bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of antibiotics and low-crude protein diets on growth performance, health, immune response, and fecal microbiota of growing pigs
Authors: Gomes Maykelly da S , Duarte Marcos E , Saraiva Alysson , de Oliveira Leandro L , Teixeira Lucas M , Rocha Gabriel C
Published: October 2023

This study aimed to investigate the effects of diets with and without antibiotics supplementation and diets with 18.5% and 13.0% crude protein (CP) on growth performance, carcass characteristics, disease incidence, fecal microbiota, immune response, and antioxidant capacity of growing pigs. One hundred and eighty pigs (59-day-old; 18.5 ± 2.5 kg) were distributed in a randomized complete block design in a 2 × 2 factorial arrangement, nine replicates, and five pigs per pen. The factors were CP (18.5% or 13.0%) and antibiotics (none or 100 mg/kg tiamulin + 506 mg/kg oxytetracycline). Medicated diets were fed from days 59 to 73. After that, all pigs were fed their respective CP diets from 73 to 87 days. Data were analyzed using the Mixed procedure in SAS version 9.4. From days 59 to 73, pigs fed antibiotics diets had higher (P < 0.05) average daily feed intake (ADFI), average daily weight gain (ADG), gain to feed ratio (G:F), compared to the diets without antibiotics. From days 73 to 87 (postmedicated period), any previous supplementation of antibiotics did not affect pig growth performance. Overall (days 59 to 87), pigs-fed antibiotics diets had higher (P < 0.05) G:F compared to pigs-fed diets without antibiotics. In all periods evaluated, pigs fed 18.5% CP diets had higher (P < 0.05) ADG and G:F compared to pigs fed 13.0% CP. Pigs fed the 13.0% CP diets had lower (P < 0.05) fecal score and diarrhea incidence than those fed 18.5% CP. Pigs fed 18.5% CP diets had improved (P < 0.05) loin area compared to pigs-fed diets with 13.0% CP. At 66 days of age, pigs-fed antibiotics diets had lower (P < 0.05) alpha diversity estimated with Shannon and Simpson compared to the pig-fed diets without antibiotics. At family level, pigs fed 18.5% CP diets had higher (P < 0.05) relative abundance of Streptococcaceae, and lower (P < 0.05) relative abundance of Clostridiaceae at days 66 and 87 compared with pigs fed 13.0% CP. Pigs-fed antibiotics diets had lower (P < 0.05) immunoglobulin G and protein carbonyl concentrations at day 66 compared to the pigs-fed diets without antibiotics. The reduction of dietary CP from 18.5% to 13.0% reduced the growth performance and loin muscle area of growing pigs, although it was effective to reduce diarrhea incidence. Antibiotics improved growth performance, lowered diarrhea incidence, improved components of the humoral immune response, and reduced microbiota diversity. However, in the postmedicated period, we found no residual effect on the general health of the animals, and considering the overall period, only G:F was improved by the use of antibiotics.
The Nuclear Cap-Binding Complex, a multitasking binding partner of RNA polymerase II transcripts
Authors: Kataoka Naoyuki
Published: October 2023

In eukaryotic cells, RNAs transcribed by RNA polymerase-II receive the modification at the 5′ end. This structure is called the cap structure. The cap structure has a fundamental role for translation initiation by recruiting eukaryotic translation initiation factor 4F (eIF4F). The other important mediator of the cap structure is a nuclear cap-binding protein complex (CBC). CBC consists of two proteins, which are renamed as NCBP1 and NCBP2 (previously called as CBP80/NCBP and CBP20/NIP1, respectively). This review article discusses the multiple roles CBC mediates and co-ordinates in several gene expression steps in eukaryotes.
Pharmacomagnetography assessment of the prokinetic effect on metronidazole absorption
Authors: Soares Guilherme Augusto , Rodrigues Gustavo Serafim , Buranello Lais Pereira , de Oliveira Ricardo Brandt , de Arruda Miranda José Ricardo
Published: October 2023

Objectives

This study aimed to evaluate the effects of prucalopride, a prokinetic agent that acts as a potent serotonin agonist of 5-HT4 receptors, on gastric emptying and small bowel transit and assess its impact on the absorption of metronidazole.

Methods

Six healthy volunteers, three men and three women, aged between 20 and 27 years, with a body weight ranging from 50 to 80 kg, were enrolled in this study. The pharmacokinetics and gastrointestinal transit parameters were evaluated simultaneously through pharmacomagnetography assessment, combining alternating current biosusceptometry and blood analysis.

Key findings

The results showed that prucalopride enhances gastric emptying and small bowel transit when administered orally and significantly impacts the rate of metronidazole absorption, leading to enhanced bioavailability and rapid therapeutic response.

Conclusion

Pharmacomagnetography assessment allows simultaneous tracking of transit by images and is a valuable method for analysing drug absorption using multiple instruments.
UPrimer: A Clade-Specific Primer Design Program Based on Nested-PCR Strategy and Its Applications in Amplicon Capture Phylogenomics
Authors: Li JiaXuan , Han GuangCheng , Tian Xiao , Liang Dan , Zhang Peng
Published: October 2023

