bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing the number of variants tracked to follow disease burden with circulating tumor DNA assays in metastatic colorectal cancer
Authors: Boutin Mélina , Topham James T. , Feilotter Harriet , Kennecke Hagen F. , Couture Félix , Harb Mohammed , Kavan Peter , Berry Scott , Lim Howard J. , Goffin John R. , Ahmad Chaudhary , Lott Anthony , Renouf Daniel J. , Jonker Derek J. , Tu Dongsheng , O’Callaghan Chris J. , Chen Eric X. , Loree Jonathan M.
Published: June 2023

Background:

The number of somatic mutations detectable in circulating tumor DNA (ctDNA) is highly heterogeneous in metastatic colorectal cancer (mCRC). The optimal number of mutations required to assess disease kinetics is relevant and remains poorly understood.

Objectives:

To determine whether increasing panel breadth (the number of tracked variants in a ctDNA assay) would alter the sensitivity in detecting ctDNA in patients with mCRC.

Design:

We used archival tissue sequencing to perform an in silico assessment of the optimal number of tracked mutations to detect and monitor disease kinetics in mCRC using sequencing data from the Canadian Cancer Trials Group CO.26 trial.

Methods:

For each patient, 1, 2, 4, 8, 12, or 16 of the most clonal (highest variant allele frequency) somatic variants were selected from archival tissue-based whole-exome sequencing and assessed for the proportion of variants detected in matched ctDNA at baseline, week 8, and progression timepoints.

Results:

Data from 110 patients were analyzed. Genes most frequently encountered among the top four highest VAF variants in archival tissue were TP53 (51.9% of patients), APC (43.3%), KRAS (42.3%), and SMAD4 (9.6%). While the frequency of detecting at least one tracked variant increased when expanding beyond variant pool sizes of 1 and 2 in baseline ( p = 0.0030) and progression ( p = 0.0030) ctDNA samples, we observed no significant benefit to increases in variant pool size past four variants in any of the ctDNA timepoints ( p < 0.05).

Conclusion:

While increasing panel breadth beyond two tracked variants improved variant re-detection in ctDNA samples from patients with treatment refractory mCRC, increases beyond four tracked variants yielded no significant improvement in variant re-detection.
Association between mean platelet volume and cardiovascular disease in obstructive sleep apnea syndrome
Authors: Kallel Souha , Kchaou Khouloud , Kharrat Ines , Chaabouni Mohamed Amin , Ayedi Sirine , Charfeddine Ilhem
Published: June 2023

Objectives:

Obstructive sleep apnea syndrome is associated with cardiovascular diseases. Mean platelet volume has emerged as a marker of prothrombotic conditions and cardiovascular risk. The aim of this study was to investigate the association between the mean platelet volume and cardiovascular diseases in patients with obstructive sleep apnea syndrome.

Methods:

The medical records of 207 patients were analyzed. Obstructive sleep apnea syndrome was diagnosed by polygraphy, and patients were classified according to apnea–hypopnea index: control group: individuals with simple snoring (apnea–hypopnea index < 5), mild obstructive sleep apnea syndrome group (5 ⩽ apnea–hypopnea index < 15), moderate obstructive sleep apnea syndrome group (15 ⩽ apnea–hypopnea index < 30), and severe obstructive sleep apnea syndrome group (apnea–hypopnea index ⩾ 30). Mean platelet volume was obtained from medical records. Cardiovascular diseases were defined if patients had hypertension, heart failure, coronary artery disease, or arrythmia. The independent predictors related to cardiovascular diseases in obstructive sleep apnea syndrome were determined by using multiple logistic regression analysis.

Results:

Of the patients, 175 were included in the analysis. Sixty-three (36%) were males and 112 (64%) were females. The mean age was 51.85 ± 11 years. There were, 26 (14.9%), 53 (30.3%), 38 (21.7%), and 58 (33.1%) participants in the simple snoring, mild, moderate, and severe obstructive sleep apnea syndrome groups, respectively. Cardiovascular diseases were significantly different between the four groups ( p = 0.014). Mean platelet volume in severe obstructive sleep apnea syndrome group was significantly higher than in mild or moderate obstructive sleep apnea syndrome group and simple snoring group ( p < 0.05). Moreover, there was a positive correlation between mean platelet volume levels and apnea–hypopnea index ( r = 0.424; p < 0.001). The independent predictors of cardiovascular diseases in obstructive sleep apnea syndrome were age ( p < 0.001; odds ratio = 1.134; confidence interval: 1.072–1.2), body mass index ( p = 0.012; odds ratio: 1.105; confidence interval: 1.022–1.194), and mean platelet volume ( p < 0.001; odds ratio: 2.092; confidence interval: 1.386–3.158).

