya (8 years/generation) and 40 kya to 100 kya (6 years/generation), respectively. The estimated admixture times were concordance to the time that domestication occurred in human history.

Conclusion

Our eSMC effectively infers the time of the most recent admixture event in history from a single individual’s genomics data. The source code of eSMC is hosted at https://github.com/zachary-zzc/eSMC.
Transcriptome analysis of gene expression profiling from the deep sea in situ to the laboratory for the cold seep mussel Gigantidas haimaensis
Authors: Zhang Hua , Yao Gaoyou , He Maoxian
Published: December 2022

Background

The deep-sea mussel Gigantidas haimaensis is a representative species from the Haima cold seep ecosystem in the South China Sea that establishes endosymbiosis with chemotrophic bacteria. During long-term evolution, G. haimaensis has adapted well to the local environment of cold seeps. Until now, adaptive mechanisms responding to environmental stresses have remained poorly understood.

Results

In this study, transcriptomic analysis was performed for muscle tissue of G. haimaensis in the in situ environment (MH) and laboratory environment for 0 h (M0), 3 h (M3) and 9 h (M9), and 187,368 transcript sequences and 22,924 annotated differentially expressed genes (DEGs) were generated. Based on Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, these DEGs were enriched with a broad spectrum of biological processes and pathways, including those associated with antioxidants, apoptosis, chaperones, immunity and metabolism. Among these significantly enriched pathways, protein processing in the endoplasmic reticulum and metabolism were the most affected metabolic pathways. These results may imply that G. haimaensis struggles to support the life response to environmental change by changing gene expression profiles.

Conclusion

The present study provides a better understanding of the biological responses and survival strategies of the mussel G. haimaensis from deep sea in situ to the laboratory environment.
Comparison of structural variants detected by PacBio-CLR and ONT sequencing in pear
Authors: Liu Yueyuan , Zhang Mingyue , Wang Runze , Li Benping , Jiang Yafei , Sun Manyi , Chang Yaojun , Wu Jun
Published: December 2022

Background

Structural variations (SVs) have recently become a topic of great interest in the area of genetic diversity and trait regulation. As genomic sequencing technologies have rapidly advanced, longer reads have been used to identify SVs at high resolution and with increased accuracy. It is important to choose a suitable sequencing platform and appropriate sequencing depth for SV detection in the pear genome.

Results

In this study, two types of long reads from sequencing platforms, continuous long reads from Pacific Biosciences (PB-CLR) and long reads from Oxford Nanopore Technologies (ONT), were used to comprehensively analyze and compare SVs in the pear genome. The mapping rate of long reads was higher when the program Minimap2 rather than the other three mapping tools (NGMLR, LRA and Winnowmap2) was used. Three SV detection programs (Sniffles_v2, CuteSV, and Nanovar) were compared, and Nanovar had the highest sensitivity in detecting SVs at low sequencing depth (10–15×). A sequencing depth of 15× was suitable for SV detection in the pear genome using Nanovar. SVs detected by Sniffles_v2 and CuteSV with ONT reads had the high overlap with presence/absence variations (PAVs) in the pear cultivars ‘Bartlett’ and ‘Dangshansuli’, both of them with 38% of insertions and 55% of deletions overlapping with PAVs at sequencing depth of 30×. For the ONT sequencing data, over 37,526 SVs spanning ~ 28 Mb were identified by all three software packages for the ‘Bartlett’ and ‘Dangshansuli’ genomes. Those SVs were annotated and combined with transcriptome profiles derived from ‘Bartlett’ and ‘Dangshansuli’ fruit flesh at 60 days after cross-pollination. Several genes related to levels of sugars, acid, stone cells, and aromatic compounds were identified among the SVs. Transcription factors were then predicted among those genes, and results included bHLH, ERF, and MYB genes.

