bluuebunny/crossref_metadata_2025 huggingface dataset:
Sweden’s front-line: an ethnographic approach to understanding child protection decisions
Authors: Mesinovic Klecina Lejla , Olin Elisabeth , Alstam Kristina
Published: October 2023

The focus of this article is on exploring the rationales behind social workers’ decision-making in everyday tasks that involve handling new referrals regarding children and families. Such decisions are made in a legal context, but at the same time require the use of discretionary space and reasoning based on sources of professional knowledge. Drawing on qualitative data compiled through an ethnographic approach, this study provides an insight into everyday practice, reasoning and decision-making. The study demonstrates that one of the important rationales for decision-making is derived from the social worker’s direct experience of interacting with parents and children. A particular aspect of the interaction, parents’ reactions to being referred, is scrutinized and serves as a form of validation for legal action.
A Pandemic Adaptation and Its Aftermath: Using AI and In-Person Facilitation for Community Health Education in Liberia and the United States
Authors: Jones Jasmine L. Blanks , Quaynor Laura , Njeri Stephanie , Bolden Yasmine
Published: October 2023

Health promotion commonly focuses on supporting youth wellness, as health behaviors acquired in childhood and adolescence tend to have a significant impact on an individual’s future. Adolescent health education is associated with positive health and educational outcomes, yet young people experience barriers to fully engaging in learning about health issues that are often unique to their social location. Barriers for successful engagement in health education for African diaspora youth in North American and European contexts may include school initiatives built around engagement models that do not center Black youth; for Black youth in majority-Black societies, barriers may include access to resources or exclusionary practices based on other social characteristics. Global health promotion has used a variety of multimodal educational tools from radio to more recently online engagement, especially in African contexts, to reach young people. This essay shares experiences using AI and in-person facilitation to engage in community health education with youth in Liberia and the United States. In our practice, we found that there are far more underlying systemic and structural similarities to the inequities experienced between African and Black American youth and that utilizing AI tools alongside of in-person discussion may contribute to better outcomes for youth health education.
Mechanisms of Neurostimulation for Epilepsy
Authors: Toprani Sheela , Durand Dominique M.
Published: October 2023

This review discusses the use of neurostimulation therapies for epilepsy treatment, including vagal nerve stimulation, responsive neurostimulation, and deep brain stimulation. Different therapeutic strategies and their underlying mechanisms are explored, with a focus on optimizing parameters for seizure reduction. The review also highlights the paradigm shift toward a more diverse and multimodal approach to deep brain neuromodulation.
Supporting change in Polish higher education: Academic middle leaders’ perspectives
Authors: Du Xiangyun , Guerra Aida , Chen Juebei , Lindsay Euan , Nørgaard Bente
Published: October 2023

This article reports a mixed-methods study examining 29 academic middle leaders’ viewpoints on supporting educational change in higher educational institutions in Poland. Following a three-dimensional conceptual framework emphasizing support at the individual, collegial, and environmental levels, Q methodology was adopted to collect and analyze data qualitatively and quantitatively. Four significantly different viewpoints were identified, respectively prioritizing (1) creating an institutional culture, (2) connecting people to form a support system, (3) supporting educators’ change readiness, and (4) supporting trust building. The follow-up focus groups, in addition to verifying the Q outcomes, identified a shared conceptualization of middle leaders as complex dynamic adaptive systems, despite their general lack of professional training for their positions. The identified consensus emphasized their shared concerns about a lack of institutional support, which echoes the prevailing research findings on university educators. The results also reveal a particular need for attention to pedagogical advancement, which has been historically neglected due to socioeconomic constraints. This study suggests broadening the scope of change, including higher education institutions’ policymaking, practice, and research, to provide systemic and systematic support to actors.
Investigating gastrointestinal disorders in pregnancy
Authors: Morton Adam
Published: October 2023

This article reviews anatomical and physiological changes and alterations in reference intervals for laboratory tests in healthy pregnancy, pertinent to investigation of the gastrointestinal system. The safety of procedures and radiological investigations relevant to the investigation of gastrointestinal disorders in pregnancy are also reviewed.
Investigating hepatitis C screening among people receiving opioid agonist treatment: A retrospective audit study
Authors: Cordaro Frank , Qian Siyu , Sinclair Barbara
Published: October 2023

Background

Estimates of the prevalence of hepatitis C virus (HCV) amongst people who inject drugs are in the range of 50%. Opioid Agonist Treatment (OAT) clinics have a large proportion of people who inject drugs. These clinics, therefore, present an excellent opportunity to identify and treat patients with HCV. Despite this, it remains unclear as to how well these clinics screen patients for HCV.

Aim

This study aims to quantify the rate of HCV screening of patients that enrolled into treatment at an OAT clinic attached to a large teaching hospital in NSW.

Methods

A retrospective audit of the electronic medical record of patients commencing OAT at the clinic was performed to determine the rate of HCV screening.

