bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the added effects of guidance in digital psychological self-care for alcohol problems (ALVA)—protocol for a randomized factorial optimization trial
Authors: Sundström Christopher , Ivanova Ekaterina , Lindner Philip , Johansson Magnus , Kraepelien Martin
Published: February 2024

Background

The continual development and implementation of effective digital interventions is one important strategy that may serve to bridge the well-known treatment gap related to problematic alcohol use. Research suggests that clinician guidance, provided in different ways during the digital intervention (i.e., written weekly messages, phone calls etc.), can boost intervention engagement and effects. Digital psychological self-care (DPSC) is a new delivery format wherein an unguided digital intervention is provided within the framework of a structured care process that includes initial clinical assessment and follow-up interviews. In a recent feasibility study, a DPSC intervention for problematic alcohol use, ALVA, provided without any extra guidance, was found safe and credible and to have promising within-group effects on alcohol consumption. The aim of the current study is to gather information on the effects and efficiency of different forms of guidance added to ALVA, in order to optimize the intervention.

Methods

This protocol describes a randomized factorial trial where the effects of two different ways of providing guidance (mid-treatment interview, weekly written messages, respectively) in DPSC for problematic alcohol use are investigated. Optimization criteria will be applied to the results regarding how effective the intervention is at reducing alcohol consumption measured by the number of standard drinks per week together with the clinician time spent on guidance.

Discussion

This study will investigate the added benefit of different forms of guidance to DPSC for problematic alcohol use. These added effects will be compared to the added cost of guidance, according to pre-defined optimization criteria.

Trial registration

Clinicaltrials.gov: NCT05649982. Registered on 06 December 2022. Prospectively registered.
Low CO2 concentration, a key environmental factor for developing plateau adapted rapeseed
Authors: Liu Sha , Tang Lin , Fu Jingyan , Zhao Caixia , Zhang Ying , Yin Meng , Wang Maolin , Wang Rui , Zhao Yun
Published: February 2024

Background

Photosynthesis is a fundamental process that underlies the formation of crop yield, wherein light serves as the driving force and carbon dioxide (CO2) as the raw material. These two factors have a direct influence on the progress and efficiency of photosynthesis in crops. Rapeseed is one of the four major oilseed crops worldwide. Plateau rapeseed has now become a research hotspot. However, the lack of high-yielding rapeseed germplasm resources on the plateau and the highly efficient strategy for screening them severely affect the development of rapeseed industry in plateau.

Results

In the rapeseed experimental fields located on the plateau (Lhasa, Tibet), we measured abundant sunlight, characterized by an average daily photosynthetically active radiation (PAR) of 1413 μmol m−2 s−1. In addition, the atmospheric CO2 concentrations range from 300 to 400 ppm, which is only two-thirds of that in the plain (Chengdu, Sichuan). We found that under different measurement conditions of light intensity and CO2 concentration, different rapeseed genotypes showed significant differences in leaf photosynthetic efficiency during the seedling stage. Moreover, the rapeseed materials with high photosynthetic efficiency under low CO2 concentrations rather than high light intensity, exhibited significant advantages in biomass, yield, and oil content when cultivated on the plateau, indicating that the CO2 is the key environmental factor which limited rapeseed production in plateau. Based on photosynthetic efficiency screening under low CO2 concentrations, six rapeseed varieties SC3, SC10, SC25, SC27, SC29 and SC37, shown significantly higher yields in plateau environment compared to local control variety were obtained. In addition, the adaptability of rapeseed to plateau was found to be related to the activities of key Calvin cycle enzymes and the accumulation of photosynthetic products.

Conclusions

This study established a screening strategy for plateau high-yielding rapeseed materials, obtained six varieties which were suitable for plateau cultivation, explored the mechanism of rapeseed response to the plateau environment, and thus provides a feasible strategy for plateau-adapted rapeseed breeding.
Evaluation of point-of-care ultrasound training among healthcare providers: a pilot study
Authors: Al-Absi Dima Tareq , Simsekler Mecit Can Emre , Omar Mohammed Atif , Soliman-Aboumarie Hatem , Abou Khater Noha , Mehmood Tahir , Anwar Siddiq , Kashiwagi Deanne Tomie
Published: February 2024

Background

The use of Point-of-Care Ultrasound (POCUS) has become prevalent across a variety of clinical settings. Many healthcare professionals have started getting hands-on training. To evaluate the effectiveness of such training programs, this study aimed to assess a 4 day POCUS training course on healthcare providers’ skills and knowledge acquisition. A secondary objective of this study is to gain valuable insights into the degree of perception, attitude, interest levels and perceived barriers of medical providers performing POCUS.

Methods

This is a prospective cohort study performed on healthcare providers in an integrated healthcare facility in Abu Dhabi undergoing the POCUS training course in February 2022. Course participants took a pre-course survey to evaluate their baseline knowledge, skills, confidence, perception, and interest in POCUS. The same survey was repeated immediately post-course. In total, seven healthcare professionals responded to the survey with a response rate of 53.8%. All data and information gathered were used to understand the effectiveness of POCUS training and gain insights into the degree of perception, interest and preparedness of POCUS among healthcare professionals in practice.

