bluuebunny/crossref_metadata_2025 huggingface dataset:
Left Ventricular Morphology and Function in Normotensive, Metabolically Healthy Obese Individuals without Fatty Liver Disease
Authors: Boszko Maria , Strzelczyk Jakub , Szmigielski Cezary , Kalinowski Piotr , Ziarkiewicz-Wróblewska Bogna , Styczyński Grzegorz
Published: October 2023

Background: Obesity is one of the major risk factors for the development of heart failure (HF), although the exact underlying mechanism remains unclear. In the clinical setting, assessing the impact of obesity on the cardiovascular system is difficult due to comorbidities. Objectives: The purpose of this study was to evaluate an independent influence of obesity on the left ventricular (LV) morphology and function. To eliminate hemodynamic and metabolic confounders, we performed an echocardiographic evaluation of severely obese but normotensive and metabolically healthy patients without fatty liver disease. Methods: The patients were retrospectively selected from the cohort of 180 consecutive obese patients systematically evaluated with transthoracic echocardiography before bariatric surgery. Finally, 25 obese subjects, predominantly females, were evaluated with transthoracic echocardiography. Inclusion criteria were defined as absence of diabetes, hypertension, and hyperlipidemia, no use of medications and no hepatic steatosis on liver biopsy. They were matched with a control group of healthy subjects with normal body mass index. Results: In obese patients, LV hypertrophy (LVH) (expressed as LV mass indexed for height in meters2.7) was significantly more frequent in the obese group (48 vs. 0%, p < 0.001). LV longitudinal systolic function measured by mitral annular systolic velocity was significantly lower in the obese group (S’ 8.5 vs. 9.7 cm/s, p = 0.002). All studied indices of the LV diastolic function (E/A, mean E’ and E/E’ ratio) were impaired in obese subjects, even after adjustment for systolic blood pressure and heart rate (E/A 1.31 vs. 1.64, p < 0.001, E’ mean 11 vs. 14.8 cm/s, p < 0.001, E/E’ 7.5 vs. 6.4, p = 0.002 for obese vs. controls, respectively). Conclusions: LVH is significantly more common, and LV diastolic and longitudinal systolic function is significantly impaired in young, metabolically healthy, normotensive, severely obese individuals without fatty liver disease when compared to age and sex-matched lean subjects. These abnormalities may represent the independent effect of the obesity on the heart, which may contribute to the development the obesity-related HF in later life.
Quando o Estado se divide: moral e política no caso dos derivados da Cannabis
Authors: Cruz Veronica Paulino da , Coutinho Marcelo James Vasconcelos
Published: October 2023

Este artigo analisou as relações políticas estabelecidas entre os poderes Executivo, Legislativo e Judiciário ao longo do processo decisório de regulamentação, no Brasil, do uso de derivados da Cannabis para fins de tratamento médico. Tratou-se de um estudo exploratório, de abordagem qualitativa, desenvolvido no período de 2014 a 2020 por meio de análise documental (materiais jornalísticos, discursos e declarações feitas em audiências públicas) e revisão de literatura. Como resultado, evidenciaram-se as discordâncias internas e as diferentes características e fundamentos que envolvem a chamada arena regulatória. O estudo mostrou que o Poder Executivo fundamenta sua posição com base em argumentação técnica e científica; o Legislativo, sob o filtro moral e empresarial, apresenta argumentação mais estritamente moralista, baseada em perspectivas de “certo” e “errado”; e o Judiciário, também com perspectiva ideológica, expõe um padrão legal-formal de argumentos, revelando-se o mais sensível aos pedidos de familiares e associações de usuários (com base no direito individual). Fundamentando-se na Teoria da Moralidade Política, o estudo concluiu que as instituições do Estado brasileiro articulam-se em torno de perspectivas construídas por valores morais que impactam diretamente as políticas públicas de saúde.
Morfodinâmica e sedimentologia da planície de marés do Rio Barra Nova, Ceará
Authors: Carneiro Narjara Maria Araújo , Muniz Robert de Lima , Rodrigues Rayron Maia , Nascimento Junior Daniel Rodrigues do
Published: October 2023

O Rio Barra Nova é uma drenagem de pequeno porte que desemboca na zona costeira de Caucaia (CE), local onde se alarga em uma planície de marés conhecida como “Lagoa” da Barra Nova. Trata-se de um sistema muito dinâmico, reconhecido pela frequente mudança em tamanho e posição de suas feições sedimentares, mas também por seu uso turístico como área de lazer e prática de esportes aquáticos. É, portanto, área de interesse dos pontos de vista científico e ambiental, sendo este último aspecto relacionado à necessidade de uso sustentável por frequentadores e turistas. Nesse âmbito, propôs-se aqui a análise da variação de suas feições de relevo por meio do exame de imagens de satélite e fotografias aéreas, levantamento das feições topográficas no campo sobre a barreira, estudo textural dos componentes terrígenos e bioclásticos e teor de carbono orgânico. Os resultados de sensoriamento remoto mostraram mudanças intensas nas feições emersas e imersas nos últimos 15 anos, destacando grande variação na largura da barreira, intervalos de fechamento do canal de maré principal, formação e emersão de bancos arenosos na forma de ilhotas e elevado dinamismo de canais de maré secundários imersos. Já os perfis topográficos na barreira destacaram grande quantidade de cascalho associado às ressacas, indícios de fechamento artificial da planície de marés, redução no volume de areia e formação de feições eólicas incipientes. Em suma, os resultados reforçam que o transporte seja dominado pelas marés enchentes, mas também que a dinâmica interna da planície é afetada tanto por ressacas como por intervenções artificiais no canal de marés principal com intuito de aproveitamento da região para o lazer e turismo.
Eloísa Cartonera: el futuro de la literatura sudaca border, 20 años después
Authors: Palmeiro Cecilia
Published: October 2023

