bluuebunny/crossref_metadata_2025 huggingface dataset:
Incorporating Consciousness into an Understanding of Emotion and Nonverbal Behavior
Authors: Matsumoto David , Wilson Matthew
Published: March 2023

We posit a model of emotion and nonverbal behavior (NVB) that incorporates a perspective of consciousness. We leverage an understanding of the neural pathways innervating NVB to describe the complexity of its neural architecture and the links between those pathways and mental states. We suggest that all NVB are activated by both cortical and subcortical structures, allowing for unconscious, coordinated movements across multiple channels as well as conscious, less coordinated movements; that mental states are associated with both cortical and subcortical structures; and thus that NVB will occur in multiple channels, both unconsciously and consciously, and differ across time. We discuss the implications of this model for future theory and research.
Cytomegalovirus haemorrhagic cystitis in a pregnant patient with AIDS
Authors: Marais Bernard , John Veena , Du Toit Mariëtte , Mbambo Jeanne , John Jeff
Published: March 2023

Cytomegalovirus (CMV), an AIDS defining disease, has a high seroprevalence in the general population, while symptomatic infections occur mostly in immunocompromised individuals. Symptomatic CMV infections commonly include pneumonia, encephalitis, retinitis and colitis, while urinary tract involvement is a rare entity. We present a rare case of massive macroscopic haematuria due to CMV haemorrhagic cystitis in a 29-year-old woman in her second trimester of pregnancy. She was treated with intravenous Ganciclovir after initial resuscitation, and her symptoms promptly resolved. Timely diagnosis and treatment of symptomatic CMV infection is necessary to prevent associated morbidity, and this is especially significant during pregnancy in order to prevent foetal transmission. Both our patient and her baby remained symptom free at the 6-month follow-up post-delivery. Clinicians should have a high index of suspicion to biopsy the bladder urothelium of at-risk patients who present with haemorrhagic cystitis and have non-specific cystoscopy findings as histopathological analysis is the mainstay of diagnosing CMV-cystitis.
Point of Decision Design to Address Adolescent Overweight and Obesity
Authors: Erfani Kimia , Grabowski Aria , Parker Grant , Garrity Ashley , Peterson Karen E. , Lee Joyce M. , Nanda Upali
Published: March 2023

Objectives:

This study aims to utilize the point of decision design framework to understand how, where, and why adolescents and families make decisions about diet and physical activity and to explore how modifications to the environment can help to promote healthier choices and reduce obesity.

Background:

Child and adolescent obesity is a critical public health problem. As environmental factors are a primary contributor, understanding the role of design in our surrounding environment highlights an important area of interdisciplinary study. Design strategies have been used successfully to increase stair use and reduce sedentary behavior and can be used to further promote healthier diet and activity choices among adolescents and families.

Methods:

We leveraged the human-centered design-thinking process through (1) qualitative interviews and survey instruments, (2) persona and prompt development, and (3) a design workshop with multidisciplinary stakeholders.

Results:

Five personas were developed from the qualitative data and used in a design-thinking workshop. During the workshop, participants generated 12 influential factors and nine points of decision which were used to generate 33 solutions spanning the design continuum (from information and policy design to the design of urban, architectural, and interior environments) aimed at improving nutrition and physical activity among adolescents. Additionally, a tool kit was prototyped, which includes interview guides, a persona framework, and a workshop facilitation guide.

Conclusions:

Our novel process led to the generation of design solutions that can be implemented to expand and improve upon existing interventions for childhood obesity and create environments that encourage positive health outcomes.
Clinical and Imaging Evaluation of COVID-19-Related Olfactory Dysfunction
Authors: Abdou Eslam Hamed Elsayed , Ebada Hisham Atef , Salem Mohammed Abdelbadie , Ghoneim Mahitab Mohamed Rashad , Sherif Fatma , Kamal Elsharawy
Published: March 2023

Background

Olfactory dysfunction has been reported in 47.85% of COVID patients. It can be broadly categorized into conductive or sensorineural olfactory loss. Conductive loss occurs due to impaired nasal air flow, while sensorineural loss implies dysfunction of the olfactory epithelium or central olfactory pathways.

Objectives

The aim of this study was to analyze the clinical and imaging findings in patients with COVID-related olfactory dysfunction. Additionally, the study aimed to investigate the possible mechanisms of COVID-related olfactory dysfunction.

Methods

The study included 110 patients with post-COVID-19 olfactory dysfunction, and a control group of 50 COVID-negative subjects with normal olfactory function. Endoscopic nasal examination was performed for all participants with special focus on the olfactory cleft. Smell testing was performed for all participants by using a smell diskettes test. Olfactory pathway magnetic resonance imaging (MRI) was done to assess the condition of the olfactory cleft and the dimensions and volume of the olfactory bulb.

Results

Olfactory dysfunction was not associated with nasal symptoms in 51.8% of patients. MRI showed significantly increased olfactory bulb dimensions and volume competed to controls. Additionally, it revealed olfactory cleft edema in 57.3% of patients. On the other hand, radiological evidence of sinusitis was detected in only 15.5% of patients.

