bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting the Chicken Auditory Brainstem Response: Frequency Specificity, Threshold Sensitivity, and Cross Species Comparison
Authors: Ordiway George , McDonnell Miranda , Sanchez Jason Tait
Published: January 2024

The auditory brainstem response (ABR) is important for both clinical and basic auditory research. It is a non-invasive measure of hearing function with millisecond-level precision. The ABR can not only measure the synchrony, speed, and efficacy of auditory physiology but also detect different modalities of hearing pathology and hearing loss. ABRs are easily acquired in vertebrate animal models like reptiles, birds, and mammals, and complement existing molecular, developmental, and systems-level research. One such model system is the chicken; an excellent animal for studying auditory development, structure, and function. However, the ABR for chickens was last reported nearly 4 decades ago. The current study examines how decades of ABR characterization in other animal species support findings from the chicken ABR. We replicated and expanded on previous research using 43 chicken hatchlings 1- and 2-day post-hatch. We report that click-evoked chicken ABRs presented with a peak waveform morphology, amplitude, and latency like previous avian studies. Tone-evoked ABRs were found for frequencies from 250 to 4000 Hertz (Hz) and exhibited a range of best sensitivity between 750 and 2000 Hz. Objective click-evoked and tone-evoked ABR thresholds were comparable to subjective thresholds. With these revisited measurements, the chicken ABR still proves to be an excellent example of precocious avian development that complements decades of molecular, neuronal, and systems-level research in the same model organism.
Initiation and Receipt of Medication for Opioid Use Disorder Among Adolescents and Young Adults in 4 State Medicaid Programs in 2018: Improving Medicaid Quality Metrics
Authors: Lynch Victoria , Clemans-Cope Lisa
Published: January 2024

Background:

Medications for opioid use disorder (MOUD) in youth can reduce harms but many youths do not receive MOUD. Improving quality metrics of MOUD among youth can advance interventions for youth with opioid use disorder (OUD).

Methods:

We relied on 2018 Medicaid claims data from California, Colorado, Massachusetts, and New Mexico. We calculated the percentage of youth with OUD included in the quality metric for initiation, and the percentage who initiated by state. We also calculated the percentage excluded from the quality metric for initiation because they have an existing episode of OUD care and their MOUD receipt. We compared the characteristics of those who initiated/received MOUD to those who did not and compared state estimates after adjusting for age and health conditions.

Results:

Estimates of initiation exclude about half of the youth with OUD because they were in an existing episode of OUD care and could not be observed initiating. Among youth in a new episode of OUD care, only about 1 in 4 initiated and state estimates varied from 18.9% to 40.1%. Among youth with an existing episode of OUD care, more than half received MOUD and state estimates ranged from 35.2% to 71.3%. Youth who initiated MOUD or received MOUD with an existing OUD had more severe OUD but fewer co-occurring substance use disorders or mental or physical health diagnoses. After adjusting for age and health conditions, MOUD still varied substantially across states.

Conclusions:

Most youth with a new OUD diagnosis do not initiate MOUD but more than half of the youth in an existing OUD diagnosis receive MOUD. MOUD quality metrics that are disaggregated, adjusted, and inclusive of youth in an existing episode of care provide additional insight into opportunities to better support youth who might choose MOUD. State differences should be further studied for insight into policies that may affect MOUD.
Study Protocol for the Healing Opioid Misuse and Pain Through Engagement Trial: Integrated Treatment for Individuals With Co-occurring Chronic Pain and Opioid Use Disorder
Authors: Hurlocker Margo C. , Kirouac Megan , Gillezeau Christina , Hijaz Donia , Moniz-Lewis David I. K. , Carlon Hannah A. , Coleman George Cameron , Ilgen Mark A. , Pearson Matthew R. , Vowles Kevin E. , Witkiewitz Katie
Published: January 2024

Chronic pain and opioid use disorder (OUD) are public health crises and their co-occurrence has led to further complications and public health impacts. Provision of treatments for comorbid chronic pain and OUD is paramount to address these public health crises. Medications for OUD (MOUD) are gold standard treatments for OUD that have also demonstrated benefit in pain management. However, clinics that provide MOUD for chronic pain or OUD often lack behavioral treatments to address the challenges experienced by individuals with both conditions. Developing and implementing a behavioral treatment that complements MOUD may better equip clinics to provide comprehensive care to the growing proportion of clients who present with comorbid chronic pain and OUD. In the Healing Opioid misuse and Pain through Engagement (HOPE) Trial, we are using an effectiveness-implementation hybrid design to examine the benefits of an integrated behavioral treatment and to determine the feasibility of implementing the integrated treatment into clinics that provide MOUD. The treatment integrated 2 evidence-based treatments—Acceptance and Commitment Therapy and Mindfulness-Based Relapse Prevention—to target the emotional, behavioral, and physiological sequelae of OUD and chronic pain. Implementation feasibility will include assessing changes in implementation readiness and identifying facilitators and barriers to implementing the integrated treatment among all personnel employed in clinics that provide MOUD. This commentary offers an overview of the study and design and details adaptations we made to our study protocol, based largely on clinic personnel time constraints and variable clinic procedures during the COVID-19 pandemic.
Implementation of Virtual Interactive Cases for Pharmacy Education: A Single-Center Experience
Authors: Cameron Karen , Cicinelli Erin , Natsheh Cindy , So Miranda , Tait Gordon , Halapy Henry
Published: January 2024

