bluuebunny/crossref_metadata_2025 huggingface dataset:
Combining magnetoencephalography with telemetric streaming of intracranial recordings and deep brain stimulation—A feasibility study
Authors: Hnazaee Mansoureh Fahimi , Sure Matthias , O’Neill George C. , Leogrande Gaetano , Schnitzler Alfons , Florin Esther , Litvak Vladimir
Published: October 2023

The combination of subcortical Local Field Potential (LFP) recordings and stimulation with Magnetoencephalography (MEG) in Deep Brain Stimulation (DBS) patients enables the investigation of cortico-subcortical communication patterns and provides insights into DBS mechanisms. Until now, these recordings have been carried out in post-surgical patients with externalised leads. However, a new generation of telemetric stimulators makes it possible to record and stream LFP data in chronically implanted patients. Nevertheless, whether such streaming can be combined with MEG has not been tested. In the present study, we tested the most commonly implanted telemetric stimulator—Medtronic Percept PC with a phantom in three different MEG systems: two cryogenic scanners (CTF and MEGIN) and an experimental Optically Pumped Magnetometry (OPM)-based system. We found that when used in combination with the new SenSight segmented leads, Percept PC telemetric streaming only generates band-limited interference in the MEG at 123 Hz and harmonics. However, the “legacy streaming mode” used with older lead models generates multiple, dense artefact peaks in the physiological range of interest (below 50 Hz). The effect of stimulation on MEG critically depends on whether it is done in bipolar (between two contacts on the lead) or monopolar (between a lead contact and the stimulator case) mode. Monopolar DBS creates severe interference in the MEG as previously reported. However, we found that the OPM system is more resilient to this interference and could provide artefact-free measurements, at least for limited frequency ranges. A resting measurement in the MEGIN system from a Parkinson’s patient implanted with Percept PC and subthalamic SenSight leads revealed artefact patterns consistent with our phantom recordings. Moreover, analysis of LFP-MEG coherence in this patient showed oscillatory coherent networks consistent in their frequency and topography with those described in published group studies done with externalised leads. In conclusion, Percept PC telemetric streaming with SenSight leads is compatible with MEG. Furthermore, OPM sensors could provide additional new opportunities for studying DBS effects.
Cyathus tongxinianus sp. nov. (Basidiomycota) from China
Authors: DUAN ZI-YAN , YANG XIN , LI QI , YAO LU , ZHAO CHANG-LIN
Published: October 2023

A new species of bird’s nest fungus, Cyathus tongxinianus, is proposed based on a combination of morphological and molecular evidence. Cyathus tongxinianus is characterized by the cupulate to obconical basidiomata with the smooth outer and inner surface of the peridium, a dimitic hyphal system of peridium walls with generative hyphae having clamp connections, the presence of the fimbriate mouth, brown black to dark grey peridioles, a monomitic hyphal system bearing the generative hyphae with clamp connections, the presence of crystals, and sub-globose, thick-walled basidiospores (8.5–19.5 × 7.5–11). Sequences of ITS and nLSU rRNA markers of the studied samples were generated, and the phylogenetic analyses were performed with maximum likelihood, maximum parsimony and bayesian inference methods on two datasets (ITS+nLSU and ITS). The analyses showed that the new species clustered into the genus Cyathus within the family Nidulariaceae based on the ITS+nLSU phylogenetic tree. The phylogenetic analyses based on molecular data from ITS sequences showed that C. tongxinianus is sister to C. annulatus, and groups with C. renweii.
Taxonomic Reconciliation of Smilacaceae in the Indian Subcontinent: Synonymy, Typification, Updated Inventory, and a Vegetative Key for Identification
Authors: SUKHRAMANI GEETIKA , CHOUDHARY RITESH KUMAR
Published: October 2023

Smilax is the sole genus of the family Smilacaceae, represented by 36 taxa in the Indian subcontinent. The taxonomy of the genus has been challenging due to its dioecious nature and substantial inter- and intra-specific variations. With an aim to clarify and streamline the nomenclature of Smilax species and resolve long-standing taxonomic ambiguities, a critical morphological analysis of the taxa belonging to Smilacaceae in the Indian subcontinent was carried out. We devised a key to the Smilax species of the Indian subcontinent based on vegetative characters alone, which will help in field identification throughout the year. Moreover, an updated checklist of the Smilacaceae in the Indian subcontinent is provided. In addition, Smilax aspericaulis and S. quadrumbellata are synonymized under S. odoratissima and S. zeylanica, respectively. The typification of four Smilax names is also addressed.
The spiraling story of Tyleropappus and a new name for Calea (Asteraceae: Neurolaeneae) from Venezuela
Authors: BUENO VINICIUS R. , GOSTEL MORGAN R. , HEIDEN GUSTAVO
Published: October 2023

