bluuebunny/crossref_metadata_2025 huggingface dataset:
Mean-squared exponential stability of distributed almost periodic sequence for nonlocal space-time discrete shunting inhibitory cellular neural networks with Brownian motions
Authors: Luo Huan , Zhang Tianwei
Published: April 2024

The discrete-time and discrete-space model for stochastic nonlocal shunting inhibitory cellular neural networks with reaction diffusions are modelled in the first time. Owing to the consideration of spatial variables, the discrete model derived in this article is more complex than the traditional ordinary difference model. In accordance with the constant-variation-formula for discrete-time and discrete-space model, Banach contracting mapping principle, the method of proof by contradiction and stochastic calculus, we also obtain the existence of a unique bounded almost periodic sequence for the discrete model, which is exponentially stable in the mean-square sense. Noting that it is the first time to consider the dynamics of almost periodicity in distribution of time-space discrete neural network models. The practicability of the present results is demonstrated by means of an illustration.
Scent, Art and Astronomy: New Light on Tang Incense Spheres and Their Global Connections
Authors: Fang Flavia Xi
Published: April 2024

This paper explores the cultural and scientific connections between China, India and Iran through examining a specific type of incense burner with a gimbal device. Similar artefacts have been found in Tang China (618–907 ce), Seljuk (1037–1194 ce) and Mamluk (1250–1517 ce) Central/West Asia, and Renaissance Europe, while textual references complicate the historical narrative. Additionally, the structural resemblance of the object to an armillary sphere and its inner gimbal device add scientific significance. By examining these objects in connection with each other, and thoroughly analysing the relevant sources, this paper argues for an earlier and continuous circulation of these artefacts. It pays close attention to the cultural significance and material features of Tang incense spheres, revealing them as multicultural items potentially influenced by Persian and Central Asian production or importation.
Association between stressful life events and sleep quality in Chinese university students: Mediating and moderating roles of emotion regulation
Authors: Li Qingyi , Ye Xuejian , Li Zheng , Yang Shuxuan , Yin Luxiao , Li Bao-ming , Wang Chunjie
Published: April 2024

This study investigated whether emotion regulation mediates or modulates the relationship of SLEs with sleep quality and potential sex differences. A total of 1447 Chinese university students completed the Adolescent Self-Rating Life Events Checklist, the Pittsburgh Sleep Quality Index, and the Emotion Regulation Questionnaire. The results indicated that both cognitive reappraisal and expressive suppression significantly mediated and moderated the negative association between SLEs and sleep quality. Additionally, sex differences were found for the mediating role of cognitive reappraisal and for the modulating roles of cognitive reappraisal and expressive suppression in the relationship between SLEs and sleep quality. Although the present cross-sectional data does not allow us to test any causal relationships, these results help clarify the underlying emotion-regulation process between SLEs and sleep in university students and highlight the importance of considering sex differences in emotion regulation.
Outcomes for Patients With Chronic Limb-Threatening Ischemia After Direct and Indirect Endovascular and Surgical Revascularization: A Meta-Analysis and Systematic Review
Authors: Tarricone Arthur , Gee Allen , de la Mata Karla , Rogers Lee , Wiley Jose , Lavery Lawrence A. , Krishnan Prakash
Published: April 2024

Purpose:

The purpose of this review and meta-analysis is to determine the clinical outcome differences between patients with chronic limb-threatening ischemia who underwent direct versus indirect angiosome revascularization using either the surgical or endovascular approach.

Materials and Methods:

The data sources used for article selection included PubMed, Embase/Medline, Cochrane reviews, and Web of Science (All studies were in English and included up to September 2023). All articles included were comparative in design, including retrospective, prospective, and randomized controlled trials that compared the clinical outcomes between direct and indirect angiosome-guided revascularization in chronic limb-threatening ischemia. A random-effects model was used to determine the measure of association between direct revascularization and amputation-free survival, wound healing, and overall survival. Publication bias was assessed with both Begg’s and Egger’s test, and heterogeneity was calculated using an I2.

Results:

Data from 9 articles were analyzed and reported in this review. Direct revascularization was associated with improved amputation-free survival (odds ratio [OR]=2.632, confidence interval [CI]: 1.625, 4.265), binary wound healing (OR=2.262, CI: 1.518, 3.372), and overall survival (OR=1.757, CI: 1.176, 2.625). Time until wound healed was not associated with either direct or indirect revascularization (Standard Mean Difference [SMD]=−2.15, p=0.11). There was a low risk of bias across all studies according to the RoB 2.0 tool.

Conclusion:

Direct revascularization is associated with improved amputation-free survival, overall survival, and wound healing in chronic limb-threatening ischemic patients compared to the indirect approach.