Results

Our results demonstrated that the brief POCUS course was effective in improving POCUS skills, knowledge and confidence amongst in-practice healthcare providers from varying medical specialties. The median skill score increased from 25% pre-course to 50% post-course. There is a notable increase in all skills scores after the POCUS training course with the greatest change in scores seen for adjusting ‘gain and depth of image (54.84%), assessing VeXUS score (52.38%) and evaluating lung congestion (50%). The study also provided valuable insights into the perception, attitude, interest and potential barriers of POCUS implementation. Although significant barriers to POCUS are present including the lack of POCUS curriculum, what is challenging is lack of expertise and skills to perform POCUS. Therefore, medical providers must acquire prespecified skills to fully utilize POCUS effectively.

Conclusion

The study confirmed the effectiveness of short POCUS training in improving the skills, knowledge and confidence of medical providers in practice. Healthcare professionals can master POCUS skills and techniques and gain confidence through brief training courses.
The usefulness of point-of-care ultrasound in dehydrated patients in a pediatric emergency department
Authors: Bellini Tommaso , Chianucci Benedetta , D’Alessandro Matteo , Ricci Margherita , Calevo Maria Grazia , Misley Silvia , Piccotti Emanuela , Moscatelli Andrea
Published: February 2024

Backgrounds

Dehydration is among the most common causes of Pediatric Emergency Department admission; however, no clinical signs, symptoms, or biomarkers have demonstrated sufficient sensitivity, specificity, or reliability to predict dehydration.

Methods

We conducted a prospective, monocentric, observational study at Giannina Gaslini Hospital, a tertiary care pediatric hospital. Our study aimed to compare inferior vena cava ultrasound measurement with volume depletion biomarkers to understand if point-of-care ultrasound could help grade, evaluate, and better manage dehydration in children presenting to the pediatric emergency department. We enrolled patients under the age of 14 who required blood tests in the suspect of dehydration; for each patient, we collected values of venous pH, natremia, bicarbonatemia, uric acid, chloremia, and blood urea nitrogen. For each patient, we performed two ultrasound scans to calculate the Inferior Vena Cava/Aorta area ratio and to assess the IVC collapsibility index; moreover, we described the presence of the “kiss sign” (100% IVC walls collapsing during the inspiratory phase).

Results

Patients with the “kiss sign” (25/65 patients, 38.5% of the total) showed worse blood tests, in particular, uric acid levels (p = 0.0003), bicarbonatemia (p = 0.001) and natriemia (p = 0.0003). Moreover, patients with the “kiss sign” showed a high frequency of ≥ 2 pathological blood tests (p = 0.0002). We found no statistical significant difference when comparing the IVC/Ao ratio and IVC-CI with the considered blood tests.

Conclusions

The “kiss sign” seems to be related to worse hydration state, whereas IVC/Ao and IVC-CI are not. In an emergency setting, where physicians must take diagnostic-therapeutic decisions quickly, the presence of the “kiss sign” in patients suspected to be dehydrated can be a helpful tool in their management.
Thoracic ultrasound use in hospitalized and ambulatory adult patients: a quantitative picture
Authors: Xirouchaki N. , Bolaki M. , Psarologakis C. , Pediaditis E. , Proklou A. , Papadakis E. , Kondili E. , Georgopoulos D.
Published: February 2024

Introduction and objectives

Thoracic ultrasound (TUS) has been established as a powerful diagnostic and monitoring tool in the Intensive Care Unit (ICU). However, studies outside the critical care setting are scarce. The aim of this study was to investigate the value of TUS for hospitalized or ambulatory community patients.

Materials and methods

This was a retrospective study conducted from 2016 to 2020 in the TUS clinic at Heraklion University Hospital. TUS examination was performed using a standard ultrasound machine (EUB HITACHI 8500), and a high-frequency microconvex probe (5–8 MHz). Patients had been referred by their primary physician to address a range of different questions. The various respiratory system entities were characterised according to internationally established criteria.

Results

762 TUS studies were performed on 526 patients due to underlying malignancy (n = 376), unexplained symptoms/signs (n = 53), pregnancy related issues (n = 42), evaluation of abnormal findings in X-ray (n = 165), recent surgery/trauma (n = 23), recent onset respiratory failure (n = 12), acute respiratory infection (n = 66) and underlying non-malignant disease (n = 25). Pleural effusion was the commonest pathologic entity (n = 610), followed by consolidation (n = 269), diaphragmatic dysfunction/paradox (n = 174) and interstitial syndrome (n = 53). Discrepancies between chest X-ray and ultrasonographic findings were demonstrated in 96 cases. The TUS findings guided invasive therapeutic management in 448 cases and non-invasive management in 43 cases, while follow-up monitoring was decided in 271 cases.

Conclusions

This study showed that TUS can identify the most common respiratory pathologic entities encountered in hospitalized and community ambulatory patients, and is especially useful in guiding the decision making process in a diverse group of patients.
Timing and clinical risk factors for early acquisition of gut pathogen colonization with multidrug resistant organisms in the intensive care unit
Authors: Shamalov Loren , Heath Madison , Lynch Elissa , Green Daniel A. , Gomez-Simmonds Angela , Freedberg Daniel E.
Published: February 2024

Background

Microbiome restitution therapies are being developed to prevent gut pathogen colonization among patients in the intensive care unit (ICU) and in other select populations. If preventive therapies are to be effective, they must be administered prior to pathogen acquisition. The timing and risk factors for early acquisition of gut pathogen colonization (within 72 h) are currently unknown and could be helpful to guide ICU trial design.

