bluuebunny/crossref_metadata_2025 huggingface dataset:
Macrophages coordinate immune response to laser-induced injury via extracellular traps
Authors: Conedera Federica M. , Kokona Despina , Zinkernagel Martin S. , Stein Jens V. , Lin Charles P. , Alt Clemens , Enzmann Volker
Published: March 2024

Background

Retinal degeneration results from disruptions in retinal homeostasis due to injury, disease, or aging and triggers peripheral leukocyte infiltration. Effective immune responses rely on coordinated actions of resident microglia and recruited macrophages, critical for tissue remodeling and repair. However, these phagocytes also contribute to chronic inflammation in degenerated retinas, yet the precise coordination of immune response to retinal damage remains elusive. Recent investigations have demonstrated that phagocytic cells can produce extracellular traps (ETs), which are a source of self-antigens that alter the immune response, which can potentially lead to tissue injury.

Methods

Innovations in experimental systems facilitate real-time exploration of immune cell interactions and dynamic responses. We integrated in vivo imaging with ultrastructural analysis, transcriptomics, pharmacological treatments, and knockout mice to elucidate the role of phagocytes and their modulation of the local inflammatory response through extracellular traps (ETs). Deciphering these mechanisms is essential for developing novel and enhanced immunotherapeutic approaches that can redirect a specific maladaptive immune response towards favorable wound healing in the retina.

Results

Our findings underscore the pivotal role of innate immune cells, especially macrophages/monocytes, in regulating retinal repair and inflammation. The absence of neutrophil and macrophage infiltration aids parenchymal integrity restoration, while their depletion, particularly macrophages/monocytes, impedes vascular recovery. We demonstrate that macrophages/monocytes, when recruited in the retina, release chromatin and granular proteins, forming ETs. Furthermore, the pharmacological inhibition of ETosis support retinal and vascular repair, surpassing the effects of blocking innate immune cell recruitment. Simultaneously, the absence of ETosis reshapes the inflammatory response, causing neutrophils, helper, and cytotoxic T-cells to be restricted primarily in the superficial capillary plexus instead of reaching the damaged photoreceptor layer.

Conclusions

Our data offer novel insights into innate immunity's role in responding to retinal damage and potentially help developing innovative immunotherapeutic approaches that can shift the immune response from maladaptive to beneficial for retinal regeneration.
Updated single cell reference atlas for the starlet anemone Nematostella vectensis
Authors: Cole Alison G. , Steger Julia , Hagauer Julia , Denner Andreas , Ferrer Murguia Patricio , Knabl Paul , Narayanaswamy Sanjay , Wick Brittney , Montenegro Juan D. , Technau Ulrich
Published: March 2024

Background

The recent combination of genomics and single cell transcriptomics has allowed to assess a variety of non-conventional model organisms in much more depth. Single cell transcriptomes can uncover hidden cellular complexity and cell lineage relationships within organisms. The recent developmental cell atlases of the sea anemone Nematostella vectensis, a representative of the basally branching Cnidaria, has provided new insights into the development of all cell types (Steger et al Cell Rep 40(12):111370, 2022; Sebé-Pedrós et al. Cell 173(6):1520–1534.e20). However, the mapping of the single cell reads still suffers from relatively poor gene annotations and a draft genome consisting of many scaffolds.

Results

Here we present a new wildtype resource of the developmental single cell atlas, by re-mapping of sequence data first published in Steger et al. (2022) and Cole et al. (Nat Commun 14(1):1747, 2023), to the new chromosome-level genome assembly and corresponding gene models in Zimmermann et al. (Nat Commun 14, 8270 (2023). https://doi.org/10.1038/s41467-023-44080-7). We expand the pre-existing dataset through the incorporation of additional sequence data derived from the capture and sequencing of cell suspensions from four additional samples: 24 h gastrula, 2d planula, an inter-parietal region of the bodywall from a young unsexed animal, and another adult mesentery from a mature male animal.

Conclusion

Our analyses of the full cell-state inventory provide transcriptomic signatures for 127 distinct cell states, of which 47 correspond to neuroglandular subtypes. We also identify two distinct putatively immune-related transcriptomic profiles that segregate between the inner and outer cell layers. Furthermore, the new gene annotation Nv2 has markedly improved the mapping on the single cell transcriptome data and will therefore be of great value for the community and anyone using the dataset.
Local knowledge of homegarden plants in Miao ethnic communities in Laershan region, Xiangxi area, China
Authors: Luo Jin , Li Qiang , He Jianwu , Yan Jin , Zhang Shujie , Chang Xuepei , Wu Tao
Published: March 2024

Background

Homegardens are small-scale land use systems with significant implications for local livelihoods, biodiversity conservation, and sustainable development due to their diverse flora and fauna. Conducting homegarden surveys enables researchers to gain insights into the traditional ecological knowledge of indigenous communities, preserve homegarden biodiversity, and promote sustainable livelihoods. This study has two objectives: first, to collect, record, and organize data on homegarden plants and related traditional knowledge from three communities in the Laershan Plateau, and second, to analyze the species and functional diversity of homegarden plants in the region while exploring the factors that contribute to the heterogeneous distribution of these plants among the communities of three townships.

