bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Glycemic Variability and Discharge Outcomes in Patients with Ischemic Stroke Following Thrombolysis
Authors: Steck Mackenzie , Wells Drew A. , Stoffel Jaclyn M. , Hudson Joanna Q. , Saeed Omar , Elangovan Cheran , Krishnaiah Balaji , Shah Samarth P.
Published: September 2023

Background and Purpose

Hyperglycemia following acute ischemic stroke (AIS) is associated with adverse outcomes including, hemorrhagic conversion and increased length of stay; however, the impact of glycemic variability is largely unknown. This study aims to evaluate the effect of glycemic variability on discharge outcomes in patients treated with alteplase for AIS.

Methods

A retrospective review of ischemic stroke patients who presented within 4.5 hours from symptom onset and received alteplase was completed. Patients hospitalized for at least 48 hours were included. Glycemic variability was measured using J-index. Groups were defined by normal or abnormal J-indices. Logistic regression models were developed to determine odds ratios for select clinical characteristics, NIHSS score, mRS, and disposition at discharge.

Results

Of the 229 patients, 97 (42%) had an abnormal J-index. In the univariate analysis, abnormal J-index was associated with worse outcomes in terms of NIHSS score, mRS, and discharge disposition compared to a normal J-index. In the unadjusted multivariate analysis, abnormal J-index was associated with higher odds of unfavorable mRS (3-6) at discharge (OR 2.1; 95% CI 1.2 – 3.5, P = .009). In the adjusted multivariate analysis, patients with an abnormal J-index had higher odds of hemorrhagic transformation (OR 5.7; 95% CI 2.1 – 15.6, P < .0001). There was no difference in mortality.

Conclusion

Glycemic variability with abnormal J-index following AIS is associated with adverse functional outcomes at discharge and increased odds of hemorrhagic conversion in patients treated with alteplase. Additional studies validating glycemic variability indices post-ischemic stroke are needed to determine the full clinical impact.
Femoroacetabular Impingement and the Effect of Osteochondroplasty on Hip Osteoarthritis Prevention: The Pandora’s Box Opening Process
Authors: Lamo-Espinosa José M. , Gómez-Álvarez Jorge , Pascual Roquet-Jalmar Elena , Iribarren Asier , Recke Anne , Roa María Cruz , Valentí-Azcárate Andrés , Granero-Moltó Froilán , San-Julián Mikel
Published: September 2023

Objective:

This study was conducted to assess the effect of osteochondroplasty on osteoarthritis (OA) prevention, comparing radiological evolution between identical hips from the same patient who had undergone unilateral surgery.

Design:

We retrospectively reviewed radiological evolution between hips with similar shape from the same patient who had undergone unilateral surgery. In all, 56 FAI patients (112 hips) with a mean age of 42.18 ± 9.16 years and had undergone unilateral arthroscopy treatment have been included. Four independent researchers measured Wiberg, Acetabular and Alpha angles, Extrusion index, and Tönnis classification preoperatively to verify that operated and non-operated hips had the same shape. OA evolution was assessed by joint space width (JSW) in 3 different articular points and Tönnis classification.

Results:

No preoperative anatomical differences were present between groups ( P > 0.05). At the end of follow-up (31.9 months), a decrease of JSW in the 3 points measured was found in OP hips (OP vs. N-OP; P < 0.01). These results were correlated with changes in the proportion of patients who progressed to grade III in Tönnis classification (from 1.3% preoperative to 23.2% at the end of follow-up).

Conclusions:

Osteochondroplasty and labrum procedures were not associated with OA prevention. The OP hips showed a faster OA degeneration, which was not seen in the N-OP. These results will encourage hip surgeons to perform further investigations to avoid the “Pandora’s Box Opening Process.”
Parents’ Perspectives on Climate Change Education: A Case Study From New Jersey
Authors: Madden Lauren , Joshi Arti , Wang Margaret , Turner Julia , Lindsay Samantha
Published: September 2023

Purpose

With climate change education becoming more prevalent in schools around the globe, it is increasingly important that we understand parental perspectives on this topic. Children cross the boundaries between home and school culture every day, and their parents’ attitudes, beliefs, and practices can influence their academic engagement in all content areas. In the 2022–2023 academic year, New Jersey (NJ) adopted climate change education standards across grade levels and subject areas. We seek to understand parental perspectives on this curriculum change.

Design/Approach/Methods

In October–November 2022, a survey was distributed to parents of children attending public (state) school in NJ to identify how they discuss, support, and question their children's education about climate change. A total of 83 parents responded to the survey.

Findings

Survey results revealed that parents talk to their children about climate change with the support of various tools and strategies. However, parents expressed concerns about teachers’ preparedness to introduce climate change topics appropriately and their own readiness to support this instruction at home. Furthermore, several respondents voiced concerns about how to approach climate change discussions in a way that is mindful of children's developmental and mental health needs.

