bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategies for the Enhancement of Nutrition Practice in a New York State Level 1 Trauma Center: A Hospital’s Journey
Authors: Musillo Lisa , Grguric Laryssa Marie , Coffield Edward , Aversano Frank , Bosworth Jeremy , Batista Richard
Published: September 2022

Background: Provision of enteral nutrition (EN) support is historically inadequate in the critically ill population. An interdisciplinary approach utilizing various strategies has been shown to improve initiation of timely EN support. The purpose of this study was to examine whether the implementation of a series of interventions led by an interdisciplinary team was associated with changes in the initiation of nutrition support in a level 1 trauma center. Methods: Patients admitted between 2009 and 2013 with isolated closed head trauma injuries were identified through the hospital’s trauma center database. The initial population consisted of 159 patients; after exclusion criteria, 141 patients were included in the statistical analyses. Two statistical analyses were conducted. The first calculated the average days to the initiation of nutrition start by admission year. The second estimated the association between admission year and time to nutrition initiation with a generalized linear model. Results: Time to initiate nutrition therapy was estimated to decrease by 1.46 days (47.31%) from 2009 to 2013. The time to initiate nutrition in 2013 was 1.63 days. A significant association was found between the time to initiate nutrition and the 2012 and 2013 binary variables while controlling for confounding variables. The time frame was estimated to be 1.09 (P = .008) and 1.75 (P = .000) days shorter in 2012 and 2013 relative to 2009. Conclusions: An interdisciplinary effort utilizing multiple strategies identified and addressed barriers, resulting in a reduction of variability and a proactive approach to early EN.
Null Association Between Isolated Orofacial Clefts and Sleep Duration: A Cohort Study From the Japan Environment and Children's Study
Authors: Sato Yukihiro , Yoshioka Eiji , Saijo Yasuaki , Kato Yasuhito , Nagaya Ken , Takahashi Satoru , Ito Yoshiya , Kobayashi Sumitaka , Ait Bamai Yu , Yamazaki Keiko , Itoh Sachiko , Miyashita Chihiro , Ikeda-Araki Atsuko , Kishi Reiko ,   The Japan Environment and Children’s Study (JECS) Group
Published: September 2022

Although children with orofacial clefts have an increased risk for sleep-disordered breathing, no studies have examined the association of sleep duration. Thus, this study aimed to examine associations between orofacial clefts and sleep duration at 1 month, 6 months, 1 year, and 3 years of age in Japan.

A cohort study from the Japan Environment and Children's Study.

This study consisted of 91 497 children, including ones with isolated cleft lip and palate (n = 69), isolated cleft lip only (n = 48), and isolated cleft palate only (n = 37), for which recruitment was undertaken during 2011 to 2014.

Seep durations (hours per day) at 1 month, 6 months, 1 year, and 3 years of age, as reported by their mothers.

In the control group, mean sleep durations and standard deviations at 1 month, 6 months, 1 year, and 3 years of age were 15.2 (2.5), 13.6 (1.9), 12.9 (1.6), and 11.6 (1.2) h, respectively. Compared to the control group, linear regression models reported effect sizes and 95% confidence intervals shorter than 1 h for sleep duration of each type of isolated orofacial cleft at each time point.

This study suggested null associations between isolated orofacial clefts and sleep duration at 1 month, 6 months, 1 year, and 3 years of age. Children with isolated orofacial clefts had sufficient mean sleep duration.
Prognosis and Treatment of Metastatic Breast Cancer From A Real-World Scenario in China: A Retrospective Cohort Study
Authors: Xie Yuxin , Ma Ji , Xia Xueming , Zheng Hong , Gou Qiheng
Published: September 2022

Objectives

Although metastatic breast cancer (MBC) is considered incurable, a specific subset of patients exhibits prolonged survival and even achieve a “cure”. We retrospectively identified predictive prognostic factors and systemic therapy models to find this group of potentially cured patients.

Methods

Consecutive patients diagnosed with MBC from 1991-2016 in West China Hospital were included. Univariate and multivariate analyses were conducted to assess the association of clinical factors and systemic therapy models with overall survival (OS), breast cancer-specific survival (BCSS) and progression-free survival (PFS).

Results

The median OS was 63.4 months. Age, tumor size, lymph node metastasis, histologic grade, molecular subtype, site and number of metastases and metastasis-free interval (MFI) were related to the prognosis of MBC (P < .05). Patients with T1, N0-1, luminal A, bone metastasis, OMBC (oligometastatic breast cancer) or metastasis-free interval (MFI) ≥ 3 years showed the median OS more than 10 years (P < .001). Independent prognostic factors that correlated with OS and BCSS were residence, lymph node metastasis, histologic grade, molecular subtype, and site of metastasis (P < .05). The group of sequential chemo-endocrine therapy (ST) in hormone receptor (HR)-positive MBC patients showed the highest overall response rate (ORR) (P < .05). However, patients who received endocrine therapy (ET) showed the best OS, BCSS and PFS in the first two-line treatment, followed by ST and chemotherapy (CT) (P < .05).

