bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of pneumothorax on mortality, morbidity, and hospital resource utilization in COVID-19 patients: a propensity matched analysis of nationwide inpatient sample database
Authors: Nasrullah Adeel , Quazi Mohammed A. , Virk Shiza , Niranjan Sitara , Butt Muhammad Ali , Shakir Muhammad Hassan , Sohail Amir Humza , Bilal Muhammad Ibraiz , Muzammil Taimur , DiSilvio Briana , Sheikh Abu Baker , Cheema Tariq
Published: July 2024

Background

Spontaneous pneumothorax (PTX) is more prevalent among COVID-19 patients than other critically ill patients, but studies on this are limited. This study compared clinical characteristics and in-hospital outcomes among COVID-19 patients with concomitant PTX to provide insight into how PTX affects health care utilization and complications, which informs clinical decisions and healthcare resource allocation.

Methods

The 2020 Nationwide Inpatient Sample was used analyze patient demographics and outcomes, including age, race, sex, insurance status, median income, length of hospital stay, mortality rate, hospitalization costs, comorbidities, mechanical ventilation, and vasopressor support. Propensity score matching was employed for additional analysis.

Results

Among 1,572,815 COVID-19 patients, 1.41% had PTX. These patients incurred significantly higher hospitalization costs ($435,508 vs. $96,668, p < 0.001) and longer stays (23.6 days vs. 8.6 days, p < 0.001). In-hospital mortality was substantially elevated for PTX patients (65.8% vs. 14.4%, p < 0.001), with an adjusted odds ratio of 14.3 (95% CI 12.7–16.2). Additionally, these patients were more likely to require vasopressors (16.6% vs. 3.3%), mechanical circulatory support (3.5% vs. 0.3%), hemodialysis (16.6% vs. 5.6%), invasive mechanical ventilation (76.9% vs. 15.1%), non-invasive mechanical ventilation (19.1% vs. 5.8%), tracheostomy (13.3% vs. 1.1%), and chest tube placement (59.8% vs. 0.8%).

Conclusions

Our findings highlight the severe impact of PTX on COVID-19 patients, characterized by higher mortality, more complications, and increased resource utilization. Also, being Hispanic, male, or obese increased the risk of developing concomitant PTX with COVID-19.
A home-based tele-rehabilitation exercise system for patients after knee replacement surgery
Authors: Salehian Farnaz , Mahmoudzadeh-Sagheb Zahra , Yoosefinejad Amin Kordi , Zakerabasali Somayyeh
Published: July 2024

Background

Knee arthritis is a destructive disorder that affects the knee joints and causes pain and reduced mobility. Drug treatments, weight loss, and exercise control the symptoms of the disease, but these methods only delay the disease process and eventually, knee joint replacement surgery will be needed. After surgery, with the help of a proper physiotherapy program, full recovery takes an average of 6–12 months. However, currently, there is no similar tool to facilitate this process in Iran.

Objective

The purpose of this research is to design and develop the prototype of a rehabilitation system for patients after knee replacement surgery, which provides patients with information and appropriate physiotherapy programs.

Methods

This study was development-applied and was done in three stages. In the first stage, the needs and content of education and therapeutic exercises were prepared in the form of a checklist, and then the necessity of each item was checked in the evaluation sessions. In the second stage, the prototype of the system was developed using Adobe XD software and based on the requirements approved from the previous stage. In the third stage, the usability of the program was analyzed from the point of view of experts using the exploratory evaluation method with Nielsen’s 13 principles of usability.

Results

At first, the system requirements were extracted and prepared in two checklists of content (51 exercises) and capabilities (60 items). Then after a survey of experts based on the Delphi technique, content information (43 exercises) and functional and non-functional requirements (53 items) were obtained. A survey of experts helped to finalize the information elements, categorize them, and prepare the final version of the checklists. Based on this, the system requirements were classified into 11 categories, and the training content was classified into 3 training periods. Finally, the design and development of the system was done. This system has admin, physician, and patient user interfaces. The result of usability showed that this system is efficient and there are only a few problems in the feature of helping users to detect and recover from errors.

Conclusion

It seems necessary to develop a system based on the principles of usability by therapists and rehabilitation specialists to train and monitor the remote rehabilitation process of patients after knee joint replacement at home. And the importance of involving stakeholders in the design and development of remote rehabilitation systems is not hidden from anyone. Kara system has all of the above.
Do educational interventions reduce the gender gap in communication skills?- a systematic review
Authors: Driscoll Alexis M. , Suresh Rohan , Popa George , Berglund Leif , Azer Amanda , Hed Helen , Duan Yajie , Chu Alice , McGrath Aleksandra
Published: July 2024

Background

Efficient doctor-patient communication is essential for improving patient care. The impact of educational interventions on the communication skills of male and female students has not been systematically reviewed. The aim of this review is to identify interventions used to improve communication skills in medical curricula and investigate their effectiveness in improving the communication skills of male and female medical students.

Methods

A systematic review of the literature was conducted using the PRISMA guidelines. Inclusion criteria were as follows: used intervention strategies aiming to improve communication skills, participants were medical students, and studies were primary research studies, systematic reviews, or meta-analyses.