Originality/Value

Little is known about the way in which parents view educational innovations affect their implementation. This study examines parents’ perspectives on a novel approach to integrating climate change instruction across subject areas and grade levels.
The ISSG-AO Complication Intervention Score, but Not Major/Minor Designation, is Correlated With Length of Stay Following Adult Spinal Deformity Surgery
Authors: Wick Joseph B. , Blandino Andrew , Smith Justin S. , Line Breton G. , Lafage Virginie , Lafage Renaud , Kim Han Jo , Passias Peter G. , Gum Jeffrey L. , Kebaish Khaled M. , Eastlack Robert K. , Daniels Alan , Mundis Gregory , Hostin Richard , Protopsaltis Themistocles , Hamilton D. Kojo , Kelly Michael P. , Gupta Munish , Hart Robert A. , Schwab Frank J. , Burton Douglas C. , Ames Christopher P. , Lenke Lawrence G. , Shaffrey Christopher I. , Bess Shay , Klineberg Eric ,   International Spine Study Group
Published: September 2023

Study Design

Retrospective review.

Objectives

The International Spine Study Group-AO (ISSG-AO) Adult Spinal Deformity (ASD) Complication Classification System was developed to improve classification, reporting, and study of complications among patients undergoing ASD surgery. The ISSG-AO system classifies interventions to address complications by level of invasiveness: grade zero (none); grade 1, mild (e.g., medication change); grade 2, moderate (e.g., ICU admission); grade 3, severe (e.g., reoperation related to surgery of interest). To evaluate the efficacy of the ISSG-AO ASD Complication Classification System, we aimed to compare correlations between postoperative length of stay (LOS) and complication severity as classified by the ISSG-AO ASD and traditional major/minor complication classification systems.

Methods

Patients age ≥18 in a multicenter ASD database who sustained in-hospital complications were identified. Complications were classified with the major/minor and ISSG-AO systems and correlated with LOS using an ensemble-based machine learning algorithm (conditional random forest) and a generalized linear mixed model.

Results

490 patients at 19 sites were included. 64.9% of complications were major, and 35.1% were minor. By ISSG-AO classification, 20.4%, 66.1%, 6.7%, and 6.7% were grades 0-3, respectively. ISSG-AO complication grading demonstrated significant correlation with LOS, whereas major/minor complication classification demonstrated inverse correlation with LOS. In conditional random forest analysis, ISSG-AO classification had the greatest relative importance when assessing correlations across multiple variables with LOS.

Conclusions

The ISSG-AO system may help identify specific complications associated with prolonged LOS. Targeted interventions to avoid or reduce these complications may improve ASD surgical quality and resource utilization.
Orthopaedic Injury Patterns Related to Ice Skating, Inline Skating, and Roller Skating: A 20-Year Epidemiologic Analysis
Authors: Dhodapkar Meera M. , Halperin Scott J. , Gardner Elizabeth C. , Grauer Jonathan N.
Published: September 2023

Background:

Ice skating, inline skating, and roller skating are popular sports in the United States (US). Although they are similar, injuries incurred may be distinct and may have evolved over time.

Purpose:

To characterize injuries related to ice skating, inline skating, and roller skating and track injury patterns over a 20-year period.

Study Design:

Descriptive epidemiology study.

Methods:

The current study utilized the National Electronic Injury Surveillance System, a database reporting consumer product-related injuries seen at emergency departments in the US. All ice skating, inline skating, and roller skating injuries between 2002 and 2021 were identified, and patient demographics, types of injury, and year of injury were compared between skating types.

Results:

A total of 1,656,746 skating-related injuries were estimated nationally: 24% (403,791) for ice skating, 24% (400,172) for inline skating, and 52% (852,783) for roller skating. While the incidence of ice-skating- and roller-skating-related injuries decreased by 34.4% (from 22,490 in 2002-2004 to 14,758 in 2019-2021) and 29.6% (from 42,452 in 2002-2004 to 31,980 in 2019-2021), respectively, injuries related to inline skating decreased comparatively more, by 75.8% over the study period (from 48,097 in 2002-2004 to 11,662 in 2019-2021). Injuries occurred predominantly to the head/face/neck for ice skating (n = 139,501; 34.5% of injuries), whereas injuries occurred predominantly in the shoulder/arm/elbow/wrist for inline skating (n = 212,088, 53.0% of injuries) and roller skating (n = 425,216, 49.9% of injuries). Fracture was the most common injury type for all 3 skating types (n = 614,853, 37.1% of injuries), and the majority of fractures occurred in the upper extremity (shoulder/arm/elbow/wrist) for all 3 skating types (n = 59,624, 60.0% [ice skating]; n = 69,197, 41.2% [inline skating], and n = 237,099, 68.2% [roller skating]). Lower extremity (leg/knee/ankle) fractures were more common among ice skating (n = 28,019, 28.2%) and roller skating (n = 82,094, 23.6%) injuries compared with inline skating (n = 21,391, 12.7%).

Conclusion:

In the current study, we found that fractures were the most common type of injury regardless of skating type but that the location of the injury/fracture varied by skating type.
Humanizing the Intensive Care Unit: Perspectives of Patients and Families on the Get to Know Me Board
Authors: Ahmad Sumera R. , Rhudy Lori , Fogelson Lindsay A. , LeMahieu Allison M. , Barwise Amelia K. , Gajic Ognjen , Karnatovskaia Lioudmila V.
Published: September 2023

