bluuebunny/crossref_metadata_2025 huggingface dataset:
Cryptogenic stroke as a working diagnosis: the need for an early and comprehensive diagnostic work-up
Authors: Acampa Maurizio , Lazzerini Pietro Enea , Lattanzi Simona , Rubiera Marta
Published: April 2023

In the Nordic Atrial Fibrillation and Stroke (NOR-FIB) study, the causes of ischemic stroke were identified in 43% of cryptogenic stroke patients monitored with implantable cardiac monitor (ICM), but one-third of these patients had non-cardioembolic causes. These results suggest the need for an early and comprehensive diagnostic work-up before inserting an ICM.
Considerable doubt about rubella screening and vaccination among unvaccinated orthodox protestant women: a mixed-methods study
Authors: de Munter Anne C. , Hautvast Jeannine L. A. , Ruijs Wilhelmina L. M. , Ruiter Robert A. C. , Hulscher Marlies E. J. L.
Published: April 2023

Background

Women who are susceptible to rubella are advised to vaccinate against rubella to prevent infection in future pregnancies, and thus avert the risk of congenital rubella syndrome in their unborn child. Rubella outbreaks periodically occur in the under-vaccinated orthodox Protestant community in the Netherlands. The objective of this mixed-methods study was to determine and understand personal experience with rubella, perceived rubella susceptibility, and intention to accept rubella screening and vaccination among unvaccinated orthodox Protestant women. The ultimate aim of this study was to inform policy and practice and contribute to the prevention of cases of congenital rubella syndrome.

Methods

A mixed-methods study was conducted combining an online survey and semi-structured interviews among unvaccinated Dutch orthodox Protestant women aged 18–40 years. Descriptive analysis was used for quantitative data. Qualitative data was analysed using codes and categories.

Results

Results of the survey (167 participants) showed that most participants had personal experience with rubella (74%, 123/167) and 101 women (61%, 101/167) indicated they had had rubella themselves. More than half of the women were undecided whether to accept rubella susceptibility screening (56%; 87/156) or rubella vaccination (55%; 80/146). Qualitative findings (10 participants) showed that most women thought they were not susceptible to rubella. Indecisiveness and negative attitudes to accept rubella vaccination were related with religious arguments to object vaccination and with women’s perception of absence of imminent threat of rubella. Furthermore, results showed presence of misconceptions among women in the interpretation of their susceptibility and high confidence in their parents’ memory that they had experienced rubella as a child although no laboratory screening had been conducted.

Conclusions

In light of an imminent rubella outbreak in the Netherlands, a tailored education campaign should be prepared aimed at and established in cooperation with the under-vaccinated orthodox Protestant community. Health care providers should provide adequate information on rubella and support decision-making in order to stimulate women to make a deliberate and informed decision on rubella screening and, if necessary, subsequent vaccination.
The consideration of surgery on primary lesion of advanced non-small cell lung cancer
Authors: Ren Jianghao , Ren Jiangbin , Wang Kan , Tan Qiang
Published: April 2023

Background

Numerous reports have shown that medical treatment confers excellent survival benefits to patients with advanced stage IV non-small cell lung cancer (NSCLC). However, the implications of surgery for primary lesions as palliative treatment remain inconclusive.

Methods

We retrospectively extracted clinical data from the Surveillance, Epidemiology, and End Results Program (SEER) database and selected patients with stage IV NSCLC. Patients were classified into non-surgery and surgery groups, and propensity score matching (PSM) analysis was performed to balance the baseline information. Patients in the surgery group, whose overall survival (OS) was longer than the median survival time of those in the non-surgery group, were deemed to benefit from surgery. We evaluated the efficacy of three surgical techniques, namely, local destruction, sub-lobectomy, and lobectomy, on the primary site in the beneficial population.

Results

The results of Cox regression analyses revealed that surgery was an independent risk factor for both OS (hazard ratio [HR]: 0.441; confidence interval [CI]: 0.426–0.456; P < 0.001) and cancer-specific survival (CSS) (HR: 0397; CI: 0.380–0.414; P < 0.001). Notably, patients who underwent surgery had a better prognosis than those who did not (OS: P < 0.001; CSS: P < 0.001). Moreover, local destruction and sub-lobectomy significantly compromised survival compared to lobectomy in the beneficial group (P < 0.001). After PSM, patients with stage IV disease who underwent lobectomy needed routine mediastinal lymph node clearing (OS: P = 0.0038; CSS: P = 0.039).

Conclusion

Based on these findings, we recommend that patients with stage IV NSCLC undergo palliative surgery for the primary site and that lobectomy plus lymph node resection should be conventionally performed on those who can tolerate the surgery.
Right basal bronchial fistula due to amebic infection: a case report
Authors: Yazawa Tomohiro , Igai Hitoshi , Kamiyoshihara Mitsuhiro , Shirabe Ken
Published: April 2023

Background

Pleuropulmonary amebiasis is the second most common form of extraintestinal invasive amebiasis, but cases that include bronchopleural fistula are rare.

Case presentation

A 43-year-old male was referred to our hospital for liver abscess, right pleural effusion, and body weight loss. He was diagnosed with a bronchopleural fistula caused by invasive pleuropulmonary amebiasis and human immunodeficiency virus (HIV) infection. After initial medical treatment for HIV infection and invasive amebiasis, he underwent pulmonary resection of the invaded lobe. Intraoperative inspection revealed a fistula of the right basal bronchus in the perforated lung abscess cavity, but the diaphragm was intact. The patient was discharged on postoperative day 3 and was in good condition at the 1-year follow-up.

