bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing predictors of students’ academic performance in Ethiopian new medical schools: a concurrent mixed-method study
Authors: Gebru Hafte Teklay , Verstegen Daniëlle
Published: June 2023

Background

Since 2012 the Ethiopian Federal Ministry of Health and Education implemented a new medical curriculum in 13 institutions. The new curriculum introduced some questions on its admission policy: students can join with different educational backgrounds. Students’ performance on qualifying exams and grade point average are lower than desired. Therefore, the aim of the study was to investigate what factors predict the academic performance of students in the New Medical Education Initiative in Ethiopia.

Methods

A concurrent mixed method of survey and qualitative was used; for the survey, a structured self-administered questionnaire was distributed to students of four randomly selected medical schools from December 2018 to January 2019. The questionnaire includes questions about socio-demographic and educational background of participants. Multiple linear regression analysis was used in order to identify the factors associated with academic performance. In-depth interviews were conducted with 15 key informants to explore qualitatively.

Results

In the multiple linear regressions, stress was associated with lower academic performance. Students with prior education in the field of health science outperformed students with other bachelors. The cumulative grade point average of the previous bachelor degree and the score on the entrance exam to join medicine also significantly predicted performance. Although some more variables are identified from the qualitative interviews, its findings supported the survey results.

Conclusions

Of the number of predictor variables analyzed in the model, only stress, prior educational degree, performance in the prior degree and entrance exam score were significantly correlated with the performance of students in their preclinical medical engagement.
Norwegian health personnel’s contacts and referrals for children of ill parents: an exploratory cross-sectional multi-centre study
Authors: Stavnes Kristin , Ruud Torleif , Benth Jūratė Šaltytė , Hanssen-Bauer Ketil , Solantaus Tytti , Hilsen Marit , Skogøy Bjørg Eva , Kallander Ellen Katrine , Kufås Elin , Weimand Bente M.
Published: June 2023

Background

In 2010, changes were made to the Norwegian Health Personnel Act. This led to all health personnel being obliged to support the patients’ children and families. The aims of this study were to investigate whether health personnel contacted or referred the patients’ children to family/friends or public services. We also investigated if there were factors in the family or the services that increased or decreased the degree of contacts and referrals. In addition the patients were asked whether the law had been a help or even a burden. This study was part of a larger multi-site study of children of ill parents conducted in five health trusts in Norway.

Method

We used cross-sectional data from 518 patients and 278 health personnel. The informants completed a questionnaire addressing the law. Data were analyzed by factor analysis and logistic regression.

Results

The health personnel contacted/referred children to different services, but not to the degree desired by their parents. Only a few contacted family/friends, or the school and/or the public health nurse, those representing the helpers who live closest to the child, and thus well situated to participate in help and preventive efforts. The service most often referred to was the child welfare service.

Conclusion

The results indicate a change in contacts/referrals for children from their parents’ health personnel but also reveal remaining needs for support/help for these children. Health personnel should strive to write more referrals and take more contacts than the current study suggests, to secure adequate support for children of ill parents in Norway, as intended in The Health Personnel Act.
How can patient registries facilitate guideline-based healthcare? A retrospective analysis of the CEDATA-GPGE registry for pediatric inflammatory bowel disease
Authors: Leiz M. , Knorr M. , Moon K. , Tischler L. , Sohrabi K. , Cantez S. , Däbritz J. , de Laffolie J. , van den Berg N. ,   CEDATA GPGE Study Group, Buderus S. , Bufler P. , Dammann S. , Hauer A. , Keller K.-M. , Krahl A. , Laaß M. , Lang T. , Posovszky C. , Rodeck B. , Trenkel S.
Published: June 2023

Background

Early diagnosis is mandatory for the medical care of children and adolescents with pediatric-onset inflammatory bowel disease (PIBD). International guidelines (‘Porto criteria’) of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition recommend medical diagnostic procedures in PIBD. Since 2004, German and Austrian pediatric gastroenterologists document diagnostic and treatment data in the patient registry CEDATA-GPGE on a voluntary basis. The aim of this retrospective study was to analyze whether the registry CEDATA-GPGE reflects the Porto criteria and to what extent diagnostic measures of PIBD according to the Porto criteria are documented.

Methods

Data of CEDATA-GPGE were analyzed for the period January 2014 to December 2018. Variables representing the Porto criteria for initial diagnostic were identified and categorized. The average of the number of measures documented in each category was calculated for the diagnoses CD, UC, and IBD-U. Differences between the diagnoses were tested by Chi-square test. Data on possible differences between data documented in the registry and diagnostic procedures that were actually performed were obtained via a sample survey.

Results

There were 547 patients included in the analysis. The median age of patients with incident CD (n = 289) was 13.6 years (IQR: 11.2–15.2), of patients with UC (n = 212) 13.1 years (IQR: 10.4–14.8) and of patients with IBD-U (n = 46) 12.2 years (IQR: 8.6–14.7).

The variables identified in the registry fully reflect the recommendations by the Porto criteria. Only the disease activity indices PUCAI and PCDAI were not directly provided by participants but calculated from obtained data. The category ‘Case history’ were documented for the largest part (78.0%), the category ‘Imaging of the small bowel’ were documented least frequently (39.1%). In patients with CD, the categories ‘Imaging of the small bowel’ (χ2 = 20.7, Cramer-V = 0.2, p < 0.001) and ‘Puberty stage’ (χ2 = 9.8, Cramer-V = 0.1, p < 0.05) were documented more often than in patients with UC and IBD-U.

