bluuebunny/crossref_metadata_2025 huggingface dataset:
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and Human Immunodeficiency virus infection: dilemmas in diagnosis and management: a case series
Authors: Gadama Yohane , Du Preez Marié , Carr Jonathan , Theron Sarel , Albertyn Christine , Ssebambulidde Kenneth , Saylor Deanna , Brey Naeem , Henning Franclo
Published: October 2023

Background

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently described autoimmune inflammatory disorder of the central nervous system (CNS). There is limited data on the association between Human Immunodeficiency virus (HIV) infection and MOGAD. We report three patients with HIV infection and myelin oligodendrocyte glycoprotein (MOG) antibodies in the setting of other central nervous system infections.

Case descriptions

The first patient, a 44-year-old black African man, presented with acute disseminated encephalomyelitis (ADEM) with positive serum MOG antibodies. He made a significant recovery with corticosteroids but had a quick relapse and died from sepsis. The second patient, an 18-year-old black woman, presented with paraplegia and imaging revealed a longitudinally extensive transverse myelitis and had positive serum MOG antibodies. She remained paraplegic after methylprednisone and plasmapheresis treatments. Her rehabilitation was complicated by development of pulmonary embolism and tuberculosis. The third patient, a 43-year-old mixed-race woman, presented with bilateral painless visual loss. Her investigations were notable for positive MOG antibodies, positive Varicella Zoster Virus on cerebral spinal fluid (CSF) and hyperintense optic nerves on magnetic resonance imaging (MRI). Her vision did not improve with immunosuppression and eventually died from sepsis.

Conclusion

Our cases illustrate the diagnostic and management challenges of MOGAD in the setting of advanced HIV infection, where the risk of CNS opportunistic infections is high even without the use of immunosuppression. The atypical clinical progression and the dilemmas in the diagnosis and treatment of these cases highlight gaps in the current knowledge of MOGAD among people with HIV that need further exploration.
A microbial flora with superior pollutant removal efficiency and its fermentation process optimization
Authors: Li Yonghong , Wu Xiuxiu , Wang Yun , Gao Yingman , Li Keke
Published: October 2023

Microbial flora plays an important role in microorganism-enhanced technology. The pollutant degradation ability and viable counts of these agents are crucial to guarantee their practical application. In this study, an efficient pollutant-degrading microbial flora was screened, its medium components and culture conditions were optimized, and its effect was verified in zeolite trickling filter towers. After a 24 h culture under the optimal conditions, the viable count reached 4.76 × 109 cfu/mL, with the degradation rates of ammonia nitrogen (NH4+-N), nitrate nitrogen (NO3−-N), total nitrogen (TN), total phosphorus (TP), and chemical oxygen demand (COD) increased to 93.5%, 100%, 68.3%, 32.6%, and 85%, respectively. After optimizing the feeding strategy, the concentration of viable bacteria reached 5.80 × 109 cfu/mL. In the application effect verification experiment, the degradation rates of NH4+-N, TN, TP, and COD in the experimental group reached 96.69%, 75.18%, 73.82%, and 90.83%, respectively, showing a significant improvement compared to the results of the control group. The main components in the control group were Dokdonella, Brevundimonas, Alishewanella, Rhodobacter, Pseudoxanthomonas, and Thauera, whereas those in the experimental group were Dokdonella, Proteocatella, Rhodobacter, Dechlomonas, and Nitrospira. Proteocatella, Dechlomonas, and Nitrosra, which were unique to the experimental group, are common bacteria used for nitrogen and phosphorus removal. This explains the difference in the sewage treatment capacity between the two groups. This study provides an alternative sewage treatment microbial flora with a reasonable production cost and high degradation efficiency for NH4+-N, TN, TP, and COD.
Niclosamide improves cancer immunotherapy by modulating RNA-binding protein HuR-mediated PD-L1 signaling
Authors: Zhang Qi , Yang Zhe , Hao Xinbao , Dandreo Lauren J. , He Lily , Zhang Yuxia , Wang Fen , Wu Xiaoqing , Xu Liang
Published: October 2023

Background

Immune checkpoint blockade (ICB) represents a revolutionary advance in cancer treatment but remains limited success in triple-negative breast cancer (TNBC). Here we aim to explore the mechanism of RNA-binding protein (RBP) HuR in cancer immune evasion by post-transcriptionally regulating PD-L1 and evaluate the potential of HuR inhibition to improve immune response.

Methods

The binding between HuR and PD-L1 mRNA was determined by ribonucleoprotein immunoprecipitation and RNA pull-down assays. The HuR knockout clones were established by CRISPR/Cas9 technology. The protein levels were assessed by Western blot, immunohistochemistry, and immunocytochemistry. The function and molecular mechanism of HuR-PD-L1 were determined by in vitro T cell activation and killing assay and in vivo efficacy assay.

Results

We found that HuR directly bound to and stabilized PD-L1 mRNA. Knocking out HuR reduced PD-L1 levels and promoted T cell activation. We discovered that niclosamide reduced PD-L1 by inhibiting HuR cytoplasmic translocation, and diminished glycosylation of PD-L1. Niclosamide enhanced T cell-mediated killing of cancer cells and significantly improved the efficacy of anti-PD-1 immunotherapy in two syngeneic animal tumor models.

