bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between vitamin A and asthma: A meta-analysis with trial sequential analysis
Authors: Hu Jun , Sang Jiajia , Hao Feng , Liu Li
Published: January 2023

Objective: To explore the association between vitamin A (vit A) status and risk of asthma.

Methods: PubMed, Web of Science, Embase and the Cochrane Library were electronically searched to identify related studies that reported the association between vit A status and asthma. All databases were searched from inception to November 2022. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Meta-analysis was performed on R software Version 4.1.2 and STATA Version 12.0.

Results: A total of 19 observational studies were included. A pooled analysis showed that the serum vit A concentrations in patients with asthma was lower than that in healthy controls (standard mean difference (SMD)= −2.479, 95% confidence interval (CI): −3.719, −.239, 95% prediction interval (PI): −7.510, 2.552), and relatively higher vit A intake in pregnancy was associated with an increased risk of asthma at age 7 years (risk ratio (RR)= 1.181, 95% CI: 1.048, 1.331). No significant correlation was observed between serum vit A levels or vit A intake and the risk of asthma.

Conclusion: Our meta-analysis confirms that serum vit A levels are lower in patients with asthma than in healthy controls. Relatively higher vit A intake during pregnancy is associated with an increased risk of asthma at age 7 years. There is no significant correlation between vit A intake and asthma risk in children, nor between serum vit A levels and asthma risk. The effect of vit A may depend on age or developmental stage, diet and genetics. Therefore, further studies are needed to explore the association of vit A and asthma.

Systematic Review Registration:https://www.crd.york.ac.uk/prospero/CRD42022358930, identifier CRD42022358930
Coincidence time resolution of radiation detector based on 6×6 mm2 ToF SiPM detectors with different readout schemes
Authors: Li Changyu , Li Yuying , Xi Jianbo , Xiang Shitao , Hu Kun
Published: January 2023

Introduction: Nowadays, attention is growing on the Silicon Photomultipliers (SiPMs) detector for many applications, especially in nuclear medicine. In Positron Emission Tomography (PET) scanner, timing performance of a PET detector plays a significant role in image reconstruction.

Methods: This work mainly aims at the processing of timing signal for the purpose of achieving a good timing performance. We applied a timing detector made up of a 3 × 3 × 10 mm3 LYSO crystal directly coupled with a large-size SensL SiPM with a sensitive area of 6 × 6 mm2. The standard output of the SiPM was used for energy calculation while the fast output was for timing pickoff. Three different readout configurations for fast timing signals were used for timing performance evaluation: 1) the recommended RF transformer-based readout, 2) the cascaded Common Emitter Amplifier (CEA), 3) the commercial RF amplifier.

Results: Experiment results show that the best FWHM CTR values for the three were 228.3 ± 1.4 ps, 235.4 ± 1.1 ps and 231.1 ± 1.5 ps for the RF transformer-based, the CEA-based and the RF amplifier-based readout configurations respectively. The schemes based on the CEA-based and the RF amplifier-based configurations have a good uniformity at different trigger thresholds.

Discussion: For practical application, the amplified timing signal based on the CEA circuit is more desirable because it is more feasible for trigger threshold selection in multichannel readout electronics system.
Efficient numerical simulation of atmospheric pulsed discharges by introducing deep learning
Authors: Zhang Yuan-Tao , Gao Shu-Han , Ai Fei
Published: January 2023

Plasma simulation is an important but sometimes time-consuming approach to study the discharge behaviors of atmospheric pulsed discharges. In this work, an efficient simulation method is proposed by introducing deep learning to investigate the discharge characteristics driven by very short pulsed voltages. A loss function is designed and optimized to minimize the discrepancy between the Deep Neural Network (DNN) and the verified fluid model. The prediction data obtained via well-trained DNN can accurately and efficiently reveal the key discharge characteristics, such as the waveforms of discharge current and gap voltage, spatial profiles of charged particles density and electric field. The spatial distributions of charged particles density and electric field obtained from DNN are also given to unveil the underlying mechanisms. Additionally, the predictions from deep learning and the formula analysis both highlight that the breakdown voltage and current density can be effectively reduced by increasing repetition frequency, which quantitatively agrees well with the experimental observations. This study provides a great potential promise for vastly improving the simulation efficiency by introducing deep learning in the field of atmospheric plasmas computation.
Acute effects of moderate vs. vigorous endurance exercise on urinary metabolites in healthy, young, physically active men—A multi-platform metabolomics approach
Authors: Kistner Sina , Mack Carina I. , Rist Manuela J. , Krüger Ralf , Egert Björn , Biniaminov Nathalie , Engelbert Ann Katrin , Seifert Stephanie , Dörr Claudia , Ferrario Paola G. , Neumann Rainer , Altmann Stefan , Bub Achim
Published: January 2023

Introduction: Endurance exercise alters whole-body as well as skeletal muscle metabolism and physiology, leading to improvements in performance and health. However, biological mechanisms underlying the body’s adaptations to different endurance exercise protocols are not entirely understood.

