bluuebunny/crossref_metadata_2025 huggingface dataset:
Earthquake-induced building damage recognition from unmanned aerial vehicle remote sensing using scale-invariant feature transform characteristics and support vector machine classification
Authors: Zhang Ying , Guo Hongmei , Yin Wengang , Zhao Zhen , Lu Changjiang
Published: March 2023

Building damage is the main cause of casualties and economic losses from earthquakes. Therefore, understanding building damage is critical for emergency handling. Current information acquisition methods for assessing earthquake damage using unmanned aerial vehicle (UAV) remote sensing systems offer great flexibility and high efficiency with the capability to obtain high-resolution images, which can reflect actual damage to affected areas intuitively. Consequently, UAV remote sensing has become a convenient and important means to acquire earthquake-induced building damage information. Although manual visual interpretation can achieve high recognition accuracy, it is extremely time-consuming. In contrast, although current automatic recognition methods require less time, they have relatively poor recognition accuracy. Neither approach can satisfactorily simultaneously meet efficiency and accuracy requirements for earthquake emergency handling. This article applies image classification algorithms based on the support vector machine (SVM) to earthquake-induced building damage recognition, and proposes a recognition method based on scale-invariant feature transform (SIFT) characteristics and SVM classification. We use the magnitude 6.4 earthquake at Yangbi (2021) as an example to validate the proposed method. Results verify that the proposed method can recognize earthquake damage quickly and accurately, providing effective support for decision-making regarding rescue actions.
Crack Growth Rate Model Derived from Domain Knowledge-Guided Symbolic Regression
Authors: Zhou Shuwei , Yang Bing , Xiao Shoune , Yang Guangwu , Zhu Tao
Published: March 2023

Machine learning (ML) has powerful nonlinear processing and multivariate learning capabilities, so it has been widely utilised in the fatigue field. However, most ML methods are inexplicable black-box models that are difficult to apply in engineering practice. Symbolic regression (SR) is an interpretable machine learning method for determining the optimal fitting equation for datasets. In this study, domain knowledge-guided SR was used to determine a new fatigue crack growth (FCG) rate model. Three terms of the variable subtree of ΔK, R-ratio, and ΔKth were obtained by analysing eight traditional semi-empirical FCG rate models. Based on the FCG rate test data from other literature, the SR model was constructed using Al-7055-T7511. It was subsequently extended to other alloys (Ti-10V-2Fe-3Al, Ti-6Al-4V, Cr-Mo-V, LC9cs, Al-6013-T651, and Al-2324-T3) using multiple linear regression. Compared with the three semi-empirical FCG rate models, the SR model yielded higher prediction accuracy. This result demonstrates the potential of domain knowledge-guided SR for building the FCG rate model.
Comparative metabolomics of root-tips reveals distinct metabolic pathways conferring drought tolerance in contrasting genotypes of rice
Authors: Ghorbanzadeh Zahra , Hamid Rasmieh , Jacob Feba , Zeinalabedini Mehrshad , Salekdeh Ghasem Hosseini , Ghaffari Mohammad Reza
Published: March 2023

Background

The mechanisms underlying rice root responses to drought during the early developmental stages are yet unknown.

Results

This study aimed to determine metabolic differences in IR64, a shallow-rooting, drought-susceptible genotype, and Azucena, a drought-tolerant and deep-rooting genotype under drought stress. The morphological evaluation revealed that Azucena might evade water stress by increasing the lateral root system growth, the root surface area, and length to access water. At the same time, IR64 may rely mainly on cell wall thickening to tolerate stress. Furthermore, significant differences were observed in 49 metabolites in IR64 and 80 metabolites in Azucena, for which most metabolites were implicated in secondary metabolism, amino acid metabolism, nucleotide acid metabolism and sugar and sugar alcohol metabolism. Among these metabolites, a significant positive correlation was found between allantoin, galactaric acid, gluconic acid, glucose, and drought tolerance. These metabolites may serve as markers of drought tolerance in genotype screening programs. Based on corresponding biological pathways analysis of the differentially abundant metabolites (DAMs), biosynthesis of alkaloid-derivatives of the shikimate pathway, fatty acid biosynthesis, purine metabolism, TCA cycle and amino acid biosynthesis were the most statistically enriched biological pathway in Azucena in drought response. However, in IR64, the differentially abundant metabolites of starch and sucrose metabolism were the most statistically enriched biological pathways.

Conclusion

Metabolic marker candidates for drought tolerance were identified in both genotypes. Thus, these markers that were experimentally determined in distinct metabolic pathways can be used for the development or selection of drought-tolerant rice genotypes.
Preselection of QTL markers enhances accuracy of genomic selection in Norway spruce
Authors: Chen Zhi-Qiang , Klingberg Adam , Hallingbäck Henrik R. , Wu Harry X.
Published: March 2023