Clinical Impact

Preservation of the lower extremity is critical for preventing mortality and maintaining independence. The benefit of angiosome-guided revascularization for chronic limb-threatening ischemia remains controversial. The authors of this article aim to review the current literature and compare direct and indirect angiosome-guided intervention for preserving the lower extremity. Current findings suggest direct angiosome-guided intervention reduces amputation rates and improves survival; however, many trials neglect to address the multifactorial approach needed in wound care management.
The Benefits of “Spoilt Milk”: Lactic Acid Can Limit Excitability via HCAR1
Authors: Borges Karin
Published: April 2024

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Cyclin-Dependent Kinase-Like 5 Deficiency Disorder: A Calcium Channelopathy?
Authors: Stafstrom Carl E.
Published: April 2024

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Examining the predictors of school exclusion for Māori and Pākehā Learners
Authors: Agnew Steve , Coupe Tom , Hingston Cassia-Rose
Published: April 2024

The sample used for this study followed an entire cohort of over 40,000 students through their compulsory education in New Zealand. A previously developed econometric model explaining higher rates of school exclusions for Pacific learners (an ethnic group over-represented in lower SES, higher rates of SEN, and greater rates of school exclusion) is applied to a large cohort of indigenous Māori and Pākehā learners in this study. Significant variables in the model that predict Pākehā learner school exclusion are very similar to those predicting Māori learner school exclusion. However, after accounting for variables identified in the literature as correlated with school exclusion, Māori learners are still more likely to be excluded, are more likely to be excluded more often, and are more likely to be excluded earlier than their Pākehā peers. One possible explanation of this result is that the Pygmalion Effect of teachers having lower expectations of Māori students may also contribute to higher rates of school exclusion. Māori students have previously reported lower rates of belonging at school. One implication of this may be the need for a cheaper, faster way for families or advocates to appeal the decision made to exclude a learner by local principals or Boards of Trustees. This is in contrast to the current system of recourse through the court system, which can be an expensive and time-consuming process.
A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus
Authors: Fareed Areeba , Rohail Samia , Zameer Ushna , Wahid Abdul , Akhtar Syed Muhammad Muneeb , Masood Waniyah
Published: April 2024

Powassan virus (POWV), a tick-borne flavivirus transmitted primarily by Ixodes ticks, poses a significant threat as it can lead to severe neuroinvasive illness. This review delves into the nuanced clinical presentation of Powassan infection, a challenge in diagnosis exacerbated by the absence of an available vaccine. Over the past decade, the prevalence of POWV has surged in North America, necessitating a thorough examination of its neurological manifestations alongside tick-borne encephalitis virus (TBEV). A comprehensive literature search conducted up to January 2024 revealed 135 cases of neurological symptoms associated with either Powassan or TBEV infection. Notably, severe occipital headache emerged as the most prevalent symptom (22.75%), followed by meningoencephalitis (10.34%), seizures (8.27%), and flaccid paresis (6.8%). Additional manifestations included poor balance, wide gait, dysarthria, facial nerve palsy, seizure, slurred speech, and absent deep tendon reflexes. Tragically, nine cases resulted in fatal outcomes attributed to POWV infection. This analysis highlights the intricate spectrum of neurological symptoms associated with Powassan infection and underscores the necessity for heightened awareness among medical practitioners, particularly in regions with a higher prevalence of the virus. The complexity of symptoms emphasizes the need for further research to unravel the factors contributing to this diversity. Additionally, exploring potential treatment avenues and vaccine development is crucial in addressing the rising threat posed by POWV, ultimately enhancing our ability to manage and prevent severe neurological outcomes.
Effects of adherence to treatment for repositioning therapy, physical therapy, and cranial remolding orthoses in infants with cranial deformation
Authors: Moses Victoria , Deville Caitlin , Simpkins Susan , Wang Jijia , Marlow Tally , Holley Cayman , Briggs Shea , Sheffer Olivia , Payne Amy , Pauline Lindsay , Lam Tristine , Blasingim Ashton , Graham Tiffany
Published: April 2024

Deformational head shapes are most often treated through repositioning therapy (RT) and/or cranial remolding orthotic (CRO) treatment. However, there is conflicting evidence about the effectiveness of each method, and treatment compliance is suspected to affect treatment effectiveness. This study examines participant adherence with these treatment methods and explores if cranial correction is related to compliance. This study also reviews effects of developmental milestones and explores other potential impacts on compliance. A total of 45 infants with cranial deformation were consented and those with congenital muscular torticollis (CMT) concurrently received physical therapy. Infants were followed from 2 to 12 months of age and initially assigned to RT. Caregivers continued RT until the head shape corrected, caregivers chose to switch to a CRO, or infants turned 12 months of age. All participants were scheduled for a final visit at 12 months of age. Throughout treatment, caregiver surveys were used to examine compliance and developmental milestones. Results show promise for future investigation into the relationship between treatment modalities and adherence with treatment for deformational head shapes. Our findings provide preliminary support that treatment adherence may be linked with treatment success and concurrent enrollment in physical therapy increases patient compliance.
Computer-assisted multimodal analysis research: A technical review of GRAPE-MARS
Authors: Liu Yingxue , Xiang Yu
Published: April 2024

Multimodal (discourse) analysis is about analyzing and theorizing individual semiotic resources (e.g., language, image, audio, space, gesture, facial expression) and inter-semiotic relations to make meaning of multimodal phenomena in context. Conducting multimodal analyses can be challenging because of its complexity. Computer-based software can support multimodal analysis by automating or semi-automating stages of annotating and analyzing, thus reducing the extensive time and labor required. The designed affordances of the software are aimed at helping researchers establish links between low-level features of multimodal texts and higher-order multimodal semantic meanings by following specific workflows. Amongst many popular multimodal transcription tools (e.g., ELAN, CLAN, ChronoViz), a new open-source multimodal annotation software for video analysis, GRAPE-MARS has been recently launched. This technical review will first describe the organization and affordances of GRAPE-MARS by illustrating a multimodal analysis of a video via this tool. We will then highlight the principal functionalities that make this software efficient in supporting multimodal analysis. Finally, the limitations and future possible applications of GRAPE-MARS will be discussed.
Implementation Readiness and Initial Effects of a Brief Mindfulness Audio Intervention Compared With a Brief Music Control During Daily Radiation Therapy for Prostate Cancer: A Randomized Pilot Study
Authors: Victorson David , Mishra Kavita K. , Sauer Joseph , Langford Grace , Maletich Carly , Horowitz Bruriah , Sauer Christina , Sejpal Samir V. , Kalapurakal John
Published: April 2024

Background

The most common and debilitating side effects of radiation therapy (RT) for prostate cancer (PC) are fatigue, sleep disturbance, anxiety, and depression. Previous research has reported palliative benefits from certain self-management approaches, such as mindfulness meditation.

