bluuebunny/crossref_metadata_2025 huggingface dataset:
Topical brimonidine induced acute uveal effusion in a patient with nanophthalmos: a case report
Authors: Li Yakun , Zhou Qi
Published: October 2023

Background

We report a case of uveal effusion in a nanophthalmic eye after topical use of brimonidine.

Case presentation

A 42-year-old male patient with nanophthalmos experienced sudden blurred vision in the right eye after using topical brimonidine when picking up tennis balls repeatedly 6 weeks after bilateral YAG peripheral iridotomy. Ocular examination showed wide choroidal and exudative retinal detachment in the temporal and inferior region, involving the macula. Acute uveal effusion in the right, bilateral nanophthalmos was diagnosed. Oral and topical corticosteroids, combined with topical nonsteroids and atropine led to a complete resolution of the uveal effusion after one month.

Conclusion

This case suggested a possible causal relationship between the topical use of brimonidine and acute uveal effusion in patients with nanophthalmos. Topical brimonidine should be used with caution in nanophthalmic eyes.
Bronchodilator reversibility testing in morbidly obese non-smokers: fluticasone/salmeterol efficacy versus salbutamol bronchodilator
Authors: Ahmed Mona Ibrahim , Ahmed Randa Ibrahim , Osama Hasnaa , Khalifa Amira Karam , Alshehri Abdullah Ali , El-Saber Batiha Gaber , Negm Walaa A , Kamal Marwa
Published: October 2023

A positive response in reversibility testing is widely used to diagnose patients with airway limitations. However, despite its simple procedure, it doesn’t accurately reflect the exact airway irreversibility. This study aimed to investigate the efficacy of a bronchodilation reversibility test using salbutamol and fluticasone/salmeterol combination in obese non-smoker subjects.

The study included patients without a history of obstructive lung disease or bronchodilators. A sub-classification of patients based on body mass index (BMI) was carried out into normal (< 24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (BMI ≥ 30). Spirometry measurements were performed before and after salbutamol or fluticasone/salmeterol administration.

The study included 415 (49.9% male) patients with a mean age of 40.92 ± 10.86 years. Obese subjects showed a high prevalence of restrictive patterns (23.4%), with non-significantly lower spirometric values compared to normal and overweight subjects (p > 0.05). The magnitude of bronchodilation, as identified by spirometry, following fluticasone/salmeterol was higher in all participants, with a significant increase in obese subjects with a p-value of 0.013, 0.002, and 0.035 for FEV1, FEV1% predicted, and FEV1/FVC, respectively.

Fluticasone/salmeterol combination increases FEV1, FEV1% of predicted, and FEV1/FVC ratio than the conventional test using salbutamol inhaler, and it can be a potential candidate for assessment of airway obstruction using reversibility test, especially among the obese population.
Potential of ultra-high-resolution CT in detecting osseous changes of temporomandibular joint: experiences in temporomandibular disorders
Authors: Zhang Ning , Tang Ruowei , Zhao Pengfei , Xu Ning , Meng Fanhao , Wang Zhen , Zhang Tingting , Zhang Zhengyu , Yin Hongxia , Ding Heyu , Qiu Xiaoyu , Dai Chihang , Huang Yan , Yang Zhenghan , Huang Xiaofeng , Wang Zhenchang
Published: October 2023

Background

Osseous changes of the temporomandibular joint (TMJ) are related to the progression of temporomandibular disorders (TMD), and computed tomography (CT) plays a vital role in disease evaluation.

Objective

The aims of this study were to evaluate the image quality and diagnostic value of ultra-high-resolution CT (U-HRCT) in TMD compared to cone-beam CT (CBCT).

Methods

TMD patients who underwent both CBCT and U-HRCT between November 2021 and September 2022 were retrospectively included. Image quality scores were assigned for four osseous structures (the cortical and trabecular bones of the condyle, articular eminence, and glenoid fossa) by two independent observers from Score 1 (unacceptable) to Score 5 (excellent). Diagnostic classification of TMD was categorized as follows: Class A (no evident lesion), Class B (indeterminate condition) and Class C (definitive lesion). Image quality scores and diagnostic classifications were compared between CBCT and U-HRCT. The Cohen’s Kappa test, Wilcoxon signed-rank test, Chi-square test and Fisher’s exact test were conducted for statistical analysis.

Results

Thirty TMD patients (median age, 30 years; interquartile range, 26–43 years; 25 females) with 60 TMJs were enrolled. Image quality scores were higher for U-HRCT than for CBCT by both observers (all Ps < 0.001). Definitive diagnoses (Class A and C) were achieved in more cases with U-HRCT than with CBCT (93.3% vs. 65.0%, Fisher’s exact value = 7.959, P = 0.012). Among the 21 cases which were ambiguously diagnosed (Class B) by CBCT, definitive diagnosis was achieved for 17 cases (81.0%) using U-HRCT.

Conclusions

U-HRCT can identify osseous changes in TMD, providing improved image quality and a more definitive diagnosis, which makes it a feasible diagnostic imaging method for TMD.
Dental implant in anterior mandible according to mandibular lingual foramens and lingual mucosal vessels: using fusion volumetric images from computed tomography and magnetic resonance imaging
Authors: Liu Li , Li Yijun , Shi Yuchao , You Meng , Wang Jun , Sakamoto Junichiro , Wang Hu
Published: October 2023

Background

Perforation of the lingual cortex while placing dental implants in the interforaminal region of the mandible can cause severe hemorrhage. The purpose of this study was to evaluate the features of mandibular lingual foraminals (MLFs) and locational relationship between them and lingual mucosal vessels (LMVs) by CT/MRI fusion volumetric images.