Methods

This research employed field surveys in the Laershan Miao Autonomous Region in Xiangxi, China, from September 2021 to August 2023. Data were collected through observation and semi-structured interviews. The study utilized descriptive statistics and quantitative analysis, including the Relative Importance Value (RI), Use Value Index (UV), Jaccard Index (JI), and Comprehensive Index of Land Use Degree (La), to examine the diversity of local homegarden plants and related traditional knowledge, as well as community heterogeneity.

Results

The study area exhibited rich biodiversity, with 152 plant species recorded belonging to 62 families and 124 genera. These findings highlight the importance of homegarden plants in maintaining ecological balance and enhancing system resilience against disturbances. Homegarden plants serve multiple functions such as food, ornamental, medicinal, and fodder purposes, with edible and trade plants having the most abundant knowledge. Furthermore, this research revealed that communities with similar forest resource compositions may have similar homegarden plant compositions, demonstrating the connection between cultural exchange among different communities and patterns of plant species distribution.

Conclusions

The Laershan region boasts diverse homegarden plant species crucial for ecological balance and resilience. Their multifunctionality reflects human impact. Plant diversity varies with residents' lifestyles, needs, and cultural exchanges. The close connection between plants and local life is clear. Factors like resource distribution, cultural exchange, and lifestyle influence plant distribution. Further research is needed for conservation and sustainable development. Future research should focus on culturally valuable plant species and traditional knowledge applications.
Glaucocalyxin A delays the progression of OA by inhibiting NF-κB and MAPK signaling pathways
Authors: Hong Xin , Liu Xuqiang , Li Bo , Shi Shoujie , Xiao Kai , Xu Tiantian , Nie Yaoyang , Dai Min , Zhu Meisong
Published: March 2024

Background

Osteoarthritis (OA) is a common degenerative joint condition marked by inflammation and cartilage breakdown. Currently, there is a dearth of treatment medications that can clearly slow the course of OA. Glaucocalyxin A (GLA) is a diterpene chemical identified and extracted from Rabdosia japonica with antithrombotic, anticoagulant, anti-tumor, anti-inflammatory, anti-oxidant, and other pharmacological properties. Previous research has linked inflammation to abnormalities in the homeostasis of the extracellular matrix (ECM). Although GLA has been shown to have anti-inflammatory qualities, its effects on the progression of OA are unknown. As a result, the goal of this study was to see if GLA could slow the course of OA.

Methods

ATDC5 cells were stimulated by IL-1β to create an inflammatory chondrocyte damage model. Quantitative polymerase chain reaction, Western Blot, high-density culture, and immunofluorescence were used to detect the expression levels of associated gene phenotypes. We also created a mouse model of OA induced by destabilization of the medial meniscus (DMM) instability, and GLA was administered intraperitoneally once every two days for eight weeks. Mice knee specimens were stained with hematoxylin–eosin, Safranin O/fast green, and immunohistochemical, and the Osteoarthritis Research Society International grade system and Mankin’s score were used to assess the protective effect of GLA on cartilage.

Results

In vitro and in vivo, we explored the effects and molecular processes of GLA as a therapy for OA. The findings demonstrated that GLA might reduce the expression of associated inflammatory mediators and protect the ECM by inhibiting the NF-κB and MAPK signaling pathways. Animal research revealed that GLA could protect against the DMM-induced OA model mice by stabilizing ECM.

Conclusion

Taken together, our findings show that GLA has a protective impact on cartilage throughout OA progression, implying that GLA could be employed as a possible therapeutic agent for OA, thus giving a new therapeutic method for the treatment of OA.
An association between heart rate variability and pediatric obstructive sleep apnea
Authors: Sonsuwan Nuntigar , Houngsuwannakorn Krittika , Chattipakorn Nipon , Sawanyawisuth Kittisak
Published: March 2024

Background

There are different findings on heart rate variability (HRV) and pediatric obstructive sleep apnea (pOSA) by an overnight HRV or a 1-hr HRV. However, there is limited data of HRV and pOSA diagnosis by using a 24-h HRV test. This study aimed to evaluate if HRV had potential for OSA diagnosis by using a 24-h HRV test.

Methods

This was a prospective study included children age between 5 and 15 years old, presenting with snoring, underwent polysomnography and a 24-h Holter monitoring. Predictors for pOSA diagnosis were analyzed using logistic regression analysis.

Results

During the study period, there were 81 pediatric patients met the study criteria. Of those, 65 patients (80.25%) were diagnosed as OSA. There were three factors were independently associated with OSA: standard deviation of all normal interval (SDNN), high frequency (HF), and low frequency (LF). The adjusted odds ratios of these factors were 0.949 (95% confidence interval 0.913, 0.985), 0.786 (95% confidence interval 0.624, 0.989), and 1.356 (95% confidence interval 1.075, 1.709).

