bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost-utility analysis of treating mild stage normal tension glaucoma by surgery in China: a decision-analytic Markov model
Authors: Song Di , Wang Liwen
Published: February 2024

Background

Many individuals suffer from normal tension glaucoma (NTG) in China. This study utilized Markov models to evaluate the cost-utility of applying many medications and surgery for mild-stage NTG when disease progression occurred at a mild stage.

Methods

A 10-year decision-analytic Markov model was developed for the cost-utility analysis of treating mild-stage NTG with surgery and increased application of medication. We hypothesized that all 100,000 samples with a mean age of 64 were in mild stages of NTG. Transitional probabilities from the mild to moderate to severe stages and the basic parameters acquired from the CNTGS were calculated. Incremental cost-utility ratios (ICUR) were calculated for treating all patients with NTG by probabilistic sensitivity analysis (PSA) and Monte Carlo simulation. One-way sensitivity analysis were conducted by adjusting the progression rate, cost of medications or trabeculectomy, cost of follow-up, and surgical acceptance rate.

Results

The ICUR of treating mild stage NTG with medication over 10 years was $12743.93 per quality-adjusted life years (QALYs). The ICUR for treating mild stage NTG patients with a 25% and 50% surgery rate with medication were $8798.93 and $4851.93 per QALYs, respectively. In this model, the cost-utility of treating NTG was sensitive to disease progression rate, surgical treatment rate, and medication costs.

Conclusions

According to the results of the cost-utility analysis, it was a reasonable and advantageous strategy to administer a lot of medication and surgery for NTG in the mild stages of the disease. In the model, the greater the probability of patients undergoing surgery, the strategy becomes more valuable.
Characterization of two distinct immortalized endothelial cell lines, EA.hy926 and HMEC-1, for in vitro studies: exploring the impact of calcium electroporation, Ca2+ signaling and transcriptomic profiles
Authors: Lisec Barbara , Bozic Tim , Santek Iva , Markelc Bostjan , Vrecl Milka , Frangez Robert , Cemazar Maja
Published: February 2024

Background

Disruption of Ca2+ homeostasis after calcium electroporation (CaEP) in tumors has been shown to elicit an enhanced antitumor effect with varying impacts on healthy tissue, such as endothelium. Therefore, our study aimed to determine differences in Ca2+ kinetics and gene expression involved in the regulation of Ca2+ signaling and homeostasis, as well as effects of CaEP on cytoskeleton and adherens junctions of the established endothelial cell lines EA.hy926 and HMEC-1.

Methods

CaEP was performed on EA.hy926 and HMEC-1 cells with increasing Ca2+ concentrations. Viability after CaEP was assessed using Presto Blue, while the effect on cytoskeleton and adherens junctions was evaluated via immunofluorescence staining (F-actin, α-tubulin, VE-cadherin). Differences in intracellular Ca2+ regulation ([Ca2+]i) were determined with spectrofluorometric measurements using Fura-2-AM, exposing cells to DPBS, ionomycin, thapsigargin, ATP, bradykinin, angiotensin II, acetylcholine, LaCl3, and GdCl3. Molecular distinctions were identified by analyzing differentially expressed genes and pathways related to the cytoskeleton and Ca2+ signaling through RNA sequencing.

Results

EA.hy926 cells, at increasing Ca2+ concentrations, displayed higher CaEP susceptibility and lower survival than HMEC-1. Immunofluorescence confirmed CaEP-induced, time- and Ca2+-dependent morphological changes in EA.hy926’s actin filaments, microtubules, and cell–cell junctions. Spectrofluorometric Ca2+ kinetics showed higher amplitudes in Ca2+ responses in EA.hy926 exposed to buffer, G protein coupled receptor agonists, bradykinin, and angiotensin II compared to HMEC-1. HMEC-1 exhibited significantly higher [Ca2+]i changes after ionomycin exposure, while responses to thapsigargin, ATP, and acetylcholine were similar in both cell lines. ATP without extracellular Ca2+ ions induced a significantly higher [Ca2+]i rise in EA.hy926, suggesting purinergic ionotropic P2X and metabotropic P2Y receptor activation. RNA-sequencing analysis showed significant differences in cytoskeleton- and Ca2+-related gene expression, highlighting upregulation of ORAI2, TRPC1, TRPM2, CNGA3, TRPM6, and downregulation of TRPV4 and TRPC4 in EA.hy926 versus HMEC-1. Moreover, KEGG analysis showed upregulated Ca2+ import and downregulated export genes in EA.hy926.

Conclusions

Our finding show that significant differences in CaEP response and [Ca2+]i regulation exist between EA.hy926 and HMEC-1, which may be attributed to distinct transcriptomic profiles. EA.hy926, compared to HMEC-1, displayed higher susceptibility and sensitivity to [Ca2+]i changes, which may be linked to overexpression of Ca2+-related genes and an inability to mitigate changes in [Ca2+]i. The study offers a bioinformatic basis for selecting EC models based on research objectives.
Human Parathyroid Hormone (1–34) accelerates skin wound healing through inducing cell migration via up-regulating the expression of Rac1
Authors: Sun Qingpeng , Zhou Liya , Yu Zhiyong , Zhang Jun , Zhang Chao , Pi Honglin
Published: February 2024

