bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconstructing feedback in graduate medical education: development of the REFLECT scale to measure feedback delivery in medical residency training
Authors: Ilaghi Mehran , Shafian Sara , Soltanizadeh Adel , Karamoozian Ali , Okhovati Maryam , Aflatoonian Sarah
Published: May 2023

Background

Feedback plays a pivotal role in graduate medical education, where medical residents are expected to acquire a wide range of practical and professional competencies. Assessing the feedback delivery status is a preliminary step for educators to enhance the quality of feedback provided. This study aims to develop an instrument to assess the various aspects of feedback delivery in medical residency training.

Methods

The fifteen-item REFLECT (Residency Education Feedback Level Evaluation in Clinical Training) questionnaire was developed. The content validity was evaluated according to a panel member consisting of fourteen clinical professors and medical education instructors. After evaluating the test-retest reliability, the questionnaire was distributed to a sample of 154 medical residents and was further assessed in terms of internal consistency and factor analysis.

Results

Content validity analysis resulted in an appropriate content validity ratio and content validity index for the final 15 items. The test-retest reliability resulted in an ICC of 0.949 (95% C.I. 0.870–0.980), indicating excellent reliability. The Cronbach’s alpha for the 15-item questionnaire was α = 0.85, demonstrating good internal consistency. The factor analysis resulted in a four-factor structure: “attitude towards feedback”, “quality of feedback”, “perceived importance of feedback”, and “reaction to feedback”.

Conclusions

REFLECT proved to a reliable tool that could be utilized as a quick assessment method of feedback delivery, making it a suitable aid for educational managers and faculties to design necessary interventions aiming to enhance the quantity and quality of feedback provided.
Rapid start antiretroviral therapies for improved engagement in HIV care: implementation science evaluation protocol
Authors: Bourdeau Beth , Shade Starley B. , Koester Kimberly A. , Rebchook Greg M. , Steward Wayne T. , Agins Bruce M. , Myers Janet J. , Phan Son H. , Matosky Marlene
Published: May 2023

Background

In 2020, the Health Resources and Services Administration’s HIV/AIDS Bureau funded an initiative to promote implementation of rapid antiretroviral therapy initiation in 14 HIV treatment settings across the U.S. The goal of this initiative is to accelerate uptake of this evidence-based strategy and provide an implementation blueprint for other HIV care settings to reduce the time from HIV diagnosis to entry into care, for re-engagement in care for those out of care, initiation of treatment, and viral suppression. As part of the effort, an evaluation and technical assistance provider (ETAP) was funded to study implementation of the model in the 14 implementation sites.

Method

The ETAP has used implementation science methods framed by the Dynamic Capabilities Model integrated with the Conceptual Model of Implementation Research to develop a Hybrid Type II, multi-site mixed-methods evaluation, described in this paper. The results of the evaluation will describe strategies associated with uptake, implementation outcomes, and HIV-related health outcomes for patients.

Discussion

This approach will allow us to understand in detail the processes that sites to implement and integrate rapid initiation of antiretroviral therapy as standard of care as a means of achieving equity in HIV care.
Dipeptidyl peptidase-1 inhibition with brensocatib reduces the activity of all major neutrophil serine proteases in patients with bronchiectasis: results from the WILLOW trial
Authors: Cipolla David , Zhang Jimin , Korkmaz Brice , Chalmers James D. , Basso Jessica , Lasala Daniel , Fernandez Carlos , Teper Ariel , Mange Kevin C. , Perkins Walter R. , Sullivan Eugene J.
Published: May 2023

Background

Brensocatib is an oral, selective, reversible inhibitor of dipeptidyl peptidase-1 (DPP-1), responsible for activating neutrophil serine proteases (NSPs) including neutrophil elastase (NE), proteinase 3 (PR3), and cathepsin G (CatG). In chronic inflammatory lung diseases such as non-cystic fibrosis bronchiectasis (NCFBE), neutrophils accumulate in the airways resulting in excess active NSPs that cause damaging inflammation and lung destruction.

Methods

The 24-week WILLOW trial (NCT03218917) was a randomized, double-blind, placebo-controlled, parallel-group trial in patients with NCFBE conducted at 116 sites across 14 countries. In this trial, treatment with brensocatib was associated with improvements in clinical outcomes including time to first exacerbation, reduction in exacerbation frequency and a reduction in NE activity in sputum. An exploratory analysis of NE activity in white blood cell (WBC) extracts and NE, PR3 and CatG activity in sputum was conducted to further characterize brensocatib’s effect and identify potential correlated effects.

Results

NE, PR3 and CatG activities were reduced in sputum and NE activity was reduced in WBC extracts in a dose-dependent manner after four weeks of brensocatib treatment, with a return to baseline four weeks after the end of treatment. Brensocatib produced the greatest reduction in the sputum activity of CatG, followed by NE and then PR3. Positive correlations among the sputum NSPs were observed both at baseline and in response to treatment, with the strongest correlation among the sputum NSPs for NE and CatG.

Conclusions

These results suggest a broad anti-inflammatory effect of brensocatib underlying its clinical efficacy observed in NCFBE patients.

