bluuebunny/crossref_metadata_2025 huggingface dataset:
“When can I get angry?” Journalists’ coping strategies and emotional management in hostile situations
Authors: Ivask Signe , Waschková Císařová Lenka , Lon Angelina
Published: August 2023

Research shows that emotional management is often part of journalists’ decision-making in the news creation process and when dealing with attacks, insults, or harassment, which we describe by the umbrella term hostility. Some emotional management strategies can lead journalists to self-censorship or to mental health problems when they do not recognise and deal with emotions. Therefore, the aim of this study is to investigate how journalists react to hostility against them by using emotional coping strategies and emotional management. We carried out 18 semi-structured interviews with news journalists in Estonia from June 2021 to December 2021. The results showed that although hostility is a part of journalists’ everyday work-life, many lack a strategy to deal with it. We can say that there are three types of perceptions and reactions: (1) the thick-skinned journalist who does not see problems with hostility and, therefore, does not take any action against receiving the hostility. (2) The pragmatically conformist journalist who sometimes sees problems with hostility and believes the solution is to grow a thicker skin. (3) The journalist who is not a punching bag and sees a problem in being constantly bombarded by hostility, most of whom seek protection from it or help to fight against it.
Risk Factors and Population-Attributable Fractions for Incident Hip Osteoarthritis
Authors: Runhaar Jos , van Berkel Annemaria C. , Agricola Rintje , van Meurs Joyce , Bierma-Zeinstra Sita M. A.
Published: August 2023

Background:

Despite the huge burden of hip osteoarthritis (OA) and the lack of effective treatment, research into the primary prevention of hip OA is in its infancy.

Purpose:

We sought to evaluate risk factors for incident clinical and incident radiographic hip OA among middle-aged and older adults, to evaluate the importance of risk factors from a preventive perspective, and to estimate the percentage of new cases attributable to these risk factors.

Methods:

We retrospectively reviewed data from the Rotterdam study, an open-population cohort study of individuals aged 55 years or older. Data including baseline age, sex, body mass index, smoking status, education level, diagnosis of diabetes, C-reactive protein (CRP), cam morphology, acetabular dysplasia, radiographic thumb OA, radiographic hip OA, and hip pain were assessed for their association with incident clinical hip OA and incident radiographic hip OA separately, after 11 years of follow-up. The population-attributable fractions (PAFs) of statistically significant modifiable risk factors were calculated, as well.

Results:

New onset of clinical hip OA was seen in 19.9% (544 of 2729) and incident radiographic hip OA in 9.9% (329 of 3309). Female sex, education level below average (PAF 21.4%), and radiographic hip OA (PAF 3.4%) were statistically significantly associated with incident clinical hip OA. Female sex, age, overweight (PAF 20.0%), cam morphology (PAF 7.9%), acetabular dysplasia (PAF 3.6%), and radiographic thumb OA (PAF 4.7%) were statistically significantly associated with radiographic hip OA.

Conclusions:

Our retrospective analysis suggests that, from a primary prevention perspective, the most important modifiable risk factors among middle-aged and older individuals may be low educational level for incident clinical hip OA and overweight for incident radiographic hip OA. Further study is warranted.
Human and Algorithmic Predictions in Geopolitical Forecasting: Quantifying Uncertainty in Hard-to-Quantify Domains
Authors: Mellers Barbara A. , McCoy John P. , Lu Louise , Tetlock Philip E.
Published: August 2023

Research on clinical versus statistical prediction has demonstrated that algorithms make more accurate predictions than humans in many domains. Geopolitical forecasting is an algorithm-unfriendly domain, with hard-to-quantify data and elusive reference classes that make predictive model-building difficult. Furthermore, the stakes can be high, with missed forecasts leading to mass-casualty consequences. For these reasons, geopolitical forecasting is typically done by humans, even though algorithms play important roles. They are essential as aggregators of crowd wisdom, as frameworks to partition human forecasting variance, and as inputs to hybrid forecasting models. Algorithms are extremely important in this domain. We doubt that humans will relinquish control to algorithms anytime soon—nor do we think they should. However, the accuracy of forecasts will greatly improve if humans are aided by algorithms.
A Critical Perspective on Neural Mechanisms in Cognitive Neuroscience: Towards Unification
Authors: van Bree Sander
Published: August 2023

A central pursuit of cognitive neuroscience is to find neural mechanisms of cognition, with research programs favoring different strategies to look for them. But what is a neural mechanism, and how do we know we have captured them? Here I answer these questions through a framework that integrates Marr’s levels with philosophical work on mechanism. From this, the following goal emerges: What needs to be explained are the computations of cognition, with explanation itself given by mechanism—composed of algorithms and parts of the brain that realize them. This reveals a delineation within cognitive neuroscience research. In the premechanism stage, the computations of cognition are linked to phenomena in the brain, narrowing down where and when mechanisms are situated in space and time. In the mechanism stage, it is established how computation emerges from organized interactions between parts—filling the premechanistic mold. I explain why a shift toward mechanistic modeling helps us meet our aims while outlining a road map for doing so. Finally, I argue that the explanatory scope of neural mechanisms can be approximated by effect sizes collected across studies, not just conceptual analysis. Together, these points synthesize a mechanistic agenda that allows subfields to connect at the level of theory.
Influence of the physical effort of reminder-setting on strategic offloading of delayed intentions
Authors: Chiu Gavin , Gilbert Sam J
Published: August 2023

