bluuebunny/crossref_metadata_2025 huggingface dataset:
Strengthening research ethics governance and regulatory oversight in Central America and the Dominican Republic in response to the COVID-19 pandemic: a qualitative study
Authors: Canario Guzmán Julio Arturo , Orlich Jessie , Mendizábal-Cabrera Renata , Ying Argentina , Vergès Claude , Espinoza Eleonora , Soriano Mario , Cárcamo Elsy , Beltrán Briana , Mendoza Marrero Eddys Rafael , Sepulveda Reyna , Nieto Anderson Claudia , Feune de Colombi Nicole , Lescano Roxana , Pérez-Then Eddy , Lang Trudie , Alger Jackeline
Published: December 2022

Background

Good governance and regulatory supervision are required to conduct research in an international public health emergency context and to ensure compliance with ethical standards. The “Strengthening research ethics governance and regulatory oversight in Central America and the Dominican Republic in response to the COVID-19 pandemic” study is a regional effort in which research ethics stakeholders participated in addressing research ethics governance and preparedness response challenges to the COVID-19 pandemic in Central America and the Dominican Republic.

Methods

A qualitative action research study was conducted following a participatory approach. Research ethics stakeholders in Central America and the Dominican Republic were mapped; a regional webinar and three virtual workshops were conducted discussing research ethics governance, ethics review and collaborative research practice during the pandemic. A roundtable session presented results and obtained feedback on a draft of a policy to strengthen regional research ethics governance.

Results

Countries across Central America and the Dominican Republic are at different stages in their development of research ethics systems. Countries with more established systems before COVID-19 were better organized and prepared to respond. This finding argues against improvisation and supports further work on strengthening governance of research ethics systems. Community engagement in research ethics public policy-making is practically absent in the region. Research and research ethics collaboration schemes are lacking amongst the countries; however, there are incipient initiatives in the region, such as the Central America and Caribbean Network of Research Ethics Committees. A policy brief with recommendations on how to advance towards strengthening the governance of research ethics systems was prepared and submitted to the Central American Integration System for analysis and possible approval.

Conclusion

National research ethics systems in Central America and the Dominican Republic were unprepared to respond to the COVID-19 pandemic with respect to research oversight and effective collaboration. In most cases, national research ethics systems were found to be weak, and regional research collaboration was practically absent. To promote collaboration, a joint strategy needs to be developed with a regional vision towards sharing knowledge and best practices.
Role of miRNAs interference on ovarian functions and premature ovarian failure
Authors: Nouri Narjes , Shareghi-Oskoue Olduz , Aghebati-Maleki Leili , Danaii Shahla , Ahmadian Heris Javad , Soltani-Zangbar Mohammad Sadegh , Kamrani Amin , Yousefi Mehdi
Published: December 2022

Premature ovarian failure is a to some extent unknown and intricate problem with diverse causes and clinical manifestations. The lack of ovarian sex hormones presumably is effective in the occurrence of ovarian failure. Our progress in this field has been very little despite undertaken scientific research endeavors; scholars still are trying to understand the explanation of this dilemmatic medical condition. In contrast, the practice of clinical medicine has made meaningful strides in providing assurance to the women with premature ovarian insufficiency that their quality of life as well as long-term health can be optimized through timely intervention. Very recently Scientists have investigated the regulating effects of small RNA molecules on steroidogenesis apoptosis, ovulation, gonadal, and corpus luteum development of ovaries. In this literature review, we tried to talk over the mechanisms of miRNAs in regulating gene expression after transcription in the ovary.
Diagnostic value of transpulmonary thermodilution measurements for acute respiratory distress syndrome in a pig model of septic shock
Authors: Endo Yusuke , Miyasho Taku , Endo Kanako , Kawamura Yoshio , Miyoshi Kenjiro , Takegawa Ryosuke , Tagami Takashi , Becker Lance B. , Hayashida Kei
Published: December 2022

Background

No direct approach assessing pulmonary vascular permeability exists in the current therapeutic strategy for patients with acute respiratory distress syndrome (ARDS). Transpulmonary thermodilution measures hemodynamic parameters such as pulmonary vascular permeability index and extravascular lung water, enabling clinicians to assess ARDS severity. The aim of this study is to explore a precise transpulmonary thermodilution-based criteria for quantifying the severity of lung injury using a clinically relevant septic-ARDS pig model.

Methods

Thirteen female pigs (weight: 31 ± 2 kg) were intubated, mechanically ventilated under anesthesia, and either assigned to septic shock-induced ARDS or control group. To confirm the development of ARDS, we performed computed tomography (CT) imaging in randomly selected animals. The pulmonary vascular permeability index, extravascular lung water, and other hemodynamic parameters were consecutively measured during the development of septic lung injury. Lung status was categorized as normal (partial pressure of oxygen/fraction of inspired oxygen ≥ 400), or injured at different degrees: pre-ARDS (300–400), mild-to-moderate ARDS (100–300), or severe ARDS (< 100). We also measured serum inflammatory cytokines and high mobility group box 1 levels during the experiment to explore the relationship of the pulmonary vascular permeability index with these inflammatory markers.

