bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of educational intervention on medication reconciliation practice of hospital pharmacists in a developing country - A non-randomised controlled trial
Authors: Aje Akinniyi A. , Showande Segun J. , Adisa Rasaq , Fakeye Titilayo O. , Olutayo Oluwakemi A. , Adebusoye Lawrence A. , Olowookere Olufemi O.
Published: May 2023

Background: Medication reconciliation is an evidence-based practice that reduces medication-related harm to patients. This study evaluated the effect of educational intervention on medication reconciliation practice of pharmacists among ambulatory diabetes and hypertensive patients.
Methods: A non-randomized clinical trial on medication reconciliation practice was carried out among 85 and 61 pharmacists at the intervention site and control site, respectively. Medication reconciliation was carried out among 334 (intervention-183; control-151) diabetes and/or hypertensive patients by the principal investigator to indirectly evaluate pharmacists’ baseline medication reconciliation practice at both sites. A general educational intervention was carried out among intervention pharmacists. Medication reconciliation was carried out by the principal investigator among another cohort of 96 (intervention-46; control-50) and 90 (intervention-44; control-46) patients at three and six months postintervention, respectively, to indirectly assess pharmacists’ postintervention medication reconciliation practice. Thereafter, a focused educational intervention was carried out among 15 of the intervention pharmacists. Three experts in clinical pharmacy analysed the medication reconciliation form filled by the 15 pharmacists after carrying out medication reconciliation on another cohort of 140 patients, after the focused intervention. Data was summarized with descriptive and inferential statistics with level of significance set at p<0.05.
Key findings: Baseline medication reconciliation practice was poor at both sites. Post-general educational intervention, medication discrepancy was significantly reduced by 42.8% at the intervention site (p<0.001). At the intervention site, a significant increase of 54.3% was observed in patients bringing their medication packs for clinic appointments making medication reconciliation easier (p=0.003), at 6-months postintervention. Thirty-five, 66 and 48 drug therapy problems were detected by 31 (43.1%), 33 (66.0%) and 32 (71.1%) intervention pharmacists at 1-, 3- and 6-month post-general educational intervention, respectively. Post-focused educational intervention, out of a total of 695 medications prescribed, 75 (10.8%) medication discrepancies were detected and resolved among 42 (30%) patients by the 15 pharmacists.
Conclusions: The educational interventions improved pharmacists’ medication reconciliation practice at the intervention site.
Repetitive and compulsive behavior after Early-Life-Pain associated with reduced long-chain sphingolipid species
Authors: Vogel Alexandra , Ueberbach Timo , Wilken-Schmitz Annett , Hahnefeld Lisa , Franck Luisa , Weyer Marc-Philipp , Jungenitz Tassilo , Schmid Tobias , Buchmann Giulia , Freudenberg Florian , Brandes Ralf P. , Gurke Robert , Schwarzacher Stephan W. , Geisslinger Gerd , Mittmann Thomas , Tegeder Irmgard
Published: May 2023

Background Pain in early life may affect cortical development and risk of chronic pain. We developed an optogenetic Cre/loxP mouse model of "early-life-pain" (ELP) using mice with transgenic expression of channelrhodopsin-2 (ChR2) under control of the Advillin (Avil) promoter, which drives expression of transgenes predominantly in isolectin B4 positive non-peptidergic nociceptors in postnatal mice. Avil-ChR2 (Cre+) and ChR2-flfl control mice were exposed to blue light in a chamber once daily from P1-P5 together with their Cre-negative mother.Results ELP caused cortical hyperexcitability at P8-9 as assessed via multi-electrode array recordings that coincided with reduced expression of synaptic genes (RNAseq) including Grin2b, neurexins, piccolo and voltage gated calcium and sodium channels, suggesting activity-dependent synaptic pruning. Young adult (8–16 wks) Avil-ChR2 mice presented with nociceptive hypersensitivity upon heat or mechanical stimulation, which did not resolve up until one year of age. The persistent "pain" phenotype was reflected by capsaicin hypersensitivity in primary sensory neurons of aged mice (1 year) as assessed by calcium imaging. Adult Avil-ChR2 mice behaved like controls in maze tests of anxiety, social interaction, and spatial memory but IntelliCage behavioral studies revealed repetitive nosepokes and corner visits and compulsive lickings. Compulsiveness at the behavioral level was associated with a reduction of sphingomyelin species in brain and plasma lipidomic studies.Conclusion The results suggest that ELP may predispose to chronic pain and compulsive psychopathology in part mediated by alterations of sphingolipid metabolism, which have been previously described in the context of addiction and psychiatric diseases.
Analysis of risk factors for Chlamydia psittaci pneumonia combined with fungal infection and a comparison of drug efficacy
Authors: Zhou Qifeng , Zhou Zhiyu , Jiang Bing , Zeng Xin , Tong Jin
Published: May 2023

