bluuebunny/crossref_metadata_2025 huggingface dataset:
Emotion recognition in autism spectrum condition during the COVID-19 pandemic
Authors: Schnitzler Tim , Korn Christoph , C. Herpertz Sabine , Fuchs Thomas
Published: October 2023

With the widespread use of masks in the COVID-19 pandemic, it is crucial to understand how emotion recognition is affected by partial face covering. Since individuals with autism spectrum condition often tend to look at the lower half of the face, they are likely to be particularly restricted in emotion recognition by people wearing masks, since they are now forced to look at the upper half of the face. This study compared the recognition of basic and complex emotions in individuals with and without autism spectrum condition, when faces were presented uncovered, with face masks, or with sunglasses. We also used eye tracking to examine group differences in gaze patterns during emotion recognition. Individuals with autism spectrum condition were less accurate at recognizing emotions in all three conditions. Averaged across the three stimulus types, individuals with autism spectrum condition had greater difficulty recognizing anger, fear, pride, and embarrassment than control group. There was no group difference in emotion recognition between the three conditions. However, compared to individuals without autism spectrum condition, there was no evidence of either gaze avoidance or preference for the mouth region. Our results suggest that emotion recognition is reduced in individuals with autism spectrum condition, but this is not due to differences in gaze patterns.

Lay Abstract

In the COVID-19 pandemic, wearing face masks became mandatory to prevent the spread of the virus. However, they restrict the ability to recognize emotions to the upper part of the face. Since individuals with autism spectrum condition often tend to look at the lower half of the face, they may be particularly restricted in emotion recognition by people wearing masks, since they are now forced to look at the upper half of the face. The current study compared the recognition of facially expressed emotions between individuals with and without autism spectrum condition. Each photo was shown in three types, once uncovered, once with face mask, and once with sunglasses. Our results revealed a reduction in accuracy of individuals with autism spectrum condition at recognizing emotions in all three stimulus types and exhibited more difficulties distinguishing anger, fear, pride, and embarrassment. During the emotion recognition task, there was no difference in which facial areas the groups looked at. We did not find evidence that the disadvantages of individuals with autism spectrum condition in emotion recognition were due to looking at different areas of the face.
Macrostructural Cerebellar Neuroplasticity Correlates With Motor Recovery After Stroke
Authors: Hanakawa Takashi , Hotta Fujiko , Nakamura Tatsuhiro , Shindo Keiichiro , Ushiba Naoko , Hirosawa Masaki , Yamazaki Yutaka , Moriyama Yoshinao , Takagi Syota , Mizuno Katsuhiro , Liu Meigen
Published: October 2023

Background

Motor recovery varies across post-stroke individuals, some of whom require a better rehabilitation strategy. We hypothesized that macrostructural neuroplasticity of the motor control network including the cerebellum might underlie individual differences in motor recovery. Objectives. To gain insight into the macrostructural neuroplasticity after stroke, we examined 52 post-stroke individuals using both the Fugl-Meyer assessment and structural magnetic resonance imaging.

Methods

We performed voxel-based lesion symptom mapping and cross-sectional voxel-based morphometry to correlate the motor scores with the lesion location and the gray matter volume (GMV), respectively. Longitudinal data were available at ~8 and/or 15 weeks after admission from 43 individuals with supratentorial lesions. We performed a longitudinal VBM analysis followed by a multiple regression analysis to correlate between the changes of the motor assessment scores and those of GMV overtime.

Results

We found a cross-sectional correlation of residual motor functioning with GMV in the ipsilesional cerebellum and contralesional parietal cortex. Longitudinally, we found increases in GMV in the ipsilesional supplementary motor area, and the ipsilesional superior and inferior cerebellar zones, along with a GMV decrease in the ipsilesional thalamus. The motor recovery was correlated with the GMV changes in the superior and inferior cerebellar zones. The regaining of upper-limb motor functioning was correlated with the GMV changes of both superior and inferior cerebellum while that of lower-limb motor functioning with the GMV increase of the inferior cerebellum only.

Conclusions

The present findings support the hypothesis that macrostructural cerebellar neuroplasticity is correlated with individual differences in motor recovery after stroke.
American College of Lifestyle Medicine Expert Consensus Statement: Lifestyle Medicine for Optimal Outcomes in Primary Care
Authors: Grega Meagan L. , Shalz Jennifer T. , Rosenfeld Richard M. , Bidwell Josie H. , Bonnet Jonathan P. , Bowman David , Brown Melanie L. , Dwivedi Mollie E. , Ezinwa Ngozi M. , Kelly John H. , Mechley Amy R. , Miller Lawrence A. , Misquitta Rajiv K. , Parkinson Michael D. , Patel Dipak , Patel Padmaja M. , Studer Karen R. , Karlsen Micaela C.
Published: October 2023