Conclusion

We identified HuR as a novel posttranscriptional regulator of PD-L1, which plays an important role in tumor immune evasion. Niclosamide might be a promising repurposed drug to improve the patient response to immunotherapy by targeting HuR-PD-L1 axis. Our study demonstrates a novel strategy for targeting HuR/PD-L1 and provides the first proof-of-principle for repurposing niclosamide as a HuR inhibitor to overcome cancer immune evasion and improve response to ICB immunotherapy.
Association of pronounced elevation of NET formation and nucleosome biomarkers with mortality in patients with septic shock
Authors: Haem Rahimi Muzhda , Bidar Frank , Lukaszewicz Anne-Claire , Garnier Lorna , Payen-Gay Léa , Venet Fabienne , Monneret Guillaume
Published: October 2023

Background

Understanding the mechanisms underlying immune dysregulation in sepsis is a major challenge in developing more individualized therapy, as early and persistent inflammation, as well as immunosuppression, play a significant role in pathophysiology. As part of the antimicrobial response, neutrophils can release extracellular traps (NETs) which neutralize and kill microorganisms. However, excessive NETs formation may also contribute to pathogenesis, tissue damage and organ dysfunction. Recently, a novel automated assay has been proposed for the routine measurement of nucleosomes H3.1 (fundamental units of chromatin) that are released during NETs formation. The aim of the present study was to measure nucleosome levels in 151 septic shock patients (according to sepsis-3 definition) and to determine association with mortality.

Results

The nucleosome H3.1 levels (as determined by a chemiluminescence immunoassay performed on an automated immunoanalyzer system) were markedly and significantly elevated at all-time points in septic shock patients compared to the control group. Immunological parameters indicated tremendous early inflammation (IL-6 = 1335 pg/mL at day 1–2) along with marked immunosuppression (e.g., mHLA-DR = 3853 AB/C and CD4 = 338 cell /µL at day 3–4). We found significantly positive correlation between nucleosome levels and organ failure and severity scores, IL-6 concentrations and neutrophil count. Significantly higher values (day 1–2 and 3–4) were measured in non-survivor patients (28-day mortality). This association was still significant after multivariate analysis and was more pronounced with highest concentration. Early (day 1–2) increased nucleosome levels were also independently associated with 5-day mortality. At day 6–8, persistent elevated nucleosome levels were negatively correlated to mHLA-DR values.

Conclusions

This study reports a significant elevation of nucleosome in patients during a one-week follow-up. The nucleosome levels showed correlation with neutrophil count, IL-6 and were found to be independently associated with mortality assessed at day 5 or 28. Therefore, nucleosome concentration seems to be a promising biomarker for detecting hyper-inflammatory phenotype upon a patient's admission. Additional investigations are required to evaluate the potential association between sustained elevation of nucleosome and sepsis-induced immunosuppression.
Patterns in bottlenecks for implementation of health promotion interventions: a cross-sectional observational study on intervention-context interactions in the Netherlands
Authors: Grêaux K. M. , van Assema P. , Bessems K. M. H. H. , de Vries N. K. , Harting J.
Published: October 2023

Background

From a complex systems perspective, implementation should be understood as the introduction of an intervention in a context with which it needs to interact in order to achieve its function in terms of improved health. The presence of intervention-context interactions could mean that during implementation particular patterns of crucial interaction points might arise. We examined the presence of – and regularities in – such ‘bottlenecks for implementation’, as this could create opportunities to predict and intervene in potential implementation problems.

Methods

We conducted a cross-sectional observational study against the background of municipal intersectoral policymaking in the Netherlands. We asked implementers of health promotion interventions to identify bottlenecks by rating the presence and importance of conditions for implementation in a range of intervention systems. We used descriptive statistics to characterize these systems (by their behaviour change method, health theme and implementation setting) and the conditions that acted as bottlenecks. After stratifying bottlenecks by intervention system and the system’s characteristics, we tested our hypotheses by comparing the number and nature of the bottlenecks that emerged.

Results

More than half of the possible conditions were identified as a bottleneck for implementation. Bottlenecks occurred in all categories of conditions, e.g., relating to the implementer, the intervention, and political and administrative support, and often connected with intersectoral policymaking, e.g., relating to the co-implementer and the co-implementer’s organization. Both our hypotheses were supported: (1) Each intervention system came across a unique set of – a limited number of – conditions hampering implementation; (2) Most bottlenecks were associated with the characteristics of the system in which they occurred, but bottlenecks also appeared in the absence of such an association, or remained absent in the presence thereof.

Conclusions

We conclude that intervention-context interactions in integrated health policymaking may lead to both regularities and variations in bottlenecks for implementation. Regularities may partly be predicted by the function of an intervention system, and may serve as the basis for building the capacity needed for the structural changes that can bring about long-lasting health improvements. Variations may point at the need for flexibility in further tailoring the implementation approach to the – mostly unpredictable – problems at individual sites.
Impact of COVID-19-related methadone regulatory flexibilities: views of state opioid treatment authorities and program staff
Authors: Mitchell Shannon Gwin , Jester Julia , Gryczynski Jan , Whitter Melanie , Fuller Douglas , Halsted Caroline , Schwartz Robert P.
Published: October 2023

Background

During the COVID-19 pandemic, federal regulations in the USA for methadone treatment of opioid use disorder (OUD) were temporarily revised to reduce clinic crowding and promote access to treatment.

