bluuebunny/crossref_metadata_2025 huggingface dataset:
H3.3 contributes to chromatin accessibility and transcription factor binding at promoter-proximal regulatory elements in embryonic stem cells
Authors: Tafessu Amanuel , O’Hara Ryan , Martire Sara , Dube Altair L. , Saha Purbita , Gant Vincent U. , Banaszynski Laura A.
Published: February 2023

Background

The histone variant H3.3 is enriched at active regulatory elements such as promoters and enhancers in mammalian genomes. These regions are highly accessible, creating an environment that is permissive to transcription factor binding and the recruitment of transcriptional coactivators that establish a unique chromatin post-translational landscape. How H3.3 contributes to the establishment and function of chromatin states at these regions is poorly understood.

Results

We perform genomic analyses of features associated with active promoter chromatin in mouse embryonic stem cells (ESCs) and find evidence of subtle yet widespread promoter dysregulation in the absence of H3.3. Loss of H3.3 results in reduced chromatin accessibility and transcription factor (TF) binding at promoters of expressed genes in ESCs. Likewise, enrichment of the transcriptional coactivator p300 and downstream histone H3 acetylation at lysine 27 (H3K27ac) is reduced at promoters in the absence of H3.3, along with reduced enrichment of the acetyl lysine reader BRD4. Despite the observed chromatin dysregulation, H3.3 KO ESCs maintain transcription from ESC-specific genes. However, upon undirected differentiation, H3.3 KO cells retain footprinting of ESC-specific TF motifs and fail to generate footprints of lineage-specific TF motifs, in line with their diminished capacity to differentiate.

Conclusions

H3.3 facilitates DNA accessibility, transcription factor binding, and histone post-translational modification at active promoters. While H3.3 is not required for maintaining transcription in ESCs, it does promote de novo transcription factor binding which may contribute to the dysregulation of cellular differentiation in the absence of H3.3.
Adjustment for baseline characteristics in randomized trials using logistic regression: sample-based model versus true model
Authors: Perneger Thomas , Combescure Christophe , Poncet Antoine
Published: February 2023

Background

Adjustment for baseline prognostic factors in randomized clinical trials is usually performed by means of sample-based regression models. Sample-based models may be incorrect due to overfitting. To assess whether overfitting is a problem in practice, we used simulated data to examine the performance of the sample-based model in comparison to a “true” adjustment model, in terms of estimation of the treatment effect.

Methods

We conducted a simulation study using samples drawn from a “population” in which both the treatment effect and the effect of the potential confounder were specified. The outcome variable was binary. Using logistic regression, we compared three estimates of the treatment effect in each situation: unadjusted, adjusted for the confounder using the sample, adjusted for the confounder using the true effect. Experimental factors were sample size (from 2 × 50 to 2 × 1000), treatment effect (logit of 0, 0.5, or 1.0), confounder type (continuous or binary), and confounder effect (logit of 0, − 0.5, or − 1.0). The assessment criteria for the estimated treatment effect were bias, variance, precision (proportion of estimates within 0.1 logit units), type 1 error, and power.

Results

Sample-based adjustment models yielded more biased estimates of the treatment effect than adjustment models that used the true confounder effect but had similar variance, accuracy, power, and type 1 error rates. The simulation also confirmed the conservative bias of unadjusted analyses due to the non-collapsibility of the odds ratio, the smaller variance of unadjusted estimates, and the bias of the odds ratio away from the null hypothesis in small datasets.

Conclusions

Sample-based adjustment yields similar results to exact adjustment in estimating the treatment effect. Sample-based adjustment is preferable to no adjustment.
Comparing the effects of breastfeeding in the laid-back and cradle position upon the experiences of primiparous women: a parallel randomized clinical trial
Authors: Bashiri Asefe , Amiri-Farahani Leila , Salehiniya Hamid , Pezaro Sally
Published: February 2023

Background and aim

Appropriate positioning is crucial to successful breastfeeding and its continuation. Positioning can create, prevent, or correct breastfeeding problems. This study aimed to determine and compare the effects of both the laid-back and cradle positions upon the breastfeeding experiences of primiparous (cisgender) women.

Methods

A parallel randomized clinical trial was conducted with a sample of primiparous women (n = 168) with a gestational age of between 31 and 34 weeks, referring to the perinatal clinic of Shahid Gharazi Hospital in Malayer (Hamadan Province, Iran). Participants were recruited via convenience sampling and allocated to one of two groups: intervention (laid-back position) (n = 85) and control (cradle position) (n = 83) using the random block method. Breastfeeding education was given to both groups during two sessions (weeks 31–34 and 35-–37 of pregnancy) by “baby-friendly” accredited hospitals in Iran. The intervention group was instructed on how to breastfeed using the laid-back position. The control group was instructed on how to breastfeed using the cradle position. In the immediate postnatal period, breastfeeding positions were assessed in both groups. Breastfeeding experiences were measured once at the time of participants returning home and again at both 1 week and 2 weeks following birth, using the breastfeeding experience scale. Data analysis was undertaken using the SPSS software version 21. A value of P < 0.05 was considered significant.

