bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of alumina addition on properties of glass/ceramic composite
Authors: El-Kheshen A.A.
Published: January 2024

A series of glass/ceramic composites were prepared from pyrex borosilicate glass with silica. The effects of 15 vol.-% alumina addition on cristobalite formation in this system have been studied. Cristobalite formation in the composites has been found to decrease with addition of alumina, which may be attributed to a strong coupling reaction between Al3+from alumina and K+from pyrex borosilicate glass. The resulting glass/ceramic composites containing alumina have low thermal expansion coefficient owing to the presence of a lower amount of cristobalite in the glass matrix. The formation of cristobalite limits the efficiency of the ceramic substrate when used in circuit boards.
How I manage acute respiratory failure in patients with hematological malignancies
Authors: Azoulay Elie , Maertens Johan , Lemiale Virginie
Published: January 2024

Acute respiratory failure (ARF) is common in patients with hematological malignancies notably those with acute leukemia, myelodysplastic syndrome, or allogeneic stem cell transplantation. ARF is the leading reason for intensive care unit (ICU) admission, with a 35% case fatality rate. Failure to identify the ARF cause is associated with mortality. A prompt, well-designed diagnostic workup is crucial. The investigations are chosen according to pretest diagnostic probabilities, estimated by the DIRECT approach: D stands for delay, or time since diagnosis; I for pattern of immune deficiency; R and T for radiological evaluation; E refers to clinical experience, and C to the clinical picture. Thorough familiarity with rapid diagnostic tests helps to decrease the use of bronchoscopy with bronchoalveolar lavage, which can cause respiratory status deterioration in those patients with hypoxemia. A prompt etiological diagnosis shortens the time on unnecessary empirical treatments, decreasing iatrogenic harm and costs. High-quality collaboration between intensivists and hematologists and all crossdisciplinary health care workers is paramount. All oxygen delivery systems should be considered to minimize invasive mechanical ventilation. Treatment of the malignancy is started or continued in the ICU under the guidance of the hematologists. The goal is to use the ICU as a bridge to recovery, with the patient returning to the hematology ward in sufficiently good clinical condition to receive optimal anticancer treatment.
Guadecitabine vs TC in relapsed/refractory AML after intensive chemotherapy: a randomized phase 3 ASTRAL-2 trial
Authors: Roboz Gail J. , Sanz Guillermo , Griffiths Elizabeth A. , Yee Karen , Kantarjian Hagop , Récher Christian , Byrne Michael T. , Patkowska Elżbieta , Kim Hee-Je , Thomas Xavier , Moors Ine , Stock Wendy , Illés Árpád , Fenaux Pierre , Miyazaki Yasushi , Yamauchi Takahiro , O'Connell Casey L. , Hao Yong , Keer Harold N. , Azab Mohammad , Döhner Hartmut
Published: January 2024

Guadecitabine is a novel hypomethylating agent (HMA) resistant to deamination by cytidine deaminase. Patients with relapsed/refractory acute myeloid leukemia (AML) were randomly assigned to guadecitabine or a preselected treatment choice (TC) of high-intensity chemotherapy, low-intensity treatment with HMAs or low-dose cytarabine, or best supportive care (BSC). The primary end point was overall survival (OS). A total of 302 patients were randomly assigned to guadecitabine (n = 148) or TC (n = 154). Preselected TCs were low-intensity treatment (n = 233 [77%; mainly HMAs]), high-intensity chemotherapy (n = 63 [21%]), and BSC (n = 6 [2%]). The median OS were 6.4 and 5.4 months for guadecitabine and TC, respectively (hazard ratio 0.88 [95% confidence interval, 0.67-1.14]; log-rank P = .33). Survival benefit for guadecitabine was suggested in several prospective subgroups, including age <65 years, Eastern Cooperative Oncology Group performance status 0 to 1, refractory AML, and lower peripheral blood blasts ≤30%. Complete response (CR) + CR with partial hematologic recovery rates were 17% for guadecitabine vs 8% for TC (P < .01); CR+CR with incomplete count recovery rates were 27% for guadecitabine vs 14% for TC (P < .01). Safety was comparable for the 2 arms, but guadecitabine had a higher rate of grade ≥3 neutropenia (32% vs 17%; P < .01). This study did not demonstrate an OS benefit for guadecitabine. Clinical response rates were higher for guadecitabine, with comparable safety to TC. There was an OS benefit for guadecitabine in several prespecified subgroups. This study was registered at www.clinicaltrials.gov as #NCT02920008.
An exploratory study evaluating the use of coping strategies while driving in obstructive sleep apnoea syndrome patients and controls
Authors: Dwarakanath Akshay , Palissery Vinod , Ghosh Dipansu , Jamson Samantha , Elliott Mark
Published: January 2024

Introduction

Sleepiness while driving is potentially fatal, and it is recommended that a driver who starts to feel tired should stop and have a rest. However, some may use various countermeasures to try to stay alert. We devised a questionnaire that assessed various potential coping strategies that might be used against fatigue and compared them between obstructive sleep apnoea syndrome (OSAS) patients and controls and with sleepiness in general (Epworth Sleepiness Scale (ESS)), specifically while driving (Driving Sleepiness Scale (DSS)) and driving incidents.

