bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare providers’ knowledge and attitudes about overdose prevention sites in Colorado
Authors: Paz Emily , Mashhouri Vahid , Payton Mark E. , Schwartz Brian D. , Linger Rachel M.A.
Published: August 2024

Background

Overdose prevention sites (OPS) are a harm reduction strategy that offer people who use drugs a variety of resources including but not limited to sterile supplies, linkage to healthcare resources, and intervention if an overdose occurs. OPS operate in over 120 countries and evidence has demonstrated they are an effective harm reduction strategy. Despite their success elsewhere, OPS remain federally illegal in the United States and thus there is limited research on their implementation and outcomes in the United States. This study aimed to identify Colorado healthcare providers’ knowledge and attitudes about OPS and determine if there is a correlation between healthcare providers with more knowledge about OPS having a more positive attitude about OPS.

Methods

An electronic survey was distributed to healthcare providers in Colorado. Responses were collected in early 2022 and recorded on a 5-point Likert scale. Mean scores between 1 and 5 were calculated for each participant and analysis of variance methods were used to determine correlating demographic factors. A p value of ≤ 0.05 was used to determine statistical significance of all findings.

Results

This study included 698 participants. A Pearson correlation analysis revealed a strong positive relationship (r = 0.76, p < 0.0001) between provider knowledge and attitudes about OPS. Emergency medicine providers scored the highest in mean knowledge and attitude scores in comparison to all other specialties. Respondents affiliated with a harm reduction center exhibited the highest mean knowledge and attitude scores. Mean knowledge and attitude scores generally rose with respondents’ increasing encounters with people who inject drugs in a typical workday, except when reaching nine or more encounters, where a sharp decline occurred.

Conclusions

Our study highlights the importance of education, exposure to harm reduction strategies, and inter-specialty collaboration in shaping healthcare providers’ knowledge and attitudes about OPS. The positive correlation between providers’ knowledge and attitudes about OPS suggests that educating healthcare providers on harm reduction strategies, specifically OPS, may lead to reduced stigmatization of OPS among healthcare professionals.
Early extubation after elective surgical aortic valve replacement during the COVID-19 pandemic
Authors: Fischbach Anna , Simons Julia Alexandra , Wiegand Steffen B. , Ammon Lieselotte , Kopp Rüdger , Marx Gernot , Rossaint Rolf , Akhyari Payam , Schälte Gereon
Published: August 2024

Background

Surgical aortic valve replacement (SAVR) is an established therapy for severe calcific aortic stenosis. Enhanced recovery after cardiac surgery (ERACS) protocols have been shown to improve outcomes for elective cardiac procedures. The COVID-19 pandemic prompted early extubation post-elective surgeries to preserve critical care resources.

Aim of this study

To investigate the effects of extubating patients within 6 h post-elective SAVR on hospital and ICU length of stay, mortality rates, ICU readmissions, and postoperative pneumonia.

Study Design and methods

The retrospective analysis at the University Hospital Aachen, Germany, includes data from 2017 to 2022 and compares a total of 73 elective SAVR patients. Among these, 23 patients were extubated within 6 h (EXT group), while 50 patients remained intubated for over 6 h (INT group).

Results

The INT group experienced longer postoperative ventilation, needed more vasopressor support, had a higher incidence of postoperative pneumonia, and longer ICU length of stay. No significant differences were noted in overall hospital length of stay, mortality, or ICU readmission rates between the groups.

Conclusion

This study demonstrates that early extubation in high-risk, multimorbid surgical aortic valve replacement patients is safe, and is associated with a reduction of pneumonia rates, and with shorter ICU and hospital length of stays, reinforcing the benefits of ERACS protocols, especially critical during the COVID-19 pandemic to optimize intensive care use.
Polyphyllin I exerts anti-hepatocellular carcinoma activity by targeting ZBTB16 to activate the PPARγ/RXRα signaling pathway
Authors: shan Lu , Chen Yijun , An Guo , Tao Xiaoyu , Qiao Chuanqi , Chen Meilin , Li Jiaqi , Lin Ruichao , Wu Jiarui , Zhao Chongjun
Published: August 2024

Background

Studies have reported that polyphyllin I (PPI) had effective anti-tumor activity against hepatocellular carcinoma (HCC). However, the precise molecular mechanism of this action and the direct target remain unclear. The aim of this study was to discover the molecular targets and the exact mechanism of PPI in the treatment of HCC.

Methods

Various HCC cells and Zebrafish xenotransplantation models were used to examine the efficacy of PPI against HCC. A proteome microarray, surface plasmon resonance (SPR) analysis, small molecule transfection, and molecular docking were conducted to confirm the direct binding targets of PPI. Transcriptome and Western blotting were then used to determine the exact responding mechanism. Finally, the anticancer effect and its precise mechanism, as well as the safety of PPI, were verified using a mouse tumor xenograft study.

Results

The results demonstrated that PPI had significant anticancer activity against HCC in both in vitro studies of two cells and the zebrafish model. Notably, PPI selectively enhanced the action of the Zinc finger and BTB domain-containing 16 (ZBTB16) protein by directly binding to it. Furthermore, specific knockdown of ZBTB16 markedly attenuated PPI-dependent inhibition of HCC cell proliferation and migration caused by overexpression of the gene. The transcriptome and Western blotting also confirmed that the interaction between ZBTB16 and PPI also activated the PPARγ/RXRα pathway. Finally, the mouse experiments confirmed the efficacy and safety of PPI to treat HCC.

