bluuebunny/crossref_metadata_2025 huggingface dataset:
Older adults’ community participation, physical activity, and social interactions during and following COVID-19 restrictions in Australia: a mixed methods approach
Authors: Gough Claire , Barr Chris , Lewis Lucy K , Hutchinson Claire , Maeder Anthony , George Stacey
Published: January 2023

Background

With the increasing age of the global population, key components of healthy ageing including community, physical, and social participation continue to gain traction. However, management of the COVID-19 pandemic aimed to protect older adults and reduce the spread of the virus, this restricted community participation and reduced the opportunities for social interaction.

Methods

This mixed methods study investigates community dwelling older adults’ community participation; physical activity and social interaction prior to, during, and following the COVID-19 lockdown in Adelaide, Australia. Twenty-six community dwelling older adults were monitored over three time-points between November 2018 and October 2020, with Global Positioning Systems, accelerometry and self-reported diaries. In addition, nineteen participants completed semi-structured interviews.

Results

Community participation varied across the three time points, with significant reduction in the number of trips taken out-of-home (p = 0.021), social interactions (p = 0.001) and sleep quality (p = 0.008) during restrictions. Five themes were identified to explain personal experiences of community participation during restrictions: (1) Reframing of meaning, (2) Redefining to maintain activities, (3) Revision of risk, (4) Reflection and renewal and (5) Future planning.

Conclusion

During COVID-19 the physical and social activities of community dwelling older adults changed. Services that support older adults to adapt their activities   , considering their capacities and preferences, to facilitate community participation are required.
“A comparative analysis of risk factors of malaria” case study Gisagara and Bugesera District of Rwanda. RDHS 2014/2015. A retrospective study
Authors: Kubana Emmanuel , Munyaneza Athanase , Sande Steven , Nduhuye Felix , Karangwa Jean Bosco , Mwesigye David , Ndagijimana Emmanuel , Habimana Samuel , Munyanshongore Cyprien
Published: January 2023

Background

Malaria is a public health concern worldwide. A figure of 3.2 billion people is at risk of malaria a report of World Health Organization in 2013. A proportion of 89 and 91 cases of malaria reported during 2015 were respectively attributed to malaria cases and malaria deaths in Sub-Saharan Africa. Rwanda is among the Sub-Saharan Africa located in East Africa. The several reports indicate that from 2001 to 2011, malaria cases increased considerably especially in Eastern and Southern Province with five million cases. The affected districts included Bugesera in the Eastern and Gisagara in the Southern Province of Rwanda with a share of 41% of the country prevalence in 2014 and during 2017–2018 a figure of 11 deaths was attributed to malaria and both Gisagara and Bugesera Districts were the high burdened.

Methodology

The RDHS 2014–2015 data was used for the study and a cross-sectional survey was used in which two clusters were considered both Gisagara and Bugesera Districts in the Southern and Eastern Province of Rwanda. Bivariate analysis was used to determine the significant predictors with malaria and reduced logistic regression model was used.

Results

The results of the study show that not having mosquito bed nets for sleeping is 0.264 times less likely of having malaria than those who have mosquito bed nets in Gisagara District. In Bugesera District, living in low altitude is 2.768 times more likely associated with the risk of getting malaria than living in high altitude.

Conclusion

The results of the study concluded that environmental and geographical factor such as low altitude is the risk factor associated with malaria than the high altitude in Bugesera District. While not having mosquito bed nets for sleeping is the protective factor for malaria than those who have it in Gisagara District. On the other hand, socio-economic and demographic characteristics do not have any effect with malaria on the results of the study.
Predictors of low dental service utilization among school children in Mekelle, Northern Ethiopia: a cross-sectional study
Authors: Mohammed Hayat Maeruf , Mehari Mihret-ab , Asgedom Akeza Awealom
Published: January 2023

Background

Dental service utilization is important for maintaining and enhancing children’s oral health status. However, there is paucity of information regarding dental service utilization and factors affecting it among school aged children in Ethiopia.

Objectives

The purpose of this study was to determine the dental service utilization and associated factors among school aged children (6–15) years in Mekelle city, Northern Ethiopia.

Methods

A school-based cross-sectional study was conducted in Mekelle city of Northern Ethiopia from January 2016 to June 2016. A multi-stage sampling method was used to select 405 school children. A modified World Health Organization oral health assessment form for children was used to collect data. Univariate and multivariable logistic regressions with 95% CI were used to test the association between past-year dental service utilization, as an outcome variable, and parental socio-demographic, and child characteristics as independent variables.

Results

A total of 398 school children participated in the study. The overall dental service utilization among these children was (10.6%), 95% Confidence Interval (CI) (7.5%, 13.6%). In multivariable logistic regression analysis, maternal educational status (illiterate versus college and above (adjusted odds ratio (AOR) 0.13, 95% CI 0.01, 0.93)), higher monthly income (AOR 11.69, 95% CI 1.19, 114.61)), and having dental pain (AOR 50.8, 95% CI 17.8, 145.17)) were significantly associated with past year dental service utilization.

