bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical specialty certification exams studied according to the Ottawa Quality Criteria: a systematic review
Authors: Staudenmann Daniel , Waldner Noemi , Lörwald Andrea , Huwendiek Sören
Published: August 2023

Background

Medical specialty certification exams are high-stakes summative assessments used to determine which doctors have the necessary skills, knowledge, and attitudes to treat patients independently. Such exams are crucial for patient safety, candidates’ career progression and accountability to the public, yet vary significantly among medical specialties and countries. It is therefore of paramount importance that the quality of specialty certification exams is studied in the scientific literature.

Methods

In this systematic literature review we used the PICOS framework and searched for papers concerning medical specialty certification exams published in English between 2000 and 2020 in seven databases using a diverse set of search term variations. Papers were screened by two researchers independently and scored regarding their methodological quality and relevance to this review. Finally, they were categorized by country, medical specialty and the following seven Ottawa Criteria of good assessment: validity, reliability, equivalence, feasibility, acceptability, catalytic and educational effect.

Results

After removal of duplicates, 2852 papers were screened for inclusion, of which 66 met all relevant criteria. Over 43 different exams and more than 28 different specialties from 18 jurisdictions were studied. Around 77% of all eligible papers were based in English-speaking countries, with 55% of publications centered on just the UK and USA. General Practice was the most frequently studied specialty among certification exams with the UK General Practice exam having been particularly broadly analyzed. Papers received an average of 4.2/6 points on the quality score. Eligible studies analyzed 2.1/7 Ottawa Criteria on average, with the most frequently studied criteria being reliability, validity, and acceptability.

Conclusions

The present systematic review shows a growing number of studies analyzing medical specialty certification exams over time, encompassing a wider range of medical specialties, countries, and Ottawa Criteria. Due to their reliance on multiple assessment methods and data-points, aspects of programmatic assessment suggest a promising way forward in the development of medical specialty certification exams which fulfill all seven Ottawa Criteria. Further research is needed to confirm these results, particularly analyses of examinations held outside the Anglosphere as well as studies analyzing entire certification exams or comparing multiple examination methods.
Intervention of pharmacist included in multidisciplinary team to reduce adverse drug event: a qualitative systematic review
Authors: Zaij Sarah , Pereira Maia Kelly , Leguelinel-Blache Géraldine , Roux-Marson Clarisse , Kinowski Jean Marie , Richard Hélène
Published: August 2023

Background

Preventable harm in healthcare is a growing public health challenge. In addition to the economic costs of safety failures, adverse drug events (ADE) may lead to complication or even death. Multidisciplinary care team involving a pharmacist appears to be an adequate response to prevention of adverse drug event. This qualitative systematic review aims to identify and describe multidisciplinary planned team-based care involving at least one pharmacist to limit or prevent adverse drug events in the adult patients.

Methods

To determine the type of interprofessional collaboration to prevent adverse drug event in which a pharmacist was involved, we conducted a qualitative systematic review of the literature of randomized controlled trials. Two independent reviewers screened trials in three databases: Medline, Web of Science, ScienceDirect. Prospective studies of at least three different health professionals’ interventions, one of whom was a pharmacist in the last five years were included. Two reviewers performed data extraction and quality appraisal independently. We used TIDieR checklist to appraise articles quality.

Results

In total 803 citations were retrieved, 34 were analysed and 16 full-text articles were reviewed. Only 3 studies published an implementation evaluation. More than half of the interventions (62%) targeted elderly patients including 6 whom lived in nursing homes. Studies outcomes were heterogeneous, and we did not perform a statistical analysis of the impact of these interventions. Most teams are composed of a physician/pharmacist/nurse trio (94%; 100%; 88%). Half of the teams were composed of the primary care physician. Other professionals were included such as physical therapists (25%), social worker (19%), occupational therapists (12%), and community health educator (6%). Multidisciplinary medication review was the most common intervention and was generally structured in four steps: data collection and baseline assessment, appraisal report by health professionals, a multidisciplinary medication review meeting and a patient follow-up.

Conclusions

The most common multidisciplinary intervention to prevent ADE in the adult population is the multidisciplinary drug review meeting at least the physician/pharmacist/nurse trio. Interventions target mostly elderly people in nursing homes, although complex chronic patients could benefit from this type of assessment.

Trial registration

PROSPERO registration: CRD42022334685.
CAR-T cells targeting CD38 and LMP1 exhibit robust antitumour activity against NK/T cell lymphoma
Authors: Li Hongwen , Song Wenting , Wu Jiazhuo , Shi Zhuangzhuang , Gao Yuyang , Li Jiwei , Han Lijuan , Zhang Jianxiang , Li Zhaoming , Li Yong , Zhang Mingzhi
Published: August 2023

Background

Natural killer/T cell lymphoma (NKTCL) is an aggressive lymphoma with a poor prognosis. Chimeric antigen receptor-transduced T (CAR-T) cell therapy has become a promising immunotherapeutic strategy against haematologic malignancies.

Methods

In this study, four CAR-T cell lines (CD38-CAR, LMP1-CAR, CD38-LMP1 tandem CAR 1 and CD38-LMP1 tandem CAR 2) were generated. The effect of CAR-T cells against NKTCL cells was evaluated both in vitro and in vivo. Expression of T cell activation markers and cytokines produced by CAR-T cells were detected by flow cytometry.