Conclusions

Clinicians should be aware that pleuropulmonary amebiasis can cause a bronchopleural fistula although it is very rare.
Mid-term comparative study between the glenoid and humerus lateralization designs for reverse total shoulder arthroplasty: which lateralization design is better?
Authors: Lee Hwan-Hee , Park Sang-Eun , Ji Jong-Hun , Jun Hyun-Sik
Published: April 2023

Introduction

The complications of the conventional medialized design for reverse total shoulder arthroplasty (RSA) are increased scapular notching, and decreased external rotation and deltoid wrapping. Currently, lateralization design RSA, which avoid scapular notching and improve impingement-free range of motion, is commonly used. Especially, humeral lateralization design was most commonly used and glenoid lateralization design was preferred for glenoid abnormities. We compared mid-term clinical and radiologic outcomes of glenoid and humeral lateralization RSA in an Asian population in this study.

Materials and Methods

We enrolled 124 shoulders of 122 consecutive patients (mean age 73.8 ± 6.8 years) who received glenoid or humeral lateralization RSA from May, 2012 to March, 2019. We divided these patients into two groups according to RSA using either glenoid or humeral lateralization design. These different designs were introduced consecutively in Korea. The clinical and radiological results of 60 glenoid lateralization RSA (Group I, 60 patients) and 64 humeral lateralization RSA (Group II, 62 patients) were retrospectively evaluated and also were compared between the two groups. All patients were followed for mean 3 years.

Results

The clinical and radiologic outcomes of the two groups did not differ significantly, including scapular notching (p = 0.134). However, humeral lateralization RSA showed a larger glenoid-tuberosity (GT) distance (p = 0.000) and less distalization shoulder angle (DSA) (p = 0.035). The complication rate did not differ significantly either. But, revision surgery was performed for 2 humeral loosening in the Group II.

Conclusion

The clinical and radiologic outcomes of the two groups did not differ significantly, including scapular notching at mid-term follow-up. However, humeral lateralization design showed larger GT distance and less DSA. Humeral lateralization design RSA could preserve the normal shoulder contour due to a larger GT distance (more lateralization) and provide less deltoid tension due to less DSA (less distalization of COR).
Comparative effectiveness of early initiation of oral nonsteroidal anti-inflammatory drug and oral acetaminophen therapies on the time to knee replacement in patients with knee osteoarthritis in Japan
Authors: Higa Shingo , Nakata Ken , Karasawa Yusuke , Ohwaki Kazuhiro
Published: April 2023

Background

Although disease-modifying properties of nonsteroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis (OA) have been reported, the effects of NSAIDs on OA progression remain controversial. The purpose of this study was to investigate the effect of early initiation of oral NSAID therapy on the progression of knee OA.

Methods

In this retrospective cohort study, we extracted data of patients newly diagnosed with knee OA between November 2007 and October 2018 from a Japanese claims database. The primary outcome was the time to knee replacement (KR), and the secondary outcome was the time to composite event including joint lavage and debridement, osteotomy, or arthrodesis in addition to KR. Weighted Cox regression analysis with standardized mortality/morbidity ratio (SMR) weight was performed to compare the outcomes between patients prescribed oral NSAID (NSAID group) and those prescribed oral acetaminophen (APAP) (APAP group) early after a diagnosis of knee OA. Propensity scores were calculated using logistic regression conditioned on potential confounding factors, and SMR weights were calculated using the propensity scores.

Results

The study population comprised 14,261 patients, who were divided into two groups as follows: 13,994 in the NSAID group and 267 in the APAP group. The mean ages of patients in the NSAID and APAP groups were 56.9 and 56.1 years, respectively. Furthermore, 62.01% and 68.16% patients in the NSAID and APAP groups, respectively, were female. The NSAID group had a reduced risk of KR compared with the APAP group in the analysis using SMR weighting (SMR-weighted hazard ratio, 0.19; 95% confidence interval, 0.05–0.78). While no statistically significant difference was found for the risk of composite event between the two groups (SMR-weighted hazard ratio, 0.56; 95% confidence interval, 0.16–1.91).

Conclusions

The risk of KR in the NSAID group was significantly lower than that in the APAP group after accounting for residual confounding using SMR weighting. This finding suggests that oral NSAID therapy early after the initial diagnosis is associated with a reduced risk of KR in patients with symptomatic knee OA.
Impact of occlusal reconstruction positions on airway dimensions in patients with edentulism and long centric occlusion
Authors: He Huiying , Zhang Sheng , Xu Jun
Published: April 2023

Objective

To study the airway changes of edentulous patients with a magnitude of long centric (MLC) ≥ 1.5 mm during occlusal reconstruction at the centric relation position (CRP) and muscular position (MP).

Methods

The CRP and MP were determined by Gothic arch. The cephalometric analysis was taken at the two occlusal positions. The sagittal distance of each part of the upper airway was measured. The differences between two occlusal positions were compared. The difference values were calculated by subtracting the two. The correlation between the MLC and the difference value was analyzed.

Results

The sagittal diameters of palatopharynx and glossopharynx airway at MP were statistically larger than those at CRP (P < 0.05). The MLC had a strong correlation with the ANB angle (r = 0.745, P < 0.001).

