bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of irreducible intertrochanteric femoral fracture with a minimally invasive clamp reduction technique via the anterior approach
Authors: Qiu Jinya , Jiang Zhen , Han Liang , Li Xingwei , Zhang Rui , Wu Bin , Zhu Fenghua , Zhao Yifeng
Published: March 2023

Objective

To investigate the efficacy of the minimally invasive clamp reduction technique via the anterior approach in the treatment of irreducible intertrochanteric femoral fractures.

Methods

From January 2015 to January 2021, 115 patients (48 males and 67 females) with irreducible intertrochanteric femoral fractures were treated. The average age of the patients was 78.7 (45–100 years old). The types of injuries were falls (91 cases), traffic accidents (12 cases), smashing (6 cases), and high falling (6 cases). The duration between injury and surgery ranged from 1 to 14 days, with an average of 3.9 days. The distribution of AO classification was as follows: 31-A1 in 15 cases, type 31-A2 in 67 cases and 31-A3 in 33 cases.

Results

All patients achieved good reduction, with fracture reduction times ranging from 10 to 32 min (mean of 18 min), and were followed up for 12–27 months after surgery (mean of 17.9 months). Two patients with pronation displacement of the proximal fracture segment died of infection or hypostatic pneumonia after internal fixation failure; one patient with failed internal fixation switched to joint replacement. After internal fixation, the lateral wall of six reversed intertrochanteric femoral fractures showed repronation and abduction displacement, but all fractures achieved bony healing. The rest of the patients did not lose fracture reduction, and all fractures achieved bony healing with a healing time ranging from 3 to 9 months (mean of 5.7 months). While two patients died and one patient exhibited failed internal fixation and thus switched to joint replacement, 91 of the remaining 112 patients had an excellent Harris score of the hip joint function at the final follow-up, while 21 patients had a good Harris score.

Conclusion

The minimally invasive clamp reduction technique via the anterior approach for the treatment of irreducible intertrochanteric femoral fractures is simple, effective and minimally invasive. In the case of irreducible intertrochanteric femoral fractures associated with lateral wall displacement, the lateral wall needs to be strengthened after clamp reduction and intramedullary nail fixation to avoid loss of reduction and failure of internal fixation.
Well-being in chronic pediatric inflammatory rheumatic diseases: the experience of a French healthcare network
Authors: El Haddad Rita , El Asmar Khalil , Hascoët Chrystelle , Rossi-Semerano Linda , Dusser Perrine
Published: March 2023

Objective

Current management of patients with pediatric rheumatic diseases (PRD) should aim at achieving the best possible well-being.

To identify sociodemographic/clinical characteristics, needed paramedical services and school accommodations associated with well-being in patients at inclusion in a French health network Réseau pour les Rhumatismes Inflammatoires Pédiatriques (RESRIP) that supports coordination of the patient’s health pathway. To evaluate the evolution of well-being over time in this patients benefiting from such support.

Methods

Patients > 3 years old enrolled in RESRIP (2013–2020) were included. At enrollment, data were collected on sociodemographic/clinical characteristics, ongoing medications, and paramedical and educational actions to be implemented by RESRIP. Well-being during the last 6 months was reported with a standardized questionnaire at enrollment and every 6 months. A well-being score was calculated with scores ranging from 0 to 18, 18 corresponding to absolute well-being. Patients were followed up from inclusion until June 2020.

Results

In total, 406 patients were included and followed up for 36 months on average: 205 juvenile idiopathic arthritis, 68 connective tissue diseases, 81 auto-inflammatory diseases and 52 other diseases. The well-being score did not differ between the groups and improved significantly, by 0.04 score units, every 6 months (95% confidence interval [0.03; 0.06]). At inclusion, use of homeopathy, need for implementation of hypnosis or psychological support, occupational therapy or for adjustment of school tests were associated with worse well-being score.

Conclusion

Well-being seems associated more with the impact of chronic illness than the type of PRD underlining the importance of a comprehensive patient care.
National incidence and mortality of hospitalized sepsis in China
Authors: Weng Li , Xu Yang , Yin Peng , Wang Yi , Chen Yan , Liu Wei , Li Shan , Peng Jin-min , Dong Run , Hu Xiao-yun , Jiang Wei , Wang Chun-yao , Gao Pei , Zhou Mai-geng , Du Bin ,   for the China Critical Care Clinical Trials Group (CCCCTG)
Published: March 2023

Background

Sepsis is a leading cause of preventable death around the world. Population-based estimation of sepsis incidence is lacking in China. In this study, we aimed to estimate the population-based incidence and geographic variation of hospitalized sepsis in China.

Methods

We retrospectively identified hospitalized sepsis from the nationwide National Data Center for Medical Service (NDCMS) and the National Mortality Surveillance System (NMSS) by ICD-10 codes for the period from 2017 to 2019. In-hospital sepsis case fatality and mortality rate were calculated to extrapolate the national incidence of hospitalized sepsis. The geographic distribution of hospitalized sepsis incidence was examined using Global Moran's Index.

