bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical efficacy of duloxetine in the treatment of axial symptoms after posterior cervical spine surgery: a retrospective study
Authors: Liu Jinkai , Yang Xiaotian , Jing Wanli , Guo Xing , Wang Rui , Zhou Jiaming , Xue Yuan
Published: July 2023

Purpose

To evaluate the efficacy of duloxetine in the treatment of patients with axial symptoms after posterior cervical spine surgery.

Methods

Patients with axial symptoms after posterior cervical spine surgery treated by duloxetine or non-drug therapy from 2018 to 2021 were reviewed. Duloxetine was administered gradually, with oral administration of 30 mg in the first week and oral administration of 60 mg from the second week. Visual analogue scale (VAS), 36-Item Short-Form Health Survey questionnaire (SF-36) and EuroQol-5 Dimensions (EQ-5D) questionnaire were used to evaluate the severity of AS at baseline and 1 week, 2 weeks, 1 month, 3 months and 6 months after medication. The occurrence of adverse reactions was recorded.

Results

A total of 63 eligible patients who received duloxetine therapy (n = 35) or non-drug therapy (n = 28) were included. All patients were followed up for 6 months. Significant improvements were found in VAS score compared with baseline in both groups (1.87 ± 0.81 vs 6.61 ± 1.16, 3.18 ± 0.67 vs 6.31 ± 1.40; P < 0.05 for all). Meanwhile, the VAS score of the duloxetine group was significantly better than that of the non-drug therapy group at 1 week, 2 weeks, 1 month, 3 months and 6 months (P < 0.05). Besides, according to 36-Item Short-Form Health Survey questionnaire (SF-36), the PCS score and MCS score are significantly higher than before the treatment in duloxetine group (PCS 62.82 ± 6.04 vs 44.36 ± 7.25, MCS 65.50 ± 4.53 vs 55.55 ± 6.06; P < 0.05 for all). And when we compared variables between the two groups, the PCS score of the duloxetine group was significantly better than that of the non-drug therapy group (P < 0.05), but there was no significant difference in MCS score between the two groups (P > 0.05). What’s more, EQ-5D score had significant improvements in the duloxetine group compared with the non-drug therapy group at 1 week, 2 weeks, 1 month, 3 months and 6 months (P < 0.05).

Conclusion

Oral duloxetine has a better short-term outcome than conventional non-drug therapy in patients with axial symptoms following posterior decompression surgery in the cervical spine.
Surgical management of descending necrotizing mediastinitis: strategy for thoracic interference
Authors: Nhat Lam Xuan , Vinh Vu Huu , Thi Chau Phu , Van Khoi Nguyen
Published: July 2023

Background

The present descriptive study shares the overall experience of treating all these patients where different surgical process was adopted depending on the treatment required after carefully evaluating the risk factors and comorbidities.

Methods

The present study was conducted at the Department of Thoracic Surgery, Choray Hospital, Vietnam between the period of 2010 to 2020. We have treated 95 patients altogether in this duration.

Results

We were able to save most of the patients by applying thoracotomy and thoracic irrigation for most of the patients based on the observed indications that were identified immediately after the compulsory standard cervicotomy. The indication for thoracic interference was considered when the infection was deeply spread into the mediastinum and cannot get out through cervicotomy, although the most effective method of drainage was applied.

Conclusion

Our statistical investigation of the patient data suggested the possible association and influence of comorbidity such as diabetes. Therefore, we recommend that in specific cases thoracotomy along with thoracic irrigation and repetitive surgical draining could be a better option to reduce the infection and the mortality rate.

Trial registration

Retrospectively registered.
Host obesity alters the ovarian tumor immune microenvironment and impacts response to standard of care chemotherapy
Authors: Liu Yueying , Yang Jing , Hilliard Tyvette S. , Wang Zhikun , Johnson Jeff , Wang Wanrui , Harper Elizabeth I. , Ott Connor , O’Brien Caitlin , Campbell Leigh , Crowley Brian , Grisoli Stephen , Stavrou Nicholas M. , Juncker-Jensen Anna , Stack M. Sharon
Published: July 2023

Background

The majority of women with epithelial ovarian cancer (OvCa) are diagnosed with metastatic disease, resulting in a poor 5-year survival of 31%. Obesity is a recognized non-infectious pandemic that increases OvCa incidence, enhances metastatic success and reduces survival. We have previously demonstrated a link between obesity and OvCa metastatic success in a diet-induced obesity mouse model wherein a significantly enhanced tumor burden was associated with a decreased M1/M2 tumor-associated macrophage ratio (Liu Y et al. Can, Res. 2015; 75:5046–57).

Methods

The objective of this study was to use pre-clinical murine models of diet-induced obesity to evaluate the effect of a high fat diet (HFD) on response to standard of care chemotherapy and to assess obesity-associated changes in the tumor microenvironment. Archived tumor tissues from ovarian cancer patients of defined body mass index (BMI) were also evaluated using multiplexed immunofluorescence analysis of immune markers.

Results

We observed a significantly diminished response to standard of care paclitaxel/carboplatin chemotherapy in HFD mice relative to low fat diet (LFD) controls. A corresponding decrease in the M1/M2 macrophage ratio and enhanced tumor fibrosis were observed both in murine DIO studies and in human tumors from women with BMI > 30.

