bluuebunny/crossref_metadata_2025 huggingface dataset:
The 50 Most Cited Papers Pertaining to American Football: Analysis of Studies From the Past 40 Years
Authors: Jenkins Anna S. , Moore Michael L. , Pollock Jordan R. , Brinkman Joseph C. , Verhey Jens , Chhabra Anikar
Published: December 2022

Background:

Bibliometric citation analyses have been widely used in medicine to help researchers gain foundational knowledge about a topic and identify subtopics of popular interest for further investigations.

Purpose:

To identify the 50 most cited research publications related to American football.

Study Design:

Cross-sectional study.

Methods:

The Clarivate Analytics Web of Science database was used to generate a list of publications relating to football. Articles were filtered by the total number of citations, and the top 50 most cited articles studying the sport of football were selected for this analysis. Articles were analyzed by author, publication year, country of origin, institution affiliation, journal, article type, main research topic area, competitive level, and the level of evidence. A total of 247 articles were reviewed to reach the top 50 articles.

Results:

The most studied topic within the top 50 articles was concussion/chronic traumatic encephalopathy (n = 40). Collegiate football was the most studied level of competition (n = 25). The journal publishing the greatest number of top articles was Neurosurgery. Two institutions, the University of North Carolina at Chapel Hill and Boston University School of Medicine, produced over one-third of top 50 articles (n = 18).

Conclusion:

Our analysis indicated that most of the top 50 publications related to the sport of football focused on concussion and CTE, were observational, and were published during or after 2000. The most studied level of competition was collegiate football.
Factors Influencing Physician Prognosis: A Scoping Review
Authors: Ferrand Amaryllis , Poleksic Jelena , Racine Eric
Published: December 2022

Introduction. Prognosis is an essential component of informed consent for medical decision making. Research shows that physicians display discrepancies in their prognostication, leading to variable, inaccurate, optimistic, or pessimistic prognosis. Factors driving these discrepancies and the supporting evidence have not been reviewed systematically. Methods. We undertook a scoping review to explore the literature on the factors leading to discrepancies in medical prognosis. We searched Medline (Ovid) and Embase (Ovid) databases for peer-reviewed articles from 1970 to 2017. We included articles that discussed prognosis variation or discrepancy and where factors influencing prognosis were evaluated. We extracted data outlining the participants, methodology, and prognosis discrepancy information and measured factors influencing prognosis. Results. Of 4,723 articles, 73 were included in the final analysis. There was significant variability in research methodologies. Most articles showed that physicians were pessimistic regarding patient outcomes, particularly in early trainees and acute care specialties. Accuracy rates were similar across all time periods. Factors influencing prognosis were clustered in 4 categories: patient-related factors (such as age, gender, race, diagnosis), physician-related factors (such as age, race, gender, specialty, training and experience, attitudes and values), clinical situation-related factors (such as physician-patient relationship, patient location, and clinical context), and environmental-related factors (such as country or hospital size). Discussion. Obtaining accurate prognostic information is one of the highest priorities for seriously ill patients. The literature shows trends toward pessimism, especially in early trainees and acute care specialties. While some factors may prove difficult to change, the physician’s personality and psychology influence prognosis accuracy and could be tackled using debiasing strategies. Exposure to long-term patient outcomes and a multidisciplinary practice setting are environmental debiasing strategies that may warrant further research.

Highlights

Literature on discrepancies in physician’s prognostication is heterogeneous and sparse. Literature shows that physicians are mostly pessimistic regarding patient outcomes. Literature shows that a physician’s personality and psychology influence prognostic accuracy and could be improved with evidence-based debiasing strategies. Medical specialty strongly influences prognosis, with specialties exposed to acutely ill patients being more pessimistic, whereas specialties following patients longitudinally being more optimistic. Physicians early in their training were more pessimist than more experienced physicians.
The Function of Mid-day Meal Scheme: A Critical Analysis of Existing Policies and Procedures in Rayagada District of Odisha (India)
Authors: Sripathi Nishchala , Mohapatra Jagatabandhu , Dehury Parthsarathi , Neeragatti Surya , Behera Sangita , Dehury Ranjit Kumar
Published: December 2022

The Government of India initiated the second-largest food security programme, named the mid-day meal (MDM) Scheme to tackle nutrition-related issues, especially for children in backward communities. The main aim of the MDM Scheme in government and government-aided schools is to improve physical and economic access to nutritious food for children. The study evaluates the challenges regarding the existing practices in implementing the MDM Scheme in two blocks of the Rayagada district (Odisha, India). Rayagada district is one of the tribal districts with a high malnutrition condition among children. Further, the two blocks have been selected based on the implementation of MDM on a unique project basis in a resource crunch area. The study shows that the MDM Scheme has challenges with critical implementation issues such as delays in delivery, low-quality food, lack of water facilities and unhygienic cooking and serving practices. The findings have implications for effective implementation of the programme in similar contexts.
Test-Retest Reliability and Agreement of Single Pulse Transcranial Magnetic Stimulation (TMS) for Measuring Activity in Motor Cortex in Patients With Acute Ischemic Stroke
Authors: Henriette Busk , Marianne Nilsen , Rønne Pedersen Julie , Glavin Kristensen Malene , Wesenberg Kjær Troels , Thorgaard Skou Søren , Troels Wienecke
Published: December 2022

Background:

Transcranial magnetic stimulation (TMS) is often used to examine neurophysiology. We aimed to investigate the inter-rater reliability and agreement of single pulse TMS in hospitalised acute ischemic stroke patients.

