bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Visuospatial Sketchpad in Second Language Acquisition
Authors: Bhatnagar Somya , Singh Pankaj
Published: April 2024

In the prior studies, the significance of working memory is linked to language acquisition which helped in understanding these disorders better (Wen, & Li, 2019). However, there is one component that is not being taken into consideration with Second Language Acquisition (SLA) (Choi, 2019). This study collected data from 122 adolescents and young adults (Female = 61, Male = 61) in the age range 15–22 years. Using four subtests of David’s Battery of Differential Abilities (DBDA), measures of VSSP and verbal ability were measured. Multiple regression analysis was carried out between the measures of VSSP and verbal ability. The results showed promise and the measures of VSSP were found to be a positive predictor of second language comprehension in the current sample. Whereas, no gender differences were observed with regard to verbal ability. With the supporting literature, this study evidently provided insights into the overall relationship.
An updated checklist for the pseudoscorpion fauna of Hungary (Arachnida: Pseudoscorpiones)
Authors: NOVÁK JÁNOS
Published: April 2024

An updated checklist of the pseudoscorpion fauna of Hungary is presented. Chthonius cf. alpicola Beier, 1951 is newly reported for the country. Neobisium inaequale Chamberlin, 1930 is regarded as a junior synonym of N. sylvaticum (C.L. Koch, 1835) (syn. nov.). Chelifer tegulatus Tömösváry, 1883 is regarded as a junior synonym of Dactylochelifer latreillii (Leach, 1817) (syn. nov.). Rhacochelifer quadrimaculatus (Tömösváry, 1882) is regarded as a senior synonym of Beierochelifer peloponnesiacus (Beier, 1929) (syn. nov.), forming the combination Beierochelifer quadrimaculatus (Tömösváry, 1882) (comb. nov). Furthermore, Chthonius pygmaeus (Beier, 1934), Neobisium (Neobisium) simoni (L. Koch, 1873), Neobisium (Neobisium) validum (L. Koch, 1873), Rhacochelifer peculiaris (L. Koch, 1873), and Chernes montigenus (Simon, 1879) are excluded from the Hungarian fauna. Neobisium (N.) seminudum (Daday and Tömösváry, 1880) and Chelifer entzii Daday and Tömösváry, 1880 are designated as nomina dubia. As a consequence, the pseudoscorpion fauna of Hungary now comprises 49 species belonging to eight families with confirmed occurrence data; the occurrence of 6 further species recorded earlier for Hungary is doubtful. Phoresy is documented for Ephippiochthonius tetrachelatus (Preyssler, 1790) and Diplotemnus balcanicus (Redikorzev, 1928). Habitat preference of each species with confirmed occurrence in Hungary are assumed. Notes are given to some old data reported by Ödön Tömösváry and Eugen Daday from neighbouring countries. Microbisium manicatum (L. Koch, 1873) is excluded from the fauna list of Romania.
A new genus and three new species of Empoascini (Hemiptera: Cicadellidae: Typhlocybinae) from China
Authors: DING YAN , YAN BIN , YU XIAO-FEI , YANG MAO-FA
Published: April 2024

One new genus and three new species of Empoascini from China are described and illustrated: Ventriappendix Ding, Yu & Yang gen. nov. with a new species V. divaricata Ding, Yu & Yang, sp. nov.; Dayus motuoensis Ding, Yu & Yang sp. nov.; and Alebroides hei Ding, Yu & Yang sp. nov. A revised key to males of Chinese species and a checklist to the genus of Dayus are also provided.
First records of Medmassa Simon, 1887 from India, with the description of two new species (Araneae: Corinnidae)
Authors: SANKARAN PRADEEP M. , KADAM GAUTAM , TRIPATHI RISHIKESH
Published: April 2024

Medmassa Simon, 1887 is recorded for the first time from India, including the description of two new species: M. sagax Tripathi, Kadam & Sankaran sp. nov. (♂ ♀) and M. postica Kadam, Tripathi & Sankaran sp. nov. (♀). The discovery of Medmassa increases the number of known corinnid genera in India to eight. Detailed descriptions and illustrations of the copulatory organs of both species are provided, their natural history is briefly discussed, and a map of the currently known distribution of both species is presented.
A high heterozygosity genome assembly of Aedes albopictus enables the discovery of the association of PGANT3 with blood-feeding behavior
Authors: Deng Yuhua , Ren Shuyi , Liu Qiong , Zhou Dan , Zhong Caimei , Jin Yabin , Xie Lihua , Gu Jinbao , Xiao Chuanle
Published: April 2024

The Asian tiger mosquito, Aedes albopictus, is a global invasive species, notorious for its role in transmitting dangerous human arboviruses such as dengue and Chikungunya. Although hematophagous behavior is repulsive, it is an effective strategy for mosquitoes like Aedes albopictus to transmit viruses, posing a significant risk to human health. However, the fragmented nature of the Ae. albopictus genome assembly has been a significant challenge, hindering in-depth biological and genetic studies of this mosquito. In this research, we have harnessed a variety of technologies and implemented a novel strategy to create a significantly improved genome assembly for Ae. albopictus, designated as AealbF3. This assembly boasts a completeness rate of up to 98.1%, and the duplication rate has been minimized to 1.2%. Furthermore, the fragmented contigs or scaffolds of AealbF3 have been organized into three distinct chromosomes, an arrangement corroborated through syntenic plot analysis, which compared the genetic structure of Ae. albopictus with that of Ae. aegypti. Additionally, the study has revealed a phylogenetic relationship suggesting that the PGANT3 gene is implicated in the hematophagous behavior of Ae. albopictus. This involvement was preliminarily substantiated through RNA interference (RNAi) techniques and behavioral experiment. In summary, the AealbF3 genome assembly will facilitate new biological insights and intervention strategies for combating this formidable vector of disease. The innovative assembly process employed in this study could also serve as a valuable template for the assembly of genomes in other insects characterized by high levels of heterozygosity.
Hospital distribution, seasonality, time trends and antifungal susceptibility profiles of all Aspergillus species isolated from clinical samples from 2015 to 2022 in a tertiary care hospital
Authors: Franconi Iacopo , Rizzato Cosmeri , Ghelardi Emilia , Lupetti Antonella
Published: April 2024

Background

Aspergillus species cause a variety of serious clinical conditions with increasing trend in antifungal resistance. The present study aimed at evaluating hospital epidemiology and antifungal susceptibility of all isolates recorded in our clinical database since its implementation.

