bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost Utility Analysis of an After-School Sports Sampling Program
Authors: Lightner Joseph S. , Valleroy Ella , Todd Reagan , Eighmy Katlyn E. , Grimes Amanda
Published: October 2023

Purpose

The purposes of this study are to describe the costs of implementing an after-school physical activity intervention in three diverse, low-resourced, schools and to understand the potential aerobic impact of this program by cost.

Design

We conducted a cost utilization study from an 8.5-month physical activity intervention.

Setting

Three diverse, low-resourced, middle schools in the Midwest; The sample (N = 178) were mostly males (52.2%), African American or Black (54.8%), and divided between 6th, 7th, and 8th grades.

Method

Costs were collected from contracts, invoices, payroll, and receipts. Metabolic equivalents were collected from past literature. Costs/MET-hour were calculated for the schools and entire program by dividing costs by total MET-hours engaged in physical activity.

Results

Costs were $2.51/MET-hour, $8.96/MET-hour, and $10.73/MET-hour for the three schools. On average, the intervention had a cost of $4.73/MET-hour.

Conclusions

Cost/MET-hour for the present study is comparable or lower than other school-based physical activity interventions that require additional staff time and programming outside of standard classroom activities. Scale-up of after-school programs may be one way to improve the costs of programs in both schools and districts.
When It Pays to Be Insincere: On the Benefits of Verbal Irony
Authors: Pfeifer Valeria A. , Pexman Penny M.
Published: October 2023

Verbal irony is pervasive in social interaction, presumably because it can be used to achieve a number of communicative goals and effects. In general, verbal irony has a reputation for having negative effects, but in this article we present evidence for the cognitive, social, and emotional benefits of verbal irony and demonstrate the potential of this form of language to provide crucial psychological insights. The power of irony lies in its ability to create meaning that is in conflict with the literal meaning—thus altering our understanding of it and by doing so enhancing cognition, mediating emotions, or shaping social relationships.
Public health nurses’ experiences of ethical responsibility: A meta-ethnography
Authors: Clancy Anne , Hovden Julia Thuve , Andersen Runa Anneli , Laholt Hilde
Published: October 2023

Public health nursing is grounded in public health ideologies and fundamental nursing values. Researchers have argued that ethical responsibility from the perspective of the nurse is an understudied phenomenon. This meta-ethnography provides in-depth knowledge of how public health nurses (PHNs) experience ethical responsibility when working to prevent injury and disease, and promote health and well-being in children, young people and their families. There are reciprocal findings across the 10 included studies. The findings reveal that these nurses often feel alone, have worries and uncertainties and are afraid of doing wrong. They describe unclear boundaries in their work, creating a heightened sense of responsibility. PHNs fight lonely battles. Yet they show courage and commitment and are ready to stand up and fight for children and families who do not receive adequate care. A line of argument is developed and the metaphorical phrase Chivalrous knights in moral armour is used to express the authors’ overall interpretations of the findings. Reflection on the findings shows how the different dimensions of ethical responsibility are interconnected. The nurses’ ethical sensitivity enables them to feel compassion for others and they show indignation when vulnerable others are not treated with dignity and respect. Indignation and compassion are interrelated, and when human life and dignity are threatened, the ethical demand to respond emerges. Indignation is a precursor to moral courage, and the nurses’ moral sensitivity and respect for their clients emboldens them to stand up for vulnerable others. The findings also illustrate the paradoxical nature of freedom. Freedom of choice due to unclear boundaries heightens the nurses' sense of responsibility. This research is an important step in theory development and has implications for further research, education and practice.
LeFort I Horizontal Osteotomy: Defining the Feasibility of the “High Osteotomy”
Authors: Verzella Alexandra N. , Alcon Andre , Schechter Jill , Shetye Pradip R. , Staffenberg David A. , Flores Roberto L.
Published: October 2023

Objective

To define “high osteotomy” and determine the feasibility of performing this procedure.

Design

Single institution, retrospective review.

Setting

Academic tertiary referral hospital.

Patients, Participants

34 skeletally mature, nonsyndromic patients with unilateral CLP who underwent Le Fort I osteotomy between 2013 and 2020. Patients with cone-beam computed tomography (CBCT) scans completed both pre- (T1) and post-operatively (T2) were included. Patients with bilateral clefts and rhinoplasty prior to post-operative imaging were excluded.

Interventions

Single jaw one-piece Le Fort I advancement surgery

Main Outcome Measures

Measurements of the superior ala and inferior turbinates were taken from the post-operative CBCT.

Results

The sample included 26 males and 8 females, 12 right- and 22 left-sided clefts. The inferior turbinates are above the superior alar crease at a rate of 73.53% and 76.48% on the cleft and non-cleft sides, respectively. One (2.9%) osteotomy cut was above the level of the cleft superior alar crease, and no cuts were above the level of the non-cleft superior ala. On average, the superior ala was 2.63 mm below the inferior turbinates. The average vertical distances from the superior alar crease and the inferior turbinates to the base of the non-cleft side pyriform aperture were 12.17 mm (95% CI 4.00–20.34) and 14.80 mm (95% CI 4.61–24.98), respectively. To complete a “high osteotomy,” with 95% confidence, the cut should be 20.36 mm from the base of the pyriform aperture.

