bluuebunny/crossref_metadata_2025 huggingface dataset:
Acupuncture plus topiramate placebo versus topiramate plus sham acupuncture for the preventive treatment of chronic migraine: A single-blind, double-dummy, randomized controlled trial
Authors: Liu Lu , Chen Qiuyi , Zhao Luopeng , Lyu Tianli , Nie Limin , Miao Quan , Liu Yuhan , Zheng Libin , Fu Feiyu , Luo Yuxi , Zeng Chenxi , Zhang Chengcheng , Peng Peiyue , Zhang Yixin , Li Bin
Published: June 2024

Background

Acupuncture has been used for the treatment of chronic migraine, but high-quality evidence is scarce. We aimed to evaluate acupuncture's efficacy and safety compared to topiramate for chronic migraine.

Methods

This double-dummy randomized controlled trial included participants aged 18–65 years diagnosed with chronic migraine. They were randomly assigned (1:1) to receive acupuncture (three sessions/week) plus topiramate placebo (acupuncture group) or topiramate (50–100 mg/day) plus sham acupuncture (topiramate group) over 12 weeks, with the primary outcome being the mean change in monthly migraine days during weeks 1–12.

Results

Of 123 screened patients, 60 (mean age 45.8, 81.7% female) were randomly assigned to acupuncture or topiramate groups. Acupuncture demonstrated significantly greater reductions in monthly migraine days than topiramate (weeks 1–12: −2.79 [95% CI: −4.65 to −0.94, p = 0.004]; weeks 13–24: −3.25 [95% CI: −5.57 to −0.92, p = 0.007]). No severe adverse events were reported.

Conclusions

Acupuncture may be safe and effective for treating chronic migraine. The efficacy of 12 weeks of acupuncture was sustained for 24 weeks and superior to that of topiramate. Acupuncture can be used as an optional preventive therapy for chronic migraine.

Trial registration

ISRCTN.org Identifier 13563102.
Evaluation of Door Zone Conflicts Between Bicycles and Parked Vehicles
Authors: Chand Cadell , Jashami Hisham , Scott-Deeter Logan , Koonce Peter , Hurwitz David
Published: June 2024

Bicyclists are vulnerable to door zone conflicts on urban roadways with on-street parallel parking adjacent to bicycle lanes; however, this conflict type is not robustly understood. This research sought to determine 1) the correlation between bicyclist experience and perceived risk of door zone conflicts, 2) bicyclist behavior in the door zone using velocity and lateral position, and 3) how time to the open door (TTD), defined as the time between the vehicle door opening and the bicyclist passing the door, and effective bicycle lane width, defined as the remaining lane width beyond the open door, contribute to the bicyclists’ decision to come to a complete stop before an open vehicle door or to maneuver around it. A bicycling simulator was used to test TTD (short and long), and effective bicycle lane width (1, 2, and 3 ft). The survey results indicated that perceived risk of door zone crashes was high despite relatively few reports of door zone crashes. The survey results additionally indicated that whereas door zone crash involvement was reportedly low, door zone near-misses were more common. The results from the bicycling simulator showed that TTD did influence bicyclist velocity, and both TTD and effective bicycle lane width influenced bicyclist lateral position within the door zone. Lateral position data showed that more bicyclists chose to depart the bicycle lane in long TTD scenarios when the effective bicycle lane width was 2 ft. The results of this study suggest that some common bicycle lane practices give bicyclists few safe options to avoid door zone crashes.
Supraspinatus Muscle and Tendon Characteristics 1 Year After Surgical Rotator Cuff Repair Compared With Contralateral Shoulder: Data From the CUT-N-MOVE Trial
Authors: Kjær Birgitte Hougs , Svensson Rene B. , Warming Susan , Peter Magnusson S.
Published: June 2024

Background:

It is necessary to better understand the structural characteristics of the supraspinatus tendon and associated muscle after rotator cuff repair and in the event of retear.

Purpose:

To study structural differences between the repaired and contralateral shoulders 1 year after rotator cuff repair in patients who received either progressive exercise therapy (PR) or usual care (UC) in a randomized controlled trial and to investigate whether there was interaction with tendon retear and limb dominance.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Patients with surgically repaired traumatic full-thickness rotator cuff tears involving the supraspinatus tendon were included. After surgery, they were randomized to PR or UC (active from postoperative week 2 or 6, respectively). The subacromial structures (acromiohumeral distance, supraspinatus tendon thickness, and vascularity) and the supraspinatus muscle thickness were examined with ultrasound at the 1-year follow-up.

Results:

A total of 79 patients were included. The characteristics of the 2 intervention groups (PR and UC) were comparable, including the Western Ontario Rotator Cuff Index score and number of retears. The authors found significantly thinner supraspinatus tendon (PR, P < .001; UC, P = .003) and reduced acromiohumeral distance (PR, P = .023; UC, P = .025) in the repaired versus the contralateral shoulders in both intervention groups. For neovascularization, there was no interlimb difference in either of the groups or between groups (PR vs UC). In patients with intact tendons, there was no interlimb difference in the muscle thickness, but in patients with tendon retear the muscle was significantly thinner on the repaired side ( P = .024 and P < .001, respectively). When the dominant supraspinatus tendon was repaired (both groups), it was significantly thinner than the nondominant healthy tendon, but this difference was not seen when the nondominant supraspinatus tendon was repaired ( P = .006).

