bluuebunny/crossref_metadata_2025 huggingface dataset:
DeepMonitoring: a deep learning-based monitoring system for assessing the quality of cornea images captured by smartphones
Authors: Li Zhongwen , Wang Lei , Qiang Wei , Chen Kuan , Wang Zhouqian , Zhang Yi , Xie He , Wu Shanjun , Jiang Jiewei , Chen Wei
Published: August 2024

Smartphone-based artificial intelligence (AI) diagnostic systems could assist high-risk patients to self-screen for corneal diseases (e.g., keratitis) instead of detecting them in traditional face-to-face medical practices, enabling the patients to proactively identify their own corneal diseases at an early stage. However, AI diagnostic systems have significantly diminished performance in low-quality images which are unavoidable in real-world environments (especially common in patient-recorded images) due to various factors, hindering the implementation of these systems in clinical practice. Here, we construct a deep learning-based image quality monitoring system (DeepMonitoring) not only to discern low-quality cornea images created by smartphones but also to identify the underlying factors contributing to the generation of such low-quality images, which can guide operators to acquire high-quality images in a timely manner. This system performs well across validation, internal, and external testing sets, with AUCs ranging from 0.984 to 0.999. DeepMonitoring holds the potential to filter out low-quality cornea images produced by smartphones, facilitating the application of smartphone-based AI diagnostic systems in real-world clinical settings, especially in the context of self-screening for corneal diseases.
Unveiling the hidden: a deep learning approach to unraveling subzone-specific changes in peripapillary atrophy in type 2 diabetes
Authors: Li Yingying , Hu Xinxin , Guo Xinyu , Ye Xueqiong , Wang Dandan , Zhang Juntao , Ren Weina , Zhao Na , Zhao Yitian , Lu Qinkang
Published: August 2024

Purpose

This study aimed to evaluate the optical coherence tomography angiography (OCTA) changes in subzones of peripapillary atrophy (PPA) among type 2 diabetic patients (T2DM) with or without diabetic retinopathy (DR) using well-designed deep learning models.

Methods

A multi-task joint deep-learning model was trained and validated on 2,820 images to automate the determination and quantification of the microstructure and corresponding microcirculation of beta zone and gamma zone PPA. This model was then applied in the cross-sectional study encompassing 44 eyes affected by non-proliferative diabetic retinopathy (NPDR) and 46 eyes without DR (NDR). OCTA was utilized to image the peripapillary area in four layers: superficial capillary plexus (SCP), deep capillary plexus (DCP), choroidal capillary (CC) and middle-to-large choroidal vessel (MLCV).

Results

The patients in both groups were matched for age, sex, BMI, and axial length. The width and area of the gamma zone were significantly smaller in NPDR group compared to the NDR group. Multiple linear regression analysis revealed a negative association between the diagnosis of DR and the width and area of the gamma zone. The gamma zone exhibited higher SCP, DCP and MLCV density than the beta zone, while the beta zone showed higher CC density than the gamma zone. In comparison to the NDR group, the MLCV density of gamma zone was significantly lower in NPDR group, and this density was positively correlated with the width and area of the gamma zone.

Discussion

DR-induced peripapillary vascular changes primarily occur in gamma zone PPA. After eliminating the influence of axial length, our study demonstrated a negative correlation between DR and the gamma zone PPA. Longitudinal studies are required to further elucidate the role of the gamma zone in the development and progression of DR.
Transition metal pincer catalysts for formic acid dehydrogenation: a mechanistic perspective
Authors: Kumar N. Sai , Adhikary Anubendu
Published: August 2024

The storage and transportation of hydrogen gas, a non-polluting alternative to carbon-based fuels, have always been challenging due to its extreme flammability. In this regard, formic acid (FA) is a promising liquid organic hydrogen carrier (LOHC), and over the past decades, significant progress has been made in dehydrogenating FA through transition metal catalysis. In this review, our goal is to provide a detailed insight into the existing processes to expose various mechanistic challenges associated with FA dehydrogenation (FAD). Specifically, methodologies catalyzed by pincer-ligated metal complexes were chosen. Pincer ligands are preferred as they provide structural rigidity to the complexes, making the isolation and analysis of reaction intermediates less challenging and consequently providing a better mechanistic understanding. In this perspective, the catalytic activity of the reported pincer complexes in FAD was overviewed, and more importantly, the catalytic cycles were examined in detail. Further attention was given to the structural modifications, role of additives, reaction medium, and their crucial effects on the outcome.
Immunogenicity and transmission-blocking potential of quiescin sulfhydryl oxidase in Plasmodium vivax
Authors: Zheng Wenqi , Cheng Shitong , Liu Fei , Yu Xinxin , Zhao Yan , Yang Fan , Thongpoon Sataporn , Roobsoong Wanlapa , Sattabongkot Jetsumon , Luo Enjie , Cui Liwang , Cao Yaming
Published: August 2024

Background

Transmission-blocking vaccines (TBVs) can effectively prevent the community’s spread of malaria by targeting the antigens of mosquito sexual stage parasites. At present, only a few candidate antigens have demonstrated transmission-blocking activity (TBA) potential in P. vivax. Quiescin-sulfhydryl oxidase (QSOX) is a sexual stage protein in the rodent malaria parasite Plasmodium berghei and is associated with a critical role in protein folding by introducing disulfides into unfolded reduced proteins. Here, we reported the immunogenicity and transmission-blocking potency of the PvQSOX in P. vivax.