Methods: We applied a multi-platform metabolomics approach to identify urinary metabolites and associated metabolic pathways that distinguish the acute metabolic response to two endurance exercise interventions at distinct intensities. In our randomized crossover study, 16 healthy, young, and physically active men performed 30 min of continuous moderate exercise (CME) and continuous vigorous exercise (CVE). Urine was collected during three post-exercise sampling phases (U01/U02/U03: until 45/105/195 min post-exercise), providing detailed temporal information on the response of the urinary metabolome to CME and CVE. Also, fasting spot urine samples were collected pre-exercise (U00) and on the following day (U04). While untargeted two-dimensional gas chromatography-mass spectrometry (GC×GC-MS) led to the detection of 608 spectral features, 44 metabolites were identified and quantified by targeted nuclear magnetic resonance (NMR) spectroscopy or liquid chromatography-mass spectrometry (LC-MS).

Results: 104 urinary metabolites showed at least one significant difference for selected comparisons of sampling time points within or between exercise trials as well as a relevant median fold change >1.5 or <0.6¯ (NMR, LC-MS) or >2.0 or <0.5 (GC×GC-MS), being classified as either exercise-responsive or intensity-dependent. Our findings indicate that CVE induced more profound alterations in the urinary metabolome than CME, especially at U01, returning to baseline within 24 h after U00. Most differences between exercise trials are likely to reflect higher energy requirements during CVE, as demonstrated by greater shifts in metabolites related to glycolysis (e.g., lactate, pyruvate), tricarboxylic acid cycle (e.g., cis-aconitate, malate), purine nucleotide breakdown (e.g., hypoxanthine), and amino acid mobilization (e.g., alanine) or degradation (e.g., 4-hydroxyphenylacetate).

Discussion: To conclude, this study provided first evidence of specific urinary metabolites as potential metabolic markers of endurance exercise intensity. Future studies are needed to validate our results and to examine whether acute metabolite changes in urine might also be partly reflective of mechanisms underlying the health- or performance-enhancing effects of endurance exercise, particularly if performed at high intensities.
Temperature affects organic acid, terpene and stilbene metabolisms in wine grapes during postharvest dehydration
Authors: Shmuleviz Ron , Amato Alessandra , Commisso Mauro , D’Incà Erica , Luzzini Giovanni , Ugliano Maurizio , Fasoli Marianna , Zenoni Sara , Tornielli Giovanni Battista
Published: January 2023

The partial dehydration of grapes after harvest is a traditional practice in several winegrowing regions that leads to the production of high quality wines. Postharvest dehydration (also known as withering) has a significant impact on the overall metabolism and physiology of the berry, yielding a final product that is richer in sugars, solutes, and aroma compounds. These changes are, at least in part, the result of a stress response, which is controlled at transcriptional level, and are highly dependent on the grape water loss kinetics and the environmental parameters of the facility where grapes are stored to wither. However, it is difficult to separate the effects driven by each single environmental factor from those of the dehydration rate, especially discerning the effect of temperature that greatly affects the water loss kinetics. To define the temperature influence on grape physiology and composition during postharvest dehydration, the withering of the red-skin grape cultivar Corvina (Vitis vinifera) was studied in two conditioned rooms set at distinct temperatures and at varying relative humidity to maintain an equal grape water loss rate. The effect of temperature was also studied by withering the grapes in two unconditioned facilities located in geographic areas with divergent climates. Technological, LC-MS and GC-MS analyses revealed higher levels of organic acids, flavonols, terpenes and cis- and trans-resveratrol in the grapes withered at lower temperature conditions, whereas higher concentrations of oligomeric stilbenes were found in the grapes stored at higher temperatures. Lower expression of the malate dehydrogenase and laccase, while higher expression of the phenylalanine ammonia-lyase, stilbene synthase and terpene synthase genes were detected in the grapes withered at lower temperatures. Our findings provide insights into the importance of the temperature in postharvest withering and its effect on the metabolism of the grapes and on the quality of the derived wines.
Analysis of proportions using arcsine transform with any experimental design
Authors: Laurencelle Louis , Cousineau Denis
Published: January 2023

Introduction

Exact tests on proportions exist for single-group and two-group designs, but no general test on proportions exists that is appropriate for any experimental design involving more than two groups, repeated measures, and/or factorial designs.

Method

Herein, we extend the analysis of proportions using arcsine transform to any sort of design. The resulting framework, which we have called Analysis of Proportions Using Arcsine Transform (ANOPA), is completely analogous to the analysis of variance for means of continuous data, allowing the examination of interactions, main and simple effects, post-hoc tests, orthogonal contrasts, et cetera.

Result

We illustrate the method with a few examples (single-factor design, two-factor design, within-subject design, and mixed design) and explore type I error rates with Monte Carlo simulations. We also examine power computation and confidence intervals for proportions.