Conclusions

A “high” osteotomy is not consistently possible due to the relationship between the superior alar crease and the inferior turbinate.
Evaluation of Newly Integrated Bivalirudin Titration Protocol in Patients With Mechanical Circulatory Support
Authors: Mitchell Madeline , Sullinger Danine , Dyer Duke , Hickey Gavin , Kaczorowski David , Minor Joni , Murray Holt , Ramanan Raj , Rhinehart Zachary , Schmidhofer Mark , Rivosecchi Ryan M.
Published: October 2023

Background:

Patients with cardiogenic shock or end-stage heart failure can be maintained on mechanical circulatory support (MCS) devices. Once a patient undergoes placement of a device, obtaining and maintaining therapeutic anticoagulation is vital. Guidelines recommend the use of institutional protocols to assist in dosing and titration of anticoagulants.

Objective:

The purpose of this study was to characterize the use of bivalirudin before and after the implementation of a standardized titration protocol in patients with MCS.

Methods:

A retrospective review of patients who received bivalirudin for MCS (VA ECMO [veno-arterial extracorporeal membrane oxygenation], Impella, or LVAD [left ventricular assist device]) before and after the implementation of the titration protocol into the electronic health record (EHR) was conducted. The primary outcome was to compare the proportion of therapeutic activated partial thromboplastin time (aPTT). Secondary outcomes included number of subtherapeutic and supratherapeutic aPTTs, incidence of bleeding and clotting events, bivalirudin titrations per day, and percentage of patients with therapeutic aPTT level.

Results:

A total of 100 patients were included (precohort = 67; postcohort = 33). The proportion of therapeutic aPTTs was significantly higher in the postcohort than that in the precohort (62% vs 48%; P < 0.001). The postcohort had 0% of patients failing to achieve therapeutic aPTT levels. The number of titrations per day was significantly lower in the postcohort, with 1.20 titrations per day versus 1.93 in the precohort ( P < 0.001).

Conclusions:

Implementation of the bivalirudin titration nomograms within the EHR significantly increased the number of therapeutic aPTTs, reduced the number of patients who never achieved a therapeutic aPTT, and reduced the required number of titrations per day.
The effect of Instagram posts on tourists’ destination perception and visiting intention
Authors: Eman Nada , Refaie Noha
Published: October 2023

Egypt depends on tourism as a major contributor in its GDP. With the emerging role of social media in shaping consumer intentions, numerous research is still needed to help Egyptian destinations employ new media to affect tourists’ intentions to visit Egypt and its emerging destinations such as El Fayoum. This research aims to investigate the relationship between content and source of Instagram posts, and El Fayoum destination perception and visiting intention. Quantitative research was conducted through collecting and analysing 482 online surveys from Instagram users. Results revealed that credibility and quality of content influence destination perception and visiting intention. Content valence influences destination perception but not visiting intention. Trusting the source, their expertise and attractiveness influence destination perception and visiting intention. Destination perception mediation effect varied between source and visiting intention. This research contributes to tourism marketing literature by investigating interrelationships between content and source of the Instagram posts, destination perception and visiting intention as those research constructs that were previously neglected for destinations such as El Fayoum. Our findings are expected to aid decision makers in tourism marketing in Egypt especially El Fayoum.
The challenge of defining news literacy: Perceptions from the UK news literacy sector
Authors: Yeoman Fran
Published: October 2023

Recent research has lamented a lack of theoretical clarity around the term news literacy, calling on the academy to produce tighter, more nuanced definitions. Vraga, described news literacy as a “bloated” term, warning in another paper that the movement was at a tipping point. If scholars want to do their bit by offering concrete guidelines to those delivering initiatives, they argued, agreement as to what news literacy actually is, and how it should be evaluated, must be reached. This paper seeks to aid this process by providing insights about how news literacy is conceived and operationalised by those delivering such education to UK. Drawn from in-depth interviews with practitioners linked to five news literacy projects in the UK conducted in summer 2021, it finds that far from there being agreement in the sector as to what news literacy is, or indeed what it could be, the term as deployed by UK practitioners is equally ‘bloated’ and lacking in clear definition. This has implications for the ability of the sector to promote itself, champion its priorities or conduct evaluation work against clear and relevant metrics. By highlighting this lack of clarity around definitions in the UK context, this study adds international weight to existing work stemming primarily from the US. It also demonstrates the need for greater clarity of terminology so that news literacy concepts including critical thinking are not lost within increasingly broad and instrumental skills-focussed definitions of a wider media literacy.
From Research to Action: Enhancing Net Promoter Score Utilization in Managerial Practice
Authors: Baehre Sven
Published: October 2023

Despite its widespread adoption by industry, the academic literature is quite skeptical about the Net Promoter Score (NPS). Given the persistent use of NPS by managers, this research note provides a deeper understanding of its practical implementation while exploring the potential benefits NPS offers to managers, focusing on the distinction between transactional and brand health NPS. Furthermore, this research note also introduces five essential managerial considerations for using NPS, further extending the scope for managerial-relevant future research.
Simultaneous evaluation of the fractional exhaled nitric oxide and blood eosinophil count of T2-high endotype in patients with non-cystic fibrosis bronchiectasis
Authors: Chen Fengjia , Zeng Zhimin , Huang Xinyan , Liu Yangli
Published: October 2023

Objective

Recently, a type 2 inflammation (T2) high endotype in bronchiectasis was identified. The fraction of exhaled nitric oxide (FeNO) and blood eosinophil count (BEC) are recognized as representative biomarkers of T2 inflammation. Herein, we investigate the clinical characteristics of T2-high endotype in non-cystic fibrosis bronchiectasis patients classified by FeNO and BEC.

