bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of microstructure, mechanical, and corrosion properties of Inconel 617 joints welded by laser–MIG hybrid welding
Authors: Pramod Kumar G. , Balasubramanian K. R. , Phani Prabhakar K.V. , Cheepu Muralimohan
Published: March 2023

The demand for Nickel-based superalloy of Inconel 617 material is increasing for manufacturing hot section components of gas turbines, chemical, and nuclear power plants. It has excellent corrosion resistance in high-temperature environments. In the present study, laser–MIG hybrid welding consisting of a 3.5 kW CO2 laser in combination with a MIG welding system was utilized to weld 10 mm thick Inconel 617 plates with the wire feed rates (WFR) of 10 and 11 m/min in a single pass to analyze the welds microstructure, mechanical, and corrosion properties. The results revealed that the microstructure of the weld zone is composed of cellular crystals with dendrites and equiaxed sub-grains. Electron backscattered diffraction (EBSD) studies revealed coarse columnar dendrites and equiaxed grains at the center of weld joints with the same crystallographic orientation across the fusion boundary. The XRD analysis revealed the dominant gamma and gamma prime (γ/γ′) [(Ni/Ni3(AlTi))] phases along with the presence of minor carbide peaks such as Ti (C, N), M23C6, Cr (C, N), and M6C. The BM has a lower hardness (232 HV) and higher impact energy (236 J) than the weld joints. Similarly, the increase in WFR results in a decrease in microhardness (268–256 HV) values and an increase in impact energy (199–212 J). The weld joints exhibit good bend ductility without any cracks. The potentiodynamic polarization results revealed a lower corrosion rate of 0.212 mpy for the base metal than for the weld joints. The increase of WFR increased the weld metal corrosion rate from 0.342 to 0.427 mpy due to an increase in heat input (0.516–0.615 kJ/mm) and solidification time, which caused the coarsening of the grains resulting in lower grain boundary density and anode reaction to accelerate, which deteriorated the corrosion resistance of the welds.
True ulnar artery aneurysm in the upper arm: A case report and literature review
Authors: Hooshyari Ali , Stephen French , Thwaite Phillip
Published: March 2023

Introduction

Ulnar artery aneurysms are rare with less than 250 previously reported in the literature. Most ulnar artery aneurysms occur distally near the palmar arch (hypothenar hammer syndrome). There are five previous reports of true ulnar artery aneurysms in the forearm; however, there are no reported cases of ulnar artery aneurysms proximal to the cubital fossa.

Case presentation

An 87-year-old man presented with pain and a rapidly progressive median nerve palsy with a pulsatile mass in the arm. Duplex ultrasound showed an aneurysm of what was thought to be the brachial artery. CT angiography shows a high bifurcating brachial artery and true aneurysm of the ulnar artery proximal to the cubital fossa. The artery was explored and the decision was made to excise the aneurysm and ligate the artery. The patient’s symptoms improved and full function was regained.

Conclusion

This is a rare case of such a diagnosis in the absence of a history of arterial puncture or trauma. This case demonstrates the value in obtaining detailed imaging in the work-up to aid operative decision making. We highlight the thought processes on the table in our approach to this aneurysm and report a favourable post-operative outcome at follow up.
Categorizing 161 plant (streptophyte) mitochondrial group II introns into 29 families of related paralogues finds only limited links between intron mobility and intron-borne maturases
Authors: Zumkeller Simon , Knoop Volker
Published: March 2023

Group II introns are common in the two endosymbiotic organelle genomes of the plant lineage. Chloroplasts harbor 22 positionally conserved group II introns whereas their occurrence in land plant (embryophyte) mitogenomes is highly variable and specific for the seven major clades: liverworts, mosses, hornworts, lycophytes, ferns, gymnosperms and flowering plants. Each plant group features “signature selections” of ca. 20–30 paralogues from a superset of altogether 105 group II introns meantime identified in embryophyte mtDNAs, suggesting massive intron gains and losses along the backbone of plant phylogeny. We report on systematically categorizing plant mitochondrial group II introns into “families”, comprising evidently related paralogues at different insertion sites, which may even be more similar than their respective orthologues in phylogenetically distant taxa. Including streptophyte (charophyte) algae extends our sampling to 161 and we sort 104 streptophyte mitochondrial group II introns into 25 core families of related paralogues evidently arising from retrotransposition events. Adding to discoveries of only recently created intron paralogues, hypermobile introns and twintrons, our survey led to further discoveries including previously overlooked “fossil” introns in spacer regions or e.g., in therps8pseudogene of lycophytes. Initially excluding intron-borne maturase sequences for family categorization, we added an independent analysis of maturase phylogenies and find a surprising incongruence between intron mobility and the presence of intron-borne maturases. Intriguingly, however, we find that several examples of nuclear splicing factors meantime characterized simultaneously facilitate splicing of independent paralogues now placed into the same intron families. Altogether this suggests that plant group II intron mobility, in contrast to their bacterial counterparts, is not intimately linked to intron-encoded maturases.
Interaction effects between sleep disorders and depression on heart failure
Authors: Fan Tianshu , Su Dechun
Published: March 2023

Background

Sleep disorders and depression were recognized as independent risk factors for heart failure, whether their interaction effects also correlated with the risk of heart failure remains elusive. This study was to explore the interaction effects between sleep disorders and depression on the risk of heart failure.

