bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychometric adequacy of the persian adapted version of the tilburg frailty indicator (P-TFI)
Authors: Safarnavadeh Maryam , Salehi Leili
Published: July 2024

Background

Frailty is identified as the primary goal of preventing the various consequences. The present study aimed to assess validity and reliability of the Persian adapted version of the Tilburg frailty indicator (TFI) in Iran.

Method

This cross-sectional study included three phases of translating the indicator to Persian, assessing the face and content validity, completing the P-TFI by older people, who helped assess the reliability and construct validity. For construct validity, convergent and divergent validity were used. It was expected that the TFI domain scores would show the highest correlations with their related measures of frailty (convergent construct validity) and the lowest correlations with measures of the other domains (divergent construct validity). The study population consisted of 400 older people, selected from six health care centers.

Results

The mean age of the participants was 69.05 ± 7.28 years and the majority of the participants were married woman with less than a high school education. The total mean score of TFI was 8.26 ± 1.80, and 42.75% was classified as frail. The test-retest reliability was 0.88 for the total scale, 0.80 for physical, 0.65 for psychological, and 0.81 for social domains. The mean score of frailty and its dimensions (physical, psychological, and social) varied from 4.35 ± 1.78, 1.81 ± 1.33, 1.69 ± 0.73, and 0.86 ± 0.61, respectively. The total score of the TFI was correlated with each alternative measure and the convergent validity was proved. Further, the kappa values ranging from 535 to 0.967 were significant and test- retest reliability for total, physical, psychological, and social dimension were 0.88, 080, 065, and 081, respectively. Further, the convergent or divergent validity is being discussed for clarity.

Conclusion

The Persian version of the TFI is valid and easy scored tools among Iranian’s older people.
Glutathione S-transferase theta 1 (GSTT1) deletion polymorphism and susceptibility to head and neck carcinoma: a systematic review with five analyses
Authors: Sadafi Sepehr , Choubsaz Parsia , Kazemeini Seyed Mohammad Mohyeddin , Imani Mohammad Moslem , Sadeghi Masoud
Published: July 2024

Glutathione S-transferase theta 1 (GSTT1) enzyme plays a key role in the neutralization of electrophilic compounds such as carcinogens. Herein, we aimed to evaluate GSTT1 deletion polymorphism and susceptibility to head and neck carcinoma (HNC) according to 107 articles in a systematic review with five analyses. The databases of PubMed/Medline, Web of Science, Scopus, and Cochrane Library from the beginning of each database until June 21, 2023, with no restrictions to identify pertinent articles. The RevMan 5.3 software was used to calculate the effect sizes, which were displayed as the odds ratio (OR) along with a 95% confidence interval (CI). Both the publication bias and sensitivity analyses were performed using the CMA 3.0 software. A trial sequential analysis (TSA) was conducted. Of the 1966 records retrieved from four databases, 107 articles were included in the analysis. The combined analysis revealed that the pooled OR was 1.28 (95% CI: 1.14 to 1.44; p-value < 0.0001). The pooled OR was highest in mixed ethnicity. Nasopharyngeal cancer had the highest OR (1.84), followed by oral cancer (OR = 1.20), and laryngeal cancer (OR = 1.17). Studies with less than 200 samples had a higher OR compared to those with 200 or more samples. The studies with a quality score of 7 or more had a higher OR compared to those with a score of less than 7. When both age and sex are considered, while the OR of 1.42 is significant, the high heterogeneity suggests caution in interpreting these results. There is no evidence of publication bias. TSA reported that the study does not have sufficient statistical power. This comprehensive meta-analysis revealed a significant association between the GSTT1 null genotype and an increased risk of HNC, with variations based on factors such as ethnicity, cancer type, sample size, control source, and quality score.
Inter-relation between diabetes mellitus and hypertension in terms of incidence and prediction in Saudi Arabia: a retrospective cohort study
Authors: Alharbi Abdulhameed A. , Alharbi Alwaleed A. , Al-Dubai Sami Abdo
Published: July 2024

Background

Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are interconnected metabolic disorders with escalating global incidence and prevalence. However, no longitudinal studies have specifically examined the incidence of HTN and T2DM in the same study population. This study aimed to elucidate the association between HTN and T2DM and ascertain their respective roles in the development of each other.

Methods

This retrospective cohort study encompassed 809 Saudi patients from primary healthcare centers in Al Madinah Al Munawarah, Saudi Arabia. The sample was stratified into three cohorts: 226 patients with HTN but without T2DM, 274 patients with T2DM but without HTN, and 309 patients devoid of both T2DM and HTN. Over a retrospective follow-up period of approximately 5 years, incidence density rates (IDR) were computed for HTN in the T2DM cohort, T2DM in the HTN cohort, and both HTN and T2DM in the control cohort. Multiple logistic regression analysis was employed to identify predictors of HTN and T2DM.

