bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound scoring system for prenatal diagnosis of placenta accreta spectrum
Authors: Zhang Junling , Li Hezhou , Feng Demin , Wu Juan , Wang Zhaoyu , Feng Fan
Published: August 2023

Background

To develop an ultrasound scoring system for placenta accreta spectrum (PAS), evaluate its diagnostic value, and provide a practical approach to prenatal diagnosis of PAS.

Methods

A total of 532 pregnant women (n = 184 no PAS, n = 120 placenta accreta, n = 189 placenta increta, n = 39 placenta percreta) at high-risk for placenta accreta who delivered in the Third Affiliated Hospital of Zhengzhou University between January 2021 and December 2022 underwent prenatal ultrasound to evaluate placental invasion. An ultrasound scoring system that included placental and cervical morphology and history of cesarean section was created. Each feature was assigned a score of 0 ~ 2, according to severity. Thresholds for the total ultrasound score that discriminated between no PAS, placenta accreta, placenta increta, and placenta percreta were calculated.

Results

Univariate and multivariate regression analysis identified seven indicators of PAS that were included in the ultrasound scoring system, including placental location, placental thickness, presence/absence of the retroplacental space, thickness of the retroplacental myometrium, presence/absence of placental lacunae, retroplacental myometrial blood flow and history of cesarean section. Using the final ultrasound scoring system, no PAS is diagnosed at a total score < 5, placenta accreta or placenta increta is diagnosed at a total score 5–10, and placenta percreta is diagnosed at a total score ≥ 10.

Conclusions

This study identified seven indicators of PAS and included them in an ultrasound scoring system that has good diagnostic efficacy and clinical utility.

Trial registration

ChiCTR2300069261 (retrospectively registered on 10/03/2023).
Preliminary psychometric properties of the Chinese version of the structured interview of personality organization (STIPO-CH)
Authors: Wang Yang , Li Zirong , Zhong Jie
Published: August 2023

Background

Kernberg originally proposed the psychoanalytic concept of personality organization (PO), which measures personality pathology from a dimensional approach with multiple scales and can be evaluated using the Structured Interview of Personality Organization (STIPO) from six domains: identity, object relations, primitive defenses, coping vs. rigidity, aggression, and moral values. The present study translated the original version into the Chinese STIPO (STIPO-CH) version and evaluated its reliability and validity.

Methods

The STIPO-CH was administered to 49 non-clinical subjects. They also completed the Chinese version of the Inventory of Personality Organization and the Millon Clinical Multiaxial Inventory to evaluate criterion-related reliability. Interrater reliability was assessed with intraclass correlations. An item analysis was carried out to explore the structure and internal consistency.

Results

Interrater reliability (intraclass correlations) ranged from 0.98 to 0.99. Results suggested acceptable internal consistency for identity and moral values. The correlations between STIPO-CH domains and self-report questionnaires indicated that construct validity and criterion-related validity were acceptable to good.

Conclusions

Overall, this study presents preliminary psychometric properties of STIPO-CH. Limitations regarding the sample, interviewers, and cultural differences are discussed. Future research is highly recommended.
Exploring factors that influence the behavioural intention of medical students to use 3D gastroscopic model to learn how to operate gastroscope using UTAUT Model
Authors: Wei Shuting , Ge Pu , Zhang Jinzi , Xu Shuxian , Wang Yujia , Li Qiyu , Feng Bojunhao , Yu Wenli , Suo Baojun , Zhang Yueyang , Wang Mingxing , Sun Xinying , Song Zhiqiang , Wu Yibo
Published: August 2023

Background

The application of virtual reality (VR) in gastroscopic operation teaching can be safe and effective, but the advantages can be realized only when students accept and use it. This study aims to identify the factors influencing Chinese clinical medical postgraduates on their intention to use the 3D gastroscopic model constructed based on VR technology using Unified Theory of Acceptance and Use of Technology (UTAUT) model. Students’ demographic factors are also taken into consideration.

Methods

All methods were carried out in accordance with relevant guidelines. Data were collected from clinical medical postgraduates students in China using stratified sampling. A total of 292 questionnaires including valid responses were used in this study. Data were processed using Amos 24.0 and SPSS 26.0 software and the statistical analysis technique was based on structural equation modeling (SEM).

Results

The results showed that different from the mediator of home location and year of clinical learning, mediator of gender, university kind and graduate degree did not affect the behavioral intention. In addition, performance expectancy, facilitating condition, and social influence directly and indirectly have effect on behavioral intention. Also, the significance between social influence and performance expectancy, social influence and effort expectancy were verified.

Conclusions

This study manifested that the proposed framework based on the UTAUT had explanatory power to identify the factors influencing the students’ behavioral intention to use the 3D gastroscopic model constructed based on VR technology. Whereas, an important variable of effort expectancy in the frame of the SEM were not certified, thereby indicating that particular attention should be paid to this variable by universities and teachers before applying 3D gastroscopic model constructed based on VR technology in teaching. Added preparatory work is required such as explaining the basic knowledge of the operating steps of VR model and make students adequately understand its accessibility, which can probably improve the intentions of them to use it. The positive effects of social influence on performance expectancy and effort expectancy we proposed was also verified in this study, which provided a direction for future research.
A scale for measuring home-based cardiac rehabilitation exercise adherence: a development and validation study
Authors: Yang Zhen , Sun Yuanhui , Wang Huan , Zhang Chunqi , Wang Aiping
Published: August 2023

Background

The benefits of home-based cardiac rehabilitation exercise are well-established and depend on long-term adherence. However, there is no uniform and recognized cardiac rehabilitation criterion to assess home-based cardiac rehabilitation exercise adherence for patients with cardiovascular disease. This study aimed to develop a home-based cardiac rehabilitation exercise adherence scale and to validate its psychometric properties among patients with chronic heart failure.