Results

2913 articles were identified based on search terms. After title, abstract, and full-text review, 58 studies were included with interventions consisting of Training or Drama Courses, Curriculum-Integrated, Patient Learning Courses, and Community-Based Learning Courses. 69% of articles reported improved communication skills for both genders equally, 28% for women more than men, and 3% for men more than women. 16 of the 58 articles reported numerical data regarding communication skills pre-and post-intervention. Analysis revealed that post-intervention scores are significantly greater than pre-intervention scores for both male (p < 0.001) and female students (p < 0.001). While the post-test scores of male students were significantly lower than that of female students (p = 0.01), there is no significant difference between genders for the benefits, or difference between post-intervention and pre-intervention scores (p = 0.15), suggesting that both genders benefited equally.

Conclusion

Implementation of communication training into medical education leads to improvement in communication skills of medical students, irrespective of gender. No specific interventions benefitting male students have been identified from published literature, suggesting need of further studies to explore the phenomenon of gender gap in communication skills and how to minimize the differences between male and female students.
Joint extraction of Chinese medical entities and relations based on RoBERTa and single-module global pointer
Authors: Li Dongmei , Yang Yu , Cui Jinman , Meng Xianghao , Qu Jintao , Jiang Zhuobin , Zhao Yufeng
Published: July 2024

Background

Most Chinese joint entity and relation extraction tasks in medicine involve numerous nested entities, overlapping relations, and other challenging extraction issues. In response to these problems, some traditional methods decompose the joint extraction task into multiple steps or multiple modules, resulting in local dependency in the meantime.

Methods

To alleviate this issue, we propose a joint extraction model of Chinese medical entities and relations based on RoBERTa and single-module global pointer, namely RSGP, which formulates joint extraction as a global pointer linking problem. Considering the uniqueness of Chinese language structure, we introduce the RoBERTa-wwm pre-trained language model at the encoding layer to obtain a better embedding representation. Then, we represent the input sentence as a third-order tensor and score each position in the tensor to prepare for the subsequent process of decoding the triples. In the end, we design a novel single-module global pointer decoding approach to alleviate the generation of redundant information. Specifically, we analyze the decoding process of single character entities individually, improving the time and space performance of RSGP to some extent.

Results

In order to verify the effectiveness of our model in extracting Chinese medical entities and relations, we carry out the experiments on the public dataset, CMeIE. Experimental results show that RSGP performs significantly better on the joint extraction of Chinese medical entities and relations, and achieves state-of-the-art results compared with baseline models.

Conclusion

The proposed RSGP can effectively extract entities and relations from Chinese medical texts and help to realize the structure of Chinese medical texts, so as to provide high-quality data support for the construction of Chinese medical knowledge graphs.
Co-designing a cardiac rehabilitation program with knowledge users for patients with cardiovascular disease from a remote area
Authors: Bernier Jessica , Breton Mylaine , Poitras Marie-Eve
Published: July 2024

Background

Cardiovascular disease is the leading cause of death worldwide. Cardiac rehabilitation (CR) programs are recognized as effective in reducing the burden of cardiovascular disease. However, CR programs are offered inequitably across regions and are available in less than 15% of remote areas worldwide. The main goal of this study was to design a CR program adapted to the contexts of remote areas to improve the service offered to patients.

Methods

We used an iterative user-centered design approach to understand the user context and services offered in cardiac rehabilitation in remote areas. We conducted two co-design processes with knowledge users in two remote regions. Two advisory committees were created in each of these regions, comprising managers (n = 6), healthcare professionals (n = 12) and patients (n = 2). We utilized the BACPR guidelines and the Hautes Autorités de santé operational model to support data collection in coding sessions to develop the CR program. We conducted four cycles of co-design with each of the committees to develop the cardiac rehabilitation program. Qualitative data were analyzed iteratively after each cycle.

Results

The co-design process resulted in developing a prototype cardiac rehabilitation program similar in both regions. It is based on a contextualized six-phase pathway of care designed for remote regions. For each phase 0 to 6 of the care pathway, knowledge users were asked to describe how to offer these phases in remote areas. Participants made structural changes to phases 0, 2, 3 and 4 in order to overcome staffing shortages in remote areas. These changes make it possible to decentralize cardiac rehabilitation expertise away from specialized centers, to ensure equity of service across the territory. Therapeutic patient education was integrated into phase 4 to meet patients' needs. Participants suggested that three follow-up offerings could come from nursing services to increase access to the cardiac rehabilitation program (primary care, home care, special chronic disease programs) in patients' home communities.

Conclusion

The co-design process enables us to meet the needs of remote regions in program development. This final program can be the subject of future implementation research.
Mosquito Shield™, a transfluthrin passive emanator, protects against pyrethroid-resistant Anopheles gambiae sensu lato in central Benin
Authors: Fongnikin Augustin , Ahoga Juniace , Ndombidje Boris , Hueha Corneille , de Souza Esperantos , Oti-Tossou Ruth , Govoetchan Renaud , Ngufor Corine
Published: July 2024

Background

Spatial repellents can provide personal and household protection against biting vector mosquitoes by volatizing repellents into the air within a given area. Mosquito Shield™ is a transfluthrin passive emanator undergoing evaluation for malaria control. Studies evaluating its entomological impact against different local malaria vector populations would help guide its deployment in endemic countries.

