bluuebunny/crossref_metadata_2025 huggingface dataset:
Educational supervision in internal medicine residency training – a scoping review
Authors: Birkeli Cecilie Normann , Normand Camilla , Rø Karin Isaksson , Kvernenes Monika
Published: September 2023

Background

Although supervision is an important part of residency training, its scope and how it relates to other types of support, such as mentoring, precepting and feedback, remain unclear. While clinical supervision consists of ongoing instructions and feedback in the workplace setting, educational supervision is a formalized component of postgraduate medical educational and supports the process that facilitates a trainee’s progression throughout their training. Since medical specialties have different supervisory traditions, this study focuses on educational supervision in internal medicine. Our aim was to investigate what is known about educational supervision practices in internal medicine and the role of educational supervision in supporting residents’ learning.

Methods

We conducted a scoping review of the literature on educational supervision in residency training in internal medicine based on Levac et al.’s modification of Arksey and O’Malley’s six-step framework. The literature search was performed in the following databases: Medline, Embase, Web of Science and the Educational Resources Information Center. In addition, we conducted a handsearch in Medical Teacher and Google Scholar. We followed the PRISMA guidelines for systematic research.

Results

Eighteen of the 3,284 identified articles were included in the analysis. We found few empirical studies describing how educational supervision is conducted and what effect routine educational supervision has on residents’ learning. Our findings suggest that the terminology can be confusing and that educational supervision practices in internal medicine has a weak theoretical foundation.

Conclusion

The distinction between educational supervision and other support structures, such as mentoring and feedback, has not been clearly defined in the research literature. We argue that shared terminology is needed to better understand current educational practices and to facilitate clear communication about how to help residents learn.
Using big data and Population Health Management to assess care and costs for patients with severe mental disorders and move toward a value-based payment system
Authors: Tozzi Valeria D. , Banks Helen , Ferrara Lucia , Barbato Angelo , Corrao Giovanni , D’avanzo Barbara , Di Fiandra Teresa , Gaddini Andrea , Compagnoni Matteo Monzio , Sanza Michele , Saponaro Alessio , Scondotto Salvatore , Lora Antonio
Published: September 2023

Background

Mental health (MH) care often exhibits uneven quality and poor coordination of physical and MH needs, especially for patients with severe mental disorders. This study tests a Population Health Management (PHM) approach to identify patients with severe mental disorders using administrative health databases in Italy and evaluate, manage and monitor care pathways and costs. A second objective explores the feasibility of changing the payment system from fee-for-service to a value-based system (e.g., increased care integration, bundled payments) to introduce performance measures and guide improvement in outcomes.

Methods

Since diagnosis alone may poorly predict condition severity and needs, we conducted a retrospective observational study on a 9,019-patient cohort assessed in 2018 (30.5% of 29,570 patients with SMDs from three Italian regions) using the Mental Health Clustering Tool (MHCT), developed in the United Kingdom, to stratify patients according to severity and needs, providing a basis for payment for episode of care. Patients were linked (blinded) with retrospective (2014–2017) physical and MH databases to map resource use, care pathways, and assess costs globally and by cluster. Two regions (3,525 patients) provided data for generalized linear model regression to explore determinants of cost variation among clusters and regions.

Results

Substantial heterogeneity was observed in care organization, resource use and costs across and within 3 Italian regions and 20 clusters. Annual mean costs per patient across regions was €3,925, ranging from €3,101 to €6,501 in the three regions. Some 70% of total costs were for MH services and medications, 37% incurred in dedicated mental health facilities, 33% for MH services and medications noted in physical healthcare databases, and 30% for other conditions. Regression analysis showed comorbidities, resident psychiatric services, and consumption noted in physical health databases have considerable impact on total costs.

Conclusions

The current MH care system in Italy lacks evidence of coordination of physical and mental health and matching services to patient needs, with high variation between regions. Using available assessment tools and administrative data, implementation of an episodic approach to funding MH could account for differences in disease phase and physical health for patients with SMDs and introduce performance measurement to improve outcomes and provide oversight.
Patient satisfaction survey of the “Healthy Heart” pharmaceutical care service – evaluation of pharmacy labelling with pharmaceutical pictograms
Authors: Merks Piotr , Religioni Urszula , Jaguszewski Miłosz , Barańska Agnieszka , Neumann-Podczaska Agnieszka , Kaźmierczak Justyna , Blicharska Eliza , Šola Katarina Fehir , Vaillancourt Regis
Published: September 2023

Introduction

Low adherence is a major challenge in healthcare worldwide, being particularly dangerous for patients with chronic diseases, such as cardiovascular diseases and heart failure, where strict adherence is essential. Non-adherence is observed in almost half of patients, and the consequences encompass a lack of therapeutic effects, health deterioration, decreased quality of life, and even death. For cardiovascular patients, the great importance of health education and pharmaceutical education can be provided within pharmaceutical care in community pharmacies. Therefore, our study aimed at evaluating the level of satisfaction with the “Healthy Heart” pharmaceutical service, in which patients received pictograms with dosage information affixed to their medication.

Material and methods

The study was designed for patients who had been prescribed an antiplatelet medication for the first time. The patients were recruited by 577 pharmacies that took part in the study after completing a special course. Ultimately, 1590 patients were enrolled in the study. The project ran from November 2019 to January 2022.

Results

Most of patients had a positive attitude to the “Healthy Heart” pharmaceutical service. More than 85% of the respondents were of the opinion that the pictograms facilitated the use of the medication, and 81.7% of the respondents stated that the system of labels helped in adherence. Over 66% of the respondents thought that such labels should be included in pharmacy services, and 77.92% of the participants reported that this system of labelling medications should be offered through all pharmacies.

