bluuebunny/crossref_metadata_2025 huggingface dataset:
An Analytical Model for Cosmology with a Single Input, the Redshift
Authors: Mostaghel Naser
Published: July 2024

We propose an analytical model for cosmology which requires only one parameter as an input. This parameter is the redshift. The model is based on conservation of energy, Planck’s Radiation Law, and the relation between energy and frequency of waves. The model yields the current age of the universe, the age of the universe at the CMB emission, as well as the time histories of its expansion velocity and acceleration. The model also is used to show the existence of a constant energy per unit area, associated with the momentum energy of photons, which generates the pressure that perpetuates the expansion of the universe. The model is completely independent of the ɅCDM model but implicitly includes the effects of gravity. Using the model we show the existence of a constant in nature that under certain assumptions can represent the Hubble constant. We have used the model to derive the Hubble constants measured by Reiss et al. and by the Planck Collaboration. Using the model we show that the path of light in the Planck collaboration measurement is along a circular arc, while the Reiss et al. measurement path is exactly along the chord of the same circular arc. The difference in the light travel times along these two paths matches exactly the difference between the two measured values for the Hubble constant, as measured by Reiss et al. and as measured by the Planck Collaboration. This result explains the cause of tension between the two methods of measurement.
Feature Selection AI Technique for Predicting Chronic Kidney Disease
Authors: Ramanaiah Preethi
Published: July 2024

The kidney is a vital organ that plays a crucial role in eliminating waste and excess water from the bloodstream. When renal function is impaired, the filtration process also ceases. This leads to an elevation of harmful molecules in the body, a condition referred to as chronic kidney disease (CKD). Early-stage chronic kidney disease often lacks noticeable symptoms, making it challenging to detect in its early stages. Diagnosing chronic kidney disease (CKD) typically involves advanced blood and urine tests, but unfortunately, by the time these tests are conducted, the disease may already be life-threatening. Our research focuses on the early prediction of chronic kidney disease (CKD) using machine learning (ML) and deep learning (DL) techniques. Utilized a dataset from the machine learning repository at the University of California, Irvine (UCI) to train various machine learning algorithms in conjunction with a Convolutional Neural Network (CNN) model. The algorithms encompassed in this set are Support Vector Machine (SVM), Decision Tree (DT), Random Forest (RF), and Gradient Boosting (GB). Based on the experimental results, the CNN model achieves a prediction accuracy of precisely 97% after feature selection, the highest among all models tested. Hence, the objective of this project is to develop a deep learning-based prediction model to aid healthcare professionals in the timely identification of chronic kidney disease (CKD), potentially leading to life-saving interventions for patients.
Neonatal Leukaemia: A Case Report and Review of the Literature
Authors: Cherrafi Fedwa , Boumaazi Hiba , Yahyaoui Hicham , Ameur Mustapha , Chakour Mohammed
Published: July 2024

Background: Acute leukemia has a particularly bad prognosis in the newborn era. Its prognosis is significantly poorer than in older youngsters. The occurrence of leukaemia in the neonatal period can present diagnostic challenges due to the rarity of the condition and its clinical presentation, which may be misleading or inconspicuous. Case report: A case of neonatal acute myeloblastic leukaemia (AML) in a newborn with trisomy 21 is presented herein. The patient was admitted with respiratory distress and a clinical examination revealed a facial dysmorphic syndrome, pallor, hepatosplenomegaly, and a bone marrow failure syndrome with bone marrow invasion by 36% myeloblasts, confirming the diagnosis of AML. The immunophenotyping results indicated that the patient had AML0, with a low CD13+ and CD33+ MPO myeloid population. During the patient's hospitalisation, a multi-resistant Klebsiella pneumoniae urinary tract infection was diagnosed, and septic shock was diagnosed after four days. Conclusion: Acute neonatal leukaemia is a rare and complex condition that requires the expertise of both neonatologists and paediatric haematologists.
Cutting–Edge Physics Driven Advancements in Medical Industry
Authors: Mengesha Wubshet
Published: July 2024

Science contributed to technology by serving as a direct source and creation of ideas for new knowledge. Technology emerged from the application of this knowledge in terms of products, processes and services. Nowadays, due to the multidisciplinary application of physics, medical technology and radiation treatment has begun and widely accompanied within a technology based medical diagnosis and treatment due to the development of physics. In this paper a detailed description and analysis of scientific achievement and technological advancements of physics in medical industry has been clearly reviewed. The application of physics principles to medical sector has made an outstanding contribution in the diagnosis and treatment of diseases. Many extraordinary tools, those could have played a great role in diagnostic and treatment methods, have appeared as a result of physics discoveries in the last century. This description of physics applications in medical technology and principles has mainly based on comprehensive review of the literature, contributes to suggest the novel ideas used for the innovation of modern medical technologies. This journal paper anecdote the fundamental physical principles used for the innovation of these technological advances, emphasizing their applications to the practice of modern medical industry based on comprehensive review of the literature.
Participatory Demonstration of Durum Wheat Production Blending Vertisols Management Technologies in Lume District, East Shewa, Ethiopia
Authors: Fetene Saba , Ahmed Mohamed , Gonfa Assefa , Amsalu Sosena
Published: July 2024

