bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular characteristics, fitness, and virulence of high-risk and non-high-risk clones of carbapenemase-producing
Klebsiella pneumoniae
Authors: Örmälä-Tiznado Anni-Maria , Allander Lisa , Maatallah Makaoui , Kabir Muhammad Humaun , Brisse Sylvain , Sandegren Linus , Patpatia Sheetal , Coorens Maarten , Giske Christian G.
Published: January 2024

Extensively drug-resistant (XDR)
Klebsiella pneumoniae
inflict a notable burden on healthcare worldwide. Of specific concern are strains producing carbapenem-hydrolyzing enzymes, as the therapeutic options for these strains are still very limited. Specific sequence types of
K. pneumoniae
have been noted for their epidemic occurrence globally, but the mechanisms behind the success of specific clones remain unclear. Herein, we have characterized 20 high-risk clones (HiRCs) and 10 non-HiRCs of XDR
K. pneumoniae
, exploring factors connected to the epidemiological success of some clones. Isolates were subjected to core genome multilocus sequence typing analysis to determine the clonal relationships of the isolates and subsequently characterized with regard to features known to be linked to overall bacterial fitness and virulence. The genomes were analyzed
in silico
for capsule types, O antigens, virulence factors, antimicrobial resistance genes, prophages, and CRISPR-Cas loci.
In vitro
growth experiments were conducted to retrieve proxies for absolute and relative fitness for 11 HiRC and 9 non-HiRC isolates selected based on the clonal groups they belonged to, and infections in a
Galleria mellonella
insect model were used to evaluate the virulence of the isolates
in vivo
. This study did not find evidence that virulence factors, prophages, CRISPR-Cas loci, or fitness measured
in vitro
alone would contribute to the global epidemiological success of specific clones of carbapenemase-producing XDR
K. pneumoniae
. However, this study did find the HiRC group to be more virulent than the non-HiRC group when measured
in vivo
in a model with
G. mellonella
. This suggests that the virulence and epidemiological success of certain clones of
K. pneumoniae
cannot be explained by individual traits investigated in this study and thus warrant further experiments in the future.

IMPORTANCE

Herein, we explored potential explanations for the successfulness of some epidemic or high-risk clones of carbapenemase-producing
Klebsiella pneumoniae
. We found differences in mortality in a larva model but found no clear genomic differences in known virulence markers. Most of the research on virulence in
K. pneumoniae
has been focused on hypervirulent strains, but here, we try to understand differences within the group of highly resistant strains. The results from the larva virulence model could be used to design experiments in higher animals. Moreover, the data could provide further support to a differentiated infection control approach against extensively drug-resistant strains, based on their classification as high-risk clones.
Strategies for recruiting adolescents in rural areas in firearm injury research
Authors: Weybright Elizabeth , Hall Ashley , Ellyson Alice M , Varrella Gary , Kuklinski Margaret R. , Gause Emma , Schleimer Julia , Dalve Kimberly , Rowhani-Rahbar Ali
Published: January 2024

Background

Participant recruitment is a central aspect of human sciences research. Barriers to participant recruitment can be categorised into participant, recruiter and institutional factors. Firearm injury research poses unique barriers to recruitment. This is especially true for rural adolescents, who are at high risk for firearm-related injury and death, and whose voice is often absent in firearms research. In particular, recruitment strategies targeting adolescents should align with developmental changes occurring during this life stage. Identifying strategies to address recruitment barriers tailored to firearm-related research can help future researchers engage rural adolescents in injury prevention efforts.

Purpose

The purpose of the current methodology paper is to outline barriers and provide strategies for recruiting rural adolescents in firearms research informed by the Youth Experiences in Rural Washington: Research on Firearm Safety project, a mixed-methods, community-based participatory research study of 13–18 year-olds residing in rural Washington.

Strategies

Recruitment barriers and related strategies were organised by participant-related and recruiter-related/institutional-related factors. While carrying out the study, key considerations or strategies which addressed multiple participant and recruiter/institutional factors, emerged with potential to enhance firearm-related research with rural adolescents more broadly. Key considerations included logistics (ie, scheduling flexibility, adequate and aligned incentives), use of a community-based participatory research approach and accounting for developmental stage.

Conclusion

Reducing the burden of firearm injury and death for rural adolescents and developing effective interventions requires understanding and navigating recruitment barriers. Strategies used in the current project can guide future qualitative or mixed methods data collection informing firearm injury prevention.
Head trauma results in manyfold increased risk of multiple sclerosis in genetically susceptible individuals
Authors: Johansson Eva , Alfredsson Lars , Strid Pernilla , Kockum Ingrid , Olsson Tomas , Hedström Anna Karin
Published: January 2024

Background

Large register-based studies have reported an association between head trauma and increased risk of multiple sclerosis (MS). We aimed to investigate possible interactions between head trauma and MS-associated HLA genes in relation to MS risk.

Methods

We used a Swedish population-based case-control study (2807 incident cases, 5950 matched controls with HLA genotypes available for 2057 cases, 2887 controls). Subjects with and without a history of self-reported head trauma were compared regarding MS risk, by calculating ORs with 95% CIs using logistic regression models. Additive interaction between head trauma,HLA-DRB1*1501and absence ofHLA-A*0201, was assessed by calculating the attributable proportion (AP) due to interaction.