Methods

119 untreated OSAS patients (male 82%, body mass index (BMI) 37±8 kg·m−2, ESS 14±5, DSS 3±2, oxygen desaturation index (ODI) 39±15) and 105 controls (male 70%, BMI 28±6 kg·m−2, ESS 4±3, DSS 7±6) matched for age and driving experience were recruited. All completed a questionnaire relating to their experience over the last year, which included sleepiness in general, sleepiness specifically while driving, 10 questions about various coping strategies they might adopt in order to avoid sleepiness and their history of incidents while driving.

Results

As compared to controls, nearly a third of OSAS patients (29.4%) used more than three coping strategies “frequently”. OSAS patients who used more than three such strategies had worse ESS (17±4versus12±5, p<0.0001); were more likely to feel sleepy while driving (10±8versus5±7, p=0.0002) and had more reported accidents (22.85%versus2.38%, p=0.0002) as compared to OSAS patients who used less than three strategies. There was no difference in patient demographics, severity of OSAS, driving experience or episodes of nodding at the wheel and reported near miss events.

Conclusions

Untreated OSAS patients frequently use certain strategies which could be surrogate markers of sleepiness. Enquiring about such strategies in clinical practice may aid the clinician in identifying the patients who are at risk of driving incidents and to advise appropriately.
Temporal classification of short time series data
Authors: Venn Benedikt , Leifeld Thomas , Zhang Ping , Mühlhaus Timo
Published: January 2024

Motivation

Within the frame of their genetic capacity, organisms are able to modify their molecular state to cope with changing environmental conditions or induced genetic disposition. As high throughput methods are becoming increasingly affordable, time series analysis techniques are applied frequently to study the complex dynamic interplay between genes, proteins, and metabolites at the physiological and molecular level. Common analysis approaches fail to simultaneously include (i) information about the replicate variance and (ii) the limited number of responses/shapes that a biological system is typically able to take.

Results

We present a novel approach to model and classify short time series signals, conceptually based on a classical time series analysis, where the dependency of the consecutive time points is exploited. Constrained spline regression with automated model selection separates between noise and signal under the assumption that highly frequent changes are less likely to occur, simultaneously preserving information about the detected variance. This enables a more precise representation of the measured information and improves temporal classification in order to identify biologically interpretable correlations among the data.

Availability and implementation

An open source F# implementation of the presented method and documentation of its usage is freely available in the TempClass repository, https://github.com/CSBiology/TempClass  [58].
Molecular epidemiology of Mycoplasma pneumoniae pneumonia in children, Wuhan, 2020–2022
Authors: Xu Meng , Li Ying , Shi Yue , Liu Haizhou , Tong Xi , Ma Li , Gao Jie , Du Qing , Du Hui , Liu Di , Lu Xiaoxia , Yan Yi
Published: January 2024

Background

Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community-acquired pneumonia in children. The factors contributing to the severity of illness caused by M. pneumoniae infection are still under investigation. We aimed to evaluate the sensitivity of common M. pneumoniae detection methods, as well as to analyze the clinical manifestations, genotypes, macrolide resistance, respiratory microenvironment, and their relationship with the severity of illness in children with M. pneumoniae pneumonia in Wuhan.

Results

Among 1,259 clinical samples, 461 samples were positive for M. pneumoniae via quantitative polymerase chain reaction (qPCR). Furthermore, we found that while serological testing is not highly sensitive in detecting M. pneumoniae infection, but it may serve as an indicator for predicting severe cases. We successfully identified the adhesin P1 (P1) genotypes of 127 samples based on metagenomic and Sanger sequencing, with P1-type 1 (113/127, 88.98%) being the dominant genotype. No significant difference in pathogenicity was observed among different genotypes. The macrolide resistance rate of M. pneumoniae isolates was 96% (48/50) and all mutations were A2063G in domain V of 23S rRNA gene. There was no significant difference between the upper respiratory microbiome of patients with mild and severe symptoms.

Conclusions

During the period of this study, the main circulating M. pneumoniae was P1-type 1, with a resistance rate of 96%. Key findings include the efficacy of qPCR in detecting M. pneumoniae, the potential of IgM titers exceeding 1:160 as indicators for illness severity, and the lack of a direct correlation between disease severity and genotypic characteristics or respiratory microenvironment. This study is the first to characterize the epidemic and genomic features of M. pneumoniae in Wuhan after the COVID-19 outbreak in 2020, which provides a scientific data basis for monitoring and infection prevention and control of M. pneumoniae in the post-pandemic era.
Comprehensive analysis the prognostic and immune characteristics of mitochondrial transport-related gene SFXN1 in lung adenocarcinoma
Authors: Liu Wenting , Du Qingwu , Mei Ting , Wang Jingya , Huang Dingzhi , Qin Tingting
Published: January 2024

Background

Mitochondria, which serve as the fundamental organelle for cellular energy and metabolism, are closely linked to the growth and survival of cancer cells. This study aims to identify and assess Sideroflexin1 (SFXN1), an unprecedented mitochondrial gene, as a potential prognostic biomarker for lung adenocarcinoma (LUAD).

