bluuebunny/crossref_metadata_2025 huggingface dataset:
Prophylactic surfactant nebulisation for the early aeration of the preterm lung: a randomised clinical trial
Authors: Gaertner Vincent D , Minocchieri Stefan , Waldmann Andreas D , Mühlbacher Tobias , Bassler Dirk , Rüegger Christoph Martin
Published: November 2022

Objective

The effect of prophylactic surfactant nebulisation (SN) is unclear. We aimed to determine whether prophylactic SN improves early lung aeration.

Design

Parallel, randomised clinical trial, conducted between March 2021 and January 2022.

Setting

Delivery room (DR) of a tertiary neonatal centre in Zurich, Switzerland.

Patients

Preterm infants between 260/7and 316/7weeks gestation

Interventions

Infants were randomised to receive positive distending pressure alone or positive distending pressure and additional SN (200 mg/kg; poractant alfa) using a customised vibrating membrane nebuliser. SN commenced with the first application of a face mask immediately after birth.

Main outcome measures

Primary outcome was the difference in end-expiratory lung impedance from birth to 30 min after birth (∆EELI30min). EELI correlates well with functional residual capacity. Secondary outcomes included physiological and clinical outcomes.

Results

Data from 35 infants were collected, and primary outcome data were analysed from 32 infants (n=16/group). Primary outcome was not different between intervention and control group (median (IQR): 25 (7–62) vs 10 (0–26) AU/kg, p=0.21). ∆EELI was slightly higher in the intervention group at 6 and 12 hours after birth, particularly in the central areas of the lung. There were no differences in cardiorespiratory and clinical parameters. Two adverse events were noted in the intervention group.

Conclusions

Prophylactic SN in the DR did not significantly affect ∆EELI30minand showed only minimal effects on lung physiology. Prophylactic SN in the DR was feasible. There were no differences in clinical outcomes.

Trial registration number

NCT04315636.
Impact of the COVID-19 pandemic on psychosocial work factors and emotional exhaustion among workers in the healthcare sector: a longitudinal study among 1915 Dutch workers
Authors: van Elk Fleur , Robroek Suzan J W , Burdorf Alex , Oude Hengel Karen M
Published: November 2022

Objectives

This study aims to investigate across subgroups of healthcare workers (1) the changes in psychosocial working conditions and emotional exhaustion during the pandemic compared with the situation before, and (2) the impact of different stages of the COVID-19 pandemic in terms of hospital pressure on psychosocial working conditions and emotional exhaustion.

Methods

Five questionnaire measurements during 2 years from 1915 healthcare workers in the longitudinal study ‘the Netherlands Working Conditions Survey-COVID-19’ were used. At each measurement, three subgroups were defined: working with patients with COVID-19, working with other patients and not working with patients. For each measurement, hospital pressure was determined by number of hospitalisations per day. Linear mixed models were fitted to analyse differences across subgroups of healthcare workers.

Results

During COVID-19, psychosocial working conditions deteriorated among healthcare workers working with patients, in particular with patients with COVID-19, compared with healthcare workers not working with patients after correcting for the situation before COVID-19. No changes were observed for emotional exhaustion in any of the subgroups. An increasing hospital pressure improved job autonomy and reduced emotional demands among healthcare workers in COVID-19 wards, but had no influence on other psychosocial working conditions and emotional exhaustion.

Conclusion

Psychosocial working conditions deteriorated for healthcare workers working with (COVID-19) patients during the pandemic, while emotional exhaustion did not change among all groups of healthcare workers.
Mortality in non-exacerbating COPD: a longitudinal analysis of UK primary care data
Authors: Lenoir Alexandra , Whittaker Hannah , Gayle Alicia , Jarvis Debbie , Quint Jennifer K
Published: November 2022

Introduction

Non-exacerbating patients with chronic obstructive pulmonary disease (COPD) are a less studied phenotype. We investigated clinical characteristics, mortality rates and causes of death among non-exacerbating compared with exacerbating patients with COPD.

Methods

We used data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics between 1 January 2004 and 31 December 2018. Ever smokers with a COPD diagnosis with minimum 3 years of baseline information were included. We compared overall using Cox regression and cause-specific mortality rates using competing risk analysis, adjusted for age, sex, deprivation, smoking status, body mass index, GOLD stage and comorbidities. Causes of death were identified using International Classification of Diseases-10 codes.

Results

Among 67 516 patients, 17.3% did not exacerbate during the 3-year baseline period. Mean follow-up was 4 years. Non-exacerbators were more likely to be male (63.3% vs 52.4%, p<0.001) and less often had a history of asthma (33.9% vs 43.6%, p<0.001) or FEV1<50% predicted (23.7 vs 31.8%) compared with exacerbators. Adjusted HR for overall mortality in non-exacerbators compared with exacerbators was 0.62 (95% CI 0.56 to 0.70) in the first year of follow-up and 0.87 (95% CI 0.83 to 0.91) thereafter. Non-exacerbating patients with COPD died less of respiratory causes than exacerbators (29.2% vs 40.3%) and more of malignancies (29.4% vs 23.4%) and cardiovascular diseases (26.2% vs 22.9%). HRs for malignant and circulatory causes of death were increased after the first year of follow-up.