Conclusions

HRV parameters including SDNN, HF, and LF were associated with pOSA diagnosis in children by using the 24-h Holter monitoring.
Factors associated with hospitalization in a pediatric population of rural Tanzania: findings from a retrospective cohort study
Authors: Mancini Vincenzo , Borellini Martina , Belardi Paolo , Colucci Maria Carolina , Kadinde Emanuel Yuda , Mwibuka Christina , Maziku Donald , Parisi Pasquale , Di Napoli Anteo
Published: March 2024

Background

Despite pediatric acute illnesses being leading causes of death and disability among children, acute and critical care services are not universally available in low-middle income countries, such as Tanzania, even if in this country significant progress has been made in child survival, over the last 20 years. In these countries, the hospital emergency departments may represent the only or the main point of access to health-care services. Thus, the hospitalization rates may reflect both the health system organization and the patients’ health status. The purpose of the study is to describe the characteristics of clinical presentations to a pediatric Outpatient Department (OPD) in Tanzania and to identify the predictive factors for hospitalization.

Methods

Retrospective cohort study based on 4,324 accesses in the OPD at Tosamaganga Voluntary Agency Hospital (Tanzania). Data were collected for all 2,810 children (aged 0–13) who accessed the OPD services, within the period 1 January − 30 September 2022. The association between the hospitalization (main outcome) and potential confounding covariates (demographic, socio-contextual and clinical factors) was evaluated using univariate and multivariate logistic regression models.

Results

Five hundred three (11.6%) of OPD accesses were hospitalized and 17 (0.4%) died during hospitalization. A higher (p < 0.001) risk of hospitalization was observed for children without health insurance (OR = 3.26), coming from more distant districts (OR = 2.83), not visited by a pediatric trained staff (OR = 3.58), and who accessed for the following conditions: burn/wound (OR = 70.63), cardiovascular (OR = 27.36), constitutional/malnutrition (OR = 62.71), fever (OR = 9.79), gastrointestinal (OR = 8.01), respiratory (OR = 12.86), ingestion/inhalation (OR = 17.00), injury (OR = 6.84).

Conclusions

The higher risk of hospitalization for children without health insurance, and living far from the district capital underline the necessity to promote the implementation of primary care, particularly in small villages, and the establishment of an efficient emergency call and transport system. The observation of lower hospitalization risk for children attended by a pediatric trained staff confirm the necessity of preventing admissions for conditions that could be managed in other health settings, if timely evaluated.
An epidermal growth factor receptor compound mutation of L858R with S768I in advanced non-small-cell lung cancer: a case report
Authors: Boukansa Sara , Mouhrach Ismail , El Agy Fatima , Bouguenouch Laila , Serraj Mounia , Amara Bouchra , Ouadnouni Yassine , Smahi Mohamed , Alami Badreeddine , Mellas Nawfel , Benbrahim Zineb , El Fatemi Hinde
Published: March 2024

Background

In the current treatment landscape for non-small cell lung cancers, epidermal growth factor receptor-tyrosine kinase inhibitors have emerged as a well-established treatment option for patients with advanced or metastatic disease. This is particularly true for those with commonly occurring epidermal growth factor receptor mutations. However, the therapeutic efficacy of these agents for so-called rare epidermal growth factor receptor mutations, and in particular those characterized by a high degree of complexity, such as double mutations, remains a subject of clinical uncertainty.

Case presentation

In this context, we present the case of a 64-year-old man of Moroccan descent, a lifelong non-smoker, diagnosed with metastatic non-small cell lung cancer characterized by a complex epidermal growth factor receptor mutation encompassing L858R and S768I. The patient subsequently underwent afatinib-based treatment, showing notable clinical results. These included a remarkable overall survival of 51 months, with a median progression-free survival of more than 39 months.

Conclusions

This case report is a compelling testimony to the evolving therapeutic landscape of non-small cell lung cancers, providing valuable insight into the potential therapeutic efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors in the realm of rare and complex epidermal growth factor receptor mutations.
Fast CU size decision and intra-prediction mode decision method for H.266/VVC
Authors: Li Mingying , Wang Zhiying , Zhang Qiuwen
Published: March 2024

H.266/Versatile Video Coding (VVC) is the most recent video coding standard developed by the Joint Video Experts Team (JVET). The quad-tree with nested multi-type tree (QTMT) architecture that improves the compression performance of H.266/VVC is introduced. Moreover, H.266/VVC contains a greater number of intra-prediction modes than H.265/High Efficiency Video Coding (HEVC), totalling 67. However, these lead to extremely the coding computational complexity. To cope with the above issues, a fast intra-coding unit (CU) size decision method and a fast intra-prediction mode decision method are proposed in this paper. Specifically, the trained Support Vector Machine (SVM) classifier models are utilized for determining CU partition mode in a fast CU size decision scheme. Furthermore, the quantity of intra-prediction modes added to the RDO mode set decreases in a fast intra-prediction mode decision scheme based on the improved search step. Simulation results illustrate that the proposed overall algorithm can decrease 55.24% encoding runtime with negligible BDBR.
On a new generalization of a Perov-type F-contraction with application to a semilinear operator system
Authors: Sarwar Muhammad , Shah Syed Khayyam , Abodayeh Kamaleldin , Khan Arshad , Altun Ishak
Published: March 2024

