bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing children's psychosocial well-being: Norwegian early childhood education and care teachers’ challenges when completing a global screening tool
Authors: Franck Karianne , Seland Monica , Rimul Johanne , Sivertsen Anne H , Kernan Margaret
Published: November 2022

In this article, the authors illustrate some of the challenges and dilemmas that Norwegian early childhood education and care teachers experienced when completing a global screening tool (UPSI-5: Universal Psychosocial Indicator for 5 Year Old Boys and Girls) concerning the psychosocial well-being of five-year-olds as part of an international research project. Based on interviews with 31 teachers, the authors present in-depth analysis of the critical reflections of 19 teachers concerning the assessment forms. While previous research has criticized standardized testing and screening in early childhood education and care, there is a need for the critical voices of practitioners to be heard. The aim of this article is to illustrate which aspects teachers find challenging and how they respond when in doubt. The authors found that teachers’ assessments are inextricably linked to the early childhood education and care context, and the values, ideas and norms that are prevalent in Nordic early childhood education and care settings.
A topic among others—examining the attention dynamics of the COVID-19 pandemic through interviews with Finnish journalists
Authors: Harjuniemi Timo
Published: November 2022

Media research has shown that media attention to pandemics is largely driven by rising case numbers, policy responses and scientific breakthroughs. However, less is known about the issue attention dynamics that feed a decline in the media attention to pandemics. By building on the literature on issue attention and on 18 semi-structured interviews with Finnish journalists, this article explores the issue attention dynamics of the COVID-19 pandemic. The article identifies three factors that lead to a decrease in the attention that a pandemic receives. First, issue fatigue diminishes the amount of attention while issue competition replaces the pandemic with other issues on the news agenda. Second, changes in the course of the pandemic—such as the introduction of vaccines— affect media attention. Third, this article illustrates how news media organisations try to balance informing the public of the risks related to the pandemic and not overreacting to the threat it poses.
Governing by slogans
Authors: Sardoč Mitja , Prebilič Vladimir
Published: November 2022

Throughout recorded history, slogans have been an important part of our public life. From political rhetoric and propaganda, to social movements and awareness-raising campaigns, their usage has overcome historical periods, cultural barriers, ethnic affiliation, political systems, party allegiance or personal taste. Arguably more than any other linguistic ‘device’, slogans deliver a clearly recognizable message with as little complexity as possible. Nevertheless, despite their rhetorical ‘economy’, the narratives provided by slogans have also been associated with a simplified or even reductionist portrayal of otherwise complex or controversial phenomena. This article aims to address a range of previously neglected aspects associated with slogans and governmentality. The introductory part provides a genealogy of discussions over slogans and the main shortcomings the use of slogans has been associated with. The central part takes a closer look at zero tolerance, a flagship policy associated with the neoliberal logic of governance. The concluding part of this article outlines the subversive character associated with the mechanism of sloganization.
Security, Public Order and Paramilitarism in Poland and Czechoslovakia, 1918–1920: Comparative Considerations
Authors: Fischerová Barbora , Böhler Jochen
Published: November 2022

This article investigates the struggle for control over the violence that the Second Polish Republic and the First Czechoslovak Republic fought during their early independence in 1918. As violence had spread throughout the European continent during World War I, it became a crucial post-war question to control its expansion throughout the societies, as different paramilitary groups started to take the law into their own hands, either to protect their co-citizen's interests, or to enforce their own political or economic ambitions, and very often both at the same time. Thus, the use and limitation of violence were ambivalent: the newcomer states often relied on paramilitary units as policing forces and instruments to expand their state power into contested, ethnically mixed border areas. On the other hand, these emerging states faced difficulties to control paramilitary groups, which challenged the state's authority and followed their own – often criminal – agenda. This article aspires to comparatively examine the use of violence and its attempted regulation in Poland and Czechoslovakia during the first years of their existence. Furthermore, presenting the Polish-Czech conflict over Cieszyn Silesia, it aims to show how, immediately after the Great War, ethnopolitical tugs-of-war, fought between regular soldiers and paramilitaries of neighbouring states over borderlands created civil war-like scenarios and put the ethnically mixed population in these regions between a proverbial rock and a hard place.
Review on: Dossier submission in the European countries by using mutual recognition procedure and decentralized procedure
Authors: Marathe Dimple D , Shahzeb Shaikh Md
Published: November 2022

There is different procedure used to submit drug product for marketing authorization process. Mutual recognition procedure (MRP) is one of them. The European commission had published the procedure in consultation with competent authorities of member state. Using MRP, the applicant can apply for marketing authorization in one or more European Union nations. (MAH) who already holds authorization for a medical product in a EUROPEAN UNION (EU) member state can use the mutual recognition method to get authorization in additional EU member states. Directive 2004/27/EC established the decentralized procedure. Because the mutual recognition mechanism is also reliant on national authorities recognizing a first assessment done by one-member state, the distinction is that it only applies to pharmaceutical products that do not yet have a marketing authorization at the time of application.
RAFF-Net: An improved tongue segmentation algorithm based on residual attention network and multiscale feature fusion
Authors: Song Haibei , Huang Zonghai , Feng Li , Zhong Yanmei , Wen Chuanbiao , Guo Jinhong
Published: November 2022

Objective

Due to the complexity of face images, tongue segmentation is susceptible to interference from uneven tongue texture, lips and face, resulting in traditional methods failing to segment the tongue accurately. To address this problem, RAFF-Net, an automatic tongue region segmentation network based on residual attention network and multiscale feature fusion, was proposed. It aims to improve tongue segmentation accuracy and achieve end-to-end automated segmentation.

