bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of immediate initiation of invasive ventilation on mortality in acute hypoxemic respiratory failure: a target trial emulation
Authors: Mellado-Artigas Ricard , Borrat Xavier , Ferreyro Bruno L. , Yarnell Christopher , Hao Sicheng , Wanis Kerollos N. , Barbeta Enric , Torres Antoni , Ferrando Carlos , Brochard Laurent
Published: May 2024

Purpose

Invasive ventilation is a fundamental treatment in intensive care but its precise timing is difficult to determine. This study aims at assessing the effect of initiating invasive ventilation versus waiting, in patients with hypoxemic respiratory failure without immediate reason for intubation on one-year mortality.

Methods

Emulation of a target trial to estimate the benefit of immediately initiating invasive ventilation in hypoxemic respiratory failure, versus waiting, among patients within the first 48-h of hypoxemia. The eligible population included non-intubated patients with SpO2/FiO2 ≤ 200 and SpO2 ≤ 97%. The target trial was emulated using a single-center database (MIMIC-IV) which contains granular information about clinical status. The hourly probability to receive mechanical ventilation was continuously estimated. The hazard ratios for the primary outcome, one-year mortality, and the secondary outcome, 30-day mortality, were estimated using weighted Cox models with stabilized inverse probability weights used to adjust for measured confounding.

Results

2996 Patients fulfilled the inclusion criteria of whom 792 were intubated within 48 h. Among the non-invasive support devices, the use of oxygen through facemask was the most common (75%). Compared to patients with the same probability of intubation but who were not intubated, intubation decreased the hazard of dying for the first year after ICU admission HR 0.81 (95% CI 0.68–0.96, p = 0.018). Intubation was associated with a 30-day mortality HR of 0.80 (95% CI 0.64–0.99, p = 0.046).

Conclusion

The initiation of mechanical ventilation in patients with acute hypoxemic respiratory failure reduced the hazard of dying in this emulation of a target trial.
Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis
Authors: Ait Hssain Ali , Vahedian-Azimi Amir , Ibrahim Abdulsalam Saif , Hassan Ibrahim Fawzy , Azoulay Elie , Darmon Michael
Published: May 2024

Background

An increasing number of patients requires extracorporeal membrane oxygenation (ECMO) for life support. This supportive modality is associated with nosocomial infections (NIs). This systematic review and meta-analysis aim to assess the incidence and risk factors of NIs in adult.

Methods

We searched PubMed, Scopus, Web of Science, and ProQuest databases up to 2022. The primary endpoint was incidence of NI. Secondary endpoints included time to infection, source of infection, ECMO duration, Intensive care and hospital length of stay (LOS), ECMO survival and overall survival. Incidence of NI was reported as pooled proportions and 95% confidence intervals (CIs), while dichotomous outcomes were presented as risk ratios (RR) as the effective index and 95% CIs using a random-effects model.

Results

Among the 4,733 adult patients who received ECMO support in the 30 included studies, 1,249 ECMO-related NIs per 1000 ECMO-days was observed. The pooled incidence of NIs across 18 studies involving 3424 patients was 26% (95% CI 14–38%).Ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) were the most common NI sources. Infected patients had lower ECMO survival and overall survival rates compared to non-infected patients, with risk ratio values of 0.84 (95% CI 0.74–0.96, P = 0.01) and 0.80 (95% CI 0.71–0.90, P < 0.001), respectively.

Conclusion

Results showed that 16% and 20% lower of ECMO survival and overall survival in patients with NI than patients without NI, respectively. However, NI increased the risk of in-hospital mortality by 37% in infected patients compared with non-infected patients. In addition, this study identified the significant positive correlation between ECMO duration and ECMO-related NI.
Early identification of macrophage activation syndrome secondary to systemic lupus erythematosus with machine learning
Authors: Lin Wenxun , Xie Xi , Luo Zhijun , Chen Xiaoqi , Cao Heng , Fang Xun , Song You , Yuan Xujing , Liu Xiaojing , Du Rong
Published: May 2024

Objective

The macrophage activation syndrome (MAS) secondary to systemic lupus erythematosus (SLE) is a severe and life-threatening complication. Early diagnosis of MAS is particularly challenging. In this study, machine learning models and diagnostic scoring card were developed to aid in clinical decision-making using clinical characteristics.

Methods

We retrospectively collected clinical data from 188 patients with either SLE or the MAS secondary to SLE. 13 significant clinical predictor variables were filtered out using the Least Absolute Shrinkage and Selection Operator (LASSO). These variables were subsequently utilized as inputs in five machine learning models. The performance of the models was evaluated using the area under the receiver operating characteristic curve (ROC-AUC), F1 score, and F2 score. To enhance clinical usability, we developed a diagnostic scoring card based on logistic regression (LR) analysis and Chi-Square binning, establishing probability thresholds and stratification for the card. Additionally, this study collected data from four other domestic hospitals for external validation.

