bluuebunny/crossref_metadata_2025 huggingface dataset:
Proportional Recovery After Stroke: Addressing Concerns Regarding Mathematical Coupling and Ceiling Effects
Authors: Chong Benjamin , Wang Alan , Stinear Cathy M.
Published: June 2023

Baseline scores after stroke have long been known as a good predictor of post-stroke outcomes. Similarly, the extent of baseline impairment has been shown to strongly correlate with spontaneous recovery in the first 3 to 6 months after stroke, a principle known as proportional recovery. However, recent critiques have proposed that proportional recovery is confounded, most notably by mathematical coupling and ceiling effects, and that it may not be a valid model for post-stroke recovery. This article reviews the current understanding of proportional recovery after stroke, discusses its supposed confounds of mathematical coupling and ceiling effects, and comments on the validity and usefulness of proportional recovery as a model for post-stroke recovery. We demonstrate that mathematical coupling of the true measurement value is not a real statistical confound, but rather a notational construct that has no effect on the correlation itself. On the other hand, mathematical coupling does apply to the measurement error and can spuriously amplify correlation effect sizes, but should be negligible in most cases. We also explain that compression toward ceiling and the corresponding proportional recovery relationship are consistent with our understanding of post-stroke recovery dynamics, rather than being unwanted confounds. However, while proportional recovery is valid, it is not particularly groundbreaking or meaningful as previously thought, just like how correlations between baseline scores and outcomes are relatively common in stroke research. Whether through proportional recovery or baseline-outcome regression, baseline scores are a starting point for investigating factors that determine recovery and outcomes after stroke.
Improving Mental Health Help-Seeking Among Male University Students: A Series of Gender-Sensitive Mental Health Feasibility Interventions
Authors: Sagar-Ouriaghli Ilyas , Godfrey Emma , Tailor Vinay , Brown June S. L.
Published: June 2023

One-third of students experience a mental health condition associated with decreased academic functioning and increased risk of dropping out. While mental health difficulties are lower among male students, they are twice as likely to die by suicide. Although the importance of gender-sensitive interventions for male students has been emphasized, feasible and effective approaches are unexplored. This investigation conducted three gender-sensitive feasibility interventions for male students to evaluate acceptability, changes to help-seeking and mental health outcomes. Three interventions were delivered to 24 male students. The interventions included the following: Intervention 1—a formal intervention targeting male students, Intervention 2—a formal intervention that adopted gender-sensitive language and promoted positive masculine traits, and Intervention 3—an informal drop-in offering a social space providing health information. These were evaluated for acceptability, attitudes to help-seeking, and mental health outcomes. All interventions were equally acceptable. The informal drop-in was more acceptable, having better engagement from male students who have greater conformity to maladaptive masculine traits, more negative attitudes to help-seeking, higher levels of self-stigma, who were less likely to have used mental health support before and belonged to an ethnic minority. These findings indicate differences in acceptability, particularly uptake, for hard-to-engage male students. Informal strategies help reach male students who would otherwise not engage with mental health support, familiarize them with help-seeking, and connect them with pre-existing mental health interventions. More work needs to be carried out using larger samples to investigate the efficacy of informal interventions to engage male students.
A Comparative Study of 2-Corner, 3-Corner, and 4-Corner Arthrodesis for Midcarpal Arthritis
Authors: Ring Justine , Clark Tod A. , Giuffre Jennifer L.
Published: June 2023

Background:

Four-corner fusion (4CF) is a common treatment for midcarpal arthritis; however, alternatives including 2-corner fusion (2CF) and 3-corner fusion (3CF) have been described. Limited literature suggests 2CF and 3CF may improve range of motion but have higher complication rates. Our objective is to compare function and patient-reported outcomes following 4CF, 3CF, and 2CF at our institution.

Methods:

Adult patients undergoing 4CF, 3CF, and 2CF from 2011 to 2021 who attended at least one follow-up were included. Four-corner fusion patients were compared with those who underwent either 3CF or 2CF using staple fixation. Outcomes include nonunion rate, reoperation rate, progression to wrist fusion, range of motion, and patient-reported pain, satisfaction, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores.

Results:

A total of 58 patients met inclusion criteria. There were 49 4CF and 9 2CF or 3CF patients. Nonunion rates, progression to wrist fusion, and repeat surgery for any indication were not significantly different among groups. Range of motion (flexion-extension, radial-ulnar deviation) and grip strength at postoperative visits were not significantly different. Significantly more 4CF patients required bone grafting. Pain, overall satisfaction, and DASH scores were similar.

Conclusions:

Although prior studies suggest increased risk of nonunion and hardware migration after 2CF/3CF, we did not observe higher complication rates compared with 4CF. Range of motion, strength, and patient-reported outcomes were similar. While 4CF is traditionally the procedure of choice for midcarpal fusion, we found that when using a staple fixation technique, 2CF and 3CF have comparable clinical and patient-reported outcomes yet decrease the need for autologous bone grafting.
Risk Factors for Secondary Revision After Finger Amputations
Authors: Adapa Nikhil , Adkins Zachary B. , Hidden Krystin A. , Goyal Kanu S.
Published: June 2023

Background:

Digit amputations are relatively simple and are often performed in the setting of trauma or infection. However, it is not uncommon for digit amputations to undergo secondary revision due to complications or patient dissatisfaction. Identifying factors associated with secondary revision may alter treatment strategy. We hypothesize that the secondary revision rate is affected by digit, initial level of amputation, and comorbidities.