Conclusion:

One year after rotator cuff surgery, the repaired supraspinatus tendon was significantly thinner and the corresponding acromiohumeral distance was reduced. In patients with retear, the supraspinatus muscle was significantly thinner on the repaired side and early initiation of tendon-loading exercises did not affect these findings.

Registration:

NCT02969135 (ClinicalTrials.gov identifier).
Contrasting Educator and Black Student Perspectives of the Special Education Placement Process: A DisCrit Counter-Narrative Analysis
Authors: Collins Tya
Published: June 2024

This critical qualitative inquiry employed a Disability Critical Race Studies Counter-Narrative framework (DCCN) to explore the contrast between educator and Black student understandings of the special education placement process and their implications. Interviews with 21 members of school personnel and 20 Black students between the ages of 14 and 18 were cross-referenced to narratively reconstruct the special education placement process in Quebec, Canada. Analysis of the results reveals a striking gap between educator and student understandings of the process, which can be linked to adverse student experiences. Subsequently, implications for enhancing educators’ knowledge of diverse learners and professional practices are discussed.
Further Validation of the Persecutory Ideation Questionnaire in the Italian Context: Results From Classical and Modern Test Theory
Authors: Colledani Daiana , Boragno Paola , Fiabane Elena Maria , Setti Ilaria , Gabanelli Paola
Published: June 2024

The Persecutory Ideation Questionnaire (PIQ) is a valuable instrument to measure persecutory ideation. The aim of this study is to validate the scale in the Italian context and to extend the study of its psychometric properties using approaches from both classical and modern test theories. The results of the study, involving 700 individuals, confirmed the one-factor structure and the good validity and reliability of the scale. Full metric invariance and partial scalar and strict invariance were also supported across gender, age, and education level groups. Rasch analysis indicated that the 5-point response scale is well-functioning and that the PIQ is most appropriate to measure high levels of persecutory ideation. The results contribute to a better understanding of the measurement properties of the PIQ. The paper discusses the advantages and contributions of each method used to explore the measurement properties of the scale.
Dating Violence Experiences Among Sex-Trafficking Youths in Juvenile Detention
Authors: Roe-Sepowitz Dominique , Lantsman-Waugh Marina , Puigvert Lídia , Merodio Guiomar , Melgar Patricia
Published: June 2024

Juvenile justice involvement is a risk factor for sex trafficking, as is teen dating violence (TDV). However, little is known about how TDV victimization correlates with sex-trafficking victimization among girls in juvenile detention. This study was conducted with 111 detained female minors from two Arizona juvenile detention centers. All female detainees were screened for sex-trafficking risk factors by a clinical staff member and completed a series of surveys about their life experiences and a dating violence history survey. Nearly half of the participants, 42.3% ( n = 47), reported having experienced sex trafficking. Girls in juvenile detention who reported sex-trafficking victimization were significantly more likely to report higher scores on the TDV scale.
A Qualitative Review of the Air Rescue One Rural Search and Rescue Program in British Columbia, Canada
Authors: Nowak Raphael , Vandekerkhove Jeremy N , Wasserman Deena D
Published: June 2024

Introduction

Rural emergency prehospital care in British Columbia is conducted primarily by the British Columbia Ambulance Services or ground search and rescue volunteers. Since 2014, the volunteer Air Rescue One (AR1) program has provided helicopter emergency winch rescue services to rural British Columbia. The aim of this research was to describe the activity of the AR1 program and to make recommendations to improve future operations.

Methods

Data were collected retrospectively from September 2014 to May 2021, and parameters of emergency callout statistics from the organization's standard operating guidelines, rescue reports, and interviews were summarized and reviewed.

Results

Of 152 missions within the study period, 105 were medically related rescues involving trauma or cardiac events. Snowmobiling, mountain biking, and hiking were the most common activities requiring rescue. The 38 medical callouts that were not completed by AR1 were reviewed for contributing factors. Response time varied due to the vast service area, but median time from request to takeoff was 55 min (interquartile range 47–69 min), and median on-scene time was 21 min (interquartile range 11–33 min).

Conclusions

AR1 provides advanced medical care into British Columbia's remote and difficult-to-access areas, minimizing delays in treatment and risk to patients and responders. Callout procedures should be streamlined enabling efficient AR1 activation. Collection of medical and flight information should be improved with standardized documentation, aiding in internal education and future research into the program's impact on emergency prehospital care. Future directions for improvement of care include the possibility of introducing portable ultrasound technology.
The diverse academic contributions of Professor Mike Tsionas
Authors: Bournakis Ioannis
Published: June 2024

This paper reviews Professor Mike G. Tsionas’ significant contributions to efficiency and productivity measurement, focusing on his pioneering work in Stochastic Frontier Analysis and Econometrics. Highlighting key publications, such as his influential study on financial development and economic growth, it emphasizes novel methodologies like Bayesian Econometric techniques. Professor Tsionas’ research has advanced our understanding of firm productivity and efficiency performance across various sectors (manufacturing, tourism, banking and hospitality). His collaborative spirit and mentorship have left a lasting impact on his colleagues and the academic community.
Illicit drug use at licensed premises and the potential for prevention: A qualitative interview study of stakeholders
Authors: Feltmann Kristin , Gustafsson Nina-Katri J , Gripenberg Johanna , Elgán Tobias H , Kvillemo Pia
Published: June 2024

