bluuebunny/crossref_metadata_2025 huggingface dataset:
Faculty and students’ perspectives of online learning during COVID-19 crisis: Constraints and opportunities for Kenyan universities
Authors: Wekullo Caroline S , Kabindio Brendah , Juma Iddi
Published: April 2023

At the onset of COVID-19 pandemic, all higher education institutions had to abruptly migrate from face-to-face mode of learning to virtual learning. Students and faculty members were thrown into the process of acquainting themselves with a fully virtual system. How prepared were institutions, faculty members, and students for the abrupt and massive transition to online learning? The study examined the faculty and students’ perspective of online learning during COVID-19 pandemic. Specifically, the study examined the perceptions of faculty and students on the preparedness of higher education institutions for online teaching and learning. The study also determined the perceptions of staff and students towards online education, constraints, and opportunities. A descriptive cross-sectional survey was conducted at a public university in Kenya. A semi-structured interview was conducted on a total sample of 36 respondents; 24 students and 12 faculty members to capture unique, idiosyncratic and whole individual viewpoints. A conventional Content Analysis was done to determine words or concepts within the transcripts. The findings showed that the study institution, faculty members, and students were unprepared for the immediate and massive shift to online teaching and learning and had challenges using virtual technologies for teaching and learning during the lockdown. These challenges ranged from insufficient or lack of internet bandwidth, training, increased teaching and learning workloads to limited time for interactions. Based on the findings, the study suggests significant implications for higher education institution leaders, policymakers, faculty, and students. The study contributes to the existing literature by analyzing the perceptions of faculty and students about the preparedness of institutions, faculty, and students on the abrupt shift to online learning during the COVID-19 pandemic.
Segmental infantile hemangioma with milia: A case report
Authors: Pastukhova Elena , Kanigsberg Nordau
Published: April 2023

Milia are common in children. They are small, keratinizing cysts that arise either as primary epidermoid cysts or secondary to other dermatoses, trauma or certain medications. In the paediatric population, milia are most frequently congenital and resolve spontaneously. Infantile hemangiomas are relatively common in neonates. They typically arise within the first few weeks of life, undergo a proliferative phase in the first 6 months, then begin to involute at around 12 months of age. After involution, residual skin changes may be observed, such as telangiectasia, fibrofatty tissue and redundant skin. However, there is a gap in the literature regarding concomitant milia and infantile hemangiomas. We report a case of a 5-months-old female who presented with a large, segmental infantile hemangioma of the posterior neck with milia.
Upadacitinib-induced paradoxical face and scalp dermatitis: A case report of a novel sequela
Authors: Pastukhova Elena , Spurr Alison , Nakonechny Quentin , Lipson Jennifer
Published: April 2023

Atopic dermatitis is a chronic, pruritic inflammatory cutaneous condition that can carry significant morbidity. Severe or recalcitrant atopic dermatitis is often treated with immunosuppressants, biologics, or immune-modulating small molecule therapies. The Janus kinase–signal transducer and activator of transcription pathway is highly implicated in atopic dermatitis pathogenesis, and agents that inhibit Janus kinase signalling are new to the atopic dermatitis landscape. Upadacitinib is a JAK1 inhibitor that has a good safety and efficacy profile and is increasingly being prescribed for atopic dermatitis. We report a case of a 35-year-old male with extensive atopic dermatitis that initially improved significantly on upadacitinib, then after 6 months developed a severe crusted dermatitic eruption on the head favouring a seborrheic distribution. While the pathogenesis of this paradoxical reaction is unclear, this phenomenon may involve a shift to a more Th1/Th17-mediated immune response.
Sensing probation in Canada: Notes on affect and penal aesthetics in risk assessment
Authors: Taylor Micheal P.
Published: April 2023

Based on 6 years of probation practitioner experience in a metropolis of Canada, I provide an autoethnographic account reflecting on my fieldwork as I now commence doctoral studies. Contributing to discussions of experience in the penal atmosphere, I explore personal ethics and values, looking specifically to LSI-R software, where my experience with risk-based programming indicates a subjugation of both supervisees and supervisors. Studying penal aesthetics within the version of the software I used to assess criminogenic risk thus elucidates why evaluators tend to score their risk ratings upward rather than downward. Implications for a desistance paradigm are juxtaposed to the RNR model of offender management, where sensing visual and haptic stimuli pertains to an algorithmic governance mode limiting human connection. I conclude by reflecting on organisational values and behaviour to indicate where therapeutic alliances with criminalised people intersect criminalisation and desistance.
Preliminary Impact Assessment of Carbon Border Adjustment Mechanism on Russian Economy
Authors: Lestan Filip , Kabiraj Sajal , George Babu
Published: April 2023