Methods and findings

The full-length recombinant PvQSOX protein (rPvQSOX) was expressed in the Escherichia coli expression system. The anti-rPvQSOX antibodies were generated following immunization with the rPvQSOX in rabbits. A parasite integration of the pvqsox gene into the P. berghei pbqsox gene knockout genome was developed to express full-length PvQSOX protein in P. berghei (Pv-Tr-PbQSOX). In western blot, the anti-rPvQSOX antibodies recognized the native PvQSOX protein expressed in transgenic P. berghei gametocyte and ookinete. In indirect immunofluorescence assays, the fluorescence signal was detected in the sexual stages, including gametocyte, gamete, zygote, and ookinete. Anti-rPvQSOX IgGs obviously inhibited the ookinetes and oocysts development both in vivo and in vitro using transgenic parasites. Direct membrane feeding assays of anti-rPvQSOX antibodies were conducted using four field P. vivax isolates (named isolates #1–4) in Thailand. Oocyst density in mosquitoes was significantly reduced by 32.00, 85.96, 43.52, and 66.03% with rabbit anti-rPvQSOX antibodies, respectively. The anti-rPvQSOX antibodies also showed a modest reduction of infection prevalence by 15, 15, 20, and 22.22%, respectively, as compared to the control, while the effect was insignificant. The variation in the DMFA results may be unrelated to the genetic polymorphisms. Compared to the P.vivax Salvador (Sal) I strain sequences, the pvqsox in isolate #1 showed no amino acid substitution, whereas isolates #2, #3, and #4 all had the M361I substitution.

Conclusions

Our results suggest that PvQSOX could serve as a potential P. vivax TBVs candidate, which warrants further evaluation and optimization.
Causal relationship between immune cells and risk of myocardial infarction: evidence from a Mendelian randomization study
Authors: Cao Wenjing , Wang Kui , Wang Jiawei , Chen Yuhua , Gong Hanxian , Xiao Lei , Pan Wei
Published: August 2024

Background

Atherosclerotic plaque rupture is a major cause of heart attack. Previous studies have shown that immune cells are involved in the development of atherosclerosis, but different immune cells play different roles. The aim of this study was to investigate the causal relationship between immunological traits and myocardial infarction (MI).

Methods

To assess the causal association of immunological profiles with myocardial infarction based on publicly available genome-wide studies, we used a two-sample mendelian randomization (MR) approach with inverse variance weighted (IVW) as the main analytical method. Sensitivity analyses were used to assess heterogeneity and horizontal pleiotropy.

Results

A two-sample MR analysis was conducted using IVW as the primary method. At a significance level of 0.001, we identified 47 immunophenotypes that have a significant causal relationship with MI. Seven of these were present in B cells, five in cDC, four in T cells at the maturation stage, six in monocytes, five in myeloid cells, 12 in TBNK cells, and eight in Treg cells. Sensitivity analyses were performed to confirm the robustness of the MR results.

Conclusions

Our results provide strong evidence that multiple immune cells have a causal effect on the risk of myocardial infarction. This discovery provides a new avenue for the development of therapeutic treatments for myocardial infarction and a new target for drug development.
Madelung disease with postoperative priapism and multiple venous thromboses: case report and literature review
Authors: Guo Linfen , Li Wei , Xu Xuewen , Xiao Haitao
Published: August 2024

Madelung disease is an uncommon metabolic disorder of uncertain pathogenesis, distinguished by the symmetric accumulation of nonencapsulated adipose tissue within the subcutaneous layer of the neck, abdomen, thighs, and other anatomical regions. This condition has been tightly connected with comorbidities including diabetes, dyslipidemia, hyperuricemia, hypothyroidism, and adrenal dysfunction, as well as sensory, motor, and autonomic polyneuropathy. The prevalence of Madelung disease is conspicuously higher in Mediterranean and Eastern European, with a distinct scarcity within the Asian population. Surgical interventions involving lipectomy and liposuction represent the foremost and most efficacious treatment approach. Herein, we present a case encompassing type II Madelung disease featuring bilateral thighs adipose tissue accumulation. The patient exhibited unexplained priapism alongside multiple venous thrombosis during four surgical interventions. The infrequent manifestation of postoperative hypercoagulability in patients of Madelung disease merits broad attention, owing to the potentiality for extensive venous thrombosis and consequential severe outcomes such as pulmonary embolism or cerebral infarction arising from thrombus dislodgment. Building upon this clinical scenario, we systematically documented the clinical manifestations and disease progression in this patient, meticulously analyzed the causes of complications, and proposed targeted preventive measures. Additionally, we conducted a comprehensive review of the relevant literature to summarize the clinical and epidemiological features of Madelung disease and to elucidate its mechanisms. This study will provide a valuable reference for future clinical treatments and mitigate perioperative complications of Madelung disease.
Case Report: A case of rapamycin-eluting stent for the treatment of refractory stenosis of arteriovenous fistula stenosis
Authors: Xiong Yu , Tu Bo , Zhang Minglu , Chen Bo , Lai Qiquan , Chen Jing , Chen Ling , Wan Ziming
Published: August 2024

