bluuebunny/crossref_metadata_2025 huggingface dataset:
Two Decades of Causal Layered Analysis: A Bibliometric Analysis and Review (2000–2022)
Authors: Wahab Abdul
Published: April 2024

Purpose: This study aims to analyze 292 peer-reviewed articles and conference papers on Causal Layered Analysis (CLA) published from 2000 to 2022. The paper delves into the scientific studies conducted over the past two decades regarding CLA. Design/Methodology/Approach: This bibliometric analysis offers a comprehensive overview of CLA research, covering trends, topics, influential authors, sources, universities, and journals. It highlights notable figures, such as Sohail Inayatullah and Ivana Milojević, recognizing their influence. The study also identifies the widespread utilization of CLA in futures studies (FS) and metaphor analysis. Biblioshiny, Excel, and Zotero were employed for analysis and mapping. Results: The findings reveal an increasing publication trend, while the number of citations has experienced a significant decline. Australia, the USA, Iran, Finland, and Taiwan are the top five countries with the most publications. Similarly, Sohail Inayatullah has the most publications and citations at the top. The Journal of Futures Studies, Futures and Foresight has published the highest number of CLA articles, while Foresight by Emerald has the most citations. In terms of author collaboration, the Single-authored studies outnumber co-authored studies. Originality/Value: Over the past decade, research on CLA has proliferated due to increased interest in futures studies and critical methods factors. The analysis also indicates constraints in data collection and biases in inclusion criteria, underscoring the necessity for future research to address these issues. This study furnishes a comprehensive overview of CLA research, enhancing understanding of the method and its implications for academic and practical applications.
Willingness to start insulin therapy among insulin-naïve persons with type 2 diabetes mellitus at Gulu Regional Referral Hospital, Gulu City, Uganda
Authors: Nakitto Brenda , Opedo Moses , Nansubuga Federes , Omondi Edward , Musinguzi Emmanuel , Otile Edwin Cleopas , Ekak Steven , Nannungi Christine , Apiyo Paska , Pebolo Pebalo Francis , Bongomin Felix
Published: April 2024

Background:

Most patients with type 2 diabetes mellitus (DM2) will require insulin for glycemic control during their disease.

Objectives:

We evaluated the willingness to start insulin therapy among insulin-naïve persons with DM2 in urban Northern Uganda.

Design:

A facility-based, quantitative, cross-sectional study was conducted between June and August 2023 recruiting insulin-naïve type 2 diabetes mellitus patients attending routine health care at Gulu Regional Referral Hospital, Gulu, Uganda.

Methods:

We gauged participants’ willingness to use insulin by asking, ‘If your doctor prescribed insulin for you, would you accept to use it?’ with responses categorized as either ‘Yes’ or ‘No’. Poisson regression analysis was performed to assess the factors associated with willingness to start insulin therapy. p < 0.05 were considered statistically significant.

Results:

We enrolled 190 participants, with a mean age of 55 ± 12.72 years. Most participants were female (63.7%, n = 121), attained a primary level of education (70.0%, n = 133), and were unemployed (84.2%, n = 160). Overall, 73.4% ( n = 138) of the participants were willing to receive insulin therapy if indicated. Participants recently advised on insulin showed a 34% higher willingness [adjusted prevalence ratio (aPR): 1.34, 95% confidence interval (CI): 1.06–1.72, p = 0.007], whereas those with a disease duration of 6 years or more were 43% less willing (aPR: 0.57, 95% CI: 0.39–0.81, p = 0.002) and those concerns about coping with insulin therapy were 55% less willing to commence insulin therapy (aPR: 0.57, 95% CI: 0.39–0.81, p = 0.002).

Conclusion:

About three in every four participants with DM were willing to receive insulin if indicated. However, healthcare providers should consider personalized counseling strategies to alleviate concerns and enhance informed decision-making regarding insulin initiation. Future interventions should focus on addressing specific barriers associated with prolonged disease duration and apprehensions related to insulin therapy to optimize glycemic control in this population.
Co-producing digital mental health interventions: A systematic review
Authors: Brotherdale Rebecca , Berry Katherine , Branitsky Alison , Bucci Sandra
Published: April 2024

Objective

Smartphone apps (apps) are widely recognised as promising tools for improving access to mental healthcare. However, a key challenge is the development of digital interventions that are acceptable to end users. Co-production with providers and stakeholders is increasingly positioned as the gold standard for improving uptake, engagement, and healthcare outcomes. Nevertheless, clear guidance around the process of co-production is lacking. The objectives of this review were to: (i) present an overview of the methods and approaches to co-production when designing, producing, and evaluating digital mental health interventions; and (ii) explore the barriers and facilitators affecting co-production in this context.

Methods

A pre-registered (CRD42023414007) systematic review was completed in accordance with The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Five databases were searched. A co-produced bespoke quality appraisal tool was developed with an expert by experience to assess the quality of the co-production methods and approaches. A narrative synthesis was conducted.

Results

Twenty-six studies across 24 digital mental health interventions met inclusion criteria. App interventions were rarely co-produced with end users throughout all stages of design, development, and evaluation. Co-producing digital mental health interventions added value by creating culturally sensitive and acceptable interventions. Reported challenges included resource issues exacerbated by the digital nature of the intervention, variability across stakeholder suggestions, and power imbalances between stakeholders and researchers.

