bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between maternal blood lipids and neonatal hypoglycaemia in pregnancy with gestational diabetes mellitus: a cohort study
Authors: Zhang Mo , Huang Xiaoqing , Lin Suiwen , Liu Bin
Published: June 2024

Background

Gestational diabetes mellitus (GDM) prevalence is on the rise globally. Offspring of diabetic mothers face increased risk of neonatal hypoglycaemia (NH), and women with GDM have abnormal lipid profiles. However, there is no consensus on the link between maternal blood lipids and NH in infants from mothers with GDM. This study aimed to explore how maternal blood lipids affect NH.

Methods

A retrospective cohort study was conducted at the First Affiliated Hospital of Sun Yat-sen University. Information on participants’ baseline characteristics and maternal metabolic profiles of glucose and lipids was collected. Significant variables from the univariate analysis were included in logistic regression, which was used to construct the predictive model for NH. A nomogram was constructed for visualizing the model and assessed using the area under the receiver operating characteristic (ROC) curve (AUC).

Results

Neonatal capillary blood glucose (CBG) decreased rapidly in the first hour after birth, increased gradually from the first to the second hour, and then remained stable. In the NH group, 86.11% (502/583) of hypoglycaemia cases occurred within the first two hours after birth. Multivariate logistic regression suggested that the lipid indices of maternal apoprotein B/apoprotein A1 (Apo-B/Apo-A1) (odds ratio (OR) = 1.36, 95% confidence intervals (CIs): 1.049–1.764, P = 0.02) and apoprotein E (Apo-E) (OR = 1.014, 95% CIs: 1.004–1.024, P = 0.004) were positively associated with NH in neonates from mothers with GDM. Triglycerides (TGs) (OR = 0.883, 95% CIs: 0.788–0.986, P = 0.028) were inversely associated with NH. Maternal glycated haemoglobin (HbA1c), age, twin pregnancy and caesarean delivery also had predictive value of NH. The AUC of the nomogram derived from these factors for the prediction model of NH was 0.657 (95% CIs: 0.630–0.684).

Conclusions

The present study revealed that the Apo-B/Apo-A1 and Apo-E levels were associated with an increased risk of NH. A nomogram was developed to forecast the risk of NH in babies born to mothers with GDM, incorporating maternal blood lipids, HbA1c, age, twin pregnancy, and caesarean section. The trajectory of glycaemia for neonates indicates the need for intensive CBG monitoring within 2 h of birth for neonates from mothers with GDM.
Longitudinal strain correlates with 6-minute walk distance whereas ejection fraction and diastolic parameters do not
Authors: Petersen John W. , Bracewell Natalie , Schneider Kevin M. , Latner Joshua , Yang Shuang , Guo Yi
Published: June 2024

Background

Impaired functional capacity is a common symptom in patients with heart failure. Standard measures of left ventricular (LV) function, such as ejection fraction (EF) and LV diastolic parameters, do not correlate with measures of functional capacity. The aim of this study is to determine if measures of global and regional LV strain better correlate with 6-minute walk distance than does EF or measures of LV diastolic function.

Methods

120 patients referred to a cardiology clinic for evaluation of known or suspected heart failure were approached for enrollment. Of those 120 patients, 58 had an echocardiogram within 3 months of enrollment with images adequate for regional and global strain assessment, had no contra-indication to exercise testing, and had no previously documented non-cardiac explanation for dyspnea on exertion. In those 58 patients, 6-minute walk distance was measured, LV EF was determined with Simpson’s biplane method, and global and regional longitudinal strain were measured with TomTec Image Arena 4.5.1 software.

Results

LV EF had no correlation with 6-minute walk distance (r = 0.22, p = 0.09) even when controlling for age, gender, and BMI (p = 0.07). No measures of LV diastolic function (including E velocity, Deceleration Time, e’ annular velocities, or E/e’) had a correlation with 6-minute walk distance. Multiple measures of global and regional LV longitudinal systolic function had a correlation with 6-minute walk distance. Longitudinal strain of the basal LV segments had the strongest correlation with 6-minute walk distance (r= -0.36, p = 0.005), and correlation persisted after controlling for age, gender, BMI, and systolic blood pressure (p = 0.004).

Conclusions

Longitudinal strain correlates with a measure of functional capacity, but LVEF and traditional measures of LV diastolic dysfunction do not. Measures of longitudinal strain, especially in basal LV segments, will likely be an important marker of clinically relevant LV function.

Graphical Abstract
Low-dose overlap initiation with split tablets of buprenorphine in intubated intensive care unit patients with opioid use disorder
Authors: Szczesniak Laura , Britton Sarah , RN Theresa Baxter , Sullivan Ross
Published: June 2024

Background

As the opioid public health crisis evolves to include fentanyl and other potent synthetic opioids, more patients are admitted to the hospital with serious complications of drug use and frequently require higher levels of care, including intensive care unit (ICU) admission, for acute and chronic conditions related to opioid use disorder (OUD). This patient population poses a unique challenge when managing sedation and ensuring adequate ventilation while intubated given their high opioid requirements. Starting a patient on medications such as buprenorphine may be difficult for inpatient providers unfamiliar with its use, which may lead to undertreatment of patients with OUD, prolonged mechanical ventilation and length of stay.