Results

No statistically significant difference was observed between the two groups in terms of concerns relating to participants nor their breasts, milk insufficiency, neonate, process, or breastfeeding experience at any time point measured. The means (SDs) of breastfeeding experience at the time of discharge, 1 week, and 2 weeks after childbirth in intervention group were 26.07 (4.533), 26.85 (3.812), and 26.65 (4.632) respectively. The means (SDs) of breastfeeding experience at the time of discharge, 1 week, and 2 weeks after childbirth in control group were 25.42 (3.315), 26.68 (3.872), and 25.41 (4.05) respectively.

Conclusion

There is no difference in breastfeeding experiences whether the laid-back or cradle position is used. Thus, broader education on breastfeeding and the provision of comprehensive support may be more effective in optimizing one’s experience of breastfeeding.

Trial registration

Registration date: 2021 July 21, Code: IRCT20180427039436N10, https://irct.ir/user/trial/57054/view
Vulvar leiomyoma in an adolescent girl: a case report and review of the literature
Authors: Goyal Lajya Devi , Garg Priyanka , Kaur Manmeet
Published: February 2023

Background

Vulvar leiomyoma is a rare soft tissue tumor, with only around 300 cases described in the literature. Owing to its low incidence of just 0.03% of all gynecological tumors, it often poses a great diagnostic challenge, especially in teenagers. We report this rare occurrence of vulvar leiomyoma in a teenage girl who was primarily left untreated due to cultural taboos and fear of loss of virginity. The main aim in presenting such rare case studies is to raise awareness and expand the diagnostic horizon of the surgeon for appropriate management.

Case presentation

We describe a case of a 15-year-old North Indian, sexually inactive unmarried girl, who presented with a history of painless swelling in the left labia majora for the last 1 year, which gradually increased in size. There was no associated pain or any other difficulty. Local examination revealed a 14 × 10 cm solid, unilateral nonpedunculated mass on the left labia majora with superficial vascularity. Differential diagnoses of sarcoma, lipoma, Bartholin cyst, and fibroid were kept in mind. Ultrasonography revealed a solid mass with superficial vascularity with normal internal genitalia. The mass was enucleated with an intact capsule under anesthesia. Histopathology confirmed it to be benign vulvar leiomyoma. The patient was discharged after 3 days in a satisfactory condition.

Conclusion

Leiomyoma of the vulva is an exceptionally rare tumor and is seldom seen in teenagers. It is often misinterpreted as a Bartholin cyst and should be kept as one of the differential diagnosis in teenage girls presenting with unilateral vulvar swelling. Vulvar leiomyoma can be completely cured by surgical removal if diagnosed timely without compromising virginity, so should never be missed in adolescents.
Paraphilia without symptoms of primary psychiatric disorder: a case report
Authors: Pang Nicholas Tze Ping , Masiran Ruziana , Alimuddin Aishah Siddiqah
Published: February 2023

Background

Paraphilias are recurrent and arousing fantasies, thoughts, and behaviors that cause distress to sufferers and surrounding people. This case report details the challenge of managing multiple paraphilias with compulsive sexual behavior.

Case presentation

A 48-year-old Malay man presented with compulsive sexual behavior, encompassing voyeuristic, frotteurism, and exhibitionistic behavior, increasing progressively over the years, with accompanying overvalued ideas of erotomania. Despite the high level of dysfunction occupationally and socially, there were no apparent psychotic, manic, or depressive symptoms. An organic workup was unremarkable, and he was diagnosed with multiple paraphilias. Treatment with selective serotonin reuptake inhibitors was commenced, and psychologically he was managed with techniques specific to compulsive sexual behavior.

Conclusion

Though rare in the literature, both paraphilic disorders and compulsive sexual behaviors are very distressing to sufferers and their families alike, and thorough biopsychological investigations are essential to ensure reversible causes are not overlooked.
Sex differences in subjective cognitive impairment and clinical correlates in Chinese patients with subthreshold depression
Authors: lv Qinyu , Li Xin , Zhang Yao , Lu Daofeng , Lu Jiajing , Xie Qingfang , Li Hong , Wu Yiming , Wang Chongze , Yi Zhenghui
Published: February 2023

Objective

Subthreshold depression (SD) is a global mental health problem given its high prevalence, comorbidity, functional impairment, and its association with increased service utilization. However, currently little is known about sex differences of SD in cognitive impairment with clinical correlates. This study aims to explore sex differences in subjective cognitive impairment and clinically associated risk factors in Chinese patients with subthreshold depression (SD).

Methods

A total of 126 patients with SD, 40 males and 86 females, aged 18–45 years, were included in this cross-sectional observational study. Their general information, psychological assessments, and psychiatric symptom assessments were collected online. The Patient Health Questionnaire depression-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Deficits Questionnaire-Depression (PDQ-D), and Toronto Alexithymia Scale (TAS-20) with 3 subdomains were used. The obtained scores were analyzed with partial correlation and multiple linear regression analysis models.

Results

Our results showed that females had significantly higher PDQ-D-20 total score than males. However, the differences in TAS-20 and subdomain score according to sex were not significant. Notably, TAS-20 and DDF (difficulty describing feelings) subdomain contributed to cognitive impairment in males, whereas both PHQ-9 total score and TAS-20 or DDF subdomain contributed to cognitive impairment in females.

