bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between renal impairment and polypharmacy among older Palestinian patients: a multi-center cross-sectional study
Authors: Naghnaghia Shayma , Nazzal Zaher , Abu Alya Layan , AL-Ramahi Rowa’ , Hamdan Zakaria , Samara Esra’a
Published: February 2023

Purpose

This study aimed to examine the association between renal impairment and polypharmacy among older Palestinian patients visiting primary healthcare centers and to examine potentially inappropriate medications among older patients.

Methods

A cross-sectional study was conducted among PHC clinic attendees aged 65 and older. We used medical records and an interviewer-administered questionnaire for data collection. Participants with eGFR less than 60mls/min/1.73 m2 were categorized as renal impaired; we then calculated the prevalence of renal impairment and used Poisson multivariable regression model with robust variance to identify associated factors. Beer’s criteria and literature reviews were used to evaluate renal impairment patients’ medication and to determine the frequency of PIPs.

Results

The study included 421 participants (224 female, 197 male), and 66.3% were between the ages of 65 and 75. The prevalence of renal impairment was 30.2% (95%CI: 25.8–34.6%). Polypharmacy [aPR = 2.7, 95%CI: 1.7–4.3], stroke [aPR = 2.6, 95%CI: 1.1–2.3], females [aPR = 1.7, 95%CI: 1.2–2.5], and older patients over the age of 80 [aPR = 2.4, 95%CI: 1.6–3.5] were the main factors associated with renal impairment. RAAS (54.3%), metformin (39.3%), and sulfonylurea (20.4%) were the most frequently reported PIP in renal impairment patients.

Conclusion

This study demonstrates a relationship between polypharmacy and renal impairment. Some people with renal impairment receive drugs that those with kidney illness should avoid or use with caution. It is important to prescribe only necessary medication, choose non-nephrotoxic alternatives, and frequently monitor renal function.
CytoSaLPs score: a promising new tool for the detection and screening of extrauterine high grade serous carcinoma
Authors: Lekka Sofia , Psomiadou Victoria , Panoskaltsis Theodoros , Tsouma Eleni , Novkovic Natasa , Trihia Helen , Tzaida Olympia , Korfias Dimitrios , Giannakas Panagiotis , Iavazzo Christos , Vakas Panagiotis , Vlahos Nikolaos , Vorgias George
Published: February 2023

Background

A recent theory supports that high-grade serous epithelial ovarian cancer derives from the fimbrial end of the fallopian tube and during the last decade, a few studies have examined the fallopian tube cytology. Our study aims to determine the cytomorphological characteristics of both benign and non-benign salpingeal samples, in order to establish fallopian cytology as a valuable diagnostic test for women with high risk for development of ovarian/fallopian/peritoneal cancer.

Methods

Our study included patients undergoing salpingoophorectomy or total hysterectomy and salpingoophorectomy for any gynecological pathology. Using a soft brush, fallopian tube smears from the fimbrial end were collected ex vivo. The Cytologists of our Institution described the morphological characteristics of the fallopian cells by adopting a proposed Table, which had a calibration system ranging from 3 to 29. This Table is referred to as the CytoSaLPs Score. Our study compared the two diagnostic cytological methods, the one of the conventional cytology and the other using the CytoSaLPs Score, having as gold standard the tubal’s pathological findings.

Results

A total of 230 tubal specimens from 144 patients were included in this study. The Score’s mean for the benign and non-benign arm was 12.8 and 18.7 respectively. The cut-off point for both arms was 16.5. The CytoSaLPs Score tool showed significantly higher specificity (87.50% vs. 75.96, p-value < 0.001) and positive predictive value PPV (40.91% vs. 26.47%, p-value < 0.001) compared to conventional cytology. Regarding the accuracy, the Score’s superiority is highlighted (86.96% vs. 76.52%, p-value < 0.001).

Conclutions

The evaluation of tubal cytology using the CytoSaLPs Score could be used as a reliable diagnostic method. Further evaluation with larger studies is warranted.
Long term positional stability of the Argus II retinal prosthesis epiretinal implant
Authors: Ghani Nimra , Bansal Jahnvi , Naidu Abhishek , Chaudhary Khurram M.
Published: February 2023

Background

The Argus II Retinal Prosthesis System (Second Sight Medical Products, Sylmar, California) is an epiretinal prosthesis that serves to provide useful vision to people who are affected by retinal degenerative diseases such as retinitis pigmentosa (RP). The purpose of this study was to analyze postoperative movement of the electrode array.

Methods

Five patients diagnosed with profound retinal dystrophy who have undergone implantation of retinal prosthesis at Stony Brook University Hospital. Fundoscopy was performed at postoperative month 1 (M1), month 3 (M3), month 6 (M6), month 12 (M12), and month 24 (M24) visits. Fundoscopy was extracted and analyzed via NIH ImageJ. Data analysis was completed using IBM SPSS. Various lengths and angles were measured each postoperative month using ImageJ.

Results

There was no significant change in distance between the optic disc and the surgical handle (length AB) over the two-year span (F = 0.196, p = 0.705). There was a significant change in distance of length AB over time between patients between M3 and M6 (p = 0.025). A repeated measures ANOVA revealed that there was statistically significant change of the optic disc-tack-surgical handle angle (𝛾) (M1 to M24) (F = 3.527, p = 0.030). There was no significant change in angle 𝜟 (the angle to the horizontal of the image), angle 𝜶 (tack-optic disc-surgical handle), and angle 𝜷 (optic-disc-surgical handle-tack).