A partir del análisis de la relación entre literatura y crisis neoliberal, este trabajo presenta una instantánea de la fundación de la editorial Eloísa Cartonera como instancia de configuración de un tipo de vanguardia productiva y un programa de literatura futura, luego puesto en práctica por la red de editoras cartoneras del mundo.
Relationship Between Community-Level Distress and Cardiac Rehabilitation Participation, Facility Access, and Clinical Outcomes After Inpatient Coronary Revascularization
Authors: Thompson Michael P. , Hou Hechuan , Stewart James W. , Pagani Francis D. , Hawkins Robert B. , Keteyian Steven J. , Sukul Devraj , Likosky Donald S.
Published: October 2023

BACKGROUND:

Although disparities in cardiac rehabilitation (CR) participation are well documented, the role of community-level distress is poorly understood. This study evaluated the relationship between community-level distress and CR participation, access to CR facilities, and clinical outcomes.

METHODS:

A retrospective cohort study was conducted on a 100% sample of Medicare beneficiaries undergoing inpatient coronary revascularization between July 2016 and December 2018. Community-level distress was defined using the Distressed Community Index quintile at the beneficiary zip code level, with the first and fifth quintiles representing prosperous and distressed communities, respectively. Outpatient claims were used to identify any CR use within 1 year of discharge. Beneficiary and CR facility zip codes were used to describe access to CR facilities. Adjusted logistic regression models evaluated the association between Distressed Community Index quintiles, CR use, and clinical outcomes, including one-year mortality, all-cause hospitalization, and acute myocardial infarction hospitalization.

RESULTS:

A total of 414 730 beneficiaries were identified, with 96 929 (23.4%) located in the first and 67 900 (16.4%) in the fifth quintiles, respectively. Any CR use was lower for beneficiaries in distressed compared with prosperous communities (26.0% versus 46.1%,
P
<0.001), which was significant after multivariable adjustment (odds ratio, 0.41 [95% CI, 0.40–0.42]). A total of 98 458 (23.7%) beneficiaries had a CR facility within their zip code, which increased from 16.3% in prosperous communities to 26.6% in distressed communities. Any CR use was associated with absolute reductions in mortality (−6.8% [95% CI, −7.0% to −6.7%]), all-cause hospitalization (−5.9% [95% CI, −6.3% to −5.6%]), and acute myocardial infarction hospitalization (−1.3% [95% CI, −1.5% to −1.1%]), which were similar across each Distressed Community Index quintiles.

CONCLUSIONS:

Although community-level distress was associated with lower CR participation, the clinical benefits were universally received. Addressing barriers to CR in distressed communities should be considered a significant priority to improve survival after coronary revascularization and reduce disparities.
Proportionality and Moral Blameworthiness in Ongwen’s icc Sentencing Decision
Authors: Sorvatzioti Demetra Fr.
Published: October 2023

The icc’s legal framework combines continental and common law features. The sentencing regime provides for a separate hearing process unknown to the continentals. The principle of proportionality governs sentencing determination. Proportionality is met by analysing gravity and moral blameworthiness. In Ongwen, the icc should address his moral blameworthiness by considering his unique dual status as a former abducted child soldier and perpetrator, the expert evidence regarding the lra and the Acholi culture and history. The Court sentenced Ongwen in a rather formal traditional continental way. However, conviction is not the icc’s ultimatum, and sentencing should not be a pure side effect of conviction. When the icc tries cases of non-western peoples, it is essential to express its understanding and respect for diversity. By addressing cultural, social, and historical aspects of the case and the offender as part of the sentencing reasoning, the icc performs the balancing process needed for proportionality.
Agriculture in al-Yamāma during the Abbasid Period*
Authors: AlSaif Abdullah Muhammad
Published: October 2023

Agriculture is a sine qua non for human societies as it provides the food that people need to live. This article will examine the state of agriculture in the region of al-Yamāma in central Arabia during the Abbasid period. It begins with a consideration of the factors affecting agriculture, including some that are uniquely important in the central Arabian context. Attention then turns to a discussion of land holdings and land grants, methods of irrigation, the different types of agriculture, and the crops cultivated. Dates are seen to be the most important agricultural commodity, followed closely by grains. Much less information is available regarding fruits and vegetables. The article relies solely on primary Arabic sources.
A New Pottery Collection from Jabal Dādān (al-Khurayba) in al-ʿUlā
Authors: Alghazzi Abdulaziz S.
Published: October 2023