Methods:

A retrospective chart review was conducted on patients undergoing digit amputations in operating rooms at our institution from 2011 to 2017. Secondary revision amputations were defined as a separate return to the operating room following initial surgical amputation, excluding emergency room amputations. Patient demographics, comorbidities, level of amputation, and complications were collected.

Results:

In all, 278 patients were included with a total of 386 digit amputations and mean follow-up of 2.6 months. Three hundred twenty-six primary digit amputations were performed in 236 patients (group A). Sixty digits were secondarily revised in 42 patients (group B). The secondary revision rate was 17.8% for patients and 15.5% for digits. Patients with heart disease and diabetes mellitus were associated with secondary revision, with wound complications being the leading indication overall (73.8%). Medicare covered 52.4% of patients in group B versus 30.1% in group A ( P = .005).

Conclusion:

Risk factors for secondary revision include Medicare insurance, comorbidities, previous digit amputations, and initial amputation of either the index finger or the distal phalanx. These data may serve as a prediction model to aid surgical decision-making by identifying patients at risk of secondary revision amputation.
Decision Criteria for the Ethically Reflected Choice of a Member Check Method in Qualitative Research: A Proposal for Discussion
Authors: Erdmann Anke , Potthoff Sarah
Published: June 2023

Methodologists recommend member checking (MC) to increase the credibility of results from qualitative studies. In this procedure, the researcher’s categories, hypotheses and interpretations can be verified or corrected by respondents, and the latter can add information. Various methods are available for conducting this procedure. However, in addition to methodological issues, MC also raises ethical questions. In this article, we investigate which member check method (MCM) is most appropriate for a particular study from an ethical perspective. Based on a literature review about ethical issues in different MCMs and ethical principles contained in guidelines for research ethics, we develop seven decision criteria that can facilitate an ethically reflected decision for a particular MCM. Accordingly, we consider the principles of beneficence, justice, scientific quality, informed consent and avoiding harm, which are widely accepted in research ethics. In addition, we recommend that participants’ wishes and concerns regarding the MC be inquired about and considered.
Study on chatter suppression in ultrasonic-assisted grinding of thin-walled workpiece of SiCp/Al composites
Authors: Dong Xiao-Wei , Li Zhen-Ao , Bian Lei , Wang Ming , Jin Zhong-Bo , Li Qing-Da
Published: June 2023

To suppress chatter is very important for ensuring processing quality and efficiency in ultrasonic-assisted grinding of thin-walled workpiece of SiCp/Al composites. Based on the chatter mechanism analysis, a stability analysis model is built and the analytical method is proposed. The cutting parameters can be selected reasonably based on the lobe diagram of stability, and the experiments were conducted using the parameters of selected points on lobe diagram. The experimental results show that the cutting force and surface roughness of unstable points are much larger than that of stable points, the vibration marks appear on the workpiece surface with unstable machining, and the surface quality is better in stable machining, which indicate that the chatter could be suppressed by this method to guarantee machining quality and efficiency.
Perspectives of adolescents with neurofibromatosis 1 and cutaneous neurofibromas: Implications for clinical trials
Authors: Cannon Ashley , Sarin Kavita Y , Petersen Andrea K , Pichard Dominique C , Wolters Pamela L , Erickson Gregg , Lessing Andrés J , Li Peng , Röhl Claas , Rosser Tena , Widemann Brigitte C , Blakeley Jaishri O , Plotkin Scott R
Published: June 2023

Background/Aims

More than 99% of individuals with neurofibromatosis 1 develop cutaneous neurofibromas, benign nerve sheath tumors that manifest as nodules on the skin. These cutaneous neurofibromas emerge with age, appearing most commonly in adolescence. Nevertheless, few data have been published on how adolescents with neurofibromatosis 1 feel about cutaneous neurofibromas. The purpose of this study was to assess the perspectives of adolescents with neurofibromatosis 1 and their caregivers regarding cutaneous neurofibroma morbidity, treatment options, and acceptable risks-benefits of treatment.

Methods

An online survey was distributed through the world’s largest NF registry. Eligibility criteria included self-reported neurofibromatosis 1 diagnosis, adolescent child ages 12–17 years, ≥1 cutaneous neurofibroma, and ability to read English. The survey was designed to collect details about the adolescent’s cutaneous neurofibromas, views on morbidity related to cutaneous neurofibromas, social and emotional impact of cutaneous neurofibromas, communication regarding cutaneous neurofibromas, and views regarding current and potential future cutaneous neurofibroma treatment.

Results

Survey respondents included 28 adolescents and 32 caregivers. Adolescents reported having several negative feelings about cutaneous neurofibromas, particularly feeling worried about the potential progression of their cutaneous neurofibromas (50%). Pruritus (34%), location (34%), appearance (31%), and number (31%) were the most bothersome cutaneous neurofibroma features. Topical medication (77%–96%), followed by oral medication (54%–93%), was the most preferred treatment modality. Adolescents and caregivers most often replied that cutaneous neurofibroma treatment should be initiated when cutaneous neurofibromas become bothersome. The majority of respondents were willing to treat cutaneous neurofibromas for at least 1 year (64%–75%). Adolescent and caregivers were least willing to risk pain (72%–78%) and nausea/vomiting (59%–81%) as a cutaneous neurofibroma treatment side effect.

