bluuebunny/crossref_metadata_2025 huggingface dataset:
Parent attributions and attention deficit/hyperactivity disorder knowledge as predictors of specific help-seeking interests
Authors: Bazier Ashley , O’Laughlin Liz , Feinstein Jessica
Published: November 2023

Many children diagnosed with attention deficit/hyperactivity disorder (ADHD) do not receive appropriate services following diagnosis. Although information about ADHD is widely available and abundant, sometimes conflicting information may impede parent help-seeking. The present study examined parent knowledge of ADHD and attributions of child behavior as predictors of interest in formal and informal help seeking at the point of child evaluation for possible ADHD. Participants (89 caregivers of children ages 5–12) completed a measure of ADHD knowledge, rated attributions of child behavior in response to vignettes depicting ADHD symptoms, and indicated their interest in a range of formal and informal services that could be recommended following the child’s evaluation. Parents reported strongest interest in academic services followed by medication, child focused therapy, and informal services (e.g., seeking information about ADHD). Family income, ADHD knowledge and attributions that child behavior will persist over time were associated with all types of help-seeking interest except academic services. Perceptions of child control over behavior predicted greater interest in medication. Findings suggest that increasing parent knowledge of ADHD and exploring parent goals and preferences for treatment may increase service utilization for children following assessment/diagnosis of ADHD.
Principal components approach of physiological and physical metrics collected through GPS technology in soccer referees
Authors: Castillo-Rodríguez Alfonso , Onetti-Onetti Wanesa , Manuel Clemente Filipe , Tomás González-Fernández Francisco
Published: November 2023

The aim of this study was to define and classify the different physical and physiological performance metrics on national and non-national soccer referees (SRs) through GPS technology. Sixty SRs (age: 28.9 ± 4.9 years; weight: 70.2 ± 8.0 kg; height: 175.7 ± 5.5 cm) were tested using the 18 Hz global positioning system (GPS) (WimuPro, Realtrack, Almería, Spain). An exploratory factor analysis was performed using principal component analysis (PCA) on performance indicators with orthogonal rotation (VariMax). Thirteen metrics (total distance, distance covered at different speeds, maximum heart rate, and heart rate recorded in different zones) were integrated in three principal components, activation (PCA1), recovery (PCA2), and high intensity (PCA3). They represented 86% and 89% of total explained variance of the competition performance in national and non-national SRs, respectively. Distance covered at very high speed and heart rate between 80% and 89.9% of the maximum integrated the high-intensity principal component and were higher in non-national SRs. The main finding of this study was that it defined for the first time in the scientific literature the main components that discriminate physical performance between national and non-national referees, where high intensity metrics have greater weight in non-national referees. In addition, GPS technology together with PCA analysis were presented as useful methods to discriminate the most representative physical and physiological performance metrics in sports competition in SRs.
Confidence of practitioners to support self-management of pain: A multidisciplinary survey
Authors: Penlington Chris , Pornsukjantra Pattramon , Chazot Paul , Cole Frances , Denneny Diarmuid
Published: November 2023

Background

Supported self-management is an important component of management for persistent pain according to current recommendations and guidelines. However, it is unclear whether staff from differing disciplines who may be in early contact with people with established or developing persistent pain are confident to introduce and support self-management for this patient group.

Aim

To determine the confidence of staff across professional disciplines to introduce and support self-management.

Design and Setting

Cross-sectional online survey.

Methods

Charts were constructed to represent information on professional grouping, prior training in self-management and confidence in supporting key components of self-management for persistent pain. Analysis of variance was used to test for differences between groups.

Results

Overall, 165 practitioners reported confidence to support self-management below the midpoint of a ten-point scale and 93 above. There were few differences between different professions apart from in explaining pain (f = 6.879 p < .001), managing activity levels (f = 6.340 p < .001) and supporting healthy habits (f = 4.700, p = .001) in which physiotherapists expressed higher confidence than other professional groups. There was no difference in confidence expressed between staff who had or had not received previous training in self-management (f = 1.357, p = .233).

Conclusions

Many front-line staff who might be expected to introduce and deliver self-management support for persistent pain lack the confidence and skills to do so. This is consistent with a known lack of education about pain across disciplinary boundaries in primary and community-based care. In order to meet treatment priorities for persistent pain there is an urgent need to upskill the workforce by providing access to good quality training and resources.
Molecular characterization of genetic mutations with fitness loss in pulmonary tuberculosis patients associated with HIV co-infection in Northwest Amhara, Ethiopia
Authors: Seid Aynias , Kassa Meseret , Girma Yilak , Dereb Eseye , Nureddin Semira , Abebe Ayenesh , Berhane Nega
Published: November 2023

Objectives:

Molecular approaches to identifying resistance-conferring mutations suggest a revolution in the field of tuberculosis. The aim of the study was to determine the association between resistance-conferring mutations with fitness loss in Mycobacterium tuberculosis clinical isolates and HIV co-infection in the Amhara region of Ethiopia.

Methods:

A laboratory-based cross-sectional study was conducted between September 2022 and June 2023. A line probe assay was performed on 146 culture-positive clinical isolates. Logistic regression analysis was used to measure the strength of the association between the drug-resistance-conferring mutations with fitness loss in M. tuberculosis isolates and tuberculosis/HIV co-infection. A p-value ⩽ 0.05 was considered statistically significant.