Results

Among all the machine learning models, the LR model demonstrates the highest level of performance in internal validation, achieving a ROC-AUC of 0.998, an F1 score of 0.96, and an F2 score of 0.952. The score card we constructed identifies the probability threshold at a score of 49, achieving a ROC-AUC of 0.994 and an F2 score of 0.936. The score results were categorized into five groups based on diagnostic probability: extremely low (below 5%), low (5–25%), normal (25–75%), high (75–95%), and extremely high (above 95%). During external validation, the performance evaluation revealed that the Support Vector Machine (SVM) model outperformed other models with an AUC value of 0.947, and the scorecard model has an AUC of 0.915. Additionally, we have established an online assessment system for early identification of MAS secondary to SLE.

Conclusion

Machine learning models can significantly improve the diagnostic accuracy of MAS secondary to SLE, and the diagnostic scorecard model can facilitate personalized probabilistic predictions of disease occurrence in clinical environments.
Clinical research on point-of-care lung ultrasound: misconceptions and limitations
Authors: Volpicelli Giovanni , Rovida Serena
Published: May 2024

Over the last 20 years, advances in point-of-care lung ultrasound (PoCLUS) have been consistent. The clinical application of PoCLUS has drastically changed the diagnosis of some respiratory conditions mainly in the acute setting. Despite these improvements, misconceptions regarding the current scientific evidence and errors in the direction given to the latest research are delaying the implementation of PoCLUS in the clinical field. The diagnostic power of PoCLUS is still under-evaluated in many settings and there is a generalized yet unjustified feeling that further evidence is needed before introducing PoCLUS as a standard of care. In the effort to build up further evidence by new studies, the role of randomized clinical trials is over-emphasized and gold standards used to investigate diagnostic accuracy of PoCLUS are sometimes not appropriate. Moreover, the sonographic patterns and techniques used to confirm the diagnoses not always are adapted to the patients’ clinical condition, which limit the scientific value of those clinical studies. Finally, there is a recurrent confusion in the role of PoCLUS scoring techniques, which should be only applied to quantify and monitor injury severity and not to diagnose lung diseases. Awareness of these misconceptions and errors could help the researchers when approaching new study projects on PoCLUS.
Enzyme variants in biosynthesis and biological assessment of different molecular weight hyaluronan
Authors: Ebrahimi Tahereh , Keramati Malihe , Khodabakhsh Farnaz , Cohan Reza Ahangari
Published: May 2024

In the present study, low- and high-molecular-weight hyaluronic acids (LMW-HA and HMW-HA) were synthesized in vitro by truncated Streptococcus equisimilis hyaluronan synthases (SeHAS). The enzyme kinetic parameters were determined for each enzyme variant. The MW, structure, dispersity, and biological activity of polymers were determined by electrophoresis, FTIR spectroscopy, carbazole, cell proliferation, and cell migration assay, respectively. The specific activities were calculated as 7.5, 6.8, 4.9, and 2.8 µgHA µgenzyme−1 min−1 for SeHAS, HAS123, HAS23, and HASIntra, respectively. The results revealed SeHAS produced a polydisperse HMW-HA (268 kDa), while HAS123 and HAS23 produced a polydisperse LMW-HA (< 30 kDa). Interestingly, HASIntra produced a low-disperse LMW-HA. Kinetics studies revealed the truncated variants displayed increased Km values for two substrates when compared to the wild-type enzyme. Biological assessments indicated all LMW-HAs showed a dose-dependent proliferation activity on endothelial cells (ECs), whereas HMW-HAs exhibited an inhibitory effect. Also, LMW-HAs had the highest cell migration effect at 10 µg/mL, while at 200 µg/mL, both LMW- and HMW-HAs postponed the healing recovery rate. The study elucidated that the transmembrane domains (TMDs) of SeHAS affect the enzyme kinetics, HA-titer, HA-size, and HA-dispersity. These findings open new insight into the rational engineering of SeHAS to produce size-defined HA.

Graphical abstract
Constrained optimal grouping of cloud application components
Authors: Różańska Marta , Horn Geir
Published: May 2024

Cloud applications are built from a set of components often deployed as containers, which can be deployed individually on separate Virtual Machines (VMs) or grouped on a smaller set of VMs. Additionally, the application owner may have inhibition constraints regarding the co-location of components. Finding the best way to deploy an application means finding the best groups of components and the best VMs, and it is not trivial because of the complexity coming from the number of possible options. The problem can be mapped onto may known combinatorial problems as binpacking and knapsack formulations. However, these approaches often assume homogeneus resources and fail to incorporate the inhibition constraints. The main contribution of this paper are firstly a novel formulation of the grouping problem as constrained Coalition Structure Generation (CSG) problem, including the specification of the value function which fulfills the criteria of a Characteristic Function Game (CFG). The CSG problem aims to determine stable and disjoint groups of players collaborating to optimize the joint outcome of the game, and a CFG is a common representation of a CSG, where each group is assigned a value and where the value of the game is the sum of the groups’ contributions. Secondly, the Integer-Partition (IP) CSG algorithm has been modified and extended to handle constraints. The proposed approach is evaluated with the extended IP algorithm, and a novel exhaustive search algorithm establishing the optimum grouping for comparison. The evaluation shows that our approach with the modified algorithm evaluates on average significantly less combinations than the CSG state-of-the-art algorithm. The proposed approach is promising for optimized constrained Cloud application management as the modified IP algorithm can optimally solve constrained grouping problems of attainable sizes.
Electronic prescription systems in Greece: a large-scale survey of healthcare professionals’ perceptions
Authors: Grammatikopoulou Margarita , Lazarou Ioulietta , Giannios George , Kakalou Christina Asimina , Zachariadou Martha , Zande Maria , Karanikas Haralampos , Thireos Eleftherios , Stavropoulos Thanos G. , Natsiavas Pantelis , Nikolopoulos Spiros , Kompatsiaris Ioannis
Published: May 2024