Results

The four CAR-T cell lines could effectively eliminate malignant NKTCL cells. They could be activated and produce inflammatory cytokines in a target-dependent manner. In vivo tests showed that the CAR-T cells exhibited significant antitumour effects in a xenotransplanted NKTCL mouse model.

Conclusions

In summary, four CAR-T cell lines exhibited significant cytotoxicity against NKTCL cells both in vitro and in vivo. These results indicated the effective therapeutic promise of CD38 and LMP1 CAR-T cells in NKTCL.
Quantifying ventilation by X-ray velocimetry in healthy adults
Authors: Siddharthan Trishul , Grealis Kyle , Kirkness Jason P. , Ötvös Tamás , Stefanovski Darko , Tombleson Alex , Dalzell Molly , Gonzalez Ernesto , Nakrani Kinjal Bhatt , Wenger David , Lester Michael G. , Richmond Bradley W. , Fouras Andreas , Punjabi Naresh M.
Published: August 2023

Rationale

X-ray velocimetry (XV) has been utilized in preclinical models to assess lung motion and regional ventilation, though no studies have compared XV-derived physiologic parameters to measures derived through conventional means.

Objectives

To assess agreement between XV-analysis of fluoroscopic lung images and pitot tube flowmeter measures of ventilation.

Methods

XV- and pitot tube-derived ventilatory parameters were compared during tidal breathing and with bilevel-assisted breathing. Levels of agreement were assessed using the Bland-Altman analysis. Mixed models were used to characterize the association between XV- and pitot tube-derived values and optimize XV-derived values for higher ventilatory volumes.

Measurements and main results

Twenty-four healthy volunteers were assessed during tidal breathing and 11 were reassessed with increased minute ventilation with bilevel-assisted breathing. No clinically significant differences were observed between the two methods for respiratory rate (average Δ: 0.58; 95% limits of agreement: -1.55, 2.71) or duty cycle (average Δ: 0.02; 95% limits of agreement: 0.01, 0.03). Tidal volumes and flow rates measured using XV were lower than those measured using the pitot tube flowmeter, particularly at the higher volume ranges with bilevel-assisted breathing. Under these conditions, a mixed-model based adjustment was applied to the XV-derived values of tidal volume and flow rate to obtain closer agreement with the pitot tube-derived values.

Conclusion

Radiographically obtained measures of ventilation with XV demonstrate a high degree of correlation with parameters of ventilation. If the accuracy of XV were also confirmed for assessing the regional distribution of ventilation, it would provide information that goes beyond the scope of conventional pulmonary function tests or static radiographic assessments.
Endophytic bacteria isolated from Urtica dioica L.- preliminary screening for enzyme and polyphenols production
Authors: Marchut-Mikołajczyk Olga , Chlebicz Magdalena , Kawecka Monika , Michalak Agnieszka , Prucnal Filip , Nielipinski Maciej , Filipek Jakub , Jankowska Michalina , Perek Zofia , Drożdżyński Piotr , Rutkowska Natalia , Otlewska Anna
Published: August 2023

Endophytes, especially those isolated from herbal plants, may act as a reservoir of a variety of secondary metabolites exhibiting biological activity. Some endophytes express the ability to produce the same bioactive compounds as their plant hosts, making them a more sustainable industrial supply of these substances. Urtica dioica L. (common stinging nettle) is a synanthropic plant that is widely used in herbal medicine due to the diversity of bioactive chemicals it contains, e.g., polyphenols, which demonstrate anti-inflammatory, antioxidant, and anti-cancerous capabilities. This study aimed at isolating endophytic bacteria from stinging nettles for their bioactive compounds. The endophytic isolates were identified by both biochemical and molecular methods (16S rRNA) and investigated for enzymes, biosurfactants, and polyphenols production. Each of the isolated bacterial strains was capable of producing biosurfactants and polyphenols. However, three of the isolated endophytes, identified as two strains of Bacillus cereus and one strain of Bacillus mycoides, possessed the greatest capacity to produce biosurfactants and polyphenols. The derivatized extracts from culture liquid showed the 1.633 mol l−1 (9.691 mg l−1) concentration of polyphenol compounds. Therefore, the present study signifies that endophytic B. cereus and B. mycoides isolated from Urtica dioica L. could be a potential source of biosurfactants and polyphenols. However, further study is required to understand the mechanism of the process and achieve efficient polyphenol production by endophytic bacteria.
Efficacy of the spatial repellent product Mosquito Shield™ against wild pyrethroid-resistant Anopheles arabiensis in south-eastern Tanzania
Authors: Swai Johnson Kyeba , Soto Alina Celest , Ntabaliba Watson Samuel , Kibondo Ummi Abdul , Ngonyani Hassan Ahamad , Mseka Antony Pius , Ortiz Anthony , Chura Madeleine Rose , Mascari Thomas Michael , Moore Sarah Jane
Published: August 2023

Background

Spatial repellents that create airborne concentrations of an active ingredient (AI) within a space offer a scalable solution to further reduce transmission of malaria, by disrupting mosquito behaviours in ways that ultimately lead to reduced human-vector contact. Passive emanator spatial repellents can protect multiple people within the treated space and can last for multiple weeks without the need for daily user touchpoints, making them less intrusive interventions. They may be particularly advantageous in certain use cases where implementation of core tools may be constrained, such as in humanitarian emergencies and among mobile at-risk populations. The purpose of this study was to assess the efficacy of Mosquito Shield™ deployed in experimental huts against wild, free-flying, pyrethroid-resistant Anopheles arabiensis mosquitoes in Tanzania over 1 month.

