bluuebunny/crossref_metadata_2025 huggingface dataset:
The Predictive Accuracy of Barrett Toric Calculator Using Measured Posterior Corneal Astigmatism Derived from Swept Source-OCT and Scheimpflug Camera
Authors: Yang Xiaotong , Jiang Yuanfeng , Lin Song , Bai Xiaomei , Yin Yufan , Zhao Fangyu , Yang Jun , Chen Xiteng , Tian Fang , Liang Jingli , Bu Shaochong
Published: March 2023

PURPOSE:
To compare the performance of Barrett toric calculator incorporated with measured posterior corneal astigmatism (PCA) derived from IOL Master 700 and Pentacam HR versus predicted PCA.
METHODS:
The predicted residual astigmatism using Barrette toric IOL calculator with predicted PCA, measured PCA from IOL Master 700 and measured PCA from Pentacam were calculated with the preoperative keratometry and intended IOL axis with modification. The vector analysis was performed to calculate the mean absolute prediction error (MAE), the centroid of the prediction error and the percentage of eyes with a prediction error within ±0.50 D, ± 0.75 D, and ± 1.00 D.
RESULTS: In 57 eyes of 57 patients with mean age of 70.42±10.75 years, the MAE among the three calculation methods were 0.59±0.38 D (Predicted PCA) , 0.60±0.38 D (Measured PCA from IOL Master 700) and 0.60±0.36 D (Measured PCA from Pentacam) with no significant difference, either in the whole sample, the WTR eyes and the ATR eyes (F = 0.078, 0.306 and 0.083, p=0.925, 0.739 and 0.920, respectively). Measured PCA obtained from IOL Master 700 resulted in one level reduction (from Tn to Tn-1) in 49.12% eyes in cylindrical model selection, while measured PCA obtained from Pentacam resulted in one level reduction of toric model selection in 18.18% eyes.
CONCLUSION:
The present study suggested that the incorporation of measured PCA values derived from IOL Master 700 and Pentacam produce comparable clinical outcome with the predicted PCA mode in Barrette toric calculator.
Coherent manipulation of extreme-ultraviolet Bessel vortex beam from solids by active wavefront shaping of driving fundamental beam
Authors: Kim Byunggi , Choi Seungman , Won Seung Jai , Kim Yong Woo , Kim Young-Jin , Kim Seung-Woo
Published: March 2023

High-harmonic generation (HHG) of extreme ultraviolet (EUV) radiation enables ultrafast spectroscopy and nanoscale coherent imaging with timing resolutions down to the attosecond regime. However, beam manipulations such as steering and focusing remain a major challenge for handy implementation of such applications towards the achievement of a wavelength-scale spatial resolution. Here, we present a solid-based non-collinear HHG scheme mediating the propagation control and helical wavefront generation commanded via a spatial light modulator. The phase-matching-insensitive nature of the solid-HHG leads to the coherent multi-fold conversion of wavefronts enabling active control of the EUV harmonic beam propagation. Further, EUV harmonics generated by double-annular beams were converted to the Bessel vortex beam, for the first time, narrowing the beam diameter to 3.4 wavelengths with a long millimetre-level depth-of-focus without extra EUV-dedicated optical components. Our results will suggest a solid-HHG as a powerful tool for high photon-energy applications with a nanoscale spatial resolution.
Measuring children’s engagement in early childhood education and care settings: a scoping literature review
Authors: Ritosa Andrea , Åström Frida , Björck Eva , Borglund Lisa , Karlsson Elin , Nylander Elisabeth , McHugh Elaine
Published: March 2023

The purpose of this scoping review was to identify studies where young children’s engagement in early childhood education and care (ECEC) settings was measured and to investigate conceptualizations and operationalizations of child engagement. The literature search conducted in March 2021 included ERIC, PsychInfo, Scopus and Web of Science databases and it resulted in 5965 articles, of which 286 were included in this review. Eligibility criteria were measurements of child engagement in any formal ECEC setting before starting first grade. Data was extracted about engagement conceptualization, theoretical frameworks, study population, study design, and engagement measurement tools and methods. The results showed variations both in the definitions and in the measurement of child engagement. The most common method of measuring children’s engagement in ECEC was observations by an external observer, followed by teacher surveys. Measures of general child engagement in ECEC have a focus on behavioral aspects of engagement while measures that focus on academic activities are more likely to include additional cognitive and emotional aspects of engagement. Child self-reports were rarely used and only present in measures of academic engagement of young children. About one-third of the identified studies relied on unestablished measures of child engagement. Seventy-seven unique established measures of child engagement were identified.
Imaging quality of an artificial intelligence denoising algorithm: validation in 68Ga PSMA-11 PET for patients with biochemical recurrence of prostate cancer
Authors: Margail Charles , Merlin Charles , Billoux Tommy , Wallaert Maxence , Otman Hosameldin , Sas Nicolas , Molnar Ioana , Guillemin Florent , Boyer Louis , Guy Laurent , Tempier Marion , Levesque Sophie , Revy Alban , Cachin Florent , Chanchou Marion
Published: March 2023