Conclusion

Our findings showed that a small proportion of the study population visited a dentist in the past year. Maternal educational status, monthly income, and dental pain were associated with past year dental service utilization. Oral health education programs focusing on dental service utilization targeting school children are crucial.
Dental professionals’ perception of their role in the practice of oral health promotion: a qualitative interview study
Authors: Shmarina Elena , Ericson Dan , Götrick Bengt , Franzén Cecilia
Published: January 2023

Objective

To explore dental professionals’ perceptions of their role in the practice of oral health promotion.

Material and method

In-depth interviews were conducted with three dentists, one specialist dentist and seven dental hygienists. All were employed in the public dental service in Kalmar County, Sweden and had at least 2 years’ work experience. The interview questions addressed the experience and views of dental professionals with reference to their role in the practice of health promotion. The interview data were subjected to qualitative content analysis.

Results

Analysis revealed two themes which capture the essence of the dental professionals’ perception of their role in the practice of oral health promotion. One theme, having person-focused approach, comprised four categories: ‘considering the patient’s life situation’, ‘establishing a trusting relationship with patients’, ‘strengthening patients’ commitment to oral health’ and ‘health education’. The other theme, perceiving social responsibility for oral health, comprised three categories: ‘dissemination of oral health knowledge’, ‘interprofessional collaboration’ and ‘equality in oral health care’.

Conclusion

Dental professionals perceived promotion of oral health to be an important aspect of their professional role. They aspired to patient participation in the decision-making process and educational activities, as well as practising and evaluating skills development. Although the dental professionals perceived that they undertook health promotion activities, they did not clearly distinguish between oral health promotion and disease prevention. There was intra- and inter-professional agreement among the dentists and dental hygienists with respect to expected outcomes for health promotion activities.
A Modified Medical Education Research Study Quality Instrument (MMERSQI) developed by Delphi consensus
Authors: Al Asmri Mansour , Haque M. Sayeed , Parle Jim
Published: January 2023

Background

The Medical Education Research Study Quality Instrument (MERSQI) is widely used to appraise the methodological quality of medical education studies. However, the MERSQI lacks some criteria which could facilitate better quality assessment. The objective of this study is to achieve consensus among experts on: (1) the MERSQI scoring system and the relative importance of each domain (2) modifications of the MERSQI.

Method

A modified Delphi technique was used to achieve consensus among experts in the field of medical education. The initial item pool contained all items from MERSQI and items added in our previous published work. Each Delphi round comprised a questionnaire and, after the first iteration, an analysis and feedback report. We modified the quality instruments’ domains, items and sub-items and re-scored items/domains based on the Delphi panel feedback.

Results

A total of 12 experts agreed to participate and were sent the first and second-round questionnaires. First round: 12 returned of which 11 contained analysable responses; second-round: 10 returned analysable responses. We started with seven domains with an initial item pool of 12 items and 38 sub-items. No change in the number of domains or items resulted from the Delphi process; however, the number of sub-items increased from 38 to 43 across the two Delphi rounds. In Delphi-2: eight respondents gave ‘study design’ the highest weighting while ‘setting’ was given the lowest weighting by all respondents. There was no change in the domains’ average weighting score and ranks between rounds.

Conclusions

The final criteria list and the new domain weighting score of the Modified MERSQI (MMERSQI) was satisfactory to all respondents. We suggest that the MMERSQI, in building on the success of the MERSQI, may help further establish a reference standard of quality measures for many medical education studies.
Translation and psychometric evaluation of the persian version of the “Nursing Profession Self-Efficacy Scale”
Authors: Lazemi Zahra , Barkhordari-Sharifabad Maasoumeh
Published: January 2023

Background

Self-efficacy demonstrates the general competence of nurses in providing nursing care. Evaluation of nurses' self-efficacy is of particular importance to improve nursing care. The existing self-efficacy scales in Iran are insufficient due to lack of focus on the specific issues of the nursing profession. This study was conducted with the aim of translating and psychometrically evaluating the Persian version of "Nursing Profession Self-Efficacy Scale" (NPSES).

Materials and method

This cross-sectional study was conducted in two parts: translation and psychometric evaluation. After getting permission from the original developer of the scale, the process of translating the questionnaire into Persian was done based on the Polit and Yang model. Then, the face validity was explored using a qualitative method with the participation of 10 nurses. The content validity was investigated using a qualitative and quantitative method (content validity index) with the participation of 15 experts. Construct validity was surveyed with exploratory and confirmatory factor analysis via completing the questionnaire by 550 nurses worked in different wards of hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd/Iran, who were selected using convenience sampling. The reliability of the tool was also established with internal consistency and stability methods, with the participation of 30 nurses. SPSS20 and AMOS were used for data analysis.

Results

"Nursing Profession Self-Efficacy Scale" includes 19 items for which the translation and cultural compatibility of the Persian version were confirmed. Face validity and content validity (SCVI/Ave = 0.9) were acceptable. By conducting exploratory factor analysis, three factors (professional situation, care situation, and support situation) were identified, which accounted for 62.38% of the variance of the scores. In the confirmatory factor analysis, the values of the fit indices confirmed the appropriate fit of the model. The reliability was established using Cronbach’s α method (α = 0.86) and an ICC of 0.83, indicating that the scale was reliable.

