bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of guidelines implementation on empiric antibiotic treatment for pediatric uncomplicated osteomyelitis and septic arthritis over a ten-year period: Results of the ELECTRIC study (ostEomyeLitis and sEptiC arThritis tReatment in children)
Authors: Minotti Chiara , Tirelli Francesca , Guariento Chiara , Sturniolo Giulia , Giaquinto Carlo , Da Dalt Liviana , Zulian Francesco , Meneghel Alessandra , Martini Giorgia , Donà Daniele
Published: February 2023

Background

Due to the growing evidence of the efficacy of intravenous (IV) cefazolin with an early switch to oral cefalexin in uncomplicated pediatric osteomyelitis (OM) and septic arthritis (SA) in children, we changed our guidelines for empiric antibiotic therapy in these conditions. This study aims at evaluating the impact of the guidelines' implementation in reducing broad-spectrum antibiotic prescriptions, duration of IV antibiotic treatment and hospital stay, treatment failure and recurrence.

Materials and methods

This is a retrospective, observational, quasi-experimental study. The four years pre-intervention were compared to the six years, ten months post-intervention (January 2012, through December 2015; January 2016, through October 31st, 2022). All patients aged 3 months to 18 years with OM or SA were evaluated for inclusion. Each population was divided into three groups: pre-intervention, post-intervention not following the guidelines, and post-intervention following the guidelines. Differences in antibiotic prescriptions such as Days of Therapy (DOT), activity spectrum and Length of Therapy (LOT), length of hospital stay (LOS), broad-spectrum antibiotics duration (bsDOT), treatment failure and relapse at six months were analyzed as outcomes.

Results

Of 87 included patients, 48 were diagnosed with OM (8 pre-intervention, 9 post-intervention not following the guidelines and 31 post-intervention following the guidelines) and 39 with SA (9 pre-intervention, 12 post-intervention not following the guidelines and 18 post-intervention following the guidelines). In OM patients, IV DOT, DOT/LOT ratio, and bsDOT were significantly lower in the guidelines group, with also the lowest proportion of patients discharged on IV treatment. Notably, significantly fewer cases required surgery in the post-intervention groups. Considering SA, LOS, IV DOT, DOT/LOT ratio, and bsDOT were significantly lower in the guidelines group. The treatment failure rate was comparable among all groups for both OM and SA. There were no relapse cases. The overall adherence was between 72 and 100%.

Conclusions

The implementation of guidelines was effective in decreasing the extensive use of broad-spectrum antibiotics and combination therapy for both OM and SA. Our results show the applicability, safety, and efficacy of a narrow-spectrum IV empirical antibiotic regimen with cefazolin, followed by oral monotherapy with first/second-generation cephalosporins, which was non-inferior to broad-spectrum regimens.
Advances in research on the effectiveness and mechanism of Traditional Chinese Medicine formulas for colitis-associated colorectal cancer
Authors: Wei Xiunan , Leng Xiaohui , Li Gongyi , Wang Ruting , Chi Lili , Sun Dajuan
Published: February 2023

Inflammatory bowel disease (IBD) can progress into colitis-associated colorectal cancer (CAC) through the inflammation-cancer sequence. Although the mechanism of carcinogenesis in IBD has not been fully elucidated, the existing research indicates that CAC may represent a fundamentally different pathogenesis pattern of colorectal cancer. At present, there is no proven safe and effective medication to prevent IBD cancer. In recent years, Chinese medicine extracts and Chinese medicine monomers have been the subject of numerous articles about the prevention and treatment of CAC, but their clinical application is still relatively limited. Traditional Chinese Medicine (TCM) formulas are widely applied in clinical practice. TCM formulas have demonstrated great potential in the prevention and treatment of CAC in recent years, although there is still a lack of review. Our work aimed to summarize the effects and potential mechanisms of TCM formulas for the prevention and treatment of CAC, point out the issues and limitations of the current research, and provide recommendations for the advancement of CAC research in the future. We discovered that TCM formulas regulated many malignant biological processes, such as inflammation-mediated oxidative stress, apoptosis, tumor microenvironment, and intestinal microecology imbalance in CAC, through a review of the articles published in databases such as PubMed, SCOPUS, Web of Science, Embase, and CNKI. Several major signal transduction pathways, including NF-κB, STAT3, Wnt/β-catenin, HIF-1α, and Nrf2, were engaged. TCM formula may be a promising treatment candidate to control the colitis-cancer transformation, however further high-quality research is required.
Aberrant splicing in human cancer: An RNA structural code point of view
Authors: Apostolidi Maria , Stamatopoulou Vassiliki
Published: February 2023