Results

The IDR of T2DM among patients with HTN stood at 73.9 (95% confidence interval [CI] 56, 92) per 1000 person-years, in contrast to 33.9 (95% CI 24, 44) per 1000 person-years in the control cohort (adjusted odds ratio [OR] = 7.1, 95%CI 3.55, 14.13). Conversely, the IDR of HTN among patients with type-2 T2DM was 55.9 (95% CI 42, 70) per 1000 person-years, while in the control cohort, it was 20.8 (95% CI 13, 28) per 1000 person-years (adjusted OR = 5.8, 95% CI 3.11, 11.09). Significant predictors of HTN in the logistic regression model encompassed age, smoking status, family history of HTN, T2DM status, and body mass index (BMI). Similarly, significant predictors of T2DM in the logistic regression model included age, sex, family history of T2DM, HTN, and BMI.

Conclusion

This study unveils HTN and T2DM as mutually significant risk factors. The IDR of each condition in the presence of the other significantly exceeded that among individuals devoid of HTN or T2DM.
Ethical considerations during Mpox Outbreak: a scoping review
Authors: El Dine Fatma Badr , Gebreal Assem , Samhouri Dalia , Estifanos Haimanot , Kourampi Islam , Abdelrhem Hasnaa , Mostafa Hamed Abdelma’aboud , Elshaar Ahmed Gamal , Suvvari Tarun Kumar , Ghazy Ramy Mohamed
Published: July 2024

Background

Historically, epidemics have been accompanied by the concurrent emergence of stigma, prejudice, and xenophobia. This scoping review aimed to describe and map published research targeting ethical values concerning monkeypox (mpox). In addition, it aimed to understand the research gaps related to mpox associated stigma.

Methods

We comprehensively searched databases (PubMed Central, PubMed Medline, Scopus, Web of Science, Ovid, and Google Scholar) to identify published literature concerning mpox ethical issues and stigma from May 6, 2022, to February 15, 2023. The key search terms used were “monkeypox”, “ethics”, “morals”, “social stigma”, “privacy”, “confidentiality”, “secrecy”, “privilege”, “egoism”, and “metaethics”. This scoping review followed the framework proposed by Arksey and O’Malley in 2005 and was further improved by the recommendations of Levac et al. in 2010.

Results

The search strategies employed in the scoping review yielded a total of 454 articles. We analyzed the sources, types, and topics of the retrieved articles/studies. The authors were able to identify 32 studies that met inclusion criteria. Six of the 32 included studies were primary research. The study revealed that the ongoing mpox outbreak is contending with a notable surge in misinformation and societal stigma. It highlights the adverse impacts of stigma and ethical concerns associated with mpox, which can negatively affect people with the disease.

Conclusion

The study’s findings underscore the imperative need to enhance public awareness; involve civil society; and promote collaboration among policymakers, medical communities, and social media platforms. These collective endeavors are crucial for mitigating stigma, averting human-to-human transmission, tackling racism, and dispelling misconceptions associated with the outbreak.
Function of serine/arginine-rich splicing factors in hematopoiesis and hematopoietic malignancies
Authors: Zhang Huifang , Zhu Hongkai , Peng Hongling , Sheng Yue
Published: July 2024

The serine/arginine-rich splicing factors (SRSFs) play an important role in regulating the alternative splicing of precursor RNA (pre-RNA). During this procedure, introns are removed from the pre-RNA, while the exons are accurately joined together to produce mature mRNA. In addition, SRSFs also involved in DNA replication and transcription, mRNA stability and nuclear export, and protein translation. It is reported that SRSFs participate in hematopoiesis, development, and other important biological process. They are also associated with the development of several diseases, particularly cancers. While the basic physiological functions and the important roles of SRSFs in solid cancer have been extensively reviewed, a comprehensive summary of their significant functions in normal hematopoiesis and hematopoietic malignancies is currently absent. Hence, this review presents a summary of their roles in normal hematopoiesis and hematopoietic malignancies.

Graphical Abstract
Stakeholders’ perspectives on involvement of community pharmacists in vaccine delivery services and implications for policy reform in Nigeria
Authors: Okafor Ukamaka Gladys , Oseni Yejide Olukemi , Odukoya Taofik Oladipupo , Oluyedun Hamidu Adediran , Ajibade Abiodun , Yussuf Azeez Olanrewaju , Okonu Abigail Isaac , Adetunji Oladapo
Published: July 2024

Vaccination has proven to be one of the most potent ways of achieving disease prevention and consequently reducing the number of global deaths due to diseases. As a result, vaccination coverage must be prioritised in public health. Community pharmacists are pitched as critical to reaching broader vaccination coverage in Nigeria due to their position as one of the most accessible healthcare professionals in the country. However, the factors affecting the involvement of these professionals as vaccine administrators have not been adequately established. This study was thus conducted as a collaborative action qualitative research via the interview of regulatory and professional stakeholders to ascertain this involvement and propose steps to be taken towards the progress of integrating the pharmacists into immunisation programmes. The study results showed that while pharmacists do not face direct restrictions when administering vaccines, they are not enabled to do so by law. Also, pharmacists’ uptake of the vaccine administrator role would benefit the Nigerian health system, and efforts are geared toward officially incorporating pharmacists. To this end, the government's support via funding and policymaking is solicited for better outcomes.
Artificial intelligence model for automated surgical instrument detection and counting: an experimental proof-of-concept study
Authors: Deol Ekamjit S. , Henning Grant , Basourakos Spyridon , Vasdev Ranveer M. S. , Sharma Vidit , Kavoussi Nicholas L. , Karnes R. Jeffrey , Leibovich Bradley C. , Boorjian Stephen A. , Khanna Abhinav
Published: July 2024

Background

Retained surgical items (RSI) are preventable events that pose a significant risk to patient safety. Current strategies for preventing RSIs rely heavily on manual instrument counting methods, which are prone to human error. This study evaluates the feasibility and performance of a deep learning-based computer vision model for automated surgical tool detection and counting.

