bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of a multidomain lifestyle intervention on white matter integrity: the SUPERBRAIN exploratory sub-study
Authors: Lee Sun Min , Kim Sohui , Jeong Jee Hyang , Hong Chang Hyung , Park Yoo Kyoung , Na Hae Ri , Song Hong-Sun , Park Hee Kyung , Choi Muncheong , Chun Buong-O , Choi Seong Hye , Lee Jong-Min , Moon So Young
Published: September 2023

In the South Korean study to prevent cognitive impairment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN), we evaluated the impact of a 24-week facility-based multidomain intervention (FMI) and home-based MI (HMI) on white matter integrity. Among 152 participants, aged 60–79 years without dementia but with ≥1 modifiable dementia risk factor, 19 FMI, 20 HMI, and 16 controls underwent brain MRI at baseline and 24 weeks. Between the intervention and control groups, we compared changes in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) at regions-of-interest (ROI) including the cingulum cingulate gyrus (CgC), cingulum hippocampus (CgH), superior longitudinal fasciculus (SLF), as well as the uncinate fasciculus (UF). In addition, correlations between total and standard scores cognitive domains of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or serum brain-derived neurotrophic factor (BDNF) and changes in brain image measures were evaluated at a statistical significance level of p < 0.05 (uncorrected for multiple corrections). The FA, MD, AD, and RD at each ROI at the baseline were not different among groups after Bonferroni correction. In the statistical analysis using two-way repeated measures ANOVA, any significant difference in longitudinal changes in the FA, MD, AD, and RD was not revealed. The statistical analysis, among the significant regions in paired t-test of the intervention group, compared with the control group, the FMI, HMI, and intervention group yielded significantly more beneficial effects on the AD of the CgC. In addition, longitudinal AD changes of the left CgC correlated with the BDNF changes (r = 0.280, p = 0.048). In this study, enhanced cognitive reserve after the multidomain lifestyle intervention could be revealed by changes in brain imaging for white matter integrity.
Potential application of ultra-low field portable MRI in the ICU to improve CT and MRI access in Canadian hospitals: a multi-center retrospective analysis
Authors: Islam Omar , Lin Amy W. , Bharatha Aditya
Published: September 2023

Background

To highlight the value of Portable MRI in ICU and to recommend use case scenarios for portable MRI in ICU patients that may increase capacity for fixed CT and MRI units. Urgent neuroimaging is commonly required in ICU. Typically, ICU patients are transported to Radiology for assessment in fixed CT and MRI units. Portable MRI use in Canadian ICU settings offers the potential advantages of reduced transport risk, earlier diagnosis, improved triaging, as well as the ability to perform frequent re-imaging at the bedside. This frees up time on fixed CT and MRI units, leading to enhanced capacity to perform CT and MRI on other patients. Portable MRI use case scenarios in Canadian institutions have not been established and potential beneficial effect on wait times has not been analyzed.

Methods

A retrospective semi-quantitative descriptive analysis was performed using all ICU neuroimaging requisitions (CT and MRI) over a 12-month period between January and December 2021, at Kingston Health Sciences Centre, Queen’s University (Kingston, Ontario) and St. Michael’s Hospital, Unity Health, University of Toronto (Toronto, Ontario). Indications for portable MRI in ICU patients were established. The number of ICU patients who could potentially undergo portable MRI was determined. Fixed CT and MRI scan times saved were calculated.

Results

In ICU patients, portable MRI could potentially replace fixed CT in 21% and fixed MRI in 26.5% of cases. This equates to annual capacity increase of 1,676 additional patients being able to undergo fixed CT scans and 324 additional patients being able to undergo fixed MRI.

Conclusion

Implementation of portable MRI in the ICU for select neurological indications can have a significant positive impact on CT and MRI wait times in Canadian hospitals.
The association between serum total folic acid concentration and severe difficulty falling asleep in US adults: NHANES 2005–2008
Authors: An Haoyu , Xue Qiyun , Zhang Jingyi
Published: September 2023

Objective

The present study aimed to explore the correlation of serum total folic acid concentration with severe difficulty falling asleep among US adults.

Methods

Cross-sectional data were collected from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2006 and 2007 to 2008 cycles. Participants were divided into the severe difficulty falling asleep (SDFA) group and the control group according to the monthly frequency of having difficulty falling asleep. Serum total folic acid was taken as independent and dependent variables, respectively. The correlation of serum total folic acid concentration with severe difficulty falling asleep was examined using multivariable logistic regression models, where the adjusted odds ratio (OR) and 95% confidential intervals (CIs) were calculated.

Results

Overall, 8,926 individuals from the NHANES 2005 to 2006 and 2007 to 2008 waves were included in the analysis, of whom 683 participants had severe difficulty falling asleep. Higher serum total folic acid concentration (ng/ml) was associated with lower odds of severe difficulty falling asleep after adjusting for potentially confounding factors (OR = 0.98; 95% CI: 0.97–1.00), while participants at the highest quartile had the least odds of severe difficulty falling asleep (OR = 0.55; 95% CI: 0.40–0.74). The subgroup analysis based on gender, smoking history, and diabetes showed that this negative correlation was more significant in males, smokers, and nondiabetic population after adjusting for confounding factors.

