bluuebunny/crossref_metadata_2025 huggingface dataset:
Afghan medical students’ perceptions, and experiences of their medical education and their professional intentions: a cross-sectional study
Authors: Stanikzai Muhammad Haroon , Wafa Mohammad Hashim , Akbari Khalid , Anwary Zabihullah , Baray Ahmad Haroon , Sayam Hadia , Wasiq Abdul Wahed
Published: August 2023

Background

Numerous challenges have crippled the Afghan healthcare system on individual, organizational, and societal levels. The Afghans have acknowledged that an evidence-based perspective is paramount to enhancing medical training capacities across the country, which may, in turn, best ensure appointing highly competent authorities to address health system problems on such multiple levels.

Objectives

This study assessed current Afghan senior medical students’ perceptions, and experiences of their medical education and their future professional intentions.

Methods

We conducted this cross-sectional study at seven public and private Afghan medical institutes from March to April 2022. We invited 665 senior medical students through an anonymous survey using the Google survey online forms via social-media platforms, such as WhatsApp Messenger. Descriptive statistics were employed for the data analyses.

Results

The mean age (± SD) of the students was 23.7 (± 2.2) years and males constituted 79.9% (510) of the study sample. About 22.6% of them rated their medical training as excellent, and nearly a third of them (37%) said that it is good. Nearly half (48.7%) of the students would prefer to stay in Afghanistan. The leading motives for moving overseas were to obtain more advanced and quality education (69.9%), and a decent personal life (43.9%). Nearly two-thirds (67.4%) of them asserted that current political and armed conflicts in Afghanistan may have influenced their professional choices.

Conclusion

This study epitomizes that the quality of medical education in Afghanistan has room for growth and development to meet the standards set on regional and global grounds.
A qualitative study of professionals’ perspectives on the ethics of medically-delivered safer injection education for people who inject drugs
Authors: Demina Anastasia , Desprès Caroline , Mamzer Marie-France
Published: August 2023

Background

In this qualitative analysis we aimed to explore addiction physicians’ perspectives on safer injection education for people who inject drugs, especially: (1) on possible means of introducing safer injection education in the medical environment, (2) on the compatibility of safer injection education with each physician’s core values and goals, and (3) on possible reasons for the ethical dilemma in safer injection education.

Methods

We conducted semi-structured interviews with eleven physicians practicing addiction medicine in France in clinical and harm reduction settings.

Results

All participants were in favor of educational interventions for people who inject drugs. Nonetheless, these interventions varied from simple advice to injection supervision and they were seen as less acceptable when they concerned the practical and material aspects of injection. Some participants found that physicians practicing in clinical settings, where patients consult mostly to stop their drug use, should not practice safer injection education. On the contrary, other participants claimed that safer injection education was essential in all settings and was not a choice but rather a duty for addiction physicians. The ethical dilemma of such intervention when delivered by medical staff was viewed as a complex phenomenon, related to the representations of intravenous drug use and to societal expectations from physicians.

Conclusion

Physicians’ views on safer injection education for people who inject drugs reveal an emotionally charged subject related to the structural organization of addiction management in France. Such education is marked by an arduous history of harm reduction policies in France.

IRB registration:

#00011928.
Discrepancy between perceptions and acceptance of clinical decision support Systems: implementation of artificial intelligence for vancomycin dosing
Authors: Liu Xinyan , Barreto Erin F. , Dong Yue , Liu Chang , Gao Xiaolan , Tootooni Mohammad Samie , Song Xuan , Kashani Kianoush B.
Published: August 2023

Background

Artificial intelligence (AI) tools are more effective if accepted by clinicians. We developed an AI-based clinical decision support system (CDSS) to facilitate vancomycin dosing. This qualitative study assesses clinicians' perceptions regarding CDSS implementation.

Methods

Thirteen semi-structured interviews were conducted with critical care pharmacists, at Mayo Clinic (Rochester, MN), from March through April 2020. Eight clinical cases were discussed with each pharmacist (N = 104). Following initial responses, we revealed the CDSS recommendations to assess participants' reactions and feedback. Interviews were audio-recorded, transcribed, and summarized.

Results

The participants reported considerable time and effort invested daily in individualizing vancomycin therapy for hospitalized patients. Most pharmacists agreed that such a CDSS could favorably affect (N = 8, 62%) or enhance (9, 69%) their ability to make vancomycin dosing decisions. In case-based evaluations, pharmacists' empiric doses differed from the CDSS recommendation in most cases (88/104, 85%). Following revealing the CDSS recommendations, we noted 78% (69/88) discrepant doses. In discrepant cases, pharmacists indicated they would not alter their recommendations. The reasons for declining the CDSS recommendation were general distrust of CDSS, lack of dynamic evaluation and in-depth analysis, inability to integrate all clinical data, and lack of a risk index.