Background
68Ga-PSMA PET is the leading prostate cancer imaging technique, but the image quality remains noisy and could be further improved using an Artificial Intelligence-based denoising algorithm. To address this issue, we analyzed the overall quality of reprocessed images compared to standard reconstructions. We also analyzed the diagnostic performances of the different sequences and the impact of the algorithm on lesion intensity and background measures.
Material and Methods
We retrospectively included 30 patients with biochemical recurrence of prostate cancer who had undergone 68Ga-PSMA-11 PET-CT. We simulated images produced using only a quarter, half, three-quarters, or all of the acquired data material reprocessed using the SubtlePET® denoising algorithm. Three physicians with different levels of experience blindly analyzed every sequence and then used a 5-level Likert scale to assess the series. The binary criterion of lesion detectability was compared between series. We also compared lesion SUV, background noise, and diagnostic performances of the series (sensitivity, specificity, accuracy).
Results
VPFX-derived series were classified differently but better than standard reconstructions (p < 0.001) using half the data. Q.Clear series were not classified differently using half the signal. Some series were noisy but had no significant effect on lesion detectability (p > 0.05). The SubtlePET® algorithm significantly decreased lesion SUV values (p < 0.005) and increased liver background (p < 0.005) and had no substantial effect on the diagnostic performance of each reader.
Conclusion
We show that the SubtlePET® can be used for 68Ga-PSMA scans using half the signal with similar image quality to Q.Clear series and superior quality to VPFX series. However, it significantly modifies quantitative measurements and should not be used for comparative examinations in case of anteriorities reconstructed with standard algorithm.
TMBpred: A bioinformatics tool for precise prediction of the Tumor Mutation Burden in 14 cancer types
Authors: Marino-Buslje Cristina , Martínez-Pérez Elizabeth , Torres Agustina , Iserte Javier , Molina-Vila Miguel
Published: March 2023

Immune checkpoint blockade (ICB) is becoming standard-of-care in many types of human malignancies, but patient selection is still imperfect. Tumor mutation burden (TMB) is being evaluated as a biomarker for ICB in clinical trials, but most of the current panels for next generation sequencing (NGS) of tumor samples are focused on drivers and actionable genes and give inaccurate predictions of TMB. TMBpred provides an easy to use web server for the selection of NGSs panels and models that can offer reliable and clinically relevant estimates of TMBs for 14 human malignancies. It also gives a TMB prediction based on preexisting sequencing data, which can be of help to improve the selection of patients that will benefit from the ICB therapy. The best panels provided by our server have between 0.23 and 1.49 Mb, in range with the panels currently used in clinical labs.
Trajectory Control Using Fuzzy Logic Applied to a Parallel Robot
Authors: de Sena Alexander Patrick Chaves , Junior Acarcio Gomes de Almeida
Published: March 2023

This work presents the development of Mamdani-type fuzzy controllers for tracking linear trajectories in the workspace of a delta-type linear parallel robot. The system comprises three positioner actuators driven by direct current motors with incremental encoders for displacement reading. A multifunctional data module made the interface between the computer and the machine, capturing the signals coming from the encoders and supplying the control signals to the power circuits that drive the motors. Labview® software was used to implement the controller, using the fuzzy logic toolkit, and Matlab® to analyze and present the experimental results. There are three phases of control: velocity control, position control with trajectory tracking, and trajectory generation. In the analysis of the system's response curves and the obtained data, it was verified a very satisfactory performance of the controllers acting with 100 mm/s. The maximum steady-state error was -1.50mm for X-axis motion, -1.76mm for Y-axis motion, and 1.02mm for Z-axis motion, resulting in a trajectory tracking error of 1.26%.
Intersection of Policy and Immunization Information Systems (IIS)
Authors: Heersema Lara A. , Cunniff Luke , Eiden Amanda , Sharma Isha , Mishra Jaya , Bhatti Alexandra
Published: March 2023

Background:
Immunization information systems (IIS) are confidential, population-based computerized databases that record vaccination doses administered to persons residing within a given geopolitical area. They play a pivotal role in achieving equitable and high vaccine uptake. In the United States (US), they are implemented and managed at the state and local level, creating variability in IIS policies.
Methods:
We conducted a legal assessment of relevant IIS statutes and administrative codes across all 50 states, the District of Columbia, Philadelphia, and New York City. Where relevant, laws were cross-checked or supplemented with state and local health department resources. Comparisons to previous legal studies were used to evaluate trends in IIS laws over time.
Results:
The compilation of these laws provides an updated overview of the diverse inter- and intra-state policies within the US that govern the capabilities and implementation of IIS. The findings of this study show that while progress has been made in improving the policies to enable and enhance IIS, gaps in IIS data collection, limited interoperability with local and national health information systems, and inconsistent access to IIS to view or utilize records, limits the full potential of IIS.
Conclusions:
Findings from this study help shine a light on the evolution of IIS policy over the last two decades, serve as a comprehensive benchmark for future analyses, and may help policy stakeholders who are exploring amending jurisdictional IIS laws.
Circadian disturbances and frailty risk in older adults: a prospective cohort study
Authors: Cai Ruixue , Gao Lei , Gao Chenlu , Yu Lei , Zheng Xi , Bennett David , Buchman Aron , Hu Kun , Li Peng
Published: March 2023