Results

We identified 9,455,279 patients with 10,682,625 implicit-coded sepsis admissions in NDCMS and 806,728 sepsis-related deaths in NMSS. We estimated that the annual standardized incidence of hospitalized sepsis was 328.25 (95% CI 315.41–341.09), 359.26 (95% CI 345.4–373.12) and 421.85 (95% CI 406.65–437.05) cases per 100,000 in 2017, 2018 and 2019, respectively. We observed 8.7% of the incidences occurred among neonates less than 1 year old, 11.7% among children aged 1–9 years, and 57.5% among elderly older than 65 years. Significant spatial autocorrelation for incidence of hospitalized sepsis was observed across China (Moran's Index 0.42, p = 0.001; 0.45, p = 0.001; 0.26, p = 0.011 for 2017, 2018, 2019, respectively). Higher number of hospital bed supply and higher disposable income per capita were significantly associated with a higher incidence of hospitalized sepsis.

Conclusion

Our study showed a greater burden of sepsis hospitalizations than previous estimated. The geographical disparities suggested more efforts were needed in prevention of sepsis.
Site-specific factors associated with clinical trial recruitment efficiency in general practice settings: a comparative descriptive analysis
Authors: Tew Michelle , Catchpool Max , Furler John , De La Rue Katie , Clarke Philip , Manski-Nankervis Jo-Anne , Dalziel Kim
Published: March 2023

Background

Recruitment of participants is crucial to the success of randomised control trials (RCTs) but can be challenging and expensive. Current research on trial efficiency is often focused at the patient-level with an emphasis on effective recruitment strategies. Less is known about selection of study sites to optimise recruitment. We examine site-level factors that are associated with patient recruitment and cost efficiency using data from an RCT conducted across 25 general practices (GP) in Victoria, Australia.

Methods

Data on number of participants screened, excluded, eligible, recruited, and randomised from each study site were extracted from a clinical trial. Details regarding site characteristics, recruitment practices, and staff time commitment were collected using a three-part survey. The key outcomes assessed were recruitment efficiency (ratio of screened to randomised), average time, and cost for each participant recruited and randomised. To identify practice-level factors associated with efficient recruitment and lower cost, outcomes were dichotomised (25th percentile vs others) and each practice-level factor assessed against the outcomes to determine its association.

Results

Across 25 GP study sites, 1968 participants were screened of which 299 (15.2%) were recruited and randomised. The mean recruitment efficiency was 7.2, varying from 1.4 to 19.8 across sites. The strongest factor associated with efficiency was assigning clinical staff to identify potential participants (57.14% vs. 22.2%). The more efficient sites were smaller practices and were more likely to be rural locations and in areas of lower socioeconomic status. The average time used for recruitment was 3.7 h (SD2.4) per patient randomised. The mean cost per patient randomised was $277 (SD161), and this varied from $74 to $797 across sites. The sites identified with the 25% lowest recruitment cost (n = 7) were more experienced in research participation and had high levels of nurse and/or administrative support.

Conclusion

Despite the small sample size, this study quantified the time and cost used to recruit patients and provides helpful indications of site-level characteristics that can help improve feasibility and efficiency of conducting RCT in GP settings. Characteristics indicative of high levels of support for research and rural practices, which often tends to be overlooked, were observed to be more efficient in recruiting.
Investigation on the effect of antimicrobial photodynamic therapy as an adjunct for management of deep caries lesions—study protocol for a randomized, parallel groups, controlled clinical trial
Authors: Martins Luiz Filipe Barbosa , de Sena Leandro Rodrigues , de Paula Diego Martins , Feitosa Victor Pinheiro , Horliana Anna Carolina Ratto Tempestini , Fernandes Kristianne Porta Santos , Mesquita-Ferrari Raquel Agnelli , Motta Lara Jansiski , Gonçalves Marcela Leticia Leal , Bussadori Sandra Kalil
Published: March 2023

Background

Alternatively to conventional treatments, chemo-mechanical caries removal agents can be used. A modality of treatment that has been increasing in dentistry is antimicrobial photodynamic therapy (aPDT). Bixa orellana is being researched for application in aPDT. This protocol aims to determine the effectiveness of aPDT with Bixa orellana extract in deep caries lesions.

Methods

A total of 160 teeth with deep occlusal dental caries will be selected and divided into 4 groups: G1 - control group (Caries removal with a low-speed drill); G2 - Partial Caries Removal with Papacarie™ (Fórmula e Ação, São Paulo, SP, Brazil); G3 - Partial Caries Removal with Papacarie™ and application Bixa orellana extract (20%) (Fórmula e Ação, São Paulo, SP, Brazil); G4 - Partial Caries Removal with Papacarie™ and application Bixa orellana extract (20%) with LED (Valo Cordless Ultradent®, South Jordan, UT, USA) (aPDT). After treatment, all the teeth will be restored with glass ionomer cement and followed up clinically and radiographically, with evaluations at immediately, 1 week, and 1, 3, 6, and 12 months. Dentin samples before and after treatment will be analyzed microbiologically. The efficacy of treatments will be assessed with microbiological (colony-forming units, before and after carious tissue removal), radiographic (integrity of the periapical area and eventual changes in the radiolucent zones), and clinical examinations (retention of the restorative material in the cavity and occurrence of secondary caries), as well as with the time required for the procedures and the need for anesthesia during the procedures. In case data distribution is normal, analysis of variance (ANOVA) will be used for both the dependent and independent variables. In case the data distribution is not normal, the Friedman test will be used for the dependent variables. For independent variables, the Kruskal-Wallis test will be used.