Methods

Data on date of isolation, biological samples, patients’ age and sex, clinical settings, and antifungal susceptibility tests for all Aspergillus spp. isolated from 2015 to 2022 were extracted from the clinical database. Score test for trend of odds, non-parametric Mann Kendall trend test and logistic regression analysis were used to analyze prevalence, incidence, and seasonality of Aspergillus spp. isolates.

Results

A total of 1126 Aspergillus spp. isolates were evaluated. A. fumigatus was the most prevalent (44.1%) followed by A. niger (22.3%), A. flavus (17.7%) and A. terreus (10.6%). A. niger prevalence increased over time in intensive care units (p-trend = 0.0051). Overall, 16 (1.5%) were not susceptible to one azole compound, and 108 (10.9%) to amphotericin B, with A. niger showing the highest percentage (21.9%). The risk of detecting A. fumigatus was higher in June, (OR = 2.14, 95% CI [1.16; 3.98] p = 0.016) and reduced during September (OR = 0.48, 95% CI [0.27; 0.87] p = 0.015) and October as compared to January (OR = 0.39, 95% CI [0.21; 0.70] p = 0.002. A. niger showed a reduced risk of isolation from all clinical samples in the month of June as compared to January (OR = 0.34, 95% CI [0.14; 0.79] p = 0.012). Seasonal trend for A. flavus showed a higher risk of detection in September (OR = 2.7, 95% CI [1.18; 6.18] p = 0.019), October (OR = 2.32, 95% CI [1.01; 5.35] p = 0.048) and November (OR = 2.42, 95% CI [1.01; 5.79] p = 0.047) as compared to January.

Conclusions

This is the first study to analyze, at once, data regarding prevalence, time trends, seasonality, species distribution and antifungal susceptibility profiles of all Aspergillus spp. isolates over a 8-year period in a tertiary care center. Surprisingly no increase in azole resistance was observed over time.
Superoxide dismutases: marker in predicting reduced left ventricular ejection fraction in patients with type 2 diabetes and acute coronary syndrome
Authors: Jiang Xiu-Yun , Chen Qing , Chen Xiao-Yu , Sun Qiu-Ying , Jing Fei , Zhang Hai-Qing , Xu Jin , Li Xiao-Hong , Guan Qing-Bo
Published: April 2024

Aim

To examine the prognostic value of superoxide dismutase (SOD) activity for monitoring reduced left ventricular ejection fraction(LVEF)in the patients with type 2 diabetes and acute coronary syndrome (ACS).

Methods

The population of this cross-sectional study included 2377 inpatients with type 2 diabetes who had an ACS admitted to the Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2016 to January 2021.

Results

Diabetic patients with ACS were divided into 2 subgroups based on LVEF. The mean SOD activity was significantly lower in patients with an LVEF ≤ 45% than in those with an LVEF > 45% (149.1 (146.4, 151.9) versus 161.9 (160.8, 163.0)). Using ROC statistic, a cut-off value of 148.8 U/ml indicated an LVEF ≤ 45% with a sensitivity of 51.6% and a specificity of 73.7%. SODs activity were found to be correlated with the levels of NT-proBNP, hs-cTnT, the inflammatory marker CRP and fibrinogen. Despite taking the lowest quartile as a reference (OR 0.368, 95% CI 0.493–0.825, P = 0.001) or examining 1 normalized unit increase (OR 0.651, 95% CI 0.482–0.880, P = 0.005), SOD activity was found to be a stronger predictor of reduced LVEF than CRP and fibrinogen, independent of confounding factors.

Conclusions

Our cross-sectional study suggests that SOD activity might be a valuable and easily accessible tool for assessing and monitoring reduced LVEF in the diabetic patients with ACS.
Impact of COVID-19 pandemic on interhospital transfer of patients with major trauma in Korea: a retrospective cohort study
Authors: Cho Sung Hoon , Nho Woo Young , Lee Dong Eun , Ahn Jae Yun , Kim Joon-Woo , Lim Kyoung Hoon , Ryoo Hyun Wook , Kim Jong Kun
Published: April 2024

Background

Interhospital transfer (IHT) is necessary for providing ultimate care in the current emergency care system, particularly for patients with severe trauma. However, studies on IHT during the pandemic were limited. Furthermore, evidence on the effects of the coronavirus disease 2019 (COVID-19) pandemic on IHT among patients with major trauma was lacking.

Method

This retrospective cohort study was conducted in an urban trauma center (TC) of a tertiary academic affiliated hospital in Daegu, Korea. The COVID-19 period was defined as from February 1, 2020 to January 31, 2021, whereas the pre-COVID-19 period was defined as the same duration of preceding span. Clinical data collected in each period were compared. We hypothesized that the COVID-19 pandemic negatively impacted IHT.