Frailty is characterized by diminished resilience to stressor events. It associates with adverse future health outcomes and impedes healthy aging. The circadian system orchestrates a ~24-h rhythm in bodily functions in synchrony with the day-night cycle, and disturbed circadian regulation plays an important role in many age-related health consequences. We investigated prospective associations of circadian disturbances with incident frailty in over 1,000 older adults who had been followed annually for up to 16 years. We found that decreased rhythm strength, reduced stability, or increased variation, were associated with a higher risk of incident frailty, and faster worsening of the overall frailty symptoms over time. Perturbed circadian rest-activity rhythms may be an early sign or risk factor for frailty in older adults.
Epidemiology of premenopausal osteoporosis in Japan: a retrospective cohort study based on real-world data
Authors: Kasahara Kyoko , Tanaka-Mizuno Sachiko , Tsuji Shunichiro , Ohashi Mizuki , Kasahara Makiko , Kawasaki Taku , Murakami Takashi
Published: March 2023

We aimed to characterize the clinical features of premenopausal osteoporosis in Japan and evaluate medical interventions after fracture diagnosis. From a nationwide Japanese administrative claims database, we extracted 105,931 records of women regarding date of childbirth and divided them into two groups based on presence of a fragility fracture diagnostic code. From the records, we identified 231 women who had suffered a low-trauma fracture at reproductive age as the case group, and we randomly selected 1000 women as the control group. Age at childbirth was significantly higher (P = 0.00146) and estrogen-deficient conditions were significantly more frequent in the case than in the control group (odds ratio = 2.97, 95% confidence interval: 1.57–5.63). The most common fracture site was the vertebrae (35.2%), and fractures were also frequent in the 18 months around childbirth (32.9%). More than half of these fracture types overlapped, with significantly more opportunities for bone densitometry, an osteoporosis diagnosis, and antiosteoporosis pharmacotherapyfor these than for other fracture types, which were seldom treated as osteoporosis. Therefore, vertebral fractures and fracturesaround childbirth are a representative subtype of premenopausal osteoporosis. More medical attention isrecommended for all cases of premenopausal osteoporosis to reduce future fracture risk.
Adrenal insufficiency management in the pediatric emergency setting and risk factors for adrenal crisis development
Authors: Abrigo Enrica , Munarin Jessica , Bondone Claudia , Tuli Gerdi , Castagno Emanuele , de Sanctis Luisa , Matarazzo Patrizia
Published: March 2023

Background: In patients with adrenal insufficiency (AI), adrenal crisis (AC) represents a clinical emergency. Early recognition and prompt management of AC or AC-risk conditions in the Emergency Department (ED) can reduce critical episodes and AC-related outcomes. The aim of the study is to report the clinical and biochemical characteristics of AC presentation to improve their timely recognition and proper management in a ED setting.
Methods: Single-centre, retrospective, observational study on pediatric patients followed at the Department of Pediatric Endocrinology of Regina Margherita Children's Hospital of Turin for primary AI (PAI) and central AI (CAI).
Results: Among the 89 children followed for AI (44 PAI, 45 CAI), 35 patients (21 PAI, 14 CAI) referred to the PED, for a total of 77 accesses (44 in patients with PAI and 33 with CAI). The main causes of admission to the PED were gastroenteritis (59.7%), fever, hyporexia or asthenia (45.5%), neurological signs and respiratory disorders (33.8%). The mean sodium value at PED admission was 137.2 ± 1.23 mmol/l and 133.3 ± 1.46 mmol/l in PAI and CAI, respectively (p= 0.05). Steroids administration in PED was faster in patients with CAI than in those with PAI (2.75 ± 0.61 and 3.09 ± 1.47 hours from PED access, p=0.83).
Significant factors related to the development of AC were triage code (yellow and red codes, p=0.09), signs of dehydration at admission (p=0.027) and lack of intake or increase of usual steroid therapy at home (p= 0.059).
Endocrinological consulting was requested in 69.2% of patients with AC and 48.4% of subjects without AC (p= 0.032).
Conclusion: children with AI may refer to the PED with an acute life-threatening condition that needs prompt recognition and management. These preliminary data indicate how critical the education of children and families with AI is to improve the management at home, and how fundamental the collaboration of the pediatric endocrinologist with all PED personnel is in raising awareness of early symptoms and signs of AC to anticipate the proper treatment and prevent or reduce the correlated serious events.
Sponge-derived matter is assimilated by coral holobionts
Authors: Reigel Alicia , Easson Cole , Apprill Amy , Freeman Christopher , Bartley Michaela , Fiore Cara
Published: March 2023

Coral reef biodiversity is maintained by a complex network of nutrient recycling among organisms. Sponges contribute by assimilating nutrients produced by other organisms like coral and algae, and releasing them as particulate and dissolved matter, but to date, only a single trophic link (to a macroalgae) fueled by sponge-derived matter has been identified. We sought to determine if sponge-coral nutrient exchange is reciprocal using a stable isotope ‘pulse-chase’ experiment to trace the uptake of sponge-derived matter by the coral holobiont. Caribbean sponges were incubated with inorganic 13C and 15N tracer compounds, then placed into aquaria containing fragments from three coral species (Acropora cervicornis, Orbicella faveolata, and Eunicea flexuosa). Coral holobionts incorporated 2.3-26.8x more 15N than 13C from sponge-derived matter, and A. cervicornis and its symbiotic micro-algae (Symbiodiniaceae) incorporated more of both elements than the other corals. E. flexuosa host and Symbiodiniaceae fractions incorporated comparable 13C and 15N, suggesting an equal propensity to assimilate sponge-derived matter. Variable isotopic incorporation among coral species aligns with their ecophysiological characteristics. Our results confirm the reciprocal nature of the sponge-coral nutrient exchange and elucidate a novel trophic pathway that has implications for improving coral aquaculture and management approaches.
Profile of Eye-Related Emergency Department Visits in Ontario – A Canadian Perspective
Authors: Nanji Keean , Gulamhusein Husayn , Jindani Yasmin , Hamilton David , Sabri Kourosh
Published: March 2023