Objective

To develop, pre-test, and evaluate the feasibility, acceptability and initial benefit of brief, audio-based mindfulness delivered during daily RT for PC compared to a relaxing music control.

Methods

Following intervention development, participants were randomized to either brief guided mindfulness audio recordings or a relaxing music control during daily RT. A pre-testing phase was first conducted to determine optimal program start time, length, and content most associated with retention. A final program (n = 26) was delivered daily, starting on day one of week 2 of RT and lasting 4 consecutive weeks. Feasibility was defined as ≥70% on enrollment rate, retention, and audio program adherence. Acceptability was measured with a 12-item post-study survey. A secondary focus compared between group changes on patient reported outcomes of fatigue, anxiety, depression, sleep disturbance, and related outcomes at baseline and follow up assessments. Descriptive statistics and general linear models were used.

Results

Overall, 76% (n = 38) of approached men enrolled. Pre-testing retention rates were <70% while the final program’s retention rate was 89%. The majority of acceptability criteria were met in both conditions, with relatively higher ratings in the mindfulness arm. Compared to music controls, mindfulness participants demonstrated significantly less uncertainty intolerance at 4-weeks ( P = .046, d = .95); and significantly lower fatigue scores ( P = .049, d = 1.3) and lower sleep disturbance scores ( P = .035, d = 1.1) at the 3 months follow up.

Conclusion

The final intervention met feasibility and acceptability criteria. Pre-testing refinements played a key role for optimal program delivery and retention. Audio-based mindfulness delivered during RT for PC hold potential to help decrease RT-related physical and emotional side effects.
Molecular and clinical presentation of UBA1-mutated myelodysplastic syndromes
Authors: Sirenko Maria , Bernard Elsa , Creignou Maria , Domenico Dylan , Farina Andrea , Arango Ossa Juan E. , Kosmider Olivier , Hasserjian Robert , Jädersten Martin , Germing Ulrich , Sanz Guillermo , van de Loosdrecht Arjan A. , Gurnari Carmelo , Follo Matilde Yung , Thol Felicitas , Zamora Lurdes , Pinheiro Ronald Feitosa , Pellagatti Andrea , Elias Harold K. , Haase Detlef , Sander Birgitta , Orna Elisa , Zoldan Katharina , Eder Lea Naomi , Sperr Wolfgang R. , Thalhammer Renate , Ganster Christina , Adès Lionel , Tobiasson Magnus , Palomo Laura , Della Porta Matteo Giovanni , Huberman Kety , Fenaux Pierre , Belickova Monika , Savona Michael R. , Klimek Virginia M. , Santos Fabio P. S. , Boultwood Jacqueline , Kotsianidis Ioannis , Santini Valeria , Solé Francesc , Platzbecker Uwe , Heuser Michael , Valent Peter , Finelli Carlo , Voso Maria Teresa , Shih Lee-Yung , Ogawa Seishi , Fontenay Michaela , Jansen Joop H. , Cervera Jose , Ebert Benjamin L. , Bejar Rafael , Greenberg Peter L. , Gattermann Norbert , Malcovati Luca , Cazzola Mario , Beck David B. , Hellström-Lindberg Eva , Papaemmanuil Elli
Published: April 2024

Mutations in UBA1, which are disease-defining for VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome, have been reported in patients diagnosed with myelodysplastic syndromes (MDS). Here, we define the prevalence and clinical associations of UBA1 mutations in a representative cohort of patients with MDS. Digital droplet polymerase chain reaction profiling of a selected cohort of 375 male patients lacking MDS disease-defining mutations or established World Health Organization (WHO) disease classification identified 28 patients (7%) with UBA1 p.M41T/V/L mutations. Using targeted sequencing of UBA1 in a representative MDS cohort (n = 2027), we identified an additional 27 variants in 26 patients (1%), which we classified as likely/pathogenic (n = 12) and of unknown significance (n = 15). Among the total 40 patients with likely/pathogenic variants (2%), all were male and 63% were classified by WHO 2016 criteria as MDS with multilineage dysplasia or MDS with single-lineage dysplasia. Patients had a median of 1 additional myeloid gene mutation, often in TET2 (n = 12), DNMT3A (n = 10), ASXL1 (n = 3), or SF3B1 (n = 3). Retrospective clinical review, where possible, showed that 82% (28/34) UBA1-mutant cases had VEXAS syndrome–associated diagnoses or inflammatory clinical presentation. The prevalence of UBA1 mutations in patients with MDS argues for systematic screening for UBA1 in the management of MDS.
Early changes in cardiac troponin T and NT-proBNP levels in neonates receiving ECMO support: a single-center experience
Authors: Xie Wen-Peng , Liu Yi-Nan , Zeng Ya-Ting , Zheng Yi-Rong , Chen Qiang
Published: April 2024

Objective

This study aimed to examine the changes in absolute value and decline rate of early serum cardiac troponin T (cTnT) and N-terminal pro b-type natriuretic peptide (NT-proBNP) in neonates who received veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) support therapy within the first week of life.

