bluuebunny/crossref_metadata_2025 huggingface dataset:
Beat‐to‐Beat Blood Pressure Variability Within 24 Hours of Ischemic Stroke Onset: A Potential Predictor of Functional Prognosis
Authors: Ren Jia‐Xin , Qu Yang , Gao Yi , Ma Hong‐Yin , Zhang Peng , Guo Zhen‐Ni , Yang Yi
Published: July 2024

Background

Beat‐to‐beat blood pressure variability (BPV) is based on each heartbeat and represents a dynamic equilibrium process modulated by artery and cardiac involvement of pressure‐receptive reflexes. To date, there remains a lack of prospective studies illustrating the clinical value of beat‐to‐beat BPV within 24 hours of acute ischemic stroke onset.

Methods and Results

This study prospectively monitored beat‐to‐beat blood pressure and heart rate in patients with acute ischemic stroke within 24 hours of onset using a noninvasive plethysmograph and calculated beat‐to‐beat BPV, heart rate variability, and the cross‐correlation baroreflex sensitivity. A modified Rankin Scale score of ≥2 at 90 days was defined as an unfavorable prognosis. Multivariate logistic regression was performed, and the nomogram model was developed by adding the beat‐to‐beat BPV to the traditional model for predicting prognosis. Beat‐to‐beat BPV increased significantly in the unfavorable outcome group (
P
<0.05) compared with that in the favorable outcome group, whereas no difference was observed in beat‐to‐beat heart rate variability and cross‐correlation baroreflex sensitivity between both groups (
P
>0.05). Furthermore, beat‐to‐beat BPV within 24 hours of acute ischemic stroke onset was independently associated with unfavorable outcome at 90 days (
P
<0.005). The addition of beat‐to‐beat BPV to the traditional model for predicting prognosis enhanced the area under the receiver operating characteristic curve from 0.816 to 0.830.

Conclusions

Increased beat‐to‐beat BPV within 24 hours of acute ischemic stroke onset was independently associated with a poor prognosis at 90 days and may be a potential predictor for discriminating unfavorable prognosis.
Neuropsychological Analysis of the Structure of Ravens’s Coloured Progressive Matrices Test in Children 6–9 Years Old
Authors: Korneev Aleksei A. , Mateeva Ekaterina Yu. , Akhitina Tatyana V.
Published: July 2024

Background. Raven’s Coloured Progressive Matrices (RCPMs) is a widely used instrument as one of psychometric measures of general intelligence in children. However, according to some researchers, the RCPM is heterogeneous and individual tasks may be associated with the assessment of various cognitive components. Objective. This study is aimed to examine the influence of functions of visual and visuospatial processing, and executive functions on the productivity of RCPMs. Sample. A total of 297 children from 6 to 9 years old participated in the study. Of these, 98 were preschoolers, 87 first graders and 112 second graders. A total of 152 boys and 145 girls participated in the study. All children had no diagnosed developmental and neurological disorders. Methods. All the children accomplished the computerized version of RCPM in the Rosanova’s modification. They also passed a neuropsychological assessment adapted for 6–9-year-old children. Results. Age differences were shown. They were the greatest when comparing preschoolers and first-grader. The differences between first-graders and second-graders were less prominent. Hierarchical regression analysis showed that three parts of the matrices are related to separate groups of functions to different degrees. The first part of the test is most related to the state of visual information processing functions; the second part refers to the state of visual-spatial information processing and executive functions; and the third part to a greater extent deals with the state of executive functions. Conclusion. The results indicate the heterogeneity of tasks in RCPM and the promise of a more detailed analysis of the structure of the technique, including the use of a neuropsychological approach.
Dichoropetalum andacii (Apiaceae), a new species from Türkiye
Authors: AKPULAT H. AŞKIN , ECEVİT-GENÇ GÜLAY , AKALIN EMİNE , ÖZCAN TANER
Published: July 2024

Dichoropetalum andacii Akpulat, G. E. Genç & Akalın is described as a new species from Antalya, Türkiye. The new species differs from the similar D. chryseum and D. palimbioides by the number of umbel rays and bracteoles, fruit size, mericarp features, and by some ITS sequence differences. Diagnostic morphological and anatomical characters, karyological features, molecular structure of ITS region, and micromorphological structures of mericarps and pollens are discussed. Also, notes are presented regarding its phenology, ecology, and conservation status.
Revision of Nearctic Microcercis Beschovski (Diptera: Chloropidae), with Synonymy of Incertella Sabrosky
Authors: FOSTER GEORGE A.
Published: July 2024