Background: The aim of this study was to explore how stakeholders perceive illicit drugs at licensed premises, existing and potential prevention interventions, and to identify facilitators and barriers to reduce illicit drugs at these locations. Methods: Semi-structured interviews with police officers, licensed premises owners, security staff and municipality officials ( n = 28) in seven counties in middle Sweden were conducted and analysed using qualitative content analysis. Results: The informants reported frequent illicit drug use and dealing at licensed premises, causing a negative influence on the restaurant environment. Efforts to prevent illicit drugs varied with respect to type and intensity but included environmental and situational changes as well as education and training, policy implementation and law enforcement. Facilitators for the reduction of illicit drugs are confidence that sufficient resources are allocated, motivated and skilled stakeholders who see benefits of prevention and collaborate closely, along with visible results. General societal prevention was also seen as important. Identified barriers were perceived drug-positive norms and high availability and use in the society, perceived lack of prioritisation and resources, difficulties to collaborate due to e.g., secrecy between organisations, lack of action among stakeholders due to financial considerations, perceived confusion about roles and mandate, and owner's and staff's fear of threats and violence from criminals or own involvement in crime. Conclusion: To maximise the potential of successful prevention, authorities should support owners of licensed premises to act firmly against illicit drugs by providing training, ensure that they apply a strict policy, work for increased stakeholder collaboration and provide appropriate police resources. Authorities should also investigate criminal activities among owners and staff as well as combat organised crime and availability of illicit drugs in the society.
The pronounced embeddedness of commercial and social entrepreneurship in rural communities
Authors: Ganany-Dagan Orly , Greenberg Zeev , Gimmon Eli , Haas Vered
Published: June 2024

This study examines the characteristics of entrepreneurship in rural villages. It was conducted during ongoingeconomic and social crises in rural areas. We interviewed 23 entrepreneurs located in small rural communities, focusing on thedynamics between rural entrepreneurs and village communities. Four themes emerged from the content analysis: (1) The village relieson entrepreneurs to provide products or services, (2) the community and the entrepreneurs establish a pattern of combined paid andunpaid services, (3) entrepreneurs leverage a rural product or service into something greater than was previously provided in thevillage, and (4) tensions may arise between entrepreneurs and the village management as well as village members. Overall, thefindings show that small business entrepreneurs in rural villages are more embedded in the community compared with those in urbanareas.
Stereotactic Body Radiotherapy Reirradiation Is Safe in Patients With Lung Cancer With In-Field Enlarged Tumor Recurrence
Authors: Berber Tanju , Yıldırım Berna Akkuş , Kandemir Gürsel Özge
Published: June 2024

Introduction: Recurrence after stage III lung cancer treatment usually appears with a poor prognosis, and salvage therapy for these patients is challenging, with limited data for reirradiation. Materials and Methods: Fifteen patients with recurrent stage III lung cancer treated with stereotactic body radiotherapy (SABR) between October 2013 and December 2017 were retrospectively evaluated for local control as a first endpoint; overall survival, disease-free survival, and treatment-related toxicity were secondary endpoints. Results: The median age was 68 (IQR: 50-71) years, and the median tumor size was 3.3 cm (IQR: 3.0-4.5). The radiation field was all within the previous radiation (previous 80%-90% isodose line), and the median dose was 66 Gy/(2 Gy × 33 standard fractionation) . For SABR, the median biologically effective dose at an α/β ratio of 10 (BED10) was 60.0 Gy (IQR: 39.38-85.0) and given in 3 to 5 fractions. Three patients experienced grade 3 or 4 toxicity but none experienced grade 5. The median follow-up period was 14 (IQR: 10-23) months. The local control rate was found as 86.7% in the first year, 80% in the second year, and 80% in the third year. The median disease-free survival was 8 (IQR: 6-20) months and the median overall survival was 14 (IQR: 10-23) months. The rate of overall survival was 66.6% for the first year and 33.3% for the second and third years. The disease-free survival rate was 46.6% for the first year and 40% for the second and third years. Nine patients who received doses of BED10 ≥ 50 Gy developed no local recurrence ( P  =  .044). Discussion: In local local–regional recurrence of lung cancer, radiosurgery as reirradiation can be used at doses of BED10 ≥ 50 Gy and above to provide local control for radical or palliative purposes. SABR is an important and relatively safe treatment option in such recurrences.
Fast loop closure detection using probabilistic integration of pose and appearance similarity
Authors: Yu Qinghua , Huang Kaihong , Lu Huimin , Xiao Junhao , Zeng Zhiwen
Published: June 2024

Loop closure detection is a key technique for robots to minimize the accumulated localization and mapping errors after long-time explorations of simultaneous localization and mapping. However, the requirement for efficiency and accuracy performance for mobile robot applications is not well satisfied. In this article, we propose a fast and accurate loop closure detection method by exploiting both pose-based and appearance-based information in a probabilistic manner, inspired by the complementarity between the pose-based and the appearance-based information. Our approach formulates a probability framework combing the pose-based loop closure detection probability and the appearance-based loop closure detection probability. In the proposed framework, the pose-based loop closure detection model is firstly derived from the nonlinear optimization model of odometry. Then the appearance-based loop similarity and the pose-based loop similarity are combined into a joint framework to improve the loop closure detection performance. We implemented our approach using C++ and ROS and thoroughly tested it on the publicly available datasets. The experiments presented in this article suggest that the proposed method can achieve high efficiency and accuracy performance on loop closure detection.
The association between neighborhood disadvantage and frailty: A retrospective case series
Authors: Fenton David , Allen Amani , Kent Johnathan R , Nordgren Rachel , Liu Allison , Rama Nihar , Wang Ally , Rubin Daniel , Gleason Lauren J , Justine Landi A , Huisingh-Scheetz Megan , Ferguson Mark K , Madariaga Maria Lucia L
Published: June 2024