In this qualitative study, we explored perspectives of patients in the intensive care unit (ICU) and their families on the Get to Know Me board (GTKMB). Of the 46 patients approached, 38 consented to participate. Of the 66 family members approached, 60 consented to participate. Most patients (26, 89%) and family members (52, 99%) expressed that GTKMB was important in recognizing patient's humanity. Most patients (20, 68%) and families (39, 74%) said that it helped to build a better relationship with the provider team. 60% of patients and families commented that the GTKMB was used as a platform by providers to interact with them. Up to 45 (85%) of the family members supported specific contents of the GTKMB. In structured interviews (11 patients, 7 family members), participants additionally commented on ways providers used the GTKMB to communicate, support patient's personhood, and on caveats in interacting with GTKMB. Critically ill patients and families found the GTKMB helpful in preserving personhood of patient, fostering communication, and building relationships with clinicians.
Adapting the stages of implementation completion to an evidence-based implementation strategy: The development of the NIATx stages of implementation completion
Authors: Ford James H. , Zehner Mark E. , Schaper Holle , Saldana Lisa
Published: September 2023

Background

Dissemination and implementation frameworks provide the scaffolding to explore the effectiveness of evidence-based practices (EBPs) targeting process of care and organizational outcomes. Few instruments, like the stages of implementation completion (SIC) examine implementation fidelity to EBP adoption and how organizations differ in their approach to implementation. Instruments to measure organizational competency in the utilization of implementation strategies are lacking.

Method

An iterative process was utilized to adapt the SIC to the NIATx implementation strategies. The new instrument, NIATx-SIC, was applied in a randomized controlled trial involving 53 addiction treatment agencies in Washington state to improve agency co-occurring capacity. NIATx-SIC data were reported by state staff and external facilitators and through participating agency documentation. Proportion and duration scores for each stage and phase of the NIATx-SIC were calculated for each agency. Competency was assessed using the NIATx fidelity tool. Comparisons of proportion, duration, and NIATx activities completed were determined using independent sample t-tests by agency competency level.

Results

The NIATx-SIC distinguished between agencies achieving competency ( n  =  23) and those not achieving competency ( n  =  26). Agencies achieving competency completed a greater proportion of implementation phase activities and had a significantly longer Stage 7 duration. These agencies participated in significantly more individual and group coaching calls, attended more in-person meetings, implemented more change projects, and spent approximately 64 more days, on average, engaging in all NIATx activities.

Conclusions

Organizational participation in dissemination and implementation research requires a significant investment of staff resources. The inability of an organization to achieve competency when utilizing a set of implementation strategies waste an opportunity to institutionalize knowledge of how to apply implementation strategies to future change efforts. The NIATx-SIC provides evidence that competency is not an attribute of the organization but rather a result of the application of the NIATx implementation strategies to improve agency co-occurring capacity.

Trial Registration

ClinicalTrials.gov, NCT03007940. Registered January 2, 2017, https://clinicaltrials.gov/ct2/show/NCT03007940
Out-of-plane shear strength of cross-laminated timber made of Japanese Larch (Larix kaempferi) with various layups and spans
Authors: Kawaai Yasuhiro , Takanashi Ryuya , Ishihara Wataru , Ohashi Yoshinori , Sawata Kei , Sasaki Takanobu
Published: September 2023

Cross-laminated timber (CLT) is a promising construction material. When CLT is used for horizontal applications, shear stress occurs in the out-of-plane direction and can fracture the transverse layers owing to the rolling shear. The out-of-plane shear strength of the CLT can be evaluated by an out-of-plane loading test and is affected by the CLT layups and/or span conditions. In this study, we conducted out-of-plane loading tests on 3-layer 4-ply, 5-layer 7-ply, 7-layer 7-ply, and 9-layer 9-ply CLT made of Japanese larch (Larix kaempferi) under various spans and investigated the effect of layups and spans on the out-of-shear strength. The fracture modes of the specimens were classified into three types: shear fracture, shear fracture accompanied by bending fracture, and bending fracture. The out-of-plane shear strength of the specimens except for the 9-layer 9-ply ones decreased as the span increased, and then converged to a constant value (1.0–1.5 kN/mm2). In addition, the shear strength decreased exponentially as the number of laminae in the transverse layers increased and then converged to a constant value (1.0–1.5 kN/mm2). The out-of-plane shear strength of the 9-layer 9-ply specimens decreased as the shear span increased; however, the converged value with a longer span could not be calculated because the tests were conducted under only three-span conditions. The shear strength of 3-layer 4-ply specimens was lower than that of the other layups. The results of the Monte Carlo simulation of the shear strength of the laminae in the transverse layers showed that a model, which assumed that the minimum shear strength of the laminae in the transverse layers determined the shear strength of a specimen, tended to correspond with the decreasing tendency of shear strength with longer spans. The results showed that the weakest link model for the out-of-plane shear fracture of the CLT would relate to a specimen with long span.
Phase prediction, microstructure, and mechanical properties of spark plasma sintered Ni–Al–Ti–Mn–Co–Fe–Cr high entropy alloys
Authors: Olorundaisi Emmanuel , Babalola Bukola J. , Teffo Moipone L. , Anamu Ufoma S. , Olubambi Peter A. , Fayomi Juwon , Ogunmefun Anthony O.
Published: September 2023