Tyleropappus was described in 1931 by Greenman and is characterized by its spiral, alternate leaves and epaleaceous receptacle. Throughout its taxonomic history, the genus was placed into the tribes Helenieae and Neurolaeneae, often treated as the sister genus of Geissopappus, which is currently a synonym of Calea. Later, Tyleropappus was synonymized with Calea; however, when its synonymization was proposed, the sole species in the genus, T. dichotomus, had not been synonymized under a previously described species nor properly transferred to Calea. Ongoing taxonomic studies in Neurolaeneae have provided opportunities to clarify the challenging taxonomic history of this monotypic genus. We confirm the synonymy of Tyleropappus in Calea; however, we recognize T. dichotomus as a distinct species that should be accepted in Calea. Nonetheless, the name C. dichotoma already exists, and is a synonym of C. ternifolia. Therefore, we propose the new name C. spiralis to accommodate this species, which is morphologically similar to C. linearifolia. The former can be distinguished from the latter by the spiral, alternate (vs. decussate) arrangement of leaves, receptacle epaleaceous (vs. oligopaleaceous) and cypselae hirsute (vs. glabrous). We also provide a detailed description of the species, the first map of its geographic occurrence, an illustration with diagnostic characters, and the first taxonomic key for the Nana clade of Calea.
Loropetalum axillare (Hamamelidaceae), a new species from Guangdong, China
Authors: JIN ZI-CHAO , XU LIAN-SHENG , XU YE-CHUN , CHEN YOU-SHENG
Published: October 2023

Loropetalum axillare (Hamamelidaceae), a new species from Zengcheng District, Guangzhou, Guangdong, China, is described and illustrated. The new species is related to Loropetalum chinense but differs by its inflorescence axillary and peduncle absent (vs. inflorescence terminal and peduncle 0.8–1 cm long). The new species is supported by phylogenetic analyses based on ITS and ETS sequences.
Dynamically Downscaled Projections of Phenological Changes across the Contiguous United States
Authors: Mallard Megan S. , Talgo Kevin D. , Spero Tanya L. , Bowden Jared H. , Nolte Christopher G.
Published: October 2023

Phenological indicators (PI) are used to study changes to animal and plant behavior in response to seasonal cycles, and they can be useful to quantify the potential impacts of climate change on ecosystems. Here, multiple global climate models and emission scenarios are used to drive dynamically downscaled simulations using the WRF Model over the contiguous United States (CONUS). The wintertime dormancy of plants [chilling units (CU)], timing of spring onset [extended spring indices (SI)], and frequency of proceeding false springs are calculated from regional climate simulations covering historical (1995–2005) and future periods (2025–2100). Southern parts of the CONUS show projected CU decreases (inhibiting some plants from flowering or fruiting), while the northern CONUS experiences an increase (possibly causing plants to break dormancy too early, becoming vulnerable to disease or freezing). Spring advancement (earlier SI dates) is projected, with decadal trends ranging from approximately 1–4 days per decade over the CONUS, comparable to or exceeding those found in observational studies. Projected changes in risk of false spring (hard freezes following spring onset) vary across members of the ensemble and regions of the CONUS, but generally western parts of the CONUS are projected to experience increased risk of false springs. These projected changes to PI connote significant effects on cycles of plants, animals, and ecosystems, highlighting the importance of examining temperature changes during transitional seasons.

Significance Statement

This study examines how phenological indicators, which track the life cycles of plants and animals, could change from 2025 to 2100 as simulated in a regional climate model over the contiguous United States. Chilling units quantify the presence of cooler weather that can benefit plants prior to their growing season. They are projected to decrease in the southern United States, possibly inhibiting agricultural production. Spring onset is projected to occur earlier in the year, advancing by 1–4 days on average over each future decade. Risk of false springs (damaging hard freezes after spring onset) increases in the western United States. Our findings highlight the need to understand effects of climate change during transitional seasons, which can impact agriculture and ecosystems.
Incidence, severity and impact on functional outcome of persistent hypoperfusion despite large-vessel recanalization, a potential marker of impaired microvascular reperfusion: Systematic review of the clinical literature
Authors: Schiphorst Adrien ter , Turc Guillaume , Hassen Wagih Ben , Oppenheim Catherine , Baron Jean-Claude
Published: October 2023

The reported incidence of persistent hypoperfusion despite complete recanalization as surrogate for impaired microvascular reperfusion (IMR) has varied widely among clinical studies, possibly due to differences in i) definition of complete recanalization, with only recent Thrombolysis in Cerebral Infarction (TICI) grading schemes allowing distinction between complete (TICI3) and partial recanalization with distal occlusions (TICI2c); ii) operational definition of IMR; and iii) consideration of potential alternative causes for hypoperfusion, notably carotid stenosis, re-occlusion and post-thrombectomy hemorrhage. We performed a systematic review to identify clinical studies that carried out brain perfusion imaging within 72 hrs post-thrombectomy for anterior circulation stroke and reported hypoperfusion rates separately for TICI3 and TICI2c grades. Authors were contacted if this data was missing. We identified eight eligible articles, altogether reporting 636 patients. The incidence of IMR after complete recanalization (i.e., TICI3) tended to decrease with the number of considered alternative causes of hypoperfusion: range 12.5–42.9%, 0–31.6% and 0–9.1% in articles that considered none, two or all three causes, respectively. No study reported the impact of IMR on functional outcome separately for TICI-3 patients. Based on this systematic review, IMR in true complete recanalization appears relatively rare, and reported incidence highly depends on definition used and consideration of confounding factors.
Use of ceftriaxone as an alternative treatment method in pregnant women diagnosed with syphilis – a single centre experience
Authors: Hartmane Ilona , Ivdra Iveta , Mikazans Ingmars , Princevs Aleksejs , Teterina Irena , Bondare-Ansberga Vanda , Reinberga Lelde
Published: October 2023

Background

There are few data on the use of ceftriaxone in pregnant women diagnosed with syphilis. The aim of this study was to investigate the safety and efficacy of ceftriaxone as an alternative treatment option for syphilis during pregnancy.