Nearctic species of Incertella Sabrosky, 1980 are transferred to Microcercis Beschovski, 1978 due to the synonymy of the type species I. incerta (Becker, 1912) with M. albipalpis (Meigen, 1830). The ten species treated are M. albipalpis (Meigen) = M. incerta (Becker) syn. n., M. bispina (Malloch), M. dorsata (Loew), M. infesta (Becker), M. insularis (Malloch), and M. minor (Adams), [all are new combinations], and the four new species: M. laytoni sp. n., M. murphyi sp. n., M. johanni sp. n. and M. trifeminarum sp. n. A generic diagnosis is provided, as are species diagnoses and descriptions and a key to Nearctic Microcercis. Lectotypes are designated for M. infesta, and M. insularis. Incertella ovalis (Adams) is moved to Conioscinella Duda comb. n. Photographs illustrating the habitus of all species, male genitalia photos of most species, and scanning electron microscope (SEM) photos of specific features are provided. Material from Canada, the United States, and Mexico is recorded.
Two new genera of tokoriro (Orthoptera: Rhaphidophoridae: Macropathinae) from Aotearoa New Zealand
Authors: TREWICK STEVEN A.
Published: July 2024

Two new genera and three new species of forest inhabiting Macropathinae (Orthoptera: Rhaphidophoridae) are described from Aotearoa New Zealand. Crux Trewick gen. nov. is described with two new species, Crux boudica sp. nov. from Rakiura Stewart Island and southwest South Island and Crux heggi sp. nov. from northwest South Island. The monotypic genus Occultastella Trewick gen. nov. is represented by Occultastella morgani sp. nov. from northwest South Island.
The Instagram Paradox: Examining Its Role in Shaping Mental Health Among Young Adults--A Comprehensive Analysis
Authors: Lunia Shaurya
Published: July 2024

Instagram has become a ubiquitous part of young adults' lives, profoundly shaping their mental health and well-being. This research was conducted to investigate the pervasive influence of Instagram usage among young adults aged 17-22, particularly focusing on its impact on anxiety, depression, and self-esteem. The rationale for this study stems from the growing concern about the psychological effects of prolonged exposure to idealized images and lifestyles presented on social media. Utilizing a comprehensive survey methodology, data was collected from a diverse sample of young adults. The results reveal that 95.2% of participants use Instagram daily, with nearly half spending over four hours on the platform each day. The study highlights significant mental health repercussions, with 70% of respondents reporting feelings of anxiety, depression, and inadequacy attributed to their Instagram use. These findings underscore the critical need for interventions to mitigate the negative impact of Instagram on mental health and to promote healthier online behaviors and interactions. The implications of this research are far-reaching, suggesting that both individual users and social media platforms must take proactive steps to foster digital environments that support mental well-being and reduce the psychological burden on young adults.
Supporting Patients with Amputated Lower Limb in Accepting Their New Body Images by Traumatology Nurses of Central Hospital Yaoundé-Cameroon: An Exploratory Study
Authors: Wankam Mispar , Fabiola Kengne , Sales Fouodji
Published: July 2024

This study aims at exploring the role of the nurse in supporting patients with the amputated lower limb towards the acceptance of their new body images in the traumatology B unit of the Central Hospital in Yaoundé-Cameroon. The study used a qualitative exploratory design. The study population was made up of eight nurses from the traumatology unit of the central hospital in Yaoundé-Cameroon. Data were collected using a semi-structured interview guide from a purposeful sample of nurses. The saturation level determined the sample size for the study. Data were analyzed using inductive content analysis. The results obtained from this study showed that it is difficult to take care of patients with amputated lower limbs as physical support e.g. hygiene care; wound dressings, pain evaluation and care were outlined by most of the nurses as the main mode of support given to patients. Consideration should be given to non-pharmacological and less invasive surgical interventions for phantom limb pain, as they are associated with less common and less severe side effects. Active listening, reassuring patients, helping relationship and confidence were the main elements of psychological support stated by the nurses. The main challenges nurses encountered in supporting amputated patients were difficult communication and language barrier. The findings from this study proposed that there were many factors to take into account in order to be able to help patients with amputated lower limb: physical and moral pain, the psychological aspect with modification of body image, loss of self-esteem etc... The nurse must demonstrate human and relational qualities and great psychological resistance in order to effectively support the amputated patient on the physical level by providing hygiene and comfort care, dressing; and on the psychological level by questioning the patients about their difficult emotions while being available to listen in order to establish a nursing diagnosis and help the patients to cope with their difficulties.
Re-visiting Sophocles’ Antigone: Dr. Dina Amin’s 2022 Egyptian Version Antigone’s Law
Authors: El-Assal Mariham
Published: July 2024

This paper attempts to compare Sophocles’ Antigone to the Egyptian adaptation Antigone’s law (2022), to highlight the significance of intertextuality. The study entails contributions to intertextuality that will be integrated in analyzing the adapted discourses. It will also capitalize on the political and social dimensions illustrated in the adapted play. The study aims to explore the oppressed female voices in the concerned texts and how the adapted work is appropriating to any oppressed culture that suffers from the same sense of oppression throughout the ages. In this respect, the paper reflects the oppressed female character who defies her uncle who embodies the tyrannical figure that does not want her to bury her brother. In this respect, the paper rests on Julia Kristeva’s and Mikhail Bakhtin’s development of intertextuality. It will also rely on Lorna Hardwick’s and Robert Fraser’s reference to the use of verbal and semiotic techniques which give the audiences a new comprehensive meaning that could be linked to their real life. This paper will also explain Susan Bassnett’s concept of polyphony or plurivocality that is set in contrast to the earlier model imposed by the colonial power of univocality. In other words, the other voices can be heard rather than the dominant single or monolithic voice. Plurivocality is capitalized on as it is at the heart of post-colonial thinking. Therefore, the study aims at proving that the experience was not only limited to the individual, but also to a whole community and humanity as well, and that reflects and highlights the power and the wisdom of women through the ages with different manifestations in the examined discourse. The study therefore, attempts to prove how the notion of intertextuality is found deeply in the Egyptian adapted work.
Dynamic insulation technology in buildings subject to intermittent heating and cooling, Part A: Iraqi case
Authors: Hosseinalipour S. M. , Al-Taee Ammar A. Hussain , Asiaei Sasan
Published: July 2024