Conclusion

The registry fully reproduces the guideline’s recommendations for the initial diagnosis of PIBD. The proportion of documented diagnostic examinations varied within the diagnostic categories and between the diagnoses. Despite technological innovations, time and personnel capacities at participating centers and study center are necessary to ensure reliable data entry and to enable researchers to derive important insights into guideline-based care.
Perceived compassionate care and associated factors among patients with mental illness at Tibebe Ghion specialized and Felege Hiwot comprehensive specialized hospital, Northwest Ethiopia
Authors: Abate Agmas Wassie , Menberu Melak , Belete Habte , Ergetie Temesgen , Teshome Assefa Agegnehu , Chekol Aklile Tsega , Aschale Mastewal , Desalegn Wondimnew
Published: June 2023

Background

Compassion is the first ethical principle of health care to provide high- quality care that influences patient satisfaction and treatment outcome. However, there is limited data on the level of compassionate mental health care practice in low-resource countries like Ethiopia.

Objectives

This study aimed to assess the level of perceived compassionate care and associated factors among patients with mental illness at Tibebe Ghion specialized and Felege Hiwot comprehensive specialized hospital, North West, Ethiopia, 2022.

Methods

An institutional-based cross-sectional study design was conducted from June 18 to July 16, 2022, at Tibebe Ghion Specialized and Felege Hiwot Comprehensive Specialized Hospital. A systematic random sampling technique was used. The level of perceived compassionate care was assessed by the validated 12-item Schwartz Center Compassionate Care Scale among 423 patients with mental illness. Epicollect-5 was used to collect data, which was then exported to the Statistical Product and Service solution version 25 for analysis. Variables with a P-value < 0.05, and 95% confidence interval (CI) were used to declare significant variables at the multivariate logistic regression analysis.

Result

The level of perceived good compassionate care was 47.5% (95% CI 42.6%-52.4%). Factors including urban residence (AOR = 1.90; 95%CI 1.08–3.36), duration of illness < 24 months (AOR = 2.68; 95% CI 1.27–5.65), strong social support (AOR = 4.43; 95%CI 2.16–9.10), shared decision making (AOR = 3.93; 95% CI 2.27–6.81), low perceived stigma(AOR = 2.97; 95% CI 1.54–5.72) and low patient anticipated stigma (AOR = 2.92; 95% CI 1.56–5.48) were positively associated with good compassionate care.

Conclusion and recommendation

Less than half of the patients had received good compassionate care. Compassionate mental health care needs public health attention. Policymakers should emphasize on compassionate care continuity by including it in the health care curriculum and design appropriate policies to strengthen compassionate care.
Construction and verification of atopic dermatitis diagnostic model based on pyroptosis related biological markers using machine learning methods
Authors: Wu Wenfeng , Chen Gaofei , Zhang Zexin , He Meixing , Li Hongyi , Yan Fenggen
Published: June 2023

Objective

The aim of this study was to construct a model used for the accurate diagnosis of Atopic dermatitis (AD) using pyroptosis related biological markers (PRBMs) through the methods of machine learning.

Method

The pyroptosis related genes (PRGs) were acquired from molecular signatures database (MSigDB). The chip data of GSE120721, GSE6012, GSE32924, and GSE153007 were downloaded from gene expression omnibus (GEO) database. The data of GSE120721 and GSE6012 were combined as the training group, while the others were served as the testing groups. Subsequently, the expression of PRGs was extracted from the training group and differentially expressed analysis was conducted. CIBERSORT algorithm calculated the immune cells infiltration and differentially expressed analysis was conducted. Consistent cluster analysis divided AD patients into different modules according to the expression levels of PRGs. Then, weighted correlation network analysis (WGCNA) screened the key module. For the key module, we used Random forest (RF), support vector machines (SVM), Extreme Gradient Boosting (XGB), and generalized linear model (GLM) to construct diagnostic models. For the five PRBMs with the highest model importance, we built a nomogram. Finally, the results of the model were validated using GSE32924, and GSE153007 datasets.

Results

Nine PRGs were significant differences in normal humans and AD patients. Immune cells infiltration showed that the activated CD4+ memory T cells and Dendritic cells (DCs) were significantly higher in AD patients than normal humans, while the activated natural killer (NK) cells and the resting mast cells were significantly lower in AD patients than normal humans. Consistent cluster analysis divided the expressing matrix into 2 modules. Subsequently, WGCNA analysis showed that the turquoise module had a significant difference and high correlation coefficient. Then, the machine model was constructed and the results showed that the XGB model was the optimal model. The nomogram was constructed by using HDAC1, GPALPP1, LGALS3, SLC29A1, and RWDD3 five PRBMs. Finally, the datasets GSE32924 and GSE153007 verified the reliability of this result.