The principal objective of the European Commission with the proposal of Carbon Border Adjustment Mechanism (CBAM) is to impose a levy on imports in particular energy-concentrated European sectors which are relative to carbon content of imported goods. The integration of carbon tax is very likely to result, that CBAM will have significant impact on international trade among European Union and Russia within the ACEFIS (aluminium, cement, electricity, fertilizers, iron, steel) industries. Therefore, the key question that authors of article addressed was the extent to which the CBAM policy trade instrument could affect Russian economy. The classification of the preliminary impact assessment in this article relies on the case-study concept with empirical data. The most significant impact could be represented on the Russian exports of iron and steel, whereas, the carbon levies would represent—€ 655 million in 2020 and € 398 million for fertilizers. The preliminary analysis clearly highlights that integration of CBAM can arise additional costs of imports from Russia within ACEFIS industries by more than € 1.1 billion. The levies from integration of CBAM could result in additional costs either on the side of exporters (Russia) in the form of loss in market share, or on the side of importers (European Union) in the form of shift of demand from ACEFIS goods or shift towards suppliers from most favourable regions. The ambition to create carbon neutral world is promising; however, decrease of the degree of carbon extensive industries will require a lot of additional investments.
Psychological Contract Types influence on Innovative Work Behaviour: Mediating Role of Leader–Member Exchange in Service Sector during Pandemic
Authors: Chakraborty Saswati , Pandey Suruchi , Khurana Anil
Published: April 2023

Technological progression and fierce competition dominate the current dynamic business environment with challenges for firms in human capital engagement. One of the ways to overcome this is by focusing on the employee’s contracts for improved work behaviour. To address this, the study examines the effect of the psychological contract on innovative work behaviour for service sector employees, with leadership role as the motivating behaviour. Two hundred forty-eight participants from IT, ITES, telecom, banking and financial services, transportation and logistics, and education and training services responded to an online questionnaire. The research employed structural equation modelling using SPSS and AMOS for analysis. The study examines the mediation effect of leader–member exchange between transactional and relational contracts and innovative work behaviour; the paper deliberates on the results of transactional and relational contracts’ influence on leadership exchange and innovative work behaviour. The theoretical and managerial implications are presented, followed by the study’s limitations, and directions for future research are outlined.
Does the Sensitivity of Firm Performance Impact the Determinants of CEO Compensations? An Empirical Evidence with Saudi Insurance Companies
Authors: Osman Mohamed Abdel Mawla , Aljeddani Sadiah Mohammed , Samontaray Durga Prasad
Published: April 2023

This article investigates the impact of insurance companies’ performance determinants that affect the CEO’s compensations in the emerging market for insurers. The researchers have pooled data for 10 Saudi insurance companies listed on the Saudi stock exchange (TADAWUL) and applied different regression models to assess the relationship between the various CEO compensations packages and insurance companies’ performance. A linear regression model was the better model fitting to explain the data well. The dependent variable is the CEO’s compensations measured by using salaries, allowances and bonuses. Five variables had used as independent variables besides two variables as insurer-specific control variables. We found a significant positive impact between the total earned premiums, the net incomes and CEO compensations. But relationship between investments, assets and revenues and CEO compensations was negative. At the same time there is no relationship between profit per stock, and the insurer’s age and CEO compensations.
How Media, Information Sources, and Trust Shape Climate Change Denial or Doubt
Authors: Sarathchandra Dilshani , Haltinner Kristin
Published: April 2023

Climate change skepticism presents an opportunity to examine the role of media, information, and trust on views about controversial scientific topics. Building on extant work on predictors of skepticism and the role of information and trust in shaping skeptical attitudes, in this paper, we examine the relationship between climate change skeptics’ access of media/information sources, trust, and the strength of their skepticism. Specifically, we use data gathered from 1,000 surveys with skeptics in the U.S. Pacific Northwest to present an analysis of how trust in institutions and institutional leaders affect the relationship between skeptics’ information sources and their type/strength of skepticism along a “continuum” of skeptical thought. Results reveal that the reliance on conservative/rightwing media and trust in actors steeped within the climate change denial countermovement is associated with a higher degree of denial of anthropogenic climate change as opposed to doubt of the phenomenon. Further, skeptics’ reliance on non-scientific sources for climate change information is partly explained by their distrust in climate scientists.
Resolving Conflict and Fostering Cooperation: A Cross-Cultural Experiential Exercise
Authors: Wong Elena M. , Crawley Rohan , Butler Seth , Olson Amber , Mchiri Ali , Gandhi Shammi , Caligiuri Michael , White Marla L.
Published: April 2023

In an ever-increasingly diverse workforce, cross-cultural communication skills are essential for success regardless of job title or task. We present an engaging and customizable 30-minute activity designed to develop participants’ cross-cultural communication skills by increasing awareness and sensitivity to interpersonal differences in collaborative group settings. Drawing from a multiculturalism approach to diversity, participants learn that acknowledging our differences facilitates more effective and strategic communication. We provide detailed instructions for running this exercise to meet instructors’ and students’ outlined learning objectives. The debriefing questions and post-lesson reflections support an environment where facilitators and participants grow. This experiential exercise suits any discipline’s synchronous undergraduate, graduate, and professional classes.
A new quantitative evaluation method of urban skyline based on object-based analysis and constitution theory
Authors: Yang Ling , Yang Xin , Li Yue , Li Sijin
Published: April 2023