Background: Understanding the epidemiology of ophthalmic presentations to emergency departments can help guide resource allocation, medical education programs, and optimize the patient experience. The purpose of this investigation was to summarize and assess the urgency of ophthalmic presentations in emergency departments (EDs) in Ontario, Canada over a 5-year period.
Methods: This was a multicentered retrospective review of all patient presentations to EDs in Ontario between January 1st, 2012, to December 31st, 2017. Presentations were included if patients had an ophthalmic related ICD-10 code as their primary problem prompting ED presentation. Patients under the age of 18 were excluded from this investigation.
Results: A total of 774,057 patients patient presentations were included across the pediatric (149,679 patients) and adult (624,378 patients) cohorts. The mean (SD) age at presentation was 47.4 (17.9) years, and 6.54 (5.20) in the adult and pediatric cohorts respectively. Of the total presentations, 256,776 (33.1%) were due to a trauma related presentation. Problems pertaining to Cornea and External disease were the most common reason for presentation (51.0% of cases). Of all presentations, 34.1% were classified as either ‘emergent’ or ‘likely emergent’; the remaining presentations were either ‘non-emergent’ (39.5%) or the urgency ‘could not be determined’ (26.4%). The three most frequent presentations were due to conjunctivitis (121,175 cases or 15.7%), ocular foreign bodies (104,322 cases or 13.5%), and corneal / conjunctival abrasions (94,554 cases of 12.2%).
Conclusions: This investigation summarizes all ophthalmic presentations to EDs in Ontario, Canada over a 5-year period. The results of this investigation can help guide ophthalmic related knowledge translation. Additionally, these results highlight that in Canadian EDs, a significant proportion of ophthalmic presentations are nonurgent; systems level efforts to improve access for eye-related complaints to healthcare professionals outside of the ED can help facilitate improved resource allocation. As we emerge from the COVID-19 pandemic, optimising the structure of patient care access is crucial to help alleviate the pressure from overburdened EDs while effectively meeting patient healthcare needs.
Extremely Large Lamb Shift in a Deep-strongly Coupled Circuit QED System with a Multimode Resonator
Authors: Ao Ziqiao , Ashhab Sahel , Yoshihara Fumiki , Fuse Tomoko , Kakuyanagi Kosuke , Saito Shiro , Aoki Takao , Semba Kouichi
Published: March 2023

We report experimental and theoretical results on the extremely large Lamb shift in a multimode circuit quantum electrodynamics (QED) system in the deep-strong coupling (DSC) regime, where the qubit-resonator coupling strength is comparable to or larger than the qubit and resonator frequencies . The system comprises a superconducting flux qubit (FQ) and a quarter-wavelength coplanar waveguide resonator (λ/4 CPWR) that are coupled inductively through a shared edge that contains a Josephson junction to achieve the DSC regime. Spectroscopy is performed around the frequency of the fundamental mode of the CPWR, and the spectrum is fitted by the single-mode quantum Rabi Hamiltonian to obtain the system parameters. Since the qubitis also coupled to a large number of higher modes in the resonator, the single-mode fitting does not provide the bare qubit energy but a value that incorporates the renormalization from all the other modes. We derive theoretical formulas for the Lambshift in the multimode resonator system. As shown in previous studies, there is a cut-off frequency ω_{cutoff} for the coupling between the FQ and the modes in the CPWR, where the coupling grows as √ωn for ω_n/ωcutoff ≪ 1 and decreases as 1/√ωn for ωn/ωcutoff ≫ 1. Here ωn is the frequency of the nth mode. The cut-off effect occurs because the qubit acts as an obstacle forthe current in the resonator, which suppresses the current of the modes above ωcutoff at the location of the qubit and results ina reduced coupling strength. Using our observed spectrum and theoretical formulas, we estimate that the Lamb shift from the fundamental mode is 82.3% and the total Lamb shift from all the modes is 96.5%. This result illustrates that the coupling to thelarge number of modes in a CPWR yields an extremely large Lamb shift but does not suppress the qubit energy to zero, which would happen in the absence of a high-frequency cut-off.
Microsatellite maker analysis reveals the low genetic diversity in an endangered fish, Osteobrama belangeri in the Indo-Myanmar region
Authors: Rakkannan Gowrimanohari , Kashyap Shubham , Debnath Bijaya , Sahoo Dibyajyoti , Singh Yambem Suresh , Patel Arun Bhai , Priyadarshi Himanshu
Published: March 2023