Conclusions

Our data suggest that the reported negative impact of obesity on OvCa patient survival may be due in part to the effect of the altered M1/M2 tumor-associated macrophage ratio and enhanced fibrosis on chemosensitivity. These data demonstrate a contribution of host obesity to ovarian tumor progression and therapeutic response and support future combination strategies targeting macrophage polarization and/or fibrosis in the obese host.
Effects of a swallowing and oral-care program on resuming oral feeding and reducing pneumonia in patients following endotracheal extubation: a randomized, open-label, controlled trial
Authors: Siao Shu-Fen , Ku Shih-Chi , Tseng Wen-Hsuan , Wei Yu-Chung , Chang Yu-Chun , Hsiao Tzu-Yu , Wang Tyng-Guey , Chen Cheryl Chia-Hui
Published: July 2023

Background

The resumption of oral feeding and free from pneumonia are important therapeutic goals for critically ill patients who have been successfully extubated after prolonged (≥ 48 h) endotracheal intubation. We aimed to examine whether a swallowing and oral-care (SOC) program provided to critically ill patients extubated from prolonged mechanical ventilation improves their oral-feeding resumption and reduces 30-day pneumonia incidence.

Methods

In this randomized, open-label, controlled trial, participants were consecutively enrolled and randomized to receive the SOC program or usual care. The interventions comprised three protocols: oral-motor exercise, sensory stimulation and lubrication, and safe-swallowing education. Beginning on the day following patient extubation, an SOC nurse provided the three-protocol care for seven consecutive days or until death or hospital discharge. With independent outcome assessors, oral-feeding resumption (yes, no) corresponded to level 6 or level 7 on the Functional Oral Intake Scale (censored seven days postextubation) along with radiographically documented pneumonia (yes, no; censored 30 days postextubation), abstracted from participants’ electronic medical records were coded.

Results

We analyzed 145 randomized participants (SOC group = 72, control group = 73). The SOC group received, on average, 6.2 days of intervention (14.8 min daily) with no reported adverse events. By day 7, 37/72 (51.4%) of the SOC participants had resumed oral feeding vs. 24/73 (32.9%) of the control participants. Pneumonia occurred in 11/72 (15.3%) of the SOC participants and in 26/73 (35.6%) of the control participants. Independent of age and intubation longer than 6 days, SOC participants were likelier than their control counterparts to resume oral feeding (adjusted hazard ratio, 2.35; 95% CI 1.38–4.01) and had lower odds of developing pneumonia (adjusted odds ratio, 0.28; 95% CI 0.12–0.65).

Conclusions

The SOC program effectively improved patients’ odds that oral feeding would resume and the 30-day pneumonia incidence would decline. The program might advance dysphagia care provided to critically ill patients extubated from prolonged mechanical ventilation.

Trial registration: NCT03284892, registered on September 15, 2017.
PHF5A regulates the expression of the DOCK5 variant to promote HNSCC progression through p38 MAPK activation
Authors: Liu Chao , Li Guo , Zheng Siyuan , She Li , Lu Shanhong , Wang Yunyun , Huang Donghai , Zhang Xin , Sun Lunquan , Liu Yong , Qiu Yuanzheng
Published: July 2023

Background

Previously, we identified an oncogenic splicing variant of DOCK5 in head and neck squamous cell carcinoma (HNSCC); however, the mechanism for the generation of this specific DOCK5 variant remains unknown. This study aims to explore the potential spliceosome genes involved in the production of the DOCK5 variant and validate its role in regulating the progression of HNSCC.

Methods

The differentially expressed spliceosome genes involved in the DOCK5 variant were analysed in The Cancer Genome Atlas (TCGA), and the correlation between the DOCK5 variant and the potential spliceosome gene PHF5A was verified by qRT-PCR. The expression of PHF5A was detected in HNSCC cells, TCGA data and a separate primary tumour cohort. The functional role of PHF5A was examined using CCK-8, colony formation, cell scratch and Transwell invasion assays in vitro and validated in vivo in xenograft models of HNSCC. Western blot analysis was used to explore the potential mechanism of PHF5A in HNSCC.

Results

PHF5A was one of the top upregulated spliceosome genes in TCGA HNSCC samples with highly expressed DOCK5 variants. Knockdown or overexpression of PHF5A in HNSCC cells correspondingly altered the level of the DOCK5 variant. PHF5A was highly expressed in tumour cells and tissues and correlated with a worse prognosis of HNSCC. Loss- and gain-of-function experiments demonstrated that PHF5A could promote the proliferation, migration and invasion of HNSCC cells in vitro and in vivo. Moreover, PHF5A inhibition reversed the oncogenic effect of the DOCK5 variant in HNSCC. Western blot analysis showed that PHF5A activated the p38 MAPK pathway, and inhibition of p38 MAPK further reversed the effect of PHF5A on the proliferation, migration and invasion of HNSCC cells.