Methods

This was a prospective cohort study. Patients in the ICU had deep rectal swabs performed within 4 h of ICU admission and exactly 72 h later. Early gut pathogen colonization was classified as the new presence (based on culture of rectal swabs) of one or more of the following organisms of interest: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant (VRE), and Gram-negative bacteria that showed multidrug resistance (MDR) or third generation Cephalosporin resistance (Ceph-R). Clinical risk factors for early acquisition of gut pathogen colonization were captured using the Acute Physiology and Chronic Health Evaluation IV (APACHE IV) scoring system.

Findings

Among 131 patients who were swabbed at ICU admission and 72 h later, the rates of gut pathogen colonization at ICU admission were 11.4%, 10.6%, 38.6%, and 8.3% for MRSA, VRE, MDR and Ceph-R Gram-negatives respectively. Among the patients who were negative for a given pathogen at ICU admission, the rates of early acquisition of gut pathogen colonization were 7.8% for MRSA (95% CI 3.6 to 14.2%), 7.7% for VRE (95% CI 3.6 to 14.1%), 11.3% for MDR Gram-negatives (95% CI 4.4 to 18.8%), and 4.2% for Ceph-R Gram-negatives (95% CI 1.4 to 9.5%). There were no clinical risk factors which independently predicted early acquisition of gut pathogen colonization.

Interpretation

Early gut pathogen colonization was common in the ICU, but our single-center study could not identify any clinical risk factors which were significantly associated with acquisition of gut pathogens.
Impact of preoperative factors and waiting time on post-appendectomy complications: a retrospective study
Authors: Lai Shuo-Lun , Chang Chin-Hao , Lee Po-Chu , Ho Cheng-Maw , Wu Jin-Ming , Lai Hong-Shiee , Lin Been-Ren
Published: February 2024

Background

Several factors are associated with increased postoperative complications after appendectomies. However, few studies combined these potential factors for comprehensive prediction of surgical outcomes. Whether high-risk patients benefit from a shorter waiting time for surgery remains unclear. This study aimed to explore the impact of surgical waiting time and potential risk factors on postoperative complications.

Methods

A total of 1343 patients diagnosed with acute appendicitis requiring an emergent appendectomy were included from 2013 to 2018. The preoperative risk factors associated with postoperative complications were selected and the probability of postoperative complications was calculated by multivariate logistic regression model. Patients were divided into four groups based on the risk (high & low) and time to surgery (> 12 & ≤12 hours). The odds ratios for complications were evaluated between groups.

Results

The selected risk factors included age, neutrophil-lymphocyte ratio, systemic inflammatory response syndrome and abdominal pain duration. Compared with low-risk patients with time to surgery ≤12 hours, high-risk patients with time to surgery > 12 hours had significant increased overall postoperative complication rate (16.85% vs. 8.16%, p = 0.002) and a trend toward increased surgical site infection rate (10.99% vs. 6.46%, p = 0.058). When operated within 12 hours, there was no difference in outcomes between high- and low-risk patients. On the other hand, time to surgery > 12 hours did not increase complication rate in low-risk patients.

Conclusions

The surgical outcome may be affected by preoperative factors and time to surgery. It is suggested that high-risk patients receive appendectomy within 12 hours to avoid increased postoperative complications.
Adverse effects of remdesivir for the treatment of acute COVID-19 in the pediatric population: a retrospective observational study
Authors: Schulz Abigail , Huynh Natalie , Heger Margaret , Bakir Mustafa
Published: February 2024

Background

Although the severity of coronavirus disease 2019 (COVID-19) tends to be lower in children, it can still lead to severe illness, particularly among those with chronic medical conditions. While remdesivir (RDV) is one of the few approved antiviral treatments for COVID-19 in children in many countries, the available data on the safety of RDV in this population is limited.

Methods

To address this knowledge gap, a multicenter study involving 65 patients retrospectively analyzed the clinical data from individuals aged <18 who were hospitalized due to severe COVID-19 (defined as SpO2 < 94% or requiring supplemental oxygen) and received at least one dose of RDV. Additionally, the study encompassed 22 patients with mild-moderate COVID-19 who were considered at high risk of developing severe disease.

Results

Nineteen children (29%) experienced mild-to-moderate adverse events (AEs) attributed to RDV, including transaminitis in 20% of children, bradycardia in 8%, and hypotension in 5%. AEs did not require discontinuation of RDV, except in one patient who developed premature ventricular contractions. The rate of AEs did not differ between patients with severe COVID-19 and those with mild-moderate COVID-19 but at high risk for severe disease. All but one patient were discharged within 23 days of admission, and no fatalities were recorded. Among high-risk patients with mild-moderate disease, only 2 (9%) progressed to the point of needing supplemental oxygen.