Methods

The dimensions and items of the scale were created based on grounded theory research, literature content analysis, and defined by a Delphi survey. Item analysis was completed to assess the discrimination and homogeneity of the scale. Factor analysis was adopted to explore and validate the underlying factor structure of the scale. Content validity and calibration validity were evaluated using the Delphi survey and correlation analysis, respectively. Reliability was evaluated by Cronbach’s α coefficients, split-half reliability coefficients, and test-retest reliability coefficients.

Results

A scale covering four dimensions and 20 items was developed for evaluating home-based cardiac rehabilitation exercise adherence. The content validity index of the scale was 0.986. In exploratory factor analysis, a four-factor structure model was confirmed, explaining 75.1% of the total variation. In confirmatory factor analysis, the four-factor structure was supported by the appropriate fitting indexes. Calibration validity of the scale was 0.726. In terms of reliability, the Cronbach’s α coefficient of the scale was 0.894, and the Cronbach’s α coefficients of dimensions ranged from 0.848 to 0.914. The split-half reliability coefficient of the scale was 0.695. The test-retest reliability coefficient of the scale was 0.745.

Conclusion

In this study, a home-based cardiac rehabilitation exercise adherence scale was developed and its appropriate psychometric properties were confirmed.
Decolonizing global health: an agenda for research
Authors: Zakumumpa Henry , Diop Nafissatou , Alhassan Robert Kaba
Published: August 2023

This editorial outlines the background to the BMC Health Services Research collection on decolonizing global health. The discourse on decolonizing global health is gaining increasing momentum. These persistent ‘voices’ have coalesced into a ‘movement’. Several commentators have critiqued the way global health continues to be structured and practiced. The colonial roots of global health dominance have come under an unprecedentedly intense spotlight amid pressure for reform.
The rise of resilient healthcare research during COVID-19: scoping review of empirical research
Authors: Ellis Louise A , Saba Maree , Long Janet C , Lyng Hilda Bø , Haraldseid-Driftland Cecilie , Churruca Kate , Wiig Siri , Austin Elizabeth , Clay-Williams Robyn , Carrigan Ann , Braithwaite Jeffrey
Published: August 2023

Background

The COVID-19 pandemic has presented many multi-faceted challenges to the maintenance of service quality and safety, highlighting the need for resilient and responsive healthcare systems more than ever before. This review examined empirical investigations of Resilient Health Care (RHC) in response to the COVID-19 pandemic with the aim to: identify key areas of research; synthesise findings on capacities that develop RHC across system levels (micro, meso, macro); and identify reported adverse consequences of the effort of maintaining system performance on system agents (healthcare workers, patients).

Methods

Three academic databases were searched (Medline, EMBASE, Scopus) from 1st January 2020 to 30th August 2022 using keywords pertaining to: systems resilience and related concepts; healthcare and healthcare settings; and COVID-19. Capacities that developed and enhanced systems resilience were synthesised using a hybrid inductive-deductive thematic analysis.

Results

Fifty publications were included in this review. Consistent with previous research, studies from high-income countries and the use of qualitative methods within the context of hospitals, dominated the included studies. However, promising developments have been made, with an emergence of studies conducted at the macro-system level, including the development of quantitative tools and indicator-based modelling approaches, and the increased involvement of low- and middle-income countries in research (LMIC). Concordant with previous research, eight key resilience capacities were identified that can support, develop or enhance resilient performance, namely: structure, alignment, coordination, learning, involvement, risk awareness, leadership, and communication. The need for healthcare workers to constantly learn and make adaptations, however, had potentially adverse physical and emotional consequences for healthcare workers, in addition to adverse effects on routine patient care.

Conclusions

This review identified an upsurge in new empirical studies on health system resilience associated with COVID-19. The pandemic provided a unique opportunity to examine RHC in practice, and uncovered emerging new evidence on RHC theory and system factors that contribute to resilient performance at micro, meso and macro levels. These findings will enable leaders and other stakeholders to strengthen health system resilience when responding to future challenges and unexpected events.
Performing up to Nordic principles? Geographic and socioeconomic equity in ambulatory care sensitive conditions among older adults in capital areas of Denmark, Finland and Sweden in 2000–2015
Authors: Satokangas Markku , Arffman Martti , Agerholm Janne , Thielen Karsten , Hougaard Charlotte Ørsted , Andersen Ingelise , Burström Bo , Keskimäki Ilmo
Published: August 2023

Background

Denmark, Finland and Sweden pursue equity in health for their citizens through universal health care. However, it is unclear if these services reach the older adult population equally across different socioeconomic positions or living areas. Thus, we assessed geographic and socioeconomic equity in primary health care (PHC) performance among the older adults in the capital areas of Denmark (Copenhagen), Finland (Helsinki) and Sweden (Stockholm) in 2000–2015. Hospitalisations for ambulatory care sensitive conditions (ACSC) were applied as a proxy for PHC performance.