Alternative splicing represents an essential process that occurs widely in eukaryotes. In humans, most genes undergo alternative splicing to ensure transcriptome and proteome diversity reflecting their functional complexity. Over the last decade, aberrantly spliced transcripts due to mutations in cis- or trans-acting splicing regulators have been tightly associated with cancer development, largely drawing scientific attention. Although a plethora of single proteins, ribonucleoproteins, complexed RNAs, and short RNA sequences have emerged as nodal contributors to the splicing cascade, the role of RNA secondary structures in warranting splicing fidelity has been underestimated. Recent studies have leveraged the establishment of novel high-throughput methodologies and bioinformatic tools to shed light on an additional layer of splicing regulation in the context of RNA structural elements. This short review focuses on the most recent available data on splicing mechanism regulation on the basis of RNA secondary structure, emphasizing the importance of the complex RNA G-quadruplex structures (rG4s), and other specific RNA motifs identified as splicing silencers or enhancers. Moreover, it intends to provide knowledge on newly established techniques that allow the identification of RNA structural elements and highlight the potential to develop new RNA-oriented therapeutic strategies against cancer.
Variations in exons 11 and 12 of the multi-pest resistance wheat gene Lr34 are independently additive for leaf rust resistance
Authors: Cloutier Sylvie , Reimer Elsa , Khadka Bijendra , McCallum Brent D.
Published: February 2023

Introduction

Characterization of germplasm collections for the wheat leaf rust gene Lr34 previously defined five haplotypes in spring wheat. All resistant lines had a 3-bp TTC deletion (null) in exon 11, resulting in the absence of a phenylalanine residue in the ABC transporter, as well as a single nucleotide C (Tyrosine in Lr34+) to T (Histidine in Lr34-) transition in exon 12. A rare haplotype present in Odesskaja 13 and Koktunkulskaja 332, both of intermediate rust resistance, had the 3-bp deletion typical of Lr34+ in exon 11 but the T nucleotide of Lr34- in exon 12.

Methods

To quantify the role of each mutation in leaf rust resistance, Odesskaja 13 and Koktunkulskaja 332 were crossed to Thatcher and its near-isogenic line Thatcher-Lr34 (RL6058). Single seed descent populations were generated and evaluated for rust resistance in six different rust nurseries.

Results

The Odesskaja 13 progeny with the TTC/T haplotype were susceptible with an average severity rating of 62.3%, the null/T haplotype progeny averaged 39.7% and the null/C haplotype was highly resistant, averaging 13.3% severity. The numbers for the Koktunkulskaja 332 crosses were similar with 63.5%, 43.5% and 23.7% severity ratings, respectively. Differences between all classes in all crosses were statistically significant, indicating that both mutations are independently additive for leaf rust resistance. The three-dimensional structural models of LR34 were used to analyze the locations and putative interference of both amino acids with the transport channel. Koktunkulskaja 332 also segregated for marker csLV46 which is linked to Lr46. Rust severity in lines with Lr34+ and csLV46+ had significantly lower rust severity ratings than those without, indicating the additivity of the two loci.

Discussion

This has implications for the deployment of Lr34 in wheat cultivars and for the basic understanding of this important wheat multi-pest durable resistance gene.
Increasing the yield of drip-irrigated rice by improving photosynthetic performance and enhancing nitrogen metabolism through optimizing water and nitrogen management
Authors: Zhao Lei , Tang Qingyun , Song Zhiwen , Yin Yongan , Wang Guodong , Li Yuxiang
Published: February 2023

Drip irrigation under plastic film mulching is an important technique to achieve water-conserving and high-efficiency rice (Oryza sativa L.) production in arid areas, but the grain yield of drip-irrigated rice is much lower than the expected yield (10.9-12.05 t·hm-2) in practical production applications. Therefore, we hope to further understand the photosynthetic physiological mechanism of drip-irrigated rice yield formation by optimizing water and nitrogen management during the growth period and provide a scientific reference for improving yield and nitrogen use efficiency (NUE) of drip-irrigated rice in arid areas. In 2020 and 2021, T-43 (a drought-resistant; V1) and Liangxiang-3 (a drought-sensitive cultivar; V2) were cultivated under two water treatments (W1: limited drip irrigation, 10200 m3·hm-2; W2: deficit drip irrigation, 8670 m3·hm-2) and three nitrogen fertilization modes with different ratios of seedling fertilizer:tillering fertilizer:panicle fertilizer:grain fertilizer (N1, 30%:50%:13%:7%; N2, 20%:40%:30%:10%; and N3, 10%:30%:40%:20%). The photosynthetic characteristics, nitrogen metabolism, yield, and NUE were analysed. The results showed that compared with other treatments, the W1N2 resulted in 153.4-930.3% higher glutamate dehydrogenase (GDH) contents and 19.2-49.7% higher net photosynthetic rates (Pn) in the leaves of the two cultivars at 20 days after heading, as well as higher yields and NUE. The two cultivars showed no significant difference in the physiological changes at the panicle initiation stage, but the Pn, abscisic acid (ABA), indole acetic acid (IAA), gibberellic acid (GA3), and zeatin riboside (ZR) levels of V1 were higher than those of V2 by 53.1, 25.1, 21.1, 46.3 and 36.8%, respectively, at 20 days after heading. Hence, V1 had a higher yield and NUE than V2. Principal component analysis revealed that Pn and GDH were the most important physiological factors affecting rice yield performance. In summary, the W1N2 treatment simultaneously improved the yield and NUE of the drought-resistant rice cultivar (T-43) by enhancing the photosynthetic characteristics and nitrogen transport capacity and coordinating the balance of endogenous hormones (ABA, IAA, GA3, and ZR) in the leaves.
Genome-wide identification of DnaJ gene family in Catalpa bungei and functional analysis of CbuDnaJ49 in leaf color formation
Authors: Yang Yingying , Zhao Linjiao , Wang Junhui , Lu Nan , Ma Wenjun , Ma Jiang , Zhang Yu , Fu Pengyue , Yao Chengcheng , Hu Jiwen , Wang Nan
Published: February 2023