Conclusions

Our results indicate that ZBTB16 is a promising drug target for HCC and that PPI as a potent ZBTB16 agonist has potential as a therapeutic agent against HCC by regulating the ZBTB16/PPARγ/RXRα signaling axis.
Comprehensive analysis of 2097 patients with dystrophinopathy based on a database from 2011 to 2021
Authors: Zhao Lei , Shi Yiyun , Hu Chaoping , Zhou Shuizhen , Li Hui , Zhang Lifeng , Qian Chuang , Zhou Yiyao , Wang Yi , Li Xihua
Published: August 2024

Background

An increasing number of clinical trials for new therapeutic strategies are underway or being considered for dystrophinopathy. Having detailed data on the natural progression of this condition is crucial for assessing the effectiveness of new drugs. However, there’s a lack of data regarding the long-term data on the natural course and how it’s managed in China. In this study, we offer a comprehensive overview of clinical and molecular findings, as well as treatment outcomes in the Chinese population.

Methods

Institutional data on all patients with dystrophinopathy from August 2011 to August 2021 were retrospectively reviewed. The data included geographic distribution, age at diagnosis, molecular findings, and treatment options, such as corticosteroids, cardiac interventions, and clinical outcomes.

Results

In total, 2097 patients with dystrophinopathy, including 1703 cases of Duchenne muscular dystrophy (DMD), 311 cases of Becker muscular dystrophy (BMD), 46 cases of intermediate muscular dystrophy (IMD), and 37 cases categorized as “pending” (individuals with an undetermined phenotype), were registered in the Children’s Hospital of Fudan University database for dystrophinopathy from August 2011 to August 2021. The spectrum of identified variants included exonic deletions (66.6%), exonic duplications (10.7%), nonsense variants (10.3%), splice-site variants (4.5%), small deletions (3.5%), small insertions/duplications (1.8%), and missense variants (0.9%). Four deep intronic variants and two inversion variants were identified. Regarding treatment, glucocorticoids were administered to 54.4% of DMD patients and 39.1% of IMD patients. The median age at loss of ambulation was 2.5 years later in DMD patients who received glucocorticoid treatment. Overall, one cardiac medicine at least was prescribed to 7.4% of DMD patients, 8.3% of IMD patients, and 2.6% of BMD patients. Additionally, ventilator support was required by four DMD patients. Eligibility for exon skipping therapy was found in 55.3% of DMD patients, with 12.9%, 10%, and 9.6% of these patients being eligible for skipping exons 51, 53, and 45, respectively.

Conclusions

This is one of the largest studies to have evaluated the natural history of dystrophinopathy in China, which is particularly conducive to the recruitment of eligible patients for clinical trials and the provision of real-world data to support drug development.
LSDDEP2: study protocol for a randomised, double-dummy, triple-blind, active placebo-controlled, parallel groups trial of LSD microdosing in patients with major depressive disorder
Authors: Daldegan-Bueno Dimitri , Donegan Carina Joy , Forsyth Anna , Sumner Rachael Louise , Murphy Robin J. , Menkes David B. , Evans William , Hoeh Nicholas , Sundram Frederick , Reynolds Lisa M. , Ponton Rhys , Cavadino Alana , Smith Todd , Roop Partha , Allen Nathan , Abeysinghe Binu , Svirskis Darren , Bansal Mahima , Muthukumaraswamy Suresh
Published: August 2024

Background

Major depressive disorder (MDD) poses a significant global health burden with available treatments limited by inconsistent efficacy and notable side effects. Classic psychedelics, including lysergic acid diethylamide (LSD), have garnered attention for their potential in treating psychiatric disorders. Microdosing, the repeated consumption of sub-hallucinogenic doses of psychedelics, has emerged as a self-treatment approach for depression within lay communities. Building upon preliminary evidence and the successful completion of an open-label pilot trial of microdosing LSD for depression (LSDDEP1), this protocol outlines a phase 2b randomised controlled trial (LSDDEP2). The main objective of LSDDEP2 is to assess the modification of depressive symptoms, measured by the Montgomery–Åsberg Depression Rating Scale (MADRS), following a regimen of LSD microdoses versus placebo.

Methods

This is a randomised, double-dummy, triple-blind, active placebo-controlled, parallel groups trial of LSD microdosing in patients meeting DSM-5 criteria for major depressive disorder. Participants will undergo an 8-week LSD microdosing regimen using the titratable MB-22001 formulation taking two doses a week. All doses will be self-administered at home and will be titratable from 4 to 20 μg based on subjective perception and tolerability. In addition to depression symptoms, outcome will include psychiatric and personality inventories, sleep and activity tracking, electroencephalography (EEG), blood biomarkers, semi-structured interviews, and safety (e.g. adverse event, laboratory exam) measures.

Discussion

This study will be the first randomised controlled trial to administer controlled microdoses of LSD for treatment of MDD in participants’ naturalistic environment. The measures included are designed to assess the drug’s safety, mechanism, and treatment efficacy over placebo in this population. The results of this study will be important for assessing the viability of psychedelic microdosing as an additional treatment option and for informing the direction of future clinical trials.

Trial registration

ANZCTR, ACTRN12624000128594. Prospectively Registered on 13 February 2024.
Knowledge and practices of youth awareness on death and dying in school settings: a systematic scoping review protocol
Authors: Allard Emilie , Coupat Clémence , Lessard Sabrina , Therrien Noémie , Godard-Sebillotte Claire , Létourneau Dimitri , Nguyen Olivia , Côté Andréanne , Fortin Gabrielle , Daneault Serge , Soulières Maryse , Le Gall Josiane , Fortin Sylvie
Published: August 2024

Background

Awareness-raising and education have been identified as strategies to counter the taboo surrounding death and dying. As the favoured venue for youth education, schools have an essential role to play in informing future decision-makers. However, school workers are not comfortable addressing the subjects of death and dying, which, unlike other social issues, have no guidelines to influence awareness of these subjects in youth.

