bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the frequent occurrence and characterization of Cytochrome B gene in Theileria annulata in cattle
Authors: Mahmoud Fatma S. , El-Khabaz Khaled A.S. , Nasr Heba A. , Abdel-Baky Mohammed M.M. , Youssef Zainab M.A.
Published: November 2024

Bovine theileriosis caused by Theileria annulata (T. annulata) that result in high mortality and financial losses for the livestock industry in Egypt. For this study, fifty cattle were utilized. Whole blood samples were collected for laboratory analysis. Giemsa-stained blood smears were employed to detect Theileria infection. Polymerase chain reaction (PCR) was used to evaluate various target genes like 30-kDa and Cyto B of T. annulata. Nine (18%) samples tested positive for piroplasm of Theileria by microscopic examination of blood smear. Twenty one (42%) of the analyzed samples tested molecularly positive depended on 30-kDa gene, while 10 (20%) samples were positive based on Cyto B gene. In our study, we carried out DNA sequencing and phylogenetic analysis of T. annulata using the Cyto B gene. The PCR products' phylogenetic analysis of the Egyptian strain of T. annulata (Assiut) showed nucleotide identity ranging from 96.16–98.92% with T. annulata strains of various governorates (Sharkia and Qulyubia) of Egypt, Sudan, Tunisia, Turkey, and India. The isolates obtained were found to be closely clustered with an isolate from Sudan (accession number LC431533). We identified thirty point mutations at the amino acids sequences. There was substantial variance (P < 0.05 and P < 0.01) between age and sex of tested cattle, respectively and percentages of T. annulata infection. The data obtained from our study in characterization of Cyto B gene of T. annulata in Assiut Governorate suggest that the Cyto B gene may be used as a genetic marker to identify resistant isolates of T. annulata.
Sex specific differences in short-term mortality after ICU-delirium
Authors: Schreiber Nikolaus , Eichlseder Michael , Orlob Simon , Klivinyi Christoph , Zoidl Philipp , Pichler Alexander , Eichinger Michael , Fandler-Höfler Simon , Scholz Laura , Baumgartner Jekaterina , Schörghuber Michael , Eller Philipp
Published: November 2024

Introduction
Delirium is a frequent complication in critically ill patients and is associated with adverse outcomes such as long-term cognitive impairment and increased mortality. It is unknown whether there are sex-related differences in ICU-delirium and associated outcomes. We aimed to assess sex-specific differences in short-term mortality following ICU-delirium.
Methods
We conducted a retrospective cohort study using the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Adult ICU patients who were diagnosed with delirium using the Confusion Assessment Method for the ICU (CAM-ICU) or the Intensive Care Delirium Screening Checklist (ICDSC) were included. The primary outcome was 30-day mortality following delirium onset. To control for baseline differences in demographics, illness severity, and comorbidities, we applied 1:1 propensity score matching. Cox proportional hazards regression models were used to evaluate the association between sex and mortality.
Results
A total of 8950 ICU patients with delirium were analyzed, of whom 42.6% were female. In univariable analysis, women had higher crude mortality (26.0% vs. 23.4%; HR 1.16, 95% CI 1.071–1.267, p < 0.001). After propensity score matching, the cohort included 3811 females and 3811 males. Thirty-day mortality was again higher in women (HR 1.14, 95% CI 1.046–1.252; p = 0.003).
Conclusion
Our study suggests that women with ICU-delirium have a significantly higher risk of short-term mortality than men. Further research is needed to understand the biological and clinical factors driving this disparity and to inform sex-specific interventions for ICU-delirium.
Decision support in the management of musculoskeletal disorders: a qualitative study of physiotherapists’ and patients’ experiences
Authors: Klevanger Nina Elisabeth , Bones Anita Formo , Meisingset Ingebrigt , Granviken Fredrik
Published: November 2024

Background
Clinical decision support systems (CDSSs) present a paradigm shift in health care by assisting complex decision-making processes. While implementing such systems has considerable potential, they simultaneously influence clinical encounters by impacting decision-making authority. SupportPrim PT (physiotherapy) is a CDSS that uses artificial intelligence methods to provide personalised treatment recommendations to patients with musculoskeletal disorders based on similar successful patients. This study aimed to explore how the CDSS influences the decision-making process of physiotherapists and patients.
Methods
This qualitative study is nested within a randomised controlled trial and is based on individual interviews with 11 patients with musculoskeletal disorders and 10 physiotherapists in Norwegian primary healthcare in 2021. The interviews were analysed thematically, with a theoretical approach inspired by Actor Network Theory.
Results
First, both patients and physiotherapists valued the visualisation of patients’ biopsychosocial health status. It helped address health issues and expand and align perceptions of relevant information, leading to trust in physiotherapists’ clinical reasoning. Nevertheless, revealing health problems also occasionally created insecurity. Second, the physiotherapists mainly felt that the CDSS treatment decision screen supported their reasoning. For some, it served as a pedagogic tool, lending the physiotherapist authority by confirming the accuracy of their treatment suggestions. However, many found it redundant to use with patients, as they felt secure in how to proceed. Patient involvement was also challenged by occasional inappropriate treatment suggestions and abundant and complex information, diminishing therapists’ trust in the CDSS.
Conclusion
CDSSs can prove valuable by cultivating trust in physiotherapists’ clinical reasoning. However, this trust can simultaneously challenge shared decision-making with the patient. Other aspects influencing decision-making include expectations of the CDSS, its timing and the content of treatment suggestions. The physiotherapists' ability and need to interpose between patients and the CDSS to counter inappropriate information also impede shared use. Future studies should investigate how such CDSSs can enhance patient agency by allowing access and addressing the changing role of the physiotherapist once a CDSS is introduced in the clinical encounter.
A Real-World Experience of Efficacy and Safety of Belantamab Mafodotin in Relapsed Refractory Multiple Myeloma
Authors: Hashmi Hamza , Dileo Rachel , Mewawalla Prerna , Babu Kalaivani , Yin Yue , Strouse Christopher , Chen Ethan , Shaikh Hira , Davis James , Green Kimberly , Alkharabsheh Omar , Rashid Aliya , Pokhrel Bidushi , Ahmed Nausheen , Abdallah Al-Ola
Published: November 2024

