bluuebunny/crossref_metadata_2025 huggingface dataset:
Health System Preparedness in Provision of Noncommunicable Diseases’ Services in Lakhimpur District, Assam State, India
Authors: Saikia Susmita , Nsamba Jonathan
Published: February 2023

Background: While noncommunicable diseases (NCDs) are one of the leading causes of mortality in the world today, we are unsure of the preparedness of the public health system in terms of provision for and utilization of NCD services in Assam. Methods: Preparedness of public health facility was assessed using WHO-SARA (Service Availability and Readiness Assessment) tool and Indian Public Health Standards tool. Ethics approval was obtained from the Institutional Human Ethics Committee of the Central University of Kerala. Results: The overall readiness of primary health centers (PHCs) ranged from 60% to 76% for NCD services, community health centers (CHCs) ranged from 72% to 87%, subdivisional hospitals from 70% to 87%, and district hospitals from 76% to 100%. Deficiencies were also noted in terms of the availability of equipment and medicines. Conclusion: The deficiencies in the PHCs and CHCs highlighted in the study emphasize the need to strengthen the health system, thereby strengthening the response of the health system to NCDs in India.
Health-Care Facilities and Road Traffic Injuries in Thiruvananthapuram City
Authors: Balathandan Annup Balan , Soman Biju
Published: February 2023

Background: Road traffic injuries (RTIs) are a growing public health concern in India. Despite good health infrastructure and better-connected roads, Kerala has the fifth highest incidence of RTI in India. The spatiotemporal analysis of RTI in Trivandrum is undertaken in this context. Methods: RTI data for 2016 was obtained from the State Crime Records Bureau, Thiruvananthapuram and the population data were taken from the Census 2011. Spatial statistical analysis was used to look for geographical distribution and spatiotemporal clustering of RTIs. Health-care facilities providing emergency trauma care services in the city were identified from secondary sources. Results: A total of 2,319 people, including pedestrians, got injured in 1,926 accidents in Thiruvananthapuram city in 2016. A Moran’s I value of 0.23 signifies spatial autocorrelation (clustering) of RTIs in Trivandrum. The rates of RTIs were significantly high among senior citizens, male sex, two-wheeler users, and during daytime. Most deaths (48.2%) occur among the active age group of 30 to 60 years. A severity map was generated and using LISA, local hotspots were identified. Eight significant cluster locations were identified among the 100 wards. The mean distance from the accident hotspots to the nearest health-care facility was 1.2 km for the public and private facilities. Conclusion: There is a significant spatial-temporal clustering of RTIs in Thiruvananthapuram city. Proportionally higher deaths occur among pedestrians, 2-wheeler users, and women, which needs further exploration. The study results could be used to plan and build RTI prevention strategies in Thiruvananthapuram city
Impact of New Competency-Based Medical Curriculum on the Educational Environment of Medical Students in a Medical College in Central Kerala
Authors: Varier E.V. Deepasree , Sobha Gayathri , Babychan Angel , Jasmin Najiya Najeem , Manu Naveena , Gopika P. , Firosh Aysha Naurin , Hanisha Gondi Gouri , Dinesh Avani , Sreedevi Aswathy , Mathew Minu Maria , Sasi Silpa Thozhuthungal
Published: February 2023

Background: Competency-based medical education (CBME) for graduate medical students was introduced by National Medical Commission from the 2019 batch. This paper seeks to estimate the impact of CBME on the educational environment of medical students and to compare the university examination outcomes after the introduction of CBME with the antecedent non-CBME batch. Methods: A cross-sectional study was carried out among all the students (197) of the CBME and preceding non-CBME batch of a medical college in central Kerala. The educational environment was collected in the online platform with a standard questionnaire, Dundee Ready Education Environmental Measure (DREEM questionnaire) in 5 domains: perception of learning, perception of teachers, student’s academic self-perception (ASP), perceptions of atmosphere, and social self-perception (SSP). Results: The overall DREEM score was found to be significantly higher at 122.7 in the CBME batch compared to 112.8 in the non-CBME batch (P < .002). The individual mean domain scores of “perceptions of learning” was the highest at 30.39 ± 5.17 followed by “student’s perception of atmosphere” with a mean score of 29.53. Perception of learning, ASP, perception of atmosphere, and SSP were statistically significantly higher in CBME (2019) batch. The proportion of failures was significantly higher in the non-CBME batch, and among those with distinction, 3 out of 4 students were from CBME batch. The DREEM score was also significantly correlated with the university marks score. Conclusion: It appears that the CBME batch is performing better than the previous non-CBME batch and also has a better educational environment, though larger studies are necessary to further examine this phenomenon.
The ShortversusLong Antibiotic Course for Pleural Infection Management (SLIM) randomised controlled open-label trial
Authors: Hassan Maged , Gad-Allah Mohamed , El-Shaarawy Basma , El-Shazly Asmaa M. , Daneshvar Cyrus , Sadaka Ahmed S.
Published: February 2023

Introduction

Based on expert opinion, the length of antibiotic treatment for pleural infection in adults is typically recommended to be a minimum of 4 weeks. This clinical trial aimed to assess whether shorter antibiotic courses lead to more treatment failures than standard longer courses.