Conclusion

Our results demonstrate that there may be postoperative movement of the retinal prosthesis over time, as a statistically significant downward rotation is reported over the 2 years span. It is important, moving forward, to further study this movement and to take into consideration such movement when designing retinal implants. It is important to note that this study is limited by the small sample size, and therefore, the conclusions drawn are limited.
Quality of sick child management by health extension workers: role of a complex improvement intervention
Authors: Daka Dawit Wolde , Wordofa Muluemebet Abera , Berhanu Della , Persson Lars Åke , Woldie Mirkuzie
Published: February 2023

Background

Despite the expansion of the Integrated Community Case Management services for childhood illness, quality and utilization of services have remained low. To address the problem, the Government of Ethiopia introduced a complex intervention that included community engagement, capacity building of health workers and enhanced district-level ownership of sick child management. We examined whether this complex intervention was associated with improved management of sick children by health extension workers.

Methods

The study was conducted in four Ethiopian regions. A baseline survey was conducted in 26 intervention and 26 comparison districts from December 2016 to February 2017, followed by an end-line survey 24 months later. We observed health extension workers’ consultations of sick 2–59 months old children. The analysis has evaluated if children with pneumonia, diarrhoea and malnutrition were assessed, classified and treated according to guidelines, and included difference-in-difference analyses.

Results

We observed 1325 consultations of sick children. At baseline, 86% of the sick children with cough in the intervention areas and 85% in comparison areas were assessed according to the guidelines, without any change at end-line associated with the intervention (difference-in-difference = -21%, p = 0.55). Sixty-two percent of children were assessed for dehydration at baseline in intervention and 47% in comparison areas, with no improvement associated with the intervention. Similarly, 87% of sick children in intervention and 91% in comparison areas were assessed for malnutrition, with no change over time associated with the intervention (difference-in-difference = 5%, p = 0.16). Appropriate pneumonia treatment with antibiotics declined and diarrhea treatment increased in both areas. Half of the malnourished children received ready-to-use therapeutic foods without any improvement associated with the intervention.

Conclusion

The intervention was not associated with improved quality of the health extension workers’ management of sick children. The lack of association may be linked to low fidelity in the implementation of the intervention. Our findings suggest that training healthcare providers without continued clinical mentoring and support does not improve the quality of care. Community-based programs can be strengthened by ensuring high coverage and continued clinical mentorships, supportive supervision, and supply of medicines and other essential commodities.

Trial registration number

ISRCTN12040912, retrospectively registered on 19/12/ 2017.
A double-suture cerclage reduction technique with Nice knots for comminuted patella fractures (AO/OTA 34-C3)
Authors: Gao Yanchun , Han Xiaojun , Zhou Bin , Zhao Shichang , Yu Xingang
Published: February 2023

Background

Comminuted patella fractures place high demands on surgeons’ surgical skills. We used a double-suture cerclage reduction with Nice knots as an intra-operative reduction technique to displaced comminuted patella fractures.

Methods

Patients were divided into two groups by whether or not an intra-operative suture cerclage reduction technique was used. Fragments count, surgical time, quality of the reduction, and fracture healing time were recorded. The postoperative function was assessed by Böstman score and range of motion.

Results

With the inclusion and exclusion criteria, 48 patients we included in the cohort between Sept. 2016 and Oct. 2021. The double-suture cerclage reduction technique with a Nice knot achieved a satisfactory reduction. When the number of fragments was over 5, this technique showed significant advantages in saving surgery time.

Conclusions

In this study, the double-suture cerclage reduction technique combined with the Nice knot shows significant advantages for displaced highly comminuted patella fractures. This technique simplifies the operation and saves surgical time, which is helpful for clinical practice.
Lateral lumbar interbody fusion (LLIF) reduces total lifetime cost compared with posterior lumbar interbody fusion (PLIF) for single-level lumbar spinal fusion surgery: a cost-utility analysis in Thailand
Authors: Boonsirikamchai Win , Phisalpapra Pochamana , Kositamongkol Chayanis , Korwutthikulrangsri Ekkapoj , Ruangchainikom Monchai , Sutipornpalangkul Werasak
Published: February 2023

Background

Lumbar interbody fusion techniques treat degenerative lumbar diseases effectively. Minimally invasive lateral lumbar interbody fusion (LLIF) decreases soft tissue disruption and accelerates recovery better than standard open posterior lumbar interbody fusion (PLIF). However, the material cost of LLIF is high, especially in Thailand. The cost-effectiveness of LLIF and PLIF in developing countries is unclear. This study compared the cost-utility and clinical outcomes of LLIF and PLIF in Thailand.

Methods

Data from patients with lumbar spondylosis who underwent single-level LLIF and PLIF between 2014 and 2020 were retrospectively reviewed. Preoperative and 1-year follow-up EuroQol-5D-5L and healthcare costs were collected. A cost-utility analysis with a lifetime time horizon was performed using a societal perspective. Outcomes are reported as the incremental cost-effectiveness ratio (ICER) and quality-adjusted life-year (QALY) gained. A Thai willingness-to-pay threshold of 5003 US dollars (USD) per QALY gained was used.