While initial trials led to the accelerated approval of belantamab mafodotin, a BCMA directed antibody drug conjugate, confirmatory trials failed to establish benefit from this therapy for patients with relapsed refractory multiple myeloma (RRMM), eventually leading to its withdrawal from commercial use. With an imminent approval as an effective combination therapy as seen in recent randomized trials, we report real-world clinical outcomes with belantamab mafodotin in 81 RRMM patients. With median of 5 (range 2–15) prior lines of therapy, 92%, 45%, and 15% of the patients were triple-class refractory, penta-class refractory, and BCMA-refractory. More than half (57%) of the patients had high-risk cytogenetics, 37% had extramedullary disease (EMD), and 67% of the patients would have been considered ineligible for the DREAMM-2 trial. Best overall response (ORR) and complete response rates were 40.0% and 15.0%, respectively. ORRs were lower in patients with EMD, BCMA-refractory and penta-refractory disease at 23%, 17%, and 24%, respectively. All grade ocular toxicity was seen in 69% of patients with grade 3 + events in 43%. Grade 3 + hematological toxicities included neutropenia (20%), anemia (28%), and thrombocytopenia (31%). With a median follow-up of 11.3 (0.3–44.6) months for the entire population, median PFS and OS were 5 (1–20) months and 12 (3–28) months, respectively. Presence of EMD was the only predictor of both PFS and OS on multivariable analysis. Compared to the pivotal trial and despite several high-risk disease features, belantamab mafodotin demonstrated comparable efficacy and safety in this real-world patient population.
Examining Disparities in Glycemic Management: A Comprehensive Retrospective Study on Rural Population
Authors: Papazachariou Andria , Malikides Onoufrios , Malikides Vironas , Vasilaki Nektaria , Stamatelatou Maria , Papakitsou Ioanna , Papadokostaki Eleni , Filippatos Theodosios D.
Published: November 2024

Objectives:
Residing in rural or remote areas is often linked to compromised access to health services, directly affecting the feasibility of follow-up on patients with diabetes. An 8-month retrospective cohort study of factors affecting glycemic control among 932 individuals with diabetes, who sought medical care in a rural area. Demographics, comorbidities and laboratory measurements were retrieved through patient interviews, from the national electronic prescription system and hospital’s medical records
Data description:
Participants (n=632) resided within a half-hour proximity to reference center, demonstrated better glycemic control, with a mean HbA1c level of 7.20±0.7%, as opposed to those (n=300) who lived more than half-hour away, who exhibited a mean HbA1c level of 7.34±0.8% (p=0.016). HbA1c levels exhibit a significant correlation with both the time in minutes and the distance in kilometers from the rural area reference center. Linear regression analyses showed that distance in kilometers or in minutes is an independent factor influencing HbA1c levels. The distance to medical services is an important factor of glycemic control in patients with diabetes, underlying the importance of improvements in the health system in rural areas.
Assessing the quality of life of adolescents with sickle cell disease and their transition to adult medicine: experience in a remote area of the Democratic Republic of Congo
Authors: Mbiya-Mukinayi Benoît , Kalala-Mushinta Corneille , Kalombo-Munganga Schadrac , Kalala-Mwanza Alexandre , Kasongo-Tshiala Steve , Mpoyi-Kalenda John , Gulbis Béatrice
Published: November 2024

Background
Sickle cell disease is the most common genetic disease in the world, affecting mainly populations in sub-Saharan Africa. It causes high morbidity and mortality rates and is a real public health problem in the Democratic Republic of the Congo. Regular medical follow-up improves the quality of life of patients, especially adolescents, and raises the issue of their transition to adult medicine. This study aims to assess the quality of life and transition of sickle-cell adolescents, identifying key factors influencing their well-being.
Method
This was a cross-sectional descriptive and observational study conducted in the form of interviews with 106 sickle cell adolescents in Mbujimayi. The SF-36 short questionnaire was used to assess quality of life. A closed questionnaire (dichotomous or nominal) was used to assess the transition period.
Results
The results revealed an overall optimal quality of life, with an average SF-36 score of 60.6 ± 8. Improvement in pain management (75,21 ± 23,49) and misperception of role limitations related to emotional issues (47,79 ± 27,53). Pain is the main factor affecting quality of life. It is significantly associated with physical functioning (p 0.014), energy/fatigue (p 0.014), functional/physical role (p 0.001), emotional well-being (p 0.000), social functioning (p 0.000) and pain itself (p 0.000). The majority, 92% of the adolescents, were unaware of the transition, and 68% did not feel ready to move from pediatric care to adult care.
Conclusion
These findings highlight the importance of considering the quality of life of sickle cell adolescents and their transition to adult medicine in Mbujimayi, highlighting the challenges they face and the factors that affect their well-being in general.
RETRACTED: A New High Voltage Gain Quasi-π-Source Converter
Authors: Shafiei-Fasaghandis Oktay , Alipour Hasan , Mohammadian Leila , Abedinzadeh Taher , Pouladi Jaber
Published: November 2024