Methods

We developed a 7-day buprenorphine low dose overlap initiation (LDOI) schedule for patients with OUD admitted to the ICU (Table 1). Buprenorphine tablets were split by pharmacists and placed into pre-made blister packs as a kit to be loaded into the automated medication dispensing machine for nursing to administer daily. An internal quality review validated the appropriate dosing of split-dose tablets. To simplify order entry and increase prescriber comfort with this new protocol, we generated an order set within our electronic health record software with prebuilt buprenorphine titration orders. This protocol was implemented alongside patient and healthcare team education and counseling on the LDOI process, with follow-up offered to all patients upon discharge.

Results

Here we report a series of 6 ICU patients started on buprenorphine using the LDOI schedule with split buprenorphine tablets. None of the 6 patients experienced precipitated withdrawal upon buprenorphine initiation using the LDOI schedule, and 5/6 patients were successfully extubated during the buprenorphine initiation. Four of six patients had a decrease in daily morphine milligram equivalents, with 3 patients transitioning to buprenorphine alone.

Conclusion

Initiating buprenorphine via LDOI was found to be successful in the development of a protocol for critically ill patients with OUD. We examined LDOI of buprenorphine in intubated ICU patients and found no events of acute precipitated withdrawal. This protocol can be used as a guide for other institutions seeking to start critically ill patients on medication treatment for OUD during ICU admission.
“If it wasn’t for them, I don’t think I would be here”: experiences of the first year of a safer supply program during the dual public health emergencies of COVID-19 and the drug toxicity crisis
Authors: Kolla Gillian , Pauly Bernie , Cameron Fred , Hobbs Heather , Ranger Corey , McCall Jane , Majalahti Jerry , Toombs Kim , LeMaistre Jack , Selfridge Marion , Urbanoski Karen
Published: June 2024

Background

In response to the devastating drug toxicity crisis in Canada driven by an unregulated opioid supply predominantly composed of fentanyl and analogues, safer supply programs have been introduced. These programs provide people using street-acquired opioids with prescribed, pharmaceutical opioids. We use six core components of safer supply programs identified by people who use drugs to explore participant perspectives on the first year of operations of a safer supply program in Victoria, BC, during the dual public health emergencies of COVID-19 and the drug toxicity crisis to examine whether the program met drug-user defined elements of an effective safer supply model.

Methods

This study used a community-based participatory research approach to ensure that the research was reflective of community concerns and priorities, rather than being extractive. We interviewed 16 safer supply program participants between December 2020 and June 2021. Analysis was structured using the six core components of effective safer supply from the perspective of people who use drugs, generated through a prior study.

Results

Ensuring access to the ‘right dose and right drugs’ of medications was crucial, with many participants reporting success with the available pharmaceutical options. However, others highlighted issues with the strength of the available medications and the lack of options for smokeable medications. Accessing the safer supply program allowed participants to reduce their use of drugs from unregulated markets and manage withdrawal, pain and cravings. On components related to program operations, participants reported receiving compassionate care, and that accessing the safer supply program was a non-stigmatizing experience. They also reported receiving support to find housing, access food, obtain ID, and other needs. However, participants worried about long term program sustainability.

Conclusions

Participants in the safer supply program overwhelmingly appreciated it and felt it was lifesaving, and unlike other healthcare or treatment services they had previously accessed. Participants raised concerns that unless a wider variety of medications and ability to consume them by multiple routes of administration became available, safer supply programs would remain unable to completely replace substances from unregulated markets.
The impact of a reproductive health voucher in Uganda using a quasi-experimental matching design
Authors: Andersson Christian , Kawuki Tonny , Månsson Jonas , Nankaja Christine , Sund Krister , Wigren Emma , Zungu Mathias Mulumba
Published: June 2024

This study assesses the impact of a voucher project that targeted vulnerable and poor pregnant women in Uganda. Highly subsidised vouchers gave access to a package of safe delivery services consisting of four antenatal visits, safe delivery, one postnatal visit, the treatment and management of selected pregnancy-related medical conditions and complications, and emergency transport. Vouchers were sold during the project’s operational period from 2016 to 2019. This study covers 8 out of 25 project-benefiting districts in Uganda and a total of 1,881 pregnancies, including both beneficiary and non-beneficiary mothers. Using a matching design, the results show a positive effect on the survival of new-born babies. The difference in the survival rate between the control group and the treatment group is 5.4% points, indicating that the voucher project reduced infant mortality by more than 65 per cent.
Depression symptoms and suicidal ideation among HIV infected Rwandans: the mediating and moderating effects of complicated grief and substance abuse
Authors: Uwiringiyimana Anualitha , Niyonsenga Japhet , Lisette Kethina Gaju , Bugenimana Athanasie , Mutabaruka Jean , Nshimiyimana Augustin
Published: June 2024

Background

People with HIV/AIDS (PWHA) have 7–36 times greater risk for completed suicide associated with depression symptoms compared to general population. However, no study has sufficiently analyzed the mediating or moderating variables of the relationship between depression and suicidal ideation in Rwanda.