Background During our clinical practice, some patients with Chlamydia psittaci pneumonia were found to have secondary pulmonary fungal infections; consequently, this study analyzed the risk factors for their combined pulmonary fungal infections. We also compared the efficacy of tetracycline and moxifloxacin in the treatment of C. psittaci pneumonia to guide the treatment of this disease.Methods Eighty cases of C. psittaci pneumonia in Chongqing were selected and divided into a non-fungal group (56 cases) and a fungal group (24 cases) according to the combination of pulmonary fungal infection. The risk factors for combined pulmonary fungal infection were analyzed. According to the type of medication used, the patients were divided into five treatment groups, including (I) 12 cases of omadacycline, (II) 12 cases of tigecycline, (III) 10 cases of doxycycline, (IV) 8 cases of minocycline, and (V) 38 cases of moxifloxacin, and the efficacy of the drugs was compared.Results (1) Comparisons of factors, including hospitalization cost, length of stay, and duration of fever, showed that, first, the prognosis of the non-fungal group was better than that of the fungal group, and second, there were statistically significant differences between the two groups in the use of broad-spectrum antibacterial drugs; the co-administration of antimicrobials; combined structural lung disease, diabetes mellitus, and liver disease; and serum ferritin levels at admission. A logistic regression analysis showed the co-administration of antimicrobials; combined structural lung disease, diabetes mellitus, and liver disease; and relatively low serum ferritin were independent risk factors for combined pulmonary fungal infections. (2) Comparison of drug efficacy: The white blood cell count in Group I was better than in groups II and V, while fever, imaging improvement, and calcitoninogen decrease time in Group I were significantly better than in groups II, III, IV, and V. The cost in Group V was lower than in groups I, II, and III, and no significant difference was seen in the occurrence of major adverse reactions.Conclusions Patients with C. psittaci pneumonia who are co-administered with antimicrobials and are combined with structural lung disease, diabetes mellitus, and liver disease along with relatively low serum ferritin need to be alerted to combined pulmonary fungal infections. The efficacy of tetracyclines in treating such infections is more pronounced than that of other drugs, while the cost of moxifloxacin is lower than that of other antibiotics.
Existence of periodic wave of a BBM equation with delay convection and weak diffusion
Authors: Wei Minzhi , He Liping
Published: May 2023

This paper focus on the existence and uniqueness of periodic waves for a BBM equation with local strong generic delay convection and weak diffusion. By analyzing the corresponding Hamiltonian system, we aim to obtain the existence of periodic orbit by constructing a locally invariant manifold according to geometric singular perturbation theory. Chebyshev criteria is applied to investigate the ratio of Abelian integrals. We prove the existence and uniqueness of periodic wave solution with sufficiently small perturbation parameter. Moreover, the upper and lower bounds of the limiting wave speed are given.
Mathematics Subject Classification (2020) 34C25 · 34C60 · 37C27
Cross-species application of the lumbar intervertebral disc radiomics model in humans and cynomolgus monkeys
Authors: Gao Manman , Wang Jianmin , Guo Lei , Li Jianfeng , Zhou Jiaxiang , Li Junhong , Li Haizhen , Zhu Zhengya , Tang Tao , Li Xianlong , Wang Wentao , Liu Shaoyu , Zhou Zhiyu , Liu Zhiguo , Xi Yongming
Published: May 2023

Nonhuman primates are ideal animal models for studying intervertebral disc degeneration. Radiomics technology could be used to accurately evaluate intervertebral disc degeneration, which is the basis for disc-related studies. In the study of nonhuman primates, the number of precious animals is limited, which cannot meet the sample size requirements of radiomics for study subjects, while these radiomics models could be obtained more easily in humans. Therefore, it is possible to construct radiomics models based on human intervertebral disc data, and then apply the models to nonhuman primates. However, cross-species application of the radiomics models has not previously been well established in the literature. Here we show that a total of 12.30% (438/3562) of radiomics features are reproducible between humans and cynomolgus monkeys. Furthermore, the human dataset is used as the training set to construct radiomics models, and the cynomolgus monkey’s dataset is used as the testing set to verify the inter species universality of the radiomics models. We found that the radiomics models constructed using human datasets as training sets still has good performance in cynomolgus monkeys. This study provides a theoretical basis for the cross-species application of radiomics model.
The chloroplast nuclear-encoded thioredoxin-like protein HCF164 is predicted to be associated with Coffea SH9 resistance factor against Hemileia vastatrix
Authors: Guerra-Guimarães Leonor , Pinheiro Carla , Oliveira Ana Sofia F. , Mira-Jover Andrea , Valverde Javier , Guedes Fernanda Freitas , Azevedo Herlander , Várzea Vitor , Pajares Antonio Muñoz
Published: May 2023

To explore the connection between chloroplast and coffee resistance factors, designated as SH1 to SH9, the whole genome of 42 coffee genotypes was sequenced and de novo assembled. The chloroplast phylogenetic haplotype network clustered individuals per species instead of SH factors. However, for the first time, it allowed the molecular validation of Coffea arabica as the maternal parent of the spontaneous hybrid Híbrido de Timor (HDT). Individual reads were aligned on the C. arabica reference to relate SH factors with chloroplast metabolism, and an in-silico analysis of selected nuclear-encoded chloroplast proteins (132 proteins) was performed. The nuclear-encoded thioredoxin-like membrane protein HCF164 enabled to discrimination of individuals with and without the SH9 factor, due to specific DNA variants linked to chromosome 7c (inherited from C. canephora). The absence of both the thioredoxin domain and redox-active disulphide center in the HCF164 protein, observed in SH9 individuals, raises the possibility of potential implications on redox regulation. This is the first time that specific DNA variants allow discriminating individuals according to the SH profile. This study introduces an unexplored strategy for identifying protein/genes associated with SH factors and candidate targets of H. vastatrix effectors, thereby creating new perspectives for coffee breeding programs.
Observation of the crossover from quantum fluxoid to half-quantum fluxoid in a chiral superconducting device
Authors: Niimi Yasuhiro , Tokuda Masashi , Nakao Mai , Watanabe Mori , Lee Sanghyun , Nakamura Ryoya , Maeda Masaki , Jiang Nan , Yue Di , Aoyama Kazushi , Mizushima Takeshi , Jin Xiaofeng , Kobayashi Kensuke
Published: May 2023