The authors have requested that this preprint be removed from Research Square.
Dietary acid load and mortality: Results from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study
Authors: Unohara Taichi , Watanabe Takeshi , Arisawa Kokichi , Matsuura Akari , Kita Kahori , Torii Yuka , Ishizu Masashi , Katsuura-Kamano Sakurako , Nguyen Tien Van , Otonari Jun , Ikezaki Hiroaki , Tanaka Keitaro , Shianoe Chisato , Nagayoshi Mako , Kubo Yoko , Matsunaga Takashi , Okada Rieko , Oze Isao , Ito Hidemi , Michihata Nobuaki , Nakamura Yohko , Tanoue Shiroh , Koriyama Chihara , Suzuki Sadao , Nishiyama Takeshi , Koyama Teruhide , Ozaki Etsuko , Kuriki Kiyonori , Takashima Naoyuki , Kondo Keiko , Tamura Takashi , Matsuo Keitaro
Published: November 2024

Purpose:The impact of diet on the body acid-base balance may be related to the risk of various chronic diseases. Despite emerging evidence on the relationships between the dietary acid load and all-cause and cause-specific mortalities, further information is needed. This prospective cohort study examined the relationships between the dietary acid load and all-cause and cause-specific mortalities in a large Japanese population.
Methods: The data of 74,360 subjects (aged 35-69 years in the baseline survey) in the Japan Multi-Institutional Collaborative Cohort Study were analyzed. The dietary acid load was estimated using the net endogenous acid production (NEAP) score. Cox proportional hazards regression analyses were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortalities according to the quartiles of the energy-adjusted NEAP score after adjustments for potential confounders. Sex-stratified analyses were also conducted.
Results: During a mean follow-up of 11.6 years, 3,761 deaths (2,467 male and 1,294 female subjects) were identified. A higher NEAP score was associated with higher all-cause mortality (HR 1.16, 95% CI 1.04-1.28) and cerebrovascular disease mortality (HR 1.69, 95% CI 1.08-2.65). Sex-stratified analyses showed that the NEAP score was associated with all-cause and cause-specific mortalities, including cerebrovascular disease mortality (HR 2.32, 95% CI 1.23 - 4.40), in male subjects, but not in female subjects.
Conclusion: The present results suggest that the dietary acid load is associated with a higher risk of all-cause and cause-specific mortalities, including cerebrovascular death, in Japanese male adults.
Seawater temperature and tidal action as modulators of Ulva spp. micropropagules density in a eutrophicated macrotidal coastal system
Authors: Caniguan Agustina Mariel , Becherucci Maria Eugenia , Gastaldi Marianela , Narvarte Maite Andrea , Saad Juan Francisco
Published: November 2024

Micropropagules are the reproductive and dispersal means of macroalgae, often linked to green macroalgal blooms in eutrophicated coastal areas. In San Antonio Bay (North Patagonia, Argentina), increased nutrients have led to Ulva spp. blooms in spring and early summer, coinciding with high Ulva spp. micropropagules (MPU) density at low tide. This study aimed to describe the variation in MPU densities throughout a year and in a tidal cycle and their relationship with environmental variables. For this, MPU density, macroalgal biomass, weight of mature and immature thalli, and seawater physical and chemical variables were determined: 1) monthly for a year at low tide, 2) during a tidal cycle at one-hour intervals covering the low tide period (approx. five hours), and 3) at different depths in the water column during daytime and nighttime high tides. Maximum MPU density (33983±9553 cel ml-1) occurred in February, while macroalgal biomass peaked in December. MPU density, seawater temperature, salinity, chlorophyll-a, and nutrients increased during low tide but decreased at high tide, with no evidence of vertical stratification. MPU density was positively associated with seawater temperature during low tide and throughout the year. We conclude that MPU variation is associated with seawater temperature annually and with tidal action daily. High MPU densities during summer raise chlorophyll and dissolved oxygen levels, while tidal flow dilutes and exports MPU. These results provide insights into the dynamics of the dispersal phase of an opportunistic and globally distributed green algal genus for the first time.
Characteristics and risk factors for postoperative bleeding following endoscopic resection of esophageal squamous neoplasms
Authors: Kitagawa Daiki , Kanesaka Takashi , Ishihara Ryu , Tani Yasuhiro , Okubo Yuki , Asada Yuya , Ueda Tomoya , Kizawa Atsuko , Ninomiya Takehiro , Ando Yoshiaki , Tanabe Gentaro , Fujimoto Yuta , Mori Hitoshi , Kato Minoru , Yoshii Shunsuke , Shichijo Satoki , Yamamoto Sachiko , Higashino Koji , Uedo Noriya , Michida Tomoki , Fujiwara Yasuhiro
Published: November 2024