Methods

37 images within complete anterior mandibular region using both MSCT and three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) MRI were taken from our imaging archives. After exclusion of 11 for lesions or artifacts, 26 CT/MRI fusion volumetric images were included to evaluate the frequency, diameter, and position of MLFs. The anterior mandibular region was divided into 4 equal segments under each teeth, and 40 regions were got from C5 to D5. Furthermore, the positional relationship between MLFs and LMVs was analyzed in this coordinate system.

Results

62 MLFs (73.81%) were located below the incisors, followed by premolars (21.43%) and canines (4.76%). Female bias, the mean diameter of the female was 0.08 mm while the male was 0.21 mm. The total number of LMVs was most distributed on lingual side of C1 and D1. According to Spearman’s correlation coefficient, the location of MLFs was related to LMVs. The MLFs in fourth segment of D1 were positively moderately correlated with LMVs in fourth segment of D4, while the MLFs in third segment of C1 showed a weak positive correlation with LMVs in third segment of D4.

Conclusions

The features and the correlation between MLFs and LMVs in CT/MRI fusion volumetric images may offer reference to dentists when only MLFs can been seen on routine preoperative CT examination of implants.

Trial registration

Retrospectively registered. (D2018-072)
Evaluation of a co-designed Parkinson’s awareness audio podcast for undergraduate nursing students in Northern Ireland
Authors: Crooks Sophie , Stark Patrick , Carlisle Susan , McMullan Johanna , Copeland Shannon , Wong Wai Yee Amy , Blake David , Lyons Elaine , Campbell Nuala , Carter Gillian , Wilson Christine Brown , Mitchell Gary
Published: October 2023

Background

Parkinson’s Disease (PD) is a common neurological condition that often causes stiffness, tremor and slow movement. People living with PD are likely to encounter nursing students throughout their journey from pre-diagnosis to death. Despite this, there is a paucity of evidence about current practice in PD education amongst nursing students. The present study provides an evaluation of a co-designed Parkinson’s Awareness audio podcast amongst nursing students in Northern Ireland.

Methods

Following co-design of an audio podcast about PD, a mixed methods evaluation was carried out. 332 student nurses completed pre-/post-test questionnaires about their knowledge and perceptions of PD before and after listening to the audio podcast. Further to this, 35 student nurses participated in focus-group interviews six months following listening to explore how the podcast influenced practice.

Results

Student nurses posted a mean score of 52% before listening to the audio podcast. This mean increased to 80% post-test. These findings were statistically significant (p < 0.001), demonstrating significant increases in PD awareness after listening. Findings from the focus groups suggested that the audio podcast improved empathy and practice towards people with PD. The findings also suggested that students perceived audio podcasts to be a good way to learn about PD.

Conclusion

Provision of a co-designed audio podcast about PD has the potential to improve student nurse knowledge and practice related to PD as evidenced in this study.
Interventions for promoting patients’ adherence to 14-day primaquine treatment in a highly malaria-endemic township in Myanmar: a qualitative study among key stakeholders
Authors: Win Kyawt Mon , Aung Pyae Linn , Ring Zau , Linn Nay Yi Yi , Kyaw Myat Phone , Nguitragool Wang , Cui Liwang , Sattabongkot Jetsumon , Lawpoolsri Saranath
Published: October 2023

Background

Plasmodium vivax malaria is considered a major threat to malaria eradication. The radical cure for P. vivax malaria normally requires a 14-day administration of primaquine (PQ) to clear hypnozoites. However, maintaining adherence to PQ treatment is a significant challenge, particularly in malaria-endemic rural areas. Hence, this study aimed to formulate interventions for promoting patients’ commitment to PQ treatment in a highly malaria-endemic township in Myanmar.

Methods

A qualitative study was conducted in Waingmaw Township in northern Myanmar, where P. vivax malaria is highly endemic. Key stakeholders including public health officers and community members participated in focus group discussions (FGDs) and in-depth interviews (IDIs) in September 2022. Data were collected using validated guidelines, translated into English, and visualized through thematic analysis.

Results

Responsible individuals from different levels of the Myanmar National Malaria Control Programme participated in the IDIs. Most of them reported being aware of the markedly increasing trend of P. vivax and the possibility of relapse cases, especially among migrants who are lost to follow-up. Workload was a key concern surrounding intervention implementation. The respondents discussed possible interventions, such as implementing directly observed treatment (DOT) by family members, piloting a shorter PQ regimen, expanding the community’s malaria volunteer network, and strengthening health education activities using local languages to promote reasonable drug adherence. FGDs among community members revealed that although people were knowledgeable about malaria symptoms, places to seek treatment, and the use of bed nets to prevent mosquito bites, most of them still preferred to be treated by quack doctors and rarely used insecticide-treated nets at worksites. Many often stopped taking the prescribed drugs once the symptoms disappeared. Nevertheless, some respondents requested more bed nets to be distributed and health promotion activities to be conducted.