Conclusion

High levels of serum folic acid were significantly related to less odds of severe difficulty in falling asleep among US adults, suggesting that folic acid supplementation may be beneficial to the prevention and even treatment of severe difficulty falling asleep.
Interictal epileptiform discharges in Alzheimer’s disease: prevalence, relevance, and controversies
Authors: Lemus Hernan Nicolas , Sarkis Rani A.
Published: September 2023

Alzheimer’s disease (AD) is the most common type of dementia and remains an incurable, progressive disease with limited disease-modifying interventions available. In patients with AD, interictal epileptiform discharges (IEDs) have been identified in up to 54% of combined cohorts of mild cognitive impairment (MCI) or mild dementia and are a marker of a more aggressive disease course. Studies assessing the role of IEDs in AD are limited by the lack of standardization in the definition of IEDs or the different neurophysiologic techniques used to capture them. IEDs are an appealing treatment target given the availability of EEG and anti-seizure medications. There remains uncertainty regarding when to treat IEDs, the optimal drug and dose for treatment, and the impact of treatment on disease course. This review covers the state of knowledge of the field of IEDs in AD, and the steps needed to move the field forward.
How can cry acoustics associate newborns’ distress levels with neurophysiological and behavioral signals?
Authors: Laguna Ana , Pusil Sandra , Acero-Pousa Irene , Zegarra-Valdivia Jonathan Adrián , Paltrinieri Anna Lucia , Bazán Àngel , Piras Paolo , Palomares i Perera Clàudia , Garcia-Algar Oscar , Orlandi Silvia
Published: September 2023

Introduction

Even though infant crying is a common phenomenon in humans’ early life, it is still a challenge for researchers to properly understand it as a reflection of complex neurophysiological functions. Our study aims to determine the association between neonatal cry acoustics with neurophysiological signals and behavioral features according to different cry distress levels of newborns.

Methods

Multimodal data from 25 healthy term newborns were collected simultaneously recording infant cry vocalizations, electroencephalography (EEG), near-infrared spectroscopy (NIRS) and videos of facial expressions and body movements. Statistical analysis was conducted on this dataset to identify correlations among variables during three different infant conditions (i.e., resting, cry, and distress). A Deep Learning (DL) algorithm was used to objectively and automatically evaluate the level of cry distress in infants.

Results

We found correlations between most of the features extracted from the signals depending on the infant’s arousal state, among them: fundamental frequency (F0), brain activity (delta, theta, and alpha frequency bands), cerebral and body oxygenation, heart rate, facial tension, and body rigidity. Additionally, these associations reinforce that what is occurring at an acoustic level can be characterized by behavioral and neurophysiological patterns. Finally, the DL audio model developed was able to classify the different levels of distress achieving 93% accuracy.

Conclusion

Our findings strengthen the potential of crying as a biomarker evidencing the physical, emotional and health status of the infant becoming a crucial tool for caregivers and clinicians.
Analyzing alternative splicing in Alzheimer’s disease postmortem brain: a cell-level perspective
Authors: Farhadieh Mohammad-Erfan , Ghaedi Kamran
Published: September 2023

Alzheimer’s disease (AD) is a neurodegenerative disease with no effective cure that attacks the brain’s cells resulting in memory loss and changes in behavior and language skills. Alternative splicing is a highly regulated process influenced by specific cell types and has been implicated in age-related disorders such as neurodegenerative diseases. A comprehensive detection of alternative splicing events (ASEs) at the cellular level in postmortem brain tissue can provide valuable insights into AD pathology. Here, we provided cell-level ASEs in postmortem brain tissue by employing bioinformatics pipelines on a bulk RNA sequencing study sorted by cell types and two single-cell RNA sequencing studies from the prefrontal cortex. This comprehensive analysis revealed previously overlooked splicing and expression changes in AD patient brains. Among the observed alterations were changed in the splicing and expression of transcripts associated with chaperones, including CLU in astrocytes and excitatory neurons, PTGDS in astrocytes and endothelial cells, and HSP90AA1 in microglia and tauopathy-afflicted neurons, which were associated with differential expression of the splicing factor DDX5. In addition, novel, unknown transcripts were altered, and structural changes were observed in lncRNAs such as MEG3 in neurons. This work provides a novel strategy to identify the notable ASEs at the cell level in neurodegeneration, which revealed cell type-specific splicing changes in AD. This finding may contribute to interpreting associations between splicing and neurodegenerative disease outcomes.
The relationship between obesity-related H19DMR methylation and H19 and IGF2 gene expression on offspring growth and body composition
Authors: Argentato Perla Pizzi , Marchesi Jorge Augusto Petroli , Dejani Naiara Naiana , Nakandakare Patrícia Yury , Teles Laísla de França da Silva , Batista Lívia Patrícia Rodrigues , Leitão Maria Paula Carvalho , Luzia Liania Alves , Ramos Ester Silveira , Rondó Patricia Helen
Published: September 2023

Background and objective

Imprinted genes are important for the offspring development. To assess the relationship between obesity-related H19DMR methylation and H19 and IGF2 gene expression and offspring growth and body composition.

Methods

Thirty-nine overweight/obese and 25 normal weight pregnant women were selected from the “Araraquara Cohort Study” according to their pre-pregnancy BMI. Fetal growth and body composition and newborn growth were assessed, respectively, by ultrasound and anthropometry. The methylation of H19DMR in maternal blood, cord blood, maternal decidua and placental villi tissues was evaluated by methylation-sensitive restriction endonuclease qPCR, and H19 and IGF2 expression by relative real-time PCR quantification. Multiple linear regression models explored the associations of DNA methylation and gene expression with maternal, fetal, and newborn parameters.