Methods

Based on the UNet backbone network, different numbers of ResBlocks combined with the Squeeze-and-Excitation (SE) block was used as an encoder to extract image layered features. The decoder structure of UNet was simplified and the number of parameters of the network model was reduced. Meanwhile, the multiscale feature fusion module was designed to optimize the network parameters by combining a custom loss function instead of the common cross-entropy loss function to further improve the detection accuracy.

Results

The RAFF-Net network structure achieved Mean Intersection over Union (MIoU) and F1-score of 97.85% and 97.73%, respectively, which improved 0.56% and 0.46%, respectively, compared with the original UNet; ablation experiments demonstrated that the improved algorithm could contribute to the enhancement of tongue segmentation effect.

Conclusion

This study combined the residual attention network with multiscale feature fusion to effectively improve the segmentation accuracy of the tongue region, and optimized the input and output of the UNet network using different numbers of ResBlocks, SE block, multiscale feature fusion and weighted loss function, increased the stability of the network and improved the overall effect of the network.
The effect of anterior ankle-foot orthosis and posterior ankle-foot orthosis on functional ambulation in stroke patients
Authors: Zarezadeh Reihaneh , Arazpour Mokhtar , Aminian Gholamreza
Published: November 2022

Background

The goal of rehabilitation after stroke is to restore safe and sufficient function to hemiplegic patients, and prescription of an ankle-foot orthosis (AFO) to improve speed and functional ambulation is a part of this program.

Objective

This crossover randomized interventional study aimed to evaluate the effect of an anterior ankle-foot orthosis (AAFO) and posterior leaf-spring ankle-foot orthosis (PLS AFO) on speed and functional ambulation in hemiplegic stroke patients.

Method

Clinical assessments were performed on 11 hemiplegic stroke patients by the AAFO, PLS AFO, and wearing shoes. Functional ambulation was measured by the 6-min walking test, Timed Up and Go Test, Time Up and Down Stair Test, and Functional Ambulation Category. Walking speed was measured by the 10-m test.

Results

Both PLS AFO and AAFO significantly improved the performance of TUDS and TUG tests in hemiplegic patients. However, by using PLS AFO, walking distance was significantly greater than walking with shoes. There was no significant effect on the walking speed improvement using PLS AFO or AAFO compared to wearing shoes.

Conclusions

The positive effects of the AAFO and PLS AFO on functional ambulation were significant. By using PLS AFO, hemiplegic patients could walk a longer distance than wearing shoes.
Dynamics of Transformation of Right to Education in India from Directive Principle to Fundamental Right: A History of Denial
Authors: Mondal Ajit
Published: November 2022

The demand for free and compulsory education in India began more than a century ago. The narration of free and compulsory education during British rule in India was a chequered history of unfulfilled vision. India attained its independence from British rule in 1947. On 26 January 1950 when the Constitution of India came into operation, the constitutional directive for free and compulsory education was under the directive principles as a ‘non-justiciable’ right through Article 45 promising to fulfil within a period of ten years from its commencement. But the state failed to do so for the next 5 decades. Ultimately, the Right of Children to Free and Compulsory Education Act (Right to Education Act), 2009, came into effect on 1 April 2010, pursuant to the 86th Amendment to the Constitution of India (2002), which mandates elementary education as a fundamental right. India took more than a half-century in evolving free and compulsory education from the directive principle to fundamental right, from ‘justiciable right’ to ‘non-justiciable right’. However, this article intends to analyse the dynamics of transformation of the right to free and compulsory education in India from directive principle to fundamental right in light of the history of persistent denial in the post-Constitutional era. The article also explores what actually happened at the time of framing the Indian Constitution that the right to education was finally shifted from a ‘justiciable right’ to ‘non-justiciable right’ in the final text of the Constitution of India.
Immunopathology of Cutaneous Leishmaniasis in a Cohort of Sri Lankan Patients
Authors: Wijesinghe Harshima Disvini , Wijesinghe Gayani Kokila , Fernando Deepika , Silva Chandu de
Published: November 2022

Introduction and objectives:

Leishmania donovani is the causative organism of leishmaniasis in Sri Lanka. Studies on the immunopathology of leishmaniasis due to L. donovani are limited. The objective of this study was to describe the immunopathological characteristics of cutaneous leishmaniasis in a cohort of Sri Lankan patients.

Methodology:

Fifty skin biopsies of cutaneous leishmaniasis confirmed by detection of organisms by histology, culture, slit-skin smear, and/or polymerase chain reaction were reviewed. The inflammatory infiltrate was characterized by immunohistochemical staining for CD4, CD8, CD20, and CD68. Associations and correlations between immunohistochemical staining pattern and the parasitic load, and patterns of inflammation were determined.

