bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of interprofessional rehabilitation programs for patients with chronic low back pain evaluated in the literature: a scoping review protocol
Authors: Wami Sintayehu Daba , Fasika Solomon , Donnelly Catherine , Gelaye Kassahun Alemu , Pullatayil Abdul , Miller Jordan
Published: June 2023

Background

Interprofessional rehabilitation programs have demonstrated effectiveness at improving health-related quality of life, function, work abilities, and reducing pain, for patients with chronic low back pain (CLBP). However, the characteristics of interprofessional rehabilitation programs vary widely across studies. Therefore, clarifying and describing key characteristics of interprofessional rehabilitation programs for patients with CLBP will be valuable for future intervention design and implementation. This scoping review aims to identify and describe the key characteristics of interprofessional rehabilitation programs for patients with CLBP.

Methods

Our scoping review will follow the framework developed by Arksey and O'Malley, further enhanced by Levac et al. and the Joanna Briggs Institute (JBI). Electronic databases, including MEDLINE, EMBASE, CINAHL, PsycINFO, SCOPUS, PubMed, Web of Science, and Cochrane Library, will be searched to identify relevant published studies. Our scoping review will consider all primary source peer-reviewed published articles that evaluated interprofessional rehabilitation programs for adults with CLBP from all countries and any therapeutic settings.

The Covidence software will be used to remove duplicates, article screening, record the step-by-step selection process, and data extraction. The analysis will involve a descriptive numerical summary and narrative analysis. Data will be presented in graphical and tabular format based on the nature of the data.

Discussion

This scoping review is expected to provide a source of evidence for developing and implementing interprofessional rehabilitation programs in new settings or contexts. As such, this review will guide future research and provide key information to health professionals, researchers and policymakers interested in designing and implementing evidence and theory-informed interprofessional rehabilitation programs for patients with CLBP.

Trial registration

https://osf.io/rquxv.
Identification of milling status based on vibration signals using artificial intelligence in robot-assisted cervical laminectomy
Authors: Wang Rui , Bai He , Xia Guangming , Zhou Jiaming , Dai Yu , Xue Yuan
Published: June 2023

Background

With advances in science and technology, the application of artificial intelligence in medicine has significantly progressed. The purpose of this study is to explore whether the k-nearest neighbors (KNN) machine learning method can identify three milling states based on vibration signals: cancellous bone (CCB), ventral cortical bone (VCB), and penetration (PT) in robot-assisted cervical laminectomy.

Methods

Cervical laminectomies were performed on the cervical segments of eight pigs using a robot. First, the bilateral dorsal cortical bone and part of the CCB were milled with a 5 mm blade and then the bilateral laminae were milled to penetration with a 2 mm blade. During the milling process using the 2 mm blade, the vibration signals were collected by the acceleration sensor, and the harmonic components were extracted using fast Fourier transform. The feature vectors were constructed with vibration signal amplitudes of 0.5, 1.0, and 1.5 kHz and the KNN was then trained by the features vector to predict the milling states.

Results

The amplitudes of the vibration signals between VCB and PT were statistically different at 0.5, 1.0, and 1.5 kHz (P < 0.05), and the amplitudes of the vibration signals between CCB and VCB were significantly different at 0.5 and 1.5 kHz (P < 0.05). The KNN recognition success rates for the CCB, VCB, and PT were 92%, 98%, and 100%, respectively. A total of 6% and 2% of the CCB cases were identified as VCB and PT, respectively; 2% of VCB cases were identified as PT.

Conclusions

The KNN can distinguish different milling states of a high-speed bur in robot-assisted cervical laminectomy based on vibration signals. This method is feasible for improving the safety of posterior cervical decompression surgery.
The association between air pollution and the daily hospital visits for atrial fibrillation recorded by ECG: a case-crossover study
Authors: Han Jiming , Zhang Rui , Guo Jingyi , Zheng Qingfeng , Chen Xin , Wu Shanmei , Tan Jianguo , Li Yongguang
Published: June 2023

Background

The relationship between air pollution and atrial fibrillation (AF) recorded by electrocardiograph (ECG) has not yet been illustrated which worsens AF precaution and treatment. This research evaluated the association between air pollution and daily hospital visits for AF with ECG records.

Methods

The study enrolled 4933 male and 5392 female patients whose ECG reports indicated AF from 2015 to 2018 in our hospital. Such data were then matched with meteorological data, including air pollutant concentrations, collected by local weather stations. A case-crossover study was performed to assess the relationship between air pollutants and daily hospital visits for AF recorded by ECG and to investigate its lag effect.

Results

Our analysis revealed statistically significant associations between AF occurrence and demographic data, including age and gender. This effect was stronger in female (k = 0.02635, p < 0.01) and in patients over 65 y (k = 0.04732, p < 0.01). We also observed a hysteretic effect that when exposed to higher nitrogen dioxide(NO2), counting AF cases recorded by ECG may elevate at lag 0 with a maximum odds ratio(OR) of 1.038 (95% CI 1.014–1.063), on the contrary, O3 reduced the risk of daily visits for AF and its maximum OR was at lag 2, and the OR value was 0.9869 (95% CI 0.9791–0.9948). Other air pollutants such as PM2.5, PM10, and SO2 showed no clear relationship with the recorded AF.