Conclusion

In rural areas where human resources are limited, interventions such as implementing family member DOT or shortening PQ regimens should be introduced to enhance the radical cure for the P. vivax infection. Disseminating information about the importance of taking the entire treatment course and emphasizing the burden of relapse is also essential.
The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: a overviews of systematic reviews
Authors: Pang Danli , Sun Aiping , Wang Fei , Lu Jingyu , Guo Yaorui , Ding Wen
Published: October 2023

Background

Studies evaluating the effectiveness and safety of telerehabilitation in patients undergoing total knee arthroplasty (TKA) have increased. However, the study quality and results differ, systematic reviews are limited. We aimed to synthesise systematic reviews and meta-analyses to assess the effects of telerehabilitation in patients post-TKA.

Materials and methods

Systematic reviews and meta-analyses regarding the effectiveness and safety of TKA telerehabilitation were retrieved from eight databases from establishment to 18 December 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Risk of Bias in Systematic Reviews (ROBIS) and GRADE system were used to evaluate results, methods, bias and evidence quality.

Results

Thirteen systematic reviews and meta-analyses were analysed. The AMSTAR 2 showed low methodological quality in seven studies and very low quality in six. Among the key items, item 2 had been registered on website before systematic review in four reviews. Concerning item 4, did not provide a comprehensive search strategy in 4 reviews. For item 7, none of the reviews provided a list of reasons for excluding an article. For item 9, regarding whether appropriate tools were used to assess the risk of bias of each included study, one review was assessed as ‘partially yes’, one review only included RCTs, and the remainder were assessed as ‘yes’. For item 11, one review did not specify the statistical methods used, and three reviews did not conduct a meta-analysis. For item 13, four reviews considered the risk of bias when interpreting or discussing the study results. For item 15, seven reviews did not evaluate publication bias. The PRISMA scores of the 13 reviews ranged from 17.5 to 26.0. The PRISMA indicated that 69.2% had no protocol registration, 38.5% did not provide other materials and evidence certainty, 23.1% did not provide certainty assessment, 30.8% did not report study bias. According to the ROBIS scale, diferrent domains have diferrent risks in all the reviews.

Conclusion

Telerehabilitation positively affects walking ability, knee extension and patient costs post-TKA surgery. Regarding the quality of life, patient satisfaction and the WOMAC, telerehabilitation had similar effects to conventional rehabilitation. Owing to the low quality of the studies, these conclusions should be interpreted cautiously, high-quality studies are needed in the future.
Prediction of pulmonary metastasis in esophageal carcinoma patients with indeterminate pulmonary nodules
Authors: Chen Maohui , Wang Hongjin , Huang Yizhou , Guo Feilong , Zheng Wei , Chen Chun , Zheng Bin
Published: October 2023

Background

Indeterminate pulmonary nodules (IPNs) are common after surgery for esophageal cancer. The paucity of data on postoperative IPNs for esophageal cancer causes a clinical dilemma.

Objective

The aim of this study was to identify the characteristics and clinical significance of IPNs after radical esophagectomy for metastatic esophageal cancer, determine the risk factors for pulmonary metastasis, and construct a risk score model to standardize the appropriate time to either follow up or treat the patient.

Methods

All consecutive patients with esophageal squamous cell carcinoma (ESCC) who underwent radical surgery between 2013 and 2016 were included in this retrospective study. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors and develop risk score models.

Results

A total of 816 patients were enrolled in the study. During a median follow-up period of 45 months, IPNs were detected in 221 (27.1%) patients, of whom 66 (29.9%) were diagnosed with pulmonary metastases. The following five variables maintained prognostic significance after multivariate analyses: the pathologic N category, number of IPNs, shape of IPNs, time of detection of IPNs, and size of IPNs. The Pulmonary Metastasis Prediction Model (PMPM) scale ranges from 0 to 15 points, and patients with higher scores have a higher probability of pulmonary metastases. The Hosmer–Lemeshow test showed a good calibration performance of the clinical prediction model (χ2 = 8.573, P = 0.380). After validation, the PMPM scale showed good discrimination with an AUC of 0.939.

Conclusion

A PMPM scale for IPNs in patients who underwent esophagectomy for ESCC may be clinically useful for diagnostic and therapeutic decision-making.
Fusobacterium nucleatum upregulates MMP7 to promote metastasis-related characteristics of colorectal cancer cell via activating MAPK(JNK)-AP1 axis
Authors: Ou Suwen , Chen Haipeng , Wang Hufei , Ye Jinhua , Liu Huidi , Tao Yangbao , Ran Songlin , Mu Xiaoqin , Liu Fangzhou , Zhu Shuang , Luo Kangjia , Guan Zilong , Jin Yinghu , Huang Rui , Song Yanni , Liu Shu-lin
Published: October 2023

Background

Colorectal cancer (CRC) is the third most common malignant tumor. Fusobacterium nucleatum (F. nucleatum) is overabundant in CRC and associated with metastasis, but the role of F. nucleatum in CRC cell migration and metastasis has not been fully elucidated.

Methods

Differential gene analysis, protein−protein interaction, robust rank aggregation analysis, functional enrichment analysis, and gene set variation analysis were used to figure out the potential vital genes and biological functions affected by F. nucleatum infection. The 16S rDNA sequencing and q-PCR were used to detect the abundance of F. nucleatum in tissues and stools. Then, we assessed the effect of F. nucleatum on CRC cell migration by wound healing and transwell assays, and confirmed the role of Matrix metalloproteinase 7 (MMP7) induced by F. nucleatum in cell migration. Furthermore, we dissected the mechanisms involved in F. nucleatum induced MMP7 expression. We also investigated the MMP7 expression in clinical samples and its correlation with prognosis in CRC patients. Finally, we screened out potential small molecular drugs that targeted MMP7 using the HERB database and molecular docking.