DnaJs are the common molecular chaperone proteins with strong structural and functional diversity. In recent years, only several DnaJ family members have been found to be able to regulate leaf color, and it remains to be explored whether there are other potential members that also regulate this character. Here, we identified 88 putative DnaJ proteins from Catalpa bungei, and classified them into four types according to their domain. Gene-structure analysis revealed that each member of CbuDnaJ family had same or similar exon-intron structure. Chromosome mapping and collinearity analysis showed that tandem and fragment duplication occurred in the process of evolution. Promoter analyses suggested that CbuDnaJs might be involved in a variety of biological processes. The expression levels of DnaJ family members in different color leaves of Maiyuanjinqiu were respectively extracted from the differential transcriptome. Among these, CbuDnaJ49 was the largest differentially expressed gene between the green and yellow sectors. Ectopic overexpression of CbuDnaJ49 in tobacco showed that the positive transgenic seedlings exhibited albino leaves, and the contents of chlorophyll and carotenoid were significantly reduced compared with those of wild type. The results suggested that CbuDnaJ49 played an important role in regulating leaf color. This study not only identified a novel gene of DnaJ family members regulating leaf color, but also provided new germplasm for landscaping.
CRISPR/Cas genome editing in tomato improvement: Advances and applications
Authors: Tiwari Jagesh Kumar , Singh Anand Kumar , Behera Tusar Kanti
Published: February 2023

The narrow genetic base of tomato poses serious challenges in breeding. Hence, with the advent of clustered regularly interspaced short palindromic repeat (CRISPR)-associated protein9 (CRISPR/Cas9) genome editing, fast and efficient breeding has become possible in tomato breeding. Many traits have been edited and functionally characterized using CRISPR/Cas9 in tomato such as plant architecture and flower characters (e.g. leaf, stem, flower, male sterility, fruit, parthenocarpy), fruit ripening, quality and nutrition (e.g., lycopene, carotenoid, GABA, TSS, anthocyanin, shelf-life), disease resistance (e.g. TYLCV, powdery mildew, late blight), abiotic stress tolerance (e.g. heat, drought, salinity), C-N metabolism, and herbicide resistance. CRISPR/Cas9 has been proven in introgression of de novo domestication of elite traits from wild relatives to the cultivated tomato and vice versa. Innovations in CRISPR/Cas allow the use of online tools for single guide RNA design and multiplexing, cloning (e.g. Golden Gate cloning, GoldenBraid, and BioBrick technology), robust CRISPR/Cas constructs, efficient transformation protocols such as Agrobacterium, and DNA-free protoplast method for Cas9-gRNAs ribonucleoproteins (RNPs) complex, Cas9 variants like PAM-free Cas12a, and Cas9-NG/XNG-Cas9, homologous recombination (HR)-based gene knock-in (HKI) by geminivirus replicon, and base/prime editing (Target-AID technology). This mini-review highlights the current research advances in CRISPR/Cas for fast and efficient breeding of tomato.
U.S. EPA oversight of pesticide traits in genetically modified plants and recent biotechnology innovation efforts
Authors: Mendelsohn Michael , Pierce Amanda A. , Striegel Wiebke
Published: February 2023

Before pesticides can be sold in the United States, the United States Environmental Protection Agency (EPA) must evaluate them thoroughly to ensure that they meet U.S. federal pesticide registration standards for human health and the environment. EPA considers pesticidal substances produced and used in plants as pesticides and defined them in the regulations as “plant-incorporated protectants” (PIPs). PIPs that are created through conventional breeding are exempted from registration requirements, while those created through biotechnology require individual assessments and approval by EPA before they can be distributed or used. This currently includes PIPs that are identical to those that could be moved through conventional breeding but are created through biotechnology (e.g., through genome editing or via precision breeding techniques). EPA proposed an exemption in October 2020 to allow certain PIPs created through biotechnology to be exempt from EPA requirements for pesticides where those PIPs: 1) pose no greater risk than PIPs that EPA has already exempted, and 2) could have otherwise been created through conventional breeding.
Sugar infusion into trees: A novel method to study tree carbon relations and its regulations
Authors: Zhang Yan-Li , Yang Yue , Saurer Matthias , Schaub Marcus , Gessler Arthur , Lehmann Marco M. , Rigling Andreas , Walser Marco , Stierli Beat , Hajjar Noureddine , Christen Daniel , Li Mai-He
Published: February 2023