The skyline is a comprehensive display of the morphological characteristics and cultural features of a city, and its quantitative evaluation is remarkable for perceiving the city and assisting in its planning. However, previous studies focused on the overall profile or tall buildings, lacking a perspective that considers the composition of skyline objects. This paper proposes a new quantitative method to evaluate the skyline based on the object-based analysis method and the constitution theory. Firstly, the skyline objects, that is, buildings, vegetation and mountains are extracted by using the object-based image analysis method. Secondly, the buildings are further classified into four classes according to their relative height. Then, two quantitative indicators, namely, richness of the object category variety and complexity of the object category spatial distribution, are proposed by considering the constitution theory. Finally, this method is applied to typical urban skylines in Shanghai, Hong Kong, New York and Vancouver. Results show that the new indicators can effectively represent the differences of city skylines when their profile indicators are relatively similar. The method can quantitatively evaluate the composition and spatial distribution of skyline objects. This paper is expected to provide a new perspective on the study of skyline aesthetics.
Schizophrenia, Human Leukocyte Antigen (HLA), and Herpes Viruses: Immunogenetic Associations at the Population Level
Authors: James Lisa M , Charonis Spyros A , Georgopoulos Apostolos P
Published: April 2023

Several factors have been implicated in schizophrenia (SZ), including human herpes viruses (HHV) and the adaptive immunity Human Leukocyte Antigen (HLA) genes. Here we investigated these issues in 2 complementary ways. In one analysis, we evaluated SZ-HLA and HHV-HLA associations at the level of a single allele by computing (a) a SZ-HLA protection/susceptibility (P/S) score based on the covariance between SZ and 127 HLA allele prevalences in 14 European countries, (b) estimating in silico HHV-HLA best binding affinities for the 9 HHV strains, and (c) evaluating the dependence of P/S score on HHV-HLA binding affinities. These analyses yielded (a) a set of 127 SZ-HLA P/S scores, varying by >200× (maximum/minimum), which could not be accounted for by chance, (b) a set of 127 alleles × 9 HHV best-estimated affinities, varying by >600×, and (c) a set of correlations between SZ-HLA P/S scores and HHV-HLA binding which indicated a prominent role of HHV1. In a subsequent analysis, we extended these findings to the individual person by taking into account the fact that every individual carries 12 HLA alleles and computed (a) the average SZ-HLA P/S scores of 12 randomly chosen alleles (2 per gene), an indicator of HLA-based SZ P/S for an individual, and (b) the average of the corresponding HHV estimated affinities for those alleles, an indicator of overall effectiveness of HHV-HLA binding. We found (a) that HLA protection for SZ was significantly more prominent than susceptibility, and (b) that protective SZ-HLA scores were associated with higher HHV-HLA binding affinities, indicating that HLA binding and subsequent elimination of several HHV strains may confer protection against schizophrenia.
Engaging the humanitarian marketplace: Values, valuations and the making of humanitarian geographies
Authors: Midgley Jane
Published: April 2023

This article argues that humanitarian procurement and supply activities create geographies that are underpinned by valuations and the various values these arrange. The article draws from interviews with global procurement, commodity and supply chain leads for European and North American humanitarian organisations providing emergency humanitarian assistance and development programming as to how they engage with values and valuations in their professional practice. The article draws from economic sociology and its focus on valuation as a situated social process to explore how different values are recognised, negotiated and ordered within humanitarian procurement and supply practices. By paying attention to reflections on self-described practice, we can see the importance of standard procurement principles in accommodating different values, economic and normative, and how these organise market arrangements for different goods and services. This approach crucially allows for the possibility for new values to be accommodated (such as sustainability). It also shows the conflicts and strains that arise when existing processes and arrangements that have been legitimised by practice are questioned, namely through the localisation agenda and its reimagining of the values which underpin the flow and control of resources and the challenges this can make to international humanitarian arrangements and the sector’s colonial legacy. The article prompts further thought as to what values will continue to resonate in the sector and which new values will be realised through procurement and supply decisions in the future. The article highlights the importance of thinking with values and valuation processes in the making of humanitarian geographies. By extension, this highlights the importance of diverse theoretical bases for understanding value and valuation as a critical geographical practice.
Lost (in) space for dialogue: On the (abandoned) need for working papers in human geography
Authors: Dörry Sabine , Wójcik Dariusz , Lai Karen PY , Aalbers Manuel B
Published: April 2023