Objectives

This study aimed to examine how complicated grief mediates and substance abuse moderates the effects of depression symptoms on suicidal ideation.

Methods

Data were collected from a convenient sample of 140 participants (M-age = 38.79 years, SD = 10.218) receiving antiretroviral therapy (ART) at Remera Health Center in a cross-sectional study. Multiple linear regression and Sobel test were used to examine the relationships between depression symptoms, complicated grief, suicidal ideation, and substance abuse.

Results

The results indicated that 29% of the sample had clinically significant symptoms of depression and 18% had suicidal ideation. The interaction between substance abuse and depression symptoms (β = .468, t = 8.02, p = 0.000) was a significant predictor, explaining the 55.7% of variance in suicidal ideation. Furthermore, the Sobel test demonstrated that complicated grief mediated the effects of depression symptoms (t = 4.67, SE = 0.0101, p ≤ 0.001) on suicidal ideation.

Conclusion

The results suggest that depression symptoms are associated with an increased risk of suicidal ideation, and this risk significantly amplified in the presence of complicated grief and substance abuse. These findings highlight the importance of integrating mental health services, particularly those addressing depression, complicated grief, and substance abuse, into HIV care programs to mitigate the risk of suicidal ideation among PWHA.
Interrelations of managing position with person-environment fit of gender-role orientation, and burnout
Authors: Wacker Eva , Fischer Axel , Schorlemmer Julia
Published: June 2024

Background

In previous studies a moderator effect of management position could be found between Person-environment fit of masculinity, and burnout. Present study goals are to analyze previous fundings of the importance of the individual gender-role in relation to the work environment in more detail.

Methods

In this cross sectional explanative study, an online survey took place using Gender Role Orientation Scale (GTS +) by Altstötter-Gleich and DearEmployee-Survey by Wiedemann et al. The sample consists of 891 participants–516 female (58%), 373 male (42%), among those 277 executives (32%) and 594 participants without managerial responsibility (68%), age 17–70 years (M = 29.86; S = 7.67). Four groups were divided according to P-E fit in femininity and P-E fit in masculinity, this enabled a more precise distinction between the participants. The proportions of executives were determined, and compared in each group by a $${\chi }^{2}$$

χ

2

-Test Hierarchical linear regression models predicting burnout and proving moderator effects of managerial position were calculated for each group.

Results

The proportions of executives were the highest in the two groups with participants, who had a higher individual masculinity compared to their work environment. A moderator effect of managerial position between P-E fit in masculinity and burnout was found in group “Indifferent” (participants with lower feminity and masculinity compared with work environment). With a worse P-E fit in masculinity burnout values rise for individuals with no managerial position. On the other hand, among leaders burnout values decrease a worse P-E fit in masculinity.

Conclusions

People with a high individual masculinity compared to work environment tend more to be selected as managers, regardless of the individual characteristics of femininity, which may generally lead to a highly masculine and less feminine leadership and corporate culture. This culture could increase burnout risk for people with low individual masculinity and high feminity scores compared to work environment as well as for persons with low individual masculinity and feminity compared to work environment, especially if they are not in a managerial position.
Left atrial volume index and interleukin-6 as predictors for postoperative atrial fibrillation
Authors: Tao Hong , Shen Xiao , Zou Lei , Zhang Cui , Hong Liang
Published: June 2024

Background

Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. However, the predictive value of single indictor still remains controversial. This study aimed to assess the predictive value of combining preoperative left atrial volume index (LAVI) and postoperative interleukin-6 (IL-6) for POAF in the patients receiving cardiac surgery.

Methods

Patients who admitted to Nanjing First Hospital during the study period between December 2022 and June 2023, and underwent open-heart surgery without a history of atrial fibrillation (AF) were enrolled. The relationships between predictors and POAF were investigated using logistic regression analysis. We determined the combined predictive value of LAVI and IL-6 for POAF by measuring the changes in the area under the receiver operating characteristic curve (AUC) and calculating the net reclassification improvements (NRIs) and integrated discrimination improvement (IDIs).

Results

102 patients were enrolled in this study, and 50 participants developed POAF (49.0%). Patients who experienced POAF had higher levels of preoperative LAVI and postoperative IL-6 than those who did not. Regression analysis revealed that larger LAVI and higher level of IL-6 were independently associated with increased risk of POAF. The combined addition of LAVI and IL-6 to the predictive model resulted in an evident increase in the AUC. Incorporating both LAVI and IL-6 increased IDIs in all models.

