bluuebunny/crossref_metadata_2025 huggingface dataset:
What Information Do Neuropsychologists Use to Guide their Clinical Decisions? A Survey on Knowledge and Application of Evidence-Based Practice in a French-Speaking Population
Authors: Blause Sacha , Tirelli Ezio , Wauquiez Grégoire , Raffard Stéphane , Didone Vincent , Willems Sylvie
Published: August 2023

Objective

Evidence-based practice (EBP) is an approach that encourages clinicians to base their practice on evidence to improve the quality of patient care and reduce uncertainty in their clinical decisions. However, the state of knowledge and practice of neuropsychologists in French-speaking countries is still unknown. This study aimed to find out what these neuropsychologists know about EBP and whether they use it.

Method

A questionnaire with 39 questions for French-speaking neuropsychologists was distributed. The questions focused on neuropsychologists’ knowledge and use of EBP and information that guide their clinical decisions.

Results

A total of 392 respondents started the survey. The data show that only 35% correctly defined EBP and there was confusion between this practice and the strict use of research data. In practice, their decisions are influenced by multiple factors, including the patient’s difficulties and advice from peers. Regarding the research, a significant proportion of the sample stated that they did not search the scientific literature frequently. Barriers to accessing scientific information and ineffective article-reading behavior were highlighted.

Conclusion

A lack of knowledge of EBP among French-speaking neuropsychologists was observed. Furthermore, the factors influencing their decision-making do not clearly fit the definitions of EBP. Information-seeking behaviors show several weaknesses and barriers to the integration of scientific evidence into practice. These results are like those of other studies conducted among psychologists or in other health professions. We will discuss possible courses of action that could be implemented to improve the knowledge and use of EBP.
The demand for ascorbate recycling capacity rises as the ascorbate pool size increases in Arabidopsis plants
Authors: Hamada Akane , Ishikawa Takahiro , Maruta Takanori
Published: August 2023

Ascorbate recycling is required for high ascorbate accumulation. Hence, when the ascorbate pool size is small, does the demand for ascorbate recycling decrease? We herein investigate the impact of ascorbate recycling capacity on ascorbate pool size in an ascorbate-deficient background. Our findings demonstrate that a smaller ascorbate pool size lowers the need for ascorbate recycling capacity even under light stress.
Evolutionary divergence of body size and wing and leg structure in relation to foraging mode in Darwin’s Galapagos finches
Authors: Lindhe Norberg Ulla M , Norberg R Åke
Published: August 2023

The wings, legs, and tail in Darwin’s finches show many clear adaptations to different types of locomotion used during foraging. We use size scaling to analyse how various characters vary with body mass to clarify dimensional relationships. The selective advantage of a character is judged in terms of energy savings. The wing aspect ratio (4.6–4.9) is very low, so the energy costs for flight are high. Low body mass, low wing loading, and short arm wings in the warbler finch, small tree finch, and small ground finch promote agility and manoeuvrability among vegetation, along with short wings in the warbler finch. Evolution towards a shorter arm wing seems to be favoured in the smaller finch species. Long legs, long toes, and long curved claws are adaptations for climbing/clinging locomotion without tail support (woodpecker finch, small and large tree finches, cactus finch but having short legs). Selection for longer legs seems to act towards a lengthening of the tarsometatarsus. The climbing technique in the woodpecker finch is described. We discuss how the diversification in the beaks relates to the locomotion organs.
A method for assessing rater reliability in applying the Vitiligo Area Scoring Index
Authors: Kumar Nishant , Pourang Aunna , Ezekwe Nneamaka , Parks-Miller Angela , Mohammad Tasneem F , Huggins Richard H , Deal Linda S , Lukic Tatjana , Zhang Fan , Lim Henry W , Hamzavi Iltefat , Kohli Indermeet
Published: August 2023

The Vitiligo Area Scoring Index (VASI) is a tool for measuring repigmentation after patients undergo vitiligo treatment, offering a standardized, quantitative scale without the need for specialized equipment. For large multicentre trials that require multiple raters, VASI must be consistently applied to generate interpretable data; therefore, a method for assessing rater reliability would improve data integrity for large clinical studies of vitiligo. This study aimed to assess a method for determining the reliability of VASI raters by evaluating raters of different levels of experience relative to a gold standard.
Looking Through the Eyes of General Practitioners: The Role of Social Work in Primary Health Care
Authors: Feryn Nele , Boeckxstaens Pauline , Ashcroft Rachelle , De Corte Joris , Roose Rudi
Published: August 2023

In Flanders, Belgium, a primary healthcare reform is ongoing to strengthen the health system and work towards improving integrated care. At the core of this transformation stands a person-centred perspective that considers social factors, which increases the tendency for collaboration between health and welfare systems. Primary care physicians and social workers are urged to collaborate; however, the way general practitioners (GPs) define and utilise the role of social work remains unclear. This study explores the perceptions of GPs regarding the role of social work. Semi-structured interviews were conducted with twenty-three GPs, working under both fee-for-service and capitation financing systems, with varying years of experience and in different geographical areas. The findings reveal that physicians recognise the influence of social factors on their patients care needs, yet, struggle with addressing them. Due to limited experience and understanding of the role of social work, GPs primarily focus on its value in individual cases, whilst having less awareness of their role and potential at the neighbourhood, organisational or population level. This study identified different factors that either facilitate or hinder collaboration with social work. The implications for the social work profession and future joint efforts are discussed.
Using Preventive, Protection, Prosecution and Partnership Framework to Explore the Successes and Constraints of Social Work to Address Sex Trafficking in Edo, Nigeria
Authors: Agwu Prince , Levy Susan , Okoye Uzoma
Published: August 2023

