bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of 30-day planned and unplanned readmissions in a tertiary teaching hospital in China
Authors: Zhang Mengjiao , Liu Siru , Bi Yongdong , Liu Jialin
Published: March 2023

Purpose

The purpose of this study was to analyze and compare the clinical characteristics of patients with 30-day planned and unplanned readmissions and to identify patients at high risk for unplanned readmissions. This will facilitate a better understanding of these readmissions and improve and optimize resource utilization for this patient population.

Methods

A retrospective cohort descriptive study was conducted at the West China Hospital (WCH), Sichuan University from January 1, 2015, to December 31, 2020. Discharged patients (≥ 18 years old) were divided into unplanned readmission and planned readmission groups according to 30-day readmission status. Demographic and related information was collected for each patient. Logistic regression analysis was used to assess the association between unplanned patient characteristics and the risk of readmission.

Results

We identified 1,118,437 patients from 1,242,496 discharged patients, including 74,494 (6.7%) 30-day planned readmissions and 9,895 (0.9%) unplanned readmissions. The most common diseases of planned readmissions were antineoplastic chemotherapy (62,756/177,749; 35.3%), radiotherapy sessions for malignancy (919/8,229; 11.2%), and systemic lupus erythematosus (607/4,620; 13.1%). The most common diseases of unplanned readmissions were antineoplastic chemotherapy (2038/177,747; 1.1%), age-related cataract (1061/21,255; 5.0%), and unspecified disorder of refraction (544/5,134; 10.6%). There were statistically significant differences between planned and unplanned readmissions in terms of patient sex, marital status, age, length of initial stay, the time between discharge, ICU stay, surgery, and health insurance.

Conclusion

Accurate information on 30-day planned and unplanned readmissions facilitates effective planning of healthcare resource allocation. Identifying risk factors for 30-day unplanned readmissions can help develop interventions to reduce readmission rates.
Understanding the Cures Act Information Blocking Rule in cancer care: a mixed methods exploration of patient and clinician perspectives and recommendations for policy makers
Authors: Brooks Joanna Veazey , Zegers Carli , Sinclair Christian T. , Wulff-Burchfield Elizabeth , Thimmesch Amanda R. , English Daniel , Nelson-Brantley Heather V.
Published: March 2023

Background

The 21st Century Cures Act Interoperability and Information Blocking Rule was created to increase patient access to health information. This federally mandated policy has been met with praise and concern. However, little is known about patient and clinician opinions of this policy within cancer care.

Methods

We conducted a convergent parallel mixed methods study to understand patient and clinician reactions to the Information Blocking Rule in cancer care and what they would like policy makers to consider. Twenty-nine patients and 29 clinicians completed interviews and surveys. Inductive thematic analysis was used to analyze the interviews. Interview and survey data were analyzed separately, then linked to generate a full interpretation of the results.

Results

Overall, patients felt more positive about the policy than clinicians. Patients wanted policy makers to understand that patients are unique, and they want to individualize their preferences for receiving health information with their clinicians. Clinicians highlighted the uniqueness of cancer care, due to the highly sensitive information that is shared. Both patients and clinicians were concerned about the impact on clinician workload and stress. Both expressed an urgent need for tailoring implementation of the policy to avoid unintended harm and distress for patients.

Conclusions

Our findings provide suggestions for optimizing the implementation of this policy in cancer care. Dissemination strategies to better inform the public about the policy and improve clinician understanding and support are recommended. Patients who have serious illness or diagnoses such as cancer and their clinicians should be included when developing and enacting policies that could have a significant impact on their well-being. Patients with cancer and their cancer care teams want the ability to tailor information release based on individual preferences and goals. Understanding how to tailor implementation of the Information Blocking Rule is essential for retaining its benefits and minimizing unintended harm for patients with cancer.
Improving the production of the micafungin precursor FR901379 in an industrial production strain
Authors: Men Ping , Zhou Yu , Xie Li , Zhang Xuan , Zhang Wei , Huang Xuenian , Lu Xuefeng
Published: March 2023

Background

Micafungin is an echinocandin-type antifungal agent used for the clinical treatment of invasive fungal infections. It is semisynthesized from the sulfonated lipohexapeptide FR901379, a nonribosomal peptide produced by the filamentous fungus Coleophoma empetri. However, the low fermentation efficiency of FR901379 increases the cost of micafungin production and hinders its widespread clinical application.

Results

Here, a highly efficient FR901379-producing strain was constructed via systems metabolic engineering in C. empetri MEFC09. First, the biosynthesis pathway of FR901379 was optimized by overexpressing the rate-limiting enzymes cytochrome P450 McfF and McfH, which successfully eliminated the accumulation of unwanted byproducts and increased the production of FR901379. Then, the functions of putative self-resistance genes encoding β-1,3-glucan synthase were evaluated in vivo. The deletion of CEfks1 affected growth and resulted in more spherical cells. Additionally, the transcriptional activator McfJ for the regulation of FR901379 biosynthesis was identified and applied in metabolic engineering. Overexpressing mcfJ markedly increased the production of FR901379 from 0.3 g/L to 1.3 g/L. Finally, the engineered strain coexpressing mcfJ, mcfF, and mcfH was constructed for additive effects, and the FR901379 titer reached 4.0 g/L under fed-batch conditions in a 5 L bioreactor.