Results:

A total of 11 distinct mutations at four genetic loci among 19 resistant isolates were detected. The frequency of rifampicin, isoniazid, and fluoroquinolones resistance-conferring mutations was identified in 12 (8.2%), 17 (11.6%), and 2 (1.4%) of the isolates, respectively. The most prominent specific mutations were S450L (5/9, 55.6%), S315T (11/11, 100%), C-15T (4/4, 100%), and D94G (1/1, 100%). Double mutations were observed in 10 (52.6%) multidrug-resistant tuberculosis isolates; the most common were detected in both the rpoB and katG genes (8/10, 80.0%). The HIV-co-infected tuberculosis patients carried a higher proportion of low fitness of non- rpoB S450L variants than those tuberculosis patients without HIV (80.0% vs 14.3%) and showed a significant association (cOR = 0.042, 95% CI: 0.002–0.877, p = 0.041), but not with the low fitness of non- katG S315T variants (cOR = 3.00, 95% CI: 0.348–25.870, p = 0.318).

Conclusion:

This study provides valuable information on the genetic variants with fitness loss associated with HIV co-infection, but requires further whole-genome-based mutation analysis.
Is the Whole Greater Than the Sum of its Parts? Aggregation of Sports Events as a Driver of Coverage of (the) European Championships on German TV News Shows
Authors: Wehden Lars-Ole , Küpper Lena Maria
Published: November 2023

Various stakeholders have hailed the recently introduced “European Championships” – a multi-sport event comprising competitions for European titles in several sports – as a huge success, particularly because some previously overlooked niche sports received an extraordinary amount of media attention. Empirical evidence indicates that the event has elicited increased live broadcasting of the participating sports. However, retrospective coverage in popular news media also plays an important role in helping sports federations attract active members, fans, and sponsors. Based on mediatization and news value theory, we investigated whether “the European Championships” elicited increased coverage of the most popular German TV news show when compared with corresponding stand-alone competitions in previous years. We also assessed whether all participating sports benefitted equally from this mediatization strategy of aggregation. Employing quantitative content analysis using a quasi-experimental design with a non-equivalent control group in a field setting, we analyzed screen time from competitions during (the) European Championships, controlling for national success. The results overall indicate a significant positive aggregation effect, though not all sports profited equally. Our study contributes to a deeper understanding of aggregation as a mediatization strategy that might be particularly attractive to niche sports federations.
A Systematic Review and Meta-Analysis of Vertebral Artery Injury After Cervical Spine Trauma
Authors: Goyal Kartik , Sunny Jesvin T. , Gillespie Conor S. , Wilby Martin , Clark Simon R. , Kaiser Radek , Fehlings Michael G. , Srikandarajah Nisaharan
Published: November 2023

Study Design

Systematic Review and Meta-Analysis.

Objective

Identify the incidence, mechanism of injury, investigations, management, and outcomes of Vertebral Artery Injury (VAI) after cervical spine trauma.

Methods

A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines (PROSPERO-ID CRD42021295265). Three databases were searched (PubMed, SCOPUS, Google Scholar, CINAHL PLUS). Incidence of VAI, investigations to diagnose (Computed Tomography Angiography, Digital Subtraction Angiography, Magnetic Resonance Angiography), stroke incidence, and management paradigms (conservative, antiplatelets, anticoagulants, surgical, endovascular treatment) were delineated. Incidence was calculated using pooled proportions random effects meta-analysis.

Results

A total of 44 studies were included (1777 patients). 20-studies (n = 503) included data on trauma type; 75.5% (n = 380) suffered blunt trauma and 24.5% (n = 123) penetrating. The overall incidence of VAI was .95% (95% CI 0.65-1.29). From the 16 studies which reported data on outcomes, 8.87% (95% CI 5.34- 12.99) of patients with VAI had a posterior stroke. Of the 33 studies with investigation data, 91.7% (2929/3629) underwent diagnostic CTA; 7.5% (242/3629) underwent MRA and 3.0% (98/3629) underwent DSA. Management data from 20 papers (n = 475) showed 17.9% (n = 85) undergoing conservative therapy, anticoagulation in 14.1% (n = 67), antiplatelets in 16.4% (n = 78), combined therapy in 25.5% (n = 121) and the rest (n = 124) managed using surgical and endovascular treatments.

Conclusion

VAI in cervical spine trauma has an approximate posterior circulation stroke risk of 9%. Optimal management paradigms for the prevention and management of VAI are yet to be standardized and require further research.
Identification of transcriptionally active transposons in Barley
Authors: Gao Dongying , Fox-Fogle Emma
Published: November 2023

Background

The genomes of many major crops including barley (Hordeum vulgare) consist of numerous transposons. Despite their important roles in crop genome evolution and morphological variations, most of these elements are silent or truncated and unable to be mobile in host genomes. Thus far, only a very limited number of active transposons were identified in plants.

