bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation of PKM2 Expression With HER2/neu and Additional Breast Cancer Biomarkers and its Prognostic Significance
Authors: Al-Qudah Mohammad A. , Al-Keilani Maha S. , Obeidat Marya , Haddad Husam K. , Bdeir Roba , Samman Lina M.
Published: May 2023

Background:

Pyruvate kinase M2 (PKM2) has a central role in both tumor development and metastasis, and it has increasingly become a valuable subject for many cancer studies due to its important prognostic value in various tumor types. In this study, we aimed to elucidate the impact of PKM2 expression level on breast cancer prognosis and survival rates and its association with various clinicopathologic characteristics and tumor markers in breast cancer patients.

Materials and Methods:

This retrospective study included sample tissues from patients with breast cancer who did not receive chemotherapy or radiotherapy before surgery. Expression levels of PKM2, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2), and Ki-67 were analyzed using tissue microarray and immunohistochemistry.

Results:

A total of 164 patients were included with an age range from 28 to 82 years. High PKM2 was observed in 48.8% of cases (80/164). A significant association was found between PKM2 expression and breast cancer molecular subtype and HER2 status (P<0.001). In HER2-negative tumors, there was a significant association between PKM2 expression and tumor grade, TNM stage, pN stage, lymphovascular invasion, and estrogen receptor/progesterone receptor status. Survival analysis revealed that high PKM2 expression levels were associated with decreased overall survival rate in HER2-positive cases with high Ki-67 index. Moreover, in the HER2-positive group, low PKM2 expression level impacted the survival outcome of metastasis (P=0.002).

Conclusions:

PKM2 is a valuable prognostic and a potential diagnostic and predictive marker in breast cancer. Moreover, the combination of PKM2 with Ki-67 provides excellent prognostic accuracy in HER2-positive tumors.
Ten-Year Analysis of Complications Related to Simple Basilar Skull Fractures in Children Presenting to a Trauma Center
Authors: Ryan Sydney , Hewes Hilary , Fenton Stephen F. , Russell Katie , Hansen Kris , Brockmeyer Douglas L. , Robison Jeff
Published: May 2023

Objectives

Head trauma is a common presenting complaint among children requiring urgent medical attention, accounting for more than 600,000 emergency department (ED) visits annually, 4% to 30% of which identify skull fractures among the patient's injuries. Previous literature shows that children with basilar skull fractures (BSFs) are usually admitted for observation. We studied whether children with an isolated BSF have complications precluding them from safe discharge home from the ED.

Methods

We performed a retrospective review of ED patients aged 0 to 18 years given a simple BSF diagnosis (defined by nondisplaced fracture, with normal neurologic examination, Glasgow Coma Score of 15, no intracranial hemorrhage, no pneumocephalus) during a 10-year period to identify complications associated with their injury. Complications were defined as death, vascular injury, delayed intracranial hemorrhage, sinus thrombosis, or meningitis. We also considered hospital length of stay (LOS) longer than 24 hours or any return visit within 3 weeks of the original injury.

Results

Of the 174 patients included in the analysis, there were no deaths, cases of meningitis, vascular injury, nor delayed bleeding events. Thirty (17.2%) patients required a hospital LOS longer than 24 hours and 9 (5.2%) returned to the hospital within 3 weeks of discharge. Of those with LOS longer than 24 hours, 22 (12.6%) patients needed subspecialty consultation or intravenous fluids, 3 (1.7%) had cerebrospinal fluid leak, and 2 (1.2%) had a concern for facial nerve abnormality. On the return visits, only 1 (0.6%) patient required readmission for intravenous fluids because of nausea and vomiting.

Conclusions

Our findings suggest that patients with uncomplicated BSFs can be safely discharged from the ED if the patient has reliable follow-up, is tolerating oral fluids, has no evidence of cerebrospinal fluid leak, and has been evaluated by appropriate subspecialists before discharge.
Utilizing Clinical Decision Support in the Treatment of Urinary Tract Infection across a Large Pediatric Primary Care Network
Authors: Karas David R. , Upadhyayula Shankar , Love April , Bigham Michael T.
Published: May 2023

Introduction:

Cystitis and pyelonephritis are common bacterial infections in infants and children, and initial treatment is usually empirical. Antimicrobial stewardship advocates using narrow-spectrum antibiotics with consideration for local resistance patterns. Narrow-spectrum antibiotic use is critical in addressing the global issue of bacterial antimicrobial resistance, associated with approximately 5 million annual deaths.

Methods:

The antimicrobial stewardship committee developed a guideline for diagnosing and managing urinary tract infections and distributed it to all primary care providers. A standardized order set provided clinical decision support regarding appropriate first-line antibiotic therapy. A chief complaint of dysuria prompted the use of the order set. Prescription rates for the most common antimicrobials were tracked on a control chart.

Results:

From March 2018 through March 2020, there were 4,506 antibiotic prescriptions for urinary tract infections. Utilization of the recommended first-line therapy, cephalexin, increased from 27.5% to 74.8%. Over the same period, trimethoprim-sulfamethoxazole, no longer recommended due to high local resistance, decreased from 31.8% to 8.1%. Providers have maintained these prescribing patterns since the conclusion of the project.

