bluuebunny/crossref_metadata_2025 huggingface dataset:
Closing the digital divide: Developing a platform to conduct training, outreach, and education for employment skills
Authors: Johnson Sarah , Allen Jesse , Fernandez Lorena , Garikiparthy Veeravenkata , Renovato Laura , Land Maria , Favela Leticia , Becerra Karina , Belmares Ricardo , Holland Nathan , Chacon Jessica
Published: February 2023

El Paso, Texas, like many communities along the United States/Mexico border, suffers from a lack of access to many social determinants of health, especially in low-income neighborhoods. These long-standing problems have only been exacerbated by the COVID-19 pandemic. The Texas Tech University Health Sciences Center El Paso Health Education and Awareness Team (EP-HEAT) is an organization that was established with a focus on disseminating health information to the community. EP-HEAT received funding from Microsoft Corporation to facilitate technology education workshops for underserved populations. These workshops were held in English and Spanish and attempted to improve social determinants of health in the community which can be negatively exacerbated by a lack of digital inclusion. Community members who attended workshops completed a LinkedIn Learning Path, or both were offered an anonymous post-course survey with a mixed method questionnaire on how their knowledge of basic technology or job skills was improved by engaging with the provided workshops and learning paths. Overall, 80% of community members who participated in the workshops reported learning a new skill, and 91% of participants who started a LinkedIn Learning Path were able to finish. The workshops were well received by the community and highlighted the potential for these programs to enhance digital skills and upward workforce mobility.
Culminating Crises: Reflections and Learnings for Sustainable Development
Authors: Pawar Manohar
Published: February 2023

This article aims to reflect on culminating crises by analysing the impact of the COVID-19 pandemic, natural disasters, wars and conflicts and political-economy and discuss how these crises have affected sustainable development efforts with a view to suggesting some strategies. Drawing mainly from the secondary data and the author’s reflections, each of the four crises is analysed in terms of its negative and positive consequences. Then how these crises have affected sustainable development efforts, particularly the achievement of the sustainable development goals, is discussed. In the final section, seven strategies are suggested to culminate these crises.
Zinc for infection prevention in children with sickle cell anemia: a randomized double-blind placebo-controlled trial
Authors: Namazzi Ruth , Opoka Robert , Conroy Andrea L. , Datta Dibyadyuti , Tagoola Abner , Bond Caitlin , Goings Michael J. , Ryu Moon-Suhn , Cusick Sarah E. , Krebs Nancy F. , Jang Jeong Hoon , Tu Wanzhu , Ware Russell E. , John Chandy C.
Published: February 2023

Data from small clinical trials in the United States and India suggest zinc supplementation reduces infection in adolescents and adults with sickle cell anemia (SCA), but no studies of zinc supplementation for infection prevention have been conducted in children with SCA living in Africa. We conducted a randomized double-blind placebo-controlled trial to assess zinc supplementation for prevention of severe or invasive infections in Ugandan children 1.00-4.99 years with SCA. Of 252 enrolled participants, 124 were assigned zinc (10 mg) and 126 assigned placebo once daily for 12 months. The primary outcome was incidence of protocol-defined severe or invasive infections. Infection incidence did not differ between treatment arms (282 vs. 270 severe or invasive infections per 100 person-years, respectively, incidence rate ratio of 1.04 [95% confidence interval (CI), 0.81, 1.32, p=0.78]), adjusting for hydroxyurea treatment. There was also no difference between treatment arms in incidence of serious adverse events or SCA-related events. Children receiving zinc had increased serum levels after 12-months, but at study exit, 41% remained zinc deficient (<65 μg/dL). In post-hoc analysis, occurrence of stroke or death was lower in the zinc treatment arm (adjusted hazard ratio (95% CI), 0.22 (0.05, 1.00); p=0.05). Daily 10 mg zinc supplementation for 12 months did not prevent severe or invasive infections in Ugandan children with SCA, but many supplemented children remained zinc deficient. Optimal zinc dosing and the role of zinc in preventing stroke or death in SCA warrant further investigation. This trial was registered at clinicaltrials.gov as #NCT03528434.
Shared and distinct factors underlying in-hospital mobility of older adults in Israel and Denmark (97/100)
Authors: Zisberg Anna , Shadmi Efrat , Andersen Ove , Shulyaev Ksenya , Petersen Janne , Agmon Maayan , Gil Efrat , Gur-Yaish Nurit , Pedersen Mette Merete
Published: February 2023

Background

Low in-hospital mobility is widely acknowledged as a major risk factor in acquiring hospital-associated disabilities. Various predictors of in-hospital low mobility have been suggested, among them older age, disabling admission diagnosis, poor cognitive and physical functioning, and pre-hospitalization mobility. However, the universalism of the phenomena is not well studied, as similar risk factors to low in-hospital mobility have not been tested.

Methods

The study was a secondary analysis of data on in-hospital mobility that investigated the relationship between in-hospital mobility and a set of similar risk factors in independently mobile prior to hospitalization older adults, hospitalized in acute care settings in Israel (N = 206) and Denmark (N = 113). In Israel, mobility was measured via ActiGraph GT9X and in Denmark by ActivPal3 for up to seven hospital days.