Conclusion

The average olfactory bulb volumes were significantly higher in the patients’ group compared to the control group, indicating significant edema and swelling in the olfactory bulb in patients with COVID-related olfactory dysfunction. Furthermore, in most patients, no sinonasal symptoms such as nasal congestion or rhinorrhea were reported, and similarly, no radiological evidence of sinusitis was detected. Consequently, the most probable mechanism of COVID-related olfactory dysfunction is sensorineural loss through virus spread and damage to the olfactory epithelium and pathways.
Status of Orchestra Programs in the Public Schools
Authors: Hamann Donald L. , Gillespie Robert , Bergonzi Louis
Published: March 2023

The purpose of this study was to monitor the status of string instruction in string programs throughout the United States. Subjects for this study were string teachers from string school programs throughout the United States. From a total of 8,556 public, private, and parochial schools at the elementary, middle school/junior high school, and high school levels, a sample of 2, 139 schools were randomly selected for study participation. A survey was administered to string teachers at these randomly selected sites. From data analyses it was found that: the number of string teachers has declined while string student enrollment has increased, almost one-fourth of the schools in 1999–2000 and over 43% of the schools in 2000–2001 were not able to find qualified teachers for their string programs. While many programs unsuccessfully attempt to find teachers, the need for string teachers increases.
Factors Contributing to Diagnostic Skill Competency of String Teachers
Authors: lhas Dijana
Published: March 2023

The purpose of this study was to determine which factors contribute to the competency of string teachers’ diagnostic skills. Participants were 49 pre-service and in-service orchestra/string music teachers from three geographical divisions as defined by MENC (1984): Eastern (Massachusetts), Southern (Louisiana), and Western (Arizona and California). A researcher-developed survey was organized in three sections: General Information, the Questionnaire, and the Diagnostic Test. Eleven possible contributing factors were examined. Participants’ diagnostic skills were assessed through a researcher-developed diagnostic test. Eleven Two-Way ANOVAs with repeated measures were computed for data analysis. Significant differences were found among subjects by analysis situation, by degree, and between in-service and pre-service teachers.
Perceived and Actual Tuning Ability of Middle School String Students
Authors: Hamann Donald L. , Lauver Jonel , Asher Katherine
Published: March 2023

The purpose of this study was to determine whether students’ perceived tuning ability was related to actual tuning ability. A secondary purpose of this study was to determine if the reference tuning pitch of A = 440 HZ, produced on a bowed string instrument or an electronic tuner would affect student tuning accuracy. Sixty middle school subjects were randomly assigned to one of two groups. Subjects in one group were instructed to tune their instruments given a reference pitch of A = 440 HZ from a viola, and subjects in the other group from a Korg tuner. Subjects in both groups had been provided instruction in tuning for a period of two years prior to the study. Subjects were administered the Tuning Survey and were to identify their instrument, length of study, grade level, and how they rated their ability to tune their instrument. From the analyses of data, it was found that there was a significant difference in total cents tuning difference scores by Perceived Tuning Ability (PTA). Students with poor or fair PTA had significantly higher scores (more tuning cents difference from the actual pitch) than students with good or excellent PTA. No significant differences were found among students’ tuning accuracy scores when the pitch was generated from either a viola or a Korg tuner.
An Investigation of Tone Production in Relation to Management of Bow Weight and Speed among Beginning and Intermediate String Players: A Pilot Study
Authors: Taylor Skip
Published: March 2023

Management of the bow to the point of achieving the most efficient physical interaction between the hair and strings is crucial to successful stringed instrument achievement and performance. Inferior tone production often restricts string students from achieving a totality of musically-acceptable performance skills.

A spectral analysis of open string bowing was performed with middle school and high school string players in grades 6–10. Each subject bowed two separate down bows on the open violin A string. The specific objective was to investigate student control of bowed weight and speed management skills among a small sample of middle school and high school string players.

Visual graphs were produced and analyzed from the digital analog recordings and are discussed in terms of amplitude across time in relation to management of weight and speed. The findings indicate that inferior tone production may be the result of inconsistency among young string players’ ability to maintain an appropriate balance between weight and speed.
The knobby ball illusion
Authors: Tse Peter U. , Hayward Vincent
Published: March 2023

A novel haptic illusion is described where deformations of the fingertip skin lead to subsequent misperceptions of an object's shape.
The diagnostic utility of creatine kinase-MB versus total creatine phosphokinase ratio in patients with non-ST elevation myocardial infarction from unstable angina
Authors: Motamed Hassan , Mohammadi Mohammad , Tayebi Zahra , Rafati Navaei Alireza
Published: March 2023

Objective:

The present study seeks to find a way to quickly and correctly differentiate myocardial infarction from unstable angina by measuring the creatine kinase-MB/creatine phosphokinase ratio and comparing in non-ST elevation myocardial infarction patients with unstable angina at different time intervals, to improve the health quality of patients with coronary artery disease.

Methods:

The present study is a retrospective epidemiological analysis of 260 patients with non-ST elevation myocardial infarction and 260 patients with unstable angina, including age, sex, creatine kinase-MB, and creatine phosphokinase biomarkers at two-time intervals, including referral (4–8 h from the onset of pain) as the first interval, and 8 h after the first sampling was extracted as the second interval. Moreover, the delta of the creatine kinase-MB/creatine phosphokinase ratio during two interval times was measured.

