bluuebunny/crossref_metadata_2025 huggingface dataset:
Chinese Dou Quantification
Authors: Feng Yuli , Pan Haihua
Published: April 2023

Dou has been seen as a typical example of universal quantification and the point of departure in the formal study of quantification in Chinese. The constraints on dou’s quantificational structure, dou’s diverse uses, and the compatibility between dou and other quantificational expressions have further promoted the refinement of the theory of quantification and sparked debate over the semantic nature of dou. The universal quantificational approach holds that dou is a universal quantifier and explains its diverse uses as the effects produced by quantification on different sorts of entities and different ways of quantificational mapping. However, non-quantificational approaches, integrating the insights of degree semantics and focus semantics, take the scalar use as dou’s core semantics. The quantificational approach to dou can account for its meaning of exclusiveness and the interpretational differences engendered by dou when it associates with a wh-indeterminate to its left or to its right, whereas non-quantificational approaches cannot determine the interpretational differences caused by rightward and leftward association and cannot explain the exclusive use of dou. Despite the differences, the various approaches to dou, quantificational or non-quantificational, have far-reaching theoretical significance for understanding the mechanism of quantification in natural language.
Decoding Connectivity Map-based drug repurposing for oncotherapy
Authors: Zhao Yuanchun , Chen Xingqi , Chen Jiajia , Qi Xin
Published: April 2023

The rising global burden of cancer has driven considerable efforts into the research and development of effective anti-cancer agents. Fortunately, with impressive advances in transcriptome profiling technology, the Connectivity Map (CMap) database has emerged as a promising and powerful drug repurposing approach. It provides an important platform for systematically discovering of the associations among genes, small-molecule compounds and diseases, and elucidating the mechanism of action of drug, contributing toward efficient anti-cancer pharmacotherapy. Moreover, CMap-based computational drug repurposing is gaining attention because of its potential to overcome the bottleneck constraints faced by traditional drug discovery in terms of cost, time and risk. Herein, we provide a comprehensive review of the applications of drug repurposing for anti-cancer drug discovery and summarize approaches for computational drug repurposing. We focus on the principle of the CMap database and novel CMap-based software/algorithms as well as their progress achieved for drug repurposing in the field of oncotherapy. This article is expected to illuminate the emerging potential of CMap in discovering effective anti-cancer drugs, thereby promoting efficient healthcare for cancer patients.
Multivariate genome-wide association analysis by iterative hard thresholding
Authors: Chu Benjamin B , Ko Seyoon , Zhou Jin J , Jensen Aubrey , Zhou Hua , Sinsheimer Janet S , Lange Kenneth
Published: April 2023

Motivation

In a genome-wide association study, analyzing multiple correlated traits simultaneously is potentially superior to analyzing the traits one by one. Standard methods for multivariate genome-wide association study operate marker-by-marker and are computationally intensive.

Results

We present a sparsity constrained regression algorithm for multivariate genome-wide association study based on iterative hard thresholding and implement it in a convenient Julia package MendelIHT.jl. In simulation studies with up to 100 quantitative traits, iterative hard thresholding exhibits similar true positive rates, smaller false positive rates, and faster execution times than GEMMA’s linear mixed models and mv-PLINK’s canonical correlation analysis. On UK Biobank data with 470 228 variants, MendelIHT completed a three-trait joint analysis (n=185 656) in 20 h and an 18-trait joint analysis (n=104 264) in 53 h with an 80 GB memory footprint. In short, MendelIHT enables geneticists to fit a single regression model that simultaneously considers the effect of all SNPs and dozens of traits.

Availability and implementation

Software, documentation, and scripts to reproduce our results are available from https://github.com/OpenMendel/MendelIHT.jl.
Lem2 is essential for cardiac development by maintaining nuclear integrity
Authors: Ross Jacob A , Arcos-Villacis Nathaly , Battey Edmund , Boogerd Cornelis , Orellana Constanza Avalos , Marhuenda Emilie , Swiatlowska Pamela , Hodzic Didier , Prin Fabrice , Mohun Tim , Catibog Norman , Tapia Olga , Gerace Larry , Iskratsch Thomas , Shah Ajay M , Stroud Matthew J
Published: April 2023

Aims

Nuclear envelope integrity is essential for the compartmentalization of the nucleus and cytoplasm. Importantly, mutations in genes encoding nuclear envelope (NE) and associated proteins are the second highest cause of familial dilated cardiomyopathy. One such NE protein that causes cardiomyopathy in humans and affects mouse heart development is Lem2. However, its role in the heart remains poorly understood.

Methods and results

We generated mice in which Lem2 was specifically ablated either in embryonic cardiomyocytes (Lem2 cKO) or in adult cardiomyocytes (Lem2 iCKO) and carried out detailed physiological, tissue, and cellular analyses. High-resolution episcopic microscopy was used for three-dimensional reconstructions and detailed morphological analyses. RNA-sequencing and immunofluorescence identified altered pathways and cellular phenotypes, and cardiomyocytes were isolated to interrogate nuclear integrity in more detail. In addition, echocardiography provided a physiological assessment of Lem2 iCKO adult mice. We found that Lem2 was essential for cardiac development, and hearts from Lem2 cKO mice were morphologically and transcriptionally underdeveloped. Lem2 cKO hearts displayed high levels of DNA damage, nuclear rupture, and apoptosis. Crucially, we found that these defects were driven by muscle contraction as they were ameliorated by inhibiting myosin contraction and L-type calcium channels. Conversely, reducing Lem2 levels to ∼45% in adult cardiomyocytes did not lead to overt cardiac dysfunction up to 18 months of age.