Methods:

Thirty-one patients with first-time acute ischemic stroke (median age 72 (IQR 64-75), 35% females) underwent TMS motor threshold (MT) assessment in 4 muscles bilaterally, conducted by 1 of 2 physiotherapists. Test-retest reliability was evaluated using a two-way random effects model (2,1) absolute agreement-type Interclass Correlation Coefficient (ICC). Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC) were used to evaluate agreement.

Results:

Reliability, SEM, and SDC of TMS was found to be moderate in right opponens pollicis (0.78 [CI 95% 0.55-0.89], SEM: 4.51, SDC: 12.51), good in right vastus medialis and tibial anterior (0.88 [CI 95% 0.72-0.96], SEM: 2.89, SDC: 8.01 and 0.88 [CI 95% 0.76-0.94], SEM: 2.88, SDC: 7.98 respectively), and excellent in right and left biceps brachii (0.98 [CI 95% 0.96-0.99], SEM: 1.79 SDC: 4.96, and 0.94 [CI 95% 0.89-0.97], SEM: 2.17 SDC: 6.01), opponens pollicis (0.92 [CI 95% 0.83-0.96], SEM: 2.68 SDC: 8.26, vastus medialis (0.92 [CI 95% 0.84-0.96], SEM: 2.87 SDC: 7.95), and tibial anterior (0.93 [CI 95% 0.86-0.96], SEM: 2.51 SDC: 6.95).

Conclusion:

The TMS demonstrated moderate to excellent inter-rater reliability confirming the ability of these measures to reliably discriminate between individuals in the current study sample. Improvements of less than 4.96 to 12.51 could be a result of measurement error and may therefore not be considered a true change.
Flotetuzumab and other T-cell immunotherapies upregulate MHC class II expression on acute myeloid leukemia cells
Authors: Rimando Joseph C. , Chendamarai Ezhilarasi , Rettig Michael P. , Jayasinghe Reyka , Christopher Matthew J. , Ritchey Julie K. , Christ Stephanie , Kim Miriam Y. , Bonvini Ezio , DiPersio John F.
Published: December 2022

Acute myeloid leukemia (AML) relapse is one of the most common and significant adverse events following allogeneic hematopoietic cell transplantation (HCT). Downregulation of major histocompatibility class II (MHC-II) surface expression on AML blasts may represent a mechanism of escape from the graft-versus-malignancy effect and facilitate relapse. We hypothesized that T-cell immunotherapies targeting AML antigens would upregulate MHC-II surface expression via localized release of interferon gamma (IFN-γ), a protein known to upregulate MHC-II expression via JAK-STAT signaling. We demonstrate that flotetuzumab (FLZ), a CD123 × CD3 bispecific DART molecule, and chimeric antigen receptor expressing T cells targeting CD123, CD33, or CD371 upregulate MHC-II surface expression in vitro on a THP-1 AML cell line with intermediate MHC-II expression and 4 primary AML samples from patients relapsing after HCT with low MHC-II expression. We additionally show that FLZ upregulates MHC-II expression in a patient-derived xenograft model and in patients with relapsed or refractory AML who were treated with FLZ in a clinical trial. Finally, we report that FLZ-induced MHC-II upregulation is mediated by IFN-γ. In conclusion, we provide evidence that T-cell immunotherapies targeting relapsed AML can kill AML via both MHC-independent mechanisms and by an MHC-dependent mechanism through local release of IFN-γ and subsequent upregulation of MHC-II expression.
Bio-distribution of Carbon Nanoparticles Studied by Photoacoustic Measurements
Authors: Dubyk Kateryna , Borisova Tatiana , Paliienko Konstantin , Krisanova Natalia , Isaiev Mykola , Alekseev Sergei , Skryshevsky Valeriy , Lysenko Vladimir , Geloen Alain
Published: December 2022

Carbon-based nanomaterials are promising for a wide range of biomedical applications, i.e. drug delivery, therapy, and imaging including photoacoustic tomography, where they can serve as contrast agents, biocompatibility and biodistribution of which should be assessed before clinical setting. In this paper, localization of carbon flurooxide nanoparticles, carbon nanodots from β-alanine, carbon nanodots from urea and citric acid and glucose-ethylenediamine nanoparticles (NPs) in organs of Wistar rats were studied by photoacoustic measurements after 24 h of their intravenous injection. 16 ns light pulse from a Q-switched Nd:YAG laser with 1064 nm wavelength was used as an excitation source. The laser-induced photoacoustic signals were recorded with a ring piezoelectric detector. Light absorption by carbon NPs resulted in noticeable enhancement of the photoacoustic amplitude in the tissues where the NPs were accumulated. The NPs were preferably accumulated in liver, kidneys and spleen, and to a lesser extent in heart and gastrocnemius muscles. Together with remarkable fluorescent properties of the studied carbon nanomaterials, their photoacoustic responses allow their application for bi-modal fluorescence-photoacoustic bio-imaging.
Enhancement of Heat and Drought Stress Tolerance in Rice by Genetic Manipulation: A Systematic Review
Authors: Yang Yingxue , Yu Jianping , Qian Qian , Shang Lianguang
Published: December 2022

