bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of sensory - motor and virtual reality interventions on indicators of gait, balance and quality of life of MS patients: a randomized trial
Authors: asghari seyed hadi , Ilbeigi saeed , Ahmadi Mohsen Mohammadnia , Yousefi Mohammad , Mirzaei Mohammad Mousavi
Published: December 2024

Introduction Multiple sclerosis (MS) is a neurological disorder that affects the central nervous system, causing inflammation and damage to the myelin sheath, leading to balance and gait impairments. Sensory-motor (SN) and virtual reality (VR) interventions have shown promise in addressing these balance issues by engaging all three components of the balance control systems. This study aimed to compare the effectiveness of SN and VR training on the functional status and quality of life of MS patients. Methods In this study, 36 MS patients receiving Rituximab therapy with an EDSS of 2 to 6 were randomly assigned to three groups: SN (n = 10), VR (n = 8) and a control group (n = 10). The SN and VR groups underwent 8 weeks of intervention, with 3 sessions per week, while the control group continued routine care. Assessments using Timed Up and Go (TUG), Timed 25-Foot Walk (T25FW), Multiple Sclerosis Quality of Life 54 Instrument (MSQOL54), and Pittsburgh Sleep Quality Index (PSQI) were conducted at baseline and after eight weeks. Results Considerable progress was made in all major and secondary variables after SN and VR training in comparison to the baseline settings. Furthermore, compared to the control group, the experimental groups showed a statistically significant improvement in both the primary and secondary outcomes. There were no significant differences in other variables between the SN and VR groups in the comparison of the experimental groups, with the exception of the PSQI, which showed significant changes in favor of the SN group. Conclusions The VR with a head-mounted display (HMD) serves as a motivational training tool, while SN training is an affordable and accessible technique. Both interventions can positively impact the functional status of MS patients by improving balance and gait through their task-oriented, dual-task, and multisensory nature.
Quality of Life and Sleep Disturbances in Afghanistan: A Large Cross- Sectional Survey Study
Authors: Neyazi Ahmad , Rahimi Bilal Ahmad , Mohammadi Abdul Qadim , Arsin Parwin , Afzali Habibah , Neyazi Mehrab , Hosaini Sayed Farooq , Sifat Sifatullah , Daulati Mohammad Naeem , Qanawezi Laila , Sarem Shararah
Published: December 2024

Background Sleep and quality of life are closely related to one another in patients as well as in the general population of all age groups. Main objective of this study was to study the prevalence and relationship between sleep disturbance and quality of life among adults in different provinces of Afghanistan.Methods This cross-sectional study was conducted from September 5, 2023 to February 10, 2024 among 1380 adult participants (age range 18–80 years) of eight provinces in southern, western, and northern regions of Afghanistan. Quality of life was evaluated with 26-item Dari version of the World Health Organization's Quality of Life–Bref (WHOQOL-Bref 26) while quality of sleep was assessed with Pittsburgh Sleep Quality Index (PSQI). For data analysis, descriptive statistics, chi-square test, and multiple regression analysis were used.Results Among the 1380 study participants, 68.9% were females, 62.1% were in age group 18–29 years, and 69.1% had experienced a bad event in the past month. Sleep disturbance was present in 50.7% (700/1380) people with mean PSQI global score of 6.13 which showed poor sleep quality among the study participants. In physical, psychological, social relationship, and environmental domains of quality of life, 19.1%, 27.6%, 22.6%, and 26.2% of the study participants had low quality of life. Based on participants’ quality of life, statistically significant sleep disturbance was observed among study participants who had poor quality of life, were very dissatisfied from their health, had high physical domain, high psychological domain, high social relationship domain, and high environment domain. Multiple logistic regression analysis showed that main factors associated with increased sleep disturbance among the study participants were age group 30–80 years (p-value 0.001), widowed or divorced (p-value 0.003), people with low family income (p-value < 0.001), and those who had experienced a bad event in the past month (p-value 0.001).Conclusion The findings of this study indicate that poor sleep quality is highly prevalent among the general population in Afghanistan, adversely impacting their quality of life. Future research on quality of life should account for sleep quality as a contributing factor. Additionally, well-designed prospective studies examining the correlation between PSQI scores and quality of life could facilitate the development of effective interventions aimed at enhancing quality of life.
PPARγ Promotes Urothelial Remodeling During Urinary Tract Obstruction
Authors: Jackson Ashley , El-Harakeh Mohammad , Rodriguez-Tirado Felipe , Miehls Alexa , Hardman Andrew , Camara Oumoulkhairy , Grounds Kelly , Tocaj Glenis , Kercsmar Macie , Li Birong , Wang Xin , Becknell Brian
Published: December 2024