Results

Parallel multivariate analyses revealed that a higher level of community mobility prior to hospitalization and higher mobility ability status on admission were common predictors of a higher number of in-hospital steps, whereas the longer length of hospital stay was significantly correlated with a lower number of steps in both samples. The risk of malnutrition on admission was associated with a lower number of steps, but only in the Israeli sample.

Conclusions

Despite different assessment methods, older adults’ low in-hospital mobility has similar risk factors in Israel and Denmark. Pre-hospitalization and admission mobility ability are robust and constant risk factors across the two studies. This information can encourage the development of both international standard risk evaluations and tailored country-based approaches.
Assessment of the phytochemical composition and antimicrobial properties of Tapinanthus bangwensis leaves hosted by the branches of Persea americana
Authors: Sakyiamah Maxwell Mamfe , Gordon Paa Kwesi , Bolah Peter , Baffour Prince Kyei , Ehun Ebenezer , Quasie Olga , Kumadoh Doris , Archer Mary-Ann , Mintah Susana Oteng , Appiah Alfred Ampomah
Published: February 2023

Background

Medicinal plants represent a valuable source for new effective and safe antimicrobial drugs making them an alternative therapy. Existing antimicrobial agents are costly and mostly associated with possible side effects. The aim of the present study therefore, was to assess the antimicrobial property and phytochemical composition of hydroethanolic extract of Tapinanthus bangwensis leaves and its fractions.

Method

T. bangwensis leaves (harvested from its host plant, Persea americana) was extracted by cold maceration with 70% ethanol and further fractionated with different organic solvents using the solvent partitioning method to obtain the crude extract, petroleum ether, chloroform, ethyl acetate and the resulting aqueous fractions. The phytochemical constituents of the extracts were screened and quantified. Also, the TLC of the extracts were analyzed to serve as a fingerprint. Using the agar diffusion and broth dilution methods, the antimicrobial properties of the extracts were assessed.

Results

The study showed that the hydroethanolic (70%) crude extract of T. bangwensis leaves and its fractions contain phenolic compounds, flavonoids, saponins, phytosterols and reducing sugars. The phytoconstituents were well extracted into the ethyl acetate fraction than the other fractions evidenced in the high levels (p < 0.0001) of saponins (66.47 ± 1.72% w/w), phenolic compounds (77.75 ± 1.06 mg/100 mg GAE) and flavonoids (44.34 ± 0.06 mg/100 mg QE) contents. From the antimicrobial studies, all the microorganisms tested exhibited varying degrees of susceptibility to the extracts with MIC values between 0.78 to 12.5 mg/mL. The crude extract of T. bangwensis leaves, its ethyl acetate and chloroform fractions also exhibited lethal antimicrobial activity with MLC between 6.25 to 50 mg/mL.

Conclusion

The crude extract of T. bangwensis leaves and its fractions demonstrated antimicrobial properties against Escherichia coli, Staphylococcus aureus, Staphylococcus saprophyticus and Candida albicans, thereby representing a potential source of natural antimicrobial agent. Further study is required to identify and isolate antimicrobial compounds from the plant for the development of the natural bioactive antimicrobial agents.
Neoadjuvant PD-1 blockade combined with chemotherapy is not superior to neoadjuvant chemotherapy alone in resectable locally advanced esophageal carcinoma
Authors: Cheng Daoan , Zhao Weiqing , Chen Rui , Li Dong , Tang Shuxian , Fang Cheng , Ji Mei
Published: February 2023

Background

Neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy followed by surgery has been recommended as standard treatment in patients with locally advanced esophageal cancer (LAEC). But the risk of tumor recurrence still remained, and many patients refused or abandoned radiotherapy because of the intolerable adverse effects in China. Neoadjuvant immunochemotherapy (nICT) followed by surgery has become an emerging treatment in patients with esophageal cancer. There was still no consensus on whether nICT was superior to nCT alone in patients with esophageal cancer.

Methods

In this retrospective study, patients with resectable esophageal cancer who received surgery after nICT (n=26, 40%) or nCT alone (n=39, 60%) were included. The patients were classified as nICT or nCT arm. The primary endpoints were pathological tumor response (PTR) and event-free survival (EFS). The different clinic-pathological features were compared by the Kruskal-Wallis test for continuous variables and the Chi-square (χ2) test for categorical variables. Kaplan-Meier curves were used to estimate EFS from the date of treatment to recurrence or death. All tests were 2-sided with a significative P-value defined <.05.

Results

Three (11.5%) of the 26 patients achieved pathological complete remission (pCR) in the nICT group, and four (10.3%) of the 39 patients achieved pCR in the nCT group, respectively (P=1.000). Six (23.1%) of the 26 patients achieved major pathological response (MPR) in the nICT group, and 11 (28.2%) of the 39 patients achieved MPR in the nCT group, respectively (P=0.645). Downstaging was achieved in 13 (44.8%) patients in the nICT group and 16 (55.2%) patients in the nCT group, respectively (P=0.732). To verify the tumor regression grade (TRG) results, we compared them with MPR and pCR, which showed a significant dependency (P< 0.001). Patients who achieved downgrading showed better MPR and pCR rates (P<0.001 and P =0.010). There was no significant difference in EFS between the nICT and nCT groups (HR=1.011, 95% CI: 0.421–2.425, P = 0.981).

