bluuebunny/crossref_metadata_2025 huggingface dataset:
How are declarations of interest working? A cross-sectional study in declarations of interest in healthcare practice in Scotland and England in 2020/2021
Authors: McCartney Margaret , Bergeron Hartman Raphaella , Feldman Harriet , MacDonald Ronald , Sullivan Frank , Heneghan C , McCutcheon Calum
Published: November 2022

Objective

To understand arrangements for healthcare organisations’ declarations of staff interest in Scotland and England in the context of current recommendations.

Design

Cross-sectional study of a random selection of National Health Service (NHS) hospital registers of interest by two independent observers in England, all NHS Boards in Scotland and a random selection of Clinical Commissioning Groups (CCGs) in England.

Setting

NHS Trusts in England (NHSE), NHS Boards in Scotland, CCGs in England, and private healthcare organisations.

Participants

Registers of declarations of interest published in a random sample of 67 of 217 NHS Trusts, a random sample of 15 CCGs of in England, registers held by all 14 NHS Scotland Boards and a purposeful selection of private hospitals/clinics in the UK.

Main outcome measures

Adherence to NHSE guidelines on declarations of interests, and comparison in Scotland.

Results

76% of registers published by Trusts did not routinely include all declaration of interest categories recommended by NHS England. In NHS Scotland only 14% of Boards published staff registers of interest. Of these employee registers (most obtained under Freedom of Information), 27% contained substantial retractions. In England, 96% of CCGs published a Gifts and Hospitality register, with 67% of CCG staff declaration templates and 53% of governor registers containing full standard NHS England declaration categories. Single organisations often held multiple registers lacking enough information to interpret them. Only 35% of NHS Trust registers were organised to enable searching. None of the private sector organisations studied published a comparable declarations of interest register.

Conclusion

Despite efforts, the current system of declarations frequently lacks ability to meaningfully obtain complete healthcare professionals’ declaration of interests.
Patient experiences of codesigned rehabilitation interventions in hospitals: a rapid review
Authors: McKercher Jonathan P , Slade Susan C , Jazayeri Jalal A , Hodge Anita , Knight Matthew , Green Janet , Woods Jeffrey , Thwaites Claire , Morris Meg E
Published: November 2022

Background

Codesign strengthens partnerships between healthcare workers and patients. It also facilitates collaborations supporting the development, design and delivery of healthcare services. Prior rehabilitation reviews have focused mainly on the clinical and organisational outcomes of codesign with less focus on the lived experience of rehabilitation patients.

Objective

To explore patient experiences of codesigned hospital rehabilitation interventions.

Design

Rapid review and evidence synthesis of the literature.

Data sources

CINAHL, MEDLINE, Embase and Cochrane were searched from 1 January 2000 to 25 April 2022.

Study selection

Studies reporting patient experiences of codesigned rehabilitation interventions in hospitals.

Results

4156 studies were screened, and 38 full-text studies were assessed for eligibility. Seven studies were included in the final rapid review. Five out of the seven studies involved neurological rehabilitation. All eligible studies used qualitative research methods. The main barriers to codesign were related to staffing and dedicated time allocated to face-to-face patient-therapist interactions. High-quality relationships between patients and their therapists were a facilitator of codesign. Thematic synthesis revealed that codesigned rehabilitation interventions can enable a meaningful experience for patients and facilitate tailoring of treatments to align with individual needs. Personalised rehabilitation increases patient involvement in rehabilitation planning, delivery and decision-making. It also promotes positive feelings of empowerment and hope.

Conclusion

This rapid review supports the implementation of codesigned rehabilitation interventions to improve patient experiences in hospitals.

PROSPERO registration number

CRD42021264547.
Improvement of pregnancy counselling and contraception counselling and documentation in a single rheumatology academic practice: a quality improvement project
Authors: Wolfgang Taylor , Anstett Sarah , Arabelovic Senada
Published: November 2022

The purpose of this quality improvement project was to improve the rate of pregnancy counselling and documentation regarding the risk of being on teratogenic medications, including leflunomide, mycophenolate, methotrexate or cyclophosphamide in women of childbearing age (17–50 years). Our goal was to increase documentation rates by 25% in 6 months. We first performed an EMR chart review of 103 women who were seen in the 6 months prior to intervention by faculty at a single rheumatology academic centre. We then determined how many of those women had documented contraception or pregnancy counselling, which included written documentation anywhere in the note or ICD codes which were specific to pregnancy counselling or contraception counselling. Interventions were then implemented. The percentage of women who had documented pregnancy counselling did not change preintervention and postintervention; preintervention 37% of women received documented pregnancy counselling and postintervention 35% of women received documented pregnancy counselling. The percentage of women who had documented contraception counselling did however change preintervention and postintervention; preintervention 37% of women received documented contraception counselling and postintervention 51% of women received documented contraception counselling, which is a 14% improvement.
Assessing the development status of intraoperative fluorescence imaging for anatomy visualisation, using the IDEAL framework
Authors: Ishizawa Takeaki , McCulloch Peter , Stassen Laurents , van den Bos Jacqueline , Regimbeau Jean-Marc , Dembinski Jeanne , Schneider-Koriath Sylke , Boni Luigi , Aoki Takeshi , Nishino Hiroto , Hasegawa Kiyoshi , Sekine Yasuo , Chen-Yoshikawa Toyofumi , Yeung Trevor , Berber Eren , Kahramangil Bora , Bouvet Michael , Diana Michele , Kokudo Norihiro , Dip Fernando , White Kevin , Rosenthal Raul J
Published: November 2022

Objectives

Intraoperative fluorescence imaging is currently used in a variety of surgical fields for four main purposes: visualising anatomy, assessing tissue perfusion, identifying/localising cancer and mapping lymphatic systems. To establish evidence-based guidance for research and practice, understanding the state of research on fluorescence imaging in different surgical fields is needed. We evaluated the evidence on fluorescence imaging used to visualise anatomical structures using the IDEAL framework, a framework designed to describe the stages of innovation in surgery and other interventional procedures.