Results

A history of head trauma was associated with a 30% increased risk of subsequently developing MS (OR 1.34, 95% CI 1.17 to 1.53), with a trend showing increased risk of MS with increasing number of head impacts (p=0.03). We observed synergistic effects between recent head trauma andHLA-DRB1*15:01as well as absence ofHLA*02:01in relation to MS risk (each AP 0.40, 95% CI 0.1 to 0.7). Recent head trauma in individuals with both genetic risk factors rendered an 18-fold increased risk of MS, compared with those with neither the genetic risk factors nor a history of head trauma (OR 17.7, 95% CI 7.13 to 44.1).

Conclusions

Our findings align with previous observations of a dose-dependent association between head trauma and increased risk of MS and add a novel aspect of this association by revealing synergistic effects between recent head trauma and MS-associated HLA genes.
Impact of white matter networks on risk for memory decline following resection versus ablation in temporal lobe epilepsy
Authors: Kaestner Erik , Stasenko Alena , Schadler Adam , Roth Rebecca , Hewitt Kelsey , Reyes Anny , Qiu Deqiang , Bonilha Leonardo , Voets Natalie , Hu Ranliang , Willie Jon , Pedersen Nigel , Shih Jerry , Ben-Haim Sharona , Gross Robert , Drane Daniel , McDonald Carrie R
Published: January 2024

Background

With expanding neurosurgical options in epilepsy, it is important to characterise each options’ risk for postoperative cognitive decline. Here, we characterise how patients’ preoperative white matter (WM) networks relates to postoperative memory changes following different epilepsy surgeries.

Methods

Eighty-nine patients with temporal lobe epilepsy with T1-weighted and diffusion-weighted imaging as well as preoperative and postoperative verbal memory scores (prose recall) underwent either anterior temporal lobectomy (ATL: n=38) or stereotactic laser amygdalohippocampotomy (SLAH; n=51). We computed laterality indices (ie, asymmetry) for volume of the hippocampus and fractional anisotropy (FA) of two deep WM tracts (uncinate fasciculus (UF) and inferior longitudinal fasciculus (ILF)).

Results

Preoperatively, left-lateralised FA of the ILF was associated with higher prose recall (p<0.01). This pattern was not observed for the UF or hippocampus (ps>0.05). Postoperatively, right-lateralised FA of the UF was associated with less decline following left ATL (p<0.05) but not left SLAH (p>0.05), while right-lateralised hippocampal asymmetry was associated with less decline following both left ATL and SLAH (ps<0.05). After accounting for preoperative memory score, age of onset and hippocampal asymmetry, the association between UF and memory decline in left ATL remained significant (p<0.01).

Conclusions

Asymmetry of the hippocampus is an important predictor of risk for memory decline following both surgeries. However, asymmetry of UF integrity, which is only severed during ATL, is an important predictor of memory decline after ATL only. As surgical procedures and pre-surgical mapping evolve, understanding the role of frontal-temporal WM in memory networks could help to guide more targeted surgical approaches to mitigate cognitive decline.
Joint surgery rates in lupus: a long-term cohort study
Authors: Nossent Johannes , Keen Helen Isobel , Preen David Brian , Inderjeeth Charles A
Published: January 2024

Aim

With scarce data on the need and type of joint surgery in SLE, we investigated the long-term rates and underlying causes for arthroplasty, arthrodesis and synovectomy in patients with SLE.

Methods

Procedure dates for arthroplasty, arthrodesis or synovectomy were retrieved from the state-wide Hospital Morbidity Data Collection between 1985 and 2015 for patients with SLE (n=1855) and propensity-matched controls (n=12 840). Patients with SLE with ≥two additional diagnostic codes for rheumatoid arthritis were classified as rhupus. ORs and incidence rates (IRs) per 100 person-years for joint procedures (JPs) were compared among patients with rhupus, patients with other SLE and controls across three study decades by regression analysis.

Results

More patients with SLE than controls underwent a JP (11.6% vs 1.3%; OR 10.8, CI 8.86 to 13.24) with a higher IR for JP in patients with SLE (1.9 vs 0.1, rate ratio 19.9, CI 16.83 to 23.55). Among patients with SLE, patients with rhupus (n=120, 60.5%) had the highest odds of arthroplasty (OR 4.49, CI 2.87 to 6.92), arthrodesis (OR 6.64, CI 3.28 to 12.97) and synovectomy (OR 9.02,CI 4.32 to 18.23). Over time, the IR for overall JP in patients with rhupus was unchanged (8.7 to 8.6, R2=0.004, p=0.98), although the IR for avascular necrosis underlying arthroplasty decreased for all patients with SLE (0.52 to 0.10, p=0.02). Patients with other SLE also had significantly higher OR and IR for all three JPs than controls with insignificant decreases in synovectomy and increases in arthroplasty over time in this group.

