bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for PDA ligation and neurodevelopmental outcomes at corrected 18–24 months in very low birth weight infants
Authors: Kim Sol , Kim Sae Yun , Shin Ju-Ae , Youn Young-Ah
Published: May 2024

Background

Patent ductus arteriosus (PDA) is commonly encountered morbidity which often occurs as up to 60% of extremely preterm infants born at < 29 weeks gestational age (GA).

Purpose

This study aims to assess the clinical risk factors associated with PDA ligation among very low birth weight infants (VLBWI) and evaluate the neurodevelopmental outcomes of those who underwent PDA ligation.

Methods

A total of 540 VLBWI were initially diagnosed with PDA in our 50-bed level IV NICU at Seoul St. Mary’s Hospital, The Catholic University of Korea, between January 2015 and June 2023. Among these 540 VLBWI with PDA, only 221 had consistent hemodynamically significant (hs) PDA which required intervention including fluid restriction, medical treatment, or surgical ligation. In this study, only those 221 VLBWI with hsPDA who underwent neurodevelopmental assessment at corrected 18–24 months of age were included in this study analysis.

Results

Out of 221 VLBWI diagnosed with hemodynamically significant (hs) PDA, 133 (60.2%) underwent PDA ligation, while the remaining 88 (39.8%) had their hs PDAs closed either medically or with fluid restriction. The mean gestational age and birth weight were significantly lower in PDA ligation group compared to no PDA ligation group (27.02 ± 2.17 vs. 27.98 ± 2.36, 907.31 ± 258.36 vs. 1006.07 ± 283.65, p = 0.001, 0.008). Resuscitation including intubation at delivery and intraventricular hemorrhage (IVH) (grade ≥ 3) were significantly higher in PDA ligation group. The clinical outcomes in the PDA ligation group revealed significantly worse oucomes compared to the no PDA ligation group. Both resuscitation, including intubation at delivery, and IVH (grade ≥ 3), consistently exhibited an increased risk for PDA ligation in a multivariable logistic regression analysis. Concerning neurodevelopmental outcomes, infants who underwent PDA ligation demonstrated significantly lower cognitive scores. However, only IVH (grade ≥ 3) and PVL were consistently associated with an increased risk of abnormal neurodevelopment at the corrected age of 18–24 months.

Conclusion

In our study, despite the consistent association between cognitive developmental delays in VLBWI who underwent PDA ligation, we observed that sicker and more vulnerable VLBWIs, specifically those experincing severe IVH, consistently exhibited an increased risk for both PDA ligation and abnormal neurodevelopment at the corrected age of 18–24 months.
The impact of intimate partner violence on PrEP adherence among U.S. Cisgender women at risk for HIV
Authors: Anderson Katherine M. , Blumenthal Jill , Jain Sonia , Sun Xiaoying , Amico K. Rivet , Landovitz Raphael , Zachek Christine M. , Morris Sheldon , Moore David J. , Stockman Jamila K.
Published: May 2024

Background

Cisgender women account for 1 in 5 new HIV infections in the United States, yet remain under-engaged in HIV prevention. Women experiencing violence face risk for HIV due to biological and behavioral mechanisms, and barriers to prevention, such as challenges to Pre-Exposure Prophylaxis for HIV Prevention (PrEP) adherence. In this analysis, we aim to characterize intimate partner violence (IPV) among cisgender heterosexual women enrolled in a PrEP demonstration project and assess the associations with PrEP adherence.

Methods

Adherence Enhancement Guided by Individualized Texting and Drug Levels (AEGiS) was a 48-week single-arm open-label study of PrEP adherence in HIV-negative cisgender women in Southern California (N = 130) offered daily tenofovir disoproxil fumarate/emtricitabine (TDF/FTC). From 6/2016 to 10/2018, women completed a survey reporting HIV risk behavior and experiences of any IPV (past 90-days) and IPV sub-types (past-year, lifetime) and biological testing for HIV/STIs at baseline, and concentrations of tenofovir-diphosphate (TFV-DP) in dried blood spots at weeks 4, 12, 24, 36, and 48. Outcomes were TFV-DP concentrations consistent with ≥ 4 or ≥ 6 doses/week at one or multiple visits. Multivariable logistic regression models were conducted to examine associations.

Results

Past-90-day IPV was reported by 34.4% of participants, and past-year and lifetime subtypes reported by 11.5-41.5%, and 21.5-52.3%, respectively. Women who engaged in sex work and Black women were significantly more likely to report IPV than others. Lifetime physical IPV was negatively associated with adherence at ≥ 4 doses/week at ≥ 3 of 5 visits, while other relationships with any IPV and IPV sub-types were variable.

Conclusion

IPV is an indication for PrEP and important indicator of HIV risk; our findings suggest that physical IPV may also negatively impact long-term PrEP adherence.

Clinical Trials Registration

NCT02584140 (ClinicalTrials.gov), registered 15/10/2015.
Duration and outcome of orthotic treatment in children with clubfoot – a four-year follow-up national register study of Swedish children born between 2015 and 2017
Authors: Naili Josefine Eriksson , Lindeberg Malin , Esbjörnsson Anna-Clara
Published: May 2024

Background

The Ponseti method for treating clubfoot consists of initial treatment with serial casting accompanied by achillotenotomy if needed, followed by the maintenance phase including treatment with a foot abduction orthosis (FAO) for at least four years. This study aimed to examine the duration, course, and outcome of orthotic treatment in children with clubfoot.