Results:

The majority of biopsies showed a CD8+/CD4− T lymphocyte predominant infiltrate (84%, n = 42). A CD68 predominant infiltrate was seen in 16%(n = 8). The mean percentage of CD8+, CD4+, CD20+, and CD68+ inflammatory cells in the biopsies were 56.1% (SD = 16.5%), 2.6% (SD = 4.5%), 12.3% (SD = 10.9%), and 25.7% (SD = 15.8%) respectively. There was no association between the predominant inflammatory cell and the degree of inflammation ( P = .173), presence of high RPI ( P = .922), MRI( P = .367) or presence of granuloma ( P = .247).The percentage of CD4+ cells showed a positive correlation with granuloma formation (Correlation coefficient = .411, P = .03). The percentage of CD20+ cells in the infiltrate showed a positive correlation with the degree of inflammation (Correlation coefficient = .491, P = .02) and the RPI (Correlation coefficient = .334, P = .018).

Discussion and Conclusion:

Skin biopsies from cutaneous leishmaniasis due to L. donovani infection showed a CD8+/CD4− predominant infiltrate. This is similar to the findings of studies on cutaneous leishmaniasis due to some other species and suggests that the cytotoxic T cell response plays a role in infections due to L. donovani.
Combined Pharmacological and Complex and High-risk Coronary Intervention of Chronic Total Occlusion for Ischemic Mitral Regurgitation
Authors: Jariwala Pankaj , Khetan Saket
Published: November 2022

Percutaneous coronary intervention for chronic total occlusion is a complex and high-risk intervention (CHIP). Even though persistent ischemia-induced mitral regurgitation is rare, ischemic mitral regurgitation is a frequent complication of an acute coronary crisis. Transcatheter mitral repair has the potential to supplant surgical repair or replacement as the gold-standard treatment for persistent mitral regurgitation. Currently, these interventions are only performed on high-risk surgical candidates, but the indications may eventually be expanded to include low-to-intermediate risk patients as well, in a manner like transcatheter aortic valve replacement.

In patients with ischemic cardiomyopathy who still had considerable viable myocardium, combining current guideline-directed pharmacological treatment with interventional complete revascularization decreased hospitalizations for heart failure. We performed a CHIP intervention on the left circumflex artery, which was chronically totally occluded, to address the severe ischemic mitral regurgitation that had been present for a long time.
Prevalence of Cardiac Dysfunction in Cirrhosis and Its Relation With Meld Score
Authors: Kumar Arvind , Bansal Tania , Bery Amit , Sood Ajit
Published: November 2022

Background:

Cardiac structural and functional abnormalities have been described in patients of liver cirrhosis. The constellation of these abnormalities is termed as cirrhotic cardiomyopathy (CCM) and its prevalence remains unknown, mostly because the disease is latent and shows itself when the patient is subjected to stress. This study was designed to evaluate the prevalence of cardiac dysfunction in patients of liver cirrhosis and to analyze its relation with model for end-stage liver disease (MELD) score.

Methods:

Hundred patients of liver cirrhosis were enrolled for the study and divided into 3 groups according to MELD score: ≤9, 10-19, and ≥20. All study participants underwent detailed cardiac assessment with Doppler echocardiography. Prevalence of cardiac dysfunction and its relation with MELD score was determined.

Results:

Prevalence of CCM and diastolic dysfunction (DD) was 48% and 30%, respectively. A total of 82%, 59%, and 50% patients had prolonged corrected QT interval (QTc), isovolumic relaxation time (IVRT), and deceleration time (DT), respectively. Prevalence of CCM, DD and prolonged QTc, IVRT, and DT had significant correlation with MELD score ( P < .05).

Conclusion:

Patients with cirrhosis had impaired cardiac function, mainly present as CCM and DD, and the extent of dysfunction was correlated with the MELD score. Hence, MELD scoring system can be used to predict risk of occurrence of cardiac dysfunction in cirrhosis.
GLPG1205 for idiopathic pulmonary fibrosis: a phase 2 randomised placebo-controlled trial
Authors: Strambu Irina R. , Seemayer Christian A. , Fagard Liesbeth M-C.A. , Ford Paul A. , Van der Aa Tom A.K. , de Haas-Amatsaleh Angela A. , Modgill Vikas , Santermans Eva , Sondag Eric N. , Helmer Eric G. , Maher Toby M. , Costabel Ulrich , Cottin Vincent
Published: November 2022

Background

GLPG1205 is a selective functional antagonist of G-protein-coupled receptor 84, which plays an important role in fibrotic processes. This study assessed the efficacy, safety and tolerability of GLPG1205 for treatment of idiopathic pulmonary fibrosis (IPF).

Methods

PINTA (ClinicalTrials.gov:NCT03725852) was a phase 2, randomised, double-blind, placebo-controlled, proof-of-concept trial. Patients with IPF were randomised 2:1 to once-daily oral GLPG1205 100 mg or placebo for 26 weeks and stratified to receive GLPG1205 alone or with local standard of care (nintedanib or pirfenidone). The primary end-point was change from baseline in forced vital capacity (FVC); other end-points were safety and tolerability, and lung volumes measured by imaging (high-resolution computed tomography). The study was not powered for statistical significance.

Results

In total, 68 patients received study medication. Least squares mean change from baseline in FVC at week 26 was −33.68 (95% CI −112.0–44.68) mL with GLPG1205 and −76.00 (95% CI −170.7–18.71) mL with placebo (least squares mean difference 42.33 (95% CI −81.84–166.5) mL; p=0.50). Lung volumes by imaging declined −58.30versus−262.72 mL (whole lung) and −33.68versus−135.48 mL (lower lobes) with GLPG1205versusplacebo, respectively. Treatment with GLPG1205versusplacebo resulted in higher proportions of serious and severe treatment-emergent adverse events and treatment-emergent discontinuations, most apparent with nintedanib.