Conclusions

The overall burden of joint surgery in SLE is high and despite a reduction in avascular necrosis, arthroplasty and arthrodesis rates have not decreased over time. These data indicate a need for increased efforts to prevent joint damage in patients with lupus.
Sexual dysfunction and commonly used drugs in neurology
Authors: Behn Maya , Kielhofner Jane , Panicker Jalesh N , Kaplan Tamara B
Published: January 2024

Sexual dysfunction is common in men and women with neurological diseases. Medications used in neurology can cause sexual dysfunction independently of the disease process and this may adversely affect patients’ quality of life. This review focuses on medications commonly prescribed to neurological patients that may contribute to altered sexual function, and discusses how they may differ in men and women.
Randomized control trial of a holographic needle guidance technique for thoracic epidural placement
Authors: Wiegelmann Julian , Choi Stephen , McHardy Paul G , Matava Clyde , Singer Oskar , Kaustov Lilia , Alam Fahad
Published: January 2024

Introduction

The Microsoft HoloLens is a head-mounted mixed reality device, which allows for overlaying hologram-like computer-generated elements onto the real world. This technology can be combined with preprocedural ultrasound during thoracic epidural placement to create a visual of the ideal needle angulation and trajectory in the users’ field of view. This could result in a technically easier and potentially safer alternative to traditional blind landmark techniques.

Methods

Patients were randomly assigned to one of two groups: (1) HoloLens-assisted thoracic epidural technique (intervention—group H) or (2) traditional thoracic epidural technique (control—group C). The primary outcome was needling time (defined as skin puncture to insertion of epidural catheter) during the procedure. The secondary outcomes were number of needle punctures, number of needle movements, number of bone contacts, and epidural failure. Procedural pain and recovery room pain levels were also evaluated.

Results

Eighty-three patients were included in this study. The primary outcome of procedure time was reduced in the HoloLens group compared with control (4.5 min vs 7.3 min, p=0.02, 95% CI), as was the number of needle movements required (7.2 vs 14.4, p=0.01), respectively. There was no difference in intraprocedure or postprocedure pain, bone contacts, or total number of needle punctures. Three patients in the control group experienced epidural failure versus one patient in the HoloLens group.

Conclusions

This study shows that thoracic epidural placement may be facilitated by using a guidance hologram and may be more technically efficient.

Trial registration number

NCT04028284.
Continuous erector spinae plane block versus thoracic epidural analgesia in video-assisted thoracoscopic surgery: a prospective randomized open-label non-inferiority trial
Authors: van den Broek Renee J C , Postema Jonne M C , Koopman Joseph S H A , van Rossem Charles C , Olsthoorn Jules R , van Brakel Thomas J , Houterman Saskia , Bouwman R Arthur , Versyck Barbara
Published: January 2024

Background and objectives

The evolving surgical techniques in thoracoscopic surgery necessitate the exploration of anesthesiological techniques. This study aimed to investigate whether incorporating a continuous erector spinae plane (ESP) block into a multimodal analgesia regimen is non-inferior to continuous thoracic epidural analgesia (TEA) in terms of quality of postoperative recovery for patients undergoing elective unilateral video-assisted thoracoscopic surgery.

Methods

We conducted a multicenter, prospective, randomized, open-label non-inferiority trial between July 2020 and December 2022. Ninety patients were randomly assigned to receive either continuous ESP block or TEA. The primary outcome parameter was the Quality of Recovery-15 (QoR-15) score, measured before surgery as a baseline and on postoperative days 0, 1, and 2. Secondary outcome parameters included pain scores, length of hospital stay, morphine consumption, nausea and vomiting, itching, speed of mobilization, and urinary catheterization.

Results

Analysis of the primary outcome showed a mean QoR-15 difference between the groups ESP block versus TEA of 1 (95% CI −9 to –12, p=0.79) on day 0, –1 (95% CI −11 to –8, p=0.81) on day 1 and −2 (95% CI −14 to –11, p=0.79) on day 2.

Conclusions

The continuous ESP block is non-inferior to TEA in video-assisted thoracoscopic surgery.

Trial registration number

Dutch Trial Register (NL6433).
Atlas for the CT Syndesmophyte Score (CTSS) in patients with axial spondyloarthritis
Authors: Marques Mary Lucy , Ramiro Sofia , van der Heijde Désirée , Reijnierse Monique , Diekhoff Torsten , Hermann Kay Geert A. , van Gaalen Floris A , de Hooge Manouk
Published: January 2024

Background: The Computed Tomography Syndesmophyte Score (CTSS) was developed as a reliable and sensitive tool to assess syndesmophytes in low-dose CT images of the entire spine in patients with axial spondyloarthritis (axSpA). The original paper provided sparce examples of the CTSS grades.

Objectives: Provide an atlas tailored to assist readers in understanding and employing the CTSS method.

Methods: In this paper, illustrations of the different grades and views of the CTSS are presented. CTSS is used to measure bone formation in the spine of patients with axial spondyloarthritis (axSpA), in the form of syndesmophytes. In both the sagittal and coronal planes, syndesmophytes can be graded from 0 to 3 over 23 vertebral units starting at C2 and ending at S1. The CTSS ranges from 0 (absence of axSpA-related syndesmophytes) to 552 (total ankylosis of the spine).

Results: The current atlas contains low-dose CT images of the spine without lesions (for reference) and all grades of syndesmophytes in different planes used in the CTSS. Examples are arranged per spinal segment (cervical, thoracic and lumbar).

