bluuebunny/crossref_metadata_2025 huggingface dataset:
Digital technology and student engagement in online synchronous collaborative learning sessions / Tecnología digital y participación de los estudiantes en las sesiones de aprendizaje colaborativo en línea
Authors: Singh Ammar Bahadur
Published: October 2024

This study examines students’ engagement in online synchronous collaborative learning (OSCL) sessions in a massive open online course (MOOC). The study focuses on the role of digital technologies in facilitating students’ agency in collaborative meaning-making activities. The primary data sources for the study were video recordings of OSCL sessions, which were analysed using the method of interaction analysis and interpreted through the lens of cultural-historical theory. The findings revealed four interconnected activities of collaborative meaning-making: establishing social connections and presence, reflecting on prior learning, sharing digital artefacts and reflecting on shared understanding. The progression from one activity to another unfolded as students contributed to collaborative learning activities using their own ideas and problem-solving approaches. The use of individually created digital artefacts, such as examination assignment drafts, deepened interactions and meaning-making processes, enhancing students’ agency in collaborative learning. The findings of this study provide insights into pedagogical strategies that can enhance student agency in MOOC environments, highlighting the crucial role of digital artefacts in developing students’ agency in collaborative learning.
How can interventions of building renovation and household energy conversion effectively improve the physical and mental health outcomes? A systematic review and meta-analysis
Authors: Li Lanlan , Wang Xin , Yang Ranran , Jiao Jianling
Published: October 2024

Household energy efficiency measures can effectively reduce indoor air pollution and positively impact the health of residents, but there is no conclusive evidence on the effectiveness of different energy efficiency measures for various diseases. This study used systematic review and meta-analysis to research the effects of two interventions on residents’ physical and mental health: building renovation (heating, insulation, double-glazed windows and ventilation) and household energy conversion (stove upgrading and clean energy use). A total of 79 papers published between 1977 and 2023 were reviewed in this study, providing comprehensive meta-analytic evidence on the effectiveness of energy efficiency measures. The results show that household energy-saving measures have a minor but significant positive influence on residents’ physical and mental health, with the effect on mental health being larger than the impact on physical health. Stove upgrading is advantageous in respiratory and cardiovascular diseases; insulation can greatly reduce the risk of skin diseases; heating is beneficial in sensory and digestive diseases; and clean energy use can successfully mitigate integrative diseases. Furthermore, a combination of heating and insulation measures has the most favourable influence on mental health conditions such as depression, anxiety and social isolation. The study findings can help residents, policymakers and relevant organizations take appropriate interventions to promote residents’ physical and mental health.
The lexical boost is not an automatic part of sentence production: Evidence from Japanese structural priming
Authors: Chang Franklin , Tsumura Saki
Published: October 2024

The lexical boost is an increase in structural priming with overlapping elements like verbs. Residual activation priming theories argue that the boost is an automatic side effect of sentence planning. In contrast, explicit memory theories of the boost argue that it is the result of a non-automatic explicit memory retrieval. These theories were contrasted in Japanese by including a prime memory task in a structural priming study. Structural priming was found for both datives and passives, but no lexical boost was found, and one possible reason was that explicit memory for the prime structure was weak. In a follow-up study, priming was found in a sentence-completion task, but there was no lexical boost. The existence of abstract priming and the lack of a lexical boost in these studies falsify theories that argue that verb overlap automatically creates a boost under conditions that exhibit abstract priming.
Is prompt engineering the future of screenwriting? Views of professional screenwriters and commissioners about the impact of AI technologies on their profession
Authors: Vainikka Eliisa , Soronen Anne , Kallio Saara-Maija
Published: October 2024

This article presents a qualitative interview study of Finnish screenwriters and commissioners about the impact of generative artificial intelligence on the profession of screenwriting. We ask how screenwriters and commissioners see the benefits and risks of AI tools in screenwriting and how screenwriters see their changing profession in the future. We identify three stances towards AI-driven work practices in screenwriting. The functional, critical and curious stance reflect the ways in which the writers position themselves against AI technologies. Prompt engineering has emerged as a new skill in commanding AI and will become a conventional part of creative work.
Protecting jobs and lives: Teachers’ passive resistance and subtle protest to curriculum policy in Lesotho, South Africa and Zimbabwe
Authors: Chimbi Godsend T , Jita Loyiso C
Published: October 2024

Most studies on teacher resistance to curriculum policy and reform implementation focus on teacher activism and visible acts of resistance. But there is growing interest in teachers’ passive resistance and covert protest in the face of intimidating state power. This paper theorises subtleties of teacher protest in three Southern African states – Lesotho, South Africa and Zimbabwe. In these countries, teacher strikes, class boycotts and sit-ins have received heavy handed reaction from the government, resulting in psychological intimidation, physical assaults and incarceration. The key question driving this paper, therefore, is: Faced with shrinking democratic space, how are teachers in Lesotho, South Africa and Zimbabwe recalibrating protest strategies? This paper argues that state repression pushes teachers to retreat from active protest and resort to subtle protest, to protect their jobs and lives. The unique contributions of this paper are that it borrows James Scott’s typology of ‘everyday invisible acts of resistance’, developed from an anthropological study of peasants struggle in a Malay village, to theorise teacher resistance in pseudo-democratic spaces. It also generates novel insights on how teachers continue to resist curriculum policy while sending false signals of compliance to repressive state power.
Nurse Perceptions of Pediatric Mental Health Emergency Care: A Qualitative Study
Authors: Alhamidi Sami Abdulrahman , Alyousef Seham Mansour
Published: October 2024