Conclusion:

The present study demonstrated that there is an association between mean platelet volume levels and cardiovascular diseases in patients with obstructive sleep apnea syndrome.
Dandy Walker-like malformation in an adult cat with seizures: clinical description and MRI characteristics
Authors: Formoso Sara , Padley Hannah , Alves Lisa
Published: June 2023

Case summary

A 2-year-old male neutered domestic shorthair cat was referred for investigation of a 10-month history of self-limiting, generalised tonic–clonic seizures. The cat was reported to be normal interictally but had always had a static abnormal gait. General physical examination was unremarkable. Neuroanatomical localisation was compatible with a diffuse cerebellar and diffuse forebrain lesion. Complete blood count, biochemistry, bile acid stimulation test, urinalysis, cisternal cerebrospinal fluid (CSF) analysis, Toxoplasma gondii serology and T gondii polymerase chain reaction in CSF were all unremarkable. MRI revealed an abnormal caudal fossa, absent cerebellar vermis and small cerebellar hemisphere with distension of the fourth ventricle. There were no forebrain abnormalities identified in the MRI or CSF changes that could justify the seizures. Considering the clinical presentation, the cat’s neurological examination and MRI features, a presumptive diagnosis of Dandy Walker-like malformation (DWLM) and epilepsy of unknown aetiology was made.

Relevance and novel information

This is the first case report of an adult cat diagnosed with cerebellar malformation resembling DWLM and concomitant seizures, its MRI characteristics and long-term follow-up. The 3-year follow-up consultation revealed static neurological status with 2–4 seizures per year. The cat’s quality of life remained good at the time of writing.
The place of digital triage in a complex healthcare system: An interview study with key stakeholders in Australia's national provider
Authors: Churruca Kate , Ellis Louise A , Pope Catherine , MacLellan Jennifer , Zurynski Yvonne , Braithwaite Jeffrey
Published: June 2023

Background

Digital triage tools such as telephone advice and online symptom checkers are now commonplace in health systems internationally. Research has focused on consumers’ adherence to advice, health outcomes, satisfaction, and the degree to which these services manage demand for general practice or emergency departments. Such studies have had mixed findings, leaving equivocal the role of these services in healthcare.

Objective

We examined stakeholders’ perspectives on Healthdirect, Australia's national digital triage provider, focusing on its role in the health system, and barriers to operation, in the context of the COVID-19 pandemic.

Methods

Key stakeholders took part in semi-structured interviews conducted online in the third quarter of 2021. Transcripts were coded and thematically analysed.

Results

Participants (n  =  41) were Healthdirect staff (n  =  13), employees of Primary Health Networks (PHNs; n  =  12), clinicians (n  =  9), shareholder representatives (n  =  4), consumer representatives (n  =  2) and other policymakers (n  =  1). Eight themes emerged from the analysis: (1) information and guidance in navigating the system, (2) efficiency through appropriate care, (3) value for consumers? (4) the difficulties in triage at a distance, (5) competition and the unfulfilled promise of integration, (6) challenges in promoting Healthdirect, (7) monitoring and evaluating digital triage services and (8) rapid change, challenge and opportunity from COVID-19.

Conclusion

Stakeholders varied in their views of the purpose of Healthdirect's digital triage services. They identified challenges in lack of integration, competition, and the limited public profile of the services, issues largely reflective of the complexity of the policy and health system landscape. There was acknowledgement of the value of the services during the COVID-19 pandemic, and an expectation of them realising greater potential in the wake of the rapid uptake of telehealth.
Identification and description of telerehabilitation assessments for individuals with neurological conditions: A scoping review
Authors: O’Neil Jennifer , Barnes Keely , Morgan Donnelly Erin , Sheehy Lisa , Sveistrup Heidi
Published: June 2023

Background

The clinical adoption of telerehabilitation accelerated rapidly over the last few years, creating opportunities for clinicians and researchers to explore the use of digital technologies and telerehabilitation in the assessment of deficits related to neurological conditions. The objectives of this scoping review were to identify outcome measures used to remotely assess the motor function and participation in people with neurological conditions and report, when available, the psychometric data of these remote outcome measures.

Methods

MEDLINE (Ovid), CINAHL, PubMed, PsychINFO, EMBASE, and Cochrane databases were searched between December 13, 2020, and January 4, 2021, for studies investigating the use of remote assessments to evaluate motor function and participation in people with neurological conditions. An updated search was completed on May 9, 2022, using the same databases and search terms. Two reviewers independently screened each title and abstract, followed by full-text screening. Data extraction was completed using a pre-piloted data extraction sheet where outcome measures were reported as per the International Classification of Functioning, Disability and Health.

Results

Fifty studies were included in this review. Eighteen studies targeted outcomes related to body structures and 32 targeted those related to activity limitation and participation restriction. Seventeen studies reported psychometric data; of these, most included reliability and validity data.

Conclusion

Clinical assessments of motor function of people living with neurological conditions can be completed in a telerehabilitation or remote context using validated and reliable remote assessment measures.
The Impact of Entrepreneurial Resilience on the Entrepreneurial Intention of Return Migrants: An Empirical Study Based on Survey Data From Multiple Provinces in China
Authors: Wu Keqiang , Zhao Xin , Wang Xinyu , Chen Xiongying , Hung Tsang-Kai , Wang Zijun , Lee Shu-Chuan
Published: June 2023