As a result of global warming, plants are subjected to ever-increasing abiotic stresses including heat and drought. Drought stress frequently co-occurs with heat stress as a result of water evaporation. These stressors have adverse effects on crop production, which in turn affects human food security. Rice is a major food resource grown widely in crop-producing regions throughout the world. However, increasingly common heat and drought stresses in growth regions can have negative impacts on seedling morphogenesis, reproductive organ establishment, overall yield, and quality. This review centers on responses to heat and drought stress in rice. Current knowledge of molecular regulation mechanisms is summarized. We focus on approaches to cope with heat and drought stress, both at the genetic level and from an agricultural practice perspective. This review establishes a basis for improving rice stress tolerance, grain quality, and yield for human benefit.
microRNA-338-3p suppresses lipopolysaccharide-induced inflammatory response in HK-2 cells
Authors: Wang Jing , Li Guokai , Lin Min , Lin Sheng , Wu Ling
Published: December 2022

Background

Inflammation is the most common cause of kidney damage, and inflammatory responses in a number of diseases are mediated by microRNA-338-3p (miR-338-3p). However, there are only a few reports which described the regulation of miR-338-3p in human proximal tubular cells. The goal of this study was to see how miR-338-3p affected lipopolysaccharide (LPS)-caused inflammatory response in HK-2 cells.

Methods

LPS was used to construct an inflammatory model in HK-2 cells. miR-338-3p mimic was used to increase the levels of miR-338-3p in HK-2 cells. MTT, JC-1 staining, and apoptosis assays were used to detect cell viability, mitochondrial membrane potential (MMP), and apoptosis, respectively. The production of inflammatory factors and the levels of p38, p65, phospho-p65, phospho-p38, Bax, Bcl-2, cleaved caspase-9, and cleaved caspase-3 were investigated using real-time polymerase chain reaction, western blotting, or enzyme-linked immunosorbent assay.

Results

The levels of miR-338-3p were significantly lower in serum from patients with sepsis-induced kidney injury compared to the serum from healthy volunteers (P < 0.05). LPS reduced the level of miR-338-3p in HK-2 cells (P < 0.05). HK-2 cell viability, mitochondrial membrane potential, and Bcl-2 mRNA and protein levels were decreased by LPS (allP < 0.05). Apoptosis, the mRNA and protein levels of inflammatory cytokines (IL-1β, IL-6, IL-8, and TNF-α) and Bax, and the levels of cleaved caspase-9 and caspase-3 were increased by LPS (allP < 0.05). Raising the level of miR-338-3p mitigated these effects of LPS (allP < 0.05).

Conclusion

LPS-induced inflammation in HK-2 cells is reduced by miR-338-3p.
Impact of the fluid challenge infusion rate on cardiac stroke volume during major spinal neurosurgery: a prospective single center randomized interventional trial
Authors: Schmidt Götz , Schneck Emmanuel , Edinger Fabian , Jablawi Fidaa , Uhl Eberhard , Koch Christian , Sander Michael
Published: December 2022

Background

Fluid therapy, including the choice of a crystalloid or colloid infusion, the execution time of a volume bolus, and the expected volume need of a patient during surgery, varies greatly in clinical practice. Different goal directed fluid protocols have been developed, where fluid boluses guided by dynamic preload parameters are administered within a specific period.

Objective

To study the efficacy of two fluid bolus infusion rates measured by the response of hemodynamic parameters.

Design

Monocentric randomized controlled interventional trial.

Setting

University hospital.

Patients

Forty patients undergoing elective major spinal neurosurgery in prone position were enrolled, thirty-one were finally analyzed.

Interventions

Patients were randomly assigned to receive 250 ml crystalloid and colloid boluses within 5 min (group 1) or 20 min (group 2) when pulse pressure variation (PPV) exceeded 14%.

Main outcome measures

Changes in stroke volume (SV), mean arterial pressure (MAP), and catecholamine administration.

Results

Group 1 showed a greater increase in SV (P = 0.031), and MAP (P = 0.014), while group 2 still had higher PPV (P = 0.005), and more often required higher dosages of noradrenalin after fluid administration (P = 0.033). In group 1, fluid boluses improved CI (P < 0.01), SV (P < 0.01), and MAP (P < 0.01), irrespective of whether crystalloids or colloids were used. In group 2, CI and SV did not change, while MAP was slightly increased (P = 0.011) only after colloid infusion.

Conclusions

A fluid bolus within 5 min is more effective than those administered within 20 min and should therefore be the primary treatment option. Furthermore, bolus infusions administered within 20 min may result in volume overload without achieving relevant hemodynamic improvements.

Trial registration

German Clinical Trials Register: DRKS00022917.
A machine learning approach using endpoint adjudication committee labels for the identification of sepsis predictors at the emergency department
Authors: Niemantsverdriet Michael S. A. , de Hond Titus A. P. , Hoefer Imo E. , van Solinge Wouter W. , Bellomo Domenico , Oosterheert Jan Jelrik , Kaasjager Karin A. H. , Haitjema Saskia
Published: December 2022

