bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical and mechanical properties of two tropical wood (Detarium macrocarpum and Piptadeniastrum africanum) and their potential as substitutes to traditionally used wood in Cameroon
Authors: Kana Stéphane Kenfack , Biwolé Achille Bernard , Mejouyo Huisken Paul William , Ganou Koungang Bernard Morino , Ngono Mvondo Rachel Raissa , Tounkam Marlène Ngansop , Njeugna Ebénézer
Published: February 2024

This study aimed to characterise two little-known woods and discuss their potential to replace those heavily exploited in Cameroon's forests. Amouk (Detarium macrocarpum) and Dabema (Piptadeniastrum africanum) were characterised for their physical and mechanical properties. Density, shrinkage, desorption kinetics, shear strength, tensile strength and modulus of elasticity (MOE) in compression and flexion were determined. A Weibull analysis was performed to predict their failure. It was found that Amouk and Dabéma can be classified as medium-heavy wood with low shrinkage and desorption, following Midilli's empirical model. The physical and mechanical characterisations show that the density, strength and MOE parameters of the woods are close to each other and enable them to be classified as medium-strength woods. The probability of failure in compression follows Weibull's law. These woods can, therefore, be used in structural applications such as construction, replacing common woods.
Generalized pustular psoriasis successfully treated with spesolimab: A case report
Authors: Brigenti Noemi , Gisondi Paolo , Bellinato Francesco , Girolomoni Giampiero
Published: February 2024

Generalized pustular psoriasis is defined as a primary, sterile, macroscopically visible pustular eruption on non-acral skin, which can occur with or without systemic inflammation and/or psoriasis vulgaris, and can either be relapsing or be persistent, according to the European Rare and Severe Psoriasis Expert Network. The treatment of generalized pustular psoriasis may be challenging. We describe a 48-year-old woman with a 15-year history of severe generalized pustular psoriasis and plaque psoriasis resistant to multiple courses of treatments with conventional and biological agents who had a rapid, complete and durable (up to 12 months) clinical remission with spesolimab, an anti-interleukin-36 receptor antagonist monoclonal antibody recently approved for the treatment of generalized pustular psoriasis flares.
Being crucial allies: A qualitative study of social and healthcare workers’ experiences of collaborating with nurse case managers
Authors: Guldborg Sofie Amalie , Rasmussen Mette Leisgaard Riis , Kollerup Mette Geil , Berthelsen Connie , Lerbæk Birgitte
Published: February 2024

Various support interventions, such as nurse case managers (NCMs), have emerged in response to increasing inequality in health and the growing population with multi-morbidity. NCMs collaborate with a wide range of professionals across social and healthcare services. This study explored social and healthcare workers’ perspectives on collaborating with hospital-based NCMs. A total of 16 social and healthcare workers were interviewed. A thematic analysis led to three themes that describe the NCMs as follows: 1) being crucial allies who gather the threads; 2) breaking free of standardised care to create flexible support solutions; and 3) making a difference to individuals who are in vulnerable positions. Highly effective and specialised societal systems have created a need for services such as the NCMs, who will act as crucial allies to both collaboration partners and patients. Based on the accounts of our participants, NCMs contributed with something more to the cross-sectorial collaboration, than what they had experienced in previous collaborative partnerships. This study underlines the need for structural changes if we are to address the sustained issues of health inequalities.
Association of Concomitant MRI-Determined Anterolateral Complex Injury With Quantitative Measurements of Altered Rotational Tibiofemoral Position on MRI in Patients With ACL Injury
Authors: Zhang Zhi-yu , Yin Yu , Bai Wen-bin , Shi Wei-li , Pan Xiao-yu , Huang Hong-jie , Zhang Xin , Wang Cheng , Wang Jian-quan
Published: February 2024

Background:

Reduced graft failure rates have been reported after anterior cruciate ligament (ACL) reconstruction combined with anterolateral complex (ALC) augmentation. However, the preoperative diagnosis of concomitant ALC injury remains a clinical challenge.

Purpose:

To identify the altered rotational tibiofemoral position on magnetic resonance imaging (MRI) in ACL-injured patients with concomitant ALC injury.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Based on the evaluation of ALC abnormalities on MRI scans by experienced surgeons, 123 patients with nonchronic (<3 months) ACL injury confirmed by arthroscopy were included. The patients were divided into 2 groups—an ALC-injured group (n = 57) and an ALC-intact group (n = 66). The altered rotational tibiofemoral position was evaluated and compared by quantitatively measuring internal rotational tibial subluxation (IRTS) and axial internal tibial rotation (ITRa) on MRI. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed to identify the factors associated with concomitant MRI-determined ALC injury.