The key goal of the mental health nurse practicing in emergency mental health care services is ensuring that their patients have access to best practice mental health care. The aim of this study was to examine mental health nurses’ perceptions of their role in and preparation for providing mental health care services for pediatric emergency department patients. A qualitative constructivist method was employed. Inductive data were gathered using a focus group discussion model employing open-ended questions as probes. The participants were nine experienced practicing mental health nurses. Discussion was facilitated through detailed probing of the nurses’ experiences in providing care for clients in emergency departments. Four principal themes emerged from the data about mental health nurses’ experiences during the provision of emergency care: (i) barriers to adequate care provision; (ii) problems among populations; (iii) pediatric special needs; and (iv) the general need for improvements to mental health care. Each participant in this study asserted that they endorse the introduction of care by specialized mental health nurses in emergency care departments to better serve this population in Saudi Arabia. Inclusion and acceptance of psychiatric mental health nurses as full members of the multidisciplinary emergency department team, improved education and training opportunities, standards-based evaluation by collegial supervisors, availability of tools for assessment, and recognition of the role of pediatric psychiatric mental health nurses in emergency department care were goals expressed by the focus group members.
Trends in Mutual Transpositions of Lexical and Grammatical Noun Categories in Russian Language
Authors: Chen Shaoxiong , Stepanov Ievgenii
Published: October 2024

This study addresses the gap in understanding the lexico-grammatical-structural types of nouns, particularly how lexico-semantic variants gain new connotations during transposition. Drawing upon Babaytseva’s theory of transitivity phenomena and building on Mel’chuk’s text semantic theory, we identify the schemes and mechanisms of transposition relations concerning the lexical and grammatical categories of modern Russian nouns, by analyzing transposition phenomena and their semantic mechanisms in 660 Russian nouns with indefinite denotation and lexical and grammatical status. The research details all possible immigration transpositions of the lexical and grammatical categories of nouns at the minimal context level and their mechanisms. Findings reveal that approximately 27% of the examined nouns carry connotative meanings, encompassing functional-stylistic, cultural-ethnic, and emotional-evaluative facets. Additionally, the transposition of nouns can occur within or between categories. The principal mechanisms of transposition at the syntagmatic level include metaphors and metonymy. Transpositions at the lexical and semantic categories of nouns coincide with several phenomena: changes in the numerical paradigm, phraseologization, connotation, and the unveiling of the noun’s stylistic potential.
Characterizing Treatment Credibility, Treatment Expectancy, and Symptom Expectancy in Patients Before Nonoperative Treatment for Degenerative Meniscal Tears
Authors: Bisson Leslie J. , Weiss-Laxer Nomi S. , Katz Jeffrey N. , Haider Mohammad N. , Flikkema Kyle B. , Lackner Jeffrey M.
Published: October 2024

Background:

The role of nonspecific factors, such as treatment credibility, treatment expectancy, and symptom expectancy, may shape the outcomes of the nonoperative treatment of degenerative meniscal tears (DMTs).

Purpose/Hypothesis:

The purpose of this study was to characterize treatment credibility and expectancy, symptom expectancy, and patient and clinical correlates of these factors among participants before undergoing 4 nonoperative treatment programs for DMTs. It was hypothesized that (1) treatment credibility scores would be similar across patient and baseline clinical subgroups and (2) treatment expectancy and symptom expectancy scores would be lower in older patients and among those reporting a longer pain duration or greater pain intensity.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

In 126 participants, validated scales were administered before treatment to assess the credibility of the assigned treatment (possible score of 1-9) as well as the expectations of treatment outcomes (0-100) and symptom improvement (1-5). Patient and clinical characteristics associated with these variables were examined.

Results:

On average, participants (mean age, 58 years [range, 45-75 years]; 51% female; 94% White) expected the treatment to improve their symptoms by a mean of 68% and expected their symptoms to be “very likely” to improve. Participants with a body mass index (BMI) ≥30 kg/m2 had lower mean treatment credibility (6.09 ± 1.81) and treatment expectancy (64.53 ± 25.16) scores on bivariate analyses than those with a BMI <30 kg/m2 (6.73 ± 1.69 [ P = .045] and 72.86 ± 19.20 [ P = .039], respectively). Participants reporting a pain duration ≥3 months also had lower mean treatment expectancy (63.85 ± 23.83) and symptom expectancy (3.70 ± 0.85) scores compared to those reporting a pain duration <3 months (75.52 ± 18.93 [ P = .003] and 4.16 ± 0.67 [ P = .001], respectively).