For patients with repeated stenosis of autologous arteriovenous fistula, percutaneous transluminal angioplasty (PTA) or bare metal stent placement had limited efficacy. Rapamycin was reported to inhibit neointimal hyperplasia and keep blood vessels patent. In this study, we reported a case with refractory stenosis, i.e., a short duration of patency maintenance after each repeated PTA, which was treated with a rapamycin-eluting stent (RES). The RES extended the patency duration from 4 to 5 months on average to 14 months. The stent was used to maintain dialysis for over 30 months. RES may be an effective way to treat refractory stenosis and salvage limited vascular resources.
Bevacizumab reduces cerebral radiation necrosis due to stereotactic radiotherapy in non-small cell lung cancer patients with brain metastases: an inverse probability of treatment weighting analysis
Authors: Zhang Jingwei , Yu Jiayi , Yang Dan , Jiang Leilei , Dong Xin , Liu Zhiyan , Yu Rong , Yu Huiming , Shi Anhui
Published: August 2024

Background

Cerebral radiation necrosis (RN), a severe complication of stereotactic radiotherapy (SRT), has been shown to significantly decrease patient survival time and quality of life. The purpose of this study was to analyze whether bevacizumab can prevent or reduce the occurrence of SRT-induced cerebral RN in non-small cell lung cancer (NSCLC) patients with brain metastases.

Materials and methods

We retrospectively reviewed the clinical records of NSCLC patients with brain metastases from March 2013 to June 2023 who were treated with SRT. Patients were divided into two groups: those in the bevacizumab group received SRT with four cycles of bevacizumab, and patients in the control group received SRT only. Inverse probability of treatment weighting (IPTW) was performed based on a multinomial propensity score model to balance the baseline characteristics. The chi-square test was used. A Cox model was used to evaluate overall survival (OS).

Results

A total of 80 patients were enrolled, namely, 28 patients in the bevacizumab group and 52 patients in the control group. The possibility of developing cerebral RN and/or symptomatic edema (RN/SE) was significantly decreased in patients treated with bevacizumab compared to those who did not receive bevacizumab before IPTW (p=0.036) and after IPTW (p=0.015) according to chi-square analysis. The IPTW-adjusted median OS was 47.7 months (95% CI 27.4-80.8) for patients in the bevacizumab group and 44.1 months (95% CI 36.7-68.0) (p=0.364) for patients in the control group.

Conclusion

The application of bevacizumab concurrent with SRT may prevent or reduce the occurrence of cerebral RN in NSCLC patients with brain metastases.
HBHA induces IL-10 from CD4+ T cells in patients with active tuberculosis but IFN-γ and IL-17 from individuals with Mycobacterium tuberculosis infection
Authors: Izumida Mai , Jobe Haddijatou , Coker Edward G. , Barry Amadou , Rashid Momodou , Manneh Ismaila L. , Daffeh Georgetta K. , Ariyoshi Koya , Sutherland Jayne S.
Published: August 2024

Background

To effectively control tuberculosis (TB), it is crucial to distinguish between active TB disease and latent TB infection (LTBI) to provide appropriate treatment. However, no such tests are currently available. Immune responses associated with active TB and LTBI are dynamic and exhibit distinct patterns. Comparing these differences is crucial for developing new diagnostic methods and understanding the etiology of TB. This study aimed to investigate the relationship between pro- and anti-inflammatory CD4+ cytokine production following stimulation with two types of latency-associated Mycobacterium tuberculosis (M.tb) antigens to allow differentiation between active TB and LTBI.

Methods

Cryopreserved PBMCs from patients with active TB disease or LTBI were stimulated overnight with replication-related antigen [ESAT-6/CFP-10 (E/C)] or two latency-associated antigens [heparin-binding hemagglutinin (HBHA) and alpha-crystallin-like protein (Acr)]. Responses were analyzed using multiparameter flow cytometry: active TB disease (n=15), LTBI (n=15) and ELISA: active TB disease (n=26) or LTBI (n=27).

Results

CD4+ central memory T cells (Tcm) specific to E/C and CD4+ effector memory T cells specific to Acr and HBHA were higher in LTBI than in TB patients. IFN-γ+Tcm and IL-17+ Tem cells was higher in the LTBI group (p= 0.012 and p=0.029 respectively), but IL-10+ Tcm was higher in the active TB group (p= 0.029) following HBHA stimulation. Additionally, following stimulation with HBHA, IL-10 production from CD4+ T cells was significantly elevated in patients with active TB compared to those with LTBI (p= 0.0038), while CD4+ T cell production of IL-17 and IFN-γ was significantly elevated in LTBI compared to active TB (p= 0.0076, p< 0.0001, respectively). HBHA also induced more CCR6+IL-17+CD4Tcells and IL-17+FoxP3+CD25+CD4Tcells in LTBI than in TB patients (P=0.026 and P=0.04, respectively). HBHA also induced higher levels of IFN-γ+IL-10+CD4+ T cells in patients with active TB (Pp=0.03) and higher levels of IFN-γ+IL-17+ CD4+ T cells in those with LTBI (p=0.04). HBHA-specific cytokine production measured using ELISA showed higher levels of IFN-γ in participants with LTBI (P=0.004) and higher levels of IL-10 in those with active TB (P=0.04).

