bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with changes in students’ self-reported nursing competence after clinical rotations: a quantitative cohort study
Authors: Egilsdottir H. Ösp , Heyn Lena Günterberg , Falk Ragnhild Sørum , Brembo Espen Andreas , Byermoen Kirsten Røland , Moen Anne , Eide Hilde
Published: February 2023

Background

The quality of nursing care in different healthcare contexts can be associated with the level of available nursing competence. Physical assessment skills are vital in nurses' assessment of patient care needs. However, in nursing education, using physical assessment skills is challenging for nursing students who struggle to apply these skills comprehensively in a clinical rotation. Therefore, this study explores changes in nursing competence, factors associated with changes after clinical rotations, and whether a Suite of Mobile Learning Tools supports changes in confident use of basic physical assessment skills.

Methods

A quantitative cohort study with an explorative pre-and post-test design. During autumn 2019 and spring 2020, 72 s-year nursing students and 99 third-year students participated in the study. The Nurse Professional Competence scale short form was used to investigate students’ self-reported changes in nursing competence, and a study-specific questionnaire was used to investigate students’ confidence concerning performing physical assessments. The students voluntarily used the Suite of Mobile Learning Tools for the learning of physical assessment. Linear regression analysis was used to identify factors associated with changes in nursing competence after clinical rotation. The STROBE guidelines for cohort studies were followed for study reporting.

Results

After the clinical rotation, both student groups reported changes in nursing competence and confidence in performing physical assessment skills, with statistically significant moderate or large changes in all areas. The Suite of Mobile Learning Tools was evaluated as being useful for learning physical assessment. The regression analysis showed that confidence in performing physical assessment skills, the usefulness of the Suite of Mobile Learning Tools, and a higher nursing competence at the start of clinical rotation were positively associated with overall nursing competence.

Conclusion

Basic physical assessment skills are an important component of nursing competence and can be considered one of the pillars of person-centered care, as proposed by the Fundamentals of Care framework. Spaced repetition and access to digital resources are suggested pedagogical approaches to enhance student confidence in the use of assessment skills within academic and clinical contexts.
A new inexpensive ultrasound-guided central venous catheterization simulation model
Authors: Liu Yan , Li Jiemei , Chang Jinzhu , Xiao Shaoling , Pei Wenbo , Wang Lei
Published: February 2023

Background

Central venous catheters (CVCs) are life-saving tools for fluid therapy during surgery. Ultrasound-guided CVC placement has been shown to be safe and highly efficient. However, it is difficult for medical workers with less experience in ultrasonography to acquire the necessary skill in a short time. Simulation-based training is a good way to enhance the skill of a beginner. Therefore, in this study, we introduced a new, inexpensive and easily implemented model for ultrasound-guided CVC placement training and assessed the feasibility of this model.

Methods

This was a quasi-experimental study. Thirty-three anaesthesiology postgraduate year 2 and 3 residents with strong CVC interest were included in a simulator-based training workshop in a department of anaesthesiology. The simulation model consisted of a piece of pork and two latex catheters filled with red and blue ink. The workshop comprised 3 parts: a 10-min introductory lecture, a 15-min orientation on performing ultrasound-guided CVC insertion based on the model, and a 30-min practice session. Participants completed relevant questionnaires before and after the training. Moreover, an examination was held to evaluate their skill with the novel model.

Results

All participants indicated that the novel model increased their self-perceived confidence in ultrasound-guided catheterization. They also all reported that the model was adequate for training anaesthesiology residents in ultrasound-guided catheterization. A few individuals thought the model did not mimic the progress of CVC insertion (3 of 33). After training, participants did not show a significant difference in the acquisition of central venous catheterization theory. However, their competency with ultrasound-guided CVC placement was enhanced. This was demonstrated not only based on subjective answers to the following questions, namely, “how do you perform central venous catheterization with ultrasound guidance?” (p < 0.001), “can you perform ultrasound-guided central venous catheterization?” (p < 0.001), and “how much self-confidence do you have in performing ultrasound-guided central venous catheterization?” (p < 0.001), but also in objective performance (evaluation of the core step in ultrasound-guided placement (p < 0.001)).

Conclusion

The new simulator is a feasible, inexpensive and easily reproducible tool for training anaesthesiologists in ultrasound-guided central venous catheterization. After the simulation-based training workshop, the competency of residents in performing central venous catheterization with ultrasound guidance improved.
Extremely premature birth bioethical decision-making supported by dialogics and pragmatism
Authors: Kaempf Joseph W. , Moore Gregory P.
Published: February 2023