In harsh climates like Iraq, characterized by extreme temperatures and energy shortages, dynamic insulation technology holds great potential to significantly reduce energy consumption and enhance thermal comfort. Dynamic insulation technology reduces building energy consumption by adjusting thermal conductivity based on climate changes. This article reviews existing literature and numerically evaluates the effectiveness of dynamic insulation technology in buildings subject to harsh climates, specifically focusing on the case of Iraq. The first part of our articles aims to provide a comprehensive overview of dynamic insulation technology and its potential effectiveness in Iraqi structures subject to intermittent heating and cooling. The collected data guides the design and implementation of future studies and experiments. The study predicts the dynamic insulation performance of an office in Baghdad compared to conventional insulation, considering factors such as lighting, number of residents, equipment, and solar gains. The results indicate that applying dynamic insulation techniques in Iraqi buildings can reduce energy consumption by 28% during the heating season and 11% during the cooling season. Implementing this technology can make a significant contribution towards creating a more sustainable and comfortable environment in harsh climates, examined in Iraqi buildings, as a model case.

Practical Applications: The study contributes to the evaluation of dynamic insulation technology in Iraqi buildings. Focusing on Iraq's harsh climate provides valuable insights into the effectiveness of this technology. Scientifically based recommendations guide the design of buildings in such environments. In addition, the study investigates the performance of intermittent cooling and heating, ensuring practicality. Overall, it enables professionals to create sustainable and efficient built environments in Iraq.
Young Adult Career Outcomes for Adolescents With ADHD, High Ability, or Twice-Exceptionality
Authors: Park Soeun , Foley-Nicpon Megan , Mahatmya Duhita
Published: July 2024

The purpose of this study was to explore career outcomes in young adulthood among adolescents with ADHD and/or high abilities. The sample included respondents who had the ability and ADHD measures from Waves 1 (1995), 3 (2002), and 4 (2009) of the National Longitudinal Study of Adolescent and Adult Health in-home questionnaire. Using multiple group path analysis, we examined the pathways for three groups of individuals (i.e., ADHD, high ability, and both/twice-exceptional). We discovered financial and educational family background predicted occupational status and career goal attainment, as well as supports and barriers among various family and adolescent predictors (e.g., school attachment, educational aspiration, depressive symptoms). Knowledge about these trajectories will help professionals design tailored career and educational services for adolescents with high ability, ADHD, and both.
SAD geographies: Making light matter
Authors: Bodden Shawn , Lorimer Hayden , Parr Hester , Williams Chris
Published: July 2024

This paper addresses the relationship between light and mental health through a multifaceted inquiry into the complex and contested condition of ‘Seasonal Affective Disorder’ (SAD). It does so by first charting a disciplinary neglect of seasonal depression in ‘geographies of mental health’, followed by a consideration of broader philosophical ideas about human sensibilities and the place of light in life. These interpretative resources are brought into correspondence with both clinical debates about the legitimacy of SAD as a phenomenon and the role of culture in the experience of light-affected sadness. The paper culminates by outlining a future research agenda for a cultural geography of SAD in the context of climate-changed environmental light.
Safety and Tolerability of Initiating Sacubitril-Valsartan With Spironolactone During Hospitalization for Acute Decompensated Heart Failure
Authors: Levine Alexander R. , Sasiela Katarzyna , Baker Mark
Published: July 2024

Background: Initiation of sacubitril-valsartan and mineralocorticoid receptor antagonists (MRA) during hospitalization for acute decompensated heart failure (ADHF) may be an ideal time to optimize guideline-directed medical therapy. However, there is limited research assessing the safety of combining these agents in the hospital. Methods: This was a multi-center, retrospective, propensity-score matched cohort study performed at 7 acute-care hospitals within a large health care system. All adult patients admitted with ADHF between January 1, 2019 to December 31, 2021 who received sacubitril-valsartan with MRA (MRA group) or without MRA (non-MRA group) and had a left ventricular ejection fraction (LVEF) < 40% were included in the study. Results: 220 patients were screened during the study time frame with 179 meeting inclusion criteria. Following propensity-score matching, 50 patients in the MRA group were matched to 50 patients in the non-MRA group. The overall incidence of adverse drug reactions (ADRs) was 24% in the non-MRA group compared to 20% in the MRA group ( P = .629). There was a significantly greater incidence of hyperkalemia in the MRA group (0% vs 10%; P = .022). None of the patients in the non-MRA group were readmitted within 30 days due to an ADR compared to 6% in the MRA group ( P = .079). Conclusion: The addition of spironolactone to sacubitril-valsartan in the hospital setting following stabilization of ADHF did not lead to a significantly greater incidence of overall ADRs, but patients were more likely to develop hyperkalemia and there was a numerically higher incidence of 30-day readmissions due to ADRs.
Managerial ethical principles and behaviours for nurse managers: A Delphi method
Authors: Ayan Güzin , Baykal Ülkü
Published: July 2024

