bluuebunny/crossref_metadata_2025 huggingface dataset:
Small intestinal strangulation in 60 cattle – clinical, laboratory and ultrasonographic findings, treatment and outcome
Authors: Braun Ueli , Gerspach Christian , Loss Sandra , Hilbe Monika , Nuss Karl
Published: November 2023

Background

Intestinal strangulation is constriction of the intestine by a band of tissue, ligament or blood vessel causing partial or complete intestinal obstruction. This retrospective study describes the clinical, laboratory and ultrasonographic findings, treatment and outcome of 60 cows with intestinal strangulation.

Results

The general condition was abnormal in all cows (60/60), 23.3% (14/60) had nonspecific signs of pain, 40.0% (24/60) had signs of colic and 48.3% (29/60) had signs of somatic (parietal) pain. The most common digestive tract abnormalities were, in decreasing frequency, reduced or absent intestinal motility (100%, 60/60), reduced or absent faecal output (98.3%, 59/60), reduced or absent rumen motility (93.4%, 56/60), dilated small intestines on transrectal palpation (63.3%, 38/60), positive ballottement and swinging auscultation (BSA) and/or percussion and simultaneous auscultation (PSA) on the right side of the abdomen (58.3%, 35/60) and at least one positive foreign body test, most commonly the back grip, in 33.9% (20/59) of the cows. Other common findings were reduced skin surface temperature (67.8%, 40/59), reduced skin turgor (51.7%, 31/60), prolonged capillary refill time (49.2%, 29/59), enophthalmus (48.3%, 29/60) and moderate to severe scleral injection (46.6%, 27/58). The most common laboratory findings were hypokalaemia (58.3%, 35/60), haemoconcentration (57.6%, 34/59), base excess (51.1%, 24/47), hyperproteinaemia (45.8%, 27/59), hyperbilirubinaemia (43.3%, 26/60), acidosis (42.6%, 20/47) and azotaemia (38.3%, 23/60). The principal ultrasonographic findings were subjectively reduced or absent small intestinal motility and dilated small intestines, but the strangulation could not be visualised by ultrasonography. With one exception, all cows underwent a right flank laparotomy to resolve the strangulation by transection or resection of the impinging tissue. Forty-nine (81.7%) cows were discharged and 11 (18.3%) were euthanized before, during or after surgery.

Conclusions

Without laparotomy, intestinal strangulation could be clinically (transrectally) diagnosed in only 10% of the cows. A laparotomy is therefore essential for the correct diagnosis. The prognosis is good with prompt surgical treatment.
The influence of upright posture on craniospinal, arteriovenous, and abdominal pressures in a chronic ovine in-vivo trial
Authors: Podgoršak Anthony , Trimmel Nina Eva , Oertel Markus Florian , Arras Margarete , Weisskopf Miriam , Schmid Daners Marianne
Published: November 2023

Introduction

Most investigations into postural influences on craniospinal and adjacent physiology have been performed in anesthetized animals. A comprehensive study evaluating these physiologies while awake has yet been completed.

Methods

Six awake sheep had telemetric pressure sensors (100 Hz) implanted to measure intracranial, intrathecal, arterial, central venous, cranial, caudal, dorsal, and ventral intra-abdominal pressure (ICP, ITP, ABP, CVP, IAPcr, IAPcd, IAPds, IAPve, respectively). They were maneuvered upright by placing in a chair for two minutes; repeated 25 times over one month. Changes in mean and pulse pressure were calculated by comparing pre-chair, P0, with three phases during the maneuver: P1, chair entrance; P2, chair halftime; P3, prior to chair exit. Statistical significance (p ≤ .05) was assessed using repeated measures ANOVA.

Results

Significant mean pressure changes of (P1 − P0) and (P3 − P0) were measured at − 12.1 ± 3.1 and − 14.2 ± 3.0(p < .001), 40.8 ± 10.5 and 37.7 ± 3.5(p = .019), 9.7 ± 8.3 and 6.2 ± 5.3(p = .012), 22.3 ± 29.8 and 12.5 ± 12.1(p = .042), and 11.7 ± 3.9 and 9.0 ± 5.2(p = .014) mmHg, for ICP, ITP, IAPds, IAPcr, IAPca, respectively. For pulse pressures, significant changes of (P1 − P0) and (P3 − P0) were measured at − 1.3 ± 0.7 and − 2.0 ± 1.1(p < .001), 4.7 ± 2.3 and 1.4 ± 1.4(p < .001), 15.0 ± 10.2 and 7.3 ± 5.5(p < .001), − 0.7 ± 1.8 and − 1.7 ± 1.7(p < .001), − 1.3 ± 4.2 and − 1.4 ± 4.7(p = .006), and 0.3 ± 3.9 and − 1.0 ± 1.3(p < .001) mmHg, for ICP, ITP, ABP, IAPds, IAPcr, IAPca, respectively.

Conclusions

Pressures changed posture-dependently to differing extents. Changes were most pronounced immediately after entering upright posture (P1) and became less prominent over the chair duration (P2-to-P3), suggesting increased physiologic compensation. Dynamic changes in IAP varied across abdominal locations, motivating the abdominal cavity not to be considered as a unified entity, but sub-compartments with individual dynamics.
Correlation between gut microbiota composition, enteric infections and linear growth impairment: a case–control study in childhood stunting in Pidie, Aceh, Indonesia
Authors: Rinanda Tristia , Riani Catur , Artarini Anita , Sasongko Lucy
Published: November 2023

Background

Gut microbiota is pivotal in maintaining children's health and well-being. The ingestion of enteric pathogens and dysbiosis lead to Environmental Enteric Dysfunction (EED), which is essential in stunting pathogenesis. The roles of gut microbiome and enteric infections have not been explored comprehensively in relation to childhood stunting in Indonesia. This study aimed to determine the correlation between gut microbiota composition, enteric infections, and growth biomarker, Insulin-like Growth Factor 1 (IGF-1), in stunted children from Pidie, Aceh, Indonesia.

