bluuebunny/crossref_metadata_2025 huggingface dataset:
The political: A view from Jakarta’s kampungs
Authors: Putri Prathiwi Widyatmi
Published: April 2024

This article is a response to Leitner and Sheppard’s recent publications on Jakarta. I argue that Jakarta’s kampungs and the eviction of their communities is a topic that needs to be situated in the realm of social reproduction. The multidimensional problems in kampungs fall within capitalism’s wider ‘crisis of care’. From this methodological position, we can access the political domain of the kampung, from which a new political agency emerges as collective bodies beyond merely the sum of individual survival tactics.
Identification and characterization of migraine in pregnancy: A Norwegian registry-based cohort study
Authors: Mitter Vera R. , Lupattelli Angela , Bjørk Marte-Helene , Nordeng Hedvig M.E.
Published: April 2024

Background

Migraine is common in women of reproductive age. Migraine’s episodic manifestation and acute and preventive pharmacological treatment options challenge studying drug safety for this condition during pregnancy. To improve such studies, we aimed to develop algorithms to identify and characterize migraines in electronic healthcare registries and to assess the level of care.

Methods

We linked four registries to detect pregnancies from 2009–2018 and used three algorithms for migraine identification: i) diagnostic codes, ii) triptans dispensed, and iii) a combination of both. We assessed migraine severity using dispensed drugs as proxies. ICD-10 diagnostic subcodes of migraine (G43) allowed the allocation of four subtypes: complicated and/or status migrainosus; with aura; without aura; other/unspecified.

Results

We included 535,089 pregnancies in 367,908 women with available one-year lookback. The prevalence of migraines identified was 2.9%–4.3% before, and 0.8%–1.5% during pregnancy, depending on algorithm used. Pregnant women with migraine were mostly managed in primary care.

Conclusions

Primary care data in combination with drug dispensation records were instrumental for identification of migraine in electronic healthcare registries. Data from secondary care and drug dispensations allow better characterization of migraines. Jointly, these algorithms may contribute to improved perinatal pharmacoepidemiological studies in this population by addressing confounding by maternal migraine indication.
The Companion: A Hospital Autoethnography on the Relationship Between Informal and Formal Institutions
Authors: Yavuz Devrim Adam
Published: April 2024

The article is an analytical autoethnography that explores the author’s experience of navigating the Turkish healthcare system while caring for his father who underwent emergency bypass surgery. Their atypical positions, at once members of a privileged group but lacking extensive familial connections, helped bring to light the diverse range of tactics that patients use to navigate the hospital, despite reforms that tried to establish greater universalism. By highlighting the relationship between formal institutions and informal practices in the healthcare system and how they survive to include/exclude different status groups, the author’s micro-level observations and background in political sociology help reveal the complex impact that non-universalistic practices have on democratization and political change in Turkey and beyond.
Exploring underlying factors for variations in digital upskilling
Authors: McCrowre Rodney , Adivar Burcu
Published: April 2024

This study aims to analyse the impact of demographic and educational factors on in digital upskilling. We address the relationship between digital skills, critical thinking skills and the student learning experience in courses with embedded upskilling programs. Statistical analysis and exploratory research are used to analyse the data collected by the digital fitness app developed by a global company leading digital talent transformation. Our research identified the following demographic indicators that have influenced individuals’ digital upskilling: Gender, Race, Residency, Pell-eligibility, Age, in addition to six academic indicators including department, major, class level, first-time freshman, High School GPA and ACT score. Discussion of findings and future research directions would lead to novel research articles focusing on longitudinal studies to assess digital skills. Also, this study shows the need for a new assessment tool to expand the scope and the sample size of the study. This article provides a valuable guidance for policy makers, higher-education institutions, educators, students, and employers, who are looking for digital talent or skill sets needed for digital transformation. The main contribution lays in data collection and analysis. This is the first study using a globally accepted digital talent assessment tool to collect data at a minority serving institution.
Predictive method of pressure loss in wet clutch caused by seal wear based on stacking ensemble learning
Authors: Gong Ran , Sun Fengming , Wang Cheng , Zhang He
Published: April 2024

The harsh operating conditions of heavy-duty vehicles accelerates the wear of the sealing ring in the transmission, leading to increased oil leakage and a reduction of the operating pressure in the piston cylinder of wet clutch. This impairs the proper functioning of the transmission in the heavy-duty vehicle. Therefore, it is necessary to predict the pressure loss inside the transmission quickly and effectively after the wear of the sealing ring. The wear of the sealing ring under different operating conditions is calculated through the modified Archard model. The relationship between the oil leakage and pressure loss after the wear of the sealing ring is analyzed using Fluent software. The analysis involves the effects of different wear levels of the sealing ring. The simulation results are validated through a high-speed oil cylinder performance test rig. Based on the validated simulation data and test data, a prediction model for pressure loss is established by using stacking ensemble learning with MLR (multiple linear regression), DTR (decision tree regression), and SVR (support vector regression) as the base learners and RF (random forest) as the meta-learner. The risk of model overfitting is reduced through k-fold cross-validation. The research results indicate that the fused stacking ensemble learning algorithm fully utilizes the advantages of each base learner and can effectively predict the pressure loss after the wear of the sealing ring, and achieve a higher accuracy. The establishment of this model provides theoretical support for real-time prediction of pressure loss after the wear of the sealing ring in actual heavy-duty vehicles.
The role of vascularized bone grafting for scaphoid nonunions in adolescents
Authors: Israel Jacqueline S. , Bishop Allen T. , Shin Alexander Y. , Pulos Nicholas
Published: April 2024