Conclusions

Our data suggest that Lem2 is critical for integrity at the nascent NE in foetal hearts, and protects the nucleus from the mechanical forces of muscle contraction. In contrast, the adult heart is not detectably affected by partial Lem2 depletion, perhaps owing to a more established NE and increased adaptation to mechanical stress. Taken together, these data provide insights into mechanisms underlying cardiomyopathy in patients with mutations in Lem2 and cardio-laminopathies in general.
Nurse-led care after ablation of atrial fibrillation: a randomized controlled trial
Authors: Vanharen Yaël , Abugattas de Torres Juan Pablo , Adriaenssens Bert , Convens Carl , Schwagten Bruno , Tijskens Maxime , Wolf Michael , Goossens Eva , Van Bogaert Peter , de Greef Yves
Published: April 2023

Aims

The added value of advanced practitioner nurse (APN) care after ablation of atrial fibrillation (AF) is unknown. The present study investigates the impact of APN-led care on AF recurrence, patient knowledge, lifestyle, and patient satisfaction.

Methods and results

Sixty-five patients undergoing AF ablation were prospectively randomized to usual care (N = 33) or intervention (N = 32) group. In addition to usual care, the intervention consisted of an educational session, three consultations spread over 6 months and telephone accessibility coordinated by the APN. Primary outcome was the AF recurrence rate at 6-month follow-up. Secondary outcomes were lifestyle factors (alcohol intake, exercise, BMI, smoking), patient satisfaction and AF knowledge measured at 1 and 6 months between groups and within each group. Study demographics at 1 month were similar, except AF knowledge was higher in the intervention group (8.6 vs. 7, P = 0.001). At 6 months, AF recurrence was significantly lower in the intervention group (13.5 vs. 39.4%, P = 0.014). Between groups, patient satisfaction and AF knowledge were significantly higher in the intervention group, respectively, 9.4 vs. 8.7 (P < 0.001) and 8.6 vs. 7.0 out of 10 (P < 0.001). Within the intervention group, alcohol intake decreased from 3.9 to 2.6 units per week (P = 0.031) and physical activity increased from 224.4 ± 210.7 to 283.8 ± 169.3 (P = 0.048). No changes occurred within the usual care group. Assignment to the intervention group was the only protective factor for AF recurrence [Exp(B) 0.299, P = 0.04] in multivariable-adjusted analysis.

Conclusion

Adding APN-led care after ablation of AF improves short-term clinical outcome, patient satisfaction and physical activity and decreases alcohol intake.
Generating synthetic laser scanning data of forests by combining forest inventory information, a tree point cloud database and an open-source laser scanning simulator
Authors: Schäfer Jannika , Weiser Hannah , Winiwarter Lukas , Höfle Bernhard , Schmidtlein Sebastian , Fassnacht Fabian Ewald
Published: April 2023

Airborne laser scanning (ALS) data are routinely used to estimate and map structure-related forest inventory variables. The further development, refinement and evaluation of methods to derive forest inventory variables from ALS data require extensive datasets of forest stand information on an individual tree-level and corresponding ALS data. A cost-efficient method to obtain such datasets is the combination of virtual forest stands with a laser scanning simulator. We present an approach to simulate ALS data of forest stands by combining forest inventory information, a tree point cloud database and the laser scanning simulation framework HELIOS++. ALS data of six 1-ha plots were simulated and compared to real ALS data of these plots. The synthetic 3D representations of the forest stands were composed of real laser scanning point clouds of individual trees that were acquired by an uncrewed aerial vehicle (UAV), and, for comparison, simplified tree models with cylindrical stems and spheroidal crowns. The simulated ALS point clouds of the six plots were compared with the real point clouds based on canopy cover, height distribution of returns and several other point cloud metrics. In addition, the performance of biomass models trained using these synthetic data was evaluated. The comparison revealed that, in general, both the real tree models and the simplified tree models can be used to generate synthetic data. The results differed for the different study sites and depending on whether all returns or only first returns were considered. The measure of canopy cover was better represented by the data of the simplified tree models, whereas the height distribution of the returns was – for most of the study sites – better represented by the real tree model data. Training biomass models with metrics derived from the real tree model data led to an overestimation of biomass, while using metrics of the simplified tree model data resulted in an underestimation of biomass. Still, the accuracy of models trained with simulated data was only slightly lower compared to models trained with real ALS data. Our results suggest that the presented approach can be used to generate ALS data that are sufficiently realistic for many applications. The synthetic data may be used to develop new or refine existing ALS-based forest inventory methods, to systematically investigate the relationship between point cloud metrics and forest inventory variables and to analyse how this relationship is affected by laser scanning acquisition settings and field reference data characteristics.
Adaptive Regulation of Stopover Refueling during Bird Migration: Insights from Whole Blood Transcriptomics
Authors: Bounas Anastasios , Komini Chrysoula , Talioura Artemis , Toli Elisavet-Aspasia , Sotiropoulos Konstantinos , Barboutis Christos
Published: April 2023