Delayed wound healing is a public issue that imposes a significant burden on both society and the patients themselves. To date, although numerous methods have been developed to accelerate the speed of wound closure, the therapeutic effects are partially limited due to the complex procedures, high costs, potential side effects, and ethical concerns. While some studies have reported that the in-vivo application of Human Parathyroid Hormone (1–34) (hPTH(1–34)) promotes the wound-healing process, the definitive role and underlying mechanisms through which it regulates the behavior of fibroblasts and keratinocytes remains unclear. Herein, hPTH(1–34)’s role in cell migration is evaluated with a series of in-vitro and in-vivo studies, whereby hPTH(1–34)’s underlying mechanism in activating the two types of cells was detected. The in-vitro study revealed that hPTH(1–34) enhanced the migration of both fibroblasts and HaCaT cells. Ras-associated C3 botulinum toxin subunit 1 (Rac1), a classical member of the Rho family, was upregulated in hPTH(1–34)-treated fibroblasts and HaCaT cells. Further study by silencing the expression of Rac1 with siRNA reversed the hPTH(1–34)-enhanced cell migration, thus confirming that Rac1 was involved in hPTH(1–34)-induced cell behavior. In-vivo study on rat wound models confirmed the effects of hPTH(1–34) on fibroblasts and keratinocytes, with increased collagen deposition, fibroblasts accumulation, and Rac1 expression in the hPTH(1–34)-treated wounds. In summary, the present study demonstrated that hPTH(1–34) accelerated wound healing through enhancing the migration of cells through the up-regulation of Rac1 expression.
Impact of sustentaculum tali screw positioning on radiographic and functional outcomes in calcaneal fractures
Authors: Li Zihua , Xiao Fajiao , Huang Hui , Xia Jiang , Zhou Haichao , Li Bing , Yang Yunfeng
Published: February 2024

Background

To investigate whether accurate placement of sustentaculum tali screws have the impacts on the clinical efficacy of calcaneal fractures.

Methods

A retrospective analysis of 72 cases (73 feet) of calcaneal fractures from September 2015 to September 2019 treated with open reduction and internal fixation with sustentaculum tali screws was conducted. Patients were divided into the sustentaculum tali fixation group (ST group) and the sustentaculum fragment fixation group (STF group) according to the location of the sustentaculum tali screw placement. The functional outcomes at preoperative, 7 days and 1 year postoperative were collected and analyzed.

Results

In the ST group (40 feet), the Gissane's angle altered from (109.89 ± 12.13)° to (121.23 ± 9.34)° and (119.08 ± 8.31)° at 7 days and 1 year postoperative, respectively. For Böhler’s angles altered from (11.44 ± 5.94)°, to (31.39 ± 7.54)°, and (30.61 ± 7.94)° at 7 days and 1 year postoperative, respectively. In the STF group (33 feet), Gissane’s angle altered from (110.47 ± 14.45)°, to (122.08 ± 8.84)°, and (120.67 ± 9.07)° and Böhler’s angle altered from (11.32 ± 6.77)°, to (28.82 ± 8.52)°, and (28.25 ± 9.13)° (P < 0.001). However, there was no statistically significant difference in functional outcomes at 1 week after surgery and 1 year after surgery (P > 0.05). The AOFAS scores at the final follow-up of the two groups: ST group (88.95 ± 6.16) and STF group (89.78 ± 8.76); VAS scores, ST group (0.83 ± 0.98) and STF group (1.03 ± 1.59), all differences were not statistically significant (P > 0.05).

Conclusion

The position of sustentaculum tali screws has no significant difference on the short-term clinical outcome in patients with calcaneal fractures, while reliable fixation of screws to sustentaculum tali fragment can achieve similar clinical outcome.

Level of evidence V.
The negative pressure wound therapy for prevention of sternal wound infection: Can we reduce infection rate after the use of bilateral internal thoracic arteries? A systematic literature review and meta-analysis
Authors: Elhassan Hind , Amjad Ridha , Palaniappan Unna , Loubani Mahmoud , Rose David
Published: February 2024

Background

Negative pressure wound therapy (NPWT) is traditionally used to treat postoperative wound infections. However, its use in closed wound sternotomy post cardiac surgery in high-risk patients has become increasingly popular. The potential preventive benefit of reducing sternal wound infections has been recently acknowledged. Bilateral internal mammary artery (BIMA) grafts are used in coronary artery bypass grafting but have been associated with an increased risk of sternal wound infections (SWIs).

Objectives

This systematic analysis examines whether NPWT can reduce the incidence of SWI following BIMA grafts, leading to more patients benefiting from the better survival outcome associated with BIMA grafting.

Method

A comprehensive systematic search and meta-analysis were performed to identify studies on the use of NPWT in closed wound sternotomy. Ovid MEDLINE (in-process and other nonindexed citations and Ovid MEDLINE 1990 to present), Ovid EMBASE (1990 to present), and The Cochrane Library (Wiley), PubMed, and Google Scholar databases were searched from their inception to May 2022 using keywords and MeSH terms. Thirty-four articles from 1991 to May 2022 were selected.

Result

Three studies reported on the outcome of NPWT following BIMA grafting. The pooled analysis did not show any significant difference in the incidence of sternal wound infection between NPWT and standard dressing (RR 0.48 95% CI 0.17–1.37; P = 0.17) with substantial heterogeneity (I2 65%). Another seven studies were found comparing the outcome of SWI incidence of negative pressure closed wound therapy with conventional wound therapy in patients undergoing adult cardiac surgery. The pooled analysis showed that NPWT was associated with a low risk of SWIs compared to conventional dressing (RR 0.47 95% CI 0.36–0.59; P < 0.00001), with low heterogeneity (I2 1%).