Results:

The ALC-injured group showed significantly increased IRTS ( P < .001), ITRa ( P < .001), lateral anterior tibial subluxation (ATS) ( P < .001), and global ATS (GATS) ( P = .002) compared with the ALC-intact group, while no significant difference in medial ATS ( P = .810) was observed. A strong positive correlation was identified between IRTS and ITRa ( rP = 0.809; P < .001). Multivariate analyses revealed that IRTS ( P < .001) and GATS ( P = .016) were associated factors for the presence of concomitant MRI-determined ALC injury. IRTS (area under the curve [AUC] = 0.734) was more strongly associated with the outcome than GATS (AUC = 0.658) in ROC analyses, suggesting a more significant internal rotational subluxation than anterior subluxation of the tibia. An IRTS threshold of 3.1 mm demonstrated a specificity of 84.2% for indicating the presence of concomitant MRI-determined ALC injury.

Conclusion:

The presence of concomitant MRI-determined ALC injury in ACL-injured patients was associated with a significant increase in IRTS and ITRa compared with those with intact ALC, indicating that these MRI measurements of the altered rotational tibiofemoral position could serve as potential quantifiable indicators for identifying concomitant ALC injury in clinical practice.
Factors Associated With Residual Pivot Shift After ACL Reconstruction: A Quantitative Evaluation of the Pivot-Shift Test Preoperatively and at Minimum 12-Month Follow-up
Authors: Kawanishi Yusuke , Kobayashi Makoto , Yasuma Sanshiro , Fukushima Hiroaki , Kato Jiro , Murase Atsunori , Takenaga Tetsuya , Yoshida Masahito , Kuroyanagi Gen , Kawaguchi Yohei , Murakami Hideki , Nozaki Masahiro
Published: February 2024

Background:

Postoperative residual rotatory laxity remains despite improvement in surgical techniques for anterior cruciate ligament (ACL) reconstruction (ACLR).

Purpose:

To evaluate factors associated with residual pivot shift after ACLR by quantitative measurement of the pivot shift before and after surgery.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 97 patients who underwent primary double-bundle ACLR between June 2016 and March 2021 and underwent surgery to remove staples, with at least 12 months of follow-up evaluation, were enrolled. Quantitative measurements were performed under general anesthesia immediately before ACLR (preoperatively), after temporary fixation of the ACL graft (intraoperatively), and immediately before staple removal (postoperatively). The laxity of pivot shift was assessed using inertial sensors to measure acceleration and external rotational angular velocity (ERAV). Descriptive data were assessed for associations with postoperative acceleration and ERAV in a univariate analysis. A multiple linear regression analysis was performed to identify factors associated with postoperative acceleration and ERAV.

Results:

Anterior tibial translation, acceleration, and ERAV increased from intra- to postoperatively ( P < .05). Factors significantly associated with postoperative acceleration were age (β = −0.238; P = .021), lateral posterior tibial slope (PTS) (β = 0.194; P = .048), and preoperative acceleration (β = 0.261; P = .008). Factors significantly affecting postoperative ERAV were age (β = −0.222; P = .029), ramp lesions (β = 0.212; P = .027), and preoperative ERAV (β = 0.323; P = .001).

Conclusion:

Greater preoperative laxity in the pivot shift was the factor having the most significant association with residual pivot shift after ACLR using quantitative measurements under general anesthesia. Younger age, higher lateral PTS, and concomitant ramp lesions were significant predictors of residual pivot shift. These findings can help pre- and intraoperative decision-making regarding whether an anterolateral structure augmentation should be added.
A data-driven approach to analyse the co-evolution of urban systems through a resilience lens: A Helsinki case study
Authors: Casali Ylenia , Aydin Nazli Yonca , Comes Tina
Published: February 2024

Urban areas are dynamic systems, in which different infrastructural, social and economic subsystems continuously co-evolve. As such, disruptions in one system can propagate to another. However, open challenges remain in (i) assessing the long-term implications of change for resilience and (ii) understanding how resilience propagates throughout urban systems over time. Despite the increasing reliance on data in smart cities, few studies empirically investigate long-term urban co-evolution using data-driven methods, leading to a gap in urban resilience assessments. This paper presents an approach that combines Getis-ord Gi* statistical and correlation analyses to investigate how cities recover from crises and adapt by analysing how the spatial patterns of urban characteristics and their relationships changed over time. We illustrate our approach through a study on Helsinki’s road infrastructure, socioeconomic system and built-up area from 1991 to 2016, a period marked by a major socioeconomic crisis. By analysing this case study, we provide insights into the co-evolution over more than two decades, thereby addressing the lack of longitudinal studies on urban resilience.
Impact of CYP2D6, CYP2C9/19, CYP3A4, UGT, and SULT Variability on Tamoxifen Metabolism in Breast Cancer Treatment
Authors: Sidibe Mariam , Tazzite Amal , Jouhadi Hassan , Dehbi Hind
Published: February 2024

In hormone-receptor-positive breast cancer, the main treatment is tamoxifen. Tamoxifen is a weak antiestrogen that requires prior activation to its most active metabolite, endoxifen, which has superior antiestrogenic activity. In the search for predictive biomarkers to optimize treatment and reduce tamoxifen resistance, studies have concluded that endoxifen concentrations are associated with CYP2D6 activity and that the concentration of endoxifen and other metabolites (whose activities are also linked to the activity of other pharmacogenes) may be associated with tamoxifen efficacy. The aim of this review is to highlight the evidence concerning the contribution of pharmacogenes (CYP2D6, CYP2C9/19, CYP3A4, UGT, and SULT) to tamoxifen metabolism and the effect of the genetic variation to which they are subject on the concentration of active tamoxifen metabolites.
Variation in multimorbidity by sociodemographics and social drivers of health among patients seen at community-based health centers
Authors: Bensken Wyatt P , Navale Suparna M , McGrath Brenda M , Cook Nicole , Nishiike Yui , Mertes Gretchen , Goueth Rose , Jones Matthew , Templeton Anna , Zyzanski Stephen J , Koroukian Siran M , Stange Kurt C
Published: February 2024

Purpose

Understanding variation in multimorbidity across sociodemographics and social drivers of health is critical to reducing health inequities.

