bluuebunny/crossref_metadata_2025 huggingface dataset:
The feasibility and usability of mixed reality teaching in a hospital setting based on self-reported perceptions of medical students
Authors: Johnston Michael , O’Mahony Megan , O’Brien Niall , Connolly Murray , Iohom Gabriella , Kamal Mohsin , Shehata Ahmed , Shorten George
Published: June 2024

Background

Clinical teaching during encounters with real patients lies at the heart of medical education. Mixed reality (MR) using a Microsoft HoloLens 2 (HL2) offers the potential to address several challenges: including enabling remote learning; decreasing infection control risks; facilitating greater access to medical specialties; and enhancing learning by vertical integration of basic principles to clinical application. We aimed to assess the feasibility and usability of MR using the HL2 for teaching in a busy, tertiary referral university hospital.

Methods

This prospective observational study examined the use of the HL2 to facilitate a live two-way broadcast of a clinician-patient encounter, to remotely situated third and fourth year medical students. System Usability Scale (SUS) Scores were elicited from participating medical students, clinician, and technician. Feedback was also elicited from participating patients. A modified Evaluation of Technology-Enhanced Learning Materials: Learner Perceptions Questionnaire (mETELM) was completed by medical students and patients.

Results

This was a mixed methods prospective, observational study, undertaken in the Day of Surgery Assessment Unit. Forty-seven medical students participated. The mean SUS score for medical students was 71.4 (SD 15.4), clinician (SUS = 75) and technician (SUS = 70) indicating good usability. The mETELM Questionnaire using a 7-point Likert Scale demonstrated MR was perceived to be more beneficial than a PowerPoint presentation (Median = 7, Range 6–7). Opinion amongst the student cohort was divided as to whether the MR tutorial was as beneficial for learning as a live patient encounter would have been (Median = 5, Range 3–6). Students were positive about the prospect of incorporating of MR in future tutorials (Median = 7, Range 5–7). The patients’ mETELM results indicate the HL2 did not affect communication with the clinician (Median = 7, Range 7–7). The MR tutorial was preferred to a format based on small group teaching at the bedside (Median = 6, Range 4–7).

Conclusions

Our study findings indicate that MR teaching using the HL2 demonstrates good usability characteristics for providing education to medical students at least in a clinical setting and under conditions similar to those of our study. Also, it is feasible to deliver to remotely located students, although certain practical constraints apply including Wi-Fi and audio quality.
Exploring the content of epilepsy fellowship program websites: an analysis of information available to applicants
Authors: Marsia Shayan , Kamran Alishba , Mahmood Shah Sayed Mustafa , Merchant Rameez Ali , Abbas Shan E.
Published: June 2024

Background

Program websites are essential resources in the process of residency and fellowship application. We evaluated the information furnished on these resources by Epilepsy fellowship programs. The extent of information provided was compared across geographic zones, academic affiliation, and national ranking.

Methods

A list of Epilepsy fellowship programs was derived from the Fellowship and Residency Electronic Interactive Database (FREIDA). Links to program websites were obtained directly from FREIDA or using Google’s search engine. Online data was categorized to reflect program information, education, recruitment, compensation, epilepsy center-specific information, and social media presence. Data points under each category were collected to develop a standardized scoring system. The frequency of criterion present was compared across geographic zones, academic affiliation, and national ranking using parametric and non-parametric statistical tests. Significance was determined at a p-value ≤ 0.05 for all cases. The study utilized IBM SPSS version 28 and Python 3.11.3.

Results

We analyzed 80 Epilepsy fellowship programs. The most reported feature was the program director’s name and email (100.0%). The least reported features included board pass rates (1.3%), preparatory boot camp (8.8%), and post-fellowship placements (11.3%). Programs were found to be well-represented on X (88.8%), Facebook (81.3%), and Instagram (71.3%). Most (85.0%) of the programs were searchable through Google. The scores for program information, education, recruitment, compensation, epilepsy center-specific information, and social media visibility did not significantly vary based on location, academic affiliation, or rank status.

Conclusions

Our results demonstrate that despite an online presence, there is much room for improvement in the content available to the applicant. To improve the Match process and attract a roster of well-informed fellows, Epilepsy fellowship programs should furnish program websites with up-to-date information relevant to program information, education, recruitment, compensation, and epilepsy center-specific information.
Compassionate Othering: the construction of refugee patients in medical students’ narratives – a qualitative study using story completion
Authors: Bauer Lena , Wienke Andreas , Führer Amand
Published: June 2024

Background

Refugees remain a marginalized population and are exposed to a variety of discriminatory processes, among them Othering which categorizes people as belonging or not-belonging according to certain ascribed characteristics. We explored how the narrative construction of refugee patients by medical students constitutes a form of Othering.

Methods

Using story completion, 124 5th year medical students at the Martin- Luther- University Halle-Wittenberg in October 2019 wrote a fictional story in response to a story stem situated in a medical practice. In a comparative approach, one patient presenting with abdominal pain lacks further characterization (version A) and the other is a refugee (version B). The stories were coded using qualitative content analysis by Mayring with a focus on content and narrative strategies (plot structure and perspective).