Conclusion

Compared with the occlusal position of CRP, occlusion reconstruction at MP can provide better airway condition for edentulous patients with large MLC.
The feasibility of existing JADAS10 cut-off values in clinical practice: a study of data from The Finnish Rheumatology Quality Register
Authors: Backström M. , Salo H. , Kärki J. , Aalto K. , Rebane K. , Levälampi T. , Grönlund M-M. , Kröger L. , Pohjankoski H. , Hietanen M. , Korkatti K. , Kuusalo L. , Rantalaiho V. , Huhtakangas J. , Relas H. , Pääkkö T. , Löyttyniemi E. , Sokka-Isler T. , Vähäsalo P.
Published: April 2023

Background

The ten-joint juvenile arthritis disease activity score (JADAS10) is designed to measure the level of disease activity in non-systemic juvenile idiopathic arthritis by providing a single numeric score. The clinical JADAS10 (cJADAS10) is a modification of the JADAS10 that excludes erythrocyte sedimentation rate (ESR). Three different sets of JADAS10/cJADAS10 cut-offs for disease activity states have been published, i.e., the Backström, Consolaro, and Trincianti cut-offs. The objective of this study was to investigate the performance of existing JADAS10 cut-offs in real-life settings using patient data from The Finnish Rheumatology Quality Register (FinRheuma).

Methods

Data were collected from the FinRheuma register. The proportion of patients with an active joint count (AJC) above zero when classified as being in clinically inactive disease (CID) or low disease activity (LDA) groups according to existing JADAS10/cJADAS10 cut-off levels were analyzed.

Results

A significantly larger proportion of the patients classified as being in CID had an AJC > 0 when using the JADAS10/cJADAS10 cut-offs by Trincianti et al. compared to those for the other cut-offs. In the LDA group, a significantly larger proportion of the polyarticular patients (35%/29%) had an AJC of two when Trincianti JADAS10/cJADAS10 cut-offs were used compared with when Backström (11%/10%) and Consolaro (7%/3%) JADAS10/cJADAS10 cut-offs were used.

Conclusions

We found the cut-offs proposed by Consolaro et al. to be the most feasible, since these cut-off levels for CID do not result in the misclassification of active disease as remission, and the proportion of patients with AJC > 1 in the LDA group is lowest using these cut-offs.
Comparative analyses of holder pasteurization vs. HTST pasteurization for donor milk: a cost-minimization study applicable to human milk banks
Authors: Escuder Vieco Diana , Arenas Vidal Jorge , Rojas García Paula , Gónzález Marino J , García Lara Nadia Raquel , Pallás Alonso Carmen Rosa
Published: April 2023

Background

High-temperature short-time (HTST) pasteurization (72–75 °C, 15 s) is an alternative treatment to traditional Holder pasteurization (HoP) (62ºC, 30 min) for donor milk. HTST pasteurization guarantees the milk’s microbiological safety and retains more of its biologically and nutritionally active compounds, but the cost of implementing this technology for a human milk bank is unknown.

Methods

A cost-minimization study was carried out on the facilities of a regional human milk bank in a public hospital. Total production costs (fixed plus variables) were quantified using HTST pasteurization and HoP in three hypothetical scenarios: (1) costs of the first 10 L of pasteurized milk in a newly opened milk bank; (2) costs of the first 10 L of pasteurized milk in an active milk bank; and (3) costs using the maximum production capacity of both technologies in the first two years of operation. The following costs were analyzed: health care professionals, equipment and software, external services, and consumables.

Results

In scenario 1, the total production costs were € 228,097.00 for the HTST method versus € 154,064.00 for the HoP method. In scenario 2, these costs were similar (€ 6,594.00 for HTST pasteurization versus € 5,912.00 for HoP). The cost of healthcare professionals was reduced by more than half when pasteurization was carried out by the HTST method versus the Holder method (€ 84.00 and € 191.00, respectively). In scenario 3, the unit cost of milk pasteurized by the HTST method decreased from the first to the second year by 43.5%, while for the HoP method, it decreased by 30%.

Conclusions

HTST pasteurization requires a high initial investment in equipment; however, it provides a significant minimization of production costs in the long term, pasteurizes large quantities of donor milk per working day and achieves a more efficient management of the time of the health care professionals in charge of the bank’s operation compared to HoP.
Malaria therapeutics: are we close enough?
Authors: Tripathi Himani , Bhalerao Preshita , Singh Sujeet , Arya Hemant , Alotaibi Bader Saud , Rashid Summya , Hasan Mohammad Raghibul , Bhatt Tarun Kumar
Published: April 2023

Malaria is a vector-borne parasitic disease caused by the apicomplexan protozoan parasite Plasmodium. Malaria is a significant health problem and the leading cause of socioeconomic losses in developing countries. WHO approved several antimalarials in the last 2 decades, but the growing resistance against the available drugs has worsened the scenario. Drug resistance and diversity among Plasmodium strains hinder the path of eradicating malaria leading to the use of new technologies and strategies to develop effective vaccines and drugs. A timely and accurate diagnosis is crucial for any disease, including malaria. The available diagnostic methods for malaria include microscopy, RDT, PCR, and non-invasive diagnosis. Recently, there have been several developments in detecting malaria, with improvements leading to achieving an accurate, quick, cost-effective, and non-invasive diagnostic tool for malaria. Several vaccine candidates with new methods and antigens are under investigation and moving forward to be considered for clinical trials. This article concisely reviews basic malaria biology, the parasite's life cycle, approved drugs, vaccine candidates, and available diagnostic approaches. It emphasizes new avenues of therapeutics for malaria.