Conclusions: These images can be used to assist any reader in the assessment of syndesmophytes on (low-dose) CT in patients with axSpA.
Identification of patient endotypes and adalimumab treatment responders in axial spondyloarthritis using blood-derived extracellular matrix biomarkers
Authors: Port Helena , Christiansen Frederik , Nielsen Signe Holm , Frederiksen Peder , Bay-Jensen Anne-C , Karsdal Morten Asser , Seven Sengul , Sørensen Inge Juul , Loft Anne Gitte , Madsen Ole Rintek , Ostergaard Mikkel , Pedersen Susanne J
Published: January 2024

Objective

To explore the potential of a panel of ECM remodelling markers as endotyping tools for axial spondyloarthritis (axSpA) by separating patients into subtypes and investigate how they differ among each other in disease activity scores and response to treatment with adalimumab.

Methods

In three axSpA studies, a panel of 14 blood-based ECM biomarkers related to formation of collagen (PRO-C2, PRO-C3, PRO-C6), degradation of collagen by metalloproteinases (C1M, C2M, T2CM, C3M, C4M, C6M, C10C), matrix metalloproteinase (MMP)-degraded prolargin (PROM), MMP-degraded and citrullinated vimentin (VICM), basement membrane turnover (PRO-C4) and neutrophil activity (CPa9-HNE) were assessed to enable patient clustering (endotyping). MASH (n=41) was a cross-sectional study, while Adalimumab in Axial Spondyloarthritis study (ASIM,n=45) and Danish Multicenter Study of Adalimumab in Spondyloarthritis (DANISH, n=49) were randomised, double-blind placebo-controlled trials of adalimumab versus placebo every other week for 6 or 12 weeks, respectively, followed by active treatment. Biomarker data were log-transformed, standardised by mean centering and scaled by the SD prior to principal component analysis and K-means clustering.

Results

Based on all three studies, we identified two orthogonal dimensions reflecting: (1) inflammation and neutrophil activity (driven by C1M and CPa9-HNE) and (2) collagen turnover (driven by PRO-C2). Three endotypes were identified: high inflammation endotype (Endotype1), low inflammation endotype (Endotype 2) and high collagen turnover endotype (Endotype3). Endotype1 showed higher disease activity (Ankylosing Spondylitis Disease Activity Score (ASDAS)) at baseline compared with Endotype2 and Endotype3 and higher percentage of patients responding to adalimumab based on ASDAS clinical improvement at week 24. Endotype3 showed higher percentage of patients with 50% improvement in Bath Ankylosing Spondylitis Disease Activity Index response at week 24 compared with Endotype2.

Conclusion

These endotypes differ in their tissue remodelling profile and may in the future have utility for patient stratification and treatment tailoring.
Tree and stand characteristics associated with the occurrence of false heartwood in individual Japanese white birch trees
Authors: Nakaya Akira , Osaki Hisashi , Ohno Yasuyuki , Yoshida Toshiya
Published: January 2024

New wood uses of Japanese white birch ( Betula platyphylla var. japonica) have attracted much attention in recent years, but false heartwood has led to a decline in commercial value due to its irregular wood color. In this study, we assessed the occurrence of false heartwood and its proportion to stem cross-sectional area (PFH) in individual Japanese white birch (482 trees) in a ca. 70-year-old natural secondary forest. Specifically, we investigated the relative strength of the direct/indirect effects of individual size (BA), growth rate (GR), crown ratio (CR), number of branch scars (NBS), basal area sum of neighboring trees (BAS) and topographic wetness index (TWI) on PFH. In total, 80.3% of trees had false heartwood. CR was found to be the most important factor, acting through direct and indirect negative effects. BA and NBS had a positive effect, and TWI had a negative effect on PFH. BA had a positive correlation with tree age, indicating that PFH can be reduced in trees with faster growth. Simultaneously, BAS had an indirect positive effect on PFH. These results suggested that thinning, which reduces BAS and increases CR, can reduce false heartwood.
Traversable wormhole model with massive gravitons, two fluids, and a variable gravity
Authors: El-Nabulsi Rami Ahmad , Anukool Waranont
Published: January 2024

We construct a new cosmological model based on relativistic theory of gravity characterized by massive gravitons. The new Friedmann–Robertson–Walker model is characterized by the presence of a static traversable wormhole, massive gravitons, and a variable gravitational coupling constant. To recover the Bianchi identity, a second cosmic fluid is introduced in the theory. Motivated from cosmic dark radiation phenomenological arguments, which suggest that the dynamical component of dark energy could be dominated by a bath of dark radiation, we assume that the original cosmic fluid is radiative, whereas the new cosmic fluid is phantom. The total equation of state of our model is equal to −1. The new model is characterized by an effective Hubble parameter. The solutions of the dynamical equations reveal an accelerated universe with a scale factor of hyperbolic type which allows the deceleration parameter to change sign from a decelerating phase to an accelerating phase. We have evaluated the deceleration parameter, the jerk and the present day variations of the gravitational constant which agree with astronomical observations.
Behaviour of redox-sensitive elements (Ti, As, V and Fe) in clay pit samples with and without Al normalization
Authors: Jurković Josip , Tvica Mirza , Babajić Elvir , Čengić Lejla , Sulejmanović Jasmina
Published: January 2024