Findings

During the audit period, there were 99 episodes of care that involved the commencement of OAT at the clinic, for patients who had a history of injecting drugs. Successful screening for HCV occurred in 56% (55/99) of these episodes. Of those screened, 26% were ribonucleic acid positive. Analysis of demographics did not reveal a statistically significant difference between those that were screened and those that were not.

Discussion

This study revealed a suboptimal rate of HCV screening at the OAT clinic. To improve the screening rate, the clinic could consider providing dried blood spot testing at the initial nurse assessment or having a clinician capable of venepuncture at the clinic.
Volvulus of a wandering enlarged pelvic spleen involving pancreatic tail: A case report
Authors: Lakmal Kasun , Nagasinghe Shalika Upendra , Niruban Ganesarajah , Chandraguptha Minidu Ravinda , Kalaiyukan Sathasivam , Wijesinghe Kanchana , Nandasena Malith
Published: October 2023

Splenic volvulus of wandering spleen is a rare clinical condition. It causes significant morbidity and mortality, especially if undetected. Here, we report a case of 32-year-old female who presented with worsening abdominal pain for 1-week duration. Contrast-enhanced computed tomography scan of the abdomen showed splenic volvulus with infarction and involvement of the pancreatic tail. She underwent exploratory laparotomy and splenectomy with preservation of the pancreatic tail. Patient progressed favourably. Our case report describes a rare clinical entity of a splenic volvulus with a twisted pancreatic tail. This is a life-threatening condition that requires prompt diagnosis and treatment.
Giant primary liposarcoma of the mediastinum: A case report and review of the literature
Authors: Rao Jingjing , Zhu Qingling , Yang Xuejiao
Published: October 2023

Liposarcoma is a carcinomatous mesenchymal tumor with various histologic features and is the most common soft tissue sarcoma originating in adipose tissue. Liposarcoma commonly occurs in the lower extremities and retroperitoneum but rarely in the mediastinum, specially extending into the thoracic cavity. We report a giant primary liposarcoma of the posterior mediastinum in a 63-year-old female who complained of cough, sputum, and pain in the right chest wall. A computed tomography scan of the chest showed a giant mass of 24 × 15 × 24 cm in the posterior mediastinum of the right thoracic cavity. After a thorough examination, no suspected lipomatous lesions were found elsewhere in the patient’s body. The patient underwent a thoracotomy to remove the mediastinal mass through a right thoracic approach. Subsequently, hematoxylin–eosin staining revealed dedifferentiated liposarcoma (DDL), immunohistochemistry showed positive expression of cyclin-dependent kinase 4, and murine double minute 2 (MDM2), in addition, fluorescence in situ hybridization for the MDM2 gene was also positive, which suggested DDL. The patient was discharged without any complications, and no metastasis or recurrence was observed after 19 months of follow-up. To provide a reference for clinical diagnosis and treatment, we reviewed and discussed the literature on primary liposarcoma of the mediastinum.
Orthodontic Management of Children with Beckwith-Wiedemann Syndrome: An Evidence-based Review
Authors: Koukou Melina , Jabr Luay , Javed Fawad , Michelogiannakis Dimitrios
Published: October 2023

Aim:

Patients with Beckwith-Wiedemann syndrome (BWS) often present with macroglossia and aberrant dentoskeletal features, which may increase the prevalence of malocclusion and complicate conventional orthodontic management (OM). The aim was to comprehensively review the available literature regarding the OM of patients with BWS.

Materials and Methods:

Indexed databases were searched until February 2023. Clinical studies that addressed the dentoskeletal manifestations and OM of patients with BWS were included. A literature search was performed in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.

Results:

Notably, 8 out of 2,664 initially-identified studies were included. Six of the studies were case reports/case series and two were retrospective clinical studies. A total of 35 patients with BWS who received orthodontic treatment (OT) were included. Common dentoskeletal and soft tissue traits included the presence of macroglossia, obtuse gonial angle, and anterior open bite. Some form of maxillary transverse discrepancy was found in nine patients. The OT modalities that were utilized included extraoral appliances, functional appliances, removable appliances, interarch elastics, and fixed appliances. The outcome of the OT was reported as successful in five studies. The follow-up, as reported by three studies, ranged from 8 months to 6 years, and the results of the OT were maintained. Adjunct interdisciplinary therapeutic procedures included glossectomy, oral physiotherapy, and orthognathic surgery.

Conclusion:

Based upon limited available evidence, OT in conjunction with tongue reduction surgery and/or myofunctional therapy can be successfully performed in children with BWS to manage various dentoskeletal discrepancies.
Characterizing urban lifestyle signatures using motif properties in network of places
Authors: Ma Junwei , Li Bo , Mostafavi Ali
Published: October 2023