Results

The 136 enrolled patients had a mean age of 62.26 ± 11.66 years. Fifty-nine patients underwent LLIF, while 77 underwent PLIF. The PLIF group experienced greater estimated blood loss (458.96 vs 167.03 ml; P < 0.001), but the LLIF group had a longer operative time (222.80 vs 194.62 min; P = 0.007). One year postoperatively, the groups’ Oswestry Disability Index and EuroQol-Visual Analog Scale scores were improved without statistical significance. The PLIF group had a significantly better utility score than the LLIF group (0.89 vs 0.84; P = 0.023). LLIF’s total lifetime cost was less than that of PLIF (30,124 and 33,003 USD). Relative to PLIF, LLIF was not cost-effective according to the Thai willingness-to-pay threshold, with an ICER of 19,359 USD per QALY gained.

Conclusions

LLIF demonstrated lower total lifetime cost from a societal perspective. Regard to our data, at the 1-year follow-up, the improvement in patient quality of life was less with LLIF than with PLIF. Additionally, economic evaluation modeling based on the context of Thailand showed that LLIF was not cost-effective compared with PLIF. A strategy that facilitates the selection of patients for LLIF is required to optimize patient benefits.
Prevalence of long-term decision regret and associated risk factors in a large cohort of ICU surrogate decision makers
Authors: Andersen Sarah K. , Butler Rachel A. , Chang Chung-Chou H. , Arnold Robert , Angus Derek C. , White Douglas B.
Published: February 2023

Background

Whether surrogate decision makers regret decisions about the use of life support for incapacitated, critically ill patients remain uncertain. We sought to determine the prevalence of decision regret among surrogates of adult ICU patients and identify factors that influence regret.

Methods

We conducted a secondary analysis of data from the PARTNER 2 trial, which tested a family support intervention for surrogates of critically ill adults. At 6-month follow-up, surrogates rated their regret about life support decisions using the Decision Regret Scale (DRS), scored from 0 to 100, with higher scores indicating more regret. We used multiple linear regression to identify covariates associated with decision regret based on a psychological construct of regret. We constructed two models using the full cohort; model 1 included patient outcomes; model 2 focused on covariates known at the time of ICU decision-making. Subgroup analyses were also conducted based on patient survival status at hospital discharge and 6-month follow-up.

Results

748 of 848 surrogates had complete DRS data. The median (IQR) DRS score was 15 (0, 25). Overall, 54% reported mild regret (DRS 5–25), 19% moderate-strong regret (DRS 30–100), and 27% no regret (DRS 0). Poor patient outcome at 6 months (death or severe functional dependence) was associated with more regret in model 1 (β 10.1; 95% C.I. 3.2, 17.0). In model 2, palliative care consultation (3.0; 0.1, 5.9), limitations in life support (LS) prior to death (6.3; 3.1, 9.4) and surrogate black race (6.3; 0.3, 12.3) were associated with more regret. Other modulators of regret in subgroup analyses included surrogate age and education level, surrogate-patient relationship, death in hospital (compared to the post-discharge period), and code status at time of ICU admission.

Conclusions

One in five ICU surrogate decision makers experience moderate to strong regret about life support decisions in ICU. Poor patient outcomes are linked to more regret. Decisions to limit life support prior to patient death may also increase regret. Future studies are needed to understand how regret relates to decision quality and how to lessen lasting regret.
DNA methylation entropy as a measure of stem cell replication and aging
Authors: Vaidya Himani , Jeong Hye Seon , Keith Kelsey , Maegawa Shinji , Calendo Gennaro , Madzo Jozef , Jelinek Jaroslav , Issa Jean-Pierre J.
Published: February 2023

Background

Epigenetic marks are encoded by DNA methylation and accumulate errors as organisms age. This drift correlates with lifespan, but the biology of how this occurs is still unexplained. We analyze DNA methylation with age in mouse intestinal stem cells and compare them to nonstem cells.

Results

Age-related changes in DNA methylation are identical in stem and nonstem cells, affect most prominently CpG islands and correlate weakly with gene expression. Age-related DNA methylation entropy, measured by the Jensen-Shannon Distribution, affects up to 25% of the detectable CpG sites and is a better measure of aging than individual CpG methylation. We analyze this entropy as a function of age in seven other tissues (heart, kidney, skeletal muscle, lung, liver, spleen, and blood) and it correlates strikingly with tissue-specific stem cell division rates. Thus, DNA methylation drift and increased entropy with age are primarily caused by and are sensors for, stem cell replication in adult tissues.