Patient case simulation software are described in pharmacy education literature as useful tools to improve skills in patient assessment (including medication history-taking and physical assessment), clinical reasoning and communication, and are typically well-received by students and instructors. The virtual interactive case (VIC) system is a web-based software developed to deliver deliberate practice opportunities in simulated patient encounters across a spectrum of clinical topics. This article describes the implementation and utilization of VIC in the undergraduate curriculum at one Canadian pharmacy school. Methods: At our facility, the use of VIC was integrated across the training spectrum in the curriculum, including core and elective didactic courses and practice labs, experiential learning, interprofessional education, and continuing education. Its use was evaluated through student and instructor surveys and qualitative student interviews). VIC is easy to navigate and created a positive and realistic learning environment. Students identified that it enhanced their ability to identify relevant patient information, accurately simulated hospital pharmacy practice and thereby helped them to prepare for their upcoming experiential courses. The use of VIC has expanded beyond its original intended purpose for individual student practice to become a valuable addition to pharmacy undergraduate education. Future plans include ongoing development of cases and exploration of further uses of VIC within the didactic curriculum, for remediation in experiential courses, and for pharmacist continuing education.
Smoking and home oxygen therapy: a review and consensus statement from a multidisciplinary Swedish taskforce
Authors: Ahmadi Zainab , Björk Joar , Gilljam Hans , Gogineni Madhuri , Gustafsson Torbjörn , Runold Michael , Ringbæk Thomas , Wahlberg Josefin , Wendel Lotta , Ekström Magnus
Published: January 2024

Background:

Home oxygen therapy (HOT) improves survival in patients with hypoxaemic chronic respiratory disease. Most patients evaluated for HOT are former or active smokers. Oxygen accelerates combustion and smoking may increase the risk of burn injuries and fire hazards; therefore, it is considered a contraindication for HOT in many countries. However, there is variability in the practices and policies regarding this matter. This multidisciplinary Swedish taskforce aimed to review the potential benefits and risks of smoking in relation to HOT, including medical, practical, legal and ethical considerations.

Methods:

The taskforce of the Swedish Respiratory Society comprises 15 members across respiratory medicine, nursing, medical law and ethics. HOT effectiveness and adverse risks related to smoking, as well as practical, legal and ethical considerations, were reviewed, resulting in five general questions and four PICO (population–intervention–comparator–outcome) questions. The strength of each recommendation was rated according to the GRADE (grading of recommendation assessment, development and evaluation) methodology.

Results:

General questions about the practical, legal and ethical aspects of HOT were discussed and summarised in the document. The PICO questions resulted in recommendations about assessment, management and follow-up of smoking when considering HOT, if HOT should be offered to people that meet the eligibility criteria but who continue to smoke, if a specific length of time of smoking cessation should be considered before assessing eligibility for HOT, and identification of areas for further research.

Conclusions:

Multiple factors need to be considered in the benefit/risk evaluation of HOT in active smokers. A systematic approach is suggested to guide healthcare professionals in evaluating HOT in relation to smoking.
BATF and BATF3 deficiency alters CD8+ effector/exhausted T cells balance in skin transplantation
Authors: Li Chenghao , Liu Zongtao , Wang Zihao , Yim Wai Yen , Huang Yajun , Chen Yuqi
Published: January 2024

Background

It is well-established that CD8+ T-cells play a critical role in graft rejection. The basic leucine zipper ATF-like transcription factor (BATF) and BATF3 are transcriptional factors expressed in T lymphocytes. Herein, we investigated the functions of BATF and BATF3 in the differentiation and exhaustion of CD8+ T cells following alloantigen activation.

Methods

Wild-type CD8+ T cells, BATF-deficient (Batf−/−) CD8+ T cells, and CD8+ T cells deficient in both BATF and BATF3 (Batf−/−Batf3−/−) were transferred to B6.Rag1−/− mice, which received skin allografts from BALB/c mice. Flow cytometry was conducted to investigate the number of CD8+ T cells and the percentage of effector subsets.

Results

BATF expression positively correlated with effector CD8+ T cell differentiation. BATF and BATF3 deficiency promoted skin allograft long-term survival and attenuated the CD8+ T cell allo-response and cytokine secretion. Finally, BATF and BATF3 deficiency prompted the generation of exhausted CD8+ T cells.