Conclusion

SV detection is of great significance in exploring phenotypic differences between pear varieties. Our study provides a framework for assessment of different SV software packages and sequencing platforms that can be applied in other plant genome studies. Based on these analyses, ONT sequencing data was determined to be more suitable than PB-CLR for SV detection in the pear genome. This analysis model will facilitate screening of genes related to agronomic traits in other crops.
Procalcitonin to reduce exposure to antibiotics and individualise treatment in hospitalised old patients with pneumonia: a randomised study
Authors: Gavazzi Gaëtan , Drevet Sabine , Debray Matthieu , Bosson Jean Luc , Tidadini Fatah , Paccalin Marc , de Wazieres Benoit , Celarier Thomas , Bonnefoy Marc , Vitrat Virginie
Published: December 2022

Background

Treating pneumonia in old patients remains challenging for clinicians. Moreover, bacterial antimicrobial resistance is a major public health threat.

Objective

The PROPAGE study evaluated the interest of a strategy using serial measurements of procalcitonin (PCT) to reduce the duration of antibiotic therapy in old patients with pneumonia.

Methods

PROPAGE took place from Dec.-2013 to Jun.-2016 in eight French geriatric units. It was a prospective, comparative, randomised, open-label study involving old patients (≥ 80 years) who had initiated antibiotic treatment for pneumonia in the previous 48 h. PCT was monitored in all patients and two decision-making PCT-based algorithms guided antibiotic therapy in patients from the PCT group.

Results

107 patients were randomised (PCT, n = 50; Control, n = 57). Antibiotic therapy exposure was reduced in the PCT group as compared to the Control group (median duration of antibiotic therapy, 8 vs. 10 days [rank-test, p = 0.001]; antibiotic persistence rates on Days 6 and 8, 54% and 44% vs. 91% and 72%) and no significant difference was found in recovery rate (84% vs. 89.5%; Pearson Chi² test, p = 0.402).

Conclusion

Although, the superiority of the strategy was not tested using a composite criterion combining antibiotic therapy duration and recovery rate was not tested due to the small sample size, the present study showed that monitoring associated with PCT-guided algorithm could help shorten antibiotic treatment duration in the very old patients without detrimental effects. Measuring PCT levels between Day 4 and Day 6 could be helpful when making the decision regarding antibiotic discontinuation.

Trial registration

NCT02173613. This study was first registered on 25/06/2014.
Impact of molecular diagnostic tests on diagnostic and treatment delays in tuberculosis: a systematic review and meta-analysis
Authors: Lee Jae Hyoung , Garg Tushar , Lee Jungsil , McGrath Sean , Rosman Lori , Schumacher Samuel G. , Benedetti Andrea , Qin Zhi Zhen , Gore Genevieve , Pai Madhukar , Sohn Hojoon
Published: December 2022

Background

Countries with high TB burden have expanded access to molecular diagnostic tests. However, their impact on reducing delays in TB diagnosis and treatment has not been assessed. Our primary aim was to summarize the quantitative evidence on the impact of nucleic acid amplification tests (NAAT) on diagnostic and treatment delays compared to that of the standard of care for drug-sensitive and drug-resistant tuberculosis (DS-TB and DR-TB).

Methods

We searched MEDLINE, EMBASE, Web of Science, and the Global Health databases (from their inception to October 12, 2020) and extracted time delay data for each test. We then analysed the diagnostic and treatment initiation delay separately for DS-TB and DR-TB by comparing smear vs Xpert for DS-TB and culture drug sensitivity testing (DST) vs line probe assay (LPA) for DR-TB. We conducted random effects meta-analyses of differences of the medians to quantify the difference in diagnostic and treatment initiation delay, and we investigated heterogeneity in effect estimates based on the period the test was used in, empiric treatment rate, HIV prevalence, healthcare level, and study design. We also evaluated methodological differences in assessing time delays.