Results

We analyzed the barley full-length cDNA (FLcDNA) sequences and detected 71 unique FLcDNAs exhibiting significant sequence similarity to the extant transposase proteins. These FLcDNAs were then used to search against the genome of a malting barley cultivar ‘Morex’, seven new intact transposons were identified. Sequence alignments indicated that six intact transposons contained the entire FLcDNAs whereas another one served as 3’ untranslated region (3’ UTR) of a barley gene. Our reverse transcription-PCR (RT-PCR) experiment further confirmed the expression of these six transposons and revealed their differential expression. We conducted genome-wide transposon comparisons and detected polymorphisms of three transposon families between the genomes of ‘Morex’ and other three genotypes including the wild barley (Hordeum spontaneum, B1K-04-12) and two cultivated barley varieties, ‘Golden Promise’ and ‘Lasa Goumang’. Lastly, we screened the transcripts of all annotated barley genes and found that some transposons may serve as the coding regions (CDSs) or UTRs of barley genes.

Conclusion

We identified six newly expressed transposons in the barley genome and revealed the recent mobility of three transposon families. Our efforts provide a valuable resource for understanding the effects of transposons on barley genome evolution and for developing novel molecular tools for barley genetic improvement and other research.
Epidemiology and zoonotic potential of Livestock-associated Staphylococcus aureus isolated at Tamil Nadu, India
Authors: Rao Relangi Tulasi , Madhavan Vinoth , Kumar Pavitra , Muniraj Gnanaraj , Sivakumar Natesan , Kannan Jayakumar
Published: November 2023

Background

Staphylococcus aureus is part of normal flora and also an opportunistic pathogen responsible for a wide range of infections in both humans and animals. Livestock-associated S. aureus (LA-SA) has gained importance in recent years due to its increased prevalence in recent years, becoming a worry in public health view. This study aimed to study the epidemiology of LA-SA strains in Madurai district, Tamil Nadu, India.

Methods

A total of 255 samples were collected from bovine and other small ruminants like goats and sheep nares (n = 129 and n = 126 respectively). Nasal swab samples were collected from study animals with sterile sample collecting cotton swabs (Hi-Media, Mumbai). Samples were transported to the lab in Cary-Blair Transport media for further analysis. The samples were tested for S. aureus using antibiotic selection and PCR-based assays. The pathogenicity of the bacteria was assessed using chicken embryo models and liver cross-sections were used for histopathology studies.

Results

The prevalence rate in bovine-associated samples was 42.63% but relatively low in the case of small ruminants associated samples with 28.57% only. The overall prevalence of S. aureus is found to 35.6% and MRSA 10.98% among the study samples. The antibiogram results that LA-SA isolates were susceptible to aminoglycosides and tetracyclines but resistant to β-lactam drugs. The biofilm formation results showed that the LA-SA isolates are weak to high-capacity biofilm formers. The enterotoxigenic patterns revealed that most of the isolated strains are enterotoxigenic and possess classical enterotoxins. The survival analysis of chicken embryos suggested that the Bovine-associated strains were moderately pathogenic.

Conclusion

The study concluded that economically important livestock animals can act as reservoirs for multi-drug resistant and pathogenic which in-turn is a concern for public health as well as livestock health.
A potential candidate gene associated with the angles of the ear leaf and the second leaf above the ear leaf in maize
Authors: Kuang Tianhui , Hu Can , Shaw Ranjan Kumar , Zhang Yudong , Fan Jun , Bi Yaqi , Jiang Fuyan , Guo Ruijia , Fan Xingming
Published: November 2023

Background

Leaf angle is a key trait for maize plant architecture that plays a significant role in its morphological development, and ultimately impacting maize grain yield. Although many studies have been conducted on the association and localization of genes regulating leaf angle in maize, most of the candidate genes identified are associated with the regulation of ligule-ear development and phytohormone pathways, and only a few candidate genes have been reported to enhance the mechanical strength of leaf midrib and vascular tissues.

Results

To address this gap, we conducted a genome-wide association study (GWAS) using the leaf angle phenotype and genotyping-by-sequencing data generated from three recombinant inbred line (RIL) populations of maize. Through GWAS analysis, we identified 156 SNPs significantly associated with the leaf angle trait and detected a total of 68 candidate genes located within 10 kb upstream and downstream of these individual SNPs. Among these candidate genes, Zm00001d045408, located on chromosome 9 emerged as a key gene controlling the angles of both the ear leaf and the second leaf above the ear leaf. Notably, this new gene’s homolog in Arabidopsis promotes cell division and vascular tissue development. Further analysis revealed that a SNP transversion (G/T) at 7.536 kb downstream of the candidate gene Zm00001d045408 may have caused a reduction in leaf angles of the ear and the second leaf above the ear leaf. Our analysis of the 10 kb region downstream of this candidate gene revealed a 4.337 kb solo long-terminal reverse transcription transposon (solo LTR), located 3.112 kb downstream of Zm00001d045408, with the SNP located 87 bp upstream of the solo LTR.