Conclusions

These data indicate that adolescents with neurofibromatosis 1 are negatively impacted by their cutaneous neurofibromas, and that both adolescents and their caregivers would be willing to try longer-term experimental treatments.
Poor effort on cognitive testing in voluntary research predicts failure in US Army Ranger School: Implications for clinical trial design
Authors: Turner Travis H , Newman Jill C , Marriott Bernadette P
Published: June 2023

Introduction

Failure to provide effortful performance on cognitive testing is not uncommon for participants in clinical trials and can significantly impact sensitivity to treatment effect. Whether poor effort on cognitive testing might relate to other behaviors of interest is unknown. In the current investigation, we examined whether effort on baseline cognitive testing in a randomized controlled trial to enhance resiliency in US Army Officers predicted subsequent success in Ranger school.

Methods

Baseline data on six cognitive tests were obtained from 237 US Army Officers entering a military training program prior to attempting Ranger School. Participation was voluntary and the Army was not informed of test scores. “Poor effort” was defined by chance-level accuracy or extreme outlier scores. Logistic regression examined likelihood of Ranger success according to the number of tests with poor effort.

Results

Overall, 170 (72%) participants provided good effort on all tests. For these participants, 47% were successful in Ranger, versus 32% with poor effort on one test and 14% with poor effort on two tests. Logistic regression analysis found poor effort on baseline testing predicted reduced likelihood of Ranger success, β =−.486, p = .005.

Discussion

A substantial number of participants exhibited poor effort on testing, and poor effort was predictive of failure in Ranger school. Findings highlight the importance of assessing effort in clinical trials involving cognitive outcomes and suggest application of cognitive effort testing in trials where other motivated behavior is targeted.

Registration

Clinical Trials.gov NCT02908932.
The ‘most maligned’ witness in the Christopher Dawson case: Gender, power, media and legal culture in the digitally distributed live-streamed court
Authors: Nelson Camilla
Published: June 2023

This article analyses the cultural construction of gender in a highly mediated, globally publicised Australian murder trial. Using the tools of multimodal socio-linguistic analysis, it interrogates the construction of a key female witness – known by the legal pseudonym ‘JC’ – in the physical, digitally distributed and livestreamed courtroom and subsequently through the media sphere, including in newspapers, magazines, podcasts, television and social media. It surfaces a victimblaming narrative in relation to alleged child sexual abuse that was an underlying theme in pretrial reporting, a central feature of the defence’s courtroom strategy and cross examination, and subsequently a dominant focus of the mainstream media’s trial coverage. It traces the emergence of a counter-discourse on social media largely propelled by contributors self-identifying as young women, and the radical reframing of the media narrative in response to the court’s verdict. The article also contextualises its findings against a background in which media technologies and media logics are dramatically reshaping the court’s practices and procedures in relation to ‘open justice’, as evidenced by the operation of the virtual media gallery and publicly livestreamed verdict. It concludes that the hyper-gendered narratives that framed the case are not new. Instead, media technologies – including the court’s livestream, and the public’s use of interactive media platforms – have brought new visibility to a longstanding socio-cultural problem. In Australia, R v Christopher Michael Dawson has been widely celebrated as a step forward for gender equality and the treatment of domestic and sexual abuse by and in the media and the legal system. This analysis demonstrates that in reality change is marginal and uneven.
War and ‘museum front’ in a digital era: The Ukrainian War Museum during the Russian invasion of Ukraine
Authors: Olzacka Elżbieta
Published: June 2023

Based on the extensive literature on the digital transformation of museums, this article explores how war museums can effectively use online media to fulfil their functions related to remembering, interpreting and debating war. The author focuses primarily on the context of ongoing armed conflict as war museums engage in a struggle, shaping, mobilizing and unifying narrative to support the war effort. The main part of the article is an analysis of the online activities of the Kyiv Museum of the History of Ukraine in the Second World War during the first months of the Russian full-scale invasion of Ukraine. The author analyses the online exhibitions, online projects and content of the official Museum’s Facebook profile in order to explain how the War Museum uses its digital online resources to inform the local population and the international communities about the Russian aggression against Ukraine, and mobilize them to support the war effort.
The analgesic effect of transmuscular quadratus lumborum block versus erector spinae plane block for women undergoing elective Caesarean section: A randomized controlled trial
Authors: Mostafa Maha , Nasr Mohamed A , Fawzy Maher , Awad Aya E , Waheeb Mohsen M
Published: June 2023

Background

We aimed to compare the analgesic effect and quality of recovery of transmuscular quadratus lumborum block (QLB) and erector spinae plane block (ESPB) in the presence of multimodal analgesia following Caesarean section.