Discussion

ANOPA is a complete series of analyses for proportions, applicable to any design.
How does online social interaction promote students’ continuous learning intentions?
Authors: Zhang Shunan , Che ShaoPeng , Nan Dongyan , Kim Jang Hyun
Published: January 2023

Learning from online videos using synchronized Danmu comments provides a co-learning experience. To explore the factors influencing learning with or without Danmu videos, an initial set of reasons and impediments was compiled based on a pilot study of 24 Chinese university students with learning experience using Danmu videos. Three hundred such students were surveyed to determine the factors that influence their motivations and hindrances with regard to using Danmu videos. The potential predictors of users’ continuance intentions were also examined. The results showed that the frequency of using Danmu videos is related to the continuous learning intention. Seeking information, social presence, and perceived entertainment motivate learners and positively impact their intention to continue learning using Danmu videos. Hindrances such as information pollution, attention failure, and visual obstacle were found to be negatively associated with learners’ continuance intention in the long run. Our findings provided constructive suggestions for addressing the issue of dropout rates, and novel ideas for future studies were proposed.
Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research
Authors: Steinman Lesley E. , Parrish Amanda T. , Kohn Marlana J. , Wu Sherry , Hara-Hubbard KeliAnne K. , Brown Lori , Imam Syed , Baquero Barbara , Hannon Peggy A. , Snowden Mark B.
Published: January 2023

Background

Embedding evidenced-based programs (EBPs) like PEARLS outside clinical settings can help reduce inequities in access to depression care. Trusted community-based organizations (CBOs) reach older adults who are underserved; however, PEARLS adoption has been limited. Implementation science has tried to close this know-do gap, however a more intentional focus on equity is needed to engage CBOs. We partnered with CBOs to better understand their resources and needs in order to design more equitable dissemination and implementation (D&I) strategies to support PEARLS adoption.

Methods

We conducted 39 interviews with 24 current and potential adopter organizations and other partners (February–September 2020). CBOs were purposively sampled for region, type, and priority older populations experiencing poverty (communities of color, linguistically diverse, rural). Using a social marketing framework, our guide explored barriers, benefits and process for PEARLS adoption; CBO capacities and needs; PEARLS acceptability and adaptations; and preferred communication channels. During COVID-19, interviews also addressed remote PEARLS delivery and changes in priorities. We conducted thematic analysis of transcripts using the rapid framework method to describe the needs and priorities of older adults who are underserved and the CBOs that engage them, and strategies, collaborations, and adaptations to integrate depression care in these contexts.

Results

During COVID-19, older adults relied on CBO support for basic needs such as food and housing. Isolation and depression were also urgent issues within communities, yet stigma remained for both late-life depression and depression care. CBOs wanted EBPs with cultural flexibility, stable funding, accessible training, staff investment, and fit with staff and community needs and priorities. Findings guided new dissemination strategies to better communicate how PEARLS is appropriate for organizations that engage older adults who are underserved, and what program components are core and what are adaptable to better align with organizations and communities. New implementation strategies will support organizational capacity-building through training and technical assistance, and matchmaking for funding and clinical support.

Discussion

Findings support CBOs as appropriate depression care providers for older adults who are underserved, and suggest changes to communications and resources to better fit EBPs with the resources and needs of organizations and older adults. We are currently partnering with organizations in California and Washington to evaluate whether and how these D&I strategies increase equitable access to PEARLS for older adults who are underserved.
Dynamic mechanism of eliminating COVID-19 vaccine hesitancy through web search
Authors: Xia Yixue , Li Qifeng , Jiao Wei , Lan Yuexin
Published: January 2023

This research focuses on the research problem of eliminating COVID-19 vaccine hesitancy through web search. A dynamic model of eliminating COVID-19 vaccine hesitancy through web search is constructed based on the Logistic model, the elimination degree is quantified, the elimination function is defined to analyze the dynamic elimination effect, and the model parameter estimation method is proposed. The numerical solution, process parameters, initial value parameters and stationary point parameters of the model are simulated, respectively, and the mechanism of elimination is deeply analyzed to determine the key time period. Based on the real data of web search and COVID-19 vaccination, data modeling is carried out from two aspects: full sample and segmented sample, and the rationality of the model is verified. On this basis, the model is used to carry out dynamic prediction and verified to have certain medium-term prediction ability. Through this research, the methods of eliminating vaccine hesitancy are enriched, and a new practical idea is provided for eliminating vaccine hesitancy. It also provides a method to predict the quantity of COVID-19 vaccination, provides theoretical guidance for dynamically adjusting the public health policy of the COVID-19, and can provide reference for the vaccination of other vaccines.
Comparison of the association between different ozone indicators and daily respiratory hospitalization in Guangzhou, China
Authors: Lin Geng , Wang Zhuoqing , Zhang Xiangxue , Stein Alfred , Maji Kamal Jyoti , Cheng Changxiu , Osei Frank , Yang Fiona Fan
Published: January 2023

Background

Epidemiological studies have widely proven the impact of ozone (O3) on respiratory mortality, while only a few studies compared the association between different O3 indicators and health.

Methods

This study explores the relationship between daily respiratory hospitalization and multiple ozone indicators in Guangzhou, China, from 2014 to 2018. It uses a time-stratified case–crossover design. Sensitivities of different age and gender groups were analyzed for the whole year, the warm and the cold periods. We compared the results from the single-day lag model and the moving average lag model.

Results

The results showed that the maximum daily 8 h average ozone concentration (MDA8 O3) had a significant effect on the daily respiratory hospitalization. This effect was stronger than for the maximum daily 1 h average ozone concentration (MDA1 O3). The results further showed that O3 was positively associated with daily respiratory hospitalization in the warm season, while there was a significantly negative association in the cold season. Specifically, in the warm season, O3 has the most significant effect at lag 4 day, with the odds ratio (OR) equal to 1.0096 [95% confidence intervals (CI): 1.0032, 1.0161]. Moreover, at the lag 5 day, the effect of O3 on the 15–60 age group was less than that on people older than 60 years, with the OR value of 1.0135 (95% CI: 1.0041, 1.0231) for the 60+ age group; women were more sensitive than men to O3 exposure, with an OR value equal to 1.0094 (95% CI: 0.9992, 1.0196) for the female group.