Methods

This retrospective study included 164 bronchiectasis patients treated in the First Affiliated Hospital of Sun Yat-sen University from December 2017 to July 2022. Clinical characteristics were analyzed after classifying patients into four groups according to T2 inflammation biomarkers (FeNO ≥25 ppb; BEC ≥200/µL).

Results

Among the 164 bronchiectasis patients, 35.3% (58/164) presented with high FeNO, 30.5% (50/164) presented with high BEC, and 10.4% (17/164) had high FeNO and BEC. Patients with high FeNO and low BEC presented with better lung function, fewer affected lobes, and lower dyspnea prevalence compared with the three other groups. Moreover, decreased FeNO, instead of decreased BEC, is revealed to be an independent predictor for disease severity and airflow obstruction in bronchiectasis.

Conclusions

Simultaneous evaluation of FeNO and BEC proposed different endotypes of bronchiectasis established that patients with low BEC and high FeNO had better lung function, fewer affected lobes, lower dyspnea prevalence, and less disease severity. This result will contribute to a more comprehensive assessment of the disease severity and lead to more precise treatment of T2 inflammation in bronchiectasis patients.
Thalassemia screening by third-generation sequencing: Pilot study in a Thai population
Authors: Traisrisilp Kuntharee , Zheng Yu , Choy Kwong Wai , Chareonkwan Pimlak
Published: October 2023

Background

Conventional thalassemia screening takes a stepwise approach and has limitations in comprehensively identifying all spectrums of mutations. This study aimed to investigate the performance of third-generation sequencing (TGS) compared to conventional molecular testing.

Methods

TGS was applied to validate all known variants detected by conventional testing and to detect missing variants in undiagnosed cases. The study was conducted at Maharaj Nakorn Chiang Mai Hospital between December 2021 and April 2022.

Results

In total, 19 cases were included in this study, among which 52.6% (10/19) had known thalassemia variants, while 47.7% (9/19) cases were undiagnosed by conventional methods. All 16 variants previously detected were validated by TGS, and TGS additionally detected 43.8% (7/16) thalassemia variants for 36.8% (7/19) cases.

Conclusion

TGS could provide additional genetic diagnoses compared with conventional methods. Further cost-effectiveness studies with a larger sample size are needed to explore the role of TGS in clinical practices.
Optimal liver drainage rate for survival in patients with unresectable malignant hilar biliary obstruction using 3D-image volume analyzer
Authors: Morimoto Kosaku , Matsumoto Kazuyuki , Obata Taisuke , Oda Takashi , Miyamoto Kazuya , Matsumi Akihiro , Terasawa Hiroyuki , Fujii Yuki , Yamazaki Tatsuhiro , Horiguchi Shigeru , Tsutsumi Koichiro , Kato Hironari , Otsuka Motoyuki
Published: October 2023

Background:

Drainage exceeding 50% of total liver volume is a beneficial prognostic factor in patients with unresectable malignant hilar biliary obstruction (UMHBO). However, it is unclear what threshold percentage of total liver volume drained (‘liver drainage rate’) significantly improves survival in patients with UMHBO who received systemic chemotherapy.

Objectives:

We aimed to assess the optimal liver drainage rate that improves survival in patients with UMHBO receiving chemotherapy using a three-dimensional (3D)-image volume analyzer.

Design:

This study was a single-center retrospective cohort study.

Methods:

Data from 90 patients with UMHBO who received chemotherapy after endoscopic biliary drainage using metal stents at Okayama University Hospital from January 2003 to December 2020 were reviewed. The liver drainage rate was calculated by dividing the drained liver volume by the total liver volume using a 3D-image volume analyzer. The primary endpoint was overall survival by liver drainage rate. The secondary endpoints were time to recurrent biliary obstruction (TRBO) and prognostic factors.

Results:

The median total liver volume was 1172 (range: 673–2032) mL, and the median liver drainage rate was 83% (range: 50–100). Overall survival was 376 (95% CI: 271–450) days, and patients with >80% drainage ( n = 67) had significantly longer survival than those with <80% drainage ( n = 23) (450 days versus 224 days, p = 0.0033, log-rank test). TRBO was 201 (95% CI: 155–327) days and did not differ significantly by liver drainage rate. Multivariate Cox proportional hazards regression analysis revealed >80% liver drainage [hazard ratio (HR): 0.35, 95% CI: 0.20–0.62, p = 0.0003] and hilar cholangiocarcinoma (HR: 0.30, 95% CI: 0.17–0.50, p < 0.0001) as significant prognostic factors.

Conclusion:

In patients with UMHBO scheduled for chemotherapy, >80% drainage is associated with improved survival. Further prospective multicenter studies are needed to verify the results of this study.

Trail registration:

Okayama University Hospital, IRB number: 2108-011.
A systematic review on diagnosis and treatment of gastrointestinal diseases by magnetically controlled capsule endoscopy and artificial intelligence
Authors: Wang Xiaotong , Hu Xiaoming , Xu Yongxue , Yong Jiahao , Li Xiang , Zhang Kaixuan , Gan Tao , Yang Jinlin , Rao Nini
Published: October 2023

Background:

Magnetically controlled capsule endoscopy (MCCE) is a non-invasive, painless, comfortable, and safe equipment to diagnose gastrointestinal diseases (GID), partially overcoming the shortcomings of conventional endoscopy and wireless capsule endoscopy (WCE). With advancements in technology, the main technical parameters of MCCE have continuously been improved, and MCCE has become more intelligent.