Background

The national e-prescription system in Greece is one of the most important achievements in the e-health sector. Healthcare professionals’ feedback is essential to ensure the introduced system tends to their needs and reduces their everyday workload. The number of surveys collecting the users’ views is limited, while the existing studies include only a small number of participants.

Methods

In this study, healthcare professionals’ perceptions on e-prescription are explored. For this, a questionnaire was distributed online, containing closed- and open-ended questions aiming to address strengths and identify drawbacks in e-prescription. Answers were collected from primary health care physicians, specialized medical doctors and pharmacists.

Results

In total, 430 answers were collected (129 from primary health care physicians, 164 responses from specialized medical doctors and 137 pharmacists). Analysis of the collected answers reveals that the views of the three groups of healthcare professionals mostly converge. The positive impact e-prescribing systems have on the overall prescribing procedure in preventing errors and providing automation is commented. Among gaps identified and proposed improvements, health care professionals note the need for access to information on adverse drug reactions, side effects, drug-to-drug interactions and allergies. Flexible interaction with Therapeutic Prescription Protocols is desired to ameliorate monitoring and decision-making, while drug dosing features, and simplified procedures for copying, repeating, canceling a prescription, are perceived as useful to incorporate.

Conclusions

Collecting healthcare professionals’ feedback is important, as their views can be transcribed to system requirements, to further promote e-prescribing and improve the provided health care services by facilitating decision making through safer and more efficient e-prescription. Introduction of the identified improvements can simplify the everyday workflow of healthcare professionals. To the best of our knowledge, a survey with more than 400 answered questionnaires on the use of e-prescription systems by healthcare professionals has never been conducted in Greece before.
Ratio of photosynthetically active radiation to global solar radiation above forest canopy in complex terrain: measurements and analyses based on Qingyuan Ker Towers
Authors: Li Shuangtian , Yan Qiaoling , Gao Tian , Wang Xingchang , Wang Qingwei , Yu Fengyuan , Lu Deliang , Liu Huaqi , Zhang Jinxin , Zhu Jiaojun
Published: May 2024

Background

Understanding of the ratio of photosynthetic photon flux density (Qp) to global solar radiation (Rs) (Qp/Rs) is crucial for applying Rs to ecology-related studies. Previous studies reported Qp/Rs and its variations based on measurements from a single observatory tower, instead of multi-site-based measurements over complex terrains. This may neglect spatial heterogeneity in the terrain, creating a gap in an understanding of how terrain affects Qp/Rs and how this effect interacts with meteorological factors.

Methods

Here the Qingyuan Ker Towers (three towers in a valley with different terrains: T1, T2, and T3) were utilized to measure Qp and Rs over mountainous forests of Northeast China. An airborne LiDAR system was used to generate a digital elevation model, and sky view factor of sectors (SVFs) divided from the field of view of tower’s pyranometer was calculated as a topographic factor to explain the variations of Qp/Rs.

Results

The results identified significant differences in Qp/Rs of the three towers at both daily and half-hour scales, with larger differences on clear days than on overcast days. Qp/Rs was positively correlated with SVFs of T1 and T3, while this correlation was negative with that of T2. The effect of SVFs on Qp/Rs interacted with clearness index, water vapor pressure and solar zenith angle. Random forest-based importance assessment demonstrated that explanation (R2) on Qp/Rs was improved when SVFs was included in the predictor variable set, indicating that incorporating terrain effects enhances the prediction accuracy of Qp/Rs. The improvement in the R2 values was more pronounced on clear days than on overcast days, suggesting that the effect of terrain on Qp/Rs depended on sky conditions.

Conclusions

All findings suggested that Qp/Rs is affected by terrain, and integrating terrain information into existing Qp/Rs models is a feasible solution to improve Qp/Rs estimates in mountainous areas.
Twenty four-month follow-up after bullectomy, unilateral and bilateral lung volume reduction surgery: a single-center retrospective analysis of consecutive cases
Authors: Bascarevic Slavisa , Ercegovac Maja , Hoda Mir Alireza , Savic Milan , Vesovic Radomir , Milenkovic Vladimir , Moromila Marina , Popovic Marko , Gompelmann Daniela , Madzarevic Petar
Published: May 2024

Purpose

While pharmacologic therapy remains the cornerstone of lung emphysema treatment, surgery is an additional therapeutic option in selected patient groups with advanced emphysema. The aim of lung volume reduction surgery (LVRS) is to improve lung function, exercise capacity, quality of life and survival. We sought to determine the therapeutic value of surgical resection in specific patients with lung emphysema.