Conclusion

PHF5A regulates the alternative splicing of DOCK5 to promote HNSCC progression through p38 MAPK activation, which provides potential therapeutic implications for HNSCC patients.
Exposure to alcohol advertising and alcohol consumption among children and early teenagers in South Africa
Authors: Osuafor Godswill N. , Okoli Chinwe E. , Chibuzor Gladys
Published: July 2023

Background

There is a paucity of information on alcohol adverts on alcohol consumption among early teenagers. The study aimed to examine the association between exposure to alcohol adverts and alcohol consumption.

Methods

A sample of 3833 early teenagers aged 12–14 years were extracted from the South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey (SABSSM) 2017. Participants answered questions related to their exposure to alcohol adverts across television, Poster/billboard, events, and social media. Alcohol consumption was assessed on ever consumed alcohol and in the previous 12 months. Information on demographic characteristics was collected. Descriptive and inferential statistics were used to process the data.

Result

Exposure to alcohol adverts increases from 5.2% for Events to 77.0% on television. All alcohol media of adverts were associated with alcohol consumption by age. The results mirror studies that demonstrated that exposure to alcohol advertisements was associated with alcohol consumption.

Conclusion

The association between alcohol consumption, exposure to alcohol adverts, and demographic characteristics need the urgent attention of policymakers and interventionists. The focus of action should be on protecting these early teenagers from exposure to media of adverts and risk background factors.
Network traffic classification model based on attention mechanism and spatiotemporal features
Authors: Hu Feifei , Zhang Situo , Lin Xubin , Wu Liu , Liao Niandong , Song Yanqi
Published: July 2023

Traffic classification is widely used in network security and network management. Early studies have mainly focused on mapping network traffic to different unencrypted applications, but little research has been done on network traffic classification of encrypted applications, especially the underlying traffic of encrypted applications. To address the above issues, this paper proposes a network encryption traffic classification model that combines attention mechanisms and spatiotemporal features. The model firstly uses the long short-term memory (LSTM) method to analyze continuous network flows and find the temporal correlation features between these network flows. Secondly, the convolutional neural network (CNN) method is used to extract the high-order spatial features of the network flow, and then, the squeeze and excitation (SE) module is used to weight and redistribute the high-order spatial features to obtain the key spatial features of the network flow. Finally, through the above three stages of training and learning, fast classification of network flows is achieved. The main advantages of this model are as follows: (1) the mapping relationship between network flow and label is automatically constructed by the model without manual intervention and decision by network features, (2) it has strong generalization ability and can quickly adapt to different network traffic datasets, and (3) it can handle encrypted applications and their underlying traffic with high accuracy. The experimental results show that the model can be applied to classify network traffic of encrypted and unencrypted applications at the same time, especially the classification accuracy of the underlying traffic of encrypted applications is improved. In most cases, the accuracy generally exceeds 90%.
Changes in knowledge and awareness for a community-based cancer screening educational program
Authors: Wu Shenghui , Chalela Patricia , Ramirez Amelie G
Published: July 2023

Background

Cervical cancer (CC), colorectal cancer (CRC), and breast cancer (BC) are diseases that can be prevented/detected through early test. Through educational programs, individuals can become better informed about these cancers and understand the importance of screening and early detection. However, many people, especially low-income, low-educated, uninsured minority population groups, do not have their cancer screenings at the recommended intervals and do not receive appropriate and timely follow-up of abnormal screening results or timely treatment after diagnosis. A community-based educational program was developed to improve knowledge and awareness toward the screening of the three cancer types in a South Texas underserved population.

Methods

Residents living in Laredo, Texas were invited to participate in the present educational program. From January 2020 to April 2021, participants were recruited using social media and flyer distributions in the general community. Participants received a free live web cancer education presentation delivered by bilingual community health educators, and online pre- and post-education surveys for CC, CRC, and BC separately. Pre-post changes in knowledge for individual items were compared using McNemar’s chi-squared tests.

Results

Overall, the participants showed increases in CC (n = 237), CRC (n = 59), and BC (n = 56) screening knowledge and awareness after receiving the cancer screening education (Ps < 0.05). After receiving the cancer screening education, 85–97% of participants had an intent to talk to a healthcare provider about CC/CRC/BC screening, 88–97% had an intent to get a CC/CRC/BC screening test in the next 12 months or at the next routine appointment, and 90–97% had an intent to talk about CC/CRC/BC with their family members or friends.

Conclusions

A community-based educational program culturally and linguistically tailored help increase knowledge and awareness about cervical, colorectal, and breast cancer screening, and promote positive changes in population’s knowledge and awareness about the benefits of cancer screening. Future cancer screening educational programs in similar populations are warranted to reduce the risk of cervical, colorectal, and breast cancer.
The influence of heat on phytolith morphology and implications for quantifying archaeological foxtail and common millets
Authors: Wang Xin , Shang Xue
Published: July 2023

