bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward interpretable and generalized mitosis detection in digital pathology using deep learning
Authors: Farooq Hasan , Saleem Saira , Aleem Iffat , Iftikhar Ayesha , Sheikh Umer Nisar , Naveed Hammad
Published: May 2024

Objective

The mitotic activity index is an important prognostic factor in the diagnosis of cancer. The task of mitosis detection is difficult as the nuclei are microscopic in size and partially labeled, and there are many more non-mitotic nuclei compared to mitotic ones. In this paper, we highlight the challenges of current mitosis detection pipelines and propose a method to tackle these challenges.

Methods

Our proposed methodology is inspired from recent research on deep learning and an extensive analysis on the dataset and training pipeline. We first used the MiDoG′22 dataset for training, validation, and testing. We then tested the methodology without fine-tuning on the TUPAC′16 dataset and on a real-time case from Shaukat Khanum Memorial Cancer Hospital and Research Centre.

Results

Our methodology has shown promising results both quantitatively and qualitatively. Quantitatively, our methodology achieved an F1-score of 0.87 on the MiDoG'22 dataset and an F1-score of 0.83 on the TUPAC dataset. Qualitatively, our methodology is generalizable and interpretable across various datasets and clinical settings.

Conclusion

In this paper, we highlight the challenges of current mitosis detection pipelines and propose a method that can accurately predict mitotic nuclei. We illustrate the accuracy, generalizability, and interpretability of our approach across various datasets and clinical settings. Our methodology can speed up the adoption of computer-aided digital pathology in clinical settings.
Assessing the impact of message relevance and frequency on physical activity change: A secondary data analysis from the random AIM trial
Authors: Wu Jingchuan , Brunke-Reese Deborah , Lagoa Constantino M , Conroy David E
Published: May 2024

Text messages are widely used to deliver intervention content; however, sending more intensive messages may not always improve behavioral outcomes. This study investigated whether message frequency was associated with daily physical activity, either by itself or in interaction with message content relevance. Healthy but insufficiently active young adults (aged 18–29 years) wore Fitbit activity trackers and received text messages for 180 days. Message frequencies varied daily at random, and messages were sent from three content libraries (40% Move More, 40% Sit Less, 20% Inspirational Quotes). Contrary to expectations, the results revealed a null association between total daily text message frequency and physical activity, both for daily step counts and moderate-to-vigorous physical activity (MVPA) duration. Additional analyses revealed that the daily frequency of messages with relevant content (i.e. Move More, Sit Less) was not associated with physical activity, but the daily frequency of messages with irrelevant content (i.e. Inspirational Quotes) was negatively associated with physical activity. We concluded that the effectiveness of text messages in promoting physical activity is impacted by the combination of content relevance and frequency, with frequent irrelevant messages potentially decreasing activity levels. This study suggests that irrelevant message frequency can negatively impact physical activity, highlighting the risks of delivering irrelevant content in digital health interventions.
Toward a Datafied Mindset: Conceptualizing Digital Dynamics and Analogue Resilience
Authors: Figueiras Rita , Bolin Göran , Kalmus Veronika
Published: May 2024

This article explores the ways in which what we call the analogue and the datafied mindsets perceive the functioning of the datafied world. Based on a qualitative interview study of two generations of media users in Estonia, Portugal, and Sweden, we present and analyze underlying patterns in participants’ media attitudes and related practices. We show that belonging to a media generation does not always produce a homogeneous mindset or a uniform attitude toward media technologies. These mindsets, being ideal-typical constructs, are not bound to individuals: the same person can display features of the analogue and the datafied mindset in relation to different parts of the datafied world. One mindset does not replace the other but rather adds another layer to the social action of the individuals. The mindsets are multi-dimensional and molded by contrasting understandings, indicating that the tenacious structures of the analogue world linger on in the datafied social space.
Diverse pathways from adolescence to early adulthood among China's rural youth: A new perspective
Authors: Feng Kai , Hannum Emily
Published: May 2024

Past studies examining the transition to adulthood within the Chinese context often implicitly or explicitly assume that the rural population is a homogeneous group and suggest that rural individuals tend to enter the workforce and marry at younger ages than their urban peers. This assumption overlooks the distinct challenges faced by rural youth, who often confront higher poverty risks and greater uncertainties compared to urban counterparts, yet empirical research on these unique challenges is limited. Using both a national survey and a unique longitudinal sample of rural youth in one of the poorest regions of China, this study demonstrates that rural youth experience a greater diversity of pathways from adolescence to early adulthood than do urban youth, which contradicts many earlier studies in Western contexts. In addition, this study identifies a variety of childhood environment factors that structure the transition pathways of rural youth. This study highlights the growing rural–urban disparity in China and has important implications for research on social stratification and rural youth development.
Tribal Communities, Their Quality of Life and the Differences: Evidence from an India District
Authors: Debnath Priyanka , Debnath Angana , Chakrabarti Kaustav , Roy Piyal Basu , Sarkar Abhijit
Published: May 2024

