bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the future-ready graduate attributes across the undergraduate curricula from the eight publicly funded Hong Kong universities in the era of academic entrepreneurism
Authors: Lam Man Ho Adrian
Published: February 2024

Given Hong Kong’s robust, high-performing, and entrepreneurial higher education system, universities are preparing their students to adapt, contribute, and thrive as productive workers, capable citizens, and life-long learners. With the employment of both qualitative document analysis and inductive thematic analysis, this study aims to analyse how the eight publicly funded universities in Hong Kong conceptualise and frame their graduate attributes, and reveal the similarities and differences of their underlying motivations and implications. This study brings together eight discourses, namely life-long learning, critical thinking, communication and collaboration, interdisciplinary mindset, contextual systems thinking, commitment and responsibility, ethical values and moral principles, as well as technological capability. Using both the lenses of academic entrepreneurism and future readiness, although several attributes are founded to be academically entrepreneurial in orientation due to the emphasis on equipping students with individual skills and dispositions, some other attributes are bringing students back to the humanistic and social nature of human beings, which reveal that Hong Kong universities are preparing their future-ready students both as agents for personal development and of social good. This study can inform how various universities worldwide can revamp and reinvigorate a common set of future-ready graduate attributes, while contextualising and adapting institution-specific variations.
Arab State Narratives on Normalization with Israel: Justifying Policy Reversal
Authors: Hallward Maia Carter , Biygautane Taib
Published: February 2024

When the Abraham Accords were announced in 2020, some lauded these deals as a groundbreaking advancement in Israeli–Arab relations, whereas others saw them as backstabbing the Palestinians. The 2002 Arab Peace Initiative (API), largely ignored by Israel, offered normalized relations with Israel in exchange for withdrawal from the 1967 Occupied Territories, the establishment of a Palestinian state, and a resolution to the Palestinian refugee situation. However, the four Arab states that established relations with Israel under the aegis of the Abraham Accords did so despite Israel’s failure to fulfill API conditions. Given the dismay of many in the region regarding this move and the turnaround in decades of official policy toward Israel, this article investigates the rationale provided by the Arab states for making this diplomatic shift, drawing on quantitative and qualitative data. The study examines the messaging of Arab states and analyzes the economic, geostrategic, and sociocultural justifications in the official media outlets of the four states—the UAE, Bahrain, Morocco, and Sudan, including comparisons with US and UK press. Specifically, it seeks to understand the justifications Arab state elites provided for shifting their policies toward Israel despite the historical conditions set by the API and whether they acknowledge the concerns of Palestinians in their discussion of the Accords. Quantitative findings suggest that media coverage of cooperation varied across the Arab signatories. The coverage in the UAE and Bahrain tended to be more frequent, optimistic, and focused on general and economic cooperation with Israel. In comparison, there tended to be more varied media coverage of the Accords in Sudan and Morocco. Qualitatively, results show that overall economic justifications tended to be used more frequently, and Morocco used sociocultural explanations more than others. Further, the agreements were not presented as peace agreements, unlike how the Accords were discussed in the US and UK press.
The transfer of eco-city concepts to China: A selective and gradual policy transfer style?
Authors: Romano Giulia C
Published: February 2024

To explain the poor results of several international collaborative projects dedicated to exploring eco-city concepts in China, some scholars pointed out that Chinese policymakers operate a form of cherry-picking that prefers technical knowledge to policy proposals. This approach is consistent with the hypothesis of a presumed Chinese style of policy transfers, according to which Chinese policymakers learn from abroad selectively and gradually. This study aims to test this hypothesis by analyzing one of these eco-city collaborations: the transfer of “Careful Urban Renewal” to the city of Yangzhou. Through a longitudinal study that looked at policy developments over the period 2003–2019 and a focus on the “demand side” of policy mobilities, it illustrates that transfers concerned several policy aspects, going beyond technical recommendations. This disconfirms the hypothesis of a consistent policy transfer style, as no specific policy preference could be spotted. Rather, the analysis of the policy process illustrated that different policy transfer styles emerged in the period considered. Variations in policy transfer style can be ascribed to the willingness, motivations, and interests of specific individuals, in particular city party secretaries and local bureaucrats, as well as to the room of maneuver and resources these actors possess, in turn, determined by the institutional structures in which they operate. Situational factors also led to variations. While this single case study cannot encompass all variations of policy transfer style, it is nonetheless hoped that this research inspires more longitudinal studies, which in turn can contribute to a promising discussion in policy studies and urban studies.
Didacticians introducing lesson study for the professional development of prospective mathematics teachers
Authors: Minisola Riccardo , Robutti Ornella , Miyakawa Takeshi
Published: February 2024

Lesson study is recognised as a cultural activity and its implementation in a context different from Japan is a complex process. Researchers’ role in this process is assumed to be critical, although this has rarely been investigated. In this paper, we analyse a teaching experiment to introduce lesson study into a professional development course for prospective teachers at an Italian university, focusing our investigation on a group of researchers acting as teacher educators (didacticians). Using the anthropological theory of the didactic and meta-didactical transposition frameworks, we investigate their dual position as researchers and as teacher educators. We observe the evolution of the didacticians’ teacher-education praxeology (a model of practice and knowledge) during their interactions with prospective teachers. The results indicate that the didacticians’ teacher-education praxeology is distinguished, shaped, and actively influenced by their research praxeology. The results also imply that coordinating the two theoretical frameworks may guide the design and analysis of teachers’ professional development courses.
Interpretable deep learning methods for multiview learning
Authors: Wang Hengkang , Lu Han , Sun Ju , Safo Sandra E.
Published: February 2024

Background

Technological advances have enabled the generation of unique and complementary types of data or views (e.g. genomics, proteomics, metabolomics) and opened up a new era in multiview learning research with the potential to lead to new biomedical discoveries.