Objective: Identify areas of consensus on integrating lifestyle medicine (LM) into primary care to achieve optimal outcomes. Methods: Experts in both LM and primary care followed an a priori protocol for developing consensus statements. Using an iterative, online process, panel members expressed levels of agreement with statements, resulting in classification as consensus, near consensus, or no consensus. Results: The panel identified 124 candidate statements addressing: (1) Integration into Primary Care, (2) Delivery Models, (3) Provider Education, (4) Evidence-base for LM, (5) Vital Signs, (6) Treatment, (7) Resource Referral and Reimbursement, (8) Patient, Family, and Community Involvement; Shared Decision-Making, (9) Social Determinants of Health and Health Equity, and (10) Barriers to LM. After three iterations of an online Delphi survey, statement revisions, and removal of duplicative statements, 65 statements met criteria for consensus, 24 for near consensus, and 35 for no consensus. Consensus was reached on key topics that included LM being recognized as an essential component of primary care in patients of all ages, including LM as a foundational element of health professional education. Conclusion: The practice of LM in primary care can be strengthened by applying these statements to improve quality of care, inform policy, and identify areas for future research.
INvestigation of the impact of a Pharmacist in a Hospital At Home Care Team (IN PHACT)
Authors: Patrick Morgan E. , Harder Curtis K. , Spina Sean P.
Published: October 2023

Background:

In November 2020, Island Health, with the support of the British Columbia Ministry of Health, introduced the Hospital at Home (HaH) care model at Victoria General Hospital in Victoria, British Columbia. Given the acuity of the patients anticipated to receive care through this model, questions arose regarding how the delivery of clinical pharmacy services on which inpatients rely on could be included. With limited supporting evidence for the inclusion of a clinical pharmacist, Island Health launched the HaH program with 2 clinical pharmacists who provide services 7 days a week during daytime hours. The aim of this study is to assess the impact of the HaH pharmacist on patient care, from the perspective of the pharmacists serving in this role, patients, caregivers and program stakeholders.

Methods:

This prospective, observational mixed-methods study was conducted from December 2021 to March 2022. Data collection involved the HaH pharmacist documenting daily clinical activities and resolving drug therapy problems, patients and caregivers completing a 4-question postdischarge phone survey and program stakeholders completing a 9-question online survey and an optional 7-question interview.

Results and Interpretation:

It was found that one of the most significant roles the pharmacist plays is in identifying indications for medication therapy and making recommendations to initiate therapy where there is an absence. There was high congruence between patient, caregiver and stakeholder perceptions that the HaH pharmacist positively affects patient care within the Island Health model.

Conclusion:

This study provides support for the integration of a dedicated clinical pharmacist in the HaH care model.
Motivated Cognition in Cooperation
Authors: Fiedler Susann , Habibnia Hooman , Fahrenwaldt Alina , Rahal Rima-Maria
Published: October 2023

Successful cooperation is tightly linked to individuals’ beliefs about their interaction partners, the decision setting, and existing norms, perceptions, and values. This article reviews and integrates findings from judgment and decision-making, social and cognitive psychology, political science, and economics, developing a systematic overview of the mechanisms underlying motivated cognition in cooperation. We elaborate on how theories and concepts related to motivated cognition developed in various disciplines define the concept and describe its functionality. We explain why beliefs play such an essential role in cooperation, how they can be distorted, and how this fosters or harms cooperation. We also highlight how individual differences and situational factors change the propensity to engage in motivated cognition. In the form of a construct map, we provide a visualization of the theoretical and empirical knowledge structure regarding the role of motivated cognition, including its many interdependencies, feedback loops, and moderating influences. We conclude with a brief suggestion for a future research agenda based on this compiled evidence.
Non-vascularized toe phalangeal transfer for reconstruction of a giant cell tumour of the proximal phalanx
Authors: Jerome J. Terrence Jose , Ravi Mohanraj
Published: October 2023

This article describes a 50-year-old woman with a giant cell tumour involving the base of the proximal phalanx, which was resected and reconstructed with a non-vascularised toe phalanx graft. The toe phalanx graft united well, and there was no tumour recurrence at the 24-month follow-up.
Automatic segmentation and labelling of wrist bones in four-dimensional computed tomography datasets via deep learning
Authors: Teule E. H. S. , Lessmann N. , van der Heijden E. P. A. , Hummelink S.
Published: October 2023

This study developed a deep learning model for fully automatic segmentation and labelling of wrist bones from four-dimensional computed tomography (4DCT) scans. This is a crucial step towards implementing 4DCT for diagnosing wrist ligament lesions, reducing time-consuming analysis of extensive data.
Health Effects of Disrupted Circadian Rhythms by Artificial Light at Night
Authors: Davis Lourdes K. , Bumgarner Jacob R. , Nelson Randy J. , Fonken Laura K.
Published: October 2023

