Increasing physicians' awareness of the impact of statistics on research outcomes: comparative power of the t-test and and Wilcoxon Rank-Sum test in small samples applied research

A Compact, Low-Cost, and Low-Power Turbidity Sensor for Continuous In Situ Stormwater Monitoring

Turbidity stands as a crucial indicator for assessing water quality, and while turbidity sensors exist, their high cost prohibits their extensive use. In this paper, we introduce an innovative turbidity sensor, and it is the first low-cost turbidity sensor that is designed specifically for long-term stormwater in-field monitoring. Its low cost (USD 23.50) enables the implementation of high spatial resolution monitoring schemes. The sensor design is available under open hardware and open-source licences, and the 3D-printed sensor housing is free to modify based on different monitoring purposes and ambient conditions. The sensor was tested both in the laboratory and in the field. By testing the sensor in the lab with standard turbidity solutions, the proposed low-cost turbidity sensor demonstrated a strong linear correlation between a low-cost sensor and a commercial hand-held turbidimeter. In the field, the low-cost sensor measurements were statistically significantly correlated to a standard high-cost commercial turbidity sensor. Biofouling and drifting issues were also analysed after the sensors were deployed in the field for more than 6 months, showing that both biofouling and drift occur during monitoring. Nonetheless, in terms of maintenance requirements, the low-cost sensor exhibited similar needs compared to the GreenSpan sensor.

An Analytical Approach for Naturalistic Cooperative and Competitive EEG-Hyperscanning Data: A Proof-of-Concept Study

Investigating the neural mechanisms underlying both cooperative and competitive joint actions may have a wide impact in many social contexts of human daily life. An effective pipeline of analysis for hyperscanning data recorded in a naturalistic context with a cooperative and competitive motor task has been missing. We propose an analytical pipeline for this type of joint action data, which was validated on electroencephalographic (EEG) signals recorded in a proof-of-concept study on two dyads playing cooperative and competitive table tennis. Functional connectivity maps were reconstructed using the corrected imaginary part of the phase locking value (ciPLV), an algorithm suitable in case of EEG signals recorded during turn-based competitive joint actions. Hyperbrain, within-, and between-brain functional connectivity maps were calculated in three frequency bands (i.e., theta, alpha, and beta) relevant during complex motor task execution and were characterized with graph theoretical measures and a clustering approach. The results of the proof-of-concept study are in line with recent findings on the main features of the functional networks sustaining cooperation and competition, hence demonstrating that the proposed pipeline is promising tool for the analysis of joint action EEG data recorded during cooperation and competition using a turn-based motor task.

Cannabis use, decision making, and perceptions of risk among breastfeeding individuals: the Lactation and Cannabis (LAC) Study

OBJECTIVE

Our primary objective was to understand breastfeeding individuals' decisions to use cannabis. Specifically, we investigated reasons for cannabis use, experiences with healthcare providers regarding use, and potential concerns about cannabis use.

METHODS

We collected survey data from twenty breastfeeding participants from Washington and Oregon who used cannabis at least once weekly. We documented individuals' cannabis use and analyzed factors associated with their decisions to use cannabis during lactation. Qualitative description was used to assess responses to an open-ended question about potential concerns.

RESULTS

Fifty-five percent of participants (n = 11) reported using cannabis to treat or manage health conditions, mostly related to mental health. Eighty percent of participants (n = 16) reported very few or no concerns about using cannabis while breastfeeding, although participants who used cannabis for medical purposes had significantly more concerns. Most participants (n = 18, 90%) reported receiving either no or unhelpful advice from healthcare providers. Four themes arose through qualitative analysis, indicating that breastfeeding individuals are: 1) identifying research gaps and collecting evidence; 2) monitoring their child's health and development; 3) monitoring and titrating their cannabis use; and 4) comparing risks between cannabis and other controlled substances.

CONCLUSIONS

Breastfeeding individuals reported cannabis for medical and non-medical reasons and few had concerns about cannabis use during breastfeeding. Breastfeeding individuals reported using a variety of strategies and resources in their assessment of risk or lack thereof when deciding to use cannabis. Most participants reported receiving no helpful guidance from healthcare providers.

The Multi-Modal Evaluation of Sensory Sensitivity (MESSY): Assessing a commonly missed symptom of acquired brain injury

Objective: Sensory hypersensitivity is common after acquired brain injury. Since appropriate diagnostic tools are lacking, these complaints are overlooked by clinicians and available literature is limited to light and noise hypersensitivity after concussion. This study aimed to investigate the prevalence of sensory hypersensitivity in other modalities and after other types of brain injury. Method: We developed the Multi-Modal Evaluation of Sensory Sensitivity (MESSY), a patient-friendly questionnaire that assesses sensory sensitivity across multiple sensory modalities. 818 neurotypical adults (mean age = 49; 244 male) and 341 chronic acquired brain injury patients (including stroke, traumatic brain injury, and brain tumour patients) (mean age = 56; 126 male) completed the MESSY online. Results: The MESSY had a high validity and reliability in neurotypical adults. Post-injury sensory hypersensitivity (examined using open-ended questions) was reported by 76% of the stroke patients, 89% of the traumatic brain injury patients, and 82% of the brain tumour patients. These complaints occurred across all modalities with multisensory, visual, and auditory hypersensitivity being the most prevalent. Patients with post-injury sensory hypersensitivity reported a higher sensory sensitivity severity on the multiple-choice items of the MESSY as compared to neurotypical adults and acquired brain injury patients without post-injury sensory hypersensitivity (across all sensory modalities) (effect sizes (partial eta squared) ranged from .06 to .22). Conclusions: These results show that sensory hypersensitivity is prevalent after different types of acquired brain injury as well as across several sensory modalities. The MESSY can improve recognition of these symptoms and facilitate further research.

Lack of stereopsis does not reduce surgical performance but prolongs the learning curve of vitreoretinal surgery

PURPOSE

To investigate whether individuals with long-term reduced stereopsis were able to obtain the same level of surgical skills in simulated vitreoretinal surgery on the Eyesi Surgical Simulator as individuals with normal stereopsis.

METHODS

Twenty-four medical students were recruited and divided into two groups according to their degree of stereopsis: Group 1 (n = 12) included subjects with normal stereopsis (60 arcsec or lower) and Group 2 (n = 12) included subjects with reduced stereopsis (120 arcsec or higher). Stereopsis was tested using the TNO test (Lameris Ootech BV, Nieuwegein, the Netherlands). The participants were trained in virtual reality-simulated vitreoretinal surgery and continuously measured using a test with solid validity evidence and a pre-defined pass-fail score. All data were analysed using the Wilcoxon rank sum test.

RESULTS

We observed no differences in overall performance scores for any of the four modules. The participants with reduced stereopsis used 5.8 more attempts in bimanual training (p = 0.04), 8.8 more attempts in removal of posterior hyaloid (p = 0.04), 9.1 more attempts in navigation training (p = 0.20) and 0.3 fewer attempts in removal of internal limiting membrane (p = 0.69).