Conclusions

Variation in approaches to co-producing digital mental health interventions is evident, with inconsistencies between stakeholder groups involved, stage of involvement, stakeholders’ roles and methods employed.
Exploring physiotherapists’ perceptions of telerehabilitation for musculoskeletal disorders: Insights from focus groups
Authors: Sia Lee Lee , Sharma Shobha , Kumar Saravana , Ajit Singh Devinder Kaur
Published: April 2024

Objective

This study explored the perceived benefits, barriers, and recommendations of telerehabilitation for musculoskeletal disorders among physiotherapists in Malaysia.

Methods

This study employed an exploratory qualitative methodology to gather the perceptions of government-employed physiotherapists in Malaysia regarding the benefits, barriers, and recommendations for telerehabilitation in treating musculoskeletal disorders. The researchers conducted semistructured focus group discussions (FGDs) via Google Meet, which were recorded, transcribed, and analyzed using thematic analysis.

Results

Five FGDs were conducted with 24 participants, 37.5% of whom had prior experience with telerehabilitation. The data analysis returned three main themes: (1) perceived benefits, (2) barriers, and (3) recommendations. Four subthemes were derived from perceived benefits: (1a) saving time and money, (1b) convenience, (1c) clients responsible for their treatment, and (1d) alternatives for infectious diseases. Perceived barriers revealed three subthemes: (2a) technology, (2b) organization, and (2c) personal barriers. Finally, participants provided recommendations for improving telerehabilitation services, including training programs to facilitate greater acceptance of this modality.

Conclusion

The findings of this study offer crucial insights into the evolving landscape of telerehabilitation in Malaysia. These findings revealed a greater prevalence of barriers to enablers among Malaysian physiotherapists, potentially influenced by varying experience levels. Despite the prevailing lack of experience among participants, this research underscores the significance of identifying barriers and enablers in implementing telerehabilitation with participants offering recommendations for integrating telerehabilitation into their practices. This study provides clear insights and a roadmap for stakeholders aiming to shape the future of telerehabilitation among physiotherapists in Malaysia.
Demographic pathways and intergenerational effects of changes in women's education: Evidence from China
Authors: Han Xiaowen
Published: April 2024

Using data from the 2011 baseline China Health and Retirement Longitudinal Study, this study employs a simulation model developed by Mare and Maralani to investigate the intergenerational effects of changes in the distribution of women's education on the educational distribution of their offspring's generation in China. Different from the conventional retrospective studies of intergenerational mobility that have focused on associations between parents’ and children's socioeconomic attainment, the prospective approach adopted in this study examines the relative importance of both the demographic pathways, namely assortative mating and fertility differentials, and the social mobility pathway to the intergenerational transmission processes in a changing socioeconomic and policy context of China. First, I found a positive intergenerational effect across all three cohorts of women born between 1925 and 1965: an increase in women's education led to an improvement in their daughters’ educational attainment. Second, the two demographic pathways, marriage and fertility, and intergenerational transmission jointly affected the educational attainment of the next generation in a complex way. While assortative mating strengthened the intergenerational effects, educational differentials in fertility dampened the intergenerational effects, since improvement in women's education increased their chances of marrying better-educated husbands but reduced their fertility levels. Third, the intergenerational effects and the respective effects of two demographic pathways became smaller across cohorts, which could be attributed jointly to educational expansion at the national level and changing family planning policies experienced by different cohorts of women and their offspring. Fourth, rural/urban comparison further demonstrated the existing educational inequality in contemporary China.
The Power of Play: Examining the Impact of a School Yard Playground on Attitudes Toward School and Peer Relationships Among Elementary School Students in Chennai, India
Authors: Lateef Shan , Zahir Rhea , Sherdil Leena , McCleary Carol , Shafin Tasnuva
Published: April 2024

Introduction. School environments may impact elementary school students’ attachment levels to school as well as their mental and emotional well-being. Yet investments in recess/play infrastructure lag commitments to academic resources, particularly in developing countries. The main objective was to examine the impact of installing playground equipment, in the school yard, on students’ attitudes toward school, peers, and the capacity to play of elementary-school children in an underserved, inner-city school in Chennai, India. Methods. A previously validated school attachment questionnaire was modified and administered to 140 and 148 students in pre- and post-playground installation, respectively. Results. For 7 out of 13 survey questions, student attitudes about their own recreational time and their attitudes toward peers significantly improved after playground installation. Conclusion. These results highlight the need for investments in play spaces, and recreational equipment may be just as important as addressing academic needs, especially among underserved children.
Jewish Muslims in The Handsome Jew and Don’t Leave Me Here Alone: Conversion, Identity, and Liminality
Authors: Alwuraafi Ebrahim Mohammed
Published: April 2024