A total of 26 adolescent patients were treated for scaphoid nonunion with a vascularized bone graft from either the medial femoral condyle or dorsal distal radius. There was an 85% union incidence, improved carpal alignment and a low incidence of complications.
Alike but not the same: Psychological profiles of COVID-19 vaccine skeptics
Authors: Voss Ursula , Schermelleh-Engel Karin , Hauser Leana , Holzmann Mira , Fichtner Diana , Seifert Sonja , Klimke Ansgar , Windmann Sabine
Published: April 2024

One of the challenges of the SARS-CoV-2 pandemic was a widespread skepticism about vaccination. To elucidate the underlying mental and emotional predispositions, we examined a sample of 1428 participants using latent profile analysis (LPA) on selected personality trait variables, mental health status, and measures of irrational beliefs. LPA revealed five distinct profiles: two classes of non-skeptics and three of skeptics. The smaller non-skeptic class reported the highest rates of mental health problems, along with high levels of neuroticism, hostility, interpersonal sensitivity, and external locus of control. The larger non-skeptic class was psychologically well-balanced. Conversely, the skeptic groups shared strong distrust of COVID-19 vaccination but differed in emotional and mental profiles, leading to graded differences in endorsing extreme conspiracy beliefs. This suggests that vaccine skepticism is not solely a result of mental illness or emotional instability; rather extreme skepticism manifests as a nuanced, graded phenomenon contingent on personality traits and conspirational beliefs.
All in the Family: Does Grandparenting Impact Chinese Grandparents’ Depressive Symptoms?
Authors: Wang Huan , Lu Yu , Huang Jianyuan
Published: April 2024

Grandparenting is becoming increasingly prevalent worldwide, especially in Chinese society. However, the impact of grandparenting on older adults’ health remains unclear. This study examined whether and how grandparenting is associated with depressive symptoms in Chinese older adults and the role of intergenerational support (i.e., financial, emotional, and instrumental support) in this relationship. Using data from the China Longitudinal Aging Social Survey (CLASS) 2018 wave, the researchers employed multivariate linear regression models to investigate variations in depressive symptoms and their associations with grandparenting; the role of intergenerational support was also explored. The results indicated that older adults who engage in grandparenting, particularly in non-intensive care, experience a reduction in depressive symptoms, even after accounting for sociodemographic and health-related factors. Overall, intergenerational support plays a mediating role in the relationship between grandparenting and associated mental health outcomes. Bidirectional emotional and financial support and receiving instrumental support were associated with lower depressive symptoms among Chinese grandparents. In general, the findings of this study suggest that grandparenting, along with intergenerational support, provides certain protective health benefits for Chinese grandparents. With rapid changes in Chinese society, further prospective longitudinal studies are needed to examine family contexts in the relationship between grandchild caregiving and associated health outcomes.
Book review: S. Sivakumar, Prakash Sharma and Abhishek Pandey (Eds.), Clinical and Continuing Legal Education: A Roadmap for India
Authors: Roy Rumi
Published: April 2024

S. Sivakumar, Prakash Sharma and Abhishek Pandey (Eds.), Clinical and Continuing Legal Education: A Roadmap for India (Gurgaon: Commonwealth Legal Education Association and Thomson Reuters, 2021), xlv + 460 pp. ₹1,450 (Hardcover), ISBN 978-9-3906-7300-1
Clonal relapse dynamics in acute myeloid leukemia following allogeneic hematopoietic cell transplantation
Authors: Wienecke Clara Philine , Heida Bennet , Venturini Letizia , Gabdoulline Razif , Krüger Katja , Teich Katrin , Büttner Konstantin , Wichmann Martin , Puppe Wolfram , Neziri Blerina , Reuter Marlene , Dammann Elke , Stadler Michael , Ganser Arnold , Hambach Lothar , Thol Felicitas , Heuser Michael
Published: April 2024

Patients with acute myeloid leukemia (AML) who experience relapse following allogeneic hematopoietic cell transplantation (alloHCT) face unfavorable outcomes regardless of the chosen relapse treatment. Early detection of relapse at the molecular level by measurable residual disease (MRD) assessment enables timely intervention, which may prevent hematological recurrence of the disease. It remains unclear whether molecular MRD assessment can detect MRD before impending relapse and, if so, how long in advance. This study elucidates the molecular architecture and kinetics preceding AML relapse by using error-corrected next-generation sequencing (NGS) in 74 patients with AML relapsing after alloHCT, evaluating 140 samples from peripheral blood collected 0.6 to 14 months before relapse. At least 1 MRD marker became detectable in 10%, 38%, and 64% of patients at 6, 3, and 1 month before relapse, respectively. By translating these proportions into monitoring intervals, 38% of relapses would have been detected through MRD monitoring every 3 months, whereas 64% of relapses would have been detected with monthly intervals. The relapse kinetics after alloHCT are influenced by the functional class of mutations and their stability during molecular progression. Notably, mutations in epigenetic modifier genes exhibited a higher prevalence of MRD positivity and greater stability before relapse, whereas mutations in signaling genes demonstrated a shorter lead time to relapse. Both DTA (DNMT3A, TET2, and ASXL1) and non-DTA mutations displayed similar relapse kinetics during the follow-up period after alloHCT. Our study sets a framework for MRD monitoring after alloHCT by NGS, supporting monthly monitoring from peripheral blood using all variants that are known from diagnosis.
Obinutuzumab vs rituximab for transplant-eligible patients with mantle cell lymphoma
Authors: Sarkozy Clémentine , Callanan Mary , Thieblemont Catherine , Obéric Lucie , Burroni Barbara , Bouabdallah Krimo , Damaj Gandhi , Tessoulin Benoit , Ribrag Vincent , Houot Roch , Morschhauser Franck , Griolet Samuel , Joubert Clémentine , Cacheux Victoria , Delwail Vincent , Safar Violaine , Gressin Remy , Cheminant Morgane , Delfau-Larue Marie-Hélène , Hermine Olivier , Macintyre Elizabeth , Le Gouill Steven
Published: April 2024