Results

H19DMR was less methylated in maternal blood of the overweight/obese group. There were associations of H19DMR methylation in cord blood with centiles of fetal biparietal diameter (BPD) and abdominal subcutaneous fat thickness and newborn head circumference (HC); H19DMR methylation in maternal decidua with fetal occipitofrontal diameter (OFD), HC, and length; H19DMR methylation in placental villi with fetal OFD, HC and abdominal subcutaneous fat thickness and with newborn HC. H19 expression in maternal decidua was associated with fetal BPD and femur length centiles and in placental villi with fetal OFD and subcutaneous arm fat. IGF2 expression in maternal decidua was associated with fetal BPD and in placental villi with fetal OFD.

Conclusion

To our knowledge, this is the first study to demonstrate associations of imprinted genes variations at the maternal-fetal interface of the placenta and in cord blood with fetal body composition, supporting the involvement of epigenetic mechanisms in offspring growth and body composition.
A cross-sectional study to test equivalence of low- versus intermediate-flip angle dynamic susceptibility contrast MRI measures of relative cerebral blood volume in patients with high-grade gliomas at 1.5 Tesla field strength
Authors: Shiroishi Mark S. , Weinert Dane , Cen Steven Y. , Varghese Bino , Dondlinger Timothy , Prah Melissa , Mendoza Jesse , Nazemi Sina , Ameli Nima , Amini Negin , Shohas Salman , Chen Shannon , Bigjahan Bavrina , Zada Gabriel , Chen Thomas , Neman-Ebrahim Josh , Chang Eric L. , Chow Frances E. , Fan Zhaoyang , Yang Wensha , Attenello Frank J. , Ye Jason , Kim Paul E. , Patel Vishal N. , Lerner Alexander , Acharya Jay , Hu Leland S. , Quarles C. Chad , Boxerman Jerrold L. , Wu Ona , Schmainda Kathleen M.
Published: September 2023

Introduction

1.5 Tesla (1.5T) remain a significant field strength for brain imaging worldwide. Recent computer simulations and clinical studies at 3T MRI have suggested that dynamic susceptibility contrast (DSC) MRI using a 30° flip angle (“low-FA”) with model-based leakage correction and no gadolinium-based contrast agent (GBCA) preload provides equivalent relative cerebral blood volume (rCBV) measurements to the reference-standard acquisition using a single-dose GBCA preload with a 60° flip angle (“intermediate-FA”) and model-based leakage correction. However, it remains unclear whether this holds true at 1.5T. The purpose of this study was to test this at 1.5T in human high-grade glioma (HGG) patients.

Methods

This was a single-institution cross-sectional study of patients who had undergone 1.5T MRI for HGG. DSC-MRI consisted of gradient-echo echo-planar imaging (GRE-EPI) with a low-FA without preload (30°/P-); this then subsequently served as a preload for the standard intermediate-FA acquisition (60°/P+). Both normalized (nrCBV) and standardized relative cerebral blood volumes (srCBV) were calculated using model-based leakage correction (C+) with IBNeuro™ software. Whole-enhancing lesion mean and median nrCBV and srCBV from the low- and intermediate-FA methods were compared using the Pearson’s, Spearman’s and intraclass correlation coefficients (ICC).

Results

Twenty-three HGG patients composing a total of 31 scans were analyzed. The Pearson and Spearman correlations and ICCs between the 30°/P-/C+ and 60°/P+/C+ acquisitions demonstrated high correlations for both mean and median nrCBV and srCBV.

Conclusion

Our study provides preliminary evidence that for HGG patients at 1.5T MRI, a low FA, no preload DSC-MRI acquisition can be an appealing alternative to the reference standard higher FA acquisition that utilizes a preload.
Prognostic factors and predictive scores for 6-months mortality of hematopoietic stem cell transplantation recipients admitted to the pediatric intensive care unit
Authors: Schober Sarah , Huber Silke , Braun Norbert , Döring Michaela , Lang Peter , Hofbeck Michael , Neunhoeffer Felix , Renk Hanna
Published: September 2023

Objective

Despite advances in hematopoietic stem cell transplantation (HSCT), a considerable number of pediatric HSCT patients develops post-transplant complications requiring admission to the pediatric intensive care unit (PICU). The objective of this study was to evaluate clinical findings, PICU supportive therapy and outcome as well as predictive factors for 6-months survival after discharge of HSCT patients from PICU.

Study design

This retrospective single-center analysis investigated patient characteristics, microbiological findings, reasons for admission and death of 54 cases accounting for 94 admissions to the PICU of the University Children’s Hospital Tuebingen from 2002 to 2017. We compared clinical characteristics between children with and without 6-months survival after discharge from PICU following HSCT. Finally, we assessed the potential prognostic value of the oncological Pediatric Risk of Mortality Score (O-PRISM), the Pediatric Sequential Organ Failure Assessment Score (pSOFA) and the pRIFLE Criteria for Acute Kidney Injury for 6-months survival using Generalized Estimating Equations (GEE) and Receiver Operating Characteristic curves.

Results

Respiratory insufficiency, gastroenterological problems and sepsis were the most common reasons for PICU admission. Out of 54 patients, 38 (70%) died during or after their last PICU admission, 30% survived for at least six months. When considering only first PICU admissions, we could not determine prognostic factors for 6-months mortality. In contrast, under consideration of all PICU admissions in the GEE model, ventilation (p=0.03) and dialysis (p=0.007) were prognostic factors for 6-months mortality. Furthermore, pSOFA (p=0.04) and O-PRISM (p=0.02) were independent risk factors for 6-months mortality considering all PICU admissions.