Conclusion

While pharmacists acknowledged enthusiasm about the advantages of AI-based models to improve drug dosing, they were reluctant to integrate the tool into clinical practice. Additional research is necessary to determine the optimal approach to implementing CDSS at the point of care acceptable to clinicians and effective at improving patient outcomes.
Exploring interdependencies, vulnerabilities, gaps and bridges in care transitions of patients with complex care needs using the Functional Resonance Analysis Method
Authors: Hedqvist Ann-Therese , Praetorius Gesa , Ekstedt Mirjam
Published: August 2023

Background

Hospital discharge is a complex process encompassing multiple interactions and requiring coordination. To identify potential improvement measures in care transitions for people with complex care needs, intra- and inter-organisational everyday work needs to be properly understood, including its interdependencies, vulnerabilities and gaps. The aims of this study were to 1) map coordination and team collaboration across healthcare and social care organisations, 2) describe interdependencies and system variability in the discharge process for older people with complex care needs, and 3) evaluate the alignment between discharge planning and the needs in the home.

Methods

Data were collected through participant observations, interviews, and document review in a region of southern Sweden. The Functional Resonance Analysis Method (FRAM) was used to model the discharge process and visualise and analyse coordination of care across healthcare and social care organisations.

Results

Hospital discharge is a time-sensitive process with numerous couplings and interdependencies where healthcare professionals’ performance is constrained by system design and organisational boundaries. The greatest vulnerability can be found when the patient arrives at home, as maladaptation earlier in the care chain can lead to an accumulation of issues for the municipal personnel in health and social care working closest to the patient. The possibilities for the personnel to adapt are limited, especially at certain times of day, pushing them to make trade-offs to ensure patient safety. Flexibility and appropriate resources enable for handling variability and responding to uncertainties in care after discharge.

Conclusions

Mapping hospital discharge using the FRAM reveals couplings and interdependencies between various individuals, teams, and organisations and the most vulnerable point, when the patient arrives at home. Resilient performance in responding to unexpected events and variations during the first days after the return home requires a system allowing flexibility and facilitating successful adaptation of discharge planning.
An automated, low-latency environment for studying the neural basis of behavior in freely moving rats
Authors: Jankowski Maciej M. , Polterovich Ana , Kazakov Alex , Niediek Johannes , Nelken Israel
Published: August 2023

Background

Behavior consists of the interaction between an organism and its environment, and is controlled by the brain. Brain activity varies at sub-second time scales, but behavioral measures are usually coarse (often consisting of only binary trial outcomes).

Results

To overcome this mismatch, we developed the Rat Interactive Foraging Facility (RIFF): a programmable interactive arena for freely moving rats with multiple feeding areas, multiple sound sources, high-resolution behavioral tracking, and simultaneous electrophysiological recordings. The paper provides detailed information about the construction of the RIFF and the software used to control it. To illustrate the flexibility of the RIFF, we describe two complex tasks implemented in the RIFF, a foraging task and a sound localization task. Rats quickly learned to obtain rewards in both tasks. Neurons in the auditory cortex as well as neurons in the auditory field in the posterior insula had sound-driven activity during behavior. Remarkably, neurons in both structures also showed sensitivity to non-auditory parameters such as location in the arena and head-to-body angle.

Conclusions

The RIFF provides insights into the cognitive capabilities and learning mechanisms of rats and opens the way to a better understanding of how brains control behavior. The ability to do so depends crucially on the combination of wireless electrophysiology and detailed behavioral documentation available in the RIFF.
Prenatal genetic diagnosis of disseminated infantile myofibromatosis: a case report and literature review
Authors: Lü Yan , Jiang Yulin , Wu Huanwen , Qi Qingwei , Zhou Xiya , Guo Qi , Hao Na , Liu Juntao , Meng Hua
Published: August 2023

Background

Infantile myofibromatosis (IM) is a rare disorder characterized by the formation of nodules in the skin, muscle, bone, and, more rarely, visceral organs. Very few cases are detected prenatally, and the final diagnosis cannot be made until pathology is completed after birth. Here, we present a case of disseminated form IM (DFIM) with a diagnosis established on prenatal genetic grounds.

Case presentation

A woman at 23 weeks of gestation was referred for ultrasound evaluation of fetal kidney abnormality. Generalized masses in the skin and muscle of the fetus developed at 28 weeks. Prenatal genetic testing identified the pathogenic heterozygous variant c.1681C > T (p.R561C) of the PDGFRB gene inherited from the asymptomatic father. Intrauterine demise occurred at 31 weeks. Autopsy confirmed DFIM with involvement of the heart and kidney. All cases of prenatally detected IM were reviewed, revealing an association of high mortality with DFIM.

Conclusions

Prenatal IM diagnosis is difficult. Initial detection is always based on ultrasound. DFIM has high mortality. The germline p.R561C mutation in PDGFRB may cause fetal demise due to severe visceral involvement of IM. Prenatal genetic testing provides a diagnosis before pathological results are available, leading to better counseling and management of pregnancy with a fetus with IM.
Acid ceramidase gene therapy ameliorates pulmonary arterial hypertension with right heart dysfunction
Authors: Katz Michael G. , Hadas Yoav , Vincek Adam , Freage-Kahn Lina , Shtraizent Nataly , Madjarov Jeko M. , Pastuszko Peter , Eliyahu Efrat
Published: August 2023

Background

Up-regulation of ceramides in pulmonary hypertension (PH), contributing to perturbations in sphingolipid homeostasis and the transition of cells to a senescence state. We assessed the safety, feasibility, and efficiency of acid ceramidase gene transfer in a rodent PH model.