Methods

This study was a case–control study involving 42 subjects aged 24 to 59 months, comprising 21 stunted children for the case and 21 normal children for the control group. The IGF-1 serum level was quantified using ELISA. The gut microbiome profiling was conducted using 16S rDNA amplicon sequencing. The expression of enteric pathogens virulence genes was determined using quantitative PCR (qPCR) assay. The correlations of observed variables were analysed using suitable statistical analyses.

Results

The result showed that the IGF-1 sera levels in stunted were lower than those in normal children (p ≤ 0.001). The abundance of Firmicutes (50%) was higher than Bacteroidetes (34%) in stunted children. The gut microbiome profile of stunted children showed enriched genera such as Blautia, Dorea, Collinsella, Streptococcus, Clostridium sensu stricto 13, Asteroleplasma and Anaerostipes. Meanwhile the depleted genera comprised Prevotella, Lactococcus, Butyrivibrio, Muribaculaceae, Alloprevotella, Akkermansia, Enterococcus, Terrisporobacter and Turicibacter. The abundance of water biological contaminants such as Aeromonas, Stappiaceae, and Synechococcus was also higher in stunted children compared to normal children. The virulence genes expression of Enteroaggregative Escherichia coli (aaiC), Enterotoxigenic E. coli (estA), Enteropathogenic E. coli (eaeA), Shigella/Enteroinvasive E. coli (ipaH3) and Salmonella enterica (ompC) in stunted was higher than in normal children (p ≤ 0.001), which negatively correlated to height and level of IGF-1.

Conclusion

The present study showed the distinctive gut microbiome profile of stunted and normal children from Pidie, Aceh, Indonesia. The gut microbiota of stunted children revealed dysbiosis, comprised several pro-inflammatory, metabolic abnormalities and high-fat/low-fiber diet-related taxa, and expressed virulence genes of enteric pathogens. These findings provide evidence that it is imperative to restore dysbiosis and preserve the balance of gut microbiota to support linear growth in children.
The association between pro-vegetarian dietary pattern and risk of colorectal cancer: a matched case-control study
Authors: Nejad Elham Tavassoli , Moslemi Elham , Souni Fateme , Mahmoodi Marzieh , Vali Mohebat , Vatanpour Mohammad , Nouri Mehran , Ramezani Atena , Shateri Zainab , Rashidkhani Bahram
Published: November 2023

Background

Few studies assess the link between plant-based diets and colorectal cancer (CRC) incidence. To our knowledge, no study has examined the association between pro-vegetarian dietary pattern (PDP) and CRC globally or among Iranians. Therefore, the objective of our matched case-control study was to evaluate the association between PDP and CRC in the Iranian population.

Methods

The present research was a hospital-based case (n = 71)-control (n = 142) study conducted in the same hospitals in Tehran, Iran. This study used a reliable and valid semi-quantitative food frequency questionnaire to evaluate the participants’ dietary intake. According to the residual method, the selected plant and animal foods have been adjusted in the total energy intake to calculate the PDP index. Odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for confounding variables were also expressed using logistic regression by SPSS software.

Results

In the crude and adjusted models, we observed that the odds of CRC decreased significantly in the 3rd and last quartile of PDP compared to the 1st quartile (Q) (Crude model: Q3: OR = 0.36, 95% CI: 0.17 − 0.79, P-value = 0.011 and Q4: OR = 0.33, 95% CI: 0.14 − 0.79, P-value = 0.012 - Adjusted model: Q3: OR = 0.41, 95% CI: 0.18 − 0.94, P-value = 0.035 and Q4: OR = 0.35, 95% CI: 0.14 − 0.87, P-value = 0.025).

Conclusions

Based on the results of the present case-control study in the Iranian population, it was concluded that PDP, which involves consuming vegetables, fruits, cereals, dairy products, and low meat consumption, reduces the odds of CRC. In conclusion, adherence to PDP is associated with a decreased odds of CRC.
Anti-Cryptosporidium oocysts polyclonal antibodies for cryptosporidiosis diagnosis and protection
Authors: Farid Alyaa , Aiad Silvia , Safwat Gehan
Published: November 2023