Methods

As part of a study seeking to implement interim methadone without routine counseling to hasten treatment access in Opioid Treatment Programs with admission delays, semi-structured qualitative interviews were conducted via Zoom with participating staff (N = 11) in six OTPs and their State Opioid Treatment Authorities (SOTAs; N = 5) responsible for overseeing the OTPs’ federal regulatory compliance. Participants discussed their views on the response of OTPs in their states to the pandemic and the impact of the COVID-related regulatory flexibilities on staff, established patients, and new program applicants. Interviews were audio recorded, transcribed, and a content analysis was conducted using ATLAS.ti.

Results

All SOTAs requested the blanket take-home exemption and supported the use of telehealth for counseling. Participants noted that these changes were more beneficial for established patients than program applicants. Established patients were able to obtain a greater number of take-homes and attend individual counseling remotely. Patients with limited resources had greater difficulty or were unable to access remote counseling. The convenience of intake through telehealth did not extend to new program applicants because the admission physical exam requirement was not waived.

Conclusions

The experienced reflections of SOTAs and OTP providers on methadone practice changes during the COVID-19 pandemic offer insights on SAMHSA’s proposed revisions to its OTP regulations.

Trial registration Clinicaltrials.gov # NCT04188977.
Interaction of Clostridioides difficile infection with frailty and cognition in the elderly: a narrative review
Authors: Fernandez-Cotarelo Maria-Jose , Jackson-Akers Jasmine Y. , Nagy-Agren Stephanie E. , Warren Cirle A.
Published: October 2023

Purpose

Clostridioides difficile infection (CDI) is the leading cause of antibiotic-related diarrhea and healthcare-associated infections, affecting in particular elderly patients and their global health. This review updates the understanding of this infection, with focus on cognitive impairment and frailty as both risk factors and consequence of CDI, summarizing recent knowledge and potential mechanisms to this interplay.

Methods

A literature search was conducted including terms that would incorporate cognitive and functional impairment, aging, quality of life, morbidity and mortality with CDI, microbiome and the gut–brain axis.

Results

Advanced age remains a critical risk for severe disease, recurrence, and mortality in CDI. Observational and quality of life studies show evidence of functional loss in older people after acute CDI. In turn, frailty and cognitive impairment are independent predictors of death following CDI. CDI has long-term impact in the elderly, leading to increased risk of readmissions and mortality even months after the acute event. Immune senescence and the aging microbiota are key in susceptibility to CDI, with factors including inflammation and exposure to luminal microbial products playing a role in the gut–brain axis.

Conclusions

Frailty and poor health status are risk factors for CDI in the elderly. CDI affects quality of life, cognition and functionality, contributing to a decline in patient health over time and leading to early and late mortality. Narrative synthesis of the evidence suggests a framework for viewing the cycle of functional and cognitive decline in the elderly with CDI, impacting the gut–brain and gut–muscle axes.
New evidence in the relationship between trade openness and food security in Sub-Saharan Africa
Authors: Gnedeka Kodjo Théodore , Wonyra Kwami Ossadzifo
Published: October 2023

Background

Since 2015, food insecurity has been a more serious threat than the previous years with a record high observed from the year 2020 onwards, especially in developing countries. This record could be due to response measures, notably the closure of borders due to the COVID-19 pandemic. This implies that trade openness have played an important role in achieving food security in the world. However, the debate on the effect of trade openness on food security remains no consensus in the economic literature. It is in this context that this paper aims to re-examine the effect of trade openness on food security in sub-Saharan African countries.

Methods

Panel data covering 37 Sub-Saharan African countries over the period from 2004 to 2018 were mobilized. We use a dynamic empirical model based on the system Generalized Method of Moment (GMM) to control the unobserved heterogeneity and potential endogeneity of the explanatory variables. As food security is a multidimensional concept, we used four indicators (“average dietary energy supply adequacy”, “average protein supply”, “per capita food supply variability”, and “share of dietary energy supply”) to capture food security. To improve the robustness of the empirical effect of openness on food security, we also used globalization as an alternative factor to trade openness.

Results

The empirical results show that trade openness significantly improves food security in 37 Sub-Saharan African countries. However, in the presence of political instability, a deterioration of the food security situation is observed. The results reveal also that the quality of institutions, economic growth, remittances, human capital, and the importance of the agricultural sector are also factors favouring the level of food security in sub-Saharan Africa countries.

Conclusion

Any policy aimed at trade openness must consider the quality of institutions to achieve the expected results.
Untargeted plasma metabolomics and risk of colorectal cancer—an analysis nested within a large-scale prospective cohort
Authors: Vidman Linda , Zheng Rui , Bodén Stina , Ribbenstedt Anton , Gunter Marc J. , Palmqvist Richard , Harlid Sophia , Brunius Carl , Van Guelpen Bethany
Published: October 2023

Background

Colorectal cancer (CRC) is a leading cause of cancer-related death worldwide, but if discovered at an early stage, the survival rate is high. The aim of this study was to identify novel markers predictive of future CRC risk using untargeted metabolomics.