Conclusions

The XGB model based on five PRBMs can be used for the accurate diagnosis of AD patients.
Association of dynamic change of triglyceride-glucose index during hospital stay with all-cause mortality in critically ill patients: a retrospective cohort study from MIMIC IV2.0
Authors: Cheng Long , Zhang Feng , Xue Wenjing , Yu Peng , Wang Xiaoyan , Wang Hairong , Wang Jun , Hu Tianyang , Gong Hui , Lin Li
Published: June 2023

Background

Biomarker of insulin resistance, namely triglyceride-glucose index, is potentially useful in identifying critically ill patients at high risk of hospital death. However, the TyG index might have variations over time during ICU stay. Hence, the purpose of the current research was to verify the associations between the dynamic change of the TyG index during the hospital stay and all-cause mortality.

Methods

The present retrospective cohort study was conducted using the Medical Information Mart for Intensive Care IV 2.0 (MIMIC-IV) critical care dataset, which included data from 8835 patients with 13,674 TyG measurements. The primary endpoint was 1-year all-cause mortality. Secondary outcomes included in-hospital all-cause mortality, the need for mechanical ventilation during hospitalization, length of stay in the hospital. Cumulative curves were calculated using the Kaplan–Meier method. Propensity score matching was performed to reduce any potential baseline bias. Restricted cubic spline analysis was also employed to assess any potential non-linear associations. Cox proportional hazards analyses were performed to examine the association between the dynamic change of TyG index and mortality.

Results

The follow-up period identified a total of 3010 all-cause deaths (35.87%), of which 2477 (29.52%) occurred within the first year. The cumulative incidence of all-cause death increased with a higher quartile of the TyGVR, while there were no differences in the TyG index. Restricted cubic spline analysis revealed a nearly linear association between TyGVR and the risk of in-hospital all-cause mortality (P for non-linear = 0.449, P for overall = 0.004) as well as 1-year all-cause mortality (P for non-linear = 0.909, P for overall = 0.019). The area under the curve of all-cause mortality by various conventional severity of illness scores significantly improved with the addition of the TyG index and TyGVR. The results were basically consistent in subgroup analysis.

Conclusions

Dynamic change of TyG during hospital stay is associated with in-hospital and 1-year all-cause mortality, and may be superior to the effect of baseline TyG index.
High FAAP24 expression reveals poor prognosis and an immunosuppressive microenvironment shaping in AML
Authors: Bao Xiebing , Chi Jingyun , Zhu Yiwei , Yang Minfeng , Du Jiahui , Tang Zaixiang , Xu Xiaogang , Mao Genxiang , Wu Zhibing , Chen Jun , Hua Jingsheng , Xu Ting , Liu Song-Bai
Published: June 2023

Background

As a core member of the FA complex, in the Fanconi anemia pathway, FAAP24 plays an important role in DNA damage repair. However, the association between FAAP24 and patient prognosis in AML and immune infiltration remains unclear. The purpose of this study was to explore its expression characteristics, immune infiltration pattern, prognostic value and biological function using TCGA-AML and to verify it in the Beat AML cohort.

Methods

In this study, we examined the expression and prognostic value of FAAP24 across cancers using data from TCGA, TARGET, GTEx, and GEPIA2. To further investigate the prognosis in AML, development and validation of a nomogram containing FAAP24 were performed. GO/KEGG, ssGSEA, GSVA and xCell were utilized to explore the functional enrichment and immunological features of FAAP24 in AML. Drug sensitivity analysis used data from the CellMiner website, and the results were confirmed in vitro.

Results

Integrated analysis of the TCGA, TARGET and GTEx databases showed that FAAP24 is upregulated in AML; meanwhile, high FAAP24 expression was associated with poor prognosis according to GEPIA2. Gene set enrichment analysis revealed that FAAP24 is implicated in pathways involved in DNA damage repair, the cell cycle and cancer. Components of the immune microenvironment using xCell indicate that FAAP24 shapes an immunosuppressive tumor microenvironment (TME) in AML, which helps to promote AML progression. Drug sensitivity analysis showed a significant correlation between high FAAP24 expression and chelerythrine resistance. In conclusion, FAAP24 could serve as a novel prognostic biomarker and play an immunomodulatory role in AML.

Conclusions

In summary, FAAP24 is a promising prognostic biomarker in AML that requires further exploration and confirmation.
Therapeutic efficacy of pyronaridine-artesunate (Pyramax®) against uncomplicated Plasmodium falciparum infection at Hamusit Health Centre, Northwest Ethiopia
Authors: Alebachew Mihreteab , Gelaye Woyneshet , Abate Megbaru Alemu , Sime Heven , Hailgiorgis Henok , Gidey Bokretsion , Haile Mebrahtom , Assefa Gudissa , Bekele Worku , Belay Habtamu , Parr Jonathan B. , Tasew Geremew , Mohammed Hussein , Assefa Ashenafi
Published: June 2023

Background

Early case detection and prompt treatment are important malaria control and elimination strategies. However, the emergence and rapid spread of drug-resistant strains present a major challenge. This study reports the first therapeutic efficacy profile of pyronaridine-artesunate against uncomplicated Plasmodium falciparum in Northwest Ethiopia.

Methods

This single-arm prospective study with 42-day follow-up period was conducted from March to May 2021 at Hamusit Health Centre using the World Health Organization (WHO) therapeutic efficacy study protocol. A total of 90 adults ages 18 and older with uncomplicated falciparum malaria consented and were enrolled in the study. A standard single-dose regimen of pyronaridine-artesunate was administered daily for 3 days, and clinical and parasitological outcomes were assessed over 42 days of follow-up. Thick and thin blood films were prepared from capillary blood and examined using light microscopy. Haemoglobin was measured and dried blood spots were collected on day 0 and on the day of failure.