This manuscript aims to present new results about the generalized F-contraction of Hardy–Rogers-type mappings in a complete vector-valued metric space, and to demonstrate the fixed-point theorems for single and pairs of generalized F-contractions of Hardy–Rogers-type mappings. The established results represent a significant development of numerous previously published findings and results in the existing body of literature. Furthermore, to ensure the practicality and effectiveness of our findings across other fields, we provide an application that demonstrates a unique solution for the semilinear operator system within the Banach space.
Childhood obesity and risk of Alzheimer’s disease: a Mendelian randomization study
Authors: Qing Wenxiang , Qian Yujie
Published: March 2024

Background

Midlife obesity is a modifiable risk factor for Alzheimer’s disease. However, the association between childhood obesity and Alzheimer’s disease remains largely unknown. Therefore, we conducted a mendelian randomization analysis (MR) to assess the causal link between childhood obesity and Alzheimer’s disease.

Methods

Using summary statistics from publicly available genome-wide association studies (GWAS) database, we explored the genetic link between childhood obesity and Alzheimer’s disease through a two-sample MR. The primary analysis employed the inverse-variance weighted (IVW) method. To complement our findings, we also employed MR-Egger, weighted median, simple model, and weighted model methods for MR estimates. Furthermore, we conducted Cochrane’s Q-statistic test, Egger intercept test, and a leave-one-out sensitivity test to ensure the robustness and reliability of our results.

Results

The IVW analysis yielded non-significant results, indicating no significant genetic association between childhood obesity and Alzheimer’s disease (OR = 0.958, 95% CI = 0.910–1.008, p = 0.095). Consistent with this, the results from MR-Egger, the weighted median, simple model, and weighted model approaches all supported these findings. Furthermore, we did not detect any signs of heterogeneity or pleiotropy, and our leave-one-out analysis confirmed that no single nucleotide polymorphisms had a substantial impact on the reliability of our results.

Conclusions

The evidence from our MR analyses suggests that there is no causal effect of childhood obesity on the risk of Alzheimer’s disease.
Effects of stress on sleep quality: multiple mediating effects of rumination and social anxiety
Authors: Zhang Jun , Li Xiaowen , Tang Zhenxing , Xiang Shungui , Tang Yin , Hu Wenxin , Tan Chenchen , Wang Xin
Published: March 2024

Background

In contemporary society, with the accelerated pace of work and life, more and more people feel different degrees of stress. Long-term stress may not only lead to insomnia, but also to mental health problems (e.g., anxiety and depression), which has a significant impact on people's quality of life and mental health.

Objective

This study primarily investigates the mechanism through which stress affects sleep quality among college students.

Methods

We conducted research on 1653 Chinese college students using four scales with high reliability and validity: stress, the Pittsburgh Sleep Quality Index, social anxiety, and rumination.

Results

The study found: (1) Stress can significantly and positively predict sleep quality and rumination; (2) Rumination can positively predict social anxiety; (3) Social anxiety can positively predict sleep quality; (4) Stress can affect sleep quality through social anxiety and rumination separately, and stress can also affect sleep quality through the chained mediation of rumination and social anxiety.

Conclusion

This study reveals the relationship and mechanisms between stress and sleep quality. It not only deepens the research on the impact of stress on sleep quality but also provides theoretical support and new methods for mental health professionals to help clients improve their sleep quality. In practice, in addition to using some common psychological intervention methods to help individuals reduce stress, we should pay more attention to how to help clients reduce rumination and social anxiety, This is significant in improving the quality of an individual's sleep.
Fire regimes and management options in mixed grassland-fynbos vegetation, South Africa
Authors: Smit Izak P. J. , Baard Johan A. , van Wilgen Brian W.
Published: March 2024

Background

Fire regimes in South African fynbos shrublands have been quantified in the western (winter rainfall) and central (aseasonal rainfall) parts. They have not been quantified at their eastern extremity (summer rainfall), where fynbos transitions to grassland and is embedded in other fire-resistant vegetation types. We assessed fire regimes at the eastern extremity of the fynbos biome and discussed the ecological and management implications of our findings.

Results

Using remote sensing, we assessed fires over 21 years in a 350,000-ha study area at the eastern edge of the fynbos biome. Only 9% of the study area burned, almost exclusively in mixed grassland-fynbos vegetation. The largest proportion (44% of the total area burnt) burnt in late winter and early spring, but fires occurred throughout the year. Fires only occurred in 39% of the mixed grassland-fynbos vegetation. Of the mixed grassland-fynbos vegetation that did burn, 44%, 11%, 26%, and 19% experienced one, two, three, and four fires, respectively. Areas with multiple fires had return intervals ranging from 3 to 15 years, with 76% of the area with multiple fires burning every 4 to 6 years. Most large fires were preceded by two relatively dry months, when fuels were drier and more flammable.