Methods

This study included prospectively collected plasma samples from 902 CRC cases and 902 matched cancer-free control participants from the population-based Northern Sweden Health and Disease Study (NSHDS), which were obtained up to 26 years prior to CRC diagnosis. Using reverse-phase liquid chromatography–mass spectrometry (LC–MS), data comprising 5015 metabolic features were obtained. Conditional logistic regression was applied to identify potentially important metabolic features associated with CRC risk. In addition, we investigated if previously reported metabolite biomarkers of CRC risk could be validated in this study population.

Results

In the univariable analysis, seven metabolic features were associated with CRC risk (using a false discovery rate cutoff of 0.25). Two of these could be annotated, one as pyroglutamic acid (odds ratio per one standard deviation increase = 0.79, 95% confidence interval, 0.70–0.89) and another as hydroxytigecycline (odds ratio per one standard deviation increase = 0.77, 95% confidence interval, 0.67–0.89). Associations with CRC risk were also found for six previously reported metabolic biomarkers of prevalent and/or incident CRC: sebacic acid (inverse association) and L-tryptophan, 3-hydroxybutyric acid, 9,12,13-TriHOME, valine, and 13-OxoODE (positive associations).

Conclusions

These findings suggest that although the circulating metabolome may provide new etiological insights into the underlying causes of CRC development, its potential application for the identification of individuals at higher risk of developing CRC is limited.
Content validation of a mental wellness measuring instrument for adolescents living with HIV: a modified delphi study
Authors: Orth Zaida , van Wyk Brian
Published: October 2023

A growing body of evidence suggests that improving the mental wellness of adolescents living with HIV (ALHIV) will also result in improved adherence to antiretroviral therapy (ART), as well as improving their general health and wellbeing as they age into adulthood. However, to develop effective strategies and interventions aimed at improving mental wellness, we require age and culturally appropriate instruments to build an evidence base. Currently, there is a lack of mental wellness measures developed for ALHIV, especially in the African context. To address this gap, we developed a measure of mental wellness following modified guidelines set out by DeVellis [1] and Godfred et al. as a guiding framework [2]; (1) Identifying the gap, (2) Set the theoretical foundations and identify domains and (3); Instrument development and initial validation. For the first two steps, we conducted a systematic review, photovoice study and integrative review – which we briefly describe as the findings have been published. Following this we describe the processes to develop the instrument and to establish content validity through a modified Delphi Study. Through this process we were able to refine the instrument which will be subject to further testing.

Implications and Contribution: This study aims to add to the body of knowledge on promoting mental health (mental wellness) among adolescents living with HIV in South Africa through developing an appropriate and valid measure of mental wellness for this population. This study reports on the results of a Delphi Study aimed at improving the content validity of the instrument Mental Wellness Measure for Adolescents Living with HIV (MWM-ALHIV).
Seismic signature detection during the 2018 Anak Krakatau flank collapse and tsunami using seismic amplitudes from regional-scale monitoring
Authors: Permana Theodorus , Yatimantoro Tatok , Handayani Asteria Satyaning
Published: October 2023

On 22 December 2018, the major flank collapse of Anak Krakatau volcano generated a tsunami that struck the surrounding coasts of Java and Sumatra islands in Indonesia without warning. It was later suggested that the corresponding seismic event lacked the body-wave arrivals typical of tectonic earthquakes, causing difficulties for the automated detection system to recognize the event. We explore the possibility of detecting the seismic signature of such events without relying on the arrival times of body waves, by measuring seismic amplitudes in a regional seismic network at the expected arrival times from a fixed, potential source and comparing them to the theoretical attenuation of surface waves. We propose a fast detection method and evaluate the method using seismograms recorded during the flank collapse and tsunami episode as well as several known tectonic earthquakes. Detailed examinations of the detection results confirm the seismic signatures of the flank collapse and teleseismic events as suggested by previous studies. We also find more seismic signatures suggesting the occurrence of two possible smaller collapse events and variations in the eruptive activity related to the major flank collapse, as well as body and surface wave signals from two teleseismic earthquakes that were present during this episode. Finally, we construct a timeline of events during this devastating episode, combining our results with previous studies as well as insights from weather radar observations. With the ability to detect and discriminate various types of seismic events from each other, the detection method can be useful in assisting the existing monitoring and early warning systems in detecting major volcano-related tsunamigenic events.

Graphical Abstract
Hybrid delivery of cluster-set resistance training for individuals previously treated for lung cancer: the results of a single-arm feasibility trial
Authors: Fairman C. M. , Owens O. L. , Kendall K. L. , Steele J. , Schumpp A. R. , Latella C. , Jones M. T. , Marcotte L. , Dawson J. M. , Peddle-McIntyre C. M. J. , McDonnell K. K.
Published: October 2023

Background

Individuals with non-small cell lung cancer (NSCLC) are burdened by long-lasting symptoms (e.g., dyspnea and fatigue) post-treatment. These symptoms often reduce physical activity levels and increase the risk of functional decline. Though we have previously proposed cluster-set resistance training to mitigate symptom burden in lung cancer, there is currently no data on the feasibility or acceptability of this mode of exercise in cancer. Therefore, the purpose of this study was to investigate the feasibility and acceptability of a hybrid-delivery home-based cluster-set resistance training program in individuals with NSCLC stages I–III (i.e., early stage).