Conclusion

The associations between air pollution and AF recorded with ECG were preliminarily discovered. Short-term exposure to NO2 was significantly associated with daily hospital visits for AF management.
First reported double drug–drug interaction in a cancer renal patient under everolimus treatment: therapeutic drug monitoring and review of literature
Authors: Fort-Casamartina Eduard , Muñoz-Sanchez Carme , Rigo-Bonnin Raul Francisco , del Valle-Celiz Pamela Maria , Gonzalo-Diego Núria , Otero-Torres Sara , Bleda-Perez Carmen , Prats-Jimenez Judith , Fontanals-Martínez Sandra
Published: June 2023

Everolimus is an inhibitor of mammalian target of rapamycin (mTOR) used in both transplantation and cancer treatment (breast, renal and neuroendocrine). In transplantation, therapeutic drug monitoring (TDM) is recommended due to the potential drug–drug interactions with chronic medications, which can affect everolimus pharmacokinetics. In cancer treatment, everolimus is used at higher doses than in transplantation and without a systematic drug monitoring.

We present a case report of a 72-year-old woman with epilepsy history to whom everolimus 10 mg QD was prescribed as third line of treatment for renal cell carcinoma (RCC). The potential drug interactions between everolimus and the patient's chronic medications, carbamazepine and phenytoin, are significant as both are known as strong inducers CYP3A4 metabolism, potentially leading to underexposure to everolimus.

TDM of everolimus was recommended by the pharmacist. The literature suggests that a minimum plasma concentration (Cminss) of everolimus over 10 ng/ml is associated with better response to treatment and progression-free survival (PFS). The patient’s everolimus dose had to be increased until 10 mg BID, and regular monitoring of everolimus levels showed an increase in Cminss from 3.7 ng/ml to 10.8 ng/ml.

This case highlights the importance of checking for potential drug interactions and monitoring everolimus levels in patients on chronic medication, especially those with several inducers or inhibitors of CYP3A4 metabolism. TDM can help to ensure that patients are treated with their optimal dose, which can improve the effectiveness of the treatment or minimize the risk of toxicities.
Establishment of HIV-negative neurosyphilis risk score model based on logistic regression
Authors: Fu Yu , Yang Ling , Du Jie , Khan Raqib , Liu Donghua
Published: June 2023

Objective

To establish the risk scoring model for HIV-negative neurosyphilis (NS) patients and to optimize the lumbar puncture strategy.

Methods

From 2016 to 2021, clinical information on 319 syphilis patients was gathered. Multivariate logistic regression was used to examine the independent risk factors in NS patients who tested negative for human immunodeficiency virus (HIV). Receiver operating characteristic curves (ROC) were used to assess the risk scoring model’s capacity for identification. According to scoring model, the timing of lumbar puncture was suggested.

Results

There were statistically significant differences between HIV-negative NS and non-neurosyphilis (NNS) patients in the following factors. These included age, gender, neuropsychiatric symptoms (including visual abnormalities, hearing abnormalities, memory abnormalities, mental abnormalities, paresthesia, seizures, headache, dizziness), serum toluidine red unheated serum test (TRUST), cerebrospinal fluid Treponema pallidum particle agglutination test (CSF-TPPA), cerebrospinal fluid white blood cell count (CSF-WBC), and cerebrospinal fluid protein quantification (CSF-Pro) (P < 0.05). Logistic regression analysis of HIV-negative NS patients risk factors showed that age, gender, and serum TRUST were independent risk factors for HIV-negative NS (P = 0.000). The total risk score (− 1 ~ 11 points) was obtained by adding the weight scores of each risk factor. And the predicted probability of NS in HIV-negative syphilis patients (1.6 ~ 86.6%) was calculated under the corresponding rating. ROC calculation results showed that the score had good discrimination value for HIV-negative NS and NNS: area under the curve (AUC) was 0.80, the standard error was 0.026 and 95% CI was 74.9–85.1% (P = 0.000).

Conclusion

The risk scoring model in this study can classify the risk of neurosyphilis in syphilis patients, optimize the lumbar puncture strategy to a certain extent, and provide ideas for the clinical diagnosis and treatment of HIV-negative neurosyphilis.
Environmental pollution loads on surface water chemistry and potentially ecological risks of inland aquatic ecosystem in South-Eastern State, Nigeria
Authors: Ubuoh E. A. , Nwogu F. U. , Ofoegbu C. C. , Chikezie P. C.
Published: June 2023