Results

We propose iDeepViewLearn (Interpretable Deep Learning Method for Multiview Learning) to learn nonlinear relationships in data from multiple views while achieving feature selection. iDeepViewLearn combines deep learning flexibility with the statistical benefits of data and knowledge-driven feature selection, giving interpretable results. Deep neural networks are used to learn view-independent low-dimensional embedding through an optimization problem that minimizes the difference between observed and reconstructed data, while imposing a regularization penalty on the reconstructed data. The normalized Laplacian of a graph is used to model bilateral relationships between variables in each view, therefore, encouraging selection of related variables. iDeepViewLearn is tested on simulated and three real-world data for classification, clustering, and reconstruction tasks. For the classification tasks, iDeepViewLearn had competitive classification results with state-of-the-art methods in various settings. For the clustering task, we detected molecular clusters that differed in their 10-year survival rates for breast cancer. For the reconstruction task, we were able to reconstruct handwritten images using a few pixels while achieving competitive classification accuracy. The results of our real data application and simulations with small to moderate sample sizes suggest that iDeepViewLearn may be a useful method for small-sample-size problems compared to other deep learning methods for multiview learning.

Conclusion

iDeepViewLearn is an innovative deep learning model capable of capturing nonlinear relationships between data from multiple views while achieving feature selection. It is fully open source and is freely available at https://github.com/lasandrall/iDeepViewLearn.
Single nucleotide polymorphisms (SNPs) in the open reading frame (ORF) of prion protein gene (PRNP) in Nigerian livestock species
Authors: Adeola Adeniyi C. , Bello Semiu F. , Abdussamad Abdussamad M. , Adedokun Rahamon A. M. , Olaogun Sunday C. , Abdullahi Nasiru , Mark Akanbi I. , Onoja Anyebe B. , Sanke Oscar J. , Mangbon Godwin F. , Ibrahim Jebi , Dawuda Philip M. , Salako Adebowale E. , Kdidi Samia , Yahyaoui Mohamed Habib
Published: February 2024

Background

Prion diseases, also known as transmissible spongiform encephalopathies (TSEs) remain one of the deleterious disorders, which have affected several animal species. Polymorphism of the prion protein (PRNP) gene majorly determines the susceptibility of animals to TSEs. However, only limited studies have examined the variation in PRNP gene in different Nigerian livestock species. Thus, this study aimed to identify the polymorphism of PRNP gene in Nigerian livestock species (including camel, dog, horse, goat, and sheep). We sequenced the open reading frame (ORF) of 65 camels, 31 village dogs and 12 horses from Nigeria and compared with PRNP sequences of 886 individuals retrieved from public databases.

Results

All the 994 individuals were assigned into 162 haplotypes. The sheep had the highest number of haplotypes (n = 54), and the camel had the lowest (n = 7). Phylogenetic tree further confirmed clustering of Nigerian individuals into their various species. We detected five non-synonymous SNPs of PRNP comprising of G9A, G10A, C11G, G12C, and T669C shared by all Nigerian livestock species and were in Hardy-Weinberg Equilibrium (HWE). The amino acid changes in these five non-synonymous SNP were all “benign” via Polyphen-2 program. Three SNPs G34C, T699C, and C738G occurred only in Nigerian dogs while C16G, G502A, G503A, and C681A in Nigerian horse. In addition, C50T was detected only in goats and sheep.

Conclusion

Our study serves as the first to simultaneously investigate the polymorphism of PRNP gene in Nigerian livestock species and provides relevant information that could be adopted in programs targeted at breeding for prion diseases resistance.
An insight into the gene expression evolution in Gossypium species based on the leaf transcriptomes
Authors: Wu Yuqing , Sun Rongnan , Huan Tong , Zhao Yanyan , Yu Dongliang , Sun Yuqiang
Published: February 2024

Background

Gene expression pattern is associated with biological phenotype and is widely used in exploring gene functions. Its evolution is also crucial in understanding species speciation and divergence. The genus Gossypium is a bona fide model for studying plant evolution and polyploidization. However, the evolution of gene expression during cotton species divergence has yet to be extensively discussed.

Results

Based on the seedling leaf transcriptomes, this work analyzed the transcriptomic content and expression patterns across eight cotton species, including six diploids and two natural tetraploids. Our findings indicate that, while the biological function of these cotton transcriptomes remains largely conserved, there has been significant variation in transcriptomic content during species divergence. Furthermore, we conducted a comprehensive analysis of expression distances across cotton species. This analysis lends further support to the use of G. arboreum as a substitute for the A-genome donor of natural cotton polyploids. Moreover, our research highlights the evolution of stress-responsive pathways, including hormone signaling, fatty acid degradation, and flavonoid biosynthesis. These processes appear to have evolved under lower selection pressures, presumably reflecting their critical role in the adaptations of the studied cotton species to diverse environments.

