bluuebunny/crossref_metadata_2025 huggingface dataset:
Up to 4 millimeters excessive distal femoral resection in total knee arthroplasty has no significant effect on patellar height and functional score in patient with severe flexion contracture: a retrospective study
Authors: Jabalameli Mahmoud , Yahyazadeh Hooman , Bagherifard Abolfazl , Askari Alireza , Mohammadpour Mehdi , Hasanikhah Masoud
Published: August 2022

Background:

Excessive distal femoral resection in patients with severe preoperative flexion contracture has been previously attributed to the joint line elevation after performing total knee arthroplasty (TKA). In this study, the authors investigated the effects of excessive distal femoral cut on the patellar height as well as the outcome of TKA.

Methods:

This retrospective study included patients with severe flexion contracture (>30°) who underwent TKA. They were divided into two groups according to the size of distal femoral cut: group A (≤9 mm, n=27) and group B (>9 mm, n=22). The functional and radiographic outcomes as well as radiographic indices of patellar height, including adductor ratio, Insall-Salvati index, Blackburne-Peel index, Caton-Deschamps index, and fibular height, were compared between these two study groups.

Results:

The baseline characteristics of the participants were comparable. The mean femoral cut was 8.3±0.8 in group A and 12.6±0.9 in group B. The mean changes of the adductor ratio, Insall-Salvati index, Caton-Deschamps index, Blackburne-Peel index, and fibular height were not significantly different between the two study groups. As well, the functional and radiographic outcomes of TKA were comparable. No revision surgery was required during the mean follow-up of 51.7±32.4 mo. No genu recurvatum was recorded, and no patient complained of knee instability.

Conclusions:

Excessive distal femoral cut does not seem to change patellar height in TKA patients, so it could be used safely for patients with a severe preoperative flexion deformity.

Level of Evidence:

Level IV.
The Utilization of Osteoarticular Transfer System in the Treatment of Distal Femur Osteoid Osteoma: A Case Report
Authors: Doerr Nikki A. , Kellish Alec S. , Kleiner Matthew T. , Gutowski Christina J.
Published: August 2022

Introduction:

Tumor excision of the subchondral bone of the distal femur epiphysis is technically challenging particularly in skeletally immature patients due to the open physis above and articular surface below. Preservation of the physis, maintenance of structural support to, and integrity of, the cartilage, and conservation of joint kinematics must all be considered and are often threatened by current percutaneous or open surgical treatment options.

Materials and Methods:

We present a case of a 16-year-old male athlete with a distal femur epiphyseal bone lesion. He underwent transarticular en bloc excision and autograft reconstruction using osteoarticular transfer system (OATS) technique.

Results:

Final pathology revealed complete excision of an osteoid osteoma. The patient had regained full strength and range of motion at 3 months postoperatively, and at 22 months postoperatively was free of disease and back to full level of athletic participation.

Conclusions:

This article describes a technique for excision of subchondral epiphyseal bone lesions in the distal femur in skeletally immature patients which mitigates the risk of complications associated with physeal injury, incomplete tumor resection, and iatrogenic injury to the overlying cartilage.
Use and Effectiveness of Virtual Simulations in Nursing Student Education
Authors: Cant Robyn , Ryan Colleen , Kelly Michelle A.
Published: August 2022

Computer-based virtual simulation in nursing is a rapidly developing field. A summary of current research could benefit nursing faculty who are incorporating this pedagogy into online teaching due to social distancing requirements. This umbrella review aimed to explore the use and effectiveness of virtual simulations in prelicensure nursing education. Our umbrella review approach was informed by The Johanna Briggs Institute guidelines. The 18 included reviews captured the experiences of over 7600 nursing students who engaged with five different virtual (screen-based) simulation modalities. Results indicated that virtual simulations can be effective in developing nursing students' knowledge and psychomotor and psychosocial skills, for example, in medication administration and communication. There was no study that showed a conclusive benefit of virtual simulations for developing clinical reasoning. Students enjoyed virtual simulations, claiming they were accessible, fun, and engaging ways to learn. Many benefits of virtual simulations and some technological challenges were identified in a mapped model. In the future, more rigorous and experimental studies are needed to confirm effects on learning outcomes. Nursing curriculum designers need to define the place and purposes of the pedagogy to ensure that knowledge and skills learned during virtual simulations can be applied to real-world, patient-centered care.
Tailored Parenting Plans of Young Adults With Sickle Cell Disease or Sickle Cell Trait
Authors: Oguntoye Anne O. , Eades Nyema T. , Aldossary Dalal , Kuenzli Grace , Gehling Gina , Ezenwa Miriam O. , Johnson-Mallard Versie , Yao Yingwei , Gallo Agatha M. , Wilkie Diana J.
Published: August 2022