Discussion

In this primary care cohort, non-exacerbators showed distinct clinical characteristics and lower mortality rates. Non-exacerbators were equally likely to die of respiratory, malignant or cardiovascular diseases.
Acupuncture May Be a Potential Complementary Therapy for Alzheimer’s Disease: A Network Meta-Analysis
Authors: Yin Wenshan , Chen Yihan , Xu Anping , Tang Yinshan , Zeng Qingtao , Wang Xin , Li Zhigang
Published: November 2022

With Alzheimer’s disease (AD) becoming a worldwide problem, traditional Chinese medicine (TCM), especially acupuncture, stands out as a complementary therapy because of its feature—“treatment based on syndrome differentiation”. This systematic review and network meta-analysis (NMA) confirms the complement effect of acupuncture and explores the best combination of therapy for AD based on the total effect and activity of daily living scale (ADL). We searched relevant randomized controlled trials (RCTs) that applied acupuncture for treating AD. 58 studies with 4334 patients were included in accordance with PRISMA guidelines. The results showed that for the total effect, the order of probability for the effect: acupuncture + western medicine > acupuncture + herbal medicine > acupuncture > acupuncture + western medicine + herbal medicine. For the ADL score, the order of probability for the effect: acupuncture + western medicine > acupuncture > acupuncture + western medicine + herbal medicine > acupuncture + herbal medicine. The combination of acupuncture and medicine has a better clinical effect than acupuncture only in a way. Acupuncture + western medicine has an obvious and exact improvement in the curative effect from both total effect and ADL score, but further higher quality studies, which can detail the classification of these interventions, are still needed to verify it.
Potential Biotics for Nutritional Improvement of Health via Microbiome-Gut-Brain Axis
Authors: Niazi Madiha Khan , Hassan Farooq
Published: November 2022

People’s dietary consumption is significantly influenced by biological, social, and psychological behaviours; as a result, complexes regarding their health arise. Due to the nutraceutical advantages of functional foods and supplements, a variety of fermented foods and beverages are now available to consumers. The properties of probiotics, prebiotics, postbiotics, and paraprobiotics are discussed in this overview along with their importance to diet and long-term health. Several synbiotic products, which are complimentary blends of chosen, defined probiotic cultures and prebiotic substrates, have drawn consumers’ attention in the nutraceutical sector recently. Probiotics and symbiotic preparations are distinct from the traditional fermented foods eaten in various cultures, even if they might be thought of as possible biotics in food. Because they are prepared with seasonal raw ingredients obtained from regional agricultural techniques, fermented foods are affordable and a staple diet component in many nations. All of the biotics mentioned in this article are meant to increase the number of good microbes in the gut, which has been shown to be crucial for the microbiome-gut-brain axis, which affects the activity of the vagus nerve.
The Tensor Brain: A Unified Theory of Perception, Memory, and Semantic Decoding
Authors: Tresp Volker , Sharifzadeh Sahand , Li Hang , Konopatzki Dario , Ma Yunpu
Published: November 2022

We present a unified computational theory of an agent's perception and memory. In our model, both perception and memory are realized by different operational modes of the oscillating interactions between a symbolic index layer and a subsymbolic representation layer. The two layers form a bilayer tensor network (BTN). The index layer encodes indices for concepts, predicates, and episodic instances. The representation layer broadcasts information and reflects the cognitive brain state; it is our model of what authors have called the “mental canvas” or the “global workspace.” As a bridge between perceptual input and the index layer, the representation layer enables the grounding of indices by their subsymbolic embeddings, which are implemented as connection weights linking both layers. The propagation of activation to earlier perceptual processing layers in the brain can lead to embodiments of indices. Perception and memories first create subsymbolic representations, which are subsequently decoded semantically to produce sequences of activated indices that form symbolic triple statements. The brain is a sampling engine: only activated indices are communicated to the remaining parts of the brain. Triple statements are dynamically embedded in the representation layer and embodied in earlier processing layers: the brain speaks to itself. Although memory appears to be about the past, its main purpose is to support the agent in the present and the future. Recent episodic memory provides the agent with a sense of the here and now. Remote episodic memory retrieves relevant past experiences to provide information about possible future scenarios. This aids the agent in decision making. “Future” episodic memory, based on expected future events, guides planning and action. Semantic memory retrieves specific information, which is not delivered by current perception, and defines priors for future observations. We argue that it is important for the agent to encode individual entities, not just classes and attributes. Perception is learning: episodic memories are constantly being formed, and we demonstrate that a form of self-supervised learning can acquire new concepts and refine existing ones. We test our model on a standard benchmark data set, which we expanded to contain richer representations for attributes, classes, and individuals. Our key hypothesis is that obtaining a better understanding of perception and memory is a crucial prerequisite to comprehending human-level intelligence.
Study on Noise Reduction of Tunable Diode Laser Absorption Spectroscopy Detection Signal Based on Complete Ensemble Empirical Mode Decomposition with Adaptive Noise-Detrended Fluctuation Analysis-Wavelet Soft Threshold
Authors: Zhao An-Sheng , Yang Xu , An Xiao-Feng , Zhang He , Zhang Shi-Da
Published: November 2022