Conclusions

Our study shows the predictive prognostic factors and systemic therapy models to facilitate patients likely to achieve long-term survival.
Effect of decentration and tilt on four novel extended range of vision intraocular lenses regarding far distance
Authors: Schmid Ruediger , Luedtke Holger , Borkenstein Andreas F.
Published: September 2022

Purpose

To analyze the effect of decentration and tilt on four novel non diffractive extended range of vision intraocular lenses (IOLs).

Methods

Acrysof Vivity, LuxSmart Crystal, RayOne EMV and Tecnis Eyhance were compared on the optical bench (power of 22 D each). Modulation transfer functions were obtained and Strehl ratio was calculated in an ISO-2 model. Apertures of 3 mm and 4.5 mm were applied. For qualitative assessment, United States Airforce (USAF) chart images were evaluated. Additional to centered IOLs, tilt of 5 degrees and decentration of 1 mm were applied.

Results

RayOne EMV was very robust against misalignment but had considerable deterioration of modulation transfer function (MTF) for large aperture with USAF images seriously blurred. Tilt and decentration decreased the performance of Eyhance significantly but had minor impact on the performance of Vivity and LuxSmart. For 4.5 mm aperture, MTF and Strehl ratio decreased markedly for all IOLs compared to 3 mm aperture size. The best MTF and Strehl ratio was obtained for Eyhance IOL well centered for both sizes of aperture.

Conclusion

Tilt and decentration had a major impact on the performance of Eyhance only, which performed best of all IOLs tested when well centered. With large aperture, performance of all IOLs significantly decreased. Manufacturer's different approaches for these novel IOLs to increase depth of focus by increasing spherical aberration lead to a different performance in respect to contrast function and sensitivity to misalignment. Our results apply to the distance vision. Near vision performance will be evaluated in a separate investigation.
Increased Revenue From Averted Missed Appointments Following Telemedicine Adoption at a Large Federally Qualified Health Center
Authors: Adepoju Omolola E. , Angelocci Tracy , Matuk-Villazon Omar
Published: September 2022

This study examined savings from averted missed appointments following telemedicine adoption. Data were obtained from a large Federally Qualified Health Center in Texas during the early pandemic months. Patient encounters fell into one of three categories: (1) in-person visit, (2) telemedicine alone with no support team engagement, and (3) telemedicine with previsit support team engagement for device and connectivity testing. Our findings revealed that in-person visits had a 21% missed appointment rate compared to 19% for telemedicine alone and 15% for telemedicine with previsit support. Translating the reductions following both telemedicine encounters into net reimbursement, telemedicine alone saved the Federally Qualified Health Center $16 444 per month, while telemedicine + support team reduced missed appointments and saved the clinic an additional $29 134. The revenue from averted missed appointments totaled $45 578 per month. In conclusion, telemedicine reduced missed appointments, and these averted missed appointments translated into cost-savings. Savings were more pronounced with the implementation of a support team that conducted previsit device and connectivity testing.
“The ultimate test of self-discipline”: Lockdown and the NoFap community
Authors: Smith David S. , Butler-Warke Alice , Davidson Emma-Lee , Stevens Gemma
Published: September 2022

NoFap is a community of mostly heterosexual men abstaining from what they see as an addictive cycle of pornography, masturbation, and orgasm, induced by the exploitation of innate male urges by the pornography industry. In the general population, increased masturbation and consumption of pornography are associated with psychological factors including low affect, loneliness, and boredom, all of which may be exacerbated by the lockdown/social distancing measures adopted in response to the Covid-19 pandemic. The present study explores how the NoFap community has responded to the pandemic through discourse analysis of an online message board. We identify four key themes: i) I let go in lockdown, ii) the opportunity of lockdown, iii) testing the parameters of NoFap, and iv) community cohesion. Each is defined and discussed. Combined they illustrate a digital community struggling to honor its meritocratic masculine ideals in the face of challenging circumstances.
Participant Use of Digital Diaries in Qualitative Research: A Strong Structuration Analysis
Authors: Seguin Maureen , Mendoza Jhaki , Mallari Eunice , Lasco Gideon , Maever L Amit Arianna , Palileo-Villanueva Lia M , Palafox Benjamin , Renedo Alicia , McKee Martin , Balabanova Dina
Published: September 2022

Lived experiences of chronic conditions are marked by fluidity and change, which should be considered if care is to be truly patient-centered. Seeking to capture this fluidity, we used digital diaries via mobile phones to communicate with hypertensive patients in the Philippines over approximately 12 months. This paper draws on Strong Structuration Theory to conceptualize the complex array of factors shaping participants’ usage (and non-usage) of the diaries, thereby offering a comprehensive understanding of how the diaries were perceived and used. We draw on qualitative data from 42 participants (73 baseline/follow-up interviews and 37 digital diaries), purposively selected from a larger pool of quantitative participants, as well as existing literature and our own study documents. The Philippines ‘digital divide' presented barriers to the usage of the diaries, stemming from a lack of access and mobile signal especially in socioeconomically marginalized rural areas. Within this context, the sharing of mobile phones both enabled and constricted diary participation. Guided by Strong Structuration Theory, we observed three cycles of structuration evident in participants’ usage of diaries. The first pertained to the frequency and mode of engagement. A low level of engagement was observed, stemming from negative or ambivalent attitudes toward texting and other factors. Conversely, mobile phone ‘top-ups’ enabled participation. Participant usage of the diaries as tools for monitoring hypertension and to request health advice comprise the second and third structuration cycles. These usages contrast with researchers’ intended usage of the diaries and with the original brief given to participants. The conflict between participants’ and researchers’ understanding of the appropriate uses of the diaries represents the dynamic field of position-practice relations, wherein agents are situated and interact, either perpetuating or challenging existing societal structures. Our findings underline the importance of considering macro- and meso-level factors when considering or conducting research using digital diaries.
Magnetic resonance imaging in the evaluation of suspected hip sepsis in children
Authors: Corin Nicole , Bennet Simon , Hill Joshua , Thomas Simon
Published: September 2022