Moral values in healthcare range widely between interest groups and are principally subjective. Disagreements diminish dialogue and marginalize alternative viewpoints. Extremely premature births exemplify how discord becomes unproductive when conflicts of interest, cultural misunderstanding, constrained evidence review, and peculiar hierarchy compete without the balance of objective standards of reason. Accepting uncertainty, distributing risk fairly, and humbly acknowledging therapeutic limits are honorable traits, not relativism, and especially crucial in our world of constrained resources. We think dialogics engender a mutual understanding that: i) transitions beliefs beyond bias, ii) moves conflict toward pragmatism (i.e., the truth of any position is verified by subsequent experience), and iii) recognizes value pluralism (i.e., human values are irreducibly diverse, conflicting, and ultimately incommensurable). This article provides a clear and useful Point-Counterpoint of extreme prematurity controversies, an objective neurodevelopmental outcomes table, and a dialogics exemplar to cultivate shared empathetic comprehension, not to create sides from which to choose. It is our goal to bridge the understanding gap within and between physicians and bioethicists. Dialogics accept competing relational interests as human nature, recognizing that ultimate solutions satisfactory to all are illusory, because every choice has downside. Nurturing a collective consciousness via dialogics and pragmatism is congenial to integrating objective evidence review and subjective moral-cultural sentiments, and is that rarest of ethical constructs, a means and an end.
Untargeted metabolomics reveals alternations in metabolism of bovine mammary epithelial cells upon IFN-γ treatment
Authors: Li Fengyang , Hu Xiuhong , Wu Zengshuai , Yang Qiulei , Sa Qila , Ren Wenbo , Wang Tingting , Ji Zhengchao , Li Na , Huang Jing , Lei Liancheng
Published: February 2023

Background

IFN-γ is a pleiotropic cytokine that has been shown to affect multiple cellular functions of bovine mammary epithelial cells (BMECs) including impaired milk fat synthesis and induction of malignant transformation via depletion of arginine, one of host conditionally essential amino acids. But the molecular mechanisms of these IFN-γ induced phenotypes are still unknown.

Methods

BMECs were treated with IFN-γ for 6 h, 12 h, and 24 h. The metabolomic profiling in BMECs upon IFN-γ induction were assessed using untargeted ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) metabolomic analysis. Key differentially expressed metabolites (DEMs) were quantified by targeted metabolomics.

Results

IFN-γ induction resulted in significant differences in the contents of metabolites. Untargeted analysis identified 221 significantly DEMs, most of which are lipids and lipid-like molecules, organic acids and derivatives, organ heterocyclic compounds and benzenoids. According to Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, DEMs were enriched in fructose and mannose metabolism, phosphotransferase system (PTS), β-alanine metabolism, arginine and proline metabolism, methane metabolism, phenylalanine metabolism, and glycolysis/gluconeogenesis. Quantification of selected key DEMs by targeted metabolomics showed significantly decreased levels of D-(-)-mannitol, argininosuccinate, and phenylacetylglycine (PAG), while increased levels in S-hydroxymethylglutathione (S-HMG) and 2,3-bisphospho-D-glyceric acid (2,3-BPG).

Conclusions

These results provide insights into the metabolic alterations in BMECs upon IFN-γ induction and indicate potential theoretical basis for clarifying IFN-γ-induced diseases in mammary gland.
Host defence peptide LEAP2 contributes to antimicrobial activity in a mustache toad (Leptobrachium liui)
Authors: Chen Jie , Zhang Chi-Ying , Chen Jing-Yi , Seah Rachel Wan Xin , Zhang Le , Ma Li , Ding Guo-Hua
Published: February 2023

Background

The liver-expressed antimicrobial peptide 2 (LEAP2) is essential in host immunity against harmful pathogens and is only known to act as an extracellular modulator to regulate embryonic development in amphibians. However, there is a dearth of information on the antimicrobial function of amphibian LEAP2. Hence, a LEAP2 homologue from Leptobrachium liui was identified, characterized, and chemically synthesized, and its antibacterial activities and mechanisms were determined.

Results

In this study, LEAP2 gene (Ll-LEAP2) cDNA was cloned and sequenced from the Chong’an Moustache Toad (Leptobrachium liui). The predicted amino acid sequence of Ll-LEAP2 comprises a signal peptide, a mature peptide, and a prodomain. From sequence analysis, it was revealed that Ll-LEAP2 belongs to the cluster of amphibian LEAP2 and displays high similarity to the Tropical Clawed Frog (Xenopus tropicalis)‘s LEAP2. Our study revealed that LEAP2 protein was found in different tissues, with the highest concentration in the kidney and liver of L. liui; and Ll-LEAP2 mRNA transcripts were expressed in various tissues with the kidney having the highest mRNA expression level. As a result of Aeromonas hydrophila infection, Ll-LEAP2 underwent a noticeable up-regulation in the skin while it was down-regulated in the intestines. The chemically synthesized Ll-LEAP2 mature peptide was selective in its antimicrobial activity against several in vitro bacteria including both gram-positive and negative bacteria. Additionally, Ll-LEAP2 can kill specific bacteria by disrupting bacterial membrane and hydrolyzing bacterial gDNA.

Conclusions

This study is the first report on the antibacterial activity and mechanism of amphibian LEAP2. With more to uncover, the immunomodulatory functions and wound-healing activities of Ll-LEAP2 holds great potential for future research.
Do nomadic lactobacilli fit as potential vaginal probiotics? The answer lies in a successful selective multi-step and scoring approach
Authors: Cappello Claudia , Acin-Albiac Marta , Pinto Daniela , Polo Andrea , Filannino Pasquale , Rinaldi Fabio , Gobbetti Marco , Di Cagno Raffaella
Published: February 2023

Background

The goal of this study was to create a multi-strain probiotic gel that would foster a lactobacilli-dominated vaginal microbiota in pregnant women and ensure appropriate eubiosis for the newborn. Nomadic lactobacilli (95 strains), mostly isolated from food sources, were preliminarily screened for functional traits before being characterized for their capability to inhibit the two vaginal pathogens Streptococcus agalactiae and Candida albicans, which may lead to adverse pregnancy-related outcomes. Eight best-performing strains were chosen and furtherly investigated for their ability to produce biofilm. Lastly, the two selected potential probiotic candidates were analyzed in vitro for their ability to reduce the inflammation caused by C. albicans infection on the reconstituted human vaginal epithelium (HVE).