Background
Pengba (Osteobrama belangeri) is a medium carp endemic to Manipur with favorable characteristics for poly-culture and a great demand for its texture. Moreover, pengba is listed as a Near-threatened species according to the IUCN and the study on genetic characterization of this species is scanty. The lack of studies on the population structure of this species is significant from the conservation point of view, thus the present study aimed to validate selected anonymous and gene-associated (growth and sex-traits related) microsatellites obtained by whole genome sequencing using Illumina next-generation sequencing.
Results
In general, the evaluation of 106 markers resulted in 13 polymorphic loci, of which 7 were gene-associated and 6 were anonymous using Whole Genome Sequenced data of O. belangeri. The mean observed heterozygosity of culture and wild populations ranged from 0.050 to 0.850 and expected heterozygosity ranged from 0.095 to 0.728, respectively. The grand average of the number of alleles (Na) and the number of effective alleles (Ne) are 2.192 and 1.602.
Conclusion
This study infers a significant lack of genetic diversity due to low heterozygosity in the culture and wild populations of Osteobrama belangeriwhere irresponsible ranching could be a reason. Additionally, the developed polymorphic microsatellites in the current study are the first molecular markers available for genetic studies in O. belangeri, which could be used for the construction of a genetic map and search for Quantitative Trait Loci (QTL) which ultimately helps in Molecular Assisted Selection (MAS) in the future studies.
Comparison of intracorporeal and extracorporeal anastomosis for left or sigmoid colectomy: updated meta-analysis of retrospective control trials
Authors: Yao Qing , Fu Ya-Yan , Sun Qian-Nan , Ren Jun , Wang Liu-Hua , Wang Daorong
Published: March 2023

Background: The feasibility and effectiveness of slecting intracorporeal anastomosis (IA) or extracorporeal anastomosis (EA) in left or sigmoid colectomy remained poorly comprehensive. This meta-analysis aimed to evaluate the difference between IA and EA in term of introperative and postoperative outcomes.
Methods: A comprehensive search of online databases (PubMed, Embase, Cochrane, and Web of Science) was conducted for for randomized controlled trials, cohort studies, and case control studies comparing the IA vusus EA in left or sigmoid colectomy. The outcomes of assessment contained four aspects like intraoperative outcomes, postoperative complications, postoperative patient condition, and postoperative outcomes. All of these data were analyzed using Rev Man 5.4
Results: eight retrospective control trials (IA, 453 patients; EA, 483 patients) were evaluated. Compared to group of EA, the IA group demonstrated priority in conversion (P<0.01), wound infection (P=0.01), overall complications (P<0.01), time to first flatus (P<0.01), time to first stool (P<0.01), time to first diet (P<0.01) and hospital stay duration (P<0.01).
Conclusions: Intracorporeal anastomosis is superior to the extracorporeal anastomosis in reducing postoperative complications, promoting postoperative recovery of gastrointestinal function and reducing hospital stay duration.
Development of a Multi-Level Family Planning Intervention for Couples in Rural Uganda: Key Findings & Adaptations Made from Community Engaged Research Methods
Authors: Muhumuza C. M. , Sileo K. S. M. , Wanyenze R. W. , Kershaw T. K. S , Lule H. L. , Sekamatte S. S. , Kiene S. K.
Published: March 2023

Background: Uganda has among the highest fertility rates in the world and multi-level barriers contribute to the low contraceptive use.
Objective The objective of this study was to develop a culturally and socially relevant, community-based intervention to increase contraceptive use among couples in rural Uganda through community-engaged research methods. This study reports on the community-engaged research that informed the intervention’s content and structure and the final content of the intervention; the evaluation of the pilot intervention will be reported upon completion.
Methods: An intervention steering committee of community stakeholders reviewed the initially proposed intervention content and approach. Focus groups were conducted with men and women separately (N=26) who had unmet need for family planning. Fifteen key-informant interviews were conducted with community leaders and family planning stakeholders. Finally, the 4-session intervention was pilot tested with a cohort of couples (N=7) similar in demographics to the target sample of the future pilot intervention trial. Qualitative data were analyzed thematically.
Results: Findings included the identification of community beliefs to reshape to increase family planning acceptance, as well as strategies to engage men, acceptable approaches for community leader involvement in the intervention to endorse family planning, and methods for managing gender dynamics and minimizing risk of unintended negative consequences of participation. The findings were used to shape the ideal structure and format of the intervention, including the distribution of contraceptives directly during group sessions, and identified the need to strengthen health worker capacity to provide Long-Acting Reversable Contraceptives (LARCs) as part of the intervention.
Conclusions: These findings were used to refine an intervention before a larger scale pilot test of its feasibility, acceptability, and potential efficacy. They can inform other multi-level family planning interventions in similar settings and the methods can be adopted by others to increase the feasibility, acceptability, and cultural relevance of interventions.
Agomelatine augmentation of sertraline in the treatment of moderate to severe obsessive-compulsive disorder: a randomized double-blinded placebo-controlled clinical trial
Authors: Shokrani Marjan , Askari Sanaz , Eissazade Negin , Shariat Seyed Vahid , Shariati Behnam , Yarahmadi Masoomeh , Shalbafan Mohammadreza
Published: March 2023