Conclusions

In summary, we have identified a novel candidate gene, Zm00001d045408 and a solo LTR that are associated with the angles of both the ear leaf and the second leaf above the ear leaf. The future research holds great potential in exploring the precise role of newly identified candidate gene in leaf angle regulation. Functional characterization of this gene can help in gaining deeper insights into the complex genetic pathways underlying maize plant architecture.
Utilization of anonymization techniques to create an external control arm for clinical trial data
Authors: Mehtälä Juha , Ali Mehreen , Miettinen Timo , Partanen Liisa , Laapas Kaisa , Niemelä Petri T. , Khorlo Igor , Ström Sanna , Kurki Samu , Vapalahti Jarno , Abdelgawwad Khaled , Leinonen Jussi V.
Published: November 2023

Background

Subject-level real-world data (RWD) collected during daily healthcare practices are increasingly used in medical research to assess questions that cannot be addressed in the context of a randomized controlled trial (RCT). A novel application of RWD arises from the need to create external control arms (ECAs) for single-arm RCTs. In the analysis of ECAs against RCT data, there is an evident need to manage and analyze RCT data and RWD in the same technical environment. In the Nordic countries, legal requirements may require that the original subject-level data be anonymized, i.e., modified so that the risk to identify any individual is minimal. The aim of this study was to conduct initial exploration on how well pseudonymized and anonymized RWD perform in the creation of an ECA for an RCT.

Methods

This was a hybrid observational cohort study using clinical data from the control arm of the completed randomized phase II clinical trial (PACIFIC-AF) and RWD cohort from Finnish healthcare data sources. The initial pseudonymized RWD were anonymized within the (k,ε)-anonymity framework (a model for protecting individuals against identification). Propensity score matching and weighting methods were applied to the anonymized and pseudonymized RWD, to balance potential confounders against the RCT data. Descriptive statistics for the potential confounders and overall survival analyses were conducted prior to and after matching and weighting, using both the pseudonymized and anonymized RWD sets.

Results

Anonymization affected the baseline characteristics of potential confounders only marginally. The greatest difference was in the prevalence of chronic obstructive pulmonary disease (4.6% vs. 5.4% in the pseudonymized compared to the anonymized data, respectively). Moreover, the overall survival changed in anonymization by only 8% (95% CI 4–22%). Both the pseudonymized and anonymized RWD were able to produce matched ECAs for the RCT data. Anonymization after matching impacted overall survival analysis by 22% (95% CI -21–87%).

Conclusions

Anonymization may be a viable technique for cases where flexible data transfer and sharing are required. As anonymization necessarily affects some aspects of the original data, further research and careful consideration of anonymization strategies are needed.
Tetanus in a vaccinated soil expert - a case report
Authors: Medu Olanrewaju , Ogunyemi Nazlee , Hennink Maurice , Mawer Shawn , Styles-Mackinnon Theresa , Wong Alex , Omosigho Charles , Diener Tania
Published: November 2023

Background

Tetanus is a life-threatening vaccine-preventable disease found more commonly in tropical climates. It accounted for up to 60 deaths annually until the introduction of the tetanus toxoid. It is now rare in Canada by immunization. This study aims to describe a case of tetanus in Saskatchewan with possible occupational exposure.

Case Report

We describe the case of a vaccinated soil expert with tetanus resulting from skin abrasions. This report highlights the early diagnosis, atypical presentation with possible vaccine attenuation and management approach, including acute care, intensive care unit referral, surgical management and physical rehabilitation. We also describe the public health management provided in this case. Despite the severity, the patient returned to his previous home environment with minimal motor sequelae.

Conclusion

Occupational exposure to tetanus is an important risk, even in regions where the disease is rare. Prevention through vaccination is a key public health intervention that must be encouraged to avoid health complications that are often fatal.
Outcomes of prophylactic lauromacrogol injection versus non-injection in patients with endogenous cesarean scar pregnancy treated by hysteroscopic surgery: a retrospective cohort study
Authors: Lu Lei , Shao Yiming , Qu Zhaoyang , Huang Guilian , Lang Suping , Yang Caiqun , Lang Siqi , Fang Shuying
Published: November 2023

Background

This study aimed to investigate the efficacy of hysteroscopic surgery for endogenous cesarean scar pregnancy (CSP) and the value of prophylactic ultrasound-guided local injection of lauromacrogol.

Methods

This retrospective study included 131 patients diagnosed with endogenous CSP who underwent hysteroscopic surgery at the Hangzhou Fuyang Women and Children Hospital between January 2018 and May 2022. Lauromacrogol (10–20 mL) was administered within 24 h preoperatively using an ultrasound-guided vaginal injection to 78 patients (L group) versus not administered to 53 patients (non-L group). Their clinical data and outcomes were analyzed.

Results

Mean gestational age, gestational mass size, and uterine scar thickness and median preoperative blood β-human chorionic gonadotropin levels of the non-L versus L groups were 46.26 versus 45.01 days, 2.05 versus 2.39 cm, 0.35 versus 0.32 cm, and 19850.0 versus 26790.0 U/L, respectively (P > 0.05 for each). The non-L and L groups had similar success rates (98.1% vs. 98.7%, P = 1.0). Complications related to lauromacrogol administration, including abdominal pain, massive bleeding, and bradycardia, were experienced by 46.2% (36/78; P < 0.001) of L group patients. The non-L had a significantly shorter mean hospital stay (4.85 ± 1.12 vs 5.44 ± 1.08 days) and lower total cost (6148.75 ± 1028.71 vs 9016.61 ± 1181.19) (P < 0.01).