Our study purpose was to evaluate the variation and accuracy of tailored parenting plans individually generated as a supplement to reproductive health education on the genetic inheritance of sickle cell disease or sickle cell trait. We present a secondary data analysis of experimental group data from a randomized controlled trial. Participants completed the valid and reliable Internet-based Sickle Cell Reproductive Health Knowledge Parenting Intent Questionnaire. We created a computerized algorithm that used participants' responses to generate tailored parenting plans based on their parenting preferences and partner's sickle cell status. Thirty-one different parenting plans were generated to meet the variety in the participants' preferences. The most frequently generated plan was for participants with sickle cell disease who had a partner with hemoglobin AA, who wanted to be a parent, was not likely to be pregnant, and wanted their child to be sickle cell disease free. More than half of the participants required alteration in their reproductive behavior to achieve their parenting goals. Findings provide insight into the variety and accuracy of computer algorithm–generated parenting plans, which could further guide refinement of the algorithm to produce patient-centered, tailored parenting plans supplemental to Internet-based genetic inheritance education.
Histologic Screening of Malignant Melanoma, Spitz, Dermal and Junctional Melanocytic Nevi Using a Deep Learning Model
Authors: Snyder Alan N. , Zhang Dan , Dreesen Steffen L. , Baltimore Christopher A. , Lopez-Garcia Dan R. , Akers Jake Y. , Metts Christopher L. , Madory James E. , Chang Peter D. , Doan Linda T. , Elston Dirk M. , Valdebran Manuel A. , Luo Feng , Forcucci Jessica A.
Published: August 2022

Objective:

The integration of an artificial intelligence tool into pathologists' workflow may lead to a more accurate and timely diagnosis of melanocytic lesions, directly patient care. The objective of this study was to create and evaluate the performance of such a model in achieving clinical-grade diagnoses of Spitz nevi, dermal and junctional melanocytic nevi, and melanomas.

Methods:

We created a beginner-level training environment by teaching our algorithm to perform cytologic inferences on 136,216 manually annotated tiles of hematoxylin and eosin-stained slides consisting of unequivocal melanocytic nevi, Spitz nevi, and invasive melanoma cases. We sequentially trained and tested our network to provide a final diagnosis-classification on 39 cases in total. Positive predictive value (precision) and sensitivity (recall) were used to measure our performance.

Results:

The tile-classification algorithm predicted the 136,216 irrelevant, melanoma, melanocytic nevi, and Spitz nevi tiles at sensitivities of 96%, 93%, 94% and 73%, respectively. The final trained model was able to correctly classify and predict the correct diagnosis in 85.7% of unseen cases (n = 28), reporting at or near screening-level performances for precision and recall of melanoma (76.2%, 100.0%), melanocytic nevi (100.0%, 75.0%), and Spitz nevi (100.0%, 75.0%).

Conclusions:

Our pilot study proves that convolutional networks trained on cellular morphology to classify melanocytic proliferations can be used as a powerful tool to assist pathologists in screening for melanoma versus other benign lesions.
ULTRASOUND BIOMICROSCOPY AND ECHOGENIC EXTERNAL MARKER ASSISTED INTRAOCULAR FOREIGN BODY REMOVAL
Authors: Patel Shivam H. , Bakhsh Saaquib , Badar Ayesha , Hajrasouliha Amir R.
Published: August 2022

Purpose:

We report a novel method of intraoperative localization of a retained anterior intraocular foreign body (IOFB), using a combination of ultrasound biomicrosopy and an insulated needle.

Methods:

A retrospective case report of a 56-year-old man who presented with a right eye IOFB.

Results:

On presentation, vision was decreased in the right eye to count fingers with a small subconjunctival hemorrhage, but no other signs of a penetrating laceration. Orbital CT revealed an IOFB, and the initial vitrectomy failed to retrieve the IOFB. Then, during the subsequent vitrectomy, using an ultrasound compatible needle and an ultrasound biomicrosopy, we were able to precisely locate and remove the small anterior IOFB.

Conclusion:

Retained IOFBs can lead to severe irreversible vision loss if not promptly removed. Ancillary imaging modalities and localization techniques can help locate occult IOFBs in difficult cases.
Study of Serum Ferritin, Zinc, and Copper Levels in Children With Helicobacter pylori Gastritis and the Effect of the Treatment
Authors: Elsaadany Eman , Amin Saleh , Abdel‐Hafez Maher , El Amrousy Doaa , Kasem Safwat , Abd Elaziz Dareen , Shawky Dina
Published: August 2022

Objectives:

This study aimed to assess serum iron, zinc, and copper in symptomatic children with Helicobacter pylori infection, to correlate their serum levels with the degree of gastritis, and to evaluate the effect of H. pylori treatment on their levels.

Methods:

This study was carried out on 70 children with upper gastrointestinal tract symptoms. H. pylori infection was diagnosed by the H. pylori antigen test in the stool and histopathologic findings during upper gastrointestinal endoscopy. Patients were divided into 2 groups; H. pylori‐positive and H. pylori‐negative groups. Hemoglobin, serum ferritin, transferrin (sTfR), zinc, and copper were assessed in all included children.

Results:

The hemoglobin level, serum ferritin, and zinc were significantly lower in H. pylori‐positive patients compared to H. pylori‐negative patients. However, the serum copper level was comparable between the 2 groups. After treatment, the hemoglobin level, serum ferritin, and serum zinc significantly increased in H. pylori‐positive patients, especially in those who responded to treatment compared to their levels before treatment. There was a significant negative correlation between the severity of histopathologic abnormalities and hemoglobin level, serum ferritin, and zinc levels, but a significant positive relation with sTfR concentrations in H. pylori‐positive patients.