Results:

In non-ST elevation myocardial infarction patients in the first and second intervals, creatine kinase-MB/creatine phosphokinase ratio was 32.7 and 33.8% higher than the normal laboratory cutoff (positive), respectively, and in the group of unstable angina patients, this index was positive in 31.9 and 30.4% of patients, respectively. There was no significant difference between the mean creatine kinase-MB to creatine phosphokinase index between the patients with non-ST elevation myocardial infarction and unstable angina ( p = 0.507). In the first interval, the sensitivity and specificity of this index in differentiating non-ST elevation myocardial infarction from unstable angina were 51.5 and 57.3% (area under the curve = 0.518), respectively. While in the second interval, the sensitivity and specificity of this index were 17.7 and 87.8% (area under the curve = 0.519), respectively. The creatine kinase-MB/creatine phosphokinase delta in the non-ST elevation myocardial infarction group was significantly higher than in patients with unstable angina during different time intervals ( p = 0.01).

Conclusion:

According to our results, creatine kinase-MB/creatine phosphokinase index cannot help differentiate the two groups of non-ST elevation myocardial infarction and unstable angina. However, the findings show that higher levels of creatine kinase-MB enzyme and creatine kinase-MB/creatine phosphokinase delta in the early hours, 4–16 h after the onset of pain in non-ST elevation myocardial infarction patients, can be used to differentiate between non-ST elevation myocardial infarction and unstable angina.
A case of drug-induced bullous pemphigoid secondary to immunotherapy treated with upadacitinib: A case report
Authors: Gresham Louise M , Kirchhof Mark G
Published: March 2023

Bullous pemphigoid is an acquired autoimmune subepidermal blistering disease that can arise following exposure to systemic medication, referred to as drug-induced bullous pemphigoid. Drug-induced bullous pemphigoid is a rare but potentially serious immune-related adverse event that should be considered in patients with advanced malignancies undergoing immunotherapy, with immune checkpoint inhibitors emerging in particular as a well-documented drug association in drug-induced bullous pemphigoid. We present a 74-year-old female with recurrent metastatic programmed cell death-ligand 1–positive squamous cell carcinoma of the head and neck area who developed drug-induced bullous pemphigoid in the setting of immunotherapy with a novel immunoglobulin-like transcript 4 inhibitor (MK-4830) in combination with pembrolizumab. Treatment with upadacitinib, a Janus-associated kinase-1 inhibitor, was pursued for significantly disabling disease that was recalcitrant to standard therapies and ultimately transition to palliative care. Follow-up at 4 weeks demonstrated good response. This is the first report describing the use of a Janus-associated kinase inhibitor for the treatment of bullous pemphigoid.
A case study of recurrent myocardial infarction secondary to socioeconomic challenges and nonadherence: Pre-discharge screening
Authors: Kosaraju Revanth , Natour Sami , Yuan Stanley , Cho Geoffrey
Published: March 2023

Medication nonadherence following myocardial infarction (MI) is prevalent and increases the risk of recurrent cardiovascular events. Socioeconomic factors including medication cost, financial insecurity, and poor health literacy are associated with nonadherence. We present a patient with a history of recurrent MI who was nonadherent due to socioeconomic challenges. Our patient subsequently developed ST-elevation MI secondary to in-stent thrombosis. This case illustrates the importance of pre-discharge screening for barriers to adherence.
‘I started seeing shadows everywhere’: The diverse chilling effects of surveillance in Zimbabwe
Authors: Stevens Amy , Fussey Pete , Murray Daragh , Hove Kuda , Saki Otto
Published: March 2023

Recent years have witnessed growing ubiquity and potency of state surveillance measures with heightened implications for human rights and social justice. While impacts of surveillance are routinely framed through ‘privacy’ narratives, emphasising ‘chilling effects’ surfaces a more complex range of harms and rights implications for those who are, or believe they are, subjected to surveillance. Although first emphasised during the McCarthy era, surveillance ‘chilling effects’ remain under-researched, particularly in Africa. Drawing on rare interview data from participants subjected to state-sponsored surveillance in Zimbabwe, the paper reveals complex assemblages of state and non-state actors involved in diverse and expansive hybrid online–offline monitoring. While scholarship has recently emphasised the importance of large-scale digital mass surveillance, the Zimbabwean context reveals complex assemblages of ‘big data’, social media and other digital monitoring combining with more traditional human surveillance practices. Such inseparable online–offline imbrications compound the scale, scope and impact of surveillance and invite analyses as an integrated ensemble. The paper evidences how these surveillance activities exert chilling effects that vary in form, scope and intensity, and implicate rights essential to the development of personal identity and effective functioning of participatory democracy. Moreover, the data reveals impacts beyond the individual to the vicarious and collective. These include gendered dimensions, eroded interpersonal trust and the depleted ability of human rights defenders to organise and particulate in democratic processes. Overall, surveillance chilling effects exert a wide spectrum of outcomes which consequently interfere with enjoyment of multiple rights and hold both short- and long-term implications for democratic participation.
How Disinformation on WhatsApp Went From Campaign Weapon to Governmental Propaganda in Brazil
Authors: Ozawa Joao V. S. , Woolley Samuel C. , Straubhaar Joseph , Riedl Martin J. , Joseff Katie , Gursky Jacob
Published: March 2023