Working papers have traditionally been an important means of communication in social sciences, including human geography. However, while some series have thrived for decades, working paper series in human geography are generally less common than in some other social sciences or the natural sciences, and face an uncertain future. Based on a survey with the editors of thirty journals in human geography, we draw a diverse and rather controversial picture of the current landscape of working paper series. We delve into the histories of some of the most prominent working paper series, identify key trends and propose ideas about the potential future of working paper series to enrich disciplinary spaces of dialogue.
Knowledge Domain and Innovation Trends Concerning Medical 3D Printing for Craniomaxillofacial Surgery Applications: A 30-Year Bibliometric and Visualized Analysis
Authors: Modgill Vikas , Balas Bogdan , Chi Minghan , Honigmann Philipp , Thieringer Florian M. , Sharma Neha
Published: April 2023

Study Design: Descriptive study (review containing bibliometric analyses). Objective: Since the inception of three-dimensional printing (3DP), various studies have been conducted worldwide to investigate the utilization of 3DP in craniomaxillofacial (CMF) surgery. Analyzing the current state of global research in medical 3DP in CMF surgery is a crucial first step in identifying knowledge gaps and focusing research resources on pressing problems that have not yet been addressed. Therefore, the current study was designed to present a comprehensive review of scientific research data to discover trends in the last 30 years of global research on 3DP in CMF surgery. Methods: All publications from 1994 until 14 February 2023 were retrieved from the core collection of Web of Science using a defined search. Detailed bibliographic data for all retrieved publications were collected. The bibliometric analysis was performed using VOS viewer, Histcite, and Microsoft Excel. Results: A total of 1367 evaluable articles were retrieved. Results showed that although there is an exponential increase in the number of publications related to 3DP in CMF surgery, there is a substantial regionalization of research, with the U.S.A. and China being the most significant contributors to the retrieved articles. It was also observed that there is a scarcity of published literature related to bioprinting in CMF surgery. Conclusion: This is the first study that specifically analyzed the published literature concerning 3DP in CMF surgery in a structured quantitative manner. The study found a concentration of research in specific geographies and indicated a need for more diversified research in this field. The study also identified a need for public sector involvement in such research to aid in the further dissemination of knowledge.
Advances in terahertz metasurface graphene for biosensing and application
Authors: Bi Hao , Yang Maosheng , You Rui
Published: April 2023

Based on the extraordinary electromagnetic properties of terahertz waves, such as broadband, low energy, high permeability, and biometric fingerprint spectra, terahertz sensors show great application prospects in the biochemical field. However, the sensitivity of terahertz sensing technology is increasingly required by modern sensing demands. With the development of terahertz technology and functional materials, graphene-based terahertz metasurface sensors with the advantages of high sensitivity, fingerprint identification, nondestructive and anti-interference are gradually gaining attention. In addition to providing ideas for terahertz biosensors, these devices have attracted in-depth research and development by scientists. An overview of graphene-based terahertz metasurfaces and their applications in the detection of biochemical molecules is presented. This includes sensor mechanism research, graphene metasurface index evaluation, protein and nucleic acid sensors, and other chemical molecule sensing. A comparative analysis of graphene, nanomaterials, silicon, and metals to develop material-integrated metasurfaces. Furthermore, a brief summary of the main performance results of this class of devices is presented, along with suggestions for improvements to the existing shortcoming.
Construction of an RNA modification-related gene predictive model associated with prognosis and immunity in gastric cancer
Authors: Tuhongjiang Airexiati , Wang Feng , Zhang Chengrong , Pang Sisi , Qu Yujiang , Feng Bo , Amuti Gulimire
Published: April 2023

Background

Gastric cancer (GC) is one of the most common causes of cancer-related fatalities worldwide, and its progression is associated with RNA modifications. Here, using RNA modification-related genes (RNAMRGs), we aimed to construct a prognostic model for patients with GC.

Methods

Based on RNAMRGs, RNA modification scores (RNAMSs) were obtained for GC samples from The Cancer Genome Atlas and were divided into high- and low-RNAMS groups. Differential analysis and weighted correlation network analysis were performed for the differential expressed genes (DEGs) to obtain the key genes. Next, univariate Cox regression, least absolute shrinkage and selection operator, and multivariate Cox regression analyses were performed to obtain the model. According to the model risk score, samples were divided into high- and low-risk groups. Enrichment analysis and immunoassays were performed for the DEGs in these groups. Four external datasets from Gene Expression Omnibus data base were used to test the accuracy of the predictive model.

Results

We identified SELP and CST2 as key DEGs, which were used to generate the predictive model. The high-risk group had a worse prognosis compared to the low-risk group (p < 0.05). Enrichment analysis and immunoassays revealed that 144 DEGs related to immune cell infiltration were associated with the Wnt signaling pathway and included hub genes such as ELN. Overall mutation levels, tumor mutation burden, and microsatellite instability were lower, but tumor immune dysfunction and exclusion scores were greater (p < 0.05) in the high-risk group than in the low-risk group. The validation results showed that the prediction model score can accurately predict the prognosis of GC patients. Finally, a nomogram was constructed using the risk score combined with the clinicopathological characteristics of patients with GC.