Methods

In an open-label randomised controlled trial, adult patients with pleural infection who were medically treated and stabilised within 14 days of admission were randomised to either a short antibiotic course (total course 14–21 days) or a long antibiotic course (total course 28–42 days). Patients were excluded if their baseline RAPID score was >4 (high-risk category). The primary outcome was the incidence of treatment failure by 6 weeks post-admission. Secondary outcomes were total length of antibiotic treatment, proportion of patients who resumed normal activity levels within 6 weeks post-admission, time from discharge to resuming normal activity levels and incidence of antibiotic-related adverse reactions.

Results

Between September 2020 and October 2021, 50 patients (mean±sdage 46±13.7 years; 35 (70%) males) were recruited to the trial and randomly assigned to the short course group (n=25) or the long course group (n=25), with outcome data available for 24 patients in each study group. Treatment failure occurred in four (16.7%) patients in the short course group and three (12.5%) patients in the long course group. In the intention-to-treat analysis the OR for treatment failure in the long course group was 0.714 (95% CI 0.142–3.600; p=0.683). The median (interquartile range) duration of antibiotic treatment in the short course group was 20.5 (18–22.5) days compared with 34.5 (32–38) days in the long course group (p<0.001). There were no statistically significant differences in the other outcomes.

Conclusions

In medically treated adult patients with pleural infection a long course of antimicrobial therapy did not lead to fewer treatment failures compared with a shorter course. These findings need to be confirmed in a larger multicentre trial.
A copper foam-based surface-enhanced Raman scattering substrate for glucose detection
Authors: Peng Wang , Xu Zhihan , Jia Xiangting , Liao Qingxi
Published: February 2023

Raman spectroscopy can quickly achieve non-destructive, qualitative and quantitative detection, and analysis the molecular structure of substances. Herein, a facile and low-cost method for preparation of highly sensitivity SERS substrates was implemented through the displacement reaction of copper foam immersed in AgNO3 ethanol solution. Due to the 3D structure of copper film and homogenous displacement, the Ag–Cu substrate showed high performance SERS enhancement (1.25 × 107), and the lowest detection concentration for R6G reached 10–10 Mol/L. For glucose detection, mixed decanethiol (DT)/mercaptohexanol (MH) interlayer was used to enable glucose attach to the substrate surface, and the limit of detection reached to 1 uM/L. SERS substrate makes the Ag–Cu SERS substrate promising for biological applications.
Influence of inflammation on bleeding and wound healing following surgical extraction of impacted lower third molars
Authors: Cheng Yusheng , Al-Aroomi Maged Ali , Al-Worafi Naseem Ali , Al‑Moraissi Essam Ahmed , Sun Changfu
Published: February 2023

Objective

This study aimed to investigate the effect of inflammatory states following impacted lower third molar (ILTM) surgery regarding postoperative bleeding and wound healing.

Methods

The study included patients who underwent extraction of ILTMs associated with or without inflammatory conditions. Post-extraction bleeding and wound healing were assessed. In addition, mean grey values (MGVs) of alveolar bone and bone height using an orthopantomography radiograph were analyzed.

Results

A total of 376 patients were enrolled; 171 pericoronitis, 51 pulpitis, 44 chronic periapical periodontitis, 36 chronic periodontitis, and 74 control. The bleeding score in the control group was significantly lower than in the periapical periodontitis and periodontitis groups. Excellent wound healing for control, pericoronitis, pulpitis, periapical periodontitis, and periodontitis groups was (78.38%, 35.67%, 70.59%, 70.45%, and 33.33%, respectively). Patients with pericoronitis and periodontitis had significantly poorer wound healing (P < 0.01). The MGV in periapical periodontitis and periodontitis was considerably lower than in the control group.

Conclusions

The inflammatory conditions associated with ILTMs increase the risk of bleeding. So suturing with the placement of local hemostatic agents over a pressure pack alone is recommended. The poorest wound healing was in localized gingival inflammation. Furthermore, MGV was affected by age and was lower with periapical periodontitis.
Need for integration of hepatitis C (HCV) services in community-based settings for people who inject drugs: results from a global values and preferences survey
Authors: Di Ciaccio M. , Villes V. , Perfect C. , El Kaim J. L. , Donatelli M. , James C. , Easterbrook P. , Delabre R. M.
Published: February 2023

Background

To inform the development of updated World Health Organization (WHO) guidelines on simplified service delivery for HCV infection, a global survey was undertaken among people affected or infected by HCV. The objective of this analysis is to identify specific needs and preferences among people who inject drugs.

Methods

A multi-country, anonymous, self-administered online survey conducted in 2021 was developed by Coalition PLUS and the World Hepatitis Alliance in partnership with the WHO. Preferences for test and treat locations and simplifying HCV care were collected among people affected or infected by HCV. Chi-square tests were used to compare respondents who identified with current or former injection drug users through identification with key population to other respondents who did not identify with this key population.

Results

Among 202 respondents, 62 (30.7%) identified with current/former injection drug users. Compared to other respondents, they were: older [median (IQR): 48 (36–57) vs. 39 (31–51) years,p = 0.003]; more likely to have been tested for HCV (90.2% vs. 64.3%,p = 0.001); more likely to prefer testing in a community-based centre (CBC) (55.4% vs. 33.3%,p = 0.005); or in a support centres for people who use drugs (SCPUD)(50.0% vs. 9.8%,p < 0.001). The most important considerations regarding testing locations among people identified with current/former injection drug users (compared to the other respondents) were: non-judgemental atmosphere (p < 0.001), anonymity (p = 0.018) and community worker (CW) presence (p < 0.001). People identified with current/former injection drug users were more likely to prefer to receive HCV treatment in a CBC (63.0% vs. 44.8%,p = 0.028) or in a SCPUD (46.3% vs. 9.5%,p < 0.001), compared to the other respondents. The most important considerations regarding treatment locations among people identified with current/former injection drug users were the non-stigmatising/non-judgemental approach at the site (p < 0.001) and the presence of community-friendly medical personnel or CW (p = 0.016 and 0.002), compared to the other respondents.