Methods

This study aimed to recruit individuals with NSCLC stages I–III post-treatment to participate in 8 weeks of home-based resistance training, 3 days per week. The program included supervised sessions in the participants’ homes and virtual supervision via videoconferencing. The primary outcome measure of feasibility was evaluated through recruitment, retention, and intervention fidelity (i.e., proportion of exercise completed, relative to what was prescribed). Intervention acceptability (i.e., ease and quality of virtual delivery, level of difficulty, and home-based approach) was assessed using a 4-point Likert-type scale from “strongly disagree” to “strongly agree”.

Results

Fourteen participants were recruited over a 6-month period, with 11 completing the intervention (2 withdrew due to unrelated illness, 1 withdrew due to requiring active treatment), yielding a retention rate of 79%. Characteristics of the participants who completed the intervention (n = 11) were as follows: mean age: 71 ± 10 years, mean BMI: 29.1 ± 6.5, and average time since diagnosis was 62 ± 51 months. Of completers, 27% were male, and 36% were Black; 10 were stage I (91%), and one was stage II (9%). Mean session attendance was 86.4 ± 9.5%. Mean intervention fidelity was 83.1 ± 13.1%. With regard to acceptability,  > 90% of participants positively rated all aspects of the intervention delivery. No adverse events related to exercise were recorded.

Conclusions

The hybrid delivery of a home-based resistance exercise program for individuals previously treated for early-stage NSCLC was found to be safe and feasible. Adaptations to the program for future interventions are required, particularly surrounding resistance exercise programming, and intervention delivery with home visits.

Trial registration

ClinicalTrials.gov: NCT05014035. Registered January 20, 2021.
Prioritizing real estate enterprises based on credit risk assessment: an integrated multi-criteria group decision support framework
Authors: Chen Zhen-Song , Zhou Jia , Zhu Chen-Ye , Wang Zhu-Jun , Xiong Sheng-Hua , Rodríguez Rosa M. , Martínez Luis , Skibniewski Mirosław J.
Published: October 2023

Credit risk assessment involves conducting a fair review and evaluation of an assessed subject’s solvency and creditworthiness. In the context of real estate enterprises, credit risk assessment provides a basis for banks and other financial institutions to choose suitable investment objects. Additionally, it encourages real estate enterprises to abide by market norms and provide reliable information for the standardized management of the real estate industry. However, Chinese real estate companies are hesitant to disclose their actual operating data due to privacy concerns, making subjective evaluation approaches inevitable, occupying important roles in accomplishing Chinese real estate enterprise credit risk assessment tasks. To improve the normative and reliability of credit risk assessment for Chinese real estate enterprises, this study proposes an integrated multi-criteria group decision-making approach. First, a credit risk assessment index for Chinese real estate enterprises is established. Then, the proposed framework combines proportional hesitant fuzzy linguistic term sets and preference ranking organization method for enrichment evaluation II methods. This approach is suitable for processing large amounts of data with high uncertainty, which is often the case in credit risk assessment tasks of Chinese real estate enterprises involving massive subjective evaluation information. Finally, the proposed model is validated through a case study accompanied by sensitivity and comparative analyses to verify its rationality and feasibility. This study contributes to the research on credit assessment for Chinese real estate enterprises and provides a revised paradigm for real estate enterprise credit risk assessment.
The consequences of task-supported language teaching via social media on academic engagement, emotion regulation, willingness to communicate, and academic well-being from the lens of positive psychology
Authors: Alazemi Asmaa Falah Theiyab , Gheisari Asma , Patra Indrajit
Published: October 2023

Although TBLT has been the subject of many prior studies, no research has addressed the impact of TBLT through social media (SM), specifically the Telegram app, on academic engagement, emotion regulation, willingness to communicate (WTC), and academic well-being. To reach this goal, a convenience sampling method was used to select 58 Iranian intermediate EFL learners out of 83 based on their Oxford Quick Placement Test performance. The selected learners were randomly assigned to the control group (CG) and experimental group (EG). Pretests were conducted to measure both groups’ academic engagement, emotion regulation, WTC, and academic well-being. During the treatment, the EG received treatment using the Telegram app and the LMS, while the CG only utilized the LMS without any social media assistance. After the treatment, posttests were administered to evaluate the performance of both groups. The results of the data analysis revealed a significant difference in the posttest scores of the EG and CG. The EG demonstrated superior outcomes (p < 0.05) regarding academic engagement, emotion regulation, WTC, and academic well-being, indicating the effectiveness of incorporating Telegram alongside the LMS. Thus, this study demonstrated that utilizing the Telegram app with an LMS can significantly enhance EFL learners’ WTC, academic engagement, well-being, and emotion regulation. The findings suggest that EFL students can utilize the Telegram app to improve their English language skills outside of traditional classroom settings. Furthermore, using social media platforms like Telegram can facilitate self-study and transform the role of students. It provides EFL students with easy and rapid access to global information. The study concludes with implications, limitations, and suggestions for future research.
Assessing the impact of university students’ involvement in the first year of Nurture-U: a national student wellbeing research project
Authors: Dooley Jemima , Ghezal Amina , Gilpin Thomas , Hassan Basri Husna , Humberstone Katy , Lahdelma Amber , Misurya Pranati , Marshall Ellen , Watkins Ed
Published: October 2023