Migrant workers returning home to start businesses has played a strong supporting role in promoting regional poverty alleviation and rural revitalization. How to enhance return migrants’ entrepreneurial intention is of vital importance. Using survey data on return migrants from many places in China, this article analyzes the mechanism of entrepreneurial resilience, perception of entrepreneurial opportunity and entrepreneurial intention, and the moderating effect of entrepreneurial atmosphere. The results show that entrepreneurial resilience has a significant positive impact on entrepreneurial intention; entrepreneurial opportunity perception plays a partial mediating role between entrepreneurial resilience and entrepreneurial intention. In addition, entrepreneurial atmosphere negatively moderates the relationship between entrepreneurial resilience and entrepreneurial intention, and between entrepreneurial resilience and perception of entrepreneurial opportunity. Therefore, we suggest that while creating a good entrepreneurial atmosphere, local governments at all levels in China must also pay attention to avoiding excessive intervention that aggravates the vulnerability of return migrants to entrepreneurship.
Identification of Local Accessibility Hubs and Leisure Amenities in Suburbanized Settlements: Case Study on the Suburban Zone of Prague
Authors: Maňas Jan
Published: June 2023

This paper focuses on the topological definition of the system of public spaces in suburbanized settlements. It identifies hubs with the best local accessibility within the system of public open spaces using the Space syntax method and analyses their leisure amenities. The topological investigation was performed on the example of the suburban zone of Prague, the immediate surroundings of which have been developing dramatically in recent decades. About 44 rapidly developing settlements in this area were included in the study and their system of public open spaces was analyzed using the Integration HH metric and local accessibility hubs (those with the highest Integration HH value) were identified. Subsequently, the placement of existing leisure amenities with respect to these accessibility hubs was evaluated. Only 32% of leisure amenities were located in the accessibility hubs, which indicates an unfulfilled potential of locally well-accessible places. At the same time, the placement of leisure amenities within new developments in areas difficult-to-access from other parts of the settlement poses a threat to the integration of the population from these new developments with those from other parts of the settlement. This paper offers solutions for preventing these issues, for identifying natural centers with the best accessibility, and proposes possible measures for mitigation of the identified problems.
Reliability of the TT-TG Index Versus TT-TG Distance on MRI: Morphometric Analyses in Asian Children and Adolescents
Authors: Park Sin Hyung , Choi Wonchul , Yoon Siyeong , Rhie Jeongbae , Ahn Wooyeol , Oh Jongbeom , Han Dong Hun , Lee Soonchul
Published: June 2023

Background:

The tibial tuberosity–trochlear groove (TT-TG) distance measured on magnetic resonance imaging (MRI) is commonly used to decide the treatment for patellar instability; however, the patient’s joint size is not considered in this measurement. The TT-TG index has been proposed as a knee size–adjusted measurement for tibial tuberosity location.

Purpose:

To evaluate the reliability of the TT-TG index compared with the TT-TG distance by analyzing variations in measurement according to age and sex in a pediatric Asian population.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

A total of 698 knee MRI scans were collected in patients between 4 and 18 years of age who did not have any patellofemoral problems. Patient age, sex, height, and weight were recorded. The scans were divided into 5 groups according to patient age (4-6 years, 46 scans; 7-9 years, 56 scans; 10-12 years, 122 scans; 13-15 years, 185 scans; and 16-18 years, 289 scans); MRI scans were also divided by sex (497 male, 201 female). Three independent observers measured the TT-TG distance and TT-TG index on each scan, and age- and sex-based differences in the measurements were evaluated after adjusting for body mass index (BMI). The reliability of the measurements was calculated with the intraclass correlation coefficient (ICC).

Results:

Good to excellent inter- and intraobserver agreement was found for TT-TG distance (ICC, 0.74) and TT-TG index (ICC, 0.88). The TT-TG distance was significantly different among the groups and increased with age, while variations in the TT-TG index were minimal between age groups and sexes. This finding was also consistent after compensating for the effect of BMI.

Conclusion:

The TT-TG distance changed with age, while the TT-TG index was relatively constant. Therefore, the TT-TG index may be more reliable and effective for diagnosing and planning treatment, especially in children and adolescents.
Bevans Revisited: Reflections on Stephen Bevans’s Models of Contextual Theology
Authors: Whyte Greg S.
Published: June 2023

Stephen Bevans’s six models of contextual theology have been helpful in sorting out different styles of understanding and practicing both historical theology and contemporary contextual theology. While briefly addressing the models themselves, the primary focus of this article is to update the original spectrum utilized by Bevans. Specifically, it seeks to clarify the primary axis to indicate the level of contextualization to a given local context. Second, it adds an additional axis, dividing the models based on relationship to the status quo of the given cultural assumptions, whether of the host culture or established church tradition.
The Apostolical Tree: A Visual Aid used by Catholic Missionaries in Western Oceania
Authors: Duffy Mervyn
Published: June 2023

When Catholic Missionaries first went to Western Oceania in the 1840s, they encountered established Protestant mission stations and worshipping Christian communities. The first Vicar Apostolic of Western Oceania, instructed his missionaries to present their church as “the ancient Church, the mother Church, the foundation Church, the true and only Church, which exists everywhere on earth.” The diocesan archives in Auckland New Zealand preserve a single copy of a poster which communicated those ideas. This article identifies the source of that visual aid which was widely used in the first thirty years of the Catholic Mission to Western Oceania.
The long-term course of the Health Assessment Questionnaire in patients with systemic sclerosis
Authors: Liem Sophie IE , Bergstra Sytske Anne , Ciaffi Jacopo , van der Meulen Coen , Ueckert David A , Schriemer Marisca R , Huizinga Tom WJ , Vliet Vlieland Theodora PM , de Vries-Bouwstra Jeska K
Published: June 2023

Objective:

The Health Assessment Questionnaire–Disability Index is an important outcome measure reflecting functional disability, but knowledge on its course over time in patients with systemic sclerosis is scarce. Therefore, we investigated the long-term course of the Health Assessment Questionnaire–Disability Index and its association with baseline characteristics in systemic sclerosis patients.