Methods

A model of PH was established by the combination of left pneumonectomy and injection of Sugen toxin. Magnetic resonance imaging and right heart catheterization confirmed development of PH. Animals were subjected to intratracheal administration of synthetic adeno-associated viral vector (Anc80L65) carrying the acid ceramidase (Anc80L65.AC), an empty capsid vector, or saline. Therapeutic efficacy was evaluated 8 weeks after gene delivery.

Results

Hemodynamic assessment 4 weeks after PH model the development demonstrated an increase in the mean pulmonary artery pressure to 30.4 ± 2.13 mmHg versus 10.4 ± 1.65 mmHg in sham (p < 0.001), which was consistent with the definition of PH. We documented a significant increase in pulmonary vascular resistance in the saline-treated (6.79 ± 0.85 mm Hg) and empty capsid (6.94 ± 0.47 mm Hg) groups, but not in animals receiving Anc80L65.AC (4.44 ± 0.71 mm Hg, p < 0.001). Morphometric analysis demonstrated an increase in medial wall thickness in control groups in comparison to those treated with acid ceramidase. After acid ceramidase gene delivery, a significant decrease of pro-inflammatory factors, interleukins, and senescence markers was observed.

Conclusion

Gene delivery of acid ceramidase provided tropism to pulmonary tissue and ameliorated vascular remodeling with right ventricular dysfunction in pulmonary hypertension.

Graphical Abstract
Recent advances in non-small cell lung cancer targeted therapy; an update review
Authors: Araghi Mahmood , Mannani Reza , Heidarnejad maleki Ali , Hamidi Adel , Rostami Samaneh , Safa Salar Hozhabri , Faramarzi Fatemeh , Khorasani Sahar , Alimohammadi Mina , Tahmasebi Safa , Akhavan-Sigari Reza
Published: August 2023

Lung cancer continues to be the leading cause of cancer-related death worldwide. In the last decade, significant advancements in the diagnosis and treatment of lung cancer, particularly NSCLC, have been achieved with the help of molecular translational research. Among the hopeful breakthroughs in therapeutic approaches, advances in targeted therapy have brought the most successful outcomes in NSCLC treatment. In targeted therapy, antagonists target the specific genes, proteins, or the microenvironment of tumors supporting cancer growth and survival. Indeed, cancer can be managed by blocking the target genes related to tumor cell progression without causing noticeable damage to normal cells. Currently, efforts have been focused on improving the targeted therapy aspects regarding the encouraging outcomes in cancer treatment and the quality of life of patients. Treatment with targeted therapy for NSCLC is changing rapidly due to the pace of scientific research. Accordingly, this updated study aimed to discuss the tumor target antigens comprehensively and targeted therapy-related agents in NSCLC. The current study also summarized the available clinical trial studies for NSCLC patients.
Combination strategies to overcome drug resistance in FLT+ acute myeloid leukaemia
Authors: Yang Jingmei , Friedman Ran
Published: August 2023

Background

Acute myeloid leukaemia (AML) remains difficult to treat despite the development of novel formulations and targeted therapies. Activating mutations in the FLT3 gene are common among patients and make the tumour susceptible to FLT3 inhibitors, but resistance to such inhibitors develops quickly.

Methods

We examined combination therapies aimed at FLT3+-AML, and studied the development of resistance using a newly developed protocol. Combinations of FLT3, CDK4/6 and PI3K inhibitors were tested for synergism.

Results

We show that AML cells express CDK4 and that the CDK4/6 inhibitors palbociclib and abemaciclib inhibit cellular growth. PI3K inhibitors were also effective in inhibiting the growth of AML cell lines that express FLT3-ITD. Whereas resistance to quizartinib develops quickly, the combinations overcome such resistance.

Conclusions

This study suggests that a multi-targeted intervention involving a CDK4/6 inhibitor with a FLT3 inhibitor or a pan-PI3K inhibitor might be a valuable therapeutic strategy for AML to overcome drug resistance. Moreover, many patients cannot tolerate high doses of the drugs that were studied (quizartinib, palbociclib and PI3K inhibitors) for longer periods, and it is therefore of high significance that the drugs act synergistically and lower doses can be used.
Enhancing prognostic accuracy in head and neck squamous cell carcinoma chemotherapy via a lipid metabolism-related clustered polygenic model
Authors: Miao Xiangwan , Wang Hao , Fan Cui , Song QianQian , Ding Rui , Wu Jichang , Hu Haixia , Chen Kaili , Ji Peilin , Wen Qing , Shi Minmin , Ye Bin , Fu Da , Xiang Mingliang
Published: August 2023

Objective

Systemic chemotherapy is the first-line therapeutic option for head and neck squamous cell carcinoma (HNSCC), but it often fails. This study aimed to develop an effective prognostic model for evaluating the therapeutic effects of systemic chemotherapy.

Methods

This study utilized CRISPR/cas9 whole gene loss-of-function library screening and data from The Cancer Genome Atlas (TCGA) HNSCC patients who have undergone systemic therapy to examine differentially expressed genes (DEGs). A lipid metabolism-related clustered polygenic model called the lipid metabolism related score (LMRS) model was established based on the identified functionally enriched DEGs. The prediction efficiency of the model for survival outcome, chemotherapy, and immunotherapy response was evaluated using HNSCC datasets, the GEO database and clinical samples.