Background

Students experience lower levels of wellbeing than the general, age-matched population. A whole-university approach to mental health is encouraged, which must work for individuals from all backgrounds and experiences. Student input is vital in researching and designing these solutions. Nurture-U is a national, large-scale research project exploring better ways to support student wellbeing, with a Student Advisory Group (SAG) that feeds into project decision making. With the first year of the project now completed, we now critically review the processes and effectiveness of the SAG and how well the project is engaging and working with students.

Methods

Assessment of the SAG’s impact on the project, the student advisors, and the researchers was undertaken through a content analysis of team meetings and collection of advisor and researcher feedback using the Patient Engagement Quality Guidance Tool.

Results

142 students worked on different tasks in the first year of the Nurture-U project. The SAG was involved in the project branding and marketing, and in the development and co-design of interventions and tools. They reported a positive experience, with involvement boosting confidence. They felt valued but reported not always knowing whether their input was implemented in final decisions. They also recommended different methods of providing feedback. Researchers found student input beneficial to communicate the viewpoint of a different generation and increase the relevance of the study, but also suggested improvements for communication between the research team and the student group.

Conclusions

This critical reflection of the SAG’s public advisor role in this large-scale research project was important in highlighting what worked well and areas to improve. As the project unfolds, we aim to adapt our methods of student input, increase the transparency of decision-making processes, and in turn increase student-led decision making within the project.
Comparison of vertical bone resorption following various types of autologous block bone grafts
Authors: Koo Hyejin , Hwang Junghye , Choi Byung-Joon , Lee Jung-Woo , Ohe Joo-Young , Jung Junho
Published: October 2023

Background

This study aims to measure and compare the differences in vertical bone resorption after vertical augmentation using different types of autologous block bone.

Methods

Data were collected from 38 patients who had undergone vertical ridge augmentation using an autologous block bone before implant insertion. The patients were divided into three groups based on the donor sites: ramus bone (RB), chin bone (CB), and iliac crestal bone (IB).

Results

The surgical outcome of the augmentation was evaluated at the follow-up periods up to 60 months. In 38 patients, the mean amount of vertical bone gain was 8.36 ± 1.51 mm in the IB group, followed by the RB group (4.17 ± 1.31 mm) and the CB group (3.44 ± 1.08 mm). There is a significant difference in vertical bone resorption between the groups (p < 0.001), and the RB group demonstrated significantly lower resorption than the CB and IB groups (p = 0.011 and p < 0.001, respectively). The most common postoperative complications included neurosensory disturbance in the CB graft and gait disturbance in the IB graft. Out of the 92 implants inserted after augmentation, four implants were lost during the study period, resulting in an implant success rate of 95.65%.

Conclusions

The RB graft might be the most suitable option for vertical augmentation in terms of maintaining postoperative vertical height and reducing morbidity, although the initial gain was greater with the IB graft compared to other block bones.
Recognising the shadow pandemic in the humanitarian sector: ending violence against women in the aftermath of COVID-19
Authors: Felten Léa
Published: October 2023

In all domains of society, from health to the economy, security, and human rights, the impacts of the COVID-19 pandemic are amplified for women and girls simply due to the issues associated with gender-based violence. This article will, therefore, explore international organisations and non-governmental organisations’ commitment to ending violence against women in the aftermath of the COVID-19 pandemic. To analyse this phenomenon, this article will first focus on the current necessity to make more efforts towards implementing a gender perspective in the field of humanitarian action. This would allow for women’s needs to be better targeted and could also enable them to be better included as actors in this process. Then, this article will highlight the involvement of different organisations in the fight against gender-based violence in parallel to the different programmes put forward in the framework of the UN Sustainable Development Goal 5. Consequently, after assessing the current actions made in the aftermath of the pandemic, this article will conclude by putting forth potential prospects for future progress.
Association of PSA variability with prostate cancer development using large-scale medical information data: a retrospective cohort study
Authors: Maeda-Minami Ayako , Nishikawa Tomoki , Ishikawa Hideki , Mutoh Michihiro , Akimoto Kazunori , Matsuyama Yutaka , Mano Yasunari , Uemura Hiroji
Published: October 2023

Background

Prostate cancer is one of the most common cancers among men worldwide and the fourth most common cause of death. The number of prostate cancer cases and deaths is increasing every year because of population aging. This study aimed to clarify the risk of developing prostate cancer due to fluctuations in Prostate Specific Antigen (PSA) levels in patients without a history of prostate cancer using large medical information data.