Accurate sepsis diagnosis is paramount for treatment decisions, especially at the emergency department (ED). To improve diagnosis, clinical decision support (CDS) tools are being developed with machine learning (ML) algorithms, using a wide range of variable groups. ML models can find patterns in Electronic Health Record (EHR) data that are unseen by the human eye. A prerequisite for a good model is the use of high-quality labels. Sepsis gold-standard labels are hard to define due to a lack of reliable diagnostic tools for sepsis at the ED. Therefore, standard clinical tools, such as clinical prediction scores (e.g. modified early warning score and quick sequential organ failure assessment), and claims-based methods (e.g. ICD-10) are used to generate suboptimal labels. As a consequence, models trained with these “silver” labels result in ill-trained models. In this study, we trained ML models for sepsis diagnosis at the ED with labels of 375 ED visits assigned by an endpoint adjudication committee (EAC) that consisted of 18 independent experts. Our objective was to evaluate which routinely measured variables show diagnostic value for sepsis. We performed univariate testing and trained multiple ML models with 95 routinely measured variables of three variable groups; demographic and vital, laboratory and advanced haematological variables. Apart from known diagnostic variables, we identified added diagnostic value for less conventional variables such as eosinophil count and platelet distribution width. In this explorative study, we show that the use of an EAC together with ML can identify new targets for future sepsis diagnosis research.
Combinational Regularity Analysis (CORA) — a new method for uncovering complex causation in medical and health research
Authors: Thiem Alrik , Mkrtchyan Lusine , Sebechlebská Zuzana
Published: December 2022

Background

Modern configurational comparative methods (CCMs) of causal inference, such as Qualitative Comparative Analysis (QCA) and Coincidence Analysis (CNA), have started to make inroads into medical and health research over the last decade. At the same time, these methods remain unable to process data on multi-morbidity, a situation in which at least two chronic conditions are simultaneously present. Such data require the capability to analyze complex effects. Against a background of fast-growing numbers of patients with multi-morbid diagnoses, we present a new member of the family of CCMs with which multiple conditions and their complex conjunctions can be analyzed: Combinational Regularity Analysis (CORA).

Methods

The technical heart of CORA consists of algorithms that have originally been developed in electrical engineering for the analysis of multi-output switching circuits. We have adapted these algorithms for purposes of configurational data analysis. To demonstrate CORA, we provide several example applications, both with simulated and empirical data, by means of the eponymous software package . Also included in is the possibility to mine configurational data and to visualize results via logic diagrams.

Results

For simple single-condition analyses, CORA’s solution is identical with that of QCA or CNA. However, analyses of multiple conditions with CORA differ in important respects from analyses with QCA or CNA. Most importantly, CORA is presently the only configurational method able to simultaneously explain individual conditions as well as complex conjunctions of conditions.

Conclusions

Through CORA, problems of multi-morbidity in particular, and configurational analyses of complex effects in general, come into the analytical reach of CCMs. Future research aims to further broaden and enhance CORA’s capabilities for refining such analyses.
Cluster analysis of functional independence in community-dwelling older people
Authors: Molenaar Esther A.L.M. , Barten Di-Janne JA , de Hoop Anne M.S. , Bleijenberg Nienke , de Wit Niek J , Veenhof Cindy
Published: December 2022

Background

The concept of Functional Independence (FI), defined as ‘functioning physically safe and independent from other persons, within one’s context”, plays an important role in maintaining the functional ability to enable well-being in older age. FI is a dynamic and complex concept covering four clinical outcomes: physical capacity, empowerment, coping flexibility, and health literacy. As the level of FI differs widely between older adults, healthcare professionals must gain insight into how to best support older people in maintaining their level of FI in a personalized manner. Insight into subgroups of FI could be a first step in providing personalized support This study aims to identify clinically relevant, distinct subgroups of FI in Dutch community-dwelling older people and subsequently describe them according to individual characteristics.

Results

One hundred fifty-three community-dwelling older persons were included for participation. Cluster analysis identified four distinctive clusters: (1) Performers – Well-informed; this subgroup is physically strong, well-informed and educated, independent, non-falling, with limited reflective coping style. (2) Performers – Achievers: physically strong people with a limited coping style and health literacy level. (3) The reliant- Good Coper representing physically somewhat limited people with sufficient coping styles who receive professional help. (4) The reliant – Receivers: physically limited people with insufficient coping styles who receive professional help. These subgroups showed significant differences in demographic characteristics and clinical FI outcomes.

Conclusions

Community-dwelling older persons can be allocated to four distinct and clinically relevant subgroups based on their level of FI. This subgrouping provides insight into the complex holistic concept of FI by pointing out for each subgroup which FI domain is affected. This way, it helps to better target interventions to prevent the decline of FI in the community-dwelling older population.
Newly diagnosed multiple myeloma patients with CD56 expression benefit more from autologous stem cell transplantation
Authors: Geng Chuanying , Zhou Huixing , Wang Huijuan , Li Yanchen , Leng Yun , Zhang Zhiyao , Jian Yuan , Yang Guangzhong , Chen Wenming
Published: December 2022

Background

Several studies showed that lack of CD56 expression was a poor prognostic factor for patients with newly diagnosed multiple myeloma (NDMM). However, other studies were not able to confirm the prognostic value of CD56 in NDMM. This study aimed to evaluate the prognostic value of CD56 expression for patients with NDMM who received autologous stem cell transplantation (ASCT).

Methods

We retrospectively analyzed 370 patients with NDMM under 66 years old and the propensity score matching technique was used to reduce the bias between two groups.