Conclusion

Our results demonstrated that combined LAVI and IL-6 achieved a higher prediction performance for POAF.
Tortuosity in non-atherosclerotic vascular diseases is associated with age, arterial aneurysms, and hypertension
Authors: Luta Xhyljeta , Zanchi Fabio , Fresa Marco , Porccedu Enrica , Keller Sanjiv , Bouchardy Judith , Déglise Sébastien , Qanadli Salah Dine , Kirsch Matthias , Wuerzner Grégoire , Superti-Furga Andrea , Buso Giacomo , Mazzolai Lucia
Published: June 2024

Background

Increased arterial tortuosity has been associated with various cardiovascular complications. However, the extent and role of arterial tortuosity in non-atherosclerotic vascular diseases remain to be fully elucidated. This study aimed to assess arterial tortuosity index (ATI) in patients with non-atherosclerotic vascular diseases and the associated factors.

Methods

This is a retrospective analysis of patients with non-atherosclerotic vascular diseases referred to the Malformation and Rare Vascular Disease Center at the University Hospital in Lausanne (Switzerland). Computed tomography angiography (CTA) images performed between October 2010 and April 2022 were retrieved and the aortic tortuosity index (ATI) was calculated. Patients were classified based on diagnosis into the following groups: arterial dissection & aneurysm, arteritis & autoimmune disease, hereditary connective tissue diseases, and fibromuscular dysplasia (FMD). Univariate and multivariate logistic regression analysis was used to determine potentially relevant predictors of aortic tortuosity.

Results

The mean age upon computed tomography angiography (CTA) was 46.8 (standard deviation [SD] 14.6) years and 59.1% of the patients were female. Mean ATI was higher in patients over 60 years old (1.27), in those with arterial aneurysms (mean: 1.11), and in those diagnosed with hypertension (mean: 1.13). When only patients over 60 years old were considered, those diagnosed with connective tissue diseases had the highest ATI. At multivariate regression analysis, increasing age (p < 0.05), presence of arterial aneurysms (p < 0.05), and hypertension (p < 0.05) were independently associated with ATI.

Conclusions

The ATI may be a promising tool in diagnostic evaluation, cardiovascular risk stratification, medical or surgical management, and prognostic assessment in several non-atherosclerotic vascular conditions. Further studies with longitudinal design and larger cohorts are needed to validate the role of ATI in the full spectrum of vascular diseases.
Minimisation of dialysis risk in hospital patients with chronic kidney disease (MinDial): study protocol for a multicentre, stepped-wedge, cluster-randomised controlled trial
Authors: Stelzer D. , Binder H. , Glattacker M. , Graf E. , Hahn M. , Hollenbeck M. , Kaier K. , Kowall B. , Kuklik N. , Metzner G. , Mueller N. , Seiler L. , Stolpe S. , Blume C.
Published: June 2024

Background

Early identification of patients with chronic kidney disease (CKD) and advancing kidney insufficiency, followed by specialist care, can decelerate the progression of the disease. However, awareness of the importance and possible consequences of kidney insufficiency is low among doctors and patients. Since kidney insufficiency can be asymptomatic even in higher stages, it is often not even known to those belonging to risk groups. This study aims to clarify whether, for hospitalised patients with advanced chronic kidney disease, a risk-based appointment with a nephrology specialist reduces disease progression.

Methods

The target population of the study is hospitalised CKD patients with an increased risk of end-stage renal disease (ESRD), more specifically with an ESRD risk of at least 9% in the next 5 years. This risk is estimated by the internationally validated Kidney Failure Risk Equation (KFRE). The intervention consists of a specific appointment with a nephrology specialist after the hospital stay, while control patients are discharged from the hospital as usual. Eight medical centres include participants according to a stepped-wedge design, with randomised sequential centre-wise crossover from recruiting patients into the control group to recruitment to the intervention. The estimated glomerular filtration rate (eGFR) is measured for each patient during the hospital stay and after 12 months within the regular care by the general practitioner. The difference in the change of the eGFR over this period is compared between the intervention and control groups and considered the primary endpoint.

Discussion

This study is designed to evaluate the effect of risk-based appointments with nephrology specialists for hospitalised CKD patients with an increased risk of end-stage renal disease. If the intervention is proven to be beneficial, it may be implemented in routine care. Limitations will be examined and discussed. The evaluation will include further endpoints such as non-guideline-compliant medication, economic considerations and interviews with contributing physicians to assess the acceptance and feasibility of the intervention.

Trial registration

German Clinical Trials Register DRKS00029691. Registered on 12 September 2022.
A proposed analytical framework for qualitative evaluation of access to medicines from a health systems perspective
Authors: Joosse I. R. , van den Ham H. A. , Mantel-Teeuwisse A. K. , Suleman F.
Published: June 2024

Objective

Despite global recognition that access to medicines is shaped by various interacting processes within a health system, a suitable analytical framework for identifying barriers and facilitators from a system’s perspective was needed. We propose a framework specifically designed to find drivers to access to medicines from a country’s health system perspective. This framework could enable the systematic evaluation of access across countries, disease areas and populations and facilitate targeted policy development. This framework is the byproduct of a larger study on the barriers and facilitators to childhood oncology medicines in South Africa.