Methods

From the multi-state OCHIN network of community-based health centers (CBHCs), we identified a cross-sectional cohort of adult (> 25 years old) patients who had a visit between 2019-2021. We used generalized linear models to examine the relationship between the Multimorbidity Weighted Index (MWI) and sociodemographics and social drivers of health (Area Deprivation Index [ADI] and social risks [e.g., food insecurity]). Each model included an interaction term between the primary predictor and age to examine if certain groups had a higher MWI at younger ages.

Results

Among 642,730 patients, 28.2% were Hispanic/Latino, 42.8% were male, and the median age was 48. The median MWI was 2.05 (IQR: 0.34, 4.87) and was higher for adults over the age of 40 and American Indians and Alaska Natives. The regression model revealed a higher MWI at younger ages for patients living in areas of higher deprivation. Additionally, patients with social risks had a higher MWI (3.16; IQR: 1.33, 6.65) than those without (2.13; IQR: 0.34, 4.89) and the interaction between age and social risk suggested a higher MWI at younger ages.

Conclusions

Greater multimorbidity at younger ages and among those with social risks and living in areas of deprivation shows possible mechanisms for the premature aging and disability often seen in community-based health centers and highlights the need for comprehensive approaches to improving the health of vulnerable populations.
Shinrin-Yoku 森林浴 (Forest Bathing): A Scoping Review of the Global Research on the Effects of Spending Time in Nature
Authors: Vermeesch Amber L. , Ellsworth-Kopkowski Alexis , Prather Jenifer G. , Passel Cheryl , Rogers Heidi Honegger , Hansen Margaret M.
Published: February 2024

Background

This Scoping review (ScR) builds upon the 2017 review conducted by Hansen et al which contributed to evidence base shinrin-yoku (SY), also known as forest bathing (FB), has many positive health effects and is becoming a prescribed dose (specific time spent in nature) by health care providers. Practice and research regarding SY, has been historically based in Asian countries with a recent increase in Europe. The need and call for more research worldwide continues to further the evidence of SY as a health promotion modality. Through this ScR the authors identified programmatic components, health information monitored and screened, time spent in nature, geographical regions, trends, and themes in SY research worldwide.

Methods

Following PRISMA-ScR guidelines we searched across 7 electronic databases for SY or FB research articles from 2017 through 2022. PubMed, CINAHL, PsycInfo, ScienceDirect, SCOPUS, Embase, JSTOR were included due to the interdisciplinary nature of SY or FB research. Each database provided unique strengths ensuring a capture of a wide range of articles. The resulting articles were screened and extracted through Covidence.

Results

Database searches returned 241 results, with 110 references removed during the deduplication process, 131 were initially screened in the title and abstract review stage. Resulting in 82 unique results deemed relevant and screened in full text. During the final stage of the review, 63 articles met all inclusion criteria and were extracted for data.

Conclusions

The practice of SY has physiological (PHYS) and psychological (PSYCH) benefits across age groups. Research findings indicate either the natural or the virtual environment (VW) has significant health benefits. Continued research is encouraged globally for short- and long-term health outcomes for all individuals. The connection with nature benefits the mind, body and soul and is supported by Henry David Thoreau’s philosophy: “Our livesneed the relief of where the pine flourishes and the jay still scream.”
Physicians’ challenges when working in the prehospital environment - a qualitative study using grounded theory
Authors: Bäckström Denise , Alvinius Aida
Published: February 2024

Background

In the rapid development in prehospital medicine the awareness of the many challenges in prehospital care is important as it highlights which areas need improvement and where special attention during education and training should be focused. The purpose of this study is to identify challenges that physicians face when working in the prehospital environment. The research question is thus; what challenges do physicians face when working in prehospital care?

Method

This is a qualitative study with an inductive approach and is based on individual interviews. The interviews were analyzed using the Classic Grounded Theory (GT) method as an approach. The interviews were conducted as semi-structured interviews via the digital platform Zoom during winter / early spring 2022.

Results

Challenges for prehospital physicians can be understood as a process that involves a balancing act between different factors linked to the extreme environment in which they operate. This environment creates unique challenges not usually encountered in routine hospital practice, which results in trade-offs that they would not otherwise be faced with. Their individual situation needs to be balanced against organizational conditions, which means, among other things, that their medical decisions must be made based on limited information as a result of the constraints that exist in the prehospital environment. They must, both as individuals and as part of a team, manoeuvre in time and space for decision-making and practical tasks. This theory of balancing different entities is based on four themes; thus the theory is the relation between the four themes: leadership, environment, emotion management and organization.