Results

CD56 expression was observed in 250 (67.6%) patients, and only half of transplant-eligible patients received ASCT for financial and adverse effects concerns after induction therapy. 54.8% (137/250) CD56 positive patients received ASCT; and 47.5% (57/120) CD56 negative patients received ASCT. Univariate and multivariate analyses showed that ASCT was correlated with longer overall survival (OS) (p < 0.001) and progression-free survival (PFS) (p < 0.001) for CD56 positive patients. However, ASCT had no impact on OS and PFS in univariate and multivariate analysis (p > 0.05). In the propensity score matching analysis, 186 CD56 positive patients were identified, 93 patients had received ASCT and 93 patients had no ASCT. Among 120 CD56 negative patients, 80 patients, 40 in each group, were identified. Among 186 matched CD56 positive patients, patients with ASCT had longer OS (87.6 vs.56.1 months, p = 0.049) and PFS (36.7 vs.30.9 months, p = 0.040). However, ASCT had no impact on OS and PFS for matched CD56 negative patients (p > 0.05).

Conclusions

These results demonstrated that ASCT may improve OS and PFS of CD56 positive patients and had no impact on survival of CD56 negative patients.
Antibiotic-impregnated calcium sulfate for the treatment of pediatric hematogenous osteomyelitis
Authors: Tao Rui , Wu Jian-qun , Luo Ji-wei , Hong Liang , Zhou Chun-hao , Cheng Guo-yun , Qin Cheng-he
Published: December 2022

Background

Antibiotic-impregnated calcium sulfate has excellent curative efficacy in chronic osteomyelitis. However, its curative efficacy in pediatric hematogenous osteomyelitis has not been sufficiently studied. The purpose of this study was to evaluate the curative effects of antibiotic-impregnated calcium sulfate in the treatment of pediatric hematogenous osteomyelitis.

Methods

Overall, twenty-one pediatric patients with hematogenous osteomyelitis treated at our hospital between 2013 and 2018 were included for assessment. The clinical history, clinical manifestation, infection recurrence rate, sinus leakage, incision leakage, pathological fractures, bone growth and surgical procedures were analyzed.

Results

The infection recurrence rate was 0% (0/21) at a minimum of 31 months (range 31 to 91 months) of follow-up. Postoperative incision leakage was found in one pediatric patient. Osteolysis was found in one pediatric patient. Acceleration of bone growth occurred in one pediatric patient. Retardation of bone growth occurred in one pediatric patient. Genu valgus deformity occurred in one pediatric patient.

Conclusions

Although noninfectious complications occurred, the curative effect of antibiotic-impregnated calcium sulfate in pediatric hematogenous osteomyelitis was satisfactory.
A Czech version of the Overall Anxiety Severity and Impairment Scale (OASIS): standardization and psychometric properties
Authors: Mikoska Petr , Novak Lukas , Pilarik Lubor , Bok Tomas , Fulep Martin , Korinek Richard
Published: December 2022

Background

The Overall Anxiety Severity and Impairment Scale (OASIS) is a transdiagnostic measure that assesses severity and impairment associated with anxiety disorders. However, its psychometric properties were primarily examined in English-speaking or western countries. Therefore, this study aims to examine its psychometric parameters in the Czech Republic.

Methods

A large representative sample (n = 1738), a clinical sample (n = 57) and a retest sample (n = 20) were used. In addition to the OASIS, conventional measures of anxiety, depression, personality traits, self-esteem, life satisfaction, and other scales were also administered. Moreover, we examined the latent structure, reliability, validity, and the cut-off score for the Reliable Change Index (RCI) and the Clinically Significant Change Index (CSI).

Results

Higher anxiety was found in females, religious non-church members, and students. The Confirmatory Factor Analysis supported the adequate fit of the unidimensional solution: x2(4) = 3.20;p < 0.525; CFI = 1.000; TLI = 1.000;RMSEA = 0, SRMR = 0. The measurement equivalence examination indicated that the OASIS measures anxiety invariantly between males and females. The validity of the OASIS was supported by positive associations with neuroticism, depression, perceived stress, guilt, shame, and the established anxiety measures. The internal consistency was excellent (Cronbach’s alpha = 0.96, McDonald’s omega = 0.96). The test-retest reliability was acceptable (r = 0.66). The cut-off for the CSI is 6 and the RCI is 5.32.

Conclusions

The OASIS represents a reliable and valid instrument for assessing anxiety in adults. Due to its shortness, excellent psychometric properties, and percentile norms, it is especially useful for short and accurate screening of anxiety and mapping therapeutic changes in clinical practice.
Socioeconomic differences in the reduction of face-to-face contacts in the first wave of the COVID-19 pandemic in Germany
Authors: Waldhauer Julia , Beese Florian , Wachtler Benjamin , Haller Sebastian , Koschollek Carmen , Pförtner Timo-Kolja , Hoebel Jens
Published: December 2022

Background

The COVID-19 pandemic has led to physical distancing measures to control the spread of SARS-CoV-2. Evidence on contact dynamics in different socioeconomic groups is still sparse. This study aimed to investigate the association of socioeconomic status with private and professional contact reductions in the first COVID-19 wave in Germany.

Methods

Data from two especially affected municipalities were derived from the population-based cross-sectional seroepidemiological CORONA-MONITORING lokal study (data collection May–July 2020). The study sample (n = 3,637) was restricted to working age (18–67 years). We calculated the association of educational and occupational status (low, medium, high) with self-reported private and professional contact reductions with respect to former contact levels in the first wave of the pandemic. Multivariate Poisson regressions were performed to estimate prevalence ratios (PR) adjusted for municipality, age, gender, country of birth, household size, contact levels before physical distancing measures, own infection status, contact to SARS-CoV-2 infected people and working remotely.