Methods

This randomised controlled trial included full-term pregnant women who underwent elective Caesarean section under spinal anaesthesia without intrathecal morphine. The included women were randomised to receive either bilateral QLB ( n = 51) or bilateral thoracic ESPB ( n = 51), in addition to the control group ( n = 51) who did not receive any block. All participants received regular paracetamol (1 g/6h) and diclofenac (50 mg/8 h). Intravenous morphine was used as a rescue analgesic. The primary outcome was time to first morphine requirement. Secondary outcomes included total postoperative morphine consumption and total Obstetric Quality of Recovery-11 (ObsQoR-11) score.

Results

We analysed 51, 50 and 48 patients in the QLB, ESPB and control groups, respectively. The time to first morphine requirement in both QLB and ESPB groups was longer than that in the control group (median [quartiles] time: 6 [6,12] h, 6 [6,6] h and 4 [3,4] h, respectively; p-value <0.001), without significant differences between the two former groups. The total morphine consumption in both QLB and ESPB groups was lower than that in the control group (median [quartiles]:0 [0,5] mg, 0 [0,5] mg and 25 [25,30] mg, respectively; p-value <0.001), without significant differences between the two former groups. The QLB and ESPB groups had comparable ObsQoR-11 score, and both groups’ scores were higher than the control group.

Conclusion

In patients undergoing elective Caesarean section under spinal anaesthesia without intrathecal morphine, both QLB and ESPB provided superior analgesia and quality of recovery compared to the standard care, without significant difference between the two blocks.
A novel simulation model for tube thoracostomy
Authors: Kouyoumjian Sarkis , Velilla Marc-Anthony , Paxton James H.
Published: June 2023

Objective:

Tube thoracostomy is a life-saving procedure that must be performed competently and expeditiously by emergency care providers. The primary objective of this project was to develop a simple, easily-reproducible, and realistic simulation model for tube thoracostomy placement by learners of emergency medicine.

Methods:

This chest tube simulator utilizes two slabs of pork ribs with associated intercostal muscle and fascial planes to aid learners in identifying anatomic landmarks, palpating intercostal spaces, and performing blunt dissection in a manner that approximates human anatomy. Holes are cut on both sides of a 1.8-bushel capacity rectangular plastic clothing hamper, and rib slabs are secured to the hamper with zip ties or metal wire. A bed pillow with plastic cover is then placed inside of the plastic hamper to simulate lung tissue. The rib-hamper complex is then wrapped with cellophane or elastic compression bandages to further anchor the rib slabs and simulate skin and subcutaneous tissues.

Results:

The initial cost of our thoracostomy model is approximately $50, much less than the $1,000–$3,000 cost for a commercial model. Although the hamper and pillow can be reused an indefinite number of times, the other components of our model must be replaced occasionally. Assuming a lifespan of 1,000 uses, our model costs approximately $1.78 per attempt, compared to $4.00 per attempt with the cheapest commercial mannequin system. In fact, assuming a longer useful lifespan for the mannequin does not substantially improve this comparison (e.g. $3.10 versus $1.77 per attempt for a 10,000 attempt lifespan for the commercial mannequin), largely due to the higher cost of commercial replacement skin pads when compared to the components consumed in our model with each attempt.

Conclusions:

We describe a porcine thoracostomy model that simulates the look and feel of human ribs for purposes of tube thoracostomy training, although it could also be used for thoracentesis and thoracotomy simulation. This model is relatively cheap (costing around $50) and easy to produce within a few minutes utilizing commonly-available materials. Further study is needed to determine whether an inexpensive model like ours provides the same educational value as more expensive commercial mannequin models.
Chemotherapy and Immune Checkpoint Inhibitors in a Case of SMARCA4-dUT: A Case Report and Review of Literature
Authors: Pokhrel Akriti , Yadav Ruchi , Manvar Kapil Kumar , Wu Richard , Jaswani Vijay , Wasserman Carrie Brooke , Wang Jen C.
Published: June 2023

SMARCA4-deficient undifferentiated tumors (SMARCA4-dUT) are infrequently occurring aggressive neoplasms found predominantly in young male smokers. These tumors are distinguished by the loss of expression of Brahma-related gene 1 (BRG1) due to a deactivating mutation of SMARCA4. Immunophenotype can be variable but characteristically lack the expression of BRG1. SMARCA4-dUT has a poor prognosis and generally progresses or recurs. The median survival is around 6 months. Here, we report a case of a 36-year-old male smoker who presents with multiple right-sided lung masses. The patient was found to have a loss of SMARAC4 and SMARCA2 along with the absence of markers of vascular, melanocytic, lymphoid, keratin, or myogenic origin. Tumor size was reduced significantly after 3 cycles of carboplatin and 1 cycle of pembrolizumab. From reviewing the literature and the clinical course in our case, we suggest combination chemotherapy plus immune checkpoint inhibitor (ICI) therapy to be the first choice of therapy for treating SMARCA4-dUT of lungs. Further research and studies are needed to evaluate the response to ICI therapy alone or combination therapy (chemotherapy plus ICI).
Complications of Delayed Arterial Injury After a Gun Shot Wound to the Upper Extremity: A Case Study
Authors: Goetsch Jordan J. , Clem Douglas W.
Published: June 2023