Conclusion

The translation, validity, and reliability of the Persian version of "Nursing Profession Self-Efficacy Scale" suggested that this tool has a clear and legitimate translation. Also, this tool has good validity and reliability and can be used as one of the tools to measure the self-efficacy of Iranian nurses.
Mixed methods instrument validation: Evaluation procedures for practitioners developed from the validation of the Swiss Instrument for Evaluating Interprofessional Collaboration
Authors: Grand-Guillaume-Perrenoud Jean Anthony , Geese Franziska , Uhlmann Katja , Blasimann Angela , Wagner Felicitas L. , Neubauer Florian B. , Huwendiek Sören , Hahn Sabine , Schmitt Kai-Uwe
Published: January 2023

Background

Quantitative and qualitative procedures are necessary components of instrument development and assessment. However, validation studies conventionally emphasise quantitative assessments while neglecting qualitative procedures. Applying both methods in a mixed methods design provides additional insights into instrument quality and more rigorous validity evidence. Drawing from an extensive review of the methodological and applied validation literature on mixed methods, we showcase our use of mixed methods for validation which applied the quality criteria of congruence, convergence, and credibility on data collected with an instrument measuring interprofessional collaboration in the context of Swiss healthcare, named the Swiss Instrument for Evaluating Interprofessional Collaboration.

Methods

We employ a convergent parallel mixed methods design to analyse quantitative and qualitative questionnaire data. Data were collected from staff, supervisors, and patients of a university hospital and regional hospitals in the German and Italian speaking regions of Switzerland. We compare quantitative ratings and qualitative comments to evaluate the quality criteria of congruence, convergence, and credibility, which together form part of an instrument’s construct validity evidence.

Results

Questionnaires from 435 staff, 133 supervisors, and 189 patients were collected. Analysis of congruence potentially provides explanations why respondents’ comments are off topic. Convergence between quantitative ratings and qualitative comments can be interpreted as an indication of convergent validity. Credibility provides a summary evaluation of instrument quality. These quality criteria provide evidence that questions were understood as intended, provide construct validity, and also point to potential item quality issues.

Conclusions

Mixed methods provide alternative means of collecting construct validity evidence. Our suggested procedures can be easily applied on empirical data and allow the congruence, convergence, and credibility of questionnaire items to be evaluated. The described procedures provide an efficient means of enhancing the rigor of an instrument and can be used alone or in conjunction with traditional quantitative psychometric approaches.
Determination of endogenous sphingolipid content in stroke rats and HT22 cells subjected to oxygen-glucose deprivation by LC‒MS/MS
Authors: Zeng Keqi , Zhou Xin , Liu Wanyi , Nie Cong , Zhang Yingfeng
Published: January 2023

Background

Stroke is the leading cause of death in humans worldwide, and its incidence increases every year. It is well documented that lipids are closely related to stroke. Analyzing the changes in lipid content in the stroke model after absolute quantification and investigating whether changes in lipid content can predict stroke severity provides a basis for the combination of clinical stroke and quantitative lipid indicators.

Methods

This paper establishes a rapid, sensitive, and reliable LC‒MS/MS analytical method for the detection of endogenous sphingolipids in rat serum and brain tissue and HT22 cells and quantifies the changes in sphingolipid content in the serum and brain tissue of rats from the normal and pMCAO groups and in cells from the normal and OGD/R groups. Using sphingosine (d17:1) as the internal standard, a chloroform: methanol (9:1) mixed system was used for protein precipitation and lipid extraction, followed by analysis by reversed-phase liquid chromatography coupled to triple quadrupole mass spectrometry.

Results

Based on absolute quantitative analysis of lipids in multiple biological samples, our results show that compared with those in the normal group, the contents of sphinganine (d16:0), sphinganine (d18:0), and phytosphingosine were significantly increased in the model group, except sphingosine-1-phosphate, which was decreased in various biological samples. The levels of each sphingolipid component in serum fluctuate with time.

Conclusion

This isotope-free and derivatization-free LC‒MS/MS method can achieve absolute quantification of sphingolipids in biological samples, which may also help identify lipid biomarkers of cerebral ischemia.

Graphical Abstract
Phosphorothioated amino-AS1411 aptamer functionalized stealth nanoliposome accelerates bio-therapeutic threshold of apigenin in neoplastic rat liver: a mechanistic approach
Authors: Dhara Moumita , Al Hoque Ashique , Sen Ramkrishna , Dutta Debasmita , Mukherjee Biswajit , Paul Brahamacharry , Laha Soumik
Published: January 2023