Methods

The efficacy of Mosquito Shield™ transfluthrin spatial repellent in reducing mosquito lands and blood-feeding was evaluated using 24 huts: sixteen huts were allocated to Human Landing Catch (HLC) collections and eight huts to estimating blood-feeding. In both experiments, half of the huts received no intervention (control) while the remaining received the intervention randomly allocated to huts and remained fixed for the study duration. Outcomes measured were mosquito landings, blood-fed, resting and dead mosquitoes. Data were analysed by multilevel mixed effects regression with appropriate dispersion and link function accounting for volunteer, hut and day.

Results

Landing inhibition was estimated to be 70% (57–78%) [IRR 0.30 (95% CI 0.22–0.43); p < 0.0001] and blood-feeding inhibition was estimated to be 69% (56–79%) [IRR 0.31 (95% CI 0.21–0.44; p < 0.0001] There was no difference in the protective efficacy estimates of landing and blood-feeding inhibition [IRR 0.98 (95% CI 0.53–1.82; p = 0.958].

Conclusions

This study demonstrated that Mosquito Shield™ was efficacious against a wild pyrethroid-resistant strain of An. arabiensis mosquitoes in Tanzania for up to 1 month and could be used as a complementary or stand-alone tool where gaps in protection offered by core malaria vector control tools exist. HLC is a suitable technique for estimating bite reductions conferred by spatial repellents especially where direct blood-feeding measurements are not practical or are ethically limited.
Understanding why racial/ethnic inequities along the HIV care continuum persist in the United States: a qualitative exploration of systemic barriers from the perspectives of African American/Black and Latino persons living with HIV
Authors: Filippone Prema , Serrano Samantha , Campos Stephanie , Freeman Robin , Cluesman Sabrina R. , Israel Khadija , Amos Brianna , Cleland Charles M. , Gwadz Marya
Published: August 2023

Background

Racial/ethnic inequities along the HIV care continuum persist in the United States despite substantial federal investment. Numerous studies highlight individual and social-level impediments in HIV, but fewer foreground systemic barriers. The present qualitative study sought to uncover and describe systemic barriers to the HIV care continuum from the perspectives of African American/Black and Latino persons living with HIV (PLWH) with unsuppressed HIV viral load, including how barriers operated and their effects.

Methods

Participants were African American/Black and Latino PLWH with unsuppressed HIV viral load (N = 41). They were purposively sampled for maximum variability on key indices from a larger study. They engaged in semi-structured in-depth interviews that were audio-recorded and professionally transcribed. Data were analyzed using directed content analysis.

Results

Participants were 49 years old, on average (SD = 9), 76% were assigned male sex at birth, 83% were African American/Black and 17% Latino, 34% were sexual minorities (i.e., non-heterosexual), and 22% were transgender/gender-nonbinary. All had indications of chronic poverty. Participants had been diagnosed with HIV 19 years prior to the study, on average (SD = 9). The majority (76%) had taken HIV medication in the six weeks before enrollment, but at levels insufficient to reach HIV viral suppression. Findings underscored a primary theme describing chronic poverty as a fundamental cause of poor engagement. Related subthemes were: negative aspects of congregate versus private housing settings (e.g., triggering substance use and social isolation); generally positive experiences with health care providers, although structural and cultural competency appeared insufficient and managing health care systems was difficult; pharmacies illegally purchased HIV medication from PLWH; and COVID-19 exacerbated barriers. Participants described mitigation strategies and evidenced resilience.

Conclusions

To reduce racial/ethnic inequities and end the HIV epidemic, it is necessary to understand African American/Black and Latino PLWH’s perspectives on the systemic impediments they experience throughout the HIV care continuum. This study uncovers and describes a number of salient barriers and how they operate, including unexpected findings regarding drug diversion and negative aspects of congregate housing. There is growing awareness that systemic racism is a core determinant of systemic barriers to HIV care continuum engagement. Findings are interpreted in this context.
BNIP3 as a potential biomarker for the identification of prognosis and diagnosis in solid tumours
Authors: Yu Qin , Fu Wenhao , Fu Yutang , Ye Wenjing , Yan Huiqiong , Yu Zecheng , Li Ruirui , Cai Yili , Chen Yuxin , Wang Lingyun , Wei Xianqiao , Chen Yangkun , Zhang Yuheng , Ying Huazhong , Tang Furong , Dai Fangwei , Han Wei
Published: August 2023

Background

Traditional radiotherapy and chemotherapy have been intensively studied for their role in the treatment of tumours. However, these therapies often cause side effects for patients, which calls for the development of novel treatment options for tumours. B-cell lymphoma-2 (Bcl-2)/adenovirus E1B 19 kDa-interacting protein 3 (BNIP3) reportedly apoptosis-inducing effects in tumour cells and is associated with the progression and treatment of multiple tumours. Nevertheless, little is known about its potential role in tumour diagnosis and targeted therapy.