Cryptosporidiosis is an intestinal infection that is triggered by the protozoan parasiteCryptosporidiumspp.Cryptosporidiumoocysts can spread from one host to another either through direct contact with infected hosts' faeces or through indirect means (consumption of contaminated water or food). Significant numbers of oocysts are produced as a result of the rapid growth of the parasite within the infected hosts. For proper care of cryptosporidiosis, a laboratory diagnosis is necessary. Therefore, this study aimed to produce anti-Cryptosporidium parvum(C. parvum) oocyst immunoglobulin (Ig)G polyclonal antibodies (pAbs). The produced pAbs were used in the detection ofC. parvumoocysts antigens in stool and serum samples of infected calves. Moreover, pAbs were tested in protection of balb-c male mice from cryptosporidiosis infection.C. parvumoocysts were used in the preparation of antigens to be used in the immunization of New Zealand white rabbits. pAb was purified by ammonium sulphate precipitation method, caprylic acid purification method and diethylaminoethyl (DEAE) anion exchange chromatographic method. Sandwich enzyme-linked immunosorbent assay (ELISA) (using prepared pAb) scored higher sensitivity (85% and 95% for serum and stool samples) than that (80%) of microscopic examination of stool samples. Moreover, pAb significantly reduced the oocysts shedding, decreased inflammatory cytokines and enhanced the loss in the body weight of protected animals. The prepared pAb succeeded in the diagnosis of cryptosporidiosis in calves with high sensitivity either in the serum or stool samples. Our results indicated the usefulness of using the prepared pAb in protection against cryptosporidiosis.
Extracorporeal adsorption of protective and toxic bile acids and bilirubin in patients with cholestatic liver dysfunction: a prospective study
Authors: Greimel Antonia , Habler Katharina , Gräfe Caroline , Maciuga Nils , Brozat Clara Isabell , Vogeser Michael , Zoller Michael , Happich Felix L. , Liebchen Uwe , Frank Sandra , Paal Michael , Scharf Christina
Published: November 2023

Background

The release of toxic bile acids (BAs) in the blood of critically ill patients with cholestatic liver dysfunction might lead to the damage of various organs. Their extracorporeal elimination using the cytokine adsorber Cytosorb® (CS) (adsorption of especially hydrophobic molecules < 60 kDa) might be promising, but data proving a potential adsorption are missing so far.

Methods

The prospective Cyto-SOVLE study (NCT04913298) included 20 intensive care patients with cholestatic liver dysfunction, continuous kidney replacement therapy, total bilirubin concentration > 10 mg/dl and the application of CS into the dialysis circuit. Bilirubin and different BAs were measured pre- and post-CS at defined timepoints (10 min, 1, 3, 6, and 12 h after initiation). Relative reduction (RR, %) was calculated with: $$1-\left(\frac{\mathrm{concentration} (\mathrm{pre}-\mathrm{post})}{\mathrm{concentration} (\mathrm{pre})}\right)*100$$

1
-

concentration
(
pre
-
post
)

concentration
(
pre
)

∗
100

.

Results

The median RR for total and conjugated bilirubin after initiation was − 31.8% and − 30.3%, respectively, and decreased to − 4.5% and − 4.8% after 6 h. A high initial RR was observed for the toxic BAs GCA (− 97.4%), TCA (− 94.9%), GCDCA (− 82.5%), and TCDCA (− 86.0%), decreasing after 6 h to − 32.9%, − 32.7%, − 12.8%, and − 14.3%, respectively. The protective hydrophilic BAs showed a comparable RR after initiation (UDCA: − 77.7%, GUDCA: − 83.0%, TUDCA: − 91.3%) dropping after 6 h to − 7.4%, − 8.5%, and − 12.5%, respectively.

Conclusions

Cytosorb® can adsorb bilirubin and toxic as well as protective BAs. However, a fast saturation of the adsorber resulting in a rapid decrease of the RR was observed. Furthermore, no relevant difference between hydrophobic toxic and hydrophilic protective BAs was detected regarding the adsorption amount. The clinical benefit or harm of the BA adsorption needs to be evaluated in the future.
Beyond the bedside: protocol for a scoping review exploring the experiences of non-practicing healthcare professionals within health professions education
Authors: Church Helen R. , Brown Megan E. L. , Govender Lynelle , Clark Deborah
Published: November 2023

Background

The number of healthcare professionals leaving clinical practice and transitioning to alternative careers in health professions education is increasing. Among these non-practicing healthcare professionals, concerns have been reported regarding tensions in relation to identity, role, and credibility in their new field. There are suggestions that this is a particularly pressing issue for minoritised professionals who make this transition. Support is critical to attract and retain diverse talent within health professions education teaching and research. The purpose of this scoping review is to explore the career experiences of non-practicing healthcare professionals who work in health professions education internationally.

Methods

Arksey and O’Malley’s framework has been utilised to guide the design of this scoping review process and will be used throughout the course of the review. A comprehensive search of seven electronic databases and limited search of Google Scholar will be conducted, as well as a hand search of eligible article reference lists. Two reviewers will independently screen all articles based on inclusion criteria, with conflicts resolved by a third reviewer. Data from included articles will be charted, collated, and analysed thematically. Meta-data will be summarised quantitatively.

Discussion

This scoping review aims to explore the role and experiences of non-practicing healthcare professionals working within health professions education. The review will follow established scoping review guidelines and will include studies from various regions and languages, provided an English translation is available. The study remit will be broad, including both quantitative and qualitative studies, as well as reviews and opinion papers. Limitations may include the exclusion of non-English articles and potential difficulty of identifying papers which discuss the experiences of non-practicing clinicians. However, the review will provide insight into the current knowledge on what it is like to be a non-practicing clinician working within health professions education and identify gaps for both future research, and future support for those making this career transition.