Methods

A retrospective analysis of 79 pregnant women diagnosed with syphilis and treated with ceftriaxone was conducted.

Results

No cases of intolerance, Jarisch-Herxheimer reactions, or allergic reactions were recorded. The average time to seronegativation for secondary syphilis with symptoms was 6.14 months ± 2.76, and for latent forms, it was 7.52 months ± 1.84. Patients received no additional treatment. No serious adverse drug reactions were reported.

Conclusions

Data from our study support the use of ceftriaxone as an effective and safe alternative treatment for pregnant women diagnosed with syphilis when penicillin therapy is contraindicated or unavailable.
Toxic mechanisms of cadmium and exposure as a risk factor for oral and gastrointestinal carcinomas
Authors: Tavakoli Pirzaman Ali , Ebrahimi Pouyan , Niknezhad Shokat , vahidi Turan , Hosseinzadeh Dariush , Akrami Sousan , Ashrafi Arash M , Moeen Velayatimehr Mohammad , Hosseinzadeh Rezvan , Kazemi Sohrab
Published: October 2023

Incidence and mortality rates of gastrointestinal (GI) and oral cancers are among the highest in the world, compared to other cancers. GI cancers include esophageal, gastric, colon, rectal, liver, and pancreatic cancers, with colorectal cancer being the most common. Oral cancer, which is included in the head and neck cancers category, is one of the most important causes of death in India. Cadmium (Cd) is a toxic element affecting humans and the environment, which has both natural and anthropogenic sources. Generally, water, soil, air, and food supplies are reported as some sources of Cd. It accumulates in organs, particularly in the kidneys and liver. Exposure to cadmium is associated with different types of health risks such as kidney dysfunction, cardiovascular disease, reproductive dysfunction, diabetes, cerebral infarction, and neurotoxic effects (Parkinson’s disease (PD) and Alzheimer’s disease (AD)). Exposure to Cd is also associated with various cancers, including lung, kidney, liver, stomach, hematopoietic system, gynecologic and breast cancer. In the present study, we have provided and summarized the association of Cd exposure with oral and GI cancers.
Proving gender and sexuality in the (homo)nationalist Greek asylum system: Credibility, sexual citizenship and the ‘bogus’ sexual other
Authors: Zisakou Sophia
Published: October 2023

The aim of this article is to analyse and critique Greek authorities’ expectations for a ‘credible’ account in queer asylum claims. As some of the caseworkers’ accounts portray, through 16 semi-structured interviews, in order to be deemed ‘credibly queer’ applicants are expected to have passed through a painful, discursively narratable process of self-realization and have suffered enough in their ‘queerphobic and oppressive’ countries of origin. At the same time, they are supposed to find safety and protection in Greece, following a linear ‘affective journey’ from oppression to liberation, happiness and pride. However, as this research argues, decision-makers do not always comply with normative expectations but, simultaneously, through their performative assessments, they go beyond them. This way, they do not only reproduce but they often resist the homonationalist discursive framework that governs intelligibility in the asylum process; a framework founded on Eurocentric and white-centred presumptions of the ‘good and happy sexual citizen’ and the ‘bogus sexual other’. By drawing on this situated, from below critique, as well as on postcolonial feminist and queer theory, this article seeks to open up racialized, classed and gendered, normative definitions of queerness to different possibilities that do not conform with neoliberal sexual politics and urges for a more critical interpretation of the Refugee Convention.
The Meaning of Waiting: Meaning-making Narratives and Counter-narratives in the Teachings of the Desert Fathers
Authors: Aijian Janelle L. , Merrill David L.
Published: October 2023

Recent work in the psychology of emotions has highlighted the helpfulness of meaning-making narratives to contextualize and make sense of experiences of suffering. In this article we argue that the experience of waiting should be regarded as an experience of suffering with the potential to produce a disruption in a person’s sense of the meaningfulness of their experience. We look to the resources of the Christian tradition for a narrative of waiting that can reorient a person feeling the disruption of a long season of waiting. We argue that Evagrius’ description of the deadly thought of acedia is best understood as a meaning-making counter-narrative, employed by a demonic tempter to disrupt a believer’s perseverance. We show how the responses suggested by Evagrius, namely to reassert an orienting narrative through the use of scriptures, can be expanded to lean on the larger Christian tradition, which grounds the meaningfulness of waiting in the theological virtues of faith, hope, and love through meditations on the Exodus narrative and the life of Christ.
Post-colonial Water Governance: Shifting Paradigms
Authors: Das Mona
Published: October 2023