Conclusion

The preferences of people identified with current/former injection drug users indicated specific needs concerning HCV services. Integration of HCV services in community-based risk reduction centres may be an important element in the development of adapted services to increase uptake and retention in HCV care among this population.
Ultra-sensitive isotope probing to quantify activity and substrate assimilation in microbiomes
Authors: Kleiner Manuel , Kouris Angela , Violette Marlene , D’Angelo Grace , Liu Yihua , Korenek Abigail , Tolić Nikola , Sachsenberg Timo , McCalder Janine , Lipton Mary S. , Strous Marc
Published: February 2023

Background

Stable isotope probing (SIP) approaches are a critical tool in microbiome research to determine associations between species and substrates, as well as the activity of species. The application of these approaches ranges from studying microbial communities important for global biogeochemical cycling to host-microbiota interactions in the intestinal tract. Current SIP approaches, such as DNA-SIP or nanoSIMS allow to analyze incorporation of stable isotopes with high coverage of taxa in a community and at the single cell level, respectively, however they are limited in terms of sensitivity, resolution or throughput.

Results

Here, we present an ultra-sensitive, high-throughput protein-based stable isotope probing approach (Protein-SIP), which cuts cost for labeled substrates by 50–99% as compared to other SIP and Protein-SIP approaches and thus enables isotope labeling experiments on much larger scales and with higher replication. The approach allows for the determination of isotope incorporation into microbiome members with species level resolution using standard metaproteomics liquid chromatography-tandem mass spectrometry (LC–MS/MS) measurements. At the core of the approach are new algorithms to analyze the data, which have been implemented in an open-source software (https://sourceforge.net/projects/calis-p/). We demonstrate sensitivity, precision and accuracy using bacterial cultures and mock communities with different labeling schemes. Furthermore, we benchmark our approach against two existing Protein-SIP approaches and show that in the low labeling range used our approach is the most sensitive and accurate. Finally, we measure translational activity using 18O heavy water labeling in a 63-species community derived from human fecal samples grown on media simulating two different diets. Activity could be quantified on average for 27 species per sample, with 9 species showing significantly higher activity on a high protein diet, as compared to a high fiber diet. Surprisingly, among the species with increased activity on high protein were several Bacteroides species known as fiber consumers. Apparently, protein supply is a critical consideration when assessing growth of intestinal microbes on fiber, including fiber-based prebiotics.

Conclusions

We demonstrate that our Protein-SIP approach allows for the ultra-sensitive (0.01 to 10% label) detection of stable isotopes of elements found in proteins, using standard metaproteomics data.
Alleviation of the adverse effects of NaCl stress on tomato seedlings (Solanum lycopersicum L.) by Trichoderma viride through the antioxidative defense system
Authors: Metwally Rabab A. , Soliman Shereen A.
Published: February 2023

Background

Trichoderma viride are well known for their biocontrol capabilities, but little is known about how they stimulate plant development and increase their resistance to salt stress. One of the main abiotic factors limiting crop development and yield is salt stress. Therefore, the purpose of this work was to ascertain how NaCl effects on T. viride growth as well as on the seedlings morphological and physio-biochemical parameters of tomato (Solanum lycopersicum L.) under plate culture conditions. Additionally, a pot experiment was conducted to determine how T. viride affected the development characteristics of tomato plants subjected to various salt concentrations (50 and 100 mM NaCl). T. viride's contribution to tomato seedling stress tolerance was also closely examined.

Results

Results showed that 100 mM NaCl decreased the colony diameter of T. viride by 13.4% compared to the control. Under plate and greenhouse conditions, tomato seedlings exposed to salt exposure exhibited an overall decline in growth. Also, a reduction in relative water content (RWC) and protein contents occurred under salt stress. At the same time, increases were found in proline, total phenolics, flavonoids, H2O2 content, malondialdehyde, likewise the activities of peroxidase (POD), catalase (CAT), polyphenol oxidase (PPO), and ascorbate peroxidase (APX) enzymes. Even though, with T. viride application, the salt negative effects on both morphological and physio-biochemical parameters were mitigated to a greater extent. T. viride increased proline and total antioxidant capacity (TAC) in tomato seedlings at 100 mM NaCl by an average of 20.66 and 43.82% compared to their comparable control. T. viride increased the activities of CAT, PPO, and APX enzymes by 74.6, 58.48, and 61.61% at 50 mM NaCl compared to non-saline control seedlings. As well, T. viride decreased MDA and H2O2 contents by an average of 14 and 24.8% in tomato seedlings at 50 mM NaCl compared to their comparable control. Also, under 100 mM NaCl, the T. viride-treated tomato seedlings showed increased total phenolics (17.85%) and flavonoids (33.17%) compared to non- treated one.