Design

IDEAL staging based on a thorough literature review.

Setting

All publications on intraoperative fluorescence imaging for visualising anatomical structures reported in PubMed through 2020 were identified for five surgical procedures: cholangiography, hepatic segmentation, lung segmentation, ureterography and parathyroid identification.

Main outcome measures

The IDEAL stage of research evidence was determined for each of the five procedures using a previously described approach.

Results

225 articles (8427 cases) were selected for analysis. Current status of research evidence on fluorescence imaging was rated IDEAL stage 2a for ureterography and lung segmentation, IDEAL 2b for hepatic segmentation and IDEAL stage 3 for cholangiography and parathyroid identification. Enhanced tissue identification rates using fluorescence imaging relative to conventional white-light imaging have been documented for all five procedures by comparative studies including randomised controlled trials for cholangiography and parathyroid identification. Advantages of anatomy visualisation with fluorescence imaging for improving short-term and long-term postoperative outcomes also were demonstrated, especially for hepatobiliary surgery and (para)thyroidectomy. No adverse reactions associated with fluorescent agents were reported.

Conclusions

Intraoperative fluorescence imaging can be used safely to enhance the identification of anatomical structures, which may lead to improved postoperative outcomes. Overviewing current research knowledge using the IDEAL framework aids in designing further studies to develop fluorescence imaging techniques into an essential intraoperative navigation tool in each surgical field.
Cost comparison of oral, transnasal and magnet assisted capsule endoscopy in the examination of the upper gastrointestinal tract in patients with dyspepsia
Authors: Tai Foong Way David , Healy Ailish , Thokala Praveen , Chetcuti Zammit Stefania , Sidhu Reena , McAlindon Mark
Published: November 2022

Introduction

Conventional oral upper gastrointestinal (GI) endoscopy can obe uncomfortable. By comparison, transnasal endoscopy (TNE) and magnet assisted capsule endoscopy (MACE) have superior tolerability. A cost comparison of competing upper GI endoscopic modalities have yet to be performed.

Methods

We performed a cost comparison study of oral, TNE and MACE by a combination of activity-based costing and averaging of fixed costs over 24 481 upper GI endoscopies performed for dyspepsia over a 10-year period.

Results

On average, 9.4 procedures were performed daily. TNE was cheapest at €125.90 per procedure, costing 30% less than oral endoscopy at €184.10 and threefold cheaper than MACE at €407.10. Flexible endoscope reprocessing cost €53.80. TNE was cheaper than oral endoscopy as sedation was not required. Oral endoscopies have a further rate of infectious complications, estimated to cost €16.20 per oral procedure in inpatient admissions. Oral and TNE equipment are more expensive to purchase and maintain than MACE costing €79 330 and €81 819, respectively compared with MACE at €15 420 per annum. However, capsule endoscopes cost significantly more per procedure at €369.00 than the consumables for flexible endoscopy (per oral €12.30, TNE €5.30).

Conclusions

TNE cost less to perform than conventional per oral endoscopy. The cost of capsule endoscopes will need to be reduced significantly if routine use is to be expected.
On the impact of nonlocal gravity on compact stars
Authors: Panotopoulos Grigoris , Rubio Javier , Lopes Ilídio
Published: November 2022

We study the impact of nonlocal modifications of General Relativity on stellar structure. In particular, assuming an analytic distortion function and specific equations of state, we made use of remnant stars to put qualitative constraints on a parameter not directly restricted by solar system tests. Using current data sets available for white dwarfs and strange quark stars candidates, we find that the most stringent bounds come from the objects displaying the highest core densities, namely strange quark stars. Specifically, the constraints obtained from this class of stars are three to four orders of magnitude tighter than those obtained using white dwarfs.
Blockchain Technology and Sustainable Supply Chain Practices: Leading Towards Organizational Performance
Authors: Zhang Yu , Shah Adeel , Rehman Syed Abdul , Nazir Sajid , Tanveer Muhammad
Published: November 2022

Today’s world is changed; the only constant thing is digital technologies galloping and enveloping all walks of life; blockchain is the most pertinent of the available technologies. Due to the high demand for the technology, this research tests blockchain technology (BTT) and its influence on organizational performance (ORP) while incorporating recycling and remanufacturing (RRM), green design (GDN), and green purchasing (GPP) as mediators to ascertain the relation between the two constructs. The data for the research is collected from the Malaysian manufacturing sector. The data was collected from four hundred enterprises, and regression analysis was used for statistical inference through Smart PLS. Significant results are found between BTT and RRM, BTT and GDN, BTT and GPP, RRM and ORP, and GDN and ORP. The study’s result also confirms that no significant value was found between GPP and ORP.
Application of the Moser–Trudinger inequality in the construction of global solutions to a strongly degenerate migration model
Authors: Winkler Michael
Published: November 2022

A no-flux initial-boundary value problem for the cross-diffusion system [Formula: see text] is considered in smoothly bounded domains [Formula: see text] with [Formula: see text]. It is shown that whenever [Formula: see text] is positive on [Formula: see text] and such that [Formula: see text] for some [Formula: see text], for all suitably regular positive initial data a global very weak solution, particularly preserving mass in its first component, can be constructed. This extends previous results which either concentrate on non-degenerate analogs, or are restricted to the special case [Formula: see text].

