bluuebunny/crossref_metadata_2025 huggingface dataset:
Global, regional, and national trends of syphilis from 1990 to 2019: the 2019 global burden of disease study
Authors: Tao Yu-Ting , Gao Teng-Yu , Li Hao-Yang , Ma Yu-Tong , Li Hui-Jun , Xian-Yu Chen-Yang , Deng Nian-Jia , Zhang Chao
Published: April 2023

Background

Syphilis is a sexually transmitted disease caused by Treponema pallidum, and the infection source is syphilis patients. This study aimed to estimate the incidence, mortality rate, and disability-adjusted life years (DALYs) of syphilis to improve the understanding of the current global situation of syphilis.

Methods

This study collected data on syphilis incidence, mortality, and DALYs from the 2019 Global Burden of Disease database.

Results

The global number of incident cases and age-standardized incidence rate (ASIR) increased from 8,845,220 (95% UI: 6,562,510–11,588,860) in 1990 to 14,114,110 (95% UI: 10,648,490–18,415,970) in 2019 and 160.03/100,000 persons (95% UI: 120.66–208.1) to 178.48/100,000 persons (95% UI: 134.94–232.34), respectively. The estimated annual percentage change (EAPC) in the ASIR was 0.16 (95% CI: 0.07–0.26). The EAPC in the ASIR associated with high and high-middle sociodemographic indices increased. The ASIR increased among males but decreased among females, and the incidence peaked among males and females between the ages of 20 and 30 years. The EAPCs in the age-standardized death rate and age-standardized DALY rate decreased.

Conclusions

The incidence and ASIR of syphilis increased worldwide from 1990 to 2019. Only the regions with high and high-middle sociodemographic indices showed an increase in the ASIR. Moreover, the ASIR increased among males but decreased among females. The age-standardized death rate and DALY rate both declined worldwide. The increase in the global ASIR of syphilis is a challenge.
Association between universal health coverage and the disease burden of acute illness and injury at the global level
Authors: Hajjar Karim , Lillo Luis , Martinez Diego A , Hermosilla Manuel , Risko Nicholas
Published: April 2023

Background

This study examines the relationship between universal health coverage (UHC) and the burden of emergency diseases at a global level.

Methods

Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables 1) coverage of essential health services and 2) proportion of the population spending more than 10% of household income on out-of-pocket health care expenditure, were extracted from the World Bank Database for years preceding our outcome of interest. A linear regression was used to analyze the association between UHC variables and DALYs for emergency diseases, controlling for other variables.

Results

A total of 132 countries were included. The median national coverage of essential health services index was 67.5/100, while the median national prevalence of catastrophic spending in the sample was 6.74% of households. There was a strong significant relationship between health service coverage and the burden of emergency diseases, with an 11.5-point reduction in DALYs of emergency medical diseases (95% CI -9.5, -14.8) for every point increase in the coverage of essential health services index. There was no statistically significant relationship between catastrophic expenditures and the burden of emergency diseases, which may be indicative of inelastic demand in seeking services for health emergencies.

Conclusion

Increasing the coverage of essential health services, as measured by the essential health services index, is strongly correlated with a reduction in the burden of emergency conditions. In addition, data affirms that financial protection remains inadequate in many parts of the globe, with large numbers of households experiencing significant economic duress related to seeking healthcare. This evidence supports a strategy of strengthening UHC as a means of combating death and disability from health emergencies, as well as extending protection against impoverishment related to healthcare expenses.
Postoperative clinical outcomes for kinematically, restricted kinematically, or mechanically aligned total knee arthroplasty: a systematic review and network meta-analysis of randomized controlled trials
Authors: Miura Takanori , Takahashi Tsuneari , Watanabe Jun , Kataoka Yuki , Ae Ryusuke , Saito Hidetomo , Takeshita Katsushi , Miyakoshi Naohisa
Published: April 2023

Background

Mechanically aligned total knee arthroplasty (MATKA) is a well-established procedure. Kinematically aligned TKA (KATKA) has been proposed to restore and preserve pre-arthritic knee anatomy. However, normal knee anatomy varies widely, and there have been concerns regarding restoring unusual anatomy. Accordingly, restricted KATKA (rKATKA) was introduced to reproduce constitutional knee anatomy within a safe range. This network meta-analysis (NMA) aimed to evaluate the clinical and radiological outcomes of the surgeries.

Methods

We performed a database search on August 20, 2022, which included randomized controlled trials (RCTs) comparing any two of the three surgical TKA techniques for knee osteoarthritis. We conducted a random-effects NMA within the frequentist framework and evaluated confidence in each outcome using the Confidence in Network Meta-Analysis tool.

Results

Ten RCTs with 1,008 knees and a median follow-up period of 1.5 years were included. The three methods might result in little to no difference in range of motion (ROM) between methods. In patient-reported outcome measures (PROMs), the KATKA might result in a slight improvement compared with the MATKA (standardized mean difference, 0.47; 95% confidence interval [CI], 0.16–0.78; very low confidence). There was little to no difference in revision risk between MATKA and KATKA. KATKA and rKATKA showed a slight valgus femoral component (mean difference [MD], -1.35; 95% CI, -1.95–[-0.75]; very low confidence; and MD, -1.72; 95% CI, -2.63–[-0.81]; very low confidence, respectively) and a slight varus tibial component (MD, 2.23; 95% CI, 1.22–3.24; very low confidence; and MD, 1.25; 95% CI, 0.01–2.49; very low confidence, respectively) compared with MATKA. Tibial component inclination and hip–knee–ankle angle might result in little to no difference between the three procedures.