Conclusions

In summary, this study provided insights into the gene expression variation within the genus Gossypium and identified essential genes/pathways whose expression evolution was closely associated with the evolution of cotton species. Furthermore, the method of characterizing genes and pathways under unexpected high or slow selection pressure can also serve as a new strategy for gene function exploration.
Annual evolution of the prescription of drugs with prognostic implications in acute decompensated heart failure with reduced ejection fraction
Authors: López-Vilella Raquel , DonosoTrenado Víctor , Guerrero Cervera Borja , Sánchez-Lázaro Ignacio , Martínez Dolz Luis , Almenar Bonet Luis
Published: February 2024

Background

Quadruple therapy (renin angiotensin system inhibitors, beta-blockers, mineralocorticoid receptor antagonists and sodium/glucose cotransporter type 2 inhibitors [SGLT2i]) has become the current prognostic modifying treatment for heart failure (HF) with reduced ejection fraction (HFrEF). This study aimed to analyse the prescription´s evolution of this combination therapy, the analysis of each pharmacological group and the differences according to HF subgroups.

Methods

Retrospective analysis of consecutive patients admitted for cardiac decompensation. Inclusion period: from 1-1-2020 to 12-31-2022. Patients with left ventricular ejection fraction > 40% and deceased during admission were excluded. Finally, 602 patients were included. These were divided into: (a) de novo HF without previous heart disease (n:108), (b) de novo with previous heart disease (n:107), and (c) non-de novo (n:387).

Results

Over the study time, all pharmacological groups experienced an increase in drugs prescription (p < 0.001). The group with the largest prescription rate increase was SGLT2i (2020:20%, 2021:42.9%, 2022:70.4%; mean increase 47.2%). The discharge rate prescription of quadruple therapy increased progressively (2020:7.4%, 2021:21.1%, 2022:32.5%; mean increase 21.9%). The subgroup with the highest combined prescription in 2022 was de novo with previous heart disease (43.9%).

Conclusion

The pharmacological group with the largest prescription´s rate increase was SGLT2i. The percentage of patients discharged on quadruple therapy has progressed significantly in recent years, although it remains low. The most optimised subgroup at discharge was that of de novo HF with previous heart disease.
Effect of mindfulness-based interventions on people with prehypertension or hypertension: a systematic review and meta-analysis of randomized controlled trials
Authors: Chen Qiongshan , Liu Hui , Du Shizheng
Published: February 2024

Background

Hypertension and prehypertension have been widely recognized as the main contributors of global mortality. Evidence shows mindfulness-based interventions may reduce blood pressure and improve mental health. However, the effect of mindfulness-based interventions on blood pressure and mental health has not been fully understood.

Methods

Potential studies published before May 24th 2023 were identified by searching Embase, Ovid Emcare, PsycINFO, CINAHL, Web of Science, Cochrane, PubMed, China National Knowledge Infrastructure, Wanfang database, and VIP China Science. Additionally, two grey databases were searched: Mednar, WorldWideScience.org. The risk of bias in the included studies was assessed using the Cochrane Risk of Bias Assessment tool. The random-effects meta-analyses were conducted using Review Man 5.4 software and the key outcomes are presented as mean difference or standard mean difference and the 95% confidential interval.

Results

Searches returned 802 studies in total, of which 12 were included (N = 715). The duration of interventions was 8 weeks in 10 trials and 6 weeks in one trial. Pooled effect sizes indicated reductions in systolic blood pressure (MD = − 9.12, 95% CI [− 12.18, − 6.05], p < 0.001), diastolic blood pressure (MD = − 5.66, 95% CI [− 8.88, − 2.43], p < 0.001), anxiety (SMD = − 4.10; 95% CI [− 6.49, − 1.71], p < 0.001), depression (SMD = − 1.70, 95%CI [− 2.95, − 0.44], p < 0.001) and perceived stress (SMD = − 5.91, 95%CI [− 8.74, − 3.09], p < 0.001) at post-intervention. The findings from subgroup analyses are favorable for mindfulness-based interventions regardless of gender and baseline blood pressure with regard to BP reduction, with a more profound effect observed in participants with higher pre-intervention blood pressure.

Conclusions

The results provide evidence for the positive role of mindfulness-based interventions in hypertension management. More large randomized control trials with sufficient statistical power and long-term follow-up are needed.

Trial registration

The protocol had been registered with Prospero on October 2nd 2021 (registration NO. CRD42021282504).
Sacubitril/valsartan inhibits the proliferation of vascular smooth muscle cells through notch signaling and ERK1/2 pathway
Authors: Xu Congfeng , Zhang Ning , Yuan Hong , Wang Liren , Li Yonghong
Published: February 2024

Aims

To explore the role and mechanism of Notch signaling and ERK1/2 pathway in the inhibitory effect of sacubitril/valsartan on the proliferation of vascular smooth muscle cells (VSMCs).

Main methods

Human aortic vascular smooth muscle cells (HA-VSMCs) were cultured in vitro. The proliferating VSMCs were divided into three groups as control group, Ang II group and Ang II + sacubitril/valsartan group. Cell proliferation and migration were detected by CCK8 and scratch test respectively. The mRNA and protein expression of PCNA, MMP-9, Notch1 and Jagged-1 were detected by qRT-PCR and Western blot respectively. The p-ERK1/2 expression was detected by Western blot.