Background

Managerial ethical principles and behaviours guide the roles, duties, responsibilities, behaviours, and relationships of nurse managers in healthcare institutions.

Research objectives

The aim of this study was to establish the managerial ethical principles and behaviours for nurse managers.

Research question

What are the managerial ethical principles and behaviours for nurse managers?

Research design

The Delphi method, one of the qualitative research methods, was used in this study. The Delphi process consisted of two rounds. Data were collected by e-Delphi technique.

Participations

42 experts were included in the first Delphi round and 39 in the second Delphi round. These experts consisted of nurse managers, academicians studying in the field of ethics and nursing management.

Ethical considerations

Participation in the study was voluntary and informed consent of the experts was obtained before the study. Approval was obtained from the ethics committee of the university at which the researcher worked (Approval date: 24.07.2020, Decision No: 2020/12-16).

Findings

At the end of the Delphi rounds, eight managerial ethical principles and 29 ethical behaviours of these principles were identified. The distribution of these behaviours and principles were: justice (six behaviours), equality (two behaviours), honesty (two behaviours), fairness (two behaviours), responsibility (eight behaviours), confidentiality (two behaviours), clarity (two behaviours), and humanity (five behaviours).

Conclusion

These managerial ethical principles and behaviours are intended to guide nurse managers when providing nursing services but should be updated accordingly in line with changing conditions and developments.
Barriers to maintaining dignity for patients with schizophrenia: A qualitative study
Authors: Amiri Elham , Baghaei Rahim , Ebrahimi Hossein , Habibzadeh Hossein
Published: July 2024

Background

Since dignity is one of the fundamental rights of each patient, maintaining patients’ dignity is essential. Unfortunately, in many cases, particularly among patients with schizophrenia (SCZ), dignity is not fully respected. Nonetheless, there is limited knowledge regarding this matter in Middle Eastern Nations.

Research Objective

This study aimed to identify the barriers to maintaining dignity for patients with schizophrenia from the perspective of patients with schizophrenia, their family caregivers, and healthcare personnel.

Research Design

This qualitative study was conducted with patients ( n = 16), family caregivers ( n = 4), and healthcare personnel ( n = 6) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until the data reached saturation. Data were analyzed using the Graneheim and Lundman method.

Ethical Considerations

The Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099).

Findings

Analysis of the interviews revealed two main themes and five subthemes as the barriers to maintaining dignity for patients with schizophrenia. The main themes included “Black shadow of stigma” (three subthemes: “Facing the fear and discrimination of others,” “Misconceptions in society,” and “Social rejection”) and “Facing violations” (two subthemes: “Basic human rights violation” and “Negative emotional responses”).

Conclusion

Patients’ dignity with schizophrenia was at a low level due to the negative attitude of society toward these patients. In this respect, the basic human rights violations, social rejection, and misconceptions were abundant in society and care centers. An in-depth comprehension of the threatening factors affecting dignity can assist policymakers in safeguarding their dignity through effective programs.
Comparative outcomes of uncemented and cemented stem revision in managing periprosthetic femoral fractures: a retrospective cohort study
Authors: Axenhus Michael , Mukka Sebastian , Magnéli Martin , Sköldenberg Olof
Published: July 2024

Introduction

Periprosthetic femoral fractures (PFFs) following hip arthroplasty, especially Vancouver B2 and B3 fractures, present a challenge due to the association with a loose femoral stem, necessitating either open reduction and internal fixation or stem revision. This study aims to compare outcomes between uncemented and cemented stem revisions in managing Vancouver B2 and B3 fractures, considering factors such as hip-related complications, reoperations, and clinical outcome.

Methods

A retrospective cohort study was conducted at Danderyd Hospital, Sweden, from 2008 to 2022, encompassing operatively treated Vancouver B2 and B3 fractures. Patients were categorized into uncemented and cemented stem revision groups, with data collected on complications, revision surgeries, fracture healing times, and clinical outcomes.

Results

A total of 241 patients were identified. Significant differences were observed between the two groups in patient demographics, with the cemented group comprising older patients and more females. Follow up ranged from 1 to 15 years. Average follow up time was 3.9 years for the cemented group and 5.5 years for the uncemented group. The cemented stems demonstrated lower rates of dislocation (8.9% versus 22.5%, P = 0.004) and stem loosening (0.6% versus 9.3%, P = 0.004) than the uncemented method. Moreover, the cemented group exhibited shorter fracture healing times (11.4 weeks versus 16.7 weeks, P = 0.034). There was no difference in clinical outcome between groups. Mortality was higher in the cemented group.