The effect of mechanical alloying on the development of Ni–Al–Ti–Mn–Co–Fe–Cr high entropy alloys (HEAs) utilizing the spark plasma sintering (SPS) method is the main goal of this study. A bulk sample was fabricated using SPS after the alloys were mixed for 12 h. Thermodynamic simulation, X-ray diffraction, scanning electron microscopy, nanoindentation, and microhardness were used to investigate the microstructure and mechanical properties of the as-mixed powders. The master alloy was made of NiAl and was subsequently alloyed with Ti, Mn, Co, Fe, and Cr at different compositions to develop HEAs at a sintering temperature of 850 °C, a heating rate of 100 °C/min, a pressure of 50 MPa, and a dwelling time of 5 min. A uniform dispersion of the alloying material can be seen in the microstructure of the sintered HEAs with different weight elements. The grain size analysis shows that the Ni25Al25Ti8Mn8Co15Fe14Cr5 alloy exhibited a refined structure with a grain size of 2.36 ± 0.27 µm compared to a coarser grain size of 8.26 ± 0.43 μm attained by the NiAl master alloy. Similarly, the HEAs with the highest alloying content had a greater microstrain value of 0.0449 ± 0.0036, whereas the unalloyed NiAl had 0.00187 ± 0.0005. Maximum microhardness of 139 ± 0.8 HV, nanohardness of 18.8 ± 0.36 GPa, elastic modulus of 207.5 ± 1.65 GPa, elastic recovery (We/Wt) of 0.556 ± 0.035, elastic strain to failure (H/Er) of 0.09.06 ± 0.0027, yield pressure (H3/$$E_{{\text{r}}}^{2}$$

E

r

2

) of 0.154 ± 0.0055 GPa, and the least plasticity index (Wp/Wt) of 0.444 ± 0.039 were attained by Ni25Al25Ti8Mn8Co15Fe14Cr5. A steady movement to the left may be seen in the load–displacement curve. Increased resistance to indentation by the developed HEAs was made possible by the increase in alloying metals, which ultimately led to higher nanohardness and elastic modulus.
Respiration kinetics and allometric scaling in the demosponge Halichondria panicea
Authors: Kumala Lars , Thomsen Malte , Canfield Donald E.
Published: September 2023

Background

The aquiferous system in sponges represents one of the simplest circulatory systems used by animals for the internal uptake and distribution of oxygen and metabolic substrates. Its modular organization enables sponges to metabolically scale with size differently than animals with an internal circulatory system. In this case, metabolic rate is typically limited by surface to volume constraints to maintain an efficient supply of oxygen and food. Here, we consider the linkeage between oxygen concentration, the respiration rates of sponges and sponge size.

Results

We explored respiration kinetics for individuals of the demosponge Halichondria panicea with varying numbers of aquiferous modules (nmodules = 1–102). From this work we establish relationships between the sponge size, module number, maximum respiration rate (Rmax) and the half-saturation constant, Km, which is the oxygen concentration producing half of the maximum respiration rate, Rmax. We found that the nmodules in H. panicea scales consistently with sponge volume (Vsp) and that Rmax increased with sponge size with a proportionality > 1. Conversly, we found a lack of correlation between Km and sponge body size suggesting that oxygen concentration does not control the size of sponges.

Conclusions

The present study reveals that the addition of aquiferous modules (with a mean volume of 1.59 ± 0.22 mL) enables H. panicea in particular, and likely demosponges in general, to grow far beyond constraints limiting the size of their component modules and independent of ambient oxygen levels.
Molecular detection of Sodalis glossinidius, Spiroplasma species and Wolbachia endosymbionts in wild population of tsetse flies collected in Cameroon, Chad and Nigeria
Authors: Mfopit Youssouf Mouliom , Engel Judith Sophie , Chechet Gloria Dada , Ibrahim Mahamat Alhadj Moussa , Signaboubo Djoukzoumka , Achukwi Daniel Mbunkah , Mamman Mohammed , Balogun Emmanuel Oluwadare , Shuaibu Mohammed Nasir , Kabir Junaidu , Kelm Soerge
Published: September 2023

Background

Tsetse flies are cyclical vectors of African trypanosomiasis (AT). The flies have established symbiotic associations with different bacteria that influence certain aspects of their physiology. Vector competence of tsetse flies for different trypanosome species is highly variable and is suggested to be affected by bacterial endosymbionts amongst other factors. Symbiotic interactions may provide an avenue for AT control. The current study provided prevalence of three tsetse symbionts in Glossina species from Cameroon, Chad and Nigeria.

Results

Tsetse flies were collected and dissected from five different locations. DNA was extracted and polymerase chain reaction used to detect presence of Sodalis glossinidius, Spiroplasma species and Wolbachia endosymbionts, using species specific primers. A total of 848 tsetse samples were analysed: Glossina morsitans submorsitans (47.52%), Glossina palpalis palpalis (37.26%), Glossina fuscipes fuscipes (9.08%) and Glossina tachinoides (6.13%). Only 95 (11.20%) were infected with at least one of the three symbionts. Among infected flies, six (6.31%) had Wolbachia and Spiroplasma mixed infection. The overall symbiont prevalence was 0.88, 3.66 and 11.00% respectively, for Sodalis glossinidius, Spiroplasma species and Wolbachia endosymbionts. Prevalence varied between countries and tsetse fly species. Neither Spiroplasma species nor S. glossinidius were detected in samples from Cameroon and Nigeria respectively.

