bluuebunny/crossref_metadata_2025 huggingface dataset:
EVALUATION OF THE EFFECTIVENESS OF DENTAL COMPLACATIONS PREVENTION AGAINST THE BACKGROUND OF CHEMOTHERAPY IN ONCOLOGICAL PATIENTS IN ZAPORIZHZHIA
Authors: Filon A. M.
Published: May 2023

SUMMARY. The aim – to investigate the condition of the oral cavity in patients with malignant neoplasms of the mammary gland and lungs before and after chemotherapy and to analyze the effectiveness of dental prophylaxis.
Material and methods. To achieve this goal, a statistical study of oncological patients undergoing chemotherapy at the ONCOLIFE medical center (Zaporizhzhia) was performed. 60 patients, both men and women, were enrolled in the study. All respondents were divided into groups according to cancer type: group 1 consisted of 30 lung cancer patients, group 2 comprised 30 breast cancer patients, and group 3, the control group, included 30 people without cancer. Research results have been processed with modern statistical methods on a PC with Statistica 13 software package.
Results. The data were checked for normality of distribution since the distribution of most data differs from normal; the median and interquartile range (Me(Q25; Q75)) of data presentation were designed. A comparison of indicators in three independent groups was performed with the Kruskall – Wallis test, in two independent groups – with the Mann – Whitney test, and the non-parametric Wilcoxon test was used to determine the effect of prophylactic treatment. The Chi-square test was used to compare qualitative data. Differences were considered statistically significant at a significance level of p<0.05.
Conclusions. Patients with oncopathology accompanied with unsatisfactory oral hygiene, caries and its complications are more likely to get dental problems during chemotherapy treatment. Oncological patients diagnosed with lung cancer and breast cancer developed relatively similar dental complications, which confirms the negative effect of chemotherapy treatment as is.
PSYCHO-EMOTIONAL HEALTH OF MEDICAL STUDENT AT THE STAGE OF CHOOSING THE FUTURE DIRECTION OF PROFESSIONAL ACTIVITY
Authors: Kichula M. Ya. , Trushchenkova L. V. , Vyshniovsky A. V. , Fedchyshyn N. O.
Published: May 2023

Abstract. The current realities exacerbate the crisis of adaptation of the individual, especially the adolescent, who is acutely experiencing an intense sense of anxiety due to the ever-increasing impact of the emotional factors, such as fear for their own safety due to the current military realities of our country. This can cause a loss of authenticity and a sense of psychological well-being. Therefore, the article analyzes in detail the concepts of “mental health”, “psychological health”, “psycho-emotional health”, identifies common and distinctive characteristics. Attention is focused on the psycho-emotional health of a student of a higher medical institution when choosing a future profession under stressful conditions. The key factors influencing the psychoemotional health of a medical student are determined. It is established that emotions play a motivating and semantic role in the choice of future professional activity, because they generate and mobilize the perception, thinking and actions of a medical student. Taking into account a number of studies, it is stated that psycho-emotional health is a guarantor of active action of the future medical specialist, aimed at realizing the need and possibility of self-realization. In addition, it is stipulated that vitality and stress resistance are of great importance in the context of understanding the psychological health of the individual at the stage of his professional development. Generally speaking, it is about the protective and compensatory parameters of personality resources throughout life, which directly or indirectly affect the components of psychological health. It is noted that each component of psycho-emotional health in this complex structural formation performs a corresponding function. Instead, it is inappropriate to consider the independent and independent role of the components. The psycho-emotional health of a student determines his ability to self-regulate behavior, activate his own vital resources, comprehend his life position, choose a future profession and assert himself in society.
PEDAGOGICAL ASPECTS OF FORMING ENGLISH LANGUAGE PROFESSIONALLY ORIENTED COMPETENCE OF FUTURE DOCTORS THROUGH THE PRISM OF COMMUNICATIVE EXERCISES
Authors: Prokop I. A. , Kitura H. Ya.
Published: May 2023

Abstract. The article covers the issues of the practical use of English language communicative exercises as a constituent of medical students’ professional competence. The core of foreign language competence as an integral part of the professional competence of health care specialist is identified. The development of a medical student’s foreign language competence is an essential concept of the professional education in higher educational medical establishments and is implemented through mastering the specifics of language competence at its phonetic, lexical and grammatical levels of study. The emphasis is placed on the need of educational communicative exercises analysis as a core component of English for Specific Purposes (ESP). The issues of special subject contents within the course of ESP, choice of teaching materials, advance of students’ communicative component in the mastering of the English language skills are reviewed. The main elements of the medical students’ communicative competence are defined; science-based classification system of exercises for the formation of communicative competence is regarded; the necessity of lexical mastering for adequate opinion formation is emphasized. Both theoretical and methodological aspects of testing students’ foreign language professional competence in the process of studying professionally oriented English are highlighted.  It has been found that the practical use of the communicative exercises makes it possible to develop speech skills and abilities, thus providing an opportunity to evaluate, express own opinions and promote self-development and self-actualization of medical students.
ПРОФЕСІЙНА ЛІНГВОДИДАКТИКА В СИСТЕМІ ПІДГОТОВКИ ФАХІВЦІВ ЗА СПЕЦІАЛЬНІСТЮ «МЕДСЕСТРИНСТВО»
Authors: Вихрущ А. B. , Тишковець М. П. , Глушок В. С.
Published: May 2023

