bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Strategy to Manage Below-Knee-Amputation (BKA) Stump Complications for Early Wound Healing and BKA Salvage
Authors: Balan Naveen , Qi Xin , Keeley Jessica , Neville Angela
Published: May 2023

Introduction

The optimal management of major stump complications (operative infection or dehiscence) following below-knee-amputation (BKA) is unknown. We evaluated a novel operative strategy to aggressively treat major stump complications hypothesizing it would improve our rate of BKA salvage.

Methods

Retrospective review of patients requiring operative intervention for BKA stump complications between 2015 and 2021. A novel strategy employing staged operative debridement for source control, negative pressure wound therapy, and reformalization was compared to standard care (less structured operative source control or above knee amputation).

Results

32 patients were studied, 29 of which were male (90.6%) with an average age of 56.1 ± 9.6 y. 30 (93.8%) had diabetes and 11 (34.4%) peripheral arterial disease (PAD). The novel strategy was used in 13 patients and 19 had standard care. Novel strategy patients had higher BKA salvage rates, 100% vs 73.7% ( P = .064), and postoperative ambulatory status, 84.6% vs 57.9% ( P = .141). Importantly, none of the patients undergoing the novel therapy had PAD, while all progressing to above-knee amputation (AKA) did. To better assess the efficacy of the novel technique, patients progressing to AKA were excluded. Patients undergoing novel therapy who had their BKA level salvaged (n = 13) were compared to usual care (n = 14). The novel therapy’s time to prosthetic referral was 72.8 ± 53.7 days vs 247 ± 121.6 days ( P < .001), but they did undergo more operations (4.3 ± 2.0 vs 1.9 ± 1.1, P < .001).

Conclusion

Utilization of a novel operative strategy for BKA stump complications is effective in salvaging BKAs, particularly for patients without PAD.
Measurement of cholesterol levels of lipoprotein subclasses in human serum using anion-exchange high-performance liquid chromatography with a linear concentration gradient of sodium perchlorate
Authors: Ito Riku , Manita Daisuke , Yanai Hidekatsu , Hirowatari Yuji
Published: May 2023

Background

Relationships between the subclasses of high-density lipoprotein (HDL) or low-density lipoprotein (LDL) and the risk of atherosclerotic cardiovascular disease have been studied, and using various methods, such as ultracentrifugation, electrophoresis, and nuclear magnetic resonance, for analysing lipoprotein subclasses. We established a method for HDL and LDL subclasses using anion-exchange high-performance liquid chromatography (AEX-HPLC) with a linear concentration gradient of sodium perchlorate (NaClO4).

Method

In the AEX-HPLC, the subclasses of HDL and LDL were separated, and detected using a post-column reactor with an enzymatic cholesterol reagent, that contained cholesterol esterase, cholesterol oxidase, and peroxidase as major ingredients. LDL subclasses were divided based on the absolute value of first-derivative chromatogram.

Result

Three HDL subclasses, HDL-P1, HDL-P2, and HDL-P3, and three LDL subclasses, LDL-P1, LDL-P2, and LDL-P3, were separated by AEX-HPLC, and detected in order. The major components of HDL-P2 and HDL-P3 were HDL3 and HDL2, respectively. The linearity was determined for each lipoprotein subclass. The coefficients of variation of cholesterol concentration of the subclasses for within-day assay ( n = 10) and between-day assay ( n = 10) ranged between 3.08–8.94% and 4.52–9.97%, respectively. Cholesterol levels in HDL-P1 of diabetic patients were positively correlated with oxidized LDL levels (r = 0.409, p = 0.002). Moreover, cholesterol levels in LDL-P2 and LDL-P3 were positively correlated with oxidized LDL levels (r = 0.393, p = 0.004 and r = 0.561, p < 0.001, respectively).

Conclusion

AEX-HPLC may be highly suitable as an assay to clinically assess lipoprotein subclasses.
Characteristics of clinical-pharmacological recommendations in psychiatry in Germany
Authors: Schröder Sebastian , Schulze Westhoff Martin , Pfister Tabea , Bleich Stefan , Wedegärtner Felix , Krüger Tillmann HC , Heck Johannes , Groh Adrian
Published: May 2023

Objective

Psychiatric patients in general, and elderly psychiatric patients in particular, are at risk of adverse drug reactions due to comorbidities and inappropriate polypharmacy. Interdisciplinary and clinical-pharmacologist-led medication reviews may contribute to medication safety in the field of psychiatry. In this study, we reported the frequency and characteristics of clinical-pharmacological recommendations in psychiatry, with a particular focus on geriatric psychiatry.

Method

A clinical pharmacologist, in collaboration with the attending psychiatrists and a consulting neurologist, conducted interdisciplinary medication reviews in a general psychiatric ward with a geropsychiatric focus at a university hospital over a 25-week period. All clinical and pharmacological recommendations were recorded and evaluated.

Results

A total of 316 recommendations were made during 374 medication reviews. Indications/contraindications of drugs were the most frequently discussed topics (59/316; 18.7 %), followed by dose reductions (37/316; 11.7 %), and temporary or permanent discontinuation of medications (36/316; 11.4 %). The most frequent recommendations for dose reduction involvedbenzodiazepines (9/37; 24.3 %). An unclear or absent indication was the most common reason for recommending temporary or permanent discontinuation of the medication (6/36; 16.7 %).