The popular encrypted messaging and chat app WhatsApp played a key role in the election of Brazilian President Jair Bolsonaro in 2018. The present study builds on this knowledge and showcases how the app continued to be used in a governmental operation spreading false and misleading information popularly known in Brazil as the Office of Hatred (OOH). By harnessing in-depth expert interviews with documentarians of the office’s daily operations—researchers, journalists, and fact-checkers ( N = 10)—this study draws up a chronology of the OOH. Via this methodological approach, we trace and chronologize events, actions, and actors associated with the OOH. Specifically, findings (a) document the rise of antipetismo and disinformation campaigns associated with attacks on the Brazilian Worker’s party from 2012 until the election of Bolsonaro in 2018, (b) describe the emergence of the OOH at the heels of the election and subsequent radicalization in WhatsApp groups, (c) provide an overview of the types of disinformation that are spread on the app by the OOH, and (d) illustrate how the OOH operates by mapping key actors and places, communicative strategies, and audiences. These findings are discussed in light of ramifications that government-sponsored forms of disinformation might have in other antidemocratic polities marked by strongman populist leadership.
“Save Our Spikes”: Social Media Advocacy and Fan Reaction to the End of Minor League Baseball
Authors: Harrison Virginia S. , Bober Joseph , Buckley Christen , Vallos Victoria
Published: March 2023

On October 18, 2019, The New York Times reported that Major League Baseball was eliminating more than 40 teams from its minor league system. Fourteen months later, some teams permanently ceased operations when contraction became official. During those 14 months, fans and community members joined advocacy campaigns to save their teams. Given how minor league fans have unique, community-based identities, social media may help them communicate support for their teams during a threat. Using a framework of social media advocacy, the study sought to (1) understand the advocacy efforts present on social media and (2) the tone and emotions manifest in tweets related to contraction. Using quantitative methods, the study found that most discussions of contraction were negative in tone and contained emotions like anger. The most often used advocacy strategy was information, which may have been a lost opportunity for fans to rally support. As time moved on, tweets contained less negativity, more sadness than anger, and more use of the community advocacy strategy, providing evidence that fans found contraction inevitable. The study makes a contribution by bringing advocacy communication into the discussion of sport fandom and uses social media data to extract fan emotions during identity threats.
Social Networks of Women in Organizations: Evolution of Research and Future Research Agenda
Authors: Shaymardanov Mukhammadyusuf , Heikkinen Suvi , Lämsä Anna-Maija
Published: March 2023

This article carries out a literature review of research on social networks regarding women’s careers in the context of organizations and management for the period of 1970–2021. Our focus is on the conceptualization of social networks, understanding gender, and identification of the network effects that are important for women’s careers. The study enables us to create a comprehensive foundation of research knowledge conducted over several decades and build a profound base of suggestions for further research. Our analysis shows that the field has widened to include individual, organizational, and social environment viewpoints. The research on women’s social networks has evolved from establishing the field, to individualistic understanding, to accounting for sociocultural dynamics. The approach to gender has evolved from gender comparison to gender particularity and then contextualizing gender. Our suggestions for future research avenues include incorporating environmental aspects, virtual social networking, diversity, and leadership perspectives to improve women’s inclusion in social network research.
Predicting Hearing aid Benefit Using Speech-Evoked Envelope Following Responses in Children With Hearing Loss
Authors: Easwar Vijayalakshmi , Purcell David , Wright Trevor
Published: March 2023

Electroencephalography could serve as an objective tool to evaluate hearing aid benefit in infants who are developmentally unable to participate in hearing tests. We investigated whether speech-evoked envelope following responses (EFRs), a type of electroencephalography-based measure, could predict improved audibility with the use of a hearing aid in children with mild-to-severe permanent, mainly sensorineural, hearing loss. In 18 children, EFRs were elicited by six male-spoken band-limited phonemic stimuli––the first formants of /u/ and /i/, the second and higher formants of /u/ and /i/, and the fricatives /s/ and /∫/––presented together as /su∫i/. EFRs were recorded between the vertex and nape, when /su∫i/ was presented at 55, 65, and 75 dB SPL using insert earphones in unaided conditions and individually fit hearing aids in aided conditions. EFR amplitude and detectability improved with the use of a hearing aid, and the degree of improvement in EFR amplitude was dependent on the extent of change in behavioral thresholds between unaided and aided conditions. EFR detectability was primarily influenced by audibility; higher sensation level stimuli had an increased probability of detection. Overall EFR sensitivity in predicting audibility was significantly higher in aided (82.1%) than unaided conditions (66.5%) and did not vary as a function of stimulus or frequency. EFR specificity in ascertaining inaudibility was 90.8%. Aided improvement in EFR detectability was a significant predictor of hearing aid-facilitated change in speech discrimination accuracy. Results suggest that speech-evoked EFRs could be a useful objective tool in predicting hearing aid benefit in children with hearing loss.
U.S. Population Data on Self-Reported Trouble Hearing and Hearing-Aid Use in Adults: National Health Interview Survey, 2007–2018
Authors: Humes Larry E.
Published: March 2023