Анотація. Важливим етапом сучасної науки стане перехід до встановлення закономірностей. Це ключове слово особливо важливе для гуманітарних наук, де основною загрозою виступає описовість. Зауважимо, що це також важливий первинний елемент наукового пошуку. Водночас без пошуку причин і прогностичної оцінки важко досягнути рівня узагальнень, важливих для теорії та практики. Саме недостатня увага до закономірностей як основи навчально-виховного процесу обумовлює упродовж століть скептичне ставлення до педагогіки вищої школи. Вважається, що добрий фахівець може навчати, опираючись на фахові знання, інтуїцію, практичний досвід. Це помилкове твердження інколи справджується, а частіше ні. Проблема загострюється в сучасних умовах. В аудиторії університетів приходить нове покоління студентів із достатнім рівнем інформаційної культури, високими потребами, знанням іноземних мов. Зауважимо, що потреби практики випереджують можливості теоретичних концептів. Можливо, це і є однією з причин постійних заяв про кризу в науці. На нашу думку, це криза зростання, переходу на якісно новий рівень навчання й учіння. Поява в медичних університетах центрів симуляційного навчання як принципово нового дидактичного засобу підтверджує необхідність подальшого пошуку оновлених засад навчання та учіння. Прогностична оцінка експертів Римського клубу про «інтегральне мислення» зайвий раз підтверджує актуальність проблеми.
Catheter-Induced Postextrasystolic Potentiation in the Assessment of Severity of Low-Gradient Aortic Valve Stenosis
Authors: Dehghani Payam , Singh Jyotpal , Singer Zachary , Booker Jeffrey , Lavoie Andrea J. , Zimmermann Rodney H. , Shavadia Jay S. , Webb John G. , Clavel Marie-Annick , Pibarot Philippe
Published: May 2023

Background:

Deciphering which patients with low-gradient aortic valve disease have severe stenosis can be difficult. We aimed to correlate the postextrasystolic potentiation (PESP) with dobutamine stress echocardiography and multidetector computed tomography in patients with low-gradient aortic valve stenosis.

Methods:

Patients with an aortic valve area ≤1 cm
2
and a mean gradient <40 mm Hg were included. Aortic valve stenosis severity was assessed by a core lab with dobutamine stress echocardiography, followed by a multidetector computed tomography aortic valve score if indeterminate. A premature ventricular contraction was induced by intentional catheter contact with the myocardium within the left ventricle. PESP was calculated as a percent change of pre-to-post mean gradient. Multidetector computed tomography was used to measure the aortic valve calcification score, and subsequently, aortic valve calcification density.

Results:

Twenty-eight patients (age, 77±10 years; 19 female) were included. Dobutamine stress echocardiography increased mean gradient from baseline of 25±7 mm Hg to 36±11 mm Hg; pre-premature ventricular contraction mean gradient was 25±7 mm Hg and increased to post-premature ventricular contraction mean gradient of 32±10 mm Hg, representing a PESP of 24±11%. A ≥20% in PESP resulted in 100% sensitivity, 77% specificity, 83% positive predictive value, and 100% negative predictive value for diagnosing severe aortic valve stenosis. There was a significant correlation between PESP and projected aortic valve area and aortic valve calcification density (R=−0.64,
P
=0.0003; R=0.057,
P
=0.014, respectively).

Conclusions:

In patients with low-gradient aortic valve stenosis, catheter-induced premature ventricular contractions during cardiac catheterization causing ≥20% PESP has a 100% sensitivity for severe aortic valve stenosis. Validation of this 20% cutoff in larger groups with correlation to clinical end points is required.
Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association
Authors: El Husseini Nada , Katzan Irene L. , Rost Natalia S. , Blake Margaret Lehman , Byun Eeeseung , Pendlebury Sarah T. , Aparicio Hugo J. , Marquine María J. , Gottesman Rebecca F. , Smith Eric E. ,   on behalf of the American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; Council on Hypertension; and Council on Lifestyle and Cardiometabolic Health
Published: May 2023

Purpose:

Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioning and quality of life, including the ability to maintain a job, live independently, sustain interpersonal relationships, and drive a vehicle. In this scientific statement, we critically appraise the literature on the prevalence, diagnosis, and management of poststroke cognitive impairment (PSCI) and provide a framework for clinical care while highlighting gaps that merit further study.

Methods:

We performed a scoping literature review of randomized controlled clinical trials, prospective and retrospective cohort studies, case-control studies, clinical guidelines, review articles, and editorials on the incidence and prevalence, natural history, diagnosis, and management of PSCI. Scoping reviews determine the scope of a body of literature on a given topic to indicate the volume of literature and the studies currently available and provide an overview of its focus.