Genomic prediction (GP) or genomic selection is a method to predict the accumulative effect of all quantitative trait loci (QTLs) in a population by estimating the realized genomic relationships between the individuals and by capturing the linkage disequilibrium between markers and QTLs. Thus, marker preselection is considered a promising method to capture Mendelian segregation effects. Using QTLs detected in a genome-wide association study (GWAS) may improve GP. Here, we performed GWAS and GP in a population with 904 clones from 32 full-sib families using a newly developed 50 k SNP Norway spruce array. Through GWAS we identified 41 SNPs associated with budburst stage (BB) and the largest effect association explained 5.1% of the phenotypic variation (PVE). For the other five traits such as growth and wood quality traits, only 2 – 13 associations were observed and the PVE of the strongest effects ranged from 1.2% to 2.0%. GP using approximately 100 preselected SNPs, based on the smallestp-values from GWAS showed the greatest predictive ability (PA) for the trait BB. For the other traits, a preselection of 2000–4000 SNPs, was found to offer the best model fit according to the Akaike information criterion being minimized. But PA-magnitudes from GP using such selections were still similar to that of GP using all markers. Analyses on both real-life and simulated data also showed that the inclusion of a large QTL SNP in the model as a fixed effect could improve PA and accuracy of GP provided that the PVE of the QTL was ≥ 2.5%.
EDDSN-MRT: multiple rodent tracking based on ear detection and dual siamese network for rodent social behavior analysis
Authors: Liu Bingbin , Qian Yuxuan , Wang Jianxin
Published: March 2023

Background

Rodent social behavior is a commonly used preclinical model to interrogate the mechanisms underpinning various human neurological conditions. To investigate the interplay between neural systems and social behaviors, neuroscientists need a precise quantitative measure for multi-rodent tracking and behavior assessment in laboratory settings. However, identifying individual differences across multiple rodents due to visual occlusion precludes the generation of stable individual tracks across time.

Methods

To overcome the present limitations of multi-rodent tracking, we have developed an Ear Detection and Dual Siamese Network for Multiple Rodent Tracking (EDDSN-MRT). The aim of this study is to validate the EDDSN-MRT system in mice using a publicly available dataset and compare it with several current state-of-the-art methods for behavioral assessment. To demonstrate its application and effectiveness in the assessment of multi-rodent social behavior, we implemented an intermittent fasting intervention experiment on 4 groups of mice (each group is with different ages and fasting status and contains 8 individuals). We used the EDDSN-MRT system to track multiple mice simultaneously and for the identification and analysis of individual differences in rodent social behavior and compared our proposed method with Toxtrac and idtracker.ai.

Results

The locomotion behavior of up to 4 mice can be tracked simultaneously using the EDDSN-MRT system. Unexpectedly, we found intermittent fasting led to a decrease in the spatial distribution of the mice, contrasting with previous findings. Furthermore, we show that the EDDSN-MRT system can be used to analyze the social behavior of multiple mice of different ages and fasting status and provide data on locomotion behavior across multiple mice simultaneously.

Conclusions

Compared with several state-of-the-art methods, the EDDSN-MRT system provided better tracking performance according to Multiple Object Tracking Accuracy (MOTA) and ID Correct Rate (ICR). External experimental validation suggests that the EDDSN-MRT system has sensitivity to distinguish the behaviors of mice on different intermittent fasting regimens. The EDDSN-MRT system code is freely available here: https://github.com/fliessen/EDDSN-MRT.
The effect of research on life satisfaction in middle-aged and older adults: physical disability and physical activity as a parallel and serial mediation analysis
Authors: Li Pei-Shan , Hsieh Chia-Jung , Shih Ya-Ling , Lin Ya-Ting , Liu Chieh-Yu
Published: March 2023

Background and objective

Maintaining the life satisfaction of frail middle-aged and older adults when they experience physical disability, lower activity status, or complex conditions that are related to each other is now an urgent issue. Therefore, the purpose of this study was to provide evidence for the impact of frailty in middle-aged and older adults on life satisfaction under the simultaneous occurrence and correlation of physical disability and physical activity status.

Methods

Data from the 2015 Taiwan Longitudinal Study in Ageing (TLSA) were analyzed by PROCESS in SPSS to explore three different mediation models (N = 4,421). The first was a parallel mediation model for exploring life satisfaction in middle-aged and older adults with frailty through physical disability or physical activity. The second was a serial mediation model for examining physical disability and physical activity in causal chains linked with a specific direction of flow and to test all combinations. The third was a moderated mediation model for testing whether the indirect effect of frailty status on life satisfaction through physical disability or physical activity was moderated by age stratification.

Results

Physical disability and physical activity partially mediated the relationship between frailty status and life satisfaction (IEOVERALL = -0.196, 95% CI: -0.255 to -0.139). The causal path with the highest indirect effect was found to be that between frailty and physical disability; increased frailty led to higher physical disability, which in turn affected physical activity, leading to lower life satisfaction (IE = 0.013, 95% CI: 0.008 to 0.019). The different stratifications by age significantly increased the mediating effect of physical activity (Index of Moderated Mediation = -0.107, SE = 0.052, 95% CI: -0.208 to -0.005) but did not reduce the mediating effect of physical disability.

Conclusion

This study provides evidence that physical activity and physical disability influence the development of frailty. It also has a significant impact on the life satisfaction of middle-aged and older adults.
Efficacy and safety of 0.05% micellar nano-particulate (MNP) cyclosporine ophthalmic emulsion in the treatment of moderate-to-severe keratoconjunctivitis sicca: a 12-week, multicenter, randomized, active-controlled trial
Authors: Rao A Tarakeswara , Gupta Amit , Chauhan Tulika , Basu Sayan , Batra Nitin , Sharma Namrata , Sangwan Virender S , Gupta Vinay , Mukherjee Shoibal
Published: March 2023

Background

Keratoconjunctivitis sicca or dry eye disease (DED) is a multifactorial disorder underpinned by a complex inflammatory cycle. Introduction of topical cyclosporine has been a significant advance in the management of DED. In recent years advancements in formulation technology have led to development of micellar nano-particulate (MNP) cyclosporine formulations that promise better penetration into ocular target tissues and potential for reduced ocular surface irritation.