Conclusions

Overall, our findings provide preliminary evidence that both BATF and BATF3 deficiency influences the differentiation of effector CD8+ T cells and mediates the exhaustion of CD8+ T cells, prolonging transplant survival. Targeting BATF and BATF3 to inhibit CD8+ T cell function has huge prospects for application as a therapeutic approach to prevent transplant rejection.
Genome-wide identification and characterization of NAC transcription factor family members in Trifolium pratense and expression analysis under lead stress
Authors: Wang Zicheng , Chen Zirui , Wu Yuchen , Mu Meiqi , Jiang Jingwen , Nie Wanting , Zhao Siwen , Cui Guowen , Yin Xiujie
Published: January 2024

Background

The NAC TF family is widely involved in plant responses to various types of stress. Red clover (Trifolium pratense) is a high-quality legume, and the study of NAC genes in red clover has not been comprehensive. The aim of this study was to analyze the NAC gene family of red clover at the whole-genome level and explore its potential role in the Pb stress response.

Results

In this study, 72 TpNAC genes were identified from red clover; collinearity analysis showed that there were 5 pairs of large fragment replicators of TpNAC genes, and red clover was found to be closely related to Medicago truncatula. Interestingly, the TpNAC genes have more homologs in Arabidopsis thaliana than in soybean (Glycine max). There are many elements in the TpNAC genes promoters that respond to stress. Gene expression analysis showed that all the TpNAC genes responded to Pb stress. qRT-PCR showed that the expression levels of TpNAC29 and TpNAC42 were significantly decreased after Pb stress. Protein interaction network analysis showed that 21 TpNACs and 23 other genes participated in the interaction. In addition, the TpNAC proteins had three possible 3D structures, and the secondary structure of these proteins were mainly of other types. These results indicated that most TpNAC members were involved in the regulation of Pb stress in red clover.

Conclusion

These results suggest that most TpNAC members are involved in the regulation of Pb stress in red clover. TpNAC members play an important role in the response of red clover to Pb stress.
Transcriptomic profiling of different developmental stages reveals parasitic strategies of Wohlfahrtia magnifica, a myiasis-causing flesh fly
Authors: Jia Zhipeng , Hasi Surong , Zhan Deng , Vogl Claus , Burger Pamela A.
Published: January 2024

Background

Wohlfahrtia magnifica is an obligatory parasite that causes myiasis in several warm-blooded vertebrates. Adult females deposit the first-stage larvae directly onto wounds or natural body orifices (e.g., genitalia) of the host, from where they quickly colonize the host tissue and feed on it for development. The infestation of W. magnifica can lead to health issues, welfare concerns, and substantial economic losses. To date, little is known about the molecular mechanisms of the W. magnifica-causing myiasis.

Results

In this study, we collected parasitic-stage larvae of W. magnifica from wounds of naturally infested Bactrian camels, as well as pupae and adult flies reared in vitro from the wound-collected larvae, for investigating the gene expression profiles of the different developmental stages of W. magnifica, with a particular focus on examining gene families closely related to the parasitism of the wound-collected larvae. As key proteins related to the parasite-host interaction, 2049 excretory/secretory (ES) proteins were identified in W. magnifica through the integration of multiple bioinformatics approaches. Functional analysis indicates that these ES proteins are primarily involved in cuticle development, peptidase activity, immune response, and metabolic processes. The global investigation of gene expression at different developmental stages using pairwise comparisons and weighted correlation network analysis (WGCNA) showed that the upregulated genes during second-stage larvae were related to cuticle development, peptidase activity, and RNA transcription and translation; during third-stage larvae to peptidase inhibitor activity and nutrient reservoir activity; during pupae to cell and tissue morphogenesis and cell and tissue development; and during adult flies to signal perception, many of them involved in light perception, and adult behavior, e.g., feeding, mating, and locomotion. Specifically, the expression level analysis of the likely parasitism-related genes in parasitic wound-collected larvae revealed a significant upregulation of 88 peptidase genes (including 47 serine peptidase genes), 110 cuticle protein genes, and 21 heat shock protein (hsp) genes. Interestingly, the expression of 2 antimicrobial peptide (AMP) genes, including 1 defensin and 1 diptericin, was also upregulated in the parasitic larvae.

Conclusions

We identified ES proteins in W. magnifica and investigated their functional distribution. In addition, gene expression profiles at different developmental stages of W. magnifica were examined. Specifically, we focused on gene families closely related to parasitism of wound-collected larvae. These findings shed light on the molecular mechanisms underlying the life cycle of the myiasis-causing fly, especially during the parasitic larval stages, and provide guidance for the development of control measures against W. magnifica.
Profiling of T cell repertoire in peripheral blood of patients from type 2 diabetes with complication
Authors: Yin YongHui , Sheng YingLi , Gao Shuo , Zhang JinTao , Wang WenKuan , Liu YingJun , Xu TingTing , Zhang Yi
Published: January 2024

Purpose

More than 90% of patients with diabetes worldwide are type 2 diabetes (T2D), which is caused by insulin resistance or impaired producing insulin by pancreatic β cells. T2D and its complications, mainly large cardiovascular (LCV) and kidney (Ne) complications, are the major cause of death in diabetes patients. Recently, the dysregulation of peripheral T cell immune homeostasis was found in most T2D patients. However, the characteristics of T-cell receptors (TCR) remain largely unexplored in T2D patients.

Patients and methods

Here we investigated the TCR repertoire using high-throughput sequencing in peripheral blood collected from T2D patient with (8 LCV and 7 Ne) or without complications.