Methods

321 children with clubfoot, born between 2015 and 2017, registered in the Swedish Pediatric Orthopedic Quality Register (SPOQ), were included in this prospective cohort study. Data on deformity characteristics and orthotic treatment were extracted. For children with bilateral clubfoot, one foot was included in the analysis.

Results

Of the 288 children with isolated clubfoot, 274 children (95.5%) were prescribed an FAO, and 100 children (35%) changed orthosis type before 4 years of age. Of the 33 children with non-isolated clubfoot, 25 children (76%) were prescribed an FAO, and 21 children (64%) changed orthosis type before 4 years of age. 220 children with isolated clubfoot (76%), and 28 children with non-isolated clubfoot (84%) continued orthotic treatment until 4 years of age or longer. Among children with isolated clubfoot, children ending orthotic treatment before 4 years of age (n = 63) had lower Pirani scores at birth compared to children ending orthotic treatment at/after 4 years of age (n = 219) (p = 0.01). It was more common to change orthosis type among children ending orthotic treatment before 4 years of age (p = 0.031).

Conclusions

The majority of children with clubfoot in Sweden are treated with an FAO during the maintenance phase. The proportion of children changing orthosis type was significantly greater and the Pirani score at diagnosis was lower significantly among children ending orthotic treatment before 4 years of age. Long-term follow-up studies are warranted to fully understand how to optimize, and individualize, orthotic treatment with respect to foot involvement and severity of deformity.

Level of evidence

II.
Bilateral simultaneous hip and knee replacement: an epidemiological nationwide study from 2001 to 2016
Authors: Longo Umile Giuseppe , Papalia Rocco , Mazzola Alessandro , Campi Stefano , De Salvatore Sergio , Candela Vincenzo , Vaiano Andrea , Piergentili Ilaria , Denaro Vincenzo
Published: May 2024

Background

Several studies have compared the pros and cons of simultaneous bilateral versus staged bilateral hip and knee replacement but the outcomes of these two surgical options remains a matter of controversy. This study aimed to evaluate demographic features, incidence and hospitalization rates of bilateral one stage total hip and knee arthroplasty in Italy.

Methods

The Italian Ministry of Health’s National Hospital Discharge Reports (SDO) were used to gather data. This study referred to the adult population (+ 20 years of age) from 2001 to 2015 for hip arthroplasty and from 2001 to 2016 for knee arthroplasty.

Results

Overall, 1,544 bilateral simultaneous hip replacement were carried out. The incidence rate was 0.21 cases per 100,000 adult Italian residents. Male/female ratio was 1.1. The average days of hospital stay was 11.7 ± 11.8 days. The main primary codified diagnosis was: osteoarthrosis, localized, primary, pelvic region and thigh (ICD code: 715.15). 2,851 bilateral simultaneous knee replacement were carried out. The incidence rate was 0.37 cases per 100,000 adult Italian residents. Male/female ratio was 0.6. The average days of hospital stay was 7.7 ± 5.8 days. The main primary codified diagnosis was: osteoarthrosis, localized, primary, lower leg (ICD code: 715.16).

Conclusions

The burden of hip and knee osteoarthrosis as a leading cause of bilateral joint replacement is significant in Italy. The national registers’ longitudinal analysis may provide data for establishing international guidelines regarding the appropriate indications for one stage bilateral simultaneous hip or knee replacement versus two stage.
Development and initiation of a preceptor program to improve midwifery and nursing clinical education in sub-saharan Africa: protocol for a mixed methods study
Authors: van de Water Brittney , Renning Kelsey , Nyondo Anda , Sonnie Mustapha , Longacre Ashley H. , Ewing Helen , Fullah Mary , Chepuka Lignet , Mann Julie
Published: May 2024

Background

Expanding the quality and quantity of midwifery and nursing clinical preceptors is a critical need in many sub-Saharan educational settings to strengthen students’ clinical learning outcomes, and ultimately to improve maternal and child mortality. Therefore, this study protocol was developed to establish a year-long, four step, precepting program to (1) improve partnership building and program development (2) provide an evidence-based course to expand competency and confidence in precepting students (3) select preceptors to become train the trainers and (4) secure accreditation for the program, ultimately to engage and support cohorts of preceptors and continue to monitor and evaluate the effectiveness of the program over five years.

Methods

Qualitative and quantitative approaches will be used including evaluation of preceptors, faculty and leadership involved with the program, as well as students taught by preceptors. Data will include validated self-assessment scales, objective structured clinical examinations (OSCEs), satisfaction surveys, and direct clinical observation, in-depth interviews and/or focus group discussions (preceptors); feedback forms (students); process mapping and organizational readiness for implementing change surveys (faculty and leadership). Median change in scores will be the primary outcome for quantitative data. Content analysis within a deductive framework to identify key implementation and adoption themes will be used for qualitative data analysis.

Discussion

This study aims to assess the readiness and early effectiveness for implementing a preceptor program for midwifery and nursing in Sierra Leone and Malawi. Determining the effectiveness of this program will guide future adaptations in order to strengthen the program for sustainability and potential scale-up.
Effects of a special continuous quality improvement in nursing on the management of adverse care events: a retrospective study
Authors: Ouyang Qing , Zhang Guixiang , Xie Ying , Yuan Hongman , Cheng Fangqun , Huang Qiyun
Published: May 2024

Objective

To explore the application effect of the direct reporting system of adverse nursing events and special continuous nursing quality improvement measures in the management of these adverse events.

