bluuebunny/crossref_metadata_2025 huggingface dataset:
The health-care utilization and economic burden in patients with genetic skeletal disorders
Authors: Liu Luna , Shi Yingzhou , Fan Xiude , Yao Yangyang , Wu Wanhong , Tian Yang , Wu Huixiao , Li Zongyue , Wang Yanzhou , Xu Chao
Published: March 2024

Background

Most genetic skeletal disorders (GSD) were complex, disabling and life-threatening without effective diagnostic and treatment methods. However, its impacts on health system have not been well studied. The study aimed to systematically evaluate the health-care utilization and economic burden in GSD patients.

Methods

The patients were derived from 2018 Nationwide Inpatient Sample and Nationwide Readmissions Database. GSD patients were extracted based on International Classification of Diseases-10th revision codes.

Results

A total of 25,945 (0.12%) records regarding GSD were extracted from all 21,400,282 records in NIS database. GSD patients were likely to have significantly longer length of stay (6.50 ± 0.08 vs. 4.63 ± 0.002, P < 0.001), higher total charges ($85,180.97 ± 1,239.47 vs. $49,884.26 ± 20.99, P < 0.001), suffering more procedure, diagnosis and transferring records in comparison to patients with common conditions. GSD patients had a significantly higher 30-day all-cause readmission rate based on Nationwide Readmissions Database.

Conclusions

The heavy health-care utilization and economic burden emphasized the urgency for policy leaders, scientific and pharmaceutical researchers, health care providers and employers to identify innovative ways and take effective measurements immediately, and eventually to help improve the care, management, and treatment of these devastating diseases.
Surgeons’ knowledge regarding perioperative pain management in patients with opioid use disorder: a survey among 260 members of the American College of Surgeons
Authors: Burgess Jessica R. , Heneghan Kathleen C. , Barot Tarra G. , Stulberg Jonah J.
Published: March 2024

Background

Patients with opioid use disorder (OUD) are increasing, challenging surgeons to adjust post-operative pain management guidelines. A literature review identified limited information on how to best care for these patients. The purpose of this study was to determine surgical perioperative management of OUD, challenges, and support needed for optimal care.

Methods

This study utilized an anonymous voluntary survey that was distributed to members of the American College of Surgeons through the association’s electronic weekly newsletter. The survey was advertised weekly for three consecutive weeks. The survey included questions regarding surgeons’ management of perioperative pain in patients with opioid use disorder and perceived barriers in treatment.

Results

A total of 260 surgeons responded representing all specialties except ophthalmology. General surgery (66.5%) and plastic and reconstructive surgery (7.5%) represented the majority of responders. Ninety-five percent of surgeons reported treating a patient who used opioids in the past month and 86% encountered a patient with OUD. Nearly half (46%) reported being uncomfortable managing postoperative pain in patients with OUD. Most (67%) were not aware of any guidelines or standards pertaining to perioperative management of patients with OUD. While consultation was sought by 86% of surgeons, analyses identified lack of timely response and a lack of care coordination among specialists. Lack of knowledge and fear of harm (contributing further to addiction) were the most common themes.

Conclusion

Nearly half of surgeons report discomfort caring for patients with OUD with the vast majority involving a consulting service to assist with their care. Most surgeons believe that it would be helpful to have guidelines regarding the care of these patients. This provides an opportunity for increased education and training on the perioperative management of patients with OUD and further collaboration with addiction medicine, psychiatry and pain management colleagues.
A risk analysis of alpelisib-induced hyperglycemia in patients with advanced solid tumors and breast cancer
Authors: Rodón Jordi , Demanse David , Rugo Hope S. , Burris Howard A. , Simó Rafael , Farooki Azeez , Wellons Melissa F. , André Fabrice , Hu Huilin , Vuina Dragica , Quadt Cornelia , Juric Dejan
Published: March 2024

Background

Hyperglycemia is an on-target effect of PI3Kα inhibitors. Early identification and intervention of treatment-induced hyperglycemia is important for improving management of patients receiving a PI3Kα inhibitor like alpelisib. Here, we characterize incidence of grade 3/4 alpelisib-related hyperglycemia, along with time to event, management, and outcomes using a machine learning model.

Methods

Data for the risk model were pooled from patients receiving alpelisib ± fulvestrant in the open-label, phase 1 X2101 trial and the randomized, double-blind, phase 3 SOLAR-1 trial. The pooled population (n = 505) included patients with advanced solid tumors (X2101, n = 221) or HR+/HER2− advanced breast cancer (SOLAR-1, n = 284). External validation was performed using BYLieve trial patient data (n = 340). Hyperglycemia incidence and management were analyzed for SOLAR-1.

Results

A random forest model identified 5 baseline characteristics most associated with risk of developing grade 3/4 hyperglycemia (fasting plasma glucose, body mass index, HbA1c, monocytes, age). This model was used to derive a score to classify patients as high or low risk for developing grade 3/4 hyperglycemia. Applying the model to patients treated with alpelisib and fulvestrant in SOLAR-1 showed higher incidence of hyperglycemia (all grade and grade 3/4), increased use of antihyperglycemic medications, and more discontinuations due to hyperglycemia (16.7% vs. 2.6% of discontinuations) in the high- versus low-risk group. Among patients in SOLAR-1 (alpelisib + fulvestrant arm) with PIK3CA mutations, median progression-free survival was similar between the high- and low-risk groups (11.0 vs. 10.9 months). For external validation, the model was applied to the BYLieve trial, for which successful classification into high- and low-risk groups with shorter time to grade 3/4 hyperglycemia in the high-risk group was observed.