Conclusions

This study represents a significant improvement for the production of FR901379 and provides guidance for the establishment of efficient fungal cell factories for other echinocandins.
Effects of the COVID-19 pandemic on general health and malaria control in Ghana: a qualitative study with mothers and health care professionals
Authors: Heuschen Anna-Katharina , Abdul-Mumin Alhassan , Abubakari Abdulai , Agbozo Faith , Lu Guangyu , Jahn Albrecht , Müller Olaf
Published: March 2023

Background

COVID-19 has severely impacted health systems and the management of non-COVID-19 diseases, including malaria, globally. The pandemic has hit sub-Saharan Africa less than expected; even considering large underreporting, the direct COVID-19 burden was minor compared to the Global North. However, the indirect effects of the pandemic, e.g. on socio-economic inequality and health care systems, may have been more disruptive. Following a quantitative analysis from northern Ghana, which showed significant reductions in overall outpatient department visits and malaria cases during the first year of COVID-19, this qualitative study aims to provide further explanations to those quantitative findings.

Methods

In the Northern Region of Ghana, 72 participants, consisting of 18 health care professionals (HCPs) and 54 mothers of children under the age of five, were recruited in urban and rural districts. Data were collected using focus group discussions with mothers and through key informant interviews with HCPs.

Results

Three main themes occurred. The first theme—general effects of the pandemic—includes impacts on finances, food security, health service provision as well as education and hygiene. Many women lost their jobs, which increased their dependance on males, children had to drop out of school, and families had to cope with food shortages and were considering migration. HCPs had problems reaching the communities, suffered stigmatisation and were often barely protected against the virus. The second theme—effects on health-seeking—includes fear of infection, lack of COVID-19 testing capacities, and reduced access to clinics and treatment. The third theme—effects on malaria—includes disruptions of malaria preventive measures. Clinical discrimination between malaria and COVID-19 symptoms was difficult and HCPs observed increases in severe malaria cases in health facilities due to late reporting.

Conclusion

The COVID-19 pandemic has had large collateral impacts on mothers, children and HCPs. In addition to overall negative effects on families and communities, access to and quality of health services was severely impaired, including serious implications on malaria. This crisis has highlighted weaknesses of health care systems globally, including the malaria situation; a holistic analysis of the direct and indirect effects of this pandemic and an adapted strengthening of health care systems is essential to be prepared for the future.
The prognostic significance of duodenal wall invasion in pancreatic adenocarcinoma
Authors: Alkhasawneh Ahmad , Rashid Tasnuva , Mohammed Ibraheem , Elhaddad Basma , Al-Balas Hassan , Virarkar Mayur , Awad Ziad , Baskovich Brett , Gopinath Arun
Published: March 2023

Objective

The most recent edition of the American Joint Committee on Cancer Staging Manual (AJCC, 8th edition) relies only on tumor size for staging resectable pancreatic adenocarcinoma, and the presence of duodenal wall invasion (DWI) no longer has an impact on staging. However, very few studies have evaluated its significance. In this study, we aim to evaluate the prognostic significance of DWI in pancreatic adenocarcinoma.

Methods

We reviewed 97 consecutive internal cases of resected pancreatic head ductal adenocarcinoma, and clinicopathologic parameters were recorded. All cases were staged according to the 8th edition of AJCC, and the patients were divided into two groups based on the presence or absence of DWI.

Results

Out of our 97 cases, 53 patients had DWI (55%). In univariate analysis, DWI was significantly associated with lymphovascular invasion and lymph node metastasis (AJCC 8th edition pN stage). In univariate analysis of overall survival, age > 60, absence of DWI, and African American race were associated with worse overall survival. In multivariate analysis, age > 60, absence of DWI, and African American race were associated with worse progression-free survival and overall survival.

Conclusion

Although DWI is associated with lymph node metastasis, it is not associated with inferior disease-free/overall survival.
Laparoscopic D3 lymph node dissection with left colic artery and first sigmoid artery preservation in rectal cancer
Authors: Huang Xing , Xiao Zhigang , Huang Zhongcheng , Li Dan
Published: March 2023

Background

D3 lymph node dissection with left colic artery (LCA) preservation in rectal cancer surgery seems to have little effect on reducing postoperative anastomotic leakage. So we first propose D3 lymph node dissection with LCA and first sigmoid artery (SA) preservation. This novel procedure deserves further study.

Methods

Rectal cancer patients who underwent laparoscopic D3 lymph node dissection with LCA preservation or with LCA and first SA preservation between January 2017 and January 2020 were retrospectively assessed. The patients were categorized into two groups: the preservation of the LCA group and the preservation of the LCA and first SA group. A 1:1 propensity score-matched analysis was performed to decrease confounding.