Methods

A two-arm single-blinded small-scale household randomised entomological trial was conducted to assess the impact of Mosquito Shield™ on the human landing rate of wild pyrethroid-resistant Anopheles gambiae sensu lato (s.l.) vector mosquitoes in houses in the Ganhoua village of the Zakpota District of central Benin. From a total of 30 houses, 15 were randomly allocated to receive Mosquito Shield™, while the remainder received a placebo product. The trial lasted through the life of the Mosquito Shield™ product (32 days). Mosquito sampling was performed by human landing catches at baseline and at 6 timepoints post-intervention (days 0–1, 7–8, 14–15, 21–22, 28–29 and 31–32). Collections were performed for 2 nights at each sampling time point. WHO cylinder bioassays were conducted during the trial with F1 An. gambiae s.l. mosquitoes that emerged from larvae from the study area to assess the intensity of resistance to pyrethroids in the wild vector population.

Results

The vector population in the study area showed a high intensity of resistance to pyrethroids. Baseline An. gambiae s.l. human landing rates were similar in houses in both study arms before product application (11.53/person/night vs 11.67/person/night, p > 0.05). A total of 5736 mosquitoes were collected in the placebo control arm and 3862 in the Mosquito Shield™ arm post-intervention. Overall An. gambiae s.l. post-intervention human landing rates were significantly lower in houses in the Mosquito Shield™ arm (18.13/person/night) compared to the houses in the placebo control arm (26.84/person/night, IRR = 0.658, p < 0.001). Over the lifespan of the product, Mosquito Shield™ provided a significant protective efficacy of 34.2% (22.1–44.4%, p < 0.001) against wild pyrethroid-resistant An. gambiae s.l. vectors compared to the placebo. Human landing rates of other nuisance vector mosquito species (Culex and Mansonia) were also reduced in houses treated with Mosquito Shield™ compared to the placebo.

Conclusion

Mosquito Shield™, a transfluthrin passive emanator, provided significant protection against pyrethroid-resistant malaria vectors to households in Benin. The spatial repellent shows potential to reduce malaria transmission by pyrethroid-resistant An. gambiae s.l. vector mosquitoes and cover gaps in malaria control when deployed to complement existing vector control interventions.
Artificially sweetened beverage consumption and all-cause and cause-specific mortality: an updated systematic review and dose-response meta-analysis of prospective cohort studies
Authors: Chen Zhangling , Wei Cheng , Lamballais Sander , Wang Kang , Mou Yuchan , Xiao Yichao , Luo Fei , Bramer Wichor M. , Voortman Trudy , Zhou Shenghua
Published: July 2024

Background

Artificially sweetened beverages (ASB) are consumed globally, but their impact on overall health remains uncertain. We summarized published associations between ASB intake with all-cause and cause-specific mortality.

Methods

We searched Medline, Embase, Web of Science, and Cochrane CENTRAL databases until August 2023. Random effect meta-analysis was conducted to calculate pooled risk ratios (RRs) and 95% confidence intervals (95%CIs) for highest versus lowest categories of ASB consumption in relation to all-cause and cause-specific mortality. Linear and non-linear dose-response analyses were also performed.

Results

Our systematic review and meta-analysis included 11 prospective cohort studies. During a median/mean follow-up period of 7.0 to 28.9 years, 235,609 deaths occurred among 2,196,503 participants. Intake of ASB was associated with higher risk of all-cause and CVD mortality with pooled RRs (95%CIs) of highest vs. lowest intake categories of 1.13 (1.06, 1.21) (I2 = 66.3%) for all-cause mortality and 1.26 (1.10, 1.44) (I2 = 52.0%) for CVD mortality. Dose-response analysis revealed a non-linear association of ASB with all-cause mortality (pnon−linearity = 0.01), but a linear positive association with CVD mortality (pnon−linearity = 0.54). No significant association was observed for ASB intake and cancer mortality. Moreover, a secondary meta-analysis demonstrated that replacing 1 serving/day of sugary sweetened beverages (SSB) with ASB was associated with 4–6% lower risk of all-cause and CVD mortality. Per NutriGrade, the evidence quality for associations between ASB intake with all-cause and CVD mortality was moderate.

Conclusions

Higher intake of ASB was associated with higher risk of all-cause and CVD mortality, albeit a lower risk than for SSB.

Systematic review registration

PROSPERO registration no. CRD42022365701.
Circular RNA hsa_circ_0000467 promotes colorectal cancer progression by promoting eIF4A3-mediated c-Myc translation
Authors: Jiang Xianjie , Peng Mingjing , Liu Qiang , Peng Qiu , Oyang Linda , Li Shizhen , Xu Xuemeng , Shen Mengzhou , Wang Jiewen , Li Haofan , Wu Nayiyuan , Tan Shiming , Lin Jinguan , Xia Longzheng , Tang Yanyan , Luo Xia , Liao Qianjin , Zhou Yujuan
Published: July 2024

Background

Colorectal cancer (CRC) is the second most common malignant tumor worldwide, and its incidence rate increases annually. Early diagnosis and treatment are crucial for improving the prognosis of patients with colorectal cancer. Circular RNAs are noncoding RNAs with a closed-loop structure that play a significant role in tumor development. However, the role of circular RNAs in CRC is poorly understood.

Methods

The circular RNA hsa_circ_0000467 was screened in CRC circRNA microarrays using a bioinformatics analysis, and the expression of hsa_circ_0000467 in CRC tissues was determined by in situ hybridization. The associations between the expression level of hsa_circ_0000467 and the clinical characteristics of CRC patients were evaluated. Then, the role of hsa_circ_0000467 in CRC growth and metastasis was assessed by CCK8 assay, EdU assay, plate colony formation assay, wound healing assay, and Transwell assay in vitro and in a mouse model of CRC in vivo. Proteomic analysis and western blotting were performed to investigate the effect of hsa_circ_0000467 on c-Myc signaling. Polysome profiling, RT‒qPCR and dual-luciferase reporter assays were performed to determine the effect of hsa_circ_0000467 on c-Myc translation. RNA pull-down, RNA immunoprecipitation (RIP) and immunofluorescence staining were performed to assess the effect of hsa_circ_0000467 on eIF4A3 distribution.