Conclusions

A risk model using 5 clinically relevant baseline characteristics was able to identify patients at higher or lower probability for developing alpelisib-induced hyperglycemia. Early identification of patients who may be at higher risk for hyperglycemia may improve management (including monitoring and early intervention) and potentially lead to improved outcomes.

Registration: ClinicalTrials.gov: NCT01219699 (registration date: October 13, 2010; retrospectively registered), ClinicalTrials.gov: NCT02437318 (registration date: May 7, 2015); ClinicalTrials.gov: NCT03056755 (registration date: February 17, 2017).
A proof of concept phase II study with the PDE-4 inhibitor roflumilast in patients with mild cognitive impairment or mild Alzheimer’s disease dementia (ROMEMA): study protocol of a double-blind, randomized, placebo-controlled, between-subjects trial
Authors: Possemis Nina , Verhey Frans , Prickaerts Jos , Blokland Arjan , Ramakers Inez
Published: March 2024

Background

Research into the neurobiological underpinnings of learning and memory has demonstrated the cognitive-enhancing effects associated with diverse classes of phosphodiesterase (PDE) inhibitors. Specific PDE inhibitors have been identified to improve neuronal communication through selective inhibition of PDE activity. Roflumilast, a PDE4 inhibitor, has demonstrated efficacy in enhancing episodic memory in healthy adults and elderly participants with pronounced memory impairment, indicative of amnestic mild cognitive impairment (aMCI). In alignment with these findings, the present protocol aims to provide a proof of concept phase II of the potential of roflumilast to aid patients diagnosed with (a)MCI or mild Alzheimer’s disease (AD) dementia.

Methods

The study will be conducted according to a double-blind, randomized placebo-controlled, between-subjects design. Participants with (a)MCI and mild AD dementia will be recruited through the Memory Clinic at the Maastricht University Medical Centre + (MUMC +) in Maastricht, the Netherlands, alongside outreach through regional hospitals, and social media. The study will have three arms: placebo, 50 μg roflumilast, and 100 μg roflumilast, with a treatment duration of 24 weeks. The primary outcome measure will focus on the assessment of episodic memory, as evaluated through participants’ performance on the 15-word Verbal Learning Task (VLT). Our secondary objectives are multifaceted, including an exploration of various cognitive domains. In addition, insights into the well-being and daily functioning of participants will be investigated through interviews with both the participants and their (informal) caregivers, we are interested in the well-being and daily functioning of the participants.

Discussion

The outcomes of the present study aim to elucidate the significance of the PDE4 inhibition mechanism as a prospective therapeutic target for enhancing cognitive function in individuals with (a)MCI and mild AD dementia. Identifying positive effects within these patient cohorts could extend the relevance of this treatment to encompass a broader spectrum of neurological disorders.

Trial registration

The Medical Ethics Committee of MUMC + granted ethics approval for the 4th version of the protocol on September 10th, 2020. The trial was registered at the European Drug Regulatory Affairs Clinical Trials (EudraCT) registered on the 19th of December 2019 (https://www.clinicaltrialsregister.eu/ctr-search/trial/2019-004959-36/NL) and ClinicalTrial.gov (NCT04658654, https://clinicaltrials.gov/study/NCT04658654?intr=roflumilast&cond=mci&rank=1) on the 8th of December 2020. The Central Committee on Research Involving Human Subjects (CCMO) granted approval on the 30th of September 2020.
Surgical repair of tetralogy of Fallot in a 78-year-old woman: a case report
Authors: Katayama Yuzo , Isobe Sho , Ozawa Tsukasa , Fujii Takeshiro
Published: March 2024

Background

Tetralogy of Fallot is a congenital heart disease mostly diagnosed and treated in early childhood. However, there are some adult cases receiving treatment.

Case presentation

We describe a 78-year-old Japanese woman who presented with severely hypertrophic right ventricle, ventricular septum defect, overriding aorta, and severe infundibular stenosis in the right ventricular outflow tract. As hypoxemia was mild and daily exertion was sufficiently possible, home oxygen therapy was introduced. After 1 month, she was referred because of a positive blood culture. The blood culture test was positive four times, therefore, the antibacterial drug was administered according to active infective endocarditis. SpO2 repeatedly decreased during hospitalization, thus oxygen was needed. As there were infective endocarditis onset and progressive hypoxemia, we planned a surgical correction.