Conclusions

Our data suggests that RDV is safe in children, with no reported serious AEs. However, the absence of a control group limits the extent to which conclusions can be drawn. RDV may contribute to clinical improvement, particularly in high-risk patients.
Deep learning based approaches from semantic point clouds to semantic BIM models for heritage digital twin
Authors: Pan Xiang , Lin Qing , Ye Siyi , Li Li , Guo Li , Harmon Brendan
Published: February 2024

This study focuses on the application of deep learning for transforming semantic point clouds into semantic Building Information Models (BIM) to create a Heritage Digital Twin, centering on Taoping Village, a site of historical and cultural significance in Sichuan, China. Utilizing advanced technologies such as unmanned aerial vehicles and terrestrial laser scanning, we capture detailed point cloud data of the village. A pivotal element of our methodology is the KP-SG neural network, which exhibits outstanding overall performance, particularly excelling in accurately identifying 11 categories. Among those categories, buildings and vegetation, achieves recognition rates of 81% and 83% respectively, and a 2.53% improvement in mIoU compared to KP-FCNN. This accuracy is critical for constructing detailed and accurate semantic BIM models of Taoping Village, facilitating comprehensive architecture and landscape analysis. Additionally, the KP-SG’s superior segmentation capability contributes to the creation of high-fidelity 3D models, enriching virtual reality experiences. We also introduce a digital twin platform that integrates diverse datasets, their semantic information, and visualization tools. This platform is designed to support process automation and decision-making and provide immersive experiences for tourists. Our approach, integrating semantic BIM models and a digital twin platform, marks a significant advancement in preserving and understanding traditional villages like Taoping and demonstrates the transformative potential of deep learning in cultural heritage conservation.
Feasibility study of Glucagon-like peptide-1 analogues for the optimization of Outcomes in obese patients undergoing AbLation for Atrial Fibrillation (GOAL-AF) protocol
Authors: Win Kyaw Z. , Armstrong Matthew , Steeds Richard P. , Kalla Manish
Published: February 2024

Background

Catheter ablation for atrial fibrillation is recommended for symptomatic patients after failed medical therapy. Ablation has a higher failure rate in obese patients, and both the prevalence of atrial fibrillation and obesity are increasingly globally. The outcome of ablation can be improved if obese patients can achieve goal-oriented weight reduction prior to ablation. Conventional weight loss strategies, however, can be difficult to access and can delay ablation, thereby risking a lower chance of maintaining sinus rhythm. Effective weight-loss medications, such as the glucagon-like peptide inhibitor-1 drugs, offer the potential for incremental impact on weight loss over a shorter period of time as a bridging therapy. The aim of this study is to assess the feasibility of using liraglutide, a glucagon-like peptide inhibitor-1, in producing weight loss in obese patients before catheter ablation.

Methods

The study is an open-label, uncontrolled, prospective single-centre feasibility study of daily liraglutide injections in the treatment of obese patients for at least 13 weeks before and 52 weeks after AF ablation. Adult patients with symptomatic AF whose body mass index ≥ 30 will be recruited from those planning to undergo ablation. Feasibility will be determined based on the recruitment rate, adherence to the medication, and the amount of weight loss achieved over the study period. Exploratory outcomes include changes in atrial structure, function, and fibrosis with weight loss evaluated by cardiac magnetic resonance imaging, electroanatomic mapping, and patient-reported outcome measure.

Discussion

This study will allow us to determine whether the use of liraglutide in obese patients with atrial fibrillation undergoing ablation is feasible with adequate recruitment. The additional information on adherence and average weight loss over the study period will inform the design of a future definitive randomized controlled trial.

Trial registration

ClinicalTrials.gov (NCT05221229). Registered on 2 February 2022.

Trial funding

Metchley Park Medical Society and University of Birmingham Starter Fellowship, British Heart Foundation Accelerator Grant, Abbott Investigator-Initiated Study Grant.
Giant pandas in captivity undergo short-term adaptation in nerve-related pathways
Authors: Li Yan , Xu Wei , Wang Juan , Liu Hong , Liu Jiawen , Zhang Liang , Hou Rong , Shen Fujun , Liu Yuliang , Cai Kailai
Published: February 2024

Background

Behaviors in captive animals, including changes in appetite, activity level, and social interaction, are often seen as adaptive responses. However, these behaviors may become progressively maladaptive, leading to stress, anxiety, depression, and other negative reactions in animals.

Results

In this study, we investigated the whole-genome sequencing data of 39 giant panda individuals, including 11 in captivity and 28 in the wild. To eliminate the mountain range effect and focus on the factor of captivity only, we first performed a principal component analysis. We then enumerated the 21,474,180 combinations of wild giant pandas (11 chosen from 28) and calculated their distances from the 11 captive individuals. The 11 wild individuals with the closest distances were used for the subsequent analysis. The linkage disequilibrium (LD) patterns demonstrated that the population was almost eliminated. We identified 505 robust selected genomic regions harboring at least one SNP, and the absolute frequency difference was greater than 0.6 between the two populations. GO analysis revealed that genes in these regions were mainly involved in nerve-related pathways. Furthermore, we identified 22 GO terms for which the selection strength significantly differed between the two populations, and there were 10 nerve-related pathways among them. Genes in the differentially abundant regions were involved in nerve-related pathways, indicating that giant pandas in captivity underwent minor genomic selection. Additionally, we investigated the relationship between genetic variation and chromatin conformation structures. We found that nucleotide diversity (θπ) in the captive population was correlated with chromatin conformation structures, which included A/B compartments, topologically associated domains (TADs) and TAD-cliques. For each GO term, we then compared the expression level of genes regulated by the above four factors (AB index, TAD intactness, TAD clique and PEI) with the corresponding genomic background. The retained 10 GO terms were all coordinately regulated by the four factors, and three of them were associated with nerve-related pathways.