CONCLUSION

The final performance scores on the Eyesi Surgical Simulator were independent of the degree of stereopsis. However, the number of attempts to achieve the pre-defined pass-fail score increased significantly with reduced stereopsis in two of four modules. These results indicate that a high degree of stereopsis is not necessary to become proficient in microsurgery but may prolong the learning curve.

Reinvestigation of the Psychological Mechanisms of Construction Experience on Hazard Recognition Performance

OBJECTIVE

The study aimed to reinvestigate psychological mechanisms of the influence of construction workers' experience on hazard recognition performance, with signal detection theory (SDT) and electroencephalogram (EEG) readings.

BACKGROUND

Existing evidence regarding the effect of experience on hazard recognition performance in the construction industry remains inconsistent. Behavior-wise, identification of dominant hazard recognition factors (sensitivity or response bias, or both) would help determine appropriate training strategies to improve hazard recognition. In terms of neuro-responses, induced gamma-band activity was expected to reflect the cognitive functions mediating the psychological effects of experience.

METHOD

Seventy-seven construction workers participated in a predesigned hazard recognition task, in which participants judged whether a hazard was present from a series of construction scenario pictures. We computed and compared the sensitivity and response bias of SDT and time-frequency representations of recorded EEG signals of the two experience-level groups.

RESULTS

Novice workers had higher hazard recognition rates. Behavior-wise, novices were more sensitive than more experienced workers. Compared with experienced workers, novices showed stronger gamma-band difference power (hazardous minus safe) in the left frontal and right posterior parietal areas during the hazard recognition process.

CONCLUSION

Novices performed better at hazard recognition, indicating their sensitivity to the hazards without a clear difference in response bias. Based on the EEG data, novices' sensitivity may be attributed to more efficient working memory and attentional control.

APPLICATION

There is a need for continuous refreshment of hazard recognition skills for experienced workers for safety interventions.

Impact of Conventional and Potential New Metal-Based Drugs on Lipid Metabolism in Osteosarcoma MG-63 Cells

This work investigated the mechanisms of action of conventional drugs, cisplatin and oxaliplatin, and the potentially less deleterious drug Pd2Spermine (Spm) and its Pt(II) analog, against osteosarcoma MG-63 cells, using nuclear-magnetic-resonance metabolomics of the cellular lipidome. The Pt(II) chelates induced different responses, namely regarding polyunsaturated-fatty-acids (increased upon cisplatin), suggesting that cisplatin-treated cells have higher membrane fluidity/permeability, thus facilitating cell entry and justifying higher cytotoxicity. Both conventional drugs significantly increased triglyceride levels, while Pt2Spm maintained control levels; this may reflect enhanced apoptotic behavior for conventional drugs, but not for Pt2Spm. Compared to Pt2Spm, the more cytotoxic Pd2Spm (IC50 comparable to cisplatin) induced a distinct phospholipids profile, possibly reflecting enhanced de novo biosynthesis to modulate membrane fluidity and drug-accessibility to cells, similarly to cisplatin. However, Pd2Spm differed from cisplatin in that cells had equivalent (low) levels of triglycerides as Pt2Spm, suggesting the absence/low extent of apoptosis. Our results suggest that Pd2Spm acts on MG-63 cells mainly through adaptation of cell membrane fluidity, whereas cisplatin seems to couple a similar effect with typical signs of apoptosis. These results were discussed in articulation with reported polar metabolome adaptations, building on the insight of these drugs' mechanisms, and particularly of Pd2Spm as a possible cisplatin substitute.

Immunotherapy Efficacy Prediction for Non-Small Cell Lung Cancer Using Multi-View Adaptive Weighted Graph Convolutional Networks

Immunotherapy is an effective way to treat non-small cell lung cancer (NSCLC). The efficacy of immunotherapy differs from person to person and may cause side effects, making it important to predict the efficacy of immunotherapy before surgery. Radiomics based on machine learning has been successfully used to predict the efficacy of NSCLC immunotherapy. However, most studies only considered the radiomic features of the individual patient, ignoring the inter-patient correlations. Besides, they usually concatenated different features as the input of a single-view model, failing to consider the complex correlation among features of multiple types. To this end, we propose a multi-view adaptive weighted graph convolutional network (MVAW-GCN) for the prediction of NSCLC immunotherapy efficacy. Specifically, we group the radiomic features into several views according to the type of the fitered images they extracted from. We construct a graph in each view based on the radiomic features and phenotypic information. An attention mechanism is introduced to automatically assign weights to each view. Considering the view-shared and view-specific knowledge of radiomic features, we propose separable graph convolution that decomposes the output of the last convolution layer into two components, i.e., the view-shared and view-specific outputs. We maximize the consistency and enhance the diversity among different views in the learning procedure. The proposed MVAW-GCN is evaluated on 107 NSCLC patients, including 52 patients with valid efficacy and 55 patients with invalid efficacy. Our method achieved an accuracy of 77.27% and an area under the curve (AUC) of 0.7780, indicating its effectiveness in NSCLC immunotherapy efficacy prediction.

Concerns on Generalizability

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Unilateral spatial neglect affected by right-sided stimuli in a three-dimensional virtual environment: A preliminary proof-of-concept study

Unilateral spatial neglect (USN) is defined as the inability to attend and see on one side, which seriously interferes with daily life. Clinically, patients with left USN commonly demonstrate a striking immediate capture of attention from ipsilesional, right-sided items as soon as a visual scene unfolds (i.e., magnetic attraction [MA]). Therefore, this preliminary study utilized a three-dimensional (3D) virtual environment to evaluate the effects of eliminating stimuli in the rightward space and directing attention to the left on neglect symptoms.

METHODS

Seven patients with USN participated in this study, and two types of visual stimuli were created: the numbers and objects in the 3D virtual environment. To eliminate the visual stimuli on the right side, a moving slit was introduced in the virtual environment. During the experiment, patients were required to orally identify each object and number both in moving and nonmoving slit conditions.

RESULTS

A statistical comparison of scores with and without the moving slit in the 3D virtual space indicated significant changes in the object stimuli condition; however, no statistically significant difference was observed in the number stimuli condition.

CONCLUSIONS

Masking the right side within the 3D virtual space increased the number of objects that can be recognized on the left side by patients with USN. The results may allow interventions in a virtual reality environment that closely resembles the patient's real-life space.Clinical Relevance-Magnetic attraction is a symptom seen in patients in clinical practice, but there is no method of rehabilitation. The proposed moving slit method is expected to be effective because it enables attention guidance in a three-dimensional space.

Prospective Validation of 2B-Cool : Integrating Wearables and Individualized Predictive Analytics to Reduce Heat Injuries

INTRODUCTION

An uncontrollably rising core body temperature (T C ) is an indicator of an impending exertional heat illness. However, measuring T C invasively in field settings is challenging. By contrast, wearable sensors combined with machine-learning algorithms can continuously monitor T C nonintrusively. Here, we prospectively validated 2B-Cool , a hardware/software system that automatically learns how individuals respond to heat stress and provides individualized estimates of T C , 20-min ahead predictions, and early warning of a rising T C .