Patients and methods

A retrospective study was performed consisting of 58 patients with lung emphysema who underwent surgical intervention over a 10-year period and were followed for 2 years postoperatively. The clinical characteristics recorded were FEV1 (forced expiratory volume in 1 s), the 6-min walk test (6-MWT), the Modified Medical Research Council (mMRC), body mass index (BMI) and quality of life prior to and 6, 12 and 24 months after surgical intervention. Moreover, all peri- and post-operative complications were noted.

Results

Out of 58 emphysema patients (72% male, FEV1 (L) 2.21 ± 0.17, RV (L) 3.39 ± 0.55), 19 underwent surgical bullectomy, 31 unilateral LVRS and 8 sequential bilateral LVRS. Six months after surgery, there was a statistically significant improvement in FEV1, RV, TLC, 6-MWT and mMRC. Over a period of 12 to 24 months postoperatively, clinical benefit gradually declines most likely due to COPD progression but patients still experienced a significant improvement in FEV1. The most common postoperative complications were persistent air leakage (> 7 days), arrhythmia and subcutaneous emphysema in 60%, 51.6% and 22.4%, respectively. No deaths were observed after surgical intervention.

Conclusion

In a selected patient population, surgery led to significant improvement of lung function parameters, exercise capacity and quality of life. Over a period of 12 to 24 months postoperatively, clinical benefit gradually decreased most likely due to COPD progression.
Associations of body composition with physical activity, nutritional intake status, and chronotype among female university students in Japan
Authors: Oshita Kazushige , Ishihara Yujiro , Seike Kohei , Myotsuzono Ryota
Published: May 2024

Background

Having higher muscle mass in early adulthood is an important factor in preventing sarcopenia. However, university students undergo lifestyle changes compared to their high school years, which may lead to changes in body composition, such as an increase in body fat and a decrease in muscle mass. The study aimed to investigate the association between body composition and lifestyle behaviors, including chronotype, among Japanese female university students, due to the prevalence of underweight among young females in the country.

Methods

The physical activity level (PAL), daily dietary intake status, morningness-eveningness questionnaire (MEQ) score, and body composition of 230 students were assessed in this cross-sectional study. Body composition was measured using a multifrequency bioelectrical impedance analyzer, and body mass index (BMI), body fat percentage (%BF), and skeletal muscle mass index (SMI) were determined.

Results

Individuals who were evening type (ET) had a higher %BF and lower SMI than those who were non-ET, but no differences in body weight or BMI were found. Although ET individuals had lower total energy intake, protein intake, and PALs than non-ETs, the differences were small. However, multiple regression analyses showed that SMI was significantly positively associated with MEQ and PAL, and %BF was significantly negatively associated with MEQ and PAL.

Conclusion

These results suggest that female university students with lateness of chronotype and low physical activity have a body composition imbalance resulting in higher body fat and lower muscle mass. Therefore, young females may need to take chronotype-specific measures (especially ET individuals) to help them maintain an appropriate body composition.
Dietary glycine supplementation enhances syntheses of creatine and glutathione by tissues of hybrid striped bass (Morone saxatilis ♀ × Morone chrysops ♂) fed soybean meal-based diets
Authors: He Wenliang , Li Xinyu , Wu Guoyao
Published: May 2024

Background

We recently reported that supplementing glycine to soybean meal-based diets is necessary for the optimum growth of 5- to 40-g (Phase-I) and 110- to 240-g (Phase-II) hybrid striped bass (HSB), as well as their intestinal health. Although glycine serves as an essential substrate for syntheses of creatine and glutathione (GSH) in mammals (e.g., pigs), little is known about these metabolic pathways or their nutritional regulation in fish. This study tested the hypothesis that glycine supplementation enhances the activities of creatine- and GSH-forming enzymes as well as creatine and GSH availabilities in tissues of hybrid striped bass (HSB; Morone saxatilis♀ × Morone chrysops♂).

Methods

Phase-I and Phase-II HSB were fed a soybean meal-based diet supplemented with 0%, 1%, or 2% glycine for 8 weeks. At the end of the 56-d feeding, tissues (liver, intestine, skeletal muscle, kidneys, and pancreas) were collected for biochemical analyses.

Results

In contrast to terrestrial mammals and birds, creatine synthesis occurred primarily in skeletal muscle from all HSB. The liver was most active in GSH synthesis among the HSB tissues studied. In Phase-I HSB, supplementation with 1% or 2% glycine increased (P < 0.05) concentrations of intramuscular creatine (15%–19%) and hepatic GSH (8%–11%), while reducing (P < 0.05) hepatic GSH sulfide (GSSG)/GSH ratios by 14%–15%, compared with the 0-glycine group; there were no differences (P > 0.05) in these variables between the 1% and 2% glycine groups. In Phase-II HSB, supplementation with 1% and 2% glycine increased (P < 0.05) concentrations of creatine and GSH in the muscle (15%–27%) and liver (11%–20%) in a dose-dependent manner, with reduced ratios of hepatic GSSG/GSH in the 1% or 2% glycine group. In all HSB, supplementation with 1% and 2% glycine dose-dependently increased (P < 0.05) activities of intramuscular arginine:glycine amidinotransferase (22%–41%) and hepatic γ-glutamylcysteine synthetase (17%–37%), with elevated activities of intramuscular guanidinoacetate methyltransferase and hepatic GSH synthetase and GSH reductase in the 1% or 2% glycine group. Glycine supplementation also increased (P < 0.05) concentrations of creatine and activities of its synthetic enzymes in tail kidneys and pancreas, and concentrations of GSH and activities of its synthetic enzymes in the proximal intestine.