Conclusion

Interdisciplinary clinical pharmacologist-led medication reviews represented a valuable contribution to medication management in psychiatric patients, particularly the elderly ones.
Neutrophil-derived cathelicidin promotes cerebral angiogenesis after ischemic stroke
Authors: Xie Wanqing , Huang Tingting , Guo Yunlu , Zhang Yueman , Chen Weijie , Li Yan , Chen Chen , Li Peiying
Published: May 2023

Neutrophils play critical roles in the evolving of brain injuries following ischemic stroke. However, how they impact the brain repair in the late phase after stroke remain uncertain. Using a prospective clinical stroke patient cohort, we found significantly increased cathelicidin antimicrobial peptide (CAMP) in the peripheral blood of stroke patients compared to that of healthy controls. While in the mouse stroke model, CAMP was present in the peripheral blood, brain ischemic core and significantly increased at day 1, 3, 7, 14 after middle cerebral artery occlusion (MCAO). CAMP−/− mice exhibited significantly increased infarct volume, exacerbated neurological outcome, reduced cerebral endothelial cell proliferation and vascular density at 7 and 14 days after MCAO. Using bEND3 cells subjected to oxygen-glucose deprivation (OGD), we found significantly increased angiogenesis-related gene expression with the treatment of recombinant CAMP peptide (rCAMP) after reoxygenation. Intracerebroventricular injection (ICV) of AZD-5069, the antagonist of CAMP receptor CXCR2, or knockdown of CXCR2 by shCXCR2 recombinant adeno-associated virus (rAAV) impeded angiogenesis and neurological recovery after MCAO. Administration of rCAMP promoted endothelial proliferation and angiogenesis and attenuated neurological deficits 14 days after MCAO. In conclusion, neutrophil derived CAMP represents an important mediator that could promote post-stroke angiogenesis and neurological recovery in the late phase after stroke.
Laboratory Investigation of Draindown Behavior of Open-Graded Friction-Course Mixtures Containing Banana and Sugarcane Bagasse Natural Fibers
Authors: Sharma Ashish , Choudhary Rajan , Kumar Ankush
Published: May 2023

Open-graded friction courses (OGFCs) are asphalt paving mixes with a higher number of interconnecting air voids to provide advantages with respect to improved drainage, increased dry/wet surface friction resistance, decreased splash and spray, and reduced aquaplaning. However, binder draindown has been a recurring issue during the manufacture, storage, transportation, and service life of OGFC mixtures. The addition of stabilizers in the form of fiber is often used with OGFC mixes to counteract the draindown. Increasing environmental awareness, the depletion of fossil resources, and the rise of global waste problems have necessitated the use of locally accessible natural fibers as an alternative to expensive synthetic fibers. In this study, the banana fiber obtained from the waste pseudo-stem of the banana plant post-harvesting and the sugarcane bagasse fiber obtained from the post-residual after sugar extraction is explored along with a commercial cellulose fiber to evaluate the draindown characteristics of OGFC mixtures. A cone penetration test and fiber absorption test was performed on the fiber-mixed asphalt binder. The draindown characteristics of 168 combinations of OGFC mixes were evaluated considering various parameters, viz. fiber parameters (types, lengths, dosages), binder dosage, binder types (unmodified binder and polymer-modified binder), and time period. Finally, a statistical analysis was conducted to determine the efficacy of different influencing factors. The best performance was exhibited by banana fiber, which had a dosage of 0.45% and a length of 9 mm, followed by sugarcane bagasse and cellulose fiber. All the input factors were found to be statistically significant.
Using Indirect Tensile Cracking Test Data for Quality Control and Acceptance
Authors: Diefenderfer Stacey D. , Habbouche Jhony , Boz Ilker
Published: May 2023

The Virginia Department of Transportation currently requires the use of the indirect tensile cracking test (IDT-CT) in accordance with ASTM D8225 in its balanced mix design specifications to evaluate the cracking resistance of several unmodified dense-graded asphalt surface mixtures. Although some studies have been performed, there is still limited information on testing processes that may have effects on the test results. This paper addresses the identification and assessment of factors that could have a significant effect on the cracking tolerance index (CT index) test results based on the IDT-CT when used for mixture quality control and acceptance by an agency, for example, specimen conditioning method, loading rate, and data collection frequency. Test results suggested that device type might be a significant factor for mixtures with relatively low CT index values. IDT-CT results were not dependent on the type of conditioning method (i.e., dry or wet). Further, they were not dependent on the loading rate applied, regardless of the machine type (servo-hydraulic or screw-drive) or the data collection frequency used over a range of 1 to 100 Hz. Sets of four and three test specimen replicates had single-operator and multi-laboratory precision estimates similar to those determined for five-replicate data sets.
Understanding English as a Foreign Language Students’ Idea Generation Strategies for Creative Writing With Natural Language Generation Tools
Authors: Woo David James , Wang Yanzhi , Susanto Hengky , Guo Kai
Published: May 2023