Conclusions

This study revealed that giant pandas in captivity undergo short-term adaptation in nerve-related pathways. Furthermore, it provides new insights into the molecular mechanism of gene expression regulation under short-term adaptation to environmental change.
Differences in migrants’ reason for migration and subjective well-being: not so different after all
Authors: Pollenne Daisy , Vargas-Silva Carlos
Published: February 2024

This article uses 2012–2021 UK survey data to explore differences in subjective well-being (i.e. happiness, anxiety, life satisfaction, and having a worthwhile life) between those born in the UK and foreign-born residents who migrated for different reasons to the country (i.e. employment, study, family reunion, and asylum). Previous literature looking at objective indicators such as employment rates and health suggests that migrants’ reasons for migration relate to major differences across groups in these types of well-being indicators. In contrast, our analysis suggests that differences in subjective well-being with the UK-born are relatively similar across those who migrated for different reasons to the country. Moreover, across reasons for migration, there is a clear pattern of convergence to the subjective well-being levels of the UK-born as length of residence in the UK increases. This differs from studies looking at objective well-being indicators, in which some groups (e.g. those who migrated for family or asylum reasons) take longer to converge to the levels of those born in the country.
Correlation between echocardiographic estimation of right atrial pressure and invasive measurement of central venous pressure in postoperative pediatric patients with congenital heart disease: a prospective observational study
Authors: Malakan Rad Elaheh , Parizadeh Nazli , Radmehr Hassan , Sheykhian Toktam , Gharib Behdad , Zeinaloo Aliakbar
Published: February 2024

Background

Right atrial pressure plays a critical role as a hemodynamic parameter in diagnosing pulmonary hypertension and other cardiac diseases, as well as guiding the treatment and prognosis of various cardiac disorders. If there is no obstruction between the inferior or superior vena cava (SVC) as central veins and the right atrium, the pressures in these veins could be considered equal to the right atrial pressure. This study aimed to examine the correlation between echocardiographic methods for estimating right atrial pressure and invasive measurements of central venous pressure (CVPi) in infants and children with congenital heart disease during the 48 h after cardiac surgery and to establish regression equations for echocardiographic estimation of central venous pressure (CVPe).

Results

We prospectively enrolled 43 infants and children, ranging in age from 6 months to 16 years, including 20 males and 23 females. We found a significant correlation between CVPi and the ratio of the maximal diameter of IVC to the maximal diameter of the descending aorta ratio (IVCmax/DAOmax) (r = 0.529, P < 0.001), SVCS/D velocity ratio (SVCS/D) (r = 0.462, P = 0.006), right atrial vertical diameter (RAVD) (r = 0.409, P = 0.01), area (r = 0.384, P = 0.014), and tricuspid valve A wave acceleration rate (TVAAR) (r = 0.315, P = 0.048). Multiple regression analysis yielded an equation for estimating central venous pressure using four parameters related to the IVC, SVC, tricuspid valve, and right atrium. The equation is as follows: estimated CVP = 4.36 + (2.35 × IVCmax/DAOmax) + (1.06 × SVCS/D) +  (0.059 × RAVD) + (0.001 × TVAAR). This equation is strongly correlated with CVPi (Pearson r = 0.698, P = 0.002).

Conclusions

The estimation of central venous pressure through a multi-parametric equation that included the ratio of the maximal diameter of the inferior vena cava to the maximal diameter of the descending aorta, the ratio of S to D velocity of the superior vena cava, the vertical diameter of the right atrium, and the acceleration rate of the A wave of the tricuspid valve demonstrated a robust correlation with invasively measured central venous pressure. To assess the accuracy of predicted pressures by this equation, further investigations are required to apply this innovative multi-parametric formula to a prospective population of pediatric patients with congenital heart disease.
Genetic and clinical study of myeloperoxidase's association with coronary artery disease
Authors: Adam Lina N. , Al-Habib Omar A. M. , Oraha Ashur Y. , Shekha Mudhir S.
Published: February 2024

Background

Unraveling myeloperoxidase’s (MPO) correlation with coronary artery disease (CAD) and genetic variations, this study seeks to enhance diagnostic precision and therapeutic strategies.

Results

CAD patients were found to be older and more male than controls. Several clinical parameters, including glucose, total bilirubin, alkaline phosphatase, creatinine, and troponin levels, showed significant variations. Moreover, CAD patients had lower red cell distribution width (RDW%) and mean platelet volume (MPV) than controls. Serum MPO levels did not differ significantly between CAD patients and controls, and no correlation was found with other clinical parameters except for glucose, creatinine, and total bilirubin.