Results

Our analysis of TCR repertoires in peripheral blood samples showed that TCR profiles in T2D patients with complications tended to be single and specific compared to controls, according to the characteristics of TCR repertoire in V-J combination number, diversity, principal component analysis (PCA) and differential genes. And we identified some differentially expressed V-J gene segments and amino acid clonotypes, which had the potential to contribute to distinguishing T2D patient with or without complications. As the progression of the disease, we found that the profiling of TCR repertoire was also differential between T2D patients with LVD and Ne complications base on this pilot analysis.

Conclusion

This study demonstrated the protentional unique property of TCR repertoire in peripheral blood of T2D patient with and without complications, or T2D patients with LVD and Ne complications, which provided the possibility for future improvements in immune-related diagnosis and therapy for T2D complications.
sFlT-1/PlGF ratio as a predictor of preeclampsia in COVID-19 pregnant patients
Authors: Pluta Kamil , Januszewski Marcin , Ziuzia-Januszewska Laura , Kudan Michał , Suchocka Maria , Kuśmierczuk Kinga , Issat Tadeusz , Jakimiuk Artur J.
Published: January 2024

The association between SARS-CoV-2 infection in pregnancy and preeclampsia is widely debated in numerous studies. The aim of our study was to investigate whether an increased sFlt-1/PlGF ratio is a good marker of preeclampsia in pregnant patients with COVID-19 infection. This single centre prospective study was conducted in the Department of Obstetrics and Gynaecology, at the Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw. The study group consisted of 68 COVID-19 pregnant patients and 57 SARS-CoV-2 negative pregnant controls. Serum sFlt-1/PlGF ratio was assessed. The two groups did not differ in terms of the frequency of IVF, nulliparity, history of hypertension, pre-gestational diabetes and chronic kidney disease. The primary outcome was the diagnosis of preeclampsia. Preeclampsia was diagnosed in 10 patients in both groups. The sFlt-1/PlGF ratio higher than 38, considered highly suggestive of developing preeclampsia, was found in 20 patients in the COVID-19 group and 15 patients in the control group. The odds of developing preeclampsia in patients with sFlt-1/PlGF ratio > 38 was approximately 4-fold higher in COVID-19 group and 11-fold higher in controls. Sflt-1/PlGF ratio does not differ significantly between the SARS-CoV-2-positive and SARS-COV-2-negative pregnant patients. The sFlt-1/PlGF ratio > 38 is associated with higher odds of the diagnosis of preeclampsia in both of these groups, and therefore may serve as its marker regardless of COVID-19 infection status.
Unveiling promising breast cancer biomarkers: an integrative approach combining bioinformatics analysis and experimental verification
Authors: Golestan Ali , Tahmasebi Ahmad , Maghsoodi Nafiseh , Faraji Seyed Nooreddin , Irajie Cambyz , Ramezani Amin
Published: January 2024

Background

Breast cancer remains a significant health challenge worldwide, necessitating the identification of reliable biomarkers for early detection, accurate prognosis, and targeted therapy.

Materials and methods

Breast cancer RNA expression data from the TCGA database were analyzed to identify differentially expressed genes (DEGs). The top 500 up-regulated DEGs were selected for further investigation using random forest analysis to identify important genes. These genes were evaluated based on their potential as diagnostic biomarkers, their overexpression in breast cancer tissues, and their low median expression in normal female tissues. Various validation methods, including online tools and quantitative Real-Time PCR (qRT-PCR), were used to confirm the potential of the identified genes as breast cancer biomarkers.

Results

The study identified four overexpressed genes (CACNG4, PKMYT1, EPYC, and CHRNA6) among 100 genes with higher importance scores. qRT-PCR analysis confirmed the significant upregulation of these genes in breast cancer patients compared to normal samples.

Conclusions

These findings suggest that CACNG4, PKMYT1, EPYC, and CHRNA6 may serve as valuable biomarkers for breast cancer diagnosis, and PKMYT1 may also have prognostic significance. Furthermore, CACNG4, CHRNA6, and PKMYT1 show promise as potential therapeutic targets. These findings have the potential to advance diagnostic methods and therapeutic approaches for breast cancer.
Subjective quality of life and schizophrenia: results from a large cohort study based in Chinese primary care
Authors: Migliorini Christine , Harvey Carol , Hou Cailan , Wang Shibin , Wang Fei , Huang Zhuo-Hui
Published: January 2024

Introduction

Much confusion exists between health-related QoL (HRQoL) scales and subjective QoL (SQoL) scales. One method to avoid confusion is use of a single question that asks What is your quality of life? or similar. This study explored the relationship between biopsychosocial factors and high SQoL, SQoL stability, and factors associated with improving SQoL.

Method

We conducted a large cohort study of community-dwelling Chinese adults with schizophrenia, with two data points (2015–2016 (N = 742), 2017–2018 (N = 491)). Demographic and clinically related items and a comprehensive suite of published measures were collected. Direct logistic regressions were used to explore links between biopsychosocial factors and high SQoL and Improvement in SQoL across time.