Social work features in human trafficking discourses as a remedial approach, but the profession’s potentials in Nigeria have not been fully realised. Thus, our research seeks to understand how social work has fared across the Prevention, Protection, Prosecution and Partnership (4Ps) of anti-human trafficking in Edo (a prime source destination for sex trafficking in Nigeria), and what can be done to scale up the presence and efficacy of social work. Qualitative research was conducted with twenty-three participants comprising qualified social workers, allied social work professionals and operational staff of ten anti-human trafficking agencies. Data were sourced using in-depth interviews, deductively coded and analysed based on the 4Ps framework. An important finding was the recognition of the social work profession by most anti-human trafficking agencies, as they employed qualified social work staff or outsourced social work roles to allied professions. Across the 4Ps, Prevention and Protection fared better, unlike Prosecution and Partnership. We provide insights on how to scale up all 4Ps using a social work lens. This research has the potential to strengthen the social work component of anti-human trafficking and presents an in-road to conduct more social work analysis in anti-human trafficking and other fields.
Umami taste perception and preferences of the domestic cat (Felis catus), an obligate carnivore
Authors: McGrane Scott J , Gibbs Matthew , Hernangomez de Alvaro Carlos , Dunlop Nicola , Winnig Marcel , Klebansky Boris , Waller Daniel
Published: August 2023

The domestic cat (Felis catus) is an obligate carnivore, and as such has a meat-based diet. Several studies on the taste perception of cats have been reported, indicating that their sense of taste has evolved based on their carnivorous diet. Here, we propose that umami (mediated by Tas1r1-Tas1r3) is the main appetitive taste modality for the domestic cat by characterizing the umami taste of a range of nucleotides, amino acids, and their mixtures for cats obtained using complementary methods. We show for the first time that cats express Tas1r1 in taste papillae. The cat umami receptor responds to a range of nucleotides as agonists, with the purine nucleotides having the highest activity. Their umami receptor does not respond to any amino acids alone; however, 11 l-amino acids with a range of chemical characteristics act as enhancers in combination with a nucleotide. l-Glutamic acid and l-Aspartic acid are not active as either agonists or enhancers of the cat umami receptor due to changes in key binding residues at positions 170 and 302. Overall, cats have an appetitive behavioral response for nucleotides, l-amino acids, and their mixtures. We postulate that the renowned palatability of tuna for cats may be due, at least in part, to its specific combination of high levels of inosine monophosphate and free l-Histidine that produces a strong synergistic umami taste enhancement. These results demonstrate the critical role that the umami receptor plays in enabling cats to detect key taste compounds present in meat.
Analyzing and visualizing polarization and balance with signed networks: the U.S. Congress case study
Authors: Capozzi Arthur , Semeraro Alfonso , Ruffo Giancarlo
Published: August 2023

Signed networks and balance theory provide a natural setting for real-world scenarios that show polarization dynamics, positive/negative relationships and political partisanship. For example, they have been proven effective in studying the increasing polarization of the votes in the two chambers of the U.S. Congress from World War II on Andris, Lee, Hamilton, Martino, Gunning & Selden (2015, PLoS ONE, 10, 1–14) and Aref & Neal (2020, Sci. Rep., 10, 1–10). To provide further insights into this particular case study, we propose the application of a pipeline to analyze and visualize a signed graphs configuration based on the exploitation of the corresponding Laplacian matrix spectral properties. The overall methodology is comparable with others based on the frustration index, but it has at least two main advantages: first, it requires a much lower computational cost and second, it allows for a quantitative and visual assessment of how arbitrarily small subgraphs (even single nodes) contribute to the overall balance (or unbalance) of the network. The proposed pipeline allows the exploration of polarization dynamics shown by the U.S. Congress from 1945 to 2020 at different resolution scales. In fact, we are able to spot and point out the influence of some (groups of) congressmen in the overall balance, as well as to observe and explore polarizations evolution of both chambers across the years.
Neochordae implantation versus leaflet resection in mitral valve posterior leaflet prolapse and dilated left ventricle: a propensity score matching comparison with long-term follow-up
Authors: Del Forno Benedetto , Tavana Kevin , Ruffo Claudio , Carino Davide , Lapenna Elisabetta , Ascione Guido , Bisogno Arturo , Belluschi Igor , Scarale Maria Giovanna , Nonis Alessandro , Monaco Fabrizio , Alfieri Ottavio , Castiglioni Alessandro , Maisano Francesco , De Bonis Michele
Published: August 2023

OBJECTIVES

Uncorrected severe mitral regurgitation (MR) due to posterior prolapse leads to left ventricular dilatation. At this stage, mitral valve repair becomes mandatory to avoid permanent myocardial injury. However, which technique among neochoardae implantation and leaflet resection provides the best results in this scenario remains unknown.

METHODS

We selected 332 patients with left ventricular dilatation and severe degenerative MR due to posterior leaflet (PL) prolapse who underwent neochoardae implantation (85 patients) or PL resection (247 patients) at our institution between 2008 and 2020. A propensity score matching analysis was carried on to decrease the differences at baseline.