The history of quality of life (QoL) of the tribal population in India is mostly oral and not well documented. The only known fact is that they used to live within the forest and struggle for their existence. This study aims to investigate the QoL of the major tribal communities in Alipurduar—a forest endowed district in Eastern India—and analyse the differences in their QoL to provide a comprehensive understanding of the socio-economic issues encountered by tribal communities who have been living in a geographically disadvantageous area endowed with tea plantations and forests. Five tribal communities, namely Mech, Santhal, Oraon, Toto and Rabha, were selected from Alipurduar district, West Bengal, for the study, with a total of 384 samples. The WHOQOL-BREF (1996) questionnaire was used to assess the QoL of the mentioned tribal communities. Factorial analysis of variance (ANOVA) was employed to analyse the data to find out the difference in QoL among different tribal communities. The study findings indicate that there is a significant positive correlation between the different domains of QoL, including physical health, psychological health, social relationships and environmental conditions. The ANOVA results demonstrate significant differences in QoL among different tribal communities. The results show that the Toto tribe has enjoyed a higher QoL (M = 3.87, SD = 0.763) compared to other tribal groups, while the people of Oraon tribe have reported a lower QoL (M = 3.10, SD =1.065). Therefore, longitudinal studies need be conducted to get a more comprehensive understanding of the factors influencing their QoL to identify the reasons for the differences. Additionally, the government needs to understand the problems of each tribe and, accordingly, appropriate policies need to be implemented in a timely manner to improve the QoL of different tribal communities and, thus, minimise the differences and bring a balanced way of life.
The Role of the Hip Capsule in Restoring Stability in the Initial Phase of Hip Distraction: An In Vivo Analysis
Authors: Mortensen Alexander J. , Featherall Joseph , Metz Allan K. , Rosenthal Reece M. , O’Neill Dillon C. , Froerer Devin L. , Khalil Ameen Z. , Tomasevich Kelly M. , Aoki Stephen K.
Published: May 2024

Background:

The labral suction seal has been shown to provide the majority of resistance in the initial phase of hip distraction. However, the effect of an unrepaired interportal capsulotomy and capsular repair on the initial phase of hip distractive stability in vivo is not well understood.

Purpose:

To investigate the effect of capsular repair on the initial phase of distractive stability of hip joints in patients with femoroacetabular impingement (FAI) syndrome.

Study Design:

Controlled laboratory study.

Methods:

Patients undergoing primary hip arthroscopy for FAI between March and August 2020 were prospectively enrolled. Total joint space was measured on fluoroscopic images at the medial and lateral edges of the sourcil at 12.5-lb (5.7-kg) axial traction intervals (up to 100 lb [45.4 kg]) in 3 capsular states: (1) native capsule, (2) interportal capsulotomy, and (3) capsular repair. Distraction on anteroposterior radiographs was calculated as the difference between total joint space at each traction interval and baseline joint space at 0 lb, normalized to millimeters. The native, capsulotomy, and capsular repair states were compared using Wilcoxon signed-rank and McNemar tests.

Results:

Included were 36 hips in 35 patients. The median force required to distract ≥3 mm was 75 lb (34.0 kg; 95% CI, 70-80 lb [31.8-36.3 kg]) in both the native and capsular repair states ( P = .629), which was significantly greater than the median force required to distract ≥3 mm in the capsulotomy state (50 lb [22.7 kg]; 95% CI, 45-55 lb [20.4-24.9 kg]) ( P < .001). The most rapid rates of change in joint space were observed at the traction interval at which hips first achieved ≥3 mm of distraction (n = 33 hips; 92%).

Conclusion:

The traction force at which hips distracted ≥3 mm was 75 lb (34.0 kg) in both the native capsular and capsular repair states. Significantly less traction force (50 lb [22.7 kg]) distracted hips ≥3 mm in the capsulotomy state. Complete capsular closure after interportal capsulotomy resulted in restoration of initial distractive stability relative to the unrepaired capsulotomy state at time zero after primary hip arthroscopy.

Clinical Relevance:

This study provides surgeons with an improved understanding of the additional stability to the hip joint from capsular repair after hip arthroscopy for FAI syndrome.
Barriers and Facilitators to Clinical Supervision in Ghana: A Scoping Review
Authors: Awiagah Sherrif Kwame , Dordunu Rebecca , Hukporti Nelson , Nukunu Promise Edem , Dzando Gideon
Published: May 2024

Background

Clinical supervision involves the professional relationship between an experienced and knowledgeable clinician and a less experienced clinician in which the experienced clinician provides support toward the skills development of the less experienced one. The concept, structure, and format of clinical supervision vary in various jurisdictions and is influenced by the availability of resources, the training needs of supervisees, and organizational structures.

Aim

The aim of this scoping review was to explore, map out and synthesize the available literature on the facilitators and barriers to clinical supervision in Ghana.

Methods

The methodological framework developed by Arksey and O’Malley and modified by Levac et al. for scoping reviews, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews were used to ensure a coherent and transparent reporting of literature. A systematic search was conducted in PubMed, CINAHL, Scopus, Medline, and Google Scholar using key words and key terms. Articles published between January 1, 2000, and February 28, 2023, were included in the review.

Results

The initial search across all the databases yielded 208 results. Two independent reviewers completed both the title and abstract, and full text screenings. A third reviewer helped to resolve all discrepancies that arose during the screening process. The review included 20 articles and generated four themes: clinical supervision as a collaborative effort, feedback mechanism, training and adaptation, and challenges with implementation.

