bluuebunny/crossref_metadata_2025 huggingface dataset:
Tobramycin and Vancomycin in an In Vitro Model of Anterior Cruciate Ligament Allograft Decontamination
Authors: Bentkowski Brett N. , Blunt Koral M. , Milliron Eric M. , Cavendish Parker A. , Barnes Ryan H. , Kaeding Christopher C. , Magnussen Robert A. , Stoodley Paul , Flanigan David C.
Published: February 2024

Background:

Approximately 100,000 anterior cruciate ligament (ACL) reconstructions (ACLRs) occur annually in the United States, and postoperative surgical-site infection is a relatively rare but devastating complication, often leading to graft failure or septic arthritis of the knee, necessitating repeat surgery. Wrapping allografts in vancomycin-soaked gauze has been adopted as a common sterilization technique in the operating room to reduce surgical-site infection; however, identifying effective alternatives to vancomycin has not been extensively pursued.

Hypothesis:

Tobramycin would be as effective as vancomycin in reducing the concentrations of Staphylococcus epidermidis bacteria on tendon allografts.

Study Design:

Controlled laboratory study.

Methods:

S. epidermidis strain ATCC 12228 was inoculated onto the human cadaveric gracilis tendon. The tendons were wrapped in sterile gauze saturated with tobramycin or vancomycin at various experimental concentrations. Bacteria remaining on the tendon were dislodged, serially diluted, and plated for colony counting. Statistical analysis was performed utilizing 2-way analysis of variance testing. Results were considered statistically significant when P < .05.

Results:

Vancomycin ( P = .0001) and tobramycin ( P < .0001) reduced bacterial concentration. Tobramycin was found to produce a statistically significant reduction in bacterial concentration at concentrations as low as 0.1 mg/mL ( P < .0001 and P = .01 at 10 and 20 minutes), while vancomycin produced a statistically significant reduction at a concentration as low as 2.5 mg/mL ( P < .0001 at both 10 and 20 minutes).

Conclusion:

This study demonstrates that tobramycin is as effective as vancomycin in bacterial concentration reduction but can achieve this reduction level at lower doses. Further studies clarifying the biomechanical and cytotoxic effects of tobramycin on tendon tissue are indicated to solidify its use as a clinical alternative to vancomycin in ACLR.

Clinical Relevance:

These results will begin establishing tobramycin as an alternative to vancomycin in ACL graft decontamination. Because of relatively frequent shortages of vancomycin, establishing tobramycin as an alternative agent is a useful option for the orthopaedic surgeon.
Fast identification of machine tool spindle system temperature rise based on multi-model fusion and improved D-S evidence theory
Authors: Chen Yushen , Fang Chengzhi , Deng Xiaolei , Lin Xiaoliang , Zheng Junjian , Han Yue , Zhou Jianqiang
Published: February 2024

Thermal equilibrium test is the key means to obtain the thermal characteristics of machine tools. In order to shorten the test period and reduce the research and development cost, a novel fast temperature rise identification method for machine tool spindle systems is proposed. The existing prediction identification methods ignore the limitation of the single prediction model, leading to large error fluctuations in different environments. In this study, various intelligent prediction models are combined with the improved D-S evidence theory to improve the accuracy and robustness of the prediction. Firstly, based on the virtual prediction, the evidence identification framework is established through the multiple evaluations of the data information in the evidence segment. Then, the weight allocation of each basic prediction model is carried out by the evidence combination theory. In this process, the evidence identification framework is reconstructed according to the improved strategy to avoid the high conflict problem in classical evidence theory. Finally, the fusion prediction of multiple models can be realized. The VM-850L machining center was selected as the research object for the thermal equilibrium test to evaluate the proposed method. The results show that the proposed multi-model fusion prediction method can accurately predict the temperature rise of selected points in a short time. Moreover, the prediction accuracy is significantly improved compared with the traditional single model. The proposed method has good universality and is expected to be popularized and applied more widely.
Operational Definitions and Structured Instruments for Childhood Emotional Abuse in Clinical Research: A Narrative Review
Authors: Rajan Tess Maria
Published: February 2024

Childhood emotional abuse (CEA) is a highly prevalent but often overlooked area of child mental health research. One of the major hurdles in research in this area is the difficulty in defining emotional abuse (EA) across different cultures. This article aims to review the operational definitions and structured instruments used to assess CEA and to critically analyse the existing lacunae and challenges in this area. Original articles, systematic reviews, and meta-analyses with the objective of assessing emotional abuse in children and adolescent populations were chosen for the study. From the chosen articles, the data pertaining to the definition or structured instrument used to assess CEA was extracted and a narrative review was done. A total of 4 operational definitions and 9 structured instruments were included in the review of the 26 included articles. From this review, as per the author, some of the shortcomings of the available definitions and tools for assessing CEA include a paucity of instruments to assess EA in young children and special populations, the need for consensus on the terminologies used to denote EA, the need for longitudinal studies, the need for culturally appropriate standards for assessment, and also the need to understand the context of EA. A CEA assessment framework has been proposed that includes a longitudinal and qualitative assessment of the subjective experience of the child, which includes the context of EA, so as to plan individualized interventions.
The System of Education as an Instrument of War in the Russia-Instigated Ukrainian Crisis
Authors: Zamkowska Iwona
Published: February 2024