Conclusion

Stimulation with HBHA and measurement of CD4+ T cell production of IFN-γ, IL-10, and IL-17 could potentially differentiate active TB from LTBI. The characteristics of cytokine-expressing cells induced by HBHA also differed between participants with active TB and LTBI.
Variant-specific antibody profiling for tracking SARS-CoV-2 variant infections in children and adolescents
Authors: Kuthning Daniela , Raafat Dina , Holtfreter Silva , Gramenz Jana , Wittmann Nico , Bröker Barbara M. , Meyer-Bahlburg Almut
Published: August 2024

Monitoring the seroprevalence of SARS-CoV-2 in children and adolescents can provide valuable information for effective SARS-CoV-2 surveillance, and thus guide vaccination strategies. In this study, we quantified antibodies against the spike S1 domains of several SARS-CoV-2 variants (wild-type, Alpha, Delta, and Omicron variants) as well as endemic human coronaviruses (HCoVs) in 1,309 children and adolescents screened between December 2020 and March 2023. Their antibody binding profiles were compared with those of 22 pre-pandemic samples from children and adolescents using an in-house Luminex®-based Corona Array (CA). The primary objectives of this study were to (i) monitor SARS-CoV-2-specific antibodies in children and adolescents, (ii) evaluate whether the S1-specific antibody response can identify the infecting variant of concern (VoC), (iii) estimate the prevalence of silent infections, and (iv) test whether vaccination or infection with SARS-CoV-2 induce HCoV cross-reactive antibodies. Both SARS-CoV-2 infection and vaccination induced a robust antibody response against the S1 domain of WT and VoCs in children and adolescents. Antibodies specific for the S1 domain were able to distinguish between SARS-CoV-2 VoCs in infected children. The serologically identified VoC was typically the predominant VoC at the time of infection. Furthermore, our highly sensitive CA identified more silent SARS-CoV-2 infections than a commercial ELISA (12.1% vs. 6.3%, respectively), and provided insights into the infecting VoC. Seroconversion to endemic HCoVs occurred in early childhood, and vaccination or infection with SARS-CoV-2 did not induce HCoV S1 cross-reactive antibodies. In conclusion, the antibody response to the S1 domain of the spike protein of SARS-CoV-2 is highly specific, providing information about the infecting VoC and revealing clinically silent infections.
Teaching medical students hematopathology: a randomized crossover study comparing direct inspection by light microscope versus projected images
Authors: Alqahtani Sultan , Al-Nasser Sami , Agha Sajida , Mohamud Mohamud S.
Published: August 2024

Background

Students’ ability to diagnose various blood disorders could be substantially improved by continuously reviewing approaches toward teaching hematology. This study aims to compare the effectiveness of light microscopes and projected images on students’ learning and determine medical students’ perception of these teaching methods.

Methods

A randomized trial was conducted using a crossover design. Two groups, each with 30 students, were subjected to teaching methods based on light microscopes and projected images alternatively.

Results

No differences were found in the two study groups’ baseline characteristics, such as median age, sex, and prior academic performance, as well as in the pre-test scores. Post-test scores were significantly higher among students subjected to the projection method than in the control group (Mean ± SD = 9.8 ± 1.7 vs. 5.1 ± 1.3, p < 0.001). In the post-cross-over assessment, 85% (n = 51) of students reported their satisfaction for the projected images, and 78% (n = 47) of students were willing to be taught by projection. Students perceived that the projection method facilitated participation and better involvement in discussions, improved learning, provided greater motivation, and eventually increased comprehension and efficiency.

Conclusion

The projection-based teaching method is more effective in improving knowledge and achieving intended learning outcomes. Students tend to prefer the projection method over the laboratory-based method and perceive it as an effective method to enhance their learning of hematology.
Being, becoming, and belonging: reconceptualizing professional identity formation in medicine
Authors: Sternszus Robert , Steinert Yvonne , Razack Saleem , Boudreau J. Donald , Snell Linda , Cruess Richard L.
Published: August 2024

Over the last decade, there has been a drive to emphasize professional identity formation in medical education. This shift has had important and positive implications for the education of physicians. However, the increasing recognition of longstanding structural inequalities within society and the profession has highlighted how conceptualizations of professional identity formation have also had unintended harmful consequences. These include experiences of identity threat and exclusion, and the promotion of norms and values that over-emphasize the preferences of culturally dominant groups. In this paper, the authors put forth a reconceptualization of the process of professional identity formation in medicine through the elaboration of 3 schematic representations. Evolutions in the understandings of professional identity formation, as described in this paper, include re-defining socialization as an active process involving critical engagement with professional norms, emphasizing the role of agency, and recognizing the importance of belonging or exclusion on one’s sense of professional self. The authors have framed their analysis as an evidence-informed educational guide with the aim of supporting the development of identities which embrace diverse ways of being, becoming, and belonging within the profession, while simultaneously upholding the standards required for the profession to meet its obligations to patients and society.
Relative multi-beneficial effect of MOs on plant health of chickpea (Cicer arietinum L. var. PG-186)
Authors: Tomer Supriya , Khati Priyanka , Suyal Deep Chandra , Perveen Kahkashan , Khan Faheema , Barasarathi Jayanthi
Published: August 2024