Results

Using CT image, we verified that animals subjected to ARDS presented an extent of consolidation in bilateral gravitationally dependent gradient that expands over time, with diffuse ground-glass opacification. Further, the post-mortem histopathological analysis for lung tissue identified the key features of diffuse alveolar damage in all animals subjected to ARDS. Both pulmonary vascular permeability index and extravascular lung water increased significantly, according to disease severity. Receiver operating characteristic analysis demonstrated that a cut-off value of 3.9 for the permeability index provided optimal sensitivity and specificity for predicting severe ARDS (area under the curve: 0.99, 95% confidence interval, 0.98–1.00; sensitivity = 100%, and specificity = 92.5%). The pulmonary vascular permeability index was superior in its diagnostic value than extravascular lung water. Furthermore, the pulmonary vascular permeability index was significantly associated with multiple parameters reflecting clinicopathological changes in animals with ARDS.

Conclusion

The pulmonary vascular permeability index is an effective indicator to measure septic ARDS severity.
Pharmaceutical targeting Th2-mediated immunity enhances immunotherapy response in breast cancer
Authors: Chen Yuru , Sun Jiazheng , Luo Yachan , Liu Jiazhou , Wang Xiaoyu , Feng Rui , Huang Jing , Du Huimin , Li Qin , Tan Jinxiang , Ren Guosheng , Wang Xiaoyi , Li Hongzhong
Published: December 2022

Background

Breast cancer is a complex disease with a highly immunosuppressive tumor microenvironment, and has limited clinical response to immune checkpoint blockade (ICB) therapy. T-helper 2 (Th2) cells, an important component of the tumor microenvironment (TME), play an essential role in regulation of tumor immunity. However, the deep relationship between Th2-mediated immunity and immune evasion in breast cancer remains enigmatic.

Methods

Here, we first used bioinformatics analysis to explore the correlation between Th2 infiltration and immune landscape in breast cancer. Suplatast tosilate (IPD-1151 T, IPD), an inhibitor of Th2 function, was then employed to investigate the biological effects of Th2 blockade on tumor growth and immune microenvironment in immunocompetent murine breast cancer models. The tumor microenvironment was analyzed by flow cytometry, mass cytometry, and immunofluorescence staining. Furthermore, we examined the efficacy of IPD combination with ICB treatment by evaluating TME, tumor growth and mice survival.

Results

Our bioinformatics analysis suggested that higher infiltration of Th2 cells indicates a tumor immunosuppressive microenvironment in breast cancer. In three murine breast cancer models (EO771, 4T1 and EMT6), IPD significantly inhibited the IL-4 secretion by Th2 cells, promoted Th2 to Th1 switching, remodeled the immune landscape and inhibited tumor growth. Remarkably, CD8+ T cell infiltration and the cytotoxic activity of cytotoxic T lymphocyte (CTL) in tumor tissues were evidently enhanced after IPD treatment. Furthermore, increased effector CD4+ T cells and decreased myeloid-derived suppressor cells and M2-like macrophages were also demonstrated in IPD-treated tumors. Importantly, we found IPD reinforced the therapeutic response of ICB without increasing potential adverse effects.

Conclusions

Our findings demonstrate that pharmaceutical inhibition of Th2 cell function improves ICB response via remodeling immune landscape of TME, which illustrates a promising combinatorial immunotherapy.
Integrative metagenomic and metabolomic analyses reveal the role of gut microbiota in antibody-mediated renal allograft rejection
Authors: Li Xin , Li Ruoying , Ji Bingqing , Zhao Lili , Wang Junpeng , Yan Tianzhong
Published: December 2022

Background

Antibody-mediated rejection (AMR) remains one of the major barriers for graft survival after kidney transplantation. Our previous study suggested a gut microbiota dysbiosis in kidney transplantation recipients with AMR. However, alternations in gut microbial function and structure at species level have not been identified. In the present study, we investigated the metagenomic and metabolic patterns of gut microbiota in AMR patients to provide a comprehensive and in-depth understanding of gut microbiota dysbiosis in AMR.

Methods

We enrolled 60 kidney transplantation recipients, 28 showed AMR and 32 were non-AMR controls with stable post-transplant renal functions. Shotgun sequencing and untargeted LC/MS metabolomic profiling of fecal samples were performed in kidney transplantation recipients with AMR and controls.

Results

Totally, we identified 311 down-regulated and 27 up-regulated gut microbial species associated with AMR after kidney transplantation, resulting in the altered expression levels of 437 genes enriched in 22 pathways, of which 13 were related to metabolism. Moreover, 32 differential fecal metabolites were found in recipients with AMR. Among them, alterations in 3b-hydroxy-5-cholenoic acid, l-pipecolic acid, taurocholate, and 6k-PGF1alpha-d4 directly correlated with changes in gut microbial species and functions. Specific differential fecal species and metabolites were strongly associated with clinical indexes (Cr, BUN, etc.), and could distinguish the recipients with AMR from controls as potential biomarkers.

Conclusions

Altogether, our findings provided a comprehensive and in-depth understanding of the correlation between AMR and gut microbiota, which is important for the etiological and diagnostic study of AMR after kidney transplantation.
Understanding the challenges, unmet needs, and expectations of mucopolysaccharidoses I, II and VI patients and their caregivers in France: a survey study
Authors: Guffon Nathalie , Genevaz Delphine , Lacombe Didier , Le Peillet Feuillet Eliane , Bausson Pascale , Noel Esther , Maillot François , Belmatoug Nadia , Jaussaud Roland
Published: December 2022

Background

Mucopolysaccharidoses (MPS) are a group of inherited lysosomal storage diseases caused by defective enzyme activity involved in the catalysis of glycosaminoglycans. Published data on adult patients with MPS remains scarce. Therefore, the present qualitative survey study was aimed at understanding knowledge of the disease, unmet needs, expectations, care, and overall medical management of adult/adolescent patients with MPS I, II and VI and their caregivers in France.