Conclusion

Findings from this review highlight that healthcare professionals in Ghana valued clinical supervision. However, the implementation of clinical supervision is faced with individual and systemic challenges. There is the need for on-going collaboration between educational and clinical institutions to develop modalities that promote clinical supervision in Ghana.
It’s not ok to not be ok . . . when you’re a prison governor:The impact of workplace culture on prison governors’ wellbeing in England, Scotland and Wales
Authors: Nichols Helen , Saunders Gary , Harrison Karen , Mason Rachael , Smith Lauren , Hall Lauren
Published: May 2024

The wellbeing of prison governors has received little attention in penological research to date. The findings of this research reveal that governors’ wellbeing is negatively impacted by a dominant Masculinity Contest Culture (MCC) permeating through the organisation. While MCC negatively contributes to governors’ wellbeing, they continue to engage in hegemonic masculine performances to show no weakness to cope with the pressures of working life. This has led to the emergence of a ‘hyper-MCC’ which we define as an overperformance of the MCC social script that is seen as a requirement to cope within an increasingly challenging workplace. The implications of hyper-MCC are a perpetuation of a toxic working culture and a reduced likelihood of engaging with wellbeing services. The response needs to be developing the right types of support that can attempt to re-frame dominant masculine working cultures, challenge hyper-MCC performances and remove the individualised responsibility of wellbeing away from the workforce themselves. However, this cultural shift will only be effective if coupled with a meaningful reconsideration of working conditions, which have resulted in the intensification of workloads and practices.
The dark triad, dating app use and online disinhibition positively predict technology-facilitated sexual violence perpetration
Authors: Gunnoo Adam , Jackson Merv , Saling Lauren L
Published: May 2024

Technology-facilitated sexual violence (TFSV) describes the perpetration of a variety of sexual offences committed through digital communication technologies. The current study aims to investigate the similarity of risk factors between TFSV and in-person sexual offending. The sample consisted of 105 young adult, Australian males who responded to measures of sexual violence acceptance, dating app usage, online disinhibition, and the dark triad. Overall, 45.3% of the sample reported at least one instance of TFSV perpetration in the past 5 years. Standard and hierarchical linear regressions revealed dating app usage, the dark triad, and online disinhibition positively predicted TFSV perpetration. Neither measure of attitudes accepting of sexual violence predicted TFSV perpetration, but their positive correlation is indicative of cultural norms enabling sexual violence against women. As illuminated here, the congruence between TFSV and in-person violence extends beyond conceptual and prevalence trends to predictive risk factors. Recommendations for interventions and prevention include raising awareness of risk-generating app features that create vulnerability to sexual harm and identifying heterogenous groups of TFSV offenders based on key characteristics to develop optimal intervention strategies.
What are the Factors that Influence Non-conformists Not to Conform to Group Norms?
Authors: Konaentey Trishul
Published: May 2024

This article aims to study the factors that influence non-conformists not to conform to group norms. In the literature about non-conformity, most of the discussion is on how non-conformists influence the world. The key factors contributing to non-conformity are not yet known. To investigate the factors, qualitative research study was used for a sample size of 20 participants with more than 5 years of work experience from various industries. In light of this possibility, this research uses a grounded theory approach to explore the factors that trigger non-conformists not to conform to group norms. This article lays a foundation for the motivation factors behind non-conformists. The study’s findings revealed 13 factors that emerged as the factors that trigger non-conformists not to conform to group norms.
SR proteins in cancer: function, regulation, and small inhibitor
Authors: Bei Mingrong , Xu Jianzhen
Published: May 2024

Alternative splicing of pre-mRNAs is a fundamental step in RNA processing required for gene expression in most metazoans. Serine and arginine-rich proteins (SR proteins) comprise a family of multifunctional proteins that contain an RNA recognition motif (RRM) and the ultra-conserved arginine/serine-rich (RS) domain, and play an important role in precise alternative splicing. Increasing research supports SR proteins as also functioning in other RNA-processing-related mechanisms, such as polyadenylation, degradation, and translation. In addition, SR proteins interact with N6-methyladenosine (m6A) regulators to modulate the methylation of ncRNA and mRNA. Dysregulation of SR proteins causes the disruption of cell differentiation and contributes to cancer progression. Here, we review the distinct biological characteristics of SR proteins and their known functional mechanisms during carcinogenesis. We also summarize the current inhibitors that directly target SR proteins and could ultimately turn SR proteins into actionable therapeutic targets in cancer therapy.
Social big data mining for the sustainable mobility and transport transition: findings from a large-scale cross-platform analysis
Authors: Stiebe Michael
Published: May 2024