Key findings

Compared with the control group, proliferation and migration of VSMCs and the expression of PCNA, MMP-9, Notch1, Jagged-1 and p-ERK1/2 was increased in Ang II group. Sacubitril/valsartan significantly reduced the proliferation and migration. Additionally, pretreatment with sacubitril/valsartan reduced the PCNA, MMP-9, Notch1, Jagged-1 and p-ERK1/2 expression.
Reverse shock index multiplied by simplified motor score as a predictor of clinical outcomes for patients with COVID-19
Authors: Wu Meng-Yu , Hou Yueh-Tseng , Chung Jui-Yuan , Yiang Giou-Teng
Published: February 2024

Background

The reverse shock index (rSI) combined with the Simplified Motor Score (sMS), that is, the rSI-sMS, is a novel and efficient prehospital triage scoring system for patients with COVID-19. In this study, we evaluated the predictive accuracy of the rSI-sMS for general ward and intensive care unit (ICU) admission among patients with COVID-19 and compared it with that of other measures, including the shock index (SI), modified SI (mSI), rSI combined with the Glasgow Coma Scale (rSI-GCS), and rSI combined with the GCS motor subscale (rSI-GCSM).

Methods

All patients who visited the emergency department of Taipei Tzu Chi Hospital between January 2021 and June 2022 were included in this retrospective cohort. A diagnosis of COVID-19 was confirmed through a SARS-CoV-2 reverse-transcription polymerase chain reaction test or SARS-CoV-2 rapid test with oropharyngeal or nasopharyngeal swabs and was double confirmed by checking International Classification of Diseases, Tenth Revision, Clinical Modification codes in electronic medical records. In-hospital mortality was regarded as the primary outcome, and sepsis, general ward or ICU admission, endotracheal intubation, and total hospital length of stay (LOS) were regarded as secondary outcomes. Multivariate logistic regression was used to determine the relationship between the scoring systems and the three major outcomes of patients with COVID-19, including. The discriminant ability of the predictive scoring systems was investigated using the area under the receiver operating characteristic curve, and the most favorable cutoff value of the rSI-sMS for each major outcome was determined using Youden’s index.

Results

After 74,183 patients younger than 20 years (n = 11,572) and without COVID-19 (n = 62,611) were excluded, 9,282 patients with COVID-19 (median age: 45 years, interquartile range: 33–60 years, 46.1% men) were identified as eligible for inclusion in the study. The rate of in-hospital mortality was determined to be 0.75%. The rSI-sMS scores were significantly lower in the patient groups with sepsis, hyperlactatemia, admission to a general ward, admission to the ICU, total length of stay ≥ 14 days, and mortality. Compared with the SI, mSI, and rSI-GCSM, the rSI-sMS exhibited a significantly higher accuracy for predicting general ward admission, ICU admission, and mortality but a similar accuracy to that of the rSI-GCS. The optimal cutoff values of the rSI-sMS for predicting general ward admission, ICU admission, and mortality were calculated to be 3.17, 3.45, and 3.15, respectively, with a predictive accuracy of 86.83%, 81.94%%, and 90.96%, respectively.

Conclusions

Compared with the SI, mSI, and rSI-GCSM, the rSI-sMS has a higher predictive accuracy for general ward admission, ICU admission, and mortality among patients with COVID-19.
Development of a prediction model for predicting the prevalence of nonalcoholic fatty liver disease in Chinese nurses: the first-year follow data of a web-based ambispective cohort study
Authors: Che Ying , Tang Rongsong , Zhang Heli , Yang Min , Geng Rongmei , Zhuo Lin , Wang Peng , Hu Xianjing , Zhou Yujie , Wang Panfeng , Zhan Siyan , Li Baohua
Published: February 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is gradually becoming a huge threat to public health. With complex working characteristics, female nurses had been found with high risk of NAFLD. To develop and validate a prediction model to predict the prevalence of NAFLD based on demographic characteristics, work situation, daily lifestyle and laboratory tests in female nurses.

Methods

This study was a part of the Chinese Nurse Cohort Study (The National Nurse Health Study, NNHS), and data were extracted from the first-year follow data collected from 1st June to 1st September 2021 by questionnaires and physical examination records in a comprehensive tertiary hospital. The questionnaires included demographic characteristics, work situation and daily lifestyle. Logistic regression and a nomogram were used to develop and validate the prediction model.

Results

A total of 824 female nurses were included in this study. Living situation, smoking history, monthly night shift, daily sleep time, ALT/AST, FBG, TG, HDL-C, UA, BMI, TBil and Ca were independent risk factors for NAFLD occurance. A prediction model for predicting the prevalence of NAFLD among female nurses was developed and verified in this study.

Conclusion

Living situation, smoking history, monthly night shift, daily sleep time, ALT/AST, FBG, TG, UA, BMI and Ca were independent predictors, while HDL-C and Tbil were independent protective indicators of NAFLD occurance. The prediction model and nomogram could be applied to predict the prevalence of NAFLD among female nurses, which could be used in health improvement.

Trial registration

This study was a part of the Chinese Nurse Cohort Study (The National Nurse Health Study, NNHS), which was a ambispective cohort study contained past data and registered at Clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT04572347) and the China Cohort Consortium (http://chinacohort.bjmu.edu.cn/project/102/).
Comparative efficacy and safety of Sofosbuvir/Velpatasvir and Danoprevir for the treatment of chronic hepatitis C: the real-world data in China
Authors: Zhou Yunjing , Liang Minfeng , Li Yiting , Chen Xing , Yang Jie , Bai Honglian , Long Yingzi , Zhang Xiaohong , Lin Chaoshuang
Published: February 2024

Background

Sofosbuvir/Velpatasvir (Epclusa, ECS) is the first pan-genotype direct-acting antiviral agent (DAA) for hepatitis C virus (HCV) infection, and Danoprevir (DNV) is the first DAA developed by a Chinese local enterprise, which is suitable for combined use with other drugs to treat genotype 1b chronic hepatitis C. However, previous reports have never compared the real-world data of ECS and DNV.