Hepatocellular carcinoma (HCC) is a leading cause of death globally. Even though the progressive invention of some very potent therapeutics has been seen, the success is limited due to the chemotherapeutic resistance and recurrence in HCC. Advanced targeted treatment options like immunotherapy, molecular therapy or surface-engineered nanotherapeutics could offer the benefits here owing to drug resistance over tumor heterogenicity. We have developed tumor-sensing phosphorothioate and amino-modified aptamer (AS1411)-conjugated stealth nanoliposomes, encapsulating with apigenin for precise and significant biodistribution of apigenin into the target tumor to exploit maximum bio-therapeutic assistances. The stable aptamer functionalized PEGylated nanoliposomes (Apt-NLCs) had an average vesicle size of 100–150 nm, a smooth surface, and an intact lamellarity, as ensured by DLS, FESEM, AFM, and Cryo-TEM. This study has specified in vitro process of optimum drug (apigenin) extrusion into the cancer cells by nucleolin receptor-mediated cellular internalization when delivered through modified AS1411 functionalized PEGylated nanoliposomes and ensured irreversible DNA damage in HCC. Significant improvement in cancer cell apoptosis in animal models, due to reduced clearance and higher intratumor drug accumulation along with almost nominal toxic effect in liver, strongly supports the therapeutic potential of aptamer-conjugated PEGylated nanoliposomes compared to the nonconjugated formulations in HCC. The study has established a robust superiority of modified AS1411 functionalized PEGylated nanoliposomes as an alternative drug delivery approach with momentous reduction of HCC tumor incidences.

Graphical Abstract
Tumor-penetrating nanoplatform with ultrasound “unlocking” for cascade synergistic therapy and visual feedback under hypoxia
Authors: Xie Zhuoyan , Wang Junrui , Luo Yuanli , Qiao Bin , Jiang Weixi , Zhu Leilei , Ran Haitao , Wang Zhigang , Zhu Wei , Ren Jianli , Zhou Zhiyi
Published: January 2023

Background

Combined therapy based on the effects of cascade reactions of nanoplatforms to combat specific solid tumor microenvironments is considered a cancer treatment strategy with transformative clinical value. Unfortunately, an insufficient O2 supply and the lack of a visual indication hinder further applications of most nanoplatforms for solid tumor therapy.

Results

A visualizable nanoplatform of liposome nanoparticles loaded with GOD, H(Gd), and PFP and grafted with the peptide tLyP-1, named tLyP-1H(Gd)-GOD@PFP, was constructed. The double-domain peptide tLyP-1 was used to specifically target and penetrate the tumor cells; then, US imaging, starvation therapy and sonodynamic therapy (SDT) were then achieved by the ultrasound (US)-activated cavitation effect under the guidance of MR/PA imaging. GOD not only deprived the glucose for starvation therapy but also produced H2O2, which in coordination with 1O2 produced by H(Gd), enable the effects of SDT to achieve a synergistic therapeutic effect. Moreover, the synergistic therapy was enhanced by O2 from PFP and low-intensity focused ultrasound (LIFU)-accelerated redox effects of the GOD. The present study demonstrated that the nanoplatform could generate a 3.3-fold increase in ROS, produce a 1.5-fold increase in the maximum rate of redox reactions and a 2.3-fold increase in the O2 supply in vitro, and achieve significant tumor inhibition in vivo.

Conclusion

We present a visualizable nanoplatform with tumor-penetrating ability that can be unlocked by US to overcome the current treatment problems by improving the controllability of the O2 supply, which ultimately synergistically enhanced cascade therapy.
Magnetofection of miR-21 promoted by electromagnetic field and iron oxide nanoparticles via the p38 MAPK pathway contributes to osteogenesis and angiogenesis for intervertebral fusion
Authors: Wang Tianqi , Zhao Hongqi , Jing Shaoze , Fan Yang , Sheng Gaohong , Ding Qing , Liu Chaoxu , Wu Hua , Liu Yang
Published: January 2023

Background

Magnetofection-mediated gene delivery shows great therapeutic potential through the regulation of the direction and degree of differentiation. Lumbar degenerative disc disease (DDD) is a serious global orthopaedic problem. However, even though intervertebral fusion is the gold standard for the treatment of DDD, its therapeutic effect is unsatisfactory. Here, we described a novel magnetofection system for delivering therapeutic miRNAs to promote osteogenesis and angiogenesis in patients with lumbar DDD.

Results

Co-stimulation with electromagnetic field (EMF) and iron oxide nanoparticles (IONPs) enhanced magnetofection efficiency significantly. Moreover, in vitro, magnetofection of miR-21 into bone marrow mesenchymal stem cells (BMSCs) and human umbilical endothelial cells (HUVECs) influenced their cellular behaviour and promoted osteogenesis and angiogenesis. Then, gene-edited seed cells were planted onto polycaprolactone (PCL) and hydroxyapatite (HA) scaffolds (PCL/HA scaffolds) and evolved into the ideal tissue-engineered bone to promote intervertebral fusion. Finally, our results showed that EMF and polyethyleneimine (PEI)@IONPs were enhancing transfection efficiency by activating the p38 MAPK pathway.

Conclusion

Our findings illustrate that a magnetofection system for delivering miR-21 into BMSCs and HUVECs promoted osteogenesis and angiogenesis in vitro and in vivo and that magnetofection transfection efficiency improved significantly under the co-stimulation of EMF and IONPs. Moreover, it relied on the activation of p38 MAPK pathway. This magnetofection system could be a promising therapeutic approach for various orthopaedic diseases.