Results:

PSCI is common after stroke, especially in the first year, and ranges from mild to severe. Although cognitive impairment is reversible in some cases early after stroke, up to one-third of individuals with stroke develop dementia within 5 years. The pathophysiology is not yet fully elucidated but is likely attributable to an acute stroke precipitating a series of pathological events, often in the setting of preexisting microvascular and neurodegenerative changes. Screening for associated comorbidities and interdisciplinary management are integral components of the care of individuals with PSCI. There is a need for prospective studies evaluating the individual trajectory of PSCI and the role of the acute vascular event in the predisposition for Alzheimer disease and related dementias, as well as high-quality, randomized clinical trials focused on PSCI management.
Grammatical Error Correction: A Survey of the State of the Art
Authors: Bryant Christopher , Yuan Zheng , Qorib Muhammad Reza , Cao Hannan , Ng Hwee Tou , Briscoe Ted
Published: May 2023

Grammatical Error Correction (GEC) is the task of automatically detecting and correcting errors in text. The task not only includes the correction of grammatical errors, such as missing prepositions and mismatched subject–verb agreement, but also orthographic and semantic errors, such as misspellings and word choice errors, respectively. The field has seen significant progress in the last decade, motivated in part by a series of five shared tasks, which drove the development of rule-based methods, statistical classifiers, statistical machine translation, and finally neural machine translation systems, which represent the current dominant state of the art. In this survey paper, we condense the field into a single article and first outline some of the linguistic challenges of the task, introduce the most popular datasets that are available to researchers (for both English and other languages), and summarize the various methods and techniques that have been developed with a particular focus on artificial error generation. We next describe the many different approaches to evaluation as well as concerns surrounding metric reliability, especially in relation to subjective human judgments, before concluding with an overview of recent progress and suggestions for future work and remaining challenges.We hope that this survey will serve as a comprehensive resource for researchers who are new to the field or who want to be kept apprised of recent developments.
Comparing Selective Masking Methods for Depression Detection in Social Media
Authors: Pananookooln Chanapa , Akaranee Jakrapop , Silpasuwanchai Chaklam
Published: May 2023

Identifying those at risk for depression is a crucial issue and social media provides an excellent platform for examining the linguistic patterns of depressed individuals. A significant challenge in depression classification problems is ensuring that prediction models are not overly dependent on topic keywords (i.e., depression keywords) such that it fails to predict when such keywords are unavailable. One promising approach is masking—that is, by selectively masking various words and asking the model to predict the masked words, the model is forced to learn the inherent language patterns of depression. This study evaluates seven masking techniques. Moreover, predicting the masked words during the pre-training or fine-tuning phase was also examined. Last, six class imbalanced ratios were compared to determine the robustness of masked words selection methods. Key findings demonstrate that selective masking outperforms random masking in terms of F1-score. The most accurate and robust models are identified. Our research also indicates that reconstructing the masked words during the pre-training phase is more advantageous than during the fine-tuning phase. Further discussion and implications are discussed. This is the first study to comprehensively compare masked words selection methods, which has broad implications for the field of depression classification and general NLP. Our code can be found at: https://github.com/chanapapan/Depression-Detection.
The Application of Immersive Virtual Reality and Machine Learning for the Assessment of Unilateral Spatial Neglect
Authors: Belger Julia , Poppe Stephan , Karnath Hans-Otto , Villringer Arno , Thöne-Otto Angelika
Published: May 2023

Even subtle forms of hemispatial neglect after stroke negatively affect the performance of daily life tasks, increase the risk of injury, and are associated with poor rehabilitation outcomes. Conventional paper-and-pencil tests, however, often underestimate the symptoms. We aimed to identify relevant neglect-specific measures and clinical decision rules based on machine learning techniques on behavioral data generated in a new Virtual Reality (VR) application, the immersive virtual road-crossing task. In total, 59 participants were included in our study: two right-hemispheric stroke groups with left neglect (N = 20) or no neglect (N = 19), classified based on conventional tests and medical diagnosis, and healthy controls (N = 20). A neuropsychological test battery and the VR task were administered to all participants. We applied decision trees and random forest models to predict the respective groups based on the results of the VR task. Our feature selection procedure yielded six features as suitable predictors, most of which involved lateral time-related measures, particularly reaction times, and head movements. Our model achieved a high training accuracy of 96.6% and estimated test accuracy of 76.8%. These results confirm previous reports that temporal behavioral patterns are key to detecting subtle neglect in patients with chronic stroke. Our results indicate that VR combined with machine learning has the potential to achieve higher test accuracies while being highly applicable to clinical practice.
Polka-dotted treasures: Revising a clade of ascidian- and bivalve-associated shrimps (Caridea: Palaemonidae)
Authors: de Gier Werner , Fransen Charles H.J.M.
Published: May 2023

Most marine shrimp species of the family Palaemonidae are characterized by symbiotic associations with hosts that belong to a wide range of invertebrate phyla. One clade of related endosymbiotic species has evolved to live inside the branchial chambers of ascidians and the mantle cavities of bivalve molluscs. The phylogeny of this clade (comprising 15 bivalve-associated species in the genera Anchistus, Neoanchistus, and Paranchistus, and three species of ascidian-associated species in the genus Dasella) is the topic of the present study, which is based on both morphological and molecular data. A concatenated phylogeny reconstruction was built by using the markers coi and 16S. With the help of a total evidence approach (with a scored morphological datamatrix), species could be added for which no molecular data were available. An ancestral character state analysis was performed to detect host switches. In contrast to another endosymbiotic clade, the ancestral host state was found to be slightly in favour of bivalves. The phylogenetic relevance of morphological features is discussed with a focus on a tympanal organ located in the major chelipeds of some bivalve-associated shrimp species. This little-known anatomical structure is illustrated by sem and µCT scans. Its possible function is discussed. In the phylogeny reconstructions, both Anchistus and Paranchistus were found to be polyphyletic. They were reclassified to obtain a more natural classification: Anchistus custoides and Anchistus custos were transferred to the resurrected genus Ensiger. Paranchistus liui, P. nobilii, P. pycnodontae, and P. spondylis were transferred to Polkamenes gen. nov. Anchistus pectinis and P. ornatus were transferred to Tympanicheles gen. nov. Per genus, a key to the species is provided.
Business in a Post-COVID World: The Move to Stakeholder Capitalism
Authors: Freeman R. Edward , Freeman Ben
Published: May 2023