Conclusion:

Most patients about to undergo physical therapy for DMTs considered it to be between “somewhat” and “very” credible and believed that their symptoms, on average, were “very likely” to improve. Although not supported by most evidence, patients with a BMI ≥30 kg/m2 believed physical therapy to be less credible and had lower treatment and symptom expectations, and those with symptoms present for ≥3 months had lower treatment and symptom expectations as well. Whether these nonspecific factors influence outcomes should be considered for further research.
Multisystem Inflammatory Syndrome in Children (MIS-C) Associated With COVID-19 Infection in Morocco
Authors: Amenzoui Naima , Zouiter Siham , Nassid Meriem , Kholaiq Halima , Belkhou Ikbal , Benhsaien Ibtihal , Ailal Fatima , Adnane Fatima , Jouhadi Zineb , Bousfiha Ahmed Aziz
Published: October 2024

Introduction. This study aims to describe the clinical and paraclinical characteristics of Multisysteminflammatory syndrome in children (MIS-C).  Methods. A retrospective study encompassing 52 children diagnosed with MIS-C according to the World Health Organization criteria, over a 3-year period at Abderrahim Harrouchi Hospital in Morocco.  Results. The median age was 6 years (IQR: 1-14), with a sex ratio of 1.16 (28 boys and 24 girls). Clinical manifestations were predominantly characterized by fever in all cases (100%), respiratory and gastrointestinal symptoms in 30 cases (58%) and 23 cases (44%) respectively, and shock in 9 cases (17%). We noted a myocarditis in 6 cases (12%). The treatment comprised intravenous human Immunoglobulin combined with methylprednisolone in all patients (100%).  Conclusion. The characteristics of our MIS-C patients were similar to those in the literature, but more studies are needed to confirm these results.
What Theory Is, What Theory Was: Whence and Whither Theory
Authors: Suddaby Roy
Published: October 2024

This essay offers a critique of Gabriel Abend’s call for more action and less abstraction in social theory. The critique questions Abend’s insistence on pragmatic presentism—research that can be used tomorrow—and his implicit rejection of our time-honored commitment to construct clarity and rigor in theory. Abend’s insistent focus on the present ignores a long history of pragmatism in both social and management theory that has served our profession well. More importantly, his argument misinterprets pragmatism as a rejection of theory when, in fact, pragmatism suggests precisely the opposite.
Varying levels of natural light intensity affect the phyto-biochemical compounds, antioxidant indices and genes involved in the monoterpene biosynthetic pathway of Origanum majorana L.
Authors: Hashemifar Zahra , Sanjarian Forough , Naghdi Badi Hassanali , Mehrafarin Ali
Published: October 2024

Background

Light is a critical environmental factor in plants, encompassing two vital aspects: intensity and quality. To assess the influence of different light intensities on Origanum majorana L., pots containing the herb were subjected to four levels of light intensity: 20, 50, 70, and 100% natural light. After a 60-day treatment period, the plants were evaluated for metabolite production, including total sugar content, protein, dry weight, antioxidant indices, expression of monoterpenes biosynthesis genes, and essential oil compounds. The experimental design followed a randomized complete blocks format, and statistical analysis of variance was conducted.

Results

The results indicated a correlation between increased light intensity and elevated total sugar and protein content, which contributed to improved plant dry weight. The highest levels of hydrogen peroxide and malondialdehyde (MDA) were observed under 100% light intensity. Catalase and superoxide dismutase enzymes exhibited increased activity, with a 4.23-fold and 2.14-fold increase, respectively, under full light. In contrast, peroxidase and polyphenol oxidase enzyme activities decreased by 3.29-fold and 3.24-fold, respectively. As light intensity increases, the expression level of the 1-deoxy-D-xylulose 5-phosphate reductoisomerase (DXR) gene increases. However, beyond a light intensity of 70%, the DXR gene expression level decreased. Furthermore, the expression levels of the cytochrome P450 genes CYP71D178 and CYP71D179 exhibited an increasing trend in response to elevated light intensity. Essential oil content increased from 0.02 to 0.5% until reaching 70% light intensity. However, with further increases in light intensity, the essential oil content decreased by 54 to 0.23%.

Conclusions

These findings emphasize the importance of balancing plant growth promotion and stress management under different light conditions. The research suggests that sweet marjoram plants thrive best in unshaded open spaces, resulting in maximum biomass. However, essential oil production decreases under the same conditions. For farmers in areas with an average light intensity of approximately 1700 µmol m−2s−1, it is recommended to cultivate sweet marjoram in shade-free fields to optimize biomass and essential oil production. Towards the end of the growth cycle, it is advisable to use shades that allow 70% of light to pass through. The specific duration of shade implementation can be further explored in future research.
Severe co-infection caused by difficult-to-diagnose hypermucoviscous Klebsiella pneumoniae K1-ST82 in a patient with COVID-19: a case report
Authors: Itoga Masamichi , Hayashi Wataru , Kayama Shizuo , Yu Liansheng , Sugawara Yo , Kimura Masahiko , Hanada Hiroyuki , Tasaka Sadatomo , Sugai Motoyuki
Published: October 2024

Background

Co-infection with Klebsiella pneumoniae presents a significant concern in hospitalized patients with coronavirus disease (COVID-19), increasing the risk of severe disease progression. Hypervirulent (hv) and hypermucoviscous (hm) K. pneumoniae (Kp) has gained prominence in Asia due to its capacity to cause invasive community-acquired infections. However, recognition of hvKp/hmKp co-infections in the context of COVID-19 remains limited. We report a severe case of rapidly progressing co-infection with hmKp exhibiting “difficult-to-diagnose” phenotypes in a hospitalized patient with COVID-19.