Results

In this study, we found that the circular RNA hsa_circ_0000467 is highly expressed in colorectal cancer and is significantly correlated with poor prognosis in CRC patients. In vitro and in vivo experiments revealed that hsa_circ_0000467 promotes the growth and metastasis of colorectal cancer cells. Mechanistically, hsa_circ_0000467 binds eIF4A3 to suppress its nuclear translocation. In addition, it can also act as a scaffold molecule that binds eIF4A3 and c-Myc mRNA to form complexes in the cytoplasm, thereby promoting the translation of c-Myc. In turn, c-Myc upregulates its downstream targets, including the cell cycle-related factors cyclin D2 and CDK4 and the tight junction-related factor ZEB1, and downregulates E-cadherin, which ultimately promotes the growth and metastasis of CRC.

Conclusions

Our findings revealed that hsa_circRNA_0000467 plays a role in the progression of CRC by promoting eIF4A3-mediated c-Myc translation. This study provides a theoretical basis and molecular target for the diagnosis and treatment of CRC.
Organ-on-a-chip: future of female reproductive pathophysiological models
Authors: Deng Zhi-Min , Dai Fang-Fang , Wang Rui-Qi , Deng Hong-Bing , Yin Tai-Lang , Cheng Yan-Xiang , Chen Gan-Tao
Published: July 2024

The female reproductive system comprises the internal and external genitalia, which communicate through intricate endocrine pathways. Besides secreting hormones that maintain the female secondary sexual characteristics, it also produces follicles and offspring. However, the in vitro systems have been very limited in recapitulating the specific anatomy and pathophysiology of women. Organ-on-a-chip technology, based on microfluidics, can better simulate the cellular microenvironment in vivo, opening a new field for the basic and clinical research of female reproductive system diseases. This technology can not only reconstruct the organ structure but also emulate the organ function as much as possible. The precisely controlled fluidic microenvironment provided by microfluidics vividly mimics the complex endocrine hormone crosstalk among various organs of the female reproductive system, making it a powerful preclinical tool and the future of pathophysiological models of the female reproductive system. Here, we review the research on the application of organ-on-a-chip platforms in the female reproductive systems, focusing on the latest progress in developing models that reproduce the physiological functions or disease features of female reproductive organs and tissues, and highlighting the challenges and future directions in this field.
Metastasis and basement membrane-related signature enhances hepatocellular carcinoma prognosis and diagnosis by integrating single-cell RNA sequencing analysis and immune microenvironment assessment
Authors: Wei Shijia , Tan Jingyi , Huang Xueshan , Zhuang Kai , Qiu Weijian , Chen Mei , Ye Xiaoxia , Wu Minhua
Published: July 2024

Background

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and second leading cause of cancer-related deaths worldwide. The heightened mortality associated with HCC is largely attributed to its propensity for metastasis, which cannot be achieved without remodeling or loss of the basement membrane (BM). Despite advancements in targeted therapies and immunotherapies, resistance and limited efficacy in late-stage HCC underscore the urgent need for better therapeutic options and early diagnostic biomarkers. Our study aimed to address these gaps by investigating and evaluating potential biomarkers to improve survival outcomes and treatment efficacy in patients with HCC.

Method

In this study, we collected the transcriptome sequencing, clinical, and mutation data of 424 patients with HCC from The Cancer Genome Atlas (TCGA) and 240 from the International Cancer Genome Consortium (ICGC) databases. We then constructed and validated a prognostic model based on metastasis and basement membrane-related genes (MBRGs) using univariate and multivariate Cox regression analyses. Five immune-related algorithms (CIBERSORT, QUANTISEQ, MCP counter, ssGSEA, and TIMER) were then utilized to examine the immune landscape and activity across high- and low-risk groups. We also analyzed Tumor Mutation Burden (TMB) values, Tumor Immune Dysfunction and Exclusion (TIDE) scores, mutation frequency, and immune checkpoint gene expression to evaluate immune treatment sensitivity. We analyzed integrin subunit alpha 3 (ITGA3) expression in HCC by performing single-cell RNA sequencing (scRNA-seq) analysis using the TISCH 2.0 database. Lastly, wound healing and transwell assays were conducted to elucidate the role of ITGA3 in tumor metastasis.

Results

Patients with HCC were categorized into high- and low-risk groups based on the median values, with higher risk scores indicating worse overall survival. Five immune-related algorithms revealed that the abundance of immune cells, particularly T cells, was greater in the high-risk group than in the low-risk group. The high-risk group also exhibited a higher TMB value, mutation frequency, and immune checkpoint gene expression and a lower tumor TIDE score, suggesting the potential for better immunotherapy outcomes. Additionally, scRNA-seq analysis revealed higher ITGA3 expression in tumor cells compared with normal hepatocytes. Wound healing scratch and transwell cell migration assays revealed that overexpression of the MBRG ITGA3 enhanced migration of HCC HepG2 cells.