Intention offloading involves using external reminders such as diaries, to-do lists, and digital alerts to help us remember delayed intentions. Recent studies have provided evidence for various cognitive and metacognitive factors that guide intention offloading, but little research has investigated the physical cost of reminder-setting itself. Here, we present two pre-registered experiments investigating how the cost of physical effort associated with reminder-setting influences strategic intention offloading under different levels of memory load. At all memory loads, reminder-setting was reduced when it was more effortful. The ability to set reminders allowed participants to compensate for the influence of memory load on accuracy in the low-effort condition; this effect was attenuated in the high-effort condition. In addition, there was evidence that participants with less confidence in their memory abilities were more likely to set reminders. Contrary to prediction, physical effort had the greatest effect on reminder-setting at intermediate memory loads. We speculate that the physical costs of reminder-setting might have the greatest impact when participants are uncertain about their strategy choice. These results demonstrate the importance of physical effort as one of the factors relevant to cost-benefit decision-making about cognitive offloading strategies.
Plate fixation versus flexible intramedullary nails for management of closed femoral shaft fractures in the pediatric population: A systematic review and meta-analysis of the adverse outcomes
Authors: Singh Abhinav , Bierrum William , Wormald Justin , Ramachandran Manoj , Firth Gregory , Eastwood Deborah
Published: August 2023

Purpose:

Fractures of the femoral diaphysis are associated with a risk of morbidity in children. Various fixation methods have been developed, but with only limited evidence to support their use. This systematic review assesses the evidence regarding clinical outcomes of closed femoral diaphyseal fractures in children treated with plate fixation or flexible intramedullary nails.

Methods:

A PROSPERO-registered, PRISMA-compliant systematic review and meta-analysis were conducted. MEDLINE, Embase, and Web of Science (WoS) databases were searched from inception to February 2023. Inclusion criteria included clinical studies reporting adverse outcomes following surgical treatment of pediatric closed femoral diaphyseal fractures using plate fixation and flexible intramedullary nails. The ROBINS-I and RoB 2 tools evaluated the risk of bias.

Results:

Thirteen papers (2 prospective randomized controlled trials and 11 retrospective cohorts) reported 805 closed diaphyseal femoral fractures in 801 children (559 males, 242 females). There were 360 plate fixations and 445 flexible intramedullary nails. Two cases of osteomyelitis and one nonunion were reported. Meta-analysis showed that plate fixation had a lower risk of soft tissue infection (relative risk 0.26 (95% confidence interval 0.07–0.92)). There was no difference in the following outcomes: malunion (relative risk 0.68 (95% confidence interval 0.32–1.44)); unplanned reoperation (relative risk 0.59 (95% confidence interval 0.31–1.14)), and leg-length difference (relative risk 1.58 (95% confidence interval 0.66–3.77)). The risk of bias was high in all studies.

Conclusions:

An analysis of 805 fractures with minimal differences in meta-analyses is considered high quality even when the quality of the evidence is low. The findings are limited by important flaws in the methodology in the published literature. Well-designed multicentre prospective studies using standardized core outcomes are required to advise treatment recommendations.

Level of evidence:

III.
Optimizing the predictive power of depression screenings using machine learning
Authors: Terhorst Yannik , Sander Lasse B , Ebert David D , Baumeister Harald
Published: August 2023

Objective

Mental health self-report and clinician-rating scales with diagnoses defined by sum-score cut-offs are often used for depression screening. This study investigates whether machine learning (ML) can detect major depressive episodes (MDE) based on screening scales with higher accuracy than best-practice clinical sum-score approaches.

Methods

Primary data was obtained from two RCTs on the treatment of depression. Ground truth were DSM 5 MDE diagnoses based on structured clinical interviews (SCID) and PHQ-9 self-report, clinician-rated QIDS-16, and HAM-D-17 were predictors. ML models were trained using 10-fold cross-validation. Performance was compared against best-practice sum-score cut-offs. Primary outcome was the Area Under the Curve (AUC) of the Receiver Operating Characteristic curve. DeLong's test with bootstrapping was used to test for differences in AUC. Secondary outcomes were balanced accuracy, precision, recall, F1-score, and number needed to diagnose (NND).

Results

A total of k = 1030 diagnoses (no diagnosis: k = 775; MDE: k = 255) were included. ML models achieved an AUCQIDS-16 = 0.94, AUCHAM-D-17 = 0.88, and AUCPHQ-9 = 0.83 in the testing set. ML AUC was significantly higher than sum-score cut-offs for QIDS-16 and PHQ-9 ( ps ≤ 0.01; HAM_D-17: p = 0.847). Applying optimal prediction thresholds, QIDS-16 classifier achieved clinically relevant improvements (Δbalanced accuracy = 8%, ΔF1-score = 14%, ΔNND = 21%). Differences for PHQ_9 and HAM-D-17 were marginal.