Life on Earth has adapted to the changing patterns of light and darkness caused by the Earth's rotation. Known as circadian rhythms, these 24 h biological rhythms are regulated through light exposure and coordinate a range of behaviors such as sleep-wake cycles, eating, activity levels, and more. However, artificial light at night can disrupt these rhythms, altering how the human internal clock regulates sleep, metabolism, and even mood. This paper discusses some common forms of circadian disruption, such as nighttime light pollution and shift work, and examines the associated health outcomes. Some policy insights for reducing circadian disruption include regulating shift work, updating public lighting, and incentivizing circadian-based technologies. Regulating artificial lighting can improve human health and wellbeing, protect wildlife, and will allow future generations to continue enjoying starry nights.
Risk for Cannabis Use Disorder in People Who Use Cannabis to Cope with Internalizing Disorders: Implications for Policy and Practice
Authors: Schermitzler Brandon S. , Preston Thomas J. , Macatee Richard J.
Published: October 2023

The prevalence of Cannabis Use Disorder (CUD) is increasing in the United States, likely related to increasing cultural and legal acceptance of cannabis. While most cannabis users will not develop a CUD, certain behaviors may increase risk. For example, smoking to cope with anxiety or depressive disorders is associated with higher rates of cannabis use. Users who smoke to cope with these internalizing disorders (anxiety, depression) increase the addictive potential of cannabis. Systems that potentially maintain problematic use in people with internalizing disorders include the reward processing and the stress responsivity systems. Both exhibit neurobiological changes after chronic heavy cannabis use and are affected across internalizing disorders. The shared importance of these systems may warrant several recommendations for policy and practice. Some reexamine cannabis-related policy, invest in local communities, and improve cannabis education.
Conducting Electroencephalography With Black Individuals: Barriers, Recommendations, and Impact on Generalizability
Authors: Brown Lisa , Rollock David , Foti Dan
Published: October 2023

Electroencephalography (EEG) is a critical tool for neuroscience research on brain functioning, as well as clinical applications in neurological and psychiatric illnesses. Anti-Black racism is a substantial societal problem that affects the validity of EEG assessments, thereby undermining efforts in research and in medical practice. There are several barriers present in the process of recording EEG with Black individuals. This includes the physical qualities of Black hair; as well as the cultural and historical significance of Black hair, the features of Black hairstyles, and the discomfort that many Black individuals feel if their hair is touched. The potential impact of these barriers on the application of EEG is considerable, including concerns of individual discomfort, lack of generalizability, and misdiagnosis. Recommendations are proposed here to combat these barriers, including individual researchers who utilize EEG methods, funding agencies that support EEG research, and journal editors who publish EEG findings.
Toward the Next Generation of Precision Medicine
Authors: Verhulst Brad , Benstock Sarah E.
Published: October 2023

The goal of precision medicine is to develop individualized preventative, predictive, diagnostic, and treatment options that focus on treating a patient with a disease rather than simply curing the disease. The distinction between patient- and disease-focused approaches to healthcare are often contrasted, but both are necessary to develop the next generation of precision medicine. Disease-focused research establishes the standard course of illness, while research into the heterogeneity in onset and treatment responses allows healthcare professionals to tailor treatments to each individual patient. This ambitious objective has evolved over the past two decades and has been influential in treating patients with some types of cancers, cardiovascular diseases, and prenatal screenings. The next generation of precision medicine must integrate genetic, behavioral, and social determinants of health to address individual needs across a broad range of medical conditions. This will require coordinated efforts from multiple stakeholders: researchers, pharmaceutical companies, healthcare providers, and patients.
Conversations on Institutions and Public Policy*
Authors: Menon Niveditha , Purohit Archana
Published: October 2023

Centre for Budget and Policy Studies, a public policy research institute, recently celebrated completion of 25 years of its existence and work with a two-day conference on Institutions and Public Policy. The conference explored the relationships between institutions and public policy in relation to the themes of independent institutions and policy discourse, gender and public spaces, education as a public good, public finance and governance, health and social security. This descriptive article, acting in-part as the Proceedings for the Conference, engages with the various dimensions of these themes and summarises the major arguments articulated within the conference.
Investigating the effect of eye drops based on iodine nanoparticles in the treatment of corneal ulcers in rabbit eyes
Authors: Feghi Mostafa , Makhmalzadeh Sharif , Masihpour Nasrin , Amin Mansour , Mortazavinia Nader
Published: October 2023

Background

Various organisms, such as bacteria, viruses, and fungi, can cause corneal ulcers. One of the leading causes of vision loss and disability worldwide is corneal ulceration. Practical, accessible, and affordable treatment for this disease seems essential.

Materials and methods

Fifteen New Zealand rabbits infected with Staphylococcus aureus (ATCC 25923) corneal ulcers were randomly divided into three groups of five for the present study. (I, II, and III). Group I was used as the control group (without treatment). The second group received an iodine solution (1.25%) without a nanoparticle structure (betadine). The third group received an iodine solution with a nanoparticle structure used as eye drops. Drops in the corneal ulcer group were used five times daily for 14 days.

Microbial counts and disease severity scores were measured on the first, second, fifth, and fourteenth days and compared between groups separately for each disease.