The article examines the impact of the present military conflict in Ukraine on the education of its children. It analyzes the effect of the war on the essential characteristics of education as a human right in four educational settings: on Ukrainian territory, in occupied territory, in reeducation camps in the Russian Federation, and in selected European countries hosting Ukrainian war refugees. Education has been targeted as a potent instrument of war against the future of the Ukrainian nation. The conflict has affected education to varying degrees, from the complete unavailability and inaccessibility of Ukrainian education to low-quality educational services.
Conceptualizing Team Disruption Through an Event-System Framework
Authors: Strizver Sam D. , Ployhart Robert E.
Published: February 2024

The success of work teams is often contingent on how they handle disruption. Although research has examined how teams respond to disruptive events, there is surprisingly little clarity about the nature of team disruption as a construct. Through an integration of Event-System Theory (EST) with team-based theories and frameworks, we define team disruption in terms of misalignment of team member coordination relative to task demands due to shifts in coordination, task demands, or both. We describe how event novelty and criticality create team disruption, and explore the temporal and spatial conditions under which team disruption is promoted or mitigated. The proposed conceptualization of team disruption offers a unifying definition of the construct that complements existing research on team adaptability, membership change, team interventions, and related approaches. The framework offers a way to understand past research in new ways, provides specific directions for future research, and contributes actionable guidance for practice.
Ruptured Saccular Aneurysm Caused by Necrotizing Arteritis of the Polyarteritis Nodosa Type in Primary Angiitis of Central Nervous System
Authors: Matsumoto Toshiharu , Ogura Kanako , Tokugawa Joji , Mitsuhashi Takashi , Hishii Makoto
Published: February 2024

Primary angiitis of central nervous system (PACNS) is a rare idiopathic vasculitis that typically involves small arteries. An 18-year-old woman was operated on for resection of a ruptured aneurysm in a cerebral artery. Multiple aneurysms of cerebral arteries had been detected by neuroimaging examinations since the age of 12, and she had been administered drugs following a diagnosis of PACNS since the age of 15. The resected aneurysm was a ruptured saccular aneurysm occurring in a medium-sized artery. Histologically, necrotizing arteritis of the polyarteritis nodosa (PAN) type was noted in the aneurysmal wall. It consisted of an admixture of acute and healing stages. In the acute stage, fibrinoid necrosis in the intima and media and intense inflammatory cell infiltrate in the entire wall were present. The inflammatory cells mainly consisted of lymphocytes, including plasma cells, neutrophils, and macrophages. In the healing stage, disappearance of fibrinoid necrosis, fibrosis in the intima and media, and scarce inflammatory cells were noted. The acute stage was mainly present near the ruptured site. From these findings, the aneurysm was considered to have been caused by necrotizing arteritis of the PAN type. Although saccular aneurysmal formation in a medium-sized artery is rare in PACNS, an understanding of aneurysms produced by necrotizing arteritis of the PAN type offers useful information for the diagnosis and treatment of PACNS.
Emerging Metropolitan Spaces in Poland and France: Co-creation of New Territorialities Through Institutional Dialogue and Soft Planning
Authors: Mikuła Łukasz , Pyka Robert , Czornik Małgorzata , Thimonier-Rouzet Emmanuel
Published: February 2024

Planning the development of metropolitan areas makes use of various forms of cooperation between associated territorial units. Regardless of the cooperation form adopted, dialogue is a factor that significantly facilitates solving spatial problems and gaining social acceptance for the selection of project locations. Its characteristics, including content, course, and participants, additionally determine the specificity of governance in a particular metropolis. The article aims to suggest a study of the emergence and improvement of an institutional dialogue and soft planning by comparing the experiences of selected Polish and French metropolitan areas. They represent different approaches to the use of dialogue in emerging metropolitan spaces resulting from different legal conditions, the length of time it takes for units to integrate, and the scale and orientation of strategic or operational interconnections.
Men’s Depression and Anxiety: Contributing Factors and Barriers to Intervention
Authors: Molewyk Doornbos Mary , Zandee Gail Landheer
Published: February 2024

BACKGROUND:

Urban, ethnically/racially diverse, impoverished men are predisposed to experience unaddressed depression and anxiety. The overlap of these factors creates significant mental health inequity.

AIMS:

This study sought to capture men’s impressions of the factors that contributed to their experience of depression and anxiety as well as barriers that they experienced in pursuing intervention.

METHODS:

Using community-based participatory research, in the context of long-term partnerships between a department of nursing and three urban, racially/ethnically diverse, and impoverished neighborhoods, the researchers recruited 50 men ages 23–83 years. Data were collected via six homogeneous, Zoom-based focus groups composed of Black, Hispanic, and White men, respectively.

RESULTS:

The men identified multiple themes pertaining to modifiable and non-modifiable contributing factors that played a role in their development of depression and anxiety as well as barriers related to stigma, resource issues, and a lack of knowledge of mental illness that they faced when seeking intervention.