Durum wheat production on Vertisols is constrained by waterlogging, where excessive soil moisture limits nutrient availability, resulting in lower yields and higher input demand. Aybar broad bed maker (BBM) was recommended to make broad beds and furrows (BBF) and drain the excess water although it is not widely adopted by farmers. Therefore, this demonstration activity was conducted to create awareness about the importance of BBF along with the recommended fertilizer rates in Lume district during the 2021 and 2022 main cropping seasons. Nine target farmers were purposefully selected based on the ground that their farms are waterlogged Vertisols. Aybar BBM to make the BBF with an 80 cm bed and 20 cm furrow width, while recommended fertilizers at a rate of 92 kg ha-1 nitrogen (N) and 10 kg ha-1 phosphorous (P) were used. The yield data and farmers’ perception were analyzed using t-test, descriptive statistics, and narration, while partial budget analysis was conducted to examine the economic feasibility of the technologies. Results showed that growing durum wheat on BBF by applying the recommended N and P rates resulted in significantly higher grain yield (3474 kg ha-1) with a 65.4% yield advantage compared to ridge and furrow (RF) (2100 kg ha-1) with the blanket fertilizer rates. The partial budget analysis revealed that land preparation using Aybar BBM, alongside the recommended fertilizer rates, brought a net benefit of 48,563 ETB ha-1 over the farmers' practice. Likewise, the marginal rate of return for changing from the local plow to Aybar BBM is 901.7%. The farmers also witnessed that the Aybar BBM even takes less plowing time and energy, and they want to continue to use it. In light of these results, the study concludes that the use of Aybar BBM and recommended N and P rates, as a production package on waterlogged Vertisols, is profitable for farmers and recommends promoting and scaling up these technologies in the study area and other waterlogged Vertisols regions of the country.
Climate Change Impact on Rain-Fed Maize Yield Cultivated with Small-Scale Landowners in Wolaita Zone, Ethiopia
Authors: Badacho Tadele , Geleta Tesfaye , Lema Mehuba , Wondimu Sintayehu , Wahima Birtukan
Published: July 2024

Ethiopia is a country that heavily relies on rainfall-aided cultivation which is carried out by small-scale landowners, leaving it very vulnerable to climate change and fluctuation. The primary goal of this research is to investigate how climate change affects maize yield in Wolaita zone of Ethiopia. The authors were employed a linear regression method to evaluate the relationship between climate parameters and maize yield. Sen's slope magnitude estimator and the Mann-Kendal trend test were used to assess the significance of climate change. The outcome demonstrated that the temperature extreme indices of warm days and the length of warm days were considerably higher by 37.5% and 3.7% of days per year, however, cold days and cold spells were significantly decreased. Over the 1981-2021 periods, there was a significant upward pattern in TXx and TNn at an average of 0.033°C and 0.034°C. There was a considerable decline of 2.3% in the simple daily precipitation intensity index and 33% decreased in extremely heavy precipitation, respectively. The correlation analysis's findings indicated that growing period precipitation and maize outputs were positively correlated, but negatively correlated with maximum and minimum temperatures. Extreme temperature and precipitation were more explained a maize yield than average climate patterns. 12.4%, 14.76%, 13.08%, and 7.95% of maize output variability was attributed by the growing season mean climate conditions, which include precipitation, mean, minimum, and maximum temperature. The variability of maize output was explained by combined impact of precipitation and temperature extremes were 67.7% and 45.0%, respectively. Therefore, livelihood diversification and relevant policy formulation are suggested to adapt inevitable climate change by implementing irrigation and resistant varieties to improve maize yield production.
CRISPR-Cas9 Gene Editing Therapy, a Curative Hope for Sickle Cell in Nigeria, West Africa
Authors: Olowu Babatunde , Olaide Ahmed , Tinubu Oluwaloni
Published: July 2024

Sickle cell anaemia is one of the haemoglobin abnormalities resulting from a genetic mutation— it is caused by inheriting two faulty genes that result in an abnormal substitution of glutamate for valine on the beta chain of haemoglobin, which causes haemoglobin molecules to stick together. According to a World Health Organization (WHO) report, 20 out of every 1,000 births suffer from sickle-cell anaemia, and 24% of Nigerians are carriers of this mutant gene. Scientists have suggested several solutions, including stem cell transplantation and gene therapies, but these have faced opposition due to ethical beliefs, high cost, and the ensuing immune issues. Research is now centered on advancing genome editing techniques for gene therapy. Ongoing studies have proven that genetic differences can be corrected methodically by modifying the genome at specific sites instead of introducing a new copy of the affected gene into the cells; due to the effectiveness of this method, scientists are testing its applications in manipulating genes in various systems. This review correlates a few studies that used the recently developed technique—CRISPR-Cas9—as a novel approach to gene therapy, dissecting the different clinical studies about sickle cell origin to point out many of its ethical and medical limitations, the consequences of these limitations, and the advancements this technology has made possible.
A Look at the Perception of Human and Civilizations in Friedrich Nietzsche’s Work Antichrist
Authors: Bilalli Shener
Published: July 2024