Methods:

Systemic sclerosis patients, fulfilling the European League Against Rheumatism and the American College of Rheumatology 2013 criteria, were included from the Leiden Combined Care in Systemic Sclerosis cohort with annual assessments including the Scleroderma Health Assessment Questionnaire–Disability Index (range = 0–3). The course of the Health Assessment Questionnaire–Disability Index was evaluated over the total follow-up (baseline to last available Health Assessment Questionnaire–Disability Index) and between yearly visits. Based on a minimal clinical important difference of 0.22, courses were categorized into worsening, stable or improvement. The course of the Health Assessment Questionnaire–Disability Index over time was evaluated with linear mixed models. Baseline characteristics were compared between patients with a worsening or improvement of the Health Assessment Questionnaire–Disability Index over the total follow-up period with logistic regression analyses.

Results:

A total of 517 systemic sclerosis patients were included, with a median follow-up of 7 years (interquartile range = 4–9; 2649 visits) and a baseline Health Assessment Questionnaire–Disability Index of 0.625 (interquartile range = 0.125–1.25). On group level, the Health Assessment Questionnaire–Disability Index is stable with an annual increase of 0.019 (95% confidence interval = 0.011 to 0.027). Looking at subgroups, patients >65 years or who died/were physically unable to come during follow-up had a worse mean Health Assessment Questionnaire–Disability Index. In individual courses from baseline to the last follow-up, the proportions of patients with a clinically meaningful worsening, stable or improved Health Assessment Questionnaire–Disability Index were 35%, 42% and 23%, respectively. Patients with immunosuppressants (odds ratio = 0.5, 95% confidence interval = 0.3 to 0.9) or gastrointestinal involvement (odds ratio = 0.6, 95% confidence interval = 0.4 to 0.9) at baseline showed a reduced chance of worsening of the Health Assessment Questionnaire–Disability Index over the total follow-up period.

Conclusion:

Over time, the average course of the Health Assessment Questionnaire–Disability Index was stable in systemic sclerosis patients. However, individual courses vary, with worsening occurring in one-third. Worsening occurred less often in individuals using immunosuppressants or with gastrointestinal involvement at baseline.
Re-writing history, re-inscribing the city: Thailand and delusions of democracy
Authors: King Ross
Published: June 2023

Cities carry traces of their pasts; they also carry traces of imagined pasts, inscribed on them by authoritarian regimes to suppress other imaginings. Bangkok in the early 20th century displayed the signification of a Buddhist royalty and imagined origins, subsequently suppressed with the imposition of new emblems of democracy following a 1932 overthrow of monarchical absolutism. Democracy was to be signified as founded in the common people. In the 21st century, a military junta dressed in the clothes of a pseudo-democracy re-writes the emblems of democracy, now to signify that democracy is not based in the people but, rather, is the gift of a benevolent monarch. The subverting of democracy is to be read from the monuments of the city, which highlight the specific strategies that the authoritarian state invokes in re-writing the national history.
An Investigation on Factors Influencing University Students’ Entrepreneurship Orientations
Authors: Baldo Carlos M. , Chen McCain Shiang-Lih , Jouflas Georgann
Published: June 2023

Enterprise-level small businesses have been a critical contributor to the U.S. economy and employment. Small businesses accounted for 67% of the net new jobs during the recovery from the 2009 to 2011 economic recession. Recognizing the employment opportunities from enterprise-level small businesses during the high unemployment time allowed higher education institutions to emphasize enhancing entrepreneurship among their students. Multiple scholars have called for more in-depth evaluations on entrepreneurial intention because it predicts whether a student will become an entrepreneur. Entrepreneurial orientation (risk-taking, innovation, and proactive) is the commonly agreeable antecedent of entrepreneurial intentions. This study collected 315 valid responses from a comprehensive mid-U.S. university with more than 40% enrollment from rural communities to evaluate how the perceived internal and external barriers influence students’ entrepreneurial orientations. The results of the Multivariate Regression Analysis indicated that overall, how students perceived internal and external barriers influenced their entrepreneurial orientations in both innovativeness and risk-taking aspects. Furthermore, entrepreneurship is particularly important in the rural community. The results revealed significant differences between students who were raised in rural areas and those who were not raised in rural areas regarding how perceived internal and external barriers impact their entrepreneurship orientations.
Bayesian Repeated-Measures Analysis of Variance: An Updated Methodology Implemented in JASP
Authors: van den Bergh Don , Wagenmakers Eric-Jan , Aust Frederik
Published: June 2023