Conclusions

ML augmented depression screenings could potentially make a major contribution to improving MDE diagnosis depending on questionnaire (e.g., QIDS-16). Confirmatory studies are needed before ML enhanced screening can be implemented into routine care practice.
Correctional Officers and Social Media: Policies, Challenges, and Vulnerabilities
Authors: Adorjan Michael , Ricciardelli Rosemary
Published: August 2023

In this article, we draw from 159 qualitative interviews with Canadian correctional officers (COs) exploring their experiences and attitudes regarding social media. We frame our study within the “synoptic” mode of surveillance and public visibility—referring to the many observing the few—impacting public safety personnel, exploring the perceived vulnerabilities of COs, including toward prisoners, management, the organization, and the public. We highlight recent research on COs, especially in the Canadian context, and review the synoptic surveillance implications of social media in society. Our findings highlight four interrelated areas: COs (sometimes lack of) awareness of Correctional Service Canada (CSC) policies regarding social media use; challenges they experience online; the central role of privacy; and strategies they use to manage challenges and maintain privacy, especially considering their role as public representatives. We conclude by discussing how the use of social media produces new vulnerabilities for COs in public spaces and suggest future directions for research and practices.
Positive Influence of Organisational Politics on Job Performance in Indian Higher Education Context: A Qualitative Inquiry
Authors: Roopa Modem , Lakshminarayanan S. , Rodrigues Prajwala Preema , Prabhu Nandan
Published: August 2023

The job performance of academics in the higher education context has transcended from the prime focus of teaching to the concurrence of learning facilitation, research and publication. These reforms address a central research question: What are the emerging factors influencing job performance in the Indian higher education context? This study adopts a qualitative research design to explore the emerging factors affecting job performance. Thirteen academic researchers from Indian universities participated in the focus group discussions. The results of focus group discussions unravel five themes: demographics, behaviours, motivation, context and skills. The focus group discussions foregrounded the debate on knowledge-sharing behaviours, organisational politics and networking skills. However, what remains unknown is whether the organisational actors’ political characteristics influence their knowledge sharing, affecting their job performance. In this regard, the authors propose a new model that binds organisational politics to knowledge sharing and its impact on job performance. This novel approach to examining job performance contributes to theory by providing insights into the emerging themes that affect job performance and emphasising the role of political characteristics in understanding the job performance of academic researchers.
Nanometric Cutting Mechanism of Cerium–Lanthanum Alloy
Authors: Zhao Chenyu , Lai Min , Fang Fengzhou
Published: August 2023

Cerium–lanthanum alloy is widely used in the green energy industry, and the nanoscale smooth surface of this material is in demand. Nanometric cutting is an effective approach to achieving the ultra-precision machining surface. Molecular dynamics (MD) simulation is usually used to reveal the atomic-scale details of the material removal mechanism in nanometric cutting. In this study, the effects of cutting speed and undeformed chip thickness (UCT) on cutting force and subsurface deformation of the cerium–lanthanum alloy during nanometric cutting are analyzed through MD simulation. The results illustrate that the dislocations, stacking faults, and phase transitions occur in the subsurface during cutting. The dislocations are mainly Shockley partial dislocation, and the increase of temperature and pressure during the cutting process leads to the phase transformation of γ-Ce (FCC) into β-Ce (HCP) and δ-Ce (BCC). β-Ce is mainly distributed in the stacking fault area, while δ-Ce is distributed in the boundary area between the dislocation atoms and γ-Ce atoms. The cutting speed and UCT affect the distribution of subsurface damage. A thicker deformed layer including dislocations, stacking faults and phase-transformation atoms on the machined surface is generated with the increase in the cutting speed and UCT. Simultaneously, the cutting speed and UCT significantly affect the cutting force, material removal rate, and generated subsurface state. The fluctuations in the cutting force are related to the generation and disappearance of dislocations. This research first studied the nanometric cutting mechanism of the cerium–lanthanum ally, providing a theoretical basis for the development of ultra-precision machining techniques of these materials.
Cutaneous allodynia as predictor for treatment response in chronic migraine: a cohort study
Authors: Pijpers Judith A. , Kies Dennis A. , van Zwet Erik W. , de Boer Irene , Terwindt Gisela M.
Published: August 2023

Background

Central sensitisation is an important mechanism in migraine chronification. It is presumed to occur in second and third order neurons sequentially, resulting in an analogous spatial distribution of cutaneous allodynia with cephalic and extracephalic symptoms. We investigated whether allodynia, and its subtypes based on spatial distribution and type of stimulus, predict response to treatment in chronic migraine patients.

Methods

This study was conducted as part of the CHARM study (NTR3440), a randomized, double-blind, placebo-controlled trial in chronic migraine patients with medication overuse. We included 173 patients. The presence of cutaneous allodynia at baseline was established with the Allodynia Symptom Checklist. Primary endpoint was reversion from chronic to episodic migraine.

Results

Of all patients, 74.6% reported cutaneous allodynia. Absence of allodynia compared to presence of allodynia was predictive for reversion from chronic to episodic migraine, odds ratio (OR): 2.45 (95% CI: 1.03–5.84), p = 0.042. The predictive value was more pronounced when subdivided for spatial distribution, for participants without allodynia versus cephalic (OR: 4.16 (95% CI: 1.21–14.30), p = 0.024) and extracephalic (OR: 7.32 (95% CI: 1.98- 27.11), p = 0.003) allodynia. Mechanical, but not thermal, allodynia, was associated with outcome.

Conclusions

Cutaneous allodynia, an important marker for central sensitization, likely has predictive value for treatment response in chronic migraine.