Tunable diode laser absorption spectroscopy (TDLAS) is a significant technique for measuring gas concentration in the combustion field. When the gas concentration is detected by wavelength modulation spectroscopy, the second harmonic (2f) signal demodulated by a lock-in amplifier can
be analyzed to obtain the gas concentration information. However, the 2f signal will be affected by the white Gaussian noise of electronic equipment and the optical fringe of the standard instrument, which will lead to the reduction of the gas detection accuracy. To solve the above problems,
this paper proposes a 2f signal noise reduction algorithm based on the complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN), detrended fluctuation analysis (DFA), and wavelet soft threshold (WST). Taking CO2 gas as an example, the 2f signal extracted from
the experiment was denoised, and the amplitude of the 2f signal was linearly fitted to the gas concentration. The R2 value was 0.9979, and the SNR was 31.9750 dB. The denoising effect is obvious, and the denoising algorithm can better retain the peak information of the second
harmonic signal. In this paper, the existing classical noise reduction algorithm is simulated and analyzed. To display the noise reduction effect visually in the time-frequency domain, the Hilbert-Huang transform three-dimensional spectrum is introduced to analyze the spectrum characteristics
of the noise reduction signal.
Evaluation of Cost-Effective Flexible High-Speed Data Exchange Links for Heterogeneously Integrated Multi-Chip Modules and Boards
Authors: Miao Min , Zhang Zhuanzhuan , Nie Xin , Bu Jingpeng
Published: November 2022

With increasing complexity and heterogeneity, miniaturized integrated system on both multi-chip module and printed circuit board levels relies more and more on high-speed point-to-point serial signal transmission links as the backbone of inter-chip data signal exchange network, which
are inevitably accompanied by signal integrity problems such as loss, reflection, and crosstalk. The difficulties in the physical design phase of interconnect routing for high-speed link on densely occupied package interposers or printed circuit boards and the associated planar area overhead
(keep-out zone for the crosstalk prevention and impedance matching, etc.), as well as the relevant cost in manufacturing, performance analysis and actual measurement or evaluation, are also sharply increasing; furthermore, the interconnects implemented on interposer or printed circuit board
substrate are physically inflexible, and the corresponding microsystems are not suitable for emerging applications that generally demand good deformability and good conformality to 3-dimensionally shaped mounting surface. How to simultaneously elevate the cost-effectiveness, signal transmission
performance and physical flexibility of the high-speed link, while keeping low profile of the whole module, has become one of the major challenges in the evolution of micro/nano system technology. Accordingly, this paper proposes a cable-based point-to-point link method, which adopts physically
flexible and widely available off-the-shell cables that can be assembled onto the surface of the interposers or boards as a potential cost-effective solution to the challenge mentioned above. Universal Serial Bus, micro-coaxial cables, and Twinax cables are explored as candidates. The full
links for each cable, from one of the paired connectors to another, are physically modeled and validated by an electromagnetic full-wave structural simulation tool, with key components of each type of link taken into considerations. The simulated results and the measured results from vector
network analyzers are compared, which verifies the effectiveness of our proposal.
Behavior Prediction Scheme Using Hierarchical Clustering and Deep Neural Networks
Authors: Altameem Arwa A. , Hafez Alaaeldin M.
Published: November 2022

Nowadays, most companies are utilizing customer behavior mining frameworks to improve their business strategies. These frameworks are used to predict different business patterns, such as sales, forecasting, or marketing. Different data mining and machine learning concepts have been
applied to predict customer behaviors. However, traditional approaches consume more time and fail to predict exact user behaviors. In this paper, intelligent techniques, such as fuzzy clustering and deep learning approaches, are utilized to investigate customer portfolios to detect customers’
purchasing patterns. To accomplish this objective, hierarchical fuzzy clustering was applied to compute the relationship between products and purchasing criteria. According to the analysis, similar data are grouped together, which reduces the maximum error classification problem. Then, an
optimized deep recurrent neural network is incorporated into this process to improve the prediction rate. The discussed system efficiency is evaluated using a number of datasets with respective performance metrics. The proposed approach was compared to other single model-based and hybrid model-based
approaches and was found to attain maximum accuracy and minimum error rate in comparison.
Analysis of long non-coding RNA expression profile of bovine monocyte-macrophage infected by Mycobacterium avium subsp. paratuberculosis
Authors: Bao Yanhong , Wu Shuiyin , Yang Tianze , Wang Zi , Wang Yiming , Jiang Xiuyun , Ma Hongxia
Published: November 2022