The study assessed water chemistry of Nworie inland aquatic ecosystem in South eastern, Nigeria from January, 2020 to December 2022. Water samples were taken from the upper, middle, and lower river at 200 m interval. Data collected were subjected to multivariate analyses. Results of physicochemical tracers indicated mean CaCO3, Ca2+&Chemical Oxygen Demand (COD) to be 172.8 mg/l, 103.1 mg/l, 16.50 mg/l respectively above the World Health Organisation (WHO) critical limits, while turbidity (NTU), dissolved oxygen (DO) mgl−1, chloride (Cl−) mg/l, Magnesium (Mg) mg/l, Sodium (Na) mg/l, sulphate (SO42+) mg/l, nitrate (NO3−) mg/l, potassium (K) mg/l and phosphate (PO34) were below the limits. Heavy metals (mg/l) showed mean values viz: Cd 2+(0.053), Cr2+(0.049), Fe2+(0.443), Ni2+(0.024), and Pb (0.787) which were all above some critical global limits, except for Cu2+ and Zn2+ and in decreasing abundance: Pb2+ ≥ Fe2+ ≥ Cu2+ ≥ Zn2+ ≥ Cd2+ ≥ Cr2+ ≥ Ni2. Physicochemical tracers and elements in water correlated in both positive and negative directions. Principal component analysis (PCA) showed significant loads of PC3; CaCO3, NO3, COD, DO, Ca, PO4, Cu, Fe, Zn, PC2; moderate loads of SO4, Cl, & Na originating from complex human activities. Contamination factor (Cf), recorded high for cadmium while pollution load & ecological risk recorded low in decreasing order: Cr2+ ≥ Zn2+ ≥ Ni2+ ≥ Cd2+ ≥ Pb2+  ≥ Cu2+ ≥ Fe2+ with contamination degree in order of: Lower River (LR) ≥ Upper River(UR) ≥ Middle River(MR) and low risk index. Continuous monitoring of human activities along the whole River is important to mitigate any aquatic ecosystem damage for water quality sustainability.
Using recovered radio transmitters to estimate positioning error and a generalized Monte Carlo simulation to incorporate error into animal telemetry analysis
Authors: Heim Kurt C. , Ardren William R. , Castro-Santos Theodore
Published: June 2023

Background

Mobile radio tracking is an important tool in fisheries research and management. Yet, the accuracy of location estimates can be highly variable across studies and within a given dataset. While some methods are available to deal with error, they generally assume a static value for error across all detections. We provide a novel method for making detection-specific error estimates using detections of recovered transmitters (i.e., mortalities or tag expulsion). These data are used to establish the relationship between received signal strength (RSS) and positional error, which can then be used to predict positional error of detections for fish at large. We then show how detection-specific estimates can be integrated into a Monte Carlo framework to analyze movement in ways robust to spatial uncertainty.

Results

In a telemetry study in a large river (~ 90 m), we recovered 22 transmitters to estimate and model positional error. Error averaged 94 m (range = 1–727 m) for transmitters tracked by researchers on foot using a Yagi antenna, and 200 m (range = 1–1141 m) for transmitters tracked from vehicles using an omnidirectional whip antenna. Transmitters located near roads were tracked more accurately with both methods. Received signal strength was a strong predictor of positional error (r2 = 0.86, ground tracking; 0.65, tracking from truck) and was thus used to make detection-specific estimates of error for detections of fish at large. Monte Carlo analysis for a binary movement classification revealed that only 18% of location estimates could be confidently assigned to movement (p < 0.05); the remainder were associated with stasis or movement that was within the range of positional error. Ignoring positional error led to positive bias of up to 1300% in individual movement estimates and varied seasonally—it was highest when fish were inactive and lowest when fish were most active.

Conclusion

Using recovered transmitters and RSS models to estimate telemetry error is a viable alternative to staged ‘dummy transmitter’ trials and assuming error is a constant. Our proposed approaches to incorporate detection-specific error estimates into analysis are broadly applicable and can ‘make the most’ out of highly accurate detections while also cautiously extracting spatial information from less-accurate detections.
The prevalence and burden of avoidant/restrictive food intake disorder (ARFID) in a general adolescent population
Authors: Van Buuren Lara , Fleming Catharine Anne Kerle , Hay Phillipa , Bussey Kay , Trompeter Nora , Lonergan Alexandra , Mitchison Deborah
Published: June 2023

Background

Little is known about the prevalence and impairment associated with possible Avoidant/restrictive food intake disorder (ARFID) in community adolescent populations. We aimed to investigate the prevalence, health-related quality of life (HRQoL), and psychological distress associated with possible ARFID in a sample of adolescents from the general population in New South Wales, Australia.

Methods

A representative sample of 5072 secondary school students aged between 11 and 19 years completed the online EveryBODY survey in 2017. The survey included demographic data, eating behaviours, psychological distress and both physical and psychosocial health-related quality of life.

Results

The prevalence of possible ARFID was 1.98% (95% CI 1.63–2.41) and did not differ significantly across school years 7–12. The weight status of participants with possible ARFID did not differ significantly from those without possible ARFID. When measuring gender identity, the ratio of males to females with possible ARFID was 1:1.7. This was statistically significant, however, the effect size was very small. Psychological distress and HRQoL did not differ significantly between the possible ARFID and non-ARFID group.

Conclusions

The prevalence of possible ARFID was found to be similar to that of anorexia nervosa and binge eating disorder in the general adolescent population. Adolescents who identify as girls rather than boys may be more likely to develop ARFID, replication with new samples is required to confirm these findings. The impact of ARFID on HRQoL may be minimal in adolescence and become more significant in adulthood, further research using longitudinal design, healthy control groups and/or diagnostic interviews is required.
The role of social support and self-control in tobacco consumption: a cross-sectional study among tobacco consumers and non-consumers
Authors: Homayuni Atefeh , Hosseini Zahra
Published: June 2023

Introduction

Tobacco use is recognized as one of the most important causes of preventable death due to non-communicable diseases and disability worldwide. The present study was conducted with the aim of comparing social support and self-control between tobacco consumers and non-consumers in Hormozgan Province.