To appropriately cope with the considerably stronger cross-degeneracies thus allowed through [Formula: see text] when [Formula: see text] is large, in its core part the analysis relies on the use of the Moser–Trudinger inequality in controlling the respective diffusion rates [Formula: see text] from below.
A Finite Element Solution to Normal Contact Forces of Viscoelastic Particles
Authors: Ding Suhang , Jian Bin , Zhang Yuhang , Hu Yiqun , Xia Re , Hu Guoming
Published: November 2022

In this paper, an approach to solve the normal contact forces of viscoelastic particles with the finite element method is presented. A viscoelastic constitutive model is deduced and established for the finite element solution, where the stress tensors of the Zener-type model expressed as partial differential equations are obtained by applying the generalized Hooke’s law, and the incremental equations are further deduced with the backward difference method. An iterative matrix of the viscoelastic constitutive model that depends on the current strain, current stress and strain increment is derived; a user material subroutine is programed based on the iterative matrix to implement the viscoelastic constitutive model in the displacement-based finite element modeling. The validity of the finite element solution to the normal contact forces of elastic particles is validated with the Hertz contact force model, and that of the solution to the normal contact forces of viscoelastic particles is verified by the experimental data. The results obtained by the proposed solution agree well with those predicted by the Prony series, and the computational efficiency of this solution is higher for different values of the shear viscosity.
A Hardware and Software Platform for Aerial Object Localization
Authors: Szenher Matthew , Delacroix Alex , Keto Eric , Little Sarah , Randall Mitch , Watters Wesley Andres , Masson Eric , Cloete Richard
Published: November 2022

To date, there are little reliable data on the position, velocity and acceleration characteristics of Unidentified Aerial Phenomena (UAP). The dual hardware and software system described in this document provides a means to address this gap. We describe a weatherized multi-camera system which can capture images in the visible, infrared and near infrared wavelengths. We then describe the software we will use to calibrate the cameras and to robustly localize objects-of-interest in three dimensions. We show how object localizations captured over time will be used to compute the velocity and acceleration of airborne objects.
Geophysical assessment for deep structuring mapping and water resources perspectivity in semi-arid land region (northeastern Tunisia, Mediterranean Basin)
Authors: Kortas Oussama , Gabtni Hakim
Published: November 2022

In Mediterranean semi-arid regions, shallow aquifers are generally over-exploited. However, several deeper groundwater boreholes exhibit serious problems of low hydraulic yield and dry wells. The existence of reliable information about the regional geological structure can enhance the success of deep well programmes.

Geophysics has proved very useful as a fast and efficient tool to understand the structuring of deep hydrogeology aquifers. Indeed, the identification and characterization of the deep structures of the Bir Drassen–Sidi Toumi region (Cap-Bon, northeastern Tunisia) contribute to a better quantification of the groundwater potential, allowing more sustainable management. This province can be considered as the SW extension of the NE–SW Jebel Abderrahman Atlasic anticline, one of the most prominent geological structures in northeastern Tunisia. To identify the Miocene and Oligocene reservoirs, a geophysical study was carried out using advanced gravity analysis, supported by boreholes, and seismic and geoelectrical calibration.

Different gravity filters were applied to reveal the sub-basin architecture and faulting network in the region. By calculating the maxima of the total horizontal gravity derivative and the distribution solutions for Euler's equations, a set of deep faults of different directions was divulged. Time-domain electromagnetic mapping illustrated the influence of these fault zones on the regional arrangement of sub-basin aquifers and their recharge processes.

Finally, a 3D residual gravity inversion was carried out to better image the tectonically controlled depocentres associated with prolific thick fluvial–deltaic reservoirs. These ‘deep aquifer valley’ can be suggested as strategic targets for deep hydrogeological exploration planning.
Reflections on Theory
Authors: Malmi Lauri
Published: November 2022

In this paper, I reflect on how my personal conceptions on “theory” have developed and become more diverse and elaborated during my career. I discuss early conceptions I learned in school and during my university studies, followed by the growing awareness of computing education research as a field that is distinct from many areas of computer science. Becoming aware of how research is carried out in social sciences and how theories are used in these contexts raised my interest in understanding what this implies for computing education research as a field, which has been building its own identity during the past 20+ years.
Upregulated Solute Carrier SLC39A1 Promotes Gastric Cancer Proliferation and Indicates Unfavorable Prognosis
Authors: Yu Dan , Chen Yong , Luo Ming , Peng Yanjin , Yi Shengen
Published: November 2022