Results

Propensity score matching yielded 56 patients in each group from the eligible patients. The rate of postoperative anastomotic leakage in the preservation of the LCA and first SA group was significantly lower than that in the LCA preservation group (7.1% vs. 0%, P=0.040). No significant differences were observed in operation time, length of hospital stay, estimated blood loss, length of distal margin, lymph node retrieval, apical lymph node retrieval, and complications. A survival analysis showed patients’ 3-year disease-free survival (DFS) rates of group 1 and group 2 were 81.8% and 83.5% (P=0.595), respectively.

Conclusion

D3 lymph node dissection with LCA and first SA preservation for rectal cancer may help reduce the incidence of anastomotic leakage without compromising oncological outcomes compare with D3 lymph node dissection with LCA preservation alone.
Lactation duration and lifetime progression to metabolic syndrome in women according to their history of gestational diabetes: a prospective longitudinal community-based cohort study
Authors: Farahmand Maryam , Rahmati Maryam , Azizi Fereidoun , Ramezani Tehrani Fahimeh
Published: March 2023

Background

Despite the many signs of progress in pharmacotherapies, metabolic syndrome (MetS) is one of the main public-health burdens worldwide. Our study aimed to compare the effect of breastfeeding (BF) in women with and without gestational diabetes mellitus (GDM) on MetS incidence.

Methods

Of females who participated in the Tehran Lipid and glucose study, women who met our inclusion criteria were selected. The Cox proportional hazards regression model, with adjustment of potential confounders, was done to evaluate the relationship between duration of BF and incident of MetS in women with a GDM history compared to non-GDM.

Results

Out of 1176 women, there were 1001 non-GDM and 175 GDM. The median follow-up was 16.3 (11.9, 19.3) years. Results of the adjusted model illustrated that the total BF duration was negatively associated with MetS incidence risk (hazard ratio (HR) 0.98, 95% CI 0.98–0.99) in total participants indicating that per one-month increase of BF duration, the hazard of MetS reduced by 2%. The HR of MetS in Comparison between GDM and non-GDM women demonstrated significantly more reduced MetS incidence with a longer duration of exclusive BF (HR 0.93, 95% CI 0.88–0.98).

Conclusions

Our findings illustrated the protective effect of BF, especially exclusive BF, on MetS incidence risk. BF is more effective in reducing the risk of MetS among women with a history of GDM than among women without such a history.
Antioxidant activities in relation to the transport of heavy metals from the soil to different parts of Betula pendula (Roth.)
Authors: Makuch-Pietraś Iwona , Grabek-Lejko Dorota , Górka Anna , Kasprzyk Idalia
Published: March 2023

Background

Birch is a tree with a common occurrence in the environment and its organs are used in the form of herbal material. An important aspect of this study is birch pollen, which is a problem for allergy sufferers, and due to a variety of environmental conditions, its allergenicity may increase. Among the organs studied, inflorescences deserve attention, which, as seen from an overview of the literature, are analysed for the content of heavy metals for the first time in this study.

Results

This paper investigated the relationship between antioxidant properties and the content of heavy metals (Cu, Zn, Cd, Pb, Ni and Cr) as the plant's response to stress, taking into account both the vegetative and generative organs of the tree Betula pendula. While studying the accumulation of elements in individual organs, the research was extended to include the aspect of different environmental conditions, reflected in two soil types of differing physicochemical properties: sandy and silty soils. In order to thoroughly analyse the transport of the studied heavy metals from the soil to individual organs (leaves, inflorescences and pollen), ecotoxicological indicators were used. A modified translocation factor (TF) index into sTF (sap translocation factor) was presented as a novelty in research, calculated based on the content of selected heavy metals in the sap flowing to individual birch organs. This allowed for a more complete description of the transport of elements in the aerial parts of plants, indicating the accumulation of zinc and cadmium, especially in leaves. Among the studied environmental conditions which may affect the accumulation of heavy metals, sandy soil is of particular significance, conditioning lower pH values, among other things. However, analysis of the reaction of birch to the conditions of the soil environment and the content of heavy metals, based on antioxidant properties, demonstrated an evident reaction to stress, but without an unambiguous response among the studied vegetative and generative organs.

Conclusions

As birch is a plant with wide utility values, monitoring studies are advisable to exclude the risk of accumulation of heavy metals in its organs, and for this purpose it may be useful to use the sTF indicator and assess the antioxidant potential.
Laser capture microdissection as a method for investigating the human hair follicle microbiome reveals region-specific differences in the bacteriome profile
Authors: Lousada Marta B. , Edelkamp J , Lachnit T , Fehrholz M , Jimenez F , Paus R
Published: March 2023

Objective

Human hair follicles (HFs) are populated by a rich and diverse microbiome, traditionally evaluated by methods that inadvertently sample the skin microbiome and/or miss microbiota located in deeper HF regions. Thereby, these methods capture the human HF microbiome in a skewed and incomplete manner. This pilot study aimed to use laser-capture microdissection of human scalp HFs, coupled with 16S rRNA gene sequencing to sample the HF microbiome and overcome these methodological limitations.