Methods

The present cross-sectional study was conducted on the adult population above the age of 15 years living in Hormozgan province. A total number of 1,631 subjects were selected using a convenient sampling method. An online questionnaire was used to collect the data, which consisted of three sections: demographic information, Zimet’s perceived social support and Tangney’s self-control questionnaires. In the present study, Cronbach’s alpha coefficients of social support and self-control questionnaires were 0.886 and 0.721, respectively. Data were analyzed using chi-squared test, Mann-Whitney U-test, and logistic regression analysis with SPSS software (v. 25).

Results

Among the participants, 842 (51.6%) reported to be tobacco non-consumers, and 789 (48.4%) reported to be consumers. The mean scores of perceived social support among the consumers and non-consumers were 4.6 ± 1.012 and 4.93 ± 0.518, respectively. The mean scores of self-control among the consumers and non-consumers were 2.74 ± 0.356 and 2.75 ± 0.354, respectively. There was a significant difference among tobacco consumers and non-consumers in gender, age, education level and job status (p < 0.001). The results showed that the mean scores of social support, support received from family and others were significantly higher in non-consumers than in consumers (p < 0.001). There was no statistically significant difference between the mean scores of self-control, self-discipline, and impulse control in consumers and non-consumers (p > 0.05).

Conclusion

According to our findings, tobacco consumers received more social support from family and others compared to non-consumers. Considering the important role of perceived support in tobacco consumption, this variable should receive copious attention in developing interventions and trainings, especially family education workshops.
Why mobile social media-related fear of missing out promotes depressive symptoms? the roles of phubbing and social exclusion
Authors: Gao Bin , Shen Quanwei , Luo Gui , Xu Yiwen
Published: June 2023

Background

With the popularity of mobile socialization, people have become more closely connected with their phones. While people enjoy the convenience that phones bring (e.g., accessing information and socializing), they also feel anxious about missing out on certain information. Previous researches have shown that fear of missing out (FoMO) can trigger depressive symptoms, however, the underlying psychological mechanisms are not yet clear. In addition, limited research has explored this issue in the context of mobile social media.

Methods

To address this research gap, we surveyed 486 Chinese college students (278 males and 208 females, mean age = 19.95 years, SD = 1.14) and all participants completed a self-report questionnaire including mobile social media-related FoMO scale, phubbing scale, social exclusion scale, and the patient health questionnaire-9. The data were analyzed by SPSS24.0 and the Process macro and developed a mediating and moderating model incorporating phubbing and social exclusion.

Results

The results showed that (1) mobile social media-related FoMO (MSM-related FoMO) can significantly and positively predict depressive symptoms among college students; (2) phubbing partially mediates the relationship between MSM-related FoMO and depressive symptoms; (3) the direct predictive effect of MSM-related FoMO on depressive symptoms is moderated by social exclusion.

Conclusion

These findings are not only valuable for understanding the underlying mechanisms linking MSM-related FoMO and depressive symptoms, but also contribute to the development of psychological intervention programs (e.g., interventions based on social exclusion or phubbing) aiming at reducing college students’ depressive symptoms.
The neuropathological landscape of Hispanic and non-Hispanic White decedents with Alzheimer disease
Authors: Scalco Rebeca , Saito Naomi , Beckett Laurel , Nguyen My-Le , Huie Emily , Wang Hsin-Pei , Flaherty Delaney A. , Honig Lawrence S. , DeCarli Charles , Rissman Robert A. , Teich Andrew F. , Jin Lee-Way , Dugger Brittany N.
Published: June 2023

Despite the increasing demographic diversity of the United States’ aging population, there remain significant gaps in post-mortem research investigating the ethnoracial heterogeneity in the neuropathological landscape of Alzheimer Disease (AD). Most autopsy-based studies have focused on cohorts of non-Hispanic White decedents (NHWD), with few studies including Hispanic decedents (HD). We aimed to characterize the neuropathologic landscape of AD in NHWD (n = 185) and HD (n = 92) evaluated in research programs across three institutions: University of California San Diego, University of California Davis, and Columbia University. Only persons with a neuropathologic diagnosis of intermediate/high AD determined by NIA Reagan and/or NIA-AA criteria were included. A frequency-balanced random sample without replacement was drawn from the NHWD group using a 2:1 age and sex matching scheme with HD. Four brain areas were evaluated: posterior hippocampus, frontal, temporal, and parietal cortices. Sections were stained with antibodies against Aβ (4G8) and phosphorylated tau (AT8). We compared the distribution and semi-quantitative densities for neurofibrillary tangles (NFTs), neuropil threads, core, diffuse, and neuritic plaques. All evaluations were conducted by an expert blinded to demographics and group status. Wilcoxon’s two-sample test revealed higher levels of neuritic plaques in the frontal cortex (p = 0.02) and neuropil threads (p = 0.02) in HD, and higher levels of cored plaques in the temporal cortex in NHWD (p = 0.02). Results from ordinal logistic regression controlling for age, sex, and site of origin were similar. In other evaluated brain regions, semi-quantitative scores of plaques, tangles, and threads did not differ statistically between groups. Our results demonstrate HD may be disproportionately burdened by AD-related pathologies in select anatomic regions, particularly tau deposits. Further research is warranted to understand the contributions of demographic, genetic, and environmental factors to heterogeneous pathological presentations.
Research on global cultural heritage tourism based on bibliometric analysis
Authors: Zhang Sunbowen , Liang Jingxuan , Su Xinwei , Chen Youcheng , Wei Qi
Published: June 2023