Methods

A novel dataset of 1,004 images containing 13,213 surgical tools across 11 categories was developed. The dataset was split into training, validation, and test sets at a 60:20:20 ratio. An artificial intelligence (AI) model was trained on the dataset, and the model’s performance was evaluated using standard object detection metrics, including precision and recall. To simulate a real-world surgical setting, model performance was also evaluated in a dynamic surgical video of instruments being moved in real-time.

Results

The model demonstrated high precision (98.5%) and recall (99.9%) in distinguishing surgical tools from the background. It also exhibited excellent performance in differentiating between various surgical tools, with precision ranging from 94.0 to 100% and recall ranging from 97.1 to 100% across 11 tool categories. The model maintained strong performance on a subset of test images containing overlapping tools (precision range: 89.6–100%, and recall range 97.2–98.2%). In a real-time surgical video analysis, the model maintained a correct surgical tool count in all non-transition frames, with a median inference speed of 40.4 frames per second (interquartile range: 4.9).

Conclusion

This study demonstrates that using a deep learning-based computer vision model for automated surgical tool detection and counting is feasible. The model’s high precision and real-time inference capabilities highlight its potential to serve as an AI safeguard to potentially improve patient safety and reduce manual burden on surgical staff. Further validation in clinical settings is warranted.
PARP4 interacts with hnRNPM to regulate splicing during lung cancer progression
Authors: Lee Yi Fei , Phua Cheryl Zi Jin , Yuan Ju , Zhang Bin , Lee May Yin , Kannan Srinivasaraghavan , Chiu Yui Hei Jasper , Koh Casslynn Wei Qian , Yap Choon Kong , Lim Edwin Kok Hao , Chen Jianbin , Lim Yuhua , Lee Jane Jia Hui , Skanderup Anders Jacobsen , Wang Zhenxun , Zhai Weiwei , Tan Nguan Soon , Verma Chandra S. , Tay Yvonne , Tan Daniel Shao Weng , Tam Wai Leong
Published: July 2024

Background

The identification of cancer driver genes from sequencing data has been crucial in deepening our understanding of tumor biology and expanding targeted therapy options. However, apart from the most commonly altered genes, the mechanisms underlying the contribution of other mutations to cancer acquisition remain understudied. Leveraging on our whole-exome sequencing of the largest Asian lung adenocarcinoma (LUAD) cohort (n = 302), we now functionally assess the mechanistic role of a novel driver, PARP4.

Methods

In vitro and in vivo tumorigenicity assays were used to study the functional effects of PARP4 loss and mutation in multiple lung cancer cell lines. Interactomics analysis by quantitative mass spectrometry was conducted to identify PARP4’s interaction partners. Transcriptomic data from cell lines and patient tumors were used to investigate splicing alterations.

Results

PARP4 depletion or mutation (I1039T) promotes the tumorigenicity of KRAS- or EGFR-driven lung cancer cells. Disruption of the vault complex, with which PARP4 is commonly associated, did not alter tumorigenicity, indicating that PARP4’s tumor suppressive activity is mediated independently. The splicing regulator hnRNPM is a potentially novel PARP4 interaction partner, the loss of which likewise promotes tumor formation. hnRNPM loss results in splicing perturbations, with a propensity for dysregulated intronic splicing that was similarly observed in PARP4 knockdown cells and in LUAD cohort patients with PARP4 copy number loss.

Conclusions

PARP4 is a novel modulator of lung adenocarcinoma, where its tumor suppressive activity is mediated not through the vault complex—unlike conventionally thought, but in association with its novel interaction partner hnRNPM, thus suggesting a role for splicing dysregulation in LUAD tumorigenesis.
Postural stability at activation and deactivation of the cochlear implant in adolescents with late lateral implantations: a quasi-experiment
Authors: Zwierzchowska Anna , Gaweł Eliza , Krużyńska Agata , Słomka Kajetan J. , Juras Grzegorz
Published: July 2024

Background

Cochlear implantation (CI) surgery has become a prevalent method of hearing rehabilitation, since it has been acknowledged that it impacts effectively on the vestibular system. However, there is still no consensus among clinicians on the most appropriate age and area (lateral/bilateral) of CI surgery in terms of postural control. The present study aimed to assess the postural control in late lateral CI adolescents with different visual (eyes opened(EO)/eyes closed(EC)) and auditory (CI activated/deactivated) conditions and to build a theoretical model of postural control based on sensual compensatory mechanisms that are predominant in late CI individuals. It was hypothesized that kinesthetic sensation and exteroceptors of the superficial sensation are critical for neuromuscular control after late CI.

Methods

A quasi-experimental study protocol was used in this study to assess the postural stability performance in the studied adolescents with different visual and auditory perceptions. 27 adolescent students with hearing loss participated in the study. A force plate (Accu Gait AMTI) with computer software (NetForce) was used in the study to assess the postural stability with four different conditions(EO)/EC), CI activated/deactivated).