Methods

We compared two dosing regimes of a proprietary MNP cyclosporine emulsion with the widely marketed topical cyclosporine formulation Restasis™ in a multicenter parallel-group randomised trial in patients with DED. Patients were randomised to one of 3 treatment groups with 90 patients eligible for the per protocol analysis: 30 in the higher dose test arm A; 32 in the lower dose test arm B; and 28 in the Restasis™ control arm C. All scored efficacy endpoints were tested for significance by comparing the mean change in scores from baseline in the test groups with that in the control group at 12 weeks, using the Student’s t test. Wilcoxon’s rank sum test was used to test individual symptom scores and clinician’s global evaluation of treatment grades.

Results

Corneal fluorescein staining score, the primary efficacy endpoint, decreased by 6.8 ± 4.0, 5.7 ± 3.9, and 4.6 ± 3.6 points in the 3 groups respectively, indicating superior efficacy in test arm A in comparison to control arm C (p = 0.0026). Schirmer’s tear test, conjunctival lissamine staining score, ocular surface disease index, and individual dry eye symptom scores also favoured higher dose MNP cyclosporine over Restasis™. The study failed to differentiate the treatment arms in terms of clinician’s global evaluation of treatment, use of tear substitutes, best corrected visual acuity or safety and toleration.

Conclusion

The results indicate that the dose of 1 drop of a 0.05% w/v ophthalmic emulsion of MNP cyclosporine administered topically twice daily yields better outcomes at 12 weeks than the lower dose tested in the study, and is more efficacious than an equivalent dose of Restasis™, the active control used in the study.

Trial registration

This trial was registered in the Clinical Trials Registry of India on 29/03/2019, and was assigned registration number CTRI/2019/03/018319.
Association between periodontitis and uric acid levels in blood and oral fluids: a systematic review and meta-analysis
Authors: Ye Lu-wen , Zhao Li , Mei Ze-song , Zhou Ying-hong , Yu Ting
Published: March 2023

Background

Uric acid, a formerly-known antioxidant that has recently been linked to numerous inflammatory diseases as a pro-inflammatory and -oxidative mediator in pathological conditions. It is imperative to reassess the association between periodontitis and uric acid locally and systematically. The aim of this systematic review was to systemically evaluate the association between periodontitis and the uric acid (UA) levels in blood, saliva and gingival crevicular fluid (GCF).

Methods

Relevant clinical studies up to January 28, 2023 were identified and retrieved from electronic databases including PubMed, Scopus, EMBASE and Web of Science, with periodontitis, uric acid, hyperuricemia and gout as the keywords. The weighted (WMD) or standardized mean difference (SMD) was calculated using fixed- or random-effect models. Methodological heterogeneity was assessed.

Results

Sixteen eligible observational studies and one RCT were enrolled, which included 1354 patients with periodontitis and 989 controls. Three sample types for UA detection were involved, including blood (n = 8), saliva (n = 9) and GCF (n = 1). Meta-analysis demonstrated an enhanced plasma UA concentration (WMD = 1.00 mg/dL, 95%CI0.63 to 1.37,P < 0.001) but a decreased salivary UA level (SMD = -0.95, 95%CI-1.23 to -0.68,P < 0.001) in periodontitis versus control. Statistical heterogeneity among the plasma- and saliva-tested studies were moderate (I2 = 58.3%, P = 0.066) and low (I2 = 33.8%,P = 0.196), respectively.

Conclusions

Within the limitations of the enrolled studies, it seems that there is an association between periodontitis and increased blood UA and decreased salivary UA. (Registration no. CRD42020172535 in Prospero).
Severity of illness and risk of mortality in Mayo Clinic’s virtual hybrid advanced care at home program: a retrospective cohort study
Authors: Paulson Margaret R. , Torres-Guzman Ricardo A. , Avila Francisco R. , Maita Karla C. , Garcia John P. , Forte Antonio J. , Matcha Gautam V. , Pagan Ricardo J. , Maniaci Michael J.
Published: March 2023

Background

In July 2020, Mayo Clinic launched Advanced Care at Home (ACH), a high-acuity virtual hybrid hospital-at-home model (HaH) of care at Mayo Clinic Florida and Northwest Wisconsin, an urban destination medical center and a rural community practice respectively. This study aims to describe demographic characteristics of ACH patients as well as their acuity of illness using severity of illness (SOI) and risk of mortality (ROM), to illustrate the complexity of patients in the program, taking into account the different diagnostic related groups.

Methods

Mayo Clinic uses All Patient Refined-Diagnosis Related Groups (APR-DRG) to calculate SOI and ROM on hospitalized patients. APR-DRG data, including SOI and ROM, were gathered from individual chart reviews from July 6, 2020, to March 31, 2022.