Conclusion

The literature identified that NPWT significantly decreased the incidence of sternal wound complications when applied to sutured sternotomy incisions in high-risk patients, and in some cases, it eliminated the risk. However, the inadequate number of randomized controlled trials assessing the effectiveness of NPWT in BIMA grafting emphasizes the need for further, robust studies.
Cardiorespiratory consequences of attenuated fentanyl and augmented rocuronium dosing during protocolised prehospital emergency anaesthesia at a regional air ambulance service: a retrospective study
Authors: Morton Sarah , Spurgeon Zoey , Ashworth Charlotte , Samouelle James , Sherren Peter B
Published: February 2024

Background

Pre-Hospital Emergency Anaesthesia (PHEA) has undergone significant developments since its inception. However, optimal drug dosing remains a challenge for both medical and trauma patients. Many prehospital teams have adopted a drug regimen of 3 mcg/kg fentanyl, 2 mg/kg ketamine and 1 mg/kg rocuronium (‘3:2:1’). At Essex and Herts Air Ambulance Trust (EHAAT) a new standard dosing regimen was introduced in August 2021: 1 mcg/kg fentanyl, 2 mg/kg ketamine and 2 mg/kg rocuronium (up to a maximum dose of 150 mg) (‘1:2:2’). The aim of this study was to evaluate the cardiorespiratory consequences of a new attenuated fentanyl and augmented rocuronium dosing regimen.

Methods

A retrospective study was conducted at EHAAT as a service evaluation. Anonymized records were reviewed from an electronic database to compare the original (‘3:2:1’) drug dosing regimen (December 2019-July 2021) and the new (‘1:2:2’) dosing regimen (September 2021-May 2023). The primary outcome was the incidence of absolute hypotension within ten minutes of induction. Secondary outcomes included immediate hypertension, immediate hypoxia and first pass success (FPS) rates.

Results

Following exclusions (n = 121), 720 PHEA cases were analysed (360 new vs. 360 original, no statistically significant difference in demographics). There was no difference in the rate of absolute hypotension (24.4% ‘1:2:2’ v 23.8% ‘3:2:1’, p = 0.93). In trauma patients, there was an increased first pass success (FPS) rate with the new regimen (95.1% v 86.5%, p = 0.01) and a reduced incidence of immediate hypoxia (7.9% v 14.8%, p = 0.05). There was no increase in immediate hypertensive episodes (22.7% vs. 24.2%, p = 0.73). No safety concerns were identified.

Conclusion

An attenuated fentanyl and augmented rocuronium dosing regimen showed no difference in absolute hypotensive episodes in a mixed cohort of medical and trauma patients. In trauma patients, the new regimen was associated with an increased FPS rate and reduced episodes of immediate hypoxia. Further research is required to understand the impact of such drug dosing in the most critically ill and injured subpopulation.
Prolonged critical avalanche burial for nearly 23 h with severe hypothermia and severe frostbite with good recovery: a case report
Authors: Gruber Elisabeth , Oberhammer Rosmarie , Brugger Hermann , Bresadola Elisa , Avogadri Matteo , Kompatscher Julia , Kaufmann Marc
Published: February 2024

Background

Accidental hypothermia with severe frostbite is a rare combination of injuries with a high risk for long-term sequelae. There are widely accepted recommendations for the management of avalanche victims and for frostbite treatment, but no recommendation exists for the treatment of frostbite in severe hypothermic patients, specifically for the management of hypothermic avalanche victims presenting with frostbite.

Case presentation

We present a case of a previously healthy, 53-year-old male skier who was critically buried by an avalanche at 2300 m of altitude at an ambient temperature of − 8 °C for nearly 23 h. The victim was found with the right hand out of the snow and an air connection to outside. He was somnolent with Glasgow Coma Scale 11 (Eye 4, Verbal 2, Motor 5) and spontaneously breathing, in a severely hypothermic state with an initial core temperature of 23.1 °C and signs of cold injuries in all four extremities. After rescue and active external forced air rewarming in the intensive care unit, the clinical signs of first-degree frostbite on both feet and the left hand vanished, while third- to fourth-degree frostbite injuries became apparent on all fingers of the right hand. After reaching a core body temperature of approximately 36 °C, aggressive frostbite treatment was started with peripheral arterial catheter-directed thrombolysis with alteplase, intravenous iloprost, ibuprofen, dexamethasone and regional sympathicolysis with a right-sided continuous axillary block. After ten months, the patient had no tissue loss but needed neuropathic pain treatment with pregabalin.

Conclusion

The combination of severe accidental hypothermia and severe frostbite is rare and challenging, as drug metabolism is unpredictable in a hypothermic patient and no recommendations for combined treatment exist. There is general agreement to give hypothermia treatment the priority and to begin frostbite treatment as early as possible after full rewarming of the patient. More evidence is needed to identify the optimal dosage and time point to initiate treatment of frostbite in severely hypothermic patients. This should be taken into consideration by future treatment recommendations.
MRI-based tumor shrinkage patterns after early neoadjuvant therapy in breast cancer: correlation with molecular subtypes and pathological response after therapy
Authors: Wang Mengfan , Du Siyao , Gao Si , Zhao Ruimeng , Liu Shasha , Jiang Wenhong , Peng Can , Chai Ruimei , Zhang Lina
Published: February 2024

Background

MRI-based tumor shrinkage patterns (TSP) after neoadjuvant therapy (NAT) have been associated with pathological response. However, the understanding of TSP after early NAT remains limited. We aimed to analyze the relationship between TSP after early NAT and pathological response after therapy in different molecular subtypes.