Conclusions

The mixed grassland-fynbos vegetation at the eastern extremity of the fynbos biome is surrounded by fire-resistant vegetation and exhibits a varied fire regime, with different parts experiencing frequent, infrequent, or no fire over 21 years. Fires were largely aseasonal, occurring throughout the year, although data over more years may reveal that a greater proportion of fires will occur in winter, when grasses are cured and rainfall is low, as well as after relatively long (> 2 months) periods of below-average rainfall. As most fires would burn out safely against fire-resistant vegetation, we conclude that lightning-ignited fires should be allowed to spread unhindered to approximate a natural and heterogeneous fire regime, provided that no neighboring properties or infrastructure are threatened. The response of the biota to fires is not well understood for this transition area, and further research is needed.
A review on marine collagen: sources, extraction methods, colloids properties, and food applications
Authors: Farooq Shahzad , Ahmad Muhammad Ijaz , Zheng Shijie , Ali Usman , Li Yang , Shixiu Cui , Zhang Hui
Published: March 2024

The growing interest in valorizing industrial by-products has led researchers to focus on exploring different sources and optimizing collagen extraction conditions over the past decade. While bovine hide, cattle bones, pork, and pig skins remain the most abundant collagen sources, there is a growing trend in the industrial utilization of collagen from non-mammalian species. This review explores alternative marine collagen sources and summarizes emerging trends in collagen recovery from marine sources, with a particular focus on environmentally friendly methods. Additionally, this review covers the colloidal structure-forming properties of marine collagens, including foam, film, gel, and emulsion formation. It also highlights the potential and important applications of marine collagen in various food products. Based on the currently reported marine sources, collagens extracted from fish, jellyfish, and sea cucumbers were found to have the highest yield and mostly comprised type-I collagen, while crustaceans and mollusks yielded lower percentages of collagen. Traditional extraction techniques isolate collagen based on acetic acid and pepsin treatment, but they come with drawbacks such as being time-consuming, causing sample destruction, and using solvents. Conversely, marine collagen extracted using conventional methods assisted with ultrasonication resulted in higher yields and strengthened the triple-stranded helical structures. Recently, an increasing number of new applications have been found in the food industry for marine collagens, such as biodegradable film-forming materials, colloid stabilizers, foaming agents, and micro-encapsulating agents. Furthermore, collagen is a modern foodstuff and is extensively used in the beverage, dairy, and meat industries to increase the stability, consistency, and elasticity of products.

Graphical abstract
Design optimization for microstrip antennas based on polymethyl methacrylate (PMMA) substrate and carbon nanotube (CNT) conductive material in sub-6 Ghz band
Authors: Ziani Djamila , Belkheir Mohammed , Rouissat Mehdi , Mokaddem Allel
Published: March 2024

Background

The rapid expansion of modern smart applications, demanding faster data transfer and extensive bandwidth, has prompted the development of new-generation networks like 5G and 6G. These networks encompass additional frequency bands such as sub-6 GHz, millimeter waves, and terahertz bands to meet the growing bandwidth requirements. However, despite the substantial bandwidth available in these bands, several challenges must be addressed to overcome unfavorable propagation characteristics. Moreover, numerous applications necessitate wireless devices with antennas that exhibit high flexibility and exceptional radiation responses, particularly when subjected to bending effects. This requirement highlights the importance of polymers-based antennas that can adapt to changing conditions while maintaining optimal performance. The present comprehensive study delves into the performance evaluation of rectangular and circular microstrip antennas utilizing PMMA (polymethyl methacrylate) polymer substrate with varying thicknesses.

Results

Notably, CNTs (Carbon Nanotubes) are employed as an alternative to traditional copper for the conductive part and ground plane. Both PMMA-based antennas, integrated with CNTs, exhibit a compact footprint of 27.8 × 47.8 × 1.5 mm3 for the circular antenna and 22.8 × 39.5 × 1.5 mm3 for the rectangular antenna. Impressively, the realized gain of both antennas surpasses 5 dBi, demonstrating robust performance in both flat and bending scenarios across different substrate thicknesses.

Conclusions

The rectangular antenna achieves a bandwidth of approximately 200 MHz, while the circular microstrip antenna showcase annotable bandwidth of 500 MHz. These exceptional outcomes position the two microstrip antennas as highly suitable for a diverse range of emerging applications within the sub-6 GHz band (the frequency range below 6 GHz in the radio spectrum). Thus, the combination of PMMA substrate, CNTs and the compact form factor of the antennas presents a compelling solution for meeting the demands of modern applications requiring efficient wireless communication with enhanced performance and bandwidth.
The differential impact of distracted auditors in managing portfolio of financially distressed audit clients on audit quality: the role of professional skepticism
Authors: Bedeir Reem Essam
Published: March 2024