Results

A total of 25 patients (MPS I, np = 11; MPS II, np = 9; MPS VI, np = 5) were included and about 36 in-depth interviews (caregivers alone, nc = 8; patients-caregiver pair, nc+p = 22; patients alone, np = 6) were conducted. Except one (aged 17 years), all patients were adults (median age: 29 years [17–50]) and diagnosed at median age of 4 years [0.4–30], with mainly mothers as caregivers (nc = 16/19). Patients were classified into three groups: Group A, Patients not able to answer the survey question because of a severe cognitive impairment (np = 8); Group B, Patients able to answer the survey question with low or no cognitive impairment and high motor disability (np = 10); and Group C, Patients able to answer the survey question with low or no cognitive impairment and low motor disability (np = 7). All groups were assessed for impact of disease on their daily lives based on a scale of 0–10. Caregivers in Group A were found to be most negatively affected by the disease, except for professional activity, which was most significantly impacted in Group B (4.7 vs. 5.4). The use of orthopaedic/medical equipments, was more prevalent in Groups A and B, versus Group C. Pain management was one of the global unmet need expressed by all groups. Group A caregivers expected better support from childcare facilities, disability clinics, and smooth transition from paediatric care to adult medicine. Similarly, Group B caregivers expected better specialised schools, whereas Group C caregivers expected better psychological support and greater flexibility in weekly infusion schedules for their patients.

Conclusions

The survey concluded that more attention must be paid to the psychosocial status of patients and caregivers. The preference for reference centre for follow-up and treatment, hospitalizations and surgeries were evident. The most significant needs expressed by the patients and caregivers include better understanding of the disease, pain management, monitoring of complications, flexibility in enzyme replacement therapy, home infusions especially for attenuated patients, and improved transitional support from paediatric to adult medicine.
Prehospital misdiagnosis of acute cerebral disease for acute coronary syndrome: a retrospective study
Authors: Grabert Josefin , Heister Ulrich , Mayr Andreas , Kirfel Andrea , Staerk Christian , Fleckenstein Tobias , Velten Markus
Published: December 2022

Objective

In cerebrovascular accidents symptoms, laboratory results and electrocardiogram (ECG) changes can mimic acute coronary syndrome (ACS) and is subsumed as neurogenic stunned myocardium. So far, data regarding the frequency of cerebrovascular accidents misdiagnosed for ACS in a prehospital setting are missing. This study aims to quantify misdiagnoses and discover discriminating features.

Methods

In a retrospective cohort study, prehospital and hospital medical records of all patients treated by physician-staffed emergency medical teams in the city of Bonn (Germany) with suspected ACS in 2018 were evaluated regarding medical history, prehospital symptoms and findings as well as hospital diagnoses.

Results

From 758 patients admitted for presumed ACS, 9 patients (1.2%, 95% CI: 0.5–2.2%) suffered from acute cerebral disease (ACD group). Mainly, diagnoses were cerebrovascular accidents and one case of neuroborreliosis. A history of intracranial haemorrhage was found more often in the ACD group compared to the remaining cohort (OR 19, p = 0.01), while a history of arterial hypertension was less frequent (OR 0.22, p = 0.03). Presentation with headaches (OR 10.1, p = 0.03) or neurological symptoms (OR 16.9, p = 0.01) occurred more frequent in the ACD group. ECG changes were similar between groups.

Conclusion

Acute cerebral disease misdiagnosed for ACS seems more common than assumed. Out of 758 patients with presumed ACS, 9 patients (1.2%) suffered from ACD, which were cerebrovascular accidents mainly. This is highly relevant, since prehospital treatment with heparin and acetylsalicylic acid is indicated in ACS but contraindicated in cerebrovascular accidents without further diagnostics. Thus, discriminating these patients is crucial. An attentive patient history and examination may be the key to differentiating ACD. Due to small ACD group size, further studies are needed.
Sport and non-specific low back pain in athletes: a scoping review
Authors: Dal Farra Fulvio , Arippa Federico , Carta Giuseppe , Segreto Marco , Porcu Elisa , Monticone Marco
Published: December 2022

Background

The contribution of sport in non-specific low back pain (NS-LBP) remains unknown, due to a large heterogeneity in the methods applied in research. The aims of this scoping review (ScR) were to systematically map and summarize findings concerning studies reporting data on NS-LBP among athletes.

Methods

This ScR was developed referring to the 2020 version of the “Joanna Briggs Institute Methodological Guidance” and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. Five medical databases (Pubmed, Cochrane, Central, Embase, Pedro and Scopus) were searched up to November 2021. No limitations in terms of study design and language were applied. Results were presented numerically and thematically.