Conclusions

These data have implications for the mechanisms of tissue-specific functional declines with aging and for the development of DNA-methylation-based biological clocks.
Multidisciplinary evaluation of plant growth promoting rhizobacteria on soil microbiome and strawberry quality
Authors: Nam Jun Haeng , Thibodeau Alyssa , Qian Yanping L. , Qian Michael C. , Park Si Hong
Published: February 2023

The natural soil environment is considered one of the most diverse habitats containing numerous bacteria, fungi, and larger organisms such as nematodes, insects, or rodents. Rhizosphere bacteria play vital roles in plant nutrition and the growth promotion of their host plant. The aim of this study was to evaluate the effects of three plant growth-promoting rhizobacteria (PGPR), Bacillus subtilis, Bacillus amyloliquefaciens, and Pseudomonas monteilii for their potential role as a biofertilizer. The effect of the PGPR was examined at a commercial strawberry farm in Dayton, Oregon. The PGPR were applied to the soil of the strawberry (Fragaria × ananassa cultivar Hood) plants in two different concentrations of PGPR, T1 (0.24% PGPR) and T2 (0.48% PGPR), and C (no PGPR). A total of 450 samples from August 2020 to May 2021 were collected, and microbiome sequencing based on the V4 region of the 16S rRNA gene was conducted. The strawberry quality was measured by sensory evaluation, total acidity (TA), total soluble solids (TSS), color (lightness and chroma), and volatile compounds. Application of the PGPR significantly increased the populations of Bacillus and Pseudomonas and promoted the growth of nitrogen-fixing bacteria. The TSS and color evaluation showed that the PGPR presumptively behaved as a ripening enhancer. The PGPR contributed to the production of fruit-related volatile compounds, while the sensory evaluation did not show significant differences among the three groups. The major finding of this study suggests that the consortium of the three PGPR have a potential role as a biofertilizer by supporting the growth of other microorganisms (nitrogen-fixing bacteria) as part of a synergetic effect and strawberry quality such as sweetness and volatile compounds.
Low carbon futures: assessing the status of decarbonisation efforts at universities within a 2050 perspective
Authors: Filho Walter Leal , Vidal Diogo Guedes , Dinis Maria Alzira Pimenta , Lambrechts Wim , Vasconcelos Claudio R. P. , Molthan-Hill Petra , Abubakar Ismaila Rimi , Dunk Rachel M. , Salvia Amanda Lange , Sharifi Ayyoob
Published: February 2023

Background

The implementation of sustainability at universities means that they can also play a key role in the transition to a low carbon economy, and in assisting global efforts towards decarbonisation. Yet, not all of them have so far fully engaged in this area. This paper reviews the state of the art on trends in decarbonisation, and outlines the need for decarbonisation efforts at universities. It also reports on a survey aimed at ascertaining the extent to which universities in a sample of 40 countries across the various geographical regions are engaged in carbon reduction efforts, identifying the challenges faced.

Results

The study has shown that the literature on the topic has been evolving over time and that increasing a given university’s energy supply from renewable energy sources has been the cornerstone of university-based climate action plans. The study also indicates that even though several universities are concerned with their carbon footprint and actively seeking ways to reduce it, there are some institutional obstacles that need to be overcome.

Conclusions

A first conclusion which can be drawn is that efforts on decarbonisation are becoming more popular, with a special focus being placed on the use of renewable energy. Also, the study has shown that, from the range of efforts being made towards decarbonisation, many universities are setting up a team with carbon management responsibilities, have Carbon Management Policy Statements, and review them. The paper points towards some measures which may be deployed, so as to allow universities to take better advantage of the many opportunities an engagement in decarbonisation initiatives offers to them.
Trends in otolaryngology publications: A 9-year bibliometric analysis of articles published in Journal of Otolaryngology—Head and Neck Surgery
Authors: Kirubalingam Keshinisuthan , Dzioba Agnieszka , Chan Yvonne , Graham M. Elise
Published: February 2023

Background

The advancement of Otolaryngology—Head and Neck Surgery (OHNS) as a specialty relies on excellence in research. The Journal of Otolaryngology-Head and Neck Surgery is an open access, peer-reviewed journal publishing on all aspects and subspecialities of OHNS. It is the official journal of the Canadian Society of Otolaryngology—Head and Neck Surgery. This study aims to analyze bibliometric trends in authorships and institutional contributions within the Journal of Otolaryngology-Head and Neck Surgery over a 9-year period.

Methods

All research articles published online in the journal were analyzed from 2013 to the end of 2021. The professional designation of all authors was recorded along with the article type, article category, institutional affiliations and international collaborations. Cochran–Armitage trend tests were used to assess the change in proportion over time between years and groups.

Results

Of the 603 articles, 20 were excluded as they represented correspondence or corrections, or author identity could not be determined. 583 articles with 3409 total authors were included. Number of first authors with a Doctor of Medicine (MD) degree decreased from 90.2 to 85.3% ( P = 0.165). Sub-group analysis of non-MD first authors demonstrated a significant increase in medical students as first authors from 1.6 to 11.8% ( P = 0.008). Senior author degree demonstrated a significant increase in MD degree from 96.7 to 98.5% ( P = 0.002). Analysis of article categories demonstrated a significant decrease in education and head and neck surgery related articles from 8.2 to 2.9% ( P = 0.032) and 44.3 to 29.4% ( P = 0.028) respectively. Pediatric otolaryngology articles increased significantly from 0 to 5.9% ( P < 0.0001). Systematic and scoping reviews significantly increased, from 3.3 to 10.3% ( P = 0.015) and original research significantly decreased from 83.6 to 82.4% ( P < 0.0001). There was a significant decrease in Canadian/international collaborations from 14.3 to 4.7% ( P = 0.037). There was a significant increase in international first and senior authors, from 23.0 to 36.8% ( P = 0.008) and 19.7 to 38.2% ( P = 0.002) respectively.

