bluuebunny/crossref_metadata_2025 huggingface dataset:
Bacterial colonisation of the airway in neonates and risk of asthma and allergy until age 18 years
Authors: Sunde Rikke Bjersand , Thorsen Jonathan , Kim Min , Schoos Ann-Marie Malby , Stokholm Jakob , Bønnelykke Klaus , Bisgaard Hans , Chawes Bo
Published: December 2023

Background

We previously showed an association between neonatal bacterial airway colonisation and increased risk of persistent wheeze/asthma until age 5 years. Here, we study the association with persistent wheeze/asthma and allergy-related traits until age 18 years.

Methods

We investigated the association between airway colonisation withStreptococcus pneumoniae,Moraxella catarrhalisand/orHaemophilus influenzaein 1-month-old neonates from the COPSAC2000mother–child cohort and the development of persistent wheeze/asthma and allergy-related traits longitudinally until age 18 years using generalised estimating equations. Replication was sought in the similarly designed COPSAC2010cohort of 700 children.

Results

Neonatal airway colonisation was present in 66 (21%) out of 319 children and was associated with a 4-fold increased risk of persistent wheeze/asthma (adjusted OR 4.01 (95% CI 1.76–9.12); p<0.001) until age 7 years, but not from age 7 to 18 years. Replication in the COPSAC2010cohort showed similar results using 16S data. Colonisation was associated with an increased number of exacerbations (adjusted incidence rate ratio 3.20 (95% CI 1.38–7.44); p<0.01) until age 7 years, but not from age 7 to 18 years. Colonisation was associated with increased levels of blood eosinophils (adjusted geometric mean ratio 1.24 (95% CI 1.06–1.44); p<0.01) and tumour necrosis factor (TNF)-α (adjusted geometric mean ratio 1.09 (95% CI 1.02–1.16); p=0.01) until age 12 years. There were no associations with lung function, bronchial reactivity, fractional exhaled nitric oxide, allergic sensitisation, total IgE or atopic dermatitis up to age 18 years.

Conclusions

Neonatal airway colonisation was associated with early-onset persistent wheeze/asthma, exacerbations, elevated blood eosinophils and elevated TNF-α in blood, most prominent in early childhood, thereafter diminishing and no longer evident by age 18 years.
Twnbiome: a public database of the healthy Taiwanese gut microbiome
Authors: Chattopadhyay Amrita , Lee Chien-Yueh , Lee Ya-Chin , Liu Chiang-Lin , Chen Hsin-Kuang , Li Yung-Hua , Lai Liang-Chuan , Tsai Mong-Hsun , Ni Yen-Hsuan , Chiu Han-Mo , Lu Tzu-Pin , Chuang Eric Y.
Published: December 2023

With new advances in next generation sequencing (NGS) technology at reduced costs, research on bacterial genomes in the environment has become affordable. Compared to traditional methods, NGS provides high-throughput sequencing reads and the ability to identify many species in the microbiome that were previously unknown. Numerous bioinformatics tools and algorithms have been developed to conduct such analyses. However, in order to obtain biologically meaningful results, the researcher must select the proper tools and combine them to construct an efficient pipeline. This complex procedure may include tens of tools, each of which require correct parameter settings. Furthermore, an NGS data analysis involves multiple series of command-line tools and requires extensive computational resources, which imposes a high barrier for biologists and clinicians to conduct NGS analysis and even interpret their own data. Therefore, we established a public gut microbiome database, which we call Twnbiome, created using healthy subjects from Taiwan, with the goal of enabling microbiota research for the Taiwanese population. Twnbiome provides users with a baseline gut microbiome panel from a healthy Taiwanese cohort, which can be utilized as a reference for conducting case-control studies for a variety of diseases. It is an interactive, informative, and user-friendly database. Twnbiome additionally offers an analysis pipeline, where users can upload their data and download analyzed results. Twnbiome offers an online database which non-bioinformatics users such as clinicians and doctors can not only utilize to access a control set of data, but also analyze raw data with a few easy clicks. All results are customizable with ready-made plots and easily downloadable tables. Database URL: http://twnbiome.cgm.ntu.edu.tw/.
Left atrial Thrombus formation after discontinuation of anticoagulation in patient with severe bioprosthetic mitral stenosis
Authors: King Ryan C. , Mathew Tobin , Whang Stella , Premyodhin Ned , Patel Pranav
Published: December 2023

Background

Mitral valve stenosis can be a highly symptomatic condition with significant complications if left untreated. In such cases, mitral valve replacement with a bioprosthetic or mechanical valve may be a viable solution to prevent progressive disease. Current guidelines do not recommend continued anticoagulation beyond 6 months for patients who have undergone bioprosthetic valve replacement without a separate indication for anticoagulation. With this case discussion we aim to 1) Review the current indications for anticoagulation for bioprosthetic mitral valves in patients without atrial fibrillation and 2) Discuss the constellation of comorbidities that may affect the decision to begin anticoagulation therapy.

Case presentation

We present a case describing a 55-year-old male with end-stage renal disease, coronary artery disease with coronary artery bypass graft surgery, and bioprosthetic mitral valve replacement 2 years prior with rapid degeneration of the replaced valve and on warfarin without a clear indication for anticoagulation. The patient was admitted for symptomatic, severe mitral stenosis and consideration of transcatheter mitral valve-in-valve replacement. During hospital admission, warfarin was discontinued and replaced with prophylactic anticoagulation. However, 8 days after warfarin cessation an intraoperative transesophageal echocardiography revealed a newly developed large left atrial thrombus leading to cancellation of the planned operation.