Results

vCOP was found to have a significant growing tendency within the conditions of CI activated/deactivated.No statistically significant relationships were noted between the range of the displacement of feet pressure (Area) and both the visual and auditory conditions. Hearing loss etiology was statistically significantly related to the values of vCOP, within the conditions of EO, CI activated/deactivated (p < 0.01), what did not occure with the condition of EC (p > 0.05). Neuromuscular control with the condition of EC x CI deactivated was found to be based on the kinesthetic-tactual compensatory model.

Conclusions

Kinesthetic sensation and exteroceptors of the superficial sensation seem to be the predominant source of information to maintain postural control in late CI adolescents, regardless of the visual and auditory conditions. The etiology of hearing loss (congenital/acquired) can be a predictor of the values of the vCOP. In order to improve neuromuscular control in this population, it is recommended that the patients perform physical activity tasks, especially to develop core muscles, based on direct stimulation and rotational stability.
A rare case of trigeminal trophic syndrome with periorbital cellulitis and full-thickness upper eyelid defect in an undiagnosed patient with human immunodeficiency virus: a case report
Authors: Apanga Stephen , Alhassan Mohammed , Abdulai Bawa
Published: July 2024

Background

Trigeminal trophic syndrome is a rare cranial and facial condition caused by damage to the central or peripheral branches of the trigeminal nerve. This syndrome consists of a triad of anesthesia, paresthesia, and crescent-shaped facial ulcer involving the ala nasi and sometimes extending to the upper lip. Although previous screening for human immunodeficiency virus in some patients with trigeminal trophic syndrome was negative, we present a unique case of trigeminal trophic syndrome who tested positive for human immunodeficiency virus with eye complications.

Case presentation

We present a rare case of trigeminal trophic syndrome in a 44-year-old Black African woman who tested positive for human immunodeficiency virus. She presented with a 6-week history of progressive, persistent, and painless left sided facial and scalp ulcerations that started as small skin erosion. Diagnosis of trigeminal trophic syndrome was made on clinical grounds based on the triad of anesthesia, paresthesia, and unilateral crescent-shaped ulcer in the trigeminal dermatome and her past medical history. The ulcer healed completely after counseling and pharmacological therapy, but she later developed left periorbital cellulitis and left upper eyelid full-thickness defect.

Conclusion

This is by far the first documented case of trigeminal trophic syndrome with a positive human immunodeficiency virus test. Testing for human immunodeficiency virus in patients with trigeminal trophic syndrome is necessary as this can help improve clinical management and treatment outcomes. Seeking the services of specialists remotely in resource constraint settings is beneficial for managing complications associated with trigeminal trophic syndrome.
Primary leiomyosarcoma of epididymis: a case report
Authors: Chen Hong-Jie , Han Yao-dong , Li Dong-hai , Li Wu , Zhang Jun
Published: July 2024

Background

Leiomyosarcoma is a tumor that can develop in any organ that contains smooth muscles. Although leiomyosarcoma is common, its epididymal localization is quite rare.

Case presentation

A 79-year-old male Chinese Han patient presented with mild pain in the right groin and scrotum for 3 years concomitant with right scrotal swelling. Ultrasonography and magnetic resonance imaging of the scrotum showed a irregular and heterogeneous mass that was extratesticular. Right high orchiectomy was performed, and pathological examination of the resected specimen confirmed the diagnosis of leiomyosarcoma of the epididymis with surgical margins clear of tumor.

Conclusion

Epididymal leiomyosarcoma is rare and difficult to diagnose preoperatively. The final diagnosis of epididymal leiomyosarcoma requires histologic examination. Resection must be extensive and complete. The effect of chemotherapy and radiation on the epididymal leiomyosarcoma remains unclear. Recurrence is common, so follow-up is necessary.
Cardiac sympathetic activity and lethal arrhythmic events: insight into bell-shaped relationship between 123I-meta-iodobenzylguanidine activity and event rates
Authors: Nakajima Kenichi , Nakata Tomoaki , Doi Takahiro , Verschure Derk O. , Frantellizzi Viviana , De Feo Maria Silvia , Tada Hayato , Verberne Hein J.
Published: July 2024

Background

123I-meta-iodobenzylguanidine (mIBG) has been applied to patients with chronic heart failure (CHF). However, the relationship between 123I-mIBG activity and lethal arrhythmic events (ArE) is not well defined. This study aimed to determine this relationship in Japanese and European cohorts.