Natural language generation (NLG) is a process within artificial intelligence where computer systems produce human-comprehensible language texts from information. English as a foreign language (EFL) students’ use of NLG tools might facilitate their idea generation, which is fundamental to creative writing. However, little is known about how EFL students interact with NLG tools to generate ideas. This study explores strategies adopted by EFL students when searching for ideas using NLG tools, evaluating ideas generated by NLG tools and selecting NLG tools for idea generation. Four Hong Kong secondary school students attended workshops where they learned to write stories comprising their own words and words generated by NLG tools. After the workshops, they answered questions to reflect on their writing experience with NLG tools. In a thematic analysis of the written reflections, we found students may have existing ideas when searching for ideas and evaluating ideas with NLG tools. Students showed some aversion to ideas generated by NLG tools and selected NLG tools that generated a greater quantity of ideas. The findings inform our understanding of EFL students’ concerns when using NLG tools for idea generation and can inform educators’ instruction to implement NLG tools for classroom creative writing.
Intimate Partner Violence and Children Under 5 Morbidities and Mortality in Afghanistan: Findings From a National Survey
Authors: Dadras Omid , Hazratzai Mohammadsediq , Dadras Fateme
Published: May 2023

Limited knowledge exists concerning the prevalence and drivers of intimate partner violence (IPV) against Afghan women and its association with child morbidity and mortality in Afghanistan. The study used data from the 2015 Afghanistan Demographic and Health Survey (ADHS 2015). The prevalence and associated sociodemographic factors of IPV were described by analyzing the data from Afghan women aged 15 to 49 years selected for the IPV module in ADHS 2015 ( n = 24,070) whose children under 5 ( n = 22,927) were included in the further analysis to estimate the morbidity and mortality of children and its association with IPV. It appeared that more than half of the Afghan women aged 15 to 49 years experienced IPV in the past year. Illiteracy (odds ratio [ OR] = 1.69; 95% CI: 1.19, 2.39), living in rural areas ( OR = 1.47; [1.19, 1.82]) being from the Pashtun, Tajik, Uzbek, and Pashai ethnic backgrounds were associated with a higher risk of IPV exposure. In general, the likelihood of child mortality within the first 5 years was higher among children born to mothers exposed to IPV, particularly physical and sexual even after adjustment for sociodemographic inequalities, the number of antenatal care, and marriage age. In addition, the odds of diarrhea, acute respiratory infection, and fever in the past 2 weeks were significantly higher among the children of victimized mothers in both adjusted and unadjusted models. Moreover, low birth weight and small birth size were more likely to be observed among the children of a mother who either experienced sexual or physical violence. The findings emphasized the elevated risk of morbidity and mortality among children under 5 born to mothers exposed to IPV and incorporating IPV screening into maternity and child care could reduce these adverse outcomes among Afghan women.
Demystifying the Impact of COVID-19 on Structural Volatility of Indian Sectoral Market: A Quantile Regression Analysis
Authors: Mishra Monika , Seth Neha , Panda Laxmidhar
Published: May 2023

The present study explores the impact of COVID-19 on the volatility structure of the sectoral market in India. ARMA(p,q)- GJR-GARCH(1, 1)-std model is used to determine the daily conditional volatility for 13 selected sectors over the period starting from January 2020 to December 2021. The quantile regression model is employed to examine the changes in the structure of volatility in each sector over the pandemic duration. The results of the study show that the volatility of Metal, Oil–Gas and PSU are more sensitive to market volatility, whereas the volume of new COVID-19 cases exceeds the threshold limit, and no extreme spillover is observed from the market volatility. In addition to this, Bankex, Metal, Oil–Gas, Private Banks and Power sector volatility are more responsive to news sentiments during the period of increase in new COVID-19 cases. Furthermore, the results also reveal that news sentiments help to control the significant fluctuation in the sectoral market.
Internet Addiction and Its Association with Demographic Variables, Depression, Anxiety, and Psychological Well-being in College Students
Authors: Kumar Krishan , Goel Kapil , Mehra Aseem
Published: May 2023

Background

Internet is an integral part of the daily life of everyone. Internet addiction (IA) is one of the major concerns, specifically among young adults. The association between IA, depression, anxiety, and psychological well-being (PWB) is least studied in young adults.

Purpose

To evaluate IA and its association with psychological morbidity and PWB in a larger sample size. In addition, to examine the factors that are associated with IA.

Methods

A total of 1287 young students were evaluated in the present study. Participants were evaluated on the Internet Addiction Test (IAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Psychological Well-Being Index-22.

Results

The mean age of the study’s participants is 19.5 years. The majority were female (68.9%), from nuclear families (61.8%), and belonged to urban localities (61.5%). On IAT, 15.9% had a presence of IA with a cut-off score of 50. 27.4% and 20.5% had a presence of depression and anxiety with a cut-off score of 10 on the PHQ-9 and GAD-7, respectively. Approximately two-thirds (66.7%) reported poor PWB. IA had a significant positive association with depression and anxiety and a negative association with PWB. Male students, the presence of depression, anxiety, and poor PWB were independent factors associated with IA.