Results

The results showed that the changes in microbial load were significant in the group that received betadine and nanoparticles. The microbial load was further reduced when using iodine nanoparticles than betadine. The betadine and nano-iodine groups significantly reduced the severity of the disease in rabbits with corneal ulcers (p < 0.05). The average changes in disease severity score were 4.8 ± 1.3, -2.6 ± 0.89, and -2.22 ± 1.22 in the untreated, nano iodine, and betadine groups, respectively. However, a significant increase in disease severity was observed in the untreated group (p = 0.001). It shows a significant difference (p < 0.001) between the nano iodine, betadine, and untreated groups. However, the difference in disease severity changes between nano iodine and non-nano iodine groups was insignificant.

Conclusion

Nanoparticle iodine is more effective than non-nanoparticle iodine in reducing bacterial load. In reducing the severity of the disease, both types of iodine were superior to no treatment. But there was no apparent difference between the two groups treated with iodine.
Regularized multi-trait multi-locus linear mixed models for genome-wide association studies and genomic selection in crops
Authors: Lozano Aurélie C. , Ding Hantian , Abe Naoki , Lipka Alexander E.
Published: October 2023

Background

We consider two key problems in genomics involving multiple traits: multi-trait genome wide association studies (GWAS), where the goal is to detect genetic variants associated with the traits; and multi-trait genomic selection (GS), where the emphasis is on accurately predicting trait values. Multi-trait linear mixed models build on the linear mixed model to jointly model multiple traits. Existing estimation methods, however, are limited to the joint analysis of a small number of genotypes; in fact, most approaches consider one SNP at a time. Estimating multi-dimensional genetic and environment effects also results in considerable computational burden. Efficient approaches that incorporate regularization into multi-trait linear models (no random effects) have been recently proposed to identify genomic loci associated with multiple traits (Yu et al. in Multitask learning using task clustering with applications to predictive modeling and GWAS of plant varieties.arXiv:1710.01788, 2017; Yu et al in Front Big Data 2:27, 2019), but these ignore population structure and familial relatedness (Yu et al in Nat Genet 38:203–208, 2006).

Results

This work addresses this gap by proposing a novel class of regularized multi-trait linearmixedmodels along with scalable approaches for estimation in the presence of high-dimensional genotypes and a large number of traits. We evaluate the effectiveness of the proposed methods using datasets in maize and sorghum diversity panels, and demonstrate benefits in both achieving high prediction accuracy in GS and in identifying relevant marker-trait associations.

Conclusions

The proposed regularized multivariate linear mixed models are relevant for both GWAS and GS. We hope that they will facilitate agronomy-related research in plant biology and crop breeding endeavors.
Pan-genome de Bruijn graph using the bidirectional FM-index
Authors: Depuydt Lore , Renders Luca , Abeel Thomas , Fostier Jan
Published: October 2023

Background

Pan-genome graphs are gaining importance in the field of bioinformatics as data structures to represent and jointly analyze multiple genomes. Compacted de Bruijn graphs are inherently suited for this purpose, as their graph topology naturally reveals similarity and divergence within the pan-genome. Most state-of-the-art pan-genome graphs are represented explicitly in terms of nodes and edges. Recently, an alternative, implicit graph representation was proposed that builds directly upon the unidirectional FM-index. As such, a memory-efficient graph data structure is obtained that inherits the FM-index’ backward search functionality. However, this representation suffers from a number of shortcomings in terms of functionality and algorithmic performance.

Results

We present a data structure for a pan-genome, compacted de Bruijn graph that aims to address these shortcomings. It is built on the bidirectional FM-index, extending the ability of its unidirectional counterpart to navigate and search the graph in both directions. All basic graph navigation steps can be performed in constant time. Based on these features, we implement subgraph visualization as well as lossless approximate pattern matching to the graph using search schemes. We demonstrate that we can retrieve all occurrences corresponding to a read within a certain edit distance in a very efficient manner. Through a case study, we show the potential of exploiting the information embedded in the graph’s topology through visualization and sequence alignment.

Conclusions

We propose a memory-efficient representation of the pan-genome graph that supports subgraph visualization and lossless approximate pattern matching of reads against the graph using search schemes. The C++ source code of our software, called Nexus, is available at https://github.com/biointec/nexus under AGPL-3.0 license.
Dung beetle-associated yeasts display multiple stress tolerance: a desirable trait of potential industrial strains
Authors: Nwaefuna Anita Ejiro , Garcia-Aloy Mar , Loeto Daniel , Ncube Thembekile , Gombert Andreas K. , Boekhout Teun , Alwasel Saleh , Zhou Nerve
Published: October 2023

Background

Stress-tolerant yeasts are highly desirable for cost-effective bioprocessing. Several strategies have been documented to develop robust yeasts, such as genetic and metabolic engineering, artificial selection, and natural selection strategies, among others. However, the significant drawbacks of such techniques have motivated the exploration of naturally occurring stress-tolerant yeasts. We previously explored the biodiversity of non-conventional dung beetle-associated yeasts from extremophilic and pristine environments in Botswana (Nwaefuna AE et.al., Yeast, 2023). Here, we assessed their tolerance to industrially relevant stressors individually, such as elevated concentrations of osmolytes, organic acids, ethanol, and oxidizing agents, as well as elevated temperatures.