Conclusion

These results show that different O3 indicators measure different impacts on respiratory hospitalization admission. Their comparative analysis provided a more comprehensive insight into exploring associations between O3 exposure and respiratory health.
Chronic exposure to yttrium induced cell apoptosis in the testis by mediating Ca2+/IP3R1/CaMKII signaling
Authors: Liu Zhehao , Ding Yechun , Xie Shuchun , Hu Yaqiong , Xiao Hai , Liu Xia , Fan Xiaona
Published: January 2023

Introduction

Environmental pollutants, such as rare earth elements, affect human health and particularly induce reproductive system injury. Yttrium (Y), one of the most widely used heavy rare earth elements, has been reported the cytotoxicity. However, the biological effects of Y3+ in the human body are largely unknown.

Methods

To further investigate the effects of Y on the reproductive system, in vivo (rat models) and in vitro studies were performed. Histopathological and immunohistochemical examination were conducted, and western blotting assays were performed to detect the protein expression. TUNEL/DAPI staining were used to detect cell apoptosis, and the intracellular calcium concentrations were also determined.

Results

Long-term exposure to YCl3 in rats produced significant pathological changes. YCl3 treatment could induce cell apoptosis in vivo and in vitro. In addition, YCl3 enhanced the concentration of cytosolic Ca2+ and up regulated the expression of IP3R1/CaMKII axis in Leydig cells. However, inhibition of IP3R1 and CaMKII with 2-APB and KN93, respectively, could reverse these effects.

Conclusion

Long-term exposure to yttrium could induce testicular injury by stimulating cell apoptosis, which might be associated with activation of Ca2+/IP3R1/CaMKII axis in Leydig cells.
An interdisciplinary nationwide complex intervention for lifespan neurodevelopmental service development: Underpinning principles and realist programme theory
Authors: Maciver Donald , Rutherford Marion , Johnston Lorna , Curnow Eleanor , Boilson Marie , Murray Mairéad
Published: January 2023

Background

People seeking support for neurodevelopmental differences often report waiting too long for assessment and diagnosis, as well as receiving inadequate support in educational and health settings. The National Autism Implementation Team (NAIT) developed a new national improvement programme in Scotland, focusing on assessment, diagnosis, educational inclusion, and professional learning. The NAIT programme was conducted within health and education services across the lifespan for a range of neurodevelopmental differences, including autism, developmental coordination disorder, developmental language disorder, and attention deficit hyperactivity disorder. NAIT included a multidisciplinary team, with the involvement of an expert stakeholder group, clinicians, teachers, and people with lived experience. This study explores how the NAIT programme was planned, delivered, and received over three years.

Design

We performed a retrospective evaluation. We collected data from review of programme documents, consultation with programme leads and consultation with professional stakeholders. A theory-based analysis was completed, drawing on the Medical Research Council Framework for developing and evaluating complex interventions, and realist analysis methods. We developed a programme theory of the contexts (C), mechanisms (M), and outcomes (O) influencing the NAIT programme, based on comparison and synthesis of evidence. A key focus was on identifying the factors that contributed to the successful implementation of NAIT activities across different domains, including practitioner, institutional and macro levels.

Results

On synthesis of the data, we identified the key principles underlying the NAIT programme, the activities and resources utilised by the NAIT team, 16 aspects of context, 13 mechanisms, and 17 outcome areas. Mechanisms and outcomes were grouped at practitioner level, service level and macro level. The programme theory is pertinent to observed practice changes across all stages of referral, diagnosis and support processes within health and education services for neurodivergent children and adults.

Conclusions

This theory-informed evaluation has resulted in a clearer and more replicable programme theory that can be used by others with similar aims. This paper illustrates the value of NAIT, as well as realist and complex interventions methodologies as tools for policymakers, practitioners, and researchers.
Robotic locomotor training for spasticity, pain, and quality of life in individuals with chronic SCI: A pilot randomized controlled trial
Authors: Shackleton Claire , Evans Robert , West Sacha , Derman Wayne , Albertus Yumna
Published: January 2023

Objective

The prevention and treatment of secondary complications is a key priority for people with spinal cord injury and a fundamental goal of rehabilitation. Activity-based Training (ABT) and Robotic Locomotor Training (RLT) demonstrate promising results for reducing secondary complications associated with SCI. However, there is a need for increased evidence through randomized controlled trials. Therefore, we aimed to investigate the effect of RLT and ABT interventions on pain, spasticity, and quality of life in individuals with spinal cord injuries.

Methods

Participants with chronic motor incomplete tetraplegia (n = 16) were recruited. Each intervention involved 60-minute sessions, 3× per week, over 24-weeks. RLT involved walking in an Ekso GT exoskeleton. ABT involved a combination of resistance, cardiovascular and weight-bearing exercise. Outcomes of interest included the Modified Ashworth Scale, the International SCI Pain Basic Data Set Version 2, and the International SCI Quality of Life Basic Data Set.