Mycobacterium avium subsp. paratuberculosis (MAP) is the causative agent of paratuberculosis. As a potential zoonotic pathogen, MAP also seriously threatens human health and social security. At present, long non-coding RNA (lncRNA) has attracted wide attention as an useful biomarker in various diseases. Therefore, our study analyzed the lncRNA expression profiles and lncRNA-mRNA regulatory network of MAP infected bovine monocytes-macrophages and uninfected bovine cells by high-throughput sequencing. A total of 4641 differentially expressed lncRNAs genes were identified, including 3111 up-regulated genes and 1530 down-regulated genes. In addition, lncRNA-mRNA interaction analysis was performed to predict the target genes of lncRNA. Among them, after MAP infection, 86 lncRNAs targeted to mRNA, of which only 6 genes were significantly different. The results of Gene Ontology (GO) enrichment analysis showed that the differentially expressed genes significantly enriched in functional groups were related to immune regulation. Multiple signal pathways including NF-κB, NOD-like receptor, Cytokine-cytokine receptor, Toll-like receptor signaling pathway, Chemokine signaling pathway, and other important biochemical, metabolic and signal transduction pathways were enriched in Kyoto Encyclopedia of Genes and Genomes (KEGG). In this study, analysis of macrophage transcriptomes in response to MAP infection is expected to provide key information to deeply understand role of the pathogen in initiating an inappropriate and persistent infection in susceptible hosts and molecular mechanisms that might underlie the early phases of paratuberculosis.
Maize Lethal Necrosis disease: review of molecular and genetic resistance mechanisms, socio-economic impacts, and mitigation strategies in sub-Saharan Africa
Authors: Biswal Akshaya Kumar , Alakonya Amos Emitati , Mottaleb Khondokar Abdul , Hearne Sarah J. , Sonder Kai , Molnar Terence Luke , Jones Alan M. , Pixley Kevin Vail , Prasanna Boddupalli Maruthi
Published: November 2022

Background

Maize lethal necrosis (MLN) disease is a significant constraint for maize producers in sub-Saharan Africa (SSA). The disease decimates the maize crop, in some cases, causing total crop failure with far-reaching impacts on regional food security.

Results

In this review, we analyze the impacts of MLN in Africa, finding that resource-poor farmers and consumers are the most vulnerable populations. We examine the molecular mechanism of MLN virus transmission, role of vectors and host plant resistance identifying a range of potential opportunities for genetic and phytosanitary interventions to control MLN. We discuss the likely exacerbating effects of climate change on the MLN menace and describe a sobering example of negative genetic association between tolerance to heat/drought and susceptibility to viral infection. We also review role of microRNAs in host plant response to MLN causing viruses as well as heat/drought stress that can be carefully engineered to develop resistant varieties using novel molecular techniques.

Conclusions

With the dual drivers of increased crop loss due to MLN and increased demand of maize for food, the development and deployment of simple and safe technologies, like resistant cultivars developed through accelerated breeding or emerging gene editing technologies, will have substantial positive impact on livelihoods in the region. We have summarized the available genetic resources and identified a few large-effect QTLs that can be further exploited to accelerate conversion of existing farmer-preferred varieties into resistant cultivars.
The application of an age adjusted D-dimer threshold to rule out suspected venous thromboembolism (VTE) in an emergency department setting: a retrospective diagnostic cohort study
Authors: Barrett Liam , Jones Tom , Horner Daniel
Published: November 2022

Background

Venous Thromboembolic disease (VTE) poses a diagnostic challenge for clinicians in acute care. Over reliance on reference standard investigations can lead to over treatment and potential harm.

We sought to evaluate the pragmatic performance and implications of using an age adjusted D-dimer (AADD) strategy to rule out VTE in patients with suspected disease attending an emergency department (ED) setting. We aimed to determine diagnostic test characteristics and assess whether this strategy would result in proportional imaging reduction and potential cost savings.

Methods

Design: Single centre retrospective diagnostic cohort study.

All patients > 50 years old evaluated for possible VTE who presented to the emergency department over a consecutive 12-month period between January and December 2016 with a positive D-dimer result. Clinical assessment records and reference standard imaging results were followed up by multiple independent adjudicators and coded as VTE positive or negative.

Results

During the study period, there were 2132 positive D-dimer results. One thousand two hundred thirty-six patients received reference standard investigations. A total increase of 314/1236 (25.1%) results would have been coded as true negatives as opposed to false positive if the AADD cut off point had been applied, with 314 reference standard tests subsequently avoided. The AADD cut off had comparable sensitivity to the current cut off despite this increase in specificity; sensitivities for the diagnosis of DVT were 99.28% (95% CI 96.06–99.98%) and 97.72% for PE (95% CI 91.94% to 97.72). There were 3 false negative results using the AADD strategy.

Conclusions

In patients with suspected VTE with a low or moderate pre-test probability, the application of AADD appears to increase the proportion of patients in which VTE can be excluded without the need for reference standard imaging. This management strategy is likely to be associated with substantial reduction in anticoagulation treatment, investigations and cost/time savings.
Using a cohort study of diabetes and peripheral artery disease to compare logistic regression and machine learning via random forest modeling
Authors: Austin Andrea M. , Ramkumar Niveditta , Gladders Barbara , Barnes Jonathan A. , Eid Mark A. , Moore Kayla O. , Feinberg Mark W. , Creager Mark A. , Bonaca Marc , Goodney Philip P.
Published: November 2022

Background

This study illustrates the use of logistic regression and machine learning methods, specifically random forest models, in health services research by analyzing outcomes for a cohort of patients with concomitant peripheral artery disease and diabetes mellitus.