The phosphate solubilizing properties of Lysinibacillus macroides ST-30, Pseudomonas pelleroniana N-26, and Bacillus cereus ST-6 were tested for the chickpea crop of the Tarai region of Uttarakhand. These microbially inoculated plants have shown significant (p > 0.05) improvement in the plant health and crop health parameters, viz., root length, shoot length, fresh weight, dry weight, nodule number, nodule fresh weight, nodule dry weight, chlorophyll content, and nitrate reductase. The highest shoot length (46.10 cm) and chlorophyll content (0.57 mg g−1 fresh weight) were observed in ST-30 at 75 DAS with 20 kg P2O5/ha. Similarly, for plant P content, an increase of 90.12% over control was recorded in the same treatment. Treatments consisting of Lysinibacillus macroides ST-30 along with 20 kg/ha P2O5 were found to be most suitable as phosphatic fertilizer. Conclusively, sustainable agriculture practices in the Tarai as well as the field region may be developed based on a strategy of exploring microbial inoculants from the pristine region of the Western Himalayas. The presence and abundance of bacterial inoculants were confirmed through qRT-PCT. We conclude that the effective plant growth-promoting bacterium Lysinibacillus macroides ST-30 broadens the spectrum of phosphate solubilizers available for field applications and might be used together with 20 Kg/ha P2O5.
Association of the protective effect of telmisartan on hearing loss among patients with hypertension
Authors: Cha Jung-Joon , Yum Yunjin , Kim Yong Hyun , Kim Eung Ju , Rah Yoon Chan , Park Euyhyun , Im Gi Jung , Song Jae-Jun , Chae Sung-Won , Choi June , Joo Hyung Joon
Published: August 2024

Aim

Hearing loss, affecting a significant portion of the global population, is prevented with peroxisome proliferator-activated receptor γ agonism. Understanding potential protective treatments is crucial for public health. We examine the effect of telmisartan, an antihypertensive drug and partial peroxisome proliferator-activated receptor γ agonist, on hearing loss in patients with hypertension.

Method and results

This retrospective cohort analysis used data from the OMOP Common Data Model database, encompassing information from three tertiary institutions in South Korea. The study included a substantial sample size of 860,103 people diagnosed with hypertension. The study included individuals who had been medically diagnosed with hypertension and had been prescribed antihypertensive drugs, including telmisartan. The study design was established to evaluate the comparative effects of telmisartan and other hypertension medications on hearing loss. We used propensity score matching (PSM) to create a balanced cohort, reducing potential biases between the telmisartan and non-telmisartan groups. From the initial 860,103 patients with hypertension, a propensity score matched cohort was derived from 20,010 patients, with 2,193 in the telmisartan group. After PSM, lower incidence of total hearing loss was observed in the telmisartan group compared to the non-telmisartan group during the 3-year follow-up (0.5% vs. 1.5%, log-rank p = 0.005). In subgroup analysis, this study showed consistent results that lower incidence of total hearing loss was higher in the telmisartan group than in the non-telmisartan group.

Conclusion

Telmisartan was associated with reducing certain types of hearing loss in patients with hypertension. Further research is needed to confirm these findings and understand the mechanisms.
Effects of body weight support training on balance and walking function in stroke patients: a systematic review and meta-analysis
Authors: Jiang Zhaoxiang , Zhang Xinxin , Fu Qian , Tao Yimin
Published: August 2024

Objective

To comprehensively and quantitatively evaluate the impact of body weight support training (BWST) on balance and gait function in stroke patients based on an evidence-based basis and to identify the most effective intervention strategies.

Methods

PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang, and Chinese SinoMed Database were searched until November 25, 2023. Quality assessment and meta-analysis were performed using RevMan 5.2 and Stata 14.0 software.

Results

A total of 31 randomized controlled trials involving 1,918 patients were included in the study. The meta-analysis demonstrated that body weight support training (BWST) significantly improved Berg Balance Scale (BBS) scores (MD = 3.60; 95% CI: 1.23 to 5.98; p = 0.003), gait speed (SMD = 0.77; 95% CI: 0.38 to 1.15; p < 0.0001), and step length (SMD = 0.46; 95% CI: 0.19 to 0.72; p = 0.0008) in stroke patients compared to conventional rehabilitation. For enhancing balance function, the most effective interventions were identified as a disease duration of 3–6 months (MD = 5.16; 95% CI: 0.76 to 9.57; p = 0.02), intervention time of 4–8 weeks (MD = 5.70; 95% CI: 2.90 to 8.50; p < 0.0001), a maximum body weight support level above 30% (MD = 3.80; 95% CI: 1.48 to 6.13; p = 0.001), and a maximum training walking speed of 0.2 m/s or more (MD = 4.66; 95% CI: 0.37 to 9.70; p = 0.03). For improving walking function, the optimal interventions were also a disease duration of 3–6 months (gait speed: SMD = 0.59; 95% CI: 0.15 to 1.03; p = 0.008; step length: SMD = 0.27; 95% CI: 0.06 to 0.56; p = 0.04), intervention time of 4–8 weeks (gait speed: SMD = 1.01; 95% CI: 0.44 to 1.59; p = 0.0006; step length: SMD = 0.83; 95% CI: 0.54 to 1.12; p < 0.00001), a maximum body weight support level above 30% (gait speed: SMD = 0.79; 95% CI: 0.36 to 1.22; p = 0.0003; step length: SMD = 0.79; 95% CI: 0.47 to 1.11; p < 0.00001), and a maximum training walking speed of 0.2 m/s or more (gait speed: SMD = 1.26; 95% CI: 0.62 to 1.90; p = 0.0001; step length: SMD = 0.85; 95% CI: 0.38 to 1.31; p = 0.0003).