Conclusions

Pharmaceutical labels in the pharmacists’ everyday practice can largely improve patient adherence. These efforts, provided as part of their pharmaceutical services, can have a huge influence on optimisation of patient health outcomes.
Genetic predisposition to nonalcoholic fatty liver disease: insights from ANGPTL8 gene variants in Iranian adults
Authors: Saghafi Samira , Chamani Elham , Salmani Fatemeh , Fadaei Reza , Shafiei Efat , Moradi Nariman , Tavakoli Tahmine
Published: September 2023

Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disease with a global prevalence, and modulation of ANGPTL8 expression has emerged as a promising predictor of NAFLD susceptibility. This research was conducted to scrutinize ANGPTL8 protein expression in NAFLD patients and elucidate the interplay between ANGPTL8 gene polymorphisms and their lipid profiles, thus shedding new light on the pathophysiology of this complex disease. The study comprised 423 unrelated participants, including 222 healthy controls and 201 individuals with NAFLD, screened using FibroScan/ultrasonography and laboratory tests. The main goal focused on the genotype and allele frequency distribution in the ANGPTL8 gene, specifically analyzing two genetic variations: rs737337 (T/C) and rs2278426 (C/T). The participants diagnosed with NAFLD were slightly younger (P ≥ 0.05) and had a higher body mass index (BMI) than the individuals in the control group. Notably, there was a significant difference in the occurrence of the rs737337 polymorphism between the NAFLD and control groups, with a lower frequency observed in the NAFLD group. Our results indicated that individuals with the TC + CC genotype and C allele of rs737337 (T/C) had a decreased risk of higher levels of ALT and AST. Conversely, those with the CT, CT + TT genotype, and T allele of rs2278426 (C/T) exhibited an increased risk of higher levels of ALT and AST. The results imply that the rs2278426 (C/T) variant of the ANGPTL8 gene is more strongly linked to an increased risk of NAFLD compared to the rs737337 polymorphism. However, additional research is needed to understand the specific molecular mechanisms responsible for the upregulation of ANGPTL8 in individuals with NAFLD.
Descriptive ethnobotanical studies are needed for the rescue operation of documenting traditional knowledge
Authors: Łuczaj Łukasz
Published: September 2023

In this essay, I claim that the primary aim of ethnobiological research is now to document disappearing traditional knowledge. This is an absolute priority due to the rate at which biocultural biodiversity in the world is disappearing. Rather than diverting our efforts into inflating the theoretical part of ethnobotany, we should concentrate on knowledge documentation to facilitate its circulation in the communties that hold it or at least to preserve it for future generations, even in the static form of databases or video recordings.
ClinPrior: an algorithm for diagnosis and novel gene discovery by network-based prioritization
Authors: Schlüter Agatha , Vélez-Santamaría Valentina , Verdura Edgard , Rodríguez-Palmero Agustí , Ruiz Montserrat , Fourcade Stéphane , Planas-Serra Laura , Launay Nathalie , Guilera Cristina , Martínez Juan José , Homedes-Pedret Christian , Albertí-Aguiló M. Antonia , Zulaika Miren , Martí Itxaso , Troncoso Mónica , Tomás-Vila Miguel , Bullich Gemma , García-Pérez M. Asunción , Sobrido-Gómez María-Jesús , López-Laso Eduardo , Fons Carme , Del Toro Mireia , Macaya Alfons ,   HSP/ataxia workgroup, García-Cazorla Àngels , Ortiz-Martínez Antonio José , Ignacio-Ortez Carlos , Cáceres-Marzal Cristina , Martínez-Salcedo Eduardo , Mondragón Elisabet , Barredo Estíbaliz , Airaldi Ileana Antón , Martínez Javier Ruiz , Ramos Joaquin A. Fernández , Vázquez Juan Francisco , Díez-Porras Laura , Vázquez-Cancela María , O’Callaghan Mar , Sánchez Tamara Pablo , Nedkova Velina , Pérez Ana Isabel Maraña , Beltran Sergi , Gutiérrez-Solana Luis G. , Pérez-Jurado Luis A. , Aguilera-Albesa Sergio , de Munain Adolfo López , Casasnovas Carlos , Pujol Aurora
Published: September 2023

Background

Whole-exome sequencing (WES) and whole-genome sequencing (WGS) have become indispensable tools to solve rare Mendelian genetic conditions. Nevertheless, there is still an urgent need for sensitive, fast algorithms to maximise WES/WGS diagnostic yield in rare disease patients. Most tools devoted to this aim take advantage of patient phenotype information for prioritization of genomic data, although are often limited by incomplete gene-phenotype knowledge stored in biomedical databases and a lack of proper benchmarking on real-world patient cohorts.

Methods

We developed ClinPrior, a novel method for the analysis of WES/WGS data that ranks candidate causal variants based on the patient’s standardized phenotypic features (in Human Phenotype Ontology (HPO) terms). The algorithm propagates the data through an interactome network-based prioritization approach. This algorithm was thoroughly benchmarked using a synthetic patient cohort and was subsequently tested on a heterogeneous prospective, real-world series of 135 families affected by hereditary spastic paraplegia (HSP) and/or cerebellar ataxia (CA).