Conclusion

This study established a direct molecular correlation between metastasis and BM, encompassing clinical features, tumor microenvironment, and immune response, thereby offering valuable insights for predicting clinical outcomes and immunotherapy responses in HCC.
Monitoring imatinib decreasing pericyte coverage and HIF-1α level in a colorectal cancer model by an ultrahigh-field multiparametric MRI approach
Authors: Hu Xinpeng , Ye Kunlin , Bo Shaowei , Xiao Zeyu , Ma Mengjie , Pan Jinghua , Zhong Xing , Zhang Dong , Mo Xukai , Yu Xiaojun , Chen Minfeng , Luo Liangping , Shi Changzheng
Published: July 2024

Background

Excessive pericyte coverage promotes tumor growth, and a downregulation may solve this dilemma. Due to the double-edged sword role of vascular pericytes in tumor microenvironment (TME), indiscriminately decreasing pericyte coverage by imatinib causes poor treatment outcomes. Here, we optimized the use of imatinib in a colorectal cancer (CRC) model in high pericyte-coverage status, and revealed the value of multiparametric magnetic resonance imaging (mpMRI) at 9.4T in monitoring treatment-related changes in pericyte coverage and the TME.

Methods

CRC xenograft models were evaluated by histological vascular characterizations and mpMRI. Mice with the highest pericyte coverage were treated with imatinib or saline; then, vascular characterizations, tumor apoptosis and HIF-1α level were analyzed histologically, and alterations in the expression of Bcl-2/bax pathway were assessed through qPCR. The effects of imatinib were monitored by dynamic contrast-enhanced (DCE)-, diffusion-weighted imaging (DWI)- and amide proton transfer chemical exchange saturation transfer (APT CEST)-MRI at 9.4T.

Results

The DCE- parameters provided a good histologic match the tumor vascular characterizations. In the high pericyte coverage status, imatinib exhibited significant tumor growth inhibition, necrosis increase and pericyte coverage downregulation, and these changes were accompanied by increased vessel permeability, decreased microvessel density (MVD), increased tumor apoptosis and altered gene expression of apoptosis-related Bcl-2/bax pathway. Strategically, a 4-day imatinib effectively decreased pericyte coverage and HIF-1α level, and continuous treatment led to a less marked decrease in pericyte coverage and re-elevated HIF-1α level. Correlation analysis confirmed the feasibility of using mpMRI parameters to monitor imatinib treatment, with DCE-derived Ve and Ktrans being most correlated with pericyte coverage, Ve with vessel permeability, AUC with microvessel density (MVD), DWI-derived ADC with tumor apoptosis, and APT CEST-derived MTRasym at 1 µT with HIF-1α.

Conclusions

These results provided an optimized imatinib regimen to achieve decreasing pericyte coverage and HIF-1α level in the high pericyte-coverage CRC model, and offered an ultrahigh-field multiparametric MRI approach for monitoring pericyte coverage and dynamics response of the TME to treatment.
Ethnobotanical insights on the management of plant pests and diseases by smallholder farmers in Mpumalanga Province of South Africa
Authors: Shai Kutullo N. , Materechera Simeon A. , Amoo Stephen O. , Aremu Adeyemi O.
Published: July 2024

Background

Pests and diseases are a major contributor to yield losses in sub-Saharan Africa, prompting smallholder farmers to seek cost-effective, accessible and ecologically friendly alternatives for crop protection. This study explored the management of pests and diseases affecting crops across eight selected villages in Ehlanzeni District, Mpumalanga Province, South Africa.

Methods

A total of 120 smallholder farmers were purposefully selected utilising the snowball technique. Information on the management of plant pests and diseases was collected through interviews and focus group discussions using semi-structured interview schedules. Ethnobotanical indices, including relative frequency of citation (RFC), use-value (UV) and informant consensus factor (Fic), were used to quantify and rank the plants used for crop protection in the study area.

Results

Twenty-three plant species (16 naturalised exotics and seven indigenous plants) belonging to 16 families were used for managing pests (vertebrates and invertebrates) and diseases (fungal and bacterial related) affecting crops in the study area. The dominant (100%) crops cultivated by the participants were Allium cepa L., Mangifera indica L., Solanum lycopersicum L. and Zea mays L. The RFC value ranged from 0.08 to 0.83 and the three most popular plants for crop protection were Capsium annuum L. (0.83), A. cepa (0.63) and Dichrostachys cinerea (L.) Wight & Arn. (0.43). In terms of the UV, the five most promising plants used as biocontrol were Tulbaghia violacea (0.13), A. cepa (0.12), C. annuum L. (0.09), Solanum campylacanthum Hochst. Ex A.Rich.(0.09) and Pinus pinaster (0.08). Based on the Fic, four categories were established and dominated by fungal diseases (0.64). Furthermore, T. violacea and A. cepa were the most often mentioned plants used against fungal conditions. Other categories cited were bacterial diseases (0.3), invertebrate pests (0.11) and vertebrate pests (0.14), an indication that smallholder farmers had limited agreement or common knowledge about the plants used for their management. The preparation methods included maceration (38%), decoction (38%) and burning (24%). Foliar application (67%) and soil drenching (33%) were used for administering plant extracts during the management of crop pests and diseases.