This study hypothesizes that distracted auditors affect audit quality. As a result of resources scarcity, auditors pay more attention to financially distressed audit clients rather than non-financially distressed audit clients at the same audit client portfolio which eventually leads to differences in audit quality. In this context, earnings restatement of audit clients is used as a distraction event of auditors. Distracted auditor is measured by the percentage of the audit fees of financially distressed audit clients to total audit fees and audit quality is proxied by total accruals. The data is obtained from firms listed on the US stock market over eleven years between 2010 and 2020. The results indicate that financially distressed audit clients of distracted auditors receive higher audit quality than non-financially distressed audit clients of the same audit client portfolio. Further analysis suggests that this difference in audit quality between financially distressed audit clients and non-financially distressed audit clients decreases with skeptical auditors. This study introduces a new comprehensive approach to measure professional skepticism using KAMs disclosure. The results are robust to different measurements of distracted auditors, audit quality and professional skepticism. Overall, the empirical analyses suggest that distracted auditors have a decreasing differential impact on audit quality by professional skepticism.
Case Report of Ruptured Large Fusiform Distal Anterior Cerebral Artery Aneurysm Treated With A3–A3 In Situ Bypass, Reimplantation, and Trapping With Aneurysmectomy: 2-Dimensional Operative Video
Authors: Gomez-Vega Juan Carlos , Kusdiansah Muhammad , Ota Nakao , Noda Kosumo , Tanikawa Rokuya
Published: March 2024

Large fusiform aneurysms in the distal anterior cerebral territory are infrequent and pose considerable treatment challenges, as they necessitate comprehensive aneurysm resolution without compromising physiological flow dynamics.
1-3
We present the case of a 52-year-old man with a ruptured distal anterior cerebral artery fusiform aneurysm. The patient consented to the procedure; this complex condition was successfully managed through an A3–A3 in situ bypass, branch reconstruction, and trapping accompanied by aneurysmectomy. The multifaceted nature of fusiform lesions precludes the feasibility of endovascular interventions as a sole remedy. In addition, reconstructive and deconstructive approaches exhibit elevated mortality rates in patients experiencing high-grade subarachnoid hemorrhage.
1,4
Given the intricacies intrinsic to this clinical context and the exigent nature of fusiform aneurysms, the surgical therapeutic arsenal embraces a diverse array of surgical methodologies, each offering a bespoke spectrum of techniques meticulously tailored to attain predefined objectives.
3,5-7
These approaches are attuned to promptly abrogate imminent threats, while concurrently mitigating latent complications linked to subarachnoid hemorrhage ensuing from aneurysmal rupture, encompassing the specters of rebleeding, ischemic stroke, and edematous sequelae.
8,9
Crucially, the selection of the most appropriate surgical approach hinges on a comprehensive understanding of available options, patient-specific anatomic considerations, and the preferences of the neurosurgeon. Such a nuanced decision-making process ensures an individualized treatment strategy tailored to optimize patient outcomes.
3,6
Microsurgical Resection of a Medulla Oblongata Cavernoma: 3-Dimensional Operative Video
Authors: Baldoncini Matías , Forlizzi Valeria , Villalonga Juan F. , Castillo Rangel Carlos , Pipolo Derek O. , Campero Alvaro
Published: March 2024

Cavernous malformations occur in approximately 0.5% of the population. When it comes to the medulla oblongata, the incidence rate is around 5%.
1,2
Patients with these conditions face potential risks such as hemorrhaging, substantial mortality, and morbidity. The symptoms experienced by the patient vary depending on the extent of hemorrhaging and the location of the lesion. Surgery stands as the primary and essential form of treatment in these cases.
1-4

The aim of this operative video was to present the removal of a medulla oblongata cavernoma. The patient consented to the procedure and to the publication of her images and surgical video. We describe the case of a 53-year-old woman presenting with headaches and with swallowing difficulties, being tracheostomized on hospital admission. Magnetic resonance imaging showed a lesion located at the medulla oblongata. Owing to the patient's symptoms and cavernoma bleeding, surgical resection was determined.

There were no adverse outcomes after surgery, and the patient evolved favorably. Postoperative imaging displayed complete removal of the cavernoma.

Microsurgical resection of cavernomas in this location with neurophysiological monitoring and selection of the safe entry zone is an effective option.
1-4
Early response and outcomes of bone marrow to chemotherapy in T-Cell Acute Lymphoblastic Leukemia
Authors: AlMoshary May , Mahmoud Altahan Shatha , Fayez Alswayyed Aziza
Published: March 2024

Objectives: To evaluate the outcomes (relapse and mortality rate) and response of the bone marrow in early stages after combination chemotherapy in patients with T-cell Acute Lymphoblastic Leukemia (T-ALL).

Methods: A descriptive cross-sectional study was conducted at King Fahad Medical City, from January 2021 to December 2022, to evaluate bone marrow findings at the time of diagnosis and post-chemotherapy in 26 patients diagnosed with T-ALL. The study included all patients diagnosed with T-ALL of any age group during the study period. The patients’ bone marrows were examined at 0 days of treatment (diagnosis work-up), followed by examination at day 15 post induction therapy, and day 30 after treatment.

Results: In this study, 26 cases of T-lymphoblastic leukemia were analyzed. The mean age at diagnosis was 15.69±14.28 years, and eight cases had central nervous system involvement. The majority of cases (88.5%) were positive for Cytoplasmic-CD3 and CD7. Positive findings by fluorescence in situ hybridization (FISH) were: T cell receptor (TCR) α/δ in 6 (23.1%) of the patients, CDNK2A/CEP9 in five (19.2%), and TRCB in one (3.8%). Examination of the bone marrow on day 15 revealed a decrease in blasts to ≤1% in nine patients, and to ≤1% in 19 patients on day 30 post-therapy. Relapse was recorded in five (19.23%) patients. Three (11.53%) patients did not survive during treatment, of which two were <10 years old. The relapse rate for T-ALL was 19.23%, with an overall survival rate of about 64%. The overall mortality rate was 11.53%.