Patients and methods

178 chronic hepatitis C patients were retrospectively recruited, and 94cases were accepted with Sofosbuvir/Velpatasvir ± Ribavirin (ECS group), and others (n = 84 treated with DNV combination therapy (DNV group). The HCV genotype, virological response, adverse effects and some laboratory biochemical indexes were contrasted between above two groups in the real world study.

Results

DNV group had significantly lower level of alpha-fetoprotein (AFP), lower rates of decompensated cirrhosis ( P < 0.05). ECS group possessed more 6a (31.91% vs.13.10%) while DNV group was provided with more 1b (48.81% vs. 22.34%) patients. Significantly poor liver function was detected in ECS group at 4-week treatment (ALT and AST) and 12-week follow-up (AST) (all P < 0.05). The SVR12 undetectable rates of both groups were 100%, and no serious event was observed during the treatment and follow-up in both groups.

Conclusion

In this retrospective real-world study, the efficacy of DNV combined therapy is similar to Sofosbuvir/Velpatasvir ± Ribavirin for chronic HCV infection, and the safety is comparable. DNV based therapy is a promising regimen for chronic hepatitis C.
Development of a multi-phase CT-based radiomics model to differentiate heterotopic pancreas from gastrointestinal stromal tumor
Authors: Sun Kui , Yu Shuxia , Wang Ying , Jia Rongze , Shi Rongchao , Liang Changhu , Wang Ximing , Wang Haiyan
Published: February 2024

Background

To investigate whether CT-based radiomics can effectively differentiate between heterotopic pancreas (HP) and gastrointestinal stromal tumor (GIST), and whether different resampling methods can affect the model’s performance.

Methods

Multi-phase CT radiological data were retrospectively collected from 94 patients. Of these, 40 with HP and 54 with GISTs were enrolled between April 2017 and November 2021. One experienced radiologist manually delineated the volume of interest and then resampled the voxel size of the images to 0.5 × 0.5 × 0.5 mm3, 1 × 1 × 1 mm3, and 2 × 2 × 2 mm3, respectively. Radiomics features were extracted using PyRadiomics, resulting in 1218 features from each phase image. The datasets were randomly divided into training set (n = 66) and validation set (n = 28) at a 7:3 ratio. After applying multiple feature selection methods, the optimal features were screened. Radial basis kernel function-based support vector machine (RBF-SVM) was used as the classifier, and model performance was evaluated using the area under the receiver operating curve (AUC) analysis, as well as accuracy, sensitivity, and specificity.

Results

The combined phase model performed better than the other phase models, and the resampling method of 0.5 × 0.5 × 0.5 mm3 achieved the highest performance with an AUC of 0.953 (0.881-1), accuracy of 0.929, sensitivity of 0.938, and specificity of 0.917 in the validation set. The Delong test showed no significant difference in AUCs among the three resampling methods, with p > 0.05.

Conclusions

Radiomics can effectively differentiate between HP and GISTs on CT images, and the diagnostic performance of radiomics is minimally affected by different resampling methods.
The ICD-9 to ICD-10 transition has not improved identification of rapidly progressing stage 3 and stage 4 chronic kidney disease patients: a diagnostic test study
Authors: Jalal Kabir , Charest Andre , Wu Xiaoyan , Quigg Richard J. , Chang Shirley
Published: February 2024

Background

The International Classification of Diseases (ICD) coding system is the industry standard tool for billing, disease classification, and epidemiology purposes. Prior research has demonstrated ICD codes to have poor accuracy, particularly in relation to rapidly progressing chronic kidney disease (CKD) patients. In 2016, the ICD system moved to revision 10. This study examines subjects in a large insurer database to determine the accuracy of ICD-10 CKD-staging codes to diagnose patients rapidly progressing towards end-stage kidney disease (ESKD).

Patients and methods

Serial observations of outpatient serum creatinine measurements from 2016 to 2021 of 315,903 patients were transformed to estimated glomerular filtration rate (eGFR) to identify CKD stage-3 and advanced patients diagnosed clinically (eGFR-CKD). CKD-staging codes from the same time period of 59,386 patients and used to identify stage-3 and advanced patients diagnosed by ICD-code (ICD-CKD). eGFR-CKD and ICD-CKD diagnostic accuracy was compared between a total of 334,610 patients.

Results

5,618 patients qualified for the progression analysis; 72 were identified as eGFR rapid progressors; 718 had multiple codes to qualify as ICD rapid progressors. Sensitivity was 5.56%, with positive predictive value (PPV) 5.6%. 34,858 patients were diagnosed as eGFR-CKD stage-3 patients; 17,549 were also diagnosed as ICD-CKD stage-3 patients, for a sensitivity of 50.34%, with PPV of 58.71%. 4,069 patients reached eGFR-CKD stage-4 with 2,750 ICD-CKD stage-4 patients, giving a sensitivity of 67.58%, PPV of 42.43%. 959 patients reached eGFR-CKD stage-5 with 566 ICD-CKD stage-5 patients, giving a sensitivity of 59.02%, PPV of 35.85%.