Objectives

To systematically explore the knowledge and practices on raising awareness about death and dying in schools, the viewpoints of the people involved (young people, school workers; parents), and the factors that either promote or hinder awareness practices.

Method

The scoping review method of Levac and Colquhoun (Implement Sci 5(1):69, 2010) will be used. Using a combination of keywords and descriptors, a body of literature will be identified through 15 databases and through grey literature searches, manual searches, consultation of key collaborators, and the list of relevant literature. Publications since 2009 will be selected if they relate directly to awareness-raising about death and dying in schools. Writings will be selected and extracted by two independent people, and conflicts resolved by consensus. The extracted data will be synthesized using a thematic analysis method. Experts from a variety of disciplines (health sciences, humanities, social sciences, and education) will be consulted to enhance the interpretation of the preliminary results. Results will be presented in narrative form and will include tables and diagrams.

Conclusion

The results of this scoping review will contribute to the development of educational practices adapted to young people and to the identification of future avenues of research on awareness of death and dying.
Policy brief – cancer research in Belgium
Authors: Toungouz Gordana Raicevic , Poirel Hélène A. , Schittecatte Gabrielle , Van Den Bulcke Marc ,   on behalf of the Belgian Cancer Research Alliance, Camille Andries , Yves Beguin , Sofie Bekaert , Geert Berx , Cedric Blanpain , Karine Breckpot , Pierre Close , Stefan Constantinescu , An Coosemans , Frederik Coopens , René Custers , De Jacques Greve , De Katleen Preter , François Fuks , Lode Godderis , Isabelle Houbracken , Frederic Kridelka , Le Veronique Ray , Robrecht Lembrechts , Evy Lobbestael , Sophie Lucas , Jean-Pascal Machiels , Bart Neyns , Agnès Noel , Piet Ost , Marc Peeters , Martine Piccart , Suzy Renckens , Ward Rommel , Pieter Rondou , Gwen Sys , Sabine Tejpar , Van den Isabelle Bulck , Van der Jiska Reest , Van Dirk Gestel , Van Johan Lint , Karin Vanderkerken , Xavier Verhelst , Agnieszka Wozniak , Pascale Zimmermann
Published: August 2024

Research is central to achieving Europe’s Beating Cancer Plan, and is the key focus of the European Commission’s Mission on Cancer. To successfully tackle the challenges we face in cancer research, a coordinated effort of the entire Belgian scientific community is needed. It is for this reason the Belgian Cancer Research Alliance was proposed. The aim of BeCRA is to bring together various Belgian research institutes and associated care institutions and position them optimally at the EU level, with respect to the many research initiatives launched in the EBCP within the EU4Health program, the Mission on Cancer, Digital Europe programs and other EU projects. Members of BeCRA collaboratively plan the participation in certain cancer research activities to ensure optimal use of investment and sustained excellence of Belgian cancer research. Belgium cancer research has an excellent track record in fundamental, translational research and phase I, II, III clinical trials. However, translating outcomes from research to patients in the Belgian healthcare system has been less successful. Gaps in the collaboration between actors in the research field, have led to fragmentation hampering the development of fundamental and translational research. Moreover, actors from multi-disciplinary background, such as behavioural or psycho-social fields, are not systematically included in cancer research. More efficient coordination between the aforementioned actors is necessary. Academic hospitals and universities should be incentivized to collaborate across regions, as well as to put sufficient focus on research activities with a virtuous spiral ("bed-to bench" and "bench to bed" process), while supporting researchers focusing on patient-driven research. There is an urgent need for Belgium to determine how best to ensure it remains an attractive market so that patients have access to innovative care. This could include streamlining regulatory complexity, while establishing lean and harmonized clinical trial designs, procedures and networks.
An algorithmic strategy for measuring police presence with GPS data
Authors: Khalfa Robin , Snaphaan Thom , Hardyns Wim
Published: August 2024

This study introduces an algorithmic strategy for measuring dimensions of police presence at microgeographic units using GPS data from police patrol units. The proposed strategy builds upon the integrated theory of hot spots patrol strategy from Sherman et al. (Journal of Contemporary Criminal Justice 30:95–122, 2014), focusing on three key dimensions: the frequency, duration, and intermittency of police presence. This study provides pseudocodes for the algorithm, facilitating the pre-processing of GPS-derived data sequences to generate measures of these three central concepts. The measures presented in this article offer a framework for investigating the impact of police presence on crime and other relevant crime-related outcomes at microgeographic units, using GPS data. This algorithmic strategy may further contribute to the development of evidence-based strategies in place-based policing initiatives.
Facile extraction of scanning probe shape for improved deconvolution of tip-sample interaction artifacts
Authors: Jung Kibum , Lee Jungchul
Published: August 2024