Results

The analyses showed significant differences in the initial level of private and professional contacts by educational and occupational status. Less private contact reductions with lower educational status (PR low vs. high = 0,79 [CI = 0.68–0.91], p = 0.002; PR medium vs. high = 0,93 [CI = 0.89–0.97], p = 0.001) and less professional contact reductions with lower educational status (PR low vs. high = 0,87 [CI = 0.70–1.07], p = 0.179; PR medium vs. high = 0,89 [CI = 0.83–0.95], p = 0.001) and lower occupational status (PR low vs. high = 0,62 [CI = 0.55–0.71], p < 0.001; PR medium vs. high = 0,82 [CI = 0.77–0.88], p < 0.001) were observed.

Conclusions

Our results indicate disadvantages for groups with lower socioeconomic status in private and professional contact reductions in the first wave of the pandemic. This may be associated with the higher risk of infection among individuals in lower socioeconomic groups. Preventive measures that a) adequately explain the importance of contact restrictions with respect to varying living and working conditions and b) facilitate the implementation of these reductions especially in the occupational setting seem necessary to better protect structurally disadvantaged groups during epidemics.
Effect of apple vinegar on folliculogenesis and ovarian kisspeptin in a high-fat diet-induced nonalcoholic fatty liver disease in rat
Authors: Shams Fahimeh , Aghajani-nasab Monireh , Ramezanpour Mahsa , Fatideh Razieh Habibipour , Mohammadghasemi Fahimeh
Published: December 2022

Background

Non-alcoholic fatty liver disease (NAFLD) adversely affects reproduction. We aimed to study the effect of a high-fat diet (HFD), supplemented with apple vinegar, on folliculogenesis in a rat model of NAFLD.

Methods

Female rats were randomly divided into four groups (N = 28): Standard diet (SD), SD + vinegar, HFD, and HFD + vinegar groups. At the end of the study, biochemical tests were assessed in serum. HOMA-IR (Homeostatic model assessment-Insulin resistance) was calculated. Sex hormones were determined using an ELISA kit; ovary follicle counts were studied using histological methods. The proliferation index of granulosa cells was determined using immunohistochemistry. Kisspeptin expression in the ovary was detected using RT-PCR.

Results

The HFD induced steatohepatitis and NAFLD. The ovaries in the rat model of NAFLD were atrophied. The ovaries had less count of developing follicles and corpus luteum, and more degenerated and cystic follicles in comparison with the SD group. Vinegar + HFD consumption decreased ALT, compared to the HFD group (P = 0.004). Steatohepatitis was reduced in the Vinegar + HFD group (P = 0.001). Vinegar + HFD considerably reduced HOMA-IR (p = 0.01). The HFD + vinegar diet could increase estradiol (P = 0.001), without significantly affecting progesterone or testosterone. In addition, an increase of primordial follicles as an ovarian reserve and also primary follicles were determined in the HFD + vinegar group. There were no statistical differences in the granulosa cell proliferation index in various follicle types between groups. HFD + vinegar significantly enhanced ovarian kisspeptin expression (p = 0.04).

Conclusions

The vinegar diet in a rat model of NAFLD raises estradiol, primordial, and small primary follicles, and increases ovarian kisspeptin expression indirectly. Insulin resistance and obesity were improved by apple vinegar, and anti-glycemic and anti-lipidemic effects were also determined. The supplementation of apple vinegar in NAFLD might be useful for ovary. However, it requires further investigation.
A preliminary study of the probitive value of personality assessment in medical school admissions within the United States
Authors: Eveland A. Peter , Wilhelm Sabrina R. , Wong Stephanie , Prado Lissett G. , Barsky Sanford H.
Published: December 2022

Background

Allopathic medicine faces a daunting challenge of selecting the best applicants because of the very high applicant / matriculant ratio. The quality of graduates ultimately reflects the quality of medical practice. Alarming recent trends in physician burnout, misconduct and suicide raise questions of whether we are selecting the right candidates. The United States (US) lags far behind the United Kingdom (UK) and Europe in the study of non-cognitive tests in medical school admissions. Although more recently, medical schools in both the UK, Europe and the US have begun to use situational judgement tests such as the Computer-Based Assessment for Sampling Personal Characteristics (CASPer) and the situational judgement test (SJT), recently developed by the Association of American Medical Colleges (AAMC) and that these tests are, in a sense non-cognitive in nature, direct personality tests per se have not been utilized. We have historically used, in the admissions process within the US, knowledge, reasoning and exam performance, all of which are largely influenced by intelligence and also improved with practice. Personality, though also undoubtedly influenced by intelligence, is fundamentally different and subject to different kinds of measurements.

Methods

A popular personality measurement used over the past two decades within the US in business and industry, but not medical school has been the Neo Personality Inventory – Revised (NEO-PI-R) Test. This test has not been utilized regularly in allopathic medicine probably because of the paucity of exploratory retrospective and validating prospective studies. The hypothesis which we tested was whether NEO-PI-R traits exhibited consistency between two institutions and whether their measurements showed probative value in predicting academic performance.

Results

Our retrospective findings indicated both interinstitutional consistencies and both positive and negative predictive values for certain traits whose correlative strengths exceeded traditional premed metrics: medical college admission test (MCAT) scores, grade point average (GPA), etc. for early academic performance.