Graphical Abstract
The usefulness of tranexamic acid for bleeding symptoms of chronic consumptive coagulopathy complicated by aortic disease: a single-institute, retrospective study of 14 patients
Authors: Suzuki Naruko , Suzuki Nobuaki , Kawaguchi Yuka , Okamoto Shuichi , Kanematsu Takeshi , Katsumi Akira , Suzuki Atsuo , Tamura Shogo , Kojima Tetsuhito , Kiyoi Hitoshi , Matsushita Tadashi
Published: January 2023

Background

Tranexamic acid (TXA) is an antifibrinolytic drug that blocks lysine-binding sites on the profibrinolytic enzyme plasminogen. Aortic diseases with chronic consumption coagulopathy may lead to disseminated intravascular coagulation (DIC) and cause fatal bleeding. Although the use of antifibrinolytic agents in DIC is generally not recommended due to enhanced fibrin deposition risking thrombotic symptoms, the efficacy of TXA has been reported in several cases of DIC with aortic diseases. However, the efficacy and safety of TXA for bleeding symptoms of chronic consumption coagulopathy with aortic diseases have not been studied in detail.

Methods

We evaluated the efficacy of TXA in 14 patients with chronic consumptive coagulopathy due to aortic disease complicated by bleeding symptoms. Changes in coagulation and fibrinolysis parameters from baseline were analyzed with Wilcoxon matched-pairs signed-rank tests, excluding missing values. Kaplan-Meier curves were used to analyze overall survival.

Results

Median age was 78.5 years (range, 66–89 years) and median observation period was 448 days (range, 0–2282 days). Twelve patients had chronic renal failure and 1 patient had chronic liver failure. Before starting treatment, median Japanese Ministry of Health and Welfare DIC diagnostic criteria score was 8 (range, 4–11) and median platelet count was 64 × 109/L (range, 25–97 × 109/L). Twelve patients underwent evaluation of bleeding symptoms after introduction of TXA, and 10 of those 12 patients showed improved bleeding tendencies within 30 days (median, 5.0 days). One patient with chronic liver failure showed worsening of bleeding symptoms. Although only one patient was initiated TXA in combination with anticoagulants, no significant worsening of thrombotic events was observed within 30 days.

Conclusions

TXA therapy appears effective against chronic consumptive coagulopathy with bleeding due to aortic disease, with few side effects.
Towards conceptualizing patients as partners in health systems: a systematic review and descriptive synthesis
Authors: Vanstone Meredith , Canfield Carolyn , Evans Cara , Leslie Myles , Levasseur Mary Anne , MacNeil Maggie , Pahwa Manisha , Panday Janelle , Rowland Paula , Taneja Shipra , Tripp Laura , You Jeonghwa , Abelson Julia
Published: January 2023

Background

With the sharp increase in the involvement of patients (including family and informal caregivers) as active participants, collaborators, advisors and decision-makers in health systems, a new role has emerged: the patient partner. The role of patient partner differs from other forms of patient engagement in its longitudinal and bidirectional nature. This systematic review describes extant work on how patient partners are conceptualized and engaged in health systems. In doing so, it furthers the understanding of the role and activities of patient partners, and best practices for future patient partnership activities.

Methods

A systematic review was conducted of peer-reviewed literature published in English or French that describes patient partner roles between 2000 and 2021 in any country or sector of the health system. We used a broad search strategy to capture descriptions of longitudinal patient engagement that may not have used words such as “partner” or “advisor”.

Results

A total of 506 eligible papers were identified, representing patient partnership activities in mostly high-income countries. These studies overwhelmingly described patient partnership in health research. We identified clusters of literature about patient partnership in cancer and mental health. The literature is saturated with single-site descriptive studies of patient partnership on individual projects or initiatives. There is a lack of work synthesizing impacts, facilitating factors and outcomes of patient partnership in healthcare.

Conclusions

There is not yet a consolidated understanding of the role, activities or impacts of patient partners. Advancement of the literature has been stymied by a lack of consistently used terminology. The literature is ready to move beyond single-site descriptions, and synthesis of existing pockets of high-quality theoretical work will be essential to this evolution.
Low expression of the dynamic network markers FOS/JUN in pre-deteriorated epithelial cells is associated with the progression of colorectal adenoma to carcinoma
Authors: Huang Xiaoqi , Han Chongyin , Zhong Jiayuan , Hu Jiaqi , Jin Yabin , Zhang Qinqin , Luo Wei , Liu Rui , Ling Fei
Published: January 2023

Background

Deterioration of normal intestinal epithelial cells is crucial for colorectal tumorigenesis. However, the process of epithelial cell deterioration and molecular networks that contribute to this process remain unclear.

Methods

Single-cell data and clinical information were downloaded from the Gene Expression Omnibus (GEO) database. We used the recently proposed dynamic network biomarker (DNB) method to identify the critical stage of epithelial cell deterioration. Data analysis and visualization were performed using R and Cytoscape software. In addition, Single-Cell rEgulatory Network Inference and Clustering (SCENIC) analysis was used to identify potential transcription factors, and CellChat analysis was conducted to evaluate possible interactions among cell populations. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set variation analysis (GSVA) analyses were also performed.

Results

The trajectory of epithelial cell deterioration in adenoma to carcinoma progression was delineated, and the subpopulation of pre-deteriorated epithelial cells during colorectal cancer (CRC) initialization was identified at the single-cell level. Additionally, FOS/JUN were identified as biomarkers for pre-deteriorated epithelial cell subpopulations in CRC. Notably, FOS/JUN triggered low expression of P53-regulated downstream pro-apoptotic genes and high expression of anti-apoptotic genes through suppression of P53 expression, which in turn inhibited P53-induced apoptosis. Furthermore, malignant epithelial cells contributed to the progression of pre-deteriorated epithelial cells through the GDF signaling pathway.

