bluuebunny/crossref_metadata_2025 huggingface dataset:
Lactation Newsmakers: Documenting our History - Supporting Breastfeeding Exchange Relations by Building Equitable and Innovative Solutions: An Interview With João Aprigio Guerra de Almeida
Authors: Cassidy Tanya M. , Aprigio Guerra de Almeida João
Published: September 2024

Professor Joao Aprigio Guerra de Almeida graduated in Food Engineering (UFV-1981) with a Master in Microbiology (UFV-1986) and a doctorate in Women’s and Children’s Health (Fiocruz/IFF, 1998) He is founder and coordinator of the Brazilian Human Milk Banks Network (Ministry of Health-Brasil/Oswaldo Cruz Foundation-Fiocruz, 1987 to 2024); Head of the National Reference Center for Human Milk Banks at the National Institute of Women, Children and Adolescent Health Fernandes Figueira-IFF (Fiocruz/IFF, 1987 to 2024); Executive Secretary of the Ibero-American Human Milk Banks Network Program (Ibero-American General Secretariat-SEGIB/Brazilian Cooperation Agency-ABC/MS-FIOCRUZ, 2008 to 2020); Coordinator of International Technical Cooperation in Human Milk Banks ABC/Fiocruz/MS (2005 to 2024); and Coordinator of the Human Milk Banks Network of the Community of Portuguese Speaking Countries – CPLP (2017 to 2024). He has been recognized with the Sasakawa Health Prize (World Health Organization [WHO], 2001); as Officer of the Order of Rio Branco (Presidency of the Federative Republic of Brazil, 2001); with Global Health Challenges and Responses of the South in Time of Crisis (WHO, 2009); as Commendator of the Order of Rio Branco-Ministry of Foreign Affairs/Presidency of the Federative Republic of Brazil (2018); and Dr LEE Jong-wook Memorial Prize for Public Health (WHO, 2020). His areas of activity include Public Health, breastfeeding, Human Milk Banks, Public Management, and International Technical Cooperation.
The political economy of development: analysing Daqing’s contribution to the formation and technocratic evolution of China’s socialist state
Authors: Zhang Yan
Published: September 2024

This essay critically examines Building for Oil, a comprehensive study of the Daqing Oil Field and its role in the evolution of China’s socialist state. It acknowledges the narrative’s intricate exploration of Daqing’s role in China’s early-stage industrialization, highlighting its unique approach to urbanization and worker-peasant village formation, and Daqing’s symbolic significance in reflecting Communist ideals and Mao Zedong’s revolutionary ethos. However, this essay also identifies critical gaps in the book’s narrative, notably the absence of pronounced connections between Daqing’s historical significance and contemporary China’s economic and energy infrastructure. The review argues for the necessity of incorporating discussions on the evolution of China’s economic model, energy transition and the role of technocracy and leadership in shaping these dynamics. Concluding, the review acknowledges the book’s significance while highlighting areas for further exploration to enrich the narrative, particularly in the context of China’s ongoing transformation and global impact.
Right on Time: Required Time of Arrival (RTA) to Anticipate Human factors Issues with Trajectory Based Operations (TBO)
Authors: Lescieux Cécile , Kang Juyeon , Obas Hans , Bae Nami , Doyon-Poulin Philippe
Published: September 2024

The future Trajectory-Based Operation (TBO) management method aims to increase the efficiency and predictability of flight operations. The use of time constraints, such as Required Time of Arrival (RTA) at specific points throughout the flight, enables flight trajectories to be better controlled. In this study, we conducted seven interviews with air traffic controllers, pilots, and civil aviation engineers to analyze the RTA management in the current airspace and to identify differences expected with its use in TBO. We found that in the current airspace, RTAs are used tactically to resolve short-term conflicts, which limits their benefits compared to a more strategic approach. From the pilots’ perspective, accepting RTAs requires an in-depth analysis of its impacts on the mission. Temporal information displayed in the cockpit is limited to support pilots’ decision-making. These results highlight the importance of studying human factors for RTA management in current airspace to address the challenges and limitations expected within TBO.
Effects of Acute Hypocapnia on Postural Standing Balance Measured by Sharpened Romberg Testing (SRT) in Healthy Subjects
Authors: Dunn Ryan , Stepanek Jan , Eboka Richard , Pradhan Gaurav N.
Published: September 2024

Introduction

The sharpened Romberg test (SRT) is a physical maneuver that has been used to identify ataxia in individuals in resource-limited settings. Previous research has suggested that performance on balance testing may be affected by hypocapnia. In this study, we sought to determine whether acute hyperventilation-induced hypocapnia affects performance on the SRT at 501 meters above sea level.

Methods

We recruited 22 healthy subjects. Each subject performed a baseline SRT. Subjects were then asked to hyperventilate to the point of hypocapnia, confirmed by measurement with a capnometer. Subjects were then asked to re-perform SRT. The primary endpoint was time to loss of balance, measured as time-to-stepout.