Conclusions

Our exploratory studies should catalyze larger and more detailed confirmatory studies designed to validate the importance of personality traits not only in predicting early medical school performance but also later performance in one’s overall medical career.
Attitude and practices of tracheostomy care among nursing staff in Saudi Arabia
Authors: Mahfoz Turki M. Bin
Published: December 2022

Background

In many regions of the world, tracheostomy care is a major health concern. Many patients die as a result of nurses' lack of awareness regarding tracheostomy care. This study was carried out to report the acquired training, clinical experience and team approach while caring for patients with tracheostomies and then evaluate these aspects on nurses’ confidence in caring for these patients.

Methods

A cross-sectional descriptive study involving a self-administered questionnaire was carried out among nurses from October 2020 to June 2021. A self-administered questionnaire including questions on sociodemographic characteristics, tracheostomy training and support and confidence in caring for patients with tracheostomies. It was disseminated electronically to the nurses working in a tertiary medical center in Saudi Arabia with multiple reminders. Group difference was determined using t test and chi square tests appropriately with a setpvalue to less than 0.05.

Results

A total of 315 nurses with different educational backgrounds were included. The majority were females, middle aged and gained their nursing degree from outside the country. Over 30% of the nurses cared for patients with tracheostomies while more than two thirds did not receive adequate training to care for this patient population. Confidence was reflected in the working units, the time spent caring for these patients and the number of patients cared for. Additionally, nurses caring for children and adults with tracheostomies were more confident in their care than those caring for adolescents and older adults.

Conclusion

Continuous training and competency evaluation are vital in delivering optimal care. Confidence level is impacted by training received and by the presence of assisted ventilation. Future studies should aim for a national representation of this topic to inform policy and practice.
Promotors and barriers to the implementation and adoption of assistive technology and telecare for people with dementia and their caregivers: a systematic review of the literature
Authors: Boyle Lydia D. , Husebo Bettina S. , Vislapuu Maarja
Published: December 2022

Background

One of the most pressing issues in our society is the provision of proper care and treatment for the growing global health challenge of ageing. Assistive Technology and Telecare (ATT) is a key component in facilitation of safer, longer, and independent living for people with dementia (PwD) and has the potential to extend valuable care and support for caregivers globally. The objective of this study was to identify promotors and barriers to implementation and adoption of ATT for PwD and their informal (family and friends) and formal (healthcare professionals) caregivers.

Methods

Five databases Medline (Ovid), CINAHL, Web of Science, APA PsycINFO and EMBASE were searched. PRISMA guidelines have been used to guide all processes and results. Retrieved studies were qualitative, mixed-method and quantitative, screened using Rayyan and overall quality assessed using Critical Appraisal Skills Programme (CASP) and Mixed Methods Assessment Tool (MMAT). Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria and assigned within categories of high, moderate, or low. NVivo was used for synthesis and analysis of article content. A narrative synthesis combines the study findings.

Results

Thirty studies (7 quantitative, 19 qualitative and 4 mixed methods) met the inclusion criteria. Identified primary promotors for the implementation and adoption of ATT were: personalized training and co-designed solutions, safety for the PwD, involvement of all relevant stakeholders, ease of use and support, and cultural relevance. Main barriers for the implementation and adoption of ATT included: unintended adverse consequences, timing and disease progress, technology anxiety, system failures, digital divide, and lack of access to or knowledge of available ATT.

Conclusion

The most crucial elements for the adoption of ATT in the future will be a focus on co-design, improved involvement of relevant stakeholders, and the adaptability (tailoring related to context) of ATT solutions over time (disease process).
Machine learning of plasma metabolome identifies biomarker panels for metabolic syndrome: findings from the China Suboptimal Health Cohort
Authors: Wang Hao , Wang Youxin , Li Xingang , Deng Xuan , Kong Yuanyuan , Wang Wei , Zhou Yong
Published: December 2022

Background

Metabolic syndrome (MetS) has been proposed as a clinically identifiable high-risk state for the prediction and prevention of cardiovascular diseases and type 2 diabetes mellitus. As a promising “omics” technology, metabolomics provides an innovative strategy to gain a deeper understanding of the pathophysiology of MetS. The study aimed to systematically investigate the metabolic alterations in MetS and identify biomarker panels for the identification of MetS using machine learning methods.

Methods

Nuclear magnetic resonance-based untargeted metabolomics analysis was performed on 1011 plasma samples (205 MetS patients and 806 healthy controls). Univariate and multivariate analyses were applied to identify metabolic biomarkers for MetS. Metabolic pathway enrichment analysis was performed to reveal the disturbed metabolic pathways related to MetS. Four machine learning algorithms, including support vector machine (SVM), random forest (RF), k-nearest neighbor (KNN), and logistic regression were used to build diagnostic models for MetS.

Results

Thirteen significantly differential metabolites were identified and pathway enrichment revealed that arginine, proline, and glutathione metabolism are disturbed metabolic pathways related to MetS. The protein-metabolite-disease interaction network identified 38 proteins and 23 diseases are associated with 10 MetS-related metabolites. The areas under the receiver operating characteristic curve of the SVM, RF, KNN, and logistic regression models based on metabolic biomarkers were 0.887, 0.993, 0.914, and 0.755, respectively.