Conclusions

We demonstrated the trajectory of epithelial cell deterioration and used DNB to characterize pre-deteriorated epithelial cells at the single-cell level. The expression of DNB-neighboring genes and cellular communication were triggered by DNB genes, which may be involved in epithelial cell deterioration. The DNB genes FOS/JUN provide new insights into early intervention in CRC.
High titers of neutralizing SARS-CoV-2 antibodies six months after symptom onset are associated with increased severity in COVID-19 hospitalized patients
Authors: Sejdic Adin , Frische Anders , Jørgensen Charlotte Sværke , Rasmussen Lasse Dam , Trebbien Ramona , Dungu Arnold , Holler Jon G. , Ostrowski Sisse Rye , Eriksson Robert , Søborg Christian , Nielsen Thyge L. , Fischer Thea K. , Lindegaard Birgitte , Franck Kristina Træholt , Harboe Zitta Barrella
Published: January 2023

Background

Viral shedding and neutralizing antibody (NAb) dynamics among patients hospitalized with severe coronavirus disease 2019 (COVID-19) and immune correlates of protection have been key questions throughout the pandemic. We investigated the duration of reverse transcriptase-polymerase chain reaction (RT-PCR) positivity, infectious viral shedding and NAb titers as well as the association between NAb titers and disease severity in hospitalized COVID-19 patients in Denmark 2020–2021.

Materials and methods

Prospective single-center observational cohort study of 47 hospitalized COVID-19 patients. Oropharyngeal swabs were collected at eight time points during the initial 30 days of inclusion. Serum samples were collected after a median time of 7 (IQR 5 – 10), 37 (IQR 35 – 38), 97 (IQR 95 – 100), and 187 (IQR 185 – 190) days after symptom onset. NAb titers were determined by an in-house live virus microneutralization assay. Viral culturing was performed in Vero E6 cells.

Results

Patients with high disease severity had higher mean log2NAb titers at day 37 (1.58, 95% CI [0.34 –2.81]), 97 (2.07, 95% CI [0.53–3.62]) and 187 (2.49, 95% CI [0.20– 4.78]) after symptom onset, compared to patients with low disease severity. Peak viral load (0.072, 95% CI [− 0.627 – 0.728]), expressed as log10SARS-CoV-2 copies/ml, was not associated with disease severity. Virus cultivation attempts were unsuccessful in almost all (60/61) oropharyngeal samples collected shortly after hospital admission.

Conclusions

We document an association between high disease severity and high mean NAb titers at days 37, 97 and 187 after symptom onset. However, peak viral load during admission was not associated with disease severity.

Trial registration. The study is registered athttps://clinicaltrials.gov/(NCT05274373).
Image augmentation and automated measurement of endotracheal-tube-to-carina distance on chest radiographs in intensive care unit using a deep learning model with external validation
Authors: Oliver Matthieu , Renou Amélie , Allou Nicolas , Moscatelli Lucas , Ferdynus Cyril , Allyn Jerôme
Published: January 2023

Background

Chest radiographs are routinely performed in intensive care unit (ICU) to confirm the correct position of an endotracheal tube (ETT) relative to the carina. However, their interpretation is often challenging and requires substantial time and expertise. The aim of this study was to propose an externally validated deep learning model with uncertainty quantification and image segmentation for the automated assessment of ETT placement on ICU chest radiographs.

Methods

The CarinaNet model was constructed by applying transfer learning to the RetinaNet model using an internal dataset of ICU chest radiographs. The accuracy of the model in predicting the position of the ETT tip and carina was externally validated using a dataset of 200 images extracted from the MIMIC-CXR database. Uncertainty quantification was performed using the level of confidence in the ETT–carina distance prediction. Segmentation of the ETT was carried out using edge detection and pixel clustering.

Results

The interrater agreement was 0.18 cm for the ETT tip position, 0.58 cm for the carina position, and 0.60 cm for the ETT–carina distance. The mean absolute error of the model on the external test set was 0.51 cm for the ETT tip position prediction, 0.61 cm for the carina position prediction, and 0.89 cm for the ETT–carina distance prediction. The assessment of ETT placement was improved by complementing the human interpretation of chest radiographs with the CarinaNet model.

Conclusions

The CarinaNet model is an efficient and generalizable deep learning algorithm for the automated assessment of ETT placement on ICU chest radiographs. Uncertainty quantification can bring the attention of intensivists to chest radiographs that require an experienced human interpretation. Image segmentation provides intensivists with chest radiographs that are quickly interpretable and allows them to immediately assess the validity of model predictions. The CarinaNet model is ready to be evaluated in clinical studies.

Graphical Abstract
Pregnancy outcomes in patients receiving assisted reproductive therapy with systemic lupus erythematosus: a multi-center retrospective study
Authors: Lao Minxi , Dai Peiyin , Luo Guangxi , Yang Xing , Peng Miaoguan , Chen Yuyi , Zhan Yanfeng , Zhan Zhongping , Chen Dongying
Published: January 2023

Objectives

To evaluate the safety, efficacy, and maternal and fetal outcomes of assisted reproductive therapy (ART) in systemic lupus erythematosus (SLE).