Vascular trauma can be a life-threatening event. Various complications can arise when injury to an artery occurs. Thus, early diagnostic imaging may be necessary for emergency treatment. A case study is presented of a delayed arterial injury, after a gunshot wound, involving the right upper extremity. This case demonstrates the importance of continued clinical surveillance and management. Duplex sonography has been shown to have 94% to 97% sensitivity and 82.5% to 98% specificity, regarding vascular injury. This case study describes the use of duplex sonography for the identification and clinical follow-up of multiple arterial injuries that presented 1 month after the initial traumatic incident.
Nfinder: automatic inference of cell neighborhood in 2D and 3D using nuclear markers
Authors: Moretti Bruno , Rodriguez Alvarez Santiago N. , Grecco Hernán E.
Published: June 2023

Background

In tissues and organisms, the coordination of neighboring cells is essential to maintain their properties and functions. Therefore, knowing which cells are adjacent is crucial to understand biological processes that involve physical interactions among them, e.g. cell migration and proliferation. In addition, some signaling pathways, such as Notch or extrinsic apoptosis, are highly dependent on cell–cell communication. While this is straightforward to obtain from membrane images, nuclei labelling is much more ubiquitous for technical reasons. However, there are no automatic and robust methods to find neighboring cells based only on nuclear markers.

Results

In this work, we describe Nfinder, a method to assess the cell’s local neighborhood from images with nuclei labeling. To achieve this goal, we approximate the cell–cell interaction graph by the Delaunay triangulation of nuclei centroids. Then, links are filtered by automatic thresholding in cell–cell distance (pairwise interaction) and the maximum angle that a pair of cells subtends with shared neighbors (non-pairwise interaction). We systematically characterized the detection performance by applying Nfinder to publicly available datasets from Drosophila melanogaster, Tribolium castaneum, Arabidopsis thaliana and C. elegans. In each case, the result of the algorithm was compared to a cell neighbor graph generated by manually annotating the original dataset. On average, our method detected 95% of true neighbors, with only 6% of false discoveries. Remarkably, our findings indicate that taking into account non-pairwise interactions might increase the Positive Predictive Value up to + 11.5%.

Conclusion

Nfinder is the first robust and automatic method for estimating neighboring cells in 2D and 3D based only on nuclear markers and without any free parameters. Using this tool, we found that taking non-pairwise interactions into account improves the detection performance significantly. We believe that using our method might improve the effectiveness of other workflows to study cell–cell interactions from microscopy images. Finally, we also provide a reference implementation in Python and an easy-to-use napari plugin.
Association filtering and generative adversarial networks for predicting lncRNA-associated disease
Authors: Zhong Hua , Luo Jing , Tang Lin , Liao Shicheng , Lu Zhonghao , Lin Guoliang , Murphy Robert W. , Liu Lin
Published: June 2023

Background

Long non-coding RNA (lncRNA) closely associates with numerous biological processes, and with many diseases. Therefore, lncRNA-disease association prediction helps obtain relevant biological information and understand pathogenesis, and thus better diagnose preventable diseases.

Results

Herein, we offer the LDAF_GAN method for predicting lncRNA-associated disease based on association filtering and generative adversarial networks. Experimentation used two types of data: lncRNA-disease associated data without lncRNA sequence features, and fused lncRNA sequence features. LDAF_GAN uses a generator and discriminator, and differs from the original GAN by the addition of a filtering operation and negative sampling. Filtering allows the generator output to filter out unassociated diseases before being fed into the discriminator. Thus, the results generated by the model focuses only on lncRNAs associated with disease. Negative sampling takes a portion of disease terms with 0 from the association matrix as negative samples, which are assumed to be unassociated with lncRNA. A regular term is added to the loss function to avoid producing a vector with all values of 1, which can fool the discriminator. Thus, the model requires that generated positive samples are close to 1, and negative samples are close to 0. The model achieved a superior fitting effect; LDAF_GAN had superior performance in predicting fivefold cross-validations on the two datasets with AUC values of 0.9265 and 0.9278, respectively. In the case study, LDAF_GAN predicted disease association for six lncRNAs-H19, MALAT1, XIST, ZFAS1, UCA1, and ZEB1-AS1-and with the top ten predictions of 100%, 80%, 90%, 90%, 100%, and 90%, respectively, which were reported by previous studies.

Conclusion

LDAF_GAN efficiently predicts the potential association of existing lncRNAs and the potential association of new lncRNAs with diseases. The results of fivefold cross-validation, tenfold cross-validation, and case studies suggest that the model has great predictive potential for lncRNA-disease association prediction.
Gene coexpression network during ontogeny in the yellow fever mosquito, Aedes aegypti
Authors: Lin Zhinan , Huang Yuqi , Liu Sihan , Huang Qiwen , Zhang Biliang , Wang Tianpeng , Zhang Ziding , Zhu Xiaowei , Liao Chenghong , Han Qian
Published: June 2023

Background

The behaviors and ontogeny of Aedes aegypti are closely related to the spread of diseases caused by dengue (DENV), chikungunya (CHIKV), Zika (ZIKV), and yellow fever (YFV) viruses. During the life cycle, Ae. aegypti undergoes drastic morphological, metabolic, and functional changes triggered by gene regulation and other molecular mechanisms. Some essential regulatory factors that regulate insect ontogeny have been revealed in other species, but their roles are still poorly investigated in the mosquito.