Migration is one of the most energy-demanding tasks in avian life cycle. Many birds might not have sufficient fuel stores to cover long distances, so they must stop to rest and refuel at stopover sites, especially after the crossing of large ecological barriers. There, birds undergo several behavioral, morphological, and physiological trait adjustments to recover from and prepare for their journey; however, regulation of such processes at the molecular level remains largely unknown. In this study, we used transcriptomic information from the whole blood of migrating garden warblers (Sylvia borin) to identify key regulatory pathways related to adaptations for migration. Birds were temporarily caged during spring migration stopover and then sampled twice at different refueling states (lean vs. fat), reflecting different migratory stages (stopover arrival vs. departure) after the crossing of an extended ecological barrier. Our results show that top expressed genes during migration are involved in important pathways regarding adaptations to migration at high altitudes such as increase of aerobic capacity and angiogenesis. Gene expression profiles largely reflected the two experimental conditions with several enzymes involved in different aspects of metabolic activity being differentially expressed between states providing several candidate genes for future functional studies. Additionally, we identified several hub genes, upregulated in lean birds that could be involved in the extraordinary phenotypic flexibility in organ mass displayed by avian migrants. Finally, our approach provides novel evidence that regulation of water homeostasis may represent a significant adaptive mechanism, allowing birds to conserve water during long-distance flight, mainly through protein catabolism.
A Twist-Box domain of the C. elegans Twist homolog, HLH-8, plays a complex role in transcriptional regulation
Authors: Gruss Michael J , O’Callaghan Colleen , Donnellan Molly , Corsi Ann K
Published: April 2023

TWIST1 is a basic helix-loop-helix (bHLH) transcription factor in humans that functions in mesoderm differentiation. TWIST1 primarily regulates genes as a transcriptional repressor often through TWIST-Box domain-mediated protein–protein interactions. The TWIST-Box also can function as an activation domain requiring 3 conserved, equidistant amino acids (LXXXFXXXR). Autosomal dominant mutations in TWIST1, including 2 reported in these conserved amino acids (F187L and R191M), lead to craniofacial defects in Saethre–Chotzen syndrome (SCS). Caenorhabditis elegans has a single TWIST1 homolog, HLH-8, that functions in the differentiation of the muscles responsible for egg laying and defecation. Null alleles in hlh-8 lead to severely egg-laying defective and constipated animals due to defects in the corresponding muscles. TWIST1 and HLH-8 share sequence identity in their bHLH regions; however, the domain responsible for the transcriptional activity of HLH-8 is unknown. Sequence alignment suggests that HLH-8 has a TWIST-Box LXXXFXXXR motif; however, its function also is unknown. CRISPR/Cas9 genome editing was utilized to generate a domain deletion and several missense mutations, including those analogous to SCS patients, in the 3 conserved HLH-8 amino acids to investigate their functional role. The TWIST-Box alleles did not phenocopy hlh-8 null mutants. The strongest phenotype detected was a retentive (Ret) phenotype with late-stage embryos in the hermaphrodite uterus. Further, GFP reporters of HLH-8 downstream target genes (arg-1::gfp and egl-15::gfp) revealed tissue-specific, target-specific, and allele-specific defects. Overall, the TWIST-Box in HLH-8 is partially required for the protein's transcriptional activity, and the conserved amino acids contribute unequally to the domain's function.
Well-Being and Aging-Related Decline in Financial and Health Literacy in Advanced Age
Authors: Stewart Christopher C , Yu Lei , Glover Crystal , Mottola Gary , Valdes Olivia , Wilson Robert S , Bennett David A , Boyle Patricia A
Published: April 2023

Objectives

Emerging evidence suggests that financial and health literacy deteriorates in advanced age. By contrast, well-being promotes health in aging. This study tested the hypothesis that well-being is associated with slower aging-related literacy decline.

Methods

Participants were 1,099 community-based older adults without dementia at baseline. Financial and health literacy was assessed at baseline and annually thereafter via a 32-item measure. Well-being was assessed at baseline via the 18-item version of Ryff’s Scales of Psychological Well-Being.

Results

During up to 12 years of annual follow-up, literacy declined about 1 percentage point per year on average (β = −0.91, standard error [SE] = 0.08, p < .001); however, there was considerable variation in change in literacy between participants (random slopes variance = 1.24, SE = 0.15, p < .001). In a linear mixed-effects model adjusted for age, sex, and education, higher well-being was associated with higher starting level of literacy (β = 2.31, SE = 0.67, p = .001) and, critically, slower literacy decline (β = 0.29, SE = 0.11, p = .01). The association of higher well-being with slower literacy decline persisted in models that additionally adjusted for income, medical conditions, depressive symptoms, and a robust measure of global cognition.

Discussion

This study suggests that well-being helps stave off aging-related literacy decline.
Tele-Savvy Outcomes of Non-Hispanic Black American and White Caregivers
Authors: Bonds Johnson Kalisha , Higgins Melinda , Epps Fayron , Brewster Glenna S , Alexander Karah , Hepburn Kenneth
Published: April 2023

Background and Objectives

Tele-Savvy is a synchronous/asynchronous psychoeducation program for caregivers of community-dwelling persons living with Alzheimer’s disease and related dementias (ADRD) designed to increase caregivers’ competence and confidence (mastery) in caregiving. Its overall efficacy was tested in a randomized controlled trial.