The lifestyles of urban dwellers could reveal important insights regarding the dynamics and complexity of cities. The availability of human movement data captured from cell phones enables characterization of distinct and recurrent human daily visitation patterns. Despite growing research on analysis of lifestyle patterns in cities, little is known about the characteristics of people’s lifestyle patterns at urban scale. This limitation is primarily due to challenges in restriction of human movement data to protect the privacy of users. To address this gap, this study constructed networks of places to model cities based on location-based human visitation data. We examined the motifs in the networks of places to map and characterize lifestyle patterns at urban scale. The results show that (1) people’s lifestyles in cities can be well depicted and quantified based on distribution and attributes of motifs in networks of places; (2) motifs show stability in quantity and distance as well as periodicity on weekends and weekdays indicating the stability of lifestyle patterns in cities; (3) networks of places and lifestyle patterns show similarities across different metropolitan areas implying the universality of lifestyle signatures across cities; (4) lifestyles represented by attributed motifs are spatially heterogeneous suggesting variations of lifestyle patterns within different population groups based on where they live in a city. The findings provide deeper insights into urban lifestyle signatures and significant implications for data-informed urban planning and management.
Absorbable vs Nonabsorbable Sutures for Achilles Tendon Repair: A Systematic Review and Meta-analysis
Authors: Oesman Ihsan , Canintika Anissa Feby
Published: October 2023

Background:

Nonabsorbable sutures are still the main choice for acute Achilles tendon rupture (AATR) repair due to strength provided. However, the rerupture rates, infection risks, foreign body reaction, and postsurgical recovery differences between absorbable and nonabsorbable suture materials in AATR repair have not been carefully reviewed.

Methods:

A systematic review was done on PubMed, EBSCO, Cochrane Central Register of Controlled Trials, and Embase to find research studies in relation to complications associated with AATR repair using the PRISMA guidelines. The risk of bias from each study included will be assessed using the Cochrane Risk of Bias Tool for randomized study (RoB 2) and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) for nonrandomized study.

Results:

Five studies with a total of 255 patients, 105 in the absorbable suture group and 150 in the nonabsorbable suture group, were included for analysis. Risk of rerupture, infection, and foreign body reaction shown no significant difference between groups, and the mean difference of recovery scores were similar.

Conclusion:

Existing literature shows that absorbable sutures appear to be associated with similar outcomes to nonabsorbable sutures regarding rates of rerupture, infection, foreign body reaction, and outcomes grading following surgical repair of acute Achilles tendon repair.
Relationship between Hardness and Deformation during Cold Rolling Process of Complex Profiles
Authors: Zhang Dawei , Hu Linghao , Liu Bingkun , Zhao Shengdun
Published: October 2023

The hardening on surface of complex profiles such as thread and spline manufactured by cold rolling can effectively improve the mechanical properties and surface quality of rolled parts. The distribution of hardness in superficial layer is closely related to the deformation by rolling. To establish the suitable correlation model for describing the relationship between strain and hardness during cold rolling forming process of complex profiles is helpful to the optimization of rolling parameters and improvement of rolling process. In this study, a physical analog experiment reflecting the uneven deformation during complex-profile rolling process has been extracted and designed, and then the large date set (more than 400 data points) of training samples reflecting the local deformation characteristics of complex-profile rolling have been obtained. Several types of polynomials and power functions were adopted in regression analysis, and the regression correlation models of 45# steel were evaluated by the single-pass and multi-pass physical analog experiments and the complex-profile rolling experiment. The results indicated that the predicting accuracy of polynomial regression model is better in the strain range (i.e., $$\varepsilon < 1.2$$

ε
<
1.2

) of training samples, and the correlation relationship between strain and hardness out strain range (i.e., $$\varepsilon > 1.2$$

ε
>
1.2

) of training samples can be well described by power regression model; so the correlation relationship between strain and hardness during complex-profile rolling process of 45# steel can be characterized by a segmented function such as third-order polynomial in the range $$\varepsilon < 1.2$$

ε
<
1.2

and power function with a fitting constant in the range $$\varepsilon > 1.2$$

ε
>
1.2

; and the predicting error of the regression model by segmented function is less than 10%.
Genetic and other epidemiological risk factors of infants and children with hypospadias: a case control study
Authors: Moustafa Wafaa , Abouelella Soheir , Tawfik Maha , Abuelyazeed Mai , Zanaty Fouad
Published: October 2023

Background

To study hypospadias as regard epidemiological risk factors and genetic association with mutations in Steroid 5 alpha reductase type 2 genes.

Materials

This study was conducted on two groups; the first group included 50 male children with hypospadias and the other group included 50 male healthy children as a matched control. All patients and controls were subjected to detailed history, physical examination and molecular study of 5-alpha-reductase gene polymorphisms (V89L and G34R).

Results

Mean age in hypospadias group was 3.28 ± 2.87 years. The most common type of hypospadias was the glanular type in 19 children (38%). Higher maternal and paternal age, consanguinity, rural residence and preterm labor carry significant epidemiological risk factors for hypospadias. According to genetic study, all healthy children carried the wild valine residue (VV) genotype, while only 44% of hypospadias cases carried the wild VV genotype and 56% carried the mutant L allele (homozygote for leucine residue and heterozygote for both valine and leucine (VL)) with high significant p value (p < 0.001). For Allele Specific—polymerase chain reaction for glycine to arginine (G34R) mutation detection in the 5 alpha reductase type 2 gene, hypospadias children had significantly higher frequency of heterozygous GR genotype than healthy controls. Binary logistic regression analysis showed that mother age and rural residence were the most independent predictors for hypospadias.