Results

A total of 2,100 individual patients were included for analysis. During the pandemic, the total number of IHTs decreased from 1,317 to 783 (− 40.5%). Patients were younger (median age, 63 [45–77] vs. 61[44–74] years, p = 0.038), and occupational injury was significantly higher during the pandemic (11.6% vs. 15.7%, p = 0.025). The trauma team activation (TTA) ratio was higher during the pandemic both on major trauma (57.3% vs. 69.6%, p = 0.006) and the total patient cohort (22.2% vs. 30.5%, p < 0.001). In the COVID-19 period, duration from incidence to the TC was longer (218 [158–480] vs. 263[180–674] minutes, p = 0.021), and secondary transfer was lower (2.5% vs. 0.0%, p = 0.025).

Conclusion

We observed that the total number of IHTs to the TC was reduced during the COVID-19 pandemic. Overall, TTA was more frequent, particularly among patients with major trauma. Patients with severe injury experienced longer duration from incident to the TC and lesser secondary transfer from the TC during the COVID-19 pandemic.
ERASE: a feasible early warning tool for elder abuse, developed for use in the Dutch emergency department
Authors: van Houten Miriam E. , Vloet Lilian C. M. , Rikkert Marcel G. M. Olde , van de Kerkhof-van Bon Brigitte , de Rooij Anneriek , Verhoeven Marieke , Bil Wilhelmina M. E. , Lucke Jacinta A. , Schoon Yvonne , Berben Sivera A. A.
Published: April 2024

Background

Elder abuse is a worldwide problem with serious consequences for individuals and society. To effectively deal with elder abuse, a timely identification of signals as well as a systematic approach towards (suspected) elder abuse is necessary. This study aimed to develop and test the acceptability and appropriateness of ERASE (EldeR AbuSE) in the emergency department (ED) setting. ERASE is an early warning tool for elder abuse self-administered by the healthcare professional in patients ≥ 70 years.

Methods

A systematic literature review was previously conducted to identify potential available instruments on elder abuse for use in the ED. Furthermore, a field consultation in Dutch hospitals was performed to identify practice tools and potential questions on the recognition of elder abuse that were available in clinical practice. Based on this input, in three subsequent rounds the ERASE tool was developed. The ERASE tool was tested in a pilot feasibility study in healthcare professionals (n = 28) working in the ED in three Dutch hospitals. A semi-structured online questionnaire was used to determine acceptability and appropriateness of the ERASE tool.

Results

The systematic literature review revealed seven screening instruments developed for use in the hospital and/or ED setting. In total n = 32 (44%) hospitals responded to the field search. No suitable and validated instruments for the detection of elder abuse in the ED were identified. The ERASE tool was developed, with a gut feeling awareness question, that encompassed all forms of elder abuse as starting question. Subsequently six signalling questions were developed to collect information on observed signs and symptoms of elder abuse and neglect. The pilot study showed that the ERASE tool raised the recognition of healthcare professionals for elder abuse. The tool was evaluated acceptable and appropriate for use in the ED setting.

Conclusions

ERASE as early warning tool is guided by an initial gut feeling awareness question and six signalling questions. The ERASE tool raised the recognition of healthcare professionals for elder abuse, and was feasible to use in the ED setting. The next step will be to investigate the reliability and validity of the ERASE early warning tool.
Bacterial etiology and antimicrobial resistance pattern of pediatric bloodstream infections: a 5-year experience in an Iranian referral hospital
Authors: Sajedi Moghaddam Sadaf , Mamishi Setareh , Pourakbari Babak , Mahmoudi Shima
Published: April 2024

Background

Bloodstream infections (BSI) are the major cause of morbidity and mortality in children in developing countries. The purpose of the current study was to establish the antimicrobial susceptibility pattern of bacterial isolates from bloodstream infections at Children’s Medical Center Hospital (CMC), Tehran, Iran.

Methods

We retrospectively recorded all positive blood cultures and antimicrobial susceptibility of all bloodstream isolates among children admitted to CMC, during 5 years. Specimen culture, bacterial identification, and antimicrobial susceptibility testing were performed according to standard laboratory methods.

Results

From 3,179 pathogens isolated from the blood cultures 2,824 bacteria were cultured, with 1,312 cases being identified as Gram-positive bacteria (46%) and 1,512 cases as Gram-negative bacteria (54%). The most common Gram-negative bacteria isolated were as follows: Pseudomonas spp. (n = 266, 17.6%), Klebsiella pneumoniae (n = 242, 16%), Stenotrophomonas maltophilia (n = 204, 13.5%), Enterobacter spp. (n = 164, 10.8%), Escherichia coli (n = 159, 10.5%), Pseudomonas aeruginosa (n = 126, 8.3%), Serratia marcescens (n = 121, 8%), and Acinetobacter baumannii (n = 73, 4.8%). The most common Gram-positive bacteria isolated were coagulase-negative staphylococci (CONS) (n = 697, 53%), Streptococcus spp. (n = 237, 18%), Staphylococcus aureus (n = 202, 15%) and Enterococcus spp. (n = 167, 12.7%). 34% of bacterial strains were isolated from ICUs. The rates of methicillin resistance in S. aureus and CONS were 34% and 91%, respectively. E. coli isolates showed high resistance to cefotaxime (84%). All isolates of K. pneumoniae were susceptible to colistin and 56% were susceptible to imipenem. P. aeruginosa isolates showed high susceptibility to all antibiotics.