METHODS

We performed a crossover heat stress study in an environmental chamber, involving 11 men and 11 women (mean ± SD age = 20 ± 2 yr) who performed three bouts of varying physical activities on a treadmill over a 7.5-h trial, each under four different clothing and environmental conditions. Subjects wore the 2B-Cool system, consisting of a smartwatch, which collected vital signs, and a paired smartphone, which housed machine-learning algorithms and used the vital sign data to make individualized real-time forecasts. Subjects also wore a chest strap heart rate sensor and a rectal probe for comparison purposes.

RESULTS

We observed very good agreement between the 2B-Cool forecasts and the measured T C , with a mean bias of 0.16°C for T C estimates and nearly 75% of measurements falling within the 95% prediction intervals of ±0.62°C for the 20-min predictions. The early-warning system results for a 38.50°C threshold yielded a 98% sensitivity, an 81% specificity, a prediction horizon of 35 min, and a false alarm rate of 0.12 events per hour. We observed no sex differences in the measured or predicted peak T C .

CONCLUSION

2B-Cool provides early warning of a rising T C with a sufficient lead time to enable clinical interventions and to help reduce the risk of exertional heat illness.

A novel hybrid PSO based on levy flight and wavelet mutation for global optimization

The concise concept and good optimization performance are the advantages of particle swarm optimization algorithm (PSO), which makes it widely used in many fields. However, when solving complex multimodal optimization problems, it is easy to fall into early convergence. The rapid loss of population diversity is one of the important reasons why the PSO algorithm falls into early convergence. For this reason, this paper attempts to combine the PSO algorithm with wavelet theory and levy flight theory to propose a new hybrid algorithm called PSOLFWM. It applies the random wandering of levy flight and the mutation operation of wavelet theory to enhance the population diversity and seeking performance of the PSO to make it search more efficiently in the solution space to obtain higher quality solutions. A series of classical test functions and 19 optimization algorithms proposed in recent years are used to evaluate the optimization performance accuracy of the proposed method. The experimental results show that the proposed algorithm is superior to the comparison method in terms of convergence speed and convergence accuracy. The success of the high-dimensional function test and dynamic shift performance test further verifies that the proposed algorithm has higher search stability and anti-interference performance than the comparison algorithm. More importantly, both t-Test and Wilcoxon's rank sum test statistical analyses were carried out. The results show that there are significant differences between the proposed algorithm and other comparison algorithms at the significance level α = 0.05, and the performance is better than other comparison algorithms.

A trained communication partner’s use of responsive strategies in aided communication with three adults with Rett syndrome: A case report

Purpose

To explore and describe a trained communication partner’s use of responsive strategies in dyadic interaction with adults with Rett syndrome.

Introduction

Responsive partner strategies facilitate social, communicative, and linguistic development. The common feature is that the communication partner responds contingently to the other’s focus of attention and interprets their acts as communicative. Research on responsive partner strategies that involves individuals with significant communication and motor disabilities remains sparse. The same applies to if, and how, the use of communication aids impacts on the partner’s use of responsive strategies.

Materials and methods

A therapist, trained in responsive partner strategies and aided communication interacted during 14 sessions with each of three participants. The participants were adults with Rett syndrome. A gaze-controlled device and responsive strategies were used during all sessions. The Responsive Augmentative and Alternative Communication Style scale (RAACS) was used to assess the partner’s responsiveness. RAACS consists of 11 items including ratings of to what extent the partner is being attentive to, confirms, and expands the individual’s communication. During eight of the 14 sessions, aided AAC Modelling was also used, i.e., the communication partner pointed at symbols on the gaze-controlled device while interacting. In addition to RAACS, each time the communication partner confirmed or expanded on communication when (a) the participants used the gaze-controlled device and (b) the participants did not use the gaze-controlled device was counted. Descriptive statistics were used to present the results. Non-parametric tests were used to compare means between the two conditions and between participants.

Results

Inter-rater agreement for the different RAACS items ranged from 0.73 to 0.96 and was thus found to be fair to excellent. The communication partner’s use of responsive strategies varied when communicating with different participants and the scores were higher when aided AAC modeling was used. The communication partner’s number of responses and use of responsive strategies were higher when the participants communicated through a gaze-controlled device.

Conclusion

The communication partner’s use of responsive and scaffolding strategies is not a fixed construct but varies in interactions with different non-speaking persons. The same is true whether the non-speaking person uses a gaze-controlled device with digitized speech or not.

Climate change effects on bread wheat phenology and grain quality: A case study in the north of Italy

Increasing temperatures, heat waves, and reduction of annual precipitation are all the expressions of climate change (CC), strongly affecting bread wheat (Triticum aestivum L.) grain yield in Southern Europe. Being temperature the major driving force of plants' phenological development, these variations also have effects on wheat phenology, with possible consequences on grain quality, and gluten protein accumulation. Here, through a case study in the Bolognese Plain (North of Italy), we assessed the effects of CC in the area, the impacts on bread wheat phenological development, and the consequences on grain gluten quality. The increasing trend in mean annual air temperature in the area since 1952 was significant, with a breakpoint identified in 1989, rising from 12.7 to 14.1°C, accompanied by the signals of increasing aridity, i.e., increase in water table depth. Bread wheat phenological development was compared in two 15-year periods before and after the breakpoint, i.e., 1952-1966 (past period), and 2006-2020 (present period), the latest characterized by aridity and increased temperatures. A significant shortening of the chronological time necessary to reach the main phenological phases was observed for the present period compared to the past period, finally shortening the whole life cycle. This reduction, as well as the higher temperature regime, affected gluten accumulation during the grain-filling process, as emerged analyzing gluten composition in grain samples of the same variety harvested in the area both before and after the breakpoint in temperature. In particular, the proportion of gluten polymers (i.e., gliadins, high and low molecular weight glutenins, and their ratio) showed a strong and significant correlation with cumulative growing degree days (CGDDs) accumulated during the grain filling. Higher CGDD values during the period, typical of CC in Southern Europe, accounting for higher temperature and faster grain filling, correlated with gliadins, high molecular weight glutenins, and their proportion with low molecular weight glutenins. In summary, herein reported, data might contribute to assessing the effects of CC on wheat phenology and quality, representing a tool for both predictive purposes and decision supporting systems for farmers, as well as can guide future breeding choices for varietal innovation.