Urinary tract obstruction (UTO) is a common cause of kidney injury that can result in chronic kidney disease and end-stage renal disease. Heterogeneity in the extent of obstructive renal damage in humans with UTO implies the existence of unknown mechanisms that protect against or accelerate kidney injury. Prior studies show that congenital and acquired UTO initiate a conserved, protective program of renal urothelium remodeling that culminates in expansion of uroplakin (UPK)+ cells to promote renal structural integrity. However, the cellular and molecular mechanisms that regulate UPK expression in the renal urothelium are unknown. Peroxisome proliferator-activated receptor γ (PPARγ) drives urothelial differentiation and UPK expression in other tissues but has not been investigated in the renal urothelium. Here, we demonstrate that activation of PPARγ in UPK+ cells is critical for UTO-induced renal urothelium remodeling. Conditional deletion of PPARγ perturbs UPK expression and accelerates parenchymal thinning during UTO, while conditional activation of PPARγ increases UPK expression and results in parenchymal preservation. This study underscores the significance of renal urothelium during UTO and shows that UTO-induced renal urothelial remodeling is achieved through activation of PPARγ. These findings form the foundation for future studies that will determine the therapeutic utility of PPARγ agonists during congenital and acquired UTO.
Transoral Endoscopic Thyroidectomy Vestibular Approach:Analysis of the Learning Curve and Clinical Outcomes Evaluation
Authors: Deng Yuhang , Zhao Jiaojiao , Tao Mei , Zhao Haixin , Fan Ruoxin , Wang Xiaoming , Lu Xiubo
Published: December 2024

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has the advantage of completely scarless on the body surface. Currently, there is still a lack of single-center large sample size analysis on the learning curve of TOETVA, especially for the treatment of thyroid cancer. This study from Zhengzhou University's First Affiliated Hospital analyzed 195 cases of TOETVA from June 2020 to June 2023 to assess the learning curve for this scarless thyroid surgery technique, particularly in thyroid cancer treatment. Using the CUSUM method, two learning phases were identified: exploration (58 cases) and maturation (137 cases). Results showed that the maturation phase had significantly shorter operation times, less bleeding, and fewer complications compared to the exploration phase. The study concludes that TOETVA is safe and feasible, capable of successfully completing complex cases after mastering the learning curve.
Clinical feature and patient-report outcome of nipple-sparing mastectomy with immediate breast reconstruction: a eighteen-year cohort study
Authors: Ding Bowen , Wang Jie , He Shanshan , Huang Qingfeng , Yin Jian
Published: December 2024

Background
Nipple-sparing mastectomy (NSM) has become increasingly common for breast cancer patients in China. There are limited data on its long-term clinical oncology and patient satisfaction. The objective of this study was to confirm the safety of clinical oncology and evaluate patient satisfaction with nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR).
Methods
We retrospectively analyzed the clinical data of patients who underwent NSM followed by immediate breast reconstruction in our department. Clinicopathological data and follow-up information were collected and analyzed to evaluate the safety of NSM with immediate breast reconstruction. The BREAST-Q questionnaire was used to assess patient-reported outcomes.
Results
A total of 610 patients, including 624 with reconstructed breasts, were included in the study. Our results revealed that factors such as age > 42 years, BMI > 24 kg/m2, periareolar incisions, reconstruction with implants and acellular dermal matrix (ADM) with or without serratus anterior were independent risk factors for short-term complications after NSM with IBR. We utilized a column chart and calibration curve to illustrate the factors affecting the occurrence of short-term postoperative complications. The overall survival (OS) of all patients was 98.7%, and nipple‒areolar complex (NAC) recurrence did not impair patient survival. The 10-year survival rate and distant metastasis-free survival (DMFS) rate of the 4 patients who experienced NAC recurrence were 100%. The 10-year OS for patients without NAC recurrence was 96.0% (p > 0.05), and the DMFS rate was 89.4% (p > 0.05). Most patients were satisfied with the aesthetic outcome (> 90%), and nipple sensation was reported in 41.0% of patients, 8.3% of whom had normal sensation.
Conclusion
NSM with immediate breast reconstruction yields favorable aesthetic outcomes, high patient satisfaction, and reliable oncological safety.
Comparison of Accuracy Between Two Novel Portable Navigation Systems with Distinct Registration Methods for Lateral Decubitus Total Hip Arthroplasty
Authors: Uchihara Yoshinobu , Saito Kenichiro , Okamoto Masakazu , Sugimoto Hironori , Ando Yushi , Yano Yudai , Miura Yusuke , Inagaki Yusuke , Tanaka Yasuhito
Published: December 2024

Accurate cup placement is critical for ensuring satisfactory outcomes following total hip arthroplasty (THA). This study compared the accuracy of two new-generation computed tomography-free, imageless, and portable navigation systems, Navbit Sprint and Naviswiss, in the lateral decubitus position. A retrospective review of 145 patients who underwent primary THA between November 2020 and April 2024 was conducted, with 84 patients in the Navbit Sprint group and 61 patients in the Naviswiss group. The mean absolute navigation error for radiographic inclination (RI) was 3.5 ± 2.3° for Navbit Sprint and 2.5 ± 2.1° for Naviswiss, with a significant difference favouring Naviswiss (P = 0.0061). For radiographic anteversion (RA), the mean absolute navigation error was 4.3 ± 3.7° for Navbit Sprint and 3.2 ± 2.6° for Naviswiss, with no significant difference (P = 0.06). The percentage of RI outliers with an absolute navigation error > 5° was significantly higher in the Navbit Sprint group (20%) compared to the Naviswiss group (4.9%), while no significant differences were observed for RA outliers. Both systems demonstrated high accuracy; however, Naviswiss showed superior precision in RI, suggesting that the anatomical landmark registration method is more reliable than the table tilt method employed by Navbit Sprint.
Assessment the Knowledge of Thirdhand Smoke Awareness in Turkey: A Call to Action for Family Physicians
Authors: Aydemir Hacı Ahmet , Aydemir Seda
Published: December 2024