Background: As 40-60% of the patients with obsessive-compulsive disorder (OCD) do not adequately respond to the first-line treatment, finding an effective second-line treatment is required. Our aim was to assess the efficacy and safety of agomelatine (a selective melatonin receptor agonist and a 5-hydroxytryptamine (HT)2C antagonist) augmentation of sertraline in the treatment of patients with moderate to severe OCD.
Methods: In this 12-week randomized, double-blinded, placebo-controlled, parallel-group clinical trial, 65 patients with moderate to severe OCD according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM–5) criteria and a Yale-Brown obsessive compulsive scale (Y-BOCS) score of over 21, were included. They were assigned with sertraline (100 mg/day for the first 4 weeks and 200 mg/day for the next 8 weeks) and either agomelatine (25 mg/day) or placebo. The primary outcome was OCD symptoms measured by the Y-BOCS.
Results: Fifty patients (24 in agomelatine group and 26 in placebo group) completed the trial. The Y-BOCS scores in total (MD (95% CI) = 12.25 (11.00, 13.49) (p-value < 0.0001) vs. MD (95% CI) = 12.46 (6.65, 15.74) (p-value < 0.0001)), the obsession subscale (MD (95% CI) = 5.04 (4.19, 5.88) (p-value < 0.0001) vs. MD (95% CI) = 5.00 (3.84, 6.16) (p-value=0.0001)), and compulsion subscale (MD (95% CI) = 7.21 (6.34, 8.07) (p-value < 0.0001) vs. MD (95% CI) = 7.460 (6.50, 8.42) (p-value < 0.0001)) significantly decreased in both groups. Although, at the end of the trial, no significant difference was observed between the scores of the two groups in total (MD (95% CI) = 0.480 (-1.23, 2.19) (p-value= 0.78)), the obsession subscale (MD (95% CI) = 1.020 (-0.15, 2.19) (p-value=0.38)), and the compulsion subscale (MD (95% CI) = 0.540 (-0.34, 1.42) (p-value=0.54)). No major adverse effects were recorded, and the frequency of side effects was not significantly different between the groups.
Conclusion:Agomelatine in augmentation with sertraline is safe and tolerable in patients with moderate to severe OCD. However, our study does not support its efficacy in improving OCD symptoms, compared to placebo.
Trial registration: The trial was registered at the Iranian Registry of Clinical Trials on 14/07/2020 (www.irct.ir; IRCT ID: IRCT20170123032145N5).
Funding: The authors disclose receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by Iran University of Medical Sciences (Grant no: 98-4-75-16914).
Neutrophil-to-lymphocyte ratio is an independent predictor for neurological disability in patients with idiopathic transverse myelitis
Authors: Min Je Hong , Sohn Sung-Yeon , Lee Seung Yeon , Seo Sang Hyun , Kim Shin Yeop , Park Bumhee , Kim Seung Il , Joo In Soo
Published: March 2023

Introduction:The neutrophil-to-lymphocyte ratio (NLR) has been found to be useful in the prognostication of immune-mediated neurological disorders because it roughly reflects the systemic innate immune response compared to the adaptive immune response. However, studies on the validity of NLR in demyelinating disorders of the central nervous system have shown conflicting results. Therefore, we aimed to investigate NLR in the idiopathic transverse myelitis (ITM) cohort.
Methods:We retrospectively analyzed the cohort data of patients with ITM between January 2006 and February 2020. The medical data of all patients with myelitis were reviewed to exclude patients with disease-associated myelopathyaccording to predefined exclusion criteria. The relationship between the natural log-transformed NLR (lnNLR) and the clinical, paraclinical, and imaging data was evaluated. Factors associated with neurological disability were analyzed using a linear mixed-effects model. Predictive factors for moderate-to-severe neurological disability (Expanded Disability Status Scale [EDSS] score ≥ 4) were investigated.
Results:A total of 124 participants were included in the analysis. The lnNLR correlated with EDSS and lesion length. Linear mixed-effects analysis showed that age, lesion length, and lnNLR were independently associated with neurological disabilities. Multivariable logistic regression revealed that lnNLR (odds ratio [OR] = 4.266, 95% confidence interval [CI] = 1.220–14.912, p = 0.023) and lesion length (OR = 1.848, 95% CI = 1.249–2.734, p = 0.002) were independent predictive factors of the worst neurological disability.
Conclusion: NLR may be used as an independent prognostic factor for predicting poor neurological outcomes in patients with ITM.
Assessing the Impact of Social, Demographic, and Economic Factors on the Economic Empowerment of Rural Women in Agricultural Activitie : A Partial Proportional Odds Model Analysis in Dire Dawa Administration, Ethiopia
Authors: Hordofa Dereje Fedasa , Badore Melekamu Ayele
Published: March 2023

The study examined the impact of social, demographic, and economic factors on the economic empowerment of rural women in agricultural activities in Ethiopia's Dire Dawa region, using a mixed-methods research approach. The research team collected data from a sample of 419 women engaged in agricultural activities and used the proportional odds model (POM) and the partial proportional odds model (PPOM) to identify the factors associated with economic empowerment. The study found that age, property ownership, and education and training had a negative effect, while social networks and media had a positive effect on economic empowerment. The results also showed that women aged 40 and above had a lower likelihood of being economically empowered, and lack of property ownership and limited contact with extension agents hurt economic empowerment. The study recommended improving women's access to credit, land ownership, and training opportunities to promote gender equity and women's economic empowerment in the agricultural sector in Ethiopia. This study contributes to the literature by using a mixed-methods approach that integrated qualitative data with quantitative data, which has not been used before in Ethiopia. The findings provide important implications for policymakers and development practitioners in promoting gender equity and women's economic empowerment in the agricultural sector. The study highlights the need to address the challenges that women face in achieving economic empowerment, including limited access to credit, training, and land ownership. By improving access to these resources, policymakers and development practitioners can create an enabling environment that fosters women's economic empowerment and promotes gender equity in Ethiopia's agricultural sector.
The impact on clinical outcomes after one year of implementation of an artificial intelligence solution for the detection of intracranial hemorrhage
Authors: Kotovich Dmitry , Twig Gilad , Itsekson-Hayosh Zeev , Klug Maximiliano , Ben-Simon Asaf , Yaniv Gal , Konen Eli , Tau Noam , Raskin Daniel , Chang Paul J , Orion David
Published: March 2023