Results

F. nucleatum infection altered the gene expression profile and affected immune response, inflammation, biosynthesis, metabolism, adhesion and motility related biological functions in CRC. F. nucleatum was enriched in CRC and promoted the migration of CRC cell by upregulating MMP7 in vitro. MMP7 expression induced by F. nucleatum infection was mediated by the MAPK(JNK)-AP1 axis. MMP7 was highly expressed in CRC and correlated with CMS4 and poor clinical prognosis. Small molecular drugs such as δ-tocotrienol, 3,4-benzopyrene, tea polyphenols, and gallic catechin served as potential targeted therapeutic drugs for F. nucleatum induced MMP7 in CRC.

Conclusions

Our study showed that F. nucleatum promoted metastasis-related characteristics of CRC cell by upregulating MMP7 via MAPK(JNK)-AP1 axis. F. nucleatum and MMP7 may serve as potential therapeutic targets for repressing CRC advance and metastasis.
The complexity of nicotinamide adenine dinucleotide (NAD), hypoxic, and aryl hydrocarbon receptor cell signaling in chronic kidney disease
Authors: Curran Colleen S. , Kopp Jeffrey B.
Published: October 2023

Early-stage detection of chronic kidney diseases (CKD) is important to treatment that may slow and occasionally halt CKD progression. CKD of diverse etiologies share similar histologic patterns of glomerulosclerosis, tubular atrophy, and interstitial fibrosis. Macro-vascular disease and micro-vascular disease promote tissue ischemia, contributing to injury. Tissue ischemia promotes hypoxia, and this in turn activates the hypoxia-inducible transcription factors (HIFs). HIF-1α and HIF-2α, share a dimer partner, HIF-1β, with the aryl hydrocarbon receptor (AHR) and are each activated in CKD and associated with kidney cellular nicotinamide adenine dinucleotide (NAD) depletion. The Preiss-Handler, salvage, and de novo pathways regulate NAD biosynthesis and gap-junctions regulate NAD cellular retention. In the Preiss-Handler pathway, niacin forms NAD. Niacin also exhibits crosstalk with HIF and AHR cell signals in the regulation of insulin sensitivity, which is a complication in CKD. Dysregulated enzyme activity in the NAD de novo pathway increases the levels of circulating tryptophan metabolites that activate AHR, resulting in poly-ADP ribose polymerase activation, thrombosis, endothelial dysfunction, and immunosuppression. Therapeutically, metabolites from the NAD salvage pathway increase NAD production and subsequent sirtuin deacetylase activity, resulting in reduced activation of retinoic acid-inducible gene I, p53, NF-κB and SMAD2 but increased activation of FOXO1, PGC-1α, and DNA methyltransferase-1. These post-translational responses may also be initiated through non-coding RNAs (ncRNAs), which are additionally altered in CKD. Nanoparticles traverse biological systems and can penetrate almost all tissues as disease biomarkers and drug delivery carriers. Targeted delivery of non-coding RNAs or NAD metabolites with nanoparticles may enable the development of more effective diagnostics and therapies to treat CKD.
Maxillary canine position of patients with non-syndromic craniofacial disorder: a retrospective evaluation of panoramic radiographs
Authors: Weismann C. , Lehmann M. , Aretxabaleta M. , Koos B. , Schulz M. C.
Published: October 2023

Background

The study evaluates the position and displacement tendency of unerupted maxillary canines in orthodontic patients with non-syndromic craniofacial disorders (CD) compared to a control (C) group.

Methods

Canine position and displacement tendency were evaluated using panoramic radiographs (PAN) examined with parameters such as sector classification (sectors 1–5) and inclination angles (α and β). The displacement tendency was defined as the positioning of the tip in sectors 1 or 2, as well as its combination with increased angles (α > 30° and β > 39°). In addition, the correlation of the tooth position and agenesis, cleft side, and sex was assessed.

Results

A total of 116 pre-treatment PAN, divided into the CD group (n = 50; mean age 8.32 ± 2.27 years) and the C group (n = 66; mean age 10.80 ± 2.82 years), were evaluated in this study. The sector classification showed no displacement tendency in both groups. Inclination angles α/β showed a statistically significant higher displacement tendency (p = 0.01) of the CD group (n = 5) on the right side, compared to healthy subjects (n = 1). Male CD patients had a statistically significant higher displacement tendency on the right side (p = 0.03). A statistically significant correlation between cleft and non-cleft-side (p = 0.03) was found.

Conclusion

Patients with CD showed a statistically significant higher displacement tendency of the maxillary canine affected by the cleft side. The inclination angle was found to be the better predictor compared to the sector classification which should be considered in the orthodontic treatment planning.
Ubiquitin-specific peptidase 25 exacerbated osteoarthritis progression through facilitating TXNIP ubiquitination and NLRP3 inflammasome activation
Authors: Sui Jie , Dai Fei , Shi Jiusheng , Zhou Changcheng
Published: October 2023