Methods

We retrospectively collected clinical data and laboratory test results of 18 neonates who underwent V-A ECMO support within one week of birth, from July 2021 to June 2023, using the electronic medical record system. These patients were categorized into survival and death groups. Comparative analyses of the absolute values and decline rates of cTnT and NT-proBNP were made between the groups at baseline, and at 24, 48, and 72 h post-ECMO initiation.

Results

Out of the 18 neonates, 12 survived (survival rate: 66.7%), while 6 succumbed. The survival group exhibited significantly lower absolute values of cTnT and NT-proBNP than the death group, and their decline rates were significantly higher. Notably, all neonates without an early decline in cTnT and NT-proBNP levels were in the death group.

Conclusion

The early changes in the absolute value and decline rate of serum cTnT and NT-proBNP in neonates undergoing V-A ECMO may serve as predictors of their prognosis.
Which training load indicators are greater correlated with maturation and wellness variables in elite U14 soccer players?
Authors: Nobari Hadi , Eken Özgür , Singh Utkarsh , Gorouhi Armin , Bordón José Carlos Ponce , Prieto-González Pablo , Kurtoğlu Ahmet , Calvo Tomás García
Published: April 2024

Background

Monitoring of training load is done to improve physical performance and minimize the incidence of injuries. The study examined the correlation between accumulated training load parameters based on periods with maturity (i.e., maturity offset and peak height velocity -PHV- and wellness variables -e.g., stress and sleep quality-). The second aim was to analyze the multi-linear regression between the above indicators.

Methods

Twenty elite young U14 soccer players (M = 13.26 ± 0.52 years, 95% CI [13.02, 13.51]) were evaluated over 26 weeks (early, mid, and end-season) to obtain stress, sleep quality, and measures of workload in the season (accumulated acute workload [AW], accumulated chronic workload [CW], accumulated acute: chronic workload ratio [ACWLR], accumulated training monotony [TM], accumulated training strain [TS]).

Results

The analysis revealed a moderate, statistically significant negative correlation between sleep quality and training monotony (r = -0.461, p < 0.05). No significant correlations were observed between other variables (p > 0.05). In the multi-linear regression analysis, maturity, PHV, sleep, and stress collectively accounted for variances of 17% in AW, 17.1% in CW, 11% in ACWLR, 21.3% in TM, and 22.6% in TS. However, individual regression coefficients for these predictors were not statistically significant (p > 0.05), indicating limited predictive power.

Conclusion

The study highlights the impact of sleep quality on training monotony, underscoring the importance of managing training load to mitigate the risks of overtraining. The non-significant regression coefficients suggest the complexity of predicting training outcomes based on the assessed variables. These insights emphasize the need for a holistic approach in training load management and athlete wellness monitoring.
The efficacy of real versus sham external Trigeminal Nerve Stimulation (eTNS) in youth with Attention-Deficit/Hyperactivity Disorder (ADHD) over 4 weeks: a protocol for a multi-centre, double-blind, randomized, parallel-group, phase IIb study (ATTENS)
Authors: Rubia Katya , Johansson Lena , Carter Ben , Stringer Dominic , Santosh Paramala , Mehta Mitul A. , Conti Aldo Alberto , Bozhilova Natali , Eraydin Irem Ece , Cortese Samuele
Published: April 2024

Background

Attention Deficit/Hyperactivity Disorder (ADHD), if severe, is usually treated with stimulant or non-stimulant medication. However, users prefer non-drug treatments due to side effects. Alternative non-medication treatments have so far only shown modest effects. External trigeminal nerve stimulation (eTNS) is a minimal risk, non-invasive neuromodulation device, targeting the trigeminal system. It was approved for ADHD in 2019 by the USA Food and Drug administration (FDA) based on a small proof of concept randomised controlled trial (RCT) in 62 children with ADHD showing improvement of ADHD symptoms after 4 weeks of nightly real versus sham eTNS with minimal side effects. We present here the protocol of a larger confirmatory phase IIb study testing efficacy, longer-term persistency of effects and underlying mechanisms of action.

Methods

A confirmatory, sham-controlled, double-blind, parallel-arm, multi-centre phase IIb RCT of 4 weeks of eTNS in 150 youth with ADHD, recruited in London, Portsmouth, and Southampton, UK. Youth with ADHD will be randomized to either real or sham eTNS, applied nightly for 4 weeks. Primary outcome is the change in the investigator-administered parent rated ADHD rating scale. Secondary outcomes are other clinical and cognitive measures, objective hyperactivity and pupillometry measures, side effects, and maintenance of effects over 6 months. The mechanisms of action will be tested in a subgroup of 56 participants using magnetic resonance imaging (MRI) before and after the 4-week treatment.

Discussion

This multi-centre phase IIb RCT will confirm whether eTNS is effective in a larger age range of children and adolescents with ADHD, whether it improves cognition and other clinical measures, whether efficacy persists at 6 months and it will test underlying brain mechanisms. The results will establish whether eTNS is effective and safe as a novel non-pharmacological treatment for ADHD.