Conclusions

The plasma metabolome provides a promising resource of biomarkers for the predictive diagnosis and targeted prevention of MetS. Alterations in amino acid metabolism play significant roles in the pathophysiology of MetS. The biomarker panels and metabolic pathways could be used as preventive targets in dealing with cardiometabolic diseases related to MetS.
The associations between changes in hepatic steatosis and heart failure and mortality: a nationwide cohort study
Authors: Park Jiyun , Kim Gyuri , Kim Hasung , Lee Jungkuk , Jin Sang-Man , Kim Jae Hyeon
Published: December 2022

Background

Non-alcoholic fatty liver disease (NAFLD) is a well-known risk factor for cardiovascular (CV) disease (CVD) and mortality. However, whether the progression or regression of NAFLD can increase or decrease the risk of heart failure (HF) and mortality has not been fully evaluated. We investigated the association between changes in hepatic steatosis and the risks of incident HF (iHF), hospitalization for HF (hHF), and mortality including CV- or liver-related mortality.

Methods

Using a database from the National Health Insurance Service in Korea from January 2009 to December 2012, we analyzed 240,301 individuals who underwent health check-ups at least twice in two years. Hepatic steatosis was assessed using the fatty liver index (FLI), with an FLI ≥ 60 considered to indicate the presence of hepatic steatosis. According to FLI changes, participants were divided into four groups. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards regression models.

Results

Persistent hepatic steatosis increased the risk of iHF, hHF, and mortality including CV- and liver-related mortality compared with the group that never had steatosis (all P < 0.05). Incident hepatic steatosis was associated with increased risk for iHF and mortality including CV- or liver-related mortality (all P < 0.05). Compared with persistent steatosis, regression of hepatic steatosis was associated with decreased risk for iHF, hHF, and liver-related mortality (iHF, HR [95% CI], 0.800 [0.691–0.925]; hHF, 0.645 [0.514–0.810]; liver-related mortality, 0.434 [0.223–0.846]).

Conclusions

FLI changes were associated with increased or decreased risk of HF outcomes and mortality.
Transcriptional profiling of hepatocytes infected with the replicative form of the malaria parasite Plasmodium cynomolgi
Authors: Mitchell Gabriel , Roma Guglielmo , Voorberg-van der Wel Annemarie , Beibel Martin , Zeeman Anne-Marie , Schuierer Sven , Torres Laura , Flannery Erika L. , Kocken Clemens H. M. , Mikolajczak Sebastian A. , Diagana Thierry T.
Published: December 2022

Background

The zoonotic simian parasite Plasmodium cynomolgi develops into replicating schizonts and dormant hypnozoites during the infection of hepatocytes and is used as a model organism to study relapsing malaria. The transcriptional profiling of P. cynomolgi liver stages was previously reported and revealed many important biological features of the parasite but left out the host response to malaria infection.

Methods

Previously published RNA sequencing data were used to quantify the expression of host genes in rhesus macaque hepatocytes infected with P. cynomolgi in comparison to either cells from uninfected samples or uninfected bystander cells.

Results

Although the dataset could not be used to resolve the transcriptional profile of hypnozoite-infected hepatocytes, it provided a snapshot of the host response to liver stage schizonts at 9–10 day post-infection and identified specific host pathways that are modulated during the exo-erythrocytic stage of P. cynomolgi.

Conclusions

This study constitutes a valuable resource characterizing the hepatocyte response to P. cynomolgi infection and provides a framework to build on future research that aims at understanding hepatocyte-parasite interactions during relapsing malaria infection.
Higher daytime systolic BP, prepregnancy BMI and an elevated sFlt-1/PlGF ratio predict the development of hypertension in normotensive pregnant women
Authors: Lara-Barea Almudena , Sánchez-Lechuga Begoña , Aguilar-Diosdado Manuel , López-Tinoco Cristina
Published: December 2022

Background

The risk of hypertensive disorders of pregnancy (HDP) varies in women with gestational diabetes mellitus (GDM), depending on the degree of insulin resistance and is also influenced by obesity. The aim of this study was to evaluate clinical features, blood pressure (BP) profiles and inflammatory markers, to identify patients with an elevated risk of developing HDP.

Methods

A total of 146 normotensive pregnant women were studied. We analysed the relationships of BP profiles detected by ambulatory blood pressure monitoring (ABPM) with serum biomarkers and angiogenic factors and their association with the development of HDP.

Results

Fourteen (9.6%) women developed HDP, of which 11 had GDM and 8 had obesity. Women with HDP had higher values of 24-h and daytime systolic/diastolic BP (113/69 vs. 104/64; 115/72 vs. 106/66 mmHg, respectively;p <  0.05). Higher levels of leptin (10.97 ± 0.82 vs. 10.2 ± 1.11;p = 0.018) andmonocyte chemoattractant protein-1 (MCP-1) (5.24 ± 0.60 vs. 4.9 ± 0.55;p = 0.044) and a higher soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio (4.37 ± 2.2 vs. 2.2 ± 1.43;p = 0.003) were also observed in the HDP patients. Multivariate analysis showed that a higher sFlt-1/PlGF ratio was associated with an increased risk of developing HDP [OR = 2.02; IC 95%: 1.35–3.05]. Furthermore, higher daytime systolic BP [OR = 1.27; IC 95% 1.00–1.26] and prepregnancy body mass index (BMI) [OR = 1.14; IC 95%: 1.01–1.30] significantly increased the risk of developing HDP.

Conclusions

Higher daytime systolic BP values, prepregnancy BMI and the sFlt-1/PlGF ratio are useful for identifying normotensive pregnant women with an increased risk of developing HDP.