Amplicon capture is a promising target sequence capture approach for phylogenomic analyses, and the design of clade-specific nuclear protein-coding locus (NPCL) amplification primers is crucial for its successful application. In this study, we developed a primer design program called UPrimer that can quickly design clade-specific NPCL amplification primers based on genome data, without requiring manual intervention. Unlike other available primer design programs, UPrimer uses a nested-PCR strategy that greatly improves the amplification success rate of the designed primers. We examined all available metazoan genome data deposited in NCBI and developed NPCL primer sets for 21 metazoan groups with UPrimer, covering a wide range of taxa, including arthropods, mollusks, cnidarians, echinoderms, and vertebrates. On average, each clade-specific NPCL primer set comprises ∼1,000 NPCLs. PCR amplification tests were performed in 6 metazoan groups, and the developed primers showed a PCR success rate exceeding 95%. Furthermore, we demonstrated a phylogenetic case study in Lepidoptera, showing how NPCL primers can be used for phylogenomic analyses with amplicon capture. Our results indicated that using 100 NPCL probes recovered robust high-level phylogenetic relationships among butterflies, highlighting the utility of the newly designed NPCL primer sets for phylogenetic studies. We anticipate that the automated tool UPrimer and the developed NPCL primer sets for 21 metazoan groups will enable researchers to obtain phylogenomic data more efficiently and cost-effectively and accelerate the resolution of various parts of the Tree of Life.
Low RNA stability signifies strong expression regulatability of tumor suppressors
Authors: Gao Xinlei , Yi Yang , Lv Jie , Li Yanqiang , Arulsamy Kulandaisamy , Babu Sahana Suresh , Bruno Ivone , Zhang Lili , Cao Qi , Chen Kaifu
Published: October 2023

RNA expression of a gene is determined by not only transcriptional regulation, but also post-transcriptional regulation of RNA decay. The precise regulation of RNA stability in the cell plays an important role in normal development. Dysregulation of RNA stability can lead to diseases such as cancer. Here we found tumor suppressor RNAs tended to decay fast in normal cell types when compared with other RNAs. Consistent with a negative effect of m6A modification on RNA stability, we observed preferential deposition of m6A on tumor suppressor RNAs. Moreover, abundant m6A and fast decay of tumor suppressor RNAs both tended to be further enhanced in prostate cancer cells relative to normal prostate epithelial cells. Further, knockdown of m6A methyltransferase METTL3 and reader YTHDF2 in prostate cancer cells both posed stronger effect on tumor suppressor RNAs than on other RNAs. These results indicated a strong post transcriptional expression regulatability mediated by abundant m6A modification on tumor suppressor RNAs.
ADAR1 links R-loop homeostasis to ATR activation in replication stress response
Authors: Zhang Biao , Li Yi , Zhang Jieyou , Wang Yuejiao , Liang Can , Lu Ting , Zhang Chunyong , Liu Ling , Qin Yan , He Jiahuan , Zhao Xiangnan , Yu Jia , Hao Jihui , Yang Jie , Li Mulin Jun , Yao Zhi , Ma Shuai , Cheng Hui , Cheng Tao , Shi Lei
Published: October 2023

Unscheduled R-loops are a major source of replication stress and DNA damage. R-loop-induced replication defects are sensed and suppressed by ATR kinase, whereas it is not known whether R-loop itself is actively involved in ATR activation and, if so, how this is achieved. Here, we report that the nuclear form of RNA-editing enzyme ADAR1 promotes ATR activation and resolves genome-wide R-loops, a process that requires its double-stranded RNA-binding domains. Mechanistically, ADAR1 interacts with TOPBP1 and facilitates its loading on perturbed replication forks by enhancing the association of TOPBP1 with RAD9 of the 9–1-1 complex. When replication is inhibited, DNA–RNA hybrid competes with TOPBP1 for ADAR1 binding to promote the translocation of ADAR1 from damaged fork to accumulate at R-loop region. There, ADAR1 recruits RNA helicases DHX9 and DDX21 to unwind R-loops, simultaneously allowing TOPBP1 to stimulate ATR more efficiently. Collectively, we propose that the tempo-spatially regulated assembly of ADAR1-nucleated protein complexes link R-loop clearance and ATR activation, while R-loops crosstalk with blocked replication forks by transposing ADAR1 to finetune ATR activity and safeguard the genome.
Changing gender norms and household resource allocation
Authors: Lee Jung Hyuk
Published: October 2023

Traditional gender norms that assume gendered household resource allocation are persistent. What happens when society-wide gender norms begin to change? By collecting newspaper articles about feminism in the past 10 years in Korea and exploiting their region–year variations, we first provide evidence that an explosive increase in newspaper coverage of feminism after the mid-2010s caused a steep change toward egalitarian attitudes among women. Then, we construct a Bartik IV with the newspapers’ market shares and growth of the feminism-related articles to show that the change in women’s perceptions of gender norms induced by the media-influence affected both spouses’ time use in household labor and women’s welfare. The wives influenced by those articles substantially reduced their household labor and outsourced them to the market, while the husbands’ participation did not increase as much. The wives’ marital happiness was improved by replacing housework burdens with shared activities with their husbands.
A mediation analysis of metabolic and inflammatory factors in the severe sleep apnea–coronary heart disease association
Authors: Lin Jing , Sheng Baihe , Zhang Xinyu
Published: October 2023

Background

It is unclear whether metabolic and inflammatory factors mediate the association between severe sleep apnea and coronary heart disease (CHD) in observational studies based on the large-scale population. This study aims to assess the association between severe sleep apnea and CHD and to explore the extent to which this association is mediated by metabolic factors and C-reactive protein (CRP).

Methods

In UK Biobank, 213 442 CHD-free (mean age: 55.00) adults were followed up for 15 years to detect incident CHD. Metabolic factors included hyperglycemia, hypertension, dyslipidemia, hypertriglyceridemia, and hyperuricemia. A higher CRP concentration level was defined as a cutoff point of >3.0 mg/l. Data were analyzed using Cox proportional hazards models and the generalized structural equation model.