Methods

This was a cross-sectional study that included data from 39,636 participants in the National Health and Nutritional Examination Survey (NHANES) database. Poisson regression model was applied to evaluate the associations of depression or sleep disorders with heart failure. The relative excess risk of interaction (RERI), attributable proportion of interaction (API) and synergy index (SI) were used to measure whether the interaction effects between depression and sleep disorders on heart failure was statistically significant.

Results

The risk of heart failure was increased in people with sleep disorders [risk ratio (RR) = 1.92, 95% confidence interval (CI): 1.68–2.19) after adjusting for confounders including age, gender, body mass index (BMI), race, marital status, education level, annual family income, drinking history, smoking history, diabetes, hypertension and stroke. The risk of heart failure was elevated in patients with depression after adjusting for confounders (RR = 1.96, 95%CI: 1.65–2.33). Patients with depression and sleep disorders were associated with increased risk of heart failure after adjusting for confounders (RR = 2.76, 95%CI: 2.23–3.42). The CIs of interactive indexes RERI was -0.42 (95%CI: -1.23–0.39), and API was -0.15 (95%CI: -0.46–0.16), which included 0. The CI of interactive indexes SI was 0.81 (95%CI: 0.54–1.21), which contained 1.

Conclusion

Depression and sleep disorders were independent risk factors for heart failure but the interaction effects between depression and sleep disorders on the occurrence of heart failure were not statistically different.
The study of nurses’ knowledge and attitudes regarding pain management and control in emergency departments
Authors: Ahmadi Sajjad , Vojdani Parya , MortezaBagi Hamid Reza
Published: March 2023

Background

Given the importance and pivotal role of nurses in pain management and control, this study was conducted to determine the nurses’ knowledge and attitudes toward in emergency departments.

Methods

This study was designed and conducted as a descriptive-analytical cross-sectional study. Nurses’ attitude and knowledge towards pain management and control and relationship between their demographic characteristics have been assessed. Nurse Attitude Survey (NAS) and Pain management and control principles assessment Test (PMPAT) questionnaires were used.

Results

Totally 400 volunteers, including 148 (37.2%) male and 250 (62.8%) female nurses recruited from 23 hospitals in East Azerbaijan, Iran, with a mean age of 30.88 years (± 6.04 SD) and age range between 22 and 53 years old. The crude mean score of participants’ knowledge of pain management and control was 12.51 (± 2.77 SD), and standardized mean score was 40.34 (± 8.92 SD), which was low at 84.8% and moderate in 15.3% of the participants. Older nurses and nurses who previously participated in pain retraining courses had significantly less knowledge about pain management and control (r= -0.104, P = 0.038), and (r= -0.148, P = 0.003) respectively. The crude mean score of participants’ attitudes toward pain control and management was 15.22 (± 2.56 SD), and standardized mean score was 60.87 (± 10.26 SD). Nurses’ attitudes have become more negative with the increase of their work experience (r = -0.168, P = 0.001), and previously participation in pain retraining courses (r =-0.207, P < 0.001). Older nurses and highly educated nurses had significantly more negative attitudes towards pain control and management (r = -0.153, P = 0.002), and (r= -0.126, P = 0.005), respectively.

Conclusions

The current study revealed that pain management and control knowledge in most emergency nurses was low, and most of them had a moderate attitude. We need more scientific and comprehensive pain management and control training courses to improve knowledge and attitude among health workers and nurses.
Measuring the impact of zero-cases studies in evidence synthesis practice using the harms index and benefits index (Hi-Bi)
Authors: Xu Chang , Furuya-Kanamori Luis , Lin Lifeng , Zorzela Liliane , Yu Tianqi , Vohra Sunita
Published: March 2023

Objectives

In evidence synthesis practice, dealing with studies with no cases in both arms has been a tough problem, for which there is no consensus in the research community. In this study, we propose a method to measure the potential impact of studies with no cases for meta-analysis results which we define as harms index (Hi) and benefits index (Bi) as an alternative solution for deciding how to deal with such studies.

Methods

Hi and Bi are defined by the minimal number of cases added to the treatment arm (Hi) or control arm (Bi) of studies with no cases in a meta-analysis that lead to a change of the direction of the estimates or its statistical significance. Both exact and approximating methods are available to calculate Hi and Bi. We developed the “hibi” module in Stata so that researchers can easily implement the method. A real-world investigation of meta-analyses from Cochrane reviews was employed to evaluate the proposed method.

Results

Based on Hi and Bi, our results suggested that 21.53% (Hi) to 26.55% (Bi) of Cochrane meta-analyses may be potentially impacted by studies with no cases, for which studies with no cases could not be excluded from the synthesis. The approximating method shows excellent specificity (100%) for both Hi and Bi, moderate sensitivity (68.25%) for Bi, and high sensitivity (80.61%) for Hi compared to the exact method.