Conclusions:

H. pylori‐infected children had low serum ferritin and zinc levels but high sTfR level with no effect on serum copper levels. After treatment, hemoglobin, serum ferritin, and zinc levels significantly improved in H. pylori‐positive patients. Gastric histologic findings correlated significantly with hemoglobin, serum ferritin, zinc, and sTfR levels.
Patient and Family Involvement in Serious Incident Investigations From the Perspectives of Key Stakeholders: A Review of the Qualitative Evidence
Authors: Ramsey Lauren , McHugh Siobhan , Simms-Ellis Ruth , Perfetto Kayley , O’Hara Jane K.
Published: August 2022

Objectives

Investigations of healthcare harm often overlook the valuable insights of patients and families. Our review aimed to explore the perspectives of key stakeholders when patients and families were involved in serious incident investigations.

Methods

The authors searched three databases (Medline, PsycInfo, and CINAHL) and Connected Papers software for qualitative studies in which patients and families were involved in serious incident investigations until no new articles were found.

Results

Twenty-seven papers were eligible. The perspectives of patients and families, healthcare professionals, nonclinical staff, and legal staff were sought across acute, mental health and maternity settings. Most patients and families valued being involved; however, it was important that investigations were flexible and sensitive to both clinical and emotional aspects of care to avoid compounding harm. This included the following: early active listening with empathy for trauma, sincere and timely apology, fostering trust and transparency, making realistic timelines clear, and establishing effective nonadversarial communication. Most staff perceived that patient and family involvement could improve investigation quality, promote an open culture, and help ensure future safety. However, it was made difficult when multidisciplinary input was absent, workload and staff turnover were high, training and support needs were unmet, and fears surrounded litigation. Potential solutions included enhancing the clarity of roles and responsibilities, adequately training staff, and providing long and short-term support to stakeholders.

Conclusions

Our review provides insights to ensure patient and family involvement in serious incident investigations considers both clinical and emotional aspects of care, is meaningful for all key stakeholders, and avoids compounding harm. However, significant gaps in the literature remain.
Explainable Machine Learning to Bring Database to the Bedside
Authors: Choi Jeff , Anderson Taylor , Tennakoon Lakshika , Spain David A. , Forrester Joseph D.
Published: August 2022

Objective:

Exemplify an explainable machine learning framework to bring database to the bedside; develop and validate a point-of-care frailty assessment tool to prognosticate outcomes after injury.

Background:

A geriatric trauma frailty index that captures only baseline conditions, is readily-implementable, and validated nationwide remains underexplored. We hypothesized Trauma fRailty OUTcomes (TROUT) Index could prognosticate major adverse outcomes with minimal implementation barriers.

Methods:

We developed TROUT index according to Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis guidelines. Using nationwide US admission encounters of patients aged ≥65 years (2016–2017; 10% development, 90% validation cohorts), unsupervised and supervised machine learning algorithms identified baseline conditions that contribute most to adverse outcomes. These conditions were aggregated into TROUT Index scores (0–100) that delineate 3 frailty risk strata. After associative [between frailty risk strata and outcomes, adjusted for age, sex, and injury severity (as effect modifier)] and calibration analysis, we designed a mobile application to facilitate point-of-care implementation.

Results:

Our study population comprised 1.6 million survey-weighted admission encounters. Fourteen baseline conditions and 1 mechanism of injury constituted the TROUT Index. Among the validation cohort, increasing frailty risk (low=reference group, moderate, high) was associated with stepwise increased adjusted odds of mortality {odds ratio [OR] [95% confidence interval (CI)]: 2.6 [2.4–2.8], 4.3 [4.0–4.7]}, prolonged hospitalization [OR (95% CI)]: 1.4 (1.4–1.5), 1.8 (1.8–1.9)], disposition to a facility [OR (95% CI): 1.49 (1.4–1.5), 1.8 (1.7–1.8)], and mechanical ventilation [OR (95% CI): 2.3 (1.9–2.7), 3.6 (3.0–4.5)]. Calibration analysis found positive correlations between higher TROUT Index scores and all adverse outcomes. We built a mobile application (“TROUT Index”) and shared code publicly.

Conclusion:

The TROUT Index is an interpretable, point-of-care tool to quantify and integrate frailty within clinical decision-making among injured patients. The TROUT Index is not a stand-alone tool to predict outcomes after injury; our tool should be considered in conjunction with injury pattern, clinical management, and within institution-specific workflows. A practical mobile application and publicly available code can facilitate future implementation and external validation studies.
Multicenter Study to Evaluate Endovascular Repair of Extent I-III Thoracoabdominal Aneurysms Without Prophylactic Cerebrospinal Fluid Drainage
Authors: Marcondes Giulianna B. , Cirillo-Penn Nolan C. , Tenorio Emanuel R. , Adam Donald J. , Timaran Carlos , Austermann Martin J. , Bertoglio Luca , Jakimowicz Tomasz , Piazza Michele , Juszczak Maciej T. , Scott Carla K. , Berekoven Bärbel , Chiesa Roberto , Lima Guilherme B.B. , Jama Katarzyna , Squizzato Francesco , Claridge Martin , Mendes Bernardo C. , Oderich Gustavo S.
Published: August 2022

Objective:

To assess outcomes of fenestrated-branched endovascular aortic repair (FB-EVAR) of Extent I-III thoracoabdominal aortic aneurysms (TAAAs) without prophylactic cerebrospinal fluid drainage (CSFD).