Results

ClinPrior successfully identified causative variants achieving a final positive diagnostic yield of 70% in our real-world cohort. This includes 10 novel candidate genes not previously associated with disease, 7 of which were functionally validated within this project. We used the knowledge generated by ClinPrior to create a specific interactome for HSP/CA disorders thus enabling future diagnoses as well as the discovery of novel disease genes.

Conclusions

ClinPrior is an algorithm that uses standardized phenotype information and interactome data to improve clinical genomic diagnosis. It helps in identifying atypical cases and efficiently predicts novel disease-causing genes. This leads to increasing diagnostic yield, shortening of the diagnostic Odysseys and advancing our understanding of human illnesses.
Autologous olfactory mucosa mesenchymal stem cells treatment improves the neural network in chronic refractory epilepsy
Authors: Liu Zheng-Zhao , Huang Yan , Hong Chun-Gu , Wang Xin , Duan Ran , Liu Jian-Yang , He Jia-Lin , Duan Da , Xie Hui , Lu Ming
Published: September 2023

Background and aims

Refractory epilepsy is also known as drug-resistant epilepsy with limited clinical treatment. Benefitting from its safety and easy availability, olfactory mucosa mesenchymal stem cells (OM-MSCs) are considered a preferable MSC source for clinical application. This study aims to investigate whether OM-MSCs are a promising alternative source for treating refractory epilepsy clinically and uncover the mechanism by OM-MSCs administration on an epileptic mouse model.

Methods

OM-MSCs were isolated from turbinal and characterized by flow cytometry. Autologous human OM-MSCs treatment on a patient was carried out using intrathecal administration. Epileptic mouse model was established by 1 mg/kg scopolamine and 300 mg/kg pilocarpine treatment (intraperitoneal). Stereotaxic microinjection was employed to deliver the mouse OM-MSCs. Mouse electroencephalograph recording was used to investigate the seizures. Brain structure was evaluated by magnetic resonance imaging (MRI). Immunohistochemical and immunofluorescent staining of GFAP, IBA1, MAP2, TUBB3, OLIG2, CD4, CD25, and FOXP3 was carried out to investigate the neural cells and Treg cells. QRT-PCR and ELISA were performed to determine the cytokines (Il1b, Il6, Tnf, Il10) on mRNA and protein level. Y-maze, the object location test, and novel object recognition test were performed to measure the cognitive function. Footprint test, rotarod test, balance beam test, and grip strength test were conducted to evaluate the locomotive function. Von Frey testing was carried out to assess the mechanical allodynia.

Results

Many beneficial effects of the OM-MSC treatment on disease status, including seizure type, frequency, severity, duration, and cognitive function, and no apparent adverse effects were observed at the 8-year follow-up case. Brain MRI indicated that autologous OM-MSC treatment alleviated brain atrophy in epilepsy patients. A study in an epileptic mouse model revealed that OM-MSC treatment recruited Treg cells to the brain, inhibited inflammation, rebuilt the neural network, and improved the cognitive, locomotive, and perceptive functions of epileptic mice.

Conclusions

Autologous OM-MSC treatment is efficacious for improving chronic refractory epilepsy, suggesting a future therapeutic candidate for epilepsy.

Trial registration: The study was registered with Chinese Clinical Trial Registry (ChiCTR2200055357).
Adipose transplantation improves olfactory function and neurogenesis via PKCα-involved lipid metabolism in Seipin Knockout mice
Authors: Yang Jing , Yang Na , Zhao Huifang , Qiao Yan , Li Yanqiu , Wang Chunfang , Lim Kah-Leong , Zhang Chengwu , Yang Wulin , Lu Li
Published: September 2023

Background

Lipodystrophy-associated metabolic disorders caused by Seipin deficiency lead to not only severe lipodystrophy but also neurological disorders. However, the underlying mechanism of Seipin deficiency-induced neuropathy is not well elucidated, and the possible restorative strategy needs to be explored.

Methods

In the present study, we used Seipin knockout (KO) mice, combined with transcriptome analysis, mass spectrometry imaging, neurobehavior test, and cellular and molecular assay to investigate the systemic lipid metabolic abnormalities in lipodystrophic mice model and their effects on adult neurogenesis in the subventricular zone (SVZ) and olfactory function. After subcutaneous adipose tissue (AT) transplantation, metabolic and neurological function was measured in Seipin KO mice to clarify whether restoring lipid metabolic homeostasis would improve neurobehavior.

Results

It was found that Seipin KO mice presented the ectopic accumulation of lipids in the lateral ventricle, accompanied by decreased neurogenesis in adult SVZ, diminished new neuron formation in the olfactory bulb, and impaired olfactory-related memory. Transcriptome analysis showed that the differentially expressed genes (DEGs) in SVZ of adult Seipin KO mice were significantly enriched in lipid metabolism. Mass spectrometry imaging showed that the levels of glycerophospholipid and diglyceride (DG) were significantly increased. Furthermore, we found that AT transplantation rescued the abnormality of peripheral metabolism in Seipin KO mice and ameliorated the ectopic lipid accumulation, concomitant with restoration of the SVZ neurogenesis and olfactory function. Mechanistically, PKCα expression was up-regulated in SVZ tissues of Seipin KO mice, which may be a potential mediator between lipid dysregulation and neurological disorder. DG analogue (Dic8) can up-regulate PKCα and inhibit the proliferation and differentiation of neural stem cells (NSCs) in vitro, while PKCα inhibitor can block this effect.