Conclusion

The landscape of the journal is evolving with increased representation of non-MDs and international authors along with content that reflects higher level of scientific evidence. Future studies should characterize trends in other Otolaryngology journals to understand the research trajectory within the field.

Graphical Abstract
Reimagining how to understand learning game experiences: a qualitative and exploratory case study
Authors: Almås Håvard , Pinkow Felix , Giæver Fay
Published: February 2023

While the use of games for learning in higher education is well established, existing research provides limited understanding of individual experiences that shape engagement and learning in collaborative learning games. Insights into players’ individual experiences can, however, contribute to a more nuanced utilization of learning games and to better understand differences in individual learning outcomes. Therefore, this study seeks to explore how learning is experienced by players in a collaborative learning game. To achieve this, the study investigates the incentive and interaction dimensions of learning and the role of engagement and motivation for learning in an online collaborative board game using an exploratory qualitative case study approach. The study draws on diverse data comprising several sources, including in-depth interviews, observation of participants during a learning game, written free-form feedback, and a survey regarding the play experience. Results accentuate the role of individual and contextual differences, especially pertaining to prior knowledge and applying knowledge in realistic settings, perception of novelty related to game learning, and support from instructors and group members. Findings are further contextualized by positioning them into theoretical foundations related to transactive memory systems and collaborative engagement. Suggestions are made for collaborative learning game practitioners to strive for intragroup acquaintance and establishing purpose and use before play, and for instructors to be trained to dynamically adapt the type and amount of support provided based on player needs.
Artificial intelligence and machine learning for hemorrhagic trauma care
Authors: Peng Henry T. , Siddiqui M. Musaab , Rhind Shawn G. , Zhang Jing , da Luz Luis Teodoro , Beckett Andrew
Published: February 2023

Artificial intelligence (AI), a branch of machine learning (ML) has been increasingly employed in the research of trauma in various aspects. Hemorrhage is the most common cause of trauma-related death. To better elucidate the current role of AI and contribute to future development of ML in trauma care, we conducted a review focused on the use of ML in the diagnosis or treatment strategy of traumatic hemorrhage. A literature search was carried out on PubMed and Google scholar. Titles and abstracts were screened and, if deemed appropriate, the full articles were reviewed. We included 89 studies in the review. These studies could be grouped into five areas: (1) prediction of outcomes; (2) risk assessment and injury severity for triage; (3) prediction of transfusions; (4) detection of hemorrhage; and (5) prediction of coagulopathy. Performance analysis of ML in comparison with current standards for trauma care showed that most studies demonstrated the benefits of ML models. However, most studies were retrospective, focused on prediction of mortality, and development of patient outcome scoring systems. Few studies performed model assessment via test datasets obtained from different sources. Prediction models for transfusions and coagulopathy have been developed, but none is in widespread use. AI-enabled ML-driven technology is becoming integral part of the whole course of trauma care. Comparison and application of ML algorithms using different datasets from initial training, testing and validation in prospective and randomized controlled trials are warranted for provision of decision support for individualized patient care as far forward as possible.
Magnetic transferrin nanoparticles (MTNs) assay as a novel isolation approach for exosomal biomarkers in neurological diseases
Authors: Jang Yoon Ok , Ahn Hee-Sung , Dao Thuy Nguyen Thi , Hong JeongYeon , Shin Wangyong , Lim Young-Min , Chung Sun Ju , Lee Jae-Hong , Liu Huifang , Koo Bonhan , Kim Myoung Gyu , Kim Kyunggon , Lee Eun-Jae , Shin Yong
Published: February 2023

Background

Brain-derived exosomes released into the blood are considered a liquid biopsy to investigate the pathophysiological state, reflecting the aberrant heterogeneous pathways of pathological progression of the brain in neurological diseases. Brain-derived blood exosomes provide promising prospects for the diagnosis of neurological diseases, with exciting possibilities for the early and sensitive diagnosis of such diseases. However, the capability of traditional exosome isolation assays to specifically isolate blood exosomes and to characterize the brain-derived blood exosomal proteins by high-throughput proteomics for clinical specimens from patients with neurological diseases cannot be assured. We report a magnetic transferrin nanoparticles (MTNs) assay, which combined transferrin and magnetic nanoparticles to isolate brain-derived blood exosomes from clinical samples.

Methods

The principle of the MTNs assay is a ligand-receptor interaction through transferrin on MTNs and transferrin receptor on exosomes, and electrostatic interaction via positively charged MTNs and negatively charged exosomes to isolate brain-derived blood exosomes. In addition, the MTNs assay is simple and rapid (< 35 min) and does not require any large instrument. We confirmed that the MTNs assay accurately and efficiently isolated exosomes from serum samples of humans with neurodegenerative diseases, such as dementia, Parkinson's disease (PD), and multiple sclerosis (MS). Moreover, we isolated exosomes from serum samples of 30 patients with three distinct neurodegenerative diseases and performed unbiased proteomic analysis to explore the pilot value of brain-derived blood protein profiles as biomarkers.

Results

Using comparative statistical analysis, we found 21 candidate protein biomarkers that were significantly different among three groups of neurodegenerative diseases.