Conclusion

These findings revealed significant sex differences in cognitive impairment and clinical correlates in SD, which should be further followed-up in the future.
Prognostic value of 18F-FDG PET/CT-based radiomics combining dosiomics and dose volume histogram for head and neck cancer
Authors: Wang Bingzhen , Liu Jinghua , Zhang Xiaolei , Wang Zhongxiao , Cao Zhendong , Lu Lijun , Lv Wenbing , Wang Aihui , Li Shuyan , Wu Xiaotian , Dong Xianling
Published: February 2023

Objectives

By comparing the prognostic performance of 18F-FDG PET/CT-based radiomics combining dose features [Includes Dosiomics feature and the dose volume histogram (DVH) features] with that of conventional radiomics in head and neck cancer (HNC), multidimensional prognostic models were constructed to investigate the overall survival (OS) in HNC.

Materials and methods

A total of 220 cases from four centres based on the Cancer Imaging Archive public dataset were used in this study, 2260 radiomics features and 1116 dosiomics features and 8 DVH features were extracted for each case, and classified into seven different models of PET, CT, Dose, PET+CT, PET+Dose, CT+Dose and PET+CT+Dose. Features were selected by univariate Cox and Spearman correlation coefficients, and the selected features were brought into the least absolute shrinkage and selection operator (LASSO)-Cox model. A nomogram was constructed to visually analyse the prognostic impact of the incorporated dose features. C-index and Kaplan–Meier curves (log-rank analysis) were used to evaluate and compare these models.

Results

The cases from the four centres were divided into three different training and validation sets according to the hospitals. The PET+CT+Dose model had C-indexes of 0.873 (95% CI 0.812–0.934), 0.759 (95% CI 0.663–0.855) and 0.835 (95% CI 0.745–0.925) in the validation set respectively, outperforming the rest models overall. The PET+CT+Dose model did well in classifying patients into high- and low-risk groups under all three different sets of experiments (p < 0.05).

Conclusion

Multidimensional model of radiomics features combining dosiomics features and DVH features showed high prognostic performance for predicting OS in patients with HNC.
Relevance of 18F-DOPA visual and semi-quantitative PET metrics for the diagnostic of Parkinson disease in clinical practice: a machine learning-based inference study
Authors: Iep Alex , Chawki Mohammad B. , Goldfarb Lucas , Nguyen Loc , Brulon Vincent , Comtat Claude , Lebon Vincent , Besson Florent L.
Published: February 2023

Purpose

To decipher the relevance of visual and semi-quantitative 6-fluoro-(18F)-L-DOPA (18F-DOPA) interpretation methods for the diagnostic of idiopathic Parkinson disease (IPD) in hybrid positron emission tomography (PET) and magnetic resonance imaging.

Material and methods

A total of 110 consecutive patients (48 IPD and 62 controls) with 11 months of median clinical follow-up (reference standard) were included. A composite visual assessment from five independent nuclear imaging readers, together with striatal standard uptake value (SUV) to occipital SUV ratio, striatal gradients and putamen asymmetry-based semi-quantitative PET metrics automatically extracted used to train machine learning models to classify IPD versus controls. Using a ratio of 70/30 for training and testing sets, respectively, five classification models—k-NN, LogRegression, support vector machine, random forest and gradient boosting—were trained by using 100 times repeated nested cross-validation procedures. From the best model on average, the contribution of PET parameters was deciphered using the Shapley additive explanations method (SHAP). Cross-validated receiver operating characteristic curves (cv-ROC) of the most contributive PET parameters were finally estimated and compared.

Results

The best machine learning model (k-NN) provided final cv-ROC of 0.81. According to SHAP analyses, visual PET metric was the most important contributor to the model overall performance, followed by the minimum between left and right striatal to occipital SUV ratio. The 10-time cv-ROC curves of visual, min SUVr or both showed quite similar performance (mean area under the ROC of 0.81, 0.81 and 0.79, respectively, for visual, min SUVr or both).

Conclusion

Visual expert analysis remains the most relevant parameter to predict IPD diagnosis at 11 months of median clinical follow-up in 18F-FDOPA. The min SUV ratio appears interesting in the perspective of simple semi-automated diagnostic workflows.
Neurocircuitry underlying the antidepressant effect of retrograde facial botulinum toxin in mice
Authors: Ni Linhui , Chen Hanze , Xu Xinxin , Sun Di , Cai Huaying , Wang Li , Tang Qiwen , Hao Yonggang , Cao Shuxia , Hu Xingyue
Published: February 2023

Backgrounds

Botulinum toxin type A (BoNT/A) is extensively applied in spasticity and dystonia as it cleaves synaptosome-associated protein 25 (SNAP25) in the presynaptic terminals, thereby inhibiting neurotransmission. An increasing number of randomized clinical trials have suggested that glabellar BoNT/A injection improves depressive symptoms in patients with major depressive disorder (MDD). However, the underlying neuronal circuitry of BoNT/A-regulated depression remains largely uncharacterized.