Conclusions

KATKA and rKATKA showed similar ROM and PROMs and a slight variation in the coronal component alignment compared with MATKA. KATKA and rKATKA are acceptable methods in short- to mid-term follow-up periods. However, long-term clinical results in patients with severe varus deformity are still lacking. Surgeons should choose surgical procedures carefully. Further trials are warranted to evaluate the efficacy, safety, and subsequent revision risk.
Non-surgical treatment of peri-implantitis with and without erythritol air-polishing a 12-month randomized controlled trial
Authors: Selimović Armin , Bunæs Dagmar F. , Lie Stein Atle , Lobekk Målfrid Aa. , Leknes Knut N.
Published: April 2023

Background

A variety of interventions have been explored in the non-surgical management of peri-implantitis. In spite of extensive testing of various study protocols, effective treatments largely remain unavailable. The objective of the present 12-month single-centre, examiner-masked, randomized controlled clinical trial was to explore whether a low-abrasive erythritol air-polishing system produces added clinical benefit when used adjunctive to conventional non-surgical management of peri-implantitis and to record any associated patient-centered outcomes.

Methods

Forty-three patients with mild to severe peri-implantitis including at least one implant either received ultrasonic/curette subgingival instrumentation and erythritol air-polishing (test) or ultrasonic/curette instrumentation only (control) at baseline and at 3, 6, 9, and 12 months. Probing depth (PD), bleeding on probing (BoP), dental plaque, suppuration (SUP), crestal bone level (CBL), and peri-implant crevicular fluid (PCF) were recorded at baseline, 6 and 12 months. Visual Analogue Scale (VAS) scores were collected immediately following subgingival interventions at all time-points.

Results

A reduction in PD was observed from baseline to 6 months for the test (p = 0.006) and control (p < 0.001) and from baseline to 12 months for the control (p < 0.001). No intergroup differences were observed for primary outcome variables PD or CBL over time (p > 0.05). At 6 months, a intergroup difference in PCF was observed in favor of the test (p = 0.042). Moreover, a reduction in SUP from baseline to 6 and 12 months was observed in the test (p = 0.019). Overall, patients in the control group experienced less pain/discomfort compared with the test (p < 0.05), females reporting more pain/discomfort than males (p = 0.005).

Conclusions

This study confirms that conventional non-surgical management of peri-implantitis produces limited clinical improvement. It is shown that an erythritol air-polishing system may not produce added clinical benefits when used adjunctive to conventional non-surgical management. In other words, neither approach effectively resolved peri-implantitis. Moreover, the erythritol air-polishing system produced added pain/discomfort particularly in female patients.

Trial registration

The clinical trial was prospectively registered in ClinicalTrials.gov with registration NCT04152668 (05/11/2019).
Do clinical interview transcripts generated by speech recognition software improve clinical reasoning performance in mock patient encounters? A prospective observational study
Authors: Shikino Kiyoshi , Tsukamoto Tomoko , Noda Kazutaka , Ohira Yoshiyuki , Yokokawa Daiki , Hirose Yuta , Sato Eri , Mito Tsutomu , Ota Takahiro , Katsuyama Yota , Uehara Takanori , Ikusaka Masatomi
Published: April 2023

Background

To investigate whether speech recognition software for generating interview transcripts can provide more specific and precise feedback for evaluating medical interviews.

Methods

The effects of the two feedback methods on student performance in medical interviews were compared using a prospective observational trial. Seventy-nine medical students in a clinical clerkship were assigned to receive either speech-recognition feedback (n = 39; SRS feedback group) or voice-recording feedback (n = 40; IC recorder feedback group). All students’ medical interviewing skills during mock patient encounters were assessed twice, first using a mini-clinical evaluation exercise (mini-CEX) and then a checklist. Medical students then made the most appropriate diagnoses based on medical interviews. The diagnostic accuracy, mini-CEX, and checklist scores of the two groups were compared.

Results

According to the study results, the mean diagnostic accuracy rate (SRS feedback group:1st mock 51.3%, 2nd mock 89.7%; IC recorder feedback group, 57.5%–67.5%; F(1, 77) = 4.0; p = 0.049), mini-CEX scores for overall clinical competence (SRS feedback group: 1st mock 5.2 ± 1.1, 2nd mock 7.4 ± 0.9; IC recorder feedback group: 1st mock 5.6 ± 1.4, 2nd mock 6.1 ± 1.2; F(1, 77) = 35.7; p < 0.001), and checklist scores for clinical performance (SRS feedback group: 1st mock 12.2 ± 2.4, 2nd mock 16.1 ± 1.7; IC recorder feedback group: 1st mock 13.1 ± 2.5, 2nd mock 13.8 ± 2.6; F(1, 77) = 26.1; p < 0.001) were higher with speech recognition-based feedback.

Conclusions

Speech-recognition-based feedback leads to higher diagnostic accuracy rates and higher mini-CEX and checklist scores.

Trial registration

This study was registered in the Japan Registry of Clinical Trials on June 14, 2022. Due to our misunderstanding of the trial registration requirements, we registered the trial retrospectively. This study was registered in the Japan Registry of Clinical Trials on 7/7/2022 (Clinical trial registration number: jRCT1030220188).
m5U-SVM: identification of RNA 5-methyluridine modification sites based on multi-view features of physicochemical features and distributed representation
Authors: Ao Chunyan , Ye Xiucai , Sakurai Tetsuya , Zou Quan , Yu Liang
Published: April 2023

Background

RNA 5-methyluridine (m5U) modifications are obtained by methylation at the C5 position of uridine catalyzed by pyrimidine methylation transferase, which is related to the development of human diseases. Accurate identification of m5U modification sites from RNA sequences can contribute to the understanding of their biological functions and the pathogenesis of related diseases. Compared to traditional experimental methods, computational methods developed based on machine learning with ease of use can identify modification sites from RNA sequences in an efficient and time-saving manner. Despite the good performance of these computational methods, there are some drawbacks and limitations.