Conclusion

Internet addiction is highly prevalent among college students and has a significant association with anxiety, depression, and poor PWB. There is a need to develop a structured plan, educational strategy, and program to minimize IA in young adults.
Investigating corruption, maladministration and misconduct in public administration: Has South Australia struck the right balance?
Authors: Woolford Jack
Published: May 2023

This article considers the appropriateness of reforms to the South Australian Independent Commission Against Corruption (ICAC) passed by the state Parliament in 2021. Specifically, the author considers the narrower definition of ‘corruption’ in public administration for the purposes of ICAC investigations, and further examines the transfer of ‘misconduct’ and ‘maladministration’ investigations to the SA Ombudsman. The author contends that the excessive application of ICAC power on alleged minor offending justified a transfer of responsibility for such matters. However, the amended definition of corruption in public administration is argued to unreasonably limit the intended utility of the ICAC.
Walking the Talk: How to Identify Anti-Pluralist Parties
Authors: Medzihorsky Juraj , Lindberg Staffan I.
Published: May 2023

The recent increase of democratic declines around the world – “the third wave of autocratization” – has sparked a new generation of studies on the topic. Scholars tend to agree that the main threat to contemporary democracy arises from democratically elected rulers who gradually erode democratic norms. Is it possible to identify future autocratizers before they win power in elections? Linz (1978) and Levitsky and Ziblatt (2018) suggest that a lacking commitment to democratic norms reveals would-be autocratizers before they reach office. This article argues that the concept of anti-pluralism rather than populism or extreme ideology captures this. We use a new expert-coded data set on virtually all relevant political parties worldwide from 1970 to 2019 (V-Party) to create a new Anti-Pluralism Index (API) to provide the first systematic empirical test of this argument. We find substantial evidence validating that the API and Linz’s litmus-test indicators signal leaders and parties that will derail democracy if and when they come into power.
Exploring reasons for divergent local communities’ responses to antiquities preservation during conflict in the northwest of Syria – 2014-2023
Authors: Almohamad Adnan , Al Saad Husam , Mehmet Ali Ibrahim
Published: May 2023

The grave damage to Syrian antiquities inflicted during the war has demonstrated the failure of international organizations and cultural agreements to protect antiquities in Syria and highlighted the divergent attitudes of Syrians themselves regarding their antiquities. Initiatives were undertaken in some areas to safeguard antiquities, but were lacking in others, and some Syrians were themselves involved in plundering and destruction actions. This paper aims to identify the reasons for such stark differences in local communities’ responses to safeguarding Syrian antiquities. A total of 46 semi-structured interviews were conducted with residents of Idlib and northern rural Aleppo, including local archaeologists. The study demonstrated differences between the two areas regarding knowledge and attitudes and revealed that a range of factors led to clear differences in the responses of the local communities in Idlib and those of northern rural Aleppo regarding antiquities protection. Some factors were anticipated, such as the impact of war, the security situation, and the deteriorating economic situation, while new factors have been identified. Understanding the local attitudes to antiquities, including the reasons for its protection or destruction, will support plans for enhancing the role of local communities in preserving their antiquities during the conflict.
Art + Labor + Sociology
Authors: Tolbert Jess , Morales María Cristina , Plankey-Videla Nancy
Published: May 2023

Jess Tolbert, Maria Cristina Morales, and Nancy Plankey-Videla on value and aesthetic labor.
Race and Contemporary Perceptions of Public Accommodations Inequality
Authors: Byron Reginald A.
Published: May 2023

Reginald A. Byron on reports of poor service.
Association Between Pronation External Rotation IV Fracture Pattern and Regional Bone Density
Authors: Casciato Dominick , DeGenova Daniel T. , Hill Zachary , Bao Lin Jia , Peabody Tucker , Schmitz Nolan , Taylor Benjamin
Published: May 2023

Introduction:

Throughout the musculoskeletal system, fracture patterns and subsequent healing rely partly on bone density. In the foot and ankle, bone density has been shown to play a role in supination and external rotation fracture patterns. Adding to previous research, this investigation examines the association between bone density and trimalleolar versus trimalleolar equivalent fracture patterns following pronation and external rotation injuries using computed tomography (CT)-derived Hounsfield units (HU).

Methods:

A retrospective chart review was conducted among patients without a history of fracture or osteoporosis who sustained a PER IV fracture. Demographic data were collected. Fractures were separated between PER IV equivalent and fracture groups. CT-derived HU was assessed at the distal tibia and fibula. Density was compared between PER IV equivalent and fracture groups and among posterior malleolar fracture patterns.

Results:

Seventy-five patients met the selection criteria, with 17 comprising the equivalent group and 58 in the fracture group. There were 38 type 1, 9 type 2, and 11 type 3 posterior malleolus fractures. The ankle bone density of the PER fracture equivalent group (331.98 ± 65.71HU) was greater than the PER fracture group (281.61 ± 76.99HU; P = .008). A statistically significant difference in tibial bone densities among equivalent and all PER fracture types ( P = .01) with the equivalent group (331.98 ± 65.71HU) maintaining a greater tibial bone density than the type 2 posterior malleolus fracture group (252.35 ± 57.33HU; P = .009).

