bluuebunny/crossref_metadata_2025 huggingface dataset:
The Aristotle 18 and 24 microwires in neuroIntervention: Early experience at a single centre
Authors: Carraro do Nascimento Vinicius , de Villiers Laetitia , Dhillon Permesh Singh , Domitrovic Luis , Leblanc Jean-Philippe , Booth Madison , Rice Hal
Published: October 2023

Background

Current neurointerventional procedures are expanding the use of large bore microcatheters, of up to 0.033” inner diameters, to accommodate intrasaccular flow disruptors or neck-bridging devices, including flow diverters. The use of large bore microwires may mitigate the ledge gap between wire and catheter, facilitate navigation and offer support in distal tortuous anatomy. We aim to report our early experience using the novel Aristotle (Scientia Vascular, West Valley City, UT) 18 and 24 microwires in neurovascular interventions.

Methods

We analysed neurointerventional procedures in which the Aristotle 18 and 24 microwires were used at a single centre. Prospectively collected data, from March 2022 to February 2023, including patient's clinical outcome (successful target vessel, aneurysm catheterisation, peri-procedural complications (thromboembolic, haemorrhagic, vessel dissection or perforation) were analysed.

Results

Overall, the use of Aristotle 18 and 24 microwires was recorded in 84 neurointerventional procedures during the study period, including endovascular aneurysm treatment (n = 30), endovascular thrombectomy (n = 46), dural venous sinus manometry/stent placement (n = 7), and extracranial carotid artery stent placement (n = 1). The Aristotle 18 microwire was used in conjunction with 0.021” microcatheters and the Aristotle 24 microwire with the 0.027 or 0.033” microcatheters. In all cases (100%), the target vessel or aneurysm was reached with the microwire, allowing seamless advancement of the selected microcatheters. No procedure related complications were recorded.

Conclusions

The use of the Aristotle 18 and 24 microwires in neurointerventional procedures is feasible and safe. The microwires provide reduced ledge gap, improved torquability, support and safety over standard 0.014” microwires.
Queer Connections and Fostering Inclusion: Reflections on Qualitative Focus Group Design
Authors: Betts David , Herb Annika
Published: October 2023

Qualitative social science research has an obligation to resist replicating or reinforcing social harms. This paper explores how researchers can adopt strategies to develop inclusive, safe, and reflexive research spaces with queer participants. Reflecting on a research study that explored the impact of queer representation in young adult literature on young readers, the paper explores the concepts of building queer connections and fostering inclusion as methods to support qualitative research design. Through this reflexive process, it has been found that intentionally using strategies to establish queer connections between participants and promoting inclusion through empathetic listening can significantly enhance participant experiences, primarily in terms of safety, support, and openness to vulnerability. These deliberate strategies also play a crucial role in reinforcing participant engagement and retention. Further, these findings indicate that these methods have additional benefits for research that transitions from face-to-face methods to online and digital formats. We argue that qualitative social science researchers who work with the queer community have an obligation to create inclusive and safe spaces for participants – not only to resist replicating stigmatising social structures, but to move beyond a pedagogy of pathologization in queer research.
Comparing In-Person and Online Modalities for Photo Elicitation Interviews Among a Vulnerable Population: Recruitment, Retention, and Data Collection Applications
Authors: Marshall Allison N. , Walton Quenette L. , Eigege Chinyere Y. , Daundasekara Sajeevika S. , Hernandez Daphne C.
Published: October 2023

The purpose of the current study was to use Orsmond and Cohn’s feasibility framework to compare two methods of collecting photo elicitation interviews: (1) in-person and (2) online among low-income community college students. We described the feasibility of the recruitment and retention procedures and compared the participants’ characteristics and the type of data obtained by data collection modality. Focus group participants ( n = 34) were invited to participate in photo elicitation interviews regarding barriers to food access and associated material hardships. Prior to the pandemic, photo elicitation interviews were conducted in-person. Due to pandemic-related stay-at-home policies, photo elicitation interviews shifted to a video conferencing platform. Descriptive and bivariate analyses were used to compare the two data collection methods in terms of sample characteristics, the average length of each interview, and the number and type of photos submitted. Of 34 recruited participants, 28 participated in photo elicitation interviews (82.4% response rate; n = 13 in-person; n = 15 online) with a mean age of 39.75 years (range: 19–62). No significant differences were found in socio-demographic characteristics between interview modality groups. In both online and in-person photo elicitation groups, participants were more likely to be female, non-Hispanic Black, single, and unemployed. Overall, both modalities were found to be feasible to recruit and retain participants and collect data from low-income, community college students. We found similar data in terms of photographs, and similar codes and themes were generated from the interview data across both modalities. Using both modalities provided an opportunity to promote equity in research through inclusion of hard-to-reach populations who may experience barriers to participation such as transportation or childcare. This study can inform recruitment and retention efforts for quantitative and qualitative research, and data collection efforts for photo elicitation interviews. The lessons learned are critical to generating rich data and advancing research conducted among vulnerable populations.
A Stimulus Set of 40 Popular Music Drum Patterns with Perceived Complexity Measures
Authors: Senn Olivier , Hoesl Florian , Jerjen Rafael , Bechtold Toni Amadeus , Kilchenmann Lorenz , Rose Dawn , Alessandri Elena
Published: October 2023