Topological superconductors are one of the intriguing material groups from the viewpoint of not only condensed matter physics but also elementally particle physics and industrial application such as quantum computers because of the existence of Majorana fermion that is its own antiparticle. For the realization of devices using Majorana fermion, developments of the thin film devices and novel functionalities are highly desirable. Bi/Ni bilayer is a possible candidate for thin-film chiral superconductors where the time-reversal symmetry is broken. Here we report the phase shift of Little-Parks oscillations by half flux quantum φ0/2 in a Bi/Ni ring-shaped device induced by a small magnetic field through the ring. The half quantum fluxoid can be a decisive evidence for unconventional superconductors where the superconducting order parameter has an internal degree of freedom. The present result demonstrates that Bi/Ni is a chiral superconductor with a spin triplet component, and that the internal degree of freedom plays an important role in the phase of supercurrent. The present work also provides a new operating principle for quantum devices where the phase of the supercurrent can be shifted by π with a small magnetic field, based on the internal degree of freedom possessed by topological superconductivity.
Generalizable neuromarker for autism spectrum disorder across imaging sites and developmental stages: A multi-site study
Authors: Itahashi Takashi , Yamashita Ayumu , Takahara Yuji , Yahata Noriaki , Nakamura Motoaki , Aoki Yuta , Aoki Ryuta , Fujino Junya , Ohta Haruhisa , Yoshihara Yujiro , Sakai Yuki , Takamura Masahiro , Ichikawa Naho , Okada Go , Okada Naohiro , Kasai Kiyoto , Tanaka Saori , Imamizu Hiroshi , Kato Nobumasa , Okamoto Yasumasa , Takahashi Hidehiko , Kawato Mitsuo , Yamashita Okito , Hashimoto Ryuichiro
Published: May 2023

Autism spectrum disorder (ASD) is a lifelong condition, and its underlying biological mechanisms remain elusive. The complexity of various factors, including inter-site and development-related differences, makes it challenging to develop generalizable neuroimaging-based biomarkers for ASD. This study used a large-scale, multi-site dataset of 730 Japanese adults to develop a generalizable neuromarker for ASD across independent sites and different developmental stages. Our adult ASD neuromarker achieved successful generalization for the US and Belgium adults and Japanese adults. The neuromarker demonstrated significant generalization for children and adolescents. We identified 141 functional connections (FCs) important for discriminating individuals with ASD from TDCs. Finally, we mapped schizophrenia (SCZ) and major depressive disorder (MDD) onto the biological axis defined by the neuromarker and explored the biological continuity of ASD with SCZ and MDD. We observed that SCZ, but not MDD, was located proximate to ASD on the biological dimension defined by the ASD neuromarker. The successful generalization in multifarious datasets and the observed relations of ASD with SCZ on the biological dimensions provide new insights for a deeper understanding of ASD.
Carious Status and Socio-Behavioral Risk Factors among 12 Year-Old Children in South-Central Region in Romania
Authors: Sfeatcu Ruxandra , Cărămidă Mariana , Sava-Rosianu Ruxandra , Matichescu Marius Lupșa , Galuscan Atena , Dumitrache Mihaela Adina
Published: May 2023

Background Regular screenings at children population level are necessary in order to assess communities’ need for education, prevention, as well as early detection and intervention programs The study aims to assess dental caries experience and oral health-related behaviors among Romania children from the South and Central region.Methods The cross-sectional study conducted in 2019–2020 is part of the national survey “Romanian Oral Health Survey”, under the endorsement of the World Health Organization (WHO). The stratified, randomized and representative sample included 98 children of 12 years of age. The assessment included a clinical examination, using International Caries Detection and Assessment System (ICDAS) and the Oral Health Questionnaire for Children recommended by the World Health Organization.Results Results revealed that the frequency of caries-free children among 12 year-olds was 36.7% and the mean DMFT was 2.89. Regarding the oral health-related habits, 38.8% of children brushed twice daily; the consumption of sugary foods multiple times per day has been frequently met and 11.2% at the age of 12 never visited the dental office.Conclusions The findings revealed that caries prevalence was high and behaviors negatively influence oral health.
Cost comparisons and factors related to cost per stay in intensive care units in Belgium
Authors: Bruyneel Arnaud , Larcin Lionel , Martins Dimitri , Bulcke Julie Van Den , Leclercq Pol , Pirson Magali
Published: May 2023