Conclusions

Our findings emphasize the need of clinicians having access to up-to-date bacterial susceptibility data for routinely prescribed drugs. Continuous monitoring of changes in bacterial resistance will aid in the establishment of national priorities for local intervention initiatives in Iran. The increased risk of BSI caused by antibiotic-resistant organisms, emphasizes the significance of implementing appropriate antibiotic prescribing regulations and developing innovative vaccination techniques in Iran.
Exploring vascular contributions to cognitive impairment and dementia (ENIGMA): protocol for a prospective observational study
Authors: Vestergaard Sigrid Breinholt , Damsbo Andreas Gammelgaard , Pedersen Niels Lech , Zachariassen Katrine , Drasbek Kim Ryun , Østergaard Leif , Andersen Grethe , Dalby Rikke Beese , Mortensen Janne Kærgård
Published: April 2024

Background

Post-stroke cognitive impairment (PSCI) is common. However, the underlying pathophysiology remains largely unknown. Understanding the role of microvascular changes and finding markers that can predict PSCI, could be a first step towards better screening and management of PSCI. Capillary dysfunction is a pathological feature of cerebral small vessel disease and may play a role in the mechanisms underlying PSCI. Extracellular vesicles (EVs) are secreted from cells and may act as disease biomarkers. We aim to investigate the role of capillary dysfunction in PSCI and the associations between EV characteristics and cognitive function one year after acute ischemic stroke (AIS) and transient ischemic attack (TIA).

Methods

The ENIGMA study is a single-centre prospective clinical observational study conducted at Aarhus University Hospital, Denmark. Consecutive patients with AIS and TIA are included and followed for one year with follow-up visits at three and 12 months. An MRI is performed at 24 h and 12 months follow-up. EV characteristics will be characterised from blood samples drawn at 24 h and three months follow-up. Cognitive function is assessed three and 12 months after AIS and TIA using the Repeatable Battery for the Assessment of Neuropsychological Status.

Discussion

Using novel imaging and molecular biological techniques the ENIGMA study will provide new knowledge about the vascular contributions to cognitive decline and dementia.

Trial registration

The study is retrospectively registered as an ongoing observational study at ClinicalTrials.gov with the identifier NCT06257823.
An evaluation of the quality, suitability and impact on equity of clinical practice guidelines relevant to preterm birth for use in Aotearoa New Zealand
Authors: Hunter Briar , Dawes Lisa , Wadsworth Makayla , Sadler Lynn , Edmonds Liza , McAra-Couper Judith , Allen-Mokaraka Tina , Groom Katie M.
Published: April 2024

Background

Preterm birth is a leading cause of perinatal morbidity and mortality and a defining event for pregnant people, infants, and whānau (extended families). Recommendations have been made for a national preterm birth prevention initiative focusing on equity in Aotearoa New Zealand, including the development of a national best practice guide. An understanding of the number and quality of guidelines, and consideration of their suitability and impact on equity is required.

Methods

Guidelines were identified through a systematic literature search, search of professional bodies websites, and invitation to regional health services in Aotearoa New Zealand. Obstetric and midwifery clinical directors were invited to report on guideline use. Identified guidelines were appraised by a 23-member trans-disciplinary Review Panel; quantitatively using the AGREE-II instrument and qualitatively using modified ADAPTE questions. The quality of guidelines available but not in use was compared against those in current use, and by health services by level of maternity and neonatal care. Major themes affecting implementation and impact on equity were identified using Braun and Clarke methodology.

Results

A total of 235 guidelines were included for appraisal. Guidelines available but not in use by regional health services scored higher in quality than guidelines in current use (median domain score Rigour and Development 47.5 versus 18.8, p < 0.001, median domain score Overall Assessment 62.5 versus 44.4, p < 0.001). Guidelines in use by regional health services with tertiary maternity and neonatal services had higher median AGREE II scores in several domains, than those with secondary level services (median domain score Overall Assessment 50.0 versus 37.5, p < 0.001). Groups identified by the Review Panel as experiencing the greatest constraints and limitations to guideline implementation were rural, provincial, low socioeconomic, Māori, and Pacific populations. Identified themes to improve equity included a targeted approach to groups experiencing the least advantage; a culturally considered approach; nationally consistent guidance; and improved funding to support implementation of guideline recommendations.

Conclusions

We have systematically identified and assessed guidelines on preterm birth. High-quality guidelines will inform a national best practice guide for use in Taonga Tuku Iho, a knowledge translation project for equity in preterm birth care and outcomes in Aotearoa.
Radiographic and clinical outcomes of muenster and sugar tong splints for distal radius fractures: a comparative study
Authors: Jo Young-Hoon , Lee Myoung Keun , Lee Young Seok , Choi Wan-Sun , Kim Joo-Hak , Kim Jiwhan , Lee Chang-Hun
Published: April 2024

Background

Non-operative management is typically indicated for extra-articular distal radius fractures. Conservative treatments such as Sugar tong splints (STs) and Muenster splints (MUs) are commonly used. However, there is limited research and outcome data comparing the two splint types. Therefore, this study aimed to investigate and compare the radiographic and clinical outcomes of treatment using STs and MUs.

Methods

In this retrospective comparative study, we aimed to evaluate and compare the radiographic and clinical outcomes of STs and MUs for the treatment of distal radius fractures. The study included 64 patients who underwent closed reduction (CR) in the emergency room and were treated with either STs or MUs splints (STs group: n = 38, MUs group: n = 26). Initial X-rays, post-CR X-rays, and last outpatient follow-up X-rays were evaluated. Radial height (RH), ulnar variance (UV), radial inclination (RI), and volar tilt (VT) were measured by a blinded investigator. The Quick DASH form was applied to measure patients’ satisfaction after treatments.

Results

There were no significant differences in baseline characteristics, initial radiographic measurements, or radiographic measurements immediately after CR between the two groups. However, the overall radiological values deteriorated to some degree in both groups compared to the post-CR images. Furthermore, using a paired test, the STs group showed significant differences in RH and RI, and the MUs group showed significant differences in RH and UV between the last follow-up and post-CR images.