Conclusion

The MTNs assay is a convenient approach for the specific and affordable isolation of extracellular vesicles from body fluids for minimally-invasive diagnosis of neurological diseases.
The prospective power of personality for childbearing: a longitudinal study based on data from Germany
Authors: Peters Steffen
Published: February 2023

The link between personality and fertility is relatively underexplored. Moreover, there are only a few studies focusing on the prospective association between personality and childbearing. However, none of these studies considered the Five-Factor Model (FFM), which is the most widely accepted measurement of personality. The present study fills this gap by examining the prospective association between the FFM and the hazard ratio of the first and the second childbirth in Germany. Analyses are based on recent data (2005–2017) from the Socio-economic Panel Study. Cox proportional hazard models are applied. Findings demonstrate that personality traits are associated with fertility. Extraversion is positively linked with the first childbirth, but is negatively associated with the second childbirth. These findings are mainly driven by males. Agreeableness is positively linked with the first childbirth across the total sample. Again, this correlation is mainly based on the findings for men, among whom a positive association between agreeableness and the second childbirth is also found. Among women, personality does not seem to be linked with the first childbirth. However, the risk of having a second child is found to be negatively associated with conscientiousness. My study adds to the current understanding of the personality–fertility association by exploring the impact of personality trait scores from the FFM on subsequent fertility behavior. However, further research is needed on the association between personality and childbearing; on the mechanisms through which personality affects fertility; and on how these links differ across cultures, among higher parities, and for births after re-partnering.
Alcohol and fatal penetration of the cranium by an airgun pellet—a case study from Poland
Authors: Glowinski Sebastian , Majdanik Sławomir , Potocka-Banaś Barbara
Published: February 2023

Background

Airguns with the energy of ejected pellets below 17 J are not considered weapons in Poland, can be purchased without permission, and do not require registration. The mere possession of this kind of airgun does not entail any legal consequences, unless it is used for an unauthorized purpose. Sports and recreational shooting do not have to take place within shooting ranges. However, the improper use of this type of weapon can lead to serious injuries and death. In addition, the impact of high blood alcohol content on pain perception can lead to a lack of awareness of the gunshot.

Case presentation

A 36-year-old woman died a few hours after a head injury inflicted by a 5.50-mm caliber pellet fired from an air gun. The first pellet penetrated perpendicularly through the left temporal bone to the brain. The gunshot tract of this head wound was 6 cm long and ran horizontally and perpendicularly to the surface of the squamous part of the temporal bone. The tract ran through the skin of the skull, the left temporal muscle, and the squamous part of the temporal bone (where the bone was only 1.5 mm thick). The pellet then penetrated the cerebral dura mater, cerebral pia mater on the borderline of the left temporal and frontal lobes, and left lateral wall of the sphenoidal sinus. The victim did not complain of pain due to a high level of alcohol intoxication (0.35 blood alcohol content). The pellet from the second shot (on the foot) penetrated the right foot and was inflicted by the victim.

Conclusion

The victim died not earlier than 3 h after being shot as a result of intracranial injuries that caused hemorrhage. The outcomes of this study indicated that high alcohol content resulted in reduced awareness of the victim and no apparent symptoms of developing intracranial injuries.
BIS-guided sedation prevents the cough reaction of patients under general anaesthesia caused by extubation: a randomized controlled trial
Authors: Zhang Erfei , Zhao Xiaoying , An Xiaoyan , Wang Min , Gao Jie , Zhang Hailiang , Li Ying
Published: February 2023

Background

The multiple modes of SARS-CoV-2 transmission including airborne, droplet, contact and faecal–oral transmissions that cause coronavirus disease 2019 (COVID-19) contribute to a public threat to the lives of people worldwide. Heavy aerosol production by coughing and the big peak expiratory flow in patients with respiratory infections (especially SARS-CoV-2) during recovery from general anaesthesia are the highest risk factors for infection in healthcare workers. To perform sedation before extubation significantly reduced the incidence of coughing during recovery from general anaesthesia. However, there are few studies on endotracheal tube removal under BIS-guided sedation in postanaesthesia care unit (PACU). We speculated that the BIS-guided sedation with dexmedetomidine and propofol would better prevent coughing caused by tracheal extubation and reducing peak expiratory flow.

Methods

Patients with general anaesthesia were randomly assigned to Group S (dexmedetomidine was infused in the operating room for 30 min, and the bispectral index (BIS) value was maintained 60–70 by infusion propofol at 0.5~1.5 μg/ml in the PACU until the endotracheal tubes were pulled out) and Group C (no dexmedetomidine and propofol treatment, replaced with the saline treatment). The incidence of coughing, agitation and active extubation, endotracheal tube tolerance and the peak expiratory flow at spontaneous breathing and at extubation were assessed.

Results

A total of 101 patients were randomly assigned to Group S (51 cases) and Group C (50 cases). The incidence of coughing, agitation and active extubation was significantly lower (1(51), 0(51) and 0(51), respectively) in Group S than (11(50), 8(50) and 5(50), respectively) in Group C (p < 0.05 or p < 0.01, respectively); the scores of cough were significantly reduced (1(1, 1)) in Group S than (1(1, 2)) in Group C (p < 0.01); and the endotracheal tube tolerance was significantly improved (0(0, 1)) in Group S than (1(1, 3)) in Group C (p < 0.001). The peak expiratory flow at spontaneous breathing and at extubation was significantly reduced (5(5, 7) and 6.5(6, 8), respectively) in Group S than (8(5, 10) and 21(9, 32)) in Group C (p < 0.001).