Conclusions

This patient developed a left atrial thrombus after discontinuing warfarin in the setting of rapidly deteriorating bioprosthetic valve stenosis and vascular comorbidities. The decision to discontinue warfarin was made in concordance with current guidelines, which do not indicate systemic anticoagulation post 3–6 months after bioprosthetic valve replacement without separate indication for anticoagulation. This case identifies the need to investigate rebound hypercoagulability and further risk stratify comorbidities which may independently increase the risk of clot formation in the setting of severe mitral valve stenosis.
Digital solutions for decision support in general practice – a rapid review focused on systems developed for the universal healthcare setting in Denmark
Authors: Clausen Anne , Christensen Emilie Rosenfeldt , Jakobsen Pernille Ravn , Søndergaard Jens , Abrahamsen Bo , Rubin Katrine Hass
Published: December 2023

Background

Digital health solutions hold the potential for supporting general practitioners in decision-making, and include telemedicine systems, decision support systems, patient apps, wearables, fitness trackers, etc.

Aim

This review aimed to identify digital solutions developed for, tested, or implemented in general practice to support the decisions of GPs in disease detection and management, using Denmark as an example country of a universal healthcare setting.

Methods

This study was conducted as a rapid review. The primary search included a database search conducted in Embase and MEDLINE. The supplementary search was conducted in Infomedia and additionally included a snowball search in reference lists and citations of key articles identified in the database search. Titles were screened by two reviewers.

Results

The review included 15 studies as key articles describing a total of 13 digital solutions for decision support in general practice in Denmark. 1.123 titles were identified through the database search and 240 titles were identified through the supplementary and snowball search.

Conclusions

The review identified 13 digital solutions for decision support in general practice in a Danish healthcare setting aimed at detection and/or management of cancer, COPD, type 2 diabetes, depression, liver disease or multiple lifestyle-related diseases. Implementation aspects should be reported more transparently in future publications to enable applicability of digital solutions as decision support to aid general practitioners in disease detection and management.
Study protocol for “In-vehicle sensors to detect changes in cognition of older drivers”
Authors: Tappen Ruth , Newman David , Rosselli Monica , Jang Jinwoo , Furht Borko , Yang KwangSoo , Ghoreishi Seyedeh Gol Ara , Zhai Jiannan , Conniff Joshua , Jan Muhammad Tanveer , Moshfeghi Sonia , Panday Somi , Jackson Kelley , Adonis-Rizzo Marie
Published: December 2023

Background

Driving is a complex behavior that may be affected by early changes in the cognition of older individuals. Early changes in driving behavior may include driving more slowly, making fewer and shorter trips, and errors related to inadequate anticipation of situations. Sensor systems installed in older drivers’ vehicles may detect these changes and may generate early warnings of possible changes in cognition.

Method

A naturalistic longitudinal design is employed to obtain continuous information on driving behavior that will be compared with the results of extensive cognitive testing conducted every 3 months for 3 years. A driver facing camera, forward facing camera, and telematics unit are installed in the vehicle and data downloaded every 3 months when the cognitive tests are administered.

Results

Data processing and analysis will proceed through a series of steps including data normalization, adding information on external factors (weather, traffic conditions), and identifying critical features (variables). Traditional prediction modeling results will be compared with Recurring Neural Network (RNN) approach to produce Driver Behavior Indices (DBIs), and algorithms to classify drivers within age, gender, ethnic group membership, and other potential group characteristics.

Conclusion

It is well established that individuals with progressive dementias are eventually unable to drive safely, yet many remain unaware of their cognitive decrements. Current screening and evaluation services can test only a small number of individuals with cognitive concerns, missing many who need to know if they require treatment. Given the increasing number of sensors being installed in passenger vehicles and pick-up trucks and their increasing acceptability, reconfigured in-vehicle sensing systems could provide widespread, low-cost early warnings of cognitive decline to the large number of older drivers on the road in the U.S. The proposed testing and evaluation of a readily and rapidly available, unobtrusive in-vehicle sensing system could provide the first step toward future widespread, low-cost early warnings of cognitive change for this large number of older drivers in the U.S. and elsewhere.
Diagnostic value of computed tomography and magnetic resonance imaging in ovarian malignant mesothelioma
Authors: Wang Hai-tao , Li Ai-jing , Gao Ji-yong , Wang Liang-jiong , Wang Yu-tao , Yu Wen-ying , Zhang Jian
Published: December 2023

Objective

To investigate the diagnostic value of computed tomography (CT) and magnetic resonance imaging (MRI) in ovarian malignant mesothelioma (OMM).

Methods

The clinical and imaging data of 10 pathologically-confirmed OMM patients were analyzed retrospectively.