Conclusions

With the help of previous studies and what we have found, it is reasonable to review what training is needed before starting to work prehospital as a physician. This should include components of the themes we have described: organization, environment, leadership and emotional management.
Palm-based tocotrienol-rich fraction (TRF) supplementation modulates cardiac sod1 expression, fxr target gene expression, and tauro-conjugated bile acid levels in aleptinemic mice fed a high-fat diet
Authors: Md Shahrulnizam Nur Aliah Natasha , Mohd Efendy Goon Mohd Danial , Ab Rahim Sharaniza , Lew Sook Weih , Sheikh Abdul Kadir Siti Hamimah , Ibrahim Effendi
Published: February 2024

Tocotrienol-rich fraction (TRF) has been reported to protect the heart from oxidative stress-induced inflammation. It is, however, unclear whether the protective effects of TRF against oxidative stress involve the activation of farnesoid X receptor (fxr), a bile acid receptor, and the regulation of bile acid metabolites. In the current study, we investigated the effects of TRF supplementation on antioxidant activities, expression of fxr and its target genes in cardiac tissue, and serum untargeted metabolomics of high-fat diet-fed mice. Mice were divided into high-fat diet (HFD) with or without TRF supplementation (control) for 6 weeks. At the end of the intervention, body weight (BW), waist circumference (WC), and random blood glucose were measured. Heart tissues were collected, and the gene expression of sod1, sod2, gpx, and fxr and its target genes shp and stat3 was determined. Serum was subjected to untargeted metabolomic analysis using UHPLC-Orbitrap. In comparison to the control, the WC of the TRF-treated group was higher (p >0.05) than that of the HFD-only group, in addition there was no significant difference in weight or random blood glucose level. Downregulation of sod1, sod2, and gpx expression was observed in TRF-treated mice; however, only sod1 was significant when compared to the HFD only group. The expression of cardiac shp (fxr target gene) was significantly upregulated, but stat3 was significantly downregulated in the TRF-treated group compared to the HFD-only group. Biochemical pathways found to be influenced by TRF supplementation include bile acid secretion, primary bile acid biosynthesis, and biotin and cholesterol metabolism. In conclusion, TRF supplementation in HFD-fed mice affects antioxidant activities, and more interestingly, TRF also acts as a signaling molecule that is possibly involved in several bile acid-related biochemical pathways accompanied by an increase in cardiac fxr shp expression. This study provides new insight into TRF in deregulating bile acid receptors and metabolites in high-fat diet-fed mice.
GPAD: a natural language processing-based application to extract the gene-disease association discovery information from OMIM
Authors: Rahit K. M. Tahsin Hassan , Avramovic Vladimir , Chong Jessica X. , Tarailo-Graovac Maja
Published: February 2024

Background

Thousands of genes have been associated with different Mendelian conditions. One of the valuable sources to track these gene-disease associations (GDAs) is the Online Mendelian Inheritance in Man (OMIM) database. However, most of the information in OMIM is textual, and heterogeneous (e.g. summarized by different experts), which complicates automated reading and understanding of the data. Here, we used Natural Language Processing (NLP) to make a tool (Gene-Phenotype Association Discovery (GPAD)) that could syntactically process OMIM text and extract the data of interest.

Results

GPAD applies a series of language-based techniques to the text obtained from OMIM API to extract GDA discovery-related information. GPAD can inform when a particular gene was associated with a specific phenotype, as well as the type of validation—whether through model organisms or cohort-based patient-matching approaches—for such an association. GPAD extracted data was validated with published reports and was compared with large language model. Utilizing GPAD's extracted data, we analysed trends in GDA discoveries, noting a significant increase in their rate after the introduction of exome sequencing, rising from an average of about 150–250 discoveries each year. Contrary to hopes of resolving most GDAs for Mendelian disorders by now, our data indicate a substantial decline in discovery rates over the past five years (2017–2022). This decline appears to be linked to the increasing necessity for larger cohorts to substantiate GDAs. The rising use of zebrafish and Drosophila as model organisms in providing evidential support for GDAs is also observed.

Conclusions

GPAD’s real-time analyzing capacity offers an up-to-date view of GDA discovery and could help in planning and managing the research strategies. In future, this solution can be extended or modified to capture other information in OMIM and scientific literature.
Combined analysis of mRNA and miRNA transcriptomes reveals the regulatory mechanism of Xanthomonas arboricola pv pruni resistance in Prunus persica
Authors: Zhu Pengxiang , Li Haiyan , Lu Tailiang , Liang Ruizheng , Wan Baoxiong
Published: February 2024

Background

Peach bacterial shot hole, caused by Xanthomonas arboricola pv pruni (Xap), is a global bacterial disease that poses a threat to the yield and quality of cultivated peach trees (Prunus persica).