Objectives: To assess the effect of a commercial Artificial Intelligence (AI) solution implementation in the emergency department on clinical outcomes in a single Level 1 Trauma Center.
Methods: A retrospective cohort study for two time periods – Pre-AI (1.1.2017-1.1.2018) and Post-AI (1.1.2019-1.1.2020), in a Level 1 Trauma Center was performed.
Participants older than 18 years with a confirmed diagnosis of ICH on head CT upon admission to the emergency department were collected. Study variables included demographics, patient outcomes, and imaging data. Participants admitted to the emergency department during the same time periods for other acute diagnoses (ischemic stroke –IS; and myocardial infarction - MI) served as control groups. Primary outcomes were 30- and 120-day all-cause mortality. Secondary outcome was morbidity based on Modified Rankin Scale for Neurologic Disability (mRS) at discharge.
Results: 587 participants (289 Pre-AI – age 71 ± 1, 169 men; 298 Post-AI – age 69 ± 1, 187 men) with ICH were eligible for the analyzed period. Demographics, comorbidities, Emergency Severity Score, type of ICH and length of stay were not significantly different between the two time periods. The 30- and 120-day all-cause mortality weresignificantly reduced in the Post-AI group when compared to the Pre-AI group (27.7% vs 17.5%; p=0.004 and 31.8% vs 21.7%; p=0.017 respectively).Modified Rankin Scale (mRS) at discharge was significantly reduced Post-AI implementation (3.2 vs 2.8; p=0.044).
Conclusion:Implementation of an AI based computer aided triage and prioritization solution for flagging participants with ICH in an emergent care setting coincided with significant reductions of 30- and 120-day all-cause mortality and morbidity.
To teach is to learn twice, revisited: A qualitative study of how residents learn through teaching in clinical environments
Authors: Kondo Takeshi , Takahashi Noriyuki , Aomatsu Muneyoshi , Nishigori Hiroshi
Published: March 2023

Background
As the saying goes, ‘to teach is to learn twice’; the teaching role contributes to one’s own learning as a professional. Near-peer teaching in clinical practice has been shown to contribute to the development of not only teaching skills but also necessary competencies for doctors. Research on how near-peer teachers learn through their teaching roles has mainly focused on classroom learning. Understanding how the phenomenon of ‘teaching is learning twice’ occurs in clinical settings and its influencing factors is important for the development of a quality workplace learning environment. We, therefore, investigated how residents learn through teaching in clinical practice and the factors influencing this process.
Methods
The study was conducted using a methodology based on grounded theory and from a social constructivist perspective. Several teaching hospitals in Japan were included, and the study participants were post-graduate year 2 residents (PGY2s) from these hospitals. The interviews were recorded, transcribed into text, and analysed by the first author.
Results
From January 2016 to July 2022, we conducted 13 interviews with 11 PGY2s from nine educational hospitals. PGY2s played diverse educational roles in clinical settings and learned competencies in almost all areas as physicians through such roles. Knowledge transfer and serving as role models stimulated their intrinsic motivation, encouraged reflection on their own experiences, and promoted self-regulated learning. Educating on procedural skills and clinical reasoning prompted reflection on their own procedural skills and thought processes, and supporting post-graduate year 1 residents’ reflections led to the refinement of their own knowledge and thought processes through the verbal expression of their learning experiences. Such processes required the formation of a community of practice. Education promoted learning through reflection and made the image of the expert that PGY2s aspired to be clearer.
Conclusions
We found that residents acquire various physician competencies through multiple processes by teaching as near-peer teachers in clinical settings, that a community of practice must be formed for near-peer teaching to occur in a clinical setting, and that teaching brings learning to those who teach by promoting reflection and helping them envision the professionals they seek to be.
The presence of wolves leads to spatial differentiation in deer browsing pressure on forest regeneration
Authors: Wójcicki Adam , Borowski Zbigniew
Published: March 2023