Results

Screening results from the study demonstrated that genes those were differentially expressed were highly associated with lipid metabolism-related pathways, and patients receiving systemic therapy had significantly different prognoses based on lipid metabolism gene characteristics. The LMRS model, consisting of eight lipid metabolism-related genes, outperformed each lipid metabolism gene-based model in predicting outcome and drug response. Further validation of the LMRS model in HNSCCs confirmed its prognostic value.

Conclusion

In conclusion, the LMRS polygenic prognostic model is helpful to assess outcome and drug response for HNSCCs and could assist in the timely selection of the appropriate treatment for HNSCC patients. This study provides important insights for improving systemic chemotherapy and enhancing patient outcomes.
ADAM8 is expressed widely in breast cancer and predicts poor outcome in hormone receptor positive, HER-2 negative patients
Authors: Pianetti Stefania , Miller Kathy D. , Chen Hannah H. , Althouse Sandra , Cao Sha , Michael Steven J. , Sonenshein Gail E. , Mineva Nora D.
Published: August 2023

Background

Breast malignancies are the predominant cancer-related cause of death in women. New methods of diagnosis, prognosis and treatment are necessary. Previously, we identified the breast cancer cell surface protein ADAM8 as a marker of poor survival, and a driver of Triple-Negative Breast Cancer (TNBC) growth and spread. Immunohistochemistry (IHC) with a research-only anti-ADAM8 antibody revealed 34.0% of TNBCs (17/50) expressed ADAM8. To identify those patients who could benefit from future ADAM8-based interventions, new clinical tests are needed. Here, we report on the preclinical development of a highly specific IHC assay for detection of ADAM8-positive breast tumors.

Methods

Formalin-fixed paraffin-embedded sections of ADAM8-positive breast cell lines and patient-derived xenograft tumors were used in IHC to identify a lead antibody, appropriate staining conditions and controls. Patient breast cancer samples (n = 490) were used to validate the assay. Cox proportional hazards models assessed association between survival and ADAM8 expression.

Results

ADAM8 staining conditions were optimized, a lead anti-human ADAM8 monoclonal IHC antibody (ADP2) identified, and a breast staining/scoring control cell line microarray (CCM) generated expressing a range of ADAM8 levels. Assay specificity, reproducibility, and appropriateness of the CCM for scoring tumor samples were demonstrated. Consistent with earlier findings, 36.1% (22/61) of patient TNBCs expressed ADAM8. Overall, 33.9% (166/490) of the breast cancer population was ADAM8-positive, including Hormone Receptor (HR) and Human Epidermal Growth Factor Receptor-2 (HER2) positive cancers, which were tested for the first time. For the most prevalent HR-positive/HER2-negative subtype, high ADAM8 expression identified patients at risk of poor survival.

Conclusions

Our studies show ADAM8 is widely expressed in breast cancer and provide support for both a diagnostic and prognostic value of the ADP2 IHC assay. As ADAM8 has been implicated in multiple solid malignancies, continued development of this assay may have broad impact on cancer management.
Judicialization and cancer: quality of life of patients and caregivers in the COVID-19 pandemic
Authors: Salha Leila Abou , de Menezes José Elmo , Dias Danilo Rocha , Brasil Virginia Visconde , Ferreira Pedro Lopes , de Santana Filho Jolivê Mendes , Barbosa Maria Alves
Published: August 2023

Background

In Brazil, cancer patients and caregivers of cancer patients seek judicial intervention for free access to medications from the public health system. Indeed, the COVID-19 pandemic potentially affected the health-related quality of life of cancer patients and caregivers of cancer patients. This study aimed to describe the sociodemographic profile and assess the health-related quality of life of patients and caregivers in the state of Goias, Brazil, in 2020.

Methods

A cross-sectional study was conducted using the Medical Outcomes Study 36—Item Short Form Health Survey (SF-36) and a sociodemographic questionnaire.

Results

A total of 88 (67,7%) patients and 42 (32,3%) caregivers participated in the study, mostly women (55,5%); aged from 18 to 60 (66%) years old; with up to nine years of education (73,1%) and monthly family income lower than the minimum wage (69,2%); married or in a stable union (92,3%); living with multiple people in the same household (73,8%). The quality of life domains with the best scores were mental health for patients and pain for caregivers. The most affected quality of life domain was physical limitation for patients and caregivers. Factors associated with better quality of life were female gender and age between 18 and 60 years in patients, more than 9 years of education, living with multiple people in the same house, and having a monthly family income higher than US$200 for caregivers.

Conclusion

The study found evidence of physical and emotional vulnerability during the pandemic, highlighting the need to strengthen public policies of assistance support to this population.
Application of a cost calculation approach in medical oncology: case of Hassan II university hospital in Morocco
Authors: Benabdallah A. , Jellouli T.
Published: August 2023

Background

In Morocco, hospitals do not have cost accounting systems that allow them to produce reliable budget forecasts to know and justify the costs of their operations. Moroccan hospitals are thus among the public organizations that do not know the cost of their services. Faced with the lack of data on the cost of care for cancer patients, this research aims to implement an approach to calculate the cost of services provided at the level of the medical oncology department of the Hassan II University Hospital in Fez. The objective is to provide data that can be used in the pricing and financing process of the different services provided in medical oncology.