The National Health Interview Survey (NHIS) data on self-reported trouble hearing and the use of hearing aids were examined for the 12 recent surveys from 2007 to 2018 for adults from 18 to 85+ years of age. The aggregate dataset for all years included data from 357,714 adult respondents. Sample size for annual data ranged from 22,058 (2008) to 36,798 (2014). The prevalence of self-reported trouble hearing and hearing aid use, both current use and ever-using hearing aids, are reported for males and females for each age decade. Measures of unmet hearing healthcare (HHC) need were derived from estimates of the prevalence of hearing aid use among those with self-reported trouble hearing. Logistic-regression analyses identified variables affecting the odds of having self-reported trouble hearing, of using or rejecting hearing aids, and of having unmet HHC needs. The results largely corroborate and extend the findings of recent analyses of data from the National Health and Nutrition Examination Survey (NHANES) for a similar period (2011–2020). Overall, for males, 18.5% (95% CI [18.2%–18.8%]) had self-reported trouble hearing and 76.6% [76.0%–77.2%] of these individuals had never used hearing aids and, for females 13.1% [12.9%–13.4%] had trouble hearing and 79.5% [78.9%–80.1%] of these individuals had never used hearing aids. Unmet HHC needs are highly prevalent in the United States and have been so for many years.
Epidemiology, Risk Factors, and Outcome of Cardiac Dysrhythmias in a Noncardiac Intensive Care Unit
Authors: Savaie Mohsen , Sheikhi Yasaman , Baghbanian Reza , Soltani Farhad , Amiri Fereshteh , Hesam Saeed
Published: March 2023

Introduction

Several extrinsic factors contribute to the development of cardiac dysrhythmias. In intensive care unit (ICU) settings and among critically ill patients who are exposed to a large number of risk factors, cardiac disturbances are more common.

Objectives

This study aimed to examine the epidemiology, risk factors, and outcome of cardiac dysrhythmias in a non-cardiac ICU.

Methods

This is a retrospective, single-center, observational study conducted in a tertiary noncardiac ICU at Imam Khomeini Hospital in Ahvaz, Iran. Out of the 360 adult patients aged 18 years and older who were admitted to ICU for longer than 24 h, 340 cases who met the study inclusion criteria were recruited between March 2018 until October 2018.

Results

The most common nonsinus dysrhythmias were new-onset atrial fibrillation (NOAF) (12.9%) and ventricular tachycardia (21 patients—6.2%). According to our results, previous percutaneous coronary instrumentation, acute kidney injury, sepsis, and hyperkalemia act as risk factors in the development of cardiac dysrhythmias. Additionally, we found out that thyroid dysfunction and pneumonia can predict the development of NOAF in critically ill patients. The estimated mortality rate among patients with NOAF in this study was 15.7% ( p < .05).

Conclusion

Cardiac dysrhythmias are common in ICU patients and treating the risk factors can help to prevent their development and improve patient management and outcome.
Team Formation Strategies Among Prospective Entrepreneurs – Evidence From a Large-Scale Survey Experiment
Authors: Arendt Kasper M.
Published: March 2023

This paper examines the influence of team formation strategy on prospective entrepreneurs’ attraction toward venturing. With the worldwide increase in entrepreneurship education, the way entrepreneurial skills such as team formation are taught influences graduates’ chances of finding entrepreneurial success from the onset. This study measures how team formation strategies affect venturing and co-founding attraction. Moreover, the paper raises awareness for educators and researchers about the role and importance of various team formation strategies in entrepreneurship education. Hypotheses are tested using data collected from 1,713 business and entrepreneurship graduates using a quasi-experimental design with vignettes. Results and implications for entrepreneurship education and research are further discussed.
Quantitative Phytochemical Profile and In Vitro Antioxidant Properties of Ethyl Acetate Extracts of Xerophyta spekei (Baker) and Grewia tembensis (Fresen)
Authors: Nyalo Paul , Omwenga George , Ngugi Mathew
Published: March 2023

Overproduction of free radicals in excess of antioxidants leads to oxidative stress which can cause harm to the body. Conventional antioxidants have drawbacks and are believed to be carcinogenic. The present study seeked to confirm folklore use and validate the antioxidant potentials of Grewia tembensis and Xerophyta spekei which have been widely used in the Mbeere community as medicinal plants. Antioxidant properties were determined through scavenging effects of diphenyl-1-picrylhydrazyl (DPPH) and hydrogen peroxide radicals as well as iron chelating effects. The data obtained was assayed in comparison to the standards (Ascorbic acid and EDTA). Ascorbic acid had a significantly greater DPPH radical scavenging property with an inhibitory concentration (IC50) value of 20.54 ± 2.24 µg/mL in comparison to the plant extracts, which had IC50 values of 33.00 ± 1.47 µg/mL, 69.66 ± 1.01 µg/mL and 86.88 ± 2.64 µg/mL for X. spekei, G. tembensis leaf and G. tembensis stem bark extracts, respectively. EDTA demonstrated a significantly greater iron chelating effect having a significantly lesser IC50 value of 25.05 ± 0.79 µg/mL as opposed to 43.56 ± 0.46 µg/mL, 89.78 ± 0.55 µg/mL, and 120.70 ± 0.71 µg/mL for X. spekei, G. tembensis leaf, and G. tembensis stem bark extracts respectively. Additionally, ascorbic acid also exhibited stronger hydrogen peroxide radical scavenging effect than the studied extracts. Generally, X. spekei extract had higher antioxidant activities as compared to both the leaf and stem bark extracts of G. tembensis. The phytochemical screening demonstrated the presence of secondary metabolites associated with antioxidant properties. The present study therefore, recommends ethno medicinal and therapeutic use of G. tembensis and X. spekei in the treatment and management of oxidative stress related infections.
Supply side stakeholders’ viewpoints about medical tourism in India and the effects of COVID 19
Authors: Hira Jiwanjot Kaur , Kaur Ratinder
Published: March 2023