This study presents an audio stimulus set of 40 drum patterns from Western popular music with empirical measurements of perceived complexity. The audio stimuli are meticulous reconstructions of drum patterns found in commercial recordings; they are based on careful transcriptions (carried out by professional musicians), drum stroke loudness information, and highly precise onset timing measurements. The 40 stimuli are a subset selected from a previously published larger corpus of reconstructed Western popular music drum patterns (Lucerne Groove Research Library). The patterns were selected according to two criteria: a) they only feature the bass drum, snare drum, and one or more cymbals, and b) they plausibly cover the complexity range of the corpus. Perceived stimulus complexity was measured in a listening experiment using a pairwise comparison design with 220 participants (4,400 trials). In each trial, participants were presented with two stimuli, and they stated which of the two sounded more complex to them. The comparison data then served to calculate complexity estimates using the Bradley–Terry probability model. The complexity estimates have an intuitive interpretation: they allow calculation of the probability that one pattern is considered more complex than another pattern in a pairwise comparison. To our knowledge, this is the first set of naturalistic music stimuli with meaningful perceived complexity estimates. The drum pattern stimuli and complexity measurements can be used for listening experiments in music psychology. The stimuli will further allow measures and models of drum pattern complexity to be assessed.
Acceptance Toward Coursera MOOCs Blended Learning: A Mixed Methods View of Vietnamese Higher Education Stakeholders
Authors: Ho Nguyen Thi Thao , Abdullah Muhammad Ridhuan Tony Lim , Idrus Hairuzila Bt , Sivapalan Subarna , Pham Hiep-Hung , Dinh Viet-Hung , Pham Huyen Khanh , Nguyen Linh Thi My
Published: October 2023

This triangulation mixed methods study employed the Technology Acceptance Model (TAM) to investigate the factors affecting continuance intention toward Coursera MOOCs blended learning (CMBL) with undergraduate students at a Vietnamese private higher education institution (HEI). IBM AMOS version 24 was employed, with which Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM) were used to examine the reliability and validity of the data collected from 637 students. Manual coding and thematic analysis of qualitative data collected from 30 interviewees, namely administrators, lecturers, curriculum developers, and students, were also conducted to identify the emerged themes and sub-themes. Content feature, social influence, and perceived usefulness were critical factors influencing the HEI students’ continuance intention to use CMBL. This study makes two significant contributions. First, we contribute to the literature from a theoretical standpoint by comparing factors influencing students’ acceptance of CMBL from critical stakeholders in a higher education institution. Second, our findings have practical implications on increasing undergraduate students’ acceptance of blended learning using MOOCs for the long term, which could provide beneficial pointers for HEIs planning to integrate MOOCs for teaching and learning within the higher education context.
Measuring Child Labor in Oil Palm Production in Sabah, Malaysia
Authors: Wahab Andika , Dollah Ramli
Published: October 2023

Can we measure child labor? It may sound simple and a classic question to ask, but scholarly discourse continues to raise doubts about how best to measure it accurately, at what level of measurement, and how to differentiate between child labor and a range of almost similar terms such as children assisting parents and working children. In this article, as part of our long-term research project in oil palm production in Sabah (Malaysia), we attempt to measure child labor focusing on four domains, (i) children’s involvement in oil palm activities; (ii) time spent in performing such activities; (iii) types of activities; and (iv) time spent on the learning and undertaking recreational activities. To better understand their involvement in oil palm activities, further analysis is undertaken from four social lenses: gender, age, identity, and education. Our overall findings indicate that while there is a clear conceptual difference and practice between children assisting parents and working children, it is challenging to distinguish between working children and child labor. Instead, most of our child respondents categorized as working children fall within the broader definition of child labor. Given the complex interplay between local contexts and root causes that create conditions of child labor, this article highlights the urgency to refresh scholarly discourse and the way we understand and measure child labor.
Balancing the Use of Behavioural Research and Design Science Research to Solve the Relevance Problem in Marketing Research
Authors: Halstrick Benedikt
Published: October 2023

Contemporary marketing research has a value problem. Claims for the managerial impact of research appear in practically every research article. Nevertheless, managers in the field do not consider scientific outputs as relevant in helping them to address the multiple challenges that organizations face. Marketing typically conducts behavioural research, aiming to understand and explain real-world problems. Other disciplines, such as engineering, focus primarily on building solutions to solve practical problems. Such practice is often termed design science. This study proposes that marketing research should focus more on building solutions, hence calling for a better balance between behavioural and design research. An improved balance between these two paradigms in marketing should increase the value of academic research to practice. Four typical case studies are presented to illustrate key differences between design science and behavioural science.
Surgical Management of Chronic Achilles Tendon Ruptures: A Systematic Review and Proposed Treatment Algorithm
Authors: Azam Mohammad T. , Butler James J. , Weiss Matthew. B. , Ubillus Hugo A. , Kirschner Noah , Mercer Nathaniel P. , Kennedy John G.
Published: October 2023

Background:

As no evidence-based treatment guidelines exist for chronic Achilles tendon rupture (CATR), a systematic review of the literature was performed to compare the different treatment options and recommend a literature-based algorithm.