Results

Eight core (pharmaceutical) functional processes were identified from existing frameworks: (I) medicine regulation, (II) public financing and pricing, (III) selection, (IV) reimbursement, (V) procurement and supply, (VI) healthcare delivery, (VII) dispensing and (VIII) use. National contextual components included policy and legislation and health information systems. To emphasize the interlinkage of processes, the proposed framework was structured as a pharmaceutical value chain. This framework focusses on national processes that are within a country’s control as opposed to global factors, and functional mechanisms versus a country’s performance or policy objectives. Further refinement and validation of the framework following application in other contexts is encouraged.
Evaluating the inter-species transmission risk of amyloid beta peptide aggregates via ingestion
Authors: Raine Joshua , Tolwinski Nicholas , Gruber Jan , Mathuru Ajay S.
Published: June 2024

Background

Recent reports suggest that amyloid beta (Aβ) peptides can exhibit prion-like pathogenic properties. Transmission of Aβ peptide and the development of associated pathologies after surgeries with contaminated instruments and intravenous or intracerebral inoculations have now been reported across fish, rodents, primates, and humans. This raises a worrying prospect of Aβ peptides also having other characteristics typical of prions, such as evasion of the digestive process. We asked if such transmission of Aβ aggregates via ingestion was possible.

Methods

We made use of a transgenic Drosophila melanogaster line expressing human Aβ peptide prone to aggregation. Fly larvae were fed to adult zebrafish under two feeding schemes. The first was a short-term, high-intensity scheme over 48 h to determine transmission and retention in the gut. The second, long-term scheme specifically examined retention and accumulation in the brain. The gut and brain tissues were examined by histology, western blotting, and mass spectrometric analyses.

Results

None of the analyses could detect Aβ aggregates in the guts of zebrafish following ingestion, despite being easily detectable in the feed. Additionally, there was no detectable accumulation of Aβ in the brain tissue or development of associated pathologies after prolonged feeding.

Conclusions

While human Aβ aggregates do not appear to be readily transmissible by ingestion across species, two prospects remain open. First, this mode of transmission, if occurring, may stay below a detectable threshold and may take much longer to manifest. A second possibility is that the human Aβ peptide is not able to trigger self-propagation or aggregation in other species. Either possibility requires further investigation, taking into account the possibility of such transmission from agricultural species used in the food industry.
PUResNetV2.0: a deep learning model leveraging sparse representation for improved ligand binding site prediction
Authors: Jeevan Kandel , Palistha Shrestha , Tayara Hilal , Chong Kil T.
Published: June 2024

Accurate ligand binding site prediction (LBSP) within proteins is essential for drug discovery. We developed ProteinUNetResNetV2.0 (PUResNetV2.0), leveraging sparse representation of protein structures to improve LBSP accuracy. Our training dataset included protein complexes from 4729 protein families. Evaluations on benchmark datasets showed that PUResNetV2.0 achieved an 85.4% Distance Center Atom (DCA) success rate and a 74.7% F1 Score on the Holo801 dataset, outperforming existing methods. However, its performance in specific cases, such as RNA, DNA, peptide-like ligand, and ion binding site prediction, was limited due to constraints in our training data. Our findings underscore the potential of sparse representation in LBSP, especially for oligomeric structures, suggesting PUResNetV2.0 as a promising tool for computational drug discovery.
Genetic analysis of 106 sporadic cases with hearing loss in the UAE population
Authors: Tlili Abdelaziz , Mahfood Mona , Al Mutery Abdullah , Chouchen Jihen
Published: June 2024

Background

Hereditary hearing loss is a rare hereditary condition that has a significant presence in consanguineous populations. Despite its prevalence, hearing loss is marked by substantial genetic diversity, which poses challenges for diagnosis and screening, particularly in cases with no clear family history or when the impact of the genetic variant requires functional analysis, such as in the case of missense mutations and UTR variants. The advent of next-generation sequencing (NGS) has transformed the identification of genes and variants linked to various conditions, including hearing loss. However, there remains a high proportion of undiagnosed patients, attributable to various factors, including limitations in sequencing coverage and gaps in our knowledge of the entire genome, among other factors. In this study, our objective was to comprehensively identify the spectrum of genes and variants associated with hearing loss in a cohort of 106 affected individuals from the UAE.

Results

In this study, we investigated 106 sporadic cases of hearing impairment and performed genetic analyses to identify causative mutations. Screening of the GJB2 gene in these cases revealed its involvement in 24 affected individuals, with specific mutations identified. For individuals without GJB2 mutations, whole exome sequencing (WES) was conducted. WES revealed 33 genetic variants, including 6 homozygous and 27 heterozygous DNA changes, two of which were previously implicated in hearing loss, while 25 variants were novel. We also observed multiple potential pathogenic heterozygous variants across different genes in some cases. Notably, a significant proportion of cases remained without potential pathogenic variants.