Background
Reports on postoperative bleeding after esophageal endoscopic resection are limited.
Aims
This study aimed to identify the clinical characteristics and risk factors for postoperative bleeding following endoscopic resection of esophageal neoplasms.
Methods
This single-center, retrospective study included consecutive patients who underwent endoscopic resection for esophageal squamous cell carcinoma or squamous intraepithelial neoplasm between January 2018 and December 2022. We investigated the incidence, timing, severity, and risk factors for postoperative bleeding.
Results
Among the 1,288 patients, postoperative bleeding occurred in seven (0.5%) patients (95% confidence interval [CI] 0.2–1.1%; median postoperative day 8 [range, 4–17 days]). In these seven patients, hemoglobin concentration decreased by a median of 3.0 g/dL (range, 1.6–6.8 g/dL). Direct oral anticoagulants (DOACs) were identified as the most significant risk factor for postoperative bleeding (odds ratio [OR] 41.9, 95% CI 6.8–294.6; P < 0.001) and were significantly associated with postoperative bleeding even after propensity score matching (3/39 [8%] vs. 0/78 [0%], P = 0.035). Among 43 patients who received DOACs, postoperative bleeding occurred in four (9%) patients (95% CI 2.6–22.1%).
Conclusions
The overall bleeding rate following esophageal endoscopic resection was 0.5%, with a delayed onset, leading to anemia. DOACs emerged as the most significant risk factor for postoperative bleeding.
The ratio of omega-6 fatty acids to omega-3 fatty acids mediating the effect of gastroesophageal reflux disease on pancreatic cancer risk: a two-step mediation Mendelian randomisation study
Authors: Ouyang Jiqi , Zhang Runshun , Lv Wenliang , Lu Yanping
Published: November 2024

Introduction:
Pancreatic cancer (PC) is the third most common cause of cancer-related deaths worldwide, with the 5-year survival rate for patients with PC in developed countries being only 9–10%. Gastroesophageal reflux disease (GERD) is known to be a high-risk factor for several cancers. However, the relationship between GERD and PC remains controversial. Therefore, this study aimed to investigate the causal association between GERD and the risk of PC. Additionally, we sought to validate the role of omega-6/omega-3 polyunsaturated fatty acids (n-6/n-3 PUFA) as mediators in this pathway by calculating their mediating effect.
Methods
First, a two-step, two-sample Mendelian randomisation (TSMR) framework was established to test the causal relationship between GERD and PC and to determine whether n-6/n-3 PUFA could act as a mediator of the causal pathway. Subsequently, using multivariate Mendelian randomisation (MVMR), the proportion of mediators mediated by n-6/n-3 PUFA was calculated using the product of coefficients approach.
Results
The two-step TSMR results showed that GERD was positively associated with PC (n = 27 SNPs, OR 2.07 95% CI 1.27–3.39, p = 0.003 β = 0.73). Additionally, GERD was positively associated with n-6/n-3 PUFAs (n = 59 SNPs, OR 1.06, 95% CI 1.02–1.11 p = 9.0×10 − 4, β1 = 0.06), which are positively associated with PC (n = 28 SNPs, OR 1.23, 95% CI 1.04–1.46, p = 0.02, β = 0.20). The MRMV results demonstrated that after controlling for GERD, the n-6/n-3 PUFA had an impact on PC (n = 17 SNPs, se = 0.07, p = 0.004, β2 = 0.21). Furthermore, the causal effect of GERD on PC was partially mediated through the n-6/n-3 PUFA (n = 31 SNPs, se = 0.20, p = 0.03, β3 = 0.42) with a 2.9% mediating effect.
Conclusion
This study provides insights into the pathological processes that link GERD to PC. In addition, it offers a novel approach to PC prevention and early detection. In clinical practice, early screening and drug usage control in patients with GERD must be prioritised. Furthermore, dietary supplementation with n-3 PUFAs and proper n-6 PUFA reduction may minimise the prevalence of PC.
Multi-Layered Dual-Input Integrative Attention Model for Path Loss Prediction
Authors: Tikaria Mamta , Saxena Vineeta
Published: November 2024

Path loss perdition significantly influences the strategic placement of base stations within cellular networks. The perdition of path loss using traditional approaches results in extensive field testing which is notably time-consuming. To address such issues, the paper explored the role of machine learning (ML) based approaches for path loss prediction. But in recent research contributions, mostly unmoral systems are used for prediction of path loss. To advance these approaches, the paper presented a bimodal path loss prediction system that integrates environmental data as well as visual information that are extracted from satellite relocation images. The paper presented a multi-layered architecture named as Dual-Input Integrative Attention Model (DIIAM) for path loss prediction. The DIIAM is composed of three major layers, Dual-Input Feature Extraction Layer (DIFEL), Feature Weighted At-tention Layer (FWAL) and Learning Layer (LL). DIFEL extracts features from each input. Environmental or channel parameters are selected by applying data imputation, normalization and relevant feature selection using T-Test and Z-Test. Whereas the relo-cation visual features are extracted by applying pre-trained transfer learning model such as ResNet50. Integration of these steps for dual-input feature extraction. This makes the DIFEL lightweight and requires less computational resources. FWAL used the attention mechanism to generate weighted features. LL layer implement six different learning models such as support vector re-gressor (SVR), Random forest regressor (RFR), Backpropagation Neural Network (BPNN), Long-short term memory (LSTM), Bidirectional LSTM (BiLSTM), and Gated recurrent unit (GRU). The multi-layered and dual-input nature of the proposed DI-IAM effectively process and learn the complex relationships between environmental characteristics and visual features. The simu-lation result was performed on four publicly available datasets for unimodal and bimodal systems. The average RMSE of the proposed DIIAM model was approx. 1.5dB which outperforms better as compared to state-of-the-art methods.
Patterns of Failure after Stereotactic Radiosurgery for Brain Metastases from Small Cell Lung Cancer: Outcomes in the Immunotherapy Era
Authors: Marwaha Alexander S. , Liang Yun , Shepard Matthew J. , Yu Alexander , Karlovits Stephen M. , Wegner Rodney E.
Published: November 2024