Results

 Out of 923 patients discharged from ACH, the average APR-DRG SOI was 2.89 (SD 0.81) and ROM was 2.73. (SD 0.92). Mean age was 70.88 (SD 14.46) years, 54.6% were male patients and the average length of stay was 4.10 days. The most frequent diagnosis was COVID-19 infection with 162 patients (17.6%), followed by heart failure exacerbation (12.7%) and septicemia (10.9%). The 30-day readmission rate after discharge from ACH was 11.2% (n = 103) and the 30-day mortality rate was 1.8% (n = 17). There were no in-program patient deaths.

Conclusions

SOI and ROM from patients at the ACH program have been shown to be in the range of “moderate/major” according to the APR-DRG classification. The ACH program is capable of accepting and managing highly complex patients that require advanced therapeutic means. Furthermore, the ACH program has an in-program mortality rate of 0 to date. Therefore, ACH is rising as a capable alternative to the brick-and-mortar hospital.
Clinical response to adding pyrotinib to pembrolizumab and lenvatinib for HER2-positive advanced intrahepatic cholangiocarcinoma: a case report
Authors: Zhang Jun-Wei , Yang Xiaobo , Pan Boju , Xu Yiyao , Lu Xin , Zhao Hai-tao
Published: March 2023

Background

Intrahepatic cholangiocarcinoma (ICC) is a highly lethal hepatobiliary cancer, and very few patients can undergo surgery. The prognosis of advanced ICC is poor, especially in patients who progress after first-line chemotherapy, with a median overall survival of less than 10 months.

Case presentation

A 64-year-old male was diagnosed with advanced intrahepatic cholangiocarcinoma with ERBB2 (HER2) 3 + amplification determined by tissue-based testing and confirmed by next-generation sequencing. The patient was treated with pyrotinib added to pembrolizumab and lenvatinib after progressing with pyrotinib and tegafur and responded very well with regression of the tumor on imaging as well as normalization of tumor marker levels without serious adverse events. PET-CT after 6 months of treatment showed a partial response. The progression-free survival with second-line treatment was 17 months. For the third line of therapy, lenvatinib and pembrolizumab were used in combination with bevacizumab. Currently, he has had stable disease for approximately 6 months during third-line treatment.

Conclusion

Adding pyrotinib to pembrolizumab and lenvatinib may represent a promising strategy for advanced ICC patients who have high levels of HER2.
Prognostic factors after isolated ipsilateral local and regional recurrence in HER2-negative luminal breast cancer: a multi-center retrospective study
Authors: Eom Yong Hwa , Yoon Chang IK , Kang Young Joon , Jeon Ye Won
Published: March 2023

Background

Although the incidence of isolated ipsilateral local and regional recurrence (IILRR) in human epidermal growth factor 2 (HER2)-negative luminal breast cancer is low, it is important because of its potential risk of distant metastasis and breast cancer related mortality. The aim of this study was to investigate prognostic factor and survival of IILRR using a large multi-center cohort.

Methods

Data on patients with HER2-negative luminal breast cancer between 2005 and 2015 were retrieved. The endpoint was IILRR rate, post-recurrence progression-free survival (P-PFS), and post-recurrence overall survival (P-OS). Prognostic factors for progression and overall survival (OS) after IILRR were assessed by multivariate analysis.

Results

Eighty (2.37%) patients experienced IILRR. Of them, 27 (33.7%) experienced a disease progression, including 23 (85.2%) who had distant metastasis. The median DFS was 48.5 months (range, 4–138 months). In 72.5% of cases, the first IILRR occurred after 3 years. Estimated 5-year P-PFS rates were 86.2%, 69.7%, 69.0%, 42.7%, and 82.2% for patients with age < 40 at diagnosis (p = 0.015), T1 stage (p = 0.012), stage I (p < 0.001), lymphovascular invasion (p = 0.003), and patients with post-recurrence endocrine therapy (p < 0.001), respectively. The 5-year Kaplan–Meier P-OS rate for patients was 81.4%. Post-recurrence endocrine therapy was independent factor for progression (HR: 0.176, p < 0.001) and OS (HR: 0.080, p < 0.001).

Conclusions

Although there is no standardized treatment for IILRR yet, endocrine therapy after local resection plays a more important role in improving prognosis than chemotherapy or radiotherapy in HER2-negative luminal breast cancer.
Reference-free phylogeny from sequencing data
Authors: Ryšavý Petr , Železný Filip
Published: March 2023

Motivation

Clustering of genetic sequences is one of the key parts of bioinformatics analyses. Resulting phylogenetic trees are beneficial for solving many research questions, including tracing the history of species, studying migration in the past, or tracing a source of a virus outbreak. At the same time, biologists provide more data in the raw form of reads or only on contig-level assembly. Therefore, tools that are able to process those data without supervision need to be developed.

Results

In this paper, we present a tool for reference-free phylogeny capable of handling data where no mature-level assembly is available. The tool allows distance calculation for raw reads, contigs, and the combination of the latter. The tool provides an estimation of the Levenshtein distance between the sequences, which in turn estimates the number of mutations between the organisms. Compared to the previous research, the novelty of the method lies in a newly proposed combination of the read and contig measures, a new method for read-contig mapping, and an efficient embedding of contigs.
TERRA G-quadruplex stabilization as a new therapeutic strategy for multiple myeloma
Authors: Scionti Francesca , Juli Giada , Rocca Roberta , Polerà Nicoletta , Nadai Matteo , Grillone Katia , Caracciolo Daniele , Riillo Caterina , Altomare Emanuela , Ascrizzi Serena , Caparello Basilio , Cerra Maria , Arbitrio Mariamena , Richter Sara N. , Artese Anna , Alcaro Stefano , Tagliaferri Pierosandro , Tassone Pierfrancesco , Di Martino Maria Teresa
Published: March 2023

Background

Multiple myeloma (MM) is a hematologic malignancy characterized by high genomic instability, and telomere dysfunction is an important cause of acquired genomic alterations. Telomeric repeat-containing RNA (TERRA) transcripts are long non-coding RNAs involved in telomere stability through the interaction with shelterin complex. Dysregulation of TERRAs has been reported across several cancer types. We recently identified a small molecule,hit17, which stabilizes the secondary structure of TERRA. In this study, we investigated in vitro and in vivo anti-MM activities ofhit17.