Background:

Rapid and accurate diagnosis of musculoskeletal infection in children is critical to enable appropriate, targeted surgical interventions. Distinguishing between septic arthritis, myositis, and osteomyelitis around the hip can be difficult using clinical criteria and ultrasound scan alone.

Materials and methods:

We performed a retrospective 5-year observational review of selective magnetic resonance imaging scanning for hip sepsis in a pediatric tertiary referral center. Included were children with atraumatic hip pain with symptom duration <2 weeks, minimum of two positive modified Kocher’s criteria, and a hip effusion on ultrasound. All cases were followed up to discharge. We evaluated hip ultrasound and magnetic resonance imaging findings, operative procedures, microbiology results, duration of treatment, outcomes, and complications.

Results:

Fifty-one patients, 55% male, with a mean age 6.4 (0–16) years were included. Thirty-nine underwent magnetic resonance imaging scan for suspected septic arthritis of the hip; 24 prior to surgical washout (pre-emptive), and 15 afterwards (postoperative). In the pre-emptive group, 1/24 had septic arthritis, 7/24 had osteomyelitis, 6/24 had myositis, 5/24 had osteomyelitis and myositis, and 5/24 had no evidence of infective pathology. In the postoperative group, 3/15 had myositis, 3/15 had osteomyelitis, 3/15 had re-accumulation of the hip effusion requiring repeat washout, 3/15 had myositis and osteomyelitis, and 1/15 had septic arthritis of a contiguous joint.

Conclusion:

Pre-emptive magnetic resonance imaging scanning avoided unnecessary hip washout in 23 cases and enabled targeted drainage of an alternative focus in four of those. Magnetic resonance imaging scanning after hip washout indicated that four cases required further surgery to drain a different focus of infection.
On postcapitalist repair
Authors: Smith Thomas S.J.
Published: September 2022

This commentary responds to Carr's thoughtful intervention on the work of climate crisis by, first, foregrounding a pluriversal perspective on repair and, second, pushing Carr's work to more explicitly engage with forms of work enacting postcapitalist possibility. This could be framed as the move from ‘transition’ to ‘transformation’. In doing so, the role of geographers in intervening for transformation is flagged as one possible future direction for such work.
A Novel Posterior Compression Score System for Outcome Prediction in Laminoplasty Treated OPLL Patients: A Propensity-Matched Analysis
Authors: Wei Leixin , Cao Peng , Xu Chen , Hu Bo , Wu Huiqiao , Tian Ye , Chen Huajiang , Shen Xiaolong , Yuan Wen
Published: September 2022

Study Design

A retrospective observational study.

Objective

To describe a novel outcome indication system, the posterior compression score (PCS), and investigate its clinical value in cervical ossification of the posterior longitudinal ligament (OPLL) patients treated with laminoplasty.

Methods

A total of 282 OPLL patients who underwent laminoplasty from January 2013 to December 2018 were reviewed. The patients were divided into high-score (HS) or low-score (LS) groups based on whether the PCS was over 8. Propensity score matching analysis with a caliper of .1 was used to attenuate the potential selection bias. Clinical measurements, including the Japanese Orthopedic Association (JOA) score, visual analog scale (VAS), neck disability index (NDI), and radiological measurements, including C2–C7 lordotic angle and range of motion (ROM), were compared between the groups.

Results

The mean follow-up period was 29.87 ± 9.17 months. There were no significant differences between the two groups regarding patients’ baseline demographical and clinical characteristics after propensity score matching. No significant differences were found in the operative time, blood loss, postoperative VAS score for neck and arm pain, postoperative C2–C7 lordotic angle, or postoperative ROM ( P > .05). However, the postoperative JOA score and recovery rate were significantly higher in the HS group than in the LS group, while the postoperative NDI was significantly lower in the HS group ( P < .05).

Conclusion

OPLL patients with higher PCS scores displayed better clinical outcomes. The novel PCS system is suggested to be a reliable scoring system for surgical outcome evaluation in patients with cervical OPLL.
Genome-wide association analyses of common infections in a large practice-based biobank
Authors: Jiang Lan , Kerchberger V. Eric , Shaffer Christian , Dickson Alyson L. , Ormseth Michelle J. , Daniel Laura L. , Leon Barbara G. Carranza , Cox Nancy J. , Chung Cecilia P. , Wei Wei-Qi , Stein C. Michael , Feng QiPing
Published: September 2022

Introduction

Infectious diseases are common causes of morbidity and mortality worldwide. Susceptibility to infection is highly heritable; however, little has been done to identify the genetic determinants underlying common infectious diseases. One GWAS was performed using 23andMe information about self-reported infections; we set out to confirm previous loci and identify new ones using medically diagnosed infections.