RESULTS

Matching yielded 85 neochordae implantations and 85 PL resections. At 10 years, freedom from cardiac death and freedom from mitral valve reoperation were 92.6 ± 6.1% vs 97.8 ± 2.1% and 97.7 ± 2.2% vs 95 ± 3% in the neochordae group and in the PL resection group, respectively. The MR ≥2+ recurrence rate was 23.9 ± 10% in the neochordae group and 20.8 ± 5.8% in the PL resection group (P = 0.834) at 10 years. At the last follow-up, the neochordae group showed a higher reduction of left ventricular end-diastolic diameter (44 vs 48 mm; P = 0.001) and a better ejection fraction (60% vs 55%; P < 0.001) compared to PL resection group.

CONCLUSIONS

In this subgroup of patients, both neochordae implantation and leaflet resection provide excellent durability of the repair in the long term. Neochordae implantation might have a better effect on dilated left ventricle.
Pituitary function before and after surgery for nonfunctioning pituitary adenomas—data from the Swedish Pituitary Register
Authors: Al-Shamkhi Nasrin , Berinder Katarina , Borg Henrik , Burman Pia , Dahlqvist Per , Höybye Charlotte , Olsson Daniel S , Ragnarsson Oskar , Ekman Bertil , Edén Engström Britt
Published: August 2023

Objective

Data on pre- and postoperative pituitary function in nonfunctioning pituitary adenomas (NFPA) are not consistent. We aimed to investigate pituitary function before and up to 5 years after transsphenoidal surgery with emphasis on the hypothalamic-pituitary-adrenal axis (HPA).

Design and methods

Data from the Swedish Pituitary Register was used to analyze anterior pituitary function in 838 patients with NFPA diagnosed between 1991 and 2014. Patients who were reoperated or had received radiotherapy were excluded.

Results

Preoperative ACTH, TSH, LH/FSH, and GH deficiencies were reported in 31% (236/755), 39% (300/769), 51% (378/742), and 28% (170/604) of the patients, respectively. Preoperative median tumor volume was 5.0 (2.4-9.0) cm3. Among patients with preoperative, 1 year and 5 years postoperative data on the HPA axis (n = 428), 125 (29%) were ACTH-deficient preoperatively. One year postoperatively, 26% (32/125) of them had recovered ACTH function while 23% (70/303) patients had developed new ACTH deficiency. Thus, 1 year postoperatively, 163 (38%) patients were ACTH-deficient (P < .001 vs. preoperatively). No further increase was seen 5 years postoperatively (36%, P = .096). At 1 year postoperatively, recoveries in the TSH and LH/FSH axes were reported in 14% (33/241) and 15% (46/310), respectively, and new deficiencies in 22% (88/403) and 29% (83/288), respectively.

Conclusions

Adrenocorticotrophic hormone deficiency increased significantly at 1 year postoperatively. Even though not significant, some patients recovered from or developed new deficiency between 1 and 5 years postoperatively. This pattern was seen in all axes. Our study emphasizes that continuous individual evaluations are needed during longer follow-up of patients operated for NFPA.
Are units of analysis properly considered in orthodontic meta-analyses?
Authors: Mheissen Samer , Daraqel Baraa , Wafaie Khaled , Khan Haris
Published: August 2023

Background

Assessment of unit of analysis (UoA) in meta-analysis with cluster, split-mouth, repeated measures designs, and multiple intervention groups is a fundamental step in the analysis. The objective of this study was to evaluate the UoAs in orthodontic meta-analysis and determine the error of the analysis.

Methods

An electronic search was conducted in the Cochrane Library and PubMed to identify orthodontic systematic reviews (SRs) with meta-analyses published in Cochrane and in the highest impact orthodontic journals between 1 January 2013 and 31 December 2022. SRs with meta-analysis assessing at least one of the following UoAs; cluster trials, crossover trials, multiple observations, or multiple intervention groups were included. Screening and data extraction were undertaken by two investigators independently. Descriptive statistics for the study characteristics were provided. The associations between avoiding the unit analysis error (yes, no) and the study characteristics were examined using Fisher’s exact test and chi-square test. Logistic regression was undertaken for the significant predictors.

Results

Eighty SRs were deemed eligible for inclusion. Only 30 per cent of the included SRs avoided UoA errors. Compared to the split-mouth design, repeated measures designs had higher odds of avoiding UoA error (odds ratio: 9.6, 95% confidence interval: 2.8–32.3, P < 0.001). In contrast, fewer odds of avoiding the UoA error were found in the cluster design (OR: 0.2, 95% CI: 0.4–1.3, P = 0.09). Though multiple intervention groups have higher odds of avoiding UoA error than split-mouth studies, this was not statistically significant (OR: 2.1, 95% CI: 0.5–8, P = 0.28). None of the SRs characteristics have influenced the appropriate handling of the unit analysis except the type of the journal; the odds of avoiding the UoA error were higher in Cochrane reviews than the non-Cochrane reviews (OR: 3.3, 95% CI: 1.2–8.7, P = 0.02), and the number of authors (P < 0.05).