Methods

Anti-proliferative activity ofhit17 was evaluated in different MM cell lines by cell proliferation assay, and the apoptotic process was analyzed by flow cytometry. Gene and protein expressions were detected by RT-qPCR and western blotting, respectively. Microarray analysis was used to analyze the transcriptome profile. The effect ofhit17 on telomeric structure was evaluated by chromatin immunoprecipitation. Further evaluation in vivo was proceeded upon NCI-H929 and AMO-1 xenograft models.

Results

TERRA G4 stabilization induced in vitro dissociation of telomeric repeat‐binding factor 2 (TRF2) from telomeres leading to the activation of ATM-dependent DNA damage response, cell cycle arrest, proliferation block, and apoptotic death in MM cell lines. In addition, up-regulation of TERRA transcription was observed upon DNA damage and TRF2 loss. Transcriptome analysis followed by gene set enrichment analysis (GSEA) confirmed the involvement of the above-mentioned processes and other pathways such as E2F, MYC, oxidative phosphorylation, and DNA repair genes as early events followinghit17-induced TERRA stabilization. Moreover,hit17 exerted anti-tumor activity against MM xenograft models.

Conclusion

Our findings provide evidence that targeting TERRA byhit17 could represent a promising strategy for a novel therapeutic approach to MM.
What are the current diabetic foot assessment methods in private podiatry practices in Flanders, Belgium: an exploratory mixed method study
Authors: Vansteenland Irene , Forss Rachel
Published: March 2023

Background

Diabetic foot assessments detect patients at risk for developing a diabetes‐related foot ulceration and can significantly reduce the risk of amputation. In order to organize this assessment effectively, diabetic foot assessment guidelines are required according to the International Working Group of the Diabetic Foot. However, these international guidelines have not been adapted into a national guideline for podiatrists in Flanders, Belgium. This study aims to identify the methods and guidelines currently used to assess the diabetic foot in private podiatry practices in Flanders, Belgium and to explore the podiatrists' opinions on developing a national diabetic foot assessment guideline.

Methods

This exploratory mixed method study was composed of an anonymous online survey comprising of open‐ and closed‐ended questions followed by 1:1 online semi‐structured interviews. Participants were recruited via e‐mail and a closed private Facebook group of podiatry alumni. Data was analyzed using SPSS statistics and thematic analysis described by Braun and Clarke.

Results

This study showed that the vascular assessment of the diabetic foot exists solely of a medical history and palpation of the pedal pulses. Non‐invasive tests such as doppler, toe brachial pressure index or ankle brachial pressure index are seldom used. Only 66% reported to use a guideline for the diabetic foot assessment. There was a variety of reported guidelines and risk stratification systems in use in private podiatry practices in Flanders, Belgium.

Conclusion

Non‐invasive tests such as the doppler, ankle brachial pressure index or toe brachial pressure index are rarely used for the vascular assessment of the diabetic foot. Diabetic foot assessment guidelines and risk stratification systems to identify patients at risk for developing a diabetic foot ulcer were not frequently used. International guidelines of the International Working Group of the Diabetic Foot have not yet been implemented in private podiatry practices in Flanders, Belgium. This exploratory research has provided useful information for future research studies.
Out- Of- Pocket health expenditure and household consumption patterns in Benin: Is there a crowding out effect?
Authors: Houeninvo Hilaire Gbodja , Quenum Venant Cossi Celestin , Senou Melain Modeste
Published: March 2023

Health shocks are common and have serious consequences for households in developing countries where health insurance is lacking. In this study, we examine whether out-of-pocket health expenditures crowd out household consumption of non-healthcare necessities, such as education items in Benin using a sample of 14,952 households from the global vulnerability and food security analysis survey. We estimated a system of conditional Engel curves with three stage least squared (3SLS) and seemingly unrelated regression (SURE) for seven categories of goods using the Quadratic Almost Ideal Demand System (QUAIDS) in the form of budget shares corresponding to proportions of total non-health expenditure. Findings show that out of pocket health expenditure leads households to spend more on health care that in fine crowd out expenditure in other necessity goods such as education item. These findings highlight the need for social protection programs to mitigate the impact of health shocks on vulnerable households in Benin.
Critical appraisal in rapid systematic reviews of COVID-19 studies: implementation of the Quality Criteria Checklist (QCC)
Authors: Duval Daphne , Pearce-Smith Nicola , Palmer Jennifer C. , Sarfo-Annin Jason Kwasi , Rudd Paul , Clark Rachel
Published: March 2023