Discussion

Procedures using aPDT have been developed for the treatment of dental caries, but there are few controlled clinical trials in the literature confirming its efficacy.

Trial registration

This protocol is registered at ClinicalTrials.gov under the number NCT05236205 and it was first posted on 01/21/2022 and last updated on 05/10/2022.
mHealth interventions to reduce stress in healthcare workers (fitcor): study protocol for a randomized controlled trial
Authors: Baumann Hannes , Heuel Luis , Bischoff Laura L. , Wollesen Bettina
Published: March 2023

Background

Causes and consequences of chronic stress levels in the context of healthcare work are well examined. Nevertheless, the implementation and evaluation of high-quality interventions to reduce stress of healthcare workers is still missing. Internet and app-based interventions are a promising venue for providing interventions for stress reduction to a population that is otherwise difficult to reach due to shift work and time constraints in general. To do so, we developed the internet and app-based intervention (fitcor), a digital coaching of individual stress coping for health care workers.

Methods

We applied the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement as a guideline for the present protocol. A randomized controlled trial will be conducted. There are five different intervention groups and one waiting control group. To achieve the sample sizes required by power analysis (G*Power) (β-error 80%; effect size 0.25), the sample sizes of the respective scenarios will be at best as follows: 336 care workers from hospitals, 192 administrative health personnel, 145 care workers from stationary elderly care homes, and 145 care workers from ambulatory care providers in Germany. Participants will randomly be assigned to one of five different intervention groups. A crossover design with a waiting control group is planned. Interventions will be accompanied by three measurement points, first a baseline measure, second a post-intervention measure directly after completion of the intervention, and a follow-up measure 6 weeks after completion of the intervention. At all three measurement points, perceived team conflict, work-related experience patterns, personality, satisfaction with internet-based training, and back pain will be assessed using questionnaires, as well as heart rate variability, sleep quality, and daily movement will be recorded using an advanced sensor.

Discussion

Workers in the health care sector increasingly face high job demands and stress levels. Traditional health interventions fail to reach the respective population due to organizational constraints. Implementation of digital health interventions has been found to improve stress coping behavior; however, the evidence in health care settings has not been established. To the best of our knowledge, fitcor is the first internet and app-based intervention to reduce stress among nursing and administrative health care personnel.

Trial registration

The trial was registered at DRKS.de on 12 July 2021, registration number: DRKS00024605.
Effectiveness of the SMART training intervention on ankle joint function in patients with first-time acute lateral ankle sprain: study protocol for a randomized controlled trial
Authors: Tennler Janina , Raeder Christian , Praetorius Arthur , Ohmann Tobias , Schoepp Christian
Published: March 2023

Background

The lateral ankle sprain (LAS) is the most common injury in the field of everyday and sports-related activities. There is a high rate of patients with LAS who will develop chronic ankle instability (CAI). A possible explanation for this high rate is an insufficient rehabilitation and/or a premature return to intense exercise and workloads. Currently, there are general rehabilitation guidelines for LAS but there is a lack of standardized evidenced-based rehabilitation concepts for LAS, which effectively reduce the high CAI rate. The primary aim of the study is to investigate the effectiveness of a 6-week sensorimotor training intervention (SMART-Treatment, SMART) in contrast to standard therapy (Normal Treatment, NORMT) after an acute LAS on perceived ankle joint function.

Methods

This study will be a prospective, single-center, interventional randomized controlled trial with an active control group. Patients (14–41 years) with an acute LAS and a MRI confirmed lesion or rupture of at least one ankle ligament will be included. Exclusion criteria are acute concomitant injuries of the ankle, pre-injuries of the ankle, serious lower-extremity injuries of the last 6 months, lower-extremity surgery, and neurological diseases. The primary outcome measure will be the Cumberland Ankle Instability Tool (CAIT). Secondary outcomes include the Foot and Ankle Ability Measurement (FAAM), isokinetic and isometric strength diagnostics, joint repositioning sense, range of motion, measurements of postural control, gait and run analysis, and jump analysis. This protocol will follow the SPIRIT guidance.

Discussion

Current management of LAS rehabilitation lacks since there is a high rate of patients developing a CAI. It has been shown that exercise therapy improves ankle function in acute LAS as well as in patients with CAI. It is further recommended to address specific impairment domains in ankle rehabilitation. However, empirical data for such a holistic treatment algorithm is missing. Therefore, this study has the potential to improve the healthcare for LAS patients and might be used for a future standardized evidence-based rehabilitation concept.