Conclusions

Treatment with GLPG1205 did not result in a significant difference in FVC declineversusplacebo. GLPG1205 demonstrated a poorer safety and tolerability profile than placebo.
Exercise rehabilitation in COPD and heart failure: comparison of two national audits
Authors: Jones Amy V. , Evans Rachael A. , Harrison Alexander S. , Sherar Lauren B. , Steiner Michael C. , Doherty Patrick , Singh Sally J.
Published: November 2022

Background

Pulmonary (PR) and cardiac rehabilitation (CR) are recommended in the management of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF); the impact of coexisting COPD and CHF on completion and outcomes of rehabilitation programmes is unknown. We examined enrolment, completion and clinical outcomes of CR and PR in adults with COPD, CHF and coexisting COPD and CHF.

Methods

The National Audit of CR and National COPD Audit Programme: clinical audits of PR were analysed (211 PR and 237 CR programmes); adults with a diagnosis of CHF, COPD or coexisting COPD and CHF were identified (COPD+CHF or CHF+COPD according to database). Propensity matching was conducted (age, sex, body mass index and functional status) between COPD+CHF and COPD, and CHF+COPD and CHF. Group by time interaction was examined using mixed 2×2 analysis of variance.

Results

Those with CHF+COPD had lower enrolment and completion of CR compared to those with CHF; there were no differences in PR enrolment or completion between the two groups. Adults with COPD made a significantly larger gain in the incremental shuttle walk test compared to adults with COPD+CHF following PR (59.3 mversus37.4 m); the improvements following CR were similar (CHF 77.3 mversusCHF+COPD 58.3 m). Similar improvements were made in the 6-min walk test following CR (CHF 45.1 mversusCHF+COPD 38.8 m) and PR (COPD 48.2 mversusCOPD+CHF 44.0 m). Comparable improvements in quality of life and mood state were made following CR and PR, regardless of diagnosis.

Conclusion

We have demonstrated that multi-morbid adults benefit from exercise-based rehabilitation, yet efforts are needed to promote completion. These findings support group-based, tailored, multi-morbid exercise rehabilitation.
Feasibility Study of the GST-SVD in Extracting the Fault Feature of Rolling Bearing under Variable Conditions
Authors: Liu Xiangnan , Zhao Xuezhi , He Kuanfang
Published: November 2022

Feature information extraction is one of the key steps in prognostics and health management of rotating machinery. In the present study, an investigation about the feasibility of a methodology based on generalized S transform (GST) and singular value decomposition (SVD) methods for feature extraction in rolling bearing, due to local damage under variable conditions, is conducted. The technique adopts the GST method, following the time-frequency analysis, to transform a raw fault signal of the rolling bearing into a two-dimensional complex matrix. And then, the SVD method is performed to decompose the matrix to obtain the feature vectors. By this procedure it is possible to obtain the fault feature information of rolling bearing under different speeds and different loads. In order to streamline the feature parameters of the feature vectors to train more uncomplicated models, the principal component analysis (PCA) subsequently performed. The particle swarm optimization-support vector machine (PSO-SVM) model is used to identify and classify the different fault states of rolling bearing. Furthermore, in order to highlight the superiority of the proposed method some comparisons are conducted with the conventional methods. The obtained results show that the proposed method can effectively extract fault features of the rolling bearing under variable conditions.
A novel method for drug-target interaction prediction based on graph transformers model
Authors: Wang Hongmei , Guo Fang , Du Mengyan , Wang Guishen , Cao Chen
Published: November 2022

Background

Drug-target interactions (DTIs) prediction becomes more and more important for accelerating drug research and drug repositioning. Drug-target interaction network is a typical model for DTIs prediction. As many different types of relationships exist between drug and target, drug-target interaction network can be used for modeling drug-target interaction relationship. Recent works on drug-target interaction network are mostly concentrate on drug node or target node and neglecting the relationships between drug-target.

Results

We propose a novel prediction method for modeling the relationship between drug and target independently. Firstly, we use different level relationships of drugs and targets to construct feature of drug-target interaction. Then, we use line graph to model drug-target interaction. After that, we introduce graph transformer network to predict drug-target interaction.

Conclusions

This method introduces a line graph to model the relationship between drug and target. After transforming drug-target interactions from links to nodes, a graph transformer network is used to accomplish the task of predicting drug-target interactions.
TeaPVs: a comprehensive genomic variation database for tea plant (Camellia sinensis)
Authors: An Yanlin , Zhang Xiaoqin , Jiang Sixia , Zhao Jingjing , Zhang Feng
Published: November 2022

Genome variation not only plays an important role in plant phenotypic modeling and adaptive evolution, but also enhances population genetic diversity and regulates gene expression. The tea tree (Camellia sinensis) has a large genome (~ 3.0 Gb), making the identification of genome-wide variants time-consuming and expensive. With the continuous publication of a large number of different types of population sequencing data, there is a lack of an open platform to integrate these data and identify variants in the tea plant genome.