In this letter, we briefly describe how we selected and implemented the quality criteria checklist (QCC) as a critical appraisal tool in rapid systematic reviews conducted to inform public health advice, guidance and policy during the COVID-19 pandemic. As these rapid reviews usually included a range of study designs, it was key to identify a single tool that would allow for reliable critical appraisal across most experimental and observational study designs and applicable to a range of topics. After carefully considering a number of existing tools, the QCC was selected as it had good interrater agreement between three reviewers (Fleiss kappa coefficient 0.639) and was found to be easy and fast to apply once familiar with the tool. The QCC consists of 10 questions, with sub-questions to specify how it should be applied to a specific study design. Four of these questions are considered as critical (on selection bias, group comparability, intervention/exposure assessment and outcome assessment) and the rating of a study (high, moderate or low methodological quality) depends on the responses to these four critical questions. Our results suggest that the QCC is an appropriate critical appraisal tool to assess experimental and observational studies within COVID-19 rapid reviews. This study was done at pace during the COVID-19 pandemic; further reliability analyses should be conducted, and more research is needed to validate the QCC across a range of public health topics.
Economic, social, and clinic influences on opioid treatment program retention in Dar es Salaam, Tanzania: a qualitative study
Authors: Knight Deja , Nkya Iddi Haruna , West Nora Solon , Yang Cui , Kidorf Michael , Latkin Carl , Saleem Haneefa T.
Published: March 2023

Background

Medications for opioid use disorder (MOUD) are associated with positive health outcomes. People remaining on MOUD have a reduced likelihood of drug overdose and mortality. Tanzania supports a national opioid treatment program (OTP) offering MOUD, but retention is a continual challenge. To date, most research on MOUD retention in Tanzania and other Sub-Saharan Africa settings has been focused on the individual-level, with little attention to economic, social, and clinic-level factors.

Methods

We qualitatively examined economic, social, and clinic factors that affect retention on MOUD, specifically methadone maintenance therapy, among former and current clients attending an OTP clinic Dar es Salaam, Tanzania. We conducted in-depth interviews with a total of 40 current and former clients receiving MOUD and four focus groups with an additional 35 current clients on MOUD between January and April 2020. We utilized a thematic analysis approach.

Results

Daily OTP clinic attendance posed a financial burden to current and former clients and was a barrier to remaining on MOUD. Though treatment is free, clients described struggles to attend clinic, including being able to afford transportation. Female clients were differentially impacted, as sex work was the most common income-generating activity that they participated in, which presented its own set of unique challenges, including barriers to attending during set clinic hours. Drug use stigma acted as a barrier to MOUD and prevented clients from securing a job, rebuilding trust within the community, and accessing transportation to attend the clinic. Being able to rebuild trust with family facilitated remaining on MOUD, as family provided social and financial support. Caretaking responsibilities and familial expectations among female clients conflicted with MOUD adherence. Finally, clinic level factors, such as clinic dispensing hours and punitive consequences for breaking rules, posed barriers to clients on MOUD.

Conclusion

Social and structural factors, both within (e.g., clinic policies) and outside of (e.g., transportation) the clinic impact MOUD retention. Our findings can inform interventions and policies to address economic and social barriers to MOUD, that can contribute to sustained recovery.
A daily diary study of self-compassion and adaptive coping behaviours in women with symptoms of bulimia nervosa
Authors: Katan Aleece , Kelly Allison C.
Published: March 2023

Background

Mental health is more than the absence of illness and includes the ability to cope adaptively with stress. To shed light on the factors that promote mental health in people with eating disorders, this daily diary study examined whether daily and trait levels of self-compassion predict adaptive coping behaviours in women with symptoms of bulimia nervosa (BN).

Methods

Women (N = 124) who met the DSM-5 criteria for BN completed 2 weeks of nightly measures assessing their daily level of self-compassion and their daily adaptive coping behaviours, namely, their use of problem-solving strategies, seeking and receiving of instrumental social support, and seeking and receiving of emotional social support.

Results

Multilevel modelling revealed that on days when self-compassion levels were higher than their personal mean level or than the preceding day’s level, participants reported greater use of problem-solving strategies, greater seeking and receiving of instrumental social support, and greater receiving of emotional social support. Daily levels of self-compassion, but not increased self-compassion from the preceding day, were associated with emotional support sought. Further, higher trait self-compassion, as measured by participants’ mean level of self-compassion over the 2 weeks, was associated with increased seeking and receiving of instrumental and emotional social support but not with problem-solving strategies. All models controlled for participants’ daily and mean eating pathology over the 2 weeks, highlighting the unique contribution of self-compassion to adaptive coping behaviours.

Conclusions

Results suggest that self-compassion may help individuals with symptoms of BN cope with challenges in their daily life more adaptively, an integral component of positive mental health. The present study is among the first to suggest that the benefits of self-compassion for individuals with eating disorder symptoms may lie not only in facilitating reduced eating pathology, as evidenced by prior research, but also in promoting positive mental health. More broadly, findings underscore the potential value of interventions designed to build self-compassion in individuals with eating disorder symptoms.
Understanding racial bias through electroencephalography
Authors: Manfredi Mirella , Comfort William E. , Marques Lucas M. , Rego Gabriel G. , Egito Julia H. , Romero Ruth L. , Boggio Paulo S.
Published: March 2023