Conclusions

The proposed method is practical and useful for systematic reviewers to measure whether studies with no cases impact the results of meta-analyses and may act as an alternative solution for review authors to decide whether to include studies with no events for the synthesis or not.
The longitudinal patterns of psychotropic drug prescriptions for subpopulations of community-dwelling older people with dementia: electronic health records based retrospective study
Authors: Du Jiamin , Janus Sarah I. M. , de Boer Michiel , Zuidema Sytse U.
Published: March 2023

Background

Studies focusing on patterns of psychotropic drug prescriptions (PDPs) for subpopulations of community-dwelling older people with dementia are lacking.

Objective

The aim of this study was to identify the longitudinal patterns of PDPs in subpopulations.

Methods

This retrospective study used electronic health records from general practitioners (GPs) in the Netherlands. People (N = 1278) firstly diagnosed with dementia between 2013 and 2015, aged 65 years or older, were selected and categorized into four subpopulations: community-dwelling (CD) group throughout follow-up, ultimately admitted to nursing homes (NH) group, ultimately died (DIE) group, and ultimately deregistered for unclear reasons (DeR) group. Generalised estimating equations were used to estimate the patterns of psychotropic drug prescriptions, after the diagnosis of dementia for a five-year follow-up, and 0–3 months before institutionalisation or death.

Results

Over the five-year follow-up, antipsychotic prescriptions increased steadily in CD (OR = 1.07 [1.04–1.10]), NH (OR = 1.10 [1.04–1.15]), and DIE (OR = 1.05 [1.02–1.08]) groups. Similarly, prescriptions of antidepressants also showed upward trends in CD (OR = 1.04 [1.02–1.06]), NH (OR = 1.10 [1.02–1.18]), and DIE (OR = 1.04 [1.00–1.08]) groups. The other psychotropic drugs did not show clear changes over time in most of the subpopulations. In the three months before institutionalisation, antipsychotic prescriptions increased (OR = 2.12 [1.26–3.57]) in the NH group compared to prior periods. Likewise, before death, prescriptions of antipsychotics (OR = 1.74 [1.28–2.38]) and hypnotics and sedatives (OR = 2.11 [1.54–2.90]) increased in the DIE group, while anti-dementia drug prescriptions decreased (OR = 0.42 [0.26–0.69]).

Conclusions

After community-dwelling older people are diagnosed with dementia, all subpopulations’ prescriptions of antipsychotics and antidepressants increase continuously during the follow-up. While we cannot judge whether these prescriptions are appropriate, GPs might consider a more reluctant use of psychotropic drugs and use alternative psychosocial interventions. Additionally, antipsychotic prescriptions rise considerably shortly before institutionalisation or death, which might reflect that older people experience more neuropsychiatric symptoms during this period.
Association of TLR4 and TLR9 gene polymorphisms with cervical HR-HPV infection status in Chinese Han population
Authors: Zhang Chunlin , Yang Zhiping , Luo Ping , Li Ting , Wang Sutong , Sun Fenglan , Gong Ping , Mei Bing
Published: March 2023

Background

Toll-like receptors (TLRs) may be involved in the natural history of human papillomavirus (HPV) infection. In our study, we aimed to investigate the association of TLR4 (rs10116253, rs1927911, rs10759931) and TLR9 (rs187084, rs352140) gene polymorphisms with cervical persistent high-risk HPV (HR-HPV) infection, as well as multiple HR-HPV infections.

Methods

A total of 269 study subjects were enrolled and grouped by retrospectively analyzing the HR-HPV testing results and other clinical data of 2647 gynecological outpatients from Jingzhou Hospital Affiliated to Yangtze University. We conducted a case–control study to compare the role of TLR4/TLR9 gene polymorphisms between HR-HPV transient and persistent infections, as well as between HR-HPV single and multiple infections. HR-HPV genotypes were detected using Real-time polymerase chain reaction (RT-PCR). PCR-restriction fragment length polymorphism (PCR–RFLP) was used to determine TLR4 and TLR9 gene polymorphisms. Analyses of the different outcome variables (HR-HPV infection status and time for HR-HPV clearance) with respect to TLR4/TLR9 polymorphisms were carried out. Logistic regression analysis was used to determine the association of TLR4/TLR9 genotypes and alleles with HR-HPV infection status. The Kaplan–Meier method with the log-rank test was used to analyze the relationship between TLR4/TLR9 genotypes and the time for HR-HPV clearance.

Results

The mutant genotypes of TLR9 rs187084 and rs352140 were associated with persistent (rs187084: CT and CT+CC; rs352140: CT and CT+TT) and multiple (rs187084: CT and CT+CC; rs352140: CT+TT) (all P < 0.05) HR-HPV infection. However, no association was found between TLR4 polymorphisms and HR-HPV infection status. Kaplan–Meier time to HR-HPV clearance analysis demonstrated that women carrying rs187084 and rs352140 mutant genotypes take longer duration to clear HR-HPV infection compared with wild-type genotype carriers (P1 = 0.012; P2 = 0.031).