Backgrounds. Solute carrier 39A1 (SLC39A1) is an indirect zinc transporter which showed diverse tumor-related functions in different malignancies. Here, we aimed to investigate its expression and role in gastric adenocarcinoma. Methods. A retrospective gastric adenocarcinoma cohort (n = 154) was collected from our hospital to test their tissue expression of SLC39A1 through immunohistochemical staining method. After SLC39A1 overexpression or knockdown, proliferation and invasion assays were conducted for proliferation and invasion estimation, respectively. Xenograft in nude mice was used as the in vivo strategy to validate in vitro findings. Results. Compared with adjacent stomach tissues, gastric adenocarcinoma tissues showed significantly higher SLC39A1 on both mRNA and protein levels. Higher SLC39A1 was observed in patients with larger tumor size (

P
=
0.003

) and advanced tumor stages (

P
<
0.001

). Univariate (

P
=
0.001

) and multivariate analyses (

P
=
0.035

) confirmed the independent prognostic significance of SLC39A1 on gastric adenocarcinoma outcomes. The median survival time was 22.0 months in patients with high-SLC39A1 expression, while up to 57.0 months in those with low-SLC39A1 (

P
=
0.001

). In vitro and in vivo assays demonstrated that overexpressing SLC39A1 could promote gastric cancer growth and invasion, while silencing SLC39A1 led to opposite effects. Conclusions. Aberrant high-SLC39A1 expression can serve as an independent unfavorable prognostic factor for gastric adenocarcinoma. High SLC39A1 is critical for a more aggressive tumor phenotype by promoting cell proliferation and invasion. Therefore, targeting SLC39A1 may provide novel therapeutic insights.
Baicalein Alleviates Testicular Ischemia-Reperfusion Injury in a Rat Model of Testicular Torsion-Detorsion
Authors: Wei Si-Ming , Huang Yu-Min
Published: November 2022

Testicular torsion/detorsion-induced ischemia/reperfusion injury is partly due to the overgeneration of reactive oxygen species. Baicalein, a main bioactive constituent derived from the dried root of Scutellaria baicalensis Georgi, possesses powerful antioxidative and anti-inflammatory properties. Therefore, we designed the research to explore the possible protective effect of baicalein against testicular ischemia-reperfusion injury. Sprague-Dawley rats were randomized into 4 groups, including control, testicular ischemia-reperfusion, testicular ischemia-reperfusion+vehicle injection, and testicular ischemia-reperfusion+baicalein therapy groups. The control group received surgical exposure of the left testis without torsion-detorsion. In the testicular ischemia-reperfusion group, the left testis underwent 720° counterclockwise torsion for two hours and then was allowed detorsion. Rats in the testicular ischemia-reperfusion+vehicle injection group received intraperitoneal injection of the vehicle at detorsion. In the baicalein-treated group, the intraperitoneal administration of baicalein dissolved in the vehicle was performed at detorsion. At four hours or three months following testicular detorsion, testicular tissues were removed to detect the levels of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) which can recruit neutrophils into the testis, myeloperoxidase activity (an index of neutrophil infiltration in the testis), protein expression of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in neutrophils which can catalyze reactive oxygen species production, malondialdehyde concentration (a common marker of reactive oxygen species), and spermatogenesis. Both testicular ischemia-reperfusion and testicular ischemia-reperfusion+vehicle injection significantly increased the TNF-α and IL-1β levels, myeloperoxidase activity, NADPH oxidase protein expression, and malondialdehyde concentration, while decreased spermatogenesis in ipsilateral testes. In contrast, baicalein administration remarkably reduced TNF-α and IL-1β levels, myeloperoxidase activity, NADPH oxidase protein expression, and malondialdehyde concentration and also elevated spermatogenesis in ipsilateral testes. The results of our experiment demonstrate that baicalein alleviates testicular ischemia-reperfusion injury by inhibiting TNF-α and IL-1β secretion, neutrophil infiltration in the testis, and NADPH oxidase protein expression in neutrophils to reduce reactive oxygen species production.
Genetic Variability Analysis and Association of Traits in Common Bean (Phaseolus vulgaris L.) Landraces Collected from Ethiopia at Jimma
Authors: Mesera Eyuel , Shifaraw Garome , Alamerew Sentayehu , Amsalu Birhanu
Published: November 2022

This study was conducted on one hundred common bean landraces at the Jimma Agricultural Research Center, Melko, with the objective of assessing genetic variability and association of traits in common bean landraces collected from different parts of Ethiopia. The experiment was laid out in a simple lattice design with two replications. Analysis of variance showed significant differences among genotypes for all traits. This highly significant difference indicates the existence of large variability among genotypes. High phenotypic coefficients of variation and genotypic coefficients of variation were obtained for plant height (19.43, 11.73), pod length (11.27, 10.69), and 100-seed weight (15.42, 12.74). High heritability in the broad sense was found for days to 50% flowering (66.98), days to 90% maturity (87.43), pod length (90.03), pod width (78.23), harvest index (98.67), and 100-seed weight (68.31). High genetic advance as a percentage of mean with high heritability was obtained for pod length, pod width, harvest index, and hundred seed weight. Grain yield had a positive and significant association with pod length (rp = 0.153