Analysis of variance (ANOVA) is widely used to assess the influence of one or more experimental (or quasi-experimental) manipulations on a continuous outcome. Traditionally, ANOVA is carried out in a frequentist manner using p values, but a Bayesian alternative has been proposed. Assuming that the proposed Bayesian ANOVA is closely modeled after its frequentist counterpart, one may be surprised to find that the two can yield very different conclusions when the design involves multiple repeated-measures factors. We illustrate such a discrepancy with a real data set from a two-factorial within-subject experiment. For this data set, the results of a frequentist and Bayesian ANOVA are in a disagreement about which main effect accounts for the variance in the data. The reason for this disagreement is that frequentist and the proposed Bayesian ANOVA use different model specifications. As currently implemented, the proposed Bayesian ANOVA assumes that there are no individual differences in the magnitude of effects. We suspect that this assumption is neither obvious to nor desired by most analysts because it is untenable in most applications. We argue here that the Bayesian ANOVA should be revised to allow for individual differences. As a default, we suggest the standard frequentist model specification but discuss a recently proposed alternative and provide guidance on how to choose the appropriate model specification. We end by discussing the implications of the revised model specification for previously published results of Bayesian ANOVAs.
Teaching through objects and collections: The case of Strängnäs Secondary Grammar School and school museum 1830-1960
Authors: Insulander Eva , Thorsén David
Published: June 2023

This paper aims to introduce educational history to multimodal studies by combining a source-oriented approach with multimodal social semiotics. We trace the role of objects and collections in teaching and learning, and focus on Strängnäs Secondary Grammar School in Sweden 1830-1960 as a case example. Closely examining original documents, remaining physical objects, and examples of their situated use as represented in photographs and drawings, the paper provides a nuanced perspective on how object-based pedagogy was applied. It traces how objects and artefacts were incorporated into the school’s collections, by the actions of different actors, in processes of recontextualisation and framing. The activity types that we use as examples, include: drawing lessons in art, weapons practice in physical education, plant collecting in botany, and map exercises in history. These examples show how objects and their meaning potential were used in teaching and learning, and how they realized certain discourses of schooling. Based on our examples, we can see how educational discourses such as progressivism came to have different impact in different subjects. While an authoritarian and national discourse prevailed in art and physical education, a scientific and progressive discourse seem to have been established in botany and history. By combining multimodality with historical research, we can understand meaning-making within a larger context of sociocultural practices and sociopolitical forces.
Strengthening Health Literacy Through Structured Sessions for Non-Communicable Diseases in Low-Resource Settings: The Learning Nest Model
Authors: Balcou-Debussche Maryvette , La Hausse Véronique , Roddier Muriel , Sokolowsky Claude , Rastami Joëlle , Besançon Stéphane , Ballet Delphine , Caroupin Jessica , Dowlut Sabeena , Debussche Xavier
Published: June 2023

Health literate self-management education is at stake for the prevention and management of non-communicable diseases in low resources settings and countries. Here we describe the Learning Nest in Ordinary Context (NA-CO in French, Nids d’Apprentissage en Contexte Ordinaire) aiming at the structuring of health education programs at the micro- (education sessions) and the meso-levels (adapted to context). The Learning Nest model was designed based on a combination on health literacy principles and on studies conducted with vulnerable people with non-communicable diseases. Observation of NA-CO active-learning sessions found them to be operational and relevant as they center on access, understanding, and use of health information while integrating the ordinary context of learners. The Learning Nest packages (including several adapted thematic sessions, training of trainers and development in context) were shown to be feasible and realistic in diverse locations (Reunion, Mali, Mayotte, Mauritius, Burundi). Qualitative and intervention studies have documented the potential usefulness of the Learning Nest model for context- and setting-specific health literacy interventions.
Assessing Psychological Resilience and Distress Among Graduate Health Profession Students During the COVID-19 Pandemic
Authors: Clark Shane , Loe Emily , Merlo Lisa J. , Estores Irene M.
Published: June 2023

Background

Resilience, a person’s ability to adapt to adverse events, is associated with positive outcomes, especially in the field of healthcare. Research into the effects of the COVID-19 pandemic may help to understand and combat the long-term mental health burden for trainees in health care.

Objective

This cross-sectional study aimed to assess the impact of the pandemic on health profession students’ educational experiences, determine the association between their self-reported resilience and psychological distress and assess group differences between students from different graduate health profession programs in an academic medical center.

Methods

Graduate health profession students completed a 44-question online survey and the 10-item Connor Davidson Resilience Scale (CD-RISC-10) during the COVID-19 pandemic period between January-March 2021. We used descriptive statistics, independent samples t test, Related-samples Wilcoxon signed rank test, Pearson correlations test and Analysis of variance (ANOVA) to analyze the data.

Results

Majority of respondents reported that COVID-19 had a negative impact on their education and caused a reduction in educational opportunities (76.6% and 73% respectively). Majority also reported feeling burned out, lonely/isolated, or frustrated by COVID-19 restrictions (70.0%, 67.4%, and 61.8% respectively). Students reported increased use of both avoidant and adaptive coping strategies during the pandemic. Higher resilience scores were associated with higher self-reported stress, fewer burnout symptoms, and better overall well-being.