Results

Time-to-stepout (TTS) on SRT at baseline had a mean ± standard deviation of 101 ± 117 s. In the hypocapnic condition, TTS was reduced to 48 ± 68 s. TTS normalized to 121 ± 132 s after recovery to normal capnic levels. Time-to-stepout was found to be significantly shorter in the hypocapnic measurement compared to the baseline measurement ( P = .0128). Statistical analysis was conducted using one-tailed, paired sample T-tests using a P-value of < .05.

Conclusions

Our study found a statistically and clinically significant reduction in performance on a balance test (SRT) when exposed to acute hyperventilation-induced hypocapnia compared to a eucapnic control. Our results suggest that acute hypocapnia may contribute to neurological dysfunction independently of hypobaric hypoxia.
Risk factors of difficult intravenous access and catheter failure in the urology ward: A prospective observational study
Authors: Abe Mari , Tanaka Kaomi , Minoru Masuda , Kume Haruki , Nakagami Gojiro
Published: September 2024

Background:

Patients in the urology ward often require peripheral intravenous catheters for cancer chemotherapy, antibiotics to treat urinary tract infections, surgery, and other treatments. Moreover, as the elderly population within urology has a high incidence of cancer, many patients also have fragile vasculature. Proper intravenous catheter insertion and management are crucial in such cases. However, no observational studies have revealed specific practices and patient outcomes related to intravenous catheter insertion and management in urology wards. This study aimed to clarify the actual situation of peripheral intravenous catheter placements in patients hospitalized in a general urology ward and investigate the risk factors for patient outcomes such as difficult intravenous access (DIVA) and catheter failure (CF).

Methods:

This was a prospective observational study. Medical record data were collected, and the actual catheter placement situation was described. A multivariate logistic regression analysis was performed to investigate the risk factors for DIVA and CF.

Results:

This study analyzed 180 catheters in 99 patients. The median age of the group was 70 years. The prevalence of DIVA and CF were 9.9% and 35.2%, respectively. A history of intravenous chemotherapy for cancer was positively associated with both DIVA and CF.

Conclusion:

This study’s results demonstrate the crucial need for careful insertion and management of intravenous catheters in patients admitted to urology wards. These findings can help identify patients at high risk of DIVA and CF, while hospitalized in the urology ward.
Multi-Dimensional Analysis of Japanese Telemedicine Patient Satisfaction
Authors: Mason Andrew N , Naito Toshio , Fukushima Shinichi , Asano Keiko , Yamaji Ken , Kuwatsuru Ryohei
Published: September 2024

Introduction:

Telemedicine is a growing segment of the healthcare industry. As telemedicine gains prominence in Japan, the importance of telemedicine patient satisfaction research will also grow. This study examines whether Japanese patients are equally impacted by the same latent dimensions discovered in the multi-dimensional service satisfaction model used by a United States (U.S.) study.

Methods:

The subjects (n = 110) were patients who received telemedicine service between January and December 2023 at Juntendo University Hospital, Tokyo, Japan. Patient satisfaction perceptions were collected using a questionnaire composed of Likert scale items. Overall patient satisfaction served as the dependent variable, and patient perceptions of various aspects of the service were the independent variables. LASSO regression analysis was used to test the impact of the independent variables on overall patient satisfaction along with cluster analysis to examine the satisfaction ratings based upon patient characteristics.

Results:

Japanese patient perceptions of telemedicine health benefits were the most impactful driver of overall satisfaction. Cluster analysis indicated that males were generally more satisfied than females. The least satisfied patients were predominately female and those experiencing telemedicine for the first time. Patients receiving service from a specialist physician were least satisfied with the telemedicine financial costs.

Discussion:

Patient satisfaction levels were found to be highly impacted by perceptions of the health benefits received and the non-financial costs of service. These benefits could be highlighted by Japanese telemedicine providers to increase utilization of telemedicine services. Patient satisfaction was also found to be influenced by patient-centered care (ie, the “soft skills” of providers) to a lesser degree. Therefore, Japanese telemedicine providers may benefit from developing patient-centered communication skills.

Conclusion:

The model used provides nuanced understandings of telemedicine patient satisfaction, which highlights where targeted improvements in Japanese telemedicine patient satisfaction are likely to be most impactful.
Process parameters selection for multi-layer friction surfacing of 7075 aluminium alloy
Authors: Li Jishuai , Jadot Matthieu , Xie Jichang , Lezaack Matthieu B. , Sapanathan Thaneshan , Gautier Romain , Rachik Mohamed , Simar Aude
Published: September 2024

The effect of deposition parameters on the microstructure and mechanical properties are studied in multi-layer friction surfacing of 7075 aluminium alloy. These multi-layer structures were successfully manufactured after a parametric study which allows the generation of a deposition window, including an interface quality comparison. A higher rotational speed leads to a larger grain sizes. The coarse precipitates size and volume fraction decrease along the build direction in correlation with the thermal cycles’ profile. The top layer has a higher hardness after deposition, while bottom layers are in annealed state due to the growth of the strengthening phases. Fracture surface analysis revealed that transversal cracks are due to interlayer decohesion and that voids nucleated on the coarse precipitates.
Analysis of Genetic Risk Factors Associated with Charcot Foot Based on the FinnGen Study R9 Data: A Wide-angle Mendelian Randomization Study
Authors: Jiang Sichao , Wang Shouyu
Published: September 2024

Background

Charcot foot or Charcot neuropathic joint disease (CN) is a rare and complex foot disease with unknown pathogenesis, hindering early identification and intervention. The study aimed to clarify the causal association between all predominant risk factors and CN.