Methods

The implementation time of continuous nursing improvement based on the direct reporting system was the demarcation point. We retrospectively collected and analyzed nursing adverse event reports and hospitalization data from Xiangtan Central Hospital before implementation (2015–2018) and after implementation (2019–2022). The active reporting rate of adverse events, the composition of these events and the processing time were compared between the two groups.

Results

The rate of active reporting of adverse events before the implementation was lower than that after the implementation (6.7% vs. 8.1%, X2 = 25.561, P < 0.001). After the implementation of the direct reporting system for nursing events and the continuous improvement of nursing quality, the reporting proportion of first-level and second-level events decreased significantly. Moreover, the reporting proportion of third-level events increased significantly. The proportion of falls and medication errors decreased, and the proportion of unplanned extubation, infusion xerostomia and improper operation increased. The processing time of the reported nursing adverse events was significantly reduced (31.87 ± 7.83 vs. 56.87 ± 8.21, t = 18.73, P < 0.001).

Conclusion

The direct reporting system of adverse nursing events and the continuous improvement measures for nursing quality can effectively improve the active reporting rate of adverse events, change their composition and reduce their processing time, as well as help create a safe psychological environment for both patients and nursing staff.
Healthcare resource utilization and costs in patients with a newly confirmed diagnosis of lupus nephritis in the United States over a 5-year follow-up period
Authors: Bell Christopher F. , Wu Benjamin , Huang Shirley P. , Rubin Bernard , Averell Carlyne M. , Chastek Benjamin , Hulbert Erin M.
Published: May 2024

Background

We aimed to describe healthcare resource utilization (HCRU) and healthcare costs in patients with newly confirmed lupus nephritis (LN) in the United States over a 5-year follow-up period.

Methods

This retrospective, longitudinal cohort study (GSK Study 214102) utilized administrative claims data to identify individuals with a newly confirmed diagnosis of LN between August 01, 2011, and July 31, 2018, based on LN-specific International Classification of Diseases diagnosis codes. Index was the date of first LN-related diagnosis code claim. HCRU, healthcare costs, and incidence of systemic lupus erythematosus (SLE) flares were reported annually among eligible patients with at least 5 years continuous enrollment post-index.

Results

Of 2,159 patients with a newly confirmed diagnosis of LN meeting inclusion and exclusion criteria, 335 had at least 5 years continuous enrollment post-index. HCRU was greatest in the first year post-LN diagnosis across all categories (inpatient admission, emergency room [ER] visits, ambulatory visits, and pharmacy use), and trended lower, though remained substantial, in the 5-year follow-up period. Among patients with LN and HCRU, the mean (standard deviation [SD]) number of ER visits and inpatient admissions were 3.7 (4.6) and 1.8 (1.5), respectively, in Year 1, which generally remained stable in Years 2–5; the mean (SD) number of ambulatory visits and pharmacy fills were 35.8 (25.1) and 62.9 (43.8), respectively, in Year 1, and remained similar for Years 2–5. Most patients (≥ 91.6%) had ≥ 1 SLE flare in each of the 5 years of follow-up. The proportion of patients who experienced a severe SLE flare was higher in Year 1 (31.6%) than subsequent years (14.3–18.5%). Total costs (medical and pharmacy; mean [SD]) were higher in Year 1 ($44,205 [71,532]) than subsequent years ($29,444 [52,310]–$32,222 [58,216]), driven mainly by inpatient admissions (Year 1: $21,181 [58,886]; subsequent years: $7,406 [23,331]–$9,389 [29,283]).

Conclusions

Patients with a newly confirmed diagnosis of LN have substantial HCRU and healthcare costs, particularly in the year post-diagnosis, largely driven by inpatient costs. This highlights the need for improved disease management to prevent renal damage, improve patient outcomes, and reduce costs among patients with renal involvement.
Inequities in human papillomavirus vaccination among children aged 9–14 years old under constrained vaccine supply in China
Authors: Wang Xiaomin , Pan Jiayi , Yan Bo , Zhang Ran , Yang Tianchi , Zhou Xudong
Published: May 2024

Background

Inequities in access to human papillomavirus (HPV) vaccine are becoming a growing critical issue globally. Few studies investigate the factors determining HPV vaccine uptake disparities when vaccine supply is constrained, especially in low- and middle-income countries. The aim of this study was to investigate inequities of HPV vaccination and related factors under the constrained vaccine supply in China.

Methods

A cross-sectional survey was conducted in a developed eastern coastal province and a developing western one in China between November and December 2022. Employing multistage stratified cluster random sampling, the study collected data from parents of children aged 9–14. Mixed-effects logistic regression models with school units as random effects were used for analysis.

Results

From 4,127 eligible parents (as vaccine decision makers for girls), 1,346 (32.6%) intended to vaccinate their daughters against HPV, of which 836 (62.1%) attempted to schedule a vaccination appointment. Only 16.4% succeeded in booking an appointment. More than half of the intended parents expected the imported 9-valent HPV vaccine. There were significant disparities in HPV vaccine awareness, intention, and vaccination behavior across educational, income, geographic, ethnic, gender, and health literacy levels. Vaccine awareness and intentions were higher among parents with higher socioeconomic status; however, girls from lower socioeconomic families were more likely to receive the HPV vaccine and had a higher domestically produced vaccination rate. Significant disparities exist in vaccination intentions and actual vaccination behaviors, primarily due to large supply constraints of the HPV vaccine.