Results

Sample at Baseline: Male = 62.3%; Med age = 38.5 years; Med Age at illness onset = 24 years; SQoL Mode = neither poor nor good. Three independent variables predicted high SQoL at T1. Contemporary age and the presence of clinically relevant symptoms had a negative relationship with high SQoL; insight had a positive relationship with high SQoL. SQoL changed significantly across time with a modest effect size. Age at illness onset was the single independent variable linked to improving SQoL favoring being older at the time of illness onset.

Discussion/Conclusions

SQoL can be high and changeable. While symptomology and illness insight may affect SQoL self-appraisals at single points in time, only age of illness onset was connected with improving SQoL. Thus, public health measures to delay illness onset are important. In addition, care about the distinction between HRQoL and SQoL in study design and choice of measures is necessary and will depend on the purpose and context.
Men’s attitude towards wife-beating: understanding the pattern and trend in India
Authors: Pradhan Manas Ranjan , De Prasenjit
Published: January 2024

Background

Intimate partner violence (IPV) is a severe human rights violation and a global burden on public health. Wife-beating is a form of IPV and an extension of the patriarchal philosophy that legitimizes men’s control over their spouses. This study investigates (a) the trends and patterns of men’s attitudes towards justification of wife-beating and (b) the socio-demographic factors associated with changes in men’s attitudes towards wife-beating between 2005–06 and 2019–21 in India.

Methods

The present study utilized data from the last three rounds of the National Family Health Survey (NFHS): NFHS-3 (2005–06), NFHS-4 (2015–16), and NFHS-5 (2019–21) with a total sample of 2,76,672 men aged 15–54. The primary outcome variable was men’s attitudes toward wife-beating. Attitude towards the household and the sexual autonomy of the wife were the two key predictors, in addition to other structural factors. Descriptive, bivariate, and multivariate logistic regression analyses were performed on weighted data using Stata. Hosmer–Lemeshow test, Classification table, and ROC curve were carried out to enhance the robustness of the analysis and validity of the model.

Results

In 2005–06, 50% of men justified wife-beating in at least one of the seven contexts, which reduced to 42% in 2015–16 and then marginally increased to 44% in 2019–21. Men with an authoritarian attitude toward household autonomy (AOR: 2.34; CI: 2.30,2.38) and sexual autonomy of the wife (AOR: 1.68; CI: 1.65,1.71) were more likely to justify wife-beating than their egalitarian counterparts. Inadequate education, younger age, family history of IPV, alcohol consumption, poverty, and rural settings are associated with an elevated risk of abusive attitudes towards wife-beating.

Conclusion

A sizable percentage of men, more so those socio-economically marginalized, continue to justify wife-beating, albeit with considerable decline over the years. The findings suggest customized policies and programs enhancing gender egalitarian norms among young men, more opportunities to pursue higher education, alleviating poverty through employment opportunities, and raising awareness about domestic violence in rural settings would help develop more egalitarian gender norms and attitudes towards wife-beating.
Changes in the characteristics and outcomes of high-risk pregnant women who delivered prior to and after China’s universal two-child policy: a real-world retrospective study, 2010–2021
Authors: Zhu Caixia , Zhang Shaofeng , Shen Lixia , Ye Lisha , Zhan Minjin , Cai Shiqin , Huang Jingwan , Wang Zilian , Chen Haitian
Published: January 2024

Background

In 2016, the “universal two-child” policy, allowing each couple to have two children, was introduced in China. The characteristic change of the long-term period after the implementation of the universal two-child policy was unclear. We studied trends in the obstetric characteristics and their potential impact on the rates of cesarean section and preterm birth in the era of China’s universal two-child policy.

Methods

A tertiary center-based study (2010–2021) retrospectively focused single high-risk pregnancies who delivered from the one-child policy period (OCP, 2010–2015) to the universal two-child policy period (TCP, 2016–2021). A total of 39, 016 pregnancies were enrolled. Maternal demographics, complications, delivery mode and obstetric outcomes were analyzed. Furthermore, logistic regression analysis was used to explore the association between the cesarean section rate, preterm birth and implementation of the universal two-child policy, adjusting maternal age, parity, and fetal distress.

Results

Ultimately a total of 39,016 pregnant women met the criteria and were included in this analysis. The proportion of women with advanced maternal age (AMA) increased from 14.6% in the OCP to 31.6% in the TCP. The number of multiparous women increased 2-fold in the TCP. In addition, the overall rate of cesarean section significantly decreased over the policy change, regardless of maternal age, whereas the risk of preterm birth significantly increased in the TCP. Adjusting for maternal age, parity and fetal distress, the universal two-child policy showed a significantly favorable impact on the cesarean section rate (RR 0.745, 95%CI (0.714–0.777), P < 0.001). Compared to the OCP group, a higher increase in fetal distress and premature rupture of membranes (PROM) were observed in the TCP group. In pregnancies with AMA, there was no increase in the risk of postpartum hemorrhage, whereas more women who younger than 35 years old suffered from postpartum hemorrhage in TCP. The logistic regression model showed that the universal two-child policy was positively associated with the risk of postpartum hemorrhage (RR: 1.135, 95%CI: 1.025–1.257, P = 0.015).