Conclusion

Tetralogy of Fallot was diagnosed and successfully treated with complete surgical correction, and the development of infective endocarditis was the definitive indication for surgery at this late age.
Fixed point theorem and iterated function system in φ-metric modular space
Authors: Acharjee Bikramjit , M Guru Prem Prasad
Published: March 2024

We introduce and study the concept of φ-metric modular space and, then define φ-α-Meir-Keeler contraction on it and explore its fixed point. Further, we define the Hausdorff distance between two non-empty compact subsets of the considered space. Some topological properties of φ-metric modular space are also explored. Additionally, we prove the existence of the attractor (fractal) of the IFS consisting of φ-α-Meir-Keeler contractions.
LRRK2 kinase inhibition reverses G2019S mutation-dependent effects on tau pathology progression
Authors: Lubben Noah , Brynildsen Julia K. , Webb Connor M. , Li Howard L. , Leyns Cheryl E. G. , Changolkar Lakshmi , Zhang Bin , Meymand Emily S. , O’Reilly Mia , Madaj Zach , DeWeerd Daniella , Fell Matthew J. , Lee Virginia M. Y. , Bassett Dani S. , Henderson Michael X.
Published: March 2024

Background

Mutations in leucine-rich repeat kinase 2 (LRRK2) are the most common cause of familial Parkinson’s disease (PD). These mutations elevate the LRRK2 kinase activity, making LRRK2 kinase inhibitors an attractive therapeutic. LRRK2 kinase activity has been consistently linked to specific cell signaling pathways, mostly related to organelle trafficking and homeostasis, but its relationship to PD pathogenesis has been more difficult to define. LRRK2-PD patients consistently present with loss of dopaminergic neurons in the substantia nigra but show variable development of Lewy body or tau tangle pathology. Animal models carrying LRRK2 mutations do not develop robust PD-related phenotypes spontaneously, hampering the assessment of the efficacy of LRRK2 inhibitors against disease processes. We hypothesized that mutations in LRRK2 may not be directly related to a single disease pathway, but instead may elevate the susceptibility to multiple disease processes, depending on the disease trigger. To test this hypothesis, we have previously evaluated progression of α-synuclein and tau pathologies following injection of proteopathic seeds. We demonstrated that transgenic mice overexpressing mutant LRRK2 show alterations in the brain-wide progression of pathology, especially at older ages.

Methods

Here, we assess tau pathology progression in relation to long-term LRRK2 kinase inhibition. Wild-type or LRRK2G2019S knock-in mice were injected with tau fibrils and treated with control diet or diet containing LRRK2 kinase inhibitor MLi-2 targeting the IC50 or IC90 of LRRK2 for 3–6 months. Mice were evaluated for tau pathology by brain-wide quantitative pathology in 844 brain regions and subsequent linear diffusion modeling of progression.

Results

Consistent with our previous work, we found systemic alterations in the progression of tau pathology in LRRK2G2019S mice, which were most pronounced at 6 months. Importantly, LRRK2 kinase inhibition reversed these effects in LRRK2G2019S mice, but had minimal effect in wild-type mice, suggesting that LRRK2 kinase inhibition is likely to reverse specific disease processes in G2019S mutation carriers. Additional work may be necessary to determine the potential effect in non-carriers.

Conclusions

This work supports a protective role of LRRK2 kinase inhibition in G2019S carriers and provides a rational workflow for systematic evaluation of brain-wide phenotypes in therapeutic development.
Beyond STEM attrition: changing career plans within STEM fields in college is associated with lower motivation, certainty, and satisfaction about one’s career
Authors: Rosenzweig Emily Q. , Chen Xiao-Yin , Song Yuchen , Baldwin Amy , Barger Michael M. , Cotterell Michael E. , Dees Jonathan , Injaian Allison S. , Weliweriya Nandana , Walker Jennifer R. , Wiegert Craig C. , Lemons Paula P.
Published: March 2024

Background

Research and policy often focus on reducing attrition from educational trajectories leading to careers in science, technology, engineering, and mathematics (STEM), but many students change career plans within STEM. This study examined how changing career plans within STEM fields was associated with psychological indicators of career readiness. We conducted a large online survey of undergraduate students (N = 1,727) across 42 courses covering every major STEM discipline at a large U.S. research-intensive public university. Students reported about their career plans, whether plans had changed, motivation for those career plans, and satisfaction with and certainty of persisting with those plans. A trained team of coders classified whether students reported having STEM career plans at the time of the survey and at the beginning of college.

Results

Students who said they had changed career plans within STEM fields during college also reported lower motivation for their new career plans, satisfaction with those plans, and certainty of persisting in them, compared to students who retained consistent STEM career plans. With few exceptions, these associations held across students’ gender, race, year in school, and STEM field of study. Within-STEM career plan changes were very common, reported by 55% of fourth-year STEM students. Women reported changing career plans within STEM fields more often than men.

Implications

Results suggest that changing career plans within STEM is an important phenomenon to consider in preparing a qualified and diverse STEM workforce. Students who change career plans within STEM fields may need additional supports for their career motivation and satisfaction compared to students who do not change plans.
Potential use of Ulva intestinalis-derived biochar adsorbing phosphate ions in the cultivation of winter wheat Tristicum aestivum
Authors: Niedzbała Natalia , Lorenc-Grabowska Ewa , Rutkowski Piotr , Chęcmanowski Jacek , Szymczycha-Madeja Anna , Wełna Maja , Michalak Izabela
Published: March 2024

In this work, the properties of biochar produced from green macroalga Ulva intestinalis by pyrolysis were studied at temperatures of 300, 500, and 700 °C. This biochar was characterized in terms of multielemental composition, BET surface area, total pore volume, and biosorption properties toward phosphate ions. Biochar produced at 700 °C–25 m2/g had the highest surface area. The kinetics and isotherms of sorption processes of phosphate ions as sorbate by these sorbents were investigated. Modified biochar was able to remove 84.3% of phosphate ions from wastewater, whereas non-modified biochar—only 40.6%. Hence, biochar enriched with phosphate ions can serve as a valuable soil amendment. Pot experiments performed on winter wheat (Triticum aestivum) with a 3% addition of dry Ulva intestinalis, pristine biochar, and Mg-modified biochar enriched with phosphate ions showed that these amendments stimulated plant growth (length and fresh weight of plants) as well as enlarging the chlorophyll content in leaves. Our results indicate that the production of biochar (pristine and Mg-impregnated) is a sustainable option to valorize the biomass of seaweeds, and to recycle phosphorus from wastewater.