Results

Lactiplantibacillus plantarum produced both isomers of lactic acid, while Lacticaseibacillus paracasei produced only l-isomer. The production of hydrogen peroxide was strain-dependent, with the highest concentrations found within Lact. paracasei strains. The auto-aggregation capacity and hydrophobicity traits were species-independent. S. agalactiae 88II3 was strongly inhibited both at pH 7.0 and 4.0, whereas the inhibition of C. albicans UNIBZ54 was less frequent. Overall, L. plantarum strains had the highest pathogen inhibition and functional scoring. L. plantarum C5 and POM1, which were selected as potential probiotic candidates also based on their ability to form biofilms, were able to counteract the inflammation process caused by C. albicans infection in the HVE model.

Conclusions

Our multi-step and cumulative scoring-based approach was proven successful in mining and highlighting the probiotic potential of two nomadic lactobacilli strains (L. plantarum C5 and POM1), being applicable to preserve and improve human vaginal health.
Transcriptome of GH-producing pituitary neuroendocrine tumours and models are significantly affected by somatostatin analogues
Authors: Saksis Rihards , Rogoza Olesja , Niedra Helvijs , Megnis Kaspars , Mandrika Ilona , Balcere Inga , Steina Liva , Stukens Janis , Breiksa Austra , Nazarovs Jurijs , Sokolovska Jelizaveta , Konrade Ilze , Peculis Raitis , Rovite Vita
Published: February 2023

Pituitary neuroendocrine tumours (PitNETs) are neoplasms of the pituitary that overproduce hormones or cause unspecific symptoms due to mass effect. Growth hormone overproducing GH-producing PitNETs cause acromegaly leading to connective tissue, metabolic or oncologic disorders. The medical treatment of acromegaly is somatostatin analogues (SSA) in specific cases combined with dopamine agonists (DA), but almost half of patients display partial or full SSA resistance and potential causes of this are unknown. In this study we investigated transcriptomic landscape of GH-producing PitNETs on several levels and functional models—tumour tissue of patients with and without SSA preoperative treatment, tumour derived pituispheres and GH3 cell line incubated with SSA to study effect of medication on gene expression. MGI sequencing platform was used to sequence total RNA from PitNET tissue, pituispheres, mesenchymal stromal stem-like cells (MSC), and GH3 cell cultures, and data were analysed with Salmon—DeSeq2 pipeline. We observed that the GH-producing PitNETs have distinct changes in growth hormone related pathways related to its functional status alongside inner cell signalling, ion transport, cell adhesion and extracellular matrix characteristic patterns. In pituispheres model, treatment regimens (octreotide and cabergoline) affect specific cell proliferation (MKI67) and core functionality pathways (RYR2, COL8A2, HLA-G, ARFGAP1, TGFBR2). In GH3 cells we observed that medication did not have transcriptomic effects similar to preoperative treatment in PitNET tissue or pituisphere model. This study highlights the importance of correct model system selection for cell transcriptomic profiling and data interpretation that could be achieved in future by incorporating NGS methods and detailed cell omics profiling in PitNET model research.
Stakeholder perspectives on a door-to-door intervention to increase community engagement for malaria elimination in Zanzibar
Authors: Abbas Faiza , Monroe April , Kiware Samson , Khamis Mwinyi , Serbantez Naomi , Al- Mafazy Abdul- Wahid , Mohamed Fauzia , Kigadye Emmanuel
Published: February 2023

Background

Malaria remains a major public health problem in sub-Saharan Africa. The 2021 World Health Organization (WHO) World Malaria Report indicates a slowing in the decline of malaria incidence since 2015. Malaria prevalence in Zanzibar has been maintained at less than 1% since 2010, however from 2018 to 2021, the annual number of reported malaria cases has gradually increased from 4106 to 9290. Community engagement has been emphasized by the WHO for reducing malaria transmission. To better understand the potential for a door-to-door approach for malaria, a three-month pilot programme was carried out. This qualitative study aimed at understanding stakeholder experiences with the pilot programme and considerations for its implementation.

Methods

Through multistage sampling, four shehias (wards—the lowest administrative structure) with comparatively high (> 1.9 per 1000) and four with low (< 1 per 1000) incidence of local malaria cases were selected and involved in a door-to-door pilot intervention. The qualitative study was conducted after the pilot intervention and employed focus group discussions and in-depth interviews. All field notes were written on paper and audiotaped using digital audio-recorders. Summaries were developed by integrating field notes with reviews of recordings; themes were developed based on the topics identified a priori. Responses for each theme were summarized using an iterative process.

Results

Most community members reported high levels of acceptance of door-to-door interventions. Some factors that might affect implementation of door-to-door include, low risk perception of the disease, local beliefs and practice, lack of initiative from the programme level to involve communities, and political instability during the election period. All Community Health Volunteers (CHVs) recommended this approach for community engagement, however, ensuring adequate resources was identified as a key factor for ensuring its sustainability.