Conclusion:

Using clinical decision support as a standardized order set can sustainably improve the use of first-line antimicrobials for treating pediatric urinary tract infections.
The Conditional Effects of Multimorbidity on Operative Versus Nonoperative Management of Emergency General Surgery Conditions
Authors: Rosen Claire B. , Roberts Sanford E. , Wirtalla Chris J. , Keele Luke J. , Kaufman Elinore J. , Halpern Scott D. , Reilly Patrick M. , Neuman Mark D. , Kelz Rachel R.
Published: May 2023

Objective:

To understand how multimorbidity impacts operative versus nonoperative management of emergency general surgery (EGS) conditions.

Background:

EGS is a heterogenous field, encompassing operative and nonoperative treatment options. Decision-making is particularly complex for older patients with multimorbidity.

Methods:

Using an instrumental variable approach with near-far matching, this national, retrospective observational cohort study of Medicare beneficiaries examines the conditional effects of multimorbidity, defined using qualifying comorbidity sets, on operative versus nonoperative management of EGS conditions.

Results:

Of 507,667 patients with EGS conditions, 155,493 (30.6%) received an operation. Overall, 278,836 (54.9%) were multimorbid. After adjustment, multimorbidity significantly increased the risk of in-hospital mortality associated with operative management for general abdominal patients (+9.8%; P = 0.002) and upper gastrointestinal patients (+19.9%, P < 0.001) and the risk of 30-day mortality (+27.7%, P < 0.001) and nonroutine discharge (+21.8%, P = 0.007) associated with operative management for upper gastrointestinal patients. Regardless of multimorbidity status, operative management was associated with a higher risk of in-hospital mortality among colorectal patients (multimorbid: + 12%, P < 0.001; nonmultimorbid: +4%, P = 0.003), higher risk of nonroutine discharge among colorectal (multimorbid: +42.3%, P < 0.001; nonmultimorbid: +55.1%, P < 0.001) and intestinal obstruction patients (multimorbid: +14.6%, P = 0.001; nonmultimorbid: +14.8%, P = 0.001), and lower risk of nonroutine discharge (multimorbid: −11.5%, P < 0.001; nonmultimorbid: −11.9%, P < 0.001) and 30-day readmissions (multimorbid: −8.2%, P = 0.002; nonmultimorbid: −9.7%, P < 0.001) among hepatobiliary patients.

Conclusions:

The effects of multimorbidity on operative versus nonoperative management varied by EGS condition category. Physicians and patients should have honest conversations about the expected risks and benefits of treatment options, and future investigations should aim to understand the optimal management of multimorbid EGS patients.
Short-term Outcomes After Laparoscopic IPOM vs. Robot-assisted Retromuscular Repair of Small to Medium Ventral Hernias
Authors: Jensen Kristian K. , Helgstrand Frederik , Henriksen Nadia A.
Published: May 2023

Objective:

To examine the short-term outcomes after laparoscopic intraperitoneal onlay mesh (IPOM) compared to robot-assisted retromuscular repair of small to medium sized ventral hernia.

Summary background information:

With the introduction of a robot-assisted approach, retromuscular mesh placement is technically more feasible compared to laparoscopic IPOM, with potential gains for the patient, including avoidance of painful mesh fixation and intraperitoneal mesh placement.

Methods:

This was a nationwide cohort study of patients undergoing either laparoscopic IPOM or robot-assisted retromuscular repair of a ventral hernia with a horizontal fascial defect <7 cm in the period 2017 to 2022, matched in a 1:2 ratio using propensity scores. Outcomes included postoperative hospital length of stay, 90-day readmission, and 90-day operative reintervention, and multivariable logistic regression analysis was performed to adjust for the relevant confounder.

Results:

A total of 1,136 patients were included for analysis. The rate of IPOM repaired patients hospitalized > 2 days was more than 3 times higher than after robotic retromuscular repair (17.3% vs. 4.5%, P < 0.001). The incidence of readmission within 90 days postoperatively was significantly higher after laparoscopic IPOM repair (11.6% vs. 6.7%, P=0.011). There was no difference in the incidence of patients undergoing operative intervention within the first 90 days postoperatively (laparoscopic IPOM 1.9% vs. robot-assisted retromuscular 1.3%, P=0.624).

Conclusions:

For patients undergoing first-time repair of a ventral hernia, robot-assisted retromuscular repair was associated with a significantly reduced incidence of prolonged length of postoperative hospital stay and risk of 90-day compared to laparoscopic IPOM.
Early lyophilized cryoprecipitate enhances the ADAMTS13/VWF ratio to reduce systemic endotheliopathy and lessen lung injury in a mouse multiple-trauma hemorrhage model
Authors: Zeineddin Ahmad , Wu Feng , Dong Jing-Fei , Vesselinov Roumen , Neal Matthew D. , Corash Laurence , Pati Shibani , Kozar Rosemary A.
Published: May 2023

BACKGROUND

Recent studies in severely injured patients suggest an important role of von Willebrand Factor (VWF) and ADAMTS13 in the endotheliopathy of trauma (EoT). We hypothesized that the early use of cryoprecipitate would be effective as an endothelial protector by supplementing physiologic VWF and ADAMTS13 to reverse the EoT. We tested a pathogen-reduced lyophilized cryoprecipitate (LPRC) that could expedite the early administration of cryoprecipitate in the battlefield.

METHODS

A mouse multiple-trauma model with uncontrolled hemorrhage (UCH) from liver injury was utilized followed by hypotensive resuscitation (mean arterial pressure, 55–60) × 3 hours with lactated Ringer's (LR), fresh frozen plasma (FFP), conventional pathogen-reduced cryoprecipitate (CC), and LPRC. Blood was collected for measurement of syndecan-1, VWF, and ADAMTS13 by ELISA. Lungs were stained for histopathologic injury and syndecan-1 and bronchial alveolar lavage (BAL) fluid harvested for protein as an indicator of permeability. Statistical analysis was by ANOVA followed by Bonferroni correction.