Result

(1) The patients were 27 years to 70 years old, with an average age of 57.2 ± 15.4 years. Seven patients reported abdominal distension and pain, 1 reported lower abdominal discomfort and decreased appetite, and 2 patients had no symptoms. (2) Two cases of localized OMM with incomplete semi-annular “capsule” observed around the localized OMM tumors were reported while 8 cases had diffuse OMM in which the tumor parenchyma showed isointense or slightly hypointense on T1WI, inhomogeneous hyperintense on T2WI, and obviously hyperintense on DWI, with obvious inhomogeneous enhancement after enhancement. Diffuse OMM was not mainly composed of ovarian masses and was mainly characterized by mild ovarian enlargement, nodular and irregular thickening of the peritoneum, cloudy omentum, unclear fat gap, and reticular or irregular thickening, which can fuse into a “cake-shape”. (3) All 10 patients underwent surgery, while 9 patients underwent systemic chemotherapy or immunotherapy after surgery. All patients with localized OMM survived. Out of the 8 diffuse-type patients, 5 died, 1 was lost to follow-up, and 2 survived.

Conclusion

OMM has certain clinical and imaging characteristics. There is no liquefaction, calcification, or partition in the tumor. The ovarian enlargement in the diffuse lesion is not significant. The diffuse thickening of the peritoneum and omentum with early appearance of mural nodules and ascites in the upper abdomen, help the diagnosis of OMM.
Metroplasty increases the take-home baby rate by reducing pregnancy loss without changing the chance of conception in women with septate uterus: a retrospective, single-center, observational study
Authors: Omoto Akiko , Ishikawa Hiroshi , Inoue Mariko , Morimoto Sachi , Koga Kaori , Shozu Makio
Published: December 2023

Background

Although abdominal or hysteroscopic metroplasty for septate uterus is considered to reduce pregnancy loss and increase the take-home baby (THB) rate in women with a history of recurrent pregnancy loss, there exists an inherent risk of impaired fertility. This study aimed to clarify the reproductive outcomes of women with septate uterus who underwent abdominal and hysteroscopic metroplasty in a single center.

Methods

This retrospective observational study enrolled 27 women who underwent metroplasty between 2007 and 2019. The analysis included women with septate uterus [European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) type U2)] or septate-bicornuate uterus (ESHRE/ESGE type U3b) who underwent either abdominal or hysteroscopic metroplasty. Women who did not have an immediate desire to conceive were excluded from the analysis. As a rule, we recommended pregnancy without surgery for women who had not experienced repeated pregnancy loss. Abdominal metroplasty (ABM) was performed using the modified Tompkins’ method and hysteroscopic metroplasty was performed using hysteroscopic transcervical resection of the septum [transcervical metroplasty (TCM)]. The conception ratio was calculated as the number of women who achieved ≥ 1 conception/total number of women, the pregnancy loss ratio was calculated as the number of women who experienced ≥ 1 pregnancy loss/the number of women who conceived, and the THB ratio was calculated as the number of women who achieved ≥ 1 THB/total number of women.

Results

Seventeen women underwent ABM and 10 women underwent TCM. Thirty-three conceptions and 26 babies were taken home after surgery. ABM did not change the ≥ 1 conception ratio (76% vs. 83% before and after surgery, respectively; RR = 1.08, p = 0.80). Meanwhile, ABM decreased the ≥ 1 pregnancy loss ratio (100% vs. 36%, RR = 0.36, p < 0.001) and increased the ≥ 1 THB ratio (12% vs. 71%, RR = 6.00, p < 0.01). Similarly, TCM did not change the ≥ 1 conception ratio, decreased the ≥ 1 pregnancy loss ratio, and increased the ≥ 1 THB ratio.

Conclusions

Both abdominal and hysteroscopic metroplasty for septate uterus increased the THB rate by preventing pregnancy loss without affecting the chance of pregnancy.

Trial registration

Not applicable.
Impact of a prehabilitation and recovery programme on emotional well-being in individuals undergoing cancer surgery: a multi-perspective qualitative study
Authors: Powell Rachael , Davies Amy , Rowlinson-Groves Kirsty , French David P. , Moore John , Merchant Zoe
Published: December 2023

Background

Prehabilitation and recovery programmes aim to optimise patients’ physical fitness and mental well-being before, during and after cancer treatment. This paper aimed to understand the impact of such a programme on emotional well-being in individuals undergoing cancer surgery. The programme was multi-modal, containing physical activity, well-being and nutritional support.

Methods

Qualitative interviews were conducted with 16 individuals who participated in a prehabilitation and recovery programme. Twenty-four health care staff involved in referral completed an online survey. An inductive, thematic analysis was conducted, integrating perspectives of patients and staff, structured with the Framework approach.

Results

Patients seemed to experience emotional benefits from the programme, appearing less anxious and more confident in their ability to cope with treatment. They seemed to value having something positive to focus on and control over an aspect of treatment. Ongoing, implicit psychological support provided by Exercise Specialists, who were perceived as expert, available and caring, seemed valued. Some patients appeared to appreciate opportunities to talk about cancer with peers and professionals. Discomfort with talking about cancer with other people, outside of the programme, was expressed.

Conclusions

Participation in a prehabilitation and recovery programme appeared to yield valuable emotional well-being benefits, even without referral to specialist psychological support.

Study registration

The study protocol was uploaded onto the Open Science Framework 24 September 2020 (https://osf.io/347qj/).
Comprehensive prognostic and immune analysis of a glycosylation related risk model in pancreatic cancer
Authors: Liu XueAng , Shi Jian , Tian Lei , Xiao Bin , Zhang Kai , Zhu Yan , Zhang YuFeng , Jiang KuiRong , Zhu Yi , Yuan Hao
Published: December 2023

Background

Pancreatic cancer (PC) is a malignant tumor with extremely poor prognosis, exhibiting resistance to chemotherapy and immunotherapy. Nowadays, it is ranked as the third leading cause of cancer-related mortality. Glycation is a common epigenetic modification that occurs during the tumor transformation. Many studies have demonstrated a strong correlation between glycation modification and tumor progression. However, the expression status of glycosylation-related genes (GRGs) in PC and their potential roles in PC microenvironment have not been extensively investigated.