Conclusions

Skeletal muscle and liver are the major organs for creatine and GSH syntheses in HSB, respectively. Dietary glycine intake regulates creatine and GSH syntheses by both Phase-I and Phase-II HSB in a tissue-specific manner. Based on the metabolic data, glycine is a conditionally essential amino acid for the growing fish.
Single-cell analysis defines highly specific leukemia-induced neutrophils and links MMP8 expression to recruitment of tumor associated neutrophils during FGFR1 driven leukemogenesis
Authors: Hu Tianxiang , Cheng Bo , Matsunaga Atsuko , Zhang Ting , Lu Xiaocui , Fang Hui , Mori Stephanie F. , Fang Xuexiu , Wang Gavin , Xu Hongyan , Shi Huidong , Cowell John K.
Published: May 2024

Background

Leukemias driven by activated, chimeric FGFR1 kinases typically progress to AML which have poor prognosis. Mouse models of this syndrome allow detailed analysis of cellular and molecular changes occurring during leukemogenesis. We have used these models to determine the effects of leukemia development on the immune cell composition in the leukemia microenvironment during leukemia development and progression.

Methods

Single cell RNA sequencing (scRNA-Seq) was used to characterize leukemia associated neutrophils and define gene expression changes in these cells during leukemia progression.

Results

scRNA-Seq revealed six distinct subgroups of neutrophils based on their specific differential gene expression. In response to leukemia development, there is a dramatic increase in only two of the neutrophil subgroups. These two subgroups show specific gene expression signatures consistent with neutrophil precursors which give rise to immature polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs). Analysis of gene expression in these precursor cells identified pathways that were specifically upregulated, the most pronounced of which involved matrix metalloproteinases Mmp8 and Mmp9, during leukemia progression. Pharmacological inhibition of MMPs using Ilomastat preferentially restricted in vitro migration of neutrophils from leukemic mice and led to a significantly improved survival in vivo, accompanied by impaired PMN-MDSC recruitment. As a result, levels of T-cells were proportionally increased. In clinically annotated TCGA databases, MMP8 was shown to act as an independent indicator for poor prognosis and correlated with higher neutrophil infiltration and poor pan-cancer prognosis.

Conclusion

We have defined specific leukemia responsive neutrophil subgroups based on their unique gene expression profile, which appear to be the precursors of neutrophils specifically associated with leukemia progression. An important event during development of these neutrophils is upregulation MMP genes which facilitated mobilization of these precursors from the BM in response to cancer progression, suggesting a possible therapeutic approach to suppress the development of immune tolerance.
Digital media use, depressive symptoms and support for violent radicalization among young Canadians: a latent profile analysis
Authors: Miconi Diana , Santavicca Tara , Frounfelker Rochelle L. , Mounchingam Aoudou Njingouo , Rousseau Cécile
Published: May 2024

Background

Despite the prominent role that digital media play in the lives and mental health of young people as well as in violent radicalization (VR) processes, empirical research aimed to investigate the association between Internet use, depressive symptoms and support for VR among young people is scant. We adopt a person-centered approach to investigate patterns of digital media use and their association with depressive symptoms and support for VR.

Methods

A sample of 2,324 Canadian young people (Mage = 30.10; SDage = 5.44 ; 59% women) responded to an online questionnaire. We used latent profile analysis to identify patterns of digital media use and linear regression to estimate the associations between class membership, depressive symptoms and support for VR.

Results

We identified four classes of individuals with regards to digital media use, named

Average Internet Use/Institutional trust, Average internet use/Undifferentiated Trust, Limited Internet Use/Low Trust and Online Relational and Political Engagement/Social Media Trust. Linear regression indicated that individuals in the Online Relational and Political Engagement/Social Media Trust and Average Internet Use/Institutional trust profiles reported the highest and lowest scores of both depression and support for VR, respectively.

Conclusions

It is essential to tailor prevention and intervention efforts to mitigate risks of VR to the specific needs and experiences of different groups in society, within a socio-ecological perspective. Prevention should consider both strengths and risks of digital media use and simulteaneously target both online and offline experiences and networks, with a focus on the sociopolitical and relational/emotional components of Internet use.
Navigating an unpredictable environment: the moderating role of perceived environmental unpredictability in the effectiveness of ecological resource scarcity information on pro-environmental behavior
Authors: Gu Dian , Jiang Jiang
Published: May 2024

Background

The global issue of ecological resource scarcity, worsened by climate change, necessitates effective methods to promote resource conservation. One commonly used approach is presenting ecological resource scarcity information. However, the effectiveness of this method remains uncertain, particularly in an unpredictable world. This research aims to examine the role of perceived environmental unpredictability in moderating the impact of ecological resource scarcity information on pro-environmental behavior (PEB).

