bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic aspects of long‐term left ventricular assist device treatment for chronic heart failure
Authors: Welp Henryk , Sindermann Jürgen , Dell'Aquila Angelo Maria , Deschka Heinz , Hoffmeier Andreas , Scherer Mirela
Published: May 2024

Aims

Technological advances and the current shortage of donor organs have contributed to an increase in the number of left ventricular assist device (LVAD) implantations in patients with end‐stage heart failure. Demographic change and medical progress might raise the number of these patients, resulting in a further increase in the number of LVAD implantations. The aim of this study was to evaluate the long‐term costs of LVAD therapy and identify diagnoses resulting in expensive stays.

Methods and results

In this retrospective analysis of prospectively collected data, all patients after implantation of a second‐ or third‐generation LVAD by 31 March 2022 were included. In addition to demographic and survival data, revenues and case mix points were determined for each patient. Of the 163 patients included, 75.5% were male. The mean age at LVAD implantation was 52 ± 14 years. The mean survival was 1458 ± 127 days. During follow‐up, the total inpatient treatment time per patient was 70 ± 87 days. The average duration of outpatient treatment was 55.1%, based on the total duration of support. The average revenue per patient for the implant stay was $193 192.35 ± $111 801.29, for inpatient readmissions $52 068.96 ± $116 630.00, and for outpatient care $53 195.94 ± $62 363.53.

Conclusions

LVAD implantation in patients with end‐stage heart failure leads to improved survival but a significant increase in treatment costs. Further multi‐centre studies are necessary in order to be able to assess the effects of long‐term LVAD treatment on the healthcare system.
Direct Functionalization of para‐Quinones: A Historical Review and New Perspectives
Authors: Kumar Jha Raushan , Kumar Sangit
Published: May 2024

The direct functionalization of quinones has always fascinated research communities due to their biological and redox activities and subsequent application. Quinone motifs play a vital role as precursors for many bioactive compounds and materials; hence, many ingenious methodologies have been elaborated for exploring these units. A significant part of the synthetic strategies towards the functionalized quinones has been achieved by installing substituents on hydroquinones, phenols, or quinone itself by different oxidative coupling reactions via radical pathways with or without the utilization of metal catalysts. The functionalization of simple quinones via direct C−H bond remains challenging due to their inherited electronic nature and high bond dissociation energy. This review article summarizes the recent advancement made for functionalized quinones through direct functionalization of simple quinones. Our primary focus will be on the synthetic approaches and mechanistic pathways of these reactions that have appeared in the last two decades, along with a short historical importance of the quinone family.
Core Shell Structured Silica/Porous Carbon Composite as an Efficient Anode for Lithium Ion Batteries
Authors: Gulavani Vaibhavi , Kanade Sandeep , Lokhande Abhay , Ottakam Thotiyl Musthafa , John Bibin , Yengantiwar Ashish
Published: May 2024

Si‐based materials are taken into consideration as suitable anode materials for lithium‐ion (Li‐ion) batteries due to their high specific capacity. However, their cycle life is limited due to high volumetric changes during discharging and charging in Li‐ion battery (LIB). Silica (SiO2) is abundantly present in nature, but standalone delivers moderate Li storage capacity. Commercially, graphite is considered as efficient anode in LIB. The current research focuses on improving the performance of silica as anode material to achieve the best specific capacity of LIBs. Herein, the core‐shell‐structured silica/porous carbon composite (50:50, wt%) is synthesized using a hydrothermal method. The shell of porous carbon not only covers the core silica but also provides a very high surface area of ≈1057 m2 g−1 to the composite. The synthesized silica/porous carbon composite acts as an active anode material in Li‐ion half‐cell, which shows the best specific capacity of ≈642 mAh g−1 at 700 cycles at 100 mA g−1 current density and a high capacity retention of ≈97%. The porous carbon on silica helps in the uniform percolation of the electrolyte. It also provides a conducting path to the electrons and further reduces Li‐ion diffusion time by producing more active sites. The shell of porous carbon on core‐silica helps to suppress the volumetric changes that happen during the lithiation and de‐lithiation process. Due to these advantages, the core‐shell‐structured silica/porous carbon composite anode shows consistent and stable cycling performance over large number of cycles.
Exploring the Thermal Potential of Shape Stabilized Graphene Nano Platelets Enhanced Phase Change Material for Thermal Energy Storage
Authors: Islam Anas , Pandey Adarsh Kumar , Bhutto Yasir Ali , Balasubramanian Kalidasan , Rahman Saidur , Zaed Md. Abu
Published: May 2024

Low thermal conductivity and liquid phase leakage impede the widespread adoption of phase change materials (PCMs). To enhance PCM performance and practical viability, addressing these limitations is crucial. Current study addresses low thermal conductivity and leakage issues. Enhanced thermal conductivity in PCMs is achieved by adding graphene nanoplatelets (GnPs), while expanded graphite (EG) acts as a leak‐proof barrier. The composite PCM (ss‐NePCM) composite is developed by ultra‐sonication followed by vacuum impregnation process. The samples underwent comprehensive analysis: thermal conductivity (TEMPOs), chemical composition (FTIR), photo‐transmittance (UV–Vis), and thermal stability (TGA). The results show that the composite with 0.6 wt% GnP (NePCM3) has the highest thermal conductivity enhancement of ≈112% while adding 15 wt% EG (ss‐NePCM3) diminishes leakage problem. According to the optical performance assessment, the composite exhibits a notable increase in absorbance of 116% higher than that of the base PCM. However, due to the introduction of additives, the differential scanning calorimeter (DSC) detected a minor variation from 154 to 144.76 J g−1 in the latent heat. Furthermore, the composite demonstrates chemical stability and thermal reliability following 250 heating and cooling cycles. The ss‐NePCM holds promise for thermal systems, where leakage could jeopardize system integrity.
Hybrid surrogate model combining physics and data for seismic drift estimation of shear‐wall structures
Authors: Fei Yifan , Liao Wenjie , Zhao Pengju , Lu Xinzheng , Guan Hong
Published: May 2024