Conclusions

UoA errors are common in orthodontic meta-analyses and were only partially avoided in split-mouth design, repeated measures design, and multiple intervention groups.
Effects of probiotics on the oral health of patients undergoing orthodontic treatment: a systematic review and meta-analysis
Authors: Chen Wener , Ren Jianhan , Li Jiachen , Peng Simin , Zhang Chengfei , Lin Yifan
Published: August 2023

Background and objective

The effect of probiotics on oral health maintenance in orthodontic patients remains controversial. The aim of the study is to systematically review and assess the effects of probiotics on the oral health and microbiome of patients undergoing orthodontic treatment.

Search methods and selection criteria

Databases including PubMed, Web of Science, Cochrane Library, ClinicalTrials.gov, and ProQuest Dissertations & Theses Global databases were searched from their inception until June 2022. Randomised controlled trials that assessed the effects of probiotics on clinical and microbial outcomes in patients undergoing orthodontic treatment were included.

Data collection and analysis

Data screening and collection were performed, and the risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. The meta-analysis evaluated the effects of probiotics on Streptococcus mutans (S. mutans) and Lactobacillus counts. The quality of the evidence from the meta-analyses was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results

A total of 405 records were identified, of which 15 studies were included in the qualitative synthesis and 4 in the meta-analysis. The patients in all the included studies were treated with fixed orthodontic appliances. Results regarding clinical outcomes were controversial; four out of five studies reported no significant changes in plaque in the probiotic group (P > .05), and two out of three studies reported no significant changes in the gingival index (P > .05). Regarding microbial outcomes, the meta-analysis results revealed that probiotics significantly increased the likelihood of reducing the abundance of S. mutans to below 105 CFU/ml (risk ratio: 2.05 [1.54, 2.72], P < .001) and reduced the likelihood of increasing the abundance of S. mutans to beyond 106 CFU/ml (risk ratio: 0.48 [0.28, 0.83], P = .009). However, the quality of evidence according to the GRADE was moderate.

Conclusions and implications

There is insufficient evidence to determine the clinical benefits of probiotics as a supplement for the oral health of patients undergoing orthodontic treatment. However, probiotics may have benefits in reducing the salivary S. mutans counts in orthodontic patients.

Registration

PROSPERO (CRD42022366650).
Initial heart rate score predicts new-onset atrial tachyarrhythmias in pacemaker patients
Authors: Hayashi Katsuhide , Abe Haruhiko , Olshansky Brian , Sharma Arjun D , Jones Paul W , Wold Nicholas , Perschbacher David , Kohno Ritsuko , Richards Mark , Wilkoff Bruce L
Published: August 2023

Aims

Heart rate score (HRSc), the per cent of atrial paced and sensed event in the largest 10 b.p.m. rate histogram bin of a pacemaker, predicts survival in patients with cardiac devices. No correlation between HRSc and development of atrial fibrillation (AF) has been reported. In this study, we evaluated the relationship between pacemaker post-implantation HRSc and the incidence of newly developed atrial tachyarrhythmias (ATAs).

Methods and results

Patients with dual-chamber pacemakers, implanted 2013–17, with the LATITUDE remote monitoring data with ≥600 000 beats of histogram data collected at baseline were included (N = 34 543). Heart rate score was determined from the initial 3-month post-implantation histogram data. Patients were excluded if they had ATAs, defined as atrial high-rate episodes >5 min or >1% of right atrial beats >170 b.p.m. during the initial 3 months post-implantation. New ATAs, after the baseline period, were defined by each of the following: >1, >10, or >25% of atrial beats >170 b.p.m. or atrial tachycardia response (ATR) events >24 h. Patients were followed a median of 2.8 (1.0–4.0) years. The incidence of ATAs increased in proportion to HRSc (log-rank P-value <0.001), and the initial HRSc ≥70% was associated with increased ATAs by all definitions. Patients with initial HRSc ≥70% were older, had a higher percentage of right atrium pacing (%RA pacing), had a lower percentage of right ventricular pacing (%RV pacing), and were more likely programmed with rate-response vs. subjects with HRSc <70%. Initial HRSc (hazard ratio: 1.07, 95% confidence interval: 1.05–1.09; P < 0.0001) independently predicted ATAs after adjusting for age, gender, %RV pacing, and rate-response programming. The %RA pacing and initial HRSc were correlated.

Conclusion

Heart rate score independently predicts any subsequent duration of ATAs in pacemaker patients.
Application of Internet hospitals for first-visit patients with COVID-19 during the pandemic in China
Authors: Zhang Ye , Zhang Ye , Huang Jie , Dong Liang
Published: August 2023

Background

There has been controversy over whether to carry out online medical inquiries and electronic prescription for first-visit patients. While Internet hospitals have become crucial to ensure providing online diagnosis and prescription needs for first-visit COVID-positive patients.

Objective

We describe the results and advantages of online medical treatment during the coronavirus disease 2019 (COVID-19) outbreak and analyse the results and advantages of online medical treatment.

Methods

Data were collected from the patients who received online medical inquiry services through the COVID-19 Special Section of our Internet hospital. The user demographic characteristics, user behaviour, clinical symptoms and medical records were collected. Baseline data of offline outpatient patients were also collected.

Results

A total of 16 173 online medical inquiries were included. The daily online outpatient service volume reached a peak of 2446 person-times. The median age was 29.92 years (SD 15.59), ranging from 20–39 years (n = 8870, 54.84%). A total of 89.20% (n = 14 426/16 173) patients had epidemic-related symptoms. Moreover, 23.35% of the people were diagnosed as COVID-19-positive through antigen or nucleic acid testing. Furthermore, 86.61% (14 008/16 173) of the patients visited our hospital for the first time or had no offline physical outpatient service record within the past 3 months. The demand for medical inquiries was mainly for drug dispensing, followed by medication guidance and disease diagnosis. And 2.07% (334/16 173) of the patients needed to go to the offline hospital for further treatment.