Research Design and Methods

This secondary data analysis examined the caregiver mastery and psychological health (i.e., perceived stress, depressive symptoms, and burden) outcome of 153 non-Hispanic Black American and White caregivers (31 non-Hispanic Black American and 122 White caregivers) from baseline to 6 months postintervention. Given the difference in the sample sizes of Black and White caregivers, a descriptive post hoc subgroup analysis was conducted of 21 non-Hispanic Black American and 20 White adult children and grandchildren caregivers.

Results

In the overall sample, Black American caregivers demonstrated higher levels of mastery and lower levels of distress than White caregivers at baseline and across all time points. Over time, White caregivers, but not Black American caregivers, experienced significantly improved levels of mastery and significantly lowered levels of depression. Within the subgroup analysis, except for a moderate effect size in the management of situation scores over time among Black American adult children caregivers, similar results were obtained.

Discussion and Implications

The findings highlight the strengths and shortcomings of the Tele-Savvy program in improving caregiver mastery and reducing negative psychological health outcomes. Intentionally tailoring the Tele-Savvy program to certain racial and caregiving groups may hold promise in meeting the needs of more ADRD caregivers.

Clinical Trial Registration

NCT03033875.
COVID-19 Does Not Lead to an Increase in Corticosteroid Prescriptions in IBD Patients: A Nationwide Cohort Study
Authors: Nørgård Bente Mertz , Zegers Floor Dijkstra , Nielsen Jan , Knudsen Torben , Kjeldsen Jens
Published: April 2023

Background

It is not known whether coronavirus 2019 (COVID-19) is a trigger for disease activity in patients with inflammatory bowel diseases (IBD). In patients with IBD, we aimed to examine the association between COVID-19 infection and prescriptions of systemic and local corticosteroids (used as proxy for disease activity).

Methods

This nationwide cohort study was based on Danish health registries and included all patients in Denmark with ulcerative colitis (UC) or Crohn’s disease (CD) by the start of the pandemic (March 1, 2020) and who had a positive COVID-19 polymerase chain reaction (PCR) test from March 1, 2020, to July 31, 2022. We calculated rates of corticosteroid prescriptions 6 months before and 6 months after a positive COVID-19 PCR test, and we calculated adjusted incidence rate ratios (aIRR).

Results

We included 30,102 patients with IBD and a positive COVID-19 test (11,159 with CD, 18,493 with UC). The aIRR for having corticosteroid prescriptions after a COVID-19 positive test was 0.85 (95% confidence interval [CI], 0.79-0.91). When we stratified for underlying disease, the aIRR for having corticosteroid after a COVID-19 positive test in UC was 0.82 (95% CI, 0.75-0.90), and in CD 0.91 (95% CI, 0.81-1.02). Stratifications according to calendar periods and age groups showed consistent results.

Conclusions

An infection with COVID-19 did not result in a higher rate of filled corticosteroid prescriptions. Using corticosteroids as a proxy for disease activity, COVID-19 did not seem to trigger disease activity, which is a reassuring result for patients with IBD.
A qualitative study to investigate community pharmacists’ perceptions about identifying and addressing inappropriately prescribed analgesia
Authors: Meaadi Jawza , Obara Ilona , Nazar Hamde
Published: April 2023

Objectives

Inappropriate prescribing, particularly for analgesia, is a recognised global problem. This leads to increased morbidity and mortality and presents a significant challenge for patients and the healthcare system. There is a need to identify strategies that best identify inappropriately prescribed analgesia (IPA). This study aims to explore the perspectives and experiences of community pharmacists (CPs) about addressing IPA.

Methods

Semi-structured interviews informed by the Behaviour Change Wheel model and the Theoretical Domains Framework (TDF) were conducted with consenting community pharmacists. Transcripts were coded using a capability, opportunity, motivation model of behaviour (COM-B) model. The COM-B components were mapped to the TDF and behaviour change techniques (BCTs) were identified to address these.

Key findings

A total of 12 pharmacists who work in community pharmacies in England were interviewed between March and May 2021. COM-B components were identified through analysis and mapped to nine TDF domains. Component 1 referred to ‘Capability’ of CPs to be involved in addressing IPA (knowledge). Component 2 pertained to ‘Opportunity’ to identify IPA (e.g. social influence). The ‘Motivation’ component linked to five TDF domains (e.g. goals). Seventeen BCTs were identified to support CPs in addressing IPA (e.g. environmental context and resources domain mapped to 2 BCTs ‘restructuring the physical and social environment’).

Conclusions

CPs expressed mixed perceptions about their involvement in the deprescribing of IPA as part of their daily practice, but they stated that social and environmental barriers needed to be addressed to facilitate their involvement. The identified BCTs provide evidence-based strategies to help the involvement of CPs to identify IPA.
Alleviating Poverty in Sub-Saharan Africa: The Role of Inclusive Business Models
Authors: Kamgnia Bernadette Dia , Ahouré Alban A E
Published: April 2023

The study aimed to analyze the ability of inclusive business (IB) models to sustainably contribute to efforts made in alleviating poverty in Sub-Saharan Africa, with an emphasis on the cases of Côte d'Ivoire and Kenya. Data collected on these two countries revealed a clear opposite stream in the integration pattern of the populations at the bottom of the pyramid (BoP) in IB models. In Côte d'Ivoire individuals at BoPs integrate IBs mainly through the agricultural sector, getting busy with the supply of raw material, and with the distribution and/or sale of products in the value chain; thus, supporting an upstream integration. In Kenya, individual at BoPs rather are concentrated in manufacturing, with a first choice on non-permanent employees as activity in the value chain, followed by permanent employees; hence, downstreaming the integration ladder. In both countries, IB contributes positively and significantly to welfare at BoPs, especially when the IB model is implemented as part of a specific program.
Does the Poverty Level Minimum Basket Adequately Inform the Scope of Governments' Poverty Reduction Strategies?
Authors: Ngugi Rose W , Munga Boaz O , Kirii Phares P , Onsomu Eldah N
Published: April 2023