The paper reports findings from a study that examining how cross-platform social media analysis can help to map the digital discourse on sustainable mobility and sustainable transport, and enhance the understanding of sociotechnical low-carbon transport transitions. Using the hashtag search queries #sustainabletransport and #sustainablemobility, 33,121 Tweets (2013–2021) and 8,089 Instagram images including captions (2017/2018–2021) were scraped using the Python modules Twint and Instaloader. Quantitative text and sentiment analyses were applied to the Tweets and image captions. Additionally, an automated machine learning-based image analysis of the Instagram images was conducted using object detection via OpenCV. Synthesized results formed the base for a cross-platform analysis inspired by Rogers’ method comprising hot topics/key themes, user mentions, sentiment polarity, and co-hashtags. Notably, electromobility emerged as a prominent theme, particularly on Instagram, while #sustainabletransport was closely associated with active travel, notably bicycling, and #sustainablemobility showcased a dominance of electromobility discourse. The study demonstrates the investigative potentials of cross-platform social media analysis studies to enhance the understanding of sociotechnical low-carbon transport transitions. Drawing on key results, the paper suggests an adapted version of the Geelsean Multi-Level Perspective on Sociotechnical Transitions.
Genome-wide association study identifies genomic regions associated with key reproductive traits in Korean Hanwoo cows
Authors: Haque Md Azizul , Lee Yun-Mi , Ha Jae-Jung , Jin Shil , Park Byoungho , Kim Nam-Young , Won Jeong-Il , Kim Jong-Joo
Published: May 2024

Background

Conducting genome-wide association studies (GWAS) for reproductive traits in Hanwoo cattle, including age at first calving (AFC), calving interval (CI), gestation length (GL), and number of artificial inseminations per conception (NAIPC), is of paramount significance. These analyses provided a thorough exploration of the genetic basis of these traits, facilitating the identification of key markers for targeted trait improvement. Breeders can optimize their selection strategies, leading to more efficient and sustainable breeding programs, by incorporating genetic insights. This impact extends beyond individual traits and contributes to the overall productivity and profitability of the Hanwoo beef cattle industry. Ultimately, GWAS is essential in ensuring the long-term genetic resilience and adaptability of Hanwoo cattle populations. The primary goal of this study was to identify significant single nucleotide polymorphisms (SNPs) or quantitative trait loci (QTLs) associated with the studied reproductive traits and subsequently map the underlying genes that hold promise for trait improvement.

Results

A genome-wide association study of reproductive traits identified 68 significant single nucleotide polymorphisms (SNPs) distributed across 29 Bos taurus autosomes (BTA). Among them, BTA14 exhibited the highest number of identified SNPs (25), whereas BTA6, BTA7, BTA8, BTA10, BTA13, BTA17, and BTA20 exhibited 8, 5, 5, 3, 8, 2, and 12 significant SNPs, respectively. Annotation of candidate genes within a 500 kb region surrounding the significant SNPs led to the identification of ten candidate genes relevant to age at first calving. These genes were: FANCG, UNC13B, TESK1, TLN1, and CREB3 on BTA8; FAM110B, UBXN2B, SDCBP, and TOX on BTA14; and MAP3K1 on BTA20. Additionally, APBA3, TCF12, and ZFR2, located on BTA7 and BTA10, were associated with the calving interval; PAX1, SGCD, and HAND1, located on BTA7 and BTA13, were linked to gestation length; and RBM47, UBE2K, and GPX8, located on BTA6 and BTA20, were linked to the number of artificial inseminations per conception in Hanwoo cows.

Conclusions

The findings of this study enhance our knowledge of the genetic factors that influence reproductive traits in Hanwoo cattle populations and provide a foundation for future breeding strategies focused on improving desirable traits in beef cattle. This research offers new evidence and insights into the genetic variants and genome regions associated with reproductive traits and contributes valuable information to guide future efforts in cattle breeding.
Identification of plasma protein markers of allergic disease risk: a mendelian randomization approach to proteomic analysis
Authors: Cao Ziqin , Li Qiangxiang , Li Yajia , Wu Jianhuang
Published: May 2024

Background

While numerous allergy-related biomarkers and targeted treatment strategies have been developed and employed, there are still signifcant limitations and challenges in the early diagnosis and targeted treatment for allegic diseases. Our study aims to identify circulating proteins causally associated with allergic disease-related traits through Mendelian randomization (MR)-based analytical framework.

Methods

Large-scale cis-MR was employed to estimate the effects of thousands of plasma proteins on five main allergic diseases. Additional analyses including MR Steiger analyzing and Bayesian colocalisation, were performed to test the robustness of the associations; These findings were further validated utilizing meta-analytical methods in the replication analysis. Both proteome- and transcriptome-wide association studies approach was applied, and then, a protein-protein interaction was conducted to examine the interplay between the identified proteins and the targets of existing medications.

Results

Eleven plasma proteins were identified with links to atopic asthma (AA), atopic dermatitis (AD), and allergic rhinitis (AR). Subsequently, these proteins were classified into four distinct target groups, with a focus on tier 1 and 2 targets due to their higher potential to become drug targets. MR analysis and extra validation revealed STAT6 and TNFRSF6B to be Tier 1 and IL1RL2 and IL6R to be Tier 2 proteins with the potential for AA treatment. Two Tier 1 proteins, CRAT and TNFRSF6B, and five Tier 2 proteins, ERBB3, IL6R, MMP12, ICAM1, and IL1RL2, were linked to AD, and three Tier 2 proteins, MANF, STAT6, and TNFSF8, to AR.