Conclusion

This research shows that recent ICD revisions have not improved identification of rapid progressors in diagnostic accuracy, although marked increases in sensitivity for stage-3 (50.34% vs. 24.68%), and PPV in stage-3 (58.71% vs. 40.08%), stage-4 (42.43% vs. 18.52%), and stage-5 (35.85% vs. 4.51%) were observed. However, sensitivity in stage-5 compares poorly (59.02% vs. 91.05%).
Tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression: a case report
Authors: Hanai Kaori , Hashimoto Masato , Nakamura Hirohiko
Published: February 2024

Background

To report a case of tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression.

Case presentation

A 39-year-old woman presenting with headache was found to have bilateral arcuate retinal nerve fiber layer (RNFL) thinning on optical coherence tomography (OCT) with a corresponding arcuate scotomas consistent with glaucomatous change. However a suprasellar tumor compressing the anterior chiasm from below was found on magnetic resonance imaging of the brain. After resection of the mass, which was diagnosed as meningothelial meningioma by the pathological examination, the glaucoma-like visual field defects resolved despite the RNFL thinning on the OCT showing no improvement.

Conclusions

Chiasmal compression may mimic glaucoma and produce arcuate scotoma rather than temporal visual field loss. There is a possibility that the development of chiasmal compression somehow converted preperimetric glaucoma into a more advanced form accompanied by visual field defects and that the glaucoma reverted to the preperimetric state after chiasmal decompression.
Clinical and electroencephalogram characteristics of methylmalonic acidemia with MMACHC and MUT gene mutations
Authors: Yuan Yujun , Ma Ying , Wu Qiong , Huo Liang , Liu Chun-Feng , Liu Xueyan
Published: February 2024

Objective

This study investigated the clinical, imaging, and electroencephalogram (EEG) characteristics of methylmalonic acidemia (MMA) with nervous system damage as the primary manifestation.

Methods

From January 2017 to November 2022, patients with nervous system injury as the main clinical manifestation, diagnosed with methylmalonic acidemia by metabolic and genetic testing, were enrolled and analyzed. Their clinical, imaging, and electroencephalogram data were analyzed.

Results

A total of 18 patients were enrolled, including 15 males and 3 females. The clinical symptoms were convulsions, poor feeding, growth retardation, disorder of consciousness, developmental delay, hypotonia, and blood system changes. There were 6 cases (33%) of hydrocephalus, 9 (50%) of extracerebral space widened, 5 (27%) of corpus callosum thinning, 3 (17%) of ventricular dilation, 3 (17%) of abnormal signals in the brain parenchyma (frontal lobe, basal ganglia region, and brain stem), and 3 (17%) of abnormal signals in the lateral paraventricular. In addition, there were 3 cases (17%) of cerebral white matter atrophy and 1 (5%) of cytotoxic edema in the basal ganglia and cerebral peduncle. EEG data displayed 2 cases (11%) of hypsarrhythmia, 3 (17%) of voltage reduction, 12(67%) of abnormal discharge, 13 (72%) of abnormal sleep physiological waves or abnormal sleep structure, 1 (5%) of immature (delayed) EEG development, and 8 (44%) of slow background. There were 2 cases (11%) of spasms, 1 (5%) of atonic seizures, and 1 (5%) of myoclonic seizures. There were 16 patients (89%) with hyperhomocysteinemia. During follow-up, 1 patient was lost to follow-up, and 1 died. In total, 87.5% (14/16) of the children had varying developmental delays. EEG was re-examined in 11 cases, of which 8 were normal, and 3 were abnormal. Treatments included intramuscular injections of vitamin B12, L-carnitine, betaine, folic acid, and oral antiepileptic therapy. Acute treatment included anti-infective, blood transfusion, fluid replacement, and correcting acidosis. The other treatments included low-protein diets and special formula milk powder.

Conclusion

Methylmalonic acidemia can affect the central nervous system, leading to structural changes or abnormal signals on brain MRI. Metabolic screening and genetic testing help clarify the diagnosis. EEG can reflect changes in brain waves during the acute phase.
Abnormal blood concentration changes in a 71-year-old female who survived a 10,000mg overdose of clozapine: a case report
Authors: Wu Yonghua , Zhou Ziyan , Ai Ziyi , Wang Tiancheng , Cui Liyan
Published: February 2024

Background

Clozapine is a highly effective second-generation antipsychotic with few extrapyramidal reactions, making it a preferred choice among clinicians. However, instances of acute clozapine poisoning resulting from suicide attempts and misuse have been reported. Through our review of existing literature, we identified that we believe to be the highest recorded overdose of clozapine in elderly patients, resulting in a nonfatal outcome.

Case presentation

The case report involves a 71-year-old female with a history of depression who ingested a dose of 10,000 mg of clozapine. Approximately 6 h after the overdose, the clozapine level was 5,200 μg/L, significantly surpassing the recommended therapeutic concentration range of 350–600 μg/L. After gastric lavage and hemoperfusion, the blood level dropped to 1847.11 μg/L. Notably, during therapeutic drugs monitoring (TDM), we found a perplexing spike in the patient’s blood level to 5554.15 μg/L after the second hemoperfusion.