Results

During follow-up, 9278 participants developed incident CHD (4.3%). The multi-adjusted hazard ratio and 95% confidence interval of CHD related to severe sleep apnea were 1.76 (1.44–2.15). In the mediation analysis, the strongest indirect association was for dyslipidemia, accounting for 20.8% of the association between severe sleep apnea and CHD (β = 0.22, 95% confidence interval = 0.16–0.28), followed by hypertriglyceridemia (12.3%). The proportion of mediation increased to 29.1% when CRP was added to the metabolic mediators.

Conclusions

Severe sleep apnea was associated with an increased risk of CHD. Lipid factors might play an essential role in the severe sleep apnea–CHD relationship. CRP increased the magnitude of mediation effects of overall metabolic factors.

What is already known on this topic It is unknown whether the association between severe sleep apnea and CHD among the large population-based cohort study. Evidence on the mediating effect of metabolic and inflammatory factors in the severe sleep apnea-CHD association remains unclear. What this study adds Lipid factors were the biggest mediation driver in the severe sleep apnea–CHD path. C-reactive protein increased the magnitude of mediation effects of overall metabolic factors. How this study might affect research, practice or policy Investigating mediation analyses not only enhances comprehension of the pathophysiological connection between severe sleep apnea and CHD but also offers valuable insights into preventing CHD.
Reduced muscle strength is closely linked to computed tomography-defined myosteatosis among inpatients with cirrhosis
Authors: Sun Chao , Zhao Tianming , Yang Wanting , Guo Gaoyue , Wang Han , Li Chaoqun , Hui Yangyang , Cui Binxin , Wang Xiaoyu , Fan Xiaofei , Zhao Xingliang
Published: October 2023

Background

Myosteatosis indicates pathological fat infiltration in muscles and is regarded as a distinct disease from sarcopenia. This muscular condition exhibits a link to muscle fiber disarrangement coinciding with disrupted muscle contractility and weakened mechanical action, mirrored as decreased muscle quality. However, the relationship between handgrip strength (HGS) and computed tomography-defined myosteatosis among cirrhosis is unclear. We aimed to investigate the association between HGS and myosteatosis and determine gender-specific cutoffs regarding HGS to identify myosteatotic subjects.

Methods

We prospectively recruited 221 cirrhotic patients. The presence of myosteatosis was determined according to intramuscular adipose tissue content. The relationship between HGS and myosteatosis was evaluated according to Spearman correlation coefficient, area under the ROC curve, and multivariate logistic regression analysis. Moreover, a model based on the classification and regression tree method was generated.

Results

Our results showed that HGS exhibits modestly negative correlation with intramuscular adipose tissue content in the entire cohort (rs = −0.269, P < .001) and across diverse subgroups precluding extremely deteriorating conditions. After controlling for multiple clinical features and biochemical parameters, HGS (odds ratio = 0.921, P = .010) was independently associated with myosteatosis in addition to age and body mass index. On applying the Japan Society of Hepatology-recommended cutoffs, an area under the ROC curve of HGS was 0.627 with a sensitivity of 77.4% and a specificity of 47.9%. The decision tree including body mass index and low HGS correctly classified ~85% of the cases in development and validation sets.

Conclusions

HGS was in close relation to myosteatosis among inpatients with cirrhosis.
The effect of applied research institutes on invention: Evidence from the Fraunhofer centres in Europe
Authors: Llanos-Paredes Pedro
Published: October 2023

This study examines the impact of the Fraunhofer Society, Europe’s largest network of applied research institutes, on patent applications. A difference-in-differences strategy was employed exploiting the establishment of five new Fraunhofer centres in the 2000s. The panel includes 65,963 European applicants (both firms and independent inventors) between 1980 and 2019. The results show that establishing a centre increases patent output by at least 13%, robust to using applicants of cities that established a centre by the end of the 2010s as an alternative control group. The effect is driven by an increase in applicants’ productivity and not by agglomeration dynamics.
Evidence for Reduced Sensory Precision and Increased Reliance on Priors in Hallucination-Prone Individuals in a General Population Sample
Authors: Benrimoh David , Fisher Victoria L , Seabury Rashina , Sibarium Ely , Mourgues Catalina , Chen Doris , Powers Albert
Published: October 2023

Background

There is increasing evidence that people with hallucinations overweight perceptual beliefs relative to incoming sensory evidence. Past work demonstrating prior overweighting has used simple, nonlinguistic stimuli. However, auditory hallucinations in psychosis are often complex and linguistic. There may be an interaction between the type of auditory information being processed and its perceived quality in engendering hallucinations.

Study Design

We administered a linguistic version of the conditioned hallucinations (CH) task to an online sample of 88 general population participants. Metrics related to hallucination-proneness, hallucination severity, stimulus thresholds, and stimulus detection rates were collected. Data were used to fit parameters of a Hierarchical Gaussian Filter (HGF) model of perceptual inference to determine how latent perceptual states influenced task behavior.

Study Results

Replicating past results, higher CH rates were observed both in those with recent hallucinatory experiences as well as participants with high hallucination-proneness; CH rates were positively correlated with increased prior weighting; and increased prior weighting was related to hallucination severity. Unlike past results, participants with recent hallucinatory experiences as well as those with higher hallucination-proneness had higher stimulus thresholds, lower sensitivity to stimuli presented at the highest threshold, and had lower response confidence, consistent with lower precision of sensory evidence.