Conclusion

Eleven Tier 1 and 2 protein targets that are promising drug target candidates were identified for AA, AD, and AR, which influence the development of allergic diseases and expose new diagnostic and therapeutic targets.
Plastid DNA is a major source of nuclear genome complexity and of RNA genes in the orphan crop moringa
Authors: Marczuk-Rojas Juan Pablo , Salmerón Antonio , Alcayde Alfredo , Isanbaev Viktor , Carretero-Paulet Lorenzo
Published: May 2024

Background

Unlike Transposable Elements (TEs) and gene/genome duplication, the role of the so-called nuclear plastid DNA sequences (NUPTs) in shaping the evolution of genome architecture and function remains poorly studied. We investigate here the functional and evolutionary fate of NUPTs in the orphan crop Moringa oleifera (moringa), featured by the highest fraction of plastid DNA found so far in any plant genome, focusing on (i) any potential biases in their distribution in relation to specific nuclear genomic features, (ii) their contribution to the emergence of new genes and gene regions, and (iii) their impact on the expression of target nuclear genes.

Results

In agreement with their potential mutagenic effect, NUPTs are underrepresented among structural genes, although their overall transcription levels and broadness were only lower when involved exonic regions; the occurrence of plastid DNA generally did not result in a broader expression, except among those affected in introns by older NUPTs. In contrast, we found a strong enrichment of NUPTs among specific superfamilies of retrotransposons and several classes of RNA genes, including those participating in the protein biosynthetic machinery (i.e., rRNA and tRNA genes) and a specific class of regulatory RNAs. A significant fraction of NUPT RNA genes was found to be functionally expressed, thus potentially contributing to the nuclear pool.

Conclusions

Our results complete our view of the molecular factors driving the evolution of nuclear genome architecture and function, and support plastid DNA in moringa as a major source of (i) genome complexity and (ii) the nuclear pool of RNA genes.
Morning light treatment for inflammatory bowel disease: a clinical trial
Authors: Cohen-Mekelburg Shirley , Goldstein Cathy A. , Rizvydeen Muneer , Fayyaz Zainab , Patel Priya J. , Berinstein Jeffrey A. , Bishu Shrinivas , Cushing-Damm Kelly C. , Kim Hyungjin Myra , Burgess Helen J.
Published: May 2024

Background

Inflammatory bowel disease (IBD) affects over 3 million Americans and has a relapsing and remitting course with up to 30% of patients experiencing exacerbations each year despite the availability of immune targeted therapies. An urgent need exists to develop adjunctive treatment approaches to better manage IBD symptoms and disease activity. Circadian disruption is associated with increased disease activity and may be an important modifiable treatment target for IBD. Morning light treatment, which advances and stabilizes circadian timing, may have the potential to improve IBD symptoms and disease activity, but no studies have explored these potential therapeutic benefits in IBD. Therefore, in this study, we aim to test the effectiveness of morning light treatment for patients with IBD.

Methods

We will recruit sixty-eight individuals with biopsy-proven IBD and clinical symptoms and randomize them to 4-weeks of morning light treatment or 4-weeks of treatment as usual (TAU), with equivalent study contact. Patient-reported outcomes (IBD-related quality of life, mood, sleep), clinician-rated disease severity, and a biomarker of gastrointestinal inflammation (fecal calprotectin) will be assessed before and after treatment. Our primary objective will be to test the effect of morning light treatment versus TAU on IBD-related quality of life and our secondary objectives will be to test the effects on clinician-rated disease activity, depression, and sleep quality. We will also explore the effect of morning light treatment versus TAU on a biomarker of gastrointestinal inflammation (fecal calprotectin), and the potential moderating effects of steroid use, restless leg syndrome, and biological sex.

Discussion

Morning light treatment may be an acceptable, feasible, and effective adjunctive treatment for individuals with active IBD suffering from impaired health-related quality of life.

Trial registration

The study protocol was registered on ClinicalTrials.gov as NCT06094608 on October 23, 2023, before recruitment began on February 1, 2024.
Risk factors of adult isoniazid-resistant and rifampicin-susceptible tuberculosis in Nanjing, 2019–2021
Authors: Guo Jing , Han Yan , Zhang Xia , Lin Feishen , Chen Liangyu , Feng Xuebing
Published: May 2024

Introduction

This study aimed to analyze the risk factors associated with isoniazid-resistant and rifampicin-susceptible tuberculosis (Hr-TB) in adults.

Method

The clinical data of 1,844 adult inpatients diagnosed with culture-positive pulmonary tuberculosis (PTB) in Nanjing Second Hospital from January 2019 and December 2021 were collected. All culture positive strain from the patient specimens underwent drug susceptibility testing (DST). Among them, 166 patients with Hr-TB were categorized as the Hr-TB group, while the remaining 1,678 patients were classified as having drug-susceptible tuberculosis (DS-TB). Hierarchical logistic regression was employed for multivariate analysis to identify variables associated with Hr-TB. Results: Multivariate logistic regression analysis revealed that individuals with diabetes mellitus (DM) (OR 1.472, 95% CI 1.037–2.088, p = 0.030) and a history of previous tuberculosis treatment (OR 2.913, 95% CI 1.971–4.306, p = 0.000) were at higher risk of developing adult Hr-TB, with this risk being more pronounced in male patients. Within the cohort, 1,640 patients were newly treated, and among them, DM (OR 1.662, 95% CI 1.123–2.461, p = 0.011) was identified as risk factors for Hr-TB. Conclusions: Diabetes mellitus is a risk factor for Hr-TB in adults, and the contribution of diabetes as a risk factor was more pronounced in the newly treatment or male subgroup. And previous TB treatment history is also a risk factor for Hr-TB in adults.
Characteristics and outcome of pregnancy-related acute kidney injury in a teaching hospital in a low-resource setting: a five-year retrospective review
Authors: Berhe Ephrem , Teka Hale , Abraha Hiluf Ebuy , Abera Bisrat Tesfay , Gebru Marta Abrha , Gebremariam Tsega , Yahya Mohammedtahir , Amare Birhane , Tadesse Habtom , Gidey Hagos , Tesfay Fireweyni , Ebrahim Mohamedawel Mohamedniguss , Kidanemariam Rahel , Legesse Awol Yemane
Published: May 2024