Results

In this study, we have developed a novel predictor, m5U-SVM, based on multi-view features and machine learning algorithms to construct predictive models for identifying m5U modification sites from RNA sequences. In this method, we used four traditional physicochemical features and distributed representation features. The optimized multi-view features were obtained from the four fused traditional physicochemical features by using the two-step LightGBM and IFS methods, and then the distributed representation features were fused with the optimized physicochemical features to obtain the new multi-view features. The best performing classifier, support vector machine, was identified by screening different machine learning algorithms. Compared with the results, the performance of the proposed model is better than that of the existing state-of-the-art tool.

Conclusions

m5U-SVM provides an effective tool that successfully captures sequence-related attributes of modifications and can accurately predict m5U modification sites from RNA sequences. The identification of m5U modification sites helps to understand and delve into the related biological processes and functions.
The right ventricular dysfunction and ventricular interdependence in patients with DM: assessment using cardiac MR feature tracking
Authors: Shi Rui , Yang Zhi-Gang , Guo Ying-Kun , Qian Wen-Lei , Gao Yue , Li Xue-Ming , Jiang Li , Xu Hua-Yan , Li Yuan
Published: April 2023

Background

To investigate the difference of right ventricular (RV) structural and functional alteration in patients with diabetes mellitus (DM) with preserved left ventricular ejection fraction (LVEF), and the ventricular interdependence in these patients, using cardiac MR (CMR) feature tracking.

Methods

From December 2016 to February 2022, 148 clinically diagnosed patients with DM who underwent cardiac MR (CMR) in our hospital were consecutively recruited. Fifty-four healthy individuals were included as normal controls. Biventricular strains, including left/right ventricular global longitudinal strain (LV-/RVGLS), left/right ventricular global circumferential strain (LV-/RVGCS), left/right ventricular global radial strain (LV-/RVGRS) were evaluated, and compared between patients with DM and healthy controls. Multiple linear regression and mediation analyses were used to evaluate DM's direct and indirect effects on RV strains.

Results

No differences were found in age (56.98 ± 10.98 vs. 57.37 ± 8.41, p = 0.985), sex (53.4% vs. 48.1%, p = 0.715), and body surface area (BSA) (1.70 ± 0.21 vs. 1.69 ± 0.17, p = 0.472) between DM and normal controls. Patients with DM had decreased RVGLS (− 21.86 ± 4.14 vs. − 24.49 ± 4.47, p = 0.001), RVGCS (− 13.16 ± 3.86 vs. − 14.92 ± 3.08, p = 0.011), and no decrease was found in RVGRS (22.62 ± 8.11 vs. 23.15 ± 9.05, p = 0.743) in patients with DM compared with normal controls. The difference in RVGLS between normal controls and patients with DM was totally mediated by LVGLS (indirect effecting: 0.655, bootstrapped 95%CI 0.138–0.265). The difference in RVGCS between normal controls and DM was partly mediated by the LVGLS (indirect effecting: 0.336, bootstrapped 95%CI 0.002–0.820) and LVGCS (indirect effecting: 0.368, bootstrapped 95%CI 0.028–0.855).

Conclusions

In the patients with DM and preserved LVEF, the difference in RVGLS between DM and normal controls was totally mediated by LVGLS. Although there were partly mediating effects of LVGLS and LVGCS, the decrease in RVGCS might be directly affected by the DM.
Effect of dual residual risk of cholesterol and inflammation on all-cause mortality in patients with cardiovascular disease
Authors: Yang Ling , Yue Qing , Fang Fang , Zhang Yinggen , Liu Peipei , Zhang Zihao , Wang Guodong , Chen Shuohua , Wu Shouling , Yang Xiuhong
Published: April 2023

Background

Randomized controlled trials confirm that risks of residual cholesterol and residual inflammation remains in patients with cardiovascular disease (CVD) even after lipid-lowering therapy. This study aims to investigate the association between dual residual risk of cholesterol and inflammation and all-cause mortality in a real-world population with CVD.

Methods

Patients with a CVD history who first took statins between 1 January 2010 and 31 December 2017 in the Kailuan Study were selected as study participants. According to low-density lipoprotein cholesterol (LDL-C) and hypersensitive C-reactive protein levels, patients were divided into those with no residual risk, residual inflammatory risk (RIR), residual cholesterol risk (RCR), and residual cholesterol and inflammatory risk (RCIR). Cox proportional hazard model was conducted to determine hazard ratio (HR) of all-cause mortality for RIR, RCR, and RCIR. Stratified analysis was conducted according to good medication adherence and 75% of the percentage LDL-C decline, high SMART 2 risk score, and blood pressure and blood glucose at standard levels.

Results

After 6.10 years of follow-up, 377 all-cause deaths occurred in 3509 participants (mean age 63.69 ± 8.41 years, 86.78% men). After adjusting for related risk factors, the HR and (95% confidence interval [CI]) of all-cause mortality in the RIR, RCR, and RCIR was 1.63 (1.05, 2.52), 1.37 (0.98, 1.90), and 1.75 (1.25, 2.46), compared with no residual risk. Similar associations were observed in participants with moderate or low statin compliance, a lower percentage of LDL-C decline, high SMART 2 risk score, uncontrolled blood pressure, and uncontrolled blood glucose, in the RCIR had a 1.66-fold, 2.08-fold, 1.69-fold, 2.04-fold, and 2.05-fold higher risk of all-cause mortality, respectively, than the reference.