Methods

The mRNA and protein levels of SFXN1 were investigated based on the Cancer Genome Atlas (TCGA) LUAD dataset, and then validated by real-time quantitative PCR, Western Blotting and immunohistochemistry from our clinical samples. The clinical correlation and prognostic value were evaluated by the TCGA cohort and verified via our clinical dataset (n = 90). The somatic mutation, drug sensitivity data, immune cell infiltration and single-cell RNA sequencing data of SFXN1 were analyzed through public databases.

Results

SFXN1 was markedly upregulated at both mRNA and protein levels in LUAD, and high expression of SFXN1 were correlated with larger tumor size, positive lymph node metastasis, and advanced clinical stage. Furthermore, SFXN1 upregulation was significantly associated with poor clinical prognosis. SFXN1 co-expressed genes were also analyzed, which were mainly involved in the cell cycle, central carbon metabolism, DNA repair, and the HIF-1α signaling pathway. Additionally, SFXN1 expression correlated with the expression of multiple immunomodulators, which act to regulate the tumor immune microenvironment. Results also demonstrated an association between SFXN1 expression and increased immune cell infiltration, such as activated CD8 + T cells, natural killer cells (NKs), activated dendritic cells (DCs), and macrophages. LUAD patients with high SFXN1 expression exhibited heightened sensitivity to multiple chemotherapies and targeted drugs and predicted a poor response to immunotherapy. SFXN1 represented an independent prognostic marker for LUAD patients with an improved prognostic value for overall survival when combined with clinical stage information.

Conclusions

SFXN1 is frequently upregulated in LUAD and has a significant impact on the tumor immune environment. Our study uncovers the potential of SFXN1 as a prognostic biomarker and as a novel target for intervention in LUAD.
Long-term outcomes of pelvic exenterations for gynecological malignancies: a single-center retrospective cohort study
Authors: Yu Jie-Hai , Tong Chong-Jie , Huang Qi-Dan , Ye Yun-Lin , Chen Gong , Li Hao , Wen Yong-Shan , Yang Fan , Luo Nan-Bin , Xu Guang-Yu , Xiong Ying
Published: January 2024

Background

Recently, with the advancement of medical technology, the postoperative morbidity of pelvic exenteration (PE) has gradually decreased, and it has become a curative treatment option for some patients with recurrent gynecological malignancies. However, more evidence is still needed to support its efficacy. This study aimed to explore the safety and long-term survival outcome of PE and the feasibility of umbilical single-port laparoscopic PE for gynecologic malignancies in a single medical center in China.

Patients and methods

PE for gynecological cancers except for ovarian cancer conducted by a single surgical team in Sun Yat-sen University Cancer Center between July 2014 and December 2019 were included and the data were retrospectively analyzed.

Results

Forty-one cases were included and median age at diagnosis was 53 years. Cervical cancer accounted for 87.8% of all cases, and most of them received prior treatment (95.1%). Sixteen procedures were performed in 2016 and before, and 25 after 2016. Three anterior PE were performed by umbilical single-site laparoscopy. The median operation time was 460 min, and the median estimated blood loss was 600 ml. There was no perioperative death. The years of the operations was significantly associated with the length of the operation time (P = 0.0018). The overall morbidity was 52.4%, while the severe complications rate was 19.0%. The most common complication was pelvic and abdominal infection. The years of surgery was also significantly associated with the occurrence of severe complication (P = 0.040). The median follow-up time was 55.8 months. The median disease-free survival (DFS) was 17.9 months, and the median overall survival (OS) was 25.3 months. The 5-year DFS was 28.5%, and the 5-year OS was 30.8%.

Conclusion

PE is safe for patient who is selected by a multi-disciplinary treatment, and can be a curative treatment for some patients. PE demands a high level of experience from the surgical team. Umbilical single-port laparoscopy was a technically feasible approach for APE, meriting further investigation.
Priority populations’ experiences of the accessibility and inclusion of recreation centres: a qualitative study
Authors: Rivera Elise , Smith Cynthia , Hesketh Kylie D
Published: January 2024

Background

Although the health benefits of physical activity are well documented, certain priority populations are often disproportionately insufficiently active and at higher risk of poor health. Recreation centres have the potential to provide accessible and supportive environments for physical activity for all. However, little is known about priority populations’ experiences of these venues and their views of how accessibility and inclusion can be optimised. This study aimed to gain in-depth insights of recreation centre experiences and potential strategies for improving inclusion and accessibility amongst priority populations (women, older adults, ethnic minorities, persons living with disabilities/additional needs, individuals identifying as LGBTQIA+, low socio-economic position).

Methods

This qualitative study (2021–2022) involved 18 semi-structured individual interviews with adult priority population users of recreation centres (50% 65 + years, 61.2% female) in one Melbourne municipality. Participants were asked to discuss their positive and negative experiences at the centres and to identify strategies for enhancing accessibility and inclusion. Interviews were audio-recorded and transcribed verbatim. Content analysis was performed for data analysis.

Results

While many participants had positive views of the facilities and programs at the centres, as they met their needs, they also had suggestions for improving accessibility and inclusion. Similarly, most participants were happy with the communications, felt included, and perceived the culture positively. Those who did not feel included at the centres offered many potential strategies for changing the culture, modifying communications (e.g., signage), and establishing partnerships for better access and inclusion.