Results

We identified four themes: characters, medical condition, access to care and provision of substandard care. The stories were predominantly framed with a medical or an interaction-based plot structure and written from a process-oriented perspective. The themes in version B, supported by their use of narrative strategies, were largely contextualized within the patients’ history of migration. An empathic depiction of patient B and the students’ compassion for the patients facing substandard care were key motifs as well.

Conclusion

The perception of the version B patients predominantly as refugees establishes their construction as an Other. The students’ compassion acts as a representation of societal inequalities and remains an inept response without the tools to counter underlying discriminatory structures. Based on a discourse of deservingness, compassion alone therefore perpetuates Othering and highlights the need for structural competency training in medical school.
Patient perceptions of and experiences with stigma using telehealth for opioid use disorder treatment: a qualitative analysis
Authors: Couch Jessica V. , Whitcomb Mackenzie , Buchheit Bradley M. , Dorr David A. , Malinoski Darren J. , Korthuis P. Todd , Ono Sarah S. , Levander Ximena A.
Published: June 2024

Background

Patients with opioid use disorder (OUD) experience various forms of stigma at the individual, public, and structural levels that can affect how they access and engage with healthcare, particularly with medications for OUD treatment. Telehealth is a relatively new form of care delivery for OUD treatment. As reducing stigma surrounding OUD treatment is critical to address ongoing gaps in care, the aim of this study was to explore how telehealth impacts patient experiences of stigma.

Methods

In this qualitative study, we interviewed patients with OUD at a single urban academic medical center consisting of multiple primary care and addiction clinics in Oregon, USA. Participants were eligible if they had (1) at least one virtual visit for OUD between March 2020 and December 2021, and (2) a prescription for buprenorphine not exclusively used for chronic pain. We conducted phone interviews between October and December 2022, then recorded, transcribed, dual-coded, and analyzed using reflexive thematic analysis.

Results

The mean age of participants (n = 30) was 40.5 years (range 20–63); 14 were women, 15 were men, and two were transgender, non-binary, or gender-diverse. Participants were 77% white, and 33% had experienced homelessness in the prior six months. We identified four themes regarding how telehealth for OUD treatment shaped patient perceptions of and experiences with stigma at the individual (1), public (2–3), and structural levels (4): (1) Telehealth offers wanted space and improved control over treatment setting; (2) Public stigma and privacy concerns can impact both telehealth and in-person encounters, depending on clinical and personal circumstances; (3) The social distance of telehealth could mitigate or exacerbate perceptions of clinician stigma, depending on both patient and clinician expectations; (4) The increased flexibility of telehealth translated to perceptions of increased clinician trust and respect.

Conclusions

The forms of stigma experienced by individuals with OUD are complex and multifaceted, as are the ways in which those experiences interact with telehealth-based care. The mixed results of this study support policies allowing for a more individualized, patient-centered approach to care delivery that allows patients a choice over how they receive OUD treatment services.
Clinical characteristic, management, and outcomes of cervical spinal brucellosis: a retrospective cohort study over 1-year postoperative follow-up
Authors: Zhang Tao , Ma Lihua , Liu Hua , Zhang Lian , Yang Chengwei , Li Songkai
Published: June 2024

Background

The incidence of cervical spinal brucellosis is low, only a few case reports have been published, and case series are not widely reported in the medical literature. Therefore, clinical features, management, and outcomes of cervical spinal brucellosis are relatively unknown. In this series, the authors report 15 cases of patients with cervical spinal brucellosis, including clinical characteristic, imaging findings, management plans, the institution’s experience, and outcomes at 1 year postoperatively.

Methods

The study reviewed the clinical and radiographic records of 15 patients who received antimicrobial pharmacotherapy, and anterior cervical debridement and fusion for cervical spinal brucellosis. The data collected included patient demographic characteristics, spinal level affected, abscess, neurology, pathological reports, duration and type of antimicrobial regimens, details of orthopedic management, and complications incurred during the procedure.

Results

Neck pain (100%) and limb paralysis (86.7%) were the most common clinical presentations, and the disease had a rapid progression. The C6-7 segment was the most commonly affected segment, followed by C4-5 and C5-6. Imaging commonly revealed epidural or paravertebral abscesses (80%). There was a significant improvement in the VAS, JOA, and NDI scores three months after surgery, and the scores continued to improve until the final follow-up. There was a statistically significant difference between the pre- and postoperative scores (P < 0.05). The ESR and CRP levels returned to normal within three months postoperatively, being 7.7 ± 4.5 mm/h and 7.55 ± 3.48 mg/L, respectively. There were statistically significant differences between the pre- and postoperative levels (P < 0.05). The positive rate of bacterial culture testing of pus or lesion tissues was only 40%, but blood cultures revealed an even lower positivity rate (33.3%). The average antimicrobial pharmacotherapy regimen duration was 6.1 ± 1.9 months. All patients achieved intervertebral bone fusion within 8 months (4.8 ± 1.4 months) after surgery and were cured with non-recurrence.