Conclusions

Sustained health education campaigns are needed to raise awareness of the HPV vaccine, improve health literacy, and decrease over-preference for the 9-valent HPV vaccine. A mother’s HPV vaccination behavior was positively associated with increased intention and actual vaccination behavior for her daughter. This study advocates for complementary cervical cancer prevention programs targeting both mothers and daughters.
The evolution of symptoms of nervous system dysfunction in a First Nation community with a history of mercury exposure: a longitudinal study
Authors: Philibert Aline , Da Silva Judy , Fillion Myriam , Mergler Donna
Published: May 2024

Background

Since the 1960’s, mercury (Hg) contamination of the aquatic environment of Asubpeeschoseewagong Anishinabek (Grassy Narrows First Nation) territories has impacted the community members’ traditions, culture, livelihood, diet and health. Despite decreasing Hg exposure over time, a recent study suggested that long-term exposure contributed to later-life symptom clusters of nervous system dysfunction. Here, the objective was to evaluate, 5 years later, the prevalence and progression of these symptoms and examine the contribution of long-term, past Hg exposure.

Methods

The symptom questionnaire, applied in the 2016/17 Grassy Narrows Community Health Assessment (GN-CHA) (Time 1), was re-administered in the 2021/22 Niibin study (Time 2). A total of 85 adults (median age: 47y; range: 29-75y) responded at both times. Paired statistics were used to test the differences (Time 2 – Time 1) in self-reported symptom frequencies. The symptom clustering algorithm, derived from the entire study group of the GN-CHA (n = 391), which had yielded 6 clusters, was applied at Time 1 and 2. Equivalent hair Hg measurements (HHg) between 1970 and 1997 were used in Longitudinal Mixed Effects Models (LMEM), with a sub-group with ≥ 10 repeated HHg mesurements (age > 40y), to examine its associations with symptom cluster scores and their progression.

Results

For most symptoms, paired analyses (Time 2 – Time 1) showed a significant increase in persons reporting “ very often” or “all the time”, and in the mean Likert scores for younger and older participants (< and ≥ 50y). The increase in cluster scores was not associated with age or sex, except for sensory impairment where a greater increase in symptom frequency was observed for younger persons. LMEM showed that, for the sub-group, long-term past Hg exposure was associated with most cluster scores at both times, and importantly, for all clusters, with their rate of increase over time (Time 2 – Time 1).

Conclusions

The persistence of reported symptoms and their increase in frequency over the short 5-year period underline the need for adequate health care services. Results of the sub-group of persons > 40y, whose HHg reflects exposure over the 28-year sampling period, suggest that there may be a progressive impact of Hg on nervous system dysfunction.
Walk With Me: reducing harm and confronting the toxic drug poisoning crisis in small British Columbia cities through community engaged research
Authors: Wideman Trevor , Karsten Sharon ,   The Walk With Me Team, Whyte Elder Barb , Haggith Kathleen , Hauschildt Christopher , Katsanikakis Sophia , Karsten Sharon , Mark Andrew , Nadeau Caresse , Wideman Trevor
Published: May 2024

In an era of escalating and intersectional crises, the toxic drug poisoning crisis stands out as a devastating and persistent phenomenon. Where we write from in British Columbia (BC), Canada, over 13,000 deaths have occurred in the eight years since the toxic drug poisoning crisis was declared a provincial health emergency. While many of these deaths have occurred in large urban centres, smaller rural communities in British Columbia are also grappling with the profound impacts of the toxic drug poisoning crisis and are struggling to provide adequate support for their vulnerable populations. In response to these challenges, the Walk With Me research project has emerged in the Comox Valley of Vancouver Island, BC, employing community-engaged methodologies grounded in pluralist knowledge production. Walk With Me seeks to understand the unique manifestations of the toxic drug poisoning crisis in small communities, identifying local harm reduction interventions that can foster community resilience, and aiming to catalyze sustainable change by amplifying the voices of those directly affected by the crisis to advocate for policy changes. This paper outlines the conceptual and methodological underpinnings of the Walk With Me project as a harm reduction initiative, which holds community partnerships and diverse ways of knowing at its heart. It presents the community-engaged research framework used by the project to address overlapping health and social crises, offering practical examples of its application in various research projects across sites and organizations. The paper concludes with a reflection on the impacts of Walk With Me to date, highlighting the lessons learned, challenges encountered, and opportunities for future research and action. Overall, this article captures the urgent need for community-engaged approaches to address the toxic drug poisoning crisis and other multidimensional crises facing society, particularly in smaller and rural communities, underscoring the potential for meaningful change through collaborative, grassroots efforts.
Exploring potential EQ-5D bolt-on dimensions with a qualitative approach: an interview study in Hong Kong SAR, China
Authors: Cheuk Wai Ng Clement , Wai Ling Cheung Annie , Lai Yi Wong Eliza
Published: May 2024

Purpose

The introduction of bolt-on dimensions in EQ-5D instruments is growing common, but most bolt-on studies have targeted the diseased population and obtained bolt-on from other existing Health-related Quality of Life (HRQoL) instruments. As the qualitative approach offers important evidence to support the consistency and design of the potential bolt-on items, this paper studies the Hong Kong SAR community’s perception of the current EQ-5D-5 L instrument and identifies potential bolt-on via a qualitative approach.