Conclusion

This study demonstrates that Seipin deficiency can lead to systemic lipid disorder with concomitant SVZ neurogenesis and impaired olfactory memory. However, AT restores lipid homeostasis and neurogenesis. PKCα is a key mediator mediating Seipin KO-induced abnormal lipid metabolism and impaired neurogenesis in the SVZ, and inhibition of PKCα can restore the impaired neurogenesis. This work reveals the underlying mechanism of Seipin deficiency-induced neurological dysfunction and provides new ideas for the treatment of neurological dysfunction caused by metabolic disorders.
LOGICS: Learning optimal generative distribution for designing de novo chemical structures
Authors: Bae Bongsung , Bae Haelee , Nam Hojung
Published: September 2023

In recent years, the field of computational drug design has made significant strides in the development of artificial intelligence (AI) models for the generation of de novo chemical compounds with desired properties and biological activities, such as enhanced binding affinity to target proteins. These high-affinity compounds have the potential to be developed into more potent therapeutics for a broad spectrum of diseases. Due to the lack of data required for the training of deep generative models, however, some of these approaches have fine-tuned their molecular generators using data obtained from a separate predictor. While these studies show that generative models can produce structures with the desired target properties, it remains unclear whether the diversity of the generated structures and the span of their chemical space align with the distribution of the intended target molecules. In this study, we present a novel generative framework, LOGICS, a framework for Learning Optimal Generative distribution Iteratively for designing target-focused Chemical Structures. We address the exploration—exploitation dilemma, which weighs the choice between exploring new options and exploiting current knowledge. To tackle this issue, we incorporate experience memory and employ a layered tournament selection approach to refine the fine-tuning process. The proposed method was applied to the binding affinity optimization of two target proteins of different protein classes, κ-opioid receptors, and PIK3CA, and the quality and the distribution of the generative molecules were evaluated. The results showed that LOGICS outperforms competing state-of-the-art models and generates more diverse de novo chemical structures with optimized properties. The source code is available at the GitHub repository (https://github.com/GIST-CSBL/LOGICS).
The power of humorous audio: exploring emotion regulation in traffic congestion through EEG-based study
Authors: Zhang Lekai , Wang Yingfan , He Kailun , Zhang Hailong , Xing Baixi , Liu Xiaofeng , Hu Fo
Published: September 2023

Traffic congestion can lead to negative driving emotions, significantly increasing the likelihood of traffic accidents. Reducing negative driving emotions as a means to mitigate speeding, reckless overtaking, and aggressive driving behaviors is a viable approach. Among the potential methods, affective speech has been considered one of the most promising. However, research on humor-based affective speech interventions in the context of driving negative emotions is scarce, and the utilization of electroencephalogram (EEG) signals for emotion detection in humorous audio studies remains largely unexplored. Therefore, our study first designed a highly realistic experiment scenario to induce negative emotions experienced by drivers in congested traffic conditions. Subsequently, we collected drivers’ EEG signals and subjective questionnaire ratings during the driving process. By employing one-way analysis of variance (ANOVA) and t tests, we analyzed the data to validate the success of our experiment in inducing negative emotions in drivers during congested road conditions and to assess the effectiveness of humorous audio in regulating drivers’ negative emotions. The results indicated that humorous audio effectively alleviated drivers’ negative emotions in congested road conditions, with a 145.84% increase in arousal and a 93.55% increase in valence ratings compared to control conditions. However, it should be noted that humorous audio only restored drivers’ emotions to the level experienced during normal driving. Our findings offer novel insights into regulating drivers’ negative emotions during congested road conditions.
Does repeated exposure to hydrogen peroxide induce Candida auris resistance?
Authors: Cobrado Luis , Ricardo Elisabete , Ramalho Patricia , Fernandes Angela Rita , Rodrigues Acacio Goncalves
Published: September 2023

Background

To minimize environmental colonization by microorganisms that may persist and thrive in healthcare settings, thus reducing healthcare-associated infections (HAIs), new insights over already known biocides are certainly of relevance. Although the efficacy of hydrogen peroxide (H2O2) against the emergent yeast Candida auris is moderately documented, concerns over the potential induction of resistance after repeated exposure do persist. The main objective of the present study was to evaluate the hypothetical induction of Candida auris resistance following 30 days of consecutive exposure to lethal and sublethal concentrations of H2O2. Furthermore, the authors aimed to elucidate about the rank of efficacy of H2O2 against C. auris comparing to other Candida species and whether different strains of C. auris may display different susceptibilities to H2O2.

Methods

During the induction of resistance assays, both type strains and clinical isolates of Candida auris, Candida albicans and Candida parapsilosis were exposed repeatedly to defined concentrations of H2O2, for 30 days.

Results

After that period, no significant differences were found when comparing the minimal inhibitory concentration values of H2O2 in case of the induced strains versus each respective positive control. Moreover, H2O2 displayed similar effectiveness against all the tested Candida species and no differences were demonstrated among the distinct strains of C. auris.