Water governance has been at the centre of societal formations. From ‘hydraulic societies’ headed by ‘oriental despots’ to community-based models of water governance all point to the centrality of this naturally available resource defining state-society-citizen relations. Accessing water under the modern welfare state came to be seen as a ‘material’ emblem of citizenship. Later, neoliberalism paved the way for commercialisation and privatisation riding high on the slogan of ‘universal access’ and discourse of ‘scarcity’. These paradigmatic shifts signalled changes in water governance. This article charts a broad-brush history of changes in the governance structure and logic of water supply over the last seven decades in Delhi. It focuses on a specific aspect of water governance, that is, mechanisms to supply drinking water in post-colonial Delhi. The case of the capital city of a developing country has been used as a prism to comment on the trajectory of water governance in post-colonial societies.
The role of procedural utility in land market dynamics in Greater Cairo: An agent based model application
Authors: Gamal Yahya , Pinto Nuno , Iossifova Deljana
Published: October 2023

In land use analyses, procedural utility is the sense of well-being achieved by an actor while participating in a land market. Such utility has not been explored as an indicator of market preferences beyond applying exploratory Agent Based Models (ABMs) and hypothetical scenarios. This paper presents an empirical approach to procedural utility and applies it in the context of Greater Cairo (GC) – a context with different formal/informal markets that lead to different market preferences for buyers. We integrate the observed market preferences in GC in an ABM incorporating procedural utility. We explore the contribution of such utility on formal/informal urban segregation and urban expansion in GC. Our findings indicate that market preferences contribute to (1) the formulation of urban enclaves and lower socio-economic diversity and (2) making the urban system in GC more attractive, leading to higher urban growth. These findings validate the relevance of procedural utility in contexts where market regulations are distinct enough to trigger buyer market preferences – specifically formal/informal contexts of the Global South.
Pranic Healing as a Complementary Therapy in Diabetic Foot Ulcer Management: A Randomised, Controlled, Double-Blind Trial
Authors: Nittur Anuradha , Pavan Belehalli , Ganapathy Raghavan , Dorai Vinod Kumar , Singhal Shivam
Published: October 2023

Background

Diabetic Foot Ulcers (DFUs), a serious complication of diabetes, have limited solutions in conventional therapies. The condition needs holistic management of blood glycemic levels; foot wounds; and possible regeneration of nerves in the soles of patients.

Objective

To evaluate the efficacy of Pranic Healing as a complimentary therapy in managing Diabetic Foot Ulcers (DFUs).

Methods

Thirty diabetic subjects already on standard therapy for Diabetes, co morbidities and wound care for Diabetic Foot Ulcers were assigned on a 1:1 basis to the trial and control groups. While both groups continued to receive standard therapy, the trial group additionally received Pranic Healing therapy. The Clinician, nursing staff, assessors and patients were blinded. Pranic Healers carried out healing on the trial group remotely, every day for 50 to 60 minute for stress, diabetes, local wound healing, blood cleansing and regeneration of nerves in the soles. The efficacy variables were the mean change from baseline in wound parameters and grade of DFU, overall well-being and HbAlc levels.

Results

At the end of the trial, about 83.33% participants in the trial group demonstrated lowering of size and severity of the ulceration and improved to a lower grade of DFU compared to 44.4% in control group. The trial group reported a significant reduction in wound area and HbA1c levels. The trial group showed better readings for improved sensory perception in the soles through changes in the large fibre dysfunction and damaged nerves as compared to the control group. Approximately 76.9% of participants in the trial group reported lower stress levels compared to 22.22% in the control group.

Conclusions

Pranic Healing intervention can be a safe and effective adjunct in managing Diabetic Foot Ulcers.
Gata2 noncoding genetic variation as a determinant of hematopoietic stem/progenitor cell mobilization efficiency
Authors: Soukup Alexandra A. , Bresnick Emery H.
Published: October 2023

Germline genetic variants alter the coding and enhancer sequences of GATA2, which encodes a master regulator of hematopoiesis. The conserved murine Gata2 enhancer (+9.5) promotes hematopoietic stem cell (HSC) genesis during embryogenesis. Heterozygosity for a single-nucleotide Ets motif variant in the human enhancer creates a bone marrow failure and acute myeloid leukemia predisposition termed GATA2 deficiency syndrome. The homozygous murine variant attenuates chemotherapy- and transplantation-induced hematopoietic regeneration, hematopoietic stem and progenitor cell (HSPC) response to inflammation, and HSPC mobilization with the therapeutic mobilizer granulocyte colony–stimulating factor (G-CSF). Because a Gata2 +9.5 variant attenuated G-CSF–induced HSPC expansion and mobilization, and HSC transplantation therapies require efficacious mobilization, we tested whether variation affects mechanistically distinct mobilizers or only those operating through select pathways. In addition to affecting G-CSF activity, Gata2 variation compromised IL-8/CXCR2- and VLA-4/VCAM1-induced mobilization. Although the variation did not disrupt HSPC mobilization mediated by plerixafor, which functions through CXCR4/CXCL12, homozygous and heterozygous variation attenuated mobilization efficacy of the clinically used plerixafor/G-CSF combination. The influence of noncoding variation on HSPC mobilization efficacy and function is important clinically because comprehensive noncoding variation is not commonly analyzed in patients. Furthermore, our mobilization-defective system offers unique utility for elucidating fundamental HSPC mechanisms.
Improved phyllosphere microbiome composition of tea plant with the application of small peptides in combination with rhamnolipid
Authors: Chen Hao , Song Yujie , Wang Shuangshuang , Fan Kai , Wang Hui , Mao Yilin , Zhang Jie , Xu Yang , Yin Xinyue , Wang Yu , Ding Zhaotang
Published: October 2023

Background

Small peptides play a crucial role in plant growth and adaptation to the environment. Exogenous small peptides are often applied together with surfactants as foliar fertilizers, but the impact of small peptides and surfactants on the tea phyllosphere microbiome remains unknown.