Conclusion

The door-to-door intervention was perceived as helpful for promoting community engagement. There are several factors to consider including ensuring that CHVs are provided with adequate education, regular supervision, and have access to essential resources. Community leaders should be fully involved in choosing CHVs that are acceptable to the community. To ensure sustainability, the government should allocate sufficient resources and improve coordination systems.
An initial study on the predictive value using multiple MRI characteristics for Ki-67 labeling index in glioma
Authors: Du Ningfang , Shu Weiquan , Li Kefeng , Deng Yao , Xu Xinxin , Ye Yao , Tang Feng , Mao Renling , Lin Guangwu , Li Shihong , Fang Xuhao
Published: February 2023

Background and purpose

Ki-67 labeling index (LI) is an important indicator of tumor cell proliferation in glioma, which can only be obtained by postoperative biopsy at present. This study aimed to explore the correlation between Ki-67 LI and apparent diffusion coefficient (ADC) parameters and to predict the level of Ki-67 LI noninvasively before surgery by multiple MRI characteristics.

Methods

Preoperative MRI data of 166 patients with pathologically confirmed glioma in our hospital from 2016 to 2020 were retrospectively analyzed. The cut-off point of Ki-67 LI for glioma grading was defined. The differences in MRI characteristics were compared between the low and high Ki-67 LI groups. The receiver operating characteristic (ROC) curve was used to estimate the accuracy of each ADC parameter in predicting the Ki-67 level, and finally a multivariate logistic regression model was constructed based on the results of ROC analysis.

Results

ADCmin, ADCmean, rADCmin, rADCmean and Ki-67 LI showed a negative correlation (r = − 0.478, r = − 0.369, r = − 0.488, r = − 0.388, all P < 0.001). The Ki-67 LI of low-grade gliomas (LGGs) was different from that of high-grade gliomas (HGGs), and the cut-off point of Ki-67 LI for distinguishing LGGs from HGGs was 9.5%, with an area under the ROC curve (AUROC) of 0.962 (95%CI 0.933–0.990). The ADC parameters in the high Ki-67 group were significantly lower than those in the low Ki-67 group (all P < 0.05). The peritumoral edema (PTE) of gliomas in the high Ki-67 LI group was higher than that in the low Ki-67 LI group (P < 0.05). The AUROC of Ki-67 LI level assessed by the multivariate logistic regression model was 0.800 (95%CI 0.721–0.879).

Conclusions

There was a negative correlation between ADC parameters and Ki-67 LI, and the multivariate logistic regression model combined with peritumoral edema and ADC parameters could improve the prediction ability of Ki-67 LI.
SARS-CoV-2 BA.2 (Omicron) variant infection in pediatric liver transplanted recipients and cohabitants during 2022 Shanghai outbreak: a prospective cohort
Authors: Zhu Xin-ye , Lu Ye-feng , Xue Feng , Luo Yi , Feng Ming-xuan , Qiu Bi-jun , Zhou Tao , Zhu Jian-jun , Zhang Jian-jun , Wan Ping , Xia Qiang
Published: February 2023

Background

The Omicron variant BA.2 was the dominant variant in the COVID-19 outbreak in Shanghai since March 2022. We aim to investigate the characteristics of SARS-CoV-2 Omicron variant infection in pediatric liver-transplanted recipients.

Methods

We conducted a single-center, prospective, observational, single-arm study. We enrolled pediatric liver-transplanted patients infected with the Omicron variant BA.2 from March 19th to October 1st, 2022 and analyzed their demographic, clinical, laboratory, and outcome data. The management of COVID-19 was conducted according to the 9th trial edition of the Chinese guideline. The immunosuppressive therapy was tailored considering the patients’ infection developments and liver functions.

Results

Five children were included. The primary diseases included Niemann-Pick disease, propionic acidemia, decompensated cirrhosis, biliary atresia, and Crigler-Najjar syndrome type I. All of the patients were onset with fever before or when getting RNA-positive results at the age of 3 (Range: 1–13) years. The infection duration was 29 (Range: 18–40) days. Three and two children were diagnosed with mild and moderate COVID-19 respectively. Two patients were tested RNA-positive within 14 days after having been tested negative. The immunosuppressants were paused or extenuated in four patients. Eight of all nine cohabitants were injected with at least two doses of inactivated SARS-CoV-2 vaccine. The disease courses were significantly longer than the patients (P < 0.05).

Conclusions

Post-transplant immunosuppression slows down the virus clearance and increases the risk of relapse but does not affect symptom duration or infection severity in pediatric patients. Patients can usually gain a favorable outcome and prognosis by extenuating immunosuppressants.
First isolation and molecular characterization of canine parvovirus-type 2b (CPV-2b) from red foxes (Vulpes vulpes) living in the wild habitat of Turkey
Authors: Kurucay Hanne Nur , Tamer Cuneyt , Muftuoglu Bahadir , Elhag Ahmed Eisa , Gozel Seda , Cicek-Yildiz Yasemin , Demirtas Sadik , Ozan Emre , Albayrak Harun , Okur-Gumusova Semra , Yazici Zafer
Published: February 2023

Background

The canine parvovirus, with its many variants, is responsible for a pivotal and common viral infection affecting millions of dogs and other carnivore species worldwide, particularly the wild ones, which are considered as the main reservoir hosts. To that end, this study investigated the presence of canine parvovirus (CPV) in red foxes (Vulpes vulpes) living in wild habitats of several regions of Turkey.

