bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing allocation of curricular content across the Undergraduate & Graduate Medical Education Continuum
Authors: Ginzburg Samara B. , Hayes Margaret M. , Ranchoff Brittany L. , Aagaard Eva , Atkins Katharyn M. , Barnes Michelle , Soep Jennifer B. , Yacht Andrew C. , Alexander Erik K. , Schwartzstein Richard M.
Published: June 2022

Background

Medical educators struggle to incorporate socio-cultural topics into crowded curricula. The “continuum of learning” includes undergraduate and graduate medical education. Utilizing an exemplar socio-cultural topic, we studied the feasibility of achieving expert consensus among two groups of faculty (experts in medical education and experts in social determinants of health) on which aspects of the topic could be taught during undergraduate versus graduate medical education.

Methods

A modified Delphi method was used to generate expert consensus on which learning objectives of social determinants of health are best taught at each stage of medical education. Delphi respondents included experts in medical education or social determinants of health. A survey was created using nationally published criteria for social determinants of health learning objectives. Respondents were asked 1) which learning objectives were necessary for every physician (irrespective of specialty) to develop competence upon completion of medical training and 2) when the learning objective should be taught. Respondents were also asked an open-ended question on how they made the determination of when in the medical education continuum the learning objective should be taught.

Results

26 out of 55 experts (13 social determinants of health and 13 education experts) responded to all 3 Delphi rounds. Experts evaluated a total of 49 learning objectives and were able to achieve consensus for at least one of the two research questions for 45 of 49 (92%) learning objectives. 50% more learning objectives reached consensus for inclusion in undergraduate (n = 21) versus graduate medical education (n = 14).

Conclusions

A modified Delphi technique demonstrated that experts could identify key learning objectives of social determinants of health needed by all physicians and allocate content along the undergraduate and graduate medical education continuum. This approach could serve as a model for similar socio-cultural content. Future work should employ a qualitative approach to capture principles utilized by experts when making these decisions.
Expediting knowledge acquisition by a web framework for Knowledge Graph Exploration and Visualization (KGEV): case studies on COVID-19 and Human Phenotype Ontology
Authors: Peng Jacqueline , Xu David , Lee Ryan , Xu Siwei , Zhou Yunyun , Wang Kai
Published: June 2022

Background

Knowledges graphs (KGs) serve as a convenient framework for structuring knowledge. A number of computational methods have been developed to generate KGs from biomedical literature and use them for downstream tasks such as link prediction and question answering. However, there is a lack of computational tools or web frameworks to support the exploration and visualization of the KG themselves, which would facilitate interactive knowledge discovery and formulation of novel biological hypotheses.

Method

We developed a web framework for Knowledge Graph Exploration and Visualization (KGEV), to construct and visualize KGs in five stages: triple extraction, triple filtration, metadata preparation, knowledge integration, and graph database preparation. The application has convenient user interface tools, such as node and edge search and filtering, data source filtering, neighborhood retrieval, and shortest path calculation, that work by querying a backend graph database. Unlike other KGs, our framework allows fast retrieval of relevant texts supporting the relationships in the KG, thus allowing human reviewers to judge the reliability of the knowledge extracted.

Results

We demonstrated a case study of using the KGEV framework to perform research on COVID-19. The COVID-19 pandemic resulted in an explosion of relevant literature, making it challenging to make full use of the vast and heterogenous sources of information. We generated a COVID-19 KG with heterogenous information, including literature information from the CORD-19 dataset, as well as other existing knowledge from eight data sources. We showed the utility of KGEV in three intuitive case studies to explore and query knowledge on COVID-19. A demo of this web application can be accessed at http://covid19nlp.wglab.org. Finally, we also demonstrated a turn-key adaption of the KGEV framework to study clinical phenotypic presentation of human diseases by Human Phenotype Ontology (HPO), illustrating the versatility of the framework.

Conclusion

In an era of literature explosion, the KGEV framework can be applied to many emerging diseases to support structured navigation of the vast amount of newly published biomedical literature and other existing biological knowledge in various databases. It can be also used as a general-purpose tool to explore and query gene-phenotype-disease-drug relationships interactively.
Enablers and barriers to post-discharge follow-up among women who have undergone a caesarean section: experiences from a prospective cohort in rural Rwanda
Authors: Nkurunziza Theoneste , Riviello Robert , Kateera Frederick , Nihiwacu Edison , Nkurunziza Jonathan , Gruendl Magdalena , Klug Stefanie J. , Hedt-Gauthier Bethany
Published: June 2022

Background

Caesarean sections account for roughly one third of all surgical procedures performed in low-income countries. Due to lack of standardised post-discharge follow-up protocols and practices, most of available data are extracted from clinical charts during hospitalization and are thus sub-optimal for answering post-discharge outcomes questions. This study aims to determine enablers and barriers to returning to the hospital after discharge among women who have undergone a c-section at a rural district hospital in Rwanda.

Methods

Women aged ≥ 18 years who underwent c-section at Kirehe District Hospital in rural Rwanda in the period March to October 2017 were prospectively followed. A structured questionnaire was administered to participants and clinical data were extracted from medical files between March and October 2017. At discharge, consenting women were given an appointment to return for follow-up on postoperative day 10 (POD 10) (± 3 days) and provided a voucher to cover transport and compensation for participation to be redeemed on their return. Study participants received a reminder call on the eve of their scheduled appointment. We used a backward stepwise logistic regression, at an α = 0.05 significance level, to identify enablers and barriers associated with post-discharge follow-up return.