Conclusion

The COVID-19 pandemic significantly affected students in graduate health profession programs. Instructional quality, educational opportunities, institutional trust, peer socialization, and personal health and wellbeing were perceived to be negatively impacted. Students may require additional support and resources from their training programs to mitigate these concerns. Future studies should evaluate the long-term impact of the COVID-19 pandemic among pandemic-era graduate health profession students.
Broadening horizons of the possible in education
Authors: Beghetto Ronald A.
Published: June 2023

The social project of education always and already has a future orientation, which is filled with unrealized possibilities. In this way, educational settings serve as sites of promise and hope. This promise and hope, however, is riddled with a paradox: If the future is unknowable—and education can only occur in the known present—then how can the social project of education fulfill the promise and hope of preparing young people to realize the possibilities of an unknowable future? The purpose of this paper is to explore how educators have attempted to resolve this educating for unknown futures paradox (EUF-paradox) and push beyond it by considering whether a more expansive approach to education can broaden the horizon of what is possible in education.
Comparing the value of mono- vs coculture for high-throughput compound screening in hematological malignancies
Authors: Herbst Sophie A. , Kim Vladislav , Roider Tobias , Schitter Eva C. , Bruch Peter-Martin , Liebers Nora , Kolb Carolin , Knoll Mareike , Lu Junyan , Dreger Peter , Müller-Tidow Carsten , Zenz Thorsten , Huber Wolfgang , Dietrich Sascha
Published: June 2023

Large-scale compound screens are a powerful model system for understanding variability of treatment response and discovering druggable tumor vulnerabilities of hematological malignancies. However, as mostly performed in a monoculture of tumor cells, these assays disregard modulatory effects of the in vivo microenvironment. It is an open question whether and to what extent coculture with bone marrow stromal cells could improve the biological relevance of drug testing assays over monoculture. Here, we established a high-throughput platform to measure ex vivo sensitivity of 108 primary blood cancer samples to 50 drugs in monoculture and coculture with bone marrow stromal cells. Stromal coculture conferred resistance to 52% of compounds in chronic lymphocytic leukemia (CLL) and 36% of compounds in acute myeloid leukemia (AML), including chemotherapeutics, B–cell receptor inhibitors, proteasome inhibitors, and Bromodomain and extraterminal domain inhibitors. Only the JAK inhibitors ruxolitinib and tofacitinib exhibited increased efficacy in AML and CLL stromal coculture. We further confirmed the importance of JAK-STAT signaling for stroma-mediated resistance by showing that stromal cells induce phosphorylation of STAT3 in CLL cells. We genetically characterized the 108 cancer samples and found that drug-gene associations strongly correlated between monoculture and coculture. However, effect sizes were lower in coculture, with more drug-gene associations detected in monoculture than in coculture. Our results justify a 2-step strategy for drug perturbation testing, with large-scale screening performed in monoculture, followed by focused evaluation of potential stroma-mediated resistances in coculture.
Superior artificial synaptic properties applicable to neuromorphic computing system in HfOx-based resistive memory with high recognition rates
Authors: Seo Hyun Kyu , Lee Su Yeon , Yang Min Kyu
Published: June 2023

With the development of artificial intelligence and the importance of big data processing, research is actively underway to break away from data bottlenecks and modern Von Neumann architecture computing structures that consume considerable energy. Among these, hardware technology for neuromorphic computing is in the spotlight as a next-generation intelligent hardware system because it can efficiently process large amounts of data with low power consumption by simulating the brain’s calculation algorithm. In addition to memory devices with existing commercial structures, various next-generation memory devices, including memristors, have been studied to implement neuromorphic computing. In this study, we evaluated the synaptic characteristics of a resistive random access memory (ReRAM) with a Ru/HfOx/TiN structure. Under a series of presynaptic spikes, the device successfully exhibited remarkable long-term plasticity and excellent nonlinearity properties. This synaptic device has a high operating speed (20 ns, 50 ns), long data retention time (> 2 h @85 ℃) and high recognition rate (94.7%). Therefore, we propose that memory and learning capabilities can be used as promising HfOx-based memristors in next-generation artificial neuromorphic computing systems.
Pan-transcriptomic Profiling Demarcates Serendipita Indica-Phosphorus Mediated Tolerance Mechanisms in Rice Exposed to Arsenic Toxicity
Authors: Sehar Shafaque , Adil Muhammad Faheem , Askri Syed Muhammad Hassan , Feng Qidong , Wei Dongming , Sahito Falak Sehar , Shamsi Imran Haider
Published: June 2023