Trial registration: The study was approved by the corresponding ethical review boards of all participating centers. The trial was approved by the Food and Drug Administration and registered at clinicaltrials.gov (NCT03218917) on July 17, 2017 and approved by the European Medicines Agency and registered at the European Union Clinical trials Register (EudraCT No. 2017-002533-32). An independent, external data and safety monitoring committee (comprising physicians with pulmonary expertise, a statistician experienced in the evaluation of clinical safety, and experts in periodontal disease and dermatology) reviewed all adverse events.
Blockage of retinoic acid signaling via RARγ suppressed the proliferation of pancreatic cancer cells by arresting the cell cycle progression of the G1-S phase
Authors: Yamakawa Kohei , Koyanagi-Aoi Michiyo , Machinaga Akihito , Kakiuchi Nobuyuki , Hirano Tomonori , Kodama Yuzo , Aoi Takashi
Published: May 2023

Background

Our study and several studies have reported that in some cancers, including pancreatic ductal adenocarcinoma (PDAC), the expression of squamous lineage markers, such as esophagus-tissue-specific genes, correlated with a poor prognosis. However, the mechanism by which the acquisition of squamous lineage phenotypes leads to a poor prognosis remains unclear. We previously reported that retinoic acid signaling via retinoic acid receptor γ (RARγ signaling) determines the differentiation lineage into the esophageal squamous epithelium. These findings hypothesized that the activation of RARγ signaling contributed to acquiring squamous lineage phenotypes and malignant behavior in PDAC.

Methods

This study utilized public databases and immunostaining of surgical specimens to examine RARγ expression in PDAC. We evaluated the function of RARγ signaling by inhibitors and siRNA knockdown using a PDAC cell line and patient-derived PDAC organoids. The mechanism of the tumor-suppressive effects by blocking RARγ signaling was examined by a cell cycle analysis, apoptosis assays, RNA sequencing and Western blotting.

Results

RARγ expression in pancreatic intraepithelial neoplasia (PanIN) and PDAC was higher than that in the normal pancreatic duct. Its expression correlated with a poor patient prognosis in PDAC. In PDAC cell lines, blockade of RARγ signaling suppressed cell proliferation by inducing cell cycle arrest in the G1 phase without causing apoptosis. We demonstrated that blocking RARγ signaling upregulated p21 and p27 and downregulated many cell cycle genes, including cyclin-dependent kinase 2 (CDK2), CDK4 and CDK6. Furthermore, using patient-derived PDAC organoids, we confirmed the tumor-suppressive effect of RARγ inhibition and indicated the synergistic effects of RARγ inhibition with gemcitabine.

Conclusions

This study clarified the function of RARγ signaling in PDAC progression and demonstrated the tumor-suppressive effect of selective blockade of RARγ signaling against PDAC. These results suggest that RARγ signaling might be a new therapeutic target for PDAC.
Prioritizing rehabilitation in low- and middle-income country national health systems: a qualitative thematic synthesis and development of a policy framework
Authors: Neill Rachel , Shawar Yusra Ribhi , Ashraf Lamisa , Das Priyanka , Champagne Sarah N. , Kautsar Hunied , Zia Nukhba , Michlig Georgia J. , Bachani Abdulgafoor M.
Published: May 2023

Background

There is a large and growing unmet need for rehabilitation – a diverse category of services that aim to improve functioning across the life course – particularly in low- and middle-income countries. Yet despite urgent calls to increase political commitment, many low- and middle-income country governments have dedicated little attention to expanding rehabilitation services. Existing policy scholarship explains how and why health issues reach the policy agenda and offers applicable evidence to advance access to physical, medical, psychosocial, and other types of rehabilitation services. Drawing from this scholarship and empirical data on rehabilitation, this paper proposes a policy framework to understand national-level prioritization of rehabilitation in low- and middle-income countries.

Methods

We conducted key informant interviews with rehabilitation stakeholders in 47 countries, complemented by a purposeful review of peer-reviewed and gray literature to achieve thematic saturation. We analyzed the data abductively using a thematic synthesis methodology. Rehabilitation-specific findings were triangulated with policy theory and empirical case studies on the prioritization of other health issues to develop the framework.

Results

The novel policy framework includes three components which shape the prioritization of rehabilitation on low- and middle-income countries’ national government’s health agendas. First, rehabilitation lacks a consistent problem definition, undermining the development of consensus-driven solutions which could advance the issue on policy agendas. Second, governance arrangements are fragmented within and across government ministries, between the government and its citizens, and across national and transnational actors engaged in rehabilitation service provision. Third, national legacies – particularly from civil conflict – and weaknesses in the existing health system influences both rehabilitation needs and implementation feasibility.

Conclusions

This framework can support stakeholders in identifying the key components impeding prioritization for rehabilitation across different national contexts. This is a crucial step for ultimately better advancing the issue on national policy agendas and improving equity in access to rehabilitation services.
Horizontal healthcare utilization inequity in patients with rare diseases in Korea
Authors: Kang Daewon , Choi Sang-Eun
Published: May 2023

Background

Rare diseases (RDs) are difficult to diagnose and expensive to treat. Thus, the South Korean government has implemented several policies to help RD patients, including the Medical Expense Support Project, supporting low- to middle-income RD patients. However, no study in Korea has yet addressed health inequity in RD patients. This study assessed inequity trends in the medical utilization and expenditures of RD patients.