Methods

We prospectively enrolled participants with invasive ductal breast cancers who received NAT and performed pretreatment DCE-MRI from September 2020 to August 2022. Early-stage MRIs were performed after the first (1st-MRI) and/or second (2nd-MRI) cycle of NAT. Tumor shrinkage patterns were categorized into four groups: concentric shrinkage, diffuse decrease (DD), decrease of intensity only (DIO), and stable disease (SD). Logistic regression analysis was performed to identify independent variables associated with pathologic complete response (pCR), and stratified analysis according to tumor hormone receptor (HR)/human epidermal growth factor receptor 2 (HER2) disease subtype.

Results

344 participants (mean age: 50 years, 113/345 [33%] pCR) with 345 tumors (1 bilateral) had evaluable 1st-MRI or 2nd-MRI to comprise the primary analysis cohort, of which 244 participants with 245 tumors had evaluable 1st-MRI (82/245 [33%] pCR) and 206 participants with 207 tumors had evaluable 2nd-MRI (69/207 [33%] pCR) to comprise the 1st- and 2nd-timepoint subgroup analysis cohorts, respectively. In the primary analysis, multivariate analysis showed that early DD pattern (OR = 12.08; 95% CI 3.34–43.75; p < 0.001) predicted pCR independently of the change in tumor size (OR = 1.37; 95% CI 0.94–2.01; p = 0.106) in HR+/HER2− subtype, and the change in tumor size was a strong pCR predictor in HER2+ (OR = 1.61; 95% CI 1.22–2.13; p = 0.001) and triple-negative breast cancer (TNBC, OR = 1.61; 95% CI 1.22–2.11; p = 0.001). Compared with the change in tumor size, the SD pattern achieved a higher negative predictive value in HER2+ and TNBC. The statistical significance of complete 1st-timepoint subgroup analysis was consistent with the primary analysis.

Conclusion

The diffuse decrease pattern in HR+/HER2− subtype and stable disease in HER2+ and TNBC after early NAT could serve as additional straightforward and comprehensible indicators of treatment response.

Trial registration: Trial registration at https://www.chictr.org.cn/. Registration number: ChiCTR2000038578, registered September 24, 2020.
SSBlazer: a genome-wide nucleotide-resolution model for predicting single-strand break sites
Authors: Xu Sheng , Wei Junkang , Sun Siqi , Zhang Jizhou , Chan Ting-Fung , Li Yu
Published: February 2024

Single-strand breaks are the major DNA damage in the genome and serve a crucial role in various biological processes. To reveal the significance of single-strand breaks, multiple sequencing-based single-strand break detection methods have been developed, which are costly and unfeasible for large-scale analysis. Hence, we propose SSBlazer, an explainable and scalable deep learning framework for single-strand break site prediction at the nucleotide level. SSBlazer is a lightweight model with robust generalization capabilities across various species and is capable of numerous unexplored SSB-related applications.
Novel genetic markers for chronic kidney disease in a geographically isolated population of Indigenous Australians: Individual and multiple phenotype genome-wide association study
Authors: Arunachalam Vignesh , Lea Rodney , Hoy Wendy , Lee Simon , Mott Susan , Savige Judith , Mathews John D. , McMorran Brendan J. , Nagaraj Shivashankar H.
Published: February 2024

Background

Chronic kidney disease (CKD) is highly prevalent among Indigenous Australians, especially those in remote regions. The Tiwi population has been isolated from mainland Australia for millennia and exhibits unique genetic characteristics that distinguish them from other Indigenous and non-Indigenous populations. Notably, the rate of end-stage renal disease is up to 20 times greater in this population compared to non-Indigenous populations. Despite the identification of numerous genetic loci associated with kidney disease through GWAS, the Indigenous population such as Tiwi remains severely underrepresented and the increased prevalence of CKD in this population may be due to unique disease-causing alleles/genes.

Methods

We used albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) to estimate the prevalence of kidney disease in the Tiwi population (N = 492) in comparison to the UK Biobank (UKBB) (N = 134,724) database. We then performed an exploratory factor analysis to identify correlations among 10 CKD-related phenotypes and identify new multi-phenotype factors. We subsequently conducted a genome-wide association study (GWAS) on all single and multiple phenotype factors using mixed linear regression models, adjusted for age, sex, population stratification, and genetic relatedness between individuals.

Results

Based on ACR, 20.3% of the population was at severely increased risk of CKD progression and showed elevated levels of ACR compared to the UKBB population independent of HbA1c. A GWAS of ACR revealed novel association loci in the genes MEG3 (chr14:100812018:T:A), RAB36 (rs11704318), and TIAM2 (rs9689640). Additionally, multiple phenotypes GWAS of ACR, eGFR, urine albumin, and serum creatinine identified a novel variant that mapped to the gene MEIS2 (chr15:37218869:A:G). Most of the identified variants were found to be either absent or rare in the UKBB population.