Graphical Abstract
Developing engineering students’ engagement in academic writing classes using corpus-based instruction
Authors: Birhan Amare Tesfie , Nurie Yenus
Published: March 2024

Engagement is a core issue in language teaching and learning. Without the students’ active involvement in the teaching–learning process, educational objectives could not be achieved. Accordingly, the concept of engagement has been the focus of researchers, practitioners, and policymakers. This research examined the effects of corpus-based instruction on engineering students’ engagement in academic writing classes. The participants were 77 randomly selected fourth-year mechanical engineering students. The data were gathered through a self-reflective report and a journal and analyzed through an independent t-test, One-Way ANOVA, and narration techniques. The data showed that students who were instructed via corpus-based instruction improved their behavioral, emotional, and cognitive engagements better than their counterparts; the experimental group enjoyed the activities and actively participated in different academic writing processes. The data also attested that there was a significant statistical difference between the experimental group and the control group engagements. This research implied that EFL teachers should consider genuine and real-life linguistic features and activities when they design academic writing instruction to enhance their engagement during the instruction.
Possible role of cardiovascular stress induced by the volume load as a cause of anemia in hemodialysis patients: a case of a maintenance hemodialysis patient with a literature review
Authors: Daimon Shoichiro
Published: March 2024

Background

Although a deficiency in erythropoietin relative to decreased hemoglobin levels is presumed to be the predominant cause of renal anemia, other factors may also exist that are not fully understood.

Case presentation

A 58-year-old man with pyelonephritis who had been on hemodialysis for 18 years presented a gradually decreasing serum creatinine level, possibly due to voluntary dietary restrictions, accompanied by a gradual increase in the cardiothoracic ratio from 48% to 56%. Concomitantly, his hemoglobin level decreased gradually from 14.5 to 8.7 g/dL by 6 months. Although he had no symptoms of heart failure and his left ventricular ejection fraction was 66.3%, which was almost identical to his condition 2 years prior, a drastic reduction in posthemodialysis body weight from 71.0 to 68.6 kg in 9 days was performed without apparent intrahemodialysis hypotension. His cardiothoracic ratio and serum prehemodialysis N-terminal pro-brain natriuretic peptide level decreased steeply, from 56% to 49% by 2 weeks and from 6139 to 647 pg/mL by 8 weeks, followed by a gradual increase in his hemoglobin level from 8.7 to 15.1 g/dL by 3 months. The patient was administered 50 mg/day sodium ferrous citrate but no erythropoietin-stimulating agents or hypoxia-inducible factor prolyl hydroxylase inhibitors. Although a modest increase in the serum protein level was observed immediately after the rapid reduction in posthemodialysis body weight, the patient’s hemoglobin level increased markedly and gradually, suggesting an improvement in anemia rather than hemoconcentration.

Conclusions

Cardiovascular stress induced by the volume load is one of the causes of anemia in hemodialysis patients.
Preclinical characterisation of gallium-68 labeled ferrichrome siderophore stereoisomers for PET imaging applications
Authors: Krasulova Kristyna , Neuzilova Barbora , Dvorakova Bendova Katerina , Novy Zbynek , Popper Miroslav , Hajduch Marian , Petrik Milos
Published: March 2024

Background

Siderophores are small iron-binding molecules produced by microorganisms to facilitate iron acquisition from the environment. Radiolabelled siderophores offer a promising solution for infection imaging, as they can specifically target the pathophysiological mechanisms of pathogens. Gallium-68 can replace the iron in siderophores, enabling molecular imaging with positron emission tomography (PET). Stereospecific interactions play a crucial role in the recognition of receptors, transporters, and iron utilisation. Furthermore, these interactions have an impact on the host environment, affecting pharmacokinetics and biodistribution. This study examines the influence of siderophore stereoisomerism on imaging properties, with a focus on ferrirubin (FR) and ferrirhodin (FRH), two cis–trans isomeric siderophores of the ferrichrome type.

Results

Tested siderophores were labelled with gallium-68 with high radiochemical purity. The resulting complexes differed in their in vitro characteristics. [68Ga]Ga-FRH showed less hydrophilic properties and higher protein binding values than [68Ga]Ga-FR. The stability studies confirmed the high radiochemical stability of both [68Ga]Ga-siderophores in all examined media. Both siderophores were found to be taken up by S. aureus, K. pneumoniae and P. aeruginosa with similar efficacy. The biodistribution tested in normal mice showed rapid renal clearance with low blood pool retention and fast clearance from examined organs for [68Ga]Ga-FR, whereas [68Ga]Ga-FRH showed moderate retention in blood, resulting in slower pharmacokinetics. PET/CT imaging of mice injected with [68Ga]Ga-FR and [68Ga]Ga-FRH confirmed findings from ex vivo biodistribution studies. In a mouse model of S. aureus myositis, both radiolabeled siderophores showed radiotracer accumulation at the site of infection.