Case presentation

A 61-year-old woman with COVID-19 initially exhibited mild symptoms resembling the common cold. However, her condition rapidly deteriorated over 7 days, leading to hospital admission with the development of dyspnea. The patient required supplemental oxygen, antibiotic treatment, and mechanical ventilation. Gram-negative bacteria with atypical phenotypes were isolated from alveolar lavage fluid and blood cultures. Both strains formed small, glossy, non-lactose-fermenting colonies on clinically relevant media and were susceptible to ampicillin. Conventional biochemical tests failed to identify the Enterobacteriales strains owing to the urease-negative phenotype. Consequently, the identification of K. pneumoniae was difficult until matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) analysis was performed. A positive string test indicated mucoviscosity, but with variability in the material used for stretching colonies. Whole-genome sequencing performed on the MiSeq and GridION platforms revealed the blood-derived strain JARB-RN-0063 as belonging to serotype K1 and sequence type (ST) 82. The hvKp-associated genes rmpA and iroCD were located on a 5.0-Mb chromosome, and iucABCD-iutA was identified on a 217.9-kb IncFIB(K)/IncR-type plasmid. Therefore, JARB-RN-0063 was genetically classified as hvKp with a Kleborate virulence score of 3. The intrinsic penicillinase gene blaSHV was defective owing to an IS1F element insertion, resulting in the strain being atypically susceptible to ampicillin.

Conclusions

This is the first case of severe COVID-19-associated co-infection with a difficult-to-diagnose K. penummoniae strain. Notably, co-infection by the hmKp K1-ST82 clone exhibited atypical phenotypes, including stunted growth, non-lactose fermentation, urease-negative reaction, ampicillin susceptibility, and abnormal mucoviscosity, posing diagnostic challenges for clinical laboratories and impedes the identification of hvKp/hmKp. Delayed identification may worsen patient outcomes, highlighting the need for increased clinical awareness of such difficult-to-diagnose clones to prevent deterioration.
A comparison of operating room toric placement tools: CALLISTO eye vs. e Wavetec AnalyzOR (CORTCO)
Authors: Scott Maria C.
Published: October 2024

Background

To evaluate procedure times for two cataract planning systems (ZEISS CALLISTO eye and the Wavetec AnalyzOR) in predicting residual astigmatism (prediction error) and other visual outcomes in patients with corneal astigmatism (maximum allowable up to 3.0D) at postoperative month 1.

Methods

This was a prospective, single center, parallel treatment group, bilateral and unilateral, randomized, 1-month study on patients scheduled to undergo routine, small-incision cataract surgery with a toric intraocular lens implantation. Both groups underwent preop measurements with the IOLMaster 700 (Zeiss, Jena, Germany) and surgery with the LenSx device (Alcon). Lens selection in the CALLISTO eye group was based on Zeiss VERACITY Surgery Planner (a web-based tool) and on the Wavetec AnalyzOR component of the ORA system (a real-time intraoperative aberrometer) for those eyes in the ORA group. All procedure and intraoperative times were measured with a stopwatch. Postoperative visual outcomes were evaluated between 1 and 2 months after surgery.

Results

There were 23 eyes in the CALLISTO group and 28 eyes in the ORA group. The mean surgical time for the CALLISTO group was 28.09 ± 1.72 min compared to 34.41 ± 1.52 min for the ORA group (P = 0.01). Toric lens placement mean time in the CALLISTO group was 2.47 ± 0.34 min compared to 3.88 ± 0.29 min in the ORA group (P = 0.0034). At month 1 postoperatively, the manifest refractive spherical error (MRSE) in the CALLISTO eye group 0.022 ± 0.388 diopters (D) compared to -0.174 ± 0.322 D in the ORA group; these were not statistically different. There was a higher percentage (75%) of eyes with an MRSE within 0.25D in the ORA group compared to the CALLISTO eye group (56.5%); at all other levels outcomes were numerically higher in the CALLISTO eye group.

Conclusions

Less surgical time was needed when using the CALLISTO eye than the ORA when performing cataract surgery with toric lens implantation. There were similar visual outcomes between the groups and no statistical differences.
Social norms and social opportunities: a qualitative study of influences on tobacco use among urban adolescent girls in Ghana
Authors: Aryee Lois N.A. , Flanagan Sara V. , Trupe Lydia , Yucel Morgan , Smith Jana
Published: October 2024

Background

Tobacco use is a global public health threat and a leading preventable cause of death in the world. While cigarette use among youth has been decreasing in high-income countries, low- and middle-income countries have contrastingly high rates of adolescent smoking. In Ghana, smoking prevalence is lower than in other parts of the African continent and more common among men than women; however the gender gap in tobacco use among adolescents has narrowed, with shisha use among girls recently surpassing boys. These trends toward increased relative use among adolescent girls are a cause for concern and highlight the need for interventions to prevent and/or reduce tobacco use in this population.

Methods

We conducted in-depth interviews with girls aged 13–20 (n = 148) and their parents (n = 7) in Ghana’s largest two cities – Accra and Kumasi, to explore the physical, social, and psychological context underlying smoking perceptions and behavior.

Results

We identified 11 key insights into influences on smoking behavior, organized into the broader themes of perceptions of smoking, environmental factors, and internal factors. Findings underscore that perceptions around smoking are very much driven by girls’ social world, which is generally small and parent-centric for non-smokers at younger ages but can start to expand as girls get farther along in school or leave school entirely. After what may have been a sheltered adolescence, many older girls in Ghana look for ways to express their independence in decision-making and a few may use their developing agency to rationalize limited or infrequent tobacco use if they perceive the benefits to them outweigh the potential consequences.