Conclusion

Hence, our research sheds new insight on the pathways by which T. viride can boost tomato seedling tolerance to salt stress at morphological and physio-biochemical levels by activating both enzymatic and non-enzymatic antioxidant defense systems.
Using an ensemble machine learning model to delineate groundwater potential zones in desert fringes of East Esna-Idfu area, Nile valley, Upper Egypt
Authors: Morgan Hesham , Madani Ahmed , Hussien Hussien M. , Nassar Tamer
Published: February 2023

The effects of climate change and rapid population growth increase the demand for freshwater, particularly in arid and hyper-arid environments, considering that groundwater is an essential water resource in these regions. The main focus of this research was to generate a groundwater potential map in the Center Eastern Desert, Egypt, using a random forest classification machine learning model. Based on satellite data, geological maps and field survey, fifteen effective features influencing groundwater potentiality were created. These effective features include elevation, slope angle, slope aspect, terrain ruggedness index, curvature, lithology, lineament density, distance from major fractures, topographic wetness index, stream power index, drainage density, rainfall, as well as distance from rivers and channels, soil type and land use/land cover. Collinearity analysis was used for feature selection. A 100 dependent points (57 water points and 43 non-potential mountainous areas) were labeled and classified according to hydrogeological conditions in the three main aquifers (Basement, Nubian and Quaternary Aquifers) in the study area. The random forest algorithm was trained using (70%) of the dependent points. Then, it was validated using (30%) and the hyper-parameters were optimized. Groundwater potential map was predicted and classified as good (5.1%), moderate (0.1%), poor (4.2%) and non-potentiality (90.6%). Sensitivity (92%), F1-score (94%) and accuracy (97%) are validation methods used due to the imbalanced dataset problem. The most important effective features for groundwater potential map were determined based on the random forest and the receiver operating characteristics curve. Groundwater management sustainability was discussed based on the predicted groundwater potential map and aquifer conditions. Therefore, the random forest model is helpful for delineating groundwater potential zones and can be used in similar locations all over the world.
Free‐floating medial meniscus implant kinematics do not change after simulation of medial open‐wedge high tibial osteotomy and notchplasty
Authors: Sukopp Matthias , Shemesh Maoz , Pruech Elena , Linder‐Ganz Eran , Hacker Scott , Condello Vincenzo , Schwer Jonas , Ignatius Anita , Dürselen Lutz , Seitz Andreas Martin
Published: February 2023

Purpose

The purpose of this in‐vitro study was to examine the kinematics of an artificial, free‐floating medial meniscus replacement device under dynamic loading situations and different knee joint states.

Methods

A dynamic knee simulator was used to perform dynamic loading exercises on three neutrally aligned and three 10° valgus aligned (simulating a medial openwedge high tibial osteotomy ‐ MOWHTO) left human cadaveric knee joints. The knee joints were tested in three states (intact, conventional notchplasty, extended notchplasty) while 11 randomised exercises were simulated (jump landing, squatting, tibial rotation and axial ground impacts at 10°, 30° and 60° knee joint flexion) to investigate the knee joint and implant kinematics by means of rigidly attached reflective marker sets and an according motion analysis.

Results

The maximum implant translation relative to the tibial plateau was < 13 mm and the maximum implant rotation was < 19° for all exercises. Both, the notchplasties and the valgus knee alignment did not affect the device kinematics.

Conclusions

The results of the present in‐vitro study showed that the non‐anchored free‐floating device remains within the medial knee joint gap under challenging dynamic loading situations without indicating any luxation tendencies. This also provides initial benchtop evidence that the device offers suitable stability and kinematic behaviour to be considered a potential alternative to meniscus allograft transplantation in combination with an MOWHTO, potentially expanding the patient collective in the future.
Mesentero-axial gastric volvulus treated with laparoscopic gastropexy: a case report
Authors: Kawahara Masato , Maruyama Tsunehiko , Kaneko Yoshiki , Konno Naoaki , Kashimura Hiroshi , Oda Tatsuya
Published: February 2023

Background

Mesentero-axial gastric volvulus (MAGV) is an uncommon subtype of gastric volvulus (GV). However, reports of such cases in adult patients are very rare. We present an unusual case of idiopathic MAGV in an old woman.

Case presentation

An 84-year-old woman was referred to the emergency department for vomiting and abdominal pain. An abdominal computed tomography scan revealed a mesentero-axial gastric volvulus, which could be corrected endoscopically, and the symptoms were relieved. Contrast-enhanced examination was performed before the elective surgery to confirm the presence of short-axis dorsal 180-degree volvulus. The patient underwent laparoscopic surgery on a wait-and-watch basis. After releasing the torsion, the stomach returned to normal position. The gastric fornix was sutured to the left diaphragm and the gastric body and antrum were sutured to the abdominal wall using non-absorbable thread. Symptoms did not flare after the surgery.

Conclusions

We experienced a rare case of adult MAGV presenting with incomplete obstruction. Laparoscopic gastropexy is useful when gastric decompression is achieved.
Drug-loaded microbubble delivery system to enhance PD-L1 blockade immunotherapy with remodeling immune microenvironment
Authors: Zheng Jun , Huang Ju , Zhang Liang , Wang Mengna , Xu Lihong , Dou Xiaoyun , Leng Xiaojing , Fang Mingxiao , Sun Yang , Wang Zhigang
Published: February 2023

Background

Although programmed cell death protein 1 (PD-1)/ programmed cell death-ligand protein 1 (PD-L1) checkpoint blockade immunotherapy demonstrates great promise in cancer treatment, poor infiltration of T cells resulted from tumor immunosuppressive microenvironment (TIME) and insufficient accumulation of anti-PD-L1 (αPD-L1) in tumor sites diminish the immune response. Herein, we reported a drug-loaded microbubble delivery system to overcome these obstacles and enhance PD-L1 blockade immunotherapy.