To address the issue of costly computational expenditure related to high‐fidelity numerical models, surrogate models have been widely used in various engineering tasks, including design optimization. Despite the successful application of the existing surrogate models, physics‐based models depend largely on simplifications and assumptions, which render parameter calibration challenging; whereas data‐driven models require substantial data to reach their full potential, with their performance often being constrained in tasks when obtaining massive data is difficult. In this study, a hybrid surrogate model is proposed combining physics‐based and data‐driven models to rapidly estimate building seismic responses. The application of this model is exemplified through effective estimation of inter‐story drift ratios (IDRs), being a critical factor in shear‐wall structure design. Initially, a data augmentation technique and a parametric modeling procedure are introduced to significantly enhance the dataset diversity. Subsequently, a task decomposition strategy is proposed to effectively integrate a data‐driven graph neural network (GNN) and a physics‐based flexural‐shear model. Additionally, the output layer and the loss function of the GNN are modified to enhance the estimation accuracy by eliminating fundamental errors. Results of numerical experiments indicate that the proposed hybrid model can complete IDR estimations in an average time of 0.56 s, with a mean absolute percentage error of 12.7%. This performance significantly surpasses that of existing purely data‐driven and physics‐based models. A case study shows that the efficiency of the proposed hybrid model is approximately 100 times greater than that of conventional finite element software. This enables an accurate assessment of the design compliance with code requirements. The results of this study can be applied to the design optimization of seismic‐resistant building structures.
Morphological and structural characteristics of preferential flow and its influencing factors on colluvial deposits of Benggang
Authors: Zhang Liting , Zhan Zhenzhi , Zhang Zhenggang , Yang Qiaoqiao , Zhou Man , Lin Jinshi , Zhang Yue , Huang Yanhe , Jiang Fangshi
Published: May 2024

Preferential flow plays a vital role in infiltration processes in structured soil. However, knowledge of preferential flow in colluvial deposits of Benggang remains limited. In this study, three typical colluvial deposits with different formation times were selected. The formation times of colluvial deposits A, B and C increased in sequence. Water infiltration in colluvial soil was visualized through Brilliant Blue dye experiments (a total of 90 photos from the dyed soil profiles). The dye morphological characteristics of preferential flow were analysed, and the influencing factors were explored. The dye morphological parameters confirmed the occurrence of preferential flow in the colluvial deposits. The dye coverage of colluvial deposit A was the greatest (61.12%), followed by colluvial deposits B (50.41%) and C (46.81%). The matrix flow depth, preferential flow fraction and length index of colluvial deposits A and B were greater than those of colluvial deposit C. Preferential flow was more notable in colluvial deposits A and B than in colluvial deposit C. The migration process of dyed water varied spatially. There were more preferential flow paths at a 10 cm horizontal width. In addition to the bulk density and saturated hydraulic conductivity, the soil particle composition, especially the gravel content (r = 0.740), was closely related to the observed dye coverage. According to the principal component analysis results, the soil particle composition imposed the greatest influence on the formation of preferential flow in the colluvial deposits, with a contribution of 45.24%. The results provide a theoretical reference for explaining the mechanism of soil infiltration processes and a systematic basis for the treatment of colluvial deposits.
Modeling the dissemination of privacy information in online social networks
Authors: Zhu Nafei , Li Wenhui , Pan Shijia , Jin Shuting , He Jingsha
Published: May 2024

Driven by the rapid development of information technology, online social networks (OSNs) have experienced a fast development in recent years, allowing increasingly more people to share and spread information over OSNs. The rapid rise of OSN platforms such as Facebook and Twitter is sufficient evidence of such development. As one type of information, privacy information can also be created and disseminated over an OSN, posing a severe threat to individual privacy. This article attempts to construct a model for disseminating privacy information in OSNs and to analyze the model by simulating the dissemination process of privacy information in OSNs. First, we establish network models that exhibit the main characteristics of OSNs. Second, by considering the factors related to social relationships, especially intimacy between users and the attention of users to the privacy subject, we derive the parameters for privacy information dissemination models in OSNs. Third, based on the theory of information dissemination dynamics, we construct a model for information dissemination that conforms to the properties of privacy information. We also present some experimental results based on the constructed model and analyze the characteristics of privacy information dissemination. Fourth, we study and verify the various properties of the model through a set of experiments. The proposed model provides the opportunity to better understand the dynamics of privacy information dissemination in OSNs and the effect of user behavior on dissemination.
Phytochemicals profiling of Cassia fistula fruit extract and its effect on serum lipids and hematological parameters in high‐fat diet‐induced hyperlipidemic female rats
Authors: Tariq Maryam , Ahmad Nazir , Nisa Mahr Un , Rahim Muhammad Abdul , Zongo Eliasse
Published: May 2024