Many carbon-related physiological questions in plants such as carbon (C) limitation or starvation have not yet been resolved thoroughly due to the lack of suitable experimental methodology. As a first step towards resolving these problems, we conducted infusion experiments with bonsai trees (Ficus microcarpa) and young maple trees (Acer pseudoplatanus) in greenhouse, and with adult Scots pine trees (Pinus sylvestris) in the field, that were “fed” with 13C-labelled glucose either through the phloem or the xylem. We then traced the 13C-signal in plant organic matter and respiration to test whether trees can take up and metabolize exogenous sugars infused. Ten weeks after infusion started, xylem but not phloem infusion significantly increased the δ13C values in both aboveground and belowground tissues of the bonsai trees in the greenhouse, whereas xylem infusion significantly increased xylem δ13C values and phloem infusion significantly increased phloem δ13C values of the adult pines in the field experiment, compared to the corresponding controls. The respiration measurement experiment with young maple trees showed significantly increased δ13C-values in shoot respired CO2 at the time of four weeks after xylem infusion started. Our results clearly indicate that trees do translocate and metabolize exogenous sugars infused, and because the phloem layer is too thin, and thus xylem infusion can be better operated than phloem infusion. This tree infusion method developed here opens up new avenues and has great potential to be used for research on the whole plant C balance and its regulation in response to environmental factors and extreme stress conditions.
Optimal timing of treatment for errors in second language learning – A systematic review of corrective feedback timing
Authors: Xu Mingfei , Zeng Simin
Published: February 2023

Although a large body of research has developed on corrective feedback in second language acquisition (SLA) in the past 30 years, there are few empirical studies examining the relationship between feedback timing and SLA. To begin to address this gap, this study reviews the existing research on the impact of corrective feedback timing on SLA. It aims to investigate the possible influential factors that might have led to inconsistent research findings and theoretical explanations. The review was conducted according to PRISMA-statement through searches in peer-reviewed electronic databases including Social Sciences Citation Index (SSCI), Scopus, EBSCO, which includes ERIC and the British Education Index and gray literature (doctoral dissertations in ProQuest). Twenty studies conducted and published between 2006 and 2021 were finally analyzed to reveal the current trends. The results of this review indicate that there is no definite answer to the question of when errors in L2 should be treated. The difficulty of drawing a conclusive finding can be attributed to the communicative modality examined and variations in research design, including the explicitness of feedback and various ways of measuring feedback timing. No certain theoretical framework has been applied to guide these studies and they have applied different theoretical explanations to interpret the inconsistent results. The review highlights the need to continue to investigate the effectiveness of corrective feedback under different timing conditions. In addition, it discusses some research gaps that should be addressed in future studies and suggests future research directions in the area of feedback timing.
Teachers and school administrators’ experiences with professional development feedback: The classroom strategies assessment system implementation
Authors: Poulou Maria S. , Reddy Linda A. , Dudek Christopher M.
Published: February 2023

To support teachers’ evaluation and professional development valid assessments that measure teachers’ classroom practices and capture teachers’ strengths and areas in need of improvement are needed. The current study examined school administrators’ and teachers’ experiences of Professional Development (PD), with the use of the Classroom Strategies Assessment System (CSAS), a classroom observational assessment that measures universal classroom instructional and behavioral practices, and their perceptions of the usability of CSAS for supporting PD. The study also examined school administrators’ ratings of elementary school teachers’ use of evidence-based instructional and behavior management practices, as an illustrative example of how performance feedback was implemented. Three school administrators observed 31 elementary school teachers three times each using the CSAS Greek version. Following each observation, teachers received brief performance feedback based on CSAS scores from their school administrator. School administrators and teachers completed the System Usability Scale to assess the usability of the CSAS administration. Semi-structured interviews with 19 of the participating teachers were conducted to further explore teachers’ professional development experiences. Overall, teacher interviews expressed their need for professional development in the areas of instructional and behavior management practices and perceived CSAS feedback helpful for instructional improvement. Findings also suggest some improvements in the frequency and quality of teacher instructional and behavior management practices as measured by the CSAS. Implications for practices and research are discussed.
Can helicopter parenting be beneficial for parent–child relationships? A person-centered approach in the United States and South Korea
Authors: Hwang Woosang , Jung Eunjoo , Kim Seonghee , Hadi Narges
Published: February 2023

Introduction

We aimed to uncover latent classes of maternal and paternal helicopter parenting among American and Korean college students and to examine whether latent classes of maternal and paternal helicopter parenting are associated with parent– child relationships.

Methods

We conducted three-step latent class analyses using five helicopter parenting indicators for 433 mother–child and 401 father-child groups in the United States and 207 mother–child and 195 father-child groups in South Korea.

Results

We identified the same three helicopter parenting latent classes (strong, weak, and managed) in mother–child and father-child groups in the United States and Korea. In addition, we found that American and Korean college students in strong and managed helicopter parenting latent classes reported better parent– child relationships than those in the weak class regardless of parents’ gender.