Results

Of 586 study participants, the majority (62.6%) were between 21–30 years old and 86.4% had a phone contact number. Of those eligible, 90.4% returned for follow-up. The predictors of return were counselling by a female data collector (OR = 9.85, 95%CI:1.43–37.59) and receiving a reminder call (OR = 16.47, 95%CI:7.07–38.38). Having no insurance reduced the odds of returning to follow-up (OR = 0.03, 95%CI:0.03–0.23), and those who spent more than 10.6 Euro for transport to and from the hospital were less likely to return to follow-up (OR = 0.14, 95%CI:0.04- 0.50).

Conclusion

mHealh interventions using calls or notifications can increase the post-discharge follow-up uptake. The reminder calls to patients and discharge counselling by a gender-matching provider had a positive effect on return to care. Further interventions are needed targeting the uninsured and patients facing transportation hardship. Additionally, association between counselling of women patients by a female data collector and greater return to follow-up needs further exploration to optimize counselling procedures.
Carriage of mutations R462Q (rs 486907) and D541E (rs 627928) of the RNASEL gene and risk factors in patients with prostate cancer in Burkina Faso
Authors: Kadanga Essonan , Zouré Abdou Azaque , Zohoncon Théodora M. , Traoré Lassina , Ky Bienvenu Désiré , Yonli Albert Théophane , Traoré Djé Djénèba Aïda , Bazié Bapio Valery Jean Télesphore Elvira , Sombié Herman Karim , Sorgho Pegdwendé Abel , Tovo Sessi Frida Appoline , Traoré Kalifou , Ouedraogo Teega-Wendé Clarisse , Djigma Florencia W. , Simpore Jacques
Published: June 2022

Background

Prostate cancer (Pca) is a public health problem that affects men, usually of middle age or older. It is the second most common cancer diagnosed in men and the fifth leading cause of death. The RNASEL gene located in 1q25 and identified as a susceptibility gene to hereditary prostate cancer, has never been studied in relation to prostate cancer in Burkina Faso. The aim of this study was to analyze the carriage of RNASEL R462Q and D541E mutations and risks factors in patients with prostate cancer in the Burkina Faso.

Methods

This case–control study included of 38 histologically diagnosed prostate cancer cases and 53 controls (cases without prostate abnormalities). Real-time PCR genotyping of R462Q and D541E variants using the TaqMan® allelic discrimination technique was used. Correlations between different genotypes and combined genotypes were investigated.

Results

The R462Q variant was present in 5.3% of cases and 7.5% of controls. The D541E variant was present in 50.0% of cases and 35% of controls. There is no association between R462Q variants (OR = 0.60; 95%IC, 0.10–3.51; p = 0.686) and D541E variants (OR = 2.46; 95%IC, 0.78–7.80; p = 0.121) and genotypes combined with prostate cancer. However, there is a statistically significant difference in the distribution of cases according to the PSA rate at diagnosis (p ˂ 0.001). For the Gleason score distribution, only 13.2% of cases have a Gleason score greater than 7. There is a statistically significant difference in the Gleason score distribution of cases (p ˂ 0.001).

Conclusions

These variants, considered in isolation or in combination, are not associated with the risk of prostate cancer.
Adsorption behavior of Cr(VI) by biomass-based adsorbent functionalized with deep eutectic solvents (DESs)
Authors: Li Qian , Huang Qing , Pan Xin Ya , Yu Hang , Zhao Zi Tong
Published: June 2022

This study was aimed to evaluate the performance of DESs functionalized peanut shell (PSD) as biosorbent for removing Cr(VI) from water. The effects of pretreatment, initial concentration, adsorption temperature, kinetics, adsorption isotherm, and thermodynamics were investigated. Scanning electron microscopy (SEM) and Point of Zero charge (pHpzc) techniques were used for characterization of the adsorbents. The results showed that the rigid structure of peanut shell was broken down after DESs modification and the point of zero charge was 6.02 for peanut shell and 6.84 for PSD, which exhibited a slightly acid character. Based on the comparisons of linear and nonlinear analysis of four kinetic models and four isotherms, the pseudo-second-order kinetic model was found to be suitable for describing the adsorption process. The presence of a boundary effect was observed within the range of research, indicating that internal diffusion was not the only rate-controlling step. The equilibrium data were well represented by the Langmuir model rather than the Freundlich, Temkin, and Dubinin–Radushkevich models. The maximum capacity derived was 5.36 mg g−1. Changes in Gibb’s free energy, enthalpy, and entropy revealed that Cr(VI) adsorption onto modified peanut-shell powders was a spontaneous and endothermic process. However, the highest desorption efficiency was only 8.77% by using NaOH as a desorbing agent.

Graphical abstract
Establish an allele-specific real-time PCR for Leishmania species identification
Authors: Wu Yun , Jiang Mengyuan , Li Shaogang , Waterfield Nicholas R. , Yang Guowei
Published: June 2022

Background

Leishmaniasis is a serious neglected tropical disease that may lead to life-threatening outcome, which species are closely related to clinical diagnosis and patient management. The current Leishmania species determination method is not appropriate for clinical application. New Leishmania species identification tool is needed using clinical samples directly without isolation and cultivation of parasites.