Conclusions

The present study adds to essential knowledge concerning priority populations’ experiences of recreation centres. For recreation facilities that were generally perceived as having positive inclusion and accessibility, the findings nonetheless highlighted suggestions for further enhancement. These strategies may be useful more broadly for improving accessibility and inclusion, thereby promoting physical activity and ultimately health for all.
Spatial spillover effect of environmental factors on the tuberculosis occurrence among the elderly: a surveillance analysis for nearly a dozen years in eastern China
Authors: Luo Dan , Wang Luyu , Zhang Mengdie , Martinez Leonardo , Chen Songhua , Zhang Yu , Wang Wei , Wu Qian , Wu Yonghao , Liu Kui , Xie Bo , Chen Bin
Published: January 2024

Background

In many areas of China, over 30% of tuberculosis cases occur among the elderly. We aimed to investigate the spatial distribution and environmental factors that predicted the occurence of tuberculosis in this group.

Methods

Data were collected on notified pulmonary tuberculosis (PTB) cases aged ≥ 65 years in Zhejiang Province from 2010 to 2021. We performed spatial autocorrelation and spatial-temporal scan statistics to determine the clusters of epidemics. Spatial Durbin Model (SDM) analysis was used to identify significant environmental factors and their spatial spillover effects.

Results

77,405 cases of PTB among the elderly were notified, showing a decreasing trend in the notification rate. Spatial-temporal analysis showed clustering of epidemics in the western area of Zhejiang Province. The results of the SDM indicated that a one-unit increase in PM2.5 led to a 0.396% increase in the local notification rate. The annual mean temperature and precipitation had direct effects and spatial spillover effects on the rate, while complexity of the shape of the greenspace (SHAPE_AM) and SO2 had negative spatial spillover effects.

Conclusion

Targeted interventions among the elderly in Western Zhejiang may be more efficient than broad, province-wide interventions. Low annual mean temperature and high annual mean precipitation in local and neighboring areas tend to have higher PTB onset among the elderly.
Misinformation, knowledge and COVID-19 vaccine acceptance: a cross-sectional study among health care workers and the general population in Kampala, Uganda
Authors: Atuheirwe Maxine , Otim Richard , Male Keneth Junior , Ahimbisibwe Stella , Sackey Joachim Dzidzor , Sande Obondo James
Published: January 2024

COVID-19 has greatly affected communities worldwide, more so in low- and middle-income countries. To successfully resolve the COVID-19 pandemic, vaccination coverage of more than 80% is required. However, misinformation has affected this by increasing COVID-19 vaccine hesitancy. Limited studies have assessed the effect of COVID-19 misinformation on vaccine acceptance, especially in Africa. This study assessed people’s knowledge of the COVID-19 vaccine and the effect of misinformation on vaccine uptake among healthcare workers (HCWs) versus the general population in Uganda.

Methods This was a cross-sectional quantitative study conducted from January 2022 to June 2022, and involved healthcare workers (HCWs) and the general population of Kampala, Uganda. A structured questionnaire was used to collect data. We recruited 564 study participants, including 311 healthcare workers (HCWs) and 253 from the general population. Data were analyzed using frequency distributions and Chi-square tests. SPSS version 22.0 was used to conduct all study analyses.

Results This study revealed that the proportion of vaccinated HCWs (77.4%) was significantly higher than that of the vaccinated general population (64.4%, p = 0.010). Nearly all study participants were aware of COVID-19 vaccines (96.7%). The research revealed that a large proportion of the participants (89.7%) encountered rumors regarding unverified adverse effects of the COVID-19 vaccine. This information significantly contributed to vaccine hesitancy, with 81.1% expressing reluctance to receive the vaccine, and 55% stating their unwillingness to get vaccinated. Misinformation affected people’s vaccine acceptance, affecting their willingness to receive vaccines if unvaccinated and potentially influencing their receptiveness to future vaccines or boosters if already vaccinated. 

Conclusions The study showed a negative impact of misinformation on vaccine uptake and could be the most significant contributor to vaccine hesitancy in future vaccine programs.
Individual, family, and environmental correlates of fundamental motor skills among school-aged children: a cross-sectional study in China
Authors: He Yuxiu , Zhou Lin , Liang Wei , Liu Qi , Liu Wanxin , Wang Shijian
Published: January 2024

Objective

This cross-sectional study examined the socio-ecological factors influencing fundamental motor skills (FMS) in Chinese school-aged children.

Methods

A total of 1012 parent-child pairs were randomly sampled between March-1st and April-15th, 2022. Based on the socio-ecological model of Children’s FMS, three levels of factors: individual-level (e.g., demographic, physical, psychological, and behavioral characteristics of children), family-level (e.g., caregiver demographics, parental support, and socioeconomic status), and environmental factors (e.g., availability of physical activity equipment) were assessed using self-reported scales (e.g., the Self-perception Profile for Children, the Physical Activity Enjoyment Scale, and the 12-item Psychological Well-Being Scale for Children) and objective measures (e.g., ActiGraph GT3X, the Chinese National Student Physical Fitness Standard, and the Test of Gross Motor Development-Third Edition). Multi-level regression models were employed using SPSS.