The last 15 years have seen a remarkable set of changes in the global business environment. Established companies and start-ups alike have been subjected to some fundamental shifts in the very way that we conceptualize business. Together with some generational challenges we have seen myriad calls for a new narrative about business. And, even more recently, the COVID pandemic has reinforced a number of these shifts and led to even more fundamental change. The purpose of this essay is to outline these challenges to the dominant narrative about business and to suggest that it is no longer a useful way to think about value creation and trade (business).
Insights from India’s Encounters with COVID-19
Authors: Gowda M. V. Rajeev , Thakur Fiza
Published: May 2023

The uncertainties relating to the COVID-19 pandemic continue to pose extraordinary challenges to policymakers worldwide. The recent lifting of restrictions in China raised the spectre of another wave of infections beyond its borders, which has thankfully not occurred, so far. Now, three years after the pandemic emerged, policy assumptions and responses are being re-evaluated—from whether the virus emerged as a laboratory leak, to whether vaccines have efficacy, to whether Sweden’s laissez-faire approach was superior to other countries’ ambitious interventions. We examine India’s experience with COVID-19—impressionistically—to draw larger lessons for policymakers. India’s responses were a mix of hits and misses. Some measures helped contain the pandemic and assisted those in need. Other measures seemed performative—geared towards garnering glory on the global stage. Together, they throw light on the challenges of coping with a crisis in real time.
Book review: Audrey Truschke, The Language of History: Sanskrit Narratives of Indo-Muslim Rule
Authors: Bednar Michael Boris
Published: May 2023

Audrey Truschke, The Language of History: Sanskrit Narratives of Indo-Muslim Rule. New York: Columbia University Press, 2021, pp. 351. ISBN: 978-0-231-19705-2 (Paperback).
Depreciation of Military Service Costs in the Fifteenth and Sixteenth Centuries in Central-Eastern Europe
Authors: Lopatecki Karol , Boldyrew Aleksander
Published: May 2023

The article presents the depreciation of soldiers’ equipment in the fifteenth–sixteenth centuries in Central-Eastern Europe based on the data from a dedicated financial institution existing in the Polish Kingdom until the 1560s. Soldiers received their pay, and the king additionally paid them compensation for any war damage. Owing to meticulous records, data were collected on 9,371 individuals. Based on the collected data, it has been established that the average losses in cavalry were equivalent to 40% of the pay and in infantry, the corresponding ratio was 13.7%. This formation was not only cheaper to equip, it was also less cost-intensive.

The article elaborates on the background of the liquidation of this institution in the Polish Crown, combined with an increase in soldiers’ pay, who gained only seemingly. It was mainly a profitable operation for the state. It improved the budgeting process, increased the combat value of the soldiers, facilitated military bureaucratisation and prevented extorted compensation. After the reform, the depreciation in the cost of the soldier’s pay is estimated to have been about 1/3. The percentage chance of losing a horse, arms and armour was also calculated, demonstrating a huge equine mortality rate of 48.2% over three months of fighting.
Book review: Farhat Hasan, Paper, Performance, and the State: Social Change and Political Culture in Mughal India
Authors: Mazumder Dipanjan
Published: May 2023

Farhat Hasan, Paper, Performance, and the State: Social Change and Political Culture in Mughal India. Cambridge University Press, 2021, pp. 155. ISBN: 9781009025256.
Do Values Predict Socially Responsible Investment Decisions? Measuring the Moderating Effects of Gender
Authors: Raut Rajdeep Kumar , Kumar Rohit
Published: May 2023

This study examines investors’ pro-environmental investment intentions by measuring the effect of economic concern (egoistic value) and environmental concern (altruistic value) on attitudes toward socially responsible investment (SRI). A self-administered structured questionnaire was used to collect data from 469 investors using a purposive sampling technique and analyzed using two-step structural equation modeling. Results show that both altruistic and egoistic values were significant predictors of a positive attitude toward SRI, portraying the greater environmental concern of investors. Additionally, male investors motivated to invest in SRI are more concerned about environmental well-being than their counterparts, that is, female investors. By analyzing values as antecedents of attitudes toward SRI, the findings of this study add a new dimension to the belief system of young investors.

JEL Codes: A13; D19; G1; G4
Comparing the torsional resistance of different fixation techniques for spiral metacarpal fractures
Authors: Choke Abby , Wong Yoke Rung , Quek Matthew , McGrouther Duncan A.
Published: May 2023

This study aimed to compare the torsional resistance of three fixation techniques for spiral metacarpal fractures: screw-only fixation, screw plus neutralization plate fixation, and a locking plate construct. A spiral fracture was created on 18 cadaveric metacarpal bones by applying an axial and torsional loading force using an Instron 3343 mechanical tester. The failure strength was defined as the native torque strength. The fractures were divided into three groups and fixed using each of the three techniques. The repaired bones were loaded to failure to determine the post-repair strength. The neutralization plate group conferred a post-repair torque (278.6 Nmm) that was similar to the native torque (292 Nmm) with a diminution of only 4.5% and appeared to provide the best resistance to torsion.
Small open reading frames: a comparative genetics approach to validation
Authors: Jain Niyati , Richter Felix , Adzhubei Ivan , Sharp Andrew J. , Gelb Bruce D.
Published: May 2023