Atomic Force Microscopy (AFM) has intrinsic tip-sample convolution artifacts. Commercially available tip-check samples are used to obtain only the tip radius, which can be used to deconvolute surface profiles or to quantify tip wear by relying on AFM alone. When the sample height is of the order of 100 nm or more, not only the tip radius but also the overall tip shape plays a key role in imaging. Therefore, it is necessary to know the overall tip shape, which requires a structured sample that is much larger than tip-check samples. Here, we propose to use deep reactive ion-etched holes of 1 µ diameter and 5 µ height to reconstruct the overall tip shape of three different AFM probes, namely conical, pyramidal and tetrahedral. The proposed cylindrical hole structure seems promising, as simple inversion of AFM images can provide sufficient collective features to be used for deconvolution and image enhancement.
Early childhood teachers amid China’s curriculum reforms: from a literature review
Authors: Chen Dandan , Chen Yucheng , Chi Jin
Published: August 2024

This article examines the crucial role of early childhood teachers in China’s ongoing curriculum reforms by addressing two key questions: (1) how teachers interact with the curriculum reform cycle, and (2) what specific roles they play within the reforms. We synthesize literature on early childhood teachers’ involvement in China’s curriculum reforms and provide insights for future improvements in teachers’ status. Our analysis reveals that teachers contribute to establishing curricular goals, selecting content, and implementing instructional methods. However, they lack formal roles in setting educational goals and face limitations due to administrative decisions and societal expectations. Their knowledge and experience are often underutilized. Based on these findings, we propose increased teacher training to enhance their capacity and contribution, and improved policies for teacher recruitment, retention, and empowerment.
Distress reactions and susceptibility to misinformation for an analogue trauma event
Authors: Sharma Prerika R. , Spearing Emily R. , Wade Kimberley A. , Jobson Laura
Published: August 2024

Accuracy of memory is critical in legal and clinical contexts. These contexts are often linked with high levels of emotional distress and social sources that can provide potentially distorting information about stressful events. This study investigated how distress was associated with susceptibility to misinformation about a trauma analogue event. We employed an experimental design whereby in Phase 1, participants (N = 243, aged 20–72, 122 females, 117 males, 4 gender diverse) watched a trauma film (car crash) and heard an audio summary that contained misinformation (misled items), true reminders (consistent items), and no reminders (control items) about the film. Participants rated their total distress, and symptoms of avoidance, intrusions, and hyperarousal, in response to the film. They then completed cued recall, recognition, and source memory tasks. One week later in Phase 2, participants (N = 199) completed the same measures again. Generalised linear mixed models were used. A significant misinformation effect was found, and importantly, participants with higher distress levels showed a smaller misinformation effect, owing to especially poor memory for consistent items compared to their less distressed counterparts. Distress was also associated with improved source memory for misled items. Avoidance of the film’s reminders was associated with a smaller misinformation effect during immediate retrieval and a larger misinformation effect during delayed retrieval. Findings suggest that distress is associated with decreased susceptibility to misinformation in some cases, but also associated with poorer memory accuracy in general. Limitations are discussed, and the need for further research is highlighted.
The effect of vitamin D on the hormonal profile of women with polycystic ovarian syndrome: a systematic review and meta-analysis
Authors: Kazeminia Mohsen , Rajati Fatemeh , Rasulehvandi Roumina , Rajati Mojgan
Published: August 2024

Background

Polycystic ovarian syndrome (PCOS) is recognized as the most common endocrine disorder among women of reproductive age and the most common cause of infertility. Given the importance of the subject and the inconsistency of the results of the primary studies, the present study aimed at estimating the pooled effect of vitamin D on the hormonal profile of women with PCOS using systematic review and meta-analysis.

Main body

A systematic literature review was performed in PubMed, Scopus, Embase, Web of Science (WoS), Cochrane, ClinicalTrials.gov databases, and Google Scholar motor engine using related Medical Subject Headings (MeSH) and Free Text words with no time limit to April 2022. Heterogeneity among studies was quantified using I2 index. After eliminating duplicates and irrelevant studies, ultimately, 19 articles with a sample size of 450 in the intervention group and 450 in the control group were included in the meta-analysis. As a result of the combination of studies, mean the standardized difference (SMD) before and after the intervention was obtained 0.241 ± 0.098 for dehydroepiandrosterone sulfate (DHEAS), 0.330 ± 0.092 for sex hormone-binding globulin (SHBG), 0.707 ± 0.171 for testosterone, 0.614 ± 0.199 for luteinizing hormone (LH), 0.220 ± 0.119 for follicle-stimulating hormone (FSH), 0.655 ± 0.505 for anti-Müllerian hormone (AMH), and 0.369 ± 0.109 for Free Androgen Index (FAI) in the intervention group compared to the control group. The results indicated that 8-week interventions had a greater positive effect than 12-week interventions.

Conclusion

The results of the current meta-analysis revealed a significant positive effect of vitamin D on the hormonal profile of women with PCOS, which should be considered by obstetricians and midwives.
Clinical, electrocardiographic, echocardiographic, and angiographic predictors for the final infarct size assessed by cardiac magnetic resonance in acute STEMI patients after primary percutaneous coronary intervention
Authors: Samir Ahmad , Nagy Sherif , Abdelhamid Magdy , Kandil Hossam
Published: August 2024

Background

Final infarct size (IS) after ST segment elevation myocardial infarction (STEMI) is a major predictor of mortality. Seeking early predictors for final IS can guide individualized therapeutic strategies for those recognized to be at higher risk.