Methods

Docetaxel (DTX) and imiquimod (R837)-loaded microbubbles (RD@MBs) were synthesized via a typical rotary evaporation method combined with mechanical oscillation. The targeted release of drugs was achieved by using the directional "bursting" capability of ultrasound-targeted microbubble destruction (UTMD) technology. The antitumor immune response by RD@MBs combining αPD-L1 were evaluated on 4T1 and CT26 tumor models.

Results

The dying tumor cells induced by DTX release tumor-associated antigens (TAAs), together with R837, promoted the activation, proliferation and recruitment of T cells. Besides, UTMD technology and DTX enhanced the accumulation of αPD-L1 in tumor sites. Moreover, RD@MBs remolded TIME, including the polarization of M2-phenotype tumor-associated macrophages (TAMs) to M1-phenotype, and reduction of myeloid-derived suppressor cells (MDSCs). The RD@MBs + αPD-L1 synergistic therapy not only effectively inhibited the growth of primary tumors, but also significantly inhibited the mimic distant tumors as well as lung metastases.

Conclusion

PD-L1 blockade immunotherapy was enhanced by RD@MBs delivery system.
The challenge of cognitive science for medical diagnosis
Authors: Croskerry Pat , Campbell Samuel G. , Petrie David A.
Published: February 2023

The historical tendency to view medicine as both an art and a science may have contributed to a disinclination among clinicians towards cognitive science. In particular, this has had an impact on the approach towards the diagnostic process which is a barometer of clinical decision-making behaviour and is increasingly seen as a yardstick of clinician calibration and performance. The process itself is more complicated and complex than was previously imagined, with multiple variables that are difficult to predict, are interactive, and show nonlinearity. They appear to characterise a complex adaptive system. Many aspects of the diagnostic process, including the psychophysics of signal detection and discrimination, ergonomics, probability theory, decision analysis, factor analysis, causal analysis and more recent developments in judgement and decision-making (JDM), especially including the domain of heuristics and cognitive and affective biases, appear fundamental to a good understanding of it. A preliminary analysis of factors such as manifestness of illness and others that may impede clinicians’ awareness and understanding of these issues is proposed here. It seems essential that medical trainees be explicitly and systematically exposed to specific areas of cognitive science during the undergraduate curriculum, and learn to incorporate them into clinical reasoning and decision-making. Importantly, this understanding is needed for the development of cognitive bias mitigation and improved calibration of JDM in clinical practice.
Red and blue states: dichotomized maps mislead and reduce perceived voting influence
Authors: Furrer Rémy A. , Schloss Karen , Lupyan Gary , Niedenthal Paula M. , Wood Adrienne
Published: February 2023

In the United States the color red has come to represent the Republican party, and blue the Democratic party, in maps of voting patterns. Here we test the hypothesis that voting maps dichotomized into red and blue states leads people to overestimate political polarization compared to maps in which states are represented with continuous gradations of color. We also tested whether any polarizing effect is due to partisan semantic associations with red and blue, or if alternative hues produce similar effects. In Study 1, participants estimated the hypothetical voting patterns of eight swing states on maps with dichotomous or continuous red/blue or orange/green color schemes. A continuous gradient mitigated the polarizing effects of red/blue maps on voting predictions. We also found that a novel hue pair, green/orange, decreased perceived polarization. Whether this effect was due to the novelty of the hues or the fact that the hues were not explicitly labeled “Democrat” and “Republican” was unclear. In Study 2, we explicitly assigned green/orange hues to the two parties. Participants viewed electoral maps depicting results from the 2020 presidential election and estimated the voting margins for a subset of states. We replicated the finding that continuous red/blue gradient reduced perceived polarization, but the novel hues did not reduce perceived polarization. Participants also expected their hypothetical vote to matter more when viewing maps with continuous color gradations. We conclude that the dichotomization of electoral maps (not the particular hues) increases perceived voting polarization and reduces a voter’s expected influence on election outcomes.
Assessing structural integrity of the pyramidal tracts with diffusion spectrum imaging to predict postoperative motor function in pediatric epilepsy patients with hemispherectomy
Authors: Zhang Huaqiang , Wei Penghu , Lu Chao , Wang Zhenming , Fan Xiaotong , Shan Yongzhi , Zhao Guoguang
Published: February 2023

Background

Hemispherectomy is an effective treatment option for patients with drug-resistant epilepsy caused by hemispheric lesions. However, patients often have deterioration of their motor functions postoperatively. Diffusion spectrum imaging (DSI) was reliable in presenting the natural shape of the white matter fibers. At the same time, the natural sprawl pyramid tract (PT) might be more intuitive for predicting postoperative motor functions. Therefore, we assessed the motor functions by the natural shape revealed by DSI tractography.

Methods

Ten children with drug-resistant epilepsy who were candidates for hemispherectomy performed DSI PTs tractography and transcranial magnetic stimulation (TMS) for motor mapping. The motor function was evaluated with muscle strength and hand grasping capability. Pyramidal tract (PT) structural integrity and TMS mapping results were compared between patients who remained stable and those with deteriorated motor functions. Receiver operating characteristic (ROC) curves with PTs asymmetric ratio were analyzed to evaluate DSI tractography diagnostic value.