Several members of the ubiquitin-specific proteases (USPs) family have been revealed to regulate the progression of osteoarthritis (OA). The current study aimed to investigate the role and the underlying mechanism of USP25 in IL-1β-induced chondrocytes and OA rat model. It was discovered that IL-1β stimulation upregulated USP25, increased ROS level, and suppressed cell viability in rat chondrocytes. Besides, USP25 knockdown alleviated IL-1β-induced injury by decreasing ROS level, attenuating pyroptosis, and downregulating the expression of IL-18, NLRP3, GSDMD-N, active caspase-1, MMP-3, and MMP-13. Furthermore, we discovered that USP25 affected the IL-1β-induced injury in chondrocytes in a ROS-dependent manner. Moreover, USP25 was revealed to interact with TXNIP, and USP25 knockdown increased the ubiquitination of TXNIP. The pro-OA effect of USP25 abundance could be overturned by TXNIP suppression in IL-1β-induced chondrocytes. Finally, in vivo experiment results showed that USP25 inhibition alleviated cartilage destruction in OA rats. In conclusion, we demonstrated that USP25 stimulated the overproduction of ROS to activate the NLRP3 inflammasome via regulating TXNIP, resulting in increased pyroptosis and inflammation in OA.
Attention-based dual-path feature fusion network for automatic skin lesion segmentation
Authors: He Zhenxiang , Li Xiaoxia , Chen Yuling , Lv Nianzu , Cai Yong
Published: October 2023

Automatic segmentation of skin lesions is a critical step in Computer Aided Diagnosis (CAD) of melanoma. However, due to the blurring of the lesion boundary, uneven color distribution, and low image contrast, resulting in poor segmentation result. Aiming at the problem of difficult segmentation of skin lesions, this paper proposes an Attention-based Dual-path Feature Fusion Network (ADFFNet) for automatic skin lesion segmentation. Firstly, in the spatial path, a Boundary Refinement (BR) module is designed for the output of low-level features to filter out irrelevant background information and retain more boundary details of the lesion area. Secondly, in the context path, a Multi-scale Feature Selection (MFS) module is constructed for high-level feature output to capture multi-scale context information and use the attention mechanism to filter out redundant semantic information. Finally, we design a Dual-path Feature Fusion (DFF) module, which uses high-level global attention information to guide the step-by-step fusion of high-level semantic features and low-level detail features, which is beneficial to restore image detail information and further improve the pixel-level segmentation accuracy of skin lesion. In the experiment, the ISIC 2018 and PH2 datasets are employed to evaluate the effectiveness of the proposed method. It achieves a performance of 0.890/ 0.925 and 0.933 /0.954 on the F1-score and SE index, respectively. Comparative analysis with state-of-the-art segmentation methods reveals that the ADFFNet algorithm exhibits superior segmentation performance.
Low levels of small HDL particles predict but do not influence risk of sepsis
Authors: Hamilton Fergus , Pedersen Kasper Mønsted , Ghazal Peter , Nordestgaard Børge Grønne , Smith George Davey
Published: October 2023

Background

Low levels of high-density lipoprotein (HDL) cholesterol have been associated with higher rates and severity of infection. Alterations in inflammatory mediators and infection are associated with alterations in HDL cholesterol. It is unknown whether the association between HDL and infection is present for all particle sizes, and whether the observed associations are confounded by IL-6 signalling.

Methods

In the UK Biobank, ~ 270,000 individuals have data on HDL subclasses derived from nuclear magnetic resonance analysis. We estimated the association of particle count of total HDL and HDL subclasses (small, medium, large, and extra-large HDL) with sepsis, sepsis-related death, and critical care admission in a Cox regression model. We subsequently utilised genetic data from UK Biobank and FinnGen to perform Mendelian randomisation (MR) of each HDL subclass and sepsis to test for a causal relationship. Finally, we explored the role of IL-6 signalling as a potential causal driver of changes in HDL subclasses.

Results

In observational analyses, higher particle count of small HDL was associated with protection from sepsis (Hazard ratio, HR 0.80; 95% CI 0.74–0.86, p = 4 × 10–9 comparing Quartile 4, highest quartile of HDL to Quartile 1, lowest quartile of HDL), sepsis-related death (HR 0.80; 95% CI 0.74–0.86, p = 2 × 10–4), and critical care admission with sepsis (HR 0.72 95% CI 0.60–0.85, p = 2 × 10–4). Parallel associations with other HDL subclasses were likely driven by changes in the small HDL compartment. MR analyses did not strongly support causality of small HDL particle count on sepsis incidence (Odds ratio, OR 0.98; 95% CI 0.89–1.07, p = 0.6) or death (OR 0.94, 95% CI 0.75–1.17, p = 0.56), although the estimate on critical care admission with sepsis supported protection (OR 0.73, 95% CI 0.57–0.95, p = 0.02). Bidirectional MR analyses suggested that increased IL-6 signalling was associated with reductions in both small (beta on small HDL particle count − 0.16, 95% CI − 0.10 to − 0.21 per natural log change in SD-scaled CRP, p = 9 × 10–8).and total HDL particle count (beta − 0.13, 95% CI − 0.09 to − 0.17, p = 7 × 10–10), but that the reverse effect of HDL on IL-6 signalling was largely null.

Conclusions

Low number of small HDL particles are associated with increased hazard of sepsis, sepsis-related death, and sepsis-related critical care admission. However, genetic analyses did not strongly support this as causal. Instead, we demonstrate that increased IL-6 signalling, which is known to alter infection risk, could confound associations with reduced HDL particle count, and suggest this may explain part of the observed association between (small) HDL particle count and sepsis.
Improvement of composite kidney outcomes by AKI care bundles: a systematic review and meta-analysis
Authors: See Chun Yin , Pan Heng-Chih , Chen Jui-Yi , Wu Chun-Yi , Liao Hung-Wei , Huang Yen-Ta , Liu Jung-Hua , Wu Vin-Cent , Ostermann Marlies
Published: October 2023

Introduction

Various approaches have been suggested to identify acute kidney injury (AKI) early and to initiate kidney-protective measures in patients at risk or with AKI. The objective of this study was to evaluate whether care bundles improve kidney outcomes in these patients.