Conclusion

Compared with conventional rehabilitation training, BWST demonstrates superior efficacy in enhancing balance and walking function in stroke patients, with a consistent optimal intervention strategy. The most effective program includes a disease duration of 3–6 months, an intervention period of 4–8 weeks, a maximum body weight support of 30% or more, and a maximum training walking speed of 0.2 m/s or greater.

Systematic review registration

http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022358963.
Investigating the effects of context, visual working memory, and inhibitory control in hybrid visual search
Authors: Barbosa Alessandra , Ruarte Gonzalo , Ries Anthony J. , Kamienkowski Juan E. , Ison Matias J.
Published: August 2024

Introduction

In real-life scenarios, individuals frequently engage in tasks that involve searching for one of the distinct items stored in memory. This combined process of visual search and memory search is known as hybrid search. To date, most hybrid search studies have been restricted to average observers looking for previously well-memorized targets in blank backgrounds.

Methods

We investigated the effects of context and the role of memory in hybrid search by modifying the task’s memorization phase to occur in all-new single trials. In addition, we aimed to assess how individual differences in visual working memory capacity and inhibitory control influence performance during hybrid search. In an online experiment, 110 participants searched for potential targets in images with and without context. A change detection and go/no-go task were also performed to measure working memory capacity and inhibitory control, respectively.

Results

We show that, in target present trials, the main hallmarks of hybrid search remain present, with a linear relationship between reaction time and visual set size and a logarithmic relationship between reaction time and memory set size. These behavioral results can be reproduced by using a simple drift-diffusion model. Finally, working memory capacity did not predict most search performance measures. Inhibitory control, when relationships were significant, could account for only a small portion of the variability in the data.

Discussion

This study provides insights into the effects of context and individual differences on search efficiency and termination.
The effect of nutritional risk management program on the growth and development of infants and toddlers with congenital heart disease after discharge
Authors: Huang Ya-Li , Luo Wen-Yi , Wang Xie-Lei , Zheng Feng , Gao Jian-Hua , Chen Ming-Xia , Pan Yang-Dong
Published: August 2024

Objective

To evaluate the effect of nutritional risk management program on the growth and development of infants and toddlers with congenital heart disease (CHD) after discharge.

Methods

Infants and toddlers with CHD discharged from a children's specialized hospital in southeast China were selected as the research subjects. The subjects were divided into the intervention group and the control group. The intervention group underwent a nutritional risk management program combined with traditional follow-up after discharge, whereas the control group received traditional follow-up after discharge. The primary outcome measure were the height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and weight-for-height Z-score (WHZ) at different time point and the percentage of growth and development curves were also recorded and analyzed.

Results

There were no statistically significant differences in general characteristics between the two groups. However, in the intervention group, the percentages of HAZ < −2, WAZ < −2, and WHZ < −2 were lower than those in the control group at 3rd and 6th months after discharge (P < 0.05). The percentage of growth and development curves (3%–97%) was higher than that in the control group (P < 0.05). The readmission rate within 6 months after discharge in the intervention group was lower than that in the control group (P < 0.05).

Conclusion

Implementing nutritional risk management program for infants and toddlers with CHD after discharge can help improve postoperative malnutrition, promote growth and development and achieve catch-up growth as soon as possible.
Improving lupus care index documentation in patients with childhood-onset systemic lupus erythematosus
Authors: Barbar-Smiley Fatima A. , Yildirim-Toruner Cagri , Akoghlanian Shoghik , AlAhmed Ohoud , Ardoin Stacy P. , Leone Ashlee , Oberle Edward , Sivaraman Vidya
Published: August 2024

Introduction

Childhood-onset systemic lupus erythematosus (c-SLE) presents unique challenges due to increased risk for severe morbidity and mortality compared to adult-onset SLE. Effective disease management relies on accurate disease assessment and documentation. Our project aimed to improve the documentation of the Lupus Care Index (LCI), a disease assessment bundle, by implementing a quality improvement (QI) initiative.

Methods

A QI project was conducted at Nationwide Children's Hospital (NCH), targeting patients with c-SLE. The LCI, comprising the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2k) Physician Global Assessment (PGA) and patient-reported pain score, was introduced to capture comprehensive disease assessment. Interventions included provider education, standardization of documentation procedures, and electronic health record (EHR) modifications. Automated reports tracked documentation rates, and Pareto charts identified areas for targeted interventions.

Results

Baseline analysis revealed incomplete documentation of LCI components in only one-third of c-SLE patients. Following interventions, documentation rates improved from 38% to 90%, with sustained improvement over at least a year.