Methods

A probe-based allele-specific real-time PCR assay was established for Leishmania species identification between Leishmania donovani and L. infantum for visceral leishmaniasis (VL) and among L. major, L. tropica and L. donovani/L. infantum for cutaneous leishmaniasis (CL), targeting hypoxanthine-guanine phosphoribosyl transferase (HGPRT) and spermidine synthase (SPDSYN) gene with their species-specific single nucleotide polymorphisms (SNPs). The limit of detection of this assay was evaluated based on 8 repeated tests with intra-assay standard deviation < 0.5 and inter-assay coefficients of variability < 5%. The specificity of this assay was tested with DNA samples obtained from Plasmodium falciparum, Toxoplasma gondii, Brucella melitensis and Orientia tsutsugamushi. Total 42 clinical specimens were used to evaluate the ability of this assay for Leishmania species identification. The phylogenetic tree was constructed using HGPRT and SPDSYN gene fragments to validate the performance of this assay.

Results

This new method was able to detect 3 and 12 parasites/reaction for VL and CL respectively, and exhibited no cross-reaction with P. falciparum, T. gondii, B. melitensis, O. tsutsugamushi and non-target species of Leishmania. Twenty-two samples from VL patients were identified as L. donovani (n = 3) and L. infantum (n = 19), and 20 specimens from CL patients were identified as L. major (n = 20), providing an agreement of 100% compared with sequencing results. For further validation, 29 sequences of HGPRT fragment from nine Leishmania species and 22 sequences from VL patients were used for phylogenetic analysis, which agreed with the results of this new method. Similar results were obtained with 43 sequences of SPDSYN fragment from 18 Leishmania species and 20 sequences from CL patients.

Conclusions

Our assay provides a rapid and accurate tool for Leishmania species identification which is applicable for species-adapted therapeutic schedule and patient management.

Graphical Abstract
Dispersal and seasonal movements of Pacific halibut (Hippoglossus stenolepis) in the eastern Bering Sea and Aleutian Islands, as inferred from satellite-transmitting archival tags
Authors: Loher Timothy
Published: June 2022

Background

Understanding connectivity is critical to the management of exploited fish stocks, but migratory dynamics of Pacific halibut (Hippoglossus stenolepis) in the Bering Sea and Aleutian Islands region are not well-understood. In the current study, 145 Pacific halibut ≥ 82 cm fork length were tagged with Pop-up Archival Transmitting (PAT) tags to evaluate interannual dispersal, seasonal migration, and depth-specific habitat use.

Results

Endpoint locations obtained after 1 year at liberty (n = 79), fishery recoveries after 2–3 years at liberty (n = 5), and at-liberty geopositions based on light data (n = 5313 estimates from 109 fish) indicated geographically distinct movement patterns: Pacific halibut tagged in the Western and Central Aleutian Islands remained within the island groups in which the fish had been tagged; fish in the eastern Bering Sea remained in that ocean basin, moving among International Pacific Halibut Commission (IPHC) regulatory areas and into Russian waters; those tagged south of Unimak Pass in IPHC Regulatory Area 4A displayed the greatest amount of emigration, dispersing eastward both seasonally and interannually to as far south as Washington State. Analysis of daily maximum depth and temperature data from 113 individuals demonstrated group-level variation in summer temperatures experienced by the fish and in the timing, duration, and synchrony of movement to deep-water wintering grounds.

Conclusions

Depth-specific habitat use was suggestive of regionally explicit migratory contingents, while interannual dispersal patterns were consistent with the existence of multiple functional spawning units. The results may guide future research to examine cross-basin connectivity in the Northern Bering Sea and provide inputs for numerical modelling of individual movements, larval advection, and recruitment analyses.
A systematic quality rating of available mobile health apps for borderline personality disorder
Authors: Steubl Lena Sophia , Reimann Josephin , Simon Laura , Terhorst Yannik , Stach Michael , Baumeister Harald , Sander Lasse Bosse , Messner Eva-Maria
Published: June 2022

Background

Mobile health apps (MHAs) may offer a mean to overcome treatment barriers in Borderline Personality Disorder (BPD) mental health care. However, MHAs for BPD on the market lack transparency and quality assessment.

Methods

European app stores were systematically searched, and two independent trained reviewers extracted relevant MHAs. Employed methods and privacy and security details documentation of included MHAs were extracted. MHAs were then assessed and rated using the German version of the standardized Mobile Application Rating Scale (MARS-G). Mean values and standard deviations of all subscales (engagement, functionality, aesthetics, information, and therapeutic gain) and correlations with user ratings were calculated.

Results

Of 2977 identified MHAs, 16 were included, showing average quality across the four main subscales (M = 3.25, SD = 0.68). Shortcomings were observed with regard to engagement (M = 2.87, SD = 0.99), potential therapeutic gain (M = 2.67, SD = 0.83), existing evidence base (25.0% of included MHAs were tested empirically), and documented privacy and security details. No significant correlations were found between user ratings and the overall total score of the MARS-G or MARS-G main subscales.