Method

We systematically integrated RNA sequencing data and clinicopathological parameters of PC patients from TCGA and GTEx databases. A GRGs risk model based on glycosylation related genes was constructed and validated in 60 patients from Pancreatic biobank via RT-PCR. R packages were used to analyze the relationships between GRGs risk scores and overall survival (OS), tumor microenvironment, immune checkpoint, chemotherapy drug sensitivity and tumor mutational load in PC patients. Panoramic analysis was performed on PC tissues. The function of B3GNT8 in PC was detected via in vitro experiments.

Results

In this study, we found close correlations between GRGs risk model and PC patients’ overall survival and tumor microenvironment. Multifaceted predictions demonstrated the low-risk cohort exhibits superior OS compared to high-risk counterparts. Meanwhile, the low-risk group was characterized by high immune infiltration and may be more sensitive to immunotherapy or chemotherapy. Panoramic analysis was further confirmed a significant relationship between the GRGs risk score and both the distribution of PC tumor cells as well as CD8 + T cell infiltration. In addition, we also identified a unique glycosylation gene B3GNT8, which could suppress PC progression in vitro and in vivo.

Conclusion

We established a GRGs risk model, which could predict prognosis and immune infiltration in PC patients. This risk model may provide a new tool for PC precision treatment.
The effects of the first versus second glaucoma drainage implant surgery in patients with primary open-angle glaucoma
Authors: Morita Shuu , Hamanaka Teruhiko , Sakurai Tetsuro , Watanabe Satoshi , Sakanishi Yoshihito , Ishida Nobuo , Ebihara Nobuyuki
Published: December 2023

Background

To investigate the outcome of non-valved glaucoma drainage implant surgery (GDIS) in primary open-angle glaucoma (POAG) patients divided in the first GDI group (patients who underwent the first GDIS) and the second GDI group (patients who underwent the second GDIS because of the failed first GDIS).

Methods

Intraocular pressure (IOP), visual acuity (VA), visual field defect (VFD), medication score (MS), survival rate of GDIS, complications, and patient background was retrospectively analyzed. Two success criteria were set: Criteria (1) IOP reduction ≥ 20% and 5 < IOP ≤ 21, Criteria (2) IOP reduction ≥ 20% and 5 < IOP ≤ 14.

Results

There were 136 eyes of 109 patients in the first GDI group and 32 eyes of 27 patients in the second GDI group. In the first GDI group and II, mean preoperative IOP was 26.7 ± 6.7 mmHg and 23.7 ± 3.5 mmHg, respectively (P = 0.09). No statistically significant difference in postoperative IOP reduction was found between the two groups (P = 0.39). At 5-years postoperative, the Criteria 1 (Criteria 2) survival rate in the first GDI group and the second GDI group was 60.4% (31.7%) and 61.2% (25.6%), respectively (Criteria 1: hazard ratio [HR]: 0.64, 95% confidence interval [CI]: 0.30–1.35 [P = 0.24]; Criteria 2: HR: 0.81, 95% CI: 0.46–1.44, P = 0.48). No significant difference in VA, VFD change, MS, or complications was observed. Young patient age was the only significant factor for failure in the first GDI group (odds ratio: 0.95, 95% confidence interval: 0.91-1.00, P = 0.03).

Conclusion

The second GDIS may be as effective as the first GDIS for IOP reduction in POAG patients, however, there is a high risk of failure in young-age patients and the surgery may be ineffective in eyes requiring Criteria 2.
Cyberbullying victimization and suicidal ideation among in-school adolescents in three countries: implications for prevention and intervention
Authors: Peprah Prince , Oduro Michael Safo , Okwei Reforce , Adu Collins , Asiamah-Asare Bernard Yeboah , Agyemang-Duah Williams
Published: December 2023

Background

Countries in South and Central America and the Caribbean are among the countries with the highest adolescent cyberbullying crimes. However, empirical evidence about the effect of cyberbullying victimization on suicidal ideation among in-school adolescents in these countries remains limited. The present study examined the association between cyberbullying victimization and suicidal ideation among in-school adolescents in Argentina, Panama, St Vincent, and the Grenadines.

Methods

A representative cross-sectional data from 51,405 in-school adolescents was used. Hierarchical logistic regression analysis was used to estimate the association between cyberbulling victimization and suicidal ideation.

Results

Overall, 20% and 21.1% of the adolescents reported cyberbullying victimization and suicidal ideation, respectively in the past year before the survey. Suicidal ideation was higher among adolescents who experienced cyberbullying victimization (38.4%) than those who did not experience cyberbullying victimization (16.6%). Significantly higher odds of suicidal ideation were found among adolescents who had experienced cyberbullying victimization than those who had not experienced cyberbullying victimization [aOR = 1.88, 95% CI: 1.77–1.98].