Medical tourism is a field where healthcare and travel both coincide. Herein, people from different parts of the world travel to different countries in order to avail world-class treatment at an affordable price. With the onset of COVID-19 pandemic, this industry has been hit hard. However, this industry has still reflected back the waves of COVID-19 and has emerged better. This paper has made an effort to comprehend the viewpoints and opinions of the providers that accept medical tourism in India. The participants were selected using judgement and snowball sampling. The data was gathered through semi-structured interviews conducted using both face-to-face method as well as telephonic method. The data was then analysed using Atlas.ti software to highlight the various factors affecting medical tourism as well as its interaction with COVID19 pandemic.
Lung transplantation for COPD/pulmonary emphysema
Authors: Verleden Geert M. , Gottlieb Jens
Published: March 2023

COPD and α-1 antitrypsin deficiency emphysema remain one of the major indications for lung transplantation. If all other treatment possibilities are exhausted or not possible (including rehabilitation, oxygen therapy, noninvasive ventilation, lung volume reduction), patients may qualify for lung transplantation. Strict selection criteria are implemented with a lot of relative and absolute contraindications. Because of an ongoing donor shortage, only a minority of endstage COPD patients will finally get transplanted. The procedure may involve a single or a double lung transplantation, dependent on the experience of the centre, the waiting list, the availability of donor lungs and the patient's risk–benefit ratio. In general, the life expectancy as well as the health-related quality of life after lung transplantation for COPD are usually increased, and may be somewhat better after double compared with single lung transplantation. Several specific complications can be encountered, such as the development of solid organ cancer and chronic lung allograft dysfunction, which develops in up to 50% of patients within 5 years of their transplant and has a major impact on long-term survival, because of the current inefficient treatment modalities.
Smoking cessation and vaccination
Authors: Montes de Oca Maria , Laucho-Contreras Maria Eugenia
Published: March 2023

A significant proportion of COPD patients (∼40%) continue smoking despite knowing that they have the disease. Smokers with COPD exhibit higher levels of nicotine dependence, and have lower self-efficacy and self-esteem, which affects their ability to quit smoking. Treatment should be adapted to the needs of individual patients with different levels of tobacco dependence. The combination of counselling plus pharmacotherapy is the most effective cessation treatment for COPD. In patients with severe COPD, varenicline and bupropion have been shown to have the highest abstinence rates compared with nicotine replacement therapy. There is a lack of evidence to support that smoking cessation reduction or harm reduction strategies have benefits in COPD patients. The long-term efficacy and safety of electronic cigarettes for smoking cessation need to be evaluated in high-risk populations; therefore, it is not possible to recommend their use for smoking cessation in COPD. Future studies with the new generation of nicotine vaccines are necessary to determine their effectiveness in smokers in general and in COPD patients.
Pickaxe: a Python library for the prediction of novel metabolic reactions
Authors: Shebek Kevin M. , Strutz Jonathan , Broadbelt Linda J. , Tyo Keith E. J.
Published: March 2023

Background

Biochemical reaction prediction tools leverage enzymatic promiscuity rules to generate reaction networks containing novel compounds and reactions. The resulting reaction networks can be used for multiple applications such as designing novel biosynthetic pathways and annotating untargeted metabolomics data. It is vital for these tools to provide a robust, user-friendly method to generate networks for a given application. However, existing tools lack the flexibility to easily generate networks that are tailor-fit for a user’s application due to lack of exhaustive reaction rules, restriction to pre-computed networks, and difficulty in using the software due to lack of documentation.

Results

Here we present Pickaxe, an open-source, flexible software that provides a user-friendly method to generate novel reaction networks. This software iteratively applies reaction rules to a set of metabolites to generate novel reactions. Users can select rules from the prepackaged JN1224min ruleset, derived from MetaCyc, or define their own custom rules. Additionally, filters are provided which allow for the pruning of a network on-the-fly based on compound and reaction properties. The filters include chemical similarity to target molecules, metabolomics, thermodynamics, and reaction feasibility filters. Example applications are given to highlight the capabilities of Pickaxe: the expansion of common biological databases with novel reactions, the generation of industrially useful chemicals from a yeast metabolome database, and the annotation of untargeted metabolomics peaks from an E. coli dataset.