Background

Pregnancy-related kidney injury contributes to a high burden of acute kidney injury in low-resource settings and causes maternal and perinatal morbidity and mortality. Few studies have examined the impact of acute kidney injury in resource-limited countries, with very limited research on pregnancy-specific disorders in Ethiopia. This study aimed to determine the characteristics of pregnancy-related acute kidney injury, outcomes and associated factors.

Methods

A retrospective study was conducted to evaluate the clinical profile and maternal-fetal outcome of pregnancy-related acute kidney injury at Ayder Comprehensive Specialized Hospital in Tigray, Ethiopia, from January 1, 2017, to December 31, 2021. Maternal and fetal outcomes were analyzed using descriptive statistics. Multivariate logistic regression was used to determine the association between the dependent and independent variables.

Results

Of 27,350 mothers who delivered at Ayder Comprehensive Specialized Hospital between January 1, 2017, and December 31, 2021, a total of 187 women developed pregnancy-related acute kidney injury, a prevalence rate of 68 per 100,000 births. Preeclampsia, sepsis and pre-renal causes due to dehydration and hemorrhage were the most common causes of pregnancy-related acute kidney injury in this study. Hemodialysis was needed in 8.6% (n = 16) of patients. Of the 187 pregnancy-related acute kidney injuries, 143 (76.5%) recovered completely and 30 (16%) partially. The mortality rate was 7.5%. Preexisting chronic kidney disease (AOR = 30.13; 95% CI: 2.92, 310.84), use of vasoactive agents (AOR = 5.77; 95% CI: 1.47, 22.67), increase in creatinine per unit (AOR = 1.65; 95% CI: 1.11, 2.45) and complications related to acute kidney injury (AOR = 5.26; 95% CI: 1.73, 16.00) were determinants of the composite endpoints (partial renal recovery and death).

Conclusions

This study emphasizes acute kidney injury in resource-limited settings is a significant cause of maternal and fetal morbidity and mortality. The vast majority of patients with pregnancy-related acute kidney injury recovered completely from kidney injury. The main causes of pregnancy-related acute kidney injury were preeclampsia, sepsis and pre-renal associated with hemorrhage and dehydration. Preexisting renal disease, use of vasopressors, increase in creatinine per unit and complications associated with acute kidney injury were determining factors for concomitant fetomaternal mortality. Appropriate preventive strategies during prenatal care and prompt treatment are needed for pregnancy-related acute kidney injury.
Iron deficiency anemia status in Iranian pregnant women and children: an umbrella systematic review and meta-analysis
Authors: Dehghani Azadeh , Molani-Gol Roghayeh , Rafraf Maryam , Mohammadi-Nasrabadi Fatemeh , Khodayari-Zarnaq Rahim
Published: May 2024

Background

Iron deficiency anemia (IDA) is a global health challenge, especially affecting females and children. We aimed to conduct an umbrella systematic review of available evidence on IDA’s prevalence in Iranian pregnant women and children.

Methods

We searched the Web of Science, Science Direct, PubMed, Scopus, and Google Scholar databases for articles published by April 2023. Meta-analyses investigating the status of IDA in Iran were included. The findings of seven meta-analyses comprising 189,627 pregnant women with a mean age of 26 and 5,890 children under six years old were included in this study. The methodological quality of each study was evaluated with the Assessment of Multiple Systematic Reviews (AMSTAR2) instrument.

Results

We estimated the prevalence of IDA at 15.71% in pregnant women and 19.91% in young children. According to our subgroup analysis of pregnant women, IDA’s prevalence in urban and rural regions was 16.32% and 12.75%; in the eastern, western, central, southern, and northern regions of Iran, it was estimated at 17.8%, 7.97%, 19.97%, 13.45%, and 17.82%, respectively.

Conclusion

IDA is common in young children and pregnant females and is a significant public health concern in Iran. The present umbrella review results estimated that Iran is in the mild level of IDA prevalence based on WHO classification. However, due to sanctions and high inflation in Iran, the prevalence of anemia is expected to increase in recent years. Multi-sectoral efforts are required to improve the iron status of these populations and reduce the burden of IDA in the country.
Artificial intelligence-based prognostic model accurately predicts the survival of patients with diffuse large B-cell lymphomas: analysis of a large cohort in China
Authors: Peng Huilin , Su Mengmeng , Guo Xiang , Shi Liang , Lei Tao , Yu Haifeng , Xu Jieyu , Pan Xiaohua , Chen Xi
Published: May 2024

Background

Diffuse large B-cell lymphomas (DLBCLs) display high molecular heterogeneity, but the International Prognostic Index (IPI) considers only clinical indicators and has not been updated to include molecular data. Therefore, we developed a widely applicable novel scoring system with molecular indicators screened by artificial intelligence (AI) that achieves accurate prognostic stratification and promotes individualized treatments.