Conclusions

The study concluded that there was no difference in clinical outcomes between the two splint types. However, both STs and MUs groups showed reduced radiographic parameters, and the MUs group showed a significant reduction of RH and UV in the treatment of distal radius fractures.

Level of evidence

Level IV; Retrospective Comparison; Treatment Study.
Application of flipped classroom teaching method based on ADDIE concept in clinical teaching for neurology residents
Authors: Zhang Juan , Chen Hong , Wang Xie , Huang Xiaofeng , Xie Daojun
Published: April 2024

Background

As an important medical personnel training system in China, standardized residency training plays an important role in enriching residents’ clinical experience, improving their ability to communicate with patients and their clinical expertise. The difficulty of teaching neurology lies in the fact that there are many types of diseases, complicated conditions, and strong specialisation, which puts higher requirements on residents’ independent learning ability, the cultivation of critical thinking, and the learning effect. Based on the concept of ADDIE (Analysis-Design-Development-Implementation-Evaluation), this study combines the theory and clinical practice of flipped classroom teaching method to evaluate the teaching effect, so as to provide a basis and reference for the implementation of flipped classroom in the future of neurology residency training teaching.

Methods

The participants of the study were 90 neurology residents in standardised training in our hospital in the classes of 2019 and 2020. A total of 90 residents were divided into a control group and an observation group of 45 cases each using the random number table method. The control group used traditional teaching methods, including problem based learning (PBL), case-based learning (CBL), and lecture-based learning (LBL). The observation group adopted the flipped classroom teaching method based on the ADDIE teaching concept. A unified assessment of the learning outcomes of the residents was conducted before they left the department in the fourth week, including the assessment of theoretical and skill knowledge, the assessment of independent learning ability, the assessment of critical thinking ability, and the assessment of clinical practice ability. Finally, the overall quality of teaching was assessed.

Results

The theoretical and clinical skills assessment scores achieved by the observation group were significantly higher than those of the control group, and the results were statistically significant (P < 0.001). The scores of independent learning ability and critical thinking ability of the observation group were better than those of the control group, showing statistically significant differences (P < 0.001). The observation group was better than the control group in all indicators in terms of Mini-Cex score (P < 0.05). In addition, the observation group had better teaching quality compared to the control group (P < 0.001).

Conclusion

Based on the concept of ADDIE combined with flipped classroom teaching method can effectively improve the teaching effect of standardized training of neurology residents, and had a positive effect on the improvement of residents’ autonomous learning ability, critical thinking ability, theoretical knowledge and clinical comprehensive ability.
Cost-effectiveness of intraoperative radiation therapy versus intensity-modulated radiation therapy for the treatment of early breast cancer: a disinvestment analysis
Authors: Muñoz-Montecinos Carlos , González-Browne Catalina , Maza Felipe , Carreño-Leiton Diego , González Pablo , Chahuan Badir , Quirland Camila
Published: April 2024

Background

Adjuvant radiotherapy represents a key component in curative-intent treatment for early-stage breast cancer patients. In recent years, two accelerated partial breast irradiation (APBI) techniques are preferred for this population in our organization: electron-based Intraoperative radiation therapy (IORT) and Linac-based External Beam Radiotherapy, particularly Intensity-modulated radiation therapy (IMRT). Recently published long-term follow-up data evaluating these technologies have motivated a health technology reassessment of IORT compared to IMRT.

Methods

We developed a Markov model to simulate health-state transitions from a cohort of women with early-stage breast cancer, after lumpectomy and adjuvant APBI using either IORT or IMRT techniques. The cost-effectiveness from a private health provider perspective was assessed from a disinvestment point of view, using life-years (LYs) and recurrence-free life-years (RFLYs) as measure of benefits, along with their respective quality adjustments. Expected costs and benefits, and the incremental cost-effectiveness ratio (ICER) were reported. Finally, a sensitivity and scenario analyses were performed to evaluate the cost-effectiveness using lower IORT local recurrence and metastasis rates in IORT patients, and if equipment maintenance costs are removed.

Results

IORT technology was dominated by IMRT in all cases (i.e., fewer benefits with greater costs). Despite small differences were found regarding benefits, especially for LYs, costs were considerably higher for IORT. For sensitivity analyses with lower recurrence and metastasis rates for IORT, and scenario analyses without equipment maintenance costs, IORT was still dominated by IMRT.

Conclusions

For this cohort of patients, IMRT was, at least, non-inferior to IORT in terms of expected benefits, with considerably lower costs. As a result, IORT disinvestment should be considered, favoring the use of IMRT in these patients.
Patterns and determinants of healthcare utilization and medication use before and during the COVID-19 crisis in Afghanistan, Bangladesh, and India
Authors: Islam Md Tauhidul , Bruce Mieghan , Alam Khurshid
Published: April 2024

Background

COVID-19 rapidly spread through South Asian countries and overwhelmed the health systems that were unprepared for such an outbreak. Evidence from high-income countries showed that COVID-19 impacted healthcare utilization, including medication use, but empirical evidence is lacking in South Asia. This study aimed to investigate the effect of COVID-19 on healthcare utilization and medication use in South Asia.

Method

The current study used longitudinal data from the ‘Premise Health Service Disruption Survey’ 2020 and 2021. The countries of interest were limited to Afghanistan, Bangladesh, and India. In these surveys, data related to healthcare utilization and medication use were collected for three-time points; ‘Pre-COVID phase’, ‘Initial phase of COVID-19 outbreak’, and ‘One year of COVID-19 outbreak’. Generalized estimating equation (GEE) along with McNemar’s test, Kruskal–Wallis test and χ2 test were applied in this study following the conceptualization of Andersen’s healthcare utilization model.