Primary and secondary host selection by Ips typographus depends on Norway spruce crown characteristics and phenolic-based defenses

Climate change is expected to intensify bark beetle population outbreaks in forests globally, affecting biodiversity and trajectories of change. Aspects of individual tree resistance remain poorly quantified, particularly with regard to the role of phenolic compounds, hindering robust predictions of forest response to future conditions. In 2003, we conducted a mechanical wounding experiment in a Norway spruce forest that coincided with an outbreak of the bark beetle, Ips typographus. We collected phloem samples from 97 trees and monitored tree survival for 5 months. Using high-performance liquid chromatography, we quantified induced changes in the concentrations of phenolics. Classification and regression tools were used to evaluate relationships between phenolic production and bark beetle resistance, in the context of other survival factors. The proximity of beetle source populations was a principal determinant of survival. Proxy measures of tree vigor, such as crown defoliation, mediated tree resistance. Controlling for these factors, synthesis of catechin was found to exponentially increase tree survival probability. However, even resistant trees were susceptible in late season due to high insect population growth. Our results show that incorporating trait-mediated effects improves predictions of survival. Using an integrated analytical approach, we demonstrate that phenolics play a direct role in tree defense to herbivory.

Evaluation of Safety and Immunogenicity of BNT162B2 mRNA COVID-19 Vaccine in IBD Pediatric Population with Distinct Immune Suppressive Regimens

Patients affected by Inflammatory Bowel Disease (IBD) present higher risk for infection and suboptimal response upon vaccination. The immunogenicity of SARS-CoV2 vaccination is still largely unknown in adolescents or young adults affected by IBD (pIBD). We investigated the safety and immunogenicity of the BNT162B2 mRNA COVID-19 vaccine in 27 pIBD, as compared to 30 healthy controls (HC). Immunogenicity was measured by anti-SARS-CoV2 IgG (anti-S and anti-trim Ab) before vaccination, after 21 days (T21) and 7 days after the second dose (T28). The safety profile was investigated by close monitoring and self-reported adverse events. Vaccination was well tolerated, and short-term adverse events reported were only mild to moderate. Three out of twenty-seven patients showed IBD flare after vaccination, but no causal relationship could be established. Overall, pIBD showed a good humoral response upon vaccination compared to HC; however, pIBD on anti-TNFα treatment showed lower anti-S Ab titers compared to patients receiving other immune-suppressive regimens (p = 0.0413 at first dose and p = 0.0301 at second dose). These data show that pIBD present a good safety and immunogenicity profile following SARS-CoV-2 mRNA vaccination. Additional studies on the impact of specific immune-suppressive regimens, such as anti TNFα, on immunogenicity should be further investigated on larger cohorts.

Deleterious effects of Schinus terebinthifolius Raddi seed flour on cowpea weevil, Callosobruchus maculatus (F.), larval development

Schinus terebinthifolius, Raddi, has been extensively studied due to its anti-inflammatory and antibiotic properties. S. terebinthifolius was also toxic to some insects, however little has been explored about the nature of its insecticide compounds or the toxicity of this plant to insect species. In this work, we investigate the toxicity of S. terebinthifolius seed flour against the insect C. maculatus. S. terebinthifolius seed flour interfered with the post hatch development of the C. maculatus larvae, decreasing larval survival, mass and length. Using DEAE-cellulose chromatography, five protein fractions were isolated, a non-retained fraction (NRF) and four retained fractions, eluted with 0.25, 0.5, 0.7 and 1.0 M NaCl. Proteins with varying molecular masses were observed in all fractions. The majority protein bands were identified by mass spectrometry analysis and among the main identified proteins are 11S globulins (such glycinin), lipoxygenase, chitinases, 7S globulins (vicilins, canavalin and β conglycinin), annexin, catalase and sucrose binding protein. All DEAE-protein fractions were toxic to the insect, interfering with the post hatch larval development and survival. Decreases greater than 90% were observed in the larval mass and length at 20 days after oviposition (DAO) for larvae raised on diet containing 0.5% of some fractions. Alterations in the level of proteins, glucose and in the activity of the enzymes lipases and cysteine proteases were also detected in these larvae. Our results show that seeds of S. terebinthifolius have an arsenal of toxic proteins with potential for the control of the insect C. maculatus.

Endo- and Exometabolome Crosstalk in Mesenchymal Stem Cells Undergoing Osteogenic Differentiation

This paper describes, for the first time to our knowledge, a lipidome and exometabolome characterization of osteogenic differentiation for human adipose tissue stem cells (hAMSCs) using nuclear magnetic resonance (NMR) spectroscopy. The holistic nature of NMR enabled the time-course evolution of cholesterol, mono- and polyunsaturated fatty acids (including ω-6 and ω-3 fatty acids), several phospholipids (phosphatidylcholine, phosphatidylethanolamine, sphingomyelins, and plasmalogens), and mono- and triglycerides to be followed. Lipid changes occurred almost exclusively between days 1 and 7, followed by a tendency for lipidome stabilization after day 7. On average, phospholipids and longer and more unsaturated fatty acids increased up to day 7, probably related to plasma membrane fluidity. Articulation of lipidome changes with previously reported polar endometabolome profiling and with exometabolome changes reported here in the same cells, enabled important correlations to be established during hAMSC osteogenic differentiation. Our results supported hypotheses related to the dynamics of membrane remodelling, anti-oxidative mechanisms, protein synthesis, and energy metabolism. Importantly, the observation of specific up-taken or excreted metabolites paves the way for the identification of potential osteoinductive metabolites useful for optimized osteogenic protocols.

The slope associated with nadir prostate-specific antigen is prognostically significant in men with hormone-sensitive prostate cancer after primary androgen deprivation therapy

BACKGROUND

Prognostic indicators based on the initial prostate-specific antigen (PSA) levels, nadir PSA, and time to PSA nadir were calculated to evaluate prognosis after primary androgen deprivation therapy (PADT), as these have been reported in very few studies. We attempted to evaluate the prognostic role of the slope associated with nadir PSA in patients treated with PADT.

METHODS

A total of 107 patients who were treated with PADT from 2015 to 2019 were reviewed. The Kaplan-Meier method and Cox regression model were used to analyze the prognostic significance of the slope associated with nadir PSA in predicting progression-free survival (PFS) and overall survival (OS).

RESULTS

After PADT, the median follow-up duration was 40.1 months; 66 patients (61.7%) had disease progression, and 33 patients (30.8%) died. In the univariate analysis, T stage, N stage, nadir PSA, time to PSA nadir, nadir PSA declining slope (nPSA-DS), nadir PSA percentage declining slope (nPSA-PDS), and nadir PSA line slope (nPSA-LS) were significant predictors for PFS and OS. The multivariate analysis showed that a higher nPSA-DS (> - 0.74) and lower PSA nadir (≤0.16 ng/ml) were independent predictors for prolonged survival. The significance of nPSA-DS and nPSA was supported by the analysis of nPSA-DS and nPSA as time-dependent covariates. The combined analyses demonstrated that patients with a higher nPSA-DS and lower PSA nadir had the best PFS and OS.

CONCLUSIONS

The slope associated with the nadir PSA of nPSA-DS was a significant independent predictor for patients treated with PADT. Nadir PSA and nPSA-DS have a synergistic effect on prognosis.