Methods

This study measured the horizontal inequity index (HI) of RD patients and an age- and sex-matched control group using the National Health Insurance Service data from 2006 to 2018. Sex, age, number of chronic diseases, and disability variables were used to model expected medical needs and adjust the concentration index (CI) for medical utilization and expenditures.

Results

The HI index of healthcare utilization in RD patients and the control group ranged from -0.0129 to 0.0145, increasing until 2012 and fluctuating since then. This increasing trend was more apparent for inpatient utilization in the RD patient group than in the outpatient group. The same index in the control group ranged from -0.0112 to -0.0040 without a significant trend. The healthcare expenditure HI in RD patients rose from -0.0640 to -0.0038, showing pro-poor values but moving toward a pro-rich state. In the control group, the HI for healthcare expenditures remained between 0.0029 and 0.0085.

Conclusions

The HI of inpatient utilization and inpatient expenditures increased in a pro-rich state. The study results showed that implementing a policy that supports inpatient service utilization could help achieve health equity for RD patients.
Horizontal inequity trends of health care utilization in rural China after the medicine and healthcare system reform: based on longitudinal data from 2010 to 2018
Authors: Xu Jinpeng , Tian Guomei , Sun Jiale , Liu Jian , Chen Fangting , Shi Qi , Zhang Ting , Zhang Hongyu , He Jingran , Deng Fangmin , Zhang Bokai , Wang Haixin , Wu Qunhong , Kang Zheng
Published: May 2023

Background

To assess the effectiveness of China's medicine and health care reform in promoting equity in health care utilization among rural residents, it is necessary to analyze temporal trends in equity in health care utilization among rural residents in China. This study is the first to assess horizontal inequity trends in health care utilization among rural Chinese residents from 2010 to 2018 and provides evidence for improving government health policies.

Methods

Longitudinal data obtained from China Family Panel Studies from 2010 to 2018 were used to determine trends in outpatient and inpatient utilization. Concentration index, concentration curve, and horizontal inequity index were calculated to measure inequalities. Decomposition analysis was applied to measure the contribution of need and non-need factors to the unfairness.

Results

From 2010 to 2018, outpatient utilization among rural residents increased by 35.10%, while inpatient utilization increased by 80.68%. Concentration indices for health care utilization were negative in all years. In 2012, there was an increase in the concentration index for outpatient utilization (CI = -0.0219). The concentration index for inpatient utilization decreased from -0.0478 in 2010 to -0.0888 in 2018. Except for outpatient utilization in 2012 (HI = 0.0214), horizontal inequity indices for outpatient utilization were negative in all years. The horizontal inequity index for inpatient utilization was highest in 2010 (HI = -0.0068) and lowest in 2018 (HI = -0.0303). The contribution of need factors to the inequity exceeded 50% in all years.

Conclusions

Between 2010 and 2018, low-income groups in rural China used more health services. This seemingly pro-poor income-related inequality was due in large part to the greater health care need among low-income groups. Government policies aimed at increasing access to health services, particularly primary health care had helped to make health care utilization in rural China more equitable. It is necessary to design better health policies for disadvantaged groups to reduce future inequities in the use of health services by rural populations.
Dissemination of Neisseria gonorrhoeae with decreased susceptibility to extended-spectrum cephalosporins in Southern China, 2021: a genome-wide surveillance from 20 cities
Authors: Liao Yiwen , Xie Qinghui , Li Xiaoxiao , Yin Xiaona , Wu Xingzhong , Liu Mingjing , Pan Yuying , Zeng Lihong , Yang Jianjiang , Feng Zhanqin , Qin Xiaolin , Zheng Heping
Published: May 2023

Background

Antimicrobial resistance (AMR) of untreatable gonococcal infection is an emerging threat, especially in Guangdong, a prosperous province in Southern China.

Methods

N.gonorrhoeae was isolated from 20 cities in Guangdong and determined antimicrobial susceptibility. Through whole-genome sequencing (WGS), multilocus sequence typing (MLST), N.gonorrhoeae multiantigen sequence typing (NG-MAST), and N.gonorrhoeae sequence typing for antimicrobial resistance (NG-STAR) were obtained based on the PubMLST database (https://pubmlst.org/). Phylogenetic analysis was used for dissemination and tracking analysis.