Conclusions

We replicate the finding that increased CH rates and recent hallucinations correlate with increased prior weighting using a linguistic version of the CH task. Results support a role for reduced sensory precision in the interplay between prior weighting and hallucination-proneness.
Beyond Clueless Mothers: Israeli “Women Wage Peace” Activists’ Perceptions of Why Women Are Key to Peacemaking
Authors: Halperin Liv
Published: October 2023

Focusing on a contemporary peace movement in Israel, Women Wage Peace (WWP), this article studies female Jewish and Arab-Palestinian activists to understand if/why they believe in women’s peacefulness and why they chose a women-led movement. While not challenging the idea of women’s peacefulness, the activists’ testimonies shed light on various explanations behind the “women and peace hypothesis,” beyond maternal arguments. Despite a militaristic/patriarchal context where maternal collective action frames are culturally resonant, some activists refuse to be reduced to one-dimensional mothers. The article also finds that through caring practices, WWP creates a unique feeling of belonging, including for Arab-Palestinian activists experiencing a deficit of belonging. The article draws on qualitative methodologies, interviews, and ethnographic work conducted in 2019–2020. Implications include the value for women’s peace movements to use both maternal and feminine collective action frames, decoupled from motherhood, and to actively create “safe spaces” where women feel that they belong.
Biocontrol Agents of Fusarium Head Blight in Wheat: A Meta-Analytic Approach to Elucidate Their Strengths and Weaknesses
Authors: Risoli Samuele , Cotrozzi Lorenzo , Pisuttu Claudia , Nali Cristina
Published: October 2023

The use of biocontrol agents (BCAs) coping with fungal pathogens causing Fusarium head blight (FHB) is a compelling strategy for disease management, but a better elucidation of their effectiveness is crucial. Meta-analysis is the analysis of the results of multiple studies, which is typically performed to synthesize evidence from many possible sources in a formal probabilistic manner. This meta-analytic study, including 30 pathometric, biometric, physiochemical, genetic, and mycotoxin response variables reported in 56 studies, evidences the BCA effects on FHB in wheat. The effectiveness of BCAs of FHB in wheat in terms of pathogen abundance and disease reductions, biomass and yield conservation, and mycotoxin prevention/control was confirmed. BCAs showed higher efficacy (i) in studies published more recently; (ii) under controlled conditions; (iii) in high susceptible wheat cultivars; (iv) when Fusarium inoculation and BCA treatment did not occur directly on the plant (i.e., at the seed and kernel levels) in terms of disease development and mycotoxin control, and vice versa in terms of biomass conservation; (v) if Fusarium inoculation and BCA treatment occurred by spraying spikes in terms of yield; (vi) at 15 to 21 days post Fusarium inoculation or BCA treatment; and (vii) if they were filamentous fungi. However, BCAs overall were less efficacious than conventional agrochemicals, especially in terms of pathogen abundance and FHB reductions, as well as of mycotoxin prevention/control, although inconsistencies were reported among the investigated moderator variables. This study also highlights the complexity of reaching a good balance among BCA effects, and the need for further research.
Simulation Software to Plan the Treatment of Acetabular Fractures: The Patient-Specific Biomechanical Model
Authors: Boudissa Mehdi , Sauzeat Bérengère , Noblet Baptiste , Tonetti Jérôme , Chabanas Matthieu
Published: October 2023

Objectives:

The objective of this study was to assess the impact of using simulation software for preoperative planning: a patient-specific biomechanical model (PSBM) in acetabular surgery. The secondary objectives were to assess operating time, intraoperative bleeding, and peroperative complications.

Design:

This is a prospective control study.

Setting:

Level 1 trauma center.

Patients/Participants:

Between January 2019 and December 2022, patients with operative acetabular fracture treated by the first author were prospectively enrolled.

Intervention:

Patients were divided into 2 groups according to the use or not of PSBM for preoperative planning. When PSBM was used, data were extracted from the preoperative high-resolution computed tomography scans to build a biomechanical model implemented in a custom software [simulation (SIM group)]. When computed tomography scans were not performed in our hospital, PSBM was not feasible (non-SIM group).

Main Outcome Measurements:

Radiological results, surgery duration, blood loss, and peroperative complications were recorded.

Results:

Sixty-six patients were included; 26 in the PSBM group and 40 in the standard group. The 2 groups were comparable regarding fracture patterns and epidemiological data. After simulation, in the SIM group, a poor reduction (>3 mm) was found in 2 of 26 patients (7.7%) versus 11 of 40 patients (27.5%) in the non-SIM group, P = 0.048. The mean operative time was shorter after simulation (110 minutes vs. 155 minutes, P = 0.01), and the mean blood loss was reduced (420 vs. 670 mL, P = 0.01).

Conclusions:

By reducing the peroperative trials for reduction, PSBM allows better reduction in a shorter operative time and with less blood loss.

Level of Evidence:

Level II: prospective study.
A machine learning model for diagnosing acute pulmonary embolism and comparison with Wells score, revised Geneva score, and Years algorithm
Authors: Xi Linfeng , Kang Han , Deng Mei , Xu Wenqing , Xu Feiya , Gao Qian , Xie Wanmu , Zhang Rongguo , Liu Min , Zhai Zhenguo , Wang Chen
Published: October 2023

Background:

Acute pulmonary embolism (APE) is a fatal cardiovascular disease, yet missed diagnosis and misdiagnosis often occur due to non-specific symptoms and signs. A simple, objective technique will help clinicians make a quick and precise diagnosis. In population studies, machine learning (ML) plays a critical role in characterizing cardiovascular risks, predicting outcomes, and identifying biomarkers. This work sought to develop an ML model for helping APE diagnosis and compare it against current clinical probability assessment models.