Natural clay minerals, because of their physical and chemical characteristics are good adsorbents of metals. Among metals, heavy metals are often investigated, but redox-sensitive metals are increasingly getting attention. Redox-sensitive elements were measured in clay pit samples from a clay mine in Bosnia and Herzegovina. For the purpose of analysis, a 23 m deep clay pit core sample was taken, and it was randomly subsampled to give 45 clay pit samples from different depths. The pH, electrical conductivity (EC), oxidation–reduction potential (ORP) and redox-sensitive elements contents were measured. Amounts of redox-sensitive metals and aluminium were measured with an inductively coupled plasma optical emission spectrophotometry instrument. For statistical evaluation, maximum, minimum, average, median, Pearson's prior correlation, correlation applying Al normalization and centred log-ratio (clr) transformation were calculated. When justified, principal component analysis (PCA) was also performed. The results show acidic pH and oxidative ORP. EC varied significantly through the sediment. The element concentrations lie in the sequence: Fe > Ti > V > As. There is a significant change in correlations with and without Al normalization. The highest difference was found for Ti and V (coefficient of correlation (
r
) value ranging from −0.553 to 0.835). Correlations and PCA after clr transformation showed mainly strong negative correlations, meaning that redox-sensitive elements behave differently in clay samples.

Supplementary material:
Graphical abstract is available at
https://doi.org/10.6084/m9.figshare.c.7014329
You've (Not) Been Warned: Developer Best Practices for Content Warnings and Why Compassion Matters
Authors: Dunlap Kelli N.
Published: January 2024

Content warnings are an essential accessibility feature in games with distressing and traumatic content. With mixed research findings and even more mixed public opinion, there are very few resources available to support developers who want to have content warnings in their games. The following article provides a brief historical overview and current research on the use of content warnings, case examples games that have successfully utilized content warnings, and best practice guidelines for content warning language and implementation.
Optimize the Age of Useful Information in Edge-assisted Energy-harvesting Sensor Networks
Authors: Shi Tuo , Cai Zhipeng , Li Jianzhong , Gao Hong
Published: January 2024

The energy-harvesting sensor network is a new network architecture to further prolong the lifetime of sensor networks and enhance the quality of IoT services. Due to the inherent problems of energy-harvesting sensor networks, it is really hard to collect fresh and useful sensory data. To solve the above problems, we investigate the data collection scheme in edge-assisted energy-harvesting sensor networks and try to collect fresh and useful sensory data from such networks. Enlightened by the concept of the age of information, we define a new metric, the age of useful information (AoUI), to measure the usefulness and freshness of the sensory data. Furthermore, we define the Minimizing the Maximum Age of Useful Information problem (Min-AoUI) to construct a sensory data collection method to minimize the AoUI of the sensory data. We prove that the Min-AoUI problem is NP-Hard, and approximation algorithms are proposed to solve this problem. The time complexity and the approximation ratio of this algorithm are analyzed. The performance of the algorithm is also verified by extensive experimental results.
Omniscient Video Super-Resolution with Explicit-Implicit Alignment
Authors: Yi Peng , Wang Zhongyuan , Luo Laigan , Jiang Kui , He Zheng , Jiang Junjun , Lu Tao , Ma Jiayi
Published: January 2024

When considering the temporal relationships, most previous video super-resolution (VSR) methods follow the iterative or recurrent framework. The iterative framework adopts neighboring low-resolution (LR) frames from a sliding window, while the recurrent framework utilizes the output generated in the previous SR procedure. The hybrid framework combines them but still cannot fully leverage the temporal relationships. Meanwhile, the existing methods are limited in the receptive field of the optical flow or lack semantic constrains on motion information. In this work, we propose an omniscient framework to fully explore the temporal relationships in the video, which encompasses both LR frames and SR outputs from the past, present, and future. The omniscient framework is more generic because the iterative, recurrent, and hybrid frameworks can be regarded as its special cases. Besides, when addressing the motion information, most previous VSR methods adopt the explicit motion estimation and compensation, while many recent methods turn to implicit alignment. In implicit alignment methods, because basic non-local means suffers from heavy computational costs, we improve it by capturing the non-local correlations in a relatively local manner to reduce the complexity. Moreover, we integrate the explicit and implicit methods into an explicit-implicit alignment module to better utilize motion information. We have conducted extensive experiments on public datasets, which show that our method is superior over the state-of-the-art methods in objective metrics, subjective visual quality, and complexity. In particular, on datasets of Vid4 and UDM10, our method improves PSNR by 0.19 dB, 0.49 dB against the most advanced method BasicVSR++, respectively.
Lessons from the year of COVID-19: insights, projections, and next steps in a high school pathophysiology classroom
Authors: Anjur Sowmya
Published: January 2024

Different ways of modifying existing assessments and labs in a pathophysiology high school classroom are described. Novel assessments were modified after the COVID-19 pandemic to better engage students during the transition from remote to in-person learning after the pandemic. These activities prompted an increase in student test gains compared during and after the pandemic. It was concluded that incorporating student feedback and providing extra time for assessments helped students articulate better on assessments.
Social media for obesity education: a general overview for the novice creator
Authors: Sobel Sandra I. , Dubé John J.
Published: January 2024

Rates of obesity continue to increase. Health care providers have a limited time to cover the nuances of obesity. Technology and social media are tools that can help health care workers provide obesity education to a large audience. This article provides the foundations for obesity education content generation and delivery for the novice creator.
“Aquilibria: The battle to balance”—a narrative card and board game on acid-base regulation for first-year medical students
Authors: Surapaneni Krishna Mohan
Published: January 2024