Graphical Abstract
Energy-efficient data transmission with proportional rate fairness for NANs of smart grid communication network
Authors: Wang Xiaocheng , Han Qiaoni , Yin Yuan , Ma Haogang
Published: April 2023

In smart grid, the neighborhood area network (NAN) serves as a bridge connecting smart meters and meter data management system (MDMS) and is one of the most important components of the smart grid communication network. In this work, we study the energy-efficient data transmissions from NAN gateways (i.e., routers) to the concentrator that connects the MDMS. Particularly, to assure that each router associated with diverse number of associated smart meters can achieve a required data rate, a set of proportional rate fairness constraints are imposed into the optimization problem. In this case, an optimization problem that balances energy efficiency and fairness is formulated. Due to the fractional form of objective function, the combinatorial constraints on channel allocation variables, and the proportional rate fairness requirements, the formulated energy-efficient data transmission problem is non-convex and extremely computationally complex. In order to solve the problem efficiently, firstly, a subtractive transformation is introduced to handle the objective function, and an iterative algorithm based on Dinkelbach method is proposed; then for the inner loop optimization problem in each iteration, a low-complexity suboptimal algorithm that separates channel allocation and power distribution is developed. Finally, numerical results demonstrate that the proposed algorithm converges in a few steps and achieves a near-optimal energy efficiency performance.
Over 40 years (1981–2023) assessing stigma with the Community Attitudes to Mental Illness (CAMI) scale: a systematic review of its psychometric properties
Authors: Sanabria-Mazo Juan P. , Doval Eduardo , Bernadàs Albert , Angarita-Osorio Natalia , Colomer-Carbonell Ariadna , Evans-Lacko Sara , Thornicroft Graham , Luciano Juan V. , Rubio-Valera María
Published: April 2023

Background

The Community Attitudes to Mental Illness (CAMI) scale measures social stigma towards people with mental illness. Although it has been used worldwide, the psychometric properties of the CAMI have not been systematically reviewed. The main aim of this study was to systematically review the psychometric properties of the different versions of the CAMI more than 40 years after of its publication.

Methods

A systematic search was conducted in MEDLINE, PsycINFO, Web of Science, and EMBASE from 1981 (year of publication) to 2023 (present). A double review was performed for eligibility, data extraction, and quality assessment.

Results

A total of 15 studies enrolling 10,841 participants were included. The most frequently reported factor structure comprises 3 or 4 factors. Overall, the internal consistency seems adequate for the global scale (α ≥ 0.80), except for CAMI-10 (α = 0.69). Internal consistency of the subscales are not supported, with authoritarianism being the weakest factor (α = 0.27 to 0.68). The stability over time of the total scale has been assessed in the CAMI-40, CAMI-BR, and CAMI-10 (r ≥ 0.39). Few studies have assessed the temporal stability of the CAMI subscales. Most of the correlations with potentially related measures are significant and in the expected direction.

Conclusions

The 3 and 4 factor structure are the most widely reported in the different versions of the CAMI. Even though reliability and construct validity are acceptable, further item refinement by international consensus seems warranted more than 40 years after the original publication.

Systematic review registration

PROSPERO identification number: CRD42018098956.
Dynamic chromatin architectures provide insights into the genetics of cattle myogenesis
Authors: Cheng Jie , Cao Xiukai , Wang Xiaogang , Wang Jian , Yue Binglin , Sun Wei , Huang Yongzhen , Lan Xianyong , Ren Gang , Lei Chuzhao , Chen Hong
Published: April 2023

Background

Sharply increased beef consumption is propelling the genetic improvement projects of beef cattle in China. Three-dimensional genome structure is confirmed to be an important layer of transcription regulation. Although genome-wide interaction data of several livestock species have already been produced, the genome structure states and its regulatory rules in cattle muscle are still limited.

Results

Here we present the first 3D genome data in Longissimus dorsi muscle of fetal and adult cattle (Bos taurus). We showed that compartments, topologically associating domains (TADs), and loop undergo re-organization and the structure dynamics were consistent with transcriptomic divergence during muscle development. Furthermore, we annotated cis-regulatory elements in cattle genome during myogenesis and demonstrated the enrichments of promoter and enhancer in selection sweeps. We further validated the regulatory function of one HMGA2 intronic enhancer near a strong sweep region on primary bovine myoblast proliferation.

Conclusions

Our data provide key insights of the regulatory function of high order chromatin structure and cattle myogenic biology, which will benefit the progress of genetic improvement of beef cattle.
Antihypertensive and antihyperglycemic effects of combinations of losartan with metformin and/or glibenclamide in desoxycorticosterone acetate and streptozotocin-induced hypertensive diabetic rats
Authors: Moke Emuesiri Goodies , Omogbai Eric Kelly Inanemo , Osagie-Eweka SammyDavies Ehiosu , Uchendu Adaeze Phina , Obayuwana Odion Martha , Okoro-Akpandu Elizabeth , Ben-Azu Benneth
Published: April 2023

Background

Hypertension is a medical condition that often comorbidly exist in patients with type II diabetes. Therefore, it is very important to manage both conditions simultaneously to mitigate the complications and mortality connected with this comorbidity. Hence, this study investigated the antihypertensive and antihyperglycemic effects of combinations of losartan (LOS) with metformin (MET) and/or glibenclamide (GLB) in hypertensive diabetic rats. Hypertensive diabetic state was induced with desoxycorticosterone acetate (DOCA) and streptozotocin (STZ) in adult Wistar rats. The rats were divided into 5 groups (n = 5): control group (group 1), hypertensive diabetic (HD) control (group 2), treatment groups receiving LOS + MET (group 3), LOS + GLB (group 4), and LOS + MET + GLB (group 5). Group 1 comprised healthy rats while groups 2–5 were HD rats. The rats were treated orally once daily for 8 weeks. Fasted blood glucose (FBS) level, haemodynamic parameters, and some biochemical indices were thereafter assessed.