RESULTS

Following multiple trauma and UCH, blood loss was similar across groups. Mean volume of resuscitation was higher in the LR group compared with the other resuscitation groups. Lung histopathologic injury, syndecan-1 immunostaining and BAL protein were higher with LR compared with resuscitation with FFP and CC, while LPRC further reduced BAL compared with FFP and CC. The ADAMTS13/VWF ratio was significantly lower in LR but improved with FFP and CC, comparable to shams while LPRC further increased this ratio.

CONCLUSION

The protective effects of CC and LPRC were comparable to FFP in ameliorating the EoT in our murine multiple trauma and UCH model. Lyophilized cryoprecipitate may also provide additional benefit by enhancing the ADAMTS13/VWF ratio. These data provide evidence of the safety and efficacy of LPRC and warrants further investigation for its potential application in military settings once approved for human administration.
Feasibility of conducting a military-relevant multicenter cohort study to assess outcomes of early trauma resuscitative interventions in a prolonged care civilian setting
Authors: Mould-Millman Nee-Kofi , Dixon Julia M. , Lategan Hendrick J. , Beaty Brenda , Fosdick Bailey , Fleischer Chelsie , de Vries Shaheem , Schauer Steven G. , Steyn Elmin , Verster Janette , Hodsdon Lesley , Mukonkole Suzan , Doubell Karlien , Stassen Willem , Keenan Sean , Cunningham Cord , Moore Ernest E. , Ginde Adit A. , Bebarta Vikhyat S.
Published: May 2023

BACKGROUND

The Epidemiology and Outcomes of Prolonged Trauma Care (EpiC) study is a 4-year, prospective, observational, large-scale epidemiologic study in South Africa. It will provide novel evidence on how early resuscitation impacts postinjury mortality and morbidity in patients experiencing prolonged care. A pilot study was performed to inform the main EpiC study. We assess outcomes and experiences from the pilot to evaluate overall feasibility of conducting the main EpiC study.

METHODS

The pilot was a prospective, multicenter, cohort study at four ambulance bases, four hospitals, and two mortuaries from March 25 to August 27, 2021. Trauma patients 18 years or older were included. Data were manually collected via chart review and abstraction from clinical records at all research sites and inputted into Research Electronic Data Capture. Feasibility metrics calculated were as follows: screening efficiency, adequate enrollment, availability of key exposure and outcome data, and availability of injury event date/time.

RESULTS

A total of 2,303 patients were screened. Of the 981 included, 70% were male, and the median age was 31.4 years. Six percent had one or more trauma relevant comorbidity. Fifty-five percent arrived by ambulance. Forty percent had penetrating injuries. Fifty-three percent were critically injured. Thirty-three percent had one or more critical interventions performed. Mortality was 5%. Four of the eight feasibility metrics exceed the predetermined threshold: screening ratio, monthly enrollment, percentage with significant organ failure, and missing injury date/time for emergency medical services patients. Two feasibility metrics were borderline: key exposure and primary outcome. Two feasibility metrics fell below the feasibility threshold, which necessitate changes to the main EpiC study: percentage with infections and missing injury date/time for walk-in patients.

CONCLUSION

The EpiC pilot study suggests that the main EpiC study is overall feasible. Improved data collection for infections and methods for missing data will be developed for the main study.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level V.
Characteristics and Treatments of Coronavirus Disease 2019 Patients Presenting With Persistent Hiccups: A Scoping Review
Authors: Boulis Michael , Boulis Mary , Cosgrove Marianne , He Ken
Published: May 2023

Objectives

Over the time of the pandemic, coronavirus disease 2019 (COVID-19) has surprised us with a growing list of atypical presentations, one of which is persistent hiccups that last more than 48 hours. The aim of this review is to investigate the characteristics of COVID-19 patients presenting with persistent hiccups and explore treatments used to control persistent hiccups in such cases.

Methods

This scoping review was performed utilizing the methodological approach proposed by Arksey and O'Malley.

Results

Fifteen relevant cases were identified. All reported cases were males, aged between 29 and 72 years. More than one-third of the cases did not have symptoms of infection. All cases had a positive severe acute respiratory syndrome coronavirus reverse transcriptase–polymerase chain reaction, as well as lung involvement evident on chest imaging. The medications most frequently used for hiccups in the reported cases were chlorpromazine (6 cases, 83% success), metoclopramide (5 cases, 0% success), and baclofen (3 cases, 100% success).

Conclusions

In patients presenting with persistent hiccups during this pandemic, even in those lacking systemic or other manifestations of COVID-19 or pneumonia, clinicians are encouraged to consider COVID-19 as one of the differential diagnoses. In light of the findings of this review, it is recommended to include a severe acute respiratory syndrome coronavirus reverse transcriptase–polymerase chain reaction test and a chest imaging as part of the workup for these patients. When considering treatment options, this scoping review shows that chlorpromazine has more favorable outcomes compared with metoclopramide for controlling persistent hiccups in COVID-19 patients.
From voice to ink (VINK): Development and assessment of an automated, free-of-charge transcription tool
Authors: Tolle Hannah , Castro Maria del Mar , Wachinger Jonas , Putri Agrin Zauyani , Kempf Dominic , Denkinger Claudia M. , McMahon Shannon A.
Published: May 2023