Conclusion

The service model of the COVID-19 Special Section based on Internet hospitals provided the public with the necessary medical support during the COVID-19 outbreak. It provides a reference for future pandemics or public health emergencies.
Phenotypic rate and state are decoupled in response to river-to-lake transitions in cichlid fishes
Authors: Burress Edward D , Muñoz Martha M
Published: August 2023

Geographic access to isolated ecosystems is an important catalyst of adaptive radiation. Cichlid fishes repeatedly colonized rift, crater, and volcanic lakes from surrounding rivers. We test the “lake effect” on the phenotypic rate and state across 253 cichlid species. The rate of evolution was consistently higher (~10-fold) in lakes, and consistent across different dimensions of the phenotype. Rate shifts tended to occur coincident with or immediately following river-to-lake transitions, generally resulting in 2- to 5-fold faster rates than in the founding riverine lineage. By contrast, river- and lake-dwelling cichlids exhibit considerable overlap in phenotypes, generally with less disparity in lakes, but often different evolutionary optima. Taken together, these results suggest that lake radiations rapidly expand into niches largely already represented by ancestral riverine lineages, albeit in different frequencies. Lakes may provide ecological opportunity via ecological release (e.g., from predators/competitors) but need not be coupled with access to novel ecological niches.
Considering equity and cost-effectiveness in assessing a parenting intervention to promote early childhood development in rural Vietnam
Authors: Baek Yeji , Ademi Zanfina , Tran Thach , Owen Alice , Nguyen Trang , Luchters Stanley , Hipgrave David B , Hanieh Sarah , Tran Tuan , Tran Ha , Biggs Beverley-Ann , Fisher Jane
Published: August 2023

Considering equity in early childhood development (ECD) is important to ensure healthy development for every child. Equity-informative cost-effectiveness analysis can further guide decision makers to maximize outcomes with limited resources while promoting equity. This cost-effectiveness study aimed to examine the equity impacts of a multicomponent ECD intervention in rural Vietnam. We estimated the cost-effectiveness of the intervention with a 30-month time horizon from the service provider and household perspectives with equity considerations. Data were from a cluster-randomized controlled trial comparing the intervention with the local standard of care. The incremental cost-effectiveness ratios (ICERs) per child cognitive development score gained were estimated by household wealth quintile and maternal education level, adjusted for cluster effects and baseline characteristics such as maternal parity and age. A 3% discount rate was applied to costs, and non-parametric cluster bootstrapping was used to examine uncertainty around ICERs. Children in the intervention had higher cognitive development scores than those in the control arm across all subgroups. Based on intervention recurrent cost, the ICER per cognitive development score gained was lower in children from the poorest quintile (−US$6) compared to those from the richest quintile (US$16). Similarly, the ICER per cognitive development score gained was lower in children whose mothers had the lowest education level (−US$0.02) than those with mothers who had the highest education level (US$7). Even though our findings should be interpreted with caution due to the insufficient study power, the findings suggest that the intervention could promote equity while improving child cognitive development with greater cost-effectiveness in disadvantaged groups.
Multiomics comparison among populations of three plant sources of Amomi Fructus
Authors: Chen Xinlian , Sun Shichao , Han Xiaoxu , Li Cheng , Wang Fengjiao , Nie Bao , Hou Zhuangwei , Yang Song , Ji Jiaojiao , Li Ge , Wang Yanqian , Han Xiaoyu , Yue Jianjun , Li Cui , Li Wei , Zhang Lixia , Yang Depo , Wang Li
Published: August 2023

Amomi Fructus (Sharen, AF) is a traditional Chinese medicine (TCM) from three source species (or varieties), including Wurfbainia villosa var. villosa (WVV), W. villosa var. xanthioides (WVX), or W. longiligularis (WL). Among them, WVV has been transplanted from its top-geoherb region, Guangdong, to its current main production area, Yunnan, for >50 years in China. However, the genetic and transcriptomic differentiation among multiple AF source species (or varieties) and between the origin and transplanted populations of WVV is unknown. In our study, the observed overall higher expression of terpenoid biosynthesis genes in WVV than in WVX provided possible evidence for the better pharmacological effect of WVV. We also screened six candidate borneol dehydrogenases (BDHs) that potentially catalyzed borneol into camphor in WVV and functionally verified them. Highly expressed genes at the P2 stage of WVV, Wv05G1424 and Wv05G1438, were capable of catalyzing the formation of camphor from (+)-borneol, (−)-borneol and DL-isoborneol. Moreover, the BDH genes may experience independent evolution after acquiring the ancestral copies, and the following tandem duplications might account for the abundant camphor content in WVV. Furthermore, four populations of WVV, WVX, and WL are genetically differentiated, and the gene flow from WVX to WVV in Yunnan contributed to the greater genetic diversity in the introduced population (WVV-JH) than in its top-geoherb region (WVV-YC), which showed the lowest genetic diversity and might undergo genetic degradation. In addition, terpene synthesis (TPS) and BDH genes were selected among populations of multiple AF source species (or varieties) and between the top- and non-top-geoherb regions, which might explain the difference in metabolites between these populations. Our findings provide important guidance for the conservation, genetic improvement, and industrial development of the three source species (or varieties) and for identifying top-geoherbalism with molecular markers, and proper clinical application of AF.
Validation of a laser projection platform for the preparation of surgical patches used in paediatric cardiac surgery
Authors: Saunders Tiffany , Recco Dominic , Kneier Nicholas , Kizilski Shannen , Hammer Peter , Hoganson David
Published: August 2023