With the recent return of large carnivores to forest ecosystems, the question for forest owners and managers is how large predators influence the behaviour of their natural prey and, consequently, cervid browsing pressure on forest regeneration. To address this question, we analyzed deer pressure on Scots pine and European beech plantations in northern Poland's ecosystems with and without permanent wolf populations. Two characteristics were used to describe deer browsing patterns in plantations: distance from the forest edge (spatial pattern of browsing) and number of saplings browsed (browsing intensity). Beech saplings were more intensively browsed by deer compared to pine saplings. In a forest ecosystem not inhabited by wolves, spatial variation in browsing patterns on small beech plantations was the same between the edge and the center. In contrast, browsing pressure by deer was greater at the edges in large pine plantations. The presence of wolves reduced deer browsing on beech and increased browsing on pine saplings. In addition, deer foraging behaviour changed in large pine plantations, and browsing pressure increased only in the central areas of the plantations. We conclude that the presence of wolves in a forest landscape is an important factor that alters browsing pressure on the youngest stands and their spatial pattern, and that this may be a major factor in forest stand regeneration, especially in small gaps.
Comparing Medical Record Abstraction (MRA) Error Rates in an Observational Study to Pooled Rates Identified in the Data Quality Literature
Authors: Garza Maryam Y. , Williams Tremaine B. , Ounpraseuth Songthip , Hu Zhuopei , Lee Jeannette , Snowden Jessica , Walden Anita C. , Simon Alan E. , Devlin Lori A. , Young Leslie W. , Zozus Meredith N.
Published: March 2023

Background: Medical record abstraction (MRA) is a commonly used method for data collection in clinical research, but is prone to error, and the influence of quality control (QC) measures is seldom and inconsistently assessed during the course of a study. We employed a novel, standardized MRA-QC framework as part of an ongoing observational study in an effort to control MRA error rates. In order to assess the effectiveness of our framework, we compared our error rates against traditional MRA studies that had not reported using formalized MRA-QC methods. Thus, the objective of this study was to compare the MRA error rates derived from the literature with the error rates found in a study using MRA as the sole method of data collection that employed an MRA-QC framework.
Methods: Using a moderator meta-analysis employed with Q-test, the MRA error rates from the meta-analysis of the literature were compared with the error rate from a recent study that implemented formalized MRA training and continuous QC processes.
Results: The MRA process for data acquisition in clinical research was associated with both high and highly variable error rates (70 – 2,784 errors per 10,000 fields). Error rates for the study using our MRA-QC framework were between 1.04% (optimistic, all-field rate) and 2.57% (conservative, populated-field rate) (or 104 – 257 errors per 10,000 fields), 4.00 – 5.53 percentage points less than the observed rate from the literature (p<0.0001).
Conclusions: Review of the literature indicated that the accuracy associated with MRA varied widely across studies. However, our results demonstrate that, with appropriate training and continuous QC, MRA error rates can be significantly controlled during the course of a clinical research study.
Correlation of Calf Circumference in Relation to Other Anthropometric Measurements in Low Birth Weight Babies
Authors: Mandloi Deepshikha , Thomas Justin , Peter Preethy
Published: March 2023

Background
India having 3rd highest incidence of low birth weight (LBW) infants(28%) in the world. In India most of the deliveries are performed at home by untrained Dhais and midwifes. So if we train them to use alternative approach for estimating low birth weight like simple anthropometric indicators such as calf circumference, which can be easily implemented by rural communities.
Methods
We conducted a cross-sectional, prospective study at a tertiary care hospital in Kerala, a southern state in India, during a one-year period in 2021–2022. We included 80 neonates without any congenital malformations who were delivered at the hospital, irrespective of gestational age, and subjected them to anthropometric measurements. We measured calf circumference, chest circumference, mid-arm circumference, thigh circumference, and head circumference using non-stretchable measuring tape. Birth weight was recorded on an electronic weighing machine. Correlation coefficients were calculated using Pearson's correlation coefficient.
Results
From different anthropometric measurements, calf circumference did not show significant correlation with birth weight. The best correlation was observed in mid arm circumference and chest circumference for identifying babies with birth weight group. Birth weight can be roughly calculated from derived formula weight (kg) = 0.06(CC + MAC)-1.76
Conclusions
In the absence of a weighing machine, simple measurements like chest and mid arm circumference can identify babies with low birth weights. Calf circumference was not well correlated with birth weight in our study.
Comparison of nonanatomical reduction of femoral neck fractures in young patients treated with femoral neck system: a retrospective cohort study
Authors: Jiang QiLong , Liu Yang , Cao Yong , Bai Xinwen , Deng Yu , Yu Chengxiang , Song Qizhi , Li Yan
Published: March 2023

Purpose

Negative buttress reduction should be avoided in the treatment of femoral neck fractures (FNFs) using conventional implant devices. As the femoral neck system (FNS) has been recently developed and utilized widely to treat FNFs, the clinical efficacy of reduction quality has not been clarified. The purpose of this study was to evaluate clinical effects of nonanatomical reduction in young FNFs treated with FNS.

Methods

This multicenter, retrospective cohort study included 58 patients diagnosed as FNFs between September 2019 and December 2021. According to radiographs immediate following surgery, reduction quality were classified into positive, anatomical and negative buttress reduction groups. Assessment of postoperative hip function using Harris hip scores (HHS) system and postoperative complication rate was performed. Logistic regression model was used to analyses risk factors.

Results

Postoperative complication rate and Harris hip scores showed no significant difference in groups (P ＞0.05). Adjusted smoking status [OR = 1.991, 95%CI (1.063, 3.698)], Pauwels classification [OR = 2.012, 95%CI (1.216, 4.325)] were independent risk factors for postoperative complications. Compared with anatomical reduction, negative buttress reduction [OR = 2.987, 95%CI (1.101, 6.337)] was found to be significantly associated with complications after surgery in femoral neck fractures treated with FNS.

Conclusion

Negative buttress reduction should be constantly avoided in young FNFs treated with FNS or conventional implant devices.