Results

Here, we modeled MDD using mice subjected to chronic restraint stress (CRS). By pre-injecting BoNT/A into the unilateral whisker intrinsic musculature (WIM), and performing behavioral testing, we showed that pre-injection of BoNT/A attenuated despair- and anhedonia-like phenotypes in CRS mice. By applying immunostaining of BoNT/A-cleaved SNAP25 (cl.SNAP25197), subcellular spatial localization of SNAP25 with markers of cholinergic neurons (ChAT) and post-synaptic membrane (PSD95), and injection of monosynaptic retrograde tracer CTB-488-mixed BoNT/A to label the primary nucleus of the WIM, we demonstrated that BoNT/A axonal retrograde transported to the soma of whisker-innervating facial motoneurons (wFMNs) and subsequent transcytosis to synaptic terminals of second-order neurons induced central effects. Furthermore, using transsynaptic retrograde and monosynaptic antegrade viral neural circuit tracing with c-Fos brain mapping and co-staining of neural markers, we observed that the CRS-induced expression of c-Fos and CaMKII double-positive neurons in the ventrolateral periaqueductal grey (vlPAG), which sent afferents to wFMNs, was down-regulated 3 weeks after BoNT/A facial pre-administration. Strikingly, the repeated and targeted silencing of the wFMNs-projecting CaMKII-positive neurons in vlPAG with a chemogenetic approach via stereotactic injection of recombinant adeno-associated virus into specific brain regions of CRS mice mimicked the antidepressant-like action of BoNT/A pre-treatment. Conversely, repeated chemogenetic activation of this potential subpopulation counteracted the BoNT/A-improved significant antidepressant behavior.

Conclusion

We reported for the first time that BoNT/A inhibited the wFMNs-projecting vlPAG excitatory neurons through axonal retrograde transport and cell-to-cell transcytosis from the injected location of the WIM to regulate depressive-like phenotypes of CRS mice. For the limited and the reversibility of side effects, BoNT/A has substantial advantages and potential application in MDD.
Two new methods applied to crown width additive models: a case study for three tree species in Northeastern China
Authors: Wang Junjie , Jiang Lichun , Xin Shidong , Wang Youzhu , He Pei , Yan Yunfei
Published: February 2023

Key message

The non-linear seemingly unrelated regression mixed-effects model (NSURMEM) and generalized additive model (GAM) were applied for the first time in crown width (CW) additive models of larch (Larix gmelinii Rupr.), birch (Betula platyphylla Suk.), and poplar (Populus davidiana Dode). The crown radii in four directions (CR) exhibited different growth trends and responded differently to tree size and competition variables. In the absence of calibration, GAM was more accurate than NSURMEM for CR and CW predictions.

Context

Crown radii in four directions (CR) and crown width (CW) are fundamental indicators used to describe tree crowns. The complexity of the CR growth in four directions of different tree species in natural forests is often ignored. There is logical additivity among CR and CW that is also often overlooked. Furthermore, the existing methods applied to CW additive models have some drawbacks.

Aims

We aim to: (i) evaluate the utility of two new methods in developing CW additive models for larch (Larix gmelinii Rupr.), birch (Betula platyphylla Suk.), and poplar (Populus davidiana Dode) in natural secondary forests of Northeastern China; and (ii) explore the growth patterns of CR in four directions to gain important ecological insights.

Methods

The non-linear seemingly unrelated regression mixed-effects model (NSURMEM) and generalized additive model (GAM) were used to develop CW additive models and to explore crown growth patterns. The predictive ability of the additive models was evaluated using leave-one-plot-out cross-validation (LOOCV).

Results

At a fair level without calibration, GAM provided slightly better results than NSURMEM. The response of the four CR to tree size and competition variables is different and may be non-uniform due to complex stand conditions and tree growth strategies.

Conclusion

The newly provided methods applied to additive models are available for external datasets. GAM is recommended in the absence of calibration. This study has important implications for the understanding of natural forest dynamics and decision-making for critical stand management.
Improving infection control in a veterinary hospital: a detailed study on patterns of faecal contamination to inform changes in practice
Authors: Singaravelu Ashokkumar , Leggett Bernadette , Leonard Finola C.
Published: February 2023

Background

The main purpose of this study was to investigate the cleanliness and microbial burden of a veterinary hospital to establish the extent of cross-contamination with faecal bacteria as an aid to reducing nosocomial infections. Enterococci and Escherichia coli were used as faecal indicator organisms as they can survive on inanimate surfaces for months and pose a threat to animal health.

The study consisted of several elements: (i) a cross-sectional study to identify sites currently contaminated with faecal organisms that could be usefully included in a longitudinal study, (ii) a 3-week longitudinal study to identify sites from which faecal bacteria were repeatedly recovered, (iii) once-off monitoring of hand hygiene, (iv) a review of all hospitalised cases with confirmed E. coli or enterococcal infection during the 8-week study period to investigate possible hospital-acquired (HAI) infection and relationship with environmental contamination. Environmental surface and hand hygiene were assessed using 3M™ Clean-Trace™ ATP test, 3M™ Petrifilm™ plates and bacteriological culture of Enterococcus species and E. coli. Cross contamination was assessed using results of antimicrobial susceptibility testing.

Results

In the cross-sectional study, 26 of 113 (24.5%) of sites sampled exceeded the accepted microbial threshold (2.5 CFU/cm2) and Enterococcus species were isolated from 31 (27.4%) and E. coli from 9 (7.9%) of 113 samples. Organic residue and microbial levels were high in the dog kennels even after cleaning and faecal organisms were also recovered from sites such as the dispensary, a student computer and staff common room. Four of 51 (7.8%) hand samples were contaminated with faecal bacteria. Nine sites were monitored on three occasions in the longitudinal study and a total of 23 Escherichia coli and 6 Enterococcus species were recovered. Seven of the nine sites were positive for faecal organisms on more than one occasion. There was no change in cleanliness or microbial burden over 3 weeks. Twenty-one of the 73 isolates (28.8%) recovered during all parts of the study were multi-drug resistant. Enterococci and E. coli isolates with similar resistance patterns were recovered from the environment in the large and small animal hospitals and from a small number of patients during the same timeframe, suggesting possible hospital acquired infections.