Systematic review registration

Open Science Framework Registration https://doi.org/10.17605/OSF.IO/485Z3
Comprehensive classification and categorization of Qanat features: an interdisciplinary exploration using landscape infrastructure concept and semi-systematic review
Authors: Abedi Samira , Ansari Mojtaba , Haghighatbin Mahdi , Mansouri Seyed Amir
Published: November 2023

Qanats, as traditional and intelligent water infrastructures, have garnered attention across various scientific disciplines. However, a comprehensive, holistic view of Qanats remains elusive. This study aims to identify and present a thorough perspective on Qanat features. To achieve this objective, a semi-systematic review methodology was employed. The semi-systematic or narrative review approach is well-suited for subjects that span multiple disciplines and different periods. The research process commenced with an extensive search for the keyword “Qanat” within the titles and abstracts of articles across the MagIran, ScienceDirect, Taylor and Francis, and Springer databases. Subsequently, a thematic content analysis method was applied to analyze the content of these articles. Thematic content analysis involves the identification and presentation of recurring patterns in the form of distinct themes within the textual data. At this stage, Qanat features were extracted from the articles and categorized thematically. The research findings underscore the functional significance of Qanats as vital water supply systems. Furthermore, within the realm of management, Qanats are recognized as essential water infrastructures. In light of these findings, this study incorporates relevant literature from the infrastructure domain to systematically categorize Qanat features. In the research, the Landscape approach, characterized by its objective-subjective perspective, will serve as an overarching narrative framework to comprehensively classify all Qanat features. The resulting model portrays Qanats as possessing a diverse spectrum of tangible and intangible attributes, spanning environmental, cultural, social, and economic domains. This comprehensive analysis enhances our understanding of the multifaceted nature of Qanats, facilitating their preservation and sustainable management.
Could natural phytochemicals be used to reduce nitrogen excretion and excreta-derived N2O emissions from ruminants?
Authors: Zhao Yuchao , Liu Ming , Jiang Linshu , Guan Leluo
Published: November 2023

Ruminants play a critical role in our food system by converting plant biomass that humans cannot or choose not to consume into edible high-quality food. However, ruminant excreta is a significant source of nitrous oxide (N2O), a potent greenhouse gas with a long-term global warming potential 298 times that of carbon dioxide. Natural phytochemicals or forages containing phytochemicals have shown the potential to improve the efficiency of nitrogen (N) utilization and decrease N2O emissions from the excreta of ruminants. Dietary inclusion of tannins can shift more of the excreted N to the feces, alter the urinary N composition and consequently reduce N2O emissions from excreta. Essential oils or saponins could inhibit rumen ammonia production and decrease urinary N excretion. In grazed pastures, large amounts of glucosinolates or aucubin can be introduced into pasture soils when animals consume plants rich in these compounds and then excrete them or their metabolites in the urine or feces. If inhibitory compounds are excreted in the urine, they would be directly applied to the urine patch to reduce nitrification and subsequent N2O emissions. The phytochemicals' role in sustainable ruminant production is undeniable, but much uncertainty remains. Inconsistency, transient effects, and adverse effects limit the effectiveness of these phytochemicals for reducing N losses. In this review, we will identify some current phytochemicals found in feed that have the potential to manipulate ruminant N excretion or mitigate N2O production and deliberate the challenges and opportunities associated with using phytochemicals or forages rich in phytochemicals as dietary strategies for reducing N excretion and excreta-derived N2O emissions.
Downregulation of pro-surfactant protein B contributes to the recurrence of early-stage non-small cell lung cancer by activating PGK1-mediated Akt signaling
Authors: Luo Hao , Li Qing , Wang Ren-Tao , Zhang Liang , Zhang Wei , Deng Meng-Sheng , Luo Yuan-Yuan , Ji Xintong , Wen Yongheng , Zhou Xuan-Rui , Xu Bo , Wang Dong , Hu Bin , Jin Hua , Xu Cheng-Xiong
Published: November 2023

Recurrence is one of the main causes of treatment failure in early-stage non-small cell lung cancer (NSCLC). However, there are no predictors of the recurrence of early-stage NSCLC, and the molecular mechanism of its recurrence is not clear. In this study, we used clinical sample analysis to demonstrate that low levels of expression of precursor surfactant protein B (pro-SFTPB) in primary NSCLC tissue compared to their adjacent tissues are closely correlated with recurrence and poor prognosis in early-stage NSCLC patients. In vitro and in vivo experiments showed that downregulation of pro-SFTPB expression activates the Akt pathway by upregulating PGK1, which promotes metastasis and tumorigenicity in NSCLC cells. We then demonstrated that pro-SFTPB suppresses the formation of the ADRM1/hRpn2/UCH37 complex by binding to ADRM1, which inhibits PGK1 deubiquitination, thus accelerating ubiquitin-mediated PGK1 degradation. In summary, our findings indicate that low expression of pro-SFTPB in primary NSCLC compared to their adjacent tissue has potential as a predictor of recurrence and poor prognosis in early-stage NSCLC. Mechanistically, downregulation of pro-SFTPB attenuates inhibition of ADRM1-deubiquitinated PGK1, resulting in elevated levels of PGK1 protein; this activates the Akt pathway, ultimately leading to the progression of early-stage NSCLC.
Impulsivity and sensitivity to reward as mediating factors of the negative relationship between emotional intelligence and health-related risk-taking: evidence from a sample of university students
Authors: Megías-Robles Alberto , Sánchez-López María T. , Gómez-Leal Raquel , Cabello Rosario , Gutiérrez-Cobo María José , Fernández-Berrocal Pablo
Published: November 2023

Background

Better abilities in emotional intelligence (EI) have been linked to a decreased tendency to engage in health-related risk behaviour. However, the processes underlying this relationship are still unclear. The aim of this research was to examine the role of impulsivity and sensitivity to reward as mediating factors in the relationship between EI and health risk-taking.

Methods

Two hundred and fifty participants (Mage = 23.60, age range = 18–59; SD = 6.67; 71.60% women) were assessed on ability EI levels, risk-taking in health contexts, impulsivity, and sensitivity to reward. Unlike previous studies in the literature, we employed a performance-based ability measure to assess EI (Mayer-Salovey-Caruso Emotional Intelligence Test, MSCEIT).