Conclusions

The adoption of H2O2 solutions in routine protocols in order to promote disinfection standards against Candida auris, improving patient safety and reducing healthcare costs, is certainly welcomed.
m1A Regulatory gene signatures are associated with certain immune cell compositions of the tumor microenvironment and predict survival in kidney renal clear cell carcinoma
Authors: Zhou Linjun , Zhou Weidong , Li Yuan , Hua Ruifang
Published: September 2023

Adenosine N1 methylation (m1A) of RNA, a type of post-transcriptional modification, has been shown to play a significant role in the progression of cancer. The objective of the current research was to analyze the genetic alteration and prognostic significance of m1A regulators in kidney renal clear cell carcinoma (KIRC). Genomic and clinicopathological characteristics were obtained from 558 KIRC patients in the Cancer Genome Atlas (TCGA) and Gene Omnibus Expression (GEO) databases. Alterations in the gene expression of ten m1A-regulators were analyzed and survival analysis was performed using the Cox regression method. We also identified three clusters of patients based on their distinct m1A alteration patterns, using integrated analysis of the ten m1A-related regulators, which were significantly related to overall survival (OS), disease-free survival (DFS) and tumor microenvironment (TME) immune cell infiltration cells in KIRC. Our findings showed that m1A alteration patterns have critical roles in determining TME complexity and its immune cell composition. Furthermore, different m1A expression patterns were significantly associated with DFS and OS rates in KIRC patients. In conclusion, the identified m1A RNA modification patterns offer a potentially effective way to classify KIRC patients based on their TME immune cell infiltration, enabling the development of more personalized and successful treatment strategies for these patients.
Development of [225Ac]Ac-DOTA-C595 as radioimmunotherapy of pancreatic cancer: in vitro evaluation, dosimetric assessment and detector calibration
Authors: Hull Ashleigh , Hsieh William , Borysenko Artem , Tieu William , Bartholomeusz Dylan , Bezak Eva
Published: September 2023

Background

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy which may benefit from radioimmunotherapy. Previously, [177Lu]Lu-DOTA-C595 has been developed as a beta-emitting radioimmunoconjugate to target cancer-specific mucin 1 epitopes (MUC1-CE) overexpressed on PDAC. However, the therapeutic effect may be enhanced by using an alpha-emitting radionuclide such as Actinium-225 (Ac-225). The short range and high linear energy transfer of alpha particles provides dense cellular damage and can overcome typical barriers related to PDAC treatment such as hypoxia. Despite the added cytotoxicity of alpha-emitters, their clinical implementation can be complicated by their complex decay chains, recoil energy and short-range impeding radiation detection. In this study, we developed and evaluated [225Ac]Ac-DOTA-C595 as an alpha-emitting radioimmunotherapy against PDAC using a series of in vitro experiments and conducted a preliminary dosimetric assessment and cross-calibration of detectors for the clinical implementation of Ac-225.

Results

Cell binding and internalisation of [225Ac]Ac-DOTA-C595 was rapid and greatest in cells with strong MUC1-CE expression. Over 99% of PDAC cells had positive yH2AX expression within 1 h of [225Ac]Ac-DOTA-C595 exposure, suggesting a high level of DNA damage. Clonogenic assays further illustrated the cytotoxicity of [225Ac]Ac-DOTA-C595 in a concentration-dependent manner. At low concentrations of [225Ac]Ac-DOTA-C595, cells with strong MUC1-CE expression had lower cell survival than cells with weak MUC1-CE expression, yet survival was similar between cell lines at high concentrations irrespective of MUC1-CE expression. A dosimetric assessment was performed to estimate the dose-rate of 1 kBq of [225Ac]Ac-DOTA-C595 with consideration to alpha particles. Total absorption of 1 kBq of Ac-225 was estimated to provide a dose rate of 17.5 mGy/h, confirmed via both detector measurements and calculations.

Conclusion

[225Ac]Ac-DOTA-C595 was shown to target and induce a therapeutic effect in MUC1-CE expressing PDAC cells.
Epidemiological analysis of patients with psoriatic arthritis in follow-up at the brazilian Unified Health System
Authors: Rossetto Chayanne Natielle , Palominos Penélope Esther , Machado Natalia Pereira , dos Santos Paiva Eduardo , Azevedo Valderílio Feijó
Published: September 2023

Introduction/Objectives

Psoriatic arthritis (PsA) is a chronic multisystem osteoarticular disease that requires specialized care. Most Brazilians depend on the public healthcare provided by the Unified Health System (Sistema Único de Saúde, SUS). This study aimed to describe the epidemiological characteristics of patients with PsA in follow-up in SUS, focusing on the incidence and prevalence of the disease, comorbidities, and hospitalizations.

Methods

We collected data from the Outpatient Data System of SUS (Sistema de Informações Ambulatoriais do SUS, SIA/SUS) regarding outpatient visits and hospitalizations in the Brazilian public healthcare system from January 2008 to March 2021 using the Techtrials Disease Explorer® platform and the medical code related to PsA were selected.

Results

We evaluated 40,009 patients and found a prevalence of 24.4 cases of visits due to PsA per 100,000 patients in follow-up in SUS. Female patients were predominant (54.38%). The incidence of visits due to PsA has been increasing in recent years and we observed an incidence of 8,982 new visits in 2020. The main comorbidities of these patients were osteoarthritis, lower back pain, shoulder injuries, oncological diseases, crystal arthropathies, and osteoporosis. Hospitalizations were mainly due to treating clinical or cardiovascular conditions and performing orthopedic procedures.

Conclusion

The number of visits due to PsA in SUS has increased in recent years, mainly on account of new diagnoses of the disease, although the prevalence found in this study’s population was lower than that observed in the general population.
Autism in adult psychiatric out-patients: self-reported suicidal ideation, suicide attempts and non-suicidal self-injury
Authors: Nyrenius Johan , Waern Margda , Eberhard Jonas , Ghaziuddin Mohammad , Gillberg Christopher , Billstedt Eva
Published: September 2023

Background

The prevalence of self-reported suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI) remains unclear among adults with autism unrecognised in childhood who attend psychiatric services.

Aims

We aimed to estimate the prevalence of suicidal ideation, suicide attempts and NSSI; identify factors associated with suicide attempts and NSSI; and describe NSSI in this group.