CONCLUSIONS:

Understanding men’s perspectives on the contributing factors and barriers to mental health intervention can provide an evidence base with which to address mental health inequity via tailored care, policy, and research agendas.
The use of linked administrative data in Australian randomised controlled trials: A scoping review
Authors: Fahridin Salma , Agarwal Neeru , Bracken Karen , Law Stephen , Morton Rachael L
Published: February 2024

Background/Aims:

The demand for simplified data collection within trials to increase efficiency and reduce costs has led to broader interest in repurposing routinely collected administrative data for use in clinical trials research. The aim of this scoping review is to describe how and why administrative data have been used in Australian randomised controlled trial conduct and analyses, specifically the advantages and limitations of their use as well as barriers and enablers to accessing administrative data for use alongside randomised controlled trials.

Methods:

Databases were searched to November 2022. Randomised controlled trials were included if they accessed one or more Australian administrative data sets, where some or all trial participants were enrolled in Australia, and where the article was published between January 2000 and November 2022. Titles and abstracts were independently screened by two reviewers, and the full texts of selected studies were assessed against the eligibility criteria by two independent reviewers. Data were extracted from included articles by two reviewers using a data extraction tool.

Results:

Forty-one articles from 36 randomised controlled trials were included. Trial characteristics, including the sample size, disease area, population, and intervention, were varied; however, randomised controlled trials most commonly linked to government reimbursed claims data sets, hospital admissions data sets and birth/death registries, and the most common reason for linkage was to ascertain disease outcomes or survival status, and to track health service use. The majority of randomised controlled trials were able to achieve linkage in over 90% of trial participants; however, consent and participant withdrawals were common limitations to participant linkage. Reported advantages were the reliability and accuracy of the data, the ease of long term follow-up, and the use of established data linkage units. Common reported limitations were locating participants who had moved outside the jurisdictional area, missing data where consent was not provided, and unavailability of certain healthcare data.

Conclusions:

As linked administrative data are not intended for research purposes, detailed knowledge of the data sets is required by researchers, and the time delay in receiving the data is viewed as a barrier to its use. The lack of access to primary care data sets is viewed as a barrier to administrative data use; however, work to expand the number of healthcare data sets that can be linked has made it easier for researchers to access and use these data, which may have implications on how randomised controlled trials will be run in future.
A Qualitative Study on the Socialization and Transitions of Early College High School Graduates in Texas
Authors: Cuellar Stephanie , Allen Taryn Ozuna
Published: February 2024

Early College High Schools (ECs) are growing in popularity as an affordable avenue for students to obtain up to an associate's degree while in high school in Texas. Using Merton's (1966) Anticipatory Socialization Theory, this study investigated how ECs shaped 13 graduates’ social behaviors and norms while in high school, and then how they leveraged those behaviors in their transition to college. Results indicate that while ECs proved to be a supportive environment with nurturing teachers, these programs deemphasized social activities, leading to varying preparation of the social skills necessary for college fully. Recommendations for practice and future research are provided.
Atrio-oesophageal fistula after radiofrequency ablation of atrial fibrillation misinterpreted as COVID-19 infection
Authors: Stöllberger Claudia , Finsterer Josef
Published: February 2024

Awareness of the various clinical manifestations and diagnostic pitfalls in patients with atrio-oesophageal fistula is necessary among healthcare professionals.
Design of a Workshop for Focused Transesophageal Echocardiography During Noncardiac Surgery in Nurse Anesthesia Education
Authors: Swerdlow Barry , Osborne-Smith Lisa , Soelberg Julie
Published: February 2024

OBJECTIVE

The use of transesophageal echocardiography (TEE) by certified registered nurse anesthetists (CRNAs) during noncardiac surgery is relatively uncommon despite its unique potential to diagnose causes of hemodynamic instability. To address this problem, educational endeavors designed to provide practical TEE skills to CRNAs are needed. The aim of the current study was to evaluate the feasibility, acceptability, efficacy, and utility of a 2-day focused TEE workshop in nurse anesthesia education that employed a protocol involving a limited number of views and used goal-directed, qualitative assessments of critical physiologic parameters.

METHODS

This was a prospective, observational study involving 14 second-year nurse anesthesia students. The cohort was evaluated following completion of this workshop by simulator-based testing involving hypothetical clinical scenarios, and this test data was analyzed according to the percent successful acquisition and interpretation of TEE views to determine immediate objective teaching efficacy. The acceptability, perceived efficacy, and perceived utility of the workshop were assessed by online survey, and survey responses were qualitative and quantitative in nature.

RESULTS

Participants acquired appropriate TEE views associated with clinical scenarios 99% of the time and correctly interpreted the pathology in those views 93% of the time. Participants uniformly perceived significant educational value in this workshop and intend to incorporate TEE in their future clinical practice.