This article discusses a group of outstanding pottery fragments from the summit of Jabal Dādān (al-Khurayba) at al-ʿUlā in Saudi Arabia. The importance of these fragments comes from the absence of published material from the Dādān site, the lack of color-decorated ceramic vessels among the published material, and the diversity in the bases and shapes of the vessels. Comparative studies indicate that this collection falls within the group of colored pottery from northwestern Saudi Arabia, generally dated to between the end of the 2nd and beginning of the 1st millennium bce. The collection appears similar to the Taymāʾ pottery in a number of decorative elements, such as: the chessboard element. These collections indicate that al-Khurayba was in contact with several sites within Saudi Arabia, such as the sites of Taymāʾ and Qurayya in the northwest, and the sites of al-Sīḥ and al-Banna in the center, as well as sites elsewhere in the Arabian Peninsula, such as the al-Muwayliḥ site in the United Arab Emirates, and sites outside the Arabian Peninsula, including Tall al-Khalīfa in the Levant.
First record of the family Neopseustidae from Yunnan, China with description of a new species (Lepidoptera, Neopseustidae)
Authors: HUANG SI-YAO , HOU YONG-XIANG , ZHU LI-JUAN , CHEN LIU-SHENG
Published: October 2023

The family Neopseustidae is reported from Yunnan Province, Southwest China, for the first time, with a new species, N. gaoligongensis Huang & Chen, sp. n., described from Mt. Gaoligong, West Yunnan, based on molecular and morphological evidence. The new species was found to belong to the N. bicornuta species-group and is closely related to N. fanjingshana Yang, 1988, but can be distinguished from it by the differences in morphology and a 3.2% COI distance. Adults and genitalia of the new species and N. fanjingshana are illustrated, and the molecular phylogeny based on COI barcoding of the genus Neopseustis is also updated.
Reincarnation of libraries via metaverse: A pathway for a sustainable knowledge system in the digital age
Authors: Ajani Yusuf Ayodeji , Enakrire Rexwhite Tega , Oladokun Bolaji David , Bashorun Musediq Tunji
Published: October 2023

The evolution of metaverse libraries offers a transformative pathway for redefining knowledge systems in the digital age. This study delves into the seamless integration of enduring library principles with the expansive capabilities of the metaverse, envisioning a harmonious coexistence that preserves traditional library values while propelling knowledge dissemination, inclusivity, and collaboration to new heights. Real-world case studies provide valuable insights into successful metaverse library implementations and offer lessons for future endeavors. By seamlessly merging traditional library attributes with immersive digital experiences, metaverse libraries can offer tailored learning journeys, foster global collaboration, and ensure secure content distribution. However, the landscape is not without challenges, such as privacy concerns, digital literacy gaps, and the imperative of inclusivity, all of which require thoughtful interdisciplinary collaboration. This evolution underscores the significance of preserving the essence of physical libraries while embracing the potential of the metaverse. Through adept navigation of these complexities, metaverse libraries have the capacity to revolutionize education, nurture collaboration, and ensure equitable access to knowledge in a dynamic and interconnected digital landscape.
Association of cerebrospinal fluid CD4+/CD8+Ratio with 60-day functional outcome after intracerebral hemorrhage
Authors: Zhu Chunying , Li Wei , Zhang Yingfu , Qianqian Li  , Wang Huan
Published: October 2023

Background: The immune inflammatory reaction has vital function in pathologic mechanism of critical intracerebral hemorrhage. It recently has been reported that CD4/CD8 ratio may represent a novel composite immune inflammatory marker to predict prognosis of critical intracerebral hemorrhage (ICH). Nevertheless, as for considering the effects of surgical evacuation upon initiation of immune inflammatory reactions, the association between cerebrospinal fluid (CSF) CD4/CD8 ratio and 60-day functional outcome of patients with critical ICH after surgery has not been investigated. Present study aimed to evaluate the predictive value concerning postoperative complement system and immunoglobulin, paired cerebrospinal fluid and peripheral blood lymphocyte subsets, as well as inflammation index before and after the operations upon the 60-day prognosis of patients with ICH.

Methods: In total, 69 patients with acute critical ICH admitted in First Central Hospital of Baoding City from January to July in 2022 were prospectively enrolled. We recorded and analyzed the relevant clinical data. Laboratory parameters included postoperative lymphocyte subsets in paired cerebrospinal fluid and peripheral blood, inflammation index before and after operation. The associations between 60-day outcome and laboratory biomarkers were assessed by multivariable logistic regression analysis. Comparisons of predictive value regarding independent predictors was evaluated by receiver operating characteristic (ROC) curves.

Results: In total, 51 patients with critical ICH exhibited poor outcomes at 60 days, which was associated with fever after surgery, hernia before surgery, SAH and lower Glasgow Coma Scale (GCS) at admission and large hematoma volume, greater CD3T%CSF, greater CD4T%CSF, and greater CD4/CD8 ratioCSF. CD4/CD8ratio CSF showcased significant predictive power by comparing with other laboratorial variables (AUC = 0.6808; cut-off = 1.61; sensitivity = 80.39%; specificity = 61.11%; 95% CI: 0.5232–0.8385; p = .0233), which was found to correlated linearly with postoperative fever, first CSF test time, CD3T% CSF, CD4T% CSF, CD8T% CSF, NKCSF, CD3T%PB, CD8T%PB, CD4/CD8 ratioPB, and glucoseCSF. Poor outcome at 60 days linearly correlated with CD4/CD8ratioCSF after adjustments. In 3–5 days after surgery tested CSF lymphocyte subsets, CD4/CD8ratioCSF ≥1.61 was associated with a higher risk for 60-day poor outcome comparing with corresponding subgroups.