Methods

Two-sample Mendelian Randomization (MR), Multivariate MR, and Bidirectional MR analyses investigated the causal association between 36 modifiable risk factors and CN. The causal relationship between CN and Inflammatory cytokine and immune cells was also analyzed.

Results

Genetic factors associated with obesity and genetic susceptibility to various autoimmune diseases and non-cancerous thyroid diseases increased the risk of CN ( P < .05), genetically associated high basal metabolic rate and high total cholesterol decreased the risk of CN ( P < .05). In addition, we found a bi-directional causal relationship between CN and diabetes. In further immune cell analysis, we found 8 CN related immune cells, and in inflammatory cytokine analysis, we found 2 CN related inflammatory cytokines.

Conclusions

This comprehensive MR Study supports the causal role of Obesity-related factors, diabetes, autoimmune-related factors, and smoking in the development and progression of CN. This study identifies a potential cause of CN that has not been identified in previous studies and provides a new direction for further research.
Manifestations of Endocrine Disease in the Lower Extremities: Beyond the Diabetic Foot
Authors: Athanasiadou Kleoniki I. , Tsiridis Christothea A. , Paschou Ioanna A. , Paschou Stavroula A. , Papanas Nikolaos
Published: September 2024

The aim of this narrative review was to discuss manifestations of endocrine disease other than diabetic foot in the lower extremities. Acromegaly, Addison's disease, Cushing's syndrome, hypo- and hyperthyroidism, hypo- and hyperparathyroidism, autoimmune polyglandular syndrome, hypopituitarism, and glucagonoma are among the endocrine diseases that may present with clinical manifestations in the lower extremities. Clinical signs vary depending on the underlying condition. Clinical suspicion is necessary for early diagnosis. Treatment of the underlying endocrine disease usually results in improvement of lower-extremity manifestations.
Optimizing link-length fitting between an operator and a robot with compensation for habitual movements
Authors: Otani Takuya , Nakamura Makoto , Kimura Koichi , Takanishi Atsuo
Published: September 2024

Teleoperation has become increasingly important for the real-world application of robots. However, in current teleoperation applications, operators need to visually recognize any physical deviations between the robot and themselves and correct its operation accordingly. Even when humans move their bodies, achieving high positional accuracy can be difficult for them, which can limit their speed of movement and place a heavy burden on them. In this study, we proposed a parameter optimization method for feedforward compensation of the link-length deviation and operator's habitual body movements in leader–follower control in 3D space. To optimize the parameters, we used Digital Annealer developed by Fujitsu Ltd, which could rapidly solve the combinatorial optimization problem. The objective function minimized the difference between the hand positions of the robot and targets. Simulations verified that the proposed method could reduce hand positional differences.
The Politics of Platforms/Pingtai平台: A Chinese Genealogy
Authors: Wu Angela Xiao
Published: September 2024

Drawing on archival research for a book-length history of Chinese media governance, this essay presents a Chinese lineage of platform, or pingtai, in the fashion of Gillespie’s famous explication of the “politics of platforms.” Gillespie demonstrates that in the mid-2000s, tech companies began to call themselves as “platforms,” to take advantage of the term’s connotation as open and neutral enabler of the ideal market. Taken as global, this rhetorical strategy features frequently in transnational platform studies. The politics of platform in China, however, does not subscribe to the “root paradigm” of liberal capitalism. The invocation of pingtai has a pedigree traceable to the intellectual zeitgeist of the 1980s and state informatization and e-government of the 1990s and 2000s, which projected a distinct imaginary about information technology in relation to social organization. It is these deep-seated normative expectations that are driving the dynamic of platform governance in contemporary China.
The Health Information Seeking Behavior of Punjabi Elders During the COVID-19 Pandemic in Canada
Authors: Thandi Amrit , Chowdhury Mohammad Z. I. , Chowdhury Nashit , Turin Tanvir C.
Published: September 2024

Health Information Seeking Behavior (HISB) refers to the behavior and strategies used to attain, clarify, or confirm health information. The uptake of health information depends on system-level and individual-level factors. The purpose of the present study is to understand the sources from which Punjabi elders obtain COVID-19 vaccine-related information and their information seeking behavior. A cross-sectional survey was conducted among 391 Punjabi elders aged 50+ years in the Greater Toronto Area (GTA), Ontario. The survey questions included the need for COVID-19 vaccine information, the type of information sought, sources of information, and barriers to seeking information. Descriptive analysis was conducted using frequencies and percentages, and logistic regression was performed to understand the associations between participants’ sociodemographic characteristics and HISB. The results suggested that Punjabi elders are more likely to use informal sources and less likely to seek information from health professionals and government health and wellness websites. The results also suggested that most participants do not cross-check their information with other sources and are more likely to cross-check the information with family/friends, compared to credible care providers, across all demographics. Ultimately, there may be a need for stakeholders to collaborate to regulate the accuracy and type of health-information that is disseminated through media, and to tailor health communication to the health information seeking behavior of this population.
The Impact of Triglyceride-Glucose Index Levels During Perioperative Period on Outcomes in Femoral Neck Fracture Patients
Authors: Astan Sezer , Balta Orhan
Published: September 2024

Introduction

The objective of the present study is to assess the impact of the triglyceride-glucose index (TyG index) on the prognosis and explore the correlation between the TyG index and all-cause mortality in femoral neck fracture patients.