Method

Sixty-three new patients at an adult psychiatric out-patient clinic (57% women, mean age 32 years) who met full (n = 52) or subthreshold (two A criteria and minimum of two B criteria; n = 11) DSM-5 criteria for autism spectrum disorder were included in the study. Clinical assessments included overall diagnostic review, Paykel's questions on passive and active suicidality, evaluation of NSSI with the Functional Assessment of Self-Mutilation, and results of cognitive tests. One follow-up of medical records was made.

Results

In this sample of psychiatric out-patients identified as first having autism in adulthood, almost a third (31%) of patients reported suicidal ideation during the past month, 86% had lifetime suicidal ideation and 25% reported at least one suicide attempt. Factors associated with suicide attempts included hazardous or harmful alcohol use and/or drug-related problems, and severity of depression. A total of 44% reported NSSI. Factors associated with NSSI were female sex, history of suicidal plans and antisocial personality disorder. Substance or alcohol use were often overlooked, especially in women.

Conclusions

Suicidal ideation, suicide attempts and NSSI were very common in adults with autism who were recently referred to an out-patient psychiatric service. Suicidal ideation and NSSI were more common than suicide attempts. Clinicians should always consider suicidal ideation and NSSI in adult psychiatric patients with autism.
Electronic Patient-Reported Outcome Data Collection Systems in Oncology Clinical Trials: A Survey of Clinical Research Professionals (an Alliance Study)
Authors: Cho Youmin , Lavoie Smith Ellen M. , Zahrieh David , Chow Selina L. , Williams David A. , Saint Arnault Denise , Jiang Yun
Published: September 2023

PURPOSE

To describe clinical research professionals (CRPs)’ experiences with electronic patient-reported outcome (ePRO) data collection systems in oncology clinical trials and identify correlates of CRPs' attitude toward technology.

METHODS

An online survey was conducted among 210 CRPs from 125 National Cancer Institute–funded research sites. Measures included CRPs' demographic characteristics, working years, employment locations, and previous experiences with various types of ePROs. Their attitude toward technology was measured by the Technology Attitude Scale-Adapted. The Wilcoxon signed-rank test was used to compare two subdomains of attitude (perceived usefulness [PU] and perceived ease of use [PEU]). Multiple linear regression was used to explore correlates of (1) overall attitude, (2) PU, and (3) PEU. The significance level was 5%.

RESULTS

Participants' median age was 41 years (range, 21-67). Most were female (90%) and White (82%). More than half of the participants had previous experiences with web-based ePROs using patients' own devices (72%) or site-/sponsor-provided on-site devices (eg, kiosks or tablets; 64%). CRPs who were 60 years or older (β = −0.32, P < .05) or worked for 10-20 years (β = −0.11, P < .05) had relatively negative attitudes, controlling for other factors. Previous experiences with more ePRO types were associated with more positive attitudes (β = 0.08, P = .02). Similar correlates were found with PU but not with PEU.

CONCLUSION

This study revealed that CRPs had various experiences with ePRO systems and attitudes toward technology. Age, working years, and previous experiences with ePROs were correlates of overall attitude toward technology and PU. These findings suggest necessary targeted training to facilitate ePRO use in oncology clinical trials by improving CRPs' awareness and attitude toward technology.
Effects of Ketogenic Diet on Reproductive Hormones in Women With Polycystic Ovary Syndrome
Authors: Khalid Karniza , Apparow Saraswathy , Mushaddik Irma Liyana , Anuar Amalina , Rizvi Syed A A , Habib Anasufiza
Published: September 2023

Context

Ketogenic diet has recently made a comeback as a part of lifestyle and dietary modifications in patients with polycystic ovary syndrome (PCOS). Despite studies suggesting its beneficial effects in reversing hormonal imbalance in women with PCOS, evidence has been patchy and derived from small populations under varying conditions.

Objective

To pool evidence from clinical trials to study the effects of ketogenic diet on reproductive hormones (LH/FSH ratio, free testosterone, serum progesterone) and observe evidence of weight change.

Methods

PubMed, ScienceDirect, Scopus, and Web of Science core collection were searched for clinical trials evaluating the effects of ketogenic diet in established PCOS women consistent with the Rotterdam classification. Single- or double-arm studies that included an outcome of interest were included. Two investigators worked independently to screen potential articles and a designated investigator extracted data on study characteristics and evaluated the outcomes. Data were pooled using a random-effects model. The quality of selected studies was assessed using the Cochrane Risk of Bias Tool.

Results

Following ≥45 days of intervention with ketogenic diet among women with PCOS, significant improvement was observed in reproductive hormone levels, with reduced LH/FSH ratio (d −0.851; 95% CI −1.015, −0.686; P < .001), reduced serum free testosterone (d −0.223; 95% CI −0.328, −0.119; P< .001), and an increased in serum sex hormone binding globulin (SHBG) (d 9.086; 95% CI 3.379, 14.792; P = .002). Significant weight loss was unanimously observed in all included studies (d −11.56; 95% CI −14.97, −8.15; P < .001).