Conclusion

Admission of HSCT patients to PICU is still associated with poor outcome and 69% of patients died within 6 months. Need for respiratory support and dialysis are associated with poor outcome. Prediction of 6-months survival is difficult, especially during a first PICU admission. However, on subsequent PICU admissions pSOFA and O-PRISM scores might be useful to predict mortality. These scores should be prospectively evaluated in further studies to verify whether they can identify pediatric HSCT recipients profiting most from transferal to the PICU.
Therapeutic potential of vasculogenic mimicry in urological tumors
Authors: Lin Xinyu , Long Sheng , Yan Congcong , Zou Xiaofeng , Zhang Guoxi , Zou Junrong , Wu Gengqing
Published: September 2023

Angiogenesis is an essential process in the growth and metastasis of cancer cells, which can be hampered by an anti-angiogenesis mechanism, thereby delaying the progression of tumors. However, the benefit of this treatment modality could be restricted, as most patients tend to develop acquired resistance during treatment. Vasculogenic mimicry (VM) is regarded as a critical alternative mechanism of tumor angiogenesis, where studies have demonstrated that patients with tumors supplemented with VM generally have a shorter survival period and a poorer prognosis. Inhibiting VM may be an effective therapeutic strategy to prevent cancer progression, which could prove helpful in impeding the limitations of lone use of anti-angiogenic therapy when performed concurrently with other anti-tumor therapies. This review summarizes the mechanism of VM signaling pathways in urological tumors, i.e., prostate cancer, clear cell renal cell carcinoma, and bladder cancer. Furthermore, it also summarizes the potential of VM as a therapeutic strategy for urological tumors.
Stage shift and relative survival for head and neck cancer during the 2020 COVID-19 pandemic: a population-based study of temporal trends
Authors: Peacock Hanna M. , De Gendt Cindy , Silversmit Geert , Nuyts Sandra , Casselman Jan , Machiels Jean-Pascal , Giusti Francesco , van Gool Bart , Vander Poorten Vincent , Van Eycken Liesbet
Published: September 2023

Objective

During the first wave of the COVID-19 pandemic in 2020, non-essential health services were suspended in Belgium, and the public was ordered to socially isolate. Underdiagnosis of cancer during this period was reported worldwide. Certain risk factors for head and neck cancer (HNC) overlap with those for COVID-19 incidence and mortality, making underdiagnosis and subsequent stage shift of this potentially rapidly progressing cancer a major concern. We aimed to analyze incidence, clinical stage at presentation, and survival of patients diagnosed with HNC in 2020 in Belgium, considering recent temporal trends.

Methods

Using population-based data from the Belgian Cancer Registry (BCR), we extrapolated 2017-2019 trends in incidence, clinical stage, and 1-year relative survival (1yRS) of HNC to create an expected value for 2020 and compared this to the observed value.

Results

There were 9.5% fewer HNCs diagnosed in 2020, compared to the predicted incidence. Underdiagnosis was larger for males (-11.8%), patients aged 50-64 (-11.2%) and 65-79 (-11.1%), and for oral cavity cancer (-17.6%). Shifts to more advanced stages were observed in larynx and oropharynx tumors and for (male) patients aged 80+. A 2.4 percentage point decline in 1yRS was observed, relative to the increasing trends in 1yRS (2017-2019).

Conclusion

The COVID-19 pandemic led to underdiagnosis of HNC, resulting in shifts to more advanced stage at presentation in certain subgroups. A stage shift can be expected for the 9.5% of tumors not yet diagnosed at the end of 2020. HNC patients diagnosed in 2020 suffered higher than expected mortality.
Lung ultrasound supports clinical evaluation of feeding competence development in preterm neonates
Authors: Controzzi Tiziana , Chesi Francesca , Scaramuzzo Rosa Teresa , Giampietri Matteo , Morganti Riccardo , Fiori Simona , Moretti Elena , Gargani Luna , Filippi Luca
Published: September 2023

Introduction

The achievement of alimentary competencies is a milestone in the development of preterm neonates. Ten percent of neonates <37 weeks of gestational age and 25% of those VLBW experience swallowing disorders, with an increased risk of problems in the early phase of life (failure to thrive, growth retardation, inhalation, and consequent risk of pulmonary infection) and later in life due to delayed development of oromotor skills.

The main diagnostic tools for swallowing disorders are endoscopic (fiber-optic endoscopic examination of swallowing, FEES) or radiographic (videofluoroscopic swallowing study, VFSS) exams. Given the invasiveness of these methods and the bias due to rheologic differences between bolus and contrast medium, FEES and VFSS are poorly reproducible. Moreover, neither of the technique is capable of detecting post-meal inhalations, especially microinhalations or those consequent to a whole meal rather than to a single swallowing.

Lung ultrasound (LUS) is a widespread, repeatable, safe, fast point-of-care tool and we reported previous encouraging results in detecting silent and overt inhalation related to the meal in children with dysphagia/gastroesophageal reflux disease (GERD) risk factors.

Methods

We report a pilot study, that investigated LUS approach (performing imaging before and after meals) to assess feeding competence development in a cohort of n. 19 newborns <32 weeks of age.

Results

Meal monitoring by LUS did not show any significant difference in scoring before/after eating. The achievement of full enteral feeding correlates with GA at birth (p < 0.001) but not with LUS scoring. The introduction of the first meal by bottle correlates both with gestational age (p < 0.001) and ultrasound scores (p = 0.004). LUS score at 7 days of life resulted predictive for length of invasive/non-invasive respiratory support (p = 0.002) and length of oxygen supply (p = 0.001), while LUS score at 48 h of life did not (p n.s.).