Conclusions

Our findings confirm the complex genetic landscape of hearing loss and the limitations of WES in achieving a 100% diagnostic rate, especially in conditions characterized by genetic heterogeneity. These results contribute to our understanding of the genetic basis of hearing loss and emphasize the need for further research and comprehensive genetic analyses to elucidate the underlying causes of this condition.
Avoidant restrictive food intake disorder: recent advances in neurobiology and treatment
Authors: Fonseca Natasha K. O. , Curtarelli Vitória D. , Bertoletti Juliana , Azevedo Karla , Cardinal Tiago M. , Moreira Júlia D. , Antunes Luciana C.
Published: June 2024

Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by persistent insufficient nutritional and/or energy intake. ARFID, before referred to as “selective eating disorder”, was introduced recently in the DSM-5 as a replacement for and expansion of the previous diagnosis. Individuals with ARFID may limit food variety and intake due to avoidance based on the sensory characteristics of the food or related to any adverse consequences of eating without the intention of losing weight and concerns of body image. The limited understanding of avoidant and restrictive eating poses challenges to effective treatment and management, impacting directly on the growth and development of children and adolescents. The ARFID neurobiological concept has not yet been clearly defined to clinical practice for nutritionists, thereby hindering screening and impeding the development of treatment recommendations. This narrative review provide useful practical information to consult the pathophysiology, the neurobiology, the clinical features, the assessment and the treatment for healthcare professionals seeking to enhance their clinical knowledge and management of this disorder.
A comparative study of AI-human-made and human-made test forms for a university TESOL theory course
Authors: O Kyung-Mi
Published: June 2024

This study examines the efficacy of artificial intelligence (AI) in creating parallel test items compared to human-made ones. Two test forms were developed: one consisting of 20 existing human-made items and another with 20 new items generated with ChatGPT assistance. Expert reviews confirmed the content parallelism of the two test forms. Forty-three university students then completed the 40 test items presented randomly from both forms on a final test. Statistical analyses of student performance indicated comparability between the AI-human-made and human-made test forms. Despite limitations such as sample size and reliance on classical test theory (CTT), the findings suggest ChatGPT’s potential to assist teachers in test item creation, reducing workload and saving time. These results highlight ChatGPT’s value in educational assessment and emphasize the need for further research and development in this area.
Tau modulation through AAV9 therapy augments Akt/Erk survival signalling in glaucoma mitigating the retinal degenerative phenotype
Authors: Thananthirige Kanishka Pushpitha Maha , Chitranshi Nitin , Basavarajappa Devaraj , Rajput Rashi , Abbasi Mojdeh , Palanivel Viswanthram , Gupta Veer Bala , Paulo Joao A. , Koronyo-Hamaoui Maya , Mirzaei Mehdi , Graham Stuart L. , Gupta Vivek
Published: June 2024

The microtubule-associated protein Tau is a key player in various neurodegenerative conditions, including Alzheimer's disease (AD) and Tauopathies, where its hyperphosphorylation disrupts neuronal microtubular lattice stability. Glaucoma, a neurodegenerative disorder affecting the retina, leads to irreversible vision loss by damaging retinal ganglion cells and the optic nerve, often associated with increased intraocular pressure. Prior studies have indicated Tau expression and phosphorylation alterations in the retina in both AD and glaucoma, yet the causative or downstream nature of Tau protein changes in these pathologies remains unclear. This study investigates the impact of Tau protein modulation on retinal neurons under normal and experimental glaucoma conditions. Employing AAV9-mediated gene therapy for Tau overexpression and knockdown, both manipulations were found to adversely affect retinal structural and functional measures as well as neuroprotective Akt/Erk survival signalling in healthy conditions. In the experimental glaucoma model, Tau overexpression intensified inner retinal degeneration, while Tau silencing provided significant protection against these degenerative changes. These findings underscore the critical role of endogenous Tau protein levels in preserving retinal integrity and emphasize the therapeutic potential of targeting Tau in glaucoma pathology.
Elaboration of an innovative plant biomaterial for its valorization in the treatment of wastewater
Authors: Hassani El Mokhtar Saoudi , Mehdaoui Imane , Azzouni Dounia , Mahmoud Rachid , Taleb Abdeslam , Wondmie Gezahign Fentahun , Salamatullah Ahmad Mohammad , Bourhia Mohammed , Ibenmoussa Samir , Taleb Mustapha , Rais Zakia
Published: June 2024

The global scientific community is deeply concerned about the deterioration of water quality resulting from the release of industrial effluents. This issue is of utmost importance as it serves to safeguard the environment and combat water pollution. The objective of this work is to elaborate a biomaterial of vegetable origin, based on the twigs of Aleppo pine, and to use it as an abundant and less expensive material for the treatment of wastewater. For this reason, the twigs were treated physically to get the powder called biomaterial FPA (Aleppo pine fiber), which was characterized by physicochemical, and spectroscopic analyses namely scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD). The crystallinity index of FPA was evaluated by the peak height method. The findings indicate that the FPA powder has an acidic nature, exhibiting a porous structure that promotes the adsorption and binding of molecules. Additionally, it has a zero charge point of 5.8 and a specific surface area of 384 m2.g−1. It is primarily composed of hydroxyl, carboxyl, and amine functional groups, along with mineral compounds and organic compounds, including cellulose and other mineral elements such as Ca, Mg, Fe, Na, P, Al, K, Ni, and Mo. Combining these characteristics, FPA biomaterial has considerable potential for use as an effective adsorbent biomaterial for various wastewater pollutants. Its abundance and relatively low cost make it an attractive solution to the growing challenges of water pollution worldwide.