The present article addresses the complex interplay of boundaries, belonging, and modes of identity and investigates the space between the distinct boundaries of religious identities. It focuses on the Jewish Muslim identity as it defies categorization and plays out in the liminal space of the Jewish Muslims, a space of fluid and blurred contours, haunted by ancestral religion and inherited culture, and obsessed by a crucial need to reconstruct a new sense of self. The article explores these concepts by referring to two narrative works: Ali Al-Muqri’s The Handsome Jew and Ihsan Abdel Quddous’s Don’t Leave Me Here Alone, which extensively elaborate on the relationship between conversion, identity, and liminality. It argues that Jewish Muslims stay within a liminal space due to their inability to forget their past and assimilate into the present, and that a non-binary Jewish Muslim subject lives in a place that borders the Jewish and Muslim spaces but never crosses into either position completely. The study aims to investigate discourses, as presented in the two texts under discussion, that construct boundaries between individuals of different religious affiliations and the motives for such constructions, and it tries to demonstrate the extent to which liminality can be used as an apt metaphor to define the life of Jewish converts to Islam.
Ecologies of co-production in the Anthropocene
Authors: Honeybun-Arnolda Elliot , Mahony Martin , Chilvers Jason
Published: April 2024

The urgency, uncertainty and unevenness of the Anthropocene has foregrounded the spatial and temporal multiplicity of co-production between science and society. In this article, we draw together work in geography, science and technology studies and cognate disciplines concerned with ‘co-producing’ knowledge for environmental governance, and with the ‘co-production’ of science and politics. Yet these existing studies and approaches have tended to focus on discrete moments of co-production within bounded time-spaces. Building on work associated with ecologies of participation and geographies of science, we introduce the notion of ‘ecologies of co-production’ as a way to more faithfully attend to multiple co-existing co-productions and the interrelations between them. We define this as diverse interrelating practices and spaces of co-production which intermingle and are co-produced with(in) wider systems and political cultures in which they are situated. We set out how this opens up new ways of thinking about and attending to the spaces and interrelations, diversities and exclusions, histories and constitutions, and responsibilities and affects of co-productions between science and society in the Anthropocene. We suggest that this approach can make a difference in how we do co-production, how we analyse co-production and how we live, act and figure in an Anthropocene world.
Maternal red blood cell alloimmunization prevalence in the United States
Authors: Sugrue Ronan P. , Moise Kenneth J. , Federspiel Jerome J. , Abels Elizabeth , Louie Judy Z. , Chen Zhen , Bare Lance , Alagia Damian P. , Kaufman Harvey W.
Published: April 2024

Hemolytic disease of fetus and newborn (HDFN) is a life-threatening disease mediated by maternal alloimmunization to red blood cell (RBC) antigens. Studies of maternal alloimmunization prevalence in the United States lack national data. This study describes prevalence and trends in alloimmunization in pregnancy in the United States. RBC antibodies (abs) were identified in a large, nationwide, commercial laboratory database from 2010 through 2021. The cohort comprised pregnancies for which the year of laboratory collection and patient’s state of residence were available. Data were normalized based on US Centers for Disease Control and Prevention estimates of live births and weighted by year and US Census Division. Cochrane-Armitage tests assessed temporal trends of alloimmunization. Of 9 876 196 pregnancies, 147 262 (1.5%) screened positive for RBC abs, corresponding to an estimated prevalence of 1518 of 100 000 pregnancies. Of identified RBC abs, anti-D comprised 64.1% pregnancies (586/100 000). Prevalence of other high-risk RBC abs for HDFN included anti-K (68/100 000) and anti-c (29/100 000). Incidence of all 3 high-risk abs increased from 2010 to 2021 (all P < .001). Among almost 10 million pregnancies in the United States, comprising an estimated 14.4% of all pregnancies, 1.5% screened positive for RBC abs. Almost three-quarters (679/100 000 [74.3%]) of RBC abs identified were high risk for HDFN. Although prevalence of anti-D is difficult to interpret without the ability to distinguish alloimmunization from passive immunity, it remains problematic in HDFN, ranking second only to anti-K in critical titers. Given the sequelae of HDFN, new initiatives are required to reduce the incidence of alloimmunization in patients of reproductive potential.
Trends in volumes and survival after hematopoietic cell transplantation in racial/ethnic minorities
Authors: Khera Nandita , Ailawadhi Sikander , Brazauskas Ruta , Patel Jinalben , Jacobs Benjamin , Ustun Celalettin , Ballen Karen , Abid Muhammad Bilal , Diaz Perez Miguel Angel , Al-Homsi A. Samer , Hashem Hasan , Hong Sanghee , Munker Reinhold , Schears Raquel M. , Lazarus Hillard M. , Ciurea Stefan , Badawy Sherif M. , Savani Bipin N. , Wirk Baldeep , LeMaistre C. Fred , Bhatt Neel S. , Beitinjaneh Amer , Aljurf Mahmoud , Sharma Akshay , Cerny Jan , Knight Jennifer M. , Kelkar Amar H. , Yared Jean A. , Kindwall-Keller Tamila , Winestone Lena E. , Steinberg Amir , Arnold Staci D. , Seo Sachiko , Preussler Jaime M. , Hossain Nasheed M. , Fingrut Warren B. , Agrawal Vaibhav , Hashmi Shahrukh , Lehmann Leslie E. , Wood William A. , Rangarajan Hemalatha G. , Saber Wael , Hahn Theresa
Published: April 2024