Research on racial bias in social and cognitive psychology has focused on automatic cognitive processes such as categorisation or stereotyping. Neuroimaging has revealed differences in the neural circuit when processing social information about one’s own or another’s ethnicity. This review investigates the influence of racial bias on human behaviour by reviewing studies that examined changes in neural circuitry (i.e. ERP responses) during automatic and controlled processes elicited by specific tasks. This systematic analysis of specific ERP components across different studies provides a greater understanding of how social contexts are perceived and become associated with specific stereotypes and behavioural predictions. Therefore, investigating these related cognitive and neurobiological functions can further our understanding of how racial bias affects our cognition more generally and guide more effective programs and policies aimed at its mitigation.
Retroperitoneal solitary neurofibroma mimicking lymph node metastasis of colon cancer: a case report
Authors: Haruna Takahiro , Takata Hideyuki , Mizutani Satoshi , Katsuno Akira , Nakata Ryosuke , Motoda Norio , Taniai Nobuhiko , Yoshida Hiroshi
Published: March 2023

Background

A neurofibroma is a benign tumor that arises from Schwann cells and neurofibromas occur throughout the skin of neurofibromatosis type 1 (NF-1: Von Recklinghausen’s disease) patients. A retroperitoneal solitary neurofibroma without any clinical signs of NF1 has been rarely reported. Herein, we present a case of a retroperitoneal solitary neurofibroma mimicking lymph node metastasis of colon cancer as well as a literature review.

Case presentation

An 80-year-old woman with abdominal pain and nausea was transported and diagnosed with bowel obstruction arising from sigmoid colon cancer A colonic stent was inserted to alleviate the bowel obstruction. A computed tomography scan with contrast revealed a liver tumor in segment 3, and an enlarged lymph node around the abdominal aorta. Whole-body 18F-fluorodeoxyglucose-positron emission tomography–CT (FDG-PET–CT) examine revealed increased FDG uptake in the liver tumor and enlarged lymph node. Liver and distant lymph node metastasis were diagnosed and we made a plan for a two-stage operation of the colon cancer and the metastatic lesions because laparotomy resection was needed for the retroperitoneal lymph node. Laparoscopic sigmoid colectomy was performed first. Pathological examination showed a tubular adenocarcinoma. A laparotomy for the metastatic lesions was performed to ensure complete lymph node dissection secondly. Histopathological findings of the liver tumor showed metastasis of sigmoid colon cancer. However, the tissue regarded as the enlarged lymph node was diagnosed as a neurofibroma. No metastasis and recurrence were observed.

Conclusion

Although most neurofibromas are benign, malignant transformation of a neurofibroma is possible. PET–CT showed our patient had a high accumulated retroperitoneal tumor co-existing with colon cancer and liver metastasis. The treatment strategy of a solitary neurofibroma must be selected carefully considering the site of occurrence and the patient’s background and aggressive resection of a tumor co-existing with another malignant tumor is needed.
Perforated gastric ulcer after unhealthy decisions in a patient with an intragastric balloon, a hangover you will regret
Authors: Molina Gabriel A. , Rojas Christian , Aguayo William , Vivar Cecilia , Guzmán Jose D.
Published: March 2023

Background

Perforated gastric ulcers are life-threatening surgical emergencies that need early diagnosis and treatment to overcome severe complications. With the rise of obesity in recent years, intragastric balloons have arisen as a "safe" strategy; however, in medicine, no treatment is risk-free. Nausea, pain, vomiting, and more severe complications like perforation, ulceration, and death can occur.

Case presentation

We present the case of a 28-year-old man with obesity; treatment with an intragastric balloon was initiated with good results at the beginning of his treatment. However, he neglected his treatment over time and made unhealthy choices, leading to a severe complication. However, thanks to prompt surgical treatment, he made a full recovery.

Complications:

Gastric perforation following an intragastric balloon is a severe and potentially life-threatening complication that an experienced multidisciplinary team must treat promptly and, more importantly, prevent.
Attending lectures in person, hybrid or online—how do students choose, and what about the outcome?
Authors: Kortemeyer Gerd , Dittmann-Domenichini Nora , Schlienger Claudia , Spilling Ekkehard , Yaroshchuk Alina , Dissertori Günther
Published: March 2023

As a consequence of the COVID-19 pandemic, most courses at a large technical university were adapted so that students had a free choice of whether to attend lectures on-site or online; in addition, in many courses, lecture recordings were available. At the subsequent exam session, over 17,000 student-survey responses were collected regarding attendance choices, learning behavior, interest in the course, perception of the exam, and recommendations to future students. A total of 27 learner attributes and their relationships were investigated. In addition, conditional attributes and free-response statements were analyzed, and the students’ exam grades were retrieved to gauge their performance. We found only minute differences with respect to exam performance, but the analysis indicates distinctly different preferences and constraints in taking advantage of learning opportunities. We also found some indications that performance differences might be larger for interactive-engagement courses. The results of the analysis may be key to answering why at many universities, faculty report that live-lecture attendance has decreased more strongly than expected with the availability of new, virtual attendance modes.
Naringenin alters the pharmacokinetics of ranolazine in part through the inhibition of cytochrome P450 (3A4) and P-glycoprotein
Authors: Alotaibi Faisal
Published: March 2023

Background

This study set out to look at how naringenin affected the pharmacokinetics of ranolazine in rats. The pharmacokinetic investigation of ranolazine in rats following oral administration of ranolazine with or without coadministration of naringenin was successfully conducted using the established technique. Animals were administered the same medications for 7 days as part of a multiple dosage study (MDS), and the amount of ranolazine in plasma was calculated on 18 days. The intestinal transit of ranolazine in the presence and absence of naringenin and verapamil was examined in an in vitro experiment using the intestinal sacs of rats and chickens (P-glycoprotein inhibitor).