Background:

Prophylactic CSFD has been routinely used during endovascular TAAA repair, but concerns about major drain-related complications have led to revising this paradigm.

Methods:

We reviewed a multicenter cohort of 541 patients treated for Extent I-III TAAAs by FB-EVAR without prophylactic CSFD. Spinal cord injury (SCI) was graded as ambulatory (paraparesis) or nonambulatory (paraplegia). Endpoints were any SCI, permanent paraplegia, response to rescue treatment, major drain-related complications, mortality, and patient survival.

Results:

There were 22 Extent I, 240 Extent II and 279 Extent III TAAAs. Thirty-day mortality was 3%. SCI occurred in 45 patients (8%), paraparesis occurring in 23 (4%) and paraplegia in 22 patients (4%). SCI was more common in patients with Extent I-II compared with Extent III TAAAs (12% vs. 5%, P=0.01). Rescue treatment included permissive hypertension in all patients, with CSFD in 22 (4%). Symptom improvement was noted in 73%. Twelve patients (2%) had permanent paraplegia. Two patients (0.4%) had major drain-related complications. Independent predictors for SCI by multivariate logistic regression were sustained perioperative hypotension [odds ratio (OR): 4.4, 95% confidence interval (95% CI): 1.7–11.1], patent collateral network (OR: 0.3, 95% CI: 0.1–0.6), and total length of aortic coverage (OR: 1.05, 95% CI: 1.01–1.10). Patient survival at 3 years was 72%±3%.

Conclusion:

FB-EVAR of Extent I-III TAAAs without CSFD has low mortality and low rates of permanent paraplegia (2%). SCI occurred in 8% of patients, and rescue treatment improved symptoms in 73% of them.
Effects of coronavirus disease 19 on the gastrointestinal tract and the potential impact on gastrointestinal toxicities during cancer treatment
Authors: Stringer Andrea M.
Published: August 2022

Purpose of review

Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has resulted in a global pandemic, with people with other conditions at greater risk of severe infection with intensified symptoms across multiple organ systems. Patients with cancer are at greater risk, and it is likely that those receiving treatment will experience greater incidence and severity of gastrointestinal toxicities, such as gastrointestinal mucositis, due to SARS-CoV-2 binding to angiotensin-converting enzyme (ACE)2 in the intestine.

Recent findings

Recent studies have shown that SARS-CoV-2 patients experience gastrointestinal toxicities, and SARS-CoV-2 has capacity to infect intestinal cells through binding to ACE2 expressed in the intestine. ACE2 has a key role in intestinal homeostasis, and as such there is a concern for the impact of SARS-CoV-2 binding to ACE2 in terms of the implications for cancer treatment-induced gastrointestinal toxicities.

SARS-CoV-2 is a high-risk infection for cancer patients receiving treatment. It is important to understand the mechanisms of intestinal infection with SARS-CoV-2 to determine the effect of SARS-CoV-2 infections on gastrointestinal toxicities, such as mucositis.
Oral pain in the cancer patient
Authors: Samim Firoozeh , Epstein Joel B. , Osagie Rachael
Published: August 2022

Purpose of review

Oral pain is a common complaint in patients with cancer. This review aims to summarize the knowledge on the causes and approach to management of oral pain garnered over the past 2 years.

Recent findings

A systematic review and meta-analysis included in the review, assessed cannabinoid versus placebo and showed only a small effect on pain, physical function, and sleep quality. Another review showed that chemical neurolysis as an adjunctive therapy, is effective in patients with pain of shorter chronicity and refractory head and neck cancer-related pain.

Patients with cancer frequently experience oral pain because of a variety of factors. Factors inherent in the type and location of the malignancy, the modality of cancer treatment, and a holistic approach to management together contribute to their overall pain experience. Basic oral care should be implemented wherever possible, before, during, and after cancer treatment.
Healthcare provider experiences during COVID-19 redeployment
Authors: Schulz-Quach Christian , Lyver Brendan , Li Madeline
Published: August 2022

Purpose of review

Among the myriad traumatic impacts of COVID-19, the need for redeployment served as a significant stressor for healthcare providers (HCPs). This narrative review summarizes the current literature on HCP redeployment experiences and institutional support for staff, while proposing a theoretical approach to mitigating the negative impact on HCP mental health.

Recent findings

Redeployment was a strong predictor of negative emotions in HCP during the initial stage of the COVID-19 pandemic, whereas reflections on benefit-finding associated with redeployment were reported more frequently during later stages. In institutions where attention to redeployment impact was addressed and effective strategies put in place, redeployed HCP felt they received adequate training and support and felt satisfied with the information provided. Redeployment had the potential to yield personal feelings of accomplishment, situational leadership, meaning, and increased sense of team connectedness.