Results

A total of 4061 records were identified through the initial search; 114 articles met the inclusion criteria. Publications have increased over the years, since 1990. Most of the studies were conducted in the USA (17.5%), even if most research was conducted in Europe (53.5%). Analytic observational (42%) and cross-sectional studies (37%) were the most used designs, followed by case reports (12%) and systematic reviews (9%). Boating (7%), football, soccer, volleyball, running and gymnastics (4.4% each) were the most investigated, although the majority of the studies considered sports in general (36.8%). The overall sample size median was 181, mean age 22 ± 10.2; 68% of athletes were professional and 32% amateur. Most of the studies (38%) did not detail the frequency of training. Sport was reported as a risk factor for developing NS-LBP in 67.5% of cases, especially in those studies which assessed activities implying high or repeated loading on the spine.

Conclusions

This is the first ScR to provide a comprehensive overview on this topic. The increased number of publications on the association between sport practice and NS-LBP demonstrates a growing interest over the years on this topic. Some sport activities seem to be more involved than others in LBP development; however, research methods are extremely varied, thus more standardized observational research may focus on specific disciplines to properly contribute to research and clinical practice.
Myopericarditis following both BNT162b2 and NVX-CoV2373
Authors: Ahmad Saima , Yuson Chino , Le Adrianna , Hissaria Pravin
Published: December 2022

Background

Myopericarditis is a well reported complication associated with SARS-Cov-2 (COVID-19) infection and vaccinations; particularly with mRNA vaccines (BNT162b2 and mRNA-1273), and in the young male population. The risk-to-benefit ratio in sequential vaccination dosing in young males is further clouded in the era of the omicron variant with its reported enhanced immune escape.

Study design

A case series of two cases of post vaccination myopericarditis following the NVX-CoV2373 after also developing myopericarditis with BNT162b2.

Conclusion

To our knowledge, we are the first to describe post vaccination myopericarditis following NVX-CoV2373 after also developing myopericarditis with BNT162b2. The similarities in presentation between the reactions of both platforms would suggest a similar pathogenesis, although the exact mechanism remains unknown. Further studies are necessary to identify these mechanisms, as well as to identify biomarkers that may identify vulnerable populations. On-going vigilance is necessary to identify those who may be at an increased risk of post-COVID vaccine myopericarditis.
Bone metastatic carcinoma coexisting with plasma cell myeloma: a case report
Authors: Aloui Marwa , Ben Rejeb Sarra , Boudokhan Manel , Dhaoui Amen , Ben Romdhane Majdi , Belakhal Syrine
Published: December 2022

Objective

Multiple myeloma is a clonal plasma cell proliferation often causing bone lytic lesions. It is sometimes challenging to differentiate these lytic lesions associated with multiple myeloma from bone destruction due to a metastasis. Although coexistence of solid tumors and plasma cell myeloma in one patient has been described, synchronous skeletal metastases from both neoplasms occurring in the same bone lesion is exceptional. Indeed, only one case has been reported in the literature.

Case presentation

Herein, we report a case involving a 68-year-old Caucasian male patient admitted to our department for coronavirus disease 2019 infection with incidental finding of multiple lytic bone lesions during hospitalization. Laboratory tests revealed an increased immunoglobulin G kappa M protein and high levels of carbohydrate antigen 19-9. Bone marrow aspiration showed increased atypical plasma cells consistent with multiple myeloma. Percutaneous image-guided biopsy of one of the osteolytic lesions was performed. Pathological examination identified both plasma cell neoplasm and poorly differentiated metastatic carcinoma within the same bone lytic lesions.

Conclusion

The present case raises awareness among clinicians and pathologists that clinical and radiologic suspicion of multiple myeloma may be within the spectrum of second primary malignancies.
A comprehensive evaluation between dexmedetomidine and midazolam for intraoperative sedation in the elderly: protocol for a systematic review and meta-analysis of randomized controlled trials
Authors: Huang Chunxia , Li Zunjiang , Long Yingxin , Li Dongli , Huang Manhua , Ding Banghan , Zhu Wei
Published: December 2022

Background

The sedative effect of intraoperative sedation in elderly surgery exerts critical influence on the prognosis. Comparison on the safety and efficacy between dexmedetomidine and midazolam in many clinical randomized controlled trials (RCTs) was inconsistent and suspicious. We aim to comprehensively evaluate the safety and efficacy between dexmedetomidine and midazolam for intraoperative sedation in the elderly via meta-analysis and systematic reviews.

Methods

RCTs regarding to the comparison of sedative effects and safety between dexmedetomidine and midazolam in elderly patients (aged ≥ 60 years) will be comprehensively searched from 2000 October to 2022 May through 4 English databases and 4 Chinese databases. After extraction in duplicate, the systematic review and meta-analysis will be performed on the primary outcomes (hemodynamic changes, sedative effect, cognitive function) and secondary outcomes (analgesic effect, surgical characteristics, complications, or adverse reactions) for assessing the two therapy methods using Review Manager software (Version 5.3). Sensitivity analysis will be conducted to evaluate the heterogeneity of the results; funnel plot and Egger’s trial will be performed to analyze publication bias of the included studies, and trial sequential analysis will be applied to assess the robustness and reliability of preliminary meta-analysis results. Finally, rating quality of evidence and strength of recommendations on the meta results will be summarized by Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Discussion

This systematic review and meta-analysis will evaluate the safety and efficacy between dexmedetomidine and midazolam for intraoperative sedation in the elderly; it will give an insight on the application of dexmedetomidine and midazolam and will provide evidence-based reference for clinical decision-making.