Trial registration

“Prospectively registered” ISRCTN – ISRCTN13640422 17/11/2021; DRKS (German Clinical Trials Register) – DRKS00026049.
Effect of low-dose aspirin on urinary 11-dehydro-thromboxane B2 in the ASCEND (A Study of Cardiovascular Events iN Diabetes) randomized controlled trial
Authors: Parish Sarah , Buck Georgina , Aung Theingi , Mafham Marion , Clark Sarah , Hill Michael R. , Collins Rory , Bowman Louise , Armitage Jane ,   on behalf of the ASCEND Study Collaborative Group
Published: March 2023

Background

Aspirin is widely used for cardioprotection with its antiplatelet effects due to the blocking of thromboxane A2 production. However, it has been suggested that platelet abnormalities in those with diabetes prevent adequate suppression with once daily aspirin.

Methods

In the ASCEND randomized double-blind trial of aspirin 100 mg once daily versus placebo in participants with diabetes but no history of cardiovascular disease, suppression was assessed by measuring 11-dehydro-thromboxane B2 excretion in urine (U-TXM) in a randomly selected sample of 152 participants (76 aspirin arm, 74 placebo arm), plus 198 (93 aspirin arm, 105 placebo arm) adherent to study drugs and selected to maximize the numbers ingesting their last tablet 12–24 h before urine sampling. U-TXM was assayed using a competitive ELISA assay in samples mailed a mean of 2 years after randomization, with time since taking last aspirin/placebo tablet recorded at the time of sample provision. Effective suppression (U-TXM < 1500 pg/mg creatinine) and percentage reductions in U-TXM by aspirin allocation were compared.

Results

In the random sample, U-TXM was 71% (95% CI 64–76%) lower among aspirin vs placebo-allocated participants. Among adherent participants in the aspirin arm, U-TXM was 72% (95% CI 69–75%) lower than in the placebo arm and 77% achieved effective suppression overall. Suppression was similar among those who ingested their last tablet more than 12 h before urine sampling with levels in the aspirin arm 72% (95% CI 67–77%) lower than in the placebo arm and 70% achieving effective suppression.

Conclusions

Daily aspirin significantly reduces U-TXM in participants with diabetes, including at 12–24 h after ingestion.

Trial registration

ISRCTN ISRCTN60635500. Registered on 1 Sept 2005; ClinicalTrials.gov NCT00135226. Registered on 24 Aug 2005.
A highly efficient transcriptome-based biosynthesis of non-ethanol chemicals in Crabtree negative Saccharomyces cerevisiae
Authors: Yao Zhen , Guo Yufeng , Wang Huan , Chen Yun , Wang Qinhong , Nielsen Jens , Dai Zongjie
Published: March 2023

Background

Owing to the Crabtree effect, Saccharomyces cerevisiae produces a large amount of ethanol in the presence of oxygen and excess glucose, leading to a loss of carbon for the biosynthesis of non-ethanol chemicals. In the present study, the potential of a newly constructed Crabtree negative S. cerevisiae, as a chassis cell, was explored for the biosynthesis of various non-ethanol compounds.

Results

To understand the metabolic characteristics of Crabtree negative S. cerevisiae sZJD-28, its transcriptional profile was compared with that of Crabtree positive S. cerevisiae CEN.PK113-11C. The reporter GO term analysis showed that, in sZJD-28, genes associated with translational processes were down-regulated, while those related to carbon metabolism were significantly up-regulated. To verify a potential increase in carbon metabolism for the Crabtree negative strain, the production of non-ethanol chemicals, derived from different metabolic nodes, was then undertaken for both sZJD-28 and CEN.PK113-11C. At the pyruvate node, production of 2,3-butanediol and lactate in sZJD-28-based strains was remarkably higher than that of CEN.PK113-11C-based ones, representing 16.8- and 1.65-fold increase in titer, as well as 4.5-fold and 0.65-fold increase in specific titer (mg/L/OD), respectively. Similarly, for shikimate derived p-coumaric acid, the titer of sZJD-28-based strain was 0.68-fold higher than for CEN.PK113-11C-based one, with a 0.98-fold increase in specific titer. While farnesene and lycopene, two acetoacetyl-CoA derivatives, showed 0.21- and 1.88-fold increases in titer, respectively. From malonyl-CoA, the titer of 3-hydroxypropionate and fatty acids in sZJD-28-based strains were 0.19- and 0.76-fold higher than that of CEN.PK113-11C-based ones, respectively. In fact, yields of products also improved by the same fold due to the absence of residual glucose. Fed-batch fermentation further showed that the titer of free fatty acids in sZJD-28-based strain 28-FFA-E reached 6295.6 mg/L with a highest reported specific titer of 247.7 mg/L/OD in S. cerevisiae.

Conclusions

Compared with CEN.PK113-11C, the Crabtree negative sZJD-28 strain displayed a significantly different transcriptional profile and obvious advantages in the biosynthesis of non-ethanol chemicals due to redirected carbon and energy sources towards metabolite biosynthesis. The findings, therefore, suggest that a Crabtree negative S. cerevisiae strain could be a promising chassis cell for the biosynthesis of various chemicals.
The association between systemic immune-inflammation index and rheumatoid arthritis: evidence from NHANES 1999–2018
Authors: Liu Bo , Wang Jie , Li Yan-yan , Li Kang-peng , Zhang Qiang
Published: March 2023

Purpose

We aimed to explore the relationship between the systemic immune-inflammation index (SII) and rheumatoid arthritis (RA) using NHANES from 1999 to 2018.