Methods

We randomly collected 630 archival fox stool specimens from rural areas of 22 provinces and used real-time PCR to detect CPV.

Results

Two of the 630 (0.3%) stool samples were positive for CPV-DNA, named Tr-Fox/128(Aydın) and Tr-Fox/159(Manisa). We attempted to isolate the virus in a MDCK cell line, and cytopathic effects were observed four days post-inoculation. Three regions corresponding to the CPV capsid protein VP2 gene from extracted DNA of positive samples were amplified by conventional PCR, and the products were visualised, purified, and Sanger sequenced. Three overlapping DNA raw sequence fragments, were read, assembled, and aligned to obtain approximately 1.5 kb-long regions that cover most of the VP2 gene, then deposited in GenBank. After comparing the isolates with parvovirus sequences data of domestic and wild carnivores by BLAST processing, our isolates' similarity rate with each other was 99.40%, with base differences in 9 nucleotide positions. They were classified as 2b variant closely related to isolates from dogs in Turkey, Egypt, Iraq, Italy, Thailand, and China.

Conclusion

This study presents evidence of interspecies transmission of CPV, of which there are no reports on prevalence in wildlife carnivores of our country. Identification of CPV in red foxes threatens local and hunting dogs, which may contract the infection or disseminate it to other wild animal species or vice-versa.
A Jacob/nsmf gene knockout does not protect against acute hypoxia- and NMDA-induced excitotoxic cell death
Authors: Gomes Guilherme M. , Bär Julia , Karpova Anna , Kreutz Michael R.
Published: February 2023

Jacob is a synapto-nuclear messenger protein that encodes and transduces the origin of synaptic and extrasynaptic NMDA receptor signals to the nucleus. The protein assembles a signalosome that differs in case of synaptic or extrasynaptic NMDAR activation. Following nuclear import Jacob docks these signalosomes to the transcription factor CREB. We have recently shown that amyloid-β and extrasynaptic NMDAR activation triggers the translocation of a Jacob signalosome that results in inactivation of the transcription factor CREB, a phenomenon termed Jacob-induced CREB shut-off (JaCS). JaCS contributes to early Alzheimer’s disease pathology and the absence of Jacob protects against amyloid pathology. Given that extrasynaptic activity is also involved in acute excitotoxicity, like in stroke, we asked whether nsmf gene knockout will also protect against acute insults, like oxygen and glucose deprivation and excitotoxic NMDA stimulation. nsmf is the gene that encodes for the Jacob protein. Here we show that organotypic hippocampal slices from wild-type and nsmf−/−mice display similar degrees of degeneration when exposed to either oxygen glucose deprivation or 50 µM NMDAto induce excitotoxicity. This lack of neuroprotection indicates that JaCS is mainly relevant in conditions of low level chronic extrasynaptic NMDAR activation that results in cellular degeneration induced by alterations in gene transcription.
Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial
Authors: MacDowall Anna , Löfgren Håkan , Edström Erik , Brisby Helena , Parai Catharina , Elmi-Terander Adrian
Published: February 2023

Background

Cervical spondylotic myelopathy (CSM) is the predominant cause of spinal cord dysfunction in the elderly. The patients are often frail and susceptible to complications. Posterior surgical techniques involving non-fusion are complicated by postlaminectomy kyphosis and instrumented fusion techniques by distal junction kyphosis, pseudarthrosis, or implant failure. The optimal surgical approach is still a matter of controversy.

Since anterior and posterior fusion techniques have been compared without presenting any superiority, the objective of this study is to compare stand-alone laminectomy with laminectomy and fusion to determine which treatment has the lowest frequency of reoperations.

Methods

This is a multicenter randomized, controlled, parallel-group non-inferiority trial. A total of 300 adult patients are allocated in a ratio of 1:1. The primary endpoint is reoperation for any reason at 5 years of follow-up. Sample size and power calculation were performed by estimating the reoperation rate after laminectomy to 3.5% and after laminectomy with fusion to 7.4% based on the data from the Swedish spine registry (Swespine) on patients with CSM. Secondary outcomes are the patient-derived Japanese Orthopaedic Association (P-mJOA) score, Neck Disability Index (NDI), European Quality of Life Five Dimensions (EQ-5D), Numeric Rating Scale (NRS) for neck and arm pain, Hospital Anxiety and Depression Scale (HADS), development of kyphosis measured as the cervical sagittal vertical axis (cSVA), and death. Clinical and radiological follow-up is performed at 3, 12, 24, and 60 months after surgery. The main inclusion criterium is 1–4 levels of CSM in the subaxial spine, C3–C7. The REDcap software will be used for safe data management. Data will be analyzed according to the modified intention to treat (mITT) population, defined as randomized patients who are still alive without having emigrated or left the study after 2 and 5 years.