Conclusions

Neoadjuvant PD-1 blockade combined with chemotherapy was not superior to chemotherapy alone for patients with resectable locally advanced esophageal carcinoma. However, more studies with long-term follow-up were needed to confirm this result.
Public conformism with health regulation is crumbling as COVID-19 becomes a chronic threat: Repeated Cross-sectional Studies
Authors: Bodas Moran , Wine Leora , Peleg Kobi
Published: February 2023

Background

The purpose of this study is to analyze the long terms trends in public attitudes toward the COVID-19 pandemic and compliance with self-quarantine regulations.

Methods

Repeated cross-sectional studies looking into data collected from nationally representative samples (N = 2568) of the adult population in Israel at five points in time representing the five morbidity waves of the COVID-19 pandemic. This study examined public trust in Israeli health regulations, levels of public panic, feelings of personal worry, and compliance with health regulations, specifically self-quarantine.

Results

Public trust in health regulations in January 2022 is at an all-time low (25%) compared to the maximum value of nearly 75% measured in March 2020. While reported worry is steadily reducing, the perception of public panic is increasing. In earlier rounds, public compliance with self-quarantine was reported close to 100%; however, it has dropped to 38% by January 2022 when compensation is not assumed. Regression analysis suggests that trust is a major predictor of compliance with health regulations.

Conclusions

The “fifth wave” of the COVID-19 pandemic brought about an all-time low in public trust in health regulations. The Israeli public, normally a highly compliant one, is showing signs of crumbling conformity.
ScRNA-seq and ST-seq in liver research
Authors: He Jia , Deng Chengxiang , Krall Leonard , Shan Zhao
Published: February 2023

Spatial transcriptomics, which combine gene expression data with spatial information, has quickly expanded in recent years. With application of this method in liver research, our knowledge about liver development, regeneration, and diseases have been greatly improved. While this field is moving forward, a variety of problems still need to be addressed, including sensitivity, limited capacity to obtain exact single-cell information, data processing methods, as well as others. Methods like single-cell RNA sequencing (scRNA-seq) are usually used together with spatial transcriptome sequencing (ST-seq) to clarify cell-specific gene expression. In this review, we explore how advances of scRNA-seq and ST-seq, especially ST-seq, will pave the way to new opportunities to investigate fundamental questions in liver research. Finally, we will discuss the strengths, limitations, and future perspectives of ST-seq in liver research.
Clinical outcomes in COVID-19 among patients with hypertension in the Philippine CORONA Study
Authors: Espiritu Adrian I. , Sucaldito Ma. Sergia Fatima P. , Ona Deborah Ignacia D. , Apor Almira Doreen Abigail O. , Sy Marie Charmaine C. , Anlacan Veeda Michelle M. , Jamora Roland Dominic G.
Published: February 2023

Objective

To describe the association between hypertension and clinical outcomes in a cohort of patients with coronavirus disease 2019 (COVID-19).

Design

Retrospective cohort study.

Setting

Thirty-seven (37) hospitals in the Philippines.

Patients

10,881 patients admitted for COVID-19 from February to December 2020.

Measurements and main results

Among the 10,881 patients included in the Philippine CORONA Study, 3647 (33.5%) had hypertension. On regression analysis adjusted for confounders (age group, sex, smoking history, diabetes, chronic cardiac disease, chronic kidney disease, chronic respiratory disease, chronic neurologic disease, chronic liver disease, HIV/AIDS, and malignancy), patients with hypertension had significantly greater odds of in-hospital mortality (OR 1.33, 95% CI 1.17–1.52), respiratory failure (OR 1.99, 95% CI 1.75–2.28), ICU admission (OR 2.16, 95% CI 1.90–2.45) and severe/critical disease (OR 1.57, 95% CI 1.41–1.75), compared to patients without hypertension. The time-to-event analysis with confounder adjustment also showed that hypertension was significantly associated with shorter time-to-event outcomes of in-hospital mortality (HR 1.13, 95% CI 1.01–1.26), respiratory failure (HR 1.86, 95% CI 1.65–2.10), and ICU admission (HR 1.99, 95% CI 1.76–2.23).

Conclusions

Our analysis of nationwide data confirmed previous findings that hypertension is an independent risk factor for worse clinical outcomes among patients hospitalized for COVID-19, with increased odds of in-hospital mortality, respiratory failure, ICU admission, and severe/critical COVID-19. More specific studies should be done to elucidate the impact of hypertension characteristics, such as chronicity, severity, drug therapy, and level of control on these clinical outcomes.
Effect of postoperative utilization of somatostatin on clinical outcome after definitive surgery for duodenal fistula
Authors: Tian Weiliang , Zhao Risheng , Luo Shikun , Xu Xi , Zhao Guoping , Yao Zheng
Published: February 2023

Purpose

To evaluate the effect of postoperative utilization of somatostatin after definitive surgery for duodenal fistula (DF) in preventing a recurrence.

Methods

Patients with definitive surgery for DF between January 2010 and December 2021 were categorized based on the utilization of somatostatin or not after the surgery. Patients in the Somatostatin group were matched to those in the Non-somatostatin group using propensity scores matching (PSM), so as to evaluate the effect of postoperative use of somatostatin by comparing the two groups.