CONCLUSIONS

A 2-day workshop to teach focused TEE to nurse anesthesia trainees directed by a streamlined protocol is feasible, acceptable, and perceived as useful by participants, and provides practical experience and entry-level competency in this point-of-care ultrasound modality.
A Taxonomy of Project Management Offices and Their Organizational Project Management Landscapes
Authors: Müller Ralf , Wang Linzhuo
Published: February 2024

Organizational project management (OPM) integrates project-related activities in organizations, including project management offices (PMOs) and their services. Using an organizational design perspective, this study models nine different PMO service delivery categories along scope, frequency, and delivery entity and identifies their particular OPM contexts (i.e., landscapes). Two hundred and sixty-five responses to a global survey identified nine types of OPM landscapes, grouped into three regions, with their particular logic of investment in OPM and their particular PMO service mix. The framework helps practitioners set up their PMOs in line with established practices. Academics benefit from a base for theorizing organizational designs using OPM.
It Takes Two to Tango: The Interactive Effect of Project Portfolio Management Offices and Voice Behavior on Project Portfolio Management Quality and Business Success
Authors: Kock Alexander , Ekrot Bastian , Gemünden Hans Georg
Published: February 2024

Despite abundant research on project management offices and project portfolio management offices (PPMOs), it is still unclear whether PPMOs contribute to business success. This study explores the role of employee voice behavior in the relationship between PPMOs and business success. The findings from 255 portfolios reveal that PPMO contributions and voice behavior positively relate to management quality, which subsequently relates to business success. Moreover, voice behavior enhances the relationships among PPMO contributions, management quality, and business success. These results have important implications for research on voice behavior in a multiproject context and for understanding PPMOs’ performance and social dynamics.
Genome-wide identification and analysis of WD40 proteins reveal that NtTTG1 enhances drought tolerance in tobacco (Nicotiana tabacum)
Authors: Meng Lijun , Su Huan , Qu Zechao , Lu Peng , Tao Jiemeng , Li He , Zhang Jianfeng , Zhang Wei , Liu Nan , Cao Peijian , Jin Jingjing
Published: February 2024

Background

WD40 proteins, which are highly prevalent in eukaryotes, play important roles in plant development and stress responses. However, systematic identification and exploration of WD40 proteins in tobacco have not yet been conducted.

Results

In this study, a total of 399 WD40 regulatory genes were identified in common tobacco (Nicotiana tabacum). Gene structure and motif analysis revealed structural and functional diversity among different clades of tobacco WD40 regulatory genes. The expansion of tobacco WD40 regulatory genes was mainly driven by segmental duplication and purifying selection. A potential regulatory network of NtWD40s suggested that NtWD40s might be regulated by miRNAs and transcription factors in various biological processes. Expression pattern analysis via transcriptome analysis and qRT-PCR revealed that many NtWD40s exhibited tissue-specific expression patterns and might be involved in various biotic and abiotic stresses. Furthermore, we have validated the critical role of NtTTG1, which was located in the nuclei of trichome cells, in enhancing the drought tolerance of tobacco plants.

Conclusions

Our study provides comprehensive information to better understand the evolution of WD40 regulatory genes and their roles in different stress responses in tobacco.
Stage II oesophageal carcinoma: peril in disguise associated with cellular reprogramming and oncogenesis regulated by pseudogenes
Authors: Pravallika Govada , Rajasekaran Ramalingam
Published: February 2024

Introduction

Pseudogenes have been implicated for their role in regulating cellular differentiation and organismal development. However, their role in promoting cancer-associated differentiation has not been well-studied. This study explores the tumour landscape of oesophageal carcinoma to identify pseudogenes that may regulate events of differentiation to promote oncogenic transformation.

Materials and method

De-regulated differentiation-associated pseudogenes were identified using DeSeq2 followed by ‘InteractiVenn’ analysis to identify their expression pattern. Gene expression dependent and independent enrichment analyses were performed with GSEA and ShinyGO, respectively, followed by quantification of cellular reprogramming, extent of differentiation and pleiotropy using three unique metrics. Stage-specific gene regulatory networks using Bayesian Network Splitting Average were generated, followed by network topology analysis. MEME, STREME and Tomtom were employed to identify transcription factors and miRNAs that play a regulatory role downstream of pseudogenes to initiate cellular reprogramming and further promote oncogenic transformation. The patient samples were stratified based on the expression pattern of pseudogenes, followed by GSEA, mutation analysis and survival analysis using GSEA, MAF and ‘survminer’, respectively.

Results

Pseudogenes display a unique stage-wise expression pattern that characterizes stage II (SII) ESCA with a high rate of cellular reprogramming, degree of differentiation and pleiotropy. Gene regulatory network and associated topology indicate high robustness, thus validating high pleiotropy observed for SII. Pseudogene-regulated expression of SOX2, FEV, PRRX1 and TFAP2A in SII may modulate cellular reprogramming and promote oncogenesis. Additionally, patient stratification-based mutational analysis in SII signifies APOBEC3A (A3A) as a potential hallmark of homeostatic mutational events of reprogrammed cells which in addition to de-regulated APOBEC3G leads to distinct events of hypermutations. Further enrichment analysis for both cohorts revealed the critical role of combinatorial expression of pseudogenes in cellular reprogramming. Finally, survival analysis reveals distinct genes that promote poor prognosis in SII ESCA and patient-stratified cohorts, thus providing valuable prognostic bio-markers along with markers of differentiation and oncogenesis for distinct landscapes of pseudogene expression.