Conclusion

Risks of residual cholesterol and residual inflammation remain in patients with CVD after receiving statins, and their combined effect significantly increases the risk of all-cause mortality. Here, this increased risk was dependent on statin compliance, LDL-C reduction, SMART 2 risk score, and blood pressure and blood glucose control.
Acalculous cholecystitis is a common extrahepatic manifestation of hepatitis E and suggests a more serious condition
Authors: Cao Xuemei , Jiang Wei , Shi Lingfeng , Wang Yanping , Chen Jie , Huang Wenxiang , Zhang Shujun
Published: April 2023

Background

This study aimed to understand the incidence and clinical significance of acalculous cholecystitis in patients with acute hepatitis E (HE).

Patients and methods

A single center enrolled 114 patients with acute HE. All patients underwent imaging of the gallbladder, and patients with gallstones and cholecystectomy were excluded.

Results

Acalculous cholecystitis was found in 66 patients (57.89%) with acute HE. The incidence in males was 63.95%, which was significantly higher than in females (39.29%) (P = 0.022). The mean length of hospital stay and the incidence of spontaneous peritonitis in patients with cholecystitis (20.12 ± 9.43 days and 9.09%, respectively) were significantly higher than those in patients without cholecystitis (12.98 ± 7.26 days and 0%, respectively) (P < 0.001 and P = 0.032). Albumin, total bile acid, bilirubin, cholinesterase, and prothrombin activity in patients with cholecystitis were significantly inferior to those in patients without cholecystitis (P < 0.001, P < 0.001, P < 0.001, P < 0.001 and P = 0.003, respectively). After correction by multivariate analysis, albumin and total bile acid were found to be closely related to acalculous cholecystitis in HE.

Conclusion

Acalculous cholecystitis is very common in patients with acute HE, and may serve as a predictor of increased peritonitis, synthetic decompensation, and longer hospital stay.
Application of 3D-printed osteotomy guide plates in proximal femoral osteotomy for DDH in children: a retrospective study
Authors: Sun Jian , Mu Yulei , Cui Yong , Qu Jing , Lian Feng
Published: April 2023

Background

Patients with developmental dysplasia of the hip (DDH) have complex proximal femoral deformities, and orthopedic surgery lacks objectivity. Expectations for surgical outcomes are often not achieved, and postoperative problems are common. Using 3D-printed technology in orthopedics offers a novel approach to precise and individualized treatment in modern orthopedics. The aim of this study was to investigate the value of the application of 3D-printed osteotomy guide plates in femoral osteotomy. The clinical indices of femoral osteotomy in children with DDH using 3D-printed osteotomy guide plates were compared with those of traditional osteotomy.

Methods

The clinical data of children with DDH who underwent open reduction and Salter pelvic osteotomy combined with femoral osteotomy from September 2010 to September 2020 were retrospectively collected and analyzed. Based on the inclusion and exclusion criteria, a total of 36 patients were included in the study: 16 in the guide plate group and 20 in the conventional group. Operation time (total), operation time (femoral side), X-ray fluoroscopy times (total), X-ray fluoroscopy times (femoral side) and intraoperative blood loss were analyzed and compared between the two groups. Comparison of treatment-related indicators such as postoperative neck-shaft angle, postoperative anteversion angle, hospitalization time, and hospitalization expenses is made between the two groups. The two groups of patients were evaluated at the last follow-up using the McKay clinical evaluation criteria.

Results

Between the two groups, there were significant differences in operation time (total), operation time (femoral side), X-ray fluoroscopy times (total), X-ray fluoroscopy times (femoral side) and intraoperative blood loss (P < 0.05). The postoperative neck-shaft angle, postoperative anteversion angle, hospitalization time and hospitalization expenses did not differ significantly (P > 0.05). The MacKay clinical evaluation did not significantly differ at the most recent follow-up (P > 0.05).

Conclusions

Children with DDH undergoing proximal femoral osteotomy using 3D-printed osteotomy guide plates benefit from a simpler surgical procedure, shorter operative time, less bleeding and less radiation exposure during surgery. This technique is of great clinical value.
Concordance of adenosine deaminase with immunoglobulins and lymphocyte subsets in EBV-related diseases
Authors: Shi Ting , Ding Qi , Liu Xinglou , Ai Guo , Zhou Hua , Huang Linlin
Published: April 2023

Background

Clinical manifestations of Epstein–Barr virus (EBV) infection are diverse. This study aimed to explore the immune response in EBV-related diseases and the correlation between immune cells and adenosine deaminase (ADA) levels.

Methods

This study was conducted at the Children’s Hospital of Soochow University. In total, 104 patients with EBV-associated respiratory tract infection (EBV-RTI), 32 patients with atypical EBV infection, 54 patients with EBV-associated infectious mononucleosis (IM1, with normal alanine aminotransferase [ALT] levels), 50 patients with EBV-IM2 (with elevated ALT levels), 50 patients with acute respiratory infection (AURI, with other pathogens), and 30 healthy controls were enrolled in this study. Indicators of ADA, immunoglobulins (Igs), and lymphocyte subsets were analyzed for EBV-related diseases.