Benefit-finding, or posttraumatic growth, is a concept in cancer psychiatry which speaks to construing benefits from adversity to support resilience. Redeployment experiences can result in unexpected benefit-finding for individual HCPs. Taking a benefit-finding, relational, and existentially informed approach to COVID-19 redeployment might serve as an opportunity for posttraumatic growth for both individuals and institutions.
Breakthrough infections after post-exposure vaccination against Monkeypox
Authors: Thy Michael , Peiffer-Smadja Nathan , Mailhe Morgane , Kramer Laura , Ferré Valentine Marie , Houhou-Fidouh Nadhira , Tarhini Hassan , Bertin Chloé , Beaumont Anne-Lise , Garé Mathilde , Pluart Diane Le , Perrineau Ségolène , Rahi Mayda , Deconinck Laurène , Phung Bao , Mollo Bastien , Cortier Marie , Cresta Mélanie , De La Porte Des Vaux Clémentine , Joly Véronique , Lariven Sylvie , Somarriba Cécile , Lescure Francois-Xavier , Charpentier Charlotte , Yazdanpanah Yazdan , Ghosn Jade
Published: August 2022

Background

A third-generation smallpox vaccine was recommended in France for individuals who had a high-risk contact with a PCR-confirmed Monkeypox patient. We aimed to describe the outcomes of high-risk contacts receiving third-generation smallpox vaccine as an early post-exposure ring vaccination (EPRV) especially tolerance and potential breakthrough infections after the first dose.

Methods

We performed an observational analysis of all consecutive individuals vaccinated with the IMVANEX® smallpox vaccine after a high-risk contact defined as close skin-to-skin or mucosal contact and/or indirect contact on textile or surface and/or droplets exposure defined by a contact at less than 2 meters during at least 3 hours with a PCR-confirmed Monkeypox patient.

Results

Between May 27th and July 13th, 2022, 276 individuals received one dose of IMVANEX® with a median delay of 11 days [IQR 8-14] after exposure with a confirmed Monkeypox patient. Mode of exposure was droplets for 240 patients (91%), indirect contact for 189 (71%) and unprotected sexual intercourse for 146 (54%). Most of the patients were men (91%, n=250) and men who have sex with men (88%, n=233). The vaccine was well tolerated with no severe adverse event. Among the 276 vaccinated individuals, 12 (4%) had a confirmed Monkeypox breakthrough infection with no severe infection. Ten out of 12 patients developed a Monkeypox infection in the five days following vaccination and two had a breakthrough infection at 22 and 25 days.

Conclusion

EPRV with a third-generation smallpox vaccine was well tolerated and effective against Monkeypox but did not completely prevent breakthrough infections.
Development of a fluorescence reporter system to quantify transcriptional activity of endogenous p53 in living cells
Authors: Tsuruoka Tatsuki , Nakayama Emiri , Endo Takuya , Harashima Shingo , Kamada Rui , Sakaguchi Kazuyasu , Imagawa Toshiaki
Published: August 2022

The tumor suppressor p53 plays a central role in cellular stress responses by regulating transcription of multiple target genes. The temporal dynamics of p53 are thought to be important for its function: it encode input information and are decoded to induce distinct cellular phenotypes. However it remains unclear to what extent the temporal dynamics of p53 reflects the activity of p53-induced gene expression. In this study, we report a multiplexed reporter system that allows us to visualize the transcriptional activity of p53 at the single cell level. Our reporter system features simple and sensitive observation of the transcriptional activity of endogenous p53 to the response elements of various target genes. Using this system, we show that the transcriptional activation of p53 exhibits strong cell-to-cell heterogeneity. The transcriptional activation of p53 by etoposide is highly dependent on the cell cycle but not by UV-C. Finally, we show that our reporter system allows simultaneous visualization of the transcriptional activity of p53 and cell cycle. Our reporter system can thus be a useful tool for studying biological processes involving the p53 signaling pathway.

Summary statement

Tumor suppressor protein p53 is one of the hub factor of the cellular stress responses. Our novel reporter system allows us to visualize the transcriptional activity of endogenous p53 easily and precisely.
Clinical validation of a wireless patch-based polysomnography system: a pilot study
Authors: Raschellà F , Knoops-Borm M , Sekeri M , Andries D , Oloo M , Moudab I , Musaka S , Mueller S , Stockhoff M , Tijssen M , Coughlin S , Schneider H
Published: August 2022

Background

Polysomnography (PSG) is the gold standard for diagnosing and monitoring sleep disorders, however, it is time-consuming and costly, as the application of the equipment can only be done by trained sleep technicians and the test must be conducted within a sleep laboratory. In this study we assessed the performance of the first wireless patch-based PSG system, the Onera Sleep Test System (STS), which can be applied by the patient and performed outside of the sleep laboratory in settings such as the home. To achieve this, sleep stage and physiological data from the Onera STS were compared to gold standard in-lab PSG.

Materials and methods

The recordings were unsupervised to simulate a home-use environment. Epoch-by-epoch agreement was assessed by calculating sensitivity, specificity, accuracy, and Cohen’s kappa coefficient. Pearson’s correlation coefficients were calculated for multiple sleep parameters to measure the level of entire night agreement.

Results

Substantial agreement with a Cohens kappa of 0.69 across all sleep stages was determined, which reached 0.81 when Stage N1 was removed from the analysis. A high accuracy, specificity, and sensitivity were found for wake N2, N3 and REM. Although specificity (95.25%) and accuracy (89.62%) were high for N1, sensitivity was low (27.19%). Sleep parameters calculated by sleep stage transitions, apnea hypopnea index and oxygen desaturation index, showed strong correlations.