Results

This retrospective cohort included 1707 male patients aged 60 years or older who had a PSA level measurement date (2-PSA) within 3 months or more and 2 years from the first PSA level measurement date (1-PSA) in the database between 2008 and 2019. We subtracted 1-PSA from 2-PSA and designated patients with a higher 2-PSA than 1-PSA to the “up” group (n = 967) and patients with a lower 2-PSA than 1-PSA to the “down” group (n = 740). By using Cox proportional hazards model, a significant increase in prostate cancer risk was observed in the up group compared with the down group (adjusted hazard ratio [HR] = 1.82, 95% confidence interval [CI] = 1.21–2.72; adjusted for patient background factors). Subgroup analysis showed that patients with PSA levels < 4 ng/mL had a significantly increased risk of developing prostate cancer if the next PSA level increases by approximately 20% (adjusted HR = 2.94, 95% CI = 1.14–7.58), and patients with PSA levels of 4 ng/mL or higher if the next PSA level is decreased by approximately 20% had a significantly reduced risk of developing prostate cancer (adjusted HR = 0.36, 95% CI = 0.18–0.74), compared to that with no change.

Conclusions

This is the first study to clarify the association between PSA variability and risk of developing prostate cancer in patients without a history of prostate cancer. These results suggest that the suppression of elevated PSA levels may lead to the prevention of prostate cancer and that it would be better to perform a biopsy because the risk of developing prostate cancer may increase in the future if the PSA value increases above a certain level.
The effect of PD-1/PD-L1 signaling axis on the interaction between CD19+B cells and CD4+T cells in peripheral blood of patients with systemic lupus erythematosus
Authors: Xie Zhuobei , Dai Li , He Haohua , Hong Dengxiao , Tang Honghui , Xu Wenyan , Chen Zhongxin , Wang Hongtao , Li Baiqing , Xie Changhao , Wang Yuanyuan
Published: October 2023

Background

The defect of B cell self-tolerance and the continuous antigen presentation by T cells (TCs) mediated by autoreactive B cells (BCs) play a key role in the occurrence and development of systemic lupus erythematosus (SLE). PD-1/PD-L1 signaling axis negatively regulates the immune response of TCs after activation and maintains immune tolerance. However, the effect of PD-1/PD-L1 signaling axis on the interaction between CD19+B/CD4+TCs in the peripheral blood of patients with SLE has not been studied in detail.

Methods

PD-1/PD-L1 and Ki-67 levels in peripheral blood (PB) of 50 SLE patients and 41 healthy controls (HCs) were detected through flow cytometry, and then the expression of PD-1+/−cells and PD-L1+/−cells Ki-67 was further analyzed. CD19+B/CD4+TCs were separated for cell culture and the supernatant was collected to determine proliferation and differentiation of TCs. IL-10 and IFN-γ secretion in the supernatant was also determined using ELISA.

Results

The PD-1, PD-L1, and Ki-67 levels on CD19+B/CD4+TCs in patients with SLE were higher than HCs. In CD19+B/CD4+TCs of SLE patients, the proliferative activity of PD-L1+ cells was higher than that of PD-L1− cells, and the proliferative activity of PD-1+ cells was higher than that of PD-1− cells. In the system co-culturing CD19+B/CD4+TCs from HCs/SLE patients, activated BCs promoted TCs proliferation and PD-L1 expression among TCs. Addition of anti-PD-L1 to co-culture system restored the proliferation of TCs, and inhibited IL-10/IFN-γ level. The addition of anti-PD-L1 to co-culture system also restored Tfh and downregulated Treg in HCs.

Conclusions

Axis of PD-1/PD-L1 on CD19+B/CD4+TCs in PB of SLE patients is abnormal, and cell proliferation is abnormal. In CD19+B/CD4+TCs of SLE patients, the proliferative activity of PD-L1+ and PD-1+ cells compared with PD-L1− and PD-1− cells in SLE patients, respectively. CD19+B/CD4+TCs in SLE patients can interact through PD-1/PD-L1.
Desmoid-type fibromatosis of neck masquerading as nerve sheath tumors: two case reports
Authors: Kant Surya , Charan Bheru Dan , Goel Vinay , Das Sumanta , Sahu Saumya , Sharma Rajiv , Borkar Sachin , Sebastian Leve Joseph Devaranjan , Garg Ajay
Published: October 2023

Background

Desmoid fibromatosis (DF) is an atypical, non-malignant tumor known for its distinctive feature of exhibiting an intermediate biological behavior that falls between benign fibrous lesions and fibrosarcoma. The article aimed to outline the imaging characteristics of desmoid fibromatosis and distinguish it from its similar counterpart, nerve sheath tumors.

Results

Here, we present two cases of desmoid fibromatosis whose imaging findings mimic nerve sheath tumors. The patients presented with neck swelling and radiating pain. Both cases were biopsy-proven. Imaging features characteristic of these lesions include elongated shape, split-fat sign, and fascial tail sign with mixed signal intensity on T1WIs and T2WIs depending upon the collagen content of the lesion.