Conclusion:

Higher bone density was associated with PER IV equivalent fractures; however, there was no density difference among posterior malleolus fracture types. When presented with PER IV fractures, consider fixation that addresses a lower bone density.

Level of Evidence:

III
Toward a democracy of translations? Local evaluation actor networks in Finnish early childhood education
Authors: Siippainen Anna , Toivonen Hanna , Paakkari Antti
Published: May 2023

This article examines the local evaluation and assessment practices of Finnish early childhood education and care (ECEC) based on Actor–Network Theory (ANT). We employ the concept of translation to discuss how evaluation and assessment practices unfold in networks and how actors come together in negotiations and contestations that seek to orient these networks. ANT approaches society as being formed of networks and directs attention to non-human actors, such as technical and material resources. In this article, we discuss how local evaluation and assessment networks are formed by translations connecting different actors. This article examines three cases in which various assessment tools were used locally by Finnish ECEC. The results highlight the arbitrariness and elasticity of the networks in the translation process. Thus, we introduce the concept of democracy of translation to examine the flexibility of assessment networks and the extent to which actors in these networks can re-negotiate and re-orient the practices taking place.
Changes in tree canopy coverage and inequality in the contiguous United States between 2010 and 2020
Authors: Li Chaosu , Ping Dazhou
Published: May 2023

Tree canopy is increasingly recognized as an important environmental amenity that raises inequity concerns, yet only few studies have examined the changes in tree canopy coverage and the associated distribution inequality in a large geographical context. This study depicts the changing trend and the associated inequality in tree canopy distribution at the county level in the contiguous United States between the years 2010 and 2020. Results show that the West and Northeast regions suffered the most from tree canopy loss, while the Midwest/Great Lakes region experienced increases in its tree canopy coverage. The inequality in tree canopy distribution has generally been exacerbated across counties from 2010 to 2020. These findings highlight the importance of incorporating the changing tree canopy coverage and the associated inequity outcome into policy considerations.
Emergence of human CMV-induced NKG2C+ NK cells is associated with CD8+ T-cell recovery after allogeneic HCT
Authors: van der Ploeg Kattria , Sottile Rosa , Kontopoulos Theodota , Shaffer Brian C. , Papanicolaou Genovefa A. , Maloy Molly A. , Cho Christina , Robinson Kevin S. , Perales Miguel-Angel , Le Luduec Jean-Benoît , Hsu Katharine C.
Published: May 2023

Cytomegalovirus (CMV) infection is associated with the expansion of a mature NKG2C+FcεR1γ− natural killer (NK) cell population. The exact mechanism underlying the emergence of NKG2C+ NK cells, however, remains unknown. Allogeneic hematopoietic cell transplantation (HCT) provides an opportunity to longitudinally study lymphocyte recovery in the setting of CMV reactivation, particularly in patients receiving T-cell−depleted (TCD) allografts. We analyzed peripheral blood lymphocytes from 119 patients at serial time points after infusion of their TCD allograft and compared immune recovery with that in samples obtained from recipients of T-cell−replete (T-replete) (n = 96) or double umbilical cord blood (DUCB) (n = 52) allografts. NKG2C+ NK cells were detected in 92% (45 of 49) of recipients of TCD HCT who experienced CMV reactivation. Although NKG2A+ cells were routinely identifiable early after HCT, NKG2C+ NK cells were identified only after T cells could be detected. T-cell reconstitution occurred at variable times after HCT among patients and predominantly comprised CD8+ T cells. In patients with CMV reactivation, recipients of TCD HCT expressed significantly higher frequencies of NKG2C+ and CD56neg NK cells compared with patients who received T-replete HCT or DUCB transplantation. NKG2C+ NK cells after TCD HCT were CD57+FcεR1γ+ and degranulated significantly more in response to target cells compared with the adaptive the NKG2C+CD57+FcεR1γ− NK cell population. We conclude that the presence of circulating T cells is associated with the expansion of a CMV-induced NKG2C+ NK cell population, a potentially novel example of developmental cooperation between lymphocyte populations in response to viral infection.
Identification of essential proteins based on edge features and the fusion of multiple-source biological information
Authors: Liu Peiqiang , Liu Chang , Mao Yanyan , Guo Junhong , Liu Fanshu , Cai Wangmin , Zhao Feng
Published: May 2023

Background

A major current focus in the analysis of protein–protein interaction (PPI) data is how to identify essential proteins. As massive PPI data are available, this warrants the design of efficient computing methods for identifying essential proteins. Previous studies have achieved considerable performance. However, as a consequence of the features of high noise and structural complexity in PPIs, it is still a challenge to further upgrade the performance of the identification methods.

Methods

This paper proposes an identification method, named CTF, which identifies essential proteins based on edge features includingh-quasi-cliques anduv-triangle graphs and the fusion of multiple-source information. We first design an edge-weight function, named EWCT, for computing the topological scores of proteins based on quasi-cliques and triangle graphs. Then, we generate an edge-weighted PPI network using EWCT and dynamic PPI data. Finally, we compute the essentiality of proteins by the fusion of topological scores and three scores of biological information.