Systematic review registration

PROSPERO CRD42021221897
Lack of systematicity in research prioritisation processes — a scoping review of evidence syntheses
Authors: Lund Hans , Tang Lars , Poulsen Ingrid , la Cour Karen , Bjerrum Merete , Nielsen Claus Vinther , Maribo Thomas
Published: December 2022

Background

A systematically and transparently prepared research priority-setting process within a specific scientific area is essential in order to develop a comprehensive and progressive evidence-based approach that will have a substantial societal impact on the site of interest. On the basis of two consensus workshops, the authors suggest the following methods for all such processes: use of experts, stakeholder involvement, literature review, and ranking.

Objectives

The identification, categorisation, and discussion of methods for preparing a research prioritisation process.

Methods

Eligibility criteria: Evidence synthesis includes original studies presenting a research prioritisation process and which listed the methods used to create a research prioritisation process. Only evidence syntheses related to health research were included.

Data sources: We searched the following electronic databases, without limiting by date or language: MEDLINE Ovid, Embase Ovid, Epistemonikos, and CINAHL EBSCO.

Charting methods: The methods used were mapped and broken down into different elements, and the use of the elements was determined. To support the mapping, (A) all of the elements were collapsed into unique categories, and (B) four essential categories were selected as crucial to a successful research prioritisation process.

Results

Twelve evidence syntheses were identified, including 416 original studies. The identification and categorisation of methods used resulted in 13 unique categories of methods used to prepare a research agenda.

Conclusion

None of the identified categories was used in all of the original studies. Surprisingly, all four of the essential categories were used in only one of the 416 original studies identified. There is seemingly no international consensus on which methods to use when preparing a research prioritisation process.

Protocol registration

The protocol was registered in Open Science Framework (https://osf.io/dygz8/).
Alcohol use and the gender-specific risk of suicidal behavior: a systematic review and meta-analysis protocol
Authors: Lange Shannon , Roerecke Michael , Orpana Heather , Bagge Courtney , Rehm Jürgen
Published: December 2022

Background

Alcohol use is an important risk factor for suicidal behavior, with a heightened risk found among women. The objective of this study is to determine the gender-specific risk of suicidal behaviors (suicide attempt and death by suicide) for different levels and dimensions of alcohol use—i.e., for (1) average alcohol volume consumed, (2) binge drinking, and (3) individuals with an alcohol use disorder.

Methods

We will systematically search the available literature for primary studies on the risk relationships specified above. Using a predetermined set of keywords, a comprehensive systematic literature search will be conducted in the following electronic databases: Embase, PsycINFO, PubMed, and Web of Science. The basic inclusion criteria will be (1) an original, quantitative (cohort, case–control or cross-sectional) study; with (2) a measure of risk of at least one dimension of our alcohol exposures in relation to at least one of our outcomes of interest (suicide attempt or death by suicide), and its corresponding measure of variability is reported (or sufficient data to calculate these); and (3) estimates of risk stratified by gender. Studies (1) that use only qualitative labels of alcohol use, and (2) where suicide attempt and non-suicidal self-harm cannot be disaggregated will be excluded. There will be no restrictions on language, geographical region, or year of publication. Two reviewers will independently perform the search and systematic assessment of each identified study and subsequent extraction of data. Categorical random-effects meta-analyses will be conducted to obtain gender-specific pooled risk estimates. Risk of bias will be assessed using the Risk of Bias In Non-randomised Studies—of Interventions tool and the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of evidence.

Discussion

This study will synthesize all available data on the gender-specific relationship between various dimensions of alcohol use and suicidal behavior simultaneously in a coherent framework. We will provide risk estimates with the detail needed to better understand the respective risk relationships and appreciate the burden of alcohol-attributable suicide.

Systematic review registration

PROSPERO CRD42022320918.
Predicting Master’s students’ academic performance: an empirical study in Germany
Authors: Alturki Sarah , Cohausz Lea , Stuckenschmidt Heiner
Published: December 2022

The tremendous growth in electronic educational data creates the need to have meaningful information extracted from it. Educational Data Mining (EDM) is an exciting research area that can reveal valuable knowledge from educational databases. This knowledge can be used for many purposes, including identifying dropouts or weak students who need special attention and discovering extraordinary students who can be offered lifetime opportunities. Although former studies in EDM used an extensive range of features for predicting students’ academic achievement (in terms of (i) achieved grades or (ii) passing and failing), those features are sometimes not obtainable for practical usage, and therefore, the prediction models are not feasible for employment. This study uses data mining (DM) algorithms to predict the academic performance of master’ s students by using a non-extensive data set and including only the features that are easy to collect at the beginning of a studying program. To perform this study, we have collected over 700 students' records from 2010 to 2018 from the Faculty of Business Informatics and Mathematics at the University of Mannheim in Germany. Those records include demographics and post-enrollment features such as semester grades. The empirical results show the following: (i) the most significant features for predicting students' academic achievements are the students’ grades in each semester (importance rate between 14 and 36%), followed by the distance from students’ accommodation to university (importance rate between 6 and 18%) and culture (importance rate between 7 and 17%). On the other hand, gender, age, the numbers of failed courses, and the number of registered and unregistered exams per semester are less significant for the predictions. (ii) As expected, predictions performed after the second semester is more accurate than those performed after the first semester. (iii) Unsurprisingly, models that predict two classes yield better results than those that predict three. (iv) Random Forest classifier performs the best in all prediction models (0.77–0.94 accuracy), and using oversampling methods to deal with imbalanced data can significantly improve the performance of DM methods. For future work, we recommend testing the predictive models on other master programs and a larger datasets. Furthermore, we recommend investigating other oversampling approaches.
Cerebrovascular pressure reactivity and brain tissue oxygen monitoring provide complementary information regarding the lower and upper limits of cerebral blood flow control in traumatic brain injury: a CAnadian High Resolution-TBI (CAHR-TBI) cohort study
Authors: Gomez Alwyn , Sekhon Mypinder , Griesdale Donald , Froese Logan , Yang Eleen , Thelin Eric P. , Raj Rahul , Aries Marcel , Gallagher Clare , Bernard Francis , Kramer Andreas H. , Zeiler Frederick A.
Published: December 2022