Results

Differences in the white blood cell, lymphocyte counts, ADA levels, IgA, IgG and IgM titers, percentage of CD3+, CD3+CD4+, CD3+CD8+, CD16+CD56+, CD3−CD19+, and CD19+CD23+ lymphocytes, and CD4+/CD8+ ratio between EBV-related disease groups were all statistically significant (P < 0.01). ADA levels in the EBV-related disease groups were significantly higher than those in the control group (P < 0.01). The lymphocyte count, ADA levels, IgA and IgG titers, and percentage of CD3+ and CD3+CD8 + lymphocytes in the atypical EBV infection, EBV-IM1, and EBV-IM2 groups were significantly higher than those in the EBV-RTI, AUTI, and control groups (P < 0.01), whereas the percentage of CD3+CD4+, CD3−CD19+, and CD19+CD23+ lymphocytes and CD4+/CD8+ ratio showed the opposite trend. ADA levels were consistent with and closely related to the viral load and cellular and humoral immunity in EBV-related diseases.

Conclusions

ADA levels, humoral immunity, and cellular immunity were diverse in EBV-related diseases, and ADA was closely related to Igs and lymphocyte subsets.
A graph neural network-based interpretable framework reveals a novel DNA fragility–associated chromatin structural unit
Authors: Sun Yu , Xu Xiang , Lin Lin , Xu Kang , Zheng Yang , Ren Chao , Tao Huan , Wang Xu , Zhao Huan , Tu Weiwei , Bai Xuemei , Wang Junting , Huang Qiya , Li Yaru , Chen Hebing , Li Hao , Bo Xiaochen
Published: April 2023

Background

DNA double-strand breaks (DSBs) are among the most deleterious DNA lesions, and they can cause cancer if improperly repaired. Recent chromosome conformation capture techniques, such as Hi-C, have enabled the identification of relationships between the 3D chromatin structure and DSBs, but little is known about how to explain these relationships, especially from global contact maps, or their contributions to DSB formation.

Results

Here, we propose a framework that integrates graph neural network (GNN) to unravel the relationship between 3D chromatin structure and DSBs using an advanced interpretable technique GNNExplainer. We identify a new chromatin structural unit named the DNA fragility–associated chromatin interaction network (FaCIN). FaCIN is a bottleneck-like structure, and it helps to reveal a universal form of how the fragility of a piece of DNA might be affected by the whole genome through chromatin interactions. Moreover, we demonstrate that neck interactions in FaCIN can serve as chromatin structural determinants of DSB formation.

Conclusions

Our study provides a more systematic and refined view enabling a better understanding of the mechanisms of DSB formation under the context of the 3D genome.
Factors related to mortality in critically ill histoplasmosis: a multicenter retrospective study in Guadeloupe and French Guyana
Authors: Camous Laurent , Surel Arthur , Kallel Hatem , Nicolas Muriel , Martino Frederic , Valette Marc , Demoule Alexandre , Pommier Jean-David
Published: April 2023

Purpose

To describe clinical and biological features and the outcomes of patients admitted for histoplasmosis in two intensive care units (ICU) in French Guyana and in the French West Indies (Guadeloupe).

Methods

All patients admitted to these two ICUs for culture-proven histoplasmosis between January 2014 to August 2022 were included in the study. Using univariate and multivariate analysis, we assessed risk factors at ICU admission that were associated with death.

Results

Forty patients were included (65% men). Median age was 56 years and simplified acute physiologic score (SAPS) II was 65. HIV was found in 58%, another immunodeficiency was identified in 28%, and no underlying immunodeficiency could be identified in 14% of patients. Within the first 24 h of ICU admission, 85% of patients had acute respiratory failure, 78% had shock, 30% had coma, and 48% had hemophagocytic lymphohistiocytosis. Mechanical ventilation was instituted in 78% of patients and renal replacement therapy in 55%. The 30-day mortality was 53%. By multivariate analysis, factors independently associated with 30-day mortality were SOFA score (odds ratio [OR] 1.5, 95% confidence interval [CI] [1.1–2.1]), time between symptom onset and treatment per day (OR 1.1, 95% CI 1.0–1.1), and hemophagocytic lymphohistiocytosis (OR 6.4, 95% CI 1.1–47.5).

Conclusion

Histoplasmosis requiring ICU admission is a protean disease with multiple and severe organ involvement. Immunodeficiency is found in most patients. The prognosis remains severe despite appropriate treatment and is worsened by late treatment initiation.
ReactiveFnJ: A choreographed model for Fork-Join Workflow in Serverless Computing
Authors: Bharti Urmil , Goel Anita , Gupta S. C.
Published: April 2023

Function-as-a-Service (FaaS) is an event-based reactive programming model where functions run in ephemeral stateless containers for short duration. For building complex serverless applications, function composition is crucial to coordinate and synchronize the workflow of an application. Some serverless orchestration systems exist, but they are in their primitive state and do not provide inherent support for non-trivial workflows like, Fork-Join. To address this gap, we propose a fully serverless and scalable design model ReactiveFnJ for Fork-Join workflow. The intent of this work is to illustrate a design which is completely choreographed, reactive, asynchronous, and represents a dynamic composition model for serverless applications based on Fork-Join workflow. Our design uses two innovative patterns, namely, Relay Composition and Master-Worker Composition to solve execution time-out challenges. As a Proof-of-Concept (PoC), the prototypical implementation of Split-Sort-Merge use case, based on Fork-Join workflow is discussed and evaluated. The ReactiveFnJ handles embarrassingly parallel computations, and its design does not depend on any external orchestration services, messaging services, and queue services. ReactiveFnJ facilitates in designing fully automated pipelines for distributed data processing systems, satisfying the Serverless Trilemma in true essence. A file of any size can be processed using our effective and extensible design without facing execution time-out challenges. The proposed model is generic and can be applied to a wide range of serverless applications that are based on the Fork-Join workflow pattern. It fosters the choreographed serverless composition for complex workflows. The proposed design model is useful for software engineers and developers in industry and commercial organizations, total solution vendors and academic researchers.
Tau in cerebrospinal fluid induces neuronal hyperexcitability and alters hippocampal theta oscillations
Authors: Brown Jessica , Camporesi Elena , Lantero-Rodriguez Juan , Olsson Maria , Wang Alice , Medem Blanca , Zetterberg Henrik , Blennow Kaj , Karikari Thomas K. , Wall Mark , Hill Emily
Published: April 2023