Results

Our study identified 6 gene modules and their intramodular hub genes that were highly associated with the ontogeny of Ae. aegypti in the constructed network. Those modules were found to be enriched in functional roles related to cuticle development, ATP generation, digestion, immunity, pupation control, lectins, and spermatogenesis. Additionally, digestion-related pathways were activated in the larvae and adult females but suppressed in the pupae. The integrated protein‒protein network also identified cilium-related genes. In addition, we verified that the 6 intramodular hub genes encoding proteins such as EcKinase regulating larval molt were only expressed in the larval stage. Quantitative RT‒PCR of the intramodular hub genes gave similar results as the RNA-Seq expression profile, and most hub genes were ontogeny-specifically expressed.

Conclusions

The constructed gene coexpression network provides a useful resource for network-based data mining to identify candidate genes for functional studies. Ultimately, these findings will be key in identifying potential molecular targets for disease control.
Prevalence of different virulence factors and their association with antimicrobial resistance among Pseudomonas aeruginosa clinical isolates from Egypt
Authors: Edward Eva A. , El Shehawy Marwa R. , Abouelfetouh Alaa , Aboulmagd Elsayed
Published: June 2023

Background

Emergence of multi-drug resistantPseudomonas aeruginosa,coupled with the pathogen’s versatile virulence factors, lead to high morbidity and mortality rates. The current study investigated the potential association between the antibiotic resistance and the production of virulence factors amongP. aeruginosaclinical isolates collected from Alexandria Main University Hospital in Egypt. We also evaluated the potential of the phenotypic detection of virulence factors to reflect virulence as detected by virulence genes presence. The role of alginate in the formation of biofilms and the effect of ambroxol, a mucolytic agent, on the inhibition of biofilm formation were investigated.

Results

A multi-drug resistant phenotype was detected among 79.8% of the isolates. The most predominant virulence factor was biofilm formation (89.4%), while DNase was least detected (10.6%). Pigment production was significantly associated with ceftazidime susceptibility, phospholipase C production was significantly linked to sensitivity to cefepime, and DNase production was significantly associated with intermediate resistance to meropenem. Among the tested virulence genes,lasBandalgDshowed the highest prevalence rates (93.3% and 91.3%, respectively), whiletoxAandplcNwere the least detected ones (46.2% and 53.8%, respectively). Significant association oftoxAwith ceftazidime susceptibility,exoSwith ceftazidime and aztreonam susceptibility, andplcHwith piperacillin-tazobactam susceptibility was observed. There was a significant correlation between alkaline protease production and the detection ofalgD,lasB,exoS,plcHandplcN; pigment production and the presence ofalgD,lasB,toxAandexoS; and gelatinase production and the existence oflasB,exoSandplcH. Ambroxol showed a high anti-biofilm activity (5% to 92%). Quantitative reverse transcriptase polymerase chain reaction showed that alginate was not an essential matrix component inP. aeruginosabiofilms.

Conclusions

High virulence coupled with the isolates’ multi-drug resistance to commonly used antimicrobials would increase morbidity and mortality rates amongP. aeruginosainfections. Ambroxol that displayed anti-biofilm action could be suggested as an alternative treatment option, yet in vivo studies are required to confirm these findings. We recommend active surveillance of antimicrobial resistance and virulence determinant prevalence for better understanding of coregulatory mechanisms.
Clinical characteristics and treatment patterns of pregnant women with hypertension in primary care in the Federal Capital Territory of Nigeria: cross-sectional results from the hypertension treatment in Nigeria Program
Authors: Mahmoud Zainab , Orji Ikechukwu A. , Shedul Gabriel L. , Aluka-Omitiran Kasarachi , Ripiye Nanna , Akor Blessing , Eze Helen , Ojo Tunde , Iyer Guhan , Baldridge Abigail S. , Hirschhorn Lisa R. , Huffman Mark D. , Ojji Dike B.
Published: June 2023

Background

Hypertensive disorders of pregnancy, including hypertension, are a leading cause of maternal mortality in Nigeria. However, there is a paucity of data on pregnant women with hypertension who receive care in primary health care facilities. This study presents the results from a cross-sectional analysis of pregnant women enrolled in the Hypertension Treatment in Nigeria Program which is aimed at integrating and strengthening hypertension care in primary health care centres.

Methods

A descriptive analysis of the baseline results from the Hypertension Treatment in Nigeria Program was performed. Baseline blood pressures, treatment and control rates of pregnant women were analysed and compared to other adult women of reproductive age. A complete case analysis was performed, and a two-sided p value < 0.05 was considered statistically significant.

Results

Between January 2020 to October 2022, 5972 women of reproductive age were enrolled in the 60 primary healthcare centres participating in the Hypertension Treatment in Nigeria Program and 112 (2%) were pregnant. Overall mean age (SD) was 39.6 years (6.3). Co-morbidities were rare in both groups, and blood pressures were similar amongst pregnant and non-pregnant women (overall mean (SD) first systolic and diastolic blood pressures were 157.4 (20.6)/100.7 (13.6) mm Hg and overall mean (SD) second systolic and diastolic blood pressures were 151.7 (20.1)/98.4 (13.5) mm Hg). However, compared to non-pregnant women, pregnant women had a higher rate of newly diagnosed hypertension (65.2% versus 54.4% p = 0.02) and lower baseline walk-in treatment (32.1% versus 42.1%, p = 0.03). The control rate was numerically lower among pregnant patients (6.3% versus 10.2%, p = 0.17), but was not statistically significant. Some pregnant patients (8.3%) were on medications contraindicated in pregnancy, and none of the pregnant women were on aspirin for primary prevention of preeclampsia.