Results

A total of 45 studies were included in this review (DS = 26; DR = 20). We found considerable heterogeneity in the definition and reporting of time delays across the studies. For DS-TB, the use of Xpert reduced diagnostic delay by 1.79 days (95% CI − 0.27 to 3.85) and treatment initiation delay by 2.55 days (95% CI 0.54–4.56) in comparison to sputum microscopy. For DR-TB, use of LPAs reduced diagnostic delay by 40.09 days (95% CI 26.82–53.37) and treatment initiation delay by 45.32 days (95% CI 30.27–60.37) in comparison to any culture DST methods.

Conclusions

Our findings indicate that the use of World Health Organization recommended diagnostics for TB reduced delays in diagnosing and initiating TB treatment. Future studies evaluating performance and impact of diagnostics should consider reporting time delay estimates based on the standardized reporting framework.
Berlin Registry of Neuroimmunological entities (BERLimmun): protocol of a prospective observational study
Authors: Sperber Pia S. , Brandt Alexander U. , Zimmermann Hanna G. , Bahr Lina S. , Chien Claudia , Rekers Sophia , Mähler Anja , Böttcher Chotima , Asseyer Susanna , Duchow Ankelien Solveig , Bellmann-Strobl Judith , Ruprecht Klemens , Paul Friedemann , Schmitz-Hübsch Tanja
Published: December 2022

Background

Large-scale disease overarching longitudinal data are rare in the field of neuroimmunology. However, such data could aid early disease stratification, understanding disease etiology and ultimately improve treatment decisions. The Berlin Registry of Neuroimmunological Entities (BERLimmun) is a longitudinal prospective observational study, which aims to identify diagnostic, disease activity and prognostic markers and to elucidate the underlying pathobiology of neuroimmunological diseases.

Methods

BERLimmun is a single-center prospective observational study of planned 650 patients with neuroimmunological disease entity (e.g. but not confined to: multiple sclerosis, isolated syndromes, neuromyelitis optica spectrum disorders) and 85 healthy participants with 15 years of follow-up. The protocol comprises annual in-person visits with multimodal standardized assessments of medical history, rater-based disability staging, patient-report of lifestyle, diet, general health and disease specific symptoms, tests of motor, cognitive and visual functions, structural imaging of the neuroaxis and retina and extensive sampling of biological specimen.

Discussion

The BERLimmun database allows to investigate multiple key aspects of neuroimmunological diseases, such as immunological differences between diagnoses or compared to healthy participants, interrelations between findings of functional impairment and structural change, trajectories of change for different biomarkers over time and, importantly, to study determinants of the long-term disease course. BERLimmun opens an opportunity to a better understanding and distinction of neuroimmunological diseases.
Infant feeding practice and gastrointestinal tolerance: a real-world, multi-country, cross-sectional observational study
Authors:   Happy Tummy Consortium, Jalaludin M. Y. , Taher S. W. B. , Kiau H. B. , Hashim S. B. , Yusof M. B. , Khew L. W. , Juffrie M. , Bardosono Saptawati , Galindez G. , Waheed K. A. I. , Gokhale P. , Ibrahim M. N. , Asghar R. , Shirazi H. , Perez M. L. M. , Kesavelu D. , Edris A. , Beleidy A. El , Hodhod M. El , Elzalabany M. , Hussein H. , Shaaban S. Y. , Elmashad A. , Abdelmoez A. , El-Asheer O. M. , Vandenplas Y. , Lavalle Luca , Sauvageot Nicolas , Cercamondi Colin Ivano , Egli Delphine , Jankovic Ivana , Vandenplas Yvan
Published: December 2022

Background

Signs of feeding intolerance, such as gastrointestinal (GI) symptoms, are frequently observed in otherwise healthy formula-fed infants in the first months of life. The primary objective of this observational study was to examine GI tolerance in formula-fed infants (FFI) vs. breastfed infants (BFI) in a real-world setting with a secondary objective being the comparison of infants fed formula with pre- and/or probiotics (FFI_PP) and those fed formula without any pre- and/or probiotics (FFI_noPP) as well as BFI.