Cassia fistula (C. fistula) has shown strong anti‐inflammatory, hepatoprotective, antitussive, antibacterial, and antifungal properties and is being used for healing wounds and gastrointestinal illness. This study was planned to obtain fruit extract from C. fistula using ultrasonic‐assisted extraction (UAE) technique and evaluated for phytochemical contents, anti‐hyperlipidemia, and hematological parameters. The results showed that total phenolic (TPC), total flavonoids (TFC), condensed tannin (CT), and saponins were 13.07 mg GAE/g, 5.24 mg QE/g, 4.01 mg/g, and 27.55%, respectively, in the extract. Proximate composition of the extract showed 2.48%, moisture, 1.25% fat, 2.80% ash, 4.59% fiber, 11.93% protein, and 76.95% NFE. The 2, 2‐diphenyl‐1‐picrylhydrazyl (DPPH) and ferric reducing antioxidant power assay (FRAP) activity was 63.30 μg/mL and 15.02 nmol/g, respectively. High‐fat diet (HFD)‐induced hyperlipidemic rats were orally administrated with 0.5 and 1.0 g of extract/kg body weight (bw) daily. The reduction of total cholesterol (TC: 90.83 ± 8.86 mg/dL), triglycerides (TG; 74.16 ± 9.10 mg/dL), and low‐density lipoproteins (LDL; 74.83 ± 4.66 mg/dL) and increase of high‐density lipoproteins (HDL; 41.83 ± 8.4 mg/dL) was observed. Significant changes in red blood cells (RBCs; 8.03 ± 0.67106/μL), mean corpuscular hemoglobin concentration (MCHC; 35.02 ± 1.78 g/dL), mean corpuscular hemoglobin (MCH; 18.00 ± 0.26 pg), and mean corpuscular volume (MCV; 55.36 ± 4.01 fL) at 1.0 g extract intake was observed. Extract administration also improved significantly liver enzymes, body weight, and liver morphology. Therefore, C. fistula extract can be effectively used as a therapeutic agent to improve serum biochemistry and hematological values.
Treatment outcomes in patients with large B‐cell lymphoma after progression to chimeric antigen receptor T‐cell therapy
Authors: Iacoboni Gloria , Iraola‐Truchuelo Josu , O'Reilly Maeve , Navarro Víctor , Menne Tobias , Kwon Mi , Martín‐López Ana África , Chaganti Sridhar , Delgado Javier , Roddie Claire , Pérez Ariadna , Norman Jane , Guerreiro Manuel , Gibb Adam , Caballero Ana Carolina , Besley Caroline , Martínez‐Cibrián Nuria , Mussetti Alberto , Sanderson Robin , Luzardo Hugo , Iyengar Sunil , Sánchez Jose Maria , Jones Ceri , Sancho Juan‐Manuel , Barba Pere , Latif Anne‐Louise , López‐Corral Lucia , Hernani Rafael , Reguera Juan Luis , Sureda Anna , Garcia‐Sancho Alejandro Martin , Bastos Mariana , Abrisqueta Pau , Kuhnl Andrea
Published: May 2024

Over 60% of relapsed/refractory (R/R) large B‐cell lymphoma (LBCL) patients who receive chimeric antigen receptor (CAR) T cells will experience disease progression. There is no standard next line of therapy and information in this setting is scarce and heterogeneous. We analyzed 387 R/R LBCL patients who progressed after CAR T cells from July 2018 until March 2022 in Spain and the United Kingdom. Median overall survival (OS) was 5.3 months, with significant differences according to the interval between infusion and progression (<2 months [1.9 months], 2–6 months [5.2 months], and >6 months [not reached]). After progression, 237 (61%) patients received treatment. Focusing on the first subsequent therapy, overall (complete) response rates were 67% (38%) for polatuzumab–bendamustine–rituximab (POLA), 51% (36%) for bispecific antibodies (BsAb), 45% (35%) for radiotherapy (RT), 33% (26%) for immune checkpoint inhibitors (ICIs), 25% (0%) for lenalidomide (LENA), and 25% (14%) for chemotherapy (CT). In terms of survival, 12‐month progression‐free survival and OS was 36.2% and 51.0% for POLA, 32.0% and 50.1% for BsAb, 30.8% and 37.5% for RT, 29.9% and 27.8% for ICI, 7.3% and 20.8% for LENA, and 6.1% and 18.3% for CT. Thirty‐two (14%) patients received an allogeneic hematopoietic cell transplant with median OS not reached after a median follow‐up of 15.1 months. In conclusion, patients with R/R LBCL who progress within the first 2 months after CAR T‐cell therapy have dismal outcomes. Novel targeted agents, such as polatuzumab and BsAbs, can achieve prolonged survival after CAR T‐cell therapy failure.
Toward a more patient‐centered drug development process in clinical trials for patients with myelodysplastic syndromes/neoplasms (MDS): Practical considerations from the International Consortium for MDS (icMDS)
Authors: Efficace Fabio , Buckstein Rena , Abel Gregory A. , Giesinger Johannes M. , Fenaux Pierre , Bewersdorf Jan Philipp , Brunner Andrew M. , Bejar Rafael , Borate Uma , DeZern Amy E. , Greenberg Peter , Roboz Gail J. , Savona Michael R. , Sparano Francesco , Boultwood Jacqueline , Komrokji Rami , Sallman David A. , Xie Zhuoer , Sanz Guillermo , Carraway Hetty E. , Taylor Justin , Nimer Stephen D. , Della Porta Matteo Giovanni , Santini Valeria , Stahl Maximilian , Platzbecker Uwe , Sekeres Mikkael A. , Zeidan Amer M.
Published: May 2024