Results

This study compared the mRNA and miRNA profiles of two peach varieties, ‘Yanbao’ (resistant) and ‘Yingzui’ (susceptible), after inoculation with Xap to identify miRNAs and target genes associated with peach tree resistance. mRNA sequencing results revealed that in the S0-vs-S3 comparison group, 1574 genes were upregulated and 3975 genes were downregulated. In the R0-vs-R3 comparison group, 1575 genes were upregulated and 3726 genes were downregulated. Through miRNA sequencing, a total of 112 known miRNAs belonging to 70 miRNA families and 111 new miRNAs were identified. Notably, some miRNAs were exclusively expressed in either resistant or susceptible varieties. Additionally, 59 miRNAs were downregulated and 69 miRNAs were upregulated in the R0-vs-R3 comparison group, while 46 miRNAs were downregulated and 52 miRNAs were upregulated in the S0-vs-S3 comparison group. Joint analysis of mRNA and miRNA identified 79 relationship pairs in the S0-vs-S3 comparison group, consisting of 48 miRNAs and 51 target genes. In the R0-vs-R3 comparison group, there were 58 relationship pairs, comprising 28 miRNAs and 20 target genes. Several target genes related to resistance, such as SPL6, TIFY6B, and Prupe.4G041800_v2.0.a1 (PPO), were identified through literature reports and GO/KEGG enrichment analysis.

Conclusion

In conclusion, this study discovered several candidate genes involved in peach tree resistance by analyzing differential expression of mRNA and miRNA. These findings provide valuable insights into the mechanisms underlying resistance to Xap in peach trees.
Pangenome analysis of Shewanella xiamenensis revealed important genetic traits concerning genetic diversity, pathogenicity and antibiotic resistance
Authors: Wang Haichen , Xia Fengjun , Xia Yubing , Li Jun , Hu Yongmei , Deng Yating , Zou Mingxiang
Published: February 2024

Background

Shewanella xiamenensis, widely distributed in natural environments, has long been considered as opportunistic pathogen. Recently, significant changes in the resistance spectrum have been observed in S. xiamenensis, due to acquired antibiotic resistance genes. Therefore, a pan-genome analysis was conducted to illuminate the genomic changes in S. xiamenensis.

Results

Phylogenetic analysis revealed three major clusters and three singletons, among which close relationship between several strains was discovered, regardless of their host and niches. The “open” genomes with diversity of accessory and strain-specific genomes took advantage towards diversity environments. The purifying selection pressure was the main force on genome evolution, especially in conservative genes. Only 53 gene families were under positive selection pressure. Phenotypic resistance analysis revealed 21 strains were classified as multi-drug resistance (MDR). Ten types of antibiotic resistance genes and two heavy metal resistance operons were discovered in S. xiamenensis. Mobile genetic elements and horizontal gene transfer increased genome diversity and were closely related to MDR strains. S. xiamenensis carried a variety of virulence genes and macromolecular secretion systems, indicating their important roles in pathogenicity and adaptability. Type IV secretion system was discovered in 15 genomes with various sequence structures, indicating it was originated from different donors through horizontal gene transfer.

Conclusions

This study provided with a detailed insight into the changes in the pan-genome of S. xiamenensis, highlighting its capability to acquire new mobile genetic elements and resistance genes for its adaptation to environment and pathogenicity to human and animals.
Phenotypic, molecular, and in silico characterization of coumarin as carbapenemase inhibitor to fight carbapenem-resistant Klebsiella pneumoniae
Authors: Abdel-Halim Mahmoud Saad , El-Ganiny Amira M. , Mansour Basem , Yahya Galal , Latif Hemat K. Abd El , Askoura Momen
Published: February 2024

Background

Carbapenems represent the first line treatment of serious infections caused by drug-resistant Klebsiella pneumoniae. Carbapenem-resistant K. pneumoniae (CRKP) is one of the urgent threats to human health worldwide. The current study aims to evaluate the carbapenemase inhibitory potential of coumarin and to test its ability to restore meropenem activity against CRKP. Disk diffusion method was used to test the antimicrobial susceptibility of K. pneumoniae clinical isolates to various antibiotics. Carbapenemase genes (NDM-1, VIM-2, and OXA-9) were detected using PCR. The effect of sub-MIC of coumarin on CRKP isolates was performed using combined disk assay, enzyme inhibition assay, and checkerboard assay. In addition, qRT-PCR was used to estimate the coumarin effect on expression of carbapenemase genes. Molecular docking was used to confirm the interaction between coumarin and binding sites within three carbapenemases.

Results

K. pneumoniae clinical isolates were found to be multi-drug resistant and showed high resistance to meropenem. All bacterial isolates harbor at least one carbapenemase-encoding gene. Coumarin significantly inhibited carbapenemases in the crude periplasmic extract of CRKP. The checkerboard assay indicated that coumarin-meropenem combination was synergistic exhibiting a fractional inhibitory concentration index ≤ 0.5. In addition, qRT-PCR results revealed that coumarin significantly decreased carbapenemase-genes expression. Molecular docking revealed that the binding energies of coumarin to NDM1, VIM-2, OXA-48 and OXA-9 showed a free binding energy of -7.8757, -7.1532, -6.2064 and − 7.4331 Kcal/mol, respectively.