Conclusions

Our findings highlight strong social influences on girls’ perceptions, exposure to opportunities, and decision-making in ways that can often be protective against smoking, particularly at younger ages, but may also leave girls unprepared to manage challenging situations later in life. Understanding this context in Ghana will be important for any future programming aiming to prevent smoking initiation among adolescents.
Management and outcomes in pulmonary arterial hypertension patients with sepsis
Authors: Flynn Spencer , Chen Haidee , Kerbel Russell , Gupta Summer , Jasuja Sonia , Saggar Rajan , Channick Richard , Sherman Alexander
Published: October 2024

Background

Sepsis is a common cause of death in patients with pulmonary arterial hypertension (PAH). Treatment requires careful fluid management and hemodynamic support. This study compares patients with or without PAH presenting with sepsis with a focus on initial fluid resuscitation.

Methods

This retrospective analysis compared adults with and without PAH admitted for sepsis at two academic hospitals between 2013 and 2022. Prior PAH diagnosis was verified by review of right heart catheterization data and sepsis present on admission was verified by chart review. Demographics, vital signs, laboratory values, imaging results, treatment approaches, and all-cause mortality data were obtained. Controls were propensity score weighted by age, sex, and Charlson Comorbidity index. Logistic regression models controlling for age and Charlson comorbidity indices were used to examine factors associated with survival.

Results

Thirty patients admitted for sepsis with pre-existing PAH were compared to 96 matched controls. Controls received significantly more fluids at 24 h compared to PAH patients (median 0 mL v. 1216 mL, p < 0.001), while PAH patients were more likely to receive vasoactive medications (23.3% vs. 8.3%, p = 0.037). At 30 days, 7 PAH patients (23.3%) and 13 control patients (13.5%) had died (p = 0.376). PAH patients that received more fluids had decreased mortality (OR 0.31, 95% CI 0.11–0.92, p = 0.03) and patients who received fluids had shorter mean time to antibiotics (2.3 h v. 6.5 h, p = 0.04), although decreased time to antibiotics was not associated with mortality. Patients who received no fluids more often had previously identified right ventricular systolic dysfunction (62.5% v. 28.6%, p = 0.136).

Conclusion

Patients with PAH and sepsis have high mortality and receive different treatments than controls, with more reliance on vasopressors and less on fluid resuscitation. PAH patients who received less fluids had higher mortality and those who received no fluids had a longer time to receiving antibiotics, indicating a potential delay in recognizing sepsis. Timely recognition of sepsis and dynamic decision-making around fluid resuscitation remains critical in this high-risk population.
The effect of empagliflozin on circulating endothelial progenitor cells in patients with diabetes and stable coronary artery disease
Authors: Hershenson Roy , Nardi-Agmon Inbar , Leshem-Lev Dorit , Kornowski Ran , Eisen Alon
Published: October 2024

Background

Diabetes mellitus (DM) is associated with premature atherosclerotic disease, coronary artery disease (CAD) and chronic heart failure (HF), leading to increased morbidity and mortality. Sodium-Glucose Co-transporter 2 Inhibitors (SGLT2i) exhibit cardioprotective benefits beyond glucose lowering, reducing the risk of major cardiovascular events (MACE) and HF hospitalizations in patients with DM and CAD. Endothelial progenitor cells (EPCs) are bone marrow-derived cells involved in vascular repair, mobilized in response to vascular injury. The number and function of circulating EPCs (cEPCs) are negatively affected by cardiovascular risk factors, including DM. This study aimed to examine the response of cEPCs to SGLT2i treatment in DM patients with stable CAD.

Methods

A prospective single-center study included patients with DM and stable CAD who were started on an SGLT2i (empagliflozin). Peripheral blood samples were collected at baseline, 1 month, and 3 months to evaluate cEPC levels and function by flow cytometry, immunohistochemistry and MTT assays.

Results

Eighteen patients were included in the study (median age 73, (IQR 69, 77) years, 67% male). After 1 month of treatment with empagliflozin, there was no significant change in cEPCs level or function. However, following 3 months of treatment, a significant increase was observed both in cell levels (CD34(+)/VEGFR-2(+): from 0.49% (IQR 0.32, 0.64) to 1.58% (IQR 0.93, 1.82), p = 0.0006; CD133(+)/VEGFR-2(+): from 0.38% (IQR 0.27, 0.6) to 0.82% (IQR 0.7, 1.95), p = 0.0001) and in cell function (from 0.25 CFUs (IQR 0, 0.5) at baseline, to 2 CFUs (IQR 1, 2) at 3 months, p = 0.0012).

Conclusions

Empagliflozin treatment in patients with DM and stable CAD increases cEPC levels and function, implying a cardioprotective mechanism. These findings highlight the potential of SGLT2i in treating cardiovascular diseases, warranting further research to explore these effects and their long-term implications.