Materials and Methods

In this retrospective cohort study, we analyzed the TyG index in the follow-up of femoral neck fracture patients who underwent partial hip prosthesis. The formula of ln [fasting triglycerides (mg/dL) x fasting blood glucose concentration (mg/dL)/2] was used in the calculation of the TyG index. The patients were separated into three categories based on the TyG index.

Results

It was found that there was a significant correlation between prolonged hospital stay and elevated admission and postoperative TyG index ( P = 0.011, P < 0.001, respectively). The Kaplan-Meier survival analysis curves revealed a higher risk of 30-day, 90-day and overall mortality in patients with higher postoperative TyG index levels, categorized by postoperative TyG tertiles (log-rank P < 0.001, P < 0.001 and P = 0.001, respectively). In the multivariate Cox proportional hazard models, higher postoperative TyG index was a significant risk factor for mortality ( P = 0.01). The receiver operating characteristic analysis indicated that a postoperative TyG index of 9.01 and above was critical for 30-day mortality (69% sensitivity, 82% specificity and 0.78 area under curve; P < 0.001).

Conclusions

In our study demonstrate that the TyG index may be useful in identifying individuals at high risk of mortality in patients with femoral neck fractures.
Fibrosis and Sports Injuries: Concept and Implications: The GESMUTE-SETRADE Consensus Statement
Authors: Beas-Jiménez J. D. , León Garrigosa A. , Doñoro Cuevas P. , Álvarez Recio M. I. , Cofré Bolados C. , Alonso J. M.
Published: September 2024

Background:

Musculoskeletal fibrosis can be frequently observed in the scope of sports medicine; however, there is no consensus regarding its definition, nor do we have substantial knowledge regarding its epidemiology or best therapeutic alternatives.

Purpose:

The GESMUTE (Group for the Study of the Muscle Tendon System) Epidemiology Group, integrated into SETRADE (The Spanish Society for Sports Traumatology) propose a definition for musculoskeletal fibrosis within the field of physical exercise.

Study Design:

Consensus statement.

Methods:

A bibliographic review of the existing scientific evidence and consensus was developed by the authors on the definition of fibrosis in the field of sport.

Results:

Our working group proposed the definition of fibrosis as an abnormal accumulation of extracellular matrix, usually with regards to an injury complication, showing various clinical findings affecting muscles, tendons, ligaments, articular capsules and nerves which, in turn, mars the recovery process, causing symptoms and finally leading to relapses.

Conclusion:

Fibrosis in sport may be considered as an abnormal accumulation of extracellular matrix, usually related to complications of an injury, showing a wide range of clinical symptomatology, affecting muscles, tendons, ligaments, articular capsules, and nerves.
The Utilization of Empathy and Self-awareness Models to Deescalate Violence in the Ambulatory Clinic Setting
Authors: Phipps Kevin
Published: September 2024

Our objective was to understand how empathy and self-awareness content, alongside traditional deescalation training, might impact ambulatory clinic staff responses to patient and family escalation events. Verbal and physical workplace violence is escalating across healthcare organizations, including ambulatory clinics. Deescalation content is often developed with acute care, psychiatric, or emergency care in mind. There is a need for relevant and empathic deescalation training for ambulatory clinic staff to address their specific needs. We developed empathic and self-reflective deescalation training which was interactive and relevant to ambulatory clinic staff. Staff were trained using both in-person and virtual modalities. Participant self-reflection pre- and postintervention questionnaires indicated increases in understanding and application of deescalation methodologies. Multiple ambulatory clinics where staff participated saw a decrease in patient complaints and grievances. Participating ambulatory clinics also saw an improvement in the likelihood to recommend practice. However, participating ambulatory clinics did not see a reduction in reported patient-involved workplace violence events. Ensuring both empathy and self-awareness content in deescalation training, along with relevant ambulatory clinic scenarios, support ambulatory staff to respond effectively and appropriately to escalation events, helps reduce patient complaints, and improves patient satisfaction.
Community-Based Participatory Research: Lessons and Challenges. Symposium Special Communication
Authors: Arriola-Pacheco F. , Ness A. , Sihuay-Torres K. , Garcia-Quintana A. , Proaño D. , Lawrence H.P.
Published: September 2024

Community-based participatory research (CBPR) is grounded in the commitment of co-creation and co-development of research that is for, by, and with the population it is intended to impact. Translational oral health researchers can harness this research approach when conceptualizing innovations and interventions, especially in those contexts where populations have been made systemically and historically vulnerable. This commentary highlights lessons shared and challenges presented when implementing CBPR, derived from a 2024 IADR/AADOCR/CADR General Session & Exhibition symposium. The presenters shared numerous considerations when planning CBPR, such as integrating an equity lens in research, the necessity of community partnerships and trust-building, and the significance of adopting principles and criteria that are developed by the communities one works with and are therefore relevant and applicable to their particular oral health needs. Additionally, the panel of speakers and symposium attendants discussed ways of ensuring the sustainability of interventions and the integration of worldviews other than that of the researchers into CBPR. Oral health scientists and program implementers working with communities’ interests in mind must be alert of how best to harness CBPR to adequately respect self-determination and governance of all peoples and, in this manner, develop strategies that are adopted and valued by the communities they intend to serve.