Conclusion

The present study revealed, for the first time, presence of Spiroplasma species infections in tsetse fly populations in Chad and Nigeria. These findings provide useful information on repertoire of bacterial flora of tsetse flies and incite more investigations to understand their implication in the vector competence of tsetse flies.
The influence of stress factors on selected phenotypic and genotypic features of Listeria monocytogenes – a pilot study
Authors: Wiktorczyk-Kapischke Natalia , Wałecka-Zacharska Ewa , Korkus Jakub , Grudlewska-Buda Katarzyna , Budzyńska Anna , Wnuk Kacper , Gospodarek-Komkowska Eugenia , Skowron Krzysztof
Published: September 2023

Background

Listeria monocytogenes are Gram-positive rods, widespread in the environment due to their wide tolerance to changing conditions. The apilot study aimed to assess the impact of six various stresses (heat, cold, osmotic, acid, alkali, frozen) on phenotypic features: MIC of antibiotics (penicillin, ampicillin, meropenem, erythromycin, co-trimoxazole; gradient stripes), motility, ability to form a biofilm (crystal violet method) and growth rate (OD and quantitative method), expression level of sigB (stress induced regulator of genes), agrA, agrB (associated with biofilm formation) and lmo2230, lmo0596 (acid and alkali stress) (qPCR) for three strains of L. monocytogenes.

Results

Applied stress conditions contributed to changes in phenotypic features and expression levels of sigB, agrA, agrB, lmo2230 and lmo0596. Stress exposure increased MIC value for penicillin (ATCC 19111 - alkaline stress), ampicillin (472CC - osmotic, acid, alkaline stress), meropenem (strains: 55 C - acid, alkaline, o smotic, frozen stress; 472CC - acid, alkaline stress), erythromycin (strains: 55 C - acid stress; 472CC - acid, alkaline, osmotic stress; ATCC 19111 - osmotic, acid, alkaline, frozen stress), co-trimoxazole (strains: 55 C - acid stress; ATCC 19111 - osmotic, acid, alkaline stress). These changes, however, did not affect antibiotic susceptibility. The strain 472CC (a moderate biofilm former) increased biofilm production after exposure to all stress factors except heat and acid. The ATCC 19111 (a weak producer) formed moderate biofilm under all studied conditions except cold and frozen stress, respectively. The strain 55 C became a strong biofilm producer after exposure to cold and produced a weak biofilm in response to frozen stress. Three tested strains had lower growth rate (compared to the no stress variant) after exposure to heat stress. It has been found that the sigB transcript level increased under alkaline (472CC) stress and the agrB expression increased under cold, osmotic (55 C, 472CC), alkali and frozen (472CC) stress. In contrast, sigB transcript level decreased in response to acid and frozen stress (55 C), lmo2230 transcript level after exposure to acid and alkali stress (ATCC 19111), and lmo0596 transcript level after exposure to acid stress (ATCC 19111).

Conclusions

Environmental stress changes the ability to form a biofilm and the MIC values of antibiotics and affect the level of expression of selected genes, which may increase the survival and virulence of L. monocytogenes. Further research on a large L. monocytogenes population is needed to assess the molecular mechanism responsible for the correlation of antibiotic resistance, biofilm formation and resistance to stress factors.
Maize-legume intercropping achieves yield advantages by improving leaf functions and dry matter partition
Authors: Fu Zhidan , Chen Ping , Zhang Xiaona , Du Qing , Zheng Benchuan , Yang Huan , Luo Kai , Lin Ping , Li Yiling , Pu Tian , Wu Yushan , Wang Xiaochun , Yang Feng , Liu Weiguo , Song Chun , Yang Wenyu , Yong Taiwen
Published: September 2023

Intercropping can obtain yield advantages, but the mechanism of yield advantages of maize-legume intercropping is still unclear. Then, we explored the effects of cropping systems and N input on yield advantages in a two-year experiment. Cropping systems included monoculture maize (Zea mays L.) (MM), monoculture soybean (Glycine max L. Merr.) (MS), monoculture peanut (Arachis hypogaea L.) (MP), maize-soybean substitutive relay intercropping (IMS), and maize-peanut substitutive strip intercropping (IMP). N input included without N (N0) and N addition (N1). Results showed that maize’s leaf area index was 31.0% and 34.6% higher in IMS and IMP than in MM. The specific leaf weight and chlorophyll a (chl a) of maize were notably higher by 8.0% and 18.8% in IMS, 3.1%, and 18.6% in IMP compared with MM. Finally, N addition resulted in a higher thousand kernels weight of maize in IMS and IMP than that in MM. More dry matter accumulated and partitioned to the grain, maize's averaged partial land equivalent ratio and the net effect were 0.76 and 2.75 t ha−1 in IMS, 0.78 and 2.83 t ha−1 in IMP. The leaf area index and specific leaf weight of intercropped soybean were 16.8% and 26% higher than MS. Although soybean suffers from shade during coexistence, recovered growth strengthens leaf functional traits and increases dry matter accumulation. The averaged partial land equivalent ratio and the net effect of intercropped soybean were 0.76 and 0.47 t ha−1. The leaf area index and specific leaf weight of peanuts in IMP were 69.1% and 14.4% lower than in the MP. The chlorophyll a and chlorophyll b of peanut in MP were 17.0% and 24.4% higher than in IMP. A less dry matter was partitioned to the grain for intercropped peanut. The averaged pLER and NE of intercropped peanuts were 0.26 and -0.55 t ha−1. In conclusion, the strengthened leaf functional traits promote dry matter accumulation, maize-soybean relay intercropping obtained a win–win yield advantage, and maize-peanut strip intercropping achieved a trade-off yield advantage.
Brain structural correlates of postoperative axial pain in degenerative cervical myelopathy patients following posterior cervical decompression surgery: a voxel-based morphometry study
Authors: Tian Aixian , Gao Hongzhi , Wang Zhan , Li Na , Ma Jianxiong , Guo Lin , Ma Xinlong
Published: September 2023

Objective

To investigate the brain structural correlates of postoperative axial pain (PAP) in degenerative cervical myelopathy (DCM) following posterior cervical decompression surgery.