Conclusion

The study highlights the importance of botanicals and associated indigenous knowledge among smallholder farmers in Mpumalanga Province, South Africa. It is pertinent to explore the valorisation of these botanicals by generating empirical data on their biological efficacies and phytochemical profiles.
Lymphomatosis cerebri caused by adult T cell leukemia/lymphoma: a differential diagnosis for depression: a case report
Authors: Inaba Satoshi , Kudo Masataka , Kamano Hironori , Ohishi Yoshihiro , Kiyasu Junichi , Watari Takashi
Published: July 2024

Background

Primary central nervous system lymphoma is rare, and primary central nervous system T cell lymphoma is relatively uncommon, contributing to < 5% of all cases. Lymphomatosis cerebri, a rare subtype of primary central nervous system lymphoma, is characterized by extensive white-matter lesions on magnetic resonance imaging and nonspecific symptoms, such as cognitive decline and depression. Reports of lymphomatosis cerebri in adult T cell leukemia/lymphoma are limited.

Case presentation

A 49-year-old Japanese man gradually developed insomnia, anorexia, and weight loss over a 2-month period following work-related promotion. Initially diagnosed with depression, his condition rapidly deteriorated with cognitive decline and motor dysfunction. Despite various treatments, his symptoms persisted within a month. Upon admission, the presence of neurological abnormalities suggestive of a central nervous system disorder raised suspicion of a cerebral lesion. Diagnostic tests revealed extensive brain lesions on imaging and the presence of atypical lymphocytes (flower cells) in the cerebrospinal fluid. The patient was diagnosed with lymphomatosis cerebri due to adult T cell leukemia/lymphoma, a rare presentation in the literature. Due to irreversible brainstem damage and poor neurological prognosis, aggressive treatment was not initiated, and the patient died, with an autopsy confirming the diagnosis.

Conclusion

Lymphomatosis cerebri with adult T cell leukemia/lymphoma is very rare. It is crucial to promptly consider lymphomatosis cerebri as a differential diagnosis, particularly in cases of rapid cognitive decline and poor treatment response. Recognition of lymphomatosis cerebri as an important differential diagnosis for cognitive decline, and depression is necessary for timely intervention and management. Further research is required to better understand this unique and rare presentation in adult T cell leukemia/lymphoma.
Businesses model innovation: a key role in the internationalisation of SMEs in the era of digitalisation
Authors: Dung Luu Tien , Dung Tran Thi Hoang
Published: July 2024

The study investigates the relationship between digital technology (DT) and the degree of internationalisation of small- and medium-sized enterprises (SMEs). The theoretical model is further extended by reviewing the mediating effects of business model innovation (BMI). The study employed partial least squares structural equation modelling (PLS-SEM) to test the hypotheses based on the cross-sectional data from 495 SMEs in Vietnam. The findings provide a novel perspective on the vital role of DT in BMI. However, DT poses challenges for SMEs in the degree of the internationalisation process. This study combines the internationalisation theory, particularly the Uppsala model and the resource-based view to examine the impact of DT on the internationalisation of SMEs through the mediating role of BMI.
Ozone therapy in musculoskeletal medicine: a comprehensive review
Authors: Jeyaraman Madhan , Jeyaraman Naveen , Ramasubramanian Swaminathan , Balaji Sangeetha , Nallakumarasamy Arulkumar , Patro Bishnu Prasad , Migliorini Filippo
Published: July 2024

Musculoskeletal disorders encompass a wide range of conditions that impact the bones, joints, muscles, and connective tissues within the body. Despite the ongoing debate on toxicity and administration, ozone demonstrated promise in managing several musculoskeletal disorders, modulating pain and inflammation. A literature search was conducted. The research design, methods, findings, and conclusions of the studies were then examined to evaluate the physiological effects, clinical application, controversies, and safety of the application of ozone in musculoskeletal medicine. Ozone application demonstrates considerable therapeutic applications in the management of musculoskeletal disorders, including fractures, osteoarthritis, and chronic pain syndromes. Despite these advantages, studies have raised concerns regarding its potential toxicity and emphasized the importance of adhering to stringent administration protocols to ensure safety. Additionally, heterogeneities in patient reactions and hazards from oxidizing agents were observed. Given its anti-inflammatory and analgesic qualities, ozone therapy holds potential in the management of several musculoskeletal disorders. Additional high-quality research with long follow-up is required to refine indications, efficacy and safety profile. Finally, for wider clinical acceptability and utilization, the development of international recommendations is essential.
Motivational determinants of athletes’ self-realisation depending on their professional qualification
Authors: Krasmik Yuliya , Aimaganbetova Olga , Iancheva Tatiana , Zhantikeyev Serik , Lashkova Eugeniya , Makhmutov Aidos , Rakhmalin Bolat
Published: July 2024

Background

In the contemporary era, there is a growing emphasis on understanding the self-realization of personality, encompassing individual-psychological traits, abilities, knowledge, skills, and motivation, extensively studied in psychology. Notably, limited attention has been given to exploring motivational determinants influencing athlete self-realization based on their professional qualifications. This gap is particularly pertinent in Kazakhstan, where significant efforts are directed towards athlete preparation.

Methods

Employing a systemic approach by Bagadirova and Kudinov, the study views athlete self-realization as a multi-level phenomenon with interconnected components. A total of 180 athletes participated, including 60 professionals (average age 23.9), 60 amateurs (average age 31.1), and 60 Paralympians (average age 24.4). The methodological toolkit comprises four diagnostic techniques: E.A. Kalinin’s “Motives of Sports Activities” (MSA) questionnaire, S. Maddi’s resilience test adapted by D.A. Leontiev and E.I. Rasskazova, and S.I. Kudinov’s multidimensional questionnaire on self-realization.