Results

HFs were laser-capture microdissected (LCM) into three anatomically distinct regions. All main known core HF bacterial colonisers, including Cutibacterium, Corynebacterium and Staphylococcus, were identified, in all three HF regions. Interestingly, region-specific variations in α-diversity and microbial abundance of the core microbiome genera and Reyranella were identified, suggestive of variations in microbiologically relevant microenvironment characteristics. This pilot study therefore shows that LCM-coupled with metagenomics is a powerful tool for analysing the microbiome of defined biological niches. Refining and complementing this method with broader metagenomic techniques will facilitate the mapping of dysbiotic events associated with HF diseases and targeted therapeutic interventions.
Rationale for the selection of dual primary endpoints in prevention studies of cognitively unimpaired individuals at genetic risk for developing symptoms of Alzheimer’s disease
Authors: Caputo Angelika , Racine Amy , Paule Ines , Tariot Pierre N. , Langbaum Jessica B. , Coello Neva , Riviere Marie-Emmanuelle , Ryan J. Michael , Lopez Cristina Lopez , Graf Ana ,   for the National Alzheimer’s Coordinating Center,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: March 2023

Background

There is a critical need for novel primary endpoints designed to detect early and subtle changes in cognition in clinical trials targeting the asymptomatic (preclinical) phase of Alzheimer’s disease (AD). The Alzheimer’s Prevention Initiative (API) Generation Program, conducted in cognitively unimpaired individuals at risk of developing AD (e.g., enriched by the apolipoprotein E (APOE) genotype), used a novel dual primary endpoints approach, whereby demonstration of treatment effect in one of the two endpoints is sufficient for trial success. The two primary endpoints were (1) time to event (TTE)—with an event defined as a diagnosis of mild cognitive impairment (MCI) due to AD and/or dementia due to AD—and (2) change from baseline to month 60 in the API Preclinical Composite Cognitive (APCC) test score.

Methods

Historical observational data from three sources were used to fit models to describe the TTE and the longitudinal APCC decline, both in people who do and do not progress to MCI or dementia due to AD. Clinical endpoints were simulated based on the TTE and APCC models to assess the performance of the dual endpoints versus each of the two single endpoints, with the selected treatment effect ranging from a hazard ratio (HR) of 0.60 (40% risk reduction) to 1 (no effect).

Results

A Weibull model was selected for TTE, and power and linear models were selected to describe the APCC score for progressors and non-progressors, respectively. Derived effect sizes in terms of reduction of the APCC change from baseline to year 5 were low (0.186 for HR = 0.67). The power for the APCC alone was consistently lower compared to the power of TTE alone (58% [APCC] vs 84% [TTE] for HR = 0.67). Also, the overall power was higher for the 80%/20% distribution (82%) of the family-wise type 1 error rate (alpha) between TTE and APCC compared to 20%/80% (74%).

Conclusions

Dual endpoints including TTE and a measure of cognitive decline perform better than the cognitive decline measure as a single primary endpoint in a cognitively unimpaired population at risk of AD (based on the APOE genotype). Clinical trials in this population, however, need to be large, include older age, and have a long follow-up period of at least 5 years to be able to detect treatment effects.
Asthma occurrence in children and early life systemic antibiotic use: an incidence density study
Authors: Bentouhami Hayat , Bungwa Milcah Kahkelam , Casas Lidia , Coenen Samuel , Weyler Joost
Published: March 2023

Background

Results of studies evaluating the relationship between asthma occurrence and early life antibiotic use have been conflicting. The aim of this study was to investigate the relationship between occurrence of asthma in children and systemic antibiotic use in the first year of life based on an incidence density study with careful consideration of the temporal aspects of the determinant-outcome relationship.

Methods

We conducted an incidence density study nested in a data collection project with information on 1128 mother–child pairs. Systemic antibiotic use in the first year of life was defined as excessive (≥ 4 courses) vs. non-excessive (< 4 courses) use based on information from weekly diaries. Events (cases) were defined as the first parent-reported occurrence of asthma in a child between 1 and 10 years of age. Population time ‘at risk’ was probed by sampling population moments (controls). Missing data were imputed. Multiple logistic regression was used to assess the association between current first asthma occurrence (incidence density) and systemic antibiotic use in the first year of life, to evaluate effect modification and adjust for confounding.

Results

Forty-seven first asthma events and 147 population moments were included. Excessive systemic antibiotic use in the first year of life showed more than twice the incidence density of asthma compared to non-excessive use (adjusted IDR [95% CI]: 2.18 [0.98, 4.87], p = 0.06). The association was more pronounced in children who have had lower respiratory tract infections (LRTIs) in the first year of life compared to children who had no LRTIs in the first year of life (adjusted IDR [95% CI]: 5.17 [1.19, 22.52] versus 1.49 [0.54, 4.14]).