Conclusions: In association of critical ICH patient prognosis, CSF CD4/CD8 ratio, especially in 3–5 days after surgery, exhibited potential independent predictive ability for 60-day functional outcomes of patients with critical ICH.
COVID-19-Associated Food Insecurity and Mental Health Symptoms Among Latinx Adults in the United States
Authors: Trabilsy Maissa , Ortiz Kasim , Camacho-Rivera Marlene
Published: October 2023

Introduction: U.S. Latinx adults were disproportionately burdened by COVID-19 infection, as well as food insecurity compared to their non- Hispanic white adults. It is less clear if within-group variations among U.S. Latinx adults exist in food insecurity and mental health outcomes. Methods: We conducted a secondary data analysis of repeated cross-sectional survey waves from the Understanding America Study (UAS) study ( N = 182,865). We computed multivariable generalized linear regression models to examine associations between food insecurity, demographic characteristics, and depressive symptoms. Results: Participants with a history of food insecurity had a higher prevalence of depressive symptoms compared to those without a history of food insecurity (21.1% compared to 5.23%, p < .0001). Mexican participants reported a significantly higher prevalence of depression compared to Latino participants of Puerto Rican, Central American, or another Latino ethnicity (8.94% compared to 2.84%, 1.76%, and 2.91%, respectively, p < .0001). Associations of self-reported food insecurity among men and women varied by asthma status. Conclusions: Our study demonstrates that participants with a history of food insecurity had a higher prevalence of depressive symptoms compared to those without a history of food insecurity. Our findings also illuminate the importance of disaggregating U.S. Latinx adults when examining associations between food insecurity and mental health.
Development of Mental Models in Decision-Making Tasks
Authors: Narayanan Ranjani , Walsh Sarah E. , Feigh Karen M.
Published: October 2023

This study aims to understand the development of users’ mental models (MMs) over time. We use behavioral data obtained from process tracing to identify key components of MMs and their relative importance. Further, we investigate the stability and predictability of these components as users learn through system interaction. Human-in-the-loop experimentation was deployed in a dynamic geospatial environment and six information attributes were provided to inform participants’ decisions. Partial Least Squares Regression was used to relate behavioral data and decision-making outcomes. We found that top-most performers initially adapt and progressively stabilize toward a suitable model as performance improves. In contrast, low performers lack adaptability and perform poorly. Overall, most participants are consistent with their choices as task familiarity increases. Identifying MMs and the underlying stability and predictability trends within performance groups has implications for improving user experience and curating decision support tools for human-AI teams.
Using Machine Learning to Predict Nonachievement of Clinically Significant Outcomes After Rotator Cuff Repair
Authors: Alaiti Rafael Krasic , Vallio Caio Sain , Assunção Jorge Henrique , Andrade e Silva Fernando Brandão de , Gracitelli Mauro Emilio Conforto , Neto Arnaldo Amado Ferreira , Malavolta Eduardo Angeli
Published: October 2023

Background:

Although some evidence suggests that machine learning algorithms may outperform classical statistical methods in prognosis prediction for several orthopaedic surgeries, to our knowledge, no study has yet used machine learning to predict patient-reported outcome measures after rotator cuff repair.

Purpose:

To determine whether machine learning algorithms using preoperative data can predict the nonachievement of the minimal clinically important difference (MCID) of disability at 2 years after rotator cuff surgical repair with a similar performance to that of other machine learning studies in the orthopaedic surgery literature.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

We evaluated 474 patients (n = 500 shoulders) with rotator cuff tears who underwent arthroscopic rotator cuff repair between January 2013 and April 2019. The study outcome was the difference between the preoperative and 24-month postoperative American Shoulder and Elbow Surgeons (ASES) score. A cutoff score was calculated based on the established MCID of 15.2 points to separate success (higher than the cutoff) from failure (lower than the cutoff). Routinely collected imaging, clinical, and demographic data were used to train 8 machine learning algorithms (random forest classifier; light gradient boosting machine [LightGBM]; decision tree classifier; extra trees classifier; logistic regression; extreme gradient boosting [XGBoost]; k-nearest neighbors [KNN] classifier; and CatBoost classifier). We used a random sample of 70% of patients to train the algorithms, and 30% were left for performance assessment, simulating new data. The performance of the models was evaluated with the area under the receiver operating characteristic curve (AUC).

Results:

The AUCs for all algorithms ranged from 0.58 to 0.68. The random forest classifier and LightGBM presented the highest AUC values (0.68 [95% CI, 0.48-0.79] and 0.67 [95% CI, 0.43-0.75], respectively) of the 8 machine learning algorithms. Most of the machine learning algorithms outperformed logistic regression (AUC, 0.59 [95% CI, 0.48-0.81]); nonetheless, their performance was lower than that of other machine learning studies in the orthopaedic surgery literature.

Conclusion:

Machine learning algorithms demonstrated some ability to predict the nonachievement of the MCID on the ASES 2 years after rotator cuff repair surgery.
Frailty as a predictor of adverse outcomes in burn patients: a systematic review
Authors: Shafiee Arman , Arabzadeh Bahri Razman , Rajai Shahryar , Ahoopai Mohammad , Seighali Niloofar , Amini Mohammad Javad
Published: October 2023

Background

The identification of new prognostic tools for the prediction of burn patients’ morbidity outcomes is necessary. Considering the feasibility of frailty assessment in the clinical setting, we aim to systematically review the literature on the associations between frailty and adverse outcomes in burn patients.