Results

A total of 154 patients were divided into the in the Somatostatin group (84) and the Non-somatostatin group (70). Forty-three patients (27.9%) exhibited a recurrent fistula, with which the postoperative use of somatostatin was not associated (19 [22.6%] in the Somatostatin group and 24 (34.3%) in the Non-somatostatin group; unadjusted OR 0.56; 95% CI 0.28–1.14; P = 0.11). However, the postoperative usage of somatostatin served as a protective factor for developing into high-output recurrent fistula (eight (13.3%) in the Somatostatin group and 15 (25%) in the Non-somatostatin group; adjusted OR 0.39; 95% CI 0.15–0.93; P = 0.04). After PSM, the recurrent fistula occurred in 29.2% subjects (35/120). The postoperative usage of somatostatin was not associated with recurrent fistula (13 in PSM Somatostatin group vs. 22 in PSM Non-somatostatin group; unadjusted OR 0.48; 95% CI 0.21–1.07; P = 0.07), while its postoperative usage decreased the incidence of recurrent high-output fistula (5/60 in the PSM Somatostatin group, compared with 13/60 in the PSM Non-somatostatin group; adjusted OR 0.30; 95% CI 0.09–0.95).

Conclusion

Postoperative use of somatostatin could effectively reduce the incidence of recurrent high-output fistula, without association with overall incidence of postoperative recurrent fistula.
Prediction of hypotension during the alveolar recruitment maneuver in spine surgery: a prospective observational study
Authors: Min Ji Young , Chang Hyun Jae , Kim Sung Jun , Cha Seung Hee , Jeon Joon Pyo , Kim Chang Jae , Chung Mee Young
Published: February 2023

Background

Atelectasis can occur in many clinical practices. One way to prevent this complication is through the alveolar recruitment maneuver (ARM). However, hemodynamic compromise can accompany ARM. This study aims to predict ARM-induced hypotension using a non-invasive method.

Methods

94 American Society of Anesthesiologists physical status I–II patients aged 19 to 75 with scheduled spinal surgery were enrolled. After anesthesia, we performed a stepwise ARM. Data on perfusion index, mean arterial pressure, heart rate, pleth variability index, cardiac index, and stroke volume variation was collected before induction of anesthesia (T0), just before ARM (T1), at the start of ARM (T2), 0.5 min (T3), 1 min (T4), 1.5 min (T5, end of ARM), and 2 min after the beginning of ARM (T6). Hypotension was defined as when the mean arterial pressure at T5 decreased by 20% or more compared to the baseline. The primary endpoint is that the perfusion index measuring before induction of anesthesia, which reflects the patients’ own vascular tone, was correlated with hypotension during ARM.

Results

Seventy-five patients (79.8%) patients developed hypotension during ARM. The pre-induction persufion index (Pi) (95% confidence interval) was 1.7(1.4–3.1) in the non-hypotension group and 3.4(2.4–3.9) in the hypotension group. (p < 0.004) The hypotension group showed considerably higher Pi than the non-hypotension group before induction. The decrease of Pi (%) [IQR] in the non-hypotensive group (52.8% [33.3–74.7]) was more significant than in the hypotensive group. (36% [17.6–53.7]) (p < 0.05) The area under the receiver operating characteristic curve of Pi for predicting hypotension during ARM was 0.718 (95% CI 0.615–0.806; p = 0.004), and the threshold value of the Pi was 2.4.

Conclusion

A higher perfusion index value measuring before induction of anesthesia can be used to predict the development of hypotension during ARM. Prophylactic management of the following hypotension during ARM could be considered in high baseline Pi patients.
Mental simulations to facilitate teacher learning of ambitious mathematics instruction in coaching interactions
Authors: Walsh Marguerite E. , Witherspoon Eben B. , Schunn Christian D. , Matsumura Lindsay Clare
Published: February 2023

Background

Many studies have shown that ambitious, “student centered” approaches to STEM instruction benefit K-12 student learning. However, relatively little research has systematically investigated the learning processes that support teachers to skillfully enact these challenging pedagogies. In this study, we used a mixed-methods, case-comparison design to examine one kind of teacher learning routine, Mental Simulations for Teacher Reflection (MSTR), for advancing robust teacher learning in the context of one mathematics-focused instructional coaching intervention. Specifically, this study draws from a large, state-wide representative dataset to select carefully matched, contrasting cases to analyze the quality of coach–teacher conversations for teachers who showed very similar baseline instructional quality but then large differences in levels of improvement. We began by qualitatively coding detailed transcripts from selected coach–teacher pairs as they reflected on lesson artifacts (i.e., lesson plans, student work, and coach observations) using MSTR as an analytical lens. Next, quantitative analyses were conducted to determine the extent to which mental simulations characterized significant differences in the conversations of high- vs. low-instructional growth pairs. Lastly, additional qualitative analyses explored finer-grain distinctions in the quality of mental simulation talk in high- vs. low-growth pairs.

Results

Quantitative analyses showed high-growth pairs were significantly more likely to engage in mental simulation talk compared to their low-growth counterparts. Moreover, the high-growth pairs were much more likely to initiate (i.e., raise an instructional ambiguity or problem for discussion) as well as complete (i.e., generate and weigh alternative instructional strategies) a MSTR routine. Qualitative analyses further revealed that engaging teachers’ in-depth pedagogical reasoning to connect specific teaching moves to conceptual learning goals in mental simulations was a key distinction of the high-growth coaches.