Conclusions

The Onera STS provides comparable clinical information to traditional PSG. Moreover, the application time was reduced by 77% which reduces the overall costs of PSG. These results open the possibility for PSG studies to be performed efficiently outside of the sleep laboratory at a larger scale, thus improving access for patients.
Predictors of maternal and fetal outcomes of pregnant women with mitral stenosis
Authors: Gebremedhin Yoseph , Guteta Senbeta , Melese Binyam , Bekele Elias
Published: August 2022

Background

Valvular heart disease, in particular mitral stenosis, is associated with unfavorable pregnancy outcomes. Data on maternal and fetal outcomes of pregnant women with mitral stenosis in Ethiopia as well as in other sub-Saharan countries is scare. Therefore the aim of this study was to assess the predictors of maternal and fetal outcomes of pregnant women with mitral valve stenosis and to show the incidence of maternal and fetal complications as well.

Method

A retrospective cross section study was conducted. Medical records of pregnant women with mitral valve stenosis admitted at Tikur Anbessa Specialized Tertiary Referral hospital labor ward from January 2014 to December 2018 were reviewed. Data were entered and analyzed using SPSS version 25. Multivariate logistic regression analysis was used to evaluate associated factors. P-value of 0.05 was considered statistically significant.

Result

This study included 58 pregnant women with mitral stenosis. The mean age of the participants was 27(SD,±4.5) years. The mean mitral valve area among the participants was 1.1cm. About 79% of cases had mitral valve area of ≤1.5cm2 and 55.2% had valve area of ≤1cm2. Fifty one (87.9%) patients had moderate to severe pulmonary hypertension. The overall incidence of serious adverse pregnancy and peripartal outcome among the study participants was 44.8%. About 69% of patients had heart failure, from which 34.5% had NYHA class III and IV functional classes. Maternal death occurred in 4(6.9%) cases, whereas thromboembolism and ICU admission rates were 2(3.4%) and 3(5.2%) respectively. Neonatal complications including low birth weight, preterm delivery, abortions and still birth were 26.5%, 16%, 17.2% and 6.1% respectively. Mitral valve area was the main determinant factor for maternal and fetal outcomes of pregnant women with mitral stenosis (AOR=15, 2.50-90% CI, P=0.003).

CONCLUSIONS

The overall incidence of serious adverse maternal and fetal events in pregnant mothers with mitral stenosis was 44.5%. Mitral valve area was the main determinant factor for maternal and fetal outcomes of pregnant women with mitral stenosis (AOR=15, 2.50-90% CI, P=0.003)
Auditory corticostriatal connections in the human brain
Authors: Sitek Kevin R. , Helou Leah B. , Chandrasekaran Bharath
Published: August 2022

Auditory learning depends on sensory, perceptual, decisional, and reward-based processes that are supported by the dorsal striatum. Auditory corticostriatal connections have been well-characterized in animal models including non-human primates, where primary auditory cortex preferentially connects to putamen, and caudate head receives most of its inputs from anterior superior temporal cortex. However, the extent to which human auditory corticostriatal connectivity follows similar organizational principles is challenging to assess due to the density of these striatal structures relative to the resolution of traditional diffusion MRI techniques, as well as dorsal striatum’s location near multiple major crossing white matter bundles. We leveraged high-quality diffusion-weighted MRI tractography to ‘virtually’ dissect structural pathways between auditory cortical regions and dorsal striatal regions in a sub-millimeter resolution single-participant dataset. Across most of auditory cortex, putamen connections were more frequent than caudate connections; only anterior-most superior temporal cortex had strong connectivity with caudate, specifically the caudate head. Putamen streamline endpoints were largely along the ventral portion of the structure, ranging from caudal to middle putamen. These results were consistent across analysis and tractography pipelines. In contrast to the auditory findings, visual corticostriatal streamlines did not preferentially reach putamen. We replicate these results in an independent sample of near-millimeter resolution single-session diffusion MRI from the Human Connectome Project. Overall, our results suggest strong structural connectivity between primary and association auditory cortices with putamen but not with any subdivision of caudate. Prioritized connectivity between superior temporal cortex and putamen is highly suggestive of distinct functional roles for striatal subdivisions in auditory perception.
Transcriptomic forecasting with neural ODEs
Authors: Erbe Rossin , Stein-O’Brien Genevieve , Fertig Elana J.
Published: August 2022

Single cell transcriptomics technologies can uncover changes in the molecular states that underlie cellular phenotypes. However, understanding the dynamic cellular processes requires extending from inferring trajectories from snapshots of cellular states to estimating temporal changes in cellular gene expression. To address this challenge, we have developed a neural ordinary differential equation-based method, RNAForecaster, for predicting gene expression states in single cells for multiple future time steps in an embedding-independent manner. We demonstrate that RNAForecaster can accurately predict future expression states in simulated single cell transcriptomic data with cellular tracking over time. We then show that using metabolic labeling scRNA-seq data from constitutively dividing cells, RNAForecaster accurately recapitulates many of the expected changes in gene expression during progression through the cell cycle over a three day period. Thus, RNAForecaster enables short term estimation of future expression states in biological systems from high-throughput datasets with temporal information.
Distinct hyperactive RAS/MAPK alleles converge on common GABAergic interneuron core programs
Authors: Knowles Sara J , Stafford April M , Zaman Tariq , Angara Kartik , Williams Michael R , Newbern Jason M , Vogt Daniel
Published: August 2022