Graphical Abstract
Gut microbiome causal impacts on the prognosis of breast cancer: a Mendelian randomization study
Authors: Hong Weimin , Huang Guoxin , Wang Danhong , Xu Yadan , Qiu Jie , Pei Bin , Qian Da , Meng Xuli
Published: August 2023

Background

Growing evidence has shown that gut microbiome composition is associated with breast cancer (BC), but the causality remains unknown. We aimed to investigate the link between BC prognosis and the gut microbiome at various oestrogen receptor (ER) statuses.

Methods

We performed a genome-wide association study (GWAS) to analyse the gut microbiome of BC patients, the dataset for which was collected by the Breast Cancer Association Consortium (BCAC). The analysis was executed mainly via inverse variance weighting (IVW); the Mendelian randomization (MR) results were verified by heterogeneity tests, sensitivity analysis, and pleiotropy analysis.

Results

Our findings identified nine causal relationships between the gut microbiome and total BC cases, with ten and nine causal relationships between the gut microbiome and ER-negative (ER-) and ER-positive (ER+) BC, respectively. The family Ruminococcaceae and genus Parabacteroides were most apparent among the three categories. Moreover, the genus Desulfovibrio was expressed in ER- BC and total BC, whereas the genera Sellimonas, Adlercreutzia and Rikenellaceae appeared in the relationship between ER + BC and total BC.

Conclusion

Our MR inquiry confirmed that the gut microbiota is causally related to BC. This further explains the link between specific bacteria for prognosis of BC at different ER statuses. Considering that potential weak instrument bias impacts the findings and that the results are limited to European females due to data constraints, further validation is crucial.
Enhancing research culture in academia: a spotlight on early career researchers
Authors: Chisholm Kim I , Finelli Mattéa J.
Published: August 2023

This editorial highlights common challenges faced by early career researchers (ECRs) who play a crucial role in our research community. We propose that enhancing the experiences of ECRs will yield benefits to the entire scientific community and we give practical suggestions on how such improvements may be achieved.
Identification of distinct clinical phenotypes of cardiogenic shock using machine learning consensus clustering approach
Authors: Wang Li , Zhang Yufeng , Yao Renqi , Chen Kai , Xu Qiumeng , Huang Renhong , Mao Zhiguo , Yu Yue
Published: August 2023

Background

Cardiogenic shock (CS) is a complex state with many underlying causes and associated outcomes. It is still difficult to differentiate between various CS phenotypes. We investigated if the CS phenotypes with distinctive clinical profiles and prognoses might be found using the machine learning (ML) consensus clustering approach.

Methods

The current study included patients who were diagnosed with CS at the time of admission from the electronic ICU (eICU) Collaborative Research Database. Among 21,925 patients with CS, an unsupervised ML consensus clustering analysis was conducted. The optimal number of clusters was identified by means of the consensus matrix (CM) heat map, cumulative distribution function (CDF), cluster-consensus plots, and the proportion of ambiguously clustered pairs (PAC) analysis. We calculated the standardized mean difference (SMD) of each variable and used the cutoff of ± 0.3 to identify each cluster’s key features. We examined the relationship between the phenotypes and several clinical endpoints utilizing logistic regression (LR) analysis.

Results

The consensus cluster analysis identified two clusters (Cluster 1: n = 9,848; Cluster 2: n = 12,077). The key features of patients in Cluster 1, compared with Cluster 2, included: lower blood pressure, lower eGFR (estimated glomerular filtration rate), higher BUN (blood urea nitrogen), higher creatinine, lower albumin, higher potassium, lower bicarbonate, lower red blood cell (RBC), higher red blood cell distribution width (RDW), higher SOFA score, higher APS III score, and higher APACHE IV score on admission. The results of LR analysis showed that the Cluster 2 was associated with lower in-hospital mortality (odds ratio [OR]: 0.374; 95% confidence interval [CI]: 0.347–0.402; P < 0.001), ICU mortality (OR: 0.349; 95% CI: 0.318–0.382; P < 0.001), and the incidence of acute kidney injury (AKI) after admission (OR: 0.478; 95% CI: 0.452–0.505; P < 0.001).

Conclusions

ML consensus clustering analysis synthesized the pattern of clinical and laboratory data to reveal distinct CS phenotypes with different clinical outcomes.
Effects of intra-aortic balloon pump on in-hospital outcomes and 1-year mortality in patients with acute myocardial infarction complicated by cardiogenic shock
Authors: Fang Dingfeng , Yu Dongdong , Xu Jiabin , Ma Wei , Zhong Yuxiang , Chen Haibo
Published: August 2023

Background

The role of intra-aortic balloon counterpulsation (IABP) in cardiogenic shock complicating acute myocardial infarction (AMI) is still a subject of intense debate. In this study, we aim to investigate the effect of IABP on the clinical outcomes of patients with AMI complicated by cardiogenic shock undergoing percutaneous coronary intervention (PCI).

Methods

From the Medical Information Mart for Intensive Care (MIMIC)-IV 2.2, 6017 AMI patients were subtracted, and 250 patients with AMI complicated by cardiogenic shock undergoing PCI were analyzed. In-hospital outcomes (death, 24-hour urine volumes, length of ICU stays, and length of hospital stays) and 1-year mortality were compared between IABP and control during the hospital course and 12-month follow-up.