Methods

We acquired individual level ACSCs for those aged ≥ 45 in 2000–2015 from national hospitalisation registers. To identify whether the disparities varied by age, we applied three age groups (those aged 45–64, 65–75 and ≥ 75). Socioeconomic disparities in ACSCs were described with incidence rate ratios (IRR) and annual rates by education, income and living-alone; and then analysed with biennial concentration indices by income. Geographic disparities were described with biennial ACSC rates by small areas and analysed with two-level Poisson multilevel models. These models provided small area estimates of IRRs of ACSCs in 2000 and their slopes for development over time, between which Pearson correlations were calculated within each capital area. Finally, these models were adjusted for income to distinguish between geographic and socioeconomic disparities.

Results

Copenhagen had the highest IRR of ACSCs among those aged 45–64, and Helsinki among those aged ≥ 75. Over time IRRs decreased among those aged ≥ 45, but only in Helsinki among those aged ≥ 75. All concentration indices slightly favoured the affluent population but in Stockholm were mainly non-significant. Among those aged ≥ 75, Pearson correlations were low in Copenhagen (-0.14; p = 0.424) but high in both Helsinki (-0.74; < 0.001) and Stockholm (-0.62; < 0.001) – with only little change when adjusted for income. Among those aged ≥ 45 the respective correlations were rather similar, except for a strong correlation in Copenhagen (-0.51, 0.001) after income adjustment.

Conclusions

While socioeconomic disparities in PHC performance persisted among older adults in the three Nordic capital areas, geographic disparities narrowed in both Helsinki and Stockholm but persisted in Copenhagen. Our findings suggest that the Danish PHC incorporated the negative effects of socio-economic segregation to a lesser degree.
Novel risk model based on angiogenesis-related lncRNAs for prognosis prediction of hepatocellular carcinoma
Authors: Xie Shicheng , Zhong Jinwei , Zhang Zhongjing , Huang Weiguo , Lin Xiaoben , Pan Yating , Kong Xiuyan , Xia Hongping , Yu Zhijie , Ni Haizhen , Xia Jinglin
Published: August 2023

Hepatocellular carcinoma (HCC) is a major cause of cancer-related death due to early metastasis or recurrence. Tumor angiogenesis plays an essential role in the tumorigenesis of HCC. Accumulated studies have validated the crucial role of lncRNAs in tumor angiogenesis. Here, we established an angiogenesis-related multi-lncRNAs risk model based on the machine learning for HCC prognosis prediction. Firstly, a total of 348 differential expression angiogenesis-related lncRNAs were identified by correlation analysis. Then, 20 of these lncRNAs were selected through univariate cox analysis and used for in-depth study of machine learning. After 1,000 random sampling cycles calculating by random forest algorithm, four lncRNAs were found to be highly associated with HCC prognosis, namely LUCAT1, AC010761.1, AC006504.7 and MIR210HG. Subsequently, the results from both the training and validation sets revealed that the four lncRNAs-based risk model was suitable for predicting HCC recurrence. Moreover, the infiltration of macrophages and CD8 T cells were shown to be closely associated with risk score and promotion of immune escape. The reliability of this model was validated by exploring the biological functions of lncRNA MIR210HG in HCC cells. The results showed that MIR210HG silence inhibited HCC growth and migration through upregulating PFKFB4 and SPAG4. Taken together, this angiogenesis-related risk model could serve as a reliable and promising tool to predict the prognosis of HCC.
Inequity of maternal-child health services in ASEAN member states from 1993 to 2021
Authors: Feng Yikai , Maimaitiming Mailikezhati , Shi Junyi , Wang Minmin , Li Na , Jin Yinzi , Zheng Zhi-Jie
Published: August 2023

Introduction

Inequity in maternal-child health services is a challenge to global health as it hinders the achievement of Sustainable Development Goals (SDGs) and Universal Health Coverage. Though the Association of Southeast Asian Nations (ASEAN) has made remarkable achievements in maternal-child health, there remain gaps in reaching global goals. This study aimed to compare and investigate the inequity in maternal-child health (MCH) services in ASEAN member states to help guide policy decisions to improve equitable health services in the SDG era and beyond.

Methods

Using the WHO Health Inequality Monitor, we identified inequity summary measures for five MCH services in ASEAN member states from 1993 to 2021: antenatal care, births attended by skilled health personnel, diphtheria, tetanus and pertussis (DTP3) immunization, measles immunization, and polio immunization. We divided the analysis dimension of inequity into urban–rural inequity, economic status inequity, and sub-regional inequity. Trends of absolute and relative inequity in every dimension of MCH services in ASEAN member states were examined with the principal component analysis (PCA).

Results

The mean coverages of MCH services are 98.80% (Thailand), 86.72% (Cambodia), 84.54% (Viet Nam), 78.52 (Indonesia), 76.94% (Timor-Leste), 72.40% (Lao PDR), 68.10% (Philippines) and 48.52% (Myanmar) in 2021. Thailand have the lowest MCH services absolute inequity indexes of -1.945, followed by Vietnam (-1.449). Lao PDR and Myanmar have relatively higher MCH services absolute inequity indexes of 0.852 and 0.054 respectively. The service in Cambodia, Indonesia, and the Philippines is pro-specific regions (with subnational region absolute inequity indexes of -0.02, 0.01, and 1.01 respectively). The service in Myanmar is pro-rich (with economic status absolute inequity index of 0.43). The service in Lao PDR and Timor-Leste is pro-urban areas, pro-rich, and pro-specific regions.