Methods

A six-country, cross-sectional study in full-term exclusively/predominantly FFI (n = 2036) and BFI (n = 760) aged 6–16 weeks was conducted using the validated Infant Gastrointestinal Symptom Questionnaire (IGSQ) and a Feeding Practice and Gut Comfort Questionnaire.

Results

The IGSQ composite score in FFI was non-inferior compared to BFI (mean difference [95%CI]: 0.17 [-0.34, 0.67]; non-inferiority p-value < 0.0001) and scores for BFI and FFI were below the threshold of 23, indicating no GI discomfort. Adjusted mean IGSQ scores ± SE were similar in FFI_PP (22.1 ± 0.2) and BFI (22.3 ± 0.3) while FFI_noPP (23.4 ± 0.3) was significantly higher and above 23 indicating some GI discomfort (mean differences [95%CI] FFI_noPP minus FFI_PP and FFI_noPP minus BFI were 1.28 [0.57, 1.98] and 1.09 [0.38, 1.80], respectively; both p < 0.01). Hard stools and difficulty in passing stool were more common in FFI compared to BFI (p < 0.01) but were less common in FFI_PP compared to FFI_noPP (p < 0.01). FFI_PP showed significantly less crying than FFI_noPP and was similar to BFI. Significantly fewer physician-confirmed colic episodes (Rome IV criteria) were reported in FFI_PP compared with FFI_noPP or BFI.

Conclusions

In this real-world observational study, FFI had non-inferior overall GI tolerance compared to BFI. Within FFI, infants receiving formulas with pre- and/or probiotics had a better GI tolerance, improved stooling and less infantile colic compared to those receiving formula without any pre- and/or probiotics and were more similar to BFI.

Trial registration

NCT03703583, 12/10/2018 (https://clinicaltrials.gov/ct2/show/NCT03703583).
Exploration of inter-jurisdictional TB programming and mobility in a Canadian First Nation community
Authors: Heendeniya Vidanaral Apeksha , Long Richard , Heffernan Courtney , Abonyi Sylvia , Clarke Sherry , Hackett Paul
Published: December 2022

Background

Colonially imposed jurisdictional boundaries that have little meaning to Indigenous peoples in Canada may confound tuberculosis (TB) prevention and care activities. This study explores how inter-jurisdictional mobility and the current accommodation of mobility through policies and programming sustain a regional TB epidemic in northwestern Saskatchewan, and northeastern Alberta.

Methods

A qualitative instrumental case study was performed using a community based participatory approach. Semi-structured interviews were conducted with First Nations peoples from a high-incidence community in Canada including community-based healthcare workers. These interview data are presented in the context of a multi-level document analysis of TB program guidelines.

Results

The location of the community, and related lack of access to employment, services and care, necessitates mobility across jurisdictional boundaries. There are currently no formal federal or provincial guidelines in place to accommodate highly mobile patients and clients within and across provincial TB prevention and care programs. As a result, locally developed community-based protocols, and related ad-hoc strategies ensure continuity of care.

Conclusion

Indigenous peoples living in remote communities face unique push/pull factors that motivate mobility. When these motivations exist in communities with increased risk of contagion by communicable infectious diseases such as TB, public health risks extend into increasingly large areas with competing jurisdictional authority. Such mobility poses several threats to TB elimination. We have identified a gap in TB services to systematically accommodate mobility, with specific implications for Indigenous peoples and reconciliation. We recommend clearly defined communication paths and inter-jurisdictional coordination to ensure maintenance of care for mobile populations.
Inequality in prevalence, awareness, treatment, and control of hypertension in Iran: the analysis of national households’ data
Authors: Mahdavi Mahdi , Parsaeian Mahboubeh , Farzadfar Farshad , Mohamadi Efat , Olyaeemanesh Alireza , Takian Amirhossein
Published: December 2022

Background

Providing an equitable Universal Health Coverage (UHC) is key for progressing towards the sustainable development goals in the health systems. To help policymakers make hypertension services more equitable with existing (limited) resources in Iran, we examined the inequality of the prevalence, awareness, treatment, and control (PATC) of hypertension as the four indicators of hypertension UHC in Iran. 