Conclusions

Hysteroscopic surgery is effective and safe for patients with endogenous CSP. Prophylactic lauromacrogol injection increases the incidence of complications and costs. Direct hysteroscopic surgery can reduce pain and financial burden in patients with endogenous CSP and save medical resources for other patients.
Effect and mechanical mechanism of spontaneous breathing on oxygenation and lung injury in mild or moderate animal ARDS
Authors: Yang Rui , Zhou Leilei , Chen Zongyu , He Shuang , Lian Siyu , Shen Yi , Zhang Xianming
Published: November 2023

Objective

The present study aimed to determine the effect and mechanical mechanism of spontaneous breathing during mechanical ventilation on oxygenation and lung injury using Beagles dogs mild or moderate acute respiratory distress syndrome (ARDS) model.

Methods

After inducing mild or moderate ARDS by infusion of oleic acid, Eighteen Beagles dogs were randomly split into Spontaneous breathing group (BIPAPSB, n = 6), and Complete muscle paralysis group (BIPAPPC, n = 6),Six Beagles without ventilator support comprised the control group. Both groups were ventilated for 8 h under BIPAP mode. High-pressure was titrated TV to 6 ml/kg. A multi-pair esophageal balloon electrode catheter was used to measure respiratory mechanics and electromyogram. End-expiratory lung volume (EELV), gas exchange and respiratory variables were recorded in the process of mechanical ventilation. The contents of Interleukin (IL)-6 and IL-8 in lung tissue were measure using qRT-PCR. Besides, lung injury score was calculated in the end of mechanical ventilation.

Results

Based on the comparable setting of ventilator, BIPAPSB group exhibited higher safety peak transpulmonary pressure, abdominal pressure, EELV and P/F(PaO2/FiO2) than BIPAPPC group, whereas mean transpulmonary pressure, the mRNA levels of the IL-6 and IL-8 in the lung tissues and lung injury score in BIPAPSB group were lower than those in BIPAPPC group.

Conclusion

In mild to moderate ARDS animal models, during mechanical ventilation, SB may improve respiratory function and reduce ventilator-induced lung injury. The mechanism may be that spontaneous inspiration up-regulates peak transpulmonary pressure and EELV; Spontaneous expiration decreases mean transpulmonary pressure by up-regulating intra-abdominal pressure, thereby reducing stress and strain.
Evaluating the affordability of asthma, chronic obstructive pulmonary disease, and cystic fibrosis medicines in a middle-income country
Authors: Fathi Mahdieh , Moradi Najmeh , Yousefi Nazila , Peiravian Farzad , Shobeiri Nikta
Published: November 2023

Background

A heavy financial burden is imposed on patients suffering from chronic diseases due to medicine out-of-pocket payments.

Objectives

This study focuses on assessing the affordability of medications used for chronic respiratory diseases (CRDs) such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) in Iran, specifically on the category R medicines listed in the 2017 Iran drug list (IDL) that are used for the treatment of these diseases, based on the anatomical therapeutic chemical (ATC) drug code.

Methods

The affordability of medicines in mono and combination therapy approaches was assessed in CRDs using the World Health Organization/Health Action International (WHO/HAI) methodology. Accordingly, if out-of-pocket payment for 30-days of pharmacotherapy exceeds one day for the lowest-paid unskilled government worker (LPGW), it’s considered non-affordable.

Results

Based on the monotherapy approach, our finding demonstrates that all generic medicines of category R were affordable. However, branded drugs such as Symbicort®, Pulmicort Respules®, Flusalmex®, Seretide®, Fluticort Plus®, Seroflo®, and Salmeflo® cost between 1.2 and 2.5 days’ wage of LPGW and considered unaffordable despite 70% insurance coverage. Moreover, based on the affordability ratio in the combination therapy approach, all medicines used in asthma, COPD, and CF patients with mild respiratory problems are affordable except omalizumab (inj), which is non-affordable due to its high price and no insurance coverage.

Conclusion

Results showed that the existing insurance coverage does not protect households from hardship, so more considerations are needed such as different insurance schedules and patient support programs.
Integrated machine learning identifies epithelial cell marker genes for improving outcomes and immunotherapy in prostate cancer
Authors: Zhu Weian , Zeng Hengda , Huang Jiongduan , Wu Jianjie , Wang Yu , Wang Ziqiao , Wang Hua , Luo Yun , Lai Wenjie
Published: November 2023

Background

Prostate cancer (PCa), a globally prevalent malignancy, displays intricate heterogeneity within its epithelial cells, closely linked with disease progression and immune modulation. However, the clinical significance of genes and biomarkers associated with these cells remains inadequately explored. To address this gap, this study aimed to comprehensively investigate the roles and clinical value of epithelial cell-related genes in PCa.