Methods

A representative sample mix was recruited based on the age group, gender, and education level composition of the Hong Kong SAR community by quota sampling. Semi-structured interviews were conducted and the interviews were transcribed and coded to identify emergent and recurrent themes.

Results

Thirty interviews were conducted and the majority of the interviewees considered the EQ-5D-5 L insufficiently comprehensive to illustrate their HRQoL. While some key HRQoL aspects included in the EQ-5D matched with the community’s HRQoL perception, respondents showed concern about the potential overlap of the existing HRQoL dimension, the optimal number or attributes, and the appropriateness of the EQ-VAS. Among the potential bolt-on dimensions that emerged, ‘Sleep’, ‘Interpersonal Relationship’, and ‘Satisfaction’ were the key potential bolt-on dimensions identified and emphasized in the interviews.

Conclusions

The qualitative findings of the study illustrate the possible gap between EQ-5D-5 L measurements and community HRQoL perception, while the findings support the development of EQ-5D bolt-on dimensions in the target community with content and face validity.
Microglial Pdcd4 deficiency mitigates neuroinflammation-associated depression via facilitating Daxx mediated PPARγ/IL-10 signaling
Authors: Li Yuan , Zhan Bing , Zhuang Xiao , Zhao Ming , Chen Xiaotong , Wang Qun , Liu Qiji , Zhang Lining
Published: May 2024

The dysregulation of pro- and anti-inflammatory processes in the brain has been linked to the pathogenesis of major depressive disorder (MDD), although the precise mechanisms remain unclear. In this study, we discovered that microglial conditional knockout of Pdcd4 conferred protection against LPS-induced hyperactivation of microglia and depressive-like behavior in mice. Mechanically, microglial Pdcd4 plays a role in promoting neuroinflammatory responses triggered by LPS by inhibiting Daxx-mediated PPARγ nucleus translocation, leading to the suppression of anti-inflammatory cytokine IL-10 expression. Finally, the antidepressant effect of microglial Pdcd4 knockout under LPS-challenged conditions was abolished by intracerebroventricular injection of the IL-10 neutralizing antibody IL-10Rα. Our study elucidates the distinct involvement of microglial Pdcd4 in neuroinflammation, suggesting its potential as a therapeutic target for neuroinflammation-related depression.
Optimizing PGRs for in vitro shoot proliferation of pomegranate with bayesian-tuned ensemble stacking regression and NSGA-II: a comparative evaluation of machine learning models
Authors: Zarbakhsh Saeedeh , Shahsavar Ali Reza , Soltani Mohammad
Published: May 2024

Background

The process of optimizing in vitro shoot proliferation is a complicated task, as it is influenced by interactions of many factors as well as genotype. This study investigated the role of various concentrations of plant growth regulators (zeatin and gibberellic acid) in the successful in vitro shoot proliferation of three Punica granatum cultivars (‘Faroogh’, ‘Atabaki’ and ‘Shirineshahvar’). Also, the utility of five Machine Learning (ML) algorithms—Support Vector Regression (SVR), Random Forest (RF), Extreme Gradient Boosting (XGB), Ensemble Stacking Regression (ESR) and Elastic Net Multivariate Linear Regression (ENMLR)—as modeling tools were evaluated on in vitro multiplication of pomegranate. A new automatic hyperparameter optimization method named Adaptive Tree Pazen Estimator (ATPE) was developed to tune the hyperparameters. The performance of the models was evaluated and compared using statistical indicators (MAE, RMSE, RRMSE, MAPE, R and R2), while a specific Global Performance Indicator (GPI) was introduced to rank the models based on a single parameter. Moreover, Non‑dominated Sorting Genetic Algorithm‑II (NSGA‑II) was employed to optimize the selected prediction model.

Results

The results demonstrated that the ESR algorithm exhibited higher predictive accuracy in comparison to other ML algorithms. The ESR model was subsequently introduced for optimization by NSGA‑II. ESR-NSGA‑II revealed that the highest proliferation rate (3.47, 3.84, and 3.22), shoot length (2.74, 3.32, and 1.86 cm), leave number (18.18, 19.76, and 18.77), and explant survival (84.21%, 85.49%, and 56.39%) could be achieved with a medium containing 0.750, 0.654, and 0.705 mg/L zeatin, and 0.50, 0.329, and 0.347 mg/L gibberellic acid in the ‘Atabaki’, ‘Faroogh’, and ‘Shirineshahvar’ cultivars, respectively.

Conclusions

This study demonstrates that the 'Shirineshahvar' cultivar exhibited lower shoot proliferation success compared to the other cultivars. The results indicated the good performance of ESR-NSGA-II in modeling and optimizing in vitro propagation. ESR-NSGA-II can be applied as an up-to-date and reliable computational tool for future studies in plant in vitro culture.
Sequential drug treatment targeting cell cycle and cell fate regulatory programs blocks non-genetic cancer evolution in acute lymphoblastic leukemia
Authors: Malyukova Alena , Lahnalampi Mari , Falqués-Costa Ton , Pölönen Petri , Sipola Mikko , Mehtonen Juha , Teppo Susanna , Akopyan Karen , Viiliainen Johanna , Lohi Olli , Hagström-Andersson Anna K. , Heinäniemi Merja , Sangfelt Olle
Published: May 2024

Background

Targeted therapies exploiting vulnerabilities of cancer cells hold promise for improving patient outcome and reducing side-effects of chemotherapy. However, efficacy of precision therapies is limited in part because of tumor cell heterogeneity. A better mechanistic understanding of how drug effect is linked to cancer cell state diversity is crucial for identifying effective combination therapies that can prevent disease recurrence.