Notable treatment advances have been made in recent years for patients with myelodysplastic syndromes/neoplasms (MDS), and several new drugs are under development. For example, the emerging availability of oral MDS therapies holds the promise of improving patients' health‐related quality of life (HRQoL). Within this rapidly evolving landscape, the inclusion of HRQoL and other patient‐reported outcomes (PROs) is critical to inform the benefit/risk assessment of new therapies or to assess whether patients live longer and better, for what will likely remain a largely incurable disease. We provide practical considerations to support investigators in generating high‐quality PRO data in future MDS trials. We first describe several challenges that are to be thoughtfully considered when designing an MDS‐focused clinical trial with a PRO endpoint. We then discuss aspects related to the design of the study, including PRO assessment strategies. We also discuss statistical approaches illustrating the potential value of time‐to‐event analyses and their implications within the estimand framework. Finally, based on a literature review of MDS randomized controlled trials with a PRO endpoint, we note the PRO items that deserve special attention when reporting future MDS trial results. We hope these practical considerations will facilitate the generation of rigorous PRO data that can robustly inform MDS patient care and support treatment decision‐making for this patient population.
Multi‐objective optimization of a Fibonacci phyllotaxis micro pin‐fin heat sink
Authors: Shemelash Ayechew , Tamrat Bimrew , Temesgen Muluken , Gopal Rajendiran , Desalegn Belachew , Mulugeta Hailemariam , Solomon Henok G/yohannes
Published: May 2024

There are still significant technical challenges associated with thermal management of electronic devices such as microprocessors. To improve heat dissipation performance of integrated circuits, a new Fibonacci phyllotaxis design of circular micropin fin heat sinks has been developed. To minimize both chip temperature and pumping power, a multi‐objective optimization technique was employed. The effect of design parameters such as phyllotaxis coefficient, pin fin diameter, and pin fin height on response parameters was numerically investigated using the full factorial design of the experiment. Artificial neural network was coupled with MO‐Jaya, to arrive at a Pareto frontier of optimal compromise solutions. The optimal set of design variables were found to be a height of 300 μm, a diameter of 122.6 μm, and a phyllotaxis coefficient of 130 μm with an inlet velocity of coolant 2.263 m/s. The selected optimum design was then investigated numerically, and the outcomes were compared to those predicted by the MO‐Jaya algorithm. The final confirmed response variables were a maximum temperature of 51.6°C and a pumping power of 0.191 W. The results show that the Fibonacci phyllotaxis structure of the micro pin fin heat sink has better heat‐dissipating performance.
Magnetohydrodynamic bioconvective flow past an elongated surface with convective heat transport, and velocity slip in a non‐Darcian porous regime
Authors: Das Utpal Jyoti , Patgiri Indushri
Published: May 2024

In recent times, bioconvection has numerous uses, like, biological and biotechnological problems. The present study describes the magnetic bioconvective Buongiorno's flow model with microorganisms in a stretchable area with convective heat transfer and second‐order velocity slip in a non‐Darcian porous regime. Here, the influence of variable viscosity, viscous dissipation, Joule heating, and heat source/sink are considered in the occurrence of higher‐order chemical reactions. Employing proper similarity transformations leading equations are transformed to dimension‐free form. The transformed equations are solved via MATLAB bvp4c problem solver. This study's main objective is to graphically analyze the effects of different pertinent factors on the density of motile microorganisms, velocity, concentration, temperature, number of motile microorganisms' density, skin friction, mass transport rate, and heat transport rate. The main findings drawn from this study are viscosity and magnetic parameter lowers the fluid velocity. Biot number increases fluid temperature, but reduces heat transport rates and skin friction. Schmidt and Eckert numbers reduce the fluid concentration. A rise of 0.3 in bioconvective Rayleigh number and 0.2 in buoyancy ratio number causes a percentage drop in velocities of 8.79% and 3.91% (approximately), respectively, in the neighborhood of the sheet. Furthermore, the increase in Peclet number by 0.2 lowers the density number of microorganisms by 28%. Additionally, the profile of motile microorganisms is improved by thermophoresis impact, while it is diminished by chemical reaction.
Back cover image
Authors: Ma Hailong , Fang Huajing , Li Jiaqi , Li Ziqing , Fang Xiaosheng , Wang Hong
Published: May 2024

Based on transmittance contrast of MXene electrodes, a general strategy for constructing self‐powered photodetectors with high response is proposed.

image
Enhancing the irrigation water productivity of rice farming: A study on sowing and irrigation practices in Pakistan
Authors: Akbar Ghani , Islam Zafar , Khalil Shahid Hameed , Wali Zeeshan
Published: May 2024

In Pakistan's arid agricultural landscape, this 4‐year (2020–2023) study on silty loam soil examined the relationships between sowing methods, irrigation practices, rice yield and water productivity. Using a randomized split block design, no tillage (NT) with alternate wetting and drying (AWD) and a furrow‐irrigated narrow bed (NB) emerged as being consistently competitive, showing potential for sustainable rice cultivation. Key findings indicate that AWD significantly enhances water productivity (11–35%) and increases yield (2–10%) compared to conventional practices. Drip‐irrigated wide beds (WBs) conserve substantial amounts of water (73%) but may compromise rice yield (4–47%). This study provides valuable insights into the dynamic outcomes and distinct performance trends of different rice varieties. The results suggest a potential maximum yield increase of 2–22% through optimized practices, and replacing rice may increase yield by 25–231%. Conversely, the selection of improper irrigation schedules and sowing methods for the given soil and crop conditions may lead to a yield reduction of up to 47% in high‐yielding rice varieties. These findings may help to establish a foundation for further research investigating informed decision making for sowing and irrigation methods. The potential scalability of the identified technologies and further in‐depth simulation strategies across diverse agroecological zones in Pakistan holds promise for widespread adoption, enhancing the sustainability of rice farming in the region.
A cross‐sectional investigation into the role of intersectionality as a moderator of the relation between youth adversity and adolescent depression/anxiety symptoms in the community
Authors: Havers Laura , Bhui Kamaldeep , Shuai Ruichong , Fonagy Peter , Fazel Mina , Morgan Craig , Fancourt Daisy , McCrone Paul , Smuk Melanie , Hosang Georgina M. , Shakoor Sania
Published: May 2024