∗

, rg = 0.282

∗
∗

) and 100-seed weight (rp = 0.294

∗
∗

, rg = 0.492

∗
∗

). Hundred seed weight exerted the highest positive direct effect (0.294) on grain yield at genotypic level. The D2 classified landraces into 7 clusters and one solitary, which makes them moderately divergent. The highest inter-cluster distance was observed between clusters VII and IV. The first five principal components with eigenvalues greater than one altogether explained about 79.56% of the total variation. In conclusion, the top high-yielding landraces, namely, P#1247, P#1092, P#1077, P#861, P#990, P#763, P#58, and P#857, should be included in the next breeding program. 100-seed weight had the highest direct effect and a positive significant association with grain yield. Thus, it should be considered as the selection criteria for further common bean yield improvement. However, the current result is merely indicative and cannot be used to draw definite conclusions. Therefore, the experiment should be replicated in different locations and seasons for greater consistency.
Prognostic Significance of Percutaneous Coronary Intervention for First Acute Myocardial Infarction with Heart Failure: Five-Year Follow-Up Results
Authors: Cheng Zichao , Shi Yuchen , Peng Hongyu , Zhao Donghui , Fan Qian , Liu Jinghua
Published: November 2022

Objective. The study aimed to investigate the incidence and influencing factors of heart failure after 5 years of percutaneous coronary intervention (PCI) for first acute myocardial infarction. Methods. A total of 1235 patients, diagnosed as acute myocardial infarction and treated with PCI in Beijing Anzhen Hospital, Capital Medical University, from January 1, 2014, to December 31, 2014, were enrolled. Based on the exclusion criteria, 671 patients were followed up to obtain echocardiographic results 5 years after the onset of myocardial infarction (from January 1, 2019, to December 31, 2019). Of 671 patients, 62 were lost to follow-up. Finally, 609 patients were recruited in this study. According to the results of the echocardiographic examination, patients were divided into a heart failure group (n = 97) (LVEF < 50%) and a nonheart failure group (n = 512) (LVEF ≥ 50%). The clinical characteristics were compared between the two groups, and the influencing factors of heart failure after 5 years of PCI in patients with acute myocardial infarction were analyzed using logistic regression and receiver-operating characteristic (ROC) analyses. Results. Of 609 patients, 97 had heart failure within 5 years after PCI for first myocardial infarction, with an incidence of 15.9%. Multivariate regression analysis finally examined the predictors related to the occurrence of heart failure, including age (aOR, 1.008; 95% confidence interval (CI), 1.054–1.123; P ≤ 0.001), peak troponin I level (aOR, 1.020; 95% CI, 1.006–1.034; P = 0.004), left ventricular ejection fraction (LVEF) (during admission) (aOR, 0.908; 95% CI, 0.862–0.956; P ≤ 0.001), and left ventricular end-diastolic dimension (LVEDD) (at admission) (aOR, 1.136; 95% CI, 1.016–1.271; P = 0.025). Conclusion. In this study, the incidence of heart failure (LVEF < 50%) in patients with acute myocardial infarction who underwent PCI was 15.9% at a five-year follow up. Age, peak troponin I level, and LVEDD (at admission) were risk factors for heart failure, while LVEF (at admission) of patients during hospitalization was a protective factor for heart failure.
A Novel RANKL-Targeted Furoquinoline Alkaloid Ameliorates Bone Loss in Ovariectomized Osteoporosis through Inhibiting the NF-κB Signal Pathway and Reducing Reactive Oxygen Species
Authors: Wong Puiian , Lv Zheng , Li Jinglan , Wei Qiushi , Xu LiangLiang , Fang Bin , Luo Yiwen , He Mincong
Published: November 2022

Dysregulation of osteoclast-osteoblast balance, resulting in abnormal bone remodeling, is responsible for postmenopausal osteoporosis (PMOP) or other secondary forms of osteoporosis. We demonstrated that dictamnine (DIC), a novel RANKL-targeted furoquinoline alkaloid, inhibits osteoclastogenesis by facilitating the activities of reactive oxygen species (ROS), NF-κB, and NFATc1 in vitro and prevents the development of OVX-induced osteoporosis mouse models in vivo. Methods. The docking mechanism of DIC and RANKL was initially identified by protein–ligand molecular docking. RNA sequencing was performed and analyzed to reveal the potential mechanism and signaling pathway of the antiosteoporosis effects of DIC. To verify the sequencing results, we examined the impact of DIC on RANKL-induced osteoclast differentiation, bone resorption, F-actin ring production, ROS generation, and NF-κB activation in osteoclasts in vitro. Moreover, a luciferase assay was performed to determine the binding and transcriptional activity of Nrf2 and NF-κB. The in vivo efficacy of DIC was assessed with an ovariectomy- (OVX-) induced osteoporosis model, which was analyzed using micro-CT and bone histomorphometry. Results. The molecular docking results indicated that DIC could bind particularly to RANKL. RNA-seq confirmed that DIC could regulate the osteoclast-related pathway. DIC suppressed osteoclastogenesis, bone resorption, F-actin belt formation, osteoclast-specific gene expression, and ROS activity by preventing NFATc1 expression and affecting NF-κB signaling pathways in vitro. The luciferase assay showed that DIC not only suppressed the activity of Nrf2 but also contributed to the combination of Nrf2 and NF-κB. Our in vivo study indicated that DIC protects against OVX-induced osteoporosis and preserves bone volume by inhibiting osteoclast activity and function. Conclusions. DIC can ameliorate osteoclast formation and OVX-induced osteoporosis and therefore is a potential therapeutic treatment for osteoporosis.
Effect of Educational Intervention Based on Theory of Planned Behaviour on Physical Activity Intention among Secondary School Teachers of Nepal
Authors: Shrestha Rajan , Pahari Durga Prasad , Adhikari Santoshi , Khatri Bijay , Majhi Sangita , Vaidya Abhinav
Published: November 2022