Conclusion

The inequity of MCH services in ASEAN persists but is in a declining trend. Thailand and Vietnam have performed well in ensuring MCH services equity, while Laos and Myanmar are still facing serious inequity dilemmas. The progress of MCH service equity in Myanmar, Cambodia, the Philippines, and Indonesia is uneven. It is acceptable to learn from the successful experiences of Thailand and Vietnam to improve the equities in other ASEAN countries. Policies should be developed according to the specific types of MCH inequity in member states to improve equity levels.
Prevalence, antimicrobial resistance, and enterotoxin gene profiles of Staphylococcus aureus isolated from mobile phones of the food vendors in Phayao province, Thailand
Authors: Khoothiam Krissana , Prapasawat Watsawan , Yosboonruang Atchariya , Rawangkan Anchalee , Phuangsri Chorpaka , Rupprom Kitwadee , Kraivuttinun Parinya , Tanomsridachchai Wimonrat , Suthienkul Orasa , Siriphap Achiraya
Published: August 2023

Background

Mobile phones are widely used and may cause bacterial pathogens to spread among various professionals. Staphylococcus aureus from the mobile phones can contaminate the hands of food vendors and food during the cooking or packaging process. This research aimed to determine the prevalence, enterotoxin genes, and antimicrobial resistance (AMR) profiles of S. aureus contaminating the vendors’ mobile phones.

Methods

In this study, 266 mobile phone samples were randomly collected from food vendors selling food on walking streets (n = 139) and in food centers (n = 127) in Phayao province. All samples were identified as S. aureus by the conventional culture method and confirmed species-specific gene by polymerase chain reaction (PCR). Then, all identified S. aureus isolates were tested for antimicrobial susceptibility by broth microdilution method and for the presence of staphylococcal enterotoxin (SE) genes by PCR.

Results

The results showed that 12.8% of the mobile phones collected were contaminated with S. aureus. Of 49 S. aureus isolates obtained, 30 (61.2%) were positive for SE genes. The most common SE gene was sea followed by sec, seb, sem, seq, and sel. Moreover, S. aureus was most frequently resistant to penicillin, followed by chloramphenicol and tetracycline, erythromycin, clindamycin, and gentamicin. Methicillin-resistant S. aureus (MRSA), vancomycin-resistant S. aureus (VRSA), and multidrug-resistant (MDR) strains were also detected.

Conclusions

This study showed that mobile phones were an intermediate surface for the transmission of S. aureus, including MDR variants. It indicates that hand hygiene and the decontamination of mobile phones are essential to prevent cross-contamination of S. aureus in food settings.
Pan-American Guidelines for the treatment of SARS-CoV-2/COVID-19: a joint evidence-based guideline of the Brazilian Society of Infectious Diseases (SBI) and the Pan-American Association of Infectious Diseases (API)
Authors: Barbosa Alexandre Naime , Chebabo Alberto , Starling Carlos , Pérez Clevy , Cunha Clóvis Arns , de Luna David , Nunes Estevão Portela , Zambrano Gabriela , Ferreira Juliana Carvalho , Croda Julio , Falavigna Maicon , Gomes-da-Silva Monica Maria , Thormann Monica , Cimerman Sergio , Parahiba Suena Medeiros , Tanni Suzana , Bernardo Wanderley Marques , Rodriguez-Morales Alfonso J.
Published: August 2023

Background

Since the beginning of the COVID-19 pandemic, therapeutic options for treating COVID-19 have been investigated at different stages of clinical manifestations. Considering the particular impact of COVID-19 in the Americas, this document aims to present recommendations for the pharmacological treatment of COVID-19 specific to this population.

Methods

Fifteen experts, members of the Brazilian Society of Infectious Diseases (SBI) and the Pan-American Association of Infectious Diseases (API) make up the panel responsible for developing this guideline. Questions were formulated regarding prophylaxis and treatment of COVID-19 in outpatient and inpatient settings. The outcomes considered in decision-making were mortality, hospitalisation, need for mechanical ventilation, symptomatic COVID-19 episodes, and adverse events. In addition, a systematic review of randomised controlled trials was conducted. The quality of evidence assessment and guideline development process followed the GRADE system.

Results

Nine technologies were evaluated, and ten recommendations were made, including the use of tixagevimab + cilgavimab in the prophylaxis of COVID-19, tixagevimab + cilgavimab, molnupiravir, nirmatrelvir + ritonavir, and remdesivir in the treatment of outpatients, and remdesivir, baricitinib, and tocilizumab in the treatment of hospitalised patients with severe COVID-19. The use of hydroxychloroquine or chloroquine and ivermectin was discouraged.