Conclusions

Our study highlights the Tiwi population’s predisposition towards elevated ACR, and the collection of novel genetic variants associated with kidney function. These associations may prove valuable in the early diagnosis and treatment of renal disease in this underrepresented population. Additionally, further research is needed to comprehensively validate the functions of the identified variants/genes.
An atlas of cell-type-specific interactome networks across 44 human tumor types
Authors: Li Zekun , Liu Gerui , Yang Xiaoxiao , Shu Meng , Jin Wen , Tong Yang , Liu Xiaochuan , Wang Yuting , Yuan Jiapei , Yang Yang
Published: February 2024

Background

Biological processes are controlled by groups of genes acting in concert. Investigating gene–gene interactions within different cell types can help researchers understand the regulatory mechanisms behind human complex diseases, such as tumors.

Methods

We collected extensive single-cell RNA-seq data from tumors, involving 563 patients with 44 different tumor types. Through our analysis, we identified various cell types in tumors and created an atlas of different immune cell subsets across different tumor types. Using the SCINET method, we reconstructed interactome networks specific to different cell types. Diverse functional data was then integrated to gain biological insights into the networks, including somatic mutation patterns and gene functional annotation. Additionally, genes with prognostic relevance within the networks were also identified. We also examined cell–cell communications to investigate how gene interactions modulate cell–cell interactions.

Results

We developed a data portal called CellNetdb for researchers to study cell-type-specific interactome networks. Our findings indicate that these networks can be used to identify genes with topological specificity in different cell types. We also found that prognostic genes can deconvolved into cell types through analyzing network connectivity. Additionally, we identified commonalities and differences in cell-type-specific networks across different tumor types. Our results suggest that these networks can be used to prioritize risk genes.

Conclusions

This study presented CellNetdb, a comprehensive repository featuring an atlas of cell-type-specific interactome networks across 44 human tumor types. The findings underscore the utility of these networks in delineating the intricacies of tumor microenvironments and advancing the understanding of molecular mechanisms underpinning human tumors.
Lung ultrasound and supine chest X-ray use in modern adult intensive care: mapping 30 years of advancement (1993–2023)
Authors: Vetrugno Luigi , Biasucci Daniele Guerino , Deana Cristian , Spadaro Savino , Lombardi Fiorella Anna , Longhini Federico , Pisani Luigi , Boero Enrico , Cereser Lorenzo , Cammarota Gianmaria , Maggiore Salvatore Maurizio
Published: February 2024

In critically ill patients with acute respiratory failure, thoracic images are essential for evaluating the nature, extent and progression of the disease, and for clinical management decisions. For this purpose, computed tomography (CT) is the gold standard. However, transporting patients to the radiology suite and exposure to ionized radiation limit its use. Furthermore, a CT scan is a static diagnostic exam for the thorax, not allowing, for example, appreciation of "lung sliding". Its use is also unsuitable when it is necessary to adapt or decide to modify mechanical ventilation parameters at the bedside in real-time. Therefore, chest X-ray and lung ultrasound are today's contenders for shared second place on the podium to acquire a thoracic image, with their specific strengths and limitations. Finally, electrical impedance tomography (EIT) could soon have a role, however, its assessment is outside the scope of this review. Thus, we aim to carry out the following points: (1) analyze the advancement in knowledge of lung ultrasound use and the related main protocols adopted in intensive care units (ICUs) over the latest 30 years, reporting the principal publications along the way, (2) discuss how and when lung ultrasound should be used in a modern ICU and (3) illustrate the possible future development of LUS.
Acuity of asthma exacerbations in Alberta, Canada is increasing: a population-based study
Authors: Adatia Adil , Moolji Jalal , Satia Imran
Published: February 2024

Background

Asthma is a common respiratory illness affecting 2.8 million Canadians, including 9.7% of Albertans. Prior studies showed a substantial decrease in ED visits for asthma in the decade preceding 2010, followed by a stabilization. This was attributed to improvements in the pharmacologic and non-pharmacologic treatments for asthma during that period followed by a balance between epidemiologic drivers and protective factors in the population.

Methods

We assessed whether this trend continued in Alberta from 2010 to 2022 using population level data for the volume of daily ED visits, acuity of asthma exacerbations in the ED, and hospitalization rate.

Results

The mean number of ED visits decreased from 4.5 to 2.2 per million persons per day, but the acuity of exacerbations and the proportion requiring hospitalization increased. The number of patients presenting with the highest level of acuity increased by over 300%, and the percentage of patients requiring hospitalization increased from 6.8 to 11.3%.

Conclusion

Total ED visits for asthma exacerbations continues to decline in Alberta. The reasons for an increase in more severe exacerbations requires further attention.
Multi-type concept drift detection under a dual-layer variable sliding window in frequent pattern mining with cloud computing
Authors: Chen Jing , Yang Shengyi , Gao Ting , Ying Yue , Li Tian , Li Peng
Published: February 2024

The detection of different types of concept drift has wide applications in the fields of cloud computing and security information detection. Concept drift detection can indeed assist in promptly identifying instances where model performance deteriorates or when there are changes in data distribution. This paper focuses on the problem of concept drift detection in order to conduct frequent pattern mining. To address the limitation of fixed sliding windows in adapting to evolving data streams, we propose a variable sliding window frequent pattern mining algorithm, which dynamically adjusts the window size to adapt to new concept drifts and detect them in a timely manner. Furthermore, considering the challenge of existing concept drift detection algorithms that struggle to adapt to different types of drifting data simultaneously, we introduce an additional dual-layer embedded variable sliding window. This approach helps differentiate types of concept drift and incorporates a decay model for drift adaptation. The proposed algorithm can effectively detect different types of concept drift in data streams, perform targeted drift adaptation, and exhibit efficiency in terms of time complexity and memory consumption. Additionally, the algorithm maintains stable performance, avoiding abrupt changes due to window size variations and ensuring overall robustness.
Diffusion of medications for opioid use disorder treatment in jail settings: a convergent mixed methods study of jail staff perspectives
Authors: Michener Pryce S. , Evans Elizabeth A. , Ferguson Warren J. , Friedmann Peter D.
Published: February 2024

Background

Implementation of medications for opioid use disorder (MOUD) in jails varies by facility and across states. Organizational climate, including staff attitudes toward change and exposure to education, can influence perceptions of innovations like MOUD in jails. Using a mixed methods design, we aimed to understand the association between organizational climate and jail staff perceptions of MOUD.