Inadvertent accumulation of arsenic (As) in rice (Oryza sativa L.) is a concern for people depending on it for their subsistence, as it verily causes epigenetic alterations across the genome as well as in specific cells. To ensure food safety, certain attempts have been made to nullify this highest health hazard encompassing physiological, chemical and biological methods. Albeit, the use of mycorrhizal association along with nutrient reinforcement strategy has not been explored yet. Mechanisms of response and resistance of two rice genotypes to As with or without phosphorus (P) nutrition and Serendipita indica (S. indica; S.i) colonization were explored by root transcriptome profiling in the present study. Results revealed that the resistant genotype had higher auxin content and root plasticity, which helped in keeping the As accumulation and P starvation response to a minimum under alone As stress. However, sufficient P supply and symbiotic relationship switched the energy resources towards plant’s developmental aspects rather than excessive root proliferation. Higher As accumulating genotype (GD-6) displayed upregulation of ethylene signaling/biosynthesis, root stunting and senescence related genes under As toxicity. Antioxidant defense system and cytokinin biosynthesis/signaling of both genotypes were strengthened under As + S.i + P, while the upregulation of potassium (K) and zinc (Zn) transporters depicted underlying cross-talk with iron (Fe) and P. Differential expression of phosphate transporters, peroxidases and GSTs, metal detoxification/transport proteins, as well as phytohormonal metabolism were responsible for As detoxification. Taken together, S. indica symbiosis fortified with adequate P-fertilizer can prove to be effective in minimizing As acquisition and accumulation in rice plants.
Effects of highway work zone temporary countermeasures
Authors: Shahin Fadi , Elias Wafa , Toledo Tomer
Published: June 2023

Highway work zones are associated with significant adverse impacts on safety. Mitigating these impacts can be achieved by implementing several countermeasures. This paper uses controlled experiments in a driving simulator to investigate the effects of physical and digital temporary traffic control countermeasures on work zone safety. These include variable message signs, dynamic speed displays, rumble strips, and lane widths. 116 participants were recruited for the experiment. A linear mixed-effects model was developed to capture the effects of these countermeasures on average travel speed and standard deviation of speeds in the advanced warning area and within the work zone itself. The results reveal that rumble strips installed within the work zone cause the strongest reduction in speeds. Narrower lanes cause smaller speed reductions. In general, the effects of temporary traffic control countermeasures on speeds were local and were not retained beyond their proximity.
Gene regulatory network inference based on a nonhomogeneous dynamic Bayesian network model with an improved Markov Monte Carlo sampling
Authors: Zhang Jiayao , Hu Chunling , Zhang Qianqian
Published: June 2023

A nonhomogeneous dynamic Bayesian network model, which combines the dynamic Bayesian network and the multi-change point process, solves the limitations of the dynamic Bayesian network in modeling non-stationary gene expression data to a certain extent. However, certain problems persist, such as the low network reconstruction accuracy and poor model convergence. Therefore, we propose an MD-birth move based on the Manhattan distance of the data points to increase the rationality of the multi-change point process. The underlying concept of the MD-birth move is that the direction of movement of the change point is assumed to have a larger Manhattan distance between the variance and the mean of its left and right data points. Considering the data instability characteristics, we propose a Markov chain Monte Carlo sampling method based on node-dependent particle filtering in addition to the multi-change point process. The candidate parent nodes to be sampled, which are close to the real state, are pushed to the high probability area through the particle filter, and the candidate parent node set to be sampled that is far from the real state is pushed to the low probability area and then sampled. In terms of reconstructing the gene regulatory network, the model proposed in this paper (FC-DBN) has better network reconstruction accuracy and model convergence speed than other corresponding models on the Saccharomyces cerevisiae data and RAF data.
Recovery of driving skills after endoscopy under propofol sedation: a prospective pilot study to assess the driving skills after endoscopic sedation using driving simulation
Authors: Hao Xiao-Wen , Zhan Yuan-Lin , Li Peng , Zhang Shu-Tian , Yan Xue-Dong , Li Xiao-Meng , Xiang Wang
Published: June 2023

Background

Patients are recommended not to drive for at least the first 24 h after endoscopy with propofol sedation. However, the evidence underlying these recommendations is scarce. We hypothesized that after endoscopic procedures performed under propofol sedation, the subject’s driving ability was restored in less than 24 h.

Methods

We prospectively enrolled thirty patients between 20 and 70 years possessing a legitimate driver’s license scheduled for endoscopy at our hospital. The sample chosen was a convenience sample. Gastroscopy or colonoscopy was performed with propofol sedation. Before and after endoscopy, the investigator drove the subjects to the laboratory to assess their driving skills using a driving simulation system, which employs 3 driving scenarios designed by professional transportation researchers. The blood propofol concentration was estimated before endoscopy, and 2 and 4 h after endoscopy. The primary outcome was the time required for subjects to recover their driving ability after propofol sedation. The secondary outcome was the blood propofol concentration before and after endoscopic procedures under propofol anesthesia.

Results

Thirty volunteers participated in the study and 18 of them completed all the interventions. In the low-risk S-curve scene, the mean acceleration, lane deviation, and number of deviations from the path at baseline (0.016 cm/s2, 42.50 cm, and 0.83, respectively) were significantly less than that at post-2 h (0.029 cm/s2, P = 0.001; 53.80 cm, P = 0.014; 2.06, P = 0.022). In the moderate-(overtaking) and high-risk (emergency collision avoidance) scenes, the tested parameters at baseline and post-2 h were statistically comparable. In the low-, moderate-, and high-risk scenes the tested parameters at baseline and post-4 h were statistically comparable. The total range of propofol was 120-280 mg.The mean blood concentration of propofol at post-2 h was 0.81 ± 0.40 µg/mL, and at post-4 h was below the limit of detection.