Discussion

Our study suggests that the development of oral feeding skills is not strictly dependent on gestational age. Moreover, our research suggests the predominant role of LUS in predicting the time of readiness to oral feeding, as the LUS score can be a marker of respiratory and lung wellness, and consequently a predictor of neonate stability during deglutitory apnea.
Case report: Blotchy skin in a puffy neonate: is there a new association?
Authors: Joseph Chacko J. , Lodha Arijit , Thomas Soumya R. , Al Awad Essa , Wright Nicola A. M. , Constantinescu Cora , Le Doan , Kamaluddeen Majeeda
Published: September 2023

Introduction

Purpura fulminans in the neonatal population is a rare but potentially life-threatening condition complicated by thrombosis, resultant vital organ necrosis, and gangrene of the extremities. Considering the rapid evolution of the pathogenetic mechanism, an index of suspicion, early identification, and prompt intervention are imperative for improved outcomes. The majority of purpura fulminans cases have an infectious etiology, but it is essential to consider other congenital and acquired causes.

Case description

We present a clinical case of a female neonate to emphasize the correlation between purpura fulminans, congenital chylothorax, involvement of the PAK2 gene, and the occurrence of retinal detachment in both eyes. After draining the congenital chylothorax, the neonate developed purpura fulminans due to a loss of protein C, S, and antithrombin factors, previously not reported in the literature. The purpuric lesions resolved after the administration of fresh frozen plasma. Subsequently, no recurring purpura fulminans lesions were noted following the normalization of the antithrombotic factor levels in the serum. Subsequently, the child also developed retinal detachment in both eyes.
A comparative randomized clinical trial evaluating the efficacy and safety of tacrolimus versus hydrocortisone as a topical treatment of atopic dermatitis in children
Authors: Mohamed Amal A. , El Borolossy Radwa , Salah Eman M. , Hussein Maha S. , Muharram Nashwa M. , Elsalawy Naglaa , Khalil Mona G. , Mahmoud Maha O. , El-Amir Reham Y. , Elsanhory Heba M. A. , Ahmed Nourelhuda , Adaroas Ahmed S. , Montaser Mahmoud , El Kholy Amal A.
Published: September 2023

Background: Atopic dermatitis (AD) aetiology is not exactly identified, but it is characterized by pruritic skin reactions with elevation in the levels of inflammatory markers. Despite the fact that Corticosteroids are the mainstay therapy in the management of AD, they have many local and systemic adverse effects.

Objective: The aim of this study is to evaluate the efficacy and safety of topical tacrolimus ointment in comparison to topical hydrocortisone cream in the management of the AD of children diagnosed with AD.

Patients and Methods: This study was conducted on 200 children with AD. They were simply randomized into two groups, the tacrolimus group treated with 0.03% topical tacrolimus ointment and the hydrocortisone group treated with 1% hydrocortisone cream twice daily during the 3 weeks study period.

Results: At the end of the study, both the tacrolimus and hydrocortisone groups showed a significant decline in the mean serum level of IL-10, IL-17, and IL-23 (p < 0.05) when compared to their baseline levels. However, the tacrolimus group showed a more significant decrease (p < 0.05) in the mean serum level of IL-10, IL-17, and IL-23 as compared to the hydrocortisone group [Mean differences = 1.600, 95% CI: 0.9858–2.214; 1.300, 95% CI: 1.086–1.514 and 4.200, 95% CI: 3.321–5.079]. Moreover, the median mEASI decreased similarly from 32 to 21 in the tacrolimus group and from 30 to 22 in the hydrocortisone group (p > 0.05) [Median difference = −2.000, 95% CI: −2.651 to −1.349; Median difference = 1.000, 95% CI: 0.3489–1.651]. Mild to moderate transient stinging and erythema were the main adverse effects that showed higher incidence in the tacrolimus group than in the hydrocortisone group (p < 0.05). In most cases, they resolved within 3–4 days. Besides, tacrolimus ointment did not cause skin atrophy as compared to the hydrocortisone group (p < 0.05).

Conclusion: Tacrolimus ointment is more beneficial than hydrocortisone cream in managing AD in children in terms of lowering the inflammatory markers, however, there is no difference on the dermatitis severity scale. Moreover, tacrolimus is safer with a better side effect profile compared to hydrocortisone.

Trial Registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT05324618)
Heparin-induced thrombocytopenia associated with low-molecular-weight heparin: clinical feature analysis of cases and pharmacovigilance assessment of the FAERS database
Authors: Liu Leping , Zheng Hong , Chen Shanshan , Wang Shengfeng , Yang Minghua
Published: September 2023

Background: Unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) are commonly used anticoagulants for the management of arterial and venous thromboses. However, it is crucial to be aware that LMWH can, in rare cases, lead to a dangerous complication known as heparin-induced thrombocytopenia (HIT). The objective of this study was to evaluate the pharmacovigilance and clinical features of HIT associated with LMWH, as well as identify treatment strategies and risk factors to facilitate prompt management.

Methods: We extracted adverse event report data from the FDA Adverse Event Reporting System (FAERS) database for pharmacovigilance assessment. Case reports on LMWH-induced thrombocytopenia dated up to 20 March 2023 were collected for retrospective analysis.