Methods

In this research work, we proposed a top-down costing approach. Two main qualitative data collection tools were used: observation and document analysis. We used mainly and Excel for data processing to determine costs and related statistics.

Results

The result of this study shows the possible application of a top-down approach to cost calculation which consists in determining the cost per department (oncology service) and per product (chemotherapy act, transfusion, ascites puncture, Inpatient day). Two main methods were mainly used, namely the volume-based allocation method and the method relative value units (RVU). The proposed top-down cost calculation approach has the advantage of being easy to implement, but on the other hand, it is not very accurate in producing results on the actual cost. The data from this study can be exploited to revise the prices of procedures provided in medical oncology.
Heart transplantation and human immunodeficiency virus–navigating drug-drug interactions: a case report
Authors: Almangour Thamer A. , Skersick Preston T. , Corbett Amanda , Rodgers Jo E. , Chang Patricia P. , Farel Claire E.
Published: August 2023

Background

Antiretroviral therapy (ART) has led to a decline in human immunodeficiency virus (HIV)-related mortality, but comorbidities, including organ dysfunction, are increasingly the focus of care. Heart transplant (HT) is a very effective therapeutic strategy for end-stage heart failure (HF); however, clinicians may be hesitant due to concerns of complex drug-drug interactions (DDIs) between ART and HT immunosuppressive regimens and the potential impact of ART on long-term HT outcomes. In this report, we describe long-term (76-month) follow-up of a patient with HIV-positive status who underwent orthotopic HT with special emphasis on complex drug interactions.

Case presentation

A 58-year-old man with HIV-1 developed ischemic cardiomyopathy, progressed to end-stage HF and underwent orthotopic HT. To avoid DDIs with planned immunosuppressive therapies, the ART regimen was modified to consist of lamivudine, tenofovir disoproxil fumarate, rilpivirine, and raltegravir. Following HT, the patient’s immunosuppression consisted of tacrolimus and mycophenolate mofetil. He has had normal cardiac function and no opportunistic infections and was subsequently switched to tenofovir alafenamide, emtricitabine, and bictegravir in combination for convenience. Serial HIV-1 RNA blood levels were constantly below the limit of quantification, and his CD4 count remained above 200 cells/mm3(30–35%). Several DDIs were identified and addressed; however, his long-term post-HT complications included one episode of asymptomatic acute cellular rejection, adenocarcinoma of the prostate, basal cell carcinoma, cardiac allograft vasculopathy, and peripheral neuropathy.

Conclusion

The clinical outcome of this case supports the conclusion of previously published reports, summarized here within, demonstrating that HIV-1 positive status should not preclude HT in carefully selected individuals. Both addressing potential DDIs prior to HT and long-term monitoring for routine post-transplant complications and secondary and incidental malignancies are imperative.
Current prevalence, changes, and determinants of breastfeeding practice in China: data from cross-sectional national household health services surveys in 2013 and 2018
Authors: Li Zeyu , Jia Yufei , Parshley Iris , Zhang Yaoguang , Wang Jia , Long Qian
Published: August 2023

Background

The World Health Organization and the government of China have made many efforts to improve breastfeeding practices. The evidence of breastfeeding practices over the past decade in China is limited. The current study aimed to describe the current prevalence, variation trends, and determinants of breastfeeding practices in China using data from the National Household Health Service Surveys (NHHSS) in 2013 and 2018.

Methods

Women who had at least one live birth in the five years from the 2013 NHHSS numbered 10,544, and 12,766 women from the 2018 NHHSS were included in the current study. The rates of breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months since birth, and continued breastfeeding accompanied by adequate complementary feeding for over two years were measured. Logistic regressions were performed to study the associations between breastfeeding practices and maternal-based, healthcare-based, and infant-based characteristics.

Results

In the 2018 survey, the rates of practiced any breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months, and continued breastfeeding for over two years were 91.50%, 28.16%, 47.90%, and 4.78%, respectively, showing significant improvements compared to the 2013 survey period. Women who received high education, were from a household with high incomes, had more than one child, and had more antenatal and postnatal visits, were more likely to practice breastfeeding and initiate it within the first hour, but they were less likely to breastfeed the infants for two years. Births by caesarean section and low birthweight were associated with worse breastfeeding practices.

Conclusions

The rates of practicing breastfeeding and exclusive breastfeeding for six months or more in China improved over the past decades, suggesting improved awareness and knowledge of breastfeeding among women. However, individual and social factors may impact practices of early initiation and continued breastfeeding. Strengthening breastfeeding support from family, community, and health professionals (e.g., family member engagement, friendly work environment, and professional consultation, etc.) during the postpartum and infant period may improve women’s confidence in breastfeeding practices.
Infant feeding practices and autism spectrum disorder in US children aged 2–5 years: the national survey of children’s health (NSCH) 2016–2020
Authors: Zhan Xiao-Ling , Pan Ning , Karatela Shamshad , Shi Lei , Wang Xin , Liu Zhao-Yan , Jing Jin , Li Xiu-Hong , Cai Li , Lin Li-Zi
Published: August 2023

Objective

To investigate the relationship between infant feeding practices and autism spectrum disorder (ASD) among children aged 2–5 years in the United States (US).