Results

Eighty STEMI patients successfully treated with primary percutaneous coronary intervention (pPCI) underwent baseline (within 48 h) 2D, 3D echocardiography with speckle tracking and then underwent cardiac magnetic resonance (CMR) at 3 months to assess the final IS. After recruitment, 4 patients were excluded for uncontainable claustrophobia while 76 patients completed the final analysis. The mean ± standard deviation age was 54.1 ± 10.9 years, 84% were males, 25% had diabetes, 26% were hypertensives, 71% were current smokers, 82% had dyslipidemia, and 18% had a family history of premature coronary artery disease. By 3 months, CMR was performed to accurately evaluate the final IS. In univariate regression analysis, the admission heart rate, baseline and post-pPCI ST elevation, STEMI location (anterior vs. inferior), highest peri-procedural troponin, large thrombus burden, baseline thrombolysis in myocardial infarction flow grade, the final myocardial blush grade, the 2D and 3D left ventricular ejection fraction (LVEF), and the 2D and 3D global longitudinal strain (GLS) parameters were significant predictors for the final IS. In the multivariate regression analysis, four models were constructed and recognized the residual post-PCI ST segment elevation, the highest peri-procedural troponin, the 2D-LVEF, 3D-LVEF, and 2D-GLS as significant independent predictors for final IS.

Conclusions

In STEMI patients who underwent successful pPCI, early predictors for the final IS are vital to guide therapeutic decisions. The residual post-pPCI ST elevation, the highest peri-procedural troponin, and the baseline 2D-LVEF, 3D-LVEF, and 2D-GLS can be excellent and timely tools to predict the final IS.
A novel approach, AngioVac use in right-sided infective endocarditis: a scoping review
Authors: Alshair Fahad M. , Alsulami Amal S. , Baghaffar Abdullah H. , Fatani Mazin A.
Published: August 2024

Background

Infective endocarditis is an infection of microbial origin affecting the endocardial layer of the heart, mostly impacting the heart valves. Right-sided infective endocarditis mainly affects the tricuspid valve. In some cases where surgical management is indicated the patients might not be good candidates for surgery. The AngioVac drainage cannula (AngioDynamics, Latham, NY, USA) is a novel device used in debulking and suction of intravascular material. It has been reported in the literature as a novel treatment for patients with right-sided tricuspid valve endocarditis vegetations, where their size is reduced and the efficacy of antibiotics in clearing the bloodstream infection is enhanced.

Methods and results

We conducted a thorough literature review to assess the uses of the AngioVac drainage cannula in the management of right-sided infective endocarditis vegetations and lesions. We collected all reported cases where the system was used for the management of right-sided infective endocarditis and performed an encompassing review of the literature. In the review, we found 65 cases reported using the AngioVac drainage cannula for the removal of right-sided infective endocarditis vegetations. Majority of the cases were successful with no complications (87.6%); 7 (10.7%) cases were successful but there were complications: 2 reported mortalities, 1 patient had worsening TR during follow-up, 3 had recurrence of the vegetation, and 1 patient remained bacteremic. There was only 1 reported failure. Four (6.1%) patients required postprocedural valvular surgery with 3 repairs and a single valve replacement.

Conclusions

The AngioVac system is a possible bailout option for surgeons managing patients with right-sided infective endocarditis vegetations who are not ideal candidates for surgery. With increased reports on its use, it could be effective at reducing the microbiological burden with minimal complications.
Pan-cancer analysis identifies venous thromboembolism-related genes F3, PLAT, and C1S as potential prognostic biomarkers for glioblastoma and lower grade glioma
Authors: Zhang Jing , Zhao Qian , Du Yun , Wang Wannan , Liu Cuiqing
Published: August 2024

Venous thromboembolism (VTE) is a prevalent complication among patients with cancer, contributing significantly to morbidity and mortality. However, the relationship between VTE-related genes (VRGs) and their potential impact on prognosis, immune response, and therapeutic targets in various cancer types remains unclear. Based on the coagulation and complement pathways, we identified hub VRGs that play a role in regulating the immune response in cancer. Specifically, coagulation factor III (F3), plasminogen activator (PLAT) and complement C1s (C1S) were identified as genes that exhibit high expression levels, positively correlating with tumor stemness and copy number variations, while inversely correlating with methylation levels, in particular cancer types. Pan-cancer survival analysis revealed detrimental effects of these VRGs in several cancer types, notably in glioblastoma and lower grade glioma (GMBLGG). Further analysis using receiver operating characteristic (ROC) curves demonstrated a high accuracy of F3, PLAT and C1S in predicting outcomes in GBMLGG, with area under the curve (AUC) values ranging from 0.78 to 0.9. Validation of the prognostic value of these three genes in GMBLGG was conducted using an independent Gene Expression Omnibus (GEO) dataset. Additionally, gene–drug association analysis identified ciclosporin, ouabain and 6- mercaptopurine, which all exhibit immunosuppressive properties, as potential therapeutic options for tumor patients exhibiting high F3, PLAT or C1S expression, respectively. In summary, our findings provide a bioinformatics perspective on VRGs in pan-cancer, highlighting the pivotal roles of F3, PLAT and C1S, which could potentially be therapeutically exploited and targeted in several cancers, especially in GBMLGG.
Anastrozole vs Letrozole to Augment Height in Pubertal Males With Idiopathic Short Stature: A 3-Year Randomized Trial
Authors: Zegarra Walter , Ranadive Sayali , Toulan Diane , Neely E Kirk
Published: August 2024

Context

Insufficient efficacy and safety data for off-label use of aromatase inhibitors to augment height in boys with short stature.

Objective

To compare anastrozole and letrozole in treatment of idiopathic short stature in pubertal boys.

Design

Open-label trial with 2 treatment arms.

Setting

Pediatric Endocrine Clinic at Stanford.

Participants

A total of 79 pubertal males ≥10 years with bone age (BA) ≤ 14 years, predicted adult height (PAH) < 5th percentile or >10 cm below mid-parental height.