Background: Given the variability of intensive care unit (ICU) costs in different countries and the importance of this information for guiding clinicians to effective treatment and to the organisation of ICUs at the national level, it is of value to gather data on this topic for analysis at the national level in Belgium. The objectives of the study were to assess the total cost of ICUs and the factors that influence the cost of ICUs in hospitals in Belgium.Methods This was a retrospective cohort study using data collected from the ICUs of 17 Belgian hospitals from January 01 to December 31, 2018. A total of 18,235 adult ICU stays were included in the study. The data set was a compilation of inpatient information from analytical cost accounting of hospitals, medical discharge summaries, and length of stay data. The costs were evaluated as the expenses related to the management of hospital stays from the hospital's point of view. The cost from the hospital perspective was calculated using a cost accounting analytical methodology in full costing. We used multivariate linear regression to evaluate factors associated with total ICU cost per stay. The ICU cost was log-transformed before regression and geometric mean ratios (GMRs) were estimated for each factor.Results The proportion of ICU beds to ward beds was a median [p25-p75] of 4.7% [4.4–5.9]. The proportion of indirect costs to total costs in the ICU was 12.1% [11.4–13.3]. The cost of nurses represented 57.2% [55.4–62.2] of direct costs and this was 15.9% [12.0-18.2] of the cost of nurses in the whole hospital. The median cost per stay was €4,267 [2,050–9,658] and was €2,160 [1,545–3,221] per ICU day. The main factors associated with higher cost per stay in ICU were Charlson score, mechanical ventilation, ECMO, continuous hemofiltration, length of stay, readmission, ICU mortality, hospitalisation in an academic hospital, and diagnosis of coma/convulsions or intoxication.Conclusions This study demonstrated that, despite the small proportion of ICU beds in relation to all services, the ICU represented a significant cost to the hospital. In addition, this study confirms that nursing staff represent a significant proportion of the direct costs of the ICU. Finally, the total cost per stay was also important but highly variable depending on the medical factors identified in our results.
Influencing Factors and Correlation Analysis of Apathy in Patients with Parkinson's Disease
Authors: zhang xuewei , Chen Min , Guo Yanjie , song jingyang , Liu Jiqiang , Tian Linqiang , Kang Lixia , Xing Hongxia
Published: May 2023

Background Parkinson's disease (PD) is a complex progressive neurodegenerative disease. The prevalence of Parkinson's disease has increased rapidly in the last 20 years. Apathy, one of the non-motor symptoms of Parkinson's disease, severely affects patients' daily functioning and quality of life, increases the burden on caregivers, and maybe a precursor to dementia. Identifying the factors associated with indifferent PD patients is essential in slowing disease progression and improving patient prognosis.Methods A total of 73 PD patients from the outpatient or inpatient department of Neurology at the Third Affiliated Hospital of Xinxiang Medical University were collected. The clinical scales of PD patients were assessed. According to Starkstein Apathy Scale (AS), these patients were divided into an apathetic group (46 patients) and a non-apathetic group (27 patients). Spearman correlation analysis and Stepwise multiple linear regression analysis were used to explore the correlation between total AS scores and clinical characteristics.Results Spearman correlation analysis showed that the total scores of AS were positively correlated with disease duration, HY stages, Movement Disorders Society Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) scores, Hamilton Anxiety Rating Scale (HAMA) scores, Hamilton Depression Rating Scale (HAMD) scores, Pittsburgh Sleep Quality Index (PSQI) scores, King's Parkinson's Disease Pain Scale ( KPPS) scores, Parkinson Autonomic Symptom Scale (SCOPA-AUT) scores, and 39-item Parkinson's Disease Questionnaire (PDQ-39) scores. It was negatively correlated with Montreal Cognitive Assessment (MoCA) scores and Mini-Mental Status Examination (MMSE) scores. Stepwise multiple linear regression analysis showed that low MoCA scores and high HAMA scores were correlated with apathy, indicating that MoCA scores and HAMA scores may be important determinants of apathy in PD patients.Conclusion PD patients with apathy showed longer disease duration, higher Hoehn and Yahr (HY) stages, more severe motor dysfunction, more severe cognitive impairment, more severe anxiety, more depression symptoms, more severe sleep symptoms, more severe autonomic dysfunction and worse quality of life. Cognitive dysfunction and anxiety may be the risk factors for PD patients with apathy.
The Critical Node of the Transmission of Iron and Steel Technology on the Silk Road in the Han Dynasty: Study on the Iron artifacts from the Han Dynasty Tombs in Xingfucheng, Guyuan, Ningxia Hui Autonomous Region, Northwest China, ca. 202 BC-141 BC
Authors: Zhu Jin , Huang Quansheng , Zou Guisen , Zhu Cunshi , Guo Jialong
Published: May 2023

In the past few decades, many iron artifacts have been excavated in the Ningxia Hui Autonomous Region, which was the critical node that connected the Eastern and Western civilizations on the ancient Silk Road. However, the exploration into the iron and steel metallurgy technology prevalent in Ningxia during that period has been inadequate. In this paper, metallurgical analysis has been conducted on the iron artifacts excavated from the tombs of the early Western Han Dynasty (202-141BC) in Xingfucheng (XFC), Guyuan, Ningxia. Results show that weapons and farming implements were made of decarburized steel and Chaogang. Furthermore, there is evidence of the use of surface carburizing and quenching technologies to control the performance of the iron. In addition, this research also uncovered the utilization of carburized bloomery steel. The iron objects excavated in XFC show traits of bloomery smelting technology from Europe, and Asia, in addition to the steel making techniques found in the Central Plains. Hence, it can be concluded that the iron and steel smelting technology developed in XFC is a result of the confluence of Eastern and Western technologies. The trend of replacing bloomery smelting technology with cast iron appeared in the early Western Han Dynasty, which establishes that Ningxia played an important role in the exchange of ancient metallurgical technology between the East and the West, thus filling the gap of iron archaeometallurgy in Ningxia after the 2nd century BC.
The comparison of corneal higher-order aberration and surgically induced astigmatism between the clear corneal incision and the limbus tunnel incision of posterior chamber implantable collame lens implantation
Authors: Dan Ting-Ting , Liu Tai-Xiang , Luo Hong-yang , Li Zongze , Liao Yi-Lu
Published: May 2023