Open reading frames (ORFs) with fewer than 100 codons are generally not annotated in genomes, although bona fide genes of that size are known. Newer biochemical studies have suggested that thousands of small protein-coding ORFs (smORFs) may exist in the human genome, but the true number and the biological significance of the micropeptides they encode remain uncertain. Here, we used a comparative genomics approach to identify high-confidence smORFs that are likely protein-coding. We identified 3,326 high-confidence smORFs using constraint within human populations and evolutionary conservation as additional lines of evidence. Next, we validated that, as a group, our high-confidence smORFs are conserved at the amino-acid level rather than merely residing in highly conserved non-coding regions. Finally, we found that high-confidence smORFs are enriched among disease-associated variants from GWAS. Overall, our results highlight that smORF-encoded peptides likely have important functional roles in human disease.
Incidence of thromboembolism in children with primary nephrotic syndrome: a systematic review and metaanalysis
Authors: Wang Zhen , Tang Han-Yun , Lin Qiang , Li Xiao-Zhong
Published: May 2023

Objective

To estimate the incidence of thromboembolism in children with primary nephrotic syndrome with Meta-analysis.

Methods

Relevant studies published from January 1, 1980 to December 31, 2021 were retrieved from Pubmed, Web of science, Cochrane library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database(VIP) and Wangfang Database. Quality evaluation of the literatures included was conducted according to Agency for Healthcare Research and Quality(AHRQ) assessment tool, followed by data extraction and Meta-analysis with software RevMan 5.3.

Results

A total of seven studies involving 3675 subjects were included. The overall prevalence was 4.9% with 95% CI of 2.83 to 7.05.However, a significant heterogeneity (P < 0.001) was observed withI2 = 89%. The prevalence of venous thromboembolism was 3.3% with 95% CI of 1.7 to 4.9. The prevalence of arterial thromboembolism was 0.5% with 95% CI of 0.2 to 1.4.

Conclusion

Children with nephrotic syndrome are prone to thromboembolism, and it may lead to disability or death, therefore prevention measures is critical to decreasing the prevalence of thromboembolism.
Pattern, frequency and factors associated with inappropriate high dosing in chronic kidney disease patients at a tertiary care hospital in Pakistan
Authors: Hayat Muhammad , Ahmad Nafees , Khan Syed Liaquat Ali , Mohkumuddin Syed , Siddique Wajeeha , Khan Amjad , Atif Muhammad
Published: May 2023

Background

Patients with chronic kidney diseases (CKD) are susceptible to the toxic drug effects if given unadjusted doses. Although Pakistan harbors a high burden of CKD patients, there is limited information available on the frequency, pattern and factors associated with unadjusted drug doses among CKD patients.

Methods

This cross-sectional study conducted at Sandeman Provincial Hospital, Quetta included 303 non-dialysis ambulatory CKD patients (glomerular filtration rate < 60 ml/min/1.73m2). The patients’ data were collected through a purpose designed data collection form. The appropriateness of doses was checked against the renal drug handbook-2018, Kidney Disease Improving Global Outcomes guidelines, British National Formulary-2022, and manufacturer leaflets. Data were analysed by SPSS 23 and multiple binary logistic regression analysis was used to assess the factors associated with receiving inappropriate high doses. A p-value < 0.05 was considered statistically significant.

Results

The patients received a total of 2265 prescription lines, with a median of eight different drugs per patient (interquartile range: 6–9 drugs). A total of 34.5% (783/2265) drugs required dose adjustment. Of these, doses were not adjusted for 56.1% (440) drugs in 162 (53.4%) patients. The most common pharmacological class of drugs requiring dose adjustment were antibiotics (79.1%), followed by antidiabetics (59.2%), diuretics (57.0%), angiotensin converting enzyme inhibitors (56.9%), beta blockers (56.9%), analgesics (56.0%), angiotensin receptor blockers (55.2%), domperidone (53.9%) and antihyperlipidmics (46.1%). Patient’s age of 41–60 (OR = 5.76) and > 60 years (OR = 9.49), hypertension (OR = 2.68), diabetes mellitus (OR = 3.47) and cardiovascular diseases (OR = 2.82) had statistically significant association (p-value < 0.05) with inappropriate high doses.

Conclusion

The high frequency of inappropriate high doses suggests an important quality gap in medication dosing for patients with ND-CKD at the study site. Special attention should be paid to the drugs and patients with identified risk factors for receiving inappropriate high doses.
The effect of environmental factors on precocious puberty in children: a case–control study
Authors: Bigambo Francis Manyori , Wang Dandan , Niu Qing , Zhang Mingzhi , Mzava Sabitina Mrisho , Wang Yubing , Wang Xu
Published: May 2023

Background

Recently the prevalence of precocious puberty development is increasing among Chinese children. Proper understanding of the risk factors for precocious puberty in children is pivotal as could help to improve children's health. This study aims to evaluate the effect of environmental factors on precocious puberty in children.

Methods

We matched the cases and controls by age at the ratio of 1:1 (201 cases and 201 controls) for girls and 1:4 (24 cases and 96 controls) for boys. We used conditional logistic regression to explore the effect of environmental factors on precocious puberty, and a random forest model to identify the most important risk factor.