Discussion

Enhancing documentation of LCI in patients with c-SLE is crucial for optimizing disease management. Our quality improvement initiative demonstrated the feasibility of improving documentation practices through targeted interventions and system modifications. Future research should explore the impact of comprehensive documentation on clinical outcomes in pediatric lupus patients. Improving documentation of LCI in patients with c-SLE is essential for optimizing care delivery and clinical outcomes; our QI initiative highlights the effectiveness of systemic interventions in enhancing documentation practices and underscores the importance of continued efforts to improve pediatric lupus care.
Schizonepeta tenuifolia Briq-Saposhnikovia divaricata decoction alleviates atopic dermatitis via downregulating macrophage TRPV1
Authors: Li Hongmin , Liang Jinyu , Li Peifeng , Li Xiangzheng , Liu Qing , Yang Songxue , Zhang Chunlei , Liu Shun , He Yuan , Tan Cheng
Published: August 2024

Objective

Schizonepeta tenuifolia -Saposhnikovia divaricata (Jingjie-Fangfeng, JF) has been used for years to treat allergic inflammatory skin diseases like atopic dermatitis, but the specific effects and mechanisms of JF are still unclear.

Purpose

We aim to investigate the therapeutic effect and mechanism of JF in MC903-induced atopic dermatitis-like model.

Methods

JF decoction was subjected to rigorous HPLC and GC analysis. The JF decoction was then freshly prepared and administered to MC903-induced atopic dermatitis -like mice models to investigate its therapeutic effects. Our evaluation focused on several markers of inflammation including the TEWL index, ear thickness, swelling, and specific inflammation indicators such as TSLP, IL33, IgE, and immune cell presence at the lesion sites. We measured Transient Receptor Potential Vanilloid 1 (TRPV1) expression levels through immunofluorescent staining in skin tissue from both atopic dermatitis patients and the MC903-treated mice. Furthermore, TRPV1 expression and macrophage activation markers were measured in LPS/IFN-γ-stimulated Raw264.7 and THP-1 cell models in vitro. Additionally, we developed cell lines that overexpress TRPV1 and investigated how JF treatment affects NF-κB p65 phosphorylation in these cells to understand better the role of TRPV1 in atopic dermatitis.

Results

The JF decoction met the standards outlined in the Chinese pharmacopeia. The JF decoction significantly alleviated inflammatory skin symptoms and helped restore skin barrier function. Additionally, it reduced the levels of IgE and pro-inflammatory cytokines TSLP, IL-33, and IL-4. There was also a noticeable decrease in mast cell infiltration and degranulation. Notably, JF decoction reduced infiltrated macrophages with limited affection on T cell infiltration. It also decreased F4/80+/TRPV1+ cells in atopic dermatitis mice and TRPV1 expression in LPS/IFNγ-stimulated microphages. Additionally, we observed that CD68+/TRPV1+ cells increased in human atopic dermatitis tissue. Further studies showed that JF water extract (JF-WE) suppressed TRPV1 expression in macrophages, potentially by affecting NF-κB p65 phosphorylation rather than the JAK-STAT6 pathway.

Conclusion

This study offers initial evidence of the effectiveness of JF-WE in suppressing inflammation in atopic dermatitis. The therapeutic effect might stems from its ability to downregulate TRPV1 expression and subsequent NF-κB p65 phosphorylation in macrophages.
Chlomito: a novel tool for precise elimination of organelle genome contamination from nuclear genome assembly
Authors: Song Wei , Li Chong , Lu Yanming , Shen Dawei , Jia Yunxiao , Huo Yixin , Piao Weilan , Jin Hua
Published: August 2024

Introduction

Accurate reference genomes are fundamental to understanding biological evolution, biodiversity, hereditary phenomena and diseases. However, many assembled nuclear chromosomes are often contaminated by organelle genomes, which will mislead bioinformatic analysis, and genomic and transcriptomic data interpretation.

Methods

To address this issue, we developed a tool named Chlomito, aiming at precise identification and elimination of organelle genome contamination from nuclear genome assembly. Compared to conventional approaches, Chlomito utilized new metrics, alignment length coverage ratio (ALCR) and sequencing depth ratio (SDR), thereby effectively distinguishing true organelle genome sequences from those transferred into nuclear genomes via horizontal gene transfer (HGT).

Results

The accuracy of Chlomito was tested using sequencing data from Plum, Mango and Arabidopsis. The results confirmed that Chlomito can accurately detect contigs originating from the organelle genomes, and the identified contigs covered most regions of the organelle reference genomes, demonstrating efficiency and precision of Chlomito. Considering user convenience, we further packaged this method into a Docker image, simplified the data processing workflow.

Discussion

Overall, Chlomito provides an efficient, accurate and convenient method for identifying and removing contigs derived from organelle genomes in genomic assembly data, contributing to the improvement of genome assembly quality.
Motor self-efficacy and physical education in school bullying
Authors: Galán-Arroyo Carmen , Flores-Ferro Elizabeth , Castillo-Retamal Franklin , Rojo-Ramos Jorge
Published: August 2024