This innovation is a captivating blend of storytelling, cards, and board gameplay to facilitate the learning of acid-base regulation. This engaging game offers a wealth of questions and diverse case scenarios, allowing learners to repeatedly explore and grasp the intricacies of acid-base balance. What sets this game apart is its robust assessment strategy, supported by overwhelmingly positive feedback and marked academic improvement. This innovation is a must-have for students seeking a dynamic and effective learning experience.
Energy depletion by cell proliferation sensitizes the kidney epithelial cells to injury
Authors: Galichon Pierre , Lannoy Morgane , Li Li , Serre Justine , Vandermeersch Sophie , Legouis David , Valerius M. Todd , Hadchouel Juliette , Bonventre Joseph V.
Published: January 2024

ATP depletion is a hallmark of acute kidney injury. Proliferation is instrumental to kidney repair. We show that ATP levels vary during the cell cycle and that proliferation sensitizes renal epithelial cells to superimposed injuries in vitro. More proliferation and less energy production by the mitochondria are associated with adverse outcomes in injured kidney allografts. This suggests that controlling the timing of kidney repair might be beneficial to mitigate the extent of acute kidney injury.
Collecting duct water permeability inhibition by EGF is associated with decreased cAMP, PKA activity, and AQP2 phosphorylation at Ser269
Authors: Chou Chung-Lin , Limbutara Kavee , Kao Anika R. , Clark Jevin Z. , Nein Ellen H. , Raghuram Viswanathan , Knepper Mark A.
Published: January 2024

The authors used native rat collecting ducts to show that inhibition of vasopressin-stimulated water permeability by epidermal growth factor involves a reduction of aquaporin 2 phosphorylation at Ser269, a consequence of reduced cAMP production and PKA activity.
Exercise for patients with chronic kidney disease: from cells to systems to function
Authors: Gollie Jared M. , Ryan Alice S. , Sen Sabyasachi , Patel Samir S. , Kokkinos Peter F. , Harris-Love Michael O. , Scholten Joel D. , Blackman Marc R.
Published: January 2024

Chronic kidney disease (CKD) is among the leading causes of death and disability, affecting an estimated 800 million adults globally. The underlying pathophysiology of CKD is complex creating challenges to its management. Primary risk factors for the development and progression of CKD include diabetes mellitus, hypertension, age, obesity, diet, inflammation, and physical inactivity. The high prevalence of diabetes and hypertension in patients with CKD increases the risk for secondary consequences such as cardiovascular disease and peripheral neuropathy. Moreover, the increased prevalence of obesity and chronic levels of systemic inflammation in CKD have downstream effects on critical cellular functions regulating homeostasis. The combination of these factors results in the deterioration of health and functional capacity in those living with CKD. Exercise offers protective benefits for the maintenance of health and function with age, even in the presence of CKD. Despite accumulating data supporting the implementation of exercise for the promotion of health and function in patients with CKD, a thorough description of the responses and adaptations to exercise at the cellular, system, and whole body levels is currently lacking. Therefore, the purpose of this review is to provide an up-to-date comprehensive review of the effects of exercise training on vascular endothelial progenitor cells at the cellular level; cardiovascular, musculoskeletal, and neural factors at the system level; and physical function, frailty, and fatigability at the whole body level in patients with CKD.
Dynamic Response Analysis of the Floor Structure under Random Crowd Excitation
Authors: Cao Dong , Pan Zuanfeng , Fang Yu
Published: January 2024

The popularity of new structural systems and prestressing technology has led to the widespread use of the large‐space floor structures in large buildings such as high‐speed rail terminals, conference centers, and sports stadiums. The reduction of nonessential load‐bearing elements and the increase in span of the structure result in a reduction in the natural frequency and damping ratio of the floor structure, while the floor is a crowded area with disorderly flow between people, which may lead to human‐induced vibration problems. In order to assess the dynamic performance of the large‐span floor structure under crowd load, the random crowd‐floor vertical interaction equation is derived, and the correctness of the equation is verified by comparing it with the test. For the stochastic nature of walking crowds, a formulation modeling method for random crowd is proposed, including pedestrian‐dynamics parameters, formulation model, and response parameters. The model is characterized by considering inter‐ and intrasubject variability and reflects the vertical interaction between pedestrians and the floor system. According to the random crowd‐floor dynamic equation, the variation of modal parameters and acceleration response of the floor during random crowd walking are also analyzed. The research in this paper will help in analyzing the comfort of large‐span floor structures under pedestrian excitation and better meet the needs of the development of lightweight large‐span structures.
Near‐Fault Response and Loading Protocols of Box Columns in Steel Frames with Self‐Centering Braces to Provide Recentering Capability
Authors: Liu Yu-Fang , Chou Chung-Che , Chung Chia-Ying , Huang Hao-Che
Published: January 2024

The main objective of this study was to establish loading protocols for self‐centering braced frames (SCBFs) while taking into account the impact of near‐fault ground motions. SCBFs are self‐centering frames that have lower residual drift than buckling‐restrained braced frames (BRBFs) under near‐fault earthquakes; thus, SCBFs can better control damage to buildings. Typically, first‐story columns are employed to represent the seismic behavior of a structure; therefore, loading protocols were developed for first‐story columns in SCBFs under near‐fault earthquakes. Nonlinear static and dynamic analyses of SCBFs designed with various periods were conducted for better understanding the seismic performance of SCBFs. Finally, the loading protocols developed for SCBFs were compared with those for BRBFs under the same near‐fault motions.
Improved Deflection Prediction Model for PSC Box Girder with Stay Cable System during Tensioning Phase
Authors: Xu Gangnian , Xu Weimin , Wang Zhanhong , Zhang Ruishuo
Published: January 2024