Alzheimer’s disease (AD) and other tauopathies are characterized by the aggregation of tau into soluble and insoluble forms (including tangles and neuropil threads). In humans, a fraction of both phosphorylated and non-phosphorylated N-terminal to mid-domain tau species, are secreted into cerebrospinal fluid (CSF). Some of these CSF tau species can be measured as diagnostic and prognostic biomarkers, starting from early stages of disease. While in animal models of AD pathology, soluble tau aggregates have been shown to disrupt neuronal function, it is unclear whether the tau species present in CSF will modulate neural activity. Here, we have developed and applied a novel approach to examine the electrophysiological effects of CSF from patients with a tau-positive biomarker profile. The method involves incubation of acutely-isolated wild-type mouse hippocampal brain slices with small volumes of diluted human CSF, followed by a suite of electrophysiological recording methods to evaluate their effects on neuronal function, from single cells through to the network level. Comparison of the toxicity profiles of the same CSF samples, with and without immuno-depletion for tau, has enabled a pioneering demonstration that CSF-tau potently modulates neuronal function. We demonstrate that CSF-tau mediates an increase in neuronal excitability in single cells. We then observed, at the network level, increased input–output responses and enhanced paired-pulse facilitation as well as an increase in long-term potentiation. Finally, we show that CSF-tau modifies the generation and maintenance of hippocampal theta oscillations, which have important roles in learning and memory and are known to be altered in AD patients. Together, we describe a novel method for screening human CSF-tau to understand functional effects on neuron and network activity, which could have far-reaching benefits in understanding tau pathology, thus allowing for the development of better targeted treatments for tauopathies in the future.

Graphical Abstract
Light ion dynamics in the topside ionosphere and plasmasphere during geomagnetic storms
Authors: Pakhotin I. P. , Burchill J. K. , Förster M. , Lomidze L.
Published: April 2023

Storm-time topside ionosphere plasma composition, especially the light ion fraction, is an important parameter which controls magnetosphere–ionosphere coupling, plays a part in the growth of local instabilities, and provides information about the ring current, ion upflow, movement of ionization and other important physical processes and parameters. Ion composition is difficult to estimate on fine scales as empirical models tend to be parametrized by fixed inputs, ignoring the role of memory in plasma, and to preferentially capture large scales, while ground radars have limited coverage. In particular, ionospheric composition measurements at mid-latitude are lacking. Here we show, using the new Swarm SLIDEM effective ion mass measurement, a superposed epoch analysis of storm-time dayside and nightside effective ion mass changes, demonstrating the extent and timescales of motion of the [O+]/[H+] transition height with the main phase of geomagnetic storms, as well as directly observing evidence for the latitude dependence of these dynamics.

Graphical Abstract
Insecticidal activity of isolated Purpureocillium lilacinum PL1 against whitefly, Bemisia tabaci Gennadius (Hemiptera: Aleyrodidae) on cassava plantations in southern Viet Nam
Authors: Nguyen Thi Hai , Phung Le Kim Yen , Thai Thien Ngoc Duc , Nguyen Thanh Diem , Do Anh Duy
Published: April 2023

Background

Whitefly Bemisia tabaci Gennadius (Hemiptera: Aleyrodidae) is a plant-damaging insect in tropical and subtropical regions that causes agricultural damage worldwide, including in Viet Nam. The abuse of pesticides derived from chemicals has resulted in the evolution of insect-resistant strains, polluting the environment and threatening human health. Using entomopathogenic fungi (EPF) for biological control is an alternative strategy in integrated pest management. Hence, an attempt was conducted to isolate, characterize and evaluate the efficacy of EPF, Purpureocillium lilacinum against whitefly B. tabaci under laboratory and field conditions.

Results

Purpureocillium lilacinum PL1 (PL1) was isolated from the whitefly B. tabaci cadavers and subsequently identified using morphological study and internal transcribed spacer sequencing. Purpureocillium lilacinum PL1 had effectively grown and sporulated at temperatures ranging from 25 to 35 °C and throughout a broad pH range, which is particularly advantageous against the harsh tropical monsoon climate. Bioassay study indicated that 1 × 107 conidia/ml of P. lilacinum PL1 had a high lethality against the whitefly B. tabaci nymphs in vitro with efficiency was 88.24% after 7 days of treatment. The median lethal concentration (LC50) of P. lilacinum PL1 to B. tabaci after 7 days of treatment was 1.24 × 105 conidia/ml. In field conditions, 1 × 107 conidia/ml of P. lilacinum PL1 lowered the population of B. tabaci nymphs with efficacy was 78.86% after 2 batches, 7 days after treatments.