Methods

We conducted a systematic review of the literature to evaluate the clinical effectiveness of AKI care bundles with or without urinary biomarkers in the recognition and management of AKI. The main outcomes were major adverse kidney events (MAKEs) consisting of moderate-severe AKI, receipt of renal replacement therapy (RRT), and mortality.

Results

Out of 7434 abstracts screened, 946 published studies were identified. Thirteen studies [five randomized controlled trials (RCTs) and eight non-RCTs] including 16,540 patients were eligible for inclusion in the meta-analysis. Meta-analysis showed a lower incidence of MAKE in the AKI care bundle group [odds ratio (OR) 0.73, 95% confidence interval (CI) 0.66–0.81] with differences in all 3 individual outcomes [moderate–severe AKI (OR 0.65, 95% CI 0.51–0.82), RRT (OR 0.63, 95% CI = 0.46–0.88) and mortality]. Subgroup analysis of the RCTs, all adopted biomarker-based approach, decreased the risk of MAKE (OR 0.55, 95% CI 0.41–0.74). Network meta-analysis could reveal that the incorporation of biomarkers in care bundles carried a significantly lower risk of MAKE when compared to care bundles without biomarkers (OR = 0.693, 95% CI = 0.50–0.96), while the usual care subgroup had a significantly higher risk (OR = 1.29, 95% CI = 1.09–1.52).

Conclusion

Our meta-analysis demonstrated that care bundles decreased the risk of MAKE, moderate–severe AKI and need for RRT in AKI patients. Moreover, the inclusion of biomarkers in care bundles had a greater impact than care bundles without biomarkers.
Molecular characterization of Clostridium perfringens isolates from a tertiary children’s hospital in Guangzhou, China, establishing an association between bacterial colonization and food allergies in infants
Authors: Huang Kun-yi , Liang Bing-shao , Zhang Xiao-yan , Chen Huan , Ma Ni , Lan Jiao-li , Li Ding-You , Zhou Zhen-wen , Yang Min
Published: October 2023

Background

Cow’s milk protein allergy (CMPA) is one of the most common types of food allergy in infants. Faecal pathogen cultures showed that the positive rate of Clostridium perfringens was more than 30%, which was significantly higher than that for other bacteria. Therefore, it is speculated that Clostridium perfringens colonization may be one of the pathogenetic factors for CMPA in infants. We conducted a real-world evidence study. Infants aged 0–6 months with diarrhoea and mucoid and/or bloody stools were recruited from a large tertiary hospital in China. Faecal pathogen cultures for the detection of Clostridium perfringens were confirmed by flight mass spectrometry, and potential toxin genes were identified using PCR. After 12 months of follow-up, the diagnoses of CMPA and food allergy were recorded. The correlation was assessed by Pearson correlation analysis.

Results

In this study, 358 infants aged 0–6 months with gastrointestinal symptoms and faecal pathogen cultures were recruited. A total of 270 (44.07% girls; mean age, 2.78 ± 2.84 months) infants were followed up for 12 months. Overall, the rate of positivity for Clostridium perfringens in faecal pathogen cultures was 35.75% (128/358) in infants aged ≤ 6 months. The earliest Clostridium perfringens colonization was detected within 2 days after birth. The majority of Clostridium perfringens isolates were classified as type C in 85 stool samples. In the Clostridium perfringens-positive group, 48.21% (54/112) of infants were clinically diagnosed with food allergies after 12 months, including 37.5% (42/112) with CMPA, which was significantly higher than that of the negative group, with 7.59% (12/158) exhibiting food allergies and 5.06% (8/158) presenting CMPA (P < 0.0001). Faecal Clostridium perfringens positivity was significantly correlated with CMPA, food allergy, faecal occult blood, faecal white blood cells, antibiotic use, increased peripheral blood platelet counts, and decreased haemoglobin levels (P < 0.0001).

Conclusions

This study demonstrates that intestinal colonization by Clostridium perfringens is common in infants. The majority of Clostridium perfringens isolates are classified as type C. Colonization of the intestine by Clostridium perfringens is associated with the development of CMPA and food allergy in infants.
Repellent efficacy of the nanogel containing Acroptilon repens essential oil in comparison with DEET against Anopheles stephensi
Authors: Zarenezhad Elham , Sanei-Dehkordi Alireza , Babaalizadeh Behina , Qasmei Hajar , Osanloo Mahmoud
Published: October 2023

Objective

Malaria is a vector-borne disease that causes many deaths worldwide; repellents are a practical approach to malaria prevention, especially in endemic regions.