Obinutuzumab (O) and rituximab (R) are 2 CD antibodies that have never been compared in a prospective randomized trial of mantle cell lymphoma (MCL). Herein, we report the long-term outcome of the LyMa-101 trial, in which newly diagnosed patients with MCL were treated with chemotherapy plus O before transplantation, followed by O maintenance (O group). We then compared these patients with those treated with the same treatment design with R instead of O (R group). A propensity score matching (PSM) was used to compare the 2 populations (O vs R groups) in terms of measurable residual disease (MRD) at the end of induction (EOI), progression-free survival (PFS), and overall survival (OS). In LyMa-101, the estimated 5-year PFS and OS after inclusion (n = 85) were 83.4% (95% confidence interval [CI], 73.5-89.8) and 86.9% (95% CI, 77.6-92.5), respectively. At EOI, patients treated in the O group had more frequent bone marrow MRD negativity than those treated in the R group (83.1% vs 63.4%; χ2, P = .007). PSM resulted in 2 sets of 82 patients with comparable characteristics at inclusion. From treatment initiation, the O group had a longer estimated 5-year PFS (P = .029; 82.8% vs 66.6%; hazard ratio [HR], 1.99; 95% confidence interval (CI), 1.05-3.76) and OS (P = .039; 86.4% vs 71.4%; HR, 2.08; 95% CI, 1.01-4.16) compared with the R group. Causes of death were comparable in the 2 groups, the most common cause being lymphoma. O before transplantation and in maintenance provides better disease control and enhances PFS and OS compared with R in transplant-eligible patients with MCL. These trials were registered at www.clinicaltrials.gov as #NCT00921414 and NCT02896582.
Outcomes of HLA-mismatched HSCT with TCRαβ/CD19 depletion or post-HSCT cyclophosphamide for inborn errors of immunity
Authors: Lum Su Han , Albert Michael H. , Gilbert Patrick , Sirait Tiarlan , Algeri Mattia , Muratori Rafaella , Fournier Benjamin , Laberko Alexandra , Karakukcu Musa , Unal Elrem , Ayas Mouhab , Yadav Satya Prakash , Fisgin Tunc , Elfeky Reem , Fernandes Juliana , Faraci Maura , Cole Theresa , Schulz Ansgar , Meisel Roland , Zecca Marco , Ifversen Marianne , Biffi Alessandra , Diana Jean-Sebastien , Vallée Tanja , Giardino Stefano , Ersoy Gizem Zengin , Moshous Despina , Gennery Andrew R. , Balashov Dmitry , Bonfim Carmem , Locatelli Franco , Lankester Arjan , Neven Bénédicte , Slatter Mary
Published: April 2024

HLA-mismatched transplants with either in vitro depletion of CD3+ T-cell receptor (TCR)αβ/CD19 (TCRαβ) cells or in vivo T-cell depletion using posttransplant cyclophosphamide (PTCY) have been increasingly used for patients with inborn errors of immunity (IEIs). We performed a retrospective multicenter study via the EBMT registry on 306 children with IEIs undergoing their first transplant between 2010 and 2019 from an HLA-mismatched donor using TCRαβ (n = 167) or PTCY (n = 139). The median age for hematopoietic stem cell transplantation (HSCT) was 1.2 years (range, 0.03-19.6 years). The 3-year overall survival (OS) was 78% (95% confidence interval (CI), 71-84) after TCRαβ and 66% (57-74) after PTCY (P = .013). Pre-HSCT morbidity score (hazard ratio [HR], 2.27; 1.07-4.80, P = .032) and non-busulfan/treosulfan conditioning (HR, 3.12; 1.98-4.92, P < .001) were the only independent predictors of unfavorable OS. The 3-year event-free survival (EFS) was 58% (50%-66%) after TCRαβ and 57% (48%-66%) after PTCY (P = .804). The cumulative incidence of severe acute graft-versus-host disease (GvHD) was higher after PTCY (15%, 9%-21%) than TCRαβ (6%, 2%-9%, P = .007), with no difference in chronic GvHD (PTCY, 11%, 6%-17%; TCRαβ, 7%, 3%-11%, P = .173). The 3-year GvHD-free EFS was 53% (44%-61%) after TCRαβ and 41% (32%-50%) after PTCY (P = .080). PTCY had significantly higher rates of veno-occlusive disease (14.4% vs TCRαβ 4.9%, P = .009), acute kidney injury (12.7% vs 4.6%, P = .032), and pulmonary complications (38.2% vs 24.1%, P = .017). Adenoviremia (18.3% vs PTCY 8.0%, P = .015), primary graft failure (10% vs 5%, P = .048), and second HSCT (17.4% vs 7.9%, P = .023) were significantly higher in TCRαβ. In conclusion, this study demonstrates that both approaches are suitable options in patients with IEIs, although they are characterized by different advantages and outcomes.
High efficacy of CD19 CAR T cells in patients with transformed Waldenström macroglobulinemia
Authors: Durot Eric , Roos-Weil Damien , Chauchet Adrien , Decroocq Justine , Di Blasi Roberta , Gastinne Thomas , Bensaber Hedi , Cheminant Morgane , Jacquet Caroline , Guidez Stéphanie , Gros François-Xavier , Bachy Emmanuel , Coste Arthur , Cony-Makhoul Pascale , Treon Steven P. , Delmer Alain , Reshef Ran , Le Gouill Steven , Castillo Jorge J. , Houot Roch
Published: April 2024