Methods

We collected data from the NHANES database from 1999 to 2018. The SII is calculated from the counts of lymphocytes (LC), neutrophils (NC), and platelets (PC). The RA patients were derived from questionnaire data. We used weighted multivariate regression analysis and subgroup analysis to explore the relationship between SII and RA. Furthermore, the restricted cubic splines were used to explore the non-linear relationships.

Result

Our study included a total of 37,604 patients, of which 2642 (7.03%) had rheumatoid arthritis. After adjusting for all covariates, the multivariate logistic regression analysis showed that high SII (In-transform) levels were associated with an increased likelihood of rheumatoid arthritis (OR=1.167, 95% CI=1.025–1.328, P=0.020). The interaction test revealed no significant effect on this connection. In the restricted cubic spline regression model, the relationship between ln-SII and RA was non-linear. The cutoff value of SII for RA was 578.25. The risk of rheumatoid arthritis increases rapidly when SII exceeds the cutoff value.

Conclusion

In general, there is a positive correlation between SII and rheumatoid arthritis. Our study shows that SII is a novel, valuable, and convenient inflammatory marker that can be used to predict the risk of rheumatoid arthritis in US adults.
Potential clinical biomarkers and perspectives in diabetic cardiomyopathy
Authors: Deng Jianxin , Yan Fang , Tian Jinglun , Qiao Aijun , Yan Dewen
Published: March 2023

Diabetic cardiomyopathy (DCM) is a serious cardiovascular complication and the leading cause of death in diabetic patients. Patients typically do not experience any symptoms and have normal systolic and diastolic cardiac functions in the early stages of DCM. Because the majority of cardiac tissue has already been destroyed by the time DCM is detected, research must be conducted on biomarkers for early DCM, early diagnosis of DCM patients, and early symptomatic management to minimize mortality rates among DCM patients. Most of the existing implemented clinical markers are not very specific for DCM, especially in the early stages of DCM. Recent studies have shown that a number of new novel markers, such as galactin-3 (Gal-3), adiponectin (APN), and irisin, have significant changes in the clinical course of the various stages of DCM, suggesting that we may have a positive effect on the identification of DCM. As a summary of the current state of knowledge regarding DCM biomarkers, this review aims to inspire new ideas for identifying clinical markers and related pathophysiologic mechanisms that could be used in the early diagnosis and treatment of DCM.
Sex differences in social and emotional insight in youth with and without autism
Authors: Mattern Hunter , Cola Meredith , Tena Kimberly G. , Knox Azia , Russell Alison , Pelella Maggie Rose , Hauptmann Aili , Covello Maxine , Parish-Morris Julia , McCleery Joseph P.
Published: March 2023

Autism was formally recognized by the medical community in the first half of the twentieth century. Almost 100 years later, a small but growing literature has reported sex differences in the behavioral expression of autism. Recent research has also begun to explore the internal experiences of individuals with autism, including social and emotional insight. The current study examines sex differences in language-based markers of social and emotional insight in girls and boys with autism and non-autistic peers during semi-structured clinical interviews. Sixty-four participants aged 5 to 17 years were individually matched on chronological age and full-scale IQ to form four groups: autistic girls, autistic boys, non-autistic girls, and non-autistic boys. Transcribed interviews were scored using four scales that index aspects of social and emotional insight. Results revealed the main effects of diagnosis, such that youth with autism exhibited lower insight than non-autistic youth on scales indexing social cognition and object relations, emotional investment, and social causality. With regards to sex differences, across diagnoses, girls were rated higher than boys on the social cognition and object relations, emotional investment, and social causality scales. Examined within each diagnosis separately, clear sex differences emerged: both autistic and non-autistic girls demonstrated better social cognition and understanding of social causality than boys in their respective diagnostic groups. No within-diagnosis sex differences were found on the emotional insight scales, however. These results suggest that relatively enhanced social cognition and understanding of social causality in girls may be a population-level sex difference that is preserved in autism, despite the core social challenges that characterize this condition. The current findings reveal critical new information about insight into social and emotional thinking and relationships in autistic girls versus boys that have important implications for improving identification and designing effective interventions.
MAW: the reproducible Metabolome Annotation Workflow for untargeted tandem mass spectrometry
Authors: Zulfiqar Mahnoor , Gadelha Luiz , Steinbeck Christoph , Sorokina Maria , Peters Kristian
Published: March 2023