Conclusions

These findings indicate significant gaps in care and important areas for future studies to improve the quality of care and outcomes for pregnant women with hypertension in Nigeria, a country with the highest burden of maternal mortality globally.
Digital health technologies for peripartum depression management among low-socioeconomic populations: perspectives from patients, providers, and social media channels
Authors: Zingg Alexandra , Singh Tavleen , Franklin Amy , Ross Angela , Selvaraj Sudhakar , Refuerzo Jerrie , Myneni Sahiti
Published: June 2023

Background

Peripartum Depression (PPD) affects approximately 10–15% of perinatal women in the U.S., with those of low socioeconomic status (low-SES) more likely to develop symptoms. Multilevel treatment barriers including social stigma and not having appropriate access to mental health resources have played a major role in PPD-related disparities. Emerging advances in digital technologies and analytics provide opportunities to identify and address access barriers, knowledge gaps, and engagement issues. However, most market solutions for PPD prevention and management are produced generically without considering the specialized needs of low-SES populations. In this study, we examine and portray the information and technology needs of low-SES women by considering their unique perspectives and providers’ current experiences. We supplement our understanding of women’s needs by harvesting online social discourse in PPD-related forums, which we identify as valuable information resources among these populations.

Methods

We conducted (a) 2 focus groups (n = 9), (b) semi-structured interviews with care providers (n = 9) and low SES women (n = 10), and (c) secondary analysis of online messages (n = 1,424). Qualitative data were inductively analyzed using a grounded theory approach.

Results

A total of 134 open concepts resulted from patient interviews, 185 from provider interviews, and 106 from focus groups. These revealed six core themes for PPD management, including “Use of Technology/Features”, “Access to Care”, and “Pregnancy Education”. Our social media analysis revealed six PPD topics of importance in online messages, including “Physical and Mental Health” (n = 725 messages), and “Social Support” (n = 674).

Conclusion

Our data triangulation allowed us to analyze PPD information and technology needs at different levels of granularity. Differences between patients and providers included a focus from providers on needing better support from administrative staff, as well as better PPD clinical decision support. Our results can inform future research and development efforts to address PPD health disparities.
MicroRNA-188-5p inhibits hepatocellular carcinoma proliferation and migration by targeting forkhead box N2
Authors: Wu Yan-hui , Yu Bin , Zhou Jiang-min , Shen Xue-han , Chen Wei-xun , Ai Xi , Leng Chao , Liang Bin-yong , Shao Ya-jie
Published: June 2023

Background

This study aimed to identify the biological functions, expression modes, and possible mechanisms underlying the relationship between metastatic human hepatocellular carcinoma (HCC) and MicroRNA-188-5p (miR-188) dysregulation using cell lines.

Methods

A decrease in miR-188 was detected in low and high metastatic HCC cells compared to that in normal hepatic cells and non-invasive cell lines. Gain- and loss-of-function experiments were performed in vitro to investigate the role of miR-188 in cancer cell (Hep3B, HepG2, HLF, and LM3) proliferation and migration.

Results

miR-188 mimic transfection inhibited the proliferation of metastatic HLF and LM3 cells but not non-invasive HepG2 and Hep3B cells; nonetheless, miR-188 suppression promoted the growth of HLF and LM3 cells. miR-188 upregulation inhibited the migratory rate and invasive capacity of HLF and LM3, rather than HepG2 and Hep3B cells, whereas transfection of a miR-188 inhibitor in HLF and LM3 cells had the opposite effects. Dual-luciferase reporter assays and bioinformatics prediction confirmed that miR-188 could directly target forkhead box N2 (FOXN2) in HLF and LM3 cells. Transfection of miR-188 mimics reduced FOXN2 levels, whereas miR-188 inhibition resulted in the opposite result, in HLF and LM3 cells. Overexpression of FOXN2 in HLF and LM3 cells abrogated miR-188 mimic-induced downregulation of proliferation, migration, and invasion. In addition, we found that miR-188 upregulation impaired tumor growth in vivo.

Conclusions

In summary, this study showed thatmiR-188 inhibits the proliferation and migration of metastatic HCC cells by targeting FOXN2.
Oral cavity and oropharyngeal carcinoma disparities in age and survival in Indigenous and non-Indigenous populations of Queensland
Authors: Alkandari Abdulrahman Sakeen , Ho Jemmi Ching Ying , Choi Siu Wai , Thomson Peter
Published: June 2023

Objectives

To investigate the risk and prognosis of oral squamous cell carcinoma (SCC) between Indigenous and non-Indigenous populations of Queensland.

Materials and methods

Retrospective analysis of data from the Queensland Cancer Registry (QCR) between the years 1982–2018. Main outcome measures were age at diagnosis and cumulative survival to compare the risk and prognosis of oral SCC between the populations.