Conclusions

V89L and G34R Steroid 5 alpha reductase type 2 gene polymorphisms, higher maternal and paternal age, consanguinity, rural residence and preterm labor carry significant risk factors for hypospadias. On multivariate logistic regression, mother age and rural residence are the most independent predictors for hypospadias.
Sustainable mobility in smart cities: a document study of mobility initiatives of mid-sized Nordic smart cities
Authors: Müller-Eie Daniela , Kosmidis Ioannis
Published: October 2023

The smart city concept is being viewed as part of the urban future, integrating technological advances, multi-sectorial collaboration, and innovative open markets with strategic goals and ambitions to achieve sustainable urban development. Smart mobility is considered a vital element of the smart city, given that urban transport systems should become more efficient and sustainable. With this in mind, we raise the question: how sustainable is smart mobility? To answer this, we review smart city strategies and measures of fourteen mid-sized cities of the Nordic Smart Cities Network, identifying smart mobility goals together with proposed or implemented mobility measures. We evaluate how they align with sustainable mobility and how effective they are with the help of two analytical frameworks: a) the EU’s Sustainable Urban Mobility Planning (SUMP) objectives and b) the S.M.A.R.T. objectives. In doing so, we assess to which degree smart mobility strategies and measures in Nordic smart cities contribute to sustainable urban mobility and development, and how they contribute to achieving sustainable and smart city goals in terms of feasibility and accountability. The study reveals that measures mainly address the SUMP objectives relating to efficiency and environment, with little focus on inclusive and safe mobility planning that caters to attractive cities and high quality of urban life. Another finding is that smart mobility measures are relatively conventional, and their goals and ambitions are often stated on an abstract level and rarely measurable with specific indicators. Thus, there seems to be a lack of feasibility and accountability related to smart mobility measures, as well as a lack of focus on social sustainability.
Comparison of efficacy of non-pharmacological intervention for post-stroke dysphagia: a systematic review and Bayesian network meta-analysis
Authors: Zhu Hao , Deng Xinyuan , Luan Guorui , Zhang Yu , Wu Yichen
Published: October 2023

Increasingly, non-pharmacological interventions are being identified and applied to post-stroke dysphagia. Nevertheless, there is insufficient evidence to assess which type of interventions are more effective. In this study, the randomized controlled trials of non-pharmacological interventions on post-stroke dysphagia were retrieved from the relevant databases. Including 96 studies and 12 non-drug treatments. Then, and the network meta-analysis is carried out by statistical software. The results show: In the aspects of videofluoroscopic swallowing study (VFSS), Standardized Swallowing Assessment (SSA), swallowing-quality of life (SWAL-QOL), Water swallow test (WST); Acupuncture + electrotherapy + rehabilitation training, acupuncture + rehabilitation training + massage, electrotherapy + rehabilitation training, acupuncture + electrotherapy + rehabilitation training, electrotherapy, acupuncture + rehabilitation training + acupoints sticking application have significant effects in post-stroke dysphagia. Compared with other interventions, they have more advantages in improving the above indicators. A substantial number of high-quality randomized clinical trials are still necessary in the prospective to validate the therapeutic effectiveness of non-pharmacological interventions in post-stroke dysphagia and the results of this Bayesian network meta-analysis.
Extracellular matrix remodeling proteins as biomarkers for clinical assessment and treatment outcomes in eosinophilic esophagitis
Authors: Pehrsson Martin , de Rooij Willemijn E. , Bay-Jensen Anne-Christine , Karsdal Morten Asser , Mortensen Joachim Høg , Bredenoord Albert Jan
Published: October 2023

Background

Eosinophilic esophagitis (EoE) is a chronic progressive inflammatory disease of the esophagus, characterized by extracellular matrix remodeling and fibrotic stricture formation. Disease monitoring requires multiple re-endoscopies with esophageal biopsies. Hence non-invasive methods for determining tissue fibrosis and treatment efficacy are warranted.

Aims

To investigate the ability of extracellular matrix proteins in serum as potential biomarkers of tissue remodeling and clinical, endoscopic, and histological disease outcomes in adult EoE patients.

Methods

Protein-fingerprint assays were used to measure neo-epitope specific fragments of collagen remodeling, human-neutrophil elastase degraded calprotectin, and citrullinated or non-citrullinated vimentin in the serum of an adult EoE-cohort. Biomarker analysis, symptoms, endoscopic features and histological disease activity (eosinophils(eos) per high-power-field(hpf)) were evaluated at baseline and after six weeks of dietary intervention.