Verbatim transcription of qualitative data is a cornerstone of analytic quality and rigor, yet the time and energy required for such transcription can drain resources, delay analysis and hinder the timely dissemination of qualitative insights. In recent years, software programs have presented a promising mechanism to accelerate transcription, but the broad application of such programs has been constrained due to expensive licensing or “per-minute” fees, data protection concerns, and limited availability of such programs in many languages. In this article, we outline our process of developing and adapting a free, open-source, speech-to-text algorithm (Whisper by OpenAI) into a usable and accessible tool for qualitative transcription. Our program, which we have dubbed “Vink” for voice to ink, is available under a permissive open-source license (and thus free of cost). We assessed Vink’s reliability in transcribing authentic interview audio data in 14 languages, and identified high accuracy and limited correction times in most languages. A majority (9 out of 12) of reviewers evaluated the software performance positively, and all reviewers whose transcript had a word-error-rate below 20% (n=9) indicated that they were likely or very likely to use the tool in their future research. Our usability assessment indicates that Vink is easy-to-use, and we are continuing further refinements based on reviewer feedback to increase user-friendliness. With Vink, we hope to contribute to facilitating rigorous qualitative research processes globally by reducing time and costs associated with transcription, and expanding the availability of this transcription software into several global languages. With Vink running on the researcher’s computers, data privacy issues arising within many other solutions do not apply.

Summary box

What is already known on this topic:Transcription is a key element to ensure quality and rigor of qualitative data for analysis. Current practices, however, often entail high costs, variable quality, data privacy concerns, stress for human transcribers, or long delays of analysis.

What this study adds:We present the development and assessment of a transcription tool (Vink) for qualitative research drawing upon an open-source automatic speech recognition system developed by OpenAI and trained on multilingual audio data (Whisper). Initial validation in real-life data from 14 languages shows high accuracy in several languages, and an easy-to-use interface.

How this study might affect research, practice or policy:Vink overcomes limitations of transcription by providing a ready to use, open source and free-of-cost tool, with minimal data privacy concerns, as no data is uploaded to the web during transcription.
Scale-up costs and societal benefits of psychological interventions for alcohol use and depressive disorders in India
Authors: Zadey Siddhesh
Published: May 2023

There is growing evidence for cost-effective psychological interventions by lay health workers for managing mental health problems. In India, Counseling for Alcohol Problems (CAP) and Healthy Activity Program (HAP) have been shown to have sustained cost-effectiveness for improving harmful alcohol use among males and depression remission among both sexes, respectively. We conducted a retrospective analysis of annual costs and economic benefits of CAP and HAP national scale-up with 2019 as the baseline. The CAP and HAP per capita integration costs were obtained from original studies, prevalence and disability-adjusted life-years for alcohol use disorders (AUD) and depressive disorders for 20-64 years old males and females from Global Burden of Disease study, and treatment gaps from National Mental Health Survey. Scale-up costs were calculated for meeting total or unmet needs Societal benefit estimates based on averted disease burden were calculated using human capital and value of life-year approaches. Net benefits were calculated from combinations of differences between societal benefits and scale-up costs. Values were transformed to 2019 international dollars. CAP scale-up costs ranged from Int$ 2.03 (95%UI: 1.67, 2.44) billion to Int$ 6.34 (5.21, 7.61) billion while HAP ones ranged from Int$ 6.85 (5.61, 8.12) billion to Int$ 23.21 (19.03, 27.52) billion. Societal benefits due to averted AUD burden ranged from Int$ 11.51 (8.75, 14.90) billion to Int$ 38.73 (29.43, 50.11) billion and those due to averted depression burden ranged from Int$ 30.89 (20.77, 43.32) billion to Int$ 105.27 (70.78, 147.61) billion. All scenarios showed net positive benefits for CAP (Int$ 6.05-36.38 billion) and HAP (Int$ 11.12-93.50 billion) scale-up. The novel national-level scale-up estimates have actionable implications for mental health financing in India.
Assessment of Working Environment and Satisfaction Among Health Care Workers In Sengerema District Mwanza, Tanzania
Authors: Chilipweli Peter , Basinda Namanya , Msilaga Evans V , Tuli Tusherahma , setebe Frank , Elias Emanuel , Konje Eveline , Kapesa Anthony , Nyanza Elias , Morona Dominica
Published: May 2023

Background

Job satisfaction is currently considered to be a measure that should be included in quality improvement programs thus it is very important to assess it among healthcare workers who are mostly exposed to work stress thus this research is going to have different consideration on health care workers working on hard-to-reach areas and low-level facilities since there is lack of enough evidence and limited studies done under this area.

Methods

This was a cross section study conducted among healthcare workers found in sengerema and it was conducted from 27/02/2023 to 10/03/2023 whereby it include 356 health care workers employed and working at sengerema district as participants found in the health facilities Statistical method used was descriptive analysis by assessing frequency of variables in terms percentages. The results were presented in form of tables and bar graphs.

Results

A total of 356 health care professionals were included in the study, female participants were more occupying 55.6% while the male were 44.4%. In the study more of the participants were married than those single with percentages of 68.5% and 31.5% respectively. Most of the health care workers were at the dispensary level were satisfied at their job (55%0 but among the health care workers working at the health center most of them were not satisfied (52%). But among married workers most of them were not satisfied with their job (50.5%) as compared to single workers who were most satisfied (56%).