Any bodily movement produced by skeletal muscle which requires energy expenditure is known as physical activity (PA). WHO has recommended that at least 150 minutes of moderate or 75 minutes of vigorous‐intensity PA or a combination of both per week is required for health benefits. Physical inactivity is one of the strongest risk factors for noncommunicable diseases (NCDs) and other conditions and is attributable to 6% of global premature death. However, data on the PA of teachers are unavailable in Nepal. They are considered one of the risk groups for NCDs because of the less active nature of their job. So, we aimed to evaluate the effect of the educational intervention based on the theory of planned behaviour on PA intention among secondary school teachers in Bhaktapur district, Nepal. For this study, we recruited 126 teachers from 6 schools. Each intervention and control group contained three randomly selected secondary schools. All the teachers from the selected schools were enrolled in the respective groups. A quasiexperimental (pretest‐posttest control group) study design was used to test the effectiveness of the intervention on attitude, behaviour control, subjective norms, and intention for engaging in regular PA. Both groups underwent baseline and follow‐up assessments at four weeks using the self‐administered questionnaire developed for this study. The intervention group delivered a one‐hour lecture session supported by audio‐video materials for PA promotion. The effect was analysed by comparing the changes in the theory of planned behaviour (TPB) constructs within and between intervention and control groups. The difference in scores between and within the groups was tested using Student’s t‐test. Adjusted difference‐in‐difference scores were calculated through linear regression. Data analysis was done using Statistical Package for Social Science version 26.0. The adjusted mean score increase in TPB constructs due to the interaction of time and intervention increased from 0.641 to 1.381. The highest gain (beta = 1.381) was seen in the intention score, while a minor improvement was seen in perceived behavioural control (beta = 0.641). After the intervention, the net increase in PA intention score was 9.35% compared to the control group. Thus, the promotion package was effective in increasing PA intention. The findings of this study and educational package could be helpful in encouraging teachers to engage in PA in other schools.
Research on Simulation System for Human-SRL Collaborative Motion Planning
Authors: Zhang Xiaobo , Liu Jinguo , Li Yangmin
Published: November 2022

At present, there is a problem of visual area switching in the existing SRL (supernumerary robotic limb) operation methods. In response to this problem, the authors’ previous work proposed a new SRL operation method called relatively independent operation, and proposed a corresponding software architecture. The purpose of this paper is to solve the theoretical problems and engineering realization problems of the human-SRL skeleton algorithm module in the software architecture. Therefore, modeling, data collection, data processing, and visualization of a human-SRL system are studied in this paper. Firstly, a human-SRL skeleton visualization simulation system is developed. The condition setting, the applications, and the core algorithm of the simulation system are introduced. The core algorithm mainly contains four types of important functions, namely skeleton model building functions, human-SRL data collection functions, human-SRL data processing functions, and skeleton visualization functions. Secondly, the implementation principles of these four functions are described: (1) For the skeleton model building functions, a human-SRL skeleton model is proposed which is an integration of a human skeleton model and an SRL skeleton model. The construction methods of these three skeleton models are described. (2) For the remaining functions, how to collect and process human data, SRL data, human-SRL data, and how to visualize a human-SRL skeleton are described. Finally, the visualization effect of the developed simulation system on human-SRL skeleton movement is verified by experiments, which proves the correctness of the functions in the simulation system.
Effect of Dietary Administration of Green Macroalgae (Ulva intestinalis) on Mucosal and Systemic Immune Parameters, Antioxidant Defence, and Related Gene Expression in Zebrafish (Danio rerio)
Authors: Rouhani Elaheh , Safari Roghieh , Imanpour Mohammad Reza , Hoseinifar Seyed Hossein , Yazici Metin , El-Haroun Ehab
Published: November 2022

This study investigated the effects of adding green macroalgae gutweed (Ulva intestinalis) powder to zebrafish (Danio rerio) feed at different levels on innate immune responses, antioxidant defence, and gene expression. A total of 600 zebrafish (

0.3
±
0.08

 g) were randomly allocated to 12 aquariums in four treatments with three replicates (50 fish per aquarium). Zebrafish were fed with different levels of U. intestinalis powder 0, 0.25, 0.5, and 1% for eight weeks. Whole-body extract (WBE) immune parameters including total protein level, globulin level, and lysozyme activity were evaluated and revealed statistically significant increased in all U. intestinalis supplemented groups compared to the control (

P
<
0.05

). However, mucus immune parameters (total protein, globulin, and lysozyme) were statistically different in only 1% gutweed supplemented groups from other groups. While glutathione peroxidase (GPx) and superoxide dismutase (SOD) increased with the addition of gutweed (