To improve the accuracy of deflection prediction for prestressed concrete (PSC) box‐girder bridges with a stay cable system (SCS) during tensioning, this study employs the Latin hypercube sampling (LHS) technique to sample random variables affecting long‐term deflection of the main girder. A long‐term deflection randomness analysis model is established, and the shear stiffness degradation factor is included to quantify the contribution of diagonal web cracking to the main girder deflection. Uncertainty and sensitivity analysis are conducted for the Dongming Huanghe River Highway Bridge. An objective function is applied to select the optimal combination of random variables, and a modified model is established and verified for accuracy. Results show that diagonal web‐cracking accounts for 8.8% of total deflection and cannot be ignored, and the prestressed tension control stress, creep uncertainty coefficient, and concrete density significantly impact long‐term deflection. The modified model predicts deflection with greater accuracy than the mean value model.
A Strong Maneuvering Target-Tracking Filtering Based on Intelligent Algorithm
Authors: Li Jing , Liang Xinru , Yuan Shengzhi , Li Haiyan , Gao Changsheng
Published: January 2024

In this paper, a variable-structure multimodel (VSMM) filtering algorithm based on the long short-term memory (LSTM) regression-deep Q network (L-DQN) is proposed to accurately track strong maneuvering targets. The algorithm can map the selection of the model set to the selection of the action label and realize the purpose of a deep reinforcement-learning agent to replace the model switching in the traditional VSMM algorithm by reasonably designing a reward function, state space, and network structure. At the same time, the algorithm introduces a LSTM algorithm, which can compensate the error of tracking results based on model history information. The simulation results show that compared with the traditional VSMM algorithm, the proposed algorithm can quickly capture the maneuvering of the target, the response time is short, the calculation accuracy is significantly improved, and the range of adaptation is wider. Precise tracking of maneuvering targets was achieved.
Why Language Matters in Digital Endpoint Development: Harmonized Terminology as a Key Prerequisite for Evidence Generation
Authors: Leyens Lada , Northcott Carrie A. , Maloney Lesley , McCarthy Marie , Dokuzova Nona , Pfister Thomas ,   on behalf of the EFPIA digital endpoint joint sub-group, with contributions from Aude Clement
Published: January 2024

Background: Developments in the field of digital measures and digitally derived endpoints demand greater attention on globally aligned approaches to enhance digital measure acceptance by regulatory authorities and health technology assessment (HTA) bodies for decision-making. In order to maximize the value of digital measures in global drug development programs and to ensure study teams and regulators are referring to the same items, greater alignment of concepts, definitions, and terminology is required. This is a fast-moving complex field; every day brings new technologies, algorithms, and possibilities. A common language is particularly important when working in multifunctional teams to ensure that there is a clear understanding of what is meant and understood. Summary: In the paper, the EFPIA digital endpoint joint subgroup reviews the challenges facing teams working to advance digital endpoints, where different terms are used to describe the same things, where common terms such as “monitoring” have significantly different meaning for different regulatory agencies, where the preface “e” to denote electronic is still used in some contexts, but the term “digital” is used in other, and where there is significant confusion as to what is understood by “raw” when it comes to data derived from digital health technologies. Key Message: The EFPIA subgroup is calling for an aligned lexicon. Alignment provides a more predictable path for development, validation, and use of the tools and measures used to collect digital endpoints supporting standardization and consistency in this new field of research, with the goal of increasing regulatory and payer harmonization and acceptance.
COPD: Zu einer umfassenden Diagnostik sollte auch ein Sarkopenie-Screening gehören
Authors: Frohnhofen Helmut
Published: January 2024

In dieser Studie wurde untersucht, wie sich Sarkopenie auf klinische Merkmale und kurzfristige Ergebnisse bei älteren Patienten mit chronisch-obstruktiver Lungenerkrankung (COPD) auswirkt. Die Forscher untersuchten 120 ältere COPD-Patienten (über 60 Jahre) aus einem Pekinger Krankenhaus. Die Patienten wurden in 2 Gruppen eingeteilt: «Sarkopenie» und «keine Sarkopenie». Die Studie analysierte Baseline-Daten, geriatrische Syndrome, Laborergebnisse und die Körperzusammensetzung. Über einen Zeitraum von einem Jahr wurden klinische Merkmale durch ambulante Besuche überwacht, und telefonische Follow-ups erfassten Todesfälle und akute Exazerbationen der COPD als Endpunktereignisse. Die Risikofaktoren für Sarkopenie wurden mittels univariater Analyse und multivariater logistischer Regression untersucht. Die Cox-Regression wurde verwendet, um den Einfluss von Sarkopenie auf die Prognose der COPD-Patienten zu bewerten. Die Ergebnisse zeigten, dass von den 120 Teilnehmern 63 Patienten (52,5%) Sarkopenie hatten. Die Sarkopenie-Gruppe wies im Vergleich zur Nicht-Sarkopenie-Gruppe eine schlechtere Lungenfunktion, schwerwiegendere geriatrische Syndrome, schlechtere Muskelindikatoren und eine abnehmende Körperzusammensetzung auf. Die multivariate Analyse ergab, dass Sarkopenie mit der Einsekundenkapazität (FEV1), dem Body-Mass-Index (BMI) und dem Hämoglobin in Verbindung stand. Die Cox-Regression deutete darauf hin, dass Sarkopenie mit akuten Exazerbationen der COPD assoziiert war. Zusammengefasst erhöht Sarkopenie das Risiko für akute Exazerbationen bei älteren COPD-Patienten. Die Wahrscheinlichkeit für Sarkopenie hängt mit FEV1, BMI und Hämoglobin-Konzentration zusammen. Daher ist eine aufmerksame Überwachung dieser Indikatoren für die frühzeitige Diagnose von Sarkopenie von Nutzen.
The Prenatal Hypoxic Pathology Associated with Maternal Stress Predisposes to Dysregulated Expression of the chrna7 Gene and the Subsequent Development of Nicotine Addiction in Adult Offspring
Authors: Stratilov Viktor , Vetrovoy Oleg , Potapova Sophia , Tyulkova Ekaterina
Published: January 2024