Results

Patients with a baseline (Endoscopic Reference score) EREFS fibrosis subscore ≥ 2 presented with increased fibrolysis of cross-linked type III collagen (CTX-III) (p < 0.01), whereas low CTX-III levels were observed in patients achieving histological remission (< 15 eos/hpf) (vs. no histological remission (p < 0.05). Progression of endoscopic fibrosis after intervention was associated with increased levels of type-III (PRO-C3) and -VI collagen (PRO-C6) formation (all; p < 0.05). A baseline EREFS inflammatory subscore ≥ 2 correlated with higher neutrophilic activity (Cpa9-HNE) at week 6 (p < 0.05). Moreover, increased degradation of type-III (C3M) and -IV (C4M/PRO-C4) collagens were associated with remission of food impaction after intervention (all; p < 0.05).

Conclusion

Serum extracellular matrix remodeling proteins demonstrated potential as surrogate biomarkers for assessing histological disease remission, endoscopic fibrosis, and remission of symptoms of food impaction after diet intervention in adult EoE patients.
Herpes Virus Infections in Kidney Transplant Patients (HINT) – a prospective observational cohort study
Authors: Hamm Sebastian Rask , Saini Sunil Kumar , Hald Annemette , Vaaben Anna V. , Pedersen Natasja Wulff , Suarez-Zdunek Moises Alberto , Harboe Zitta Barrella , Bruunsgaard Helle , Johansen Isik Somuncu , Larsen Carsten Schade , Bistrup Claus , Birn Henrik , Sørensen Søren Schwartz , Hadrup Sine Reker , Nielsen Susanne Dam
Published: October 2023

Background

Kidney transplant recipients receive maintenance immunosuppressive therapy to avoid allograft rejection resulting in increased risk of infections and infection-related morbidity and mortality. Approximately 98% of adults are infected with varicella zoster virus, which upon reactivation causes herpes zoster. The incidence of herpes zoster is higher in kidney transplant recipients than in immunocompetent individuals, and kidney transplant recipients are at increased risk of severe herpes zoster-associated disease. Vaccination with adjuvanted recombinant glycoprotein E subunit herpes zoster vaccine (RZV) prevents herpes zoster in older adults with excellent efficacy (90%), and vaccination of kidney transplant candidates is recommended in Danish and international guidelines. However, the robustness and duration of immune responses after RZV vaccination, as well as the optimal timing of vaccination in relation to transplantation remain unanswered questions. Thus, the aim of this study is to characterize the immune response to RZV vaccination in kidney transplant candidates and recipients at different timepoints before and after transplantation.

Methods

The Herpes Virus Infections in Kidney Transplant Patients (HINT) study is a prospective observational cohort study. The study will include kidney transplant candidates on the waiting list for transplantation (n = 375) and kidney transplant recipients transplanted since January 1, 2019 (n = 500) from all Danish kidney transplant centers who are offered a RZV vaccine as routine care. Participants are followed with repeated blood sampling until 12 months after inclusion. In the case of transplantation or herpes zoster disease, additional blood samples will be collected until 12 months after transplantation. The immune response will be characterized by immunophenotyping and functional characterization of varicella zoster virus-specific T cells, by detection of anti-glycoprotein E antibodies, and by measuring cytokine profiles.

Discussion

The study will provide new knowledge on the immune response to RZV vaccination in kidney transplant candidates and recipients and the robustness and duration of the response, potentially enhancing preventive strategies against herpes zoster in a population at increased risk.

Trial registration

ClinicalTrials.gov (NCT05604911).
Development and validation of a self-regulation scale within the German version of the Early Development Instrument
Authors: Georg Sabine , Genser Bernd , Fischer Joachim , Sachse Steffi , De Bock Freia
Published: October 2023

Background

Early childhood self-regulation (SR) is key for many health- and education-related outcomes across the life span. Kindergarten age is a crucial period for SR development, and within this developmental window, potential SR difficulties can still be compensated for (e.g., through interventions). However, efficient measurement of SR through brief, comprehensive, and easy-to-use instruments that identify SR difficulties are scarce. To address this need, we used items of an internationally applied kindergarten teacher questionnaire—the Early Development Instrument (EDI) – to develop and validate a specific SR measurement scale.

Methods

The psychometric evaluation and validation of the selected SR-items was performed in data collected with the German version of the EDI (GEDI), in two independent data sets – (a) the development dataset, with 191 children, and b) the validation dataset, with 184 children. Both included three- to six-year-old children and contained retest and interrater reliability data. First, three independent raters—based on theory—selected items eligible to form a SR scale from the two SR-relevant GEDI domains "social competence" and "emotional maturity". Second, exploratory and confirmatory factor analysis using structural equation modeling examined the item structure across both data sets. This resulted in a defined SR scale, of which internal consistency, test–retest and interrater reliability, cross-validation, and concurrent validity using correlation and descriptive agreements (Bland–Altman (BA) plots) with an existing validated SR-measuring instrument (the Kindergarten Behavioral Scales) were assessed.

Results

Confirmatory factor analysis across both data sets yielded the best fit indices with 13 of the GEDI 20 items initially deemed eligible for SR measurement, and a three-factor structure: a) behavioral response inhibition, b) cognitive inhibition, c) selective or focused attention (RMSEA: 0.019, CFI: 0.998). Psychometric evaluation of the resulting 13-item-GEDI-SR scale revealed good internal consistency (0.92), test–retest and interrater reliability (0.85 and 0.71, respectively), validity testing yielded stability across populations and good concurrent validity with the Kindergarten Behavioral Scales (Pearson correlation coefficient: mean 0.72, range 0.61 to 0.84).