Background

Adolescents exposed to adversity show higher levels of depression and anxiety, with the strongest links seen in socially/societally disadvantaged individuals (e.g., females, low socioeconomic status [SES]), as well as neurodivergent individuals. The intersection of these characteristics may be important for the differential distribution of adversity and mental health problems, though limited findings pertain to the extent to which intersectional effects moderate this association.

Methods

Combined depression/anxiety symptoms were measured using the emotional problems subscale of the Strengths and Difficulties Questionnaire in 13–14‐year‐olds in Cornwall, United Kingdom in 2017‐2019. In a cross‐sectional design (N = 11,707), multiple group structural equation modeling was used to estimate the effects of youth adversity on depression/anxiety symptoms across eight intersectionality profiles (based on gender [female/male], SES [lower/higher], and traits of hyperactivity/inattention [high/low]). Moderation effects of these characteristics and their intersections were estimated.

Results

Youth adversity was associated with higher levels of depression/anxiety (compared to an absence of youth adversity), across intersectional profiles. This effect was moderated by gender (stronger in males; β = 0.22 [0.11, 0.36]), and SES (stronger in higher SES; β = 0.26 [0.14,0.40]); with indications of moderation attributable to the intersection between gender and hyperactivity/inattention (β = 0.21 [−0.02,0.44]).

Conclusions

Youth adversity is associated with heightened depression/anxiety across intersectional profiles in 13–14‐year‐olds. The stronger effects observed for males, and for higher SES, may be interpreted in terms of structural privilege. Preliminary findings suggest that vulnerability and resilience to the effects of youth adversity may partially depend on specific intersectional effects. Importantly, the current results invite further investigation in this emerging line of inquiry.
Using nanotechnology to progress the utilization of marine natural products in combating multidrug resistance in cancer: A prospective strategy
Authors: Bhusare Nilam , Gade Anushree , Kumar Maushmi S.
Published: May 2024

Achieving targeted, customized, and combination therapies with clarity of the involved molecular pathways is crucial in the treatment as well as overcoming multidrug resistance (MDR) in cancer. Nanotechnology has emerged as an innovative and promising approach to address the problem of drug resistance. Developing nano‐formulation‐based therapies using therapeutic agents poses a synergistic effect to overcome MDR in cancer. In this review, we aimed to highlight the important pathways involved in the progression of MDR in cancer mediated through nanotechnology‐based approaches that have been employed to circumvent them in recent years. Here, we also discussed the potential use of marine metabolites to treat MDR in cancer, utilizing active drug‐targeting nanomedicine‐based techniques to enhance selective drug accumulation in cancer cells. The discussion also provides future insights for developing complex targeted, multistage responsive nanomedical drug delivery systems for effective cancer treatments. We propose more combinational studies and their validation for the possible marine‐based nanoformulations for future development.
Multimetal exposure: Challenges in diagnostics, prevention, and treatment
Authors: Panghal Archna , Thakur Ashima , Deore Monika S. , Goyal Manoj , Singh Charan , Kumar Jayant
Published: May 2024

Extensive use of heavy metals has posed a serious concern for ecosystem and human too. Heavy metals are toxic in nature and their accumulation in human body causes serious disorders such as neurological disease, cardiac disease, gastrointestinal problems, skin disorders, reproductive disease, lungs diseases, and so on. Furthermore, heavy metals not only affect the human health but also have a negative impact on the economy. In the current review, we have elaborated the impact of heavy metal exposure on human health and socioeconomics. We have discussed the molecular mechanism involved in the heavy metal‐induced human disorders such as oxidative stress, neuroinflammation, and protein misfolding. Finally, we discussed the preventive measure and treatment strategy that could counter the negative effects of heavy metal intoxications. In conclusion, there is a substantial correlation between heavy metals and the onset and advancement of several health issues. Chelation treatment could be a useful tactic to lessen the toxic metal load and the difficulties that come with it.
Enterotoxin‐related genes PPFIA4 and SCN3B promote colorectal cancer development and progression
Authors: Zheng Feng‐Xian , Yang Cheng‐Rui , Sun Fang‐Yuan , Zhang Yan‐Zhong , Wang Yan‐Liang , Li Xu‐Zhao , Wu Xiao‐Yong
Published: May 2024