Conclusions

The 68Ga-complexes of stereoisomers ferrirubin and ferrirhodin revealed different pharmacokinetic profiles. In vitro uptake was not affected by isomerism. Both compounds had uptake with the same bacterial culture with similar efficacy. PET/CT imaging showed that the [68Ga]Ga-complexes accumulate at the site of S. aureus infection, highlighting the potential of [68Ga]Ga-FR as a promising tool for infection imaging. In contrast, retention of the radioactivity in the blood was observed for [68Ga]Ga-FRH. In conclusion, the stereoisomerism of potential radiotracers should be considered, as even minor structural differences can influence their pharmacokinetics and, consequently, the results of PET imaging.
Empowering ChatGPT with guidance mechanism in blended learning: effect of self-regulated learning, higher-order thinking skills, and knowledge construction
Authors: Lee Hsin-Yu , Chen Pei-Hua , Wang Wei-Sheng , Huang Yueh-Min , Wu Ting-Ting
Published: March 2024

In the evolving landscape of higher education, challenges such as the COVID-19 pandemic have underscored the necessity for innovative teaching methodologies. These challenges have catalyzed the integration of technology into education, particularly in blended learning environments, to bolster self-regulated learning (SRL) and higher-order thinking skills (HOTS). However, increased autonomy in blended learning can lead to learning disruptions if issues are not promptly addressed. In this context, OpenAI's ChatGPT, known for its extensive knowledge base and immediate feedback capability, emerges as a significant educational resource. Nonetheless, there are concerns that students might become excessively dependent on such tools, potentially hindering their development of HOTS. To address these concerns, this study introduces the Guidance-based ChatGPT-assisted Learning Aid (GCLA). This approach modifies the use of ChatGPT in educational settings by encouraging students to attempt problem-solving independently before seeking ChatGPT assistance. When engaged, the GCLA provides guidance through hints rather than direct answers, fostering an environment conducive to the development of SRL and HOTS. A randomized controlled trial (RCT) was employed to examine the impact of the GCLA compared to traditional ChatGPT use in a foundational chemistry course within a blended learning setting. This study involved 61 undergraduate students from a university in Taiwan. The findings reveal that the GCLA enhances SRL, HOTS, and knowledge construction compared to traditional ChatGPT use. These results directly align with the research objective to improve learning outcomes through providing guidance rather than answers by ChatGPT. In conclusion, the introduction of the GCLA has not only facilitated more effective learning experiences in blended learning environments but also ensured that students engage more actively in their educational journey. The implications of this study highlight the potential of ChatGPT-based tools in enhancing the quality of higher education, particularly in fostering essential skills such as self-regulation and HOTS. Furthermore, this research offers insights regarding the more effective use of ChatGPT in education.
Lyme disease and Whipple’s disease: a comprehensive review for the rheumatologist
Authors: Giardini Henrique Ayres Mayrink , Neves Fabricio Souza , Pereira Ivanio Alves , Cordeiro Rafael Alves
Published: March 2024

Despite their rarity, Lyme disease and Whipple’s disease are of significant importance in rheumatology, as both can manifest as chronic arthritis, presenting challenges in the differential diagnosis of inflammatory arthropathies. In Lyme disease, arthritis typically emerges as a late manifestation, usually occurring six months after the onset of erythema migrans. The predominant presentation involves mono- or oligoarthritis of large joints, with a chronic or remitting-recurrent course. Even with appropriate antimicrobial treatment, arthritis may persist due to inadequate immunological control triggered by the disease. In contrast, Whipple’s disease may present with a migratory and intermittent seronegative poly- or oligoarthritis of large joints, preceding classic gastrointestinal symptoms by several years. Both disorders, particularly Whipple’s disease, can be misdiagnosed as more common autoimmune rheumatic conditions such as rheumatoid arthritis and spondyloarthritis. Epidemiology is crucial in suspecting and diagnosing Lyme disease, as the condition is transmitted by ticks prevalent in specific areas of the United States, Europe, and Asia. On the contrary, the causative agent of Whipple’s disease is widespread in the environment, yet invasive disease is rare and likely dependent on host genetic factors. In addition to erythema migrans in Lyme disease and gastrointestinal manifestations in Whipple’s disease, neurological and cardiac involvement can further complicate the course of both. This article offers a comprehensive review of the epidemiological, pathophysiological, clinical, and therapeutic aspects of both diseases.
Dual-assisted high-precision tracking technique for wideband multiplexed signals in new generation GNSS
Authors: Qi Yunhan , Yao Zheng , Lu Mingquan
Published: March 2024