Conclusion: The relapse rate for T-ALL in our study was approximately 19%, but the mortality rate was 11.5%. A substantial decrease in blast percentages was observed, suggesting a favorable initial reaction of the bone marrow to the combined chemotherapy. This suggests that the use of aggressive and more effective chemotherapy has led to better outcomes.

doi: https://doi.org/10.12669/pjms.40.5.7584

How to cite this: AlMoshary M, Altahan SM, Alswayyed AF. Early response and outcomes of bone marrow to chemotherapy in T-Cell Acute Lymphoblastic Leukemia. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.7584

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Needs analysis for an undergraduate dental curriculum in KPK, Pakistan: Gap identification and general needs assessment
Authors: Mehboob Bushra , Mahboob Usman , Jamil Brekhna , Shaheen Neelofar
Published: March 2024

Objective: Dental institutes continue to face challenges in making the transition from a discipline-based to an integrated curriculum. The need analysis is often the first step in the development and implementation of any curriculum. This study intends to carry out a needs analysis for a contemporary dental curriculum in private and public sector dental colleges of Peshawar, KPK, Pakistan.

Methods: The mixed method study was carried out at public and private dental institutes in Peshawar from April to July 2022. To guarantee triangulation, data were gathered from three sources. The first source was an analysis of the Pakistan Medical and Dental Council’s dental curriculum accreditation standards. The second source was gathering the experts’ perspectives, and the final source was a systematic literature search to explore the necessity for an integrated undergraduate dental curriculum from the experiences and expertise of contemporary curricula.

Results: Thematic analysis identified the need for the dental curriculum to be a five-year BDS program, involvement of students, and inclusion of digital dentistry and environmental sustainability in the dental curriculum. PMDC accreditation standards focus on alignment in mission, vision, curricular outcomes, an integrated curriculum, and a quality assurance system for assessment. Experts identified the need for a patient-centered curriculum focusing on integrated patient care. They also identified that the current educational environment should be improved to sustain a contemporary dental curriculum in Pakistan. For the literature review, nine articles were included in the final review.

Conclusion: The current dental curriculum is not accommodating to the needs of the students in Peshawar. The current dental education environment lacks the infrastructure, logistics, and teacher training to sustain the standards set by PMDC.

doi: https://doi.org/10.12669/pjms.40.5.8364

How to cite this: Mehboob B, Mahboob U, Jamil B, Shaheen N. Needs analysis for an undergraduate dental curriculum in KPK, Pakistan: Gap identification and general needs assessment. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8364

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Analysis of factors affecting the clinical efficacy and quality of life in the treatment of pediatric acute lymphoblastic leukemia
Authors: Liu Dan , Zhang Yi-fei
Published: March 2024

Objective: To analyze the factors affecting the long-term clinical efficacy and quality of life in the treatment of pediatric acute lymphoblastic leukemia (ALL).

Methods: This is a retrospective study. One hundred children with ALL were collected before June, 2018 at The First Affiliated Hospital of Yangtze University and followed up for five years. Not only were their five-years survival rates analyzed, but univariate and multivariate analyses were also performed for factors that might affect their five-year survival rates. The MOS 36-Item Short Form of Health Survey (SF-36) was utilized to investigate the surviving children after five years in order to analyze the factors that may affect the quality of life of the children.

Results: The five-years survival rate of one hundred children with ALL after treatment was 91.00% (91/100). Univariate and multivariate Logistic regression analyses were performed on the factors that may affect the long-term efficacy of pediatric ALL. The results showed that white blood cell count at first diagnosis, prednisone response test, treatment compliance and recurrence were independent risk factors for the long-term efficacy of pediatric ALL(p<0.05). The SF-36 survey of 91 surviving children after five years showed that prednisone response test and treatment compliance were independent risk factors affecting the quality of life of pediatric ALL (p<0.05).

Conclusion: In the initial diagnosis of pediatric ALL, sufficient attention and control should be given to the factors that may affect the long-term clinical efficacy and quality of life, and appropriate treatment plans should be adopted. Meanwhile, the treatment compliance of children should be improved during treatment to improve the survival rate and quality of life of pediatric ALL.

doi: https://doi.org/10.12669/pjms.40.5.8619

How to cite this: Liu D, Zhang Y. Analysis of factors affecting the clinical efficacy and quality of life in the treatment of pediatric acute lymphoblastic leukemia. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8619

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan
Authors: Ahmad Riaz , Jan Abbasi Hussain , Ul Islam Nasir Irfan , Shah Muhammad Fahd
Published: March 2024

Objective: In Pakistan, colon cancer ranks fourth in incidence, exhibiting survival rates of 90% to 14%, contingent on TNM staging and early detection. This research focuses on the demographic involvement and short-term outcomes of elective colon cancer resections at a newly established tertiary care cancer center utilizing laparoscopic procedures.