Findings

The results of the study demonstrated that the interaction of BNIP3 with HDAC1 may affect the progression of breast invasive cancer (BRCA), sarcoma (SARC), kidney renal clear cell carcinoma (KIRC), and low-grade glioma (LGG). BNIP3 seemed to exert its effects in BRCA and SARC primarily through gene silencing and integrator complex, and in KIRC and LGG, mainly by affecting olfactory function, suggesting that targeted therapy can be developed based on the above signalling pathway and downstream molecules.

Interpretation

BNIP3 has emerged as a promising therapeutic and diagnostic target for BRCA, SARC, KIRC, and LGG, providing new insights into tumour molecular therapies in the clinic.
Health system governance assessment in protracted crisis settings: Northwest Syria
Authors: Alaref Maher , Al-Abdulla Orwa , Al Zoubi Zedoun , Al Khalil Munzer , Ekzayez Abdulkarim
Published: August 2023

Background

Since the withdrawal of government forces from Northwest Syria due to the conflict, several national initiatives have aimed to create alternative governance approaches to replace the central governmental system. One of the recent initiatives was the formulation of so-called ‘Central Bodies’ as institutional governance structures responsible for thematic planning and service provision; for example, the referral unit is responsible for planning and delivering medical referral services. However, the governance and administrative rules of procedures of these bodies could be immature or unsystematic. Assessing the governance of this approach cannot be condoned, especially with the urgent need for a methodical approach to strategic planning, achieving strategic humanitarian objectives, and efficiently utilizing available resources. Multiple governance assessment frameworks have been developed. However, none were created to be applied in protracted humanitarian settings. This research aims to assess the extent to which the existing health governance structure (central bodies) was capable of performing the governance functions in the absence of a legitimate government in Northwest Syria.

Methods and materials

A governance assessment framework was adopted after an extensive literature review and group discussions. Four principles for the governance assessment framework were identified; legitimacy, accountability and transparency, effectiveness and efficiency, and strategic vision. Focus Group Discussions were held to assess the levels of the selected principles on the governance thermometer scale. Qualitative and quantitative data were analyzed using NVivo 12 and SPSS 22 software programs, respectively.

Results

The level of the four principles on the governance thermometer scale was between the lowest and middle quintiles; ‘very poor or inactive’ and ‘fair and requires improvement’, respectively. The results indicate that the governance approach of Central Bodies in NWS is underdeveloped and summons comprehensive systematic development. The poor internal mechanisms, poor planning and coordination, and the absence of strategic vision were among the most frequent challenges to developing the approach.

Conclusion

Humanitarian actors and donors should pay more attention to health governance approaches and tools in protracted crises. The central bodies must improve coordination with the stakeholders and, most importantly, strategic planning. Establishing or utilizing an independent planning committee, with financial and administrative independence, is crucial to maintain and improving contextual governance mechanisms in Northwest Syria.
Quantitative proteomic and phosphoproteomic analysis reveal the relationship between mitochondrial dysfunction and cytoskeletal remodeling in hiPSC-CMs deficient in PINK1
Authors: Liu Huiwen , Wang Li , Xu Hao , Tan Bin , Yi Qin , Deng Hongrong , Chen Yunxia , He Bolin , Tian Jie , Zhu Jing
Published: August 2023

Background

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are seed cells that can be used for alternative treatment of myocardial damage. However, their immaturity limits their clinical application. Mitochondrial development accompanies cardiomyocyte maturation, and PINK1 plays an important role in the regulation of mitochondrial quality. However, the role and mechanism of PINK1 in cardiomyocyte development remain unclear.

Methods

We used proteomic and phosphoproteomic to identify protein and phosphosite changes in hiPSC-CMs deficient in PINK1. Bioinformatics analysis was performed to identify the potential biological functions and regulatory mechanisms of these differentially expressed proteins and validate potential downstream mechanisms.

Results

Deletion of PINK1 resulted in mitochondrial structural breakdown and dysfunction, accompanied by disordered myofibrils arrangement. hiPSC-CMs deficient in PINK1 exhibited significantly decreased expression of mitochondrial ATP synthesis proteins and inhibition of the oxidative phosphorylation pathway. In contrast, the expression of proteins related to cardiac pathology was increased, and the phosphoproteins involved in cytoskeleton construction were significantly altered. Mechanistically, PINK1 deletion damaged the mitochondrial cristae of hiPSC-CMs and reduced the efficiency of mitochondrial respiratory chain assembly.

Conclusion

The significantly differentially expressed proteins identified in this study highlight the important role of PINK1 in regulating mitochondrial quality in hiPSC-CMs. PINK1-mediated mitochondrial respiratory chain assembly is the basis for mitochondrial function. Whereas the cytoskeleton may be adaptively altered in response to mitochondrial dysfunction caused by PINK1 deletion, inadequate energy supply hinders myocardial development. These findings facilitate the exploration of the mechanism of PINK1 in cardiomyocyte development and guide efforts to promote the maturation of hiPSC-CMs.
Gegen Qinlian decoction (GQD) inhibits ulcerative colitis by modulating ferroptosis-dependent pathway in mice and organoids
Authors: Wang Xue , Quan Jianye , Xiu Chengkui , Wang Jiali , Zhang Jiaqi
Published: August 2023

Background

Gegen Qinlian decoction (GQD) is a classic prescription for treating ulcerative colitis (UC) in traditional Chinese medicine. However, the therapeutic mechanism has not been fully clarified.