Background: This study aimed to compare the corneal high-order aberration and surgically induced astigmatism between the clear corneal incision and limbus tunnel incision of posterior chamber implantable collame lens (ICL/TICL) implantation.
Methods :
127 eyes of 73 myopic patients underwent ICL-V4c implantation, 70 eyes underwent clear corneal incisions, and 57 eyes were limbus tunnel incisions. The anterior and back corneal surface of RMS of all higher-order aberration (HOA RMS), spherical aberration(Z40 ), coma coefficients (Coma RMS) Z3-1 Z31, and surgically induced astigmatism (SIA) were collected at preoperative and postoperative one day, one week, and 1, 3, and 6 months. The corneal higher-order aberration was estimated as the Zernike coefficient calculated up to fifth order at a maximum diameter of 6.5 mm using Pentacam.
Results:
After the operation for one week, the corneal back Z31 of the clear corneal incision group was 0.06±0.06 compared to 0.05±0.06 of the limbus tunnel incision group(p=0.031). The corneal back Z40 of the clear corneal incision group was -0.02±0.25 compared to -0.04±0.21 of the limbus tunnel incision group(p=0.01). After the operation one month, the corneal back SIA of the clear corneal incision group was 0.11±0.11 compared to 0.08±0.11of the limbus tunnel incision group (p=0.013), the total corneal SIA of the clear corneal incision group was 0.33±0.3 compared to 0.15±0.16 of the limbus tunnel incision group(p=0.004), the corneal incision has more back astigmatism and total SIA than the limbus tunnel incision in post-operation one month. At post-operation six months, there are no significant differences between the two groups in Z31, Z40 , and other HOA data. The total SIA of the corneal incision group and the limbus tunnel incision group were (0.24±0.14, 0.33± 0.32, p=0.393); there is no significant difference between the two groups after the operation of six months.
Conclusion:
Our data showed that at 6m after ICL-V4c implantation, the high-order aberration and SIA have no significant difference using clear corneal and limbus tunnel incisions.
Proximate composition and antioxidant potentiality of underutilized and neglected edible plants for sustainable development in food security
Authors: Reang Muktadhar , Sarma Dipan , Datta Badal Kumar
Published: May 2023

For decades, indigenous people of rural regions have been consuming wild edible plants as food and medicines. Wild edible plants are neglected and underutilized food plants whose utilization is only restricted to a specific location. It is also referred as Future Smart Foods. Nutritional analysis can provide valuable insights into the potentiality of native wild edible plants as sustainable and nutritious food source. This study aims to analysis the proximate and elemental composition, and antioxidant activity of underutilized and neglected plants in Tripura. In our findings, relatively high carbohydrate, protein and fats content was observed in Oroxylum indicum (13.34±0.29), Trachyspermum roxburghianum (10.43±0.19) and Flacourtia indica (4.25±0.28) respectively. The highest Total energy was recorded in Flacourtia indica (107.97 Kcal). The highest moisture and ash content was observed in Alpinia nigra (94.95%) and Trachyspermum roxburghianum (42.16%) respectively. The quantitative concentration (Wt %) of six micronutrients (Mg, P, K, Ca, Fe and Cl) reveals that the highest was observed in potassium (K) i.e. 34.15% (34.15 mg/gm) in S. pennata. The free radical scavenging activity of the ethanolic extracts showed that L. leucocephala possessed high antioxidant activity (IC50 =125.4±1.78). The nutritional values may be helpful for these underutilized crops to encourage future conservation plans and assess the level of dietary supplement dependency of the local communities. Therefore by promoting the cultivation and consumption of underutilized crops, we can support local communities and accomplish sustainable development in food security.
Lung Transplantation for Pulmonary Graft Versus Host Disease: Experience from a Referral Organ Transplantation Center
Authors: Fakih Riad El , Abdulqawi Rayid , Bugnah Amer , Arabi Tarek , Rasheed Walid , Ezzat Loui , Shaheen Marwan , Chaudhri Naeem , Almohareb Fahad , Mutairy Eid Al , Aljurf Mahmoud D
Published: May 2023