Methods

Cohort study using fee-for-service Medicare beneficiaries in 2015 who were newly diagnosed with peripheral artery disease and diabetes mellitus. Exposure variables include whether patients received preventive measures in the 6 months following their index date: HbA1c test, foot exam, or vascular imaging study. Outcomes include any reintervention, lower extremity amputation, and death. We fit both logistic regression models as well as random forest models.

Results

There were 88,898 fee-for-service Medicare beneficiaries diagnosed with peripheral artery disease and diabetes mellitus in our cohort. The rate of preventative treatments in the first six months following diagnosis were 52% (n = 45,971) with foot exams, 43% (n = 38,393) had vascular imaging, and 50% (n = 44,181) had an HbA1c test. The directionality of the influence for all covariates considered matched those results found with the random forest and logistic regression models. The most predictive covariate in each approach differs as determined by the t-statistics from logistic regression and variable importance (VI) in the random forest model. For amputation we see age 85 + (t = 53.17) urban-residing (VI = 83.42), and for death (t = 65.84, VI = 88.76) and reintervention (t = 34.40, VI = 81.22) both models indicate age is most predictive.

Conclusions

The use of random forest models to analyze data and provide predictions for patients holds great potential in identifying modifiable patient-level and health-system factors and cohorts for increased surveillance and intervention to improve outcomes for patients. Random forests are incredibly high performing models with difficult interpretation most ideally suited for times when accurate prediction is most desirable and can be used in tandem with more common approaches to provide a more thorough analysis of observational data.
Gambling, fast food and alcohol sponsorship in elite sport – perspectives from Australian sporting fans
Authors: Boelsen-Robinson Tara , Thow Anne-Marie , Lee Nancy , Gill Tim , Colagiuri Stephen
Published: November 2022

Background

Public health bodies in Australia remain concerned about marketing of unhealthy commodities; namely unhealthy food, alcohol and gambling products. Children are particularly susceptible to the influence of unhealthy commodity marketing. This study explored adults’ perceptions of unhealthy commodities sponsorship in elite sport and policies to restrict them.

Methods

Four focus groups of 7–8 frequent sport spectators were recruited, including parents and non-parents, and located in inner and outer suburbs of Sydney, Australia. Results were analysed thematically.

Results

Participants identified the contradictions of healthy messages of sport and unhealthy commodities, while highlighting the commercial value of sport sponsorship to sporting clubs. There is concern around children’s exposure to effective and integrated marketing techniques when viewing sport, which encouraged unhealthy habits. Support for restricting sponsorship related to perceived product harm, with gambling viewed as having the greatest health impact. Participants were supportive of policies that reduced exposure of unhealthy commodities to children, but were concerned about the financial risk to sporting clubs. Governments and sports associations were identified as holding responsibility for enacting changes.

Conclusion

A number of options were identified for advocates to gain public and political traction to reduce unhealthy commodity sponsorship. There is potential for shifts away from unhealthy sponsorship by both governments and sports associations.
The socioeconomic impact of tuberculosis on children and adolescents: a scoping review and conceptual framework
Authors: Atkins S. , Heimo L , Carter DJ , Ribas Closa M. , Vanleeuw L. , Chenciner L. , Wambi P. , Sidney-Annerstedt K. , Egere U , Verkuijl S , Brands A , Masini T , Viney K , Wingfield T. , Lönnroth K , Boccia D.
Published: November 2022

Background

Tuberculosis (TB) has been repeatedly shown to have socioeconomic impacts in both individual-level and ecological studies; however, much less is known about this effect among children and adolescents and the extent to which being affected by TB during childhood and adolescence can have life-course implications. This paper describes the results of the development of a conceptual framework and scoping review to review the evidence on the short- and long-term socioeconomic impact of tuberculosis on children and adolescents.

Objectives

To increase knowledge of the socioeconomic impact of TB on children and adolescents.

Methods

We developed a conceptual framework of the socioeconomic impact of TB on children and adolescents, and used scoping review methods to search for evidence supporting or disproving it. We searched four academic databases from 1 January 1990 to 6 April 2021 and conducted targeted searches of grey literature. We extracted data using a standard form and analysed data thematically.

Results

Thirty-six studies (29 qualitative, five quantitative and two mixed methods studies) were included in the review. Overall, the evidence supported the conceptual framework, suggesting a severe socioeconomic impact of TB on children and adolescents through all the postulated pathways. Effects ranged from impoverishment, stigma, and family separation, to effects on nutrition and missed education opportunities. TB did not seem to exert a different socioeconomic impact when directly or indirectly affecting children/adolescents, suggesting that TB can affect this group even when they are not affected by the disease. No study provided sufficient follow-up to observe the long-term socioeconomic effect of TB in this age group.