Methods:

In June 2022, MEDLINE, Embase, and Cochrane Library databases were systematically reviewed based on the PRISMA guidelines. The level of evidence (LOE) and quality of evidence were evaluated, and statistics on clinical outcomes and complications were calculated.

Results:

Twenty-seven studies with 614 patients were included. Three studies were LOE III and 25 studies were LOE IV. The mean Achilles tendon rupture score improved from a preoperative weighted mean of 38.8 ± 12.4 to a postoperative score 90.6 ± 4.7. The overall complication rate was 11.4%. Single techniques were used in 23 studies and dual techniques were used in 5 studies. The FHL tendon transfer was the most frequently used technique. We devised an algorithmic approach based on time from injury to surgical intervention and the length of the gap between the tendon stumps: >3 months: FHL transfer; <3 months (a) gap <2 cm, end-to-end repair; (b) gap 2 to 5 cm, gastrocnemius transfer, (c) gap >5 cm, semitendinosus autograft.

Conclusion:

Surgical management of CATR produced improvements in patient-reported outcome scores at midterm follow up, but a high complication rate (11.4%) was noted. Our proposed treatment algorithm may assist in shared decision making for this complex problem.
Unveiling Resilience to Alzheimer’s Disease: Insights From Brain Regional Proteomic Markers
Authors: Huang Zhi , Merrihew Gennifer E , Larson Eric B , Park Jea , Plubell Deanna , Fox Edward J , Montine Kathleen S , Keene C Dirk , Latimer Caitlin S , Zou James Y , MacCoss Michael J , Montine Thomas J
Published: October 2023

Studying proteomics data of the human brain could offer numerous insights into unraveling the signature of resilience to Alzheimer’s disease. In our previous study with rigorous cohort selection criteria that excluded 4 common comorbidities, we harnessed multiple brain regions from 43 research participants with 12 of them displaying cognitive resilience to Alzheimer’s disease. Based on the previous findings, this work focuses on 6 proteins out of the 33 differentially expressed proteins associated with resilience to Alzheimer’s disease. These proteins are used to construct a decision tree classifier, enabling the differentiation of 3 groups: (i) healthy control, (ii) resilience to Alzheimer’s disease, and (iii) Alzheimer’s disease with dementia. Our analysis unveiled 2 important regional proteomic markers: Aβ peptides in the hippocampus and PA1B3 in the inferior parietal lobule. These findings underscore the potential of using distinct regional proteomic markers as signatures in characterizing the resilience to Alzheimer’s disease.
What’s love got to do with it? A systemic view of agape
Authors: Sheehan Jim , Vetere Arlene
Published: October 2023

In this article, we explore what love feels like in systemic therapy, for us, as practitioners. The idea for writing this article as a personal set of reflections was born in our walking to work relationship. We both have the same part time visiting position in a systemic training programme in a Norwegian University. We leave our hotel at 8a.m. to walk up the hill, talking about training, supervision and therapy as we go along. Increasingly our attention turned to the experience of love in therapy – to what it looked like, to what it felt like, to what it meant, and to the inevitable challenges, risks and benefits of naming love in the therapy process. We soon discovered there was a relative silence on this topic in the systemic literature, and we wondered why. We open this article with a series of further reflections and questions to each other, following our first publication on therapeutic love as agape (Sheehan and Vetere, 2023). We identify agape as the best characterisation of the kind of love emergent in therapeutic relationships and conclude this article with a brief look at the existing systemic literature on the topic. In turn, we invite you, the reader, if you will, to respond.
How to stay with the trouble: Spartina invasion and management in the tidal flats of the Yellow Sea
Authors: Choi Young Rae
Published: October 2023

Spartina is known as a globally invasive coastal plant, which has recently emerged as a troublesome intruder in the Yellow Sea. By grabbing sediment, surviving in harsh conditions of changing salinity, and eventually turning tidal flats into salt marshes, Spartina in China and South Korea is imagined to be a “tidal flat killer,” which must be eradicated promptly and completely. Yet, in what sense does it kill and, in turn, become killable? Also, is eradication the best management strategy to control Spartina and, ultimately, to protect tidal flats? This paper interrogates these questions by thinking through the notion of “staying with the trouble,” which I interpret as a provocative call for a situated multispecies ethic. Rather than taking its invasive status for granted, I examine the situated contexts in which Spartina became a trouble plant and, moreover, criminalized as the destroyer of tidal flats, a nature that has received multiple international conservation recognitions over recent years. Rather than its destructive effects, I also attend to the productive effects of Spartina in terms of producing new knowledges about coastal ecologies and imagining the Yellow Sea as one transnational ecological entity. Based on these findings, I argue that the policy focus on elimination reduces the complex coastal dynamics endangering tidal flats into a matter of Spartina management although accepting the plant as a resident is complicated. The case of Spartina in the Yellow Sea exemplifies the value of a willingness to stay with the trouble, while also illustrating its dilemma.
Reconfigurable frequency multipliers based on graphene field-effect transistors
Authors: Toral-Lopez A. , Marin E. G. , Pasadas F. , Ganeriwala M. D. , Ruiz F. G. , Jiménez D. , Godoy A.
Published: October 2023