Results

All patients underwent DSI acquisition, while four patients successfully performed TMS. One patient had no response to TMS until the maximal machine output was reached. Four patients failed to perform TMS due to lacking cooperation. One patient was contraindicated to TMS. DSI successfully reconstructed the sharp angle fan-shaped PTs within the hemisphere. The accurate fiber distribution with fiber termination and thickness within the lesioned hemisphere was replicated with DSI tractography. No significance was found in patients’ age, sex, seizure frequency, or medication between patients with stable or deteriorated postoperative motor functions. DSI effectively predicted postoperative motor function as stable with damaged PTs, mild deterioration with atrophied PTs, and intact PTs with contralateral innervation confirmed by intracranial stimulation. The area under the curve (AUC) of DSI tractography was 0.84. According to ROC, the cut-off value of PTs asymmetric ratio was 11.5% with 100% sensitivity and 75% specificity. The sensitivity and specificity of TMS were 2/3 and 1/2, respectively.

Conclusions

The anatomic integrity of PTs with DSI tractography could effectively predict postoperative motor function after hemispherectomy. This enables neurosurgeons to inform patients and relatives about postoperative motor functions with direct morphological evidence of PTs to help them with their surgical decisions.
Effect of hepatic fat fraction on major hepatocellular carcinoma features at magnetic resonance imaging
Authors: Osman Mohamed Fouad , Mohammed Ahmed Ramadan , Gadalla Amr Abd Elfattah Hassan , Ali Mohammed Mahmoud Abdelhamid , Mahmoud Bahaa Eldin
Published: February 2023

Background

Hepatocellular carcinoma (HCC) is the fifth most frequent cancer on the world. Fat accumulation within hepatocytes is known as hepatic steatosis. In recent years, research has found that people with non-alcoholic fatty liver disease have a higher chance of developing HCC. The LI-RADS® (Liver Imaging Reporting and Data System) was created to facilitate consistent reporting of imaging findings in patients at risk of HCC. The aim of this study was to see how hepatic fat fraction affects the LI-RADS major HCC features on magnetic resonance imaging (MRI).

Results

All HCCs (92/92; 100%) showed arterial phase hyperenhancement (APHE); however, a significant association between hepatic steatosis and late APHE was found. Encapsulation was observed in 51 HCC (55.4%); in hepatic steatosis patients 17 HCC (37.8%) displayed enhancing capsule in delayed phase of the study, compared to 34 HCC (72.3%) in non-steatotic patients. The HCC size ranged from 11 to 200 mm (Mean 42.2 ± 51.8 mm) in the hepatic steatosis group; however, in patients with negative hepatic steatosis the size ranged from 13 to 205 (Mean 62.9 ± 54.5 mm).

Conclusions

Hepatic steatosis had a significant association with absent enhancing capsule, late arterial enhancement, as well as a lesion size less than 50 mm. “Fat sparing in solid mass” and "non-enhancing capsule" ancillary features had a significant association with hepatic steatosis, while “mild–moderate T2 hyperintensity” and “fat in mass, more than adjacent liver” ancillary features had a significant association with absent hepatic steatosis.
Shear wave elastography versus strain elastography to identify benign superficial lymph nodes: sonographic assessment with histopathological confirmation
Authors: Kerim Amr A. Abdel , Abd Amr M. El , Naguib Nagy N. , Guimei Maha , Emara Doaa M.
Published: February 2023

Background

Differentiation between benign and malignant superficial lymph nodes (LNs) presents clinical dilemma. No specific criteria are established with conventional ultrasound to make a distinction. We aimed to study the added value of shear wave velocity (SWV) measurement with acoustic radiation force impulse (ARFI) and strain elastography (SE) to identify benign superficial LNs. The study included 115 superficial LNs subjected to conventional ultrasonography, 4-scale strain elastography and shear wave velocity measurement using ARFI. Histopathological analysis was obtained for all examined nodes.

Results

SE correctly diagnosed 89.3% of the reactive and 92.2% of the metastatic LNs and erroneously diagnosed 72.7% of the lymphoma LNs as being benign. Overall sensitivity, specificity, PPV, NPV and accuracy were 74.4%, 73%, 85.3%, 57.4% and 73.9%, respectively. The receiver operating curve analysis of SWV measurement using ARFI revealed a cut-off value of ≥ 2.70 m/sec to recognize malignant LNs and to obtain best sensitivity (88.5%) and specificity (89.2%) (Area under the curve: 0.819, 95% confidence interval (CI): 0.744 and 0.894). The PPV, NPV and accuracy were 94.5%, 78.6% and 88.7%, respectively. As compared to SE, ARFI boosted the diagnostic accuracy of lymphoma LNs from 27.3 to 68.2% and showed better specificity and NPV to identify benign LN as contrasted to SE.

Conclusions

SE could be adequate to differentiate reactive from metastatic LN but not from Lymphomas. Shear wave elastography is a reasonable imaging modality to identify benign lymph nodes. ARFI at a cut-off value of < 2.7 m/sec was superior to SE and the best B-mode features.
Association between histamine 2 receptor antagonists and sepsis outcomes in ICU patients: a retrospective analysis using the MIMI-IV database
Authors: Firzli Tarek R. , Sathappan Sunil , Antwi-Amoabeng Daniel , Beutler Bryce D. , Ulanja Mark B. , Madhani-Lovely Farah
Published: February 2023

Background

Sepsis is marked by elevated histamine, which is a vasodilator that increases vascular permeability. Although human studies are lacking, murine models of sepsis have indicated potential protective effects of histamine 2 receptor antagonist administration (H2RAs).