Objectives:

The aim of this systematic review was to summarize the research progress of MCCE and artificial intelligence (AI) in the diagnosis and treatment of GID.

Data Sources and Methods:

We conducted a systematic search of PubMed and EMBASE for published studies on GID detection of MCCE, physical factors related to MCCE imaging quality, the application of AI in aiding MCCE, and its additional functions. We synergistically reviewed the included studies, extracted relevant data, and made comparisons.

Results:

MCCE was confirmed to have the same performance as conventional gastroscopy and WCE in detecting common GID, while it lacks research in detecting early gastric cancer (EGC). The body position and cleanliness of the gastrointestinal tract are the main factors affecting imaging quality. The applications of AI in screening intestinal diseases have been comprehensive, while in the detection of common gastric diseases such as ulcers, it has been developed. MCCE can perform some additional functions, such as observations of drug behavior in the stomach and drug damage to the gastric mucosa. Furthermore, it can be improved to perform a biopsy.

Conclusion:

This comprehensive review showed that the MCCE technology has made great progress, but studies on GID detection and treatment by MCCE are in the primary stage. Further studies are required to confirm the performance of MCCE.
Combustion dynamics analysis of a pressurized airblast swirl burner using proper orthogonal decomposition
Authors: Ghasemi Alireza , Christou Thomas , Kok Jim B.W. , Stelzner Björn , Zarzalis Nikolaos
Published: October 2023

Jet fuel-fired combustors in aero gas turbine engines have switched to lean burn to decrease nitric oxide emissions in recent years as a result of strict emission regulations. Lean operating conditions, however, exhibit a heightened sensitivity to thermoacoustic instabilities and such burners require careful consideration in design and operation. Similar to natural gas-fired combustors, they exhibit thermoacoustic instabilities, but the characteristics are more complex and less well-studied. This paper presents a numerical investigation of an airblast jet fuel swirl burner operating with preheated air at lean pressurized conditions. In order to understand the acoustic characteristics of the in-house designed burner (Magister UT burner), detached eddy simulations are performed at relevant aero engine conditions. Simulation results are then analyzed by means of our internally developed parallel modal analysis package, PARAMOUNT, to perform proper orthogonal decomposition (POD) on large datasets. The resulting modes are inspected to highlight flow features of interest and their associated acoustic frequencies at unforced conditions. Single frequency acoustic forcing is employed to study the acoustic response of the burner to perturbations at similar frequencies to its precessing vortex core. We show that parallel computation of POD modes is a viable tool to investigate the main flow features of swirl burners and is suitable for highlighting the important acoustic frequencies without the need to employ fully compressible computational fluid dynamics solvers. Additionally, the analysis method reveals the ways in which various flow structures correlate with each other and how external perturbations modify them.
The reach of the trade in Captagon beyond the Middle East
Authors: Rose Caroline
Published: October 2023

Over the last five years, illicit trade in the amphetamine-type stimulant Captagon has expanded considerably, both in size and scope, posing new challenges to the rule of law, public health and even security dynamics. With its production hub anchored heavily in regime-held areas of Syria—with sponsorship from Syria’s Fourth Division and partnered Iran-aligned militias—the Captagon trade has been used as both an alternative revenue source for the cash-strapped and sanctioned Syrian regime and a tool for influence on the diplomatic stage. The Syrian regime has leveraged its agency over the trade, violent cross-border smuggling clashes and plausible deniability with affiliated actors to achieve its aims of the normalisation of relations with it regionally and the granting of concessions.

However, these normalisation efforts have come under pressure as demands from regional neighbours to reduce the flow of Captagon and interdiction capacity have increased. Incentivised to retain their profits from Captagon, producers and traffickers aligned with the Syrian regime’s security apparatus have begun to identify new routes and markets outside its primary destinations in the Arab Gulf. As a result, criminal networks have carved out new transit routes across Iraq and Turkey and through African ports, and have even established nodes in southern and mainland Europe—all with the potential for pills to trickle into local consumer markets over time. With the Captagon challenge no longer confined to the Middle East, European countries and their partners are quickly beginning to focus on key aspects of the trade, implementing policies that address supply, demand and accountability for implicated actors.
Prospective Outcomes of a Biological Resurfacing Arthroplasty with Fascia Lata Autograft (BioJoint) for the Treatment of Osteoarthritis of the Midtarsal Joint Complex
Authors: Dahmen Jari , Stufkens Sjoerd A.S. , Kerkhoffs Gino M.M.J.
Published: October 2023

Objective

To determine the clinical, safety, and radiological outcomes after biological resurfacing arthroplasty for the treatment of osteoarthritis (OA) of one or more joints of the midtarsal joint complex.

Design

All prospectively followed patients with OA to one of or multiple joints of the midtarsal joint complex who were operated with a biological resurfacing arthroplasty with a fascia lata autograft (BioJoint procedure) were included. A total of 7 patients were included (5 males, 2 females), with a median age of 52 (interquartile range [IQR] 44-55) years. The primary outcome was the Numeric Rating Scale (NRS) for pain during walking 2 years postoperatively. Range of motion (ROM), revision rates, and complications were assessed. A postoperative MRI scan was performed to assess progression of OA, graft position and ingrowth, and the degree of bone marrow edema.