OBJECTIVES

Reconstruction of cardiovascular anatomy with patch material is integral to the repair of congenital heart disease. We present validation of a laser projection platform for the preparation of surgical patches as a proof-of-concept for intraoperative use in patient-specific planning of paediatric cardiac surgery reconstructions.

METHODS

The MicroLASERGUIDE, a compact laser projection system that displays computer-aided designs onto 2D/3D surfaces, serves as an alternative to physical templates. A non-inferiority comparison of dimensional measurements was conducted between laser projection (‘laser’) and OZAKI AVNeo Template (‘template’) methods in creation of 51 (each group) size 13 valve leaflets from unfixed bovine pericardium. A digital version of the OZAKI AVNeo Template dimensions served as control. Feasibility testing was performed with other common patch materials (fixed bovine pericardium, PTFE and porcine main pulmonary artery as a substitute for pulmonary homograft) and sizes (13, 23) (n = 3 each group).

RESULTS

Compared to control (height 21.5, length 21.0 mm), template height and length were smaller (height and length differences of −0.3 [−0.5 to 0.0] and −0.4 [−0.8 to −0.1] mm, P < 0.01 each); whereas, both laser height and length were relatively similar (height and length differences of height 0.0 [−0.2 to 0.2], P = 0.804, and 0.2 [−0.1 to 0.4] mm, P = 0.029). Template percent error for height and length was −1.5 (−2.3 to 0.0)% and −1.9 (−3.7 to −0.6)% vs 0.2 (−1.0 to 1.1)% and 1.0 (−0.5 to 1.8)% for the laser. Similar results were found with other materials and sizes. Overall, laser sample dimensions differed by a maximum of 5% (∼1 mm) from the control.

CONCLUSIONS

The laser projection platform has demonstrated promise as an alternative methodology for the preparation of surgical patches for use in cardiac surgery. This technology has potential to revolutionize preoperative surgical planning for numerous congenital anomalies that require patient-specific patch-augmented repair.
The 3′ Untranslated Regions of Ebola Virus mRNAs Contain AU-Rich Elements Involved in Posttranscriptional Stabilization and Decay
Authors: Nelson Emily V , Ross Stephen J , Olejnik Judith , Hume Adam J , Deeney Dylan J , King Emily , Grimins Autumn O , Lyons Shawn M , Cifuentes Daniel , Mühlberger Elke
Published: August 2023

The 3′ untranslated regions (UTRs) of Ebola virus (EBOV) mRNAs are enriched in their AU content and therefore represent potential targets for RNA binding proteins targeting AU-rich elements (ARE-BPs). ARE-BPs are known to fine-tune RNA turnover and translational activity. We identified putative AREs within EBOV mRNA 3′ UTRs and assessed whether they might modulate mRNA stability. Using mammalian and zebrafish embryo reporter assays, we show a conserved, ARE-BP-mediated stabilizing effect and increased reporter activity with the tested EBOV 3′ UTRs. When coexpressed with the prototypic ARE-BP tristetraprolin (TTP, ZFP36) that mainly destabilizes its target mRNAs, the EBOV nucleoprotein (NP) 3′ UTR resulted in decreased reporter gene activity. Coexpression of NP with TTP led to reduced NP protein expression and diminished EBOV minigenome activity. In conclusion, the enrichment of AU residues in EBOV 3′ UTRs makes them possible targets for cellular ARE-BPs, leading to modulation of RNA stability and translational activity.
Shigella Serotypes Associated With Carriage in Humans Establish Persistent Infection in Zebrafish
Authors: Torraca Vincenzo , Brokatzky Dominik , Miles Sydney L , Chong Charlotte E , De Silva P Malaka , Baker Stephen , Jenkins Claire , Holt Kathryn E , Baker Kate S , Mostowy Serge
Published: August 2023

Shigella represents a paraphyletic group of enteroinvasive Escherichia coli. More than 40 Shigella serotypes have been reported. However, most cases within the men who have sex with men (MSM) community are attributed to 3 serotypes: Shigella sonnei unique serotype and Shigella flexneri 2a and 3a serotypes. Using the zebrafish model, we demonstrate that Shigella can establish persistent infection in vivo. Bacteria are not cleared by the immune system and become antibiotic tolerant. Establishment of persistent infection depends on the O-antigen, a key constituent of the bacterial surface and a serotype determinant. Representative isolates associated with MSM transmission persist in zebrafish, while representative isolates of a serotype not associated with MSM transmission do not. Isolates of a Shigella serotype establishing persistent infections elicited significantly less macrophage death in vivo than isolates of a serotype unable to persist. We conclude that zebrafish are a valuable platform to illuminate factors underlying establishment of Shigella persistent infection in humans.
Electrogenic Staphylococcus epidermidis colonizes nasal cavities and alleviates IL-6 progression induced by the SARS2-CoV nucleocapsid protein
Authors: Zayabaatar Enkhbat , Tang Nguyen Mai Trinh , Pham Minh Tan
Published: August 2023

Aim

Certain probiotic bacteria have been shown to possess an immunomodulatory effect and a protective effect on influenza infections. Using the Staphylococcus epidermidis K1 colonized mice model, we assessed the effect of nasal administration of glycerol or flavin mononucleotide (FMN) on the production of interleukin (IL)-6 mediated by the severe acute respiratory syndrome coronavirus 2 (SARS2-CoV) nucleocapsid protein (NPP).