Conclusion

This risk score from the prediction model related to the tumor microenvironment and immunotherapy could accurately predict the overall survival of GC patients.
Differences in gut microbiota and its metabolic function among different fasting plasma glucose groups in Mongolian population of China
Authors: Liu Yanchao , Wang Mingxiao , Li Wuyuntana , Gao Yumin , Li Hailing , Cao Ning , Hao Wenli , Zhao Lingyan
Published: April 2023

Background

Many studies reported the association between gut microbiota and type 2 diabetes mellitus (T2D), but it is still unclear which bacterial genus plays a key role and how the metabolic function of gut microbiota changes in the occurrence and development of T2D. Besides, there is a high diabetic prevalence in Mongolian population, which may be partly affected by their high calorie diet. This study identified the main bacterial genus influencing T2D in Mongolian population, and analyzed the changes of metabolic function of gut microbiome. The association between dietary factors and the relative abundance of main bacterial genus and its metabolic function was also studied.

Methods

Dietary surveys and gut microbiota test were performed on 24 Mongolian volunteers that were divided into T2D (6 cases), PRET2D (6 cases) and Control group (12 cases) according to fasting plasma glucose (FPG) values. The relative abundance and metabolic function of gut microbiome from their fecal samples were measured by metagenomic analysis. Statistic method was used to evaluate the association between dietary factors and the relative abundance of the main bacterial genus or its metabolic function.

Results

This study found that the Clostridium genus may be one of the key bacterial genera affecting the process of T2D. First, the relative abundance of Clostridium genus was significantly different among the three groups. Second, there was a higher relative abundance of metabolic enzymes of gut bacteria in PRET2D and T2D group than that in Control group. Third, a strong correlation between Clostridium genus and many metabolic enzymes was uncovered, many of which may be produced by the Clostridium. Last, carotene intake daily was negatively correlated with the Clostridium but positively correlated with tagaturonate reductase catalyzing interconversions of pentose and glucuronate.

Conclusions

The gut Clostridium genus may play an important role in the development of T2D and it could be a potential biomarker for T2D in Mongolian population. Meanwhile, the metabolic function of gut bacteria has changed during the early stage of T2D and the changes in carbohydrate, amino acid, lipid or energy metabolism of Clostridium genus may play a critical role. In addition, the carotene intake may affect reproduction and metabolic function of Clostridium genus.
Genome-wide identification and characterization analysis of RWP-RK family genes reveal their role in flowering time of Chrysanthemum lavandulifolium
Authors: Zhang Qiuling , Li Junzhuo , Wen Xiaohui , Deng Chengyan , Yang Xiuzhen , Dai Silan
Published: April 2023

Background

RWP-RKs are plant specific transcription factors, which are widely distributed in plants in the form of polygenic families and play key role in nitrogen absorption and utilization, and are crucial to plant growth and development. However, the genome-wide identification and function of RWP-RK in Compositae plants are widely unknown.

Results

In this study, 101 RWP-RKs in Chrysanthemum lavandulifolium were identified and tandem repeat was an important way for the expansion of RWP-RKs in Compositae species. 101 RWP-RKs contain 38 NIN-like proteins (NLPs) and 31 RWP- RK domain proteins (RKDs), as well as 32 specific expansion members. qRT-PCR results showed that 7 ClNLPs in leaves were up-regulated at the floral transition stage, 10 ClNLPs were negatively regulated by low nitrate conditions, and 3 of them were up-regulated by optimal nitrate conditions. In addition, the flowering time of Chrysanthemum lavandulifolium was advanced under optimal nitrate conditions, the expression level of Cryptochromes (ClCRYs), phytochrome C (ClPHYC) and the floral integration genes GIGANTEA (ClGI), CONSTANS-LIKE (ClCOL1, ClCOL4, ClCOL5), FLOWERING LOCUS T (ClFT), FLOWERING LOCUS C (ClFLC), SUPPRESSOR OF OVER-EXPRESSION OF CONSTANS 1 (ClSOC1) also were up-regulated. The expression level of ClCRY1a, ClCRY1c, ClCRY2a and ClCRY2c in the vegetative growth stage induced by optimal nitrate reached the expression level induced by short-day in the reproductive growth stage, which supplemented the induction effect of short-day on the transcription level of floral-related genes in advance.