Results

Out of 90 patients, 86/90 (95.6%) completed the 42-day follow-up study period. The overall PCR-corrected cure rate (adequate clinical and parasitological response) was very high at 86/87 (98.9%) (95% CI: 92.2–99.8%) with no serious adverse events. The parasite clearance rate was high with fast resolution of clinical symptoms; 86/90 (95.6%) and 100% of the study participants cleared parasitaemia and fever on day 3, respectively.

Conclusion

Pyronaridine-artesunate was highly efficacious and safe against uncomplicated P. falciparum in this study population.
DHA supplementation and pregnancy complications
Authors: Jiang Yi , Chen Yuting , Wei Lijie , Zhang Huiting , Zhang Jingyi , Zhou Xuan , Zhu Shenglan , Du Yuanyuan , Su Rui , Fang Chenyun , Ding Wencheng , Feng Ling
Published: June 2023

Docosahexaenoic acid (DHA) supplementation is recommended for women during pregnancy because of its neurological, visual, and cognitive effects. Previous studies have suggested that DHA supplementation during pregnancy may prevent and treat certain pregnancy complications. However, there are contradictions in the current related studies, and the specific mechanism by which DHA acts remains unclear. This review summarizes the research on the relationship between DHA intake during pregnancy and preeclampsia, gestational diabetes mellitus, preterm birth, intrauterine growth restriction, and postpartum depression. Furthermore, we explore the impact of DHA intake during pregnancy on the prediction, prevention, and treatment of pregnancy complications as well as its impact on offspring neurodevelopment. Our results suggest that there is limited and controversial evidence for the protective effect of DHA intake on pregnancy complications, with the exception of preterm birth and gestational diabetes mellitus. However, additional DHA supplementation may improve long-term neurodevelopmental outcomes in the offspring of women with pregnancy complications.
Establishment and evaluation of a novel practical tool for the diagnosis of pre-sarcopenia in young people with diabetes mellitus
Authors: Li Ruina , Lin Sixian , Tu Jiayuan , Chen Yongzhuang , Cheng Bin , Mo Xiaoqiao , Xie Tian
Published: June 2023

Objective

Sarcopenia has been recognized as a third category of complications in people with diabetes. However, few studies focus on the reduction of skeletal muscle mass in young people with diabetes. The aim of this study was to investigate risk factors of pre-sarcopenia in young patients with diabetes and establish a practical tool to diagnose pre-sarcopenia in those people.

Methods

Patients (n = 1246) enrolled from the National Health and Nutrition Examination Survey (NHANES) cycle year of 2011 to 2018 were randomly divided into the training set and validation set. The all-subsets regression analysis was used to select the risk factors of pre-sarcopenia. A nomogram model for the prediction of pre-sarcopenia in the diabetic population was established based on the risk factors. The model was evaluated by the area under the receiver operating characteristic curve for discrimination, calibration curves for calibration, and decision curve analysis curves for clinical utility.

Results

In this study, gender, height, and waist circumference were elected as predictive factors for pre-sarcopenia. The nomogram model presented excellent discrimination in training and validation sets with areas under the curve of 0.907 and 0.912, respectively. The calibration curve illustrated excellent calibration, and the decision curve analysis showed a wide range of good clinical utility.

Conclusions

This study develops a novel nomogram that integrates gender, height, and waist circumference and can be used to easily predict pre-sarcopenia in diabetics. The novel screen tool is accurate, specific, and low-cost, highlighting its potential value in clinical application.
Advantages and robustness of partial VMAT with prone position for neoadjuvant rectal cancer evaluated by CBCT-based offline adaptive radiotherapy
Authors: Zhang Zhe , Yu Shou , Peng Feng , Tan Zhibo , Zhang Lei , Li Daming , Yang Pengfei , Peng Zhaoming , Li Xin , Fang Chunfeng , Wang Yuenan , Liu Yajie
Published: June 2023

Background and purpose

This study aims to explore the advantages and robustness of the partial arc combined with prone position planning technique for radiotherapy in rectal cancer patients. Adaptive radiotherapy is recalculated and accumulated on the synthesis CT (sCT) obtained by deformable image registration between planning CT and cone beam CT (CBCT). Full and partial volume modulation arc therapy (VMAT) with the prone position on gastrointestinal and urogenital toxicity, based on the probability of normal tissue complications (NTCP) model in rectal cancer patients were evaluated.

Materials and methods

Thirty-one patients were studied retrospectively. The contours of different structures were outlined in 155 CBCT images. First, full VMAT (F-VMAT) and partial VMAT (P-VMAT) planning techniques were designed and calculated using the same optimization constraints for each individual patient. The Acuros XB (AXB) algorithm was used in order to generate more realistic dose distributions and DVH, considering the air cavities. Second, the Velocity 4.0 software was used to fuse the planning CT and CBCT to obtain the sCT. Then, the AXB algorithm was used in the Eclipse 15.6 software to conduct re-calculation based on the sCT to obtain the corresponding dose. Furthermore, the NTCP model was used to analyze its radiobiological side effects on the bladder and the bowel bag.