To integrate the genetic variation confidence in the tea plant population genome, 238 whole-genome resequencing, 213 transcriptome sequencing, and 96 hybrid F1 individuals with a total of more than 20 Tb were collected for mutation site identification. Based on these variations information, we constructed the first tea tree variation web service database TeaPVs (http://47.106.184.91:8025/ and http://liushang.top:8025/). It supports users to search all SNP, Indel, SV mutations and SSR/Polymorphic SSR sequences by location or gene ID. Furthermore, the website also provides the functions of gene expression search of different transcriptome, sequence blast, sequence extraction of CDS and mutation loci, etc.

The features of the TeaPVs database make it a comprehensive tea plant genetic variation bioinformatics platform for researchers, and will also be helpful for revealing new functional mutations in the tea plant genome and molecular marker-assisted breeding.
Two-dimensional speckle tracking echocardiography demonstrates improved myocardial function after intravenous infusion of bone marrow mesenchymal stem in the X-Linked muscular dystrophy mice
Authors: Liu Xiao , Yao Shixiang , Pan Min , Cai Yingying , Shentu Weihui , Cai Wenqian , Yu Hongkui
Published: November 2022

Background

Bone marrow mesenchymal stem cells (BMSCs) are commonly used in regenerative medicine. However, it is not clear whether transplantation of BMSCs can improve cardiac function of the X-Linked Muscular Dystrophy Mice (mdx) and how to detect it. We aimed to investigate the role of speckle tracking echocardiography (STE) in detecting cardiac function of the BMSCs-transplanted mdx in comparison with the untreated mdx.

Methods

The experimental mice were divided into the BMSCs-transplanted mdx, untreated mdx, and control mice groups (n = 6 per group). The BMSCs were transplanted via tail vein injections into a subset of mdx at 20 weeks of age. After four weeks, the cardiac functional parameters of all the mice in the 3 groups were analyzed by echocardiography. Then, all the mice were sacrificed, and the cardiac tissues were harvested and analyzed by immunofluorescence. The serum biochemical parameters were also analyzed to determine the beneficial effects of BMSCs transplantation.

Results

Traditional echocardiography parameters did not show statistically significant differences after BMSCs transplantation for the three groups of mice. In comparison with the control group, mdx showed significantly lower left ventricular (LV) STE parameters in both the long-axis and short-axis LV images (P < 0.05). However, BMSCs-transplanted mdx showed improvements in several STE parameters including significant increases in a few STE parameters (P < 0.05). Immunofluorescence staining of the myocardium tissues showed statistically significant differences between the mdx and the control mice (P < 0.05), and the mdx transplanted with BMSCs demonstrated significantly improvement compared with the untreated mdx (P < 0.05).

Conclusion

This study demonstrated that the early reduction in the LV systolic and diastolic function in the mdx were accurately detected by STE. Furthermore, our study demonstrated that the transplantation of BMSCs significantly improved myocardial function in the mdx.
The cardiac distress inventory: A new measure of psychosocial distress associated with an acute cardiac event
Authors: Jackson Alun C , Grande Michael R Le , Rogerson Michelle C , Ski Chantal F , Amerena John , Smith Julian A , Hoover Valerie , Alvarenga Marlies E , Higgins Rosemary O , Thompson David R , Murphy Barbara M
Published: November 2022

Background

Many challenges are posed by the experience of a heart attack or heart surgery which can be characterised as ‘cardiac distress’. It spans multiple psychosocial domains incorporating patients’ responses to physical, affective, cognitive, behavioural and social symptoms and experiences related to their cardiac event and their recovery. Although some measures of the psychological and emotional impacts of a cardiac event exist, none provides a comprehensive assessment of cardiac distress. To address this gap, the study aimed to develop a Cardiac Distress Inventory (CDI) using best practice in instrument design.

Method

An item pool was generated through analysis of cognate measures, mostly in relation to other health conditions and through focus group and individual review by a multidisciplinary development team, cardiac patients, and end-users including cardiac rehabilitation co-ordinators. The resulting 144 items were reduced through further reviews to 74 for testing. The testing was carried out with 405 people recruited from three hospitals, through social media and by direct enrolment on the study website. A two-stage psychometric evaluation of the 74 items used exploratory factor analysis to extract the factors followed by Rasch analysis to confirm dimensionality within factors.

Results

Psychometric analysis resulted in the identification of 55 items comprising eight subscales, to form the CDI. The subscales assess fear and uncertainty, disconnection and hopelessness, changes to roles and relationships, overwhelm and depletion, cognitive challenges, physical challenges, health system challenges, and death concerns. Validation against the Kessler 6 supports the criterion validity of the CDI.

Conclusion

The CDI reflects a nuanced understanding of cardiac distress and should prove to be a useful clinical assessment tool, as well as a research instrument. Individual subscales or the complete CDI could be used to assess or monitor specific areas of distress in clinical practice. Development of a short form screening version for use in primary care, cardiac rehabilitation and counselling services is warranted.
Association between miRNA-145 and miRNA-155 expression in peripheral blood mononuclear cells of patients with multiple sclerosis: a case-control study
Authors: Ali Ashrafi Sepide , Asadi Milad , Shanehbandi Dariush , Sadigh Eteghad Saeed , Fazlollahi Asra , Nejadghaderi Seyed Aria , Shaafi Sheida
Published: November 2022

Introduction

MicroRNAs (miR or miRNA) are short regulatory RNAs, which modulate post-transcriptional gene expression. Dysregulation of these molecules contributes to pathogenicity of autoimmune disorders, such as multiple sclerosis (MS).

Aims

This study was conducted to investigate changed expression pattern of miRNA-145 and miRNA-155 in MS.