Results

In this study, we investigated the effects of small peptides and different surfactants on the tea phyllosphere microbiome using 16S and ITS sequencing. Our results showed that the use of small peptides reduced the bacterial diversity of the tea phyllosphere microbiome and increased the fungal diversity, while the use of surfactants influenced the diversity of bacteria and fungi. Furthermore, the addition of rhamnolipid to small peptides significantly improved the tea phyllosphere microbiome community structure, making beneficial microorganisms such as Pseudomonas, Chryseobacterium, Meyerozyma, and Vishniacozyma dominant populations.

Conclusion

Our study suggests that the combined use of small peptides and surfactants can significantly modify the tea phyllosphere microbiome community structure, particularly for beneficial microorganisms closely related to tea plant health. Thus, this preliminary study offers initial insights that could guide the application of small peptides and surfactants in agricultural production, particularly with respect to their potential for modulating the phyllosphere microbiome community in tea plant management.
Sub-lethal concentration of a colloidal nanosilver formulation (Silversol®) triggers dysregulation of iron homeostasis and nitrogen metabolism in multidrug resistant Pseudomonas aeruginosa
Authors: Gajera Gemini , Thakkar Nidhi , Godse Chhaya , DeSouza Anselm , Mehta Dilip , Kothari Vijay
Published: October 2023

Background

Pseudomonas aeruginosa is a notorious pathogen. Its multidrug resistant strains are listed among priority pathogens against whom discovery of novel antibacterial agents and, elucidation of new anti-pathogenicity mechanisms are urgently warranted. This study describes multiple antibacterial effects of a colloidal nano-silver formulation- Silversol® against a multi-drug resistant strain of P. aeruginosa.

Results

Minimum inhibitory concentration (MIC) of Silversol® against P. aeruginosa was found to be 1.5 ppm; and at sub-MIC of 1 ppm, it was able to alter quorum-sensing regulated pigmentation (pyocanin 82%↓; pyoverdine 48%↑), exopolysaccharide synthesis (76%↑) and biofilm formation, susceptibility to antibiotics (streptomycin and augmentin), protein synthesis and export (65%↑), nitrogen metabolism (37%↑ nitrite accumulation), and siderophore production in this pathogen. Network analysis of the differentially expressed genes in the transcriptome of the silversol-treated bacterium identified ten genes as the potential molecular targets: norB, norD, nirS, nirF, nirM, nirQ, nosZ, nosY, narK1, and norE (all associated with nitrogen metabolism or denitrification). Three of them (norB, narK1, and norE) were also validated through RT-PCR.

Conclusions

Generation of nitrosative stress and disturbance of iron homeostasis were found to be the major mechanisms associated with anti-Pseudomonas activity of Silversol®.
What is important to the GP in recognizing acute appendicitis in children: a delphi study
Authors: Blok Guus C.G.H. , Berger Marjolein Y. , Ahmeti Arjan B. , Holtman Gea A.
Published: October 2023

Background

For diagnostic research on appendicitis in registration data, insight is needed in the way GPs generate medical records. We aimed to reach a consensus on the features that GPs consider important in the consultation and medical records when evaluating a child with suspected appendicitis.

Methods

We performed a three-round Delphi study among Dutch GPs selected by purposive sampling. An initial feature list was created based on a literature search and features in the relevant Dutch guideline. Finally, using a vignette describing a child who needed later reassessment, we asked participants to complete an online questionnaire about which consultation features should be addressed and recorded.

Results

A literature review and Dutch guideline yielded 95 consultation features. All three rounds were completed by 22 GPs, with the final consensus list containing 26 symptoms, 29 physical assessments and signs, 2 additional tests, and 8 further actions (including safety-netting, i.e., informing the patient about when to contact the GP again). Of these, participants reached consensus that 37 should be actively addressed and that 20 need to be recorded if findings are negative.

Conclusions

GPs agreed that negative findings do not need to be recorded for most features and that records should include the prognostic and safety-netting advice given. The results have implications in three main domains: for research, that negative findings are likely to be missing; for medicolegal purposes, that documentation cannot be expected to be complete; and for clinical practice, that safety-netting advice should be given and documented.
Computer-assisted evaluation of small airway disease in CT scans of Iran-Iraq war victims of chemical warfare by a locally developed software: comparison between different quantitative methods
Authors: Baradaran Mahdavi Mohammad Mehdi , Rafati Mehravar , Ghanei Mostafa , Arabfard Masoud
Published: October 2023

Objective

Diagnosis of small airway disease on computed tomography (CT) scans is challenging in patients with a history of chemical warfare exposure. We developed a software package based on different methodologies to identify and quantify small airway disease in CT images. The primary aim was to identify the best automatic methodology for detecting small airway disease in CT scans of Iran-Iraq War victims of chemical warfare.