Methods:

This is a single-center retrospective study. Patients with suspected APE were continuously enrolled and randomly divided into two groups including training and testing sets. A total of 8 ML models, including random forest (RF), Naïve Bayes, decision tree, K-nearest neighbors, logistic regression, multi-layer perceptron, support vector machine, and gradient boosting decision tree were developed based on the training set to diagnose APE. Thereafter, the model with the best diagnostic performance was selected and evaluated against the current clinical assessment strategies, including the Wells score, revised Geneva score, and Years algorithm. Eventually, the ML model was internally validated to assess the diagnostic performance using receiver operating characteristic (ROC) analysis.

Results:

The ML models were constructed using eight clinical features, including D-dimer, cardiac troponin T (cTNT), arterial oxygen saturation, heart rate, chest pain, lower limb pain, hemoptysis, and chronic heart failure. Among eight ML models, the RF model achieved the best performance with the highest area under the curve (AUC) (AUC = 0.774). Compared to the current clinical assessment strategies, the RF model outperformed the Wells score (P = 0.030) and was not inferior to any other clinical probability assessment strategy. The AUC of the RF model for diagnosing APE onset in internal validation set was 0.726.

Conclusions:

Based on RF algorithm, a novel prediction model was finally constructed for APE diagnosis. When compared to the current clinical assessment strategies, the RF model achieved better diagnostic efficacy and accuracy. Therefore, the ML algorithm can be a useful tool in assisting with the diagnosis of APE.
“Three medicines and three formulas” in COVID-19: from bench to bedside
Authors: Xiao Guangxu , Wang Simeng , Wang Ruijiao , Tan Li , Ma Shibo , He Shuang , Fan Guanwei , Zhu Yan , Lyu Ming
Published: October 2023

Chinese guideline has proven effective in the fight against coronavirus disease 2019 (COVID-19) during the global spread of the epidemic. Traditional Chinese medicine (TCM) is widely recognized for its effectiveness in alleviating symptoms, inhibiting disease progress, reducing mortality, and improving the cure rate of patients with COVID-19. During the pandemic, “three medicines and three formulas” (TMTFs) stood out from hundreds of others in registered clinical studies, which became highly recommended as TCM for COVID-19 treatment. The TMTFs not only effectively relieve the clinical symptoms of fever, cough, fatigue, and phlegm, but also substantially shorten the time of nucleic acid negative conversion, improve lung computed tomography imaging features and inflammation, ameliorate clinical biochemical indicators, and reduce sequelae. Their potential pharmacological mechanisms are mainly related to the crosstalk between viral toxicity, endothelial damage, cytokine storm, immune response, and microthrombus. In brief, the clinical effects and the potential mechanisms of TMTFs on COVID-19 were systematically analyzed and summarized covering the entirety of disease development, including virus invasion and replication, immune response and cytokine storm, and acute respiratory distress syndrome and multiple organ dysfunction syndrome. This review provides a theoretical basis and reference for the in-depth understanding of the positive role of TMTFs in COVID-19 treatment.
Development and validation of an interpretable markov-embedded multi-label model for predicting risks of multiple postoperative complications among surgical inpatients: A multicenter prospective cohort study
Authors: Yu Xiaochu , Zhang Luwen , He Qing , Huang Yuguang , Wu Peng , Xin Shijie , Zhang Qiang , Zhao Shengxiu , Sun Hong , Lei Guanghua , Zhang Taiping , Jiang Jingmei
Published: October 2023

Background:

When they encounter various highly related postoperative complications, existing risk evaluation tools that focus on single or any complications are inadequate in clinical practice. This seriously hinders complication management because of the lack of a quantitative basis. An interpretable multi-label model framework that predicts multiple complications simultaneously is urgently needed.

Materials and Methods:

We included 50,325 inpatients from a large multicenter cohort (2014–2017). We separated patients from one hospital for external validation and randomly split the remaining patients into training and internal validation sets. A MARKov-EmbeDded (MARKED) multi-label model was proposed, and three models were trained for comparison: binary relevance (BR), a fully connected network (FULLNET), and a deep neural network (DNN). Performance was mainly evaluated using the area under the receiver operating characteristic curve (AUC). We interpreted the model using Shapley Additive Explanations. Complication-specific risk and risk source inference were provided at the individual level.

Results:

There were 26,292, 6574, and 17,459 inpatients in the training, internal validation, and external validation sets, respectively. For the external validation set, MARKED achieved the highest average AUC (0.818, 95% confidence interval: 0.771–0.864) across eight outcomes (compared with BR, 0.799 [0.748–0.849], FULLNET, 0.806 [0.756–0.856], and DNN, 0.815 [0.765–0.866]). Specifically, the AUCs of MARKED were above 0.9 for cardiac complications (0.927 [0.894–0.960]), neurological complications (0.905 [0.870–0.941]), and mortality (0.902 [0.867–0.937]). Serum albumin, surgical specialties, emergency case, American Society of Anesthesiologists score, age, and sex were the six most important preoperative variables. The interaction between complications contributed more than the preoperative variables, and formed a hierarchical chain of risk factors, mild complications, and severe complications.