Results

We evaluated the performance of the CTF method by comparison with 16 other methods, such as MON, PeC, TEGS, and LBCC, the experiment results on three datasets ofSaccharomyces cerevisiaeshow that CTF outperforms the state-of-the-art methods. Moreover, our method indicates that the fusion of other biological information is beneficial to improve the accuracy of identification.
The increasing role of electronic media in headache
Authors: Do Thien Phu , Andreou Anna P. , de Oliveira Arao Belitardo , Shapiro Robert E. , Lampl Christian , Amin Faisal Mohammad
Published: May 2023

Most individuals with access to the internet use social media platforms. These platforms represent an excellent opportunity to disseminate knowledge about management and treatment to the benefit of patients. The International Headache Society, The European Headache Federation, and The American Headache Society have electronic media committees to promote and highlight the organizations’ expertise and disseminate research findings. A growing mistrust in science has made dealing with infodemics (i.e., sudden access to excessive unvetted information) an increasing part of clinical management. An increasing role of these committees will be to address this challenge. As an example, recent studies have demonstrated that the most popular online content on migraine management is not evidence-based and is disseminated by for-profit organizations. As healthcare professionals and members of professional headache organizations, we are obliged to prioritize knowledge dissemination. A progressive social media strategy is associated not only with increased online visibility and outreach, but also with a higher scientific interest. To identify gaps and barriers, future research should assess the range of available information on headache disorders in electronic media, characterize direct and indirect consequences on clinical management, and recognize best practice and strategies to improve our communication on internet-based communication platforms. In turn, these efforts will reduce the burden of headache disorders by facilitating improved education of both patients and providers.
Efficacy of the polyglycolic acid sheet for preventing anastomotic leakage in double-stapling technique anastomosis for left-sided colon or rectal cancer surgery: a propensity score-matched study
Authors: Shibutani Masatsune , Fukuoka Tatsunari , Iseki Yasuhito , Kasashima Hiroaki , Maeda Kiyoshi
Published: May 2023

Background

To prevent anastomotic leakage in patients with left-sided colorectal cancer who underwent double-stapling technique (DST) anastomosis, we investigated a new method: DST anastomosis with a polyglycolic acid (PGA) sheet. This procedure has been shown to have the potential to decrease the rate of anastomotic leakage. However, due to the small number of cases enrolled in our previous study, it was not possible to compare the outcomes of the new and conventional procedures. The aim of this study was to evaluate the effect of the PGA sheet on preventing anastomotic leakage in patients with left-sided colorectal cancer who underwent DST anastomosis by retrospectively comparing the anastomotic leakage rate between the PGA sheet and conventional groups.

Methods

A total of 356 patients with left-sided colorectal cancer who underwent DST anastomosis during surgery at Osaka City University Hospital between January 2016 and April 2022 were enrolled in this study. Propensity score matching was performed to reduce the confounding effects secondary to imbalances in the use of PGA sheets.

Results

The PGA sheet was used in 43 cases (PGA sheet group) and it was not used in 313 cases (conventional group). After propensity score matching, the incidence of anastomotic leakage in the PGA sheet group was significantly lower than that in the conventional group.

Conclusion

DST anastomosis with PGA sheet, which is easy to perform, contributes to the reduction of anastomotic leakage rate by increasing the strength of the anastomotic site.
Findings from a mixed-methods evaluation of a multi-level adolescent and youth reproductive and maternal health intervention in Karnali Province, Nepal
Authors: Bhandari Rajan , Malakoff Sara , Thakuri Dipendra Singh , Balami Roma , Khatri Sangita , Simon Callie , Castro Wendy , Hanson-Hall Nana Apenem
Published: May 2023

Introduction

Adolescent girls and young women (AGYW) in Nepal have disproportionately poor reproductive and maternal health outcomes. In response, Save the Children, the Nepal government, and local partners designed and implemented Healthy Transitions for Nepali Youth, a multi-level integrated intervention. The intervention aimed to improve reproductive, maternal, and newborn health knowledge, attitudes, and behaviors among AGYW, and address gender attitudes and norms in four districts of Karnali Province, Nepal.

Methods

Married and unmarried AGYW aged 15–24 were engaged in a small group, curriculum-based intervention; husbands and families received home visits, using short videos to catalyze discussion; communities were engaged through dialogue-based activities; and the health system was made more adolescent-responsive through quality assessments, training, and supervision. An external organization conducted a quantitative survey with a sample of 786 AGYW intervention participants at baseline and 565 of the same AGYW at endline. Pooled linear regressions were estimated for each indicator to assess the statistical significance of differences between baseline and endline. Focus group discussions and key informant interviews were conducted with AGYW, husbands, families, community leadership, and program implementers. Data analysis was done through STATA 14th version and NVivo.

Results

The percentage of AGYW currently using a modern contraceptive method increased significantly, and more AGYW believed that their family was supportive of delaying marriage and motherhood at the endline. Young women’s knowledge of danger signs during labor increased, and there was a significant improvement in essential newborn care practices immediately after birth. AGYW reported shifts towards more gender equitable attitudes and behaviors, including related to decision-making about reproductive and maternal health.