Conclusions

The GEDI contains 13 items suitable to assess SR, either as part of regular EDI developmental monitoring or as a valid stand-alone scale. This short 13-item (G)EDI-SR scale may allow early detection of children with SR difficulties in the kindergarten setting in future and could be the basis for public health intervention planning. To attain this goal, future research should establish appropriate reference values using a representative standardization sample.
Oropharyngeal administration of colostrum targeting gut microbiota and metabolites in very preterm infants: protocol for a multicenter randomized controlled trial
Authors: Wang Na , Zhang Jia , Yu Zhangbin , Yan Xudong , Zhang Lian , Peng Haibo , Chen Cheng , Li Rui
Published: October 2023

Background

Oropharyngeal administration of colostrum (OAC) has an immune-stimulating effect on oropharyngeal-associated lymphoid tissue, and can promote the maturation of the gastrointestinal tract. However, how OAC promotes intestinal maturation in preterm infants by altering gut microbiota remains unclear. We aim to assess changes in gut microbiota and metabolites after OAC in very preterm infants.

Methods

A multicenter, double-blind, randomized controlled trial will be conducted in three large neonatal intensive care units in Shenzhen, China, with preterm infants with gestational age less than 32 weeks at birth and birth weight less than 1500 g. It is estimated that 320 preterm infants will be enrolled in this study within one year. The intervention group will receive oropharyngeal administration of 0.2 ml colostrum every 3 h, starting between the first 48 to 72 h and continued for 5 consecutive days. Following a similar administration scheme, the control group will receive oropharyngeal administration of sterile water. Stool samples will be collected at the first defecation, as well as on the 7th, 14th, 21st and 28th days after birth for analysis of effect of OAC on gut microbiota and metabolites through 16sRNA gene sequencing and liquid chromatography-mass spectrometry.

Discussion

This proposal advocates for the promotion of OAC as a safe and relatively beneficial protocol in neonatal intensive care units, which may contribute to the establishment of a dominant intestinal flora. Findings of this study may help improve the health outcomes of preterm infants by establishment of targeted gut microbiota in future studies.

Trial registration

NCT05481866 (registered July 30, 2022 on ClinicalTrials.gov).
Gender differences in alcohol abuse/dependence among medical undergraduates during the post-COVID‑19 pandemic period (October 20, 2020-April 5, 2021) in China
Authors: Wang Xin , Peng Pu , Liu Yueheng , Yang Winson Fuzun , Chen Shubao , Wang Yunfei , Yang Qian , Li Manyun , Wang Yingying , Hao Yuzhu , He Li , Wang Qianjin , Zhang Junhong , Ma Yuejiao , He Haoyu , Zhou Yanan , Long Jiang , Qi Chang , Tang Yi-Yuan , Liao Yanhui , Tang Jinsong , Wu Qiuxia , Liu Tieqiao
Published: October 2023

Background

This study aimed to assess the prevalence and the gender-specific risk factors of alcohol abuse/dependence among medical undergraduates during the post-COVID‑19 pandemic period in China.

Method

The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was used to identify respondents with alcohol abuse/dependence. A questionnaire on basic demographics and mental distresses (learning burnout, depression symptoms, anxiety symptoms, excessive daytime sleepiness, and history of mental disorders) was used. The logistic regression model was used to explore the associations between the above characteristics and alcohol abuse/dependence.

Results

A total of 3,412 medical undergraduates were included in the analysis. Males showed a higher prevalence of alcohol abuse/dependence than females (16.6% vs 7.4%, p < 0.001). Alcohol abuse/dependence was associated with learning burnout (OR: 2.168, p < 0.001) and having a partner (OR: 1.788 p = 0.001) among female medical undergraduates. Among male medical undergraduates, excessive daytime sleepiness (OR: 1.788 p = 0.001) and older age (OR: 1.788, p = 0.001) were independently associated with alcohol abuse/dependence.

Conclusion

Alcohol abuse/dependence was common among medical undergraduates during the post-COVID‑19 pandemic period. Substantial gender differences in the prevalence and risk factors of alcohol abuse/dependence were found among medical undergraduates in this study, which highlighted the need for timely gender-specific screening and interventions. However, the cross-sectional design adopted in this study has limited the examination of causality, thus further longitudinal studies are warranted.
Association of internet gaming disorder with impulsivity: role of risk preferences
Authors: Zhu Lin , Zhu Yuqiong , Li Shuxuan , Jiang Yulian , Mei Xian , Wang Yuting , Yang Dengxian , Zhao Jing , Mu Linlin , Wang Wenjuan
Published: October 2023

Background

Internet gaming disorder (IGD) is a formal mental disorder leading to personal and social impairment. Although it shares similar physical and psychosocial effects to substance use disorder, the psychological mechanisms underlying IGD remain unclear, although several researches have made significant contributions to its understanding. This study aims to elucidate the correlation between IGD, impulsive personality and risk preference of medical college students in China, from a questionnaire-based investigation.