Mapping the chemical space of compounds to chemical structures remains a challenge in metabolomics. Despite the advancements in untargeted liquid chromatography-mass spectrometry (LC–MS) to achieve a high-throughput profile of metabolites from complex biological resources, only a small fraction of these metabolites can be annotated with confidence. Many novel computational methods and tools have been developed to enable chemical structure annotation to known and unknown compounds such as in silico generated spectra and molecular networking. Here, we present an automated and reproducibleMetabolomeAnnotationWorkflow (MAW) for untargeted metabolomics data to further facilitate and automate the complex annotation by combining tandem mass spectrometry (MS2) input data pre-processing, spectral and compound database matching with computational classification, and in silico annotation. MAW takes the LC-MS2spectra as input and generates a list of putative candidates from spectral and compound databases. The databases are integrated via the R package Spectra and the metabolite annotation tool SIRIUS as part of the R segment of the workflow (MAW-R). The final candidate selection is performed using the cheminformatics tool RDKit in the Python segment (MAW-Py). Furthermore, each feature is assigned a chemical structure and can be imported to a chemical structure similarity network. MAW is following the FAIR (Findable, Accessible, Interoperable, Reusable) principles and has been made available as the docker images, maw-r and maw-py. The source code and documentation are available on GitHub (https://github.com/zmahnoor14/MAW). The performance of MAW is evaluated on two case studies. MAW can improve candidate ranking by integrating spectral databases with annotation tools like SIRIUS which contributes to an efficient candidate selection procedure. The results from MAW are also reproducible and traceable, compliant with the FAIR guidelines. Taken together, MAW could greatly facilitate automated metabolite characterization in diverse fields such as clinical metabolomics and natural product discovery.
Immobilization of E. coli expressing γ-glutamyltranspeptidase on its surface for γ-glutamyl compound production
Authors: Arai Shintaro , Suzuki Hideyuki
Published: March 2023

An Escherichia coli strain expressing γ-glutamyltranspeptidase on its extracellular surface using the Met1 to Arg232 fragment of YiaT of E. coli as an anchor protein was immobilized with alginate for repeated use. Measurement of γ-glutamyltranspeptidase activity of the immobilized cells was performed repeatedly at pH 8.73 and 37 °C for 10 days using γ-glutamyl-p-nitroanilide in the presence of 100 mM CaCl2 and 3% NaCl with and without glycylglycine. Even after the 10th day, the enzyme activity did not decrease from the initial levels. The production of γ-glutamylglutamine from glutamine using the immobilized cells was performed repeatedly at pH 10.5 and 37 °C for 10 days in the presence of 250 mM glutamine, 100 mM CaCl2, and 3% NaCl. Sixty-four % of glutamine was converted to γ-glutamylglutamine in the first cycle. While repeating the production 10 times, the surface of the beads gradually became covered with white precipitate, and the conversion efficiency gradually decreased, but 72% of the initial value still remained even at the 10th measurement.
Increased investment in Universal Health Coverage in Sub–Saharan Africa is crucial to attain the Sustainable Development Goal 3 targets on maternal and child health
Authors: Dowou Robert Kokou , Amu Hubert , Saah Farrukh Ishaque , Adeagbo Oluwafemi , Bain Luchuo Engelbert
Published: March 2023

Universal Health Coverage (UHC) is considered a strategic component of the Sustainable Development Goals specifically for goal 3 which seeks to ensure healthy lives and promote well-being for all, where all individuals and communities have equal access to key promotive, preventive, curative, and rehabilitative health interventions without financial constraints. Despite Sub-Saharan Africa (SSA) accelerated gains on the UHC effective coverage of 2.6% between 2010 to 2019, many countries in the sub-region show lagging performance. The major challenges faced in attaining the UHC in many countries include inadequate capital investment for health and their equitable distribution, fiscal space to finance UHC policies and programs. This paper discusses how increased investment in Universal Health Coverage in SSA is crucial to attain the Sustainable Development Goal 3 targets on maternal and child health. The Universal Health Monitoring Framework (UHMF) is adopted in this paper as the underpinning framework. The delivery of essential maternal and child health services to achieve UHC in SSA requires strategic actions such as policies, plans and programs with focus on maternal and child health. We report findings from recently published papers that clearly highlighted the strong connection between health insurance coverage and maternal health care utilization. Strategic actions such as implementing national health insurance scheme (NHIS) that directly incorporates free maternal and child health care could strengthen maternal health services and transform health systems in order to achieve UHC in SSA. We argue that achieving the SDG 3 on maternal and child health will only be possible if significant progress in made in increasing UHC. This is key to ensure optimal maternal health care utilization, and consequently reducing maternal and child deaths.
Comparison of the efficacy and safety of conventional curettage adenoidectomy with those of other adenoidectomy surgical techniques: A systematic review and network meta-analysis
Authors: Malas Moayyad , Althobaiti Awwadh A. , Sindi Abdullah , Bukhari Afnan F. , Zawawi Faisal
Published: March 2023

Objectives

There is a lack of robust evidence in regards to whether the intra and post-operative safety and efficacy of conventional curettage adenoidectomy is better than those of other available surgical techniques. Therefore, this study was conducted as a systematic review and network meta-analysis of published randomized controlled trials (RCTs) with the aim of comparing the safety and efficacy of conventional curettage adenoidectomy with all other available adenoidectomy techniques.

Materials and methods

A systematic search of published articles was performed in 2021 using databases such as PubMed/Medline, EMBASE, EBSCO, and the Cochrane Library. All RCTs that compared conventional curettage adenoidectomy with other surgical techniques and were published in English between 1965 and 2021 were included. The quality of the included RCTs have been assessed using Cochrane Collaboration Risk of Bias Tool.