Conclusions

Results suggested that movement between the small and large animal hospital areas may have been responsible for cross-contamination and possible hospital-acquired infections. The data show that cross-sectional and longitudinal monitoring of faecal contamination across all hospital areas can play an important role in informing review of infection control protocols in veterinary hospital settings. Changes in practices in the hospital based on results generated are outlined.
COVID-19 knowledge, attitude, and practice of United Arab Emirates heath providers at the start of the pandemic 2020
Authors: Alghfeli Aljazia Khalfan , Al Zarooni Amal Abdul Rahim , Alremeithi Hamda Musabbah , Almadhaani Roqayah Abdulla , Alketbi Latifa Baynouna
Published: February 2023

Background

Early in 2020, healthcare providers faced the novel virus COVID-19 that had unprecedented risk to them and the community they serve. With COVID-19 high infectivity rate and considerable morbidity and mortality, healthcare providers ' precautionary practices to protect themselves, colleagues, and patients were determinantal to provide safe health services. This study aims to assess the knowledge, attitude, and practice of healthcare providers in the United Arab Emirates toward COVID-19 and to examine its determinants.

Method

This cross-sectional study was conducted to assess COVID-19 knowledge, attitudes, and practice (KAP) of healthcare providers in the Emirates of Abu Dhabi, the United Arab Emirates, from April to July 2020, using an online anonymous self-administered questionnaire. A convenient sampling method was used to distribute the online survey link through the organization's email network admin list and smartphone messaging. Descriptive statistics, t-tests, and multivariant linear regression were used.

Results

A total of 2371 healthcare providers responded to the survey. A total of 1091 worked in inpatient hospitals, 494 in primary health care, and 388 in emergency and ICU care. The overall performance score for all healthcare providers was as follows: 49.1%, poor score; 41.8%, intermediate score; and 9.2%, good score with a mean result of 17.14. Factors leading to better overall performance scores were years of experience, pediatricians’ specialty, and specialist occupation. A total of 55.7% received good direct knowledge from all healthcare providers. In practice, 48% had good practices toward COVID-19. The overall attitude mean was 2.8, with a maximum score of 7, indicating a positive attitude toward COVID-19.

Conclusions

Although this study describes a dynamic learning status and could reflect the early pandemic situation in Abu Dhabi health care, it does provide a method to assess the precursor of the critical outcome. It is recommended to follow this study with an assessment of the training program targeting all healthcare providers to ensure a better response to emerging infections.
Is the online ‘creating healthy eating and active environments survey' (CHEERS) tool reliable for early childhood educators in Alberta, Canada: a randomized crossover trial
Authors: Lafave Lynne M. Z.
Published: February 2023

Background

The creating healthy eating and active environments survey (CHEERS) is an audit tool used to assess the nutrition and physical activity environment in early childhood education and care (ECEC) centres. Availability of the tool has been limited to paper-based versions. Digital health initiatives offer improved reach and immediacy of support for community-based clients through novel technology products. In order to provide increased access to the CHEERS tool, an online version was developed. The objective of this study was to assess the reliability of an online version of CHEERS.

Methods

Utilizing a randomized crossover design, ECEC educators completed either a paper-based or online-based survey and then the opposite mode with a two to three-week interval. The intraclass correlation coefficient (ICC, with 95% confidence interval) was used to determine the reliability between test and retest. Absolute index of reliability in the original measurement was assessed through the standard error of measurement (SEM = SD × √1-ICC). The smallest amount of change not due to inherent variation was assessed by determining minimal detectable change at the 95% confidence level (MDC95 = SEM × 1.96 ×√2; MDC95% = MDC95/mean ×100).

Results

Test–retest reliability was good to excellent for the online-based CHEERS total score (ICC = 0.86) and for each of the four subscales: food served (ICC = 0.82), healthy eating environment (ICC = 0.76), program planning (ICC = 0.76), and physical activity environment (ICC = 0.79). The SEM, MDC95, and MDC95% for the CHEERS overall score were 0.79, 2.19, and 9.6%, respectively.

Conclusions

The results of this study demonstrate that the online-based and paper-based versions of the CHEERS audit tool share comparable accuracy. The CHEERS tool can be reliably implemented in an online environment and this provides users an alternative means to complete the centre-based health assessment. The advantage of the online-based version includes user accessibility and the potential to develop a feedback response for participants using digitally collected data.
Identifying effective diagnostic biomarkers for childhood cerebral malaria in Africa integrating coexpression analysis with machine learning algorithm
Authors: Li Jia-Xin , Liao Wan-Zhe , Huang Ze-Min , Yin Xin , Ouyang Shi , Gu Bing , Guo Xu-Guang
Published: February 2023

Background

Cerebral malaria (CM) is a manifestation of malaria caused by plasmodium infection. It has a high mortality rate and severe neurological sequelae, existing a significant research gap and requiring further study at the molecular level.