Discussion

This will be the first randomized controlled trial comparing two of the most common surgical treatments for CSM: the posterior muscle-preserving selective laminectomy and posterior laminectomy with instrumented fusion. The results of the myelopathy randomized controlled (MyRanC) study will provide surgical treatment recommendations for CSM. This may result in improvements in surgical treatment and clinical practice regarding CSM.

Trial registration

ClinicalTrials.gov
NCT04936074. Registered on 23 June 2021
Alveolar capillary dysplasia with misalignment of pulmonary veins in a premature newborn: the role of lung ultrasound
Authors: Atun Macarena L. , Fernandez Jonusas Silvia A. , Acosta Cecilia M.
Published: February 2023

Background

Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a lethal neonatal lung disorder characterized by the decrease of the alveolar units, abnormalities in the air–blood barrier of the lung, and impaired gas exchange. Typically, it affects a full-term newborn; the symptoms usually start within a few hours after birth, resulting in severe respiratory distress and pulmonary hypertension. In most of the cases, this disorder is refractory to conventional pulmonary support.

Case presentation

We report a case of a newborn male of 29 weeks gestational age, with birth weight of 850 g and intrauterine growth restriction. Severe respiratory distress appeared a few minutes after birth; non-invasive ventilatory support was provided in the delivery room and, as a consequence of persistent respiratory failure, he was admitted to the neonatal intensive care unit (NICU) where mechanical ventilation was required.

Due to the symptoms and pulmonary ultrasound pattern suggestive of respiratory distress syndrome, surfactant treatment was administered. Lung ultrasound (LU) was used for monitoring the responsiveness to surfactant; severe pulmonary hypertension ensued, followed by respiratory failure, refractory shock, and death within 48 h.

Owing to the poor response to the established therapy, ACD/MPV was suspected. The diagnosis was confirmed through autopsy. The main goal of this case report is to show the role of LU for monitoring the evolution of this disorder.

Conclusion

LU could provide essential information to help diagnose and follow-up the underlying cause of persistent pulmonary hypertension of the newborn in an earlier and more effective way than chest X-ray. LU is suitable for routine monitoring of lung disease in the NICU.
Global reactivity models are impactful in industrial synthesis applications
Authors: Neves Paulo , McClure Kelly , Verhoeven Jonas , Dyubankova Natalia , Nugmanov Ramil , Gedich Andrey , Menon Sairam , Shi Zhicai , Wegner Jörg K.
Published: February 2023

Artificial Intelligence is revolutionizing many aspects of the pharmaceutical industry. Deep learning models are now routinely applied to guide drug discovery projects leading to faster and improved findings, but there are still many tasks with enormous unrealized potential. One such task is the reaction yield prediction. Every year more than one fifth of all synthesis attempts result in product yields which are either zero or too low. This equates to chemical and human resources being spent on activities which ultimately do not progress the programs, leading to a triple loss when accounting for the cost of opportunity in time wasted. In this work we pre-train a BERT model on more than 16 million reactions from 4 different data sources, and fine tune it to achieve an uncertainty calibrated global yield prediction model. This model is an improvement upon state of the art not just from the increase in pre-train data but also by introducing a new embedding layer which solves a few limitations of SMILES and enables integration of additional information such as equivalents and molecule role into the reaction encoding, the model is called BERT Enriched Embedding (BEE). The model is benchmarked on an open-source dataset against a state-of-the-art synthesis focused BERT showing a near 20-point improvement in r2 score. The model is fine-tuned and tested on an internal company data benchmark, and a prospective study shows that the application of the model can reduce the total number of negative reactions (yield under 5%) ran in Janssen by at least 34%. Lastly, we corroborate the previous results through experimental validation, by directly deploying the model in an on-going drug discovery project and showing that it can also be used successfully as a reagent recommender due to its fast inference speed and reliable confidence estimation, a critical feature for industry application.
MDSuite: comprehensive post-processing tool for particle simulations
Authors: Tovey Samuel , Zills Fabian , Torres-Herrador Francisco , Lohrmann Christoph , Brückner Marco , Holm Christian
Published: February 2023

Particle-Based (PB) simulations, including Molecular Dynamics (MD), provide access to system observables that are not easily available experimentally. However, in most cases, PB data needs to be processed after a simulation to extract these observables. One of the main challenges in post-processing PB simulations is managing the large amounts of data typically generated without incurring memory or computational capacity limitations. In this work, we introduce the post-processing tool: MDSuite. This software, developed in Python, combines state-of-the-art computing technologies such as TensorFlow, with modern data management tools such as HDF5 and SQL for a fast, scalable, and accurate PB data processing engine. This package, built around the principles of FAIR data, provides a memory safe, parallelized, and GPU accelerated environment for the analysis of particle simulations. The software currently offers 17 calculators for the computation of properties including diffusion coefficients, thermal conductivity, viscosity, radial distribution functions, coordination numbers, and more. Further, the object-oriented framework allows for the rapid implementation of new calculators or file-readers for different simulation software. The Python front-end provides a familiar interface for many users in the scientific community and a mild learning curve for the inexperienced. Future developments will include the introduction of more analysis associated with ab-initio methods, colloidal/macroscopic particle methods, and extension to experimental data.
Antibiotic dispensing practices during COVID-19 and implications for antimicrobial resistance (AMR): parallel mystery client studies in Uganda and Tanzania
Authors: Olamijuwon Emmanuel , Konje Eveline , Kansiime Catherine , Kesby Mike , Keenan Katherine , Neema Stella , Asiimwe Benon , Mshana Stephen E. , Mushi Martha F. , Loza Olga , Sunday Benjamin , Sandeman Alison , Sloan Derek J. , Benitez-Paez Fernando , Mwanga Joseph R. , Sabiiti Wilber , Holden Matthew T. G. ,   CARE Consortium, Bazira Joel , Muhumuza Christine , Muhwezi Ivan , Fredricks Kathryn Jean
Published: February 2023