Background:

Frailty predicts poorer outcomes in surgical patients. Recent studies have found socioeconomic status to be an important characteristic for surgical outcomes. We evaluated the association of Area Deprivation Index (ADI) and Social Vulnerability Index (SVI), two geospatial atlases that provide a multidimensional evaluation of neighborhood deprivation, with frailty in a surgery population.

Design & methods:

A retrospective study of patients undergoing routine frailty screening was conducted 12/2020–8/2022. Frailty was measured using Fried’s Frailty Phenotype (FFP) and the five-item Modified Frailty Index (mFI-5). ADI and SVI quartiles were determined using patient residence. Logistic regression models were used to evaluated associations of FFP (frail only vs not frail) and mFI-5 (≥2 vs 0–1) with ADI and SVI (α = 0.05).

Results:

Of 372 screened patients, 41% (154) were women, median age was 68% (63–74), and 46% (170) identified as non-White. Across ADI and SVI quartiles, higher number of comorbidities, decreasing median income, and frailty were associated with increasing deprivation ( p < 0.01). When controlling for age, sex, comorbidities, and BMI category, frailty by FFP was associated with the most deprived two quartiles of ADI (OR 2.61, CI: [1.35–5.03], p < 0.01) and the most deprived quartile of SVI (OR 2.33, [1.10–4.95], p < 0.05). These trends were also seen with mFI-5 scores ≥2 (ADI: OR 1.64, [1.02–2.63], p < 0.05; SVI: OR 1.71, [1.01–2.91], p < 0.05).

Conclusions:

Surgical patients living in socioeconomically deprived neighborhoods are more likely to be frail. Interventions may include screening of disadvantaged populations and resource allocation to vulnerable neighborhoods.
Clinical Results of Primary Repair Versus Reconstruction of the Anterior Cruciate Ligament: A Systematic Review and Meta-analysis of Contemporary Trials
Authors: Kunze Kyle N. , Pareek Ayoosh , Nwachukwu Benedict U. , Ranawat Anil S. , Pearle Andrew D. , Kelly Bryan T. , Allen Answorth A. , Williams Riley J.
Published: June 2024

Background:

Primary anterior cruciate ligament (ACL) repair has gained renewed interest in select centers for patients with proximal or midsubstance ACL tears. Therefore, it is important to reassess contemporary clinical outcomes of ACL repair to determine whether a clinical benefit exists over the gold standard of ACL reconstruction (ACLR).

Purpose:

To (1) perform a meta-analysis of comparative trials to determine whether differences in clinical outcomes and adverse events exist between ACL repair versus ACLR and (2) synthesize the midterm outcomes of available trials.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

The PubMed, OVID/Medline, and Cochrane databases were queried in August 2023 for prospective and retrospective clinical trials comparing ACL repair and ACLR. Data pertaining to tear location, surgical technique, adverse events, and clinical outcome measures were recorded. DerSimonian-Laird random-effects models were constructed to quantitatively evaluate the association between ACL repair/ACLR, adverse events, and clinical outcomes. A subanalysis of minimum 5-year outcomes was performed.

Results:

Twelve studies (893 patients; 464 ACLR and 429 ACL repair) were included. Random-effects models demonstrated a higher relative risk (RR) of recurrent instability/clinical failure (RR = 1.64; 95% confidence interval [CI], 1.04-2.57; P = .032), revision ACLR (RR = 1.63; 95% CI, 1.03-2.59; P = .039), and hardware removal (RR = 4.94; 95% CI, 2.10-11.61; P = .0003) in patients who underwent primary ACL repair versus ACLR. The RR of reoperations and complications (knee-related) were not significantly different between groups. No significant differences were observed when comparing patient-reported outcome scores. In studies with minimum 5-year outcomes, no significant differences in adverse events or Lysholm scores were observed.

Conclusion:

In contemporary comparative trials of ACL repair versus ACLR, the RR of clinical failure, revision surgery due to ACL rerupture, and hardware removal was greater for primary ACL repair compared with ACLR. There were no observed differences in patient-reported outcome scores, reoperations, or knee-related complications between approaches. In the limited literature reporting on minimum 5-year outcomes, significant differences in adverse events or the International Knee Documentation Committee score were not observed.
Book review: Sumantra Bose, Kashmir at the Crossroads: Inside India’s 21st-Century Conflict
Authors: Maitra Sreya
Published: June 2024

Sumantra Bose, Kashmir at the Crossroads: Inside India’s 21st-Century Conflict. New Delhi: Picador India, Pan Macmillan India, 2021, 333 pp. (hardcover). ISBN: 978-93-90742-73-8
Retrospective Large Database Study of Central Serous Chorioretinopathy Treatments and Visual Outcomes Analysis in the United States
Authors: Burgett Lauren , Aggarwal Nitika , Latona John , Driban Matthew , Chhablani Jay , Maturi Raj K.
Published: June 2024