Conclusion

This guideline provides recommendations for treating patients in the Americas following the principles of evidence-based medicine. The recommendations present a set of drugs that have proven effective in the prophylaxis and treatment of COVID-19, emphasising the strong recommendation for the use of nirmatrelvir/ritonavir in outpatients as the lack of benefit from the use of hydroxychloroquine and ivermectin.
The East Asian-specific LPL p.Ala288Thr (c.862G > A) missense variant exerts a mild effect on protein function
Authors: Hu Yuepeng , Zhang Guofu , Yang Qi , Pu Na , Li Kaiwei , Li Baiqiang , Cooper David N. , Tong Zhihui , Li Weiqin , Chen Jian-Min
Published: August 2023

Background

Lipoprotein lipase (LPL) is the key enzyme responsible for the hydrolysis of triglycerides. Loss-of-function variants in the LPL gene are associated with hypertriglyceridemia (HTG) and HTG-related diseases. Unlike nonsense, frameshift and canonical GT-AG splice site variants, a pathogenic role for clinically identified LPL missense variants should generally be confirmed by functional analysis. Herein, we describe the clinical and functional analysis of a rare LPL missense variant.

Methods

Chinese patients with HTG-associated acute pancreatitis (HTG-AP) were screened for rare nonsense, frameshift, missense or canonical GT-AG splice site variants in LPL and four other lipid metabolism-related genes (APOC2, APOA5, GPIHBP1 and LMF1) by Sanger sequencing. The functional consequences of the LPL missense variant of interest were characterized by in vitro expression in HEK-293T and COS-7 cells followed by Western blot and LPL activity assays.

Results

Five unrelated HTG-AP patients were found to be heterozygous for a rare East Asian-specific LPL missense variant, c.862G > A (p.Ala288Thr). All five patients were adult males, and all were overweight and had a long history of alcohol consumption. Transfection of LPL wild-type and c.862G > A expression vectors into two cell lines followed by Western blot analysis served to exclude the possibility that the p.Ala288Thr missense variant either impaired protein synthesis or increased protein degradation. Contrary to a previous functional study that claimed that p.Ala288Thr had a severe impact on LPL function (reportedly having 36% normal activity), our experiments consistently demonstrated that the variant had a comparatively mild effect on LPL functional activity, which was mediated through its impact upon LPL protein secretion (~ 20% reduced secretion compared to wild-type).

Conclusions

In this study, we identified the East Asian-specific LPL c.862G > A (p.Ala288Thr) missense variant in five unrelated HTG-AP patients. We demonstrated that this variant exerted only a relatively mild effect on LPL function in two cell lines. Heterozygosity for this LPL variant may have combined with alcohol consumption to trigger HTG-AP in these patients.
Generation of a recombinant Saffold Virus expressing UnaG as a marker for the visualization of viral infection
Authors: Okuwa Takako , Himeda Toshiki , Utani Koichi , Higuchi Masaya
Published: August 2023

Background

Saffold virus (SAFV), which belongs to the genus Cardiovirus of the family Picornaviridae, is associated with acute respiratory or gastrointestinal illnesses in children; it is also suspected to cause severe diseases, such as acute flaccid paralysis and aseptic meningitis. However, the understanding of the mechanism of its pathogenicity is still limited due to the many unknowns about its lifecycle; for example, the cellular receptor for its infection remains to be determined. A system to monitor SAFV infection in vitro and in vivo is required in order to accelerate research on SAFV.

Results

We generated a recombinant SAFV expressing green fluorescent protein (GFP) or UnaG, a novel fluorescent protein derived from Japanese eel. HeLa cells infected by either GFP or UnaG-expressing SAFV showed a bright green fluorescent signal, enabling convenient monitoring of SAFV infection. However, the expression of GFP but not UnaG was quickly lost during virus passaging due to the difference in genetic stability in the SAFV virus genome; the UnaG gene was stably maintained in the virus genome after at least five passages.

Conclusions

SAFV infection of cultured cells can easily be monitored using UnaG-expressing SAFV, which is superior to GFP in terms of genetic stability in the virus genome. This virus could be a useful tool for SAFV research, such as comparing the susceptibility of various cells to SAFV infection and evaluating the effects of antivirals on SAFV infection in high-throughput screening.
Collision tumor of a papillary and follicular thyroid carcinoma: a case report
Authors: Kawasaki Kanako , Kai Keita , Tanaka Nariyuki , Kido Shinichi , Ibi Arisa , Minesaki Akimichi , Yamauchi Moriyasu , Kuratomi Yuichiro , Aishima Shinichi , Nakashima Masahiro , Ito Masahiro
Published: August 2023

Background

Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) are common differentiated thyroid cancers, but the detection of a collision tumor is an extremely rare event.

Case presentation

The patient was a 69-year-old Japanese female with multiple cervical lymph node swellings and a thyroid tumor. Preoperative fine needle aspiration cytology of the enlarged lymph node revealed a cytological diagnosis of papillary thyroid carcinoma (PTC). A total thyroidectomy, right cervical dissection and paratracheal dissection were performed. Histopathological and immunohistochemical analyses of resected specimens revealed a collision tumor of PTC and FTC. Multiple metastases of papillary carcinoma were found in the dissected lymph nodes. In the PTC lesion, IHC for BRAF (V600E) was positive but negative for the FTC lesion. Genetic analyses further revealed a TERT promoter C228T mutation in PTC and a NRAS codon 61 mutation in FTC. The patient died of recurrent cancer 8 months after surgery.