Results

FBS level and blood pressure measurements were significantly (P < 0.05) increased following induction by DOCA/STZ. The drug treatment combinations, particularly combination of LOS + MET + GLB, significantly (P < 0.05) reduced the induced hyperglycemia and remarkably decreased systolic blood pressure and heart rate. There was significant (P < 0.05) reduction in raised lactate dehydrogenase and creatinine kinase levels by all drug treatment combinations except LOS + GLB.

Conclusions

Our findings suggest that LOS combinations with MET and/or GLB exhibited significant antidiabetic and antihypertensive effects against DOCA/STZ-induced hypertensive diabetic state in rats.
Improving air pollutant prediction in Henan Province, China, by enhancing the concentration prediction accuracy using autocorrelation errors and an Informer deep learning model
Authors: Cai Kun , Zhang Xusheng , Zhang Ming , Ge Qiang , Li Shenshen , Qiao Baojun , Liu Yang
Published: April 2023

Air pollution is an important issue affecting sustainable development in China, and accurate air quality prediction has become an important means of air pollution control. At present, traditional methods, such as deterministic and statistical approaches, have large prediction errors and cannot provide effective information to prevent the negative effects of air pollution. Therefore, few existing methods could obtain accurate air pollutant time series predictions. To this end, a deep learning-based air pollutant prediction method, namely, the autocorrelation error-Informer (AE-Informer) model, is proposed in this study. The model implements the AE based on the Informer model. The AE-Informer model is used to predict the hourly concentrations of multiple air pollutants, including PM10, PM2.5, NO2, and O3. The experimental results show that the mean absolute error (MAE) and root mean square error (RMSE) values of AE-Informer in multivariate prediction are 3% less than those of the Informer model; thus, the prediction error is effectively reduced. In addition, a stacking ensemble model is proposed to supplement the missing air pollutant time series data. This study uses Henan Province in China as an example to test the validity of the proposed methodology.
Prevalence of suicidal behaviour among students living in Muslim-majority countries: systematic review and meta-analysis
Authors: Arafat S. M. Yasir , Baminiwatta Anuradha , Menon Vikas , Singh Rakesh , Varadharajan Natarajan , Guhathakurta Saptarshi , Mahesar Rameez Ali , Rezaeian Mohsen
Published: April 2023

Background

Assessing suicidal behaviours among students would help to understand the burden and enhance suicide prevention.

Aims

We aimed to determine the prevalence of suicidal behaviour among students living in Muslim-majority countries.

Method

We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was conducted in Medline, EMBASE and PsycINFO. Meta-analyses were performed to pool the lifetime, 1-year and point prevalence rates for suicidal ideation, plans and attempts.

Results

From 80 studies, 98 separate samples were included in this analysis. The majority (n= 49) were from the Eastern Mediterranean, and 61 samples were of university students. The pooled prevalence of suicidal ideation was 21.9% (95% CI 17.4%–27.1%) for lifetime, 13.4% (95% CI 11.1%–16.1%) for the past year and 6.4% (95% CI 4.5%–9%) for current. The pooled prevalence of suicide plans was 6.4% (95% CI 3.7%–11%) for lifetime, 10.7% (95% CI 9.1%–12.4%) for the past year and 4.1% (95% CI 2.7%–6.2%) for current. The pooled prevalence of suicide attempts was 6.6% (95% CI 5.4%–8%) for lifetime and 4.9% (95% CI 3.6%–6.5%) for the past year. The lifetime prevalence of suicidal ideation was highest (46.2%) in South-East Asia, but the 12-month prevalence was highest (16.8%) in the Eastern Mediterranean.

Conclusions

The study revealed notably high rates of suicidal behaviours among students living in Muslim-majority countries. However, the quality of studies, differences in regional and cultural factors, stages of studentship and methods of measurement should be considered when generalising the study results.
A Three-Step Taxane Titration Protocol Decreases Hypersensitivity Reactions During First and Second Exposures
Authors: Lynch Donna-Marie , Menon Susanne , Mazzola Emanuele , Costa Jennifer , Jabaley Terri
Published: April 2023

INTRODUCTION:

Patients receiving taxanes are at risk for developing hypersensitivity reactions (HSRs) primarily during first and second lifetime exposures. Immediate HSRs require emergency care and can interfere with the continuation of preferred treatment. Although different approaches to slow titration have been used successfully for desensitization after HSR occurrence, there are no standardized recommendations for taxane titration to prevent HSRs.

PURPOSE:

To determine if a gradual, three-step infusion rate titration decreases the rate and severity of immediate HSRs during first and second lifetime exposures to paclitaxel and docetaxel.

METHODS:

We used a prospective, interventional design with historical comparisons to evaluate a sample of 222 first and second lifetime exposure paclitaxel and docetaxel infusions. The intervention was a three-step infusion rate titration provided at the initiation of first and second lifetime exposures. Ninety-nine titrated infusions were compared with 123 historical records of nontitrated infusions.