There has been an increase in volume as well as an improvement in overall survival (OS) after hematopoietic cell transplantation (HCT) for hematologic disorders. It is unknown if these changes have affected racial/ethnic minorities equally. In this observational study from the Center for International Blood and Marrow Transplant Research of 79 904 autologous (auto) and 65 662 allogeneic (allo) HCTs, we examined the volume and rates of change of autoHCT and alloHCT over time and trends in OS in 4 racial/ethnic groups: non-Hispanic Whites (NHWs), non-Hispanic African Americans (NHAAs), and Hispanics across 5 2-year cohorts from 2009 to 2018. Rates of change were compared using Poisson model. Adjusted and unadjusted Cox proportional hazards models examined trends in mortality in the 4 racial/ethnic groups over 5 study time periods. The rates of increase in volume were significantly higher for Hispanics and NHAAs vs NHW for both autoHCT and alloHCT. Adjusted overall mortality after autoHCT was comparable across all racial/ethnic groups. NHAA adults (hazard ratio [HR] 1.13; 95% confidence interval [CI] 1.04-1.22; P = .004) and pediatric patients (HR 1.62; 95% CI 1.3-2.03; P < .001) had a higher risk of mortality after alloHCT than NHWs. Improvement in OS over time was seen in all 4 groups after both autoHCT and alloHCT. Our study shows the rate of change for the use of autoHCT and alloHCT is higher in NHAAs and Hispanics than in NHWs. Survival after autoHCT and alloHCT improved over time; however, NHAAs have worse OS after alloHCT, which has persisted. Continued efforts are needed to mitigate disparities for patients requiring alloHCT.
Effects of high-flow nasal therapy on swallowing function: a scoping review
Authors: Crimi Claudia , Chiaramonte Rita , Vignera Fabio , Vancheri Carlo , Vecchio Michele , Gregoretti Cesare , Carlucci Annalisa , Andersen Tiina , Cortegiani Andrea
Published: April 2024

Background

High-flow nasal therapy is widely used in patients with respiratory failure in different clinical settings, but the effect of high-flow nasal therapy on respiratory-swallow coordination is unknown. Understanding this relationship is crucial, considering the necessity for patients to maintain adequate nutrition during daytime high-flow nasal therapy. This scoping review aims to synthesise available data on the effects of high-flow nasal therapy flow rates on swallowing function and the possible risk of aspiration during treatment, focusing on knowledge and evidence gaps.

Methods

PubMed, Scopus, Web of Science and Google Scholar databases were searched from inception to 30 May 2023 for studies reporting data on swallowing assessment in healthy adults or patients with acute or chronic respiratory failure receiving high-flow nasal therapy. Data on study design, patients’ characteristics and quality outcomes were extracted.

Results

Eight studies were included, four including cohorts of healthy volunteers (n=148) and four including patients with acute or chronic respiratory failure (n=151). Study designs, patient populations and quality outcome measures were heterogeneous. Two studies indicated improvement while four articles showed impairment in swallowing function during high-flow nasal therapy; two studies showed that patients’ overall clinical picture and underlying medical conditions influenced swallowing-breathing coordination rather than high-flow nasal therapyper se.

Conclusion

This scoping review found limited and controversial evidence on the impact of high-flow nasal therapy on swallowing function. Remarkably, methods for swallowing function assessment were quite heterogeneous. Additional research is required to test the effect of high-flow nasal therapy on respiratory-swallowing coordination.
Real-world effectiveness and satisfaction with intravenous eptinezumab treatment in patients with chronic migraine: REVIEW, an observational, multi-site, US-based study
Authors: Argoff Charles , Herzog Steven P. , Smith Ryan M. , Kotak Sameer V. , Sopina Liza , Saltarska Yvonna , Soni-Brahmbhatt Seema , Khan Fawad A.
Published: April 2024

Background

Despite recent advancements in migraine treatment, some patients continue to endure significant disease burden. Due to the controlled nature of randomized trials in migraine prevention, many real-world patients with comorbidities or prior exposure to certain therapies are excluded. Capturing evidence of the effectiveness of treatment in real-world clinical settings can further shape treatment paradigms. The objective of this study was to develop a comprehensive understanding of both patients’ and physicians’ real-world experiences with eptinezumab for chronic migraine (CM).

Methods

REVIEW (Real-world EVidence and Insights into Experiences With eptinezumab) is an observational, multi-site (n = 4), US-based study designed to evaluate real-world experiences of patients treated with eptinezumab and their treating physicians. Patients were ≥ 18 years of age, with a diagnosis of CM, who had completed ≥ 2 consecutive eptinezumab infusion cycles (≥ 6 months of exposure). The study included a retrospective chart review, a patient survey, and a semi-structured physician interview that assessed patient and/or physician satisfaction with elements of daily living / well-being, migraine symptomology, and perspectives of the eptinezumab infusion experience.

Results

Of the 94 patients enrolled, 83% (78/94) were female, the mean age was 49.2 years, and the mean time since migraine diagnosis was 15.4 years. Before eptinezumab treatment, patients experienced a mean of 8 self-reported “good” days/month, which increased to 18 after treatment. Most patients took, on average, ≥ 10 days/month of prescription and/or over-the-counter medication (81% [75/93] and 66% [61/93], respectively) to treat migraine attacks before eptinezumab treatment, which dropped to 26% (24/93) and 23% (21/93) following eptinezumab treatment. Prior to receiving eptinezumab, 62% (58/93) of patients indicated being at least slightly concerned about infusions; after eptinezumab infusion, this dropped to 14% (13/93). These patient survey findings were consistent with physician responses.