Intervention

Anastrozole 1.0 mg or letrozole 2.5 mg daily for up to 3 years.

Main Outcome Measures

Annual hormone levels and growth parameters during treatment and a year posttherapy; annual BA and PAH (primary outcome measure); spine x-rays and dual energy X-ray absorptiometry at baseline and 2 years.

Results

Compared with anastrozole (n = 35), letrozole (n = 30) resulted in higher testosterone levels, lower estradiol and IGF-1 levels, and slower growth velocity and BA advance. The PAH increase observed at year 1 in both groups did not persist at years 2 and 3. Change in PAH from baseline was not different between treatment groups. In groups combined, PAH gain over 3 years vs baseline was +1.3 cm (P = .043) in linear mixed models.

Conclusion

Letrozole caused greater deviations than anastrozole in hormone levels, growth velocity, and BA advancement, but no group differences in PAH or side effects were found. Change in PAH after 2 to 3 years of treatment was minimal. The efficacy of AI as monotherapy for height augmentation in pubertal boys with idiopathic short stature may be limited, and safety remains an issue.
Racial and Ethnic Differences in Postoperative Nausea and Vomiting Care
Authors: Owusu-Agyemang Pascal , Idowu Olakunle , Muthukumar Arun , Guerra-Londono Juan Jose , Idowu Techecia , Diaz Nancy N. , Feng Lei , Miller Malachi , Gundre Satvik , Wright Crystal , Cata Juan P.
Published: August 2024

BACKGROUND:

Racial and ethnic differences in health care may result in significant morbidity. The objective of this study was to determine whether there was an association between a patient’s race or ethnicity and the receipt of an antiemetic agent preoperatively, during surgery, and in the recovery room.

METHODS:

A single-institution retrospective study of adult patients (>18 years) who had undergone cancer-related operating room procedures under anesthesia between March 2016 and August 2021 was conducted. A multivariable logistic regression model was fitted to estimate the effects of covariates on antiemetic administration.

RESULTS:

Of the 60,595 patients included in the study, 3053 (5.0%) self-identified as Asian, 5376 (8.9%) as Black, 8431 (13.9%) as Hispanic or Latino, 42,533 (70.2%) as White, and 1202 (2.0%) as belonging to another racial or ethnic group. Multivariable analyses showed significant associations between a patient’s race or ethnicity and the receipt of antiemetics in the preoperative holding area, operating room, and recovery room (all P < .001). In the preoperative holding area, White patients (8962 of 42,533 [21.1%]; odds ratio [OR], 1.188; 95% confidence interval [CI], 1.100–1.283; P < .001) had higher odds of receiving an antiemetic than Black patients (1006 of 5376 [18.7%]). Intraoperatively, the odds were significantly greater for Hispanic or Latino (7323 of 8431 [86.9%]; OR, 1.175; 95% CI, 1.065–1.297; P = .001) and patients who identified as belonging to another race (1078 of 1202 [89.7%]; OR, 1.582; 95% CI, 1.290–1.941; P < .001) than for Black patients (4468 of 5376 [83.1%]). In the recovery room, Asian (499 of 3053 [16.3%]; OR, 1.328; 95% CI: 1.127–1.561; P < .001), Hispanic or Latino (1335 of 8431 [15.8%]; OR, 1.208; 95% CI, 1.060–1.377; P < .005), and White patients (6533 of 42,533 [15.4%]; OR, 1.276; 95% CI, 1.140–1.427; P < .001) had significantly higher odds of receiving antiemetics than Black patients (646 of 5376 [12%]).

CONCLUSIONS:

This retrospective study suggests significant differences between the administrations of antiemetics to patients of different races or ethnicities, with Black patients often being less likely to receive an antiemetic than patients belonging to all other races or ethnicities.
Preoperative Atelectasis in Patients with Obesity Undergoing Bariatric Surgery: A Cross-Sectional Study
Authors: Mancilla-Galindo Javier , Ortiz-Gomez Jesus Elias , Pérez-Nieto Orlando Rubén , De Jong Audrey , Escarramán-Martínez Diego , Kammar-García Ashuin , Ramírez Mata Luis Carlos , Díaz Adriana Mendez , Guerrero-Gutiérrez Manuel Alberto
Published: August 2024

BACKGROUND:

Pulmonary atelectasis is present even before surgery in patients with obesity. We aimed to estimate the prevalence and extension of preoperative atelectasis in patients with obesity undergoing bariatric surgery and to determine if variation in preoperative Spo
2 values in the seated position at room air is explained by the extent of atelectasis coverage in the supine position.

METHODS:

This was a cross-sectional study in a single center specialized in laparoscopic bariatric surgery. Preoperative chest computed tomographies were reassessed by a senior radiologist to quantify the extent of atelectasis coverage as a percentage of total lung volume. Patients were classified as having atelectasis when the affection was ≥2.5%, to estimate the prevalence of atelectasis. Crude and adjusted prevalence ratios (aPRs) and odds ratios (aORs) were obtained to assess the relative prevalence of atelectasis and percentage coverage, respectively, with increasing obesity category. Inverse probability weighting was used to assess the total, direct (not mediated), and indirect (mediated through atelectasis) effects of body mass index (BMI) on preoperative Spo
2, and to quantify the magnitude of mediation (proportion mediated). E-values were calculated, to represent the minimum magnitude of association that an unmeasured confounder with the same directionality of the effect should have to drive the observed point estimates or lower confidence intervals (CIs) to 1, respectively.