Conclusions

These findings indicate MSTR captured meaningful variation in coaching quality in this context. Notably, all coaches discussed the same instructional topics with teachers (i.e., teaching–learning goals and dimensions) and engaged in the same training that did not explicitly include MSTR, suggesting the possibility that MSTR captured a more implicit process of effective coaches. This study thus offers insight into the ‘black box’ of teacher learning and how it can be supported in similar professional learning contexts.
Pre-eruptive dynamics at the Campi Flegrei Caldera: from evidence of magma mixing to timescales estimates
Authors: Petrelli Maurizio , Ágreda López Mónica , Pisello Alessandro , Perugini Diego
Published: February 2023

We review pre-eruptive dynamics and evidence of open-system behavior in the volcanic plumbing system beneath Campi Flegrei Caldera, together with estimates of magma residence time, magma ascent, and mixing-to-eruption timescales. In detail, we compile pre- and syn-eruptive dynamics reported in the literature for (a) the Campanian Ignimbrite ~ 40 ka, (b) the Neapolitan Yellow Tuff (~ 15 ka), and (c) the recent activity within the Phlegrean area. We first summarize geochemical and textural evidence (e.g., magma mixing, crystal disequilibria, vertical zonings, and isotopic records) of open-system behavior for the pyroclasts erupted in the last 40 ky at Campi Flegrei Caldera. We show that the fingerprint of open-system dynamics is ubiquitous in the deposits associated with the volcanic activity at the Campi Flegrei Caldera in the last 40 ky. Then, we describe the results of geophysical and petrological investigations that allow us to hypothesize the structure of the magma feeding system. We point to a trans-crustal magmatic feeding system characterized by a main storage reservoir hosted at ~ 9 km that feeds and interacts with shallow reservoirs, mainly placed at 2–4 km. Finally, we define a scenario depicting pre-eruptive dynamics of a possible future eruption and provide new constraints on timescales of magma ascent with a physical model based on magma-driven ascending dyke theory. Results show that considerably fast ascent velocities (i.e., of the order of m/s) can be easily achieved for eruptions fed by both shallow (i.e., 3–4 km) and deep (i.e., ~ 9 km) reservoirs. Comparing the results from experimental and numerical methods, it emerges that mixing-to-eruption timescales occurring at shallow reservoirs could be on the order of minutes to hours. Finally, we highlight the volcanological implications of our timescale estimates for magma ascent and mixing to eruption. In particular, explosive eruptions could begin with little physical ‘warning’, of the order of days to months. In this case, the onset of volatile saturation might provide pre-eruptive indicators.

Graphical Abstract
Lower gut dysbiosis and mortality in acute critical illness: a systematic review and meta-analysis
Authors: Evans Tess , Ali Umar , Anderton Ryan , Raby Edward , Manning Laurens , Litton Edward
Published: February 2023

Background

The human gastrointestinal tract harbours a complex multi-kingdom community known as the microbiome. Dysbiosis refers to its disruption and is reportedly extreme in acute critical illness yet its clinical implications are unresolved. The review systematically evaluates the association between gut dysbiosis and clinical outcomes of patients early in critical illness.

Methods

Following PRISMA guidelines, a prospectively registered search was undertaken of MEDLINE and Cochrane databases for observational studies undertaking metagenomic sequencing of the lower gastrointestinal tract of critically ill adults and children within 72 h of admission. Eligible studies reported an alpha diversity metric and one or more of the primary outcome, in-hospital mortality, or secondary clinical outcomes. After aggregate data were requested, meta-analysis was performed for four studies with in-hospital mortality stratified to high or low Shannon index.

Results

The search identified 26 studies for systematic review and 4 had suitable data for meta-analysis. No effect of alpha diversity was seen on in-hospital mortality after binary transformation of Shannon index (odds ratio 0.52, CI 0.12–4.98, I2 = 0.64) however certainty of evidence is low. Pathogen dominance and commensal depletion were each more frequently associated with in-hospital mortality, adverse clinical and ecological sequelae, particularly overabundance of Enterococcus.

Conclusions

There is a paucity of large, rigorous observational studies in this population. Globally, alpha diversity was dynamically reduced in early ICU admission in adults and children and was not associated with in-hospital mortality. The abundance of taxa such as Enterococcus spp. appears to offer greater predictive capacity for important clinical and ecological outcomes.
White-light crosslinkable milk protein bioadhesive with ultrafast gelation for first-aid wound treatment
Authors: Zhu Qinchao , Zhou Xuhao , Zhang Yanan , Ye Di , Yu Kang , Cao Wangbei , Zhang Liwen , Zheng Houwei , Sun Ziyang , Guo Chengchen , Hong Xiaoqian , Zhu Yang , Zhang Yajun , Xiao Ying , Valencak Teresa G. , Ren Tanchen , Ren Daxi
Published: February 2023

Background

Post-traumatic massive hemorrhage demands immediately available first-aid supplies with reduced operation time and good surgical compliance.
In-situ
crosslinking gels that are flexibly adapting to the wound shape have a promising potential, but it is still hard to achieve fast gelation, on-demand adhesion, and wide feasibility at the same time.