Discussion

Our findings indicate that helicopter parenting is multidimensional and can be similarly interpreted by college students in Western and Eastern societies. Further, our findings suggest that helicopter parenting could be helpful for college students to establish an intimate relationship with their parents.
Factor structure of the parent-rated strengths and difficulties questionnaire in a sample of Canadian children from military families
Authors: Coulthard Julie , Sudom Kerry
Published: February 2023

The Strengths and Difficulties Questionnaire is a 25-item screening tool designed to measure the emotional and behavioral well-being of children. It includes five subscales including Emotional Symptoms, Conduct Problems, Peer Problems, Hyperactivity-Inattention and Prosocial Behavior. While the Strengths and Difficulties Questionnaire has been studied extensively on a global scale, it has not yet been evaluated among Canadian children from military families. This study used data collected from spouses and partners of Canadian Armed Forces members who completed a questionnaire assessing their quality of life, including the Strengths and Difficulties Questionnaire for respondents with children aged 3–16 years (N = 651). Using two independent randomized samples drawn from the overall group of respondents, the factorial structure was studied using exploratory factor analysis (n = 323) and confirmatory factor analysis (n = 328). Results of this study provide evidence for the factorial validity of the parent-rated Strengths and Difficulties Questionnaire for a sample of children from military families. Specifically, the exploratory factor analysis and confirmatory factor analysis supported the original proposed five-factor solution (CFI = 0.84; TLI = 0.82; SRMR = 0.073; RMSEA = 0.065) with good internal reliability of the Total Difficulties Scale and subscales. Overall, the results of this study were found to align with past research findings on the Strengths and Difficulties Questionnaire and support the future utility of this tool in assessing the well-being of Canadian children from military families.
I know that I know. But do I know that I do not know?
Authors: Polyanskaya Leona
Published: February 2023

Metacognition–the ability of individuals to monitor one’s own cognitive performance and decisions–is often studied empirically based on the retrospective confidence ratings. In experimental research, participants are asked to report how sure they are in their response, or to report how well their performance in high-level cognitive or low-level perceptual tasks is. These retrospective confidence ratings are used as a measure of monitoring effectiveness: larger difference in confidence ratings assigned to correct and incorrect responses reflects better ability to estimate the likelihood of making an error by an experiment participant, or better metacognitive monitoring ability. We discuss this underlying assumption and provide some methodological consideration that might interfere with interpretation of results, depending on what is being asked to evaluate, how the confidence response is elicited, and the overall proportion of different trial types within one experimental session. We conclude that mixing trials on which decision confidence is assigned when positive evidence needs to be evaluated and the trials on which absence of positive evidence needs to be evaluated should be avoided. These considerations might be important when designing experimental work to explore metacognitive efficiency using retrospective confidence ratings.
Investigating a neural language model’s replicability of psycholinguistic experiments: A case study of NPI licensing
Authors: Shin Unsub , Yi Eunkyung , Song Sanghoun
Published: February 2023

The recent success of deep learning neural language models such as Bidirectional Encoder Representations from Transformers (BERT) has brought innovations to computational language research. The present study explores the possibility of using a language model in investigating human language processes, based on the case study of negative polarity items (NPIs). We first conducted an experiment with BERT to examine whether the model successfully captures the hierarchical structural relationship between an NPI and its licensor and whether it may lead to an error analogous to the grammatical illusion shown in the psycholinguistic experiment (Experiment 1). We also investigated whether the language model can capture the fine-grained semantic properties of NPI licensors and discriminate their subtle differences on the scale of licensing strengths (Experiment 2). The results of the two experiments suggest that overall, the neural language model is highly sensitive to both syntactic and semantic constraints in NPI processing. The model’s processing patterns and sensitivities are shown to be very close to humans, suggesting their role as a research tool or object in the study of language.
Usability of the IDDEAS prototype in child and adolescent mental health services: A qualitative study for clinical decision support system development
Authors: Clausen Carolyn , Leventhal Bennett , Nytrø Øystein , Koposov Roman , Røst Thomas Brox , Westbye Odd Sverre , Koochakpour Kaban , Frodl Thomas , Stien Line , Skokauskas Norbert
Published: February 2023

Introduction

Child and adolescent mental health services (CAMHS) clinical decision support system (CDSS) provides clinicians with real-time support as they assess and treat patients. CDSS can integrate diverse clinical data for identifying child and adolescent mental health needs earlier and more comprehensively. Individualized Digital Decision Assist System (IDDEAS) has the potential to improve quality of care with enhanced efficiency and effectiveness.

Methods

We examined IDDEAS usability and functionality in a prototype for attention deficit hyperactivity disorder (ADHD), using a user-centered design process and qualitative methods with child and adolescent psychiatrists and clinical psychologists. Participants were recruited from Norwegian CAMHS and were randomly assigned patient case vignettes for clinical evaluation, with and without IDDEAS. Semi-structured interviews were conducted as one part of testing the usability of the prototype following a five-question interview guide. All interviews were recorded, transcribed, and analyzed following qualitative content analysis.

Results

Participants were the first 20 individuals from the larger IDDEAS prototype usability study. Seven participants explicitly stated a need for integration with the patient electronic health record system. Three participants commended the step-by-step guidance as potentially helpful for novice clinicians. One participant did not like the aesthetics of the IDDEAS at this stage. All participants were pleased about the display of the patient information along with guidelines and suggested that wider guideline coverage will make IDDEAS much more useful. Overall, participants emphasized the importance of maintaining the clinician as the decision-maker in the clinical process, and the overall potential utility of IDDEAS within Norwegian CAMHS.