Methods

Leveraging single-cell sequencing data from GSE176031, we conducted an extensive analysis to identify epithelial cell marker genes (ECMGs). Employing consensus clustering analysis, we evaluated the correlations between ECMGs, prognosis, and immune responses in PCa. Subsequently, we developed and validated an optimal prognostic signature, termed the epithelial cell marker gene prognostic signature (ECMGPS), through synergistic analysis from 101 models employing 10 machine learning algorithms across five independent cohorts. Additionally, we collected clinical features and previously published signatures from the literature for comparative analysis. Furthermore, we explored the clinical utility of ECMGPS in immunotherapy and drug selection using multi-omics analysis and the IMvigor cohort. Finally, we investigated the biological functions of the hub gene, transmembrane p24 trafficking protein 3 (TMED3), in PCa using public databases and experiments.

Results

We identified a comprehensive set of 543 ECMGs and established a strong correlation between ECMGs and both the prognostic evaluation and immune classification in PCa. Notably, ECMGPS exhibited robust predictive capability, surpassing traditional clinical features and 80 published signatures in terms of both independence and accuracy across five cohorts. Significantly, ECMGPS demonstrated significant promise in identifying potential PCa patients who might benefit from immunotherapy and personalized medicine, thereby moving us nearer to tailored therapeutic approaches for individuals. Moreover, the role of TMED3 in promoting malignant proliferation of PCa cells was validated.

Conclusions

Our findings highlight ECMGPS as a powerful tool for improving PCa patient outcomes and supply a robust conceptual framework for in-depth examination of PCa complexities. Simultaneously, our study has the potential to develop a novel alternative for PCa diagnosis and prognostication.
Drone network for early warning of forest fire and dynamic fire quenching plan generation
Authors: Manoj S. , Valliyammai C.
Published: November 2023

Wildfires are one of the most frequent natural disasters which significantly harm the environment, society, and the economy. Transfer learning algorithms and modern machine learning tools can help in early forest fire prediction, detection, and dynamic fire quenching. A group of drones that has high-definition image processing and decision-making capabilities are used to detect the forest fires in the very early stage. The proposed system generates a fire quenching plan using particle swarm optimization technique and alerts the fire and rescue department for a quick action, thereby stop the forest fire at an early stage. Also, the drone network plays a major role to track the live status of forest fire and quenches the fire. ResNet, VGGNet, MobileNet, AlexNet, and GoogLeNet are used to detect the forest fire hazards. The experimental results prove that the proposed technique GoogLeNet-TL provides 96% accuracy and 97% F1 score in comparison with the state-of-the-art deep learning models.
CENPE and LDHA were potential prognostic biomarkers of chromophobe renal cell carcinoma
Authors: Wu Hui-feng , Liu Hao , Zhang Zhe-wei , Chen Ji-min
Published: November 2023

Background

Most sarcomatoid differentiated renal cell carcinoma was differentiated from Chromophobe renal cell carcinoma (KICH) and related to a bad prognosis. Thus, finding biomarkers is important for the therapy of KICH.

Methods

The UCSC was used for determining the expression of mRNA and miRNA and clinical data in KICH and normal samples. KEGG and GO were used for predicting potential function of differently expressed genes (DEGs). Optimal prognostic markers were determined by Lasso regression. Kaplan–Meier survival, ROC, and cox regression were used for assessing prognosis value. GSEA was used for predicting potential function of markers. The relations between markers and immune cell infiltration were determined by Pearson method. The upstream miRNA of markers was predicted in TargetScan and DIANA.

Results

The 6162 upregulated and 13,903 downregulated DEGs were identified in KICH. Further CENPE and LDHA were screened out as optimal prognostic risk signatures. CENPE was highly expressed while LDHA was lowly expressed in KICH samples, and the high expressions of 2 genes contributed to bad prognosis. The functions of CENPE and LDHA were mainly enriched in proliferation related pathways such as cell cycle and DNA replication. In addition, the correlation of 2 genes with immune infiltrates in KICH was also observed. Finally, we found that has-miR-577 was the common upstream of 2 genes and the binding sites can be predicted.

Conclusion

CENPE and LDHA were identified as the important prognostic biomarkers in KICH, and they might be involved in the proliferation of cancer cell.
Curriculum implementation challenges: Development and validation of an integrated curriculum implementation challenges tool
Authors: Aslam Kinza , Khan Rehan Ahmed , Aslam Mohammad Annas , Zaidi Fatima Zia
Published: November 2023

Objective: To develop an instrument to identify the challenges faced by faculty while implementing an integrated curriculum in an undergraduate dentistry program.

Methods: The study was conducted between September 2020 and October 2021 at the University College of Medicine and Dentistry (UCMD), University of Lahore (UOL). A preliminary questionnaire, developed through literature review and faculty interviews was sent to 10 medical education experts for content validation via the Delphi technique. Content Validity Index (CVI) was calculated for individual items (I-CVI) as well as for the composite scale (S-CVI). A panel agreement of more than 75% was considered as the criterion for the inclusion of items in the questionnaire. Cognitive pretesting of five faculty members was conducted and pilot testing was subsequently done with 27 faculty members. The reliability of the tool was determined by Cronbach’s alpha.

Results: After the Delphi process, the final Integrated Curriculum Implementation Challenges (ICIC) questionnaire had 42 items. S-CVI was 0.87 and the cut-off value for I-CVI was taken as 0.78 as the criterion for item deletion. Cognitive interviews and pretesting revealed good item interpretation. Cronbach’s alpha for this tool was 0.87.