Conclusions

MRI is the best diagnostic modality for differentiating fibromatosis from nerve sheath tumors. Surgery continues to be the primary approach for treating these growths, but in some cases, chemoradiation is employed to achieve improved control rates. The presence of intralesional low-intensity bands in T2WIs is a characteristic feature of fibromatosis. Given its local aggressiveness and propensity for recurrence, the use of multiple imaging modalities is essential for providing informed guidance on outcomes and treatment strategies.
Peroral Endoscopic Myotomy (POEM) for the treatment of achalasia in an Egyptian cohort
Authors: Elkholy Shaimaa , Essam Kareem , Gamal Gina , Maurice Karim K. , Abdellatif Zeinab , El-Sherbiny Mohammed , Haggag Hany , Awad Abeer , Yousef Kerolis
Published: October 2023

Background and study aims

Peroral endoscopic myotomy (POEM) has been regarded as a novel and minimally invasive therapy for the treatment of achalasia. Data from the Middle East and North Africa (MENA) region and Arabic countries are scarce, and this study represents the first study from this area. The aim of this study was to assess the efficacy and safety of POEM in an Egyptian cohort.

Patients and methods

This is a prospective study that included 34 Egyptian patients who underwent POEM for achalasia.

Results

This study included 19 (55.9%) males with a median age of 33.5 years (range: 11–75 years). 16 (47.1%) patients had previous pneumatic balloon dilation, and 1 (2.9%) patient had previous surgical myotomy. The median Eckardt score pre-POEM was 9 (range: 4–12). The median integrated relaxation pressure for 4 s (IRP4s) was 25.6 mmHg (range: 11.5–49.4 mmHg). High-resolution manometry showed that 12 patients had type I achalasia (35.2%), 18 patients had type II achalasia (52.9%), and 4 patients had type III achalasia (11.7%). The median procedure time was 120 min (range: 75–260 min). Technical success was achieved in all patients (100%), and clinical success was achieved in 33/34 patients (97.1%). There was no significant difference in success rates among different types of achalasia (p 0.208). There was a significant reduction in the Eckardt score (P < 0.0001) and IRP4s values pre- and post-POEM (P < 0.0001). There was also a significant increase in the body mass index of the patients (P 0.006) during a median follow-up of 10 months (range: 6–24 months).

Conclusions

POEM is a safe, effective, and feasible treatment option for achalasia in an Egyptian cohort. POEM is becoming an attractive option and is gaining patient satisfaction.
The hidden star: mastoiditis as a late sequela of retained foreign body in the nose
Authors: Jaafar Nur Faqihah , Enci Yong , Chen Irise Hoi Khin
Published: October 2023

Background

Acute mastoiditis is an intratemporal complication due to acute otitis media (AOM). Common risk factors include young age (often < 24 months), high values of C-reactive protein and previous antibiotic therapy, previous middle ear infection, or history of ear surgery. The main factor of acute mastoiditis is obstruction of the aditus antrum by granulation tissue or mucosa edema, inhibiting purulent drainage from the mastoid. Retained foreign body in the nose is a rare indirect cause of acute mastoiditis. It may be due to mucosal inflammation and accumulation of secretion causing nasal tract or nasopharyngeal infection leading to otitis media and later manifesting as an intratemporal complication.

Case presentation

We report a case of acute mastoiditis as a late sequela of retained foreign body in the nose, and we also emphasize the incidental radiological finding of a star-shaped foreign body in the nose, which was a miss during the initial presentation. Further questioning revealed a history of recurrent unilateral blood-stained, foul-smelling nasal discharge, which was left untreated for years, leading to a delayed presentation of acute mastoiditis. After removing the foreign body and broad-spectrum antibiotic administration, complete disease resolution was achieved.

Conclusion

Although rare, retained foreign bodies of the nose must be ruled out in certain cases of mastoiditis. A thorough history with a high index of clinical suspicion is recommended for early diagnosis to prevent complications.
Quantitative analysis and modeling of minimum flow patterns in Temsa River, Abbay Basin, Ethiopia
Authors: Bayana Darara Dabtara , Diriba Bikila Gedefa
Published: October 2023

The extent and occurrence of extremely low-flow events are necessary to determine the minimum river flow. Since the true probability distribution is usually not known, the best fitting distribution function describing the low flow in the catchment is important for reliable estimation of low flow and its frequency. The Temsa River is one of the most important tributaries of the Abay River Basin in Ethiopia and has a high ecological value for the country that can be affected by land cover changes. Climate influences watershed development, while landscape features control the accumulation and release of water over time, influencing stream flow, such as low flow. Therefore, analyzing the state of river discharge is important for the economic management of water resources. Rapid population growth has raised serious concerns about the adequacy of the Temsa River’s future water intake in terms of quantity and quality. However, future water resources planning requires information on water flow variability and trends. The aim of this study is to identify and analyze the existing Temsa watersheds and their current status based on river water data collected by the Ethiopian Ministry of Water and Energy from 1997 to 2021 GC. Analysis focused on daily flow, mean annual flow, mean monthly flow, and consecutive 7-day mean minimum flow were included in the model. Methods for trend detection and quantification were the Mann–Kendall test (MK) and Sen’s slope estimator (SS). The results of the MK and SS tests indicate the existence of a trend of statistical significance. The study shows a positive trend for two models and a negative trend for the other two models. The daily discharge analysis and the annual average flow analysis show a decreasing trend and the second model shows an increasing trend. BFI results show that the proportion of groundwater in the watershed is moderate, 73.6%, and the lognormal distribution fits the frequency analysis data.