Conclusions

BIS-guided sedation with dexmedetomidine and propofol significantly prevented coughing and reduced peak expiratory flow during recovery from general anaesthesia, which may play an important role in preventing medical staff from contracting COVID-19.

Trial registration

Chinese Clinical Trial Registry: ChiCTR2200058429 (registration date: 09-04-2022) “retrospectively registered”.
Development and Validation of a Prediction Model for Kidney Failure in Long-Term Survivors of Childhood Cancer
Authors: Wu Natalie L. , Chen Yan , Dieffenbach Bryan V. , Ehrhardt Matthew J. , Hingorani Sangeeta , Howell Rebecca M. , Jefferies John L. , Mulrooney Daniel A. , Oeffinger Kevin C. , Robison Leslie L. , Weil Brent R. , Yuan Yan , Yasui Yutaka , Hudson Melissa M. , Leisenring Wendy M. , Armstrong Gregory T. , Chow Eric J.
Published: February 2023

PURPOSE

Kidney failure is a rare but serious late effect following treatment for childhood cancer. We developed a model using demographic and treatment characteristics to predict individual risk of kidney failure among 5-year survivors of childhood cancer.

METHODS

Five-year survivors from the Childhood Cancer Survivor Study (CCSS) without history of kidney failure (n = 25,483) were assessed for subsequent kidney failure (ie, dialysis, kidney transplantation, or kidney-related death) by age 40 years. Outcomes were identified by self-report and linkage with the Organ Procurement and Transplantation Network and the National Death Index. A sibling cohort (n = 5,045) served as a comparator. Piecewise exponential models accounting for race/ethnicity, age at diagnosis, nephrectomy, chemotherapy, radiotherapy, congenital genitourinary anomalies, and early-onset hypertension estimated the relationships between potential predictors and kidney failure, using area under the curve (AUC) and concordance (C) statistic to evaluate predictive power. Regression coefficient estimates were converted to integer risk scores. The St Jude Lifetime Cohort Study and the National Wilms Tumor Study served as validation cohorts.

RESULTS

Among CCSS survivors, 204 developed late kidney failure. Prediction models achieved an AUC of 0.65-0.67 and a C-statistic of 0.68-0.69 for kidney failure by age 40 years. Validation cohort AUC and C-statistics were 0.88/0.88 for the St Jude Lifetime Cohort Study (n = 8) and 0.67/0.64 for the National Wilms Tumor Study (n = 91). Risk scores were collapsed to form statistically distinct low- (n = 17,762), moderate- (n = 3,784), and high-risk (n = 716) groups, corresponding to cumulative incidences in CCSS of kidney failure by age 40 years of 0.6% (95% CI, 0.4 to 0.7), 2.1% (95% CI, 1.5 to 2.9), and 7.5% (95% CI, 4.3 to 11.6), respectively, compared with 0.2% (95% CI, 0.1 to 0.5) among siblings.

CONCLUSION

Prediction models accurately identify childhood cancer survivors at low, moderate, and high risk for late kidney failure and may inform screening and interventional strategies.
Factors Associated With Response to Growth Hormone in Pediatric Growth Disorders: Results of a 5-year Registry Analysis
Authors: Ross Judith , Fridman Moshe , Kelepouris Nicky , Murray Kristine , Krone Nils , Polak Michel , Rohrer Tilman R , Pietropoli Alberto , Lawrence Neil , Backeljauw Philippe
Published: February 2023

Context

Growth hormone (GH) therapy can increase linear growth in patients with growth hormone deficiency (GHD), Turner syndrome (TS), Noonan syndrome (NS), and Prader-Willi syndrome (PWS), although outcomes vary by disease state.

Objective

To assess growth and identify factors associated with growth response with long-term GH therapy.

Methods

Data from pediatric patients with GHD, TS, NS, and PWS obtained at GH treatment initiation (baseline) and annually for 5 years in the ANSWER Program and NordiNet® IOS were analyzed retrospectively. Height standard deviation score (HSDS) was assessed over time, and multivariate analyses determined variables with significant positive effects on growth outcomes in each patient cohort.

Results

Data from patients with GHD (n = 12 683), TS (n = 1307), NS (n = 203), and PWS (n = 102) were analyzed. HSDS increased over time during GH treatment in all cohorts. Factors with significant positive effects on ΔHSDS were younger age at GH initiation and lower HSDS at baseline (all cohorts) and higher GH dose (GHD and TS only); sex had no effect in any cohort. The modeling analysis showed that ΔHSDS was greatest in year 1 and attenuated over consecutive years through year 5. Estimated least-squares mean ΔHSDS values at year 5 by cohort were 1.702 (females) and 1.586 (males) in GHD, 1.033 in TS, 1.153 in NS, and 1.392 in PWS.