Phytoliths are silica bodies formed in living plant tissues, and they can be reliable indicators of their parent plants when they demonstrate characteristic phytolith morphology. As shown by the growing case studies around the globe, phytolith morphology is of significant value for identifying and even quantifying domesticated plants. However, researchers also alert that phytoliths morphology can change, for example, in alkaline solutions or heat, causing the loss of characteristic phytoliths and eventually leading to the over- or under-identification of certain phytoliths. Focusing on the degree to which heat can cause changes to the phytolith morphology of millet, the present study carried out a series of controlled heating experiments on six varieties of modern common millet (Panicum miliaceum) growing in different regions of Northern China. Husked grains were heated following the dry ashing method. Specimens prepared from the dry ashing method were examined under an optical microscope to quantify articulated husk phytoliths, which are characteristic millet phytoliths, and to estimate the surface area of millet grains. We estimated that 30.8% to 59.5% of the common millet phytoliths underwent morphological damage in the heating experiments. Considering our previous heating experiments on foxtail millet, we conclude that compared to foxtail millet phytoliths, common millet phytoliths experience morphological damage more quickly when exposed to heat. This observation may explain (at least partially) the contradictory results between macro- and micro-botanical results. It reminds us that common millet can be underrepresented in the micro-botanical evidence (phytoliths). We conclude the paper by discussing the potential archaeological implications of our heating experiments.
IKT Guiding Principles: demonstration of diffusion and dissemination in partnership
Authors: Shwed Alanna , Hoekstra Femke , Bhati DivyaKanwar , Athanasopoulos Peter , Chernesky John , Martin Ginis Kathleen , McBride Christopher B. , Mortenson W. Ben , Sibley Kathryn M. , Sweet Shane N. ,   SCI Guiding Principles Panel, Gainforth Heather L.
Published: July 2023

Introduction

Integrated knowledge translation (IKT) is a partnered approach to research that aims to ensure research findings are applied in practice and policy. IKT can be used during diffusion and dissemination of research findings. However, there is a lack of understanding how an IKT approach can support the diffusion and dissemination of research findings. In this study, we documented and described the processes and outcomes of an IKT approach to diffusing and disseminating the findings of consensus recommendations for conducting spinal cord injury research.

Methods

Communication of the IKT Guiding Principles in two phases: a diffusion phase during the first 102 days from the manuscript’s publication, followed by a 1147 day active dissemination phase. A record of all inputs was kept and all activities were tracked by monitoring partnership communication, a partnership tracking survey, a project curriculum vitae, and team emails. Awareness outcomes were tracked through Google Analytics and a citation-forward search. Awareness includes the website accesses, the number of downloads, and the number of citations in the 29 month period following publication.

Results

In the diffusion period, the recommendations were viewed 60 times from 4 different countries, and 4 new downloads. In the dissemination period, the recommendations were viewed 1109 times from 39 different countries, 386 new downloads, and 54 citations. Overall, during dissemination there was a 17.5% increase in new visitors to the website a month and a 95.5% increase in downloads compared to diffusion.

Conclusion

This project provides an overview of an IKT approach to diffusion and dissemination. Overall, IKT may be helpful for increasing awareness of research findings faster; however, more research is needed to understand best practices and the the impact of an IKT approach on the diffusion and dissemination versus a non-partnered approach.
High frequency alternating current neurostimulation decreases nocifensive behavior in a disc herniation model of lumbar radiculopathy
Authors: Dewberry Lauren Savannah , Porche Ken , Koenig Travis , Allen Kyle D. , Otto Kevin J.
Published: July 2023

Background

The purpose of this study was to evaluate if kilohertz frequency alternating current (KHFAC) stimulation of peripheral nerve could serve as a treatment for lumbar radiculopathy. Prior work shows that KHFAC stimulation can treat sciatica resulting from chronic sciatic nerve constriction. Here, we evaluate if KHFAC stimulation is also beneficial in a more physiologic model of low back pain which mimics nucleus pulposus (NP) impingement of a lumbar dorsal root ganglion (DRG).

Methods

To mimic a lumbar radiculopathy, autologous tail NP was harvested and placed upon the right L5 nerve root and DRG. During the same surgery, a cuff electrode was implanted around the sciatic nerve with wires routed to a headcap for delivery of KHFAC stimulation. Male Lewis rats (3 mo., n = 18) were separated into 3 groups: NP injury + KHFAC stimulation (n = 7), NP injury + sham cuff (n = 6), and sham injury + sham cuff (n = 5). Prior to surgery and for 2 weeks following surgery, animal tactile sensitivity, gait, and static weight bearing were evaluated.

Results

KHFAC stimulation of the sciatic nerve decreased behavioral evidence of pain and disability. Without KHFAC stimulation, injured animals had heightened tactile sensitivity compared to baseline (p < 0.05), with tactile allodynia reversed during KHFAC stimulation (p < 0.01). Midfoot flexion during locomotion was decreased after injury but improved with KHFAC stimulation (p < 0.05). Animals also placed more weight on their injured limb when KHFAC stimulation was applied (p < 0.05). Electrophysiology measurements at end point showed decreased, but not blocked, compound nerve action potentials with KHFAC stimulation (p < 0.05).

Conclusions

KHFAC stimulation decreases hypersensitivity but does not cause additional gait compensations. This supports the idea that KHFAC stimulation applied to a peripheral nerve may be able to treat chronic pain resulting from sciatic nerve root inflammation.
Conflicting forces in the implementation of medicinal cannabis regulation in Uruguay
Authors: Alvarez Eliana , Queirolo Rosario , Sotto Belen
Published: July 2023

Background

Uruguay is widely known as a pioneer country regarding cannabis regulation policies, as it was the first state to regulate the cannabis market for both recreational and medicinal purposes in 2013. However, not all aspects of the regulation have moved forward at the same speed. Medicinal uses keep facing several challenges that undermine patients’ effective access to treatments and products. What are those persistent challenges for the medicinal cannabis policy in Uruguay? This paper aims to describe and understand the current state of medicinal cannabis in the country and identify the most critical challenges and conflicting forces for its proper implementation.