Run-time device-level reconfigurability has the potential to boost the performance and functionality of numerous circuits beyond the limits imposed by the integration density. The key ingredient for the implementation of reconfigurable electronics lies in ambipolarity, which is easily accessible in a substantial number of two-dimensional materials, either by contact engineering or architecture device-level design. In this work, we showcase graphene as an optimal solution to implement high-frequency reconfigurable electronics. We propose and analyze a split-gate graphene field-effect transistor, demonstrating its capability to perform as a dynamically tunable frequency multiplier. The study is based on a physically based numerical simulator validated and tested against experiments. The proposed architecture is evaluated in terms of its performance as a tunable frequency multiplier, able to switch between doubler, tripler or quadrupler operation modes. Different material and device parameters are analyzed, and their impact is assessed in terms of the reconfigurable graphene frequency multiplier performance.
CurvAGN: Curvature-based Adaptive Graph Neural Networks for Predicting Protein-Ligand Binding Affinity
Authors: Wu Jianqiu , Chen Hongyang , Cheng Minhao , Xiong Haoyi
Published: October 2023

Accurately predicting the binding affinity between proteins and ligands is crucial for drug discovery. Recent advances in graph neural networks (GNNs) have made significant progress in learning representations of protein-ligand complexes to estimate binding affinities. To improve the performance of GNNs, there frequently needs to look into protein-ligand complexes from geometric perspectives. While the “off-the-shelf” GNNs could incorporate some basic geometric structures of molecules, such as distances and angles, through modeling the complexes as homophilic graphs, these solutions seldom take into account the higher-level geometric attributes like curvatures and homology, and also heterophilic interactions.To address these limitations, we introduce the Curvature-based Adaptive Graph Neural Network (CurvAGN). This GNN comprises two components: a curvature block and an adaptive attention guided neural block (AGN). The curvature block encodes multiscale curvature informaton, then the AGN, based on an adaptive graph attention mechanism, incorporates geometry structure including angle, distance, and multiscale curvature, long-range molecular interactions, and heterophily of the graph into the protein-ligand complex representation. We demonstrate the superiority of our proposed model through experiments conducted on the PDBbind-V2016 core dataset.
Functional analysis of differentially expressed circular RNAs in sheep subcutaneous fat
Authors: Liu Tian-yi , Feng Hui , Yousuf Salsabeel , Xie Ling-li , Miao Xiang-yang
Published: October 2023

Background

Circular RNAs (circRNAs), as important non-coding RNAs (ncRNAs), are involved in many biological activities. However, the exact chemical mechanism behind fat accumulation is unknown. In this paper, we obtained the expression profiles of circRNAs using high-throughput sequencing and investigated their differential expression in subcutaneous fat tissue of Duolang and Small Tail Han sheep.

Results

From the transcriptomic analysis, 141 differentially expressed circRNAs were identified, comprising 61 up-regulated circRNAs and 80 down-regulated circRNAs. These host genes were primarily enriched in the MAPK and AMPK signaling pathways which is closely associated with fat deposition regulation. We identified circRNA812, circRNA91, and circRNA388 as vital genes in fat deposition by miRNA-circRNA target gene prediction. The functional annotation results of target genes of key circRNAs showed that the signaling pathways mainly included PI3K-Akt and AMPK. We constructed the competing endogenous RNA (ceRNA) regulatory network to study the role of circRNAs in sheep lipid deposition, and circRNA812, circRNA91, and circRNA388 can adsorb more miRNAs. NC_040253.1_5757, as the source of miRNA response element (MRE) among the three, may play an important role during the process of sheep fat deposition.

Conclusions

Our study gives a systematic examination of the circRNA profiles expressed in sheep subcutaneous fat. These results from this study provide some new basis for understanding circRNA function and sheep fat metabolism.
Unregulated medication use and complications: a case study of prolonged self-treated tuberculosis in Nepal
Authors: Achhami Eliz , Lamichhane Seshkanta , Mahaju Satyam , Kandel Ashim , Poudel Anubhav , KC Rabina
Published: October 2023

Background

Tuberculosis (TB) is a global public health issue, particularly in resource-constrained countries like Nepal. This case report highlights the consequences of prolonged self-treatment and non-compliance with TB management protocols, emphasizing the need for increased awareness and intervention.

Case Presentation

A 50-year-old male from Nepal self-medicated with anti-tubercular drugs for 13 years after completing the recommended course of treatment. He experienced worsening symptoms, including respiratory distress and visual impairment. Upon evaluation, he was diagnosed with chronic cavitary pulmonary aspergillosis. The patient received comprehensive treatment, including antifungal therapy, steroids, antibiotics, and respiratory support, resulting in significant improvement.