Results

The results confirmed the negative relationship between EI and health risk-taking and revealed the existence of a significant negative indirect effect of EI on health-risk taking through various dimensions of impulsivity and sensitivity to reward. EI abilities —particularly the ability to manage emotions— were associated with lower levels of impulsivity under positive and negative emotional states, a better management of the tendency towards sensation seeking, and a decreased emotional reactivity to rewards.

Conclusions

The present research provides a better understanding of the processes underlying the negative relationship between EI and health risk-taking. Our findings suggest that having higher levels of EI abilities would allow for a more objective evaluation of risk scenarios and a more appropriate and safer decision making through its influence on the levels of impulsivity and emotional reactivity to rewards. Practical implications, limitations, and future lines of research are discussed.
How standardised are antibiotic regimens in otologic surgery?
Authors: Lui Justin T. , Dahm Valerie , Arnoldner Christoph , Lam Philip W. , Le Trung N. , Chen Joseph M. , Lin Vincent Y.
Published: November 2023

Background

Within otologic surgery, a paucity of well-controlled studies assessing the use of systemic antibiotic to reduce surgical site infections exists. Moreover, discrepancies in wound classification of procedures challenge consensus in antimicrobial prescribing patterns. We sought to compare surgeons from two different health systems to examine how surgeons’ prescribing habits compared to practice guidelines for numerous otologic procedures.

Methods

An online questionnaire was distributed to 33 Canadian and 32 Austrian surgeons who regularly perform otologic surgery. Current systemic antibiotic prescribing habits for cochlear implantation, cholesteatoma surgery, stapes surgery, and tympanoplasty ± ossiculoplasty were collected.

Results

Eighteen of 33 (54.5%) Canadian surgeons provided responses, while 18 of 32 (56.3%) of Austrian surgeons answered. Clear consistency with clinical practice guidelines exists for pre-operative antibiotics use in cochlear implant surgery and infected cholesteatoma surgery. However, for stapes surgery and tympanoplasty ± ossiculoplasty, consensus is lacking for both pre- and post-operative antibiotic prescribing habits. Notable differences between the two countries include post-operative antibiotics for cochlear implant surgery (Austria: 36.4%, Canada: 71.4%) and uninfected cholesteatoma surgery (Austria: 33.3%, Canada: 77.8%). Across all procedures, both induction and post-operative antibiotic administration was not significantly associated with surgeon seniority when stratified by five-year increments.

Conclusion

The lack of consensus among each country's otologic surgeons underscores the uncertainty in wound classification and thus, adherence to clinical practice guidelines.

Graphical Abstract
From fatherhood premium to motherhood penalty: trends in the fertility effects on men's and women's wage in China (1989–2015)
Authors: Xu Qi
Published: November 2023

Investigating the impact of fertility on the wage earnings of men and women and its trends is important for understanding and coping with both the widening gender wage gap and the continuously declining fertility rate in China. Through an in-depth analysis of China Health and Nutrition Survey data from 1989 to 2015, the study finds that in the late 1980s, fertility had a significant positive impact on the wage earnings of men in China, while the negative impact on women's wages was not significant. Over time, the fatherhood wage premium has been declining, while the motherhood wage penalty has been rising at a faster rate, and the gender wage gap has been widening. The expansion of the market sector in China since the deepening of reforms in 1992 is an important reason for the rapid increase of motherhood wage penalty.
Psychometric validation of the Pyruvate Kinase Deficiency Diary and Pyruvate Kinase Deficiency Impact Assessment in adults in the phase 3 ACTIVATE trial
Authors: Andrae David A. , Grace Rachael F. , Jewett Adrian , Foster Brandon , Klaassen Robert J. , Salek Sam , Li Junlong , Tai Feng , Boscoe Audra N. , Zagadailov Erin
Published: November 2023

Background

Pyruvate kinase (PK) deficiency is a rare hereditary disorder characterized by chronic hemolytic anemia and serious sequalae which negatively affect patient quality of life. This study aimed to psychometrically validate the first disease-specific patient-reported outcome (PRO) instruments: the 7-item PK Deficiency Diary (PKDD) and 12-item PK Deficiency Impact Assessment (PKDIA), designed to assess signs, symptoms, and impacts of PK deficiency in patients enrolled in the ACTIVATE global phase 3 study of mitapivat versus placebo (NCT03548220).

Methods

All validation analyses for the PKDD and PKDIA were performed on blinded data, with analyses on item integrity, scoring, reliability, and validity conducted on data from screening and baseline. Completion rates and baseline response distributions were characterized using descriptive statistics. Item response modelling was used to inform a weighted scoring system. Reliability was assessed by internal consistency and test–retest reliability; and validity by convergent and known-groups analyses.

Results

Of the 80 adults enrolled, baseline data were available for 77 (96.3%) and 78 (97.5%) patients for the PKDD and PKDIA, respectively. Item responses skewed right, indicating that mean values exceeded median values, especially for items utilizing a 0–10 numeric scale, which were subsequently recoded to a 0–4 scale; 4 items were removed from the PKDIA due to redundancy or low relevance to the trial population. Both the PKDD and PKDIA demonstrated high internal consistency (McDonald’s coefficient ω = 0.86 and 0.90, respectively), test–retest reliability (intra-class coefficients of 0.94 and 0.87, respectively), and convergent validity with other PROs (linear correlation coefficients [|r|] between 0.30–0.73 and 0.50–0.82, respectively).