RESULTS:

Compared with the nontitrated group (n = 123), the titrated group (n = 99) had significantly less HSRs (19% v 7%; P = .017). No significant difference in HSR severity was found between groups ( P = 1.00). However, four nontitrated patients received epinephrine, and one required transfer to the emergency department (ED) because of reaction severity. In contrast, no titrated patients received epinephrine or required transfer to the ED. In the nontitrated group, seven patients did not complete their infusions versus one patient in the titrated group.

CONCLUSION:

A standardized, three-step infusion rate titration prevented HSR occurrence. Significant issues affecting practice feasibility and sustainability were addressed.
Peripheral Intravenous Waveform Analysis Responsiveness to Subclinical Hemorrhage in a Rat Model
Authors: Barajas Matthew B. , Riess Matthias L. , Hampton Matthew J. W. , Li Zhu , Shi Yaping , Shotwell Matthew S. , Staudt Genevieve , Baudenbacher Franz J. , Lefevre Ryan J. , Eagle Susan S.
Published: April 2023

BACKGROUND:

Early detection and quantification of perioperative hemorrhage remains challenging. Peripheral intravenous waveform analysis (PIVA) is a novel method that uses a standard intravenous catheter to detect interval hemorrhage. We hypothesize that subclinical blood loss of 2% of the estimated blood volume (EBV) in a rat model of hemorrhage is associated with significant changes in PIVA. Secondarily, we will compare PIVA association with volume loss to other static, invasive, and dynamic markers.

METHODS:

Eleven male Sprague Dawley rats were anesthetized and mechanically ventilated. A total of 20% of the EBV was removed over ten 5 minute-intervals. The peripheral intravenous pressure waveform was continuously transduced via a 22-G angiocatheter in the saphenous vein and analyzed using MATLAB. Mean arterial pressure (MAP) and central venous pressure (CVP) were continuously monitored. Cardiac output (CO), right ventricular diameter (RVd), and left ventricular end-diastolic area (LVEDA) were evaluated via transthoracic echocardiogram using the short axis left ventricular view. Dynamic markers such as pulse pressure variation (PPV) were calculated from the arterial waveform. The primary outcome was change in the first fundamental frequency (F1) of the venous waveform, which was assessed using analysis of variance (ANOVA). Mean F1 at each blood loss interval was compared to the mean at the subsequent interval. Additionally, the strength of the association between blood loss and F1 and each other marker was quantified using the marginal R
2 in a linear mixed-effects model.

RESULTS:

PIVA derived mean F1 decreased significantly after hemorrhage of only 2% of the EBV, from 0.17 to 0.11 mm Hg, P = .001, 95% confidence interval (CI) of difference in means 0.02 to 0.10, and decreased significantly from the prior hemorrhage interval at 4%, 6%, 8%, 10%, and 12%. Log F1 demonstrated a marginal R
2 value of 0.57 (95% CI 0.40–0.73), followed by PPV 0.41 (0.28–0.56) and CO 0.39 (0.26–0.58). MAP, LVEDA, and systolic pressure variation displayed R
2 values of 0.31, and the remaining predictors had R
2 values ≤0.2. The difference in log F1 R
2 was not significant when compared to PPV 0.16 (95% CI −0.07 to 0.38), CO 0.18 (−0.06 to 0.04), or MAP 0.25 (−0.01 to 0.49) but was significant for the remaining markers.

CONCLUSIONS:

The mean F1 amplitude of PIVA was significantly associated with subclinical blood loss and most strongly associated with blood volume among the markers considered. This study demonstrates feasibility of a minimally invasive, low-cost method for monitoring perioperative blood loss.
Ultramassive Transfusion for Trauma in the Age of Hemostatic Resuscitation: A Retrospective Single-Center Cohort From a Large US Level-1 Trauma Center, 2011–2021
Authors: Muldowney Maeve , Liu Zhinan , Stansbury Lynn G. , Vavilala Monica S. , Hess John R.
Published: April 2023

BACKGROUND:

Uncontrolled bleeding is a leading cause of death in trauma. In the last 40 years, ultramassive transfusion (UMT; ≥20 units of red blood cells [RBCs]/24 hours) for trauma has been associated with 50% to 80% mortality; the question remains as to whether the increasing number of units transfused in urgent resuscitation is a marker of futility. We asked whether the frequency and outcomes of UMT have changed in the era of hemostatic resuscitation.

METHODS:

We performed a retrospective cohort study of all UMTs in the first 24 hours of care over an 11-year period at a major US level-1 adult and pediatric trauma center. UMT patients were identified, and a dataset was built by linking blood bank and trauma registry data, then reviewing individual electronic health records. Success in achieving hemostatic proportions of blood products was estimated as (units of plasma + apheresis-platelets-in-plasma + cryoprecipitate-pools + whole blood]/[all units given] ≥0.5. Demographics, injury type (blunt or penetrating), severity (Injury Severity Score [ISS]), severity pattern (Abbreviated Injury Scale score for head [AIS-Head] ≥4), admitting laboratory, transfusion, selected emergency department interventions, and discharge status were assessed using χ2 tests of categorical association, the Student t-test of means, and multivariable logistic regression. P <.05 was considered significant.