Considering the perception lik a abilty to see, hear or become aware, in this research, focused upon a subject that has left a great mark on the world-wide literature and opened the door to great debates. This subject is mentioned in Nietzsche's famous work, ANTICHRIST. of man and person its nature of development your obstacles and this your obstacles How will be surpassed over One attempt to do has been studied. Same in time human being One individual and society One Part of its aspect civilization to be able to create in front of philosophical, religious, and political of your obstacle’s detection and this your determination to the reader reflection has been made. The main theme of this study while real politics and social of development According to Nietzsche, how it should be done was expressed. A pivotal aspect of Nietzsche’s analysis lies in the contradictory nature of the modern individual's consciousness and ignorance. Despite the allure of advancement, Nietzsche scrutinizes modernity’s superficial enlightenment, championing increased awareness and resilience against societal shortcomings. Nietzche challenges traditional notions of virtue, advocating for a shift away from rigid moral doctrines towards innate instincts and personal growth. Nietzsche’s discourse extends beyond mere criticism, promoting education, primal instincts, and nuanced comprehension of human development. Rejecting simplistic hierarchical frameworks, he attributes human advancement to intrinsic impulses rather than societal constructs. At the core of Nietzsche’s argument lies the concept of instinctual power, crucial for both societal progress and individual fulfillment. The study elucidates Nietzsche’s condemnation of compassion as an impediment to progress, echoing Aristotle’s insights. Nietzsche advocates for an unyielding stance against barriers hindering societal evolution, urging individuals to embrace self-esteem, self-affection, and autonomy. Nietzsche’s "Antichrist" provides profound reflections on humanity’s trajectory, urging a departure from dogmatic beliefs towards instinct-driven growth. The research underscores Nietzsche’s vision of a civilization harmonized with nature, liberated from societal constraints, and driven by individual integrity and primal instincts.
Experimental Study of a Prototype Solar Water Heater Used in Sahelian Homes
Authors: Ouiminga Abdoul
Published: July 2024

Environmentally-friendly, low-cost energy supplies are the backbone of sustainable development. Development must not only meet current needs, but must also look to the future and consider environmental issues as a challenge. Solar power as an environmentally-friendly energy source is a promising way of reducing greenhouse gas emissions. One of the most important applications of solar energy is the production of hot water using solar water heaters. These solar water heaters, which can provide between 100 and 200 l/d of hot water over a temperature range of 40-70°C., are of the separate-element and integrated-storage types. In the Saharan environment, hot water requirements are concentrated in winter. It is therefore necessary to develop efficient systems adapted to this reality. It is then necessary to develop effective systems adapted to this reality. There is a need to propose a new design to boost the solar irradiation absorbed by the collector-storage while reducing nighttime thermal losses. For greater user-friendliness and with the aim of adapting them to the Saharan environment, it is also necessary to offer solar water heaters integrated into the building and operating mainly in the winter period. The present work represents an experimental study of a solar water heater with separate elements and a simple design, in a Burkinabe climate. This is a separate element solar water heater with a capacity of 200 liters with an aluminum collector as absorber designed at the Research Institute of Applied Sciences and Technologies (IRSAT). The water in the tank forms a loop with the sensor. In the tank, donut a copper coil of a length equal to 15m with a diameter of 16mm. They use the principle of thermosyphon (cold water pressure) to circulate and store heat and are simpler and less expensive, but can only be installed in sunny countries and have limited efficiency. During the measurement period from 11:25 a.m. to 4:05 p.m., the maximum temperature of the hot water was around 57°C at 11:45 a.m., and that of the cold water was around 27°C at 12:15 p.m.. The experimental results showed acceptable thermal performance despite the simplicity of the sensor. Finally, an improvement can easily be made whether by perfecting the thermal insulation or using selective collection surfaces.
Current Typology of Social Services in Bulgaria
Authors: Kolarova Tsetska
Published: July 2024

This article makes a systematization of current typology of social services in nowadays Bulgaria, because new Social Services Act entered into force in 2020 and started a reform in the social sphere in the country. The new legislation regulates social services with an innovative concept that interprets them as support activities that can be organized and structured according to the needs of the population. This research was done with a view to clarifying certain aspects in the concept of the new legislation, which would allow it to be interpreted theoretically correctly and, accordingly, to be fully applied in practice. The article offers an analysis of the typology of social services in Bulgaria, which is based on five normative acts, as well as the theory of social work. Various classification criteria format this typology – accessibility, functions, age of users, main groups of activities, term and environment of social service providing. Based on the adopted profiling criteria, the article arranges and reviews the possible types of social services in modern Bulgaria: generally accessible and specialized; preventive, supportive and restorative; for children and for adults; for children and adults with disabilities; for adults in a crisis situation; for information and counseling; community work; therapy and rehabilitation; day care; residential care; assistant support; hourly, half-day, full-day, 24/7; services in a home environment, services in a specialized environment and services that are provided mobile etc. A special place in the group of residential services is occupied by integrated health and social services for residential care, which build their internal own typology according to the type of persons for whom they are intended. The typology of social services made in this article is a kind of theoretical result of the analysis both of sources with scientific literature and of Bulgarian innovative legislation in the social sphere.
Factors Associated with Mild Cognitive Impairment in Community-Dwelling Elderly Individuals: A Re-evaluation of Systematic Reviews
Authors: Cao Yifan , Wang Jin , Xue Jia , Ding Hansheng
Published: July 2024