Conclusions

Available MHAs for BPD vary in quality and evidence on their efficacy, effectiveness, and possible adverse events is scarce. More substantial efforts to ensure the quality of MHAs available for patients and a focus on transparency, particularly regarding privacy and security documentation, are necessary.
Laboratory research of solvent-assisted menthol sols as temporary consolidants in archaeological excavation applications
Authors: Zhang Wenjin , Wang Xuemei , Han Xiangna , Meng Chenglei , Huang Xiao , Luo Hongjie
Published: June 2022

Temporary consolidation is a quite common practice during archeological excavations nowadays. Melts of cyclododecane or menthol are among the most used consolidants. When using melting protocol to consolidate fragile heritages in archaeological excavation sites, one of the most frequently encountered challenges is the poor penetration of the melt into the heritages, especially in cases of low environmental temperatures, high water content or compact substrates. In this work, we explore the possibility of using solvent-assisted menthol sols as temporary consolidant. Six common organic liquids are individually introduced into menthol at a concentration of 9.1 wt% to formulate room temperature menthol sols. Their potentials as temporary consolidants are systematically investigated. Experimental data indicate that solvent polarity is the most important feature for temporary consolidation purpose and ethanol with medium polarity is among the most appropriate solvents. Laboratory research results show that much better penetration behavior and good consolidation performances can be achieved in menthol-ethanol sol. The as-prepared menthol-ethanol sol is applied in Liangzhu archeological excavation site with satisfactory outcomes. This work shows that menthol-ethanol sol is an excellent temporary consolidation material for archaeological excavation purpose especially in extremely wet condition.
Spatiotemporal evolution of the coupling coordination between inheritance of local culture and new-style urbanization in China
Authors: Yan Lu , Shen Xia , Pengling Liu
Published: June 2022

The rapid new-style urbanization process in China has had a significant impact on the inheritance and protection of local culture. This paper quantitatively analyzes the spatiotemporal difference regarding the coupling coordination between the inheritance of local culture and the new-style urbanization process in China. It is found that during the period between 1991 and 2017, the coexistence of inheritance of local culture and new-style urbanization in China has successively undergone three stages, and at present, the coupling coordination between these two processes is still at a relatively low level, featuring significant differences across various regions and a progressive decrease in the degree of coupling coordination from east to west in China. However, the economically underdeveloped regions, especially ethnic minority regions, are under far greater pressure in terms of coordinated coexistence of both the inheritance of local culture and new-style urbanization.
Effective food hygiene principles and dietary intakes to reinforce the immune system for prevention of COVID-19: a systematic review
Authors: Mirzay-Razaz Jalaledin , Hassanghomi Majid , Ajami Marjan , Koochakpoor Glareh , Hosseini-Esfahani Firoozeh , Mirmiran Parvin
Published: June 2022

Background

This study aimed at reviewing effective food hygiene principles and dietary intakes to reinforce the immune system for prevention of corona virus disease 2019 (COVID-19).

Methods

The systematic literature search was performed in three databases from Jan. 2020 up to 10th July 2020. English articles that focused on nutrition, food, immunity and corona virus were searched. Systematic and narrative reviews were included.

Results

After evaluation of search papers, 27 relevant articles were used in this review. The importance of nutrients, phytochemicals, probiotics and some spices were highlighted for enhancing immunity during the COVID-19 pandemic. A healthy dietary pattern with proper energy intake provides sufficient nutrients. The unhealthy dietary pattern is linked with inflammation and risk factors related to high mortality in patients with severe COVID-19 infection. Different thermal procedures have been used for the inactivation of viruses. It is recommended not to consume raw or undercooked animal products.

Conclusions

It is critical to ensure that the nutritional needs of the population are met and sustained based on standards during a COVID-19 pandemic. Clear advice on adequate calorie intake and an optimal healthy diet to support the immune function should be provided. Good hygiene practices must be performed by everyone and done in the food industry.
The human impact of commercial delivery cycling injuries: a pilot retrospective cohort study
Authors: Sarkies Mitchell N. , Hemmert Cameron , Pang Yu-Chen , Shiner Christine T. , McDonell Karon , Mitchell Rebecca , Lystad Reidar P. , Novy Michael , Christie Lauren J.
Published: June 2022

Background

Commercial delivery cyclists represent a uniquely vulnerable and poorly understood road user. The primary aim of this study was to pilot whether cycling injuries could be categorised as either commercial or non-commercial using documentation entered into routine hospital medical records, in order to determine the feasibility of conducting a large cohort study of commercial cycling injuries in the future. A secondary aim was to determine which key demographic, incident and injury characteristics were associated with commercial versus non-commercial cycling injuries in emergency.

Methods

Pilot retrospective cohort study of adults presenting to an acute public hospital emergency department between May 2019 and April 2020 after sustaining a cycling-related injury. Multinomial logistic regression was used to examine the demographic, incident and injury characteristics associated with commercial compared to non-commercial cycling.

Results

Of the 368 people presenting to the emergency department with a cycling-related injury, we were able to categorise 43 (11.7%) as commercial delivery cyclists, 153 (41.6%) as non-commercial cyclists and the working status of 172 (46.7%) was unable to be confirmed. Both commercial and unconfirmed cyclists were more likely to be younger than non-commercial cyclists. Compared to non-commercial cyclists, commercial cyclists were 11 times more likely to speak a language other than English (AOR 11.3; 95% CI 4.07–31.30; p<0.001), less likely to be injured from non-collision incidents than vehicle collisions (AOR 0.36; 95% CI 0.15–0.91; p=0.030) and were over 13 times more likely to present to the emergency department between 8.00pm and 12.00am compared to the early morning hours (12.00 to 8.00am) (AOR 13.43; 95% CI 2.20–82.10; p=0.005).