Conclusion

Pickaxe predicts novel metabolic reactions and compounds, which can be used for a variety of applications. This software is open-source and available as part of the MINE Database python package (https://pypi.org/project/minedatabase/) or on GitHub (https://github.com/tyo-nu/MINE-Database). Documentation and examples can be found on Read the Docs (https://mine-database.readthedocs.io/en/latest/). Through its documentation, pre-packaged features, and customizable nature, Pickaxe allows users to generate novel reaction networks tailored to their application.
Bayesian kinetic modeling for tracer-based metabolomic data
Authors: Zhang Xu , Su Ya , Lane Andrew N. , Stromberg Arnold J. , Fan Teresa W. M. , Wang Chi
Published: March 2023

Background

Stable Isotope Resolved Metabolomics (SIRM) is a new biological approach that uses stable isotope tracers such as uniformly $$^{13}C$$

13

C

-enriched glucose ($$^{13}C_6$$

13

C
6

-Glc) to trace metabolic pathways or networks at the atomic level in complex biological systems. Non-steady-state kinetic modeling based on SIRM data uses sets of simultaneous ordinary differential equations (ODEs) to quantitatively characterize the dynamic behavior of metabolic networks. It has been increasingly used to understand the regulation of normal metabolism and dysregulation in the development of diseases. However, fitting a kinetic model is challenging because there are usually multiple sets of parameter values that fit the data equally well, especially for large-scale kinetic models. In addition, there is a lack of statistically rigorous methods to compare kinetic model parameters between different experimental groups.

Results

We propose a new Bayesian statistical framework to enhance parameter estimation and hypothesis testing for non-steady-state kinetic modeling of SIRM data. For estimating kinetic model parameters, we leverage the prior distribution not only to allow incorporation of experts’ knowledge but also to provide robust parameter estimation. We also introduce a shrinkage approach for borrowing information across the ensemble of metabolites to stably estimate the variance of an individual isotopomer. In addition, we use a component-wise adaptive Metropolis algorithm with delayed rejection to perform efficient Monte Carlo sampling of the posterior distribution over high-dimensional parameter space. For comparing kinetic model parameters between experimental groups, we propose a new reparameterization method that converts the complex hypothesis testing problem into a more tractable parameter estimation problem. We also propose an inference procedure based on credible interval and credible value. Our method is freely available for academic use at https://github.com/xuzhang0131/MCMCFlux.

Conclusions

Our new Bayesian framework provides robust estimation of kinetic model parameters and enables rigorous comparison of model parameters between experimental groups. Simulation studies and application to a lung cancer study demonstrate that our framework performs well for non-steady-state kinetic modeling of SIRM data.
Performance of heart rate adjusted heart rate variability for risk stratification of sudden cardiac death
Authors: Yan Su-Peng , Song Xin , Wei Liang , Gong Yu-Shun , Hu Hou-Yuan , Li Yong-Qin
Published: March 2023

Purpose

As a non-invasive tool for the assessment of cardiovascular autonomic function, the predictive value of heart rate variability (HRV) for sudden cardiac death (SCD) risk stratification remains unclear. In this study, we investigated the performance of the individualized heart rate (HR) adjusted HRV (HRVI) for SCD risk stratification in subjects with diverse risks.

Methods

A total of 11 commonly used HRV metrics were analyzed in 192 subjects, including 88 healthy controls (low risk group), 82 hypertrophic cardiomyopathy (HCM) patients (medium risk group), and 22 SCD victims (high risk group). The relationship between HRV metrics and HR was examined with long-term and short-term analysis. The performance HRVI was evaluated by area under the receiver operating characteristic curve (AUC) and covariance of variation (CV).

Results

Most of the HRV metrics were exponentially decayed with the increase of HR, while the exponential power coefficients were significantly different among groups. The HRVI metrics discriminated low, medium and high risk subjects with a median AUC of 0.72[0.11], which was considerably higher than that of the traditional long-term (0.63[0.04]) and short-term (0.58[0.05]) HRV without adjustment. The average CV of the HRVI metrics was also significantly lower than traditional short-term HRV metrics (0.09 ± 0.02 vs. 0.24 ± 0.13, p < 0.01).

Conclusions

Subjects with diverse risks of SCD had similar exponential decay relationship between HRV metrics and HR, but with different decaying rates. HRVI provides reliable and robust estimation for risk stratification of SCD.
Prevalence of potentially inappropriate medication use in older population: comparison of the Finnish Meds75+ database with eight published criteria
Authors: Paulamäki Jasmin , Jyrkkä Johanna , Hyttinen Virva , Jämsen Esa
Published: March 2023

Background

There are several national and international criteria available for identifying potentially inappropriate medications (PIMs) for older people. The prevalence of PIM use may vary depending on the criteria used. The aim is to examine the prevalence of potentially inappropriate medication use in Finland according to the Meds75+ database, developed to support clinical decision-making in Finland, and to compare it with eight other PIM criteria.

Methods

This nationwide register study consisted of Finnish people aged 75 years or older (n = 497,663) who during 2017–2019 purchased at least one prescribed medicine considered as a PIM, based on any of the included criteria. The data on purchased prescription medicines was collected from the Prescription Centre of Finland.