Conclusions

Excessive use of systemic antibiotics in the first year of life may play a role in the genesis of asthma in children. This effect is modified by the occurrence of LRTIs in the first year of life, with a stronger association observed in children experiencing LRTIs in the first year of life.
Going dark? Analysing the impact of end-to-end encryption on the outcome of Dutch criminal court cases
Authors: Hartel Pieter , van Wegberg Rolf
Published: March 2023

Law enforcement agencies struggle with criminals using end-to-end encryption (E2EE). A recent policy paper states: “while encryption is vital and privacy and cyber security must be protected, that should not come at the expense of wholly precluding law enforcement”. The main argument is that E2EE hampers attribution and prosecution of criminals who rely on encrypted communication - ranging from drug syndicates to child sexual abuse material (CSAM) platforms. This statement - in policy circles dubbed ‘going dark’ - is not yet supported by empirical evidence. That is why, in our work, we analyse public court data from the Netherlands to show to what extent law enforcement agencies and the public prosecution service are impacted by the use of E2EE in bringing cases to court and their outcome. Our results show that in cases brought to court, the Dutch courts appear to be as successful in convicting offenders who rely on E2EE as those who do not. Our data do not permit us to draw conclusions on the effect of E2EE on criminal investigations.
Characterization of bone marrow heterogeneity in NK-AML (M4/M5) based on single-cell RNA sequencing
Authors: Wu Wenqi , Shi Zeyan , Tang Zhongyuan , Li Huiqun , Huang Xiaoke , Liang Xiaolin , Li Jing , Yao Yibin , Zhao Weihua , Wu Meiqing , Luo Jun , Liu Zhenfang
Published: March 2023

Normal karyotype acute myeloid leukemia (NK-AML) is a heterogeneous hematological malignancy that contains a minor population of self-renewing leukemia stem cells (LSCs), which complicate efforts to achieve long-term survival. We performed single-cell RNA sequencing to profile 39,288 cells from 6 bone marrow (BM) aspirates including 5 NK-AML (M4/M5) patients and 1 healthy donor. The single-cell transcriptome atlas and gene expression characteristics of each cell population in NK-AML (M4/M5) and healthy BM were obtained. In addition, we identified a distinct LSC-like cluster with possible biomarkers in NK-AML (M4/M5) and verified 6 genes using qRT‒PCR and bioinformatic analyses. In conclusion, we utilized single-cell technologies to provide an atlas of NK-AML (M4/M5) cell heterogeneity, composition, and biomarkers with implications for precision medicine and targeted therapies.
Exploring female otolaryngologists’ experiences with gender bias and microaggressions: A cross sectional Canadian survey
Authors: Hu Amanda C. , Nguyen Kelly , Meyer Tanya K.
Published: March 2023

Background

Gender bias is behavior that shows favoritism towards one gender over another. Microaggressions are defined as subtle, often unconscious, discriminatory, or insulting actions that communicate demeaning or negative attitudes. Our objective was to explore how female otolaryngologists experience gender bias and microaggressions in the workplace.

Methods

Anonymous web-based cross-sectional Canadian survey was distributed to all female otolaryngologists (attendings and trainees) using the Dillman's Tailored Design Method from July to August of 2021. Quantitative survey included demographic data, validated 44-item Sexist Microaggressions Experiences and Stress Scale (MESS) and validated 10-item General Self-efficacy scale (GSES). Statistical analysis included descriptive and bivariate analysis.

Results

Sixty out of 200 participants (30% response rate) completed the survey (mean age 37 ± 8.3 years, 55.0% white, 41.7% trainee, 50% fellowship-trained, 50% with children, mean 9.2 ± 7.4 years of practice). Participants scored mild to moderate on the Sexist MESS—Frequency (mean ± standard deviation) 55.8 ± 24.2 (42.3% ± 18.3%), Severity 46.0 ± 23.9 (34.8% ± 18.1%), Total 104.5 ± 43.7 (39.6% ± 16.6%) and high on GSES (32.7 ± 5.7). Sexist MESS score was not associated with age, ethnicity, fellowship-training, having children, years of practice, or GSES. In the sexual objectification domain, trainees had higher frequency (p = 0.04), severity (p = 0.02) and total MESS (p = 0.02) scores than attendings.

Conclusions

This was the first multicenter, Canada-wide study exploring how female otolaryngologists experience gender bias and microaggressions in the workplace. Female otolaryngologists experience mild to moderate gender bias, but have high self-efficacy to manage this issue. Trainees had more severe and frequent microaggressions than attendings in the sexual objectification domain. Future efforts should help develop strategies for all otolaryngologists to manage these experiences, and thereby improve the culture of inclusiveness and diversity in our specialty.

Graphical Abstract
Climate-relevant properties of black carbon aerosols revealed by in situ measurements: a review
Authors: Moteki Nobuhiro
Published: March 2023

Light-absorbing aerosols affect atmospheric radiation, dynamics, and precipitations through shortwave absorption in the atmosphere and snowpack. Black carbon (BC) is considered the most significant contributor to global shortwave absorption among all the known light-absorbing aerosol components. In analyses and predictions of BC’s lifecycle and climate effects, multiscale field observations are needed to test the fundamental assumptions in the climate model. In situ measurements, the focus of this review, fill the gap of observational information accessible from remote sensing and laboratory analyses. This article reviews historical backgrounds, recent advances in in situ measurements of BC, and the resulting observational findings used to update the assumptions in climate models and remote sensing. Finally, we raise open problems that demand a rethinking and future investigation.