Methods

Structural images with high-resolution T1 weighting were collected from 62 patients with DCM and analyzed, in addition to 42 age/gender matched subjects who were healthy. Voxel-based morphometry (VBM) was analyzed, grey matter volume (GMV) was computed. One-way ANOVA was performed to reveal the GMV differences among DCM patients with PAP, patients without PAP and healthy controls (HC). Post-hoc analyses were conducted to identify the pair-wise GMV differences among these three groups. Analyses of correlations were conducted to uncover the link between clinical measurements and GMV variations. Last, support vector machine (SVM) was conducted to test the utility of GMV for classifying PAP and nPAP DCM patients.

Results

Three main findings were observed: [1] Compared to healthy controls, DCM patients showed a significantly lower GMV in the precuneus preoperatively. DCM patients with PAP also exhibited a lower GMV within precuneus than those without; [2] In DCM patients with PAP, the precuneus GMV was inversely related to the postoperative pain intensity; [3] Moreover, successful classification between PAP and nPAP were observed via SVM based on precuneus GMV as features.

Conclusion

In summary, our results indicate that precuneus GMV may be linked to PAP in DCM, and could be employed to forecast the emergence of PAP in DCM patients.
Delineation and detection of breast cancer using novel label-free fluorescence
Authors: Mahmoud Alaaeldin , El-Sharkawy Yasser H.
Published: September 2023

Background

Accurate diagnosis of breast cancer (BC) plays a crucial role in clinical pathology analysis and ensuring precise surgical margins to prevent recurrence.

Methods

Laser-induced fluorescence (LIF) technology offers high sensitivity to tissue biochemistry, making it a potential tool for noninvasive BC identification. In this study, we utilized hyperspectral (HS) imaging data of stimulated BC specimens to detect malignancies based on altered fluorescence characteristics compared to normal tissue. Initially, we employed a HS camera and broadband spectrum light to assess the absorbance of BC samples. Notably, significant absorbance differences were observed in the 440–460 nm wavelength range. Subsequently, we developed a specialized LIF system for BC detection, utilizing a low-power blue laser source at 450 nm wavelength for ten BC samples.

Results

Our findings revealed that the fluorescence distribution of breast specimens, which carries molecular-scale structural information, serves as an effective marker for identifying breast tumors. Specifically, the emission at 561 nm exhibited the greatest variation in fluorescence signal intensity for both tumor and normal tissue, serving as an optical predictive biomarker. To enhance BC identification, we propose an advanced image classification technique that combines image segmentation using contour mapping and K-means clustering (K-mc, K = 8) for HS emission image data analysis.

Conclusions

This exploratory work presents a potential avenue for improving "in-vivo" disease characterization using optical technology, specifically our LIF technique combined with the advanced K-mc approach, facilitating early tumor diagnosis in BC.
Knowledge and practices of preconception care among rural Japanese women: findings from a mixed methods investigation
Authors: Shibata Yasumi , Abe Michiko , Narumoto Keiichiro , Kaneko Makoto , Tanahashi Nobuko , Fetters Michael D. , Inoue Machiko
Published: September 2023

Background

Preconception care is not widespread in Japan and there is a pressing need to improve the practice. The present study assessed the knowledge and behavior of preconception care among women to seek effective intervention. Our research questions were: 1) How much do women know about preconception care? 2) How much are they practicing preconception care and what are the information sources of their behavior? 3) Do the women's preconception care behavior associated with accurate knowledge?

Methods

The research was conducted in a rural town in central Japan. Using an exploratory sequential mixed methods design, we undertook interviews, developed a survey based on the qualitative results, and then conducted a survey. The interviews explored how preconception care was perceived and practiced in women of childbearing age. The survey was designed to investigate the knowledge of preconception care among women with and without pregnancy experience, their practice behavior of preconception care, and whether the behavior is associated with knowledge.

Results

The participants were 13 for the interview and 232 for the survey. They had limited access to preconception care recommendations and advice for specific actions was given by obstetricians and gynecologists after pregnancy. There was a large gap in knowledge about preconception care between parous and nulliparous women, especially about the need for folic acid supplementation. Practices that were manageable in their daily lives, such as cessation of smoking and alcohol, diet, and weight management, were considered common sense. In contrast, recommended practices that require medical attention, such as screening for sexually transmitted diseases and cervical cancer, tended to be less accurately known and practiced. Participants' sources of information about preconception care were the Internet, family and friends and mass media.

Conclusion

In rural Japan, women of childbearing age lack knowledge about preconception care, especially before their first pregnancy. Primary care providers should try outreach to schools and women’s groups in the community, promote information sharing among family and close friends, and utilize information technology to enhance the knowledge and practice of preconception care.
Association of epidural analgesia during labor and early postpartum urinary incontinence among women delivered vaginally: a propensity score matched retrospective cohort study
Authors: Xu Chuangchuang , Wang Xianjing , Chi Xiaolei , Chen Yiyao , Chu Lei , Chen Xinliang
Published: September 2023

Background

Although epidural analgesia is considered the gold standard for pain relief during labor and is safe for maternity and fetus, the association between the epidural analgesia and pelvic floor disorders remains unclear. Thus we estimate the association between epidural analgesia and early postpartum urinary incontinence (UI).