Methods

This research was a cross-sectional study of inequality of PATC of hypertension using a representative sample of Iranians aged ≥ 25 years from the Iran 2016 STEP wise approach to Surveillance study (STEPS). Outcome variables consisted of PATC of hypertension. Covariates were demographic (age, sex, and marital status) and living standard (area of residence, wealth status, education, and health insurance) indicators. We drew concentration curves (CC) and estimated concentration indices (C). We also conducted normalized Erreygers decomposition analysis for binary outcomes to identify covariates that explain the wealth-related inequality in the outcomes. Analysis was conducted in STATA 14.1.

Results

The normalized concentration index of hypertension prevalence and control was -0.066 (p < .001) and 0.082 (p < .001), respectively. The C of awareness and treatment showed nonsignificant difference between the richest and poorest. Inequality in the hypertension prevalence of females was significantly higher than males (C = -0.103 vs. male C = -0.023, p < .001). Our analyses explained 33% of variation in the C of hypertension prevalence and 99.7% of variation in the C of control. Education, wealth index, and complementary insurance explained most inequality in the prevalence. Area of residence, education, wealth status, and complementary insurance had the largest contribution to C of control by 30%, 28%, 26%, and 21%, respectively.

Conclusions

This study showed a pro-rich inequality in the prevalence and control of hypertension in Iran. We call for expanding the coverage of complementary insurance to reduce inequality of hypertension prevalence and control as compared with other factors it can be manipulated in short run. We furthermore advocate for interventions to reduce the inequality of hypertension control between rural and urban areas.
Multilevel analysis of individual- and community-level determinants of birth certification of children under-5 years in Nigeria: evidence from a household survey
Authors: Anaduaka Uchechi Shirley
Published: December 2022

Promoting birth certification is central to achieving legal identity for all - target 16.9 of the 2030 Sustainable Development Goals. Nigeria is not on track to achieve this goal with its low coverage of birth certification (BC). This study is aimed at identifying patterns of BC and its associated individual- and community-level factors, using pooled cross-sectional data from three rounds (2008, 2013, and 2018) of the nationally representative Nigerian Demographic and Health Survey. A weighted sample of 66,630 children aged 0–4 years was included, and a two-level multilevel logistic model which accommodates the hierarchical nature of the data was employed. Of the total sample, 17.1% [95% CI: 16.3–17.9] were reported to be certified. Zamfara state (2.3, 95% CI: 0.93–3.73) and the Federal Capital Territory (36.24, 95% CI: 31.16–41.31) reported the lowest and the highest BC rates. Children with an SBA [AOR = 1.283, 95% CI: 1.164–1.413] and with at least one vaccination [AOR = 1.494, 95% CI: 1.328–1.681] had higher odds of BC. The AOR for mothers with at least one prenatal visit was 1.468 [95% CI: 1.271–1.695], and those aged 30–34 years at the time of birth [AOR = 1.479, 95% CI: 1.236–1.772] had the highest odds. Further, the odds of BC increased the most for mothers [AOR = 1.559, 95% CI: 1.329–1.829] and fathers [AOR = 1.394, 95% CI: 1.211–1.605] who were tertiary-educated. In addition, children in middle-income [AOR = 1.430, 95% CI: 1.197–1.707] or rich wealth HHs [AOR = 1.776, 95% CI: 1.455–2.169] or those whose families had bank accounts [AOR = 1.315, 95% CI: 1.187–1.456] had higher odds. Living in non-poor and within close proximity to a registration center (RC) act as protective factors for BC, while living in poor communities [AOR = 0.613, 95% CI: 0.486–0.774] and more than 10kms from an RC reduce the odds of BC [AOR = 0.466, 95% CI: 0.377–0.576]. The study identified several protective and risk factors which policymakers can adopt as strategic areas for universal birth certification. National and sub-national programs should integrate non-formal institutions as well as target child and maternal utilization of healthcare services to promote BC in Nigeria.