Conclusion

This finding calls for developing and implementing evidence-based programs and practices by school authorities and other relevant stakeholders to reduce cyberbullying victimization among adolescents in this digital age. Protective factors such as parental support and peer support should be encouraged.
Tobacco use in Haiti: findings from demographic and health survey
Authors: Paul Bénédique , Jean Simon David , Kondo Tokpovi Vénunyé Claude , Kiragu Ann , Balthazard-Accou Ketty , Emmanuel Evens
Published: December 2023

Introduction

Although tobacco has harmful effects on the physical and mental health of individuals, its use remains significant, according to the World Health Organization. To understand this phenomenon, studies have been carried out in many countries around the world, while in Haiti where more than 5,000 people die each year due to tobacco use, little is known about the use of this substance. The aim of this study was to examine the prevalence and the factors associated with tobacco use in Haiti.

Methods

We used data from the 2016/17 Haitian Demographic Health Survey. Both descriptive and multivariate analyses were conducted using STATA 16.0 software to assess the prevalence and identify factors associated with tobacco use. Results were reported as adjusted odds ratios with 95% confidence intervals. Statistical significance was declared at p < 0.05.

Results

The prevalence of tobacco use was estimated at 9.8% (95% CI: 9.2–10.4) among men and 1.7% (95% CI: 1.5–1.9) among women. Although the prevalence of tobacco use was low among young people, it increased with age. Respondents aged 35 and above, with no formal education, non-Christians, divorced/separated/widowed, from poorest households, rural areas, “Aire Métropolitaine de Port-au-Prince” region, with high media exposure had a higher likelihood of tobacco use.

Conclusion

The low prevalence of tobacco use among Haitian women and youth represents a public policy opportunity to prevent these vulnerable groups from starting smoking. Adult male smokers should also be targeted by appropriate policy to reduce the different health burdens associated with tobacco, both for the smokers and other people they may expose to passive smoking. Government and health sector stakeholders, along with community leaders, should create and enforce awareness strategies and rules to control advertisements that encourage irresponsible and health-risky consumption behaviors.
Factors influencing treatment outcomes assessed by the American Board of Orthodontics Objective Grading System (ABO-OGS)
Authors: Kongboonvijit Tanyapak , Satrawaha Sirichom , Somboonsavatdee Anupap
Published: December 2023

Background

Treatment outcomes can be influenced by various factors. This study aimed to determine the association between predisposing patient- and treatment-related factors (demographic, cephalometric parameters, skeletal relationships, Discrepancy Index (DI), extractions, treatment type and duration) and treatment outcomes measures according to the American Board of Orthodontics Objective Grading System index (ABO-OGS).

Methods

Completed cases (N = 100) were included in this cross-sectional study. One calibrated examiner assessed DI, pretreatment lateral cephalometric parameters and ABO-OGS. Patient data, including sex, age, types of malocclusion, extractions, treatment type, and duration, were also collected. Intraexaminer reliability for each measurement was evaluated using the intraclass correlation coefficients. Multiple linear regression analysis, using the backward elimination method with a significance level (α) of 0.05, was used to determine which factors significantly influenced the ABO-OGS score.

Results

From the study, the overall mean ABO-OGS score was 11.36 points. Factors influencing the ABO-OGS score were pretreatment Wits values (p value = .000), L1-NB (°) (p value = .023) and treatment duration (p value = .019). Subjects with lower negative values of Wits and L1-NB (°) tended to have higher ABO-OGS scores. Additionally, the ABO-OGS score tended to be higher for subjects with longer treatment times.

Conclusions

The majority of treated subjects had satisfactory orthodontic treatment outcomes assessed by the ABO-OGS. The pretreatment severity of skeletal discrepancies determined by the Wits parameter, the degree of retroclined lower incisors and longer treatment duration negatively impacted the treatment outcomes.
Force degradation of two orthodontic accessories analyzed in vivo and in vitro
Authors: Yang Liu , Lv Chenxing , Li Xiaomin , Feng Jianying
Published: December 2023

Objective

To compare force degradation of elastomeric chains and NiTi coil springs in vivo and in vitro, and evaluate the effects of pre-stretched and reused elastomeric chains in the oral cavity during the time.

Methods

In the in vitro groups, 4-unit elastomeric chains and NiTi coil springs with an initial force of 200 g were placed in dry air and artificial saliva. The volunteers wore clear retainers which were used to hold the sample of 4-unit chains, pre-stretched 4-unit chains, and NiTi coil springs with the initial force of 200 g in the in vivo groups. After the first 4 weeks, 4-unit specimens were stretched to 200 g again for another 4 weeks in vivo. The force value and the percentage of force degradation were recorded at each measurement time interval in the in vivo and in vitro groups.

Results

The force degradation of elastomeric chains was greatest within the initial 4 hours, followed by a more stable phase after 1 week. The average force degradation of 4-unit elastomeric chains after 4 weeks was in vivo (64.8%) > artificial saliva (55.0%) > dry air (46.42%) (P < 0.05). The force degradation of NiTi coil springs in vivo (15.36%) or in artificial saliva (15.8%) was greater than in dry air (7.6%) (P < 0.05). NiTi coil springs presented a gentler force decay than elastomeric chains during the period (P < 0.05). In vivo, the force degradation of pre-stretched and reused elastomeric chains decreased less than the regular style(P < 0.05).