Histologic transformation of Waldenström macroglobulinemia (HT-WM) carries a poor prognosis with standard treatments. Here, we report the first series of HT-WM treated with chimeric antigen receptor T cells showing a high efficacy and no unexpected toxicity.
Myosin-1C augments endothelial secretion of von Willebrand factor by linking contractile actomyosin machinery to the plasma membrane
Authors: El-Mansi Sammy , Mitchell Tom P. , Mobayen Golzar , McKinnon Thomas A. J. , Miklavc Pika , Frick Manfred , Nightingale Thomas D.
Published: April 2024

Blood endothelial cells control the hemostatic and inflammatory response by secreting von Willebrand factor (VWF) and P-selectin from storage organelles called Weibel-Palade bodies (WPBs). Actin-associated motor proteins regulate this secretory pathway at multiple points. Before fusion, myosin Va forms a complex that anchors WPBs to peripheral actin structures, allowing for the maturation of content. After fusion, an actomyosin ring/coat is recruited and compresses the WPB to forcibly expel the largest VWF multimers. Here, we provide, to our knowledge, the first evidence for the involvement of class I myosins during regulated VWF secretion. We show that the unconventional myosin-1C (Myo1c) is recruited after fusion via its pleckstrin homology domain in an actin-independent process. This provides a link between the actin ring and phosphatidylinositol 4,5-bisphosphate (PIP2) at the membrane of the fused organelle and is necessary to ensure maximal VWF secretion. This is an active process requiring Myo1c ATPase activity because inhibition of class I myosins using the inhibitor pentachloropseudilin or expression of an ATPase-deficient Myo1c rigor mutant perturbs the expulsion of VWF and alters the kinetics of the exocytic actin ring. These data offer a novel insight into the control of an essential physiological process and provide a new way in which it can be regulated.
Exploring combinations of dimensionality reduction, transfer learning, and regularization methods for predicting binary phenotypes with transcriptomic data
Authors: Oshternian S. R. , Loipfinger S. , Bhattacharya A. , Fehrmann R. S. N.
Published: April 2024

Background

Numerous transcriptomic-based models have been developed to predict or understand the fundamental mechanisms driving biological phenotypes. However, few models have successfully transitioned into clinical practice due to challenges associated with generalizability and interpretability. To address these issues, researchers have turned to dimensionality reduction methods and have begun implementing transfer learning approaches.

Methods

In this study, we aimed to determine the optimal combination of dimensionality reduction and regularization methods for predictive modeling. We applied seven dimensionality reduction methods to various datasets, including two supervised methods (linear optimal low-rank projection and low-rank canonical correlation analysis), two unsupervised methods [principal component analysis and consensus independent component analysis (c-ICA)], and three methods [autoencoder (AE), adversarial variational autoencoder, and c-ICA] within a transfer learning framework, trained on > 140,000 transcriptomic profiles. To assess the performance of the different combinations, we used a cross-validation setup encapsulated within a permutation testing framework, analyzing 30 different transcriptomic datasets with binary phenotypes. Furthermore, we included datasets with small sample sizes and phenotypes of varying degrees of predictability, and we employed independent datasets for validation.

Results

Our findings revealed that regularized models without dimensionality reduction achieved the highest predictive performance, challenging the necessity of dimensionality reduction when the primary goal is to achieve optimal predictive performance. However, models using AE and c-ICA with transfer learning for dimensionality reduction showed comparable performance, with enhanced interpretability and robustness of predictors, compared to models using non-dimensionality-reduced data.

Conclusion

These findings offer valuable insights into the optimal combination of strategies for enhancing the predictive performance, interpretability, and generalizability of transcriptomic-based models.
Plant immunity suppression by an β-1,3-glucanase of the maize anthracnose pathogen Colletotrichum graminicola
Authors: Gu Xiaoyu , Cao Zhiyan , Li Zhiqiang , Yu Haiyue , Liu Wende
Published: April 2024

Background

Many phytopathogens secrete a large number of cell wall degrading enzymes (CWDEs) to decompose host cell walls in order to penetrate the host, obtain nutrients and accelerate colonization. There is a wide variety of CWDEs produced by plant pathogens, including glycoside hydrolases (GHs), which determine the virulence, pathogenicity, and host specificity of phytopathogens. The specific molecular mechanisms by which pathogens suppress host immunity remain obscure.