Methods

To do so, we conduct twelve in-depth interviews with key informants, including governments officials, activists, entrepreneurs, researchers, and doctors. These interviews are complemented with information from the congressional committees’ public records and other documentary sources.

Results

This research shows that the legal framework was thought to assure quality products over access. The main challenges of medicinal cannabis in Uruguay are related to three issues: (i) the timid development of the industry, (ii) a limited and expensive supply, and (iii) the emergence of an informal productive sector.

Conclusions

The political decisions regarding medicinal cannabis made in the last seven years have derived from a halfway policy that fails to guarantee patient access or promote the growth of a vibrant national industry. Positively, the several actors involved are aware of the extent of these challenges and new decisions have been made to overcome them, meaning that monitoring the future of the policy is very much needed.
Cannabis sativa demonstrates anti-hepatocellular carcinoma potentials in animal model: in silico and in vivo studies of the involvement of Akt
Authors: Akinloye Dorcas I. , Metibemu Damilohun S. , Shittu Mujidat T. , Lawal Mariam A. , Olatunji Faith O. , Oyediran Muideen A. , Akinloye Oluseyi A.
Published: July 2023

Background

Targeting protein kinase B (Akt) and its downstream signaling proteins are promising options in designing novel and potent drug candidates against hepatocellular carcinoma (HCC). The present study explores the anti-HCC potentials of Cannabis sativa (C. sativa) extract via the involvement of Akt using both in silico and in vivo animal models of HCC approaches.

Methods

Phytoconstituents of C. sativa extract obtained from Gas Chromatography Mass-spectrometry (GCSM) were docked into the catalytic domain of Akt-2. The Diethylnitrosamine (DEN) model of HCC was treated with C. sativa extract. The effects of C. sativa extract treatments on DEN model of hepatocellular carcinoma were assessed by One-way analysis of variance (ANOVA) of the treated and untreated groups

Result

The lead phytoconstituents of C. sativa extract, Δ-9-tetrahydrocannabinol (Δ-9-THC) and cannabidiol form stable hydrophobic and hydrogen bond interactions within the catalytic domain of Akt-2. C. sativa extract (15 mg/kg and 30 mg/kg) respectively gives a 3-fold decrease in the activities of liver function enzymes when compared with the positive control (group 2). It also gives a 1.5-fold decrease in hepatic lipid peroxidation and elevates serum antioxidant enzymes’ activities by 1-fold in HCC treated Wistar rats when compared with the positive control (group 2). In an animal model of hepatocellular carcinoma, C. sativa extract significantly downregulated Akt and HIF mRNAs in groups 3, 4, and 5 with 2, 1.5, 2.5-fold decrease relative to group 2. VEGF mRNA was downregulated by 1.5-fold decrease in groups 3-5 when compared to group 2. The expression of XIAP mRNA was downregulated by 1.5, 2, and 1.25-folds in groups 3, 4, and 5 respectively, in comparison with group 2. In comparison to group 2, COX-2 mRNA levels were downregulated by 1.5, 1, and 1-folds in groups 3–5. In groups 3–5, CRP mRNA was downregulated by 2-fold in comparison with group 2. In groups 3–5, p21 mRNA was upregulated by 2, 2.5, and 3-folds, respectively when compared with group 2. It upregulated p53 mRNA by 2.5, 3.5, and 2.5-folds in groups 3–5 in comparison with group 2. It downregulated AFP mRNA by 3.5, 2.5, .2.5-folds in groups 3, 4, and 5 respectively when compared with group 2. Histologic analysis showed that C. sativa extract reduced necrosis and inflammation in HCC.

Conclusion

C. sativa demonstrates anti-hepatocellular carcinoma potentials in an animal model of HCC and with the involvement of Akt. Its anticancer potential is mediated through antiangiogenic, proapoptotic, cycle arrest, and anti-inflammatory mechanisms.

In future studies, the mechanisms of anti-HCC effects of Δ-9-tetrahydrocannabinol (Δ-9- THC) and cannabidiol via the PI3K-Akt signaling pathways should be explored.
Characterization of blaTEM and blaCTX-M beta-lactam resistance genes in chronic rhinosinusitis
Authors: Arian Nejad Mojdeh , Sabaei Milad , Ahmadi Alireza , Minaeian Sara , Amin Panah Danesh , Mozahheb Yousefi Kimia
Published: July 2023

Background

Chronic sinusitis is one of the most challenging health problems of contemporary society. Although several treatment methods have been defined, a comprehensive understanding of the underlying causes (e.g., antibiotic resistance) is still elusive. The aim of this study was to characterize two of the main extended-spectrum beta-lactamase genes—i.e., blaTEM and blaCTX-M genes—and investigate antimicrobial resistance in bacteria isolated from chronic sinusitis. Samples from 70 chronic sinusitis patients and 20 healthy individuals (controls) were analyzed for the presence of blaTEM and blaCTX-M resistance genes using the polymerase chain reaction (PCR) test, followed by gene sequence analysis.