Purpose: To evaluate a large database detailing the changes in visual acuity (VA) and central subfield thickness after various treatments for central serous chorioretinopathy (CSCR). Methods: A retrospective analysis was performed of patients with CSCR from January 2015 to September 2022 using the Vestrum Health Retina Database of aggregated de-identified electronic medical records from retina specialists in the United States. The cases of CSCR were categorized by age, sex, and treatment provided. Results: The annual incidence of CSCR was 1.72% (61 755 of 3 598 672 patient eyes), with a mean patient age of 53 years. Male eyes comprised 71.8% of the patient population. Eighty-five percent of patients received no treatment within 1 year of diagnosis. Of the patients needing treatment, 21% received thermal laser therapy, 23% photodynamic therapy, and 49% antivascular endothelial growth factor (anti-VEGF) intraocular injection. Patients not receiving treatment had the best baseline and 1-year VA. All treatment groups had an increased percentage of patients gaining letters compared with patients not receiving treatment. Conclusions: Although most patients did not require treatment, those who received treatment generally did well, with a large proportion having visual gain. Statistical analysis suggests treatment has a positive impact on VA outcomes. Patients receiving combination treatment were older and had the least visual gain of the treated cohorts. Younger patients with CSCR treated with anti-VEGF (and without a secondary diagnosis of macular degeneration) had the greatest increase in VA at 1 year.
Mobility spaces: Grounding the implications of politically-driven shifts in mobility regimes
Authors: Greenfield-Gilat Yehuda , Feitelson Eran
Published: June 2024

With increasing levels of mobility, driven by political, economic, technological, and cultural factors, mobility regimes are established to facilitate and control both internal and cross-border travel. Still, the degree to which individuals are mobile is a function of multiple factors, including power, citizenship, ethnicity, income, education, culture, networks, and technology. We advance the concept of “Mobility Spaces” as a way to identify the implications of politically induced changes in mobility regimes for individuals. In particular, we show how politically induced shifts in such regimes affect the mobility options of different groups. Mobility spaces are defined as the area to which a person belonging to a certain group can possibly travel, in a regulated but unimpeded or in a partially impeded fashion. The restrictions limiting mobility spaces can be divided into three thematic hierarchies, domestic, international and for refugees. The mobility spaces implications of changes in mobility regimes resulting from political shifts are exemplified along the first two hierarchies for the Israeli-Palestinian and German-European cases.
Tumor microenvironment of Burkitt lymphoma: different immune signatures with different clinical behavior
Authors: Siciliano Maria Chiara , Bertolazzi Giorgio , Morello Gaia , Tornambè Salvatore , Del Corvo Marcello , Granai Massimo , Sapienza Maria Rosaria , Leahy Ciara I. , Fennell Eanna , Belmonte Beatrice , Arcuri Felice , Vannucchi Margherita , Mancini Virginia , Guazzo Raffaella , Boccacci Roberto , Onyango Noel , Nyagol Joshua , Santi Raffaella , Di Stefano Gioia , Ferrara Domenico , Bellan Cristiana , Marafioti Teresa , Ott German , Siebert Reiner , Quintanilla-Fend Leticia , Fend Falko , Murray Paul , Tripodo Claudio , Pileri Stefano , Lazzi Stefano , Leoncini Lorenzo
Published: June 2024

Burkitt lymphoma (BL) is characterized by a tumor microenvironment (TME) in which macrophages represent the main component, determining a distinct histological appearance known as “starry sky” pattern. However, in some instances, BL may exhibit a granulomatous reaction that has been previously linked to favorable prognosis and spontaneous regression. The aim of our study was to deeply characterize the immune landscape of 7 cases of Epstein-Barr virus–positive (EBV+) BL with granulomatous reaction compared with 8 cases of EBV+ BL and 8 EBV-negative (EBV–) BL, both with typical starry sky pattern, by Gene expression profiling performed on the NanoString nCounter platform. Subsequently, the data were validated using multiplex and combined immunostaining. Based on unsupervised clustering of differentially expressed genes, BL samples formed 3 distinct clusters differentially enriched in BL with a diffuse granulomatous reaction (cluster 1), EBV+ BL with typical starry sky pattern (cluster 2), EBV– BL with typical “starry sky” (cluster 3). We observed variations in the immune response signature among BL with granulomatous reaction and BL with typical “starry sky,” both EBV+ and EBV–. The TME signature in BL with diffuse granulomatous reaction showed a proinflammatory response, whereas BLs with “starry sky” were characterized by upregulation of M2 polarization and protumor response. Moreover, the analysis of additional signatures revealed an upregulation of the dark zone signature and epigenetic signature in BL with a typical starry sky. Tumor-associated macrophages and epigenetic regulators may be promising targets for additional therapies for BL lymphoma, opening novel immunotherapeutic strategies.
Mitoxantrone ameliorates ineffective erythropoiesis in a β-thalassemia intermedia mouse model
Authors: Zhang Haihang , Liu Rui , Fang Zheng , Nie Ling , Ma Yanlin , Sun Fei , Mei Jingjing , Song Zhiyin , Ginzburg Yelena Z. , Liu Jing , Chen Huiyong
Published: June 2024