Results: Significantly elevated reporting rates of HIT were shown in adverse event (AE) data of LMWHs in the FAERS database, while tinzaparin had a higher proportional reporting ratio (PRR) and reporting odds ratio (ROR) than other LMWHs, indicating a greater likelihood of HIT. Case report analysis indicated that a total of 43 patients showed evidence of LMWH-induced thrombocytopenia with a median onset time of 8 days. Almost half of the events were caused by enoxaparin. LMWHs were mainly prescribed for the treatment of embolism and thromboprophylaxis of joint operation. Patients with a history of diabetes or surgery appeared to be more susceptible to HIT. Clinical symptoms were mostly presented as thrombus, skin lesion, and dyspnea. Almost 90% of the patients experienced a platelet reduction of more than 50% and had a Warkentin 4T score of more than 6, indicating a high likelihood of HIT. In all patients, LMWHs that were determined to be the cause were promptly withdrawn. Following the discontinuation of LMWHs, almost all patients were given alternative anticoagulants and eventually achieved recovery.

Conclusion: LMWH-induced thrombocytopenia is rare but serious, with increased risk in patients with diabetes or a surgical history. Prompt recognition and management are crucial for the safe use of LMWHs.
High-energy X-ray spectrum reconstruction: solving the inverse problem from optimized multi-material transmission measurements
Authors: Walker A. , Friou A. , Ginsburger K.
Published: September 2023

Reconstructing the unknown spectrum of a given X-ray source is a common problem in a wide range of X-ray imaging tasks. For high-energy sources, transmission measurements are mostly used to recover the X-ray spectrum, as a solution to an inverse problem. While this inverse problem is usually under-determined, ill-posedness can be reduced by improving the choice of transmission measurements. A recently proposed approach optimizes custom thicknesses of calibration materials used to generate transmission measurements, employing a genetic algorithm to minimize the condition number of the system matrix before inversion. In this paper, we generalize the proposed approach to multiple calibration materials and show a much larger decrease of the condition number of the system matrix than thickness-only optimization. Additionally, the spectrum reconstruction pipeline is tested in a simulation study with a challenging high-energy Bremsstrahlung X-ray source encountered in Linear Induction Accelerators with strong scatter noise. Using this approach, a realistic noise level is obtained on measurements. A generic anti-scatter grid is designed to reduce noise to an acceptable -yet still high-noise range. A novel noise-robust reconstruction method is then presented, which shows much less sensitive to initialization than common expectation-maximization approaches, enables a precise choice of spectrum resolution and a controlled injection of prior knowledge of the X-ray spectrum.
Genome-wide identification of the heat shock transcription factor gene family in two kiwifruit species
Authors: Tu Jing , Abid Muhammad , Luo Juan , Zhang Yi , Yang Endian , Cai Xinxia , Gao Puxin , Huang Hongwen , Wang Zupeng
Published: September 2023

High temperatures have a significant impact on plant growth and metabolism. In recent years, the fruit industry has faced a serious threat due to high-temperature stress on fruit plants caused by global warming. In the present study, we explored the molecular regulatory mechanisms that contribute to high-temperature tolerance in kiwifruit. A total of 36 Hsf genes were identified in the A. chinensis (Ac) genome, while 41 Hsf genes were found in the A. eriantha (Ae) genome. Phylogenetic analysis revealed the clustering of kiwifruit Hsfs into three distinct groups (groups A, B, and C). Synteny analysis indicated that the expansion of the Hsf gene family in the Ac and Ae genomes was primarily driven by whole genome duplication (WGD). Analysis of the gene expression profiles revealed a close relationship between the expression levels of Hsf genes and various plant tissues and stress treatments throughout fruit ripening. Subcellular localization analysis demonstrated that GFP-AcHsfA2a/AcHsfA7b and AcHsfA2a/AcHsfA7b -GFP were localized in the nucleus, while GFP-AcHsfA2a was also observed in the cytoplasm of Arabidopsis protoplasts. The results of real-time quantitative polymerase chain reaction (RT-qPCR) and dual-luciferase reporter assay revealed that the majority of Hsf genes, especially AcHsfA2a, were expressed under high-temperature conditions. In conclusion, our findings establish a theoretical foundation for analyzing the potential role of Hsfs in high-temperature stress tolerance in kiwifruit. This study also offers valuable information to aid plant breeders in the development of heat-stress-resistant plant materials.
Grassland health assessment based on indicators monitored by UAVs: a case study at a household scale
Authors: Luo Yifei , Ji Wenxiang , Wu Wenjun , Liao Yafang , Wei Xinyi , Yang Yudie , Dong Guoqiang , Ma Qingshan , Yi Shuhua , Sun Yi
Published: September 2023

Grassland health assessment (GHA) is a bridge of study and management of grassland ecosystem. However, there is no standardized quantitative indicators and long-term monitor methods for GHA at a large scale, which may hinder theoretical study and practical application of GHA. In this study, along with previous concept and practices (i.e., CVOR, the integrated indexes of condition, vigor, organization and resilience), we proposed an assessment system based on the indicators monitored by unmanned aerial vehicles (UAVs)-UAVCVOR, and tested the feasibility of UAVCVOR at typical household pastures on the Qinghai-Tibetan Plateau, China. Our findings show that: (1) the key indicators of GHA could be measured directly or represented by the relative counterpart indicators that monitored by UAVs, (2) there was a significantly linear relationship between CVOR estimated by field- and UAV-based data, and (3) the CVOR decreased along with the increasing grazing intensity nonlinearly, and there are similar tendencies of CVOR that estimated by the two methods. These findings suggest that UAVs is suitable for GHA efficiently and correctly, which will be useful for the protection and sustainable management of grasslands.
Effects of biochar and vermicompost on growth and economic benefits of continuous cropping pepper at karst yellow soil region in Southwest China
Authors: Zhang Meng , Liu Yanling , Wei Quanquan , Liu Lingling , Gu Xiaofeng , Gou Jiulan , Wang Ming
Published: September 2023