RAS/MAPK gene dysfunction underlies various cancers and neurocognitive disorders. While the role of RAS/MAPK genes have been well studied in cancer, less is known about their function during neurodevelopment. There are many genes that work in concert to regulate RAS/MAPK signaling, suggesting that if common brain phenotypes could be discovered they could have a broad impact on the many other disorders caused by distinct RAS/MAPK genes. We assessed the cellular and molecular consequences of hyperactivating the RAS/MAPK pathway using two distinct genes in a cell type previously implicated in RAS/MAPK-mediated cognitive changes, cortical GABAergic interneurons. We uncovered some GABAergic core programs that are commonly altered in each of the mutants. Notably, hyperactive RAS/MAPK mutants bias developing cortical interneurons towards those that are somatostatin+. The increase in somatostatin+ interneurons could also be induced by elevated neural activity and we show the core RAS/MAPK signaling pathway is one mechanism by which this occurs. Overall, these findings present new insights into how different RAS/MAPK mutations can converge on GABAergic interneurons, which may be important for other RAS/MAPK genes/disorders.
A simple formula for determining nanoparticle size distribution by combining small-angle X-ray scattering and diffraction results
Authors: Morelhão Sérgio L. , Kycia Stefan W.
Published: August 2022

X-ray scattering and diffraction phenomena are widely used as analytical tools in nanoscience. Size discrepancies between the two phenomena are commonly observed in crystalline nanoparticle systems. The root of the problem is that each phenomenon is affected by size distribution differently, causing contrasting shifts between the two methods. Once understood, the previously discrepant results lead to a simple formula for obtaining the nanoparticle size distribution.
A systematic analysis of assorted machine learning classifiers to assess their potential in accurate prediction of dementia
Authors: Khan Afreen , Zubair Swaleha , Khan Samreen
Published: August 2022

Purpose

This study aimed to assess the potential of the Clinical Dementia Rating (CDR) Scale in the prognosis of dementia in elderly subjects.

Design/methodology/approach

Dementia staging severity is clinically an essential task, so the authors used machine learning (ML) on the magnetic resonance imaging (MRI) features to locate and study the impact of various MR readings onto the classification of demented and nondemented patients. The authors used cross-sectional MRI data in this study. The designed ML approach established the role of CDR in the prognosis of inflicted and normal patients. Moreover, the pattern analysis indicated CDR as a strong cohort amongst the various attributes, with CDR to have a significant value ofp < 0.01. The authors employed 20 ML classifiers.

Findings

The mean prediction accuracy varied with the various ML classifier used, with the bagging classifier (random forest as a base estimator) achieving the highest (93.67%). A series of ML analyses demonstrated that the model including the CDR score had better prediction accuracy and other related performance metrics.

Originality/value

The results suggest that the CDR score, a simple clinical measure, can be used in real community settings. It can be used to predict dementia progression with ML modeling.
A nexus of market web traffic and investor's behavior in the EdTech market: evidence of performance from US and India
Authors: Sethi Surbhi , Saxena Srishti , Singh Manju
Published: August 2022

Purpose

The unexpected outbreak of COVID-19 has expedited the trend toward online education. To facilitate undisruptive learning, EdTech companies are continuously working on providing solutions to restore teaching and learning practices. This has caused a significant behavioral shift of the investors in the EdTech market. This study aims to analyze the effects of Web Market Traffic on the increased number of investors funding an EdTech Company in the market.

Design/methodology/approach

By drawing on the multi-method web analytics approach, this study analyses the nexus between Web Market Traffic and Investor's Behavior in the US and India, proving the hypothesized relationship in the proposed Model using a data sample of 300 EdTech Players.

Findings

There is a significant difference between the investor's behavior in India and the US. This study shows that the investors in the US are more inclined towards investing in EdTech companies in comparison to India. The Results demonstrate that monthly visits of consumers and the number of acquisitions by players positively affect the investor's behavior, while bounce rates take a toll on the number of investors.

Practical implications

This Study suggests that EdTech investors in the US and India should harness Web Traffic to capture the EdTech market. Further, this study offers practical implications that EdTech players can use to attract potential investors and increase brand visibility by improving web market traffic parameters.

Originality/value

This paper's original contribution is to empirically shed light on the effects of web market traffic on the investor's behavior. The study emphasizes the quintessentiality of managing the bounce rates and monthly visits for an EdTech market to attract more investors and capital inflow that enhance brand visibility. The study found that the investors behave distinctly in the developed and emerging markets in the US and India.
How and when top management green commitment facilitates employees green behavior: a multilevel moderated mediation model
Authors: Ye Xinfeng , Cai Shaohan , Li Xinchun , Wang Zhining
Published: August 2022

Purpose

The purpose of this paper is to argue that green hope (GH) and green organizational identification (GOI) play critical roles in transforming top management green commitment (TMGC) into desired employees task-related green behavior (TRGB) and voluntary workplace green behavior (VWGB) based on positive psychology.

Design/methodology/approach

The authors test the multilevel moderated mediation model by analyzing data collected from 491 hospitality employees and their direct supervisors in 103 teams. At Time 1, the authors conducted a survey of 905 team members to provide demographic information and evaluate TMGC, as well as their own GOI. At Time 2, the authors sent a follow-up questionnaire to employees who participated Time 1, asking them to evaluate their GH in the workplace. At Time 3, the authors sent questionnaires to the leaders of the respondents of T2 survey and invited them to evaluate TRGB and VWGB in the workplace.