Conclusion

Child and adolescent mental health services psychiatrists and psychologists expressed strong support for the IDDEAS clinical decision support system if better integrated in daily workflow. Further usability assessments and identification of additional IDDEAS requirements are necessary. A fully functioning, integrated version of IDDEAS has the potential to be an important support for clinicians in the early identification of risks for youth mental disorders and contribute to improved assessment and treatment of children and adolescents.
Synapses, predictions, and prediction errors: A neocortical computational study of MDD using the temporal memory algorithm of HTM
Authors: Sherif Mohamed A. , Khalil Mostafa Z. , Shukla Rammohan , Brown Joshua C. , Carpenter Linda L.
Published: February 2023

Introduction

Synapses and spines play a significant role in major depressive disorder (MDD) pathophysiology, recently highlighted by the rapid antidepressant effect of ketamine and psilocybin. According to the Bayesian brain and interoception perspectives, MDD is formalized as being stuck in affective states constantly predicting negative energy balance. To understand how spines and synapses relate to the predictive function of the neocortex and thus to symptoms, we used the temporal memory (TM), an unsupervised machine-learning algorithm. TM models a single neocortical layer, learns in real-time, and extracts and predicts temporal sequences. TM exhibits neocortical biological features such as sparse firing and continuous online learning using local Hebbian-learning rules.

Methods

We trained a TM model on random sequences of upper-case alphabetical letters, representing sequences of affective states. To model depression, we progressively destroyed synapses in the TM model and examined how that affected the predictive capacity of the network. We found that the number of predictions decreased non-linearly.

Results

Destroying 50% of the synapses slightly reduced the number of predictions, followed by a marked drop with further destruction. However, reducing the synapses by 25% distinctly dropped the confidence in the predictions. Therefore, even though the network was making accurate predictions, the network was no longer confident about these predictions.

Discussion

These findings explain how interoceptive cortices could be stuck in limited affective states with high prediction error. Connecting ketamine and psilocybin’s proposed mechanism of action to depression pathophysiology, the growth of new synapses would allow representing more futuristic predictions with higher confidence. To our knowledge, this is the first study to use the TM model to connect changes happening at synaptic levels to the Bayesian formulation of psychiatric symptomatology. Linking neurobiological abnormalities to symptoms will allow us to understand the mechanisms of treatments and possibly, develop new ones.
Primary care providers' knowledge, attitudes, and practices related to prediabetes in China: A cross-sectional study
Authors: Pi Linhua , Yan Jianru , Fei Dongxue , Zheng Ying , Shi Xiajie , Wang Zhen , Zhou Zhiguang
Published: February 2023

Background

The management of prediabetes has great clinical significance, and primary care providers (PCPs) play important roles in the management and prevention of diabetes in China. Nevertheless, little is known about PCPs' knowledge, attitudes, and practices (KAP) regarding prediabetes. This cross-sectional study aimed to assess the KAP regarding prediabetes among PCPs in the Central China region.

Methods

This cross-sectional study was conducted using self-administered KAP questionnaires among PCPs from Central China region.

Results

In total, 720 PCPs completed the survey. Most physicians (85.8%) claimed to be aware of the adverse effects of prediabetes and reported positive attitudes toward prediabetes prevention, but the PCPs' knowledge of prediabetes and management practices showed substantial gaps. The prediabetes knowledge level and practice subscale scores of the PCPs were only 54.7% and 32.6%, respectively, of the corresponding optimal scores. Female PCPs showed higher prediabetes knowledge level scores (p = 0.04) and better practice scores (p = 0.038). Knowledge and attitude scores were inversely correlated with participants' age and duration of practice (p < 0.001). The PCPs who served in township hospitals had significantly higher knowledge and attitude scores than those who served in village clinics (p < 0.001). Furthermore, knowledge and practice scores increased with increasing professional titles. Recent continuing medical education (CME) attendance had a significant positive influence on knowledge of prediabetes (p = 0.029), but more than four-fifths of the surveyed PCPs did not participate in diabetes-related CME in the past year.

Conclusions

Substantial gaps were observed in PCPs' knowledge and practices regarding prediabetes in the Central China region. CME programmes were under-utilized by PCPs. Structured programmes are required to improve PCPs' prediabetes-related knowledge and practices in China.
Cost benefit analysis of alternative testing and quarantine policies for travelers for infection control: A case study of Singapore during the COVID-19 pandemic
Authors: Lou Jing , Lim Nigel Wei-Han , Cai Celestine Grace XueTing , Dickens Borame Sue Lee , Huynh Vinh Anh , Wee Hwee-Lin
Published: February 2023

Background

Border control mitigates local infections but bears a heavy economic cost, especially for tourism-reliant countries. While studies have supported the efficacy of border control in suppressing cross-border transmission, the trade-off between costs from imported and secondary cases and from lost economic activities has not been studied. This case study of Singapore during the COVID-19 pandemic aims to understand the impacts of varying quarantine length and testing strategies on the economy and health system. Additionally, we explored the impact of permitting unvaccinated travelers to address emerging equity concerns. We assumed that community transmission is stable and vaccination rates are high enough that inbound travelers are not dissuaded from traveling.

Methods

The number of travelers was predicted considering that longer quarantine reduces willingness to travel. A micro-simulation model predicted the number of COVID-19 cases among travelers, the resultant secondary cases, and the probability of being symptomatic in each group. The incremental net monetary benefit (INB) of Singapore was quantified under each border-opening policy compared to pre-opening status, based on tourism receipts, cost/profit from testing and quarantine, and cost and health loss due to COVID-19 cases.