Conclusion

Pseudogenes associated with the events of differentiation potentially aid in the initiation of cellular reprogramming to facilitate oncogenic transformation, especially during SII ESCA. Despite a better overall survival of SII, patient stratification reveals combinatorial de-regulation of pseudogenes as a notable marker for a high degree of cellular differentiation with a unique mutational landscape.
Integrated metabolome and transcriptome analysis of differences in quality of ripe Lycium barbarum L. fruits harvested at different periods
Authors: Liu Deshuai , Yuan Miao , Wang Ye , Zhang Li , Yao Wenkong , Feng Mei
Published: February 2024

Background

Wolfberry is well-known for its high nutritional value and medicinal benefits. Due to the continuous ripening nature of Goji berries and the fact that they can be commercially harvested within a few weeks, their phytochemical composition may change during the harvesting process at different periods.

Result

The involved molecular mechanisms of difference in fruit quality of ripe Lycium barbarum L. harvested at four different periods were investigated by transcriptomic and metabolomics analyses for the first time. According to the results we obtained, it was found that the appearance quality of L. barbarum fruits picked at the beginning of the harvesting season was superior, while the accumulation of sugar substances in L. barbarum fruits picked at the end of the harvesting season was better. At the same time the vitamin C and carotenoids content of wolfberry fruits picked during the summer harvesting season were richer. Ascorbic acid, succinic acid, glutamic acid, and phenolic acids have significant changes in transcription and metabolism levels. Through the network metabolic map, we found that ascorbic acid, glutamic acid, glutamine and related enzyme genes were differentially accumulated and expressed in wolfberry fruits at different harvesting periods. Nevertheless, these metabolites played important roles in the ascorbate–glutathione recycling system. Ascorbic acid, phenolic substances and the ascorbate–glutathione recycling system have antioxidant effects, which makes the L. barbarum fruits harvested in the summer more in line with market demand and health care concepts.

Conclusion

This study laid the foundation for understanding the molecular regulatory mechanisms of quality differences of ripe wolfberry fruits harvested at different periods, and provides a theoretical basis for enhancing the quality of L. barbarum fruits.
Ultrasound-guided caudal anaesthesia combined with epidural anaesthesia for caesarean section: a randomized controlled clinical trial
Authors: Wang Fangjun , Lü Qi , Wang Min , Xu Hongchun , Xie Dan , Yang Zheng , Ye Qin
Published: February 2024

Background

Although epidural anaesthesia and spinal anaesthesia are currently the general choices for patients undergoing caesarean section, these two neuraxial anaesthesia methods still have drawbacks. Caudal anaesthesia has been considered to be more appropriate for gynaecological surgery. The purpose of this study was to compare epidural anaesthesia combined with caudal anaesthesia, spinal anaesthesia and single-space epidural anaesthesia for caesarean section with respect to postoperative comfort and intraoperative anaesthesia quality.

Methods

In this clinical trial, 150 patients undergoing elective caesarean section were recruited and randomized into three groups according to a ratio of 1:1:1to receive epidural anaesthesia only, spinal anaesthesia only or epidural anaesthesia combined with caudal anaesthesia. The primary outcome was postoperative comfort in the three groups. Secondary outcomes included intraoperative anaesthesia quality and the incidences of nausea, vomiting, postdural puncture headache, maternal bradycardia, or hypotension.

Results

More patients were satisfied with the intraoperative anaesthesia quality in the EAC group than in the EA group (P = 0.001). The obstetrician was more significantly satisfied with the intraoperative anaesthesia quality in the SA and EAC groups than in the EA group (P = 0.004 and 0.020, respectively). The parturients felt more comfortable after surgery in the EA and EAC groups (P = 0.007). The incidence of maternal hypotension during caesarean section was higher in the SA group than in the EA and EAC groups (P = 0.001 and 0.019, respectively).

Conclusions

Epidural anaesthesia combined with caudal anaesthesia may be a better choice for elective caesarean section. Compared with epidural anaesthesia and spinal anaesthesia, it has a higher quality of postoperative comfort and intraoperative anaesthesia.
Exploring the link between pediatric headaches and environmental noise exposure
Authors: Lee Sunho , Kim Kyung-Ran , Lee Wanhyung
Published: February 2024

Background

Headaches are the most common neurologic symptoms in the pediatric population. Most primary headache in children and adolescents focuses on associated factors, including noise. Auditory discomfort is related to recognizing the pain. We aimed to analyze the headache profile of pediatric populations and the connection between noise exposure and head pain in children and adolescents.

Methods

We reviewed retrospectively medical records of the pediatric population with headaches in Gyeongsang National University Changwon Hospital from January 2022 to April 2023. Personal headache profiling from self-questionnaires and environmental noise data from the National Noise Information System (NNIS) were used to analyze each variable, and chi-square tests and linear regression models by SAS were used to analyze the statistical correlation.