Results

Antimicrobial susceptibility was performed on 347 isolates, and 50 isolates were identified as decreased susceptibility (DS) to cephalosporins. Of which 16.0% (8/50) were ceftriaxone DS, 38.0% (19/50) were cefixime DS, and 46.0% (23/50) were both ceftriaxone and cefixime DS. In all, the dual-resistant rate of the cephalosporin-DS isolates was 96.0% for penicillin and 98.0% for tetracycline-resistant, and 10.0% (5/50) were resistant to azithromycin. All cephalosporin-DS isolates were resistant to ciprofloxacin but sensitive to spectinomycin. The predominant MLSTs were ST7363 (16%, 8/50), ST1903 (14%, 7/50), ST1901 (12%, 6/50), and ST7365 (10%, 5/50). Besides some isolates that failed genotyping (NA), NG-STAR ST1143 (n = 6) and NG-MAST ST17748 (n = 4) were the most prevalent. Twelve isolates with mosaic penA-60.001 allele retained the most elevated cephalosporin MIC (Minimum Inhibitory Concentration). Phylogenetic analysis revealed that epidemic penA-60.001 clones, either domestic or foreign, had spread to nine cities in Guangdong, and 9/12 clones were from the Pearl River Delta region.

Conclusions

N. gonorrhoeae with cephalosporins-DS was extensively disseminated in Guangdong, Southern China, requiring strict surveillance.
Biased data, biased AI: deep networks predict the acquisition site of TCGA images
Authors: Dehkharghanian Taher , Bidgoli Azam Asilian , Riasatian Abtin , Mazaheri Pooria , Campbell Clinton J. V. , Pantanowitz Liron , Tizhoosh H. R. , Rahnamayan Shahryar
Published: May 2023

Background

Deep learning models applied to healthcare applications including digital pathology have been increasing their scope and importance in recent years. Many of these models have been trained on The Cancer Genome Atlas (TCGA) atlas of digital images, or use it as a validation source. One crucial factor that seems to have been widely ignored is the internal bias that originates from the institutions that contributed WSIs to the TCGA dataset, and its effects on models trained on this dataset.

Methods

8,579 paraffin-embedded, hematoxylin and eosin stained, digital slides were selected from the TCGA dataset. More than 140 medical institutions (acquisition sites) contributed to this dataset. Two deep neural networks (DenseNet121 and KimiaNet were used to extract deep features at 20× magnification. DenseNet was pre-trained on non-medical objects. KimiaNet has the same structure but trained for cancer type classification on TCGA images. The extracted deep features were later used to detect each slide’s acquisition site, and also for slide representation in image search.

Results

DenseNet’s deep features could distinguish acquisition sites with 70% accuracy whereas KimiaNet’s deep features could reveal acquisition sites with more than 86% accuracy. These findings suggest that there are acquisition site specific patterns that could be picked up by deep neural networks. It has also been shown that these medically irrelevant patterns can interfere with other applications of deep learning in digital pathology, namely image search.

This study shows that there are acquisition site specific patterns that can be used to identify tissue acquisition sites without any explicit training. Furthermore, it was observed that a model trained for cancer subtype classification has exploited such medically irrelevant patterns to classify cancer types. Digital scanner configuration and noise, tissue stain variation and artifacts, and source site patient demographics are among factors that likely account for the observed bias. Therefore, researchers should be cautious of such bias when using histopathology datasets for developing and training deep networks.
The use of a new high-speed shielded curved drill is associated with improved intraoperative and clinical outcomes after cervical corpectomy and fusion procedures: a retrospective case series
Authors: Peloza John , Malone Hani , Jacobian Erel , Kolsky Daniel E. , Harel Ran , Guyer Richard D. , Millgram Michael A. , Ashkenazi Ely
Published: May 2023

Background

Anterior cervical corpectomy and fusion (ACCF) is an effective technique to address multi-level degenerative cervical myelopathy. However, as the number of surgical levels increases, the outcomes worsen with respect to complication rates, range of motion and length of surgery. This study aimed to determine the clinical outcome of ACCF procedures performed using a new distally curved and shielded drilling device.

Methods

A retrospective study was conducted on 43 ACCF procedures in which the device was used for osteophyte removal. Patient files were reviewed to assess the early clinical results and complications following ACCF. Clinical outcomes were evaluated using patient neck and arm pain scores and SF-36 questionnaires. Hospitalization characteristics were compared with historical controls.

Results

All procedures were uneventful and without major complications or neurological deterioration. Single-level ACCF procedures required an average of 71 min and followed by an average hospitalization of 3.3 days. Osteophyte removal, verified by intraoperative imaging, was satisfactory. Average neck pain score was improved by 0.9 points (p = 0.24). Average arm pain score was improved by 1.8 points (p = 0.06). SF-36 scores were improved in all domains.

Conclusions

The new curved device enabled safe and efficient removal of osteophytes sparing adjacent vertebral removal in ACCF procedures, thus improving the clinical outcome.
Identification of the Main Chemical constituents and mechanism of Renshen Guben oral liquid against Renal Fibrosis
Authors: Zhang Junhong , Peng Juqin , Zhang Tong , Jiang Hong , Qin Yuewen , Chen Hong , Deng Xiaofang , Ren Junguo , Wang Ping , Xu Haiyu
Published: May 2023

Background

Renal fibrosis is the late stage of many chronic kidney diseases (CKD). Clinically, there is almost no effective treatment for renal fibrosis except dialysis. Renshen Guben oral liquid (RSGB) is a Chinese patent medicine approved by National Medical Products Administration (NMPA), which is suitable for clinical patients with chronic nephritis. Currently, the chemical constituents of RSGB remains unclear, and its efficacy and mechanism on renal fibrosis have not been reported.