Results

An IABP was implanted in 30.8% (77/250) of patients with infarct-related cardiogenic shock undergoing PCI. IABP patients had higher levels of Troponin T (3.94 [0.73–11.85] ng/ml vs. 1.99 [0.55–5.75] ng/ml, p-value = 0.02). IABP patients have a longer length of ICU and hospital stays (124 [63–212] hours vs. 83 [43–163] hours, p-value = 0.005; 250 [128–435] hours vs. 170 [86–294] hours, p-value = 0.009). IABP use was not associated with lower in-hospital mortality (33.8% vs. 33.0%, p-value = 0.90) and increased 24-hour urine volumes (2100 [1455–3208] ml vs. 1915 [1110–2815] ml, p-value = 0.25). In addition, 1-year mortality was not different between the IABP and the control group (48.1% vs. 48.0%; hazard ratio 1.04, 95% CI 0.70–1.54, p-value = 0.851).

Conclusion

IABP may be associated with longer ICU and hospital stays but not better short-and long-term clinical prognosis.
Activities of daily living predict periprocedural myocardial infarction and injury following percutaneous coronary intervention: a cross-sectional study
Authors: Pan Yifan , Xu Min , Mei Yaosheng , Wang Yunxiang , Zhang Qiongli
Published: August 2023

Background

In recent years, there has been growing interest in exploring the relationship between activities of daily living (ADL) and cardiovascular diseases. This retrospective cross-sectional study aimed to investigate the association of ADL measured by Barthel index (BI) with periprocedural myocardial infarction (PMI) and injury following percutaneous coronary intervention (PCI).

Methods

Enrolled patients were stratified into impaired and unimpaired ADL groups according to their BI scores. Logistic regressions were conducted to explore the association of ADL on admission with periprocedural myocardial injury and infarction. Restricted cubic spline (RCS) curve and subgroup analysis were also performed.

Results

Totally, 16.4% of patients suffered from PMI; the mean age was 65.8 ± 10.4 years old. RCS analysis showed that the morbidity of periprocedural myocardial infarction and injury showed a downward tendency with increasing BI scores. Multivariable logistic regression analysis demonstrated that impaired ADL was an independent risk factor for periprocedural myocardial infarction (OR = 1.190, 95% CI [1.041, 1.360], P = 0.011) and injury (OR = 1.131, 95% CI [1.017, 1.257], P = 0.023). Subgroup analysis showed that the association between ADL and PMI was founded in several subgroups, while the association between ADL and periprocedural myocardial injury was founded only in BMI ≥ 24 kg/m2 subgroup.

Conclusion

Impaired ADL at hospital admission was an independent risk factor for periprocedural myocardial infarction and injury among patients following PCI.
System interventions to support rural access to maternity care: an analysis of the rural surgical obstetrical networks program
Authors: Kornelsen Jude , Lin Stephanie , Williams Kim , Skinner Tom , Ebert Sean
Published: August 2023

Background

The Rural Surgical Obstetrical Networks (RSON) project was developed in response to the persistent attrition of rural maternity services across Canada over the past two decades. While other research has demonstrated the adverse health and psychosocial consequences of losing local maternity services, this paper explores the impact of a program designed to increase the sustainability of rural services themselves, through the funding of four “pillars”: increased scope and volume, clinical coaching, continuous quality improvement (CQI) and remote presence technology.

Methods

We conducted in-depth, qualitative research interviews with rural health care providers and administrators in eight rural communities across British Columbia to understand the impact of the RSON program on maternity services. Researchers used thematic analysis to generate common themes across the dataset and interpret findings.

Findings

Participants articulated six themes regarding the sustainability of maternity care as actualized through the RSON project: safety and quality through quality improvement opportunities, improved access to care through increased surgical volume and OR backup, optimized team function through innovative models of care, improved infrastructure, local innovation surrounding workforce shortages, and locally tailored funding models.

Conclusion

Rural maternity sites benefited from the funding offered through the RSON pillars, as demonstrated by larger volumes of local deliveries, nearly unanimous positive accounts of the interventions by health care providers, and evidence of staffing stability during the study time frame. As such, the interventions provided through the Rural Surgical Obstetrical Networks project as well as study findings on the common themes of sustainable maternity care should be considered when planning core rural health services funding schemes.
Clinical features and prognosis of pregnancy-related renal damage and pregnancy after chronic kidney disease
Authors: Fang Li , Shen Bingbing , Zhang Huhai , Yin Na , Cai Juan , Zhang Jun , Zhao Hongwen
Published: August 2023

Objective

To explore the clinical features of renal damage related to pregnancy and pregnancy after chronic kidney disease (CKD), providing clinical evidence for the relationship between renal damage and pregnancy.

Methods

A retrospective analysis was performed on patients admitted to our hospital between March 2013 and February 2021 who had both pregnancy and kidney damage. The study collected pathology results from renal biopsies, 24-hour urinary protein quantity, albumin (Alb), serum creatinine (Scr), blood lipids, coagulation function, blood routine, and other indicators during and after pregnancy.