Objective This study aims to re-evaluate systematic reviews on factors associated with mild cognitive impairment (MCI) in community-dwelling elderly individuals to inform prevention and intervention strategies in community settings. Methods Comprehensive searches were conducted across multiple databases, including CNKI, Wanfang Data, VIP Journal Integration Platform, PubMed, Scopus, Web of Science, and Cochrane Library, to identify systematic reviews on factors contributing to MCI in community-dwelling elderly individuals. Dual reviewers screened the literature, and the methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR 2). Relevant factors were summarized and analyzed. Results Eleven systematic reviews were included in the analysis. Of these, two were classified as high quality, two as low quality, and the remaining seven as very low quality. Protective factors against MCI included the consumption of tea, fish, and shellfish, physical exercise, and social participation. Risk factors encompassed a history of chronic diseases, depression, sleep disorders, smoking, and alcohol consumption. Conclusion The methodological quality of systematic reviews on factors associated with MCI in community-dwelling elderly individuals is generally low. MCI is closely linked to various aspects of physiological health, psychological health, dietary nutrition, and lifestyle behaviors. It is crucial to focus on high-risk groups, particularly the elderly and females, as well as individuals experiencing subjective cognitive decline, and conduct psychological screenings and assessments of dietary quality. These factors may serve as early indicators for MCI in community-dwelling elderly individuals.
The Effect of Metal Cation Doping on the Microstructure and Electrochemical Properties of Co-Fe Layered Double Hydroxide
Authors: Liu Xin-Yu , Ma Dong-Mei , Xiang Jun , Zhao Rong-Da , Zhang Shu-Bai
Published: July 2024

A hydrothermal method is employed to successfully fabricate Co-Fe LDH self-supported materials on a nickel foam substrate. Ni2+ and Mn2+ are additionally incorporated into the materials. The electrode materials are subjected to phase analysis using an X-ray diffractometer.
The electrode materials are analyzed for morphology employing a scanning electron microscope. Electrochemical characteristics of the electrode materials are assessed by cyclic voltammetry, galvanostatic charge–discharge, and electrochemical impedance spectroscopy tests using an electrochemical
workstation. The research results demonstrate that the electrode materials doped with Ni2+ and Mn2+ exhibit significantly enhanced electrochemical properties. The Ni2+-doped Co-Fe LDH exhibits a charge–discharge duration of 2200 s with a specific capacitance
of 1036.4 C g−1, whereas the Mn2+-doped Co-Fe LDH shows a specific capacitance of 708.1 C g−1. Furthermore, the calculation of specific capacitance at different current densities indicates that the electrode doped with Ni2+ (71.20%) and
Mn2+ (74.00%) outperform the Co-Fe LDH electrode (67.39%) in terms of rate capability.
Characterization of 3D printable Polyethylene Terephthalate Glycol composite filament reinforced with agricultural waste derived from pineapple plant
Authors: Kumar Jitendra , Mishra Vishal , Kumar Avinash , Negi Sushant
Published: July 2024

The aim of the current research is to develop a 3D printable PETG composite filament reinforced with pineapple fiber particulate (PALF-P). These filaments were produced using an extrusion technique, incorporating varying weight percentages (1.5%, 2.5%, 5%, and 7.5%) of PALF particles treated with a 5% NaOH chemical solution. Analytical techniques like Fourier Transform Infrared Spectroscopy (FTIR) and X-ray Diffraction (XRD) evaluated the impact of this treatment. A comprehensive study of the resulting composite filaments’ mechanical and physical attributes revealed improved cohesion between the PETG matrix and PALF particles, enhancing the overall properties. Specifically, the incorporation of 5 wt % PALF particles showed the highest ultimate tensile strength (53.54 ± 2.7 MPa), Young’s modulus (1443 ± 72.22 MPa), and load-bearing capacity (104.97 ± 5.25 N). In contrast, 2.5% of particles had the least noticeable effect on mechanical properties. Moreover, the developed sustainable composite filament showed significant promise in advancing bio-composites through additive manufacturing, potentially contributing to sustainable manufacturing practices.
Safety in Housing for Older Adults—A Qualitative Case Study
Authors: Verma Ira
Published: July 2024

Housing solutions for older adults aim at providing a safe environment to live in. The construction is heavily based on aspects of physical safety, often disregarding the social aspects of feeling safe. The older adults themselves are looking for a living environment that supports their individual capacities and social networks. The living environment can contribute to their physical, social, and emotional safety by providing accessible housing and spaces for community building. Interviews with older adults who had recently lived through a building fire highlighted the importance of the community in daily life, in emergency as well as in recovery from hazards. The results show that community building is related to access to common-use spaces and daily interaction with neighbors. The shared spaces in the immediate surroundings can enhance community cohesion and generate peer support. The common-use spaces and public facilities in urban environment have a significant role in emergencies and in the process of recovery from adversities.
Understanding Dementia Carer Experiences Before Admission to a Residential Aged Care Facility: Implications for Integrated Care
Authors: White Jennifer , Falcioni Dane , Barker Roslyn , Bajic-Smith Julie , Krishnan Chitra , Mansfield Elise , Hullick Carolyn
Published: July 2024