Conclusions

The growth of commercial cycling, particularly through online food delivery services, has raised concern regarding commercial cyclist safety. Improvements in the recording of cycling injury commercial status is required to enable ongoing surveillance of commercial cyclist injuries and establish the extent and risk factors associated with commercial cycling.
RETRACTED ARTICLE: Factors associated with decision-making power on family planning utilization among HIV-positive women attending public health facilities in Eastern Ethiopia
Authors: Dejene Hiwot , Girma Derara , Adugna Leta , Tefera Bilisumamulifna
Published: June 2022

Background

Family planning for HIV-positive women has numerous advantages. However, the need of family planning utilization is challenged by women’s nonautonomous decision-making power. Therefore, this study aimed to examine the level and associated factors of decision-making power to utilize family planning among HIV-positive married women.

Methods

A facility-based cross-sectional study was conducted from March to June 2020 among 363 HIV-positive married women on ART, using systematic random sampling technique. Logistic regression analysis was used to identify variables that affect women’s decision-making power on family planning utilization. Statistical significance was declared at p-value < 0.05 with 95% confidence interval and strength of association was reported by adjusted odds ratio.

Results

Overall 55.2% (95% CI: 49.9–60.5) of the women had decision-making power on family planning utilization. Women’s having good knowledge (AOR: 2.87, 95% CI: 1.52–5.40), favorable attitude (AOR: 1.96, 95% CI: 1.13–3.38), women’s getting family planning counseling in ART clinics (AOR: 2.04, 95% CI: 1.16–3.59), women who get integration service of FP and ART (AOR: 1.83, 95% CI:1.07–3.12) were factors independently associated with women decision-making power on family planning utilization.

Conclusion

Decision-making power to utilize family planning among married HIV-positive women was low. Factors like poor knowledge about family planning, dissatisfaction with family planning service, not getting counseling about family planning in ART clinics, and not receiving family planning service in ART clinics were independently associated with women's decision-making power on family planning. Infrastructure linked with the health facility, knowledge, and attitudinal factors should all be combined in future family planning programs.
Short- and long-distance avian migrants differ in exercise endurance but not aerobic capacity
Authors: Hahn Steffen , Emmenegger Tamara , Riello Sara , Serra Lorenzo , Spina Fernando , Buttemer William A. , Bauer Silke
Published: June 2022

Background

Migratory birds differ markedly in their migration strategies, particularly those performing short- versus long-distance migrations. In preparation for migration, all birds undergo physiological and morphological modifications including enlargement of fat stores and pectoral muscles to fuel and power their flights, as well as cardiovascular and biochemical adjustments that improve lipid and oxygen delivery and uptake by flight muscles. While the magnitude of these changes varies in relation to migration strategy, the consequence of these variations on aerobic performance is unknown. We tested whether the aerobic performance of four Old-world flycatcher species (Muscicapidae) varied according to migration strategy by comparing minimum resting metabolic rates (RMRmin), exercise-induced maximum metabolic rates (MMR), and exercise endurance times of short-distance and long-distance migratory birds.

Results

As expected, RMRmin did not vary between short-distance and long-distance migrants but differed between the species within a migration strategy and between sexes. Unexpectedly, MMR did not vary with migration strategy, but MMR and blood haemoglobin content were positively related among the birds tested. Exercise endurance times differed substantially between migration strategies with long-distance migrants sustaining exercise for > 60% longer than short-distance migrants. Blood haemoglobin content had a significant positive effect on endurance among all birds examined.

Conclusions

The lack of difference in RMRmin and MMR between long- and short-distance migrants during this stage of migration suggests that the attributes favouring the greater aerobic endurance of long-distance migrants did not come at the expense of increased maintenance costs or require greater aerobic capacity.
Pascal short-pulse plus subthreshold endpoint management laser therapy for diabetic macular edema: the “sandwich technique”
Authors: Cardillo J. A. , Rodrigues M. W. , Oliveira R. C. , Messias A. M. V. , Jorge R.
Published: June 2022

Background

Diabetic macular edema (DME) is the main cause of visual loss in diabetic patients. Despite the use of anti-VEGF therapy as first-line treatment, there are many patients whose response to treatment is poor or transient at best. Sophisticated laser techniques have emerged aiming at low-intensity retinal damage, avoiding excessive heat that causes tissue necrosis and related collateral effects.

Objective

To evaluate the effect of combined sublethal laser modalities from short-pulse duration (SPD) with endpoint management (EpM) subthreshold laser [named the “sandwich technique” (SWiT)] on central subfield thickness (CST) and best-corrected visual acuity (BCVA) in patients with DME.

Material and methods

In this consecutive retrospective study, 37 patients (37 eyes) with center-involved (CI) DME were treated with SWiT laser therapy from April 2017 to June 2021. The technique consisted of a mean number of 200 (range number 50–400) SPD laser burns OCT-guided thickened area performed on the juxta- and perifoveal area 500 µm away from the foveal center, overlapping with a mean number of 1000 (range number 800–1200) EpM laser burns focused on 6 mm macular diameter area but saving 300 µm toward the foveal center. All patients underwent ophthalmological evaluations, including BCVA and CST measurement by spectral-domain optical coherence tomography (SD-OCT), before and after SWiT laser therapy. The mean follow-up time was 19.2 months (range 2–60 months).