Background

Over-the-counter antibiotic access is common in low-and-middle-income countries and this may accelerate antimicrobial resistance. Our study explores critical aspects of the drug seller–client interaction and antibiotic dispensing patterns for simulated COVID-19 symptoms during the pandemic in two study sites in Tanzania and Uganda, countries with different government responses to the pandemic.

Methods

Research assistants posing as clients approached different types of drug sellers such as pharmacies (Pharms), drug shops (DSs), and accredited drug dispensing outlets (ADDOs) in Mwanza, Tanzania (nPharms =  415, nADDOs = 116) and Mbarara, Uganda (nPharms = 440, nDSs  = 67), from June 10 to July 30, 2021. The mystery clients held no prescription and sought advice for simulated COVID-19 symptoms from the drug sellers. They documented the quality of their interaction with sellers and the type of drugs dispensed.

Results

Adherence to COVID-19 preventive measures and vigilance to COVID-19 symptoms was low in both sites but significantly higher in Uganda than in Tanzania. A higher percentage of drug sellers in Mbarara (Pharms = 36%, DSs = 35%, P-value = 0.947) compared to Mwanza (Pharms = 9%, ADDOs = 4%, P-value = 0.112) identified the client’s symptoms as possibly COVID-19. More than three-quarters of drug sellers that sold prescription-only medicines in both Mbarara (Pharms = 86%, DSs = 89%) and Mwanza (Pharms = 93%, ADDOs = 97%) did not ask the MCs for a prescription. A relatively high percentage of drug sellers that sold prescription-only medicines in Mwanza (Pharms = 51%, ADDOs = 67%) compared to Mbarara (Pharms = 31%, DSs = 42%) sold a partial course without any hesitation. Of those who sold antibiotics, a higher proportion of drug sellers in Mbarara (Pharms = 73%, DSs = 78%, P-value = 0.580) compared to Mwanza (Pharms = 40% ADDOs = 46%, P-value = 0.537) sold antibiotics relevant for treating secondary bacterial infections in COVID-19 patients.

Conclusion

Our study highlights low vigilance towards COVID-19 symptoms, widespread propensity to dispense prescription-only antibiotics without a prescription, and to dispense partial doses of antibiotics. This implies that drug dispensing related to COVID-19 may further drive AMR. Our study also highlights the need for more efforts to improve antibiotic stewardship among drug sellers in response to COVID-19 and to prepare them for future health emergencies.
The immunomodulatory properties of low-level ionizing radiation as a potential treatment for COVID-19’s life-threatening symptoms
Authors: Hussien Soha M.
Published: February 2023

Public health experts are looking into the current coronavirus outbreak to see if there are any ways to prevent potentially fatal symptoms. Low-Dose Radiotherapy (LD-RT) induces anti-inflammatory cytokine responses that act as a counterweight to pro-inflammatory cytokines, potentially providing therapeutic benefits for COVID-19-related diseases associated with significant morbidity and mortality. This study will look into positive immuno-radiological reactions to see if they are feasible, practicable, and effective in lowering the critical inflammatory condition of the crucial stage COVID-19. This study aims to investigate the use of low-dose lung radiation in bacterial and viral pneumonia, as well as to provide a treatment plan for COVID-19-associated pneumonia. This article discusses the evidence for and against LD-RT theories in COVID-19 patients. The use of LD-RT at various stages of COVID-19 appears to be beneficial, with fewer side effects than other currently being studied treatments.
Crisis social support after work-related violence and threats and risk for depressive symptoms: a 3-months follow-up study
Authors: Andersen Lars Peter , Elklit Ask , Pihl-Thingvad Jesper
Published: February 2023

Introduction

Employees working at psychiatric wards are at risk for work-related threats and violence that may impact their physical and mental health. Studies have found that crisis social support may mitigate these adverse health effects.

Purpose

To examine the effects crisis social support on depressive symptoms 3 months after a violent or threating work incident and furthermore, to examine the effect of variations in prolonged social support on depressive symptoms during 3 months after a violent or threating incident.

Methodology

After exposure to work-related violence and threats at work, the employees received a questionnaire within the first month and after 3 months. Right after the incident, 374 employees answered both the depression and crisis support items and were included in the analyses. 3 months later 276 employees answered both the depression and social support items. Prospective associations between crisis social support and depression were calculated using stepwise regressions and linear mixed models.

Results

Crisis social support at T1 was significantly and inversely associated with a lower level of depressive symptoms at T2, Std. Beta =  − 012, t (3) =  − 2.1, p = .040. Employees experiencing either a stable or increasing level of support from T1 to T2 had significantly lower levels of depressive symptoms compared to employees who experienced a decrease in support in the same period, mean differenceStable–Decreasing = 4.0 t (190) = 5.2, p = 0.006 and mean differenceIncreasing–Decreasing = 7.6, t (189) = 5.3, p < .001.