Methods

Patients from three tertiary hospitals from Guangzhou, China followed-up from 2013 to 2022 were included retrospectively. Patients with planned or unplanned natural pregnancy were chosen as controls. ART procedure and pregnancy outcomes were recorded and compared.

Results

A total of 322 ART cycles in 142 women were analyzed. Sixty-six intrauterine pregnancies out of 72 clinical pregnancies yielded 65 live infants, including 5 pairs of twins. The clinical pregnancy rate was 46.5% (66/142). The mean age at the first clinical pregnancy was 34.0 ± 3.8 years. The median (interquartile range, IQR) disease course was 42.5 (25, 84.8) months. Twenty-seven (40.9%) of them had a history of adverse pregnancy. Primary infertility occurred in 20 (30.3%) patients. Obstruction of fallopian tubes (17/66, 25.8%) and premature ovarian failure (9/66, 13.6%) were the leading causes for infertility. Ovulation induction therapy (OIT) were conducted in 60 (83.3%) pregnancies, and no ovarian hyperstimulation syndrome (OHSS) or thrombosis was observed. The leading maternal adverse pregnancy outcomes (APOs) included premature delivery (21/66, 31.8%), gestational diabetes mellitus (GDM) (15/66, 22.7%), and disease flares (10/66, 15.2%). Spontaneous premature delivery (9/21, 42.9%) and preterm premature rupture of membranes (PPROM) (6/21, 28.6%) were the leading causes for premature delivery. Preeclampsia (19.0% vs 0%, P = 0.012) increased in premature delivery. Infants delivered prematurely were likely to be low-birth-weight (LBW)/very-low-birth-weight (VLBW) (81.0% vs 7.7%, P < 0.001). Disease flares were mild (4/10, 40.0%) or moderate (5/10, 50.0%), and developed during the second (3/10, 30.0%) or third (6/10, 60.0%) trimester with favorable outcomes. Fetal loss in ART (6/66, 9.1%) was primarily attributed to early spontaneous abortion (n = 5). The average delivery time was 36.8 ± 2.1 weeks of gestation. The average birth weight was 2653.5 ± 578.6 g. LBW infants accounted for 30.8% (20/65). No neonatal death or neonatal lupus occurred. The incidence of adverse pregnancy outcomes did not increase in patients with ART compared with planned pregnancy and reduced significantly compared with an unplanned pregnancy.

Conclusion

The safety and efficacy of ART is assured in lupus patients with stable disease. Maternal and fetal APOs are comparable with planned pregnancy, with a relatively high incidence of premature delivery, GDM, and LBW infants.
Prevalence of vitamin B complex deficiencies in women in reproductive age, pregnant, or lactating woman in Brazil: a systematic review and meta-analysis protocol
Authors: Mocellin Michel Carlos , Curioni Cintia Chaves , da Silva Pereira Alessandra , Ribas Simone Augusta , Teixeira Michelle Teixeira , de Macedo Tatiane Salgado Galvão , Palermo Gabriel Mantolvão
Published: January 2023

Background

Vitamin B deficiencies are involved with several outcomes in fertility and pregnancy. In Brazil, the national prevalence rates of these micronutrient deficiencies in women of reproductive age were not known. This study aims to systematically identify, select, evaluate, analyze, and report the prevalence rates of vitamin B complex deficiencies in women of reproductive age in Brazil and identify variables that may modify the outcome rates.

Methods

A systematic review will be conducted guided by the following question: “What is the prevalence of vitamin B deficiencies in women of reproductive age in Brazil?”. The studies will be identified and selected from a literature search using electronic databases, consultation with researchers/specialists, and reference lists of eligible studies and reviews on the topic. Major eligibility criteria include observational cross-sectional and cohort studies carried out in Brazil and performed in women 10–49 years old, or pregnant and lactating mothers, and investigated the deficiency of vitamin B complex by laboratory test. Two reviewers independently will perform the screening and selection of the studies, data extraction, and risk of bias assessment. For the data report, a narrative approach will be used to present the characteristics of the included studies and individual findings. A random meta-analysis model will be implemented to summarize the individual prevalence rates in a global value if the studies are sufficiently homogeneous.

Discussion

This study aims to identify the national and regional prevalence rates of vitamin B complex deficiencies in women of reproductive age; allow the policymakers discuss, plan, and implement public policies to screen; and prevent and/or treat these malnutrition conditions. This also aims to know the rates of nutritional deficiencies over the years, serving as an indirect indicator of the socioeconomic and dietary patterns of the population. Specifically for folate, this study allows to compare the prevalence rates of deficiency of this vitamin before and after the mandatory fortification of wheat and corn flours implemented since 2004 in Brazil, in this specific population. The evidence gathered may highlight the need for population-based studies to investigate the deficiency of these vitamins.