Methods

In our research, ultra-high performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS/MS) was employed to describe the chemical profile of RSGB, unilateral ureteral obstruction (UUO) model in mice was established to evaluate the beneficial effect of RSGB on renal fibrosis by biochemical indexes, HE and Masson staining. RNA sequencing and “constituents-targets-pathways” multi-dimensional network was established to mine the mechanisms of RSGB. Key targets were verified by quantitative real-time PCR (qRT-PCR) and western bolt (WB).

Results

A total of 201 constituents were identified or tentatively characterized, 15 of which were confirmed with standards. The number of triterpenes was the highest with 49, followed by phenols with 46. RSGB ameliorated the blood urea nitrogen (BUN) and serum creatinine (Scr) levels in serum, normalizing pathological structure of kidney tissue. RNA sequencing revealed that RSGB regulates 226 differential genes, which were involved in kidney development. According to the “constituents-targets-pathways” network, 26 key active constituents may mainly regulate the inflammatory immune system through 88 corresponding targets. qRT-PCR and WB results showed that RSGB inhibited the activation of the Tgfβ1/Smad2/3 pathway, Wnt4/β-Catenin pathway and NGFR/NF-κB pathway.

Conclusions

Overall, our study, for the first time, characterized 201 chemical constituents in RSGB, and 26 of them were screened out to alleviates renal fibrosis mainly through Tgfβ1/Smad2/3 pathway, Wnt4/β-catenin pathway and NGFR/NF-κB pathway, which may provide a new research strategy for research on the mechanism of traditional Chinese Medicine.
Patterns of attentional biases in children and emotional symptoms during the COVID-19 pandemic: a two-wave longitudinal study
Authors: Zhang Qiaochu
Published: May 2023

Background

It is unknown how the patterns of negative and positive attentional biases in children predict fear of COVID-19, anxiety symptoms, and depression symptoms during the COVID-19 pandemic. The study identified profiles of negative and positive attentional biases in children and examined their association with emotional symptoms during the COVID-19 pandemic.

Method

264 children (girls: 53.8% and boys: 46.2%) of 9–10 years born in Hong Kong or mainland China from a primary school in Shenzhen, People’s Republic of China were involved in a two-wave longitudinal study. Children completed the COVID-19 Fear Scale, the Revised Child Anxiety and Depression Scale, and the Attention to Positive and Negative Information Scale to measure fear of COVID-19, anxiety and depression symptoms, and negative and positive attentional biases in classrooms. After six months, they completed the second assessment of fear of COVID-19, anxiety symptoms, and depression symptoms in classrooms. Latent profile analysis was conducted to reveal distinct profiles of attentional biases in children. A series of repeated MANOVA was performed to examine the association of profiles of attentional biases to fear of COVID-19, anxiety symptoms, and depression symptoms across 6 months.

Results

Three profiles of negative and positive attentional biases were revealed in children. Children with a “moderate positive and high negative attentional biases” profile had significantly higher fear of the COVID-19 pandemic, anxiety symptoms, and depression symptoms than children with a “high positive and moderate negative attentional biases” profile. Children with a “low positive and negative attentional biases” profile were not significantly different in fear of COVID-19, anxiety symptoms, and depression symptoms than those with the other two profiles.

Conclusions

Patterns of negative and positive attentional biases were related to emotional symptoms during the COVID-19 pandemic. It might be important to consider children's overall patterns of negative and positive attentional biases to identify children at risk of higher emotional symptoms.
Associations of preschool reactive bed-sharing with sociodemographic factors, sleep disturbance, and psychopathology
Authors: Marakovitz Susan E. , Sheldrick R. Christopher , Copeland William E. , Restrepo Bibiana , Hastedt Ingrid , Carpenter Kimberly L.H. , McGinnis Ellen W. , Egger Helen L.
Published: May 2023

Objective

To advance understanding of early childhood bed-sharing and its clinical significance, we examined reactive bed-sharing rates, sociodemographic correlates, persistence, and concurrent and longitudinal associations with sleep disturbances and psychopathology.

Methods

Data from a representative cohort of 917 children (mean age 3.8 years) recruited from primary pediatric clinics in a Southeastern city for a preschool anxiety study were used. Sociodemographics and diagnostic classifications for sleep disturbances and psychopathology were obtained using the Preschool Age Psychiatric Assessment (PAPA), a structured diagnostic interview administered to caregivers. A subsample of 187 children was re-assessed approximately 24.7 months after the initial PAPA interview.

Results

Reactive bed-sharing was reported by 38.4% of parents, 22.9% nightly and 15.5% weekly, and declined with age. At follow-up, 48.9% of nightly bed-sharers and 88.7% of weekly bed-sharers were no longer bed-sharing. Sociodemographics associated with nightly bed-sharing were Black and (combined) American Indian, Alaska Native and Asian race and ethnicity, low income and parent education less than high school. Concurrently, bed-sharing nightly was associated with separation anxiety and sleep terrors; bed-sharing weekly was associated with sleep terrors and difficulty staying asleep. No longitudinal associations were found between reactive bed-sharing and sleep disturbances or psychopathology after controlling for sociodemographics, baseline status of the outcome and time between interviews.