Illustrating the physical principle of detecting the light-absorbing black carbon and iron oxides
aerosol particles using the single-particle laser-induced incandescence
Effect of polypharmacy on plasma bepridil concentration in patients with heart failure: a multicenter retrospective study
Authors: Asai Yuki , Arihara Hiroki , Omote Saki , Tanio Ena , Yamashita Saena , Higuchi Takashi , Hashimoto Ei , Yamada Momoko , Tsuji Hinako , Kondo Yoshihiro , Hayashi Makoto , Yamamoto Yoshiaki
Published: March 2023

Background

Polypharmacy, defined as the concurrent use of over six drugs, is common in the treatment of heart failure (HF); however, unpredictable drug interactions with bepridil may occur. In this study, we have elucidated the influence of polypharmacy on plasma bepridil concentrations in patients with HF.

Methods

We conducted a multicenter retrospective study involving 359 adult patients with HF who received oral bepridil. Because QT prolongation is an adverse effect following plasma bepridil concentrations ≥800 ng/mL, the risk factors for patients achieving these concentrations at steady state were elucidated via multivariate logistic regression. The correlation between bepridil dose and plasma concentration was examined. The effect of polypharmacy on the value of the concentration-to-dose (C/D) ratio was investigated.

Results

A significant relationship was observed between bepridil dose and plasma concentration (p <  0.001), and the intensity of the correlation was moderate (r = 0.503). Based on multivariate logistic regression, the adjusted odds ratios for a daily dose of bepridil ≥1.6 mg/kg, polypharmacy, and concomitant of aprindine, a cytochrome P450 2D6 inhibitor, were 6.82 (95% coefficient interval: 2.104–22.132, p = 0.001), 2.96 (95% coefficient interval: 1.014–8.643, p = 0.047), and 8.63 (95% coefficient interval: 1.684–44.215, p = 0.010), respectively. Despite the moderate correlation in non-polypharmacy, the correlation was not observed in polypharmacy. Therefore, inhibiting metabolism, along with other mechanisms, may contribute to the polypharmacy-induced increase in plasma bepridil concentrations. Moreover, the C/D ratios in the groups receiving 6–9 and 10≤ concomitant drugs were 1.28- and 1.70-fold higher than in those receiving <6 drugs, respectively.

Conclusions

Plasma bepridil concentrations may be influenced by polypharmacy. Moreover, the plasma bepridil concentration increased in correlation with the number of concomitant drugs used. Although the mechanism of this increase could not be determined, plasma bepridil concentrations should be periodically monitored for safe use in patients with HF.

Trial registration

Retrospectively registered.
The predictive power of Bitcoin prices for the realized volatility of US stock sector returns
Authors: Bouri Elie , Salisu Afees A. , Gupta Rangan
Published: March 2023

This paper is motivated by Bitcoin’s rapid ascension into mainstream finance and recent evidence of a strong relationship between Bitcoin and US stock markets. It is also motivated by a lack of empirical studies on whether Bitcoin prices contain useful information for the volatility of US stock returns, particularly at the sectoral level of data. We specifically assess Bitcoin prices’ ability to predict the volatility of US composite and sectoral stock indices using both in-sample and out-of-sample analyses over multiple forecast horizons, based on daily data from November 22, 2017, to December, 30, 2021. The findings show that Bitcoin prices have significant predictive power for US stock volatility, with an inverse relationship between Bitcoin prices and stock sector volatility. Regardless of the stock sectors or number of forecast horizons, the model that includes Bitcoin prices consistently outperforms the benchmark historical average model. These findings are independent of the volatility measure used. Using Bitcoin prices as a predictor yields higher economic gains. These findings emphasize the importance and utility of tracking Bitcoin prices when forecasting the volatility of US stock sectors, which is important for practitioners and policymakers.
Variant femoral nerve: the path beneath the iliacus muscle and into neuropathic symptoms
Authors: Vinson Colby , Pavlovsky Ethan , Loomis Mario
Published: March 2023

Background

Previous discussions regarding variant femoral nerves often report an aberrant slip of a small portion of the iliacus muscle as a common cause of the femoral nerve splitting. Within these reported cases, the variant path involves a small amount of the nerve and treatment often involves surgical intervention to relieve nerve entrapment. Only a few cases have been reported that were not secondary to an aberrant muscle slippage, none of which include the variant discussed below.

Case presentation

A Caucasian male cadaver in his 70 s was discovered to have a variant femoral nerve upon dissection and evaluation of the pelvic region, without evidence of muscle slippage or surgical intervention. The bulk of the nerve pierced and traveled deep within the iliacus muscle before emerging distal to the pubic eminence and merging with the smaller portion that continued with the native course anteriorly. This variation would result in a predisposition to nerve compression during hip flexion and knee extension, with subsequent patient concerns of muscle weakness and sensory loss of unknown origins.

Conclusion

Awareness of this atypical variation could provide clinicians with another potential diagnosis to consider when managing femoral neuropathy, as well as the rationale for a noninvasive treatment option.
Blood levels of brain-derived neurotrophic factor (BDNF) in systemic lupus erythematous (SLE): a systematic review and meta-analysis
Authors: Shobeiri Parnian , Maleki Saba , Amanollahi Mobina , Habibzadeh Amirhossein , Teixeira Antonio L. , Rezaei Nima
Published: March 2023

Objectives

BDNF has been implicated in the pathophysiology of systemic lupus erythematosus (SLE), especially its neuropsychiatric symptoms. The purpose of this study was to investigate the profile of blood BDNF levels in patients with SLE.