Systematic review registration

PROSPERO CRD42020188474
Variable impact of geochemical gradients on the functional potential of bacteria, archaea, and phages from the permanently stratified Lac Pavin
Authors: Jaffe Alexander L. , Bardot Corinne , Le Jeune Anne-Hélène , Liu Jett , Colombet Jonathan , Perrière Fanny , Billard Hermine , Castelle Cindy J. , Lehours Anne-Catherine , Banfield Jillian F.
Published: January 2023

Background

Permanently stratified lakes contain diverse microbial communities that vary with depth and so serve as useful models for studying the relationships between microbial community structure and geochemistry. Recent work has shown that these lakes can also harbor numerous bacteria and archaea from novel lineages, including those from the Candidate Phyla Radiation (CPR). However, the extent to which geochemical stratification differentially impacts carbon metabolism and overall genetic potential in CPR bacteria compared to other organisms is not well defined.

Results

Here, we determine the distribution of microbial lineages along an oxygen gradient in Lac Pavin, a deep, stratified lake in central France, and examine the influence of this gradient on their metabolism. Genome-based analyses revealed an enrichment of distinct C1 and CO2 fixation pathways in the oxic lake interface and anoxic zone/sediments, suggesting that oxygen likely plays a role in structuring metabolic strategies in non-CPR bacteria and archaea. Notably, we find that the oxidation of methane and its byproducts is largely spatially separated from methane production, which is mediated by diverse communities of sediment methanogens that vary on the centimeter scale. In contrast, we detected evidence for RuBisCO throughout the water column and sediments, including form II/III and form III-related enzymes encoded by CPR bacteria in the water column and DPANN archaea in the sediments. On the whole, though, CPR bacteria and phages did not show strong signals of gene content differentiation by depth, despite the fact that distinct species groups populate different lake and sediment compartments.

Conclusions

Overall, our analyses suggest that environmental gradients in Lac Pavin select for capacities of CPR bacteria and phages to a lesser extent than for other bacteria and archaea. This may be due to the fact that selection in the former groups is indirect and depends primarily on host characteristics.
Deep learning based identification of bone scintigraphies containing metastatic bone disease foci
Authors: Ibrahim Abdalla , Vaidyanathan Akshayaa , Primakov Sergey , Belmans Flore , Bottari Fabio , Refaee Turkey , Lovinfosse Pierre , Jadoul Alexandre , Derwael Celine , Hertel Fabian , Woodruff Henry C. , Zacho Helle D. , Walsh Sean , Vos Wim , Occhipinti Mariaelena , Hanin François-Xavier , Lambin Philippe , Mottaghy Felix M. , Hustinx Roland
Published: January 2023

Purpose

Metastatic bone disease (MBD) is the most common form of metastases, most frequently deriving from prostate cancer. MBD is screened with bone scintigraphy (BS), which have high sensitivity but low specificity for the diagnosis of MBD, often requiring further investigations. Deep learning (DL) - a machine learning technique designed to mimic human neuronal interactions- has shown promise in the field of medical imaging analysis for different purposes, including segmentation and classification of lesions. In this study, we aim to develop a DL algorithm that can classify areas of increased uptake on bone scintigraphy scans.

Methods

We collected 2365 BS from three European medical centres. The model was trained and validated on 1203 and 164 BS scans respectively. Furthermore we evaluated its performance on an external testing set composed of 998 BS scans. We further aimed to enhance the explainability of our developed algorithm, using activation maps. We compared the performance of our algorithm to that of 6 nuclear medicine physicians.

Results

The developed DL based algorithm is able to detect MBD on BSs, with high specificity and sensitivity (0.80 and 0.82 respectively on the external test set), in a shorter time compared to the nuclear medicine physicians (2.5 min for AI and 30 min for nuclear medicine physicians to classify 134 BSs). Further prospective validation is required before the algorithm can be used in the clinic.
“No matter what your story is, there is a place for you in science”: Students’ Ability to Relate to Scientists Positively Shifts after Scientist Spotlight Assignments, Especially for First-Generation Students and Women
Authors: Metzger Kelsey J. , Dingel Molly , Brown Ethan
Published: January 2023

This study reports a significant, positive shift in undergraduate biology students’ ability to relate to scientists following exposure to Scientist Spotlight assignments, as well as concomitant shifts in the ways students describe scientists, with a disproportionate, positive change for students who identify as first-generation students or as female.
New Gnadenhutten, Moravian Missionaries, and Ojibwe Land Tenure on the Clinton River, 1781–1787
Authors: Quint Jonathan
Published: January 2023

This article reveals how Lake St. Clair Ojibwe communities limited newcomer encroachment and maintained territorial sovereignty by strategically absorbing and then expelling a community of Moravian missionaries and Christian Lenape. In 1782 the Ojibwe allowed Moravians to settle in a liminal Ojibwe hunting territory on the Clinton River. Over five years the settlement expanded, with conflict and cooperation defining Moravian engagement with Ojibwe land tenure and interactions with surrounding communities. Through oratory and formal and informal social practices like verbal warnings, threats, and intimidation, the Ojibwe mediated disputes, regulated Moravian use of land and resources, and attempted to curtail environmental destruction. This article reveals how the Moravian community encountered and experienced Ojibwe land tenure practices, the consequences of transgressing Ojibwe law, and how Ojibwe communities resisted encroachment on traditional lands and territories.