Graphical Abstract
Relocating from EFL to EMI: a case study on L2 learning motivation of English major students in a transnational university in China
Authors: Li Mingyu
Published: June 2024

Drawing from (Dörnyei’s, The Psychology of the language learner: Individual differences in second language acquisition, 2005) L2 Motivational Self System, this case study delved into the L2 learning motivations of liberal arts and science English majors at a transnational university in China, where English Medium Instruction (EMI) is prevalent. The study aimed to uncover how the EMI educational setting, alongside disciplinary backgrounds, shapes students' motivational landscapes. Utilising a mixed-methods approach, a 4-point Likert scale questionnaire was first administered to 182 students, followed by semi-structured interviews with six purposively selected participants to ensure a representation of diverse perspectives. Quantitative data were analysed using descriptive statistics and an independent samples t-test to pinpoint motivational differences between the two groups, with Cohen’s d effect size test further elucidating the significance of these differences. Thematic analysis of qualitative data provided a deeper layer of insight, which, when cross-examined with quantitative results, revealed a nuanced understanding of motivational dynamics. Key findings highlighted that both student groups were driven by factors such as ideal L2 self, ought-to L2 self, international posture, and instrumentality. However, within the EMI context, liberal arts students exhibited heightened sensitivity to their ought-to L2 selves, language anxiety, and teacher influence compared to their science counterparts (p < 0.05, dCohen > 0.8). These distinctions underscore the EMI context's role in modulating motivational profiles, particularly accentuating certain motivational factors among liberal arts students. In light of these EMI-mediated motivational nuances, the study proposes several educational implications, including enhancing teachers’ professional development training, integrating English learning in EMI programmes with students’ aspirations, and fostering intercultural interactions to enrich students’ language and cultural experiences.
Experiences of co-producing person-centred and cohesive clinical pathways in the national system for knowledge-based management in Swedish healthcare: a qualitative study
Authors: Määttä Sylvia , Petersson Christina , Gäre Boel Andersson , Henriks Göran , Ånfors Henrik , Lundberg Christin , Nilsagård Ylva
Published: June 2024

Background

When the 21 Swedish county councils decided to collaborate in the creation of a national system for knowledge-based management, patient participation was mandatory. Patient and next-of-kin representatives (PR) co-produced person-centred and cohesive clinical pathways together with healthcare professionals (HPR). Research on co-production in healthcare at the national level is scarce. The aim of this study is to explore experiences of patient participation from the perspectives of both PRs and HPRs when co-producing clinical pathways within the Swedish nationwide healthcare system for knowledge-based management.

Methods

A qualitative study was conducted. A strategic sample of nine PRs and eight HPRs were interviewed individually between August 2022 and January 2023 using a semi-structured interview guide. We analysed data using an inductive content analysis.

Results

Three main categories were identified: (1) Finding appropriate patient representativeness; (2) Working methods that facilitate a patient perspective; and (3) Influence of the patient perspective in the clinical pathways.

Conclusions

The study demonstrates the importance of patient and next-of-kin participation in the construction of clinical pathways at the national level. The results provide a platform for further research on patient participation on the national level and add to studies on if and how patient participation on this level has an impact on how the clinical pathways are put into practice at the micro level, and the support provided at the meso level. The study contributes to the growing body of literature studying patient participation and co-production.

Trial registration

Region Örebro County ID 276,940. An advisory opinion was obtained from the Swedish Ethical Review Authority (2021-05899-01).
Time-of-flight MRA of intracranial vessels at 7 T
Authors: Cosottini Mirco , Calzoni Tommaso , Lazzarotti Guido Andrea , Grigolini Alessandro , Bosco Paolo , Cecchi Paolo , Tosetti Michela , Biagi Laura , Donatelli Graziella
Published: June 2024

Background

Three-dimensional time-of-flight magnetic resonance angiography (TOF-MRA) is a largely adopted non-invasive technique for assessing cerebrovascular diseases. We aimed to optimize the 7-T TOF-MRA acquisition protocol, confirm that it outperforms conventional 3-T TOF-MRA, and compare 7-T TOF-MRA with digital subtraction angiography (DSA) in patients with different vascular pathologies.

Methods

Seven-tesla TOF-MRA sequences with different spatial resolutions acquired in four healthy subjects were compared with 3-T TOF-MRA for signal-to-noise and contrast-to-noise ratios as well as using a qualitative scale for vessel visibility and the quantitative Canny algorithm. Four patients with cerebrovascular disease (primary arteritis of the central nervous system, saccular aneurism, arteriovenous malformation, and dural arteriovenous fistula) underwent optimized 7-T TOF-MRA and DSA as reference. Images were compared visually and using the complex-wavelet structural similarity index.