Methods and results

FMN, one of the key electron donors for the generation of electricity facilitated by S. epidermidis ATCC 12228, was detected in the glycerol fermentation medium. Compared to the S. epidermidis ATCC 12228, the S. epidermidis K1 isolate showed significant expression of the electron transfer genes, including pyruvate dehydrogenase (pdh), riboflavin kinase (rk), 1,4-dihydroxy-2-naphthoate octaprenyltransferase (menA), and type II NADH quinone oxidoreductase (ndh2). Institute of cancer research (ICR) mice were intranasally administered with S. epidermidis K1 with or without pretreatment with riboflavin kinase inhibitors, then nasally treated with glycerol or FMN before inoculating the NPP. Furthermore, J774A.1 macrophages were exposed to NPP serum and then treated with NPP of SARS2-CoV. The IL-6 levels in the bronchoalveolar lavage fluid (BALF) of mice and macrophages were quantified using a mouse IL-6 enzyme-linked immunosorbent assay kit.

Conclusions

Here, we report that nasal administration of NPP strongly elevates IL-6 levels in both BALF and J774A.1 macrophages. It is worth noting that NPP-neutralizing antibodies can decrease IL-6 levels in macrophages. The nasal administration of glycerol or FMN to S. epidermidis K1-colonized mice results in a reduction of NPP-induced IL-6 production.
An open natural language processing (NLP) framework for EHR-based clinical research: a case demonstration using the National COVID Cohort Collaborative (N3C)
Authors: Liu Sijia , Wen Andrew , Wang Liwei , He Huan , Fu Sunyang , Miller Robert , Williams Andrew , Harris Daniel , Kavuluru Ramakanth , Liu Mei , Abu-el-Rub Noor , Schutte Dalton , Zhang Rui , Rouhizadeh Masoud , Osborne John D , He Yongqun , Topaloglu Umit , Hong Stephanie S , Saltz Joel H , Schaffter Thomas , Pfaff Emily , Chute Christopher G , Duong Tim , Haendel Melissa A , Fuentes Rafael , Szolovits Peter , Xu Hua , Liu Hongfang
Published: August 2023

Despite recent methodology advancements in clinical natural language processing (NLP), the adoption of clinical NLP models within the translational research community remains hindered by process heterogeneity and human factor variations. Concurrently, these factors also dramatically increase the difficulty in developing NLP models in multi-site settings, which is necessary for algorithm robustness and generalizability. Here, we reported on our experience developing an NLP solution for Coronavirus Disease 2019 (COVID-19) signs and symptom extraction in an open NLP framework from a subset of sites participating in the National COVID Cohort (N3C). We then empirically highlight the benefits of multi-site data for both symbolic and statistical methods, as well as highlight the need for federated annotation and evaluation to resolve several pitfalls encountered in the course of these efforts.
The impact of the COVID-19 pandemic on daily rhythms
Authors: Luong Nguyen , Barnett Ian , Aledavood Talayeh
Published: August 2023

Objective

The COVID-19 pandemic has significantly impacted daily activity rhythms and life routines with people adjusting to new work schedules, exercise routines, and other everyday life activities. This study examines temporal changes in daily activity rhythms and routines during the COVID-19 pandemic, emphasizing disproportionate changes among working adult subgroups.

Materials and Methods

In June 2021, we conducted a year-long study to collect high-resolution fitness tracker data and questionnaire responses from 128 working adults. Questionnaire data were analyzed to explore changes in exercise and work routines during the pandemic. We build temporal distributions of daily step counts to quantify their daily movement rhythms, then measure their consistency over time using the inverse of the Earth mover’s distance. Linear mixed-effects models were employed to compare movement rhythm variability among subpopulations.

Results

During the pandemic, our cohort exhibited a shift in exercise routines, with a decrease in nonwalking physical exercises, while walking remained unchanged. Migrants and those living alone had less consistent daily movement rhythms compared to others. Those preferring on-site work maintained more consistent daily movement rhythms. Men and migrants returned to work more quickly after pandemic restriction measures were eased.

Discussion

Our findings quantitatively show the pandemic’s unequal impact on different subpopulations. This study opens new research avenues to explore why certain groups return to on-site work, exercise levels, or daily movement rhythms more slowly compared to prepandemic times.