Methods

We downloaded the GSE117613 dataset from the Gene Expression Omnibus (GEO) database to determine the differentially expressed genes (DEGs) between the CM group and the control group. Weighted gene coexpression network analysis (WGCNA) was applied to select the module and hub genes most relevant to CM. The common genes of the key module and DEGs were selected to perform further analysis. The least absolute shrinkage and selection operator (LASSO) logistic regression and support vector machine recursive feature elimination (SVM-RFE) were applied to screen and verify the diagnostic markers of CM. Eventually, the hub genes were validated in the external dataset. Gene set enrichment analysis (GSEA) was applied to investigate the possible roles of the hub genes.

Results

The GO and KEGG results showed that DEGs were enriched in some neutrophil-mediated pathways and associated with some lumen structures. Combining LASSO and the SVM-RFE algorithms, LEF1 and IRAK3 were identified as potential hub genes in CM. Through the GSEA enrichment results, we found that LEF1 and IRAK3 participated in maintaining the integrity of the blood–brain barrier (BBB), which contributed to improving the prognosis of CM.

Conclusions

This study may help illustrate the pathophysiology of CM at the molecular level. LEF1 and IRAK3 can be used as diagnostic biomarkers, providing new insight into the diagnosis and prognosis prediction in pediatric CM.
The efficacy of traditional Chinese medicine in the treatment of the COVID-19 pandemic in Henan Province: a retrospective study
Authors: Han Ruiting , Xie Yang , Zhao Hulei , Li Bin , Yu Xueqing , Wang Minghang , Li Suyun , Li Jiansheng
Published: February 2023

Background

Since 2020, novel coronavirus disease (COVID-19) has posed serious threats to health systems and led to tremendous economic decline worldwide. Traditional Chinese medicine (TCM) is considered a promising treatment strategy for COVID-19 in China and is increasingly recognized as a key participant in the battle against COVID-19. Clinicians also need accurate evidence regarding the effectiveness of TCM treatments for COVID-19.

Methods

We retrospectively analyzed patients diagnosed with COVID-19 by collected from the electronic medical records of the hospitals in Henan Province from January 19, 2020, to March 2, 2020. Demographic characteristics, clinical data, frequency analysis of Chinese patent medicines (CPMs), Chinese medicine injections (CMIs), evaluation of baseline symptom scores, nucleic acid negative conversion, length of hospitalization, and mortality rates were studied.

Results

Between 15 January 2020 and 2 March 2020, 131 hospitals with 1245 patients were included. Survey response Chinese herbal decoction, CPMs, and CMIs combined with conventional Western medicine (CWM) used for the treatment of COVID-19. The top 8 CPMs were Lianhua Qingwen capsules, Shuanghuanglian oral liquid, Pudilan Xiaoyan oral liquid, Banlangen granules, Lanqin oral liquid, compound licorice tablets, Bailing capsules, montmorillonite powder. The most frequently used CMIs were Xuebijing, Tanreqing, Reduning, Xiyanping and Yanhuning. TCM combined with CWM improved the patients’ symptom scores for fever, cough, chest tightness, shortness of breath, and fatigue. Nucleic acid negative conversion occurred at11.55 ± 5.91 d and the average length of hospitalization was 14.92 ± 6.15 d. The mortality rate was approximately 1.76%, which is a reduction in patient mortality.

Conclusions

TCM combined with CWM improved clinical symptoms and reduced hospitalization and mortality rates.
Origins, timing and introgression of domestic geese revealed by whole genome data
Authors: Wen Junhui , Li Haiying , Wang Huie , Yu Jincheng , Zhu Tao , Zhang Jinxin , Li Xinghua , Jiang Zhihua , Ning Zhonghua , Qu Lujiang
Published: February 2023

Background

Geese are among the most important poultry species in the world. The current generally accepted hypothesis is that the European domestic geese originated from greylag geese (Anser anser), and Chinese domestic geese have two origins, most of which originated from swan geese (Anser cygnoides), and the Yili goose originated from greylag geese. To explain the origin and demographic history of geese, we selected 14 goose breeds from Europe and China and wild populations of swan and greylag geese, and whole genome sequencing data were obtained for 74 samples.

Results

Population structure analysis and phylogenetic trees showed that the wild ancestor of Chinese domestic geese, except for Yili, is the swan geese, and the wild ancestor of Chinese Yili and European domestic geese is greylag geese. Analysis of the demographic history suggests that the domestication of Chinese geese occurred ~ 3499 years ago and that of the European geese occurred ~ 7552 years ago. Furthermore, gene flow was observed between domestic geese and their wild ancestors. Analysis of introgression showed that Yili geese had been introgressed by Chinese domestic geese, and the body size of Yili geese may be influenced by introgression events of some growth-related genes, including IGF-1.

Conclusions

Our study provides evidence for the origin of geese at the genome-wide level and advances the understanding of the history of goose domestication and the traits affected by introgression events.
The role of genetic testing in the diagnostic workflow of pediatric patients with kidney diseases: the experience of a single institution
Authors: Vaisitti Tiziana , Bracciamà Valeria , Faini Angelo Corso , Brach Del Prever Giulia Margherita , Callegari Martina , Kalantari Silvia , Mioli Fiorenza , Romeo Carmelo Maria , Luca Maria , Camilla Roberta , Mattozzi Francesca , Gianoglio Bruno , Peruzzi Licia , Amoroso Antonio , Deaglio Silvia
Published: February 2023

Purpose

Inherited kidney diseases are among the leading causes of kidney failure in children, resulting in increased mortality, high healthcare costs and need for organ transplantation. Next-generation sequencing technologies can help in the diagnosis of rare monogenic conditions, allowing for optimized medical management and therapeutic choices.