Appropriately guided and implemented government interventions help in achieving the desired outcome. They complement the household budget in meeting their basic needs, allowing them to move to a higher satisfaction level. The study looks at the nexus between household poverty and government strategies to stem it. The analysis uses various approaches including the binary and polychotomous logit models to see who is likely to benefit from the interventions, the Tobit model to measure the intensity in closing poverty gap and simulations to capture the impact and cost implications of interventions. While several interventions were introduced, results reveal implementation gaps where the deserving households are not comprehensively covered; the extremely poor have lower probability of uptake of the interventions. Thus, more targeted coverage is necessary in closing the poverty gap.
Regendering Childbirth: Catholicism, Medical Activism, and Birth Preparation in Post-War Poland
Authors: Ignaciuk Agata , Kościańska Agnieszka
Published: April 2023

This article examines the work of the gynecologist Włodzimierz Fijałkowski, the key promoter of preparation for childbirth in Communist and early democratic Poland. From the late 1950s until the 1990s, Fijałkowski developed a childbirth preparation training protocol that served as an inspiration for childbirth preparation schools across the country. Through analysis of Fijałkowski’s publications in medical journals, books aimed at both professional and lay readers, visual aids for childbirth training, and archival material, we demonstrate that a specific vision of gender roles and relationships lay at the core of Fijałkowski’s psychoprophylactic project. This vision represented a re-definition and re-essentialization of femininity and masculinity, and motherhood and fatherhood, while simultaneously advocating for radical change in the relationship between women in labor and obstetric professionals. Fijałkowski’s ideas and advocacy were intimately connected with a humanization of the embryo and fetus from the earliest stages of pregnancy, and we show how his work became an important transmission medium for the gradual mainstreaming of anti-abortion ideas within public discourse in late-Communist Poland.
Inventing Young Offenders: The Legal and Medical Categorization of Juvenile Delinquency in Hashemite Iraq, 1921–1958
Authors: Farhan Sara , Olsen Pelle Valentin
Published: April 2023

This article traces the emergence of juvenile delinquency as a legal and medical category in Hashemite Iraq (1921–58). We argue that as children and youth became increasingly visible through actions and inactions that highlighted the weaknesses of political and social structures, state institutions adopted international frameworks and vernaculars concerning the participation of youth in labor. Medicine played a key role in defining the “juvenile” and determining young people’s physical abilities and, by extension, their productive potential. Focusing on children and youth who were for the most part unaffiliated with organized political groups, the article demonstrates that Iraq’s correctional facilities, including reformatories, were integral to the Hashemite state’s attempt at crafting and regulating citizens. Juvenile delinquency was also a uniquely gendered and classed category. Gender in particular became a distinguishing marker that in effect deprived young women and girls of the juvenile status that allowed mostly lower-class young men and boys to access reformatories rather than adult prisons. While defiant young men and boys who were considered as potentially redeemable gained access to judicial and social institutions that aimed to rehabilitate the juvenile delinquent, the crimes of young women and girls were often sexualized and assessed according to interpretations of maturity determined by the onset of puberty rather than legal age.
Comparison of the optimized direct spectrophotometric serum prolidase enzyme activity assay method with the currently used spectrophotometric assay methods and liver fibrosis indexes to distinguish the early stages of liver fibrosis in patients with chronic hepatitis B infection
Authors: Kayadibi Huseyin , Köker İbrahim Hakkı , Gucin Zuhal , Şentürk Hakan , Merzifonlu Sakine Candan , İnce Ali Tüzün
Published: April 2023

Objective

The aim of this study was to optimize the currently used direct spectrophotometric serum prolidase enzyme activity (SPEA) assay method and compare its diagnostic accuracy with current precipitation and direct spectrophotometric assay methods, AST-to-ALT ratio, age platelet index, AST-to-platelet ratio index, cirrhosis discriminate score, Doha score, FIB-4, FibroQ, fibrosis index, Goteborg University Cirrhosis Index , King’s score, and Pohl score for distinguishing Ishak F0 from F1–F3 in patients with chronic hepatitis B (CHB) infection.

Methods

Liver biopsy results from 112 patients were included in this study. 

Results

The SPEA values were 529 (292–794) U/L, 671 (486–927) U/L, and 1077 (867–1399) U/L with the precipitation, current, and optimized direct spectrophotometric assay methods, respectively. According to multivariate logistic regression analysis optimized direct spectrophotometric SPEA was the only statistically significant parameter to predict the early stages of liver fibrosis. 

Conclusions

Optimized direct spectrophotometric SPEA assay method could be used to distinguish early stages of liver fibrosis in patients with CHB infection instead of the currently used spectrophotometric SPEA assay methods and other evaluated liver fibrosis indexes.
Prediction equations to estimate muscle mass using anthropometric data: a systematic review
Authors: Duarte Camila Kümmel , de Abreu Silva Luciana , Castro Carolina Fernandes , Ribeiro Mariana Vassallo , Saldanha Marcelle Ferreira , Machado Adriane Moreira , Jansen Ann Kristine
Published: April 2023

Context

Reduced muscle mass is linked to poor outcomes in both inpatients and outpatients, highlighting the importance of muscle mass assessment in clinical practice. However, laboratory methods to assess muscle mass are not yet feasible for routine use in clinical practice because of limited availability and high costs.