Results

We calculated heart-to-mediastinum (H/M) count ratios and washout rates (WRs) of 827 patients using planar 123I-mIBG imaging. We defined ArEs as sudden cardiac death, arrhythmic death, and potentially lethal events such as sustained ventricular tachycardia, cardiac arrest with resuscitation, and appropriate implantable cardioverter defibrillator (ICD) discharge, either from a single ICD or as part of a cardiac resynchronization therapy device (CRTD). We analyzed the incidence of ArE with respect to H/M ratios, WRs and New York Heart Association (NYHA) functional classes among Japanese (J; n = 581) and European (E; n = 246) cohorts. We also simulated ArE rates versus H/M ratios under specific conditions using a machine-learning model incorporating 13 clinical variables. Consecutive patients with CHF were selected in group J, whereas group E comprised candidates for cardiac electronic devices. Groups J and E mostly comprised patients with NYHA functional classes I/II (95%) and II/III (91%), respectively, and 21% and 72% were respectively implanted with ICD/CRTD devices. The ArE rate increased with lower H/M ratios in group J, but the relationship was bell-shaped, with a high ArE rate within the intermediate H/M range, in group E. This bell-shaped curve was also evident in patients with NYHA classes II/III in the combined J and E groups, particularly in those with a high (> 15%) mIBG WR and with ischemic, but not in those with non-ischemic etiologies. Machine learning-based prediction of ArE risk aligned with these findings, indicating a bell-shaped curve in NYHA class II/III but not in class I.

Conclusions

The relationship between cardiac 123I-mIBG activity and lethal arrhythmic events is influenced by the background of patients. The bell-shaped relationship in NYHA classes II/III, high WR, and ischemic etiology likely aids in identifying patients at high risk for ArEs.
Clostridium butyricum regulates intestinal barrier function via trek1 to improve behavioral abnormalities in mice with autism spectrum disorder
Authors: Liu Simeng , Xi Huayuan , Xue Xia , Sun Xiangdong , Huang Huang , Fu Dongjun , Mi Yang , He Yongzheng , Yang Pingchang , Tang Youcai , Zheng Pengyuan
Published: July 2024

Background

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that has been found to be associated with dysregulation of gastrointestinal functions and gut microbial homeostasis (the so-called “gut-brain axis”). ASD is often accompanied by poor performances in social interaction and repetitive behaviors. Studies on the gut-brain axis provide novel insights and candidate targets for ASD therapeutics and diagnosis. Based on the ASD mice model, this work aims to reveal the mechanisms behind the interaction of intestinal barrier function and probiotics in ASD mouse models.

Results

We found an altered intestinal barrier in both BTBR T+ Itpr3tf/J (BTBR) and valproic acid (VPA) mice, including increased intestinal permeability, decreased expression of intestinal tight junction proteins (claudin1, claudin3, and occludin), and increased levels of IL-6, TNF-α, and IFN-γ. Based on intestinal microbial alternation, C. butyricum can drive reduced expression of histone deacetylases 1 (HDAC1) and enhanced intestinal barrier function, significantly promoting behavioral abnormalities of ASD in BTBR mice. In parallel, we confirmed that C. butyricum was involved in the regulation of intestinal function by the Trek1 channel, indicating that it is a target of C. butyricum/butyric acid to improve intestinal barrier function in ASD mice.

Conclusions

Our finding provides solid evidence for the gut microbiota involved in ASD through the brain-gut axis. In addition, the probiotics C. butyricum hold promise to improve gut health and ameliorate behavioral abnormalities associated with ASD.
The Israeli Trauma system during wartime - policy and management
Authors: Nitzan Dorit , Mendlovic Joseph , Ash Nachman
Published: July 2024

On October 7, 2023, Hamas terrorists attacked people in their homes, fields, and at a music festival in Israeli communities near the border with Gaza. More than 1,145 men, women, and children were killed, about 1,800 wounded were evacuated to hospitals in the country, and 253 infants, children, women, elderly, and men were abducted. This mass casualty incident (MCI) was the start of a war that is still ongoing. The Israeli medical system, which faced an overwhelming first 24 h, continues to take care of casualties, including those who are injured by missiles that target Israeli residential areas.

Israel has a well-established trauma system, and as a result of the experience gained in this war, the system merited review. This was the topic of a meeting of leaders of the Israeli healthcare system, and it forms the basis of this report. The meeting and report provide a platform for presenting the trauma system management during the war, highlighting the strengths of the system as well as its challenges and lessons learned. The participants also brainstormed and discussed possibilities for future improvements.
Clinical value of serum neuron-specific enolase in sepsis-associated encephalopathy: a systematic review and meta-analysis
Authors: Zhi Meiling , Huang Jian , Jin Xuli
Published: July 2024

Objective

This study aimed to investigate the serum levels of neuron-specific enolase (NSE) in sepsis-associated encephalopathy (SAE) and perform a meta-analysis to assess the diagnostic and prognostic potential of serum NSE in SAE patients.

Methods

We searched English and Chinese databases for studies related to SAE that reported serum NSE levels until November 2023. We extracted information from these studies including the first author and year of publication, the number of samples, the gender and age of patients, the collection time of blood samples in patients, the assay method of serum NSE, the study methods, and the levels of serum NSE with units of ng/mL. The quality assessment of diagnostic accuracy studies 2 (QUADAS-2) tool was used to evaluate the study quality. A meta-analysis was performed using Review Manager version 5.3, employing either a random effects model or a fixed effects model.