Background

Brain tissue oxygen tension (PbtO2) and cerebrovascular pressure reactivity monitoring have emerged as potential modalities to individualize care in moderate and severe traumatic brain injury (TBI). The relationship between these modalities has had limited exploration. The aim of this study was to examine the relationship between PbtO2 and cerebral perfusion pressure (CPP) and how this relationship is modified by the state of cerebrovascular pressure reactivity.

Methods

A retrospective multi-institution cohort study utilizing prospectively collected high-resolution physiologic data from the CAnadian High Resolution-TBI (CAHR-TBI) Research Collaborative database collected between 2011 and 2021 was performed. Included in the study were critically ill TBI patients with intracranial pressure (ICP), arterial blood pressure (ABP), and PbtO2 monitoring treated in any one of three CAHR-TBI affiliated adult intensive care units (ICU). The outcome of interest was how PbtO2 and CPP are related over a cohort of TBI patients and how this relationship is modified by the state of cerebrovascular reactivity, as determined using the pressure reactivity index (PRx).

Results

A total of 77 patients met the study inclusion criteria with a total of 377,744 min of physiologic data available for the analysis. PbtO2 produced a triphasic curve when plotted against CPP like previous population-based plots of cerebral blood flow (CBF) versus CPP. The triphasic curve included a plateau region flanked by regions of relative ischemia (hypoxia) and hyperemia (hyperoxia). The plateau region shortened when cerebrovascular pressure reactivity was disrupted compared to when it was intact.

Conclusions

In this exploratory analysis of a multi-institution high-resolution physiology TBI database, PbtO2 seems to have a triphasic relationship with CPP, over the entire cohort. The CPP range over which the plateau exists is modified by the state of cerebrovascular reactivity. This indicates that in critically ill TBI patients admitted to ICU, PbtO2 may be reflective of CBF.
Nematicidal potential of plant growth-promoting rhizobacteria against Meloidogyne incognita infesting tomato under protected cultivation
Authors: Gowda A. P. Abhishek , Pankaj  , Singh Dinesh , Singh Awani Kumar , Sowmya R.
Published: December 2022

Background

In the protected cultivation of tomato (Solanum lycopersicum L.) crop, the severity of root-knot nematode, Meloidogyne incognita, incidence is alarming nowadays. To combat this, growers usually prefer using synthetic chemical pesticides, which in turn results in harming non-target beneficial microbes present in the soil micro-flora and indirectly toxic to human health. Therefore, attempts were made to find out the nematicidal potential of plant growth-promoting rhizobacteria (PGPR) against M. incognita, which could be used as an alternative solution to manage M. incognita incidence under protected cultivation.

Results

Nematicidal potential of three PGPR isolates and their consortium against M. incognita under laboratory, pots, and field experiments was studied. Juvenile mortality of 91.67% was recorded at 100% consortium, followed by 73.33–81.33% by individual isolates. Similarly, hatching inhibition of 84.26% was recorded at 100% PGPR consortium followed by 78.48–83.21% in individual isolates after 96 h. of incubation. In the pots’ study, soil drenched with PGPR isolates consortium, followed by Bacillus subtilis DTBS 5, Pantoea agglomerans, and Bacillus amyloliquefaciens DSBA 11 recorded significant reductions in the nematode incidence. Whereas in the field study, PGPR isolates applied as soil drenching also significantly reduced nematode’s incidence in consortium, followed by B. subtilis DTBS 5 and B. amyloliquefaciens DSBA 11-treated soil in both field experiments. On an average, the plant growth promotion and fruit yield were enhanced than untreated control and PGPR isolates applied as soil drenching gave a significant result than bare root dip treatment.

Conclusions

PGPR isolates, B. amyloliquefaciens DSBA 11, B. subtilis DTBS 5, and P. agglomerans, were found to be effective against M. incognita. This finding can be incorporated into the nematode management strategy in tomato crop grown under protected cultivation. Further to enhance the biocontrol efficacy of these PGPR isolates, suitable formulations of either individual or consortium need to be done.
Relevance of bright spotty lesions in neuromyelitis optica spectrum disorders (NMOSD): a case series
Authors: Joseph Joe , Feizi Parissa , Pasham Shreya R. , Sharma Kanika , Srivastava Samiksha , Elkhooly Mahmoud , Nirwan Lalit , Jaiswal Shruti , Sriwastava Shitiz
Published: December 2022

Background

Neuromyelitis optica (NMO), or neuromyelitis optica spectrum disorder (NMOSD), is an autoimmune CNS condition which often has a complex clinical course. Longitudinally extensive transverse myelitis (LETM) is an important and sensitive MRI finding but is not very specific to NMOSD and is seen in other causes of myelitis.