Conclusion

Coumarin rendered CRKP sensitive to meropenem as evidenced by its inhibitory action on hydrolytic activity and expression of carbapenemases. The current findings suggest that coumarin could be a possible solution to overcome carbapenems resistance in CRKP.
Digital stressors and resources perceived by emergency physicians and associations to their digital stress perception, mental health, job satisfaction and work engagement
Authors: Bernburg Monika , Tell Anika , Groneberg David A. , Mache Stefanie
Published: February 2024

Background

Digital technologies are increasingly being integrated into healthcare settings, including emergency departments, with the potential to improve efficiency and patient care. Although digitalisation promises many benefits, the use of digital technologies can also introduce new stressors and challenges among medical staff, which may result in the development of various negative work and health outcomes. Therefore, this study aims to identify existing digital stressors and resources among emergency physicians, examine associations with various work- and health-related parameters, and finally identify the potential need for preventive measures.

Methods

In this quantitative cross-sectional study, an online questionnaire was used to examine the relationship between digital stressors (technostress creators), digital resources (technostress inhibitors), technostress perception as well as mental health, job satisfaction and work engagement among 204 physicians working in German emergency medicine departments. Data collection lasted from December 2022 to April 2023. Validated scales were used for the questionnaire (e.g. “Technostress”-scale and the Copenhagen Psychosocial Questionnaire (COPSOQ). Descriptive and multiple regression analyses were run to test explorative assumptions.

Results

The study found medium levels of technostress perception among the participating emergency physicians as well as low levels of persisting technostress inhibitors. The queried physicians on average reported medium levels of exhaustion symptoms, high levels of work engagement and job satisfaction. Significant associations between digital stressors and work- as well as health-related outcomes were analyzed.

Conclusion

This study provides a preliminary assessment of the persistence of digital stressors, digital resources and technostress levels, and their potential impact on relevant health and work-related outcomes, among physicians working in German emergency departments. Understanding and mitigating these stressors is essential to promote the well-being of physicians and ensure optimal patient care. As digitisation processes will continue to increase, the need for preventive support measures in dealing with technology stressors is obvious and should be expanded accordingly in the clinics. By integrating such support into everyday hospital life, medical staff in emergency departments can better focus on patient care and mitigate potential stress factors associated with digital technologies.
Change analysis for intermediate disease markers in nutritional epidemiology: a causal inference perspective
Authors: Tang Dan , Hu Yifan , Zhang Ning , Xiao Xiong , Zhao Xing
Published: February 2024

Background

Several approaches are commonly used to estimate the effect of diet on changes of various intermediate disease markers in prospective studies, including “change-score analysis”, “concurrent change-change analysis” and “lagged change-change analysis”. Although empirical evidence suggests that concurrent change-change analysis is most robust, consistent, and biologically plausible, in-depth dissection and comparison of these approaches from a causal inference perspective is lacking. We intend to explicitly elucidate and compare the underlying causal model, causal estimand and interpretation of these approaches, intuitively illustrate it with directed acyclic graph (DAG), and further clarify strengths and limitations of the recommended concurrent change-change analysis through simulations.

Methods

Causal model and DAG are deployed to clarify the causal estimand and interpretation of each approach theoretically. Monte Carlo simulation is used to explore the performance of distinct approaches under different extents of time-invariant heterogeneity and the performance of concurrent change-change analysis when its causal identification assumptions are violated.

Results

Concurrent change-change analysis targets the contemporaneous effect of exposure on outcome (measured at the same survey wave), which is more relevant and plausible in studying the associations of diet and intermediate biomarkers in prospective studies, while change-score analysis and lagged change-change analysis target the effect of exposure on outcome after one-period timespan (typically several years). Concurrent change-change analysis always yields unbiased estimates even with severe unobserved time-invariant confounding, while the other two approaches are always biased even without time-invariant heterogeneity. However, concurrent change-change analysis produces almost linearly increasing estimation bias with violation of its causal identification assumptions becoming more serious.

Conclusions

Concurrent change-change analysis might be the most superior method in studying the diet and intermediate biomarkers in prospective studies, which targets the most plausible estimand and circumvents the bias from unobserved individual heterogeneity. Importantly, careful examination of the vital identification assumptions behind it should be underscored before applying this promising method.
Impact of COVID-19 pandemic on pediatric dental procedures in primary healthcare settings in Piracicaba, Brazil: an ecological study
Authors: Figueiredo dos Santos Rúbia Vanessa , Bado Fernanda Maria Rovai , da Cunha Inara Pereira , de Castro Meneghim Marcelo
Published: February 2024

Background

The COVID-19 pandemic brought significant changes to dental care, which may have affected pediatric dental care offered in primary healthcare settings. Therefore, the aim of this study was to analyze the quantity of dental procedures performed in primary healthcare for children aged 6 to 12 years, before and during the COVID-19 pandemic.