Results

A total of 17 studies were included in the final meta-analysis, including 682 SAE patients and 946 NE patients. The meta-analysis demonstrated significantly higher serum NSE levels in SAE patients compared to NE patients (Z = 5.97, P < 0.001, MD = 7.79, 95%CI 5.23–10.34), irrespective of the method used for serum NSE detection (Z = 6.15, P < 0.001, mean difference [MD] = 7.75, 95%CI 5.28–10.22) and the study methods (Z = 5.97, P < 0.001, MD = 7.79, 95%CI 5.23–10.34). Furthermore, sepsis patients with a favorable outcome showed significantly lower levels of serum NSE compared to those with an unfavorable outcome (death or adverse neurological outcomes) (Z = 5.44, P < 0.001, MD = − 5.34, 95%CI − 7.26–3.42).

Conclusion

The Serum level of NSE in SAE patients was significantly higher than that in septic patients without encephalopathy. The higher the serum NSE level in SAE patients, the higher their mortality rate and incidence of adverse neurological outcomes.
Do Agricultural stakeholder panels enhance post-harvest loss reduction? Evidence from Malawi
Authors: Amadu Festus O. , McNamara Paul E.
Published: July 2024

Post-harvest loss significantly affects food security in sub-Saharan Africa (SSA) and elsewhere across developing countries. Weak institutional factors like ineffective agricultural extension services in rural communities can exacerbate such problems among smallholder farmers in SSA and other developing countries. Therefore, international development policies have prioritized strengthening rural extension systems to enhance access to effective extension services and thereby enhance food security outcomes like ineffective agriculturalpost-harvest loss reduction among rural households. As such, the US-Agency for International Development supported theStrengthening Agricultural and Nutrition Extensionprogram in Malawi from 2015 to 2021 to improve access to rural extension services by promoting Agricultural Stakeholder Panels (ASPs)—platforms designed to enhance farmer interaction with local extension agents in rural communities and thereby enhance improved access to quality extension services in rural areas. The ASP approach can reduce post-harvest losses for major crops, such as maize. However, rigorous analyses of the effects of ASPs on post-harvest loss reduction remain limited. To address this knowledge gap, we apply recursive bivariate probit regression to primary survey data from 2134 households in Malawi to estimate the effects of the ASP approach on post-harvest loss reduction in 2018. The results show that ASPs reduced post-harvest losses among households by 53%, and a crucial outcome that can improve household food security. The result demonstrates that policies that strengthen rural extension systems can contribute to the achievement of the Sustainable Development Goals on hunger and food security in rural Malawi and similar contexts.
Rosin reinforcement and protection of the unearthed outer coffin from the tomb of Marquis Yi of Zeng in Hubei, China
Authors: Chen Hua , Chen Shaohui , Wu Changxiong , Chen Zhuofeng , Mai Bingjie , Cao Jing
Published: July 2024

The tomb of Marquis Yi of Zeng was unearthed in 1978 at Leiguudun in Suizhou City, Hubei Province, China. This is the largest wooden coffin in rock pit and vertical cave in the Warring States period in China. The large wooden coffin components provide reliable material data for the study of the feudal burial system in the pre-Qin period and have high value. In this paper, the wooden coffin excavated from the tomb of Marquis Yi of Zeng was studied. By understanding the composition of wood, studying the weight gain rate, shrinkage rate, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR) and compression resistance, the wood reinforced by rosin and epoxy resin was compared, and the reinforcement effect and principle of the two reinforcement methods were discussed. The study found that the wood properties of rosin reinforced group were better than those of epoxy reinforced group in the aspects of compressive strength, weight gain rate and volume shrinkage rate, and the mechanical properties of wood were significantly improved. In addition, methanol or ethanol can be used to dissolve the rosin shellac in this strengthening process, which can achieve reversible strengthening treatment. The results provide valuable examples and research ideas for the selection of different conservation techniques of large wooden cultural relics unearthed in the middle and lower reaches of the Yangtze River during the Warring States Period.
Environmental analysis and comparison of the conventional and fractal glass textured surface photovoltaic panels
Authors: Shoaei Mersad , Aslani Alireza , Zahedi Rahim
Published: July 2024

There are two major forms of solar energy that are typically utilized: photovoltaic and concentrated applications. The application of fractal glass texture to photovoltaic solar panels is a cutting-edge technique in the field of solar panels that generate electricity from exposure to light. When it comes to studying the environmental implications of a product during its development and commercialization, the life cycle assessment (LCA) approach is an excellent technique that can be utilized. The purpose of this study is to offer a thorough understanding of the product’s effects on the environment by taking into consideration a wide range of criteria, including environmental, economic, and other evaluations. Through the utilization of the life cycle assessment (LCA) methodology and the SimaPro software, this paper presents a comparative analysis of conventional solar panels and fractal glass texture panels. During the course of this research, 18 midpoint indicators and three endpoint indices were investigated. In addition, a sensitivity analysis has been carried out on the fractal property of the panel in order to evaluate the impact that it has on environmental impacts and damages. For the purpose of this study, three distinct levels of fractal coating were applied to the panel surface: one percent, three percent, and five percent. As a result of the data, it was determined that the “Photovoltaic cell single-Si wafer” and the “Transport, freight, sea, transoceanic tanker” had the most significant impact on the midpoint and endpoint indices for both panels, respectively. Furthermore, there is a direct association between the rise in fractal coating on panels and the reduction in environmental repercussions, approximately. This correlation exists because of several factors.
18F-FDG whole-body PET/CT for the evaluation of suspected native valve infective endocarditis
Authors: Chen Shihan , Ben-Ezra Noah , Probst Stephan , Abikhzer Gad
Published: July 2024