Cultural heritage is the sum of material wealth and spiritual wealth left by a nation in the past. Because of its precious and fragile characteristics, cultural heritage protection and tourism development have received extensive global academic attention. However, application visualization software is still underused, and studies are needed that provide a comprehensive overview of cultural heritage tourism and prospects for future research. Therefore, this research employs the bibliometric method with CiteSpace 5.8. R2 software to visualize and analyze 805 literature items retrieved from the SSCI database between 2002 and 2022. Results show, first, scholars from China, Spain, Italy have published the most articles, and Italian scholars have had the most influence. Second, Hong Kong Polytech University, the Chinese Academy of Sciences, Jinan University have had significant influence on cultural heritage tourism research. Third, Annals of Tourism Research is the most cited journal in the field. Influenced by politics, culture, and technology, sustainable development and consumer behavior have become key topics in this field over the past 21 years. Fourth, tourist satisfaction, rural development, cultural heritage management are the key research frontiers. Fifth, in future, cultural heritage tourism should pay more attention to micro-level research, using quantitative methods to integrate museums, technology, and cultural heritage into consumer research. The results offer a deeper understanding of the development and evolution of the global cultural heritage tourism field from 2002 to 2022. At the same time, our findings have provided a new perspective and direction for future research on global cultural heritage tourism among scholars.
Structural control of the graben fault on hydrothermal alteration in the Cerro Pabellón geothermal system (Andean Cordillera, Northern Chile)
Authors: Vidal J. , Patrier P. , Beaufort D. , Maza S. , Rivera G. , Volpi G. , Morata D.
Published: June 2023

This study focuses on hydrothermal alteration in the geothermal reservoir of Cerro Pabellón (Andean Cordillera, Northern Chile). It is based on CP2A and CP5A production wells drilled above a local normal fault and presenting unlike hydraulic properties. Cuttings from 300 to 1555 m depth were sampled and analyzed using X-ray diffraction (XRD) to observe distribution of hydrothermal minerals and crystal chemistry variations of clays (fraction < 5 μm). Then, scanning electron microscopy coupled with energy dispersive spectroscopy (SEM–EDX) allowed to perform microanalysis of hydrothermal minerals. These results highlight a mineral assemblage that was not observed before, composed of adularia + Ba-rich feldspar + feathery quartz + chalcedony + calcium arsenates + illite. They are characteristics of high-temperature hydrothermal alteration in epithermal settings and are restricted to shallow permeable fracture zones of the active part of the reservoir. Another fracture-controlled event related to a typical illitization is observed in all permeable fracture and fault zones of the geothermal system. This multi-event alteration seems strongly controlled by the eastern graben fault and the associated interconnected fracture network.
Organ dysfunction, injury, and failure in cardiogenic shock
Authors: Shirakabe Akihiro , Matsushita Masato , Shibata Yusaku , Shighihara Shota , Nishigoori Suguru , Sawatani Tomofumi , Kiuchi Kazutaka , Asai Kuniya
Published: June 2023

Background

Cardiogenic shock (CS) is caused by primary cardiac dysfunction and induced by various and heterogeneous diseases (e.g., acute impairment of cardiac performance, or acute or chronic impairment of cardiac performance).

Main body

Although a low cardiac index is a common finding in patients with CS, the ventricular preload, pulmonary capillary wedge pressure, central venous pressure, and systemic vascular resistance might vary between patients. Organ dysfunction has traditionally been attributed to the hypoperfusion of the organ due to either progressive impairment of the cardiac output or intravascular volume depletion secondary to CS. However, research attention has recently shifted from this cardiac output (“forward failure”) to venous congestion (“backward failure”) as the most important hemodynamic determinant. Both hypoperfusion and/or venous congestion by CS could lead to injury, impairment, and failure of target organs (i.e., heart, lungs, kidney, liver, intestines, brain); these effects are associated with an increased mortality rate. Treatment strategies for the prevention, reduction, and reversal of organ injury are warranted to improve morbidity in these patients. The present review summarizes recent data regarding organ dysfunction, injury, and failure.

Conclusions

Early identification and treatment of organ dysfunction, along with hemodynamic stabilization, are key components of the management of patients with CS.
Non-invasive monitoring of pulmonary blood flow, functional residual capacity, and shunt index in a porcine model
Authors: Edlinger-Stanger Maximilian , Fritz Caroline , McGregor Hanna C. , Bustin Spencer L. , Ayoubi Nathan , Bath Harpreet K. , Müller Johannes , Kühnl-Brady Sebastian , Schweiger Thomas , Jedamzik Julia , Windpassinger Marita , Hiesmayr Michael , Cholley Bernard P. , Fleming Neal W.
Published: June 2023

Background

Management of mechanically ventilated patients can be improved with monitoring of key pulmonary function parameters that facilitate individualization and optimization. The VQm Pulmonary Health Monitor™ (PHM) (Rostrum Medical Innovations Inc., Vancouver, Canada) is a new monitor that continuously measures pulmonary blood flow (PBF), functional residual capacity (FRC) and a novel parameter: shunt index (Qsi). The goal of this study was to provide an initial assessment of the performance of the VQm PHM™ when compared with reference measures of PBF, FRC and intra-pulmonary shunt.