Methods

Data from the 2016–2020 National Survey of Children’s Health, a nationally representative cross-sectional survey, were utilized for this study. Questionnaires were administered to parents of children aged 2–5 years to gather information on ASD diagnosis, infant feeding practices, and demographic factors (e.g., child sex, ethnic group, and maternal age at birth). Logistic regression with sample weights was employed to assess the association between infant feeding practices and ASD, while controlling for demographic variables. Polynomial regression models were used to examine trends in exclusive breastfeeding and ever breastfeeding rates among children with and without ASD.

Results

A total of 35,050 children aged 2–5 years were analyzed, including 616 diagnosed with ASD, after excluding participants with missing information on breastfeeding and ASD diagnosis. Of these children with ASD, 76.6% (n = 472) had a breastfeeding history, with 66.6% (n = 410) engaged in partial breastfeeding and 10.1% (n = 62) exclusively breastfed. Adjusted odds ratios for each additional month of breastfeeding compared to never being breastfed were 0.99 (95% CI, 0.97–1.01). The adjusted odds ratios for breastfeeding durations of > 0–6 months, > 6–12 months, > 12–24 months, and > 24 months were 0.84 (95% CI, 0.51–1.36), 0.76 (95% CI, 0.42–1.35), 0.79 (95% CI, 0.43–1.45), and 0.66 (95% CI, 0.32–1.35), respectively. Compared to children who were never breastfed, the adjusted odds ratio for children who were ever breastfed was 0.79 (95% CI, 0.50–1.25). Among children with ASD, the proportion of ever breastfeeding declined from 82.0% in 2017 to 64.3% in 2020, while exclusive breastfeeding decreased from 12.0% in 2016 to 5.9% in 2020.

Conclusions and relevance

Although no significant association was found between infant feeding practices and ASD among US children aged 2–5 years, the rates of breastfeeding, particularly exclusive breastfeeding, were suboptimal among children with ASD. This highlights the need for specific policies and practices to promote and support breastfeeding among parents of children with ASD or those at high risk of having a child with ASD.
Globally elevated levels of histone H3 lysine 9 trimethylation in early infancy are associated with poor growth trajectory in Bangladeshi children
Authors: Kupkova Kristyna , Shetty Savera J. , Pray-Grant Marilyn G. , Grant Patrick A. , Haque Rashidul , Petri William A. , Auble David T.
Published: August 2023

Background

Stunting is a global health problem affecting hundreds of millions of children worldwide and contributing to 45% of deaths in children under the age of five. Current therapeutic interventions have limited efficacy. Understanding the epigenetic changes underlying stunting will elucidate molecular mechanisms and likely lead to new therapies.

Results

We profiled the repressive mark histone H3 lysine 9 trimethylation (H3K9me3) genome-wide in peripheral blood mononuclear cells (PBMCs) from 18-week-old infants (n = 15) and mothers (n = 14) enrolled in the PROVIDE study established in an urban slum in Bangladesh. We associated H3K9me3 levels within individual loci as well as genome-wide with anthropometric measurements and other biomarkers of stunting and performed functional annotation of differentially affected regions. Despite the relatively small number of samples from this vulnerable population, we observed globally elevated H3K9me3 levels were associated with poor linear growth between birth and one year of age. A large proportion of the differentially methylated genes code for proteins targeting viral mRNA and highly significant regions were enriched in transposon elements with potential regulatory roles in immune system activation and cytokine production. Maternal data show a similar trend with child’s anthropometry; however, these trends lack statistical significance to infer an intergenerational relationship.

Conclusions

We speculate that high H3K9me3 levels may result in poor linear growth by repressing genes involved in immune system activation. Importantly, changes to H3K9me3 were detectable before the overt manifestation of stunting and therefore may be valuable as new biomarkers of stunting.
Risk of dementia in primary aldosteronism compared with essential hypertension: a nationwide cohort study
Authors: Hong Namki , Kim Kyoung Jin , Yu Min Heui , Jeong Seong Ho , Lee Seunghyun , Lim Jung Soo , Rhee Yumie
Published: August 2023

Background

Although hypertension is a critical risk factor for dementia, the association between primary aldosteronism (PA) and dementia has been scarcely reported. We aimed to investigate whether the risk of dementia in patients with PA was elevated compared with patients with essential hypertension (EH).

Methods

From the National Health Insurance Claim database in Korea (2003–2017), 3,687 patients with PA (adrenalectomy [ADX], n = 1,339, mineralocorticoid receptor antagonist [MRA] n = 2,348) with no prior dementia were age- and sex-matched at a 1:4 ratio to patients with EH (n = 14,741). The primary outcomes were all-cause dementia events, including Alzheimer’s disease, vascular dementia, or other dementia combined with a prescription of one or more medications for dementia (donepezil, galantamine, memantine, or rivastigmine). Multivariable Cox regression models were used to evaluate the hazard ratios (HRs) and 95% confidence intervals for the outcome incidence rates between patients with PA and their EH matches.