Conclusions

Reactive bed-sharing is relatively common among preschoolers, varies significantly by sociodemographic factors, declines during the preschool years and is more persistent among nightly than weekly bed-sharers. Reactive bed-sharing may be an indicator of sleep disturbances and/or anxiety but there is no evidence that bed-sharing is an antecedent or consequence of sleep disturbances or psychopathology.
Celloscope: a probabilistic model for marker-gene-driven cell type deconvolution in spatial transcriptomics data
Authors: Geras Agnieszka , Darvish Shafighi Shadi , Domżał Kacper , Filipiuk Igor , Rączkowska Alicja , Szymczak Paulina , Toosi Hosein , Kaczmarek Leszek , Koperski Łukasz , Lagergren Jens , Nowis Dominika , Szczurek Ewa
Published: May 2023

Spatial transcriptomics maps gene expression across tissues, posing the challenge of determining the spatial arrangement of different cell types. However, spatial transcriptomics spots contain multiple cells. Therefore, the observed signal comes from mixtures of cells of different types. Here, we propose an innovative probabilistic model, Celloscope, that utilizes established prior knowledge on marker genes for cell type deconvolution from spatial transcriptomics data. Celloscope outperforms other methods on simulated data, successfully indicates known brain structures and spatially distinguishes between inhibitory and excitatory neuron types based in mouse brain tissue, and dissects large heterogeneity of immune infiltrate composition in prostate gland tissue.
The Child Healthcare at MATER Pediatric Study (CHAMPS): a 2-arm cluster randomized control trial of group well child care for mothers in treatment for opioid use disorder and their children
Authors: Short Vanessa L. , Abatemarco Diane J. , Sood Erica , Hand Dennis J. , Gannon Meghan , Hossain Jobayer , Goyal Neera K.
Published: May 2023

Background

Studies suggest that group-based well child care—a shared medical appointment where families come together as a group to receive pediatric primary care—increases patient-reported satisfaction and adherence to recommended care. Evidence supporting the use of group well child care for mothers with opioid use disorder, however, is lacking. The overall objective of the Child Healthcare at MATER Pediatric Study (CHAMPS) trial is to evaluate a group model of well child care for mothers with opioid use disorder and their children.

Methods

CHAMPS is a single-site 2-arm cluster randomized controlled trial. A total of 108 mother–child dyads will be enrolled into the study. Twenty-six clusters of approximately 4 mother-infant dyads each will be randomized 1:1 to one of two study arms (intervention or control). Clustering will be based on child’s month of birth. In the intervention arm, group well child care will be provided on-site at a maternal substance use disorder treatment program. Mother–child dyads in the control arm will receive individual well child care from one nearby pediatric primary care clinic. Dyads in both study arms will be followed prospectively for 18 months, and data will be compared between the two study arms. Primary outcomes include well child care quality and utilization, child health knowledge, and parenting quality.

Discussion

The CHAMPS trial will provide evidence to determine if a group well child care offered on-site at an opioid treatment program for pregnant and parenting women is beneficial over individual well child care for families impacted by maternal opioid use disorder.

Trial registration

ClinicalTrials.gov identifier: NCT05488379. Registered on Aug. 04, 2022.
Streptococcus cristatus bacteremia in a patient with poor oral hygiene: a case report
Authors: Guzman Camilo , Zaclli Adi , Molinari John
Published: May 2023

Background

Streptococcus cristatus is a member of the Mitis streptococcus group. Like other members of this group, it resides on mucosal surfaces of the oral cavity. However, little is known about its ability to cause disease as there are only a handful of cases in the literature. Two of these cases involved infective endocarditis with significant complications. However, these cases involved additional microbes, limiting the inferences about the pathogenicity of Streptococcus cristatus.

Case presentation

A 59-year-old African American male with end-stage cryptogenic cirrhosis and ascites presented with fatigue and confusion. A paracentesis was negative for spontaneous bacterial peritonitis, but two separate blood cultures grew Streptococcus cristatus. Our patient had a history of dental caries and poor oral hygiene, which were likely the source of the infection. Echocardiograms revealed new aortic regurgitation, indicating “possible endocarditis” per the Modified Duke Criteria. However, since his clinical picture and cardiac function were reassuring, we elected against treatment for infective endocarditis. He was treated for bacteremia with a 2-week course of cephalosporins consisting of 8 days of ceftriaxone, transitioning to cefpodoxime after discharge. Despite having end-stage liver disease, our patient did not experience any significant complications from the infection.