Conclusions

This case highlights the dangers of self-treatment and non-compliance with TB management protocols. It emphasizes the importance of patient education, awareness programs, and regular follow-up to ensure treatment adherence and detect complications. The case also reveals gaps in the DOTS (Directly Observed Treatment, Short Course) program, including the need for improved surveillance, and a multidisciplinary approach. The ease of over-the-counter purchase of anti-tubercular drugs in Nepal contributed to the patient’s prolonged self-medication, highlighting a concerning. The complications arising from prolonged self-medication underscore the need for increased awareness, intervention, and patient education in TB management. Improving patient education, raising awareness about the risks of self-medication, and integrating ophthalmologic evaluations into standard management are essential for better TB control in Nepal.
Application of metagenomics for diagnosis of broilers displaying neurological symptoms
Authors: Kim Hyeon-Su , Kim Si-Hyeon , Song Hye-Soon , Kwon Yong-Kuk , Park Choi-Kyu , Kim Hye-Ryoung
Published: October 2023

Background

Thirty-two-day-old broiler chickens at a farm located in northwestern South Korea displayed adverse neurological symptoms including limping, lying down, and head shaking. Approximately 2.1% of chickens died or were culled due to severe symptoms. Five carcasses were submitted to the Avian Disease Division of the Animal and Plant Quarantine Agency (APQA) for disease diagnosis.

Results

Broilers displayed severe pericarditis and perihepatitis associated with gross lesions. Broilers also displayed microscopic lesions in the cerebrum and in the granular layer of the cerebellum, which were associated with multifocal perivascular cuffing and purulent necrosis in the cerebrum, and severe meningitis with heterophil and lymphocyte infiltration. Staphylococcus spp. were identified in the liver and heart using bacteriological culture. PCR/RT-PCR assays revealed that broilers were negative for avian Clostridium botulinum, Newcastle disease virus, and avian encephalomyelitis virus. Bacterial and viral metagenomic analysis of brain sample further revealed the presence of Pseudomonas spp. and Marek’s disease virus, which are known etiological agents of chicken meningoencephalitis.

Conclusions

This study reports a diagnostic analysis of gross and histopathological lesions from 32-day-old broilers displaying unique neurological symptoms that revealed the presence of the several neurological diseases including meningoencephalitis. The causative agents associated with meningoencephalitis of broilers that had not been identified by routine diagnostic methods could be diagnosed by metagenomics, which proves the usefulness of metagenomics as a diagnostic tool for unknown neurological diseases in broilers.
A critical review on experimental Streptococcus suis infection in pigs with a focus on clinical monitoring and refinement strategies
Authors: Liedel Carolin , Rieckmann Karoline , Baums Christoph G.
Published: October 2023

Streptococcus suis (S. suis) is a major pig pathogen worldwide with zoonotic potential. Though different research groups have contributed to a better understanding of the pathogenesis of S. suis infections in recent years, there are still numerous neglected research topics requiring animal infection trials. Of note, animal experiments are crucial to develop a cross-protective vaccine which is highly needed in the field. Due to the severe clinical signs associated with S. suis pathologies such as meningitis and arthritis, implementation of refinement is very important to reduce pain and distress of experimentally infected pigs. This review highlights the great diversity of clinical signs and courses of disease after experimental S. suis pig infections. We review clinical read out parameters and refinement strategies in experimental S. suis pig infections published between 2000 and 2021. Currently, substantial differences exist in describing clinical monitoring and humane endpoints. Most of the reviewed studies set the body temperature threshold of fever as high as 40.5°C. Monitoring intervals vary mainly between daily, twice a day and three times a day. Only a few studies apply scoring systems. Published scoring systems are inconsistent in their inclusion of parameters such as body temperature, feeding behavior, and respiratory signs. Locomotion and central nervous system signs are more common clinical scoring parameters in different studies by various research groups. As the heterogenicity in clinical monitoring limits the comparability between studies we hope to initiate a discussion with this review leading to an agreement on clinical read out parameters and monitoring intervals among S. suis research groups.
Shaping global vaccine acceptance with localized knowledge: a report from the inaugural VARN2022 conference
Authors: Underwood Talya , Hopkins Kathryn L. , Sommers Theresa , Howell Cassidy , Boehman Nicholas , Dockery Meredith , Dubé Ève , Dhaliwal Baldeep K. , Kazi Abdul M. , Limaye Rupali , Qasim Rubina , Seale Holly , Kitutu Freddy Eric , Kanwagi Robert , Knobler Stacey
Published: October 2023

The first conference of the Vaccination Acceptance Research Network, VARN2022: Shaping Global Vaccine Acceptance with Localized Knowledge, was held virtually, from March 1st to 3rd 2022. This inaugural event brought together a global representation of experts to discuss key priorities and opportunities emerging across the ecosystem of vaccine acceptance and demand, from policies to programs and practice. Convened by the Sabin Vaccine Institute, VARN aims to support dialogue among multidisciplinary stakeholders to enhance the uptake of social and behavioral science-based solutions for vaccination decision-makers and implementers. The conference centered around four key themes: 1) Understanding vaccine acceptance and its drivers; 2) One size does not fit all: community- and context-specific approaches to increase vaccine acceptance and demand; 3) Fighting the infodemic and harnessing social media for good; and 4) Frameworks, data integrity and evaluation of best practices. Across the conference, presenters and participants considered the drivers of and strategies to increase vaccine acceptance and demand relating to COVID-19 vaccination and other vaccines across the life-course and across low-, middle- and high-income settings. VARN2022 provided a wealth of evidence from around the world, highlighting the need for human-centered, multi-sectoral and transdisciplinary approaches to improve vaccine acceptance and demand. This report summarizes insights from the diverse presentations and discussions held at VARN2022, which will form a roadmap for future research, policy making, and interventions to improve vaccine acceptance and demand globally.
Comprehensive analysis of BTNL9 as a prognostic biomarker correlated with immune infiltrations in thyroid cancer
Authors: Zhang Luyao , Yu Shuang , Hong Shubin , Xiao Xi , Liao Zhihong , Li Yanbing , Xiao Haipeng
Published: October 2023