Methods

We conducted three studies to test our hypothesis on moderation. Study 1 (N = 256) measured perceived general environmental unpredictability, perceived resource scarcity and daily PEB frequencies in a cross-sectional survey. Study 2 (N = 107) took it a step further by manipulating resource scarcity. Importantly, to increase ecological validity, Study 3 (N = 135) manipulated the information on both ecological resource scarcity and nature-related environmental unpredictability, and measured real water and paper consumption using a newly developed washing-hands paradigm.

Results

In Study 1, we discovered that perceived resource scarcity positively predicted PEB, but only when individuals perceive the environment as less unpredictable (interaction effect: 95% CI = [-0.09, -0.01], ΔR2 = 0.018). Furthermore, by manipulating scarcity information, Study 2 revealed that only for individuals with lower levels of environmental unpredictability presenting ecological resource scarcity information could decrease forest resource consumption intention (interaction effect: 95%CI = [-0.025, -0.031], ΔR2 = .04). Moreover, Study 3 found that the negative effect of water resource scarcity information on actual water and (interaction effect: 95%CI = [3.037, 22.097], ηp2 = .050) paper saving behaviors (interaction effect: 95%CI = [0.021, 0.275], ηp2 = .040), as well as hypothetical forest resource consumption (interaction effect: 95%CI = [-0.053, 0.849], ηp2 = .023) emerged only for people who receiving weaker environmental unpredictability information.

Conclusion

Across three studies, we provide evidence to support the moderation hypothesis that environmental unpredictability weakens the positive effect of ecological resource scarcity information on PEB, offering important theoretical and practical implications on the optimal use of resource scarcity to enhance PEB.
Community-based participatory-research through co-design: supporting collaboration from all sides of disability
Authors: Benz Cloe , Scott-Jeffs Will , McKercher K. A. , Welsh Mai , Norman Richard , Hendrie Delia , Locantro Matthew , Robinson Suzanne
Published: May 2024

Background

As co-design and community-based participatory research gain traction in health and disability, the challenges and benefits of collaboratively conducting research need to be considered. Current literature supports using co-design to improve service quality and create more satisfactory services. However, while the ‘why’ of using co-design is well understood, there is limited literature on ‘how’ to co-design. We aimed to describe the application of co-design from start to finish within a specific case study and to reflect on the challenges and benefits created by specific process design choices.

Methods

A telepractice re-design project has been a case study example of co-design. The co-design was co-facilitated by an embedded researcher and a peer researcher with lived experience of disability. Embedded in a Western Australian disability organisation, the co-design process included five workshops and a reflection session with a team of 10 lived experience and staff participants (referred to as co-designers) to produce a prototype telepractice model for testing.

Results

The findings are divided into two components. The first describes the process design choices made throughout the co-design implementation case study. This is followed by a reflection on the benefits and challenges resulting from specific process design choices. The reflective process describes the co-designers’ perspective and the researcher’s and organisational experiences. Reflections of the co-designers include balancing idealism and realism, the value of small groups, ensuring accessibility and choice, and learning new skills and gaining new insights. The organisational and research-focused reflections included challenges between time for building relationships and the schedules of academic and organisational decision-making, the messiness of co-design juxtaposed with the processes of ethics applications, and the need for inclusive dissemination of findings.

Conclusions

The authors advocate that co-design is a useful and outcome-generating methodology that proactively enables the inclusion of people with disability and service providers through community-based participatory research and action. Through our experiences, we recommend community-based participatory research, specifically co-design, to generate creative thinking and service design.
Assessment of pulmonary vascular anatomy: comparing augmented reality by holograms versus standard CT images/reconstructions using surgical findings as reference standard
Authors: Petrella Francesco , Rizzo Stefania Maria Rita , Rampinelli Cristiano , Casiraghi Monica , Bagnardi Vincenzo , Frassoni Samuele , Pozzi Silvia , Pappalardo Omar , Pravettoni Gabriella , Spaggiari Lorenzo
Published: May 2024

Background

We compared computed tomography (CT) images and holograms (HG) to assess the number of arteries of the lung lobes undergoing lobectomy and assessed easiness in interpretation by radiologists and thoracic surgeons with both techniques.

Methods

Patients scheduled for lobectomy for lung cancer were prospectively included and underwent CT for staging. A patient-specific three-dimensional model was generated and visualized in an augmented reality setting. One radiologist and one thoracic surgeon evaluated CT images and holograms to count lobar arteries, having as reference standard the number of arteries recorded at surgery. The easiness of vessel identification was graded according to a Likert scale. Wilcoxon signed-rank test and κ statistics were used.