Conclusion

The findings indicated that P. lilacinum PL1 was effective in the biological control of B. tabaci nymphs, which could be a potential alternative to chemical pesticides for pest management.
The first chick brain with non-invasively embedded beads: a foundation for the automation of brain research
Authors: Yoshimura Akari , Seki Masayuki
Published: April 2023

Background

The automation of biotechnology, such as next-generation DNA sequencing, revolutionarily provides massive amounts of data and integrates various research fields. By contrast, many non-automated brain research fields are not interconnected with one other. In this study, we developed a basis for the automation of brain research. Two major technical barriers for the automation of brain research in vertebrates are the necessity for skull incision and a precise inoculation system for probes, devices, and electrodes in defined brain locations.

Results

The former barrier in the background was overcome by inoculating probes into the future brain area of chick embryos before skull formation. Fluorescent micro-beads that mimic probes were inoculated into the future brain area of chick embryos, and 20% of the manipulated embryos hatched, with 71% of the hatched chicks containing multiple beads in their brains.

Conclusions

With this technique, beads are embedded inside the brain without skull incision, promising a novel non-invasive method that overcomes the drawbacks associated with traditional invasive brain manipulation.
Independence and domination in divisor graph and mod-difference graphs
Authors: Elsakhawy Sayed
Published: April 2023

We initiate the study of domination and inverse domination in labeled graphs. In this paper, we determined the cardinality of maximal independent and minimum variant dominating (total dominating/independent dominating/co-independent dominating) sets and their inverse in divisor graph and in two new labeling definitions called 0-mod-difference and 1-mod-difference graphs.
Anti-wear (AW) and extreme-pressure (EP) behavior of jojoba oil dispersed with green additive CaCO3 nanoparticles
Authors: Kulkarni Trishul , Toksha Bhagwan , Chatterjee Aniruddha , Naik Jitendra , Autee Arun
Published: April 2023

Lubricating approaches involving nanoparticles have a significant role in reducing friction and wear. Reducing friction is crucial for preserving energy, minimizing emissions, and protecting the environment. The present experimental study investigates green nano-lubricants prepared by dispersing various concentrations of CaCO3 nanoparticles in jojoba oil. The aim of the study is to assess the usability of a bio-sourced alternative nanolubricant to depleting conventional lubricants. The role of nanoparticle concentration and thermo-physical properties in improving the lubrication properties of jojoba oil was thoroughly investigated in the present study. The anti-wear and extreme-pressure behavior of jojoba oil dispersed with CaCO3 nanoparticles were evaluated as per the ASTM D4172 and ASTM D2783 test standards. The coefficient of friction, wear scar diameter, last non-seizure load, initial seizure load, weld point load, and load wear index of each sample were assessed. Compared with pure jojoba oil, the addition of CaCO3 nanoparticles in jojoba oil revealed remarkable anti-wear and extreme-pressure properties with significant improvements in the last non-seizure load, initial seizure load, weld point load, and load wear index, the average friction coefficient and the average wear scar diameter of the steel balls decreased by as much as 34.1% and 40.2%, respectively.
Incorporating Cost Measures Into the Merit-Based Incentive Payment System: Implications for Oncologists
Authors: Patel Vishal R. , Cwalina Thomas B. , Nortj� Nico , Mullangi Samyukta , Parikh Ravi B. , Shih Ya-Chen Tina , Gupta Arjun , Hussaini S.M. Qasim
Published: April 2023

PURPOSE

The Merit-Based Incentive Payment System (MIPS) is currently the only federally mandated value-based payment model for oncologists. The weight of cost measures in MIPS has increased from 0% in 2017 to 30% in 2022. Given that cost measures are specialty-agnostic, specialties with greater costs of care such as oncology may be unfairly affected. We investigated the implications of incorporating cost measures into MIPS on physician reimbursements for oncologists and other physicians.

METHODS

We evaluated physicians scored on cost and quality in the 2018 MIPS using the Doctors and Clinicians database. We used multivariable Tobit regression to identify physician-level factors associated with cost and quality scores. We simulated composite MIPS scores and payment adjustments by applying the 2022 cost-quality weights to the 2018 category scores and compared changes across specialties.

RESULTS

Of 168,098 identified MIPS-participating physicians, 5,942 (3.5%) were oncologists. Oncologists had the lowest cost scores compared with other specialties (adjusted mean score, 58.4 for oncologists v 71.0 for nononcologists; difference, –12.66 [95% CI, –13.34 to –11.99]), while quality scores were similar (82.9 v 84.2; difference, –1.31 [95% CI, –2.65 to 0.03]). After the 2022 cost-quality reweighting, oncologists would receive a 4.3-point (95% CI, 4.58 to 4.04) reduction in composite MIPS scores, corresponding to a four-fold increase in magnitude of physician penalties ($4,233.41 US dollars [USD] in 2018 v $18,531.06 USD in 2022) and greater reduction in exceptional payment bonuses compared with physicians in other specialties (–42.8% [95% CI, –44.1 to –41.5] for oncologists v –23.6% [95% CI, –23.8 to –23.4] for others).

CONCLUSION

Oncologists will likely be disproportionally penalized after the incorporation of cost measures into MIPS. Specialty-specific recalibration of cost measures is needed to ensure that policy efforts to promote value-based care do not compromise health care quality and outcomes.
Coming Undone
Authors: Fowler Daren
Published: April 2023

Black transness has been marked and made broken by necropolitical systems of power. Theories and politics of and for black trans women have often prioritized a rejection of or confrontation with this “state of brokenness,” as poet Nat Raha terms it. Visual artist Tourmaline offers a different relationship with brokenness in her call to “come undone,” whereby those who are “broken” can gather their broken pieces together not to heal but to give and share one's pieces with another. This essay engages Tourmaline's Salacia (2019), a film about the life of Mary Jones, a black trans sex worker who became infamous in 1836 following her arrest in New York City, as producing a black trans aesthetic of brokenness. Using a collage style of placing distinct frames upon frames, Tourmaline mixes speculative retellings of Jones's life alongside archival footage of Latina trans activist Sylvia Rivera to create an image built from the pieces and fragments of the trans archive. This aesthetic of brokenness offers an aestheticization of Saidiya Hartman's “critical fabulation” that holds and cares for black transness, a practice of gathering and being-with and being-for.
El Monte
Authors: Cabrera Lydia
Published: April 2023