Result

The use of healthcare and medication was unevenly impacted by the COVID-19 epidemic in Afghanistan, Bangladesh, and India. Immediately after the COVID-19 outbreak, respondents in Bangladesh reported around four times higher incomplete healthcare utilization compared to pre-COVID phase. In contrast, respondents in Afghanistan reported lower incomplete utilization of healthcare in a similar context. In the post COVID-19 outbreak, non-adherence to medication use was significantly higher in Afghanistan (OR:1.7; 95%CI:1.6,1.9) and India (OR:1.3; 95%CI:1.1,1.7) compared to pre-COVID phase. Respondents of all three countries who sought assistance to manage non-communicable diseases (NCDs) had higher odds (Afghanistan: OR:1.5; 95%CI:1.3,1.8; Bangladesh: OR: 3.7; 95%CI:1.9,7.3; India: OR: 2.3; 95% CI: 1.4,3.6) of non-adherence to medication use after the COVID-19 outbreak compared to pre-COVID phase.

Conclusion

The present study documented important evidence of the influence of COVID-19 epidemic on healthcare utilization and medication use in three countries of South Asia. Lessons learned from this study can feed into policy responses to the crisis and preparedness for future pandemics.
Tobacco smoke condensate-induced senescence in endothelial cells was ameliorated by colchicine treatment via suppression of NF-κB and MAPKs P38 and ERK pathways activation
Authors: Khan Dilaware , Zhou Huakang , You Jinliang , Kaiser Vera Annika , Khajuria Rajiv K , Muhammad Sajjad
Published: April 2024

Smoking is the major cause of cardiovascular diseases and cancer. It induces oxidative stress, leading to DNA damage and cellular senescence. Senescent cells increase the expression and release of pro-inflammatory molecules and matrix metalloproteinase, which are known to play a vital role in the initiation and progression of cardiovascular diseases and metastasis in cancer. The current study investigated the smoking induced cellular senescence and employed colchicine that blocked senescence in endothelial cells exposed to tobacco smoke condensate. Colchicine prevented oxidative stress and DNA damage in tobacco smoke-condensate-treated endothelial cells. Colchicin reduced β-gal activity, improved Lamin B1, and attenuated cell growth arrest markers P21 and P53. Colchicine also ameliorated the expression of SASP factors and inhibited the activation of NF-kB and MAPKs P38 and ERK. In summary, colchicine inhibited tobacco smoke condensate-induced senescence in endothelial cells by blocking the activation of NF-kB and MAPKs P38 and ERK.

Graphical Abstract
CD137+ and regulatory T cells as independent prognostic factors of survival in advanced non-oncogene addicted NSCLC patients treated with immunotherapy as first-line
Authors: Gelibter Alain , Asquino Angela , Strigari Lidia , Zizzari Ilaria Grazia , Tuosto Lucrezia , Scirocchi Fabio , Pace Angelica , Siringo Marco , Tramontano Elisa , Bianchini Serena , Bellati Filippo , Botticelli Andrea , Paoli Donatella , Santini Daniele , Nuti Marianna , Rughetti Aurelia , Napoletano Chiara
Published: April 2024

Background

Immune checkpoint inhibitors (ICIs), administered alone or combined with chemotherapy, are the standard of care in advanced non-oncogene addicted Non-Small Cell Lung Cancer (NSCLC). Despite these treatments' success, most long-term survival benefit is restricted to approximately 20% of patients, highlighting the need to identify novel biomarkers to optimize treatment strategies. In several solid tumors, immune soluble factors, the activatory CD137+ Tcells, and the immunosuppressive cell subsets Tregs and MDSCs (PMN(Lox1+)-MDSC and M-MDSCs) correlated with responses to ICIs and clinical outcomes thus becoming appealing predictive and prognostic factors. This study investigated the role of distinct CD137+ Tcell subsets, Tregs, MDSCs, and immune-soluble factors in NSCLC patients as possible biomarkers.

Methods

The levels of T cells, MDSCs and soluble factors were evaluated in 89 metastatic NSCLC patients who underwent ICIs as first- or second-line treatment. T cell analysis was performed by cytoflurimetry evaluating Tregs and different CD137+ Tcell subsets also combined with CD3+, CD8+, PD1+, and Ki67+ markers. Circulating cytokines and immune checkpoints were also evaluated by Luminex analysis. All these parameters were correlated with several clinical factors (age, sex, smoking status, PS and TPS), response to therapy, PFS , and OS . The analyses were conducted in the overall population and in patients treated with ICIs as first-line (naïve patients).

Results

In both groups of patients, high levels of circulating CD137+ and CD137+PD1+ T cells (total, CD4 and CD8) and the soluble factor LAG3 positively correlated with response to therapy. In naïve patients, PMN(Lox1+)-MDSCs negatively correlated with clinical response, and a high percentage of Tregs was associated with favorable survival. Moreover, the balance between Treg/CD137+ Tcells or PMN(Lox1+)-MDSC/CD137+ Tcells was higher in non-responding patients and was associated with poor survival. CD137+ Tcells and Tregs resulted as two positive independent prognostic factors.