Methods

Clinical exome sequencing (CES) was performed on a cohort of 191 pediatric patients from a single institution, followed by Sanger sequencing to confirm identified variants and for family segregation studies.

Results

All patients had a clinical diagnosis of kidney disease: the main disease categories were glomerular diseases (32.5%), ciliopathies (20.4%), CAKUT (17.8%), nephrolithiasis (11.5%) and tubular disease (10.5%). 7.3% of patients presented with other conditions. A conclusive genetic test, based on CES and Sanger validation, was obtained in 37.1% of patients. The highest detection rate was obtained for ciliopathies (74.4%), followed by nephrolithiasis (45.5%), tubular diseases (45%), while most glomerular diseases and CAKUT remained undiagnosed.

Conclusions

Results indicate that genetic testing consistently used in the diagnostic workflow of children with chronic kidney disease can (i) confirm clinical diagnosis, (ii) provide early diagnosis in the case of inherited conditions, (iii) find the genetic cause of previously unrecognized diseases and (iv) tailor transplantation programs.
Genetic association of PRKCD and CARD9 polymorphisms with Vogt–Koyanagi–Harada disease in the Chinese Han population
Authors: Zhou Chunya , Cai Shiya , Xie Yuhong , Zeng Zhen , Zhang Jun , Su Guannan , Wu Qiuying , Ye Xingsheng , Cao Qingfeng , Yang Peizeng , Hu Jianmin
Published: February 2023

Background

Protein kinase C delta (PRKCD) and caspase recruitment domain family member 9 (CARD9) are genes involved in B and T cell activation, and cytokine production, which are vital mechanisms underlying autoimmune disease development. This study aimed to explore the association of the PRKCD and CARD9 genes with Vogt–Koyanagi–Harada disease (VKH) disease. The case–control study was performed to in 912 patients with VKH and 878 normal controls. MassARRAY system, SHEsis online platform, real-time PCR, and enzyme-linked immunosorbent assay were used to detect genotyping, haplotyping, mRNA expression, and cytokine levels, respectively.

Results

We found that rs74437127 C allele of PRKCD, rs3812555 CC genotype, and C allele of CARD9 were associated with increased susceptibility of VKH (Pc = 0.020, OR = 1.624; Pc = 2.04 × 10–5, OR = 1.810; Pc = 2.76 × 10–5, OR = 1.698, respectively). However, the rs74437127 T allele, and rs3812555 TC genotype and T allele were linked with decreased susceptibility to VKH (Pc = 0.020, OR = 0.616; Pc = 7.85 × 10–5, OR = 0.559; Pc = 2.76 × 10–5, OR = 0.589, respectively). PRKCD ATG and CARD9 GCTTA haplotypes decreased susceptibility to VKH (Pc = 3.11 × 10–3, OR = 0.594; Pc = 5.00 × 10–3, OR = 0.639, respectively). Functional studies on rs3812555 genotyped individuals revealed that CC carriers had significantly higher CARD9 mRNA expression and tumour necrosis factor-α production than TC/TT carriers (P = 1.00 × 10–4; P = 2.00 × 10–3, respectively).

Conclusions

We found an association between PRKCD rs74437127 and CARD9 rs3812555 polymorphisms and VKH susceptibility and revealed that the increased susceptibility of rs3812555 for VKH may be mediated by regulating CARD9 gene expression and the production of pro-inflammatory cytokines, such as TNF-α.
Transdiagnostic fears and avoidance behaviors in self-reported eating disorders
Authors: Melles Hanna , Jansen Anita
Published: February 2023

Background

Fears and avoidance behaviors are common symptoms of eating disorders. It was investigated whether different eating disorder diagnoses are equally characterized by similar fears and avoidance behaviors.

Methods

Individuals with self-reported eating disorders (n = 250) and healthy controls (n = 95) completed online questionnaires assessing general fears, eating related fears, and avoidance behaviors.

Results

All self-reported eating disorder diagnoses showed more eating related fears, general fears, and avoidance behaviors than healthy controls. Individuals with binge eating disorder showed less specific and general fears on some but by no means all scales, yet they showed less food avoidance behaviors than all other eating disorders and less eating restraint than anorexia nervosa and bulimia nervosa.

Conclusions

Eating related fears, general fears, and food avoidance behaviors were found to be transdiagnostic symptoms in self-reported eating disorders. Individuals with binge eating disorder also exhibit more fears and avoidance behaviors than healthy controls, but to a lesser extent than the other eating disorders. Specialized interventions targeting fears and avoidance may be promising add-on interventions not only in the treatment of anorexia nervosa, but in the treatment of all eating disorders.
Vietnamese university EFL teachers’ and students’ beliefs and teachers’ practices regarding classroom assessment
Authors: Bui Hung Phu
Published: February 2023