Conclusions

This retrospective study indicates that cemented stem revision for Vancouver B2–3 fractures is correlated with lower dislocation and stem loosening rates, necessitating fewer reoperations and shorter fracture healing times compared with the uncemented approach. The cemented group had a notably higher mortality rate, urging caution in its clinical interpretation.

Level of evidence III
Catecholamine concentration as a predictor of mortality in emergency surgical patients
Authors: Suh João Isuk , da Roza Daiane Leite , Cadamuro Filipe Matheus , Malbouisson Luiz Marcelo Sá , Sanches Talita Rojas , Andrade Lúcia
Published: July 2024

Background

Trauma and emergency surgery are major causes of morbidity and mortality. The objective of this study was to determine whether serum levels of epinephrine and norepinephrine are associated with aging and mortality.

Methods

This was a prospective observational cohort study conducted in a surgical critical care unit. We included 90 patients who were admitted for postoperative care, because of major trauma, or both. We collected demographic and clinical variables, as well as serum levels of epinephrine and norepinephrine.

Results

For patients in the > 60-year age group, the use of vasoactive drugs was found to be associated with an undetectable epinephrine level (OR [95% CI] = 6.36 [1.12, 36.08]), p = 0.05). For the patients with undetectable epinephrine levels, the in-hospital mortality was higher among those with a norepinephrine level ≥ 2006.5 pg/mL (OR [95% CI] = 4.00 [1.27, 12.58]), p = 0.03).

Conclusions

There is an association between age and mortality. Undetectable serum epinephrine, which is more common in older patients, could contribute to poor outcomes. The use of epinephrine might improve the clinical prognosis in older surgical patients with shock.
Seasonal variation effect on water quality and sediments criteria and its influence on soil pollution: Fayoum Governorate, Egypt
Authors: Mansour H. , Ahmed Sayed A. , Zaghloul A. , Kabary H. , Nassar Hossam F.
Published: July 2024

Background

Irrigation with low-quality water without considering the acceptable levels negatively impacts not only humans, but also extends to the whole surrounding ecosystem. The current research is a comprehensive-integrated appraisal of the irrigation water quality gathered from El-Batts drain in Fayoum Governorate, from September 2021 to June 2022, together with the drain sediments and the soils adjacent to it. The characteristics (physical, chemical and biological), and the risk fate of some heavy metals (As, B, Cr, Cu, Zn, Cd, Pb, Ni, Fe and Mn) were measured. Moreover, the risks of the studied pollutants were assessed using many indices: irrigation water quality index (IWQI), contamination factor (Cf), degree of contamination (Cd), Salinity indices and Zn equivalent (ZE). Additionally, kinetic studies of the inorganic pollutants were evaluated to determine their availability and impact on the surrounding environment.

Results

Data from IQWI showed that water in all five sites was assumed to be very bad and unsuitable for usage with a general average (14.62 and 25.35) in all four seasons. ZE exceeds the critical level of 250, which means there is a risk of soil contamination.

Conclusions

The elevated levels of heavy metals, microbial enzymes, pathogenic fecal coliform and Salmonella reflect bad and direct risk of dealing with such water in irrigation and its effect on the soil ecosystem and the growing crops. Most of the tested parameters exceeded the acceptable levels of the Egyptian Governmental Law Guidelines, WHO and FAO, which may threaten aquatic life. Best managements practices and remediation techniques should be applied to minimize the hazards in such waters.
Spatiotemporal patterns of leaf nutrients of wild apples in a wild fruit forest plot in the Ili Valley, China
Authors: Wang Meng-Ting , Xue Zhi-Fang , Tao Ye , Kan Zi-Han , Zhou Xiao-Bing , Liu Hui-Liang , Zhang Yuan-Ming
Published: July 2024

Malus sieversii, commonly known as wild apples, represents a Tertiary relict plant species and serves as the progenitor of globally cultivated apple varieties. Unfortunately, wild apple populations are facing significant degradation in localized areas due to a myriad of factors. To gain a comprehensive understanding of the nutrient status and spatiotemporal variations of M. sieversii, green leaves were collected in May and July, and the fallen leaves were collected in October. The concentrations of leaf nitrogen (N), phosphorus (P), and potassium (K) were measured, and the stoichiometric ratios as well as nutrient resorption efficiencies were calculated. The study also explored the relative contributions of soil, topographic, and biotic factors to the variation in nutrient traits. The results indicate that as the growing period progressed, the concentrations of N and P in the leaves significantly decreased (P < 0.05), and the concentration of K in October was significantly lower than in May and July. Throughout plant growth, leaf N–P and N–K exhibited hyperallometric relationships, while P–K showed an isometric relationship. Resorption efficiency followed the order of N < P < K (P < 0.05), with all three ratios being less than 1; this indicates that the order of nutrient limitation is K > P > N. The resorption efficiencies were mainly regulated by nutrient concentrations in fallen leaves. A robust spatial dependence was observed in leaf nutrient concentrations during all periods (70.1–97.9% for structural variation), highlighting that structural variation, rather than random factors, dominated the spatial variation. Nutrient resorption efficiencies (NRE, PRE, and KRE) displayed moderate structural variation (30.2–66.8%). The spatial patterns of nutrient traits varied across growth periods, indicating they are influenced by multifactorial elements (in which, soil property showed the highest influence). In conclusion, wild apples manifested differentiated spatiotemporal variability and influencing factors across various leaf nutrient traits. These results provide crucial insights into the spatiotemporal patterns and influencing factors of leaf nutrient traits of M. sieversii at the permanent plot scale for the first time. This work is of great significance for the ecosystem restoration and sustainable management of degrading wild fruit forests.
A preliminary prediction model of pediatric Mycoplasma pneumoniae pneumonia based on routine blood parameters by using machine learning method
Authors: Peng Xuelian , Liu Yulong , Zhang Bo , Yang Chunyan , Dong Jian , Yong Chen , Han Baoru , Li Jin
Published: July 2024