Conclusion: ICIC is a useful instrument with good reliability and content validity. It can be used to identify the presence and extent of challenges faced by the faculty while implementing an integrated curriculum.

doi: https://doi.org/10.12669/pjms.40.1.7258

How to cite this: Aslam K, Khan RA, Aslam MA, Zaidi FZ. Curriculum implementation challenges: Development and validation of an integrated curriculum implementation challenges tool. Pak J Med Sci. 2024;40(1):---------. doi: https://doi.org/10.12669/pjms.40.1.7258

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gender‐affirming hysterectomy in the United States: A comparative outcomes analysis and potential implications for uterine transplantation
Authors: Siringo Nicolette V. , Boczar Daniel , Berman Zoe P. , Chaya Bachar F. , Kimberly Laura , Rodriguez Colon Ricardo , Trilles Jorge , Brydges Hilliard , Rodriguez Eduardo D.
Published: November 2023

Purpose

Hysterectomy is a gynecological procedure sometimes performed as part of the gender‐affirming process for transgender and gender‐expansive patients assigned female at birth. Our goal was to compare surgical outcomes between patients undergoing gender‐affirming hysterectomy and patients undergoing hysterectomy for benign menstrual disorders. We then explored the implications of gender‐affirming hysterectomy for uterine transplantation.

Methods

We performed a retrospective cohort study using data from the American College of Surgeons National Surgical Quality Improvement Program database from 2009 through 2018. We identified patients undergoing hysterectomy in the United States based on Current Procedural Terminology code. We used the International Classification of Diseases 9 or 10 codes to identify patients with benign menstrual disorders (non‐gender‐affirming group) and gender dysphoria (gender‐affirming group). We compared patient characteristics and surgical complications.

Results

Of the 40,742 patients that met inclusion criteria, 526 (1.3%) patients were individuals with gender dysphoria. Compared to patients who underwent hysterectomy for benign menstrual disorders, gender‐affirming patients were younger, were healthier, had a lower prevalence of diabetes, and were more likely to undergo surgery in the outpatient setting, with shorter time to discharge. Complication rates were similar between groups. Logistic regression controlling for the American Society of Anesthesiology classification determined the difference of return to the operating room was not statistically significant (OR 1.082; 95% CI, 0.56–2.10; p = 0.816).

Conclusion

Gender‐affirming hysterectomy has a safety profile similar to hysterectomy performed for benign menstrual disorders. Researchers should further explore the possibility of uterus donation among these patients as they may be suitable candidates.
A rabbit model of ear otitis established using the Malassezia pachydermatis strain C23 from dogs
Authors: Sachivkina Nadezhda , Karamyan Arfenya , Petrukhina Olesya , Kuznetsova Olga , Neborak Ekaterina , Ibragimova Alfia
Published: November 2023

Background and Aim: Fungal infections are a growing problem for both humans and animals due to the emergence of pathogenic strains resistant to modern antifungal treatments. To evaluate the efficacy of new antifungal drugs, it is essential to develop animal models that demonstrate typical responses to both the infection (pathogenesis and clinical course) and to the treatment, including adverse effects. In this study, we established a rabbit otitis model by infection of an aggressive multidrug-resistant strain from dogs, Malassezia pachydermatis C23, with no need for concomitant immunosuppression.

Materials and Methods: Twenty healthy adult male gray giant rabbits (1 year old, 5.5 kg) were inoculated once with M. pachydermatis C23 at 108 colony-forming units/mL. We observed the clinical signs of the disease and collected ear smears and blood samples every 5 days.

Results: The infection progressed rapidly and exhibited characteristic clinical signs without spontaneous recovery for at least 1 month. In fact, substantial deterioration was observed as evidenced by blood parameters.

Conclusion: This rabbit otitis model established using an aggressive drug-resistant fungus strain without immunosuppression could prove valuable for testing novel antifungal agents.

Keywords: in vivo model, Malassezia pachydermatis, otitis media, rabbit.
Effects of N2O elimination on the elimination of second gases in a two‐step mathematical model of heterogeneous gas exchange
Authors: Korman Ben , Dash Ranjan K. , Peyton Philip J.
Published: November 2023

We have investigated the elimination of inert gases in the lung during the elimination of nitrous oxide (N2O) using a two‐step mathematical model that allows the contribution from net gas volume expansion, which occurs in Step 2, to be separated from other factors. When a second inert gas is used in addition to N2O, the effect on that gas appears as an extra volume of the gas eliminated in association with the dilution produced by N2O washout in Step 2. We first considered the effect of elimination in a single gas‐exchanging unit under steady‐state conditions and then extended our analysis to a lung having a log‐normal distribution of ventilation and perfusion. A further increase in inert gas elimination was demonstrated with gases of low solubility in the presence of the increased ventilation‐perfusion mismatch that is known to occur during anesthesia. These effects are transient because N2O elimination depletes the input of that gas from mixed venous blood to the lung, thereby rapidly reducing the magnitude of the diluting action.
Targeted quantitative lipidomic uncovers lipid biomarkers for predicting the presence of compensated cirrhosis and discriminating decompensated cirrhosis from compensated cirrhosis
Authors: Zeng Yongbin , Zhang Li , Zheng Zhiyi , Su Jingyi , Fu Ya , Chen Tianbin , Lin Kun , Liu Can , Huang Huanhuan , Ou Qishui , Zeng Yongjun
Published: November 2023

Objectives

This study aimed to characterize serum lipid metabolism and identify potential biomarkers for compensated cirrhosis (CC) predicting and decompensated cirrhosis (DC) discrimination using targeted quantitative lipidomics and machine learning approaches.