Results

Thirty-five out of 37 cases showed an improvement in CST and BCVA following treatment. At baseline, mean CST (µm) ± standard error (SE) and mean BCVA (logMAR) ± SE was 456.95 ± 37.00 and 0.71 ± 0.29, respectively. After a mean follow-up of 19.2 months, mean CST (µm) ± SE and BCVA (logMAR) ± SE were 272.09 ± 9.10 (p < 0.0001) and 0.54 ± 0.26 (p = 0.003), respectively. A statistically significant reduction in CST and improvement in BCVA was noted after laser therapy application. The anti-VEGF injection frequency was reduced during the mean 19.2 months of the study period.

Conclusions

The novel “sandwich” laser therapy aid reduced CST and improved BCVA in this retrospective case series. Further prospective studies are warranted.
RNA sequencing analysis between ruptured and un-ruptured brain AVM
Authors: Li Hao , Yan Zihan , Huo Ran , Ya Xiaolong , Xu Hongyuan , Liu Zechen , Jiao Yuming , Weng Jiancong , Wang Jie , Wang Shuo , Cao Yong
Published: June 2022

Background

A brain arteriovenous malformation (BAVM) is a tangle of abnormal blood vessels connecting the arteries and veins in the brain and is associated with a higher risk for intracerebral hemorrhage (ICH). RNA sequencing technology has been recently used to investigate the mechanism of diseases owing to its ability to identify the gene changes on a transcriptome-wide level. This study aims to gain insights into the potential mechanism involved in BAVM rupture.

Methods

Sixty-five BAVM nidus samples were collected, among which 28 were ruptured and 37 were un-ruptured. Then, next-generation RNA sequencing was performed on all of them to obtain differential expressed genes (DEGs) between the two groups. In addition, bioinformatics analysis was performed to evaluate the involved biological processes and pathways by GO and KEGG analysis. Finally, we performed a univariate Cox regression analysis to obtain the early rupture-prone DEGs.

Results

A total of 951 genes were differentially expressed between the ruptured and un-ruptured BAVM groups, of which 740 genes were upregulated and 211 genes were downregulated in ruptured BAVMs. Then, bioinformatics analysis showed the biological processes and pathways related to the inflammatory processes and extracellular matrix organization were significantly enriched. Meanwhile, some downregulated genes are involved in cell adhesion and genes participating in response to muscle activity and the terms of nervous system development. Finally, one hundred twenty-five genes, many were involved in inflammation, were correlated with the early rupture of BAVMs.

Conclusions

The upregulated genes in the ruptured BAVM group were involved in inflammatory processes and extracellular matrix organization. Some of the downregulated genes participated in cell adhesion and myofibril assembly, indicating the role of enhanced inflammation and reduced inflammation vessel strength in BAVMs rupture.
Why do open and distance education students drop out? Views from various stakeholders
Authors: Bağrıacık Yılmaz Ayşe , Karataş Serçin
Published: June 2022

While the demand for open and distance education is increasing, it also faces high dropout rates. The reasons and solutions for student dropouts need considerable attention. This study aims to uncover the reasons for student dropouts considering the perspective of students, field experts, instructors, administrators, and support staff. Data from semi-structured interviews with 40 participants revealed that students decide to drop out mainly due to four main reasons: internal reasons, external reasons, student characteristics, and student skills. These reasons include 37 sub-factors such as academic integration, social integration, financial status, personality, and self-regulation. The sub-factors and selected quotations from the interviews are presented in the findings. According to the results, administrators, field experts, instructors, and support staff are not aware of all the dropout reasons. The results of this research are believed to guide researchers, practitioners, and administrators in enhancing the quality of open and distance education.
ECG optimisation for CRT systems in the era of automatic algorithms: a comprehensive review
Authors: Zoppo Franco , Cocciolo Andrea , Mangiameli Daniele , Perazza Luca , Corrado Andrea
Published: June 2022

Cardiac resynchronisation therapy (CRT) may fail in up to one third of patients, mainly due to anatomical and procedural issues. In the daily practice, ECG optimisation is largely used to address CRT delivery. Ineffective CRT can be related to non-optimal pacing timing as well as inadequate pacing-capture. A rate-competitive atrial fibrillation (AF) or a high daily burden of premature ventricular contractions (PVC) may also affect CRT by means of fusion or pseudo-fusion captures. Growing observations suggest that in a subset of patients with typical left bundle branch block (LBBB), selected LV pacing may be more effective, producing a complete fusion between the left pacing and the intrinsic right bundle activation. The His-ventricular (HV) interval is an invasive measurement (derived from electrophysiological study), which mainly reflects the RV activation (and its contribution to QRS timing) and has been proposed by some authors when addressing LV-paced–RV-sensed fusion. In sinus rhythm CRT patients, with baseline typical LBBB criteria and preserved AV conduction, the “dromotropic” management to achieve RV intrinsic activation with LV fusion is also “AV delay dependent”. In this regard, the RV intrinsic activation (detected by RV sensing) and the A (paced/sensed)-RV (sensed) interval are also influenced by the RV lead position within the RV. The current families of CRT devices have implemented automatic algorithms to optimise AV and VV timing intervals. The proof of principle is again the evidence that fusion of an LV-paced beat with intrinsic rhythm may be more beneficial than standard biventricular pacing, provided a preserved AV conduction. In the present review, all the above issues are discussed.
Impact of limb length discrepancy on functional outcome in total knee arthroplasty patients: a prospective cohort study
Authors: Pradhan Siddharth Satyakam , Tripathy Sujit Kumar , Jain Mantu , Behera Hrudeswar , Velagada Sandeep , Srinivasan Anand
Published: June 2022

Background

Limb length alteration following total knee arthroplasty (TKA) has been under-reported. Few studies have shown a significant association between limb length discrepancy (LLD) and poor functional outcome. This prospective study evaluated the impact of radiographic and perceived LLD on functional outcome in TKA. The variables affecting LLD were also evaluated.