Methods

This was a prospective, experimental, large animal (porcine) study. After baseline measurements, three interventions were performed: increased cardiac output (CO) using dobutamine infusion, increased PEEP (from 4 to 12 cmH2O), and experimental shunt induced by an extracorporeal circuit. PBF, FRC and shunt were measured by the VQm Pulmonary Health Monitor™ (PHM) before and after each intervention. The PHM™ uses sequential gas delivery to deliver targeted alveolar concentrations of CO2 or N2O. PBF and FRC were calculated using CO2 bolus delivery and the modified differential Fick equation. Shunt was estimated from the number of breaths required to eliminate N2O after a 25-breath N2O bolus and expressed as Qsi. PHM™-derived PBF and Qsi were compared to thermodilution CO and calculated Berggren shunt, respectively.

Results

Studies were completed in 19 animals. Measurements of PBF, FRC and Qsi obtained from the PHM™ trended as expected following each intervention. The mean difference between paired values of PBF was − 0.2 ± 0.9 L/min and the 95% limits of agreement were 1.5 and − 1.9 L/min. Concordance was 94.1%. The mean baseline FRC was 1.7 $$\pm$$ 0.4 L and increased to 2.0 $$\pm$$0.6 L, following the increase in PEEP (p = 0.0078). For shunt (Qsi), the mean values during low (1 L/min) and high (50% of baseline CO) shunt value were 40 $$\pm$$ 4 and 27 $$\pm$$ 5, respectively, p = 0.002.

Conclusions

PBF obtained through the modified differential Fick equation and Qsi obtained through N2O uptake and decay dynamics by the VQm PHM™ provide comparable results to reference standards. FRC measurements trended as expected following interventions.
Deep learning-aided extraction of outer aortic surface from CT angiography scans of patients with Stanford type B aortic dissection
Authors: Kesävuori Risto , Kaseva Tuomas , Salli Eero , Raivio Peter , Savolainen Sauli , Kangasniemi Marko
Published: June 2023

Background

Guidelines recommend that aortic dimension measurements in aortic dissection should include the aortic wall. This study aimed to evaluate two-dimensional (2D)- and three-dimensional (3D)-based deep learning approaches for extraction of outer aortic surface in computed tomography angiography (CTA) scans of Stanford type B aortic dissection (TBAD) patients and assess the speed of different whole aorta (WA) segmentation approaches.

Methods

A total of 240 patients diagnosed with TBAD between January 2007 and December 2019 were retrospectively reviewed for this study; 206 CTA scans from 206 patients with acute, subacute, or chronic TBAD acquired with various scanners in multiple different hospital units were included. Ground truth (GT) WAs for 80 scans were segmented by a radiologist using an open-source software. The remaining 126 GT WAs were generated via semi-automatic segmentation process in which an ensemble of 3D convolutional neural networks (CNNs) aided the radiologist. Using 136 scans for training, 30 for validation, and 40 for testing, 2D and 3D CNNs were trained to automatically segment WA. Main evaluation metrics for outer surface extraction and segmentation accuracy were normalized surface Dice (NSD) and Dice coefficient score (DCS), respectively.

Results

2D CNN outperformed 3D CNN in NSD score (0.92 versus 0.90, p = 0.009), and both CNNs had equal DCS (0.96 versus 0.96, p = 0.110). Manual and semi-automatic segmentation times of one CTA scan were approximately 1 and 0.5 h, respectively.

Conclusions

Both CNNs segmented WA with high DCS, but based on NSD, better accuracy may be required before clinical application. CNN-based semi-automatic segmentation methods can expedite the generation of GTs.

Relevance statement

Deep learning can speeds up the creation of ground truth segmentations. CNNs can extract the outer aortic surface in patients with type B aortic dissection.

Key points

• 2D and 3D convolutional neural networks (CNNs) can extract the outer aortic surface accurately.

• Equal Dice coefficient score (0.96) was reached with 2D and 3D CNNs.

• Deep learning can expedite the creation of ground truth segmentations.

Graphical Abstract
Aducanumab: an uprising hope with vague horizons
Authors: Hazegh Fetratjoo Delara , Kargar Alireza , Noroozian Maryam
Published: June 2023