Conclusions

Spinal brucellosis rarely affects the cervical region, but its impact is more dangerous due to potential complications such as paraplegia or tetraplegia arising from epidural abscesses that compress the spinal cord. Surgical debridement, along with essential antimicrobial therapy, is an effective strategy and can lead to satisfactory prognosis in managing cervical spinal brucellosis.
Shortness of breath on the day of discharge: an early alert for post-discharge complications in patients undergoing lung cancer surgery
Authors: Kang Dan , Lei Cheng , Zhang Yong , Wei Xing , Dai Wei , Xu Wei , Zhang Jingyu , Yu Qingsong , Su Xueyao , Huang Yanyan , Shi Qiuling
Published: June 2024

Purpose

Symptom assessment based on patient-reported outcome (PRO) can correlate with disease severity, making it a potential tool for threshold alerts of postoperative complications. This study aimed to determine whether shortness of breath (SOB) scores on the day of discharge could predict the development of post-discharge complications in patients who underwent lung cancer surgery.

Methods

Patients were from a study of a dynamic perioperative rehabilitation cohort of lung cancer patients focusing on patient-reported outcomes. Patients were assessed using the Perioperative Symptom Assessment Scale for Lung surgery (PSA-Lung). Logistic regression model was used to examine the potential association between SOB on the day of discharge and complications within 3 months after discharge. The post-discharge complications were taken as the anchor variable to determine the optimal cutpoint for SOB on the day of discharge.

Results

Complications within 3 months post-discharge occurred in 71 (10.84%) of 655 patients. Logistic regression analysis revealed that being female (OR 1.764, 95% CI 1.006–3.092, P < 0.05) and having two chest tubes (OR 2.026, 95% CI 1.107–3.710, P < 0.05) were significantly associated with post-discharge complications. Additionally, the SOB score on the day of discharge (OR 1.125, 95% CI 1.012–1.250, P < 0.05) was a significant predictor. The optimal SOB cutpoint was 5 (on a scale of 0–10). Patients with an SOB score ≥ 5 at discharge experienced a lower quality of life 1 month later compared to those with SOB score<5 at discharge (73 [50–86] vs. 81 [65–91], P < 0.05).

Conclusion

SOB on the day of discharge may serve as an early warning sign for the timely detection of 3 month post-discharge complications.
Effects of different anesthetic regimens on postoperative cognitive function of elderly patients undergoing thoracic surgery: a double-blinded randomized controlled trial
Authors: Xie Li , Wei Xin , He Keqiang , Wang Sheng , Xu Min
Published: June 2024

Objective

Postoperative cognitive dysfunction (POCD) is a serious surgical complication. We assessed the different POCD incidences between anesthesia using sevoflurane and sevoflurane combined with dexmedetomidine, with propofol-based sedation in elderly patients who underwent a thoracic surgical procedure.

Methods

A total of 90 patients aged 65 to 80 years old who underwent a thoracic surgical procedure at our hospital and 15 nonsurgical participants as controls, were enrolled in this study. Patients were divided in a randomized 1:1:1 ratio into 3 groups. All participants were randomized into a trial with three anesthesia groups (P, PS, PSD) or a control group (C) of healthy matches. All trial groups received distinct anesthetic combinations during surgery, while controls mirrored patient criteria.Group P (propofol and remifentanil were maintained during the surgery), Group PS (propofol, remifentanil, and sevoflurane were maintained during the surgery), and Group PSD (propofol, remifentanil, sevoflurane, and dexmedetomidine were maintained during the surgery).All participants were rated using a series of cognitive assessment scales before and three days after surgery. All participants were interviewed over the telephone, 7 days, 30 days, and 90 days postoperatively.

Results

POCD incidences in the PSD (combined anesthetization with propofol, sevoflurane, and dexmedetomidine) group was significantly lower than that in the PS (combined anesthetization with propofol and sevoflurane) group, 1 day post-surgery (10.0% vs. 40.0%, P = 0.008), and the results were consistent at 3 days post-surgery. When the patients were assessed 7 days, 30 days, and 90 days postoperatively, there was no significant difference in POCD incidence among the three groups. Multivariate logistic regression analysis of POCD one day after surgery showed that education level was negatively correlated with incidence of POCD (P = 0.018) and single lung ventilation time was positively correlated with incidence of POCD (P = 0.001).

Conclusion

For elderly patients who underwent a thoracic surgical procedure, dexmedetomidine sedation shows an obvious advantage on improving short-term POCD incidence, which is caused by sevoflurane.
Volatile vs Total intravenous Anaesthesia for major non-cardiac surgery: a pragmatic randomised triaL (VITAL)
Authors: Yeung Joyce , Jhanji Shaman , Braun John , Dunn Janet , Eggleston Lucy , Frempong Samuel , Hiller Louise , Jacques Claire , Jefford Monica , Mason James , Moonesinghe Ramani , Pearse Rupert , Shelley Benjamin , Vindrola Cecilia ,   on behalf of VITAL trial team
Published: June 2024

Background

Improving outcomes after surgery is a major public health research priority for patients, clinicians and the NHS. The greatest burden of perioperative complications, mortality and healthcare costs lies amongst the population of patients aged over 50 years who undergo major non-cardiac surgery. The Volatile vs Total Intravenous Anaesthesia for major non-cardiac surgery (VITAL) trial specifically examines the effect of anaesthetic technique on key patient outcomes: quality of recovery after surgery (quality of recovery after anaesthesia, patient satisfaction and major post-operative complications), survival and patient safety.

Methods

A multi-centre pragmatic efficient randomised trial with health economic evaluation comparing total intravenous anaesthesia with volatile-based anaesthesia in adults (aged 50 and over) undergoing elective major non-cardiac surgery under general anaesthesia.