Result

In this study, we found that CgEC124 encodes a glycosyl hydrolase with a signal peptide and a conserved Glyco_hydro_cc domain which belongs to glycoside hydrolase 128 family. The expression of CgEC124 was significantly induced in the early stage of Colletotrichum graminicola infection, especially at 12 hpi. Furthermore, CgEC124 positively regulated the pathogenicity, but it did not impact the vegetative growth of mycelia. Ecotopic transient expression of CgEC124 decreased the disease resistance and callose deposition in maize. Moreover, CgEC124 exhibited the β-1,3-glucanase activity and suppresses glucan-induced ROS burst in maize leaves.

Conclusions

Our results indicate that CgEC124 is required for full virulence of C. graminicola but not for vegetative growth. CgEC124 increases maize susceptibility by inhibiting host reactive oxygen species burst as well as callose deposition. Meanwhile, our data suggests that CgEC124 explores its β-1,3-glucanase activity to prevent induction of host defenses.
Assessment and management of chronic insomnia disorder: an algorithm for primary care physicians
Authors: Selsick Hugh , Heidbreder Anna , Ellis Jason , Ferini-Strambi Luigi , García-Borreguero Diego , Leontiou Chrysoula , Mak Michael S.B. , O’Regan David , Parrino Liborio
Published: April 2024

Background

Primary care physicians often lack resources and training to correctly diagnose and manage chronic insomnia disorder. Tools supporting chronic insomnia diagnosis and management could fill this critical gap. A survey was conducted to understand insomnia disorder diagnosis and treatment practices among primary care physicians, and to evaluate a diagnosis and treatment algorithm on its use, to identify ways to optimize it specifically for these providers.

Methods

A panel of experts developed an algorithm for diagnosing and treating chronic insomnia disorder, based on current guidelines and experience in clinical practice. An online survey was conducted with primary care physicians from France, Germany, Italy, Spain, and the United Kingdom, who treat chronic insomnia patients, between January and February 2023. A sub-sample of participants provided open-ended feedback on the algorithm and gave suggestions for improvements.

Results

Overall, 106 primary care physicians completed the survey. Half (52%, 55/106) reported they did not regularly screen for insomnia and half (51%, 54/106) felt they did not have enough time to address patients’ needs in relation to insomnia or trouble sleeping. The majority (87%,92/106) agreed the algorithm would help diagnose chronic insomnia patients and 82% (87/106) agreed the algorithm would help improve their clinical practice in relation to managing chronic insomnia. Suggestions for improvements were making the algorithm easier to read and use.

Conclusion

The algorithm developed for, and tested by, primary care physicians to diagnose and treat chronic insomnia disorder may offer significant benefits to providers and their patients through ensuring standardization of insomnia diagnosis and management.
A practical approach to screening for carbapenemase-producing Enterobacterales– views of a group of multidisciplinary experts from English hospitals
Authors: Jenkins DR. , Auckland C. , Chadwick C. , Dodgson AR. , Enoch DA. , Goldenberg SD. , Hussain A. , Martin J. , Spooner E. , Whalley T.
Published: April 2024

Introduction

Carbapenemase-producing Enterobacterales (CPE) are an important public health threat, with costly operational and economic consequences for NHS Integrated Care Systems and NHS Trusts. UK Health Security Agency guidelines recommend that Trusts use locally developed risk assessments to accurately identify high-risk individuals for screening, and implement the most appropriate method of testing, but this presents many challenges.

Methods

A convenience sample of cross-specialty experts from across England met to discuss the barriers and practical solutions to implementing UK Health Security Agency framework into operational and clinical workflows. The group derived responses to six key questions that are frequently asked about screening for CPE.

Key findings

Four patient groups were identified for CPE screening: high-risk unplanned admissions, high-risk elective admissions, patients in high-risk units, and known positive contacts. Rapid molecular testing is a preferred screening method for some of these settings, offering faster turnaround times and more accurate results than culture-based testing. It is important to stimulate action now, as several lessons can be learnt from screening during the COVID-19 pandemic, as well as from CPE outbreaks.

Conclusion

Further decisive and instructive information is needed to establish CPE screening protocols based on local epidemiology and risk factors. Local management should continually evaluate local epidemiology, analysing data and undertaking frequent prevalence studies to understand risks, and prepare resources– such as upscaled screening– to prevent increasing prevalence, clusters or outbreaks. Rapid molecular-based methods will be a crucial part of these considerations, as they can reduce unnecessary isolation and opportunity costs.
Predicting chronic kidney disease progression with artificial intelligence
Authors: Isaza-Ruget Mario A. , Yomayusa Nancy , González Camilo A. , H. Catherine Alvarado , de Oro V. Fabio A. , Cely Andrés , Murcia Jossie , Gonzalez-Velez Abel , Robayo Adriana , Colmenares-Mejía Claudia C. , Castillo Andrea , Conde María I.
Published: April 2024

Background

The use of tools that allow estimation of the probability of progression of chronic kidney disease (CKD) to advanced stages has not yet achieved significant practical importance in clinical setting. This study aimed to develop and validate a machine learning-based model for predicting the need for renal replacement therapy (RRT) and disease progression for patients with stage 3–5 CKD.

Methods

This was a retrospective, closed cohort, observational study. Patients with CKD affiliated with a private insurer with five-year follow-up data were selected. Demographic, clinical, and laboratory variables were included, and the models were developed based on machine learning methods. The outcomes were CKD progression, a significant decrease in the estimated glomerular filtration rate (eGFR), and the need for RRT.