Results

Significant differences in motivational determinants and self-realization attitudes emerge across athlete groups based on their sports qualifications. Noteworthy aspects include declining in motivation among professional athletes of masters of sports and masters of sports of international class, and rigidity in life resilience among Paralympic athletes. Overall, self-realization levels are not high, with extremely low levels of professional self-realization in all three athlete categories.

Conclusions

The study’s scientific novelty lies in systematically organizing knowledge on fundamental motivational determinants impacting athlete self-realization according to professional qualifications. This research addresses the acute shortage of psychological studies in sports psychology for Kazakhstan, which is still in its early stages. The findings underscore the need for targeted interventions by coaches and sports psychologists to enhance motivation levels, especially among elite athletes, and foster resilience, particularly in Paralympic athletes, ultimately advancing the field in the country.
Quantifying the increased risk of illness in malnourished children: a global meta-analysis and propensity score matching approach
Authors: Ijaiya Mukhtar A. , Anjorin Seun , Uthman Olalekan A.
Published: July 2024

Background

Childhood morbidity and mortality continue to be major public health challenges. Malnutrition increases the risk of morbidity and mortality from illnesses such as acute respiratory infections, diarrhoea, fever, and perinatal conditions in children. This study explored and estimated the magnitude of the associations between childhood malnutrition forms and child morbidity.

Methods

We performed an individual participant data (IPD) meta-analysis and employed propensity score matching to examine crude (unadjusted) and adjusted associations. Our analysis utilized demographic and health datasets from surveys conducted between 2015 and 2020 in 27 low- and middle-income countries. Our objective was to quantify the risk of morbidity in malnourished children and estimate the population-attributable fraction (PAF) using a natural experimental design with a propensity score-matched cohort.

Results

The IPD meta-analysis of child morbidity across three childhood malnutrition forms presented nuanced results. Children with double-burden malnutrition had a 5% greater risk of morbidity, which was not statistically significant. In contrast, wasted children had a 28% greater risk of morbidity. Overweight children exhibited a 29% lower risk of morbidity. Using the matched sample, children with double-burden malnutrition and overweight children had lower morbidity risks (1.7%, RR: 0.983 (95% CI, 0.95 to 1.02) and 20%, RR: 0.80 (95% CI, 0.76 to 0.85), respectively), while wasting was associated with a 1.1 times (RR: 1.094 (95% CI, 1.05 to 1.14)) greater risk of morbidity. Eliminating double-burden malnutrition and wasting in the four and seven countries with significant positive risk differences could reduce the child morbidity burden by an estimated average of 2.8% and 3.7%, respectively.

Conclusions

Our study revealed a correlation between specific childhood malnutrition subtypes—double-burden malnutrition and wasting—and increased risks of morbidity. Conversely, overweight children exhibited a lower risk of immediate morbidity, yet they may face potential long-term health challenges, indicating the necessity for nuanced approaches to childhood nutrition.
Cut-off points to classify numeric values of quality of life into normal, mild, moderate, and severe categories: an update for EORTC-QLQ-H&N35
Authors: Saini Jyoti , Bakshi Jaimanti , Panda Naresh K. , Sharma Maryada , Vir Dharam , Goyal Atul Kumar
Published: July 2024

Background

Quality of life (QoL) is an important determinant of physical and mental health. QoL in head and neck cancer tends to deteriorate due to changes in the physical, functional, psychological aspects. EORTC-QLQ-H&N35 is an instrument that measure the QoL specifically in head and neck cancer patients. EORTC-QLQ-H&N35 give a numeric value to QoL of patients with high value correspond to better QoL.

Objective

The aim of present study was to find out the cut-off points of numeric values of EORTC-QLQ-H&N35 to categorize QoL impairment into different categories (normal, mild, moderate, and severe). Present study also aims analyze the QoL among head and neck cancer patients under these new categories.

Methodology

Total 205 patients of head and neck cancer visiting to the outpatient unit were enrolled in this study. Hindi version of EORTC-QLQ-H&N35 was used to evaluate the QoL. Total 9 classification schemes were created with different cut-off points to classify the global QoL score into normal, mild, moderate and severe categories. QoL data was then analyze using the scheme having highest F value in ANOVA test.

Results

Classification scheme having cut-off values 76–100 for normal QoL, 51–75 for mild QoL impairment, 26–50 for moderate and 0–25 for severe QoL impairment found to have highest F value (729.915) in ANOVA test. The mean QoL score among total 205 patients were 60.08 ± 19.06. Based on the new classification scheme, QoL was normal in 46 (22.4%) patients whereas QoL was impaired to mild level in 76 (37.1%) patients, to moderate level in 76 (37.1%) and to severe level in 7 (3.4%) patients. Role functioning, emotional functioning and social functioning was impaired to severe level in 4 (2.0%), 13 (6.3%) and 3 (1.5%) patients respectively.