Results

Our findings suggest that these dung beetle-associated yeasts tolerate various stresses comparable to those of the robust bioethanol yeast strain, Saccharomyces cerevisiae (Ethanol Red™). Fifty-six percent of the yeast isolates were tolerant of temperatures up to 42 °C, 12.4% of them could tolerate ethanol concentrations up to 9% (v/v), 43.2% of them were tolerant to formic acid concentrations up to 20 mM, 22.7% were tolerant to acetic acid concentrations up to 45 mM, 34.0% of them could tolerate hydrogen peroxide up to 7 mM, and 44.3% of the yeasts could tolerate osmotic stress up to 1.5 M.

Conclusion

The ability to tolerate multiple stresses is a desirable trait in the selection of novel production strains for diverse biotechnological applications, such as bioethanol production. Our study shows that the exploration of natural diversity in the search for stress-tolerant yeasts is an appealing approach for the development of robust yeasts.
Systemic biochemical changes in pepper (Capsicum annuum L.) against Rhizoctonia solani by kale (Brassica oleracea var. acephala L.) green manure application
Authors: Rodríguez Víctor M. , Velasco Pablo , Cartea María Elena , Poveda Jorge
Published: October 2023

Background

In the search for new alternatives to avoid the problems associated with the use of synthetic chemical fungicides in agriculture, the use of green manure (GrM) could help combat fungal diseases of crops, such as those produced by the necrotrophic pathogen Rhizoctonia solani. In the case of the use of Brassica tissues as GrM, it could have an elicitor capacity for systemic plant resistance.

Results

We used kale leaves as a GrM and applied it to pepper plants infected with R. solani. The application of freeze-dried kale tissues to the roots of pepper plants produced a systemic activation of foliar defences via the salicylic acid (SA) and ethylene (ET) pathways, significantly reducing pathogen damage. In addition, this systemic response led to the accumulation of secondary defence metabolites, such as pipecolic acid, hydroxycoumarin and gluconic acid, in leaves. Remarkably, pepper plants treated with lyophilised kale GrM accumulated glucosinolates when infected with R. solani. We also confirmed that autoclaving removed part of the glucobrassicin (85%) and sinigrin (19%) content of the kale tissues.

Conclusions

GrM kale tissues can activate systemic defences in bell pepper against foliar pathogens through SA/ET hormonal pathways, accumulating secondary defence metabolites.
Functional data analysis to characterize disease patterns in frequent longitudinal data: application to bacterial vaginal microbiota patterns using weekly Nugent scores and identification of pattern-specific risk factors
Authors: Biswas Rahul , Thoma Marie , Kong Xiangrong
Published: October 2023

Background

Technology advancement has allowed more frequent monitoring of biomarkers. The resulting data structure entails more frequent follow-ups compared to traditional longitudinal studies where the number of follow-up is often small. Such data allow explorations of the role of intra-person variability in understanding disease etiology and characterizing disease processes. A specific example was to characterize pathogenesis of bacterial vaginosis (BV) using weekly vaginal microbiota Nugent assay scores collected over 2 years in post-menarcheeal women from Rakai, Uganda, and to identify risk factors for each vaginal microbiota pattern to inform epidemiological and etiological understanding of the pathogenesis of BV.

Methods

We use a fully data-driven approach to characterize the longitudinal patters of vaginal microbiota by considering the densely sampled Nugent scores to be random functions over time and performing dimension reduction by functional principal components. Extending a current functional data clustering method, we use a hierarchical functional clustering framework considering multiple data features to help identify clinically meaningful patterns of vaginal microbiota fluctuations. Additionally, multinomial logistic regression was used to identify risk factors for each vaginal microbiota pattern to inform epidemiological and etiological understanding of the pathogenesis of BV.

Results

Using weekly Nugent scores over 2 years of 211 sexually active and post-menarcheal women in Rakai, four patterns of vaginal microbiota variation were identified: persistent with a BV state (high Nugent scores), persistent with normal ranged Nugent scores, large fluctuation of Nugent scores which however are predominantly in the BV state; large fluctuation of Nugent scores but predominantly the scores are in the normal state. Higher Nugent score at the start of an interval, younger age group of less than 20 years, unprotected source for bathing water, a woman’s partner’s being not circumcised, use of injectable/Norplant hormonal contraceptives for family planning were associated with higher odds of persistent BV in women.