Objective
Thirdhand smoke (THS) refers to contaminants in cigarette smoke that contaminate surfaces and continue to be released for a long time. This period may extend up to 6 months. THS adversely affects human health. In this study, we aimed to investigate the level of knowledge and awareness of THS among individuals who applied to a family medicine unit.
Method
The study, which was a cross-sectional study, included individuals over the age of 18 who registered with a family medicine unit between October and December 2023. The questionnaire form, which was created using Google Forms, asked individuals to provide demographic information and complete questions from the Beliefs About Third-Hand Smoking (BATHS-T) scale. The questionnaire form was read to the individuals face-to-face by the clinician. Some individuals were asked to complete the questionnaire themselves in the virtual environment by reading the generated QR code.
Results
A total of 998 participants were included in the study; the mean age was 34.3 ± 11.2 years, 75.3% (n = 751) were female, 80.2% (n = 800) were married, and 19.8% (n = 198) had chronic diseases. A total of 26.9% (n = 268) of the participants were smokers. Only 15.2% (n = 152) of the participants were aware of the harms of thirdhand smoke. The awareness of female participants, nonsmokers, those who had information about thirdhand smoke, and those who cared whether there was smoking when while buying a car or staying at a hotel was significantly greater (p < 0.05). On the other hand, no significant difference was found in the answers given by the participants according to the amount of daily cigarette use, duration of smoking, reason for starting smoking, or smoking status as soon as they woke up in the morning (p > 0.05).
Conclusion
In this study, THS awareness levels were found to be quite low. Family physicians who have a preventive medicine mission have a great duty to increase this awareness.
Gut microbiota composition is related to anxiety and aggression scores in companion dogs
Authors: Pellowe Sarita D. , Zhang Allan , Bignell Dawn R. D. , Peña-Castillo Lourdes , Walsh Carolyn J.
Published: December 2024

There is mounting evidence for a link between behaviour and the gut microbiome in animal and human health. However, the role of the gut microbiome in the development and severity of behavioural issues in companion dogs is not yet fully understood. Here, we investigated the relationship between gut microbiota composition and aggression or anxiety in pet dogs. Dogs were assigned to higher or lower anxiety and aggression groups based on their owner’s responses to the Canine Behavioral Assessment & Research Questionnaire (C-BARQ). Then, the gut microbiota composition of each animal, sequenced from microbial DNA extracted from fecal samples, was assessed for association with the dog’s assigned behavioural group using multiple approaches. While minimal differences in relative abundance were seen between behavioural groups, machine-learning and compositional balance models could predict behavioural group based on gut microbiota composition. The genus Blautia was identified consistently across analyses, suggesting a link between this genus and anxiety in pet dogs. This study provides insight into specific bacteria that are linked to increased anxiety and aggression in pet dogs. Further research is required to identify bacteria to the species level, and to better understand the specific role of Blautia in the canine gut-brain axis.
Rural Health Care - Challenges and Opportunities: Lessons Learned from the Villages in Rural Rajasthan
Authors: MM Rajeev
Published: December 2024

Rural communities, on average, have far less access to healthcare services than urban areas. Access to health care can prevent disease by means of early identification and treatment, as well as provide a higher quality of life and increase life expectancy for persons in the community. People and communities who lack economic clout and autonomy will inevitably have restricted or non-existent access to medical care. Here, the author highlights the various issues pertaining to health and mental health concerns of people living in the rural areas of Rajasthan, who often experience discrimination as well as social stigma towards services such as health, social, economic, and education. Poor socioeconomic conditions, a lack of education, and poor health status are common among rural people living inside villages. The author emphasizes how discrimination and bias prohibit people from having equal access to healthcare services by preventing vulnerable populations from participating in the delivery of healthcare, limiting their legal access, or preventing them from entering healthcare systems altogether. The study was conducted in the village of Bandarsindri in Kishangarh Taluk, Ajmer district, Rajasthan. The study's aims consist of (a) to know the general health status of people living in the village (b) learn the mental health-related requirements of the individuals in the study location (c) to determine the pressing health problems of the children and women in the village (d) to understand the access to healthcare of the people in the rural areas and (e) to determine the scope of implementing a programme/intervention with the support of Central University of Rajasthan and the use of other local resources. The methodology adopted for this study is qualitative, and the data were collected through individual interviews and focus group discussions. The researcher used a purposive sampling method for selecting the samples; the sample size for the qualitative interviews was 20, and the FGD was 3. The qualitative interviews were conducted among women, aged persons and the youth population in the village. Content analysis was performed for the qualitative study, and detailed notes were prepared for analysing the FGDs. The findings emphasize the urgent need to address the various health needs of the community and empower them to seek health care and support from government resources by building advocacy and networking activities by development professionals.
The Correlation Between Five Inflammatory Indices and Overactive Bladder: A Cross-Sectional Study from NHANES 2005-2010
Authors: Yan Yanyuan , Cheng Qiong , Hong Anjie , Zhou Ping
Published: December 2024