Conclusion

Based on our research, the prevalence of job satisfaction among health care workers in Sengerema district is generally high by 53.9% which shows that most workers are satisfied with their jobs. Most health care workers have good relationship with each other and can depend on each other and they get their benefit as health care workers.
Aortic valve sclerosis in patients with acute myocardial infarction: a marker of increased risk of re-infarction
Authors: Myasoedova Veronika A. , Chiesa Mattia , Cosentino Nicola , Bonomi Alice , Ludergnani Monica , Bozzi Michele , Valerio Vincenza , Moschetta Donato , Massaiu Ilaria , Mantegazza Valentina , Marenzi Giancarlo , Poggio Paolo
Published: May 2023

Background

Patients with acute myocardial infarction (AMI) are at increased risk of recurrent cardiovascular events. Aortic valve sclerosis (AVSc), which reflects a systemic damage, may serve as a marker of risk. The aim of the present study is to better stratify sub-groups of AMI patients with specific probabilities of recurrent AMI and to evaluate the importance of AVSc in this setting.

Methods

We analyzed 2120 AMI patients admitted at Centro Cardiologico Monzino (2010-2019) who underwent echocardiographic evaluation for AVSc assessment. Topological data analysis (TDA) was used to stratify sub-groups of patients experiencing recurrent AMI and a random forest procedure to evaluate the importance of baseline clinical characteristics. Kaplan-Meier and Cox regression analyses were used to evaluate recurrent AMI incidence, for up to 10 years.

Results

TDA highlighted the presence of 8 clusters of patients with specific risks of recurrent AMI. The evaluation of time-to-event curves allowed us to combine these clusters into three super-clusters (i.e., low-, moderate-, and high-risk) and a random forest procedure showed AVSc as the most relevant variable to discriminate the three classes of risk. AVSc was detected in 1000 (47%) patients. After full adjustment, we found a significant association of AVSc with recurrent AMI (hazard ratio (HR) 1.42, 95%CI:1.03-1.97). Stratifying by age, this association was significant only for patients younger than 75 years after 5 years of follow-up (HR 1.59, 95%CI:1.03-2.46).

Conclusions

AVSc has been identified to be the most relevant variable to recognize patients at high risk of recurrent AMI. AVSc is frequently detected in AMI patients and is strongly associated with recurrent AMI, especially in patients younger than 75 years old. The presence of AVSc should be taken into consideration to improve the risk stratification and clinical management of AMI patients.
Clinical analysis of myocardial injury in highlanders with pulmonary hypertension
Authors: Zhao Maolin , Wu Qianjin , Duanmu Wangsheng , Shen Junxian , Yuan Weixin , Sun Yingbin , Zhang Xu , Zhang Jinbao , He Siyi
Published: May 2023

Background

High altitude environment can give rise to Myocardial injury (MI) mainly because of hypoxia, where MI with pulmonary hypertension (PH) is one of the severe pathologies. In the present study, we intend to explore clinical characteristics of MI in patients with PH at high altitude and diagnostic value of various myocardial markers.

Methods

Consecutive patients at the altitude of 3650m were selected into this retrospective study. Clinical and biochemical data were collected. According to the results of Cardiac troponin I (cTnI), patients were divided into MI group and non-MI group.

Results

A total of 231 patients were enrolled in this study. MI occurred in 29 patients (12.6%). We found that body mass index (BMI,P=0.045), left ventricular end-diastolic dimension (LVEDD,P=0.005), and serum level of creatine kinase-MB (CK-MB,P=0.001) in MI group were significantly higher than that in non-MI group. Spearman correlation analysis revealed that cTnI have a significant positive correlation with CK-MB (P=0.000) and LDH (P<0.001) instead of aspartate aminotransferase (AST). A receiver operating characteristic (ROC) curve was drawn to demonstrate that CK-MB could significantly predict the occurrence of MI with an area under the curve (AUC) of 0.749 (P=0.000), and the level of 3.035 (sensitivity = 59.3%, specificity = 90.5%) was optimal cutoff value.

Conclusion

The incidence of MI with PH is high in highlander. As a convenient and efficient marker, CK-MB is closely associated with cTnI and have a predict role in the occurrence of MI with PH under expose to high altitude hypoxia.
Soluble DNA Concentration in the Perfusate is a Predictor of Post-Transplant Renal Function in Hypothermic Perfused Kidney Allografts
Authors: Duarte Sergio , Carpenter Anne-Marie , Willman Matthew , Lewis Duncan , Warren Curtis , Angeli-Pahim Isabella , De Faria Werviston , Vrakas Georgios , El Hinnawi Ashraf , Beduschi Thiago , Battula Narendra , Zarrinpar Ali
Published: May 2023

Introduction

Hypothermic machine perfusion (HMP) has greatly facilitated kidney allograft preservation. However, tissue damage still occurs during HMP, deleteriously affecting post-transplant graft function. Therefore, improved methods to assess organ quality and to predict post-transplant graft function and survival are needed. We propose that soluble DNA (sDNA) measured in HMP perfusate can used as a non-invasive biomarker for this purpose.

Methods

Perfusate samples of kidney grafts placed on HMP were collected after 5 minutes and at the conclusion of HMP. sDNA of nuclear origin within the perfusate was quantified by real-time polymerase chain reaction and correlated with HMP parameters and post-transplant clinical outcomes.