Results

Phenotypic and genotypic beta-lactam resistance was observed in 58.7% and 61.54% of the gram-negative isolates, respectively, with 38.46% carrying the blaTEM gene and 34.62% harboring the blaCTX-M gene. Sequencing data indicated high heterogeneity in blaCTX-M genes (69–100% similarity to reported sequences) and lower heterogeneity in blaTEM genes (93–99%).

Conclusion

Broad-spectrum beta-lactam resistance is a major pathogenesis factor in chronic rhinosinusitis, and careful consideration is required for antimicrobial therapy. High blaCTX-M heterogeneity could mean high horizontal transfer rate of this gene and warrant a surveillance program.
Effect of ovulation on postural sway in association with sex hormone variation across the menstrual cycle in college students: an observational study
Authors: Aziz Hager M. Abdel , Aziz Khadyga S. Abdel , Wahab Abd El Rahman H. Abd El , El-Shafei Manal A.
Published: July 2023

Background

Poor balance associated with increased postural sway is a risk factor for the high incidence of injuries found during specific menstrual cycle phases. This fact led to the hypothesis that female reproductive hormones affect soft tissue and neuromuscular function, reducing postural balance and resulting in a high injury prevalence among female college students. So, the current study aimed to identify the influence of ovulation in association with sex hormone variation across the menstrual cycle on postural sway in college students.

Material and methods

Forty female college students were enrolled in this study. They were recruited among physical therapy students at Deraya University, New Minya, Egypt. They were aged from 17 to 22 years. They were allocated to a single group. Progesterone and estradiol blood levels were measured to detect the timing of the follicular and luteal phases, and a urine luteinizing hormone (LH) strip test was used to determine when ovulation occurred. The dynamic postural sway index was assessed by using the Biodex Balance system. All measurements were taken on the early follicular (1st–3rd) day, the ovulatory (11th–13th) day, and the mid-luteal phase (21st–23rd) day from the onset of menstruation.

Results

Statistical analysis showed that the anteroposterior, mediolateral, and overall sway index increased significantly during the ovulatory phase compared to the earlier follicular and mid-luteal menstrual cycle phases in female college students (P < 0.05). There was no significant variance between the early follicular and mid-luteal phases (P > 0.05).

Conclusions

It can be concluded that increased female sex hormones during ovulation affect postural sway, which may disturb balance and increase the risk of injuries in college students.
End-user acceptability of a prototype digital stethoscope to diagnose childhood pneumonia- a qualitative exploration from Sylhet, Bangladesh
Authors: Joarder Taufique , Tune Samiun Nazrin Bente Kamal , Islam ASMD Ashraful , Islam Arifa , Roy Arunangshu Dutta , McCollum Eric D. , Nair Harish , Cunningham Steven , McLane Ian Mitra , Shahidullah Mohammod , Baqui Abdullah H. , Ahmed Salahuddin
Published: July 2023

Background

Considering the high frequency of respiratory infections among children in low- and middle-income countries (LMICs), the World Health Organization (WHO) developed a pragmatic guideline for managing pneumonia in low-resource settings. The guideline’s low specificity leads to many false-positive pneumonia cases receiving antibiotic treatment. Integrating diagnostic technology to incorporate lung sounds into WHO guidelines could improve childhood pneumonia diagnosis and management. This qualitative study aimed to explore the acceptability of a prototype digital stethoscope device among potential end-users in Bangladesh.

Methods

We conducted four focus group discussions (FGDs) with beneficiaries and service providers who used a 2018 digital stethoscope prototype. The data collection was conducted in November 2020. The study was carried out at Zakiganj Upazila (sub-district) of Sylhet district of Bangladesh. A total of 34 respondents, including parents of under-5 children, Community Health Care Providers (CHCPs), and community leaders were enrolled. Two researchers (TJ and a research assistant (not a co-author of this manuscript) conducted the FGDs. Verbatim transcripts were prepared, and translations were completed. Coding was executed in Microsoft Excel, and relevant quotes were extracted to ascertain the emerging themes. To ensure validity, two researchers coded the dataset independently and inconsistencies were resolved through discussion.

Findings

Mothers were more aware of the digital stethoscope than fathers. Except for the female community leaders, male leaders were unaware of the stethoscopes. Most CHCPs had positive perceptions of the digital stethoscope. They appreciated stethoscope training as they learned about new technology and diagnostic approaches. The users mentioned several technical shortcomings of the prototype device. A few stakeholders expressed dissatisfaction with the level of community involvement and information sharing from the study. The use of the device plummeted during the COVID-19 pandemic for fear of infection, to counteract which the CHCPs cleaned the device with chlorhexidine after every application as a precaution.