Conclusions

It was speculated that ClNLPs may act on the photoperiodic pathway under optimal nitrate environment, and ultimately regulate the flowering time by up-regulating the transcription level of ClCRYs. These results provide new perspective for exploring the mechanism of nitrate/nitrogen affecting flowering in higher plants.
Time-trend analysis of the center frequency of the intrinsic mode function from the Hilbert–Huang transform of electroencephalography during general anesthesia: a retrospective observational study
Authors: Obata Yurie , Yamada Tomomi , Akiyama Koichi , Sawa Teiji
Published: April 2023

Background

Anesthesiologists are required to maintain an optimal depth of anesthesia during general anesthesia, and several electroencephalogram (EEG) processing methods have been developed and approved for clinical use to evaluate anesthesia depth. Recently, the Hilbert–Huang transform (HHT) was introduced to analyze nonlinear and nonstationary data. In this study, we assessed whether the changes in EEG characteristics during general anesthesia that are analyzed by the HHT are useful for monitoring the depth of anesthesia.

Methods

This retrospective observational study enrolled patients who underwent propofol anesthesia. Raw EEG signals were obtained from a monitor through a previously developed software application. We developed an HHT analyzer to decompose the EEG signal into six intrinsic mode functions (IMFs) and estimated the instantaneous frequencies (HHT_IF) for each IMF. Changes over time in the raw EEG waves and parameters such as HHT_IF, BIS, spectral edge frequency 95 (SEF95), and electromyogram parameter (EMGlow) were assessed, and a Gaussian process regression model was created to assess the association between BIS and HHT_IF.

Results

We analyzed EEG signals from 30 patients. The beta oscillation frequency range (13–25 Hz) was detected in IMF1 and IMF2 during the awake state, then after loss of consciousness, the frequency decreased and alpha oscillation (8–12 Hz) was detected in IMF2. At the emergence phase, the frequency increased and beta oscillations were detected in IMF1, IMF2, and IMF3. BIS and EMGlow changed significantly during the induction and emergence phases, whereas SEF95 showed a wide variability and no significant changes during the induction phase. The root mean square error between the observed BIS values and the values predicted by a Gaussian process regression model ranged from 4.69 to 9.68.

Conclusions

We applied the HHT to EEG analyses during propofol anesthesia. The instantaneous frequency in IMF1 and IMF2 identified changes in EEG characteristics during induction and emergence from general anesthesia. Moreover, the HHT_IF in IMF2 showed strong associations with BIS and was suitable for depicting the alpha oscillation. Our study suggests that the HHT is useful for monitoring the depth of anesthesia.
External validation of the QLifetime cardiovascular risk prediction tool: population cohort study
Authors: Livingstone Shona , Morales Daniel R. , Fleuriot Jacques , Donnan Peter T. , Guthrie Bruce
Published: April 2023

Background

Prediction of lifetime cardiovascular disease (CVD) risk is recommended in many clinical guidelines, but lifetime risk models are rarely externally validated. The aim of this study was to externally validate the QRiskLifetime incident CVD risk prediction tool.

Methods

Independent external validation of QRiskLifetime using Clinical Practice Research Datalink data, examining discrimination and calibration in the whole population and stratified by age, and reclassification compared to QRISK3. Since lifetime CVD risk is unobservable, performance was evaluated at 10-years’ follow-up, and lifetime performance inferred in terms of performance for in the different age-groups from which lifetime predictions are derived.

Results

One million, two hundreds sixty thousand and three hundreds twenty nine women and 1,223,265 men were included in the analysis. Discrimination was excellent in the whole population (Harrell’s-C = 0.844 in women, 0.808 in men), but moderate to poor stratified by age-group (Harrell’s C in people aged 30–44 0.714 for both men and women, in people aged 75–84 0.578 in women and 0.556 in men). Ten-year CVD risk was under-predicted in the whole population, and in all age-groups except women aged 45–64, with worse under-prediction in older age-groups. Compared to those at highest QRISK3 estimated 10-year risk, those with highest lifetime risk were younger (mean age: women 50.5 vs. 71.3 years; men 46.3 vs. 63.8 years) and had lower systolic blood pressure and prevalence of treated hypertension, but had more family history of premature CVD, and were more commonly minority ethnic. Over 10-years, the estimated number needed to treat (NNT) with a statin to prevent one CVD event in people with QRISK3 ≥ 10% was 34 in women and 37 in men, compared to 99 and 100 for those at highest lifetime risk.

Conclusions

QRiskLifetime underpredicts 10-year CVD risk in nearly all age-groups, so is likely to also underpredict lifetime risk. Treatment based on lifetime risk has considerably lower medium-term benefit than treatment based on 10-year risk.
Stress hyperglycemia ratio: an independent predictor for in-hospital major adverse cardiovascular and cerebrovascular events in patients with st-segment elevation myocardial infarction
Authors: Guo Wen , Zhu Jiajia , Liu Wenxian
Published: April 2023

Background

To assess the predictive accuracy of the stress hyperglycemia ratio (SHR) for in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) in patients with ST-segment elevation myocardial infarction (STEMI).