Conclusion

In this case we mainly focused on the abnormal fluctuations in the concentration of clozapine. We conducted a comprehensive analysis of potential factors contributing to this abnormal phenomenon in terms of the patient’s age, clinical symptoms, various laboratory test indexes, and the pharmacokinetics of clozapine. Our findings underscore the importance of timely TDM and the precision of results in managing elderly patients experiencing high-dose clozapine poisoning.
Differences in Covid-19 mortality among persons 70 years and older in an integrated care setting in region Stockholm: a multi-level analysis between March 2020-February 2021
Authors: Doheny Megan , de Leon Antonio Ponce , Burström Bo , Liljas Ann , Agerholm Janne
Published: February 2024

Background

In Norrtälje municipality, within Region Stockholm, there is a joint integrated care organisation providing health and social care, which may have facilitated a more coordinated response to the covid-19 pandemic compared to the otherwise decentralised Swedish system. This study compares the risk of covid-19 mortality among persons 70 years and older, in the municipalities of Stockholm, Södertälje, and Norrtälje, while considering area and individual risk factors.

Methods

A population-based study using linked register data to examine covid-19 mortality among those 70 + years (N = 127,575) within the municipalities of interest between the periods March-August 2020 and September 2020-February 2021. The effect of individual and area level variables on covid-19 mortality among inhabitants in 68 catchment areas were examined using multi-level logistic models.

Results

Individual factors associated with covid-19 mortality were sex, older age, primary education, country of birth and poorer health as indicated by the Charlson Co-morbidity Index. The area-level variables associated were high deprivation (OR: 1.56, CI: 1.18–2.08), population density (OR: 1.14, CI: 1.08–1.21), and usual care. Together, this explained 85.7% of the variation between catchment areas in period 1 and most variation was due to individual risk factors in period 2. Little of the residual variation was attributed to differences between catchment areas.

Conclusion

Integrated care in Norrtälje may have facilitated a more coordinated response during period 1, compared to municipalities with usual care. In the future, integrated care should be considered as an approach to better protect and meet the care needs of older people during emergency situations.
The impact of perceived life stress and online social support on university students’ mental health during the post-COVID era in Northwestern China: gender-specific analysis
Authors: Xin Moye , Yang Chengxi , Zhang Lijin , Gao Chenzhuo , Wang Sasa
Published: February 2024

Background

Before the pandemic, research had already established the potential impact of perceived life stress and social support on the mental health status of Chinese students. However, in the Post-COVID Era, the specific mechanisms linking these variables and the distinct role of online social support remain relatively unexplored.

Methods

After the cessation of China’s dynamic zeroing policy, a total of 1180 university students from Northwestern China participated in this study by completing a demographic questionnaire, as well as self-report measures assessing mental health, perceived life stress, and online social support.

Results

Approximately 25% of students exhibited psychological symptoms. When examining different categories of perceived life stress, males reported experiencing a significantly greater impact in terms of punishment and interpersonal relationships compared to females. Females experienced significantly higher levels of learning pressure compared to males. Specific types of perceived life stress were found to be significant predictors of students’ mental health status. Moreover, online social support was identified as a significant moderator in the relationship between all types of perceived life stress and mental health, irrespective of gender.

Conclusion

Our study findings unveiled two significant aspects: Firstly, the impact of perceived life stress on the mental health of students was identified as a risk factor. Secondly, the role of online social support emerged as a protective factor, particularly in the post-pandemic context. Additionally, gender-specific patterns were observed in these relationships.
Psychometric properties of the Chinese version of the Gudjonsson compliance scale: scale validation and associations with mental health
Authors: Hang Yaming , Gudjonsson Gisli H. , Yao Yingying , Feng Yi , Qiao Zhihong
Published: February 2024

Background

Trait compliance involves people reacting favorably to demands made by others across different situations. This may lead to susceptibility to external pressures, exploitation, and manipulation. Moreover, trait compliance was found to correlate with various mental health outcomes, such as depression and anxiety. The Gudjonsson Compliance Scale (GCS) is an efficient tool for assessing trait compliance in Western contexts. To date, no study has validated the psychometric properties of the GCS in Chinese populations.

Methods

Two college student samples from China were recruited. The first sample (N = 4,276) was used to conduct exploratory factor analysis. The second (N = 4,356) was used to perform a confirmatory factor analysis. The reliability, measurement invariance, and correlational tests were conducted on the two combined samples.

Results

The Chinese GCS showed a 3-factor structure, with two items deleted. Reliability was supported by moderate-to-good internal consistency of the three-factor scales and good internal consistency on the full scale. Strong measurement invariance across sex, ethnicity, and group recruitment was supported. Scores of the total scale and factor scales were found to significantly associated with several mental health problems.

Conclusions

The Chinese version of the GCS appears to be a valid and reliable instrument for measuring trait compliance and could promote both the assessment and research on compliance in Chinese population.
The optical behavior of nano filled resin composite loaded with graphene oxide nanoparticles
Authors: fathy Heba , Haroun Hassan , Riad Mona
Published: February 2024

Objectives

Assessment of the effect of incorporation of graphene oxide nanoparticles (GONPs), different concentrations into resin composite with different thicknesses on its color modulation.