Results

Three prediction models were developed—Model 1 (risk at 4.5 years, n = 1446) with a F1 of 0.82, 0.53, and 0.55 for RRT, stage progression, and reduction in the eGFR, respectively,— Model 2 (time- to-event, n = 2143) with a C-index of 0.89, 0.67, and 0.67 for RRT, stage progression, reduction in the eGFR, respectively, and Model 3 (reduced Model 2) with C-index = 0.68, 0.68 and 0.88, for RRT, stage progression, reduction in the eGFR, respectively.

Conclusion

The time-to-event model performed well in predicting the three outcomes of CKD progression at five years. This model can be useful for predicting the onset and time of occurrence of the outcomes of interest in the population with established CKD.
Clinical features and comprehensive treatment of persistent corneal epithelial dysfunction after cataract surgery
Authors: Xiao Xianwen , Lin Yuan , Fang Xie , Xie Zhiwen , Luo Shunrong , Wu Huping
Published: April 2024

Objective

Evaluation of clinical efficacy and safety of tobramycin/dexamethasone eye ointment in treating persistent corneal epithelial dysfunction (PED) after cataract surgery.

Methods

26 cases diagnosed as PED after cataract surgery accept the tobramycin/dexamethasone ophthalmic ointment and intense pulse light treatment in the Xiamen University of Xiamen eye center between September 2016 and April 2022 were retrospectively analyzed, mainly including clinical manifestations, characteristics of morphological changes imaged by in vivo confocal microscopy, meibomian glands infrared photography, lipid layer thickness (LLT), management and therapeutic effects.

Results

There were 26 eyes, include 8(35%) males and 15(65%) females with an average age of 69.6 ± 5.2 years(50 to 78 years). The mean hospitalization time was (18.4 ± 7.5) days after cataract surgery. Twenty patients had meibomian gland dysfunction. Infrared photography revealed varying loss in the meibomian glands, with a mean score of 3.8 ± 1.2 for gland loss. The mean LLT was 61.6 ± 8.4 nm. After treatment, 20 patients were cured, and 3 received amniotic membrane transplantation. After treatment, the uncorrected visual acuity (UCVA) and best-corrected vision activity (BCVA) improved (P < 0.001), and there was no significant difference in intraocular pressure (IOP) before and after treatment (P > 0.05).

Conclusions

The early manifestation of PED after surgery is punctate staining of the corneal epithelium. Tobramycin and dexamethasone eye ointment bandages have a good repair effect. The meibomian gland massage combined with intense pulse light treatment can effectively shorten the course of the disease.
Irisin combined index to diagnose central precocious puberty in girls: a cross-sectional study
Authors: Wang Jie , Tang Yongquan , Chen Guanyu , Yang Mingming , Gao Qian , Wang Yingdan , Zhou Wendi
Published: April 2024

Background

To investigate serum irisin levels in girls at different developmental status and explore the significance of irisin for the diagnosis of central precocious puberty (CPP) in girls.

Methods

In this cross-sectional study 111 girls were enrolled, including 43 cases of CPP, 44 cases of peripheral precocious puberty (PPP) and 24 cases of girls with normal sexual development as controls. The data on age, weight and height, measured blood levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and irisin were collected. Pelvic Doppler ultrasound was performed to evaluate uterine length, transverse diameter, anteroposterior diameter. The girls were divided into non-CPP group and CPP group according to gonadotropin-releasing hormone (GnRH) stimulation test.

Results

Serum irisin levels were significantly higher in CPP group than in PPP group and normal control group. Serum irisin level was positively correlated with basal LH level, basal FSH level, peak LH level, peak LH /FSH ratio, uterine volume, bone age, and bone age index. The area under the curve, cut-off value, sensitivity and specificity of serum irisin were 0.958, 219.255 pg/ml, 100% and 80.6%. The combined diagnosis of CPP in girls by serum irisin and serum basal LH combined with uterine volume had an AUC, sensitivity, and specificity of 0.994, 97.6%, and 100%, superior to that of the single index.

Conclusions

Serum irisin level in girls with CPP is significantly increased. An irisin combined index could help the diagnosis of CPP in girls.
Asbestos ban policies and mesothelioma mortality in Greece
Authors: Gogou Evdoxia , Hatzoglou Chryssi , Siachpazidou Dimitra , Zarogiannis Sotirios G. , Gourgoulianis Konstantinos I.
Published: April 2024

Background

Malignant mesothelioma is a rare form of cancer that mostly affects the pleura and has a strong link to asbestos exposure. Greece banned the use of asbestos in 2005, however, the public was already aware of this substance in the 1980s. This research aims to present an overview of Greece’s mesothelioma age-standardized mortality rates (ASMR) from 1983 to 2019 by age, gender, and geographic region and to determine whether the actions to ban asbestos impacted these rates.

Methods

Data were retrieved by the Hellenic Statistical Authority (HSA) from death certificates that mentioned mesothelioma as the cause of death from 1983 to 2019 with details on the residence, gender, and age. Statistical analysis was performed using PRISM 6.0 software, a two-way ANOVA test, Trend analysis was conducted using Joinpoint Regression Program 5.0 software. The linear and non-linear model was used to calculate the age-standardized rates of annual percentage change (APC) and its 95% confidential interval (95% CI).