Results

Compared to polymerase chain reaction (PCR), rapid antigen test (ART) detects fewer imported cases but results in fewer secondary cases. Longer quarantine results in fewer cases but lower INB due to reduced tourism receipts. Assuming the proportion of unvaccinated travelers is small (8% locally and 24% globally), allowing unvaccinated travelers will accrue higher INB without exceeding the intensive care unit (ICU) capacity. The highest monthly INB from all travelers is $2,236.24 m, with 46.69 ICU cases per month, achieved with ARTs at pre-departure and on arrival without quarantine. The optimal policy in terms of highest INB is robust under changes to various model assumptions. Among all cost-benefit components, the top driver for INB is tourism receipts.

Conclusions

With high vaccination rates locally and globally alongside stable community transmission, opening borders to travelers regardless of vaccination status will increase economic growth in the destination country. The caseloads remain manageable without exceeding ICU capacity, and costs of cases are offset by the economic value generated from travelers.
Effects of dysfunctional beliefs about sleep on sleep quality and mental health among patients with COVID-19 treated in Fangcang shelter hospitals
Authors: Peng Jiaxi , Zhang Tian , Li Yijun , Wu Lin , Peng Xiyuan , Li Chenxi , Lin Xinxin , Yu Jing , Mao Li , Sun Jingjing , Fang Peng
Published: February 2023

Introduction

With the COVID-19 pandemic in China, a large number of mild or ordinary confirmed cases have been sent to Fangcang shelter hospitals for treatment. We aimed to investigate the mental health condition of Fangcang patients 2 years after the pandemic when patients knew more about COVID-19 and the virus was less virulent. We focused on the effect of dysfunctional beliefs and attitudes about sleep on depression, anxiety, and insomnia.

Methods

A total of 1,014 patients from two large Fangcang shelter hospitals in Shanghai between 22 April and 8 May 2022 completed a set of questionnaires comprising: the Dysfunctional Beliefs and Attitudes about Sleep scale, the Generalized Anxiety Disorder scale, the Patient Health Questionnaire, and the Insomnia Severity Index scale.

Results

Results show that the positive screening rates for anxiety, depression, and insomnia among tested patients were 55.3, 27.0, and 47.8%, respectively. Patients were more likely to report higher anxiety, depression, and insomnia, and to endorse affective and sleep disorders if they were: female, aged 18–40 years, with undergraduate course or above, white-collar employees, or those who thought the pandemic would have severe economic effects. About 51.4% of the participants had dysfunctional beliefs about sleep to varying degrees. Compared with patients who had accurate beliefs about sleep, the ratios of insomnia, anxiety, and depression were significantly higher among patients with dysfunctional beliefs about sleep.

Discussion

Attention should be paid to the mental health problems of patients in Fangcang shelter hospitals. The results indicate that dysfunctional beliefs about sleep significantly increased anxiety, depression, and insomnia of Fangcang patients.
Incidence of unintended pregnancy and associated factors among adolescent girls and young women at risk of HIV infection in Kampala, Uganda
Authors: Namukisa Mary , Kamacooko Onesmus , Lunkuse Jane Frances , Ruzagira Eugene , Price Matt A. , Mayanja Yunia
Published: February 2023

Background

In sub-Saharan Africa, one in every five young women becomes pregnant, and 50% of these are unintended. Pregnancies in adolescent girls and young women (AGYW) are associated with poorer maternal and neonatal outcomes and a high abortion rate, yet data are still limited on incident pregnancies among AGYW in vulnerable situations. We studied the incidence and factors associated with unintended pregnancy among AGYW who were frequently engaged in transactional sex in Kampala, Uganda.

Methods

We analyzed data from a study that investigated the uptake of oral pre-exposure prophylaxis among AGYW from January 2019 to December 2020. Volunteers attended 3-monthly study visits for 12 months each. Contraceptive services were provided to interested volunteers free of charge. Interviewers collected data on sociodemographics, sexual behavior, reproductive health outcomes, and substance use. Pregnancy was determined by testing for beta-human chorionic gonadotropin hormone in urine. The pregnancy incidence rate was estimated using the Kaplan–Meier technique, and logistic regression was used to determine the correlates of pregnancy.

Results

We included 285 volunteers with a mean age of 19.9 [standard deviation (SD), ± 2.24] years; 54.7% had attained secondary school education or higher, 57.2% were single (never married), 92.6% reported engaging in transactional sex, 21.0% reported sex work as their main job, 51.9% consumed alcohol in the month prior to the interview, of whom 12.8% consumed alcohol daily, and 25.3% had Chlamydia trachomatis/Neisseria gonorrhoeae. The mean age at first sexual intercourse was 15.7 (SD, ±2.1) years. We recorded 44 pregnancies over 187.2 person-years of follow-up, an incidence of 23.5 per 100 person-years [95% confidence interval (CI), 17.5–31.6]. Incident pregnancies were more likely among volunteers who had ≥10 sexual partners in the past 3 months [adjusted risk ratio (aRR) 1.97; 95% CI, 1.05–3.70] and those who reported not using contraception (aRR 5.89; 95% CI, 2.74–12.66). Incident pregnancies were less likely among those who reported alcohol consumption in the past month (aRR 0.52; 95% CI, 0.30–0.90).