Conclusion

Overall, device use was supported by stakeholders despite perceptions that the prototype had some technological limitations, community engagement was suboptimal, and the COVID-19 pandemic caused disruptions. Stronger community engagement, addressing technological issues, and further research on its health systems application would improve the acceptability and effective use of the digital stethoscope.
Imaging and Characterization of Cement Annulus and Bonding Interfaces in Cased-wells with Fully Connected Neural Network
Authors: Zhang Siqi , Zeng Zhoumo , Wang Xiaocen , Chen Shili , Liu Yang
Published: July 2023

Well integrity evaluation is of great significance to the production life and productivity of oil and gas wells, as well as the protection of reservoir layers. However, traditional sonic logging technology has been unable to meet the current requirement for evaluating unconventional oil and gas resources. For instance, it falls short when it comes to detecting cementing quality between the cement and formation, as well as achieving a quantitative assessment of annulus. In addition, factors such as mud invasion and wellbore damage have the potential to compromise the integrity of the cement sheath and lead to radial alteration in the medium in the wellbore, which can affect cementing quality. To address these issues, a novel approach based on deep learning is proposed to reconstruct slowness models from wellbore data using a fully connected neural network (FCNN) to evaluate the cementing quality. This interpretation workflow requires forward modeling with the three-dimensional dyadic Green’s function to explore borehole acoustic signals and thus generate training and test datasets. Afterward, the spatial feature maps are learned to reconstruct the slowness models by utilizing all the wellbore data. Additionally, the Real-ESRGAN method is applied to borehole imaging to further improve the above inversion. The inversion results regarding the slowness value, wellbore structure, and interface are more consistent with the true model. Finally, the image pixels are optimized using the thresholding method, resulting in an image of superior quality in terms of sharpness and detail compared to previous results. This research reveals that the FCNN-based method can effectively invert the radial profile of slowness around the wellbore from monopole sonic logging data, and the Real-ESRGAN method can further enhance the imaging results to better approximate the true models. This method has also been applied to realistic borehole scenario models, demonstrating its feasibility.
Automated Classification of Breast Cancer Across the Spectrum of ERBB2 Expression Focusing on Heterogeneous Tumors With Low Human Epidermal Growth Factor Receptor 2 Expression
Authors: Guvakova Marina A.
Published: July 2023

PURPOSE

Although pharmaceutical companies conduct clinical trials of novel human epidermal growth factor receptor 2 (HER2)-low–directed drugs, diagnosing HER2-low cancer by immunohistochemistry (IHC) and in situ hybridization (ISH) remains challenging. This study investigates the performance of first-in-kind computerized intelligence to classify samples across gene expression levels and differentiate HER2-low tumors.

MATERIALS AND METHODS

We classified 251 samples: 142 primary invasive breast cancers (IBCs), 75 ductal carcinomas in situ (DCIS), and 34 mammaplasties (reference) using mRNA expression data from the QuantiGene Plex 2.0 assay. We used g3mclass probabilistic software to assess the number of classes in the assay data, the mean and the variance in each class, diagnostic cutoffs, and the prevalence of each class in the study population.

RESULTS

HER2-low (IHC score of 1+ or 2+/ISH–) accounted for 31% of IBC. First, we discovered that HER2-low tumors were represented by cases with normal ERBB2 transcript levels that were expected to produce physiologic levels of HER2 (70%) and cases with abnormally upregulated unamplified ERBB2 (30%). We termed the latter cancers ERBB2-up as they do not meet the standard definitions for ERBB2 overexpression and amplification. Second, HER2-low IBC classified as ERBB2-up had not only abnormally increased luminal growth and adhesion markers ( ERBB2, ESR1, PGR, IGF1R, VAV2, VAV3, KRT8, CDH1) but also downregulated myoepithelial marker ( KRT5). The vascularization ( RAP1 and C3G), immune cell infiltration ( VAV1), and mesenchymal transition ( CDH2) markers were dysregulated. Finally, in the independent cohort of DCIS, 40% of HER2-low DCIS shared similar traits with HER2-low IBC except for rare downregulation of KRT5 and no change in C3G, VAV1, and CDH2.

CONCLUSION

We demonstrated how innovative bioinformatic tools could help diagnose cancer across the spectrum of ERBB2 expression to aid decision making for HER2-low.
An Other
Authors: Holland Sharon Patricia
Published: July 2023

In an other, Sharon Patricia Holland offers a new theorization of the human animal/divide by shifting focus from distinction toward relation in ways that acknowledge that humans are also animals. Holland centers ethical commitments over ontological concerns to spotlight those moments when Black people ethically relate with animals. Drawing on writers and thinkers ranging from Hortense Spillers, Sara Ahmed, Toni Morrison, and C. E. Morgan to Jane Bennett, Jacques Derrida, and Donna Haraway, Holland decenters the human in Black feminist thought to interrogate blackness, insurgence, flesh, and femaleness. She examines MOVE's incarnation as an animal liberation group; uses sovereignty in Morrison's A Mercy to understand blackness, indigeneity, and the animal; analyzes Charles Burnett's films as commentaries on the place of animals in Black life; and shows how equestrian novels address Black and animal life in ways that rehearse the practices of the slavocracy. By focusing on doing rather than being, Holland demonstrates that Black life is not solely likened to animal life; it is relational and world-forming with animal lives.
Indifference
Authors: Davé Naisargi N.
Published: July 2023