In-depth understanding of dementia carer experience can assist clinicians by providing insight into dementia onset, symptoms and management, and help conceptualize and understand the pattern of dementia progress over time and what help is needed. We undertook a qualitative study to understand dementia carers experiences of providing care and reasons for admission to a residential aged care facility (RACF). Three themes were identified: (1) Challenges in the path to diagnosis and care, leading to delays accessing support; (2) Carer role impacted by living circumstances; and (3) Variation in decision support prior to admission to a RACF. Identifying dementia carer experiences, reinforces the need for more timely diagnosis, referral for support and interventions to promote better quality of life for a people living with dementia and their carer and to delay premature RACF placement.
Temporal and Racial/Ethnic Patterns of Social Engagement among Older Adults: Evidence from American Time Use Survey 2019 to 2022
Authors: Yu Jiao , Huang Wenxuan , Kahana Eva
Published: July 2024

This study examines temporal and racial/ethnic patterns in social engagement among older adults from 2019 to 2022, using data from the American Time Use Survey (ATUS) for adults aged 60 and older ( n = 13,605). Social engagement was operationalized as time spent on five activities in in-home and out-of-home settings. Descriptive analysis was used to characterize temporal trends of social engagement, and zero-inflated negative binomial regression was utilized to estimate year-specific racial/ethnic differences. Results indicate an initial decline in out-of-home social engagement, followed by a gradual recovery. Racial differences in social engagement became salient during the pandemic period. The evolving racial and ethnic patterns in social engagement underscore the challenges that Black and Hispanic older adults faced during the public health crisis. Understanding activity patterns specific to racial/ethnic groups has implications for targeted interventions, informing strategies to support Black, Hispanic, and other minoritized older adults in public health emergencies.
Benefits of reflection-based monitoring in action research projects
Authors: Dahmen-Adkins Jennifer , Peterson Helen
Published: July 2024

This article reports on reflection-based monitoring tools developed and used in an action research project to improve gender equality in science and research institutions. Several of these tools were developed to facilitate individual and joint reflection from the perspective of the co-researchers involved. The aim of the article is to make the case for the integration of a systematic reflection-based monitoring approach, to describe its approach and theoretical underpinnings that link critical reflection theory with reflexive action learning theory, and to present the details of six monitoring tools so that they can be adopted in other project settings. It also highlights how these monitoring tools stimulated both individual and group reflection and how they facilitated the sharing of knowledge and experience between change agents involved in co-production. The article also shows that the process monitoring approach based on systematic reflection can contribute to successful project implementation and offers several important advantages.
Pulmonary fibrosis in patients with autoimmune pulmonary alveolar proteinosis: a retrospective nationwide cohort study
Authors: Guirriec Yoann , Luque-Paz David , Bernard Gontran , Mabo Axelle , Kerjouan Mallorie , Ménard Cédric , Monnier Delphine , Nunes Hilario , Uzunhan Yurdagül , Reynaud-Gaubert Martine , Bermudez Julien , Borie Raphaël , Crestani Bruno , Traclet Julie , Wémeau-Stervinou Lidwine , Chenivesse Cécile , Gomez Emmanuel , Prévot Grégoire , Bourdin Arnaud , Bondue Benjamin , Bergeron Anne , Cottin Vincent , Lederlin Mathieu , Jouneau Stéphane ,   the OrphaLung network
Published: July 2024

Background

Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease that may progress towards pulmonary fibrosis. Data about fibrosis prevalence and risk factors are lacking.

Methods

In this retrospective multicentre nationwide cohort, we included patients newly diagnosed with aPAP between 2008 and 2018 in France and Belgium. Data were collected from medical records using a standardised questionnaire.

Results

61 patients were included in the final analysis. We identified 5 patients (8%) with fibrosis on initial computed tomography (CT) and 16 patients (26%) with fibrosis on final CT after a median time of 3.6 years. Dust exposure was associated with pulmonary fibrosis occurrence (OR 4.3; p=0.038). aPAP patients treated with whole-lung lavage, rituximab or granulocyte–monocyte colony-stimulating factor therapy did not have more fibrotic evolution than patients who did not receive these treatments (n=25 out of 45, 57%versusn=10 out of 16, 62%; p=0.69). All-cause mortality was significantly higher in fibrotic than in nonfibrotic cases (n=4 out of 16, 25%versusn=2 out of 45, 4.4%; p=0.036, respectively).