Methods

Based on the cluster random sampling method, a questionnaire survey was conducted among medical college students in Northern Anhui, China from September 3 to October 27, 2020. The questionnaires included the Internet Gaming Disorder Scale (IGD-20), Chinese revised of Barratt Impulsiveness Scale Version 11 (BIS-11), and risk appetite index (RPI). Perform independent sample t-tests, analysis of variance (ANOVA), correlation analysis, and moderating effect analysis using SPSS 23.0. P < 0. 05 is considered statistically significant.

Results

624 participants completed the survey, including 257 males (41.19%) and 367 females (58.81%). All participants were between 18 and 24 years. We found that in IGD and its six different dimensions and RPI, males scored significantly higher than females. Additionally, our finding revealed there is statistical significance in IGD and impulsiveness between gaming group with game time greater than or equal to 4 h and non-gaming group. The IGD and its six different dimensions, among which all except for mood modification are positively correlated with impulsiveness and RPI. Mediating effects indicate that RPI plays a partial mediating role between motor impulsiveness and IGD.

Conclusion

The findings shows that there is a certain relationship between impulsivity and RPI, as well as IGD and its dimensions. RPI may be a mediator between impulsivity and IGD, and men have higher IGD. The findings supported the compensatory hypothesis. These findings may contribute to further research and development of intervention and prevention measures for IGD.
Cytokine release syndrome after bronchoalveolar lavage
Authors: Guerriero Margaret , Ally Feras , Loeb Keith R. , Nair Viswam S.
Published: October 2023

Background

Immunosuppressed bone marrow transplant patients with pulmonary infiltrates routinely undergo bronchoscopy with bronchoalveolar lavage (BAL) to investigate potential etiologies. Cytokine release syndrome after BAL is unreported in the literature in general and in this patient population.

Case presentation

We report on an allogeneic bone marrow transplant patient with non-infectious organizing pneumonia of the lungs who developed delayed and rapidly progressive shock and hypoxia post-procedure over the course of 12 h resulting in intensive care unit admission for supportive care. BAL was characterized by a marked lymphocytic, cytotoxic T cell infiltrate on pathology and flow cytometry without clear evidence of infection. The patient’s clinical status improved quickly only after the initiation of high dose intravenous steroids and returned to baseline as an outpatient.

Conclusion

The patient’s clinical data and course suggest a cytotoxic T cell response from the lung and BAL as the etiology. With an increasing number of cellular therapies for cancer entering the clinic, the potential for unusual but morbid complications from routine bronchoscopy should be considered.
Machine learning approach for the detection of vitamin D level: a comparative study
Authors: Sancar Nuriye , Tabrizi Sahar S.
Published: October 2023

Background

After the World Health Organization declared the COVID-19 pandemic, the role of Vitamin D has become even more critical for people worldwide. The most accurate way to define vitamin D level is 25-hydroxy vitamin D(25-OH-D) blood test. However, this blood test is not always feasible. Most data sets used in health science research usually contain highly correlated features, which is referred to as multicollinearity problem. This problem can lead to misleading results and overfitting problems in the ML training process. Therefore, the proposed study aims to determine a clinically acceptable ML model for the detection of the vitamin D status of the North Cyprus adult participants accurately, without the need to determine 25-OH-D level, taking into account the multicollinearity problem.

Method

The study was conducted with 481 observations who applied voluntarily to Internal Medicine Department at NEU Hospital. The classification performance of four conventional supervised ML models, namely, Ordinal logistic regression(OLR), Elastic-net ordinal regression(ENOR), Support Vector Machine(SVM), and Random Forest (RF) was compared. The comparative analysis is performed regarding the model's sensitivity to the participant’s metabolic syndrome(MtS)'positive status, hyper-parameter tuning, sensitivities to the size of training data, and the classification performance of the models.

Results

Due to the presence of multicollinearity, the findings showed that the performance of the SVM(RBF) is obviously negatively affected when the test is examined. Moreover, it can be obviously detected that RF is more robust than other models when the variations in the size of training data are examined. This experiment's result showed that the selected RF and ENOR showed better performances than the other two models when the size of training samples was reduced. Since the multicollinearity is more severe in the small samples, it can be concluded that RF and ENOR are not affected by the presence of the multicollinearity problem. The comparative analysis revealed that the RF classifier performed better and was more robust than the other proposed models in terms of accuracy (0.94), specificity (0.96), sensitivity or recall (0.94), precision (0.95), F1-score (0.95), and Cohen's kappa (0.90).