Knowledge Transfer Statement:

Community-based participatory research is an equitable and wholesome approach that aims to respectfully collaborate with the communities that it seeks to impact. It offers everyone a seat at the table when trying to create transformative clinical, behavioral, and health services change. Oral health scientists and program implementers can apply this framework for research and programming in communities where past approaches have not necessarily benefited the peoples or their communities in an equitable manner.
“Urological Claudication”: Blind ending ureteric remnant in a bifid ureteric system causing neurological claudication—Case report with brief review of the literature
Authors: Aravind T K , Yadav Siddharth , Singh Harshdeep
Published: September 2024

Background

A blind ending ureteric remnant in a duplicated urinary system is extremely rare, and most of these anomalies go unrecognized as they are asymptomatic. We describe a unique case of a blind ending ureteric remnant presenting with neurological claudication in the lower limb secondary to sacral nerve root radiculopathy which was managed by robotic excision.

Case presentation

A 61-year-old male presented with radiating pain in the left gluteal region for the past 2 years, which persisted despite multiple conservative treatments. Extensive evaluation for the pain revealed a blind ending ureteric remnant in a partially duplicated system, which contained multiple calculi and caused the compression of the adjacent sacral nerve roots. The patient was subsequently taken up for excision of the remnant, which was performed robotically, after which the symptoms resolved completely.

Conclusion

Blind ending ureteric duplications are rare anomalies that mostly go unrecognized as they are asymptomatic. Rarely, these anomalies may produce clinically relevant symptoms and result in diagnostic dilemmas, meriting intervention.
Can the parameters of penile duplex assessment predict the success of urethroplasty?
Authors: Ghoneima Waleed , Rammah Ahmed M. , El gharably Mohamed Aboulfotouh , Zamel Samih , Mohamed Moamen , Torad Hesham
Published: September 2024

Background

This work aimed to study the role of penile duplex in predicting the outcome of anastomotic urethroplasty.

Methods

Between March 2022 and February 2023, all patients presented with posterior urethral distraction defect (PUDD) underwent anastomotic end to end urethroplasty. Preoperative evaluation of sexual function was performed using international index of erectile function (IIEF-5) and penile doppler parameters (the response E1 to E5, peak systolic velocity (PSV), end diastolic velocity (EDV) and resistivity index (RI)). Each patient was, routinely, evaluated through 12 month-follow up using IIEF-5, penile doppler parameters, uroflowmetry for Qmax and pelvic ultrasound for postvoid residual urine (PVR). The procedure was considered successful if Qmax > 15 ml/s and PVR < 50 cc at the end of follow up. The correlation between the success rate of anastomotic urethroplasty and pre-operative penile Doppler parameters was the primary outcome.

Results

Thirty patients with a mean age of 29.47 ± 9.79 years were evaluated. Twenty patients (66.7%) had previous orthopedic surgery. The stricture site was membranous in 6 patients (20.0%) and bubo-membranous in 24 (80.0%). The mean stricture length was 2.52 ± 0.98 cm. There was a statistically significant increase in mean end-diastolic velocity (P < 0.001) with a subsequent significant decrease in mean resistance index (P < 0.001). 14.3% of pre-operatively potent patients developed venous leakage (P < 0.001), while there was no change of arteriogenic or venogenic erectile dysfunction. In addition, of the patients who have arteriogenic erectile dysfunction, 37.5% did not require surgery, 25% had a urethrocystoscopy, and 37.5% required a repeat end to end urethroplasty. There is a significant association between pre-operative peak systolic velocity and the need for re-operation (P = 0.005).

Conclusion

Penile duplex may anticipate anastomotic urethroplasty efficacy in the case of PUDD.
Taxanorm: a novel taxa-specific normalization approach for microbiome data
Authors: Wang Ziyue , Lloyd Dillon , Zhao Shanshan , Motsinger-Reif Alison
Published: September 2024

Background

In high-throughput sequencing studies, sequencing depth, which quantifies the total number of reads, varies across samples. Unequal sequencing depth can obscure true biological signals of interest and prevent direct comparisons between samples. To remove variability due to differential sequencing depth, taxa counts are usually normalized before downstream analysis. However, most existing normalization methods scale counts using size factors that are sample specific but not taxa specific, which can result in over- or under-correction for some taxa.

Results

We developed TaxaNorm, a novel normalization method based on a zero-inflated negative binomial model. This method assumes the effects of sequencing depth on mean and dispersion vary across taxa. Incorporating the zero-inflation part can better capture the nature of microbiome data. We also propose two corresponding diagnosis tests on the varying sequencing depth effect for validation. We find that TaxaNorm achieves comparable performance to existing methods in most simulation scenarios in downstream analysis and reaches a higher power for some cases. Specifically, it balances power and false discovery control well. When applying the method in a real dataset, TaxaNorm has improved performance when correcting technical bias.