P
<
0.05

), catalase (CAT) did not change (

P
>
0.05

). The study results showed that dietary gutweed remarkably upregulated immune-related genes such as lysozyme (Lyz) and Interleukin 1 beta (IL-1β). Antioxidant-related genes (SOD and CAT) and growth-related genes, including growth hormone (GH) and insulin-like growth factor-I (IGF-1), were remarkably upregulated with gutweed treatment (

P
<
0.05

). In conclusion, dietary U. intestinalis showed beneficial effects on immunity, and same effects were observed in case of antioxidant and growth related genes expression in zebrafish.
The Efficacy and Safety of Fostamatinib in Elderly Patients with Immune Thrombocytopenia: A Single-Center, Real-World Case Series
Authors: Liu Jessica , Hsia Cyrus C.
Published: November 2022

Fostamatinib is a small molecule spleen tyrosine kinase (Syk) inhibitor that was approved for the treatment of adult patients with immune thrombocytopenia (ITP) in second-line therapy. Syk inhibition prevents cytoskeletal rearrangements during phagocytosis, allowing platelet survival in ITP. However, fostamatinib treatment in elderly patients with ITP has not been well established. We performed a retrospective review of all elderly patients (age greater than or equal to 65 years) who had started on fostamatinib for the treatment of ITP at a single tertiary care centre to evaluate its efficacy and safety. Seven patients, median age 80 years (range 78–94), four women and three men, all of Caucasian background, with various comorbidities, started fostamatinib 100 mg orally twice daily as second or subsequent line therapy. Patients had a diagnosis of ITP for a median of 6 years (range approximately 6 months–30 years), had six comorbidities (range 2–14), and experienced 2 unique prior lines of ITP therapy (range 1 to 6). Over 1290 days of fostamatinib exposure, two patients required dose escalation to 150 mg orally twice daily, while five patients remained on the initial starting dose of 100 mg twice daily. The median platelet count at the time of initiating fostamatinib was 25 × 109/L (range less than 10–193). The median time to response (defined as any first platelet count greater than or equal to 30 × 109/L) was 19 days (range 0–181 days), with two patients responding rapidly (5 days and 19 days). Two patients required dose escalation and rescue therapy, and these same two patients discontinued fostamatinib after 175 days and 216 days of treatment. Treatment was tolerated in all patients with no thromboembolic events observed. One death was noted and unrelated to treatment. Overall, fostamatinib was effective and safe for the majority of these very elderly patients with ITP.
Patterns and Predictors of Timely Presentation and Outcomes of Polytrauma Patients Referred to the Emergency Department of a Tertiary Hospital in Tanzania
Authors: Premji Elishah N. , Kilindimo Said S. , Sawe Hendry R. , Yussuf Amne O. , Simbila Alphonce N. , Manji Hussein K. , Mfinanga Juma A. , Weber Ellen J.
Published: November 2022

Background. Polytrauma patients require special facilities to care for their injuries. In HICs, these patients are rapidly transferred from the scene or the first-health facility directly to a trauma center. However, in many LMICs, prehospital systems do not exist and there are long delays between arrivals at the first-health facility and the trauma center. We aimed to quantify the delay and determine the predictors of mortality among polytrauma patients. Methodology. We consecutively enrolled adult polytrauma patients (≥18 years) with ISS >15 referred to the Emergency Medicine Department of Muhimbili National Hospital, a major trauma center in Tanzania between August 2019 and January 2020. Based on a pilot study, the arrival of >6 hours after injury was considered a delay. The outcome of interest was factors associated with delayed presentation and the association of timeliness with 7-day mortality. Results. We enrolled 120 (4.5%) referred polytrauma adult patients. The median age was 30 years (IQR 25–39) and the ISS was 29 (IQR 24–34). The majority (85%) were males. While the median time from injury to first-health facility was 40 minutes (IQR 33–50), the median time from injury to arrival at EMD-MNH, was 377 minutes (IQR 314–469). Delayed presentation was noted in more than half (54.2%) of participants, with the odds of dying being 1.4 times higher in the delayed group (95% CI 0.3–5.6). Having a GCS <8 (AOR 16.3 (95% CI 3.1–86.3), hypoxia <92% (AOR 8.3 (95% CI 1.4–50.9), and hypotension <90 mmHg (R 7.3 (95% CI 1.6–33.6) were all independent predictors of mortality. Conclusion. The majority of polytrauma patients arrive at the tertiary facilities delayed for more than 6 hours and a distance of more than 8 km between facilities is associated with delay. Hypotension, hypoxia, and GCS of less than 8 are independent predictors of poor outcome. In the interim, there is a need to expedite the transfer of polytrauma patients to trauma care capable centers.
Targeting UGCG Overcomes Resistance to Lysosomal Autophagy Inhibition
Authors: Jain Vaibhav , Harper Sandra L. , Versace Amanda M. , Fingerman Dylan , Brown Gregory Schuyler , Bhardwaj Monika , Crissey Mary Ann S. , Goldman Aaron R. , Ruthel Gordon , Liu Qin , Zivkovic Aleksandra , Stark Holgar , Herlyn Meenhard , Gimotty Phyllis A. , Speicher David W. , Amaravadi Ravi K.
Published: November 2022