With the evolution of Global Navigation Satellite System (GNSS), new generation GNSS signals have adopted the dual-frequency multiplexing modulation techniques, which jointly modulate multiple signals located on multiple sub-frequencies into a Wideband Multiplexed Signal (WMS). Although WMSs were proposed initially to reduce the complexity of satellite transmitters and improve the transmission efficiency of signals, their multi-component structures and wide root mean square bandwidths introduced by high-frequency subcarriers also provide the possibility to improve the GNSS ranging precision. Therefore, this paper proposes a Dual-assisted Multi-component Tracking (DMT) technique, which can not only fully use high-frequency subcarriers in WMSs, but also effectively track carrier, subcarrier, and code by jointly utilizing all components in WMS. In this paper, the tracking and ranging performances of DMT are comprehensively analyzed theoretically and by simulation and real experiments. The results show that compared with existing WMS tracking methods, DMT can achieve tracking results with lower tracking jitters and ranging results with higher precision, providing a highly advantageous solution for new generation GNSS signal processing.
Autistic, schizotypal traits, and insight level in patients with obsessive–compulsive disorder
Authors: Farouk M. , Nasr M. , Khalil M. , Dozebik I. , El Makawi S. , Fakher W. , Ayoub D. R.
Published: March 2024

Background

Comorbid personality disorders and obsessive–compulsive disorder (OCD) range between 33 and 87%. Patients having OCD more commonly receive cluster A (the odd and eccentric cluster) compared with other nonpsychotic patients. Poor insight levels within OCD increase disease severity and impair neuropsychological factors, where OCD patients exhibit poorer speech learning and memory.

Objectives

To assess schizotypal, autistic traits, and insight levels in patients with OCD.

Methods

Forty subjects with OCD were recruited from outpatient clinics of Kasr Alainy Psychiatry and Addiction Prevention Hospital and assessed using the Dimensional Yale-Brown Obsessive–Compulsive Scale (DYBOCS), Schizotypal Personality Questionnaire-Brief Revised (SPQ-BR), and Autism Spectrum Quotient (AQ) while insight level was assessed using Brown Assessment of Beliefs Scale (BABS).

Results

Total DY-BOCS score was positively correlated with the AQ score and SPQ score. Global distress and interference subdomains of DY-BOCS were positively correlated with AQ, SPQ score, and Insight level (BABS). Indicating that the worse the insight the higher the distress and interference in daily life. Global distress and interference were also positively correlated to all subscales of SPQ. Aggressive obsessions were correlated with SPQ score, cognitive-perceptual (CP) traits, ideas of reference, and magical thinking. Contamination/cleaning obsessions were positively correlated with the level of insight (BABS). While sexual and religious obsessions were negatively correlated with the level of insight.

Conclusion

Increased severity of OCD is associated with more autistic symptoms, schizotypal symptoms, and poorer insight. No gender differences in OCD patients regarding severity, autistic symptoms, schizotypal symptoms, or insight.
Building a communication and support network among quality improvement teams in nursing homes: a longitudinal study of the SCOPE trial
Authors: Yousefi Nooraie Reza , Qin Qiuyuan , Wagg Adrian , Berta Whitney , Estabrooks Carole
Published: March 2024

Background

We applied a longitudinal network analysis approach to assess the formation of knowledge sharing and collaboration networks among care aide-led quality improvement (QI) teams in Canadian nursing homes participating in the Safer Care for Older Persons (in residential) Environments (SCOPE) trial which aimed to support unregulated front-line staff to lead unit-based quality improvement (QI) teams in nursing homes. We hypothesized that SCOPE's communicative and participatory nature would provide opportunities for peer support, knowledge sharing, and collaboration building among teams.

Methods

Fourteen QI teams in Alberta (AB) and seventeen QI teams in British Columbia (BC) participated in the study. Communications across nursing homes occurred through a series of 4 collaborative Learning Congresses (training sessions) over a 1-year period. The senior leaders of QI teams participated in two online network surveys about the communication/collaboration between teams in their province, 1 month after the first, and 6 months later, after the fourth Learning Congress. We developed communication and collaboration network maps pertaining to three time points: before SCOPE, at 2 months, and at 9 months.

Results

Over time, teams made significantly more new connections and strengthened existing ones, within and across regions. Geographic proximity and co-membership in organizational chains were important predictors of connectivity before and during SCOPE. Teams whose members were well connected at baseline disproportionately improved connectivity over time. On the other hand, teams that did not have prior opportunities to connect appeared to use SCOPE to build new ties.

Conclusions

Our findings suggest the importance of network-altering activities to the formation of collaboration networks among QI teams across nursing homes. Active strategies could be used to better connect less connected teams and facilitate collaboration among geographically proximate teams. These findings may inform the development of interventions to leverage existing networks and provide new networking opportunities to develop and sustain organizational improvements.
Prognostic values and immune infiltration of KLF15, AQP7, AGPAT9 in glioma and glioblastoma
Authors: Olajuyin Ayobami Matthew , Nwachukwu Onyinyechi Sharon , Olajuyin Adefunke K. , Hayatu Raji M. , James Adewale , Adesupo Akinrefon , Adegoke Ayodeji Mathias , Akingbade Adebola Idowu
Published: March 2024

Backgrounds

The overall survival of patients with lower-grade gliomas and glioblastoma varies greatly. No reliable or existing procedures can accurately forecast survival and prognostic biomarkers for early diagnosis in glioma and glioblastoma. However, investigations are progressing in immunotherapy, tumor purity, and tumor microenvironment which may be therapeutic targets for glioma and glioblastoma.