Conclusions

The findings provide evidence of validity and reliability for the PKDD and PKDIA, the first disease-specific PRO measures for PK deficiency, and can therefore increase understanding of, and more accurately capture, the wider impact of PK deficiency on health-related quality of life.

Trial registration ClinicalTrials.gov, NCT03548220. Registered June 07, 2018; https://www.clinicaltrials.gov/ct2/show/NCT03548220.
Performance evaluation of Cuckoo filters as an enhancement tool for password cracking
Authors: Cano Maria-Dolores , Villafranca Antonio , Tasic Igor
Published: November 2023

Cyberthreats continue their expansion, becoming more and more complex and varied. However, credentials and passwords are still a critical point in security. Password cracking can be a powerful tool to fight against cyber criminals if used by cybersecurity professionals and red teams, for instance, to evaluate compliance with security policies or in forensic investigations. For particular systems, one crucial step in the password-cracking process is comparison or matchmaking between password-guess hashes and real hashes. We hypothesize that using newer data structures such as Cuckoo filters could optimize this process. Experimental results show that, with a proper configuration, this data structure is two orders of magnitude more efficient in terms of size/usage compared to other data structures while keeping a comparable performance in terms of time.
The efficacy of ultra-high-density mapping guided partial antral ablation for pulmonary vein isolation in atrial fibrillation patients
Authors: Hwang Jongmin , Han Seongwook , Hwang Chun , Chung Tae-Wan , Park Hyoung-Seob
Published: November 2023

Background

The muscular discontinuities or lack of myocardial extensions around the pulmonary veins (PVs) antrum were previously reported. The objective of our study was to compare the efficacy of a partial antral ablation for PV isolation (PVI) using ultra-high density (UHD) mapping with a conventional wide antral circumferential ablation (WACA) in atrial fibrillation (AF) patients.

Methods

A total of 119 patients medical records who received catheter ablation for AF in our hospital were analyzed. In one group of patients, detailed activation mapping of each PV was performed using a UHD mapping system. Each PV antral segment’s activation pattern was classified into “directly-activated from the LA” or “passively-activated from an adjacent PV segment” patterns. The ablation applications were performed at the directly-activated PV antral segment only for the PVI when the PV had “passively-activated segments” (partial antral ablation; PA-UHD group). Another patient group received a conventional WACA for the PVI (WACA group).

Results

Sixty patients received partial antral ablation (PA-UHD), and age/sex-matched 59 patients received WACA. In the PA-UHD group, passively-activated segments were observed in 58.3% of all PV segments. The success rate of a partial antral ablation for the PVI in PVs with passively-activated segments was 85%. The 1-year atrial tachyarrhythmia recurrence did not differ between the PA-UHD and WACA groups.

Conclusions

Our study revealed the presence of passively-activated PV segments, which could potentially indicate muscular discontinuity at the PV-LA junction. In most PVs with passively-activated segments, PVI was successfully achieved by ablation with only directly-activated segments. The 1-year recurrence rate of atrial tachyarrhythmia in PA-UHD group was comparable to that observed in the WACA group.
Prognostic value of combined central venous oxygen saturation and lactate in pediatric patients after cardiac surgery
Authors: Abdelaziz Alyaa Ahdy , ElGendy Fady Mohammed , Hegazy Alaa Atef , Hussein Mai , Ghazy Ramy Mohamed
Published: November 2023

Objectives

This study assessed the value of measuring both arterial lactate levels and central venous oxygen saturation (ScvO2) in predicting cardiac surgery outcomes in pediatric patients.

Methods

A prospective cohort study was conducted on 73 patients who underwent surgery for congenital heart disease. Vasoactive-inotropic score (VIS), serial mean arterial blood pressures (MAP), lactate levels, and ScvO2 were measured immediately and 3, 6, 12, 18, and 24 h after admission to the pediatric intensive care unit (PICU). To test the prognostic values of these markers, we calculated the areas under the receiver operating characteristic curves (AUCs). Binary logistic regression was used to identify the determinants of postsurgical complications.

Results

The most common complications after cardiac surgery were the prolonged need for mechanical ventilation (38.36%), chest infection (30.14%), prolonged stay in the PICU (24.66%), and sepsis (9.59%). ScvO2 6 h after admission was most predictive of complications (AUC = 85.5%), followed by ScvO2/lactate (AUC = 83.0%), lactate level 12 h after admission (AUC = 75.0%), MAP (AUC = 73.6%), and VIS (AUC = 63.4). In multivariate analysis, body weight and ScvO2 6 h after PICU admission were the main predictors of complications (OR = 0.01, 95% CI 0.001–0.689, p = 0.033), and (OR = 0.87, 95% CI 0.798–0.948, p = 0.002) respectively.

Conclusions

To predict complications after pediatric cardiac surgery, lactate measurement does not add value to ScvO2 measurement 6 h after admission.

The Cochrane TRN

PACTR202104905893217.

Date of registration 12 April 2021.
A mixed methods partner-focused cost and budget impact analysis to deploy implementation strategies for school-based prevention
Authors: Eisman Andria B. , Whitman Jacob , Palinkas Lawrence A. , Fridline Judy , Harvey Christina , Kilbourne Amy M. , Hutton David W.
Published: November 2023

Background

Obtaining information on implementation strategy costs and local budget impacts from multiple perspectives is essential to data-driven decision-making about resource allocation for successful evidence-based intervention delivery. This mixed methods study determines the costs and priorities of deploying Enhanced Replicating Effective Programs (REP) to implement the Michigan Model for Health™, a universal school-based prevention intervention, from key shareholder perspectives.