RESULTS:

In 236 patients with a median BMI of 40.3 kg/m2 (interquartile range [IQR], 34.6–46.0, range: 30.0–77.3), the overall prevalence of atelectasis was 32.6% (95% CI, 27.0–38.9) and by BMI category: 30 to 35 kg/m2, 12.7% (95% CI, 6.1–24.4); 35 to 40 kg/m2, 28.3% (95% CI, 17.2–42.6); 40 to 45 kg/m2, 12.3% (95% CI, 5.5–24.3); 45 to 50 kg/m2, 48.4% (95% CI, 30.6–66.6); and ≥50 units, 100% (95% CI, 86.7–100). Compared to the 30 to 35 kg/m2 group, only the categories with BMI ≥45 kg/m2 had significantly higher relative prevalence of atelectasis—45 to 50 kg/m2, aPR = 3.52 (95% CI, 1.63–7.61, E-value lower bound: 2.64) and ≥50 kg/m2, aPR = 8.0 (95% CI, 4.22–15.2, E-value lower bound: 7.91)—and higher odds of greater atelectasis percentage coverage: 45–50 kg/m2, aOR = 7.5 (95% CI, 2.7–20.9) and ≥50 kg/m2, aOR = 91.5 (95% CI, 30.0–279.3). Atelectasis percent alone explained 70.2% of the variation in preoperative Spo
2. The proportion of the effect of BMI on preoperative Spo
2 values <96% mediated through atelectasis was 81.5% (95% CI, 56.0–100).

CONCLUSIONS:

The prevalence and extension of atelectasis increased with higher BMI, being significantly higher at BMI ≥45 kg/m2. Preoperative atelectasis mediated the effect of BMI on Spo
2 at room air in the seated position.
A critical review of the Iranian National Olympic Committee's performance in designing the opening parade costumes: signs of inefficiency and damage to the national identity
Authors: Kiani Mohammad Saeid
Published: August 2024

This research aims to evaluate and critique the performance of the Iranian National Olympic Committee in designing the costumes for the Olympic opening parade. The study seeks to identify the strengths and weaknesses of these designs and compare them with successful global examples to help improve future designs. A review method was used to achieve this goal. This method involved examining previous research related to the design of Olympic uniforms and the criticisms they received. The analysis included public and media critiques, athlete surveys, and an examination of the characteristics of successful international designs.The findings indicate that Iran's Olympic uniforms have struggled to make a positive impact internationally due to weaknesses in aligning with global standards, a lack of attention to cultural symbols, and inadequate use of modern technologies. Compared to successful global designs, these uniforms have faced challenges in representing national identity and effectively communicating with audiences. The study concludes that to improve future designs, the Iranian National Olympic Committee should focus on enhancing collaboration with cultural and social experts, using international consultants to align with global standards, and establishing continuous evaluation processes to identify and address weaknesses. Additionally, developing specialized teams and providing training for designers are recommended to improve design quality and elevate national prestige on the international stage.
Erythritol's Impact on Body Weight and Overall Health
Authors: Marcinkowska Jagoda , Miśkiewicz Marek , Ptak Jakub , Noga Rafał , Herc Adrian , Koczkodon Karolina , Teska Victoria , Perłowski Jakub , Sawczuk Marcelina , Krompiewski Mariusz
Published: August 2024

Erythritol, a sugar alcohol derived from carbohydrate hydrolysis, is gaining attention for its unique properties and potential health benefits. While it occurs naturally in small quantities in certain foods, industrial production methods have made it a popular sugar substitute in various consumer products.
Erythritol's sweetness coupled with its low or negligible calorie content, positions it as an attractive option for individuals seeking to manage weight or diabetes. Unlike some polyol sweeteners, erythritol's absorption in the small intestine does not lead to gastrointestinal distress, making it widely used in foods and beverages.
Research indicates that erythritol's ingestion does not significantly impact serum glucose or insulin levels, making it suitable for individuals with diabetes or those managing carbohydrate intake.
Moreover, erythritol shows promise in improving endothelial function and protecting against vascular complications associated with diabetes. Individuals with carbohydrate disorders or those who are overweight represent only a segment of the population that may benefit from erythritol. This sweetener also offers a spectrum of advantageous effects on oral and gastrointestinal health.
However, while erythritol offers numerous potential benefits, further studies are needed to fully understand its long-term effects on the human body.
This review compiles current data on erythritol's metabolism and underscores erythritol's multifaceted and beneficial potential role in health.
Plan for revamp of early help
Authors: Simpson Fiona
Published: August 2024

Pathfinder aims to get support to families earlier, but limited funding will restrict impact, say experts
Schools to extend reach through more places for two-year-olds
Authors: Weinstein Nicole
Published: August 2024

Faced with a shortage of childcare provision in some areas, councils are submitting proposals to allow schools to admit two-year-olds, but some experts raise questions over the quality of early education being provided
Factors for high DCS turnover
Authors: Harle Emily
Published: August 2024

Directors of children's services say they need better training to prepare for demands of the role
Research evidence: Using young people's stories to gather evidence and show impact
Authors: Podyma Ross
Published: August 2024

How does a charity with a history of meeting the needs of young people in deprived communities adapt how it works to gather evidence of impact? Here's how Sporting Communities tackled this
The impact of inflation
Authors: Rome Andrew
Published: August 2024

Double-digit cost increases for providers are an issue commissioners must navigate carefully, explains Andrew Rome
Legal aid changes
Authors: Oldershaw Richard
Published: August 2024