Method: A retrospective analysis of elective laparoscopic colorectal resections at Shaukat Khanum Memorial Cancer Institute and Research Centre, Peshawar, from April 2021 to February 2022 was conducted. Out of 157 cases, 79 had colon cancer. Criteria included patients >18 years old with positive biopsies; consent non-providers were excluded. Statistical analysis employed descriptive statistics and cross-tabulations using SPSS-22.

Results: The study encompassed biopsy-confirmed colon cancers in patients >18 years. 157 colorectal cases were performed, including 79 colon cancers. The sample comprised 61 males (77.2%) and 18 females (22.7%), mean age 42 years. Most patients (33%) were in the 36-45 age group. Majority were from KPK (69.6%), followed by Afghanistan (24%). Tumors were predominantly in the ascending colon (30.3%). Most were moderately differentiated (70.8%). Mean lymph node yield was 19.0, with 1.2% requiring open laparotomy. Post-discharge, one readmission occurred within 30 days. Mortality within 90 days was 2%, attributed to aspiration pneumonia and chemotherapy-related effects.

Conclusions: Elective laparoscopic colonic surgery exhibits safety and efficacy in treating colon cancer. The study provides evidence of minimal morbidity and mortality, low readmission rates, and absence of anastomotic leaks. Hence, elective laparoscopic colonic surgery should be favored due to fewer post-operative complications and superior short-term outcomes. Larger studies on colon cancer are imperative for enhanced healthcare delivery.

doi: https://doi.org/10.12669/pjms.40.5.8732

How to cite this: Ahmad R, Abbasi HJ, Nasir II, Shah MF. Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan. Pak J Med Sci. 2024;40(5):---------.  doi: https://doi.org/10.12669/pjms.40.5.8732

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
A la Ciénaga Grande de Santa Marta le urge un derecho que mire las relaciones entre la gente y la naturaleza
Authors: Gómez Rey Andrés , Soto Méndez Michelle
Published: March 2024

Pasar de proteger recursos a visibilizar las relaciones que tejen las personas con su entorno. Esa es la propuesta que hacen los investigadores Andrés Gómez Rey, Gloria Amparo Rodríguez y Álvaro José Henao para tratar de disminuir los conflictos y garantizar una vida digna para todos.
Randomized Assortment Optimization
Authors: Wang Zhengchao , Peura Heikki , Wiesemann Wolfram
Published: March 2024

When a firm selects an assortment of products to offer to customers, it uses a choice model to anticipate their probability of purchasing each product. In practice, the estimation of these models is subject to statistical errors, which may lead to significantly suboptimal assortment decisions. In “Randomized Assortment Optimization,” Wang, Peura, and Wiesemann show that the standard approach of deterministically selecting a single assortment to offer is not always optimal in this setting: Instead, the firm can do better by selecting an assortment randomly according to a prudently designed probability distribution. The authors show how an optimal randomization strategy can be determined for common choice models, improving performance in realistic data-driven settings. The results suggest that more general versions of the assortment optimization problem—incorporating business constraints, more flexible choice models and/or more general forms of uncertainty—tend to be more receptive to the benefits of randomization.
Academic Footprint of Journal of Orthopaedic Case Reports in the past 5 years – A Scientometric Analysis
Authors:   [1] Orthopaedic Research Group, Coimbatore, Tamil Nadu, India, [2] Department of Biotechnology, Faculty of Engineering, Karpagam Academy of Higher Education, Coimbatore, Tamil Nadu, India, [3] Department of Orthopaedics, Government Medical College, Karur, Tamil Nadu, India,, Muthu Sathish , Annamalai Saravanan ,   [4] Department of Orthopaedics, Thiruvallur Medical College, Thiruvallur, Tamil Nadu, India.
Published: March 2024

Patient outcomes have been enhanced every day due to significant research, advances in clinical methods, and insights presented in case reports, which numerous contemporary journals now publish.[1] The significance of accessing these case reports in our evolving and dynamic world remains acknowledged.[2] While case reports might sometimes be overshadowed by more comprehensive, evidence-backed publications, their impact has been profound.[3] Sharing such reliable information has catalyzed breakthroughs and the development of treatments for new diseases.[4] This practice of sharing experiential insights has evolved into a respected academic publication mode, efficiently disseminating knowledge to the broader medical community. Journal of Orthopaedic Case Reports (JOCR) is an international, online, scientific, peer-reviewed, monthly journal that started out publishing high-quality articles in 2011.[5] The journal is the official publication of the Indian Orthopaedic Research Group. The journal is indexed in various journal indexing databases including the Directory of Open Access Journals, Index Copernicus, PubMed Central, and so. The articles published are under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License.[6] In this article, the academic impact of the journal in the past 5 years has been analyzed. The scientometric analysis was performed using the metadata of the articles published in the journal and indexed in PubMed Central over the past 5 years (2018-2022). Visualization of the data is made using VOSviewer (version 1.6.19) software.[7]