Conclusions

Considering the pandemic’s unequal impact on subpopulations, organizations and policymakers should address diverse needs and offer tailored support during future crises.
Current status of vulvar cancer in Japan: analysis of the Japanese Gynecologic Oncology Group nationwide survey study
Authors: Nishio Shin
Published: August 2023

This review provides an overview of the current status of vulvar cancer in Japan, focusing specifically on the findings from the Japanese Gynecologic Oncology Group nationwide survey study. The author offers a comprehensive summary of the current status of vulvar cancer in Japan, along with an exploration of the molecular mechanisms underlying the disease. Notably, the review highlights the concerning upward trend of vulvar cancer in older age groups and advanced stages in Japan. The author concludes that addressing these challenges may require the centralization of resources and expertise. By bridging knowledge gaps and identifying areas for improvement, this review contributes to enhancing the understanding and management of vulvar cancer in Japan.
Heterogeneity in the US gender wage gap
Authors: Bach Philipp , Chernozhukov Victor , Spindler Martin
Published: August 2023

As a measure of gender inequality, the gender wage gap has come to play an important role both in academic research and the public debate. In 2016, the majority of full-time employed women in the United States earned significantly less than comparable men. The extent to which women were affected by gender inequality in earnings, however, depended greatly on socio-economic characteristics, such as marital status or educational attainment. In this paper, we analyse data from the 2016 American Community Survey using a high-dimensional wage regression and applying double lasso to quantify heterogeneity in the gender wage gap. We find that the wage gap varied substantially across women and that the magnitude of the gap varied primarily by marital status, having children at home, race, occupation, industry, and educational attainment. These insights are helpful in designing policies that can reduce discrimination and unequal pay more effectively.
Mesenteric embryonal rhabdomyosarcoma in an adolescent: a case report
Authors: Kakooza Jackson , Odur Felix , Ogei Esau , Taylor Katrina , Kalungi Sam , Lewis Catherine R
Published: August 2023

Rhabdomyosarcoma (RMS) is a soft tissue sarcoma that histologically resembles embryonic skeletal muscle. It can occur anywhere in the body, including tissues devoid of skeletal muscles. RMS is a common malignancy in children, and it accounts for ˃50% of all soft tissue sarcomas in children. Embryonal rhabdomyosarcoma (ERMS) mostly affects children younger than 10 years of age. The head and neck area, the genitourinary tract and the retroperitoneum are described as the preferred anatomic sites for ERMS development. However, the mesentery location is extremely rare. We report a rare case of an ERMS occurring in the mesentery of a 17-year-old male.
Schistosomiasis (Schistosoma mansoni)—a rare cause of complex liver cysts
Authors: Chmielewski Jan , Probst Pascal , Muller Markus K , Antony Pia , Kovacevic Dragoljub
Published: August 2023

In this paper, we describe the case of a 40-year-old patient with an expanding and symptomatic complex liver cyst. Despite comprehensive diagnostics, including labs, imaging and biopsy, a clear etiology could not be determined. As a result, a partial liver resection was performed. The histopathological examination revealed evidence of schistosomas. We postulate that the displacement of the portal fields created a pseudocyst and that the resultant ischemia was the root cause of the patient’s discomfort. Postoperatively, the patient received an antihelmintic therapy with praziquantel with which she was able to fully recover.
Double trouble: concomitant Meckel’s diverticulitis and acute appendicitis
Authors: McKellar Stewart Kate , Lee Jessica , De Robles Marie Shella
Published: August 2023

Although Meckel’s diverticulum is the most common congenital anomaly of the small bowel (2% prevalence worldwide), it rarely causes symptoms, with only 4% of those with the anomaly developing any complications, including Meckel’s diverticulitis. In contrast to this, appendicitis is the most common general surgical emergency, with a lifetime incidence of 6.7–8.6%. Therefore, the case of a man presenting with right-sided abdominal pain to an Emergency Department with both Meckel’s diverticulitis and appendicitis is rare. This case study illustrates the importance of careful assessment of the entire abdomen when operating on patients with right-sided abdominal pain, so as not to miss Meckel’s diverticulitis even when appendicitis has already been found.
Relative Risk of All-Cause Medical Evacuation for Behavioral Health Conditions in U.S. Central Command
Authors: Hall Andrew , Olsen Cara , Gomes Jennifer , Bajjani-Gebara Jouhayna , Meyers Eric , Wilson Ramey
Published: August 2023

Introduction

Behavioral health disorders are the leading category of evacuations from the U.S. Central Command (USCENTCOM) area of responsibility. Understanding the relative risk of behavioral health conditions associated with all-cause evacuation is important for the allocation of resources to reduce the evacuation burden.

Materials and Methods

Data from the USTRANSCOM Regulating and Command & Control Evacuation System and Theater Medical Data Store covering personnel deployed to the USCENTCOM area of responsibility between January 1, 2017 and December 31, 2021 were collected and analyzed. All individuals who were diagnosed with a behavioral health–specific ICD-9 (290–316) or ICD-10 (F00–F99) code during the period were included. Using the earliest medical encounter, the number of individuals diagnosed with a particular code and the frequency individuals were evacuated being diagnosed with any code were calculated.

Results

The mean monthly USCENTCOM population during this period was 62,535. A total of 22,870 individuals were diagnosed with a behavioral health–related disorder during the study period. Of this population, 1,414 individuals required an evacuation. The relative risk of the top 30 diagnosis codes used during the initial visit of individuals during the study period was calculated. Within this group of initial diagnoses, F32.9 ‘Major depressive disorder, single episode, unspecified’ had the highest proportion evacuated at 15.9%.

Conclusions

There is a broad array of behavioral health–specific diagnoses used initially in the care of behavioral health disorders with a great variation in their association with evacuation risk. Variations of diagnoses associated with anxiety, depressive, and adjustment disorders are most associated with eventual evacuation.