Methods

We used the electronic health record (EHR)-based biobank at Vanderbilt and diagnosis codes to identify cases of 12 infectious diseases in white patients: urinary tract infection, pneumonia, chronic sinus infections, otitis media, candidiasis, streptococcal pharyngitis, herpes zoster, herpes labialis, hepatitis B, infectious mononucleosis, tuberculosis (TB) or a positive TB test, and hepatitis C. We selected controls from patients with no diagnosis code for the candidate disease and matched by year of birth, sex, and calendar year at first and last EHR visits. We conducted GWAS using SAIGE and transcriptome-wide analysis (TWAS) using S-PrediXcan. We also conducted phenome-wide association study to understand associations between identified genetic variants and clinical phenotypes.

Results

We replicated three 23andMe loci (p ≤ 0.05): herpes zoster and rs7047299-A (p = 2.6 × 10–3) and rs2808290-C (p = 9.6 × 10–3;); otitis media and rs114947103-C (p = 0.04). We also identified 2 novel regions (p ≤ 5 × 10–8): rs113235453-G for otitis media (p = 3.04 × 10–8), and rs10422015-T for candidiasis (p = 3.11 × 10–8). In TWAS, four gene-disease associations were significant: SLC30A9 for otitis media (p = 8.06 × 10–7); LRP3 and WDR88 for candidiasis (p = 3.91 × 10–7 and p = 1.95 × 10–6); and AAMDC for hepatitis B (p = 1.51 × 10–6).

Conclusion

We conducted GWAS and TWAS for 12 infectious diseases and identified novel genetic contributors to the susceptibility of infectious diseases.
The effect of lockdowns and distant learning on the health-related behaviours of school students in the United Arab Emirates
Authors: Sajwani Najla Hussain , Qawas Ahmed , Al Ali Nouf , Sajwani Fatma Hussain , Alrustamani Asma Hamed , Al Maamari Shamma , Al Mazrouei Shereena K. , Al Shehhi Budoor , Al Rand Hussain , Fikri Asma Mahmoud
Published: September 2022

Background

The COVID-19 pandemic began to affect the world in early 2020. As a preventive measure, schools in the UAE adopted remote learning. This study aimed to assess the effects of the lockdown and remote learning on the health-related behaviours of school students in the UAE.

Methods

A cross-sectional study using an online survey comprising 33 questions related to physical activity, eating, sleeping and screen time was answered by the students’ parents. Chi-square tests, paired Student’s t tests and frequency tables were used for analysis.

Results

A total of 27,754 responses were received: 46.3% of the parents indicated a significant decrease in physical activity; 44.6% indicated an increase in unhealthy snack consumption; and 51.9% indicated decreased food ordering from restaurants. The percentage of students who slept more than 9 hours and those who slept less than 6 hours increased. Screen time increased significantly for both educational and entertainment purposes (P value < 0.0001).

Conclusion

The study showed changes in the lifestyle and health-related behaviours of school students as indicated by their parents. Risk factors such as a lack of physical activity, increased food consumption, sleeping and screen time were directly affected. Therefore, it is important to further investigate these changes and their effects to help design targeted health education programs and promotion campaigns.
Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines
Authors: De Simone Belinda , Chouillard Elie , Ramos Almino C. , Donatelli Gianfranco , Pintar Tadeja , Gupta Rahul , Renzi Federica , Mahawar Kamal , Madhok Brijesh , Maccatrozzo Stefano , Abu-Zidan Fikri M. , E. Moore Ernest , Weber Dieter G. , Coccolini Federico , Di Saverio Salomone , Kirkpatrick Andrew , Shelat Vishal G. , Amico Francesco , Pikoulis Emmanouil , Ceresoli Marco , Galante Joseph M. , Wani Imtiaz , De’ Angelis Nicola , Hecker Andreas , Sganga Gabriele , Tan Edward , Balogh Zsolt J. , Bala Miklosh , Coimbra Raul , Damaskos Dimitrios , Ansaloni Luca , Sartelli Massimo , Pararas Nikolaos , Kluger Yoram , Chahine Elias , Agnoletti Vanni , Fraga Gustavo , Biffl Walter L. , Catena Fausto
Published: September 2022

Background

Patients presenting with acute abdominal pain that occurs after months or years following bariatric surgery may present for assessment and management in the local emergency units. Due to the large variety of surgical bariatric techniques, emergency surgeons have to be aware of the main functional outcomes and long-term surgical complications following the most performed bariatric surgical procedures. The purpose of these evidence-based guidelines is to present a consensus position from members of the WSES in collaboration with IFSO bariatric experienced surgeons, on the management of acute abdomen after bariatric surgery focusing on long-term complications in patients who have undergone laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass.

Method

A working group of experienced general, acute care, and bariatric surgeons was created to carry out a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and to answer the PICO questions formulated after the Operative management in bariatric acute abdomen survey. The literature search was limited to late/long-term complications following laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass.