Conclusion:

We demonstrated the advantage of MARKED in terms of performance and interpretability. We expect that the identification of high-risk patients and inference of the risk source for specific complications will be valuable for clinical decision-making.
Prediction of reported monthly incidence of hepatitis B in Hainan Province of China based on SARIMA-BPNN model
Authors: Fang Kang , Cao Li , Fu Zhenwang , Li Weixia
Published: October 2023

In recent years, the incidence of hepatitis B has been serious in Hainan Province of China. To construct a statistical model of the monthly incidence of hepatitis B in Hainan Province of China and predict the monthly incidence of hepatitis B in 2022. Simple central moving average method and seasonal index were used to analyze the trend and seasonal effects of monthly incidence of hepatitis B. Based on the time series of reported monthly incidence of hepatitis B in Hainan Province from 2017 to 2020, a multiplicative seasonal model (SARIMA), multiplicative seasonal model combined with error back propagation neural network model (SARIMA-BPNN), and a gray prediction model were constructed to fit the incidence, and the time series of monthly incidence of hepatitis B in 2021 was used to verify the accuracy of models. The lowest and highest monthly incidence of hepatitis B in Hainan Province were in February and August, respectively, and MAPE of SARIMA, SARIMA-BPNN, and gray prediction models were 0.089, 0.087, and 0.316, respectively. The best fitting model is the SARIMA-BPNN model. The predicted monthly incidence of hepatitis B in 2022 showed a downward trend, with the steepest decline in March, which indicates that the prevention and control of hepatitis B in Hainan Province is effective, and the study can provide scientific and reasonable suggestions for the prevention and control of hepatitis B in Hainan.
Noninvasive external therapy of traditional Chinese medicine for preventing postpartum urinary retention in women with vaginal delivery: A network meta-analysis
Authors: Chen Hua-Ting , Luo Tai-Zhen , Jiang Zi-Yan , Dai Si-Di , Xia Hua-An , Yang Shuai , Huang Shi-Ying , Chen Li-Ping
Published: October 2023

Background:

To compare the effect of different noninvasive external therapies of traditional Chinese medicine (TCM) on the prevention of postpartum urinary retention (PUR) using a network meta-analysis (NMA).

Methods:

A search of the China National Knowledge Infrastructure, WanFangDate, VIP, China Biomedical Literature Database, PubMed, The Cochrane Library, Embase, and Web of Science databases were reviewed for related randomized controlled trials dated between database inception and December 31, 2022, on the prevention of PUR by noninvasive TCM. Two researchers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies; then, a NMA was performed using Revman5.3 software, State13.1 software, and frequency methodology.

Results:

In total, 16 studies involving 3637 cases of parturients and 9 types of noninvasive TCM external treatments were incorporated into the NMA. The NMA results show that based on routine nursing, in terms of reducing the incidence of urinary retention, acupoint compressing combined with auricular acupressure is ranked first, followed by acupoint hot compress, acupoint massage combined with auricular acupressure, Yin-Yang therapy, acupoint massage, auricular acupressure, acupoint compressing, and routine nursing. In terms of urination time, acupoint compressing combined with auricular acupressure ranked first, followed by acupoint massage combined with auricular acupressure, acupoint electrical stimulation, acupoint compressing, TCM heating therapy, acupoint massage, auricular acupressure, and routine nursing. In terms of reducing residual urine volume after the first urination, acupoint compressing combined with auricular acupressure was ranked first, followed by auricular acupressure, acupoint compressing, acupoint massage, TCM heating therapy, and routine nursing.

Conclusion:

Current evidence shows that acupoint compressing combined with auricular acupressure may be the best noninvasive TCM treatment for preventing PUR based on routine nursing; however, further high-quality clinical randomized controlled trials are needed for validation and support.
Development and validation of prediction model for early warning of ovarian metastasis risk of endometrial carcinoma
Authors: Zhao Qin , Li Yinuo , Wang Tiejun
Published: October 2023

Ovarian metastasis of endometrial carcinoma (EC) patients not only affects the decision of the surgeon, but also has a fatal impact on the fertility and prognosis of patients. This study aimed build a prediction model of ovarian metastasis of EC based on machine learning algorithm for clinical diagnosis and treatment management guidance. We retrospectively collected 536 EC patients treated in Hubei Cancer Hospital from January 2017 to October 2022 and 487 EC patients from Tongji Hospital (January 2017 to December 2020) as an external validation queue. The random forest model, gradient elevator model, support vector machine model, artificial neural network model (ANNM), and decision tree model were used to build ovarian metastasis prediction model for EC patients. The predictive efficacy of 5 machine learning models was evaluated by receiver operating characteristic curve and decision curve analysis. For screening of candidate predictors of ovarian metastasis of EC, the degree of tumor differentiation, lymph node metastasis, CA125, HE4, Alb, LH can be used as a potential predictor of ovarian metastasis prediction model in EC patients. The effectiveness of the prediction model constructed by the 5 machine learning algorithms was between (area under curve [AUC]: 0.729, 95% confidence interval [CI]: 0.674–0.784) and (AUC: 0.899, 95% CI: 0.844–0.954) in the training set and internal verification set, respectively. Among them, the ANNM was equipped with the best prediction effectiveness (training set: AUC: 0.899, 95% CI: 0.844–0.954) and (internal verification set: AUC: 0.892, 95% CI: 0.837–0.947). The prediction model of ovarian metastasis of EC patients based on machine learning algorithm can achieve satisfactory prediction efficiency, among which ANNM is the best, which can be used to guide clinicians in diagnosis and treatment and improve the prognosis of EC patients.
Analysis of sagittal parameters for easier and more accurate determination of cervical spine alignment
Authors: Oh Byeong Ho , Kim Jee Yong , Lee Jong Beom , Kim Il Sup , Hong Jae Taek , Sung Jae Hoon , Lee Ho Jin
Published: October 2023