Identification and characterisation of spontaneous mutations causing deafness from a targeted knockout programme

Background

Mice carrying targeted mutations are important for investigating gene function and the role of genes in disease, but off-target mutagenic effects associated with the processes of generating targeted alleles, for instance using Crispr, and culturing embryonic stem cells, offer opportunities for spontaneous mutations to arise. Identifying spontaneous mutations relies on the detection of phenotypes segregating independently of targeted alleles, and having a broad estimate of the level of mutations generated by intensive breeding programmes is difficult given that many phenotypes are easy to miss if not specifically looked for. Here we present data from a large, targeted knockout programme in which mice were analysed through a phenotyping pipeline. Such spontaneous mutations segregating within mutant lines may confound phenotypic analyses, highlighting the importance of record-keeping and maintaining correct pedigrees.

Results

Twenty-five lines out of 1311 displayed different deafness phenotypes that did not segregate with the targeted allele. We observed a variety of phenotypes by Auditory Brainstem Response (ABR) and behavioural assessment and isolated eight lines showing early-onset severe progressive hearing loss, later-onset progressive hearing loss, low frequency hearing loss, or complete deafness, with vestibular dysfunction. The causative mutations identified include deletions, insertions, and point mutations, some of which involve new genes not previously associated with deafness while others are new alleles of genes known to underlie hearing loss. Two of the latter show a phenotype much reduced in severity compared to other mutant alleles of the same gene. We investigated the ES cells from which these lines were derived and determined that only one of the 8 mutations could have arisen in the ES cell, and in that case, only after targeting. Instead, most of the non-segregating mutations appear to have occurred during breeding of mutant mice. In one case, the mutation arose within the wildtype colony used for expanding mutant lines.

Conclusions

Our data show that spontaneous mutations with observable effects on phenotype are a common side effect of intensive breeding programmes, including those underlying targeted mutation programmes. Such spontaneous mutations segregating within mutant lines may confound phenotypic analyses, highlighting the importance of record-keeping and maintaining correct pedigrees.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12915-022-01257-8.

NMR Metabolomics Assessment of Osteogenic Differentiation of Adipose-Tissue-Derived Mesenchymal Stem Cells

This Article presents, for the first time to our knowledge, an untargeted nuclear magnetic resonance (NMR) metabolomic characterization of the polar intracellular metabolic adaptations of human adipose-derived mesenchymal stem cells during osteogenic differentiation. The use of mesenchymal stem cells (MSCs) for bone regeneration is a promising alternative to conventional bone grafts, and untargeted metabolomics may unveil novel metabolic information on the osteogenic differentiation of MSCs, allowing their behavior to be understood and monitored/guided toward effective therapies. Our results unveiled statistically relevant changes in the levels of just over 30 identified metabolites, illustrating a highly dynamic process with significant variations throughout the whole 21-day period of osteogenic differentiation, mainly involving amino acid metabolism and protein synthesis; energy metabolism and the roles of glycolysis, the tricarboxylic acid cycle, and oxidative phosphorylation; cell membrane metabolism; nucleotide metabolism (including the specific involvement of O-glycosylation intermediates and NAD⁺); and metabolic players in protective antioxidative mechanisms (such as glutathione and specific amino acids). Different metabolic stages are proposed and are supported by putative biochemical explanations for the metabolite changes observed. This work lays the groundwork for the use of untargeted NMR metabolomics to find potential metabolic markers of osteogenic differentiation efficacy.

Grxcr1 regulates hair bundle morphogenesis and is required for normal mechanoelectrical transduction in mouse cochlear hair cells

Tasmanian devil (tde) mice are deaf and exhibit circling behaviour. Sensory hair cells of mutants show disorganised hair bundles with abnormally thin stereocilia. The origin of this mutation is the insertion of a transgene which disrupts expression of the Grxcr1 (glutaredoxin cysteine rich 1) gene. We report here that Grxcr1 exons and transcript sequences are not affected by the transgene insertion in tde homozygous (tde/tde) mice. Furthermore, 5'RACE PCR experiments showed the presence of two different transcripts of the Grxcr1 gene, expressed in both tde/tde and in wild-type controls. However, quantitative analysis of Grxcr1 transcripts revealed a significantly decreased mRNA level in tde/tde mice. The key stereociliary proteins ESPN, MYO7A, EPS8 and PTPRQ were distributed in hair bundles of homozygous tde mutants in a similar pattern compared with control mice. We found that the abnormal morphology of the stereociliary bundle was associated with a reduction in the size and Ca2+-sensitivity of the mechanoelectrical transducer (MET) current. We propose that GRXCR1 is key for the normal growth of the stereociliary bundle prior to the onset of hearing, and in its absence hair cells are unable to mature into fully functional sensory receptors.

Current exposure to a second language modulates bilingual visual word recognition: An EEG study

Bilingual word recognition has been the focus of much empirical work, but research on potential modulating factors, such as individual differences in L2 exposure, are limited. This study represents a first attempt to determine the impact of L2-exposure on bilingual word recognition in both languages. To this end, highly fluent bilinguals were split into two groups according to their L2-exposure, and performed a semantic categorisation task while recording their behavioural responses and electro-cortical (EEG) signal. We predicted that lower L2-exposure should produce less efficient L2 word recognition processing at the behavioural level, alongside neurophysiological changes at the early pre-lexical and lexical levels, but not at a post-lexical level. Results confirmed this hypothesis in accuracy and in the N1 component of the EEG signal. Precisely, bilinguals with lower L2-exposure appeared less accurate in determining semantic relatedness when target words were presented in L2, but this condition posed no such problem for bilinguals with higher L2-exposure. Moreover, L2-exposure modulates early processes of word recognition not only in L2 but also in L1 brain activity, thus challenging a fully non-selective access account (cf. BIA + model, Dijkstra and van Heuven, 2002). We interpret our findings with reference to the frequency-lag hypothesis (Gollan et al., 2011).

A systematic review of one-legged balance performance and falls risk in community-dwelling adults

OBJECTIVE

The aim of this systematic review was to synthesise all published evidence on associations between one-legged balance performance and falls.

METHODS

Medline, EMBASE, CINAHL and Web of Science were systematically searched (to January 2021) to identify peer-reviewed, English language journal articles examining the association between one-legged balance performance and falls in community-dwelling adults.

RESULTS

Of 4310 records screened, 55 papers were included (n = 36954 participants). There was considerable heterogeneity between studies including differences in study characteristics, ascertainment of balance and falls, and analytical approaches. A meta-analysis of the time that individuals could maintain the one-legged balance position indicated that fallers had worse balance times than non-fallers (standardised mean difference: -0.29 (95%CI:-0.38,-0.20) in cross-sectional analyses; -0.19 (-0.28, -0.09) in longitudinal analyses), although there was no difference in the pooled median difference. Due to between-study heterogeneity, regression estimates between balance and fall outcomes could not be synthesised. Where assessed, prognostic accuracy indicators suggested that one-legged balance was a poor discriminator of fall risk; for example, 5 of 7 studies demonstrated poor prognostic accuracy (Area Under the Curve <0.6), with most studies demonstrating poor sensitivity.