Conclusion

Our results suggested that TLR9 polymorphisms, but not TLR4, were associated with cervical persistent and multiple HR-HPV infections, which could be useful as a potential predictor of HR-HPV infection status.
The effect of anti-coagulation dosage on the outcome of hospitalized COVID-19 patients in Ethiopia: a multi-center retrospective cohort study
Authors: Tessema Abel Girma , Mengiste Zekarias Masresha , Hundie Tsegaye Gebreyes , Yosef Hailemichael Getachew , Huluka Dawit Kebede , Seyoum Abebaw Bekele , Abate Hannibal Kassahun , Howe Rawleigh Craig
Published: March 2023

Background

Studies have indicated that hospitalized COVID-19 patients benefit from anticoagulation therapy in terms of survival; however, there is an ongoing controversy over the optimum anticoagulant dosage. This study aimed to compare clinical outcomes between patients who received prophylactic anticoagulation and those who received therapeutic anticoagulation.

Methods

A multi-center retrospective cohort study was conducted to determine the impact of anticoagulation dosage in hospitalized COVID-19 patients in Ethiopia. The primary outcome measure was in-hospital mortality, and it was assessed using multivariable binary logistic regression and covariate-adjusted Cox Proportional Hazard model. For critical and severe COVID-19 patients, subgroup analyses were performed using multivariable binary logistic regression model and multivariable Cox regression models.

Result

A total of 472 hospitalized COVID-19 patients were included in this study, of whom 235 (49.8%) received therapeutic anticoagulation and 237 (50.2%) received prophylactic dose. The demographic and baseline clinical characteristics were roughly similar between the groups. After adjustment for several confounders, in critical COVID-19 subgroup, therapeutic dose of anticoagulation was significantly associated with a higher inpatient mortality (AOR 2.27, 95% CI, 1.18—4.35, p = 0.013), whereas in severe COVID-19 subgroup, anticoagulation dosage was not associated with inpatient mortality (OR, 1.02, 95% CI, 0.45 – 2.33, p = 0.958). In severe COVID-19 patient group however, the incidence of thrombosis was slightly lower in the therapeutic group as compared with prophylactic group although the difference was not statistically significant (AOR 0.15, 95% CI, 0.02 – 1.20, p = 0.073). Although there were only six major bleeding events in this study, all these were recorded from patients in the therapeutic subgroup, making the difference statistically significant (p = 0.013).

Conclusion

Although this study is limited by its observational design, our results are not consistent with current recommendations on anti-coagulation dose for hospitalized patients with COVID-19, necessitating the need for RCT in resource limited settings.
Three-dimensional relationships between condylar volume and dentoskeletal characteristics in Class II hyperdivergent female adults
Authors: Xie Bingjie , Huang Lingyi , Feng Anna , Han Xianglong , Tian Ye , Li Juan
Published: March 2023

Background

This study aimed to determine the differences among various volumes of condylar osseous patterns and the corresponding dentoskeletal characteristics based on the risk of temporomandibular disorder.

Methods

Craniofacial spiral computed tomography data of 60 Class II hyperdivergent female adults were divided into normal, resorptive, flattened, and osteophyte groups based on condylar osseous forms. The condylar volumes of each group were compared, and their correlations with the dentoskeletal characteristics were assessed in three dimensions. Pairwise least significant difference tests were used to examine individual pairwise differences between groups, and one-way analysis of variance was used to measure differences among multiple groups. Pearson correlation and Spearman rank correlation analyses were used to determine the correlation between condylar volume and dentofacial characteristics. Statistical significance was established at p < 0.05.

Results

The condylar volume in the normal group was significantly greater than that in the changed groups, with no significant differences between the subgroups. The decrease in condylar volume was associated with a retruded and clockwise-rotated mandible with shorter rami. Condylar volume was negatively correlated with overjet, the alveolar height of the lower anterior and posterior teeth, sagittal inclinations of the lower teeth, intermolar width of the mandibular first molars, and width between the corresponding alveolar crests.

Conclusion

Multiple three-dimensional dentoskeletal characteristics of Class II hyperdivergent female adults are correlated with condylar bony changes, regardless of the form. These results could be helpful in indicating potential pathological changes in the temporomandibular joint and in making proper treatment plans for these patients.
Reliability and validity of an innovative high performing healthcare system assessment tool
Authors: Aqil Anwer , Saldana Kelly , Mian Naeem uddin , Ndu Mary
Published: March 2023

Background

Universal Health coverage (UHC) is the mantra of the twenty-first century yet knowing when it has been achieved or how to best influence its progression remains elusive. An innovative framework for High Performing Healthcare (HPHC) attempts to address these issues. It focuses on measuring four constructs of Accountable, Affordable, Accessible, and Reliable (AAAR) healthcare that contribute to better health outcomes and impact. The HPHC tool collects information on the perceived functionality of health system processes and provides real-time data analysis on the AAAR constructs, and on processes for health system resilience, responsiveness, and quality, that include roles of community, private sector, as well as both demand, and supply factors affecting health system performance. The tool attempts to capture the multidimensionality of UHC measurement and evidence that links health system strengthening activities to outcomes. This paper provides evidence on the reliability and validity of the tool.