Results

Of the 224 participants, 125 were clinically diagnosed with headaches. Of the 104 pubertal subjects, 56.7% were diagnosed with headaches, compared to 60% in the prepubertal group. Both daytime and nighttime noise was significantly higher in the diagnosed headache group than in the non-diagnosed group. Headache duration increased by daytime and nighttime noise with statistical significance in age-adjusted models.

Conclusion

We found that noise exposure is correlated to headaches in children and adolescents. Daytime and nighttime environmental noise exposure was significantly associated with the duration of headaches through our data. Therefore, we assume that noise exposure is vitally relevant to prolonged headaches in the pediatric population. Further research is needed to improve our data.
A case of neonatal tsutsugamushi disease diagnosed with the aid of rickettsial macrogenomic detection
Authors: Yang Xu , Zhang Ling , Chen Shanping , Chen Wei , Zhang Yushan , Zhang Yi , Liang Jialong , Lv Ying , Wang Weiyan , Zhou Yini , Huang Rui , Pan Dongju , Li Xueyu , Li Qiurong
Published: February 2024

Background

Tsutsugamushi, also known as bush typhus, is a naturally occurring disease caused by Orientia tsutsugamushi. We reported a case of vertical mother-to-newborn transmission of Orientia tsutsugamushi infection in a newborn from Yunnan (China).

Case presentation

Decreased fetal movements were observed at 39 weeks of gestation. After birth, the newborn (female) had recurrent fever, shortness of breath, and bruising around the mouth and extremities. At 5 h 58 min of age, the newborn was admitted for fever, shortness of breath and generalized rash. The liver was palpable 3 cm below the costal margin, and the limbs showed pitting edema. There was subcutaneous bleeding. Investigations suggested heavy infection, myocardial damage, decreased platelets. Treatment with cefotaxime and ampicillin failed. The mother was hospitalized at 29 weeks of gestation with a fever for 4 consecutive days, and an ulcerated crust was found in the popliteal fossa. Due to this pregnancy history, A diagnosis of Orientia tsutsugamushi infection was suspected in our index case and confirmed by macrogenomic testing and she was treated with vancomycin and meropenem, and later azithromycin for 1 week. The newborn was discharged in good general condition, gradually normalizing body temperature, and decreasing rash and jaundice. There were no abnormalities on subsequent blood macrogenomic tests for the baby. And one month later she showed good mental health, sleep, and food intake and no fever, rash, or jaundice.

Conclusion

Determining the cause of symptoms is the key to treating diseases, especially the rare diseases that can be misdiagnosed.

Suitable for people with

Infectious Diseases; Neonatology; Obstetrics.
The effect of screw orientation on internal fixation of Letenneur type II Hoffa fractures: a biomechanics study
Authors: Liu Jialun , Lu Zhe , Zheng Zhanle
Published: February 2024

Background

To investigate the biomechanical effects of screw orientation and fracture block size on the internal fixation system for Letenneur type II Hoffa fractures.

Methods

The fracture models were randomly divided into six groups according to the fracture subtypes and the direction of nail placement, and a plumb line of the posterior condylar tangent was made across the base of the posterior femoral condyle. The fracture blocks of the three types of fracture were calculated and recorded in the sagittal position, and the biomechanical performance of the six groups was evaluated by biomechanical tests. The axial load on the fracture block at a displacement of 2 mm was set as the failure load, a gradually increasing axial load was applied to each fracture model using a customized indenter at a load of 250-750 N, and the displacements and failure loads of the six groups were recorded at different axial loads.

Results

Biomechanical test results showed that the larger the fracture block, the greater was the stability when nailing from front to back, and the smaller the fracture block, the greater was the strength when nailing from back to front (p < 0.001). As the fracture block became larger, the biomechanical advantage of nailing from posterior to anterior decreased.The displacement under 250 N load were 1.351 ± 0.113 mm, 1.465 ± 0.073 mm for Group IIa AP and Group IIa PA. The displacement under 500 N load were 2.596 ± 0.125 mm, 2.344 ± 0.099 mm for Group IIa AP and Group IIa PA. The displacement under 750 N load were 3.997 ± 0.164, 3.386 ± 0.125 mm for Group IIa AP and Group IIa PA. The failure loads were 384 ± 14 N, 415 ± 19 N for Group IIa AP and Group IIa PA. In the type IIa fracture group, the difference was no longer significant (p > 0.001). Therefore, there is a mechanical threshold that ranges from 38.36 to 52.33% between type IIa and type IIb fractures.

Conclusions

The effect of the nailing direction on the strength of fixation has a fracture-block critical point, which is consistent overall with the trend that the larger the fracture block is, the greater the stability when nailing from anterior to posterior, and the smaller the fracture block is, the greater the strength when nailing from posterior to anterior.
Root canal morphology of anterior permanent teeth in Jordanian population using two classification systems: a cone-beam computed tomography study
Authors: Taha Nessrin A , Makahleh Nisrein , Hatipoglu Fatma Pertek
Published: February 2024

Background

Adequate knowledge of root canal morphology and its variation is essential for success of root canal treatment and to overcome treatemnt failure. The aim of this study was to investigate the root and canal morphology of mandibular anterior teeth using 2 classification systems.