Results

After screening 1494 articles, 17 were identified for comparing several adenoidectomy techniques and were eligible for quantitative analysis. Of those, 9 RCTs were analyzed for intraoperative blood loss, and 6 articles were included for post-operative bleeding. Furthermore; 14, 10, and 7 studies were included for surgical time, residual adenoid tissue, and postoperative complications respectively. Endoscopic-assisted microdebrider adenoidectomy yielded a statistically significantly greater estimate of intraoperative blood loss compared with conventional curettage adenoidectomy (mean difference [MD], 92.7; 95% confidence interval [CI] 28.3–157.1), suction diathermy (MD, 117.1; 95% CI 37.2–197.1). Suction diathermy had the highest cumulative probability of being the preferred technique because it was estimated to result in the least intraoperative blood loss. Electronic molecular resonance adenoidectomy was estimated to be more likely to result in the shortest surgical time (mean rank, 2.2). Participants in the intervention group were 97% less likely to have residual adenoid tissue than children in the conventional curettage group (odds ratio 0.03; 95% CI 0.01–0.15); therefore, conventional curettage was not considered an appropriate technique for complete removal of adenoid tissue.

Conclusion

There is no single technique that can be considered best for all possible outcomes. Therefore, otolaryngologists should make an appropriate choice after critically reviewing the clinical characteristics of children requiring adenoidectomy. Findings of this systematic review and meta-analysis may guide otolaryngologists when making evidence-based decisions regarding the treatment of enlarged and symptomatic adenoids in children.
Tactile maps of historical gardens: method of content selection
Authors: Zwirowicz-Rutkowska A. , Mościcka A. , Araszkiewicz A. , Wabiński J. , Kiliszek D.
Published: March 2023

Historical gardens are a significant part of the cultural heritage. Exploration of such gardens is an important element of education. A particular challenge is to increase the accessibility of these facilities for the people with visual impairments (PVI). Among the aids enabling PVI visiting the gardens are tactile maps. The currently used tactile maps focus mainly on orientation and mobility. They do not allow exploration of gardens as a spatial composition, taking into account their cultural values. Therefore, the aim of our study was to develop the rules for content selection of tactile maps presenting those features of gardens that decide about their value, and to formalize these rules using the Unified Modeling Language (UML). In this research we analyzed features of 15 gardens in the five garden design styles: Baroque, Renaissance, English, Romantic, and Japanese. In result, we have proposed the way of mapping of the five garden design styles in a form useful for PVI. We have defined the procedure of content selection, as well as the catalogues of elements to be mapped at different levels of details, distinguishing repetitive and unique elements of each style. Finally, we have defined the easy-to-use list of content elements of tactile maps in the five design styles. Our solutions are described in a formalized way that allows their unambiguous understanding and universal application. The proposed solutions contribute to increasing the accessibility of gardens to PVI and allow them to learn about the values of cultural heritage of such places.
Data-centric artificial intelligence in oncology: a systematic review assessing data quality in machine learning models for head and neck cancer
Authors: Adeoye John , Hui Liuling , Su Yu-Xiong
Published: March 2023

Machine learning models have been increasingly considered to model head and neck cancer outcomes for improved screening, diagnosis, treatment, and prognostication of the disease. As the concept of data-centric artificial intelligence is still incipient in healthcare systems, little is known about the data quality of the models proposed for clinical utility. This is important as it supports the generalizability of the models and data standardization. Therefore, this study overviews the quality of structured and unstructured data used for machine learning model construction in head and neck cancer. Relevant studies reporting on the use of machine learning models based on structured and unstructured custom datasets between January 2016 and June 2022 were sourced from PubMed, EMBASE, Scopus, and Web of Science electronic databases. Prediction model Risk of Bias Assessment (PROBAST) tool was used to assess the quality of individual studies before comprehensive data quality parameters were assessed according to the type of dataset used for model construction. A total of 159 studies were included in the review; 106 utilized structured datasets while 53 utilized unstructured datasets. Data quality assessments were deliberately performed for 14.2% of structured datasets and 11.3% of unstructured datasets before model construction. Class imbalance and data fairness were the most common limitations in data quality for both types of datasets while outlier detection and lack of representative outcome classes were common in structured and unstructured datasets respectively. Furthermore, this review found that class imbalance reduced the discriminatory performance for models based on structured datasets while higher image resolution and good class overlap resulted in better model performance using unstructured datasets during internal validation. Overall, data quality was infrequently assessed before the construction of ML models in head and neck cancer irrespective of the use of structured or unstructured datasets. To improve model generalizability, the assessments discussed in this study should be introduced during model construction to achieve data-centric intelligent systems for head and neck cancer management.
Supporting “time awareness” in self-regulated learning: How do students allocate time during exam preparation?
Authors: Hsu Chia-Yu , Horikoshi Izumi , Li Huiyong , Majumdar Rwitajit , Ogata Hiroaki
Published: March 2023