To identify the role of enterotoxin‐related genes in colorectal cancer (CRC) development and progression. Upregulated differentially expressed genes shared by three out of five Gene Expression Omnibus (GEO) data sets were included to screen the key enterotoxin‐induced oncogenes (EIOGs) according to criteria oncogene definition, enrichment, and protein–protein interaction (PPI) network analysis, followed by prognosis survival, immune infiltration, and protential drugs analyses was performed via integration of RNA‐sequencing data and The Cancer Genome Atlas‐derived clinical profiles. We screened nine common key EIOGs from at least three GEO data sets. A Cox proportional hazards regression models verified that more alive cases, decreased overall survival, and highest 4‐year survival prediction in CRC patients with high‐risk score. Protein tyrosine phosphatase receptor type F polypeptide‐interacting protein alpha‐4 (PPFIA4), STY11, SCN3B, and SPTBN5 were shared in the same PPI network. Immune infiltration results showed that SCN3B and synaptotagmin 11 expression were obviously associated with B cell, macrophage, myeloid dendritic cell, neutrophils, and T cell CD4+ and CD8+ in both colon adenocarcinoma and rectal adenocarcinoma. CHIR‐99021, MLN4924, and YK4‐279 were identified as the potential drugs for treatment. Finally, upregulated EIOGs genes PPFIA4 and SCN3B were found in colon adenocarcinoma and PPFIA4 and SCN3B were proved to promote cell proliferation and migration in vitro. We demonstrated here that EIOGs promoting a malignancy phenotype was related with poor survival and prognosis in CRC, which might be served as novel therapeutic targets in CRC management.
Analysis of MRI features and associated factors of the pituitary neuroendocrine tumor streaky sign
Authors: Zhong Jiansheng , Zhang Heng , Chen Yuyang , Li Jun , Wei Liangfeng , Wang Shousen
Published: May 2024

Objectives

Observation of pituitary neuroendocrine tumors with streaky sign on MRI, analysis of their features on imaging and further investigation of the relationship between the direction of the streak sign and the direction of optimal tumor expansion.

Methods

The MR images of 237 patients with pituitary neuroendocrine tumors were retrospectively analyzed. The streaky‐like high signal with a substantial length of more than 10 mm and obvious enhancement on T1WI was defined as the streaky sign. Finally, 66 patients were included in the study, comprising 33 patients with streaky sign pituitary neuroendocrine tumors and 33 randomly selected patients with non‐streaky sign pituitary neuroendocrine tumors. The general condition of these 66 patients, the imaging features of the tumor, and the measurement and analysis of the direction of the streaky sign in relation to the direction of optimal tumor extension were observed and analyzed.

Results

On MRI, 85 streaky signs were observed. The average deviation between the direction angle of all the streaky signs and the optimal extension direction angle of the tumor was approximately 11°. The longest streaky sign angle was positively correlated with the optimal extension angle of the tumor, with a correlation coefficient of 0.967.

Conclusion

The presence of a streaky sign of pituitary neuroendocrine tumors may indicate a dilated sinus or a small blood vessel. Its direction is highly consistent with the optimal extension direction of the tumor, which has a certain supporting effect on the long‐distance growth of the tumor.
Novel report on soil infection with Metarhizium rileyi against soil‐dwelling life stages of insect pests
Authors: Vivekanandhan Perumal , Kamaraj Chinnaperumal , Alharbi Sulaiman A. , Ansari Mohammad J.
Published: May 2024

Entomopathogenic fungi are the most effective control remedy against a wide range of medical and agricultural important pests. The present study aimed to isolate, identify, and assess the virulence of Metarhizium rileyi against Spodoptera litura and Spodoptera frugiperda pupae under soil conditions. The biotechnological methods were used to identify the isolate as M. rileyi. The fungal conidial pathogenicity (2.0 × 107, 2.0 × 108, 2.0 × 109, 2.0 × 1010, and 2.0 × 1011 conidia/mL−1) was tested against prepupae of S. litura and S. frugiperda at 3, 6, 9, and 12 days after treatments. Additionally, the artificial soil‐conidial assay was performed on a nontarget species earthworm Eudrilus eugeniae, using M. rileyi conidia. The present results showed that the M. rileyi caused significant mortality rates in S. litura pupae (61‐90%), and S. litura pupae were more susceptible than S. frugiperda pupae (46%–73%) at 12 day posttreatment. The LC50 and LC90 of M. rileyi against S. litura, were 3.4 × 1014–9.9 × 1017 conidia/mL−1 and 6.6 × 105–4.6 × 1014 conidia/mL−1 in S. frugiperda, respectively. The conidia of M. rileyi did not exhibit any sublethal effect on the adult stage of E. eugeniae, and Artemia salina following a 12‐day treatment period. Moreover, in the histopathological evaluation no discernible harm was observed in the gut tissues of E. eugeniae, including the lumen and epithelial cells, as well as the muscles, setae, nucleus, mitochondria, and coelom. The present findings provide clear evidence that M. rileyi fungal conidia can be used as the foundation for the development of effective bio‐insecticides to combat the pupae of S. litura and S. frugiperda agricultural pests.
Unveiling the Associative Mechanisms Underlying the Additive Bias: Using an Implicit Association Test to Gain Insight into People's Preference for Additive Actions
Authors: Neroni Maria Adriana , Crilly Nathan , Brandimonte Maria Antonella
Published: May 2024

When faced with the need to transform an object, idea, or situation, people have a tendency to favor adding new components rather than removing existing ones. This is called the additive bias. Previous research, along with historical and anecdotal examples, shows that this bias may significantly reduce problem‐solving abilities and have a detrimental impact on the innovation process. In this study, our objective was to develop a novel tool, the additive bias implicit association test (ad‐IAT), to investigate the reasons underlying people's preference for additive actions. By using this tool, we empirically demonstrated that people displayed an inherent tendency to assign a positive valence to additive concepts and to perceive additive actions as safer and more functional than subtractive concepts. Importantly, we also found that implicit preference for addition resulted in participants favoring additive actions while neglecting subtractive alternatives when engaged in a problem‐solving task. Collectively, our series of experiments substantiated the effectiveness of our ad‐IAT in uncovering and quantifying the additive bias. This, in turn, provided a deeper comprehension of the underlying factors contributing to the bias and its impact on people's behavior.
Standardizing steroid protocols for newly diagnosed inflammatory bowel disease patients: A quality improvement initiative
Authors: Lendner Nuphar , Perry Sharon , Sferra Thomas J. , Moses Jonathan , Young Denise D.
Published: May 2024

Objectives

Systemic steroids can be used for induction of inflammatory bowel disease (IBD), but are not recommended as long‐term therapy. Steroid weaning requires rigorous monitoring of symptoms, which may be cumbersome and lead to missed opportunities. We aim to describe our local quality improvement (QI) initiative to improve and standardize the steroid weaning process.