Conclusions

A case of a collision tumor of PTC and FTC is very rare, and even fewer cases have been subjected to genetic scrutiny. The present case was successfully diagnosed by pathological examination using immunohistochemical and genetic analyses. The TERT promoter mutation in the PTC lesion was consistent with the aggressive behavior of the cancer.
The forgotten cohort-lessons learned from prehospital trauma death: a retrospective cohort study
Authors: Jakob Dominik A. , Müller Martin , Jud Sebastian , Albrecht Roland , Hautz Wolf , Pietsch Urs
Published: August 2023

Background

Trauma related deaths remain a relevant public health problem, in particular in the younger male population. A significant number of these deaths occur prehospitally without transfer to a hospital. These patients, sometimes termed “the forgotten cohort”, are usually not included in clinical registries, resulting in a lack of information about prehospitally trauma deaths. The aim of the present study was to compare patients who died prehospital with those who sustained life-threatening injuries in order to analyze and potentially improve prehospital strategies.

Methods

This cohort study included all primary operations carried out by Switzerland's largest helicopter emergency medical service (HEMS) between January 1, 2011, and December 31, 2021. We included all adult trauma patients with life-threatening or fatal conditions. The outcome of this study is the vital status of the patient at the end of mission, i.e. fatal or life-threatening. Injury, rescue characteristics, and interventions of the forgotten trauma cohort, defined as patients with a fatal injury (NACA score of VII), were compared with life-threatening injuries (NACA score V and VI).

Results

Of 110,331 HEMS missions, 5534 primary operations were finally analyzed, including 5191 (93.8%) life-threatening and 343 (6.2%) fatal injuries. More than two-thirds of patients (n = 3772, 68.2%) had a traumatic brain injury without a significant difference between the two groups (p > 0.05). Thoracic trauma (44.6% vs. 28.7%,p < 0.001) and abdominal trauma (22.2% vs. 16.1%,p = 0.004) were more frequent in fatal missions whereas pelvic trauma was similar between the two groups (13.4% vs. 12.9%,p = 0.788). Pneumothorax decompression rate (17.2% vs. 3.7%,p < 0.001) was higher in the forgotten cohort group and measures for bleeding control (15.2% vs. 42.7%,p < 0.001) and pelvic belt application (2.9% vs. 13.1%p < 0.001) were more common in the life-threating injury group.

Conclusion

Chest decompression rates and measures for early hemorrhage control are areas for potential improvement in prehospital care.
Synthesis, DFT and molecular docking of novel (Z)-4-bromo-N-(4-butyl-3 (quinolin-3-yl)thiazol-2(3H)-ylidene)benzamide as elastase inhibitor
Authors: Mustafa Muhammad Naeem , Channar Pervaiz Ali , Ejaz Syeda Abida , Afzal Saira , Aziz Mubashir , Shamim Tahira , Saeed Aamer , Alsfouk Aisha A. , Ujan Rabail , Abbas Qamar , Hökelek Tuncer
Published: August 2023

A new compound, C23H20BrN3OS, containing a quinoline-based iminothiazoline with a thiazoline ring, was synthesized and its crystal and molecular structures were analyzed through single crystal X-ray analysis. The compound belongs to the triclinic systemP − 1 space group, with dimensions of a = 9.2304 (6) Å, b = 11.1780 (8) Å, c = 11.3006 (6) Å, α = 107.146 (5)°, β = 93.701 (5)°, γ = 110.435 (6)°, Z = 2 and V = 1025.61 (12) Å3. The crystal structure showed that C–H···N and C–H···O hydrogen bond linkages, forming infinite double chains along the b-axis direction, and enclosing R22(14) and R22(16) ring motifs. The Hirshfeld surface analysis revealed that H…H (44.1%) and H…C/C…H (15.3%) interactions made the most significant contribution. The newly synthesized (Z)-4-bromo-N-(4-butyl-3 (quinolin-3-yl)thiazol-2(3H)-ylidene)benzamide, in comparison to oleanolic acid, exhibited more strong potential against elastase with an inhibition value of 1.21 µM. Additionally, the derivative was evaluated using molecular docking and molecular dynamics simulation studies, which showed that the quinoline based iminothiazoline derivative has the potential to be a novel inhibitor of elastase enzyme. Both theoretical and experimental findings suggested that this compound could have a number of biological activities.
Expression of hes, iha, and tpsA codified in locus of adhesion and autoaggregation and their involvement in the capability of shiga toxin-producing Escherichia coli strains to adhere to epithelial cells
Authors: Colello Rocío , Vélez M. Victoria , Farias M. Victoria Nieto , Rodríguez Marcelo , Montero David , Vidal Roberto , Etcheverría Analía I. , Padola Nora Lía
Published: August 2023

Objectives

Shiga toxin-producing Escherichia coli strains LAA-positive are important cause of human infection. The capability to adhere to epithelial cells is a key virulence trait, and genes codified in LAA pathogenicity island could be involved in the adhesion during the pathogenesis of LAA-positive STEC strains. Thus, our objectives were to compare hes-negative and hes-positive STEC strains in their adherence capability to epithelial cells (HEp-2) and to evaluate the expression levels of the hes, iha, and tpsA in the bacteria adhered and non-adhered to HEp-2 cells. These genes are encoded in LAA, and are virulence factors that participate in adhesion and autoaggregation.