Results

With a CTV coverage of 98%, when compared with F-VMAT, P-VMAT with the prone position technique can effectively reduce the mean dose of the bladder and the bowel bag. The NTCP model showed that the P-VMAT combined with the prone planning technique resulted in a significantly lower complication probability of the bladder (1.88 ± 2.08 vs 1.62 ± 1.41, P = 0.041) and the bowel bag (1.28 ± 1.70 vs 0.95 ± 1.52, P < 0.001) than the F-VMAT. In terms of robustness, P-VMAT was more robust than F-VMAT, considering that less dose and NTCP variation was observed in the CTV, bladder and bowel bag.

Conclusion

This study analyzed the advantages and robustness of the P-VMAT in the prone position from three aspects, based on the sCT fused by CBCT. Whether it is in regards to dosimetry, radiobiological effects or robustness, P-VMAT in the prone position has shown comparative advantages.
On weighted k-mer dictionaries
Authors: Pibiri Giulio Ermanno
Published: June 2023

We consider the problem of representing a set of$$k$$k-mers and their abundance counts, or weights, in compressed space so that assessing membership and retrieving the weight of a$$k$$k-mer is efficient. The representation is called aweighted dictionaryof$$k$$k-mers and finds application in numerous tasks in Bioinformatics that usually count$$k$$k-mers as a pre-processing step. In fact,$$k$$k-mer counting tools produce very large outputs that may result in a severe bottleneck for subsequent processing. In this work we extend the recently introduced SSHash dictionary (Pibiri in Bioinformatics 38:185–194, 2022) to also store compactly the weights of the$$k$$k-mers. From a technical perspective, we exploit the order of the$$k$$k-mers represented in SSHash to encoderunsof weights, hence allowing much better compression than the empirical entropy of the weights. We study the problem of reducing the number of runs in the weights to improve compression even further and give an optimal algorithm for this problem. Lastly, we corroborate our findings with experiments on real-world datasets and comparison with competitive alternatives. Up to date, SSHash is the only$$k$$k-mer dictionary that is exact, weighted, associative, fast, and small.
Folate-mediated one-carbon metabolism as a potential antifungal target for the sustainable cultivation of microalga Haematococcus pluvialis
Authors: Yan Hailong , Ding Meng , Lin Juan , Zhao Liang , Han Danxiang , Hu Qiang
Published: June 2023

Background

Microalgae are widely considered as multifunctional cell factories that are able to transform the photo-synthetically fixed CO2 to numerous high-value compounds, including lipids, carbohydrates, proteins and pigments. However, contamination of the algal mass culture with fungal parasites continues to threaten the production of algal biomass, which dramatically highlights the importance of developing effective measures to control the fungal infection. One viable solution is to identify potential metabolic pathways that are essential for fungal pathogenicity but are not obligate for algal growth, and to use inhibitors targeting such pathways to restrain the infection. However, such targets remain largely unknown, making it challenging to develop effective measures to mitigate the infection in algal mass culture.

Results

In the present study, we conducted RNA-Seq analysis for the fungus Paraphysoderma sedebokerense, which can infect the astaxanthin-producing microalga Haematococcus pluvialis. It was found that many differentially expressed genes (DEGs) related to folate-mediated one-carbon metabolism (FOCM) were enriched in P. sedebokerense, which was assumed to produce metabolites required for the fungal parasitism. To verify this hypothesis, antifolate that hampered FOCM was applied to the culture systems. Results showed that when 20 ppm of the antifolate co-trimoxazole were added, the infection ratio decreased to ~ 10% after 9 days inoculation (for the control, the infection ratio was 100% after 5 days inoculation). Moreover, application of co-trimoxazole to H. pluvialis mono-culture showed no obvious differences in the biomass and pigment accumulation compared with the control, suggesting that this is a potentially algae-safe, fungi-targeted treatment.

Conclusions

This study demonstrated that applying antifolate to H. pluvialis culturing systems can abolish the infection of the fungus P. sedebokerense and the treatment shows no obvious disturbance to the algal culture, suggesting FOCM is a potential target for antifungal drug design in the microalgal mass culture industry.
The association and prediction value of acylcarnitine on diabetic nephropathy in Chinese patients with type 2 diabetes mellitus
Authors: Li Xuerui , Miao Yuyang , Fang Zhongze , Zhang Qiang
Published: June 2023

Background

Acylcarnitines play a role in type 2 diabetes mellitus (T2DM), but the relationship between acylcarnitine and diabetic nephropathy was unclear. We aimed to explore the association of acylcarnitine metabolites with diabetic nephropathy and estimate the predictive value of acylcarnitine for diabetic nephropathy.

Methods

A total of 1032 (mean age: 57.24 ± 13.82) T2DM participants were derived from Liaoning Medical University First Affiliated Hospital. Mass Spectrometry was utilized to measure levels of 25 acylcarnitine metabolites in fasting plasma. Diabetic nephropathy was ascertained based on the medical records. Factor analysis was used to reduce the dimensions and extract factors of the 25 acylcarnitine metabolites. Logistic regression was used to estimate the relationship between factors extracted from the 25 acylcarnitine metabolites and diabetic nephropathy. Receiver operating characteristic curves were used to test the predictive values of acylcarnitine factors for diabetic nephropathy.