Background

Thyroid cancer (THCA) is the most common type of endocrine cancers, and the disease recurrences were usually associated with the risks of metastasis and fatality. Butyrophilin-like protein 9 (BTNL9) is a member of the immunoglobulin families. This study investigated the prognostic role of BTNL9 in THCA.

Methods

Gene enhancers ofBTNL9were identified by interrogating H3K27ac ChIP-seq and RNA-seq data of papillary thyroid cancer (PTC) and benign thyroid nodule (BTN) tissues. Meanwhile,BTNL9expression level was verified by qRT-PCR in 30 pairs of primary THCA and adjacent normal tissues. Clinicopathological and RNA sequencing data were obtained from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) to analyze the relations betweenBTNL9expression and immune cell infiltration, chemokines/cytokines, immune checkpoint genes, clinical parameters and prognosis values. Besides, survival analysis combiningBTNL9expression and immune cell infiltration scores was conducted. Functional enrichment analysis was performed to investigate the potential biological mechanisms. Cox regression analyses were used to explore independent clinical indicators, and a nomogram model incorporatingBTNL9expression with clinical parameters was established.

Results

BTNL9showed significantly stronger H3K27ac modifications in BTN than PTC tissues at the promoter region (chr5: 181,035,673–181,047,436) and gene body (chr5: 181,051,544–181,054,849). The expression levels ofBTNL9were significantly down-regulated in THCA samples compared to normal tissues, and were strongly associated with different tumor stages, immune cell infiltrations, chemokines/cytokines and immune checkpoint genes in THCA. Functional enrichment analyses indicated that BTNL9 was involved in immune-related and cancer-related pathways. The Kaplan–Meier analysis showed lowerBTNL9expression was associated with poorer progression-free interval (PFI).BTNL9expression and pathologic stages were independent prognostic indicators of PFI in THCA.

Conclusions

The results implied an important role of BTNL9 in the tumor progression, with the possibility of serving as a novel prognostic biomarker and a potential therapeutic target for THCA.
Clinical utilization of artificial intelligence-based COVID-19 pneumonia quantification using chest computed tomography – a multicenter retrospective cohort study in Japan
Authors: Tanaka Hiromu , Maetani Tomoki , Chubachi Shotaro , Tanabe Naoya , Shiraishi Yusuke , Asakura Takanori , Namkoong Ho , Shimada Takashi , Azekawa Shuhei , Otake Shiro , Nakagawara Kensuke , Fukushima Takahiro , Watase Mayuko , Terai Hideki , Sasaki Mamoru , Ueda Soichiro , Kato Yukari , Harada Norihiro , Suzuki Shoji , Yoshida Shuichi , Tateno Hiroki , Yamada Yoshitake , Jinzaki Masahiro , Hirai Toyohiro , Okada Yukinori , Koike Ryuji , Ishii Makoto , Hasegawa Naoki , Kimura Akinori , Imoto Seiya , Miyano Satoru , Ogawa Seishi , Kanai Takanori , Fukunaga Koichi
Published: October 2023

Background

Computed tomography (CT) imaging and artificial intelligence (AI)-based analyses have aided in the diagnosis and prediction of the severity of COVID-19. However, the potential of AI-based CT quantification of pneumonia in assessing patients with COVID-19 has not yet been fully explored. This study aimed to investigate the potential of AI-based CT quantification of COVID-19 pneumonia to predict the critical outcomes and clinical characteristics of patients with residual lung lesions.

Methods

This retrospective cohort study included 1,200 hospitalized patients with COVID-19 from four hospitals. The incidence of critical outcomes (requiring the support of high-flow oxygen or invasive mechanical ventilation or death) and complications during hospitalization (bacterial infection, renal failure, heart failure, thromboembolism, and liver dysfunction) was compared between the groups of pneumonia with high/low-percentage lung lesions, based on AI-based CT quantification. Additionally, 198 patients underwent CT scans 3 months after admission to analyze prognostic factors for residual lung lesions.

Results

The pneumonia group with a high percentage of lung lesions (N = 400) had a higher incidence of critical outcomes and complications during hospitalization than the low percentage group (N = 800). Multivariable analysis demonstrated that AI-based CT quantification of pneumonia was independently associated with critical outcomes (adjusted odds ratio [aOR] 10.5, 95% confidence interval [CI] 5.59–19.7), as well as with oxygen requirement (aOR 6.35, 95% CI 4.60–8.76), IMV requirement (aOR 7.73, 95% CI 2.52–23.7), and mortality rate (aOR 6.46, 95% CI 1.87–22.3). Among patients with follow-up CT scans (N = 198), the multivariable analysis revealed that the pneumonia group with a high percentage of lung lesions on admission (aOR 4.74, 95% CI 2.36–9.52), older age (aOR 2.53, 95% CI 1.16–5.51), female sex (aOR 2.41, 95% CI 1.13–5.11), and medical history of hypertension (aOR 2.22, 95% CI 1.09–4.50) independently predicted persistent residual lung lesions.