Findings

The results show that TMGC facilitates two types of employees’ behaviors toward both TRGB and VWGB by enhancing hospitality employees’ GH. As a team-level variable, GOI has a positive moderating effect on the association between TMGC and GH. The authors discuss the theoretical implications as well as practical implications for managers seeking to promote sustainability in their hospitality industry.

Originality/value

This is one of the first empirical studies to investigate the mediating effects of a positive psychology variable, namely, GH – and the moderating effects of GOI on the relationship between TMGC and employee green behavior (EGB).
The policy trajectory of China’s globalizing Internet
Authors: Yang Feng , Zhao Shan , Zhang Xiaoqian
Published: August 2022

Purpose

China’s globalizing Internet describes a situation where China is using the Internet as a tool or medium to transmit its voice on the world stage and enhance its influence over the global Internet governance system and the global digitalization process. Several concerns, however, exist regarding China’s globalizing Internet strategies. This paper aims to respond to these concerns and enhance the understanding of China’s globalizing Internet strategies.

Design/methodology/approach

This paper will use content analysis to trace the policy development trajectory of China’s globalizing Internet, including policy vision, policy-making agencies and policy tools.

Findings

The Chinese government has issued a considerable number of policies to regulate and promote the development of the Internet since 2014. The key trend that emerged from the analysis of China’s globalizing Internet policy is the cooperation among different agencies. Existing policies have comprehensively used the supply-oriented tools, the environment-oriented tools and the demand-oriented tools; and the last two tools have been used more frequently in recent years.

Originality/value

The analysis results contribute to understanding how China uses digital technology to enhance its influence over the global Internet governance system.
Modeling the influence patterns of barriers to electronic procurement technology usage in construction projects
Authors: Yevu Sitsofe Kwame , Yu Ann Tit Wan , Darko Amos , Nani Gabriel , Edwards David J.
Published: August 2022

Purpose

This study aims to investigate the dynamic influences of clustered barriers that hinder electronic procurement technology (EPT) implementation in construction procurement, using the neuro-fuzzy system.

Design/methodology/approach

A comprehensive literature review was conducted and 21 barriers to EPT implementation within construction projects were identified. Based on an expert survey, 121 datasets were gathered for this study. Using mean and normalization analysis for the datasets, 15 out of the 21 barriers were deemed to have critical influences in EPT barriers phenomenon. Subsequently, the critical barriers were classified into five groups: human-related; technological risk-related; government-related; industry growth-related; and financial-related. The relationships and influence patterns between the groups of barriers to EPT implementation were analyzed using the neuro-fuzzy system. Furthermore, sensitivity analysis was performed to examine the dynamic influence levels of the barriers within the hindrance level composition.

Findings

The results reveal that addressing one barrier group does not reduce the high levels of hindrances experienced in EPT implementation. However, addressing at least two barrier groups mostly tends to reduce the hindrance levels for EPT implementation. Further, this study revealed that addressing some barrier group pairings, such as technological risk-related and government-related barriers, while other barrier groups remained at a high level, still resulted in high levels of hindrances to EPT implementation in construction procurement.

Research limitations/implications

This study provides insights for researchers to help them contribute to the development of theory with contemporary approaches based on the influence patterns of barrier interrelationships.

Practical implications

This study provides a model that would help practitioners and decision makers in construction procurement to understand and effectively determine the complex and dynamic influences of barrier groups to EPT uptake, for the development of suitable mitigation strategies.

Originality/value

This study provides novel insights into the complex influence patterns among grouped barriers concerning EPT adoption in the construction industry. Researchers and practitioners are equipped with knowledge on the influence patterns of barriers. This knowledge aids the development of effective strategies that mitigate the combined groups of barriers, and promote the wider implementation of EPT in the construction industry.
Integrating push–pull dynamics for understanding the association between boundary control and work outcomes in the context of mandatory work from home
Authors: Biron Michal , Turgeman-Lupo Keren , Levy Oz
Published: August 2022

Purpose

Much of what we know about work from home (WFH) is based on data collected in routine times, where WFH is applied on a partial and voluntary basis. This study leverages the conditions of mandatory WFH imposed by COVID-19 lockdowns to shed new light on factors that relate to well-being and performance among employees who WFH. Specifically, the authors explore how boundary control and push–pull factors (constraints and benefits that employees associate with WFH) interact to shape employees' exhaustion and goal setting/prioritization.

Design/methodology/approach

Surveys were administered in Israel and in the USA to 577 employees in “teleworkable” roles who were mandated to WFH shortly after the COVID-19 outbreak (March–April 2020).

Findings

(1) Boundary control is negatively related to exhaustion and positively related to goal setting/prioritization. (2) These associations are weakened by perceptions of high WFH constraints (push factors). (3) WFH benefits (pull factors) attenuate the moderating effect of WFH constraints.

Practical implications

Organizations may benefit from identifying and boosting the saliency of WFH benefits, while considering and remedying WFH constraints.

Originality/value

The authors contribute theoretically by integrating push–pull factors into the discussion about WFH and boundary management. We also make a contextual contribution by drilling down into the specificities of nonvoluntary WFH. The expected upward trends in nonvoluntary WFH rates underscore the need to understand factors that improve outcomes among individuals who lack agency in the decision to WFH.