Lysosomal autophagy inhibition (LAI) with hydroxychloroquine or DC661 can enhance cancer therapy, but tumor regrowth is common. To elucidate LAI resistance, proteomics and immunoblotting demonstrated that LAI induced lipid metabolism enzymes in multiple cancer cell lines. Lipidomics showed that LAI increased cholesterol, sphingolipids, and glycosphingolipids. These changes were associated with striking levels of GM1+ membrane microdomains (GMM) in plasma membranes and lysosomes. Inhibition of cholesterol/sphingolipid metabolism proteins enhanced LAI cytotoxicity. Targeting UDP-glucose ceramide glucosyltransferase (UGCG) synergistically augmented LAI cytotoxicity. Although UGCG inhibition decreased LAI-induced GMM and augmented cell death, UGCG overexpression led to LAI resistance. Melanoma patients with high UGCG expression had significantly shorter disease-specific survival. The FDA-approved UGCG inhibitor eliglustat combined with LAI significantly inhibited tumor growth and improved survival in syngeneic tumors and a therapy-resistant patient-derived xenograft. These findings nominate UGCG as a new cancer target, and clinical trials testing UGCG inhibition in combination with LAI are warranted.

Significance:

We discovered UGCG-dependent lipid remodeling drives resistance to LAI. Targeting UGCG with a drug approved for a lysosomal storage disorder enhanced LAI antitumor activity without toxicity. LAI and UGCG inhibition could be tested clinically in multiple cancers.

This article is highlighted in the In This Issue feature, p. 247
Risk Factors of Rapid FEV1 Decline in a Real-World Chronic Obstructive Pulmonary Disease Cohort
Authors: Lee Hyun Woo , Lee Jung-Kyu , Lee Myung Goo , Shin Kyung-Cheol , Ra Seung Won , Kim Tae-Hyung , Hwang Yong-Il , Jung Ki-Suck , Yoo Kwang Ha , Kim Deog Kyeom
Published: November 2022

Background: Rapid forced expiratory volume in 1 s (FEV1) decliners have been considered a unique subgroup of patients with chronic obstructive pulmonary disease (COPD). Rapid FEV1 decline manifests early and is associated with poor prognosis. This necessitates the pre-emptive identification of risk factors for rapid FEV1 decline. Objectives: We aimed to determine the risk factors and clinical outcomes in patients with COPD. Methods: This longitudinal, observational study was based on the Korea COPD Subgroup Study cohort (NCT02800499) from January 2012 to December 2019 across 54 medical centers in South Korea. Eligible patients were followed up for 3 years with serial spirometric tests. We calculated the annualized percentage change in FEV1 from baseline. Rapid decliners were defined as the quartile of patients with the highest annualized percentage FEV1 decline. Results: Of the 518 patients, 130 were rapid decliners who lost 6.2%/year and 100 mL/year of FEV1. The multivariable logistic regression identified male sex, current smoking, blood eosinophil count <150/µL, and high forced vital capacity as the independent risk factors for rapid FEV1 decline. Among rapid decliners, the lung function deteriorated more rapidly in current smokers and patients with severe dyspnea, while triple combination therapy attenuated lung function decline in comparison with mono-bronchodilator therapy. Rapid decliners had a higher rate of severe exacerbation than nonrapid decliners (0.2/year vs. 0.1/year, p value = 0.032). Conclusions: We identified the independent risk factors for rapid FEV1 decline. This information may assist physicians in the early detection and pertinent management of rapid decline among patients with COPD.
Splitting the Unity of Bodily Self: Toward a Comprehensive Review of Phenomenology and Psychopathology of Heautoscopy
Authors: Szczotka Joanna , Wierzchoń Michał
Published: November 2022

Background: Heautoscopy refers to a pathological experience of visual reduplication of one’s body with an ambiguous sense of self-location and a disturbing sensation of owning the illusory body. It has been recognized to occur in the course of strikingly diverse psychiatric and neurological disorders, such as schizophrenia, space-occupying lesions, frequently of the temporal or parietal lobes, migraine, epilepsy, and depression. The literature on the subject suffers from numerous conceptual inconsistencies, scarcity of clinical data, and a lack of theoretical integratory framework that could explain the uniqueness of these symptoms. Aims: In the study, we aimed to review all case reports on heautoscopy we could cull from the literature with an attempt to extract common factors and to foster a theoretical synthesis. Methods: All medical and psychological databases were rigorously searched, along with reference lists of the preselected articles. First-person reports were classified according to aspects of bodily self-consciousness primarily affected: body ownership, self-location, sense of agency and consequently, collated with their etiological backgrounds. Results: Out of over 140 case studies, a total of only 9 patients with heautoscopy were selected as satisfying functional criteria, carefully distinguishing heautoscopy from other typically conflated full-body anomalies: autoscopy, out-of-body experience, or feeling of presence. Numerous cases turned out to be mislabeling autoscopy or out-of-body experience as heautoscopy. In addition, several problems with existing neuroimaging experiments were identified. Conclusion: Phenomenological analysis revealed that from the patients’ perspective, heautoscopy resembles a somatesthetic-proprioceptive illusion, rather than a cognitive delusion, and occurs much less frequently than reported. A most peculiar symptom, described by some as a sense of “bilocation,” appears to stem from dynamic shifts in self-location and expanded body ownership, rather than an expanded first-person perspective. Although extremely rare in its pure form, heautoscopy gives a unique opportunity to explore the brain limits to the plasticity of bodily boundaries and the origin of the first-person spatial perspective.