Current research indicates a strong association between inflammation and the development of overactive bladder (OAB). This study aims to explore the correlation between five inflammatory indices—Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR), Lymphocyte/Monocyte Ratio (LMR), Albumin × Lymphocyte/(CRP × 10) (CALLY), and Systemic Immune-Inflammation Index (SII)—and OAB. We analyzed data from 12,689 participants from 2005 to 2010, defining OAB by nocturia and urgent urinary incontinence. Logistic regression models, Receiver Operating Characteristic (ROC) curves, restricted cubic splines (RCS), and subgroup analyses were utilized to assess the relationship between the five inflammatory indices and OAB. Results indicate that all selected inflammatory indices reflect the inflammation levels in OAB patients, with NLR showing outstanding predictive performance and a significant positive correlation with OAB risk. Higher NLR values are associated with increased likelihood of OAB (OR=1.356, 95% CI=1.241-1.483, P<0.001), and incidence rises with increasing quartiles. This study reveals the correlation between the five inflammatory indices and OAB, suggesting that NLR could serve as a safe, effective, and independent predictive indicator compared to other inflammatory markers. This finding underscores the potential role of NLR as a clinical tool for identifying individuals at risk for OAB.
Incidence, Prevalence, and Mortality of diseases among Children and Adolescents in national and subnational levels of Iran, 1990-2021: A systematic analysis for the Global Burden of Disease 2021
Authors: Gholami Samira , Bastan Mohammad-Mahdi , Gholami Bahareh , Khosravi Sepehr , Malekpour Mohammad-Reza , Rezaei Nazila , Shahin Sarvenaz , Golestani Ali
Published: December 2024

Introduction: Child and youth mortality serves as a critical indication of a nation's growth, with significant ramifications for the future of its people. Current statistics on Iranian children and adolescents' disease patterns are inadequate and outdated. This study seeks to examine the incidence, prevalence, and death rates of diseases in children and adolescents at both national and subnational levels in Iran, utilizing the Global Burden of Disease (GBD) 2021 data.
Methods: We employed data from the GBD 2021 study regarding all-cause mortality in children and adolescents, sourced from the Institute for Health Metrics and Evaluation. This research analyzes the patterns in the primary and secondary tiers of the GBD cause hierarchy of mortality and morbidity. We analyze the incidence, prevalence, and mortality rates for children and adolescents under 20 years old in Iran and its 31 provinces from 1990 to 2021.
Results: From 1990 to 2021, there has been a significant reduction in incidence (28.1%), prevalence (19.7%), and death (90.6%) from all causes among children and adolescents in Iran. Several rates that decreased included those for communicable, maternal, neonatal, and nutritional diseases (CMNNDs), non-communicable diseases (NCDs), and injuries. The sole rate that increased was the prevalence rate for NCDs, rising from 82437.7 (95% UI: 80130.1 to 84458.9) to 83458.5 (81399.3 to 85197.9), representing a 1.2% increase. In 2021, respiratory infections and tuberculosis, intestinal infections, and other non-communicable disorders exhibited the greatest incidence rates across all provinces. Moreover, in most areas, transportation injuries, maternal and neonatal disorders, and other non-communicable diseases exhibited the highest mortality rates.
Conclusion: This study highlights the remarkable advancements achieved in lowering mortality, incidence, and prevalence rates among children and adolescents in Iran over the last thirty years; Despite progress, challenges remain, particularly concerning NCDs. Policymakers should draw on insights from studies like these to create specific strategies that respond to the evolving health needs of children and adolescents in Iran, while also working to reduce health inequalities across different provinces.
WITHDRAWN: Postoperative Joint Scores of Comparison between total and unicondylar knee arthroplasty：A matched comparison
Authors: Liu Chen-ci , Zhang Zhen-dong , Shi Chen-hui
Published: December 2024

The full text of this preprint has been withdrawn by the authors as it was submitted and made public without the full consent of all the authors. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
Association of elevated albumin-corrected anion gap with all-cause mortality risk in atrial fibrillation: a retrospective study
Authors: Xu Jia , Wang Zhen , Wang Yun , Chen Xinran , Ma Lan , Wang Xiaochen
Published: December 2024

Background
Compared to the conventional anion gap, albumin-corrected anion gap (ACAG) offers a more precise measure of acid-base imbalance in patients than, providing superior prognostic insight. However, the prognostic relevance of ACAG in individuals of atrial fibrillation (AF) remains insufficiently explored. This research seeks to evaluate the correlation between ACAG levels and mortality risk in individuals with AF.
Methods
We identified individuals diagnosed with AF from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Participants were categorized into quartiles in accordance with their ACAG levels. The outcomes included 30 days and 365 days all-cause mortality. Cumulative survival across the quartiles was assessed using Kaplan–Meier survival curves. We applied Cox regression and restricted cubic spline regression analyses to evaluate the correlation between ACAG levels and prognosis. Subgroup analyses and interaction assessments were applied to confirm the robustness of the findings.
Results
A total of 2920 AF patients (54.93% male) were incorporated into the analysis. The 30 and 365-day mortality were 22.91% and 39.21%, respectively. Kaplan–Meier survival curves demonstrated that elevated ACAG levels were significantly linked to increased mortality (log-rank P < 0.001). In multivariate Cox proportional hazards analyses, increased ACAG independently predicted mortality at 30 days (adjusted hazard ratio [aHR], 1.04; 95% CI, 1.02–1.05; P < 0.01) and 365 days (aHR, 1.03; 95% CI, 1.02–1.05; P < 0.01) after adjusting for potential confounders. A positive relationship between rising ACAG levels and mortality risk, as showed by restricted cubic spline analysis. Subgroup analyses revealed no significant interactions (all interaction P-values > 0.05).
Conclusions
In individuals with AF, higher ACAG levels are related to a greater mortality risk at 30 and 365 days. These results show the potential value of ACAG as a prognostic indicator for patient stratification. Incorporating ACAG into clinical decision-making could support improved therapeutic strategies and enhance patient outcomes.
Pediatric Traumatic Dental Injuries in Rural Pennsylvania: a 9-year retrospective review
Authors: Salvato Jason , Wang Shengxuan , Stinton Natalie , Malik Gayatri
Published: December 2024