Results

There was a 100% follow-up of the patients (median follow-up: 33 [IQR 26-33] months). The NRS during walking improved from 6 preoperatively to 2 at 2 years postoperatively ( P < 0.05). There were no reoperations nor severe complications. The limitations in the ROM remained limited in the majority of the cases. MRI at 2 years of follow-up showed no progression of OA, reduced bone marrow edema, and no loosening of the grafts.

Conclusion

Biological resurfacing arthroplasty with a fascia lata autograft (BioJoint procedure) for OA to one or more joints in the midtarsal joint complex showed clinically relevant pain reduction during walking, improvement in clinical and radiological outcomes, and proved to be safe and durable.
Unfolding the reality of the smoking paradox in a South Asian cohort of patients presenting with ST-elevation acute coronary syndrome undergoing primary percutaneous coronary intervention
Authors: Kumar Rajesh , Shaikh Abdul Hakeem , Ahmed Rameez , Siddiqui Maria Noor , Rahooja Kubbra , Chachar Kalsoom , Khan Muhammad Qasim , Samad Maryam , Urooj Abiha , Naseer Ali Bin , Sial Jawaid Akbar , Saghir Tahir , Khan Sohail , Qamar Nadeem
Published: October 2023

Objectives:

Smoking is a potent risk factor for coronary artery disease, but there is controversy about its protective nature in terms of prognosis in ST-elevation acute coronary syndrome patients undergoing primary percutaneous coronary intervention. So, the main objective of this study is to unfold this controversy in a South Asian population in terms of clinical angiographic parameters and its in-hospital outcomes.

Methods:

In this study, we included 1756 consecutive patients diagnosed with ST-elevation acute coronary syndrome undergoing primary percutaneous coronary intervention. Patients were classified into smokers and non-smokers, and the in-hospital mortality rate was compared. Multivariable logistic regression analysis was performed to evaluate the paradoxical role of smoking.

Results:

Smokers were younger (53.78 ± 11.16 years vs 56.43 ± 11.17 years; p < 0.001) and more frequently men (98.7% vs 69.9%; p < 0.001) and had less diabetes (19.6% vs 44.8%; p < 0.001) and hypertension (38.5% vs 64.9%; p < 0.001). Smokers presented less frequently in Killip III (5.6% vs 8.1%; p < 0.001) and Killip IV (2.5% vs 4.8%; p < 0.001). Smokers mostly had single vessel disease (41.7% vs 34.4%; p = 0.013), whereas non-smokers had the multi-vessel disease and frequently presented with total occlusion of the culprit vessel (64.6% vs 58.8%; p = 0.040). Smokers have significantly lesser mortality (1.8% vs 4.3%; p = 0.009) compared to non-smokers with an odds ratio of 0.41 (95% confidence interval (CI): 0.21–0.82, p = 0.011); however, adjusted odds ratio on multivariable analysis was 0.67 (95% CI: 0.31–1.41, p = 0.290).

Conclusions:

The paradoxical protective role of smoking is the confounding effect of mainly younger age, less coronary artery disease burden, lower prevalence of diabetes and hypertension, and lower Killip III/IV at presentation.
Brucella infection-induced hemophagocytic syndrome with subsequent development of the probable vanishing bile duct syndrome: A case report and literature review
Authors: Xu Musen , Mo Shaojian , Fu Xifeng
Published: October 2023

Vanishing bile duct syndrome is a rare clinical manifestation, and many clinicians tend to classify vanishing bile duct syndrome as a surgical disease and perform emergency surgery, leading to poor prognosis for patients. In this report, we present a case of a patient initially diagnosed with probable vanishing bile duct syndrome. However, through a meticulous step-by-step investigation, we ultimately determined that the patient was suffering from Brucella infection-induced hemophagocytic syndrome, which contributed to the development of the probable vanishing bile duct syndrome. Once a definitive diagnosis was established, the patient underwent treatment following anti- Brucella and Hemophagocytic lymphohistiocytosis-2004 protocols, leading to an improvement in the patient’s condition. We conducted a literature review on brucellosis, and it demonstrated the lack of specificity in diagnosing Brucella infections and the diverse range of clinical manifestations. Failure to arrive at a definitive diagnosis may result in clinical misdiagnosis and delayed treatment, thereby leading to grave consequences.
Size and Morphology of the Anterior and Posterior Cruciate Ligaments at Different Pediatric Age Intervals: An MRI Analysis
Authors: Brockmeyer Matthias , Norrick Swen , Wagenpfeil Gudrun , Stroeder Jonas , Landgraeber Stefan
Published: October 2023

Background:

The incidence of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears in children and adolescents has increased over the past decade, with increasing numbers of ACL and PCL reconstructions in this patient population.

Purpose:

To evaluate the size and morphology of both the ACL and the PCL by magnetic resonance imaging (MRI) in different pediatric age groups.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

MRI examinations of 127 knees (67 female, 60 male; aged 0-18 years) were analyzed retrospectively. The cohort was split into 6 age subgroups, 1 subgroup for every 3 years (minimum 8 patients per subgroup). The following parameters were measured by 2 independent raters at 2 different time points: ACL length, anteroposterior and mediolateral ACL width, sagittal and coronal ACL inclination, inclination of the intercondylar notch, bicondylar width, notch width, coronal ACL and PCL width, PCL length, and sagittal width of the lateral femoral condyle. The following indices, areas, and volumes were calculated: sagittal width of the lateral femoral condyle/PCL length, ACL area and volume, notch width index, ACL width/notch width, PCL width/notch width, ACL width/bicondylar width, and PCL width/bicondylar width. A correlation analysis was performed for patient age, height, weight, and body mass index (BMI).