Objective

To assess any association between H2RA use in sepsis-3 patients admitted to the ICU and mortality, mechanical ventilation, length of stay, and markers of renal, liver, and lung dysfunction.

Design

Retrospective cohort study.

Setting

Intensive care units of the Beth Israel Deaconess Medical Center (BIDMC) accessed via the MIMIC-IV database spanning an 11-year period from 2008 to 2019.

Patients (or participants)

A total of 30,591 patients met the inclusion criteria for sepsis-3 on admission (mean age 66.49, standard deviation 15.92).

Main measures

We collected patient age, gender, ethnicity, comorbidities (contained within the Charlson comorbidity index), SOFA score, OASIS score, APS III score, SAPS II score, H2RA use, creatinine, BUN, ALT, AST, and P/F ratios. Primary outcomes were mortality, mechanical ventilation, and ICU length of stay.

Key results

A total of 30,591 patients met inclusion criteria over the 11-year sample period. The 28-day in hospital mortality rate was significantly lower among patients who received an H2RA (12.6% vs 15.1%, p < 0.001) as compared to those who did not receive an H2RA. Patients receiving an H2RA had significantly lower adjusted odds of mortality (0.802, 95% CI 0.741–0.869, p < 0.001), but significantly higher adjusted odds of invasive mechanical ventilation (4.426, 95% CI 4.132–4.741, p < 0.001) and significantly higher ICU LOS (3.2 days vs. 2.4 days, p < 0.001) as compared to the non-H2RA group. H2RA use was also associated with decreased severity of acute respiratory distress syndrome (ARDS) and lower serum creatinine.

Conclusion

Among patients hospitalized in the ICU for sepsis, the use of an H2RA was associated with significantly lower odds of mortality, decreased severity of ARDS, and a lower incidence of renal insufficiency.
Clinical Administration Characteristics of Subcutaneous and Intravenous Administration of Daratumumab in Patients With Multiple Myeloma at Mayo Clinic Infusion Centers
Authors: Soefje Scott A. , Carpenter Corinne , Carlson Katherine , Awasthi Samir , Lin Thomas S. , Kaila Shuchita , Tarjan Daniel , Kayal Nikhil , Kirkup Christian , Wagner Tyler E. , Gray Kathleen S. , Kumar Shaji
Published: February 2023

PURPOSE:

Median duration of daratumumab (DARA) administration for treatment of multiple myeloma is 3-7 hours for the intravenous formulation (DARA IV) and 3-5 minutes for the subcutaneous formulation (DARA SC). Here, we describe clinical administration characteristics of DARA using a novel method for data extraction from electronic health records.

METHODS:

Time-based measurements were extracted using a scheduling/pharmacy software program that tracked patient movement through appointments for patients initiating DARA in Mayo Clinic infusion centers from April 5, 2017, to October 14, 2021. Cohorts included patients who received DARA IV or DARA SC, or converted from DARA IV to DARA SC. The DARA SC cohort was further analyzed before (DARA SC initial) and after (DARA SC shortened) a reduction in the postadministration observation time mandated by the treatment plan. Events associated with administration-related reactions (ARRs) were also identified.

RESULTS:

Median total clinic times were 2.7-3.0 hours shorter for DARA SC versus DARA IV. Median clinic times were highest at dose 1 and decreased with subsequent doses. Median total chair times were 2.7-2.8 hours shorter for DARA SC versus DARA IV. Incidences of ARR-related events with DARA SC were low across doses.

CONCLUSION:

Reduced clinic times were observed with DARA SC, indicating that use of DARA SC as a treatment option results in time savings that may free clinic resources. Furthermore, novel methods of electronic health record data extraction can provide insights that may help inform clinic resource optimization.
Development and feasibility testing of action observation training videos in acute stroke survivors: Preliminary findings
Authors: Biswas Arunima , Natarajan Manikandan , Subramanian Sandeep K , Solomon John M.
Published: February 2023

Background: Action observation training (AOT) is used for lower limb (LL) stroke rehabilitation in subacute and chronic stages, but concise information regarding the types of activities to be used and the feasibility of administration in the acute stroke population is unknown. The aim of this study was to develop and validate videos of appropriate activities for LL AOT and test administrative feasibility in acute stroke.  

Method: A video inventory of LL activities was created after a literature survey and expert scrutiny. Five stroke rehabilitation experts validated the videos per domains of relevance, comprehension, clarity, camera position and brightness. LL AOT was then tested on ten individuals with acute stroke for uncovering barriers for clinical use in a feasibility study. Participants watched the activities and attempted imitation of the same. Determination of administrative feasibility was undertaken via participant interviews.  

Results: Suitable LL activities for stroke rehabilitation were identified. Content validation of videos led to improvements in selected activities and video quality. Expert scrutiny led to further video processing to include different perspectives of view and speeds of projected movements. Barriers identified included inability to imitate actions shown in videos and increased distractibility for some participants.   