In Indifference, Naisargi N. Davé examines the complex worlds of animalists and animalism in India. Through ethnographic fieldwork with animal healers, animal activists, farmers, laborers, transporters, and animals themselves, and moving across animal shelters and dairy farms to city streets and abattoirs, Davé shows how human-animal relations often manifest through care and violence. More surprisingly, what Davé also finds animating interspecies relationality in India is an ethic of indifference---that is, an orientation of mutual regard rather than curiosity, love, desire, or animus. For Davé, indifference is a respect for others in their otherness that allows human and nonhuman animals to flourish in immanent encounters. Indifference, then, becomes the basis for an interspecies ethics and a method of care and practice in everyday life. With indifference, Davé describes both a mode of relationality in the world and a scholarly approach: seeking what is possible when we approach ethico-political concepts with indifference rather than commitment or antagonism. Moments of indifference, Davé contends, offer the promise of otherwise worlds.
Comparison of Olympic-Style Weightlifting Performances of Elite Athletes: Scaling Models Account for Body Mass
Authors: HUEBNER MARIANNE , MELTZER DAVID E. , BJARNASON ÁSGEIR , PERPEROGLOU ARIS
Published: July 2023

Purpose

We developed a scale for comparison of performances by weightlifters of different body mass and compare this scaling formula to current systems.

Methods

Data from Olympics and World and Continental Championships from 2017 to 2021 were obtained; results from athletes with doping violations were excluded, resulting in performances from 1900 athletes from 150 countries for use in analysis. Functional relationships between performance and body mass were explored by testing various transformations of body mass in the form of fractional polynomials that include a wide range of nonlinear relationships. These transformations were evaluated in quantile regression models to determine the best fit, examine sex differences, and distinguish fits for different performance levels (90th, 75th, and 50th percentiles).

Results

The resulting model used a transformation of body mass with powers −2 and 2 for males and females and was used to specify a scaling formula. The small percentage deviations between modeled and actual performances confirm the high accuracy of the model. In the subset of medalists, scaled performances were comparable across different body masses, whereas both Sinclair and Robi scalings, currently used in competitions, were more variable. The curves had similar shapes for the 90th and 75th percentile levels but were less steep for the 50th percentile.

Conclusions

The scaling formula we derived to compare weightlifting performances across a range of body mass can easily be implemented in the competition software to determine the overall best lifters. This is an improvement over current methods that do not accurately account for differences in body mass and result in bias or yield large variations even with small differences in body mass despite identical performances.
Aseptic leptomeningitis induced by azathioprine in systemic lupus erythematosus: a rare manifestation
Authors: Santos Mariana , da Silva Matheus Alves , Piassa Maria Laura , Santos Danielly , Baeta Alex Machado , Amaral Lázaro Luis
Published: July 2023

Systemic lupus erythematosus (SLE) is an autoimmune systemic disease and these patients can have neurological involvement; however, aseptic leptomeningitis is considered to be a very rare feature, observed in 1.4–2.0% of patients. Here, we described a case of a young male with SLE treated with azathioprine with progressive headache, which revealed diffuse posterior fossa leptomeningitis, relatively sparing the supratentorial compartment, that represent an adverse drug reaction – a rare manifestation of central nervous system involvement in SLE. Treatment with azathioprine was interrupted and methylprednisolone was initiated and the patient has significant improvement of his neurological state in 5 days later, demonstrating total involution of the leptomeningeal enhancement on MRI follow-up.
Use of whole exome sequencing for identification of genetic variants related to Growth Hormone Deficiency and Short Stature: A Family-Based Study
Authors: Alharazy Shatha , Naseer Muhammad Imran
Published: July 2023

Objective: Genetic polymorphisms in genes involved in growth process and Vitamin-D metabolism form a significant etiology behind growth hormone deficiency and short stature. The aim of this study was to explore for known and unknown genes and variants related to growth hormone and short stature in a family based study using whole exome sequencing (WES).

Method: This family-based study included a family with members diagnosed with growth hormone deficiency, short stature and Vitamin-D deficiency (four boys affected and four boys non-affected). The participants were recruited from King Abdulaziz University Hospital (Jeddah, Saudi Arabia) and referred to King Fahad Centre for Medical Research (Jeddah, Saudi Arabia from April 2022 to June 2022. The consanguineous parents and one of the affected boys (aged 16 years old) underwent WES.

Results: Several variants in RNPC3, ACAN, GC, VDR and LRP2 were identified in index cases but not in controls. Novel frameshift and splice region variants in RNPC3 (c.358dupA, p.Arg120fs) were detected. Other missense variants were also observed including variants in ACAN (c.2591C>T, c.2789G>T, c.2815T>A, c.4207A>G, c.4523A>C and c.7119C>G), GC (rs4588 and rs7041) and LRP2 (rs2075252 and rs1991517). A start loss variant in VDR (rs2228570) with high impact was also observed.

Conclusions: Our findings suggest a potential association of these variants with growth hormone deficiency and short stature. In this study, novel pathogenic variants in RNPC3 were revealed as well as other variants in ACAN and in genes related to Vitamin-D metabolism (GC, VDR and LRP2) that some or all might be associated with growth hormone deficiency. Further large-scale studies are required to address the association of these variants with growth hormone deficiency and its subsequent short stature.

doi: https://doi.org/10.12669/pjms.39.5.7601

How to cite this: Alharazy S, Naseer MI. Use of whole exome sequencing for identification of genetic variants related to Growth Hormone Deficiency and Short Stature: A Family-Based Study. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7601

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.