Methods

This retrospective case–control study enrolled 46 patients with a history of chemical warfare exposure and 27 controls with inspiratory/expiratory (I/E) CT scans and spirometry tests. Image data were automatically segmented, and inspiratory images were registered into the expiratory images' frame using the locally developed software. Parametric response mapping (PRM) and air trapping index (ATI) mapping were performed on the CT images. Conventional QCT methods, including expiratory/inspiratory mean lung attenuation (E/I MLA) ratio, normal density E/I (ND E/I) MLA ratio, attenuation volume Index (AVI), %low attenuation areas (LAA) < -856 in exhale scans, and %LAA < -950 in inhale scans were also computed. QCT measurements were correlated with spirometry results and compared across the two study groups.

Results

The correlation analysis showed a significant negative relationship between three air trapping (AT) measurements (PRM, ATI, and %LAAExp < -856) and spirometry parameters (Fev1, Fvc, Fev1/Fvc, and MMEF). Moreover, %LAAExp < -856 had the highest significant negative correlation with Fev1/Fvc (r = -0.643, P-value < 0.001). Three AT measurements demonstrated a significant difference between the study groups. The E/I ratio was also significantly different between the two groups (P-value < 0.001). Binary logistic regression models showed PRMFsad, %LAAExp < -856, and ATI as significant and strong predictors of the study outcome. Optimal cut-points for PRMFsad = 19%, %LAAExp < -856 = 23%, and ATI = 27% were identified to classify the participants into two groups with high accuracy.

Conclusion

QCT methods, including PRM, ATI, and %LAAExp < -856 can greatly advance the identification and quantification of SAD in chemical warfare victims. The results should be verified in well-designed prospective studies involving a large population.
Spatial distribution and determinants of tetanus toxoid immunization among pregnant women in Ethiopia using data from Ethiopian demographic and health survey 2016
Authors: Fentie Beletech , Alemu Tewodros Getaneh , Techane Masresha Asmare , Wubneh Chalachew Adugna , Assimamaw Nega Tezera , Belay Getaneh Mulualem , Tamir Tadesse Tarik , Muhye Addis Bilal , Kassie Destaye Guadie , Wondim Amare , Terefe Bewuketu , Tarekegn Bethelihem Tigabu , Ali Mohammed Seid , Gonete Almaz Tefera , Tekeba Berhan , Kassa Selam Fisiha , Desta Bogale Kassahun , Ayele Amare Demsie , Dessie Melkamu Tilahun , Atalell Kendalem Asmare
Published: October 2023

Introduction

Tetanus is a major public health problem caused by clostridium tetani. Although it is vaccine-preventable, the case fatality rate among neonates in areas with poor immunization coverage and limited access to clean deliveries reaches 80-100%. Vaccination of pregnant mothers with the tetanus toxoid (TT) vaccine is the most effective way to protect against neonatal tetanus. This study aimed to examine the spatial distribution and determinants of tetanus toxoid immunization among pregnant mothers using the 2016 EDHS data.

Method

Secondary analysis of the Ethiopia Demographic and Health Survey 2016 was done to assess the spatial distribution and determinants of tetanus toxoid vaccine among pregnant women in Ethiopia. Spatial autocorrelation analysis and hot spot analysis were used to detect spatial dependency and spatial clustering of the tetanus toxoid vaccine in Ethiopia. Spatial interpolation was used to predict the tetanus toxoid vaccine coverage in unsampled areas. The multilevel binary logistic regression model was fitted to identify factors associated with tetanus toxoid vaccination. An adjusted odds ratio with 95% CI was calculated and used as the measure of association and a p-value less than 0.05 were considered statistically significant.

Result

From the total of 7043 pregnant women, 42.4% of them have taken at least two doses of tetanus toxoid immunization. Spatial clustering of TT immunization was observed in the Northern, Southwestern and Southwestern parts of Ethiopia. Whereas, low TT coverage was observed in the Eastern and Western parts of the country. Increased ANC visits and the richest economic status favored TT immunization, whereas living in Addis Ababa and Dire Dewa cities decreased the TT immunization coverage.

Conclusion

The finding of this study reveals that TT immunization had spatial dependency, with the highest immunization coverage observed in the Northern, Southwestern and Southeastern parts of the Country. Thus, geographically targeted interventions should be implemented particularly in the eastern and western parts of the country.
Corneal topographic indices of scheimpflug camera in type 2 diabetic and non-diabetic elderly populations
Authors: Hashemi Alireza , Khabazkhoob Mehdi , Narooei Foroozan , Mortazavi Abolghasem , Hashemi Hassan
Published: October 2023

Purpose

The present study was conducted to determine the corneal topographic indices of Scheimpflug camera in type 2 diabetes patients without diabetic retinopathy (DR), DR and non-diabetic elderly populations.

Methods

A total of 1105 participants were selected using random cluster sampling from Tehran, Iran and categorized into three groups including type 2 diabetes patients without diabetic retinopathy (DR), DR and non-diabetic. The diabetic group had HbA1c levels ≥ 6.4% with no other systemic problems. The non-diabetic participants had normal eye findings and no systemic diseases. The pachymetric progression index (PPI) values were measured using the Pentacam AXL.