Purpose/Objective(s): Small cell lung cancer (SCLC) is known to have high rates of development of brain metastases. Standard treatment has been whole brain radiation therapy (WBRT) but the role for more focused treatment and hippocampal avoidance has arisen in the past decade. In addition, with possible penetration of the central nervous system by more modern immunotherapies, the risk of distant failure may be lower. As such, we reviewed patients at our institution treated with stereotactic radiosurgery (SRS) to look at patterns, locations, and predictors of failure in the brain.
Materials/Methods: A retrospective review and analysis of charts was done on 46 patients treated with SRS (no history of prior WBRT) for their brain metastases from SCLC. Multivariate analysis was used to determine significant prognostic factors influencing survival and local/distant failure. We tracked timing and type of immunotherapy, if any, as well as if patients failed in the hippocampus or required WBRT.
Results: There were 46 patients with 97 total brain metastases treated with SRS in this study. Median number of metastases was 2 (1–5). The median dose of radiation was 20Gy (20–30) in 3 fractions (1–5) for all 97 tumors. 11 patients did not receive immunotherapy, whereas 35 patients had immunotherapy of some sort. Median overall survival (OS) for the entire cohort was 13 months, with a 12 month OS of 59% and 2-year OS of 30%. Cox regression did not reveal any significant predictors of OS, including age, sex, total volume, extracranial disease, KPS, immunotherapy, or number of metastases. 12 month and 24 month local control of disease was 95% and 80%, respectively. There were no significant predictors of local failure including volume, dose, or immunotherapy. 25 of the patients had distant brain failure, with a rate of distant failure of 38% and 64% for 6 and 12 months, respectively. Immunotherapy, number of metastases, total target volume, nor presence of extracranial disease was predictive of distant brain failure. WBRT free survival was also measured and found to be 73% at one year. There were no significant predictors for this measure. Lastly, 5 patients in this cohort showed failure in the hippocampus, where the rate of failure at 6 and 12 months was 16%.
Conclusion: Rates of distant brain failure in SCLC patients after SRS remain similar to those of NSCLC patients in the immunotherapy era. We did not show a decrease in distant failure rate based on immunotherapy use. The rate of hippocampal failure was quite low and should provide reassurance that SRS and techniques such as HA-IMRT can be reasonably used in these patients. Ongoing clinical trials will help provide more definitive answers in this arena.
Prevalence of Urinary Pathogen and Antimicrobial Susceptibility of isolates in cervical cancer patient attending BPKMCH Bharatpur, Chitwan
Authors: sedai Bishnu Ram , Neupane Promish , Nagila Amar , Pant Dhaka Raj , Pandit Prashant , Malla komal , Paudel Rajan , Chapagain Bipin , Regmi sanjib Mani
Published: November 2024

Introduction:
Cervical cancer is one of the many diseases in the wide family of cancers that include abnormal cell development and have the potential to infiltrate or spread to other regions of the body. Most cervical cancer patients are at high risk for urinary tract infections as a result of several treatment modalities, including invasive surgery, chemotherapy, radiation, and immunosuppressive or anticancer medication. Therefore, the purpose of this study was to identify urinary tract infections and test isolates from cervical cancer patients who were treated at BPKMCH Bharatpur, Chitwan, for antibiotic susceptibility.
Methodology:
Urine samples were received from the cervical cancer patients attending BPKMCH, Chitwan. The samples were processed following standard guidelines in the Microbiology Laboratory of B.P. Koirala Memorial Cancer Hospital. Isolates were identified using standard techniques and biochemical tests like catalase, coagulase, oxidase, and sugar utilization in TSI, motility, indole, H2S production in SIM media, citrate utilization and urea hydrolysis. Pure colonies were tested for antimicrobials susceptibility on Mueller Hinton agar (MHA) using Kirby- Baeur disc diffusion method following CLSI guideline 2017.
Results
Of total 350 specimens received from cervical cancer patient, 151 gave significant growth of microorganism which accounts for 43.1%. Among the isolates Escherichia coli had highest predominance accounting 35.9% (n = 54), followed by Klebsiella spp. Among the Gram positive organisms Staphylococcus aureus showed predominance which was 4 times more isolated than CONS. Most of the isolates were resistant to Ampicillin, followed by Cotrimoxazole and Cefixime. Polymyxin B and Imipenem were most effective for all Gram Negative bacilli while Vancomycin and Azithromycin were most effective for Gram positive cocci.
Conclusion
Out of 350 patients, 43.1% had a UTI. Cervical cancer patients are more likely to get UTI as a result of immunosuppressive medication therapy and invasive surgery. As a result, they should be evaluated on a regular basis for the development of UTI, and their treatment should include AST. Such hospital-based study should be conducted to establish empirical therapy of UTI among cervical cancer patients with UTI, as well as to ensure adequate treatment and care.
Evaluation of the Effectiveness of Greater Occipital Nerve Blockade in Menstrual Migraine
Authors: Cetin Guldeniz , Totuk Ozlem , Demir Serkan , Sahin Sevki
Published: November 2024