Results

The results demonstrated that children’s age, sex, physical fitness, parental support, and the quality of home and community physical activity environments consistently influenced all three types of FMS, including locomotor, ball, and composite skills. Additionally, seven individual-level factors (children’s age, sex, body mass index, light physical activity, sleep duration, perceived motor competence, and physical fitness) were associated with different types of FMS.

Conclusions

The findings underscore the multidimensional and complex nature of FMS development, with individual-level factors playing a particularly significant role. Future research should adopt rigorous longitudinal designs, comprehensive assessment tools covering various FMS skills, and objective measurement of parents’ movement behaviors to better understand the strength and direction of the relationship between socio-ecological factors and children’s FMS.
Induction of antimicrobial, antioxidant metabolites production by co-cultivation of two red-sea-sponge-associated Aspergillus sp. CO2 and Bacillus sp. COBZ21
Authors: Hamed Ahmed A. , Ghareeb Mosad A. , Kelany Ayda K. , Abdelraof Mohamed , Kabary Hoda A. , Soliman Nariman R. , Elawady Mohamed E.
Published: January 2024

The growing spread of infectious diseases has become a potential global health threat to human beings. According to WHO reports, in this study, we investigated the impact of co-cultivating the isolated endophytic fungus Aspergillus sp. CO2 and Bacillus sp. COBZ21 as a method to stimulate the production of natural bioactive substances. (GC/MS)-based metabolomics profiling of two sponge-associated microbes, Aspergillus sp. CO2 and Bacillus sp. COBZ21, revealed that the co-culture of these two isolates induced the accumulation of metabolites that were not traced in their axenic cultures. By detection of different activities of extracts of Bacillus sp. COBZ21 and Aspergillus sp. CO2 and coculture between Bacillus sp. COBZ21 and Aspergillus sp. CO2. It was noted that the coculture strategy was the reason for a notable increase in some different activities, such as the antimicrobial activity, which showed potent activity against Escherichia coli ATCC 25,922, Staphylococcus aureus NRRLB-767, and Candida albicans ATCC 10,231. The antibiofilm activity showed significant biofilm inhibitory activity toward Bacillus subtilis ATCC 6633, Pseudomonas aeruginosa ATCC 10,145, and Staph aureus NRRLB-767, with activity up to 53.66, 71.17, and 47.89%, while it showed low activity against E. coli ATCC 25,922, while the antioxidant activity based on the DPPH assay showed maximum activity (75.25%). GC-MS investigations revealed the presence of variable chemical constituents belonging to different chemical categories, which reflected their chemical diversity. The main components are (+-) cis-Deethylburnamine (2.66%), Bis(3,6,9,12-tetraoxapentaethylene) crowno-N,N,N’,N’-tetra methylpphanediamine (2.48%), and 11-phenyl-2,4,6,8-tetra(2-thienyl)-11-aza-5,13-dithiaeteracyclo[7.3.0.1(2,8)0.0(3,7)] trideca-3,6-diene-10,12,13-trione (3.13%), respectively, for Bacillus sp. axenic culture, Aspergillus sp. CO2, Aspergillus sp. CO2, and Bacillus sp. COBZ21 coculture. By studying the ADME-related physicochemical properties of coculture extract, the compound showed log Po/w values above 5 (8.82). The solubility of the substance was moderate. In order to provide a comprehensive definition of medicinal chemistry and leadlikness, it is important to note that the latter did not meet the criteria outlined in the rule of three (RO3). The toxicity prediction of the coculture extract was performed using the ProTox II web server, which showed that the selected compound has no pronounced toxicity.
Metagenomic analysis of healthy and diseased peri-implant microbiome under different periodontal conditions: a cross-sectional study
Authors: Song Liang , Feng Ziying , Zhou Qianrong , Wu Xingwen , Zhang Limin , Sun Yang , Li Ruixue , Chen Huijuan , Yang Fei , Yu Youcheng
Published: January 2024

Background

Peri-implantitis is a polybacterial infection that can lead to the failure of dental implant rehabilitation. This study aimed to profile the microbiome of the peri-implant plaque and estimate the effect of periodontitis on it among 40 Chinese participants with dental implant prostheses and presenting with varying peri-implant and periodontal health states.

Methods

Submucosal plaque samples were collected from four distinct clinical categories based on both their implant and periodontal health status at sampling point. Clinical examinations of dental implant and remaining teeth were carried out. Metagenomic analysis was then performed.

Results

The microbiome of the peri-implantitis sites differed from that of healthy implant sites, both taxonomically and functionally. Moreover, the predominant species in peri-implantitis sites were slightly affected by the presence of periodontitis. T. forsythia, P. gingivalis, T. denticola, and P. endodontalis were consistently associated with peri-implantitis and inflammatory clinical parameters regardless of the presence of periodontitis. Prevotella spp. and P. endodontalis showed significant differences in the peri-implantitis cohorts under different periodontal conditions. The most distinguishing function between diseased and healthy implants is related to flagellar assembly, which plays an important role in epithelial cell invasion.