Results

Here, we characterize the effect of G2/M checkpoint inhibition in acute lymphoblastic leukemia (ALL) and demonstrate that WEE1 targeted therapy impinges on cell fate decision regulatory circuits. We find the highest inhibition of recovery of proliferation in ALL cells with KMT2A-rearrangements. Single-cell RNA-seq and ATAC-seq of RS4;11 cells harboring KMT2A::AFF1, treated with the WEE1 inhibitor AZD1775, reveal diversification of cell states, with a fraction of cells exhibiting strong activation of p53-driven processes linked to apoptosis and senescence, and disruption of a core KMT2A-RUNX1-MYC regulatory network. In this cell state diversification induced by WEE1 inhibition, a subpopulation transitions to a drug tolerant cell state characterized by activation of transcription factors regulating pre-B cell fate, lipid metabolism, and pre-BCR signaling in a reversible manner. Sequential treatment with BCR-signaling inhibitors dasatinib, ibrutinib, or perturbing metabolism by fatostatin or AZD2014 effectively counteracts drug tolerance by inducing cell death and repressing stemness markers.

Conclusions

Collectively, our findings provide new insights into the tight connectivity of gene regulatory programs associated with cell cycle and cell fate regulation, and a rationale for sequential administration of WEE1 inhibitors with low toxicity inhibitors of pre-BCR signaling or metabolism.
Survival analysis for AdVerse events with VarYing follow-up times (SAVVY): summary of findings and assessment of existing guidelines
Authors: Rufibach Kaspar , Beyersmann Jan , Friede Tim , Schmoor Claudia , Stegherr Regina
Published: May 2024

Background

The SAVVY project aims to improve the analyses of adverse events (AEs) in clinical trials through the use of survival techniques appropriately dealing with varying follow-up times and competing events (CEs). This paper summarizes key features and conclusions from the various SAVVY papers.

Methods

Summarizing several papers reporting theoretical investigations using simulations and an empirical study including randomized clinical trials from several sponsor organizations, biases from ignoring varying follow-up times or CEs are investigated. The bias of commonly used estimators of the absolute (incidence proportion and one minus Kaplan-Meier) and relative (risk and hazard ratio) AE risk is quantified. Furthermore, we provide a cursory assessment of how pertinent guidelines for the analysis of safety data deal with the features of varying follow-up time and CEs.

Results

SAVVY finds that for both, avoiding bias and categorization of evidence with respect to treatment effect on AE risk into categories, the choice of the estimator is key and more important than features of the underlying data such as percentage of censoring, CEs, amount of follow-up, or value of the gold-standard.

Conclusions

The choice of the estimator of the cumulative AE probability and the definition of CEs are crucial. Whenever varying follow-up times and/or CEs are present in the assessment of AEs, SAVVY recommends using the Aalen-Johansen estimator (AJE) with an appropriate definition of CEs to quantify AE risk. There is an urgent need to improve pertinent clinical trial reporting guidelines for reporting AEs so that incidence proportions or one minus Kaplan-Meier estimators are finally replaced by the AJE with appropriate definition of CEs.
Comparison of resistance training using barbell half squats and trap bar deadlifts on maximal strength, power performance, and lean mass in recreationally active females: an eight-week randomised trial
Authors: Hagerupsen Karianne , Pedersen Sigurd , Giller Nicoline B. , Thomassen Nora K. , Heitmann Kim Arne , Sagelv Edvard H. , Osborne John O. , Johansen Kristoffer R.
Published: May 2024

Background

The aim of this study was to investigate the effect of high load resistance training using barbell half squats compared with trap bar deadlifts on maximal strength, power performance, and lean mass in recreationally active females.

Methods

Twenty-two recreationally active female participants (age: 26.9 ± 7.7 yrs.; height: 166.0 ± 5.1 cm; weight: 68.6 ± 9.9 kg) were randomly assigned to either a barbell half squat group (SG: n = 10) or trap bar deadlift group (DG: n = 12). Training consisted of twice-weekly sessions for eight weeks. Both groups completed one-repetition maximum (1RM) testing for both barbell half squat and trap bar deadlift groups. Countermovement jump (CMJ) and sprint performance were also assessed. Total body (TBLM) and leg lean mass (LLM) were measured with dual-energy x-ray absorptiometry. Between-group differences were analysed using analysis of covariance.

Results

SG tended to improve 1RM half squat (21.0 ± 11.5 kg vs. 13.1 ± 7.5 kg) more than DG (mean difference (MD): 8.0 kg, 95% CI: -0.36 – 16.3 kg). A similar pattern in favour of DG (18.4 ± 11.2 vs. 11.7 ± 8.1 kg) compared to SG was observed (MD: 6.5 kg, 95% CI: -2.5 – 15.6 kg). No between-group differences for sprint, jump or lean body mass changes was observed. For groups combined, the following changes in CMJ (2.0 ± 2.4 cm), 5-m sprint (-0.020 ± 0.039 s), 15-m sprint (-0.055 ± 0.230 s), TBLM (0.84 ± 1.12 kg), and LLM (0.27 ± 0.59 kg) was observed.