Results

Neither intervention altered symptoms of spasticity. Pain intensity increased from pre-post intervention for both groups, with a mean increase of 1.55 [−0.82, 3.92] (p = 0.03) and 1.56 [−0.43, 3.55] (p = 0.02) points for the RLT and ABT group, respectively. The ABT group had an increase in pain interference scores of 100%, 50%, and 109% for the daily activity, mood, and sleep domain, respectively. The RLT group had an increase in pain interference scores of 86% and 69% for the daily activity and mood domain respectively, but no change in the sleep domain. The RLT group had increased perceptions of quality of life with changes of 2.37 [0.32, 4.41], 2.00 [0.43, 3.56] and 0.25 [−1.63, 2.13] points, p = 0.03, for the general, physical, and psychological domains, respectively. The ABT group had increased perceptions of general, physical and psychological quality of life with changes of 0.75 [−1.38, 2.88], 0.62 [−1.83, 3.07] and 0.63 [−1.87, 3.13] points, respectively.

Conclusions

Despite increased pain ratings and no change in symptoms of spasticity, there was an increase in perceived quality of life for both groups over 24-weeks. This dichotomy warrants additional investigation in future large-scale randomized controlled trials.
Prerequisites for implementing physical activity on prescription for children with obesity in paediatric health care: A cross-sectional survey
Authors: Boman Charlotte , Bernhardsson Susanne , Lauruschkus Katarina , Lundqvist Stefan , Melin Karin
Published: January 2023

Background

Physical inactivity is a main driver of childhood obesity that tracks into adulthood, making it crucial to address early in life. Swedish physical activity on prescription (PAP) is an effective intervention for increasing physical activity levels in adults and is being implemented in primary care in Sweden. Before implementing PAP for children, both intervention effectiveness and implementation prerequisites need to be examined. Framed by the Normalization Process Theory (NPT) domains, this study aimed to investigate perceptions of PAP amongst paediatric staff and managers working with children with obesity, as well as acceptability, appropriateness, feasibility, and barriers and facilitators for implementing PAP in paediatric health care.

Methods

Staff and managers in 28 paediatric outpatient clinics in western Sweden were surveyed using validated implementation instruments and open-ended questions. Data were analysed using Mann–Whitney U tests and Kruskal–Wallis tests. Qualitative data were categorised into NPT domains.

Results

The survey response rate was 54% (125/229). Most respondents (82%) reported PAP to be familiar and many (56%) perceived it as a normal part of work; nurses and physiotherapists to a greater extent (p < 0.001). This was anticipated to increase in the future (82%), especially amongst those with the longest work experience (p = 0.012). Respondents reported seeing the potential value in their work with PAP (77%), being open to working in new ways to use PAP (94%), and having confidence in their colleagues' ability to use PAP (77%). Barriers and facilitators were found in all the NPT domains, mainly collective action and reflexive monitoring, where, for example, inadequacies of education, resources, and research on PAP for children were reported as barriers. Most respondents agreed that PAP was acceptable, appropriate, and feasible (71% to 88%).

Conclusions

PAP is familiar and perceived as an acceptable, appropriate, and feasible intervention, and by many viewed as a normal part of clinical routines in paediatric outpatient clinics in western Sweden, especially by physiotherapists and nurses. Barriers and faciliators are mainly related to collective action and reflexive monitoring. The wide acceptance demonstrates receptiveness to PAP as an intervention to promote an active lifestyle for children with obesity.
Adaptation of a social risk screening and referral initiative across clinical populations, settings, and contexts in the Department of Veterans Affairs Health System
Authors: Cohen Alicia J. , Russell Lauren E. , Elwy A. Rani , Mitchell Kathleen M. , Cornell Portia Y. , Silva Jennifer W. , Moy Ernest , Kennedy Meaghan A.
Published: January 2023

Identifying and addressing social risks and social needs in healthcare settings is an important step towards achieving health equity. Assessing Circumstances and Offering Resources for Needs (ACORN) is a Department of Veterans Affairs (VA) social risk screening and referral model that aims to systematically identify and address social needs. Since initial piloting in 2018, our team has collaborated with clinical and operations partners to implement ACORN across multiple VA clinical settings while adapting and tailoring the initiative to meet the needs of different populations, specialties, and individuals administering screening. Given ACORN's complexity as a growing initiative with multiple partners and frequent real-time modifications within a large national healthcare system, we recognized a need to systematically document the rationale and process of adaptations over time. We looked to three implementation frameworks—RE-AIM, the Adaptome, and FRAME—to describe the rationale for adaptations, the nature of and context within which adaptations were made, and the details of each adaptation. In this manuscript, we uniquely interweave these three frameworks to document adaptations to ACORN across diverse VA clinical settings, with a focus on how adaptations support the promotion of heath equity in the Veteran population.
Did you choose appropriate mouthwash for managing chemoradiotherapy-induced oral mucositis? The therapeutic effect compared by a Bayesian network meta-analysis.
Authors: Wang Xue , Zeng Li , Feng Xue , Zhao Na , Feng Na , Du Xin
Published: January 2023

Background

Oral mucositis (OM) is one of the most common adverse effects of radiotherapy and chemotherapy. It greatly affects the patients' quality of life and hinders cancer treatment implementation. Treating OM with mouthwash is a widely used strategy that can effectively relieve symptoms and promote healing. However, the wide mouthwash selection confuses clinicians. This Bayesian network meta-analysis aimed to compare the effects of various mouthwash types used to treat OM and provide high-level evidence-based recommendations for OM treatment.