Purpose
Rural communities face unique challenges regarding traumatic dental injuries (TDIs) which may influence the causes of TDIs. The aim of this study was to analyze a pediatric population of patients who had suffered from TDIs in rural environments.
Methods
Electronic health records of 268 pediatric dental patients, ages 6 months to 17 years, who had presented at the emergency department at Geisinger Medical Center between July 2010 and July 2019 with TDIs were reviewed. The electronic health records of each patient were evaluated, including an analysis of epidemiological variables.
Results
The patient population consisted of 171 males and 97 females, with a mean age of 11.9 years. A total of 350 orofacial trauma injuries were recorded. The most frequently injured primary tooth was #E (20.4%), while the most commonly injured permanent tooth was #9 (38.6%). The most prevalent types of TDIs were uncomplicated crown fractures (25.7%) and avulsions (18.6%). TDIs were more common in male patients (63.8%) than female patients (36.2%). TDIs were most likely to be present during the summer months of May, June, July, and August (41.8%). The most common injury location was outdoors (32.2%), with falls (21.9%) and sporting activities (20.0%) being the leading causes of TDIs.
Conclusions
Based on the findings of the analysis, it can be concluded that males were more frequently affected by TDIs than females. Half of the patients suffered from TDIs before they turned 12 years of age. Overall, the uncomplicated crown fractures were found to be the most frequent injury, followed by avulsions.
Bioclimatic Conditions of Turkey: Spatial analysis of thermal comfort zones according to monthly mean physiological equivalent temperatures
Authors: Çalışkan Onur
Published: December 2024

Turkey is composed of two peninsulas situated between the European and Asian continents. Due to variations in elevation and continentality, the country experiences 13 different climate types, ranging from semi-arid to polar tundra. The bioclimatic conditions of Turkey were determined by analyzing data from 262 stations for the period 1975–2022, considering latitude, elevation, and maritime characteristics. A multiple linear regression model was employed to evaluate the spatial distribution of monthly mean Physiological Equivalent Temperature (PET). According to the calculations, PET values in the coastal belt and lowlands (floodplains and coastal plains) in the south and west of Turkey are 5°C-25°C higher than in other areas. PETs in the mountain ranges, which generally extend in a north-south direction, are approximately 10°C lower than in the surrounding lowlands. The highest PET values are observed in the lowlands of the southeast from May to September, and along the Mediterranean coast from October to April. The lowest PET values occur at the summits of the mountains border to Black Sea during the warm season, which are more northerly and maritime, and at the summit of Greater Ararat Mountain (volcanic mountain in Eastern Anatolia) during the cold season, which is more continental and elevated. PET values decrease with increasing latitude, maritime influence, and elevation. Annually, mean PET values decline by 1.4°C for every 1° increase in latitude northward, by 0.72°C for every 100 m increase in elevation and increase by 1.09°C for every 100 km distance from the sea.
Cost Effective Analysis of Inhalers Used for Asthma Management: An Interventional Approach
Authors: Alexander Nizi , Nair Prathiksha S , Iyer Swaminath G , Dharman Dhanya , Chandran Chintha , Dharan Shaiju. S.
Published: December 2024

Objective: To evaluate the cost-effectiveness of corticosteroid inhalers, patient counseling, and factors influencing prescribing patterns and medication adherence.
Methods: Prospective interventional sampling approach included patients aged 18-60 with asthma, excluding pregnant/lactating women, unwilling patients, and those with communication problems. Patients received counseling on inhaler use.
Results: Asthma incidence peaked in patients aged 48+ (30.6%).Upper-middle-class patients predominated (59%). Counseling improved adherence (76.4%). Patient satisfaction was high (47.2%). Pulmonary function test (PFT) values improved post-adherence (84.118±12.647). Fluticasone/Formoterol was the most common inhaler (41.7%). Budesonide/Formoterol had the lowest mean drug cost (Rupees 476.095±119.717). Total cost analysis revealed Fluticasone/Formoterol as most cost-effective (Rupees 5464.547 ± 1015.616). Proper adherence reduced drug costs (Rupees 544.042±398.614 vs. 1154.499 ± 369.435).
Conclusion: Fluticasone/Formoterol was the most cost-effective corticosteroid inhaler. Direct patient/caregiver interaction and counseling significantly improved asthma control, medication adherence, and patient satisfaction. Using clear language and visual aids enhanced comprehension.
Microbiome and Cancer: Exploring the Influence of Gut Microbiota on Immunotherapy Efficacy and Toxicity
Authors: MANFOUO WILFRED QUENTIN WOLASSE
Published: December 2024