Case presentations

We report 11 NMO cases, all seen in women from 25 to 75 years at the time of diagnosis, with most above 65 years of age. All patients were seropositive for AQP4–IgG antibodies, and none had anti-MOG antibodies. Clinical presentations were diverse, the most common being paralytic and visual changes. In this study, 5 of the 11 seropositive NMO patients (45%) had bright spotty lesion (BSLs) on their MRI spine, as opposed to none (0%) in the control group. BSLs were defined as hyperintense foci of signal abnormality on T2-weighted images compared to the surrounding CSF. Treatment included symptomatic management and immunotherapy; timely management led to improvement in all the cases, with partial recovery seen in most (91%) and complete recovery seen only in one.

Conclusions

BSLs are a newly defined spinal MRI finding with high specificity, but low sensitivity for NMOSD. The absence of BSLs in the control group establishes its prolific role in distinguishing NMO from MS, ITM, MOGAD and other forms of myelitis. The main aim of this retrospective case–control study was to determine the diagnostic importance and specificity of bright spotty lesions (BSLs) in NMOSD and its ability to discriminate NMOSD from other causes of LETM.
Use of the triple coaxial (triaxial) microcatheter system in superselective arterial embolisation for complex interventional cases: an initial experience with the system
Authors: Tashi Sonam , Tan Zehao , Gogna Apoorva
Published: December 2022

Learning objective

To share our experience in utilising the triple coaxial (triaxial) system in superselective cannulation of arteries for complex embolisation procedures.

Background

Percutaneous transcatheter selective embolisation is widely performed for a myriad of oncologic (e.g., trans-arterial chemo- or radio-embolisation) and non-oncologic (e.g., for embolisation of bleeding and benign conditions such as uterine fibroid and benign prostate hyperplasia) purposes.

The cornerstone of such embolisation procedures is to achieve superselective cannulation of the arterial supply to the tumour/organ, preventing the complication of non-target embolisation. However, a multitude of factors, such as complex vascular anatomy, can pose challenges to achieving this goal.

Clinical findings/procedural details

The triaxial system utilises two smaller microcatheters telescoped through each other over a microwire. We have adopted the triaxial system for specific cases due to its perceived superior torquability and trackability compared to the conventional coaxial system, in which superselective cannulation is anticipated to be challenging. The triaxial system is also favourable in situations where the inner microcatheter needs to be “sacrificed” after administering the embolics (e.g., after administering radioisotopes in radioembolisation, N-butyl cyanoacrylate [NBCA] glue or ethylene–vinyl alcohol copolymer [EvOH] Onyx). Through a case series with procedural details such as fluoroscopic time, contrast administered, etc., we hope to illustrate the utility and efficacy of the triaxial system as well as present pitfalls in its usage.

Conclusion

The triaxial system appears to be a valuable system for certain complex embolisation procedures and could be better suited than the conventional coaxial systems in these specific circumstances.
Ultrasound-guided percutaneous insertion of small vascular surgical clips versus dedicated breast mammoclips as markers for breast cancer prior to neo-adjuvant therapy: a prospective randomized controlled trial
Authors: El-bakoury Eman , Abd El Maksoud Walid Mohamed , Sultan Mohamed Hussein , Elwany Yasmine Nagy , Bawahab Mohammed A. , Ahmed Yasser S. , Mehanna Ayman Ahmed
Published: December 2022

Aim

To investigate the feasibility of applying small vascular surgical clips as tissue markers for breast cancer in patients scheduled for neoadjuvant chemotherapy (NAC) in comparison with the dedicated breast clips with assessment of their different complications.

Patients and methods

This prospective randomized controlled trial included 160 female patients with breast cancer whose neoadjuvant chemotherapy was required for their management. Patients were randomly allocated into 2 groups; group I for patients who were subjected to the insertion of the small vascular surgical clips, and Group II for patients who were subjected to the insertion of the dedicated breast clips (UltraClips®). Assessment of the feasibility of the application of the vascular surgical clips and detection of the complications of the vascular surgical clips compared to the UltraClip® commercial clips were the endpoints of this study.

Results

Vascular surgical clips application had significantly longer duration than the duration of application of the UltraClips® (9.10 ± 2.67 min, and 5.44 ± 1.09 min respectively, P < 0.001). The application of vascular surgical clips was feasible in all patients. There were more incidences of non-deployment (6 patients) and mal-deployment (4 patients) in group I, compared to one patient and 2 patients in group II, respectively. All patients of non-deployment and mal-deployment in both groups had reapplication of other clips successfully. There were no significant differences between the two groups regarding incidence of complications.

Conclusions

The spinal needle/surgical vascular clip technique seems to be a cheap and effective alternative to the dedicated commercial mammoclips when required, with convenient results and minimal complications.
Aortic valve calcium score in prediction of post-TAVI complications in an Egyptian cohort
Authors: Salem Mohammed Ali , Ismail Ahmed Shehata , Donkol Ragab Hani , Reyad Mohamed Adam , Ramadan Ahmed Mohammed
Published: December 2022

Background

Severe symptomatic aortic stenosis is a common disorder in the elderly and is associated with high morbidity and mortality rate. Traditionally, surgical aortic valve replacement has been considered the most effective treatment for advanced disease. Transcatheter aortic valve implantation (TAVI) has been established as a valuable alternative treatment option for inoperable and high-risk patients with symptomatic severe aortic stenosis. Pre-procedure ECG-gated CT aortography study is important in planning the procedure. The aim of the study was to correlate the aortic valve calcium score with the post-TAVI complications.