Methods

Studies were retrieved from MEDLINE (through PubMed), Web of Science, Scopus, and Embase from their inception up to 8 September 2022. Included studies were those that used frailty indices to predict adverse outcomes in burn patients. The quality assessment was done using the National, Heart, Lung, and Blood Institute (NHLBI) checklist. The results were synthesized narratively.

Results

We included 18 studies. The sample size among the included studies varied between 42–1615 patients. There were 12 research articles and 6 conference abstracts. Most of the studies were recently published in 2021 and 2022. Seven different frailty measures were evaluated. The following frailty measures were used: Canadian Study for Health and Ageing (CSHA) Clinical Frailty score (CFS), Modified frailty index-11 (mFI-11), Hospital frailty index, FRAIL scale, Emergency General Surgery Frailty Index (EGSFI), and Burn frailty index (BFI). There was only one report regarding a specific frailty index designed for the burn population (BFI). Except for one study (which used mFI-11), all included studies have shown a significant effect between assessing frailty and predicting worse outcomes. The CFS was an independent predictor of mortality among the burn population with high certainty of evidence. We found a significant association for other frailty indices as a predictor of mortality, however, the certainty of evidence regarding those was not high. Eight studies found a positive association between assessing frailty and unfavorable discharge location. There was no association between frailty and increased length of stay.

Conclusion

In conclusion, the postadmission assessment of frailty can be a reliable tool for predicting unfavorable outcomes and mortalities among patients with burn injuries. In addition, future studies with various populations from other countries are required to evaluate the efficacy of frailty indices measurement in order to strengthen the available evidence.
Contextualizing the results of an integrative review on the characteristics of dementia-friendly hospitals: a workshop with professional dementia experts
Authors: Manietta Christina , Purwins Daniel , Reinhard Anneke , Feige Melanie , Knecht Christiane , Alpers Birgit , Roes Martina
Published: October 2023

Background

To become a dementia-friendly hospital (DFH) is increasingly being discussed in health care practice, research, politics and society. In our previous integrative review, we identified six characteristics of DFHs. To thoroughly discuss and contextualize these characteristics in relation to hospitals in Germany, we involved professional dementia experts in our review process.

Methods

At the end of our review process, we involved professional dementia experts at the ‘contributing’ level of the ACTIVE framework to discuss and reflect on the six DFH characteristics we identified. We conducted a group process in the form of a one-day workshop. The workshop consisted of four steps: 1. presentation of review results (input), 2. modification of DFH characteristics and rating of their relevance in smaller working groups, 3. discussion of group results in plenary and 4. questionnaire for prioritization and rating of feasibility. The data were analyzed in MAXQDA using content analysis and descriptive statistics.

Results

A total of 16 professional dementia experts working in hospitals participated in the workshop. All the previously identified characteristics of a DFH were rated as relevant or very relevant for patients with dementia, their relatives and health care professionals from the professional dementia experts’ perspective. They made a few modifications of the six characteristics at the level of subcategories, aspects, and descriptions. The feasibility of the characteristics in hospitals was critically discussed regarding resources, hospital structures and processes, the role of nurses, and the current care situation of people with dementia in hospitals. More than half of the subcategories of the characteristics were considered very difficult or difficult to implement by most professional dementia experts.

Conclusion

The involvement of professional dementia experts helped us contextualize our review findings within the German hospital setting. These results highlight the need to consider resources, funding options, influencing factors, and the current situation and culture of care provided by hospitals before implementing DFH characteristics. Beside the involvement of professional dementia experts and various health care professionals, the involvement of other stakeholders, such as people with dementia and their relatives, is necessary in future research for the development of a DFH.
Diabetic retinopathy: a comprehensive update on in vivo, in vitro and ex vivo experimental models
Authors: Sadikan Muhammad Zulfiqah , Abdul Nasir Nurul Alimah , Lambuk Lidawani , Mohamud Rohimah , Reshidan Nur Hidayah , Low Evon , Singar Saiful Anuar , Mohmad Sabere Awis Sukarni , Iezhitsa Igor , Agarwal Renu
Published: October 2023

Diabetic retinopathy (DR), one of the leading causes of visual impairment and blindness worldwide, is one of the major microvascular complications in diabetes mellitus (DM). Globally, DR prevalence among DM patients is 25%, and 6% have vision-threatening problems among them. With the higher incidence of DM globally, more DR cases are expected to be seen in the future. In order to comprehend the pathophysiological mechanism of DR in humans and discover potential novel substances for the treatment of DR, investigations are typically conducted using various experimental models. Among the experimental models, in vivo models have contributed significantly to understanding DR pathogenesis. There are several types of in vivo models for DR research, which include chemical-induced, surgical-induced, diet-induced, and genetic models. Similarly, for the in vitro models, there are several cell types that are utilised in DR research, such as retinal endothelial cells, Müller cells, and glial cells. With the advancement of DR research, it is essential to have a comprehensive update on the various experimental models utilised to mimic DR environment. This review provides the update on the in vitro, in vivo, and ex vivo models used in DR research, focusing on their features, advantages, and limitations.
Dermatologic laser-induced ocular and periocular complications: a review
Authors: Bonińska Karolina
Published: October 2023