Purpose

In the present study, we aimed to evaluate the role of ferroptosis-mediated IEC death in UC treated mice with GQD by using DSS-induced a colitis mouse model and RSL3-induced ferroptosis in intestinal organoids.

Methods

The effects of GQD on DSS-treated colitis were examined via daily body weight, DAI, colon length, HE staining, PAS staining, ZO-1 and Occludin immunohistochemical staining. Ferroptosis was determined by analysis of iron load, MDA, GSH, mitochondrial morphology, and expression of ferroptosis-associated proteins (GPX4, SLC7A11 and ACSL4).

Results

In vivo, GQD administration reduced body weight loss and DAI scores, increased colon length, and improved intestinal histological characteristics and epithelial barrier dysfunction. GQD administration obviously improved the levels of ferroptosis markers (iron load, MDA, GSH, and mitochondrial morphology) and the expression of ferroptosis-associated proteins (GPX4, SLC7A11 and ACSL4). Consistent with in vivo results, GQD administration partially reversed the levels of mtROS, Fe2+ and MDA in intestinal organoids induced by RSL3, and notably improved morphological destruction, histological damage and epithelial barrier dysfunction in organoids.

Conclusions

In this study, we demonstrated that ferroptosis was triggered in DSS-induced experimental colitis and that GQD adiministration could protect against colonic damage and intestinal epithelial barrier dysfunction by inhibiting ferroptosis.
Evaluation of randomized controlled trials: a primer and tutorial for mental health researchers
Authors: Harrer Mathias , Cuijpers Pim , Schuurmans Lea K. J. , Kaiser Tim , Buntrock Claudia , van Straten Annemieke , Ebert David
Published: August 2023

Background

Considered one of the highest levels of evidence, results of randomized controlled trials (RCTs) remain an essential building block in mental health research. They are frequently used to confirm that an intervention “works” and to guide treatment decisions. Given their importance in the field, it is concerning that the quality of many RCT evaluations in mental health research remains poor. Common errors range from inadequate missing data handling and inappropriate analyses (e.g., baseline randomization tests or analyses of within-group changes) to unduly interpretations of trial results and insufficient reporting. These deficiencies pose a threat to the robustness of mental health research and its impact on patient care. Many of these issues may be avoided in the future if mental health researchers are provided with a better understanding of what constitutes a high-quality RCT evaluation.

Methods

In this primer article, we give an introduction to core concepts and caveats of clinical trial evaluations in mental health research. We also show how to implement current best practices using open-source statistical software.

Results

Drawing on Rubin’s potential outcome framework, we describe that RCTs put us in a privileged position to study causality by ensuring that the potential outcomes of the randomized groups become exchangeable. We discuss how missing data can threaten the validity of our results if dropouts systematically differ from non-dropouts, introduce trial estimands as a way to co-align analyses with the goals of the evaluation, and explain how to set up an appropriate analysis model to test the treatment effect at one or several assessment points. A novice-friendly tutorial is provided alongside this primer. It lays out concepts in greater detail and showcases how to implement techniques using the statistical software R, based on a real-world RCT dataset.

Discussion

Many problems of RCTs already arise at the design stage, and we examine some avoidable and unavoidable “weak spots” of this design in mental health research. For instance, we discuss how lack of prospective registration can give way to issues like outcome switching and selective reporting, how allegiance biases can inflate effect estimates, review recommendations and challenges in blinding patients in mental health RCTs, and describe problems arising from underpowered trials. Lastly, we discuss why not all randomized trials necessarily have a limited external validity and examine how RCTs relate to ongoing efforts to personalize mental health care.
Automating Rey Complex Figure Test scoring using a deep learning-based approach: a potential large-scale screening tool for cognitive decline
Authors: Park Jun Young , Seo Eun Hyun , Yoon Hyung-Jun , Won Sungho , Lee Kun Ho
Published: August 2023

Background

The Rey Complex Figure Test (RCFT) has been widely used to evaluate the neurocognitive functions in various clinical groups with a broad range of ages. However, despite its usefulness, the scoring method is as complex as the figure. Such a complicated scoring system can lead to the risk of reducing the extent of agreement among raters. Although several attempts have been made to use RCFT in clinical settings in a digitalized format, little attention has been given to develop direct automatic scoring that is comparable to experienced psychologists. Therefore, we aimed to develop an artificial intelligence (AI) scoring system for RCFT using a deep learning (DL) algorithm and confirmed its validity.