Conclusion

In our population, a quarter of aPAP patients progressed towards pulmonary fibrosis. Dust exposure seems to be an important factor associated with this complication. More studies are needed to analyse precisely the impact of dust exposure impact, especially silica, in patients with aPAP.
A diagnostic dilemma: distinguishing a sulfasalazine induced DRESS hypersensitivity syndrome from a CD30 + lymphoma in a young patient
Authors: Aleksandrova Natalija , De Rop Jonas , Camu Frederic , Hubloue Ives , Devue Katleen
Published: July 2024

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe hypersensitivity reaction characterized by cutaneous rash, lymphadenopathy, fever, eosinophilia, leukocytosis, and life-threatening organ dysfunctions. We describe the case of a 26 year old patient admitted to the Emergency Department for DRESS syndrome after sulfasalazine treatment for rheumatoid arthritis in the right knee. Whole body computer tomography showed multiple neck, chest, and abdominal lymphadenopathy with splenomegaly, massive ascites and severe hepatic cytolysis. Serology results for Epstein-Barr Virus (EBV), influenza, measles, rubella, hepatitis A and B were negative. The histologic analysis of skin, lymph node and bone marrow biopsies could not indicate a classical Hodgkin’s Disease or iatrogenic immunodeficiency/EBV-associated lymphoproliferative disorder (LPD), Hodgkin type. The relatively small caliber of the CD30 + immunoreactive blastoid cells in the lymph nodes suggested reactive immunoblasts rather than Hodgkin cells. The morphologic aspects of the lymph node biopsies with predominance of T-cells were compatible with the diagnosis of a sulfasalazine-induced DRESS syndrome as the patient had a high RegiSCAR score for DRESS. [DRESS Syndrome Foundation: Diagnosis and Treatment. (2023)] The patient’s complex clinical course, marked by two hospital admissions, highlights the challenges in diagnosing and managing DRESS. This case underscores the need for individualized care, close patient monitoring, and further research to better understand DRESS’s underlying mechanisms and optimal therapeutic strategies.
Prolonged administration of the granisetron transdermal delivery system reduces capecitabine plus oxaliplatin regimen induced nausea and vomiting
Authors: Wang Cong , Jiang Zhansheng , Zhang Jie , Zhuang Yan , Sun Lining , Zhang Jing , Quan Manman , Lan Lan , Li Yanwei , Wang Bin , Pan Zhanyu , Yan Zhuchen
Published: July 2024

Objective

To evaluate the safety and efficacy of the granisetron transdermal delivery system (GTDS) combined with Dexamethasone for preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving Capecitabine plus Oxaliplatin (CapeOX) therapy.

Design

Open-label, prospective, multi-center phase II trial.

Setting

Three institutions.

Participants

Fifty-four patients scheduled to receive CapeOX chemotherapy.

Interventions

Participants received GTDS (3.1 mg applied to the upper arm 48 h before chemotherapy, replaced on day 5, and discarded on day 12) and Dexamethasone.

Main outcome measures

The primary endpoint was the complete control rate of CINV. Secondary endpoints included the duration of delayed complete control, complete control rate in the acute phase, safety, and quality of life.

Results

The complete control rate for delayed CINV over the entire period (25–480 h) was 72.7% (95% CI 0.57–0.88). The duration of delayed complete control was 17.2 ± 4.5 days, with 51.5% of patients experiencing no nausea during the delayed phase. The complete control rate in the acute phase was 81.8% (95% CI 0.69–0.95). No serious adverse events related to the antiemetic regimen were reported.

Conclusion

Prolonged administration of GTDS is safe and effective for preventing CINV in patients with gastrointestinal malignancies treated with CapeOX.

Trial Registration

ClinicalTrials.gov registry (NCT05325190); registered on October 10, 2021.
Efficacy of pars plana vitrectomy combined with internal limiting membrane peeling and gas tamponade for treating myopic foveoschisis: a meta-analysis
Authors: Song Shuqi , He Guanglun , Huang Di , Li Xiaojuan , Wu Zhenzhen , Sun Yongfeng
Published: July 2024

Objective

This study aimed to evaluate and explore the efficacy of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) peeling and gas tamponade in treating myopic foveoschisis (MF) through a meta-analysis.

Methods

Systematic searches were conducted on the PubMed, Web of Science and National Library of Medicine (NLM) English-language databases and the China National Knowledge Infrastructure (CNKI) and Wanfang Chinese-language databases. The primary outcome measures were postoperative best-corrected visual acuity (BCVA) and central foveal thickness (CFT), with the secondary outcome being the postoperative complication rate. Data analysis was performed using RevMan5.3 software.

Results

A total of 10 studies involving 234 eyes were included. The meta-analysis results showed the following: (1) The average postoperative BCVA improved compared with preoperative levels, with an average improvement in the logarithm of the minimum angle of resolution of 0.40, a statistically significant difference (95% CI: −0.44, − 0.20, p < 0.001); (2) the rate of postoperative BCVA improvement was 77% (95% CI: 65%, 90%, p < 0.001); (3) the postoperative CFT significantly decreased by an average of 385.92 μm, a statistically significant difference (95% CI: −437.85, − 333.98, p < 0.001); (4) the postoperative macular retinal complete reattachment rate was 90% (95% CI: 83%, 97%, p < 0.001); (5) the most common postoperative complication was a cataract, with an incidence of 55.9%.

Conclusion

Using PPV combined with ILM peeling and gas tamponade to treat MF is reliable.
3D-printed porous titanium suture anchor: a rabbit lateral femoral condyle model
Authors: Wu Lien-Chen , Hsieh Yueh-Ying , Hsu Ting-Shuo , Liu Po-Yi , Tsuang Fon-Yih , Kuo Yi-Jie , Chen Chia-Hsien , Van Huynh TIN , Chiang Chang-Jung
Published: July 2024

Background

The inclusion of a connecting path in a porous implant can promote nutrient diffusion to cells and enhance bone ingrowth. Consequently, this study aimed to evaluate the biomechanical, radiographic, and histopathological performance of a novel 3D-printed porous suture anchor in a rabbit femur model.