Conclusion

Positive shifts in reproductive, maternal, and newborn health and gender knowledge, attitudes, and behavior were observed among AGYW, their male partners, and families. The results can inform the design of future interventions to effectively reach this critical population.

Trail registration

Not applicable.
Using cognitive load theory to evaluate and improve preparatory materials and study time for the flipped classroom
Authors: Fischer Krisztina , Sullivan Amy M. , Cohen Amy P. , King Randall W. , Cockrill Barbara A. , Besche Henrike C.
Published: May 2023

Background

Preclinical medical education is content-dense and time-constrained. Flipped classroom approaches promote durable learning, but challenges with unsatisfactory student preparation and high workload remain. Cognitive load theory defines instructional design as “efficient” if learners can master the presented concepts without cognitive overload. We created a PReparatory Evaluation Process (PREP) to systematically assess and measure improvement in the cognitive-load efficiency of preparatory materials and impact on study time (time-efficiency).

Methods

We conducted this study in a flipped, multidisciplinary course for ~ 170 first year students at Harvard Medical School using a naturalistic post-test design. For each flipped session (n = 97), we assessed cognitive load and preparatory study time by administering a 3-item PREP survey embedded within a short subject-matter quiz students completed before class. Over three years (2017–2019), we evaluated cognitive load- and time- based efficiency to guide iterative revisions of the materials by content experts. The ability of PREP to detect changes to the instructional design (sensitivity) was validated through a manual audit of the materials.

Results

The average survey response rate was ≥ 94%. Content expertise was not required to interpret PREP data. Initially students did not necessarily allocate the most study time to the most difficult content. Over time, the iterative changes in instructional design increased the cognitive load- and time-based efficiency of preparatory materials with large effect sizes (p < .01). Furthermore, this increased the overall alignment of cognitive load with study time: students allocated more time to difficult content away from more familiar, less difficult content without increasing workload overall.

Conclusions

Cognitive load and time constraints are important parameters to consider when designing curricula. The PREP process is learner-centered, grounded in educational theory, and works independently of content knowledge. It can provide rich and actionable insights into instructional design of flipped classes not captured by traditional satisfaction-based evaluations.
Does the immediate reimbursement of medical insurance reduce the socioeconomic inequality in health among the floating population? Evidence from China
Authors: He Wen
Published: May 2023

Background

Enhancing health intervention for floating populations has become an essential aspect of public health around the world. China launched a policy reform aimed at implementing immediate reimbursement for trans-provincial inpatient treatments. The objective of this study was to investigate the effects of this policy change on socioeconomic inequality in health among the floating population.

Methods

This study used two waves of individual-level data from the China Migrants Dynamic Survey (CMDS) collected in 2017 and 2018 as well as administrative hospital data at the city level. The sample included 122061 individuals and 262 cities. Under a quasi-experimental research design, we built up the framework to employ the generalized and multi-period difference-in-differences estimation strategy. We used the number of qualified hospitals that could provide immediate reimbursement to represent the degree and intensity of the implementation of this policy change. We also calculated the Wagstaff Index (WI) to measure socioeconomic inequality in health.

Results

This policy change and income level had a negative joint impact on the health status of floating population (odds ratio = 0.955, P < 0.01), that is, the lower the income, the better the number of qualified hospitals' effect on health improvement. Furthermore, as the number of qualified tertiary hospitals increased, the health inequality would decrease significantly on average at the city level (P < 0.05). In addition, inpatient utilization as well as total expenditure and reimbursement significantly improved after the policy change, and the magnitude of increase was greater in the relatively lower-income group (P < 0.01). Finally, only inpatient spending could obtain immediate reimbursement in the early stage, thus, compared with primary care, these impacts were greater in tertiary care.

Conclusions

Our study revealed that after the implementation of immediate reimbursement, the floating population could obtain greater and more timely reimbursement, which significantly increased its inpatient utilization, promoted health, and reduced the health inequality caused by socioeconomic factors. These results suggest that a more accessible and friendly medical insurance scheme should be promoted for this group.
Introme accurately predicts the impact of coding and noncoding variants on gene splicing, with clinical applications
Authors: Sullivan Patricia J. , Gayevskiy Velimir , Davis Ryan L. , Wong Marie , Mayoh Chelsea , Mallawaarachchi Amali , Hort Yvonne , McCabe Mark J. , Beecroft Sarah , Jackson Matilda R. , Arts Peer , Dubowsky Andrew , Laing Nigel , Dinger Marcel E. , Scott Hamish S. , Oates Emily , Pinese Mark , Cowley Mark J.
Published: May 2023