Results

Kidney grafts from 52 donors placed on HMP were studied. Perfusate sDNA concentration was significantly elevated in transplanted kidneys with delayed graft function. Grafts with higher concentrations of perfusate sDNA at 5min and at HMP conclusion also had reduced graft function in the initial post-transplant period, as measured by post-operative day 2, 3, and 4 creatinine reduction ratios (CRR). Standard pump parameters such as renal vascular resistance and renal vascular flow were poor indicators of early post-transplant graft function.

Conclusion

sDNA concentration in HMP perfusate of kidney grafts can predict the quality of kidney graft preservation and indicate post-transplant renal function. This biomarker should be explored further to improve renal organ assessment and transplantation outcomes.
Health Technology Assessment (HTA) readiness in Uganda: Stakeholder’s perceptions on the potential application of HTA to support National Universal Health Coverage efforts
Authors: Mayora Chrispus , Kazibwe Joseph , Ssempala Richard , Nakimuli Brenda , Ssenyonjo Aloysius , Ekirapa Elizabeth , Byakika Sarah , Aliti Tom , Musila Timothy , Gad Mohamed , Vassall Anna , Ruiz Francis , Ssengooba Freddie
Published: May 2023

Introduction

Health technology assessment (HTA) is an area that remains less implemented in low- and lower middle-income countries. The aim of the study is to understand the perceptions of stakeholders in Uganda towards HTA and its role in decision making, in order to inform its potential implementation in the country.

Methods

The study takes a cross-sectional mixed methods approach, utilising an adapted version of an International Decision Support Initiative questionnaire with both semi-structured and open-ended questions. We interviewed thirty key informants from different stakeholder institutions in Uganda that have decision making roles in the health sector.

Results

All participants perceived HTA as an important tool for decision making. Allocative efficiency was regarded as the most important use of HTA receiving the highest average score (8.8 out of 10), followed by quality of healthcare (7.8/10), transparency (7.6/10), budget control (7.5/10) and equity (6.5/10). There was concern that some of the uses of HTA may not be achieved in reality if there was political interference during the HTA process. The technology areas that interviewees highlighted as needing HTA type evaluations urgently were identified as medicines (60.0% of the participants), diagnostics (53.3%), vaccines (40.0%), and public health programs (26.7%). The study participants identified development partners as the most likely potential users of HTA (66.7% of participants), followed by Ministry of Health (43.3%).

Conclusion

Interviewed stakeholders in Uganda viewed the role of HTA positively, suggesting that there exists a promising environment for the establishment and operationalisation of HTA as a tool for decision making within the health sector. However, sustainable development and application of HTA in Uganda will require adequate capacity both to undertake HTAs and to support their use and uptake.
Impact of a nutrition-sensitive agroecology program in Andhra Pradesh, India, on dietary diversity, nutritional status, and child development
Authors: Durga Lakshmi , Bharath Yandrapu , Bliznashka Lilia , Kumar Vijay , Jonnala Veerendra , Chekka Vijayalakshmi , Yebushi Srileka , Roy Aditi , Venkateshmurthy Nikhil Srinivasapura , Prabhakaran Poornima , Jaacks Lindsay M.
Published: May 2023

Introduction

To date, most food-based nutrition interventions have not considered food production practices, particularly the use of synthetic chemicals. This study aimed to evaluate the impact of a multi-component food-based nutrition intervention involving homestead food production, nutrition counselling, cooking demonstrations, and crop planning exercises, and employing agroecological production practices (herein ‘nutrition-sensitive agroecology program’), on dietary diversity, nutritional status, and child development in Andhra Pradesh, India.

Methods

A cross-sectional assessment was conducted in 2021-2022 of 50 intervention villages where the nutrition-sensitive agroecology program had been implemented since 2018 and 79 control villages where only the agroecology program had been implemented. Data on self-reported dietary intake, caregiver-reported early child development, anthropometric measurements, and hemoglobin concentrations were collected using standardized procedures by trained Nutrition Farming Fellows, who were also responsible for implementing the program.

Results

A sample of 3,511 households (1,121 intervention and 2,390 control) participated in the survey. Dietary diversity scores (DDS) among women and men were mean (SD) 6.53 (±1.62) and 6.16 (±1.65), respectively, in intervention villages and 5.81 (±1.58) and 5.39 (±1.61), respectively, in control villages (p<0.01). DDS among children 6-24 months of age in intervention and control villages was 2.99 (±1.52) and 2.73 (±1.62), respectively (p<0.01). Children <2 years of age were less likely to be anemic in intervention versus control villages (59% versus 69%, p<0.01). Children 18-35 months age in intervention villages had higher child development scores than children in control villages (all p<0.05).

Conclusion

Nutrition-sensitive agroecological programs may be effective in improving diets, nutrition, and child development in rural India.
Reasons for mosquito net non-use in malaria-endemic countries: A review of qualitative research published between 2011 and 2021
Authors: Ladu Hadiza Isa , Shuaibu Umar , Pulford Justin
Published: May 2023

Mosquito nets, particularly insecticide-treated nets [ITNs], are the most recommended method of malaria control in endemic countries. However, many individuals do not use them as advised. The current paper expands on a previous review published in 2011 which highlighted a need for more qualitative research on the reasons for mosquito net non-use. We present a systematic review of qualitative research published in the past decade to assess the growth and quality of qualitative papers about net non-use and examine and update the current understanding.

A comprehensive literature search was carried out in MEDLINE, CINAHL, and Global Health, in addition to a citation search of the initial review. Relevant papers were screened and discussed. The critical appraisal assessment tool was used to ensure quality. Thematic synthesis was used to extract, synthesise, and analyse study findings.