Methods

A propensity score-matched retrospective cohort study was conducted at a university-affiliated hospital in Shanghai, China. Primiparous women with term, singleton, and vaginal delivery between December 2020 and February 2022 were included. UI was self-reported by maternity at 42 to 60 days postpartum and was classified by International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Using logistic regression models, the associations between epidural analgesia and early postpartum UI were assessed.

Results

Among 5190 participants, 3709 (71.5%) choose epidural anesthesia during labor. Analysis of the propensity-matched cohort (including 1447 maternal pairs) showed epidural anesthesia during labor was independently associated with UI in early postpartum period (aOR 1.50, 95% CI 1.24–1.81). This association was mainly contributed to stress UI (aOR 1.38, 95% CI 1.12–1.71) rather than urge UI (aOR 1.45, 95% CI 0.99–2.15) and mixed UI (aOR 1.52, 95% CI 0.95–2.45). Furthermore, we observed that the association between epidural anesthesia and UI was more pronounced among older women (≥ 35 y) and women with macrosomia (infant weight ≥ 4000 g), compared with their counterparts (both P for interaction < 0.01). After further analysis excluding the women with UI during pregnancy, the results remained largely consistent with the main analysis.

Conclusions

The findings support that epidural anesthesia was associated with SUI in the early postpartum period.
Factors affecting pregnancy registration in India: does the pregnancy intention matter?
Authors: Mondal Sourav , Anand Abhishek , Awasthi Niharika , Singh Bharti , Pradhan Manas Ranjan
Published: September 2023

Background

Pregnancy registration is one of the most critical components of women’s reproductive health because it is the gateway to entering the continuum of care services such as antenatal care, institutional delivery, and postnatal care. There is a lack of studies exploring the relationship between pregnancy intention and pregnancy registration, especially in the Indian context.

Method

This study used the National Family Health Survey-5 (2019-21) data to explore the relationship between birth intention and failure of pregnancy registration. The bivariate and multivariate (binary logistic regression) analysis was carried out.

Results

Adjusting the effects of socio-demographic and economic characteristics, compared with women with an intended pregnancy, the odds of failure of pregnancy registration were significantly high among women with a mistimed pregnancy (OR = 1.60, 95% CI = 1.47–1.73) and unwanted pregnancy (OR = 1.38, 95% CI = 1.26–1.52). The study found pregnancy intention as a significant predictor of pregnancy registration.

Conclusions

Results suggest strengthening the interaction of grassroots-level health workers with women, especially those with possibly lower healthcare autonomy and unintended pregnancy. Higher and earlier pregnancy registration will enhance maternal healthcare utilization and reduce adverse health consequences to mothers and children, thus ensuring better maternal and child health.
Incidence and predictors of mortality among neonates admitted with perinatal asphyxia at west Oromia tertiary hospitals, Ethiopia, 2022
Authors: Daka Dawit Tesfaye , Wubneh Chalachew Adugna , Alemu Tewodros Getaneh , Terefe Bewuketu
Published: September 2023

Background

Perinatal asphyxia is one of the preventable and treatable causes of neonatal mortality. However, it is the fifth-largest cause of under-five mortality. Even with management advancements, it remains one of the key public health issues in underdeveloped countries, including Ethiopia. Comorbidities are also understated; therefore, adequate information regarding the incidence of death and its predictors is required.

Methods

A four-year retrospective follow-up study was conducted from October 3 to November 2, 2022. From a total sample size, of 655, 616 data were collected by nurse through follow-up reviews charts using Kobo Toolbox software. The data was exported to STATA Version 14 for analysis. The Cox proportional hazard assumption was checked, and the model for the data was selected using Akaike Information Criteria. Finally, an adjusted hazard ratio with 95% CI was computed, and variables with a P-value < 0.05 in the multivariable analysis were taken as significant predictors of death.

Result

The overall incidence of mortality was 38.86/1000 (95% CI: 33.85–44.60). The median time of follow-up was 15 days (95% CI: 14–20). The proportion of deaths was 202 (32.79%, 95% CI: 29.18–36.61) among neonates with perinatal asphyxia. While the distance from health facility > 10 km is (AHR: 2.25; 95% CI: 1.60–3.17), direct oxygen (AHR: 1.83; 95% CI: 1.35–2.48), APGAR score (Appearance, Pulse, Grimace, Activity, and Respiration) < 3 at the fifth minute (AHR: 2.63; 95% CI: 1.03–6.73), prolonged rupture of membrane (AHR: 1.41; 95% CI: 1.02–1.94), and stage III hypoxic ischemic encephalopathy (AHR: 2.02; 95% CI: 1.18–3.47) were predictors of mortality among neonates with perinatal asphyxia.