Conclusion

This real-world evidence study demonstrated high overall satisfaction with the effectiveness of eptinezumab treatment for CM among most patients and their physicians.
The burden of headache disorders in the adult general population of the Kingdom of Saudi Arabia: estimates from a cross-sectional population-based study including a health-care needs assessment
Authors: Al Jumah Mohammed , Al Khathaami Ali M. , Kojan Suleman , Husøy Andreas , Steiner Timothy J.
Published: April 2024

Background

We have previously shown headache to be highly prevalent among adults in Saudi Arabia. Here we estimate associated symptom burden and impaired participation (impaired use of time, lost productivity and disengagement from social activity), and use these estimates to assess headache-related health-care needs in Saudi Arabia.

Methods

A randomised cross-sectional survey included 2,316 adults (18–65 years) from all 13 regions of the country. It used the standardised methodology of the Global Campaign against Headache with a culturally mandated modification: engagement by cellphone using random digit-dialling rather than door-to-door visits. Enquiry used the HARDSHIP questionnaire, with diagnostic questions based on ICHD-3 beta, questions on symptom burden, enquiries into impaired participation using the HALT index and questions about activity yesterday in those reporting headache yesterday (HY). Health-care “need” was defined in terms of likelihood of benefit. We counted all those with headache on ≥ 15 days/month, with migraine on ≥ 3 days/month, or with migraine or TTH and meeting either of two criteria: a) proportion of time in ictal state (pTIS) > 3.3% and intensity ≥ 2 (moderate-severe); b) ≥ 3 lost days from paid work and/or household chores during 3 months.

Results

For all headache, mean frequency was 4.3 days/month, mean duration 8.4 h, mean intensity 2.3 (moderate). Mean pTIS was 3.6%. Mean lost days from work were 3.9, from household chores 6.6, from social/leisure activities 2.0. Of participants reporting HY, 37.3% could do less than half their expected activity, 19.8% could do nothing. At population-level (i.e., for every adult), 2.5 workdays (potentially translating into lost GDP), 3.6 household days and 1.3 social/leisure days were lost to headache. According to HY data, mean total impaired participation (not distinguishing between work, household and social/leisure) was 6.8%. A total of 830 individuals (35.8%) fulfilled one or more of our needs assessment criteria.

Conclusion

A very high symptom burden is associated with a commensurately high burden of impaired participation. The economic cost appears to be enormous. Over a third of the adult population are revealed to require headache-related health care on the basis of being likely to benefit, demanding highly efficient organization of care.
Orthogonal multimodality integration and clustering in single-cell data
Authors: Liu Yufang , Chen Yongkai , Lu Haoran , Zhong Wenxuan , Yuan Guo-Cheng , Ma Ping
Published: April 2024

Multimodal integration combines information from different sources or modalities to gain a more comprehensive understanding of a phenomenon. The challenges in multi-omics data analysis lie in the complexity, high dimensionality, and heterogeneity of the data, which demands sophisticated computational tools and visualization methods for proper interpretation and visualization of multi-omics data. In this paper, we propose a novel method, termed Orthogonal Multimodality Integration and Clustering (OMIC), for analyzing CITE-seq. Our approach enables researchers to integrate multiple sources of information while accounting for the dependence among them. We demonstrate the effectiveness of our approach using CITE-seq data sets for cell clustering. Our results show that our approach outperforms existing methods in terms of accuracy, computational efficiency, and interpretability. We conclude that our proposed OMIC method provides a powerful tool for multimodal data analysis that greatly improves the feasibility and reliability of integrated data.
Environmental colour pattern variation in Mediterranean Podarcis
Authors: Escoriza Daniel
Published: April 2024

Background

Lizards of the genusPodarcisare widespread in the Mediterranean region, including islands and island archipelagos. These small-bodied lizards have a predominantly protective green-brown colouration. However, some populations display unusual patterns, in which the colouration is predominantly blue or uniformly black. This study explores the factors that influence this chromatic variation, whether environmental (climate and island conditions) or evolutionary (phylogenetic trait conservatism). The colouration of 1400 individuals (27 species) was analysed in the CIELAB colour space.

Results

Pagel’s λ indicated that colouration is weakly conserved within phylogenetic lineages. Although the island surface plays a key role in the chromatic variability of these lacertids, geographic isolation and climate hold less influence. The colouration of some small island populations tends to be uniform and dark, possibly due to intense intraspecific competition and lower predatory pressure.

Conclusions

This study highlights the importance of island populations in understanding the processes that favour the emergence of extreme phenotypes in small ectothermic vertebrates.
Genetic analysis and QTL mapping for pericarp thickness in maize (Zea mays L.)
Authors: Gong Guantong , Jia Haitao , Tang Yunqi , Pei Hu , Zhai Lihong , Huang Jun
Published: April 2024