Conclusion

The incidence of unintended pregnancy was high despite the availability of free contraceptive services. We recommend sociobehavioral studies to explore this further. Sexual and reproductive health campaigns should strengthen demand creation and motivation to use contraception among young women with multiple sexual partners.
How Do We Catch Our Tongue From Slipping?
Authors: Andrade Katherine Diane , Riès Stéphanie Kathleen
Published: February 2023

Speaking is such an important part of our lives. We use it to communicate with our families, friends, and even our pets! Not only do we talk a lot, but we are also very good at it. Healthy speakers can say 2–3 words per second and usually produce an error only about once every 1,000 words. To limit the number of errors we make, we are continuously monitoring our own speech. While speaking is easy, the brain process of monitoring our own speech is quite complex. In this article, we outline the process of selecting a word, understanding what happens when a speech error is made, and what could happen if the parts of the brain responsible for monitoring speech are damaged.
The effect of severe intensity bouts on muscle oxygen saturation responses in trained cyclists
Authors: Yogev Assaf , Arnold Jem , Nelson Hannah , Clarke David C. , Guenette Jordan A. , Sporer Ben C. , Koehle Michael S.
Published: February 2023

Near-infrared spectroscopy (NIRS) quantifies muscle oxygenation (SmO2) during exercise. Muscle oxygenation response to self-paced, severe-intensity cycling remains unclear. Observing SmO2 can provide cycling professionals with the ability to assess muscular response, helping optimize decision-making. We aimed to describe the effect of self-paced severe intensity bouts on SmO2, measured noninvasively by a wearable NIRS sensor on the vastus lateralis (VL) muscle, and examine its reliability. We hypothesized a greater desaturation response with each bout, whereas, between trials, good reliability would be observed. Fourteen recreationally trained, and trained cyclists completed a ramp test to determine the power output (PO) at the respiratory compensation point (RCP). Athletes completed two subsequent visits of 50-minute sessions that included four severe-intensity bouts done at 5% above RCP PO. Muscle oxygenation in the VL was monitored using a wearable NIRS device. Measures included mean PO, heart-rate (HR), cadence, and SmO2 at bout onset, during work (work SmO2), and ΔSmO2. The bouts were compared using a one-way repeated measures ANOVA. For significant differences, a Fisher's least square difference post-hoc analysis was used. A two-way repeated measures ANOVA was used using trial and bout as main factors. Intraclass correlations (ICC) were used to quantify relative reliability for mean work, and standard error of the measurement (SEM) was used to quantify absolute agreement of mean work SmO2. Both PO and cadence showed no effect of bout or trial. Heart-rate at bout 2 (168 ± 8 bpm) and 4 (170 ± 7 bpm) were higher than bout 1 (160 ± 6 bpm). Onset SmO2 (%) response significantly increased in the final two bouts of the session. Mean work SmO2 increased across bouts, with the highest value displayed in bout 4 (36 ± 22%). ΔSmO2 showed a smaller desaturation response during bout 4 (27 ± 10%) compared to bout 3 (31 ± 10%). Mean work SmO2 ICC showed good reliability (ICC = 0.87), and SEM was 12% (CI 9-15%). We concluded that a non-invasive, affordable, wearable NIRS sensor demonstrated the heterogeneous muscle oxygenation response during severe intensity cycling bouts with good reliability in trained cyclists.
Impact of perception and assessment of consumers on willingness to pay for upgraded fresh pork: An experimental study in Vietnam
Authors: Ngo Hai Hoang Tuan , Dang-Xuan Sinh , Målqvist Mats , Pham-Duc Phuc , Nguyen-Hong Phi , Le-Thi Hang , Nguyen-Viet Hung , Le Trang T. H. , Grace Delia , Lindahl Johanna F. , Unger Fred
Published: February 2023

Traditional pork shops play an essential role in delivering pork, the most popular food in Vietnam, to consumers. Studies have shown the need for investment in training and equipment to improve the safety of pork sold at traditional shops. However, it remains unclear how consumers perceived improvement to the hygiene in pork shops and if they are ready to pay premium prices for safer products. This study used an experimental approach to determine consumers' perception and assessment of improved pork shops and their willingness to pay (WTP) for pork products. A total of 152 respondents in two provinces in Vietnam joined in a Becker–DeGroot–Marschak (BDM) mechanism experiment to collect data on WTP for pork from typical and upgraded pork shops. A questionnaire was used to record consumers' perceptions and assessments of the pork shops and products. Overall, consumers were willing to pay 20% more for upgraded fresh pork than for what is currently available on the market. Consumers trusted in the effectiveness of the upgraded intervention and the quality of pork at the pork shop, which increased their WTP for the upgraded pork. Concerns about contaminated pork had a negative impact on the WTP for typical pork, while the high frequency of pork consumption and the existence of elderly family members led to higher WTP for both products. The findings indicate the potential economic benefit of upgrading pork shops, which would be an important driver to motivate sellers to improve food safety.