Conclusion

According to this study’s findings, high neonatal mortality due to perinatal asphyxia requires proper intervention regarding membrane rupture, APGAR score (Appearance, Pulse, Grimace, Activity, and Respiration), oxygen use, stage III hypoxic-ischemic encephalopathy, and residence distance.
Association between the rs6313 polymorphism in the 5-HTR2A gene and the efficacy of antipsychotic drugs
Authors: Wang Yulong , Tan Xingru , Chen Zhoufangyuan , Zhang Bide , Gao Yunzhi , Wang Yanlong
Published: September 2023

Background

Prescribing the optimal antipsychotic treatment to schizophrenia is very important as it is well established that patients have different sensitivity to the available antipsychotic drugs. The genotype of the HTR2A T102C (rs6313) polymorphism has been suggested to affect the efficacy of antipsychotic drugs, but the results of different studies have been inconsistent

Methods

In this study, a meta-analysis was used to ascertain the association between allele and genotype polymorphism of rs6313 and the efficacy of antipsychotic drugs. Related studies publicated from January 1995 to December 2021 were retrieved from PubMed, Embase, ScienceDirect, and Web of Science databases. The correlations between allele and genotype polymorphism of rs6313 and the responder rate and scale score reduction rate of antipsychotics were analyzed. In addition, subgroup analyses were performed on time, drug, and ethnicity.

Results

A total of 18 studies were included. The meta-analysis showed that allele and genotype polymorphisms at the rs6313 locus overall were not associated with antipsychotic drug responder rate or scale score reduction rate. Ethnicity subgroup analysis showed that antipsychotic drugs were more effective in patients with allele T in the Caucasian population. Indian patients with the TT genotype had the lowest scale score reduction rate and poor drug treatment effect. East Asian patients with the TC genotype had better treatment effect, whereas in patients with the CC genotype, the treatment was less effective. Drug subgroup analysis showed that patients with the TC genotype treated with clozapine had the highest responder rate and score reduction rate.

Conclusions

The association between rs6313 polymorphism and the efficacy of antipsychotic drugs is mainly influenced by drug and ethnicity. Caucasian patients with the T allele respond better to drug therapy, and Asian patients with TC genotype. The TC genotype was also a good predictor of the efficacy of clozapine treatment.
Temporal and spatial patterns of recurrence in oral squamous cell carcinoma, a single-center retrospective cohort study in China
Authors: Wang Yannan , Yang Tianru , Gan Chengwen , Wang Kai , Sun Bincan , Wang Mengxue , Zhu Feiya
Published: September 2023

Background

Oral squamous cell carcinoma (OSCC) is an invasive cancer with a high recurrence rate. Most clinical studies have focused on the prognosis of patients with OSCC, few have investigated the causes and interventions that affect the recurrence. Our study is to explore the temporal and spatial patterns of recurrence in OSCC.

Methods

234 OSCC patients with recurrence in our hospital and 64 OSCC patients with recurrence in TCGA database were included in the study. Log-rank test and Multivariate Cox Regression Analysis were used to determine whether there was a significant difference between each selected demographic or clinical factors and recurrence. The Kaplan–Meier method was used to plot survival curves for each recurrence interval.

Results

The proportion of OSCC patients in clinical and TCGA with early recurrence was 93.6% and 84.4%, respectively. Age, chewing betel nut, previous radiotherapy, histopathological grading of the primary tumor (poorly differentiated), lymph node metastasis and postoperative infection were found to be associated with the timing of recurrence. It was found that tongue cancer has more regional recurrences, while buccal cancer is mostly local and loco-regional recurrences. The earlier the recurrence, the greater the possibility of local-regional recurrence and the worse the prognosis.

Conclusion

Most of recurrent OSCC patients present early recurrence (< 18 months) with poor prognosis, and early recurrence is more prone to local recurrence. Moreover, recurrence site is related with primary site of OSCC.
Acquisition of temporal patterns from electronic health records: an application to multimorbid patients
Authors: Ageno Alicia , Català Neus , Pons Marcel
Published: September 2023

Background

The exponential growth of digital healthcare data is fueling the development of Knowledge Discovery in Databases (KDD). Extracting temporal relationships between medical events is essential to reveal hidden patterns that can help physicians find optimal treatments, diagnose illnesses, detect drug adverse reactions, and more. This paper presents an approach for the extraction of patient evolution patterns from electronic health records written in Catalan and/or Spanish.

Methods

We propose a robust formulation for extracting Temporal Association Rules (TARs) that goes beyond simple rule extraction by considering the sequence of multiple visits. Our highly configurable algorithm leverages this formulation to extract Temporal Association Rules from sequences of medical instances. We can generate rules in the desired format, content, and temporal factors while accounting for different levels of abstraction of medical instances. To demonstrate the effectiveness of our methodology, we applied it to extract patient evolution patterns from clinical histories of multimorbid patients suffering from heart disease and stroke who visited Primary Care Centers (CAP) in Catalonia. Our main objective is to uncover complex rules with multiple temporal steps, that comprise a set of medical instances.

Results

As we are working with real-world, error-prone data, we propose a process of validation of the results by expert practitioners in primary care. Despite our limited dataset, the high percentage of patterns deemed correct and relevant by the experts is promising. The insights gained from these patterns can inform preventive measures and help detect risk factors, ultimately leading to better treatments and outcomes for patients.

Conclusion

Our algorithm successfully extracted a set of meaningful and relevant temporal patterns, especially for the specific type of multimorbid patients considered. These patterns were evaluated by experts and demonstrated the ability to predict risk factors that are commonly associated with certain diseases. Moreover, the average time gap between the occurrence of medical events provided critical insight into the term of these risk factors. This information holds significant value in the context of primary healthcare and preventive medicine, highlighting the potential of our method to serve as a valuable medical tool.