CONCLUSIONS

This systematic review identified 55 papers that examined associations between balance and fall risk, the majority in older aged adults. However, the evidence was commonly of low quality and results were inconsistent. This contradicts previous perceptions of one-legged balance as a useful fall risk tool and highlights crucial gaps that must be addressed in order to translate such assessments to clinical settings.

Spectral Temporal Information for Missing Data Reconstruction (STIMDR) of Landsat Reflectance Time Series

The number of Landsat time-series applications has grown substantially because of its approximately 50-year history and relatively high spatial resolution for observing long term changes in the Earth’s surface. However, missing observations (i.e., gaps) caused by clouds and cloud shadows, orbit and sensing geometry, and sensor issues have broadly limited the development of Landsat time-series applications. Due to the large area and temporal and spatial irregularity of time-series gaps, it is difficult to find an efficient and highly precise method to fill them. The Missing Observation Prediction based on Spectral-Temporal Metrics (MOPSTM) method has been proposed and delivered good performance in filling large-area gaps of single-date Landsat images. However, it can be less practical for a time series longer than one year due to the lack of mechanics that exclude dissimilar data in time series (e.g., different phenology or changes in land cover). To solve this problem, this study proposes a new gap-filling method, Spectral Temporal Information for Missing Data Reconstruction (STIMDR), and examines its performance in Landsat reflectance time series. Two groups of experiments, including 2000 × 2000 pixel Landsat single-date images and Landsat time series acquired from four sites (Kenya, Finland, Germany, and China), were performed to test the new method. We simulated artificial gaps to evaluate predicted pixel values with real observations. Quantitative and qualitative evaluations of gap-filled images through comparisons with other state-of-the-art methods confirmed the more robust and accurate performance of the proposed method. In addition, the proposed method was also able to fill gaps contaminated by extreme cloud cover for a period (e.g., winter in high-latitude areas). A down-stream task of random forest supervised classification through both gap-filled simulated datasets and the original valid datasets verified that STIMDR-generated products are relevant to the user community for land cover applications.

Effects of temporal fine structure preservation on spatial hearing in bilateral cochlear implant users

Typically, the coding strategies of cochlear implant audio processors discard acoustic temporal fine structure information (TFS), which may be related to the poor perception of interaural time differences (ITDs) and the resulting reduced spatial hearing capabilities compared to normal-hearing individuals. This study aimed to investigate to what extent bilateral cochlear implant (BiCI) recipients can exploit ITD cues provided by a TFS preserving coding strategy (FS4) in a series of sound field spatial hearing tests. As a baseline, we assessed the sensitivity to ITDs and binaural beats of 12 BiCI subjects with a coding strategy disregarding fine structure (HDCIS) and the FS4 strategy. For 250 Hz pure-tone stimuli but not for broadband noise, the BiCI users had significantly improved ITD discrimination using the FS4 strategy. In the binaural beat detection task and the broadband sound localization, spatial discrimination, and tracking tasks, no significant differences between the two tested coding strategies were observed. These results suggest that ITD sensitivity did not generalize to broadband stimuli or sound field spatial hearing tests, suggesting that it would not be useful for real-world listening.

Health information-seeking behavior in the time of COVID-19: information horizons methodology to decipher source path during a global pandemic

Purpose

To determine the differences, as represented by information horizons mapping, in the health information-seeking behavior from a group of participants between March 2019 and April 2020 of the novel coronavirus pandemic.

Design/methodology/approach

In March 2019, the author conducted a study on health information-seeking behavior in which 149 participants drew information horizons maps in a health-related context. They also took health and information literacy assessments. This exact study was replicated using the same population in April 2020 to determine the differences in what the participants drew on their maps and how these changes interacted with their health and information literacy, their age and their education.

Findings

There is a statistically significant difference in the increased number of sources and the ranked quality of the sources that people used during the pandemic. Participants were much more likely to use credible sources and news sources, especially if they were older, more educated and had higher literacy levels – both health and information. They also relied heavily on social media. The participant group in the pandemic had a much heavier reliance on sources that are often used in a passive encountering way but engaging with them in an active information-seeking manner. The health information-seeking behavior in this study did not adhere to other research that found issue with information overload, avoidance and cyberchondria in response to crisis situations.

Originality/value

This article utilizes information horizons methodology to explore pre- and post-pandemic information-seeking. It is completely unique in this approach.

QUALITY PAPERA new rapid and robust multi-factorial screening for low-percentile use-rate accelerated reliability analysis

Purpose

The study aims to provide a quick-and-robust multifactorial screening technique for early detection of statistically significant effects that could influence a product's life-time performance.

Design/methodology/approach

The proposed method takes advantage of saturated fractional factorial designs for organizing the lifetime dataset collection process. Small censored lifetime data are fitted to the Kaplan–Meier model. Low-percentile lifetime behavior that is derived from the fitted model is used to screen for strong effects. A robust surrogate profiler is employed to furnish the predictions.

Findings

The methodology is tested on a difficult published case study that involves the eleven-factor screening of an industrial-grade thermostat. The tested thermostat units are use-rate accelerated to expedite the information collection process. The solution that is provided by this new method suggests as many as two active effects at the first decile of the data which improves over a solution provided from more classical methods.

Research limitations/implications

To benchmark the predicted solution with other competing approaches, the results showcase the critical first decile part of the dataset. Moreover, prediction capability is demonstrated for the use-rate acceleration condition.

Practical implications

The technique might be applicable to projects where the early reliability improvement is studied for complex industrial products.

Originality/value

The proposed methodology offers a range of features that aim to make the product reliability profiling process faster and more robust while managing to be less susceptible to assumptions often encountered in classical multi-parameter treatments.

The resistance of the cowpea cv. BRS Xiquexique to infestation by cowpea weevil is related to the presence of toxic chitin-binding proteins

The cowpea weevil (Callosobruchus maculatus) is the main pest that attacks cowpea (Vigna unguiculata) seeds during storage, causing nutritional and economic losses in the cowpea crop. Thus, studies aiming to identify resistant cowpea cultivars have been developed. Chitin-binding proteins (CBP), such vicilins and chitinases, have been detected in seeds and related with the toxicity to insects. In this work, we investigated the presence of chitin-binding proteins in the partially resistant cowpea cv. BRS Xiquexique and evaluated their toxicity towards cowpea weevil. The CBP fraction was isolated by chitin affinity chromatography. CBP fraction showed, through 15% SDS PAGE, protein bands with varying molecular masses, mainly below 55 kDa. Proteins present in CBP fraction were identified by Western blotting and mass spectrometry analysis, as vicilins and chitinases. CBP fraction, at 5%, was able to interfere with the development of cowpea weevil, decreasing larval mass and length. A CBV (chitin-binding vicilin) fraction isolated from CBP fraction was toxic, at 2.0%, to C. maculatus, decreasing larval mass and length in 64.3% and 33.23%, respectively. These results suggest that chitin binding proteins, such vicilins and chitinases, may be related to the resistance of cowpea cv. BRS Xiquexique to the infestation by C. maculatus.