β-thalassemia is a condition characterized by reduced or absent synthesis of β-globin resulting from genetic mutations, leading to expanded and ineffective erythropoiesis. Mitoxantrone has been widely used clinically as an antitumor agent considering its ability to inhibit cell proliferation. However, its therapeutic effect on expanded and ineffective erythropoiesis in β-thalassemia is untested. We found that mitoxantrone decreased α-globin precipitates and ameliorated anemia, splenomegaly, and ineffective erythropoiesis in the HbbTh3/+ mouse model of β-thalassemia intermedia. The partially reversed ineffective erythropoiesis is a consequence of effects on autophagy as mitochondrial retention and protein levels of mTOR, P62, and LC3 in reticulocytes decreased in mitoxantrone-treated HbbTh3/+ mice. These data provide significant preclinical evidence for targeting autophagy as a novel therapeutic approach for β-thalassemia.
CAR T-cell toxicities: from bedside to bench, how novel toxicities inform laboratory investigations
Authors: Perna Fabiana , Parekh Samir , Diorio Caroline , Smith Melody , Subklewe Marion , Mehta Rakesh , Locke Frederick L. , Shah Nirali N.
Published: June 2024

Multiple chimeric antigen receptor (CAR) T-cell therapies are US Food and Drug Administration–approved, and several are under development. Although effective for some cancers, toxicities remain a limitation. The most common toxicities, that is, cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome, are well described. With increasing utilization, providers worldwide are reporting other emergent and often complicated toxicities. Given the evolving toxicity profiles and urgent need to catalog these emerging and emergent CAR T-cell toxicities and describe management approaches, the American Society of Hematology Subcommittee on Emerging Gene and Cell Therapies organized the first scientific workshop on CAR T-cell toxicities during the annual society meeting. The workshop functioned to (1) aggregate reports of CAR T-cell emergent toxicities, including movement disorders after B-cell maturation antigen CAR T cell, coagulation abnormalities, and prolonged cytopenia; (2) disseminate bedside-to-bench efforts elucidating pathophysiological mechanisms of CAR T-cell toxicities, including the intestinal microbiota and systemic immune dysregulation; and (3) highlight gaps in the availability of clinical tests, such as cytokine measurements, which could be used to expand our knowledge around the monitoring of toxicities. Key themes emerged. First, although clinical manifestations may develop before the pathophysiologic mechanisms are understood, they must be studied to aid in the detection and prevention of such toxicities. Second, systemic immune dysregulation appears to be central to these emergent toxicities, and research is needed to elucidate the links between tumors, CAR T cells, and microbiota. Finally, there was a consensus around the urgency to create a repository to capture emergent CAR T-cell toxicities and the real-world management.
Factors associated with unfavorable treatment outcomes among multidrug-resistant tuberculosis patients, Sierra Leone: a cross-sectional secondary data analysis
Authors: Koroma Josephine Amie , Elduma Adel Hussein , Sesay Umaru , Gebru Gebrekrstos Negash
Published: June 2024

Background

Globally, multidrug-resistant tuberculosis (MDR-TB) is a major public health problem. The tuberculosis rate in Sierra Leone is 298 per 100,000 people, and Sierra Leone is considered a country with a high burden of tuberculosis. In Sierra Leone, there are few studies on the outcomes of MDR-TB treatment, especially those exacerbated by COVID-19. We identified factors associated with unfavorable treatment outcomes among people with MDR-TB in Sierra Leone.

Methods

We conducted a cross-sectional study to analyze hospital-based MDR-TB data from 2017 to 2021. Demographic, clinical, and treatment outcome data were extracted from the main MDR-TB referral hospital database. We defined unfavorable outcomes as patients who died, were lost to follow-up, or defaulted. We calculated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to identify predictors of the outcomes of MDR-TB treatment.

Results

Between 2017 and 2021, 628 people with MDR-TB were reported at Lakka Hospital; 441 (71%) were male, with a median age of 25 years (interquartile ranges: 17–34). Clinically, 21% of the 628 MDR-TB patients were HIV positive, and 413 were underweight (66%). 70% (440) of MDR-TB patients received tuberculosis treatment. The majority of patients, 457 (73%), were treated with a short treatment regimen, and 126 (20%) experienced unfavorable outcomes. Age 45 years or younger (aOR = 5.08; CI:1.87–13.82), 21–45 years (aOR = 2.22; CI:140–3.54), tuberculosis retreatment (aOR = 3.23; CI:1.82–5.73), age group, HIV status (aOR = 2.16; CI:1.33–3.53), and malnourishment status (aOR = 1.79; CI:1.12–2.86) were significantly associated with unfavorable treatment outcomes for DR-TB patients.

Conclusion

This analysis revealed a high proportion of unfavorable treatment outcomes among MDR-TB patients in Sierra Leone. Malnourishment, TB retreatment, HIV coinfection, and age 45 years or younger were associated with unfavorable outcomes of MDR-TB treatment. Increasing patients’ awareness, mainly among young people, heightens treatment adherence and HIV monitoring by measuring the amount of HIV in patient blood, which can reduce adverse treatment outcomes in Sierra Leone and other sub-Saharan African countries.
Investigating causal associations between pneumonia and lung cancer using a bidirectional mendelian randomization framework
Authors: Song Lujia , Wu Dongsheng , Wu Jiayang , Zhang Jiexi , Li Weimin , Wang Chengdi
Published: June 2024

Background

Pneumonia and lung cancer are both major respiratory diseases, and observational studies have explored the association between their susceptibility. However, due to the presence of potential confounders and reverse causality, the comprehensive causal relationships between pneumonia and lung cancer require further exploration.