Proper pericarp thickness protects the maize kernel against pests and diseases, moreover, thinner pericarp improves the eating quality in fresh corn. In this study, we aimed to investigate the dynamic changes in maize pericarp during kernel development and identified the major quantitative trait loci (QTLs) for maize pericarp thickness. It was observed that maize pericarp thickness first increased and then decreased. During the growth and formation stages, the pericarp thickness gradually increased and reached the maximum, after which it gradually decreased and reached the minimum during maturity. To identify the QTLs for pericarp thickness, a BC4F4 population was constructed using maize inbred lines B73 (recurrent parent with thick pericarp) and Baimaya (donor parent with thin pericarp). In addition, a high-density genetic map was constructed using maize 10 K SNP microarray. A total of 17 QTLs related to pericarp thickness were identified in combination with the phenotypic data. The results revealed that the heritability of the thickness of upper germinal side of pericarp (UG) was 0.63. The major QTL controlling UG was qPT1-1, which was located on chromosome 1 (212,215,145–212,948,882). The heritability of the thickness of upper abgerminal side of pericarp (UA) was 0.70. The major QTL controlling UA was qPT2-1, which was located on chromosome 2 (2,550,197–14,732,993). In addition, a combination of functional annotation, DNA sequencing analysis and quantitative real-time PCR (qPCR) screened two candidate genes, Zm00001d001964 and Zm00001d002283, that could potentially control maize pericarp thickness. This study provides valuable insights into the improvement of maize pericarp thickness during breeding.
Association of uncertain significance genetic variants with myocardial mechanics and morphometrics in patients with nonischemic dilated cardiomyopathy
Authors: Mėlinytė-Ankudavičė Karolina , Šukys Marius , Kasputytė Gabrielė , Krikštolaitis Ričardas , Ereminienė Eglė , Galnaitienė Grytė , Mizarienė Vaida , Šakalytė Gintarė , Krilavičius Tomas , Jurkevičius Renaldas
Published: April 2024

Background

Careful interpretation of the relation between phenotype changes of the heart and gene variants detected in dilated cardiomyopathy (DCM) is important for patient care and monitoring.

Objective

We sought to assess the association between cardiac-related genes and whole-heart myocardial mechanics or morphometrics in nonischemic dilated cardiomyopathy (NIDCM).

Methods

It was a prospective study consisting of patients with NIDCM. All patients were referred for genetic testing and a genetic analysis was performed using Illumina NextSeq 550 and a commercial gene capture panel of 233 genes (Systems Genomics, Cardiac-GeneSGKit®). It was analyzed whether there are significant differences in clinical, two-dimensional (2D) echocardiographic, and magnetic resonance imaging (MRI) parameters between patients with the genes variants and those without. 2D echocardiography and MRI were used to analyze myocardial mechanics and morphometrics.

Results

The study group consisted of 95 patients with NIDCM and the average age was 49.7 ± 10.5. All echocardiographic and MRI parameters of myocardial mechanics (left ventricular ejection fraction 28.4 ± 8.7 and 30.7 ± 11.2, respectively) were reduced and all values of cardiac chambers were increased (left ventricular end-diastolic diameter 64.5 ± 5.9 mm and 69.5 ± 10.7 mm, respectively) in this group. It was noticed that most cases of whole-heart myocardial mechanics and morphometrics differences between patients with and without gene variants were in the genes GATAD1, LOX, RASA1, KRAS, and KRIT1. These genes have not been previously linked to DCM. It has emerged that KRAS and KRIT1 genes were associated with worse whole-heart mechanics and enlargement of all heart chambers. GATAD1, LOX, and RASA1 genes variants showed an association with better cardiac function and morphometrics parameters. It might be that these variants alone do not influence disease development enough to be selective in human evolution.

Conclusions

Combined variants in previously unreported genes related to DCM might play a significant role in affecting clinical, morphometrics, or myocardial mechanics parameters.
FLAMES overlaying anti-N-methyl-D-aspartate receptor encephalitis: a case report and literature review
Authors: Zhong Rimei , Chen Xiongjin , Liao Feng , Lin Zhijun , Zhang Zhijian , Chen Yusen , Cui Lili
Published: April 2024

Background

In recent years, simultaneous or sequential occurrence of MOG antibody disease and anti-NMDAR encephalitis in the same patient has been reported with increasing frequency. Scholars refer to the overlapping occurrence of these two disorders as MOG antibody disease and anti-NMDAR encephalitis overlap syndrome (MNOS). Cortical T2-weighted fluid-attenuated inversion recovery (FLAIR) -hyperintense lesions in anti-MOG-associated encephalitis with seizures (FLAMES) is a rare clinical phenotype of MOGAD in which cortical FLAIR high-signal lesions are unilateral, with little spread to the cortex and meninges bilaterally. Although cases of FLAMES have been consistently reported. However, to our knowledge, such cases of FLAMES combined with NMDARE are rare.

Case presentation

Here, we describe a case of FLAMES combined with anti-NMDARE. The patient was a young male, 29 years old, admitted to our hospital with isolated seizures, whose MRI showed unilateral thalamic and bilateral frontal and parietal leptomeningeal involvement. Since we were unaware of the possibility of bilateral meningo-cortical MOGAD manifestations, the case was initially diagnosed as viral encephalitis and was given antiviral therapy. The diagnosis was not clarified until anti-NMDAR-IgG and MOG-IgG positivity was detected in the cerebrospinal fluid and serum. The patient was then treated with high-dose corticosteroids and his symptoms responded well to the steroids. Therefore, this case expands the clinical spectrum of MNOS overlap syndrome. In addition, we describe the clinical features of MNOS by summarizing the existing literature and exploring the possible mechanisms of its immune response.