Results:

ACL length was between 18 and 37 mm, and ACL width was between 4 and 6 mm. PCL length ranged between 27 and 43 mm, while PCL width was between 7 and 9 mm. Growth of the cruciate ligaments was the most pronounced between the ages of 4 and 12 years. Correlations with size and weight were strong, while BMI correlated slightly with the measurements. Measurements in female patients were slightly larger than in their male counterparts between the ages of 0 and 6 years, while male patients tended to have larger values starting from ages 7 to 9 years. These values were significantly larger in male patients from the ages of 16 to 18 years ( P < .05).

Conclusion:

This study provides normative data on the morphology of pediatric anatomic features in the knee as a basis for age-appropriate and individualized surgical care of ACL and PCL injuries in children and adolescents.
Advancing Methods in Entrepreneurship Education Impact Research: The Benefits and Limitations of Register Data
Authors: Aadland Torgeir
Published: October 2023

With the increasing introduction of entrepreneurship education, supported by governments and policymakers, questions on their effect have occurred. Thus, several studies on their impact have also emerged over the years. However, many of these studies have issues related to control groups, students’ self-selection into the education, unclear objectives and vague descriptions of the education, or no contextual considerations in the studies’ design. In addition, although there have been many calls for studies investigating behavioural outcomes over a longer timeframe, few studies have answered the calls. As a continuous evaluation of graduates in many instances would be costly and time-consuming, not to mention the difficulty of obtaining a sufficient response rate over time, a potential source for evidence is register data, for instance, from public records. In this conceptual paper, I discuss the issues of the current evaluation practices of entrepreneurship education before the use of register data is introduced in consideration of long-term evaluation and common methodological issues. I present potential evaluation examples using register data on a particular program in entrepreneurship. The potential benefits and limitations of using such data are addressed, along with potential avenues for future research using register data in entrepreneurship education impact research.
deltaXpress (ΔXpress): a tool for mapping differentially correlated genes using single-cell qPCR data
Authors: Murillo Carrasco Alexis Germán , Furuya Tatiane Katsue , Uno Miyuki , Citrangulo Tortelli Tharcisio , Chammas Roger
Published: October 2023

Background

High-throughput experiments provide deep insight into the molecular biology of different species, but more tools need to be developed to handle this type of data. At the transcriptomics level, quantitative Polymerase Chain Reaction technology (qPCR) can be affordably adapted to produce high-throughput results through a single-cell approach. In addition to comparative expression profiles between groups, single-cell approaches allow us to evaluate and propose new dependency relationships among markers. However, this alternative has not been explored before for large-scale qPCR-based experiments.

Results

Herein, we present deltaXpress (ΔXpress), a web app for analyzing data from single-cell qPCR experiments using a combination of HTML and R programming languages in a friendly environment. This application uses cycle threshold (Ct) values and categorical information for each sample as input, allowing the best pair of housekeeping genes to be chosen to normalize the expression of target genes. ΔXpress emulates a bulk analysis by observing differentially expressed genes, but in addition, it allows the discovery of pairwise genes differentially correlated when comparing two experimental conditions. Researchers can download normalized data or use subsequent modules to map differentially correlated genes, perform conventional comparisons between experimental groups, obtain additional information about their genes (gene glossary), and generate ready-to-publication images (600 dots per inch).

Conclusions

ΔXpress web app is freely available to non-commercial users at https://alexismurillo.shinyapps.io/dXpress/ and can be used for different experiments in all technologies involving qPCR with at least one housekeeping region.
Organic amendments improve salinity-induced osmotic and oxidative stress tolerance in Okra (Abelmoschus esculentus (L.)Moench)
Authors: Naseem Alia , Iqbal Sumera , Jabeen Khajista , Umar Aisha , Alharbi Khadiga , Antar Mohammed , Grądecka-Jakubowska Katarzyna , Gancarz Marek , Ali Iftikhar
Published: October 2023

Aims

Salinity adversely affects okra [Abelmoschus esculentus (L.) Moench] plants by inducing osmotic and oxidative stresses. This study was designed to enhance salinity-induced osmotic and oxidative stress tolerance in okra plants by applying organic amendments.

Methods

The effects of different organic amendments (municipal solid waste compost, farmyard manure (FYM) and press mud) on osmotic potential, water use efficiency, activities of antioxidant enzymes, total soluble sugar, total soluble proline, total soluble protein and malondialdehyde (MDA) contents of okra plants grown under saline conditions (50 mM sodium chloride) were evaluated in a pot experiment. The organic amendments were applied each at the rate of 5% and 10% per pot or in various combinations (compost + FYM, FYM + press mud and compost + press mud each at the rate of 2.5% and 5% per pot).

Results

As compared to control, high total soluble sugar (60.41), total soluble proline (33.88%) and MDA (51%) contents and increased activities of antioxidant enzymes [superoxide dismutase (83.54%), catalase (78.61%), peroxidase (53.57%] in salinity-stressed okra plants, were indicative of oxidative stress. Salinity significantly reduced the osmotic potential (41.78%) and water use efficiency (4.75%) of okra plants compared to control. Under saline conditions, 5% (farmyard manure + press mud) was the most effective treatment, which significantly improved osmotic potential (27.05%), total soluble sugar (4.20%), total soluble protein (73.62%) and total soluble proline (23.20%) contents and superoxide dismutase activity (32.41%), compared to saline soil. Application of 2.5% (FYM + press mud), 5% press mud, and 10% compost significantly reduced MDA content (27%) and improved activities of catalase (38.64%) and peroxidase (48.29%), respectively, compared to saline soil, thus facilitated to alleviate oxidative stress in okra plants.