Conclusions

The acute abdomen after bariatric surgery is a common cause of admission in emergency departments. Knowledge of the most common late/long-term complications (> 4 weeks after surgical procedure) following sleeve gastrectomy and Roux-en-Y gastric bypass and their anatomy leads to a focused management in the emergency setting with good outcomes and decreased morbidity and mortality rates. A close collaboration between emergency surgeons, radiologists, endoscopists, and anesthesiologists is mandatory in the management of this group of patients in the emergency setting.
Single-cell analysis reveals heterogeneity of juvenile idiopathic arthritis fibroblast-like synoviocytes with implications for disease subtype
Authors: Simonds Megan M. , Sullivan Kathleen E. , Brescia AnneMarie C.
Published: September 2022

Background

Fibroblast-like synoviocytes (FLS) play a crucial role in JIA pathogenesis; however, the mechanisms by which they contribute to disease progression are not well described. Previous studies demonstrated that rheumatoid arthritis FLS are heterogeneous, and subpopulations with transformed, aggressive phenotypes cause invasive and destructive disease activity. We employ single-cell RNA-sequencing (scRNA-seq) to investigate JIA FLS heterogeneity and gene expression that distinguishes JIA subtypes.

Methods

JIA FLS cell lines from three persistent oligoarticular, three pre-extension oligoarticular, and three polyarticular subtypes were cultured. scRNA-seq was performed by Genewiz according to 10 × Genomics Chromium protocols. SeuratR package was used for QC, analysis, and exploration of data.

Results

FLS are heterogeneous and have characteristics of fibroblasts, chondrocytes, and smooth muscle cells. The chondrocyte-like subpopulation is the predominant cell type and percentages of this subpopulation increase with disease severity. Despite overlapping subpopulations, the chondrocyte-like cells have unique genetic fingerprints that distinguish between JIA subtypes. LRRC15, GREM1, and GREM2 are overexpressed in chondrocyte-like cells from persistent oligoarticular JIA FLS compared to pre-extension oligoarticular JIA FLS. S100A4, TIMP3, and NBL1 are overexpressed in pre-extension oligoarticular JIA FLS compared to polyarticular JIA FLS. CRLF1, MFAP5, and TNXB are overexpressed in persistent oligoarticular JIA FLS compared to polyarticular JIA FLS.

Conclusions

We found biologically relevant differences in gene expression between JIA subtypes that support a critical role for FLS in pathogenesis. We also demonstrate that gene expression within the chondrocyte-like subpopulation can be used to distinguish between these subtypes.
Psychometric properties of Persian version of diabetes health literacy scale (DHLS) in patients with type 2 diabetes
Authors: Moshki Mahdi , Alami Ali , Zadehahmad Zohreh , Ghelichi-Ghojogh Mousa , Dogonchi Mitra , Jafari Alireza
Published: September 2022

Background

The purpose of this study was to investigate the psychometric properties of the Persian version of Diabetes Health Literacy Scale in type 2 diabetic patients.

Method

This cross-sectional study was conducted in 2021 in 1040 patients with type 2 diabetes in eastern Iran. Participants was selected by proportional stratified sampling method. The validity of DHLS was investigated through qualitative face validity, qualitative content validity, and structural validity (exploratory factor analysis and confirmatory factor analysis). The reliability of DHLS was checked by Cronbach's alpha coefficient, McDonald omega coefficient, and test–retest.

Results

In exploratory factor analysis, 3 factors with eigenvalues greater than 1 were extracted, explaining 68.57% of the variance. These factors entered the confirmatory factor analysis, none of the questions were removed, and all questions had factor loading above 0.4. Cronbach's alpha coefficient and McDonald omega coefficient of DHLS were 0.919 and 0.922. Also, the Intraclass correlation coefficient of DHLS was 0.957. Finally, the DHLS was approved with 14 questions and the three subscales of Informational Health Literacy (6 items), Numerate Health Literacy (5 items), and Communicative Health Literacy (3 items).

Conclusions

DHLS with 14 questions and the three subscales is a valid and reliable tool for examining diabetes health literacy in people with type 2 diabetes.
Regulatory effect of peroxiredoxin 1 (PRDX1) on doxorubicin-induced apoptosis in triple negative breast cancer cells
Authors: Han Ying-Hao , Lian Xu-Dong , Lee Seung-Jae , Li Wei-Long , Sun Hu-Nan , Jin Mei-Hua , Kwon Taeho
Published: September 2022