Discussion

Given the very large number of patients exposed to general anaesthesia every year, even small differences in outcome between the two techniques could result in substantial excess harm. Results from the VITAL trial will ensure patients can benefit from the very safest anaesthesia care, promoting an early return home, reducing healthcare costs and maximising the health benefits of surgical treatments.

Trial registration

ISRCTN62903453. September 09, 2021.
Strengths, challenges, and strategies for implementing pragmatic multicenter randomized controlled trials (RCTs): example of the Personalized Citizen Assistance for Social Participation (APIC) trial
Authors: Levasseur Mélanie , Chaintré-Prieur Agathe , Dubois Marie-France , Maisonneuve Catherine , Filiatrault Johanne , Vassiliadis Helen-Maria
Published: June 2024

Background

Randomized controlled trials (RCTs) are rigorous scientific research designs for evaluating intervention effectiveness. However, implementing RCTs in a real-world context is challenging. To develop strategies to improve its application, it is essential to understand the strengths and challenges of this design. This study thus aimed to explore the strengths, challenges, and strategies for improving the implementation of a pragmatic multicenter, prospective, two-arm RCT evaluating the effects of the Personalized Citizen Assistance for Social Participation (Accompagnement-citoyen Personnalisé d’Intégration Communautaire: APIC; weekly 3-h personalized stimulation sessions given by a trained volunteer over a 12-month period) on older adults’ health, social participation, and life satisfaction.

Methods

A multiple case study was conducted with 14 participants, comprising one research assistant, seven coordinators, and six managers of six community organizations serving older adults, who implemented the APIC in the context of a RCT. Between 2017 and 2023, qualitative data were extracted from 24 group meetings, seven semi-directed interviews, emails exchanged with the research team, and one follow-up document.

Results

Aged between 30 and 60 (median ± SIQR: 44.0 ± 6.3), most participants were women from organizations already offering social participation interventions for older adults and working with the public sector. Reported strengths of this RCT were its relevance in assessing an innovative intervention to support healthy aging, and the sharing of common goals, expertise, and strategies with community organizations. Challenges included difficulties recruiting older adults, resistance to potential control group assignments, design complexity, and efforts to mobilize and engage volunteers. The COVID-19 pandemic lockdown and health measures exacerbated challenges related to recruiting older adults and mobilizing volunteers and complicated delivery of the intervention. The strategies that mostly overcame difficulties in recruiting older adults were reducing sample size, simplifying recruitment procedures, emphasizing the health follow-up, extending partnerships, and recognizing and supporting volunteers better. Because of the lockdown and physical distancing measures, the intervention was also adapted for remote delivery, including via telephone or videoconferencing.

Conclusion

Knowledge of the strengths and challenges of pragmatic RCTs can contribute to the development of strategies to facilitate implementation studies and better evaluate health and social participation interventions delivered under real-life conditions.

Trial registration

NCT03161860; Pre-results. Registered on May 22, 2017.
The new phthalic acid-based deep eutectic solvent as a versatile catalyst for the synthesis of pyrimido[4,5-d]pyrimidines and pyrano[3,2-c]chromenes
Authors: Monem Arezo , Habibi Davood , Alizadeh Abdolhamid , Goudarzi Hadis
Published: June 2024

A new DES (MTPPBr-PHTH-DES) was prepared from a mixture of methyltriphenyl-phosphonium bromide (MTPPBr) and phthalic acid (PHTH). The eutectic point phase diagram showed that a one-to-one molar ratio of MTPPBr to PHTH is the optimal molar ratio for the synthesis of new DES. Then, it was characterized with various techniques such as FT-IR, TGA/DTA, densitometer, eutectic point, and NMR and used as a novel acid catalyst in the synthesis of pyrimido[4,5-d]pyrimidines and pyrano[3,2-c]chromes in solvent-free condition. Short reaction time, low temperature, high efficiency, green condition, and easy recycling and separation of the DES catalyst are among the most important features of the presented method.
Association between indoor residual spraying and the malaria burden in Zambia and factors associated with IRS refusals: a case-control study in Vubwi District
Authors: Zhang Wan-Xue , Zhou Yiguo , Tembo Elijah , Du Juan , Zhang Shan-Shan , Wei Ting-Ting , Liu Ya-Qiong , Wang Chao , Zulu Reuben , Hamainza Busiku , Cui Fuqiang , Lu Qing-Bin
Published: June 2024

Background

Indoor residual spraying (IRS) has been implemented to prevent malaria in Zambia for several decades, but its effectiveness has not been evaluated long term and in Vubwi District yet. This study aimed to assess the association between IRS and the malaria burden in Zambia and Vubwi District and to explore the factors associated with refusing IRS.

Methods

A retrospective study was used to analyze the association between IRS and malaria incidence in Zambia in 2001–2020 and in Vubwi District in 2014–2020 by Spearman correlation analysis. A case-control study was used to explore the factors associated with IRS refusals by households in Vubwi District in 2021. A logistic regression model was performed to identify factors associated with IRS refusals.