Conclusion

The evidence gathered in this review reinforces our understanding of the impact of TB on children and adolescents and highlights the importance of considering effects during the entire life course. Both ad-hoc and sustainable social protection measures and strategies are essential to mitigate the socioeconomic consequences of TB among children and adolescents.
Socio-economic and demographic factors influencing open defecation in Haiti: a cross-sectional study
Authors: Paul Bénédique , Jean Simon David , Kiragu Ann , Généus Woodley , Emmanuel Evens
Published: November 2022

Background

Open defecation (OD) remains an important public health challenge in Haiti. The practice poses a significantly high risk of disease transmission. Considering these negative health consequences, this paper aims to identify socio-economic and demographic factors that influence OD practice among households in Haiti.

Methods

The study used secondary data from 13,405 households from the Haiti Demographic and Health Survey 2016-2017. Descriptive statistics and bivariate analysis were used to find the preliminary results. Further, multivariate analysis was performed to confirm the findings.

Results

Around one quarter (25.3%) of Haitian households still defecate in the open, almost 10% in urban areas, and nearly 36% in rural areas. Multivariate analysis revealed that the age and sex of the household head, household size, number of children aged 1-14 years old in the household, education level, wealth index, access to mass media, place of residence, and region were significant predictors of OD practice among households in Haiti.

Conclusion

To accelerate the elimination of OD by 2030 and therefore achieve sustainable open defecation-free status, the government of Haiti and its partners should consider wealth disparities among regions and mobilize mass media and community-based networks to raise awareness and promote education about sane sanitation practices. Furthermore, because the possibilities to build toilets differ between rural and urban areas, specific interventions must be spearheaded for each of these regions. The public program can subsidize individual toilets in rural areas with room to collect dry excreta for the preparation of fertilizers, while in urban areas collective toilets can be built in slums. Interventions should also prioritize households headed by women and young people, two underpriviledged socioeconomic groups in Haiti.
Comparative proteomic analysis of mustard lung as a complicated disease using systems biology approach
Authors: Parvin Shahram , Arabfard Masoud , Ghazvini Ali , Ghanei Mostafa , Najafi Ali
Published: November 2022

During Iraq-Iran conflict, chemical weapons, particularly SM gas, were used numerous times, whose aftereffects are still present. This study aimed to compare serum proteome in the chronic ML (n = 10) and HC (n = 10). TMT label-based quantitative proteomics was used to examine serums from two groups. Among total significant proteins, 14 proteins were upregulated (log2 ≥ FC 0.5, p 0.05), and 6 proteins were downregulated (log2 ≤ FC − 0.5, p 0.05). By helping PPI network, and EA, 11 main pathways connected to significantly different protein expression levels were discovered, including inflammatory and cell adhesion signaling pathways. It may be deduced that the wounded organs of exposed individuals experience poor repair cycles of cell degeneration and regeneration because certain repair signals were elevated while other structural and adhesion molecules were downregulated. The systems biology approach can help enhance our basic knowledge of biological processes, and contribute to a deeper understanding of pathophysiological mechanisms, as well as the identification of potential biomarkers of disease.
The prognostic significance of CXCR4 and SDF-1 in differentiated thyroid cancer depends on CD8+ density
Authors: Wilhelm Alexander , Lemmenmeier Isabelle , Lalos Alexandros , Posabella Alberto , Kancherla Venkatesh , Piscuoglio Salvatore , Delko Tarik , von Flüe Markus , Glatz Kathrin , Droeser Raoul André
Published: November 2022

Background

Tumor infiltration with cytotoxic CD8+ T-cells is associated with a favorable outcome in several neoplasms, including thyroid cancer. The chemokine axis CXCR4/SDF-1 correlates with more aggressive tumors, but little is known concerning the prognostic relevance in relation to the tumor immune microenvironment of differentiated thyroid cancer (DTC).

Methods

A tissue microarray (TMA) of 37 tumor specimens of primary DTC was analyzed by immunohistochemistry (IHC) for the expression of CD8+, CXCR4, phosphorylated CXCR4 and SDF-1. A survival analysis was performed on a larger collective (n = 456) at RNA level using data from The Cancer Genome Atlas (TCGA) papillary thyroid cancer cohort.

Results

Among the 37 patients in the TMA-cohort, the density of CD8+ was higher in patients with less advanced primary tumors (median cells/TMA-punch: 12.5 (IQR: 6.5, 12.5) in T1–2 tumors vs. 5 (IQR: 3, 8) in T3–4 tumors, p = 0.05). In the TCGA-cohort, CXCR4 expression was higher in patients with cervical lymph node metastasis compared to N0 or Nx stage (CXCR4high/low 116/78 vs. 97/116 vs. 14/35, respectively, p = 0.001). Spearman’s correlation analysis of the TMA-cohort demonstrated that SDF-1 was significantly correlated with CXCR4 (r = 0.4, p = 0.01) and pCXCR4 (r = 0.5, p = 0.002). In the TCGA-cohort, density of CD8+ correlated with CXCR4 and SDF-1 expression (r = 0.58, p < 0.001; r = 0.4, p < 0.001). The combined marker analysis of the TCGA cohort demonstrated that high expression of both, CXCR4 and SDF-1 was associated with reduced overall survival in the CD8 negative TCGA cohort (p = 0.004).