Results

In the multivariate regression, cesarean section (OR = 1.99, 95% CI: 1.05, 3.76), child body mass index [BMI] (OR = 1.25, 95% CI: 1.10, 1.43), maternal BMI (OR = 1.13, 95%CI: 1.01, 1.26), and exposure to secondhand smoke several times a month but less than once a week (OR = 4.09, 95%CI: 1.79,9.35), and almost every day (OR = 6.48, 95% CI: 2.14, 19.56) were risk factors for precocious puberty in girls. While maternal height (OR = 0.82, 95% CI: 0.75, 0.88), paternal height (OR = 0.91, 95% CI: 0.85, 0.98), bedtime at night (OR = 0.30, 95% CI: 0.17, 0.51), and night sleep (OR = 0.43, 95% CI: 0.21, 0.86) were protective factors. In boys, only exposure to secondhand smoke several times a month but less than once a week (OR = 7.94, 95% CI: 1.25, 50.33) was a risk factor for precocious puberty. In the random forest model, Child BMI was the most important risk factor for precocious puberty in girls.

Conclusions

Our findings suggest that environmental factors were associated with precocious puberty in children, particularly in girls.
Functionality appreciation is inversely associated with positive psychotic symptoms in overweight/obese patients with schizophrenia
Authors: Mahfoud Daniella , Fekih-Romdhane Feten , Abou Zeid Jawad , Rustom Lea , Mouez Charbel , Haddad Georges , Hallit Souheil
Published: May 2023

Background

While the relationship between negative aspects of body image and positive schizophrenia symptoms was extensively investigated and is relatively well-established, there is a dearth of literature on the relationship between positive symptoms and positive aspects of body image, such as body appreciation and functionality appreciation, in patients with schizophrenia. This study aimed to (1) compare weight stigma, body and functionality appreciation between obese/overweight and normal-weight patients with schizophrenia, and (2) explore the associations between these variables and positive psychotic symptoms in the obese/overweight group.

Method

A cross-sectional study was conducted in the Psychiatric Hospital of the Cross, Lebanon during September 2022 recruiting selected in-patients diagnosed with schizophrenia. Patients were classified as overweight/obese if they had a BMI > 25 (N = 76 (37.25%), aged 55.57 ± 11.30 years, 42.6% females). The Weight self‑stigma questionnaire, the Functionality Appreciation Scale, and the Body Appreciation Scale, and the Positive and Negative Syndrome Scale (PANSS) were used.

Results

No significant difference was found between overweight/obese and normal-weight patients for all variables, except for weight stigma; a significantly higher weight stigma score was significantly found in overweight/obese compared to normal-weight patient. In the bivariate analysis, higher functionality appreciation was significantly associated with higher positive PANSS scores. The results of the linear regression, taking the positive PANSS score as the dependent variable, showed that higher functionality appreciation (Beta = − 0.52) and higher social support (Beta = − 0.16) were significantly associated with lower positive PANSS scores, whereas having a secondary education level compared to illiteracy (Beta = 7.00) was significantly associated with higher positive PANSS scores.

Conclusion

Although based on cross-sectional data, these findings preliminarily suggest that higher functionality appreciation can help reduce the severity of positive psychotic symptoms in overweight/obese schizophrenia patients, and that interventions aimed at improving functionality appreciation could be regarded beneficial therapeutic targets in the treatment of psychosis.
A critical role for erythropoietin on vagus nerve Schwann cells in intestinal motility
Authors: Govindappa Prem Kumar , Begom Mosammat , Gupta Yash , Elfar John C. , Rawat Manmeet , Elfar Walaa
Published: May 2023

Background

Dysmotility and postoperative ileus (POI) are frequent major clinical problems post-abdominal surgery. Erythropoietin (EPO) is a multifunctional tissue-protective cytokine that promotes recovery of the intestine in various injury models. While EPO receptors (EPOR) are present in vagal Schwann cells, the role of EPOR in POI recovery is unknown because of the lack of EPOR antagonists or Schwann-cell specific EPOR knockout animals. This study was designed to explore the effect of EPO via EPOR in vagal nerve Schwann cells in a mouse model of POI.

Results

The structural features of EPOR and its activation by EPO-mediated dimerization were understood using structural analysis. Later, using the Cre-loxP system, we developed a myelin protein zero (Mpz) promoter-driven knockout mouse model of Schwann cell EPOR (MpzCre-EPORflox/flox / Mpz-EPOR-KO) confirmed using PCR and qRT-PCR techniques. We then measured the intestinal transit time (ITT) at baseline and after induction of POI with and without EPO treatment. Although we have previously shown that EPO accelerates functional recovery in POI in wild type mice, EPO treatment did not improve functional recovery of ITT in POI of Mpz-EPOR-KO mice.

Conclusions

To the best of our knowledge, this is the first pre-clinical study to demonstrate a novel mouse model of EPOR specific knock out on Schwan cells with an effect in the gut. We also showed novel beneficial effects of EPO through vagus nerve Schwann cell-EPOR in intestinal dysmotility. Our findings suggest that EPO-EPOR signaling in the vagus nerve after POI is important for the functional recovery of ITT.
Gender bias in academic medicine: a resumé study
Authors: Burke Elaine , Heron Elizabeth A. , Hennessy Martina
Published: May 2023

Background

Minimising the effects of unconscious bias in selection for clinical academic training is essential to ensure that allocation of training posts is based on merit. We looked at the effect of anonymising applications to a training programme for junior doctors on the scores of the applications and on gender balance; and whether female candidates were more likely to seek gender-concordant mentors.