Background

The prevalence and severity of pediatricMycoplasma pneumoniae pneumonia(MPP) poses a significant threat to the health and lives of children. In this study, we aim to systematically evaluate the value of routine blood parameters in predicting MPP and develop a robust and generalizable ensemble artificial intelligence (AI) model to assist in identifying patients with MPP.

Methods

We collected 27 features, including routine blood parameters and hs-CRP levels, from patients admitted to The Affiliated Dazu’s Hospital of Chongqing Medical University with or without MPP between January, 2023 and January, 2024. A classification model was built using seven machine learning (ML) algorithms to develop an integrated prediction tool for diagnosing MPP. It was evaluated on both an internal validation set (982 individuals) and an external validation set (195 individuals). The primary outcome measured the accuracy of the model in predicting MPP.

Results

The GBDT is state-of-the-art based on 27 features. Following inter-laboratory cohort testing, the GBDT demonstrated an AUC, accuracy, specificity, sensitivity, PPV, NPV, and F1-score of 0.980 (0.938–0.995), 0.928 (0.796–0.970), 0.929 (0.717-1.000), 0.926 (0.889–0.956), 0.922 (0.727-1.000), 0.937 (0.884–0.963), and 0.923 (0.800-0.966) in stratified 10-fold cross-validation. A GBDT-based AI Lab was developed to facilitate the healthcare providers in remote and impoverished areas.

Conclusions

The GBDT-based AI Lab tool, with high sensitivity and specificity, could help discriminate between pediatric MPP infection and non-MPP infection based on routine blood parameters. Moreover, a user-friendly webpage tool for AI Lab could facilitate healthcare providers in remote and impoverished areas where advanced technologies are not accessible.
Pediatric antibody responses to SARS-CoV-2 after infection and vaccination in Calgary, Canada
Authors: Ricketson Leah J. , Doucette Emily J. , Alatorre Isabella , Tarannum Tarannum , Gray Joslyn , Booth William , Tipples Graham , Charlton Carmen , Kanji Jamil N. , Fonseca Kevin , Kellner James D.
Published: July 2024

Background

There are few reports of longitudinal serologic responses in children following Sars-CoV-2 infection and vaccination. This study describes longitudinal SARS-CoV-2 antibody responses following infection, vaccination, or both (hybrid immunity) in a cohort of Canadian children. The objectives of our study were to compare antibody levels following SARS-CoV-2 infection, vaccination, and hybrid immunity and to examine antibody decline after final antigen exposure.

Methods

The Alberta Childhood COVID-19 Cohort (AB3C) study was a prospective longitudinal cohort study conducted from July 2020 to September 2022 with repeat sampling across 5 visits. Children under 18 years of age were enrolled for serial measurement of antibody responses to SARS-CoV-2 virus vaccine and infection.

Results

The final sample size was 919; participants were 50.5% female, 48.2% were > 12 years and 88.5% were white ethnicity. The median peak spike IgG level of those with only infection was not different from those with no vaccination or infection (233 AU/mL (IQR: 99–944 AU/mL) vs. 3 AU/mL (IQR: 1–5 AU/mL; P = 0.1765). Participants with infections after vaccination had higher IgG levels than those where infection preceded vaccination (median: 36,660 (IQR: 22,084 − 40,000 AU/mL) vs. 17,461 AU/mL (IQR: 10,617 − 33,212 AU/mL); P < 0.0001). In a linear mixed methods model, children with infection-only had low levels of antibody that stayed stable over the study duration without further antigen exposures. Those with infection after vaccination had the slowest rate of antibody decline over time at 4% (95%CI: 2-5%) per week, compared with children where infection preceded vaccine 7% (95%CI: 6-8%) per week.