Results

This study included 82 cases, with 48 cases in the pregnancy-related renal damage group. Thirty-four cases were in the post-CKD pregnancy group. Of the patients, 30 cases (88.24%) had CKD stage 1–2. Results showed better pregnancy and fetal outcomes in the post-CKD pregnancy group compared to the pregnancy-related renal damage group (Ρ was 0.029 and 0.036, respectively). Renal biopsy pathology revealed that 16 cases (33.33%) in the pregnancy-related renal damage group mainly had focal segmental glomerulosclerosis (FSGS), while the post-CKD pregnancy group was dominated by 14 cases (43.75%) of IgA nephropathy. The first blood test indicators revealed that the pregnancy-related renal damage group had lower estimated glomerular filtration (eGFR) and Alb levels compared to the post-CKD pregnancy group (Ρ was 0.003 and 0.000, respectively). Additionally, 24-hour urinary protein quantity, total cholesterol (Tch), triglyceride (TG), and platelet (PLT) counts were higher in the pregnancy-related renal damage group compared to the post-CKD pregnancy group (Ρ was 0.005, 0.001, 0.008, and 0.031, respectively). The abnormal rate of Scr during pregnancy was 41.67% (20/48) in the pregnancy-related renal damage group and 17.39% (4/23) in the post-CKD pregnancy group, with a statistically significant difference (Ρ was 0.043).

Conclusion

The pregnancy-related renal damage group is mainly associated with FSGS, while the post-CKD pregnancy group is characterized by IgA nephropathy. Patients with CKD1-2 can have a successful pregnancy after achieving good control of eGFR, albumin, 24-hour urinary protein quantity and other indicators, resulting in better pregnancy and fetal outcomes. Abnormal Scr levels during pregnancy of pregnancy-related renal damage can be improved within 3 months after delivery.
Factors associated with adherence to provider referrals for lung cancer screening with low dose computed tomography before and during COVID-19 pandemic
Authors: Li Jiang , Stults Cheryl D. , Liang Su-Ying , Martinez Meghan
Published: August 2023

Background

Lung cancer has been the leading cause of American deaths from cancer. Although Medicare started covering lung cancer screening (LCS) with low-dose computed tomography (LDCT) in 2015, the uptake of LDCT-LCS remains low. This study examines the changes in adherence to provider referrals for LDCT-LCS and the factors at patient, provider, and health system levels that influence the completion rate of LDCT-LCS orders before and during the COVID-19 pandemic.

Methods

Our study examined electronic health record data (December 2013 - December 2020) from a large, community-based clinical healthcare delivery system in California. We plotted monthly trends in the frequency of LDCT-LCS orders and completion rate and compared the annual LDCT-LCS completion rate between LCS-eligible, LCS-ineligible, and unknown eligibility groups. We then explored multilevel factors associated with the completion of LDCT-LCS orders using hierarchical generalized linear models.

Results

There was an increase in LDCT-LCS orders (N = 12,469) from 2013 to 2019, followed by a sharp decline in March 2020 due to the onset of the COVID-19 pandemic. Thereafter, LDCT-LCS orders slowly increased again in June 2020. The completion rate of LDCT-LCS increased from 0% in December 2013 to approximately 70% in 2018–2019 but declined to 50–60% in 2020 during the pandemic. Ineligible patients had lower completion rates of LDCT-LCS. Patients who were new to the healthcare system, Black, received the LDCT-LCS order in the first few years after Medicare coverage (2016 or 2017), during the pandemic, had major comorbidities, and smoked less than 30 pack-years were less likely to complete an order. Patients were more likely to complete LDCT-LCS orders if they were younger, received the LDCT-LCS order from a physician (vs. nonphysician provider), from family medicine or other specialties (vs. internal medicine), or saw a provider with more experience in LDCT-LCS.

Conclusions

The beginning of the COVID-19 pandemic largely decreased the volume of LDCT-LCS orders, but rates have since been slowing recovering. Future interventions to improve lung cancer screening should consider doing more targeted outreach to new patients and Black patients as well as providing additional education to nonphysician practitioners and those providers with lower rates of LDCT-LCS referral orders.
A co-formulation of interferons alpha2b and gamma distinctively targets cell cycle in the glioblastoma-derived cell line U-87MG
Authors: Miranda Jamilet , Vázquez-Blomquist Dania , Bringas Ricardo , Fernandez-de-Cossio Jorge , Palenzuela Daniel , Novoa Lidia I. , Bello-Rivero Iraldo
Published: August 2023

Background

HeberFERON is a co-formulation of α2b and γ interferons, based on their synergism, which has shown its clinical superiority over individual interferons in basal cell carcinomas. In glioblastoma (GBM), HeberFERON has displayed promising preclinical and clinical results. This led us to design a microarray experiment aimed at identifying the molecular mechanisms involved in the distinctive effect of HeberFERON compared to the individual interferons in U-87MG model.

Methods

Transcriptional expression profiling including a control (untreated) and three groups receiving α2b-interferon, γ-interferon and HeberFERON was performed using an Illumina HT-12 microarray platform. Unsupervised methods for gene and sample grouping, identification of differentially expressed genes, functional enrichment and network analysis computational biology methods were applied to identify distinctive transcription patterns of HeberFERON. Validation of most representative genes was performed by qPCR. For the cell cycle analysis of cells treated with HeberFERON for 24 h, 48 and 72 h we used flow cytometry.