Methods

Internet survey with non-probability sampling was used for testing reliability and validity of the HPHC tool. The volunteers were recruited using international networks and listservs. Two hundred and thirteen people from public, private, civil society and international organizations volunteered from 35 low-and-middle-income countries. Analyses involved testing reliability and validity and validation from other international sources of information as well as applicability in different setting and contexts.

Results

The HPHC tool’s AAAR constructs, and their sub-domains showed high internal consistency (Cronbach alpha >.80) and construct validity. The tool scores normal distribution displayed variations among respondents. In addition, the tool demonstrated its precision and relevance in different contexts/countries. The triangulation of HPHC findings with other international data sources further confirmed the tool’s validity.

Conclusions

Besides being reliable and valid, the HPHC tool adds value to the state of health system measurement by focusing on linkages between AAAR processes and health outcomes. It ensures that health system stakeholders take responsibility and are accountable for better system performance, and the community is empowered to participate in decision-making process. The HPHC tool collects and analyzes data in real time with minimum costs, supports monitoring, and promotes adaptive management, policy, and program development for better health outcomes.
Implementation through translation: a qualitative case study of translation processes in the implementation of quality improvement collaboratives
Authors: Carstensen Kathrine , Kjeldsen Anne Mette , Lou Stina , Palmhøj Nielsen Camilla
Published: March 2023

Background

Quality improvement collaboratives (QICs) are used extensively to implement quality improvement in healthcare, and current research is demonstrating positive yet varying evidence. To interpret the effectiveness results, it is necessary to illuminate the dynamics of QIC implementation in specific contexts. Using Scandinavian institutionalist translation theory as a theoretical framework, this study aims to make two contributions. First, we provide insights into the dynamics of the translation processes inherent in QIC implementation. Second, we discuss the implications of the translation processes as experienced by participating actors.

Methods

We used empirical data from a qualitative case study investigating the implementation of QICs as an approach to quality improvement within a national Danish healthcare quality program. We included two diverse QICs to allow for exploration of the significance of organizational complexity for the translation processes. Data comprised qualitative interviews, participant observation and documentary material.

Results

Translation was an inherent part of QIC implementation. Key actors at different organizational levels engaged in translation of their implementation roles, and the QIC content and methodology. They drew on different translation strategies and practices that mainly materialized as kinds of modification. The translations were motivated by deliberate, strategic, and pragmatic rationales, contingent on combinations of features of the actors’ organizational contexts, and the transformability and organizational complexity of the QICs. The findings point to a transformative power of translation, as different translations led to various regional and local QIC versions. Furthermore, the findings indicate that translation affects the outcomes of the implementation process and the QIC intervention. Translation may positively affect the institutionalization of the QICs and the creation of professional engagement and negatively influence the QIC effects.

Conclusion

The findings extends the current research concerning the understanding of the dynamics of the translation processes embedded in the local implementation of QICs, and thus constitute a valuable contribution to a more sustainable and effective implementation of QICs in healthcare improvement. For researchers and practitioners, this highlights translation as an embedded part of the QIC implementation process, and encourages detailed attention to the implications of translation for both organizational institutionalization and realisation of the expected intervention outcomes.
Centering and collaborating with community knowledge systems: piloting a novel participatory modeling approach
Authors: Shaikh Yahya , Jeelani Muzamillah , Gibbons Michael Christopher , Livingston Denisa , Williams David Rudyard , Wijesinghe Sanith , Patterson Jenine , Russell Sybil
Published: March 2023

Background

Systems science approaches like simulation modeling can offer an opportunity for community voice to shape policies. In the episteme of many communities there are elders, leaders, and researchers who are seen as bearers of historic knowledge and can contextualize and interpret contemporary research using knowledge systems of the community. There is a need for a systematic methodology to collaborate with community Knowledge Bearers and Knowledge Interpreters. In this paper we report the results of piloting a systematic methodology for collaborating with a community Knowledge-Bearer and Knowledge-Interpreter to develop a conceptual model revealing the local-level influences and architecture of systems shaping community realities. The use case for this pilot is ‘persistent poverty’ in the United States, specifically within the inner-city African American community in Baltimore City.

Methods

This pilot of a participatory modeling approach was conducted over a span of 7 sessions and included the following steps, each with an associated script:

Step 1: Knowledge-Bearer and Knowledge-Interpreter recruitment

Step 2: Relationship building

Step 3: Session introduction, Vignette development & enrichment

Step 4: Vignette analysis & constructing architecture of systems map

Step 5: Augmenting architecture of systems map

Results

Each step of the participatory modeling approach resulted in artifacts that were valuable for both the communities and the research effort.

Vignette construction resulted in narratives representing a spectrum of lived experiences, trajectories, and outcomes within a community. The collaborative analysis of vignettes yielded the Architecture of Systemic Factors map, that revealed how factors inter-relate to form a system in which lived experience of poverty occurs. A literature search provided an opportunity for the community to contextualize existing research about them using realities of lived experience.