Trial registration: ISRCTN82129325 on 02/08/2021, https://doi.org/10.1186/ISRCTN82129325.
Medication adherence and costs of medical care among patients with Parkinson’s disease: an observational study using electronic medical records
Authors: Yi Zhanmiao , Mao Yudan , He Chenxuan , Zhang Yantao , Zhou Junwen , Feng Xing Lin
Published: April 2024

Background

Adherence to antiparkinsonian drugs (APDs) is critical for patients with Parkinson’s disease (PD), for which medication is the main therapeutic strategy. Previous studies have focused on specific disorders in a single system when assessing clinical factors affecting adherence to PD treatment, and no international comparative data are available on the medical costs for Chinese patients with PD. The present study aimed to evaluate medication adherence and its associated factors among Chinese patients with PD using a systematic approach and to explore the impact of adequate medication adherence on direct medical costs.

Methods

A retrospective analysis was conducted using the electronic medical records of patients with PD from a medical center in China. Patients with a minimum of two APD prescriptions from January 1, 2016 to August 15, 2018 were included. Medication possession ratio (MPR) and proportion of days covered were used to measure APD adherence. Multiple linear regression analysis was used to identify factors affecting APD adherence. Gamma regression analysis was used to explore the impact of APD adherence on direct medical costs.

Results

In total, 1,712 patients were included in the study, and the mean MPR was 0.68 (± 0.25). Increased number of APDs and all medications, and higher daily levodopa-equivalent doses resulted in higher MPR (mean difference [MD] = 0.04 [0.03–0.05]; MD = 0.02 [0.01–0.03]; MD = 0.03 [0.01–0.04], respectively); combined digestive system diseases, epilepsy, or older age resulted in lower MPR (MD = -0.06 [-0.09 to -0.03]; MD = -0.07 [-0.14 to -0.01]; MD = -0.02 [-0.03 to -0.01], respectively). Higher APD adherence resulted in higher direct medical costs, including APD and other outpatient costs. For a 0.3 increase in MPR, the two costs increased by $34.42 ($25.43–$43.41) and $14.63 ($4.86–$24.39) per year, respectively.

Conclusions

APD adherence rate among Chinese patients with PD was moderate and related primarily to age, comorbidities, and healthcare costs. The factors should be considered when prescribing APDs.
Advanced AI-driven approach for enhanced brain tumor detection from MRI images utilizing EfficientNetB2 with equalization and homomorphic filtering
Authors: Zubair Rahman A. M. J. , Gupta Muskan , Aarathi S. , Mahesh T. R. , Vinoth Kumar V. , Yogesh Kumaran S. , Guluwadi Suresh
Published: April 2024

Brain tumors pose a significant medical challenge necessitating precise detection and diagnosis, especially in Magnetic resonance imaging(MRI). Current methodologies reliant on traditional image processing and conventional machine learning encounter hurdles in accurately discerning tumor regions within intricate MRI scans, often susceptible to noise and varying image quality. The advent of artificial intelligence (AI) has revolutionized various aspects of healthcare, providing innovative solutions for diagnostics and treatment strategies. This paper introduces a novel AI-driven methodology for brain tumor detection from MRI images, leveraging the EfficientNetB2 deep learning architecture. Our approach incorporates advanced image preprocessing techniques, including image cropping, equalization, and the application of homomorphic filters, to enhance the quality of MRI data for more accurate tumor detection. The proposed model exhibits substantial performance enhancement by demonstrating validation accuracies of 99.83%, 99.75%, and 99.2% on BD-BrainTumor, Brain-tumor-detection, and Brain-MRI-images-for-brain-tumor-detection datasets respectively, this research holds promise for refined clinical diagnostics and patient care, fostering more accurate and reliable brain tumor identification from MRI images. All data is available on Github: https://github.com/muskan258/Brain-Tumor-Detection-from-MRI-Images-Utilizing-EfficientNetB2).
Assessing satisfaction in simulation among nursing students: psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale
Authors: Alberti Sara , Guasconi Massimo , Bolzoni Marina , Donnini Giulia , Volpi Paola , Rovesti Sergio , Monaco Federico , Bonacaro Antonio , Ferri Paola
Published: April 2024

Background

The Satisfaction with Simulation Experience scale is a 5-point Likert scale that measures students’ satisfaction in medium and high-fidelity simulation scenarios. This study aims at investigating the psychometric properties of the Satisfaction with Simulation Experience - Italian Version scale.

Methods

A multi-centre cross-sectional study was conducted. The scale was administered to a sample of 266 undergraduate nursing students from two Italian universities after attending a medium- and high-fidelity simulation session in November 2022 and March 2023. Cronbach’s alpha coefficient and item-total correlation were sorted out to assess internal consistency and reliability. The test-retest method was used as a measure of scale stability over time as well as the confirmatory factor analysis to verify construct validity.

Results

The Cronbach’s alpha value was 0.94 for the overall scale, indicating excellent reliability, and it was 0.84 or higher for each subscales, indicating good reliability. A large correlation coefficient of 0.60 or higher was found between each item and its subscale and between each item and the overall scale score. A medium test-retest correlation coefficient was found for most items (r > 0.30). The confirmatory factor analysis confirmed the factorial structure found in the original study.