Methods

We searched PubMed, EMBASE, and the Cochrane Library for papers that compared BDNF levels in SLE patients and healthy controls (HCs). The Newcastle–Ottawa scale was used to assess the quality of the included publications, and statistical analyses were carried out using R 4.0.4.

Results

The final analysis included eight studies totaling 323 healthy controls and 658 SLE patients. Meta-analysis did not show statistically significant differences in blood BDNF concentrations in SLE patients compared to HCs (SMD 0.08, 95% CI [ − 1.15; 1.32], P value = 0.89). After removing outliers, there was no significant change in the results: SMD -0.3868 (95% CI [ − 1.17; 0.39], P value = 0.33. Univariate meta-regression analysis revealed that sample size, number of males, NOS score, and mean age of the SLE participants accounted for the heterogeneity of the studies (R2 were 26.89%, 16.53%, 18.8%, and 49.96%, respectively).

Conclusion

In conclusion, our meta-analysis found no significant association between blood BDNF levels and SLE. The potential role and relevance of BDNF in SLE need to be further examined in higher quality studies.
Save the microbes to save the planet. A call to action of the International Union of the Microbiological Societies (IUMS)
Authors: Rappuoli Rino , Young Paul , Ron Eliora , Pecetta Simone , Pizza Mariagrazia
Published: March 2023

Our planet is populated by at least a trillion species of microorganisms. Every life form is sustained by them and they make the planet habitable. Only a minority of them, about 1400 species, cause infectious diseases that are responsible for human morbidity, mortality, pandemics and the resulting huge economic losses. Modern human activities, environmental changes and the attempt to control infectious agents using broad spectrum antibiotics and disinfectants jeopardize the global microbial diversity. The International Union of the Microbiological Societies (IUMS) is launching a call to action to mobilize all microbiological societies globally to promote the development of sustainable solutions to control infectious agents while preserving the global microbial diversity and the healthy life of our planet.
Mutual interaction of lncRNAs and epigenetics: focusing on cancer
Authors: Ranjbar Maryam , Heydarzadeh Samaneh , Shekari Khaniani Mahmoud , Foruzandeh Zahra , Seif Farhad , Pornour Majid , Rahmanpour Dara , Tarhriz Vahideh , Alivand MohammadReza
Published: March 2023

Long noncoding RNAs are characterized as noncoding transcripts longer than 200 nucleotides in response to a variety of functions within the cells. They are involved in almost all cellular mechanisms so as epigenetics. Given that epigenetics is an important phenomenon, which participates in the biology of complex diseases, many valuable studies have been performed to demonstrate the control status of lncRNAs and epigenetics. DNA methylation and histone modifications as epigenetic mechanisms can regulate the expression of lncRNAs by affecting their coding genes. Reciprocally, the three-dimensional structure of lncRNAs could mechanistically control the activity of epigenetic-related enzymes. Dysregulation in the mutual interaction between epigenetics and lncRNAs is one of the hallmarks of cancer. These mechanisms are either directly or indirectly involved in various cancer properties such as proliferation, apoptosis, invasion, and metastasis. For instance, lncRNA HOTAIR plays a role in regulating the expression of many genes by interacting with epigenetic factors such as DNA methyltransferases and EZH2, and thus plays a role in the initiation and progression of various cancers. Conversely, the expression of this lncRNA is also controlled by epigenetic factors. Therefore, focusing on this reciprocated interaction can apply to cancer management and the identification of prognostic, diagnostic, and druggable targets. In the current review, we discuss the reciprocal relationship between lncRNAs and epigenetic mechanisms to promote or prevent cancer progression and find new potent biomarkers and targets for cancer diagnosis and therapy.
The effect of spinal magnetic stimulation on the management of functional constipation in adults
Authors: Fawaz Shereen Ismail , Elshatby Nehad Mohamed , El-Tawab Sarah Sayed
Published: March 2023

Background

Functional constipation is a type of functional bowel disorder characterized by difficult defecation with a sense of incomplete evacuation. It is a common disorder with an increasing prevalence, and the underlying cause is poorly identified. Nonpharmacological management of functional constipation includes lifestyle and dietary modification, regular physical activity, advice about toileting posture, and behavioral therapy. Biofeedback training as part of the behavioral training showed great efficacy with long-term results. Spinal magnetic stimulation is the application of extracorporeal magnetic stimuli to the spinal nerves and deep pelvic muscles to enhance bowel evacuation without surgical drawbacks. This study was designed to enhance bowel elimination in functional constipation patients through the dual effect of biofeedback and spinal magnetic stimulation. This work aimed to study the efficacy of spinal magnetic stimulation and biofeedback training versus biofeedback alone in the management of functional constipation.

Results

There was a statistically significant difference between before and after the intervention in both studied groups regarding the mean weekly spontaneous bowel movement, a Numerical Rating Scale for pain assessment, and the Patient Assessment of Constipation Quality of Life questionnaire. When comparing the two groups after the intervention, the spinal magnetic stimulation showed superiority in the mean weekly spontaneous bowel movement and manometric anal pressure at rest.