Conclusion

The force degradation of the elastomeric chains and NiTi coil springs varied in different environments. NiTi coil springs presented a gentler force decay than elastomeric chains during the period. Orthodontists should consider the force degradation characteristics of orthodontic accessories in clinical practice.
A qualitative study to explore student learning and development of interprofessional collaboration during an online interprofessional education intervention
Authors: Almoghirah Hailah , Illing Jan , Nazar Hamde
Published: December 2023

Interprofessional education (IPE) during undergraduate education and training has been found to improve collaboration between health care students. This supports interprofessional working in clinical practice to enhance patient safety and care delivery.

Undergraduate students from pharmacy and medical programmes worked online in pairs to review notes of hospital patients due to be discharged. Students were tasked to complete a discharge letter and undertake an online consultation with a simulated patient prior to discharge. Online interactions were recorded and assessed using a validated tool to measure interprofessional professionalism. Students undertook this intervention in different pairings with different patient cases for three iterations after receiving feedback and undertaking a reflective exercise.

The aim was to investigate the student learning and development that could be used to inform intervention optimisation and scale-up.

Qualitative data were collected from different sources. Method triangulation was employed to develop a comprehensive understanding of the student learning and development. Data was collected from written feedback provided by the assessment team, student reflections on their performance, and from semi-structured interviews conducted with the student pairs and one to one with the assessment team. Content and thematic analysis was used to analyse these data and the Kirkpatrick/Barr evaluation model provided a framework to organise the themes.

Eighteen students (nine from each professional programme) completed the study and a total of 27 IPE sessions were conducted. The assessment team completed 54 assessment tools and 31 student reflections were received (from a maximum of 36). Students were interviewed in their interprofessional pairs to yield nine interview transcripts and one interview was conducted with the assessment team.

Students reported and were observed to improve in interprofessional collaboration over the three iterations following feedback and rehearsal opportunities. Longitudinal observation and assessment of student interprofessional working in changing teams provided the opportunity to capture the influence of interdependence on student performance and assessment of competence.
Association of applicant demographic factors with medical school acceptance
Authors: Perez Michael A. , Williams Cheyenne , Henderson Korey , McGregor Ryan , Vapiwala Neha , Shea Judy A. , Dine C. Jessica
Published: December 2023

Background

Medical school acceptance rates in the United States (US) have been lower for applicants who identify as Underrepresented-in-Medicine (UiM) compared to non-UiM applicants. The gap between UiM and no-UiM groups is narrowing in recent years. Less well-studied are associations of acceptance decisions with family income and parental education. This study’s purpose is to evaluate the relationships between medical school acceptance and family income, parental education status, racial/ethnic background, Grade Point Average (GPA), Medical College Admission Test (MCAT) score, and participation in extracurricular activities.

Methods

This is a cross-sectional study of first-time US medical school applicants between 2017 and 2020. Acceptance rates for first-time applicants were calculated for first-generation (FG), low-income (LI), and UiM applicants. Associations of these attributes with MCAT scores, science GPAs, and seven categories of extracurricular activities were evaluated. Regression analyses estimated associations between acceptance to medical school with all variables with and without interaction terms (FG*URM, LI*URM, FG*LI).

Results

The overall acceptance rate for first-time applicants from 2017–2020 was 45.3%. The acceptance rates among FG, LI and UiM applicants were 37.9%, 39.6% and 44.2%, respectively. In univariable logistic regression analyses, acceptance was negatively associated with being FG (OR: 0.68, CI: 0.67–0.70), LI (OR: 0.70, CI: 0.69–0.72), and UiM (OR: 0.95, CI: 0.93–0.97). In multivariable regression, acceptance was most strongly associated with science GPA (OR: 7.15, CI: 6.78–7.54 for the highest quintile) and UiM (OR: 5.56, CI: 5.48–5.93) status and MCAT score (OR: 1.19, CI: 1.18–1.19), FG (OR: 1.14, CI: 1.10–1.18), and most extracurricular activities. Including interaction terms revealed a negative association between acceptance and LI (OR:0.90, CI: 0.87–0.94) and FG was no longer significant (OR:1.10, CI:0.96–1.08).

Conclusions

Collectively these results suggest medical school admissions committees may be relying on holistic admission practices. While MCAT and GPA scores continue to predict acceptance, individuals from racially and ethnically UiM backgrounds have favorable odds of acceptance when controlling for MCAT and GPA. However, these positive associations were not seen for low-income and first-generation applicants. Additional preparation for college and the MCAT for these latter groups may help further diversify the medical profession.
Gamified versus non-gamified online educational modules for teaching clinical laboratory medicine to first-year medical students at a large allopathic medical school in the United States
Authors: Do Marie , Sanford Kimberly , Roseff Susan , Hovaguimian Alexandra , Besche Henrike , Fischer Krisztina
Published: December 2023

Background

Medical educators seek innovative ways to engage learners efficiently and effectively. Gamification has been explored as one way to accomplish this feat; however, questions remain about which contexts gamification would be most useful. Time constraints and student interest present major barriers for teaching laboratory medicine to students. This study aims to compare two versions of an interactive online module, one gamified and one not, for teaching laboratory medicine concepts to pre-clinical medical students.

Methods

First-year medical students reviewed either a gamified or non-gamified version of an interactive online module in preparation for an in-person flipped classroom session on Laboratory Medicine. Learning theory guided the design of the modules and both contained identical content, objectives, and structure. The “gamified” module included the additional elements of personalization, progress meters, points, badges, and story/role play. After reviewing the module, students completed an anonymous knowledge check and optional survey.