Methods

A total of 6680 subjects were enrolled in the Gwangju Alzheimer’s and Related Dementia cohort registry, Korea, from January 2015 to June 2021. We obtained 20,040 scanned images using three images per subject (copy, immediate recall, and delayed recall) and scores rated by 32 experienced psychologists. We trained the automated scoring system using the DenseNet architecture. To increase the model performance, we improved the quality of training data by re-examining some images with poor results (mean absolute error (MAE) $$\ge$$
≥
5 [points]) and re-trained our model. Finally, we conducted an external validation with 150 images scored by five experienced psychologists.

Results

For fivefold cross-validation, our first model obtained MAE = 1.24 [points] and R-squared ($${R}^{2}$$

R

2

) = 0.977. However, after evaluating and updating the model, the performance of the final model was improved (MAE = 0.95 [points], $${R}^{2}$$

R

2

= 0.986). Predicted scores among cognitively normal, mild cognitive impairment, and dementia were significantly different. For the 150 independent test sets, the MAE and $${R}^{2}$$

R

2

between AI and average scores by five human experts were 0.64 [points] and 0.994, respectively.

Conclusion

We concluded that there was no fundamental difference between the rating scores of experienced psychologists and those of our AI scoring system. We expect that our AI psychologist will be able to contribute to screen the early stages of Alzheimer’s disease pathology in medical checkup centers or large-scale community-based research institutes in a faster and cost-effective way.
Bilateral total hip arthroplasty in a case with fibrous dysplasia: a case report
Authors: Moharrami Alireza , Mirghaderi Peyman , Moazen-Jamshidi Mir Mansour , Hoseini Zare Nima , Sharifpour Sadula , Mortazavi S. M. Javad
Published: August 2023

Background

Fibrous dysplasia (FD) is a benign neoplasm with a broad spectrum of presentations. The treatment of FD in the hip region is controversial among orthopedic surgeons. Several treatment options exist, including curettage and grafting, valgus osteotomy, medial displacement osteotomy, and so on. Performing total hip arthroplasty (THA) on these patients and their subsequent outcome is still in infancy.

Case presentation

The patient is a 32-year-old white female with bilateral proximal femur FD who underwent bilateral THA with long stem implants. A year following surgery, she had no complications and had satisfactory radiological, pain, and functional outcomes.

Conclusion

A bilateral THA with a long stem prosthesis showed promising results when performed following appropriate curettage of the proximal bone in an FD case. A cementless long stem could have enabled better diaphyseal fixation distal to the lesion site.
Similarity-based pairing improves efficiency of siamese neural networks for regression tasks and uncertainty quantification
Authors: Zhang Yumeng , Menke Janosch , He Jiazhen , Nittinger Eva , Tyrchan Christian , Koch Oliver , Zhao Hongtao
Published: August 2023

Siamese networks, representing a novel class of neural networks, consist of two identical subnetworks sharing weights but receiving different inputs. Here we present a similarity-based pairing method for generating compound pairs to train Siamese neural networks for regression tasks. In comparison with the conventional exhaustive pairing, it reduces the algorithm complexity from O(n2) to O(n). It also results in a better prediction performance consistently on the three physicochemical datasets, using a multilayer perceptron with the circular fingerprint as a proof of concept. We further include into a Siamese neural network the transformer-based Chemformer, which extracts task-specific features from the simplified molecular-input line-entry system representation of compounds. Additionally, we propose a means to measure the prediction uncertainty by utilizing the variance in predictions from a set of reference compounds. Our results demonstrate that the high prediction accuracy correlates with the high confidence. Finally, we investigate implications of the similarity property principle in machine learning.

Graphical Abstract
Hepatocyte-specific Sox9 knockout ameliorates acute liver injury by suppressing SHP signaling and improving mitochondrial function
Authors: Qin Dan , Wang Rui , Ji Jinwei , Wang Duo , Lu Yuanyuan , Cao Shiyao , Chen Yaqing , Wang Liqiang , Chen Xiangmei , Zhang Lisheng
Published: August 2023

Background and Aims

Sex determining region Y related high-mobility group box protein 9 (Sox9) is expressed in a subset of hepatocytes, and it is important for chronic liver injury. However, the roles of Sox9+ hepatocytes in response to the acute liver injury and repair are poorly understood.

Methods

In this study, we developed the mature hepatocyte-specific Sox9 knockout mouse line and applied three acute liver injury models including PHx, CCl4 and hepatic ischemia reperfusion (IR). Huh-7 cells were subjected to treatment with hydrogen peroxide (H2O2) in order to induce cellular damage in an in vitro setting.

Results

We found the positive effect of Sox9 deletion on acute liver injury repair. Small heterodimer partner (SHP) expression was highly suppressed in hepatocyte-specific Sox9 deletion mouse liver, accompanied by less cell death and more cell proliferation. However, in mice with hepatocyte-specific Sox9 deletion and SHP overexpression, we observed an opposite phenotype. In addition, the overexpression of SOX9 in H2O2-treated Huh-7 cells resulted in an increase in cytoplasmic SHP accumulation, accompanied by a reduction of SHP in the nucleus. This led to impaired mitochondrial function and subsequent cell death. Notably, both the mitochondrial dysfunction and cell damage were reversed when SHP siRNA was employed, indicating the crucial role of SHP in mediating these effects. Furthermore, we found that Sox9, as a vital transcription factor, directly bound to SHP promoter to regulate SHP transcription.