Conclusions

Spinal magnetic stimulation in addition to biofeedback pelvic floor muscle training could increase the mean weekly complete spontaneous bowel movements and manometric anal pressure at rest in patients with functional constipation. It did not show any additive benefits in improving pain during defecation or patient quality of life.

Trial registration

ClinicalTrials.gov, 0305398. https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000BQ0H&selectaction=Edit&uid=U0004JW0&ts=2&cx=-xmnims
Bearing failure diagnosis and prognostics modeling in plants for industrial purpose
Authors: Omoregbee Henry Ogbemudia , Edward Bright Aghogho , Olanipekun Mabel Usunobun
Published: March 2023

When condition-based maintenance (CBM) is combined with proper decision support systems, it leads to enhanced utilization of resources and increased productivity which tends towards business efficiency. The forecasting of the future condition, the remaining operating life, or probability of stable system behavior, based on data from acquired condition monitoring is referred to as prognosis which is an important part of the CBM process. Despite auto-regression integrated moving average (ARIMA) time series modeling, being long established and dating back to the 1960s, it has surged through new advances over the years and is now recognized as a major forecasting technique. Its application is therefore investigated here in the context of the FEMTO–ST Institute (Franche-Comté Électronique Mécanique Thermique et Optique-Sciences et Technologies) bearing dataset. The work discussed in this article uses a time series approach which contributes to modeling and forecasting the remaining useful life (RUL) of bearings in plants, thereby helping to prevent catastrophic failure before it occurs. The motivation for this paper lies in the approach used in structuring the ARIMA models, thereby adding value in its application by first ensuring the stationarity of the time series signal by using the Dickey-Fuller Test, which then makes forecasting easy and accurate. The result obtained here using ARIMA is compared to the results obtained in the literature where neural network regression (NNR) was used as part of the FEMTO competition. We checked by contrasting our observations with the NNR observations obtained as well as the experimental results from the National Aeronautics and Space Administration (NASA)
Mobile applications in the Philippines during the COVID-19 pandemic: systematic search, use case mapping, and quality assessment using the Mobile App Rating Scale (MARS)
Authors: Gonzales Aldren , Custodio Razel , Lapitan Marie Carmela , Ladia Mary Ann
Published: March 2023

Background

In the Philippines, various mobile health apps were implemented during the COVID-19 pandemic with very little knowledge in terms of their quality. The aims of this paper were 1) to systemically search for mobile apps with COVID-19 pandemic use case that are implemented in the Philippines; 2) to assess the apps using Mobile App Rating Scale (MARS); and 3) to identify the critical points for future improvements of these apps.

Methods

To identify existing mobile applications with COVID-19 pandemic use case employed in the Philippines, Google Play and Apple App Stores were systematically searched. Further search was conducted using the Google Search. Data were extracted from the app web store profile and apps were categorized according to use cases. Mobile apps that met the inclusion criteria were independently assessed and scored by two researchers using the MARS—a 23-item, expert-based rating scale for assessing the quality of mHealth applications.

Results

A total of 27 apps were identified and assessed using MARS. The majority of the apps are designed for managing exposure to COVID-19 and for promoting health monitoring. The overall MARS score of all the apps is 3.62 points (SD 0.7), with a maximum score of 4.7 for an app used for telehealth and a minimum of 2.3 for a COVID-19 health declaration app. The majority (n = 19, 70%) of the apps are equal to or exceeded the minimum “acceptable” MARS score of 3.0. Looking at the categories, the apps for raising awareness received the highest MARS score of 4.58 (SD 0.03) while those designed for managing exposure to COVID-19 received the lowest mean score of 3.06 (SD 0.6).

Conclusions

There is a heterogenous quality of mHealth apps implemented during the COVID-19 pandemic in the Philippines. The study also identified areas to better improve the tools. Considering that mHealth is expected to be an integral part of the healthcare system post-pandemic, the results warrant better policies and guidance in the development and implementation to ensure quality across the board and as a result, positively impact health outcomes.
Evaluation of a Pathway team for homeless mental health in-patients
Authors: Tulloch Alex D. , Khan Zana , Hewett Nigel , Koehne Sophie , Rao Ranga
Published: March 2023

Aims and method

The Pathway model is an enhanced care coordination model for homeless people in hospital. We aimed to evaluate the first attempt to apply it on psychiatric wards, which started in 2015 in South London. We developed a logic model which expressed how the Pathway approach might work. Two predictions from this model were tested, using propensity scores and regression to estimate the effect of the intervention among people who were eligible for it.

Results

The Pathway team theorised that their interventions would reduce length of stay, improve housing outcomes and optimise the use of primary care – and, more tentatively, reduce readmission and emergency presentations. We were able to estimate effects on length of stay (−20.3 days; 95% CI −32.5 to −8.1; P = 0.0012) and readmission (a non-significant reduction).

Clinical implications

The marked reduction in length of stay, explicable in terms of the logic model, constitutes preliminary support for the Pathway model in mental health services.