Results

From 1983 to 2019, 850 total mesothelioma deaths were recorded, the majority of whom were males (634). A rate of 74.6% accounts for males and 25.4% for females, and the ratio of Males: Females was 3:1. Males’ ASMR and the whole population’s ASMR reached their highest levels in 2011 (0.93/100000person-years and 0.53/100000person-years, respectively). To look for potential changes between the first two decades of the 21st century, we compared the mean ASMR of each geographic region in Greece between two different 10-year subperiods (2000–2009 and 2010–2019). Except for Epirus, all regions of Greece had elevated regional ASMRs, particularly in those with the highest asbestos deposits. Notably, the ASMR in Epirus decreased from 0.54/100000person-years (2000–2009) to 0.31/100000person-years (2010–2019). After 2011, the ASMR for men and the general population stabilized. This stability is important since mesothelioma in men is associated with occupational asbestos exposure. The intriguing discovery of a lower ASMR in Epirus emphasizes the need to raise awareness of the condition and implement effective public health measures.

Conclusions

In Greece, the annual ASMR for males and the whole population reached its highest level in 2011, which is positive and encouraging and may be a sign that the rate will stabilize during the following years. Moreover, this study showed that the actions made in the 1980s regarding public awareness and surveillance directly impacted the decrease in Epirus rates. Future research, continual awareness, information, and recording are needed to monitor the mesothelioma epidemic. The possible benefit of a mesothelioma registry and the epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, need to be addressed.

Trial registration

Not applicable.
A new neonatal BCG vaccination pathway in England: a mixed methods evaluation of its implementation
Authors: Jones Koren , Chisnall Georgia , Crocker-Buque Tim , Elliman David , Horwood Jeremy , Mounier-Jack Sandra , Campbell Colin NJ , Saliba Vanessa , Chantler Tracey
Published: April 2024

Introduction

The introduction of a national evaluation of newborn screening for Severe Combined Immunodeficiency (SCID) in England triggered a change to the selective Bacillus Calmette-Guerin (BCG) vaccination programme delivery pathway, as this live attenuated vaccine is contraindicated in infants with SCID. The neonatal BCG vaccination programme is a targeted programme for infants at increased risk of tuberculosis and used to be offered shortly after birth. Since September 2021 the BCG vaccine is given to eligible infants within 28 days of birth, when the SCID screening outcome is available. We explore the experiences of those implementing the new pathway, and how they made sense of, engaged with, and appraised the change.

Methods

A mixed-methods evaluation was conducted between October 2022 and February 2023. This involved national online surveys with BCG commissioners and providers and qualitative semi-structured interviews with commissioners, providers, and Child Health Information System stakeholders in two urban areas. Survey data was analysed using descriptive statistics and interview data was analysed thematically. The data was triangulated using Normalization Process Theory as a guiding framework.

Results

Survey respondents (n = 65) and qualitative interviewees (n = 16) revealed that making sense of the new pathway was an iterative process. Some expressed a desire for more direction on how to implement the new pathway. The perceived value of the change varied from positive, ambivalent, to concerned. Some felt well-prepared and that improvements to data capture, eligibility screening, and accountably brought by the change were valuable. Others were concerned about the feasibility of the 28-day target, reductions in vaccination coverage, increased resource burden, and the outcome of the SCID evaluation. New collaborations and communities of practice were required to facilitate the change. Three main challenges in implementing the pathway and meeting the 28-day vaccination target were identified: appointment non-attendance; appointment and data systems; and staffing and resourcing. Feedback mechanisms were informal and took place in tandem with implementation.

Conclusion

The new NHS neonatal BCG service specification has created an effective structure for monitoring and managing the BCG vaccination programme, but further work is required to support delivery of the 28-day vaccination target and improve uptake rates.
The risk of contact between visitors and Borrelia burgdorferi-infected ticks is associated with fine-scale landscape features in a southeastern Canadian nature park
Authors: Dumas Ariane , Bouchard Catherine , Drapeau Pierre , Lindsay L. Robbin , Ogden Nicholas H. , Leighton Patrick A.
Published: April 2024

Background

Infectious diseases are emerging across temperate regions of the world, and, for some, links have been made between landscapes and emergence dynamics. For tick-borne diseases, public parks may be important exposure sites for people living in urbanized areas of North America and Europe. In most cases, we know more about the ecological processes that determine the hazard posed by ticks as disease vectors than we do about how human population exposure varies in urban natural parks.

Methods

In this study, infrared counters were used to monitor visitor use of a public natural park in southern Quebec, Canada. A risk index representing the probability of encounters between humans and infected vectors was constructed. This was done by combining the intensity of visitor trail use and the density of infected nymphs obtained from field surveillance. Patterns of risk were examined using spatial cluster analysis. Digital forest data and park infrastructure data were then integrated using spatially explicit models to test whether encounter risk levels and its components vary with forest fragmentation indicators and proximity to park infrastructure.

Results

Results suggest that, even at a very fine scales, certain landscape features and infrastructure can be predictors of risk levels. Both visitors and Borrelia burgdorferi-infected ticks concentrated in areas where forest cover was dominant, so there was a positive association between forest cover and the risk index. However, there were no associations between indicators of forest fragmentation and risk levels. Some high-risk clusters contributed disproportionately to the risk distribution in the park relative to their size. There were also two high-risk periods, one in early summer coinciding with peak nymphal activity, and one in early fall when park visitation was highest.