Methods

A white-light crosslinkable natural milk-derived casein hydrogel bioadhesive is presented for the first time. Benefiting from abundant tyrosine residues, casein hydrogel bioadhesive was synthesized by forming di-tyrosine bonds under white light with a ruthenium-based catalyst. We firstly optimized the concentration of proteins and initiators to achieve faster gelation and higher mechanical strength. Then, we examined the degradation, cytotoxicity, tissue adhesion, hemostasis, and wound healing ability of the casein hydrogels to study their potential to be used as bioadhesives.

Result

Rapid gelation of casein hydrogel is initiated with an outdoor flashlight, a cellphone flashlight, or an endoscopy lamp, which facilitates its usage during first-aid and minimally invasive operations. The rapid gelation enables 3D printing of the casein hydrogel and excellent hemostasis even during liver hemorrhage due to section injury. The covalent binding between casein and tissue enables robust adhesion which can withstand more than 180 mmHg blood pressure. Moreover, the casein-based hydrogel can facilitate post-traumatic wound healing caused by trauma due to its biocompatibility.

Conclusion

Casein-based bioadhesives developed in this study pave a way for broad and practical application in emergency wound management.
The digital competence of academics in higher education: is the glass half empty or half full?
Authors: Inamorato dos Santos Andreia , Chinkes Ernesto , Carvalho Marco A. G. , Solórzano Claudia M. V. , Marroni Lilian S.
Published: February 2023

This paper aims to evaluate and discuss the digital competence of academics at universities, to identify challenges and define recommendations for policy. This study was conducted through collaboration between the Joint Research Centre (JRC) of the European Commission and Metared of the Universia Foundation, surveying 30,407 participants who present the perceptions of their own digital competence levels. These self-reflections took place in universities in seven countries, namely Argentina, Brazil, Colombia, Chile, Peru, Mexico and Portugal, and used the Check-In tool, which consists of 22 questions based on the European Framework for the Digital Competence of Educators—or ‘DigCompEdu’ framework. A descriptive statistical analysis was performed, followed by a qualitative evaluation. Almost 70% of the academics have an average intermediate level of competence when the data is aggregated, with results varying in each DigCompEdu area according to the specific question asked. There is no significant difference between young and senior academics, as well as between men and women. The results present a discussion of whether the age and gender of educators and their work environment have an impact on their digital competence level, and at the same time highlights the areas in which educators perceive themselves to be most and least competent. It shows how the amount of institutional support that is offered affects the academics’ perceptions of their level of digital competence. On the basis of the results, recommendations are presented for higher-education institutions, with the aim of supporting the professional development of their academics.
Parental self-efficacy managing a child’s medications and treatments: adaptation of a PROMIS measure
Authors: Foster Carolyn C. , Blackwell Courtney K. , Kan Kristin , Morales Luis , Cella David , Shaunfield Sara
Published: February 2023

Purpose

Self-efficacy is important for managing chronic conditions; however, its measurement in pediatric healthcare settings remains rare. The goal of this project was to adapt an existing disease-agnostic adult self-efficacy patient reported outcome (PRO) measure to enhance suitability of items for measuring the self-efficacy of parents that manage their children’s health conditions.

Methods

We adapted the existing Patient-Reported Outcomes Measurement Information System® (PROMIS®) adult self-efficacy healthcare measure to parental voice. First, a targeted literature review informed rephrasing of the adult items and identification of new pediatric-specific content. The initial item pool was revised based on input from 12 multidisciplinary experts. Next cognitive interviews of adapted items were simultaneously conducted with English and Spanish-speaking parents of pediatric patients with a range of chronic and/or disabling conditions recruited from a Midwestern children’s hospital to finalize the measure.

Results

Findings resulted in an initial item pool of 33 pediatric-specific items which were narrowed to 31 draft items based on expert input. Parent cognitive interview findings (N = 26) informed further item reduction resulting in a final measure consisting of 30 items representing nine domains. Fourteen items are relevant to children regardless of condition severity (e.g., health care information/decision making; symptom identification/management) and 16 items are relevant to children with specific health care needs (e.g., medication usage, equipment).

Conclusion

We conducted a first step in developing a condition-agnostic, PRO measure of parental self-efficacy managing their children’s chronic and/or disabling conditions that is acceptable and understandable to English and Spanish-speaking parents.
The anti-tumor drug 2-hydroxyoleic acid regulates the oncogenic potassium channel Kv10.1
Authors: Morán-Zendejas Rita , Rodríguez-Menchaca Aldo A.
Published: February 2023

Background

2-hydroxyoleic acid (2OHOA) is a synthetic fatty acid with antitumor properties that alters membrane composition and structure, which in turn influences the functioning of membrane proteins and cell signaling. In this study, we propose a novel antitumoral mechanism of 2OHOA accomplished through the regulation of Kv10.1 channels. We evaluated the effects of 2OHOA on Kv10.1 channels expressed in HEK-293 cells by using electrophysiological techniques and a cell proliferation assay.

Results

2OHOA increased Kv10.1 channel currents in a voltage-dependent manner, shifted its conductance-voltage relationship towards negative potentials, and accelerated its activation kinetics. Moreover, 2OHOA reduced proliferation of cells that exogenously (HEK-293) and endogenously (MCF-7) expressed Kv10.1 channels. It is worth noting that the antiproliferative effect of 2OHOA was maintained in HEK-293 cells expressing a non-conducting mutant of Kv10.1 channel (Kv10.1-F456A), while it did not affect HEK-293 cells not expressing Kv10.1 channels, suggesting that 2OHOA interferes with a non-conducting function of Kv10.1 channels involved in cell proliferation. Finally, we found that 2OHOA can act synergistically with astemizole, a Kv10.1 channel blocker, to decrease cell proliferation more efficiently.