Introduction: Severe pulmonary GvHD after allo-HCT is a significant cause of morbidity and mortality with limited therapeutic options. Selected patients can be lung transplanted, however there are no consensus guidelines on whom to select nor on when to refer.
Method: Retrospective review of patients who underwent LT for lung GvHD after allo-HCT.
Results: Ten patients were identified between January 2002 and December 2020. The median age at LT was 31 years. Seven patients developed aGvHD after allo-HCT and all patients developed cGvHD. The median immunosuppressive lines used before lung transplant was four. The median time between allo-HCT and bronchiolitis obliterans syndrome was 20.5 months. The median time from allo-HCT to LT was 71 months. The median time from first lung transplant evaluation to actual LT was 61 months. The median time from listing for LT to actual LT was 4.8 months. The median FEV1 upon referral to LT clinic was 31% and the median FEV1 upon LT was 25%. All patients received cadaveric bilateral lung transplants. After a median follow up of 4.5 years post-LT, the estimated 5-years OS after LT was 85.7%. The cumulative incidence of CLAD was 50% with a median time from LT to CLAD of 47 months. The CLAD-free survival at 5 years was 50%. Two patients died after developing CLAD complications. No hematologic relapse nor secondary malignancies reported.
Conclusion: LT is an effective intervention for selected lung GvHD patients. Multidisciplinary management and consensus guidelines are needed to better serve these patients.
A Comparative Study of Two Techniques to Avoid Bone Cement Loosening and Displacement after PVP Treating Unstable Kummell's Disease
Authors: Zhang Xinliang , Zhan Yi , Wang Jiangtao , Li Liang , Wang Yuhang , Miao Junxian , Hao Dingjun , Wang Biao
Published: May 2023

Percutaneous vertebroplasty (PVP) is the most common surgical procedure for Kummell's disease (KD), but bone cement loosening or displacement often occurs after the operation. From May 2015 to May 2019, 77 patients who had received PVP-PPP therapy were included in PPP group, and 42 patients who had received PVP-bone cement bridging screw system therapy were included in screw group. The changes in the vertebral body index (VBI), Cobb angle, visual analog scale (VAS) and Oswestry disability index (ODI) and the bone cement loosening and displacement rate at different follow-up time points were used to evaluate the clinical efficacy. Before operation, immediately after operation and at Month 6 after operation, there was no significant difference in VBI or Cobb angle between two groups (P > 0.05), while at Year-1 and Year-2 postoperative evaluations, screw group had higher VBI and Cobb angle than PPP group (P < 0.05). Before operation, immediately after operation, at Month 6 after operation and at Year-1 after operation, there was no significant difference in VAS or ODI score between two groups (P > 0.05), while at Year-2 after operation, screw group had higher VAS and ODI scores than the PPP group (P < 0.05). The rate of bone cement loosening was 14.29% in group PPP, and 0 in screw group (P < 0.05). This two-year follow-up study shows that PVP-bone cement bridging screw system therapy had better treatment efficacy than PVP-PPP therapy, and the bone cement bridging screw system is a preferred therapy with better anti cement loosening ability.
Evidence of intensification of Pyrethroid Resistance in the major Malaria Vectors in Kinshasa, Democratic Republic of Congo
Authors: NGUIFFO-NGUETE Daniel , MUGENZI Leon M. J. , MANZAMBI Emile Zola , TCHOUAKUI Magellan , WONDJI Murielle , TEKOH Theofelix , WATSENGA Francis , AGOSSA Fiacre , Wondji charles S
Published: May 2023

Assessing patterns and evolution of insecticide resistance in malaria vectors is a prerequisite to design suitable control strategies. Here, we characterised resistance profile inAnopheles gambiaeandAnopheles funestusin Kinshasa and assess the level of aggravation by comparing to previous 2015 estimates. Bothspeciescollected in July 2021 were highly resistant to pyrethroids at 1X, 5X and 10X concentrations (mortality < 90%) and remain fully susceptible to bendiocarb and pirimiphos methyl. Partial recovery of susceptibility was observed inAn. gambiaeafter PBO synergist assays for both permethrin and α-cypermethrin with total recovery of susceptibility observed for deltamethrin compared to 2015, the efficacy of bednets decreased significantly in 2021, for the most of nets. Genotyping of resistance markers revealed a near fixation of the L1014-Kdr mutation (98.3%) inAn. gambiaein 2021. The frequency of the 119F-GSTe2 resistant significantly increased between 2015 and 2021 (19.6% vs 33.3%; P = 0.02) inAn. funestus. Transcriptomic analysis also revealed a significant increased expression (P < 0.001) of key cytochrome P450s inAn. funestusnotablyCYP6P9a. The escalation of pyrethroid resistance observed inAnophelespopulations from Kinshasa coupled with increased frequency/expression level of resistance genes highlights an urgent need to implement tools to improve malaria vector control.
Record linkage without patient identifiers: proof of concept using data from South Africa’s national HIV program
Authors: Shumba Khumbo , Bor Jacob , Nattey Cornelius , Gareta Dickman , Lauren Evelyn , Macleod William , Fox Matthew P. , Puren Adrian , Mlisana Koleka , Onoya Dorina
Published: May 2023