Conclusion

The hierarchical functional data clustering method can be used for fully data driven unsupervised clustering of densely sampled longitudinal data to identify clinically informative clusters and risk-factors associated with each cluster.
Nasal MRSA carriage is a risk factor for development of antibiotic resistance in diabetic foot ulcers and is significantly higher than diabetic and non-diabetic individuals without foot ulcer
Authors: Mukherjee Poulami , Paul Shouvik , Dutta Tanmoy , Nath Shankha , Ghosh Bikramaditya , Chatterjee Debika , Mukhopadhyay Satinath , Mukherjee Souvik
Published: October 2023

Background

Diabetic foot ulcer (DFU) is a major complication of diabetes often impacted by polymicrobial infection in the wound site. Diabetic patients are immunocompromised in nature and hence vulnerable to infection once the skin barrier is breached. Microbiological culture-based methods show that Staphylococcus aureus (SA) is the most frequently isolated bacteria from the DFU wounds. SA and its most clinically important antibiotic resistant variant methicillin-resistant S. aureus (MRSA) are commonly found in the nasal vestibule and colonization of SA as well as MRSA in any wound site can aggravate the condition. We hypothesize that the presence of nasal MRSA carriage can serve as a potential risk factor contributing to the emergence of antibiotic resistance in diabetic foot ulcer wounds.

Methods

In the present study, we have compared the carriage of SA and MRSA in nasal cavity and foot skin among DFU patients (D+F+, n = 50), diabetic patients without any ulcer (D+F-, n = 50), and healthy controls (D-F-, n = 40) by using bacterial culture and PCR based methods. The D+F+, D+F- and D-F-individuals were further categorized based on the presence or absence of MRSA and clinical parameters were compared between MRSA+ ve and MRSA-ve individuals in each of the three groups mentioned above.

Results

Our results show that, (a) nasal MRSA carriage is significantly higher (p < 0.05) in D+F+ group than the D+F- and D-F- and significantly associated with wound MRSA carriage in D+ F+ individuals (O.R. = 4.09; 95% C.I. = 1.12–15.05) and (b) the HbA1C level is significantly higher (p < 0.02) in wound MRSA positive, compared to MRSA negative D+F+ patients. Interestingly more than half of the MRSA (64%) isolated from DFU wound were identified to be multidrug resistant.

Conclusion

These findings strongly suggest that nasal MRSA carriage can act as a risk factor for development of antibiotic resistance in diabetic foot ulcers and it is therefore important to screen nasal and wound sites of these patients regularly. We have also developed a rapid multiplex PCR assay to detect MRSA from clinical isolates or microbial DNA isolated from clinical samples in the hospital settings.
Analysis of enhanced CT imaging signs and clinicopathological prognostic factors in hepatoid adenocarcinoma of stomach patients with radical surgery: a retrospective study
Authors: Yan Xin-Yue , Ju Hai-Yue , Hou Fang-Jing , Li Xiao-ting , Yang Ding , Tang Lei , Wang Ya-Kun , Li Zhong-Wu , Sun Ying-Shi , Gao Shun-Yu
Published: October 2023

Background

To investigate the association between CT signs and clinicopathological features and disease recurrence in patients with hepatoid adenocarcinoma of stomach (HAS).

Methods

Forty nine HAS patients undergoing radical surgery were retrospectively collected. Association between CT and clinicopathological features and disease recurrence was analyzed. Multivariate logistic model was constructed and evaluated for predicting recurrence by using receiver operating characteristic (ROC) curve. Survival curves between model-defined risk groups was compared using Kaplan–Meier method.

Results

24(49.0%) patients developed disease recurrence. Multivariate logistic analysis results showed elevated serum CEA level, peritumoral fatty space invasion and positive pathological vascular tumor thrombus were independent factors for disease recurrence. Odds ratios were 10.87 (95%CI, 1.14–103.66), 6.83 (95%CI, 1.08–43.08) and 42.67 (95%CI, 3.66–496.85), respectively. The constructed model showed an area under ROC of 0.912 (95%CI,0.825–0.999). The model-defined high-risk group showed poorer overall survival and recurrence-free survival than the low-risk group (both P < 0.001).

Conclusions

Preoperative CT appearance of peritumoral fatty space invasion, elevated serum CEA level, and pathological vascular tumor thrombus indicated poor prognosis of HAS patients.
Construction and validation of a risk assessment model for acute kidney injury in patients with acute pancreatitis in the intensive care unit
Authors: Jiang Ziming , An Xiangyu , Li Yueqian , Xu Chen , Meng Haining , Qu Yan
Published: October 2023

Background

To construct and validate a risk assessment model for acute kidney injury (AKI) in patients with acute pancreatitis (AP) in the intensive care unit (ICU).

Methods

A total of 963 patients diagnosed with acute pancreatitis (AP) from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database was included. These patients were randomly divided into training set (N = 674) and validation set (N = 289) at a ratio of 7:3. Clinical characteristics were utilized to establish a nomogram for the prediction of AKI during ICU stay. These variables were selected by the least absolute shrinkage and selection operation (LASSO) regression and included in multivariate logistic regression analysis. Variables with P-values less than 0.05 were included in the final model. A nomogram was constructed based on the final model. The predicted accuracy of the nomogram was assessed by calculating the receiver operating characteristic curve (ROC) and the area under the curve (AUC). Moreover, calibration curves and Hosmer-Lemeshow goodness-of-fit test (HL test) were performed to evaluate model performance. Decision curve analysis (DCA) evaluated the clinical net benefit of the model.