Methods

Our study included teachers in 8 high schools across 3 Michigan counties as part of a pilot cluster randomized trial. We used activity-based costing, mapping key Enhanced REP activities across implementation phases. We included multiple perspectives, including state agencies, regional education service agencies, lead organization, and implementers. We also conducted a budget impact analysis (BIA, assessing the potential financial impact of adopting Enhanced REP) and a scenario analysis to estimate replication and account for cost variability. We used an experimental embedded mixed methods approach, conducting semi-structured interviews and collecting field notes during the trial to expand and explain the cost data and the implications of costs across relevant perspectives.

Results

Based on trial results, we estimate costs for deploying Enhanced REP are $11,903/school, with an estimated range between $8263/school and $15,201/school. We estimate that adding four additional schools, consistent with the pilot, would cost $8659/school. Qualitative results indicated misalignment in school and teacher priorities in some cases. Implementation activities, including training and implementation facilitation with the health coordinator, were sometimes in addition to regular teaching responsibilities. The extent to which this occurred was partly due to leadership priorities (e.g., sticking to the district PD schedule) and organizational priorities (e.g., budget).

Conclusions

Previous research findings indicate that, from a societal perspective, universal prevention is an excellent return on investment. However, notable misalignment in cost burden and priorities exists across shareholder groups. Our results indicate significant personal time costs by teachers when engaging in implementation strategy activities that impose an opportunity cost. Additional strategies are needed to improve the alignment of costs and benefits to enhance the success and sustainability of implementation. We focus on those perspectives informed by the analysis and discuss opportunities to expand a multi-level focus and create greater alignment across perspectives.

Trial registration

ClinicalTrials.gov NCT04752189. Registered on 12 February 2021.
Desigualdades de gênero e cor/raça entre os dirigentes municipais e estaduais no Brasil (2010 e 2019)
Authors: Mendes Jose
Published: November 2023

Este trabalho analisa as desigualdades nas remunerações e chances de progressão hierárquica entre os dirigentes municipais e estaduais no Brasil. Utilizando dados da Relação Anual de Informações Sociais adaptada pela equipe do Atlas do Estado Brasileiro, a análise aplica modelos lineares e ordinais, somados ao pré-tratamento dos dados com matching, para estimar os efeitos do gênero e da cor/raça nas remunerações dos dirigentes e em suas chances de progressão no funcionalismo. Os achados indicam que há, ainda, amplas discrepâncias entre os salários e a progressão explicadas pelo gênero e pela cor/raça, com mulheres e negros sendo desfavorecidos com relação a homens e brancos. Em termos interseccionais, a mulher negra ocupa a base da pirâmide dos dirigentes municipais e estaduais, enquanto o homem branco se encontra no topo, tanto em termos remuneratórios quanto hierárquicos.
Intraempreendedorismo na área pública: o caso da cota nos contratos do Senado Federal
Authors: Trombka Ilana , Meira Paulo
Published: November 2023

Clara Kelbert era diretora-geral do Senado Federal quando uma marcante visita ao abrigo de mulheres do Distrito Federal a colocou na posição de intraempreendedora, ao se convencer de que precisava buscar uma forma de enfrentar a problemática da empregabilidade quando relacionada à violência contra a mulher. Clara convenceu a Comissão Diretora a criar uma cota nos contratos de terceirização de mão de obra para mulheres vítimas de violência doméstica em situação de vulnerabilidade econômica. Masaté que ponto a prospecção de uma política de cotas (reserva de mercado de trabalho) caracteriza o intraempreendedorismo no setor público, com a capacidade de ressignificar o desempenho organizacional de uma instituição (Senado Federal), gerando maior valor público?
Effectiveness of neutral honey as a tissue fixative in histopathology
Authors: Alwahaibi Nasar , Al Dhahli Buthaina , Al Issaei Halima , Al Wahaibi Loai , Al Sinawi Shadia
Published: November 2023

Background: In routine histopathology, 10% neutral buffered formalin (NBF) is the choice fixative. However, formalin is a human carcinogen, so there is a necessity for a safer alternative. To the best of our knowledge, neutral honey, not natural or artificial honey, has not been tested to fix histological samples. This study determined the effectiveness of neutral buffered honey and other types of fixatives to fix histological tissues. Methods: The study was conducted between July 2019 and August 2020 at Sultan Qaboos University, Oman. Sections from three rat livers, kidneys, and stomach tissues were fixed with 10% NBF, neutral buffered Sumer honey, neutral buffered date honey, formalin, Sumer honey, date honey, alcoholic formalin, alcoholic Sumer honey, and alcoholic date honey for 24 hours. Samples were stained with hematoxylin and eosin (H&E), special stains, and vimentin methods. Three expert biomedical scientists then evaluated the fixed and stained samples for the quality of all sections. The fixation ability of the different honey solutions was then compared to 10% NBF and the utility was determined using nuclear and cytoplasmic criteria, specificity, and intensity. Results: H&E showed adequate staining in all groups compared to 10% NBF. The specificity and intensity of all groups for the Periodic acid–Schiff method were identical to 10% NBF except for Sumer honey and alcoholic date honey. Vimentin showed comparable findings with 10% NBF as there were no significant differences. Conclusions: The findings of this study encourage the use of honey, including neutral, as a possible safe substitute fixative for formalin, however, further experiments on larger specimens should be conducted.
In silico drug repurposing using molecular docking and dynamics to target the protein interaction between the SARS-CoV-2 S-glycoprotein and the ACE2 receptor
Authors: Hussein Dania , Almatrafi Abdullah , Gomaa Mohammed , Alhowsawi AlAnood , Almustafa Sarah , Alsaihaty Hadi , Alghamdi Manar
Published: November 2023

Background: The protein interaction between the viral surface S-glycoprotein and the host angiotensin converting enzyme-2 receptor (ACE2) is key to the virulent nature of SARS-CoV-2. The potential role that effective drug repurposing strategies may have to help stem the impact of future outbreaks has been brought to light in the recent COVID-19 pandemic. This study outlines a comprehensive approach towards in-silico drug discovery which aims to identify hit agents that can be suitably translated into a clinical setting.