Objective: This study aimed to compare the short-term prophylactic efficacy of greater occipital nerve (GON) blockade in menstrual migraine (MM) subgroups and evaluate the long-term effects on patients' quality of life.
Methods: In this prospective study, 33 patients diagnosed with MM (15 with pure menstrual migraine [PMM] and 18 with menstrually related migraine [MRM]) received bilateral GON blockade once a month, one week before menstrual bleeding, for three months. Patients were evaluated before treatment (month 0) and after treatment completion (months 3 and 6) using the Visual Analog Scale (VAS), Headache Impact Test-6 (HIT-6), Migraine Disability Assessment (MIDAS), and Beck Depression Inventory (BDI) scores.
Results: MRM patients had a lower age of MM onset (p=0.024), higher headache frequency (p=0.004), and increased medication overuse (p=0.027) compared to PMM patients. After GON blockade, significant improvements were observed in VAS, HIT-6, MIDAS, and BDI scores in both subgroups, with no significant differences between them. The improvement persisted during the medication-free follow-up period (months 3-6). Patients with mild or no depression showed a more substantial increase in quality of life. Patients experiencing a 50% reduction in headache days demonstrated significant improvement in BDI scores.
Conclusion: GON blockade may be an effective option for short-term and long-term prophylaxis in the treatment of MM, reducing the frequency and severity of headaches and improving quality of life and psychological state. Further research with larger patient cohorts and placebo-controlled trials is necessary to validate these findings.
You are the colour of what you eat: higher invertebrate consumption correlates with redder muscle pigmentation in anadromous Arctic char (Salvelinus alpinus) along western Hudson Bay, Nunavut, Canada
Authors: Faulkner Connor W. , Ittinuar Sonny J. , Tartak Clayton U. , L’Herault Vincent , Harris Les N. , Davoren Gail K. , Yurkowski David J.
Published: November 2024

Salmonid fishes exhibit marked intra-specific variation in muscle pigmentation. This variation is primarily due to individual differences in the accumulation and assimilation of dietary carotenoids synthesized by primary producers and microorganisms and present in the tissues of crustaceans that can serve as important prey for salmonids. Despite anadromous Arctic char (Salvelinus alpinus) being a key subsistence and economic resource across Inuit Nunangat, their muscle pigmentation in relation to diet and environmental variability (e.g., sea ice dynamics) has not been investigated. Using carotenoid spectrophotometry analysis and a muscle colour scale, we examined the influence of Arctic char diet, inferred from stomach contents, stable isotopes (δ15N), and highly branched isoprenoids on their muscle pigmentation, as well as muscle pigmentation of their prey near the communities of Rankin Inlet and Naujaat, Nunavut in two years (2021, 2022) with contrasting sea ice cover. Among prey types, invertebrates had higher carotenoid concentrations than fishes. Arctic char in Naujaat contained higher muscle carotenoid concentrations and redder muscle than in Rankin Inlet in 2021, associated with a higher invertebrate-based diet and more prevalent sea ice cover. In 2022, muscle carotenoid concentrations of Naujaat and Rankin Inlet Arctic char were similar, associated with a largely fish-based diet and similar sea ice cover, although muscle still remained redder in Naujaat Arctic char. Inter-annual variation in carotenoid concentration and muscle pigmentation associated with diet variability observed in this species may affect local resource users over the long-term due to unpredictable climate-driven environmental changes, resulting in socioeconomic impacts across the Arctic.
Mapping Inclusive Migration Governance: A Comparative Analysis of Turkish Municipalities Using Qualitative Comparative Analysis (QCA)
Authors: Rass-Turgut Seda
Published: November 2024

This study critically examines how Turkish municipalities are responding to migration challenges posed by the influx of Syrian refugees. By combining qualitative and quantitative methods, it explores the mechanisms that enable inclusive governance at the local level. The findings highlight that municipalities governed by the ruling party and supported by international organizations are more likely to adopt inclusive policies, while those led by opposition parties depend heavily on local resources and economic strength. The results provide valuable insights into the complex dynamics shaping migration governance in Türkiye.
Türkiye, hosting the largest refugee population globally since the Syrian crisis in 2011, faces significant migration challenges. This study examines the factors shaping municipal responses to the refugee influx and emerging migration governance. Through a combination of quantitative and qualitative methods, including Qualitative Comparative Analysis (QCA) and text mining of strategic and performance plans from 81 municipalities, it explores inclusionary migration policies at the subnational level. The research identifies mechanisms that foster inclusive governance in Turkish municipalities, focusing on the roles of local politics, international organizations, and economic factors. The findings indicate that municipalities governed by the ruling party, with strong international NGO support and large refugee populations, tend to adopt inclusive measures. In contrast, opposition-led municipalities with strong economies depend more on local resources and international partnerships. These results underscore the complexity of local migration governance and the interplay between national, local, and international dynamics.
Population pharmacokinetic modeling of tamoxifen and its active metabolite endoxifen in healthy volunteers of African ancestry genotyped for CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4 and CYP3A5.
Authors: Chiwambutsa Shingirai Melidith , Ali Ali Mahomed , Cubasch Herbert , Joffe Maureen , Ruff Paul , White-Koning Melanie , Masimirembwa Collen
Published: November 2024