RESULTS:

Among 66,734 trauma admissions from April 6, 2011 to December 31, 2021, we identified 6288 (9.4%) who received any blood products in the first 24 hours, 159 of whom received UMT (0.23%; 154 aged 18–90 + 5 aged 9–17), 81% in hemostatic proportions. Overall mortality was 65% (n = 103); mean ISS = 40; median time to death, 6.1 hours. In univariate analyses, death was not associated with age, sex, or more RBC units transfused beyond 20 but was associated with blunt injury, increasing injury severity, severe head injury, and failure to receive hemostatic blood product ratios. Mortality was also associated with decreased pH and evidence of coagulopathy at admission, especially hypofibrinogenemia. Multivariable logistic regression showed severe head injury, admission hypofibrinogenemia and not receiving a hemostatic resuscitation proportion of blood products as independently associated with death.

CONCLUSIONS:

One in 420 acute trauma patients at our center received UMT, a historically low rate. A third of these patients lived, and UMT was not itself a marker of futility. Early identification of coagulopathy was possible, and failure to give blood components in hemostatic ratios was associated with excess mortality.
Comparison of Bifrontal Craniotomy and Multiple Burr Hole Encephalogaleoperiosteal-Synangiosis for Pediatric Moyamoya Disease: An Experience of 346 Patients
Authors: Kim Joo Whan , Phi Ji Hoon , Lee Ji Yeoun , Koh Eun Jung , Kim Kyung Hyun , Kim Hee-Soo , Kim Seung-Ki
Published: April 2023

BACKGROUND AND OBJECTIVES:

Moyamoya disease (MMD) is a steno-occlusive disease treated with revascularization surgery. Craniotomy and multiple burr hole encephalogaleoperiosteal-synangiosis (EGPS) are used for revascularization of the anterior cerebral artery territory. The aim of this study was to compare the clinical outcome between the 2 surgical methods in pediatric patients with MMD.

METHODS:

A retrospective review of patients with MMD who underwent bifrontal indirect bypass surgery was performed. Clinical features, perioperative data, and angiographic, perfusion, and functional outcomes were compared between the 2 groups. Propensity score matching was performed to compare the perioperative characteristics and clinical outcomes.

RESULTS:

A total of 346 patients were included in this study, 111 patients underwent bifrontal craniotomy EGPS, and 235 patients had bifrontal multiple burr hole EGPS. An insignificant higher rate of postoperative infarction (11.7% vs 5.5%, P = .072) and more postoperative hemorrhage occurred in the craniotomy EGPS group (3.6% vs 0%, P = .004). Of the 83 patients selected with propensity score matching for each group, the duration of operation was shorter (P < .001) and the amount of intraoperative bleeding was significantly less in the multiple burr hole EGPS group (P = .008). There was no difference in clinical outcomes between the 2 groups.

CONCLUSION:

Bifrontal multiple burr hole EGPS has benefits over craniotomy with shorter surgical time, less intraoperative bleeding, fewer postoperative complications, and comparable perfusion and functional outcomes. Multiple burr hole EGPS is a safe and effective method that might be considered for revascularization of the anterior cerebral artery territory in pediatric patients with MMD.
Disease association and comparative genomics of compositional bias in human proteins
Authors: Kouros Christos E. , Makri Vasiliki , Ouzounis Christos A. , Chasapi Anastasia
Published: April 2023

Background: The evolutionary rate of disordered protein regions varies greatly due to the lack of structural constraints. So far, few studies have investigated the presence/absence patterns of compositional bias, indicative of disorder, across phylogenies in conjunction with human disease. In this study, we report a genome-wide analysis of compositional bias association with disease in human proteins and their taxonomic distribution.

Methods: The human genome protein set provided by the Ensembl database was annotated and analysed with respect to both disease associations and the detection of compositional bias. The Uniprot Reference Proteome dataset, containing 11297 proteomes was used as target dataset for the comparative genomics of a well-defined subset of the Human Genome, including 100 characteristic, compositionally biased proteins, some linked to disease.

Results: Cross-evaluation of compositional bias and disease-association in the human genome reveals a significant bias towards biased regions in disease-associated genes, with charged, hydrophilic amino acids appearing as over-represented. The phylogenetic profiling of 17 disease-associated, proteins with compositional bias across 11297 proteomes captures characteristic taxonomic distribution patterns.

Conclusions: This is the first time that a combined genome-wide analysis of compositional bias, disease-association and taxonomic distribution of human proteins is reported, covering structural, functional, and evolutionary properties. The reported framework can form the basis for large-scale, follow-up projects, encompassing the entire human genome and all known gene-disease associations.
P2P lending platforms in Malaysia: What do we know?
Authors: Nguyen Lan Thi Phuong , Kalabeke Wisdom , Muthaiyah Saravanan , Cheng Ming Yu , Hui Kwan Jing , Mohamed Hazik
Published: April 2023

Background - With the recent evolution of Financial Technology (FinTech), 11 peers to peer (P2P) lending platforms have been regulated by the Securities Commission in Malaysia since 2016. P2P lending platforms offer new investment opportunities to individual investors to earn higher rates on return than what traditional lenders usually provide. However, individual investors may face higher potential risks of default from their borrowers. Therefore, individual investors need to understand the potential exposure to such P2P lending platforms to make an effective investment decision. This study aims to explore the potential risk exposures that individual investors may experience at Malaysia's licensed P2P lending platforms.  

Methods - Based on data collected manually from nine P2P lending platforms over five months, relationships between interest rates and various risk classifying factors such as credit rating, industry, business stage, loan purpose, and loan duration are examined.  

 Results- This study shows that loans with a similar credit rating and with or without similar loan purpose; and a business stage may offer investors significantly different interest rates. In addition, loans with shorter durations may provide investors with higher interest rates than those with longer durations. Finally, loans issued by companies from the same industry appeared to be charged with similar interest. These findings are valuable to investors to prepare themselves before making their investments at the P2P lending platforms.  