Results

Contrast-to-noise ratio was higher at 7 T (4.5 ± 0.8 (mean ± standard deviation)) than at 3 T (2.7 ± 0.9). The mean quality score for all intracranial vessels was higher at 7 T (2.89) than at 3 T (2.28). Angiogram quality demonstrated a better vessel border detection at 7 T than at 3 T (44,166 versus 28,720 pixels). Of 32 parameters used for diagnosing cerebrovascular diseases on DSA, 27 (84%) were detected on 7-T TOF-MRA; the similarity index ranged from 0.52 (dural arteriovenous fistula) to 0.90 (saccular aneurysm).

Conclusions

Seven-tesla TOF-MRA outperformed conventional 3-T TOF-MRA in evaluating intracranial vessels and exhibited an excellent image quality when compared to DSA. Seven-tesla TOF-MRA might improve the non-invasive diagnostic approach to several cerebrovascular diseases.

Relevance statement

An optimized TOF-MRA sequence at 7 T outperforms 3-T TOF-MRA, opening perspectives to its clinical use for noninvasive diagnosis of paradigmatic pathologies of intracranial vessels.

Key points

• An optimized 7-T TOF-MRA protocol was selected for comparison with clinical 3-T TOF-MRA for assessing intracranial vessels.

• Seven-tesla TOF-MRA outperformed 3-T TOF-MRA in both quantitative and qualitative evaluation.

• Seven-tesla TOF-MRA is comparable to DSA for the diagnosis and characterization of intracranial vascular pathologies.

Graphical Abstract
Experimental characterization of Grewia Ferruginea fiber reinforced polyester matrix composite materials
Authors: Seyoum Dejen , Asratie Aychew , Gnanadurai Robinson , Gzate Yewondwosen
Published: June 2024

Researchers have recently altered their focus and have become more interested in natural fiber-reinforced polymer composites because they are more ecologically friendly and environmentally conscious than synthetic fiber-reinforced polymer composites. Among the best sources of natural fiber, Grewia ferruginea, sometimes known locally as Lenquata, is a source of natural fiber from other plant fibers. The goal of this study was to create polyester matrix composites reinforced with short Grewia ferruginea plant fibers measuring 10, 20, and 30 mm. The fibers were extracted using the traditional water-retting method and chemically treated with 5% NaOH. The findings indicated that the average tensile strength of a single fiber from Grewia ferruginea plants is 214 MPa, with a density of 1.11 g/cm3. Furthermore, the composite, which was created with a fiber length of 10 mm, fiber weight ratio of 25 %, and polyester matrix composite of 75 %, exhibited superior performance since it is stronger than any combination that was used to create the composite in this investigation, with 18.3 MPa tensile and 35.2 MPa flexural strength.
TAK-242 (Resatorvid) inhibits proinflammatory cytokine production through the inhibition of NF-κB signaling pathway in fibroblast-like synoviocytes in osteoarthritis patients
Authors: Khomeijani-Farahani Mohammadreza , karami Jafar , Farhadi Elham , Soltani Samaneh , Delbandi Ali-Akbar , Shekarabi Mehdi , Tahmasebi Mohammad Naghi , Vaziri Arash Sharafat , Jamshidi Ahmadreza , Mahmoudi Mahdi , Akhlaghi Masoomeh
Published: June 2024

Background

Fibroblast-like synoviocytes (FLSs) are involved in osteoarthritis (OA) pathogenesis through pro-inflammatory cytokine production. TAK-242, a TLR4 blocker, has been found to have a significant impact on the gene expression profile of pro-inflammatory cytokines such as IL1-β, IL-6, TNF-α, and TLR4, as well as the phosphorylation of Ikβα, a regulator of the NF-κB signaling pathway, in OA-FLSs. This study aims to investigate this effect because TLR4 plays a crucial role in inflammatory responses.

Materials and methods

Ten OA patients’ synovial tissues were acquired, and isolated FLSs were cultured in DMEM in order to assess the effectiveness of TAK-242. The treated FLSs with TAK-242 and Lipopolysaccharides (LPS) were analyzed for the mRNA expression level of IL1-β, IL-6, TNF-α, and TLR4 levels by Real-Time PCR. Besides, we used western blot to assess the protein levels of Ikβα and pIkβα.

Results

The results represented that TAK-242 effectively suppressed the gene expression of inflammatory cytokines IL1-β, IL-6, TNF-α, and TLR4 which were overexpressed upon LPS treatment. Additionally, TAK-242 inhibited the phosphorylation of Ikβα which was increased by LPS treatment.

Conclusion

According to our results, TAK-242 shows promising inhibitory effects on TLR4-mediated inflammatory responses in OA-FLSs by targeting the NF-κB pathway. TLR4 inhibitors, such as TAK-242, may be useful therapeutic agents to reduce inflammation and its associated complications in OA patients, since traditional and biological treatments may not be adequate for all of them.