Results

The malaria incidence reached its peak (391/1000) in 2001 and dropped to the lowest (154/1000) in 2019. The annual percentage change in 2001–2003, 2003–2008, 2008–2014, 2014–2018 and 2018–2020 was − 6.54%, − 13.24%, 5.04%, − 10.28% and 18.61%, respectively. A significantly negative correlation between the percentage of population protected by the IRS against the total population in Zambia (coverage) and the average malaria incidence in the whole population was observed in 2005–2020 (r = − 0.685, P = 0.003) and 2005–2019 (r = − 0.818, P < 0.001). Among 264 participants (59 in the refuser group and 205 in the acceptor group), participants with specific occupations (self-employed: OR 0.089, 95% CI 0.022–0.364; gold panning: OR 0.113, 95% CI 0.022–0.574; housewives: OR 0.129, 95% CI 0.026–0.628 and farmers: OR 0.135, 95% CI 0.030–0.608 compared to employees) and no malaria case among household members (OR 0.167; 95% CI 0.071–0.394) had a lower risk of refusing IRS implementation, while those with a secondary education level (OR 3.690, 95% CI 1.245–10.989) had a higher risk of refusing IRS implementation compared to those who had never been to school.

Conclusions

Increasing coverage with IRS was associated with decreasing incidence of malaria in Zambia, though this was not observed in Vubwi District, possibly because of the special geographical location of Vubwi District. Interpersonal communication and targeted health education should be implemented at full scale to ensure household awareness and gain community trust.
Uncommon triggers of insulin autoimmune syndrome: a case report
Authors: Abeyagunawardena Ishanya , Madurapperuma Chirath , Thuvarakan Poobalasingham , Thowfeek Zeenath , Sujeewa Nagaratnam , Katulanda Gaya , Karunatilake Harindra
Published: June 2024

Background

Insulin autoantibody syndrome (IAS), or Hirata disease, is caused by high concentrations of insulin autoantibodies, which result in spontaneous, mainly post-prandial, hypoglycemic episodes. We report a case of a previously healthy 67-year-old man presenting with recurrent fasting hypoglycemia culminating in a diagnosis of insulin autoimmune syndrome linked to omeprazole and probably spices, namely, coriander, and ginger.

Case presentation

A previously healthy 67-year-old Sinhalese man presented with recurrent syncopal attacks for 3 months, which were found to be hypoglycemic episodes. He experienced mainly fasting hypoglycemic attacks, at a frequency gradually increasing to daily attacks. His cardiovascular, respiratory, abdominal, and neurologic examinations were normal. He was found to have insulin levels > 6000 mU/L and a post-polyethylene glycol insulin recovery of less than 9.5%. Contrast-enhanced computed tomography of the pancreas was normal. The diagnosis of insulin autoantibody syndrome was confirmed by testing for the insulin autoantibody level, yielding a level of > 300 U/mL. With regard to a possible trigger, he had a history of omeprazole intake for 2 weeks, 4 weeks prior to the onset of symptoms. He also consumed an herbal supplement containing coriander and ginger extracts daily for a period of 1 year, approximately 2 years prior to the onset of hypoglycemic attacks. He was commenced on prednisolone 30 mg daily, and hypoglycemic episodes responded dramatically, and thus he was tapered off corticosteroids.

Conclusion

Omeprazole-induced insulin autoantibody syndrome is likely in this patient; however, the known hypoglycemic effects of coriander and ginger make it worthwhile to consider a possible association with insulin autoantibody syndrome. In addition, this case report highlights the need to consider insulin autoantibody syndrome even in patients presenting with fasting hypoglycemic attacks.
Ameliorating and refining islet organoids to illuminate treatment and pathogenesis of diabetes mellitus
Authors: Li Yushan , Xu Meiqi , Chen Jiali , Huang Jiansong , Cao Jiaying , Chen Huajing , Zhang Jiayi , Luo Yukun , Wang Yazhuo , Sun Jia
Published: June 2024

Diabetes mellitus, a significant global public health challenge, severely impacts human health worldwide. The organoid, an innovative in vitro three-dimensional (3D) culture model, closely mimics tissues or organs in vivo. Insulin-secreting islet organoid, derived from stem cells induced in vitro with 3D structures, has emerged as a potential alternative for islet transplantation and as a possible disease model that mirrors the human body’s in vivo environment, eliminating species difference. This technology has gained considerable attention for its potential in diabetes treatment. Despite advances, the process of stem cell differentiation into islet organoid and its cultivation demonstrates deficiencies, prompting ongoing efforts to develop more efficient differentiation protocols and 3D biomimetic materials. At present, the constructed islet organoid exhibit limitations in their composition, structure, and functionality when compared to natural islets. Consequently, further research is imperative to achieve a multi-tissue system composition and improved insulin secretion functionality in islet organoid, while addressing transplantation-related safety concerns, such as tumorigenicity, immune rejection, infection, and thrombosis. This review delves into the methodologies and strategies for constructing the islet organoid, its application in diabetes treatment, and the pivotal scientific challenges within organoid research, offering fresh perspectives for a deeper understanding of diabetes pathogenesis and the development of therapeutic interventions.
AutoTemplate: enhancing chemical reaction datasets for machine learning applications in organic chemistry
Authors: Chen Lung-Yi , Li Yi-Pei
Published: June 2024