Results

The three treatments show different behavior based on the gene expression profiles. The enrichment analysis identified several mitotic cell cycle related events, in particular from prometaphase to anaphase, which are exclusively targeted by HeberFERON. The FOXM1 transcription factor network that is involved in several cell cycle phases and is highly expressed in GBMs, is significantly down regulated. Flow cytometry experiments corroborated the action of HeberFERON on the cell cycle in a dose and time dependent manner with a clear cellular arrest as of 24 h post-treatment. Despite the fact that p53 was not down-regulated, several genes involved in its regulatory activity were functionally enriched. Network analysis also revealed a strong relationship of p53 with genes targeted by HeberFERON. We propose a mechanistic model to explain this distinctive action, based on the simultaneous activation of PKR and ATF3, p53 phosphorylation changes, as well as its reduced MDM2 mediated ubiquitination and export from the nucleus to the cytoplasm. PLK1, AURKB, BIRC5 and CCNB1 genes, all regulated by FOXM1, also play central roles in this model. These and other interactions could explain a G2/M arrest and the effect of HeberFERON on the proliferation of U-87MG.

Conclusions

We proposed molecular mechanisms underlying the distinctive behavior of HeberFERON compared to the treatments with the individual interferons in U-87MG model, where cell cycle related events were highly relevant.
Research interests of family physicians applying for research training
Authors: Carroll Jennifer K. , Hester Christina M. , Lutgen Cory B. , Callen Elisabeth , Hunt Sharon , Lanigan Angela M. , Bartlett-Esquilant Gillian , Irwin Gretchen , Jones Warren A. , Loskutova Natalia , Mabachi Natabhona M. , Okuyemi Kolawole S. , Peterson Lars E. , Smith Richard Edward , Tabel Cheri , Weidner Amanda
Published: August 2023

Background

There is an ongoing need for research to support the practice of high quality family medicine. The Family Medicine Discovers Rapid Cycle Scientific Discovery and Innovation (FMD RapSDI) program is designed to build capacity for family medicine scientific discovery and innovation in the United States. Our objective was to describe the applicants and research questions submitted to the RapSDI program in 2019 and 2020.

Methods

Descriptive analysis for applicant characteristics and rapid qualitative analysis using principles of grounded theory and content analysis to examine the research questions and associated themes. We examined differences by year of application submission and the applicant’s career stage.

Results

Sixty-five family physicians submitted 70 applications to the RapSDI program; 45 in 2019 and 25 in 2020. 41% of applicants were in practice for five years or less (n = 27), 18% (n = 12) were in in practice 6–10 years, and 40% (n = 26) were ≥ 11 years in practice. With significant diversity in questions, the most common themes were studies of new innovations (n = 20, 28%), interventions to reduce cost (n = 20, 28%), improving screening or diagnosis (n = 19, 27%), ways to address mental or behavioral health (n = 18, 26%), and improving care for vulnerable populations (n = 18, 26%).

Conclusion

Applicants proposed a range of research questions and described why family medicine is optimally suited to address the questions. Applicants had a desire to develop knowledge to help other family physicians, their patients, and their communities. Findings from this study can help inform other family medicine research capacity building initiatives.
Influence of oral comprehensive nursing intervention on mechanically ventilated patients in ICU: a randimized controlled study
Authors: Lei Shengxia , Liu Yan , Zhang Enkun , Liu Chuanxia , Wang Jing , Yang Lingling , Zhang Ping , Shi Ying , Sheng Xiaomin
Published: August 2023

Objective

To explore the effect of oral comprehensive nursing intervention on mechanically ventilated patients in ICU.

Methods

Select 76 cases of mechanically ventilated patients in severe ICU admitted to our hospital from January 2022 to October 2022 as the research objects, and divide them into the control group and the observation group according to the way the patients receive oral care. 38 cases each. The patients in the control group received routine nursing intervention, and the patients in the observation group received comprehensive oral nursing intervention on the basis of the nursing of the control group. The clinical index data, oropharyngeal hygiene, pH value, blood gas analysis index levels, and the occurrence and death of ventilator-associated pneumonia were compared between the two groups of patients.

Results

The hospitalization time of the two groups was compared (P > 0.05); the mechanical ventilation time and ICU stay time of the observation group were significantly lower than those of the control group (all, P < 0.05); the oral odor scores, The plaque index and soft scale index were significantly lower than those of the control group (all, P < 0.05); the pH value, PaO 2 value, and SpO 2 value of the observation group were significantly lower than those of the control group, and the PaCO 2 value was significantly higher than that of the control group. group (all, P < 0.05); the incidence of VAP in the control group was 55.26%, and the mortality rate was 15.79%, the incidence rate of VAP in the observation group was 21.05%, and the mortality rate was 2.63%, and the incidence rate and mortality rate of VAP in the observation group were significantly lower in the control group (all, P < 0.05).

Conclusion

The application of nursing intervention can effectively promote the recovery of patients, improve the hygiene of patients’ oropharynx, adjust the levels of pH and blood gas-related indicators in patients, and reduce VAP in patients. risk of morbidity and mortality.
Outpatient visits before and after Lyme disease diagnosis in a Maryland employer-based health plan
Authors: Rebman Alison W. , Yang Ting , Wang Lin , Marsteller Jill A. , Murphy Shannon M. E. , Uriyo Maria , Aucott John N.
Published: August 2023

Background

Insurance claims data have been used to inform an understanding of Lyme disease epidemiology and cost of care, however few such studies have incorporated post-treatment symptoms following diagnosis. Using longitudinal data from a private, employer-based health plan in an endemic US state, we compared outpatient care utilization pre- and post-Lyme disease diagnosis. We hypothesized that utilization would be higher in the post-diagnosis period, and that temporal trends would differ by age and gender.