Results

Gas chromatography-mass spectrometry analysis was used to identify compounds in Acroptilon repens essential oil (EO). Alpha-copaene (15.67%), α-cubenen (3.76%), caryophyllene oxide (14.00%), 1-heptadecane (5.61%), and δ-cadinene (2.84) were five major compounds. After that, the nanoemulsion containing the EO with a particle size of 46 ± 4 nm, SPAN 0.85, PDI 0.4, and zeta potential − 5.7 ± 0.4 mV was prepared. Then, it was gellified by adding CMC (carboxymethyl cellulose) to the nanoemulsion. Besides, ATR-FTIR analysis (Attenuated Total Reflection-Fourier Transform InfraRed) was used to confirm the EO’s successful loading in the nanogel. Finally, the protection time and repellent activity of nanogel compared to DEET (N, N-diethyl-meta-toluamide) were investigated against Anopheles stephensi. Interestingly, the nanogel with a protection time of 310 ± 45 min was significantly more potent than DEET (160 ± 17 min). It could thus be considered for future investigation against other mosquitoes.
Knowledge of stop the bleed techniques- a national survey
Authors: Sheth Siddharth , Mangal Rohan K. , Stead Thor S. , Ganti Latha
Published: October 2023

Objective

This article presents the dataset titled “Do you know how to Stop The Bleed®? [1]” The dataset contains the survey responses of 200 US persons aged 16 years and above regarding their knowledge of hemorrhage control, based on the American College of Surgeons Stop The Bleed® (STB) course [2].

Results

Two hundred adults in the United States completed this web-based survey, which consisted of a quiz to assess STB knowledge. Factors that were not statistically correlated to STB knowledge retention included age, sex, race and education level up to college level. On the other hand, resuscitation coursework (p = 0.004) and income (p = 0.049) were important determinants of Stop the Bleed® knowledge. In particular, participants with CPR certification (p = 0.020) and/or a postgraduate degree (p = 0.015) scored higher than their counterparts in this sample cohort.
Spontaneous rectosigmoid perforation at the watershed area of the Sudeck point in an apparently healthy toddler boy: a case report
Authors: Solomon Netsanet , Habte Tilahun , Alemu Seifu , Sori Ayana
Published: October 2023

Background

Spontaneous colon perforation can be classified into stercoral and idiopathic. Stercoral type is associated with chronic constipation, thus it is rare in infants and children. The idiopathic type is sporadic and could occur at any age. Delay in diagnosing or treating idiopathic colon perforation is associated with high mortality and morbidity rates. There are few studies on rectal perforation related to other etiologies or past the neonatal period, and their effect on disease onset and prognosis are unknown.

Case presentation

We report on a case of 2-year-and-5-month-old Oromo boy who presented with fever, diarrhea, vomiting, and progressive abdominal pain of 5-day duration. The boy underwent an exploratory laparotomy for suspected peritonitis and there was a single perforation of approximately 2.0 cm size in the anterior part of the upper one-third of rectum. The perforated rectum was repaired primarily and sigmoid divided diversion colostomy was carried out.

Conclusion

It is important to be aware of idiopathic colon perforation in children, a rare but dangerous condition with high mortality and morbidity in cases of delayed diagnosis or management. Pediatricians and surgeons should consider colon perforation as a cause in children who present with abdominal distention and a history of diarrhea for more than 5 days.
Algorithms for coupled Burgers’ equations by sharing characteristic curves within BSLM
Authors: Bak Soyoon , Jeon Yonghyeon
Published: October 2023

This paper introduces a new perspective of the traditional view on the velocity of each physical particle in the coupled Burgers’ equation in the backward semi-Lagrangian method (BSLM). The proposed methods reduce the number of Cauchy problems to be solved by observing a single virtual characteristic curve with a velocity. This can drastically reduce the computational cost of determining the departure point. Then, we solve the derived system reflected by the single virtual characteristic curve. Moreover, an efficient strategy for the derived linear system of equations is provided. Four examples are tested to demonstrate the adaptability and efficiency of the proposed method. The test results show that the proposed method has third- and fourth-order accuracy in time and space, respectively. In addition, compared with the existing method of solving the problem along two particles with different velocities, we confirm that the proposed method significantly reduces computational cost while maintaining accuracy well.
Making programmable packet scheduling time-sensitive with a FIFO queue
Authors: Lv Qianru , Jiang Xuyan , Yang Xiangrui
Published: October 2023

Time-Sensitive Networking (TSN) is an emerging technology for real-time and non-real-time hybrid networked systems. TSN is standardized by IEEE 802.1 TSN Task Group and is becoming widely used in various scenarios including the cloud network. However, existing programmable packet schedulers such as PIFO, PIEO, and AIFO in programmable switches either lack the ability to express most scheduling algorithms in TSN or introduce intolerable on-chip memory overhead (e.g., strict-priority queues). This makes programmable switches and NICs incapable of providing deterministic forwarding.

In this paper, we present AIAO (Admission-In-Admission-Out), a new set of programmable scheduling primitives using just a single FIFO to support typical TSN scheduling algorithms, as well as other popular work-conserving algorithms. AIAO is inspired by AIFO but improves it with a group of high-speed packet ingress/egress admission control triggered by high-precise and globally synchronized time, thus being able to support time-sensitive scheduling. We implement AIAO and evaluate it with FPGA-based TSN switches. The preliminary results show that AIAO guarantees correctness for a typical TSN scheduling algorithm with minimal logic and memory overhead.
The prevention and treatment of COVID-19 in patients treated with hemodialysis
Authors: Zeng Binyu , Zhou Jia , Peng Daizhuang , Dong Chengmei , Qin Qun
Published: October 2023