Conclusion

This methodology showed that a community Knowledge Bearer can function as communicators and interpreters of their community’s knowledge base, can develop coherent narratives of lived experiences within which research and knowledge is contextualized, and can collaboratively construct conceptual mappings necessary for simulation modeling. This participatory modeling approach showed that even if there already exists a vast body of research about a community, collaborating with community gives context to that research and brings together disparate findings within narratives of lived experience.
A novel selection model based on multivariate methods and arbitrary genetic parameters: a case study on tomato families
Authors: Eynizadeh Peyman , Dehghani Hamid , Dehghani Ali
Published: March 2023

Background

Selection is one of the essential skills whereby breeders reduce the population size and increase the chance of success. Various selection methods with special applications have been developed. Superior genotypes are assessed according to interesting traits, including univariate, multivariate, phenotypic, genotypic, etc.

Methods

Mathematical calculation of the traits' importance based on the genetic makeup of investigated population (average degree of dominance/additive involved in the action of genes) and arbitrary genetic parameters is functional. In this paper, a general model for multivariate selection has been presented whereby the selection can be made for (a) more than one interesting trait, (b) the trait(s) with complex inheritance, (c) finding superior genotypes from among a large-scale population, (d) finding superior genotypes in segregating generations and (f) finding tolerant genotypes to stresses. This model is developed based on biometric concepts in four steps. MATLAB script is provided for the model, and users can easily apply that to identify the most suitable genotypes after data collection according to the breeding purposes.

Results

The main features of this model are simplicity, precision, repeatability, and speed (improving several traits simultaneously). All the steps and the analysis of the results are explained step by step in a case study.
Little All Children in Focus (Little ACF), evaluation of a parental support program for parents of children aged 1–2 years: study protocol for a randomized controlled trial
Authors: Blom Lisa , Edenius Anna , Enebrink Pia , Hjern Anders , Silfverdal Sven Arne , Åhlén Johan , Bergström Malin , Lindberg Lene
Published: March 2023

Background

Child health and development can be promoted by strengthening and supporting parents. Research on parental support programs based on positive psychology and a health-promoting approach aimed at all parents, and in particular parents of infants is limited. All Children in Focus (ACF) is a parental support program that has been evaluated in a randomized trial in parents of children 3–12 years. The ACF is based on health promotion aiming to increase parents’ confidence and child’s well-being. In the current study, we will study the effects of a revised version of the ACF called Little ACF adapted to parents with children aged 1–2 years.

Methods

The study includes a randomized controlled trial (RCT) taking place at several Child Health Centers (CHCs) in Sweden. The RCT will evaluate the efficacy of Little ACF (intervention) in comparison with four digital lectures about child development and parenting (active control). Parents are recruited at the 10-, 12-, or 18-month visits to CHC by CHC-nurses. Data to assess changes in parental competencies and child socio-emotional development are collected through online questionnaires completed by parents at five time points: baseline, post-intervention, after 6 and 12 months, and when the child is 3 years old.

Discussion

The paper describes a study protocol of a randomized controlled trial evaluating the effects of a parental support program during infancy. Several issues related to the methodology and implementation are discussed.

Trial registration

ClinicalTrials.gov NCT05445141. Registered on 6 July 2022.
Site-specific assessment of spinal radiographic progression improves detection of TNF blocker-associated disease modification in axial spondyloarthritis: longitudinal observational data from the Swiss Clinical Quality Management Registry
Authors: Popova Vjara , Kissling Seraphina , Micheroli Raphael , Bräm René , de Hooge Manouk , Baraliakos Xenofon , Nissen Michael J. , Möller Burkhard , Exer Pascale , Andor Michael , Distler Oliver , Scherer Almut , Ospelt Caroline , Ciurea Adrian
Published: March 2023

Objectives

To analyse whether time-varying treatment with tumour necrosis factor inhibitors (TNFi) in radiographic axial spondyloarthritis (r-axSpA) has a differential impact on structural damage progression on different spinal segments (cervical versus lumbar spine).

Methods

Patients with r-axSpA in the Swiss Clinical Quality Management cohort were included if cervical and lumbar radiographs were available at intervals of 2 years for a maximum of 10 years. Paired radiographs were scored by two calibrated readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). The relationship between TNFi use and progression in the cervical and the lumbar spine was analysed using generalised estimating equation models and adjustment for potential confounding. Radiographic progression per spinal segment was defined as an increase of ≥ 1 mSASSS unit or by the formation of ≥ 1 new syndesmophyte over 2 years.

Results

Mean ± SD symptom duration was 13.8 ± 9.8 years. Mean ± SD mSASSS progression per radiographic interval was 0.41 ± 1.69 units in the cervical spine and 0.45 ± 1.45 units in the lumbar spine (p = 0.66). Prior use of TNFi significantly reduced the odds of progression in the cervical spine by 68% (OR 0.32, 95% CI 0.14–0.72), but not in the lumbar spine (OR 0.99, 95% CI 0.52–1.88). A more restricted inhibition of progression in the lumbar spine was confirmed after multiple imputation of missing covariate data (OR 0.43, 95% CI 0.24–0.77 and 0.85, 95% CI 0.51–1.41, for the cervical and lumbar spine, respectively). It was also confirmed with progression defined as formation of ≥ 1 syndesmophyte (OR 0.31, 95% CI 0.12–0.80 versus OR 0.56, 95% CI 0.26–1.24 for the cervical and lumbar spine, respectively).