Conclusions

An exercise intervention consisting of half squats or trap bar deadlift were associated with improved muscle strength, power, and lean mass. Our findings suggests that in recreationally active females, exercise selection is less of a concern provided that heavy loads are applied, and relevant muscle groups are targeted.
Association between prehospital ROX index with 30-day mortality among septic shock
Authors: Jouffroy Romain , Fabre Tristan , Gilbert Basile , Travers Stéphane , Bloch-Laine Emmanuel , Ecollan Patrick , Boularan Josiane , Bounes Vincent , Vivien Benoît , Gueye Papa
Published: May 2024

Purpose

Respiratory dysfunction is one of the most frequent symptoms observed during sepsis reflecting hypoxemia and/or acidosis that may be assessed by the ROX index (ratio of oxygen saturation by pulse oximetry/fraction of inspired oxygen to respiratory rate). This study aimed to describe the relationship between the prehospital ROX index and 30-day mortality rate among septic shock patients cared for in the prehospital setting by a mobile intensive care unit (MICU).

Methods

From May 2016 to December 2021, 530 septic shock patients cared for by a prehospital MICU were retrospectively analysed. Initial ROX index value was calculated at the first contact with MICU. A Cox regression analysis after propensity score matching was performed to assess the relationship between 30-day mortality rate and a ROX index ≤ 10.

Results

Pulmonary, digestive and urinary sepsis were suspected among 43%, 25% and 17% patients, respectively. The 30-day overall mortality reached 31%. Cox regression analysis showed a significant association between 30-day mortality and a ROX index ≤ 10: adjusted hazard ratio of 1.54 [1.08–2.31], p < 0.05.

Conclusions

During the prehospital stage of septic shock patients cared for by a MICU, ROX index is significantly associated with 30-day mortality. A prehospital ROX ≤ 10 value is associated with a 1.5-fold 30-day mortality rate increase. Prospective studies are needed to confirm the ability of prehospital ROX to predict sepsis outcome since the prehospital setting.
GB-AFS: graph-based automatic feature selection for multi-class classification via Mean Simplified Silhouette
Authors: Levin David , Singer Gonen
Published: May 2024

This paper introduces a novel graph-based filter method for automatic feature selection (abbreviated as GB-AFS) for multi-class classification tasks. The method determines the minimum combination of features required to sustain prediction performance while maintaining complementary discriminating abilities between different classes. It does not require any user-defined parameters such as the number of features to select. The minimum number of features is selected using our newly developed Mean Simplified Silhouette (abbreviated as MSS) index, designed to evaluate the clustering results for the feature selection task. To illustrate the effectiveness and generality of the method, we applied the GB-AFS method using various combinations of statistical measures and dimensionality reduction techniques. The experimental results demonstrate the superior performance of the proposed GB-AFS over other filter-based techniques and automatic feature selection approaches, and demonstrate that the GB-AFS method is independent of the statistical measure or the dimensionality reduction technique chosen by the user. Moreover, the proposed method maintained the accuracy achieved when utilizing all features while using only 7–$$30\%$$

30
%

of the original features. This resulted in an average time saving ranging from $$15\%$$

15
%

for the smallest dataset to $$70\%$$

70
%

for the largest. Our code is available at https://github.com/davidlevinwork/gbfs/.
Epidemiology of acute liver failure in Egyptian children
Authors: Mansour Nehad Sobhy , Behairy Behairy El-Sayed , Sira Ahmad Mohamed , Elkhadry Sally Waheed , Fouad Ola Ahmed
Published: May 2024

Background

Acute liver failure (ALF) is a serious condition that refers to the development of synthetic function impairment after severe acute liver injury in an individual without pre-existing liver disease. Understanding the epidemiology of ALF in children constitutes a cornerstone in its preventive and treatment plans. Nevertheless, there is a lack of information about its epidemiology in Egypt.

Objective

The aim of this study was to assess the epidemiologic data of ALF in Egyptian children.

Patients and methods

The medical records of children with ALF aged from 6 months to 18 years who were admitted from 2015 to 2020 were analyzed to identify the patient’s epidemiologic, laboratory, and investigational data together with their outcome.

Results

The study included 154 patients who fulfilled the definition of ALF were included. Their age ranged from 7 months to 17 years, with a median of 5.8 years. Hepatitis A virus (HAV) was the most commonly identifiable etiology (37.7%). Mortality was the outcome for 73 patients (47.4%). The prognostic factors associated with mortality were elevated international normalized ratio (INR), total bilirubin (TB), creatinine, and ammonia levels at presentation with cutoff values (2.97, 21.15, 0.385, and 212, respectively).