Methods

The preoperative and postoperative limb lengths of TKA patients (112 knees, 81 patients, KL grade ≥ 3) were measured in full-length digital radiographs. The Hip-Knee-Ankle (HKA) angles were also measured. The functional outcome (Western Ontario and McMaster Universities Arthritis Index) and perception about LLD were evaluated after six months.

Results

The mean preoperative radiographic LLD in the unilateral and bilateral TKA groups was 0.75 cm ± 0.60 cm and 0.58 cm ± 0.52 cm (P = 0.197), respectively. Similarly, postoperative LLD was 0.76 cm ± 0.85 cm in the unilateral group and was 0.59 cm ± 0.92 cm (P = 0.402) in the bilateral group. Only 19.7% of patients had postoperative radiographic LLD of ≥ 10 mm, and 80.2% of patients had LLD of < 10 mm. The functional outcome was significantly affected when LLD exceeded 10 mm (correlation coefficient 0.54, P < 0.001). Linear regression analysis revealed no significant effects of age, sex, height, weight, BMI, preoperative LLD and difference in deformity between the limbs on postoperative LLD. 34.5% of patients perceived LLD in the preoperative period, which decreased to 3.7% in the postoperative period. Perceived LLD did not correlate to radiographic LLD and functional outcome.

Conclusions

There is no significant difference in radiographic LLD between unilateral and bilateral TKA. The functional outcome is adversely affected by radiographic LLD of ≥ 10 mm. Age, sex, BMI, preoperative LLD and difference in deformity angle do not affect the LLD. About one-third of patients perceive LLD in the preoperative period, which improves significantly after TKA.

Levels of evidence

II.
Extended culture of cleavage embryo to blastocyst embryo is among the good predictors of successful outcome in vitrified-thawed ICSI cycles
Authors: Albahlol Ibrahim , Ghanem Mohamad , Elboghdady Layla , Sedeek Emad , Mesbah Yaser , Helal Adel , Abdelaziz Mohamed
Published: June 2022

Background

Previous studies showed that top-quality embryo transfer (ET), number of transferred embryos, endometrial preparation with natural cycles or mild stimulation, and female BMI independently affected the outcome in frozen-thawed ET. However, the effect of culturing thawed cleavage embryos to blastocyst stage on the outcome was not sufficiently elucidated. Our objective is to evaluate the role of this extended culturing as predictor of cycle outcome in vitrified-thawed ICSI cycles.

Materials and methods

One thousand forty-two consecutive cycles of vitrified-thawed ET done in a single IVF unit [Mansoura Integrated Fertility Centre (MIFC)] were reviewed during a period from 2014 to 2017. Endometrial preparation methods were natural, stimulation by antiestrogen and/or gonadotropins, or replacement using sequential estradiol (E2) and progesterone (P4). The primary outcome was the clinical pregnancy rate while the secondary outcome was the chemical and ongoing pregnancy rate.

Results

Overall clinical pregnancy rate (CPR) is 298/1042 is 28.5%, chemical pregnancy rate (326/1042) 31.3%, and ongoing pregnancy rate (167/615) 27.2%. Comparing clinically pregnant (n = 298) and non-pregnant (n = 744) showed, respectively, the following: age 28.76 ± 5.0, 28.85 ± 5.18 (p = 0.8); BMI 31.06 ± 5.9, 32.45 ± 5.9 (p = 0.002); infertility duration 4.17 ± 3.2, 4.6 ± 3.5 (p = 0.038); endometrial thickness 10.82 ± 1.6, 10.13 ± 2.06 (p = 0.0001); and no. of ET 3.35 ± 1.5, 3.12 ± 1.60 (p = 0.035). The clinical pregnancy rate when vitrification was done on cleavage embryos was 198/502 (39.4%), and when vitrification done on blastocyst stage 100/ 536 (18.7%) (P < 0.0001); endometrial preparation: natural 72/240(29.1%), stimulated 204/680 (30.0%) replacement 17/90 (18.8%) (p = 0.09); extended culture of cleavage embryos to blastocyst stage: clinical pregnancy rate 116/194 (59.7%) chemical pregnancy rate 125/194 (64.1%), ongoing pregnancy rate 87/165 (52.7%) and non extended culture clinical pregnancy rate 182/848 (21.4%), chemical pregnancy rate 201/848 (23.7%), and ongoing pregnancy rate 80/450 (17.7%) (P < 0.0001).