This study aimed to discuss severe ocular and periocular complications after dermatological laser treatment. This literature review evaluated published journal articles (clinical trials or scientific reviews) extracted from electronic databases (MEDLINE and PubMed) and the reference lists of related articles. Individual eyeball structures, such as chromophores, were found to interact with laser radiation. The type of damage was found to be influenced by the wavelength emitted by the laser-active medium. Moreover, in the absence of proper protection of the eyeballs, the structures that are crucial for vision can be damaged. In conclusion, laser treatment can also cause serious and irreversible complications. Appropriate patient selection, intraoperative techniques, early identification, and interventions for adverse postoperative effects are crucial to avoid major complications and even blindness.
Constructing an extracellular matrix-related prognostic model for idiopathic pulmonary fibrosis based on machine learning
Authors: Luo Hong , Yan Jisong , Zhou Xia
Published: October 2023

Background

Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive interstitial lung disease. Multiple research has revealed that the extracellular matrix (ECM) may be associated with the development and prognosis of IPF, however, the underlying mechanisms remain incompletely understood.

Methods

We included GSE70866 dataset from the GEO database and established an ECM-related prognostic model utilizing LASSO, Random forest and Support vector machines algorithms. To compare immune cell infiltration levels between the high and low risk groups, we employed the ssGSEA algorithm. Enrichment analysis was conducted to explore pathway differences between the high-risk and low-risk groups. Finally, the model genes were validated using an external validation set consisting of IPF cases, as well as single-cell data analysis.

Results

Based on machine learning algorithms, we constructed an ECM-related risk model. IPF patients in the high-risk group had a worse overall survival rate than those in the low-risk group. The model’s AUC predictive values were 0.786, 0.767, and 0.768 for the 1-, 2-, and 3-year survival rates, respectively. The validation cohort validated these findings, demonstrating our model’s effective prognostication. Chemokine-related pathways were enriched through enrichment analysis. Moreover, immune cell infiltration varied significantly between the two groups. Finally, the validation results indicate that the expression levels of all the model genes exhibited significant differential expression.

Conclusions

Based on CST6, PPBP, CSPG4, SEMA3B, LAMB2, SERPINB4 and CTF1, our study developed and validated an ECM-related risk model that accurately predicts the outcome of IPF patients.
Negative pressure wound therapy for flap closed-incisions after 3D-printed prosthesis implantation in patients with chronic osteomyelitis with soft tissue defects
Authors: Lin Zhiyu , Zhang Xinling , Chen Yujie , Tian Yun , Yang Xin , Zhao Zhenmin
Published: October 2023

Background

The flap closed-incisions healing after 3D-printed prosthesis implantation in Chronic Osteomyelitis with Soft Tissue Defects (COSTD) is critical. This study aimed to explore the safety and effectiveness of Negative Pressure Wound Therapy (NPWT) in promoting flap closed-incisions healing.

Methods

Retrospective analysis of clinical data was performed, including baseline, surgical and hospitalization information. The efficacy of NPWT was assessed by comparing the ASEPSIS scores, Visual Analogue Scale (VAS), Activity of Daily Living Scale (ADLS), and Lower Extremity Functional Scale (LEFS), as well as the major postoperative complications.

Results

The study included 20 patients, 13 received conventional dressing (Control group) and 7 received NPWT treatment (NPWT group). These two groups exhibited a notable disparity in the distribution of ASEPSIS scores, and the median scores were 24 in Control group and 9 in NPWT group (p = 0.001). Eight patients in the Control group experienced major incisional complications, including 7 cases of exudation, 3 cases of infection, 2 cases of non-healing, and 1 case of dehiscence, while none were observed in the NPWT group (p = 0.015). The VAS, ADLS, and LEFS scores were significantly improved in the NPWT group compared to the Control group (p = 0.003, 0.017, and 0.043, respectively).

Conclusions

The study findings suggest that NPWT applied to the healing process of flap closed-incisions after 3D prosthesis implantation in patients with COSTD can reduce the occurrence of postoperative major complications and promote the recovery of lower limb function and daily activities, which should be recommended for clinical practice.
Effectiveness of sensory adaptive dental environments to reduce psychophysiology responses of dental anxiety and support positive behaviours in children and young adults with intellectual and developmental disabilities: a systematic review and meta-analyses
Authors: Reynolds Kaitlyn , Chimoriya Ritesh , Chandio Navira , Tracey Danielle , Pradhan Archana , Fahey Paul , Stormon Nicole , Arora Amit
Published: October 2023

Background

People with Intellectual and developmental disabilities (IDDs) experience oral health inequality due to myriad of risk factors and complex needs. Sensory processing difficulties, maladaptive behaviours and dental anxiety contribute to difficulties in receiving preventive and routine dental treatments. This study aimed to systematically review the evidence on the effectiveness of sensory adaptive dental environments (SADE) for children and young adults (up to the ages 24 years) with IDD to address cooperation and dental anxiety.

Methods

This review was reported according to The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE (Ovid), The Cochrane Library, Embase, Google Scholar, Web of Science and OT Seeker were searched using appropriate terms to identify Randomised Control Trails (RCTs) that matched inclusion criteria. Screening was conducted by two reviewers after de-duplication based on titles and abstracts followed by full text retrieval. Quality of the included studies was assessed using Cochrane Risk of Bias (ROB)-2 for crossover trials and data extracted by two reviewers. The details of the interventions and effectiveness were compared and discussed narratively, and comparable outcomes were included to meta-analyses using R software.