Purpose
Wide inter-individual variability is seen in the clinical outcomes of tamoxifen treatment, which may be attributable to cytochrome P450 genetic polymorphisms. To investigate this, we analysed data from an open-label three parallel arm trial with 36 healthy volunteers of African ancestry to whom a dose of 20 mg of tamoxifen had been administered and drug concentrations of tamoxifen and its three metabolites measured over 34 time points after administration.
Methods
The data was best described by a pharmacokinetic model, which focused on tamoxifen and its active metabolite endoxifen only. The model was described by a two-compartment model for the parent linked to a one-compartment model for the metabolite.
Results
Data exploration and estimated pharmacokinetic parameters for both compounds indicated wide variability between participants. The findings demonstrated high inter individual variability (99.3%) in the formation of endoxifen with no evidence to suggest that the CYP2D6 gene could explain this variation. Model diagnostic plots such as goodness of fit plots and visual predictive checks showed a good predictive performance of the model.
Conclusion
Age, BMI, CYP2D6, CYP3A4, CYP3A5, CYP2B6, CYP2C9 and CYP2C19 genotypes had no significant impact in explaining the variability in pharmacokinetic parameters for tamoxifen and endoxifen.
Exosomal miR-365b-5p derived from keratinocyte promotes melanogenesis by directly targeting GLI2
Authors: Zhao HaiRu , Jo ChanSong , Hwang JaeSung
Published: November 2024

In previous studies, we analyzed that exosomal microRNA (miRNA) secreted by keratinocytes exposed to Ultraviolet B(UVB) light regulate melanogenesis in melanocytes. Through functional experiments, it was determined that a subgroup of exosomal miRNAs had distinct impacts on melanogenesis. In the current study, we focused on hsa-miR-365b-5p which founded upregulated in UVB-irradiated keratinocyte exosomes and confirmed to exert enhancing effects on melanogenesis in human melanocyte. Hsa-miR-365b-5p is a specific, mature microRNA derived from the precursor hsa-miR-365. We demonstrated that the overexpression of hsa-miR-365b-5p in normal human epidermal melanocytes (NHEM) resulted in an approximate 50% increase in melanin content relative to the control group. Furthermore, treatment with an inhibitor of hsa-miR-365b-5p substantiated its specific regulatory role in melanogenesis, as inhibition resulted in a nearly 90% reduction in melanin production. Notably, hsa-miR-365b-5p upregulates the expression of genes associated with melanogenesis, including MITF, TYR, TRP1, and TRP2. Additionally, we established that GLI Family Zinc Finger 2 (GLI2) functions as a repressor of MITF, with its inhibition via siRNA leading to increased melanogenesis. Moreover, we constructed a luciferase reporter vector containing the 3' UTR of GLI2, confirming that hsa-miR-365b-5p specifically targets GLI2, a known repressor of MITF. These findings elucidate the regulatory pathways governing melanogenesis and underscore the significant role of hsa-miR-365b-5p in this biological process.
A Dual-Targeted Nanocapsule Inhibitor Alleviates Severe Acute Pancreatitis via Cytokine and NLRP3 Inflammasome Regulation
Authors: Wu Ling , Liao Shuqi , Li Yuhang , Rao Yu , Cao Zhong , Liu Sulai , Zhou Lei , Li Yufeng , Liu Jie , Hu Lin , Xie Haijiao , Cheng Yao
Published: November 2024

Severe acute pancreatitis (SAP), a special type of acute abdomen, lacks effective treatment methods for clinical diagnosis because of its complex etiology and unclear pathogenesis. Herein, we engineered a structurally controllable gold-doped Prussian blue analogues-based nanozyme by optimizing the preparation procedure as a dual-targeted inhibitor of the NLRP3 inflammasome and inflammatory cytokine pathways for treating SAP. The as-synthesized nanomaterials with different structures, including nanocapsular (CaAuHCF), ultramicro nanocube (CAHCF-Au), and nanocube (CaHCF) structures, exhibit multienzyme-like activities, such as peroxidase (POD), glutathione peroxidase (GPx), and superoxide dismutase (SOD), which are dependent on their structure. Density functional theory (DFT) simulations revealed the underlying mechanisms of differences in reactivity among nanomaterials with different compositions and structures, indicating that the POD catalytic activity of CaAuHCF nanocapsules plays a leading role under physiological conditions. In vitro or vivo experiments confirmed that CaAuHCF nanocapsules can efficiently remove exogenous and endogenous reactive oxygen species (ROS) at the cellular level and are nontoxic. Importantly, the CaAuHCF nanozyme not only is a cytokine regulator that can mediate the level of cytokine factors related to proinflammatory cell pathways (IL-6, TNF-α, and IL-1β) but also acts as an inhibitor of NLRP3 activation to effectively relieve the inflammatory symptoms of SAP through preventing the cleavage of Gasdermin-D into Gasdermin-N via targeted inhibition of cleaved Caspase-1 activation, thus suppressing the pyroptosis of pancreatic and immune cells. Overall, our data highlight the feasibility of CaAuHCF nanocapsules as dual-targeted inhibitors of cytokines and the NLRP3 inflammasome and provide potential nanozyme-based antioxidants for SAP treatment.
Effect of inter-layer thickness on dynamic mechanical properties of rock mass combined with hard and soft media
Authors: SONG Jiahui , WANG Yanbing , XIE Quanmin , YAO Yingkang , REN Bin
Published: November 2024