The gut microbiome is a complex ecosystem of trillions of microorganisms that are essential to help regulate the human immune system, and its role in cancer treatment outcomes has become recognized as particularly relevant for immunotherapy. The landscape of cancers such as melanoma, lung or renal cancer has dramatically changed since immune checkpoint inhibitors (ICIs) including anti-PD-1, anti-PD-L1 and anti CTLA-4 therapies emerged. Nevertheless, response rates are limited and challenges remain regarding immune-related adverse events (irAEs). Recent studies have compellingly shown ICIs efficacy and toxicity to be influenced by the composition of an individual’s gut microbiota. Several bacterial taxa, including Akkermansia muciniphila, Faecalibacterium and Bifidobacterium are associated with better response to therapy whereas dysbiosis can contribute both treatment failure and irAEs. The review examines the mechanisms of gut microbiota in affecting immune responses and discusses how translating these findings might be used to leverage immunotherapy, as well describing potential actions already available (probiotic/ pre/pro-symbiotics/ FMT) for improving efficacy; also, it presents implications on clinical perspectives using microbiome-based strategies driving personalized cancer care. Given the critical role of gut-cancer-immune axis in cancer immunotherapy, a more comprehensive understanding on its mechanisms could open new avenues for improving patient outcomes and reducing toxicity.
The Predictive Value of Laboratory Parameters in Diagnosing Gastrointestinal Malignancy in Older Adults
Authors: Borazan Funda Yildirim , Yilmaz Meryem , Tuzcu Barış , Gulbahar Ozlem , Göker Berna , Varan Hacer Dogan
Published: December 2024

Introduction: Early diagnosis and treatment through screening tests to identify and remove precancerous lesions or detect cancer at a curable stage are crucial for managing gastrointestinal (GI) cancers. However, achieving early detection in older adults, particularly those who are frail, can be challenging. This retrospective study aimed to evaluate the predictive value of pre-endoscopic biochemical parameters for detecting malignant lesions in older adults undergoing upper and lower GI endoscopies.
Material and Methods: We retrospectively analyzed 419 individuals aged 60 and above. Of these, 109 older adult patients who underwent both upper and lower GI endoscopies were included in the study. Patients with a prior history of GI cancer or those who could not complete the procedure due to intolerance were excluded. Patients were categorized based on the presence of benign or malignant lesions.
Results: Malignant lesions were identified in 10.1% (11/109) of patients. Statistically significant differences were observed between the benign and malignant groups in terms of hemoglobin (Hb), neutrophil count, mean corpuscular volume (MCV), neutrophil-lymphocyte ratio (NLR), iron (Fe), 25-hydroxyvitamin D [25(OH)D], C-reactive protein (CRP), total protein, albumin (Alb), blood urea nitrogen (BUN), CRP/albumin ratio (CAR), and aspartate aminotransferase (AST). The ROC curve analysis suggests that MCV, NLR, 25(OH)D, Fe, and CAR are valuable indicators for predicting malignant lesions in older adults, with optimal cut-off values of 79.5 fL, 3.28, 12 µg/L, 22 µg/dL, and 5.93, respectively.
Conclusion: These findings underscore the predictive value of CAR, NLR, MCV, Fe, and 25(OH)D in identifying GI neoplasms in older adults. The study suggests that patients should undergo an endoscopic evaluation to investigate potential GI malignancies when they have MCV ≤79.5 fL, NLR <3.28, 25(OH)D ≤12 µg/L, Fe≤22 µg/dL and CAR >5.93.
Noise Pollution in the Center of the Iberian Peninsula: Diversity and Abundance on Urban Birds Breeding
Authors: Almarza-Batuecas Paula , Pescador Moisés
Published: December 2024

In an increasingly urbanized world, biodiversity, and more specifically birdlife located in urbanized ecosystems, faces several threats. Among these, noise pollution has proven to be one of the most significant, as it affects the effectiveness and efficiency of acoustic communication. We studied the relationship between noise and the diversity and abundance of birds breeding in urban areas in the central region of the Iberian Peninsula (Spain). We analyzed how species diversity and density varied across three levels of noise pollution (high, medium, and low). Species diversity decreased in areas with high noise pollution as compared to the sites with medium and low levels of noise. We analyzed the density of the most frequent species found within each category. We identified eight additional noise-tolerant species, whose density had significantly increased in environments with high levels of noise (e.g. Blackbird, Eurasian Tree Sparrow, and the Coal Tit). The ten most sensitive species, such as the Common Linnet, House Sparrow, and the European Greenfinch, had significantly decreased densities when the level of noise increased. Identifying the sensitivity (the effect) of urban bird species to acoustic pollution is vital for effective conservation management measures and for the sustainable planning and management of cities.
Fluoroestradiol (FES) and Fluorodeoxyglucose (FDG) PET imaging in patients with ER+, HER2-positive or HER2-negative metastatic breast cancer
Authors: Hunter Natasha B , Peterson Lanell M , Specht Jennifer M , Mankoff David A , Muzi Mark , Chen Delphine L , Gwin William R , Vinayak Shaveta , Davidson Nancy E , Linden Hannah M
Published: December 2024