Methods

Three test groups were formed based on the type of suture anchor (SA): Commercial SA (CSA, Group A, n = 20), custom solid SA (CSSA, Group B, n = 20), and custom porous SA (CPSA, Group C, n = 20). The SAs were implanted in the lateral femoral condyle of the right leg in each rabbit. The rabbits (New Zealand white rabbits, male, mean body weight of 2.8 ± 0.5 kg, age 8 months) underwent identical treatment and were randomized into experimental and control groups via computer-generated randomization. Five rabbits (10 femoral condyles) were euthanized at 0, 4, 8, and 12 weeks post-implantation for micro-CT, histological analysis, and biomechanical testing.

Results

At 12 weeks, the CPSA showed a higher BV/TV (median 0.7301, IQR 0.7276–0.7315) than the CSSA and CSA. The histological analysis showed mineralized osteocytes near the SA. At 4 weeks, new bone was observed around the CPSA and had penetrated its porous structure. By 12 weeks, there was no significant difference in ultimate failure load between the CSA and CPSA.

Conclusions

We demonstrated that the innovative 3D-printed porous suture anchor exhibited comparable pullout strength to conventional threaded suture anchors at the 12-week postoperative time-point period. Furthermore, our porous anchor design enhanced new bone formation and facilitated bone growth into the implant structure, resulting in improved biomechanical stability.
Immersive virtual reality for interdisciplinary trauma management – initial evaluation of a training tool prototype
Authors: Hanke Laura Isabel , Vradelis Lukas , Boedecker Christian , Griesinger Jan , Demare Tim , Lindemann Nicola Raphaele , Huettl Florentine , Chheang Vuthea , Saalfeld Patrick , Wachter Nicolas , Wollstädter Jochen , Spranz Marike , Lang Hauke , Hansen Christian , Huber Tobias
Published: July 2024

Introduction

Emergency care of critically ill patients in the trauma room is an integral part of interdisciplinary work in hospitals. Live threatening injuries require swift diagnosis, prioritization, and treatment; thus, different medical specialties need to work together closely for optimal patient care. Training is essential to facilitate smooth performance. This study presents a training tool for familiarization with trauma room algorithms in immersive virtual reality (VR), and a first qualitative assessment.

Materials and methods

An interdisciplinary team conceptualized two scenarios and filmed these in the trauma room of the University Medical Center Mainz, Germany in 3D-360°. This video content was used to create an immersive VR experience. Participants of the Department of Anesthesiology were included in the study, questionnaires were obtained and eye movement was recorded.

Results

31 volunteers participated in the study, of which 10 (32,2%) had completed specialist training in anesthesiology. Participants reported a high rate of immersion (immersion(mean) = 6 out of 7) and low Visually Induced Motion Sickness (VIMS(mean) = 1,74 out of 20). Participants agreed that VR is a useful tool for medical education (mean = 1,26; 1 very useful, 7 not useful at all). Residents felt significantly more secure in the matter after training (p < 0,05), specialist showed no significant difference.

Discussion

This study presents a novel tool for familiarization with trauma room procedures, which is especially helpful for less experienced residents. Training in VR was well accepted and may be a solution to enhance training in times of low resources for in person training.
Dietary Moringa oleifera mitigates Fluconazole-Induced immunological and spleen-histological alterations in Catfish (Clarias gariepinus)
Authors: Basry Doaa M. , Mansour Salwa , H. Sayed Alaa El-Din
Published: July 2024

Fluconazole (FCZ), an antifungal from the azole family, causes several detrimental effects in fish. In recent times, there has been a notable surge in interest regarding the utilization of Moringa oleifera (Mo) as a dietary antioxidant. This research aimed to evaluate the potential protective effects of dietary Moringa oleifera (MO) against the adverse impacts of fluconazole in the African catfish (Clarias gariepinus). The fish were allocated into four groups as follows: a control group fed a basal diet, an FCZ - exposed (200 ng/L) fed basal diet, 1% MO fed through basal diet, and an FCZ-exposed (200 ng/L) and 1% MO fed through basal diet fed group. The results showed that FCZ exposure decreased superoxide dismutase, total antioxidant capacity, and acetylcholine esterase levels. On the other hand, FCZ exposure increased malonaldehyde and cortisol levels as compared to control (P < 0.05). FCZ caused immunosuppressive effects in C. gariepinus as revealed by lower immunity indices (lysozyme and phagocytic activity and immunoglobulin level) and increased cytokine levels (IL-6 IL-1β). Histological examination of the spleen from fish exposed to FCZ showed several splenic changes. We conclude that dietary MO supplementation has the potential to alleviate the oxidative stress, restore immune response balance, and mitigate histological damage induced by FCZ exposure, thus positioning MO as an immunostimulant in C. gariepinus when administered alongside FCZ.
Regulation of myofibroblast dedifferentiation in pulmonary fibrosis
Authors: Ju Xuetao , Wang Kai , Wang Congjian , Zeng Chenxi , Wang Yi , Yu Jun
Published: July 2024