Cross-sectional comparative study. This study aimed to analyze the role of cervical parameters, in terms of the perception process, when evaluating cervical sagittal balance on an X-ray image. Reports on the role of cervical parameters in the perception of cervical sagittal balance have not been made. The study included 4 board-certified neurosurgeons and 6 residents of a neurosurgical department. They were instructed to answer a total of 40 questions. The parameter that was the most helpful in deriving the answer was checked. The correct answer rate, dependency on the parameter, and correct answer contribution of the parameter were analyzed. Among the various parameters, 5 parameters [C2-7 angle (C2-7A), T1 slope minus cervical lordosis (T1s-CL), C2 slope (C2s), C7 slope (C7s), and C2-7 sagittal vertical axis) were selected. The simple parameter (C2s, C7s) has a higher dependency and correct answer contribution than the complex parameter (C2-7A, T1s-CL). The angular (C2-7A, T1s-CL, C2s, C7s) parameters have a higher dependency; however, both the length and angular parameters correct answer contribution were similar. The cervical parameters that have simpler properties were highly preferred and had a lower perception error.
The Role of RARG rs2229774, SLC28A3 rs7853758, and UGT1A6*4 rs17863783 Single-nucleotide Polymorphisms in the Doxorubicin-induced Cardiotoxicity in Solid Childhood Tumors
Authors: Gündüz Abdullah , Duman Derya , Başbinar Yasemin , Taşdelen Bahar , Küpeli Serhan , Karpuz Derya
Published: October 2023

Background:

The objective of our study was to determine the role of retinoic acid receptor gamma (RARG) rs2229774, SLC28A3 rs7853758, and UGT1A6*4 rs17863783 single-nucleotide polymorphisms in identifying the risk of doxorubicin-induced cardiotoxicity in pediatric solid tumors.

Methods:

A total of 60 pediatric patients who had completed their treatment at least 2 years ago and 50 healthy children matched for age and sex were included in the study. All patients were evaluated for cardiotoxicity by echocardiography. The blood samples were analyzed for RARG rs2229774, SLC28A3 rs7853758, and UGT1A6*4 rs17863783 polymorphisms. Demographic characteristics, echocardiographic parameters, and genetic results of both groups were evaluated.

Results:

In our study, the RARG rs2229774 AA genotype was associated with cardiotoxicity (P=0.017). The SLC28A3 rs7853758 AA+GA genotype was detected more frequently in patients who did not develop cardiotoxicity (P<0.023). Furthermore, the frequency of the SLC28A3 rs7853758 A allele was significantly lower in the cardiotoxicity group (P<0.025).

Conclusions:

This is the first study in the Turkish population to investigate the correlation between the cardiotoxicity risk and 3 marker genes, which are recommended in the pharmacogenetic guideline for risk assessment in pediatric doxorubicin patients. The gene polymorphism that we investigated in this study was useful for the early prediction of cardiotoxicity risk.
Conducting a Comprehensive Assessment of the Public Health Workforce: Lessons Learned and Opportunities for the Future
Authors: Yeager Valerie A. , Hilts Katy Ellis , Dearth Shandy , Sanner Lindsey , McNamee Cassidy , Duszynski Thomas
Published: October 2023

Indiana was one of the earliest states to conduct a comprehensive public health workforce assessment in preparation for the use of federal funds for infrastructure strengthening. Experiences from this assessment provide insights that may be useful to other public health agencies and partners. This brief summarizes key lessons and highlights opportunities for improved workforce assessments. For example, the lack of standardized job titles within local health departments (LHDs) can be mitigated by collecting the top 3 job tasks employees engage in daily and reassigning standardized titles based on nationally collected workforce data. This facilitates comparisons across LHD employees nationally. In addition, many employees felt their job tasks did not align well with the Foundational Public Health Services (FPHS) areas and capabilities, which contributed to the likely overestimation of effort. Further consideration of how to better align and/or integrate FPHS assessment within current practice is needed in addition to improved ways of assessing efforts toward FPHS.
Estimates of HIV testing at visits to United States emergency departments
Authors: Clay Carson E. , Hoover Karen W. , Le Guen Yann , Bennett Christopher L.
Published: October 2023

Objectives:

Emergency department-based HIV testing rates are historically low, but recent testing trends surrounding the COVID-19 pandemic and launch of the Ending the HIV Epidemic (EHE) initiative are unknown. The objective of the study is to estimate recent trends in the proportion of emergency department visits that included HIV testing.

Methods:

We performed a cross-sectional analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS), a weighted nationally representative survey of US emergency departments, from 2014 to 2020. Given EHE's focus on several rural Southern jurisdictions as well as populations disproportionately affected by HIV, we stratified by characteristics including US region and visit-listed race and ethnicity.

Results:

The proportion of emergency department visits that included HIV testing increased from 2014 (0.6%) to 2018 (1.1%) but was lower in 2019 and 2020 (0.8%). Compared with other regions, the South had the lowest rates of testing in both 2019 (0.6%) and 2020 (0.5%); testing rates in the nonmetropolitan South remained 0.1% or less across all years. Testing rates for emergency department visits by persons who identified as Hispanic/Latino were highest in 2018 (2.2%) but were sharply lower in 2019 and 2020 (0.8%).