This paper presents AutoTemplate, an innovative data preprocessing protocol, addressing the crucial need for high-quality chemical reaction datasets in the realm of machine learning applications in organic chemistry. Recent advances in artificial intelligence have expanded the application of machine learning in chemistry, particularly in yield prediction, retrosynthesis, and reaction condition prediction. However, the effectiveness of these models hinges on the integrity of chemical reaction datasets, which are often plagued by inconsistencies like missing reactants, incorrect atom mappings, and outright erroneous reactions. AutoTemplate introduces a two-stage approach to refine these datasets. The first stage involves extracting meaningful reaction transformation rules and formulating generic reaction templates using a simplified SMARTS representation. This simplification broadens the applicability of templates across various chemical reactions. The second stage is template-guided reaction curation, where these templates are systematically applied to validate and correct the reaction data. This process effectively amends missing reactant information, rectifies atom-mapping errors, and eliminates incorrect data entries. A standout feature of AutoTemplate is its capability to concurrently identify and correct false chemical reactions. It operates on the premise that most reactions in datasets are accurate, using these as templates to guide the correction of flawed entries. The protocol demonstrates its efficacy across a range of chemical reactions, significantly enhancing dataset quality. This advancement provides a more robust foundation for developing reliable machine learning models in chemistry, thereby improving the accuracy of forward and retrosynthetic predictions. AutoTemplate marks a significant progression in the preprocessing of chemical reaction datasets, bridging a vital gap and facilitating more precise and efficient machine learning applications in organic synthesis.

Scientific contribution

The proposed automated preprocessing tool for chemical reaction data aims to identify errors within chemical databases. Specifically, if the errors involve atom mapping or the absence of reactant types, corrections can be systematically applied using reaction templates, ultimately elevating the overall quality of the database.

Graphical Abstract
Effects of various prosthetic methods for patients with Kennedy Class I partial edentulism on oral hypofunction, subjective symptoms, and oral health-related quality of life
Authors: Morinaga Daisaku , Nagai Shoji , Kaku Toshio , Itoh Takatoshi , Soejima Yoshiki , Takeshita Fumitaka , Horikawa Tadashi , Abe Naruyoshi , Iijima Toshikazu , Soejima Daigo , Hara Toshihiro , Sato Ryuta , Murakami Mamoru , Sawase Takashi , Nishimura Masahiro
Published: June 2024

Purpose

This propensity score matching, multicenter, cross-sectional study was performed to examine the effects of various prosthetic methods for dental clinic outpatients with Kennedy Class I partial edentulism (KCIPE) on oral hypofunction, subjective frailty symptoms, and oral health-related quality of life (QOL).

Methods

Patients (n = 348) were classified into the following three groups for analysis: NT, patients with natural dentition providing intermaxillary contact in four occlusal supporting zones; RPD, patients with KCIPE who received removable partial dentures; and ISFP, patients with KCIPE who received implant-supported fixed prostheses. Participants' basic characteristics were recorded, and oral function tests were conducted. Subjective symptoms of physical and oral frailty were investigated via questionnaire. Oral health-related QOL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP-JP16). Propensity score matching was performed to adjust for patient background factors that could influence oral hypofunction in each group.

Results

Compared with the ISFP group, the RPD group had significantly higher rates of poor oral hygiene, reduced occlusal force, decreased masticatory function, and declines in swallowing function and oral hypofunction; the odds ratio for oral hypofunction was 4.67. Compared with the ISFP group, the RPD group had significantly greater subjective symptoms of physical frailty and oral frailty, as well as higher OHIP scores.

Conclusions

Prosthetic treatment of KCIPE affected oral hypofunction, subjective frailty symptoms, and oral health-related QOL in dental clinic outpatients.
Comparative study of machine learning algorithms for wind speed prediction in Dhaka, Bangladesh
Authors: Hossain Mohammad Liton , Shams S. M. Nasif , Ullah Saeed Mahmud
Published: June 2024

This study evaluated the performance of multiple models that used machine learning to anticipate wind speed in the city of Dhaka. The NASA Power website provided the data set for this investigation. The models used for prediction included the decision tree regressor, support vector regressor, random forest, linear regression, neural network and polynomial regression. A hold-out check and k-fold cross-validation were used to assess how well these models performed. With the highest R2 scores and lowest RMSEs on both the validation and test sets, the results demonstrated that the polynomial regression model performed the best. With the lowest R2 scores and largest RMSEs on both sets, the decision tree model scored the poorest. High R2 scores and low RMSEs were achieved by the random forest model, which had comparable performance to the polynomial regression model but required a longer computation time. In addition, the neural network model demonstrated commendable predictive accuracy, yielding an R2 score of 0.67 and a low RMSE of 0.57. However, its application is contingent on the availability of substantial computational resources, given its extensive computation time of 457.93 s. The study concludes by highlighting the efficacy of the Polynomial Regression model as the optimal choice for wind speed prediction in Dhaka, offering a balance between superior performance and efficient computation. This insight provides valuable guidance for practitioners and researchers seeking effective models for similar applications.
cGMP compliant one-step, one-pot automated [18F]FBnTP production for clinical imaging of mitochondrial activity
Authors: Lin Mai , Pham Cong-Dat , Ta Robert T. , Manning H. Charles
Published: June 2024