Objective

This work aims to review the literature on muscle mass prediction by anthropometric equations in adults or older people.

Data Sources

The following databases were searched for observational studies published until June 2022: MEDLINE, Embase, Scopus, SPORTDiscus, and Web of Science.

Data Extraction

Of 6437 articles initially identified, 63 met the inclusion criteria for this review. Four independent reviewers, working in pairs, selected and extracted data from those articles.

Data Analysis

Two studies reported new equations for prediction of skeletal muscle mass: 10 equations for free-fat mass and lean soft tissue, 22 for appendicular lean mass, 7 for upper-body muscle mass, and 7 for lower-body muscle mass. Twenty-one studies validated previously proposed equations. This systematic review shows there are numerous equations in the literature for muscle mass prediction, and most are validated for healthy adults. However, many equations were not always accurate and validated in all groups, especially people with obesity, undernourished people, and older people. Moreover, in some studies, it was unclear if fat-free mass or lean soft tissue had been assessed because of an imprecise description of muscle mass terminology.

Conclusion

This systematic review identified several feasible, practical, and low-cost equations for muscle mass prediction, some of which have excellent accuracy in healthy adults, older people, women, and athletes. Malnourished individuals and people with obesity were understudied in the literature, as were older people, for whom there are only equations for appendicular lean mass.

Systematic Review Registration

PROSPERO registration number CRD42021257200.
COP 27 insights to increase food-systems climate adaptation and resilience
Authors: Varyvoda Yevheniia , Taren Douglas
Published: April 2023

The limited resilience of agricultural and food systems has become an agenda in the time of more extreme natural hazards. The impact of such events is extensive, and the level of damage and recovery strongly depends on ecosystem services, including their own resilience capacity. Most of the time, ecosystems themselves can offer mitigation measures based on the benefits people get from nature, including cultivated and wild biomass for nutrition, materials, or energy; pest and disease control; and regulation of baseline flows, among others. The 27th Conference of the Parties to the United Nations Framework Convention on Climate Change, held in Sharm el-Sheikh, Egypt, addressed issues related to crop production, food security, and nutrition. The information garnered from this conference provided impetus for actions that we believe can ensure a future with the resources needed for sustainable development and that support the health and nutrition for all the inhabitants on Earth.
Short Interest and Aggregate Stock Returns: International Evidence
Authors: Gorbenko Arseny
Published: April 2023

I find that short interest significantly and negatively predicts aggregate stock returns in 24 of 32 countries examined. This predictability survives out-of-sample tests, persists outside of recessions, and is not subsumed by other well-known return predictors. The results indicate that short interest contains valuable information for forecasting international market returns that is distinct and more powerful than that of other available predictors. However, the predictive power of short interest varies over time and across regions. It is higher around economic downturns when margin requirements tighten and in regions where short selling is constrained by regulations or equity lending market frictions.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Spatial and Temporal Abnormalities of Spontaneous Fixational Saccades and Their Correlates With Positive and Cognitive Symptoms in Schizophrenia
Authors: Liu Xu , Li Yu , Xu Lihua , Zhang Tianhong , Cui Huiru , Wei Yanyan , Xia Mengqing , Su Wenjun , Tang Yingying , Tang Xiaochen , Zhang Dan , Spillmann Lothar , Max Andolina Ian , McLoughlin Niall , Wang Wei , Wang Jijun
Published: April 2023

Background and Hypothesis

Visual fixation is a dynamic process, with the spontaneous occurrence of microsaccades and macrosaccades. These fixational saccades are sensitive to the structural and functional alterations of the cortical-subcortical-cerebellar circuit. Given that dysfunctional cortical-subcortical-cerebellar circuit contributes to cognitive and behavioral impairments in schizophrenia, we hypothesized that patients with schizophrenia would exhibit abnormal fixational saccades and these abnormalities would be associated with the clinical manifestations.

Study Design

Saccades were recorded from 140 drug-naïve patients with first-episode schizophrenia and 160 age-matched healthy controls during ten separate trials of 6-second steady fixations. Positive and negative symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Cognition was assessed using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB).

Study Results

Patients with schizophrenia exhibited fixational saccades more vertically than controls, which was reflected in more vertical saccades with angles around 90° and a greater vertical shift of horizontal saccades with angles around 0° in patients. The fixational saccades, especially horizontal saccades, showed longer durations, faster peak velocities, and larger amplitudes in patients. Furthermore, the greater vertical shift of horizontal saccades was associated with higher PANSS total and positive symptom scores in patients, and the longer duration of horizontal saccades was associated with lower MCCB neurocognitive composite, attention/vigilance, and speed of processing scores. Finally, based solely on these fixational eye movements, a K-nearest neighbors model classified patients with an accuracy of 85%. Conclusions: Our results reveal spatial and temporal abnormalities of fixational saccades and suggest fixational saccades as a promising biomarker for cognitive and positive symptoms and for diagnosis of schizophrenia.
Tree growth is correlated with hydraulic efficiency and safety across 22 tree species in a subtropical karst forest
Authors: Aritsara Amy N A , Ni Ming-Yuan , Wang Yong-Qiang , Yan Chao-Long , Zeng Wen-Hao , Song Hui-Qing , Cao Kun-Fang , Zhu Shi-Dan
Published: April 2023