Methods

After identifying drivers of steroid weaning, a protocol was developed and implemented for newly diagnosed IBD patients started on steroids and subsequently initiated on anti‐TNF‐α therapy. Interventions included development of a tapering schedule, and standardizing communication with patients and evaluation of symptoms. The primary aim was to increase the percent of patients called on a weekly basis by 20%; secondary aims were to decrease the median steroid days by 25% and to increase the number of our patients weaned off steroids at 8 weeks from 35% to 75% by 1 year after the initiative.

Results

The median percent of patients called on a weekly basis to assess clinical symptoms and to wean steroids increased to 80% after 1 year. The median number of systemic corticosteroid days decreased from 67.5 to 50.5 days post‐protocol implementation with 61.1% patients weaned off by 8 weeks from discharge. Zero patients were admitted for flares with the protocol implementation.

Conclusion

Our experience illustrates that QI methodology can be used successfully to improve and standardize the steroid weaning process, leading to shortened steroid duration and without increased flares and hospitalizations.
MRI and SPECT/CT demonstrate, with low certainty of evidence, the highest diagnostic accuracy for aseptic knee arthroplasty loosening: A systematic comparative diagnostic test review and meta‐analysis
Authors: Buijs George S. , Kooijenga Anne C. , Rikken Quinten G. H. , Schafroth Matthias U. , Kievit Arthur J. , Blankevoort Leendert
Published: May 2024

Purpose

The purpose of this study was to evaluate and compare the diagnostic accuracy of modalities used to aid the diagnosis of aseptic knee arthroplasty loosening.

Methods

A comparative diagnostic test accuracy systematic review and meta‐analysis was conducted following the Cochrane and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines. PubMed, EMBASE and Cochrane databases were searched for original articles evaluating diagnostic modalities up to March 2024. Included studies compared the modality (index test) to the intraoperative finding as reference test. The QUADAS‐C (Quality Assessment of Diagnostic Accuracy Studies‐Comparative) tool was used to assess the quality of the included studies. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to evaluate the certainty of evidence. Level of evidence was evaluated using the Oxford Levels of Evidence tool. The primary outcome was the summary of diagnostic accuracy metrics for each modality as demonstrated by a summary receiver‐operating characteristic (SROC) curve.

Results

The search yielded 467 articles. Of these, 14 articles were included. These 14 articles evaluated a total of five different diagnostic modalities: bone scintigraphy (three studies, 146 cases), 18‐fluorodeoxyglucose positron emission tomography (two studies, 50 cases), single‐photon emission computed tomography combined with computed tomography (SPECT/CT) (seven studies, 371 cases), radionuclide arthrogram (three studies, 196 cases) and magnetic resonance imaging (MRI) (one study, 116 cases). Nine studies exhibited a high risk of bias in patient selection, and all studies showed a high risk of bias related to the reference test. The majority of the included studies were classified as Level III evidence, leading to an overall low level of certainty in the evidence. The most accurate tests, as demonstrated by the SROC analysis, were MRI and SPECT/CT, with sensitivities ranging from 0.00 to 1.00 and 0.33 to 1.00 and specificities between 0.31–1.00 and 0.00–1.00, respectively.

Conclusions

This review and meta‐analysis evaluated available diagnostic modalities to aid the diagnosis of knee arthroplasty loosening and based on a low certainty of evidence suggests that MRI and SPECT/CT are currently the most accurate modalities available to aid the diagnosis of aseptic loosening of knee arthroplasty components.

Level of Evidence

Level III.
Magnetic resonance imaging should be the first‐line imaging modality for investigating suspected proximal hamstring avulsion injuries
Authors: Lefèvre Nicolas , Coughlan Adam , Valentin Eugénie , Sezer Hasan B. , Bohu Yoan , Moussa Mohamad K. , Hardy Alexandre
Published: May 2024

Purpose

The purpose of the study was to evaluate how the initial diagnostic tool used—specifically ultrasound (US) or magnetic resonance imaging (MRI)—for diagnosing proximal hamstring avulsion injury affects the delay before surgery and, secondarily, the outcomes of these injuries.

Methods

This was a retrospective analysis of prospectively collected data (2012–2020). It targeted patients primarily treated for proximal hamstring avulsion injury. It included all patients with a preoperative US and/or MRI. Patients were divided into two groups based on the initial diagnostic tool used (US‐first vs. MRI‐first groups). The primary outcomes measure was the time from initial injury to surgical intervention (surgical delay). The secondary outcomes were the Parisien Hamstring Avulsion Score, as well as the activity level as measured by the University of California, Los Angeles (UCLA) Activity Scale and Tegner Activity Scale.