Conclusion

These findings suggest that the prognostic significance of CXCR4 and SDF-1 in differentiated thyroid cancer depends on the density of CD8 positive T-lymphocytes. Further studies with larger sample sizes are needed to support our findings and inform future investigations of new treatment and diagnostic options for a more personalized approach for patients with differentiated thyroid cancer.
Surface roughness and characteristics of CAD/CAM zirconia and glass ceramics after combined treatment procedures
Authors: Dikicier Sibel , Korkmaz Cumhur , Atay Arzu
Published: November 2022

Background

The roughening of the inner surface of a fixed ceramic restoration is an important factor for the bonding process. The aim of this study is to investigate the effect of combined surface treatments (acid etching, air-abrasion and Er: YAG Laser) on surface roughness of CAD/CAM fabricated zirconia (ZrO2) and lithium-disilicate glass ceramics (LDS).

Methods

Sixty ZrO2(Ceramill Zi) and LDS (IPS e.max CAD) specimens, (5 mm in width, 5 mm in length and 1.5 mm in height) were fabricated using CAD/CAM and sintered according to the manufacturer’s instructions. All specimens subjected to three surface treatment combinations; etching with 4% hydrofluoric acide (HF), airborne-particle abrasion with 110-μm alumina (Al2O3) (AP) and Er:YAG laser (Er:YAG) (Group A—HF + AP; Group B—Er:YAG + AP, and Group C—Er:YAG + HF). Perthometer was used to measure the surface roughness of the specimens before and after the tretments.

Results

Group A presented the highest Ra (LDS 0.81 ± 0.27 and ZrO20.67 ± 0.21 after treatment) and Group C the lowest (LDS 0.45 ± 0.13 and ZrO20.26 ± 0.07, after treatment). Compared with before treatment, the Ra were significantly different only in Group A both ZrO2and LDS after treatment (p < 0.05). Qualitative SEM images suggested the surface topography of the ZrO2was smoother than the LDS. Less surface changes were observed in the Er:YAG combined procedures than HF + AP.

Conclusions

HF + AP was significantly succesful in modifying the ceramic surface. Er:YAG did not sufficiently promote the surface topography, even if combined with any other treatments. Overall, surface tretments on ZrO2not easier than LDS.
Opinion seeking behaviour of healthcare providers in ambulatory cardiovascular care in Germany: a cross-sectional study
Authors: Hennrich Patrick , Arnold Christine , Traulsen Pia , Peters-Klimm Frank , Wensing Michel
Published: November 2022

Background

Healthcare providers’ inclination to seek or lead other providers’ opinions on clinical topics may influence healthcare practices, particularly regarding their alignment across different providers in controversial domains. This study aimed to explore opinion-seeking behaviours of general practitioners and their impacts on clinical opinions in ambulatory cardiovascular care in Germany.

Methods

Between 2019 and 2021, we performed a written survey in two samples of general practitioners and one sample of self-employed cardiologists in three German states. The general practitioners were asked to identify a person they deemed influential on their views on cardiovascular conditions. Their self-perceived opinion leadership and opinion seeking behaviours were then measured, using a validated 12-item-questionnaire. General practitioners and cardiologists were requested to indicate their agreement with three potentially controversial aspects of cardiovascular ambulatory care. Potential impacts on the general practitioners’ views, including local cardiologists’ opinions, were examined using multi-level linear regression models.

Results

A total of 129 general practitioners and 113 cardiologists returned the questionnaire. 68.50% of general practitioners named an opinion leader, mainly cardiologists outside of their practice. General practitioners perceived themselves as opinion seeking and as opinion leading at the same time. Views on the presented controversial topics were mixed among both general practitioners and cardiologists. Self-reported opinion leadership behaviour of general practitioners was associated with their views on one of the three topics. No such associations were found for opinion seeking behaviours and the views of local cardiologists.

Conclusion

While most general practitioners named a cardiovascular opinion leader and saw themselves as opinion seeking regarding cardiovascular issues, they simultaneously perceived themselves as opinion leading, suggesting that opinion leadership and opinion seeking are not mutually exclusive concepts. The views of local cardiologists were not associated with the general practitioners’ view, suggesting that local medical specialists do not necessarily influence the surrounding opinion seekers’ views per se.

Trial registration:

We registered the study prospectively on 7 November 2019 at the German Clinical Trials Register (DRKS, www.drks.de) under ID no. DRKS00019219.
Evidence for publicly reported quality indicators in residential long-term care: a systematic review
Authors: Osińska Magdalena , Favez Lauriane , Zúñiga Franziska
Published: November 2022

Background

An increasing number of countries are using or planning to use quality indicators (QIs) in residential long-term care. Knowledge regarding the current state of evidence on usage and methodological soundness of publicly reported clinical indicators of quality in nursing homes is needed. The study aimed to answer the questions: 1) Which health-related QIs for residents in long-term care are currently publicly reported internationally? and 2) What is the methodological quality of these indicators?