Results

A total of 622 articles were identified and five articles met eligibility for inclusion. Three studies used multi-sensory adaptations and one used single sensory adaptation of music. Narrative synthesis showed some evidence of SADE reducing magnitude and duration, although, questionable for reducing the number of maladaptive behaviours. Two studies demonstrated conflicting evidence of the effect of SADE on cooperation. Three studies demonstrated significant positive impact of SADE on psychophysiological outcomes. Despite an overall tendency to favour SADE, no statistically significant difference of maladaptive behaviours was found between SADE and regular dental environment (RDE) (Standardised mean change (SMC) = 0.51; 95% Confidence Interval (CI) -0.20 to 1.22;p = 0.161). SADE was superior to RDE (SMC -0.66; 95% CI -1.01 to -0.30;p =  < 0.001) in reducing psychophysiological responses of dental anxiety.

Conclusion

Current evidence suggests that adapting visual, tactile, and auditory aspects of the dental environment in a single or multi-sensory approach demonstrates small positive effects on psychophysiological responses and maladaptive behaviours of dental anxiety for people with IDD.

Trial registration

The title of this review was registered with PROSPERO (CRD42022322083).
Maxillary gingival neurolemmoma: a case report and literature review
Authors: Zhang Xiangzi , Gao Qiming , Xuan Yunze
Published: October 2023

Objective

To explore and summarize the clinical features, differential diagnosis and treatment of the oral maxillofacial schwandoma.

Case presentation

This is a report of a case of a 46-year-old female patients with neurolemmoma in the maxillary gingiva. The clinical features, pathological features, differential diagnosis and treatment were analyzed. Literature review was conducted in search of domestic and overseas journal full-text database from 1986 ~ 2017. 39 reports on the oral and maxillofacial Neurolemmoma from 1986 to 2017 in the database of China hospital knowledge database and the PubMed database, there were 405 patients. There were 23 cases of gingival mucosa, 17 in foreign literature and only 6 in the domestic literature.

Conclusions

The incidence of gingival Neurolemmoma is extremely low, the predilection age is similar to other parts, it is middle-aged and young, and there is no obvious gender tendency. About 25–45% of schwannomas are found in the head and neck, and rarely in the mouth (only 1%). The most common internal location of the mouth is the tongue, followed by the floor of the mouth, buccal mucosa, palate, gums, and lips. Schwannomas are slow-growing benign tumors that are rare in the gums. Gingival schwannoma is usually a single occurrence, and the clinical manifestations are mostly painless gum mass, tooth loosening and displacement, without peripheral bone changes and regional lymph node metastasis. It is difficult to diagnose this tumor according to clinical manifestations, and pathological diagnosis is still the basis for the diagnosis of gingival schwannoma. So far, surgical resection is the preferred treatment for this disease, and the prognosis is good.
Cardiac arrhythmia detection using deep learning approach and time frequency representation of ECG signals
Authors: Daydulo Yared Daniel , Thamineni Bheema Lingaiah , Dawud Ahmed Ali
Published: October 2023

Background

Cardiac arrhythmia is a cardiovascular disorder characterized by disturbances in the heartbeat caused by electrical conduction anomalies in cardiac muscle. Clinically, ECG machines are utilized to diagnose and monitor cardiac arrhythmia noninvasively. Since ECG signals are dynamic in nature and depict various complex information, visual assessment and analysis are time consuming and very difficult. Therefore, an automated system that can assist physicians in the easy detection of arrhythmia is needed.

Method

The main objective of this study was to create an automated deep learning model capable of accurately classifying ECG signals into three categories: cardiac arrhythmia (ARR), congestive heart failure (CHF), and normal sinus rhythm (NSR). To achieve this, ECG data from the MIT-BIH and BIDMC databases available on PhysioNet were preprocessed and segmented before being utilized for deep learning model training. Pretrained models, ResNet 50 and AlexNet, were fine-tuned and configured to achieve optimal classification results. The main outcome measures for evaluating the performance of the model were F-measure, recall, precision, sensitivity, specificity, and accuracy, obtained from a multi-class confusion matrix.

Result

The proposed deep learning model showed overall classification accuracy of 99.2%, average sensitivity of 99.2%, average specificity of 99.6%, average recall, precision and F- measure of 99.2% of test data.

Conclusion

The proposed work introduced a robust approach for the classification of arrhythmias in comparison with the most recent state of the art and will reduce the diagnosis time and error that occurs in the visual investigation of ECG signals.
Impact of multidisciplinary care of diabetic foot infections for inpatients at Campbelltown Hospital
Authors: Choi Timothy , Osuagwu Uchechukwu Levi , Tran Chau , Bulsari Krupali , Simmons David
Published: October 2023

Background

Diabetic foot infection (DFI), including diabetic foot ulcer, is a serious complication of diabetes, particularly in the South Western Sydney (SWS) region where it is a leading cause of diabetes-related hospitalisations. Multidisciplinary team (MDT) involvement is effective at improving the health outcomes of DFI patients. This study investigated the impact of MDT (High Risk Foot Service, HRFS) on the length of stay and surgical outcomes of inpatients with DFI in a Sydney tertiary hospital.