Graphical Abstract
Aripiprazole once-monthly for the treatment of adult patients with earlier-stage bipolar I disorder: a post hoc analysis of data from a double-blind, placebo-controlled, 52-week randomized withdrawal trial
Authors: Bell Lynum Karimah S. , Castro Christine F. , Zhang Zhen , Patel Mehul , Tohen Mauricio
Published: October 2024

Background

Increased awareness of the factors contributing to the diagnostic disparities seen in bipolar disorder between individuals of different heritage is needed to achieve equity in diagnosis and treatment. One such inequity is the provision of earlier treatment. Earlier treatment of patients diagnosed with bipolar disorder may prolong time to recurrence of mood episodes and reduce functional impairment and other poor outcomes associated with disease progression. The aim of this post hoc analysis was to study the efficacy and safety of long-acting injectable aripiprazole once-monthly 400 mg (AOM 400) in patients with earlier-stage bipolar I disorder (BP-I). Data from a 52-week multicenter, double-blind, placebo-controlled, randomized withdrawal trial of AOM 400 versus placebo in patients with BP‑I (NCT01567527) were analyzed. Those patients in the lowest quartiles for age (18–≤32 years; n = 70) or disease duration (0.13–≤4.6 years; n = 67) at baseline were categorized with earlier-stage BP-I. The primary endpoint was time from randomization to recurrence of any mood episode. Other endpoints included proportion of patients with recurrence of any mood episode, and change from baseline in Young Mania Rating Scale (YMRS) and Montgomery–Åsberg Depression Rating Scale (MADRS) total scores.

Results

Maintenance treatment with AOM 400 significantly delayed time to recurrence of any mood episode versus placebo in patients aged 18–≤32 years (hazard ratio [HR]: 2.46 [95% confidence interval (CI) 1.09, 5.55]; p = 0.0251) or with disease duration 0.13–≤4.6 years (HR: 3.21 [95% CI 1.35, 7.65]; p = 0.005). This was largely driven by a lower proportion of patients in the AOM 400 group with YMRS total score ≥15 or clinical worsening. Changes from baseline in MADRS total score in both earlier-stage groups indicated AOM 400 did not worsen depression versus placebo. The safety profile of AOM 400 was consistent with the original study. Note that the original study included patients who had previously been stabilized on AOM 400 monotherapy, which may have enriched the population with patients who respond to and tolerate AOM 400.

Conclusions

In this post hoc analysis, AOM 400 prolonged time to recurrence of any mood episode versus placebo in earlier-stage BP-I. These findings support early initiation of maintenance treatment with AOM 400.
Nephroprotective role of resveratrol in renal ischemia-reperfusion injury: a preclinical study in Sprague-Dawley rats
Authors: Alaasam Elaf R. , Janabi Ali M. , Al-Buthabhak Karrar M. , Almudhafar Rihab H. , Hadi Najah R. , Alexiou Athanasios , Papadakis Marios , Abo-El Fetoh Mohammed E. , Fouad Dalia , El-Saber Batiha Gaber
Published: October 2024

Background

Renal ischemia-reperfusion injury (IRI) is a significant contributor to renal dysfunction, acute kidney injury (AKI), and associated morbidity and mortality. Resveratrol, a polyphenol and phytoalexin, is known for its anti-inflammatory, antioxidant, and anti-cancer properties. This study investigates the nephroprotective potential of resveratrol in a rat model of renal IRI.

Materials and methods

Twenty-eight male Sprague-Dawley rats were divided into four groups: Sham, IRI, DMSO, and Resveratrol. The Sham group underwent identical procedures without renal pedicle clamping, while the IRI group experienced 30 min of ischemia followed by 2 h of reperfusion. The DMSO group received dimethyl sulfoxide (DMSO) intraperitoneally 30 min before ischemia, and the Resveratrol group received 30 mg/kg resveratrol intraperitoneally 30 min before ischemia. Biochemical parameters (Urea, creatinine, IL-1β, NF-κβ, SOD, GSH, Bcl-2, and caspase-3) and histopathological changes were assessed.

Results

IRI caused a substantial increase in serum creatinine, Urea, IL-1β, NF-κβ, and caspase-3 levels, while simultaneously decreasing SOD, GSH, and Bcl-2 levels. Resveratrol treatment mitigated these effects by lowering inflammatory and apoptotic markers, enhancing antioxidant defenses, and improving histological outcomes.

Conclusion

Resveratrol demonstrates significant nephroprotective effects in renal IRI, primarily through its antioxidant, anti-inflammatory, and anti-apoptotic properties.
Left inguinal dedifferentiated liposarcoma and primary unclassified sarcoma of the left lung as synchronous multiple sarcomas: a case report
Authors: Kobayashi Masao , Satomi Hidetoshi , Chikaraishi Hisaya , Samejima Hironobu , Horiguchi Julian , Kanzaki Ryu , Maniwa Tomohiro , Honma Keiichiro , Okami Jiro
Published: October 2024

Background

Pulmonary nodules in patients with soft tissue sarcomas are likely pulmonary metastases, whereas synchronous primary pulmonary sarcomas are rare. Without surgery, determining whether a solitary pulmonary nodule is a primary or metastatic nodule is difficult. Herein, we report a rare case of a primary pulmonary sarcoma that presented synchronously with a primary dedifferentiated liposarcoma.