Results

Fifty-two patients were prospectively included. The two doctors detected the same number of arteries in 44/52 images (85%) and in 51/52 holograms (98%). The mean difference between the number of artery branches detected by surgery and CT images was 0.31 ± 0.98, whereas it was 0.09 ± 0.37 between surgery and HGs (p = 0.433). In particular, the mean difference in the number of arteries detected in the upper lobes was 0.67 ± 1.08 between surgery and CT images and 0.17 ± 0.46 between surgery and holograms (p = 0.029). Both radiologist and surgeon showed a higher agreement for holograms (κ = 0.99) than for CT (κ = 0.81) and found holograms easier to evaluate than CTs (p < 0.001).

Conclusions

Augmented reality by holograms is an effective tool for preoperative vascular anatomy assessment of lungs, especially when evaluating the upper lobes, more prone to anatomical variations.

Trial registration

ClinicalTrials.gov, NCT04227444

Relevance statement

Preoperative evaluation of the lung lobe arteries through augmented reality may help the thoracic surgeons to carefully plan a lobectomy, thus contributing to optimize patients’ outcomes.

Key points

• Preoperative assessment of the lung arteries may help surgical planning.

• Lung artery detection by augmented reality was more accurate than that by CT images, particularly for the upper lobes.

• The assessment of the lung arterial vessels was easier by using holograms than CT images.

Graphical Abstract
Volatiles of symbiotic bacterial origin explain ectoparasitism and fledging success of hoopoes
Authors: Mazorra-Alonso Mónica , Peralta-Sánchez Juan Manuel , Martín-Vivaldi Manuel , Martínez-Bueno Manuel , Gómez Rafael Núñez , Soler Juan José
Published: May 2024

Background

Some parasites use olfactory cues to detect their hosts and, since bacterial symbionts are partially responsible for animal odours, they could influence host parasitism. By autoclaving nest materials of hoopoe (Upupa epops) nests before reproduction started, we explored the hypothetical links between host-associated bacteria, volatiles and parasitism. During the nestling stage, we (i) estimated the level of ectoparasitism by chewing lice (Suborder Mallophaga) in adult hoopoe females and by Carnus haemapterus flies in nestlings, and (ii) characterized microbial communities and volatile profiles of nest environments (nest material and nest cavity, respectively) and uropygial secretions.

Results

Experimental nests had less diverse bacterial communities and more diverse volatile profiles than control nests, while occupants experienced lower intensity of parasitism in experimental than in control nests. The experiment also affected beta diversity of the microbial communities of nest material and of the volatiles of the nestling uropygial secretions. Moreover, microbial communities of uropygial secretions and of nest materials covaried with their volatile profiles, while the volatile profile of the bird secretions explained nest volatile profile. Finally, a subset of the volatiles and bacteria detected in the nest material and uropygial secretions were associated with the ectoparasitism intensity of both adult females and nestlings, and with fledging success.

Conclusions

These results show that a component of animal odours is linked with the microbial communities of the host and its reproductive environment, and emphasize that the associations between bacteria, ectoparasitism and reproductive success are partially mediated by volatiles of bacterial origin. Future work should focus on mechanisms underlying the detected patterns.
Immature oocyte proportion in a cohort led to poor embryo development but did not reduce clinical pregnancy rate
Authors: Handayani Nining , Sundari Ayu Mulia , Aprilliana Tri , Boediono Arief , Polim Arie A. , Wiweko Budi , Sirait Batara , Sini Ivan
Published: May 2024

Purpose

This study aimed to evaluate the effects of immature oocyte proportion in a cohort on both IVF laboratory and clinical outcomes.

Materials and methods

This retrospective cohort study took place at Morula IVF Jakarta Clinic from January 2016 to July 2020. A total of 1.826 couples undergoing IVF-ICSI/IMSI were included and classified into four groups according to the proportion of immature oocytes retrieved during OPU as follows: (1) immature ≤ 15% (n = 1.064), (2) immature 16–25% (n = 369), (3) immature 26–50% (n = 331), and (4) immature > 50% (n = 62). Primary outcomes were clinical pregnancy and miscarriage. Embryology laboratory results were assessed as the secondary outcomes. Statistical analyses were carried out utilizing Kruskal–Wallis or chi-square tests. p-value < 0.05 was considered statistically significant.

Results

Increased proportion of immature oocytes in a cohort was significantly associated with body mass index, tubal factors, and estradiol level on trigger day (p < 0.05). Neither clinical pregnancy nor miscarriage was associated with the immature oocyte proportion (adjusted p-value = 0.872 and p = 0.345, respectively). However, a higher proportion of immature oocytes significantly reduced the total number of fertilized oocytes, number of top-quality cleavages, and blastocysts (p < 0.001). Furthermore, embryo transfer cancelation rates due to poor embryo quality were elevated significantly.