In recent years, there has been a notable increase in bullying rates in school. Bullying is characterized as a repeated set of malicious actions by an individual or group toward another individual in an imbalanced power dynamic, resulting in physical, psychological, social, or material harm to the victim, with the intention of causing social exclusion. The scientific literature has investigated the factors that influence this type of behavior, environmental factors, such as school location and student age, as well as other factors, such as gender and level of physical fitness, also play an important role. This study examined the correlation between motor self-efficacy and bullying, considering that physical activity acts as a regulator in these cases. The Kolmogorov-Smirnov test was employed to assess the normality of the data distribution, and Spearman's Rho test was used to analyze the relationship between each dimension of the EBIPQ and E-AEM scores. The Cronbach's alpha was used to evaluate the reliability of each instrument. The results indicated a significant inverse correlation between the EBIP-Q and E-AEM in the variables of sex, educational stage and school environment. In conclusion, an inverse correlation was observed between motor self-efficacy and bullying, indicating that higher levels of motor self-efficacy are related to lower levels of bullying victimization. Motor self-efficacy could be used as a tool to reduce bullying situations at school. It would be important for government policies to encourage the practice of physical activity in all areas of life in order to improve motor self-efficacy and end bullying.
Design and validation of a simulated multitasking environment for assessing the cognitive load on the infantry squad leader
Authors: Remigereau Alexis , Darses Françoise , Dozias Baptiste , Albentosa Julie
Published: August 2024

The increasing cognitive load on infantry squad leaders is a common challenge in modern military operations. As this can increase health and safety risks, there is a need to study the factors responsible for the increase in cognitive load. Ecological situations inherently lack strong experimental controls; therefore, microworlds that simulate real tasks are the usual alternative to field studies. However, to the best of our knowledge, there are currently no microworlds that reproduce the main tasks of the squad leader during operations. This article adresses this gap by describing the design and validation of a new microworld: the Simulated Multitasking Environment for the Squad leader (SMES). Qualitative research was firstly conducted to highlight several squad leader’s generic tasks (i.e., common to many situations in the field) that guided the design of the SMES. Psychometric validation of the SMES was then based on two experiments: (i) the first evaluated the microworld’s psychometric qualities when tasks were performed individually; and (ii) the second explored concurrent tasks, reflecting real-world complexity. The results showed that the parameters manipulated for each task were relevant for inducing cognitive load, measured using a secondary detection response task and the NASA-TLX questionnaire. The SMES demonstrated satisfactory convergent and content validity in multitasking but not in single-task conditions. Performance in multitasking situations therefore does not seem to depend on task-specific skills, suggesting the existence of an independent factor–multitasking ability. Theoretical and practical implications of the SMES validation are discussed.
Measuring the harm of sugar sweetened beverages and internalities associated with it
Authors: Ding Ningxin , Desai Jaikishan
Published: August 2024

Introduction

Obesity, which is partly driven by the consumption of sugar-sweetened beverages (SSBs), significantly increases the risk of type-2 diabetes and cardiovascular diseases, leading to substantial health and economic burdens.

Methods

This study aims to quantify the monetary value of health harms caused by SSB consumption, along with the associated internalities, through a contingent valuation survey. The results are crucial for determining the socially optimal tax rate.

Results

We surveyed 293 residents of Wellington, New Zealand, to assess their willingness to pay (WTP) for reductions in the risks of diabetes, stroke, and heart disease associated with SSB intake. Logistic regression analysis revealed the marginal WTP for a 1% risk reduction in diabetes, stroke, and heart disease to be NZ$404.86, NZ$809.04, and NZ$1,236.84, respectively. Based on these values, we estimate the marginal harm from SSB consumption to be approximately NZ$17.37 per liter in New Zealand, with internalities amounting to NZ$6.43 per liter, suggesting an optimal tax rate of NZ$6.49 per liter.

Discussion

Implementing such a tax is feasible and would likely double or triple the price of SSBs in New Zealand.
Equity and efficiency of health resource allocation in the Chengdu–Chongqing Economic Circle of China
Authors: Wang Tianqi , Zhou Ting , Zhou Leming , He Yunfei , Wang Jian , Wang Yonghong , Huang Li
Published: August 2024

Objective

This study aimed to evaluate the fairness and efficiency of health resource allocation (HRAE) in Chengdu-Chongqing Economic Circle after the new healthcare reform. This study also aimed to identify existing problems, providing empirical evidence for the government to formulate regional health plans scientifically and reasonably.

Methods

The fairness of health resource allocation was analyzed using the Gini coefficient, Theil index, and agglomeration degree from population and geographical area perspectives. The three-stage data envelopment analysis and the Malmquist productivity index were used to analyze HRAE from static and dynamic perspectives.

Results

The Gini coefficient for population allocation in Chengdu-Chongqing Economic Circle was 0.066–0.283, and the Gini coefficient for geographical area allocation was 0.297–0.469. The contribution rate within a region was greater than that between regions, and health resources were mainly concentrated in economically developed core areas. The overall fairness of Chengdu Economic Circle was relatively better than that of Chongqing Economic Circle. Moreover, the adjusted mean technical efficiency was 0.806, indicating room for HRAE improvement in Chengdu-Chongqing Economic Circle. Stochastic Frontier Analysis found that different environmental variables have varying degrees of impact on HRAE. The adjusted mean total factor productivity change (Tfpch) was 1.027, indicating an overall upward trend in HRAE since the new healthcare reform. However, scale efficiency change (Sech) (0.997) limited the improvement of Tfpch.

Conclusion

The fairness of health resources allocated by population was better than that allocated by geographical area. The unfairness of health resources mainly stemmed from intra-regional differences, with considerable health resources concentrated in core areas. Over the past 13 years, HRAE has improved but exhibited spatial heterogeneity and Sech-hindered productivity improvement. The study recommends strengthening regional cooperation and sharing to promote the integrated and high-quality development of the health and well-being in Chengdu–Chongqing Economic Circle.