Methods

We retrospectively enrolled a cohort of 401 patients with DLBCL from our hospital, covering the period from January 2015 to January 2019. We included 22 variables in our analysis and assigned them weights using the random survival forest method to establish a new predictive model combining bidirectional long-short term memory (Bi-LSTM) and logistic hazard techniques. We compared the predictive performance of our “molecular-contained prognostic model” (McPM) and the IPI. In addition, we developed a simplified version of the McPM (sMcPM) to enhance its practical applicability in clinical settings. We also demonstrated the improved risk stratification capabilities of the sMcPM.

Results

Our McPM showed superior predictive accuracy, as indicated by its high C-index and low integrated Brier score (IBS), for both overall survival (OS) and progression-free survival (PFS). The overall performance of the McPM was also better than that of the IPI based on receiver operating characteristic (ROC) curve fitting. We selected five key indicators, including extranodal involvement sites, lactate dehydrogenase (LDH), MYC gene status, absolute monocyte count (AMC), and platelet count (PLT) to establish the sMcPM, which is more suitable for clinical applications. The sMcPM showed similar OS results (P < 0.0001 for both) to the IPI and significantly better PFS stratification results (P < 0.0001 for sMcPM vs. P = 0.44 for IPI).

Conclusions

Our new McPM, including both clinical and molecular variables, showed superior overall stratification performance to the IPI, rendering it more suitable for the molecular era. Moreover, our sMcPM may become a widely used and effective stratification tool to guide individual precision treatments and drive new drug development.
Methylation-regulated tumor suppressor gene PDE7B promotes HCC invasion and metastasis through the PI3K/AKT signaling pathway
Authors: Du Yuanxiao , Xu Yuqiu , Guo Xuefeng , Tan Chao , Zhu Xiaonian , Liu Guoyu , Lyu Xiao , Bei Chunhua
Published: May 2024

Background

Hepatocellular carcinoma (HCC) has a high mortality rate, and the mechanisms underlying tumor development and progression remain unclear. However, inactivated tumor suppressor genes might play key roles. DNA methylation is a critical regulatory mechanism for inactivating tumor suppressor genes in HCC. Therefore, this study investigated methylation-related tumor suppressors in HCC to identify potential biomarkers and therapeutic targets.

Methods

We assessed genome-wide DNA methylation in HCC using whole genome bisulfite sequencing (WGBS) and RNA sequencing, respectively, and identified the differential expression of methylation-related genes, and finally screened phosphodiesterase 7B (PDE7B) for the study. The correlation between PDE7B expression and clinical features was then assessed. We then analyzed the changes of PDE7B expression in HCC cells before and after DNA methyltransferase inhibitor treatment by MassArray nucleic acid mass spectrometry. Furthermore, HCC cell lines overexpressing PDE7B were constructed to investigate its effect on HCC cell function. Finally, GO and KEGG were applied for the enrichment analysis of PDE7B-related pathways, and their effects on the expression of pathway proteins and EMT-related factors in HCC cells were preliminarily explored.

Results

HCC exhibited a genome-wide hypomethylation pattern. We screened 713 hypomethylated and 362 hypermethylated mCG regions in HCC and adjacent normal tissues. GO analysis showed that the main molecular functions of hypermethylation and hypomethylation were “DNA-binding transcriptional activator activity” and “structural component of ribosomes”, respectively, whereas KEGG analysis showed that they were enriched in “bile secretion” and “Ras-associated protein-1 (Rap1) signaling pathway”, respectively. PDE7B expression was significantly down-regulated in HCC tissues, and this low expression was negatively correlated with recurrence and prognosis of HCC. In addition, DNA methylation regulates PDE7B expression in HCC. On the contrary, overexpression of PDE7B inhibited tumor proliferation and metastasis in vitro. In addition, PDE7B-related genes were mainly enriched in the PI3K/ATK signaling pathway, and PDE7B overexpression inhibited the progression of PI3K/ATK signaling pathway-related proteins and EMT.

Conclusion

PDE7B expression in HCC may be regulated by promoter methylation. PDE7B can regulate the EMT process in HCC cells through the PI3K/AKT pathway, which in turn affects HCC metastasis and invasion.
Barriers to pregnancy prevention for adolescents in rural Haiti: perceptions of healthcare providers
Authors: Wooten Shelbie , Hurley Emily , Schuetz Nikolaus , Miller Melissa K. , Rodean Jonathan , Rupe Emily , Lewis Kemi , Boncoeur Marie Daphnée , Masonbrink Abbey R.
Published: May 2024

Background

Little is known about healthcare providers’ (HCPs) contraceptive views for adolescents in Haiti, who experience high rates of unintended pregnancy. We sought to describe HCPs’ perspectives on barriers and facilitators to contraceptive care delivery in rural Haiti.