Patients with triple negative breast cancer (TNBC) lack the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2; thus, conventional hormone and targeted therapies have minimal effect on them. Therefore, clinical treatment of TNBC is still based on chemotherapy and supplemented by other methods. Doxorubicin (DOX), a common drug used in TNBC chemotherapy, has high affinity for cardiolipin, and the nematosomes are rich in cardiolipin; therefore, DOX has high mitochondria-targeting ability. DOX accumulates and plunders the electrons of nicotinamide adenine dinucleotide phosphate (NADPH) and cytochrome C in mitochondria to produce semiquinone DOX. Under the action of oxygen molecules, semiquinone DOX is reduced to DOX and reactive oxygen species (ROS) are generated. The accumulation of ROS can cause mitochondrial dysfunction and lead to mitochondrial dependent apoptosis. Bioinformatic analysis of samples from TNBC patients revealed that peroxiredoxin 1 (PRDX1) was highly expressed in TNBC tissues, and the poor prognosis of patients with high PRDX1 expression was considerably increased. Previous studies determined that DOX can upregulate the expression of the PRDX1 protein in the human TNBC cell line (MDA-MB-231). Thus, we speculate that PRDX1 plays an important role in the process of DOX-induced TNBC cell apoptosis. In this study, we aimed to explore the role of PRDX1 in the process of DOX-induced TNBC cell apoptosis. We found that PRDX1 deletion increased the sensitivity of MDA-MB-231 cells to DOX, which was mainly due to mitochondrial oxidative stress caused by intracellular ROS accumulation, leading to mitochondria-dependent apoptosis. Deletion of PRDX1 promotes the PI3K/Akt signaling pathway to mediate the expression of GSK3β. Gsk3β is an upstream signal of mitochondria-dependent apoptosis, and is also an important target of ROS. PRDX1 participates in adriamycin-induced apoptosis of TNBC cells by regulating the expression level of GSK3β. Our findings present new insights to treat breast cancer and TNBC, outlines the clinical use of DOX, and provides a basic theory to develop PRDX1 gene function.
Kernel density estimation of conditional distributions to detect responses in satellite tag data
Authors: Hewitt Joshua , Gelfand Alan E. , Quick Nicola J. , Cioffi William R. , Southall Brandon L. , DeRuiter Stacy L. , Schick Robert S.
Published: September 2022

Background

As levels of anthropogenic noise in the marine environment rise, it is crucial to quantify potential associated effects on marine mammals. Yet measuring responses is challenging because most species spend the majority of their time submerged. Consequently, much of their sub-surface behavior is difficult or impossible to observe and it can be difficult to determine if—during or following an exposure to sound—an observed dive differs from previously recorded dives. We propose a method for initial assessment of potential behavioral responses observed during controlled exposure experiments (CEEs), in which animals are intentionally exposed to anthropogenic sound sources. To identify possible behavioral responses in dive data collected from satellite-linked time–depth recorders, and to inform the selection and parameters for subsequent individual and population-level response analyses, we propose to use kernel density estimates of conditional distributions for quantitative comparison of pre- and post-exposure behavior.

Results

We apply the proposed method to nine Cuvier’s beaked whales (Ziphius cavirostris) exposed to a lower-amplitude simulation of Mid-Frequency Active Sonar within the context of a CEE. The exploratory procedure provides evidence that exposure to sound causes animals to change their diving behavior. Nearly all animals tended to dive deep immediately following exposure, potentially indicating avoidance behavior. Following the initial deep dive after exposure, the procedure provides evidence that animals either avoided deep dives entirely or initiated deep dives at unusual times relative to their pre-exposure, baseline behavior patterns. The procedure also provides some evidence that animals exposed as a group may tend to respond as a group.

Conclusions

The exploratory approach we propose can identify potential behavioral responses across a range of diving parameters observed during CEEs. The method is particularly useful for analyzing data collected from animals for which neither the baseline, unexposed patterns in dive behavior nor the potential types or duration of behavioral responses is well characterized in the literature. The method is able to be applied in settings where little a priori knowledge is known because the statistical analyses employ kernel density estimates of conditional distributions, which are flexible non-parametric techniques. The kernel density estimates allow researchers to initially assess potential behavioral responses without making strong, model-based assumptions about the data.
Explaining the diminishing of Muslim advantage in child survival in India
Authors: Ganguly Dibyasree , Goli Srinivas , Rammohan Anu
Published: September 2022

Religion is one of the key instrumental social institutions in determining child health and mortality. Muslim advantage in child survival in India has been widely reported. Recent India’s National Family Health Survey (NFHS) shows that the gap between Hindu–Muslim childhood mortality rates is shrinking—reversing decades of child survival advantage for Muslims. This study examines the factors linked to the diminishing of Muslim advantage in childhood survival and attempts to uncover the mechanisms accounting for the convergence using the characteristics hypothesis of Goldscheider (Population, modernization, and social structure Little, Brown & Co; 1971) and the analytical framework of Guillot and Allendorf (Genus 66(2), 2010). We have analyzed a pooled sample of 23,47,245 all live births and 428,541 of last live births from four rounds of NFHS (1992–2016). Kaplan–Meier survival plots over time by religion confirm convergence in Hindu–Muslim child survival probabilities. The Pyatt decomposition model reveals that the gap in Hindu–Muslim childhood mortality is diminishing due to a decline in within-Hindu inequality. Cox proportional hazard regression model shows that improvement in household and maternal socioeconomic factors has contributed to Hindu children catching up with Muslims—leading to a convergence in Hindu–Muslim childhood survival probabilities. Conditional β-convergence regression model also suggests the convergence in socio-economic status and maternal health care is driving the convergence in child survival of Hindus and Muslims across Indian states.
Autism-associated CHD8 keeps proliferation of human neural progenitors in check by lengthening the G1 phase of the cell cycle
Authors: Coakley-Youngs Emma , Ranatunga Medhavi , Richardson Simon , Getti Giulia , Shorter Susan , Fivaz Marc
Published: September 2022