Conclusions

Overall, our findings unravel the mechanism by which hepatocyte-specific Sox9 knockout ameliorates acute liver injury via suppressing SHP signaling and improving mitochondrial function. This study may provide a new treatment strategy for acute liver injury in future.

Graphical Abstract
Indigenous communities and influenza: protocol for a systematic review and meta-analysis
Authors: Alves D. E. , Rogeberg O. , Sattenspiel L. , Mamelund S.
Published: August 2023

Background

Several studies have documented that specific Indigenous groups have been disproportionately affected by previous pandemics. The objective of this paper is to describe the protocol to be used in a review and meta-analysis of the literature on Indigenous groups and influenza. Using this protocol as a guide, a future study will provide a comprehensive historical overview of pre-COVID impact of influenza on Indigenous groups by combining data from the last five influenza pandemics and seasonal influenza up to date.

Methods/principle findings

The review will include peer-reviewed original studies published in English, Spanish, Portuguese, Swedish, Danish, and Norwegian. Records will be identified through systematic literature search in eight databases: Embase, MEDLINE, CINAHL, Web of Science, Academic Search Ultimate, SocINDEX, ASSIA, and Google Scholar. Results will be summarized narratively and using meta-analytic strategies.

Discussion

To our knowledge, there is no systematic review combining historical data on the impact of both seasonal and pandemic influenza on Indigenous populations. By summarizing results within and across Indigenous groups, different countries, and historical periods, as well as research in six different languages, we aim to provide information on how strong the risk for influenza is among Indigenous groups and how consistent this risk is across groups, regions, time, and seasonal versus the specific pandemic influenza strains.

Systematic review registration

PROSPERO CRD42021246391
Checklists for interpreting chest radiographs: a scoping review protocol
Authors: Sethole Khethiwe Margaret , Mshunqane Nombeko , Kekana Mable
Published: August 2023

Introduction

What is known about checklists for interpreting chest radiographs? The question will guide the development of the inclusion criteria for the scoping review. Breaking down the scoping review question will allow the evaluation of inclusion and exclusion criteria for the protocol. The eligibility of the proposed research question will be assessed using the Population or Participants, Concept and Context (PCC) framework.

Background

X-ray reporting can be standardised using checklists. Checklists may reduce the time needed to produce a comprehensive X-ray report and improve the quality and consistency of detecting abnormalities on chest radiographs. This scoping review aims to map the available literature on what is known about checklists for interpreting chest radiographs.

Methods

We will follow the methodological framework for scoping reviews originally described by Arksey and O’Malley. The scoping review will include articles that describe checklists for reducing diagnostic errors, checklists for analysing chest radiographs, checklists for identifying abnormalities on chest radiographs and checklists for reporting chest radiographs in all settings. Search terms are chest radiographs, checklists, and chest X-rays. We will search for peer-reviewed articles and grey literature including dissertations and theses. We will search online databases including Ovid Medline and Ebscohost, to identify articles published in English from 1994 to 2022. The searched articles will undergo two levels of screening, first the title and abstract screening, then a full-text screening by two reviewers. Data from the selected articles will be extracted, using a tested extraction form and charted using the Joanna Briggs Institute guidelines.

Results

The results will be collated, summarised and discussed including any limitations of the included articles. The articles will be summarised in a table, as well as narratively. The distribution of studies will be summarised quantitatively and the numerical analysis will provide an overview and identify knowledge gaps. Content analysis will map different checklists available for chest interpretation.

Discussion

The results of the scoping review will be used to develop a checklist that will be used by medical doctors in collaboration with radiographers working in settings where there are no radiologists on-site, for interpreting chest radiographs.

Systematic review registration

Scoping review protocol registered with Open Science Framework on 27 July 2022. Registration https://doi.org/10.17605/OSF.IO/JS5PQ
φ-fixed point results for nonlinear contractions with an application
Authors: Hu Ju , Liu Xiao-lan , Sun Yan , Deng Jia , Zhang Huan
Published: August 2023

In this paper, using the notion ofw-distance in metric spaces, we introduce two types of nonlinear contractions,$(\iota ,\psi ,\varphi ,\phi ,p)$(ι,ψ,φ,ϕ,p)and rational-$(\iota ,\psi , \varphi ,\phi ,p)$(ι,ψ,φ,ϕ,p)contractions. Based on these contractions, we prove the existence and uniqueness of aφ-fixed point for the corresponding contraction. We also provide some examples to demonstrate the correctness and practicability of our results, along with a numerical experiment. Finally, we apply the obtained results to linear matrix equations and nonlinear Fredholm integral equations.
Short note on a solution with large amplitude for the limiting system arising from the competition-diffusion system
Authors: Kan-on Yukio
Published: August 2023

This paper is concerned with positive solutions of the limiting system arising from the Shigesada–Kawasaki–Teramoto model with large interspecific competition rate. It has previously been suggested that the limiting system has positive solutions with large amplitude for a certain value of parameters. As a first step, the purpose of this paper is to discuss the precise spatial profile of such solutions by employing formal calculations by the singular perturbation technique.
AI-empowered game architecture and application for resource provision and scheduling in multi-clouds
Authors: Yu Lei , Duan Yucong
Published: August 2023