Results

A total of 1105 participants including 429 diabetes patients (38.46% male) and 676 non-diabetic (38.76% male) subjects entered the study. Only PPIavg and PPImax were higher in the diabetics versus non-diabetics (P = 0.019 and 0.010, respectively). There was a significant difference in PPImax between the three groups (P = 0.036). There were significant differences only in index of vertical asymmetry (IVA), central keratoconus index (CKI), PPI average, and PPI max between different stages of diabetic retinopathy (DR) (P = 0.045, 0.005, 0.002, and 0.004, respectively). There was a significant difference in index of Surface Variance (ISV), index of vertical asymmetry (IVA), PPIavg, and PPImax between diabetes patients with and without DR (P = 0.016, 0.022, < 0.001, and < 0.001, respectively).

Conclusion

According to the results, diabetes and DR change several topographic indices. In addition, the HbA1c level may affect pachymetric progression index max. Therefore, special attention should be paid to these patients for different treatment strategies.
Patient, clinician, and performance-based measures provide different information about clinical symptoms in patients with severe knee osteoarthritis presenting with depressive symptoms: a cross-sectional study
Authors: Pérez-Maletzki José , Domínguez-Navarro Fernando , Roig-Casasús Sergio , Díaz-Díaz Beatriz , Querol-Giner Felipe , García-Gomáriz Carmen , Blasco José-María
Published: October 2023

Background and purpose

Clinical status of subjects with knee osteoarthritis (KOA) is influenced by a complex interaction of several biopsychosocial factors. The use of patient-reported measures (PROM) is considered the gold standard for their evaluation. However, considering that 1 in 5 subjects with KOA present with depressive symptoms, it is necessary to analyse how this psychological domain may influence the subjective perception of PROM. The objective was to study the impact that depressive symptoms have on functional outcome assessments, according to the degree of objectivity of diverse outcome measures.

Methods

Cross-sectional study. Subjects with severe KOA, verified with clinical and radiological symptoms, were assessed with patient-reported (Oxford Knee Score), clinician-reported (knee range of motion), and performance-based (Timed up and go test) measures. The existence of depressive symptoms was assessed with the Yesavage scale, and participants were classified for having no-, mild- or severe-symptoms. Linear correlations (r) and one-way analysis of variance compared groups (95% CI).

Results

244 participants were analysed, of which 75 (30.7%) had depressive symptoms. These symptoms had an inverse moderate association with Oxford Knee Score (r = -0.387). However, the correlation with the Timed up and go test was low (r = 0.176), while there was no correlation with knee ROM (r = -0.087).

Conclusions

This study supports that patient-reported questionnaires may offer biased information on the clinical status of patients with severe knee osteoarthritis who present with depressive symptoms. Consideration of such symptoms may be critical to ensure data collected to accurately reflect patients’ capacities and perceptions.
The relationship between spiritual intelligence and self-management in patients with diabetes type 1
Authors: Rafiei Sima , Souri Saber , Nejatifar Zahra , Amerzadeh Mohammad
Published: October 2023

Background

Diabetes is widely recognized as one of the most pressing public health concerns globally. To manage blood glucose levels and reduce subsequent complications and mortality rates, self-management mechanisms have been found to be effective in controlling diabetes. This study aimed to investigate the association between spiritual intelligence and diabetes self-management in patients with type 1 diabetes in Qazvin, Iran.

Methods

This cross-sectional study included 220 adults with type 1 diabetes aged 18–35 years who referred to an outpatient diabetes clinic of a tertiary hospital in Qazvin province, and were selected through a convenience sampling method in 2022. Two valid and reliable questionnaires were used for data collection, including the 24-item questionnaire of spiritual intelligence and self-management of type 1 diabetes for adolescents (SMOD-A). To analyze the data, correlation coefficients and multiple linear regression analysis were used.

Results

The total score of spiritual intelligence was 57.24 ± 10.77, and self-management was 77.14 ± 8.92. Among different subscales of spiritual intelligence, critical thinking obtained the highest score. In self-management, the highest score was achieved for communication.Findings also revealed that spiritual intelligence could predict 7.2% of changes in self-management among diabetes patients, and its relationship with diabetes self-management was estimated at 0.27.

Conclusion

The growing prevalence of diabetes worldwide underscores the significance of self-management of the disease in the well-being of patients. This study demonstrated that spiritual intelligence played a crucial role among young adults with diabetes and assisted them in coping with stressful situations. As such, placing greater emphasis on the spiritual aspects of care is necessary, especially in the healthcare of young adults who are dealing with diabetes and its complex conditions.
The roles of health literacy in parents’ honey use and the use of complementary alternative medicine in a Turkish population
Authors: Tek Ayaz Suzan
Published: October 2023

Background

As a biologically based therapy, honey is used by parents in many parts of the world as a home remedy for their children. While information exists regarding the traditional use of honey for health issues in children, data regarding its relationship with health literacy is lacking. The aims of this study were to determine the use of honey to address children’s health issues among parents of children aged 0–72 months and to explore the relationship between the use of complementary and alternative medicine (CAM) and health literacy.