Conclusions

After the implementation of the universal two-child policy in China, the rate of the cesarean section significantly decreased, especially for women under 35 years old. However, the overall risk of postpartum hemorrhage increased in women under 35 years old, while there was no change in women with AMA. Under the new population policy, the prevention of postpartum hemorrhage in the young women should not be neglected.
Percutaneous endoscopic lumbar discectomy for single and double segment lumbar disc herniation with sciatic scoliosis in adults: a retrospective study
Authors: Yang Jitao , Luan Haopeng , Ren Jiawei , Tao Jiyuan , Sheng Weibin , Guo Hailong , Deng Qiang
Published: January 2024

Objective

Sciatic scoliosis can be seen in patients with lumbar disc herniation. Percutaneous endoscopic lumbar discectomy (PELD) is a common surgical method for the treatment of lumbar disc herniation. The difference between single-segment lumbar disc herniation and double-segment lumbar disc herniation with Sciatic Scoliosis in adults after PELD needs further study. The aim of this study was to compare the imaging features of single-segment and double-segment lumbar disc herniation with Sciatic Scoliosis in adults and to further explore the clinical outcomes of functional improvement and scoliosis imaging parameters of the two groups after PELD.

Methods

Adult patients with lumbar disc herniation with sciatic scoliosis who received PELD from January 2019 to June 2022 were analyzed retrospectively. According to the number of operative segments, the patients were divided into a single-segment group and a double-segment group. Perioperative parameters were observed and compared between the two groups. The Visual Analogue Scale (VAS) score, Oswestry dysfunction index (ODI), Japanese Orthopaedic Association scores (JOA) and imaging parameters of the two groups were recorded and compared before the operation and during the follow-up.

Results

A total of 53 patients with single segments and 21 patients with double segments were included in this study. During the follow-up, the VAS score, ODI index and JOA score of the two groups were significantly improved as compared with those before the operation(P < 0. 05). Ninety-two point five percent of single-segment patients and 90.5% of double segment patients returned to normal scoliosis within 12 months after the operation. The operation time, number of intraoperative fluoroscopy times and the amount of intraoperative blood loss in single-segment patients were better than those in double-segment group(P < 0. 05). At the last follow-up, the AVT, CBD and SVA in the double-segment group were 5.2 ± 2.3, 5.1 ± 1.0 and 12.2 ± 3.0 mm, respectively, which were higher than those in the single-segment group (1.9 ± 0.4, 1.1 ± 1.6 and 3.9 ± 2.1 mm) (P < 0. 05).

Conclusion

PELD is an effective treatment for single-segment and double-segment lumbar disc herniation with Sciatic scoliosis. Double-segment patients can enjoy similar clinical efficacy to single-segment patients, avoiding complications caused by decompression, fusion, and internal fixation. Scoliosis was corrected spontaneously within 12 months after operation, and the sagittal curve was significantly improved in both groups. The improvement of coronal and sagittal balance in double -segment patients may take longer.
The oral microbiome of a family including Papillon-Lefèvre-syndrome patients and clinically healthy members
Authors: Vályi Péter , Wirth Roland , Minárovits János , Strang Orsolya , Maróti Gergely , Kovács Kornél L.
Published: January 2024

Aims

The oral microbiota composition of patients diagnosed with Papillon-Lefèvre-syndrome and treated for several years were compared to those existing in the oral cavity of the clinically healthy family members and a cohort of patients having various stages of chronic periodontitis.

Materials and methods

A family with two sisters affected with severe periodontitis and with the typical skin symptoms of Papillon-Lefèvre-syndrome, and symptomless parents and third sibling were investigated. The Patients received periodontal treatment for several years and their oral microbiome was analysed by amplicon sequencing. Data were evaluated by microbial cluster analysis.

Results

The microbiome of the patients with Papillon-Lefèvre-syndrome was predominated with Aggregatibacter actinomycetemcomitans and associated oral periodontopathogens. Although the clinically healthy family members showed no oral disorder, their microbiome resembled that of subjects having mild periodontitis.

Conclusions

Predominance of A. actinomycetemcomitans in the subgingival microbiome of patients with Papillon-Lefèvre-syndrome suggests that specific treatment strategies directed against this pathobiont may improve the oral health status of the affected individuals.

Trial registration

The study was conducted in accordance with the Declaration of Helsinki and the ethical permission has been issued by the Human Investigation Review Board of the University of Szeged, Albert Szent-Györgyi Clinical Centre (Permission No. 63/2017-SZTE). September 19, 2017. https://u-szeged.hu/klinikaikutatas/rkeb-altal-jovahagyott/rkeb-2017.
O2 supplementation disambiguation in clinical narratives to support retrospective COVID-19 studies
Authors: Abdulnazar Akhila , Kugic Amila , Schulz Stefan , Stadlbauer Vanessa , Kreuzthaler Markus
Published: January 2024

Background

Oxygen saturation, a key indicator of COVID-19 severity, poses challenges, especially in cases of silent hypoxemia. Electronic health records (EHRs) often contain supplemental oxygen information within clinical narratives. Streamlining patient identification based on oxygen levels is crucial for COVID-19 research, underscoring the need for automated classifiers in discharge summaries to ease the manual review burden on physicians.