Conclusion

After endoscopy performed under propofol sedation, subjects’ driving abilities were completely restored at 4 h when tested on a simulator.
ALDH2 rs671 and MTHFR rs1801133 polymorphisms are risk factors for arteriosclerosis in multiple arteries
Authors: Cai Nan , Li Cunren , Gu Xianfang , Zeng Wenfeng , Liu Jingfeng , Zeng Guopeng , Zhong Jiawei , Zhu Junxing , Hong Haifeng
Published: June 2023

Background

Arteriosclerosis in multiple arteries has long been associated with heightened cardiovascular risk. Acetaldehyde dehydrogenase 2 (ALDH2) and methylenetetrahydrofolate reductase (MTHFR) play an important role in the pathogenesis of arteriosclerosis by participating in the oxidation and reduction reactions in vascular endothelial cells. The purpose was to investigate the relationship of ALDH2 and MTHFR gene polymorphisms with arteriosclerosis in multiple arteries.

Methods

410 patients with arteriosclerosis in single artery and 472 patients with arteriosclerosis in multiple arteries were included. The relationship between ALDH2 rs671 and MTHFR rs1801133 polymorphisms and arteriosclerosis in single artery and arteriosclerosis in multiple arteries was analyzed.

Results

The proportion of ALDH2 rs671 A allele (35.6% vs. 30.9%, P = 0.038) and MTHFR rs1801133 T allele (32.6% vs. 27.1%, P = 0.012) in patients with arteriosclerosis in multiple arteries was significantly higher than that in arteriosclerosis in single artery, respectively. The proportion of history of alcohol consumption in patients with ALDH2 rs671 G/G genotype was higher than those in ALDH2 rs671 G/A genotype and A/A genotype (P < 0.001). The results of logistic regression analysis indicated that ALDH2 rs671 A/A genotype (A/A vs. G/G: OR 1.996, 95% CI: 1.258–3.166, P = 0.003) and MTHFR rs1801133 T/T genotype (T/T vs. C/C: OR 1.943, 95% CI: 1.179–3.203, P = 0.009) may be independent risk factors for arteriosclerosis in multiple arteries (adjusted for age, sex, smoking, drinking, hypertension, and diabetes).

Conclusions

ALDH2 rs671 A/A and MTHFR rs1801133 T/T genotypes may be independent risk factors for arteriosclerosis in multiple arteries.
Different hydration methods for the prevention of contrast-induced nephropathy in patients with elective percutaneous coronary intervention: a retrospective study
Authors: Chen Fei , Lu Jingchao , Yang Xiuchun , Liu Demin , Wang Qian , Geng Xue , Xiao Bing , Zhang Jie , Liu Fan , Gu Guoqiang , Cui Wei
Published: June 2023

Background

Hydration is currently the main measure to prevent contrast-induced nephropathy (CIN). We aimed to compare the preventive effect of preprocedure and postprocedure hydration on CIN in patients with coronary heart disease undergoing elective percutaneous coronary intervention (PCI).

Methods

A retrospective study included 198 cases of postprocedure hydration and 396 cases of preprocedure hydration using propensity score matching. The incidence of CIN 48 h after PCI and adverse events within 30 days after contrast media exposure were compared between the two groups. Logistic regression analysis was used to analyse the risk factors for CIN.

Results

The incidence of CIN in the postprocedure hydration group was 3.54%, while that in the preprocedure hydration group was 4.8%. There was no significant difference between the two groups (p = 0.478). Multivariate logistic regression analysis showed that diabetes mellitus, baseline BNP and cystatin C levels, and contrast agent dosage were independent risk factors for CIN. There was no significant difference in the incidence of major adverse events between the two groups (3.03% vs. 2.02%, p = 0.830).

Conclusions

Postprocedure hydration is equally effective compared to preoperative hydration in the prevention of CIN in patients with coronary heart disease undergoing elective PCI.
What quantifies good primary care in the United States? A review of algorithms and metrics using real-world data
Authors: Wang Yun , Zheng Jianwei , Schneberk Todd , Ke Yu , Chan Alexandre , Hu Tao , Lam Jerika , Gutierrez Mary , Portillo Ivan , Wu Dan , Chang Chih-Hung , Qu Yang , Brown Lawrence , Nichol Michael B.
Published: June 2023

Primary care physicians (PCPs) play an indispensable role in providing comprehensive care and referring patients for specialty care and other medical services. As the COVID-19 outbreak disrupts patient access to care, understanding the quality of primary care is critical at this unprecedented moment to support patients with complex medical needs in the primary care setting and inform policymakers to redesign our primary care system. The traditional way of collecting information from patient surveys is time-consuming and costly, and novel data collection and analysis methods are needed. In this review paper, we describe the existing algorithms and metrics that use the real-world data to qualify and quantify primary care, including the identification of an individual’s likely PCP (identification of plurality provider and major provider), assessment of process quality (for example, appropriate-care-model composite measures), and continuity and regularity of care index (including the interval index, variance index and relative variance index), and highlight the strength and limitation of real world data from electronic health records (EHRs) and claims data in determining the quality of PCP care. The EHR audits facilitate assessing the quality of the workflow process and clinical appropriateness of primary care practices. With extensive and diverse records, administrative claims data can provide reliable information as it assesses primary care quality through coded information from different providers or networks. The use of EHRs and administrative claims data may be a cost-effective analytic strategy for evaluating the quality of primary care.