HDG-select: A novel GUI based application for gene selection and classification in high dimensional datasets

The selection and classification of genes is essential for the identification of related genes to a specific disease. Developing a user-friendly application with combined statistical rigor and machine learning functionality to help the biomedical researchers and end users is of great importance. In this work, a novel stand-alone application, which is based on graphical user interface (GUI), is developed to perform the full functionality of gene selection and classification in high dimensional datasets. The so-called HDG-select application is validated on eleven high dimensional datasets of the format CSV and GEO soft. The proposed tool uses the efficient algorithm of combined filter-GBPSO-SVM and it was made freely available to users. It was found that the proposed HDG-select outperformed other tools reported in literature and presented a competitive performance, accessibility, and functionality.

Hearing impairment due to Mir183/96/182 mutations suggests both loss and gain of function effects

The microRNA miR-96 is important for hearing, as point mutations in humans and mice result in dominant progressive hearing loss. Mir96 is expressed in sensory cells along with Mir182 and Mir183, but the roles of these closely-linked microRNAs are as yet unknown. Here we analyse mice carrying null alleles of Mir182, and of Mir183 and Mir96 together to investigate their roles in hearing. We found that Mir183/96 heterozygous mice had normal hearing and homozygotes were completely deaf with abnormal hair cell stereocilia bundles and reduced numbers of inner hair cell synapses at four weeks old. Mir182 knockout mice developed normal hearing then exhibited progressive hearing loss. Our transcriptional analyses revealed significant changes in a range of other genes, but surprisingly there were fewer genes with altered expression in the organ of Corti of Mir183/96 null mice compared with our previous findings in Mir96 Dmdo mutants, which have a point mutation in the miR-96 seed region. This suggests the more severe phenotype of Mir96 Dmdo mutants compared with Mir183/96 mutants, including progressive hearing loss in Mir96 Dmdo heterozygotes, is likely to be mediated by the gain of novel target genes in addition to the loss of its normal targets. We propose three mechanisms of action of mutant miRNAs; loss of targets that are normally completely repressed, loss of targets whose transcription is normally buffered by the miRNA, and gain of novel targets. Any of these mechanisms could lead to a partial loss of a robust cellular identity and consequent dysfunction.

Hormone-Independent Mouse Mammary Adenocarcinomas with Different Metastatic Potential Exhibit Different Metabolic Signatures

The metabolic characteristics of metastatic and non-metastatic breast carcinomas remain poorly studied. In this work, untargeted Nuclear Magnetic Resonance (NMR) metabolomics was used to compare two medroxyprogesterone acetate (MPA)-induced mammary carcinomas lines with different metastatic abilities. Different metabolic signatures distinguished the non-metastatic (59-2-HI) and the metastatic (C7-2-HI) lines, with glucose, amino acid metabolism, nucleotide metabolism and lipid metabolism as the major affected pathways. Non-metastatic tumours appeared to be characterised by: (a) reduced glycolysis and tricarboxylic acid cycle (TCA) activities, possibly resulting in slower NADH biosynthesis and reduced mitochondrial transport chain activity and ATP synthesis; (b) glutamate accumulation possibly related to reduced glutathione activity and reduced mTORC1 activity; and (c) a clear shift to lower phosphoscholine/glycerophosphocholine ratios and sphingomyelin levels. Within each tumour line, metabolic profiles also differed significantly between tumours (i.e., mice). Metastatic tumours exhibited marked inter-tumour changes in polar compounds, some suggesting different glycolytic capacities. Such tumours also showed larger intra-tumour variations in metabolites involved in nucleotide and cholesterol/fatty acid metabolism, in tandem with less changes in TCA and phospholipid metabolism, compared to non-metastatic tumours. This study shows the valuable contribution of untargeted NMR metabolomics to characterise tumour metabolism, thus opening enticing opportunities to find metabolic markers related to metastatic ability in endocrine breast cancer.

Development of a tool to assess visual attention in Rett syndrome: a pilot study

This was a two-phase study that aimed to (a) develop a tool for assessing visual attention in individuals with Rett syndrome using AAC with a communication partner during naturalistic interactions in clinical settings; and (b) explore aspects of the tool's reliability, validity, and utility. The Assessment of Visual Attention in Interaction (AVAI) tool was developed to assess visual attention operationalized as focused gazes (1 s or longer) at the communication partner, an object, and a symbol set. For the study, six video-recorded interactions with nine female participants diagnosed with Rett syndrome (range: 15-52-years-old) were used to calculate intra- and inter-rater agreement, and 18 recorded interactions were analyzed to examine sensitivity to change and acceptability. There was a significant difference in the AVAI results between two conditions (with and without aided-language modeling). Inter-rater agreement ranged from moderate and strong. There was a range in scores, indicating that the AVAI could differentiate between participants. The AVAI was found to be reliable, able to detect change, and acceptable to the participants. This tool could potentially be used for evaluating interventions that utilize aided AAC.

3Rs-based optimization of mice behavioral testing: The habituation/dishabituation olfactory test

BACKGROUND

There is clear evidence that most of the paradigms that are used in the field of behavioral neuroscience suffer from a lack of reliability mainly because of oversimplification of both testing procedures and interpretations. In the present study we show how an already existing behavioral test, the olfactory habituation / dishabituation task, can be optimized in such a way that animal number and animal distress could be minimized, number/confidence of behavioral outcomes and number of explored behavioral dimensions could be increased.

NEW METHOD

We used ethologically relevant technical and procedural changes associated with videotracking-based automated quantification of sniffing behavior to validate our new setup. Mainly internal and construct validity were challenged through the implementation of a series of simple experiments.

RESULTS

We show that the new version of the test: 1) has very good within and inter laboratory replicability, 2) is sensitive to some environmental / experimental factors while insensitive to others, 3) allows investigating hedonism, both state and trait anxiety, efficacy of anxiolytic molecules, acute stress, mental retardation-related social impairments and learning and memory. 4) We also show that interest for both nonsocial and social odors is stable over time which makes repetitive testing possible.

CONCLUSIONS

This work paves the way for future studies showing how behavioral tests / procedures may be improved by using ethologically relevant changes, in order to question laboratory animals more adequately. Refining behavioral tests may considerably increase predictivity of preclinical tests and, ultimately, help reinforcing translational research.

A Systematic Methodology to Analyze the Impact of Hand-Rim Wheelchair Propulsion on the Upper Limb

Manual wheelchair propulsion results in physical demand of the upper limb extremities that, because of its repetitive nature, can lead to chronic pathologies on spinal cord injury patients. The aim of this study was to design and test a methodology to compare kinematic and kinetic variables of the upper limb joints when propelling different wheelchairs. Moreover, this methodology was used to analyze the differences that may exist between paraplegic and tetraplegic patients when propelling two different wheelchairs. Five adults with paraplegia and five adults with tetraplegia performed several propulsion tests. Participants propelled two different wheelchairs for three minutes at 0.833 m/s (3 km/h) with one minute break between the tests. Kinematic and kinetic variables of the upper limb as well as variables with respect to the propulsion style were recorded. Important differences in the kinetic and kinematic variables of the joints of the upper limb were found when comparing paraplegic and tetraplegic patients. Nevertheless, this difference depends on the wheelchair used. As expected, in all tests, the shoulder shows to be the most impacted joint.