Conclusion

Our data suggest that 2OHOA decreases cell proliferation, at least in part, by regulating Kv10.1 channels.
Monkeypox outbreak in the post-eradication era of smallpox
Authors: Kandra Naga Vishnu , Varghese Anjaly Mary , Uppala Praveen Kumar , Uttaravelli Upendrarao , Lavanya Butti , Shabana S. K. M. , Somarouthu Venkata Saibaba , Balijepalli Murali Krishna
Published: February 2023

Human monkeypox (MPOX) which recently hit the headlines is a rare, emerging zoonotic disease, only next to smallpox yet never attended adequately to halt the epidemic outbreak threat. MPOX is caused byOrthopox virus, which is a double-stranded, linear DNA virus, transmitted from infected animals, commonly rodents to humans. Monkeypox is endemic to the tropical jungles in Central-West Africa; occasional cases reported in other nations could be due to people traveling from endemic regions of MPOX. Transmission may occur via direct contact with human body secretions, cutaneous or mucosal lesions in the mouth or throat or respiratory droplets, and contaminated objects. Typical MPOX symptoms are fever, lymphadenopathy, skin rashes, intense headache, muscle, back pain, etc. Lesions can range from a few to numerous and may be filled with clear or yellowish fluid that later dries up or crusts, eventually falling off. MPOX is often considered as infrequent and self-limiting; nonetheless, the latest sporadic reports call for urgent vigilance, precautionary preparedness, and immediate response. Paucity of the data available about MPOX virus diversity and incomplete information on validated management protocols instigate a sense of impending danger and loom large as a global health emergency. MPOX is a completely preventable infection, and this article will cater to the need for creating general awareness and developing cutting-edge surveillance measures to curtail the spread of the disease. Genomic investigations of new cases of MPOX must be undertaken to check for mutations which can lead to higher human susceptibility. Local health stakeholders and clinicians should emphasize early identification and give out appropriate treatment as per the existing protocol
Application of a rehabilitation program for executive functions in a sample of Egyptian children with learning disorder
Authors: Elhakeem Engy Samy , Ibrahim Soha Abd Elatif Ahmed , El-Maghraby Riham Mohamed , Fouad Ahmed Abd El Aal
Published: February 2023

Background

In recent years, significant progress has been made on ways to improve executive function (EF) skills for school readiness involving direct EF training and classroom educational programs. Due to the absence of a well-structured Arabic program for EF training in children, the rationale of this study is to implement a comprehensive, evidence-based intervention program to help Egyptian children with learning disorders to overcome their EF impairment. It uses the multimodality approach to help meet the needs of students with a variety of learning styles. The aim of this study is to adapt the combined form of the “Executive Functions Training-Elementary” and the “Promoting Executive Function In The Classroom” programs and its application to test its effectiveness in the rehabilitation of Egyptian learning-disordered children.

Results

The results showed significant improvement in the Arabic version of Barkley Deficits in Executive Functioning Scale, Children and Adolescents long-form (BDEFS-CA) scores for executive functions (EF) evaluation (executive function summery score from 228.63 to 213.77 with p-value < 0.001), and it also showed significant improvement in the Arabic dyslexia assessment test (ADAT) scores (from 1.89 to 1.33 with p-value < 0.001) for dyslexia evaluation.

Conclusion

The study concluded that designing an Arabic rehabilitation program specific for executive function difficulties was effective for improving both EF deficits and dyslexia, but there is a need for further studies comparing this program to other methods of traditional interventions.

Trial registration

The study was retrospectively registered at www.clinicaltrials.gov NCT05476133, approved on 26 July 2022. Register name is the following: application of a rehabilitation program for executive functions in a sample of Egyptian children with learning disorder.
Behavioral Changes in Patients With Prader-Willi Syndrome Can Mask Severe Physical Illness
Authors: Van Loo Liselotte , Vogels Annick , Rochtus Anne
Published: February 2023

Behavioral and psychiatric problems are common in patients with Prader-Willi syndrome (PWS), while physical complaints such as pain, fever, and vomiting are rare due to a high pain threshold and dysregulation of temperature control. PWS patients have an increased mortality rate, some due to undiagnosed life-threatening diseases. We describe 2 patients with PWS whose behavioral changes, initially thought to be part of their behavioral phenotype, delayed the final diagnosis of a life-threatening underlying illness. A 13-year-old girl with PWS presented with a sudden change in behavior including aggression, scratching, and self-injury. She was seen by several health care providers, and after 5 months the diagnosis of pyosalpinx was made, for which laparoscopic resection of an infected tailgut cyst was performed, resolving the behavioral symptoms. A 38-year-old man with PWS presented with recurrent vague inguinal pain and nonepileptic seizures. After several years of consulting physicians and psychiatrists, including several hospital admissions, the diagnosis of bilateral inguinal hernia was made. After surgical correction, the pain and seizures ceased. In PWS patients presenting with unexplained behavioral changes and unusual somatic complaints, clinicians should perform an extensive clinical examination and consider underlying physical illness rather than attribute the problem to the behavioral phenotype.
Associations Between Repeated Measures of Urinary Phthalate Metabolites With Hormones and Timing of Natural Menopause
Authors: Ding Ning , Zheutlin Emily , Harlow Siobán D , Randolph John F , Mukherjee Bhramar , Park Sung Kyun
Published: February 2023