Conclusion

The study results indicate that depressive symptoms following work-related violence or threats can be mitigated by prolonged social support. We recommend that organizations continue to offer crisis social support in the subsequent months, and not just immediately after a violent or threating incident.
Natal colony influences age-specific movement patterns of the Yellow-legged gull (Larus michahellis)
Authors: Souc Charly , Sadoul Nicolas , Blanchon Thomas , Vittecoq Marion , Pin Christophe , Vidal Eric , Mante Alain , Choquet Rémi , McCoy Karen D.
Published: February 2023

Background

As for other life history traits, variation occurs in movement patterns with important impacts on population demography and community interactions. Individuals can show variation in the extent of seasonal movement (or migration) or can change migratory routes among years. Internal factors, such as age or body condition, may strongly influence changes in movement patterns. Indeed, young individuals often tend to move across larger spatial scales compared to adults, but relatively few studies have investigated the proximate and ultimate factors driving such variation. This is particularly the case for seabirds in which the sub-adult period is long and difficult to follow. Here, we examine migration variation and the factors that affect it in a common Mediterranean seabird, the Yellow-legged gull (Larus michahellis).

Methods

The data include the encounter histories of 5158 birds marked as fledglings between 1999 and 2004 at 14 different colonies in southern France and resighted over 10 years. Using a multi-event mark-recapture modeling framework, we use these data to estimate the probability of movement and survival, taking into account recapture heterogeneity and age.

Results

In accordance with previous studies, we find that young individuals have greater mobility than older individuals. However, the spatial extent of juvenile movements depends on natal colony location, with a strong difference in the proportion of sedentary individuals among colonies less than 50 km apart. Colony quality or local population dynamics may explain these differences. Indeed, young birds from colonies with strong juvenile survival probabilities (~ 0.75) appear to be more sedentary than those from colonies with low survival probabilities (~ 0.36).

Conclusions

This study shows the importance of studying individuals of different ages and from different colonies when trying to understand seabird movement strategies. Local breeding success and the availability of food resources may explain part of the among colony differences we observe and require explicit testing. We discuss our results with respect to the feedback loop that may occur between breeding success and mobility, and its potential implications for population demography and the dissemination of avian disease at different spatial scales.
Comparative effectiveness of virtual reality (VR) vs 3D printed models of congenital heart disease in resident and nurse practitioner educational experience
Authors: Awori Jonathan , Friedman Seth D. , Howard Christopher , Kronmal Richard , Buddhe Sujatha
Published: February 2023

Background

Medical trainees frequently note that cardiac anatomy is difficult to conceive within a two dimensional framework. The specific anatomic defects and the subsequent pathophysiology in flow dynamics may become more apparent when framed in three dimensional models. Given the evidence of improved comprehension using such modeling, this study aimed to contribute further to that understanding by comparing Virtual Reality (VR) and 3D printed models (3DP) in medical education.

Objectives

We sought to systematically compare the perceived subjective effectiveness of Virtual Reality (VR) and 3D printed models (3DP) in the educational experience of residents and nurse practitioners.

Methods

Trainees and practitioners underwent individual 15-minute teaching sessions in which features of a developmentally typical heart as well as a congenitally diseased heart were demonstrated using both Virtual Reality (VR) and 3D printed models (3DP). Participants then briefly explored each modality before filling out a short survey in which they identified which model (3DP or VR) they felt was more effective in enhancing their understanding of cardiac anatomy and associated pathophysiology. The survey included a binary summative assessment and a series of Likert scale questions addressing usefulness of each model type and degree of comfort with each modality.

Results

Twenty-seven pediatric residents and 3 nurse practitioners explored models of a developmentally typical heart and tetralogy of Fallot pathology. Most participants had minimal prior exposure to VR (1.1 ± 0.4) or 3D printed models (2.1 ± 1.5). Participants endorsed a greater degree of understanding with VR models (8.5 ± 1) compared with 3D Printed models (6.3 ± 1.8) or traditional models of instruction (5.5 ± 1.5) p < 0.001. Most participants felt comfortable with modern technology (7.6 ± 2.1). 87% of participants preferred VR over 3DP.

Conclusions

Our study shows that, overall, VR was preferred over 3DP models by pediatric residents and nurse practitioners for understanding cardiac anatomy and pathophysiology.
Modeling of vertical microplastic transport by rising bubbles
Authors: Lehmann Moritz , Häusl Fabian P. , Gekle Stephan
Published: February 2023

Microplastic particle concentration at the sea surface is critical for quantifying microplastic transport across the water-air interface. Previous studies suggest that the concentration at the sea surface is enhanced compared to bulk concentration, yet little is known about the detailed mechanisms behind this enhancement. In this work, we model one particular process in simulation that may contribute to this enhanced surface concentration: bubble scavenging. Using lattice-Boltzmann Volume-of-Fluid simulations, we find that rising bubbles indeed generate a net flow of particles toward the surface. The efficiency of the process, however, highly depends on the microplastic particle surface properties. Clean, hydrophobic particles adhere much better to the bubble surface and are therefore transported significantly better than weathered, hydrophilic particles that are only entrained in the flow around a bubble.