Methods

Database search included PubMed, Embase, Cochrane Library, and Web of Science from inception to April 21, 2022. The primary outcome was OM score improvement following the World Health Organization grades. The randomized controlled trial (RCT) bias risk assessment tool provided in the Cochrane Handbook assessed the studies' risk of bias. We performed pairwise and Bayesian network meta-analysis with random effects following the PRISMA guideline.

Results

The study included 13 RCTs with 570 patients. Pairwise comparisons showed that povidone-iodine was more effective than chlorhexidine (weighted mean difference [WMD], −2.64; 95% confidence interval [CI], −2.72 to −2.56) but inferior to granulocyte-macrophage colony-stimulating factor (GM-CSF; WMD, 0.20; 95% CI, 0.06–0.34) after one week of mouthwash treatment. Vitamin E (WMD, −0.94; 95% CI, −1.03 to −0.85), natural drugs (WMD, −0.93; 95% CI, −1.46 to −0.40), and phenytoin (WMD, −0.38; 95% CI, −0.59 to −0.17) exhibited better therapeutic effects than a placebo after three weeks of treatment. Bayesian network meta-analysis showed that povidone-iodine was superior to chlorhexidine in treating OM (WMD, 2.63; 95% CI, 0.20–5.01). Other mouthwashes showed no significant differences. Rank probability indicated that the best OM therapeutic mouthwashes were GM-CSF (54%), vitamin E (24%), and natural drugs (43%) after one, two, and three weeks of treatment, respectively.

Conclusion

GM-CSF was the most effective mouthwash type for OM treatment. When considering the cost and effectiveness, povidone-iodine and sodium bicarbonate might be the most advantageous. Furthermore, natural drugs have the same potential in treating OM. Safety and acceptability are their most outstanding characteristic.
Knowledge and awareness of oral cancer: A cross-sectional survey in Trieste, Italy
Authors: Rupel Katia , Biasotto Matteo , Gobbo Margherita , Poropat Augusto , Bogdan Preda Magdalena Theodora , Borruso Giuseppe , Torelli Lucio , Di Lenarda Roberto , Ottaviani Giulia
Published: January 2023

The aim of the study was to verify the knowledge on oral cancer and to assess possible differences in awareness and information basing on different demographic and subject-related factors. An anonymous survey was provided to 750 random subjects using online-based questionnaires. Statistical analysis was performed in order to evaluate the influence of demographic variables (gender, age, education) on knowledge of oral cancer and its risk factors. 68.4% of individuals knew about the existence of oral cancer, mostly from media and family/friends. Awareness was significantly influenced by gender and higher education, but not by age. Most participants recognized smoking as a risk factor, but alcohol abuse and sunlight exposure are less known, especially among less educated subjects. On the contrary, our study shows a diffusion of false information: more than 30% of the participants indicated the possible role of amalgam fillings in oral cancer onset, independently of gender, age or education. The results of our study suggest the need for oral cancer awareness campaigns, where school and healthcare professionals should be actively involved in promoting, organizing and finding methods to monitor the medium and long-term efficacy with proper methodological quality.
The role of neuromuscular function in sleep apnea pathogenesis and management: A consensus of experts
Authors: Mehra Reena , Schwab Richard , Kimoff R. John , Shah Neomi , Gottlieb Daniel J. , Patel Sanjay R. , Ayas Najib T. , Hanly Patrick , Sheean Geoff , Malhotra Atul
Published: January 2023

Study objectives

Although the importance of upper airway assessment in the consideration of obstructive sleep apnea (OSA) is recognized, there are current limitations in our approach to assessment.

Methods

We convened a group of experts in upper airway neuromuscular physiology and anatomy, sleep apnea endophenotypes, novel therapeutics and sleep epidemiology to summarize existing literature and delineate future opportunities to utilize and incorporate innovative and less invasive techniques focused on upper airway neuromuscular physiology to assess and manage OSA.

Results

In OSA, genioglossus electromyogram (EMG) activity is reduced during sleep onset with higher levels observed during wakefulness compared to controls. Surface EMG recordings are limited due to distance from the actual muscle and while needle EMG offers more direct assessment, this approach is more invasive. Novel alternatives overcoming these limitations to assess upper airway neuromuscular physiology in OSA may therefore prove beneficial. Specifically, such an approach would facilitate identification of upstream prognostic biomarkers of OSA clinical trajectory and offer more informative mechanistic data. Novel approaches to neuromuscular assessment in OSA would enhance phenotyping to predict better tolerance to positive airway pressure therapy and set the stage to target neuromuscular function and upper airway anatomy. A quantifiable and repeatable neuromuscular physiologic metric has potential to facilitate a precision medicine strategy and personalize treatment, including measuring treatment response to neurophysiologic-focused interventions including hypoglossal nerve stimulation (HGNS), myofunctional therapy and neuromuscular electrical stimulation. A key area for future investigation is whether observed neuromuscular changes can identify patients at future risk of OSA, facilitating early intervention or prevention strategies.