Karst forests are habitats in which access to soil water can be challenging for plants. Therefore, safe and efficient xylem water transport and large internal water storage may benefit tree growth. In this study, we selected 22 tree species from a primary subtropical karst forest in southern China and measured their xylem anatomical traits, saturated water content (SWC), hydraulic conductivity (Ks) and embolism resistance (P50). Additionally, we monitored growth of diameter at breast height (DBH) in 440 individual trees of various sizes over three consecutive years. Our objective was to analyze the relationships between xylem structure, hydraulic efficiency, safety, water storage and growth of karst tree species. The results showed significant differences in structure but not in hydraulic traits between deciduous and evergreen species. Larger vessel diameter, paratracheal parenchyma and higher SWC were correlated with higher Ks. Embolism resistance was not correlated with the studied anatomical traits, and no tradeoff with Ks was observed. In small trees (5–15 cm DBH), diameter growth rate (DGR) was independent of hydraulic traits. In large trees (>15 cm DBH), higher Ks and more negative P50 accounted for higher DGR. From lower to greater embolism resistance, the size–growth relationship shifted from growth deceleration to acceleration with increasing tree size in eight of the 22 species. Our study highlights the vital contributions of xylem hydraulic efficiency and safety to growth rate and dynamics in karst tree species; therefore, we strongly recommend their integration into trait-based forest dynamic models.
Flipped Classroom Case Learning vs Traditional Lecture-Based Learning in Medical School Ophthalmology Education: A Randomized Trial
Authors: Chan Poemen P. , Lee Vivian W.Y. , Yam Jason C.S. , Brelén Marten E. , Chu Wai Kit , Wan Kelvin H. , Chen Li J. , Tham Clement C. , Pang Chi P.
Published: April 2023

Purpose

To address the problem of teaching noncore specialties, for which there is often limited teaching time and low student engagement, a flipped classroom case learning (FCCL) module was designed and implemented in a compulsory 5-day ophthalmology rotation for undergraduate medical students. The module consisted of a flipped classroom, online gamified clinical cases, and case-based learning.

Method

Final-year medical students in a 5-day ophthalmology rotation were randomized to the FCCL or a traditional lecture-based (TLB) module. The outcomes of subjective assessments (student-rated anonymous Likert scale questionnaire, scale 1 to 5, and course and teaching evaluation, scale 1 to 6) and objective assessments (end-of-rotation and post-MBChB multiple-choice questions, scale 0 to 60) were compared between the 2 groups.

Results

Between May 2021 and June 2022, 216 students (108 in each group) completed the study. Compared with the TLB students, the students in the FCCL group rated various aspects of the course statistically significantly higher, including feeling more enthusiastic and engaged by the course and more encouraged to ask questions and participate in discussions (all P < .001). They also gave higher ratings for the instructional methods, course assignments, course outcomes, and course workload (P < .001). They gave higher course and teaching evaluation scores to the tutors (5.7 ± 0.6 vs 5.0 ± 1.0, P < .001). The FCCL group scored higher than the TLB group on the end-of-rotation multiple-choice questions (53.6 ± 3.1 vs 51.8 ± 2.8, P < .001). When 32 FCCL students and 36 TLB students were reassessed approximately 20 weeks after the rotation, the FCCL group scored higher (40.3 ± 9.1) than the TLB group (34.3 ± 10.9, P = .018).

Conclusions

Applying the FCCL module in ophthalmology teaching enhanced medical students’ satisfaction, examination performance, and knowledge retention. A similar model may be suitable for other specialties.
Comparison of a Modern Digital Mechanomyograph to a Mechanomyograph Utilizing an Archival Grass Force Transducer
Authors: Michaelsen Kelly E. , Jelacic Srdjan , Nguyen Sharon T. , Haththotuwegama Kishanee J. , Togashi Kei , Bowdle Andrew
Published: April 2023

Background

Mechanomyography is the traditional gold standard research technique for quantitative assessment of neuromuscular blockade. Mechanomyography directly measures the isometric force generated by the thumb in response to ulnar nerve stimulation. Researchers must construct their own mechanomyographs since commercial instruments are no longer available. A mechanomyograph was constructed, and its performance was compared against an archival mechanomyography system from the 1970s that utilized an FT-10 Grass force transducer, hypothesizing that train-of-four ratios recorded on each device would be equivalent.

Methods

A mechanomyograph was constructed using 3D-printed components and modern electronics. An archival mechanomyography system was assembled from original components, including an FT-10 Grass force transducer. Signal digitization for computerized data collection was utilized instead of the original paper strip chart recorder. Both devices were calibrated with standard weights to demonstrate linear voltage response curves. The mechanomyographs were affixed to opposite arms of patients undergoing surgery, and the train-of-four ratio was measured during the onset and recovery from rocuronium neuromuscular blockade.

Results

Calibration measurements exhibited a positive linear association between voltage output and calibration weights with a linear correlation coefficient of 1.00 for both mechanomyography devices. The new mechanomyograph had better precision and measurement sensitivity than the archival system: 5.3 mV versus 15.5 mV and 1.6 mV versus 5.7 mV, respectively (P < 0.001 for both). A total of 767 pairs of train-of-four ratio measurements obtained from eight patients had positive linear association (R 
2 = 0.94; P < 0.001). Bland–Altman analysis resulted in bias of 3.8% and limits of agreement of −13% and 21%.