Conclusion

EORTC-QLQ-H&N35 offer a comprehensive review of QoL in head and neck cancer patients. By designating the QoL score into different categories, it will become easier for clinician to have a better idea of QoL of head and neck cancer patients.
The impact of receiver arrays on suppressing seismic speckle scattering noise caused by the meter-scale near-surface heterogeneity
Authors: Bakulin Andrey , Neklyudov Dmitry , Silvestrov Ilya
Published: July 2024

Managing seismic scattering noise in geophysical surveying, especially from near-surface heterogeneity, presents significant challenges. We revisit the role of receiver arrays in mitigating such noise in regions with near-surface meter-scale heterogeneity. Moving beyond traditional approaches that focus on suppressing coherent noise from near-surface arrivals and random ambient noise, our research highlights the substantial impact of speckle scattering noise. This noise, resulting from near-ballistic scattering on small-scale heterogeneities, introduces considerable trace-to-trace variability in phase and amplitude, complicating data processing. By integrating a novel model of random multiplicative noise with sophisticated statistical techniques, we determine the efficacy of array stacking in significantly reducing this type of noise and decreasing the dispersion of phase and amplitudes. Our analytical and numerical analyses reveal a notable trend: the reduction in phase and amplitude spread amplifies with the array size. A key finding of our study is the identification of a [Formula: see text] law for phase spread reduction, analogous yet distinct from the well-known [Formula: see text] law observed in amplitude attenuation of additive ambient noise. In our context, this law implies that the standard deviation of residual phase disturbances diminishes in proportion to [Formula: see text], where N denotes the array size. This insight holds particular significance for smaller arrays, such as those with nine receivers commonly used in desert environments.
Evaluation of CD3 and CD8 T-Cell Immunohistochemistry for Prognostication and Prediction of Benefit From Adjuvant Chemotherapy in Early-Stage Colorectal Cancer Within the QUASAR Trial
Authors: Williams Christopher J.M. , Gray Richard , Hills Robert K. , Shires Michael , Zhang Liping , Zhao Zuo , Gardner Tracie , Sapanara Nancy , Xu Xiao-Meng , Bai Isaac , Yan Dongyao , Muranyi Andrea , Dance Sarah , Aghaei Faranak , Hemmings Gemma , Hale Michael , Kurkure Uday , Guetter Christoph , Richman Susan D. , Hutchins Gordon , Seligmann Jenny F. , West Nicholas P. , Singh Shalini , Shanmugam Kandavel , Quirke Philip
Published: July 2024

PURPOSE

High densities of tumor infiltrating CD3 and CD8 T-cells are associated with superior prognosis in colorectal cancer (CRC). Their value as predictors of benefit from adjuvant chemotherapy is uncertain.

PATIENTS AND METHODS

Tumor tissue from 868 patients in the QUASAR trial (adjuvant fluorouracil/folinic acid
v
observation in stage II/III CRC) was analyzed by CD3 and CD8 immunohistochemistry. Pathologists, assisted by artificial intelligence, calculated CD3 and CD8 cell densities (cells/mm
2
) in the core tumor (CT) and invasive margin (IM). Participants were randomly partitioned into training and validation sets. The primary outcome was recurrence-free interval (RFI), 2-year RFI for assessment of biomarker-treatment interactions. Maximum-likelihood methods identified optimal high-risk/low-risk group cutpoints in the training set. Prognostic analyses were repeated in the validation set.

RESULTS

In the training set, the recurrence rate in the high-risk group was twice that in the low-risk group for all measures (CD3-CT: rate ratio [RR], 2.00,
P
= .0008; CD3-IM: 2.38,
P
< .00001; CD8-CT: 2.17,
P
= .0001; CD8-IM: 2.13,
P
= .0001). This was closely replicated in the validation set (RR, 1.96, 1.79, 1.72, 1.72, respectively). In multivariate analyses, prognostic effects were similar in colon and rectal cancers, and in stage II and III disease. Proportional reductions in recurrence with adjuvant chemotherapy were of similar magnitude in the high- and low-recurrence risk groups. Combining information from CD3-IM and CD3-CT (CD3 Score) generated high-, intermediate-, and low-risk groups with numbers needed to treat (NNTs) to prevent one disease recurrence being 11, 21, and 36, respectively.

CONCLUSION

Recurrence rates in the high-risk CD3/CD8 groups are twice those in the low-risk groups. Proportional reductions with chemotherapy are similar, allowing NNTs derived in QUASAR to be updated using contemporary, nonrandomized data sets.
Development and In vivo Evaluation of Atomoxetine Hydrochloride ODMTs in a Nicotine-induced Attention Deficit Hyperactivity Disorder (ADHD) Model in Rats
Authors: Atalay Özbeyen , Ozyilmaz Emine Dilek , Önal Deniz , Pehli̇vanoğlu Bilge , Çomoğlu Tansel
Published: July 2024

The current study aimed to evaluate the efficacy of orally administered rapid mini-tablets containing atomoxetine hydrochloride (ODMT) relative to the conventional capsule formulation of atomoxetine hydrochloride (ATO). To mask the bitter taste of ATO and render it more palatable for pediatric administration in individuals with Attention Deficit Hyperactivity Disorder (ADHD), an inclusion complex of ATO with β-cyclodextrin (β-CD) was synthesized. The ODMT and conventional capsule ATO formulations were administered orally to a cohort of ADHD rat pups born to nicotine-exposed dams, facilitating an in vivo efficacy assessment. Behavioral assays, including the open field test, novel object recognition test, and Barnes maze test, were conducted pre- and post-administration of the therapeutics. The outcomes suggested that the ODMT formulation, incorporating ATO-β-CD inclusion complexes, shows promise as a viable alternative to the capsule form of ATO. Conclusively, the preparation of the ATO-β-CD complexes and ODMTs leveraged a factorial experimental design, with the animal model being subjected to nicotine-induced hyperactivity to provide a unique evaluative framework for the ODMT formulation under development.

Graphical Abstract