Results

Among all T2DM participants, 138 (13.37%) patients had diabetic nephropathy. Six factors were extracted from 25 acylcarnitines, which account for 69.42% of the total variance. In multi-adjusted logistic regression models, the odds ratio (OR, 95% confidence interval [CI]) of diabetic nephropathy on factor 1 (including butyrylcarnitine/glutaryl-carnitine/hexanoylcarnitine/octanoylcarnitine/decanoylcarnitine/lauroylcarnitine/tetradecenoylcarnitine), factor 2 (including propionylcarnitine/palmitoylcarnitine/hydroxypalmitoleyl-carnitine/octadecanoylcarnitine/arachidiccarnitine), and factor 3 (including tetradecanoyldiacylcarnitine/behenic carnitine/tetracosanoic carnitine/hexacosanoic carnitine) were 1.33 (95%CI 1.12–1.58), 0.76 (95%CI 0.62–0.93), and 1.24 (95%CI 1.05–1.47), respectively. The area under the curve for diabetic nephropathy prediction was significantly increased after the complement of factors 1, 2, and 3 in traditional factors model (P < 0.01).

Conclusions

Some plasma acylcarnitine metabolites extracted in factors 1 and 3 were higher in diabetic nephropathy, while factor 2 was lower in diabetic nephropathy among T2DM patients. The addition of acylcarnitine to traditional factors model improved the predictive value for diabetic nephropathy.
Insulin therapy and blood glucose management in critically ill patients: a 1-day cross-sectional observational study in 69 French intensive care units
Authors: Desgrouas Maxime , Demiselle Julien , Stiel Laure , Brunot Vincent , Marnai Rémy , Sarfati Sacha , Fiancette Maud , Lambiotte Fabien , Thille Arnaud W. , Leloup Maxime , Clerc Sébastien , Beuret Pascal , Bourion Anne-Astrid , Daum Johan , Malhomme Rémi , Ravan Ramin , Sauneuf Bertrand , Rigaud Jean-Philippe , Dequin Pierre-François , Boulain Thierry
Published: June 2023

Background

Hyperglycaemia is common in critically ill patients, but blood glucose and insulin management may differ widely among intensive care units (ICUs). We aimed to describe insulin use practices and the resulting glycaemic control in French ICUs. We conducted a multicentre 1-day observational study on November 23, 2021, in 69 French ICUs. Adult patients hospitalized for an acute organ failure, severe infection or post-operative care were included. Data were recorded from midnight to 11:59 p.m. the day of the study by 4-h periods.

Results

Two ICUs declared to have no insulin protocol. There was a wide disparity in blood glucose targets between ICUs with 35 different target ranges recorded. In 893 included patients we collected 4823 blood glucose values whose distribution varied significantly across ICUs (P < 0.0001). We observed 1135 hyperglycaemias (> 1.8 g/L) in 402 (45.0%) patients, 35 hypoglycaemias (≤ 0.7 g/L) in 26 (2.9%) patients, and one instance of severe hypoglycaemia (≤ 0.4 g/L). Four hundred eight (45.7%) patients received either IV insulin (255 [62.5%]), subcutaneous (SC) insulin (126 [30.9%]), or both (27 [6.6%]). Among patients under protocolized intravenous (IV) insulin, 767/1681 (45.6%) of glycaemias were above the target range. Among patients receiving insulin, short- and long-acting SC insulin use were associated with higher counts of hyperglycaemias as assessed by multivariable negative binomial regression adjusted for the propensity to receive SC insulin: incidence rate ratio of 3.45 (95% confidence interval [CI] 2.97–4.00) (P < 0.0001) and 3.58 (95% CI 2.84–4.52) (P < 0.0001), respectively.

Conclusions

Practices regarding blood glucose management varied widely among French ICUs. Administration of short or long-acting SC insulin was not unusual and associated with more frequent hyperglycaemia. The protocolized insulin algorithms used failed to prevent hyperglycaemic events.

Graphical Abstract
Dynamic rate and channel use allocation for cooperative wireless networks
Authors: Al Khansa Ali , Cerovic Stefan , Visoz Raphael , Hayel Yezekael , Lasaulce Samson
Published: June 2023

In this paper, we investigate the performance of link adaptation (LA) algorithms for cooperative multiple access multiple relay networks. In the first transmission phase, the sources transmit in turn in consecutive time slots. In the second cooperative retransmission phase, the destination schedules one relaying node to send redundancies. LA is a fundamental mechanism allowing the source nodes to adapt to the radio channel conditions. In this paper, we investigate the problem of rate allocation using a centralized method, where the destination is the central node that determines the source rates. Furthermore, and in sharp contrast with existing cooperative transmission schemes, we consider the packet size to be time-varying. In other words, we propose adapting the slot duration of each of the sources during the transmission phase as a new degree of freedom. Accordingly, the LA process determines the rate and the time slot duration of each source. We consider a practical performance metric namely, the network spectral efficiency. This metric being difficult to be optimized (given the complex multi-variable optimization problem), we propose best-response dynamic (BRD) algorithms to solve the rate and time duration allocation. Then, we conduct a thorough performance analysis using Monte-Carlo simulations. Our numerical results validate the effectiveness of the proposed BRD algorithms as they yield performance close to the corresponding exhaustive search approach. Furthermore, the results ensure the gain of exploiting the new degree of freedom of the variable slot duration.
Fast DRL-based scheduler configuration tuning for reducing tail latency in edge-cloud jobs
Authors: Wen Shilin , Han Rui , Liu Chi Harold , Chen Lydia Y.
Published: June 2023