Methods

We collected blood samples of 75 patients with relapsing-remitting MS patients and 75 healthy controls. Ficoll-Hypaque density gradient method was used to isolate peripheral blood mononuclear cells. Also, total RNA was extracted and subjected to RT-PCR analysis. We used the Mann–Whitney U test to evaluate the differences in expression levels of target miRNAs between the groups.

Results

We found that expression of miRNA-145 (P = 0.012) and miRNA-155 (P = 0.005) were partly reduced in patients with relapse-remitting MS in comparison with healthy controls. The miRNA-145 had an area under curve (AUC) of 0.621 (P = 0.01) and miRNA-155 levels had an AUC of 0.625 (P = 0.008).

Conclusion

Decreased expression of miRNA-145 and miRNA-155 contributes to development of relapse-remitting MS, while further large scale observational studies and meta-analyses are required.
A nomogram combining clinical factors and biomarkers for predicting the recurrence of high-risk cutaneous squamous cell carcinoma
Authors: Oh Yeongjoo , Zheng Zhenlong , Kim Ki-Yeol , Xu Xiangshu , Pei Meiling , Oh Byungho , Kim Sang Kyem , Chung Kee Yang , Roh Mi Ryung
Published: November 2022

Background

Although determining the recurrence of cutaneous squamous cell carcinoma (cSCC) is important, currently suggested systems and single biomarkers have limited power for predicting recurrence.

Objective

In this study, combinations of clinical factors and biomarkers were adapted into a nomogram to construct a powerful risk prediction model.

Methods

The study included 145 cSCC patients treated with Mohs micrographic surgery. Clinical factors were reviewed, and immunohistochemistry was performed using tumor tissue samples. A nomogram was constructed by combining meaningful clinical factors and protein markers.

Results

Among the various factors, four clinical factors (tumor size, organ transplantation history, poor differentiation, and invasion into subcutaneous fat) and two biomarkers (Axin2 and p53) were selected and combined into a nomogram. The concordance index (C-index) of the nomogram for predicting recurrence was 0.809, which was higher than that for the American Joint Committee on Cancer (AJCC) 7th, AJCC 8th, Brigham and Women’s Hospital, and Breuninger staging systems in the patient data set.

Conclusion

A nomogram model that included both clinical factors and biomarkers was much more powerful than previous systems for predicting cSCC recurrence.
Association between serum albumin and 60-day mortality in Chinese Hakka patients with non-APL acute myeloid leukemia: a retrospective cohort study
Authors: Xiao Zuomiao , Li Haibo , Xiao Dejun , Liu Yulan , Chen Xianchun , Luo Shi , Ji Yanhong
Published: November 2022

Background

Acute myeloid leukemia (AML) is the main type of adult leukemia, and 60-day mortality is a vital clinical problem that doctors have to face at the begin with treatment. Studies on the association between serum albumin and 60-day mortality from AML (non-APL) are limited.

Methods

In this retrospective cohort study, ALB was measured after admission in all patients diagnosed with primary AML from Affiliated Ganzhou Hospital of Nanchang University between January 2013 and May 2021. The outcome was all-cause, 60-day mortality. Multivariable Cox regression analyses were performed to calculate the adjusted hazard ratio (HR) and its corresponding 95% confidence interval (CI).

Results

This study included 394 primary AML patients. The overall 60-day mortality was 28.9% (114/394); it was 43.1% (56/130), 27.5% (36/131), and 16.5% (22/133) for ALB quantile1 (Q, < 34.5 g/L), quantile 2 (Q2, 34.5–38.5 g/L), and quantile 3 (Q3, ≥ 38.6 g/L), respectively (P = 0.001). After adjusting for potential confounders, we found an association between a 6% decrease in 60-day mortality rate and a 1 g/L increase in ALB level (HR = 0.94, 95% CI: 0.89–0.99, P = 0.015), which was associated with 38 and 70% decreases in 60-day mortality rates in Q2 (HR = 0.50, 95% CI: 0.30–0.86, P = 0.012) and Q3 (HR = 0.47, 95% CI: 0.2 5–0.90, P = 0.022), respectively, compared with that in Q1. Similar results were obtained after subgrouping based on an ALB level of 35 g/L (HR = 0.55, 95% CI: 0.34–0.88, P = 0.013).

Conclusions

Serum albumin was significantly associated with 60-day mortality of primary AML, which has important clinical significance. Further investigation is warranted.
Advances and limitations for the treatment of spinal muscular atrophy
Authors: Day John W. , Howell Kelly , Place Amy , Long Kimberly , Rossello Jose , Kertesz Nathalie , Nomikos George
Published: November 2022