Conclusion

TaxaNorm both sample- and taxon- specific bias by introducing an appropriate regression framework in the microbiome data, which aids in data interpretation and visualization. The ‘TaxaNorm’ R package is freely available through the CRAN repository https://CRAN.R-project.org/package=TaxaNorm and the source code can be downloaded at https://github.com/wangziyue57/TaxaNorm.
Response is increased using postal rather than electronic questionnaires – new results from an updated Cochrane Systematic Review
Authors: Edwards Phil , Perkins Chloe
Published: September 2024

Background

A decade ago paper questionnaires were more common in epidemiology than those administered online, but increasing Internet access may have changed this. Researchers planning to use a self-administered questionnaire should know whether response rates to questionnaires administered electronically differ to those of questionnaires administered by post. We analysed trials included in a recently updated Cochrane Review to answer this question.

Methods

We exported data of randomised controlled trials included in three comparisons in the Cochrane Review that had evaluated hypotheses relevant to our research objective and imported them into Stata for a series of meta-analyses not conducted in the Cochrane review. We pooled odds ratios for response using random effects meta-analyses. We explored causes of heterogeneity among study results using subgroups. We assessed evidence for reporting bias using Harbord’s modified test for small-study effects.

Results

Twenty-seven trials (66,118 participants) evaluated the effect on response of an electronic questionnaire compared with postal. Results were heterogeneous (I-squared = 98%). There was evidence for biased (greater) effect estimates in studies at high risk of bias; A synthesis of studies at low risk of bias indicates that response was increased (OR = 1.43; 95% CI 1.08–1.89) using postal questionnaires. Ten trials (39,523 participants) evaluated the effect of providing a choice of mode (postal or electronic) compared to an electronic questionnaire only. Response was increased with a choice of mode (OR = 1.63; 95% CI 1.18–2.26). Eight trials (20,909 participants) evaluated the effect of a choice of mode (electronic or postal) compared to a postal questionnaire only. There was no evidence for an effect on response of a choice of mode compared with postal only (OR = 0.94; 95% CI 0.86–1.02).

Conclusions

Postal questionnaires should be used in preference to, or offered in addition to, electronic modes.
Feasibility, acceptability and preliminary evaluation of a user co-facilitated psychoeducational programme: a feasibility proof-of-concept randomised control trial
Authors: Skliarova Tatiana , Lara-Cabrera Mariela L. , Hafstad Hege , Havnen Audun , Saether Sverre Georg , Salvesen Øyvind , Vaag Jonas , Torgersen Terje
Published: September 2024

Background

Mental health settings are increasingly using co-facilitation of educational group interventions in collaboration with patient partners and service users. However, despite promising results, limited information is available regarding the feasibility and satisfaction levels of these programmes among adults newly diagnosed with attention-deficit hyperactivity/impulsivity disorder (ADHD). Hence, this study aimed to determine the feasibility, acceptability, and preliminary effects of a user co-facilitated psychoeducational group programme for adults diagnosed with ADHD.

Methods

This feasibility proof-of-concept randomised controlled trial recruited outpatients from a Norwegian community mental health centre. Outpatients randomised to the intervention group (IG) received a psychoeducational programme supplementing Treatment As Usual (TAU), while the control group received TAU. Feasibility was determined by the acceptance rate, adherence rate, and dropout rate. Acceptability was measured with the Client Satisfaction Questionnaire and a 3-item scale measuring satisfaction with the received information. To test the preliminary effects, self-efficacy, symptom severity, and quality of life were measured at baseline and pre- and post-intervention.

Results

Feasibility was demonstrated; most of the patients were willing to enrol, participants attended 82% of the psychoeducational programme, and only 13% dropped out of the study. The between-group analyses revealed that the IG reported significantly greater mean satisfaction than the CG. Moreover, the intervention group was more satisfied with the information they received during the psychoeducational programme. Concerning the preliminary effects, the linear mixed model showed improvement in quality of life (the subscale relationship); however, other patient-reported outcomes did not show improvements.

Conclusions

This proof-of-concept randomised controlled trial supports the feasibility and acceptability of the user co-facilitated psychoeducational programme for patients newly diagnosed with ADHD in an outpatient setting. While preliminary findings indicate promise in enhancing patient-reported outcomes, a larger study is warranted to assess the intervention’s effectiveness rigorously.

Trial registration

NCT03425, 09/11/2017.
RCC-Supporter: supporting renal cell carcinoma treatment decision-making using machine learning
Authors: Song Won Hoon , Park Meeyoung
Published: September 2024

Background

The population diagnosed with renal cell carcinoma, especially in Asia, represents 36.6% of global cases, with the incidence rate of renal cell carcinoma in Korea steadily increasing annually. However, treatment options for renal cell carcinoma are diverse, depending on clinical stage and histologic characteristics. Hence, this study aims to develop a machine learning based clinical decision-support system that recommends personalized treatment tailored to the individual health condition of each patient.