Methods

A total of 1,944 patients were enrolled within 24 h of a new STEMI diagnosis. The SHR was obtained by dividing the blood glucose level at admission by the estimated average glucose. MACCE were defined as acute cerebral infarction, mechanical complications of myocardial infarction, cardiogenic shock, and all-cause death. Patients were then categorized into the MACCE and non-MACCE groups according to the occurrence of in-hospital MACCE. Propensity score matching was used to balance confounding factors, and logistic regression was used to identify the potential predictive factors for MACCE.

Results

A total of 276 patients were included after 1:1 matching, and the confounding factors were balanced between the two groups. The SHR was an independent predictor of in-hospital MACCE (odds ratio = 10.06, 95% confidence interval: 4.16–27.64,P < 0.001), while blood glucose at admission was not. The SHR was also an independent predictor for in-hospital MACCE in nondiabetic patients with STEMI (odds ratio = 11.26, 95% confidence interval: 3.05–55.21,P < 0.001).

Conclusion

SHR is an independent predictor of in-hospital MACCE in patients with acute STEMI, especially in nondiabetic patients.
Serum neurofilament light chain as a predictive marker of neurologic outcome after cardiac arrest: a meta-analysis
Authors: Wang Shu Li , Li Nan , Feng Shun Yi , Li Yong
Published: April 2023

Objective

Recently, an increasing number of studies have suggested using serum neurofilament light (NfL) chain to predict the neurologic outcome after cardiac arrest. However, the predictive ability of this approach remains inconclusive. Meta-analysis was performed on related studies to assess the ability of serum NfL to predict the neurologic outcome after cardiac arrest.

Materials and methods

PubMed, ScienceDirect and Embase were systematically searched from the date of their inception until June 2022. Data were extracted to calculate the area under the receiver operating characteristic curve (AUC), the sensitivity, the specificity and the publication bias to evaluate the predictive power of serum NfL using Stata 14.0.

Results

Nine studies were included in the present meta-analysis. Seven studies involving 1296 participants reported serum NfL 24 h post arrest for predicting the neurological outcome, and the AUC was 0.92 (77% sensitivity and 96% specificity). Seven studies involving 1020 participants reported serum NfL 48 h post arrest for predicting the neurological outcome, and the AUC was 0.94 (78% sensitivity and 98% specificity). Four studies involving 804 participants reported serum NfL 72 h post arrest for predicting the neurological outcome, and the AUC was 0.96 (90% sensitivity and 98% specificity). No significant publication bias was observed among the included studies.

Conclusion

The present meta-analysis results support the potential use of serum NfL as an early biomarker of neurologic outcome, especially 72 h post arrest.
A new pathway for considering trigger factors based on parallel-serial connection models and displaying the relationships of causal factors in low-probability events
Authors: Hui Liu
Published: April 2023

Background

To determine the effect size of observed factors considering trigger factors based on parallel-serial models and to explore how multiple factors can be related to the result of complex events for low-probability events with binary outcomes.

Methods

A low-probability event with a true binary outcome can be explained by a trigger factor. The models were based on the parallel-serial connection of switches; causal factors, including trigger factors, were simplified as switches. Effect size values of an observed factor for an outcome were calculated as SAR = (Pe-Pn)/(Pe + Pn), where Pe and Pn represent percentages in the exposed and nonexposed groups, respectively, and SAR represents standardized absolute risk. The influence of trigger factors is eliminated by SAR. Actual data were collected to obtain a deeper understanding of the system.

Results

SAR values of < 0.25, 0.25–0.50, and > 0.50 indicate low, medium, and high effect sizes, respectively. The system of data visualization based on the parallel-serial connection model revealed that at least 7 predictors with SAR > 0.50, including a trigger factor, were needed to predict schizophrenia. The SAR of the HLADQB1*03 gene was 0.22 for schizophrenia.

Conclusions

It is likely that the trigger factors and observed factors had a cumulative effect, as indicated by the parallel-serial connection model for binary outcomes. SAR may allow better evaluation of the effect size of a factor in complex events by eliminating the influence of trigger factors. The efficiency and efficacy of observational research could be increased if we are able to clarify how multiple factors can be related to a result in a pragmatic manner.
Characterization of an obese population: a retrospective longitudinal study from real-world data in northern Portugal
Authors: Páscoa Rosália , Teixeira Andreia , Henriques Teresa S. , Monteiro Hugo , Monteiro Rosário , Martins Carlos
Published: April 2023

Background

Obesity is a serious and largely preventable global health problem. Obesity-related electronic health records can be a useful resource to identify and address obesity. The analysis of real-world data from T82-coded (International Classification of Primary Care coding, for obesity) primary care individuals can be an excellent national source of data on obesity’s prevalence, characteristics, and impact on the National Health Service.