Richard Oldershaw, senior legal consultant at Coram Children's Legal Centre's Child Law Advice Service, looks at the impact of changes to legal aid arrangements on children's access to justice
Bury Metropolitan Borough Council
Authors: Hayes Derren
Published: August 2024

North West borough has plans to transform children's social care but a shortage of permanent practitioners remains a problem
Türk Kültüründe Ant İçme Törenleri ve Yeni Bir Ant İçme Töreni Olarak “Toprak Ferağı (Toprak Andı)"
Authors: Çeribaş Mehmet
Published: August 2024

Kültürel unsurları yaşamını sürdürmesi ve geleceğe taşınması toplumun o unsura yüklediği anlam ve işlevle orantılıdır. Toplum nazarında değerini ve işlevini koruyan bu unsurların, tarih süreçte değişim ve dönüşümü söz konusu olsa da varlığını koruduğu ve farklı şekillerde yaşamaya devam ettiği görülmektedir. Türklerin de töreci/kültürcü bir toplum olarak çağın şartlarına göre kendi kültürel unsurlarını değiştirerek ve dönüştürerek yaşattığı anlaşılmaktadır. Bu türden kültürel unsurları başat unsurlar olarak adlandırmak mümkündür.
Türk kültür evreninde başat unsurlardan birisi de ant törenleridir. Türklerin farklı coğrafyalarda, farklı zamanlarda, farklı tarihi ve siyasi şartlarda vazgeçmediği kültürel unsur olarak yaşamanı sürdüren ant törenleri, şekli birtakım değişikliklere uğrasa da varlığını canlı olarak korumayı bilmiştir. Bu durum büyük oranda sözlü kültürün gücünü de göstermektedir. Sözlü kültür ortamında insan ilişkilerini düzenleyen, toplumda düzenin ve hukuk sisteminin yaşatılması amacına hizmet eden ant törenlerinin çeşitleri çok olmakla birlikte özellikle bir hukuk sistemine ihtiyaç duyulan evlilik gibi törenlerde, devlet törenlerinde, askeri törenlerde ve alışveriş gibi uygulamalarda karşımıza çıktığı dikkatten kaçmamaktadır. Sözlü, sözsüz ve sözlü ve davranışa dayalı olarak yapılan bu törenlerde değişik kutsal unsurların kullandığı görülmektedir. Bu unsurların içerisinde kan, şarap, kılıç, kutsal kitap gibi nesneler olabileceği gibi su, taş, toprak gibi, gök gibi kutsal tabiat unsurları da kullanılmaktadır. Bu çalışmada da Anadolu Türk coğrafyasının kültürel laboratuvarlarından sayılan ve Kuzeydoğu Çukurova’da, Kadirli ve Andırın havalisi arasında yaşayan ve yakın zamanda tespit ettiğimiz bir ant içme töreni olan Toprak Ferağı (Toprak Andı) üzerinde durulacaktır.
Self-sovereign and Secure Data Sharing Through Docker Containers for Machine Learning on Remote Node
Authors: Seo Jungchul , Lee Younggyo , Yoon Young
Published: August 2024

Collecting personal data from various sources and using it for machine learning (ML) is prevalent. However, there are increasing concerns about the monopolization and potential breach of private data by greedy and malicious organizations. Interest in Web 3.0 systems is on the rise as an alternative. These systems aim to guarantee the self-sovereignty of personal data in a decentralized setting. Users can share data with others directly for fair compensation. Nevertheless, malicious remote users can still violate the integrity and confidentiality of personal data. Therefore, this paper proposes a novel method of preventing unwanted leakage and counterfeiting of the private data lent on the premise of remote users. This paper focuses on the decentralized nature of Web 3.0 to leverage existing personal storage so that the burden of collecting secure data is relieved. Data owners create a lightweight Docker container to encapsulate their private data sources. The data owners generate another container to be deployed on a remote premise for taking and executing any ML algorithms remote users create. Between the containers forming a distributed trusted execution environment (TEE), data are read through a secure channel. Since the TEE is strictly controlled by the data owner, no malicious ML application can leak or breach the private information. This paper explains the engineering details of how this new method is realized.
Diversity of Social Hymenoptera (Hymenoptera: Aculeata) and Reduction of Sampling Effort in a Dense “terra-firme” Rainforest in the Amazon
Authors: Silva Antonielson Bezerra , Ronchi-Teles Beatriz , Godoi Fabio Siqueira Pitaluga , Souza Jorge Luiz Pereira , Fernandes Daniell Rodrigo Rodrigues
Published: August 2024

We investigated the richness and composition of social Hymenoptera collected with a Malaise trap in a rainforest in the Amazon. In addition, we studied the possibility of reducing the number of traps and the time the traps remain in the field to minimize the sampling effort. In reducing sampling effort, we seek to maintain taxonomic standards (similarity in composition) and reduce both the time the Malaise trap remains in the field and the number of traps per plot. We collected 63 species of social Hymenoptera, represented by 11 species of Apidae, 31 of Formicidae, and 21 of Vespidae, in 30 plots of 250 m distributed in 25 km² of rainforest in the Amazon. It was possible to reduce the permanence time of the Malaise trap in the field from 72 to 48 hours without significant loss of the maximum recorded diversity since there is high similarity (80%) to the maximum effort of 72 hours of sampling. The reduction from two to one trap directly impacted the sampled diversity. We estimate savings of 30.53% by reducing sampling effort and trap dwell time, allowing the resources saved to be invested more efficiently in biodiversity monitoring studies in the Amazon basin.