Conclusion

High levels of CD137+, CD137+PD1+ Tcells and sLAG3 could predict the response to ICIs in NSCLC patients independently by previous therapy. Combining the evaluation of CD137+ Tcells and Tregs also as Treg/CD137+ T cells ratio it is possible to identify naive patients with longer survival.
B-1 derived anti-Thy-1 B cells in old aged mice develop lymphoma/leukemia with high expression of CD11b and Hamp2 that different from TCL1 transgenic mice
Authors: Hayakawa Kyoko , Zhou Yan , Shinton Susan A.
Published: April 2024

Human old aged unmutated chronic lymphocytic leukemia U-CLL are the TCL1+ZAP70+CD5+ B cells. Since CD5 makes the BCR signaling tolerance, ZAP70 increased in U-CLL not only TCL1+ alone. In mice, TCL1 (TCL1A) is the negative from neonate to old aged, as TC–. VH8-12/Vk21-5 is the anti-thymocyte/Thy-1 autoreactive ATA B cell. When ATA μκTg generation in mice, ATA B cells are the neonate generated CD5+ B cells in B-1, and in the middle age, CD5+ can be down or continuously CD5+, then, old aged CLL/lymphoma generation with increased CD11b in TC–ZAP70–CD5– or TC–ZAP70+CD5+. In this old aged TC–ATA B microarray analysis showed most similar to human CLL and U-CLL, and TC–ZAP70+CD5+ showed certain higher present as U-CLL. Original neonate ATA B cells showed with several genes down or further increase in old aged tumor, and old aged T-bet+CD11c+, CTNNB1hi, HMGBhi, CXCR4hi, DPP4hi and decreased miR181b. These old aged increased genes and down miR181b are similar to human CLL. Also, in old age ATA B cell tumor, high CD38++CD44++, increased Ki67+ AID+, and decreased CD180– miR15Olow are similar to U-CLL. In this old aged ATA B, increased TLR7,9 and Wnt10b. TC+Tg generated with ATAμκTg mice occurred middle age tumor as TC+ZAP70–CD5+ or TC+ZAP70+CD5+, with high NF-kB1, TLR4,6 and Wnt5b,6 without increased CD11b. Since neonatal state to age with TC+Tg continuously, middle age CLL/lymphoma generation is not similar to old aged generated, however, some increased in TC+ZAP70+ are similar to the old age TC– ATA B tumor. Then, TC– ATA B old age tumor showed some difference to human CLL. ATA B cells showed CD11b+CD22++, CD24 down, and hepcidin Hamp2++ with iron down. This mouse V8-12 similar to human V2-5, and V2-5 showed several cancers with macrophages/neutrophils generated hepcidin+ ironlow or some showed hepcidin– iron+ with tumor, and mouse V8-12 with different Vk19-17 generate MZ B cells strongly increased macrophage++ in old aged and generated intestine/colon tumor. Conclusion, neonate generated TC–ATA B1 cells in old aged tumor generation are CD11b+ in the leukemia CLL together with lymphoma cancer with hepcidin-related Hamp2++ in B-1 cell generation to control iron.
Clinicopathological analysis of 22 Müllerian adenosarcomas and the sequencing of DICER1 mutation
Authors: Yao Xiaohong , Wang Wei , He Ying
Published: April 2024

Background

Müllerian adenosarcoma, a rare malignancy, presents diagnostic and therapeutic challenges. In this study, we conducted an analysis of the clinicopathological characteristics of 22 adenosarcomas, with a particular focus on screening for DICER1 hot mutations.

Methods

The cohort consisted of patients with adenosarcoma who were registered at the West China Second Hospital between the years 2020 and June 2022. Sanger sequencing was employed to screen for somatic Hotspot mutations in the RNase IIIb domain of DICER1 in the 22 adenosarcomas.

Results

Only one patient exhibited a DICER1 mutation that was not a DICER1 Hotspot mutation. Among the 22 patients, all underwent total hysterectomy with bilateral salpingo-oophorectomy, and 14 out of these 22 patients received adjuvant treatment.

Conclusion

In summary, our study of 22 Müllerian adenosarcomas focused on the clinicopathological features and the presence of DICER1 Hotspot mutations. Although our findings did not reveal any DICER1 mutations in the studied samples, this negative result provides valuable information for the field by narrowing down the genetic landscape of adenosarcomas and highlighting the need for further research into alternative molecular pathways driving this malignancy.
Merit of integrating in situ transcriptomics and anatomical information for cell annotation and lineage construction in single-cell analyses of Populus
Authors: Chen Ying-Lan , Hsieh Jo-Wei Allison , Kuo Shang-Che , Kao Chung-Ting , Tung Chia-Chun , Yu Jhong-He , Chang Tien-Hsien , Ku Chuan , Xie Jianbo , Zhang Deqiang , Li Quanzi , Lin Ying-Chung Jimmy
Published: April 2024

Cell type annotation and lineage construction are two of the most critical tasks conducted in the analyses of single-cell RNA sequencing (scRNA-seq). Four recent scRNA-seq studies of differentiating xylem propose four models on differentiating xylem development in Populus. The differences are mostly caused by the use of different strategies for cell type annotation and subsequent lineage interpretation. Here, we emphasize the necessity of using in situ transcriptomes and anatomical information to construct the most plausible xylem development model.
The influence of plant extracts on viability of ST3 and ST7 subtypes of Blastocystis sp.
Authors: Kot Karolina , Michaliszyn Adam , Kalisińska Elżbieta , Lepczyńska Małgorzata
Published: April 2024