Idiopathic pulmonary fibrosis is a lethal, progressive, and irreversible condition that has become a significant focus of medical research due to its increasing incidence. This rising trend presents substantial challenges for patients, healthcare providers, and researchers. Despite the escalating burden of pulmonary fibrosis, the available therapeutic options remain limited. Currently, the United States Food and Drug Administration has approved two drugs for the treatment of pulmonary fibrosis—nintedanib and pirfenidone. However, their therapeutic effectiveness is limited, and they cannot reverse the fibrosis process. Additionally, these drugs are associated with significant side effects. Myofibroblasts play a central role in the pathophysiology of pulmonary fibrosis, significantly contributing to its progression. Consequently, strategies aimed at inhibiting myofibroblast differentiation or promoting their dedifferentiation hold promise as effective treatments. This review examines the regulation of myofibroblast dedifferentiation, exploring various signaling pathways, regulatory targets, and potential pharmaceutical interventions that could provide new directions for therapeutic development.
Blood lipid profiles as a prognostic biomarker in idiopathic pulmonary fibrosis
Authors: Oh Ju Hyun , Chae Ganghee , Song Jin Woo
Published: July 2024

Background

Dysregulation of lipid metabolism is implicated in the pathogenesis of idiopathic pulmonary fibrosis (IPF). However, the association between the blood lipid profiles and the prognosis of IPF is not well defined. We aimed to identify the impacts of lipid profiles on prognosis in patients with IPF.

Methods

Clinical data of 371 patients with IPF (145 and 226 in the derivation and validation cohorts, respectively), including serum lipid profiles (total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A-I [Apo A-I], and apolipoprotein B), were retrospectively collected. The association with mortality was analyzed using the Cox proportional hazard model.

Results

In the derivation cohort, the mean age was 67.5 years, 86.2% were men, and 30.3% died during the follow-up (median: 18.0 months). Non-survivors showed lower lung function and greater gender-age-physiology scores than survivors. Among the serum lipid profiles, the levels of triglyceride and Apo A-I were significantly lower in non-survivors than in survivors. In the multivariate Cox analysis, low Apo A-I levels (< 140 mg/dL) were independently associated with the risk of mortality (hazard ratio 3.910, 95% confidence interval 1.170-13.069; P = 0.027), when adjusted for smoking history, body mass index, GAP score, and antifibrotic agent use. In both derivation and validation cohorts, patients with low Apo A-I levels (< 140 mg/dL) had worse survival (median survival: [derivation] 34.0 months vs. not reached, P = 0.003; [validation] 40.0 vs. 53.0 months, P = 0.027) than those with high Apo A-I levels in the Kaplan–Meier survival analysis.

Conclusions

Our results indicate that low serum Apo A-1 levels are an independent predictor of mortality in patients with IPF, suggesting the utility of serum Apo A-I as a prognostic biomarker in IPF.
Adipose-derived stem cell exosomes loaded with icariin alleviates rheumatoid arthritis by modulating macrophage polarization in rats
Authors: Yan Qiqi , Liu Haixia , Sun Shiyue , Yang Yongsheng , Fan DanPing , Yang Yuqin , Zhao Yukun , Song Zhiqian , Chen Yanjing , Zhu Ruyuan , Zhang Zhiguo
Published: July 2024

Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by synovitis and cartilage destruction. The active compound, icariin (ICA), derived from the herb Epimedium, exhibits potent anti-inflammatory properties. However, its clinical utility is limited by its water insolubility, poor permeability, and low bioavailability. To address these challenges, we developed a multifunctional drug delivery system—adipose-derived stem cells-exosomes (ADSCs-EXO)-ICA to target active macrophages in synovial tissue and modulate macrophage polarization from M1 to M2. High-performance liquid chromatography analysis confirmed a 92.4 ± 0.008% loading efficiency for ADSCs-EXO-ICA. In vitro studies utilizing cellular immunofluorescence (IF) and flow cytometry demonstrated significant inhibition of M1 macrophage proliferation by ADSCs-EXO-ICA. Enzyme-linked immunosorbent assay, cellular transcriptomics, and real-time quantitative PCR indicated that ADSCs-EXO-ICA promotes an M1-to-M2 phenotypic transition by reducing glycolysis through the inhibition of the ERK/HIF-1α/GLUT1 pathway. In vivo, ADSCs-EXO-ICA effectively accumulated in the joints. Pharmacodynamic assessments revealed that ADSCs-EXO-ICA decreased cytokine levels and mitigated arthritis symptoms in collagen-induced arthritis (CIA) rats. Histological analysis and micro computed tomography confirmed that ADSCs-EXO-ICA markedly ameliorated synovitis and preserved cartilage. Further in vivo studies indicated that ADSCs-EXO-ICA suppresses arthritis by promoting an M1-to-M2 switch and suppressing glycolysis. Western blotting supported the therapeutic efficacy of ADSCs-EXO-ICA in RA, confirming its role in modulating macrophage function through energy metabolism regulation. Thus, this study not only introduces a drug delivery system that significantly enhances the anti-RA efficacy of ADSCs-EXO-ICA but also elucidates its mechanism of action in macrophage function inhibition.

Graphical abstract