Conclusions

The composition of the peri-implant microbiome varied in the diseased and healthy states of implants and is affected by individual periodontal conditions. Based on their correlations with clinical parameters, certain species are associated with disease and healthy implants. Flagellar assembly may play a vital role in the process of peri-implantitis.
“Determining the efficacy of a machine learning model for measuring periodontal bone loss”
Authors: Cerda Mardini Diego , Cerda Mardini Patricio , Vicuña Iturriaga Daniela Paz , Ortuño Borroto Duniel Ricardo
Published: January 2024

Background

Considering the prevalence of Periodontitis, new tools to help improve its diagnostic workflow could be beneficial. Machine Learning (ML) models have already been used in dentistry to automate radiographic analysis.

Aims

To determine the efficacy of an ML model for automatically measuring Periodontal Bone Loss (PBL) in panoramic radiographs by comparing it to dentists.

Methods

A dataset of 2010 images with and without PBL was segmented using Label Studio. The dataset was split inton = 1970 images for building a training dataset andn = 40 images for building a testing dataset. We propose a model composed of three components. Firstly, statistical inference techniques find probability functions that best describe the segmented dataset. Secondly, Convolutional Neural Networks extract visual information from the training dataset. Thirdly, an algorithm calculates PBL as a percentage and classifies it in stages. Afterwards, a standardized test compared the model to two radiologists, two periodontists and one general dentist. The test was built using the testing dataset, 40 questions long, done in controlled conditions, with radiologists considered as ground truth. Presence or absence, percentage, and stage of PBL were asked, and time to answer the test was measured in seconds. Diagnostic indices, performance metrics and performance averages were calculated for each participant.

Results

The model had an acceptable performance for diagnosing light to moderate PBL (weighted sensitivity 0.23, weighted F1-score 0.29) and was able to achieve real-time diagnosis. However, it proved incapable of diagnosing severe PBL (sensitivity, precision, and F1-score = 0).

Conclusions

We propose a Machine Learning model that automates the diagnosis of Periodontal Bone Loss in panoramic radiographs with acceptable performance.
Scoping review on the association between early childhood caries and responsible resource consumption and production: exploring Sustainable Development Goal 12
Authors: Foláyan Morẹ́nikẹ́ Oluwátóyìn , Virtanen Jorma I. , Gaffar Balgis , Abodunrin Olunike , Sun Ivy Guofang , Duangthip Duangporn , Kemoli Arthur , Masumo Ray M. , Vukovic Ana , Al-Batayneh Ola B. , Mfolo Tshepiso , Schroth Robert J , El Tantawi Maha
Published: January 2024

Background

The Sustainable Development Goal 12 (SDG12) promotes patterns that minimize waste and maximize resource utilization. It is therefore plausible that preventing Early Childhood Caries (ECC) and promoting oral health can contribute to sustainable consumption. In addition, sustainable consumption and production can contribute to the control of ECC. This scoping review aimed to explore the possible evidence on the link between ECC and the SDG12 targets.

Methods

This scoping review identified articles on the link between resource consumption and production and caries according to the PRISMA-ScR guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were systematically searched in August 2023, using specific search terms. Studies written in English, with full text available, addressing dental caries and linked with waste minimization and resource utilization maximisation, with results that could be extrapolated to ECC in children less than 6 years of age) were included. Descriptive statistics were planned to summarize the categories of retrieved papers.

Results

The initial search yielded 904 articles, with 863 screened for eligibility after the removal of duplicates. No studies were identified that reported data on an association between responsible consumption and production of resources factors and ECC.

Conclusion

This scoping review did not identify any articles published in English on evidence of the direct associations between ECC and SDG12 targets. However, there is a plausibility of such a link using minimum intervention dentistry for ECC management as a waste prevention and resource utilisation maximization strategy.
Analysis of narrative assessments of internal medicine resident performance: are there differences associated with gender or race and ethnicity?
Authors: Klein Robin , Snyder Erin D. , Koch Jennifer , Volerman Anna , Alba-Nguyen Sarah , Julian Katherine A. , Thompson Vanessa , Ufere Nneka N. , Burnett-Bowie Sherri-Ann M. , Kumar Anshul , White Bobbie Ann A. , Park Yoon Soo , Palamara Kerri
Published: January 2024

Background

Equitable assessment is critical in competency-based medical education. This study explores differences in key characteristics of qualitative assessments (i.e., narrative comments or assessment feedback) of internal medicine postgraduate resident performance associated with gender and race and ethnicity.

Methods

Analysis of narrative comments included in faculty assessments of resident performance from six internal medicine residency programs was conducted. Content analysis was used to assess two key characteristics of comments- valence (overall positive or negative orientation) and specificity (detailed nature and actionability of comment) – via a blinded, multi-analyst approach. Differences in comment valence and specificity with gender and race and ethnicity were assessed using multilevel regression, controlling for multiple covariates including quantitative competency ratings.