Compared to the initial review, the results showed a ten-fold increase in qualitative research on the reasons for mosquito net non-use between 2011 and 2021. In addition, the quality of the research has improved, with more than 90% of the papers receiving high scores, using the critical appraisal assessment tool. The reported reasons for non-use were categorised into four themes Human factors, Net factors, Environmental/Lifestyle factors, and Administrative/Economic factors. More than two-thirds of the studies were carried out in Africa, with lead African researchers in African institutions.

Despite the distribution of free mosquito nets in malaria-endemic countries, new challenges to their use continue to emerge. The most common reasons for net non-use across all regions of Malaria endemic countries were discomfort and perceived ineffectiveness of nets. Technical challenges and improper net use dominated East and South African regions, signifying the need for dedicated and region-specific measures and strategies to ensure the continued usage of mosquito nets, particularly ITNs.
Intentions and Willingness to receive Covid-19 vaccine among teaching and non-teaching staff in selected higher institutions of learning in Kampala and Wakiso districts, Central - Uganda
Authors: Lulu Patrick Madrama , Atim Fiona , Ronald Kareodu , Wakula Fredrick Lugaro , Okiria John Charles
Published: May 2023

Background

COVID-19 was first discovered by WHO, 2019 in Wuhan, later spread to different parts of the world with thousands of deaths. COVID-19 vaccine was very important in reducing severity of the infection. Willingness to be vaccinated considerably varied according to regions. We assessed factors influencing intentions and willingness to receive covid-19 vaccines among teaching and non-teaching staff in higher institutions of learning.

Methods

A descriptive cross-sectional study design was adopted employing quantitative data collection and analysis approaches. Data was collected electronically using different online sources including emails, social media, popular media platforms and websites. 363 sample determined using Kish & Leslie (1965) of simple random sampling for single proportions. Univariate, bivariate and multivariate analysis done using SPP (23.0).

Results

130(35.8%) intentions and willingness to receive COVID-19 vaccine. Influencing factors were; age between 30-39 (aOR=15491.54,95% CI=359-667551.9, P=0.000**, 40-49 (aOR=931, 95% CI=25.6-33816.4, p=0.000**), gender (aOR=4.66, 95% CI=2.06-1056, p=0.000*), staff category (aOR=7.71, 95% CI=4.34-14.71,p=0.000**), ownership (aOR=0.08, 95% CI=0.032-0.206, p=0.000**), being under health insurance (aOR=200.62, 95% CI=29.6-1359.18, p=0.000*, residency (aOR=19.88, 95% CI=4.63-85.26, p=0.000*), knowing where to get the vaccine (aOR=121.15, 95% CI=161.1-910.3, p=0.000**), COVID-19 vaccine important for prevention of the infection (aOR=19.73, 95% CI=2.27-171.52, p=0.007*), minor side effects of COVID-19 vaccines manageable (aOR=002, 95% CI= 0.00-0.15, p=0.000**), take painkillers if developed side effects (aOR=8.67, 95% CI=4.87-15.43, p=0.000*), responsibility to protect others by getting vaccinated (aOR=0.36, 95% CI=0.21-0.62, p=0.000**), concerned about getting infected with COVID-19 from the vaccine (aOR=0.002, 95% CI=0.00-0.03, p=0.000*).

Conclusion

Intentions and willingness to receive COVID-19 vaccine was low. This was attributed to age, gender, staff category, ownership, knowledge, attitude, where to get the vaccine, trust, vaccine efficacy, concern about getting infected after receiving the vaccine. MoH/MoE&S and development partners should emphasize improving attitude and knowledge of teaching and non-teaching staff in higher institutions to increase willingness.
Spatial Pattern Analysis using Closest Events (SPACE) – A Nearest Neighbor Point Pattern Analysis Framework for Assessing Spatial Relationships from Image Data
Authors: Soltisz Andrew M. , Craigmile Peter F. , Veeraraghavan Rengasayee
Published: May 2023

The quantitative description of biological structures is a valuable yet difficult task in the life sciences. This is commonly accomplished by imaging samples using fluorescence microscopy and analyzing resulting images using Pearson’s correlation or Manders’ co-occurrence intensity-based colocalization paradigms. Though conceptually and computationally simple, these approaches are critically flawed due to their reliance on signal overlap, sensitivity to cursory signal qualities, and inability to differentiate true and incidental colocalization. Point pattern analysis provides a framework for quantitative characterization of spatial relationships between spatial patterns using the distances between observations rather than their overlap, thus overcoming these issues. Here we introduce an image analysis tool calledSpatial Pattern Analysis using Closest Events(SPACE) that leverages nearest neighbor-based point pattern analysis to characterize the spatial relationship of fluorescence microscopy signals from image data. The utility of SPACE is demonstrated by assessing the spatial association between mRNA and cell nuclei from confocal images of cardiac myocytes. Additionally, we use synthetic and empirical images to characterize the sensitivity of SPACE to image segmentation parameters and cursory image qualities such as signal abundance and image resolution. Ultimately, SPACE delivers performance superior to traditional colocalization methods and offers a valuable addition to the microscopist’s toolbox.
Unsupervised single-cell clustering with Asymmetric Within-Sample Transformation and per cluster supervised features selection
Authors: Pagnotta Stefano Maria
Published: May 2023

This chapter shows applying the Asymmetric Within-Sample Transformation [14] to single-cell RNA-Seq data matched with a previous dropout imputation. The asymmetric transformation is a special winsorization that flattens low-expressed intensities and preserves highly expressed gene levels. Before a standard hierarchical clustering algorithm, an intermediate step removes non-informative genes according to a threshold applied to a per-gene entropy estimate.