Methods

Retrospective longitudinal study, based on a database of electronic medical records, from the Regional Health Administration of northern Portugal. The study objectives were to determine the prevalence of obesity and to characterize an adult obese population in northern Portugal from a bio-demographic point of view along with profiles of comorbidities and the use of health resources. This study used a database of 266,872 patients in December 2019 and screened for diagnostic code T82 from the International Classification of Primary Care.

Results

The prevalence of obesity was 10.2% and the highest prevalence of obesity was in the 65–74 age group (16.1%). The most prevalent morbidities in patients with obesity as coded through ICPC-2 were K86 (uncomplicated hypertension), T90 (non-insulin-dependent diabetes), and K87 (complicated hypertension). Descriptive information showed that T82 subjects used more consultations, medications, and diagnostic tests than non-T82 subjects.

Conclusions

Routine recording of weight and height deserves special attention to allow obesity recognition at an early stage and move on to the appropriate intervention. Future work is necessary to automate the codification of obesity for subjects under 18 years of age, to raise awareness and anticipate the prevention of problems associated with obesity.

Practical strategies need to be implemented, such as the creation of a specific program consultation with truly targeted approaches to obesity.
Use of preventive medication and supplements in general practice in patients in their last year of life: a Retrospective cohort study
Authors: Antonisse Anne , van der Baan Frederieke H. , Grant Matthew , Uyttewaal Gon , Verboeket Cathelijne , Smits-Pelser Hanneke , Teunissen Saskia C. C. M. , Geijteman Eric C. T.
Published: April 2023

Background

Several preventive medications and supplements become inappropriate in the last phase of life due to increased risk of adverse events caused by changed pharmacokinetics, drug-drug interactions, and changed care goals. Information on these preventive medication and supplements use in patients with a life-limiting illness in the home-care setting is limited. The primary aim of this study was to assess the use of four different groups of preventive drugs and supplements, which are inappropriate in adult patients with a life-limiting illness, living at home in the last year of life. The secondary aims were to assess reasons for discontinuing these drugs as documented in the general practitioners’ patient file and whether these reasons affected the time between medication discontinuation and death.

Methods

We performed a retrospective cohort study using the routine primary care database of the Julius General Practitioners’ Network of the University Medical Centre Utrecht, a database consisting of routine care data from GPs from the city of Utrecht and its vicinity. Patients in the homecare setting with a life-limiting illness, diagnosed at least one year before death, were included. Descriptive analyses were used to describe the study population and the frequency of starting, using, and discontinuing medication and supplements in the last year of life.

Results

A total of 458 of 666 included patients (69%) used at least one preventive drug in the last year of life. Vitamins were used by 36% of the patients, followed with 35% using cholesterol-lowering medication, 24% using calcium supplements and 9% using bisphosphonates. Bisphosphonates were discontinued by 70% of the users, calcium supplements by 61%, vitamins by 56% and cholesterol-lowering medication by 48% of the users, with a median interval between day of discontinuation and death of 119, 60, 110 and, 65 days, respectively. The median time between medication or supplement discontinuation and death was longest in patients with side effects and who had medication reviews.

Conclusion

Many patients in their last phase of life in the home-care setting use inappropriate medication and supplements. Timely medication review may contribute to optimise medication use in the last year of life.
The exacerbated hypokalemia in membranous glomerulonephritis due to proximal tubular injury: a neglect issue from a case report and literature review
Authors: Chang Chih-Hao , Yu Hui-Jung , Hou Yi-Chou
Published: April 2023

Background

Membranous glomerulonephritis is the most common primary etiology for the nephrotic syndrome in adults. Beyond the clinical hallmark of nephrotic syndrome such as fluid overloading, dyslipidemia and hypoalbuminemia, the dysregulated homeostasis of potassium and its possible mechanism is seldomly discussed, and its association with the clinical course of membranous GN is lacking.

Case presentation

A 65 year-old female attended to our emergent department for progressive lower leg edema after taking 15-h of flight. Hypoalbuminemia and hyperlipidemia were both noted, and 24-h urinary total protein was up to 17,950 mg/day. Elevated creatin-phospho-kinase developed at the initial presentation with hypokalemia due to excressive renal excretion. Glycosuria without elevated glycated Hemoglobin occurred. The pathology of kidney biopsy revealed subepithelial immunocomplex deposits with spike formation in the electron microscopy and the positive anti-Phosphlipase A2 receptor antibodies(PLA-2R) with hallmark of membranous glomerulonephritis. In the light microscopy, the vacuolization of proximal tubules was noted, which contributed to the potassium wasting. After 1 year following up duration, the patient’s proteinuria persisted after maintenance treatment with calcineurin inhibitor.

Conclusion

Hypokalemia is a neglected issue in the membranous glomerulonephritis. Unlike the previous literature, our patient had the vacuolization of proximal tubule at the initial presentation with hypokalemia, which might contribute the potassium wasting. The proximal tubular damage with hypokalemia might be a predictive factor for membranous glomerulonephritis.