Results

The analysis included 392 patients with a mean age of 43.8 ± 13.6 years for the MRI‐first group and 47.6 ± 12.0 years for US‐first group. Patients in the MRI‐first group had a significantly shorter median time from injury to surgery of 20.0 days (interquartile range [IQR]: 11.0–61.0) compared to 30 days (IQR: 18–74) in the US‐first group. At the final follow‐up (4.2 ± 2.2 years for the MRI‐first group and 5.1 ± 1.9 years for the US‐first group), the MRI‐first group had significantly higher mean Tegner Activity Scale and UCLA scores than the US‐first group: The Tegner Activity Scale was median 5 (IQR: 3–7) for the MRI‐first group versus median 4 (IQR: 2–6) for the US‐first group (p < 0.05). The UCLA scores were 7.9 ± 2.4 for the MRI‐first group compared to 7.3 ± 2.4 for the US‐first group (p < 0.05). This difference was more pronounced when comparing the MRI‐first group with the patient‐false negative initial ultrasound. No difference was found regarding the Parisien Hamstring Avulsion Score.

Conclusion

MRI as the initial diagnostic tool for proximal hamstring avulsion injury is associated with a shorter time to surgery and better postoperative outcomes in Tegner Activity Scale and UCLA scores, compared to US.

Level of Evidence

Level III.
Outcomes from different aspects indicate the all‐inside technique may serve as an ideal option for anterior cruciate ligament reconstruction
Authors: Cai Zijun , Liu Di , Yang Yuntao , Lu Wenhao , Pan Linyuan , Liu Xu , Liu Gaoming , Vithran Djandan Tadum Arthur , Li Yusheng , Xiao Wenfeng
Published: May 2024

Purpose

To evaluate the postoperative outcomes of the all‐inside technique in arthroscopic anterior cruciate ligament reconstruction (ACLR).

Methods

Patients who underwent ACLR using the all‐inside technique between 2018 and 2021 were retrospectively assessed. All patients were followed up for at least 2 years. Functional recovery and pain relief were assessed using the International Knee Documentation Committee (IKDC) score, Lysholm score, Knee Injury and Osteoarthritis Outcome Score (KOOS) and visual analogue scale (VAS). Instrumented laxity was assessed via side‐to‐side difference using the Kneelax3 arthrometer. Graft maturity was estimated using the signal‐to‐noise quotient value based on magnetic resonance imaging (MRI). Adverse events during and after the surgery were recorded.

Results

A total of 78 patients were included in this study, with a mean age of 28.1 ± 7.6 years. The IKDC (p < 0.001), Lysholm (p < 0.001) and KOOS (p < 0.001 for all subgroups) scores at the final follow‐up were significantly higher than those before the surgery. The VAS scores (p < 0.05) were significantly lower than those before surgery. The side‐to‐side difference results indicated that 50 patients had a difference of less than 3 mm, indicating a tight graft, whereas only 1 patient had a difference of >5 mm, indicating a loose graft. The median signal‐to‐noise quotient of the graft on MRI was 1.4 (P25, P75: 1.0, 2.0). No intraoperative adverse events were observed. Postoperative adverse events included three cases of infection, three cases of graft rerupture, two cases of cyclops lesion and one case of surgical intervention for a meniscal tear.

Conclusion

ACLR using the all‐inside technique offers promising results in patients with ACL rupture.

Level of Evidence

Level IV.
Nonanatomical femoral tunnel positioning in isolated MPFL reconstruction is not associated with an increased risk of patellofemoral osteoarthritis after a minimum follow‐up of 10 years
Authors: Erard Julien , Olivier Joris , Gunst Stanislas , Shatrov Jobe , Batailler Cécile , Lustig Sébastien , Servien Elvire
Published: May 2024

Purpose

The association between the prevalence of patellofemoral arthritis (PFA) and femoral tunnel positioning following isolated medial patellofemoral ligament reconstruction (MPFLr) has not been well described. The aim of this study was to analyse the relationship between femoral tunnel positioning and the prevalence of PFA.

Methods

This was a single‐centre study of patients undergoing an isolated MPFLr between 2006 and 2011 with a minimum of 10 years of follow‐up. Outcomes assessed were the presence of PFA on radiographs, recurrence of instability requiring revision surgery and patient‐reported outcomes, including Kujala, Tegner and IKDC scores. Tunnel positioning was assessed on postoperative radiographs using two radiographic methods: Schöttle's point and the grid method to localise the femoral tunnel. Patients were grouped based on tunnel positioning and compared.

Results

Fifty patients were analysed at a mean follow‐up of 12.4 years. Thirty‐three patients (66%) had a femoral tunnel position within 7 mm of Schöttle's point and 39 (78%) within the anatomic quadrant, with the most common location according to the grid method in D4 (28%) and E4 (26%), respectively. Thirty‐seven patients (74%) had a satisfactory (>80 versus <80) Kujala score at long‐term follow‐up. None of the examined tunnel assessment methods demonstrated a significant relationship with Tegner, Kujala or International Knee Documentation Committee scores. Patients with a femoral tunnel position >7 mm outside Schöttle's point or were considered to be in a nonanatomic position were not significantly more likely to result in unsatisfactory Kujala scores at the last follow‐up. Tunnel positioning and the other tested parameters were not found to be significantly associated with the development of PFA.

Conclusion

No correlation between femoral tunnel position and risk of PFA or poor outcomes was observed in patients undergoing isolated MPFLr at long‐term follow‐up. The impact of femoral tunnel placement on long‐term outcomes in patients with PFI may be less significant than originally considered.

Level of Evidence

Level IV.