Methods

The data for this descriptive, cross-sectional study were collected between October and November 2022 via an online survey of 907 parents of children aged 0–72 months. A sociodemographic data collection form, the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), and the Turkey Health Literacy Scale-32 (THLS-32) were used to collect the data. A t-test, one-way analysis of variance, and Pearson correlation analysis were used to analyze the data.

Results

The majority (86.5%) of the parents used honey for their children’s health problems. Among the parents, 83.1% utilized honey as a remedy for alleviating cough symptoms, 10.4% employed it as a treatment for diarrhea, and 14% administered it for the management of oral mucositis. The mean THLS-32 and HCAMQ scores of the parents were 29.39 and 21.31, respectively, and there was a moderate correlation between the parents’ THLS-32 and HCAMQ mean scores (r = 0.662, p < 0.001).

Conclusion

This study revealed that a significant proportion of parents who used honey to alleviate their children’s health issues displayed positive attitudes toward complementary and alternative medicine (CAM) while concurrently exhibiting insufficient or limited health literacy levels. Therefore, it is advisable to enhance health literacy regarding the proper and safe utilization of honey, which functions as a biologically based CAM therapy.
Development of novel composite data quality scores to evaluate facility-level data quality in electronic data in Kenya: a nationwide retrospective cohort study
Authors: Odeny Beryne M. , Njoroge Anne , Gloyd Steve , Hughes James P. , Wagenaar Bradley H. , Odhiambo Jacob , Nyagah Lilly M. , Manya Ayub , Oghera Ooga Wesley , Puttkammer Nancy
Published: October 2023

Background

In this evaluation, we aim to strengthen Routine Health Information Systems (RHIS) through the digitization of data quality assessment (DQA) processes. We leverage electronic data from the Kenya Health Information System (KHIS) which is based on the District Health Information System version 2 (DHIS2) to perform DQAs at scale. We provide a systematic guide to developing composite data quality scores and use these scores to assess data quality in Kenya.

Methods

We evaluated 187 HIV care facilities with electronic medical records across Kenya. Using quarterly, longitudinal KHIS data from January 2011 to June 2018 (total N = 30 quarters), we extracted indicators encompassing general HIV services including services to prevent mother-to-child transmission (PMTCT). We assessed the accuracy (the extent to which data were correct and free of error) of these data using three data-driven composite scores: 1) completeness score; 2) consistency score; and 3) discrepancy score. Completeness refers to the presence of the appropriate amount of data. Consistency refers to uniformity of data across multiple indicators. Discrepancy (measured on a Z-scale) refers to the degree of alignment (or lack thereof) of data with rules that defined the possible valid values for the data.

Results

A total of 5,610 unique facility-quarters were extracted from KHIS. The mean completeness score was 61.1% [standard deviation (SD) = 27%]. The mean consistency score was 80% (SD = 16.4%). The mean discrepancy score was 0.07 (SD = 0.22). A strong and positive correlation was identified between the consistency score and discrepancy score (correlation coefficient = 0.77), whereas the correlation of either score with the completeness score was low with a correlation coefficient of -0.12 (with consistency score) and -0.36 (with discrepancy score). General HIV indicators were more complete, but less consistent, and less plausible than PMTCT indicators.

Conclusion

We observed a lack of correlation between the completeness score and the other two scores. As such, for a holistic DQA, completeness assessment should be paired with the measurement of either consistency or discrepancy to reflect distinct dimensions of data quality. Given the complexity of the discrepancy score, we recommend the simpler consistency score, since they were highly correlated. Routine use of composite scores on KHIS data could enhance efficiencies in DQA at scale as digitization of health information expands and could be applied to other health sectors beyondHIV clinics.
Association between fibrosis-related gene polymorphism and long-term allograft outcome in renal transplant recipients
Authors: Yin Yu , Zhang Han , Sun Li , Han Qianguang , Zheng Ming , Chen Hao , Fei Shuang , Tan Ruoyun , Ju Xiaobing , Wang Zijie , Gu Min
Published: October 2023

Background

Renal allograft fibrosis is one of characteristic causes of long-term renal function loss. The purpose of our study is to investigate the association between fibrosis-related genes single nucleotide polymorphism (SNPs) and kidney function in 5 years after kidney transplantation.

Methods

A total of 143 recipients were eligible for screening with 5-year follow-up information and SNP sequencing information from blood samples were included in this study. Minor Allele Frequency (MAF) and Hardy–Weinberg Equilibrium (HWE) analysis was conducted to identify tagger single-nucleotide polymorphisms (SNPs) and haplotypes. SNPs associated with the fifth year chronic kidney disease (CKD) staging were screened by SPSS and the “SNPassoc” package in RStudio and used for subsequent prediction model construction.

Results

A total of 275 renal transplant-related SNPs identified after target sequencing analysis. 64 Tagger SNPs were selected, and two SNPs (rs13969 and rs243849) were statistically significant for stage of CKD in 5 years. Finally, a model based on Gender, Age, rs1396, and rs243849 was constructed by multivariate linear regression analysis. Additionally, this model has a good performance in predicting uremia five years after kidney transplantation.

Conclusion

Two SNPs (rs13969 and rs243849) were identified to be significantly associated with long-term renal allograft function. Based on this, a prediction model for long-term allograft function was established containing Gender, Age, rs1396, and rs243849. However, an independent cohort should be enrolled to validate the predicting performance.