Results

The annual prevalence of 10.7–57.0% was observed for PIM use depending on which criteria was used. The highest prevalence was detected with the Beers and lowest with the Laroche criteria. According to the Meds75+ database, annually every third person had used PIMs. Regardless of the applied criteria, the prevalence of PIM use decreased during the follow-up. The differences in the prevalence of medicine classes of PIMs explain the variance of the overall prevalence between the criteria, but they identify the most commonly used PIMs quite similarly.

Conclusion

PIM use is common among older people in Finland according to the national Meds75+ database, but the prevalence is dependent on the applied criteria. The results indicate that different PIM criteria emphasize different medicine classes, and clinicians should consider this issue when applying PIM criteria in their daily practice.
Predicting outcomes in chronic kidney disease: needs and preferences of patients and nephrologists
Authors: van der Horst Dorinde E. M. , Engels Noel , Hendrikx Jos , van den Dorpel Marinus A. , Pieterse Arwen H. , Stiggelbout Anne M. , van Uden–Kraan Cornelia F. , Bos Willem jan W.
Published: March 2023

Introduction

Guidelines on chronic kidney disease (CKD) recommend that nephrologists use clinical prediction models (CPMs). However, the actual use of CPMs seems limited in clinical practice. We conducted a national survey study to evaluate: 1) to what extent CPMs are used in Dutch CKD practice, 2) patients’ and nephrologists’ needs and preferences regarding predictions in CKD, and 3) determinants that may affect the adoption of CPMs in clinical practice.

Methods

We conducted semi-structured interviews with CKD patients to inform the development of two online surveys; one for CKD patients and one for nephrologists. Survey participants were recruited through the Dutch Kidney Patient Association and the Dutch Federation of Nephrology.

Results

A total of 126 patients and 50 nephrologists responded to the surveys. Most patients (89%) reported they had discussed predictions with their nephrologists. They most frequently discussed predictions regarded CKD progression: when they were expected to need kidney replacement therapy (KRT) (n = 81), and how rapidly their kidney function was expected to decline (n = 68). Half of the nephrologists (52%) reported to use CPMs in clinical practice, in particular CPMs predicting the risk of cardiovascular disease. Almost all nephrologists (98%) reported discussing expected CKD trajectories with their patients; even those that did not use CPMs (42%). The majority of patients (61%) and nephrologists (84%) chose a CPM predicting when patients would need KRT in the future as the most important prediction. However, a small portion of patients indicated they did not want to be informed on predictions regarding CKD progression at all (10–15%). Nephrologists not using CPMs (42%) reported they did not know CPMs they could use or felt that they had insufficient knowledge regarding CPMs. According to the nephrologists, the most important determinants for the adoption of CPMs in clinical practice were: 1) understandability for patients, 2) integration as standard of care, 3) the clinical relevance.

Conclusion

Even though the majority of patients in Dutch CKD practice reported discussing predictions with their nephrologists, CPMs are infrequently used for this purpose. Both patients and nephrologists considered a CPM predicting CKD progression most important to discuss. Increasing awareness about existing CPMs that predict CKD progression may result in increased adoption in clinical practice. When using CPMs regarding CKD progression, nephrologists should ask whether patients want to hear predictions beforehand, since individual patients’ preferences vary.
Acceptability and user experiences of a patient-held smart card for antenatal services in Nigeria: a qualitative study
Authors: Itanyi Ijeoma Uchenna , Iwelunmor Juliet , Olawepo John Olajide , Gbadamosi Semiu , Ezeonu Alexandra , Okoli Adaeze , Ogidi Amaka Grace , Conserve Donaldson , Powell Byron , Onoka Chima Ariel , Ezeanolue Echezona Edozie
Published: March 2023

Background

Poor maternal, newborn and child health outcomes remain a major public health challenge in Nigeria. Mobile health (mHealth) interventions such as patient-held smart cards have been proposed as effective solutions to improve maternal health outcomes. Our objectives were to assess the acceptability and experiences of pregnant women with the use of a patient-held smartcard for antenatal services in Nigeria.

Methods

Using focus group discussions, qualitative data were obtained from 35 pregnant women attending antenatal services in four Local Government Areas (LGAs) in Benue State, Nigeria. The audio-recorded data were transcribed and analyzed using framework analysis techniques such as the PEN-3 cultural model as a guide.

Results

The participants were 18–44 years of age (median age: 24 years), all were married and the majority were farmers. Most of the participants had accepted and used the smartcards for antenatal services. The most common positive perceptions about the smartcards were their ability to be used across multiple health facilities, the preference for storage of the women’s medical information on the smartcards compared to the usual paper-based system, and shorter waiting times at the clinics. Notable facilitators to using the smartcards were its provision at the “Baby showers” which were already acceptable to the women, access to free medical screenings, and ease of storage and retrieval of health records from the cards. Costs associated with health services was reported as a major barrier to using the smartcards. Support from health workers, program staff and family members, particularly spouses, encouraged the participants to use the smartcards.

Conclusion

These findings revealed that patient-held smart card for maternal health care services is acceptable by women utilizing antenatal services in Nigeria. Understanding perceptions, barriers, facilitators, and supportive systems that enhance the use of these smart cards may facilitate the development of lifesaving mobile health platforms that have the potential to achieve antenatal, delivery, and postnatal targets in a resource-limited setting.