Methods

Jail staff (n = 111) who operate MOUD programs in 6 Massachusetts jails completed surveys that included the Organizational Readiness for Implementing Change (ORIC) survey. Random effects logistic regression models assessed associations between organizational climate and several outcomes of perceived MOUD efficacy, acceptability, and knowledge, while controlling for covariates. Jail staff (N = 61) participated in qualitative interviews and focus groups focused on organizational climate and knowledge diffusion, which we analyzed using inductive and deductive methods.

Results

The results indicate that organizational change readiness on the ORIC was associated with positive perceptions of MOUD, and educational resources facilitated MOUD implementation. Greater ORIC was associated with higher perception of methadone as highly acceptable for jail populations (Odds ratio [OR] 2.3, 95% Confidence Interval [CI] 1.2 to 4.4), and high knowledge of methadone (OR 2.3, 95% CI 1.1 to 4.9), with similar magnitude of effects for buprenorphine. High levels of training for jail staff on methadone and buprenorphine were also associated with higher knowledge of these medications (Methadone: OR 7.2, 95% CI 2.2 to 23.2; Buprenorphine: OR 3.4, 95% CI 1.2 to 9.5). Qualitative results point towards the importance of organizational climate and elucidate educational strategies to improve staff perceptions of MOUD.

Conclusion

Results underscore the importance of organizational climate for successful implementation of jail MOUD programs and provide support for medication-specific educational resources as a facilitator of successful MOUD implementation in jail settings. Findings highlight implementation strategies that may improve jail staff perceptions of MOUD.
Assessment of agricultural land suitability for cereal crops based on the analysis of soil physico-chemical characteristics
Authors: Abate Simeneh Gedefaw , Anteneh Mihret Bizuye
Published: February 2024

This research aimed at evaluation of a given land resource suitable for selected rain fed crops production (malt barley, wheat and teff) in Ambesh watershed. It also quantified suitable land and classified into the land mapping units (LMUs), and presents a land suitability map. Land suitability assessment (LSA) made using climatic condition, topography, soil physical and chemical properties as a major factor integrated with a multi criteria decision making (MCDM) analysis in Ambesh watershed. Fourteen composite soil samples were taken by categorizing the watershed into different land mapping units (LMUs) and analyzed in a soil laboratory. Climatic data, rainfall was obtained from two meteorological stations nearby to the study area. Temperature data derived from Landsat 8 satellite thermal bands data. Data obtained from the soil laboratory and others were finally analyzed using ArcGIS environment and priority estimation tool (PriEsT) software’s. Weighted Sum Overlay was implemented to investigate the final LSA map of the watershed. Results revealed that LMUs, VRe–LPq and LPK.Pq–FLc LMUs has higher overall suitability for all the selected rain fed crops. However, LMUs (VRe–NTu and NTu–VRe) has lower overall suitability values particularly for S1 suitability class (0.05% and 10.6%, respectively). The least suitable LMU is VRe–NTu with 0.05% S1 suitability class and above 99% of the land laid under the suitability classes of moderately suitable, marginally suitable and not suitable for the selected land utilization types. Moreover, about 219.06 ha (17.76%), 217.6 ha (17.64%), 168.9 ha (13.7%), of land are highly suitable for malt barley, teff and wheat crop production, respectively. In conclusion, during MCDM, classifying the land into closer homogeneities (LMU) an important application of LSA integrated with remote sensing and GIS for a better decision making. Meanwhile, majority (above two third’s) of the land in the watershed is under moderate and marginally suitable, it needs intensive land management activities to increase the land qualities and obtain high yields. LSA recommended before land utilization decision has to be made. It is also important to classifying the land into LMUs to make it more homogeneous for sample taking and reducing the prestigious soil laboratory analysis costs.
Metagenome-assembled genome reveals species and functional composition of Jianghan chicken gut microbiota and isolation of Pediococcus acidilactic with probiotic properties
Authors: Shen Hongye , Wang Tinghui , Dong Weiwei , Sun Guoping , Liu Jun , Peng Nan , Zhao Shumiao
Published: February 2024

Background

Chickens are one of the most widely farmed animals worldwide and play a crucial role in meat and egg production. Gut microbiota is essential for chickens’ health, disease, growth, and egg production. However, native chickens such as Jianghan chickens have better meat and egg production quality than centralized chickens, their intestinal microbial diversity is richer, and the potential gut microbial resources may bring health benefits to the host.