Conclusion

Disease modification by treatment with TNFi seems to more profoundly affect the cervical spine in this r-axSpA population with longstanding disease. Site-specific analysis of spinal progression might, therefore, improve detection of disease modification in clinical trials in axSpA.
Associations between meniscal tears and various degrees of osteoarthritis among dogs undergoing TPLO for cranial cruciate ligament rupture
Authors: Fung Canny , Ficklin Michael , Okafor Chika C.
Published: March 2023

Objective

The aim of this study was to evaluate the association between meniscal lesions and severity of osteoarthritis (OA) among dogs that underwent Tibial Plateau Leveling Osteotomy (TPLO) for stabilization of cranial cruciate ligament rupture (CrCLR) at the University of Tennessee in 2011–2017.

Results

There were a total of 252 meniscal tears. Factors associated with diagnosis of medial meniscal tears (MMT) in dogs were severe OA in comparison to no OA (3.8 OR, 2.0–8.0 95% CI, 0.001 p-value), sporting and mixed breed group compared to other breed (3.6 OR, 1.7–7.6 95% CI, 0.004 p-value; 3.2 OR, 1.6–6.6 95% CI, 0.019 p-value, respectively), increasing age (1.1 OR, 1.0-1.2 95% CI, 0.018 p-value), complete CrCLR compared to partial (3.3 OR, 2.1-5.0 95% CI, < 0.001 p-value), and arthrotomy compared to arthroscopy (2.2 OR, 1.4–3.1 95% CI, 0.002 p-value). The factors that did not have significance in predicting MMT were weight, sex, lameness period, and side affected.
Evaluation of the use of GRADE in dentistry systematic reviews and its impact on conclusions: a protocol for a methodological study
Authors: Ibrahim Sara , Azab Maria , Miroshnychenko Anna , Brignardello-Petersen Romina
Published: March 2023

Background

There is a growing body of evidence of systematic reviews (SRs) with varying degrees of methodological quality. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach allows SR authors to assess the certainty of the evidence they found and transparently relay their conclusions. As there appears to be infrequent utilization of GRADE in the field of dentistry, to identify the impact of GRADE, the aim of this study is to evaluate the use of GRADE in the dental literature and determine whether SRs that use GRADE differ from those that do not with respect to their conclusions.

Methods/design

We will search Ovid MEDLINE for SRs published from 2016 to the present. We will conduct both screening and data extraction independently and in duplicate and use pre-piloted, standardized forms for data extraction. We will determine the frequency of the use of GRADE and the varying levels of certainty in the current literature and evaluate whether GRADE is being used appropriately. We will also evaluate whether SRs not using GRADE differ from those that use GRADE with regard to methodological quality. We will also determine whether the conclusions of SRs that do not use GRADE would change had GRADE been utilized. Additionally, we will evaluate whether SRs using GRADE are more likely to formulate appropriate conclusions compared to SRs that do not use it.

Discussion

This study will investigate the frequency of GRADE assessments in dentistry SRs and the impact of GRADE assessments on the conclusions of a SR. It has important implications for both SR authors and users of this type of literature.
Metastasis of breast cancer to bones alters the tumor immune microenvironment
Authors: Chao Xue , Zhang Ying , Zheng Chengyou , Huang Qitao , Lu Jiabin , Pulver Emilia M. , Houthuijzen Julia , Hutten Stefan , Luo Rongzhen , He Jiehua , Sun Peng
Published: March 2023

Background

Bone is one of the most frequent sites for breast cancer metastasis. Breast cancer bone metastasis (BCBM) leads to skeletal morbidities including pain, fractures, and spinal compression, all of which severely impact quality of life. Immunotherapy is a promising therapy for patients with advanced cancer, but whether it may provide benefit to metastatic bone cancer is currently unknown. Thus, a better understanding of the immune landscape of bone-disseminated breast cancers may reveal new therapeutic strategies. In this study, we use histopathological analysis to investigate changes within the immune microenvironment of primary breast cancer and paired BCBM.

Methods

Sixty-three patients with BCBM, including 31 with paired primary and bone metastatic lesions, were included in our study. The percentage of stroma and stromal tumor-infiltrating lymphocytes (TILs) was evaluated by histopathological analysis. The quantification of stromal TILs (CD4 + and CD8 +), macrophages (CD68 + and HLA-DR +), programmed cell death protein 1 (PD-1), and programmed cell death protein ligand 1 (PD-L1) was evaluated through immunohistochemical (IHC) staining. Statistical analysis was performed with paired t test, Wilcoxon test, spearman correlation test, and univariate and multivariate cox regression.

Results

Median survival after BCBM pathological diagnosis was 20.5 months (range: 3–95 months). Of the immune parameters measured, none correlated with survival after bone metastasis was diagnosed. Compared to the primary site, bone metastases exhibited more tumor stroma (mean: 58.5% vs 28.87%, p < 0.001) and less TILs (mean: 8.45% vs 14.03%, p = 0.042), as determined by H&E analysis. The quantification of primary vs metastatic tissue area with CD4 + (23.95/mm2vs 51.69/mm2, p = 0.027 and with CD8 + (18.15/mm2vs 58.95/mm2, p = 0.004) TILs similarly followed this trend and was reduced in number for bone metastases. The number of CD68 + and HLA-DR + macrophages showed no significant difference between primary sites and bone metastases. PD-1 expression was present in 68.25% of the bone metastasis, while PD-L1 expression was only present in 7.94% of the bone metastasis.