Conclusions

AI-based CT quantification of pneumonia provides valuable information beyond qualitative evaluation by physicians, enabling the prediction of critical outcomes and residual lung lesions in patients with COVID-19.
3D in vitro hydrogel models to study the human lung extracellular matrix and fibroblast function
Authors: Phogat Sakshi , Thiam Fama , Al Yazeedi Safiya , Abokor Filsan Ahmed , Osei Emmanuel Twumasi
Published: October 2023

The pulmonary extracellular matrix (ECM) is a macromolecular structure that provides mechanical support, stability and elastic recoil for different pulmonary cells including the lung fibroblasts. The ECM plays an important role in lung development, remodeling, repair, and the maintenance of tissue homeostasis. Biomechanical and biochemical signals produced by the ECM regulate the phenotype and function of various cells including fibroblasts in the lungs. Fibroblasts are important lung structural cells responsible for the production and repair of different ECM proteins (e.g., collagen and fibronectin). During lung injury and in chronic lung diseases such as asthma, idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD), an abnormal feedback between fibroblasts and the altered ECM disrupts tissue homeostasis and leads to a vicious cycle of fibrotic changes resulting in tissue remodeling. In line with this, using 3D hydrogel culture models with embedded lung fibroblasts have enabled the assessment of the various mechanisms involved in driving defective (fibrotic) fibroblast function in the lung’s 3D ECM environment. In this review, we provide a summary of various studies that used these 3D hydrogel models to assess the regulation of the ECM on lung fibroblast phenotype and function in altered lung ECM homeostasis in health and in chronic respiratory disease.
Multivariate multiscale entropy (mMSE) as a tool for understanding the resting-state EEG signal dynamics: the spatial distribution and sex/gender-related differences
Authors: Lewandowska Monika , Tołpa Krzysztof , Rogala Jacek , Piotrowski Tomasz , Dreszer Joanna
Published: October 2023

Background

The study aimed to determine how the resting-state EEG (rsEEG) complexity changes both over time and space (channels). The complexity of rsEEG and its sex/gender differences were examined using the multivariate Multiscale Entropy (mMSE) in 95 healthy adults. Following the probability maps (Giacometti et al. in J Neurosci Methods 229:84–96, 2014), channel sets have been identified that correspond to the functional networks. For each channel set the area under curve (AUC), which represents the total complexity, MaxSlope—the maximum complexity change of the EEG signal at thefine scales (1:4 timescales), and AvgEnt—to the average entropy level at coarse-grained scales (9:12 timescales), respectively, were extracted. To check dynamic changes between the entropy level at the fine and coarse-grained scales, the difference in mMSE between the #9 and #4 timescale (DiffEnt) was also calculated.

Results

We found the highest AUC for the channel sets corresponding to the somatomotor (SMN), dorsolateral network (DAN) and default mode (DMN) whereas the visual network (VN), limbic (LN), and frontoparietal (FPN) network showed the lowest AUC. The largest MaxSlope were in the SMN, DMN, ventral attention network (VAN), LN and FPN, and the smallest in the VN. The SMN and DAN were characterized by the highest and the LN, FPN, and VN by the lowest AvgEnt. The most stable entropy were for the DAN and VN while the LN showed the greatest drop of entropy at the coarse scales. Women, compared to men, showed higher MaxSlope and DiffEnt but lower AvgEnt in all channel sets.

Conclusions

Novel results of the present study are: (1) an identification of the mMSE features that capture entropy at the fine and coarse timescales in the channel sets corresponding to the main resting-state networks; (2) the sex/gender differences in these features.
Minimally invasive tubular microdiscectomy for recurrent lumbar disc herniation: step-by-step technical description with safe scar dissection
Authors: AlAli Khaled Fares
Published: October 2023

Introduction

Recurrent lumbar disc herniation (RLDH) is one of the most common reasons for re-operation after primary lumbar disc herniation with an incidence ranging from 5 to 23%. Numerous RLDH studies have been conducted; however, no available studies have provided a specific description of the use of the tubular retractor discectomy technique for RLDH emphasizing safe scar dissection. The objective of this study is to describe a detailed step-by-step technique for RLDH.

Material and methods

A surgical technique reporting on our experience from the year 2013–2021 in 9 patients with RLDH at the same level and same side was included in the study. Clinical outcomes were assessed using the visual analog score (VAS) for leg pain before and three months after surgery.

Results

A significant improvement was observed between the preoperative and postoperative VASs [mean (SD): 9.2 (1) vs. 1.5 (1)] for all patients. We did not report any incidental durotomy, neurological deficits or mortality in this study. One patient had superficial wound infection. The study is limited by small population, short follow-up and not reporting stability or spondylolisthesis.