Recently, biochar (B) and vermicompost (V) have been widely used as amendments to improve crop productivity and soil quality. However, the ameliorative effects of biochar and vermicompost on the continuous cropping of pepper under open-air conditions, particularly in the karst areas of southwestern China, remain unclear. A field experiment was conducted to study the effects of biochar and vermicompost application, alone or in combination, on the yield, quality, nutrient accumulation, fertilizer utilization, and economic benefits of continuous pepper cropping from 2021 to 2022. The experiment included six treatments: CK (no fertilizer), TF (traditional fertilization of local farmers), TFB (TF combined with biochar of 3000 kg·ha-1), TFV (TF combined with vermicompost of 3000 kg·ha-1), TFBV1 (TF combined with biochar of 1500 kg·ha-1 and vermicompost of 1500 kg·ha-1), and TFBV2 (TF combined with biochar of 3000 kg·ha-1 and vermicompost of 3000 kg·ha-1). Compared with the TF treatment, biochar and vermicompost application alone or in combination increased the yield of fresh pod pepper by 24.38–50.03% and 31.61–88.92% in 2021 and 2022, respectively, whereas the yield of dry pod pepper increased by 14.69–40.63% and 21.44–73.29% in 2021 and 2022, respectively. The application of biochar and vermicompost reduced the nitrate content and increased the vitamin C (VC) and soluble sugar content of the fruits, which is beneficial for improving their quality. Biochar and vermicompost application alone or in combination not only increased nutrient uptake but also significantly improved agronomic efficiency (AE) and recovery efficiency (RE). In addition, although the application of biochar or vermicompost increased production costs, the increase in yield improved net income (ranging from 0.77 to 22.34% in 2021 and 8.82 to 59.96% in 2022), particularly in the TFBV2 treatment. In conclusion, the use of biochar and vermicompost amendments had a positive effect on the productivity and economic benefits of continuous pepper cropping, and the co-application of biochar and vermicompost could be an effective nutrient management strategy for the continuous cropping of pepper in the karst mountain areas of southwest China.
CRISPR/Cas9-mediated lipoxygenase gene-editing in yellow pea leads to major changes in fatty acid and flavor profiles
Authors: Bhowmik Pankaj , Yan Wei , Hodgins Connor , Polley Brittany , Warkentin Tom , Nickerson Michael , Ro Dae-Kyun , Marsolais Frédéric , Domoney Claire , Shariati-Ievari Shiva , Aliani Michel
Published: September 2023

Introduction

Although pulses are nutritious foods containing high amounts of protein, fiber and phytochemicals, their consumption and use in the food industry have been limited due to the formation of unappealing flavors/aromas described as beany, green, and grassy. Lipoxygenase (LOX) enzymes are prevalent among pulse seeds, and their activity can lead to the formation of specific volatile organic compounds (VOCs) from certain polyunsaturated fatty acids (PUFAs). As a widespread issue in legumes, including soybean, these VOCs have been linked to certain unappealing taste perception of foods containing processed pulse seeds.

Methods

To address this problem in pea and as proof of principle to promote the wider use of pulses, a Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) construct was designed to create null alleles (knockouts) of PsLOX2 which had been implicated in the generation of VOCs in peas.

Results and discussion

Successful CRISPR/Cas9-mediated LOX gene editing of stable transgenic pea lines (TGP) was confirmed by DNA sequencing of the wild type (WT) and TGP pslox2 mutant lines. These lines were also assessed for LOX activity, PUFA levels, and VOCs. Compared to WT peas, the TGP lines showed a significant reduction (p < 0.05) in LOX activity and in the concentration of key VOCs, including hexanal, 2-hexenal, heptanal, (E)-2-heptenal, (E,E)-2,4-heptadienal, 1-octen-3-ol, octanal, (E)-2-octenal (E,E)-2,4-nonadienal and furan-2-pentyl. The content of two essential PUFAs, linoleic and α-linolenic acids, the known substrates of LOX in plants, was higher in TGP flours, indicating the efficacy of the CRISPR-mediated gene editing in minimizing their oxidation and the further modification of PUFAs and their products. The collection of VOCs from the headspace of ground pea seeds, using a portable eNose also distinguished the TGP and WT lines. Multiple regression analysis showed that LOX activity correlated with the two VOCs, heptanal and (E,E)-2,4-heptadienal in pea flours. Partial Least Squares Regression (PLS-R) plot for selected PUFAs, VOCs, and sensor responses in WT and TGP lines showed distinct clusters for WT and TGP lines. Together this data demonstrates the utility of CRISPR mediated mutagenesis of PsLOX2 to quickly improve aroma and fatty acid (FA) profiles of pea seeds of an elite Canadian variety.
The representation of child–parent relation: validation of the Italian version of the child–parent relationship scale (CPRS-I)
Authors: Rinaldi Teresa , Castelli Ilaria , Palena Nicola , Greco Andrea , Pianta Robert , Marchetti Antonella , Valle Annalisa
Published: September 2023