Results

This study indicated the possible prognostic signatures that can be used to identify immune-related prognostic biomarkers in the prediction of the survival of low-grade glioma (LGG) patients which may be a possible therapeutic target. In addition, the Kaplan–Meier plot, ESTIMATE algorithm, and TIMER 2.0 analysis indicated that Krüppel-like factor 15 (KLF15) p = 0.030, Aquaporin 7 (AQP7) p = 0.001, and Human 1-acylglycerol-3-phosphate O-acyltransferase 9 (AGPAT9) p = 0.005 are significantly associated in glioma. Hence, they may be possible prognostic biomarkers in glioma. Meanwhile, in the glioblastoma, only KLF15 has a significant association with glioblastoma (p = 0.025). Stromal and immune scores of gliomas were determined from transcriptomic profiles of LGG cohort from TCGA (The Cancer Genome Atlas) using the ESTIMATE (Estimation of Stromal and Immune cells in Malignant Tumours using Expression data algorithm). The immune infiltration of the KLF15, AQP7, and AGPAT9 for low-grade glioma and glioblastoma was determined using TIMER immune 2.0 which indicates correlation with tumor purity for KLF15, AQP7, and AGPAT9, but only KLF15 and AGPAT9 are significantly associated in both glioma and glioblastoma, respectively.

Conclusions

These results highlight the significance of microenvironment monitoring, analysis of glioma and glioblastoma prognosis, and targeted immunotherapy. To our knowledge, this is the first time to investigate an analysis that revealed that KLF15, AQP7, and AGPAT9 may be important prognostic biomarkers for patients with glioma and KLF15 for patients with glioblastoma. Meanwhile, KLF15 and AGPAT9 are significantly associated in both glioma and glioblastoma, respectively, for tumor purity.
Renal amyloidosis: a hidden complication of celiac disease (a case report)
Authors: Kaouiri Zaineb , Ftaimi Ikram , Benbella Meryem , Bayahia Rabia , Benamar Loubna , Ouzeddoun Naima , Bouattar Tarik
Published: March 2024

We report a case of a 36-year-old female with untreated celiac disease, exhibiting both digestive discomfort and extra-digestive symptoms, including anemia. She subsequently developed a nephrotic syndrome. Biopsy of the accessory salivary gland confirmed amyloid deposits, as indicated by positive Congo red staining. Esophagogastroduodenal fibroscopy revealed characteristic signs of celiac disease and ruled out lymphoma. Further etiological screening identified celiac disease as the only possible cause of the amyloidosis. Complete remission was achieved after 3 months on a gluten-free diet, with later laboratory assessments indicating the absence of nephrotic syndrome and hematological abnormalities.
Profiling triglyceride-glucose index in Filipinos with type 2 diabetes mellitus: a single-center study
Authors: Flake Chastene Christopher , Morales-Valenzuela Madonna , Tiongco Raphael Enrique , Navarro Annalyn
Published: March 2024

Background

In this study, we evaluated the utility of the TyG index among Filipino patients with type 2 diabetes mellitus (T2DM) and explored its association with various laboratory markers.

Methods

An analytical cross-sectional study was conducted by retrospectively obtaining data from the medical records of 109 Filipino T2DM patients from a tertiary level teaching hospital. Data obtained were then statistically analyzed.

Results

Results revealed an overall TyG index of 9.15 ± 0.71 among the participants. A significant dose-response relationship was observed between the TyG index and HbA1c. The AUC result has an acceptable discriminating ability among patients with varying glycemic control. The optimal cut-off value of >8.4 has a sensitivity of 92.5% and a specificity of 47.1% in identifying patients with poor glycemic control.

Conclusion

Overall, our findings show the potential of TyG index in glycemic control assessment among Filipinos with T2DM. However, further analysis must be performed to verify its clinical utility and applicability in different populations.
Methodology for calculating load capacity reduction and slip relationship of clustered group nail connectors
Authors: Wang Shichao , Tang Chenhao , Fu Yanqing , Zhu Jianrui , Di Jianping , Li Guodong
Published: March 2024

Clustered group nail connectors are key connecting components for the full lifecycle construction and safe operation of steel–concrete composite structural bridges. To thoroughly investigate the stress mechanism of clustered group nail connectors in steel–concrete composite structures, this paper conducts a detailed numerical analysis on 100 sets of such connectors. It analyzes the stress mechanism of individual nail connectors and quantitatively calculates the group nail effect under the coupled action of multiple factors (nail spacing between layers, number of nail layers, concrete strength). Based on clarifying the force transmission patterns of nails and concrete in different layers during the loading process, this paper proposes a method for calculating the average bearing capacity reduction coefficient and the load-slip curve of single nails in clustered group nail connectors under the coupled action of multiple factors, which has been validated by experimental data. This research provides a theoretical basis for the design and calculation of group nail connectors in steel–concrete composite structural bridges.
Frontal theta oscillations during emotion regulation in people with borderline personality disorder
Authors: Haaf Moritz , Polomac Nenad , Starcevic Ana , Lack Marvin , Kellner Stefanie , Dohrmann Anna-Lena , Fuger Ulrike , Steinmann Saskia , Rauh Jonas , Nolte Guido , Mulert Christoph , Leicht Gregor
Published: March 2024

Background

Borderline personality disorder (BPD) is a severe psychiatric disorder conceptualised as a disorder of emotion regulation. Emotion regulation has been linked to a frontolimbic network comprising the dorsolateral prefrontal cortex and the amygdala, which apparently synchronises its activity via oscillatory coupling in the theta frequency range.