Conclusions

Using organic amendments (municipal solid waste compost, farmyard manure and press mud) was a cost-effective approach to improve salinity-induced osmotic and oxidative stress tolerance in okra plants.
Transcriptomics integrated with metabolomics reveals the effect of cold stress on rice microspores
Authors: Li Yingbo , Zong Yingjie , Li Wenrui , Guo Guimei , Zhou Longhua , Xu Hongwei , Gao Runhong , Liu Chenghong
Published: October 2023

Background

Microspore culture is one of the important biotechnological tools in plant breeding. The induction of microspore embryogenesis is a critical factor that affects the yield of microspore-derived embryo productions. Cold treatment has been reported to reprogram the gametophytic pathway in various plant species. However, the exact mechanism(s) underlying the effect of cold pre-treatment of floral buds on the efficiency of ME is still not clear.

Results

In this study, the effects of cold stress on the microspore totipotency of rice cultivar Zhonghua 11 were investigated. Our results revealed that a 10-day cold treatment is necessary for microspore embryogenesis initiation. During this period, the survival rate of microspores increased and reached a peak at 7 days post treatment (dpt), before decreasing at 10 dpt. RNA-seq analysis showed that the number of DEGs increased from 3 dpt to 10 dpt, with more downregulated DEGs than upregulated ones at the same time point. GO enrichment analysis showed a shift from ‘Response to abiotic stimulus’ at 3 dpt to ‘Metabolic process’ at 7 and 10 dpt, with the most significant category in the cellular component being ‘cell wall’. KEGG analysis of the pathways revealed changes during cold treatment. Mass spectrometry was used to evaluate the variations in metabolites at 10 dpt compared to 0 dpt, with more downregulated DEMs being determined in both GC-MS and LC-MS modes. These DEMs were classified into 11 categories, Most of the DEMs belonged to ‘lipids and lipid-like molecules’. KEGG analysis of DEMs indicates pathways related to amino acid and nucleotide metabolism being upregulated and those related to carbohydrate metabolism being downregulated. An integration analysis of transcriptomics and metabolomics showed that most pathways belonged to ‘Amino acid metabolism’ and ‘Carbohydrate metabolism’. Four DEMs were identified in the interaction network, with stearidonic acid involving in the most correlations, suggesting the potential role in microspore totipotency.

Conclusions

Our findings exhibited the molecular events occurring during stress-induced rice microspore. Pathways related to ‘Amino acid metabolism’ and ‘Carbohydrate metabolism’ may play important roles in rice microspore totipotency. Stearidonic acid was identified, which may participate in the initiation of microspore embryogenesis.
MiR-483-5p downregulation alleviates ox-LDL induced endothelial cell injury in atherosclerosis
Authors: Zhu Hezhong , Liang Hui , Gao Zhen , Zhang Xiaoqiao , He Qian , He Chaoyong , Cai Chao , Chen Jiajuan
Published: October 2023

Background

In light of the abnormal expression of microRNA (miR-483-5p) in patients with atherosclerosis (AS), its role in vascular endothelial cell injury was explored. And the mechanisms related to autophagy were also elucidated.

Methods

Human umbilical vein endothelial cells (HUVECs) were given 100 mg/L ox-LDL to induce endothelial injury. Cell transfection was done to regulate miR-483-5p levels. Cell viability and apoptosis were detected. qRT-PCR was employed for the mRNA levels’ detection.

Results

Autophagic flux impairment of HUVECs was detected after ox-LDL treatment, along with the upregulation of miR-483-5p. Ox-LDL inhibited cell viability and promoted cell apoptosis, but these influences were changed by miR-483-5p downregulation. MiR-483-5p downregulation decreased the mRNA levels of IL-1β, IL-6, ICAM-1 and VCAM-1. 3-MA, the autophagy inhibitor, reversed the beneficial role of miR-483-5p downregulation in ox-LDL-induced HUVECs’ injury. TIMP2 acts as a target gene of miR-483-5p, and was downregulated in HUVEC models.

Conclusion

MiR-483-5p downregulation alleviated ox-LDL-induced endothelial injury via activating autophagy, this might be related to TIMP2.
Cross-sectional associations between questionnaire-measured physical activity and tissue doppler indices of left ventricular diastolic function
Authors: Su Lina , Yan Xiaodi , Pan Yongmei , Yang Songna
Published: October 2023

Background

The prevalence of left ventricular (LV) diastolic dysfunction has been increasing over the past decade, and to date, effective pharmacotherapies that enhance LV diastolic function have not yet been identified. Though some data has demonstrated the beneficial effects of exercise training on LV diastolic function, little is known about the adaptations of diastolic function to daily physical activity (PA). Accordingly, our study aimed to investigate the impact of daily PA on tissue Doppler indices of LV diastolic function.