This study proposes a psychometric validation of the Italian version of the Child–Parent Relationship Scale (CPRS) developed by Pianta in 1992. Based on attachment theory, the scale assesses parents’ relationship perceptions with their own child and comprises three scales: Closeness, Conflict, and Dependency. A sample of 501 parents (188 fathers and 313 mothers) completed 30 items of the Italian version of the Child–Parent Relationship Scale (CPRS-I) online, but only 437 answered 85% of the entire protocol; hence, the analyses only focused on 437 participants. The first analysis of the original theoretical model revealed poor fit, item loadings, and internal consistency. Therefore, a follow-up analysis was conducted. Exploratory and confirmatory analyses with a split sample (EFA = 218; CFA = 219) confirmed the original three-factor structure of the Italian sample, although some items were eliminated. The validity and reliability of the Italian version of the CPRS-I were also verified by correlating the above three factors with measures of adult attachment styles and children’s internalizing and externalizing behaviors. The CPRS-I showed significant correlations with all tested constructs, in line with those found by Driscoll and Pianta for the short form of the scale. Our results confirm that the CPRS-I has the same structure as the original scale; therefore, it can be a useful tool for assessing parents’ perceptions of their relationship with their children. The implications for educational and clinical settings are also discussed.
Publishing in English or Chinese: a qualitative analysis of Chinese researchers’ academic language choice
Authors: Cui Jing , Qiu Changbo , Wang Zhigang
Published: September 2023

Non-native language scholars often struggle to choose between English and their native language in scholarly publishing. This study aims to identify the mechanism by which journal attributes influence language choice by investigating the perspectives of 18 Chinese scholars through semi-structured interviews. Drawing on grounded theory, this study develops a model for how journal attributes influence researchers’ language preferences. We find that journal attributes influence researchers’ perceived value which, in turn, affects their particular language choice, with contextual factors playing a moderating role. By examining the motivations underlying Chinese scholars’ language choice, this study provides a critical understanding of the factors shaping their decision-making processes. These findings have significant implications for Chinese scholars, policymakers, and journal operators, shedding light on the issue of discrimination in academic publishing. Addressing these concerns is crucial for fostering a fair and inclusive academic environment.
When healers get wounded! Moral injury in healthcare providers during the COVID-19 pandemic in Pakistan
Authors: Fatima Madah , Imran Nazish , Aamer Irum , Iqtadar Somia , Shabbir Bilquis
Published: September 2023

Introduction

Moral injury (MI) is a multi-faceted and multidimensional phenomenon. Occupational MI has been studied mainly among military personnel and first responders and is linked to mental health problems. MI encompasses negative moral emotions such as shame, guilt, and anger leading to distress, and impairment in social and occupational functioning. The COVID-19 pandemic predisposed healthcare providers to moral dilemmas, potentially morally injurious events (PMIEs), and MI. We aimed to assess the prevalence and predictors of MI in healthcare providers during the COVID-19 pandemic in Pakistan.

Materials and methods

This cross-sectional study was conducted in July–October 2021 among physician/clinician staff working at teaching hospitals in Lahore. The Moral Injury Symptoms Scale-Health Professionals (MISS-HP) was used to collect data. SPSS 26 was used for data analysis applying Wilcoxon Mann–Whitney U and Kruskal–Wallis tests on non-normally distributed data at α = 0.05. Predictors of MI were ascertained through Binary Logistic Regression analysis.

Results

Four hundred and twenty physicians responded to the questionnaires. The Median (IQR) MI scores were 37(28–47). Guilt, moral concerns, and shame were higher-scoring MI dimensions. 40.8% (n = 171) suffered from clinically significant distress and impaired functioning while 14.3% (n = 60) from severe distress. Gender, department, and history of psychiatric illness predicted higher levels of distress which were 1.9 times higher in females than males and 2.5 times higher with a history of psychiatric illness. Working on the front lines did not predict MI.

Conclusion

Our findings highlight the substantial burden of MI in our sample during COVID-19, having implications for healthcare providers’ well-being, healthcare quality, and service delivery. This calls for concerted efforts from all stakeholders to better prepare for future disasters through effective human-resource policies, pre-trauma exposure soft-skills training, effective teamwork and communication strategies; self-stewardship and resilience modules, and mental health support for healthcare providers. The dimensional construct of MI may vary across cultures; hence we recommend further cross-cultural research on MI in healthcare providers, particularly in the context of public health disasters.
Gender diversity in autistic clients: an ethical perspective
Authors: Glaves Katie Jo , Kolman Leah
Published: September 2023

Autonomy and dignity are key ethical principles in psychiatric and psychological codes of ethics. Yet, when working with autistic individuals who are transgender/gender non-conforming (TGNC), non-autistic and cisgender clinicians can unintentionally take away client dignity and autonomy by disbelieving or stigmatizing clients’ gender identities. Lack of awareness or discomfort around autism and gender dysphoria can lead clinicians to assumptions and interventions that damage both client rapport and client mental health; discouraging clients from being honest with clinicians about their mental health, and potentially leading to harm. Clinicians must take an intersectional view of their autistic clients’ gender identities to reduce stigma and recognize the needs of the whole person. Facilitating access to gender-affirming care is an important part of caring for TGNC clients, including those who are autistic. The authors will discuss the ethical imperative to help autistic clients access gender-affirming care, while discussing common concerns clinicians have when helping autistic clients access this care, as well as the need to believe and support autistic clients when they share their gender identities with clinicians.