Spinal muscular atrophy (5q-SMA; SMA), a genetic neuromuscular condition affecting spinal motor neurons, is caused by defects in both copies of the SMN1 gene that produces survival motor neuron (SMN) protein. The highly homologous SMN2 gene primarily expresses a rapidly degraded isoform of SMN protein that causes anterior horn cell degeneration, progressive motor neuron loss, skeletal muscle atrophy and weakness. Severe cases result in limited mobility and ventilatory insufficiency. Untreated SMA is the leading genetic cause of death in young children. Recently, three therapeutics that increase SMN protein levels in patients with SMA have provided incremental improvements in motor function and developmental milestones and prevented the worsening of SMA symptoms. While the therapeutic approaches with Spinraza®, Zolgensma®, and Evrysdi® have a clinically significant impact, they are not curative. For many patients, there remains a significant disease burden. A potential combination therapy under development for SMA targets myostatin, a negative regulator of muscle mass and strength. Myostatin inhibition in animal models increases muscle mass and function. Apitegromab is an investigational, fully human, monoclonal antibody that specifically binds to proforms of myostatin, promyostatin and latent myostatin, thereby inhibiting myostatin activation. A recently completed phase 2 trial demonstrated the potential clinical benefit of apitegromab by improving or stabilizing motor function in patients with Type 2 and Type 3 SMA and providing positive proof-of-concept for myostatin inhibition as a target for managing SMA. The primary goal of this manuscript is to orient physicians to the evolving landscape of SMA treatment.
Association between preterm births and socioeconomic development: analysis of national data
Authors: Montemor Marina Sanches , Demarque Gabriella Ferreira , Rodrigues Agatha Sacramento , Francisco Rossana Pulcinelli Vieira , de Carvalho Mario Henrique Burlacchini
Published: November 2022

Background

The increasing prevalence of preterm birth, which is a global phenomenon, is attributable to the increased medical indications, artificial gestations, and some socioeconomic factors. This study was conducted to identify whether development and equality indices are associated with the incidence of preterm birth, specifically, spontaneous and elective preterm births.

Methods

This retrospective observational study comprised an analysis of data on live births from 2019 in Brazil and on socioeconomic indices that were derived from census information in 2017. Data were summarised using absolute and relative frequencies. Spearman’s correlation was used to determine the correlation between socioeconomic factors and the preterm birth rate. Multiple beta regression analysis was performed to determine the best model of socioeconomic covariates and preterm birth rate. The significance level was set at 5%.

Results

In 2019 in Brazil, the preterm birth rate was 11.03%, of which 58% and 42% were spontaneous and elective deliveries, respectively. For all preterm births, Spearman’s correlation varied from ρ = 0.4 for the Gini Index and ρ =  − 0.24 for illiteracy. The best fit modelled the spontaneous preterm birth fraction as a negative function of the Human Development Index (HDI). The best-fit model considered the expected elective preterm birth fraction as a positive function of the HDI and as a negative function of the Gini Index, which was used as a precision parameter.

Conclusions

We observed a reduction in the fraction of spontaneous preterm births; however, the distribution was not uniform in the territory: higher rates of spontaneous preterm birth were noticed in the north, northeast, and mid-west regions. Thus, areas with lower education levels and inequal income distribution have a higher proportion of spontaneous preterm birth. The fraction of elective preterm birth was positively associated with more advantaged indices of socioeconomic status.
Comparison of frailty in patients with nontuberculous mycobacterial lung disease and bronchiectasis: a prospective cohort study
Authors: Fujita Kohei , Ito Yutaka , Yamamoto Yuki , Kanai Osamu , Imakita Takuma , Oi Issei , Ito Takanori , Saito Zentaro , Mio Tadashi
Published: November 2022

Background

The incidence of nontuberculous mycobacterial lung disease (NTM-LD) peaks in middle- and old age groups, coinciding with senescence; thus, chronic infectious diseases can accelerate frailty and worsen mental health in the elderly. In this study, we aimed to compare the prevalence of physical and psychiatric frailty between patients with NTM-LD and bronchiectasis (BE).

Methods

The Kihon Checklist Questionnaire (KCQ) was used to assess physical and psychiatric frailties and identify those at risk of requiring care among patients with newly diagnosed NTM-LD and BE. Additionally, the Hospital Anxiety and Depression Scale (HADS) scores and chronic inflammatory biomarkers of the alveolar region (surfactant protein [SP]-A, SP-D, and human cationic antibacterial protein [hCAP]/LL-37) were assessed and compared between NTM-LD and BE patients.

Results

There were no significant differences in the background characteristics between the 33 NTM and 36 BE patients recruited. The KCQ revealed that the proportion of frail NTM patients at diagnosis was higher than that of frail BE patients (48.5% vs. 22.2%, p = 0.026). HADS scores were significantly higher in the NTM group than in the BE group (p < 0.01). Bronchoalveolar lavage fluid (BALF) hCAP/LL-37 and SP-D levels were significantly higher (p = 0.001), but serum hCAP/LL-37 levels were significantly lower in the NTM group than in the BE group (p = 0.023). However, there were no significant differences in the BALF and serum SP-D levels between the two groups.

Conclusions

The number of frail NTM patients at diagnosis was significantly higher than that of frail BE patients. Biomarker analysis suggested that the former had more localized lung inflammation than the latter.

Trial registration

This trial was prospectively registered in the Clinical Trials Registry (UMIN 000027652).
Attitudes of Polish physicians, nurses and pharmacists towards the ethical and legal aspects of the conscience clause
Authors: Czekajewska Justyna , Walkowiak Dariusz , Domaradzki Jan
Published: November 2022

Background

While healthcare professionals’ right to invoke the conscience clause has been recognised as a fundamental human right, it continues to provoke a heated debate in Polish society. Although public discourse is filled with ethical and legal considerations on the conscience clause, much less is known about the attitudes of healthcare professionals regarding that matter. The aim of this study was therefore to describe the attitudes of Polish physicians, nurses and pharmacists towards the ethical and legal aspects of the conscience clause.