Conclusion

Top-quality ET, number of transferred embryos and extended culture of cleavage embryos to blastocyst stage, cleavage embryos but not infertility duration, BMI, endometrial thickness, or hCG trigger of ovulation independently predict successful outcome in frozen cycle ET and extended culture of cleavage embryos significantly improved clinical and chemical and ongoing pregnancy rates.
Periodic limb movement index and severity of obstructive sleep apnea
Authors: Ahmed Randa Ibrahim , Hendy Rasha Mohamed , Ahmed Mona Ibrahim , Ali Salah Ahmed , AboOmira Marwa Hanafy , Shaban Marwa Moawad
Published: June 2022

Background

Periodic limb movements during sleep (PLMS) and obstructive sleep apnea syndrome (OSAS) are two frequent coincident sleep disorders. The association of PLMS with OSAS severity and predictors of PLMS in OSAS patients were investigated.

Material and method

This is a retrospective study that enrolled adult patients ≥ 16 years old who visited the sleep unit at Mouwasat Hospital, Saudi Arabia, between January 2021 and October 2021. All were subjected to full medical history, clinical examination, Epworth Sleepiness (ESS), STOP-Bang questionnaires, and standard overnight polysomnography. Subjects were subdivided into two groups based on PSG findings: group I, OSA patients (153). Patients were classified into mild n = 57 (AHI ≥ 5 and < 15), moderate n = 35 (AHI ≥ 15 and < 30), and severe n = 61 (AHI ≥ 30). Group II, control group included 100 subjects.

Result

There was a higher frequency of PLMS in OSA patients vs control group (with a statistically significant value). The study showed a statistically significantly positive correlation between PLMI and each of AHI, hypopnea index, desaturation index, and PLMs with arousal index, in contrast; it had a statistically significantly negative correlation with BMI among the OSA group. By performing multivariate logistic regression to predict the possible factors associated with the existence of PLMS among the OSA group, it was showed that the apnea index and desaturation index were statistically significant predictors.

Conclusion

The present study showed that OSA patients with PLM were older; had greater AHI, hypopnea index, desaturation index, and PLMs with arousal index; and had lower BMI. Further studies are needed for better understanding this complex relationship.
Evaluation of influential value engineering factors on the function of interchanges: case studies in Iran
Authors: Nigjeh Mohsen Jafari , Amani Nima
Published: June 2022

In Iran, recently in large-scale projects, the science of value engineering has become very important and in order to show the significant impact of value engineering results in increasing efficiency and reducing the cost of projects, the reason for choosing this research. The experience of value engineering in the developed countries shows the significant effect of this method in the value optimization of plans and projects. This research, too, aims to evaluate the effects of value engineering on the performance of interchanges in Iran, so that with comparing their results, the most important qualitative parameters can be determined, and also to present a suitable model for cost reduction per each IRR of the value engineering study’s expenses. The first part of this research will give a short introduction on value engineering and its job plan, and then, 8 value engineering studies of interchanges in the cities of Tehran, Karaj, Shiraz, and Mashhad will be qualitatively and quantitatively analyzed, and their results as a qualitative and quantitative evaluation (including construction cost, total value index, and relative value index) will be compared with the base plan of the projects and also with each other. Finally, the outcome of the research will show that among the evaluation parameters, the acquisition parameter plays a significant role in choosing the best design in value engineering, some part of which depends on the employer’s view in this regard. In the next step, the best improvements were in reducing travel time and in increasing safety, and also the most neglected parameter in the value engineering analyzed here is environmental improvements, which demands especial attention. From this research, it can be concluded that per every one IRR of expenditure on performing value engineering studies, the total cost of interchange projects in Iran is reduced by 334 IRR.
Integration of Genomic Biology Into Therapeutic Strategies of Gastric Cancer Peritoneal Metastasis
Authors: Gwee Yong Xiang , Chia Daryl Kai Ann , So Jimmy , Ceelen Wim , Yong Wei Peng , Tan Patrick , Ong Chin-Ann Johnny , Sundar Raghav
Published: June 2022

The peritoneum is a common site of metastasis in advanced gastric cancer (GC). Diagnostic laparoscopy is now routinely performed as part of disease staging, leading to an earlier diagnosis of synchronous peritoneal metastasis (PM). The biology of GCPM is unique and aggressive, leading to a dismal prognosis. These tumors tend to be resistant to traditional systemic therapy, and yet, this remains the current standard-of-care recommended by most international clinical guidelines. As this is an area of unmet clinical need, several translational studies and clinical trials have focused on addressing this specific disease state. Advances in genomic sequencing and molecular profiling have revealed several promising therapeutic targets and elucidated novel biology, particularly on the role of the surrounding tumor microenvironment in GCPM. Peritoneal-specific clinical trials are being designed with a combination of locoregional therapeutic strategies with systemic therapy. In this review, we summarize the new knowledge of cancer biology, advances in surgical techniques, and emergence of novel therapies as an integrated strategy emerges to address GCPM as a distinct clinical entity.
A Nation of Laws, and Race Laws
Authors: Banks Nina , Whatley Warren C.
Published: June 2022

This article reviews the history of race laws in the United States as distinct from the rule of law, an idea found in the writing and speeches of Sadie Tanner Mossell Alexander, the first African American PhD in economics (1921). We review the race laws of slavery, lynching, Negro Jobs, and the making of the Black ghetto. We highlight the life and writings of Alexander and other early African American economists as an example of the cost of racial exclusion in the economics profession and how it has impeded the production of useful knowledge about the workings of the US economy. (JEL J15, K38, N31, N32, N41, N42)