Conclusions

Here, we demonstrate the importance of integrating indicators of human behaviour visitation with tick distribution data to characterize risk patterns for tick-borne diseases in public natural areas. Indeed, understanding the environmental determinants of human-tick interactions will allow organisations to deploy more effective risk reduction interventions targeted at key locations and times, and improve the management of public health risks associated with tick-borne diseases in public spaces.
Retinol and retinol binding protein 4 levels and COVID-19: a Mendelian randomization study
Authors: Wang Haixia , Zhang Zhiyun , Xie Li , Lu Kongli , Zhang Shuyi , Xing Shunpeng
Published: April 2024

Background

The Corona Virus Disease 2019 (COVID-19) pandemic has struck globally. Whether the related proteins of retinoic acid (RA) signaling pathway are causally associated with the risk of COVID-19 remains unestablished. We conducted a two-sample Mendelian randomization (MR) study to assess the associations of retinol, retinol binding protein 4 (RBP4), retinol dehydrogenase 16 (RDH16) and cellular retinoic acid binding protein 1 (CRABP1) with COVID-19 in European population.

Methods

The outcome utilized the summary statistics of COVID-19 from the COVID-19 Host Genetics Initiative. The exposure data were obtained from public genome wide association study (GWAS) database. We extracted SNPs from exposure data and outcome data. The inverse variance weighted (IVW), MR-Egger and Wald ratio methods were employed to assess the causal relationship between exposure and outcome. Sensitivity analyses were performed to ensure the validity of the results.

Results

The MR estimates showed that retinol was associated with lower COVID-19 susceptibility using IVW (OR: 0.69, 95% CI: 0.53–0.90, P: 0.0065), whereas the associations between retinol and COVID-19 hospitalization or severity were not significant. RBP4 was associated with lower COVID-19 susceptibility using the Wald ratio (OR: 0.83, 95% CI: 0.72–0.95, P: 0.0072). IVW analysis showed RDH16 was associated with increased COVID-19 hospitalization (OR: 1.10, 95% CI: 1.01–1.18, P: 0.0199). CRABP1 was association with lower COVID-19 susceptibility (OR: 0.95, 95% CI: 0.91–0.99, P: 0.0290) using the IVW.

Conclusions

We found evidence of possible causal association of retinol, RBP4, RDH16 and CRABP1 with the susceptibility, hospitalization and severity of COVID-19. Our study defines that retinol is significantly associated with lower COVID-19 susceptibility, which provides a reference for the prevention of COVID-19 with vitamin A supplementation.
Can local infiltration analgesia supplemented with tranexamic acid reduce blood loss during total knee arthroplasty?
Authors: Wiktor Łukasz , Osadnik Bartłomiej , Damps Maria
Published: April 2024

Purpose

The aim of this study was to investigate the efficacy of TXA supplemented with local infiltration analgesia (LIA) for reducing blood loss in patients undergoing total knee replacement.

Materials

A retrospective study of 530 individuals with a mean age of 71.44 years was performed after posterior stabilized total knee arthroplasty. Patients were divided into three groups according to the method of bleeding control: I - patients without an additional bleeding protocol (control group); II - patients receiving IV TXA (TXA group); and III - patients receiving the exact TXA protocol plus intraoperative local infiltration analgesia (TXA + LIA group). Blood loss was measured according to the maximal decrease in Hb compared to the preoperative Hb level.

Results

The mean hospitalization duration was 7.02 (SD 1.34) days in the control group, 6.08 (SD 1.06) days in the TXA group, and 5.56 (SD 0.79) in the TXA + LIA group. The most significant decrease in haemoglobin was found in the control group, which was an average of 30.08%. The average decrease in haemoglobin was 25.17% (p < 0.001) in the TXA group and 23.67% (p < 0.001) in the TXA + LIA group. A decrease in the rate of allogeneic blood transfusions was observed: 24.4% in the control group, 9.9% in the TXA group, and 8% in the TXA + LIA group (p < 0.01).

Conclusions

Compared to the separate administration of tranexamic acid, the combination of perioperative administration with local infiltration analgesia significantly reduced blood loss in patients after total knee replacement.
Effects on gait kinematics, pedobarography, functional and subjective results after isolated chopart injury
Authors: Cibura Charlotte , Lülsdorff Raimund , Rosteius Thomas , Brinkemper Alexis , Bernstorff Maria , Jettkant Birger , Godolias Periklis , Ramczykowski Tim , Königshausen Matthias , Schildhauer Thomas A. , Kruppa Christiane
Published: April 2024

Background

This study analysed changes in gait and pedobarography and subjective and functional outcomes after isolated Chopart joint injury.

Methods

The results of 14 patients were reviewed. Kinematic 3D gait analysis, comparative bilateral electromyography (EMG) and pedobarography were performed.

Results

On the injured side, the 3D gait analysis showed a significantly increased internal rotation and decreased external rotation of the hip and significantly decreased adduction and decreased range of motion (ROM) for the ankle. On the healthy side, the pedobarography revealed a significantly increased mean force in the forefoot, an increased peak maximum force and an increased maximum pressure in the metatarsal. When standing, significantly more weight was placed on the healthy side.

The EMG measurements showed no significant differences between the healthy and injured legs.

Conclusions

After isolated Chopart injuries, significant changes in gait and pedobarography can be seen over the long term.