Conclusions

The data suggest that serum MPO levels are not substantially related to CAD patients, as indicated by lower MPO levels in CAD patients compared to controls. While highlighting the potential of MPV and RDW% as predictors of severe atherosclerosis in CAD. Further research is needed to validate the diagnostic and prognostic value of RDW%, MPV, and MPO levels in CAD.

Trial registration: 15092021-9-12. Registered 15 September 2021.
Mean platelet volume and D-dimer as predictors for complicated community-acquired pneumonia in hospitalized children
Authors: Elmeazawy Rehab , Toema Osama , Mobarak Amira
Published: February 2024

Background

Community-acquired pneumonia (CAP) is one of the primary causes of child mortality and morbidity. The primary objective of our research was to assess the value of mean platelet volume (MPV) and D-dimer levels in predicting complicated community-acquired pneumonia in hospitalized children.

Methods

This observational retrospective study gathered medical data from the electronic medical records of children diagnosed with CAP who were admitted to the Pediatric Pulmonology Unit between December 2021 and December 2022.

Results

This study included 154 pediatric patients. Their age at presentation was 4.15 ± 3.60 years. A comparison of patients with complicated CAP and non-complicated CAP revealed a statistically significant decrease of MPV in the complicated CAP group than in the non-complicated group (p = 0.016). The D-dimer level was significantly higher in the complicated CAP 3.42 ± 3.02 µg/ml compared than in the non-complicated 1.63 ± 2.04 µg/ml, p = 0.002). Low MPV and increased D-dimer were powerful indicators of complicated CAP (OR 0.577, p = 0.021, OR 1.419, p = 0.003).

Conclusion

The current study highlights that low MPV and high D-dimer levels can be useful predictors of pulmonary complications of CAP in children. However, prospective observational studies are needed to evaluate the changes in these predictors during the disease and assess the time needed for normalization.
Modeling retroreflectivity degradation of pavement markings across the US with advanced machine learning algorithms
Authors: Idris Ipshit Ibne , Mousa Momen , Hassan Marwa
Published: February 2024

Retroreflectivity is the primary metric that controls the visibility of pavement markings during nighttime and in adverse weather conditions. Maintaining the minimum level of retroreflectivity as specified by Federal Highway Administration (FHWA) is crucial to ensure safety for motorists. The key objective of this study was to develop robust retroreflectivity prediction models that can be used by transportation agencies to reliably predict the retroreflectivity of their pavement markings utilizing the initially measured retroreflectivity and other key project conditions. A total of 49,632 transverse skip retroreflectivity measurements of seven types of marking materials were retrieved from the eight most recent test decks covered under the National Transportation Product Evaluation Program (NTPEP). Decision Tree (DT) and Artificial Neural Network (ANN) algorithms were considered for developing performance prediction models to estimate retroreflectivity at different prediction horizons for up to three years. The models were trained with randomly selected 80% data points and tested with the remaining 20% data points. Sequential ANN models exhibited better performance with the testing data than the sequential DT models. The training and testing R2 ranges of the sequential ANN models were from 0.76 to 0.96 and 0.55 to 0.94, respectively, which were significantly higher than the R2 range (0.14 to 0.75) from the regression models proposed in past studies. Initial or predicted retroreflectivity, snowfall, and traffic were found to be the most important inputs to model predictions.
Angiotensin II therapy in refractory septic shock: which patient can benefit most? A narrative review
Authors: Coloretti Irene , Genovese Andrea , Teixeira J. Pedro , Cherian Anusha , Ferrer Ricard , Landoni Giovanni , Leone Marc , Girardis Massimo , Nielsen Nathan D.
Published: February 2024

Patients with septic shock who experience refractory hypotension despite adequate fluid resuscitation and high-dose noradrenaline have high mortality rates. To improve outcomes, evidence-based guidelines recommend starting a second vasopressor, such as vasopressin, if noradrenaline doses exceed 0.5 µg/kg/min. Recently, promising results have been observed in treating refractory hypotension with angiotensin II, which has been shown to increase mean arterial pressure and has been associated with improved outcomes. This narrative review aims to provide an overview of the pathophysiology of the renin-angiotensin system and the role of endogenous angiotensin II in vasodilatory shock with a focus on how angiotensin II treatment impacts clinical outcomes and on identifying the population that may benefit most from its use.
Acute mediastinal mass syndrome after surgical biopsy of a massive anterior mediastinal tumor: a case report
Authors: Kobayashi Masao , Kimura Toru , Nagata Hideki , Fukui Eriko , Kanou Takashi , Ose Naoko , Funaki Soichiro , Kurashige Masako , Morii Eiichi , Shintani Yasushi
Published: February 2024

Background

Mediastinal lymphatic tumors are relatively rare. The prognosis is poor but has improved due to recent advances in treatment strategies. Herein, we report a case of mediastinal lymphoma diagnosed using surgical biopsy, which was complicated by mediastinal mass syndrome due to general anesthesia.