Conclusions

Overall, recognizing the critical contributions of abnormalities of upper airway neuromuscular function to the pathophysiology of OSA, it may be important to find accurate and reproducible neurophysiological assessments to address existing knowledge gaps in OSA assessment and management.
Deciphering solar magnetic activity: The (solar) hale cycle terminator of 2021
Authors: McIntosh Scott W. , Leamon Robert J. , Egeland Ricky
Published: January 2023

We previously identified an event in the solar timeline that appeared to play a role in how sunspot Cycle 23 (SC23) transitioned into sunspot Cycle 24 (SC24). The timeframe for this transition was rapid, taking place over a very short time and perhaps in a time as short as a single solar rotation. Further, we inferred that the transition observed was a critical moment for the Sun’s global-scale magnetic field as it was being manifest in the spatially and temporally overlapping magnetic systems belonging to the Sun’s 22-year (Hale) magnetic cycle. These events have been dubbed as Hale Cycle terminations, or ‘terminators’ for short. Subsequent exploration of the sunspot record revealed a relationship between terminator separation (as a measure of overlap in the Hale Cycles) and the upcoming sunspot cycle amplitude using a Hilbert transform. Finally, we extrapolated the contemporary sunspots data’s Hilbert phase function to project the occurrence of the SC24 terminator in Mid-2020 and inferred that this would result in a large sunspot Cycle 25 (SC25) amplitude. This paper presents observational evidence that the end of SC24 and the initial growth of SC25 followed a terminator that occurred in mid-December 2021 (approximately 12/13/2021). Using this December 2021 terminator identification we can finalize our earlier preliminary forecast of SC25 amplitude - anticipating a peak total monthly sunspot number of 184±17 with 68% confidence, and 184±63 with 95% confidence. Finally, we use other terminator-related superposed epoch analyses developed in parallel work we project the timing of SC25 sunspot maximum to occur between late 2023 to mid 2024.
Transcriptional profiling of extraintestinal Escherichia coli exposed to cranberry pomace extracts alone or in combination with ceftriaxone
Authors: Das Quail , Hasted Teri-Lyn , Lepp Dion , Yin Xianhua , Tang Joshua , Chalmers Gabhan , Ross Kelly , Boerlin Patrick , Diarra Moussa S.
Published: January 2023

Extraintestinal pathogenic Escherichia coli (ExPEC) includes several serotypes that have been associated with colibacillosis in poultry, as well as urinary tract infections and newborn meningitis in humans. This study investigated the antimicrobial activities of ceftriaxone (AXO) and cranberry pomace extracts (CRAN) alone or in combination (CC) against multidrug-resistant (MDR) ExPEC from broiler. The growth-inhibitory activity of CRAN and synergy tests by a checkerboard method were determined in cation-adjusted Mueller–Hinton broth (CAMHB). The transcriptomic profile of the MDR E. coli O7:H18 (ST38) grown in CAMHB supplemented with sub-inhibitory concertation of CRAN and AXO alone or in combination was obtained by RNA-seq. The MIC of CRAN for all isolates was 16 mg/mL. An additive activity was observed between 4 mg/mL of CRAN and 4 μg/mL of AXO. Compared to the control, the transcriptomic analysis revealed that 4 mg/ml of (1/4MIC) CRAN and its combination with 4 μg/mL of (1/8MIC) AXO (CC) exposures resulted in 727 and 712 differentially expressed genes, respectively (false discovery rate < 0.001 and log2-fold change > 2), in the studied E. coli. Major virulence genes including adhesins (fim, flg, csg, and yad), protectins (omp, tra, waa, and hly), secretion systems (hof, pho, and vir), and quorum sensing (lsr), which are energetically expensive for bacteria, were downregulated. Most importantly, 1/4MIC of CRAN or CC downregulated the β-lactamase blaCMY-2 and efflux pump including tolC, mdtEIJ, gadEW, and their regulator gene evgS, while upregulating the cysteine biosynthesis and oxidative stress-related regulatory genes including cys, dmlA, sbp, nrdGHI, soxSR, and rpoH. Downregulation of multiple enzymes involved in TCA cycles and upregulation of Fe–S cluster coordinated by Cys and Isc proteins reflect the regulation of energy metabolism of the studied E. coli upon CRAN or CC exposure. The downregulation of outer membrane protein genes that control permeability barriers, along with different antimicrobial resistance genes, demonstrates that CRAN may have the unique potential to enhance the antimicrobial activities of third-generation cephalosporins such as AXO against MDR E. coli.
Anesthesia management of patients undergoing off-pump coronary artery bypass grafting: A retrospective study of single center
Authors: Lin Yong , Sun Tao , Cheng Ning-ning , Liu Jing-jing , He Li-xian , Wang Li-hong , Liu Xian-wen , Chen Mei-fang , Chen Liang-wan , Yao Yun-tai ,   the Evidence in Cardiovascular Anesthesia (EICA) Group
Published: January 2023

Background

To summarize the current practice of anesthesia management for Chinese patients undergoing off-pump coronary artery bypass (OPCAB) surgery at a large-volume cardiovascular center.