Methods

Applications to the training programme were reviewed and scored independently by reviewers who received either an anonymised or named copy. Scores were compared using a paired t-test, and differences in scores compared by gender. The gender of named supervisors for male and female candidates was compared.

Results

Scores of 101 applications were reviewed. When their identity was known, male candidates scored 1.72% higher and female candidates scored 0.74% higher, but these findings were not statistically significant (p value = 0.279 and 0.579). Following introduction of anonymisation, the proportion of successful female candidates increased from 27 to 46%. Female candidates were more likely to name a female supervisor compared to male (41% vs. 25% of supervisors).

Conclusions

Anonymising applications did not significantly change scores, although gender balance improved. Gender-concordant mentoring initiatives should consider effects on mentors as well as mentees.
Recent advances in the roles of exosomal microRNAs (exomiRs) in hematologic neoplasms: pathogenesis, diagnosis, and treatment
Authors: Jahromi Faride Nam Avar , Dowran Razieh , Jafari Reza
Published: May 2023

In clinical diagnosis, the capability of exosomes to serve as biomarkers is one of the most important biological functions of exosomes. The superior stability of exosome biomarkers makes them superior to those isolated from traditional samples such as serum and urine. Almost all body fluids contain exosomes, which contain proteins, nucleic acids, and lipids. Several molecular components of exosomes, including exosome proteins and microRNAs (miRNAs), are promising diagnostic biomarkers. These exosomes may carry genetic information by containing messenger RNA (mRNA) and miRNA. The miRNAs are small noncoding RNAs that regulate protein-coding genes by acting as translational repressors. It has been shown that miRNAs are mis-expressed in a range of conditions, including hematologic neoplasms. Additionally, miRNAs found within exosomes have been linked with specific diseases, including hematologic neoplasms. Numerous studies suggest that circulating exosomes contain miRNAs similar to those found in parental cancer cells. Exosomes contain miRNAs that are released by almost all kinds of cells. MiRNAs are packaged into exosomes and delivered to recipient cells, and manipulate its function. It has been recognized that exosomes are new therapeutic targets for immunotherapy and biomedicine of cancers. The current review discusses the current evidence around exosomal miRNAs involved in the pathogenesis, diagnosis, and treatment of hematologic neoplasms.
Neutrophil extracellular traps induced by the hypoxic microenvironment in gastric cancer augment tumour growth
Authors: Li Jiacheng , Xia Yu , Sun Biying , Zheng Nanbei , Li Yang , Pang Xuehan , Yang Fan , Zhao Xingwang , Ji Zhiwu , Yu Haitao , Chen Fujun , Zhang Xuemei , Zhao Bin , Jin Jiaqi , Yang Shifeng , Cheng Zhuoxin
Published: May 2023

Background

Inflammation-related predisposition to cancer plays an essential role in cancer progression and is associated with poor prognosis. A hypoxic microenvironment and neutrophil infiltration are commonly present in solid tumours, including gastric cancer (GC). Neutrophil extracellular traps (NETs) have also been demonstrated in the tumour immune microenvironment (TIME), but how NETs affect GC progression remains unknown. Here, we investigated the role of NET formation in the TIME and further explored the underlying mechanism of NETs in GC tumour growth.

Methods

Hypoxia-induced factor-1α (HIF-1α), citrulline histone 3 (citH3) and CD66b expression in tumour and adjacent nontumor tissue samples was evaluated by western blotting, immunofluorescence and immunohistochemical staining. The expression of neutrophil-attracting chemokines in GC cells and their hypoxic-CM was measured by qRT‒PCR and ELISA. Neutrophil migration under hypoxic conditions was evaluated by a Transwell assay. Pathway activation in neutrophils in a hypoxic microenvironment were analysed by western blotting. NET formation was measured in vitro by immunofluorescence staining. The protumour effect of NETs on GC cells was identified by Transwell, wound healing and cell proliferation assays. In vivo, an lipopolysaccharide (LPS)-induced NET model and subcutaneous tumour model were established in BALB/c nude mice to explore the mechanism of NETs in tumour growth.

Results

GC generates a hypoxic microenvironment that recruits neutrophils and induces NET formation. High mobility group box 1 (HMGB1) was translocated to the cytoplasm from the nucleus of GC cells in the hypoxic microenvironment and mediated the formation of NETs via the toll-like receptor 4 (TLR4)/p38 MAPK signalling pathway in neutrophils. HMGB1/TLR4/p38 MAPK pathway inhibition abrogated hypoxia-induced neutrophil activation and NET formation. NETs directly induced GC cell invasion and migration but not proliferation and accelerated the augmentation of GC growth by increasing angiogenesis. This rapid tumour growth was abolished by treatment with the NET inhibitor deoxyribonuclease I (DNase I) or a p38 MAPK signalling pathway inhibitor.