Blastocystis sp. is one of the most frequently detected protozoa during stool specimen examination. In the last decade, the studies about the pathogenic potential of Blastocystis sp. have intensified. Additionally, treatment approaches against this parasite are still disputable. The study aimed to investigate the in vitro activity of the substances of natural origin against two subtypes (ST) of Blastocystis sp.—ST3 and ST7. Garlic and turmeric extracts exhibited the highest inhibitory effect in relation to the ST3 viability. While horseradish and turmeric were found to be the most effective extracts to the ST7 viability. The study showed that ginger, garlic, horseradish, and turmeric extracts have potent antimicrobial activity against Blastocystis ST3 and ST7, with the half-maximal inhibitory concentration (IC50) ranging from 3.8 to 4.8 µg/ml and from 3.3 to 72.0 µg/ml, respectively, and thus may be useful in the prevention and control of Blastocystis infections. Additionally, this research confirmed that Blastocystis ST7 is more resistant to the selected plant extracts treatment than Blastocystis ST3 which in consequence may bring some difficulties in its eradication.
The genetic basis of early-onset hereditary ataxia in Iran: results of a national registry of a heterogeneous population
Authors: Mahdieh Nejat , Heidari Morteza , Rezaei Zahra , Tavasoli Ali Reza , Hosseinpour Sareh , Rasulinejad Maryam , Dehnavi Ali Zare , Ghahvechi Akbari Masoud , Badv Reza Shervin , Vafaei Elahe , Mohebbi Ali , Mohammadi Pouria , Hosseiny Seyyed Mohammad Mahdi , Azizimalamiri Reza , Nikkhah Ali , Pourbakhtyaran Elham , Rohani Mohammad , Khanbanha Narges , Nikbakht Sedigheh , Movahedinia Mojtaba , Karimi Parviz , Ghabeli Homa , Hosseini Seyed Ahmad , Rashidi Fatemeh Sadat , Garshasbi Masoud , Kashani Morteza Rezvani , Ghiasvand Noor M. , Zuchner Stephan , Synofzik Matthis , Ashrafi Mahmoud Reza
Published: April 2024

Background

To investigate the genetics of early-onset progressive cerebellar ataxia in Iran, we conducted a study at the Children’s Medical Center (CMC), the primary referral center for pediatric disorders in the country, over a three-year period from 2019 to 2022. In this report, we provide the initial findings from the national registry.

Methods

We selected all early-onset patients with an autosomal recessive mode of inheritance to assess their phenotype, paraclinical tests, and genotypes. The clinical data encompassed clinical features, the Scale for the Assessment and Rating of Ataxia (SARA) scores, Magnetic Resonance Imaging (MRI) results, Electrodiagnostic exams (EDX), and biomarker features. Our genetic investigations included single-gene testing, Whole Exome Sequencing (WES), and Whole Genome Sequencing (WGS).

Results

Our study enrolled 162 patients from various geographic regions of our country. Among our subpopulations, we identified known and novel pathogenic variants in 42 genes in 97 families. The overall genetic diagnostic rate was 59.9%. Notably, we observed PLA2G6, ATM, SACS, and SCA variants in 19, 14, 12, and 10 families, respectively. Remarkably, more than 59% of the cases were attributed to pathogenic variants in these genes.

Conclusions

Iran, being at the crossroad of the Middle East, exhibits a highly diverse genetic etiology for autosomal recessive hereditary ataxia. In light of this heterogeneity, the development of preventive strategies and targeted molecular therapeutics becomes crucial. A national guideline for the diagnosis and management of patients with these conditions could significantly aid in advancing healthcare approaches and improving patient outcomes.
Assessment of the locational potential of floating offshore wind energy in South Africa
Authors: Umoh Kubiat , Hasan Abbas , Kenjegaliev Amangeldi , Al-Qattan Ayman
Published: April 2024

Expanding floating wind into new markets could support emission reduction targets in several national contexts. It furthers the need for adequate assessments to gain a full understanding of the technology’s potential in future markets. South Africa is a prime case study as it has seen limited industry and policy developments despite its huge technical potential for floating offshore wind (FOW). This paper assessed the locational potential of floating wind in South Africa through a three-phased approach that evaluated the key technical drivers/barriers of the technology, conducted a Geographic Information System analysis (GIS) using ArcMap 10.8 to exclude unsuitable sites based on a predetermined exclusion criteria (including marine protected zones, underwater cables, major oil and gas deposits, etc.), and estimated the total harvestable capacity in the feasible sites. The study found that 2% (246,105.4 km2) of South Africa’s entire Exclusive Economic Zone (EEZ) is suitable for hosting floating wind turbines, with a potential to generate a maximum of 142.61 GW of floating wind power. Although the Western Cape province holds the highest potential (80.52 GW) for floating wind in the country, the Eastern Cape region, with a locational potential of 20.04 GW, is considered most suitable for early-stage developments due to the availability of grid connection points, limited marine traffic, and proximity to appropriate port facilities. Future work can conduct techno-economic assessments to evaluate the technical and economic implications of developing floating wind in distinct sites in the country’s EEZ.
Anesthesia experience in an adult Silver-Russell syndrome: a case report
Authors: Hibino Akinobu , Hibino Ayaka , Kamiya Yoshinori
Published: April 2024

Background

There are no reports of anesthesia use in adult patients with Silver-Russell syndrome (SRS). Here, we report our experience with anesthesia in an adult patient with SRS complicated by chronic respiratory failure.

Case presentation

A 33-year-old woman was clinically diagnosed with SRS. She had severe chronic respiratory failure, complicated by superior mesenteric artery syndrome. Percutaneous gastrostomy was scheduled for nutritional management under epidural anesthesia; however, soon after esophagogastroduodenoscopy was started, she lost consciousness and spontaneous respiration. The patient was urgently intubated and converted to general anesthesia. The end-tidal carbon dioxide tension was > 90 mmHg at intubation.

Conclusions

Adult SRS patients with chronic respiratory failure have a risk of CO2 narcosis. SRS also requires preparation for difficult airway management during the perioperative period.