Phthalates, ubiquitous endocrine-disrupting chemicals, may affect ovarian folliculogenesis and steroidogenesis. We examined the associations of urinary phthalate metabolites with hormones including estradiol, testosterone, follicle-stimulating hormone (FSH), sex hormone–binding globulin (SHBG), and anti-Müllerian hormone (AMH), and timing of natural menopause in midlife women. Data were from 1189 multiracial/multiethnic women aged 45 to 56 years without hormone therapy from the Study of Women's Health Across the Nation (SWAN). Urinary concentrations of 12 phthalate metabolites and hormones were repeatedly measured in 1999 to 2000 and 2002 to 2003, resulting in a total of 2111 observations. Linear mixed-effect models were used to calculate percentage differences (%D) and 95% CIs in serum concentrations of estradiol, testosterone, FSH, SHBG, and AMH. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% CIs of natural menopause. We observed statistically significant associations of phthalate metabolites with lower testosterone concentrations: MCOP with testosterone (%D: −2.08%; 95% CI, −3.66 to −0.47) and MnBP with testosterone (%D: −1.99%; 95% CI, −3.82 to −0.13), after adjusting for multiple comparisons with false discovery rates less than 5%. Lower AMH concentrations were also found with higher MECPP (%D: −14.26%; 95% CI, −24.10 to −3.14), MEHHP (%D: −15.58%; 95% CI, −24.59 to −5.50), and MEOHP (%D: −13.50%; 95% CI, −22.93 to −2.90). No associations were observed for other hormones or timing of natural menopause. These results suggest that exposure to phthalates may affect circulating levels of testosterone and diminish the ovarian reserve in midlife women. Given the widespread exposure, reduced exposure to phthalates may be a key step to prevent reproductive effects of phthalates.
The development of a digital twin concept system
Authors: Duan Hyman , Gao Su , Yang Xu , Li Yuanlin
Published: February 2023

Background: Digital twins are gaining ever-increasing attention from academies and industries to standardization bodies worldwide owing to their great capabilities and fundamental values in the coming fourth industrial revolution. However, there is no consistent set of definitions or concept system of the digital twin domain yet. Especially, the polysemy problem of the term “digital twin” is leading to ambiguities and an obstacle to standardization.

Methods: This paper summarizes the  principles and guidelines of developing a concept system mentioned in two international standards, enriches them to a methodology of developing a concept system with (1) system thinking viewpoints and systems engineering methods, (2) procedures for analyzing the semantic relationships among candidate superordinate concepts, and (3) a three-dimensional taxonomy framework with procedures of developing a taxonomy, and proposed a maturity level model for terminology work which offers a high-level vision of digital twin terminology work.

Results: This paper analyzes the polysemy phenomenon of the term "digital twin” and identifies the necessity to differentiate digital twin entity and digital twin system from the general term “digital twin”. After analyzing twenty-one definitions of digital twin and summarizing ten superordinate concepts from them, this paper proposes that a digital twin entity is a kind of digital asset rather than digital representation. Based on the new superordinate concept and definition of digital twin entity, a systematic digital twin concept system is developed with one hundred concepts and fifty definitions.

Conclusions: This work resolves the polysemy problem of the term “digital twin” and demonstrates the effectiveness of the enhanced methodology of developing a concept system. The proposed digital twin concept system could be a benchmark for future digital twin terminology work and useful input to the development of digital twin system reference architecture standard and lays a solid foundation for future concept systems development of other domains.
Global landscape of randomized controlled trials responding to the COVID-19 pandemic: a literature review protocol
Authors: Inada Mai , Ichihara Naoaki , Saito Hiroki
Published: February 2023

Introduction: Evidence-based care is challenging during public health crisis. During the COVID-19 pandemic, although the tremendous number of clinical trials were conducted, small trials were prevalent, which posed the risk of duplication, heterogeneity, underreporting and limited applicability of the trial results to patients in the clinical setting. These factors are known to potentially jeopardize the efficient production of scientific data for evidence-based care. The objective of this review is to critically appraise the characteristics of randomized controlled trials related to COVID-19 therapeutics and vaccines. This article is a protocol for literature review. 

Methods: This review will include randomized controlled trials (RCTs) on therapeutics and vaccines for COVID-19. Therapeutics include a single drug or a combination of multiple drugs for COVID-19. Non-human trials will be excluded. The search strategy is designed for identifying publication of study results in peer-review journals. Databases to be searched include MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of science and CINAHL. Two or more independent reviewers will screen identified publications for inclusion/exclusion and retrieve data including standard information of studies and specific details about RCT designs as well as reporting, for which we will follow the set of information in international trial registries and the CONSORT statement. 

Discussion: It remains unclear what should be improved or strengthened for ecosystems of clinical trials for future pandemics. This review is expected to provide a landscape of RCTs related to COVID-19 therapeutics and vaccines and to explicitly show successful factors for evidence generation in response to pandemics.