Background
18F-Fluorodeoxyglucose (FDG) and 18F-Fluorestradiol (FES) have been FDA approved for measuring tumor glycolytic activity and estrogen receptor (ER) uptake, respectively, in clinical positron emission tomography (PET) imaging for patients with hormone-receptor (HR) positive metastatic breast cancer (MBC), but little is known about its utility in patients with breast tumors that overexpress human epidermal growth factor 2 (HER2). We hypothesize that comparing patterns of FDG and FES uptake in patients with HER2-positive versus HER2-negative MBC can guide further biologic and clinical studies into the HR/HER2-positive phenotype.
Methods
We conducted a retrospective study examining uptake in matched lesions for FES and FDG-PET scans, assessing these parameters in 213 patients with ER-positive/HER2-positive (n = 33) versus ER-positive/HER2-negative MBC (n = 180).
Results
No difference in FES or FDG avidity was observed between patients with HER2-negative or HER2-positive tumor status. Limited data also suggests that patients with HER2-positive disease had better overall survival (p = 0.024), than those with HER2-negative disease, but not time-to-progression between the same patient cohorts.
Conclusion
This retrospective analysis suggests that there is a possible role for future trials using FES-PET in helping to select patients with ER+/HER2-positive primary tumors who retain ER expression at all sites of disease and may benefit from endocrine therapy.
Factors influencing the type of self-acceptance in drug addicts and the relationship with subthreshold depression: evidence based on latent profile analysis
Authors: Li Yongqiu , Wang Rufang , Liu Jun , Zhou Yinghua
Published: December 2024

Objective
To study the heterogeneity and influencing factors of self-acceptance of drug addicts in compulsory isolation in 2 drug rehabilitation centers in Sichuan Province, and to analyze the effects of different types of self-acceptance on subthreshold depression in drug addicts, in order to provide useful references for improving their mental health.
Methods
Self-acceptance Questionnaire(SAQ), Drug use Stereotype Threat Scale(DSTS) and Center for Epidemiologic Studies Depression Scale(CES-D) were used to conduct a questionnaire survey in January 2024 on 1068 drug addicts in two compulsory isolation drug rehabilitation centers in Sichuan Province.
Results
Drug addicts self-acceptance can be categorized into 5 potential categories;the results of the multiple logistic regression demonstrated that, males were more likely to exhibit lower self-acceptance than females; drug addicts with an education level of elementary school and below were categorized into the‘low self-acceptance-low self-evaluation’ group ;HIV-negative drug addicts were more likely to show higher self-acceptance than positive patients; the‘low-low’group had the greatest likelihood of being alienated.The results of multiple linear regression showed that drug addicts in the‘ moderate self-appraisal-moderate self-acceptance’group and‘high self-appraisal-high self-acceptance’group had significantly lower subthreshold depression than those in the‘low self-appraisal-low self-acceptance’group;the results of the Kruskal-Wallis Test showed that the‘high self-appraisal-high self-acceptance’group had the lowest level of subthreshold depression, and the‘low self-appraisal-low self-acceptance’,‘low self-appraisal-high self-acceptance’and‘high self-appraisal-low self-acceptance’groups had the highest mean ranks in different dimensions of subthreshold depression.
Conclusion
Heterogeneity exists in drug addicts' self-acceptance, and gender, HIV-positive or not, education level, and drug use stereotype threat are factors influencing self-acceptance in compulsory isolated drug addicts. High self-appraisal-high self-acceptance had the lowest level of subthreshold depression in drug addicts, and the consistency of poor self-appraisal and self-acceptance also affected the level of subthreshold depression in drug addicts.
Design of Infinite Impulse Response Maximally Flat Stable Digital Filter With Low Group Delay
Authors: Yi Huoping , Chang Fuhao , Tan Ping , Huang Bingqiang , Wu Yongbo , Xu Zhen , Ma Bingyu , Ma Jien
Published: December 2024

Maximally flat digital filters (MFDFs) are widely applied in applications where the energy of useful signals is concentrated around some specific frequencies. A typical design method of MFDFs is to impose constraints on the filter’s frequency response and its first- to high-order derivatives at some frequencies and to fully determine the filter coefficients from these constraints. However, infinite impulse response (IIR) MFDFs that are designed by the method are not necessarily stable or may have heavy magnitude overshoots, especially when the desired group delay is low. To overcome this shortcoming, a stability constraint that is characterized by the maximum pole radius is also imposed on the filters in this paper, resulting in IIR maximally flat stable digital filters (MFSDFs). An algorithm is presented for the design of the flatness and pole-radius constrained IIR filters with specified group delay. Using the proposed method, low-pass, high-pass, band-pass and band-stop IIR MFSDFs with low group delay have been designed. Results demonstrate the effectiveness of the proposed method and the superior performance of the IIR MFSDFs over existing MFDFs.
Identification and field validation of QTLs for soybean red crown rot resistance from wild soybean accessions
Authors: Taguchi-Shiobara Fumio , Mimuro Genki , Hishinuma Ai , Kobayashi Michie , Yano Ryoichi , Mizubayashi Tatsumi , Xu Donghe , Kaga Akito , Takahashi Koji , Nanjo Yohei , Jiang Chang-Jie
Published: December 2024