De novo mutations (DNMs) in chromodomain helicase DNA binding protein 8 (CHD8) are associated with a specific subtype of autism characterized by enlarged heads and distinct cranial features. The vast majority of these DNMs are heterozygous loss-of-function mutations with high penetrance for autism. CHD8 is a chromatin remodeler that preferentially regulates expression of genes implicated in early development of the cerebral cortex. How CHD8 haploinsufficiency alters the normal developmental trajectory of the brain is poorly understood and debated. Using long-term single-cell imaging, we show that disruption of a single copy of CHD8 in human neural precursor cells (NPCs) markedly shortens the G1 phase of the cell cycle. Consistent with faster progression of CHD8+/− NPCs through G1 and the G1/S checkpoint, we observed increased expression of E cyclins and elevated phosphorylation of Erk in these mutant cells – two central signaling pathways involved in S phase entry. Thus, CHD8 keeps proliferation of NPCs in check by lengthening G1, and mono-allelic disruption of this gene alters cell-cycle timing in a way that favors self-renewing over neurogenic cell divisions. Our findings further predict enlargement of the neural progenitor pool in CHD8+/− developing brains, providing a mechanistic basis for macrocephaly in this autism subtype.
Online mentoring of medical students during COVID-19 pandemic: Another new normal
Authors: Usmani Ambreen , Imran Manal , Javaid Quratulain , Tariq Junaid
Published: September 2022

Objectives: To determine the impact of online mentoring sessions on the students during the pandemic time.

Methods: The cross-sectional descriptive study was conducted at Bahria University Medical and Dental College, Karachi. The total study duration was 5 months from March 2021 to July 2021. Quantitative research design was used. Categorical data was scored on a three point Likert scale (1= ‘Disagree’, 2= ‘Neutral’ and 3= ‘Agree’). Frequencies and percentages were calculated to determine the impact of online mentoring.

Results: Sixty two percent of 2nd year MBBS students were of the opinion that online mentoring was helpful as compared to 58% 1st year and 50% 3rd year students. Students were anxious while sharing their issues online. A total of 61.66% were eager to have classes on campus as compared to online as learning difficulties were felt in 70%, 77% and 81% of 1st, 2nd and 3rd year classes respectively. Of the 1st year 39%, 2nd year 46% and 3rd year 32% showed relief after the mentoring session but were in favor of face to face sessions. Technical issues were faced by 54% 1st year, 66% 2nd year and 64% 3rd year students.

Conclusion: The study suggested that students were overall satisfied with the online mentoring sessions. They do have certain apprehensions like privacy and confidentiality issues but on the whole, they considered this medium as being a powerful one in times of the pandemic.

doi: https://doi.org/10.12669/pjms.38.8.5833

How to cite this:Usmani A, Imran M, Javaid Q, Tariq J. Online mentoring of medical students during COVID-19 pandemic: Another new normal. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5833

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effectiveness of avocado leaf extract (Persea americana Mill.) as antihypertensive
Authors: Sutiningsih Dwi , Sari Dewi Puspito , Adi Mateus Sakundarno , Hadi Mochammad , Azzahra Nur Azizah
Published: September 2022

Background

Long-term chemical drug consumption to treat hypertension may have side effects because the levels are sometimes difficult for the body to tolerate. Therefore, some people have used plants as herbal medicine, including avocado leaves (Persea americana Mill.) as antihypertensive. This study aims to find out the differences in the effectiveness of modern drugs and natural antihypertensive ingredients in avocado leaf extract (containing flavonoids and quercetin compounds) in inhibiting the ACE enzyme, which causes decreasing systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as increasing urine volume.

Methods

This study used an experimental in vivo study design involving 24 white male Wistar rats (Rattus norvegicus), aged 2–3 months, weighing 130–250 g, and of a healthy condition with active movement. The samples were randomly divided into six treatment groups and post-test only research design with control group design.

Results

The result of the study showed that avocado leaf extract was effective in reducing blood pressure in Wistar rats with hypertension induced by 16% NaCl for 14 days. SBP fell from 164.92 mmHg to 116.83 mmHg and DBP from 118.42 mmHg to 82.83 mmHg. One-way ANOVA test value significance SBP p=0.000 and Kruskal–Wallis test value of DBP p=0.030, Kruskal–Wallis test urine volume value of p=0.002. The statistical test results proved that avocado leaf extract significantly reduced the blood pressure and increased the urine volume in hypertensive rats. The ACE inhibitor test, performed using an ELISA, showed that the extract inhibition against the ACE enzyme was 60.0±12.1%, serum nitrate levels 41.1±11.5. The decrease in blood pressure occurred because the extract contained a quercetin compound discovered by the high-performance liquid chromatography (HPLC) method of 1129.597 ppm.

Conclusions

The study showed that the leaf extract of Persea americana Mill. was effective as an antihypertensive.
Recent advancements in machine vision methods for product code recognition: A systematic review
Authors: Koponen Jarmo , Haataja Keijo , Toivanen Pekka
Published: September 2022

Background: Manufacturing markings printed on products play an important role in the handling and use of pharmaceuticals and perishable foods. Currently, optical character recognition, neural networks, deep learning-based methods, and combinations of these methods are used to recognize these codes.