Results

A multivariable model that included 6 variables: weight, SOFA score, white blood cell count, albumin, chronic heart failure, and sepsis. The C-index of the nomogram was 0.82, and the area under the receiver operating characteristic curve (AUC) of the training set and validation set were 0.82 (95% confidence interval:0.79–0.86) and 0.76 (95% confidence interval: 0.70–0.82), respectively. Calibration plots showed good consistency between predicted and observed outcomes in both the training and validation sets. DCA confirmed the clinical value of the model and its good impact on actual decision-making.

Conclusion

We identified risk factors associated with the development of AKI in patients with AP. A risk prediction model for AKI in ICU patients with AP was constructed, and improving the treatment strategy of relevant factors in the model can reduce the risk of AKI in AP patients.
Safety and efficacy of therapeutic hypothermia in neonates with mild hypoxic-ischemic encephalopathy
Authors: Wang Zheng , Zhang Dan , Zhang Peng , Zhou Wenhao , Hu Liyuan , Wang Laishuan , Cheng Guoqiang
Published: October 2023

Background

Though there has been an increase in the number of neonates with hypoxic-ischemic encephalopathy (HIE) treated by therapeutic hypothermia (TH) in recent years, the effect of therapeutic hypothermia on mild HIE neonates is still uncertain.

Objectives

This study aims to explore the safety and efficacy of therapeutic hypothermia in neonates with mild HIE.

Methods

Retrospectively collected between January 2010 to December 2022 at Children’s Hospital of Fudan University, neonates with mild HIE were divided into TH and non-TH groups. Clinical data of the mild HIE neonates and their mothers’ general information during pregnancy were collected. SPSS 23.0 was used to compare the general condition, the incidence of adverse events, and efficacy in the two groups.

Results

A total of 71 neonates with mild HIE were included, including 31 in the TH group and 40 in the non-TH group. Compared with the non-TH group, the TH group had significantly lower 5-minute Apgar scores [6 (5–7) points vs. 7 (5–8) points, p = 0.033 ], but a higher rate of tracheal intubation at birth (68%, 21/31 vs. 40%, 16/40, p = 0.02), a higher rate of chest compressions > 30 s (39%, 12/31 vs. 15%, 6/40, p = 0.023), the later initiation enteral feeding [4 (3–4) days vs. 1 (1–2) days, p < 0.001], a higher usage rate of analgesic and sedative drugs (45%, 14/31 vs. 18%, 7/40, p = 0.011) and the longer hospital stay [12.5 (11–14) days vs. 9 (7-13.9) days, p = 0.003]. There was no death in 71 mild HIE neonates. TH group had lower incidence of brain injury (16%, 5/31 vs. 43%, 17/40, p = 0.017) and encephalopathy progression (10%, 3/31 vs. 45%, 18/40, p = 0.001) than the non-TH group. There was no statistical significance in the incidence of adverse events between the two groups.

Conclusion

Therapeutic hypothermia can reduce the incidence of brain injury in neonates with mild HIE.
The correlation of anxiety and depression with C3 and C4 Levels and systemic lupus erythematosus activity
Authors: Shatri Hamzah , Purnamandala  , Hidayat Rudy , Sinto Robert , Widhani Alvina , Putranto Rudi , Purnamasari Rr Dyah , Ginanjar Eka , Jasirwan Chyntia Olivia Maurine
Published: October 2023

Background

Anxiety and depression are psychosomatic disorders that are frequently observed in chronic conditions such as systemic lupus erythematosus (SLE). Anxiety and depression can be induced by immunological and neurotransmitter dysregulation, which is characterized by hypothalamic–pituitary–adrenal (HPA) axis dysfunction, production of proinflammatory cytokines, and activation of complement in the blood, such as C3 and C4. The causes of anxiety and depression in SLE are complex, ranging from neuropsychiatric involvement to drug adverse effects. Detecting anxiety and depression symptoms in SLE patients is critical to preventing disability from impacting quality of life.

Objective

To assess the relationship between anxiety and depression symptomatology, SLE disease activity with levels of C3 and C4 in Cipto Mangunkusumo National Hospital.

Methods

This study used a cross-sectional design. The study included 120 SLE patients from Cipto Mangunkusumo National Hospital, aged 18 to 60 years. All patients were requested to complete a Hospital Anxiety and Depression Scale (HADS) questionnaire to assess their anxiety and depression symptoms. Subjects with anxiety and depression were assessed for disease activity using the Mexican Systemic Lupus Erythematosus Systemic Disease Activity (Mex-SLEDAI), and blood samples were collected to test complement C3 and C4 levels. Spearman's correlation test was used to examine the relationship between HADS scores, Mex-SLEDAI, and C3 and C4 levels.

Results

The results of the study showed a very weak statistically significant negative correlation between anxiety symptoms based on HADS and C3 levels (r = -0.189; p = 0.038) and a weak correlation between anxiety symptoms and C4 levels (r = -204; p = 0.026). Depressive symptoms based on HADS revealed a very poor connection and no statistical significance with levels of C3 (r = -0.056; p = 0.546) and C4 (r = -0.068; p = 0.461). Anxiety (r = 0.06; p = 0.173) and depression (r = 0.031; p = 0.753) symptoms have a weak and insignificant positive connection with SLE activity.