Conclusion

Despite overall poor embryo development in the laboratory, our study seems to suggest that the proportion of immature oocytes in a cohort has no impact on clinical pregnancy and miscarriage rate in IVF program.
Heterogeneity and molecular landscape of melanoma: implications for targeted therapy
Authors: Beigi Yasaman Zohrab , Lanjanian Hossein , Fayazi Reyhane , Salimi Mahdieh , Hoseyni Behnaz Haji Molla , Noroozizadeh Mohammad Hafez , Masoudi-Nejad Ali
Published: May 2024

Uveal cancer (UM) offers a complex molecular landscape characterized by substantial heterogeneity, both on the genetic and epigenetic levels. This heterogeneity plays a critical position in shaping the behavior and response to therapy for this uncommon ocular malignancy. Targeted treatments with gene-specific therapeutic molecules may prove useful in overcoming radiation resistance, however, the diverse molecular makeups of UM call for a patient-specific approach in therapy procedures. We need to understand the intricate molecular landscape of UM to develop targeted treatments customized to each patient's specific genetic mutations. One of the promising approaches is using liquid biopsies, such as circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA), for detecting and monitoring the disease at the early stages. These non-invasive methods can help us identify the most effective treatment strategies for each patient. Single-cellular is a brand-new analysis platform that gives treasured insights into diagnosis, prognosis, and remedy. The incorporation of this data with known clinical and genomics information will give a better understanding of the complicated molecular mechanisms that UM diseases exploit. In this review, we focused on the heterogeneity and molecular panorama of UM, and to achieve this goal, the authors conducted an exhaustive literature evaluation spanning 1998 to 2023, using keywords like "uveal melanoma, “heterogeneity”. “Targeted therapies”," "CTCs," and "single-cellular analysis".
Long-term survival after conversion surgery for an esophageal neuroendocrine carcinoma: a case report
Authors: Enjoji Takahiro , Kobayashi Shinichiro , Hayashi Kohei , Tetsuo Hanako , Matsumoto Ryo , Maruya Yasuhiro , Araki Tomonori , Honda Takuya , Akazawa Yuko , Kanetaka Kengo , Nakao Kazuhiko , Eguchi Susumu
Published: May 2024

Background

Esophageal neuroendocrine carcinomas (NECs) are extremely rare. Published information on their clinical features, pathological findings, and prognosis is lacking. The optimal treatment for esophageal NECs has not yet been determined because they appear extremely malignant histologically and have a poor prognosis. We here report on a patient with an esophageal NEC who was successfully treated with multidisciplinary therapies.

Case presentation

The patient, a 47-year-old man, was admitted to our hospital with dysphagia and weight loss and an ECOG performance status of 3–4. Upper endoscopy showed a large circumferential neoplasm at the esophagogastric junction. Computed tomography showed lymph node metastases around the left gastric artery. Echocardiography raised a suspicion of invasion of the left atrium. Histopathological examination of biopsy tissue revealed diffuse proliferation of small atypical cells resembling naked nuclei with extensive necrosis and degeneration. The cells showed positive staining for CD56, chromogranin A, and synaptophysin on immunohistochemical analysis. Ki67 was positive in over 90% of cells. He was diagnosed with an esophageal NEC that had infiltrated the left atrium; his cancer was therefore inoperable. Because of his poor overall condition, palliative radiotherapy (30 Gy in 15 fractions) was administered, accompanied by nutritional management. This was followed by four courses of chemotherapy with carboplatin plus etoposide, after which the primary tumor and locoregional lymph node metastases were found to have shrunk. Thoracoscopic- and laparoscopic-assisted McKeown esophagectomy were performed. The postoperative pathological diagnosis was NEC pT3pN0M0 Stage II. The patient had a good postoperative course and received two courses of postoperative adjuvant chemotherapy (carboplatin plus etoposide). Currently, 3 years after commencing treatment, there is no evidence of recurrence.

Conclusions

As mentioned above, there is no established treatment regime for esophageal NEC, and the benefits of conversion surgery are unknown. Our patient achieved long-term recurrence-free survival after radiation therapy, chemotherapy, and surgery for an esophageal NEC with left atrial invasion and multiple lymph node metastases. Conversion surgery for esophageal NECs that respond to chemotherapy may contribute to long-term survival.
Porosity estimation based on the shear modulus inversion of seismic shear wave
Authors: Dai Fucai , Zhang Feng , Li Xiangyang , Xu Yong
Published: May 2024

Reliable estimation of subsurface porosity is necessary for hydrocarbon reservoir characterization and fluid identification. Porosity estimations from seismic data can provide the lateral distribution of subsurface porosity, but the results may be highly nonunique because subsurface elastic properties (such as velocity and density) can be affected by porosity and pore fluids. Because shear modulus is insensitive to pore fluid content, it can be effectively used to estimate porosity. We develop a novel porosity estimation method using the reflected SH wave (SH-SH wave), whose propagation characteristics depend mainly on shear modulus and S-wave velocity. We derive a new analytical expression for the SH-SH-wave reflection coefficient, which acts as a function of shear modulus and S-wave velocity in its natural logarithm form. This new approximation has high accuracy, and both coefficients corresponding to shear modulus and S-wave velocity are “model-parameter independent”; thus, there is no need for prior estimation of any model parameter during inversion. Numerical analysis indicates that shear modulus inverted from the SH-SH wave has lower uncertainty, the problem is better conditioned, and the method requires data with fewer incidence angles than algorithms that invert for the shear modulus from the PP wave. Furthermore, the highly correlated rock-physics relationships between porosity and shear modulus facilitate accurate porosity estimation. A field data application indicates that high-resolution porosity of fine structures can be reliably recovered using our method.