Results

One hundred seventy-one students completed the post module knowledge check as assigned (82 gamified, 89 non-gamified). Knowledge check scores were higher for the students who reviewed the gamified module (p < 0.02), corresponding to an effect size of 0.4 for the gamified module. Eighty-one students completed optional post-module surveys (46 gamified, 35 non-gamified). Instructional efficiency was calculated using task difficulty questions and knowledge check scores, and the resulting instructional efficiency was higher for the gamified module. There was no significant difference in the student-reported time required to complete the modules. Additionally, both versions of the module were well received and led to positive ratings related to motivation and confidence. Finally, examination of open-ended survey results suggested that the addition of game elements added value to the gamified module and enhanced engagement and enjoyment.

Conclusions

In this setting, the addition of gamification to an interactive online module enhanced learning outcome, instructional efficiency, student engagement and enjoyment. These results should inspire further exploration of gamification for teaching Laboratory Medicine concepts to pre-clinical medical students.
Have there been sustained impacts of the COVID-19 pandemic on trends in smoking prevalence, uptake, quitting, use of treatment, and relapse? A monthly population study in England, 2017–2022
Authors: Jackson Sarah E. , Tattan-Birch Harry , Shahab Lion , Beard Emma , Brown Jamie
Published: December 2023

Background

Studies conducted during the early stages of the pandemic documented mixed changes in smoking behaviour: more smokers quitting successfully but little change in prevalence. This study aimed to examine whether there have been sustained impacts of the COVID-19 pandemic on smoking patterns in England.

Methods

Data were from 101,960 adults (≥ 18 years) participating in the Smoking Toolkit Study, a monthly representative household survey, between June 2017 and August 2022. Interviews were conducted face-to-face until March 2020 and via telephone thereafter. Generalised additive models estimated associations of the pandemic onset (March 2020) with current smoking, uptake, cessation, quit attempts, and use of support. Models adjusted for seasonality, sociodemographic characteristics, and (where relevant) dependence and tobacco control mass-media expenditure.

Results

Before the COVID-19 pandemic, smoking prevalence fell by 5.2% per year; this rate of decline slowed to 0.3% per year during the pandemic (RRΔtrend = 1.06, 95% CI = 1.02, 1.09). This slowing was evident in more but not less advantaged social grades (RRΔtrend = 1.15, 1.08, 1.21; RRΔtrend = 1.00, 0.96, 1.05). There were sustained step-level changes in different age groups: a 34.9% (95% CI = 17.7, 54.7%) increase in smoking prevalence among 18–24-year-olds, indicating a potential rise in uptake, in contrast to a 13.6% (95% CI = 4.4, 21.9%) decrease among 45–65-year-olds. In both age groups, these step-level changes were followed by the pre-pandemic declines stopping, and prevalence remaining flat. There were sustained increases in quitting among past-year smokers, with a 120.4% (95% CI = 79.4, 170.9%) step-level increase in cessation and a 41.7% (95% CI = 29.7, 54.7%) increase in quit attempts. The main limitation was the change in modality of data collection when the pandemic started; while this may have contributed to the step-level changes we observed, it is unlikely to explain changes in the slope of trends.

Conclusions

In England, the rate of decline in adult smoking prevalence stagnated during the COVID-19 pandemic through to 2022. At the start of the pandemic, a potential reduction in smoking prevalence among middle-aged adults and increases in quitting among smokers may have been offset by an increase in smoking among young adults. The slowing in the rate of decline was pronounced in more advantaged social grades.
Acarbose reduces Pseudomonas aeruginosa respiratory tract infection in type 2 diabetic mice
Authors: Liu Lin , Fan Haiyang , Li Liang , Fan Yunping
Published: December 2023

Background

Type 2 diabetes mellitus (T2DM) is widely prevalent worldwide, and respiratory tract infections (RTIs) have become the primary cause of death for T2DM patients who develop concurrent infections. Among these, Pseudomonas aeruginosa infection has been found to exhibit a high mortality rate and poor prognosis and is frequently observed in bacterial infections that are concurrent with COVID-19. Studies have suggested that acarbose can be used to treat T2DM and reduce inflammation. Our objective was to explore the effect of acarbose on P. aeruginosa RTI in T2DM individuals and elucidate its underlying mechanism.

Methods

High-fat diet (HFD) induction and P. aeruginosa inhalation were used to establish a RTI model in T2DM mice. The effect and mechanism of acarbose administered by gavage on P. aeruginosa RTI were investigated in T2DM and nondiabetic mice using survival curves, pathological examination, and transcriptomics.

Results

We found that P. aeruginosa RTI was more severe in T2DM mice than in nondiabetic individuals, which could be attributed to the activation of the NF-κB and TREM-1 signaling pathways. When acarbose alleviated P. aeruginosa RTI in T2DM mice, both HIF-1α and NF-κB signaling pathways were inhibited. Furthermore, inhibition of the calcium ion signaling pathway and NF-κB signaling pathway contributed to the attenuation of P. aeruginosa RTI by acarbose in nondiabetic mice.