Predicting the impact of coding and noncoding variants on splicing is challenging, particularly in non-canonical splice sites, leading to missed diagnoses in patients. Existing splice prediction tools are complementary but knowing which to use for each splicing context remains difficult. Here, we describe Introme, which uses machine learning to integrate predictions from several splice detection tools, additional splicing rules, and gene architecture features to comprehensively evaluate the likelihood of a variant impacting splicing. Through extensive benchmarking across 21,000 splice-altering variants, Introme outperformed all tools (auPRC: 0.98) for the detection of clinically significant splice variants. Introme is available at https://github.com/CCICB/introme.
The role of angiotensin I-converting enzyme gene polymorphism and global DNA methylation in the negative associations between urine di-(2-ethylhexyl) phthalate metabolites and serum adiponectin in a young Taiwanese population
Authors: Lin Chien-Yu , Lee Hui-Ling , Chen Ching-Way , Wang Chikang , Sung Fung-Chang , Su Ta-Chen
Published: May 2023

Background

Adiponectin is a key protein produced in adipose tissue, with crucial involvement in multiple metabolic processes. Di-(2-ethylhexyl) phthalate (DEHP), one of the phthalate compounds used as a plasticizer, has been shown to decrease adiponectin levels in vitro and in vivo studies. However, the role of angiotensin I-converting enzyme (ACE) gene polymorphism and epigenetic changes in the relationship between DEHP exposure and adiponectin levels is not well understood.

Methods

This study examined the correlation between urine levels of DEHP metabolite, epigenetic marker 5mdC/dG, ACE gene phenotypes, and adiponectin levels in a sample of 699 individuals aged 12–30 from Taiwan.

Results

Results showed a positive relationship between mono-2-ethylhexyl phthalate (MEHP) and 5mdC/dG, and a negative association between both MEHP and 5mdC/dG with adiponectin. The study found that the inverse relationship between MEHP and adiponectin was stronger when levels of 5mdC/dG were above the median. This was supported by differential unstandardized regression coefficients (− 0.095 vs. − 0.049,Pvalue for interaction = 0.038)). Subgroup analysis also showed a negative correlation between MEHP and adiponectin in individuals with the I/I ACE genotype, but not in those with other genotypes, although thePvalue for interaction was borderline significant (0.06). The structural equation model analysis indicated that MEHP has a direct inverse effect on adiponectin and an indirect effect via 5mdC/dG.

Conclusions

In this young Taiwanese population, our findings suggest that urine MEHP levels are negatively correlated with serum adiponectin levels, and epigenetic modifications may play a role in this association. Further study is needed to validate these results and determine causality.
Early continuous renal replacement therapy for postoperative patient with acute kidney injury following total pancreato-splenectomy: a case report
Authors: Ratnaningrum Apriliana , Taufik M. Azhari , Irawany Vera , Sedono Rudyanto
Published: May 2023

Background

Acute kidney injury is a devastating postoperative complication. Renal replacement therapy is a treatment modality for acute kidney injury. Continuous renal replacement therapy is the treatment of choice for patients with hemodynamic instability. The main question in the management of acute kidney injury is when to initiate the renal replacement therapy. Several studies have demonstrated improvement in patients with septic acute kidney injury, following early continuous renal replacement therapy. To date, no guidelines have been established on the perfect timing to initiate continuous renal replacement therapy. In this case report, we did an early continuous renal replacement therapy as an extracorporeal therapy for blood purification and renal support.

Case presentation

Our patient was a 46-year-old male of Malay ethnicity, undergoing total pancreatectomy due to a duodenal tumor. The preoperative assessment showed that the patient was high risk. Intraoperatively, massive surgical bleeding was sustained due to extensive tumor resection; thus, massive blood product transfusion was necessary. After the surgery, the patient suffered from postoperative acute kidney injury. We performed early continuous renal replacement therapy, within 24 hours after the diagnosis of acute kidney injury. Upon completion of continuous renal replacement therapy, the patient’s condition improved, and he was discharged from the intensive care unit on the sixth postoperative day.

Conclusion

The timing for the initiation of renal replacement therapy remains controversial. It is clear that the “conventional criteria” for initiating renal replacement therapy need correction. We found that early continuous renal replacement therapy initiated in less than 24 hour after the postoperative acute kidney injury diagnosis gave our patient survival benefit.
Effects of natural weathering on aged wood from historic wooden building: diagnosis of the oxidative degradation
Authors: Mi Xiaochen , Li Yingqi , Qin Xiaochao , Li Jie
Published: May 2023

Historic wooden buildings located outdoors are exposed to natural weathering conditions for extended periods of time, causing deterioration of wood properties by sunlight, oxygen, and other environmental factors. Current diagnostic procedures are limited to macroscopic inspection. In this interdisciplinary study, several aged samples from Yingxian Wooden Pagoda (ca. 1056 AD) were analyzed. Their micro-morphology and changes in chemical composition were investigated using less invasive multi-chemical techniques. The aim is to elucidate the oxidative degradation and its deterioration mechanism of the wood, which is essential in identifying the key factors responsible for natural weathering and devising strategies to counteract the surface deterioration. All aged wood samples had varying degrees of decay and lignin content was decreased in most of them. The high ratio of oxygen/carbon elements evidenced the occurrence of chemical reactions. In particular, the increasing ratio of oxygenated carbon/unoxygenated carbon indicates potential oxidation reactions. Overall, for the aged wood of historic wood building under warm-dry natural conditions, their deterioration occurred through the oxidative degradation of lignin. These unique results are useful in developing effective repair and restoration measures to conserve wooden components in historic buildings.