Alzheimer’s disease (AD) is the leading cause of dementia worldwide. Amyloid-beta (Aβ) deposition, is one of the processes involved in the pathophysiology of AD, has inspired interest in targeted therapies, including monoclonal antibodies. Aducanumab acts as a fully human IgG1 monoclonal antibody against Aβ by binding to amyloid plaques and was approved by the Food and Drug Administration (FDA) as the first disease-modifying drug for mild cognitive impairment and mild stages of AD. This accelerated approval, albeit the termination of the two phase III clinical trials of aducanumab due to results of futility analysis, has provoked controversy among the key opinion leaders in the field of cognitive neurology. Aducanumab poses significant financial constraints on patients and healthcare systems. Furthermore, the precise diagnosis of AD stages for appropriate aducanumab initiation remains a formidable challenge. The drug’s administration necessitates specialized infrastructure and medical equipment, and it may induce amyloid-related imaging abnormalities (ARIA), potentially resulting in cerebral edema or hemorrhage. These disadvantages might outweigh the potential benefits of the medication, especially considering the uncertainties regarding its efficacy. This commentary is intended to briefly evaluate the application of aducanumab in developing countries, considering the associated diagnostic challenges, clinical efficacy, cost, and potential adverse effects.
Author response to "Absence of proximal muscle weakness, dysarthria, and facial diplegia suggest Guillain–Barre syndrome rather than CIDP"
Authors: Tsiptsios Dimitrios , Fotiadou Aggeliki , Karatzetzou Stella , Kitmeridou Sofia , Iliopoulos Ioannis
Published: June 2023

In many instances, the differential diagnosis between Guillain–Barre syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP) may be challenging. The aim of this letter to the editor is to elucidate comments and concerns raised, regarding our latest published article dealing with two patients that developed acute-onset CIDP after SARS-CoV-2 infection and Ad26.COV2.S vaccination, respectively.
Supplementation of rapamycin during in vitro maturation promotes oocyte quality and subsequent embryo development in bovine
Authors: Khatun Hafiza , Islam Md Rasadul , Khan Muckta , Sultana Fowzia
Published: June 2023

Background

The developmental competence of oocyte derived from in vitro maturation (IVM) is significantly lower than those of oocyte matured in vivo. Rapamycin is an immunosuppressive substance and widely used to prolong the survival and preserve the cells culture. The objective of this research was to explore whether rapamycin supplementation during IVM enhances meiotic maturation, oocyte quality, and subsequent embryonic development.

Methods

Depending on the purpose, bovine cumulus oocyte complexes were matured without (control) or with rapamycin at different concentrations (0, 1, 10, and 100 nM) for 22 h (h) followed by 6 h in vitro fertilization, and zygotes were cultured for 8 days. Following treatment, oocytes developmental competence was assessed by meiotic progression, intra-oocyte GSH synthesis, reactive oxygen species (ROS) levels, and subsequent embryonic development.

Results

The results showed that addition of 1 nM rapamycin to IVM medium significantly increased the nuclear maturation (90.1 ± 1.5 vs. 81.2 ± 2.5; P < 0.01) and subsequent embryonic development (47.6 ± 2.2 vs. 41.5 ± 1.9; P < 0.05) than that observed in the control group. Consequently, compared to the control group, the relative fluorescence’s intensity of ROS levels in oocyte significantly reduced by rapamycin treatment. More importantly, rapamycin supplementation during maturation significantly increased the reduced glutathione synthesis levels in oocyte compared to that observed in control, indicating the bidirectional communication between cumulus cells and oocyte becomes easy via rapamycin treatment.

Conclusions

This study suggests that the presence of rapamycin during maturation can afford to enhance reduced glutathione synthesized by the oocyte, which is an internal oocyte antioxidant defense and contributes to improve subsequent high-quality embryo production.
The microbiota knows: handling-stress and diet transform the microbial landscape in the gut content of rainbow trout in RAS
Authors: Suhr Marvin , Fichtner-Grabowski Finn-Thorbjörn , Seibel Henrike , Bang Corinna , Franke Andre , Schulz Carsten , Hornburg Stéphanie Céline
Published: June 2023

Background

The aim of the present study was to characterize the effects of handling stress on the microbiota in the intestinal gut contents of rainbow trout (Oncorhynchus mykiss) fed a plant-based diet from two different breeding lines (initial body weights: A: 124.69 g, B: 147.24 g). Diets were formulated in accordance with commercial trout diets differing in their respective protein sources: fishmeal (35% in fishmeal-based diet F, 7% in plant protein-based diet V) and plant-based proteins (47% in diet F, 73% in diet V). Experimental diets were provided for 59 days to all female trout in two separate recirculating aquaculture systems (RASs; mean temperature: A: 15.17 °C ± 0.44, B: 15.42 °C ± 0.38). Half of the fish in each RAS were chased with a fishing net twice per day to induce long-term stress (Group 1), while the other half were not exposed to stress (Group 0).

Results

No differences in performance parameters were found between the treatment groups. By using 16S rRNA amplicon sequencing of the hypervariable region V3/V4, we examined the microbial community in the whole intestinal content of fish at the end of the trial. We discovered no significant differences in alpha diversity induced by diet or stress within either genetic trout line. However, the microbial composition was significantly driven by the interaction of stress and diet in trout line A. Otherwise, in trout line B, the main factor was stress. The communities of both breeding lines were predominantly colonized by bacteria from the phyla Fusobacteriota, Firmicutes, Proteobacteria, Actinobacteriota, and Bacteroidota. The most varying and abundant taxa were Firmicutes and Fusobacteriota, whereas at the genus level, Cetobacterium and Mycoplasma were key components in terms of adaptation. In trout line A, Cetobacterium abundance was affected by factor stress, and in trout line B, it was affected by the factor diet.