Results

9424 patients with self-declared ethnicity were identified with oral SCC from the QCR, with a male to female ratio of 2.56:1. Of these patients, 9132 were non-Indigenous (96.9%) and 292 Indigenous (3.1%). Indigenous people were significantly younger at diagnosis (mean (SD) age 54.3 (10.1) years), compared to 62.0 (12.1) years in non-Indigenous people. Mean survival in the full cohort was 4.3 years (SD: 5.6), with Indigenous people presenting a significant shorter mean survival of 2.0 years (SD: 3.5) when compared with 4.4 years (SD: 5.7) in non-Indigenous people (p < 0.001).

Conclusions

Indigenous Australians are diagnosed at a significantly younger age and present with worse survival and poorer prognosis. Due to missing variables in the Queensland Cancer Registry, it is not possible in the current study to ascertain the scientific or social reasons behind these disparities.

Clinical relevance

Results from this study can inform public policy and raise awareness in Queensland regarding disparity in oral cancer prognosis.
The mediating role of psychological capital in the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic: a cross-sectional study
Authors: Wang Simeng , Li Honghe , Chen Xin , Yan Nan , Wen Deliang
Published: June 2023

Background

Although life satisfaction is a predictor of depressive and anxiety symptoms, the mechanisms underlying this association are poorly understood. This study examined how psychological capital (PsyCap), a positive psychological state, mediated the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic.

Methods

A cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 583 students. Depressive symptoms, anxiety symptoms, life satisfaction, and PsyCap were measured anonymously. A hierarchical linear regression analysis was performed to explore the effects of life satisfaction on depressive and anxiety symptoms. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between life satisfaction and depressive and anxiety symptoms.

Results

Life satisfaction was positively associated with PsyCap and its four components. There were significant negative associations between life satisfaction, psychological capital, resilience, optimism, and depressive and anxiety symptoms among medical students. Self-efficacy was negatively associated with depressive and anxiety symptoms. Psychological capital (a×b = -0.3201, BCa 95% CI: -0.3899, -0.2446; a×b = -0.2749, BCa 95% CI: -0.3817, -0.1996), resilience (a×b = -0.2103, BCa 95% CI: -0.2727, -0.1580; a×b = -0.1871, BCa 95% CI: -0.2520, -0.1414), optimism (a×b = -0.2100, BCa 95% CI: -0.3388, -0.1150; a×b = -0.1998, BCa 95% CI: -0.3307, -0.0980), and self-efficacy (a×b = -0.0916, BCa 95% CI: 0.0048, 0.11629; a×b = 0.1352, BCa 95% CI: 0.0336, 0.2117) significantly mediated the association between life satisfaction and depressive and anxiety symptoms.

Limitations

This was a cross-sectional study, and causal relationships between the variables could not be ascertained. Self-reported questionnaire instruments were used for data collection, which may have recall bias.

Conclusions

Life satisfaction and PsyCap can be used as positive resources to reduce depressive and anxiety symptoms among third-year Chinese medical students during the COVID-19 pandemic. Psychological capital and its components (self-efficacy, resilience, and optimism) partially mediated the relationship between life satisfaction and depressive symptoms, and completely mediated the relationship between life satisfaction and anxiety symptoms. Therefore, improving life satisfaction and investing in psychological capital (especially self-efficacy, resilience, and optimism) should be included in the prevention and treatment of depressive and anxiety symptoms among third-year Chinese medical students. Additional attention is needed to pay for self-efficacy in such disadvantageous contexts.
Demographic dividend-favorable policy environment in two pre-dividend African nations: review of national policies and prospects for policy amendments in Nigeria and Tanzania
Authors: Chen Xiaomeng , Prata Menezes Neia , Rusatira Jean Christophe , Cardona Carolina , Odeku Mojisola , Kioko Deanna , Castro Jessica , Ibeawuchi Charity , Lincoln Joel Silas , Ng’wanansabi Deo , Macha Jacob , Msemo Abubakar , Yusuph Nazir , Rimon Jose G.
Published: June 2023

Background

In collaboration with local partners, we reviewed 18 national policy documents across two sub-Saharan African countries identified as pre-dividend nations by the World Bank in 2017: Nigeria and Tanzania. Our aim was to assess national policies in pre-dividend countries and to determine whether national strategies were primed to capitalize on changing demographic structures, maximally attain the demographic dividend, and augment socio-economic growth.

Methods

We conducted policy reviews by focusing on five key sectors of the Gates Institute Demographic Dividend Framework: Family Planning, Maternal and Child Health, Education, Women’s Empowerment, and Labor Market. This framework was developed as a tool for countries to apply targeted policies for accelerating the demographic dividend based on their demographic structure. For each component we used a comprehensive list of indicators, defined via a systematic literature review, through which we assessed national policies aimed at maximizing the demographic dividend.

Results

Between the two countries, we observed persistent gaps in policies targeting family planning. Although more comprehensive, policies addressing maternal and child health, education, women’s empowerment, and labor market still lagged in their specificity and measurability. We identified specific policy amendments and alternatives that Nigeria and Tanzania could consider to mitigate these gaps. We also stress the importance of designing measurable policy initiatives across sectors.

Conclusions

Based on these recommendations, as Nigeria, Tanzania, and other pre-dividend nations start experiencing rapid demographic changes, they may consider implementing routine policy reviews to strengthen policies across the five key sectors and harness the benefits of a demographic dividend.