Results

We could not observe differences between the adhesion of strains but also in the expression level of of hes, iha, and tpsA. Genes encoded in LAA contribute to the adhesion phenotype though the expression of STEC adhesins is a coordinated event that depends not only the strain but also on the environment as well as its genetic background. Therefore, the results of this study suggest that LAA ,the most prevalent PAI among LEE-negative STEC strains, plays a role in pathogenesis.
Global effects of identity and aging on the human sperm methylome
Authors: de Sena Brandine Guilherme , Aston Kenneth I. , Jenkins Timothy G. , Smith Andrew D.
Published: August 2023

Background

As the average age of fatherhood increases worldwide, so too does the need for understanding effects of aging in male germline cells. Molecular change, including epigenomic alterations, may impact offspring. Age-associated change to DNA cytosine methylation in the cytosine–guanine (CpG) context is a hallmark of aging tissues, including sperm. Prior studies have led to accurate models that predict a man’s age based on specific methylation features in the DNA of sperm, but the relationship between aging and global DNA methylation in sperm remains opaque. Further clarification requires a more complete survey of the methylome with assessment of variability within and between individuals.

Results

We collected sperm methylome data in a longitudinal study of ten healthy fertile men. We used whole-genome bisulfite sequencing of samples collected 10 to 18 years apart from each donor. We found that, overall, variability between donors far exceeds age-associated variation. After controlling for donor identity, we see significant age-dependent genome-wide change to the methylome. Notably, trends of change with age depend on genomic location or annotation, with contrasting signatures that correlate with gene density and proximity to centromeres and promoter regions.

Conclusions

We uncovered epigenetic signatures that reflect a stable process which begins in early adulthood, progressing steadily through most of the male lifespan, and warrants consideration in any future study of the aging sperm epigenome.
Improving the classification of cardinality phenotypes using collections
Authors: Alghamdi Sarah M. , Hoehndorf Robert
Published: August 2023

Motivation

Phenotypes are observable characteristics of an organism and they can be highly variable. Information about phenotypes is collected in a clinical context to characterize disease, and is also collected in model organisms and stored in model organism databases where they are used to understand gene functions. Phenotype data is also used in computational data analysis and machine learning methods to provide novel insights into disease mechanisms and support personalized diagnosis of disease. For mammalian organisms and in a clinical context, ontologies such as the Human Phenotype Ontology and the Mammalian Phenotype Ontology are widely used to formally and precisely describe phenotypes. We specifically analyze axioms pertaining to phenotypes of collections of entities within a body, and we find that some of the axioms in phenotype ontologies lead to inferences that may not accurately reflect the underlying biological phenomena.

Results

We reformulate the phenotypes of collections of entities using an ontological theory of collections. By reformulating phenotypes of collections in phenotypes ontologies, we avoid potentially incorrect inferences pertaining to the cardinality of these collections. We apply our method to two phenotype ontologies and show that the reformulation not only removes some problematic inferences but also quantitatively improves biological data analysis.
Intention to use maternal waiting home and its predictors among pregnant women in Ethiopia: systematic review and meta-analysis
Authors: Gebeyehu Natnael Atnafu , Assefa Yibeltal , Abebe Kelemu
Published: August 2023

Background

A high maternal death rate is a result of maternal delays in seeking emergency obstetric care, particularly in countries with limited resources like Ethiopia. Utilizing maternity waiting homes is a strategy to overcome geographical barriers and improve maternal and neonatal health outcomes. Pregnant women must intend to use this service in addition to it being available. Therefore, the goal of this study was to assess pregnant women's intentions to use maternity waiting homes and associated characteristics.

Methods

PubMed, Google Scholar, Scopus, Science Direct, and online institutional repository homes were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's, and Egger's tests. To look for heterogeneity,I2was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by study region, sample size, and publication. The pooled odds ratio for associated factors was also computed.

Results

Out of 258 articles assessed, 8 studies with 4111 study participants met the criteria and were included in this study. The pooled prevalence of intention to use maternity waiting home was 52.25% (95% CI 45.88–58.66),I2 = 93.8%). Amhara region had a higher intention to use maternal waiting for home prevalence (63.5%), per subgroup analysis. In studies with sample sizes higher than 5000, the usage of maternity waiting homes was less prevalent (45.2%). Between published research (52.9%) and unpublished studies (51.3%), there was no appreciable difference in the intention to use a maternity waiting home. Experience of maternity waiting home (AOR = 3.337; 95% CI 2.038–5.463), direct subjective norm (AOR = 2.763; 95% CI 1.395–5.471), and direct perceived behavioral control (AOR = 23.147; 95% CI 2.341–4.231).

Conclusion

In Ethiopia, the intention to use maternity waiting was low. There was an intentional variation in to use of maternity waiting homes across regions of Ethiopia. Improving behavioral perception through intervention programs such as antenatal education should have been strengthened.
Linking fine-scale behaviour to the hydraulic environment shows behavioural responses in riverine fish
Authors: Elings J. , Mawer R. , Bruneel S. , Pauwels I. S. , Pickholtz E. , Pickholtz R. , Coeck J. , Schneider M. , Goethals P.
Published: August 2023

Background

Fish migration has severely been impacted by dam construction. Through the disruption of fish migration routes, freshwater fish communities have seen an incredible decline. Fishways, which have been constructed to mitigate the problem, have been shown to underperform. This is in part due to fish navigation still being largely misunderstood. Recent developments in tracking technology and modelling make it possible today to track (aquatic) animals at very fine spatial (down to one meter) and temporal (down to every second) scales. Hidden Markov models are appropriate models to analyse behavioural states at these fine scales. In this study we link fine-scale tracking data of barbel (Barbus barbus) and grayling (Thymallus thymallus) to a fine-scale hydrodynamic model. With a HMM we analyse the fish’s behavioural switches to understand their movement and navigation behaviour near a barrier and fishway outflow in the Iller river in Southern Germany.