Methods

We conducted a cross-sectional survey and qualitative interviews with HCPs in two rural communities in Haiti from 08/2021–03/2022. We assessed demographics, clinical practice behaviors and explored contraception perspectives according to Theory of Planned Behavior constructs: attitudes, subjective norms, and perceived behavioral control (e.g., people’s perceptions of their ability to perform a given behavior, barriers and facilitators of a behavior).15–17 We used descriptive statistics to report proportions and responses to Likert scale and multiple-choice questions. Guided by content analysis, we analyzed interview transcripts through thematic inductive coding and team debriefing.

Results

Among 58 respondents, 90% (n = 52) were female and 53% (n = 31) were nurses. Most reported always (n = 16, 28%) or very often (n = 21, 36%) obtaining a sexual history for adolescents. A majority agreed/strongly agreed that clinicians should discuss pregnancy prevention (n = 45, 78%), high-risk sexual behaviors (n = 40, 69%), and should prescribe contraception (n = 41, 71%) to adolescents. The most frequently cited provider-level barriers (i.e., significant or somewhat of a barrier) included insufficient contraception knowledge (n = 44, 77%) and time (n = 37, 64%). HCPs were concerned about barriers at the patient-level (e.g. adolescents’ fear of parental notification [n = 37, 64%], adolescents will give inaccurate information about sexual behaviors [n = 25, 43%]) and system-level (e.g. resistance to providing care from administration [n = 33, 57%]). In interviews (n = 17), HCPs generally supported contraception care for adolescents. Many HCPs echoed our quantitative findings on concerns about privacy and confidentiality. HCPs reported concerns about lack of contraception education leading to misconceptions, and community and parental judgement. HCPs expressed interest in further contraception training and resources and noted the importance of providing youth-friendly contraceptive care.

Conclusions

While HCPs support contraceptive care, we identified actionable barriers to improve care for adolescents in rural Haiti. Future efforts should include increasing HCP knowledge and training, community and parent coalition building to increase contraception support and offering youth-friendly contraceptive care to offset risk for related adverse health outcomes in adolescents in rural Haiti.
“A part of my life”. A qualitative study about perceptions of female genital mutilation and experiences of healthcare among affected women residing in Sweden
Authors: Eshraghi Bita , Marions Lena , Berger Cecilia , Berggren Vanja
Published: May 2024

Background

Female genital mutilation (FGM) is defined as all procedures involving partial or total removal of the external female genitalia, or other injuries to them for non-medical reasons. Due to migration, healthcare providers in high-income countries need to better understand the consequences of FGM. The aim of this study was to elucidate women’s experiences of FGM, with particular focus on perceived health consequences and experiences of healthcare received in Sweden.

Methods

A qualitative study was performed through face-to-face, semi-structured interviews with eight women who had experienced FGM in childhood, prior to immigration to Sweden. The transcribed narratives were analyzed using content analysis.

Results

Three main categories were identified : “Living with FGM”, “Living with lifelong health consequences” and “Encounters with healthcare providers”. The participants highlighted the motives behind FGM and their mothers’ ambivalence in the decision process. Although the majority of participants had undergone FGM type 3, the most severe type of FGM, the lifelong health consequences were diverse. Poor knowledge about FGM, insulting attitude, and lack of sensitive care were experienced when seeking healthcare in Sweden.

Conclusions

Our findings indicate that FGM is a complex matter causing a diversity in perceived health consequences in women affected. Increased knowledge and awareness about FGM among healthcare providers in Sweden is of utmost importance. Further, this subject needs to be addressed in the healthcare encounter in a professional way.
Joint interprofessional education of pharmacy and dietetics undergraduates - a scoping review
Authors: Rudzińska Anna , Guzy Piotr , Skowron Agnieszka , Gąsowski Jerzy , Piotrowicz Karolina
Published: May 2024

Introduction

Interprofessional education (IPE) is an integrative approach that enables collaboration of students of two or more different health professions in aim to acquire skills and competencies related not only to their field of study but also to ensure the standard of care based on collaborative practice. IPE has not yet been explored in relation to collaboration between dietetics-nutrition and pharmacy students, while there is evidence that in many cases nutrition is complementary to pharmacotherapy in the treatment process.

Aim

The aim of this scoping review was to gather, describe and discuss all relevant literature regarding joint interprofessional training of pharmacy and dietetics-nutrition undergraduates.

Methods

We performed a literature search for studies where IPE between dietetics-nutrition and pharmacy students was described. 2204 articles on this topic were identified. After eligibility assessment, 8 articles were included in the review.

Results

Eight studies were included in the review. Two of these described IPE activities between dietetics and pharmacy students only. The included studies varied in setting, methodology and outcome measures and covered a wide range of topics relevant to clinical practice, such as management of inflammatory bowel diseases, care of the older adults or counselling skills. The most common teaching method was the use of case studies. Some of the included studies did not identify specific learning objectives. The most common way of gathering feedback from participants was through questionnaires and interviews.

Conclusions

IPE of pharmacy and dietetics-nutrition students is feasible and may be beneficial in many aspects related to learning. However, there is no well-established model or standard that would facilitate the implementation of such activities in individual educational institutions.