In order to explore the influence of interlayer thickness on the dynamic mechanical properties of the rock mass composed of soft and hard media, taking sandstone and granite as the soft and hard rock matrix, the energy evolution and loss laws of the rock mass composed of soft and hard media under different interlayer thicknesses (0 mm, 5 mm, 10 mm, 15 mm) were studied by using the split Hopkinson pressure bar device, and the energy driving mechanism of its failure was explored. The discrete lattice spring method (DLSM) was used to simulate the crack growth, stress time and damage strain evolution of rock mass with different interlayer thicknesses. The results show that with the increase of interlayer thickness, the resistance of interlayer to the crack growth and development of rock mass is gradually enhanced, and the energy consumption is gradually increased. The energy driving mechanism for the failure of the composite rock mass containing interlayers of soft and hard media is: under the impact load, the elastic energy in soft rock, hard rock and interlayers increases continuously, and the elastic energy stored in the interlayers of the composite rock mass first reaches its bearing capacity limit, and the interlayers are rapidly destroyed. After the failure of the interlayer, the stored energy is released instantaneously and transferred to the soft rock and hard rock. Cracks begin to appear in the soft rock. Under the combined action of the energy released by the interlayer and the energy stored in the rock itself, the soft rock will have cracks and produce a little damage. The failure of interbedded rock mass starts at the interbedded cementation surface. With the increase of the interbedded thickness, only one side of the sandstone near the cementation surface is partially fractured. The growth rate of rock mass stress is inversely proportional to the interlayer thickness. The rate of damage degree increasing with strain of rock mass with low interlayer thickness (0 mm, 5 mm) is relatively constant compared with that of rock mass with other interlayer thickness. The damage degree of rock mass with high interlayer thickness (10mm, 15mm) increases rapidly with the strain in the late stage of crack growth.
Securing a future for Serbia's newly discovered Lycaena helle: Conservation recommendations from population study and ecological niche models
Authors: Ilić Milan , Stojanović Iva , Nikolić Marko , Popović Miloš
Published: November 2024

Lycaena helle is a glacial relict, threatened by habitat and climate change, and designated as conservation priority species. It has been discovered recently within an isolated colony on Stara Planina Mt., facing threats from habitat overgrowing and large scale fires. The study aims to explore species population and map its distribution to aid future conservation efforts. Population was surveyed using mark-release-recapture method, distribution was mapped in the field, while habitat preferences and potential distribution were explored using correlative ecological niche models. The local population of L. helle was estimated to 724 individuals, with more than 10,000 adults in the metapopulation system. Colonization events and increasing metapopulation occupancy suggest functional metapopulation structure. The residence of females (0.84) was lower compared to males (0.95), suggesting their higher emigration in search for oviposition resources. Ecological niche models confirmed species preferences towards higher altitudes with low vegetation cover and nitrate rich soils, where some of these highlands could be lost with the rise in global temperature. A large fire in 2019 rendered a portion of the habitat unsuitable even after five years, while localized fire events did not seem to affect species survival. Implications for insect conservation Large and functional metapopulation of L. helle on Stara Planina Mt. requires limited habitat management to prevent overgrowing, preferably through traditional animal grazing. Conservation efforts are required to map suitable habitats using ecological niche models as a guide, and to implement monitoring protocols for timely habitat interventions and prevention of population decline.
Awareness of Female genital mutilation (FGM) and its determinants among women of reproductive age in Tanzania: Implications for public health Intervention
Authors: Asingwire Jackson Micheal , isiko Isaac , Rombe Kuli Faith , Ikwara Emmanuel Asher , Olot Haron , Izunwanne Manankong Jane Precious , Emmanuel Ogidi Chinaza , Kyada AshishKumar , Benjamin Nerat Stephanie
Published: November 2024

Background
Female genital mutilation is a cultural practice carried out in African communities such as Uganda, Kenya and Tanzania. It involves the partial or complete removal of external female genitalia or damage to the female genital organs for purposes other than medical ones. This study aimed at assessing determinants for female genital mutilation awareness among females of reproductive age in Tanzania
Methods
This was a complex cross-sectional survey that was conducted in Tanzania in 2022. The study population consists of women aged 15–49 and data was collected from February to July 2022. Descriptive, bivariate and multivariate analyses were performed using STATA software version 17. The significance level of p-value < 0.05 was set at 95% CI and the determinant variables were identified.
Results
The study contained 2531 women of the reproductive. The women with a primary level of education and secondary education had heard of female circumcision with [AOR: 2.62, CI:1.61–4.27]and [AOR: 4.69, CI: 2.40–9.19] odds respectively were higher than women with no education. In addition, the odds of women aged 35–39 having heard of female circumcision were [AOR: 1.75, CI:1.01–3.06] significantly lower than the odds of women between the ages of 15–19. Also, the odds of women who are occupationally employed [AOR: 0.47, CI:0.23–0.97] knew about female circumcision were lower than those employed all year. The odds of women who earn in kind only and have heard of female circumcision [AOR: 0.15, CI: 0.04–0.53] were significantly lower than those. In comparison to reading magazines for at least a week, the odds of having heard of the female is [AOR: 0.43, CI:0.23–0.82] significantly lower than those that did not read magazines, the odds of women watching TV less than once a week and have heard of female circumcision were [AOR:1.99, CI: 1.28–3.10] significantly higher than those that do not watch tv Also, the odds of women watching TV at least a week and having heard of female circumcision were [AOR: 2.11, CI:1.29–3.45] significantly higher than those that do not watch TV
Conclusion
The study shows that the age of women, educational level, type of employment and earnings, literacy level and media exposure as the predictors for female genital mutilation. For policymakers, the study suggests that female circumcision awareness should be incorporated into broader educational and healthcare programs. Improving media literacy and ensuring equitable access to information, especially in rural areas with limited media access, are crucial steps.