Conclusions

Our findings suggest that compared to the primary breast cancer site, bone metastases harbor a less active immune microenvironment. Despite this relatively dampened immune landscape, expression of PD-1 and PD-L1 in the bone metastasis indicates a potential benefit from immune checkpoint inhibitors for some BCBM cases.
The impact of lymphovascular space invasion on survival in early stage low-grade endometrioid endometrial cancer
Authors: Yarandi Fariba , Shirali Elham , Akhavan Setare , Nili Fatemeh , Ramhormozian Sara
Published: March 2023

Background

The lymphovascular space invasion (LVSI) is suggested as a prognostic factor for endometrial cancer in many studies, but it has not yet been employed in FIGO staging system. The present study was aimed to evaluate the impact of LVSI on survival in patients with early stage endometrioid endometrial cancer.

Methods

This retrospective cohort was conducted on early stage endometrial cancer patients who underwent surgical staging [total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH/BSO)] and omental biopsy at Referral Teaching Hospitals of Tehran from 2005 to 2021. Patient’s age, menopause status, tumor grade, tumor size, depth of myometrial invasion, LVSI and lower segment involvement were recorded. Data were analyzed with SPSS 22.

Results

415 patients with stage I and grade 1–2, endometrioid endometrial cancer were analyzed. 100 patients (24.1%) were LVSI-positive. 3-year and 5-year survival rates were 97.1% and 88.9%, respectively. Recurrence occurred in 53 patients (12.8%). 3-year overall survival rates in LVSI-negative and LVSI-positive were 98.7% and 92%. These rates for 5-year survival were 92.1% and 79%, respectively. Recurrence rates in LVSI-negative were 8.9% while it was 25% in LVSI-positive cases. Multivariate analysis showed that LVSI has significant correlation with 3-year and 5-year overall survival rates.

Conclusions

LVSI in early stage endometrial cancer significantly and independently influences 3-year and 5-year survival rates and acts as a strong prognostic factor in these patients. LVSI should be implemented in endometrial cancer staging systems due to its significant correlation with cancer recurrence rates and 5-year survival rates.
Assessment of clinico-epidemiological profile of Hepatocellular carcinoma in the last two decades
Authors: Ali Ahmed Abdel Kareem , Gamal Salah El , Anwar Rokiah , Elzahaf Eman , Eskandere Dina
Published: March 2023

Background

Hepatocellular carcinoma represents 85%—90% of primary liver tumors; it represents the 2nd leading cause of cancer-related death all over the world. There is a growing incidence of HCC worldwide and similarly, the incidence of HCC has almost doubled over the last decade in Egypt.

Aim of the work

To assess clinico-epidemiological character of HCC in the last two decades and to compare between the first and second decade regarding these characters.

Patients and methods

This retrospective study included 497 HCC patients’ data collected from Clinical Oncology and Nuclear Medicine Department from 1999 to 2019, HCC patients were classified into 1st decade (from 1999 to 2009) and 2nd decade (2010 – 2019). Diagnosis of HCC was based on clinical, laboratory, (AFP), and radiological examinations (The abdominal US and triphasic CT scan).

Results

The study revealed that the average age of HCC cases was 57 years, the majority of these were males (88%), residents in rural areas (70%), about one-fourth of them, were smokers (26.4%), DM was present in 14% of these while only 7% were hypertension. Thirty presents (30%) of them were represented by ascites and (20%) by hepatic encephalopathy of different grades. The majority of HCC patients (92.2%) have HCV Abs positive. HBS Ag was positive in 2.4% while mixed infection (HCV Abs + ve and HBS Ag + ve) was in 2% of patients only. The median level of AFP was 300 ng/ml.

The severity of underlying chronic liver disease was assessed by the Child–Pugh score the mean score was 7.5 (from 6–11) and the MELD score (the mean score was 18.8 (from 6–29).

Regarding tumor characteristics, HCC mass was located in the Right lobe of the liver in (63.8%), in the left lobe in (26.6%) and both lobes were affected in 9.6%. A single focal hepatic lesion was detected in about 60% of patients, 3 focal lesions in about 20%, and two focal lesions or multifocal HCC in the remaining percent. The median size of the largest tumor’s diameter was 5 cm by the US and 5.3 cm by the triphasic CT. PVT, vascular invasion, LN, and distant metastasis were detected in (35.6%), (40%), (40%) and (54%) of patients respectively. In less than one-third of HCC cases, the tumors were within Milan criteria (30%).

Conclusion

The 1st decade showed a significantly higher frequency of patients presented with marked splenomegaly and splenectomy, while the second decade showed a significantly higher frequency in patients who reside in rural areas. Higher frequency of DM, advanced hepatic encephalopathy grade III/ IV, and unfortunately more aggressive tumors with PVT, vascular invasion, LN metastasis, and distant metastasis were detected in the 2nd decade.