Materials and methods

GONPs were prepared using the chemical reduction method and characterized using a transmission electron microscope and X-ray diffraction. The minimum concentrations of GONPs that provided the most effective antibacterial action (0.05 wt% and 0.2 wt%.) were prepared to be the concentration added to the tested resin composite. Calculations were done to find the required volume of the GONPs solution needed according to the mass of the resin composite. 70 nano-filled resin composite discs were prepared with 10 mm diameter × 3 mm height. 10 resin composite discs were prepared without GONPs incorporation and served as a control (G0). The other 60 resin composite specimens were divided into 2 equal groups (G1& G2) according to the concentration of the loaded nanoparticles in the specimens. Each group was divided into 3 equal subgroups according to the thickness of the resin composite containing GONPs; [T1: GONPs dispersed in the bottom 1 mm of the disc, while the top 2 mm of the disc was of resin composite only. T2: GONPs dispersed only in the bottom 2 mm of the disc and T3: GONPs dispersed in the total thickness of the disc (3 mm)]. ∆E values were calculated using a Vita Easy shade Spectrophotometer.

Results

Incorporation of GONPs into resin composite induced significant color change and among all the 6 experimental groups, G1T1 group (of 0.05 wt% concentration GONPs dispersed only in the bottom 1 mm of the disc) showed a non-significant color change.

Conclusion

Dispersion of GONPs has a detectable effect on the color change of resin composite. Meanwhile, dispersion in low concentration for only the bottom 1 mm thickness of resin composite has an undetectable effect on its color.
The involvement of Neuregulin-1 in the process of facial nerve injury repair through the utilization of dental pulp stem cells
Authors: Yao Lihong , Xu Wanqiu , Liu Lixue , Xu Xiaohang , Xi Hualei , Xue Bing , Cao Xiaofang , Lin Song , Piao Guiyan , Sun Jian , Wang Xiumei
Published: February 2024

Background

Facial nerve injury often results in poor prognosis due to the challenging process of nerve regeneration. Neuregulin-1, a human calmodulin, is under investigation in this study for its impact on the reparative capabilities of Dental Pulp Stem Cells (DPSCs) in facial nerve injury.

Methods

Lentivirus was used to transfect and construct Neuregulin-1 overexpressed DPSCs. Various techniques assessed the effects of Neuregulin-1: osteogenic induction, lipid induction, Reverse Transcription Polymerase Chain Reaction, Western Blot, Cell Counting Kit-8 assay, wound healing, immunofluorescence, Phalloidin staining, nerve stem action potential, Hematoxylin-eosin staining, transmission electron microscopy, and immunohistochemistry.

Results

Neuregulin-1 effectively enhanced the proliferation, migration, and cytoskeletal rearrangement of DPSCs, while simultaneously suppressing the expression of Ras homolog gene family member A (RhoA) and Microfilament actin (F-actin). These changes facilitated the neural differentiation of DPSCs. Additionally, in vivo experiments showed that Neuregulin-1 expedited the restoration of action potential in the facial nerve trunk, increased the thickness of the myelin sheath, and stimulated axon regeneration.

Conclusion

Neuregulin-1 has the capability to facilitate the repair of facial nerve injuries by promoting the regenerative capacity of DPSCs. Thus, Neuregulin-1 is a significant potential gene in the reparative processes of nerve damage.
Effects of clear aligners on the vertical position of the molar teeth and the vertical and sagittal relationships of the face: a preliminary retrospective before-after clinical trial
Authors: Moradinejad Mehrnaz , Harrell Ricky E. , Mousavi Sayed Mohammad , Alavi Minoo , Basseri Alireza Darvish , Feiz Arman , Daryanavard Hanie , Rakhshan Vahid
Published: February 2024

Introduction

Despite the popularity of clear aligners, their predictability has not been assessed adequately. Moreover, no study has investigated their effects on numerous dentomaxillary variables. Therefore, this study was conducted for the first time, assessing several new or controversial items. The aim of the study was to evaluate the effects of clear aligners on the vertical position of the molar teeth and the vertical and sagittal relationships of the face.

Methods

This preliminary retrospective before-after non-randomized clinical trial was performed on 168 observations of 84 patients (33.60±9.28 years, 54 females) treated with 0.75mm Invisalign appliances. Pretreatment and posttreatment values were measured for: mandibular plane angle, occlusal plane angle, Y-Axis, ANB, facial angle, lower anterior facial height, overbite, and the distances of the molars from the palate and mandibular plane were measured. The alterations in parameters caused by treatment (delta values) were calculated for each measurement. Effects of treatment and some parameters on delta values were analyzed statistically (α=0.05).

Results

Mean±SD of ΔMP-FH, ΔOP-FH, ΔY-Axis, ΔLAFH, ΔNPog-FH, ΔANB, ΔOverbite, ΔSNB, Δ6-PP, Δ7-PP, Δ6-MP, and Δ7-MP were respectively 0.11±1.61, 0.80±1.56, 0.15±1.18, 0.07±0.91, -0.22±1.25, 0.03±0.62, 0.04±1.15, -0.06±1.14, -0.36±0.94, -0.32±1.14, 0.19±0.96, 0.18±1.10. Only the alterations in OP-FH, 6-PP, and 7-PP were significant (P≤0.011). Age, sex, treatment duration, or pretreatment mandibular plane angle were not correlated with any delta values. However, the pretreatment occlusal plane angle was negatively correlated with ΔOP-FH and ΔY-Axis. Crowding was correlated negatively with ΔOP-FH and ΔY-Axis and positively with ΔNPog-FH. Overjet was negatively correlated with ΔANB and ΔOverbite (P≤0.035).

Conclusions

Invisalign intruded first/second maxillary molars and increased the occlusal plane angle. Age, sex, and treatment duration were not correlated with post-treatment anatomic alterations.