Methods

3342 lower anteriors were evaluated from 557 CBCT scans. The images were examined in sagittal, axial and coronal views using a CS 3D imaging software (V3.10.4, Carestream Dental). Demographic data recorded, the number of roots and canal’s morphology were described according to Vertucci and Ahmed classifications.

Results

Frequency of Type I configuration was significantly the highest in incisors and canines (76%, N = 2539), followed by Type III (20.6%, N = 687). Type II (1.1%, N = 37), IV (1.1%, N = 37), and V (0.3%, N = 11) were rarely encountered. 0.9% (N = 31) of the teeth could not be classified with the Vertucci System. The frequency of 2 roots (2MA in Ahmed classification) which has no correspondence in the Vertucci classification, was 1.1% (N = 38), it was significantly higher in canines and in females (35 canines and 3 laterals). A moderate correlation in root canal morpology was found between the left and right sides (V > 0.30). 80% (N = 2538) of the teeth did not exhibit any divergence/merging. The bifurcation level occurred mostly in the middle third of the root.

Conclusions

One fourth of anterior teeth had variation from the simple type I canal configuration and therefore requires attention during treatment. The new classification system offers a more accurate and simplified presentation of canal morphology.

Clinical relevance

The prevalence and mid root bifurcation of second canal in lower anteriors requires attention to ensure adequate quality root canal treatment without compromising the integrity of teeth.
Genetic analysis and molecular basis of G6PD deficiency among malaria patients in Thailand: implications for safe use of 8-aminoquinolines
Authors: Boonyuen Usa , Jacob Beatriz Aira C. , Wongwigkan Jutamas , Chamchoy Kamonwan , Singha-art Natsamon , Pengsuk Natnicha , Songdej Duantida , Adams Emily R. , Edwards Thomas , Chamnanchanunt Supat , Amran Syazwani Itri , Latif Nurriza Ab , Louis Naveen Eugene , Chandran Shamini
Published: February 2024

Background

It was hypothesized that glucose-6-phosphate dehydrogenase (G6PD) deficiency confers a protective effect against malaria infection, however, safety concerns have been raised regarding haemolytic toxicity caused by radical cure with 8-aminoquinolines in G6PD-deficient individuals. Malaria elimination and control are also complicated by the high prevalence of G6PD deficiency in malaria-endemic areas. Hence, accurate identification of G6PD deficiency is required to identify those who are eligible for malaria treatment using 8-aminoquinolines.

Methods

The prevalence of G6PD deficiency among 408 Thai participants diagnosed with malaria by microscopy (71), and malaria-negative controls (337), was assessed using a phenotypic test based on water-soluble tetrazolium salts. High-resolution melting (HRM) curve analysis was developed from a previous study to enable the detection of 15 common missense, synonymous and intronic G6PD mutations in Asian populations. The identified mutations were subjected to biochemical and structural characterisation to understand the molecular mechanisms underlying enzyme deficiency.

Results

Based on phenotypic testing, the prevalence of G6PD deficiency (< 30% activity) was 6.13% (25/408) and intermediate deficiency (30–70% activity) was found in 15.20% (62/408) of participants. Several G6PD genotypes with newly discovered double missense variants were identified by HRM assays, including G6PD Gaohe + Viangchan, G6PD Valladolid + Viangchan and G6PD Canton + Viangchan. A significantly high frequency of synonymous (c.1311C>T) and intronic (c.1365-13T>C and c.486-34delT) mutations was detected with intermediate to normal enzyme activity. The double missense mutations were less catalytically active than their corresponding single missense mutations, resulting in severe enzyme deficiency. While the mutations had a minor effect on binding affinity, structural instability was a key contributor to the enzyme deficiency observed in G6PD-deficient individuals.

Conclusions

With varying degrees of enzyme deficiency, G6PD genotyping can be used as a complement to phenotypic screening to identify those who are eligible for 8-aminoquinolines. The information gained from this study could be useful for management and treatment of malaria, as well as for the prevention of unanticipated reactions to certain medications and foods in the studied population.
Body mass index is associated with health-related quality of life and disease characteristics in young adults with juvenile idiopathic arthritis
Authors: Tuomi Anna-Kaisa , Rebane Katariina , Arnstad Ellen Dalen , Berntson Lillemor , Fasth Anders , Glerup Mia , Herlin Troels , Kautiainen Hannu , Nordal Ellen , Peltoniemi Suvi , Rygg Marite , Rypdal Veronika , Zak Marek , Aalto Kristiina
Published: February 2024

Background

There is a growing interest concerning the relationship between obesity and several medical conditions and inflammation. Nevertheless, there is a lack of studies regarding body mass index (BMI) among patients with juvenile idiopathic arthritis (JIA). Our aim was to investigate the impact of BMI on health-related quality of life (HRQoL) measured with a 36-Item Short Form Survey (SF-36), disease activity, and disability in young adults with JIA.

Methods

This study is a part of the population-based Nordic JIA cohort study. All newly diagnosed patients with JIA were recruited consecutively between 1997–2000 in specific regions in the Nordic countries. Patients in this sub-study were enrolled from 434 patients who attended their 18-year follow-up visit. Patients were classified according to the World Health Organization (WHO) into four groups based on their BMI. HRQoL, disease characteristics, disability, fatigue, sleep quality, physical activity, pain, comorbidities, and social status were assessed.