Conclusion

A modified tubular discectomy technique with safe scar dissection is effective for RLDH treatment. Technically, the only scar needed to be dissected is the scar lateral to the exposed normal dura and the scar extended caudally till the level of the superior end plate of the targeted disc space where the scar can be entered ventrally and the disc fragment retrieved. Adherence to the step-by-step procedure described in our study will help surgeons operate with more confidence and minimize complications of recurrent lumbar disc herniation.
The effect and mechanism of iodophors on the adhesion and virulence of Staphylococcus aureus biofilms attached to artificial joint materials
Authors: Chen Sihui , Jiang Yi , Wang Wei , Chen Junjie , Zhu Jinyu
Published: October 2023

Background

Iodophors are known to be a treatment for biofilm-related periprosthetic joint infection. However, the efficacy and mechanism of eradicating biofilms from different artificial joint materials after iodophor treatment are unknown. This study was conducted to understand the effect and mechanism of iodophors with respect to the adhesion and virulence of Staphylococcus aureus biofilms attached to artificial joint materials.

Methods

Biofilms of Staphylococcus aureus strains were grown on titanium alloy, cobalt chromium molybdenum and polyethylene coupons, which are commonly used materials for artificial joints, for 24 h. Afterward, all coupons were divided into experimental and control groups: (1) exposed to a 0.5 ± 0.05% iodophor for 5 min and (2) exposed to phosphate-buffered saline for 5 min. To gauge the level of biofilm, colony forming units (CFU), live/dead staining confocal microscopy and crystal violet staining were used. Meanwhile, the expression of icaACDR and clfA, which are related to virulence and adhesion, was examined in both the experimental and control groups.

Results

A roughly three-log decrease in CFU/cm2 was seen in the viable plate count compared to the control group. Confocal imaging and crystal violet staining verified the CFU data. Moreover, the expression of icaACDR was reduced on three different orthopaedic implant materials, and the expression of clfA was also inhibited on titanium alloy coupons exposed to the iodophor.

Conclusions

Our results indicated that exposure to an iodophor for 5 min could significantly eliminate biofilms. When Staphylococcus aureus that had adhered to these three materials, which were used for artificial joints, was treated with an iodophor for 5 min, the expression of icaACDR was significantly reduced. This provides strong evidence for clinically clearing periprosthetic joint infections without removing the artificial joints.
Dermatophyte resistance – on the rise
Authors: Bristow Ivan R. , Joshi Lovleen Tina
Published: October 2023

Dermatophytes are group of filamentous fungi which have adapted to living on the skin of humans and other animals. In the last decade, reports have emerged from Asia of new dermatophyte strains showing resistance to the commonly used antifungal agent terbinafine and others. The spread of these resistant strains has been noted in many other countries globally. Little is known about the mechanisms or management of this emerging problem. Urgent research and changes to current practice are required if the spread of the infection is to be contained and managed effectively.
The (cost) effectiveness of a very low-energy diet intervention with the use of eHealth in patients with type 2 diabetes and obesity: study protocol for a randomised controlled non-inferiority trial (E-diet trial)
Authors: Geurts Karlijn A. M. , Ozcan Behiye , van Hoek Mandy , van de Laar Roel , van Teeffelen Jolande , van Rosmalen Joost , van Rossum Elisabeth F. C. , Berk Kirsten A.
Published: October 2023

Background

Despite preventive measures, the number of people with type 2 diabetes and obesity is increasing. Obesity increases morbidity and mortality in people with type 2 diabetes, making weight loss a cornerstone of treatment. We previously developed a very low energy diet (VLED) intervention that effectively reduced weight in people with type 2 diabetes in the long term. However, this intervention requires considerable time and manpower, which reduces the number of people who can benefit from it. eHealth offers more efficient solutions but has proven to be less effective than face-to-face interventions. Therefore, we want to investigate whether a blended version of our VLED intervention (in which face-to-face contact is partly replaced by an eHealth (mobile) application (E-VLED)) would be more cost-effective than the current face-to-face intervention.

Methods

We will conduct a randomised, controlled trial with non-inferiority design in patients with type 2 diabetes and obesity (BMI > 30 kg/m2), aged 18–75 years. The control group will receive the usual care VLED intervention, while the intervention group will receive the E-VLED intervention for 1 year, where face-to-face contact will be partly replaced by an eHealth (mobile) application. The main study endpoint is the difference in weight (% change) between the control and intervention group after 1 year, plus the difference between the total costs (euro) of the treatment in the control and intervention groups. The secondary aims are to investigate the effectiveness of the E-VLED diet intervention regarding cardiovascular risk factors, quality of life, patient satisfaction, compliance, and to study whether there is a difference in effectiveness in pre-specified subgroups. General linear models for repeated measurements will be applied for the statistical analysis of the data.

Discussion

We hypothesise that the E-VLED intervention will be equally effective compared to the usual care VLED but lower in costs due to less time invested by the dietician. This will enable to help more people with type 2 diabetes and obesity to effectively lose weight and improve their health-related quality of life.

Trial registration

Netherlands Trial Register, NL7832, registered on 26 June 2019.