First published in Cuba in 1954 and appearing here in English for the first time, Lydia Cabrera’s El Monte is a foundational and iconic study of Afro-Cuban religious and cultural traditions. Drawing on conversations with elderly Afro-Cuban priests who were one or two generations away from the transatlantic slave trade, Cabrera combines ethnography, history, folklore, literature, and botany to provide a panoramic account of the multifaceted influence of Afro-Atlantic cultures in Cuba. Cabrera details the natural and spiritual landscape of the Cuban monte (forest, wilderness) and discusses hundreds of herbs and the constellations of deities, sacred rites, and knowledge that envelop them. The result is a complex spiritual and medicinal architecture of Afro-Cuban cultures. This new edition of what is often referred to as “the Santería bible” includes a new foreword, introduction, and translator notes. As a seminal work in the study of the African diaspora that has profoundly impacted numerous fields, Cabrera’s magnum opus is essential for scholars, activists, and religious devotees of Afro-Cuban traditions alike.
Cancer-Related Worry as a Predictor of 5-yr Physical Activity Level in Childhood Cancer Survivors
Authors: WARE MEGAN E. , DELANEY ANGELA , KRULL KEVIN R. , BRINKMAN TARA M. , ARMSTRONG GREGORY T. , WILSON CARMEN L. , MULROONEY DANIEL A. , WANG ZHAOMING , LANCTOT JENNIFER Q. , KRULL MATTHEW R. , PARTIN ROBYN E. , SHELTON KYLA C. , SRIVASTAVA DEO KUMAR , HUDSON MELISSA M. , ROBISON LESLIE L. , NESS KIRSTEN K.
Published: April 2023

Purpose

Cancer-related worry (CRW; concerns related to cancer and its late effects) is prevalent among childhood cancer survivors. Elevated CRW has been associated with self-reported suboptimal physical activity. The aim of this investigation was to describe associations between CRW and objectively assessed physical activity in childhood cancer survivors.

Methods

CRW was assessed at a baseline evaluation using six survey items. Weekly minutes of moderate and vigorous physical activity were captured by actigraphy 5.25 (3.8–8.0) yr later. Factor analysis was used to identify types of worry; multiple regression determined independent associations between CRW and moderate and vigorous physical activity adjusting for sex, race, diagnosis, age at baseline, anxiety level at baseline, self-reported physical activity at baseline, and pain interference at baseline.

Results

Participants (n = 1223) were an average of 30.9 (SD, 6.9) yr at baseline and 36.1 (SD, 7.1) yr at follow-up. Thirty-seven percent were survivors of leukemia, 26% of non-CNS solid tumors, 19% of lymphoma, 11% of CNS tumors, and 6% of other malignancies. Two types of CRW were identified: “body-focused” and “general fear.” Body-focused CRW (β = −19.6, P = 0.012), endorsing pain interference (β = −27.7, P = 0.002) at baseline, and having a diagnosis of CNS tumor (β = −41.3, P = 0.0003) or non-CNS solid tumor (β = −19.4, P = 0.02) were negatively associated with physical activity at follow-up.

Conclusions

CRW related to bodily function and appearance is associated with decreased physical activity. Clinicians should consider the potential negative impact of CRW on physical activity levels and provide behavioral counseling.
Impact of Motor Competence Profiles on Adolescents’ Physical Activity and Cardiorespiratory Fitness across Four Years
Authors: KOLUNSARKA IIRIS , GRÅSTÈN ARTO , STODDEN DAVID , HUHTINIEMI MIKKO , JAAKKOLA TIMO
Published: April 2023

Introduction

Physical activity levels have decreased over past decades with most adolescents neither meeting the current physical activity recommendations nor demonstrating adequate cardiorespiratory fitness (CRF). Motor competence (MC) is foundational for a physically active lifestyle; however, children demonstrate significant differences in their levels of MC in a broad foundation of movement skills. This study investigated developmental patterns of physical activity and CRF in children across 4 yr based on their longitudinal MC profiles.

Methods

The data included annual measurements of MC, accelerometry-measured moderate-to-vigorous physical activity (MVPA), and CRF over 4 yr from the age 11 to 15 (n = 1147, girls 582, boys 565). Latent profile analysis was used to identify longitudinal MC profiles and latent growth curve modeling to examine intercepts and slopes (s) of MVPA and CRF in these MC profiles.

Results

Three different longitudinal MC profiles were identified: low, moderate, and high. The MC profiles showed significant differences in intercepts of CRF and MVPA. The high MC profile showed the highest intercepts for both, but also a statistically significant decline in MVPA over time (s = −3.36, P < 0.001). Cardiorespiratory fitness increased similarly in all three profiles over time: low (s = 1.20, P < 0.01), moderate (s = 1.28, P < 0.001), high (s = 2.21, P < 0.001).

Conclusions

These results highlight the long-term associations between different MC profiles and development of MVPA and CRF. Adolescents with lower MC demonstrated lower levels of MVPA and CRF, indicating decreased participation in physical activities that can optimally enhance CRF. However, significant differences in MVPA levels between MC profiles faded over time in adolescence, whereas significant differences in CRF remained.