Patients treated with hemodialysis are often immunocompromised due to concomitant disease. As a result, this population is at high risk of infection and mortality from COVID-19. In addition to symptomatic treatment, a series of antiviral drugs targeting COVID-19 are now emerging. However, these antivirals are used mainly in mild or moderate patients with high-risk factors for progression to severe disease and are not available as pre- or post-exposure prophylaxis for COVID-19. There is a lack of clinical data on the use of anti-COVID-19 drugs, especially in patients treated with hemodialysis, therefore, vaccination remains the main measure to prevent SARS-CoV-2 infection in these patients. Here, we review the clinical features and prognosis of patients on hemodialysis infected with SARS-CoV-2, the main anti-COVID-19 drugs currently available for clinical use, and the safety and efficacy of anti-COVID-19 drugs or COVID-19 vaccination in patients treated with hemodialysis. This information will provide a reference for the treatment and vaccination of COVID-19 in patients treated with hemodialysis and maximize the health benefits of these patients during the outbreak.
When it’s not safe to be me: employee authenticity mediates the effect of perceived manager psychopathy on employee well-being
Authors: Sutton Anna , Stapleton Madeleine
Published: October 2023

Background

Psychopathy in managers is often measured on global scales and associated with detrimental outcomes for subordinates, such as bullying and reduced well-being. Yet some features of psychopathy, like boldness, appear to have beneficial outcomes. Using the triarchic model of psychopathy, we differentiate between adaptive and maladaptive traits in managers and model their effects on employee engagement and burnout. In addition, we test the extent to which authenticity, known to ameliorate the effect of some negative experiences on well-being, might mediate the influence of managers’ perceived psychopathic traits on employee well-being.

Methods

In a two-wave study, full-time employees (N = 246) reported on their manager’s psychopathic traits (boldness, meanness, disinhibition), their own authenticity and, six weeks later, their engagement and burnout.

Results

In support of our hypotheses, manager boldness enhanced engagement and reduced burnout while meanness and disinhibition reduced engagement and increased burnout. Additionally, employee authenticity was a partial mediator of the effect of managerial psychopathy on engagement and burnout.

Conclusions

Perceived psychopathic traits in managers have the potential to influence whether employees feel able to be their authentic selves at work, which consequently affects their well-being. A work culture that values authenticity can directly improve well-being and help employees to deal with managerial behaviour that stems from maladaptive psychopathic traits. We also highlight the importance of discriminating between constituent psychopathic traits to identify the potentially adaptive nature of the boldness element of psychopathy.
Explainable machine learning models for Medicare fraud detection
Authors: Hancock John T. , Bauder Richard A. , Wang Huanjing , Khoshgoftaar Taghi M.
Published: October 2023

As a means of building explainable machine learning models for Big Data, we apply a novel ensemble supervised feature selection technique. The technique is applied to publicly available insurance claims data from the United States public health insurance program, Medicare. We approach Medicare insurance fraud detection as a supervised machine learning task of anomaly detection through the classification of highly imbalanced Big Data. Our objectives for feature selection are to increase efficiency in model training, and to develop more explainable machine learning models for fraud detection. Using two Big Data datasets derived from two different sources of insurance claims data, we demonstrate how our feature selection technique reduces the dimensionality of the datasets by approximately 87.5% without compromising performance. Moreover, the reduction in dimensionality results in machine learning models that are easier to explain, and less prone to overfitting. Therefore, our primary contribution of the exposition of our novel feature selection technique leads to a further contribution to the application domain of automated Medicare insurance fraud detection. We utilize our feature selection technique to provide an explanation of our fraud detection models in terms of the definitions of the selected features. The ensemble supervised feature selection technique we present is flexible in that any collection of machine learning algorithms that maintain a list of feature importance values may be used. Therefore, researchers may easily employ variations of the technique we present.
Gender differences in high school students’ interest in STEM careers: a multi-group comparison based on structural equation model
Authors: Wang Ning , Tan Aik-Ling , Zhou Xiaohong , Liu Ke , Zeng Feng , Xiang Jiong
Published: October 2023

Background

Females are underrepresented in Science, Technology, Engineering, and Mathematics (STEM) fields all over the world. To encourage more girls to choose STEM majors and careers, it is critical to increase their interest in STEM careers. Many studies have investigated the factors that influence females' entry into STEM fields, but few studies have explored the gender differences in the relationships between these factors. Therefore, based on the Social Cognitive Career Theory, this study explored the gender differences in the effects of environmental factors (school education, informal education, social support, and media) on high school students' interest in STEM careers through the mediating roles of STEM self-efficacy and STEM careers perceptions.

Results

A questionnaire survey was conducted among 1240 high school students in Hunan Province, China, and the results of t-test, regression analysis, and structural equation model multi-group comparison showed that: Firstly, the scores of male students in all the dimensions except for STEM career perception were significantly higher than those of female students. Secondly, the environmental factor that had the greatest effect on male and female students' interest in STEM careers was different. Finally, there were gender differences in the mediating roles of STEM self-efficacy and STEM careers perceptions between environmental factors and interest in STEM careers.

Conclusions

This study revealed the influence mechanisms and gender differences in male and female students' interest in STEM careers in the context of Chinese Confucian culture, and the conclusions are as follows: (1) Male students' interest in STEM careers was significantly higher than that of female students; (2) The environmental factors that had the greatest effect on male and female students' interest in STEM careers were social support and media, respectively; and (3) Environmental factors could affect male students' interest in STEM careers through the mediating roles of STEM self-efficacy and STEM career perception, while environmental factors could affect female students' interest in STEM careers through the mediating role of STEM self-efficacy. Finally, the mediating mechanisms of STEM self-efficacy and STEM career perception between environmental factors and interest in STEM careers, and the importance of STEM self-efficacy for female students were discussed.