Conclusion

A patient with end-stage cirrhosis and poor oral hygiene developed bacteremia with an oral bacterium called Streptococcus cristatus. Unlike previous cases in literature, our patient did not meet criteria for a definitive diagnosis of infective endocarditis, and he experienced no other complications from the infection. This suggests coinfectants may have been primarily responsible for the severe cardiac sequelae in prior cases, whereas isolated Streptococcus cristatus infection may be relatively mild.
Caviomorph rodents from the Pampean region (Argentina) in the historical Santiago Roth Collection in Switzerland
Authors: Kerber Leonardo
Published: May 2023

Here I reviewed the Pleistocene caviomorphs collected by Santiago Roth (collection from Catalog No. 5) and housed at the paleontological collection of the Paläontologisches Institut und Museum, Universität Zürich, Zurich (Switzerland). The fossils were found in Pleistocene strata from Buenos Aires and Santa Fé provinces (Argentina) during the late nineteenth century. The material includes craniomandibular remains assigned toLagostomus maximus(Chinchilloidea: Chinchillidae), craniomandibular and postcranial (thoracic and sacral vertebra, left scapula, left femur, and right tibia) bones identified asDolichotissp. (Cavioidea: Caviidae), and a fragmented hemimandible and isolated tooth ofMyocastorsp. (Octodontoidea: Echimyidae). Other rodent specimens from this collection (Ctenomyssp. andCaviasp.) are possibly sub-recent materials.
An accurate management method of public services based on big data and cloud computing
Authors: Xu Jiamuzi
Published: May 2023

Information technology and resource grouping are developing rapidly thanks to governmental policies. Large-scale data mining is a hugely practical and scientific zone of “digital gold”. This is not only a modern-day problem, but it also necessitates the rapid growth of service of publics. As a result, the benefits of information can be fully realized, service efficiency improved, and the service gap closed. Cloud computing has gained popularity due to its quick accounting, limited memory requirements, and efficient resource distribution. As a result, big data was employed to analyze the existing state of cloud-based service of publics in this paper, and the fuzzy evaluation process was used to analyze the accurate monitoring. Eventually, service of public organization was improved, and the path to the accurate organization of the entire service of public process initiated by big data was developed. The design value and data entropy of cloud-based services of public were growing exponentially, according to fuzzy comprehensive assessment; the value of average of the design value of accurate organization of cloud-based government services was around 4.35, and the average importance of data entropy was around 0.98. Furthermore, the organization control and detailed efficiency of big data-driven precision organization of social public social welfare outperformed traditional precision monitoring of cloud-based service of publics; suggesting that the effects were 7% higher, and overall capacity was 9% higher than the compared techniques.
Relationship between leadership-member exchange (LMX) and flow at work among medical workers during the COVID-19: the mediating role of job crafting
Authors: Ji Huazhen , Zhao Xiaoyun , Dang Junhua
Published: May 2023

Based on relational leadership theory and self-determination theory, this study aims to investigate the relationship between leader-member exchange (LMX), job crafting, and flow at work among medical workers in the context of the COVID-19 pandemic. Participants in the study consisted of 424 hospital employees. The results showed that: (1) the LMX positively predicted flow at work; (2) two types of job crafting (increasing structural job resources and challenging job demands) played a mediating role between the LMX and flow at work; and (3) gender did not moderate these mediating effects as suggested by previous studies. These results indicate that the LMX can not only directly predict flow at work, but also indirectly predict work-related flow through job crafting by increasing structural job resources and challenging job demands, thus providing new insights for enhancing flow experiences of medical workers.
Senescence-related impairment of autophagy induces toxic intraneuronal amyloid-β accumulation in a mouse model of amyloid pathology
Authors: Suelves Nuria , Saleki Shirine , Ibrahim Tasha , Palomares Debora , Moonen Sebastiaan , Koper Marta J. , Vrancx Céline , Vadukul Devkee M. , Papadopoulos Nicolas , Viceconte Nikenza , Claude Eloïse , Vandenberghe Rik , von Arnim Christine A. F. , Constantinescu Stefan N. , Thal Dietmar Rudolf , Decottignies Anabelle , Kienlen-Campard Pascal
Published: May 2023

Aging is the main risk factor for Alzheimer’s disease (AD) and other neurodegenerative pathologies, but the molecular and cellular changes underlying pathological aging of the nervous system are poorly understood. AD pathology seems to correlate with the appearance of cells that become senescent due to the progressive accumulation of cellular insults causing DNA damage. Senescence has also been shown to reduce the autophagic flux, a mechanism involved in clearing damaged proteins from the cell, and such impairment has been linked to AD pathogenesis. In this study, we investigated the role of cellular senescence on AD pathology by crossing a mouse model of AD-like amyloid-β (Aβ) pathology (5xFAD) with a mouse model of senescence that is genetically deficient for the RNA component of the telomerase (Terc−/−). We studied changes in amyloid pathology, neurodegeneration, and the autophagy process in brain tissue samples and primary cultures derived from these mice by complementary biochemical and immunostaining approaches. Postmortem human brain samples were also processed to evaluate autophagy defects in AD patients. Our results show that accelerated senescence produces an early accumulation of intraneuronal Aβ in the subiculum and cortical layer V of 5xFAD mice. This correlates with a reduction in amyloid plaques and Aβ levels in connecting brain regions at a later disease stage. Neuronal loss was specifically observed in brain regions presenting intraneuronal Aβ and was linked to telomere attrition. Our results indicate that senescence affects intraneuronal Aβ accumulation by impairing autophagy function and that early autophagy defects can be found in the brains of AD patients. Together, these findings demonstrate the instrumental role of senescence in intraneuronal Aβ accumulation, which represents a key event in AD pathophysiology, and emphasize the correlation between the initial stages of amyloid pathology and defects in the autophagy flux.
Design and implementation of I/O performance prediction scheme on HPC systems through large-scale log analysis
Authors: Kim Sunggon , Sim Alex , Wu Kesheng , Byna Suren , Son Yongseok
Published: May 2023