Methods

Genome-wide association study (GWAS) summary-level data were obtained from the hitherto latest FinnGen database, COVID-19 Host Genetics Initiative resource, and International Lung Cancer Consortium. We implemented a bidirectional Mendelian randomization (MR) framework to evaluate the causal relationships between several specific types of pneumonia and lung cancer. The causal estimates were mainly calculated by inverse-variance weighted (IVW) approach. Additionally, sensitivity analyses were also conducted to validate the robustness of the causalty.

Results

In the MR analyses, overall pneumonia demonstrated a suggestive but modest association with overall lung cancer risk (Odds ratio [OR]: 1.21, 95% confidence interval [CI]: 1.01 − 1.44, P = 0.037). The correlations between specific pneumonia types and overall lung cancer were not as significant, including bacterial pneumonia (OR: 1.07, 95% CI: 0.91 − 1.26, P = 0.386), viral pneumonia (OR: 1.00, 95% CI: 0.95 − 1.06, P = 0.891), asthma-related pneumonia (OR: 1.18, 95% CI: 0.92 − 1.52, P = 0.181), and COVID-19 (OR: 1.01, 95% CI: 0.78 − 1.30, P = 0.952). Reversely, with lung cancer as the exposure, we observed that overall lung cancer had statistically crucial associations with bacterial pneumonia (OR: 1.08, 95% CI: 1.03 − 1.13, P = 0.001) and viral pneumonia (OR: 1.09, 95% CI: 1.01 − 1.19, P = 0.037). Sensitivity analysis also confirmed the robustness of these findings.

Conclusion

This study has presented a systematic investigation into the causal relationships between pneumonia and lung cancer subtypes. Further prospective study is warranted to verify these findings.
Molecular and agro-morphological characterization of new barley genotypes in arid environments
Authors: Elshafei Adel A. , Ibrahim Eid I. , Abdellatif Kamal F. , Salem Abd El-Azeem K. , Moustafa Khaled A. , Al-Doss Abdullah A. , Migdadi Hussein M. , Hussien Amal M. , Soufan Walid , Abd El Rahman Taha , Eldemery Samah M.
Published: June 2024

Background

Genetic diversity, population structure, agro-morphological traits, and molecular characteristics, are crucial for either preserving genetic resources or developing new cultivars. Due to climate change, water availability for agricultural use is progressively diminishing. This study used 100 molecular markers (25 TRAP, 22 SRAP, 23 ISTR, and 30 SSR). Additionally, 15 morphological characteristics were utilized to evaluate the optimal agronomic traits of 12 different barley genotypes under arid conditions.

Results

Substantial variations, ranging from significant to highly significant, were observed in the 15 agromorphological parameters evaluated among the 12 genotypes. The KSU-B101 barley genotype demonstrated superior performance in five specific traits: spike number per plant, 100-grain weight, spike number per square meter, harvest index, and grain yield. These results indicate its potential for achieving high yields in arid regions.

The Sahrawy barley genotype exhibited the highest values across five parameters, namely leaf area, spike weight per plant, spike length, spike weight per square meter, and biological yield, making it a promising candidate for animal feed. The KSU-B105 genotype exhibited early maturity and a high grain count per spike, which reflects its early maturity and ability to produce a high number of grains per spike. This suggests its suitability for both animal feed and human food in arid areas. Based on marker data, the molecular study found that the similarity coefficients between the barley genotypes ranged from 0.48 to 0.80, with an average of 0.64. The dendrogram constructed from these data revealed three distinct clusters with a similarity coefficient of 0.80. Notably, the correlation between the dendrogram and its similarity matrix was high (0.903), indicating its accuracy in depicting the genetic relationships. The combined analysis revealed a moderate correlation between the morphological and molecular analysis, suggesting alignment between the two characterization methods.

Conclusions

The morphological and molecular analyses of the 12 barley genotypes in this study effectively revealed the varied genetic characteristics of their agro-performance in arid conditions. KSU-B101, Sahrawy, and KSU-B105 have emerged as promising candidates for different agricultural applications in arid regions. Further research on these genotypes could reveal their full potential for breeding programs.
The relationship between ambulance team’s professional commitment, occupational anxiety, and resilience levels
Authors: Uysal İbrahim , Korkmaz Güneş , Toraman Çetin
Published: June 2024

Background

Individuals who have the ability to bounce back from stressful events, to recover from their troubles and adverse environmental conditions by getting stronger each time are known as resilient people. Some professions may cause more occupational anxiety than others due to their characteristics and working conditions. In this research, we aimed to develop a professional commitment scale for the ambulance team. Another aim was to analyze the relationships between professional commitment, occupational anxiety, resilience, gender, job, seniority and working unit variables.

Methods

In the study, data were collected from a total of 1142 emergency ambulance workers working in Emergency Ambulance and Emergency Call Centers in 34 different cities in Turkey. Data were collected using the “Professional Commitment of Ambulance Team Scale (PCATS), Occupational Anxiety Scale for Emergency Medical Service Professionals (OASEMSP), and Resilience Scale for Adults (RSA). Scale development analyses were carried out using Classical Test Theory (CTT) and Item Response Theory (IRT). Regression analysis were used to examine the relationships between professional commitment, occupational anxiety, resilience, gender, job, seniority and working unit.