Following the clustering, a time-intensive algorithm is shown to uncover the molecular features associated with each cluster. This step implements a resampling algorithm to generate a random baseline to measure up/down-regulated significant genes. To this aim, we adopt a GLM model [10] as implemented in DESeq2 [9] package.

We render the results in graphical mode. While the tools are standard heat maps, we introduce some data scaling so that the results’ reliability is crystal clear.
Growth sensitivity to water availability as potential indicator of drought-induced tree mortality in MediterraneanPinus sylvestrisforests
Authors: Herrero Asier , González-Gascueña Raquel , González-Díaz Patricia , Ruiz-Benito Paloma , Andivia Enrique
Published: May 2023

Drought-associated tree mortality has worldwide increased in the last decades, impacting structure and functioning of forest ecosystems, with implications for energy, carbon and water fluxes. However, the understanding of the factors underlying this mortality are still limited, especially at stand scale. We aim to identify the factors that triggered the mortality of the widely distributedPinus sylvestrisin an extensive forest area in central Spain. We compared radial growth patterns in pairs of live and recently dead individuals that co-occur in close proximity and present similar age and size, thereby isolating the effects of size and environment from the mortality process. Temporal dynamics of growth, growth synchrony, and growth sensitivity to water availability (P-PET) were compared between live and recently dead trees. Over the last 50 years, we observed an increase in the growth synchrony and sensitivity to water availability as drought conditions intensified consistent to prior research. However, no differences were found in radial growth between live and dead individuals 15 years before mortality, and dead individuals showed lower growth synchrony and sensitivity to water availability than live ones for much of the period studied. This suggests a decoupling between tree’s growth responses and climatic conditions, which could increase vulnerability to hydraulic failure and/or carbon starvation. Overall, our results point to an important role of growth sensitivity to water availability in tree mortality forP. sylvestrisat its southern distribution limit.
Kv7 Channel Opener Retigabine Reduces Self-Administration of Cocaine but Not Sucrose in Rats
Authors: Urena Esteban S. , Diezel Cody C. , Serna Mauricio , Hala’ufia Grace , Majuta Lisa , Barber Kara R. , Vanderah Todd W. , Riegel Arthur C.
Published: May 2023

The increasing rates of drug misuse highlight the urgency of identifying improved therapeutics for treatment. Most drug-seeking behaviors that can be modeled in rodents utilize the repeated intravenous self-administration (SA) of drugs. Recent studies examining the mesolimbic pathway suggest that Kv7/KCNQ channels may contribute in the transition from recreational to chronic drug use. However, to date, all such studies used noncontingent, experimenter-delivered drug model systems, and the extent to which this effect generalizes to rats trained to self-administer drug is not known. Here, we tested the ability of retigabine (ezogabine), a Kv7 channel opener, to regulate instrumental behavior in male Sprague Dawley rats. We first validated the ability of retigabine to target experimenter-delivered cocaine in a CPP assay and found that retigabine reduced the acquisition of place preference. Next, we trained rats for cocaine-SA under a fixed-ratio or progressive-ratio reinforcement schedule and found that retigabine-pretreatment attenuated the self-administration of low to moderate doses of cocaine. This was not observed in parallel experiments, with rats self-administering sucrose, a natural reward. Compared to sucrose-SA, cocaine-SA was associated with reductions in the expression of the Kv7.5 subunit in the nucleus accumbens, without alterations in Kv7.2 and Kv7.3. Therefore, these studies reveal a reward specific reduction in SA behavior considered relevant for the study of long-term compulsive-like behavior and supports the notion that Kv7 is a potential therapeutic target for human psychiatric diseases with dysfunctional reward circuitry.
PlantC2U: Deep learning of cross-species sequence landscapes predicts plastid C-to-U RNA editing in plants
Authors: Xu Chaoqun , Li Jing , Song Ling-Yu , Guo Ze-Jun , Song Shi-Wei , Zhang Lu-Dan , Zheng Hai-Lei
Published: May 2023

In plants, C-to-U RNA editing is mainly occurred in the plastids and mitochondria transcripts, which contributes to complex transcriptional regulatory network. More evidences reveal that RNA editing plays critical roles in plant growth and development. However, RNA editing sites accurately detected by transcriptome sequencing data alone are still challenging. In the present study, we developed PlantC2U, which is a convolutional neural network to predict plastid C-to-U RNA editing based on the genomic sequence. PlantC2U achieves over 95% sensitivity and 99% specificity, which outperforms random forest and support vector machine. PlantC2U not only further checks RNA editing sites from transcriptome data to reduce the possible false positives, but also assesses the effect of different mutations on C-to-U RNA editing status based on the flanking sequences. Moreover, we found the patterns of tissue-specific RNA editing in mangrove plantKandelia obovata, and observed reduced C-to-U RNA editing rates in cold stress response ofK. obovata, suggesting their potential regulatory roles in the plants stress adaption. In addition, we present RNAeditDB, available online athttps://jasonxu.shinyapps.io/RNAeditDB/. Together, PlantC2U and RNAeditDB would help researchers explore the RNA editing events in plants and thus would be of broad utility for the plant research community.

Highlight

We develop a convolutional neural network based deep learning, PlantC2U program, which help researchers explore the plastids C-to-U RNA editing events in plants and thus would be of broad utility for the plant research community.