Large-scale high performance computing (HPC) systems typically consist of many thousands of CPUs and storage units used by hundreds to thousands of users simultaneously. Applications from large numbers of users have diverse characteristics, such as varying computation, communication, memory, and I/O intensity. A good understanding of the performance characteristics of each user application is important for job scheduling and resource provisioning. Among these performance characteristics, I/O performance is becoming increasingly important as data sizes rapidly increase and large-scale applications, such as simulation and model training, are widely adopted. However, predicting I/O performance is difficult because I/O systems are shared among all users and involve many layers of software and hardware stack, including the application, network interconnect, operating system, file system, and storage devices. Furthermore, updates to these layers and changes in system management policy can significantly alter the I/O behavior of applications and the entire system. To improve the prediction of the I/O performance on HPC systems, we propose integrating information from several different system logs and developing a regression-based approach to predict the I/O performance. Our proposed scheme can dynamically select the most relevant features from the log entries using various feature selection algorithms and scoring functions, and can automatically select the regression algorithm with the best accuracy for the prediction task. The evaluation results show that our proposed scheme can predict the write performance with up to 90% prediction accuracy and the read performance with up to 99% prediction accuracy using the real logs from the Cori supercomputer system at NERSC.
Face negotiation in graduate school: the decision to conceal or reveal depression among life sciences Ph.D. students in the United States
Authors: Wiesenthal Nicholas J. , Gin Logan E. , Cooper Katelyn M.
Published: May 2023

Background

Depression is one of the top mental health concerns among biology graduate students and has contributed to the “graduate student mental health crisis” declared in 2018. Several prominent science outlets have called for interventions to improve graduate student mental health, yet it is unclear to what extent graduate students with depression discuss their mental health with others in their Ph.D. programs. While sharing one’s depression may be an integral step to seeking mental health support during graduate school, depression is considered to be a concealable stigmatized identity (CSI) and revealing one’s depression could result in loss of status or discrimination. As such, face negotiation theory, which describes a set of communicative behaviors that individuals use to regulate their social dignity, may help identify what factors influence graduate students’ decisions about whether to reveal their depression in graduate school. In this study, we interviewed 50 Ph.D. students with depression enrolled across 28 life sciences graduate programs across the United States. We examined (1) to what extent graduate students revealed their depression to faculty advisors, graduate students, and undergraduates in their research lab, (2) the reasons why they revealed or concealed their depression, and (3) the consequences and benefits they perceive are associated with revealing depression. We used a hybrid approach of deductive and inductive coding to analyze our data.

Results

More than half (58%) of Ph.D. students revealed their depression to at least one faculty advisor, while 74% revealed to at least one graduate student. However, only 37% of graduate students revealed their depression to at least one undergraduate researcher. Graduate students’ decisions to reveal their depression to their peers were driven by positive mutual relationships, while their decisions to reveal to faculty were often based on maintaining dignity by performing preventative or corrective facework. Conversely, graduates performed supportive facework when interacting with undergraduate researchers by revealing their depression as a way to destigmatize struggling with mental health.

Conclusions

Life sciences graduate students most commonly revealed their depression to other graduate students, and over half reported discussing depression with their faculty advisor. However, graduate students were reluctant to share their depression with undergraduate researchers. Power dynamics between graduate students and their advisors, their peers, and their undergraduate mentees influenced the reasons they chose to reveal or conceal their depression in each situation. This study provides insights into how to create more inclusive life science graduate programs where students can feel more comfortable discussing their mental health.
A fragmented segment of a central venous catheter caused delayed ventricular fibrillation: a case report
Authors: Takahashi Kei , Arai Takero , Asai Takashi , Okuda Yasuhisa
Published: May 2023

Background

Central venous port systems may be safely used for chemotherapy of patients with cancer, but several complications may occur associated with their use.

Case presentation

An 83-year-old man with heat stroke was transferred to our emergency department, where he was treated and became able to eat on the same day. He had been fit and healthy, except for colorectomy and chemotherapy using a central venous access port placed in the right upper jugular vein 8 years ago. The next day, he suddenly had ventricular fibrillation. Cardiopulmonary resuscitation was successful. Emergency coronary angiography showed a catheter-like foreign body in the coronary sinus. Physicians failed to remove the foreign body using catheter therapy, and ventricular fibrillation occurred repeatedly. After induction of general anesthesia, the fractured catheter was removed surgically. Postoperative course was uneventful.

Conclusions

A fragmented segment of a catheter may suddenly cause ventricular fibrillation years later.