Soybean red crown rot (RCR), a soil-borne disease caused by the fungus Calonectria ilicicola, can lead to annual yield losses of up to 30%. This study identified quantitative trait loci (QTLs) associated with RCR resistance in three wild soybean accessions, ‘Gs-7,’ ‘Gs-9,’ and ‘Gs-27.’ QTL analysis was performed using four populations of recombinant inbred lines (RILs) derived from crossing these wild soybean accessions with two susceptible soybean cultivars ‘Enrei’ (populations En7, En9, and En27, respectively) and ‘Williams 82’ (W9). Genetic linkage maps were constructed using 145–256 simple sequence repeat (SSR) markers for each population, and the RILs were evaluated for RCR resistance in a greenhouse. Consequently, eight QTLs were detected across four regions: qRci1 (En9) and qRci1t (W9) on chromosome 8; qRci2 (En9), qRci2t (En7), and qRci2tw (W9) on chromosome 13; qRci3 (W9) on chromosome 18; qRci4 (En7) and qRci4t (En27) on chromosome 3. Further mapping using residual heterozygous lines localized qRci1 to a 2.52 Mb region between BARCSOYSSR_08_0371 and BARCSOYSSR_08_0507, containing 76 candidate genes. Mapping and QTL-seq analysis suggested that qRci2 was in a 0.90 Mb region downstream of BARCSOYSSR_13_1504, containing 33 candidate genes. Four QTLs—qRci1, qRci2, qRci2t, and qRci4—were backcrossed into ‘Enrei,’ an elite Japanese cultivar, reducing disease severity in both greenhouse and field trials. No epistatic interactions were observed, and two QTLs, qRci2t and qRci4, conferred greater resistance than a single QTL in BC1F4 lines. Thus, pyramiding these QTLs is recommended to confer RCR resistance in commercial soybean cultivars.
Clinical Characteristics and Induced Pluripotent Stem Cells (iPSCs) Disease Model of Harel-Yoon Syndrome Caused by Compound Heterozygous ATAD3A Variants
Authors: Jiang Ziyi , Chen Hongyu , Zhang Xianghong , Jiang Xiaoling , Tong Zhengqing , Ye Jingjing , Shi Shanshan , Shi Xucong , Li Fengxia , Shao Weiqin , Shu Qiang , Yu Lan
Published: December 2024

ATPase family AAA-domain-containing protein 3A (ATAD3A) is enriched on the mitochondrial membrane and is essential to the maintenance of mitochondrial structure and function. Variants of the ATAD3A gene can lead to Harel-Yoon syndrome (HAYOS), a developmental defect in neurological, cardiovascular, and other systems. This study aims to develop induced pluripotent stem cells (iPSCs) from the somatic cells of a patient (ZJUCHYLi001-A) and a negative control (ZJUCHYLi002-A) as effective tools for further investigations into the etiology of ATAD3A variant-related disease. We described and analyzed the clinical manifestations of the proband and her family members. Somatic cells from the proband and a negative control were collected and reprogrammed into iPSCs. Furthermore, we measured the ATAD3A expression levels in the iPSCs to confirm the validity of these cell lines. The proband and her elder sister were both critically ill and harbored compound heterozygous ATAD3A variants (F459S/T498Nfs*13). Their parents were carriers of these variants without any clinical manifestations. Both variants are located on the ATPase domain of the ATAD3A protein. Cell lines ZJUCHYLi001-A and ZJUCHYLi002-A presented typical features of pluripotent stem cells. The ATAD3A expression levels of ZJUCHYLi001-A were significantly reduced compared with ZJUCHYLi002-A. This study generated iPSCs from a patient with compound heterozygous variants of ATAD3A and a negative control as valuable tools for clarifying the molecular mechanisms underlying ATAD3A variant-related diseases.
Holographic inspired high-performance circular polarized spoof surface plasmon polariton leaky-wave antenna excited by a novel launcher
Authors: Zohrevand Sajjad , Zadeh Mohammad Amin Chaychi , Farokhipour Ehsan , Erni Daniel , Komjani Nader
Published: December 2024

The holographic technique is one of the simplest methods for designing antennas based on metasurface. This paper presents a spoof surface plasmon polariton (SSPP) leaky-wave antenna (LWA) based on the concept of impedance modulated metasurfaces by the anisotropic holographic technique. Instead of parasitic elements, anisotropic SSPP elements are exploited to achieve radiation with circular polarization (CP). The characteristics of the SSPP elements are obtained by the aperture field estimate (AFE) method. The hologram surface consists of hollow cross-bars unit cells. The anisotropy of each unit cell is achieved by combining the transformation optic (TO) method and the particle swarm optimization (PSO) algorithm. A major challenge of the SSPP LWA based on modulated impedance surfaces is to find a suitable excitation technique. This study proposes a waveguide strip line launcher for excitation to minimize interference on the radiation pattern beam. The designed launcher provides a good impedance matching from 8 to 20 GHz, with an impedance bandwidth of 142%. The peak gain, radiation efficiency, axial ratio (AR) bandwidth, and side lobe level at the design frequency of 18 GHz are 19.7dBi, 93%, 11%, and − 12.1dB, respectively. After optimizations and simulations are conducted using MATLAB and CST software, the proposed antenna is fabricated, and its radiation characteristics are measured. The measured results agree well with the simulated ones, indicating the high validity of the method.