Conclusion

Short-term ketogenic diet potentially improved hormonal imbalances commonly associated with PCOS.
DPH1 and DPH2 variants that confer susceptibility to diphthamide deficiency syndrome in human cells and yeast models
Authors: Ütkür Koray , Mayer Klaus , Khan Maliha , Manivannan Thirishika , Schaffrath Raffael , Brinkmann Ulrich
Published: September 2023

The autosomal-recessive diphthamide deficiency syndrome presents as intellectual disability with developmental abnormalities, seizures, craniofacial and additional morphological phenotypes. It is caused by reduced activity of proteins that synthesize diphthamide on human translation elongation factor 2. Diphthamide synthesis requires seven proteins (DPH1-DPH7), with clinical deficiency described for DPH1, DPH2 and DPH5. A limited set of variant alleles from syndromic patients has been functionally analyzed, but databases (gnomAD) list additional so far uncharacterized variants in human DPH1 and DPH2. Because DPH enzymes are conserved among eukaryotes, their functionality can be assessed in yeast and mammalian cells. Our experimental assessment of known and uncharacterized DPH1 and DPH2 missense alleles showed that six variants are tolerated despite inter-species conservation. Ten additional human DPH1 (G113R, A114T, H132P, H132R, S136R, C137F, L138P, Y152C, S221P, H240R) and two DPH2 (H105P, C341Y) variants showed reduced functionality and hence are deficiency-susceptibility alleles. Some variants locate close to the active enzyme center and may affect catalysis, while others may impact on enzyme activation. In sum, our study has identified functionally compromised alleles of DPH1 and DPH2 genes that likely cause diphthamide deficiency syndrome.
Υδρίσκες από τα Άβδηρα
Authors: Μότσιου Παρασκευή
Published: September 2023

Η παρούσα διδακτορική διατριβή έχει ως αντικείμενο τη μελέτη του φαινομένου των μικρογραφικών αγγείων στην αιγαιακή Θράκη και το βορειοανατολικό Αιγαίο, τα οποία προέρχονται από ιερά, νεκροταφεία, δημόσια κτίρια και οικίες και χρονολογούνται από την αρχαϊκή έως την ελληνιστική περίοδο. Κύριος στόχος της είναι να πληρώσει, κατά το δυνατόν, τα ερευνητικά κενά που δεν έχουν καλυφθεί από τις προηγούμενες μελέτες και αφορούν τις διαφορετικές χρήσης αυτής ειδικής κατηγορίας κεραμικής ανάλογα το συγκείμενο εύρεσής της. Επιπλέον, στόχος είναι η πειραματική διερεύνηση του τρόπου κατασκευής αυτής της ειδικής κατηγορίας κεραμικής και η διαχείρισή της ως προϊόντος, αλλά και ως μέρους του αρχαίου ελληνικού υλικού πολιτισμού, το οποίο, αν και πανταχού παρόν στις αρχαιολογικές έρευνες πεδίου, δεν έχει μελετηθεί επαρκώς από την επιστημονική κοινότητα. Δομικό στοιχείο της διατριβής αποτελεί η πρωτογενής έρευνα της κύριας μελέτης περίπτωσης, δηλαδή των μικρογραφικών αγγείων που εντοπίστηκαν στην χώρα και το άστυ των Αβδήρων, όπως και της δευτερεύουσας μελέτης περίπτωσης, των υδριών μικρού μεγέθους, υδρισκών και δακτυλιόσχημων κέρνων από το ιερό της Δήμητρας στην Αμφίπολη. Βασική επιδίωξη της παρούσας έρευνας είναι η ανάδειξη της μοναδικότητας του αποθέτη του ιερού της Δήμητρας και Κόρης των Αβδήρων, όπου εντοπίστηκαν περίπου 18.000 μικρογραφικές υδρίες, αρχικά βάσει της ίδιας της μοναδικότητας της επαναληψιμότητας της υδρίσκης στον αποθέτη, αλλά και των διάφορων προεκτάσεων των επιπέδων χρήσης του αυτού του μικρογραφικού αγγείου σε τελετουργικό πλαίσιο.
Sexual functioning is not, but psychological burden is predictive for seeking help in pelvic physical therapy practice: A cross-sectional study
Authors: Brand Alma , Waterink Wim , van Lankveld Jacques
Published: September 2023

Background. Pelvic floor complaints are common among women and often accompanied by sexual dysfunction and psychological burden. They are also associated with pregnancy and childbirth. However, not all women with these complaints seek help in pelvic physical therapy practice. This study explored if pregnancy, parity, pelvic floor complaints, sexual functioning, and psychological burden are predictive of seeking help in pelvic physical therapy practice.

Methods. In a cross-sectional exploratory design, women completed an online survey about pelvic floor complaints, sexual function, and psychological burden. Binary logistic analysis was used to analyze the predictive value of the above-mentioned factors.

Results. Data from 542 participants were analyzed. Pregnancy and parity, PFC severity, psychological burden, and the interaction between pelvic floor complaints and psychological burden were significant predictors of seeking help. Against expectations, sexual functioning was not predictive of seeking help.

Conclusions. Women’s psychological burden is an important factor in determining if or when women seek help in PPT practice. More research is needed to unravel the role of sexual functioning in the context of pelvic floor complaints and women’s psychological burden. More insight into this area of expertise could possibly improve and enhance pelvic health care for women with pelvic floor complaints.
Deriving and validating an asthma diagnosis prediction model for children and young people in primary care
Authors: Daines Luke , Bonnett Laura J , Tibble Holly , Boyd Andy , Thomas Richard , Price David , Turner Steve W , Lewis Steff C , Sheikh Aziz , Pinnock Hilary
Published: September 2023

Introduction: Accurately diagnosing asthma can be challenging. We aimed to derive and validate a prediction model to support primary care clinicians assess the probability of an asthma diagnosis in children and young people.