Conclusions

Children with hybrid immunity conferred through vaccination (2 + doses) followed by a SARS-CoV-2 infection had the highest and longest lasting antibody levels, compared to children who had an infection followed by vaccination, vaccination-only, or infection-only. The longer-term clinical importance of these findings, related to prevention of repeated infections and severe outcomes and need for further vaccine doses, is not yet known.
Diagnostic performance of magnetic resonance imaging features to differentiate adrenal pheochromocytoma from adrenal tumors with positive biochemical testing results
Authors: Huang Rukun , Lin Tingsheng , Chen Mengxia , Li Xiaogong , Guo Hongqian
Published: July 2024

Background

It is extremely essential to accurately differentiate pheochromocytoma from Adrenal incidentalomas (AIs) before operation, especially biochemical tests were inconclusive. We aimed to evaluate the value of magnetic resonance imaging (MRI) features to differentiate pheochromocytomas among adrenal tumors, among which the consequences of biochemical screening tests of catecholamines and/or catecholamine metabolites are positive.

Methods

With institutional review board approval, this study retrospectively compared 35 pheochromocytoma (PHEO) patients with 27 non-pheochromocytoma(non-PHEO) patients between January 2022 to September 2023, among which the consequences of biochemical screening tests of catecholamines and/or catecholamine metabolites are positive. T test was used for the independent continuous data and the chi-square test was used for categorical variables. Univariate and multivariate logistic regression were applied to find the independent variate of the features to differentiate PHEO from non-PHEO and ROC analysis was applied to evaluate the diagnostic value of the independent variate.

Results

We found that the T2-weighted (T2W) signal intensity in patients with pheochromocytoma was higher than other adrenal tumors, with greatly significant (p < 0.001). T2W signal intensity ratio (T2W nodule-to-muscle SI ratio) was an independent risk factor for the differential diagnosis of adrenal PHEOs from non-PHEOs. This feature alone had 91.4% sensitivity and 81.5% specificity to rule out pheochromocytoma based on optimal threshold, with an area under the receiver operating characteristics curve (AUC‑ROC) of 0.910(95% C I: 0.833–0.987).

Conclusion

Our study confirms that T2W signal intensity ratio can differentiate PHEO from non-PHEO, among which the consequences of biochemical screening tests of catecholamines and/or catecholamine metabolites are positive.
Clinical application of FIGO 2023 staging system of endometrial cancer in a Chinese cohort
Authors: Yu Changmin , Yuan Xinhui , Yao Qianlan , Xu Yuyin , Zhou Xiaoyan , Hu Xin , Yang Huijuan , Wang Huaying , Zhu Xiaoli , Ren Yulan
Published: July 2024

Objective

The International Federation of Gynecology and Obstetrics (FIGO) 2023 staging system for endometrial cancer (EC) was released with incorporating histology, lympho-vascular space invasion, and molecular classification together. Our objective is to further explore the clinical utility and prognostic significance of the 2023 FIGO staging system in China.

Methods

A retrospective analysis was conducted for patients who received standard surgeries and underwent genetic testing using multigene next-generation sequencing (NGS) panels between December 2018 and December 2023 at Fudan University Shanghai Cancer Center, Shanghai, China. The genomic and clinical data of all patients were analyzed, and stages were determined by both the 2009 and 2023 FIGO staging systems. Kaplan–Meier estimators and Cox proportional hazards models were used for survival analysis.

Results

A total of 547 patients were enrolled in the study. After the restaged by the FIGO 2023 staging system, stage shifts occurred in 147/547 (26.9%) patients. In patients with early stages in FIGO 2009 (stage I-II), 63 cases were rearranged to IAmPOLEmut and 53 cases to IICmp53abn due to the molecular classification of POLEmut and p53abn. Altogether 345 cases were in stage I, 107 cases in stage II, 69 cases in stage III, and 26 cases in stage IV according to the FIGO 2023 staging criteria. For stage I diseases, the 3-year PFS rate was 92.7% and 95.3% in 2009 and 2023 FIGO staging systems, respectively. The 3-year PFS of stage II in 2023 FIGO was lower than that of FIGO 2009 (3-year PFS: 85.0% versus 90.9%), especially in substage IIC and IICmp53abn. Three cases (12%) of stage IIIA in FIGO 2009 were shifted to stage IA3 FIGO 2023, with 3-year PFS rates of 90.9% versus 100%, respectively. In NGS analysis, the most prevalent gene alterations were observed in PTEN and PIK3CA.

Conclusion

The FIGO 2023 staging system was proved to be a good predictor of survival for EC patients with enhanced precision compared to FIGO 2009. Predominant stage shifts were observed in early-stage diseases. Distinct gene alterations of different subtypes may help to explore more accurate target therapies.
Investıgatıon of the effects of treatment with enoxaparın sodıum and hyperbarıc oxygen therapy on the recovery of rats wıth achılles tendon rupture
Authors: Aytekin Cafer Erman , Turhan Yalcın , Karaduman Zekeriya Okan , Arıcan Mehmet , Saglam Sönmez , Coskun Sinem Kantarcıoglu , Uludag Veysel
Published: July 2024

Purpose

In this study, we aimed to investigate the effects of hyperbaric oxygen therapy and enoxaparin sodium, which are known to accelerate bone tissue healing as well as tendon and soft tissue healing, on the healing of Achilles tendon rupture.