Conclusions

Satisfaction is an important teaching and learning quality indicator along with the achievement of learning outcomes in simulation. The Satisfaction with Simulation Experience - Italian Version scale showed good reliability and validity; therefore, it could be a useful tool to assess simulation impact in Italian nursing students. The extensive utilization of the Satisfaction with Simulation Experience scale, along with its various validated versions, could facilitate assessing satisfaction in simulation across diverse contexts and enable comparisons of findings across studies in different countries.
Blockade of PI3K/AKT signaling pathway by Astragaloside IV attenuates ulcerative colitis via improving the intestinal epithelial barrier
Authors: Zhang Xinhui , Zhang Fan , Li Yan , Fan Na , Zhao Ke , Zhang Anding , Kang Jiefang , Lin Yan , Xue Xiaochang , Jiang Xun
Published: April 2024

Background

The specific pathogenesis of UC is still unclear, but it has been clear that defects in intestinal barrier function play an important role in it. There is a temporary lack of specific drugs for clinical treatment. Astragaloside IV (AS-IV) is one of the main active ingredients extracted from Astragalus root and is a common Chinese herbal medicine for the treatment of gastrointestinal diseases. This study aimed to determine whether AS-IV has therapeutic value for DSS or LPS-induced intestinal epithelial barrier dysfunction in vivo and in vitro and its potential molecular mechanisms.

Methods

The intestinal tissues from UC patients and colitis mice were collected, intestinal inflammation was observed by colonoscopy, and mucosal barrier function was measured by immunofluorescence staining. PI3K/AKT signaling pathway activator YS-49 and inhibitor LY-29 were administered to colitic mice to uncover the effect of this pathway on gut mucosal barrier modulation. Then, network pharmacology was used to screen Astragaloside IV (AS-IV), a core active component of the traditional Chinese medicine Astragalus membranaceus. The potential of AS-IV for intestinal barrier function repairment and UC treatment through blockade of the PI3K/AKT pathway was further confirmed by histopathological staining, FITC-dextran, transmission electron microscopy, ELISA, immunofluorescence, qRT-PCR, and western blotting. Finally, 16 S rRNA sequencing was performed to uncover whether AS-IV can ameliorate UC by regulating gut microbiota homeostasis.

Results

Mucosal barrier function was significantly damaged in UC patients and murine colitis, and the activated PI3K/AKT signaling pathway was extensively involved. Both in vivo and vitro showed that the AS-IV-treated group significantly relieved inflammation and improved intestinal epithelial permeability by inhibiting the activation of the PI3K/AKT signaling pathway. In addition, microbiome data found that gut microbiota participates in AS-IV–mediated intestinal barrier recovery as well.

Conclusions

Our study highlights that AS-IV exerts a protective effect on the integrality of the mucosal barrier in UC based on the PI3K/AKT pathway, and AS-IV may serve as a novel AKT inhibitor to provide a potential therapy for UC.

Graphical abstract
Utility and usability of a wearable system and progressive-challenge cued exercise program for encouraging use of the more involved arm at-home after stroke—a feasibility study with case reports
Authors: Horder Jake , Mrotek Leigh A. , Casadio Maura , Bassindale Kimberly D. , McGuire John , Scheidt Robert A.
Published: April 2024

Background

Understanding the role of adherence to home exercise programs for survivors of stroke is critical to ensure patients perform prescribed exercises and maximize effectiveness of recovery.

Methods

Survivors of hemiparetic stroke with impaired motor function were recruited into a 7-day study designed to test the utility and usability of a low-cost wearable system and progressive-challenge cued exercise program for encouraging graded-challenge exercise at-home. The wearable system comprised two wrist-worn MetaMotionR+ activity monitors and a custom smartphone app. The progressive-challenge cued exercise program included high-intensity activities (one repetition every 30 s) dosed at 1.5 h per day, embedded within 8 h of passive activity monitoring per day. Utility was assessed using measures of system uptime and cue response rate. Usability and user experience were assessed using well-validated quantitative surveys of system usability and user experience. Self-efficacy was assessed at the end of each day on a visual analog scale that ranged from 0 to 100.

Results

The system and exercise program had objective utility: system uptime was 92 ± 6.9% of intended hours and the rate of successful cue delivery was 99 ± 2.7%. The system and program also were effective in motivating cued exercise: activity was detected within 5-s of the cue 98 ± 3.1% of the time. As shown via two case studies, accelerometry data can accurately reflect graded-challenge exercise instructions and reveal differentiable activity levels across exercise stages. User experience surveys indicated positive overall usability in the home settings, strong levels of personal motivation to use the system, and high degrees of satisfaction with the devices and provided training. Self-efficacy assessments indicated a strong perception of proficiency across participants (95 ± 5.0).

Conclusions

This study demonstrates that a low-cost wearable system providing frequent haptic cues to encourage graded-challenge exercise after stroke can have utility and can provide an overall positive user experience in home settings. The study also demonstrates how combining a graded exercise program with all-day activity monitoring can provide insight into the potential for wearable systems to assess adherence to—and effectiveness of—home-based exercise programs on an individualized basis.
Clinical and epidemiological characteristics of 96 pediatric human metapneumovirus infections in Henan, China after COVID-19 pandemic: a retrospective analysis
Authors: Ji Wangquan , Chen Yu , Han Shujie , Dai Bowen , Li Kang , Li Shuang , Li Zijie , Chen Shouhang , Zhang Yaodong , Zhang Xiaolong , Li Xiaolong , Wang Qingmei , Zheng Jiaying , Wang Chenyu , Liang Qiujing , Han Shujuan , Zhang Ruyu , Wang Fang , Jin Yuefei
Published: April 2024

Background

In the aftermath of the COVID-19 pandemic, there has been a surge in human metapneumovirus (HMPV) transmission, surpassing pre-epidemic levels. We aim to elucidate the clinical and epidemiological characteristics of HMPV infections in the post-COVID-19 pandemic era.