Background

4-[18F]fluorobenzyl-triphenylphosphonium ([18F]FBnTP) is a lipophilic cation PET tracer. The cellular uptake of [18F]FBnTP is correlated with oxidative phosphorylation by mitochondria, which has been associated with multiple critical diseases. To date, [18F]FBnTP has been successfully applied for imaging myocardial perfusion, assessment of severity of coronary artery stenosis, delineation of the ischemic area after transient coronary occlusion, and detection/quantification of apoptosis in various animal models. Recent preclinical and clinical studies have also expanded the possibilities of using [18F]FBnTP in oncological diagnosis and therapeutic monitoring. However, [18F]FBnTP is typically prepared through a tediously lengthy four-step, three-pot reaction and required multiple synthesizer modules; Thus, such an approach remains a challenge for this promising radiopharmaceutical to be implemented for routine clinical studies. Herein, we report an optimized one-step, one-pot automated approach to produce [18F]FBnTP through a single standard commercially-available radiosynthesizer that enables centralized production for clinical use.

Results

The fully automated production of [18F]FBnTP took less than 55 min with radiochemical yields ranging from 28.33 ± 13.92% (non-decay corrected), apparent molar activity of 69.23 ± 45.62 GBq/µmol, and radiochemical purities of 99.79 ± 0.41%. The formulated [18F]FBnTP solution was determined to be sterile and colorless with a pH of 4.0–6.0. Our data has indicated no observable radiolysis after 8 h from the time of final product formulation and maximum assay of 7.88 GBq.

Conclusions

A simplified and cGMP-compliant radiosynthesis of [18F]FBnTP has been established on the commercially available synthesizer in high activity concentration and radiochemical purity. While the preclinical and clinical studies using [18F]FBnTP PET are currently underway, the automated approaches reported herein facilitate clinical adoption of this radiotracer and warrant centralized production of [18F]FBnTP for imaging multiple patients.
Belonging, happiness, freedom and empowerment—a qualitative study of patients’ understanding of health in early rheumatoid arthritis
Authors: Landgren Ellen , Mogard Elisabeth , Bremander Ann , Lindqvist Elisabet , Nylander Maria , Larsson Ingrid
Published: June 2024

Background

Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory joint disease, that influences patients’ health in different ways, including physical, social, emotional, and psychological aspects. The goal of rheumatology care is to achieve optimal health and personalised care and therefore, it is essential to understand what health means for patients in the early course of RA. The aim of this study was to describe the understanding of health among patients with early RA.

Methods

The study had a descriptive qualitative design with a phenomenographic approach. Phenomenography is used to analyse, describe, and understand various ways people understand or experience a phenomenon, in this study, patients’ understandings of health. Individual semi-structured interviews were conducted with 31 patients (22 women and nine men, aged (38–80) with early RA, defined as a disease duration of < 1 year, and disease-modifying anti-rheumatic drugs (DMARDs) for 3–7 months. The phenomenographic analysis was conducted in 7 steps, and the outcome space presents the variation in understanding and the interrelation among categories. In accordance with the European Alliance of Associations for Rheumatology’s (EULAR) recommendations, a patient research partner participated in all phases of the study.

Results

The analysis revealed four main descriptive categories: ‘Health as belonging’ was described as experiencing a sense of coherence. ‘Health as happiness’ was understood as feeling joy in everyday life. ‘Health as freedom’ was understood as feeling independent. ‘Health as empowerment’ was understood as feeling capable. Essential health aspects in early RA are comprised of a sense of coherence, joy, independence, and the capability to manage everyday life.

Conclusions

This study revealed that patients’ perception of health in early RA encompasses various facets, including a sense of belonging, happiness, freedom, and empowerment. It highlighted that health is multifaceted and personal, emphasizing the importance of acknowledging this diversity in providing person-centred care. The findings can guide healthcare professionals to deepen patients’ participation in treatment goals, which may lead to better treatment adherence and health outcomes.
Prostate volume: does it predict patient outcomes following prostate artery embolisation? A retrospective cohort study
Authors: Wise Robert , Fu Howell , Tapping Charles Ross
Published: June 2024

Prostate artery embolisation (PAE) is a minimally invasive procedure commonly performed to treat lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia. International Prostate Symptom Score (IPSS) is a validated patient questionnaire quantifying LUTS and is used for patient selection for PAE, but it is largely subjective. Prostate volume is an easily estimated objective parameter across multiple imaging modalities. No strict threshold of prostate volume is established as a selection criterion for PAE, but it is generally accepted that prostate volume should be over 40 to 50 mL.

We looked at a sample of 65 cases performed at a large teaching hospital between 2017 and 2019 with a minimum of four years follow up. Embospheres between 100 to 500 microns were injected into the prostatic arteries bilaterally (if technically feasible). A ‘bullet shape’ model was used to estimate prostatic volume from initial CT. N = 13 had an estimated volume < 51 mL (range 31-50 mL). IPSS before and at 3 months post-procedure were collected.

80% of patients indicated a beneficial response to PAE (IPSS improvement > 5). 23% of patients required further PAE procedure or surgery. No major complications were recorded. The mean change in IPSS under 51 mL compared to over 51 mL cohort was 10.2 versus 11 (standard deviation 7.5 versus 7.3) (p = 0.44, 2 tailed Student’s T-test).