Results

Thirty patients who were candidates for TAVI procedure were enrolled for ECG-gated CT aortic valve calcium score and CT aortography. The calcium score was calculated. The patients were followed up both clinically and by echocardiography every 3 months for 1 year. Those who developed complications were enrolled for another CT study. Fourteen out of 30 patients (46.7%) presented with post-TAVI complications [9 cases (30%) presented with paravalvular leak (PVL) and 5 cases (16.7%) presented with major adverse cardiac events (MACE), while 16 cases (53.3%) had no complications]. There was a strong correlation between the calcium score and post-procedure complications.

Conclusions

The degree of aortic valve calcification can be considered as a predictor of post-TAVI complications: PVL and MACE.
Improved Accuracy and Lowered Learning Curve of Ventricular Targeting Using Augmented Reality—Phantom and Cadaveric Model Testing
Authors: Bounajem Michael T. , Cameron Brandon , Sorensen Kiel , Parr Ryan , Gibby Wendell , Prashant Giyarpuram , Evans James J. , Karsy Michael
Published: December 2022

BACKGROUND:

Augmented reality (AR) has demonstrated significant potential in neurosurgical cranial, spine, and teaching applications. External ventricular drain (EVD) placement remains a common procedure, but with error rates in targeting between 10% and 40%.

OBJECTIVE:

To evaluate Novarad VisAR guidance system for the placement of EVDs in phantom and cadaveric models.

METHODS:

Two synthetic ventricular phantom models and a third cadaver model underwent computerized tomography imaging and registration with the VisAR system (Novarad). Root mean square (RMS), angular error (γ), and Euclidian distance were measured by multiple methods for various standard EVD placements.

RESULTS:

Computerized tomography measurements on a phantom model (0.5-mm targets showed a mean Euclidean distance error of 1.20 ± 0.98 mm and γ of 1.25° ± 1.02°. Eight participants placed EVDs in lateral and occipital burr holes using VisAR in a second phantom anatomic ventricular model (mean RMS: 3.9 ± 1.8 mm, γ: 3.95° ± 1.78°). There were no statistically significant differences in accuracy for postgraduate year level, prior AR experience, prior EVD experience, or experience with video games (P> .05). In comparing EVDs placed with anatomic landmarks vs VisAR navigation in a cadaver, VisAR demonstrated significantly better RMS and γ, 7.47 ± 0.94 mm and 7.12° ± 0.97°, respectively (P≤ .05).

CONCLUSION:

The novel VisAR AR system resulted in accurate placement of EVDs with a rapid learning curve, which may improve clinical treatment and patient safety. Future applications of VisAR can be expanded to other cranial procedures.
Changes in Immune Function during Initial Military Training
Authors: HATCH-MCCHESNEY ADRIENNE , RADCLIFFE PATRICK N. , PITTS KENNETH P. , KARIS ANTHONY J. , O’BRIEN RORY P. , KRIEGER STEPHANIE , NELMAN-GONZALEZ MAYRA , DIAK DOUGLASS M. , MEHTA SATISH K. , CRUCIAN BRIAN , MCCLUNG JAMES P. , SMITH TRACEY J. , MARGOLIS LEE M. , KARL J. PHILIP
Published: December 2022

Purpose

Initial military training (IMT) is a transitionary period wherein immune function may be suppressed and infection risk heightened due to physical and psychological stress, communal living, and sleep deprivation. This study characterized changes in biomarkers of innate and adaptive immune function, and potential modulators of those changes, in military recruits during IMT.

Methods

Peripheral leukocyte distribution and mitogen-stimulated cytokine profiles were measured in fasted blood samples, Epstein–Barr (EBV), varicella zoster (VZV), and herpes simplex 1 (HSV1) DNA was measured in saliva by quantitative polymerase chain reaction as an indicator of latent herpesvirus reactivation, and diet quality was determined using the healthy eating index measured by food frequency questionnaire in 61 US Army recruits (97% male) at the beginning (PRE) and end (POST) of 22-wk IMT.

Results

Lymphocytes and terminally differentiated cluster of differentiation (CD)4+ and CD8+ T cells increased PRE to POST, whereas granulocytes, monocytes, effector memory CD4+ and CD8+ T cells, and central memory CD8+ T cells decreased (P ≤ 0.02). Cytokine responses to anti-CD3/CD28 stimulation were higher POST compared with PRE, whereas cytokine responses to lipopolysaccharide stimulation were generally blunted (P < 0.05). Prevalence of EBV reactivation was higher at POST (P = 0.04), but neither VZV nor HSV1 reactivation was observed. Diet quality improvements were correlated with CD8+ cell maturation and blunted proinflammatory cytokine responses to anti-CD3/CD28 stimulation.

Conclusions

Lymphocytosis, maturation of T-cell subsets, and increased T-cell reactivity were evident POST compared with PRE IMT. Although EBV reactivation was more prevalent at POST, no evidence of VZV or HSV1 reactivation, which are more common during severe stress, was observed. Findings suggest increases in the incidence of EBV reactivation were likely appropriately controlled by recruits and immune-competence was not compromised at the end of IMT.