Edge-cloud applications are rapidly prevailing in recent years and pose the challenge of using both resource-strenuous edge devices and elastic cloud resources under dynamic workloads. Efficient resource allocation on edge-cloud jobs via cluster schedulers (e.g. Kubernetes/Volcano scheduler) is essential to guarantee their performance, e.g. tail latency, and such allocation is sensitive to scheduler configurations such as applied scheduling algorithms and task restart/discard policy. Deep reinforcement learning (DRL) is increasingly applied to optimize scheduling decisions. However, DRL faces the conundrum of achieving high rewards at a dauntingly long training time (e.g. hours or days), making it difficult to tune the scheduler configurations online in accordance to dynamically changing edge-cloud workloads and resources. For such an issue, this paper proposes EdgeTuner, a fast scheduler configuration tuning approach that efficiently leverages DRL to reduce tail latency of edge-cloud jobs. The enabling feature of EdgeTuner is to effectively simulate the execution of edge-cloud jobs under different scheduler configurations and thus quickly estimate these configurations’ influence on job performance. The simulation results allow EdgeTuner to timely train a DRL agent in order to properly tune scheduler configurations in dynamic edge-cloud environment. We implement EdgeTuner in both Kubernetes and Volcano schedulers and extensively evaluate it on real workloads driven by Alibaba production traces. Our results show that EdgeTuner outperforms prevailing scheduling algorithms by achieving much lower tail latency while accelerating DRL training speed by an average of 151.63x.
CRISPR arrays as high-resolution markers to track microbial transmission during influenza infection
Authors: Zhang Lingdi , Rahman Jahan , Chung Matthew , Lashua Lauren , Gordon Aubree , Balmaseda Angel , Kuan Guillermina , Bonneau Richard , Ghedin Elodie
Published: June 2023

Background

Disruption of the microbial community in the respiratory tract due to infections, like influenza, could impact transmission of bacterial pathogens. Using samples from a household study, we determined whether metagenomic-type analyses of the microbiome provide the resolution necessary to track transmission of airway bacteria. Microbiome studies have shown that the microbial community across various body sites tends to be more similar between individuals who cohabit in the same household than between individuals from different households. We tested whether there was increased sharing of bacteria from the airways within households with influenza infections as compared to control households with no influenza.

Results

We obtained 221 respiratory samples that were collected from 54 individuals at 4 to 5 time points across 10 households, with and without influenza infection, in Managua, Nicaragua. From these samples, we generated metagenomic (whole genome shotgun sequencing) datasets to profile microbial taxonomy. Overall, specific bacteria and phages were differentially abundant between influenza positive households and control (no influenza infection) households, with bacteria like Rothia, and phages like Staphylococcus P68virus that were significantly enriched in the influenza-positive households. We identified CRISPR spacers detected in the metagenomic sequence reads and used these to track bacteria transmission within and across households. We observed a clear sharing of bacterial commensals and pathobionts, such as Rothia, Neisseria, and Prevotella, within and between households. However, due to the relatively small number of households in our study, we could not determine if there was a correlation between increased bacterial transmission and influenza infection.

Conclusion

We observed that airway microbial composition differences across households were associated with what appeared to be different susceptibility to influenza infection. We also demonstrate that CRISPR spacers from the whole microbial community can be used as markers to study bacterial transmission between individuals. Although additional evidence is needed to study transmission of specific bacterial strains, we observed sharing of respiratory commensals and pathobionts within and across households.
Comprehensive genetic screening of early-onset dementia patients in an Austrian cohort-suggesting new disease-contributing genes
Authors: Silvaieh Sara , König Theresa , Wurm Raphael , Parvizi Tandis , Berger-Sieczkowski Evelyn , Goeschl Stella , Hotzy Christoph , Wagner Matias , Berutti Riccardo , Sammler Esther , Stögmann Elisabeth , Zimprich Alexander
Published: June 2023

Early-onset dementia (EOD), with symptom onset before age 65, has a strong genetic burden. Due to genetic and clinical overlaps between different types of dementia, whole-exome sequencing (WES) has emerged as an appropriate screening method for diagnostic testing and novel gene-finding approaches. We performed WES and C9orf72 repeat testing in 60 well-defined Austrian EOD patients. Seven patients (12%) carried likely disease-causing variants in monogenic genes, PSEN1, MAPT, APP, and GRN. Five patients (8%) were APOE4 homozygote carriers. Definite and possible risk variants were detected in the genes TREM2, SORL1, ABCA7 and TBK1. In an explorative approach, we cross-checked rare gene variants in our cohort with a curated neurodegeneration candidate gene list and identified DCTN1, MAPK8IP3, LRRK2, VPS13C and BACE1 as promising candidate genes. Conclusively, 12 cases (20%) carried variants relevant to patient counseling, comparable to previously reported studies, and can thus be considered genetically resolved. Reduced penetrance, oligogenic inheritance and not yet identified high-risk genes might explain the high number of unresolved cases. To address this issue, we provide complete genetic and phenotypic information (uploaded to the European Genome-phenome Archive), enabling other researchers to cross-check variants. Thereby, we hope to increase the chance of independently finding the same gene/variant-hit in other well-defined EOD patient cohorts, thus confirming new genetic risk variants or variant combinations.
Biomarkers as targets for CAR-T/NK cell therapy in AML
Authors: Shao Ruonan , Li Zijian , Xin Honglei , Jiang Suyu , Zhu Yilin , Liu Jingan , Huang Rong , Xu Kailin , Shi Xiaofeng
Published: June 2023