Conclusion- With first hand-collected data, this study provides an original insight into Malaysia's current P2P lending platforms. Findings obtained for relationships between interest rates and risk classifying factors such as credit rating, industry, business stage, loan purpose and loan duration are valuable to investors of Malaysian P2P lending platforms.
Host plants and antennal sensilla of Anomala testaceipennis Blanchard (Coleoptera: Scarabaeidae: Rutelinae)
Authors: Souza Ana Caroline , Fuhrmann Juares , Rodrigues Sérgio Roberto
Published: April 2023

This study was conducted at the Universidade Estadual de Mato Grosso do Sul, Cassilândia, Brazil from September 2017 to December 2021 in a Brazilian Cerrado. Adults of Anomala testaceipennis Blanchard were collected associated with host plants and taken to the laboratory for studies. Some phytophagous scarab beetles found host plants through detection of plant volatiles. The detection of those odorants is intermediated by antennal sensilla. The main goals of the present study are to describe the antennal sensilla of A. testaceipennis and check the host plants used as food resource. This specie was found feeding on flowers of: Anadenanthera colubrina var. cebil (Fabaceae), Azadirachta indica (Meliaceae), Buchenavia sp. (Combretaceae), Cordia glabrata (Boraginaceae), Inga edulis (Fabaceae), Moquilea tomentosa (Chrysobalanaceae), Paubrasilia echinata (Fabaceae), Tabernaemontana catharinensis (Apocynaceae), Tapirira guianensis (Anacardiaceae), Xylophragma pratense (Bignoniaceae). To the sensilla study, antennae were dissected and images of the sensilla were obtained using a scanning electron microscope. Antennae of A. testaceipennis have sensilla chaetica, trichodea, placodea (type I, II, and III), coeloconica (type I and II), basiconica (type I), and ampullacea (or pore). Males have a total of about 6,243 sensilla of which 5,868 (93.99%) are sensilla placodea, 370 (5.93%) are sensilla coeloconica, and 5 (0.08%) are sensilla basiconica. Females have a total of about 5,119 sensilla of which 4,820 (94.16%) are sensilla placodea, 270 (5.27%) are sensilla coeloconica, and 29 (0.57%) are sensilla basiconica.
‘What has happened to the unique child?’
Authors: Allingham Sue
Published: April 2023

Sue Allingham, author, trainer and consultant, discusses some of the news stories and developments in early childhood education causing her most concern, after reflecting on international comparisons following a professional visit to Delhi.
Bored out of our minds
Authors: Brown Paula
Published: April 2023

Paula Brown, early years teacher and play therapist, considers whether boredom is a wholesome precursor to creativity or a dangerous force which should be banished from early years settings, and how practitioners can use children's boredom and work with it constructively.
Professional Book Reviews
Authors: Celinska Angelica
Published: April 2023

Angelica Celinska, lecturer and trainer, reviews the 2nd edition of Learning Theories for Early Years Practice by Sean MacBlain. The picture books present a few options for board books aimed at those children who may be ready for early reading, as well as a book with many different storylines each time it is read!
Early Years Equality protest the Government's childcare policy
Authors: Kenyon Claire
Published: April 2023

Claire Kenyon, one of the founders of Early Years Equality, shares more about the association's campaign and what they would like to see instigated for the sector ahead of their demonstration next month.
‘The Gingerbread Man’
Authors: Marycz Adam
Published: April 2023

Inspire and encourage children and their families to bake at home with this modern and engaging home learning experience exploring the traditional tale of ‘The Gingerbread Man’ through the wonderful work of Clare Thompson.
Effect of phytase and citric acid supplementation in the feed quality of laying hen
Authors: NUNINGTYAS YULI FRITA , HUDA ASRI NURUL , MARJUKI MARJUKI , ULFAH SITI NUR
Published: April 2023

Abstract. Nuningtyas YF, Huda AN, Marjuki, Ulfah SN. 2022. Effect of phytase and citric acid supplementation in the feed quality of laying hen. Asian J Agric 6: 55-60. This study aims to determine and evaluate the combination of phytase and high dosage of citric acid on the feed quality based on seeds. This study used data experimental at Brawijaya University, Malang, Indonesia, with five treatments and four replications. This research analyzes the nutritional feed content in vitro digestibility and phosphorus content in concentrate. The result of the study was a basal feed of laying hens followed by a dry matter of 90.63%, organic matter of 81.92%, crude protein of 16.44%, crude fiber of 4.34%, and fat of 7.49%. The basal laying hen feed without adding phytase enzyme and citric acid had a relatively low phosphorus content of 0.43%. It would be limited due to the absence of phytic acid breakdown assistance from the phytase enzyme. The nutrient phosphorus content in the residual feed digestibility is sequent T0 2.2431%, T1 2.7809%, T2 1.6225%, T3 2.0717%, and T4 2.7199%, with T4 for the higher value and the lowest in T2. The addition of the phytase enzyme and citric acid to animal feed for laying hens with various levels has a significant difference (P<0.01) when viewed at the end of the digestibility of phosphor. However, the T2 laying hens feed with the addition of 2% phytase enzyme + 2% citric acid had the lowest phosphorus content in residue feed digestibility in vitro. Therefore, further research should be carried out in-vivo testing, especially on laying hens, to determine the effectiveness of the added enzymes by using the in-vivo test and the amount of phosphorus.