Materials and methods

The clinical data of consecutive patients undergoing isolated, primary OPCAB surgery during the period from September 2019 to December 2019 were retrospectively analyzed. Patient characteristics, intraoperative data, and short-term outcomes were extracted from the Hospital Information System and the Anesthesia Information Management System.

Results

A total of 255 patients who underwent OPCAB surgery were enrolled in the current study. High-dose opioids and short-acting sedatives were the most commonly administrated anesthetics intraoperatively. Pulmonary arterial catheter insertion is frequently performed in patients with serious coronary heart disease. Goal-directed fluid therapy, a restricted transfusion strategy, and perioperative blood management were routinely used. Rational usages of inotropic and vasoactive agents facilitate hemodynamic stability during the coronary anastomosis procedure. Four patients underwent re-exploration for bleeding, but no death was observed.

Conclusions

The study introduced the current practice of anesthesia management at the large-volume cardiovascular center, and the short-term outcomes indicated the efficacy and safety of the practice in OPCAB surgery.
Waiting-List and early posttransplant prognosis among ethnoracial groups: Data from the organ procurement and transplantation network
Authors: Wu Yangyang , Lv Kaikai , Hao Xiaowei , Lv Chao , Lai Wenhui , Xia Xinze , Pang Aibo , Yuan Qing , Song Tao
Published: January 2023

Background

Racial/ethnic disparity in waiting-list mortality among candidates listed for kidney transplantation (KT) in the United States remains unclear. We aimed to assess racial/ethnic disparity in waiting-list prognosis among patients listed for KT in the United States in the current era.

Methods

We compared waiting-list and early posttransplant in-hospital mortality or primary nonfunction (PNF) among adult (age ≥18 years) white, black, Hispanic, and Asian patients listed for only KT in the United States between July 1, 2004 and March 31, 2020.

Results

Of the 516,451 participants, 45.6%, 29.8%, 17.5%, and 7.1% were white, black, Hispanic, and Asian, respectively. Mortality on the 3-year waiting list (including patients who were removed for deterioration) was 23.2%, 16.6%, 16.2%, and 13.8% in white, black, Hispanic, and Asian patients, respectively. The cumulative incidence of posttransplant in-hospital death or PNF after KT was 3.3%, 2.5%, 2.4%, and 2.2% in black, white, Hispanic, and Asian patients,respectively. White candidates had the highest mortality risk on the waiting list or of becoming too sick for a transplant, while black (adjusted hazard ratio, [95% confidence interval, CI], 0.67 [0.66–0.68]), Hispanic (0.59 [0.58–0.60]), and Asian (0.54 [0.52–0.55]) candidates had a lower risk. Black KT recipients (odds ratio, [95% CI] 1.29 [1.21–1.38]) had a higher risk of PNF or death before discharge than white patients. After controlling confounders, black recipients (0.99 [0.92–1.07]) had a similar higher risk of posttransplant in-hospital mortality or PNF as white patients than Hispanic and Asian counterparts.

Conclusions

Despite having a better socioeconomic status and being allocated better kidneys, white patients had the worst prognosis during the waiting periods. Black recipients and white recipients have higher posttransplant in-hospital mortality or PNF.
Characterization of small plasmids carrying florfenicol resistance gene floR in Actinobacillus pleuropneumoniae and Pasteurella multocida isolates from swine in China
Authors: Yao Xiaohui , Song Qiangqiang , Zhu Wei , Wei Jianchao , Shao Donghua , Liu Ke , Li Zongjie , Qiu Yafeng , Ma Zhiyong , Xia Lining , Li Beibei
Published: January 2023

Actinobacillus pleuropneumoniae and Pasteurella multocida are two important bacterial pathogens in swine industry. In the present study, resistance profiles of nine commonly used antibiotics of A. pleuropneumoniae and P. multocida isolates of swine origin from different regions of China were investigated by determination of minimum inhibitory concentrations (MICs). In addition, genetic relationship of the florfenicol-resistant A. pleuropneumoniae and P. multocida isolates was determined by pulsed-field gel electrophoresis (PFGE). The genetic basis of florfenicol resistance in these isolates were explored by floR detection and whole genome sequencing. High resistance rates (>25%) of florfenicol, tetracycline and trimethoprim- sulfamethoxazole were observed for both bacteria. No ceftiofur- and tiamulin- resistant isolates were detected. Furthermore, all the 17 florfenicol-resistant isolates (nine for A. pleuropneumoniae and eight for P. multocida) were positive for floR gene. The presence of similar PFGE types in these isolates suggested that clonal expansion of some floR-producing strains occurred in the pig farms from same regions. WGS and PCR screening showed that three plasmids, named pFA11, pMAF5, and pMAF6, were the cargos of the floR genes in the 17 isolates. Plasmid pFA11 exhibited novel structure and carried several resistance genes, including floR, sul2, aacC2d, strA, strB, and blaROB − 1. Plasmids pMAF5 and pMAF6 were presented in A. pleuropneumoniae and P. multocida isolates from different regions, suggesting horizontal transfer of the two plasmids are important for the floR dissemination in these Pasteurellaceae pathogens. Further studies of florfenicol resistance and its transfer vectors in Pasteurellaceae bacteria of veterinary origin are warranted.