Methods

A total of 432 participants were enrolled for clinically indicated echocardiography from July 2019 to July 2020 at Peking University People’s Hospital. Participants aged ≥ 18 years were included if they had stable PA in the past six months and normal LV systolic function. A questionnaire was used to collect demographic characteristics, medical history, and daily PA. According to PA Guidelines for Americans, we identified these participants into low-intensity PA (LPA) group and moderate-high-intensity PA (MHPA) group. Propensity score matching (PSM) was performed to match potential confounding factors between the two groups. The clinical characteristics and echocardiographic parameters between LPA group and MHPA group were compared using student’s t-test, Mann-Whitney U test, and chi-square test as appropriate.

Results

After matching potential confounding factors using PSM with a 1:3 matching ratio, our final analysis included 86 cases in the MHPA group and 214 cases in the LPA group. All demographic characteristics and comorbidities were statistically similar between the two groups. Compared to the LPA group, the MHPA group showed higher septal e’ (7.9 ± 2.9 cm/s versus 7.2 ± 2.6 cm/s, P = 0.047). Other echocardiographic parameters associated with LV diastolic function concerning lateral e’ and average E/e’, also trended towards improved LV diastolic function in the MHPA group, but failed to reach statistical significance.

Conclusions

Our study demonstrated that moderate-high-intensity daily PA was associated with improved septal e’, suggesting that moderate-high-intensity PA could potentially ameliorate LV diastolic dysfunction.
Incorporating uric acid into the CHA2DS2-VASc score improves the prediction of new-onset atrial fibrillation in patients with acute myocardial infarction
Authors: Wu Xuefeng , Zhang Yi , Yang Xili , Xu Zhaoyan , Feng Yingqing
Published: October 2023

Background

New-onset atrial fibrillation (NOAF) is a common cardiac arrhythmia observed in patients with acute myocardial infarction (AMI) and is associated with worse outcomes. While uric acid has been proposed as a potential biomarker for predicting atrial fibrillation, its association with NOAF in patients with AMI and its incremental discriminative ability when added to the CHA2DS2-VASc score are not well established.

Methods

We conducted a retrospective analysis of 1000 consecutive patients with AMI without a history of atrial fibrillation between January 2018 and December 2020. Continuous electrocardiographic monitoring was performed during the patients’ hospital stay to detect NOAF. We assessed the predictive ability of the different scoring models using receiver operating characteristic (ROC) curves. In addition, we employed the area under the curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) analyses to assess the incremental discriminative ability of uric acid when added to the CHA2DS2-VASc score.

Results

Ninety-three patients (9.3%) developed NOAF during hospitalisation. In multivariate regression analyses, the adjusted odds ratio (OR) for NOAF was 1.439 per one standard deviation increase in uric acid level (95% confidence intervals (CI):1.182–1.753, p < 0.001). The ROC curve analysis revealed that the AUC for uric acid was 0.667 (95% CI:0.601–0.719), while the AUC for the CHA2DS2-VASc score was 0.678 (95% CI:0.623–0.734). After integrating the uric acid variable into the CHA2DS2-VASc score, the combined score yielded an improved AUC of 0.737 (95% CI:0.709–0.764, p = 0.009). Furthermore, there was a significant improvement in both IDI and NRI, indicating an incremental improvement in discriminative ability (IDI = 0.041, p < 0.001; NRI = 0.627, p < 0.001).

Conclusion

Our study suggests that uric acid level is an independent risk factor for the development of NOAF after AMI. Furthermore, the incorporation of uric acid into the CHA2DS2-VASc score significantly improves the discriminative ability of the score in identifying patients at high risk for NOAF.
Association of nutritional status and comorbidity with long-term survival among community-dwelling older males
Authors: Hou Baicun , Lin Yunjuan , Zhang Wangjingyi , Lin Qiqi , Wang Shengshu , Meng Fansen , Dai Wei , Wang Gangshi
Published: October 2023

Background

Estimates of survival in the older can be of benefit in various facets, particularly in medical and individual decision-making. We aim to validate the value of a combination of nutrition status evaluation and comorbidity assessment in predicting long-term survival among community-dwelling older.

Methods

The Charlson Comorbidity Index (CCI) was applied for comprehensive evaluation of comorbidities. Participants were classified into CCI score ≤ 2 and ≥ 3 subgroups. Nutritional status was assessed by using Mini Nutritional Assessment-Short Form (MNA-SF) and Geriatric Nutritional Risk Index (GNRI) evaluations. Mortality rates and survival curves over a 5-year period were compared among subgroups classified by CCI and/or MNA-SF/GNRI evaluations.

Results

A total of 1033 elderly male participants were enrolled in this study, with an average age of 79.44 ± 8.61 years. 108 deceased participants (10.5%) were identified during a follow-up of 5 years. Cox proportional hazards regression analysis showed that age, CCI, MNA-SF and GNRI were independent predictors of 5-year all-cause death in this cohort. Compared to those with normal nutrition status and CCI ≤ 2, the subgroup at risk of malnutrition and CCI ≥ 3 had a significantly higher 5-year all-cause mortality rate (HR = 4.671; 95% CI:2.613–8.351 for MNA-SF and HR = 7.268; 95% CI:3.401–15.530 for GNRI; P < 0.001 for both). Receiver operating characteristic curve analysis demonstrated that a combination of either MNA-SF or GNRI with CCI had significantly better performance than CCI, MNA-SF or GNRI alone in predicting all-cause death.

Conclusion

The combination of nutritional assessment (MNA-SF or GNRI) with CCI can significantly improve the predictive accuracy of long-term mortality outcomes among community-dwelling older males.