Results

Naringenin raised the maximal level (Cmax) of ranolazine from 231 ± 10.16 to 303.67 ± 9.46 and 325.67 ± 21.81 ng/mL in SDS and MDS, respectively. Moreover, naringenin elevated the area under the curve (AUC) of ranolazine from 1293.54 ± 37.18 to 1505.38 ± 100.30 and 1575.42 ± 76.98 ng/mL/h in SDS and MDS. In the presence of naringenin, there was an increase in the transfer of ranolazine from the mucosal side to the serosal side. Naringenin inhibits the enzymes Cytochrome P450 (3A4) or (CYP3A4) and P-glycoprotein (P-gp). The findings showed that naringenin might have a considerable impact on ranolazine pharmacokinetics, including extending its t1/2 and raising its AUC.

Conclusions

The findings of the study showed that naringenin inhibits the enzymes CYP3A4 and P-gp. Therefore, naringenin might have a considerable impact on ranolazine pharmacokinetics, including extending its t1/2 and raising its AUC.

Graphical abstract
Kinetics of CD169, HLA-DR, and CD64 expression as predictive biomarkers of SARS-CoV2 outcome
Authors: Gatti Arianna , Fassini Paola , Mazzone Antonino , Rusconi Stefano , Brando Bruno , Mistraletti Giovanni
Published: March 2023

Introduction

Discriminating between virus-induced fever from superimposed bacterial infections is a common challenge in intensive care units. Superimposed bacterial infections can be detected in severe SARS-CoV2-infected patients, suggesting the important role of the bacteria in COVID-19 evolution. However, indicators of patients’ immune status may be of help in the management of critically ill subjects.

Monocyte CD169 is a type I interferon-inducible receptor that is up-regulated during viral infections, including COVID-19. Monocyte HLA-DR expression is an immunologic status marker, that decreases during immune exhaustion. This condition is an unfavorable prognostic biomarker in septic patients. Neutrophil CD64 upregulation is an established indicator of sepsis.

Methods

In this study, we evaluated by flow cytometry the expression of cellular markers monocyte CD169, neutrophil CD64, and monocyte HLA-DR in 36 hospitalized patients with severe COVID-19, as possible indicators of ongoing progression of disease and of patients’ immune status. Blood testings started at ICU admission and were carried on throughout the ICU stay and extended in case of transfer to other units, when applicable.

The marker expression in mean fluorescence intensity (MFI) and their kinetics with time were correlated to the clinical outcome.

Results

Patients with short hospital stay (≤15 days) and good outcome showed higher values of monocyte HLA-DR (median 17,478 MFI) than long hospital stay patients (>15 days, median 9590 MFI, p= 0.04) and than patients who died (median 5437 MFI, p= 0.05). In most cases, the recovery of the SARS-CoV2 infection-related signs was associated with the downregulation of monocyte CD169 within 17 days from disease onset. However in three surviving long hospital stay patients, a persistent upregulation of monocyte CD169 was observed. An increased neutrophil CD64 expression was found in two cases with a superimposed bacterial sepsis.

Conclusion

Monocyte CD169, neutrophil CD64, and monocyte HLA-DR expression can be used as predictive biomarkers of SARS-CoV2 outcome in acutely infected patients. The combined analysis of these indicators can offer a real-time evaluation of patients’ immune status and of viral disease progression versus superimposed bacterial infections. This approach allows to better define the patients’ clinical status and outcome and may be useful to guide clinicians’ decisions. Our study focused on the discrimination between the activity of viral and bacterial infections and on the detection of the development of anergic states that may correlate with an unfavorable prognosis.
Multiple cardiac calcified amorphous tumors with morphologically different characteristics complicated by aortic regurgitation: a case report
Authors: Sakurai Hironobu , Someya Takeshi , Yamamoto Satoshi , Ito Eisaku , Kuroki Hidehito , Shirai Toshizumi
Published: March 2023

Background

Cardiac calcified amorphous tumors (CATs) are non-neoplastic cardiac tumors of unknown origin and etiology. Several simultaneous CATs rarely occur in multiple cardiac chambers. Although CATs carry a benign prognosis, they have a risk of complications such as systemic embolism.

Case presentation

We report the case of a 79-year-old woman with two CATs and aortic regurgitation due to perforations of aortic cusps. She underwent surgical tumor resection with aortic valve replacement. The CATs were macroscopically and histologically different, which may suggest different developmental stages. One CAT was in the left atrium; it was less mobile and had nodular calcifications within dense fibrous tissue. The other CAT was in the left ventricular outflow tract; it was highly mobile, with nodular calcifications surrounded by amorphous fibrin and sanguineous deposits. The highly mobile CAT mechanically damaged the aortic cusps and caused perforations. The patient has survived over 2 years with no recurrence of the cardiac masses on echocardiography.

Conclusion

The patient underwent surgical resection for two CATs. The tumors occurred in different areas and had different macroscopic and histological characteristics. We recommend early resection for highly mobile CATs because of the high risks of embolization and injuries to the surrounding tissues.