Background:Linkage between health databases typically requires identifiers such as patient names and personal identification numbers. We developed and validated a record linkage strategy to combine administrative health databases without the use of patient identifiers, with application to South Africa’s public sector HIV treatment program.
Methods: We linked CD4 counts and HIV viral loads from South Africa’s HIV clinical monitoring database (TIER.Net) and the National Health Laboratory Service (NHLS) for patients receiving care between 2015-2019 in Ekurhuleni District (Gauteng Province). We used a combination of variables related to lab results contained in both databases (result value; specimen collection date; facility of collection; patient year and month of birth; and sex). Exact matching linked on exact linking variable values while caliper matching applied exact matching with linkage on approximate test dates (± 5 days). We then developed a sequential linkage approach utilising specimen barcode matching, then exact matching, and lastly caliper matching. Performance measures were sensitivity and positive predictive value (PPV); share of patients linked across databases; and percent increase in data points for each linkage approach.
Results: We attempted to link 2,017,290 lab results from TIER.Net (representing 523,558 unique patients) and 2,414,059 lab results from the NHLS database. Linkage performance was evaluated using specimen barcodes (available for a minority of records in TIER.net) as a “gold standard”. Exact matching achieved a sensitivity of 69.0% and PPV of 95.1%. Caliper-matching achieved a sensitivity of 75.7% and PPV of 94.5%. In sequential linkage, we matched 41.9% of TIER.Net labs by specimen barcodes, 51.3% by exact matching, and 6.8% by caliper matching, for a total of 71.9% of labs matched, with PPV=96.8% and Sensitivity= 85.9%. The sequential approach linked 86.0% of TIER.Net patients with at least one lab result to the NHLS database (N=1,450,087). Linkage to the NHLS Cohort increased the number of laboratory results associated with TIER.Net patients by 62.6%.
Conclusions: Linkage of TIER.Net and NHLS without patient identifiers attained high accuracy and yield without compromising patient privacy. The integrated cohort provides a more complete view of patients’ lab history and could yield more accurate estimates of HIV program indicators.
Metaheuristic Model of Gene Selection for Deep Learning Early Prediction of Cancer Disease Using Gene Expression Data
Authors: Joshi Amol Avinash , Aziz Rabia Musheer
Published: May 2023

Cancer prediction in the early stage is a topic of major interest in medicine since it allows accurate and efficient actions for successful medical treatments of cancer. Mostly cancer datasets contain various gene expression levels as features with less samples, so firstly there is a need to eliminate similar features to permit faster convergence rate of prediction algorithms. These features (genes) enable us to identify cancer disease, choose the best prescription to prevent cancer and discover deviations amid different techniques. To resolve this problem, proposed a hybrid novel technique CSSMO, based feature selection for cancer prediction. First, combine the use of Spider Monkey Optimization (SMO) along with Cuckoo search (CS) algorithm viz. CSSMO for feature selection, which helps to combine the benefit of both metaheuristic algorithms to discover a subset of genes which helps to predict a cancer disease in early stage. Next, these subsets of genes are classified using Deep Learning (DL) to identify different groups or classes related to a particular cancer disease. Six different datasets have utilized to analyze the performance of the proposed approach in terms of cancer sample classification and prediction with Recall, Precision, F1-Score, and confusion matrix. Proposed gene selection method with DL achieves much better prediction accuracy than other existing Deep Learning (DL) and Machine learning models with a large gene expression datasets.
Anoikis-related genes signature development for kidney renal clear cell carcinoma prognosis and tumor microenvironment
Authors: wang Zhengyan , Wang Ying , Yan Jing , Zhang Yinzhen , Hou Yulong , Wang Xukai
Published: May 2023

Kidney renal clear cell carcinoma (KIRC) is one of the most common primary malignancies of the urinary tract, highly heterogeneous, and increasing in incidence worldwide. Anoikis is a specific type of programmed cell death in which solid tumor cells or normal epithelial cells that do not have metastatic properties lose adhesion to the extracellular matrix (ECM) or undergo inappropriate cell adhesion-induced apoptosis. Anoikis is thought to play a critical role in tumorigenesis, maintenance, and treatment, according to an increasing amount of research. However, there is still some uncertainty regarding the general impact of anoikis-related genes (ARGs) on the prognostic importance, tumor microenvironment (TME) characteristics, and treatment reaction of KIRC patients. For this study, we used The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) datasets to access the RNA sequencing results and clinical information from KIRC patients. 29 ARGs related to survival were found using differential analysis and univariate Cox regression analysis. The samples were then divided into two clusters that had different immune traits via unsupervised cluster analysis using 29 prognosis-associated differently expressed ARGs. Then, to build an ARGs signature, 7 genes (PLAU, EDA2R, AFP, PLG, TUBB3, APOBEC3G, and MALAT1) were found using Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis. The new ARGs signature demonstrated outstanding prognostic capability for KIRC patients' overall survival (OS). On the basis of the clinical parameters (gender, tumor grade, age, and stage) and the ARGs risk score, a clinical nomogram was created. This nomogram demonstrated excellent predictive value. In addition, patients that were categorized based on risk ratings also exhibited distinguishing immunological traits and medication sensitivity. In conclusion, for KIRC patients, we created an ARGs signature that strongly connects to immunological traits and therapy response. Clinicians may find this ARGs signature helpful in developing more individualized and detailed treatment strategies for KIRC patients.
Suspension of the penis – dissection, anatomical description and highlighting of anatomical risks in sectioning the suspensory ligaments
Authors: Filipoiu Florin Mihail , Ion Radu Tudor , Filipoiu Zoran Florin , Tulin Adrian Daniel , Enciu Octavian , Enyedi Mihaly
Published: May 2023