The most common kind of acute leukemia in adults is acute myeloid leukemia (AML), which is often treated with induction chemotherapy regimens followed by consolidation or allogeneic hematopoietic stem cell transplantation (HSCT). However, some patients continue to develop relapsed or refractory AML (R/R-AML). Small molecular targeted drugs require long-time administration. Not all the patients hold molecular targets. Novel medicines are therefore needed to enhance treatment outcomes. T cells and natural killer (NK) cells engineered with chimeric antigen receptors (CARs) that target antigens associated with AML have recently been produced and are currently being tested in both pre-clinical and clinical settings. This review provides an overview of CAR-T/NK treatments for AML.
Students’ and teachers’ perceptions of students’ academic outcomes in Slovenia: evidence from REDS data
Authors: Mirazchiyski Plamen V. , Klemenčič Mirazchiyski Eva
Published: June 2023

The COVID-19 pandemic brought immense challenges to global society. The entire social and work life had to be reorganized to accommodate for the restrictions imposed to limit the spread of COVID-19. These restrictions affected the eduFIGation worldwide as well. Face-to-face education was disrupted and alternatives had to be found. One of the questions raised with the disruption was the student outcomes in the times when the usual teaching and learning was disrupted by the lockdowns and remote classes took place. There are not many studies on the topic in Slovenia but, more importantly, the existing ones do not use representative data to investigate the depth of the problem. The aim of this article is to fill this gap in research through comprehensive and in-depth analyses of the Slovenian student, school and teacher data from the international Responses to Educational Disruption Survey (REDS), conducted in 2020/2021. The data analysis involves descriptive and multivariate statistical methods appropriate for the mostly categorical data available from REDS. The results show that students’ perception on their learning and academic outcomes during the school disruptions depend on their background characteristics, i.e. the disruptions did not affect all students equally. These results are also supported by the findings from school principals’ and teachers’ data. In addition, the long-lasting issue of “grade inflation” in Slovenia has become even more severe, as shown by both student and teacher data. However, students and teachers are at contrasting opinions about student learning—while most of the students think they learned more at home during the disruptions and have shown more progress, teachers are of the opposite opinion. Furthermore, teachers tended to grade students’ academic outcomes higher during the disruptions which has increased the issue of “grade inflation” in Slovenia.
eBF: an enhanced Bloom Filter for intrusion detection in IoT
Authors: Gebretsadik Fitsum Gebreegziabher , Nayak Sabuzima , Patgiri Ripon
Published: June 2023

Intrusion Detection is essential to identify malicious incidents and continuously alert many users of the Internet of Things (IoT). The constant monitoring of events generated from many devices connected to the IoT and the extensive analysis of every event based on predefined security policies consumes enormous resources. Accordingly, performance enhancement is a crucial concern of Intrusion Detection in IoT and other massive Big Data Applications to ensure a secure environment. Like many Big Data Applications, the Intrusion Detection system of the IoT needs to employ the fast membership filter, Bloom Filter, to quickly identify possible attacks. Bloom Filter is an admiringly fast and space-efficient data structure that quickly handles elements of extensive datasets in small memory space. However, the trade-off between the query performance, the number of hash functions, memory space, and false positive probability remains an issue of Bloom Filter. Thus, this article presents an enhanced Bloom Filter (eBF) that remarkably improves memory efficiency and introduces new techniques to accelerate the filtering of malicious URLs. We experimentally show the efficacy of eBF using a real Intrusion Detection dataset. The experimental result shows that the proposed filter is remarkably memory efficient, faster, and more accurate than the state-of-the-art filters. eBF requires 15.6x, 13x, and 8x less memory compared with Standard Bloom Filter, Cuckoo filter, and robustBF, respectively. Therefore, this new system significantly enhances the performance of Intrusion Detection of IoT that concurrently monitors several billion events crosschecking with the defined security policies.
Use of a laryngeal tube for sialolithotomy in a pediatric patient with left vocal cord paralysis: a case report
Authors: Fujii Masashi , Shime Nobuaki , Kawabata Yasuyo
Published: June 2023

Background

The laryngeal tube (LT), a closed esophageal supraglottic device comprising pharyngeal and esophageal cuffs, is used for emergency airway management. However, it is not often used in intraoperative airway management.

Case presentation

A 9-year-old boy was scheduled for a sialolithotomy for sialolithiasis. He had a history of surgery for tetralogy of Fallot and had undergone vocal cord fusion for postoperative left-sided vocal cord paralysis. Following a strong request by the mother to avoid tracheal intubation to reduce the risk of bilateral vocal cord paralysis, management without intubation was initially considered in the preoperative anesthesia plan. Airway management was planned using an LT in case of ventilation failure due to positional abnormalities. Although some leakage was observed during intraoral surgery, it was quickly resolved by adjusting the position of the LT outside the sterile surgical field.

Conclusions

The LT may be a viable option in cases where tracheal intubation is not preferred.