Methods

A systematic search was conducted in the electronic databases PubMed, CINAHL and Embase in October 2019 and last updated on August 31st, 2022. Grey literature was also searched. We used the Appraisal of Indicators through Research and Evaluation (AIRE) instrument for the methodological quality assessment of the identified QIs.

Results

Of 23′344 identified records, 22 articles and one report describing 21 studies met the inclusion criteria. Additionally, we found 17 websites publishing information on QIs. We identified eight countries publicly reporting a total of 99 health-related QIs covering 31 themes. Each country used between six and 31 QIs. The most frequently reported indicators were pressure ulcers, falls, physical restraints, and weight loss. For most QI sets, we found basic information regarding e.g., purpose, definition of the indicators, risk-adjustment, and stakeholders’ involvement in QIs’ selection. Little up to date information was found regarding validity, reliability and discriminative power of the QIs. Only the Australian indicator set reached high methodological quality, defined as scores of 50% or higher in all four AIRE instrument domains.

Conclusions

Little information is available to the public and researchers for the evaluation of a large number of publicly reported QIs in the residential long-term care sector. Better reporting is needed on the methodological quality of QIs in this setting, whether they are meant for internal quality improvement or provider comparison.
Circadian gene Rev-erbα influenced by sleep conduces to pregnancy by promoting endometrial decidualization via IL-6-PR-C/EBPβ axis
Authors: Cui Liyuan , Xu Feng , Xu Chunfang , Ding Yan , Wang Songcun , Du Meirong
Published: November 2022

Background

Sleep disturbance can cause adverse pregnancy outcomes by changing circadian gene expression. The potential mechanisms remain unclear. Decidualization is critical for the establishment and maintenance of normal pregnancy, which can be regulated by circadian genes. Whether Rev-erbα, a critical circadian gene, affects early pregnancy outcome by regulating decidualization needs to be explored.

Methods

QPCR, western blot and artificial decidualization mouse model were used to confirm the effect of sleep disturbance on Rev-erbα expression and decidualization. The regulatory mechanism of Rev-erbα on decidualization was assessed using QPCR, western blot, RNA-Seq, and Chip-PCR. Finally, sleep disturbance mouse model was used to investigate the effect of therapeutic methods targeting Rev-erbα and interleukin 6 (IL-6) on improving adverse pregnancy outcomes induced by sleep disturbance.

Results

Dysregulation of circadian rhythm due to sleep disturbance displayed abnormal expression profile of circadian genes in uterine including decreased level of Rev-erbα, accompanied by defective decidualization. Rev-erbα could regulate decidualization by directly repressing IL-6, which reduced the expression of CCAAT/enhancer-binding protein β (C/EBPβ) and its target insulin-like growth factor binding protein 1 (IGFBP1), the marker of decidualization, by inhibiting progesterone receptors (PR) expression. Moreover, deficient decidualization, higher abortion rate and lower implantation number were exhibited in the mouse models with sleep disturbance compared with those in normal mouse. Pharmacological activation of Rev-erbα or neutralization of IL-6 alleviated the adverse effect of sleep disturbance on pregnancy outcomes.

Conclusions

Taken together, Rev-erbα regulated decidualization via IL-6-PR-C/EBPβ axis and might be a connector between sleep and pregnancy outcome. Therapies targeting Rev-erbα and IL-6 might help improving adverse pregnancy outcomes induced by sleep disturbance.
Expression and purification of soluble recombinant β-lactamases using Escherichia coli as expression host and pET-28a as cloning vector
Authors: Li Lele , Li Hui , Tian Qingwu , Ge Baosheng , Xu Xiaotong , Chi Yuanyuan , Zhao Huaizhi , Liu Yanfei , Jia Nan , Zhou Tingting , Zhu Yuanqi , Zhou Yusun
Published: November 2022

Background

Due to its high expression capability, recombination of Escherichia coli and pET vector has become the bioengineering preferred expression system. Because β-lactamases mediate bacterial antimicrobial resistance, these enzymes have a substantial clinical impact. Using the E. coli expression system, several kinds of β-lactamases have been produced. However, previous studies have been focused on characterizing target β-lactamases, and the effects of cultivation and induction conditions on the expression efficiency of target enzymes were not addressed.

Results

Using pET-28a as the cloning vector and E. coli BL21(DE3) as the expression host, this study originally elucidated the effects of IPTG concentration, culture temperature, induction time, and restriction sites on recombinant β-lactamase expression. Moreover, the effects of the target protein length and the 6 × His-tag fusion position on enzyme purification were also explored, and consequently, this study yielded several important findings. (i) Only the signal peptide–detached recombinant β-lactamase could exist in a soluble form. (ii) Low-temperature induction was beneficial for soluble β-lactamase expression. (iii) The closer to the rbs the selected restriction site was, the more difficult it was to express soluble β-lactamase. (iv) The short-chain recombinant protein and the protein with His-tag fused at its C-terminus showed high affinity to the Ni2+ column.

Conclusions

Based on our findings, researchers can easily design an effective program for the high production of soluble recombinant β-lactamases to facilitate other related studies.