Conclusion

Long-term GH therapy results in large increases in HSDS in patients with GHD, TS, NS, and PWS. Greater gains in HSDS can be obtained with higher GH doses and earlier initiation of treatment.
Imaging of Central Nervous System Demyelinating Disorders
Authors: Tillema Jan-Mendelt
Published: February 2023

OBJECTIVE

This article summarizes neuroimaging findings in demyelinating disease, the most common being multiple sclerosis. Revisions to criteria and treatment options have been ongoing, and MRI plays a pivotal role in diagnosis and disease monitoring. The common antibody-mediated demyelinating disorders with their respective classic imaging features are reviewed, as well as the differential diagnostic considerations on imaging.

LATEST DEVELOPMENTS

The clinical criteria of demyelinating disease rely heavily on imaging with MRI. With novel antibody detection, the range of clinical demyelinating syndromes has expanded, most recently with myelin oligodendrocyte glycoprotein–IgG antibodies. Imaging has improved our understanding of the pathophysiology of multiple sclerosis and disease progression, and further research is underway. The importance of increased detection of pathology outside of the classic lesions will have an important role as therapeutic options are expanding.

ESSENTIAL POINTS

MRI has a crucial role in the diagnostic criteria and differentiation among common demyelinating disorders and syndromes. This article reviews the typical imaging features and clinical scenarios that assist in accurate diagnosis, differentiation between demyelinating diseases and other white matter diseases, the importance of standardized MRI protocols in clinical practice, and novel imaging techniques.
A Year at the Forefront of Proteostasis and Aging
Authors: Thompson Maximilian A. , De-Souza Evandro A.
Published: February 2023

During aging, animals experience a decline in proteostasis activity, including loss of stress-response activation, culminating in the accumulation of misfolded proteins and toxic aggregates, which are causal in the onset of some chronic diseases. Finding genetic and pharmaceutical treatments that can increase organismal proteostasis and lengthen life is an ongoing goal of current research. The regulation of stress responses by cell non-autonomous mechanisms appears to be a potent way to impact organismal healthspan. In this Review, we cover recent findings in the intersection of proteostasis and aging, with a special focus on articles and preprints published between November 2021 and October 2022. A significant number of papers published during this time increased our understanding of how cells communicate with each other during proteotoxic stress. Finally, we also draw attention to emerging datasets that can be explored to generate new hypotheses that explain age-related proteostasis collapse.
Sustainability of mangrove forest management in the former bauxite mining area on Bintan Island
Authors: Azizah Diana , Hamidy Rasoel , Mubarak . , Efriyeldi . , Said Raza’i Tengku , Muzammil Wahyu , Pardi Hilfi
Published: February 2023

Background : The bauxite mining area on Bintan Island continues to expand into the mangrove forest area. Mangrove forests have ecological, economic, and social importance, which must be managed accordingly to maintain their sustainability. This research was conducted to examine the sustainability of mangrove forest management in the former bauxite mining area on Bintan Island.                                                         Methods: The approach used is Multi Dimensional Scaling- Rapid Appraisal for Sustainability through the modified Rapfish ordinance software technique for the Mangrove Ecosystem. The type of data used is quantitative, covering five dimensions of sustainability, namely ecological, economic, social, legal and institutional as well as technology.                                                                                                        Results: The results showed that the sustainability index status of the ecological, social, legal and institutional dimensions was quite sustainable, while the sustainability index of the economic dimension was unsustainable, and the technological dimension was less sustainable. Attributes of levers that are sensitive to the sustainability of mangrove forest management are: 1) Mangrove density, 2) Substrate fraction, 3) sedimentation, 4) Mangrove importance index, 5) Bio-concentration factor, 6) Benefit value direct, 7) Indirect benefit value, 8) Dependence on mangrove forest as a source of livelihood, 9) Corporate Social Responsibility funding support, 10) Community income, 11) Community health level, 12) Community perception, 13) Legality of mangrove area and mining, 14) Pollution monitoring technology in ex-mining areas and 15) Mangrove rehabilitation technology.                                                                                          Conclusions:The status of the mangrove forest sustainability index on Bintan Island is quite good. the economic and technological dimensions can be upgraded to sustainable status by carrying out management that is more focused on the lever attributes of the ecological, social, legal and institutional dimensions.
Application of computer vision techniques for 3D matching and retrieval of archaeological objects
Authors: Jiménez-Badillo Diego , Mendoza-Montoya Omar , Ruiz-Correa Salvador
Published: February 2023

Background: As cultural institutions embark in projects oriented to digitise art and archaeological collections in three dimensions, the need for developing means to access the resulting 3D models has become imperative. Shape recognition techniques developed in the field of computer vision can help in this task.

Methods: This paper describes the implementation of three shape descriptors, specifically shape distributions, reflective symmetry and spherical harmonics as part of the development of a search engine that retrieves 3D models from an archaeological database without the need of using keywords as query criteria.

Use case: The usefulness of this system is obvious in the context of cultural heritage museums, where it is essential to provide automatic access to archaeological and art collections. The prototype described in this paper uses, as study case, 3D models of archaeological objects belonging to Museo del Templo Mayor, a Mexican institution that preserves one of the largest collections of Aztec cultural heritage.

Conclusions:  This work is part of an ongoing project focused on creating generic methodologies and user-friendly computational tools for shape analysis for the benefit of scholars and students interested in describing, interpreting and disseminating new knowledge about the morphology of cultural objects.