Results

We reviewed the real-world medical data of 1,867 participants diagnosed with renal cell carcinoma between November 2008 and June 2021 at the Pusan National University Yangsan Hospital in South Korea. Data were manually divided into a follow-up group where the patients did not undergo surgery or chemotherapy (Surveillance), a group where the patients underwent surgery (Surgery), and a group where the patients received chemotherapy before or after surgery (Chemotherapy). Feature selection was conducted to identify the significant clinical factors influencing renal cell carcinoma treatment decisions from 2,058 features. These features included subsets of 20, 50, 75, 100, and 150, as well as the complete set and an additional 50 expert-selected features. We applied representative machine learning algorithms, namely Decision Tree, Random Forest, and Gradient Boosting Machine (GBM). We analyzed the performance of three applied machine learning algorithms, among which the GBM algorithm achieved an accuracy score of 95% (95% CI, 92–98%) for the 100 and 150 feature sets. The GBM algorithm using 100 and 150 features achieved better performance than the algorithm using features selected by clinical experts (93%, 95% CI 89–97%).

Conclusions

We developed a preliminary personalized treatment decision-support system (TDSS) called “RCC-Supporter” by applying machine learning (ML) algorithms to determine personalized treatment for the various clinical situations of RCC patients. Our results demonstrate the feasibility of using machine learning-based clinical decision support systems for treatment decisions in real clinical settings.
Paternal undernutrition and overnutrition modify semen composition and preimplantation embryo developmental kinetics in mice
Authors: Morgan Hannah L. , Eid Nader , Holmes Nadine , Henson Sonal , Wright Victoria , Coveney Clare , Winder Catherine , O’Neil Donna M. , Dunn Warwick B. , Boocock David J. , Watkins Adam J.
Published: September 2024

Background

The importance of parental diet in relation to eventual offspring health is increasing in prominence due to the increased frequency of parents of reproductive age consuming poor diets. Whilst maternal health and offspring outcome have been studied in some detail, the paternal impacts are not as well understood. A father’s poor nutritional status has been shown to have negative consequences on foetal growth and development and ultimately impact the long-term adult health of the offspring. In this study, we examined sperm- and seminal vesicle fluid-mediated mechanisms of preimplantation embryo development alterations in response to sub-optimal paternal diets.

Results

Male mice were fed a diet to model either under (low-protein diet (LPD)) or over (high-fat/sugar ‘Western’ diet (WD)) nutrition, LPD or WD supplemented with methyl donors or a control diet (CD) before mating with age-matched females. Male metabolic health was influenced by WD and MD-WD, with significant changes in multiple serum lipid classes and hepatic 1-carbon metabolites. Sperm RNA sequencing revealed significant changes to mRNA profiles in all groups when compared to CD (LPD: 32, MD-LPD: 17, WD: 53, MD-WD: 35 transcripts). Separate analysis of the seminal vesicle fluid proteome revealed a significant number of differentially expressed proteins in all groups (LPD: 13, MD-LPD: 27, WD: 24, MD-WD: 19) when compared to control. Following mating, in vitro time-lapse imaging of preimplantation embryos revealed a significant increase in the timing of development in all experimental groups when compared to CD embryos. Finally, qPCR analysis of uterine tissue at the time of implantation identified perturbed expression ofCd14andPtgs1following mating with WD-fed males.

Conclusions

Our current study shows that paternal nutritional status has the potential to influence male metabolic and reproductive health, impacting on embryonic development and the maternal reproductive tract. This study highlights potential direct (sperm-mediated) and indirect (seminal vesicle fluid-mediated) pathways in which a father’s poor diet could shape the long-term health of his offspring.
An algorithm for discontinuing mechanical ventilation in boys with x-linked myotubular myopathy after positive response to gene therapy: the ASPIRO experience
Authors: Graham Robert J. , Amin Reshma , Demirel Nadir , Edel Lisa , Lilien Charlotte , MacBean Victoria , Rafferty Gerrard F. , Sawnani Hemant , Schön Carola , Smith Barbara K. , Syed Faiza , Sarazen Micaela , Prasad Suyash , Rico Salvador , Perez Geovanny F.
Published: September 2024