Conclusion

We conclude that microbial gut composition, but neither microbial diversity nor fish performance, is highly influenced by stress handling, which also interacts with dietary protein sources. This influence varies between different genetic trout lines and depends on the fish’s life history.
Dynamic interplay between available resources and implementation climate across phases of implementation: a qualitative study of a VA national population health tool
Authors: Lin Ying-Jen , Ranusch Allison , Seagull F. Jacob , Sussman Jeremy B. , Barnes Geoffrey D.
Published: June 2023

Background

Available resources within an organization can determine the implementation success of an intervention. However, few studies have investigated how the required resources change over the phases of implementation. Using stakeholder interviews, we examined the changes in and interactions between available resources and implementation climate in the implementation and sustainment phases of a national implementation effort for a population health tool.

Methods

We conducted a secondary analysis of the interviews with 20 anticoagulation professionals at 17 clinical sites in the Veterans Health Administration health system about their experiences with a population health dashboard for anticoagulant management. Interview transcripts were coded using constructs from the Consolidated Framework for Implementation Research (CFIR) and according to the phase of implementation (pre-implementation, implementation, and sustainment) as defined by the VA Quality Enhancement Research Initiative (QUERI) Roadmap. We analyzed the factors that may determine successful implementation by examining the co-occurrence patterns between available resources and implementation climate across different implementation phases. To illustrate the variations in these determinants across phases, we aggregated and scored coded statements using a previously published CFIR scoring system (− 2 to + 2). Key relationships between available resources and implementation climate were identified and summarized using thematic analysis.

Results

The resources necessary to support the successful implementation of an intervention are not static; both the quantity and types of resources shift based on the phases of the intervention. Furthermore, increased resource availability does not guarantee the sustainment of intervention success. Users need different types of support beyond the technical aspects of an intervention, and this support varies over time. Specifically, available resources in the form of technological support and social/emotional support help users establish trust in a new technological-based intervention during the implementation phase. Resources that foster and maintain collaboration between users and other stakeholders help them stay motivated during sustainment.

Conclusions

Our findings highlight the dynamic nature of available resources and their impacts on the implementation climate across different phases of implementation. A better understanding of the dynamics of available resources over time from the users’ perspectives will allow the adaptation of resources to better meet the needs of the intervention stakeholders.
Cerebral dominance in spatial hearing and working memory abilities in adults with normal hearing sensitivity
Authors: Banumathi  , Nethra R , Raj Brunda L. , Nisha Kavassery Venkateswaran
Published: June 2023

Background

Cerebral dominance refers to the biological description of the brain, where one cerebral hemisphere is dominant over the other in certain cerebral functions. There is scanty literature on cerebral dominance and its impact on auditory spatial processing and working memory, which is explored in the study.

Methods

A total of 45 participants with normal hearing were divided into three groups of 15 participants. The groups were categorized based on scores obtained on the alert scale of the cognitive style checklist as the bilateral dominant, left dominant, and the right dominant group. The spatial hearing was assessed using interaural time difference (ITD), the interaural level difference (ILD), and virtual acoustic space identification (VASI) tests, whereas the auditory working memory abilities were tested using forward span, backward span, ascending digit span, descending digit span, and 2n back tests.

Results

MONOVA results indicated that there is no significant main effect of cerebral dominance on all auditory working memory tests. In spatial hearing, although ILD and ILD thresholds were not influenced by cerebral dominance, the main effect of cerebral dominance was seen on VASI accuracy scores. Post-hoc analyses of VASI scores showed that the bilateral dominant group demonstrated significantly better spatial perception scores compared to the left and right dominant groups, with latter groups showing similar performance.

Conclusions

While ITD and ILD tests fall short of revealing cerebral asymmetry, VASI’s power in capturing cerebral dominance effects makes it a valuable tool in spatial processing assessment. The study’s findings highlight the need for assessing cerebral dominance, before administering spatial hearing tests.
The COVID-19 pandemic as a catalyst for integrated global mental healthcare and tuberculosis care
Authors: Chu Alexander L. , Pasha Aneeta , Contreras Carmen , Lecca Leonid , Sweetland Annika C. , Galea Jerome T.
Published: June 2023

Mental disorders are common among persons with tuberculosis (TB), and the COVID-19 pandemic has only amplified the mental and physical health consequences of this deadly synergy. Here, we call to attention the immense vulnerability of people with TB to mental disorders during the pandemic and highlight the unique challenges and opportunities that the pandemic brings to the future integration of global TB and mental healthcare. We argue that the pandemic era is an ideal period to accelerate this integration and we provide research and policy recommendations to actualise this urgent need.
The Value of Working Conditions in the United States and Implications for the Structure of Wages
Authors: Maestas Nicole , Mullen Kathleen J. , Powell David , von Wachter Till , Wenger Jeffrey B.
Published: June 2023

We document variation in working conditions in the United States, present estimates of how workers value these conditions, and assess the impact of working conditions on estimates of wage inequality. We conduct a series of stated-preference experiments to estimate workers’ willingness to pay for a broad set of working conditions, which we validate with actual job choices. We find that working conditions vary substantially, play a significant role in job choice, and are central components of the compensation received by workers. We find that accounting for differences in preferences for working conditions often exacerbates wage differentials and intensifies measures of wage inequality. (JEL J22, J28, J31, J81)