Methods

Thirty-six rats were used in the present study. All rats were divided into groups of nine. The groups were the enoxaparin sodium group, enoxaparin sodium and hyperbaric oxygen group, hyperbaric oxygen group and control group. After 21 days, the process was completed, and the rats were sacrificed. Achilles tendon samples were evaluated histopathologically.

Results

The groups were compared according to the results of statistical analysis based on the histopathological data. There was no significant difference between the groups in terms of acute inflammation (p = 0.785) or chronic inflammation (p = 0.827) scores, but there were significant differences in neovascularization (p = 0.009), proliferation (p < 0.001) and fibrosis (p = 0.006) scores.

Conclusion

Our study showed that the use of enoxaparin sodium and hyperbaric oxygen had a positive effect on the healing of the Achilles tendon. Based on these results, we believe that the use of enoxaparin sodium and hyperbaric oxygen therapy after Achilles tendon rupture will be beneficial for healing and preventing complications.
Living and dying between cultural traditions in African & Caribbean Heritage families: a constructivist grounded theory
Authors: De Souza Joanna , Gillett Karen , Salifu Yakubu , Walshe Catherine
Published: July 2024

Background

Ethnic differences influence end-of-life health behaviours and use of palliative care services. Use of formal Advance care planning is not common in minority ethnic heritage communities. Older adults expect and trust their children to be their decision makers at the end of life. The study aim was to construct a theory of the dynamics that underpin end-of-life conversations within families of African and Caribbean heritage. This is a voice not well represented in the current debate on improving end-of-life outcomes.

Methods

Using Charmaz’s constructivist grounded theory approach, a purposive sample of elders, adult-children, and grandchildren of African and Caribbean Heritage were recruited. In-person and online focus groups were conducted and analysed using an inductive, reflexive comparative analysis process. Initial and axial coding facilitated the creation of categories, these categories were abstracted to constructs and used in theory construction.

Results

Elders (n = 4), adult-children (n = 14), and adult grandchildren (n = 3) took part in 5 focus groups. A grounded theory of living and dying between cultural traditions in African and Caribbean heritage families was created. The constructs are (a) Preparing for death but not for dying (b) Complexity in traditions crosses oceans (c) Living and dying between cultures and traditions (d) There is culture, gender and there is personality (e) Watching the death of another prompts conversations. (f) An experience of Hysteresis.

Discussion

African and Caribbean cultures celebrate preparation for after-death processes resulting in early exposure to and opportunities for discussion of these processes. Migration results in reforming of people’s habitus/ world views shaped by a mixing of cultures. Being in different geographical places impacts generational learning-by-watching of the dying process and related decision making.

Conclusions

Recognising the impact of migration on the roles of different family members and the exposure of those family members to previous dying experiences is important. This can provide a more empathetic and insightful approach to partnership working between health care professionals and patients and families of minority ethic heritage facing serious illness. A public health approach focusing on enabling adult-children to have better end of life conversations with their parents can inform the development of culturally competent palliative care.
The vaginal microbiome of South African pregnant women living with human immunodeficiency virus (HIV) with and without Chlamydia trachomatis infection
Authors: Mabaso Nonkululeko G. , Ngobese Bongekile , Ganesan Hamilton , van der Westhuizen Donald , Hassan Wail M. , Abbai Nathlee S.
Published: July 2024

Background

Chlamydia genital infections continue to be a serious health concern globally. Previous studies have reported that Chlamydia trachomatis infection alters the vaginal microbiota of infected women. This study investigated differences in the vaginal microbiome of South African pregnant women living with HIV with and without C. trachomatis infection.

Methods

This was a cross-sectional study among 385 pregnant women, recruited from the King Edward VIII Hospital in Durban, South Africa. C. trachomatis was detected using the Applied Biosystems™ TaqMan® Assays. A total of 40 samples, 20 C. trachomatis positive and 20 C. trachomatis negative, were selected for sequencing. The sequencing of the vaginal microbiome was performed using the PacBio platform. Statistical analysis was performed on IBM SPSS version 26.

Results

The prevalence of C. trachomatis infection was 12.2% (47/385). The genus Gardnerella (32.14% vs. 24.02%) and species in the genus Gardnerella (31.97% vs. 24.03%) were more abundant in the C. trachomatis-infected group compared to the uninfected group. Lactobacillus iners were also more abundant in the C. trachomatis-infected women (28.30%) compared to the uninfected women. However, these observed patterns did not reach statistical significance. Discriminant analysis showed that the class Alpha-Proteobacteria; order Bacillales; family Enterococcaceae; the genera Enhydrobacter, Enterococcus, and Parabacteroides; Enterococcus spp.; and Pseudomonas stutzeri significantly contributed to a model separating C. trachomatis-infected women from the uninfected group (p < 0.05).

Conclusion

The organisms and taxa that significantly contributed to separating the vaginal microbiota of C. trachomatis-infected women from the uninfected women in this study cohort have not been previously observed in association with C. trachomatis infection or the vaginal microbiota. Future studies in larger cohorts that will investigate the role of these microorganisms in C. trachomatis infection and the vaginal microbiota are required.