Conclusions

Our case serves as a reminder to clinicians that when patients present with atypical clinical manifestations such as seizures, consideration should be given to MNOS and conduct testing for various relevant autoantibodies (including MOG abs) and viruses in both serum and cerebrospinal fluid, as it is easy to misdiagnose the disease as other CNS diseases, such as viral meningoencephalitis. This syndrome exhibits a high responsiveness to steroids, highlighting the critical importance of recognizing the clinical and neuroimaging features of this overlap syndrome for prompt diagnosis and treatment. Furthermore, it enriches the disease spectrum of MNOS.
Comparison of the efficacy of nifedipine with ritodrine, nitroglycerine and magnesium sulfate for the management of preterm labor: a systematic review and meta-analysis
Authors: Zamani Maryam , Alimi Rasoul , Arabi Seyyed Mostafa , Moradi Maryam , Azmoude Elham
Published: April 2024

Background

Some studies have compared the efficacy of nifedipine with that of other tocolytic drugs in the treatment of preterm labor, but the reported results are conflicting.

Objective

To compare the efficacy of nifedipine with that of ritodrine, nitroglycerine and magnesium sulfate for the management of preterm labor.

Methods

In this systematic review and meta-analysis, PubMed/MEDLINE, Scopus, Clarivate Analytics Web of Science, and Google Scholar were searched until April 3,2024 using predefined keywords. Randomized controlled trials (RCTs) and clinical trials that compared the efficacy of nifedipine with that of ritodrine, nitroglycerine and magnesium sulfate for the management of preterm labor were included. Two authors independently reviewed the articles, assessed their quality and extracted the data. The quality of the included RCTs based on the Cochrane Risk of Bias Tool 1 for clinical trial studies. The risk difference (RD) with the associated 95% confidence interval (CI) was calculated. A forest plot diagram was used to show the comparative point estimates of nifedipine and other tocolytic drugs on the prevention of preterm labor and their associated 95% confidence intervals based on the duration of pregnancy prolongation. Study heterogeneity was evaluated by the I2 index, and publication bias was evaluated by Egger’s test.

Results

Forty studies enrolling 4336 women were included. According to our meta-analysis, there was a significant difference in the prolongation of preterm labor within the first 48 h between the nifedipine group and the nitroglycerine group (RD, -0.04; 95% CI, -0.08 to -0.00; I2: 32.3%). Additionally, there were significant differences between nifedipine and ritodrine (RD, 0.11; 95% CI, 0.02 to 0.21; I2, 51.2%) for more than one week RD, 0.10; 95% CI, 0.03 to 0.19; I2, 33.2%) and for 34 weeks and more. The difference between nifedipine and magnesium sulfate was not significant in any of the four time points.

Conclusions

Considering the superiority of nifedipine over ritodrine and nitroglycerine and its similar efficacy to magnesium sulfate for tocolysis, it seems that the side effects of these options determine the first drug line.
The current clinical landscape of neonatal respiratory failure in Jiangsu Province of China: patient demographics, NICU treatment interventions, and patient outcomes
Authors: Wang Na , Lu Ke-Yu , Jiang Shan-Yu , Wu Hong-Wei , Cheng Rui , Pan Zhao-Jun , Wang Huai-Yan ,   on behalf of the Jiangsu Provincial Collaborative Study Group for Neonatal Respiratory Diseases, Lu Keyu , Wang Huaiyan , Jiang Shanyu , Pan Zhaojun , Wu Hongwei , Yang Zuming , Shao Jie , Han Shuping , Li Zhengying , Xu Yan , Ye Li , Wu Xinping , Li Hong , Shu Guihua , Cai Jinlan , Zhou Jinjun , Yin Xiaoping , Chen Xiaoqing , Liu Songlin , Yu Mengzhu , Gao Yan , Bao Zhidan , Xue Mei , Huang Li , Li Haiying , Song Lei , Wu Wei , Xu Huai , Li Hongxin
Published: April 2024

Introduction

Neonatal respiratory failure (NRF) is a serious condition that often has high mortality and morbidity, effective interventions can be delivered in the future by identifying the risk factors associated with morbidity and mortality. However, recent advances in respiratory support have improved neonatal intensive care units (NICUs) care in China. We aimed to provide an updated review of the clinical profile and outcomes of NRF in the Jiangsu province.

Methods

Infants treated for NRF in the NICUs of 28 hospitals between March 2019 and March 2022 were retrospectively reviewed. Data collected included baseline perinatal and neonatal parameters, NICU admission- and treatment-related data, and patient outcomes in terms of mortality, major morbidity, and survival without major morbidities.

Results

A total of 5548 infants with NRF were included in the study. The most common primary respiratory disorder was respiratory distress syndrome (78.5%). NRF was managed with non-invasive and invasive respiratory support in 59.8% and 14.5% of patients, respectively. The application rate of surfactant therapy was 38.5%, while that of neonatal extracorporeal membrane oxygenation therapy was 0.2%. Mortality and major morbidity rates of 8.5% and 23.2% were observed, respectively. Congenital anomalies, hypoxic-ischemic encephalopathy, invasive respiratory support only and inhaled nitric oxide therapy were found to be significantly associated with the risk of death. Among surviving infants born at < 32 weeks of gestation or with a birth weight < 1500 g, caffeine therapy and repeat mechanical ventilation were demonstrated to significantly associate with increased major morbidity risk.