Results

Data included 3,383 evaluations with narrative comments by 597 faculty of 698 residents, including 45% of comments about women residents and 13.2% about residents who identified with race and ethnicities underrepresented in medicine. Most comments were moderately specific and positive. Comments about women residents were more positive (estimate 0.06, p 0.045) but less specific (estimate − 0.07, p 0.002) compared to men. Women residents were more likely to receive non-specific, weakly specific or no comments (adjusted OR 1.29, p 0.012) and less likely to receive highly specific comments (adjusted OR 0.71, p 0.003) or comments with specific examples of things done well or areas for growth (adjusted OR 0.74, p 0.003) than men. Gendered differences in comment specificity and valence were most notable early in training. Comment specificity and valence did not differ with resident race and ethnicity (specificity: estimate 0.03, p 0.32; valence: estimate − 0.05, p 0.26) or faculty gender (specificity: estimate 0.06, p 0.15; valence: estimate 0.02 p 0.54).

Conclusion

There were significant differences in the specificity and valence of qualitative assessments associated with resident gender with women receiving more praising but less specific and actionable comments. This suggests a lost opportunity for well-rounded assessment feedback to the disadvantage of women.
Integrating basic sciences into clerkship rotation utilizing Kern’s six-step model of instructional design: lessons learned
Authors: Hashmi Satwat , Riaz Qamar , Qaiser Husnain , Bukhari Saira
Published: January 2024

Background

It is generally agreed that basic and clinical sciences should be integrated throughout the undergraduate medical education, however, there is still need for continued formal integration of basic sciences into clinical clerkship in many medical schools across the globe.

Methods

Utilizing Kern’s Six-Step Model of Instructional Design, we aimed to develop an intervention that would facilitate cognitive integration of basic and clinical sciences. After problem identification and targeted needs assessment through focused group discussion with the students and faculty, objectives were devised with an implementation plan of using flipped class approach to develop a content-focused and learner-centered teaching strategy. This intervention was piloted in the 2-week cardiology clerkship in Year 5. Evaluation of the content, integration, student and faculty experiences were recorded through in-depth interviews, FGDs and a formative MCQ test.

Results

Flipped classroom based integrated sessions were successfully developed. The implementation phase was met with challenges that primarily stemmed from the diverse teaching styles among faculty members, hesitance to deviate from conventional practices, variations in clinic timings, and demanding schedules. Noteworthy observations were in terms of ownership of the project, the need for faculty development in modern student-centered teaching pedagogies, opportunities for content improvement, scheduling of sessions, and suggestion of revisiting fundamental concepts in basic sciences through a brief boot camp-style session at the onset of the clerkship. The role of flipped case model and clinical cases in integrating basic sciences into clinical sciences were appreciated by the students. Standardization in teaching practices was identified as the major challenge by the faculty.

Conclusions

A functional, learner-centered framework of cognitive integration of basic sciences in clinical sciences curriculum of cardiology rotation was developed with a potential to be implemented in other clerkship rotations.
The sexual and gender minority (LGBTQ+) medical trainee: the journey through medical education
Authors: Danckers Mauricio , Nusynowitz Jake , Jamneshan Lily , Shalmiyev Richard , Diaz Raiko , Radix Asa E.
Published: January 2024

In this literature overview, we share with the reader challenges faced by LGBTQ + individuals pursuing medical education, from undergraduate to postgraduate training. The LGBTQ + acronym has evolved to encompass the diverse spectrum of sexual orientation and gender identities. Recently, the term “Sexual and Gender Minority” (SGM) has emerged as an umbrella term to provide consistency in research advancing SGM health. The unique obstacles LGBTQ + trainees encounter are highlighted throughout this article, including external factors influencing career decisions, a lack of LGBTQ + healthcare curricula, discriminatory social interactions, limited mentorship opportunities, and a higher mental health burden. These challenges have the capacity to affect educational experiences, personal well-being, and professional growth. Additionally, we examine the impact of inclusive institutional climates on LGBTQ + trainees’ selection of medical schools and residency programs, as they may prioritize inclusiveness and diversity when making their choice. In postgraduate training, LGBTQ + trainees continue to face challenges, exemplified by disparities in placement rates and discriminatory experiences based on sexual orientation and gender identity. We describe the gap in current research and its long-term impact of these challenges on career paths. Hostile environments persist in certain specialties, and the lack of LGBTQ + mentorship and support can hinder academic pursuits. We shed light on the unique and pervasive challenges faced by LGBTQ + trainees throughout their medical education journey, while emphasizing the need for inclusive policies, support systems, and research to address these challenges. With increasing research and studies, we hope to create a medical workforce and community that better represents the diverse communities it serves.
People living with HIV’s perspectives of acceptability of fee for home delivery of ART: a qualitative study
Authors: Ntinga Xolani , Musiello Franco , Pita Thembelihle , Mabaso Nomagugu , Celum Connie , Szpiro Adam , van Rooyen Heidi , Barnabas Ruanne , van Heerden Alastair
Published: January 2024

Introduction

Significant progress has been made in the HIV response in South Africa; however, gaps remain in ensuring engagement in care to support life-long medication adherence and viral suppression. The National Department of Health (NDoH) has introduced community-based and clinic-based HIV differentiated service delivery (DSD) models to tackle suboptimal adherence and retention in care. Nevertheless, differentiated care models require adaptation to better serve clients who struggle with adherence. There is limited research on the acceptability of fee for home delivery of ART in resource-constrained settings. The current study investigates the acceptability of fee for home delivery of ART among people living with HIV in South Africa.