Case presentation

A 77-year-old man presented to another hospital with left inguinal swelling and a suspected recurrent inguinal hernia. Computed tomography revealed a left inguinal mass and pure-solid nodule in the left lung and the patient was referred to our hospital for detailed examination and treatment. The inguinal mass was pathologically diagnosed as a dedifferentiated liposarcoma using needle biopsy, whereas bronchoscopic biopsy revealed histological findings suggestive of a sarcoma; however, the primary site could not be determined. Positron emission tomography–computed tomography revealed no high-accumulation lesions except for the two sarcomas. We decided to perform surgery on both sarcomas for diagnostic and curative purposes. The surgical specimens showed that the two sarcomas were different. Based on the immunohistochemical staining findings of MDM2, a left inguinal dedifferentiated liposarcoma and primary pulmonary unclassified sarcoma were diagnosed. The patient displayed no evidence of recurrence 1 year after surgery.

Conclusions

We encountered a rare case of synchronous multiple primary sarcomas, one presenting in the lung and the other in the soft tissue. Surgery was required to achieve a definitive diagnosis for the patient, who achieved disease-free survival at 1 year. This case suggests that proactive resection of pulmonary nodules in patients with soft tissue sarcomas may be feasible as a diagnostic treatment if complete resection is achieved.
Unsupervised machine learning identifies distinct phenotypes in cardiac complications of pediatric patients treated with anthracyclines
Authors: Jacquemyn Xander , Chinni Bhargava K. , Barnes Benjamin T. , Rao Sruti , Kutty Shelby , Manlhiot Cedric
Published: October 2024

Background

Anthracyclines are essential in pediatric cancer treatment, but patients are at risk cancer therapy-related cardiac dysfunction (CTRCD). Standardized definitions by the International Cardio-Oncology Society (IC-OS) aim to enhance precision in risk assessment.

Objectives

Categorize distinct phenotypes among pediatric patients undergoing anthracycline chemotherapy using unsupervised machine learning.

Methods

Pediatric cancer patients undergoing anthracycline chemotherapy at our institution were retrospectively included. Clinical and echocardiographic data at baseline, along with follow-up data, were collected from patient records. Unsupervised machine learning was performed, involving dimensionality reduction using principal component analysis and K-means clustering to identify different phenotypic clusters. Identified phenogroups were analyzed for associations with CTRCD, defined following contemporary IC-OS definitions, and hypertensive response.

Results

A total of 187 patients (63.1% male, median age 15.5 years [10.4–18.7]) were included and received anthracycline chemotherapy with a median treatment duration of 0.66 years [0.35–1.92]. Median follow-up duration was 2.78 years [1.31–4.21]. Four phenogroups were identified with following distribution: Cluster 0 (32.6%, n = 61), Cluster 1 (13.9%, n = 26), Cluster 2 (24.6%, n = 46), and Cluster 3 (28.9%, n = 54). Cluster 0 showed the highest risk of moderate CTRCD (HR: 3.10 [95% CI: 1.18–8.16], P = 0.022) compared to other clusters. Cluster 3 demonstrated a protective effect against hypertensive response (HR: 0.30 [95% CI: 0.13– 0.67], P = 0.003) after excluding baseline hypertensive patients. Longitudinal assessments revealed differences in global longitudinal strain and systolic blood pressure among phenogroups.

Conclusions

Unsupervised machine learning identified distinct phenogroups among pediatric cancer patients undergoing anthracycline chemotherapy, offering potential for personalized risk assessment.
Radiographic predictors of peritumoral brain edema in intracranial meningiomas: a review of current controversies and illustrative cases
Authors: Orešković Darko , Blažević Andrea , Kaštelančić Anđelo , Konstantinović Ivan , Lakić Marin , Murn Filip , Puljiz Marko , Štenger Martina , Barač Pia , Chudy Darko , Marinović Tonko
Published: October 2024

Meningiomas are among the most common primary tumors of the central nervous system. In the past several decades, many researchers have emphasized the importance of radiographic findings and their possible role in predicting the various aspects of the meningioma biology. One of the factors most commonly analyzed with respect to the lesions’ clinical behavior is peritumoral brain edema (PTBE), not only one of the most common signs associated with meningiomas, but also a significant clinical problem. Radiographic predictors of PTBE are usually noted as being the size of the tumor, its location, irregular margins, heterogeneity, and the peritumoral arachnoid plane with its pial vascular recruitment. Here, we review the available literature on the topic of these radiographic predictors of PTBE formation, we analyze the methodology of the research conducted, and we highlight the many controversies still present. Indeed, the evidence about PTBE pathogenesis, predictive factors, and clinical significance still seems to be mostly inconclusive, despite intense research in the area. We believe that by highlighting the many inconsistencies in the methodology used, we can showcase how little is actually known about the pathogenesis of PTBE, which in turn has important clinical implications. Additionally, we provide several MR images of intracranial meningiomas from our own practice which, we believe, showcase the unpredictable nature of PTBE, and demonstrate vividly the topics we discuss.
Elimination of mutagenic contaminants from water using cellulose bearing ferrous-phthalocyanine
Authors: Sano Kayoko , Soga Yuka , Ohta Kaori , Kitamura Yuki , Arimoto-Kobayashi Sakae
Published: October 2024

Background

We previously investigated methods for separating mutagenic contaminants from aqueous solutions using cellulose-bearing covalently bound trisulfo-Cu-phthalocyanine (blue cotton and blue rayon). Mutagenic contaminants with three or more fused aromatic rings in their structures were adsorbed onto blue cotton and rayon. Since Cu-phthalocyanine is considered an unsuitable absorption ligand for byproducts of water chlorination, such as 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone (Mutagen X or MX), we investigated the development of a new material for the elimination of MX from aqueous solvents.