Methods

Fish were tracked with acoustic telemetry as they approached a hydropower facility and were presented with a fishway. Tracking resulted in fish tracks with variable intervals between subsequent fish positions. This variability stems from both a variable interval between tag emissions and missing detections within a track. After track regularisation hidden Markov models were fitted using different parameters. The tested parameters are step length, straightness index calculated over a 3-min moving window, and straightness index calculated over a 10-min window. The best performing model (based on a selection by AIC) was then expanded by allowing flow velocity and spatial velocity gradient to affect the transition matrix between behavioural states.

Results

In this study it was found that using step length to identify behavioural states with hidden Markov models underperformed when compared to models constructed using straightness index. Of the two different straightness indices assessed, the index calculated over a 10-min moving window performed better. Linking behavioural states to the ecohydraulic environment showed an effect of the spatial velocity gradient on behavioural switches. On the contrary, flow velocity did not show an effect on the behavioural transition matrix.

Conclusions

We found that behavioural switches were affected by the spatial velocity gradient caused by the attraction flow coming from the fishway. Insight into fish navigation and fish reactions to the ecohydraulic environment can aid in the construction of fishways and improve overall fishway efficiencies, thereby helping to mitigate the effects migration barriers have on the aquatic ecosystem.
A detection method for the ridge beast based on improved YOLOv3 algorithm
Authors: Hou Miaole , Hao Wuchen , Dong Youqiang , Ji Yuhang
Published: August 2023

The ridge beast is a beast placed on the ridge of the roof of ancient Chinese buildings, not only has a decorative function, and has a strict hierarchical meaning, the number and form of the ridge beast placed on different levels of buildings are strictly limited. The detection technology of ridge beast decorative parts has important application value in the fields of fine 3D reconstruction of ancient buildings, historical dating and cultural and tourism services. Aiming at the problem of poor detection performance of traditional detection algorithms due to high texture similarity and poor discrimination of ridge beast, this paper proposed an improved YOLOv3 based detection algorithm for ridge beast decorative pieces. In terms of basic network improvement, local features are aggregated to the deep separable convolution internal embedding summation layer, and point convolution is used to connect the channel information of original features and aggregated features, so as to expand the receptive field and learn more diverse features. The residual structure of the feature extraction network was constructed by using the convolution, and the extraction effect of the model on the fine-grained features of the ridge beast was optimized, so that the detection accuracy was improved. In the prediction head improvement of the model, the original linear structure was reconstructed, and the extrusion and excitation modules were introduced to model the channel relationship of multi-scale feature map, which suppressed the response of interference signals and made the feature more directivity. The parallel 1 × 1 and 3 × 3 convolution are used to construct a multi-size convolution structure, which enhances the semantic information extraction ability of the model and further improves the detection effect. Experiments were conducted on the constructed ridge-beast dataset, and the results showed that the mAP of the improved algorithm can reach 86.48%, which is 3.05% higher than YOLO-v3, and the model parameters are reduced by 70%, which has a better detection performance and can provide a reference for the automated detection of ancient building components.
Does different vertical position of maxillary central incisors in women with different facial vertical height affect smile esthetics perception?
Authors: Atik Ezgi , Turkoglu Hilal
Published: August 2023

Background

The aim of this study was to assess the esthetic perceptions of orthodontists, prosthodontists and laypersons with regard to different vertical positions of the maxillary central incisors related to lateral incisors for different facial vertical height cases.

Subject and methods

Frontal full-face photographs showing social smiles of three adult women aged between 18 and 25 years were used. Vertical position of the maxillary central incisor was changed (intruded or extruded) with 0.5 mm increments according to the reference gingival line resulting five images for each woman in a full-face view yielding a total of 15 images. A visual analog scale was placed below each smile to allow the raters to evaluate the attractiveness of each smile independently. One-way analysis of variance was used to determine whether there was a difference between more than two independent groups in terms of quantitative variables. Comparisons of more than two dependent groups were examined with repeated measures one-way ANOVA. The significance level was taken as 0.05 for all analyses.

Results

For increased facial vertical height, the highest scores for orthodontists were given to the 0.5 mm extruded (64.18 ± 26.36), for prosthodontists to the control (57.28 ± 19.80), and for layperson to the 1 mm extruded (61.27 ± 25.98) central incisor position. For decreased facial vertical height, the highest scores were obtained at the 0.5 mm intrusion with an increasing pattern from orthodontists to laypersons (63.95 ± 22.08 for orthodontists, 79.87 ± 21.43 for prosthodontists, and 79.88 ± 19.17 for laypersons). All three rater groups gave the highest scores to the 0 mm (control) smile design for normal facial vertical height. When these scores were compared among the groups, laypersons gave significantly higher scores compared to orthodontists (p < 0.001) and prosthodontists (p = 0.005).

Conclusions

The facial vertical height significantly affected the perception of smile esthetics. Keeping the distance between the central and lateral incisors longer than 1 mm in individuals with increased facial height may be important in terms of increasing patient satisfaction in terms of clinical aesthetics. On the contrary, keeping the distance between the central and lateral incisors shorter than 1 mm may create a more esthetically acceptable result in individuals with short facial height.