Methods

Members with Lyme disease were required to have both a corresponding ICD-9 code and a fill of an antibiotic indicated for treatment of the infection within 30 days of diagnosis. A 2-year ‘pre- diagnosis’ period and a 2-year ‘post-diagnosis period’ were centered around the diagnosis month. Lyme disease-relevant outpatient care visits were defined as specific primary care, specialty care, or urgent care visits. Descriptive statistics examined visits during these pre- and post-diagnosis periods, and the association between these periods and the number of visits was explored using generalized linear mixed effects models adjusting for age, season of the year, and gender.

Results

The rate of outpatient visits increased 26% from the pre to the post-Lyme disease diagnosis periods among our 317-member sample (rate ratio = 1.26 [1.18, 1.36], p < 0.001). Descriptively, care utilization increases appeared to persist across months in the post-diagnosis period. Women’s care utilization increased by 36% (1.36 [1.24, 1.50], p < 0.001), a significantly higher increase than the 14% increase found among men (1.14 [1.02, 1.27], p = 0.017). This gender difference was mainly driven by adult members. We found a borderline significant 17% increase in visits for children < 18 years, (1.17 [0.99, 1.38], p = 0.068), and a 31% increase for adults ≥ 18 years (1.31 [1.21, 1.42], p < 0.001).

Conclusions

Although modest at the population level, the statistically significant increases in post-Lyme diagnosis outpatient care we observed were persistent and unevenly distributed across demographic and place of service categories. As Lyme disease cases continue to grow, so will the cumulative prevalence of persistent symptoms after treatment. Therefore, it will be important to confirm these findings and understand their significance for care utilization and cost, particularly against the backdrop of other post-acute infectious syndromes.
Molecular and biological characterization of pyocyanin from clinical and environmental Pseudomonas aeruginosa
Authors: Shouman Heba , Said Heba Shehta , Kenawy Hany I. , Hassan Ramadan
Published: August 2023

Background

Pyocyanin is a secondary metabolite secreted by P. aeruginosa. It is a redox-active blue/green phenazine pigment that has various beneficial applications. The present study aims at screening the production of pyocyanin among clinical and environmental P. aeruginosa isolates in Dakahlya governorate, Egypt. Thereafter, large-scale production, purification, structure elucidation, and assessment of the biological activity of the highest pyocyanin producers were targeted.

Results

Pyocyanin from the highest clinical (PsC05) and environmental (PsE02) producers were subjected to large-scale production, followed by purification using silica gel column. Pyocyanin was characterized using TLC, UV-Vis, 1 H NMR, and FTIR spectroscopy to confirm its structure and purity. Purified pyocyanin showed remarkable antimicrobial efficacy against all tested food-borne pathogens, MDR/XDR clinically isolated bacteria and C. albicans. Furthermore, it showed a substantial effect on biofilm inhibition and eradication of pre-formed biofilm against strong biofilm producing bacterial pathogens. However, it had limited antibiofilm activity against C. albicans. Pyocyanin from PsC05 had higher antioxidant and radicals scavenging activity than that from PsE02 as determined by FRAP, DPPH, and ABTS assays. Likewise, pyocyanin from PsC05 was more active against tested cancer cell lines, especially human Breast Cancer (MCF-7) and Colorectal Carcinoma (HCT-116), than that from PsE02. More importantly, it showed minimal cytotoxicity to normal cells.

Conclusions

P. aeruginosa clinical and environmental isolates produce pyocyanin pigment in varying amounts. Pyocyanin exhibits substantial anti-bacterial, and anti-fungal activity; thus, enhancing its medical applicability. It could be used to inhibit and/or eradicate biofilm from the surfaces of medical devices which is a chief source of nosocomial infections. Its antioxidant along with cytotoxic activity against cancer cell lines, make it a promising contender for use as a substitute for synthetic agents in cancer treatment.
Metabolic engineering strategies for naringenin production enhancement in Streptomyces albidoflavus J1074
Authors: Ye Suhui , Magadán-Corpas Patricia , Pérez-Valero Álvaro , Villar Claudio J. , Lombó Felipe
Published: August 2023

Background

Naringenin is an industrially relevant compound due to its multiple pharmaceutical properties as well as its central role in flavonoid biosynthesis.

Results

On our way to develop Streptomyces albidoflavus J1074 as a microbial cell factory for naringenin production, we have significantly increased the yields of this flavanone by combining various metabolic engineering strategies, fermentation strategies and genome editing approaches in a stepwise manner. Specifically, we have screened different cultivation media to identify the optimal production conditions and have investigated how the additive feeding of naringenin precursors influences the production. Furthermore, we have employed genome editing strategies to remove biosynthetic gene clusters (BGCs) associated with pathways that might compete with naringenin biosynthesis for malonyl-CoA precursors. Moreover, we have expressed MatBC, coding for a malonate transporter and an enzyme responsible for the conversion of malonate into malonyl-CoA, respectively, and have duplicated the naringenin BGC, further contributing to the production improvement. By combining all of these strategies, we were able to achieve a remarkable 375-fold increase (from 0.06 mg/L to 22.47 mg/L) in naringenin titers.

Conclusion

This work demonstrates the influence that fermentation conditions have over the final yield of a bioactive compound of interest and highlights various bottlenecks that affect production. Once such bottlenecks are identified, different strategies can be applied to overcome them, although the efficiencies of such strategies may vary and are difficult to predict.