Methods: We use two different computational platforms to analyze the viral S-glycoprotein in its bound conformational state to the ACE2 receptor. We employed a comprehensive screening approach to shortlist compounds capable of binding to the viral target interface and corroborated these findings using both Schrödinger’s Glide and AutoDock Vina. Molecular dynamic simulation studies further verified the stability of the interaction at the viral-host protein interface.

Results: Lymecycline, pentagalloylglucose, polydatin, and hexoprenaline were identified as prime candidates for further studies given the robust and stable nature of their interaction at the viral-host interface and relevance for clinical testing. These agents were shown in a 100-nanosecond simulation trajectory to favorably disrupt key binding interactions at the viral-host interface and may potentially inhibit viral entry into host cells. In all hit molecules it was observed that inhibiting the interaction with the following key viral binding residues: Lys17, Gly496, Tyr 505, and key host residues: His34, Asp38, Lys353, played a critical role toward the inhibition of the viral-host protein interaction.

Conclusions: Our study is unique in its comprehensive approach to identify agents that can bind to the S-glycoprotein-ACE2 interface using multiple computational platforms. Among the hit compounds shortlisted in this study, both lymecycline and hexoprenaline may be considered as candidates for preliminarily clinical studies to assess their therapeutic potential in the management of COVID-19 infections.
Serum calprotectin as a marker of neonatal sepsis: a hospital-based cross-sectional diagnostic study
Authors: Ramineni Pardha , Kamath Sowmini Padmanabh , Manjrekar Poornima , Kamath Padmanabh , Mithra Prasanna , Kulkarni Vaman
Published: November 2023

Background Despite significant advances in neonatal care, neonatal sepsis remains a major contributor to mortality, morbidity, and protracted hospitalization. The development of early possible diagnostic indicators for newborn sepsis is critical. Since calprotectin participates in major biological processes, it could be a diagnostic marker for infection/inflammation. This study aimed to estimate serum calprotectin in neonates with clinical sepsis. In addition, we compared serum calprotectin with standard sepsis markers and serum procalcitonin to evaluate its diagnostic accuracy. Methods A hospital-based cross-sectional diagnostic study of neonates identified with clinical sepsis using standard criteria was carried out. We compared estimated serum calprotectin levels to serum procalcitonin levels and conventional sepsis markers (leucocyte count, blood culture, immature to total neutrophil ratio, and C- reactive protein). We used SPSS version 25 to analyze the data. To examine diagnostic accuracy and determine a cut-off value for serum calprotectin, we used the receiver operating characteristics (ROC) curve. Results Of the 83 subjects included, 36.5% (30/83) had blood culture positive status, the median value of serum calprotectin being 0.93 ng/ml (0.67 to 1.3). Respiratory, cardiovascular, and gastrointestinal instabilities were present in 67.5% (56/83), 59% (49/83), and 50.1% (42/83) cases, respectively. The median values of serum calprotectin, procalcitonin, TLC, and I/T ratio between neonates withpositive blood culturesand negative culturesdid not differ significantly.. On ROC, calprotectin was not predictive for blood culture positivity (sensitivity: 50%; specificity: 44% at 0.83 ng/ml of serum calprotectin) and C-reactive protein (CRP) levels (sensitivity: 57%; specificity: 67% at serum calprotectin levels of 0.89 ng/ml). However, compared with serum procalcitonin, serum calprotectin at 1.2 ng/ml had sensitivity and specificity of 60% and 73%, respectively. Conclusions Serum calprotectin did not show a distinct advantage over the existing sepsis markers. Serum calprotectin level at 1.2 ng/ml had a sensitivity and specificity of 60% and 73%, respectively, compared to serum procalcitonin in detecting neonatal sepsis.
Awareness regarding breast cancer among the female population in Wardha District
Authors: Banmare Shraddha , Mude Gaurav
Published: November 2023

Breast carcinoma is the second-leading cause of cancer mortality in women and the most prevalent carcinoma in female worldwide. It is most often presented as a pain-free lump or thickening in the breast. Modern breast carcinoma screening and medication methods have increased survival rates, with 50% of females now surviving the disease. Breast carcinoma accounts for 10.4% of all instances of carcinoma among females each year, with more than 1.5 million present cases. According to a previous study in the year 2015, approximately 570,000 deaths occur due to breast cancer. Whereas in 2015 there were 2.3 million females diagnosed with breast carcinoma and 685000 deaths caused worldwide and 7.8 million were viable who were diagnosed with breast carcinoma in the past 5 years. This number continues to increase especially in more advanced countries. A cross sectional study will be performed among Wardha district women to assess the awareness of breast carcinoma. Awareness will be assessed using a questionnaire in the year 2023. The previous data shows 27% awareness among the female population in the year 2020, and we now expect the results of this study to be between 50%-60% in the year 2023 in the Wardha district female population.