Method

We analysed text lines extracted from anonymised COVID-19 patient discharge summaries in German to perform a binary classification task, differentiating patients who received oxygen supplementation and those who did not. Various machine learning (ML) algorithms, including classical ML to deep learning (DL) models, were compared. Classifier decisions were explained using Local Interpretable Model-agnostic Explanations (LIME), which visualize the model decisions.

Result

Classical ML to DL models achieved comparable performance in classification, with an F-measure varying between 0.942 and 0.955, whereas the classical ML approaches were faster. Visualisation of embedding representation of input data reveals notable variations in the encoding patterns between classic and DL encoders. Furthermore, LIME explanations provide insights into the most relevant features at token level that contribute to these observed differences.

Conclusion

Despite a general tendency towards deep learning, these use cases show that classical approaches yield comparable results at lower computational cost. Model prediction explanations using LIME in textual and visual layouts provided a qualitative explanation for the model performance.
An evaluation of GPT models for phenotype concept recognition
Authors: Groza Tudor , Caufield Harry , Gration Dylan , Baynam Gareth , Haendel Melissa A. , Robinson Peter N. , Mungall Christopher J. , Reese Justin T.
Published: January 2024

Objective

Clinical deep phenotyping and phenotype annotation play a critical role in both the diagnosis of patients with rare disorders as well as in building computationally-tractable knowledge in the rare disorders field. These processes rely on using ontology concepts, often from the Human Phenotype Ontology, in conjunction with a phenotype concept recognition task (supported usually by machine learning methods) to curate patient profiles or existing scientific literature. With the significant shift in the use of large language models (LLMs) for most NLP tasks, we examine the performance of the latest Generative Pre-trained Transformer (GPT) models underpinning ChatGPT as a foundation for the tasks of clinical phenotyping and phenotype annotation.

Materials and methods

The experimental setup of the study included seven prompts of various levels of specificity, two GPT models (gpt-3.5-turbo and gpt-4.0) and two established gold standard corpora for phenotype recognition, one consisting of publication abstracts and the other clinical observations.

Results

The best run, using in-context learning, achieved 0.58 document-level F1 score on publication abstracts and 0.75 document-level F1 score on clinical observations, as well as a mention-level F1 score of 0.7, which surpasses the current best in class tool. Without in-context learning, however, performance is significantly below the existing approaches.

Conclusion

Our experiments show that gpt-4.0 surpasses the state of the art performance if the task is constrained to a subset of the target ontology where there is prior knowledge of the terms that are expected to be matched. While the results are promising, the non-deterministic nature of the outcomes, the high cost and the lack of concordance between different runs using the same prompt and input make the use of these LLMs challenging for this particular task.
Exploring patient safety risk in an emergency ward for substance use through a mixed-method analysis
Authors: Svensson Jakob
Published: January 2024

Background

There is limited knowledge of how psychiatric patient safety measures can detect and understand risk as an emergent property within a healthcare system. Overcrowding poses a risk for patient safety in psychiatric emergency wards and is associated with increased mortality and violence. This paper aims to explore patterns of risk emergence in a psychiatric ward and provide insights into the dynamics of workload pressure.

Method

A case study was conducted in a psychiatric emergency ward for patients with substance use disorders. The study employed a four-phased mixed-methods design. Phase one used clinical experts to identify patient safety pressure issues. Phase two used data on patient visits extracted from medical records between 2010 and 2020. In phase three, a quantitative analysis of patient visits and diagnosis was made. Phase four used a focus group of clinical experts for a semi-structured interview, analysing the result from phase three.

Result

Trend analysis demonstrated a steady growth of patient visits to the emergency ward over the studied ten-year period. The findings showed a decrease in patients being diagnosed with delirium when visiting the emergency ward and an increase in percentage of patients receiving a psychosis diagnosis. The focus group expressed concerns about delayed treatments, increased violence and underestimating patients’ needs.

Conclusion

This study indicated that increased workload pressure can be predicted at a system level by analysing patient visits and diagnostics trends over time. The study advocates for ongoing awareness of patient safety risks by monitoring factors identified by clinical front-end workers as potential sources of risk. Healthcare management could employ supportive tools to detect and address emerging risks, including expected workload, overcrowding, staffing issues or bed shortages.
Predicting the 10-year incidence of dyslipidemia based on novel anthropometric indices, using data mining
Authors: Takhttavous Alireza , Saberi-Karimian Maryam , Hafezi Somayeh Ghiasi , Esmaily Habibollah , Hosseini Marzieh , Ferns Gordon A. , Amirfakhrian Elham , Ghamsary Mark , Ghayour-Mobarhan Majid , Alinezhad-Namaghi Maryam
Published: January 2024

Background

The aim was to establish a 10-year dyslipidemia incidence model, investigating novel anthropometric indices using exploratory regression and data mining.