Methods

This is an ecological study using data from the health information system of Piracicaba, São Paulo, Brazil. The variables considered were: coverage of first programmed dental consultation, restoration of permanent and deciduous teeth, topical fluoride application (individual per session), emergency care, and deciduous tooth extraction. Two periods were considered: period I (March 1, 2019 to February 29, 2020) and period II (April 1, 2020 to March 31, 2021), before and during the pandemic, respectively. Comparisons between periods were made using the paired nonparametric Wilcoxon test with a significance level of 5%.

Results

There was an increase in emergency care from 15.4 to 32.4% (p = 0.0095) and a decrease in the number of restorations of deciduous teeth from 32.8 to 20.2% (p = 0.0217). The first programmed consultation showed a decrease of 9.60% (p = 0.0930) in period II.

Conclusions

The COVID-19 pandemic has hindered access to primary dental care for children, impacting the quantity of emergency care, reducing restorations of deciduous teeth, and first programmed dental consultations. These findings highlight the need for strategies to ensure that pediatric dental care is not neglected during pandemics.
Effect of home-based lifestyle interventions on cognition in older adults with mild cognitive impairment: a systematic review
Authors: Zou Cynthia , Amos-Richards Divinity , Jagannathan Ram , Kulshreshtha Ambar
Published: February 2024

Background

Mild Cognitive Impairment (MCI) is frequently a precursor to dementia, affecting aspects of cognition such as language, thinking, or memory. Lifestyle interventions are increasingly studied as potential means to slow the progression from MCI to dementia.

Objective

A systematic review was conducted to investigate the effectiveness of home-based lifestyle interventions in reducing cognitive decline in older adults with MCI.

Methods

A systematic review of randomized controlled trials (RCTs) was conducted to identify home-based lifestyle interventions for individuals with MCI from 1980 to 2023. These interventions were either single-component or multi-component and included diet, physical activity, stress-reduction, or cognitive stimulation treatments to assess their impact on cognition. We performed a comprehensive search in the PubMed, Web of Science, Google Scholar, Embase, and MEDLINE databases.

Results

From 320 abstracts, 20 (6.25%) studies met the criteria for inclusion, with five multi-component and fifteen single-component studies. Eighteen home-based lifestyle interventions for MCI patients were focused on physical activity, diet, and/or cognitive training, while two studies were identified that incorporated stress reduction training as a method to improve cognitive function. Nineteen studies reported significant improvements in cognitive performance between the experimental and control groups post-intervention for at least one aspect of cognition. Four studies reported nonsignificant improvements in cognitive function between the two groups for at least one area of cognition.

Conclusions

Home-based lifestyle interventions have the potential to improve cognition in elderly patients with MCI. However, future RCTs with larger sample sizes and longer intervention durations are needed to confirm these findings.
Exploration of subgroups and predictors of loneliness among older adults in rural China: A latent profile analysis
Authors: Wang Yuecong , Li Shasha , Zou Xiaoyue , Ni Yingyuan , Xu Lijun , Liao Shufang , Cao Lijun , Bao Jianyi , Li Yue , Xi Yingxue
Published: February 2024

Background

Loneliness is a negative emotional state that can lead to physical and mental health problems. This study’s objective was to acquire an in-depth understanding of the heterogeneity and the predictors of loneliness among older adults in rural China and provide valuable references for practical interventions.

Methods

Older rural adults in China (N = 680) were recruited between January and April 2023. Latent profile analysis (LPA) was employed to identify subgroups of loneliness among participants. Single-factor and multinomial logistic regression analyses were conducted to investigate predictors of loneliness.

Results

The loneliness of rural older adults could be divided into three subgroups: low interaction loneliness group (55.0%), moderate emotional loneliness group (31.8%), and high loneliness group (13.2%). The subgroup predictors included age, gender, religious beliefs, marital status, living alone, number of chronic diseases, and smartphone use (P < 0.05).

Conclusion

This study identified a classification pattern for loneliness among older adults in rural areas of China, revealed the characteristics of different demographic variables in loneliness categories, and highlighted the heterogeneity of loneliness in this population. It serves as a theoretical reference for formulating intervention plans aimed at addressing various loneliness categories for local rural older adults.

Clinical trial registration

ChiCTR2300071591.
Automated machine learning for the identification of asymptomatic COVID-19 carriers based on chest CT images
Authors: Yin Minyue , Xu Chao , Zhu Jinzhou , Xue Yuhan , Zhou Yijia , He Yu , Lin Jiaxi , Liu Lu , Gao Jingwen , Liu Xiaolin , Shen Dan , Fu Cuiping
Published: February 2024

Background

Asymptomatic COVID-19 carriers with normal chest computed tomography (CT) scans have perpetuated the ongoing pandemic of this disease. This retrospective study aimed to use automated machine learning (AutoML) to develop a prediction model based on CT characteristics for the identification of asymptomatic carriers.

Methods

Asymptomatic carriers were from Yangzhou Third People’s Hospital from August 1st, 2020, to March 31st, 2021, and the control group included a healthy population from a nonepizootic area with two negative RT‒PCR results within 48 h. All CT images were preprocessed using MATLAB. Model development and validation were conducted in R with the H2O package. The models were built based on six algorithms, e.g., random forest and deep neural network (DNN), and a training set (n = 691). The models were improved by automatically adjusting hyperparameters for an internal validation set (n = 306). The performance of the obtained models was evaluated based on a dataset from Suzhou (n = 178) using the area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and F1 score.