Methods

We analysed a group of three hundred healthcare professionals: physicians, nurses and pharmacists in Poznan, Poland, using a standard questionnaire comprising of 29 questions about various ethical and legal aspects of the conscience clause and participants’ personal experiences with the conscience clause. The study was conducted between January and March 2020.

Results

This research shows that although most Polish healthcare workers support the right to invoke the conscience clause they differ significantly in their opinions on to whom and to what medical procedures the conscience clause should apply to. It also demonstrated that while the conscience clause is rarely invoked in Poland, most healthcare professionals declare that the current legal regulations in that sphere are unclear and inaccurate.

Conclusions

While there is an urgent need to raise the awareness regarding the conscience clause among medical students and healthcare professionals and educate them about such issues, it is even more important to improve the legal system in regard to the CC so that it protects both HCPs’ right to the CC and safeguards patients’ rights to medical services.
Isolation and identification of the broad-spectrum high-efficiency phage vB_SalP_LDW16 and its therapeutic application in chickens
Authors: Cao Shengliang , Yang Wenwen , Zhu Xihui , Liu Cheng , Lu Jianbiao , Si Zhenshu , Pei Lanying , Zhang Leilei , Hu Wensi , Li Yanlan , Wang Zhiwei , Pang Zheyu , Xue Xijuan , Li Yubao
Published: November 2022

Background

Salmonella infection in livestock and poultry causes salmonellosis, and is mainly treated using antibiotics. However, the misuse use of antibiotics often triggers the emergence of multi-drug-resistant Salmonella strains. Currently, Salmonella phages is safe and effective against Salmonella, serving as the best drug of choice. This study involved 16 Salmonella bacteriophages separated and purified from the sewage and the feces of the broiler farm. A phage, vB_SalP_LDW16, was selected based on the phage host range test. The phage vB_SalP_LDW16 was characterized by the double-layer plate method and transmission electron microscopy. Furthermore, the clinical therapeutic effect of phage vB_SalP_LDW16 was verified by using the pathogenic Salmonella Enteritidis in the SPF chicken model.

Results

The phage vB_SalP_LDW16 with a wide host range was identified to the family Siphoviridae and the order Caudoviridae, possess a double-stranded DNA and can lyse 88% (22/25) of Salmonella strains stored in the laboratory. Analysis of the biological characteristics, in addition, revealed the optimal multiplicity of infection (MOI) of vB_SalP_LDW16 to be 0.01 and the phage titer to be up to 3 × 1014 PFU/mL. Meanwhile, the phage vB_SalP_LDW16 was found to have some temperature tolerance, while the titer decreases rapidly above 60 ℃, and a wide pH (i.e., 5–12) range as well as relative stability in pH tolerance. The latent period of phage was 10 min, the burst period was 60 min, and the burst size was 110 PFU/cell. Furthermore, gastric juice was also found to highly influence the activity of the phage. The clinical treatment experiments showed that phage vB_SalP_LDW16 was able to significantly reduce the bacterial load in the blood through phage treatment, thereby improving the pathological changes in the intestinal, liver, and heart damage, and promoting the growth and development of the chicken.

Conclusions

The phage vB_SalP_LDW16 is a highly lytic phage with a wide host range, which can be potentially used for preventing and treating chicken salmonellosis, as an alternative or complementary antibiotic treatment in livestock farming.
A comprehensive genotype–phenotype evaluation of eight Chinese probands with Waardenburg syndrome
Authors: Li Sijun , Qin Mengyao , Mao Shuang , Mei Lingyun , Cai Xinzhang , Feng Yong , He Chufeng , Song Jian
Published: November 2022

Background

Waardenburg syndrome (WS) is the most common form of syndromic deafness with phenotypic and genetic heterogeneity in the Chinese population. This study aimed to clarify the clinical characteristics and the genetic cause in eight Chinese WS families (including three familial and five sporadic cases). Further genotype–phenotype relationships were also investigated.

Methods

All probands underwent screening for the known WS-related genes including PAX3, SOX10, MITF, EDNRB, EDN3, and SNAI2 using next-generation sequencing to identify disease-causing genes. Further validation using Sanger sequencing was performed. Relevant findings for the associated genotype–phenotype from previous literature were retrospectively analyzed.

Result

Disease-causing variants were detected in all eight probands by molecular genetic analysis of the WS genes (SOX10(NM_006941.4): c.544_557del, c.553 C > T, c.762delA, c.336G > A; MITF(NM_000248.3): c.626 A > T; PAX3(NM_181459.4): c.838delG, c.452-2 A > G, c.214 A > G). Six mutations (SOX10:c.553 C > T, c.544_557del, c.762delA; PAX3: c.838delG, c.214 A > G; MITF:c.626 A > T) were first reported. Clinical evaluation revealed prominent phenotypic variability in these WS patients. Twelve WS1 cases and five WS2 cases were diagnosed in total. Two probands with SOX10 mutations developed progressive changes in iris color with age, returning from pale blue at birth to normal tan. Additionally, one proband had a renal malformation (horseshoe kidneys).All cases were first described as WS cases. Congenital inner ear malformations were more common, and semicircular malformations were exclusively observed in probands with SOX10 mutations. Unilateral hearing loss occurred more often in cases with PAX3 mutations.

Conclusion

Our findings helped illuminate the phenotypic and genotypic spectrum of WS in Chinese populations and could contribute to better genetic counseling of WS.