18F-FDG-PET/CT is indicated in the workup of patients with suspected infective endocarditis to detect intra-cardiac and disseminated infections, as well as its source. We present the case of a 66-year-old female patient known for recurrent diabetic foot infection, with equivocal TTE results and persistent MRSA bacteremia despite medical management. PET/CT revealed evidence of left foot osteomyelitis. Whole body PET/CT diagnosed native mitral valve infective endocarditis (IE) and right lower lobe segmental pulmonary artery uptake, consistent with septic pulmonary embolism (PE).
Traditional Italian flatbreads: cultural diversity, processing technology and future perspectives
Authors: Mefleh Marina , Vurro Francesca , Summo Carmine , Pasqualone Antonella
Published: July 2024

Flatbreads are particularly prevalent in the Mediterranean region, including Italy, where each community has its unique traditional recipe, preparation method, and baking system. This traditional narrative review provides an overview of the Italian flatbreads that have achieved national or international quality recognitions. The aims of this study are, firstly, to scientifically evaluate these flatbreads and establishing a catalog that includes both technical and cultural information, which are currently missing in the international scientific literature and, secondly, to conduct a comparative analysis of the technical and cultural diversity of traditional Italian flatbreads, outlining areas for future research development. The examined flatbreads were found to be characterized by considerable diversity, reflecting the Italian region’s diverse culinary heritage. The formulation is generally simple and includes flour, water, possibly yeast, and salt. Additional ingredients are region dependent, reflecting local availability, and include fats of animal origin, or ham, mostly found in flatbreads from Northern Italy, while olive oil or EVOO is common in flatbreads of Tuscany, Liguria, and Sardinia. The types of flour also differ regionally: Besides soft wheat flour, durum wheat semolina is used in southern Italy and Sardinia, chestnut flour in Tuscany, rye flour in Alto Adige, chickpea flour in Liguria, and corn flour in central Italy. Historically, high-extraction flour and sourdough were largely used but have been replaced by refined flour and commercial baker’s yeast over time. Flash baking (short time, high temperature) is generally adopted, and some flatbreads, typical of Sardinia, are baked twice, resulting in complete dryness and long shelf-life. In contrast, quickly prepared unleavened bread is a staple in the Tuscan-Emilian Apennines, Lunigiana, and the Po Valley. Overall, these results suggest encouraging the revival of the ancient baking tradition of using high-extraction flours and sourdough fermentation, which today are almost lost. Reintroducing these methods could increase the fiber, mineral and, vitamin content and ensure a rich sensory profile. Further research could focus on improving the nutritional quality, particularly, through salt reduction, acrylamide levels mitigation, and protein content increase. The lack of historical information highlights the need to perform historical research to gain a deeper understanding of origins, evolution and characteristics of Italian flatbreads.

Graphical Abstract
The prevalence and consequences of workplace violence among psychiatrists in Saudi Arabia: a cross-sectional study
Authors: Alwabili Afnan A. , AlGhammas Nada I. , ALkhalaf Hanoof H. , Almutairi Malak A.
Published: July 2024

Background and objective

There has been increasing concern globally about the rise in workplace violence (WPV), which is considered a persistent problem generally overlooked by the public and professional organizations. WPV is a significant challenge faced by psychiatrists internationally, yet little is known about WPV among psychiatrists in Saudi Arabia. This study aims to estimate the prevalence of WPV against psychiatrists in Saudi Arabia and identify the types and sources of violence experienced as well as the associated risk factors that contribute to WPV.

Results

Among 239 psychiatrists, the prevalence of WPV in Saudi Arabia was 56.3%. The prevalence was particularly high among those working in the central region (55.4%) and in Ministry of Health hospitals, Violent behavior was exhibited mostly by patients 133 (99.3%), and the most common type of violence was verbal abuse 75 (56.0%). Respondents reported that patients’ health conditions, denial of admission to the hospital, and staff shortages were the most common triggers for violence. More than two-thirds of the psychiatrists (74.6%) did not require medical intervention after incidents of violence. The majority of psychiatrists felt either stressed (39%) or angry (22.0%) after such incidents. Reasons for not reporting violent events included feeling that violence is part of the job (76.9%) and being unaware of the violence reporting system (50.8%).

Conclusion

This study underscores the significant prevalence of WPV among Saudi Arabian psychiatrists, especially in the central region and in Ministry of Health hospitals, notably in emergency rooms. Perpetrators are primarily psychiatric patients and their relatives. The issue is compounded by staffing shortages. WPV poses physical risks and causes psychological stress, negatively impacting productivity. Underreporting persists due to a lack of awareness or violence being perceived as part of the job. Addressing these challenges through raising awareness, providing support mechanisms, and enforcing regulations is essential to bolster workplace safety and patient care for psychiatrists.
Neonatal sepsis-a peek into our findings in Northwest Nigeria: a prospective study
Authors: Mustapha Samaha S. , Zaidu Aishatu Musa , Azaria Nanret Tanko , Aliyu Shamsudin , Abdulkadir Isa
Published: July 2024

Background

Neonatal sepsis is still a global health concern as it contributes to a high burden of neonatal morbidity and mortality especially in developing countries. The aim of the study is to give an insight into neonatal sepsis: risk factors, sepsis types, clinical features, pathogen burden with their antibiotic sensitivities, and outcome of admission in our facility. The study was a prospective hospital-based study conducted over 10 months, October 2018–July 2019.