Conclusion

Hepatitis A virus is the most commonly identified etiology of ALF in Egyptian children. The mortality rate is high, and most of the deaths occurred early in the first 5 days of admission. So, early preparation for liver transplantation is recommended. Higher values of INR, TB, and creatinine above the cutoff levels at presentation may be potential markers for predicting death in affected children.
GPU accelerated sparse curvelet-constrained wavefield reconstruction inversion with source estimation: Application to Chevron Benchmark 2014 blind test data set
Authors: Fang Zhilong , Wang Hua
Published: May 2024

Full-waveform inversion (FWI) is a pivotal tool in seismic exploration and seismology but encounters a persistent challenge known as “cycle-skipping,” causing it to frequently converge to local minima. Wavefield reconstruction inversion (WRI) has emerged as a potential solution to mitigate the risk of cycle skipping. Researchers have provided numerical examples indicating that WRI is less prone to being ensnared in local minima caused by the absence of low-frequency component data and the absence of a well-defined initial model compared with conventional FWI. Despite its potential, the computational demands of WRI have hindered its widespread application, especially in scenarios involving ocean towed streamer seismic acquisition and unknown sources, where the augmented systems differ from source to source. In our study, we introduce a novel approach — sparse curvelet-constrained WRI with source estimation (WRI-SE-CC) — accelerated by graphics processing unit (GPU). Real-time source function estimation is achieved through the variable projection method, and noise-related artifacts are suppressed using sparse curvelet constraints. By optimizing the utilization of hundreds of computation processors within a GPU for parallel computing of matrix-vector multiplications, we present a GPU-based grouped conjugate gradient method to accelerate the computation of WRI-SE-CC. Numerical experiments demonstrate a significant 240-fold acceleration compared with the preconditioned conjugate gradient using one CPU core for computations involving multiple sources. Inversion experiments with the overthrust model demonstrate the capability of our method in mitigating local minima and suppressing noise-related artifacts. Furthermore, we validate the framework on the Chevron 2014 blind test data set, showcasing its effectiveness in addressing practical challenges in the field.
Source Word versus Target Poem
Authors: Clarke Chris
Published: May 2024

This essay examines the complex role of the poet-translator through the specific case of the collaborative relationship between Mexican poet Octavio Paz and his long-time translator, the American poet Muriel Rukeyser. The article first outlines the role of literary translation in Rukeyser’s artistic practice and illustrates her outlook on the process. More generally, it engages with existing theorizations of the translation of poetry, especially those that focus on the often precarious position of the established poet as translator. With Rukeyser’s translatorial position established, the article then provides a close reading of the correspondence between these two long-time collaborators, bringing to the foreground a gradually increasing disconnect over how Paz’s poetry should be translated. These progressively differing points of view on translation would eventually play a role in opening up Paz’s Spanish-language poetry to new translators in the United States. While this article examines an understudied but crucial facet of Rukeyser’s career as a writer and translator, it also sheds light on the complicated set of expectations and realities involved when one poet translates another.
Under the Cobblestones, Prehistory!
Authors: Vozel Francois-Nicolas
Published: May 2024

Maurice Blanchot and Marguerite Duras experienced May ’68 as a miraculous event, a radical interruption of the order of things. Throughout the 1970s, both writers explored whether it is possible to account for, while remaining faithful to, a movement that interrupted the political, economic, and axiological frameworks that structured the Western world. By focusing on the May revolution as a pivotal moment in the writers’ friendship, intellectual life, and political commitments, the author traces the afterlife of May ’68 in their respective texts, concentrating specifically on one of Duras’s most understudied works, Les Mains négatives (1979). In this cine-poem, Duras pursues a dialogue begun with Blanchot during the general strike over the reconceptualization of communism as a form of communal experience antithetic to all power structures. Duras envisions this inoperative communism as a manifestation of “desire” conceived as an impersonal force that establishes an ethical relation with the foreign, the inassimilable, the other. More specifically, this essay ponders the aesthetic, ethical, and political implications of the cine-poem’s construal of the negative hands of upper-Paleolithic art as the first representation of desire, positing that, for Duras, the negative hands are both the prehistoric archetype and the afterlife of the soixante-huitards’ communist desire.
Social Mobility Across the Pacific: An Analysis of Japanese Americans in the Continental United States
Authors: Kihara Tate
Published: May 2024

The impact of immigrant parents’ premigration family background on their second-generation children residing in destination countries remains underexplored in the literature on historical social mobility. Using multigenerational historical survey records from the Japanese American Research Project, this study investigates the influence of premigration socioeconomic and cultural background of Japan-born grandparents and parents on the social mobility of second-generation Japanese Americans born in the continental United States in the early twentieth century. The analysis reveals the enduring effects of family premigration socioeconomic status, as indicated by occupation and education, and culture conducive to upward mobility, proxied by samurai ancestry, on second-generation Japanese Americans’ educational and income levels. These effects may extend back to their nonmigrant grandparents and possibly contrast with their European second-generation immigrant counterparts, who typically experienced upward mobility regardless of their family background. The results point to the critical role of origin-country socioeconomic status and culture in immigrant social mobility research, particularly for populations whose negative reception has hindered their resource access in their new countries.
To Have and to Hold
Authors: Dalyan Can
Published: May 2024

Heritage politics in Turkey came under global scrutiny in July 2020 following the conversion of the Hagia Sophia Museum in Istanbul back into a mosque, and then again in October 2020 after the confiscation of ancient and modern seed collections residing at the British Institute in Ankara. In the accounts of several Turkish and international critics, these two events were presented as kindred, reactionary maneuvers aimed at galvanizing nationalist fervor, and Turkish claims on biological and cultural property were pitted against universalist ideals of conservation. Drawing on long-term ethnographic and archival research on the Turkish conservation bureaucracy, this article analyzes the role of plants and antiquities in Turkish metanarratives of loss, sovereignty, and modernization, and it offers an anthropological account of everyday conservation work in Turkey that challenges the purported divide between universalist science and nationalist politics that very much mimics the contours of a civilizational split.