Methods: This systematic review was performed to find papers that can answer the following research questions: How have machine vision methods that can recognize product texts evolved over the past eight years? What are the most common difficulties in recognizing product texts? Articles published between 2012 and 2020 were systematically searched from Science Direct/SCOPUS, and Google Scholar in November-December 2020. Ten studies were eligible, with inclusion criteria: details about the recognition method used, performance analysis result, imaging method, product and the text printed on it.

Results: Product text recognition methods have evolved significantly over the last two years to tolerate the most common difficulties in the field. This is due to the ability of the deep learning neural network (DNN) architectures such as convolutional neural networks (CNN) to extract and learn salient character features straight from packaging surface images. Four of the most recent methods use two consecutive deep learning networks, one detecting the text area based on an image captured from the product package's surface and the other recognizing the characters within. Furthermore, this paper presents solutions to the most common product text recognition difficulties.

Conclusions: There were a limited number of studies that met the eligibility criteria for this systematic review. The study's aim was to evaluate the development of machine vision methods for recognizing manufacturing marking texts printed on the surface of products. The study results demonstrated how methods have evolved over time, beginning with optical character recognition, and advancing to methods which can recognize texts despite the field's most common problems.
Spectral-domain biphoton interferometry with frequency scanning: theoretical proposal and resolution limits
Authors: Ushakov Nikolai , Markvart Aleksandr , Liokumovich Leonid
Published: September 2022

The paper proposes a spectral-domain version of a biphoton (Hong–Ou–Mandel) interferometry. The operation principle is based on measuring the coincidence rate of entangled photons while scanning the difference between their central frequencies. A theoretical apparatus describing the operation principle and the resolution limits of the proposed spectral-domain biphoton interferometry is developed. The analysis is based on quantum and classical Cramer–Rao bounds. It was shown that the proposed spectral-domain biphoton interferometry approach enables the mitigation of the fringe number counting errors, often encountered in classical spectral interferometry. A comparison with a conventional Hong–Ou–Mandel biphoton interferometry is also presented.
A novel implantable mechanism-based tendon transfer surgery for adult acquired flatfoot deformity: Evaluating feasibility in biomechanical simulation
Authors: Ling Hantao , Balasubramanian Ravi
Published: September 2022

Adult acquired flatfoot deformity becomes permanent with stage III posterior tibialis tendon dysfunction and results in foot pain and difficulty walking and balancing. To prevent progression to stage III posterior tibialis tendon dysfunction when conservative treatment fails, a flexor digitorum longus to posterior tibialis tendon transfer is often conducted. However, since the flexor digitorum longus only has one-third the force-capability of the posterior tibialis, an osteotomy is typically also required. We propose the use of a novel implantable mechanism to replace the direct attachment of the tendon transfer with a sliding pulley to amplify the force transferred from the donor flexor digitorum longus to the foot arch. In this work, we created four OpenSim models of an arched foot, a flatfoot, a flatfoot with traditional tendon transfer, and a flatfoot with implant-modified tendon transfer. Paired with these models, we developed a forward dynamic simulation of the stance phase of gait that reproduces the medial/lateral distribution of vertical ground reaction forces. The simulation couples the use of a fixed tibia, moving ground plane methodology with simultaneous activation of nine extrinsic lower limb muscles. The arched foot and flatfoot models produced vertical ground reaction forces with the characteristic double-peak profile of gait, and the medial/lateral distribution of these forces compared well with the literature. The flatfoot model with implant-modified tendon transfer produced a 94.2% restoration of the medial/lateral distribution of vertical ground reaction forces generated by our arched foot model, which also represents a 2.1X improvement upon our tendon transfer model. This result demonstrates the feasibility of a pulley-like implant to improve functional outcomes for surgical treatment of adult acquired flatfoot deformity with ideal biomechanics in simulation. The real-world efficacy and feasibility of such a device will require further exploration of factors such as surgical variability, soft tissue interactions and healing response.
Extracting Chinese events with a joint label space model
Authors: Huang Wenzhi , Zhang Junchi , Ji Donghong
Published: September 2022

The task of event extraction consists of three subtasks namely entity recognition, trigger identification and argument role classification. Recent work tackles these subtasks jointly with the method of multi-task learning for better extraction performance. Despite being effective, existing attempts typically treat labels of event subtasks as uninformative and independent one-hot vectors, ignoring the potential loss of useful label information, thereby making it difficult for these models to incorporate interactive features on the label level. In this paper, we propose a joint label space framework to improve Chinese event extraction. Specifically, the model converts labels of all subtasks into a dense matrix, giving each Chinese character a shared label distribution via an incrementally refined attention mechanism. Then the learned label embeddings are also used as the weight of the output layer for each subtask, hence adjusted along with model training. In addition, we incorporate the word lexicon into the character representation in a soft probabilistic manner, hence alleviating the impact of word segmentation errors. Extensive experiments on Chinese and English benchmarks demonstrate that our model outperforms state-of-the-art methods.