Methods: The derivation dataset was created from the Avon Longitudinal Study of Parents and Children (ALSPAC) linked to electronic health records. Participants with at least three inhaled corticosteroid prescriptions in 12-months and a coded asthma diagnosis were designated as having asthma. Demographics, symptoms, past medical/family history, exposures, investigations, and prescriptions were considered as candidate predictors. Potential candidate predictors were included if data were available in ≥60% of participants. Multiple imputation was used to handle remaining missing data. The prediction model was derived using logistic regression. Internal validation was completed using bootstrap re-sampling. External validation was conducted using health records from the Optimum Patient Care Research Database (OPCRD).

Results: Predictors included in the final model were wheeze, cough, breathlessness, hay-fever, eczema, food allergy, social class, maternal asthma, childhood exposure to cigarette smoke, prescription of a short acting beta agonist and the past recording of lung function/reversibility testing. In the derivation dataset, which comprised 11,972 participants aged <25 years (49% female, 8% asthma), model performance as indicated by the C-statistic and calibration slope was 0.86, 95% confidence interval (CI) 0.85–0.87 and 1.00, 95% CI 0.95–1.05 respectively. In the external validation dataset, which included 2,670 participants aged <25 years (50% female, 10% asthma), the C-statistic was 0.85, 95% CI 0.83–0.88, and calibration slope 1.22, 95% CI 1.09–1.35.

Conclusions: We derived and validated a prediction model for clinicians to calculate the probability of asthma diagnosis for a child or young person up to 25 years of age presenting to primary care. Following further evaluation of clinical effectiveness, the prediction model could be implemented as a decision support software.
Apocalyptic Motifs in Targum Neofiti 1 in the Context of the Apocalypse of Abraham
Authors: Chwiła Dorota
Published: September 2023

Motywy apokaliptyczne w Targum Neofiti 1 w kontekście Apokalipsy Abrahama
Literatura apokaliptyczna rozwijała się w judaizmie jako reakcja na prześladowania i uciski ze strony obcych mocarstw, szczególnie w okresie pomiędzy 200 r. przed Chr. a 135 r. po Chr. Jej głównym celem było przekazanie Bożego objawienia zapowiadającego nadejście zbawienia. Wśród licznych dzieł, które podejmują tę myśl, można wymienić Apokalipsę Abrahama oraz Targum Neofiti 1, będący aramejskim tłumaczeniem Pięcioksięgu. W niniejszym artykule przedstawione zostaną idee apokaliptyczne występujące w obu tekstach, takie jak motyw dwóch światów, sądu, nagrody i kary, życia po śmierci, Mesjasza i aniołów. Analiza porównawcza pozwoli na wyodrębnienie starożytnych tradycji w Targumie Neofiti 1, sięgających okresu powstawania Ewangelii.
Optimizing Ultrasound Probe Extraction for Anthocyanin and Phenolic Content from Purple Waxy Corn's Dried Cobs: Impact of Extraction Temperature and Time
Authors: Muangrat Rattana
Published: September 2023

The utilization of purple waxy corn's dried cobs as agricultural waste holds potential for the recovery of valuable anthocyanins and phenolic compounds, thereby adding value to the cobs and facilitating their application in the food industry. This study aimed to employ an ultrasound probe extraction technique in combination with the central composite face-centered design, which is widely used in response surface methodology (RSM). Specifically, this research aimed to determine the suitable extraction temperature and time that would result in the highest possible yield of anthocyanins and phenolic compounds from the purple waxy corn’s dried cobs The ultrasound probe extraction method was implemented with a solvent-sample weight ratio of 20:1 w/w, utilizing a solvent composition consisting of a water to ethanol weight ratio of 1:1 w/w. Furthermore, an ultrasonic amplitude of 50% was employed during the extraction process. The result indicated that the optimal extraction condition to obtain the high yield of anthocyanins and phenolics simultaneously was at the extraction temperature of 70 C for 25 min extraction time. Under the suitable extraction condition, the experimental extraction produced the dried cob extract with a high total anthocyanin content of 305.40 g cyanidin-3-glucoside equivalent (C3G)/g dried cob) and total phenolic content of 25.50 mg gallic acid equivalent (GAE)/g dried cob). For this optimal condition, an antioxidant activity of the extract of approximately 6.41 mg/mL was also found, resulting in 50% reduction in the initial DPPH concentration.
Expert Opinion on Current Polysomnography Procedure for Diagnosis of Rapid Eye Movement Sleep Behavior Disorder in Korea
Authors: Byun Jung-Ick , Ji Ki-Hwan , Shin Hye-Rim , Koo Dae Lim , Jung Yu Jin , Kim Tae-Joon , Sunwoo Jun-Sang , Yang Tae-Won , Jun Jin-Sun , Shin Jung-Won , Jung Ki-Young
Published: September 2023

Rapid eye movement (REM) sleep behavior disorder (RBD) is diagnosed based on a history of dream-enactment behavior and documentation of REM sleep without atonia (RWA) on polysomnography (PSG). RWA can be quantified using various methods. To establish comprehensive and clear PSG criteria for diagnosing RBD, the International RBD Study Group (IRBDSG) has recently published guidelines, which include the use of a video-PSG technical setup, REM sleep staging, RWA scoring, video and audio recording and analyses, and a video-PSG procedure for the diagnosis and identification of the prodromal stages of neurodegenerative diseases. Although the guidelines can identify patients with homogeneous RBD, their applicability in a real-world setting, particularly in Korea, presents challenges. Therefore, the aim of the present study was to evaluate and introduce IRBDSG guidelines and results of Korean sleep experts’ opinion survey for diagnosing RBD based on PSG findings.