Methods

Two mixed-gender focus group discussions (FGDs) took place between June and November 2019, consisting of 10 participants in each group. A purposive sampling strategy was employed to identify and select 10 people living with HIV who were ART-eligible but not in care, and 10 people living with HIV who were currently taking ART and in care. Participants were grouped according to their treatment status. A coding framework, informed by a priori categories and derived from topics in the interview guide, was developed and utilized to facilitate analysis.

Results

Participants expressed enthusiasm for having ART home-delivered, as it would save the time spent waiting in long queues at the clinic. However, some participants raised concerns about potential payment difficulties due to high unemployment rates in the community. Some participants believed this would be acceptable, as patients already incur costs for travel and food when visiting the clinic. Participants in both FGDs expressed strong concerns about home delivery of their ART based on fear of accidental disclosure, especially for those who have not disclosed to their immediate families and partners.

Conclusion

Our study suggests that charging a fee for home delivery is an acceptable and innovative approach to supporting PLHIV in maintaining adherence to their medication and remaining in care.
Postabortion care service availability, readiness, and access in Burkina Faso: results from linked female-facility cross-sectional data
Authors: Onadja Yentéma , Compaoré Rachidatou , Yugbaré Danielle Belemsaga , Thomas Haley L. , Guiella Georges , Lougué Siaka , Ouedraogo Henri Gautier , Bazie Fiacre , Kouanda Seni , Moreau Caroline , Bell Suzanne O.
Published: January 2024

Background

Little is known about postabortion care (PAC) services in Burkina Faso, despite PAC’s importance as an essential and life-saving component of emergency obstetric care. This study aims to evaluate PAC service availability, readiness, and accessibility in Burkina Faso.

Methods

Data for this study come from the Performance Monitoring for Action (PMA) Burkina Faso project and the Harmonized Health Facility Assessment (HHFA) conducted by the Institut de Recherche en Sciences de la Santé and the Ministry of Health. PMA data from a representative sample of women aged 15–49 (n = 6,385) were linked via GPS coordinates to HHFA facility data (n = 2,757), which included all public and private health facilities in Burkina Faso. We assessed readiness to provide basic and comprehensive PAC using the signal functions framework. We then calculated distance to facilities and examined percent within 5 kms of a facility with any PAC, basic PAC, and comprehensive PAC overall and by women’s background characteristics.

Results

PAC services were available in 46.4% of health facilities nationwide; only 38.3% and 35.0% of eligible facilities had all basic and comprehensive PAC signal functions, respectively. Removal of retained products of conception was the most common missing signal function for both basic and comprehensive PAC, followed by provision of any contraception (basic) or any LARC (comprehensive). Nearly 85% of women lived within 5 km of a facility providing any PAC services, while 50.5% and 17.4% lived within 5 km of a facility providing all basic PAC and all comprehensive PAC signal functions, respectively. Women with more education, greater wealth, and those living in urban areas had greater odds of living within 5 km of a facility with offering PAC, basic PAC, or comprehensive PAC.

Conclusions

Results indicate a need for increased PAC availability and readiness, prioritizing basic PAC services at the primary level—the main source of care for many women—which would reduce structural disparities in access. The current deficiencies in PAC signal a need for broader strengthening of the primary healthcare services in Burkina Faso to reduce the burden of unsafe abortion-related morbidity and mortality while improving maternal health outcomes more broadly.
Use of chitin:DNA ratio to assess growth form in fungal cells
Authors: Kovács-Simon Andrea , Fones Helen N.
Published: January 2024

Background

Dimorphism, the ability to switch between a ‘yeast-like’ and a hyphal growth form, is an important feature of certain fungi, including important plant and human pathogens. The switch to hyphal growth is often associated with virulence, pathogenicity, biofilm formation and stress resistance. Thus, the ability to accurately and efficiently measure fungal growth form is key to research into these fungi, especially for discovery of potential drug targets. To date, fungal growth form has been assessed microscopically, a process that is both labour intensive and costly.

Results

Here, we unite quantification of the chitin in fungal cell walls and the DNA in nuclei to produce a methodology that allows fungal cell shape to be estimated by calculation of the ratio between cell wall quantity and number of nuclei present in a sample of fungus or infected host tissue. Using the wheat pathogen Zymoseptoria tritici as a test case, with confirmation in the distantly related Fusarium oxysporum, we demonstrate a close, linear relationship between the chitin:DNA ratio and the average polarity index (length/width) of fungal cells. We show the utility of the method for estimating growth form in infected wheat leaves, differentiating between the timing of germination in two different Z. tritici isolates using this ratio. We also show that the method is robust to the occurrence of thick-walled chlamydospores, which show a chitin:DNA ratio that is distinct from either ‘yeast-like’ blastospores or hyphae.

Conclusions

The chitin:DNA ratio provides a simple methodology for determining fungal growth form in bulk tissue samples, reducing the need for labour-intensive microscopic studies requiring specific staining or GFP-tags to visualise the fungus within host tissues. It is applicable to a range of dimorphic fungi under various experimental conditions.