Conclusion

Our study demonstrates the current clinical landscape of infants with NRF treated in the NICU, and, by proxy, highlights the ongoing advancements in the field of perinatal and neonatal intensive care in China.
Prospective study to evaluate radioactive iodine of 20 mCi vs 10–15 mCi in Graves’ disease
Authors: Kanokwongnuwat Wasit , Penpong Nawarat
Published: April 2024

Objectives

To assess whether increasing radioactive iodine dose can increase treatment efficacy in Graves’ disease.

Methods

A prospective study was conducted, including 106 patients receiving 20 mCi (740 MBq) radioactive iodine (RAI), compared with a retrospective data, including 113 patients receiving 10–15 mCi (370–555 MBq) RAI. Remission and failure rates were evaluated at 6 months post-RAI. Statistical analysis was performed using logistic regression and Kaplan–Meier curves.

Results

Patients receiving 20 mCi RAI demonstrated a significantly higher remission rate compared to the 10–15 mCi group (82.1% vs 66.4%, p = 0.009). Median time to remission was shorter in the 20 mCI group (3 vs 4 months, p = 0.002). Hypothyroidism at 6 months was more prevalent in the 20 mCi group (67% vs 53%, p = 0.03). Larger thyroid size (> 60 g) was associated with treatment failure (p = 0.02).

Conclusions

Higher dosage (20 mCi) RAI showed superior efficacy in achieving remission compared to lower dosages (10–15 mCi) in Graves’ disease treatment.
Health literacy as mediator between perception of illness and self-medication behaviour among outpatients in the Kingdom of Saudi Arabia: implication to primary healthcare nursing
Authors: Pasay-an Eddieson , Saguban Reynita , Cabansag Dolores , Alkubati Sameer
Published: April 2024

Introduction

Perception of illness (PI) and self-medication (SM) have been thoroughly explored in the existing literature. However, there is a lack of understanding about the mediating effect of health literacy on PI and SM in a non-homogenous population like Saudi Arabia. As such, primary healthcare nurses who have constant interaction with the outpatients have difficulty addressing self-medication. This study aimed to investigate health literacy as mediator between PI and SM among outpatients in the Kingdom of Saudi Arabia (KSA).

Methods

This study employed a cross-sectional approach and was conducted at 10 major primary healthcare (PHC) clinics serving 30 million individuals in 13 different regions of KSA. The 424 outpatients who participated in this study were selected through convenience sampling. Data collection started in November 2022 and concluded in February 2023.

Results

The mean of the Brief Health Literacy Screening Tool, self-medication scale (SMS), and PI scores were 13.01 ± 3.32, 27.46 ± 7.01, and 45.56 ± 7.69, respectively. There was a significant relationship between the age and BRIEF scores (p = 0.039), and the level of education was significantly related to all variables, as were nationality and BRIEF scores (p = 0.001). Finally, occupation was significantly related to BRIEF and SMS scores (p = 0.001 and 0.003, respectively). Completing college and being non-Saudi had positively significant effects on health literacy (p < 0.01). The structural equation model (SEM) found no effect of PI on health literacy or SM behaviour (p = 0.263 and 0.84, respectively), but health literacy did have an effect on SM behaviour (p<0.001).

Conclusion

Health literacy is an important factor in self-medication behavior and that PI is not directly related to health literacy or self-medication behavior, but that health literacy does influence self-medication behavior. Therefore, primary healthcare givers should promote public health literacy alongside the control of other conditions as one of the most effective ways to decrease the prevalence of self-medication and the risks associated with it.
Effects of the stress hyperglycemia ratio on long-term mortality in patients with triple-vessel disease and acute coronary syndrome
Authors: Zhang Yu , Guo Lei , Zhu Hao , Jiang Lin , Xu Lianjun , Wang Dong , Zhang Yin , Zhao Xueyan , Sun Kai , Zhang Channa , Zhao Wei , Hui Rutai , Gao Runlin , Wang Jizheng , Yuan Jinqing , Xia Yunlong , Song Lei
Published: April 2024

Aims

Risk assessment for triple-vessel disease (TVD) remain challenging. Stress hyperglycemia represents the regulation of glucose metabolism in response to stress, and stress hyperglycemia ratio (SHR) is recently found to reflect true acute hyperglycemic status. This study aimed to evaluate the prognostic value of SHR and its role in risk stratification in TVD patients with acute coronary syndrome (ACS).

Methods

A total of 3812 TVD patients with ACS with available baseline SHR measurement were enrolled from two independent centers. The endpoint was cardiovascular mortality. Cox regression was used to evaluate the association between SHR and cardiovascular mortality. The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) II (SSII) was used as the reference model in the model improvement analysis.

Results

During a median follow-up of 5.1 years, 219 (5.8%) TVD patients with ACS suffered cardiovascular mortality. TVD patients with ACS with high SHR had an increased risk of cardiovascular mortality after robust adjustment for confounding (high vs. median SHR: adjusted hazard ratio 1.809, 95% confidence interval 1.160–2.822, P = 0.009), which was fitted as a J-shaped pattern. The prognostic value of the SHR was found exclusively among patients with diabetes instead of those without diabetes. Moreover, addition of SHR improved the reclassification abilities of the SSII model for predicting cardiovascular mortality in TVD patients with ACS.

Conclusions

The high level of SHR is associated with the long-term risk of cardiovascular mortality in TVD patients with ACS, and is confirmed to have incremental prediction value beyond standard SSII. Assessment of SHR may help to improve the risk stratification strategy in TVD patients who are under acute stress.