Conclusion

It is evident that the RF achieved better than the SVM(RBF), ENOR, and OLR. These comparison findings will be applied to develop a Vitamin D level intelligent detection system for being used in routine clinical, biochemical tests, and lifestyle characteristics of individuals to decrease the cost and time of vitamin D level detection.
Use of lactulose as a prebiotic in laying hens: its effect on growth, egg production, egg quality, blood biochemistry, digestive enzymes, gene expression and intestinal morphology
Authors: Elkomy Hassan S. , Koshich Ivan I. , Mahmoud Sahar F. , Abo-Samaha Magda I.
Published: October 2023

Background

The rising popularity of eggs as an alternative source of protein to meat has led to significant increase in egg consumption over the past decade. To meet the increasing demand for eggs, poultry farmers have used antibiotics to treat infections and, to some extent, promote growth and egg production in raising layer. However, the emergence and global spread of antibiotic resistant bacteria has now necessitated antibiotic-free poultry farming. As alternatives to antibiotics, prebiotics are feed additives that can be used to improve the growth and laying performance of poultry which positively impacts their performance and general health. In this study we evaluated the effect of lactulose, formulated as Vetelact, on body weight, egg production, egg quality, blood biochemical parameters and expression of genes associated with reproductive performance in laying hens.

Results

Vetelact supplementation improved egg weight, egg production as well as egg quality. Following Vetalact supplementation, the levels of total bilirubin, total protein, globulin and phosphorus were increased, while the activities of alkaline phosphatase and lipase enzymes were increased compared to control. Vetelact at 0.10 ml/kg body weight upregulated OCX-36, OVAL, CALB1, OC-116, OCX-32 and IL8 transcripts while downregulating the transcription of Gal-10, PENK and AvBD9. At this optimal inclusion rate of Vetalect, histomorphologic analyses of intestinal tissue showed increased villi length with more goblet cell distribution and obvious mucus covering a surface, increase in the depth of intestinal crypts produce digestive enzymes, as well as more developed muscle layer that promote improved nutrient absorption.

Conclusion

Vetelact at a dose of 0.10 ml/ kg body weight was effective in improving productive performance of laying hens. Adding lactulose (0.10 ml/ kg body weight) to layer diet is recommended to promote growth and improve egg laying performance in antibiotics-free poultry production.
Cellular signaling modulated by miRNA-3652 in ovarian cancer: unveiling mechanistic pathways for future therapeutic strategies
Authors: Imran Komal , Iqbal Muhammad Javed , Abid Rameesha , Ahmad Muhammad Mushtaq , Calina Daniela , Sharifi-Rad Javad , Cho William C.
Published: October 2023

MicroRNAs (miRNAs) are small non-coding RNA molecules that play pivotal roles in regulating gene expression and have been implicated in the pathogenesis of numerous cancers. miRNA-3652, though relatively less explored, has recently emerged as a potential key player in ovarian cancer's molecular landscape. This review aims to delineate the functional significance and tumor progression role of miRNA-3652 in ovarian cancer, shedding light on its potential as both a diagnostic biomarker and therapeutic target. A comprehensive literature search was carried out using established databases, the focus was on articles that reported the role of miRNA-3652 in ovarian cancer, encompassing mechanistic insights, functional studies, and its association with clinical outcomes. This updated review highlighted that miRNA-3652 is intricately involved in ovarian cancer cell proliferation, migration, and invasion, its dysregulation was linked to altered expression of critical genes involved in tumor growth and metastasis; furthermore, miRNA-3652 expression levels were found to correlate with clinical stages, prognosis, and response to therapy in ovarian cancer patients. miRNA-3652 holds significant promise as a vital molecular player in ovarian cancer's pathophysiology. Its functional role and impact on tumor progression make it a potential candidate for diagnostic and therapeutic applications in ovarian cancer. Given the pivotal role of miRNA-3652 in ovarian cancer, future studies should emphasize in-depth mechanistic explorations, utilizing advanced genomic and proteomic tools. Collaboration between basic scientists and clinicians will be vital to translating these findings into innovative diagnostic and therapeutic strategies, ultimately benefiting ovarian cancer patients.
The effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trial
Authors: Cai Yunying , Li Mengge , Zhang Lun , Zhang Jie , Su Heng
Published: October 2023

Background

The optimization of glucose control in type-1 diabetes is challenged by postprandial glycemic variability. This study aimed to compare the postprandial glycemic effects of carbohydrate counting and the modified fat-protein unit (FPU) algorithms following meals with different protein and fat emphases in adults with type-1 diabetes.

Methods

Thirty adults with type-1 diabetes aged 18 to 45 years participated in a randomized crossover trial. In a random order, participants consumed four test meals with equivalent energy and different macronutrient emphases on four separate mornings. The modified FPU algorithms and carbohydrate counting were used to determine the insulin dose for the test meals. A continuous glucose monitoring system was used to measured postprandial glycemia.

Results

Compared with carbohydrate counting, the modified FPU algorithm significantly decreased the late postprandial mean glucose levels (p = 0.026) in high protein-fat meals. The number of hypoglycemia episodes was similar between insulin dosing algorithms for the high protein-fat meals; hypoglycemic events were considerably higher for the modified FPU in the normal protein-fat meal (p = 0.042).

Conclusions

The modified FPU algorithm may improve postprandial glycemic control after consuming high protein-fat meals in adults with type-1 diabetes but may result in increased hypoglycemia risk when used with a normal protein-fat meal.