Results

A total of 1,175 images were preprocessed with high stability. Six models were developed, and the performance of the DNN model ranked first, with an AUC value of 0.898 for the test set. The sensitivity, specificity, PPV, NPV, F1 score and accuracy of the DNN model were 0.820, 0.854, 0.849, 0.826, 0.834 and 0.837, respectively. A plot of a local interpretable model-agnostic explanation demonstrated how different variables worked in identifying asymptomatic carriers.

Conclusions

Our study demonstrates that AutoML models based on CT images can be used to identify asymptomatic carriers. The most promising model for clinical implementation is the DNN-algorithm-based model.
Reference values for the 6-min walking test in children and adolescents living in a moderate altitude region of Peru
Authors: Sulla-Torres Jose , Vidal-Espinoza Rubén , Avendaño-Llanque Christopher , Calla-Gamboa Alexander , Zúñiga-Carnero Manuel , Gomez-Campos Rossana , Cossio-Bolaños Marco
Published: February 2024

Background

The assessment of cardiorespiratory fitness is important because it allows the identification of subgroups with poor health status and the targeting of effective intervention strategies to improve health.

Objective

To compare the cardiorespiratory capacity of children and adolescents living in a moderate altitude region of Peru with international studies and to develop reference values for the 6-min walk test (6MWT) according to age and sex.

Methodology

A descriptive cross-sectional study of schoolchildren from a region of moderate altitude in Peru was carried out. A total of 704 schoolchildren (400 males and 304 females) with an age range of 6 to 17 years were studied. Weight, standing height, waist circumference (WC), body mass index (BMI) and tri-ponderal mass index (TMI) were evaluated. The 6MWT was assessed in a straight line over a distance of 30 m. Percentiles were created through the LMS method [L (skewness: lambda), M (median: mu) and S (coefficient of variation: Mu)].

Results

There were discrepancies in cardiorespiratory fitness performance with international studies by age and sex. The schoolchildren in the study reached stability and the highest number of meters in the last two age ranges (14 to 15 years: 698.1 m and 16 to 17 years 686.3 m in males). While females (14 to 15 years: 698.1 m and 16 to 17 years: 686.3 m). The proposed percentile values show ascending values as age advances. The cut-off points adopted are: low cardiorespiratory fitness < p25, moderate p25 to p75 and high cardiorespiratory fitness p > 75.

Conclusion

We verified that the cardiorespiratory fitness evaluated by means of the 6MWT is ascending with the course of age. Even the performance with other countries is heterogeneous at early and middle ages, stabilizing during adolescence. The proposed reference values can be used to evaluate and monitor cardiorespiratory fitness during physical education classes.
COVID-19-related dysfunctional anxiety and associated factors among adolescents in Southwest Ethiopia: a cross-sectional study
Authors: Berhanu Robera Demissie , Feyisa Jira Wakoya , Boru Jibril Dori , Jabana Desalegn Emana , Senbeta Birbirsa Sefera , Tekle Million Girma , Alemayehu Yadeta , Aga Hunde Tarafa
Published: February 2024

Background

COVID-19 pandemic causes serious threats to people’s mental health, particularly it has huge negative mental health outcomes for adolescents. However, there is lack of studies examining COVID-19-related anxiety among adolescents in Ethiopia. Hence, this study was aimed to examine COVID-19-related dysfunctional anxiety and its associated factors among adolescents in Mettu town.

Methods

Community-based cross-sectional study was conducted from September 1 to 30, 2020 among 847 adolescents selected by stratified sampling technique. IBM SPSS Statistics Version 26.0 was used for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were computed. Bivariate and multivariate binary logistic regression analyses were done to identify factors associated with COVID-19-related dysfunctional anxiety. The statistical significance was declared at p ≤ 0.05; and the strength of association was described in terms of adjusted odds ratio.

Results

Out of the total sample, 819 adolescents participated in this study. The mean age of the participants was 14.9 (SD = 2.798) years. The magnitude of COVID-19-related dysfunctional anxiety was found to be 20.9% (95% CI (18.1, 23.9)). The finding indicates that sex [(AOR (95% CI)); (0.724 (0.502, 1.043))], having both parents deceased [(AOR (95% CI)); (2.981 (1.138, 7.814))], living alone [(AOR (95% CI)); (2.363 (1.050, 5.321))], having unemployed mothers [(AOR (95% CI)); (1.943 (1.194, 3.163))], absence of close friend [(AOR (95% CI)); (0.377 (0.225, 0.630))], and medical problem [(AOR (95% CI)); (0.408 (0.278, 0.597))] were significantly associated with COVID-19-related anxiety.

Conclusion

The magnitude of COVID-19-related dysfunctional anxiety was found to be high in the study area. The findings have shown that the likelihood of developing COVID-19-related dysfunctional anxiety was linked to several factors. Provision of continued psychological support for adolescents is extremely encouraged.