Conclusion: A video catalogue of LL activities was developed and validated. AOT was deemed safe and feasible for acute stroke rehabilitation and may be used in future research and clinical practice.
Use of ivermectin and factors associated with the prevention and/or treatment of COVID-19: a cross-sectional online survey in the province of Chincha, Peru
Authors: Salvador-Carrillo Jose , Campos-Loza Luz , Guillen-Carbajal David , Osada Jorge , Zevallos Alejandra , Torres-Roman J. Smith
Published: February 2023

Background: Peru has reported one of the highest mortality rates from COVID-19 worldwide. The Chincha province has been one of the most affected regions in Peru and the leading promoter of the use of ivermectin for the treatment of COVID-19. Therefore, our study aimed to evaluate the frequency of use and factors associated with the use of ivermectin for COVID-19 in Chincha.

Methods: A cross-sectional study was conducted during the second wave of COVID-19 in Peru. For statistical analyses, frequencies and percentages were reported. Prevalence ratios (PR) with a 95% confidence interval (CI), and a p-value of 0.05 were used to determine statistical significance. SPSS version 22 (IBM Corp) program was used for the analyses.

Results: A total of 432 participants were included in the study. A total of 67.6% (n = 292) of the participants used ivermectin during the COVID-19 pandemic. Of these, 20.20% (n=59) of the people used ivermectin for prophylactic purposes only, while 41.79% (n=122) used it as treatment for COVID-19 only, and 38.01% (n=111) used it for both reasons. The consumption of ivermectin was associated with being 50 years or older (PR:1.27, 95% CI:1.04–1.54), having a technical education level (PR:1.16, 95% CI:1.01–1.34), having had symptoms of COVID-19 with negative/no diagnosis (PR: 1.28, 95% CI: 1.07–1.53) or positive diagnosis (PR:1.38, 95% CI:1.18–1.61), or having had contact with infected people (PR:1.45, 95% CI:1.06–1.98).

Conclusions: Most people in Chincha used ivermectin during the second wave of the COVID-19 pandemic. The main factors associated with the use of ivermectin for the prevention/treatment of COVID-19 were age ≥50 years, having a technical education level, having had symptoms with negative/no diagnosis or positive diagnosis, and contact with people infected with SARS-CoV-2.
Identification of binding sites in nicastrin and binding modes of its inhibitors
Authors: Zinyama Ngceboyakwethu P , Guyo Upenyu , Mugumbate Grace
Published: February 2023

Background: Nicastrin is a confirmed breast cancer target, but the lack of knowledge about its binding sites and the structural basis of interactions with known small molecules makes the development of small molecules against it challenging.

Methods: Molecular docking and molecular dynamics simulations were used in this work to identify binding sites in nicastrin, a gamma-secretase component that has been implicated in breast cancer and a potential drug target in cancer chemotherapy.

Results: Docking calculations identified three binding sites, however binding site analysis using druggability assessment identified a region that encompasses the DYIGS motif, the DYIGS site as the most favorable binding site. This site was validated by a 50 ns molecular dynamic simulation with a known inhibitor CID44433923 and free energy of binding was found to be -11.4 kcal/mol and mainly driven by hydrophobic interactions. Per residue decomposition analysis showed that Gln139, Val138 and Arg105 had a relatively high contribution towards the free energy of binding. These results suggest that these residues might be critical in nicastrin inhibition. Binding mode analysis by docking previously reported nicastrin inhibitors identified residues Gln139, Val138 and Asp143 as key in the interactions.

Conclusions: This work affords an insight into the binding mechanism of small molecules and might direct drug design efforts towards nicastrin.
En el desvío
Authors: Petit-Laurent Charpentier Claudio Andrés
Published: February 2023

La propuesta visual "En el desvío" constituye una reflexión artística individual en torno al cuerpo masculino y a la propia masculinidad. Parte de la premisa de que las imágenes heredadas de los cuerpos implican tradicionalmente una identidad prefijada, en la que los guerreros, los héroes y otras idealizaciones conforman un único camino que se constituye en eje vertebrador a partir del cual se establecen comportamientos que no se ajustan al estándar establecido socialmente. En este sentido, Claudio Petit-Laurent nos ofrece en esta exposición la representación de una serie de cuerpos musculados colocados en situación de vulnerabilidad que simbolizan alternativas de comportamiento no prefijadas, así como la salida de un camino férreo establecido.
Editorial: calidad y valoración de literatura infantil para bibliotecas infantiles.
Authors: Jiménez Fernández Concepción María
Published: February 2023

A partir de las palabras de Cerrillo y Cañamares (2008) y las de Patte (2008) sobre la necesidad de ofrecer a los niños lecturas adecuadas y que valgan la pena, se analizan diferentes obras dirigidas al público infantil. En este sentido, se hace una revisión comparativa de varios textos profundizando en aquellos aspectos que sirven para diferenciar una obra de calidad de otra mediocre para configurar una biblioteca infantil ideal. Concluye este trabajo con algunas reflexiones sobre la importancia de saber seleccionar literatura de calidad para la infancia.
Introducción al número monográfico: música popular y educación literaria (ss. XX-XXI). Propuestas didácticas para E.S.O. y Bachillerato.
Authors: García Candeira Margarita
Published: February 2023

El monográfico que aquí presentamos pretende explorar las posibilidades y desafíos que supone el empleo pedagógico de la música popular en ESO y Bachillerato, a partir de algunas de sus manifestaciones genéricas más señaladas en la actualidad. Apoyándose en la apertura curricular de las últimas legislaciones educativas, se proponen diversas vías de aprovechamiento didáctico de la música popular, teniendo en cuenta no solo musicalizaciones de poemas sino, también, canciones tradicionales y producciones contemporáneas de géneros como el rap.