Case presentation

A 25-year-old man with cough, fever, dyspnea, and night sweats was transferred to our hospital for resection of a large anterior mediastinal tumor. Although his preoperative diagnosis was WHO type B1 thymoma, the clinical findings suggested a lymphoma. A repeat surgical biopsy was performed under general anesthesia. Immediately after extubation, the patient developed acute respiratory failure with hypolucency of the right lung field on chest radiography. He was reintubated immediately and was diagnosed with negative pressure pulmonary edema in the right lung. He was managed with positive-pressure ventilation and his respiratory distress resolved within 5 days. Pathological examination of surgical specimens confirmed the diagnosis of lymphoma.

Conclusion

Surgical biopsy is useful for the diagnosis of mediastinal tumors. However, the risk of perioperative mediastinal mass syndrome should be carefully assessed before administering general anesthesia.
Complete resection of a recurrent bronchogenic cyst tightly adhered to the left atrium using cardiopulmonary bypass: a case report
Authors: Furugen Tomonori , Teruya Takao , Nakasone Shoko , Kawasaki Hidenori , Toyama Masahiro , Miyaishi Keita , Higa Syotaro , Ando Mizuki , Maeda Tatsuya , Kise Yuya , Inafuku Hitoshi , Nakaema Moriyasu , Nagano Takaaki , Furukawa Kojiro
Published: February 2024

Background

Most surgeons agree that symptomatic mediastinal bronchogenic cysts should be resected, and complete resection is considered mandatory to avoid recurrence. However, a symptomatic mediastinal bronchogenic cyst sometimes adheres to a vital organ, making complete resection hazardous. In such case, surgical resection using cardiopulmonary bypass should be performed to achieve complete resection.

Case presentation

A 65-year-old female patient had undergone surgical drainage of a mediastinal bronchogenic cyst 30 years ago. Recently, she presented with complaints of orthopnea, and computed tomography revealed a few days later a subcarinal bronchogenic cyst markedly compressing the left atrium. Complete resection of the mediastinal bronchogenic cyst was performed using cardiopulmonary bypass. The postoperative course was uneventful. The patient was followed up for 1 year, with no recurrence of the bronchogenic cyst.

Conclusions

For patients with mediastinal bronchogenic cysts compressing the left atrium, we recommend complete resection using cardiopulmonary bypass.
Digitally Enabled Transitional Care Management in Oncology
Authors: Daly Bobby , Cracchiolo Jennifer , Holland Jessie , Ebstein AnnMarie Mazzella , Flynn Jessica , Duck Elaine , Moy Morgan , Walters Chasity B. , Giacomazzo Lisa , Huang Jennie , Fahy Rosanna , Bernal Camila , Ackerman Jill , Salvaggio Rori , Begue Aaron , Raj Nitya , Kuperman Gilad , Mao Jun J. , Panageas Katherine
Published: February 2024

PURPOSE

Improving care transitions for patients with cancer discharged from the hospital is considered an important component of quality care. Digital monitoring has the potential to better the delivery of transitional care through improved patient-provider communication and enhanced symptom management. However, remote patient monitoring (RPM) interventions have not been widely implemented for oncology patients after discharge, an innovative setting in which to apply this technology.

METHODS

We implemented a RPM intervention which identifies medical oncology patients at discharge, monitors their symptoms for 10 days, and intervenes as necessary to manage symptoms. We evaluated the feasibility (>50% patient engagement with symptom assessment), appropriateness (symptom alerts), and acceptability (net promoter score >0.7) of the intervention and the initial effect on acute care visits and return on investment.

RESULTS

During the study period, January 1, 2021, to December 31, 2022, we evaluated 2,257 medical oncology discharges representing 1,857 unique patients. We found that 65.9% of patients discharged (N = 1,489) completed at least one symptom assessment postdischarge and of them, 45.5% (n = 678) generated a severe symptom alert that we helped to manage. Patients expressed high satisfaction with the intervention with a net promoter score of 84%. In preliminary analysis of patients with GI malignancies (n = 449), we found a nonsignificant decrease in 30-day readmissions for the intervention cohort (n = 269) by 5.8% as compared with the control (n = 180; from 33.3% to 27.5%; P = .22).

CONCLUSION

Digital transitional care management was feasible and demonstrated that patients transitioning from the hospital to home have a substantial symptom burden. The intervention was associated with high patient satisfaction but will require further refinement and evaluation to increase its impact on 30-day readmission.
Optimal mean first-passage time of a run-and-tumble particle in a class of one-dimensional confining potentials
Authors: Guéneau Mathis , Majumdar Satya N. , Schehr Grégory
Published: February 2024

We consider a run-and-tumble particle (RTP) in one dimension, subjected to a telegraphic noise with a constant rate γ, and in the presence of an external confining potential

with

. We compute the mean first-passage time (MFPT) at the origin

for an RTP starting at x
0. We obtain a closed form expression for

for all

, which becomes fully explicit in the case

and in the limit

. For generic

we find that there exists an optimal rate

that minimizes the MFPT and we characterize in detail its dependence on x
0. We find that

as

, while

converges to a non-trivial constant as

. In contrast, for p = 1, there is no finite optimum and

in this case. These analytical results are confirmed by our numerical simulations.
Shooting for Change
Authors: Lee Jung Joon
Published: February 2024