Results

During a median follow-up of 5.2 years, there were 156 cases of all-cause dementia (4.2%), 140 cases of Alzheimer's disease (3.8%), and 65 cases of vascular dementia (1.8%). Compared with EH, the risk of all-cause dementia was increased in treated PA (unadjusted hazard ratio [HR] 1.26; p < 0.011). Among PA, MRA group had higher risks of all-cause dementia, especially vascular dementia, adjusted for age, sex, income, comorbidities, and concurrent medication (adjusted HR 1.31; p = 0.027 and adjusted HR 1.62; p = 0.020, respectively) compared to EH. ADX group seemed to have a lower dementia risk than the EH group, but there was no statistical significance after full adjustment. This trend became more prominent when the dementia risks were evaluated from the time of hypertension diagnosis rather than treatment initiation for PA.

Conclusion

The findings of this cohort study suggest that PA, especially the MRA group, is associated with an increased risk of dementia. Monitoring cognitive function in PA patients even after treatment initiation might be warranted to prevent dementia.
An extension of the BioAssay Ontology to include pharmacokinetic/pharmacodynamic terminology for the enrichment of scientific workflows
Authors: Penn Steve , Lomax Jane , Karlsson Anneli , Antonucci Vincent , Zachmann Carl-Dieter , Kanza Samantha , Schurer Stephan , Turner John
Published: August 2023

With the capacity to produce and record data electronically, Scientific research and the data associated with it have grown at an unprecedented rate. However, despite a decent amount of data now existing in an electronic form, it is still common for scientific research to be recorded in an unstructured text format with inconsistent context (vocabularies) which vastly reduces the potential for direct intelligent analysis. Research has demonstrated that the use of semantic technologies such as ontologies to structure and enrich scientific data can greatly improve this potential. However, whilst there are many ontologies that can be used for this purpose, there is still a vast quantity of scientific terminology that does not have adequate semantic representation. A key area for expansion identified by the authors was the pharmacokinetic/pharmacodynamic (PK/PD) domain due to its high usage across many areas of Pharma. As such we have produced a set of these terms and other bioassay related terms to be incorporated into the BioAssay Ontology (BAO), which was identified as the most relevant ontology for this work. A number of use cases developed by experts in the field were used to demonstrate how these new ontology terms can be used, and to set the scene for the continuation of this work with a look to expanding this work out into further relevant domains. The work done in this paper was part of Phase 1 of the SEED project (Semantically Enriching electronic laboratory notebook (eLN) Data).
On positively invariant polyhedrons for discrete-time positive linear systems
Authors: Wang ChengDan , Yang HongLi
Published: August 2023

In this paper, necessary and sufficient conditions for the polyhedron set to be a positively invariant polyhedron of a discrete-time positive linear system subject to external disturbances are established. By solving a set of inequalities, which is also a linear programming, necessary and sufficient conditions for the existence of positive invariant polyhedra for discrete-time positive linear systems are proposed, and the relationship between Lyapunov stability and positively invariant polyhedron is also investigated, numerical examples illustrate our results.
Establishing the criterion validity of an adapted dietary screener for Asian Americans amongst Chinese American adults
Authors: Woo Lena , Yi Stella S. , Park Agnes , Hu Lu , Thorpe Lorna E. , Rummo Pasquale E. , Beasley Jeannette M.
Published: August 2023

Objective

To assess the criterion validity of a dietary screener questionnaire adapted for Asian Americans (ADSQ) compared to Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA-24) food diary data amongst Chinese American Adults (CHAs). The ADSQ incorporated example ethnic foods from six Asian American groups. Lessons learned with respect to translating the ADSQ from English into Simplified Chinese were also documented.

Design

Agreement between a two-day food diary (one weekend day and one weekday) and the ADSQ was assessed for vegetable, fruit, dairy, added sugar, fiber, calcium, and whole grain intake using paired t-tests to compare means and Spearman correlations to assess agreement between intake of food components.

Setting

Data were collected online and via phone interviews.

Participants

Thirty-three CHAs aged 19–62 years (63.6% female).

Results

Mean differences were small for fruit, dairy, fiber, calcium, and whole grain intake, but were significantly different for vegetables and added sugar intake. Spearman correlations were < 0.5 and non-significant (p > 0.05) for all components. Both the ASA-24 and the ADSQ identified the same categories where CHAs intake is misaligned with dietary recommendations: whole grains, total fruit, and dairy. Difficulties were encountered in translating 13 out of 26 questions.

Conclusions

The ADSQ may be a useful tool to identify intervention targets for improving dietary quality, but caution is warranted when interpreting vegetable and added sugar estimates. Differences in the English and Chinese languages underscore the need to take into account both literal translations and semantics in translating the ADSQ into other languages.
Prevalence of asymptomatic strongyloidiasis co-infection in COVID-19 patients residing in endemic areas
Authors: Ashiri Alireza , Beiromvand Molouk , Rafiei Abdollah , Heidari Reza , Takesh Ameneh
Published: August 2023

Background

Fatal forms of strongyloidiasis, hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), are caused by exaggerated autoinfection of the intestinal nematode, Strongyloides stercoralis (S. stercoralis). Corticosteroids, frequently administered to patients with severe COVID-19, can transform chronic asymptomatic strongyloidiasis into the above-mentioned fatal diseases. This study aimed to investigate the prevalence of strongyloidiasis in COVID-19 patients receiving corticosteroids in a hypoendemic region.