Results

The bacterial species composition in the gut microbiota of Jianghan chickens is similar to that of other chicken breeds, with Phocaeicola and Bacteroides being the most abundant bacterial genera. The LEfSe analysis revealed significant differences in species composition and functional profiles between samples from Jingzhou and the other three groups. Functional annotation indicated that the gut microbiota of Jianghan chickens were dominated by metabolic genes, with the highest number of genes related to carbohydrate metabolism. Several antibiotic resistance genes (ARGs) were found, and the composition of ARGs was similar to that of factory-farmed chickens, suggesting that antibiotics were widely present in the gut microbiota of Jianghan chickens. The resistance genes of Jianghan chickens are mainly carried by microorganisms of the Bacteroidota and Bacillota phylum. In addition, more than 829 isolates were selected from the microbiota of Jianghan chickens. Following three rounds of acid and bile tolerance experiments performed on all the isolated strains, it was determined that six strains of Pediococcus acidilactici exhibited consistent tolerance. Further experiments confirmed that three of these strains (A4, B9, and C2) held substantial probiotic potential, with P. acidilactici B9 displaying the highest probiotic potential.

Conclusions

This study elucidates the composition of the intestinal microbiota and functional gene repertoire in Jianghan chickens. Despite the absence of antibiotic supplementation, the intestinal microbial community of Jianghan chickens still demonstrates a profile of antibiotic resistance genes similar to that of intensively reared chickens, suggesting resistance genes are prevalent in free-ranging poultry. Moreover, Jianghan and intensively reared chickens host major resistance genes differently, an aspect seldom explored between free-range and pastured chickens. Furthermore, among the 829 isolates, three strains of P. acidilatici exhibited strong probiotic potential. These findings provide insights into the unique gut microbiota of Jianghan chickens and highlight potential probiotic strains offering benefits to the host.
In masks we trust: explicit and implicit reactions to masked faces vary by political orientation
Authors: Ingram Gordon P. D. , Chuquichambi Erick G. , Jimenez-Leal William , Rosa Antonio Olivera-La
Published: February 2024

Previous studies in the context of the COVID-19 pandemic indicated that wearing a medical-style mask affects whether a stranger’s face is judged as more trustworthy, socially desirable, or likely to be ill. However, given political controversies around mask use, these effects might vary by political orientation. In a pre-registered online experiment, we measured evaluations of trustworthiness, social desirability and perceived illness in masked and unmasked faces by 1241 British and US participants. We included questions on political orientation, along with the implicit online-VAAST approach/avoid task to test reaction times to masked/unmasked faces. There was a medium-sized effect of masks on trustworthiness and a significant interaction with political orientation, in that conservatives found masked faces less trustworthy than did liberals. Participants were quicker to approach masked than unmasked faces, but conservatives were relatively slower than liberals. The effects on trustworthiness suggest that differential moralization of novel social norms can affect how their adherents are evaluated in terms of their suitability for social interactions. Furthermore, the congruence between implicit and explicit methods implies that such differences can have deep-seated effects on reactions.
The use of predominance area diagrams (PAD) to determine the oxygen and sulfur fugacities prevailing during historical metallurgical processes: the case of fifteenth to seventeenth century copper slags from Polichno (Old Polish industrial district)
Authors: Kupczak Krzysztof , Warchulski Rafał , Gawęda Aleksandra , Ślęzak Marta , Migas Piotr
Published: February 2024

The study presents the first use of predominance area diagrams (PADs) to determine oxidation–reduction conditions during reconstructing historical copper smelting processes. The smelting temperature and oxygen and sulfur fugacities during smelting were determined based on experiments and the geochemical (ICP-MS/ES, XRF) and mineralogical (SEM, EPMA) analyses of the fifteenth to seventeenth century slags from Polichno (Holy Cross Mountains, Poland). Results obtained during high-temperature experiments allowed to determine the slags' solidus and liquidus temperatures. The liquidus temperature was in the range of 1100–1200 °C, and the solidus temperature was in the range of 800–1100 °C. Data on temperature conditions were used in thermodynamic calculations to construct predominance area diagrams and then to determine the ranges of oxygen and sulfur fugacities in which the formation of slags was possible. Slags from Polichno were formed with the oxygen fugacity in the range of

$$\text{logP}_{{\text{O}}_2}$$

logP

O
2

 = − 4.30 (POL1, POL4 at 1200 °C) to − 14.08 atm. (POL3 at 1090 °C). In turn, the sulfur fugacity during slag formation ranged from

$$\text{logP}_{{\text{S}}_2}$$

logP

S
2

 = − 2.50 (POL5 at 1200 °C) to − 6.92 (POL4 at 1060 °C) atm. The relatively high sulfur availability confirms using sulfide ores without prior roasting. The wide range of sulfur and oxygen fugacity indicates the process's heterogeneity.
Analysis of forage quality, volatile organic compounds and metabolic pathways in alfalfa (Medicago sativa L.) at different stages based on electronic nose and GC-MS
Authors: Liu Yichao , Wang Zhijun , Sun Lin , Bao Jian , Si Qiang , Liu Mingjian , Sun Pengbo , Ge Gentu , Jia Yushan , Liu Tingyu
Published: February 2024

The odor of alfalfa (Medicago sativa L.), the most extensively cultivated forage, can interfere with livestock feeding. This study used an electronic nose in conjunction with gas chromatography–mass spectrometry (GC–MS) to examine the quality, volatile organic compounds (VOCs), and metabolic pathways of alfalfa at budding (X), early flowering (C), and full flowering (S) stages. Results showed that terpenoids increased first and then decreased with growth and development, heterocyclic substances decreased continuously, and alcohols and ketones increased. The crude protein and ether extract decreased and were positively correlated with terpenoids, heterocycles, and nitrogen and sulfur compounds, while the dry matter content, soluble carbohydrates, and neutral detergent fiber increased and were positively correlated with alcohols and ketones. The VOCs were most accumulated in the early flowering stages, which had more sweet and fruity flavors, and the main substances that differed from the budding stage and the full flowering stage were methyl heptanoate, butyl butyrate, β-ionone, and other esters and terpenoids. The monoterpene, sesquiterpene, and triterpene pathways were up-regulated in the early flowering stage, and the phenyl-propylene synthesis pathway was up-regulated in the full flowering stage. These substances and pathways were key to further improving alfalfa odor, grade and utilization.