Current deep learning technologies used a large number of parameters to achieve a high accuracy rate, and the number of parameters is commonly more than a hundred million for image-related tasks. To improve both training speed and accuracy in multi-clouds, distributed deep learning is also widely applied. Therefore, reducing the network scale or improving the training speed has become an urgent problem to be solved in multi-clouds. Concerning this issue, we proposed a game architecture in multi-clouds, which can be supported by resource provision and service schedule. Furthermore, we trained a deep learning network, which can ensure high accuracy while reducing the number of network parameters. An adapted game, called flappy bird, is used as an experimental environment to test our neural network. Experimental results showed that the decision logic of the flappy bird, including flight planning, avoidance, and sacrifice, is accurate. In addition, we published the parameters of the neural network, so other scholars can reuse our neural network parameters for further research.
Technology adoption as survival strategy for small and medium enterprises during COVID-19
Authors: Mishrif Ashraf , Khan Asharul
Published: August 2023

Globally, operational capabilities of small and medium enterprises (SMEs) have been immensely affected by the COVID-19 pandemic, forcing many companies to use technology and innovation rather than the more traditional methods of operations. As the extent to which SMEs’ adoption of technological tools is still unknown, this study assesses the technological transformations and the challenges facing SMEs during the pandemic. It also evaluates the levels of customers satisfaction and future technological innovation plans in SMEs. Using quantitative and qualitative primary date, we empirically examine how COVID-19 lockdowns accelerated technology use in Omani SMEs and test eight hypotheses applying paired t test and Pearson’s correlation. Although the impact of the COVID-19 pandemic has been globally felt, this study focuses on the effect of the pandemic on SMEs operating in the logistics and supply chain sector in the Sultanate of Oman. The primary data used was collected through the survey questionnaire and interviews with business owners and company executives covering the period 2020–2021. The results show strong correlations between technology use before and during COVID-19; technology use during COVID-19 and in future; and technology use before COVID-19 and in future. They also reveal that technology adoption has been a successful persistence strategy during the pandemic and that highly digitized SMEs are more likely to adopt industry 4.0 technology. The findings are expected to have practical implications for policy making by investing and developing digital infrastructure to accelerate digital transformation, while company executives appreciating the requirements and benefits of adopting innovation and technology solutions to remain competitive. We acknowledge the limitation of our study to only SMEs in the Sultanate of Oman and within a short period of time during the COVID-19 pandemic. This makes it hard to generalize our findings; hence, we recommend further research in other business sectors and countries in the post-pandemic to corroborate our findings and compare outcomes. To the best of the authors' knowledge, no research has been done on SMEs that consider technological transformation during COVID-19. The study will advance knowledge of the development and adoption of technology in SMEs, as well as their impacts on productivity and efficiency.
Research and technology organizations as entrepreneurship instruments: the case of the Institut National d’Optique in the Canadian optics and photonics industry
Authors: Khelfaoui Mahdi , Bernier Luc
Published: August 2023

Research and technology organizations (RTOs) are studied in the innovation policy literature mainly as providers of R&D services and as intermediaries between universities and the private sector. Through the case of the Institut National d’Optique (INO), Canada’s leading RTO in the optics and photonics industry, we argue that RTOs can also act as entrepreneurs by generating technologies and commercializing them through licensing, technology transfers and spin-offs. By analyzing the broad range of activities undertaken by INO, we also discuss what characteristics make some RTOs more likely to embrace entrepreneurship than others. Those characteristics include the following: renewed access to government funding to build a strong in-house research infrastructure and scientific workforce; strategic R&D planning that incorporates commercial objectives and an environment that encourages a culture of entrepreneurship among employees; the ability to act as the driving force of a network of academic, government and private sector organizations. From a policy perspective, the INO case indicates that the main value of using RTOs as entrepreneurship instruments does not lie in profitability but rather in developing dynamic regional systems of innovation.
Women entrepreneurs’ struggles during the COVID-19 pandemic and their use of social media
Authors: Rahayu Ninik Sri , Masduki  , Ellyanawati E. R. Nur
Published: August 2023

Small and medium enterprises (SMEs) throughout the world are facing a very complicated crisis due to COVID-19 pandemic and other structural challenges. This study is aimed at demonstrating the challenges faced by SMEs, particularly the struggles that women entrepreneurs of SMEs in Indonesia experienced to survive against these structural issues: COVID-19, digital presence and the male-dominated business sector in the country. Focusing on female-owned businesses in Yogyakarta, Indonesia, this paper carefully considers how social media platforms helped these businesses to continue. Using a descriptive quantitative approach, we collected data from 130 respondents and found that the COVID-19 pandemic has severely affected women entrepreneurs—especially those operating small and medium enterprises. They have experienced reduced income due to decreased sales, disrupted supply chains, difficulty paying credit instalments, and lack of access to government assistances. This study further sheds light on social media’s important role in sustaining women-owned businesses. Facebook, WhatsApp, and Instagram have become the new tools through which women promote their products and reach new audiences. To overcome this issue, we advise a stronger government intervention to women-owned SMEs in the post-pandemic. Aside from managing social media for selling, we recommend women-owned small companies to internally intensify digital engagement, promotions, coupled by innovative products and attractive offers such as discounts.