Result

Of the 248 term neonates with features of sepsis enrolled in the study 94 (37.9%) were confirmed to have sepsis. Late-onset sepsis LOS (68%) was found to be the most common, and most of the neonates were delivered elsewhere. Clinical features were non-specific for both early-onset (EOS) and LOS and include fever, jaundice, poor suck, and depressed primitive reflexes. Infections were mostly caused by gram-negative bacteria, and while Staphylococcus aureus was the single most common isolate for both EOS and LOS. Antibiotic sensitivity was highest with ciprofloxacin for both EOS and LOS. Mortality was high at 14.9% and was mostly contributed to by Staphylococcus aureus infection.

Conclusion

Neonatal sepsis is still a burden with mostly non-specific clinical features. The local prevalent organisms were Staphylococcus aureus, Enterobacter agglomerans and Klebsiella pneumonia with good antibiotic susceptibility to ciprofloxacin. Most presented with late-onset sepsis and therefore infection is likely to be community-acquired which to a great extent can be prevented with robust public health interventions.
Cubosomes: evolving platform for intranasal drug delivery of neurotherapeutics
Authors: Gawarkar-Patil Priyanka , Mahajan Bhavna , Pawar Atmaram , Dhapte-Pawar Vividha
Published: July 2024

Background

As per World Health Organization (WHO) database, neurological and psychiatric disorders constitute a significant and escalating source of morbidity, impacting over one billion lives with a staggering 9 million fatalities. Unfortunately, the magnitude of these disorders remains largely untreated, primarily due to the formidable challenge of the cerebrospinal fluid–brain barrier (CBB), blood–brain barrier (BBB), as well as the blood–cerebrospinal fluid barrier (BCSFB) compromising the central nervous system (CNS) therapies. Thus, there is a need to explore innovative drug delivery platforms capable of overcoming these barriers in order to facilitate effective delivery of therapeutic drugs.

Main body of abstract

Intranasal drug delivery (INDD) of nanoformulations has emerged as a promising approach, leveraging advantages such as a high surface area, nanoscale particle size, mucoadhesion, noninvasive administration with rapid, and greater drug bioavailability. In this, cubosomal drug delivery (DD) has emerged as a pivotal targeted drug delivery strategy, particularly in the therapy of neurological ailments. Nowadays, researchers and academicians have focused their efforts to tailor cubosomes (CBS) specifically for improving efficacy of central nervous system (CNS) therapies.

Conclusion

This review gives an idea about current status of neurological disorders (ND), the barriers that restricts CNS drug delivery (BBB), and possible nasal pathways of CBS for effective drug transport. A central focus is placed on intranasal (IN) cubosomal formulations for several NDs, elucidating their potential benefits while addressing existing challenges. In essence, this comprehensive review provides valuable insights into innovative approaches that hold promise for addressing the use and need of IN-CBS in the treatment of NDs.
Software symptomcheckR: an R package for analyzing and visualizing symptom checker triage performance
Authors: Kopka Marvin , Feufel Markus A.
Published: July 2024

Background

A major stream of research on symptom checkers aims at evaluating the technology’s predictive accuracy, but apart from general trends, the results are marked by high variability. Several authors suggest that this variability might in part be due to different assessment methods and a lack of standardization. To improve the reliability of symptom checker evaluation studies, several approaches have been suggested, including standardizing input procedures, the generation of test vignettes, and the assignment of gold standard solutions for these vignettes. Recently, we suggested a third approach––test-theoretic metrics for standardized performance reporting–– to allow systematic and comprehensive comparisons of symptom checker performance. However, calculating these metrics is time-consuming and error prone, which could hamper the use and effectiveness of these metrics.

Results

We developed the R package symptomcheckR as an open-source software to assist researchers in calculating standard metrics to evaluate symptom checker performance individually and comparatively and produce publication-ready figures. These metrics include accuracy (by triage level), safety of advice (i.e., rate of correctly or overtriaged cases), comprehensiveness (i.e., how many cases could be entered or were assessed), inclination to overtriage (i.e., how risk-averse a symptom checker is) and a capability comparison score (i.e., a score correcting for case difficulty and comprehensiveness that enables a fair and reliable comparison of different symptom checkers). Each metric can be obtained using a single command and visualized with another command. For the analysis of individual or the comparison of multiple symptom checkers, single commands can be used to produce a comprehensive performance profile that complements the standard focus on accuracy with additional metrics that reveal strengths and weaknesses of symptom checkers.

Conclusions

Our package supports ongoing efforts to improve the quality of vignette-based symptom checker evaluation studies by means of standardized methods. Specifically, with our package, adhering to reporting standards and metrics becomes easier, simple, and time efficient. Ultimately, this may help users gain a more systematic understanding of the strengths and limitations of symptom checkers for different use cases (e.g., all-purpose symptom checkers for general medicine versus symptom checkers that aim at improving triage in emergency departments), which can improve patient safety and resource allocation.