Introduction. The suspension of the penis is provided by two ligaments: fundiform and suspensory. These ligaments are sectioned during some augmentative surgical procedures. The structure, the relations and the variability of these ligaments have been demonstrated. The penile neurovascular bundle and its relationships have also been emphasized. A clear knowledge of these details should ensure a reduction of the risk of surgical injury during augmentation procedures.
Material and methods. We dissected the ligaments providing the suspension of the penis in 7 formalized corpses. We identified, for each of the ligaments, the origin, the insertion and the relations. The dissection pieces were photographed and the images obtained were discussed upon.
Results. We described the variability of the anatomical distribution and highlighted the relations with the vascular and nervous structures for each of these ligaments. The anatomical variability of the fascia and the relations with the baseof the penis were also emphasized. For the suspensory ligament, we identified three groups of fibers through which it is attached to the penile body.
Conclusions. The dissections were conducted in layers, corresponding to the operative stepsfor the penile augmentation procedures. We believe that our study highlights the anatomical basis necessary to safely perform these surgeries. The study contributes to the description of the anatomical variability of the ligaments and logically presents details that contribute to preventing most surgical incidents.
Big Data and AI-driven Product Design: A Survey
Authors: Quan Huafeng , Li Shaobo , Zeng Changchang , Wei Hongjing , Hu Jianjun
Published: May 2023

As living standards improve, modern products need to meet increasingly diversified and personalized user requirements. Traditional product design methods fall short due to their strong subjectivity, limited survey scope, lack of real-time data, and poor visual display. However, recent progress in big data and artificial intelligence (AI) are bringing a transformative big data and AI driven product design methodology with significant impact on many industries. Big data in the product lifecycle contains valuable information, such as customer preferences, market demands, product evaluation, and visual display: online product reviews reflect customer evaluations and requirements, while product images contain shape, color, and texture information that can inspire designers to quickly generate initial design schemes or even new product images. This survey provides a comprehensive review on big data and AI-driven product design, focusing on how big data of various modalities can be processed, analyzed, and exploited in aiding product design using AI algorithms. It identifies the limitations of traditional product design methods and shows how textual, image, audio, and video data in product design cycles can be utilized to achieve much more intelligent product design. We finally discuss the major deficiencies of existing data-driven product design studies and outline promising future research directions and opportunities, aiming to draw increasing attention to modern AI-driven product design.
EEG functional connectivity in infants at elevated familial risk for autism spectrum disorder
Authors: O’Reilly Christian , Huberty Scott , Noordt Stefon , Desjardins James , Wright Nicky , Scorah Julie , Webb Sara Jane , team BASIS , Elsabbagh Mayada
Published: May 2023

Background: Many studies have reported that autism spectrum disorder (ASD) is associated with atypical structural and functional connectivity. However, relatively little is known about the development of these differences in infancy and on how trajectories may vary between sexes.
Methods: We used the International Infant EEG Platform (EEG-IP), a high-density electroencephalogram (EEG) dataset pooled from two independent infant sibling cohorts, to characterize such neurodevelopmental deviations during the first years of life. EEG was recorded at 6, 12, and 18 months of age at typical (N=97) or high familial risk for ASD (N=98), determined by the presence of an older sibling with a confirmed ASD diagnosis. We computed the functional connectivity between cortical EEG sources during video watching using the corrected imaginary part of phase-locking values.
Results: Our findings showed low regional specificity for group differences in functional connectivity but revealed different sex-specific trajectories between females and males in the group of high-risk infants. Specifically, functional connectivity was negatively correlated with ADOS calibrated severity scores, particularly at 12 months for the social affect score for females and for the restrictive and repetitive behaviors for males.
Limitations: This study has been limited mostly due to issues related to the relatively small effective sample size inherent in sibling studies, particularly for diagnostic group comparisons.
Conclusions: These results are consistent with sex differences in ASD observed in previous research and provide further insights into the role of functional connectivity in these differences.
Congenital external carotid-internal carotid artery anastomosis: a report of three cases and literature review
Authors: Uchino Akira , Suzuki Jun , Baba Yasutaka
Published: May 2023

Purpose Congenital external carotid-internal carotid artery (EC-ICA) anastomosis is a cervical arterial variation that was initially reported, based on anatomic dissection, from Japan in 2000. The purpose of this report is to show the characteristic radiological findings of this extremely rare cervical arterial variation.Methods We analyzed nine cases, including six previously reported cases and three cases that we recently experienced. Three of the six previously reported cases were from Japan, and the remaining three cases were from Korea. MR angiography (4), CT angiography (2), catheter angiography (2) and autopsy (1) were used as diagnostic modalities.Results The study population included eight men and one woman. Anastomosis was seen on the left side in seven cases and the right side in two cases, and it was located at the level of the C1/2-C2/3 intervertebral space. In all cases, ECA was larger than the ICA at the level of their origins. In four cases, the ICA was extremely small in caliber. In one case, the ICA may have been occluded postnatally, and its configuration was similar to that of the nonbifurcating cervical carotid artery (CCA). With the exception of this occluded case, the carotid bifurcation and EC-ICA anastomosis formed a large arterial ring in all cases.Conclusion EC-ICA anastomosis can be regarded as a variant of the nonbifurcating CCA because if the most proximal segment of the small ICA is occluded, nonbifurcating CCA may form. EC-ICA anastomosis is located between the C1/2-C2/3 intervertebral space and may be formed by the remnants of the proatlantal artery I.