Methods

Serum samples from a cohort of 120 participants was analyzed, including 90 cirrhosis patients (45 CC patients and 45 DC patients) and 30 healthy individuals. Lipid metabolic profiling was performed using targeted LC-MS/MS. Two machine learning methods, least absolute shrinkage and selection operator (LASSO), and random forest (RF) were applied to screen for candidate metabolite biomarkers.

Results

The metabolic profiling analysis showed a significant disruption in patients with CC and DC. Compared to the CC group, the DC group exhibited a significant upregulation in the abundance of glycochenodeoxycholic acid (GCDCA), glyco-ursodeoxycholic acid (GUDCA), glycocholic acid (GCA), phosphatidylethanolamine (PE), N-acyl-lyso-phosphatidylethanolamine (LNAPE), and triglycerides (TG), and a significant downregulation in the abundance of ceramides (Cer) and lysophosphatidylcholines (LPC). Machine learning identified 11 lipid metabolites (abbreviated as BMP11) as potential CC biomarkers with excellent prediction performance, with an AUC of 0.944, accuracy of 94.7 %, precision of 95.6 %, and recall of 95.6 %. For DC discrimination, eight lipids (abbreviated as BMP8) were identified, demonstrating strong efficacy, with an AUC of 0.968, accuracy of 92.2 %, precision of 88.0 %, and recall of 97.8 %.

Conclusions

This study unveiled distinct lipidomic profiles in CC and DC patients and established robust lipid-based models for CC predicting and DC discrimination.
Deutsche Banken auf dem Weg in die zweite Globalisierung
Authors: Sattler Friederike , Ziegler Dieter
Published: November 2023

This article introduces the problematic situation of the great German banks and some non-German banks during the so-called second globalization since the 1970s. It formulates the questions that should be answered in the following contributions, each for a particular bank or group of banks. The most important overarching questions are firstly, to what extent banks were the driving force in the interconnectedness of cross-border money and capital flows and, secondly, to what extent they acted as triggers of the severe financial and/or sovereign debt crises during the last half century.
Neuer Aufbruch ins globale Bankgeschäft: Die Personal- und Steuerungsprobleme der Deutschen Bank beim Einstieg ins internationale Investmentbanking
Authors: Sattler Friederike
Published: November 2023

The article examines the genesis, perception and handling of the staffing and governance problems of Deutsche Bank, which stemmed from its entry into international investment banking in the mid-1980s and which have remained virulent into the bank’s recent past. Why was it not possible to prevent the blatant, extremely costly and permanently reputation-damaging breaches of rules by many investment bankers in this business area? An important explanatory factor seems to be the only half-hearted adherence to the concept of a global universal bank with integrated investment banking, while investment banking – which expanded strongly through the acquisitions of Morgan Grenfell (1989) and Bankers Trust (1998) – was de facto granted extensive autonomy within the group and a continuous but not precisely recorded transfer of resources by the parent company.
Latin American Banks and Euromarkets: A View on the Process of Early Bank Globalization from the Periphery
Authors: Alvarez Sebastian
Published: November 2023

Global banks and interconnected national banking sectors have been a main characteristic of the modern international financial systems over the last half century. After a sluggish wake up in the early postwar years, international banking took off in the 1970s as the Euromarkets gained traction and strongly developed in the lead up to the international debt crisis of 1982. This article examines the birth of bank globalization in Latin America, a region of the developing world at the centre of global finance and Euromarket developments during this period. It shows that, like their counterparts in industrial countries, leading banking institutions from the region also went international, expanding their presence overseas and their participation in the Euromarkets. The world leading financial centres of London and New York were the main destinations, but they also settled in offshore centres in the Caribbean and other US financial districts from where they conducted international business on their own or in collaboration with other banks. The presence in Germany along with the joint business between Latin American and German banks in the Euromarkets are explored as well. While assessing the extent and scope of early Latin American bank globalization for the first time, the article also provides insights on the evolution and changing nature of this process over the following period.
Banking in Globalisation: Commerzbank in the New Economic Course of the People’s Republic of China and the Role of Hong Kong
Authors: Liu Yi
Published: November 2023

Since the open-up policy at the end of the 1970s, China – the largest single market in Asia – received growing attention from foreign investors and banks. However, the fragile domestic market and undeveloped financial system in China did not allow a rapid inflow of foreign banks, given that the foreign banks could exert suppression on the domestic banks. As a result, it took several years for most foreign banks to gain a foothold in mainland China. This article demonstrates how Commerzbank – one of the German Big Three – entered the Chinese market in the 1980s by establishing a branch in Hong Kong and opening a representative office in Beijing. On the basis of archival evidence and other contemporary sources, the case of China provides one slice of the history of Commerzbank’s expansion and illustrates how it coped with the surge of internationalisation in the 1980s.