Aims

To analyse whether there are distinct differences in theta oscillatory coupling in frontal brain regions between individuals with BPD and matched controls during emotion regulation by cognitive reappraisal.

Method

Electroencephalogram (EEG) recordings were performed in 25 women diagnosed with BPD and 25 matched controls during a cognitive reappraisal task in which participants were instructed to downregulate negative emotions evoked by aversive visual stimuli. Between- and within-group time–frequency analyses were conducted to analyse regulation-associated theta activity (3.5–8.5 Hz).

Results

Oscillatory theta activity differed between the participants with BPD and matched controls during cognitive reappraisal. Regulation-associated theta increases were lower in frontal regions in the BPD cohort compared with matched controls. Functional connectivity analysis for regulation-associated changes in the theta frequency band revealed a lower multivariate interaction measure (MIM) increase in frontal brain regions in persons with BPD compared with matched controls.

Conclusions

Our findings support the notion of alterations in a frontal theta network in BPD, which may be underlying core symptoms of the disorder such as deficits in emotion regulation. The results add to the growing body of evidence for altered oscillatory brain dynamics in psychiatric populations, which might be investigated as individualised treatment targets using non-invasive stimulation methods.
A Case of Diffuse Thyroid Lipomatosis With Amyloid Deposits Presenting With Thyrotoxicosis
Authors: Gonzalez-Gil Adrian M , Ruiz-Santillan Marco A , Force Bahar K , Gaba Ruchi
Published: March 2024

Diffuse thyroid lipomatosis (DTL) is a rare entity of unknown etiology that can be associated with amyloidosis and rarely, thyrotoxicosis. Here, we present a case of DTL with amyloid deposits and concurrent thyrotoxicosis. A 64-year-old South-Asian woman with a several-year history of an enlarging goiter, unintentional weight loss, and work-up 10 months prior suggestive of thyroiditis presented with a viral syndrome in setting of several weeks of progressive fatigue. Her examination was notable for resting sinus tachycardia and massive painless goiter. Initial work-up revealed nephrotic range proteinuria with hypoalbuminemia, which progressed to end-stage-renal disease, elevated inflammatory markers, and elevated free thyroxine (FT4) with a suppressed thyrotropin. Hemodialysis was initiated. Further testing revealed a negative antithyroid antibody panel, an enlarged fatty thyroid per thyroid ultrasound and neck computed tomography, and normal 24-hour uptake on radioactive iodine uptake scan. Both renal and thyroid core biopsies showed amyloid deposits, with the latter confirming benign adipose tissue with entrapped thyroid follicles. Given her rising FT4 levels and persistent tachycardia, methimazole and atenolol were initiated. FT4 levels nearly normalized after uptitration of methimazole and dosing after dialysis. Although the etiopathogenesis and natural history of DTL remain unclear, we discuss the possible mechanisms of thyrotoxicosis in our patient.
Delayed Diagnosis of Ectopic Cushing Syndrome
Authors: Matson Brooke C , Evron Joshua M , Johnson Steven M , Zeitler Evan M , Klein Klara R
Published: March 2024

Here, we present the case of a 40-year-old man in whom the diagnosis of ectopic adrenocorticotropin (ACTH) syndrome went unrecognized despite evaluation by multiple providers until it was ultimately suspected by a nephrologist evaluating the patient for edema and weight gain. On urgent referral to endocrinology, screening for hypercortisolism was positive by both low-dose overnight dexamethasone suppression testing and 24-hour urinary free cortisol measurement. Plasma ACTH values confirmed ACTH-dependent Cushing syndrome. High-dose dexamethasone suppression testing was suggestive of ectopic ACTH syndrome. Inferior petrosal sinus sampling demonstrated no central-to-peripheral gradient, and 68Ga-DOTATATE scanning revealed an avid 1.2-cm left lung lesion. The suspected source of ectopic ACTH was resected and confirmed by histopathology, resulting in surgical cure. While many patients with Cushing syndrome have a delayed diagnosis, this case highlights the critical need to increase awareness of the signs and symptoms of hypercortisolism and to improve the understanding of appropriate screening tests among nonendocrine providers.
Polarity establishment in the plant zygote at a glance
Authors: Matsumoto Hikari , Ueda Minako
Published: March 2024

The complex structures of multicellular organisms originate from a unicellular zygote. In most angiosperms, including Arabidopsis thaliana, the zygote is distinctly polar and divides asymmetrically to produce an apical cell, which generates the aboveground part of the plant body, and a basal cell, which generates the root tip and extraembryonic suspensor. Thus, zygote polarity is pivotal for establishing the apical-basal axis running from the shoot apex to the root tip of the plant body. The molecular mechanisms and spatiotemporal dynamics behind zygote polarization remain elusive. However, advances in live-cell imaging of plant zygotes have recently made significant insights possible. In this Cell Science at a Glance article and the accompanying poster, we summarize our understanding of the early steps in apical-basal axis formation in Arabidopsis, with a focus on de novo transcriptional activation after fertilization and the intracellular dynamics leading to the first asymmetric division of the zygote.