Conclusion

C3 and C4 serum levels appeared to decrease when the presence of anxious symptoms increased. There was no significant correlation in SLE disease activity between anxious and depressed patients.
One-year unplanned readmission after total hip arthroplasty in patients with osteonecrosis of the femoral head: rate, causes, and risk factors
Authors: Wang Tianyu , Gao Congliang , Wu Dongwei , Li Chengsi , Cheng Xinqun , Yang Zhenbang , Zhang Yingze , Zhu Yanbin
Published: October 2023

Background

The primary objectives of this study were to focus on one - year unplanned readmissions after THA in ONFH patients and to investigate rates, causes, and independent risk factors.

Methods

Between October 2014 and April 2019, eligible patients undergoing THA were enrolled and divided into unplanned readmission within one year and no readmission in this study. All unplanned readmissions within 1 year of discharge were reviewed for causes and the rate of unplanned readmissions was calculated. Demographic information, ONFH characteristics, and treatment-related variables of both groups were compared and analysed.

Results

Finally, 41 out of 876 patients experienced unplanned readmission. The readmission rate was 1.83% in 30 days 2.63% in 90 days, and 4.68% in 1 year. Prosthesis dislocation was always the most common cause at all time points studied within a year. The final logistic regression model revealed that higher risks of unplanned readmission were associated with age > 60 years (P = 0.001), urban residence (P = 0.001), ARCO stage IV (P = 0.025), and smoking (P = 0.033).

Conclusions

We recommend the introduction of a strict smoking cessation program prior to surgery and the development of comprehensive management strategies, especially for the elderly and end-stage ONFH patients, and pay more attention to preventing prosthesis dislocation in the early days after surgery.
Medical education in times of war: a mixed-methods needs analysis at Ukrainian medical schools
Authors: Mayer Anja , Yaremko Olena , Shchudrova Tetiana , Korotun Olena , Dospil Karolin , Hege Inga
Published: October 2023

Background

As Ukraine struggles with the education of healthcare professionals due to the war, we aimed to identify the specific effects of the war on medical education, the resulting needs, and the expected consequences for schools, faculty, staff, students, and the healthcare system.

Methods

In October and November 2022, we performed a survey of students, faculty, and staff of medical schools in Ukraine and conducted semi-structured interviews with faculty leaders (i.e., rectors, vice-rectors). We conducted a descriptive analysis of the survey’s closed-ended questions. The survey and the interviews included open-ended questions about war-related restrictions to teaching and learning, resulting needs, and expected consequences, for which we applied a thematic analysis.

Results

We received 239 survey responses (N = 49 faculty and staff, N = 190 students) and conducted nine interviews with faculty leaders across Ukraine. Most survey participants indicated that they had experienced restrictions or changes to their work or study due to the war (86% of faculty and staff, 69% of students). From the thematic analysis of the survey and interviews, we identified eight themes: disruption of teaching, increased workload, mental stress, financial restrictions, non-war related needs, international cooperation, quality of education, and prospects of future professionals. The quality of healthcare education in Ukraine was threatened, and schools, faculty, staff, and students were under great strain. While already established international cooperation has been supportive, some needs have still not been addressed.

Conclusions

We hope that our findings will help researchers and educators from abroad contribute to meeting Ukraine’s needs in medical education.
Developing research skills in medical students online using an active research study
Authors: Asghar Aziz U. R. , Aksoy Murat , Graham Alison I. , Baseler Heidi A.
Published: October 2023

Background

Developing research skills and scholarship are key components of medical education. The COVID-19 pandemic necessitated that all teaching be delivered online. We introduced an approach to small group teaching in the academic year 2020–2021 online which involved students in an active (ongoing) research study to develop their research skills.

Methods

We acquired student feedback to evaluate their perspectives quantitatively on development of research and scholarship skills, teaching content and format, and tutor performance using this teaching approach. In addition, we captured free text responses from both students and tutors on the positives and negatives of our course, and their suggested improvements. We also compared summative assessment marks for the online/active research course (2020–2021) with those obtained from previous (2017–2019) and subsequent (2021–2023) teaching sessions.

Results

Students were largely positive about most aspects of the online course utilising an active research study (n = 13). Students agreed that they were able to acquire research skills, particularly related to data analysis, transferable skills, and giving scientific presentations. A one-way ANOVA revealed no significant difference for assessment marks across all five teaching years (two years prior and two years following the online/active research course), indicating that the course achieved the learning outcomes. Students enjoyed the convenience of online teaching and the availability of course resources, but least liked the lack of in-person interaction and laboratory training. Tutors enjoyed the collaborative aspects of online teaching, but least liked the lack of face-to-face interactions with students.

Conclusions

Our study demonstrates that delivering online teaching which involves students in active research engages and motivates them to develop their research and scholarship skills. We recommend that educators consider incorporating a current research study in their undergraduate courses as this can enhance the student learning experience as well as the research project itself.