There was no statistically significant difference in the IPSS improvement or outcome of small volume prostates under 51 mL compared to large volume. Our results suggest that prostate volume should not be used to exclude patients for PAE.
Cannabidiol decreases histological intestinal injury in a neonatal experimental model of necrotizing enterocolitis
Authors: Huertos Soto Nerea , Gómez Cervantes Juan Manuel , Fernández Aceñero María Jesús , Soto Beauregard María del Carmen
Published: June 2024

Background

Necrotizing enterocolitis (NEC) is a severe inflammatory bowel disease in neonates. Our group has developed an experimental model of NEC, with an effectiveness of 73%. Cannabidiol (CBD) is an innovative treatment for neonatal cerebral hypoxic-ischemic pathologies due to its neuroprotective effect, as a potent anti-inflammatory and reducing oxidative stress substance.

Our aim was to evaluate the effect of CBD on intestinal lesions in an experimental model of NEC.

Results

Mortality and intestinal histological damage was significantly lower in the CBD group compared to the rest (p<0.05), establishing CBD as a protective factor against the development of NEC (OR=0.0255; 95% CI=0.0015-0.4460). At IHQ level (TUNEL technique), a lower cell death rate was also observed in the CBD group compared to the VEH group (p<0.05).

Conclusions

In our experimental model, intraperitoneal CBD acts as a protective factor against NEC, resulting in less histological damage and a lower rate of intestinal cell death.
Keratin-Positive Giant Cell Tumor of Bone and Soft Tissue With HMGA2::NCOR2 Fusion in Children Under 10 With Response to Imatinib Therapy: A Case Series
Authors: Rungsiprakarn Phassawan , Ryan Anne L. , Wong Daniel D. , Luo Minjie , Kazahaya Ken , Arkader Alexandre , Lau Loretta M.S. , Ajuyah Pamela , Rudzinski Erin , Kreiger Portia A. , Roebuck Derek J. , Surrey Lea F. , Foo Tiffany S.Y.
Published: June 2024

HMGA2::NCOR2 keratin-positive giant cell tumors in children with response to imatinib in an infant
On the Einstein-de Haas effect in van der Waals microelectromechanical systems
Authors: Koliushenkov Maksim A. , Pyatakov Alexander P.
Published: June 2024

The electric-field–induced gyromagnetic effect in antiferromagnetic 2D films, analogous to the classical Einstein-de Haas effect in ferromagnetic materials, is considered. It is shown that for the micrometer-sized flakes of antiferromagnetic van der Waals materials having a non-diagonal tensor of the magnetoelectric effect, the magnitude of the electrically induced Einstein-de Haas effect is sufficient to be detected with the conventional optical lever approach of an atomic force microscope.
Genome-wide Methylation Dynamics and Context-dependent Gene Expression Variability in Differentiating Preadipocytes
Authors: Yadav Binduma , Singh Dalwinder , Mantri Shrikant , Rishi Vikas
Published: June 2024

Obesity, characterized by the accumulation of excess fat, is a complex condition resulting from the combination of genetic and epigenetic factors. Recent studies have found correspondence between DNA methylation and cell differentiation, suggesting a role of the former in cell fate determination. There is a lack of comprehensive understanding concerning the underpinnings of preadipocyte differentiation, specifically when cells are undergoing terminal differentiation (TD). To gain insight into dynamic genome-wide methylation, 3T3 L1 preadipocyte cells were differentiated by a hormone cocktail. The genomic DNA was isolated from undifferentiated cells and 4 hours, 2 days postdifferentiated cells, and 15 days TD cells. We employed whole-genome bisulfite sequencing (WGBS) to ascertain global genomic DNA methylation alterations at single base resolution as preadipocyte cells differentiate. The genome-wide distribution of DNA methylation showed similar overall patterns in pre-, post-, and terminally differentiated adipocytes, according to WGBS analysis. DNA methylation decreases at 4 hours after differentiation initiation, followed by methylation gain as cells approach TD. Studies revealed novel differentially methylated regions (DMRs) associated with adipogenesis. DMR analysis suggested that though DNA methylation is global, noticeable changes are observed at specific sites known as “hotspots.” Hotspots are genomic regions rich in transcription factor (TF) binding sites and exhibit methylation-dependent TF binding. Subsequent analysis indicated hotspots as part of DMRs. The gene expression profile of key adipogenic genes in differentiating adipocytes is context-dependent, as we found a direct and inverse relationship between promoter DNA methylation and gene expression.
Engines of the Future
Authors: Cheney-Lippold John
Published: June 2024

Chess engines are suites of algorithms that evaluate game positions through prediction—they calculate billions of possible moves, dozens of steps into the future state of play. And over the past two decades, these algorithms have usurped humans as the principal arbiters of chess knowledge. Openings, tactics, and strategies are now all authenticated, and often dictated, by engine analysis, leading to new styles of play. This article uses the example of predictive chess engines to conceptualize an emergent temporal interplay between the future and the present. Drawing inspiration from historical metaphors of geology, this article proposes a topographical approach to temporal becoming. In this approach, engine predictions facilitate not preparations for some forecasted future state, but future-reliant calibrations of present activity, where second-by-second algorithmic futures are used to make second-by-second decisions.