X-linked myotubular myopathy (XLMTM) is a rare, life-threatening congenital myopathy. Most (80%) children with XLMTM have profound muscle weakness and hypotonia at birth resulting in severe respiratory insufficiency, the inability to sit up, stand or walk, and early mortality. At birth, 85–90% of children with XLMTM require mechanical ventilation, with more than half requiring invasive ventilator support. Historically, ventilator-dependent children with neuromuscular-derived respiratory failure of this degree and nature, static or progressive, are not expected to achieve complete independence from mechanical ventilator support. In the ASPIRO clinical trial (NCT03199469), participants receiving a single intravenous dose of an investigational gene therapy (resamirigene bilparvovec) started showing significant improvements in daily hours of ventilation support compared with controls by 24 weeks post-dosing, and 16 of 24 dosed participants achieved ventilator independence between 14 and 97 weeks after dosing. At the time, there was no precedent or published guidance for weaning chronically ventilated children with congenital neuromuscular diseases off mechanical ventilation. When the first ASPIRO participants started showing dramatically improved respiratory function, the investigators initiated efforts to safely wean them off ventilator support, in parallel with primary protocol respiratory outcome measures. A group of experts in respiratory care and physiology and management of children with XLMTM developed an algorithm to safely wean children in the ASPIRO trial off mechanical ventilation as their respiratory muscle strength increased. The algorithm developed for this trial provides recommendations for assessing weaning readiness, a stepwise approach to weaning, and monitoring of children during and after the weaning process.
Rapid imaging of intravenous gadolinium-based contrast agent (GBCA) entering ventricular cerebrospinal fluid (CSF) through the choroid plexus in healthy human subjects
Authors: Sun Yuanqi , Cao Di , Pillai Jay J. , Paez Adrian , Li Yinghao , Gu Chunming , Pogson Jacob M. , Knutsson Linda , Barker Peter B. , van Zijl Peter C. M. , Bakker Arnold , Ward Bryan K. , Hua Jun
Published: September 2024

Background

Pathways for intravenously administered gadolinium-based-contrast-agents (GBCAs) entering cerebrospinal-fluid (CSF) circulation in the human brain are not well-understood. The blood-CSF-barrier (BCSFB) in choroid-plexus (CP) has long been hypothesized to be a main entry-point for intravenous-GBCAs into CSF. Most existing studies on this topic were performed in animals and human patients with various diseases. Results in healthy human subjects are limited. Besides, most studies were performed using MRI methods with limited temporal resolution and significant partial-volume effects from blood and CSF.

Methods

This study employs the recently developed dynamic-susceptibility-contrast-in-the-CSF (cDSC) MRI approach to measure GBCA-distribution in the CSF immediately and 4 h after intravenous-GBCA administration in healthy subjects. With a temporal resolution of 10 s, cDSC MRI can track GBCA-induced CSF signal changes during the bolus phase, which has not been investigated previously. It employs a long echo-time (TE = 1347 ms) to suppress tissue and blood signals so that pure CSF signal is detected with minimal partial-volume effects. GBCA concentration in the CSF can be estimated from cDSC MRI. In this study, cDSC and FLAIR MRI were performed immediately and 4 h after intravenous GBCA administration in 25 healthy volunteers (age 48.9 ± 19.5 years; 14 females). Paired t-tests were used to compare pre-GBCA and post-GBCA signal changes, and their correlations with age were evaluated using Pearson-correlation-coefficients.

Results

At ~ 20 s post-GBCA, GBCA-induced cDSC signal changes were detected in the CSF around CP (ΔS/S = − 2.40 ± 0.30%; P < .001) but not in the rest of lateral ventricle (LV). At 4 h, significant GBCA-induced cDSC signal changes were observed in the entire LV (ΔS/S = − 7.58 ± 3.90%; P = .002). FLAIR MRI showed a similar trend. GBCA-induced CSF signal changes did not correlate with age.

Conclusions

These results provided direct imaging evidence that GBCAs can pass the BCSFB in the CP and enter ventricular CSF immediately after intravenous administration in healthy human brains. Besides, our results in healthy subjects established a basis for clinical studies in brain diseases exploiting GBCA-enhanced MRI to detect BCSFB dysfunction.
Individualized C1-2 intra-articular three-dimensional printed porous titanium alloy cage for craniovertebral deformity
Authors: Jian Qiang , Qin Shaw , Hou Zhe , Zhao Xingang , Liang Cong , Fan Tao
Published: September 2024

Background

Congenital craniovertebral deformity, including basilar invagination (BI) and atlantoaxial instability (AAI), are often associated with three-dimensional (3D) deformity, such as C1-2 rotational deformity, craniocervical kyphosis, C1 lateral inclination, among other abnormalities. Effective management of these conditions requires the restoration of the 3D alignment to achieve optimal reduction. Recently, 3D printing technology has emerged as a valuable tool in spine surgery, offering the significant advantage of allowing surgeons to customize the prosthesis design. This innovation provides an ideal solution for precise 3D reduction in the treatment of craniovertebral deformities.

Objective

This study aims to describe our approach to individualized computer-simulated reduction and the design of C1-2 intra-articular 3D printed porous titanium alloy cages for the quantitative correction of craniovertebral junction deformities.

Methods

A retrospective analysis was conducted on patients with craniovertebral deformities treated at our institution using individualized 3D-printed porous titanium alloy cages. Preoperative CT data were used to construct models for 3D realignment simulations. Cage designs were tailored to the simulated joint morphology following computer-assisted realignment. Preoperative and postoperative parameters were statistically analyzed.

Results

Fourteen patients were included in the study, with a total of 28 3D-printed porous titanium alloy cages implanted. There were no cases of C2 nerve root resection or vertebral artery injury. All patients experienced symptom relief and stable implant fixation achieved in all cases. No implant-related complications were reported.

Conclusion

The use of individualized computer-simulated reduction and the design of C1-2 intra-articular 3D printed porous titanium alloy cage facilitates precise 3D realignment in patients with craniovertebral deformities, demonstrating effectiveness in symptom relief and stability.