Results

We selected green cellulose powder bearing ferrous phthalocyanine (FePh), hereafter referred to as green cellulose or GP, as the candidate material. GP is composed of cationized cellulose (white cellulose, WP) and FePh tetracarboxylic acid. The mutagenicity of MX dissolved in buffer or dimethyl sulfoxide (DMSO) solution significantly decreased after treatment with GP. The effects of GP on the elimination of MX from the solvent were very close to being expired after 70 cycles of repeated adsorption of the same GP, and the capacity of GP for MX removal was estimated to be exhausted after 120 cycles of repeated adsorption based on the extrapolation of the obtained result; thus, the interacting ligands on GP may be saturated after complete MX adsorption. The mutagenicity of MX dissolved in aqueous buffer significantly decreased after treatment at pH7.4 but not at pH 4.0. Since MX is dissociated to be the anionic form at pH 6 or higher, the negative charge of MX in the buffer at pH 7.4 may interact with the positive charge of ferrous ions in GP to create a linkage between MX and GP. After GP adsorbed MX, mutagenicity was extracted with water or acetonitrile and recovered in the eluent. Thus, the reversible interaction between MX and FePh may have caused adsorption of MX onto GP.

Conclusion

GP could be used as a new eliminator and recovery agent for MX in chlorinated drinking water. Developing new materials for the removal and recovery of agents for the detection of mutagenic contaminant-related chlorination in water is beneficial for environmental health.
The relationship between feeding practices and stunting among children under two years in Tanzania mainland: a mixed-method approach
Authors: Mandara Faith , Festo Charles , Killel Erick , Lwambura Samwel , Mrema Jackline , Katunzi Farida , Martin Haikael D. , Elisaria Ester
Published: October 2024

Background

Proper infant and young child feeding practices have gained attention over the years as one of the interventions to reduce childhood stunting. However, there is still a gap in research to determine these relationships in children under two years and the reasons for improper feeding.

Objective

This study aimed to assess the relationship between feeding practices, stunting and barriers among children under two years.

Methodology

Utilizing a mixed-method approach, the study involved secondary analysis of 1806 records of children aged 6–23 month, from the Next Generation Nutrition Program conducted in Tanzania (2015–2019). Both quantitative and qualitative data analyses were employed. Frequency distribution tables were utilized to describe study participants stratified by their stunting status. Subsequently, modified Poisson regression models identified predictors of stunting. Qualitative analysis encompassed deductive and inductive approaches, to extract themes that address the behaviors contributing to inappropriate feeding practices.

Results

Stunting prevalence was 28.8% among children aged 6–23 months, with the majority (65%) of stunted children aged 1 year or older. Dietary diversity was low: 88.3% and 86.3% of stunted and non-stunted children, respectively, consumed less than 5 food groups. Surprisingly, early initiation of breastfeeding, time of stopping breastfeeding, and minimum dietary diversification were not significantly associated with child stunting (p-value > 0.05). Barriers to proper feeding practices identified were inadequate knowledge of feeding, maternal condition, economic hardship, cultural issues, and seasonality.

Conclusion

Early breastfeeding and minimum dietary diversity were not significant predictors of stunting. However, the mother’s age and height > 150 cm reduced stunting risk while child sex, age, birth weight, marital status, and place of delivery also influenced stunting risk. It is crucial for initiatives to emphasize good feeding practices while addressing the complex factors that may hinder optimal feeding practices in this age group to reduce childhood stunting effectively.
Prevalence of tinnitus in temporomandibular joints disorder patients
Authors: Fadal-Allah Nourhan Gamil , Helmy Emad Saeed , Algarf Tareq Muhammad , Sheta Sarah Mohamed , Aziz Omniya Abdel
Published: October 2024

Background

Disorders affecting the temporomandibular joint (TMJ), related structures, and the masticatory muscles are called temporomandibular disorders (TMD). The two most typical symptoms are mouth opening restriction and pain. Costen noted the connection between TMD and tinnitus in 1934. These conditions are brought about by the shared structures that connect the TMJ and the auditory apparatus (bones and muscles) through a shared innervation source and specific ligaments. Wright addresses Costen ideas, which suggest that otological symptoms of TMD could be caused by auriculotemporal nerve damage, Eustachian tube restriction, or other factors causing an incorrect intratympanic pressure adjustment.

Methods

Cross-sectional observation was regulated at Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University. The following are the inclusion criteria: patients with a TMD diagnosis and those older than 16 years old. The following conditions are excluded: neurological or oncological disorders, ear infection, and a history of face trauma.

Results

The total number was 196 patients, 63.8% females and 36.2% males. A total of 76.5% had bilateral joint pain, and 21.9% had unilateral joint pain. While 70.4% had bilateral muscle pain, 18.9% had unilateral muscle pain. A total of 91.8% had mild tinnitus, while 8.2% had moderate tinnitus.

Conclusion

In this study, 8.2% of patients complaining of tinnitus had severe tinnitus, while 91.8% had mild tinnitus.