This study investigates Vietnamese university EFL teachers’ and students’ beliefs and teachers’ practices regarding classroom assessment. Data were collected from a questionnaire administered to 455 participants (104 teachers and 351 students), interviews with nine teachers and twelve students, and 18 observations of 90-min lessons in five universities in Vietnam. In general, the teachers were aware of all assessment types in the current literature. They dominantly used interactive scaffolding and performance assessment. They also denoted some contextual factors as barriers to their assessment practices, leading to their seeming negligence of other classroom assessment types in their practices. The students preferred formative assessment and some assessment tasks (e.g., group work), while the teachers believed that summative assessment could engage students in learning and associated performance assessment with a summative assessment. Implications for L2 classroom assessment practices are discussed.
Stress and movement trend of lower incisors with different IMPA intruded by clear aligner: a three-dimensional finite element analysis
Authors: Li Yixin , Xiao Shengzhao , Jin Yu , Zhu Cheng , Li Ruomei , Zheng Yikan , Chen Rongjing , Xia Lunguo , Fang Bing
Published: February 2023

Background

During the intrusion of lower incisors with clear aligners (CAs), root disengagement from the alveolar bone often occurs, resulting in serious complications. This study aimed to determine the potential force mechanism of the mandibular anterior teeth under the pressure of CA, providing theoretical data for clinical practice.

Methods

In this study, a 3D finite element model was established, including the CA, periodontal ligament, and mandibular dentition. Incisor mandibular plane angles were set as 5 groups: 90°, 95°, 100°, 105°, and 110°. The 4 mandibular incisors were intruded by 0.2 mm, while the canines were the anchorage teeth. The stress, force systems, and potential movement trends of mandibular anterior teeth were obtained.

Results

The compressive stress of the incisors was concentrated in the lingual fossa, incisal ridge, and apex. With the increase in IMPA, the moment of central incisors changed from lingual crown moment to labial crown moment, with the turning point between 100° and 105°, but the center of resistance (CR) was always subjected to the force toward the lingual and intrusive direction. The force and moment toward the labial side of the lateral incisors were greater than those toward the central incisors. The canines always tipped distally and received extrusive force with no relationship with IMPA.

Conclusions

With the increase in the initial IMPA, the direction of labiolingual force on the mandibular incisors was reversed. However, the root of the lower incisors always tipped labially, which indicated fenestration and dehiscence.
Descriptive statistics and risk factor analysis of children with community-acquired septic shock
Authors: Miura Shinya , Michihata Nobuaki , Hashimoto Yohei , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo
Published: February 2023

Background

Children with community-acquired septic shock can rapidly deteriorate and die in acute-care hospitals. This study aimed to describe the mortality, timing, and risk factors in children with community-acquired septic shock.

Methods

This is a retrospective cohort study using a national inpatient database in Japan. The study population included children (age < 20 years) who were admitted to acute-care hospitals with a diagnosis of sepsis from July 2010 to March 2020, who were treated with antibiotics, and who were supported with vasoactive drugs within three days of hospitalization. We used a Cox proportional-hazards regression model to identify risk factors for earlier death.

Results

Among 761 eligible children, the median age was 3 (interquartile range, 0–11) years and 57.2% had underlying conditions. Among these, 67.1% were admitted to accredited intensive care units within three days of hospitalization and 38.6% were transported from other hospitals. The median hospital volume, defined as the number of eligible children in each hospital over the study period, was 4 (interquartile range, 2–11). Overall, 244 children died (in-hospital mortality rate, 32.1%). Among them, 77 (31.6%) died on the first day, and 156 (63.9%) died within three days of hospitalization. A Cox proportional-hazards regression model showed that earlier death was associated with lower hospital volume and age 1–5 years, whereas it was inversely associated with admission to an accredited intensive care unit and transport from other hospitals. Among 517 survivors, 178 (34.4%) were discharged with comorbidities.

Conclusions

Children with community-acquired septic shock had high mortality, and early death was common. Our findings may warrant future efforts to enhance the quality of initial resuscitation for sepsis in low-volume hospitals and to ensure a healthcare system in which children with sepsis can be treated in accredited intensive care units.
Towards automatic text-based estimation of depression through symptom prediction
Authors: Milintsevich Kirill , Sirts Kairit , Dias Gaël
Published: February 2023

Major Depressive Disorder (MDD) is one of the most common and comorbid mental disorders that impacts a person’s day-to-day activity. In addition, MDD affects one’s linguistic footprint, which is reflected by subtle changes in speech production. This allows us to use natural language processing (NLP) techniques to build a neural classifier to detect depression from speech transcripts. Typically, current NLP systems discriminate only between the depressed and non-depressed states. This approach, however, disregards the complexity of the clinical picture of depression, as different people with MDD can suffer from different sets of depression symptoms. Therefore, predicting individual symptoms can provide more fine-grained information about a person’s condition. In this work, we look at the depression classification problem through the prism of the symptom network analysis approach, which shifts attention from a categorical analysis of depression towards a personalized analysis of symptom profiles. For that purpose, we trained a multi-target hierarchical regression model to predict individual depression symptoms from patient–psychiatrist interview transcripts from the DAIC-WOZ corpus. Our model achieved results on par with state-of-the-art models on both binary diagnostic classification and depression severity prediction while at the same time providing a more fine-grained overview of individual symptoms for each person. The model achieved a mean absolute error (MAE) from 0.438 to 0.830 on eight depression symptoms and showed state-of-the-art results in binary depression estimation (73.9 macro-F1) and total depression score prediction (3.78 MAE). Moreover, the model produced a symptom correlation graph that is structurally identical to the real one. The proposed symptom-based approach provides more in-depth information about the depressive condition by focusing on the individual symptoms rather than a general binary diagnosis.