Introduction: Previous studies have shown that fetal hypoxia predisposes individuals to develop addictive disorders in adulthood. However, the specific impact of maternal stress, mediated through glucocorticoids and often coexisting with fetal hypoxia, is not yet fully comprehended. Methods: To delineate the potential effects of these pathological factors, we designed models of prenatal severe hypoxia (PSH) in conjunction with maternal stress and prenatal intrauterine ischemia (PII). We assessed the suitability of these models for our research objectives by measuring HIF1α levels and evaluating the glucocorticoid neuroendocrine system. To ascertain nicotine dependence, we employed the conditioned place aversion test and the startle response test. To identify the key factor implicated in nicotine addiction associated with PSH, we employed techniques such as Western blot, immunohistochemistry, and correlational analysis between chrna7 and nr3c1 genes across different brain structures. Results: In adult rats exposed to PSH and PII, we observed increased levels of HIF1α in the hippocampus (HPC). However, the PSH group alone exhibited reduced glucocorticoid receptor levels and disturbed circadian glucocorticoid rhythms. Additionally, they displayed signs of nicotine addiction in the conditioned place aversion and startle response tests. We also observed elevated levels of phosphorylated DARPP-32 protein in the nucleus accumbens (NAc) indicated compromised glutamatergic efferent signaling. Furthermore, there was reduced expression of α7 nAChR, which modulates glutamate release, in the medial prefrontal cortex (PFC) and HPC. Correlation analysis revealed strong associations between chrna7 and nr3c1 expression in both brain structures. Conclusion: Perturbations in the glucocorticoid neuroendocrine system and glucocorticoid-dependent gene expression of chrna7 associated with maternal stress response to hypoxia in prenatal period favor the development of nicotine addiction in adulthood.
Impact of low molecular weight acid and moisture on the thermal ageing properties of palm oil
Authors: Muzamil Mustam Muhammad , Azis Norhafiz , Jasni Jasronita , Halis Rasmina , Aizam Talib Mohd , Aqilah Mohamad Nur , Yaakub Zaini
Published: January 2024

This study examines the effect of low molecular weight acid (LMA), moisture and oxygen on the thermal ageing characteristics of refined, bleached, and deodorised palm oil (RBDPO). The paper moisture was varied between 0.5% and 3.5%. The oil was initially subjected to 0.2 g of LMA and 20 mbar of oxygen pressure. The thermal ageing experiment was performed at 120 °C and 140 °C for 28 days. Several dielectric and physiochemical parameters were measured which included dielectric dissipation factor, relative permittivity, resistivity, moisture in oil, acidity, and thermogravimetric analysis (TGA). It is found that LMA and moisture in paper do not affect the relative permittivity of RBDPO and mineral oil (MO). The dielectric dissipation factor of RBDPO and MO reveals slight increment trends within the ageing time. The decrements of resistivities occur after 7 days of ageing for both RBDPO and MO while only RBDPO shows decrement trend of moisture in oil. The ageing patterns of relative permittivities, dielectric dissipation factors and resistivities for RBDPO are similar to MO. The increment of acidity for RBDPO is more apparent that MO throughout the ageing time. All RBDPOs are more resistant to ageing than MO based on the TGA.
Transforming image descriptions as a set of descriptors to construct classification features
Authors: Gorokhovatskyi Volodymyr , Tvoroshenko Iryna , Yakovleva Olena
Published: January 2024

The article develops methods to solve a fundamental problem in computer vision: image recognition of visual objects. The results of the research on the construction of modifications for the space of classification features based on the application of the transformation of the structural description through the decomposition in the orthogonal basis and the implementation of the distance matrix model between the components of the description are presented. The application of the system of orthogonal functions as an apparatus for the transformation of the description showed the possibility of a significant gain in the speed of processing while maintaining high indicators of classification accuracy and interference resistance. The synthesized feature systems’ effectiveness has been confirmed in terms of a significant increase in the rate of codes and a sufficient level of efficiency. An experimental example showed that the time spent calculating the relevance of descriptions according to their modified presentation is more than ten times shorter than for traditional metric approaches. The developed classification features can be used in applied tasks where the time of visual objects’ identification is critical.