Conclusion:

After a small but insufficient increase in emergency department-based HIV testing since 2014, rates decreased between 2018 and 2019 and were stable between 2019 and 2020. Overall, very few emergency department visits during our entire study period included an HIV test, and there were persistently low rates of HIV testing for populations prioritized in national efforts and during visits in rural jurisdictions in the South.
Nonviral Liver Disease Burden in People Living With HIV and Elevated Transaminases: A Cross-Sectional Study
Authors: Katarey Dev , Tan Yishi , Mourad Adele , Potts Jonathan R. , Vickers Laura , Beksinska Alicja , Sharp Harriet , Parnell Bethany , Gilleece Yvonne , Verma Sumita
Published: October 2023

Introduction:

Because of improved life expectancy in people living with HIV (PLWH), liver disease is increasingly being recognized. We assessed nonviral chronic liver disease burden in PLWH.

Methods:

The HIV non-virAL liver disease study (2014–2021) prospectively recruited PLWH with elevated serum alanine aminotransferase levels and negative hepatitis serology. Clinically significant hepatic fibrosis (CSHF) was defined as liver stiffness measurement of >7.1 kPa and hazardous alcohol use as Alcohol Use Disorders Identification Test score ≥ 8. Primary outcome was prevalence/predictors of CSHF.

Results:

Total recruited were n = 274, 92% male, median age 52 (45–59) years, and 96% having undetectable HIV viral load. Overall, n = 97 (35%) had hazardous alcohol use, n = 72 (26%) had metabolic syndrome, and 17%–27% had exposure to hepatotoxic antiretrovirals. Prevalence of CSHF was 20% (n = 54), prevalence of cirrhosis (liver stiffness measurement > 12.5 kPa) being 7% (19/274). Risk factors for CSHF were hazardous alcohol use in 44% (n = 24), metabolic syndrome in 46% (n = 25), and hepatotoxic antiretrovirals in 56% (n = 30), most having more than one risk factor. Independent predictors of CSHF were serum high-density lipoprotein (odds ratio [OR] 0.220; 95% confidence interval [CI]: 0.061 to 0.790, P = 0.020) (inverse relationship); serum aspartate aminotransferase (OR 1.033, 95% CI: 1.001 to 1.067, P = 0.045), and didanosine use (OR 2.878, 95% CI: 1.228 to 6.774, P = 0.015). Moderate–severe hepatic steatosis was identified in 52% (n = 142). FIB-4 and aspartate aminotransferase-to-platelet ratio index performed poorly in predicting CSHF (positive predictive value 27.3% and 30.6%, respectively) and advanced fibrosis (≥F3) (positive predictive value 17.6% and 5.9%, respectively).

Conclusion:

In this study, 20% of PLWH had CSHF associated with high prevalence of hazardous alcohol use/metabolic syndrome/potentially hepatotoxic antiretrovirals. These potentially modifiable risk factors need addressing.
Estimating the Cost-Effectiveness of HIV Self-Testing in the United States Using Net Benefit Regression
Authors: Islam Md Hafizul , Shrestha Ram K. , Hoch Jeffrey S. , Farnham Paul G.
Published: October 2023

Background:

Cost-effectiveness analysis of HIV self-testing using patient-level data from a randomized clinical trial can inform HIV prevention funding decisions. Cost-effectiveness analysis using net-benefit regression addresses the sampling uncertainty in the trial data and the variability of policymakers' willingness to pay (WTP).

Methods:

We used published data from a 12-month longitudinal randomized clinical trial that enrolled 2665 men who had sex with men randomly assigned to the self-testing arm (participants receiving self-test kits) and control arm (participants receiving standard-of-care), and the self-testing arm identified 48 additional new HIV cases. We used net-benefit regression to investigate the cost-effectiveness of an HIV self-testing intervention, which compared the incremental cost per new HIV diagnosis with policymakers' WTP thresholds. We addressed the uncertainties in estimating the incremental cost and the policymakers' WTP per new diagnosis through the incremental net-benefit (INB) regression and cost-effectiveness acceptability curve (CEAC) analyses.

Results:

From the health care provider's perspective, the INB analysis showed a positive net benefit of HIV self-testing compared with standard-of-care when policymakers' WTP per new HIV diagnosis was $9365 (95% confidence interval: $5700 to $25,500) or higher. The CEAC showed that the probability of HIV self-testing being cost-effective compared with standard-of-care was 58% and >99% at a WTP of $10 000 and $50 000 per new HIV diagnosis, respectively.

Conclusion:

The INB and CEAC analyses suggest that HIV self-testing has the potential to be cost-effective for relatively low values of policymakers' WTP.
Impact of the COVID-19 Pandemic on Lung Cancer Screening Processes in a Northeast Tertiary Health Care Network
Authors: Udelsman Brooks V. , Detterbeck Frank , Tanoue Lynn , Mase Vincent , Boffa Daniel , Blasberg Justin , Dhanasopon Andrew , Ely Sora , Mazzarelli Louis J. , Bader Anna , Woodard Gavitt
Published: October 2023

The coronavirus disease 2019 (COVID-19) pandemic disrupted health care systems, including implementation of lung cancer screening programs. The impact and recovery from this disruption on screening processes is not well appreciated. Herein, the radiology database of a Northeast tertiary health care network was reviewed before and during the pandemic (2013–2022). In the 3 months before the pandemic, an average of 77.3 lung cancer screening with computed tomography scans (LCS-CT) were performed per month. The average dropped to 23.3 between April and June of 2020, whereas COVID-19 hospitalizations peaked at 1604. By July, average hospitalizations dropped to 50, and LCS-CTs rose to >110 per month for the remaining year. LCS-CTs did not decline during COVID-19 surges in December of 2021 and 2022. The LCS-CT performance grew by 4.5% in 2020, 69.6% in 2021, and 27.0% in 2022, exceeding projected growth by 722 examinations. This resiliency indicates a potentially smaller impact of COVID-19 on lung cancer diagnoses than initially feared.