Results

Three hundred fifty-five patients from the original study cohort were enrolled in this study and 72% of them were female. Mean age was 23.9 (± SD 4.4) years. A significant relationship was found between the JIA categories and BMI groups (p = 0.014). A significant relationship was also found between BMI and disease activity scores (DAS28) (p = 0.028), disability (p < 0.001), pain (p = 0.013), fatigue (p = 0.035), and sleep quality (p = 0.044). Moreover, a significant relationship between BMI and HRQoL regarding bodily pain (p = 0.010) and general health (p = 0.048) was revealed when adjusted for sex, age, and JIA subtype.

Conclusion

We discovered that BMI was significantly related to HRQoL, disease activity, and disability. BMI deserves more attention considering the treatment options and outcome of JIA in young adults.
Ensemble learning-assisted prediction of prolonged hospital length of stay after spine correction surgery: a multi-center cohort study
Authors: Li Wenle , Zhang Yusi , Zhou Xin , Quan Xubin , Chen Binghao , Hou Xuewen , Xu Qizhong , He Weiheng , Chen Liang , Liu Xiaozhu , Zhang Yang , Xiang Tianyu , Li Runmin , Liu Qiang , Wu Shi-Nan , Wang Kai , Liu Wencai , Zheng Jialiang , Luan Haopeng , Yu Xiaolin , Chen Anfa , Xu Chan , Luo Tongqing , Hu Zhaohui
Published: February 2024

Purpose

This research aimed to develop a machine learning model to predict the potential risk of prolonged length of stay in hospital before operation, which can be used to strengthen patient management.

Methods

Patients who underwent posterior spinal deformity surgery (PSDS) from eleven medical institutions in China between 2015 and 2022 were included. Detailed preoperative patient data, including demographics, medical history, comorbidities, preoperative laboratory results, and surgery details, were collected from their electronic medical records. The cohort was randomly divided into a training dataset and a validation dataset with a ratio of 70:30. Based on Boruta algorithm, nine different machine learning algorithms and a stack ensemble model were trained after hyperparameters tuning visualization and evaluated on the area under the receiver operating characteristic curve (AUROC), precision-recall curve, calibration, and decision curve analysis. Visualization of Shapley Additive exPlanations method finally contributed to explaining model prediction.

Results

Of the 162 included patients, the K Nearest Neighbors algorithm performed the best in the validation group compared with other machine learning models (yielding an AUROC of 0.8191 and PRAUC of 0.6175). The top five contributing variables were the preoperative hemoglobin, height, body mass index, age, and preoperative white blood cells. A web-based calculator was further developed to improve the predictive model's clinical operability.

Conclusions

Our study established and validated a clinical predictive model for prolonged postoperative hospitalization duration in patients who underwent PSDS, which offered valuable prognostic information for preoperative planning and postoperative care for clinicians.

Trial registration ClinicalTrials.gov identifier NCT05867732, retrospectively registered May 22, 2023, https://classic.clinicaltrials.gov/ct2/show/NCT05867732.
PDK4 inhibits osteoarthritis progression by activating the PPAR pathway
Authors: Li Zhengnan , Xie Lifeng , Zeng Hui , Wu Yaohong
Published: February 2024

Background

Osteoarthritis (OA) is a degenerative joint disease caused by the deterioration of cartilage. However, the underlying mechanisms of OA pathogenesis remain elusive.

Methods

Hub genes were screened by bioinformatics analysis based on the GSE114007 and GSE169077 datasets. The Sprague–Dawley (SD) rat model of OA was constructed by intra-articular injection of a mixture of papain and L-cysteine. Hematoxylin–eosin (HE) staining was used to detect pathological changes in OA rat models. Inflammatory cytokine levels in serum were measured employing the enzyme-linked immunosorbent assay (ELISA). The reverse transcription quantitative PCR (RT-qPCR) was implemented to assess the hub gene expressions in OA rat models. The roles of PDK4 and the mechanism regulating the PPAR pathway were evaluated through western blot, cell counting kit-8 (CCK-8), ELISA, and flow cytometry assays in C28/I2 chondrocytes induced by IL-1β.

Results

Six hub genes were identified, of which COL1A1, POSTN, FAP, and CDH11 expressions were elevated, while PDK4 and ANGPTL4 were reduced in OA. Overexpression of PDK4 inhibited apoptosis, inflammatory cytokine levels (TNF-α, IL-8, and IL-6), and extracellular matrix (ECM) degradation protein expressions (MMP-3, MMP-13, and ADAMTS-4) in IL-1β-induced chondrocytes. Further investigation revealed that PDK4 promoted the expression of PPAR signaling pathway-related proteins: PPARA, PPARD, and ACSL1. Additionally, GW9662, an inhibitor of the PPAR pathway, significantly counteracted the inhibitory effect of PDK4 overexpression on IL-1β-induced chondrocytes.

Conclusion

PDK4 inhibits OA development by activating the PPAR pathway, which provides new insights into the OA management.