"I prefer a male nurse to a female nurse": patients' preference for, and satisfaction with nursing care provided by male nurses at the Komfo Anokye teaching hospital

Background

Although most male nurses join the profession for self-actualisation, the cultural and societal stereotyping of male nurses as “He-Man”, “gay” and “troublemakers”, and their marginalisation at the hospital during certain personal and intimate care procedures, tend to deepen the existing gender discrimination prevalent within the nursing profession. This study therefore assessed patients’ preference for, and satisfaction with nursing care provided by male nurses at the medical and surgical wards of Komfo Anokye Teaching Hospital [KATH].

Methods

An inferential cross-sectional study design, in which the prevalence of a condition among an identified population is determined, was used. Using convenience sampling, 150 respondents who meet certain practical criteria and are available and willing to participate were sampled. Data from a context-based research instrument on the opinion, preference and satisfaction of patients with male nursing were analysed using χ² test, Mann Whitney U test, ordinal logistic regression and logistic regression.

Results

The study indicates that more females than males had ever been attended to by a male nurse for the period considered by the study, and females described male nurses as polite and courteous and were comfortable with their treatment. Being single [OR = 0.111, 95% CI (0.013–0.928)] and professing Islamic faiths [OR = 36.533, 95% CI (2.116–630.597)] were functions of respondents’ preference for a male nurse. Significantly too, affiliating to a religious sect (OR = 2.347, 95% CI [0.076–1.630]) and being educated (OR = 1.387, 95% CI [0.040–0.615]), were associated with higher odds of falling in one of the higher categories of satisfaction with nursing care provided by male nurses as against the lower categories.

Conclusion

Although marital status, religious affiliation and educational level were the significant predictors of patients’ preference for, and satisfaction with care provided by male nurses, the effect of the other variables should not be overlooked. The finding disproves assertions on the negative effect of religion on male nurses. It is recommended that public awareness be created on the role of male nurses in the healthcare delivery system to promote acceptance of gender diversity in the nursing profession.

Ventilator-Free Day Outcomes Can Be Misleading

INTRODUCTION

Acute respiratory distress syndrome often requires invasive mechanical ventilation, with both mortality and mechanical ventilation duration as outcomes of interest. The concept of ventilator-free days has been proposed as an outcome combining these two outcomes. Here we analyzed the construction of the ventilator-free day outcome and provided a hypothetical scenario to alert physicians that such an outcome can lead to misleading interpretations.

METHODS

We proposed the isoventilator-free day curve concept and, using an analytical development, illustrated how a median ventilator-free day value can actually result from very different combinations of death rates and mechanical ventilation durations. We also used a hypothetical example to compare the Student t test, Wilcoxon rank-sum test, and Gray test (which accounts for death as a competing event with extubation) in comparing exposition to mechanical ventilation.

RESULTS

A median ventilator-free day value of 10 days may mean that 10% of the patients died while survivors were ventilated during a median of 14 days or that 40% died while survivors were ventilated during a median of 5 days. Changing the time horizon affected the Student t test but not the Wilcoxon rank-sum result. The Gray test was more relevant than both the Student t test and Wilcoxon rank-sum test in identifying differences in groups showing highly different mechanical ventilation duration, despite equal median ventilator-free days. This approach was also illustrated using real data.

CONCLUSIONS

Use of ventilator-free days as an outcome appears to have many drawbacks. Suitable methods of analyzing time to extubation should be preferred.

Hypothalamic dopamine signaling regulates brown fat thermogenesis

Dopamine signaling is a crucial part of the brain reward system and can affect feeding behavior. Dopamine receptors are also expressed in the hypothalamus, which is known to control energy metabolism in peripheral tissues. Here we show that pharmacological or chemogenetic stimulation of dopamine receptor 2 (D2R) expressing cells in the lateral hypothalamic area (LHA) and the zona incerta (ZI) decreases body weight and stimulates brown fat activity in rodents in a feeding-independent manner. LHA/ZI D2R stimulation requires an intact sympathetic nervous system and orexin system to exert its action and involves inhibition of PI3K in the LHA/ZI. We further demonstrate that, as early as 3 months after onset of treatment, patients treated with the D2R agonist cabergoline experience an increase in energy expenditure that persists for one year, leading to total body weight and fat loss through a prolactin-independent mechanism. Our results may provide a mechanistic explanation for how clinically used D2R agonists act in the CNS to regulate energy balance.

A critical assessment of the feature selection methods used for biomarker discovery in current metaproteomics studies

Microbial community (MC) has great impact on mediating complex disease indications, biogeochemical cycling and agricultural productivities, which makes metaproteomics powerful technique for quantifying diverse and dynamic composition of proteins or peptides. The key role of biostatistical strategies in MC study is reported to be underestimated, especially the appropriate application of feature selection method (FSM) is largely ignored. Although extensive efforts have been devoted to assessing the performance of FSMs, previous studies focused only on their classification accuracy without considering their ability to correctly and comprehensively identify the spiked proteins. In this study, the performances of 14 FSMs were comprehensively assessed based on two key criteria (both sample classification and spiked protein discovery) using a variety of metaproteomics benchmarks. First, the classification accuracies of those 14 FSMs were evaluated. Then, their abilities in identifying the proteins of different spiked concentrations were assessed. Finally, seven FSMs (FC, LMEB, OPLS-DA, PLS-DA, SAM, SVM-RFE and T-Test) were identified as performing consistently superior or good under both criteria with the PLS-DA performing consistently superior. In summary, this study served as comprehensive analysis on the performances of current FSMs and could provide a valuable guideline for researchers in metaproteomics.

The relative impact of urbanization and precipitation on long-term water level variations in the Yangtze River Delta

The combined and individual hydrological impacts of climate variation and urbanization have been extensively discussed over the past few decades, yet little is known about the relative impact of each. In this paper we took one of the most developed regions worldwide, Yangtze River Delta, as an example to analyse the long-term relative impacts of precipitation and urbanization change on water level alterations, based on precipitation, water level series, and annual impervious area data from 1960 to 2015. Abrupt changes detection in the water level series divided the data into the pre-impact period (1960-1988) and impacted period (1989-2015), and relative impacts of precipitation and urbanization on the water level increase from pre-impacted to impacted period, as well as their spatial and seasonal variations were estimated with the elasticity method. The results indicated that the urbanization change showed no distinct influence on the water level rise in the pre-impact period, while the precipitation played distinct roles only during summer months in the impacted period; the precipitation dominated two thirds of the water level rise in flood season, and in non-flood season the urbanization controlled the two thirds of the water level rise; spatially, the water level variations in old and new urban area were dominated by precipitation and urbanization process respectively; compared with precipitation amount, the water level correlated more strongly to the contribution ratio of precipitation. The results would provide a good reference for flood control and water resource management in the river basin, especially in the economically developed areas.