Results

As a result of the exploratory factor analysis (EFA), it was determined that 8 items remaining in the professional commitment scale formed a single-factor structure, explaining 46% of the variance of professional commitment of the team. The Cronbach’s Alpha reliability value was 0.867. Confirmatory factor analysis (CFA) confirmed the results of exploratory factor analysis. The Cronbach’s Alpha reliability coefficient obtained through CTT was 0.868, and the marginal reliability coefficient within the scope of IRT was 0.877. The test-retest reliability coefficient was calculated as 0.832, which indicates that the scale is valid and reliable.

Conclusions

The study revealed that resilience has a positive effect for professional commitment while occupational anxiety has a negative effect for professional commitment. In addition, having a moderate seniority has a negative (reducing) effect for professional commitment. Other variables (gender, job, and working unit) was found to have no significant impact on professional commitment.
Mechanism of ERBB2 gene overexpression by the formation of super-enhancer with genomic structural abnormalities in lung adenocarcinoma without clinically actionable genetic alterations
Authors: Kaneko Syuzo , Takasawa Ken , Asada Ken , Shiraishi Kouya , Ikawa Noriko , Machino Hidenori , Shinkai Norio , Matsuda Maiko , Masuda Mari , Adachi Shungo , Takahashi Satoshi , Kobayashi Kazuma , Kouno Nobuji , Bolatkan Amina , Komatsu Masaaki , Yamada Masayoshi , Miyake Mototaka , Watanabe Hirokazu , Tateishi Akiko , Mizuno Takaaki , Okubo Yu , Mukai Masami , Yoshida Tatsuya , Yoshida Yukihiro , Horinouchi Hidehito , Watanabe Shun-Ichi , Ohe Yuichiro , Yatabe Yasushi , Saloura Vassiliki , Kohno Takashi , Hamamoto Ryuji
Published: June 2024

Background

In an extensive genomic analysis of lung adenocarcinomas (LUADs), driver mutations have been recognized as potential targets for molecular therapy. However, there remain cases where target genes are not identified. Super-enhancers and structural variants are frequently identified in several hundred loci per case. Despite this, most cancer research has approached the analysis of these data sets separately, without merging and comparing the data, and there are no examples of integrated analysis in LUAD.

Methods

We performed an integrated analysis of super-enhancers and structural variants in a cohort of 174 LUAD cases that lacked clinically actionable genetic alterations. To achieve this, we conducted both WGS and H3K27Ac ChIP-seq analyses using samples with driver gene mutations and those without, allowing for a comprehensive investigation of the potential roles of super-enhancer in LUAD cases.

Results

We demonstrate that most genes situated in these overlapped regions were associated with known and previously unknown driver genes and aberrant expression resulting from the formation of super-enhancers accompanied by genomic structural abnormalities. Hi-C and long-read sequencing data further corroborated this insight. When we employed CRISPR-Cas9 to induce structural abnormalities that mimicked cases with outlier ERBB2 gene expression, we observed an elevation in ERBB2 expression. These abnormalities are associated with a higher risk of recurrence after surgery, irrespective of the presence or absence of driver mutations.

Conclusions

Our findings suggest that aberrant gene expression linked to structural polymorphisms can significantly impact personalized cancer treatment by facilitating the identification of driver mutations and prognostic factors, contributing to a more comprehensive understanding of LUAD pathogenesis.
Efficiency of hospitals in COVID-19 era: a case study of an affected country
Authors: Hamdollahzadeh Anita , Nabilou Bahram , Yusefzadeh Hasan
Published: June 2024

Background

The COVID-19 pandemic has affected all aspects of human life and society and has damaged the global economy. Health systems and hospitals were not exempted from this situation. The performance of hospitals during the COVID-19 pandemic was affected by policies related to the pandemic and other factors. This study aimed to investigate hospital performance indicators such as admissions and revenue.

Methods

The medical records of patients with selected orthopedic and general surgical diseases were studied in two government hospitals in the capital city of Urmia in the second quarter of 2019, with the same period in 2020. Data were extracted based on the number of medical records, including length of stay, hospitalization type, sex, age, insurance, number of deaths, and readmissions from the medical records department. Payment amounts were collected from the revenue department and Hospital Information System. Two performance indicators, two result indicators, and two control indicators were used. Mean disease-specific revenue, total revenue, length of stay, and bed occupancy rate were calculated for both periods. Data were analyzed using SPSS (version 16) and the Mann-Whitney statistical test.

Results

2140 cases were studied in the two disease groups. An increase was observed in the number of hospitalizations and average length of stay during the pandemic. The mean disease-specific revenue in the quarter of 2020 was higher than in 2019. However, total revenue decreased, and the difference in the mean of total revenue was significant for the two years (P = 0.00) in teaching center. The number of readmissions remained unchanged throughout in the pandemic. The number of deaths due to general surgery diseases in 2020 compared to the same period in 2019 was associated with a relative increase.

Conclusions

The COVID-19 pandemic increased the slope of health care costs. The analysis of the studied variables as performance, result, and control indicators showed that hospitalization rate, bed occupancy rate, and total revenue followed a similar and decreasing pattern in the selected hospitals during the COVID-19 pandemic. Hospitals should adopt appropriate strategies so that, in conditions identical to the COVID-19 pandemic, their performance is accompanied by proper management of resources, efficiency, and minimal reduction in revenue.