Graphical Abstract
PAM trial protocol: a randomised feasibility study of psychedelic microdosing–assisted meaning-centred psychotherapy in advanced stage cancer patients
Authors: Wells Alesha , Muthukumaraswamy A. P. Suresh , Morunga Eva , Evans Will , Cavadino Alana , Bansal Mahima , Lawrence Nicola J. , Ashley Amanda , Hoeh Nicholas R. , Sundram Frederick , Applebaum Allison J. , Parkinson Hineatua , Reynolds Lisa
Published: February 2024

Background

An advanced cancer diagnosis can be associated with a significant profile of distress. Psychedelic compounds have shown clinically significant effects in the treatment of psychological distress in patients with advanced-stage cancer. Given the challenges of delivering timely and effective intervention in the advanced cancer context, it is possible that an alternative, more pragmatic, approach lies in psychedelic ‘microdosing’. Microdosing refers to repeated administration of psychedelics in sub-hallucinogenic doses. The purpose of this study is to evaluate the feasibility of conducting a full-scale randomised controlled trial comparing psychedelic microdose-assisted–meaning-centred psychotherapy (PA-MCP) to standard meaning-centred psychotherapy (MCP) in New Zealand indigenous (Māori) and non-indigenous people with advanced cancer and symptoms of anxiety and/or depression. Although MCP is a well-established psychotherapeutic treatment in advanced cancer populations, the potential efficacy and effectiveness of this therapy when delivered alongside a standardised microdose regimen of a psychedelic compound have not been investigated.

Methods

Participants with advanced-stage cancer and symptoms of anxiety and/or depression (N = 40; 20 Māori, 20 non-Māori) will be randomised under double-blind conditions to receive 7 sessions of MCP alongside 13 doses of either an LSD microdose (4–20 µg) (PA–MCP) or inactive placebo (placebo-MCP). The feasibility, acceptability, and safety of this intervention and physiological and psychological measures will be recorded at baseline, at each session of MCP, and at a 1-month and 6-month follow-up.

Discussion

Our findings will evaluate the feasibility, acceptability, and safety of a larger randomised controlled trial and provide an initial indication of the potential benefits of psychedelic microdosing for psychological distress in advanced-stage indigenous and non-indigenous cancer patients.

Trial Registration

NZCTR, ACTRN12623000478617. Registered 11 May 2023. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385810&isReview=true.
How do residents respond to uncertainty with peers and supervisors in multidisciplinary teams? Insights from simulations with epistemic fidelity
Authors: Blissett Sarah , Skinner Jamila , Banner Harrison , Cristancho Sayra , Taylor Taryn
Published: February 2024

Background

Residents struggle to express clinical uncertainty, often exhibiting negative cognitive, behavioral, and emotional responses to uncertainty when engaging with patients or supervisors. However, the Integrative Model of Uncertainty Tolerance posits that individuals may have positive or negative responses to perceived uncertainty. Situational characteristics, such as interactions with other health professionals, can impact whether the response is positive or negative. The team context in which residents interact with resident peers and supervisors could represent varying situational characteristics that enable a spectrum of responses to uncertainty. Understanding the situational characteristics of multidisciplinary teams that allow residents to display positive responses to perceived uncertainty could inform strategies to foster positive responses to uncertainty in other contexts. We explored resident responses to perceived uncertainty in a simulated multidisciplinary team context.

Methods

A simulation-primed qualitative inquiry approach was used. Fourteen residents from Cardiology and Obstetrics and Gynecology participated in simulation scenarios involving pregnant patients with heart disease. We incorporated epistemic fidelity through the deliberate inclusion of ambiguity and complexity to prompt uncertainty. Audio recordings of debriefing sessions were analyzed using directed content analysis.

Results

Residents recognized that uncertainty is unavoidable, and positive responses to uncertainty are crucial to team dynamics and patient safety. While residents had positive responses to expressing uncertainty to peers, they had predominantly negative responses to expressing uncertainty to supervisors. Predominant negative response to supervisors related to judgement from supervisors, and impacts on perceived trustworthiness or independence. Although residents recognized expressing uncertainty to a supervisor could identify opportunities for learning and resolve their uncertainty, the negative responses overshadowed the positive responses. Residents highly valued instances in which supervisors were forthcoming about their own uncertainty.

Conclusions

Through participation in simulations with epistemic fidelity, residents reflected on how they perceive and respond to uncertainty in multidisciplinary teams. Our findings emphasize the role of situational characteristics, particularly peers and supervisors, in moderating responses to perceived uncertainty. The productive discussions around responses to uncertainty in debriefing sessions suggest further studies of multidisciplinary simulations could enhance our understanding of how uncertainty is expressed, and potentially be used as an instructional intervention to promote positive responses to uncertainty.