Methods

The present cross-sectional study enrolled 308 COVID-19 patients admitted to two hospitals in Ahvaz and Abadan in the southwest of Iran between 2020 and 2022. A real-time reverse transcription polymerase chain reaction (RT-PCR) test and chest computed tomography (CT) scan were employed to detect and monitor the disease’s severity in the patients, respectively. All patients were evaluated for IgG/IgM against S. stercoralis using Enzyme-linked immunosorbent assay (ELISA) test. Subsequently, individuals with a positive ELISA test were confirmed using parasitological methods, including direct smear and agar plate culture (APC).

Results

The patients were between 15 and 94 years old, with a mean age of 57.99 ± 17.4 years. Of the 308 patients, 12 (3.9%) had a positive ELISA test, while 296 (96.1%) had negative results. Three of the 12 patients with a positive ELISA result died, and three failed to provide a stool sample. To this end, only six cases were examined parasitologically, in which S. stercoralis larvae were observed in five patients. Significant differences were found between S. stercoralis infection with sex (p = 0.037) and age (p = 0.027). Binary regression analysis revealed that strongyloidiasis was positively associated with sex (odds ratio [OR]: 5.137; 95% confidence interval [CI]: 1.107–23.847), age (OR: 5.647; 95% CI 1.216–26.218), and location (OR: 3.254; 95% CI: 0.864–12.257).

Conclusions

Our findings suggest that screening for latent strongyloidiasis in COVID-19 patients in endemic areas using high-sensitivity diagnostic methods, particularly ELISA, before receiving suppressive drugs should be given more consideration.
Interactions of gulf cordgrass, Spartina spartinae (Trin.) Merr. ex Hitchc., habitat with ixodids on the South Texas coastal plain
Authors: Showler Allan T.
Published: August 2023

Many ixodid species on the South Texas coastal plain can transmit pathogens to their hosts. Substantial areas are dominated by gulf cordgrass, Spartina spartinae (Trin.) Merr. ex Hitch. The S. spartinae habitat was examined in terms of abiotic and biotic factors that likely impinge upon ixodids using the plant for questing. Natural enemies, temperature, humidity, and plant structure were investigated as possible mortality factors and improving ixodid survival. Spartina spartinae (soil and foliage) harbored few natural enemies of ixodids, and soil salinity was nonlethal. Conditions were cooler and more humid inside S. spartinae clumps than in the canopies; hence, questing ixodids can rehydrate inside the clump when threatened by desiccation. Leaves were mostly “V” shaped in cooler months and, during warm months, the tightly folded leaf slot predominated, into which larvae crawled. Immature ixodids were more abundant in the concave side of the “V”-shaped leaves than on the exposed convex side. Larvae sought refuge from potential lethal ambient air conditions by entering tight warm season leaf folds. The leaf “V” and fold offer opportunities for rehydration on the leaf without moving to the clump’s base. In addition to five other species collected on the grass, a relatively heavy larval southern cattle fever tick, Rhipicephalus (Boophilus) microplus (Canestrini), population was detected, suggesting that abundances in the South Texas cattle fever tick eradication quarantine zone are increasing and might spread further into Texas.
Evaluation of Holstein cows with different tongue-rolling frequencies: stress immunity, rumen environment and general behavioural activity
Authors: Sun Fuyu , Chen Xiaoyang , Li Yongfeng , Zhao Guangyong , Gu Xianhong
Published: August 2023

Background

The tongue-rolling behaviour of cows is regarded as an outward sign of stressed animals in a low welfare status. The primary aim of this observational study was to evaluate the association between the frequency of tongue-rolling behaviour and its physiological function. The secondary aim was to explore the relationship between general activities and the frequency of tongue-rolling behaviour of cows. A total of 126 scan sampling behavioural observations were collected over 7 d on 348 Holstein cows with the same lactation stage in the same barn. The tongue-rolling frequency was defined as the number of tongue-rolling observations as a percentage to the total observations per individual cow. According to their tongue-rolling frequency, the cows were grouped into the CON (no tongue-rolling), LT (frequency 1%), MT (frequency 5%), and HT (frequency 10%) groups. Six cows from each group were randomly selected for sampling. Serum samples, rumen fluid, milk yield, and background information were collected. The general behaviour data during 72 continuous hours of dairy cows, including eating time, rumination time, food time (eating time + rumination time), and lying time, were recorded by the collar sensor.

Results

Cortisol (P = 0.012), γ-hydroxybutyric acid (P = 0.008), epinephrine (P = 0.030), and dopamine (P = 0.047) levels were significantly higher in tongue-rolling groups than in the CON group. Cortisol levels and tongue-rolling frequency had a moderate positive correlation (linearly r = 0.363). With the increase in tongue-rolling frequency, the rumen pH decreased first and then increased (P = 0.013), comparing to the CON group. HT cows had significantly less food time than CON cows (P = 0.035). The frequency of tongue-rolling had a moderate negative relationship with rumination time (r = −0.384) and food time (r = −0.492).

Conclusions

The tongue-rolling behaviour is considered as a passive coping mechanism, as the stress response in cows with high tongue-rolling frequency increased. Food intake and rumination activities were all closely related to the occurrence of tongue-rolling behaviour.