Methods

In this retrospective single-center study, participants diagnosed with laboratory confirmed HMPV infection through Targeted Next Generation Sequencing were included. The study encompassed individuals admitted to Henan Children's Hospital between April 29 and June 5, 2023. Demographic information, clinical records, and laboratory indicators were analyzed.

Results

Between April 29 and June 5, 2023, 96 pediatric patients were identified as infected with HMPV with a median age of 33.5 months (interquartile range, 12 ~ 48 months). The majority (87.5%) of infected children were under 5 years old. Notably, severe cases were statistically younger. Predominant symptoms included fever (81.3%) and cough (92.7%), with wheezing more prevalent in the severe group (56%vs21.1%). Coinfection with other viruses was observed in 43 patients, with Epstein–Barr virus (EBV) (15.6%) or human rhinovirus A (HRV type A) (12.5%) being the most common. Human respiratory syncytial virus (HRSV) coinfection rate was significantly higher in the severe group (20%vs1.4%). Bacterial coinfection occurred in 74 patients, with Haemophilus influenzae (Hin) and Streptococcus pneumoniae (SNP) being the most prevalent (52.1% and 41.7%, respectively). Severe patients demonstrated evidence of multi-organ damage. Noteworthy alterations included lower concentration of IL-12p70, decreased lymphocytes percentages, and elevated B lymphocyte percentages in severe cases, with statistical significance. Moreover, most laboratory indicators exhibited significant changes approximately 4 to 5 days after onset.

Conclusions

Our data systemically elucidated the clinical and epidemiological characteristics of pediatric patients with HMPV infection, which might be instructive to policy development for the prevention and control of HMPV infection and might provide important clues for future HMPV research endeavors.
Health-related quality of life in children and adolescents with Marfan syndrome or related disorders: a controlled cross-sectional study
Authors: Edouard Thomas , Picot Marie-Christine , Bajanca Fernanda , Huguet Helena , Guitarte Aitor , Langeois Maud , Chesneau Bertrand , Van Kien Philippe Khau , Garrigue Eric , Dulac Yves , Amedro Pascal
Published: April 2024

Background

This cross-sectional controlled study aims to assess health-related quality of life (HRQoL) of children and adolescents with a molecular diagnosis of Marfan syndrome (MFS) or related disorders and to evaluate the factors associated with HRQoL in this population. Sixty-three children with MFS and 124 age- and sex-matched healthy children were recruited. HRQoL was assessed using the Pediatric Quality of Life Inventory (PedsQL™) generic questionnaire. The correlation between HRQoL scores and the different continuous parameters (age, body mass index, disease severity, systemic score, aortic sinus diameter, and aerobic physical capacity) was evaluated using Pearson’s or Spearman’s coefficient. A multiple linear regression analysis was performed on the two health summary self-reported PedsQL™ scores (physical and psychosocial) to identify the factors associated with HRQoL in the MFS group.

Results

Except for emotional functioning, all other domains of HRQoL (psychosocial and physical health, social and school functions) were significantly lower in children with MFS compared to matched healthy children. In the MFS group, the physical health summary score was significantly lower in female than in male patients (self-report: absolute difference [95%CI] = -8.7 [-17.0; -0.47],P = 0.04; proxy-report: absolute difference [95%CI] = -8.6 [-17.3; 0.02],P = 0.05) and also negatively correlated with the systemic score (self-report:R = -0.24,P = 0.06; proxy-report:R = -0.29,P = 0.03) and with the height Z-score (proxy-report:R = -0.29,P = 0.03). There was no significant difference in the physical health summary scores between the different genetic subgroups. In the subgroup of 27 patients who performed a cardiopulmonary exercise test, self- and proxy-reported physical health summary scores were highly correlated with their aerobic physical capacity assessed by peak oxygen consumption (VO2max) and ventilatory anaerobic threshold (VAT). In the multivariate analysis, the most important independent predictors of decreased physical health were increased height, decreased body mass index, decreased VAT and use of prophylactic therapy.

Conclusions

This study reports an impaired HRQoL in children and adolescents with MFS or related conditions, in comparison with matched healthy children. Educational and rehabilitation programs must be developed and evaluated to improve exercise capacity and HRQoL in these patients.

Trial registration

ClinicalTrials.gov,NCT03236571. Registered 28 July 2017.
Predictors of long-term mortality in older patients with hip fractures managed by hemiarthroplasty: a 10-year study based on a population registry in Saxony, Germany
Authors: Fakler Johannes K.M. , Pieroh Philipp , Höch Andreas , Roth Andreas , Kleber Christian , Löffler Markus , Heyde Christoph E. , Zeynalova Samira
Published: April 2024

Background

Mortality of patients with a femoral neck fracture is high, especially within the first year after surgery, but also remains elevated thereafter. The aim of this study was to identify factors potentially associated with long-term mortality in patients homogeneously treated with hemiarthroplasty for femoral neck fracture.