Conclusions

This study confirmed the attenuating effect of acarbose on P. aeruginosa RTIs in T2DM and nondiabetic mice and investigated its mechanism, providing novel support for its clinical application in related diseases.
Recombination-mediated dissemination of Methicillin-resistant S. aureus clonal complex 1 in the Egyptian health care settings
Authors: Elsayed Salma W. , Elghaish Reem A. , Badr Eman , Mouftah Shaimaa F. , Saif Nehal A. , Naga Iman S. , Shata Ahmed H. , Pascoe Ben , Sheppard Samuel K. , Elhadidy Mohamed
Published: December 2023

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is a rapidly evolving pathogen that is frequently associated with outbreaks and sustained epidemics. This study investigated the population structure, resistome, virulome, and the correlation between antimicrobial resistance determinants with phenotypic resistance profiles of 36 representative hospital-acquired MRSA isolates recovered from hospital settings in Egypt.

Results

The community-acquired MRSA lineage, clonal complex 1 (CC1) was the most frequently detected clone, followed by three other globally disseminated clones, CC121, CC8, and CC22. Most isolates carried SCCmec type V and more than half of isolates demonstrated multi-drug resistant phenotypes. Resistance to linezolid, a last resort antibiotic for treating multidrug resistant MRSA, was observed in 11.11% of the isolates belonging to different genetic backgrounds. Virulome analysis indicated that most isolates harboured a large pool of virulence factors and toxins. Genes encoding aureolysin, gamma hemolysins, and serine proteases were the most frequently detected virulence encoding genes. CC1 was observed to have a high pool of AMR resistance determinants including cfr, qacA, and qacB genes, which are involved in linezolid and quaternary ammonium compounds resistance, as well as high content of virulence-related genes, including both of the PVL toxin genes. Molecular clock analysis revealed that CC1 had the greatest frequency of recombination (compared to mutation) among the four major clones, supporting the role of horizontal gene transfer in modulating AMR and hypervirulence in this clone.

Conclusions

This pilot study provided evidence on the dissemination success of CA-MRSA clone CC1 among Egyptian hospitals. Co-detection of multiple AMR and virulence genes in this lineage pose a broad public health risk, with implications for successful treatment. The results of this study, together with other surveillance studies in Egypt, should be used to develop strategies for controlling MRSA infections in Egyptian health-care settings.
Prostate cancer-derived small extracellular vesicle proteins: the hope in diagnosis, prognosis, and therapeutics
Authors: Chen Haotian , Pang Bairen , Zhou Cheng , Han Meng , Gong Jie , Li Yong , Jiang Junhui
Published: December 2023

Current diagnostic tools for prostate cancer (PCa) diagnosis and risk stratification are insufficient. The hidden onset and poor efficacy of traditional therapies against metastatic PCa make this disease a heavy burden in global men’s health. Prostate cancer-derived extracellular vesicles (PCDEVs) have garnered attention in recent years due to their important role in communications in tumor microenvironment. Recent advancements have demonstrated PCDEVs proteins play an important role in PCa invasion, progression, metastasis, therapeutic resistance, and immune escape. In this review, we briefly discuss the applications of sEV proteins in PCa diagnosis and prognosis in liquid biopsy, focus on the roles of the PCa-derived small EVs (sEVs) proteins in tumor microenvironment associated with cancer progression, and explore the therapeutic potential of sEV proteins applied for future metastatic PCa therapy.

Graphical Abstract
Adapting the Planetary Health Diet Index for children and adolescents
Authors: Venegas Hargous Carolina , Orellana Liliana , Strugnell Claudia , Corvalan Camila , Allender Steven , Bell Colin
Published: December 2023

Background

Tools for measuring adherence to sustainable healthy diets among children and adolescents are lacking.

Objective

To advance methods for measuring adherence to sustainable healthy diets among children and adolescents by adapting an existing index, compare scores obtained using the original and adapted versions of the index in a sample of Chilean children, and describe the adapted index association with diet characteristics.

Methods

The Planetary Health Diet Index (PHDI) was adapted to better reflect children's and adolescents’ nutritional requirements. The adapted index (PHDI-C) comprises 16 components with a maximum score of 150 points. PHDI-C was piloted among a sample of 958 Chilean children (3–6 years) using dietary data collected in 2016 through single 24-h recalls. A decision tree and food disaggregation methodology were developed to guide the calculation of scores. Scores obtained using the original and adapted versions of the index were compared. Linear regression models adjusted by child’s gender and age were fitted to explore associations between total PHDI-C score, dietary recall characteristics and nutritional composition of children’s diets.

Results

PHDI accounted for 75.7% of children’s total caloric intake, whereas PHDI-C accounted for 99.6%. PHDI & PHCI-C scores were low among this sample of children; however, mean total score was lower when using PHDI compared to PHDI-C [40.7(12.1) vs 50.1(14.6)]. Children’s scores were very low for nuts & peanuts, legumes, dark green vegetables, whole cereals, tubers & potatoes, and added sugars components across both indices, but were higher for dairy products and eggs & white meats components when using the PHDI-C due to adjustments made to ensure nutritional adequacy. Mean total PHDI-C score was significantly lower on weekends and special occasions, and significantly higher when children reported having a special diet (e.g., vegetarian). Total PHDI-C score was negatively associated with total sugars, saturated fats, trans fats, and animal-based protein intake, and positively associated with total protein, plant-based protein, total carbohydrates, and total fibre intake.

Conclusions

This study provides a replicable method for measuring adherence to sustainable healthy diets among children and adolescents that can be used to monitor trends and measure the effectiveness of actions targeting improving children’s diets.