Conclusions

Hypoxia triggers an inflammatory response and NET formation in the GC TIME to augment tumour growth. Targeting NETs with DNase I or HMGB1/TLR4/p38 MAPK pathway inhibitors is a potential therapeutic strategy to inhibit GC progression.
Thyrotoxic periodic paralysis in a Caucasian man without identifiable genetic predisposition: a case report
Authors: Heydorn Arne , Bertelsen Birgitte , Nolsöe Rúna Louise Mortansdóttir , Eiken Pia , Kristensen Peter Lommer
Published: May 2023

Background

Thyrotoxic periodic paralysis (TPP) is a rare condition characterized by muscle paralysis, thyrotoxicosis, and hypokalemia. It presents with paralysis of both proximal and distal musculature in upper and lower limbs and may affect respiratory musculature and the cardiac conduction system. Early diagnosis is essential, as the condition is potentially reversible by oral or intravenous potassium treatment, leading to rapid resolution without lasting weakness. Overlooking the diagnosis may result in respiratory failure and cardiac arrhythmias including QT prolongation, Torsades de points, and ventricular arrhythmias.

Case presentation

A 19-year-old Caucasian man was admitted acutely with paralysis in upper and lower limbs and tachycardia. Over several months, he had experienced anxiousness, sweating more than usual, had daily palpitations, shortness of breath on exertion, and loose stools, and had lost 21 kg over the last year. Initial blood gas showed very low potassium of 1.4 mM, and blood tests showed decreased Thyroid-stimulating hormone (TSH) < 0.01 × 10− 3 IU/L, elevated free thyroxine (fT4) of 63.5 pM (reference interval (RI): 12.0–22.0 pM), and elevated total triiodothyronine (T3) of 8.2 nM (RI: 1.0–2.6 nM). He was diagnosed with TPP and treated with liquid oral potassium chloride (30 mmol every 30 minutes) and propylthiouracil (initial dose of 400 mg followed by 200 mg three times daily). TSH-receptor antibodies (TRAB) and thyroid-peroxidase antibodies (TPO-ab) were highly elevated. Thyroid ultrasound showed a normal-sized gland and color Doppler sonography showed increased vascularity throughout the gland, compatible with Graves’ disease. He was discharged on day 4 with a normal potassium level and followed in the outpatient clinic where he received standard care for Graves’ disease. Genetic testing using whole-genome sequencing found no genetic variants in genes previously associated with TPP.

Conclusion

TPP is very rare in Caucasians but more often affects young men in East Asian populations. The case presents a Caucasian man with TPP where genetic testing of CACNA1S, KCNJ18, SCN4A, KCNJ2, KCNE3, and ABCC8 shows no pathogenic variants in genes previously associated with TPP.
Activation of ACLY by SEC63 deploys metabolic reprogramming to facilitate hepatocellular carcinoma metastasis upon endoplasmic reticulum stress
Authors: Hu Chenyu , Xin Zechang , Sun Xiaoyan , Hu Yang , Zhang Chunfeng , Yan Rui , Wang Yuying , Lu Min , Huang Jing , Du Xiaojuan , Xing Baocai , Liu Xiaofeng
Published: May 2023

Background

Tumor cells display augmented capability to maintain endoplasmic reticulum (ER) homeostasis and hijack ER stress pathway for malignant phenotypes under microenvironmental stimuli. Metabolic reprogramming is a well-known hallmark for tumor cells to provide specific adaptive traits to the microenvironmental alterations. However, it’s unknown how tumor cells orchestrate metabolic reprogramming and tumor progression in response to ER stress. Herein, we aimed to explore the pivotal roles of SEC63-mediated metabolic remodeling in hepatocellular carcinoma (HCC) cell metastasis after ER stress.

Methods

The expression levels of SEC63 in HCC tissues and adjacent non-cancerous tissues were determined by immunohistochemistry and western blot. The regulatory roles of SEC63 in HCC metastasis were investigated both in vitro and in vivo by RNA-sequencing, metabolites detection, immunofluorescence, and transwell migration/invasion analyses. GST pull-down, immunoprecipitation/mass spectrometry and in vivo ubiquitination/phosphorylation assay were conducted to elucidate the underlying molecular mechanisms.

Results

We identified SEC63 as a new regulator of HCC cell metabolism. Upon ER stress, the phosphorylation of SEC63 at T537 by IRE1α pathway contributed to SEC63 activation. Then, the stability of ACLY was upregulated by SEC63 to increase the supply of acetyl-CoA and lipid biosynthesis, which are beneficial for improving ER capacity. Meanwhile, SEC63 also entered into nucleus for increasing nuclear acetyl-CoA production to upregulate unfolded protein response targets to improve ER homeostasis. Importantly, SEC63 coordinated with ACLY to epigenetically modulate expression of Snail1 in the nucleus. Consequently, SEC63 promoted HCC cell metastasis and these effects were reversed by ACLY inhibition. Clinically, SEC63 expression was significantly upregulated in HCC tissue specimens and was positively correlated with ACLY expression. Importantly, high expression of SEC63 predicted unfavorable prognosis of HCC patients.

Conclusions

Our findings revealed that SEC63-mediated metabolic reprogramming plays important roles in keeping ER homeostasis upon stimuli in HCC cells. Meanwhile, SEC63 coordinates with ACLY to upregulate the expression of Snail1, which further promotes HCC metastasis. Metastasis is crucial for helping cancer cells seek new settlements upon microenvironmental stimuli. Taken together, our findings highlight a cancer selective adaption to ER stress as well as reveal the potential roles of the IRE1α-SEC63-ACLY axis in HCC treatment.