Methods

This retrospective cohort study was performed at a single level 1 national trauma center at the university hospital of Leipzig (Saxony, Germany). The study time-window was January 1, 2010 to December 31, 2020. Primary outcome measure was mortality depending on individual patient-related characteristics and perioperative risk factors. Inclusion criteria was a low-energy femoral neck fracture (Garden I-IV) in geriatric patients 60 years of age or older that were primarily treated with bipolar hemiarthroplasty. Date of death or actual residence of patients alive was obtained from the population register of the eastern German state of Saxony, Germany. The outcome was tested using the log-rank test and plotted using Kaplan-Meier curves. Unadjusted and adjusted for other risk factors such as sex and age, hazard ratios were calculated using Cox proportional hazards models and presented with 95% confidence intervals (CI).

Results

The 458 included patients had a median age of 83 (IQR 77–89) years, 346 (75%) were female and 113 (25%) male patients. Mortality rates after 30 days, 1, 5 and 10 years were 13%, 25%, 60% and 80%, respectively. Multivariate regression analysis revealed age (HR = 1.1; p < 0.001), male gender (HR = 1.6; p < 0.001), ASA-Score 3–4 vs. 1–2 (HR = 1.3; p < 0.001), dementia (HR = 1.9; p < 0.001) and a history of malignancy (HR = 1.6; p = 0.002) as independent predictors for a higher long-term mortality risk. Perioperative factors such as preoperative waiting time, early surgical complications, or experience of the surgeon were not associated with a higher overall mortality.

Conclusions

In the present study based on data from the population registry from Saxony, Germany the 10-year mortality of older patients above 60 years of age managed with hemiarthroplasty for femoral neck fracture was 80%. Independent risk factors for increased long-term mortality were higher patient age, male gender, severe comorbidity, a history of cancer and in particular dementia. Perioperative factors did not affect long-term mortality.
Refractory pneumonia caused by Prevotella heparinolytica: a case report
Authors: Sun Jiongzhou , Xu Xun , Gao Shiyuan , Pan Qiong , Liu Zian , Huang Yiwen , Lian Yixin
Published: April 2024

Background

Prevotellaheparinolytica is a Gram-negative bacterium that is commonly found in the oral, intestinal, and urinary tracts. It has been extensively studied in lower respiratory tract infections in horses, which has heparinolytic activity and can secrete heparinase and further induces virulence factors in cells and causes disease. However, no such cases have been reported in humans.

Case presentation

A 58-year-old male patient from China presented to the respiratory clinic in Suzhou with a productive cough producing white sputum for 20 days and fever for 3 days. Prior to this visit, a chest computed tomography scan was conducted, which revealed multiple patchy nodular opacities in both lungs. On admission, the patient presented with a temperature of 38.1 °C and a pulse rate of 110 beats per minute. Despite routine anti-infective treatment with moxifloxacin, his temperature fluctuated and the treatment was ineffective. The patient was diagnosed with Prevotellaheparinolytica infection through metagenomic next-generation sequencing. Therefore, the antibiotics were switched to piperacillin–tazobactam in combination with ornidazole, which alleviated his symptoms; 1 week after discharge, the patient returned to the clinic for a follow-up chest computed tomography, and the opacities on the lungs continued to be absorbed.

Conclusion

Prevotellaheparinolytica is an opportunistic pathogen. However, it has not been reported in human pneumonia. In refractory pneumonia, measures such as metagenomic next-generation sequencing can be used to identify pathogens and help guide antibiotic selection and early support.
Prevalence of thyroid dysfunction and associated factors among adult type 2 diabetes mellitus patients, 2000–2022: a systematic review and meta-analysis
Authors: Hadgu Rishan , Worede Abebaw , Ambachew Sintayehu
Published: April 2024

Background

Thyroid dysfunction (TD) and type 2 diabetes mellitus (T2DM) frequently co-occur and have overlapping pathologies, and their risk increases with age. Thyroid dysfunction along with T2DM will worsen macro- and microvascular complications, morbidity, and mortality.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline was followed. The databases used were Embase, ScienceDirect, PubMed, and Google Scholar. The Joana Briggs Institute (JBI) scale was used to assess the quality of the included studies. The data was extracted by Microsoft Excel and analyzed through STATA version 14 software. The overall pooled prevalence of TD and its main components were estimated using the random-effects model. The consistency of studies was assessed byI2test statistics. Pooled meta-logistic regression was used to present the pooled prevalence with a 95% confidence interval (CI). Besides, subgroup and sensitivity analyses were employed.

Result

Thirty-eight studies were included. The pooled prevalence of TD was 20.24% (95%CI: 17.85, 22.64). The pooled prevalence of subclinical hypothyroidism, hypothyroidism, subclinical hyperthyroidism, and hyperthyroidism was found to be 11.87% (95%CI: 6.90, 16.84), 7.75% (95%CI: 5.71, 9.79), 2.49% (95%CI: 0.73, 4.25), and 2.51% (95%CI: 1.89, 3.13), respectively. Subgroup analysis based on continent revealed a higher prevalence of TD in Asia and Africa. Factors like being female,HbA1c ≥ 7%, DM duration > 5 years, family history of TD, central obesity, smoking, the presence of retinopathy, and neuropathy were found associated with TD.

Conclusion

The current systematic review and meta-analysis showed that the TD’s pooled prevalence was relatively higher than the general population. Therefore, regular screening of TD should be done for T2DM patients.