Conclusions

The new mechanomyograph resulted in similar train-of-four ratio measurements compared to an archival mechanomyography system utilizing an FT-10 Grass force transducer. These results demonstrated continuity of gold standard measurement of neuromuscular blockade spanning nearly 50 yr, despite significant changes in the instrumentation technology.

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Near-infrared spectroscopy and processed electroencephalogram monitoring for predicting peri-operative stroke risk in cardiothoracic surgery
Authors: Pierik Ramon , Scheeren Thomas W.L. , Erasmus Michiel E. , van den Bergh Walter M.
Published: April 2023

BACKGROUND

Stroke is a feared complication after cardiothoracic surgery, with an incidence of around 2 to 3%. Anaesthesia and postoperative sedation may obscure clinical symptoms of stroke and thus delay diagnosis and timely intervention.

OBJECTIVES

The objective was to assess the value of intra-operative neuromonitoring and blood pressure monitoring for predicting the occurrence of peri-operative stroke within 3 days after cardiothoracic surgery.

DESIGN

Single-centre retrospective observational cohort study.

SETTING

Academic tertiary care medical centre.

PATIENTS

All consecutive patients with cardiothoracic surgery and intra-operative neuromonitoring admitted postoperatively to the Intensive Care Unit (ICU) between 2008 and 2017.

MAIN OUTCOME MEASURES

The primary endpoint was the occurrence of any stroke confirmed by brain imaging within 3 days postcardiothoracic surgery. Areas under the curve (AUC) of intra-operative mean arterial pressure (MAP), cerebral oxygen saturation (ScO2) and bispectral index (BIS) below predefined thresholds were calculated, and the association with early stroke was tested using logistic regression analyses.

RESULTS

A total of 2454 patients admitted to the ICU after cardiothoracic surgery had complete intra-operative data for ScO2, BIS and MAP and were included in the analysis. In 58 patients (2.4%), a stroke was confirmed. In univariate analysis, a larger AUCMAP<60 mmHg [odds ratio (OR) 1.43; 95% confidence interval (CI), 1.21 to 1.68) and larger AUCBIS<25 (OR 1.51; 95% CI, 1.24 to 1.83) were associated with the occurrence of postoperative stroke while ScO2 less than 50% or greater than 20% reduction from individual baseline was not (OR 0.91; 95% CI, 0.50 to 1.67). After multivariable analysis, AUCBIS<25 (OR 1.45; 95% CI, 1.12 to 1.87) and longer duration of MAP less than 60 mmHg (OR 1.52; 95% CI, 1.02 to 2.27) remained independently associated with stroke occurrence.

CONCLUSION

Cumulative intra-operative BIS values below 25 and longer duration of MAP below 60 mmHg were associated with the occurrence of peri-operative stroke within 3 days after cardiothoracic surgery. Prospective studies are warranted to evaluate a causal relationship between low BIS and stroke to establish whether avoiding intra-operative BIS values below 25 might reduce the incidence of peri-operative stroke.
Dermoscopic Assessment of Pityriasis Versicolor: A Cross-Sectional Observational Study
Authors: Manickam Navakumar , Saminathan Praveen Vasanthi , Vazhavanthan Deepika , Gopalan Kannan
Published: April 2023

Objective:

Pityriasis versicolor (PV) is usually a clinical diagnosis. In uncertain cases, PV is confirmed by microscopic examination with 10% potassium hydroxide (KOH). However, the KOH test is not 100% sensitive in diagnosing PV. Dermoscopy of PV is still an unexplored area with very little data reported. This study was planned to study the various dermoscopic features and their utility in the diagnosis of PV.

Methods:

This cross-sectional observational study was carried out over a 1-year period (September 2020–September 2021) among 57 patients with KOH-confirmed PV. All patients underwent dermoscopy using a handheld dermoscope (DermLite DL4; DermLite LLC, San Juan Capistrano, CA, USA). The chi-square test or Fisher’s exact test was used to analyze the data.

Results:

Of the 57 patients, most had the hypopigmented type (n = 43, 75.44%), followed by the hyperpigmented type (n = 12, 21.05%) and the perifollicular type (n = 2, 3.51%). Non-uniform pigmentation was the most common dermoscopic finding observed in both patients with hypopigmented PV (n = 42, 97.67%) and hyperpigmented PV (n = 12, 100%) (P = 0.001). Scaling was the next most commonly observed finding; patchy scaling (n = 25, 58.13%) and perifollicular scaling (n = 13, 30.23%) were commonly seen in hypopigmented PV, while hyperpigmented PV showed more diffuse scaling (n = 6, 50.00%) (P = 0.04) followed by patchy scaling (n = 5, 41.66%). Dermoscopy showed unique “double-edged scales” in all lesions with furrow scaling (n = 11, 19.30%) after eliciting a positive evoked scale sign. Other interesting features seen in hypopigmented PV were hypopigmentation around the hair follicle (n = 24, 55.48%) (P = 0.001) and perilesional hyperpigmentation (the halo sign) (n = 15, 34.88%) (P = 0.04).

Conclusion:

We observed several dermoscopic findings in PV that can serve as useful clues for differentiating PV from other similar disorders.