Methods

This data mining study was conducted on people who were diagnosed with dyslipidemia in phase 2 (n = 1097) of the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study, who were compared with healthy people in this phase (n = 679). The association of dyslipidemia with several novel anthropometric indices including Conicity Index (C-Index), Body Roundness Index (BRI), Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), Abdominal Volume Index (AVI), Weight-Adjusted-Waist Index (WWI), A Body Shape Index (ABSI), Body Mass Index (BMI), Body Adiposity Index (BAI) and Body Surface Area (BSA) was evaluated. Logistic Regression (LR) and Decision Tree (DT) analysis were utilized to evaluate the association. The accuracy, sensitivity, and specificity of DT were assessed through the performance of a Receiver Operating Characteristic (ROC) curve using R software.

Results

A total of 1776 subjects without dyslipidemia during phase 1 were followed up in phase 2 and enrolled into the current study. The AUC of models A and B were 0.69 and 0.63 among subjects with dyslipidemia, respectively. VAI has been identified as a significant predictor of dyslipidemias (OR: 2.81, (95% CI: 2.07, 3.81)) in all models. Moreover, the DT showed that VAI followed by BMI and LAP were the most critical variables in predicting dyslipidemia incidence.

Conclusions

Based on the results, model A had an acceptable performance for predicting 10 years of dyslipidemia incidence. Furthermore, the VAI, BMI, and LAP were the principal anthropometric factors for predicting dyslipidemia incidence by LR and DT models.
Calcium phosphate coating enhances osteointegration of melt electrowritten scaffold by regulating macrophage polarization
Authors: Shi Yubo , Tao Weidong , Yang Wenjing , Wang Lei , Qiu Zhennan , Qu Xiaoli , Dang Jingyi , He Jiankang , Fan Hongbin
Published: January 2024

The osteoimmune microenvironment induced by implants plays a significant role in bone regeneration. It is essential to efficiently and timely switch the macrophage phenotype from M1 to M2 for optimal bone healing. This study examined the impact of a calcium phosphate (CaP) coating on the physiochemical properties of highly ordered polycaprolactone (PCL) scaffolds fabricated using melt electrowritten (MEW). Additionally, it investigated the influence of these scaffolds on macrophage polarization and their immunomodulation on osteogenesis. The results revealed that the CaP coated PCL scaffold exhibited a rougher surface topography and higher hydrophilicity in comparison to the PCL scaffold without coating. Besides, the surface morphology of the coating and the release of Ca2+ from the CaP coating were crucial in regulating the transition of macrophages from M1 to M2 phenotypes. They might activate the PI3K/AKT and cAMP-PKA pathways, respectively, to facilitate M2 polarization. In addition, the osteoimmune microenvironment induced by CaP coated PCL could not only enhance the osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) in vitro but also promote the bone regeneration in vivo. Taken together, the CaP coating can be employed to control the phenotypic switching of macrophages, thereby creating a beneficial immunomodulatory microenvironment that promotes bone regeneration.

Graphical abstract
Feasibility of caregiver-administered anthropometric measurements of children under age 5: evidence from Zambia
Authors: Fink Günther , Chembe Mpela , Henderson Savanna , Rockers Peter C , Parkerson Doug
Published: January 2024

Background

Accurate measurement of children’s anthropometry is of central importance for the assessment of nutritional status as well as for the evaluation of nutrition-specific interventions. Social distancing requirements during the recent Covid-19 pandemic made administration of standard assessor-led measurement protocols infeasible in many settings, creating demand for alternative assessment modalities.

Objective

To assess the feasibility and reliability of caregiver-administered anthropometric assessments of children under age 5.

Design

We compared standard and caregiver-administered assessments within an ongoing nutrition trial in Zambia (NCT05120427). We developed a “no-contact” protocol whereby trained staff verbally instruct caregivers from an appropriate distance to measure the height, weight and MUAC of their children. We captured measurements of height, weight and MUAC among a sample of caregivers and infants in Zambia using both the “no-contact” protocol and a standard assessor-led protocol. We analyzed each anthropometric variable, comparing means between protocol group, the proportions yielding standardized z-scores outside the plausible ± 6SD range and the proportions of children classified stunted, underweight and wasted.

Results

Anthropometric measurements were captured for 76 children using both the no-contact protocol and the standard protocol. An additional 1430 children were assessed by the standard protocol only and an additional 748 children by the no-contact protocol only. For the 76 children measured by both methods, we find no differences in average height, weight and MUAC between caregivers and interviewer assessments. The estimated kappa for the binary stunting and underweight classifications were 0.84 and 0.93, respectively. In the larger samples measured only following one protocol, we find no differences in average outcomes after adjusting for child, caregiver and household characteristics.

Conclusions

Anthropometric measurement protocols administered by caregivers with verbal instruction from trained assessors are a promising alternative to standard protocols in situations where study staff are unable to come in close contact with study participants.

Clinical trials registration This study was conducted within a larger trial registered at clinicaltrials.gov as trial NCT05120427. https://clinicaltrials.gov/ct2/show/NCT05120427.