The development of technology enables diverse learning experiences nowadays, which shows the importance of learners’ self-regulated skills at the same time. Particularly, the ability to allocate time properly becomes an issue for learners since time is a resource owned by all of them. However, they tend to struggle to manage their time well due to the lack of awareness of its existence. This study, hence, aims to reveal how learners allocate their time and evaluate the effectiveness of the time allocation by examining its effects on learners’ performance. We collect the learning logs of 116 seventh-graders from the online learning system implemented in a Japanese public junior high school. We look at the data in the time window of 34 days before the regular exam. Even though clustering techniques as a Learning Analytics method help identify different groups of learners, it is seldom applied to group students’ learning patterns with different levels of indicators extracted from their learning process data. In this study, we adopt the method to cluster students’ patterns of time allocation and find that better performance can result from the consistency of study time throughout the exam preparation period. Practical suggestions are then proposed for different roles involved in digital learning environments to facilitate students’ time management. Collectively, this study is expected to make contributions to smart learning environments supporting self-regulated learning in the digital era.
Identification of the shared genes and immune signatures between systemic lupus erythematosus and idiopathic pulmonary fibrosis
Authors: Liao Sheng , Tang Youzhou , Zhang Ying , Cao Qingtai , Xu Linyong , Zhuang Quan
Published: March 2023

Background

Systemic lupus erythematosus (SLE) is an autoimmune disorder which could lead to inflammation and fibrosis in various organs. Pulmonary fibrosis is a severe complication in patients with SLE. Nonetheless, SLE-derived pulmonary fibrosis has unknown pathogenesis. Of pulmonary fibrosis, Idiopathic pulmonary fibrosis (IPF) is a typicality and deadly form. Aiming to investigate the gene signatures and possible immune mechanisms in SLE-derived pulmonary fibrosis, we explored common characters between SLE and IPF from Gene Expression Omnibus (GEO) database.

Results

We employed the weighted gene co-expression network analysis (WGCNA) to identify the shared genes. Two modules were significantly identified in both SLE and IPF, respectively. The overlapped 40 genes were selected out for further analysis. The GO enrichment analysis of shared genes between SLE and IPF was performed with ClueGO and indicated that p38MAPK cascade, a key inflammation response pathway, may be a common feature in both SLE and IPF. The validation datasets also illustrated this point. The enrichment analysis of common miRNAs was obtained from the Human microRNA Disease Database (HMDD) and the enrichment analysis with the DIANA tools also indicated that MAPK pathways’ role in the pathogenesis of SLE and IPF. The target genes of these common miRNAs were identified by the TargetScan7.2 and a common miRNAs-mRNAs network was constructed with the overlapped genes in target and shared genes to show the regulated target of SLE-derived pulmonary fibrosis. The result of CIBERSORT showed decreased regulatory T cells (Tregs), naïve CD4+ T cells and rest mast cells but increased activated NK cells and activated mast cells in both SLE and IPF. The target genes of cyclophosphamide were also obtained from the Drug Repurposing Hub and had an interaction with the common gene PTGS2 predicted with protein-protein interaction (PPI) and molecular docking, indicating its potential treatment effect.

Conclusions

This study originally uncovered the MAPK pathway, and the infiltration of some immune-cell subsets might be pivotal factors for pulmonary fibrosis complication in SLE, which could be used as potentially therapeutic targets. The cyclophosphamide may treat SLE-derived pulmonary fibrosis through interaction with PTGS2, which could be activated by p38MAPK.
Staying sane in psychiatric residency during COVID times
Authors: Ayub Maryam
Published: March 2023

This article gives a junior psychiatry resident's personal story of burnout during the COVID-19 pandemic: what led to it, what helped her get through it and the continual process of working to avoid burnout in the future.
Cancer Outcomes Among Prediabetes and Type 2 Diabetes Populations With Dietary and Physical Activity–based Lifestyle Interventions
Authors: Zhang Minghui , Zucatti Kelly Pozzer , Teixeira Paula Portal , Correia Poliana Espíndola , Wayerbacher Laura Fink , Spiazzi Bernardo F , Socal Mariana P , Boyko Edward J , Colpani Verônica , Gerchman Fernando
Published: March 2023

Context

People with type 2 diabetes (T2D) have higher risks of cancer incidence and death.

Objective

We aimed to evaluate the relationship between dietary and physical activity–based lifestyle intervention and cancer outcomes among prediabetes and T2D populations.

Methods

We searched for randomized controlled trials with at least 24 months of lifestyle interventions in prediabetes or T2D populations. Data were extracted by pairs of reviewers and discrepancies were resolved by consensus. Descriptive syntheses were performed, and the risk of bias was assessed. Relative risks (RRs) and 95% CIs were estimated using a pairwise meta-analysis with both a random-effects model and a general linear mixed model (GLMM). Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation framework, and trial sequential analysis (TSA) was conducted to assess if current information is enough for definitive conclusions. Subgroup analysis was performed by glycemic status.

Results

Six clinical trials were included. Among 12 841 participants, the combined RR for cancer mortality comparing lifestyle interventions with usual care was 0.94 (95% CI, 0.81-1.10 using GLMM and 0.82-1.09 using random-effects model). Most studies had a low risk of bias, and the certainty of evidence was moderate. TSA showed that the cumulative Z curve reached futility boundary while total number did not reach detection boundary.

Conclusion

Based on the limited data available, dietary and physical activity–based lifestyle interventions had no superiority to usual care on reducing cancer risk in populations with prediabetes and T2D. Lifestyle interventions focused on cancer outcomes should be tested to better explore their effects.