Method

A retrospective audit of electronic medical records of inpatient admissions for DFI at Campbelltown Hospital between January 2019 - December 2021, was performed. The main outcome of the study was MDT involvement, defined as having two or more specialities involved in the patient’s treatment. The other measured variables included length of stay (defined as the total duration from admission to discharge), and surgical outcomes including debridement, minor amputation, and major amputation.

Results

Over the three years, 78 participants presented to the hospital for 89 unique DFI admissions. There were 24 admissions in 2019, 28 admissions in 2020, and 37 admissions in 2021, with MDT attendance showing a steady increase at 62.5%, 75.0% and 83.8% respectively. Patients with serious comorbidities such as chronic kidney disease were more likely to have MDT involvement (84.8% vs. 15.2%, P = 0.048). Imaging was more likely to be performed with MDT involvement (78.8% vs. 21.3%, p < 0.05). Comparing patients who received and did not receive MDT care, the mean HbA1c (%) (8.4 ± 2.0 vs. 8.2 ± 2.7, P = 0.701), median length of stay (LOS: 7.8, IQR 15.0 days vs. 4.8 IQR 7.9 days, P = 0.243) and rate of surgical outcomes (74.6% vs. 72.7%, P = 0.262) were similar. Patients who required major amputation had significantly longer LOS (24 days, IQR 21.5 vs. 5.2 days, IQR 13.0, P = 0.004) but similar HbA1c (P = 0.552) compared to those who had conservative intervention.

Conclusion

Adopting an MDT approach was associated with more thorough investigation of DFI, with similar rates of surgical outcomes. Further research on the impacts of MDT on length of stay and surgical outcomes of DFI patients in other SWS hospitals is needed.
Growth hormone supplementation during ovarian stimulation in women with advanced maternal age undergoing preimplantation genetic testing for Aneuploidy
Authors: Sui Yilun , Xiao Min , Fu Jing , Li Lu , Xu Yining , Lei Caixia , Sun Xiaoxi
Published: October 2023

Background

Studies have shown that supplementation with recombinant human GH (rh-GH) during ovarian stimulation (OS) may improve the ovarian response and clinical outcomes of IVF. However, it remains unclear whether GH is associated with the ploidy status of embryos, and therefore, is unable to explain the underlying reason for the effect of GH on IVF outcomes. This study aimed to investigate whether GH supplementation in women with advanced maternal age (AMA) during OS is related to an increased probability of obtaining euploid blastocysts.

Methods

This was a single center retrospective cohort study. The data of all women aged 38–46 years who underwent their first preimplantation genetic testing for aneuploidy (PGT-A) cycle between January 2021 and June 2022 were reviewed. Patients in the GH group received 4 IU/day subcutaneous GH supplementation from the beginning of OS to the trigger day, and patients in the control group did not. A total of 140 patients in the GH group and 272 patients in the control group were included after 1:2 propensity score matching.

Results

The baseline and cycle characteristics between the two groups were similar. The proportion of cycles which obtained euploid blastocysts was significantly higher in the GH group than that in the control group (41.43% vs. 27.21%, P = 0.00). The GH group had a significantly higher euploid blastocyst rate per cohort (32.47% vs. 21.34%, P = 0.00) and mean euploid blastocyst rate per cycle (per biopsy cycle 0.35 ± 0.40 vs. 0.21 ± 0.33, P = 0.00; per OS cycle 0.27 ± 0.38 vs. 0.16 ± 0.30, P = 0.02). However, the benefit of GH was more significant in patients aged 38–40 years, but not significant in patients aged 41–46 years. Pregnancy outcomes were similar between the two groups after embryo transfer.

Conclusions

GH supplementation during OS is associated with a significantly increased probability of obtaining euploid blastocysts in women aged 38–40 years, but this benefit is not significant in women aged 41–46 years. Our results explained the underlying reason for the effect of GH on IVF outcomes in existing studies, and might be helpful for AMA patients undergoing PGT-A cycles to obtain a better outcome meanwhile to avoid over-treatment.

Trial registration

NCT05574894, www.clinicaltrials.gov.
Seven-day, free-living, objectively-measured ambulatory activity: a data set from the Dikgale Health and Demographic Surveillance System site, Limpopo Province, South Africa
Authors: Cook Ian
Published: October 2023

Objectives

To investigate first, the level, distribution, patterns and prevalence of seven-day, objectively-measured physical activity (ambulation) in a rural health and demographic surveillance system (HDSS) site in South Africa, across demographic, temporal and anthropometric measures, within a sample of adolescent and adult participants from a defined ethnic group. Second, to investigate the strength and direction of association between levels of adiposity and physical activity (ambulation).

Data description

The data collected comprises anonymized, individual-level, seven-day pedometry data from a cross-sectional, conveniently sampled survey conducted in 2005–2007. The data includes daily steps and daily activity energy expenditure, basic demographic and temporal information (age, sex, village, day, season) and anthropometric measures (stature, body mass, waist and hip circumference, skinfold thickness) and resting heart rate and blood pressure. Given that this data set was of the first large-scale surveys of objectively-measured physical activity in a South African sample, it could be useful for inclusion in future ecological studies investigating the trend of physical activity over time in the South African population. In addition, this objectively-measured data could provide a useful triangulation point for the interpretation and validation of surveys conducted using self-report measures, especially within rural communities.