In Shooting for Change, Jung Joon Lee examines postwar Korean photography across multiple genres and practices, including vernacular, art, documentary, and archival photography. Tracing the history of Korean photography while considering what is disguised or lost by framing the history of photography through nationhood, Lee considers the role of photography in shaping memory of historical events, representing the ideal national family, and motivating social movements. Further, through an investigation of what it means to practice photography under the normalized conditions of militarism, Lee treats the transnational militarism of Korea as a lens through which to probe the officially and culturally sanctioned readings of images when returning to them at different times. Among other themes, Lee draws on photography of militarized sex work, political protest in the military era, war orphans, and mass protests. Ultimately, Lee treats the formative periods in nation building and transnational militarization as both backdrop and cultivator for photographic works.
High-resolution RNA tertiary structures in Zika virus stem-loop A for the development of inhibitory small molecules
Authors: Tipo Jerricho , Gottipati Keerthi , Choi Kyung H
Published: February 2024

Flaviviruses such as Zika (ZIKV) and dengue virus (DENV) are positive-sense RNA viruses belonging to Flaviviridae. The flavivirus genome contains a 5’ end stem-loop promoter sequence known as stem-loop A (SLA) that is recognized by the flavivirus polymerase NS5 during viral RNA synthesis and 5’ guanosine cap methylation. The crystal structures of ZIKV and DENV SLAs show a well-defined fold, consisting of a bottom stem, side loop, and top stem-loop, providing unique interaction sites for small-molecule inhibitors to disrupt the promoter function. To facilitate identification of small molecule binding sites in flavivirus SLA, we determined high-resolution structures of bottom and top stems of ZIKV SLA, which contain a single U- or G-bulge, respectively. Both bulge nucleotides exhibit multiple orientations, from folded back on the adjacent nucleotide to flipped out of the helix, and are stabilized by stacking or base triple interactions. These structures suggest that even a single unpaired nucleotide can provide flexibility to RNA structures and its conformation is mainly determined by the stabilizing chemical environment. To facilitate discovery of small molecule inhibitors that interfere with the functions of ZIKV SLA, we screened and identified compounds that bind to the bottom and top stems of ZIKV SLA.
Käsikirjaliste mustrivihikute tähtsus kangakudumise mustrite levimise ajaloos / The historical importance of weaving pattern books
Authors: Veelmaa Marge
Published: February 2024

The late 19th century can be considered a transformative period in the history of Estonian textile weaving, during which the weaving of art fabrics onso-called Finnish looms became increasingly widespread. From this period onwards, an increasing amount of Estonian women started to study weaving in Finland, and Finnish women were invited to Estonia to teach.

The article describes, based on various surviving sources, the spread of weaving patterns in Estonia and the functioning of various weaving courses and schools during this time period. It also provides an overview of the weaving pattern books, which were prevalent in Estonia until the first decades of the 20th century, based on samples preserved in museums and private collections.

Pattern looms, also known as countermarch looms, Finnish looms, and sometimes also “artisan weavers’ looms”, were expensive and seemed complicated to an average weaver. Therefore, by the end of the 19th century, these types of looms were not yet widely prevalent in Estonian peasant households. They only started to become common during the early years of the independent Republic of Estonia, and it was soon a matter of honor to have Finnish looms in the house.

With the establishment of weaving schools and the spread of various courses in the late 19th century, new patterns from Europe reached Estonian households. Countermarch looms that arrived via Finland offered more opportunities for weaving different textile surfaces. Also, it was possible to weave wider fabrics on these looms compared to simple looms that had been used in farmsteads earlier.

The development of weaving pattern books and textbooks in time shows how the spread of more complex looms into homes went hand in hand with the emergence and popularity of women’s handicraft schools. The industrial revolution that altered the previously established modes of production from the end of the 18th century to the beginning of the 19th century did bring more affordable factory products to homes. The national awakening in turn created a situation where the promotion of handicrafts was back on the social agenda.

The industrial revolution, new trade relations, and the intensification of cultural exchange with neighbouring countries provided Estonian women with the opportunity to improve their position in society. From the beginning of the 20th century, cultural and educational interactions that had begun at the end of the previous century between educated and progressive women and women’s organisations became even more frequent.

Keywords: weaving on loom, women’s crafts, housekeeping education, weaving pattern books, textile artisans
Luues käsitööuurimust: emotsiooni ja teadmiste ühendamine / Designing craft research: joining emotion and knowledge
Authors: Niedderer Kristina , Townsend Katherine
Published: February 2024

This paper considers how both craft and research can be joined in the enterprise of craft research. The rationale is that craft research is still relatively new compared to mainstream design research and that craft, being linked to the creation of artefacts as a source of experience and emotion, is not usually associated with research and the production of knowledge.

The paper discusses the emerging need for creative researach in the crafts based on sensibilities of material understanding and human values, which contrast with the current strictures of research. Drawing on current models of design research and knowledge, the paper proposes experiential knowledge as the unifying conceptual underpinning of both. The outcome and contribution of the paper is a better understanding of the relationship of craft and research, and of the value of research for advancing craft as a discipline that is viable and relevant for the future.

Keywords: craft research, experience, emotion, knowledge, material understanding, human values